Abstract:
BACKGROUND:Parathyroidectomy has a success rate of greater than 95% in the hands of experienced surgeons. To maintain this result in a more cost-effective way, intraoperative monitoring of intact parathyroid hormone (iPTH) has been used to decrease operative times. This technique signals when all hyperfunctioning tissue has been excised or when further dissection is necessary. METHODS:Eighty-nine consecutive patients with hyperparathyroidism had plasma samples measured for iPTH levels during parathyroidectomy. Nine patients had previous neck explorations. Perioperative iPTH measurements using immunochemiluminescent assays with a turnaround time of 10 minutes were done after excision of each suspected abnormal parathyroid gland. RESULTS:All patients except one returned to and maintained normal calcium levels during the follow-up period of 8 months (range, 1 to 25 months). Prediction of postoperative calcium levels by means of quick immunochemiluminescent assay has a sensitivity of 97%, specificity of 100%, and an overall accuracy of 97%. Specific influence on surgical judgment was noted in four patients with multiglandular disease, in seven with difficult localization problems, and in one patient in whom the hyperfunctioning parathyroid tissue was not recognized. Monitoring the plasma iPTH levels during parathyroidectomy directly aided the surgeon's operative approach in these 12 patients. CONCLUSIONS:Intraoperative iPTH assay is useful with predictive accuracy of 97%. It influenced or changed the operative approach in 13% of patients.
journal_name
Surgeryjournal_title
Surgeryauthors
Boggs JE,Irvin GL 3rd,Molinari AS,Deriso GTdoi
10.1016/s0039-6060(96)80040-7subject
Has Abstractpub_date
1996-12-01 00:00:00pages
954-8issue
6eissn
0039-6060issn
1532-7361pii
S0039-6060(96)80040-7journal_volume
120pub_type
杂志文章相关文献
SURGERY文献大全abstract::Coexistent caval and portal hypertension was recognized on preoperative angiographic study of a patient with cirrhosis and variceal bleeding. This hemodynamic situation can preclude adequate reduction of portal hypertension by portasystemic shunt and can result in fatal postoperative bleeding. Resection of a very larg...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1980-05-01 00:00:00
abstract:BACKGROUND:This study was conducted to evaluate the effects of tumor removal and body weight loss on insulin resistance. METHODS:Insulin sensitivity was examined in 12 patients with cancer and stable weight and five patients with cancer and weight loss before operation, six patients after complete tumor removal, and t...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Interaction of the CD11/CD18 complex on polymorphonuclear neutrophils (PMNs) and intercellular adhesion molecule (ICAM)-1 on endothelium is a critical event in PMN-mediated tissue injury. In addition, increased expression of ICAM-1 on type I pneumocytes has been identified in a variety of pulmonary disorders...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(05)80320-4
更新日期:1995-08-01 00:00:00
abstract::To further define the clinicopathologic features and determinants of survival, we reviewed the cases of 110 patients with primary hepatic malignancy managed surgically between 1975 and 1986. Presenting signs of symptoms were pain (57%), fatigue (48%), abdominal mass (40%), and weight loss (33%). Twenty-six percent of ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
abstract:BACKGROUND:We hypothesized that acetylation of the Stat1 regulates interferon-gamma (IFN-gamma) mediated macrophage expression of inducible nitric oxide synthase (iNOS). METHODS:RAW 264.7 iNOS expression was induced with IFN-gamma. Deacetylase inhibitors trichostatin A (TSA) or valproic acid (VPA) were added. Stat1 an...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2007.02.016
更新日期:2007-08-01 00:00:00
