Neuroendocrine Symptoms Research Articles

Emotional disorders in the structure of psychoorganic pathology in tumors of the diencephalon

IntroductionThe tumors of the diencephalon region (thalamic-hypothalamic-pituitary system) include a large group: pituitary adenomas, craniopharyngiomas, gliomas, and others. Tumors differ in the histological structure, and manifestations of the clinical symptoms; by hormonal data; by approaches and methods in treatment.Psychic symptoms are revealed in disease in addition to cerebral, neuroendocrine symptoms, neurological disorders. Psychoorganic syndrome is represented by emotional, motivational, personal, cognitive impairments, inversion of the sleep-wake cycle, seizures.Disorders of mental activity are detected in all tumors of this localization in varying degrees, according to the different authors from 20 to 100%; affective pathology varies from 2 to 80% by the literature.ObjectivesTo study the emotional disorders in the structure of psychoorganic pathology in tumors of diencephalon regionMethods290 patients (18-78 years old, mean age 38+2): pituitary adenomas (PA), as the most common – 170 (58,6%), craniopharyngiomas (CG), as with the most varied manifestation of mental symptoms – 120 (41,4%). Methods: psychopathological, data from endocrinological, neurological, neuroimaging methods.ResultsEmotional disorders were detected in patients from 30 to 68% of cases, depending on the histology of the tumours: PA with excessive secretion of growth hormone - emotional disorders are in 60%; PA with excessive secretion of adrenocorticotropic hormone - in 50%; PA with excessive secretion of prolactin - in 30%; with excessive secretion of thyroid-stimulating hormone - in 40%; non-functioning PA - in 16%; CG - in 68%.Emotional disorders were more often represented by changeable mood, depression, apathy, sleep disturbance, and visceral symptoms. Symptoms differed depending on the histology of the tumor (type and level of hormones), the volume of the lesion and direction of growth, and concomitant hypertensive-hydrocephalic symptoms. Emotional disturbances often include memory impairment, personality and behavior changes.ConclusionsEmotional disorders are detected in patients in 30-68% of cases in the structure of psychoorganic pathology with damage to the diencephalon region (in particular, with pituitary adenomas and craniopharyngiomas); are determined by the topography of the tumor and histology with the involvement of the corresponding structures and nuclei in the pathological process.Disclosure of InterestNone Declared

Acute and Reversible Hypothalamic Symptoms in a Lateral Head Impact Mouse Model of Mild Traumatic Brain Injury.

Central autonomic and endocrine dysfunctions following traumatic brain injury (TBI) are believed to involve the hypothalamus; however, underlying mechanisms are unknown. Although chronic deficits might be caused by irreversible tissue damage, various neuroendocrine and autonomic symptoms are only observed transiently, suggesting they might result from a temporary alteration in the activity of hypothalamic neurons. We therefore examined if a mouse model of mild TBI could induce reversible autonomic phenotypes and cause acute changes in c-Fos expression within corresponding regions of the hypothalamus. Adult C57Bl/6 male mice were lightly anesthetized with isoflurane and subjected to TBI by lateral head impact using a Gothenburg impactor. Mice treated the same way, but without the head impact served as controls (shams). We monitored body weight and core body temperature by infrared thermography and performed immunohistochemistry against c-Fos in various regions of the hypothalamus. We determined that a projectile velocity of 9 m/s significantly delayed recovery from the anesthesia without inducing skull fractures and signs of discomfort disappeared within 3 h, as assessed by grimace scale. Compared with shams, TBI mice displayed a rapid decrease in core body temperature which resolved within 48 h. Daily body weight gain was also significantly lower in TBI mice on the day following injury but recovered thereafter. c-Fos analysis revealed a significantly higher density of c-Fos-positive cells in the paraventricular nucleus and a significantly lower density in the median preoptic nucleus and medial preoptic area. We conclude that mild TBI induced by a single lateral head impact in mice at 9 m/s produces acute and reversible symptoms associated with hypothalamic dysfunction accompanied by significant changes in c-Fos expression within relevant areas of the hypothalamus. These findings support the hypothesis that a temporary alteration of neuronal activity may underlie the expression of reversible central autonomic and neuroendocrine symptoms.

