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  • 1
    Electronic Resource
    Electronic Resource
    Gelatinase A and Membrane-type 1 Matrix Metalloproteinase mRNA: Expressed in Adrenocortical Cancers but Not in Adenomas (1999)
    Springer
    World journal of surgery 23 (1999), S. 237-242 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00013183
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  • 2
    Electronic Resource
    Electronic Resource
    Clinical course of metastatic parathyroid cancer (1994)
    Springer
    World journal of surgery 18 (1994), S. 594-598 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Dans une étude rétrospective, l'évolution clinique de 40 patients, ayant un cancer de la parathyroïde symptomatique persistant ou récidivant, a été analysée pour évaluer la valeur d'une attitude chirurgicale agressive. La récidive a été mise en évidence après une médiane de 33 (1–228) mois. Vingt-et-un patients avaient une maladie locorégionale alors que 14 avaient à la fois une extension locale et à distance. Les quatre autres patients avaient des métastasees à distance. Les patients avec une extension locorégionale ont eu entre 1 et 9 réinterventions. La médiane de survie à partir de la dernière intervention était de 39 (1–204) mois. Huit patients n'avaient aucune évidence de maladie, trois étaient hypercalcémiques, et 9/11 avaient un cancer de la parathyroïde. Une extension à distance a été retrouvée chez 17 des 40 patients, essentiellement pulmonaires (14/17). Une exérèse chirurgicale a été réalisée dans 9/14 cas. Parmi ceux-là, deux patients out eu un intervalle libre de maladie respectivement de 36 et 72 mois. Un patient était hypercalcémique après 84 mois alors que cinq patients sont décédés de leur cancer entre 4 et 60 mois après leur dernière intervention chirurgicale. Un patient a été perdu de vue. En tout, 21 patients (53%) sont décédés d'un cancer de la parathyroïde. Des atypies nucléaires et des mitoses fréquentes prédominaient. L'analyse d'ADN par cytométrie de flux a montré un taux élevé pour les trois groupes (médiane p 90=80%) (extrêmes: 21–98%). L'évolution de cancer parathyroïde métastatique est variable, et la récidive tardive peut toujours se voir. Des métastases à distance concomitantes peuvent être anticipées en cas d'hypercalcémie persistente. Le poumon est la localisation la plus fréquente, et la métastasectomie est généralement faisable.
    Abstract: Resumen En un estudio retrospectivo se analizó la evolución clínica de 40 pacientes con cáncer paratiroideo sintomáticamente persistente o recidivante, con el propósito de definir el valor de la intervención quirúrgica agresiva. La recidiva fue diagnosticada luego de un intervalo de tiempo promedio de 33 meses (1–228). Veintidos pacientes presentaban enfermedad local-regional y 14 presentaban tanto enfermedad local como extensión a distancia; los 4 pacientes restantes presentaban extensión a distancia. Los pacientes que sólo tenían enfermedad local-regional fueron sometidos a 1–9 procedimientos reoperatorios. El tiempo promedio de sobrevida desde la última operación fue 39 meses (1–204). Para entonces ocho pacientes se hallaban libres de enfermedad, tres aparecían hipercalcémicos y 9–11 habían muerto por cáncer paratiroideo; en 17/40 se demostró extensión a distancia, con predominio de las metástasis pulmonares (14/17). Se practicó resección quirúrgica en 9/14 casos, de los cuales dos tuvieron un ulterior intervalo libre de enfermedad de 36+ y 72+ meses, respectivamente. Un paciente fue hallado hipercalcémico luego de 84 meses y cinco habían muerto por cáncer a los 4–60 meses luego de su última exploración quirúrgica; se perdió un paciente para seguimiento. En total 21 pacientes (53%) murieron por cáncer paratiroideo. Se registró predominio de conspícua atipía nuclear y de mitosis frecuentes. El análisis citométrico de ADN mostró altas tasas para los tres grupos (media p90=80%, rango 21–98). La evolución del cáncer paratiroideo metastásico es variable, y se puede presentar la recidivia tardía. En los pacientes con hipercalamia persistente se puede predecir la existencia de metástasis a distancia, con el pulmón como el lugar de más frecuente ubicación. Su resección puede significar beneficio para los pacientes que las albergan.
