1027 who one
come
despite quite inadequate premises. Unfortunately
of our greatest
be to sweep away the apabout STD in some sectors of the medical
problems
palling ignorance nursing professions.
Department of Genito-Urinary Medicine, General Infirmary at Leeds, Leeds LS1 3EX
M. A. WAUGH G. R. KINGHORN
BALLOT IN SCOTLAND ON PROPOSED CONSULTANT CONTRACT
SiR,-After the collapse of negotiations on the N.H.S. consultants’ contract very few consultants were aware of the fact that fresh discussions were taking place with Mr Patrick Jenkin or were aware of their nature until a letter appeared in The Scotsman on Aug. 24 by a member of the N.H.S. Consultants Association giving some details of proposals which appeared greatly to favour part-time consultants. The letter prompted a rebuff from Mr David Bolt, which ended "I am sure that Scottish consultants will wish to be fully informed of the details of the offer before making up their minds about the new situation". Elsewhere’ Mr Bolt stated: "it is essential, however, that the profession give very careful thought to the offer now before it and that the regional representatives on CCHMS are fully briefed on the views ’of their colleagues when the final decision has to be taken". However, nothing further was heard until there was a rush to push a decision through the Scottish Committee for Hospital Medical Services on Sept. 25. Very few regional representatives had been given information in time to arrange the meetings which Mr Bolt considered essential. The S.C.H.M.S. meeting, under pressure from the C.C.H.M.S., accepted the new proposals, though some representatives did so against the expressed wishes of those whom they represented. The voting was 27 to 13 in favour. There was an immediate wave of protest from all parts of Scotland. Mr James Kyle, chairman of the S.C.H.M.S, was asked to arrange an official ballot, but he declined on the grounds that this would require a special meeting, it would be too expensive, and a complete list of Scottish consultants was not available. Those difficulties have now been overcome by a small group of full-time consultants. 2164 ballot papers were sent out and 1205 (55-7%) were returned (the Electoral Reform Society states that an unofficial ballot with unstamped envelopes does not normally result in a poll of more than 30%). The first question asked whether the four main proposals were acceptable: the result was 44% in favour and 56%’against. The second question was of much less general importance but was included to assess the overall wish to preserve the present situation in which the vast majority of Scottish consultants are whole-time. The result was an almost equal split, 51% being in favour and 49% not having strong convictions at this point. The ballot was held to determine if the S.C.H.M.S. vote did indeed represent the views of the majority of Scottish consultants. It was not held to try to destroy the proposed contract changes. Senior registrars were not called because it was impossible in the time available to compile an up-to-date list of their whereabouts. The ballot was not held in an attempt to obtain a separate contract for Scottish consultants.
Aberdeen
J. D. BROWN W. GIBSON D. HAMILTON A. A. MARR J. MCCORMICK C. V. RUCKLEY W. WALKER
The Borders
J. WARD
Ayr Dundee
Glasgow Kirkcaldy Dumfries
Edinburgh
PURE ANTI-HEPARIN COMPONENT OF
PROTAMINE
seems to
SIR,-A tiresome feature of the reversal of heparin therapy by protamine is the necessity to titrate the amount of protamine given against clotting tests.’ This is because of the anticoagulant effect of protamine alone, if given in excess. However, at alkaline pH, protamine dissociates into two components. One of these possesses an anti-heparin activity, whilst the other has some anticoagulant effect. This was noticed by chance. I was separating protamine from other materials on a ’Sephadex’ (Pharmacia) column. Protamine (Evans) 50 mg in
v
D
v 1.
Anticoagulant (or anti-heparin) activity
ii: 748.
V 2.u
4.
of
protamine
com-
ponents.
5 ml diluted in 10 ml of bicarbonate buffer 0.5mol/1 pH 9 was eluted from a 100 ml column of G25 sephadex beads with isotonic phosphate-buffered saline as eluant at a working pressure of 100 cm water. The first protein-bearing fractions (A and B) to appear exhibited antiheparin activity only, whilst the subsequent fraction (C) showed an anticoagulant effect (see figure). The fractions were tested against various dilutions of. mucous heparin from 0.0 to 0.25 units/ml using a standard thrombin clotting test in 0.025 mol/1 calcium chloride. The results suggest the existence of a low-molecular-weight companent of protamine possessed of heparin-neutralising activity alone. The use of this substance to reverse heparin therapy would presumably obviate the need precisely to titrate the amount
required.
Department of Surgery, Guy’s Hospital,
T. K. DAY
London SE1 9RT
1. Wade A, ed. Martindale: The
1. Br med J 1979;
1.0
Heparin (IJ. Iml)
Press, 1977: 340.
extra
pharmacopoeia. London: Pharmaceutical
come
despite quite inadequate premises. Unfortunately
of our greatest
be to sweep away the apabout STD in some sectors of the medical
problems
palling ignorance nursing professions.
