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Biomedical subjects

B R Frueh

Publications and source records attributed to B R Frueh.

At least 55 records · Page 3Linked to original sources
PubMed1986

Exophthalmometer readings in patients with Graves' eye disease.

Exophthalmometer readings were measured in 84 patients with Graves' eye disease (GED) and 111 normal subjects. The mean exophthalmometer reading was significantly greater in patients with GED than in normal subjects. Asymmetry of the orbital disease produced less correlation of the exophthalmometer readings between right and left eyes of GED patients than is found in normal subjects. Expected gender and age effects on the exophthalmometer reading were not found among the GED patients. The mean exophthalmometer reading was not significantly higher for GED patients with compressive optic neuropathy than in the other subgroups of GED patients, suggesting that exophthalmos per se is not harmful to the optic nerve.

Adolescent↗
PubMed1986

The effects of Graves' eye disease on levator muscle function.

The levator function and exophthalmometer reading were measured on each side of 81 patients with Graves' eye disease (GED) and 111 normal subjects. There was a significant positive correlation between the levator function and exophthalmometer reading for both GED patients and normal subjects. This indicates that the forward position of the eye chronically stretches the levator muscle by the addition of sarcomeres which increases the range of movement of the lid. The range of movement may be decreased in patients with Graves' eye disease, from inflammation, such as is seen with other extraocular muscles. This effect is most likely to be marked in the patient with compressive optic neuropathy.

Adult↗
PubMed1986

Lid retraction and levator aponeurosis defects in Graves' eye disease.

Vertical palpebral fissure determinants and lid crease height were measured in patients with Graves' eye disease (GED) and in normal subjects. The fissure and crease height are positively correlated with exophthalmometer readings in each group. Compensatory levator aponeurosis defects are shown to occur in patients with GED. These, along with the effect of exophthalmos on the lower lid position, the observation that the lower lid is closer to the inferior limbus than the upper lid is to the superior limbus in normal subjects, and the effect of contracture of the inferior rectus on the lower lid position, explain why inferior scleral show is found to be greater than superior scleral show in patients with GED. Thus, lid retractor surgery in GED patients should be performed only after the palpebral fissure, levator function, and lid crease height stabilize, and after any contemplated surgery that would alter the exophthalmos and extraocular muscles has been performed.

Adolescent↗
PubMed1985

Positional effects on exophthalmometer readings in Graves' eye disease.

Forty-eight patients with Graves' eye disease, half of whom had extraocular muscle restriction, and 45 normal adult subjects underwent exophthalmometry while in the upright and the supine positions to determine whether the difference in measurement due to position would serve to differentiate the groups. A previous report claimed that the upright reading would be greater than the supine reading for normal subjects and patients with Graves' eye disease without clinical extraocular muscle involvement, whereas those with extraocular muscle restriction would show little change in their exophthalmometer readings. Our study showed an increase in exophthalmometer readings in going from the upright to the supine position for normal subjects and both groups of patients with Graves' eye disease. Furthermore, this test did not serve to differentiate these three groups.

Adolescent↗
PubMed1985

The reliability of Hertel exophthalmometry. Observer variation between physician and lay readers.

In order to quantify and characterize the interobserver variation in exophthalmometry and to assess the impact of experience on that variation, four observers of varying levels of experience obtained an exophthalmometer reading from 100 subjects' right eyes and 97 subjects' left eyes. Observers were masked to the measurements of their colleagues. The subjects measured were referrals to the eye plastic and orbital service over a three week interval. Substantial interobserver variation was demonstrated. Fully one-fourth to one-third of all measurements by the three less-experienced observers differed enough from the senior observer to be of concern to him. The direction of disagreement varied with experience. The least-experienced observer consistently underread whereas the more experienced observer slightly overread exophthalmometry, relative to the senior observer. As the study progressed, the least-experienced observer's reliability increased. Interobserver agreement for this observer was influenced by the degree of proptosis presenting in the eye being measured.

Analysis of Variance↗
PubMed1985

Exposure of tantalum mesh orbital implants.

This retrospective study of 195 enucleations with tantalum mesh implants reviews the role of demographic, preoperative, and operative factors in subsequent implant exposure or extrusion. Fourteen implants (7.2%) became exposed, two of which subsequently extruded. Significant associations were found between implant exposure and history of prior orbital infection, and suturing of the inferior oblique to the lateral rectus muscle. The average age at enucleation was 20.4 years for those whose implant became exposed, which was significantly less than the average age of 38.7 years for those without exposure of the implant. No association was found between implant exposure and gender, preoperative diagnosis, proptosis, chemosis, sharp trauma to the orbit, orbital fracture, previous orbital surgery, implant size, closing of posterior Tenon's capsule, or muscles sutured to the implant. Because of the high exposure rate, it is recommended that the use of tantalum mesh implants be discontinued.

