Brown tumors in dialyzed patients with secondary hyperparathyroidism: Report of 16 cases

Brown tumors (BTs) are relatively uncommon but they are serious complications of renal osteodystrophy. The objective of this study was to analyze the clinical, biological, and radiological characteristics of 16 patients with BTs provoked by secondary hyperparathyroidism (sHPT) and its response to the decrease in parathyroid hormone levels after parathyroidectomy (PTX). The management of that uncommon condition was also reviewed. We conducted a retrospective study including 16 end‐stage renal disease patients who underwent subtotal PTX between 1997 and 2007 for severe sHPT with BTs. Our study included 10 men and 6 women, whose average age was 34 years. All patients were on dialysis. Ten of them were on dialysis for more than 5 years. The median duration on dialysis was 84 months. Patients included suffered from swellings associated with functional limitations. BTs had multiple locations in 7 patients. Jaw was the most frequent location (62%). Radiography and tomodensitometry demonstrated a mixed radio lucent and radio‐opaque lesions with an expansion of the cortical bone. Bone scan demonstrated an increased uptake of lesions. Chirurgical treatment was indicated in all cases because of severe refractory sHPT with functional limitations and/or disfiguring deformities. In all cases, BTs stopped its progression and even decreased in size. However, it was insufficient in four cases, which required a surgical resection. PTX remains an efficacious approach in resistant cases of sHPT with persistent BTs.     

Microstructure,Hardness, and Residual Stress Distributions in T-Joint Weld of HSLA S500MC Steel

This paper investigates the characterization of the microstructure, hardness, and residual stress distributions of MIG-welded high-strength low-alloy S500MC steel. The T-joint weld for 10-mm-thick plates was joined using a two passes MIG welding technology. The contour method was performed to measure longitudinal welding residual stress. The obtained results highlighted a good correlation between the metallurgical phase constituents and hardness distribution within the weld zones. In fact, the presence of bainite and smaller ferrite grain size in the weld-fusion zone might be the reason for the highest hardness measured in this region. A similar trend of the residual stress and hardness distributions was also obtained.