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Objective. To determine the relationship of the biochemical parameters serum phosphate, serum calcium, and serum parathyroid hormone levels with respect to parathyroid adenoma weight and volume in primary hyperparathyroidism. Study Design. Retrospective review of 63 cases of primary hyperparathyroidism from 1992 to 1998. Methods. Single parathyroid adenomas were identified from surgical pathology reports. Preoperative calcium, phosphate, and parathyroid hormone levels were collected from charts. The volume of the adenoma was calculated using a mathematical equation for the volume of an ellipsoid object. The data were analyzed using a multiple analysis of variance, and a correlation coefficient was calculated. The level of significance was set at p ≤ .05. Results. With respect to adenoma volume, there was a significant correlation with serum calcium and parathormone levels (p = .0001 and p = .0001, respectively). There was no significant correlation between serum phosphate and adenoma volume. With respect to adenoma weight, there was a significant correlation with serum calcium and parathormone levels (p = .0001 and p = .0001, respectively). There was no significant correlation between serum phosphate and adenoma weight. Conclusions. Preoperative serum calcium and parathormone levels may be able to predict adenoma weight and volume in primary hyperparathyroidism for a single adenoma. © 2002 Wiley Periodicals, Inc. Head Neck 24: 1000–1003, 2002

OBJECTIVE: Diabetic nephropathy (DN) is a leading cause of kidney disease in the US. At least four factors influence whether people with diabetes will develop DN: (1) hypertension, (2) hyperglycemia, (3) dietary protein intake, and (4) intrarenal hemodynamics. The angiotensin-converting enzyme (ACE) inhibitors are known to affect blood pressure (BP) and intrarenal hemodynamics; thus, they may prevent the onset of DN or slow the decline in renal function once DN has been diagnosed. DATA SOURCES: English-language, controlled, and crossover studies published between 1973 and 1991 and indexed in MEDLINE under the headings diabetic nephropathies and angiotensin-converting enzyme inhibitors. MAIN OUTCOME MEASURES: The primary outcome indicators of interest were the effects of the ACE inhibitors captopril, enalapril, and lisinopril on BP control and urinary albumin excretion rate. CONCLUSIONS: ACE inhibitors delay the onset and slow the progression of DN in people with diabetes independent of BP effects. They also slow the progression of DN in people with diabetes who have poorly controlled hyperglycemia. The proper dose and time at which to initiate ACE inhibitor therapy to prevent the appearance of DN is not known. It is also not known how long the beneficial effects of ACE-inhibitor therapy persists as only two studies have followed patients for more than one year. Finally, large, long-term, controlled clinical trials are needed before ACE inhibitors can be considered for prophylactic use to prevent the onset and/or progression of DN.

The effect of oral nifedipine on cerebral blood flow velocity was studied in six elderly hypertensive patients using transcranial Doppler. Serial measurements of blood pressure (BP), middle cerebral artery (MCA) flow velocity and nifedipine serum concentrations were obtained over an 8-hour period. The authors found a significant inverse relationship between MCA velocities and nifedipine concentrations, independent of BP changes. These results are consistent with a direct vasodilatory effect of nifedipine on cerebral vessels and support the use of TCD in pharmacodynamic investigations of the cerebral vasculature.