A five year audit of the role of parathyroid hormone assays and thallium-technetium isotope subtraction scanning in the preoperative investigation of primary hyperparathyroidism.

An audit has been performed of the value of parathyroid hormone assays and thallium-technetium isotope scanning in the pre-operative investigation of 67 hypercalcaemic patients referred for surgery over a 5 year period. Parathyroid hormone assay by region-specific technique was found to have a diagnostic sensitivity of 75% (n = 52) whilst the more recent assay for the intact molecule was 97% sensitive (n = 34). Thallium-technetium isotope scanning was only 64% sensitive overall (n = 59), due in part to the small size of adenomata now being referred for surgery.

Synthesis and characterization of inhibitors of myristoyl-CoA:protein N-myristoyltransferase.

Several substrate and product analogs were synthesized and tested as in vitro inhibitors of bovine brain N-myristoyl-CoA:protein N-myristoyltransferase (NMT; EC 2.3.1.

[Infiltrating transitional carcinoma of the bladder (I). Comparison of 2 groups treated with preoperative radiotherapy (long-term protocol and short-term protocol) + radical cystectomy versus radical cystectomy only. Analysis of local recurrence and metastasis].

We analyze our experience in 175 patients with transitional bladder cancer for whom radical cystectomy was indicated. Patients were divided into three groups: one group was managed with radical cystectomy only and the other two with pre-operative radiotherapy: long-term approach and short-term approach. No significant differences have been observed when comparing current survival rate and disease-free intervals of all three groups.

Comparison of fine needle aspiration cytology, radioisotopic and ultrasound scanning in the management of thyroid nodules.

In 175 patients presenting with thyroid nodules, the diagnostic value in management of fine needle aspiration and cytology (FNAC), pertechnetate (99mTc) scanning and ultrasound imaging was examined. In 82 patients, the diagnosis was confirmed at operation; in the remaining 93, there was a follow-up period of at least 2 years. Thyroid cancer was found in 13 patients.

[Primary necrotizing cellulitis of the scrotum in a diabetic patient].

Necrosing infections of subcutaneous cell tissue are uncommon processes which constitute a diagnostic and therapeutic vital emergency. Generally secondary to anorectal or genitourinary processes, a small percentage of these infections have no apparent cause. This paper presents one case of primary necrosing cellulitis in a diabetic patient.

Skeletal blood flow, iliac histomorphometry, and strontium kinetics in osteoporosis: a relationship between blood flow and corrected apposition rate.

In 20 untreated patients with idiopathic or postmenopausal osteoporosis, kinetic studies of skeletal blood flow (using 18F) and bone turnover (using 85Sr) were combined with dynamic histomorphometry performed on transiliac biopsies taken within 6 weeks of each other. In 8 patients the combined studies were repeated after treatment. A further 5 patients were studied only while receiving treatment.

Hyperthyroidism and thyroid cancer.

Ten of 502 patients presenting with thyroid cancer were hyperthyroid due to Graves' disease (4 patients), multinodular goitre (3), an autonomous functioning nodule (1) and a large functioning tumour (2). In addition eight patients had a past history of Graves' disease and four of hyperthyroidism associated with multinodular goitre. Mortality in patients with Graves' disease and with multinodular goitre appeared similar to that of other patients of comparable age.

The assessment of bone formation and bone resorption in osteoporosis: a comparison between tetracycline-based iliac histomorphometry and whole body 85Sr kinetics.

Bone formation and resorption have been measured in patients with idiopathic osteoporosis by histomorphometry of 7.5-mm trephine biopsies and in the whole body by 85Sr radiotracer methodology and calcium balances. The studies were synchronized and most were preceded by double in vivo tetracycline labeling.

Periodic courses of human 1-34 parathyroid peptide alternating with calcitriol paradoxically reduce bone remodelling in spinal osteoporosis.

In an attempt to achieve an anabolic response in both axial and peripheral bone, we treated twelve patients with osteoporosis using human 1-34 parathyroid peptide given discontinuously. The peptide was given as seven daily subcutaneous injections followed by 21 days' treatment with 0.25 mg calcitriol orally.

