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Genotype-phenotype correlation for nucleotide substitutions in the IgII- IgIII linker of FGFR2 总被引:6,自引:3,他引:3
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C Camenzuli AN DiMarco KE Isaacs Y Grant J Jackson A Alsafi C Harvey TD Barwick N Tolley FF Palazzo 《Annals of the Royal College of Surgeons of England》2021,103(1):29
IntroductionReoperative parathyroidectomy for persistent and recurrent primary hyperparathyroidism is dependent on radiology. This study aimed to compare outcomes in reoperative parathyroidectomy at a single centre using a combination of traditional and newer imaging studies.Materials and methodsRetrospective case note review of all reoperative parathyroidectomies for persistent and recurrent primary hyperparathyroidism over five years (June 2014 to June 2019; group A). Imaging modalities used and their positive predictive value, complications and cure rates were compared with a published dataset spanning the preceding nine years (group B).ResultsFrom over 2000 parathyroidectomies, 147 were reoperations (101 in group A and 46 in group B). Age and sex ratios were similar (56 vs 62 years; 77% vs 72% female). Ultrasound use remains high and shows better positive predictive value (76% vs 57 %). 99mTc-sestamibi use has declined (79% vs 91%) but the positive predictive value has improved (74% vs 53%). 4DCT use has almost doubled (61% vs 37%) with better positive predictive value (88% vs 75%). 18F-fluorocholine positron emission tomography-computed tomography and ultrasound-guided fine-needle aspiration for parathyroid hormone are novel modalities only available for group A. Both carried a positive predictive value of 100%. Venous sampling with or without angiography use has decreased (35% vs 39%) but maintains a high positive predictive value (86% vs 91%). Cure rates were similar (96% vs 100%). Group A had 5% permanent hypoparathyroidism, 1% permanent vocal cord palsy and 1% haematoma requiring reoperation. No complications for group B.ConclusionOptimal imaging is key to good cure rates in reoperative parathyroidectomy. High-quality, non-interventional imaging techniques have produced a shift in the preoperative algorithm without compromising outcomes. 相似文献
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Gonzales AJ; Christensen JG; Preston RJ; Goldsworthy TL; Tlsty TD; Fox TR 《Carcinogenesis》1998,19(7):1173-1183
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A 26‐year‐old man with a history of heavy marijuana and minimal tobacco use was found to have extensive bilateral lung bullae and interstitial fibrosis, heavily infiltrated by pigmented macrophages. These features can be associated with marijuana smoking. The differential diagnoses in this patient are also discussed. 相似文献
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Melatonin rhythms in the eyes, pineal bodies, and blood of Japanese quail (Coturnix coturnix japonica) 总被引:1,自引:0,他引:1
Melatonin levels in the eyes, pineal bodies, and blood of Japanese quail exposed to 12L:12D show robust daily rhythms with high levels occurring in the night and low levels occurring during the day. Since melatonin is synthesized in both the eyes and pineal bodies of birds, the relative contribution of these structures to the blood melatonin levels was determined. A rhythm of blood melatonin persisted in 12L:12D in birds blinded by complete orbital enucleation and in pinealectomized birds but the nighttime levels were reduced by 33 and 54%, respectively, as compared to melatonin levels in control quail. Only a small melatonin rhythm (13% of control levels) was detected in the blood of pinealectomized, blinded quail. This "residual" rhythm could indicate either the contribution of extrapineal, extraocular sources of melatonin or melatonin secretion from remnants (if any) of pineal body tissue remaining after pinealectomy. Blinding did not obviously affect pineal melatonin levels nor did pinealectomy affect ocular melatonin levels. It was concluded that (1) daily rhythms in melatonin content occur in the pineal bodies, the eyes, and the blood of quail; (2) the blood rhythm is the result of melatonin secretion from both the pineal body and the eyes; (3) extraretinal photoreceptors can mediate entrainment of the pineal melatonin rhythm; and (4) obvious compensatory changes in melatonin levels do not occur in the eye following pinealectomy or in the pineal body following blinding. 相似文献