Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study has been carried out in order to evaluate both serum osteocalcin levels in primary hyperparathyroidism and their changes following surgery. Twenty-one consecutive patients were studied (12 females and 9 males, aged 46 +/- 17 years). Preoperatively, a better correlation was found between serum osteocalcin and serum alkaline phosphatase activity (r = 0.79, p less than 0.001) than between serum osteocalcin and the 24-hour urinary hydroxyproline/creatine ratio (r = 0.55, p less than 0.05). Following the surgical removal of hyperfunctioning parathyroid tissue, a modest but significant decrease was observed in the serum levels of osteocalcin; this reached a nadir during the 1st or 2nd day after the removal of the adenoma. The mean levels then tended to rise, so that the values measured on the 7th day after parathyroidectomy (12.4 +/- 2.5 ng/ml) were not significantly different in respect to basal values (13.6 +/- 2.7 ng/ml). A parallel pattern was also noted as concerns the serum alkaline phosphatase activity. On the contrary, mean values of serum immunoreactive parathyroid hormone (243 +/- 78 vs. 58 +/- 11 pmol/l; p less than 0.02) and serum calcium (12.4 +/- 0.5 vs. 9.2 +/- 0.3 mg/dl; p less than 0.01) were significantly reduced and mean values of serum phosphorus (2.4 +/- 0.2 vs. 3.1 +/- 0.2 mg/dl; p less than 0.001) significantly higher in comparison to basal values.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Serum osteocalcin in primary hyperparathyroidism: short-term effect of surgery. 326 76

Osteocalcin (or bone Gla protein, BGP) is a non-collagenous vitamin K-dependent protein accounting for 1-2% of the total bone proteins. It represents a specific index of osteoblastic activity and directly reflects the bone turnover. Serum levels of osteocalcin were measured by a radioimmunoassay method. In 40 postmenopausal women with osteoporosis, mean serum BGP levels were lower than the normal range (3.69 +/- 1.35 ng/ml), whereas they significantly increased in 7 patients with osteomalacia (10.48 +/- 3.05 ng/ml), in 12 patients with secondary hyperparathyroidism (11.1 +/- 4.9 ng/ml) and in 41 patients with Paget's disease (12.09 +/- 6.5 ng/ml). Four patients with primary hyperparathyroidism showed very high BGP levels (64.0 +/- 32.3 ng/ml), which strikingly fell after the surgical removal of a parathyroid adenoma. These results confirm that the quantitation of serum osteocalcin is a specific and sensitive method in the diagnosis of bone disease, represents a useful index of bone turnover and is particularly helpful in the follow-up of patients with treated bone disease.
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PMID:Serum osteocalcin radioimmunoassay in bone diseases. 387 67

Among the vitamin K-dependent proteins, characterized by a high content of gamma-carboxyglutamic acid (Gla), one has been identified in bone tissue which has been referred to as osteocalcin (BGP): it has been found in fish, birds, mammalians, primates and in man without significant changes in structure. "In vitro" and "in vivo" studies in the experimental animal and in man have shown that BGP: 1) binds to hydroxyapatite crystals in bone tissue at the maturation of the mineral phase; 2) is probably synthesized by the osteoblasts; 3) circulates as a newly synthesized molecule before binding to bone; 4) shows a rapid turnover rate and is subjected to renal clearance. In conclusion osteocalcin seems to represent a very good index of osteoblast activity. BGP ca be measured in biological fluids by radioimmunoassay. Plasma levels in man range 4-7 ng/ml, they increase in malignant or metabolic disorders (Paget's disease of bone, bone metastases, hyperparathyroidism) and decrease in hypoparathyroidism. In this paper we report the results obtained using a new radioimmunoassay for osteocalcin; the plasma levels were measured in 72 normal adults aged 18-84 years (37 males, 35 females) and in three normal adolescents. The normal range (M +/- SD) was found to be 4,1-7,84 ng/ml. No significant differences were found between males and females, whereas adolescents showed significantly higher values than adults. A positive correlation was found between plasma BGP level and age of subjects in males as well as in females (r = 0,613, p less than 0,001). Fifteen patients with Paget's disease and two with primary hyperparathyroidism showed very high values which fell dramatically in the latter group after surgical removal of parathyroid adenoma. Six cases of secondary hyperparathyroidism were also found to have higher values than normal. The significance of the progressive increase in BGP with increasing age is still to be interpreted.
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PMID:[Osteocalcin]. 633 18

