Alterations of Hypothakamopituitary Interaction and Pain Threshold Following Pituitary Neuroadenolysis : A Clinical Investigation of the Mechanism of Cancer Pain Relief

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概要

• 論文の詳細を見る

• Clinical investigations were carried out to elucidate the mechanism through which pituitary neuroadenolysis (NALP) relieved intractable cancer pain. When investigating hypothalamopituitary interaction, continuous elevation of TRH and arginine vasopressin were observed in the cerebrospinal fluid (CSF) following NALP. ACTH^<1-39>in the CSF abruptly increased after NALP in cases with complete pain relief, in contrast with the far less elevation in cases without complete relief. There was no significant increase of endorphins in the CSF. The sufficient inactivation of the anterior and posterior pituitary functions indicated the success of the procedure, but had no exact correlation with the obtainability of complete relief of cancer pain, though cancer pain was more frequently alleviated in hormone-dependent carcinomas than in non-dependent. Valuation of pain responsiveness showed the duration of tourniquet tolerance in cases with complete relief of cancer pain following NALP was twice as long as before NALP, while it was unchanged in cases without complete pain relief. Radiant heat dolorimetry revealed no significant differences between cases with complete pain relief and those without. Sensory decision theory analysis denoted increased pain threshold and improved discriminability in cases with complete relief. Pain threshold determination thus indicated increased C-fiber thresholds, which mainly mediate cancer pain, and excluded the placebo effect of NALP. Observations indicated that the increase of peptides in the CSF, which are mainly synthesized in the hypothalamopituitary axis, would exert a suppressive effect on the mediation and perception of cancer pain through the C-fibers and the central nervous system.

• 日本脳神経外科学会の論文
• 1983-07-15

著者

• FUJITA TATSUSHI

  Department of Anesthesiology, School of Medicine, Gunma University

• Fujita Tatsushi

  Department Of Anesthesiology School Of Medicine Gunma University

• Uki Jiro

  Neurosurgery Clinic Saitama Cancer Center

• KITANI Yasuharu

  Department of Anesthesiology and Animatology, Gunma University

• Takeda Fumikazu

  Neurosurgery Clinic Saitama Cancer Center

• Tozawa Ryuji

  Anesthesiology Clinic Saitama Cancer Center

• FUJII Takashi

  Neurosurgery Clinic, Saitama Cancer Center

• FUSE Yoshiaki

  Anesthesiology Clinic, Saitama Cancer Center

• Kitani Yasuharu

  Department Of Anesthesiology Gunma University

• Kitani Yasuharu

  Department Of Anesthesiology And Animatology Gunma University

• Fuse Yoshiaki

  Anesthesiology Clinic Saitama Cancer Center

• Fujii Takashi

  Neurosurgery Clinic Saitama Cancer Center

• Fujita Tatsushi

  Department of Anesthesiology and Resuscitology, Gunma University School of Medicine

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• Alterations of Hypothakamopituitary Interaction and Pain Threshold Following Pituitary Neuroadenolysis : A Clinical Investigation of the Mechanism of Cancer Pain Relief
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