Biomedical subjects

R H Sheppard

Publications and source records attributed to R H Sheppard.

12 recordsLinked to original sources

PubMed1989

Treatment of chronic alcoholic pancreatitis by pancreatic resection.

Forty-one patients with chronic pancreatitis caused by alcoholism were selected for resective surgery on the basis of clinical criteria and findings on pancreatography. Five patients had Whipple resections, 32 had 80 percent resections, and 7 had total pancreatectomies (3 previously had subtotal pancreatectomies). One perioperative and three late deaths accounted for the overall mortality of 10 percent. Complete freedom from pain on long-term follow-up was achieved in all of the patients who had total pancreatectomy, in half of the patients who had 80 percent resection, and in only one of five patients who had Whipple resection. Diabetes occurred in only one patient after Whipple resection, in nearly half of the patients after 80 percent pancreatectomy, in a gradually accelerating manner, up to 5 years, and in all patients after total resection, where it was frequently complicated by recurrent alcoholism. Jaundice was a rare complication of disease progression in the overall treatment group; none of these patients presented with cholestasis preoperatively. Recurrent alcoholism was reported in 32 percent of the patients and contributed to two deaths.

Alcoholism↗

PubMed1977

Clotrimazole vs haloprogin treatment of tinea cruris.

A study to compare the efficacy of clotrimazole 1% solution with that of haloprogin 1% solution for the treatment of tinea cruris was conducted among military personnel on active duty in a hot, humid climate. Eighty patients with documented dermatophyte infections were treated with the topical antifungal agents. Analysis of the response to treatment for 14 days demonstrated that clotrimazole was significantly more effective clinically and mycologically than haloprogin. With no further treatment, significantly more patients treated with clotrimazole remained free of the disease four weeks later.

Clotrimazole↗

PubMed1977

"Brown tumor" of hyperparathyroidism induced with anticonvulsant medication.

A case history is presented of a 50-year-old epileptic receiving massive dose of phenobarbital and small doses of dilantin. Following a minor injury to her forearm a "brown tumor" of hyperparathyroidism and osteomalacia, both of which responded to vitamin D.A review of the literature is given; this is the second case reported which documents hyperparathyroidism under such circumstances, and the first to show radiographs of such changes. Radiologists should be aware of the possibility of these changes in patients on long-term anticonvulsants.

Anticonvulsants↗

PubMed1976

Light and electron microscopic features of a pituitary adenoma in Nelson's syndrome.

Electron microscopy of an amphophil pituitary adenoma surgically removed from a 51-year-old woman who had Nelson's syndrome revealed that the tumor was composed of melanocorticotroph cells. This finding is consistent with the view that in the human pituitary gland one single cell type produces both adrenocorticotropic hormone (ACTH) and melanocyte-stimulating hormone (MSH). In contrast to the ultrastructure of pituitary adenomas associated with Cushing's syndrome, no or only very few microfilaments were detected in the cytoplasm of the tumor cells, suggesting that adrenocortical steroids are required for the formation of microfilaments. The presence or absence of microfilaments in the tumor cells may be regarded as a distinguishing ultrastructural feature between Cushing's syndrome and Nelson's syndrome. It appears that changes in the level of circulating corticoids may affect the ultrastructural features of melanocorticotroph cells not only in normal pituitaries but also in adenohypophyseal adenomas.

Adenoma↗

PubMed1975