[Parathyroidectomy and autotransplantation in renal hyperparathyroidism. II. Functional in vitro studies for tissue selection].
The PTH secretion was studied in fragments of 83 (reactive) hyperplastic parathyroids (type 1 a: n = 24; type 1 b: n = 20, type 2: n = 39) simulating hypo- (0.3 mmol Ca++ = maximal PTH secretion), normo- (0.9 and 1.2 mmol Ca++) and hypercalcemia (3.0 mmol Ca++ = basic PTH secretion, maximal suppressibility) in vitro. 56 out of 83 glands (67%) were suppressible (PTH secretion decreased under 50% of maximal secretion) with no significant difference in suppressibility of diffuse and nodular hyperplasia (50% and 74%, respectively). Differentiating diffuse hyperplastic glands in those with (type 1 a) and without (type 1 b) stroma fat cells, 92% of type 1 a glands and only 25% of type 1 b glands were suppressible (Fischer's test: p less than 0.001). Separated (oxyphilic and/or chief cell) nodules, type 1 b- and type 1 a-like areas (both localized between nodules) of types 2 glands were suppressible in 18%, 17% and 91%, respectively (Fischer's test: p less than 0.001). Thus fragments of type 1 a regions should be autotransplanted for preference. Type 1 b regions or nodules should not be used for grafting.
Niederle
B
B
I. Chirurgische Universitätsklinik, Wien.
Hörandner
H
H
Roka
R
R
Wolosczuk
W
W
Waldhör
T
T
D002118:Calcium / Q000097:blood; D006085:Graft Survival; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000503:physiopathology / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000150:complications*; D008940:Mitotic Index; D010280:Parathyroid Glands / Q000503:physiopathology / Q000601:surgery / Q000637:transplantation*; D010281:Parathyroid Hormone / Q000378:metabolism*; D011379:Prognosis
D010281:Parathyroid Hormone; D002118:Calcium
Parathyreoidektomie und Autotransplantation beim renalen Hyperparathyreoidismus. II. Funktionelle in vitro Untersuchungen zur Gewebeauswahl.