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Biomedical subjects

T R Hedges

Publications and source records attributed to T R Hedges.

At least 73 records · Page 4Linked to original sources
PubMed1983

Corneal and conjunctival effects of monobenzone in patients with vitiligo.

Monobenzone (the monobenzyl ether of hydroquinone [Benoquin]) is used topically by patients with extensive vitiligo to depigment their remaining normally pigmented skin. A patient who had been applying the drug for one year had an anterior linear deposition of pigment in both corneas. Of 15 additional patients with vitiligo, 11 of whom were using monobenzone, acquired conjunctival melanosis in two patients and pingueculae in three may have been related to monobenzone use. Light and electron microscopy of one corneal epithelial scraping and 12 conjunctival biopsy specimens revealed pleomorphic, single-membrane-limited intracytoplasmic inclusions within the corneal epithelium and within the epithelium, fibrocytes, histiocytes, and vascular endothelium of the conjunctiva. The ultrastructural aspects of these inclusions suggested that they are residual bodies containing lipid and lipofuscin.

Adult↗
PubMed1983

Botulin ophthalmoplegia. Clinical and oculographic observations.

Two patients with botulin ophthalmoplegia had rapid quivering eye motions during attempts to refixate laterally placed objects; these abnormal eye movements occurred in conjunction with a disjunctive limitation of range of eye movements. Oculographic examination showed that the quivering motions were composed of multiple hypometric saccades, many of which had subnormal and stuttering velocities. By blocking acetylcholine release into myoneural junctions, botulin toxin seems to limit the duration of saccadic burst innervation reaching ocular muscle.

Botulism↗
PubMed1983

The clinical value of negative temporal artery biopsy specimens.

The clinical course of patients with signs and symptoms suggestive of temporal arteritis but with negative temporal artery biopsy specimens was evaluated. Ninety-one patients undergoing a biopsy formed the basis of this study. Of these, 63 patients had no evidence of arteritis on biopsy, and 28 patients had biopsy specimens showing granulomatous inflammation. False-negative findings from biopsy specimens occurred in 5% of patients who had the disease. Cancer was the final diagnosis in 21% of patients with negative biopsy specimens v 3% of patients with temporal arteritis. Various chronic systemic inflammatory diseases were found in 16% of patients with negative biopsy specimens, while none of the patients with temporal arteritis had additional systemic inflammatory diseases. Patients with proven arteritis were notably older and had higher ESRs than patients without the disease. However, no laboratory test or frequently observed symptom or sign noted on initial examination, considered alone or in combination with other findings, had diagnostic sensitivity or specificity as high as temporal artery biopsy.

Aged↗
PubMed1983

Computed tomography in the diagnosis of retinoblastoma.

The role of orbital computed tomography (CT) in the management of retinoblastoma is reviewed. All 21 patients with retinoblastoma studied with high-resolution computed tomography had intraocular calcification demonstrable in at least one eye. 83% of tumours showed evidence of calcification on CT scan. The degree of calcification appeared to depend on tumour size; only small tumours were devoid of calcification. The amount and distribution of calcification was similar on both histological study and CT scan. In patients under 3 years old in whom a retinoblastoma is suspected the presence of calcification on CT is virtually diagnostic of it. Patients with leucocoria without calcification on CT probably have a simulating lesion.

Calcinosis↗
PubMed1982

The atypical pigmentary retinopathy of Kearns-Sayre syndrome. A light and electron microscopic study.

Two postmortem eyes from a 52-year-old man with Kearns-Sayre syndrome were examined by light, scanning, and transmission electron microscopy. Prior to death, pronounced ptosis, total external ophthalmoplegia, an episodic ventricular cardiac arrhythmia, and an atypical pigmentary retinopathy characterized by "choroidal sclerosis" and pigment clumping were documented. Histopathologic examination revealed atrophy of the retinal pigment epithelium and outer retina that was most marked posteriorly. The preservation of photoreceptors appeared to mirror the health of the underlying retinal pigment epithelium. Numerous healthy appearing rods were present in the relatively well-preserved temporal retina. The pattern of photoreceptor degeneration observed in this form of "atypical retinitis pigmentosa" suggests that the primary defect may reside in the retinal pigment epithelium.

