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Chan Il Park - One of the best experts on this subject based on the ideXlab platform.
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prevention of postoperative Hypocalcemia with routine oral calcium and vitamin d supplements in patients with differentiated papillary thyroid carcinoma undergoing total thyroidectomy plus central neck dissection
Cancer, 2009Co-Authors: Jaeyong Park, Chan Il ParkAbstract:BACKGROUND: Routine oral calcium and vitamin D supplementation may prevent hypocalcemic crisis, but its efficacy has not been studied in patients undergoing thyroidectomy plus central neck dissection (CND). The authors therefore prospectively evaluated the clinical usefulness of routine oral calcium and vitamin D supplementation for prevention of Hypocalcemia after total thyroidectomy and CND. METHODS: Of 197 patients with differentiated papillary thyroid carcinoma, 49 underwent total thyroidectomy alone, and 148 underwent total thyroidectomy plus CND. The latter were randomized to oral calcium (3 g/day) plus vitamin D (1 mg/day) (Group A, n=49), calcium alone (Group B, n=49), or no supplements (Group C, n=50). Hypocalcemic symptoms, serum calcium, and parathyroid hormone (PTH) levels were compared among the groups. RESULTS: Group C had significantly higher incidences of symptomatic (26.0% vs 6.1%; P<.015) and laboratory (44.0% vs 14.3%; P<.015) Hypocalcemia than the group without CND. The incidences of symptomatic and laboratory Hypocalcemia were significantly decreased in Groups A (2.0% and 8.2%, respectively) and B (12.2% and 24.5%, respectively) (P<.05). Serum calcium levels decreased in most patients after surgery, but recovered earliest in Group A. Hypercalcemia and PTH inhibition did not occur in gs A and B. CONCLUSIONS: Compared with total thyroidectomy alone, CND significantly increases the rate of postoperative Hypocalcemia, which can be prevented by routine postoperative supplementation with oral calcium and vitamin D.
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prevention of postoperative Hypocalcemia with routine oral calcium and vitamin d supplements in patients with differentiated papillary thyroid carcinoma undergoing total thyroidectomy plus central neck dissection
Cancer, 2009Co-Authors: Jonglyel Roh, Jaeyong Park, Chan Il ParkAbstract:BACKGROUND: Routine oral calcium and vitamin D supplementation may prevent hypocalcemic crisis, but its efficacy has not been studied in patients undergoing thyroidectomy plus central neck dissection (CND). The authors therefore prospectively evaluated the clinical usefulness of routine oral calcium and vitamin D supplementation for prevention of Hypocalcemia after total thyroidectomy and CND. METHODS: Of 197 patients with differentiated papillary thyroid carcinoma, 49 underwent total thyroidectomy alone, and 148 underwent total thyroidectomy plus CND. The latter were randomized to oral calcium (3 g/day) plus vitamin D (1 mg/day) (Group A, n = 49), calcium alone (Group B, n = 49), or no supplements (Group C, n = 50). Hypocalcemic symptoms, serum calcium, and parathyroid hormone (PTH) levels were compared among the groups. RESULTS: Group C had significantly higher incidences of symptomatic (26.0% vs 6.1%; P < .015) and laboratory (44.0% vs 14.3%; P < .015) Hypocalcemia than the group without CND. The incidences of symptomatic and laboratory Hypocalcemia were significantly decreased in Groups A (2.0% and 8.2%, respectively) and B (12.2% and 24.5%, respectively) (P < .05). Serum calcium levels decreased in most patients after surgery, but recovered earliest in Group A. Hypercalcemia and PTH inhibition did not occur in gs A and B. CONCLUSIONS: Compared with total thyroidectomy alone, CND significantly increases the rate of postoperative Hypocalcemia, which can be prevented by routine postoperative supplementation with oral calcium and vitamin D. Cancer 2009. © 2009 American Cancer Society.
