bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biochemical Effects from Treatment with Bisphosphonate and Surgery in Patients with Primary Hyperparathyroidism
Authors: Jansson Svante , Morgan Eric 
Published: November 2004

AbstractPatients with primary hyperparathyroidism (pHPT) are sometimes treated with bisphosphonates (BPs) as an alternative to surgery despite sparse documentation of the efficacy in this disorder. It is therefore of interest to study the biochemical effects from BPs in patients with pHPT. A series of 21 pHPT patients with serum calcium levels > 2.8 mmol/L were included. One month before surgery the patients underwent intravenous infusions of 30 to 40 mg pamidronate. Study parameters were total and ionized serum calcium, intact parathormone (PTH), alkaline phosphatase (ALP) and isoenzymes, creatinine, osteocalcin, 25‐OH vitamin D3, 1,25‐OH2 vitamin D3, urine calcium/creatinine, and osmolality. Registration of hypercalcemia‐related symptoms were done by questionnaire. After pamidronate there was a temporary reduction in serum calcium with a nadir at 6 to 10 days. Normalization of serum calcium was achieved only by surgery. Intact PTH rose after pamidronate, with a maximum on day 6. Urinary calcium excretion was reduced after both pamidronate and surgery. ALP was reduced 30 days after pamidronate and also after surgery. Serum osteocalcin was not influenced by pamidronate. No statistically significant differences in symptoms were reported after treatment. In conclusion, there was a short, limited calcium‐lowering effect from pamidronate in pHPT patients and a transient increase in PTH corresponding to the reduced calcium concentration. An obvious change in bone markers was found only after surgery. Treatment with BPs should not be considered an alternative to surgery, which is still the only method to cure patients with pHPT.
Multiple Endocrine Neoplasia 2B Syndrome due to Codon 918 Mutation: Clinical Manifestation and Course in Early and Late Onset Disease
Authors: Brauckhoff Michael , Gimm Oliver , Weiss Carl‐Ludwig , Ukkat Jörg , Sekulla Carsten , Brauckhoff Katrin , Thanh Phuong Nguyen , Dralle Henning 
Published: November 2004

AbstractMore than 50% of patients with typical MEN‐2B have a de novo M918T germline mutation of the RET protooncogene. However, even in typical MEN‐2B, extrathyroidal manifestations of MEN‐2B can be found to be differently expressed. We analyzed the clinical manifestation and course in 21 patients harboring a de novo RET M918T mutation. Mean age at MEN‐2B diagnosis was 14.2 years (range: 1–31 years). All patients had medullary thyroid carcinoma (MTC). At the time of syndrome diagnosis, oral manifestations (bumpy lips, ganglioneuroma), ocular manifestations (corneal fibers, conjunctivitis sicca), intestinal dysfunctions, musculoskeletal manifestations, and pheochromocytoma were found in 86%, 90%, 74%, 79%, and 19% of the patients, respectively. At the time of follow‐up examination, the symptoms were found at higher frequency. Severe intestinal manifestation was predominantly found in patients with prepubertal onset (≤ 12 years) of MTC (n = 4/10) compared with patients with late onset (> 12 years) of MTC (n = 0/11) (40% versus 0%; p = 0.019). Although biochemical cure was found only in four patients with early onset of MTC, the long‐term prognosis for patients with early onset of MTC was poorer than for patients presenting with late onset of MTC (p = 0.005). During mean follow‐up of 55.8 months (range: 3–161 months), seven patients (33%) died from MTC. In conclusion, whereas most typical MEN‐2B symptoms were found to be age‐related, severe intestinal manifestation was found to be predominantly expressed in patients with early onset of MTC. Furthermore, in patients with early onset of MTC who could not be biochemically cured, the long‐term prognosis was found to be worse than that of non‐cured patients with late onset of MTC, suggesting an additional pathological process in the younger subgroup reinforcing the very high transforming in vitro activity of the M918T RET mutation.
Results of Video‐assisted Parathyroidectomy: Single Institution’s Six‐year Experience
Authors: Miccoli Paolo , Berti Piero , Materazzi Gabriele , Massi Marco , Picone Antonella , Minuto Michele N. 
Published: November 2004

