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Biomedical subjects

C Sundaram

Publications and source records attributed to C Sundaram.

At least 37 records · Page 2Linked to original sources
PubMed2001

Sinocranial aspergillosis: a form of central nervous system aspergillosis in south India.

Of the 21 patients with aspergillosis of central nervous system seen during the years 1990-1997, 16 (76%) had aspergillosis of sino-cranial origin. The occupation in patients with sino-cranial aspergillosis was either agricultural or manual work and predisposing risk factors were present in only two (12.5%) patients. Skull-base syndromes were the presenting features in 13 patients and three patients presented with features of intracranial space-occupying lesion. Paranasal sinus mass lesions were seen in all the 16 patients. Computerized tomography showed intracranial extradural-enhancing mass lesions in the anterior, middle or posterior cranial fossa in nine (68%) patients, intracranial and orbital lesions in four and orbital lesions in three. Well-formed granuloma with dense fibrosis was the histological feature. Survival rates were not good even after surgical and antifungal chemotherapy. Surgical treatment was subradical in our series. The majority of cases of sinocranial aspergillosis are reported from countries with temperate climates and the high incidence in these regions is probably related to constant exposure to the high spore content of pathogenic Aspergillus species in the 'mouldy' work environment.

Adolescent↗
PubMed2001

Infections in children under 5 years old and latrine cleanliness.

The aim of this study is to assess the cleanliness of the latrine and its relation to occurrence of disease in children under 5 years old. A stratified random sample of 1327 households was conducted in 11 villages in Upper Egypt. It included a sub-sample of 541 children under 5 years living in households with latrines. The latrine cleanliness was assessed and its relationship to disease occurrence within a period of 2 weeks. Thirty-three percent (33.1%) of children under 5 years old with latrines in their household had infections, compared to 28.3% of those without latrines in the house. Infection with diarrhoea was found most in houses with latrine and water tap. A relation was found between latrine cleanliness score and presence of flies, house building material and maternal education, but none with occurrence of infection in children under 5 years old within a period of 2 weeks.

Child Welfare↗
PubMed2001

Isolation of a Nodulisporium species from a case of cerebral phaeohyphomycosis.

A fungal infection of the brain of a 55-year-old male patient is reported. The lesion and involved fungus were located exclusively in the right medial temporo-parietal region. The patient was successfully treated with surgical resection of the lesion and antifungal chemotherapy. Few pathogenic dematiaceous fungi exhibit neurotropism and can cause primary infection in the central nervous system (CNS). The etiological agent is described as a Nodulisporium species. To date Nodulisporium has never been reported as an agent of CNS infection in humans.

Ascomycota↗
PubMed2001

Missed anterior crossing vessels during open retroperitoneal pyeloplasty: laparoscopic transperitoneal discovery and repair.

PURPOSE: Extrinsic ureteropelvic junction obstruction due to anterior crossing segmental renal vessels is present in more than 50% of patients in adulthood. In this situation the ureter must usually be dismembered and transposed anterior to the crossing vascular structures, where it is anastomosed to the renal pelvis. Via the open retroperitoneal approach there may be a limited view of the anterior surface of the ureteropelvic junction and, hence, anterior crossing vessels may possibly be missed. We describe 2 patients with ureteropelvic junction obstruction in whom anterior vessels were missed during open retroperitoneal repair. Laparoscopic transperitoneal secondary pyeloplasty with posterior displacement of the crossing renal vessel was performed in each case. MATERIALS AND METHODS: Two patients presented with symptomatic congenital ureteropelvic junction obstruction after failed endopyelotomy in 1 and failed open retroperitoneal procedures in both. Preoperatively spiral computerized tomography angiography with a ureteropelvic junction protocol revealed crossing vessels in the 2 cases. This finding was confirmed at transperitoneal laparoscopic pyeloplasty. The ureter and renal pelvis were transposed anterior to the crossing vessels and 2 rows of running sutures were placed to complete the anastomosis. RESULTS: The 2 laparoscopic procedures were completed successfully. The anterior crossing vessels were preserved in each case. Currently the patients are asymptomatic and furosemide washout renal scan was normal. CONCLUSIONS: Spiral CT angiography reliably delineates the renal vascular anatomy in patients with ureteropelvic junction obstruction. This study may be valuable before planned open retroperitoneal ureteropelvic junction obstruction repair. Laparoscopic pyeloplasty may successfully manage anterior crossing vessels associated with secondary ureteropelvic junction obstruction.

