Cephalometric comparisons of craniofacial and upper airway structure by skeletal subtype and gender in patients with obstructive sleep apnea

To investigate whether patients with obstructive sleep apnea (OSA) have abnormalities in their craniofacial and upper airway (UA) structures compared with normal subjects, cephalometric comparisons were systematically performed in both the upright and the supine positions in subjects with and without OSA, who were then grouped according to their craniofacial skeletal type and gender. A total of 347 patients with OSA and 101 control subjects were divided into male and female groups and then classified into Class I (CI), Class II, Division 1 (CII/1), Class II, Division 2 (CII/2), and Class III (CIII) skeletal subtypes. In the upright position, the most atypical craniofacial and UA structure was shown in male patients with CI OSA. In patients with OSA, the degree of UA abnormalities was less in the supine position regardless of skeletal subtype. In the supine position, the most atypical craniofacial and UA structure was also shown in male patients with CI OSA; there were no significant differences between male patients with CII/2 OSA and control subjects or between female patients with CI OSA and control subjects. With a change in body position from upright to supine, distinctive changes in the UA structure in both patients with OSA and control subjects occurred, according to skeletal subtype and gender. We conclude that there are a series of characteristics of craniofacial and UA structure that differ between patients with OSA and control subjects matched for skeletal subtype and gender. These differences may predispose to UA obstruction during sleep in patients with OSA.

Oral appliance therapy for the treatment of obstructive sleep apnea

A variety of oral appliances (OA) are now available for the treatment of obstructive sleep apnea (OSA), OA therapy is effective in some patients with mild to moderate OSA and is associated with greater patient satisfaction than nasal CPAP. Adjustable OA are associated with improved treatment success and fewer compliance failures compared to non-adjustable OA. Large randomized clinical trials are necessary to further determine the precise indications, benefits, and risks of each OA in the treatment of OSA.

Sleep-disordered breathing in amyotrophic lateral sclerosis

OBJECTIVE

The purpose of this study was to assess sleep and breathing in patients with amyotrophic lateral sclerosis (ALS) with bulbar muscle involvement.

DESIGN

Prospective, controlled study of sleep and breathing measured during polysomnography.

SETTING

University teaching hospital and referral center.

PATIENTS

Patients with definite ALS and healthy age-matched control subjects.

INTERVENTIONS

Eighteen ALS patients and 10 age-matched control subjects underwent one night of polysomnography. Thirteen patients with ALS were studied for a second night.

RESULTS

The ALS patients had more arousals per hour (p = 0.008), more stage 1 sleep (p = 0.01), and a shorter total sleep time (TST) (279 +/- 69 vs 331.4 +/- 55.9 min, mean +/- SD, p = 0.04) than the control subjects. The ALS patients had mild sleep-disordered breathing with a greater apnea/hypopnea index (AHI) than the control subjects (p = 0.005). On the second night of polysomnography, there was an increase in TST (p = 0.003) and rapid eye movement (REM) sleep (p = 0.009), an improvement in sleep efficiency (p = 0.02), and less stage 1 sleep (p = 0.04). Eight ALS patients had sleep-disordered breathing consisting of periods of hypoventilation, predominantly during REM sleep.

CONCLUSIONS

Sleep-disordered breathing occurs in patients with ALS and is similar to patients without ALS with respiratory muscle weakness. No obstructive sleep apnea was observed. One potential reason for its absence might be the inability of patients with respiratory muscle weakness to generate an inspiratory pressure greater than the upper airway closing pressure. This hypothesis should be addressed in future studies.

The effect of the tongue retaining device on awake genioglossus muscle activity in patients with obstructive sleep apnea