A 65-year-old female patient was admitted with complaining chiefly of lower back pains and arthralgia in the bilateral knee joints of 10-years duration. The serum calcium concentration was normal or only slightly increased, whereas the serum intact PTH and 1,25-dihydroxyvitamin D concentrations were substantially increased. Serum phosphate and 25-hydroxyvitamin D concentrations were decreased. Renal function was normal. Serum alkaline phosphatase activity, the osteocalcin concentration and urinary hydroxyproline excretion were markedly increased. Bone X-ray examination showed severe osteopenia and bone biopsy revealed hyperosteoidosis without tetracycline deposition, consistent with osteomalacia. A parathyroid adenoma was demonstrated by echography and CT-scan. Surgical exploration of the neck revealed a chief cell adenoma behind the right upper pole of the thyroid gland. After parathyroidectomy, all the abnormal biochemical data gradually normalized and the patient has been doing well without any symptoms for the last 13 months. These clinical data suggest that osteomalacia of the patient was probably induced by hypophosphatemia of prolonged duration. When hypercalcemia is not evident in a patient with primary hyperparathyroidism, in whom serum alkaline phosphatase and intact PTH levels are inappropriately increased, osteomalacia should be taken into consideration.
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PMID:A patient with primary hyperparathyroidism associated with osteomalacia: markedly increased serum levels of intact PTH and 1,25-dihydroxyvitamin D with normo- and hypercalcemia. 795 85

Aminohydroxypropylidene diphosphonate (APD), a potent inhibitor of bone resorption, is used to control hypercalcemia in various diseases. It is less effective, however, in the management of hypercalcemia induced by primary hyperparathyroidism. We investigated the effect of APD on the bone metabolism of five patients with parathyroid adenoma. Before parathyroidectomy, 30 mg of APD was administered intravenously. Serum calcium decreased in all cases one to two days after APD administration, although it did not decrease to the normal range. Serum phosphorus also decreased. Urine calcium and hydroxyproline excretion, markers of osteoclasts activity, decreased dramatically. Serum alkaline phosphatase (ALP) and osteocalcin, markers of osteoblast activity, decreased after APD administration. Serum intact parathyroid hormone (PTH) and 1,25-dihydroxy-vitamin D (1,25[OH]2D) increased. These results indicate that APD is partially effective in the management of preoperative serum calcium level in patients with parathyroid adenoma. As osteoclasts activity is inhibited by APD, osteoblasts activity is also suppressed. Elevation of PTH and 1,25(OH)2D after APD-induced decrease in serum calcium level may explain the partial and limited effect of APD on lowering serum calcium in patients with parathyroid adenoma.
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PMID:Effect of aminohydroxypropylidene diphosphonate on the bone metabolism of patients with parathyroid adenoma. 822 4

