Pituitary abnormalities in eating disorders: further evidence from MRI studies

1. The frequent occurrence of hypothalamo-pituitary dysfunction in patients with eating disorders as well as prior reports that nutritional and endocrine status influence pituitary morphology, led us to hypothesize that pituitary size and shape may be altered in patients with eating disorders. 2. Magnetic resonance imaging (MRI) does not use ionizing radiation and is currently one of the most feasible modalities available to study the pituitary gland in vivo. Using MRI, we have previously reported in a preliminary study that female patients with eating disorders had significantly smaller pituitary glands than controls. In addition MRI excluded any pituitary mass lesions. 3. In this report, we confirm our previous MRI findings and provide further evidence of pituitary abnormalities in an expanded sample of eating disorder patients. Preliminary data on pituitary volume estimates from MRI scans are provided for a subset of patients and controls.     

The Treatment of Low Grade Cerebral Astrocytomas by Radiotherapy in Queensland

The records of 108 adult patients with supratentorial low grade astrocytoma presenting between 1/1/80 and 31/12/87 were examined for the following factors which might affect survival: patient age, extent of surgical resection, site of tumour, tumour grade, radiation field size and radiation dose. Univariate analysis showed that patient age, field size and radiation dose were significant prognostic factors, but with multivariate analysis only patient age and radiation field size were significant independent variables. It is possible that field size is a proxy variable for tumour size.     

Acoustic neuroma--the patient's perspective: subjective assessment of symptoms, diagnosis, therapy, and outcome in 541 patients

Surgical treatment of acoustic neuroma has been reviewed in the medical literature, but assessment of outcome from the patient's perspective has received little attention. The Acoustic Neuroma Association (A.N.A.) is a large organization of acoustic neuroma patients which provides information and support services. This article reports the subjective assessment of symptoms, diagnosis, treatment, and outcome as evaluated by 541 A.N.A. members. This retrospective study presents an extensive overview of the experience of acoustic neuroma patients treated at a variety of institutions, and provides a unique perspective not previously represented in the medical literature.     

Diagnostic value of load tests in the evaluation of nonspecific changes in the electrocardiogram

The paper describes the examinations of 353 patients with various cardiovascular pathologies and changes in the end-portion of the ECG ventricular complex. For that purpose potassium chloride, obsidan, orthostatic and hyperventilation tests were used. The examinations demonstrated that the ECG changes were of functional nature in 178 patients, of organic nature in 155 patients and of mixed nature in 20 patients which was important for reliable diagnostic and expertise conclusions.     

Congenital esophageal cysts in adults

Sixteen adult patients with congenital esophageal cysts were operated on between 1957 and 1979. Preoperatively, 7 patients (44%) were asymptomatic and the cyst was found incidentally on a routine chest roentgenogram. Esophageal symptoms were present in only 3 patients (19%), whereas most symptomatic patients had precordial sensations or arrhythmias. A correct preoperative diagnosis was made in only 1 patient. After enucleation of the cyst, preoperative symptoms were alleviated in all patients and short-term results were excellent. However, long-term follow-up 13.2 +/- 5.6 (+/- standard deviation) years later revealed moderate reflux in 9 (64%) of the surviving 14 patients. During esophagoscopy, macroscopic esophagitis was found in 12 (92%) of 13 patients. On histological examination of specimens obtained by forceps biopsy, esophagitis was present in 10 (77%) of 13 patients and included Barrett esophagus in 2. We conclude that, despite excellent early results, long-term follow-up of patients who undergo operation for congenital esophageal cysts is indicated because of the increased incidence of reflux esophagitis.