Adolescent↗
PubMed2001

Prospective randomized trial comparing shock wave lithotripsy and ureteroscopy for management of distal ureteral calculi.

PURPOSE: We compared the efficacy of shock wave lithotripsy and ureteroscopy for treatment of distal ureteral calculi. MATERIALS AND METHODS: A total of 64 patients with solitary, radiopaque distal ureteral calculi 15 mm. or less in largest diameter were randomized to treatment with shock wave lithotripsy (32) using an HM3 lithotriptor (Dornier MedTech, Kennesaw, Georgia) or ureteroscopy (32). Patient and stone characteristics, treatment parameters, clinical outcomes, patient satisfaction and cost were assessed for each group. RESULTS: The 2 groups were comparable in regard to patient age, sex, body mass index, stone size, degree of hydronephrosis and time to treatment. Procedural and operating room times were statistically significantly shorter for the shock wave lithotripsy compared to the ureteroscopy group (34 and 72 versus 65 and 97 minutes, respectively). In addition, 94% of patients who underwent shock wave lithotripsy versus 75% who underwent ureteroscopy were discharged home the day of procedure. At a mean followup of 21 and 24 days for shock wave lithotripsy and ureteroscopy, respectively, 91% of patients in each group had undergone imaging with a plain abdominal radiograph, and all studies showed resolution of the target stone. Minor complications occurred in 9% and 25% of the shock wave lithotripsy and ureteroscopy groups, respectively (p value was not significant). No ureteral perforation or stricture occurred in the ureteroscopy group. Postoperative flank pain and dysuria were more severe in the ureteroscopy than shock wave lithotripsy group, although the differences were not statistically significant. Patient satisfaction was high, including 94% for shock wave lithotripsy and 87% for ureteroscopy (p value not significant). Cost favored ureteroscopy by $1,255 if outpatient treatment for both modalities was assumed. CONCLUSIONS: Ureteroscopy and shock wave lithotripsy were associated with high success and low complication rates. However, shock wave lithotripsy required significantly less operating time, was more often performed on an outpatient basis, and showed a trend towards less flank pain and dysuria, fewer complications and quicker convalescence. Patient satisfaction was uniformly high in both groups. Although ureteroscopy and shock wave lithotripsy are highly effective for treatment of distal ureteral stones, we believe that HM3 shock wave lithotripsy, albeit slightly more costly, is preferable to manipulation with ureteroscopy since it is equally efficacious, more efficient and less morbid.

Adult↗
PubMed2001

Cysts of the central nervous system : a clinicopathologic study of 145 cases.

Non-neoplastic, non-inflammatory cysts of the central nervous system may cause symptoms because of pressure, rupture or secondary inflammation. A total of 145 cases of cysts were reviewed during a study period of 12 years. The clinical details and histological features were noted in all cases. During this period 53 epidermoid cysts, 16 dermoid cysts, 38 colloid cysts, 23 arachnoid cysts, 5 neurenteric cysts, 5 ependymal and glial cysts, 2 Rathke's cleft cysts and 3 unclassified cysts were encountered. The possible histogenesis is also discussed.

Adolescent↗
PubMed2000

Captopril MR renography in a swine model: toward a comprehensive evaluation of renal arterial stenosis.

