Less-than-subtotal parathyroidectomy increases the risk of persistent/recurrent hyperparathyroidism after parathyroidectomy in tertiary hyperparathyroidism after renal transplantation.

Background: The optimal surgical approach for tertiary hyperparathyroidism (HPT) after kidney transplantation is unknown. Existing studies are limited by small sample size, lack of adjustment for kidney function, and no long-term follow-up.

Methods: We retrospectively analyzed 74 patients with tertiary HPT who underwent parathyroidectomy at two centers since 1978.

[Results of systematic subtotal parathyroidectomy with thymectomy for tertiary hyperparathyroidism after renal transplantation - 70 patients].

Background: Due to the relatively small number of patients involved, there is currently no consensus on what operation should be performed in patients with tertiary hyperparathyroidism after renal transplantation.

Method: Retrospective analysis of the 70 patients with tertiary hyperparathyroidism who all underwent subtotal parathyroidectomy with transcervical thymectomy in the same institution between 1978 and 2003.

Results: The delay between transplantation and parathyroidectomy was 4,1+/-4,3 years.

Intraoperative decay profile of intact (1-84) parathyroid hormone in surgery for renal hyperparathyroidism--a consecutive series of 80 patients.

Background: The utility of intraoperative parathyroid hormone (PTH) monitoring is unclear in the surgical management of renal hyperparathyroidism. Our goal was to define the normal pattern of decay during operation for renal hyperparathyroidism by using the rapid intact (1-84) parathyroid hormone (PTH) assay.

Methods: Eighty consecutive patients underwent neck exploration for renal hyperparathyroidism.

Supernumerary parathyroid glands: frequency and surgical significance in treatment of renal hyperparathyroidism.

Supernumerary parathyroid glands (SPGs) are found in 13% of random autopsies. The high incidence of SPGs could explain the persistence or trigger recurrence of renal hyperparathyroidism after surgery. The aim of this study was to assess the frequency and clinical relevance of SPG in patients operated on for renal hyperparathyroidism (HPT).

[Muscle infarction. An unknown complication of diabetes mellitus].

Introduction: Diabetic muscle infarction (MI) is a rare and little-known complication of diabetes mellitus.

Case Report: We report a case of relapsing MI in which magnetic resonance imaging (MRI) suggested the diagnosis. A 53-year-old man with multi-complicated type II diabetes mellitus was admitted to our unit for illness and deep tumefaction of the right thigh.

[Limits of parathyroid scintigraphy before surgery for hyperparathyroidism of renal origin].

Aim Of The Study: To evaluate the results of parathyroid scinti scans (sestamibi or tetrofosmin) for detection of hyperplastic parathyroid glands responsible for renal hyperparathyroidism.

Methods: Injection of 15 mCi sestamibi or tetrofosmin and gammacamera acquisition of images focused on neck and mediastinum, 20 minutes and 2 hours thereafter. Injection of 150 mCi Iodine 123, acquisition of images 2 hours afterwards and visual subtraction.

Distinct HLA class II alleles determine antibody response to vaccination with hepatitis B surface antigen.

Major histocompatibility complex (MHC) determinants control antibody production in response to protein antigens. Vaccination with hepatitis B surface antigen (HBsAg) frequently fails in hemodialyzed patients, but the genetic factors that modulate humoral responsiveness are poorly characterized. We studied the distribution of HLA class II alleles in 415 hemodialyzed Caucasian patients who received a full course of HBsAg vaccination, using class II oligotyping after genomic amplification of the DRB1 and DQB1 loci.

[Specific renal lesions revealing the presence of sarcoidosis (author's transl)].

Three cases of granulomatous nephropathy are reported. In two patients this was definitely related to a true renal sarcoidosis, while the third case raised the problem of the significance of an "isolated sarcoidosis nodule". The authors discuss the frequency, clinical symptoms, and pathological appearances of these renal lesions which reveal the presence of sarcoidosis, as well as the relationship between renal insufficiency and the parenchymatous lesions observed, and therapy.