Department of Genito-Urinary Medicine, General Infirmary at Leeds, Leeds LS1 3EX
M. A. WAUGH G. R. KINGHORN
BALLOT IN SCOTLAND ON PROPOSED CONSULTANT CONTRACT
SiR,-After the collapse of negotiations on the N.H.S. consultants’ contract very few consultants were aware of the fact that fresh discussions were taking place with Mr Patrick Jenkin or were aware of their nature until a letter appeared in The Scotsman on Aug. 24 by a member of the N.H.S. Consultants Association giving some details of proposals which appeared greatly to favour part-time consultants. The letter prompted a rebuff from Mr David Bolt, which ended "I am sure that Scottish consultants will wish to be fully informed of the details of the offer before making up their minds about the new situation". Elsewhere’ Mr Bolt stated: "it is essential, however, that the profession give very careful thought to the offer now before it and that the regional representatives on CCHMS are fully briefed on the views ’of their colleagues when the final decision has to be taken". However, nothing further was heard until there was a rush to push a decision through the Scottish Committee for Hospital Medical Services on Sept. 25. Very few regional representatives had been given information in time to arrange the meetings which Mr Bolt considered essential. The S.C.H.M.S. meeting, under pressure from the C.C.H.M.S., accepted the new proposals, though some representatives did so against the expressed wishes of those whom they represented. The voting was 27 to 13 in favour. There was an immediate wave of protest from all parts of Scotland. Mr James Kyle, chairman of the S.C.H.M.S, was asked to arrange an official ballot, but he declined on the grounds that this would require a special meeting, it would be too expensive, and a complete list of Scottish consultants was not available. Those difficulties have now been overcome by a small group of full-time consultants. 2164 ballot papers were sent out and 1205 (55-7%) were returned (the Electoral Reform Society states that an unofficial ballot with unstamped envelopes does not normally result in a poll of more than 30%). The first question asked whether the four main proposals were acceptable: the result was 44% in favour and 56%’against. The second question was of much less general importance but was included to assess the overall wish to preserve the present situation in which the vast majority of Scottish consultants are whole-time. The result was an almost equal split, 51% being in favour and 49% not having strong convictions at this point. The ballot was held to determine if the S.C.H.M.S. vote did indeed represent the views of the majority of Scottish consultants. It was not held to try to destroy the proposed contract changes. Senior registrars were not called because it was impossible in the time available to compile an up-to-date list of their whereabouts. The ballot was not held in an attempt to obtain a separate contract for Scottish consultants.
Aberdeen
J. D. BROWN W. GIBSON D. HAMILTON A. A. MARR J. MCCORMICK C. V. RUCKLEY W. WALKER
The Borders
J. WARD
Ayr Dundee
Glasgow Kirkcaldy Dumfries
Edinburgh
PURE ANTI-HEPARIN COMPONENT OF
PROTAMINE
seems to
SIR,-A tiresome feature of the reversal of heparin therapy by protamine is the necessity to titrate the amount of protamine given against clotting tests.’ This is because of the anticoagulant effect of protamine alone, if given in excess. However, at alkaline pH, protamine dissociates into two components. One of these possesses an anti-heparin activity, whilst the other has some anticoagulant effect. This was noticed by chance. I was separating protamine from other materials on a ’Sephadex’ (Pharmacia) column. Protamine (Evans) 50 mg in
v
D
v 1.
Anticoagulant (or anti-heparin) activity
ii: 748.
V 2.u
4.
of
protamine
com-
ponents.
5 ml diluted in 10 ml of bicarbonate buffer 0.5mol/1 pH 9 was eluted from a 100 ml column of G25 sephadex beads with isotonic phosphate-buffered saline as eluant at a working pressure of 100 cm water. The first protein-bearing fractions (A and B) to appear exhibited antiheparin activity only, whilst the subsequent fraction (C) showed an anticoagulant effect (see figure). The fractions were tested against various dilutions of. mucous heparin from 0.0 to 0.25 units/ml using a standard thrombin clotting test in 0.025 mol/1 calcium chloride. The results suggest the existence of a low-molecular-weight companent of protamine possessed of heparin-neutralising activity alone. The use of this substance to reverse heparin therapy would presumably obviate the need precisely to titrate the amount
required.
Department of Surgery, Guy’s Hospital,
T. K. DAY
London SE1 9RT
1. Wade A, ed. Martindale: The
1. Br med J 1979;
1.0
Heparin (IJ. Iml)
Press, 1977: 340.
extra
pharmacopoeia. London: Pharmaceutical
