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Biomedical subjects

N M Gupta

Publications and source records attributed to N M Gupta.

At least 19 recordsLinked to original sources
PubMed1992

Double pigtail cystogastric stent in the management of pancreatic pseudocyst.

We describe placement of a double pigtail cystogastric stent in 5 patients with pancreatic pseudocyst using real-time ultrasonography and fluoroscopy as guidance techniques. This was done as a two-step procedure. First, a transgastric drainage catheter was placed for a period of six days. All the patients continued to have high drainage output and the cyst size decreased, as seen sonographically. Simultaneous barium meal and sinogram were then done to measure the distance between the posterior gastric wall and the cyst. A polyurethane double pigtail stent of appropriate size was then introduced to achieve cystogastric drainage. The cyst resolved in all the patients by four weeks to six weeks, when the stent was removed endoscopically. There was no recurrence of pseudocyst during follow-up for 6 months to 13 months. None of the patients suffered any complication. Cystogastric drainage using a double pigtail stent is an easy and safe alternative to surgical cystogastrostomy.

Adult↗
PubMed1992

Ultrasound-guided fine needle aspiration cytology of carcinoma involving the intra-abdominal oesophagus.

Ultrasound-guided fine needle aspiration cytology (FNAC) of carcinoma of the intra-abdominal oesophagus was attempted on 21 patients with a 21 G spinal needle using a percutaneous anterior epigastric approach. The results were compared with those of endoscopic biopsy and brush cytology. The ultrasound-guided FNAC had a positive yield in 20/21 (95.2%) compared with 18/21 (85.7%) for endoscopic biopsy and 18/21 (85.7%) for brush cytology (P greater than 0.59). The combination of US-guided FNAC with endoscopic biopsy and the brush cytology achieved a positive yield in 21/21 (100%) whereas combining endoscopic biopsy and brush cytology produced a positive yield of 19/21 (90.5%). Two patients developed temporary epigastric pain. We recommend US-guided FNAC as a safe and effective technique that can be used alone or as an adjunct to endoscopic procedures for the diagnosis of carcinoma of the intra-abdominal oesophagus.

Abdomen↗
PubMed1992

Colorectal carcinoma in Indian patients with idiopathic ulcerative colitis.

In contrast to reports from Western countries, the incidence of colorectal carcinoma among patients with idiopathic ulcerative colitis is considered to be low in the Indian subcontinent. In order to assess the risk of carcinoma in Indian patients, a retrospective analysis of 436 cases of idiopathic ulcerative colitis seen by us over a period of 12 years was carried out. Eight cases of colitis carcinoma (1.8%) were encountered during the study period. Pancolitis was present in six of them while colitis was of limited extent in two cases. The mean duration of colitis prior to development of carcinoma was 12.1 (range 7-25) years. While four of these patients were on our follow-up list and were diagnosed to have carcinoma at the time of a medical or surgical complication, four others first presented to us with a surgical complication of colitis carcinoma. We conclude that colitis carcinoma is not a rare entity among Indian patients with idiopathic ulcerative colitis. We feel that until proved otherwise, patients with idiopathic ulcerative colitis from the Indian subcontinent should not be denied the benefits of a cancer surveillance programme.

Adult↗
PubMed1992

Optimal number of biopsy specimens in the diagnosis of carcinoma of the oesophagus.

The study evaluated 48 patients with carcinoma of the oesophagus to assess the optimal number of biopsy specimens required to obtain the highest yield. Eight specimens were obtained from each patient and two specimens were placed serially in each of four vials. The first vial provided a positive diagnosis in 95.8% of cases. The addition of two more specimens (second vial) increased the yield to 97.9% and the fifth and sixth specimens increased the positive yield to 100%. There was no statistically significant difference in the yield according to the site and the type of growth.

Adult↗
PubMed1991

Fibrinolytic activity in human malignant tumors.

We have studied fibrinolytic activity of 12 cases of infiltrating duct carcinoma of breast (7 metastatic and 5 non-metastatic) and ten cases of adenocarcinoma of gastrointestinal tract (5 each of metastatic and nonmetastatic), and compared with some of their normal tissue counterparts. Both metastatic and non-metastatic tumors of breast and gastrointestinal tract had significantly higher levels of fibrinolytic activity as compared to normal tissues. Though mean fibrinolytic activity (expressed as ug/ml of urokinase activity) of metastatic tumors of breast and gut had higher values as compared to non-metastatic counterparts, however it did not reach statistical significance.

Adenocarcinoma↗
PubMed1991

Carcinoma of the esophagus presenting with esophagocutaneous fistula--a case report.

An interesting manifestation of carcinoma of the esophagus, hitherto undescribed is reported. The patient at the time of diagnosis had presented with an esophagocutaneous fistula. He was treated by feeding jejunostomy and local palliative radiotherapy and showed good clinical improvement. The extreme rarity of such a presentation is highlighted.

Adult↗
PubMed1991

Giant perforations of duodenal ulcer.

Over a period of eleven years, eight patients were treated for duodenal ulcer perforation measuring more than one centimetre in diameter. In five of these patients, the perforation was sealed using a jejunal loop as serosal onlay patch; one patient underwent gastrectomy and in two patients catheter duodenostomy was done. Two patients died, both due to renal failure. The six surviving patients were discharged with the advice for a subsequent 'ulcer-curing' operation after six months. Two patients developed life threatening complications during this waiting period and one of these died. Giant perforations of duodenal ulcer can safely be closed using a jejunal loop as serosal patch. Delay in doing the second stage definitive surgery for the ulcer may be dangerous.

