Evidence that fatty acid chain length is a type II cell lipid-sorting signal

This study was undertaken to determine those structural features of phospholipid molecules which influence their enrichment in type II cell lamellar body material. Cultured fetal rabbit lung tissue was labeled with [1-14C]acetate, type II cells were isolated, and extracellular lamellar body and microsomal fractions were prepared. Radiolabeled molecular species of phosphatidylcholine (PC) and phosphatidylethanolamine were analyzed by high-performance liquid chromatography (HPLC), followed by silver nitrate thin-layer chromatography of HPLC peak fractions that overlapped. Compared with microsomes, lamellar body PC was selectively enriched with molecular species containing 14- and 16-carbon fatty acids and depleted of species containing 18-carbon fatty acids. Palmitoleic acid and an ether linkage positively influenced the enrichment of PC molecular species in the lamellar body material, but these structural features were secondary to the predominant influence of fatty acid chain length. In vivo, lung tissue normally contains low levels of palmitoleic acid; hence most unsaturated fatty acids are 18-carbons or longer. A cellular lipid-sorting mechanism that selects PCs by recognition of 14- and 16-carbon fatty acid chains (and not by recognition of fatty acid saturation) should serve to enrich the resulting pulmonary surfactant with disaturated molecular species of PC.

Psychiatric morbidity in patients with life-threatening asthma: initial report of a controlled study

Thirteen patients who have suffered a "near-miss" death of asthma have been compared to 36 patients with asthma who had not experienced such an episode. Contrary to expectations, there were no differences between the groups in their levels of psychiatric morbidity, their degree of life-style and social restrictions or in their levels of compliance with prescribed medication. However, both groups did show higher than expected levels of psychiatric morbidity, severe life-style and social restrictions and an unexpectedly-high compliance with prescribed medication. The main psychiatric diagnoses that were noted were anxiety disorders. It is concluded that more comprehensive asthma education and close medical follow-up are likely to improve the physical and psychological health of asthmatic patients. The high-risk patients in this study who received such follow-up have shown hospital-admission rates that have been reduced by a half while maintaining good asthma control. This South Australian longitudinal study is continuing.

Food group system of analysis with special attention to type and amount of fat--methodology

A system for reporting dietary data in terms of food groups is described. The scheme was developed jointly by the National Heart, Lung, and Blood Institute (NHLBI) and the U.S. Department of Agriculture to identify food use patterns in various population groups. The system comprises 14 major groups and 75 minor groups based on major nutrient composition with special attention to fats. One-day dietary recalls from 5,640 participants in the Lipid Research Clinics (LRC) Prevalence Study were analyzed to determine the frequency of food group usage by males and females in age groups 6 to 9, 10 to 19, 20 to 59, and 60 and older. Food group use is reported as percent of the population reporting use as obtained by the dietary recall as well as the average number of times each food group was mentioned by the users. LRC food selection patterns are compared with the Dietary Guidelines. Findings in this report indicate that, for the LRC population, some of the foods emphasized in the guidelines are not eaten with a high degree of frequency.

A cephalometric study of mandibular changes in modified function regulator (Fränkel) treatment

A cephalometric study is reported of changes in mandibular dimensions occurring in treatment with a modified function regulator derived from the Fränkel (FR1) appliance; the findings are compared with those observed in a similar group of untreated control children. Both groups consisted of 16 boys and 13 girls with Angle Class II, Division 1 malocclusions. The mean age and age range of the groups were similar (114 months and 98 to 132 months, respectively), and the mean period of observation or treatment was 3 years (range 20 to 65 months in control children, 20 to 72 months in those receiving treatment). Statistically highly significant differences (P less than 0.005) were found in the treatment group for dimensions articulare-B point and articulare-1, gonion-B point and gonion-1, occlusal plane length, and posterior border-mandibular incisor distance. Smaller statistically significant differences were observed for the dimension articulare-pogonion, and between the Bolton plane and inferior border of the mandible. The changes appear to affect the relative distances between the anterior structures of the mandible, and articulare and gonion, respectively. The increases observed were between 2 and 3 mm (2.66% to 4.65%); although these values are small in relation to the overall dimensions of the variables investigated, they may significantly affect the clinical result. The most stable dimensions were found to be the posterior border of the mandible, width of the ascending ramus, and the oblique cross section of the mandibular body; these changes varied between 0.19 and 0.43 mm (0.62% to 1.5%).