    Notes: Abstract In a retrospective study the clinical course of 40 patients with symptomatic persistent or recurrent parathyroid cancer was analyzed in order to assess the value of aggressive surgical intervention. Recurrence was diagnosed after a median period of 33 months (1–228 months). Twenty-two patients had locoregional disease, whereas 14 patients had both local and distant spread. The remaining four patients had distant spread. Patients with just locoregional disease were subject to one to nine reoperative procedures. The median survival time from the last operation was 39 months (1–204 months). Eight patients then had no evidence of disease, three were hypercalemic and 9 of 11 had died of parathyroid cancer. Distant spread was demonstrated in 17 of 40 patients. Pulmonary metastases predominated (14 of 17). Surgical excision was performed in 9 of 14 cases. Of these nine, two patients had a subsequent disease-free interval of 36+ and 72+ months, respectively. One patient was reported hypercalcemic after 84 months, whereas five patients died of cancer between 4 and 60 months after their last surgical exploration. One patient was lost to follow-up. In all, 21 patients (53%) died of parathyroid cancer. Conspicuous nuclear atypia and frequent mitoses predominated. Image cytometric DNA analysis showed high rates for all three groups (median p90=80%, range 21–98%).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00353773
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  • 3
    Electronic Resource
    Electronic Resource
    Evaluation of Retinoblastoma and Ki-67 Immunostaining as Diagnostic Markers of Benign and Malignant Parathyroid Disease (1999)
    Springer
    World journal of surgery 23 (1999), S. 68-74 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Assessment of the malignant potential of parathyroid tumors in the absence of metastases can be difficult using morphologic criteria alone. In this study we have examined a total of 58 parathyroid tumors (31 benign, 15 malignant, and 12 equivocal) from 54 patients using immunohistochemistry with monoclonal antibodies directed against the retinoblastoma (RB) protein and the cell cycle-associated antigen Ki-67 to evaluate their role as diagnostic markers. RB protein immunoreactivity was not useful for distinguishing between benign and malignant parathyroid tumors. Analysis of the proliferation marker Ki-67 showed that there was a trend toward more intense staining in the malignant cases. The Ki-67 labeling index was highest in the parathyroid cancers (median 33) and lowest in the sporadic primary adenomas (median 2). An observation that might have clinical implications is that tumors from patients with familial hyperparathyroidism linked to chromosome 1q showed a high Ki-67 index, indicating strong proliferative activity (median 25). This correlates well with the clinical observation of tumors with malignant potential in this syndrome. Because of the considerable overlap between groups of tumors, Ki-67 is not suitable for definitive differentiation between benign and malignant tumors. However, Ki-67 may give valuable information about which patients should be followed more closely. RID="" ID="" 〈E5〉Correspondence to:〈/E5〉 F. Farnebo, M.D., Ph.D.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002689900567
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  • 4
    Electronic Resource
    Electronic Resource
    Cervical exploration for suspected primary hyperparathyroidism in renal stone formers: A challenge to the surgeon (1988)
    Springer
    World journal of surgery 12 (1988), S. 534-536 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé L'analyse rétrospective de 579 patients opérés d'hyperparathyroïdisme primitif a montré que, chez les patients mâles, ceux qui présentaient une lithiase urinaire comparés à ceux qui n'en présentaient pas, étaient plus jeunes, avaient une hypercalcémie moindre, des symptômes neuromusculaires moins nombreux et une fréquence d'hyperplasie plus élevée ou pas de lésion parathyroïde. En revanche, chez les femmes, avec ou sans lithiase urinaire, il n'y avit pas de différence significative selon l'âge, le degré d'hypercalcémie ou les symptômes préopératoires. Mais, comme chez les hommes, la fréquence de l'hyperplasie était plus grande chez les femmes lithiasiques que chez celles qui ne l'étaient pas. Nous concluons qu'à l'exploration cervicale pour hyperparathyroïdisme, les femmes posent autant de problèmes que les hommes.
    Abstract: Resumen Un análisis retrospectivo de 579 pacientes operados por probable hiperparatiroidismo primario muestra que el hombre formador de cálculos es más joven, exhibe menor hipercalcemia, menos síntomas neuromusculares, y una mayor frecuencia de hiperplasia paratiroidea o de hallazgos normales que aquellos libres de cálculos. Por el contrario, las mujeres formadoras de cálculos no difieren de las libres de cálculos en cuanto a edad, grado de hipercalcemia, o síntomas preoperatorios, pero al igual que los hombres formadores de cálculos ellas exhiben una mayor frecuencia de hiperplasia. Esto quiere decir que tanto la mujer como el hombre presentan problemas especiales en cuanto a la exploración cervical en probable hiperparatiroidismo primario en pacientes formadores de cálculos.
