A neuroendocrinological study in female migraineurs: prolactin and thyroid stimulating hormone responses

To evaluate the change of the neurotransmitter function in migraine, a neuroendocrinological study was performed in eleven female migraineurs and nine female controls. Thyrotropin releasing hormone, luteinizing hormone releasing hormone, and insulin were simultaneously loaded (the Triple test). Before and after loading, serum glucose, prolactin (PRL), thyroid stimulating hormone (TSH), luteinizing hormone, follicle stimulating hormone, adrenocorticotropic hormone, cortisol, human growth hormone and beta-endorphin were measured. The Triple test produced an increase of PRL in both migraine and control groups, but in migraineurs the increase was significantly larger than in controls. TSH also increased in response to the test, but the TSH response in patients was less than in controls, although not significantly so. The responses of other substances showed no significant differences between the two groups. Although dopaminergic hypofunction in migraine has been proposed by some authors, the present findings rather suggest a serotonergic hyperfunction.     

The Relationship Between Muscle Contraction Headache and Migraine: A Multivariate Analysis Study

SYNOPSIS
Increasing evidence of the similarity between muscle contraction headache (MCH) and migraine has been reported. However, there seem to be some problems and confusion about the notion that MCH and migraine are similar. For clarification of the relationship of MCH to migraine, we carried out a series of multivariate analysis studies. One hundred and eighty headache patients (including 60 MCH patients, 60 combined headache patients and 60 migraine patients) were investigated. Clinical data of these 180 patients were analyzed using Hayashi's Quantification analysis and cluster analysis. It was possible to determine an MCH factor and a migraine factor from headache symptoms and characteristics. A diffuse and sequential distribution of patients was observed in the histogram of quantified symptoms with the purpose of discriminating headache categories. Thus, most headache patients might have both the MCH factor and the migraine factor in various proportions. We propose a slight modification of the headache severity model and add some development of the concept that MCH and migraine are a continuum. We submit a new headache model.     

Evaluation of intraoperative radiotherapy for carcinoma of the pancreas: prognostic factors and survival analyses

Among 145 patients with carcinoma of the pancreas who had been admitted to three institutions between 1976 and 1985, 117 were entered into a prognostic factor analysis system according to Cox's proportional hazards model. The treatment was classified into four modalities: bypass surgery, single-dose intraoperative radiotherapy (IOR), IOR combined with external irradiation, and resection with or without various radiations. The most important prognostic factors for treatment were identified as location of tumor, TNM stage, and relief of back pain. Adjusting the imbalances among the treatment groups using Cox's model, the superiority of IOR with external irradiation was confirmed for both bypass and single-dose IOR. With this adjustment, the survival rates proved to be more meaningful than the simple Kaplan-Meier estimates.     

The voice of patients for improving cesarean delivery care

BACKGROUND: The incidence of cesarean delivery (CS) is about 15% of birth in Japan in recent years. The patient satisfaction has not been adequately studied during the entire perioperative experience. The purpose of this study is to examine what attention anesthesiologists should pay during anesthesia for CS. METHODS: The women who had received CS filled out questionnaire survey a few days or six months after CS. RESULTS: Their problems included nausea, vomiting, the pain and numbness of the lower extremities during the operation, as well as the pain, delay in facing the child, and painful feeding after the operation. CONCLUSIONS: These observations suggest that to all pregnant women and family, the medical staffs should offer correct information concerning CS at the early stage and should try to make arrangement that the mothers can meet their neonates earlier. The anesthesiologists should also be aware of nausea and vomiting during operation, and offer superior perioperative pain-relief after CS.