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Biomedical subjects

R C Kersten

Publications and source records attributed to R C Kersten.

80 records · Page 5Linked to original sources
PubMed1984

Hematoporphyrin derivative photoradiation therapy in managing nevoid basal-cell carcinoma syndrome. A preliminary report.

Hematoporphyrin derivative (HpD) is a photodynamically active dye that is preferentially retained by malignant tissues and initiates a cytotoxic reaction when exposed to red light. Normal tissues adjacent to a tumor retain HpD to a lesser degree and are thus spared damage from the light-induced reaction. We describe the treatment of 40 basal-cell carcinomas in three patients with nevoid basal-cell carcinoma syndrome. All treated lesions showed disappearance of clinically apparent tumor within four to six weeks, and there was no damage to surrounding skin. Thirty-three lesions (82.5%) showed complete response on biopsy findings, while seven showed residual tumor cells. The recurrence rate was 10.8%, with the follow-up ranging from 12 to 14 months. Tumor response was related to the total light dose delivered and the size and location of the tumor.

Aged↗
PubMed1984

Management of choroidal malignant melanoma at Iowa.

Approximately 50% of patients undergoing enucleation for choroidal melanoma will eventually die of metastases. The majority of tumor related deaths will occur within 5 years of enucleation, but late metastases may occur 20-30 years after enucleation. Long-term follow-up of patients refusing treatment has shown a 100% mortality. Although recent reports have attempted to link the performance of enucleation with the development of metastases, examination of available data suggests that metastases occur preoperatively, but are subclinical at the time of enucleation. The most important variable determining prognosis in these cases is the size of the tumor at the time of diagnosis and treatment. Patients who undergo enucleation before the tumor exceeds 7 X 7 X 2 mm have an extremely favorable prognosis. Patients whose maximum tumor diameter exceeds 12 mm have an extremely poor prognosis. Metastases and extrascleral extension have both been reported to occur in tumors which failed to demonstrate growth while being followed. For these reasons we recommend immediate enucleation be carried out in all patients whose tumors exceed 7 X 7 X 2 mm and in whom the diagnosis can be confirmed by indirect ophthalmoscopy, ultrasound, fluorescein angiography, and other tests. Follow-up of non-enucleation methods of treatment of choroidal melanomas is too short to draw meaningful conclusions. The consistent finding of persistence of some tumor mass and the histopathologic presence of viable tumor cells following these treatment modalities leaves us very concerned about the long-term results in these patients. Late metastases continue to occur decades following diagnosis of a choroidal melanoma, especially if it is small. The ophthalmologist must remain aware that the results of his decision concerning treatment of a melanoma may not become apparent for many years.

Choroid↗
PubMed1982

Ophthalmic drugs.

The author reviews the indications and dosage schedules for various categories of ophthalmic medications. The family physician should be especially alert to the potential systemic side effects that may occur with use of ophthalmic drugs.

Adrenergic alpha-Agonists↗
PubMed1982

Intraocular lens implantation: residents vs. staff.

Our first 96 consecutive IOL implantations were reviewed. Results of resident cases (85% maintaining 20/40 or better acuity at an average follow-up of 16 months) were comparable to those of staff physicians at our institution as well as to those reported in the literature by experienced implant surgeons. Results of residents' initial cases improved with changes in surgical technique and increasing experience of the assisting staff. Training of residents in implantation with adequate assistance represents no increased risk to the patient, and is likely to decrease the risk to subsequent patients encountered in practice.

Follow-Up Studies↗
PubMedDate not supplied

Iris melanoma. Nevus or malignancy?

Although iris melanomas have an excellent prognosis when diagnosed and treated early, they should not be considered benign lesions. The authors report the orbital recurrence of a melanoma in a patient whose eye had been enucleated 30 years earlier because of an iris melanoma. The clinical, epidemiological and pathological characteristics of iris melanomas are summarized and compared to those of other uveal melanomas. The similarities suggest that iris melanomas are not by nature more benign than other uveal melanomas and that their better prognosis is due to the earlier detection allowed by their more obvious location.

Age Factors↗
PubMedDate not supplied

Medial rectus muscle incarceration in pediatric medial orbital wall trapdoor fractures.

PURPOSE: We describe two cases of orbital trapdoor fractures with medial rectus muscle incarceration. METHODS: Small interventional case series. RESULTS: This is a retrospective university based report of two healthy males (11 and 14 years old) who developed diplopia following blunt orbital trauma. Both patients had decreased horizontal ocular motility of the involved eye with minimal additional evidence of trauma. Computed tomography (CT) demonstrated no significant bony displacement; however, the left medial rectus muscle was located within the ethmoid sinus in the first and had an abnormal size and shape in the second case. In both cases, during urgent surgical repair, the incarcerated medial rectus muscle was gently released from linear non-displaced medial wall fractures and ocular motility normalized postoperatively. CONCLUSIONS: In pediatric patients sustaining blunt orbital trauma, medial rectus incarceration should be considered and managed accordingly.

Adolescent↗
PubMedDate not supplied

The eyelid crease approach to superficial lateral dermoid cysts.

Although the traditional approaches to lateral orbital dermoids with incision directly over the lesion or camouflaged beneath the inferior brow provide good direct exposure of the lesion, the result may be cosmetically less acceptable due to prolonged erythema and ultimate depression of the scar when placed in the thicker skin of this region. The results in 11 patients in whom an eyelid crease incision was used are reported. Camouflage of the incision by the overlying lid fold resulted in very satisfactory cosmesis in the immediate postoperative period. The extremely thin lid skin in the crease resulted in rapid healing with a virtually imperceptible mature scar. With sufficient extension of the incision and undermining, the lid tissues could be displaced to allow adequate exposure and removal of the dermoid in all cases.

Adolescent↗