Intraoperative urinary cyclic adenosine monophosphate as a guide to successful reoperative parathyroidectomy

Sixty patients with persistent or recurrent primary hyperparathyroidism underwent reexploration during which urinary cyclic adenosine monophosphate (UcAMP) levels were determined at half-hour intervals by radioimmunoassay. Retrospective analysis of the data allowed us to develop UcAMP criteria for surgical success. Following removal of parathyroid tissue, if an individual UcAMP level dropped 50% from the median baseline level, or if elevated levels dropped to less than 4.0 nmol/dl glomerular filtrate, surgery was predicted to be successful. Eight unsuccessful procedures in seven patients produced no decline in UcAMP, and the intraoperative results accurately predicted surgical failure. Fifty-three patients underwent successful procedures and in every case UcAMP fell. Ninety-eight per cent of these successful procedures were predicted by our criteria. Levels of UcAMP fell 1.5 +/- 0.5 hours (means +/- SD) following abnormal parathyroidectomy. In 19 of 36 successful cases diagnosed before surgery as adenoma, the operative procedure was terminated before a significant drop in UcAMP. In 16 of 17 successful cases diagnosed before surgery as hyperplasia or uncertain histology, UcAMP fell during the operation. Intraoperative determination of UcAMP is helpful in reoperative parathyroid surgery. The criteria established allow intraoperative prediction of success with remarkable accuracy. Urinary cyclic AMP is especially helpful in reoperation for multigland disease; when enough pathologic tissue has been removed, the criteria will be met and the procedure may be terminated with confidence.

Preparation and properties of vesicles enclosed by fatty acid membranes

Stable preparations of microscopic particles were obtained from long-chain fatty acids by mechanical agitation of evaporated films in presence of buffer solutions. Oleic and linoleic acids were used. Studies of osmotic swelling and shrinking of the particles indicated that they are enclosed by semipermeable membranes. The particles, which were named ufasomes, are also capable of entrapping glucose in spaces inaccessible to enzymes. It was concluded that the ufasomes closely resemble phospholipid liposomes in their structure and properties.

Serosurvey of dogs for Brucella canis infection in Memphis, Tennessee

Following occurrence of a rare case of human Brucella canis in Memphis, Tennessee, the free roaming and confined dog populations of that community and a similar geographical location were surveyed for B canis positivity to identify the foci of infection and to compare positivity rates. Three hundred and two dogs were sampled. Positivity was found only in free roaming dogs in both communities. It is concluded that presence of B canis positivity in free roaming dogs may pose an additional medical threat to communities, thus providing one more sound reason for controlling strays and confining dogs.

Successful enforcement of an immunization law

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Studies on the role of the morphological constituents of the microsome fraction from rat liver in protein synthesis

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