[Effects of reducing the number of general practitioners on call on the pattern of the use of ambulances and emergency services]. / Storvagtkredses indflydelse på ambulanceudrykningsmønsteret i Ringkøbing Amt.

The aim of the study was to evaluate the effect of a reduction of the number of general practitioners on call on the use of ambulance emergency service. A prospective registration of all ambulance emergency activity in the county of Ringkøbing over an eight week period was made before and after the reduction of the number of general practitioners on call, together with a 4 + 4 week prospective registration of persons who claimed that contact to the general practitioners service was impossible, therefore resulting in a contact to the emergency central or the accident and emergency department. The numbers of emergency calls and emergency ambulance services in the population were unchanged, but there was a significant reduction from 78.9% to 69.3% in the relative number of ambulance services resulting in an admission to hospital of the patient. The number of patients, who claimed that contact to the general practitioner service was impossible was unchanged. We conclude that a reduction of the number of general practitioners on call has resulted in a reduction in the relative number of ambulance services resulting in hospital admission of the patient, which suggests a decline in the threshold of the population for calling an ambulance.

Fatty acid composition of glycerophospholipids in seven tissues of cod (Gadus morhua), determined by combined high-performance liquid chromatography and gas chromatography.

A method for the separation from fish tissues of the four main glycerophospholipid classes, phosphatidylcholine, phosphatidylethanolamine, phosphatidylinositol and phosphatidylserine, using adsorption high-performance liquid chromatography with ultraviolet detection and consecutive gas chromatographic analysis, based on one injection for their fatty acid compositions, is described. Fatty acid 19:0 was used as an internal standard for the calculation of the relative concentrations of the phospholipids. The patterns of fatty acid distribution within each of the phospholipids from seven cod organs had some general similarities. Phosphatidylcholine had the highest levels of 16:0 and 18:2 n - 6, and the ratio of 20:5 to 22:6 varied between 0.5 and 0.9. Phosphatidylethanolamine had the highest total polyunsaturated fatty acids, (n -3) polyunsaturated fatty acids, and 22:6 n -3, and the ratio of 20:5 to 22:6 varied between 0.2 and 0.5. Phosphatidylinositol showed the highest level of 18:0 and 20:4 n - 6 and had the lowest ratio of (n - 3) to (n - 6). Phosphatidylserine had the highest ratio of (n - 3) to (n - 6) and the lowest ratio of 20:5 to 22:6. A generally low level (less than 1.5%) of the long-chain monoene, 22:1, was found in the phospholipids in all tissues.

[An ambulance manned by physicians--a different model]. / Laegeambulance--en anderledes model.

An arrangement is described in which the general practitioners on duty participate in the ambulance service and the prehospital treatment of acutely ill patients. This arrangement has been followed prospectively for one year and was utilized in 141 cases. Approximately 40% of the cases involved cardiac patients and the remainder consisted of a varied assortment of other diagnoses. Attempts were made to resuscitate 11 patients with cardiac arrest and two of these could be discharged alive from hospital after admission. It is concluded that this arrangement is feasable as a means of improving the prehospital treatment of acutely ill patients but that it should be supplemented by increased efforts in training the population in resuscitation. In addition, it is concluded that the function of the alarm central was not optimal as half of the alarms came via the doctor on duty instead.

Comparative metabolism of erucic and oleic acid in hepatocytes from rats fed partially hydrogenated marine oil or palm oil.

Rats were fed for 8 weeks high fat diets containing 20% of either palm oil (PO) or linoleic-supplemented partially hydrogenated marine oil (PHMO). Hepatocytes were isolated from rats fasted overnight. Incubations were performed with albumin bound [10-14C] oleic acid and [14-14C] erucic acid, respectively, for 15 or 60 min. The cell viability was better than 90% after 60 min of incubation. The incorporation of radioactive metabolites into lipids of the cells and of the secreted products was determined. The uptake and channelling of 18:1 and 22:1 into various lipid classes in the hepatocytes were different, but were little influenced by the diets. Erucic acid disappeared more rapidly from the incubation medium than 18:1 at both incubation times and for both dietary groups, and was mainly incorporated into the hepatocyte triglycerides and found in the free fatty acid pool, whereas only small amounts of labelling were detected in the phospholipids. Oleic acid, however, was readily incorporated into both phospholipids and triglycerides, and little was found in the free fatty acid pool. For both the triglycerides and the free fatty acids more than 90% of the radioactivity was represented by the incubation fatty acid. Chain-shortened products were found in the phospholipids, especially after incubation with 22:1. The chain-shortening capacity was somewhat higher in the PHMO group, relative to the PO group. At both incubation times, the major part (80-90%) of the total radioactivity was found in the lipid-soluble fraction of the incubation medium, and for both groups 60-80% still as the original incubation fatty acid. 20-30% of the radioactivity was found in the triglycerides secreted from the cells. Phospholipids were secreted in minor amounts (1-5%). Water soluble products constituted 3-7% at 15 min of incubation, increasing to 10-12% at 60 min, highest when incubating with 22:1 and similar for both dietary groups.