The aim of this prospective study was to evaluate the diagnostic utility of a technetium-99m sestamibi dual-phase protocol enhanced by single-photon emission tomography (SPET) and semiquantitative analysis in comparison to established preoperative staging procedures in patients with primary hyperparathyroidism. Twenty-eight (50%) out of 56 patients had superimposed thyroid disease, and 12 patients had previously undergone neck surgery. Visual and semiquantitative analysis of planar 99mTc-sestamibi dual-phase imaging, SPET of the delayed phase, ultrasonography, and thallium-201 chloride-technetium-99m pertechnetate subtraction scintigraphy was further correlated with the histopathological examination of the surgical specimens. 99mTc-sestamibi dual-phase imaging achieved the highest sensitivity for side localization and precise localization compared with 201Tl-99mTc subtraction scintigraphy and ultrasonography, but the differences reached statistical significance only in comparison to ultrasonsography. Semiquantitative analysis did not enhance sensitivity. Adenoma detection by 99mTc-sestamibi dual-phase imaging was only correlated to serum calcium levels and osteocalcin, not to cell density or oxyphil cell count (SPET yielded additional information for the exact topographical localization of the parathyroid tumour in 22 (39%) patients with superimposed thyroid disease or previous neck surgery but did not enhance the overall detection rate.
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PMID:Comparison and histopathological correlation of three parathyroid imaging methods in a population with a high prevalence of concomitant thyroid diseases. 902 Nov 11

Remarkable changes of parathyroid function immediately after parathyroidectomy were evaluated in primary (PHPT) and secondary (RHPT) hyperparathyroidism. Bone metabolism was also evaluated by new specific markers of bone formation and resorption. A rapid decline into the undetectable range, and a rapid recovery of serum bioactive parathyroid hormone (PTH) concentrations were observed after parathyroidectomy in PHPT. Since the function of the remnant parathyroid glands was not clear, we investigated the transcription of PTH mRNA. Despite the suppression of PTH secretion in the remnant parathyroid glands, no significant difference was found in the amount of PTH mRNA present in an adenoma as compared to a remnant gland when evaluated by cytoplasmic dot hybridization and in situ hybridization. Although measurement of serum PTH concentration by assays of inactive fragment was available for the longterm follow-up of PTH function in RHPT, parathyroid function should be evaluated by biologically active intact PTH immediately after operation. The PTH gradient also was successfully evaluated by the measurement of intact PTH. A discrepancy was observed between bone resorption evaluated by type I collagen cross-linked N-telopeptide as compared to bone formation evaluated by osteocalcin immediately after operation. This discrepancy will improve and bone mineral density will increase in the first 6 months after parathyroidectomy.
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PMID:Parathyroid function and bone metabolic markers in primary and secondary hyperparathyroidism. 908 68

This study was carried out in order to evaluate clinical usefulness of cross-linked N-telopeptides (NTx) of type I collagen determination, in patients with primary hyperparathyroidism. Twenty-six consecutive patients (6 males and 20 females, aged 56.3 +/- 15.0, SD, yrs) with primary hyperparathyroidism were studied in basal conditions and, ten of them, after surgical cure of the disease. Cross-linked collagen peptides were measured by enzyme-linked immunosorbent assay and conventional markers of bone turnover according to standard procedures. Bone densitometry at the lumbar spine and proximal femur was performed using dual-energy X-ray absorptiometry. Bone mineral density, was also assessed at the junction of the distal and middle third of the radius and at the ultradistal radius of the non-dominant arm by a dual photon densitometer. Mean urinary NTx values (194.2 +/- 121.9 pmoles bone collagen equivalents/mumoles creatinine) were significantly higher (p < 0.001) in respect to those found in normal subjects. The mean increase of Z score values of both serum tartrate resistant acid phosphatase activity (1.4 +/- 1.8) and the fasting hydroxyproline/creatinine ratio (1.45 +/- 2.0) was significantly lower (p < 0.02) in respect to that of NTx Z score values (3.3 +/- 3.3); the latter values were not significantly different than mean Z score values of serum osteocalcin (4.0 +/- 3.9), serum alkaline phosphatase activity (2.6 +/- 2.6) and urinary calcium/creatinine ratio (3.2 +/- 3.3). We found a significant inverse correlation between NTx values and both lumbar spine (p < 0.01) and ultradistal radius bone mineral density (p < 0.05); a modest inverse correlation was also observed between serum tartrate resistant acid phosphatase activity and lumbar spine bone mineral density (p < 0.04). Following successful adenoma removal, the percentage decrease of both NTx and hydroxyproline was similar in patients with increased bone turnover rate; major discrepancies were observed in patients with normal values of NTx, the telopeptide reduction being greater than that of hydroxyproline. Finally, in a hypercalcemic patient with metastatic parathyroid cancer, telopeptide excretion was shown to be more sensitive in respect to urinary hydroxyproline when evaluating the effects of antiresorptive therapy. Our results seem to indicate that amongst the markers with good sensitivity, NTx is the only one that is inversely related with bone mineral density at two different skeletal sites. This assay should therefore have a place in both the initial screening and medical follow-up of patients with this glandular disorder; in fact, in both situations an increased urinary excretion of this marker should warn about the possibility of hidden bone loss.
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PMID:The measurement of urinary amino-terminal telopeptides of type I collagen to monitor bone resorption in patients with primary hyperparathyroidism. 941 11

