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Biomedical subjects

S B Paul

Publications and source records attributed to S B Paul.

13 recordsLinked to original sources

MR spectrum in spinal dysraphism.

Spinal dysraphism is a general term which encompasses a wide variety of anomalies of the spine, all of which result from imperfect midline fusion of the embryonic neural tube. This term refers to large defects that involve the spine and not to small vertical clefts commonly seen within the spinal process of L5 or S1. We present a spectrum of MR imaging findings selected from a retrospective review of 100 patients of spinal dysraphism evaluated at our institution.

Diagnosis, Differential↗

Pre-operative management of congenital choledochal cyst with ultrasound-guided percutaneous choledochalcystostomy.

Choledochal cyst is a rare congenital anomaly of the biliary system, presenting in infancy. Two cases of choledochal cyst (one infected) with grossly deranged liver function tests and associated biliary atresia, which were successfully managed pre-operatively by sonoguided percutaneous choledochalcystostomy, are reported here. The use of this technique in the treatment of patients such as these is proposed.

Choledochal Cyst↗

Arthroplasty of the hand and wrist.

The historical perspectives of the wrist and its pathologies are discussed in light of developments made by the pioneers of hand surgery.

Arthroplasty↗

Enhancement of neuromuscular recovery after nerve repair in primates.

This investigation describes the use of the calcium-activated protease inhibitor, leupeptin, as an adjunctive therapy to the microsurgical repair of median nerves in a primate model. Our results indicate that leupeptin facilitates morphological recovery in denervated thenar muscles and in distal sensory and mixed motor-sensory nerve trunks and functional recovery measured by motor nerve conduction velocity. Toxicological testing of leupeptin showed that, when administered at a dose of 12 mg/kg, intramuscularly, once daily, haematological and clotting profiles were not adversely affected.

Animals↗

Uterine arteriovenous malformations: the role of intravenous 'dual-phase' CT angiography.

The authors describe the use of dual-phase intravenous CT angiography of the pelvis in two female patients, who presented with ongoing excessive vaginal bleeding, to demonstrate large adnexal and uterine arteriovenous malformations (AVMs). Power Doppler was used as the initial modality to diagnose the AVMs. CT angiography, along with 3-D rendering in the form of maximum intensity projections and shaded surface display, were especially useful for anatomical conceptualization to the gynecologist. This greatly helped in the subsequent management in the form of therapeutic embolization in both patients by reducing the time, radiation dose, and contrast required for the procedure. Subsequent surgery, which was required in both patients (due to failed embolization), was also greatly aided by the demonstration of the exact extent of the AVMs on axial CT images. Thus, CT angiography emerged as an impressive non-invasive imaging modality for the complete evaluation and management of the uterine AVMs.

Adult↗

Evaluation of extrahepatic portal hypertension and surgical portal systemic shunts by intravenous CT portography.

The purpose of this study was to evaluate the splenoportal (SP) axis and patency of portal systemic shunts in extrahepatic portal venous obstruction (EHO) by intravenous CT portography (CTP). Fifty-five patients of preshunt EHO, and 21 patients of postshunt (surgical portal systemic shunts) EHO, were subjected to intravenous CTP on a subsecond helical CT scanner. Thin, axial sections and three dimensional (3-D) reconstructions, including maximum intensity projection (MIP) and shaded surface display (SSD), were obtained. The findings were correlated with Color Doppler Flow Imaging (CDFI). In the EHO preshunt group, the site of the block demonstrated on CTP correlated with CDFI in 53 of 55 cases. In the postshunt group, shunt patency evaluation by CTP was in agreement with CDFI in 19 of 21 patients (8 patent; 13 blocked). Two patients in each group could not be evaluated on CDFI, while CTP could provide the appropriate information. There was no false positivity or negativity with CTP in patients evaluated on both modalities. The etiology of EHO, the global view of collaterals, and the 3-D anatomy of SP axis could be well depicted and was well accepted by the surgeons. We conclude that CTP is an impressive new technique that can effectively evaluate pre- and postshunt cases of EHO.

Adult↗

Esophageal and gastric vasculature in children with extrahepatic portal hypertension: evaluation by intravenous CT portography.

PURPOSE: To compare the findings related to esophageal/gastric varices and congestive gastropathy on intravenous computed tomography (CT) portography (CTP) and upper gastrointestinal endoscopy (UGIE) in children with extrahepatic portal venous obstruction (EHO) presented with hematemesis. METHODS/MATERIALS: Fifty pediatric patients (age < 15 years) with EHO (initially diagnosed on abdominal ultrasound) presented with hematemesis and underwent UGIE and intravenous CTP using a helical CT scanner. Axial sections of 2 mm each were obtained with a collimation of 2 mm and a table feed of 3 mm. CTP findings on these axial sections were compared with UGIE (gold standard). RESULTS: The sensitivity of CTP for detection of esophageal varices, gastric varices, and gastropathy was 32/33 (97%), 38/40 (95%), and 30/32 (93%), respectively. CTP showed false positivity as well, which was 5/17 (29%), 2/10 (20%), and 13/17 (76%) for esophageal varices, gastric varices, and gastropathy, respectively. On follow-up UGIE, the endoscopic features appeared in 14/19 (74%) of false positive patients. Therefore, false positivity for all the parameters on CTP when compared to the initial UGIE represented the changes in vasculature before they were endoscopically manifest. CONCLUSIONS: CTP was likely to pick up changes in esophageal and gastric vasculature earlier than UGIE in children with EHO presented with hematemesis.

Adolescent↗

CT appearances in abdominal tuberculosis. A pictorial essay.

Abdominal tuberculosis continues to be endemic in the developing world and has shown a resurgence in the West. Computed tomography (CT) evaluation is singularly informative as it demonstrates involvement of the bowel, peritoneum, lymph nodes, and solid organs in a single examination. A spectrum of CT findings in an immunocompetent population is presented, ranging from subtle to advanced and common to rare. Genitourinary tuberculosis and tuberculosis in AIDS are excluded as they merit separate discussions.

Humans↗

Radiofrequency ablation: a new therapeutic modality for the management of hepatocellular cancer.

We report two patients of hepatocellular cancer who recently underwent radiofrequency ablation at our center. Both underwent successful ablation of the tumour requiring 1-2 sessions of upto 15 minutes. There were no post procedure complications. One of the patients had developed another lesion after 10 months of follow up and underwent another session of RFA, while the second patient is doing well after one year of the procedure.

Carcinoma, Hepatocellular↗