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Pathology (Philadelphia, Pa.) 1996
Review
Topics: Humans; Intraoperative Care; Parathyroid Glands; Referral and Consultation
PubMed: 8795828
DOI: No ID Found -
Head & Neck Mar 2022To evaluate the diagnostic accuracies of indocyanine green (ICG) fluorescence for identifying parathyroid glands during surgery and predicting the postoperative function. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
To evaluate the diagnostic accuracies of indocyanine green (ICG) fluorescence for identifying parathyroid glands during surgery and predicting the postoperative function.
METHODS
From six databases, 21 studies were finally included in the study. True-positive, true-negative, false-positive, and false-negative data were extracted for the analysis. The quality of each study was analyzed using the QUADAS-2 tool.
RESULTS
The sensitivity of ICG-based parathyroid gland identification was 0.9380 (95% CI [0.9003, 0.9621]). The diagnostic odds ratio for ICG-based prediction of parathyroid gland function was 54.5652 [13.2059, 225.4570]. The area under the summary receiver operating characteristic curve was 0.909. Fluorescence intensity-based prediction presented higher diagnostic accuracy than that of score-based prediction. The incidence of postoperative hypoparathyroidism was higher in the group with a zero ICG score compared to the high scored group.
CONCLUSIONS
Identification of parathyroid gland and prediction of postoperative function using ICG are valuable to patients undergoing thyroidectomy or parathyroidectomy.
Topics: Fluorescence; Humans; Hypoparathyroidism; Indocyanine Green; Parathyroid Glands; Postoperative Complications; Thyroidectomy
PubMed: 34908194
DOI: 10.1002/hed.26950 -
Nihon Rinsho. Japanese Journal of... Mar 2011
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The Laryngoscope Mar 2022Near-infrared imaging for intraoperative parathyroid gland (PG) detection has recently commanded significant attention. The PTeye (Medtronic, Minneapolis, MN) is a...
OBJECTIVE
Near-infrared imaging for intraoperative parathyroid gland (PG) detection has recently commanded significant attention. The PTeye (Medtronic, Minneapolis, MN) is a probe-based system for near-infrared autofluorescent evaluation of PGs. This study was designed to evaluate the capabilities of the PTeye in the setting of surgery for primary hyperparathyroidism.
STUDY DESIGN
Prospective, Cohort study.
METHODS
This single-institution, prospective cohort study included all patients undergoing parathyroidectomy for primary hyperparathyroidism with presumed single gland disease from June 2020 to December 2020. Absolute intensity and intensity ratios, with the thyroid as the control tissue, were obtained for the adenoma, ipsilateral normal PG, and adjacent tissue. The ability of the PTeye to function when not in direct contact with tissue was measured.
RESULTS
Twenty-two patients were included. The median intensity ratio for the in situ adenomas was 4.38 (interquartile range [IQR]: 2.03-5.87), ipsilateral normal PGs 6.17 (IQR: 3.83-7.67), strap muscle 0.47 (IQR: 0.30-0.60), and fat 0.20 (IQR: 0.17-0.47). All normal PGs and 21/22 adenomas demonstrated autofluorescence above the detection threshold. The PTeye functioned at a maximum distance of separation of 10 mm through saline medium and 6 mm through clear solid medium.
CONCLUSION
This study confirms the PTeye's ability to recognize PGs with a high degree of precision. The device was found to function properly even with the probe not in direct contact with the tissue. Although adenomatous PGs appear to demonstrate altered autofluorescent properties from normal PGs, additional research is required to determine if these differences are clinically useful.
LEVEL OF EVIDENCE
3 Laryngoscope, 132:715-721, 2022.
Topics: Adenoma; Adult; Aged; Aged, 80 and over; Female; Humans; Hyperparathyroidism, Primary; Male; Middle Aged; Optical Imaging; Parathyroid Glands; Parathyroid Neoplasms; Prospective Studies
PubMed: 34612528
DOI: 10.1002/lary.29880 -
Current Opinion in Nephrology and... Jul 2008The purpose of this review is to describe the development and function of the parathyroid gland from fish to mammals. We describe the molecular mechanisms regulating... (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to describe the development and function of the parathyroid gland from fish to mammals. We describe the molecular mechanisms regulating parathyroid gland embryogenesis and the clinical syndromes related to mutations in control genes.
RECENT FINDINGS
Recent studies have shown that fish express parathyroid hormone. This is contrary to the long held view that the earliest animals to possess parathyroid hormone were amphibians. Two fish species have been demonstrated to express parathyroid hormone but the source and physiological function of this peptide in fish remains to be determined. There is strong recent evidence that regulation and development of the parathyroid gland in mammals is controlled by a cascade of genes. A number of these regulatory factors have been identified using genetically modified mouse models or as genes causing human disease. These include, Gcm2/GCMB, Pax1 and Pax9, Hox3a, Tbx1, GATA3, TBCE, Sox3, Eya1 and Six1/4. Expression of a number of these factors occurs in the gill in fish.
SUMMARY
The function of parathyroid hormone and the parathyroid gland in humans is to regulate serum calcium levels to maintain homeostasis. Parathyroid hormone genes are present in fish but their function remains to be elucidated. Parathyroid development is regulated by a cascade of genes, which are now being rapidly defined in mouse models and in human mutations.
