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Solitary parathyroid adenomas were correctly located before surgery in 20 out of 21 cases by using 20lmTl and 99mTc in a subtraction technique. The Attempts at detecting parathyroid adenomas with 75Se-selenomethionine and "31Cs-caesium chloride have been unsatisfactory. 205Tl-thallous chloride has better imaging properties, and preliminary reports7 suggest that it is a superior agent for identifying parathyroid tissue. Because thallium is also taken up by the thyroid gland we have used a subtraction technique which removes a 99mTc thyroid image, leaving the parathyroid tumour as a "hot" area. We report the results of this method in our first 34 patients with hyperparathyroidism who underwent subsequent surgical exploration of the neck.

The thromboresistance of 13 potentially blood-compatible polymers was assessed in sheep by determining survival of 51Cr-labeled platelets. Polymer tubing (120-150 cm x 2.0-2.3 mm i.d.) coiled around the neck was incorporated into the circulation through silicone rubber connectors as a carotid artery-external jugular vein shunt. The mean platelet half-life in control animals ("shunt control") was 78.2 +/- 2.8 (SEM) hours. Eleven of the 13 polymers tested significantly shortened platelet half-life. Polyvinyl chloride (T1/2 = 45.4 +/- 3.0 hours), polyperfluoro ethylene (T1/2 = 47.0 +/-1.6 hours), and a polymethylacrylate (PMA)/acrilonitrile copolymer (T1/2 = 50.7 +/- 7.0 hours) produced the greatest shortening. Only silica-free polydimethyl siloxane (T1/2 = 74.7 +/- 4.9 hours) and PMA (T1/2 = 81.5 +/- 3.4 hours) were indistinguishable from shunt controls. Pretreatment of PMA tubing with autologous plasma in a paired trial significantly increased platelet half-life (P less than 0.05 vs. untreated PMA). This system offers an economical, reproducible, sensitive, and biologically relevant method for assessment of the reactivity of artificial surfaces with platelets.

We present four cases of transitional cell carcinoma of the transplant ureter (TCCtu). In three cases, localized tumor resection and a variety of reconstructive techniques were possible. Transplant nephrectomy with cystectomy was performed as a secondary treatment in one locally excised case. Transplant nephroureterectomy was performed as primary treatment in one case. The role of oncogenic viruses and genetic fingerprinting to determine the origin of TCCtu are described. Our cases and a systematic literature review illustrate the surgical, nephrological, and oncological challenges of this uncommon but important condition.

who developed thrombocytopenia and in whom a lymphocyte transformation test to gold in vitro was positive. Probably a direct toxic mechanism was responsible for at least some of the adverse reactions to Myocrisin. We thank the Medical Research Council of New Zealand for financial support, and Karen Chaney, working under the supervision of Dr M Sears, for the IgE estimations.