PubMed · 11130546
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
A Bartolazzi, A Gasbarri. 2000-12-09. Thyroid disease classification.. https://doi.org/10.1016/s0140-6736(05)72981-0
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
The high mobility group As (HMGAs) belong to a family of nonhistone nuclear proteins that orchestrate the assembly of nucleoprotein complexes. Through a complex network of protein-DNA and protein-protein interaction, they play important roles in gene transcription, recombination, and chromatin structure. This protein family is involved, through different mechanisms, in both benign and malignant neoplasias. We have recently reported that transgenic mice carrying the Hmga1 or Hmga2 genes under transcriptional control of the cytomegalovirus promoter develop pituitary adenomas secreting prolactin and growth hormone. We have shown that the mechanism of the HMGA2-induced pituitary adenoma is based on the increased E2F1 activity. The expression profile of mouse normal pituitary glands and adenomas induced in HMGA transgenic mice revealed an increased expression of the ccnb2 gene, coding for the cyclin B2 protein, in the neoplastic tissues compared with the normal pituitary gland. Here, we show, by electrophoretic mobility shift assay and chromatin immunoprecipitation, a direct binding of HMGA proteins to the promoter of ccnb2 gene, whereas luciferase assays showed that HMGAs are able to up-regulate ccnb2 promoter activity. Finally, we report an increased CCNB2 expression in human pituitary adenomas of different histotypes that is directly correlated with HMGA1 and HMGA2 expression. Because cyclin B2 is involved in the regulation of the cell cycle, these results taken together indicate that HMGA-induced cyclin B2 overexpression gives an important contribution to experimental and human pituitary tumorigenesis.
BACKGROUND: The success of parathyroid surgery depends on the identification and removal of all hyperactive parathyroid tissue. At this writing, bilateral cervical exploration and identification of all parathyroid glands represent the operative standard for primary hyperparathyroidism (pHPT). However, improved preoperative localization techniques and the availability of intraoperative parathyroid hormone monitoring prepare the way for minimally invasive procedures. METHODS: Patients with pHPT and one unequivocally enlarged parathyroid gland on preoperative ultrasound and 99mTc-SestaMIBI scintigraphy underwent minimally invasive video-assisted parathyroidectomy by an anterior approach. Intraoperatively, a rapid chemiluminescense immunoassay was used to measure intact parathyroid hormone (iPTH) levels shortly before and then 5, 10, and 15 min after excision of the adenoma. The operation was considered successful when more than a 50% decrease in preexcision iPTH levels was observed after 5 min. RESULTS: Between October 1999 and November 2001, 36 of 82 patients with pHPT were eligible for a minimally invasive approach. A conversion to open surgery became necessary in five patients because of technical problems. In three cases, intraoperative iPTH monitoring showed no sufficient decrease in iPTH values. In these cases, subsequent cervical exploration showed one double adenoma and two hyperplasias, respectively. In two patients we had difficulty interpreting intraoperative iPTH values, resulting in persistent pHPT. CONCLUSIONS: Despite the use of high-resolution ultrasound and 99mTc-SestaMIBI scintigraphy, the presence of multiple glandular disease cannot be ruled out completely. Intraoperative iPTH monitoring to ensure operative success is indispensible for a minimally invasive approach. Despite our problems with iPTH monitoring in two patients, we believe that in selected cases, minimally invasive parathyroidectomy represents an attractive alternative to conventional surgery.
BACKGROUND: We have performed endoscopic thyroidectomy by an anterior chest approach and by an axillary approach. In this study, we evaluate the efficacy of these two types of endoscopic procedures and conventional open surgery. METHODS: Each procedure was performed in 15 patients. The degree of surgical invasiveness and the nature of patients' complaints after surgery were compared using results of the operation and a questionnaire. RESULTS: Although the mean operating time for the endoscopic procedure was significantly longer than for open surgery, there was no postoperative pain difference in the three groups. Three months after surgery, the incidence of swallowing discomfort was higher in the open surgery group than in endoscopic surgery group. All of the patients treated using the axillary approach were satisfied with the cosmetic results. However, three patients (20%) treated using the anterior chest approach and 11 patients (73%; p < 0.01) who underwent open surgery complained about the cosmetic results. CONCLUSIONS: The incidence of postoperative complaints after endoscopic surgery is significantly lower than after open surgery. Patients treated using the axillary approach can obtain cosmetic results superior to those achieved with other procedures.