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278 THE MEDICAL SOCIETY OF THE STATE OF NORTH CAROLINA Fig. 1. Schematic representation of the daily calcium metabolism in individuals with normal and excess parathyroid secretion. The normal patient31 is in positive calcium balance. He excretes less calcium than he takes in the diet, the excretion in the feces being about four times that in the urine. The patient with hyperparathyroidism82 is in negative calcium balance. He is excreting five times as much calcium as is taken in the diet. Calcium is being withdrawn continuously from its storehouse in the bones, carried in high level in the blood and excreted in excess from the kidneys. The demin-eralization of the skeletal and the deposition of calcium salts in the calyces of the kidneys and in the kidney pelvis is shown. NORMAL HYPERPARATHYROIDISM The blood calcium was 5.4 mgm. the phosphorus 2 mgm. and the phosphatase 2.4 Bodansky units. The urinary tract was studied by Dr. W. L. Haltom. Urine from each kidney pelvis was sterile and neither pelvis was dilated on pyelography. There was rather marked nephroptosis on the right side. The phthalein excretion was normal. At operation December 5, 1935, a soft, brownish-red parathyroid tumor about 4x2x1 cm. in size was removed from under the superior pole of the right lobe of the thyroid gland (Fig. 8). When this lobe was rolled medially no tumor could be seen or felt as in our first case. Dissection was carried along the inferior thyroid artery until it entered the thyroid gland without encountering any abnormality. A branch of the inferior thyroid artery which coursed upward was then followed and the lower portion of the tumor uncovered. It was of the same consistency as the surrounding tissues and on palpation could not be detected. Because we felt this might be a case of diffuse hyperplasia of all the parathyroid glands the left side was explored immediately. The left superior gland was normal in every respect. Neither of the inferior glands could be detected. The tumor was then approached and was readily removed. The postoperative convalescence was uneventful. There was no evidence of tetany. Blood calcium and phosphorus levels promptly returned to normal. (Fig. 6). She left the hospital on the seventh postoperative day. We have thus far been unable to get her to return for postoperative studies.
Object Description
Rating | |
Fixed Title * | NCHH-16: Transactions of the Medical Society of the State of North Carolina [1891-1939] |
Document Title | Transactions of the Medical Society of the State of North Carolina [1891-1939] |
Subject Topical | Medicine -- North Carolina -- Societies, etc. |
Subject Topical Other | Societies, Medical -- North Carolina. |
Description | After 1939 transactions published in the North Carolina Medical Journal |
Creator | Medical Society of the State of North Carolina. Annual Session. |
Publisher | Raleigh, N.C. : Medical Society of the State of North Carolina, 1891-1939. |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1936 |
Identifier | NCHH-16-083 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 83 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-16/nchh-16-083.pdf |
Document Sort | all; group-d; nchh-16 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-16-083 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-16 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb2983307 |
Revision History | keep |
Description
Fixed Title * | Page 278 (image) |
Document Title | Transactions of the Medical Society of the State of North Carolina [1891-1939] |
Subject Topical | Medicine -- North Carolina -- Societies, etc. |
Subject Topical Other | Societies, Medical -- North Carolina. |
Description | After 1939 transactions published in the North Carolina Medical Journal |
Creator | Medical Society of the State of North Carolina. Annual Session. |
Publisher | Raleigh, N.C. : Medical Society of the State of North Carolina, 1891-1939. |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1936 |
Identifier | NCHH-16-083-0324 |
Form General | Periodicals |
Page Type | all; all images; diagram; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | transactions831936medi_0324.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 83 |
Page Number | 278 |
Health Discipline | Medicine |
Full Text | 278 THE MEDICAL SOCIETY OF THE STATE OF NORTH CAROLINA Fig. 1. Schematic representation of the daily calcium metabolism in individuals with normal and excess parathyroid secretion. The normal patient31 is in positive calcium balance. He excretes less calcium than he takes in the diet, the excretion in the feces being about four times that in the urine. The patient with hyperparathyroidism82 is in negative calcium balance. He is excreting five times as much calcium as is taken in the diet. Calcium is being withdrawn continuously from its storehouse in the bones, carried in high level in the blood and excreted in excess from the kidneys. The demin-eralization of the skeletal and the deposition of calcium salts in the calyces of the kidneys and in the kidney pelvis is shown. NORMAL HYPERPARATHYROIDISM The blood calcium was 5.4 mgm. the phosphorus 2 mgm. and the phosphatase 2.4 Bodansky units. The urinary tract was studied by Dr. W. L. Haltom. Urine from each kidney pelvis was sterile and neither pelvis was dilated on pyelography. There was rather marked nephroptosis on the right side. The phthalein excretion was normal. At operation December 5, 1935, a soft, brownish-red parathyroid tumor about 4x2x1 cm. in size was removed from under the superior pole of the right lobe of the thyroid gland (Fig. 8). When this lobe was rolled medially no tumor could be seen or felt as in our first case. Dissection was carried along the inferior thyroid artery until it entered the thyroid gland without encountering any abnormality. A branch of the inferior thyroid artery which coursed upward was then followed and the lower portion of the tumor uncovered. It was of the same consistency as the surrounding tissues and on palpation could not be detected. Because we felt this might be a case of diffuse hyperplasia of all the parathyroid glands the left side was explored immediately. The left superior gland was normal in every respect. Neither of the inferior glands could be detected. The tumor was then approached and was readily removed. The postoperative convalescence was uneventful. There was no evidence of tetany. Blood calcium and phosphorus levels promptly returned to normal. (Fig. 6). She left the hospital on the seventh postoperative day. We have thus far been unable to get her to return for postoperative studies. |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-16/nchh-16-083.pdf |
Document Sort | all; group-d; nchh-16 |
Article Title | Hyperparathyroidism � Its Recognition And Treatment |
Article Author | E. C. Gardner |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-16-083 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-16 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb2983307 |
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