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Primary hyperparathyroidism in patients with multiple endocrine neoplasia type 1: experience by a single surgical team in Japan. 多发1型内分泌肿瘤患者原发性甲状旁腺功能亢进:日本单一手术团队的经验
Henry Ford Hospital medical journal Pub Date : 1992-01-01
T Obara, Y Fujimoto, Y Ito
{"title":"Primary hyperparathyroidism in patients with multiple endocrine neoplasia type 1: experience by a single surgical team in Japan.","authors":"T Obara,&nbsp;Y Fujimoto,&nbsp;Y Ito","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Nineteen patients were surgically treated for hyperparathyroidism associated with multiple endocrine neoplasia type 1 syndrome. Fourteen patients (74%) had removal of three or more parathyroid glands at the first operation, and five (26%) by removal of 2 1/2 or fewer glands. Two patients had recurrent hypercalcemia during the mean follow-up period of 65 months. One had a recurrence 10 years after subtotal parathyroidectomy. Reexploration in this patient revealed enlargement of the remaining tissue in the neck and an enlarged supernumerary gland in the aorticopulmonary window. The other patient had persistent hypercalcemia after removal of two hyperplastic parathyroid glands until after another 1 1/2 more glands were removed. After reoperation the patient was normocalcemic for 10 years before hypercalcemia was again noticed. The patient subsequently died from renal carcinoma metastases, which might have been the cause of the hypercalcemia before death.</p>","PeriodicalId":12988,"journal":{"name":"Henry Ford Hospital medical journal","volume":"40 3-4","pages":"191-4"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12535767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
High-sensitivity serum calcitonin assays applied to screening for thyroid C-cell disease in multiple endocrine neoplasia type 2A. 高灵敏度血清降钙素测定在多发性内分泌肿瘤2A型甲状腺c细胞病筛查中的应用
Henry Ford Hospital medical journal Pub Date : 1992-01-01
M M Kaplan, G M Stall, T Cummings, A MacAulay, P Motté, H J Wolfe, S Reichlin, A H Tashjian
{"title":"High-sensitivity serum calcitonin assays applied to screening for thyroid C-cell disease in multiple endocrine neoplasia type 2A.","authors":"M M Kaplan,&nbsp;G M Stall,&nbsp;T Cummings,&nbsp;A MacAulay,&nbsp;P Motté,&nbsp;H J Wolfe,&nbsp;S Reichlin,&nbsp;A H Tashjian","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Unlabelled: </strong>Two serum calcitonin assays with sensitivities < or = 10 pg/mL were compared to our standard radioimmunoassay (sensitivity 100 pg/mL) in multiple endocrine neoplasia type 2A (MEN 2A) screening. Values from the Nichols displacement radioimmunoassay averaged 38% higher than values from the CIS immunoradiometric assay; values from both were highly correlated, r = 0.845. In three individuals, both of the newer assays revealed abnormalities in pentagastrin tests three to four years before abnormalities were detected by the standard assay. Pentagastrin tests after total thyroidectomy were assayed by the newer methods in patients with medullary thyroid carcinoma (MTC) diagnosed at initial testing (group I); in patients with early MTC diagnosed by prospective screening (group II); and in patients with pure C-cell hyperplasia detected by prospective screening (group III). At least 64% of group I, at least 25% of group II, but none of group III had detectable postoperative C-cell function.</p><p><strong>Conclusions: </strong>1) The previous estimate of 12 years as median age of onset of C-cell disease in MEN 2A is probably three to four years too old. 2) Patients diagnosed with early MTC by screening had not necessarily skipped a preneoplastic phase of C-cell hyperplasias. At least some early disease was not detected by the standard assay. Higher sensitivity assay should improve screening for C-cell disease by earlier disease detection. 3) Biochemical cure by thyroidectomy after the development of MTC is not as frequent as previously thought, but the apparent cure rate of pure C-cell hyperplasia remains 100%.</p>","PeriodicalId":12988,"journal":{"name":"Henry Ford Hospital medical journal","volume":"40 3-4","pages":"227-31"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12535691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Urban health and the social contract: poverty, race, and death. 城市健康和社会契约:贫穷、种族和死亡。
Henry Ford Hospital medical journal Pub Date : 1992-01-01
H J Geiger
{"title":"Urban health and the social contract: poverty, race, and death.","authors":"H J Geiger","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":12988,"journal":{"name":"Henry Ford Hospital medical journal","volume":"40 1-2","pages":"29-34"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12599712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Radical surgery in the treatment of localized carcinoma of the prostate. 根治性手术治疗局限性前列腺癌。
Henry Ford Hospital medical journal Pub Date : 1992-01-01
D J Telang, B J Miles, R N Farah, R H Littleton, A K Kirkemo, J O Peabody, D A Burks, C Fleming, J C Cerny
