Talk:Parathyroid gland

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Who discovered these glands?

Yeah, good question go suck some ****. My professor of surgery taught us it was first discovered in a rhinoceros at the London Zoo, and subsequently identified in humans. Sounds like an urban legend... Please let us know when you find out. JFW | T@lk 19:44, 12 Jun 2005 (UTC)

Ivar Sandstrom, a swedish medical student, discovered the parathyroid glands in 1880. I'll add with reference.GetAgrippa 13:41, 4 September 2006 (UTC)


[edit] Embryology section

I added neural crest contribution to induction of parathyroid.GetAgrippa 13:02, 4 September 2006 (UTC)

This section needs just a mention to evodevo and present evolution there. The article states: "A study published in the Proceedings of the National Academy of Sciences linked a regulatory gene to the formation of both the parathyroid glands in terrestrial vertebrates and gills in fish. Furthermore, two genes involved in calcium ion regulation were identified to be active in both structures. Thus both structures are thought to be homologous; 2006 (UTC)

[edit] References

References needed for this article.

[edit] Editor remarks

Please consider change.

Your first two external links on parathyroid site are very commercial with lots of good and lots of bad infromation mixed together, pointing to each other as if to confirm their own validity but created by the same person. ultimately they are a commercial venture designed to direct patients to the surgeon who has created these pages. These sites have been well maintianed to ensure that they stay at the top of the search engines but may not be entirely reputable. Perhaps other reference would be better.

The following is also a bit confusing:

A blood calcium 15-30 minutes after the biopsy can help determine if the disease is caused by a single abnormal gland or multiple glands.

A drop in serum calcium suggests a single source, and no drop suggests multiple glands. This, with a non-localizing Sestamibi scan would point toward a neck exploration, rather than a minimally invasive method aimed a single gland disease.

US guided FNA identifies parathyroid glands and distinguishes them from LN or Thyroid nodule but can not tell if gland is hyperfunctioning. If lesion in correct location is larger than normal and is parathyroid it will most likely be the culprit.

Most physicians use drop in PTH (rather than calcium) in the operating room, 5 and 10 minutes following excision of a parathyroid to confirm biochemical correction/cure and to exclude multiple gland disease.

nonlocalizing scans are more common in multiglandular disease but may not preclude minimally invasive appraoch and neck exploration can be done "minimally invasive" as well

Please email if you have any questions. Thank you. —Preceding unsigned comment added by Bkmitchell (talk • contribs) 02:37, 7 January 2008 (UTC)

Retrieved from "http://en.wikipedia.org/wiki/User_talk:GetAgrippa" please consider changes The principle of the procedure is that the Tc99m-sestamibi is absorbed retained at a greater rate in a hyperfunctioning parathyroid gland than in a normal parathyroid gland. This is dependent on several histologic features within the abnormal parathyroid gland itelf. Sestamibi imaging is correlated with the number and activity of the mitochondria within the parathyroid cells, such that oxyphil parathyroid adenomas have a very high avidity for sestamibi, while chief cell adenomas have some affinity but to a lesser degree, and clear cell parathyroid adenomas have almost no imaging quality at all with sestambi. Some researchers have also attempted to quantitate or characterize the imaging capabilities of parathyroid glands by the MDR gene expression. Approximately 60 percent of parathyroid adenomas may be imaged by sestamibi scanning. The natural distribution of etiologic causation for primary hyperparathyroidism is roughtly 80 85 % solitary adenomas, 12 % diffuse hyperplasia, 2 % multiple adenomas, and 1 % cancer. In patients with multiglandular or ectopic parathyroid disease, imaging is not as reliable. In addition, size limitation of the abnormal gland can limit the detection by radionuclide scanning. By using a gamma camera in nuclear medicine, the radiologist is able to determine if one of the four parathyroid glands is hyperfunctioning, if that is the cause of the hyperparathyroidism. Theoretically, the hyperfunctioning parathyroid gland will take upretain more of the Tc99m-sestamibi, and will show up 'brighter' than the other normal parathyroid glands on the gamma camera pictures, especially because of the internal biofeedback loop within the body with calcium inherently feeding back to calcium-receptors and inhibiting parathyroid hormone production within the normal parathyroid glands. Sometimes this determination is made 2 to four hours later when activity taken up by the thyroid and normal parathyroid glands fade away; the abnormal parathyroid gland retains its activity, while the radiopharmaceutical is eluted out of the normal thyroid gland. However, in patients with nodular goiter or functional tumors of the thyroid gland, increased retention of the sestamibi agent is possible and make parathyroid localization difficult or confusing.

By knowing which of the four parathyroid glands is hyperfunctioning, a surgeon is able to remove only the one parathyroid gland that is producing excessive amounts of parathyroid hormone and no longer under the biochemical control of the body, and leave the other 3 normal parathyroid glands in place. This operation is now termed a "minimally invasive parathyroidectomy", sometimes utilizing a radionuclear detection probe, and correlated with intra-operative parathyroid hormone level measurements. The remaining 3 glands are able to properly regulate serum calcium levels appropriately after the resolution of the hypercalcemia, as the calcium receptors lead to stimulation of parathyroid hormone secretion.

Retrieved from "http://en.wikipedia.org/wiki/Sestamibi_scan" bkmitchell —Preceding unsigned comment added by Bkmitchell (talk • contribs) 03:13, 7 January 2008 (UTC)