J Järhult

Umeå University, Umeå, Västerbotten, Sweden

Are you J Järhult?

Claim your profile

Publications (12)17.91 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Renal function was investigated immediately before and 1 year following parathyroidectomy in 19 patients with moderate hypercalcaemia. On both occasions, all patients underwent five different tests of glomerular and tubular function: plasma creatinine, creatinine clearance, 51Cr-EDTA-clearance, beta 2-microglobulin excretion and the desmopressin test. Glomerular filtration rate, as assessed by plasma creatinine and clearance of both creatinine and 51Cr-EDTA, was normal in most patients, and was little affected by restoration of normocalcaemia. Renal concentrating capacity, as determined by the desmopressin test, was abnormally low in 14 of 19 patients, but increased significantly after surgery. It is concluded that serious renal damage is seldom encountered in present-day HPT patients, but that a treatable decrease in renal concentrating capacity often exists.
    Journal of Internal Medicine 06/1990; 227(5):317-24. · 6.46 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Calcium, parathyroid hormone, follicle-stimulating hormone, luteinizing hormone, and estradiol were measured in 15 postmenopausal women with primary hyperparathyroidism before and 1 year after parathyroidectomy. Normalization of serum calcium concentrations (from 2.87 to 2.29 mmol/l) was followed by a highly significant fall in serum LH and FSH concentrations. No significant alteration occurred in plasma estradiol concentration.
    Acta endocrinologica 04/1989; 120(3):379-82.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Muscle function in ten hyperparathyroid patients and six patients with benign thyroid disease was assessed by measuring maximal expiratory (Pe max) and inspiratory (Pi max) pressures before and 6-12 months after neck surgery. Pe max was improved in all the hyperparathyroid patients postoperatively (p less than 0.002), while the median value of Pi max was unchanged. In the control (thyroid) group there was no significant postoperative change in either Pe max or Pi max. It is concluded that normalization of hypercalcemia improves respiratory muscular capacity, which can be quantified by measuring maximal expiratory pressure.
    Acta chirurgica Scandinavica 01/1988; 154(7-8):415-8.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Three hundred and eleven patients with presumed hyperparathyroidism were operated upon between the years 1961 and 1983 at the two surgical clinics in Northern Sweden equipped with pathologic facilities. Eighty per cent were women. All of the patients were hypercalcemic. Parathyroid hormone (PTH) levels were elevated in 66 per cent of the patients. The correlation between serum calcium and PTH levels was only 0.38. Serum creatinine levels were normal in 92 per cent of the patients while renal concentrating ability was depressed in 79 per cent. The main patient symptoms were fatigue, mental disturbances and renal stones. Eighteen per cent were asymptomatic at the time of the operation. Most patients were diagnosed during in-hospital investigations. Many were also found to be hypercalcemic at regular outpatient controls. At operation, adenomas were found in 80 per cent, different kinds of hyperplasia in 15 per cent, normal histologic finding in 4 per cent, while cancer was found in less than 1 per cent of the patients. At follow-up study, 79 per cent were normocalcemic while 3 per cent were hypocalcemic and 11 per cent were still hypercalcemic--7.5 per cent were lost to follow-up study. Nine patients had a permanent paralysis of the recurrent laryngeal nerve.
    Surgery, gynecology & obstetrics 03/1987; 164(2):119-23.
  • [Show abstract] [Hide abstract]
    ABSTRACT: A retrospective study of the long-term effects of surgery for normocalcaemic hyperparathyroidism in 82 patients is presented. The median postoperative follow-up time was 96 months. In most of the patients recurrent renal calculi had been the main preoperative symptom, and intermittent peaks of hypercalcaemia were recognized in more than 50% of them. Of the 19 patients with severe tendency to calculus formation, 12 appeared to have been cured by parathyroidectomy. These cured patients were found at operation to have parathyroid adenoma or hyperplasia, or even normal glands. Preoperatively depressed renal function normalized in about 50% of cases, as assessed by the desmopressin test. No patient had paralysis of the recurrent laryngeal nerve, and all were normocalcaemic during follow-up. Parathyroid surgery should be considered for this category of patients, although it is very difficult to distinguish between those who stand to benefit and those who do not.
    Acta chirurgica Scandinavica 02/1987; 153(5-6):331-6.
  • [Show abstract] [Hide abstract]
    ABSTRACT: A randomized study of the value of drainage in thyroid and parathyroid surgery is presented. Fifty patients were provided with surgical drains and another fifty patients were allocated to a control group without drainage. Complications were few in either group and the rate of subjective discomfort from the collar incision was equally low in both groups. The observations suggest that the provision of drainage is not necessary after uncomplicated neck surgery.
