RESUMEN
Objective To investigate the different clinical behavior and the diagnosis and trearment of primary hyperparathyroidism(PHPT). Methods Clinical data of 53 patients with PHPT treated in Beijing Jishuitan Hospital from May 1977 to April 2004 were collected and analyzed. Results 53 patients with PHPT were confirmed by operation and pathology. The majority of the patients were aged 20~50 years. There were more female than male patients. There were various clinical manifestations, and the duration of illness was (protracted). Many cases were misdiagnosed. There were bone pathologic changes of varying extent in all (patients), stones in urinary system plus bone pathology in 11 cases, serum level of calcium was raised in 51 patients(96.2%) and (parathyroid) hormone (PTH) was elevated in all examined 48 cases. Ultrasound, MIBI and CT were done before operation after 1991, and accurate preoperative localization diagnosis was (obtained). Minimally invasive (parathyroidectomy) (MIP) was successfully completed in 39 of 45 cases, and the primary operation cure rate was 97.4%. At postoperative follow-up of 10 months to 10 years, with the (exception) of 15 cases of severe bone deformity that had no obvious improvement, the other symptoms and signs were all relieved to varying (extents), the laboratory markers returned to normal, and there was no permanent hypoparathyroidism or (recurrent) nerve injury or other complications.Conclusions Early diagnosis of PHPT and effective early (treatment) by surgical removal of the pathologic lesion can alleviate the occurrence of severe bone changes and deformity. The preoperative combined use of imaging localization technique and overall assessment can improve the accuracy of diagnostic localization of the lesion.
RESUMEN
From 1993 to 1995,117 patients with breast masses were admitted to Ji Shun Tan Hospital. Among these patients,there were 69 cases of cancer and 48 benign lesions. Both were verified by operation and pathology. All of these cases were examined by infrared light scanning(ILS) and color doppler flow image(CDFI) before operation. The diagnostic accuracy rate increased from 62.4% to 86.3% by ILS with CDFI comparing with clinical palpation. The misdiagnostic rates of ILS with CDFI were of 4.3% on cancer and 6.3% on benign lesion. The reasons of misdiagnoses were analyzed in the paper.