Orbital computed tomography. Does it help in diagnosing the infiltration of choroid, sclera and/or optic nerve in retinoblastoma?

High-resolution computerized tomography of the orbit was performed in patients with histologically proven retinoblastoma to assess the efficacy of CT in delineating the retro-orbital extent of the tumor and determining if the optical nerve was involved. High-resolution CT proved able to accurately delineate tumor size, tumor localization, tumor calcification, retro-orbital and intracranial tumor growth. Microscopical tumor spread past the lamina cribrosa of the optic nerve, however, could not be detected by CT.

Parenteral bromocriptine in the treatment of hormonally active pituitary tumours.

Eleven patients with PRL and three with GH-secreting pituitary adenomas were treated with a single intramuscular injection of 50 mg of bromocriptine retard (Parlodel, LA (long-acting)). There was a marked PRL suppression in 9 prolactinoma patients, in four for a period of at least 6 weeks. In one patient with acromegaly GH plasma levels decreased into the normal range. The size of the pituitary adenoma diminished considerably, as shown by CT scan, in three out of the 9 responding patients with prolactinoma and in the above acromegalic patient. Visual fields normalized within 14 d in one patient with a PRL-secreting macroadenoma and bitemporal hemianopsia who also had CT scan-documented shrinkage of the tumour. There were no side-effects except slight hypotension in two and local tenderness at the injection site in one patient; these symptoms disappeared without treatment. It is concluded that bromocriptine retard is a safe and effective therapeutic tool for shrinking hormonally active pituitary tumours in selected patients. Due to its good tolerance and the rapid hormonal and clinical improvement it may be also considered as the best therapeutic approach to initiate the treatment of PRL- and/or GH-secreting pituitary tumours.

[Function tests of the lower small intestine with 75selenium-labeled homotaurocholic acid in Crohn disease and resections of the small intestine]. / Funktionsuntersuchungen des unteren Dünndarms mit 75Selen-Homotaurocholsäure bei Morbus Crohn und Dünndarmresektionen.

UNLABELLED: Faecal excretion of bile acids was investigated using 75Se-homotaurocholic acid (75SeHCAT) in a total of 75 patients: 9 with irritable colon, 58 with Crohn's disease and 8 with small-bowel resection due to various indications but without Crohn's disease. Bile acid malabsorption, taken as a pathological bile acid retention of less than 19%, was found present in 43 patients with diseased terminal ileum or with more than 20 cm resection of this organ, except in one case (12 cm). On the other hand a normal bile acid retention (21 to 27%) was found in 29 of 72 patients (including 9 patients with irritable colon) who showed either no radiologically detectable lesion of the ileum (n = 21) or changes involving an extension of up to 30 cm (inflammation or resection) in the terminal ileum (n = 8), with the exception of one case (50 cm). Three patients had a raised bile acid excretion contrary to clinical expectation: they had colitis Crohn without radiologically detectable involvement of the small intestine. Thus using the 75SeHCAT-retention test it seems possible to recognize functional disorders in diseased segments of the bowel before the appearance of radiologically detectable changes. CONCLUSION: 75SeHCAT is a suitable substance for investigations on the function of the lower small intestine.

[Comparative studies of various methods of measuring bile acid secretion using 75Se-labelled homotaurocholic acid (75Se-HCAT)]. / Vergleichende Untersuchung über verschiedene Messverfahren zur Beurteilung der Gallensäurenausscheidung mittels 75Se-markierter Homotaurocholsäure (75Se-HCAT).

The simple determination of whole-body retention of the bile acid analogue 75Se-HCAT provides results which are in agreement with those of the established but more difficult measurement of 24-14C-TCA excretion in the feces. Determining whole-body retention of 75Se-HCAT is not only practicable with a whole-body counter but also, with precision, with the more widely used gamma camera. Therefore, the bile acid retention test may be employed wherever there is a gamma camera available.

[Changes of renal function following revascularisation of renal arteries especially by Dotter's technique (author's transl)]. / Veränderung der Nierenfunktion nach Eingriffen an den Nierenarterien unter besonderer Berücksichtigung der Methode nach Dotter.

The rapid sequential scintigraphy with 131I-hippuran is a well established valuable procedure in follow-up studies of patients after non surgical revascularisation of renal artery stenosis. With this non invasive easily reproducible method both the changes of renal circulation and of renal function can be assessed simultaneously.