Hyperparathyroidism, both primary and secondary in chronic renal failure, leads to pathologic changes in the bones. Newly introduced markers of bone metabolism enable to biochemically detect and evaluate these changes. The aim of our studies was to perform determinations of serum osteocalcin as a marker of bone formation, and C-terminal telopeptide of collagen I (ICTP) as a marker of bone resorption in patients with excessive secretion of parathyroid hormone (PTH). Our studies comprised of 15 patients with primary and 24 patients with secondary hyperparathydroidism. In all patients serum PTH, osteocalcin and ICTP were detected by radioimmunoassay; the correlations between PTH and osteocalcin as well as between PTH and ICTP were also performed. Serum PTH was elevated in both, primary and secondary hyperparathyroidism. In primary hyperparathyroidism serum osteocalcin was moderately or definitely elevated, similarly serum ICTP was high. Following surgical removal of a parathyroid adenoma, concomitantly with a drop in serum PTH there was a rapid normalization of serum osteocalcin and ICTP. Secondary hyperparathyroidism in uraemia was characterised by markedly elevated serum osteocalcin and ICTP which surpassed the concentration of these markers in primary hyperparathyroidism. There was a positive correlation between serum PTH and osteocalcin levels, and a lower correlation between PTH and ICTP. From our studies it is concluded that excessive secretion of PTH in primary and secondary hyperparathyroidism stimulates bone formation and to higher degree--bone resorption.
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PMID:[Markers of bone formation and resorption in primary and secondary hyperparathyroidism]. 976 Aug 16

Increased levels of intact parathyroid hormone (PTH) have been documented after surgery for primary hyperparathyroidism (pHPT) despite normocalcemia. The pathogenesis remains to be elucidated. Seventeen consecutive patients operated on for solitary parathyroid adenoma were investigated before and at 8 weeks and 1 year after surgery with serum levels of intact PTH, biochemical variables known to reflect PTH activity, and bone mineral content (BMC). In addition, an oral calcium loading test was performed 8 weeks after the operation. All patients had low or normal serum calcium levels during follow-up. Eight weeks after operation six patients (35%) had an increased serum PTH level. These patients (group I) preoperatively had higher serum levels of PTH and alkaline phosphatase than patients with normal PTH levels (group II). They also had lower BMC and larger parathyroid adenomas. They did not differ in renal function. At 8 weeks after operation group I showed higher mean serum levels of osteocalcin and propeptide of type I procollagen but lower urinary calcium excretion. In contrast to patients in group II, they also showed a lower calciuric response and a trend to a lower calcemic response during the oral calcium load. The two groups showed similar parathyroid sensitivity for calcium. Patients in group I demonstrated a significant increase in BMC the first year after the operation. Increased serum PTH 8 weeks after surgery for sporadic parathyroid adenoma was not due to persistent pHPT or impaired renal function. Instead, the results imply there is diminished calcium absorption and increased bone turnover with cortical bone remineralization.
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PMID:Postoperative elevated serum levels of intact parathyroid hormone after surgery for parathyroid adenoma: sign of bone remineralization and decreased calcium absorption. 1103 1


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