Cardiac Monitoring in a Community Hospital—Analysis of 18 Months' Experience

Cardiac monitoring facilities have been present in teaching hospital centers for over five years. A substantial decrease in mortality has been observed in monitored patients with acute myocardial infarction. The community hospital system offers a challenge to effective monitoring since many physicians care for patients and often many kinds of therapy are used.After 18 months of operation mortality from myocardial infarction was only 16.6 percent in a community hospital monitoring unit where the majority of the emergency care and resuscitation was carried out by nurses. Vital to this success was the use of standing orders for nurses, requirement of privilege to practice within the monitoring facility and acceptance of the nurse as a therapist in emergency situations.Fourteen patients were successfully resuscitated and were later discharged from the hospital. Four of them had ventricular fibrillation from digitalis intoxication.Patients with shock and severe congestive heart failure continue to be a major unsolved clinical problem. The results indicate that the potentially viable patient with serious electrical disturbances can almost invariably be salvaged.     

Gammaphotography

The Anger scintillation camera greatly broadens the range of studies performed by radioisotope imaging devices. Its ability to view in any direction, to make an image simultaneously of an entire field of view, and to obtain images rapidly, all serve to make scintiphotography analogous to fluoroscopy. Illustrations of its uses in static and dynamic gammaphotography and in numerical data processing are described.     

Medicine in Society—Part I: Change and Challenge

The Committee to Study the Role of Medicine of the California Medical Education and Research Foundation (CMERF) is grateful to Dr. Watts for the following paper which served as the philosophical basis for the Committee''s study and discussions. The Committee is also grateful to CMERF and to its president, James C. Doyle, for the encouragement and cooperation it has received in the course of its intensive study of a problem which is of great interest and concern to the medical profession of California.Dr. Watts'' background paper has served as a potent stimulus in directing the Committee''s attention to the continuing dialogue between medicine and society, and in focussing on problems and issues which will be the subject of the Committee''s Second Progress Report, excerpts from which are scheduled for publication in the next issue of California Medicine.     

"Necking" behaviour in the giraffe

Previous references to "necking" behaviour, and the main features of the study area are briefly outlined.
"Necking" behaviour in giraffe takes place only in all male herds. When the animals are in a head to head posture the intensity is either high or low, but when animals take up a head to tail posture the actions are always of high intensity and appear to have greater sexual significance.
The significance of "necking" is discussed, and it is suggested that these ritualized actions form an important sexuo-social bonding mechanism whereby a hierarchy is created amongst the males, and movement between strictly bachelor and mixed herds helps to maintain contact between the sexes in this polygamous mammal.     

Meeting announcements

The levels of individual free and conjugated ecdysteroids and ecdysteroid acids, labeled from [¹⁴C]cholesterol, in five different age groups of male Manduca sexta during pupal-adult development were determined by HPLC. Eight free ecdysteroids, eight ecdysteroid phosphates, and two ecdysteroid acids were identified. Newly ecdysed pupae contained predominantly 3-epiecdysteroids in each of the free, conjugated, and acidic ecdysteroid fractions. The titer of each ecdysteroid fraction rose sharply by day 4, and this was particularly noteworthy with respect to free ecdysone and 3-epi-20-hydroxyecdysonoic acid. This stage demonstrated high degrees of ecdysone biosynthesis, oxidative catabolism, and phosphorylation. As development proceeded to day 16, total ecdysteroid titer remained constant; a decreasing free ecdysteroid titer was accompanieid by increasing titers of both conjugates and acids resulting from the metabolic processes of hydroxylation, oxidation, epimerization, and phosphorylation. The predominant metabolites throughout development were 3-epi-20-hydroxyecdysonoic acid and the phosphate conjugates of 3-epi-20-hydroxyecdysone and 3-epi-20,26-dihydroxyecdysone. The ultimate inactivation of the ecdysteroids of M. sexta during pupal-adult development is possibly mediated by two pairs of metabolically-linked processes, one leading to a 3-epiecdysteroid acid, and the other to 3-epiecdysteroid phosphates.     

Captive breeding for the conservation of cichlid fishes

Cichlid fishes are by far the largest familial group of endangered vertebrates, especially the haplochromines. This paper concerns the organization and management of captive breeding of haplochromine cichlids. The setting up of a small-scale laboratory programme for the conservation of endangered species is described in terms of funding, staffing, installation and livestock husbandry. Breeding is discussed in the context of the selection of broodstock, basic reproductive biology, rearing, disease, pathological disorders and the arrangements necessary for the transfer and documentation of progeny. There are already indications in Africa and elsewhere that the dramatic decline and demise of cichlid taxa in Lake Victoria will not be an isolated phenomenon. There is no prospect that the captive breeding of cichlids can alone resolve such large-scale problems in fisheries management and ecology, or prevent the loss of taxa in nature. Nevertheless, captive breeding provides conservation options which are otherwise limited or unavailable regarding the saving of individual 'heritage' species, restocking to the wild, fundamental laboratory research and, finally, public education on the grave issue of actual and prospective mass extinctions of cichlids and other rare fishes.