Exercise as a Moderator of Persistent Neuroendocrine Symptoms of COVID-19.

Precipitated by chronic psychological stress, immune system dysregulation, and a hyperinflammatory state, the sequelae of postacute COVID-19 (long COVID) include depression and new-onset diabetes. We hypothesize that exercise counters the neuropsychiatric and endocrine sequelae of long COVID by inducing the release of circulating factors that mediate the anti-inflammatory response, support brain homeostasis, and increase insulin sensitivity.

Нейроэндокринные нарушения при COVID-19 и постковидном синдроме и особенности их лечения препаратами гамма-аминомасляной кислоты (обзор литературы и собственные данные)

В статье освещены основные патогенетические механизмы развития нейроэндокринных нарушений при COVID-19 и постковидном синдроме. К проявлениям поражения центральной нервной системы относятся жалобы на головную боль, часто очень сильную, повышенную утомляемость, «мозговой туман» и периодическое кратковременное головокружение, изменения психического состояния и когнитивных функций. Поражение периферической нервной системы проявляется аносмией и гипогевзией, болями в мышцах и суставах, миофасциальными болями, болями, похожими на невропатии, гиперестезией кожи. Наблюдаются нарушения эндокринного статуса в виде аутоиммунного тиреоидита с дисфункцией щитовидной железы, нарушения толерантности к углеводам или инсулиннезависимого сахарного диабета (2-го типа), дисменореи у женщин и эректильной дисфункции у мужчин. Патогенетические изменения персистенции вируса SARS-CoV-2 вызывают состояние хронического стресса с гипоталамической дисфункцией. Также выявлены гистологические изменения в виде нарушений нейроглиальных взаимодействий: с учетом тесной связи астроцитов и нейронов изменения метаболизма в астроцитах нарушают функцию нейронов, влияют на синаптическую функцию трансмиссии гамма-аминомасляной кислоты. Актуальна оптимизация терапии у пациентов с COVID-19, постковидным синдромом с нейроэндокринной симптоматикой. Гамалате В6 — препарат гамма-аминомасляной кислоты, имеющий лучшие характеристики для таких пациентов.

S2960 Incidental Diagnosis of a Rare Metastatic Neuroendocrine Breast Cancer During Routine Screening Mammogram Which Eventually Revealed Primary Small Intestine Carcinoid Tumor

Introduction: Neuroendocrine neoplasms (NENs), defined as epithelial neoplasms with predominant neuroendocrine differentiation, typically occur in the pancreas, tubular gastrointestinal tract, or lung with or without secretory syndromes. Neuroendocrine breast carcinoma (NEBC) is a rare tumor which accounts for 1-2% of all invasive breast carcinoma. When NENs are found on a biopsy of a breast nodule it is considered either primary NEBC or metastatic if another primary organ is discovered. NEBC usually presents as a breast lump on exam without neuroendocrine symptoms. Therefore, making a diagnosis of NEBC prior to biopsy is difficult. We present a case of an incidentaloma discovered on routine mammography that turned out to be NEBC on biopsy and further evaluation discovered an asymptomatic primary small bowel NEN, thus confirming the breast as metastatic NEBC. Case Description/Methods: A routine mammogram in 60 yo. female revealed an abnormal 4 mm solid nodule in the right breast. A core needle biopsy found a low grade, well differentiated NEN, with positive staining for synaptophysin and chromogranin. She felt well and denied any symptoms. Medical history was notable for immune hepatitis with liver cirrhosis managed by her hepatologist. An abdominal MRI/MRCP revealed thickening in the small bowel wall consistent with a primary carcinoid tumor and demonstrated hepatic surface metastases. Plasma and 24 hr. urine 5 HIAA and chromogranin A plasma levels were normal. A lumpectomy was performed and therapy with lanreotide i.m. monthly injections begun. At 6 months follow-up, she remains asymptomatic, with stable disease. Discussion: Metastasis to the breast from a primary NEN is infrequently reported in the literature. If discovered in a patient without a history of known primary NEN in another organ, imaging is warranted to seek asymptomatic and non-secreting tumors elsewhere, as in the GI tract of our patient. No proven effective chemotherapy or RT for either primary or metastatic NEBC exists. No proven effective chemotherapy regimen exists for NENs, but therapy with long-acting somatostatin analogs are the preferred first-line option for NENs associated with several hormonal syndromes as well as for growth control in well-differentiated unresectable or metastatic gastroenteropancreatic NENs as in our case.