AbstractEndoscopic surgery for primary hyperparathyroidism (PHPT) started in 1996 with a parathyroidectomy performed by Michel Gagner. The technique we propose and have been using for 6 years is based on a unique central access and external retraction. From February 1997 to October 2003, 370 of 520 patients affected with PHPT (71%) underwent minimally invasive video‐assisted parathyroidectomy (MIVAP). There were 72 men and 298 women, with a mean age of 55.8 years. Twenty‐four patients (6.5%) of the 370 in this series underwent MIVAP under loco‐regional anesthesia, and the others had general anesthesia. Eleven patients were lost to follow‐up. Surgical cure of PHPT was achieved in 353 patients (98,3%), as confirmed by a median follow‐up of 35.1 months (range: 2–82 months). Video‐assisted exploration was successfully performed in 350 patients (94%). The mean operative time was 36.2 minutes. In 21 cases (5.6%) a concomitant procedure was performed: a thyroid lobectomy in 14 cases and a total thyroidectomy in 7 cases. Patients were generally discharged the day after surgery. Most of the patients (91%) were satisfied with the cosmetic result 6 or more months after the procedure. Complications developed in 14 cases: 10 cases (2.7%) of transient hypoparathyroidism 3 cases (0.8%) of definitive palsies of the recurrent nerve, and 1 case of postoperative bleeding (0.27%). After 6 years of experience, MIVAP appears to be as safe and curative as traditional surgery, with better cosmetic results and better postoperative outcome.
Technetium‐99m 2‐Methoxyisobutyl isonitrile‐scintigraphy: Preoperative and Intraoperative Guidance for Primary Hyperparathyroidism
Authors: Farley David R. 
Published: November 2004

AbstractAs refinement of technetium‐99m 2‐methoxyisobutyl isonitrile‐scintigraphy (MIBI)‐scintigraphy of parathyroid glands has continued since its initial use in 1989, the sensitivity, specificity, and overall accuracy of the technique have improved greatly, approaching 100% for larger, solitary adenomas. Preoperative use of sestamibi scintigraphy has become commonplace and allows surgeons the option of a minimally invasive, or focused approach for their patients with primary hyperparathyroidism. Intraoperative use of the gamma probe based on sestamibi localization has not caught on due to lesser accuracy, cumbersome gamma probes, small doses of radiation exposure for patients and staff, and the greater accuracy and current confidence in intraoperative parathormone (PTH) monitoring. However, with the potential for smaller and more accurate gamma probes that truly assist in localizing abnormal parathyroid glands, the potential for cost reduction by shortening operative times, avoiding expensive PTH assays, and eliminating the need for pathologic analysis, gamma scintigraphy may yet become a viable option for many parathyroid surgeons.
Timing and Extent of Surgery in Patients with Familial Medullary Thyroid Carcinoma/Multiple Endocrine Neoplasia 2A‐related RET Mutations Not Affecting Codon 634
Authors: Gimm Oliver , Ukkat Jörg , Niederle Barbara E. , Weber Theresa , Thanh Phuong Nguyen , Brauckhoff Michael , Niederle Bruno , Dralle Henning 
Published: November 2004

AbstractIn hereditary medullary thyroid carcinoma (MTC), recommendations regarding timing and extent of surgery are mainly based on the data of patients with the codon 634 RET mutation, which is the most often affected codon. Little is known about whether these recommendations may also be applied to patients with less common RET mutations. We ascertained the data from 140 patients with FMTC/MEN2A‐related RET mutation not affecting codon 634 who have been treated at three specialized centers. The several RET mutations found affected codons 611 (n = 17), 618 (n = 22), 620 (n = 17), 768 (n = 9), 790 (n = 24), 791 (n = 21), 804 (n = 23), and 891 (n = 7). For each codon, the age of the youngest patient with MTC only (41, 7, 18, 29, 13, 47, 20, and 15 years, respectively), MTC with lymph node metastases (46, 24, 21, 34, 46, 47, 50, and 76 years, respectively), and MTC with distant metastases (52, 69, 43, 68, 57, ‐, ‐, and 75 years, respectively) was determined. All patients with lymph node metastases had elevated basal calcitonin levels. Based on these data, a more individual recommendation regarding timing and extent of surgery can be given. Because neither gender nor the type of nucleotide substitution for a specific codon appeared to have a significant influence on the age of onset, this recommendation should be based on the affected codon, the age of the patient, and the calcitonin level. Recurrent laryngeal nerve palsy (n = 6) and hypoparathyroidism (n = 3) were rather rare and were found only in patients older than 30 and 43 years, respectively, giving evidence that surgery in young patients can be performed safely.
Intraoperative Parathyroid Hormone Monitoring
Authors: Inabnet William B. 
Published: November 2004