Profile changes in modified functional regulator therapy

Comparison of lateral cephalometric radiographs of treatment and control groups finds the changes achieved with a modified functional regulator are limited to improvement in dental and lip relations. No effects are found on mandibular growth or position in relation to the profile.

Food choices among white adolescents: the Lipid Research Clinics Prevalence Study

Food groups have been widely used in nutrition education but relatively few studies have employed food groups to interpret dietary intake. The 24-h dietary recalls of 534 male and 476 female adolescents, aged 10-19 yr, were analyzed using a food grouping scheme. Foods were grouped with emphasis placed on fats and carbohydrates. Frequency of use and contribution of food groups to the macronutrients were determined. When nutrient intake was analyzed as a percentage of total calories, both males and females were found to have similar profiles. More than 60% of each macronutrient was contributed by combinations of three major food groups. The meat/fish/poultry, milk/cheese/yogurt, and bread/cereal products food groups contributed 81.2% of the protein; milk/cheese/yogurt, bread/cereal products and sweets accounted for 63.0% of the carbohydrate intake; and 74.3% of the dietary fat consumption was attributable to the meat/fish/poultry, milk/cheese/yogurt, and fats food groups. There were no notable differences in the food groups used by males and females. However, differences between the sexes emerged when nutrient intakes as a percentage of calories were stratified and food group usage was investigated. Food groups associated with macronutrients that are believed to affect health status have been identified.

Acute idiopathic oedema of the lips associated with function regulator treatment

An acute idiopathic oedema of the lips is described in a patient undergoing function regulator treatment. The event was associated with the fitting of the patient's second appliance which was successfully reintroduced following antihistamine therapy.

A comparison of the frequency of general practitioner orthodontic treatments in Scotland 1966 and 1975. Should the present system be reviewed?

In both 1966 and 1975, a relatively high proportion of general dental practitioners in Scotland failed to provide orthodontic treatment in the General Dental Service (35 and 38 per cent respectively), and the majority of those practitioners providing an orthodontic service commenced treatment for no more than ten patients in each of these years, i.e. 56 per cent (1966) and 61 per cent (1975).

These findings indicate that an urgent review of the present system is required if the quantity and quality of orthodontic treatment provided by the British National Health Service is to be improved. The present system has remained virtually unchanged since 1947, and it can now be seen to be both inefficient and uneconomic.

The anomaly of specialist orthodontists acting as ‘general dental practitioners’ in practices ‘limited to orthodontics’ in the General Dental Service is also discussed. It is suggested that those dental specialties requiring prolonged postgraduate training should receive formal specialist recognition and status in the United Kingdom, and that the most satisfactory method of providing a more comprehensive service is by the recognition of orthodontics as a true specialty and by the simultaneous expansion of the hospital service to play a more positive role in the provision of treatment.

A quantitative study of general dental practitioner orthodontic care in Scottish Health Board areas (1966-1975)

A quantitative assessment of the true dental practitioner contribution to orthodontic care in Scottish Health Board areas during the period 1966–1975, shows that the amount of orthodontic treatment given by general dental practitioners in Scotland has diminished in the 10 year period studied.

A wide variation was observed in respect of the mean number of orthodontic treatments per year per practitioner, and there was also a lack of uniformity in the proportion of practitioners providing an orthodontic service relative to the different area health boards.

The findings have also shown that between 1966–1975, a considerable reduction has occurred in the mean number of practitioner orthodontic treatments commenced each year in the Greater Glasgow and Lothian Health Board areas.

The evidence of this study also suggests that orthodontics should become recognized as a postgraduate dental specialty and that it would be appropriate to introduce specialist registration as a means of improving the quality and quantity of orthodontic care within the National Health Service. This should also be accompanied by certain administrative changes, as the present anomalous situation whereby specialist practitioners are permitted to practise within the general dental service should be discontinued.

The relationship between the rate of gastric emptying and the dumping syndrome

Following an oral hypertonic glucose challenge, gastric emptying and changes in plasma volume were measured in 15 subjects before and in 36 subjects after a truncal or selective vagotomy with a drainage procedure. The symptoms experienced during the test were noted, and the postoperative patients divided into two groups, (a) 20 patients who experienced dumping symptoms during the test and (b) 16 patients who did not. Gastric emptying was significantly faster and the fall in plasma volume significantly greater in those patients who experienced symptoms after the ingestion of hypertonic glucose than in those who did not, clearly demonstrating that the dumping syndrome is associated with an increased rate of gastric emptying. In addition, there was a significant positive correlation between the rate of gastric emptying and the fall in plasma volume.

