ABSTRACT
The primary hyperparathyroidism, accompanied with a wide scope of bone resorption in every bone matrix of the body, cyst formation, deformity and pathologic fracture, is a generalized disease which causes atrophy and weakness of skeletal muscle and a disturbance of the digestive system as well as renal function. The primary cause of this disease is an adenoma and a hyperplasia of the parathyroid gland. However, all the progress of the disease can be stopped through surgical excision. The authors medically confirmed the diagnoses through typical radiologic findings, electrolyte and enzyme level of serum and urine and by carotid arteriography on four patients(a 41 year ald male, and 28, 35 and 36 year old females) who had complained of generalized weakness, pain and motion limitation. The authors obtained the following results after surgical excision and continuous follow-up study with medication for 7 years, 3 years, 17 months and 13 months each: 1. Of the four cases, 3 cases were female patients and 1 case was a male patient which showed females outnumbered males 3 times in our study. 2. By age distribution, most cases fell in middle age. 3. All the cases were chief cell type of adenoma. 4. It is conjectured that the symptoms has nothing to do with age or history. 5. In all the cases, serun calsium showed a marked decrease immediately after the surgery but recovered to normal limits within 2 months. 6. In all the cases, serum phosphorus showed an irregular increase immediately after the surgery but also stavilized gradually to normal limits within 2 to 3 months. 7. In all the cases, serum alkaline phosphatase was stable for 3 months after the surgery, then gradually decreased. 8. According to the X-rays, subperiosteal resorption of phalangeal bones almost completely disappeared in 3 months. Cyst and brown tumor disappeared in 6~12 months. Granular mottling of the skull almost completely disappeared in 6 months. Intra articular calcification in 2 cases almost completely disappeared in 6 months, 3 cases which showed loss of lamina dura developed edentia during treatment. 9. In 4th case, small multiple cysts and several small brown tumors of the pelvis healed well, but several lager ones were still unhealed after 10 years of treatment. In first case, the cyst in proximal shaft of the left femur is reduced in size but still evident after 7years of treatment. This case needs further study and observation.
Subject(s)
Female , Humans , Male , Middle Aged , Adenoma , Age Distribution , Alkaline Phosphatase , Angiography , Atrophy , Bone Matrix , Bone Resorption , Clinical Study , Congenital Abnormalities , Diagnosis , Digestive System , Femur , Follow-Up Studies , Fractures, Spontaneous , Hyperparathyroidism, Primary , Hyperplasia , Muscle, Skeletal , Parathyroid Glands , Parathyroid Neoplasms , Pelvis , Phosphorus , SkullABSTRACT
The kinetics of strontium metabolism in man has been extensively reviewed by Bauer and his collegues. Photoscanning of bone lesions utilizing (Sr-85) have been a recent contribution to the clinical usefulness. The authors studied 60 cases of various skeletal lesions with strontium 85 bone scanning. Increased uptake of Sr-85 was observed on the lesions of metastatic cancer, osteosarcoma, giant cell tumor, chondroblastoma, reticulum cell sarcoma, chloroma, delayed union of fracture, healing fracture, postradiation fracture, chronic osteomyelitis (including 5 infected compound fracture), chronic arthritis, aseptic necrosis of femur head, osteoarthritis of spine, ricket, osteogenesis imperfecta, hemophilic arthropathy, epiphysiodesis, and more unconfirmed diseases.