AbstractThe principles of minimally invasive parathyroidectomy include the successful preoperative localization of a solitary adenoma, a targeted operative approach that does not disturb the normal parathyroid glands, and intraoperative confirmation of excision of all hypersecreting parathyroid tissue. By providing real‐time feedback to the surgical team, the rapid PTH assay allows surgeons to assess the completeness of parathyroid resection without visualizing all the parathyroid glands. Intraoperative PTH monitoring facilitates the use of local anesthesia, decreases the duration of surgery, and allows ambulatory surgery in most patients. This article reviews current recommendations and controversies surrounding the use of intraoperative PTH monitoring during parathyroidectomy.
Current Concepts in Functioning Endocrine Tumors of the Pancreas
Authors: Proye Charles A.G. , Lokey Jonathan S. 
Published: November 2004

AbstractDuodenal and pancreatic endocrine tumors are uncommon and their surgical treatment is often difficult. The management of these tumors has changed with recent advancements in tumor localization, intraoperative hormone measurements, standardized surgical techniques, and a better understanding of the genetic basis of multiple endocrine neoplasia syndrome. We present our experience with 191 endocrine tumors and elaborate the contemporary management of functioning duodenopancreatic endocrine tumors.
Differentiated Operative Strategy in Minimally invasive, Video‐assisted Thyroid Surgery Results in 196 Patients
Authors: Schabram Jochen , Vorländer Christian , Wahl Robert A. 
Published: November 2004

AbstractTo date, experience in minimally invasive thyroid surgery has been limited to unilateral lobectomy and total thyroidectomy. There are no reports regarding selective operative strategy, guided by morphology and function, which is widely accepted in endemic goiter regions. To analyze the efficiency and outcome of tissue‐preserving thyroid surgery using a minimally invasive video‐assisted technique (MIVA‐T), a total of 196 patients were operated on for thyroid nodules between February 1999 and October 2003. Concurrent primary hyperthyroidism was treated in 22 (11%) cases. Indications for operation were solitary, multiple unilateral, or bilateral nodules with a maximum diameter of 30 mm and a maximum lobe volume of 15 ml. Contraindications for minimally invasive operation were thyroid malignancy diagnosed by fine‐needle aspiration (FNA), recurrent goiter, and Hashimoto’s thyroiditis. Nodule excision was performed in 6% of these cases; subtotal lobectomy, in 6%; selective resection, in 48%; and total lobectomy, in 39%. Histological examination revealed follicular adenoma in 82%, colloid and cystic lesions in 11%, thyroiditis in 1%, and differentiated thyroid carcinoma in 6%. Conversion to open surgery was necessary in 7.7% of the patients (secondary to malignancy demonstrated on frozen section in 3% and to technical difficulties in 4.7%). Transient and permanent laryngeal nerve palsy occurred in 2.0% and 0.5% of patients, respectively. Temporary hypoparathyroidism occurred in 5.6% of patients exclusively after conversion to open total thyroidectomy or in those patients (n = 22) with additional primary hyperparathyroidism. Given a correct indication, MIVA‐T technique can be performed with low conversion and complication rates. Selective operative strategy, guided by morphology and thyroid function, with a variety of operative procedures fitting the individual situation may be performed by this minimally invasive technique.
FADD and its Phosphorylation
Authors: Zhang Jing , Zhang Dapeng , Hua Zichun 
Published: November 2004

AbstractThe adaptor protein FADD is essential for apoptosis induced by 'death receptors', mediating aggregation and autocatalytic activation of caspase‐8. Surprisingly, FADD is also involved in regulating T and B cell development. Accumulating evidences now suggest that FADD and its phosphorylation have additional roles in controlling pathways of cellular activation and proliferation, while the kinase modifying FADD phosphorylation is still unidentified. The cellular localization of FADD may also contribute to define FADD's role in apoptosis or proliferation. FADD may be a pivotal molecule which coupling the opposite cell processes of proliferation and apoptosis. FADD, probably modulated by phosphorylation, may function as a 'cell renewal set point' co‐regulating proliferation and apoptosis in parallel. IUBMB Life, 56: 395‐401, 2004
The Central Role of Perilipin A in Lipid Metabolism and Adipocyte Lipolysis
Authors: Tansey John , Sztalryd Carole , Hlavin Erica , Kimmel Alan , Londos Constantine 
Published: November 2004

