Large parathyroid adenomas: Potential mechanisms to reconcile adenoma size and disease phenotype

Parathyroid adenomas weighing more than 3.5 g are reported variously as atypical , large or giant parathyroid adenomas. All such adenomas are rare variants accounting for no more than 1.5% of all parathyroid adenomas. Large parathyroid adenomas are often associated with more severe form of the disease, including osteitis fibrosa cystica (OFC) and share many biochemical, histological, and molecular features of both benign and malignant parathyroid neoplasms, and are considered a distinct clinical entity. However, the pathogenesis of oversized parathyroid adenomas and the often-associated skeletal phenotype remains unclear. We present 5 cases of primary hyperparathyroidism (PHPT) with OFC, an uncommon manifestation of contemporary PHPT, associated with larger parathyroid adenomas, seen in the Bone and Mineral Disorders Clinic of the Henry Ford Health in the last 30 years to illustrate the critical role of vitamin D nutrition in the pathogenesis of both the OFC and adenoma size. The estimated prevalence of OFC was very low 0.2%, 5 of the \u3e3000 surgically confirmed cases of PHPT seen during this time. The mean ± SD values were: age: 36.8 ± 22.1 years (4 of the 510 years of follow-up. Because OFC is a very rare in the West, but very common areas of endemic vitamin D deficiency, we also examined the relationship between vitamin D nutrition, as assessed by serum 25-hydroxyvitamin D level, and parathyroid adenoma weight as well as prevalence of OFC in two large secularly diverse cohorts of patients with PHPT (Detroit, USA and Chandigarh, India). Based on this relationship and the relative prevalence of OFC in these two large cohorts, we propose that vitamin D nutrition (and perhaps calcium nutrition) best explains both the adenoma size and prevalence of OFC

Field dependent nilpotent symmetry for gauge theories

We construct the field dependent mixed BRST (combination of BRST and anti-BRST) transformations for pure gauge theories. These are shown to be an exact nilpotent symmetry of both the effective action as well as the generating functional for certain choices of the field dependent parameters. We show that the Jacobian contributions for path integral measure in the definition of generating functional arising from BRST and anti-BRST part compensate each other. The field dependent mixed BRST transformations are also considered in field/antifield formulation to show that the solutions of quantum master equation remain invariant under these. Our results are supported by several explicit examples.Comment: 25 pages, No figures, Revte

BV formulation of higher form gauge theories in a superspace

We discuss the extended BRST and anti-BRST symmetry (including shift symmetry) in the Batalin-Vilkovisky (BV) formulation for two and three form gauge theories. Further we develop the superspace formulation for the BV actions for these theories. We show that the extended BRST invariant BV action for these theories can be written manifestly covariant manner in a superspace with one Grassmann coordinate. On the hand a superspace with two Grassmann coordinates are required for a manifestly covariant formulation of the extended BRST and extended anti-BRST invariant BV actions for higher form gauge theories.Comment: 30 pages, No figure, version to appear in EPJ

Relationship between bone structural variables from bone biopsy and bone mineral density (BMD) in patients on long term bisphosphonate (BP) Therapy

BMD is a 2D measurement of a 3D structure that has been the cornerstone to diagnose osteoporosis, monitor progression, and response to therapy. Bone volume in biopsy is also a 3D estimate of a 2D measurement. Intuitively it is expected to correlate with each other. A few studies showed significant correlations between bone biopsy and BMD variables in a group of patients with various metabolic bone diseases. However, the strengths of correlations were modest or not significant in a more homogenous subset. Our aim was to understand if there were correlations between the bone structural variables and BMD in a group of post-menopausal women on long-term BP therapy. Methods: Trans-Iliac bone biopsies were obtained from 25 postmenopausal women (mean age 66.8 ± 6.6y) treated with BP for 6.1 ± 4.3 y. Using standard methods cortical bone volume, mean cortical thickness, trabecular bone volume, and trabecular thickness were measured. BMD of both proximal femurs (femoral neck, total hip, and trochanter) was measured by DEXA about 1-2 months before biopsy. Correlations among proximal femur measures and among biopsy variables, as well as between BMD and biopsy structural variables were performed using SigmaPlot. Results: Mean right and left femoral neck BMDs were 0.636 ± 0.068 and 0.637 ± 0.072 with highly significant correlation between the sides (r=0.77;