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P R Gupta

Publications and source records attributed to P R Gupta.

At least 37 records · Page 2Linked to original sources

Electrophysiologic evidence of subclinical injury to the posterior columns of the human spinal cord after therapeutic radiation.

Spinal somatosensory conduction velocity (SSCV) was indirectly estimated from cerebral evoked potentials in 15 adults who had received therapeutic radiation (RT) (2000-4380 rad) to the thoracic spinal cord during treatment for lung cancer, and in 15 age-matched normal controls. Thirteen of the patients had also received 4400-5500 rad to the supraclavicular fossae. One-way impulse conduction time in the arm, estimated from F-wave latency, was prolonged in the patients as compared to controls (12.0 +/- 1.2 versus 10.4 +/- 1.0 msec; P less than 0.001) but conduction time in the leg was similar in the two groups (22.4 +/- 2.4 versus 22.0 +/- 2.5 msec; P less than 0.1). SSCV was significantly slower in the patient group (37.9 +/- 13.9 versus 54.5 +/- 12.9 m/sec; P less than 0.001) whereas supraspinal latency (cervical cord to cortex) was identical (5.5 +/- 0.9 versus 5.5 +/- 0.8 msec; P less than 0.1). SSCV in the patient group was not related to total RT dose (r = 0.15; P = 0.2), but was correlated with both treatment time and number of fractions (r = 0.49 and 0.43; P = 0.003 and 0.007, respectively). These findings suggest that RT may produce subclinical spinal cord dysfunction even at conventional dosage schedules, and that it may be possible physiologically to monitor the myelopathic effects of RT in individual patients.

Aged↗

Spinal somatosensory conduction in diabetes.

The velocity of impulse conduction was compared in peripheral nerve, spinal cord, and supraspinal segment of the somatosensory pathway in 15 diabetic subjects (mean age, 34.3 +/- 12.4 years) with little or no evidence of polyneuropathy, and in 15 age-matched normal controls. Motor and sensory conduction velocities (CVs) were slower in the diabetic subjects, and the latencies of F waves and somatosensory evoked potentials (SEPs) from arm and leg were longer (p less than 0.001 in each case), showing a relationship to duration of disease (0.51 less than lrl less than 0.84, p less than 0.001 in each case). Indirect estimates of spinal somatosensory conduction velocity (SSCV) were slower in the diabetic subjects (39.4 +/- 13.3 m/sec versus 54.2 +/- 10.5 m/sec, p less than 0.001), but conduction in the supraspinal segment (cervical cord to cortex) was identical in the two groups (5.6 +/- 1.3 msec versus 5.6 +/- 0.8 msec, p less than 0.1). In relationship to peripheral nerve CV, the incidence of subnormal SSCV in the diabetic subjects could not be fully explained on the basis of: (1) a passive consequence of peripheral neuropathy, (2) a sensory distal axonopathy, or (3) a primary diabetic myelopathy. We conclude that 40% of diabetics have subclinical electrophysiologic dysfunction of the posterior columns of the spinal cord, which may contribute to the lower-extremity sensory symptoms that are so prevalent in this disorder.

Adolescent↗

Fiberoptic bronchoscopy in the diagnosis of pulmonary tuberculosis.

Fiberoptic bronchoscopy was performed in 30 cases of suspected pulmonary tuberculosis. Sputum was negative for tubercle bacilli in all the patients, but in specimens obtained at bronchoscopy tubercle bacilli were found in 86.6%. By postbronchoscopy sputum smear examination tubercle bacilli were detected in 73.3% of the cases.

Bronchoscopy↗