AbstractThe related disorders of obesity and diabetes are increasing to epidemic proportions. The role of neutral lipid storage and hydrolysis, and hence the adipocyte, is central to understanding this phenomenon. The adipocyte holds the major source of stored energy in the body in the form of triacylglycerols (TAG). It has been known for over 35 years that the breakdown of TAG and release of free (unesterified) fatty acids and glycerol from fat tissue can be regulated by a cAMP‐mediated process. However, beyond the initial signaling cascade, the mechanistic details of this lipolytic reaction have remained unclear. Work in recent years has revealed that both hormone‐sensitive lipase (HSL), generally thought to be the rate‐limiting enzyme, and perilipin, a lipid droplet surface protein, are required for optimal lipid storage and fatty acid release. There are multiple perilipin proteins encoded by mRNA splice variants of a single perilipin gene. The perilipin proteins are polyphosphorylated by protein kinase A and phosphorylation is necessary for translocation of HSL to the lipid droplet and enhanced lipolysis. Hence, the surface of the lipid storage droplet has emerged as a central site of regulation of lipolysis. This review will focus on adipocyte lipolysis with emphasis on hormone signal transduction, lipolytic enzymes, the lipid storage droplet, and fatty acid release from the adipocyte. IUBMB Life, 56: 379‐385, 2004
Pronator Quadratus Flap for Burn Reconstruction
Authors: Marshall M P. , Gutheil J P. 
Published: November 2004

Abstract
Full-thickness skin loss in the distal volar forearm presents a challenge to the burn surgeon. Two cases are presented in which a pronator quadratus muscle flap with split-thickness skin was used to cover the underlying tendons and nerves. The unique vascular perfusion makes this a useful and predictable transfer.
Gas Fireplace Contact Burns in Young Children
Authors: Zettel Julie C. , Khambalia Amina , Barden Wendy , Murthy Trisha , Macarthur Colin 
Published: November 2004

Abstract
Contact burns from domestic appliances are common in young children. Recently, gas fireplaces have been recognized as a potential cause of contact burns in young children. We sought to quantify the frequency of gas fireplace contact burns in young children, to identify the etiology of contact, to describe the clinical presentation, and to describe clinical outcomes. Children with gas fireplace contact burn injuries presenting to The Hospital for Sick Children in Toronto (1999–2002) were identified using three data sources: the Canadian Hospitals Injury Reporting and Prevention Program Database, the Burn Unit Registry, and the Rehabilitation Services Database. Demographic, clinical, and outcomes data were collected on all children. During the 4-year study period, 27 children presented to the hospital because of a gas fireplace contact burn (approximately 9% of all contact burns). The median age of the children was 14 months (range, 8–36 months), with 16 boys (59%). Most children were burned in their own home. With regard to etiology, 10 children (37%) lost their balance near the fireplace, 2 (7%) walked too close to the glass front, and 8 (30%) touched the glass front out of curiosity. Almost half (44%) of the children burned the palms and digits of both hands. The median total burn surface area was 1% (range, 0.2–2.5%). In total, 30% of children were admitted to hospital, and 11% required skin grafts. All children had full wound closure after 4 to 43 days. Given the etiology of these burns (loss of balance or curiosity), passive prevention, such as barriers or changes in the composition of glass panels, may be the most effective approach to combat them.
Circulating Leptin and Cortisol After Burn Injury: Loss of Diurnal Pattern
Authors: Hobson Kristina G. , Havel Peter J. , McMurtry Addison L. , Lawless Mary Beth , Palmieri Tina L. , Greenhalgh David D. 
Published: November 2004