Adolescent↗
PubMed1982

The progression of the ocular abnormalities of herpes zoster. Histopathologic observations of nine cases.

The ocular pathologic findings from nine patients who suffered from herpes zoster ophthalmicus are described. Autopsy material from four patients who died within weeks of the illness and ocular specimens from five patients who required surgery for complications of the disease months to years later demonstrated how the ocular abnormalities caused by zoster may progress in severity with time. The changes ranged from superficial keratitis and mild uveitis to severe granulomatous inflammation of the ciliary body, choroid, and optic nerve within the first several weeks of the disease. In some instances damage secondary to vasculitis predominated, and in others inflammation directly involved ocular tissue. In some chronically affected eyes, granulomatous reaction to Descemet's membrane persisted for years, whereas in others the inflammatory reaction apparently resolved, allowing successful penetrating keratoplasty to be performed in one case.

Adult↗
PubMed1982

Correlation of ocular findings and plain skull roentgenogram in pituitary adenoma.

A review of the conditions of 44 consecutive patients diagnosed as having pituitary tumor is presented. In none of those with abnormal visual acuity, visual field defect, or extraocular muscle palsy was the plain skull roentgenogram normal. In all but one patient who had an abnormality on ocular examination), there was erosion of the clinoids on the plain lateral skull roentgenogram and, in that one patient, erosion was found on the side of the visual loss by the use of tomography. Based on these observations, we have stressed primarily the early use of simple plain skull roentgenograms in the evaluation of the conditions of patients with unexplained visual loss or extraocular movement palsy. We have also presented a scheme for evaluation of the conditions and the follow-up of patients suspected of having pituitary tumors.

Adenoma↗
PubMed1979

Evidence for vasculitis in acute posterior multifocal placoid pigment epitheliopathy.

A case of acute posterior multifocal placoid pigment epitheliopathy is presented with the unusual feature of the exposure of deep choroidal vessels which filled with dye in the early phase of the fluorescein angiogram in the center of many of the placoid lesions. Visualization of these vessels with surrounding hypofluorescence implies nonperfusion of choriocapillaris presumably due to inflammation, rather than retinal pigment epithelial blockage. The pathology of acute posterior multifocal placoid pigment epitheliopathy is probably a vasculitis of the choriocapillaries, which causes transient occlusion of these vessels and the initial hypofluorescence in the typical lesions during angiography. In many lesions the ischemia is mild enough to cause only temporary disturbance of visual function with subsequent recovery. Only in the center of some of the lesions is the inflammation severe enough to allow for the findings observed in the case presented and to account for the permanent visual defects found in some patients.

Adult↗
PubMed1977

Amaurosis fugax caused by a prolapsed mitral valve leaflet in the midsystolic click, late systolic murmur syndrome.

A 28-year-old man had recurrent episodes of amaurosis fugax of eight years' duration and had a congenital, late systolic mitral insufficiency murmur with the characteristics of the midsystolic click, late systolic murmur syndrome. The ophthalmologist must consider the clinical entity of the midsystolic click, late systolic murmur syndrome in the differential diagnosis of amaurosis fugax, especially when such attacks occur in young patients.

Adult↗
PubMed1977

Orbital neurilemoma.

The diagnosis of orbital tumors is a challenging one. Neurilemomas are among the rarer causes of lesions in this location and usually are curable by local excision. The results of tests used in diagnosing orbital tumors are inconsistent in patients with this disease entity. Four patients with orbital neurilemoma are reported. Radiographic (including arteriogram, venogram, and computerized axial tomography) and ultrasonic findings were helpful in making the diagnosis.

Adult↗