PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “PARATHYROID DISEASES”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMed1978

A density test for the intraoperative differentiation of parathyroid hyperplasia from neoplasia.

A simple, instant, and reliable test called the Density Test, based on the difference in density between the normal and the diseased parathyroid tissue, was performed intraoperatively in 73 patients with primary hyperparathyroidism. Whereas the normal parathyroid tissue floated, the diseased tissue invariably sank in a mannitol solution with a density range between 1.049 and 1.069. With the aid of this test, a diagnosis of adenoma was made in 66 patients and of primary hyperplasia in the remaining seven. In every case the diagnosis was subsequently confirmed. Forty-two of the 66 patients with an adenoma (64%) had a unilateral exploration of the neck. The Density Test saved these patients from an unnecessary contralateral exploration by the finding of an adenoma and a normal second gland in the same side of the neck. These data show that the Density Test is useful in the intraoperative diagnosis of a diseased from a normal parathyroid tissue. Tissue that sinks within the density range of 1.049 and 1.069 is without exception diseased and should therefore be either partially or completely excised even if the gland is of average size or only of slight enlargement. If it does not sink, it is virtually certain to be normal and should be spared. The Density Test provides a valuable clue in the differentiation of primary parathyroid hyperplasia from neoplasia.

Adenoma↗
PubMed2000

A novel, noninvasive imaging technique for intraoperative assessment of parathyroid glands: confocal reflectance microscopy.

BACKGROUND: Successful surgical management of primary hyperparathyroidism requires the ability to identify and distinguish normal from abnormal parathyroid tissue. Microscopic pathologic confirmation often helps with the diagnoses and decisions regarding the extent of parathyroid resection. Confocal reflectance microscopy (CRM) is an optical method of noninvasively imaging tissue without fixation, sectioning, and staining as in standard histopathology. The goal of this study was to determine if CRM imaging could be used to distinguish normal from diseased parathyroid tissue intraoperatively. METHODS: In this study, 44 parathyroid glands from 21 patients undergoing operations for primary hyperparathyroidism were imaged immediately after excision. CRM images were compared with conventional hematoxylin-and-eosin stained sections obtained from the same gland. The percentage area occupied by fat cells was calculated in images of both normal and diseased glands. RESULTS: Characteristic microscopic features of parathyroid glands were distinguishable by CRM and correlated well with histopathology. The stromal fat content of normal and diseased glands could easily be determined. The percentage area occupied by fat cells differed significantly (P <.00001) in normal glands (average, 23.0% +/- 10.9%) and adenomatous glands (average, 0.4% +/- 0.7%). CONCLUSIONS: CRM imaging rapidly revealed microscopic features that reliably differentiated normal and diseased parathyroid glands. The success of this preliminary ex vivo study promotes interest in further development of an in situ probe for in vivo clinical diagnostic use.

Adenoma↗
PubMed1993

Exogenous calciferol (vitamin D) and vitamin D endocrine status among elderly nursing home residents in the New York City area.

OBJECTIVE: To determine the role and relative importance of sources of exogenous calciferol (vitamin D) in maintaining vitamin D endocrine status in the mid-winter and early spring in a representative sample of institutionalized elderly persons in the New York City area. DESIGN: Cross-sectional survey. SETTING: A privately-run urban nursing home and the long-term care unit of a suburban public hospital. PARTICIPANTS: Residents aged 60 years and older scheduled for a routine annual physical examination and an additional group of individuals ascertained by random sampling. Those with a history of anti-convulsant or glucocorticoid use, liver disease, chronic renal disease (or serum creatinine > 1.5 mg/dL), parathyroid disease, Paget's disease, gastric surgery, or pharmacological vitamin D use were excluded. Of 301 sampled individuals, 221 were found eligible to participate, and 109 were successfully enrolled. RESULTS: The average vitamin D intake was 379 IU/day (range 55-1006 IU/day) and total vitamin D intake was below the Recommended Dietary Allowance in 16% of subjects. Fifty percent of total vitamin D intake came from fortified milk, and 26% came from vitamin supplements. Vitamin supplement use was not associated with low dietary intake. Among subjects taking a supplement containing 400 IU/day, none had serum calcidiol levels below 15 ng/mL, while among subjects with vitamin D intake between 200 and 400 IU/day, 46% had serum calcidiol levels below 15 ng/mL and 14% had calcidiol levels below 10 ng/mL. Vitamin D intake from non-supplement sources (but not from supplements) appeared to have a negative association with serum calcitriol levels. CONCLUSIONS: Many nursing home residents may require vitamin supplements in order to achieve optimal levels of calciferol replacement. The choice of a vehicle for calciferol replacement may affect calcitriol levels.