Knowledge of how dental appliances alter upper airway muscle activity when they are used for the treatment of snoring and/or obstructive sleep apnea (OSA) is very limited. The purpose of this study was to define the effect of a tongue retaining device (TRD) on awake genioglossus (GG) muscle activity in 10 adult subjects with OSA and in 6 age and body mass index (BMI) matched symptom-free control subjects. The TRD is a custom-made appliance designed to allow the tongue to remain in a forward position between the anterior teeth by holding the tongue in an anterior bulb with negative pressure, during sleep. This pulls the tongue forward to enlarge the volume of the upper airway and to reduce upper airway resistance. In this study, two customized TRDs were used for each subject. The TRD-A did not have an anterior bulb but incorporated lingual surface electrodes to record the GG electromyographic (EMG) activity. The TRD-B contained an anterior bulb and two similar electrodes. The GG EMG activity was also recorded while patients used the TRD-B but were instructed to keep their tongue at rest outside the anterior bulb; this condition is hereafter referred to as TRD-X. The GG EMG activity and nasal airflow were simultaneously recorded while subjects used these customized TRDs during spontaneous awake breathing in both the upright and supine position. The following results were obtained and were consistent whether subjects were in the upright or the supine position. The GG EMG activity was greater with the TRD-B than with the TRD-A in control subjects (p < 0.05), whereas the GG EMG activity was less with the TRD-B than with the TRD-A in subjects with OSA (p < 0.01). Furthermore, there was no significant difference between the GG EMG activity of the TRD-A and the TRD-X in control subjects, whereas there was less activity with the TRD-X than with the TRD-A in subjects with OSA (p < 0.05). On the basis of these findings, it was concluded that the TRD has different effects on the awake GG muscle activity in control subjects and patients with OSA. The resultant change in the anatomic configuration of the upper airway caused by the TRD may be important in the treatment of OSA because such a change may alleviate the impaired upper airway function.

Associations among upper airway structure, body position, and obesity in skeletal Class I male patients with obstructive sleep apnea

Interactions between upper airway structure and posture in relation to obesity were studied in a sample of 61 adult Class I skeletal type male patients with obstructive sleep apnea (OSA) and 10 homologous control subjects. A pair of upright and supine lateral cephalometric films were taken for each subject. A Pearson correlation analysis identified significant r values for several demographic variables in patients with OSA such as apnea and hypopnea index, percentage of predicted neck circumference, minimum arterial oxygen saturation, and body mass index (BMI). The difference between cephalometric variables identified in upright and supine subjects was calculated. When patients with OSA changed their posture from upright to supine, significant correlations were observed between the cranial base to upper cervical column angle and the hypopharynx cross-sectional area and BMI. Moreover, the mandibular plane angle and the sella-nasion plane was significantly correlated with BMI. This occurred along with a significant positive correlation between the sella-nasion plane angle and BMI and a significant inverse correlation between the mandibular plane angle in reference to the absolute vertical and horizontal planes, with BMI after the positional change. Such correlations were not observed in control subjects. No correlations were observed between the variables related to the position of the hyoid bone with BMI in either patients with OSA or control subjects after the change in posture. On the basis of these findings, we propose that when patients with OSA change their body position from upright to supine (1) the patient's neck is more extended, and (2) the hyoid bone moves more anterosuperiorly in conjunction with an upward and forward rotation of the mandible. This change in craniofacial structure may be a compensatory geometrical change in the upper airway to secure its patency.

A randomized crossover study of an oral appliance vs nasal-continuous positive airway pressure in the treatment of mild-moderate obstructive sleep apnea

STUDY OBJECTIVE

To compare efficacy, side effects, patient compliance, and preference between oral appliance (OA) therapy and nasal-continuous positive airway pressure (N-CPAP) therapy.

DESIGN

Randomized, prospective, crossover study.

SETTING

University hospital and tertiary sleep referral center.

PATIENTS

Twenty-seven unselected patients with mild-moderate obstructive sleep apnea (OSA).

INTERVENTIONS

There was a 2-week wash-in and a 2-week wash-out period, and 2 x 4-month treatment periods (OA and N-CPAP). Efficacy, side effects, compliance, and preference were evaluated by a questionnaire and home sleep monitoring.

MEASUREMENTS AND RESULTS

Two patients dropped out early in the study and treatment results are presented on the remaining 25 patients. The apnea/hypopnea index was lower with N-CPAP (3.5 +/- 1.6) (mean +/- SD) than with the OA (9.7 +/- 7.3) (p < 0.05). Twelve of the 25 patients who used the OA (48%) were treatment successes (reduction of apnea/hypopnea to <10/h and relief of symptoms), 6 (24%) were compliance failures (unable or unwilling to use the treatment), and 7 (28%) were treatment failures (failure to reduce apnea/hypopnea index to <10/h and/or failure to relieve symptoms). Four people refused to use N-CPAP after using the OA. Thirteen of the 21 patients who used N-CPAP were overall treatment successes (62%), 8 were compliance failures (38%), and there were no treatment failures. Side effects were more common and the patients were less satisfied with N-CPAP (p < 0.005). Seven patients were treatment successes with both treatments, six of these patients preferred OA, and one preferred N-CPAP as a long-term treatment.

CONCLUSIONS

We conclude that OA is an effective treatment in some patients with mild-moderate OSA and is associated with fewer side effects and greater patient satisfaction than N-CPAP.

