OBJECTIVE: To determine the usefulness of the rapid @entity461 ( @entity461 ) assay during venous localization for @entity459 (1 degrees HPTH). SUMMARY BACKGROUND DATA: Remedial exploration for persistent 1 degrees HPTH poses a significant challenge when noninvasive preoperative localization studies are negative. Based on experience with the intraoperative rapid @entity461 assay, this technique was extrapolated to the interventional radiology suite and generated near real-time data for the interventional radiologist employing on-site hormone analysis, with a 12-minute turnaround time from blood sampling to assay result. METHODS: Between November 1997 and July 2002, 446 @entity1 with 1 degrees HPTH were referred for treatment. Of these, 56 (12.5%) represented remedial @entity1 who had each undergone one or more previous cervical explorations. Noninvasive imaging studies were positive for or suggestive of localized disease in 49/56 (87.5%) of these @entity1 , who therefore proceeded directly to surgical exploration. Seven @entity1 with persistent 1 degrees HPTH and negative noninvasive studies underwent selective venous sampling employing a rapid @entity461 assay in the interventional suite. RESULTS: Venous localization demonstrated an apparent @entity461 gradient in six of the seven @entity1 . In three, a subtle gradient demonstrated in near real-time prompted additional sampling, which confirmed an unequivocal hormone gradient. In an additional case, the absence of a gradient on initial sampling prompted further sampling, which was positive. All of the @entity1 were explored, and in five of the six @entity1 with a positive @entity461 gradient, a @entity3243 (mean weight 636 +/- 196 mg) was resected from a location predicted by venous localization. In the sixth @entity1 with a positive gradient, parathyroid tissue was not identified; however, there was a significant fall in the intraoperative @entity461 values, and immediate postoperative and follow-up laboratory data at 1 month are indicative of a cure. In the one @entity1 with negative localization, abnormal parathyroid tissue could not be located during surgical exploration. CONCLUSIONS: The rapid @entity461 assay is a major adjunct for obtaining informative venous localization in @entity1 with persistent 1 degrees HPTH. This information is extremely helpful to the surgeon in this challenging group of @entity1 and resulted in a 100% cure rate when a venous gradient was demonstrated. The authors now employ this technique routinely in remedial @entity1 with negative noninvasive imaging studies.

Rapid XXXX analysis during venous localization.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity3243 :: ('MESH:D010282', 'Disease') :: ['parathyroid adenoma'] @entity459 :: ('MESH:D049950', 'Disease') :: ['primary hyperparathyroidism'] @entity461 :: ('5741', 'Gene') :: ['PTH', 'parathyroid hormone']
@entity461 :: (5741,Gene) :: ['parathyroid hormone']
