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Biomedical subjects

K K Jain

Publications and source records attributed to K K Jain.

At least 73 records · Page 4Linked to original sources
PubMed1985

Complications of use of the neodymium: yttrium-aluminum-garnet laser in neurosurgery.

Review of the clinical records of 32 patients who underwent operation for brain tumors with the use of the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser during a 4-month period revealed 5 cases of complications related to laser use. One death was presumed to be due to intratumor explosion (the popcorn effect) after excessive Nd:YAG laser application. The other death was due to heat necrosis of the brain stem after radiation of an ependymoma of the 4th ventricle. Two patients suffered neurological deficits. One had facial palsy after radiation of the site of attachment of a meningioma to the petrous bone. The other suffered aphasia and hemiparesis due to heat damage to the cerebral cortex after laser coagulation of the overlying dura mater. The fifth patient suffered postoperative hemorrhage in a residual necrotic chromophobe adenoma after a transsphenoidal approach using the Nd:YAG laser. These complications are preventable. Suggestions are made for the safe use of this laser.

Adenoma, Chromophobe↗
PubMed1984

Laser surgery.

Explore the source record for details and available documents.

Humans↗
PubMed1984

Cerebral protection during carotid endarterectomy--EEG monitoring as a guide to the use of intraluminal shunts.

The authors have reviewed the literature concerning measures for cerebral protection during carotid endarterectomy, with particular reference to the controversy regarding the use of an intraluminar shunt. The authors use preoperative EEG analysis during the carotid compression test as well as intraoperative EEG monitoring, and insert a shunt only when signs of cerebral ischaemia appear. This approach was used in 100 patients during a 4 year period and an internal shunt was required in only 10% of these patients. The mortality was 1% and morbidity 1% in this series. The authors believe that EEG monitoring is a reliable technique in detecting signs of cerebral ischaemia before irreversible changes occur and that an intraoperative shunt should be used only when necessary, and not routinely, as it may contribute to operative and postoperative complications.

Adult↗
PubMed1984

The treatment of extragonadal seminoma.

Primary extragonadal seminoma (EGS) is a rare tumor of young adults that often presents with bulky primary tumors and metastatic disease. Long-term survival is inadequate with conventional therapy consisting of radiotherapy with or without surgery. The charts of 21 patients with EGS treated initially either with conventional therapy (group I) or with multimodality therapy including initial chemotherapy with high doses of cisplatin followed by either radiotherapy or surgery or both (group II) were reviewed. Five of the ten patients in group I developed recurrent disease and four of them eventually died of disease. Only one of 11 patients in group II died of metastatic disease and the remaining patients are free of disease with 19+ to 46+ months of follow-up. Of the six patients from group II who underwent surgical resection of apparently residual disease after chemotherapy but prior to radiotherapy, five were found to have completely necrotic tumor and one had microscopic disease on histologic examination, proving the efficacy of chemotherapy. Combined modality therapy including initial chemotherapy containing high doses of cisplatin provided rapid reduction in tumor burden and the results appeared superior to treatment that did not include initial chemotherapy.

Adult↗
PubMed1983

[Lasers in neurosurgery].

In recent years neurosurgeons have shown an increasing interest in lasers. An understanding of the basic laser mechanism and tissue effects is important. CO2 laser is an excellent no-touch tool for excising and evaporating brain tumors. It has several other uses in neurosurgery both with free hand technique and with microscope attachment and micromanipulator. Nd: YAG and Argon lasers are more effective for coagulation of blood vessels and dealing with vascular neoplasms. Advantages and disadvantages of this technique are discussed and compared with other methods like bipolar coagulation and CUSA. Indications for the use of the different laser types in neurosurgery are summarized and a prospect of laser in neurosurgery is given.

Brain Diseases↗
PubMed1983

Lasers in neurosurgery: a review.

In recent years neurosurgeons have shown an increasing interest in lasers. An understanding of the basic laser mechanism and tissue effects is important. CO2 laser is an excellent no-touch tool for excising and evaporating brain tumors. It has several other uses in neurosurgery both with free-hand technique and with microscope attachment and a micromanipulator. It is easier and more precise to manipulate a laser beam than any of the conventional instruments. Nd:YAG and argon lasers are more effective for coagulation of blood vessels and for dealing with vascular neoplasms. Microvascular anastamosis has been achieved with the use of Nd:YAG laser in experimental animals and has potential for practical application in extra-intracranial bypass operations. There are many advantages and some disadvantages to the use of lasers in neurosurgery.

Argon↗
PubMed1983

Pitfalls in diagnosing intracranial aneurysms.

A medical record review of 90 consecutive patients with intracranial aneurysm disclosed a startling incidence of delayed or incorrect diagnosis. In 31 of the patients, the diagnosis was not made by the referring physician. Definite diagnosis by angiography will detect an aneurysm as small as 2 mm when there is no spasm of the parent vessel. A high index of suspicion and the use of computed tomography with contrast enhancement are the major tools facilitating diagnosis of an intact aneurysm.

Adolescent↗
PubMed1982

Surgical treatment of unruptured intracranial aneurysms.

The author has reviewed a series of 19 patients with unruptured aneurysms treated surgically during a 5-year period from 1976 to 1981. Unruptured aneurysms found in patients with multiple aneurysms and subarachnoid haemorrhage due to ruptured aneurysms are not included in this series. Literature on this subject is reviewed. There was no mortality and results were excellent in 7 patients with asymptomatic aneurysms. In 12 patient with symptomatic aneurysms there was no mortality and results were good to excellent in 9 patients. In 2 the results were unsatisfactory. The series included aneurysms varying in size from 5 mm to over 2.5 cm (giant aneurysm). Controversial aspects of surgery of unruptured intracranial aneurysms are discussed. The authors recommend surgical treatment of unruptured intracranial aneurysms regardless of size until such time when more definitive information is available about the natural history of these lesions.

Adult↗
PubMed1979

Asymmetry in the skull.

Various linear and angular measurements were taken in 118 normal skulls of adult humans. The two halves of the skulls were found to be symmetrical. The phenomenon of asymmetry of various parts of the body, in relation to cerebral dominance and specific skills has been discussed in view of the findings of the study and in the light of the available literature.

Adult↗
PubMed1979

Repair of small blood vessels with the neodymium-YAG laser: a preliminary report.

A technique for repair of incisions in small blood vessels (diameter, 0.3 to 1.0 mm) in the rat is described using a Neodymium-YAG laser. It is possible to seal the incision without the use of sutures and to preserve the lumen of the vessel. The advantages of this technique over electrocoagulation and microsuture techniques are pointed out. Although the work is in preliminary stages, the technique is considered to be relatively safe, and the potential use of the application in human surgery is indicated. The possible complications of this technique are pointed out.

Animals↗