Aged↗
PubMed1987

Multimodality imaging of the thyroid and parathyroid glands.

Nuclear imaging of the thyroid and parathyroid glands has evolved from early radionuclide rectilinear thyroid scanning to the recently developed dual isotope subtraction technique for detecting parathyroid lesions. At the same time, x-ray fluorescent scanning, ultrasound, x-ray computed tomography, and magnetic resonance imaging have improved identification of these endocrine organs. The appropriate use and relative role of these imaging modalities in the investigation of patients with thyroid and parathyroid diseases is discussed.

Adenoma↗
PubMed1994

Management of individual tumor syndromes. Medullary thyroid carcinoma and hyperparathyroidism.

Significant advances have been made in the understanding of the pathophysiology and the ability to effectively screen for and treat medullary thyroid carcinoma. The parafollicular cells, or C-cells, are the cell of origin for medullary thyroid carcinoma. C-cell hyperplasia is a premalignant disease that progresses rapidly to medullary thyroid carcinoma. C-cells produce calcitonin, which serves as a marker to prospectively screen patients for C-cell disease. One major concern in screening for this disease has been the incidence of false positive results. This problem is addressed in light of new, more stringent criteria for the diagnosis of C-cell hyperplasia. The association of hyperparathyroidism with MEN 2 is discussed with evidence that thyroidectomy of C-cell disease may affect the incidence of parathyroid disease.

Humans↗
PubMed1995

Monoclonality of parathyroid tumors in chronic renal failure and in primary parathyroid hyperplasia.

The pathogeneses of parathyroid disease in patients with uremia and nonfamilial primary parathyroid hyperplasia are poorly understood. Because of multigland involvement, it has been assumed that these common diseases predominantly involve polyclonal (non-neoplastic) cellular proliferations, but an overall assessment of their clonality has not been done. We examined the clonality of these hyperplastic parathyroid tumors using X-chromosome inactivation analysis with the M27 beta (DXS255) DNA polymorphism and by searching for monoclonal allelic losses at M27 beta and at loci on chromosome band 11q13. Fully 7 of 11 informative hemodialysis patients (64%) with uremic refractory hyperparathyroidism harbored at least one monoclonal parathyroid tumor (with a minimum of 12 of their 19 available glands being monoclonal). Tumor monoclonality was demonstrable in 6 of 16 informative patients (38%) with primary parathyroid hyperplasia. Histopathologic categories of nodular versus generalized hyperplasia were not useful predictors of clonal status. These observations indicate that monoclonal parathyroid neoplasms are common in patients with uremic refractory hyperparathyroidism and also develop in a substantial group of patients with sporadic primary parathyroid hyperplasia, thereby changing our concept of the pathogenesis of these diseases. Neoplastic transformation of preexisting polyclonal hyperplasia, apparently due in large part to genes not yet implicated in parathyroid tumorigenesis and possibly including a novel X-chromosome tumor suppressor gene, is likely to play a central role in these disorders.

Adult↗
PubMed1999

Unintentional parathyroidectomy during thyroidectomy.

