TOTAL parathyroidectomy and autotransplantation of tissue into the subcutaneous layer of the forearm or thigh is a well-accepted treatment of symptomatic hyperparathyroidism.^1-3 The development of a rapid 2-site immunoradiometric assay (IRMA) and an intraoperative immunochemiluminescent assay to measure intact (amino acids, 1-84) parathyroid hormone (iPTH) has provided a valuable tool for identifying any surgical failures during the operation.^4-7

Research from JAMA Surgery — Parathyroidectomy Can Improve Bone Mineral Density in Patients With Symptomatic Secondary Hyperparathyroidism

TRADITIONALLY, bone pain, itchy skin, and soft tissue calcification are indications for parathyroidectomy in those with secondary hyperparathyroidism.^1,2 We recently discovered that general weakness that is frequently observed in conditions of secondary hyperparathyroidism could be improved by parathyroidectomy and autotransplantation. In this article we report the factors that affect patients with general weakness and the postoperative results.

Male gender is a risk factor for mortality in patients with papillary thyroid carcinoma (PTC). This study investigated the impact of androgen receptor (AR) gene expression on the clinical features and progression of PTC. The levels of AR mRNA and protein in frozen, formalin-fixed, paraffin-embedded tissue samples from PTC and adjacent normal thyroid tissue were assessed by quantitative real-time polymerase chain reaction and immunohistochemical staining, respectively, and the relationships between AR expression and clinical features were analyzed. The thyroid cancer cell lines, BCPAP and TPC-1, were used to evaluate the effects of AR on the regulation of cell migration, and key epithelial–mesenchymal transition (EMT) markers. AR mRNA expression was significantly higher in normal thyroid tissue from men than women. The sex difference in AR mRNA expression diminished during PTC tumorigenesis, as AR mRNA expression levels were lower in PTC than normal thyroid tissues from both men and women. AR mRNA expression was significantly decreased in PTC patients with higher risk and in those with extrathyroidal extension. Overexpression of AR in BCPAP cells decreased cell migration and repressed the EMT process by down-regulating mRNA expression of N-cadherin, Snail1, Snail2, Vimentin, and TWIST1 and up-regulating E-cadherin gene expression. These results suggest that suppression of the androgen–AR axis may lead to aggressive tumor behavior in patients with PTC.