    British Journal of Surgery 03/1986; 73(2):121-2. · 4.84 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A retrospective analysis of 34 patients undergoing 45 re-explorations for persistent hypercalcemia is presented. Thirteen out of the 20 enlarged parathyroid glands were found at reoperation to be normally located, indicating that the initial exploration had been incomplete. A follow-up study of the reoperated patients showed that 25 (74%) were normocalcaemic. Three patients had permanent unilateral recurrent laryngeal nerve damage and 2 patients required calcium and/or vitamin D therapy. Ultrasonography was effective in the diagnosis and localisation of residual parathyroid adenoma in patients with persistent postoperative hyperparathyroidism.
    Urological Research 02/1986; 14(6):323-5. · 1.59 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The history of a pregnant woman with primary hyperparathyroidism is presented. The patient underwent successful operation during the second trimester and the subsequent pregnancy and delivery were completely normal. Previously, 72 women with an established diagnosis of hyperparathyroidism in pregnancy are reported in the English literature. Twenty-three women underwent operation during pregnancy and 18 normal children were born. Fifty women with a total of 79 pregnancies during a hyperparathyroid state bore 35 normal children while 40 births had different kinds of complications. It is thus clearly documented that the risk of severe fetal complications is much higher if the hyperparathyroidism is left untreated than if the mother undergoes operation during the pregnancy. Therefore when the diagnosis is established the mother should undergo operation, if possible during the second trimester, which minimizes the complication rate significantly in both mother and child. Correction of the hypercalcemic state enables the development of adequate parathyroid gland function in the baby.
    Surgery 04/1985; 97(3):326-30. · 3.37 Impact Factor
  • A Kristoffersson, S Emdin, J Järhult
    [Show abstract] [Hide abstract]
    ABSTRACT: Choriocarcinomas are rare malignancies which occasionally cause acute abdominal symptoms, mainly in the form of hemorrhage. We here describe a patient with metastatic choriocarcinoma presenting as acute intestinal obstruction and splenic hemorrhage. This seems to be the first report in the literature of a choriocarcinoma causing invagination of the small intestine. The abdominal manifestations of the neoplasm are briefly discussed.
    Acta chirurgica Scandinavica 02/1985; 151(4):381-4.
  • A Kristoffersson, J Järhult
    [Show abstract] [Hide abstract]
    ABSTRACT: The relationship between extent of surgery and calcium levels 6-12 months postoperatively has been analysed in 177 patients in whom a parathyroid adenoma was found at exploratory surgery of the neck. The analysis showed that the frequency of postoperative hypocalcaemia and the need of longterm calcium and vitamin D supplements increased if macroscopically normal glands were extirpated and/or biopsied in addition to removal of the adenoma. It was also shown that the frequency of postoperative hypercalcaemia was similar in patients in whom the peroperative histopathological examination of macroscopically normal glands showed normal cellularity or hyperplasia. The data favour a more conservative approach in parathyroid surgery.
    Annales chirurgiae et gynaecologiae 02/1985; 74(5):215-8.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The value of high-resolution real-time ultrasonography in locating parathyroid adenomas was compared with that of computed tomography (CT). In 21 patients with a single parathyroid adenoma verified at neck exploration, preoperative ultrasonography and CT detected the adenoma in 15 and 11 cases, respectively. Ultrasound gave false-positive results in four patients and false-negative in two, whereas CT was false-positive in four patients and false-negative in six. Most false-positive reports were due to misinterpretation of small thyroid nodules. For acceptable accuracy both methods require an experienced radiologist. Technical and interpretive problems seem to be somewhat less frequent with ultrasonography than with CT. Ultrasonography has therefore become the method of choice for preoperative location of enlarged parathyroid glands at our hospital, and CT is used as a complementary procedure, e.g. when a mediastinal adenoma is suspected.
    Acta chirurgica Scandinavica 02/1985; 151(7):583-7.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Thirteen patients with primary hyperparathyroidism were treated for 4-8 weeks with the H2-blocker cimetidine at a daily dose of 1 g. The drug had no effect on the serum concentrations of calcium or parathyroid hormone, nor did any of the patients improve clinically during the period of treatment. The recently reported efficacy of cimetidine in primary hyperparathyroidism is strongly questioned by the present results.
    Journal of endocrinological investigation 01/1984; 6(6):489-91. · 1.65 Impact Factor