Biomedical subjects
Publications and source records attributed to J Devkota.
In this series, thorough evaluation of 250 mediastinal lesions by various diagnostic methods showed that contrast enhanced CT scans of the mediastinum were superior to other modalities in differentiation and precise localization of the various types of lesions. Such superior evaluation may have a profound effect on the management of patients.
We have reported a case of primary interhemispheric subdural hematoma with successful surgical removal. Paresis of the lower extremity out of proportion to the arm and face may provide a clue to the location of the lesion. Although CT is the most valuable single diagnostic procedure, carotid angiography is needed to exclude a vascular lesion.
A modified C1-2 myelogram, using metrizamide (Amipaque), provides excellent visualization of the cervical spinal cord. The mean values of the sagittal diameter of the spinal cord are given in 100 selected cases. Comparison with these normal values is useful in the preliminary diagnosis of cervical cord atrophy versus syringohydromyelia.
Cranial computed tomography (CT) is an extremely useful diagnostic modality in the evaluation and follow-up of children undergoing treatment for metastatic neuroblastoma. Information regarding the location, extent of the cranial metastatic lesions, and their response to treatment was provided by sequential CT examinations in three patients. Computed tomography showed nonneoplastic lesions in four patients treated by parenteral chemotherapy alone using vincristine and Cytoxan. We postulate that these lesions were neurotoxic sequelae of the prolonged chemotherapy.
Precise localization, detection, and recognition of minor changes in testicular lesions are important because teratocarcinoma is notorious for manifesting as secondaries at the time the primary site is obvious to the clinician. In the past, questionable enlargement of the testis due to significant pathology required numerous radiographic invasive special procedures to provide a correct diagnosis. Due to the advent of the sophisticated digital ultrasound imager with high frequency quarter wave transducer, it is possible to detect minor changes in the tissue character of the testis, thus enabling the physician to tackle primary neoplasms prior to distant spread.In our case we were able to detect the abnormality in the testis, but unfortunately a large secondary abnormal mass was present. Even at that stage we were able to map out the extent of the lesion which was beneficial to the surgeon and the patient. Ultrasound studies were utilized in serial follow-up studies.
Metastasis of pineal germinoma to the peritoneal cavity via the patient's ventriculoperitoneal shunt represents an unusual complication of this rare tumor. We report such a case with autopsy correlation of the abdominal CT findings. CT accurately delineated the extent of the metastatic mass and revealed associated complications including biliary tract obstruction, thrombosis of the inferior vena cava and a small amount of ascitic fluid. Since this tumor is very sensitive to radiotherapy and chemotherapy, the need for early detection of such metastasis is apparent. Possible implications with respect to the management of these patients are considered.