Pathologic quiz case. Extrarenal rhabdoid tumor.
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Biomedical subjects
Publications and source records attributed to N R Gundamraj.
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Coagulation is an essential part of a surgical procedure, especially in neurosurgery. Beginning in the early years of this century, various techniques have been used to control bleeding at the surgical site. Over the years, these techniques have led to the invention of the bipolar coagulator and its modifications. Prevention of charring and tissue adhesion have been the goals of bipolar coagulator manufacturers all over the world; new techniques and different metallurgical compositions for the forceps have been tried to achieve these results. The NS2000, with its microprocessor-based controlled coagulative sequence, can be a good system for reducing tissue adhesion and charring under desired limits of low output power ranges provided by the system. Comparable results can also be obtained with the Malis CMC III and Synergy Malis systems with irrigation channels. These systems have the additional advantages of providing higher power outputs at lower panel settings and a maximum power output greater than that of NS2000. For neurosurgeons who need the additional option of cutting, the Malis CMC III is the recommended system.
Neurosurgical drill systems have evolved enormously over the centuries, from the early tools of trephination to the latest motor powered drills. The Midas Rex III Motor system and the Midas Rex driver motor are the newest systems, incorporating features that allow convenient operation by surgeons.
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Knowledge of the magnetic properties of cerebral aneurysm clips in patients undergoing magnetic resonance (MR) imaging is imperative. The authors quantified in electromagnetic units the magnetic properties of 13 different types of aneurysm clips by using a vibrating sample magnetometer. Their results showed that the magnetic moment of these clips ranged from 0.15 EMU/g to as high as 152.7 EMU/g. Based on these results and tests of the movement of the clips during MR imaging, they conclude that aneurysm clips with a magnetic moment less than 1 EMU/g may be safely used during MR imaging. The quantification of magnetic properties into electromagnetic units by using a vibrating sample magnetometer is a reliable method applicable to any testing field gradient. This method can be used as a standard to measure and label the magnetic properties of aneurysm clips.
We studied magnetic field intensity in the magnetic resonance imaging suite at our hospital and its possible effect on several different types of aneurysm clips, including one Heifetz 17-7 PH, six Heifetz Elgiloy, one Mayfield, six Perneczky, fifteen Sugita, one Sundt-Kees Variangle, four Variangle-McFadden and fifteen Yasargil clips. We carefully observed the clips for any translational or rotational movements along the path from the door towards the magnetic resonance imaging gantry. The magnetic field strength was 0.04 kiloGauss at the entrance of the room, with an acute increase of magnetic strength at 310 cm away from the entrance to the room, 90 cm to the entrance of the gantry. The magnetic strength continued to increase at a rate of 1.0-1.5 kiloGauss for every 20 cm up to the entrance to the gantry. No movement was observed in any of the clips at the entrance to the suite except for the Heifetz 17-7 PH clip, which showed small movement in the longitudinal plane of the clip. At the entrance to the gantry, the Heifetz 17-7 PH, Sundt-Kees Variangle, and Mayfield clips were aligned on the walls of the test container perpendicular to the magnetic bore. The, Heifetz Elgiloy, Perneczky, Sugita, Variangle-McFadden, and Yasargil clips showed no movement throughout the path of the stretcher or near the gantry.