Фактори ризику рецидиву неактивних аденом гіпофіза у хворих із дефіцитом гормона росту

Актуальність. На даний час залишається актуальним пошук діагностично значущих маркерів агресивності неактивних аденом гіпофіза (НАГ) для визначення подальшого прогнозу в постопераційному періоді. Аденоми гіпофіза, що не мають клінічних проявів гіперсекреції гіпофізарних гормонів, є формами доброякісних пухлин аденогіпофіза. У загальній популяції частота НАГ становить 50 випадків на 1 млн населення. Мета дослідження: визначити клініко­діагностичні маркери агресивності пухлини у хворих із НАГ і дефіцитом гормона росту і їх роль у формуванні тяжкості нейроендокринної симптоматики захворювання. Матеріали та методи. Під наглядом перебувало 87 хворих (із них чоловіків — 44, жінок — 43) із верифікованим діагнозом НАГ після трансназальної гіпофізектомії; період спостереження — від одного до трьох років. Результати. При розподілі хворих на групи залежно від гістологічної характеристики НАГ переважали пацієнти з крупноклітинною хромофобною аденомою гіпофіза (77,5 %). НАГ у жінок супроводжувалася ожирінням, первинним і вторинним гіпотиреозом, вторинним гіпогонадизмом, синдромом персистуючої галактореї — аменореї (симптоматична й ідіопатична форми), нецукровим діабетом, синдромом порожнього турецького сідла та ін. У чоловіків НАГ супроводжувалася ожирінням, первинним і вторинним гіпотиреозом, вторинним гіпогонадизмом, нецукровим діабетом, гінекомастією. Розроблена шкала маркерів агресивності НАГ дозволила ідентифікувати фактори за трьома ступенями і розробити комплекс профілактичних заходів, покликаних унеможливлювати рецидив зростання пухлини. Висновки. Маркерами агресивності перебігу НАГ є: молодий вік пацієнта, перші симптоми маніфестації хвороби, великі розміри пухлини, асиметричність і деформація гіпофіза, ознаки інвазії пухлини в сусідні тканини/артерії/кавернозний синус, наявність дрібноклітинних і/або темноклітинних хромофобних аденом, пангіпопітуїтаризм.

Understanding Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and the Emerging Osteopathic Approach: A Narrative Review.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating syndrome of unknown origin, characterized by profound postexertional malaise and fatigue, unrefreshing sleep, cognitive impairments, immune dysfunction, pain, autonomic dysfunction, and neuroendocrine symptoms. Although ME/CFS is well documented within the medical literature, it remains difficult to diagnosis and manage. Some of the current challenges include an absence of diagnostic markers, differing diagnostic criteria, and an overall lack of awareness within the medical community. As a result, patients are often frustrated by the difficulties in acquiring a diagnosis and from the overall lack of available treatments. In an effort to increase awareness, this review discusses disease pathophysiology, clinical presentation, and treatment options, while also highlighting the benefits of an osteopathic approach.