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routine oral calcium and vitamin d supplements for prevention of Hypocalcemia after total thyroidectomy
American Journal of Surgery, 2006Co-Authors: Chan Il Park, Jonglyel RohAbstract:Abstract Background The purpose of this study was to evaluate the clinical usefulness of routine oral calcium and vitamin D supplements in the prevention of Hypocalcemia after total thyroidectomy. Methods Ninety patients who underwent total thyroidectomy were randomly assigned to routinely receive or not receive a supplement containing oral calcium (3 g/d) and vitamin D (1 g/d) for 2 weeks. Hypocalcemic signs and symptoms, serum calcium, and parathyroid hormone (PTH) levels were monitored and compared between the 2 groups. Results The incidences of symptomatic and laboratory Hypocalcemia were significantly lower in the oral calcium/vitamin D group than in the group not receiving the supplement: 3 of 45 patients (7%) versus 11 of 45 (24%) and 6 of 45 (13%) versus 16 of 45 (36%), respectively (P ≤ .02). The hypocalcemic symptoms were minimal in the supplement group but more severe in the group not receiving the supplement. Serum calcium levels decreased in both groups after surgery but recovered earlier in the supplement group. No hypercalcemia or PTH inhibition developed in the supplement group. Conclusion Routine administration of a supplement containing oral calcium and vitamin D is effective in reducing the incidence and severity of Hypocalcemia after total thyroidectomy.
Jonglyel Roh - One of the best experts on this subject based on the ideXlab platform.
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prevention of postoperative Hypocalcemia with routine oral calcium and vitamin d supplements in patients with differentiated papillary thyroid carcinoma undergoing total thyroidectomy plus central neck dissection
Cancer, 2009Co-Authors: Jonglyel Roh, Jaeyong Park, Chan Il ParkAbstract:BACKGROUND: Routine oral calcium and vitamin D supplementation may prevent hypocalcemic crisis, but its efficacy has not been studied in patients undergoing thyroidectomy plus central neck dissection (CND). The authors therefore prospectively evaluated the clinical usefulness of routine oral calcium and vitamin D supplementation for prevention of Hypocalcemia after total thyroidectomy and CND. METHODS: Of 197 patients with differentiated papillary thyroid carcinoma, 49 underwent total thyroidectomy alone, and 148 underwent total thyroidectomy plus CND. The latter were randomized to oral calcium (3 g/day) plus vitamin D (1 mg/day) (Group A, n = 49), calcium alone (Group B, n = 49), or no supplements (Group C, n = 50). Hypocalcemic symptoms, serum calcium, and parathyroid hormone (PTH) levels were compared among the groups. RESULTS: Group C had significantly higher incidences of symptomatic (26.0% vs 6.1%; P < .015) and laboratory (44.0% vs 14.3%; P < .015) Hypocalcemia than the group without CND. The incidences of symptomatic and laboratory Hypocalcemia were significantly decreased in Groups A (2.0% and 8.2%, respectively) and B (12.2% and 24.5%, respectively) (P < .05). Serum calcium levels decreased in most patients after surgery, but recovered earliest in Group A. Hypercalcemia and PTH inhibition did not occur in gs A and B. CONCLUSIONS: Compared with total thyroidectomy alone, CND significantly increases the rate of postoperative Hypocalcemia, which can be prevented by routine postoperative supplementation with oral calcium and vitamin D. Cancer 2009. © 2009 American Cancer Society.
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routine oral calcium and vitamin d supplements for prevention of Hypocalcemia after total thyroidectomy
American Journal of Surgery, 2006Co-Authors: Chan Il Park, Jonglyel RohAbstract:Abstract Background The purpose of this study was to evaluate the clinical usefulness of routine oral calcium and vitamin D supplements in the prevention of Hypocalcemia after total thyroidectomy. Methods Ninety patients who underwent total thyroidectomy were randomly assigned to routinely receive or not receive a supplement containing oral calcium (3 g/d) and vitamin D (1 g/d) for 2 weeks. Hypocalcemic signs and symptoms, serum calcium, and parathyroid hormone (PTH) levels were monitored and compared between the 2 groups. Results The incidences of symptomatic and laboratory Hypocalcemia were significantly lower in the oral calcium/vitamin D group than in the group not receiving the supplement: 3 of 45 patients (7%) versus 11 of 45 (24%) and 6 of 45 (13%) versus 16 of 45 (36%), respectively (P ≤ .02). The hypocalcemic symptoms were minimal in the supplement group but more severe in the group not receiving the supplement. Serum calcium levels decreased in both groups after surgery but recovered earlier in the supplement group. No hypercalcemia or PTH inhibition developed in the supplement group. Conclusion Routine administration of a supplement containing oral calcium and vitamin D is effective in reducing the incidence and severity of Hypocalcemia after total thyroidectomy.