{"title":"Radical surgery in the treatment of localized carcinoma of the prostate.","authors":"D J Telang,&nbsp;B J Miles,&nbsp;R N Farah,&nbsp;R H Littleton,&nbsp;A K Kirkemo,&nbsp;J O Peabody,&nbsp;D A Burks,&nbsp;C Fleming,&nbsp;J C Cerny","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>New methods of early detection combined with recent advances in surgical techniques have resulted in more patients undergoing radical surgery for treatment of localized carcinoma of the prostate. Over 350 radical prostatectomies have been performed by our group since January 1987. We review the role of radical prostatectomy in the treatment of prostate cancer and our experience with 100 patients undergoing radical retropubic prostatectomy since the advent of nerve-sparing techniques to preserve potency.</p>","PeriodicalId":12988,"journal":{"name":"Henry Ford Hospital medical journal","volume":"40 1-2","pages":"108-10"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12599789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hyperparathyroidism with normal albumin-corrected total calcium in patients with multiple endocrine neoplasia type 1. 多发性内分泌肿瘤1型患者甲状旁腺功能亢进伴白蛋白校正总钙正常。
Henry Ford Hospital medical journal Pub Date : 1992-01-01
J J Shepherd, B T Teh, V Parameswaran, R David
{"title":"Hyperparathyroidism with normal albumin-corrected total calcium in patients with multiple endocrine neoplasia type 1.","authors":"J J Shepherd,&nbsp;B T Teh,&nbsp;V Parameswaran,&nbsp;R David","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the largest reported family of patients with multiple endocrine neoplasia type 1 (MEN 1), hyperparathyroidism was expressed at first screening in 33 patients by elevation of ionized calcium (IC) (30 cases) or parathyroid hormone (three cases) without elevation of albumin-corrected total calcium (ACTC). Three of these 33 patients have shown a progressive rise in IC and later an elevation of ACTC. However, the age distribution suggests that in others the level of IC may remain stable at a minimally elevated level throughout life with ACTC remaining normal except for transient rises at the times of intercurrent illness or surgical operation. Even when ACTC is normal preoperatively, patients with an elevation of IC require radical subtotal parathyroidectomy or total parathyroidectomy and forearm implantation to restore IC to a normal level. Institutions that rely on ACTC as a screening test for hyperparathyroidism in MEN 1 will miss the diagnosis in nearly half of patients under the age of 30. The greatest deficiency in using ACTC occurs in the follow-up of patients who have undergone parathyroidectomy for MEN 1. Only three of 11 recurrences were evidenced by this measurement.</p>","PeriodicalId":12988,"journal":{"name":"Henry Ford Hospital medical journal","volume":"40 3-4","pages":"186-90"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12535766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Unusual features of multiple endocrine neoplasia. 多发性内分泌瘤的不寻常特征。
Henry Ford Hospital medical journal Pub Date : 1992-01-01
A Frilling, H Becker, H D Roeher
{"title":"Unusual features of multiple endocrine neoplasia.","authors":"A Frilling,&nbsp;H Becker,&nbsp;H D Roeher","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In addition to the common presentations of the multiple endocrine neoplasia (MEN) syndromes, unusual organ involvement as rare manifestations of a single disease may occur. Among our patients we have identified four cases in which unusual features of MEN were present. In the first patient, bilateral adrenal cortical adenoma, parathyroid adenoma, multiple pancreatic tumors, and follicular thyroid carcinoma were observed. The second patient suffered from thymic carcinoid, parathyroid hyperplasia, gastrinoma, and pituitary adenoma. Additionally, one family was discovered in which medullary thyroid carcinoma (MTC), Hirschsprung's disease, and pheochromocytoma occurred and another family had MTC and ovarian cancer. Based on these observations, we stress the importance of screening for MEN syndromes in all patients with pathologic findings in any endocrine organ.</p>","PeriodicalId":12988,"journal":{"name":"Henry Ford Hospital medical journal","volume":"40 3-4","pages":"253-5"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12534944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The urban hospital: rediscovering abandoned values. 城市医院:重新发现被抛弃的价值。
Henry Ford Hospital medical journal Pub Date : 1992-01-01
T W Chapman
{"title":"The urban hospital: rediscovering abandoned values.","authors":"T W Chapman","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":12988,"journal":{"name":"Henry Ford Hospital medical journal","volume":"40 1-2","pages":"77-80"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12599625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PDN-21 (katacalcin) and chromogranin A: tumor markers for medullary thyroid carcinoma. PDN-21(片钙素)和嗜铬粒蛋白A:甲状腺髓样癌的肿瘤标志物。
Henry Ford Hospital medical journal Pub Date : 1992-01-01
F Raue, E Blind, A Grauer