Possible Mechanisms Underlying Epipharyngeal Abrasive Therapy (EAT) with ZnCl2 Solution for the Treatment of Autoimmune Diseases and Functional Somatic Syndrome

Chronic epipharyngitis is a common latent but serious condition that may contribute to a wide range of diseases in humans, including collagen diseases, glomerulonephritis and autonomic nervous disorders. In a previous study, we presented a putative causal role of chronic epipharyngitis in the development of functional somatic symptoms and syndromes following human papillomavirus vaccination by demonstrating a significant improvement in symptoms following abrasive therapy using ZnCl2 on the epipharynx. Since this initial study, we have expanded our clinical experience, providing epipharyngeal abrasive therapy to 988 patients with confirmed chronic epipharyngitis associated with a wide variety of clinical symptoms. These symptoms could be classified into three broad categories, namely local inflammation-referred, autoimmune-related, and neuroendocrine symptoms. Symptom alleviation was achieved in the majority of patients with repeated epipharyngeal abrasive therapy.Through an in-depth review of the literature on epipharyngeal abrasive therapy, combined with our clinical experience, we propose three mechanisms underlying the therapeutic effects of epipharyngeal abrasive therapy: the astringent anti-inflammatory effect of ZnCl2, a blood-letting effect that promotes removal of epipharyngeal activated lymphocytes and drainage of excess inflammatory fluids containing various antigens, cytokines or noxious substances, and a neuromodulation effect achieved through stimulation of the vagus nerve. These effects can be explained within the context of current understanding of immunology, lymphology and neuroscience.Our hypothesis-driven review provides a theoretical basis for the observed therapeutic effects of epipharyngeal abrasive therapy in ameliorating various diseases, including functional somatic symptoms and syndromes following human papillomavirus vaccination.

Gamma knife radiosurgery of craniopharyngioma: results of 30 cases treated at Nagoya Radiosurgery Center.

Evaluation of 30 cases of craniopharyngioma treated by Gamma Knife at Nagoya Radiosurgery Center (NRC), Nagoya Kyoritsu Hospital since July, 2004 has been made. The mean volume of the tumor was 2.64 ml, which was treated with the marginal dose of 11.7 Gy. Mean follow-up period was 79.9 months. The effects were evaluated by MRI findings, neuro-endocrine and hypothalamic signs and symptoms, complications and KPS every 3~6 months. As the results, complete remission was obtained in 8, partial remission in 12, no change in 6, progression in 3, in which two died by hypothalamic invasion. Tumor response rate was 68.9% and control rate 87.9%. Actuarial survival was 96% at 5 and 86% at 10 years. However, progression free survival was 76% and 76%, respectively. Using marginal dose of 11.7Gy to a smaller tumor, better control without complications has been obtained. KPS was excellent in 14, good in 9, fair in 2, poor in 1 and unknown in a case. Finally, there were three deaths, where two were died of tumor progression and one by infirmity. The progression of hypothalamic symptoms other than diabetes insipidus were found in two cases. Volume reduction and effective dose setting will be important for the improvement of QOL and survival after combined microsurgery and radiosurgery of craniopharyngioma.

56. Pituicytoma: A case report and literature review

Background The pituicytoma, or infundibuloma, is an exceptionally rare sellar-suprasellar glial neoplasm of adults with low proliferative activity (WHO grade I). 1,2 They are thought to arise from the pituicytes, which are specialised glial cells of the neurohypophysis. 3 Less than 60 cases are reported so far. Case report A 37-year-old female presented with amenorrhoea. No other clinical or neuro-endocrine symptoms were present. MRI brain showed a 22mm intrasellar/suprasellar mass. Frozen section showed a spindle cell tumour. Histology showed cellular tumour with spindle cells arranged in short fascicles and sheets with focal storiform and packeted pattern. The tumour cells had an oval to elongated nuclei with pinpoint nucleoli. Scattered dilated staghorn-like blood vessels and patchy lymphocytic infiltrates were present. No whorls, psammoma bodies, cytoplasmic granularity, eosinophilic granular bodies or Rosenthal fibres were noted. No mitotic figures or necrosis were noted. The spindle cells were strongly immunoreactive to S-100 protein, BCL-2, and CD99; patchy strong reactivity to GFAP and EMA; patchy weak reactivity to synaptophysin, and CD31; negative to broad-spectrum cytokeratins (AE1/AE3), chromogranin and CD34. The Ki-67 (MIB1) proliferation index was 2% to 8%. Conclusion We present a case report of this rare entity, review available literature, and discuss the clues to differentiate it from other spindle cell tumours such as granular cell tumour, meningioma, pilocytic astrocytoma, schwannoma and other lesions, which are common to the sellar-suprasellar site, as accurate diagnosis is essential to guide the appropriate management.

