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Biomedical subjects

A K Mahapatra

Publications and source records attributed to A K Mahapatra.

At least 163 records · Page 9Linked to original sources
PubMed1983

Leiomyosarcoma of the parotid gland.

An unusual case of leiomyosarcoma of the parotid gland is reported. The tumour recurred thrice and metastasized to one of the adjacent lymph nodes. Histologically, a leiomyosarcoma in the salivary gland closely resembles a tumour of myoepithelial cells origin but lacks the dual cell morphology seen in the latter.

Adolescent↗
PubMed1982

Assessment of postoperative hearing in 528 middle ear and mastoid surgery cases in Tokai University Hospital.

The postoperative hearing results in cases of tympanoplasty, radical mastoidectomy, modified radical mastoidectomy and tympanoplasty combined with modified radical mastoidectomy on 528 ears, performed in the Tokai University Hospital between 1975 and 1980 were assessed. The assessment was based on pure-tone audiograms taken 3 months to 5 years after the operation. Out of 528 cases 70.5% gained better postoperative hearing, 6% showed no change of hearing and 23.5% showed deterioration of hearing. Auditory success of those who attained social hearing, air-bone gap closure to within 20dB or gained hearing of 20 dB or more was 53.4%. The results in cholesteatoma cases were poorer than those of non-cholesteatoma cases. In 44% of the cases, ossiculoplasty was performed, and the most successful ossiculoplasty results were obtained when the malleus was repositioned to the head of the stapes. Fairly good results were achieved when an artificial prosthesis, such as a Teflon-piston, Gelfoam-wire or platinum-piston, was used. The least successful results were found when the incus was transpositioned. In the non-ossiculoplasty group, type I tympanoplasty produced 59.5% auditory success whereas 37.3% auditory success was achieved in radical mastoidectomy. Better auditory success rates were obtained when the bony bridge was preserved than when it was removed. The results were identical in cases where the mastoid cavity was obliterated or when it was kept open. A new technique, "scutumplasty", was used for reconstructing the scutum. Revision surgery was required in only 3.4% of the cases.

Hearing↗
PubMedDate not supplied

Anterior encephaloceles.

Sixty five children with anterior encephaloceles were retrospectively studied for clinical presentation, radiological findings, surgery and outcome. They were sampled over a 22 years period (Jan 1973-Dec 1994). Only 6 children were above 10 years of age. Naso-ethmoid type was the most frequent type, encountered in 45 patients. Surprisingly, nasopharyngeal type was observed in 6 children. Swelling over the nose and hypertelorism were usual findings, recorded in 53 and 50 patients respectively. Ten patients, each, had CSF rhinorrhoea and proptosis. In fifty four patients CT scans were performed and bony defect could be demonstrated in 45 of them. Three each had agenesis of corpus callosum and porencphalic cysts. Six patients with hydrocephalus underwent ventricul operitoneal shunt, prior to surgical repair of the encephaloceles. In fifty nine patients, one stage repair of encephalocele and hpertelorism was carried out. There was one postoperative mortality. Ten patients developed postoperative CSF rhinorrhoea, among them 6 required percutaneous lumbo-peritoneal shunt. This study brings out the rare cases of nasopharyngeal encephaloceles and highlights the need for one stage repair in these patients.

Adolescent↗
PubMedDate not supplied

Spinal dysraphism.

Spinal dysraphism (SD) is characterized by maldevelopment of neural tube, notochord, mesoderm and cutaneous ectoderm. Incidence of SD is 2-4/1000 live births. One hundred and nineteen patients operated from January 1991-June 1996 at Department of Neurosurgery, All India Institute of Medical Sciences, were studied. Only 21 patients (17.6%) presented when they were less than one year old and 17 patients came in adult age group (> 16 years). Lumbar and lumbosacral region was the commonly involved site in 81 patients (74.7%). Weakness of lower limbs (74%), difficulty in walking (54%), muscle atrophy (41.2%) were the commonest indicators of motor system involvement. Loss of sensation, trophic ulcer, backache were seen in 45, 14, 10 patients respectively. Cutaneous lipoma (26%), hypertrichiosis (20%), dermal sinus (13.4%), midline dimples (7%) were the important cutaneous markers. Foot and limb deformity was seen in 25% cases. Tethering of cord, syringomyelia & split cord malformation were the most common radiological findings. Only 10% of our patients had hydrocephalus that required shunt. Out on 119 cases operated, 43 improved, Twenty had sensory improvement and 18 showed motor improvement. Fifteen patients regained continence. Twelve patients were lost to follow-up. Sixty-seven patients had no change in neurological status, post-operatively. Six cases deteriorated in terms of motor or sensory deficit and one patient lost continence. CSF leak (8%) and wound infection (6%) were the common complications. Six patients required second surgery as T.P. Shunt (4), rotation flap (1), reexploration and duraplasty (1).