PURPOSE: To test the feasibility of captopril magnetic resonance (MR) renography and to validate the technique in an animal model of renal arterial stenosis. MATERIALS AND METHODS: Seven pigs with induced renal arterial stenosis were studied. MR renography was performed with a T1-weighted approach by using three-dimensional fast imaging with steady-state precession, or FISP, sequences after administration of a bolus of 0.1 mmol of gadopentetate dimeglumine per kilogram of body weight. Captopril was administered to improve the specificity. RESULTS: The results demonstrate that differences in renographic curves and indices are observed only if an anatomically substantial stenosis, typically a diameter reduction of more than 70%, is present and captopril is administered. CONCLUSION: In this preliminary experience in an animal model, captopril MR renography provided data consistent with expectations based on conventional renographic results.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed2000

Spinal extradural abscess following local steroid injection.

A case of spinal extradural abscess following local steroid injection for back ache, in a 26 years old male is described. The abscess presented as a swelling externally. MRI localised the lesion to L2-S1 segments. Mechanism of such an infection has been discussed.

Abscess↗
PubMed2000

Clinical, pathological and magnetic resonance imaging features of focal myositis: report of three cases.

Focal myositis is a rare idiopathic form of inflammatory myositis involving a single muscle. The presentation is often as a soft tissue pseudotumour. Magnetic resonance imaging (MRI) is a useful noninvasive imaging modality to demonstrate focal nature of the lesion. We describe three patients presenting as pseudotumour of the lower leg. MRI showed hyperintense signals in the involved muscle.

Adolescent↗
PubMed2000

Periurethral transurethral microwave thermotherapy for the treatment of benign prostatic hyperplasia: an interim 1-year safety and efficacy analysis using the thermatrx TMx-2000.

Transurethral microwave thermotherapy (TUMT) represents an accepted minimally invasive approach to the management of patients with benign prostatic hyperplasia (BPH). The TherMatrx TMx-2000 represents a further evolution in TUMT technique. This device uses periurethral transurethral microwave thermotherapy (P-TUMT) technology to directly target the BPH tissue adjacent to the prostatic urethra by using a catheter without a urethral-cooling surface. This article provides a technical review of the device and describes the results of a randomized, controlled multicenter study of P-TUMT for the treatment of symptomatic BPH. A discussion of the physiologic effects of P-TUMT is presented and compared to conventional TUMT. A comparison of P-TUMT to contemporary TUMT series in relation to efficacy and complications is also described. This study concludes that P-TUMT using the TherMatrx TMx-2000 device represents a minimally invasive, efficacious, and well-tolerated treatment for symptomatic BPH.

Aged↗
PubMed2000

Pleomorphic xanthoastrocytoma--a clinicopathological study.

Six cases of Pleomorphic Xanthoastrocytoma of central nervous system are presented. One case presented with recurrent refractory seizures and others as intracranial space occupying lesions. They were located in temporal/parietal lobes, were partly cystic and partly solid on CT scan, enhancing with contrast. Histopathology was characterized by pleomorphic giant cells and cells with vacuolated cytoplasm. Glial fibrillary acidic protein was strongly positive in all the cases.

Adolescent↗
PubMed2000

Aspergillosis of central nervous system: a study of 21 patients seen in a university hospital in south India.

AIM: To study the pattern of central nervous system aspergillosis in a tropical country. MATERIAL AND METHODS: Case records of patients with CNS aspergillosis seen by the authors in a university hospital in south India were reviewed. RESULTS: Of the 21 patients seen during the study period, 16 (76%) patients had intracranial invasion by contiguous spread from paranasal sinuses and one had from ear. Predisposing risk factors were present in two (12.5%) patients with sinocranial aspergillosis and in both patients with disseminated form. Skull bases syndromes were the presenting features in 13 patients, six patients presented with features of intracranial space occupying lesion and two patients had stroke like presentation. CT scans showed intracranial extradural contrast enhancing mass lesions in the anterior, middle or posterior cranial fossa in addition to mass lesions in the paranasal sinuses in 13 patients with sinocranial aspergillosis and in seven orbital lesions. Intracerebral contrast enhancing mass lesion was the CT finding in both the patients with solitary cerebral aspergillus granuloma and in the patient with otocranial aspergillus granuloma. Well-formed granuloma with dense fibrosis was the histological feature in patients with sinocranial and otocranial aspergillosis. Angioinvasion was the pathological feature in both the patients with disseminated form of aspergillosis. Surgical treatment was sub-radical in our series. Survival rates were not good even after surgical and antifungal chemotherapy. CONCLUSIONS: This study suggests that in this part of the world sinocranial aspergillosis is the most common form of histologically verified CNS aspergillosis. Associated predisposing factors and immune status of the host determine the clinical syndrome and type of pathology in patients with CNS aspergillosis.

