ABSTRACT
Objective: To observe the safety and efficacy of ultrasound-guided microwave ablation (MWA) for treatment of patients with secondary hyperparathyroidism (SHPT) after renal transplantation (RT). Methods: Data of 20 SHPT patients after RT who underwent MWA were retrospectively analyzed. The level of intact parathyroid hormone (iPTH), serum calcium, serum phosphorus, creatinine and blood urea nitrogen concentrations before and after MWA were assessed and compared. Results: Complete ablation was achieved in a total of 34 parathyroid nodules among 20 SHPT patients. The mean maximum diameter of parathyroid nodule was (1.41±0.61)cm, and the median ablation time was 219 s. The mean iPTH, serum calcium and phosphorus concentrations after MWA were significantly lower than those before MWA (P0.05). No major operation-related complication occurred in 20 patients. Conclusion: Ultrasound-guided MWA is a safe and effective method for treating SHPT after RT.
ABSTRACT
Objective@#To evaluate the safety, feasibility, and efficacy of microwave ablation (MWA) for the treatment of primaryhyperparathyroidism (PHPT). @*Materials and Methods@#This study enrolled 67 PHPT patients (22 men, 45 women; mean age, 56.0 ± 16.3 years; range, 18–83 years) from January 2015 to December 2018. The laboratory data, including the serum intact parathyroid hormone (iPTH),calcium, phosphorus, and alkaline phosphatase (ALP) levels, were evaluated before MWA and again 2 hours, 1 day, 7 days, 1month, 3 months, 6 months, 12 months, 18 months, and 24 months after. @*Results@#Complete ablation was achieved with all 72 hyperplastic parathyroid glands found on the 67 patients enrolled, 64 ofwhom were treated in one session and 3 were treated over two sessions. The technical success rate was 100%. The medianfollow-up time was 13.6 months (range, 10.0–31.1 months). The clinical success rate was 89.4%. The volume reduction ratewas 79.4% at 6 months. Compared to pre-MWA, the serum iPTH, calcium, phosphorus, and ALP levels had significantlyimproved 6 months post-MWA (iPTH, 157.3 pg/mL vs. 39.2 pg/mL; calcium, 2.75 ± 0.25 mmol/L vs. 2.34 ± 0.15 mmol/L;phosphorus, 0.86 ± 0.20 mmol/L vs. 1.12 ± 0.22 mmol/L; ALP, 79 U/L vs. 54 U/L, respectively; all, p < 0.01). Hoarseness wasa major complication in 4 patients (6.0%), but it improved spontaneously within 2–3 months. @*Conclusion@#MWA is safe, feasible, and effective for the treatment of PHPT.
ABSTRACT
Virus inactivation of plasma can be achieved by phototreatment with methylene blue (MB). Subsequently, elimination of MB may reduce the adverse effects of MB. This study examined the effects of adsorbing MB with the use of cross-linked agar bead entrapped attapulgite clay (CAA) on normal ingredients in MB-treated plasma units. The biomedical characteristics of CAA were assessed by determination of partial biochemical indexes, coagulation potency and some cationic concentration in a control sample and the MB-treated plasma eluted from CAA column. The biochemistry indexes or K+, Na+ in plasma were almost unaltered before and after CAA adsorption. In contrast, the concentrations of CA2+ and Mg2+ increased and the blood ammonium decreased obviously. The activated partial thromboplastin time (APTT) was prolonged from 42 s to 53 s, and prothrombin time (PT) from 13 s to 14 s. The result indicates that CAA as an adsorbent for hemopurification retains the most important characters of human plasma. CAA can be useful for the elimination of MB in MB-treated plasma and does not bring on harmful alteration in clinical significance.