Prevalence of upper lip posture and incisor overjet

1,159 children (612 girls and 547 boys) aged 11-12 years were examined to determine the range and mean overjet values in four defined upper lip-maxillary central incisor relationships. No clinically significant differences were found on comparison of the data relative to each upper lip position. The findings suggest that upper lip posture is adaptive to the maxillary central incisor angulation and that the upper lip musculature is unlikely to influence the development of the incisor occlusion.

Meckel's diverticulitis due to Schistosomiasis mansoni

An unusual case of schistosomal Meckel's diverticulitis is presented. Parasites were subsequently found in either stool or rectal biopsies of three siblings. The possibility of serious sequels makes the early diagnosis of Schistosomiasis mansoni often by simple stool and rectal biopsy examination particularly valuable.

The lower lip position and incisor overjet

1147 children aged 11–12 years were examined to determine the mean overjet values relative to five defined postural lower lip/maxillary central incisor relationships.

A mean overjet of 3·025 mm was found in those children having a postural lower lip position related to the middle third of the maxillary central incisor; and those having no lower lip cover had a mean overjet of 4·26 mm. In contrast, the mean overjet value was 9·18 mm for those children having a “negative” lip position.

The observed differences between the mean overjet values relative to each lower lip position are statistically significant, but the only lower lip/maxillary central incisor relationship which appears to have any marked clinical significance is the one defined as—1 (i.e. the trapped lower lip).

A study of overjet values and their relationship to the type of swallow and type of lip activity during swallowing

An investigation of overjet values in children exhibiting different forms of soft tissue behaviour during(a) a “conscious” swallowing test and (b) a “water” swallowing test is described and the findings show that both a “teeth apart” swallow and “vigorous” lower lip behaviour on swallowing are each unlikely to have a marked clinical effect on overjet values. A “vigorous” lip contraction on swallowing was found to be associated with a slightly increased mean overjet value compared with a “passive” lip contraction and this finding is statistically significant. The differences between the mean overjet values however were only 0·61 mm in “conscious” swallowing and 0·60 mm in “water” swallowing. It is therefore considered that the “functional” variations in the behaviour of the lips and tongue are unlikely to have any marked clinical effect upon incisor relationships.

Orthodontic treatment needs in English children aged 11-12 years

A subjective clinical investigation of the extent of the need for orthodontic treatment in English children aged 11–12 years is described. The sample consisted of 566 boys and 619 girls attending randomly selected schools in Grimsby, England, and included children of all social groups. No significant sex differences were found with respect to either the prevalence of acceptable occlusions or the different basic types of orthodontic treatment required. Approximately 70 per cent required some form of orthodontic treatment; almost 25 per cent required extractions alone and 35·5 per cent required extractions and appliances. It was found that the ratio of removable to fixed appliances for those requiring active treatment was approximately 10: 1.

Unabsorbable suture material--a rare cause of recurrent stones in the common bile-duct

Three cases are reported in which unabsorbable suture material used to ligate the cystic duct at chole-cystectomy was subsequently found within the lumen of the extrahepatic bile-ducts. In 2 cases well-formed gall-stones having a central nucleus of either silk or nylon were removed from the common bile-duct. In the third case two braided nylon sutures were found within the stump of the cystic duct. The use of absorbable suture material for ligating the cystic duct is therefore recommended.

The effect of vagotomy and a drainage procedure on alcohol tolerance

An oral alcohol-tolerance test using a bodyweight-related dose of alcohol was performed on two groups of patients undergoing truncal vagotomy and a drainage procedure for uncomplicated chronic duodenal ulcer. Eight patients received 0.65g. of absolute alcohol per kg. body-weight and 12 received 0.35 g. per kg. body-weight. The test was performed before operation and 4 months after operation on each patient. After operation the peak blood-alcohol concentration was significantly higher than before operation, and occurred significantly sooner after the ingestion of alcohol. The cause of these changes is discussed, and it is concluded that they are probably due to an increased rate of gastric emptying. The relevance of these results to the Road Safety Act, 1967, is discussed.

Ampicillin levels in human bile in the presence of biliary tract disease

Ampicillin levels were measured in the serum and in the bile from both the gall bladder and the common bile duct in patients undergoing surgery for biliary tract diseases. In patients with radiologically non-functioning gall bladders ampicillin was either not present or its concentration was lower than normal. Therapeutic levels were present in the common bile duct of all patients except those with obstruction of the common bile duct. Hence ampicillin fails appreciably to penetrate the obstructed viscus in obstructive biliary tract disease, and it is unlikely to be effective in treating infection associated with this.