Sleep-related breathing disorders. 4. Consequences of sleep disordered breathing

Images

The relationship between obesity and craniofacial structure in obstructive sleep apnea

STUDY OBJECTIVE

To evaluate the interaction between craniofacial structure and obesity in male patients with obstructive sleep apnea (OSA).

DESIGN

Retrospective analysis of a cohort of OSA patients. The relationships between neck circumference (NC), body mass index, apnea severity, and craniofacial and upper airway soft-tissue measurements from upright lateral cephalometry were examined. Patients were divided into groups; small to normal NC (group A), intermediate NC (group B), or large NC (group C).

SETTING

A university teaching hospital and tertiary sleep referral center.

PATIENTS

A consecutive series of patients with OSA who underwent polysomnography and lateral cephalometry.

MEASUREMENTS AND RESULTS

Group A patients were less obese and had more craniofacial abnormalities such as a smaller mandible and maxilla and a more retrognathic mandible. Group B patients had both upper airway soft-tissue and craniofacial abnormalities. Group C patients were more obese with larger tongues and soft palates, and an inferiorly placed hyoid. Group C patients also had fewer craniofacial abnormalities than group A or B patients. There was no difference in airway size among the three groups.

CONCLUSIONS

We conclude that there is a spectrum of upper airway soft-tissue and craniofacial abnormalities among OSA patients: obese patients with increased upper airway soft-tissue structures, nonobese patients with abnormal craniofacial structure, and an intermediate group of patients with abnormalities in both craniofacial structure and upper airway soft-tissue structures.

Outpatient abortion for fetal anomaly and fetal death from 15-34 menstrual weeks' gestation: techniques and clinical management

OBJECTIVE

To determine the safety of providing outpatient abortion services for women with complicated advanced pregnancies.

METHODS

During a 10-year period, 124 abortions were performed after 14 menstrual weeks' gestation at an outpatient abortion facility for indications of fetal anomaly, diagnosed genetic disorder, or fetal death. Gestational lengths ranged from 15-34 menstrual weeks. Fetal diagnoses included a variety of chromosomal abnormalities, malformations, and death. Techniques for performing the late abortions included a serial multiple laminaria method of cervical dilation. Abortions performed after 20 menstrual weeks were effected by instillation of intra-amniotic hyperosmolar urea or induction of fetal death by injection of digoxin and/or hyperosmolar urea into the fetus, followed by artificial rupture of membranes, induction of labor, and assisted expulsion or instrumental extraction of the fetus. At less than 20 weeks, dilation and evacuation following serial multiple laminaria treatment of the cervix was the method of choice.

RESULTS

The median gestational age was 23 menstrual weeks. The median procedure time for all cases was 12 minutes and median blood loss was 125 mL. Procedure time increased with length of gestation (P = .00). Blood loss was only slightly increased by gestation length (P = .154) and not by procedure time (P = .299). Complication rates were not significantly related to gestation length (P = .895). There was one major complication in this series. There were no uterine perforations and one cervical laceration.

CONCLUSION

Outpatient abortion may be performed safely in most cases of fetal disorder, including death, through 34 menstrual weeks under proper conditions.

Human chorion cells respond to growth factors but lose steroidogenic capacity in primary monolayer cell culture

This study has defined a method for preparation and monolayer culture of cells from chorion laeve. Cell number and cell protein content are stable over 7 d in culture. The cells will divide in response to epidermal growth factor in the presence of a supplemented, enriched medium and a collagen matrix, but they lose steroidogenic activity over time in culture. This culture system can be used as the starting point for the development of a chemically defined hormone-supplemented, serum-free culture system for studies of chorion cell differentiation and fetal membrane cell interactions.

Fatty acid desaturase specificity of Tetrahymena

The ciliate, Tetrahymena, was provided a supplement of the fatty acid [1-14 C]18:2 delta 6.9. After a period of growth the cells were claimed, the lipids extracted, the polar lipids recovered and the mild alkali-labile fatty acid methyl esters generated. The fatty acids were resolved by high pressure liquid chromatography (HPLC), the 18:3 delta 6.9,12(gamma-linolenic acid) was recovered and its identity verified by high pressure liquid chromatography (HPLC), gas liquid chromatography (GLC), hydrogenation and oxidation. Fifty-three percent of the cell-associated label was found in gamma-linolenic acid; thus, a delta 12 fatty acid desaturase converts the 6,9 octadecadienoic acid to the 6,9,12 derivative. No carboxyl or methyl terminus restriction appears on delta 9 monoenoic or dienoic fatty acid desaturation in this cell as is found in higher plants and animals.

