Biomedical subjects

A Krudy

Publications and source records attributed to A Krudy.

4 recordsLinked to original sources

PubMed1981

Results of reoperation for persistent and recurrent hyperparathyroidism.

Between August 1975 and January 1981, 106 patients thought to have persistent or recurrent hyperparathyroidism underwent a total of 108 parathyroid re-explorations at the National Institutes of Health. These 106 patients had a total of 175 previous operations for hyperparathyroidism (156 cervical and 19 mediastinal). Nephrolithiasis (54% of patients) and bone disease (24% o patients) were the predominant symptoms. Arteriographic examination and selective venous sampling provided highly accurate localizing results in 33% of the patients, and were of some help in 64%. The final diagnoses after reoperation and re-evaluation were: single-gland disease in 58 patients, primary nonfamilial hyperplasia in 19 patients, familial hyperplasia in three patients, multiple endocrine neoplasia (MEN) Type I in ten patients, MEN Type II in two, parathyroid carcinoma in four patients, secondary hyperplasia in three patients, and familial hypocalciuric hypercalcemia (FHH) in two patients. The diagnosis was in doubt in five patients. In the 95 patients with unequivocal hyperparathyroidism, not due to parathyroid carcinoma, surgery eliminated hypercalcemia in 91 (96%). Two patients died after operation, one of disseminated candidiasis, and one patient, with an immunodeficiency, of sepsis. Five patients developed temporary, and one permanent, recurrent nerve damage; 41% of the patients were hypocalcemic, at the time of discharge from the hospital.

Adenoma↗

PubMed1981

Radioimmunoassay for the middle region of human parathyroid hormone: studies with a radioiodinated synthetic peptide.

We radioiodinated a synthetic fragment representing residues 44-68 from the middle region of human parathyroid hormone (hPTH). At least 90% of the purified [125I]-hPTH-(44-68) was able to bind to anti-hPTH serum. Antibody-bound [125I]hPTH-(44-68) could be rapidly and efficiently separated from nonbound radioligand by dextran-coated charcoal. [125I]hPTH-(44-68) was not degraded after a 72-h incubation in undiluted plasma at 7 C, and it was stable for many weeks at -20 C in a 1% albumin buffer. [125I]hPTH-(44-68) was used to develop midregion specific PTH RIAs. The immunoreactive PTH concentration in plasma was above the upper limit of the normal range in 39 of 43 patients with primary hyperparathyroidism. Values from the midregion assay and an established carboxy-terminus assay correlated using peripheral plasma from 17 patients with primary hyperparathyroidism (r = 0.84; P less than 0.0001) or using parathyroid gland venous effluent plasma from the same 17 patients (r = 0.79; P less than 0.0005). Gel filtration analysis of peripheral plasma from 2 patients with primary hyperparathyroidism and azotemia suggested peptides possessing midregion immunoreactivity but deficient in carboxyterminus immunoreactivity. Similar peptides were present at higher concentrations in parathyroid gland venous effluent plasma than in peripheral plasma, indicating release from the parathyroid gland. In conclusion, [125I]hPTH-(44-68) had properties favorable for the development of RIAs reactive solely with the midregion of PTH. Fragments secreted in vivo by two human parathyroid glands were reactive in midregion assays but nonreactive in a carboxy-terminus assay.

Chemical Phenomena↗

PubMed1980

False aneurysm formation following arteriographic intimal dissection: serial studies in 2 patients.

Two patients with metastatic islet-cell carcinoma underwent multiple hepatic artery catheterizations for streptozotocin infusion. An intimal flap was raised during one of the initial arteriographic procedures and a false aneurysm developed. The progression of the aneurysm was documented on sequential studies. False aneurysm formation appears to be a relatively unappreciated complication of intimal dissection, and these 2 cases permitted observation of their natural history.

Adenoma, Islet Cell↗

PubMed1980

Localizing insulinomas with combined radiographic methods.

Twenty-one patients with hyperinsulinism were studied to localize the source of the insulin production. Nineteen patients had pancreatic tumors and two patients studied after pancreatectomy had hepatic metastases. Of the 19 pancreatic tumors, 16 were identified by angiography. CT found six tumors in 14 patients studied while sonography correctly localized only three of 12 tumors. Neither CT nor sonography was positive in those patients with a negative arteriogram. Noninvasive imaging methods can localize large tumors and may be useful for detecting hepatic metastases. Angiography, however, remains the most accurate method for detecting smaller lesions.

Adenoma, Islet Cell↗