ABSTRACT
beta-Endorphin immunoactivity was measured in the plasma and cerebrospinal fluid (CSF) of 13 patients with metastatic cancer 1 day before and 5 days after complete transsphenoidal hypophysectomy. Preoperatively, mean beta-endorphin-like immunoactivity in plasma was 18.2 +/- 3.5 pg/ml (SEM) and in CSF 32.3 +/- 6.3 pg/ml. No correlation was noted between the concentration of beta-endorphin in plasma and CSF. Postoperatively, plasma beta-endorphin was undetectable (less than 7 pg/ml) in 12 patients and was low (9.6 pg/ml) in 1 patient. In CSF, however, beta-endorphin was detectable in 10 of the 13 patients postoperatively, with a mean of 14.0 +/- 2.2 pg/ml. Chromatography on Sephadex G-50 of CSF extracts pooled from 3 patients after hypophysectomy showed that the majority of beta-endorphin immunoactivity eluted in the same position as synthetic human beta-endorphin. We conclude that beta-endorphin becomes undetectable in plasma after hypophysectomy in patients receiving exogenous glucocorticoid replacement but remains detectable in significant amounts in CSF. It appears, therefore, that a considerable portion of the beta-endorphin in CSF is of nonpituitary origin, most likely resulting from synthesis and secretion of this peptide by brain directly into the CSF.
Subject(s)
Endorphins/cerebrospinal fluid , Pituitary Gland/physiology , Adult , Aged , Chromatography, Gel , Endorphins/blood , Female , Humans , Hypophysectomy , Male , Middle Aged , Postoperative Period , Radioimmunoassay , beta-EndorphinABSTRACT
A hypophysectomy was performed for palliation of metastatic carcinoma of the breast in a 62-year-old woman who also had diabetes insipidus. At operation a neurohypophyseal mass was discovered; it proved to be a granular cell tumor. The diabetes insipidus resolved postoperatively.
Subject(s)
Diabetes Insipidus/etiology , Neoplasms, Muscle Tissue/complications , Pituitary Neoplasms/complications , Female , Humans , Hypophysectomy , Middle Aged , Neoplasms, Muscle Tissue/pathology , Neoplasms, Muscle Tissue/surgery , Pituitary Neoplasms/pathology , Pituitary Neoplasms/surgeryABSTRACT
Four joggers had early confirmation of clinically suspected stress fractures by radionuclide bone scans. The radioactive bone scan was abnormal as early as six weeks prior to the appearance of conventional roentgenographic changes. The stress fractures involved the bones of the lower extremities and included the femur, tibia, and calcaneus. Radioactive bone scanning also correctly identified stress fractures with bilateral involvement and referred pain. In joggers, when a stress fracture is clinically suspected and the conventional radiographs are negative, a radioactive bone scan is indicated for early confirmation and institution of appropriate treatment.
Subject(s)
Athletic Injuries/etiology , Fractures, Bone/etiology , Jogging , Running , Adult , Bone and Bones/diagnostic imaging , Femoral Fractures/diagnostic imaging , Humans , Middle Aged , Radiography , Stress, Mechanical , Tibial Fractures/diagnostic imagingABSTRACT
A focal defect at the inferior margin of the right lobe of the liver was found in two patients with subhepatic abscesses. This defect must be differentiated from the porta hepatis and the gallbladder fossa. When technetium liver scans are obtained in patients with usspect abdominal abscesses, the inferior margin of the right lobe of the liver should be carefully scrutinized so that right subhepatic abscesses will not be overlooked.
Subject(s)
Liver Abscess/diagnostic imaging , Technetium , Abdomen , Adult , Diagnosis, Differential , False Negative Reactions , Gallium Radioisotopes , Humans , Male , Middle Aged , Radionuclide Imaging , UltrasonographyABSTRACT
Schistosomiasis of the spinal cord is a rare presentation of a disease involving over 200 million people. A patient from an endemic area presenting as a transverse myelitis or a spinal cord tumor, and with eosinophilia, should alert the physician to the possibility of schistosomiasis of the spinal cord. Diagnosis is based on finding the characteristic eggs in the stool or urine, or if necessary, by rectal, bladder or liver biopsies. Myelography is performed to determine if decompressive laminectomy is necessary.
