On days 0 and 30 of a double blind study, two groups of 15 subjects each were evaluated using a plaque index, a gingival index, a gingival exudate flow and fasting plasma folic acid levels. Group I received 2 mg of folic acid twice daily for 30 days while Group II received a placebo. Results of the study seem to indicate that folic acid supplemented to the diet may increase the resistance of the gingiva to local irritants and thus lead to a reduction in inflammation.

SUMMARY Serum creatine kinase, aspartate transaminase, and hydroxybutyrate dehydrogenase activities were abnormal in 76, 50, and 28% respectively of 50 patients studied within 26 hours of surgery. No patient showed clinical evidence of myocardial infarction. Creatine kinase MB isoenzyme elevation, and lactate dehydrogenase LD 1 activity greater than LD 2 (LD 1 > LD 2 ) were infrequent (6 and 10% respectively). No patient showed the combination of transient MB isoenzyme elevation and LD 1 > LD 2 , although their rare association without infarction after surgery is to be anticipated.The specificity of serum enzyme determinations for the diagnosis of myocardial infarction is improved by the demonstration in postinfarct serum of a transient increase of the MB isoenzyme of creatine kinase (CK) and more prolonged elevation of the LDI isoenzyme oflactate dehydrogenase (LD) (Galen, 1975). Both of these isoenzymes are abundant in heart, but neither is prominent in most normal skeletal muscles, so their determination should be valuable for the diagnosis of infarction in the early postoperative period, when measurement of total enzyme activity levels is unhelpful because of elevation from surgical trauma to muscle. Serum CK and LD isoenzymes were therefore studied in postoperative patients and compared with enzyme assays in current routine use for the diagnosis of myocardial infarction.phoresis (Rosalki, 1974), CK isoenzyrnes by electrophoresis, with isoenzyme demonstration by staining and by fluorescence (Rosalki, 1965(Rosalki, , 1975.1ncreased LOI and LOs activity and LOt activity in excess of L02 (LOt > L02) were assessed VIsually, by comparison with normal serum controls. The presence of MB creatine kinase was also assessed visually. The sensitivity of the method (detection limit 7 U/I at 30°C) is such that the MB isoenzyme is undetectable in normal serum but is demonstrable in virtually all post infarct subjects.All patients were examined clinically before discharge. Those showing CK isoenzyme abnormality had immediate electrocardiographic examination and repeat blood samples at weekly intervals. No patient had clinical evidence of infarction. The incidence of increased levels of enzymes and isoenzymes is shown in the Table. The greatest incidence is shown by total CK (76 %) and the least by the creatine kinase MB isoenzyme (6%) and LOt> LDz Results Materials and methods

SUMMARY Serum creatine kinase and lactate dehydrogenase isoenzymes were studied in 73 patients with alcoholism, including two patients with clinical alcoholic cardiomyopathy and 28 patients with haemodynamic evidence (systolic time interval abnormality) of disordered myocardial function. No isoenzyme abnormalities suggestive of myocardial injury were observed. We conclude that isoenzyme examination is unsuitable for the early detection of myocardial damage from alcohol.Two patients showed clinical alcoholic cardiomyopathy. A further 28 patients showed increased PEPjLVET ratios without blood ethanol elevation. These patients were diagnosed as having subclinical cardiomyopathy.Serum total CK activity was increased in eight of these 30 subjects and HBD was elevated in three. Total CK was also raised in six and HBD in five of the remaining 43 patients without evidence of cardiac abnormality.Serum CK isoenzyme examination in all subjects showed only the 'muscle' (MM) isoenzyme. LD isoenzyme determination showed either a normal or isomorphic pattern (LD2, LDa increase) or a 'liver'j'muscle' pattern (increased LDs). NQ patient showed increase of the 'cardiac-specific' Ck-MB or LDI isoenzymes. et al., 1977). The upper reference limit (mean plus 2SD) for the PEPjLVET ratio determined in 49 healthy controls matched for age and sex was 0·350. ResultsSince STI values are known to alter during alcohol intoxication, blood ethanol levels were also measured for all subjects by gas-liquid chromatography (courtesy Dr J. Spencer-Peer). Patients and methodsSeventy-three documented alcoholic patients, 60 men (mean age 29 years) and 13 women (mean age 35 years), all previously consuming in excess of 80g ethanol per day, were studied immediately after admission to the Alcohol Unit at St Bernard's Hospital, Southall. A full clinical examination was carried out, blood samples were taken, and STI values measured.The following serum enzyme activities and isoenzymepatterns were determined, using methodology and normal values described previously (Krafft et al., 1977); creatine kinase (CK), hydroxybutyrate Discussion dehydrogenase (HBD); CK and lactate dehydrogenase(LD) isoenzymes.Determination of total CK and LD or HBD activity For STI measurement the electrocardiogram, in serum followed by CK and LD isoenzyme phonocardiogram, and carotid pulse pressure waves examination is widely used for the identification of were simultaneously recorded, and the pre-ejection myocardial injury. Total enzyme determination period relative to the left ventricular ejection time lacks cardiospecificity, and this is especially dis-(PEPjLVET ratio) was calculated. This value reflects advantageous when evidence of heart damage is the contractile efficiency of heart muscle (Lewis sought in alcoholics, in whom accompanying liver 165Measurement of enzymes and isoenzymes of cardiac origin in serum is of established value for the identification of myocardial damage. Alcohol is cardiotoxic. Clinical cardiomyopathy occurs in some 1-2% of chronic alcoholics, but haemody...