A health centre E.C.G. services: its use and abuse.

An average of 10-5 E.C.G.s were recorded weekly in a health centre used by 32 general practitioners serving a population of almost 65,000. The main indication for an E.C.G. was chest pain (73%). 47% of the E.C.G.s were abnormal. A change in clinical diagnosis occurred in 28% of cases and in patient management in 16%. A significant number of these changes were unwarranted, however. It is recommended that the E.C.G.s should be recorded by suitably trained nurses and reported by a specially trained general practitioner. Further education of general practitioners in the clinical use of the E.C.G. is required.

Electrospray ionisation mass spectrometric analysis of lipid restructuring in the carp (Cyprinus carpio L.) during cold acclimation.

Cold acclimation of carp from 30 degrees C to 10 degrees C causes a restructuring of liver microsomal phospholipids characterised by increased proportions of monounsaturated fatty acid in phosphatidylcholine (PC) and phosphatidylethanolamine (PE). Here, we have used electrospray ionisation mass spectrometry (ESI-MS) to determine the patterns of alteration to individual molecular species compositions of PC, PE and phosphatidylinositol (PI) in response to gradually decreasing temperature. The results demonstrate that cold induces precise changes to a limited number of phospholipid species, and that these changes are distinct and different for each phospholipid class. The major change for PC was increased 16:1/22:6, but for PE the species that increased was 18:1/22:6. By contrast, the PI species that increased during cold acclimation were characterised by an sn-1 monounsaturated fatty acid in combination with arachidonoyl or eicosapentaenoyl fatty acid at the sn-2 position. Analysis of acyl distribution indicates that cold only caused the accumulation of monounsaturated fatty acids at the sn-1 and not at the sn-2 position of phospholipids. These results highlight the tight and restricted range of modifications that membranes make to their phospholipid composition in response to thermal stress.