Resection of Carotid Body Tumors reduces arterial blood pressure. An underestimated neuroendocrine syndrome

IntroductionCarotid Body Tumors (CBTs) are Paragangliomas (PGLs) located in the head and neck region which usually do not cause overt neuroendocrine symptoms and hypertension. Matrix Metalloproteinases (MMPs) have shown a strong correlation between CBTs and their clinical behavior. Aim of this study is to analyze the relationship between changes in arterial blood pressure and metalloproteinases levels after surgical resection of CBTs. MethodsWe performed a multicenter clinical study on 17 patients with benign and malignant CBTs (5 males; 12 females). Tumors were completely resected and biopsies, obtained at the time of surgery, were lysed for Western blot analysis to determine MMPs levels in tissues. An enzyme-linked immune sorbent assay (ELISA) kit was used to determine the concentration of MMPs in plasma fluid.Blood pressure values were measured at admission and at 10 days after surgery. ResultsAt the time of the admission, blood pressure values were higher in patients with CBTs respect to control patients; moreover in patients with malignant CBTs blood pressure values were higher (P < 0.01) respect to patients with benign CBTs. 10 days after the surgery, we documented a significant decrease (P < 0.01) in blood pressure values and in MMPs levels in all patients with CBTs. ConclusionThese results suggest that, despite the CTBs are considered non-functional tumors, an “underestimated” neuroendocrine activity on arterial blood pressure may be detected.

Blockade of Group I Metabotropic Glutamate Receptors (mGluRs) Activation Inhibits Nociception Following Descending Colon Distension in Sheep

Expression of mGluRs of groups I and II was found in structures of CNS closely related with nociception: spinal cord superficial fields, responsible for pain filling or modulation of neurotransmission in the peripheral receptors. The present study examined contribution of mGluRs to the development and maintenance of changes in behavioral and clinical symptoms caused by visceral pain. Experiments were carried out in fourth stages (each of six Polish Merino ewes). Every experiment was performed simultaneously on two fasted animals, which were placed in two individual cages at one-week intervals. Sheep were fitted with a permanent stainless steel cannula in the lateral ventricle of the brain. Blood was collected before and few times after intracerebroventricular (i.c.v.) administration of the mGluR1 antagonist: L-2-Amino-3-phosphonopropionic acid (L-AP3). The L-AP3 was infused at doses: 0.2, 0.4 or 0.8 mg/animal, 10 min before the provoking of visceral pain by distention of Descending Colon (CD) with the rubber balloon of 200 mL water. This data demonstrated that the development and maintenance of the visceral pain symptoms of the CD is dependent on activation of mGluR1 in the CNS and that these receptors play a crucial role in modulating experimental acute visceral pain. The group I of the mGluR antagonist prevent behavioral, clinical and neuroendocrine symptoms of visceral pain. They can be possibly used in cases of acute visceral pain, especially, in combination with opioid agonists. Their simultaneous administration would probably allow minimizing dose of opioids. This knowledge can be also useful in palliative medicine.