Adolescent↗
PubMedDate not supplied

Pituitary tumours.

This report describes the presentation, pre-operative findings, surgical management and follow-up results of 20 pediatric patients with pituitary adenomas. The most common presenting complaints encountered were, headache and decrease in visual acuity. Among the patients with endocrine problems, majority had frank Cushing's disease (30%). Nine patients (45%) were endocrinally normal. The most common, histological type of pituitary tumour encountered in this series was the Chromophobe adenoma. One patient died following surgery. Radiation therapy was given in all post operative cases. Response to radiation therapy has been satisfactory on follow up. The generally encouraging results we have observed following the multi-disciplinary treatment, confirms the findings reported by other workers.

Adenoma↗
PubMedDate not supplied

Pigmented medulloepithelioma: report of a case and review of the literature.

A 9-year-old male child had a IV ventricular medulloepithelioma of classical histology, showing tubulopapillary and undifferentiated areas. The unusual feature, however, was the presence of melanin pigmentation in the cells, which was further confirmed by electron microscopy. So far 28 cases of medulloepithelioma have been reported in the English literature. However, none of them showed melanin pigmentation. To the best of our knowledge this is the first case of pigmented medulloepithelioma in the English literature.

Biomarkers, Tumor↗
PubMedDate not supplied

An unusual presentation of lumbosacral dermal sinus with CSF leak and meningitis. A case report and review of the literature.

Dermal sinus tracts are common skin manifestations seen with spinal dysraphism. Most of these dermal sinus tracts occur in the lumbosacral region. Though dermal sinus tracts are a common manifestation, their presentation with CSF leak is rare and important as they predispose to recurrent meningitis along with neurological deficits. Here we present an interesting case of a 33-month-old female child with dermal sinus CSF leak, tethered cord and intradural dermoid who presented with meningitis and was treated with excision of the tract, removal of the dermoid and detethering of the cord.

Cerebral Ventricles↗
PubMedDate not supplied

Does cerebral perfusion improve following CSF diversion in pediatric hydrocephalus? A prospective study using 99mTc ECD single photon emission computed tomography.

AIMS AND OBJECTIVES: To study regional cerebral perfusion before and after ventriculoperitoneal shunt placement in children with hydrocephalus, using (99m)Tc ECD single photon emission computed tomography (SPECT). MATERIALS AND METHODS: 17 consecutive children (less than 16 years) with hydrocephalus due to various causes, who were planned for ventriculoperitoneal shunt, were included in this prospective study. Brain SPECT using (99m)Tc ECD was performed pre- and postoperatively and changes in cerebral perfusion were compared with the change in ventricular size (assessed using Evan's ratio). OBSERVATIONS: There were 11 males and 6 females with a median age of 24 months. Nine children were up to 2 years of age and the mean duration of symptoms was 6 months. The cause of hydrocephalus was congenital in 10, secondary to tumor in 5 and as sequelae of infection in 2 children. Fourteen children (82%) showed improvement in cerebral perfusion following shunting. Of these, 12 also had a concomitant decrease in ventricular size postoperatively. RESULTS: On logistic regression analysis, none of the factors analyzed, i.e. age, duration of symptoms, etiology of hydrocephalus and decrease in ventricular size, were found to predict improvement of cerebral perfusion following shunting. CONCLUSIONS: Cerebral perfusion improves in the majority of the children following CSF diversionary procedures, and contrary to the common belief, duration of hydrocephalus and decreased ventricular size do not influence this improvement in cerebral perfusion. SPECT can therefore prove to be a valuable tool for objective assessment of improvement in cerebral perfusion in children with hydrocephalus secondary to various etiologies following surgical or medical interventions.

Brain↗