Effects of feeding high-fat diets to rats: metabolism of erucic acid (C 22:1 n-9) in the perfused liver and secretion of metabolites to the perfusate.

The liver metabolism of erucic acid, 22:1 n-9, was studied in rat livers perfused with 14-14C-labelled erucic acid for 15 and 60 min, determining the distribution of radioactivity in the perfusate and in the lipids of the liver cell organelles. The rats were adapted to a high-fat diet containing either partially hydrogenated marine oil (PHMO) or palm oil (PO), both adjusted to a 10% content of linoleic acid. The results showed an efficient uptake and metabolism of erucic acid with the secretion to the perfusate medium of labelled free fatty acids other than erucic acid, labelled phospholipids as well as water soluble oxidation products. Only minor amounts of secreted labelled triglycerides were found within 60 min of perfusion. In the liver, labelled lipids accumulated in the endoplasmic reticulum, after 15 min mainly as free fatty acids, after 60 min as triglycerides. The esterification pathway, including the erucic acid given as well as chain-shortened fatty acids, seemed to be preferred under the experimental conditions and with adequate linoleic acid in the diet. A chain shortening of erucic acid probably took place in both peroxisomes and mitochondria shown by the presence of labelled 18:1 and 20:1 in the organelle-bound phospholipids. A chain shortening was found in both dietary groups, and is assumed to be an affect of the adaptation to a high-fat diet rather than an effect of dietary very long chain monoenoic fatty acids. Somewhat higher levels were found in the PHMO group, but the difference in the dietary fat was not a major factor in the liver lipid adaptation.

Morphological changes and fatty acid composition in hearts from pigs fed rapeseed oil, fish oil, partially hydrogenated fish oil, partially hydrogenated soybean oil and lard.

Female pigs, fed diets in which 42% of the caloric intake came from either rapeseed oil, fish oil, partially hydrogenated fish oil, partially hydrogenated soybean oil or lard, were killed after one week, five weeks, six months and one year. Type of fat or length of feeding did not affect the cardiac content of total fat which was normal in all animals. The fatty acid pattern of tissue triglycerides only partly reflected the fatty acid pattern of diets. The relative amounts of C22:1 and C20:1 were greatest after six months and levelled off during the following six months. The content of C22:1 in cardiac triglycerides never exceeded one fifth of the dietary concentration. Microscopic lipidosis was found in some pigs after one week, five weeks and six months. Minor heart lesions consisting of focal necrosis of muscle cells were found after one week and more frequently after six months and one year. No relationship between incidence and severity of the heart lesions and any particular type of fat in the diet could be found.

Ubiquinone analyses in fish tissues and in some marine invertebrates.

1. Ubiquinone contents were determined in species of marine invertebrates, and in heart, red and white muscle and liver of three species of fish. 2. Three different methods of determination were compared, based on spectrophotometry, reduction and a reaction with the dimethoxy groups of ubiquinone. 3. Using ubiquinone homologues 6-10 prepared from beef heart and commercially available microorganisms (SCP) as standards, ubiquinone 10 was found in all samples. In addition were found minor amounts of Q-9 in samples of saithe heart and red muscle. 4. Less than 10 mg/kg wet wt of ubiquinone was found in the samples of marine invertebrates and in white muscle and liver of the fish samples, with one exception: 40 mg/kg in a sample of mackerel liver. 5. Higher contents of ubiquinone were found in fish heart and red muscle tissues, ranging from 24 to 116 mg/kg wet wt. The ubiquinone contents were comparable in the two tissues. 6. A test on cellular fragments of red muscle tissue of saithe showed that the ubiquinone was concentrated in the mitochondria fraction.

Naturally occurring vitamin D3 in fish products analysed by HPLC, using vitamin D2 as an international standard.

A chemical method for the analysis of naturally occurring vitamin D is proposed. The unsaponifiable matter of oils and tissues is prepared, cholesterol is partly removed by double precipitation at low temperature in methanol. The vitamin D fraction is collected on an adsorption column by high performance liquid chromatography. The fraction is further purified and the vitamins D2 and D3 are separated on a partition column (reverse phase) by HPLC. Recovery was 89 to 93%, standard deviation 3%. The only vitamin D analogue found in fish oils, livers and fillets, was cholecalciferol (D3). Hence, ergocalciferol (D2) could be used as an internal standard. The provitamins ergosterol and 7-dehydrocholesterol, as well as the previtamins, were separated from the vitamin D-fraction on the adsorption column. Results in the range 0.050 to 134 microgram D3 per gram (2 to 5360 I.U. per gram) are given. One cod liver oil was analysed in a rat bioassay, giving supporting results.