Oleic acid desaturation in Tetrahymena pyriformis

The desaturation of oleoyl-CoA by a microsomal preparation from Tetrahymena has been studied. Desaturation of oleoyl-CoA required oxygen and NADH, and was inhibited by cyanide. HPLC analysis of fatty acid phenacyl esters, prepared from TLC-purified phospholipid, confirmed that radioactivity appeared in oleate, linoleate and gamma-linolenate. Both the time course of desaturation and the apparent desaturation of 1-palmitoyl-2-[14C]oleoylphosphatidylcholine suggested that phospholipid-bound oleate could be a substrate for desaturation. In the crude microsomal preparation, acylation of oleoyl-CoA to give oleoyl phospholipid was rapid. Therefore, preincubation in the absence of NADH was employed to create [14C]oleoyl phospholipids, and kinetic studies were carried out upon subsequent addition of NADH. When data were plotted in a double reciprocal form, a linear function was observed.

A cytochrome b5 electron transport chain in Tetrahymena

Tetrahymena microsomes contain cytochrome b5 and an NADH-dependent cytochrome b5 reductase, but these proteins are present at only one-tenth the levels observed in rat liver microsomes. We show that both proteins can be partially purified by techniques developed for the rat liver proteins. We can show that cyanide inhibits the rate of exhaustion of NADH, and therefore reoxidation of cytochrome b5 by microsomes, and that stearoyl CoA enhances the rate of reoxidation of the cytochrome. Also, we find that a fragment of rat liver NADH-cytochrome b5 reductase can restore NADH-dependent cytochrome b5 reduction to Tetrahymena microsomes which have been treated with N-ethylmaleimide to eliminate endogenous reductase activity. These results indicate that there is considerable resemblance between the rat and Tetrahymena systems, and that desaturation of stearoyl and oleoyl groups may occur in Tetrahymena via pathways similar to those known in liver.

Effects of different dietary fats on mammary carcinogenesis

Mammary tumor induction was examined in female Fischer rats fed a low-corn oil, a high-corn oil, a high-lard, a high-beef tallow, or a high-coconut oil diet since weaning. The diets were prepared by adding the experimental fat to a basal diet containing sufficient essential fatty acids for growth. These diets differed only in the concentration or type of dietary fat. The rats were given a single i.v. dose (50 mg/kg body weight) of N-nitrosomethylurea at 50 days of age. Mammary tumor incidences 28 weeks after N-nitrosomethylurea treatment in rats on low-corn oil, high-corn oil, high-lard, high-beef tallow, and high-coconut oil diets were 33, 85, 65, 50, and 43%, respectively. The data show that an increase in fat intake enhances mammary carcinogenesis, but the magnitude of the increase depends on the type of fat. Further analyses showed that the total oleic and linoleic acid intake in the five groups of rats correlated positively (r = 0.95) with mammary tumor incidence, whereas the composition of the mammary tissue neutral lipids and phospholipids did not. Our data suggest that the total oleate and linoleate intake in the high-fat diet is the major factor influencing the incidence of tumors by N-nitrosomethylurea.

Phase behavior of the major lipids of tetrahymena ciliary membranes

The major lipids of Tetrahymena membranes have been purified by thin-layer and high pressure liquid chromatography and the phosphatidylethanolamine and aminoethylphosphonate lipids were examined in detail. 31P-NMR, X-ray diffraction and freeze-fracture electron microscopy were employed to describe the phase behavior of these lipids. The phosphatidylethanolamine was found to form a hexagonal phase above 10 degrees C. The aminoethylphosphonate formed a lamellar phase up to 20 degrees C, but converted to a hexagonal phase structure at 40 degrees C. Small amounts of phosphatidylcholine stabilized the lamellar phase for the aminoethylphosphonate. 31P-NMR spectra of the intact ciliary membranes were consistent with a phospholipid bilayer at 30 degrees C, suggesting that phosphatidylcholine in the membrane stabilized the lamellar form, even though most of the lipid of that membrane prefers a hexagonal phase in pure form at 30 degrees C. 31P-NMR spectra also showed a distinctive difference in the chemical shift tensor of the aminoethylphosphonolipid, when compared to that of phosphatidylethanolamine, due to the difference in chemical structure of the polar headgroups of the two lipids.

