Diverticulosis in the defunctioned limb of a long-standing colostomy.
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Aged↗
Biomedical subjects
K Moorthy
Publications and source records attributed to K Moorthy.
Fetus in fetu.
Fetus in fetu occurs due to aberration of monozygotic twinning. A 16-year-old boy presented with abdominal pain and mass. Laparotomy revealed an anencephalic fetus within an encapsulated retroperitoneal mass. Pathologic examination confirmed rib formation with a primitive vertebral column with bone marrow. There was no other organogenesis.
Adolescent↗
Wandering spleen causing splenic flexure volvulus and obstruction.
A 48-year-old woman presented with symptoms of distal bowel obstruction. On examination she had abdominal distension and a lump in the left lumbar and iliac regions. X-ray revealed distension of the colon with dilated small bowel. Exploration revealed an enlarged ptotic spleen whose pedicle caused obstruction of the colon. There was concomitant partial volvulus of the splenic flexure around the splenic pedicle. The splenic vein was thrombosed. Splenectomy was performed.
Colonic Diseases↗
A short-term plaque study using Lactitol as a non-sugar sweetener.
A short-term plaque study was undertaken in a group of 12 children of 8-12 years age to evaluate the effect of lactitol, 4-O (beta-galactosyl)-D-glucitol, on dental plaque pH, weight and microchemical composition. Sucrose which was taken as control and lactitol, were used in both solution form and sweets. Plaque pH recording was done at rest and post consumption periods at 5, 10, 20 and 30 minute intervals. Weight and microchemical analysis were done with 3-day-old plaque after consumption of sweets. Throughout the study period lactitol did not reach to a pH where the demineralization of enamel starts. A significant reduction in plaque formation, carbohydrate content, increase in calcium, phosphorus and protein in lactitol showed the potentiality of this bulk sweetener as non-cariogenic.
Calcium↗
Fetus in fetu or a retroperitoneal teratoma--a controversy revisited. A case report and review of literature.
A 25 year old man male presented with a lump in the left side of the abdomen. Ultrasonography revealed an echogenic retroperitoneal mass with hyperechoic areas within it suggestive of bone. CT scan confirmed the presence of a large retroperitoneal mass with bone within it. On exploration there was a large encapsulated retroperitoneal lump. There was a soft tissue mass within the lump surrounded by a yellow pultaceous material admixed with pus. Examination of the specimen showed a bone at the cephalic end with teeth embedded within it. There were two limb buds near the cephalic end. The whole specimen was covered with skin with all its appendages. There was coelomic cavity present. The distinction between fetus in fetus and teratoma has for long been the subject of controversy. According to the criteria described by Willis, there should be a vertebral axis present to make the diagnosis of fetus in fetu. But there have been a few reports where cases have been described as fetus in fetu even in the absence of a vertebral axis. A review of the literature concerning this controversy is briefly given.
Adult↗
Acute superior mesenteric artery syndrome due to rapid weight loss following massive small bowel resection.
Acute superior mesenteric artery syndrome is a rare condition and may follow rapid weight loss and immobilization. We present one such case due to rapid weight loss following massive small bowel resection.
Adolescent↗
Echocardiographic appearance of aortic valve vegetations in bacterial endocarditis due to Actinobacillus actinomycetemcomitans.
This report describes the echocardiographic features seen in a case of bacterial endocarditis due to Actinobacillus actinomycetemcomitans. The echocardiogram demonstrated large, bulky clusters of echoes filling the aortic root in diastole which extended to the subvalvular and supravalvular areas. The echocardiographic features mimicked those described in cases of Candida endocarditis. The morphologic appearance of vegetations at surgery correlated with the echocardiographic findings.
Actinobacillus Infections↗
Reliability of echocardiography in quantitating pericardial effusion: a prospective study.
A method of estimating the volume of pericardial effusion by echocardiography has used the difference between the cubed diameters at end-diastole of the pericardium and epicardium. To evaluate the reliability of this technique in quantitating the volume of pericardial effusion in a prospective study, 22 echocardiograms were obtained in six patients before and after 11 separate pericardiocenteses. The correlation coefficient between the actual volume of aspirated pericardial effusion and the echocardiographically estimated volume of aspirated pericardial effusion was r = 0.27 (P not significant). The volume of pericardial effusion aspirated was overestimated or underestimated by echocardiography by more than 100 ml in seven of 11 estimations (64 percent) and by more than 150 ml in five of 11 estimations (45 percent). Therefore, although echocardiography is the procedure of choice in diagnosing the presence of pericardial effusion, it is not an entirely accurate method of quantitating the volume of pericardial effusion. However, echocardiography can differentiate a large effusion from a moderate or small effusion.
Adult↗
First heart sound: a phono-echocardiographic correlation with mitral, tricuspid, and aortic valvular events.