Aged↗
PubMed1990

Modified ultrasound-guided percutaneous transgastric drainage of pancreatic pseudocysts.

We describe a modified ultrasound-guided transgastric drainage technique for pancreatic pseudocysts. Using a water-filled stomach to improve visualization, we have successfully drained pseudocysts in ten patients. This report also describes the use of a stiffening cannula to assist transgastric catheter placement. We emphasize the value of constant real-time tracking of the dilator and guidewire to ensure correct positioning of the drainage catheter.

Adolescent↗
PubMed1990

Procoagulant activity of human tumours: existence of Xa and thrombin-like activities.

We have analysed 15 infiltrating duct carcinomas of the breast, 10 gastrointestinal adenocarcinomas, one each of the thyroid and larynx, and four mesenchymal tumours for the presence and the nature of procoagulant activity (PCA). The metastatic tumours had a significantly higher PCA (P = 0.01-0.001) as compared to the non-metastatic tumours in the respective groups, and almost 20-25 times the activity as compared to normal tissue (P = 0.001). Although the majority of the tumours had FVII-dependent tissue thromboplastin-like activity, some of the tumour homogenates revealed the presence of an FVII-independent PCA. Unlike the known alternate PCA, which acts via factor X activation, this PCA was factor X independent. It caused clot formation in FX-deficient plasma (six cases) and purified fibrinogen solution (four cases), indicating the presence of a Xa-like enzyme or a thrombin-like activity respectively.

Adenocarcinoma↗
PubMed1990

Fine needle aspiration cytology of rectal masses.

This paper describes the results of transproctoscopic fine needle aspiration cytology in the diagnosis of rectal lesions. Fifty one consecutive patients referred with a presumptive diagnosis of rectal mass were subjected to proctoscopic examination when fine needle aspiration cytology, brush cytology and biopsy samples were taken. Of the 30 patients of malignancy of rectum in whom all the three sampling techniques were applied, the biopsy was positive in 27 (90%), brush cytology in 25 (83.3%) and fine needle aspiration cytology in 29 (96.6%). A combination of fine needle aspiration cytology with brush cytology gave a positive yield in 96.6% while that fine needle aspiration cytology with brush cytology gave a yield of 100%. Fine needle aspiration cytology was most helpful in infiltrative tumours. All 10 patients with secondaries in the pouch of Douglas or rectovesical pouch, and the single patient with submucosal rectal carcinoma were correctly diagnosed at fine needle aspiration cytology. There were no false positive results with fine needle aspiration cytology and no complications were encountered with the procedure.

Adenocarcinoma↗
PubMed1990

Occult carcinoma esophagus metastatic to spine producing paraplegia--a case report and review of literature.

An extremely rare case of asymptomatic squamous cell carcinoma of the esophagus metastatic to the spine leading to paraplegia is reported. The rarity of such an event signifies the relationship between hypercalcaemia and carcinoma of the esophagus. Its occurrence as a second silent primary neoplasm and its association with a negative esophagogram is highlighted.

Carcinoma, Squamous Cell↗
PubMed1990

Transhiatal esophagectomy.

Transhiatal esophagectomy without thoracotomy was performed on 40 patients with cancer of the esophagus and two with corrosive stricture. The resection and esophagogastric anastomosis in the neck were done in a single stage. The 30-day mortality was 12%. Complications included intraoperative pneumothorax (71%), transient hoarseness (19%), anastomotic leak (17%) and pulmonary complications requiring respiratory assistance (7%). Two patients required surgery for internal hemorrhage, but there was no bleeding from the posterior mediastinum. Short operating time and avoidance of thoracotomy are the clear advantages of this procedure. As experience was gained, mortality and morbidity diminished. Transhiatal esophagectomy is a safe and well-tolerated surgical procedure.

Adenocarcinoma↗
PubMed1990

Endoscopic management of chronic organoaxial volvulus of the stomach.

Endoscopic correction of the chronic organoaxial volvulus of the stomach was attempted in seven cases of primary and three cases of secondary volvulus. Endoscopic correction was successful in six cases of primary volvulus and one case of volvulus secondary to duodenal carcinoma. This paper describes the details of the technique of endoscopic correction of gastric volvulus, and documentation of correction of the volvulus by barium meal study with a follow-up of 5-26 months.

Adult↗
PubMed1989

Primary choledochal echinococcosis.

Hydatid cysts involving organs other than liver and lungs are rather uncommon. A case of primary hydatid cyst of the common bile duct producing obstructive jaundice due to extrinsic compression of the bile duct is reported.

Adult↗
PubMed1989

Esophageal exclusion and gastric bypass for unresectable carcinoma of the thoracic esophagus.

Total esophageal exclusion and substernal gastric bypass were performed on eight patients with unresectable carcinoma of the thoracic esophagus who had received radiotherapy as the primary treatment. One patient died postoperatively. Three patients developed cervical anastomotic leaks which settled with conservative treatment. Average survival after the surgery was eight months and all seven survivors were able to eat normally. The simplicity and effectiveness of the operation have been emphasized.

Adult↗