Dysmorphophobia and the search for cosmetic surgery.

may have been zinc deficient, though none had features attributable to zinc depletion. Again, these results might be explained by a diminished amount of zinc binder in the leucocytes. A cellular effect of a low plasma concentration of zinc has recently been found by Patrick and his colleagues,10 who showed that the zinc is an important controller of the sodium pump in leucocytes. More recently Patrick et all' have reported an effect of zinc supplements on sodium transport in children with protein-energy malnutrition. They suggest that there may be a causal relation between the low plasma concentration of zinc and the impaired sodium transport seen, for example, in trauma and malnutrition. Our knowledge of the chemical anatomy of zinc in health and disease is increasing rapidly. What we know so far suggests that low concentrations of zinc in plasma or cells are not adequate evidence of a primary zinc depletion. The cornerstone of the definition and detection of nutritional deficiencies is a therapeutic test. Prasad AS. Clinical, biochemical and pharmacological role of zinc. Annu Rev Pharmacol Toxicol 1979;19:393-426. 2 Klevay LM, Reck SJ, Barcome DF. Evidence of dietary copper and zinc deficiencies._JAMA 1979;241 :1916-8. 3 Aggett PJ, Harries JT. Current status of zinc in health and disease states. Arch Dis Child 1979;54:909-17. 4 Walker BE, Dawson JB, Kelleher J, Losowsky MS. Plasma and urinary zinc in patients with malabsorption syndromes or hepatic cirrhosis. Gut 1973 ;14 :943-8. 5 Walker BE, Bone I, Mascie-Taylor BH, Kelleher J. Is plasma zinc a useful investigation ? IntJ7 Vitam Nutr Res 1979 ;49 :413-8. 6 Lekakis J, Kalofoutis A. Zinc concentrations in serum related to myocardial infarction. Clin Chem 1980;26:1660-1. 7 Balogh Z, El-Ghobarey AF, Fell GS, Brown DH, Dunlop J, Dick WC. Plasma zinc and its relationship to clinical symptoms and drug treatment in rheumatoid arthritis. Ann Rheum Dis 1980;39:329-32. 8 Swaminathan R, Chapman C, Segall NH, Morgan DB. Red-blood-cell composition in thyroid disease. Lancet 1976;ii :1382-5. 9 Keeling PWN, Jones RB, Hilton PJ, Thompson RPH. Reduced leucocyte zinc in liver disease. Gut 198021:561-4. 0 Patrick J, Michael J, Golden MN, Golden BE, Hilton PJ. Effect of zinc on leucocyte sodium transport in vitro. Clinical Science and Molecular Medicine 1978 ;54 :585-7. 11 Patrick J, Golden BE, Golden MHN. Leucocyte sodium transport and dietary zinc in protein energy malnutrition. Am Jf Clin Nutr 1980;33: 617-20.