Use of the platelet function analyser (PFA-100) to quantify the effect of low dose aspirin in patients with ischaemic heart disease

Continuing aspirin up until surgery in cardiac surgical patients may increase peri-operative blood loss. It is possible that there is a subset of patients particularly sensitive to aspirin. The platelet function analyser (PFA-100) can demonstrate the antiplatelet effect of aspirin. This study was designed to assess the effect of daily 75 mg aspirin on platelet function, as measured by the PFA-100, in 92 patients with ischaemic heart disease. Patients were classified into three groups according to their PFA-100 results; aspirin hyper-responders (16%), aspirin normal responders (33%) and aspirin non-responders (51%). The PFA-100 has potential as a screening tool to identify patients who are either hyper-responsive or resistant to aspirin. Pre-operative PFA-100 screening to isolate aspirin hyper-responders could enable the vast majority of patients to continue with aspirin therapy pre-operatively, avoiding the risks of stopping treatment.

Fractured neck of the femur in the elderly patient

The 6-month mortality for these patients is quoted as up to 50%, so optimal technique is needed. General anaesthesia (GA) is better for these patients for both practical and theoretical reasons.

A monoclonal antibody to a conserved sequence in the extracellular domain recognizes the angiotensin II AT1 receptor in mammalian target tissues

We have generated hybridomas which secrete monoclonal antibodies to the AT1 subtype of the angiotensin II receptor (AT1 receptor). These were obtained after immunization of Balb C/c mice with synthetic peptides representing sequences from either the extracellular domain (residues 8-17) or the intracellular domain (residues 229-237) of the AT1 receptor. Hybridoma populations were first screened for the production of antibodies which bound to rat liver cells. Further selection, and cloning by limiting dilution, was carried out for antibodies which bound specifically to rat adrenal glomerulosa cells. Confirmation that the antibody designated 6313/G2 interacted with the angiotensin II receptor was obtained using COS-7 cells transfected with AT1A receptor cDNA. In particular, the initial characterization of 6313/G2 showed specific immunofluorescence of vascular endothelium.

Comparison of COS cell transfected AT1A and AT1B angiotensin II receptors and angiotensin II receptor isoforms in rat tissues using isoelectric focusing

Rat adrenal AT1A and AT1B receptors from transfected COS-7 cells were labelled with 125I-Angiotensin II, solubilised, and run on isoelectric focusing gels. Receptors from rat tissues were treated similarly. COS-7 cell-expressed AT1A and AT1B receptors each produced a single peak of specific radioactivity at pI 6.8. Rat liver and rat ovary tissue preparations gave peaks at pI 6.8 and 6.5, respectively. In contrast, rat adrenal tissue preparations gave four peaks at pI 7.0, 6.8, 6.5, and 6.3. The additional isoforms found in the rat adrenal tissue preparations may represent post-translationally modified or novel receptors.