OBJECTIVES: In the United States thyroidectomy is a frequently performed surgery by both general and head and neck surgeons. Even the most experienced thyroid surgeon, however, has probably received a pathology report stating that an incidental parathyroid gland or parathyroid tissue was found in the submitted thyroidectomy specimen. The aim of this report is to explore some of the pathologic and clinical characteristics of unintentional parathyroidectomy during thyroidectomy. STUDY DESIGN: A retrospective review was performed of thyroidectomies performed at the University of California, Los Angeles, Center for the Health Sciences between 1989 and June 1998 which had pathology reports showing parathyroid tissue contained within the thyroidectomy specimen. This excluded any tissue submitted separately to be evaluated for parathyroid tissue and parathyroid tissue removed unintentionally during a thyroidectomy for a different procedure such as a laryngectomy or surgery for parathyroid disease. METHODS: The pathology slides were reviewed to determine the incidence of unintentional parathyroid tissue removal, the size of the parathyroid tissue found within the thyroid specimen, the location of the parathyroid tissue (extracapsular, intracapsular, intrathyroidal), and whether this unintentional parathyroidectomy during thyroidectomy caused clinical consequences. RESULTS: Four hundred fourteen applicable thyroidectomies were performed during this time with 45 (11%) discovered cases of unintentional parathyroidectomy during thyroidectomy. Twenty-five (56%) cases were discovered during thyroidectomy for benign disease, and 20 (44%) during thyroidectomy for malignant thyroid disease. All the parathyroid tissue was normal and was found in extracapsular (58%), intracapsular (20%), or intrathyroidal (22%) locations. Of these 45 cases, recurrent laryngeal nerve paralysis was found only in two patients who had the nerve resected intentionally during the thyroidectomy, and none of the patients developed permanent hypocalcemia. CONCLUSIONS: Incidental parathyroid gland tissue was reported in 11% of the thyroidectomies performed in our series, without the clinical consequence of hypocalcemia. The majority (78%) of this parathyroid tissue was found in the extracapsular and intracapsular locations; therefore it is possible that these parathyroid glands may be identified and preserved with more meticulous inspection of the thyroid capsule during and after thyroidectomy to decrease the incidence of unintentional parathyroidectomy during thyroidectomy in the future.

Carcinoma↗
PubMed2006

Does hyperparathyroidism cause pancreatitis? A South Indian experience and a review of published work.

BACKGROUND: The association between pancreatic disease and primary hyperparathyroidism (PHPT) is controversial. We attempt to suggest a causal correlation and characterize the nature of pancreatic disease in PHPT. METHODS: This study is a retrospective review of the medical records of patients who were diagnosed with PHPT and presented with pancreatic disease between 1 May 2000 and 30 May 2005 at Christian Medical College, Vellore. RESULTS: During the period of 5 years, there were 1284 patients with pancreatic disease and 101 patients with PHPT admitted to our hospital, accounting for 0.42 and 0.03%, respectively, of the total hospital inpatient admissions of 302 883. Of them, 13 patients had both pancreatic disease and PHPT accounting for 1% of all admissions for pancreatic disease and 12% of admissions for PHPT. Patients admitted with PHPT have a 28-fold increased risk of developing pancreatitis compared with patients admitted without parathyroid disease. The ages of the patients ranged from 22 to 52 years with a median age of 37 years. There were 9 male and 4 female patients. The mean calcium values among patients with PHPT and pancreatic disease were significantly higher than patients with PHPT without pancreatic involvement. CONCLUSION: The data suggest a causal association between the pancreatic disease and PHPT. This may be correlated to the higher calcium values. Until more information is available, it would be prudent to check serum calcium in all patients presenting with unexplained pancreatic disease.

Adult↗
PubMed1981

Surgery of hyperparathyroidism: a conservative approach.

The extent of surgery in the treatment of primary hyperparathyroidism should be based on the pathologic entity of the disease. In neoplasia (either the common adenoma or the rare carcinoma), excision of the diseases parathyroid will generally suffice to cure the disease, but in primary hyperplasia, the removal of all the diseased glands except for a small amount of glandular tissue is required. The pathologic diagnosis of primary hyperparathyroidism can usually be made by a macroscopic assessment of the parathyroid. It is further delineated by the density test and confirmed by Sudan fat-frozen section examination.

Densitometry↗
PubMed1975

[Scintigraphy. 2].

Explore the source record for details and available documents.

Bone Diseases↗