Treatment of suprasellaer arachnoid cysts in children with neuroendoscopy

Objective To investigate the effectiveness and safty of the ventriculocystostomy (VC)combined with cystocisternostomy (CC) in dealing with the suprasellae arachaid cysts (SACs) and secondary hydrocephalus.Methods 15 pediatric patients with SACs and secondary hydrocephalus were admitted into Tianjin Huanhu Hospital during Jan.2008 to Oct.2011.They received operation with neuroendoscopy to make fenestrations to communicate the suprasellar cyst with lateral ventricules and the prepontine cistern named ventriculocystocister nostomy (VCC).The outcomes were analyzed contrastively with several indexes,such as neuroendocrine symptoms improvements,shrinkage of the cyst,replacement of the pontine,optic chiasm and the opening of the Sylvian aqueduct.With the method of MRI-cine,the CSF flowing could be observed at the inferior fistula ora and/or Sylvian aqueduct.Results The operation were achieved and symptoms of hyhrocephalus were released in all patients.Intraoperatively,opening of Sylvian aqueduct was fouud in most of the patients.Among all neuroendocrine symptoms,the diabetes insipidus improved most markedly.The indexes evaluating the effectiveness of the VCC showed remarkably difference between post and pre-operation.Conclusions The procedure of VCC is effective in dealing with the symptoms with few complications and signs derived from the SACs. Key words: Suprasellae cysts; Children; Hydrocephalus; Ventriculocystocisternostomy; Neuroendoscopy

PMO-023 Assessment of quality of life, coping strategies and personal beliefs in neuroendocrine tumour patients

IntroductionMedical research is focused on the developing of treatments and improving survival outcomes. In recent years, quality of life (QoL) measurements have been included in clinical trials as a relevant...

Neurocutaneous spectrum of multiple endocrine neoplasia-1

Multiple endocrine neoplasia type I or Wermer syndrome is characterized by primary hyperparathyroidism, enteropancreatic endocrine tumor, and a pituitary pathology. A 35-year-old male presented with visual field defects, hyperprolactinemia, and hypogonadism. He also had multiple infraumbilical skin-colored nodules. A syndromal association of Wermer syndrome was derived using the dermal, pituitary, parathyroid, and gastrointestinal hormonal manifestations of the tumor. The radiological and histological findings of lesion which underwent biopsy are discussed. The presence of collagenomas, lipomas, and hypopigmented macules in a patient with neuroendocrine symptoms should raise the suspicion of an underlying multiple endocrine neoplasia.

Targeted Therapy in Advanced Well-Differentiated Neuroendocrine Tumors

Treatments for advanced neuroendocrine tumors were, until recently, rather limited. Salvage surgery and liver-directed therapy both have relatively limited impact, and systemic cytotoxic chemotherapy has minimal efficacy. In the absence of other effective treatments, somatostatin analogs have been used for years to control disease and neuroendocrine symptoms, without cytotoxic intent. Advances in targeted therapy for neuroendocrine tumors have opened several potentially new treatment paradigms in the management of these otherwise relatively drug-resistant neoplasms. Promising results have emerged from studies evaluating radiolabeled somatostatin analogs and inhibitors of the vascular endothelial growth factor and mammalian target of rapamycin pathways. This article reviews several of the more encouraging developments in this field.

Histiocytosis X: Characteristics, behavior, and treatments as illustrated in a case series

Background:Langerhans cell histiocytosis (LCH) is a proliferative disorder predominantly found in children. It often presents with pain in calvarium or spine and may cause neuroendocrine symptoms. The gold standard for diagnosing LCH is the detection of Birbeck Granules by EM. Here, we describe two unique presentations of LCH and we review current treatment guidelines.Case Description:The first patient was a 23-year-old man who presented with progressive swelling and redness of the left eye. MRI revealed a left retrobulbar lesion extending into the middle cranial fossa with no signal abnormality in the brain parenchyma. The lesion was resected and pathological analysis revealed LCH. Bone scans were negative and the patient was discharged soon after. He later underwent fractionated radiotherapy (cumulative dose 26 Gy). Follow-up MRIs show no disease at 24 months post-op. The second patient was a 56-year-old man with left frontal skull pain for 5 months. Imaging showed a solitary osteolytic lesion extending into both dura and scalp with no signal abnormality of the parenchyma. Excisional biopsy revealed LCH. Surgery was well tolerated and follow-up imaging shows no recurrence at 24 months post-op.Conclusion:We demonstrate that LCH, though uncommon, must remain on the differential when osteolytic lesions present in the adult. Although LCH often has the clinical and radiographical presentation of an abscess, pathology analysis can successfully diagnose LCH based on markers and morphological characteristics. LCH has an excellent prognosis when treated aggressively with surgical resection and radiotherapy as both of our patients were and are now disease free at 2 year follow-up.