Tally Navehmany - One of the best experts on this subject based on the ideXlab platform.
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parathyroid specific deletion of dicer dependent micrornas abrogates the response of the parathyroid to acute and chronic Hypocalcemia and uremia
The FASEB Journal, 2015Co-Authors: Vitali Shilo, Justin Silver, Iddo Z Bendov, Morris Nechama, Tally NavehmanyAbstract:MicroRNAs (miRNAs) down-regulate gene expression and have vital roles in biology but their functions in the parathyroid are unexplored. To study this, we generated parathyroid-specific Dicer1 knockout (PT-Dicer−/−) mice where parathyroid miRNA maturation is blocked. Remarkably, the PT-Dicer−/− mice did not increase serum parathyroid hormone (PTH) in response to acute Hypocalcemia compared with the >5-fold increase in controls. PT-Dicer−/− glands cultured in low-calcium medium secreted 5-fold less PTH at 1.5 h than controls. Chronic Hypocalcemia increased serum PTH >4-fold less in PT-Dicer−/− mice compared with control mice with no increase in PTH mRNA levels and parathyroid cell proliferation compared with the 2- to 3-fold increase in hypocalcemic controls. Moreover, uremic PT-Dicer−/− mice increased serum PTH and FGF23 significantly less than uremic controls. Therefore, stimulation of the parathyroid by both Hypocalcemia and uremia is dependent upon intact dicer function and miRNAs. In contrast, the PT-D...
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parathyroid specific deletion of dicer dependent micrornas abrogates the response of the parathyroid to acute and chronic Hypocalcemia and uremia
The FASEB Journal, 2015Co-Authors: Vitali Shilo, Justin Silver, Iddo Z Bendov, Morris Nechama, Tally NavehmanyAbstract:MicroRNAs (miRNAs) down-regulate gene expression and have vital roles in biology but their functions in the parathyroid are unexplored. To study this, we generated parathyroid-specific Dicer1 knockout (PT-Dicer(-/-) ) mice where parathyroid miRNA maturation is blocked. Remarkably, the PT-Dicer(-/-) mice did not increase serum parathyroid hormone (PTH) in response to acute Hypocalcemia compared with the >5-fold increase in controls. PT-Dicer(-/-) glands cultured in low-calcium medium secreted 5-fold less PTH at 1.5 h than controls. Chronic Hypocalcemia increased serum PTH >4-fold less in PT-Dicer(-/-) mice compared with control mice with no increase in PTH mRNA levels and parathyroid cell proliferation compared with the 2- to 3-fold increase in hypocalcemic controls. Moreover, uremic PT-Dicer(-/-) mice increased serum PTH and FGF23 significantly less than uremic controls. Therefore, stimulation of the parathyroid by both Hypocalcemia and uremia is dependent upon intact dicer function and miRNAs. In contrast, the PT-Dicer(-/-) mice responded normally to activation of the parathyroid calcium-sensing receptor (Casr) by both hypercalcemia and a calcimimetic that decreases PTH secretion, demonstrating that they are dicer-independent. Therefore, miRNAs are essential for the response of the parathyroid to both acute and chronic Hypocalcemia and uremia, the major stimuli for PTH secretion.
Francis D Moore - One of the best experts on this subject based on the ideXlab platform.
