Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Parathyroidectomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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

At least 415 records · Page 23Linked to original sources
PubMed1985

Parathyroidectomy-pinealectomy-induced seizures: effects of intersurgical length.

Parathyroidectomized rats subjected to pinealectomy experience seizures characterized by wild running typically followed by clonic-tonic activity. By increasing the number of days between parathyroidectomy and pinealectomy an increase in seizure activity was observed. Increasing the length of time between the two surgical procedures resulted in significant increases in both the percentage of animals experiencing seizures and the mean number of seizures per convulsing animal. Conversely, a decrease in the average time to onset of the first seizure episode was observed with increasing intersurgical time intervals. The potential for exhibiting seizures developed between 8 and 24 h after parathyroidectomy. The highest incidence of seizures occurred after an intersurgical interval of 3 days and remained constant at approximately 75% thereafter.

Animals↗
PubMed1989

The influence of early parathyroidectomy on aluminum-induced rickets in growing uremic rats.

Rats were subjected to a two-stage 5/6 nephrectomy and treated with aluminum for 2 and 4 weeks with a cumulative dose of 4.2 and 8.4 mg of aluminum, respectively. Other animals were parathyroidectomized and loaded with 8.4 mg of aluminum for 4 weeks. Histomorphometry and electron microscopy (tibiae), aluminum tissue (bone, kidney, liver) determination, serum (Ca, Mg, Zn, P, urea, creatinine, alkaline phosphatase, 1,25(OH)2D3, PTH) and urine (creatinine, A1) revealed that: (a) a dose of 8.4 mg aluminum was sufficient to induce rickets within 4 weeks of treatment and was associated with decreased serum calcitriol values and high aluminum accumulation within organs (electron-dense material was found in osteoblasts only); (b) previous parathyroidectomy prevented the occurrence of any aluminum-induced alteration of bone. It was associated with higher calcitriol and phosphorus values than in corresponding non-parathyroidectomized rats and significantly reduced aluminum accumulation within organs. The results was influenced neither by a drop in serum calcium values nor by different degrees of renal failure. We suggest that aluminum-induced rickets in growing uremic rats is prevented or delayed when previous parathyroidectomy has been performed.

Aluminum↗
PubMed1980

The effect of parathyroidectomy in patients with normocalcemic calcium stones.

With the entity of normocalcemic primary hyperparathyroidism increasingly prevalent in the literature the treatment of parathyroidectomy has been advocated. A total of 21 patients with recurrent calcium-containing calculi and normocalcemia underwent parathyroidectomy. Of the 21 patients 1 had an adenoma, 9 had hyperplasia and 11 had normal glands. Of the 19 patients followed stones ceased forming in 32 per cent, while in 42 per cent calculi continued to form. Of 5 patients with multiple unassessable calculi 1 ceased passing stones. We conclude that the entity of normocalcemic hyperparathyroidism is rare and repeated serum calcium determinations to identify true hypercalcemic hyperparathyroidism are necessary.

Adult↗
PubMed1994

Chemical parathyroidectomy for recurrence of secondary hyperparathyroidism.

To avoid the risks of reoperation, we treated 15 uremic patients on regular extracorporeal dialysis and affected by hyperparathyroidism recurring after subtotal parathyroidectomy with ultrasound-guided ethanol injection. Follow-up was extended to 12 months after the last injection and for 11 patients to 24 months. Plasma parathyroid hormone concentration, as measured with a carboxyterminal parathyroid hormone (c-PTH) radioimmunoassay (normal, 0.2 to 2 ng/mL), significantly decreased from a basal value of 19.29 +/- 14.73 ng/mL to 11.19 +/- 9.54 ng/mL at 1 month, 7.45 +/- 4.99 ng/mL at 6 months, 6.91 +/- 4.71 ng/mL at 12 months, and 6.51 +/- 3.89 ng/mL at 24 months. Total and bone alkaline phosphatase decreased in parallel. The only remarkable side effect was transient dysphonia, which occurred in two cases. These data suggest that the technique of ultrasound-guided fine-needle ethanol injection might be a valuable alternative to surgery for recurrent hyperparathyroidism after subtotal parathyroidectomy in selected patients. This should be confirmed in larger series of patients and with a more prolonged follow-up.

Adult↗
PubMed1984

Total parathyroidectomy and delayed parathyroid autotransplantation using a simplified cryopreservation technique: human and animal studies.