Topics: Animals; Biological Evolution; Fishes; Gene Expression Regulation, Developmental; Humans; Hypoparathyroidism; Parathyroid Glands
PubMed: 18660669
DOI: 10.1097/MNH.0b013e328304651c -
Molecules (Basel, Switzerland) Apr 2020Accurate pre-operative determination of parathyroid glands localization is critical in the selection of minimally invasive parathyroidectomy as a surgical treatment... (Meta-Analysis)
Meta-Analysis Review
Accurate pre-operative determination of parathyroid glands localization is critical in the selection of minimally invasive parathyroidectomy as a surgical treatment approach in patients with primary hyperparathyroidism (PHPT). Its importance cannot be overemphasized as it helps to minimize the harmful side effects associated with damage to the parathyroid glands such as in hypocalcemia, severe hemorrhage or recurrent laryngeal nerve dysfunction. Preoperative and intraoperative methods decrease the incidence of mistakenly injuring the parathyroid glands and allow for the timely diagnosis of various abnormalities, including parathyroid adenomas. This article reviews 139 studies conducted between 1970 and 2020 (49 years). Studies that were reviewed focused on several techniques including application of carbon nanoparticles, carbon nanoparticles with technetium sestamibi (99m Tc-MIBI), Raman spectroscopy, near-infrared autofluorescence, dynamic optical contrast imaging, laser speckle contrast imaging, shear wave elastography, and indocyanine green to test their potential in providing proper parathyroid glands' localization. Apart from reviewing the aforementioned techniques, this study focused on the applications that helped in the detection of parathyroid adenomas. Results suggest that applying all the reviewed techniques significantly improves the possibility of providing proper localization of parathyroid glands, and the application of indocyanine green has proven to be the 'ideal' approach for the diagnosis of parathyroid adenomas.
Topics: Clinical Decision-Making; Disease Management; Humans; Intraoperative Care; Multimodal Imaging; Parathyroid Glands; Parathyroid Neoplasms; Preoperative Care; Radiopharmaceuticals; Spectrum Analysis, Raman; Technetium Tc 99m Sestamibi; Theranostic Nanomedicine
PubMed: 32283730
DOI: 10.3390/molecules25071724 -
BMJ Case Reports Feb 2021Ectopic or supernumerary parathyroid tissue has been generally described in the literature in cases found during workup for parathyroid adenoma. We present two unique...
Ectopic or supernumerary parathyroid tissue has been generally described in the literature in cases found during workup for parathyroid adenoma. We present two unique cases of intratracheal parathyroid gland, a rare occurrence that has not yet been described in the literature. In both cases, the masses were found incidentally and showed no clinical or laboratory evidence of hyperparathyroidism. In both cases, surveillance was chosen as the method of treatment. We present this case series to increase awareness of this potential diagnosis.
Topics: Adult; Aged; Female; Humans; Male; Parathyroid Glands; Parathyroid Neoplasms; Trachea; Treatment Outcome
PubMed: 33579799
DOI: 10.1136/bcr-2020-239435 -
Water Clear Cell Adenoma of the Parathyroid Gland: A Forgotten Cause of Primary Hyperparathyroidism.International Journal of Surgical... Aug 2017Water clear cell adenoma of the parathyroid gland is a rare neoplasm composed of large clear cells with foamy cytoplasm and mild nuclear pleomorphism, compressing the... (Review)
Review
Water clear cell adenoma of the parathyroid gland is a rare neoplasm composed of large clear cells with foamy cytoplasm and mild nuclear pleomorphism, compressing the residual nonneoplastic parathyroid tissue. The differential diagnosis includes a variety of neoplasms with clear cell features. In this article, we provide an overview of the entity with a historical perspective, in order to help pathologists in distinguishing it from other neoplasms in their daily practice.
Topics: Adenoma; Carcinoma, Renal Cell; Cytoplasm; Diagnosis, Differential; Humans; Hyperparathyroidism, Primary; Microscopy, Electron; Parathyroid Glands; Parathyroid Neoplasms; Rare Diseases; Salivary Gland Neoplasms
PubMed: 28382826
DOI: 10.1177/1066896917701577 -
Journal of Biophotonics Dec 2019Preservation of the parathyroid gland (PTG) in neck endocrine surgery is important for regulating the amount of calcium in the blood and within the bones. Localization...
Preservation of the parathyroid gland (PTG) in neck endocrine surgery is important for regulating the amount of calcium in the blood and within the bones. Localization of the PTG has been attempted using various methods such as ultrasound, sestamibi, computerized tomography, magnetic resonance imaging and indocyanine green fluorescence imaging. These methods cannot be used during surgery, have high sensitivity or have PTG specificity. However, autofluorescence technique has shown high sensitivity and does not require exogenous contrast. In this study, a new optical system was designed and developed into a clinical system. The system enabled easier and faster focusing on the surgical area and high-resolution video imaging while maintaining a clear image. The system was located above the head of the surgeon. The surgeon was able to see the real-time autofluorescent image on the monitor next to the operating table at any time to locate the PTG. The PTG buried in the adipose tissue and connective tissue was located easily and accurately. The clinical trial conducted in this study consisted of 56 parathyroid cases in 26 patients. For the statistical results, the sensitivity and accuracy in this redesigned autofluorescent imaging system were 98.1% and 96.4%, respectively.
Topics: Humans; Optical Phenomena; Parathyroid Glands; Video-Assisted Surgery
PubMed: 31408277
DOI: 10.1002/jbio.201900017 -
Nephrology, Dialysis, Transplantation :... Aug 1998
Review
Topics: Aniline Compounds; Animals; Calcitriol; Calcium; Humans; Hyperplasia; Parathyroid Glands; Parathyroid Hormone; Phenethylamines; Propylamines; Vitamin D
PubMed: 9719139
DOI: 10.1093/ndt/13.8.1923