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Title: Hemiptera of Mauritius
Author: Orian, Alfred Joseph Emilien
Awarding Body: University of London
Current Institution: Imperial College London
Date of Award: 1965
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The radiological anatomy of the pituitary gland, optic chiasma, and oculomotor nerve were defined from combined autopsy, dissection and radiology. Accurate planning of pituitary implantation and more precise detection of pituitary tumours is thereby possible. From histological and radiological (study of the pituitary at autopsy in patients treated by yttrium-90 implantation, the irradiation dose to cause necrosis of the pituitary gland, pituitary stalk, and oculomotor nerve were established. The safe limits of irradiation were defined at critical sites so as to avoid complications of cerebrospinal fluid rhinorthoea, oculomotor nerve and chiasmatic damage, and diabetes insipidus. Operative techniques. and implant planning methods were evolved for either total, or deliberate partial, destruction of the normal pituitary gland, and pituitary tumours. Pituitary biopsy could be obtained. By pituitary function Resting after implantation, and autopsy measurement of the % pituitary necrosis, it was possible to obtain the critical test values for the 1-131 test, water diuresis test (and steroid dependency), and urinary gonadotrophin level that indicated 90% necrosis or more. Criteria for interpretation of the water diuresis test of adrenal function were established. The E.C.G. was also assessed as a means of showing impaired adrenal function. A new method was evolved for grading the objective response of breast cancer to pituitary ablation. Only the best response grade (25% patients) was associated with striking clinical remission. Serum and urinary calcium, serum alkaline phosphatase, and serum phosphoglucose isomerase were extensively evaluated and found useful as objective measures of cancer activity. Criteria for the interpretation of each was defined, and possible causes of abnormality shown. Severe diabetic retinopathy was treated by either total or partial pituitary ablation, and the effect obtained by study of serial retinal photographs. Certain lesions were found to respond. Some cases of Cushing's syndrome and acromegaly had clear remissions ions after partial ablation, so allowing assessment of test criteria for disease tyre and activity.
Supervisor: Fraser, Russell Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available