Gamma knife surgery of the pituitary: new treatment for thalamic pain syndrome.

OBJECT: Although reports in the literature indicate that thalamic pain syndrome can be controlled with chemical hypophysectomy, this procedure is associated with transient diabetes insipidus. It was considered reasonable to attempt gamma knife surgery (GKS) to the pituitary gland to control thalamic pain. METHODS: Inclusion criteria in this study were poststroke thalamic pain, failure of all other treatments, intolerance to general anesthetic, and the main complaint of pain and not numbness. Seventeen patients met these criteria and were treated with GKS to the pituitary. The target was the pituitary gland together with the border between the pituitary stalk and the gland. The maximum dose was 140 to 180 Gy. All patients were followed for more than 3 months. CONCLUSIONS: An initial significant pain reduction was observed in 13 (76.5%) of 17 patients. Some patients experienced pain reduction within 48 hours of treatment. Persistent pain relief for more than 1 year was observed in five (38.5%) of 13 patients. Rapid recurrence of pain in fewer than 3 months was observed in four (30.8%) of 13 patients. The only complication was transient diabetes insipidus in one patient. It would seem that GKS of the pituitary might have a role to play in thalamic pain arising after a stroke.

Strenuous exercise-induced change in redox state of human serum albumin during intensive kendo training.

A high-performance liquid chromatographic (HPLC) analysis of human serum albumin (HSA) using an ion-exchange (DEAE-form) column shows three components: The principal component corresponds to human mercaptalbumin (HMA); the secondary to nonmercaptalbumin (HNA), having mixed disulfide with cystine (HNA[Cys]), or oxidized glutathione (HNA[Glut]); and the tertiary to HNA, oxidized more highly than mixed disulfide. The purpose of the present study is to clarify the effects of strenuous exercise load on HMA--><--HNA conversion (i.e., dynamic change in redox state) of HSA from elite kendo athletes (n=30; 20.0+/-1.1 years old). They participated in an intensive kendo training camp for 5 d. The mean value for the HMA fraction (f[HMA]) of kendo athletes after camp (62.8+/-2.4%) was significantly lower than before camp (71.9+/-3.7%) (p<0.0005). In contrast, the mean value for f(HNA-1) (i.e., f[HNA(Cys) and HNA(Glut)]) after camp (34.2+/-2.1%) was significantly higher than before camp (25.7+/-3.7%) (p<0.0005). These results suggested that strenuous physical exercise markedly increased the oxidized albumin level in extracellular fluids during the intensive training camp.