    Notes: Abstract A retrospective analysis of 579 patients operated on for suspected primary hyperparathyroidism (PHPT) shows that male stone formers are younger, have less hypercalcemia, fewer neuromuscular symptoms, and a higher frequency of parathyroid hyperplasia or normal findings than men without renal stones. On the other hand, female stone formers do not differ from female patients without renal stones with regard to age, degree of hypercalcemia, or preoperative symptoms, but, like the male stone formers, they have a higher frequency of hyperplasia. This circumstance means that female as well as male patients present special problems at cervical exploration.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01655443
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  • 5
    Electronic Resource
    Electronic Resource
    Prognostic factors in parathyroid cancer: A review of 95 cases (1992)
    Springer
    World journal of surgery 16 (1992), S. 724-731 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé L'évolution de 95 patients atteints de cancer des parathyroïdes (PT) a été évaluée dans une étude internationale. L'anatomie pathologique a été ré-évaluée et les caractères de distribution de l'ADN analysés. Le suivi médian était de 6 ans (1–25 ans). Un diagnostic de bénignité avait été porté lors de la première intervention chez 18 patients. L'intervention initiale consistait en une résection tumorale (RT) chez 42 patients et RT+hémi ou thyroïdectomie totale chez 40 patients. Quarante patients ont présenté une récidive. Trente six parmi eux ont eu entre 1 et 9 réinterventions. Récidives cervicales et métastases pulmonaires étaient les plus fréquentes des récidives. Le temps médian entre la première intervention et la récidive était de 33 mois (extrêmes 1–228 mois). Vingt et un patients sont décédés du cancer PT après une médiane de suivi de 28 mois après la découverte de la premire récidive. La ré-évaluation anatomopathológique sans le biais des données cliniques a confirmé de façon certaine le cancer de PT par l'existence d'infiltration et/ou de métastases dans 41 cas. Cinquante quatre cas n'avaient plus ces critères mais présentaient des formes variées d'atypie cellulaire (cancer équivoque). La cytométrie a mis en évidence une tumeur aneuploïde dans 26/39 cas avec critères de cancer certains et seulement dans 13/52 cas avec cancers équivoques. Douze patients ayant des tumeurs aneuploïdes et sept avec des tumeurs euploïdes sont décèdés de cancer PT. Selon une analyse multifactorielle, les patients traités par chirurgie large (TR+thyroïdectomie uni ou bilatérale) avaient une survie plus longue et un intervalle sans rechute plus prolongé. Les autres facteurs importants pour la survie étaient l'âge et l'histologie et pour le délai de récidive, l'histologie le contenu en ADN du noyau aberrant. On peut conclure que l'histopathologie seule est incapable de confirmer le diagnostic de cancer en l'absence d'infiltration et/ou de métastases. Les récidives pouvant se produire tardivement, les patients devraient être suivis de près d'autant que les réinterventions chirurgicales répétées se sont avèrées bénéfiques.
    Abstract: Resumen La evolución de 95 pacientes con cáncer de la glándula paratiroides (CPT) fue analizada en un estudio internacional. Se revisó la histopatología y se analizaron los patrones de distribución de DNA. La media del periodo de seguimiento fue de 6 años (1–25). En dieciocho pacientes se hizo el diagnóstico de enfermedad benigna después de su primera operación. El procedimiento inicial consistió en resección del tumor en 42 pacientes y en resección del tumor+hemitiroidectomía o tiroidectomía total en 40 pacientes. Cuarenta pacientes desarrollaron enfermedad recurrente y 36 fueron sometidos a 1–9 reoperaciones. La recurrencia cervical y las metástasis pulmonares fueron los hallazgos más frecuentemente registrados. La media del intervalo entre la primera operación y la recurrencia fue de 33 meses (1–228). Veintiún pacientes murieron de CPT en un tiempo medio de 28 meses después del hallazgo de la primera recurrencia. La revision histopatológica, desprovista del sesgo de los datos clínicos, confirmó la presencia inequívoca de CPT, o sea la presencia de infiltración o de metastásis, en 41 casos. En cincuenta y cuatro casos hubo ausencia de tales criterios, pero se encontraron diversas formas de atipia (casos equívocos). La citometría de imagen demostró aneuploidia tumora en 26/39 casos con criterios definidos de cáncer, en comparación con 13/52 casos equívocos. Doce pacientes con tumores aneuploides y siete con tumores euploides murieron de CPT. En un análisis multivariable los pacientes tratados con cirugía extensa, o sea aquellos sometidos a resección del tumor + tiroidectomía uni o bilateral, exhibieron sobrevidad más prolongada y un periodo libre de recurrencia más largo. Otros factores de importancia en relación a la supervivencia fueron la edad y la histopatología, y la histopatología y un contenido nuclear aberrante de DNA en cuanto al tiempo de recurrencia. La conclusión es que la histopatología de por sí es incapaz de confirmar un diagnóstico de cáncer en ausencia de infiltración y/o metastásis. Los pacientes deben ser seguidos muy de cerca, por cuanto las metástasis pueden ocurrir tardíamente. Aún los procedimientos quirúrgicos repetidos han probado ser beneficiosos.
