Oesophageal dilatation in Parkinson's disease

In an unselected group of 37 patients with Parkinsonism the mean diameter of the oesophagus at the level of the 9th dorsal vertebra was 3·11 cm, which was significantly higher than the mean of 2·24 cm in a group of control patients. Six of the patients with Parkinsonism had gross oesophageal dilatation.

Cytomegalovirus myocarditis

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Twins: early mental development

Mental development was appraised periodically for infant twins, and the twins displayed high within-pair concordance for level of mental development during the first and second years. Twins were also concordant for the spurts and lags in development in this period (monozygotic twins more so than dizygotic). From these results it was inferred that infant mental development was primarily determined by the twins' genetic blueprint and that, except in unusual cases, other factors served mainly a supportive function.

Diffuse pulmonary fibrosis and hiatus hernia

Six patients presenting with initially obscure pulmonary fibrosis are described. Reasons are given for attributing the condition to chronic aspiration pneumonitis from gastro-oesophageal reflux in association with hiatus hernia, supported by lung histology in three cases. Study of a further series of 143 cases of hiatus hernia suggests a 4% incidence of this insidious complication in addition to any more acute bronchopulmonary episodes. This possibility should be remembered in the differential diagnosis of any patient with pulmonary fibrosis of doubtful origin, as the advanced condition bears a poor prognosis.