{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T22:34:35Z","timestamp":1785278075403,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[1992,7,1]],"date-time":"1992-07-01T00:00:00Z","timestamp":709948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1992,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Two\u2010hundred seventy\u2010four patients with primary hyperparathyroidism had selective removal of enlarged parathyroid glands. Biopsies were taken from all parathyroid glands. Normal\u2010size glands were not resected irrespective of their histological appearance. After a mean follow\u2010up of 13.5 years the rates of persistent and recurrent hyperparathyroidism were, respectively, 3.6% and 0.7%. Transient and permanent hypoparathyroidism occurred in 24% and 2.5% of the patients. The microscopic appearance of enlarged glands and of biopsies taken from normal\u2010size glands were reviewed by two pathologists. Normal parathyroid glands were distinguished from abnormal glands fairly accurately (sensitivity 93%, specificity 80%). Microscopic classification of abnormal parathyroid glands as adenomas or hyperplastic glands correlated poorly with the gross classification as single or multigland disease. Flow cytometric DNA analysis of paraffin embedded parathyroid tissue showed significant differences for DNA index, % S\u2010phase and % G2M (<jats:italic>p<\/jats:italic>&lt;0.001). Differentiating single from multigland disease by means of DNA analysis was not possible. In conclusion, removal of only enlarged parathyroid glands results in acceptable rates of persistent and recurrent hyperparathyroidism. Biopsies should only be taken sparingly to prevent transient and permanent hypoparathyroidism. Microscopic examination and flow cytometric DNA analysis can differentiate normal from abnormal parathyroid glands but are unable to differentiate abnormal glands into single or multigland disease.<\/jats:p>","DOI":"10.1007\/bf02067373","type":"journal-article","created":{"date-parts":[[2005,8,13]],"date-time":"2005-08-13T21:45:46Z","timestamp":1123969546000},"page":"737-743","source":"Crossref","is-referenced-by-count":31,"title":["Single and multigland disease in primary hyperparathyroidism: Clinical follow\u2010up, histopathology, and flow cytometric DNA analysis"],"prefix":"10.1002","volume":"16","author":[{"given":"H. Jaap","family":"Bonjer","sequence":"first","affiliation":[{"name":"Departments of Surgery and Internal Medicine University Hospital Dijkzigt Rotterdam The Netherlands"},{"name":"Department of Pathology Maine Medical Center and Maine Cytometry Research Institute Portland Maine U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajo A.","family":"Bruining","sequence":"additional","affiliation":[{"name":"Departments of Surgery and Internal Medicine University Hospital Dijkzigt Rotterdam The Netherlands"},{"name":"Department of Pathology Maine Medical Center and Maine Cytometry Research Institute Portland Maine U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan C.","family":"Birkenhager","sequence":"additional","affiliation":[{"name":"Departments of Surgery and Internal Medicine University Hospital Dijkzigt Rotterdam The Netherlands"},{"name":"Department of Pathology Maine Medical Center and Maine Cytometry Research Institute Portland Maine U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald H.","family":"Nishiyama","sequence":"additional","affiliation":[{"name":"Departments of Surgery and Internal Medicine University Hospital Dijkzigt Rotterdam The Netherlands"},{"name":"Department of Pathology Maine Medical Center and Maine Cytometry Research Institute Portland Maine U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Jones","sequence":"additional","affiliation":[{"name":"Departments of Surgery and Internal Medicine University Hospital Dijkzigt Rotterdam The Netherlands"},{"name":"Department of Pathology Maine Medical Center and Maine Cytometry Research Institute Portland Maine U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Bruce Bagwell","sequence":"additional","affiliation":[{"name":"Departments of Surgery and Internal Medicine University Hospital Dijkzigt Rotterdam The Netherlands"},{"name":"Department of Pathology Maine Medical Center and Maine Cytometry Research Institute Portland Maine U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[1992,7]]},"reference":[{"key":"e_1_2_1_2_1","first-page":"643","article-title":"Late results of operation for primary hyperparathyroidism","volume":"99","author":"Rudberg C.","year":"1986","journal-title":"Surgery"},{"key":"e_1_2_1_3_1","first-page":"8","article-title":"The role of routine biopsy of all parathyroid glands in primary hyperparathyroidism","volume":"51","author":"McGarity W.C.","year":"1985","journal-title":"Am. 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