Abstract
Leptin, a hormone involved in appetite and metabolic energy expenditure, could have a role in the reduced appetite and/or energy expenditure after burn injury. In this study, the diurnal pattern of circulating leptin concentrations was compared with body mass index (BMI), sex, glucose, insulin, and the diurnal cortisol rhythm in burn patients. Plasma samples were collected at 12:00 pm and 02:00 am from severely burned adults and children. Circulating leptin, insulin, and cortisol were measured by radioimmunoassay. Results were compared with previously published data from healthy control subjects. Overall, plasma leptin levels were lower in burn patients (5.7 ± 1.2 ng/mL) compared with control subjects (10.5 ± 1.7 ng/mL, P = .02). The normal nocturnal increase of circulating leptin concentrations observed in control subjects was completely absent in burn patients. Cortisol levels were higher in burn patients (20.4 ± 1.0 mg/dL) than in control subjects (9.8 ± 1.6mg/dL, P &lt; .0001) and the normal circadian decrease of circulating cortisol levels was markedly blunted in burn patients. Plasma cortisol did not correlate with circulating leptin levels. Plasma insulin and plasma glucose levels were significantly elevated in burn patients and the insulin:glucose ratio was dramatically increased compared with control subjects. Patients with burn injuries exhibited significantly decreased circulating leptin levels. This decrease may be the result of marked insulin resistance, as suggested by the elevated insulin to glucose ratio in burn patients. The loss of the diurnal pattern in burn patients is likely to result from the continuous nutritional supplementation. Because low leptin levels should induce appetite, burn-related anorexia is probably controlled by other regulatory systems.
Electrical Injuries: A 20-Year Review
Authors: Arnoldo Brett D. , Purdue Gary F. , Kowalske Karen , Helm Phala A. , Burris Agnes , Hunt John L. 
Published: November 2004

Abstract
Electrical injuries continue to present problems with devastating complications and long-term socioeconomic impact. The purpose of this study is to review one institution's experience with electrical injuries. From 1982 to 2002, there were 700 electric injury admissions. A computerized burn registry was used for data collection and analysis. Of these injuries, 263 were high voltage (≥1000 V), 143 were low voltage (&lt;1000 V), 277 were electric arc flash burns, and 17 were lightning injuries. Mortality was highest in the lightning strikes (17.6%) compared with the high voltage (5.3%) and low voltage (2.8%) injuries, and mortality was least in electric arc injuries without passage of current through the patient (1.1%). Complications were most common in the high-voltage group. Mean length of stay was longest in this group (18.9 ± 1.4 days), and the patients in this group also required the most operations (3 ± 0.2). Work-related activity was responsible for the majority of these high-voltage injuries, with the most common occupations being linemen and electricians. These patients tended to be younger men in the prime of their working lives. Electrical injuries continue to make up an important subgroup of patients admitted to burn centers. High-voltage injuries in particular have far reaching social and economic impact largely because of the patient population at greatest risk, that is, younger men at the height of their earning potential. Injury prevention, although appropriate, remains difficult in this group because of occupation-related risk.
Telemedicine Follow-up of Burns: Lessons Learned from the First Thousand Visits
Authors: Nguyen Lan T. , Massman Nancy J. , Franzen Beth J. , Ahrenholz David H. , Sorensen Nicholas W. , Mohr William J. , Solem Lynn D. 
Published: November 2004

Abstract
Telemedicine is an evolving technology that is used for health education, health care administration, and health care distribution. The potential benefits of telemedicine include a decrease in travel expenses, improved continuity of care, and increased access to specialized consultants, thus meeting the needs of patients, practitioners, and communities. Telemedicine has many evolving applications, including improved access to health care in medically underserved and rural areas. Regions Burn Center assessed the efficacy and efficiency of burn visits via telemedicine and identified the barriers and benefits specific to burn care. Information regarding travel costs and financial data were evaluated from a total of 1000 burn follow-up visits with 294 patients via telemedicine during a 5-year interval. Our results indicate that telemedicine burn visits are a cost-effective clinical alternative for the patient. However, telemedicine can be a financial burden to health care systems and inefficient for health care providers.
The Use of Haloperidol and Associated Complications in the Agitated, Acutely Ill Pediatric Burn Patient
Authors: Ratcliff Stephen L. , Meyer Walter J. , Cuervo Luis J. , Villarreal Cynthia , Thomas Christopher R. , Herndon David N. 
Published: November 2004

Abstract
The use of haloperidol to induce sedation and control agitation in the acutely ill adult patient has been well documented. There are few reports, however, of the use of this neuroleptic agent to control the severe delirium and agitation that may occur in critically ill pediatric patients or acute pediatric patients suffering from burn wounds. We assessed the effectiveness and safety of the use of haloperidol by completing a retrospective chart review of 855 acutely ill children treated consecutively during the period from April 1999 to May 2002, during which time 26 children received haloperidol. The safe use of haloperidol was assessed by documenting any adverse effects or reactions observed after the administration of the drug. Of patients given haloperidol, 23% had adverse effects. This result suggests that the use of haloperidol to treat the acutely agitated and delirious pediatric burn patients is fraught with a number of difficulties and is not completely safe and effective.