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oral calcium supplements to enhance early hospital discharge after bilateral surgical treatment of the thyroid gland or exploration of the parathyroid glands
Journal of The American College of Surgeons, 1994Co-Authors: Francis D MooreAbstract:: One hundred and seventy consecutive patients undergoing parathyroid gland exploration and bilateral thyroidectomy received, postoperatively, routine oral calcium supplementation, close monitoring of total serum calcium, and addition of vitamin D for specific criteria, all to accomplish a postoperative course free of symptomatic Hypocalcemia and early discharge from the hospital. Twelve of these patients underwent simultaneous thyroid gland and parathyroid gland operation. Parathyroid gland manipulation during these operations was aggressive. Of the 58 patients undergoing parathyroid exploration, two required hospitalization for more than three days to treat Hypocalcemia. No patients required intravenous calcium and 17 of the last 24 having total serum calcium greater than or equal to 9.0 milligrams per deciliter at 36 hours were discharged uneventfully on the morning of the second postoperative day. Of the 124 patients undergoing bilateral thyroidectomy, four required hospitalization in excess of three days for Hypocalcemia, one required intravenous calcium and one still requires daily vitamin D after a year. Eighty-five of the last 96 patients having a total serum calcium greater than or equal to 8.5 milligrams per deciliter at 36 hours were discharged on the morning of the second postoperative day, without subsequent hypocalcemic events. These data suggest that a program of calcium supplementation combined with enthusiastic outpatient support can be the future basis for same day or one day admissions after parathyroid gland or extensive thyroid gland operations.
Vitali Shilo - One of the best experts on this subject based on the ideXlab platform.
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parathyroid specific deletion of dicer dependent micrornas abrogates the response of the parathyroid to acute and chronic Hypocalcemia and uremia
The FASEB Journal, 2015Co-Authors: Vitali Shilo, Justin Silver, Iddo Z Bendov, Morris Nechama, Tally NavehmanyAbstract:MicroRNAs (miRNAs) down-regulate gene expression and have vital roles in biology but their functions in the parathyroid are unexplored. To study this, we generated parathyroid-specific Dicer1 knockout (PT-Dicer−/−) mice where parathyroid miRNA maturation is blocked. Remarkably, the PT-Dicer−/− mice did not increase serum parathyroid hormone (PTH) in response to acute Hypocalcemia compared with the >5-fold increase in controls. PT-Dicer−/− glands cultured in low-calcium medium secreted 5-fold less PTH at 1.5 h than controls. Chronic Hypocalcemia increased serum PTH >4-fold less in PT-Dicer−/− mice compared with control mice with no increase in PTH mRNA levels and parathyroid cell proliferation compared with the 2- to 3-fold increase in hypocalcemic controls. Moreover, uremic PT-Dicer−/− mice increased serum PTH and FGF23 significantly less than uremic controls. Therefore, stimulation of the parathyroid by both Hypocalcemia and uremia is dependent upon intact dicer function and miRNAs. In contrast, the PT-D...
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parathyroid specific deletion of dicer dependent micrornas abrogates the response of the parathyroid to acute and chronic Hypocalcemia and uremia
The FASEB Journal, 2015Co-Authors: Vitali Shilo, Justin Silver, Iddo Z Bendov, Morris Nechama, Tally NavehmanyAbstract:MicroRNAs (miRNAs) down-regulate gene expression and have vital roles in biology but their functions in the parathyroid are unexplored. To study this, we generated parathyroid-specific Dicer1 knockout (PT-Dicer(-/-) ) mice where parathyroid miRNA maturation is blocked. Remarkably, the PT-Dicer(-/-) mice did not increase serum parathyroid hormone (PTH) in response to acute Hypocalcemia compared with the >5-fold increase in controls. PT-Dicer(-/-) glands cultured in low-calcium medium secreted 5-fold less PTH at 1.5 h than controls. Chronic Hypocalcemia increased serum PTH >4-fold less in PT-Dicer(-/-) mice compared with control mice with no increase in PTH mRNA levels and parathyroid cell proliferation compared with the 2- to 3-fold increase in hypocalcemic controls. Moreover, uremic PT-Dicer(-/-) mice increased serum PTH and FGF23 significantly less than uremic controls. Therefore, stimulation of the parathyroid by both Hypocalcemia and uremia is dependent upon intact dicer function and miRNAs. In contrast, the PT-Dicer(-/-) mice responded normally to activation of the parathyroid calcium-sensing receptor (Casr) by both hypercalcemia and a calcimimetic that decreases PTH secretion, demonstrating that they are dicer-independent. Therefore, miRNAs are essential for the response of the parathyroid to both acute and chronic Hypocalcemia and uremia, the major stimuli for PTH secretion.