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Biomedical subjects

H Gopal

Publications and source records attributed to H Gopal.

9 recordsLinked to original sources
PubMed2000

Symptomatic hypercalcemia of immobilization in a patient with end-stage renal disease.

The phenomenon of hypercalcemia in immobilization is well known, but there is limited awareness of the potential for this complication in patients with end-stage renal disease (ESRD) on maintenance hemodialysis with reduced capacity for disposition of calcium. We describe such a patient who showed a calcemic response to just 3 days of immobilization in the setting of an acute illness marked by coma. Despite intensive initial therapy for hypercalcemia, including withdrawal of all calcium products and daily hemodialysis treatments using low calcium baths, her serum calcium rose to 14.0 mg/dL during the hospitalization; this metabolic abnormality appeared to perpetuate her stuporous state. Mobilization as an outpatient was the most effective therapy. Extensive testing was performed to rule out other causes for this patient's hypercalcemia. Greater recognition of acute hypercalcemia in patients with ESRD immobilized by various illnesses would preclude unnecessarily expensive and invasive testing for other causes of hypercalcemia.

Female↗
PubMed1998

Endoscopic sinus surgery with magnetic resonance imaging guidance: initial patient experience.

We report the first endoscopic surgeries performed with patients under general anesthesia using intraoperative guidance with MRI. The procedures were experimental and intended to test (1) the unusual working environment of a unique new "open-configuration" MRI unit for head and neck surgery, and (2) real-time image guidance. Twelve patients underwent endoscopic sinus surgery while under general anesthesia in a new open MRI unit that provides the surgeon with access to the patient while imaging is performed. Eleven patients had chronic sinusitis (eight of them had bilateral disease), and one had a right nasoethmoid and antral tumor. All 12 surgeries were performed without complications. Both the endoscopic view and the MRI scans were available at the surgical field. The image plane was surgeon controlled, and the MRI updated images in as little as 14 seconds. MRI provided adequate visualization of both the disease and the related anatomy and allowed the surgeon to navigate during the procedure. The intraoperative data reflect the tissue changes during surgery and provide optimum feedback for surgical guidance. Although the operating environment poses some limitations, it has become apparent that intraoperative MRI has a role in the treatment of head and neck disorders and warrants further study.

Adult↗
PubMed1997

Image-guided endoscopic surgery: results of accuracy and performance in a multicenter clinical study using an electromagnetic tracking system.

Image-guided surgery has recently been described in the literature as a useful technology for improved functional endoscopic sinus surgery localization. Image-guided surgery yields accurate knowledge of the surgical field boundaries, allowing safer and more thorough sinus surgery. We have previously reviewed our initial experience with The InstaTrak System. This article presents a multicenter clinical study (n=55) that assesses the system's capability for localizing structures in critical surgical sites. The purpose of this paper is to present quantitative data on accuracy and performance. We describe several new advances including an automated registration technique that eliminates the redundant computed tomography scan, compensation for head movement, and the ability to use interchangeable instruments.

Adolescent↗