    Notes: Abstract The clinical course, histopathology, and tumor DNA distribution patterns were analyzed in 95 patients with parathyroid cancer. The median follow-up was 6 years (range 1–25 years). Eighteen patients received a benign diagnosis at their first operation. The initial procedure was tumor resection in 42 patients and tumor resection plus partial or total thyroidectomy in 40 patients. Forty patients developed recurrent disease and 36 patients underwent 1 to 9 re-operations. Cervical recurrence and lung metastases were most commonly encountered. The median time from the first operation to recurrence was 33 months (range 1–228 month). Twenty-one patients died of parathyroid cancer a median of 28 months following discovery of their first recurrence. The histopathological reevaluation confirmed unequivocal parathyroid cancer, i.e., infiltration and/or metastases, in 41 cases. Fifty-four cases lacked these criteria but showed various forms of atypia. Image cytometry demonstrated tumor aneuploidy in 26 of 39 cases with definite cancer by histological criteria, compared to the 13 of the 52 with equivocal histological diagnosis. Twelve patients with aneuploid tumors and 7 patients with euploid tumors died of parathyroid cancer. In a multivariate analysis, patients treated with extensive surgery, i.e., tumor resection and unilateral or bilateral thyroidectomy, had a longer survival and a longer relapse-free period. Other factors of importance for survival were age and histopathology. Histopathology and an aberrant nuclear DNA content were important factors for the time to recurrence. We conclude that histopathology alone is unable to confirm a cancer diagnosis in the absence of infiltration and/or metastases. Because recurrence may occur late, patients should be followed closely. Even repeated surgical interventions have proven beneficial.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02067369
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  • 6
    Electronic Resource
    Electronic Resource
    Differential loss of heterozygosity in familial, sporadic, and uremic hyperparathyroidism (1997)
    Springer
    Human genetics 〈Berlin〉 99 (1997), S. 342-349 
    Details
    ISSN: 1432-1203
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract Various genetic loci harboring oncogenes, tumor suppressor genes, and genes for calcium receptors have been implicated in the development of parathyroid tumors. We have carried out loss of heterozygosity (LOH) studies in chromosomes 1p, 1q, 3q, 6q, 11q, 13q, 15q, and X in a total of 89 benign parathyroid tumors. Of these, 28 were sporadic parathyroid adenomas from patients with no family history of the disease, 41 were secondary parathyroid tumors, 5 were from patients with a history of previous irradiation to the neck, 12 were from patients with a family history of hyperparathyroidism, and 3 were parathyroid tumors related to multiple endocrine neoplasia type 1 (MEN1). In addition, we determined the chromosomal localization of a second putative calcium-sensing receptor, CaS, for inclusion in the LOH studies. Based on analysis of somatic cell hybrids and fluorescent in situ hybridization to metaphase chromsomes, the gene for CaS was mapped to chromosomal region 2q21-q22. The following results were obtained from the LOH studies: (1) out of the 24 tumors that showed LOH, only 4 had more than one chromosomal region involved, (2) in the tumours from uremic patients, LOH of chromosome 3q was detected in a subset of the tumors, (3) LOH of the MEN1 region at 11q13 was the most common abnormality found in both MEN1-related and sporadic parathyroid tumours but was not a feature of the other forms of parathyroid tumors, (4) LOH in 1p and 6q was not as frequent as previously reported, and (5) tumor suppressor genes in 1q and X might have played a role, particularly on the X chromosome, in the case of familial parathyroid adenomas. We therefore conclude that the tumorigenesis of familial, sporadic, and uremic hyperparathyroidism involves different genetic triggers in a non-progressive pattern.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004390050369
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  • 7
    Electronic Resource
    Electronic Resource
    Brain tissue transplanted to the anterior chamber of the eye (1976)
    Springer
    Cell & tissue research 165 (1976), S. 157-170 
    Details
    ISSN: 1432-0878
