The purpose of the present study was to examine whether combined ingestion of a large amount of fructose and glucose during cycling exercise would lead to exogenous carbohydrate oxidation rates >1 g/min. Eight trained cyclists (maximal O(2) consumption: 62 +/- 3 ml x kg(-1) x min(-1)) performed four exercise trials in random order. Each trial consisted of 120 min of cycling at 50% maximum power output (63 +/- 2% maximal O(2) consumption), while subjects received a solution providing either 1.2 g/min of glucose (Med-Glu), 1.8 g/min of glucose (High-Glu), 0.6 g/min of fructose + 1.2 g/min of glucose (Fruc+Glu), or water. The ingested fructose was labeled with [U-(13)C]fructose, and the ingested glucose was labeled with [U-(14)C]glucose. Peak exogenous carbohydrate oxidation rates were approximately 55% higher (P < 0.001) in Fruc+Glu (1.26 +/- 0.07 g/min) compared with Med-Glu and High-Glu (0.80 +/- 0.04 and 0.83 +/- 0.05 g/min, respectively). Furthermore, the average exogenous carbohydrate oxidation rates over the 60- to 120-min exercise period were higher (P < 0.001) in Fruc+Glu compared with Med-Glu and High-Glu (1.16 +/- 0.06, 0.75 +/- 0.04, and 0.75 +/- 0.04 g/min, respectively). There was a trend toward a lower endogenous carbohydrate oxidation in Fruc+Glu compared with the other two carbohydrate trials, but this failed to reach statistical significance (P = 0.075). The present results demonstrate that, when fructose and glucose are ingested simultaneously at high rates during cycling exercise, exogenous carbohydrate oxidation rates can reach peak values of approximately 1.3 g/min.

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A study of the prevalence of asthma in school children in Birmingham which was first carried out in 1956-57 was repeated in 1968-69. There has been an increase in the prevalence of definitely diagnosed asthma from 1-8% to 2-3%, not including an even higher number of children (3-2%) with wheezing. A considerably higher prevalence in boys than in girls was again found both for definite asthma and for wheezing but the tendency to recovery in boys with definite asthma was slight whereas there was a marked recovery in cases of wheezing which almost certainly represented mild asthma.Negro children born in England had a similar prevalence to European children but children born outside England in the West Indies or in Asia had a significantly lower prevalence of asthma and of wheezing for reasons which are not fully understood but which might profitably be considered further. Asian children, however, appeared to retain their low prevalence of asthma even when born in England.

The outcome of patients with cholesterolosis was compared with that of those with chronic cholecystitis operated on for chronic acalculous biliary pain. A total of 55 patients with acalculous biliary pain with a median symptom duration of 24 (range 6-120) months were investigated by dynamic cholescintigraphy and followed for a median of 24 (range 12-60) months. Thirty-five patients underwent cholecystectomy, of whom 22 had a low gallbladder ejection fraction (under 35 per cent), with symptomatic improvement in 21 of these (P < 0.01). All four patients with a normal ejection fraction (35-50 per cent) improved after cholecystectomy but only four of nine with a high ejection fraction (over 50 per cent) did so. Results of histological examination were available in 32 patients and revealed cholesterolosis in 20. A low ejection fraction was found in 16 patients with cholesterolosis, of whom 15 showed symptomatic improvement after cholecystectomy; the other four patients had a high fraction and all improved after cholecystectomy. Overall, symptoms in 19 of 20 patients with cholesterolosis improved after cholecystectomy compared with only seven of 12 with chronic cholecystitis (P = 0.03).

Retraction pockets of the pars tensa in children can result in erosion of the ossicles leading to hearing loss and eventually cholesteatoma formation. Several different types of treatment for the more severe grades of retraction pocket have been described. The aim of this pilot study was to assess the outcome following simple excision and ventiolation tube insertion of grade II, III and IV retraction pockets of the pars tensa. The eardrums were grades according to Sadé's classification (1979).There were seven grade II and four garade III ratractions. Ten eardrums healed completely in a mean time of 3.6 months (mean follow-up 16 months) and there was one residual perforation. Two retractions recurred and both of these were only grade I. Clinically, an improvement in hearing was reported in seven children (eight ears) and the average air conduction threshold gain for these patients was 16 dB. A larger prospective study is currently underway.

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A method for predicting postoperative respiratory function following lung resection has been used in 11 patients with both histologically proven bronchial carcinoma and chronic obstructive airways disease, in order to assess their fitness for surgical treatment. Quantitative ventilation and perfusion scintigrams were used to measure the amount of functioning tissue in each lung. These data were used in conjunction with spirometric measurements to calculate the likely functional effect of pneumonectomy. There was a high degree of correlation (r) between predicted and measured lung function for both FEV1 (r = 0.75, P less than 0.01) and FVC (r = 0.88, P less than 0.01). The postoperative FEV1 was within 150 ml of the predicted value in 45% of the patients. In the remaining patients the actual volumes were greater than predicted by 210-540 ml. For FVC the results were within 150 ml of predicted in 45% of patients and in the remainder actual volumes were greater by 160-650 ml. Both sets of calculations underestimated lung volumes by an average of 200 ml. The method is shown to be accurate, simple, non-invasive, and readily available and brings a degree of objectivity to an important decision that is often based mainly on clinical assessment.