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SUMMARY 34 preterm infants with birthweights < 1200 g were randomly assigned to total parenteral nutrition (TPN) or oral (Milk) feeding regimens for the first 2 weeks after birth. Infants in the TPN group were started on a modified Vamin-based glucose amino-acid infusion and Intralipid. The daily amounts of carbohydrate, amino-acids, and fat infusions were increased. In the Milk group, infants were started on intermittent gavage feeding, supplemented with a glucose-electrolyte infusion as necessary. The overall mortality rate did not differ in the two groups. Four infants in the Milk group developed necrotising enterocolitis but none did in the TPN group. Despite mean daily energy intakes which were not greatly different, there were much higher mean daily intakes of carbohydrate and protein in the TPN group compared with the Milk group. Fat intake in the TPN group was lower than in the Milk group in the 1st week because of neonatal jaundice which contraindicated the use of Intralipid. There was no difference in the mean daily fat intake by the 2nd week. Although mean daily weight loss in the 1st week and the maximum postnatal weight loss in the two groups were similar, infants in the TPN group had a greater mean daily weight gain in the 2nd week and took less time to regain and maintain birthweight. Metabolic complications were equally common in both groups and were reversible with early recognition. Limits of tolerance for water and most nutrients tended to be variable and the nutritional programme had to be adjusted for each baby. Nevertheless, we found that TPN, when properly managed, is an effective and safe procedure in very low birthweight infants.

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This article discusses alternative methods for the removal of unwanted hair, the mechanisms of action of each, and their advantages and disadvantages. Epilating needle design is discussed and epilating technique is described. Physician-patient interaction and the role of the dermatologist in electrosurgical epilation are explored.

These experiments assessed the interrelationship between location and distance cues in the coding of movements. In separate experiments subjects recalled either the terminal location or the distance of constrained (Experiment 1) or preselected (Experiment 2) movements following a 15-sec retention interval. Changes in direction amd amplitude of starting position were used to ascertain whether recall errors were related to these changes. The findings of both experiments indicated that location and distance were recalled with similar accuracy when the starting position was identical for the criterion and recall movement. However, analysis of constant errors when the recall starting position was varied in either direction clearly indicated neither terminal location nor distance are coded independently, and memory for movement is based on an interaction between these cues.

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1. Myofibrillar protein degradation has been measured by the rate of 3-methylhistidine excretion in premature infants weighing between 635 g and 1295 g. Analyses were made in conjunction with 1--3 day nitrogen balance studies. 2. In 56 balance studies in 36 infants, total muscle protein breakdown varied between 0.70 and 2.58 (mean 1.05) g day-1 kg-1 body weight while the percentage of total muscle protein degraded each day was between 3.3 and 8.3 (mean 4.8). 3. Both total and fractional rates of protein breakdown showed highly significant negative correlations with nitrogen retention but no relationship to total energy input. 4. Protein degradation was higher than average in infants who were losing weight at the time of the balance study, lower in infants who were gaining weight and higher in those who died within 2 weeks of the analysis. 5. Myofibrillar protein breakdown was not different between infants fed orally and those receiving total parenteral nutrition. 6. Generally the effects of nitrogen and evergy status on muscle protein degradation in the premature infants are different from changes reported in adult human beings or adult rats. We suggest that this difference may be a consequence of the very limited energy reserves of the premature infant.

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