Distribution of β-endorphin in normal and schizophrenic human brains

beta-Endorphin was measured by radioimmunoassay in post-mortem human brains. Samples of brain were taken from five discrete areas, both from control brains and brains of schizophrenic patients. No difference in beta-endorphin levels was found in these two groups of brains. beta-Endorphin was confirmed to be widely distributed in the brain, but there were considerable differences in the concentrations in different areas.     

PRIMARY MERKEL CELL TUMOR: A CLINICAL ANALYSIS OF EIGHT CASES

Background. In recent years, an unusual biologic behavior of Merkel cell tumor (mct ) has been noted. In some patients, the tumor was indolent and well controlled by therapy, while in others it was lethal in a few months. Even though the majority of the reported cases are between these two biologic extremes, it seems evident that there is a high variability in the clinical course of the tumor. Methods. A clinical analysis of eight cases of primary Merkel cell tumor was performed. All the patients presented with similar clinical features: age, tumor staging, duration of the disease, lack of complicating cutaneous or systemic diseases. On the basis of these common findings, which made this group quite homogeneous, our attempt was to identify other clinical signs that could correlate with the local recurrence and/or the onset of metastases. The outcome of our patients, in fact, was quite variable. Results. The tumor size, the clinical aspect at presentation (single, multiple nodules, or plaque), the histologic pattern (all were of the trabecular type), and immunohistology did not correlate with the outcome. Conclusions. We report the rare occurrence of mct in the perianal area, which suggests that it should be included in the differential diagnosis of perianal tumors, the very aggressive behavior of the tumor in two patients (death < 6 months from diagnosis), which confirms how the prognosis for mct is unpredictable even if the diagnosis is established at an incipient stage and the tumor promptly removed.     

Melanoacanthoma Simulating Pigmented Spitz Nevus: an Unusual Dermoscopy Pitfall

BACKGROUND: The starburst pattern is the dermoscopic hallmark of pigmented Spitz nevus, although it has been rarely observed in melanoma as well. OBJECTIVE: To describe a case of melanoacanthoma simulating pigmented Spitz nevus. MATERIAL AND METHODS: Clinical, dermoscopic, and histopathologic examinations were performed for the occurrence of a 4-mm pigmented skin lesion on the hip of a 38-year-old Caucasian woman. RESULTS: Dermoscopy examination of the lesion disclosed a stereotypical starburst pattern characterized by pigmented streaks symmetrically distributed at the periphery. A preoperative diagnosis of pigmented Spitz nevus was made, and the lesion was excised. However, subsequent histopathologic examination revealed a melanoacanthoma. CONCLUSION: The starburst pattern, although diagnostic for pigmented Spitz nevus, can be rarely observed in other benign or malignant pigmented skin lesions. Accordingly, all lesions in adults exhibiting a starburst pattern or other spitzoid features should be excised for histopathologic evaluation.     

Near‐infrared spectroscopy correlates with continuous superior vena cava oxygen saturation in pediatric cardiac surgery patients

Background: Cerebral regional oxygen saturation (rSO₂) measured with near‐infrared spectroscopy (NIRS) has a well‐proven clinical utility. A goal‐oriented treatment based on the rSO₂ resulted in a significant reduction in major morbidity and in a shortening of postoperative hospital stay in patients undergoing coronary revascularization. In this study, we have compared the values of superior vena cava saturation (ScvO₂) continuously measured with a Pediasat catheter and the corresponding NIRS rSO₂ values obtained during cardiac operations in pediatric patients. Methods: This was a prospective observational study enrolling fifteen pediatric patients (age: 6 days–7 years) undergoing cardiac operations. ScvO₂ data obtained with the Pediasat during the operation were compared with simultaneously recorded NIRS rSO₂ values. Results: One hundred and seventeen matched sets of data were obtained during the operation. ScvO₂ continuously measured with the Pediasat was significantly correlated with the corresponding NIRS rSO₂ values. However, there was a constant positive bias (ScvO₂ values were higher than NIRS rSO₂ values) of 5.6%, with a precision of 10.4%. Time‐related percentage changes of NIRS rSO₂ were significantly correlated with the corresponding ScvO₂ percentage changes. A decrease in ScvO₂ is predictive for a decrease in rSO₂ with a sensitivity of 73.7% and a specificity of 85.7%. Conclusions: The continuous measurement of ScvO₂ values obtained by the Pediasat may provide useful information about the metabolic conditions of the brain during cardiac operations in pediatric patients if considered as percentage changes. Absolute values of ScvO₂ tend to overestimate the correspondent rSO₂ values.