Search PubMed⌕ Search

Biomedical subjects

R S Hepler

Publications and source records attributed to R S Hepler.

At least 55 records · Page 3Linked to original sources
PubMed1976

Cryosurgery in removal of orbital tumors.

Two cases in which medially placed retro-orbital tumors were approached transfrontally have been presented. The computerized tomographic scanner was important in the localization of both lesions. Although of different histologic types, both tumors were friable and vascular. This friability and vascularity would have caused severe difficulties in removal had it not been for the facility with which a cryoprobe froze and grasped tumor tissue. The importance of this instrument, previously unemphasized, has been pointed out.

Aged↗
PubMed1976

Antral-ethmoidal decompression in Graves' disease. Five-year experience.

The orbital manifestations of Graves' disease frequently constitute the major and distressing portion of the morbidity in this poorly understood process. Patients with optic neuropathy, exposure keratopathy or disfiguring proptosis may be aided considerably by decompression to permit swollen orbital contents to move into the maxillary and ethmoid sinus cavities. Experience with 38 patients treated over a five-year period indicates that antral-ethmoidal decompression is a logical, successful form of therapy and generally free of serious complications. it may provide benefit earlier in the course of Graves' exophthalmopathy than has been accepted in the past.

Decompression↗
PubMed1975

Myotonic pupils in Charcot-Marie-Tooth disease. Successful relief of symptoms with 0.025% pilocarpine.

Twenty-seven members of a family with dominantly inherited Charcot-Marie-Tooth disease (CMTD) were examined. Fifteen members had CMTD and 13 of these had varying amounts of myotonic pupillary abnormalities similar in some ways to Adie tonic pupil syndrome. Those with graver neurologic disease showed greater pupillary abnormalities. Ten of the 15 patients had pupillary constriction with methacholine chloride (Mecholyl) and some of these had extensive iris atrophy. Several affected patients received symptomatic relief from 0.025% pilocarpine. Seven other patients with CMTD who were not related to our initial family were checked for myotonic pupils; two had findings similar to our initial family. Pupillary abnormalities in certain patients with CMTD appear secondary to a parasympathetic denervation of the iris sphincter and ciliary muscle, as shown by a positive methacholine test, and probably represent part of the autonomic nervous system dysfunction associated with the polyneuropathy in CMTD.

Adult↗
PubMed1975

Loss and recovery of vision with suprasellar meningiomas.

Central visual acuity losses were documented in a group of 23 patients with surgically and histologically verified suprasellar meningiomas. The pattern demonstrated was that of acute, gradual or fluctuating loss in one eye, followed by later loss of central acuity in the other eye. Both optic nerves and chiasm were invariably involved either by stretching or compression. Neither preoperative field abnormalities nor central acuity deficits could be correlated with the anatomical location of the tumor, nor could postoperative changes in vision be correlated with tumor size. Lengthy duration of acuity loss and severe visual deficit did not preclude postoperative recovery of vision. Improvement in sight most frequently occurred within the first several weeks after operation, and further return of vision was not noted after 1 year.

Blindness↗