FACTORS RELATED TO THE RECURRENT HYPERFUNCTION OF AUTOGRAFTS AFTER TOTAL PARATHYROIDECTOMY IN PATIENTS WITH SEVERE SECONDARY HYPERPARATHYROIDISM

被引：27
作者：
TANAKA, Y
SEO, H
TOMINAGA, Y
FUNAHASHI, H
MATSUI, N
TAKAGI, H
机构：
[1] The Second Department of Surgery, Nagoya University School of Medicine, Nagoya, 466, 65 Tsurumai, Showa-ku
[2] The Division of Endocrinology and Metabolism, Research Institute of Environmental Medicine, Nagoya University, Nagoya
[3] The Organ Transplant Center, Nagoya Second Red Cross Hospital, Nagoya
来源：
SURGERY TODAY-THE JAPANESE JOURNAL OF SURGERY | 1993年 / 23卷 / 03期
关键词：
SECONDARY HYPERPARATHYROIDISM; PARATHYROID HORMONE; MESSENGER RIBONUCLEIC ACID; HYBRIDIZATION; CHRONIC RENAL FAILURE;
D O I：
10.1007/BF00309231
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
Total parathyroidectomy with autotransplantation has been widely accepted as the appropriate treatment for patients with hyperparathyroidism due to chronic renal failure on long term hemodialysis. However, recurrence has been an enigma and therefore, the factors involved in the recurrence of hyperparathyroidism were studied in 128 patients followed for more than 2 years after surgical treatment. The preoperative serum parathyroid hormone (PTH) concentrations correlated with the total weights of the parathyroid glands. When the original autotransplanted glands were divided into two groups, being diffuse and nodular, the rate of recurrent hyperparathyroidism due to graft hyperfunction was significantly higher in the patients who received nodular glands (24%) than in those who received diffuse glands (8.4%) (P < 0.05). To investigate whether PTH synthetic activity is different in diffuse and nodular glands, the amount of PTH mRNA was studied by in situ hybridization. There was no significant difference in the amount of PTH mRNA in the cells from either diffuse or nodular glands. These data suggest that the recurrence of hyperparathyroidism is not due to enhanced PTH synthetic activity of autotransplant grafts but to the abnormal growth rate of the transplanted gland.
引用
收藏
页码：220 / 227
页数：8
相关论文
共 22 条
  • [1] Akerstrom G.J., Malmaeus J., Grimelius L., Ljunghall S., Bergstrom R., Histological changes in parathyroid glands in subclinical and clinical renal disease — An autopsy investigation, Scandinavian Journal of Urology and Nephrology, 18, pp. 75-84, (1984)
  • [2] Takagi H., Tominaga Y., Uchida K., Yamada N., Kano T., Kawahara K., Suzuki H., Polymorphism of parathyroid glands in patients with chronic renal failure and secondary hyperparathyroidism, Endocrinol Jpn, 30, 4, pp. 463-468, (1983)
  • [3] Matsusita H., Different responses between the upper and the lower parathyroid gland in a state of secondary hyper function, Virchows Archiv A Pathological Anatomy and Histopathology, 414, pp. 331-337, (1989)
  • [4] Gittes R.F., Radde I.C., Experimental model for hyperparathyroidism: Effect of excessive numbers of transplanted isologus parathyroid glands, J Urol, 95, pp. 595-603, (1966)
  • [5] Parfitt A.W., Relation between parathyroid cell mass and plasma calcium concentration in normal and uremic subjects, Arch Intern Med, 124, pp. 269-273, (1969)
  • [6] Castleman B., Mallory T.B., The pathology of the parathyroid gland in hyperparathyroidism, Am J Pathol, 11, pp. 1-89, (1935)
  • [7] Malmaeus J., Grimelius L., Johansson H., Akerstrom G., Ljunghall S., Parathyroid pathology in hyperparathyroidism secondary to chronic renal failure, Scand J Urol Nephrol, 18, pp. 157-166, (1984)
  • [8] Oka T., Yoshioka T., Shrestha G.R., Koide T., Sonoda T., Hosokawa S., Onoe K., Sakurai M., Immunohistochemical study of nodular hyperplastic parathyroid glands in patients with secondary hyperparathyroidism, Virchows Archiv, 413, pp. 53-60, (1988)
  • [9] Shvil Y., Naveh-Many T., Barach P., Silver J., Regulation of parathyroid cell gene expression in experimental uremia, J Am Soc Nephrol, 1, pp. 99-104, (1990)
  • [10] Fukagawa M., Kaname S., Igarashi T., Ogata E., Kurokawa K., Regulation of parathyroid hormone synthesis in chronic renal failure in rats, Kidney Int, 39, 5, pp. 874-881, (1991)
123