Following earlier studies using a simplified cryopreservation method in rats, we report the successful use of this technique in a hemodialysis patient who had previously undergone total parathyroidectomy. In additional studies, parathyroid glands from rats were conserved by this rapid freezing procedure after total parathyroidectomy. Six weeks after parathyroid autotransplantation the animals were submitted to a low-calcium diet and their parathyroid gland function compared to that of rats that had previously undergone sham operation, immediate autotransplantation, or delayed autotransplantation using the classical cryopreservation method. With both cryopreservation techniques, plasma calcium, phosphorus, and 1,25 (OH)2 vitamin D concentrations after low-calcium diet were similar although results were less satisfactory than with immediate autotransplantation or after sham operation. We suggest that this simplified cryopreservation technique, developed in rats, yields functioning parathyroid gland tissue and can be successfully used in the human.

Adult↗
PubMed1976

[Total parathyroidectomy and autologous parathyroid transplantation in secondary hyperparathyroidism (author's transl)].

In a 17-year-old female patient with marked secondary hyperparathyroidism and progressive bone changes all four parathyroid glands were removed. Part of the endocrine tissue was reimplanted into the muscles of the forearm. The transplant took successfully and showed a satisfactory function. Total parathyroidectomy and autologous parathyroid transplantation has a number of advantages as compared with subtotal parathyroidectomy: The function of the transplant can be directly observed and tissue can be easily removed in the further course of the disease. It is thus possible to regulate parathormone secretion over long periods in patients with chronic renal failure.

Adolescent↗
PubMed1980

Long-term evaluation of patients with primary parathyroid hyperplasia managed by total parathyroidectomy and heterotopic autotransplantation.

Since 1973, we have performed total parathyroidectomy and forearm parathyroid autotransplantation in 36 patients with generalized (four gland) primary parathyroid hyperplasia. Twenty (56%) patients had nonfamilial parathyroid hyperplasia (NFPH) and 16 (44%) patients had familial parathyroid hyperplasia (FPH). Twenty-one patients (Group A) were undergoing operation for the first time and 15 (Group B) were having either second, third or fourth re-explorations for persistent hyperparathyroidism. All patients in Group A and nine patients in Group B had parathyroid resection and immediate autotransplantation as a single procedure. Six Group B patients had hyperfunctioning parathyroid tissue resected, cryopreserved, and subsequently grafted when it was evident that they had been rendered aparathyroid. A sustained differential elevation (13.7 fold +/- 2.7) of parathyroid hormone was detected in the antecubital vein of the grafted compared to the nongrafted arm in 35 (97%) patients. Two (5.6%) of the 36 patients (both with FPH; one Group A and one Group B) required permanent oral calcium and vitamin D replacement therapy and one (3%) patient (NFPH: Group A) had persistent hypercalcemia postoperatively, presumably due to a supernumerary gland. The remaining 33 (92%) patients became normocalcemia after surgery and 23 (70%) of them remained so. Ten (30%) of the 33 patients developed recurrent graft dependent hyperparathyroidism. Eight patients were from the group with FPH (8/14, 57%) and two were from the group with NFPH (2/19, 11%)(FPH vs. NFPH, p < 0.005). Because of symptoms of hypercalcemia or a serum calcium concentration exceeding 11 mg/dl, partial graft resection was performed in five patients and four became normocalcemic. Patients with generalized primary parathyroid hyperplasia may be difficult to cure, especially if the disease is familial. The technique of total parathyroidectomy and heterotopic autotransplantation of fresh or cryopreserved parathyroid tissue offers distinct advantages over alternative techniques.

Humans↗
PubMed1981

Subtotal parathyroidectomy for primary chief cell hyperplasia of the multiple endocrine neoplasia type I syndrome.

To evaluate the efficacy of subtotal parathyroidectomy (STP) in the treatment of primary hyperparathyroidism due to multiple gland disease, 12 patients with multiple endocrine neoplasia (MEN) type I syndrome were reviewed out of 132 patients undergoing parathyroidectomy. Each patient had yearly follow-up examinations and calcium determinations for a minimum of four years except for one patient who died one year after S.T.P. Permanent hypoparathyroidism occurred in three patients. Two patients remained persistently hypercalcemic, and two patients developed recurrent hypercalcemia. One patient required oral administration of calcium and vitamin D for ten years following STP before recurrent hypercalcemia developed. Another patient was normocalcemic for three years before recurrent hypercalcemia was noted. Only five of these 12 patients remain normocalcemic without need of calcium and vitamin D therapy. In patients with MEN type I, the long-term results of STP are less than satisfactory. Not only is it difficult to gauge how viable parathyroid tissue must be left to prevent both permanent hypoparathyroidism and persistent hyperparathyroidism but there is also a long-term risk of recurrence.