We evaluated the relationship of S1 recorded by phonocardiography at the mitral area with motion of the mitral, tricuspid, and aortic valves, recorded by simultaneous echocardiography in 20 cardiac patients with a normal PR interval. The first major component of S1 coincided with mitral valve closure in 20 of 20 patients (100%) and also with tricuspid valve closure in 14 of 20 patients (70%). The second major component of S1 coincided with aortic valve opening in 20 of 20 patients and also with tricuspid valve closure in six of 20 patients (30%). We conclude that the first major component of S1 coincides with mitral valve closure in all patients but may also coincide with tricuspid valve closure in many patients, and the second major component of S1 coincides with aortic valve opening in all patients but may also coincide with tricuspid valve closure in some patients.
Adult↗
Effect of timolol versus propranolol on hypertension and hemodynamics.
The effect of timolol versus propranolol on hypertension, hemodynamics, and plasms renin activity was evaluated in 20 men. After two weeks of placebo, 11 men received timolol 30 to 60 mg daily, and nine men received propranolol, 240 to 480 mg daily, for five weeks in a double-blind randomized study. The 20 men then received placebo again for two weeks. Right heart catheterization was performed in all 20 patients after two weeks of the first placebo and after five weeks of timolol or propranolol. Equipotent doses of timolol and propranolol were equally effective in significantly lowering supine and upright systolic and diastolic blood pressure and heart rate recorded on an outpatient basis. Equipotent doses of timolol and propranolol caused similar hemodynamic effects including similar significant depression of cardiac index. Equipotent doses of timolol and propranolol caused similar marked depression of plasma renin activity. The hypotensive action of timolol and of propranolol was unrelated to their effect on plasma renin activity.
Adrenergic beta-Antagonists↗
Long-term efficacy of halofenate on serum triglyceride levels.
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Cholesterol↗
Evaluation of virtual reality bronchoscopy as a learning and assessment tool.
BACKGROUND: Conventional training in bronchoscopy involves a trainee performing on a real patient under supervision. This method of training is not only expensive, but there is also potential for increased patient discomfort. Simulators permit the acquisition of necessary technical skills required for the procedure. Virtual reality (VR) has been an integral part of training in aviation, and the application of this technology in medical training needs to be evaluated. OBJECTIVE: This study was conducted to evaluate the efficacy of a VR bronchoscopy simulator as a learning and assessment tool. METHODS: The bronchoscopic simulator (HT Medical Systems, Maryland, USA) is a VR computer programme. The simulator has the ability to assess competence by a set of parameters, which formed the data for the study. Nine novices without previous bronchoscopic experience formed the study group (group 1). Nine experienced bronchoscopists having performed between 200 and 1000 bronchoscopies formed the other group (group 2). We assessed the efficacy of the system as a learning tool by studying whether there was a significant difference between the first and subsequent sessions of the subjects from group 1 and by comparing the performance of the two groups. Statistical analysis was done using the Mann-Whitney U test and the Wilcoxon signed ranks test. RESULTS: There was a significant difference in performance between the first attempt of group 1 and the performance of the experts in terms of percentage of segments visualised and number of wall collisions and the economy of performance. Among the subjects from group 1, there was a significant improvement in percentage of segments visualised by the third attempt (p = 0.04), in the economy of performance by the sixth attempt (0.008) and in the number of wall collisions by the sixth attempt (0.024). When each attempt of the novices was compared with the performance of group 2, the significance in the difference of the percentage of segments studied (p = 0.09) and the economy of performance disappeared by the third attempt (0.06), while the difference in the number of wall collisions disappeared by the fifth attempt (p = 0.06). CONCLUSIONS: This study has been able to establish the face, construct and content validity of the simulator and the potential for it to be an effective training tool.
Bronchoscopy↗
The laparoscopic management of benign bowel fistulas.
BACKGROUND: The presence of a fistula has usually been a factor predicting high conversion and complication rates following laparoscopic procedures for Crohn's disease and diverticulitis. METHODS: We studied retrospective data collected from the medical case notes of patients. A single surgeon carried out all these procedures from 1991 through 2001. RESULTS: Fourteen patients underwent 15 procedures. Six patients were males and 8 were females. The diagnosis was Crohn's disease in 10 patients and diverticulitis in 4. In 10 cases, the operation was the primary procedure, but 5 procedures were for recurrences. Two patients with diverticulitis and 3 with Crohn's disease had only the fistulae divided with the application of an Endo-GIA stapier across the fistulae (stapled fistulectomy). No bowel resections were carried out in these 5 patients. Four cases had to be converted due to bleeding (23%). The only postoperative complication was a single case of wound infection after conversion. CONCLUSION: The presence of a fistula isn't necessarily an indication for conversion. If it is possible to dissect the loops free, we believe that a stapled fistulectomy is effective with a low incidence of fistula recurrence, especially in Crohn's disease.
Crohn Disease↗