Adult↗
PubMed1985

Orbital compliance in Graves' eye disease.

Thirty-three patients with Graves' eye disease (GED) and 68 normal subjects had their orbital compliance measured by determining the force generated on retropulsing the eye and also estimated on digital retropulsion, and their eye position determined with an exophthalmometer. Patients with compressive optic neuropathy showed significantly higher mean forward force on retropulsion than other Graves' eye disease patients or normal subjects, supporting the theory that the tissue is compressed in these orbits. There is a suggestion that orbital compliance testing of a GED patient without compressive optic neuropathy may be of value in predicting the risk of the patient developing compressive optic neuropathy. There is no association between the force on ocular retropulsion and the exophthalmometer reading. The digital estimation of the resistance to retropulsion did not reliably suggest the measured forces.

Compliance↗
PubMed1985

Exogenous ball valve in the lacrimal sac.

A young man presented with symptoms and findings of a chronic partial obstruction of the lacrimal sac outlet. A dacryocystogram revealed a BB in the lower portion of the lacrimal sac where this foreign body was functioning as a ball valve, impeding lacrimal drainage. Surgical removal of the BB and dacryocystorhinostomy were curative. Previously reported foreign bodies in the lacrimal sac have all been endogenous in origin. This is the first reported case of an exogenous foreign body in the lacrimal sac outlet. Exogenous sources of lacrimal sac foreign bodies should be considered in chronic dacryocystitis.

Adolescent↗
PubMed1985

Isometric contractile properties of the extraocular muscles of the monkey.

Isometric contractile properties were measured for three superior rectus muscles, one inferior rectus muscle, and three levator muscles, all obtained from monkeys. These are the first reported measurements for the superior rectus and levator muscle on any mammalian species and the first reported for a primate on the inferior rectus. The levator muscle was shown to be a fast muscle, like other extraocular muscles. Time to peak tension and time to relax to one-half peak tension were short for each muscle tested and were similar to those found for extraocular muscles of other mammalian species. The data for the ratio of peak twitch tension to peak tetanic tension are not reliable because there is evidence that the muscle fibers were damaged.

Animals↗
PubMed1984

Treatment of blepharospasm with botulinum toxin. A preliminary report.

The effects of botulinum A toxin injections for the treatment of facial spasm were analyzed for 22 patients. Sixteen patients had unoperated on essential blepharospasm, three had essential blepharospasm with residual spasm following previous surgical treatment, and three had unoperated on hemifacial spasm. Treatment was effective for most patients, but transient, with the mean interval of relief of spasm after the first injections being ten weeks. The injection of botulinum toxin reduced the maximum lid force by about 10%. While side effects were common, they were generally mild and well tolerated. No cumulative effect of botulinum toxin was evident in those receiving three series of injections. There is no significant difference in either the interval free of spasm or the rate of lid-force recovery following any of three sequential injections of increasing doses of botulinum toxin.

Adult↗
PubMed1983

Associated facial contractions after seventh nerve palsy mimicking jaw-winking.

A 51-year-old woman who had recovered from Bell's palsy complained of closure of her right eyelids synchronous with chewing. Examination revealed the closure to be synchronous with contraction of the orbicularis oris muscles, not jaw muscles. Other associated facial movements were detected. Electromyography demonstrated that the decrease in size of the palpebral fissure is from contraction of the orbicularis oculi muscles, not inhibition of the levator muscle, proving that this is the effect of aberrant seventh nerve regeneration. This is one of many mass action effects which can occur with seventh nerve regeneration and should not be termed a syndrome.

Blinking↗
PubMed1981

Treatment of distichiasis with cryotherapy.

The surgical treatment of distichiasis has frequently resulted in disfigurement of the treated eyelid. Since the follicles of the aberrant lashes in lids with distichiasis are placed more posteriorly than the follicles of normal lashes, it is theoretically possible to destroy the follicles of the aberrant lashes without destroying the follicles of the normally placed lashes if transconjunctival cooling creates a sufficient temperature gradient from the conjunctival to the anterior tarsal surface. This report illustrates a successful application of this concept. However, further data are needed to delineate the optimum cryo treatment of distichiasis.

Child↗