Calcium↗
PubMed1981

Treatment of secondary hyperparathyroidism in patients with chronic renal failure by total parathyroidectomy and parathyroid autograft.

Sixty-one patients with chronic renal failure and secondary hyperparathyroidism underwent total parathyroidectomy and parathyroid autograft. Symptoms relieved by parathyroidectomy included bone pain, pruritus, soft tissue calcification, muscle weakness and healing of fractures. Serum parathormone levels measured before and after operation in 48 patients returned to normal in all but two patients. Serum alkaline phosphatase levels also returned toward normal after operation, except in one patient with a retained parathyroid gland. Complete radiographic studies before and after operation were available in 30 of 61 patients. Twenty-three of 24 patients with osteitis fibrosa had evidence of healing, and in one patient no change occurred. Osteosclerosis noticed in 23 patients improved slightly in eight patients, did not change in 14 and became worse in one. Pathologic examinations revealed 45 patients to have diffuse hyperplasia and 16 nodular hyperplasia. There were two early postoperative deaths, in the first 30 days, and 16 late postoperative deaths, from four months to four years afterward. In no case did the operation contribute to death. Some patients required the administration of supplemental calcium after operation, but in no instance did profound hypocalcemia occur. No patient developed recurrent hyperparathyroidism.

Adolescent↗
PubMed1982

Unilateral parathyroidectomy in hyperparathyroidism due to single adenoma.

As a general principle in the treatment of primary hyperparathyroidism due to single adenoma, unilateral parathyroidectomy was applied to 50 patients and compared with another group of 50 conventionally explored patients. Twenty-five patients were explored only on the "adenoma" side. The other 25 patients were explored on both sides, avoiding biopsies at the first. In the conventionally explored patients, the adenoma was removed and one to three normal glands were biopsied. Oil-red-O technique was used in the intraoperative microscopical examination. The patients in whom the operation could be limited to the "adenoma" side had a statistically more favorable situation concerning early postoperative hypocalcemia, length of operation time, and need for calcium and vitamin D substitution. The principle of unilateral parathyroidectomy in conjunction with intraoperative oil-red-O staining technique is advocated in hyperparathyroidism due to single adenoma because it offers more reliable peroperative distinction between uni- and multi-glandular involvement, reduced operation time, decreased risk for complication, reduced early hypocalcemia, and more favorable technical conditions for reoperation.

Adenoma↗
PubMedDate not supplied

Sequential changes in bone density before and after parathyroidectomy in primary hyperparathyroidism.

Bone density (bone mineral content/bone width) was determined by iodine-125 (125I)-photon absorptiometry in the distal third of the radius before and after successful parathyroidectomy in 37 patients with primary hyperparathyroidism. Bone density progressively declined during the two years immediately preceding surgery. It rose by 6.4% during the first year following surgery but remained stable thereafter. The results suggest that photon absorptiometry analysis of bone density may disclose continuing bone loss before surgery and may show a partial recovery of bone loss that may ensue after successful parathyroidectomy.

Bone and Bones↗
PubMed1985

Total parathyroidectomy for posttransplantation hyperparathyroidism.

The acute and short-term clinical course of 19 subjects who underwent total parathyroidectomy and forearm implantation for persistent hyperparathyroidism following successful kidney transplantation (mean [+/- SD] time after transplant 43.7 +/- 29.5 months) is described. Their mean preoperative serum calcium level of 10.8 +/- 0.5 mg% decreased to a nadir of 7.9 +/- 0.9 mg%, 62.5 +/- 27.7 hr after the operation. The lowest serum ionized calcium (1.80 +/- 0.2 mEq/L) was recorded 57 +/- 49 hr postoperatively. After an average of five hospital days, the patients were discharged with a mean serum total calcium concentration of 8.3 +/- 1.0 mg%. Three months following the operation, the mean serum total calcium concentration was 9.5 +/- 0.6 mg%. With an average follow-up of 19 months (range 3-36 months) serum total calcium was 9.6 +/- 0.6 mg%, with only one subject requiring calcium supplementation. Total parathyroidectomy with forearm implantation was associated with normalization of serum-immunoreactive parathyroid hormone concentrations and maintenance of stable allograft function. Our experience suggest that this procedure is an effective modality with a predictable postoperative recovery of parathyroid function when used to treat persistent hyperparathyroidism in the long-term survivor of renal transplantation.