    Keywords: Brain transplants ; Nerve growth ; Transmitter release ; Monoamines ; Presynaptic receptors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Summary Small pieces of fetal rat brain selected to contain a high number of noradrenaline (NA), dopamine (DA), or 5-hydroxytryptamine (5-HT) neuroblasts were transplanted to the anterior chamber of the eye of adult rats. The sympathetic ground plexus of the host iris was removed by superior cervical ganglionectomy so that transmitter mechanisms of the different central monoamine fibers innervating the iris could be selectively studied after intraocular maturation. Such irides, containing NA, DA, or 5-HT nerve terminals were incubated with radiolabelled transmitters and then stimulated by an electrical field while superfused, to investigate the spontaneous and stimulation-induced release of amine, both in drug-free buffer and buffer containing drugs acting on monoamine receptors. The central monoamine neurons of all three types were able to take up exogenous amines and release them upon stimulation by an electrical field, in much the same way as corresponding nerves in situ in slices of cerebral cortex (NA, 5-HT) or olfactory tubercle (DA). The α-adrenergic receptor blocking agent phentolamine increased the stimulation-induced release of 3H-NA from central NA fibers on the iris significantly. The dopamine receptor stimulating agent apomorphine decreased the stimulation-induced release of 3H-DA from central DA fibers on the iris. Pimozide, a DA receptor blocking drug tended to increase the 3H-DA release. The 5-HT receptor stimulating agent ergocornine tended to reduce the stimulation-induced release of 3H-5-HT from central 5-HT fibers on the iris. It was concluded that all three types of central monoamine nerve fibers develop essentially normal transmitter storage and release mechanisms also in an environment completely devoid of normal postsynaptic receptors. The drug experiments add strong support to the view that there are presynaptic monoamine receptors (“autoreceptors”) able to modulate transmitter release present on the monoamine nerve terminals.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00226656
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  • 8
    Electronic Resource
    Electronic Resource
    Histochemical demonstration of transmitter release from noradrenaline, dopamine and 5-hydroxytryptamine nerve terminals in field stimulated rat brain slices (1971)
    Springer
    Cell & tissue research 122 (1971), S. 503-519 
    Details
    ISSN: 1432-0878
    Keywords: Transmitter release ; Central nervous system ; Field stimulation ; Fluorescence ; Monoamine nerves
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Summary The effect of electrical field stimulation on noradrenaline (NA), dopamine (DA) and 5-hydroxytryptamine (5-HT) nerve terminals in rat brain slicesin vitro was investigated. Slices prepared from the cerebral cortex or the neostriatum were incubated in physiologic buffer for 30 min and then superfused by buffer and stimulated by an electrical field (biphasic pulses, 10 Hz, 12 mA, 2 ms) for various time periods. The effect of the stimulation was studied at the cellular level with the histochemical fluorescence technique of Falck and Hillarp. The transmitter overflow into the superfusing buffer caused by the stimulation was studied with isotope technique. Cerebral Cortex NA Nerve Terminals. Stimulation caused release of NA from cortical NA nerve terminals. Already after 2 min stimulation a slight decrease of the fluorescence intensity of the nerve terminals could be found. Stimulation for 15 to 30 min greatly reduced the fluorescence intensity. In slices preincubated with3H-NA the stimulation-induced overflow of tritium during 2 min stimulation was about 15% (i.e. 15% of the tissue tritium content was overflowing into the superfusing buffer in response to stimulation for 2 min). During prolonged stimulation there was a considerable decline of the tritium efflux. Cerebral Cortex 5-HT Nerve Terminals. The 5-HT-analogue 6-hydroxytryptamine (6-HT) which is readily taken up into 5-HT nerve terminals was used to permit good visualization of these nerve terminals. Uptake of 6-HT into cortical NA nerve terminals was prevented by preincubation with 6-hydroxydopamine (6-OH-DA) or protriptyline. Stimulation for 15 to 30 min reduced the fluorescence intensity of the 5-HT nerve terminals. In slices preincubated with3H-5-HT the stimulation-induced overflow of tritium during 2 min stimulation was about 5%. The tritium efflux slowly decreased during continuous stimulation. Neostriatal DA Nerve Terminals. In slices frozen directly after preparation an intense diffuse fluorescence could be seen. After incubation in drug-free buffer at 37° C the fluorescence was localized in the varicosities of the DA nerve terminals. The central parts of the slices almost completely lacked specific fluorescence, while the outer zones were brightly fluorescent. No clear reduction of the fluorescence intensity of the DA nerve terminals in the outer zone could be observed after stimulation for 30 min. In slices preincubated with3H-DA the stimulation-induced overflow of tritium during 2 min stimulation was about 2%. The tritium efflux slowly decreased during continuous stimulation. It is suggested that the differences in release between the various nerve terminal systems foundin vitro reflect differences in transmitter release occurringin vivo. The comparably high release of NA per impulse from the cortical NA nerve terminals implicate that the discharge rate of these neuronsin vivo is very low.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00936084
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