Chromosomal abnormalities associated with infertility

From a population of 515 subfertile couples and 119 women with amenorrhea, 38 patients were karyotyped because of specific signs and symptoms suggestive of chromosomal abnormality. The indications for karyotyping included primary amenorrhea, secondary amenorrhea with gonadal failure before 35 years of age, stature of less than 147.5 cm, azoospermia with eunuchoidism, and personal or family history of more than 2 spontaneous abortions or more than 2 severely abnormal children. In addition, 19 patients from the same subfertile population were selected randomly for karyotyping to serve as controls. Using banding techniques, chromosomal abnormalities were found in 18 of the 38 specifically selected individuals, whereas no abnormality was found among those randomly selected. Three of the 18 patients had chromosomal abnormalities not previously described; their karyotypes were 46,XY/48,XY,+8,+21; 46,X,inv dup(Xq)/q26 leads to q21); and 46,XY,t(9;20)(q22;q12).

Differential biosynthesis of polyunsaturated fatty acids by Tetrahymena supplemented with ergosterol

Tetrahymena grown with foreign sterols such as ergosterol incorporate them into cellular membranes at the expense of the native compound, tetrahymanol. It is shown that cells grown with ergosterol have a lessened capacity to produce the polyunsaturated linoleic and gamma-linolenic acids from [14C]oleic acid. However, the same cells have normal capacities to introduce double bonds at C-6 into linoleate, alpha-linolenate, or cis-vaccenate. Thus, a presumed 12-desaturase is inhibited in the presence of ergosterol, while desaturation at C-6 is unaffected.

Effect of nutrition, genotype, lactation and wool cover on response by grazing sheep to methionine esters and polymer-encapsulated methionine

Esters of methionine added to the diet of penned sheep have been reported to increase wool growth. Four experiments were undertaken in which grazing sheep were drenched with methionine derivatives. In experiment 1 methyl methionine hydroxy analogue (MeMHA) and ethyl methionine hydrochloride (EMHCl) increased wool growth similarly, by about 30% (P < 0.001) on native pasture and 4% (P > 0.05) on improved pasture. Dosing three times per week was as effective as dosing six times per week. In experiment 2, wool growth of unsupplemented sheep on improved pasture in spring was c. 12 g/d and was not increased by the administration of MeMHA to fine- or strong-wool sheep whether lactating or dry. Daily weight gain by young lambs declined from 258 to 215 g/d when their dams were given MeMHA at 4 g/d 5 days per week (P < 0.05). Administration of methionine as MeMHA or EMHCl or in a polymer-encapsulated form at 1.25 gld gave c. 1 g/d additional wool in experiment 3; 2.5 g/d increased wool growth by c. 1.5 g/d (P < 0.001). In experiment 4, MeMHA doses of 1.25 and 2.5 g methionine equivalent per day produced no response in sheep in full wool. In shorn Merinos wool growth increased by 1.2 and 0.4 g/d, and Dorset Horn x Merinos showed a decrease of 0.5 and an increase of 1 .3 g wool/d at the two dose levels (P < 0.01). Wool growth was increased by c. 1 g/d by 1.25 g MeMHA in sheep that had received 10 mg selenium but not in control sheep. These responses are less than those reported from pen experiments in which methionine derivatives were incorporated in the diet. It is concluded that at current prices it would not be profitable to supplement grazing sheep with any of these forms of methionine.

Effect of sterol replacement in vivo on the fatty acid composition of Tetrahymena

The addition of ergosterol to cultures of Tetrahymena pyriformis results in (a) the accumulation of the sterol by the cells; (b) the inhibition of the synthesis of the pentacyclic triterpenoid alcohol, tetrahymanol; (c) the replacement of tetrahymanol by ergosterol in the ciliate membranes. The dry weight and lipid content of sterol-supplemented ciliates did not differ from the controls. Examination of the lipid classes revealed no change in composition except for a higher content of ergosterol in supplemented cells than tetrahymanol in control cultures. The relative proportions of triglycerides, the major classes of polar lipids, 1-alkyl phospholipids and phosphonolipids, appeared unaltered. A complex array of fatty acids is found in this ciliate. Several acids not reported previously in this organism were isolated and identified, and the novel fatty acid 18:2 delta 6, 11, was found in substantial amounts. Ergosterol supplementation altered the proportions of the fatty acids, although not all lipid classes were affected to the same extent. The changes noted were of three general types: (a) a shortening of the fatty acyl chain length in the acids of the normal series; (b) a lowering in the degree of unsaturation; (c) a discrimination between two isomers of lionoleate, 18:2 delta 6, 11 and 18:2 delta 9, 12. The former is elevated in the presence of ergosterol while the latter is depressed. Each class of polar lipids has a distinctive fatty acid composition. Among the glycerophospholipids, cardiolipin and phosphatidylcholine were least affected, while the mixture of 1-alkyl-2-acyl-sn-glycero-3-(2-aminoethyl)-phosphonate and 1,2-diacyl-sn-glycero-3-(2-aminoethyl)-phosphonate was most markedly altered. Sphingolipid fatty acid composition was influenced by ergosterol supplementation. Two changes were noted: (a) a reduction in the length of the hydrocarbon chain; (b) an increase in the proportion of alpha-hydroxy acids. The impact of ergosterol on the fatty acid composition of the polar lipids may be on fatty acid biosynthesis, on incorporation of fatty acids, or on the turnover rates of the fatty acyl groups. Ergosterol is concentrated in the ciliary (limiting) membrane, as are the polar lipids most affected. This localization allows the speculation that the change in fatty acid composition may be related to the maintenance of optimal membrane properties upon the introduction of the sterol.