Adolescent↗
PubMed1975

Arterial calcification and progressive peripheral gangrene after renal transplantation. Report of two cases treated with parathyroidectomy.

Two cases of progressive arterial calcification and peripheral gangrene after successful renal transplantation are presented. Parathyroidectomy was performed and was followed in one case by healing of the peripheral necroses. It is suggested that parathyroidectomy should be considered in similar cases even in the absence of hypercalcemia.

Arteriosclerosis↗
PubMed1979

Changes of urinary cyclic AMP excretion and plasma parathyroid hormone levels before and after parathyroidectomy in patients with primary hyperparathyroidism.

Urinary cyclic AMP excretion and plasma parathyroid hormone(PTH) levels were examined in three patients with primary hyperparathyroidism before and after parathyroidectomy. Plasma PTH and urinary cyclic AMP in the individual patients decreased in parallel following parathyroidectomy. During surgery there was a statistically significant correlation between PTH levels and cyclic AMP excretion in individual patients. These findings support the claim that the rate of urinary cyclic AMP excretion reflects endogenous PTH activity in patients with primary hyperparathyroidism.

Adult↗
PubMed1991

Effect of parathyroidectomy on development of hypertension and atrial responsiveness in spontaneous hypertensive rats.

1. In order to further clarify the relationships between parathyroid function and development of hypertension, the effects of parathyroidectomy (PTX) on blood pressure and on responsiveness of atria isolated from spontaneous hypertensive rats (SHR) were examined. 2. PTX was carried out in 6-week-old SHR and normotensive Wistar rats. The experiments were performed 2 weeks after surgery. 3. PTX reduced the plasma calcium concentration and decreased atrial calcium content in SHR. On the other hand, basal contractile force and beat frequency of isolated atria were higher in PTX SHR than in sham-operated SHR. In response to cumulative addition of isoprenaline, atria from PTX SHR displayed diminished inotropic and chronotropic responses compared with sham-operated SHR. Similar results were obtained in atria isolated from Wistar rats. When calcium sensitivity was studied in atria from Wistar rats, basal and isoprenaline-induced maximum contractile forces were higher in PTX group than in the sham-operated group. Nevertheless, basal and isoprenaline-induced maximum contractile forces, determined at the respective plasma ionized calcium concentration of PTX and sham-operated groups (0.83 and 1.22 mmol/L), were not significantly different. 4. Our results do not favour a role for alteration in atrial activity as a causal mechanism in delayed development of experimental genetic hypertension after parathyroidectomy.

Animals↗
PubMed1986

Neonatal primary hyperparathyroidism: total parathyroidectomy with autotransplantation of cryopreserved parathyroid tissue.

Primary neonatal hyperparathyroidism is a life threatening disease because of severe hypercalcemia. The best therapy is early total parathyroidectomy which requires permanent replacement therapy. We describe the first case treated by total parathyroidectomy and late autotransplantation of cryopreserved parathyroid tissue. Twenty months after transplantation, serum calcium and phosphate levels are normal in the absence of any supplementary treatment.

Female↗
PubMed1978

The influence of parathyroidectomy upon calcium and phosphate homeostasis in adult sheep.

The absorption and secretion of Ca and PO4 were measured with the use of radioactive isotopes in 4 adult sheep before and after parathyroidectomy. Secretion of Ca and PO4 into the stomach and intestines was measured separately. Parathyroidectomy resulted in a negative balance for Ca and PO4 and an accompanying fall in plasma Ca and PO4 concentrations. In the case of PO4 this response was attributed primarily to a reduced intestinal absorption, but for Ca increases in urinary excretion and intestinal secretion also contributed significantly. Secretion of PO4 to the stomach was reduced but endogenous PO4 excretion in the faeces was unchanged which indicated a reduced reabsorption of secreted PO4 by the intestines.

Animals↗
PubMed1987

Tetany despite normocalcaemia and normomagnesaemia following parathyroidectomy.

Two patients with long-standing hyperparathyroidism due to a parathyroid adenoma are described. Both had severe osteitis fibrosa cystica and a proximal myopathy. Both were treated with alfacalcidol (2 micrograms/day) prior to and following parathyroidectomy, and infused with calcium gluconate following the operation. Plasma total and ionized calcium and magnesium concentrations were maintained within the normal range. However, both developed tetany in the postoperative period in spite of normal ionized calcium and magnesium concentrations. Tetany continued for 4 weeks in one patient and for longer in the other. Prolonged hypercalcaemia may result in a state of neuromuscular excitability following parathyroidectomy even at high normal concentrations of ionized calcium.

Adenoma↗