Aspergillosis↗
PubMed1999

Exclusive CNS involvement by lymphomatoid granulomatosis in a 12-year-old boy: a case report.

BACKGROUND: Lymphomatoid granulomatosis [LYG] is an angiocentric, angiodestructive disease at the higher grade end of the spectrum of angiocentric immunoproliferative lesions. It primarily involves the lungs, but it may also involve several extrapulmonary sites including the central nervous system (CNS), skin, and kidneys. CASE DESCRIPTION: Clinical presentation, radiology and treatment of LYG in a 12-year-old male child with multiple intracranial extraaxial lesions is described. A 12-year-old boy presented with sudden onset of left focal motor seizures with associated history of headache and vomiting. Computerized tomographic scan of the brain suggested high-density, bilateral, parietal extraaxial lesions. On magnetic resonance imaging, the lesions were iso- to hyperintense on T1-weighted images and hyperintense on T2-weighted images. The lesions were excised in two stages and histopathological examination confirmed the diagnosis. CONCLUSION: LYG seldom involves the CNS exclusively. The present case demonstrates exclusive CNS involvement by LYG in a young boy.

Central Nervous System Neoplasms↗
PubMed1999

Distal calcarine fusiform aneurysm: a case report and review of literature.

A 50 year old female who was operated for atrial septal defect 8 years back, presented with clinical features suggestive of subarachnoid haemorrhage (grade I, Hunt and Hess). CT scan of brain revealed haemorrhage in all the supratentorial basal cisterns, sylvian cistern and small haematoma in the left occipital lobe. Conventional CT and MR angiography revealed aneurysm in relation to distal part of the calcarine branch of the left posterior cerebral artery (PCA). Left occipital craniotomy in prone position followed by deep dissection in the occipital lobe showed fusiform aneurysm of the distal part of the calcarine branch. PCA aneurysms constitute only 0.2 to 1% of all intracranial aneurysms and among them distal PCA aneurysms are most rare, constituting only 1.3%. They too are mostly seen at the bifurcation of the PCA. The present case however, is unique in the sense that it has developed as a fusiform aneurysm in the distal part of the calcarine branch. To the best of our knowledge this is rare among the rarest.

Craniotomy↗
PubMed1998

Quantitative ELISA for platelet m-calpain: a phenotypic index for detection of carriers of Duchenne muscular dystrophy.

In order to measure the amount of m-calpain in platelets from Duchenne muscular dystrophy (DMD) patients, carriers and controls, an enzyme linked immunosorbent assay (ELISA) has been developed using polyclonal antibodies raised against m-calpain (Calcium dependent neutral protease), purified from human placenta. Compared to controls a nine-fold increase in the level of m-calpain was observed in all 25 DMD patients and eight obligate carrier mothers studied. Serum creatine kinase (SCK) values of four of these obligate carriers were found to be overlapping with that of normal values, limiting its usefulness. Since calpain levels were found to be raised in all DMD patients and obligate carriers, the estimation of calpain in all female relatives of the ones affected with DMD (with or without raised serum CK) would prove a facile index. Population screening for carrier females using this cost and labour effective index may help in assessing the carrier status and counselling the at risk families.

Adolescent↗
PubMed1998

Plasmacytoma of dens as a cause of atlanto-axial instability.

A case of Plasmacytoma of dens (Odontoid Process) in an adult male managed by trans-oral excision and posterior fusion is reported for its rarity. The importance of neuro-imaging and the treatment options, in view of the associated instability at the atlanto-axial region and the difficulty in preoperative diagnosis are emphasized.

Adult↗