Ein Beitrag zur klinischen Diagnostik des ektopischen ACTH-Syndroms

Es wird über einen Fall von ektopischem ACTH-Syndrom mit Hypercortizismus und hypokaliämischer Alkalose bei einem metastasierten Pankreas-Carcinom berichtet. Das Fehlen einer Differenz zwischen den ACTH-Spiegeln im Plasma aus dem Bulbus cranialis venae jugularis und aus der Vena femoralis unterstützte die Annahme einer nicht hypophysären Herkunft der erhöhten ACTH-Spiegel.A case of ectopic ACTH syndrome is reported presenting with hypercorticism and pronounced hypokalemic alkalosis in a woman aged 55 y. with metastatic cancer of the pancreas. The failure to show a significant difference of plasma ACTH-levels from bulbus superior venae jugularis resp. femoral vein supported the clinical assumption of non pituitary origin of elevated plasma ACTH

Serumproteinbindung von ACTH

3H- 1–23-Corticotropin wurde an Dextrangel (Sephadex G-25) gebunden und konnte durch Serumproteine, Albumin oder 0,1 N HCl eluiert werden. Mittels Dextrangelfiltration wurde gefunden, daß3H-ACTH kompetitiv an Serumproteine (Albumin) und Dextrangel gebunden wurde. Auch für natürliches Schweine-ACTH und endogenes ACTH in Patientenplasma (Adrenalektomie) wurde mittels biologischer ACTH-Bestimmung die Bindung von ACTH an Proteine bestätigt.3H- 1–23 corticotropin was bound to dextran gel (sephadex G-25) and was eluted by either serum proteins, albumin or 0.1 N HCl. Competitive binding of3H-ACTH to serum proteins (albumin) and dextran gel was shown by dextran gel filtration. Likewise natural ACTH (pig) and endogenous ACTH from plasma of an adrenalectomized patient were shown to be partly protein bound using biological ACTH-assay

Meta-KANSEI modeling with Valence-Arousal fMRI dataset of brain

Background: Traditional KANSEI methodology is an important tool in the field of psychology to comprehend the concepts and meanings; it mainly focusses on semantic differential methods. Valence-Arousal is regarded as a reflection of the KANSEI adjectives, which is the core concept in the theory of effective dimensions for brain recognition. From previous studies, it has been found that brain fMRI datasets can contain significant information related to Valence and Arousal. Methods: In this current work, a Valence-Arousal based meta-KANSEI modeling method is proposed to improve the traditional KANSEI presentation. Functional Magnetic Resonance Imaging (fMRI) was used to acquire the response dataset of Valence-Arousal of the brain in the amygdala and orbital frontal cortex respectively. In order to validate the feasibility of the proposed modeling method, the dataset was processed under dimension reduction by using Kernel Density Estimation (KDE) based segmentation and Mean Shift (MS) clustering. Furthermore, Affective Norm English Words (ANEW) by IAPS (International Affective Picture System) were used for comparison and analysis. The data sets from fMRI and ANEW under four KANSEI adjectives of angry, happy, sad and pleasant were processed by the Fuzzy C-Means (FCM) algorithm. Finally, a defined distance based on similarity computing was adopted for these two data sets. Results: The results illustrate that the proposed model is feasible and has better stability per the normal distribution plotting of the distance. The effectiveness of the experimental methods proposed in the current work was higher than in the literature. Conclusions: mean shift can be used to cluster and central points based meta-KANSEI model combining with the advantages of a variety of existing intelligent processing methods are expected to shift the KANSEI Engineering (KE) research into the medical imaging field

Diagnostische Bedeutung der Proteinbindung von Plasmacortisol, bestimmt durch Dextrangelfiltration

1. Mittels Dextrangelfiltration wurde nach Inkubation von markiertem Cortisol und Plasma der proteingebundene und der sog. freie Anteil (%) des endogenen Plasmacortisols ermittelt und bei gleichzeitiger fluorimetrischer Bestimmung der 11-OHCS auch die Menge proteingebundenen, bzw. sog. freien Cortisols (µg-%) berechnet. 2. Die diagnostische Brauchbarkeit der Methode wurde bei Patienten mit Nebennierenrindeninsuffizienz, mit Hypophysentumoren, nach Hypophysektomie, mit Cushing-Syndrom mit der fluorimetrischen Bestimmung der 11-OHCS verglichen. Die einfache Bestimmung der Cortisolbindung war bei hypophysektomierten Patienten der Bestimmung der 11-OHCS überlegen und entsprach der aufwendigeren ACTH-Belastung. 3. Falsch hohe fluorimetrische 11-OHCS-Spiegel im Plasma unter Spirolacton- oder Oestrogenbehandlung und in der Gravidität lassen sich durch Bestimmung der Cortisolbindung klären. Bei Schilddrüsenüberfunktion war das sog. freie Cortisol im Plasma relativ und absolut vermehrt, bei Schilddrüsenunterfunktion fand sich eine Zunahme des plasmaproteingebundenen Cortisols.1. Following incubation of labeled cortisol and plasma the percentages of protein bound and socalled free endogenous cortisol were determined by means of dextran gel filtration. 2. The diagnostic value of this method was compared with fluorimetric determinations of 11-OHCS for patients with adrenal insufficiency, Cushing-Syndrome, pituitary tumors and after hypophysectomy. In hypophysectomized patients the simple determination of protein bound cortisol was found to correlate well with diagnostic ACTH-infusion tests and to be more sensitive than fluorimetric determinations of 11-OHCS in 9 a.m. plasma. 3. Falsely elevated fluorimetric values of plasma 11-OHCS in patients treated with spirolactone or estrogens, resp. during pregnancy may be recognized through determination of cortisol binding. — In thyrotoxicosis socalled free cortisol was elevated, both relatively and absolutely; in hypothyroidism an increase of protein bound cortisol was found