The Parathyroid glands are small glands located in the neck behind the thyroid. These four glands are part of the endocrine system and are similar to the shape and size of a grain of rice. Healthy glands are a mustard yellow color. The parathyroid glands secrete a hormone known as parathormone, which controls the concentration of calcium (calcium ion) and phosphorus (phosphate) in the blood. The proper balance of these two keeps the nervous system and muscular systems functioning normally.
Hyperparathyroidism is the most common disease of the parathyroid. This is when one or more of the glands continue to produce parathyroid hormone regardless of the level of calcium levels in the bloodstream. The most common cause of this condition occurs when a benign tumor has developed in one of the parathyroid glands. This enlargement of one parathyroid gland is called a “Parathyroid Adenoma.” Rarely, more than one or even all four parathyroid glands are enlarged. The symptoms associated with primary hyperthyroidism are:
- Bone pain
- Kidney stones
- Diffusing abdominal pain and complaints
Minimally Invasive Radioguided Parathyroid (MIRP) Surgery is the preferred method for treating parathyroid disease. MIRP surgery has the highest cure rate and is the least invasive of all parathyroid operations. There is a minimal pain, a much smaller incision (as small as 1 inch); it’s a same-day surgery and a quick return to normal activities.
A goiter is the enlargement of the thyroid gland itself. Swelling may occur on one or both sides of the neck when the gland enlarges. It may be noticed when a collar or necklace has become tighter. A person with hypothyroidism may develop a goiter because the thyroid gets larger in an attempt to produce more hormone. A person with hyperthyroidism may have thyroid cells that multiply too rapidly and cause the thyroid to enlarge. Multiple nodules may also increase the size of the thyroid.
Tumors of the adrenal glands are rare. However, when present, they can cause a multitude of disorders by excessively secreting certain adrenal-produced hormones. One type of tumor of the adrenal glands is called a pheochromocytoma.
A pheochromocytoma is a benign adrenal gland tumor that secretes epinephrine and norepinephrine hormones. These hormones are responsible for regulating heart rate and blood pressure, among other functions. Pheochromocytomas occur most frequently in young- to middle-aged adults between the ages of 30 and 60.
The most common symptom of pheochromocytoma is high blood pressure, which is sometimes extreme. Other symptoms are usually nonexistent unless the person experiences pressure from the tumor, emotional stress, changes in posture, or is taking beta-blocker drugs for a heart disorder. Each individual may experience symptoms differently. Other symptoms may include:
- Rapid pulse
- A headache
- Clammy skin
The symptoms of pheochromocytoma may resemble other conditions or medical problems. Consult a physician for a diagnosis. In addition to a complete medical history and medical examination, diagnostic procedures for pheochromocytoma may include:
- Blood and urine tests to measure hormone levels
- Computed tomography (CT or CAT scan) – a non-invasive procedure that takes cross-sectional images of the brain or other internal organs; to detect any abnormalities that may not show up on an ordinary X-ray
- Radioisotope scan – uses radioactive substances introduced into the body to create an image of the functioning adrenal gland
Treatment for pheochromocytoma usually includes removing the tumor. Before removing the tumor, however, your physician may prescribe drugs to control high blood pressure. Rarely, pheochromocytomas can be malignant and may metastasize to other organs. Chemotherapy following resection of the primary tumor is the treatment of choice for malignant pheochromocytomas.
The pancreas plays an important role in the digestion of food and in the regulation of blood sugar. Loss of pancreatic tissue after surgical removal increases the risks for the development of diabetes mellitus and malabsorption of food.
Preservation of pancreatic tissue is an important goal during surgery for pancreatic and biliary diseases to reduce the risk of loss of pancreatic tissue. During the Whipple operation, organs that play a vital role in digestive function are often removed. The organs removed include part of the pancreas and bile duct and all of the duodenum. The duodenum appears to play an important role in regulating the motility of the stomach and the upper gastrointestinal tract. It is thought that partial or complete loss of the duodenum is responsible for the delay in emptying of the stomach that often occurs after the Whipple operation.
For malignant tumors affecting the duodenum, head of the pancreas, and the distal (bottom end) of the bile duct, the Whipple operation is the standard of care and the procedure of choice. The Whipple operation is also frequently performed for benign (non-cancerous) disorders that affect the bottom end of the bile duct, duodenum, or head of the pancreas. While in some patients the extent or nature of disease may require a Whipple operation, alternate procedures that preserve some of the organs removed during the standard Whipple operation may be an option in other patients.
A vasectomy is a simple operation designed to make a man sterile, or unable to father a child. It is used as a means of contraception in many parts of the world. A total of about 50 million men have had a vasectomy — a number that corresponds to roughly 5% of all married couples of reproductive age. In comparison, about 15% of couples rely on female sterilization for birth control.
Approximately half a million vasectomies are performed in the United States each year. About one out of six men over age 35 have been vasectomized, the prevalence increasing along with education and income. Among married couples in this country, only female sterilization and oral contraception are relied upon more often for family planning. At Eviva we perform vasectomies in a comfortable environment typically within 30 minutes!
Vasectomy involves blocking the tubes through which sperm pass into the semen. Sperm is produced in a man’s testis and stored in an adjacent structure known as the epididymis. During sexual climax, the sperm moves from the epididymis through a tube called the vas deferens and mix with other components of the semen to form the ejaculate. All vasectomy techniques involve cutting or otherwise blocking both the left and right vas deferens so that the man’s ejaculate will no longer contain sperm and he will not be able to make a woman pregnant.
A physician makes one or two small incisions, or cuts, in the skin of the scrotum, which has been numbed with a local anesthetic. The vas is cut, and a small piece may be removed. Next, the doctor ties the cut ends and sews up the scrotal incision. The entire procedure is then repeated on the other side.
Vasectomy offers many advantages as a method of birth control. Like female sterilization, it is a highly effective one-time procedure that provides permanent contraception. A vasectomy is medically much simpler than female sterilization, has a lower incidence of complications, and is much less expensive.
After a vasectomy, the patient will probably feel sore for a few days, and he should rest for at least one day. However, he can expect to recover completely in less than a week. Many men have the procedure on a Friday and return to work on Monday. Although complications such as swelling, bruising, inflammation, and infection may occur, they are relatively uncommon and almost never serious. Nevertheless, men who develop these symptoms at any time should inform their physician.
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