abstract::Thyroglossal cysts are common developmental abnormalities of the thyroid gland. The malignant form of these cysts, however, is extremely rare, with fewer than 100 cases reported since 1915. Here we add 10 cases of malignant thyroglossal cysts, nine women and one man, encountered at M.D. Anderson Cancer Center, based o...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract::From 1979 to 1990, 33 children required operative treatment for pancreatitis. Causes included ductal abnormalities (12 children), trauma (10 children), idiopathic (four children), gallstones (three children), drug-induced (three children), and tumor (one child). This study reviews the characteristics and outcome of th...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:For the normal resolution of an acute inflammatory response, neutrophil (PMN) apoptosis is essential to maintain immune homeostasis and to limit inappropriate host tissue damage. A delay in PMN apoptosis has been implicated in the pathogenesis of the systemic inflammatory response syndrome (SIRS). Dopamine, ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1999-08-01 00:00:00
abstract::Eleven patients with previous esophageal atresia repair (TEF) underwent esophageal motility studies and were compared to 10 normal patients. The upper sphincters (UES) in the two groups did not differ in resting pressure, contraction pressure, or coordination. UES relaxation, was 100% in normal patients and 83+/-8% in...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1977-07-01 00:00:00
abstract:BACKGROUND:Although the effect of preoperative biliary drainage in patients with obstructive jaundice is controversial, bacterial or endotoxin translocation is one of the main postoperative problem in jaundiced patients. Failure in gut barrier functions causes bacterial translocation; homing and distribution of T lymph...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2004.02.001
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Patient-reported outcomes (PRO) reflect the functional outcomes of inguinal herniorrhaphy. We studied the effect of hernia recurrence and complications on PRO for participants in the Veterans Affairs trial of Open or Laparoscopic Repair of Inguinal Hernia. METHODS:Analyzed PRO included (1) the Medical Outco...
journal_title:Surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.surg.2006.02.003
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Failure to achieve primary fascial closure (PFC) after damage control laparotomy is costly and carries great morbidity. We hypothesized that time from the initial laparotomy to the first take-back operation would be predictive of successful PFC. METHODS:Trauma patients managed with open abdominal techniques...
journal_title:Surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.surg.2014.04.019
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Ruptured abdominal aortic aneurysm is one of the most difficult clinical problems in surgical practice, with extraordinarily high morbidity and mortality. During the past 23 years, the literature has become replete with reports regarding ruptured endovascular aneurysm repair. METHODS:A variety of study desi...
journal_title:Surgery
pub_type: 杂志文章,评审
doi:10.1016/j.surg.2017.08.008
更新日期:2017-12-01 00:00:00
abstract::A quantitative directional Doppler system was used to determine blood flow in 8 mm. aortoaortic Dacron grafts in dogs. The Doppler was calibrated with frequency standards and the output was integrated for one minute intervals. With the probe held at an angle of 60 degrees to the flow axis, the average frequency of the...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1976-05-01 00:00:00
abstract::Multivisceral isografts and allografts were transplanted to Lewis rats, and the histopathologic changes were studied in the liver, intestine, and other constituent organs. Rats receiving isografts had indefinite survival with maintenance of weight. With multivisceral allografts (from Brown-Norway donors), the intestin...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract::No new chemotherapy agents have been developed recently that present hope for improving survival in patients with colon or rectal cancer. We undertook this study to investigate a new route of administering an old drug, 5-fluorouracil (5-FU). Sixty-six patients with advanced primary colon or rectal cancer were randomiz...
