Guenter Corssen

Respiratory Distress and Beta-Endorphin-Like Immunoreactivity in Humans

Beta-endorphin-like immunoreactivity was determined in the plasma of twenty patients suffering from hypoxia of various etiologies and in twenty healthy adult volunteers who served as controls. Mean beta-endorphin-like immunoreactivity in the hypoxic patients was 53.2 +/- 5.5 (SEM) pg/ml, as compared to the volunteer subjects in whom the mean level was 6.2 +/- 1.9 pg/ml (P less than 0.01). Significant negative correlations were present between both arterial pH (r = -0.85; P less than 0.01) and arterial PO2 (r = -0.80; P less than 0.01) and beta-endorphin-like immunoreactivity. These findings seem to lend support to the hypothesis that hypoxia and acidosis represent stressful conditions which may stimulate the release of beta-endorphin in humans.

Relief of cancer pain in man: alcohol-induced neuroadenolysis vs. electrical stimulation of the pituitary gland

&NA; To explore new methods for the control of intractable pain caused by advanced cancer, the analgesic effect of electrical stimulation of the pituitary gland was investigated in 25 patients. The results were compared with a control study and with the effects of alcohol‐induced pituitary neuroadenolysis (NALP) in the same patients. The pain score (0: no pain at all, 4: extreme pain) in the control study was 3.88 ± 0.33. After electrical stimulation of the pituitary gland it was 1.24 ± 1.61; and after NALP it was 1.0 ± 1.60. The pain scores after electrical stimulation and NALP were significantly lower (P < 0.01) than those in the control study; but there was no significant difference when the two were compared with each other. The duration of pain relief following NALP (59.65 ± 68.72 days) was significantly longer compared with that recorded following electrical stimulation (2.97 ± 2.58 days). Autopsy examinations of 3 patients who expired from their malignancies revealed that the pain relief was unrelated to the degree of necrosis induced in the pituitary by alcohol. Naloxone administration did not inhibit the analgesic effect of either NALP or electrical stimulation. The advantages and disadvantages of electrical stimulation, the pain relief mechanism activated by this method, and potential clinical applications are also discussed.

The role of sympathetic blockade in terminating acute herpes zoster and preventing postherpetic neuralgia

University of Tokyo, Tokyo, Ja anland Central Arizona Anesthesiology, Scottsdale, Arizona 85254, USA 3 . Aim of Investigation: Since Rosemak in 1938 reported that sympathetic blockade can terminate acute herpes zoster, its effectiveness in the treatment of the disease and in the prevention of postherpetic neuralgia has been confirmed by several clinical investigators. This study examines the question whether sympathetic blockade applied during the period of general malaise and pain prior to manifestation of cutaneous herpetic eruption may yield better results in terminating acute herpes zoster and preventing the development of postherpetic neuralgia as compared to the application of sympathetic blockade after skin eruption. Methods: 45 patients with signs and symptoms of acute herpes zoster received sympathetic blockade prior to skin manifestation (Group A) and 218 patients received sympathetic blockade within 10 days after skin eruption occurred (Group B). Results: In the 45 patients of Group A, 66.7% experienced complete pain relief, 20.0% improved and 13.38 developed postherpetic neuralgia. Of the 218 patients of Group B, complete pain relief was achieved in 71.8

The pituitary inhibitory system: its role in pain perception

, improvement was recorded in 17.1% and postherpetic neuralgia developed in 11.1% Conclusion: Application of sympathetic blockade prior to or after the the occurrence of herpetic cutaneous skin eruption yields essentially the same results in providing complete or partial pain relief (86.7% versus 88.9% respectively) and in preventing the development of postherpetic neuralgia (13.3% versus 11.1% respectively). The value of sympathetic blockade in the prevention of postherpetic neuralgia may be questioned since only about 10.0% of patients with acute herpes zoster develope postherpetic neuralgia without being subjected to sympathetic blockade.

Electrophysiologic Evidence for Involvement of the Pituitary Region in Opiate Analgesia

The present study was designed to investigate the pain relief mechanism of electrical stimulation to the pituitary and the relationship between hypothalamic and pituitary analgesic mechanism through the observation of monkey behavior and characteristics of tooth pulp-evoked potentials. The results suggest that pituitary-stimulating analgesia should be differentiated from hypothalamic-stimulating effect. In view of the facts, the theory of the Pituitary Inhibitory System is proposed.

Intravenous anesthesia and analgesia

In the past, various reports have discussed the relationship between the pituitary and analgesia. The purpose of the present study was to explore the possible role of the pituitary region in the mediation of pain by opioids. Tooth pulp evoked potentials recorded from primary somatosensory cortex and from the pituitary region of rabbits were recorded before and after an injection of opiates. Tooth pulp evoked potentials recorded from the primary somatosensory cortex were markedly inhibited after admission of fentanyl, while the tooth pulp evoked potentials recorded from the pituitary region were facilitated. It is concluded that the pituitary region plays a role in the mediation of pain and that this area is involved in the mechanism of opiate analgesia