Alteration of fatty acid composition of LM cells by lipid supplementation and temperature

Alteration of the fatty acid composition of monolayer cultures of LM cells grown in chemically defined medium was achieved by supplementation with fatty acids complexed to bovine serum albumin. Phospholipids containing up to 40% linoleate were found in cells grown in medium containing 20 mu g of linoleate/ml. Incorporation of linoleate into phospholipids reached a plateau after 12-24 hr, and cells remained viable for at least 3-4 days. Although linoleic, linolenic, and arachidonic acids were incorporated into LM cells equally well, only the latter was elongated by these cells under these experimental conditions. Nonadecanoic acid was incorporated to a lesser extent than the polyunsaturated fatty acids. Phosphatidylcholine and phosphatidylethanolamine of LM cells had different fatty acid compositions; phosphatidylethanolamine contained more longer chain and unsaturated fatty acids. Cells were also grown in the absence of choline and presence of choline analogs such as N,N-dimethylethanolamine, N-methylethanolamine, 3-amino-1-propanol, and 1-2-amino-1-butanol. The analog phospholipids in these cells had fatty acid compositions which were intermediate between those of phosphatidylethanolamine and phosphatidylcholine of control cells grown in the presence of choline. Linoleate was found in both phosphatidylcholine and phosphatidylethanolamine of cells supplemented with linoleate. The sphingolipid fraction of these cells, however, did not contain significant amounts of linoleate. When linoleate was present in the phospholipids, compensatory decreases in the oleate and palmitoleate content of phospholipids were observed. Lowering of the growth temperature to 28 degrees produced an increase in unsaturate fatty acid content of the phospholipids. When linoleate was supplied to cells grown at 28 degrees, there was no further increase in the unsaturated fatty acid composition of the phospholipids. Using both fatty acid supplementation and lowered growth temperature, LM cell membranes can be produced which have phospholipids with vastly different fatty acid compositions.

Calcium-binding activity of rat intestinal mucosa after massive small bowel resection

Male Sprague-Dawley rats underwent resection of 50 cm of either proximal or distal small intestine or sham-operation. 6-7 weeks after operation mucosal calcium-binding activity was measured in segments of duodenum ileum and remaining 'midgut'. Similar measurements were obtained from weight and age-matched unoperated rats. There was no difference in calcium-binding activity between unoperated and sham-operated animals. After proximal resection the binding activity increased significantly in duodenum and midgut but did not change in ileum. After distal resection the binding activity decreased in duodenum but was unchanged in midgut and ileum. These studies show that mucosal calcium-binding activity undergoes changes but alteration of the binding activity in remaining gut varies with the location of the small bowel resection.

Manipulation of the phospholipid composition of tissue culture cells

Methods have been devised to significantly alter the phospholipid composition of LM cells grown in serum-free tissue culture medium. The polar head groups of the phospholipids, as well as the acyl groups of these lipids, can be changed. When LM cells were grown in medium containing choline analogues, either N-methyl-ethanolamine or N,N-dimethylethanolamine, or the unnatural analogues, 1-2-amino-1-butanol or 3-amino-1-propanol, up to 50% of the cellular phospholipids contained the analogue supplied. When linoleate was added to the cells as a bovine serum albumin complex, up to 40% of the fatty acids of the phospholipids were linoleate. Under the conditions discussed, the polar head group composition, the fatty acid composition, or both together could be varied in the membrane phospholipids.