Estimation of whole body bone resorption rate: a comparison of urinary total hydroxyproline excretion with two radioisotopic tracer methods in osteoporosis.

In 37 female patients with primary osteoporosis, urinary hydroxyproline excretion, determined in 18 24-h consecutive complete urine collections was compared with two radioisotopic measurements of bone resorption rate measured simultaneously using 85Sr. A somewhat better fit was obtained when the kinetically determined bone resorption rate was corrected for long-term exchange processes within bone. Regression analysis showed that the intercept of the regression of hydroxyproline excretion on resorption rate, corrected or uncorrected for exchange, was significantly higher than zero at about 100 mumol/day.

Trabecular and cortical bone in the radii of women with parathyroid adenomata: a greater trabecular deficit, with a preliminary assessment of recovery after parathyroidectomy.

Radial bone mineral content (BMC) has been reported to be lower than normal in patients with hyperparathyroidism, but those measurements have been made with techniques which do not discriminate between trabecular and cortical bone. We have used a low radiation dose computed tomography technique to make differential measurements of trabecular and cortical bone in the radii of 18 out of 27 eligible female patients with surgically proven adenomata. Prior to parathyroidectomy there was a mean deficit of 40% (P less than 0.

Skeletal blood flow in metabolic disorders of the skeleton.

Results are presented of measurements of skeletal blood flow made in 80 patients with painful benign or malignant diseases of the skeleton, excluding patients with Paget's disease. In crush fracture osteoporosis, total bone blood flow was slightly lower than normal although skeletal perfusion was normal. High values of bone blood flow were seen in 14/20 patients with osteomalacia and 3/12 patients with primary hyperparathyroidism.

In-vivo studies of a human-thyrotrophin preparation.

The effects on thyroid function of a new preparation of human thyrotrophin (hTSH) were studied in four subjects whose endogenous production of TSH had been suppressed by administration of thyroxine (T4). The hTSH, prepared from human cadaveric pituitary glands and highly purified using a monoclonal antibody technique, was given as an intravenous bolus of 2 i.u.

Radiation-induced osteochondroma-like lesion in young rat radius.

To investigate the effects of radiation on the perichondrial groove of Ranvier in osteochondroma development, the external surface of the distal growth plate of the radius in both forelimbs of 30 ten-day-old rats was exposed to a single low dose of radiation (150 r), which was focused on the perichondrial groove. This induced the formation of a chondrocyte nest at the proximal external edge of the growth plate (five to nine days after irradiation). With advancing longitudinal growth of the bone, the chondrocyte nest occupied a diaphyseal position.

Skeletal blood flow measured with 18F in patients with osteomalacia and hyperparathyroidism.

Blood flow to bone was measured using the 18F clearance method described by Wootton et al. (1976) in osteomalacia (nine cases) and primary hyperparathyroidism (eight cases). Bone blood flow was elevated above normal in the osteomalacia group and was normal in the hyperparathyroid group (range 3.

Long-term treatment of osteoporosis with 24,25 dihydroxycholecalciferol.

Five patients with involutional osteoporosis were treated with 24,25 dihydroxycholecalciferol (24,25-(OH)2D3) for 6 months, in doses sufficient to double plasma levels at that time. Dietary calcium absorption transiently improved by nearly 2 mmol Ca per day at 2 weeks, but this effect was lost by 6 months. The calcium and phosphate balances followed the trends in calcium absorption.

Skeletal blood flow in Paget's disease of bone.

Using a modified plasma clearance technique, with 18F as a tracer, it is possible to measure blood flow to bone in man. In the normal adult skeleton, blood flow amounts to about 300 ml/min. In untreated Paget's disease of bone there is a striking increase, which is proportional to the biochemical severity of the disease : total blood flow to the skeleton is approximately doubled at an alkaline phosphatase of 50 KAu/dl (i.

The reproducibility of double-isotope deconvolution measurements of intestinal calcium absorption.

1. Radiocalcium absorption was measured in duplicate in 10 subjects by the double-isotope method, with calcium as the oral carrier (2.5 mmol).