journal_title:Surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1985-09-01 00:00:00
abstract::We retrospectively reviewed 37 patients who underwent hepatic resection between 1970 and 1989 to evaluate the role of cytoreductive hepatic surgery in patients with metastatic neuroendocrine tumors (carcinoid, 24; islet cell, 13). Seventeen resections were curative (no gross residual tumor); nine patients had symptoma...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1990-12-01 00:00:00
abstract::Between 1969 and 1976, 174 patients were treated surgically for simultaneous carotid and coronary atherosclerosis. In 59 patients, staged carotid endarterectomy was performed a few days to 6 months prior to myocardial revascularization. Severe (more than 60% stenosis) coronary atherosclerosis affected a single vessel ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1978-12-01 00:00:00
abstract:BACKGROUND:Thoracic aortic injuries have traditionally been associated with high morbidity and mortality. Thoracic endovascular aortic repair has emerged as a suitable alternative to open repair, but its impact at a national level remains ill defined. This study aimed to analyze the national trends of patient character...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2018.04.015
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Secondary hyperparathyroidism (SHPT) and its associated abnormalities in mineral metabolism increase the risk of cardiovascular morbidity and death in chronic renal failure (CRF). The effect of parathyroidectomy (PTX) on the incidence of major cardiovascular events in CRF patients with SHPT is unknown. We te...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2007.06.015
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:The nonparenchymal cells (NPC) of the liver have strong cytotoxic activity. Our hypothesis is that their activity may be imparted by obstructive jaundice and show recovery after biliary drainage. METHODS:In Donryu rats, we performed either a sham operation (group C; n = 5), production of irreversible obstru...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1999-11-01 00:00:00
abstract::The role of splenectomy in the management of immune thrombocytopenia purpura is well known. Recent improvements in laparoscopic technology have significantly expanded the variety of general surgical procedures amenable to a minimally invasive approach. An initial experience of four cases of immune thrombocytopenic pur...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:The Michigan Surgical Home and Optimization Program is a structured, home-based, preoperative training program targeting physical, nutritional, and psychological guidance. The purpose of this study was to determine if participation in this program was associated with reduced hospital duration of stay and hea...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2016.12.021
更新日期:2017-06-01 00:00:00
abstract::Dr McCarthy is a fellow in cardiothoracic surgery at the University of Washington. During his general surgery training at Northwestern University, he completed a research fellowship in surgical innovation and obtained masters' degrees with a focus on health enterprise management, entrepreneurship, and innovation. ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2016.08.035
更新日期:2017-04-01 00:00:00
abstract::Percutaneous drainage (PCD) of abdominal infection is a therapeutic modality whose role is not well defined. Surgical literature on abdominal infection cites a cumulative mortality rate in the range of 20% to 30%, markedly dissimilar from the 80% to 90% cure rates reported in the literature on PCD. We reviewed the PCD...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1984-10-01 00:00:00
abstract:BACKGROUND:Despite the emphasis on medical error as a major cause of hospital morbidity and mortality, there has been little published work on errors committed by trainees. This issue is particularly relevant to the training of surgeons and was addressed by our study. METHODS:Sixty simulated laparoscopic cholecystecto...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2005.02.014
更新日期:2005-07-01 00:00:00
abstract::During the 23-year period from January 1959 to February 1982, 142 patients (78 men and 64 women) underwent arterial reconstructive operations for obstruction of the brachiocephalic arteries. A single vessel was involved in 75% and multiple vessels were involved in 25% of the cases. Distal involvement of internal carot...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00
abstract:BACKGROUND:The experience at Loyola University Chicago was retrospectively reviewed to evaluate survival and functional outcome after single lung transplantation (SLT) and bilateral lung transplantation (BLT). METHODS:Ninety patients underwent lung transplantation at Loyola University Chicago between April 1990 and De...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:The role of routine prophylactic central-neck lymph node dissection (CLND) for papillary thyroid cancer (PTC) remains controversial. We perform CLND for PTC only in patients with enlarged nodes as determined by preoperative ultrasound and intraoperative inspection and palpation. METHODS:We identified all pa...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2010.03.021
更新日期:2010-08-01 00:00:00
abstract::A case of abdominal aortic aneurysm associated with renovascular hypertension in a 3-year-old boy is reported. The child was treated by resection of the aneurysm and replacement with a 12 mm polyester (Dacron) bifurcated graft. The cause of the aneurysm was not revealed by clinical and pathologic examination. In addit...
journal_title:Surgery
pub_type: 杂志文章,评审
doi:
更新日期:1989-09-01 00:00:00