Reliability and validity of Short Form 36 Version 2 to measure health perceptions in a sub-group of individuals with fatigue

Purpose. To determine the validity and reliability of Short Form 36 Version 2 (SF36v2) in sub-groups of individuals with fatigue.Method. Thirty subjects participated in this study, including n == 16 subjects who met case definition criteria for chronic fatigue syndrome (CFS) and n == 14 non-disabled sedentary matched control subjects. SF36v2 and Multidimensional Fatigue Inventory (MFI-20) were administered before two maximal cardiopulmonary exercise tests (CPETs) administered 24 h apart and an open-ended recovery questionnaire was administered 7 days after CPET challenge. The main outcome measures were self-reported time to recover to pre-challenge functional and symptom status, frequency of post-exertional symptoms and SF36v2 sub-scale scores.Results. Individuals with CFS demonstrated significantly lower SF36v2 and MFI-20 sub-scale scores prior to CPET. Between-group differences remained significant post-CPET, however, there were no significant group by test interaction effects. Subjects with CFS reported significantly more total symptoms (p < 0.001), as well as reports of fatigue (p < 0.001), neuroendocrine (p < 0.001), immune (p < 0.01), pain (p < 0.01) and sleep disturbance (p < 0.01) symptoms than control subjects as a result of CPET. Many symptom counts demonstrated significant relationships with SF36v2 sub-scale scores (p < 0.05). SF36v2 and MFI-20 sub-scale scores demonstrated significant correlations (p < 0.05). Various SF36v2 sub-scale scores demonstrated significant predictive validity to identify subjects who recovered from CPET challenge within 1 day and 7 days (p < 0.05). Potential floor effects were observed for both questionnaires for individuals with CFS.Conclusion. Various sub-scales of SF36v2 demonstrated adequate reliability and validity for clinical and research applications. Adequacy of sensitivity to change of SF36v2 as a result of a fatiguing stressor should be the subject of additional study.

Efficacy of surgical treatment for cavernous sinus hemangiomas

to analyze the efficacy of surgical treatment for cavernous sinus hemangiomas (CSH). the data from 29 surgical CSH patients, 7 males and 22 females, aged 52 ± 9 years old, at our department were collected from 2003 to 2009 and analyzed retrospectively. The main presenting symptoms included headache (n = 15), impaired visual acuity (n = 9), diplopia (n = 7), ptosis (n = 2), facial paresthesia (n = 6), hemiparesis (n = 1) and infrequent menstruation (n = 4). MRI was major preoperative modality. All patients underwent craniotomy via frontotemporal approach with or without orbitozygomatic osteotomy. The tumor was removed through intradural approach in all patients. total removal was achieved in 14 (48.3%) patients. And 13 (44.8%) and 2 (6.9%) patients had subtotal and partial procedures respectively. No postoperative death occurred. Follow-up study of 3 months to 6 years was conducted in 27 patients (93%). All headaches were relieved postoperatively. The central nervous symptoms improved in 12 patients. The neuroendocrine symptom had no improvement. The most common surgical complications included impaired visual acuity (n = 2, 6.9%), paralyses of oculomotor nerve (n = 17, 58.6%), abduct nerve (n = 8, 27.6%) and trigeminal nerve (n = 4, 13.8%). A MRI follow-up of 1 - 6 years was obtained in 16 patients without recurrence. surgery is an effective management strategy for CSH. However, total tumor removal remains difficult. Complications such as cranial nerve injury are still rather troublesome.

Relationship between neuroendocrine tumor-related symptoms and PROMIS health-related quality-of-life scores.

6109 Background: Neuroendocrine tumors (NETs) can secrete hormones that cause flushing and diarrhea (carcinoid syndrome) and disrupt health-related quality of life (HRQL). The objective of this stu...