The intraoperative rapid PTH assay may be of significant benefit in permitting directed unilateral parathyroid explorations for adenoma when combined with preoperative localization with a technetium-99m sestamibi scan. Additionally, the rapid PTH assay has proved to be of benefit in confirming excision of all hyperfunctioning parathyroid tissue in patients with multiple gland hyperplasia, particularly those who may harbor ectopic parathyroid tissue.

ABSTRACI To assess the diagnostic value of measuring free plasma deoxyribonucleic acid (DNA) in patients suspected of having pulmonary embolism, we prospectively assayed the plasma of 40 consecutive patients who underwent pulmonary angiography for the presence of free plasma DNA. Fifteen of them had angiographic evidence of pulmonary embolism. Of these 15 only two (13%) had a positive result in the test for free double-stranded plasma DNA. We concluded that measuring free double-stranded plasma DNA is of no value in the diagnosis of pulmonary embolism.Pulmonary embolism is the most common preventable cause of hospital death' and the third most frequent cause of death in the United States.2 In making the diagnosis of pulmonary embolism, the clinician requires diagnostic studies which are both sensitive and specific. Recently, Sipes and coworkers3 reported that detection of free plasma DNA was 83% sensitive and "extremely specific" for the diagnosis of pulmonary embolism. In their study the diagnostic criterion for a pulmonary embolism was a "high-probability" lung scan. Radionuclide perfusion scanning is sensitive but relatively non-specific in the diagnosis of pulmonary embolism.4 Pulmonary angiography with selective lobar and segmental injection is both highly sensitive and specific.4 The purpose of our study was to assess the value of plasma DNA in the diagnosis of pulmonary embolism, the pulmonary angiogram being used as the diagnostic standard. exclude patients with diagnoses known to be associated with raised concentrations of free plasma DNA.Pulmonary angiograms were performed by an experienced angiographer using the Seldinger technique via a femoral vein. All except one of the studies were performed within 48 hours of the onset of symptoms. The single exception was performed within 72 hours. Standard diagnostic criteria of intravascular filling defects and vessel "cut-offs" were applied. All angiograms were read without knowledge of the results of the plasma DNA assay.Forty plasma specimens from patients with systemic lupus erythematosus that were positive for antibody to double-stranded DNA by the Crithidia luciliae assay were screened for potential use in the counterimmunoelectrophoresis (CIE) method for the detection of free plasma DNA. A specimen producing a visible precipitin line within the 1-g DNA standard was used for testing patients' specimens. This specimen had an anti-DNA titre of 1/320.The DNA standard (Sigma Chemical Corporation, 3500 Dekalb Street, St Louis, Missouri 63118) was dissolved to make a solution of 100 mg/dl. The positive control in each plate was 1-5 ,ug/ml.6The plasma was separated from the patients' blood samples by centrifugation and heated for one hour at 56°C to destroy complement activity. The plasma samples were then frozen at -70°C until tested at a later date. Counter-current electrophoresis was performed on commercially prepared plates (Cordis Laboratories, Miami, Florida 33137) by placing the antibody in the anodal well and the patient's sample in the cathodal well. B...

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The transferrin receptor (TR), the HLA DR antigen (DR), and the antigen binding OKT10 (T10) are present on activated lymphocyte populations. The authors have studied their expression and that of antigens defined by eight commercial monoclonal antibodies on peripheral blood lymphocytes of 50 healthy hospital workers aged 23-60 years. A whole blood lysis technique was employed and cells were enumerated on a flow cytometer. The percentage of cells bearing the three activation antigens were generally low: mean values for T10 being 7.2%; for TR 1.8%; and for DR 8.8%. There was, however, considerable variability, with occasional subjects having 20% or more cells positive for one of the three antigens. High values of one activation antigen did not correspond with high values of another in the same subject. Nor was there correlation of the presence of activation antigens with the occurrence of cells bearing T11, T4, T8, Leu 1, Leu 2a, Leu 3a, or Leu 7. Double labelling with the following pairs of fluorescein (FITC) and phycoerythrin (PE) labeled antibodies: Leu 2a, DR; Leu 3a, DR; Leu 3a, Leu 2a; TR, DR, indicated that simultaneous expression of the corresponding antigens do not normally occur on lymphocytes of healthy individuals. Double labelling with B1 and DR in five subjects indicated the presence of B1 (+) DR (-) cell population. No pattern of relationship could be detected among common clinical variables or HLA type and an increased expression of activation antigens.

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