| 1. |
- Bergenfelz, A, et al.
(författare)
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Stapling in thyroid surgery. A prospective study
- 1992
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Ingår i: Annales Chirurgiae et Gynaecologiae. - 0355-9521. ; 81:1, s. 48-50
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Tidskriftsartikel (refereegranskat)abstract
- In a prospective study, resection of the thyroid gland by means of a linear stapling device was compared with the conventional resection technique in 12 consecutive patients with thyreotoxicosis. The median time for resection of the stapled lobe was shorter than for the conventionally resected right lobe, although the difference was not statistically significant. The median preoperative bleeding during resection of the stapled left lobe was 42 ml (range 15-126 ml), compared with 78 ml (range 34-247 ml) during the conventional resection of the right lobe (P less than 0.05). Median postoperative bleeding was somewhat less from the stapled side compared with the conventionally resected side, but did not reach statistical significance. The study thus demonstrates the feasibility of carrying out resection of the thyroid gland with a linear stapling device. The technique minimizes peroperative bleeding. It could therefore be used in thyroid surgery.
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| 2. |
- Bergenfelz, A, et al.
(författare)
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Surgery for primary hyperparathyroidism performed under local anaesthesia
- 1992
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 79:9, s. 4-931
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Tidskriftsartikel (refereegranskat)abstract
- Patients with primary hyperparathyroidism are often elderly with cardiovascular disease and in some an operation might be hazardous owing to anaesthetic complications. A technique for operation for primary hyperparathyroidism under local anaesthesia is described. The method uses a unilateral approach. Seventeen consecutive patients operated on under local anaesthesia were compared with a group of 15 patients undergoing surgery under general anaesthesia. Normocalcaemia was achieved in 14 patients in each group. There was no difference in the extent of pain or the overall well-being between the two groups as determined by a visual analogue scale. Patients receiving local anaesthesia, however, experienced significantly less nausea after operation (P < 0.01). There was more fluctuation in blood pressure and heart rate in the general anaesthesia group compared with the other group. Surgery for primary hyperparathyroidism can be performed safely under local anaesthesia, and could be offered to patients if general anaesthesia were not suitable or involved an increased perioperative risk. It should not be recommended for routine use in patients who are fit for general anaesthesia.
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| 3. |
- Bergenfelz, A, et al.
(författare)
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Serum osteocalcin levels do not change during rapidly induced hypercalcemia in healthy subjects
- 1992
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Ingår i: Hormone Research. - : S. Karger AG. - 0301-0163 .- 1423-0046. ; 37:1-2, s. 29-32
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Tidskriftsartikel (refereegranskat)abstract
- Since osteocalcin has been suggested to play a role in calcium homeostasis, we investigated its serum levels in 6 healthy subjects during a rapid calcium infusion. Serum levels of intact parathyroid hormone (PTH), 25-hydroxyvitamin D [25-(OH) D3] and 1,25-dihydroxyvitamin D [1,25-(OH)2 D3] were also determined. The calcium infusion increased plasma-ionized calcium levels from 1.25 +/- 0.04 to 1.54 +/- 0.07 mmol/l at 30 min (p less than 0.05). Concomitantly, serum levels of intact PTH declined from 2.1 +/- 0.9 to 0.2 +/- 0.3 mmol/l (p less than 0.05). In contrast, serum osteocalcin levels did not change. Further, during calcium infusion, serum levels of 1,25-(OH)2 D3 decreased from 81 +/- 17 to 75 +/- 15 pmol/l (p less than 0.05) whereas serum levels of 25-(OH) D3 did not change. The results therefore suggest that calcium per se does not influence osteocalcin secretion.
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| 4. |
- Bergenfelz, A, et al.
(författare)
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Biochemical variables associated with bone density in patients with primary hyperparathyroidism
- 1992
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Ingår i: European Journal of Surgery, Acta Chirurgica. - 1102-4151. ; 158:9, s. 6-473
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To clarify the association between primary hyperparathyroidism and cortical osteopenia.DESIGN: Open study.SETTING: Department of Surgery, University of Lund, Sweden.SUBJECTS: 38 patients with primary hyperparathyroidism.OUTCOME MEASURES: Correlation between bone density (measured by single photon absorption) and age; sex; serum concentrations of parathyroid hormone and ionised calcium; serum alkaline phosphatase activity; and serum concentration of calcium, phosphate, creatinine, urea, osteocalcin, 25 hydroxycholecalciferol, and 1,25 dihydroxycholecalciferol.RESULTS: There was no difference in bone density between men and women. There was no correlation between bone density and severity of hypercalcaemia or age. No biochemical abnormality was peculiar to the seven patients whose bone density was more than two SD below the population mean. Serum concentrations of 1,25 dihydroxycholecalciferol and osteocalcin both correlated significantly with bone density (p < 0.05) and there was a strong correlation between serum osteocalcin and serum intact parathyroid hormone (p < 0.001). Serum osteocalcin had the strongest correlation with bone density of any of the biochemical variables.CONCLUSION: There is little association between bone density and serum concentration of parathyroid hormone.
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