{"title":"PDN-21 (katacalcin) and chromogranin A: tumor markers for medullary thyroid carcinoma.","authors":"F Raue,&nbsp;E Blind,&nbsp;A Grauer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The malignant C-cell releases several markers of potential clinical significance into the circulation. To determine the usefulness of these markers for management of medullary thyroid carcinoma (MTC), it is necessary to compare the usefulness of these markers with calcitonin (CT), the classical tumor marker for MTC. Measurement of serum concentrations of the peptide PDN-21 (katacalcin), a carboxyterminal cleavage product of procalcitonin, showed a high correlation with serum CT levels (r = 0.99, P < 0.01, n = 65 patients with MTC). The presence of equimolar concentrations of CT and PDN-21 (CT/PDN-21 molar ratio = 0.95 +/- 0.33) indicates the peptide is cosecreted with CT. Stimulation of CT release by intravenous pentagastrin was associated with a parallel increase of PDN-21, providing further evidence of cosecretion of these two peptides. Finally, measurement of either PDN-21 or CT in selective venous catheterization specimens was useful for localization of MTC. Chromogranin A (CgA) levels were also measured in patients with MTC. Circulating levels were elevated in most patients with advanced disease. There was a moderate correlation between CgA and CT serum levels (r = 0.87, P < 0.01, n = 61 patients with MTC). Pentagastrin did not stimulate CgA, and the long half-life of CgA in the circulation did not make it possible to use this peptide for tumor localization by selective venous catheterization. We conclude that measurement of PDN-21 provides an independent assay system for diagnosis, localization, and postoperative management of MTC, whereas CgA measurement is not useful in early diagnosis of MTC and is of limited value for localization or management of progressive disease.</p>","PeriodicalId":12988,"journal":{"name":"Henry Ford Hospital medical journal","volume":"40 3-4","pages":"296-8"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12655070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Expression of the ret proto-oncogene in human medullary thyroid carcinomas and pheochromocytomas of MEN 2A. ret原癌基因在人甲状腺髓样癌和嗜铬细胞瘤中的表达。
Henry Ford Hospital medical journal Pub Date : 1992-01-01
A Miya, M Yamamoto, H Morimoto, N Tanaka, E Shin, K Karakawa, K Toyoshima, Y Ishizaka, T Mori, S Takai
{"title":"Expression of the ret proto-oncogene in human medullary thyroid carcinomas and pheochromocytomas of MEN 2A.","authors":"A Miya,&nbsp;M Yamamoto,&nbsp;H Morimoto,&nbsp;N Tanaka,&nbsp;E Shin,&nbsp;K Karakawa,&nbsp;K Toyoshima,&nbsp;Y Ishizaka,&nbsp;T Mori,&nbsp;S Takai","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We studied the expression of the ret proto-oncogene (proto-ret) in human medullary thyroid carcinomas (MTCs) and pheochromocytomas of multiple endocrine neoplasia type 2A (MEN 2A) by Northern blot analysis. Expression of the normal-sized transcripts was detected in all 12 MTCs and in 6 of 8 pheochromocytomas. In situ localization of proto-ret mRNA revealed that the signal was confined to the cytoplasm of MTC cells. By Southern blot analysis neither amplification nor gross genetic changes of proto-ret were found in the tumors. Although no transcripts were detected in the normal portion of the thyroid from one MEN 2A patient, faint signals were detected in normal adrenal glands by Northern blot analysis, probably due to minor populations of C-cells and chromaffin cells in specimens from which MTC and pheochromocytoma might later develop. Proto-ret may play an important role in differentiation of a specific cell lineage from neuroectoderm, and it may be involved in development of MEN 2A tumors.</p>","PeriodicalId":12988,"journal":{"name":"Henry Ford Hospital medical journal","volume":"40 3-4","pages":"215-9"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12535688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Federal, state, and local partnerships in providing primary care: one urban health department's endeavor with a state university medical center. 联邦、州和地方在提供初级保健方面的合作:一个城市卫生部门与州立大学医疗中心的合作。
Henry Ford Hospital medical journal Pub Date : 1992-01-01
J L Getzenberg, D P Lenihan
{"title":"Federal, state, and local partnerships in providing primary care: one urban health department's endeavor with a state university medical center.","authors":"J L Getzenberg,&nbsp;D P Lenihan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We describe how the federal government, the City of Chicago, and the State of Illinois worked together to increase the availability and accessibility of health care services on Chicago's underserved west side by reopening a bankrupt, federally-funded community health center. The federal government made the building available to the City which then contracted with a state university medical center to be the provider of services. This partnering has allowed the Chicago Department of Health to offer services in a previously underserved area. The University has gained an opportunity for community-based primary care teaching, as well as community relations. Patients have increased access to a wide variety of specialty and inpatient care. If public health providers are to be successful in this financial climate, they must look to new partners and new ways of delivering services to increase availability of services at a time when they are greatly needed.</p>","PeriodicalId":12988,"journal":{"name":"Henry Ford Hospital medical journal","volume":"40 1-2","pages":"13-5"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12599795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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