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PubMed1986

Adenoma weight: a predictor of transient hypocalcemia after parathyroidectomy.

To evaluate the relationship of parathyroid adenoma weight to perioperative serum calcium levels, 51 selected patients with pathologically confirmed single adenomas and minimal biopsy at operation were reviewed. Three age- and sex-matched groups were established according to adenoma weight. Compared with Group 1 patients who had adenomas of less than 1 g, Group 3 patients with adenomas of more than 2 g demonstrated significantly higher preoperative serum parathyroid hormone and calcium levels, and significantly lower preoperative serum phosphate levels. Multiple regression analysis revealed a strong correlation between adenoma weight to preoperative parathyroid hormone and calcium levels (r = 0.63, p less than 0.001). These results suggest that larger adenomas may be associated with a more severe form of primary hyperparathyroidism. The incidence of transient postoperative hypocalcemia in the 51 patients who underwent adenoma excision was 37 percent. Permanent hypoparathyroidism did not develop in any of them. Compared with Group 1 patients, Group 3 patients demonstrated a higher incidence of postoperative transient hypocalcemia (69 percent versus 14 percent in Group 1, p less than 0.001) and significantly lower mean serum calcium levels on the third and fourth postoperative days. Increased adenoma weight may be a valuable aid in identifying those patients at risk for transient hypocalcemia after neck exploration.

Adenoma↗
PubMed1977

Serum lipids before and after parathyroidectomy in patients with primary hyperparathyroidism.

Eight males and 36 females with hypercalcaemia were operated upon for primary hyperparathyroidism and parathyroid adenomata were revealed in every case. The serum levels of cholesterol and triglycerides were determined before the operations and 6,12 and 18 months after them. Furthermore, the serum lipids of the patients were compared with those of a normacalcaemic sex- and age-matched control group. The serum cholesterol concentration in primary hyperparathyroidism was about 8-10% lower in both females and males compared with the correspondeing control cases and the levels of serum trigycerides were about 22% and 60% lower. After operation the serum cholesterol concentration returned to a normal level and the triglycerides nomalized. The results are discussed in the light of present knowledge about dietary calcium intake, primary hyperparathyroidism and lipid metabolism.

Adenoma↗
PubMed1977

Natriuretic and phosphaturic response to diuretics after parathyroidectomy in dogs.

Intact and acutely parathyroidectomized (TPTX) dogs were studied during hydropenia, volume expansion (VE), volume expansion plus ethacrynic acid (EA), and volume expansion plus acetazolamide (AZ). In intact dogs, VE produced marked increases in both Na+ and phosphate (Pi) excretion; in TPTX dogs, Na+ excretion increased but phosphaturia was minimal. Addition of EA increased Na+ but not Pi excretion in both groups. Discontinuing EA and substituting AZ in intact dogs produced a marked increase in Pi excretion compared to both VE and VE + EA. In TPTX dogs, AZ failed to increase Pi excretion compared to VE alone. The results suggest that increased distal Pi absorption in acutely TPTX dogs is not associated with NaCl reabsorption in the thick ascending loop of Henle or may occur at an alternative nephron site. Furthermore, the increased distal Pi reabsorptive capacity revealed by TPTX can overcome the increased distal Pi delivery produced by the superimposition of AZ on VE.

Acetazolamide↗
PubMed1989

Effects of sex, thyro-parathyroidectomy, and light regime on levels and circadian rhythms of wheel-running in rats.

Intact and thyro-parathyroidectomized (TPX) Sprague-Dawley rats of both sexes were observed for 24 days under a 12:12 light:dark cycle (Entrainment), followed by 20 days in constant dim red light (Free-Run). Circadian periods and levels of wheel-running activity were examined. Intact females and TPX males were significantly more active and had significantly shorter free-running circadian periods than intact males, and the effects of TPX in females were different from those in males. Circadian periods in TPX females were slightly, but not significantly, shorter than in intact females, and activity levels in TPX females were nonsignificantly depressed relative to intact females. It was also found that day versus night activity levels differed more in TPX animals than in intact animals, especially during entrainment, suggesting that TPXs may be more sensitive to some effects of light. A number of possible explanations for the effects of TPX are considered, including changes in thyroid and calcitonin levels, interactions with gonadal hormones, and possible developmental effects of thyroid hormones on the circadian system. It is also possible that rhythm changes are secondary to alterations in activity levels. Human manic depressives reportedly have an unusually high incidence of thyroid, parathyroid, and calcium regulation abnormalities, display shortened circadian sleep-wake rhythms and abnormal levels of activity, and may also be hypersensitive to some effects of light; in addition, depression predominates in women, whereas mania predominates in men. The present results suggest that thyroid dysfunction could be partially responsible for the some of these abnormalities, and for sex differences in the manifestations of these disorders.

Animals↗
PubMed1982

Healing of osteitis fibrosa cystica after partial parathyroidectomy despite persistent parathyroid hyperfunction: a case report.

The diagnosis of primary hyperparathyroidism was made in a 55-year-old female with marked hypercalcemia (15 mg/100 ml) and hypercalciuria and skeletal x-rays showing typical lesions of subperiosteal resorption and numerous cystic areas. At surgery a left lower parathyroid adenoma presumably was totally excised. Serum calcium returned to normal levels immediately postoperatively, but 4 months after surgery hypercalcemia (11.5 mg/100 ml) was again found. During the following 18 months the patient was free of symptoms, and radiologic studies revealed complete healing of the subperiosteal resorption and repair of the bone cysts. Cortical bone mineral content also increased. However, elevated levels of serum parathyroid hormone (PTH) and calcium clearly indicated the persistence of primary hyperparathyroidism. Thus, a decrease in the degree of PTH hypersecretion permitted the repair of the skeletal lesions caused by a more severe level of parathyroid hyperfunction.

Bone Resorption↗