Bilateral sabre-like tibial deformity in secondary syphilis: case report.
A girl aged 12 years having early acquired syphilis with a rare bilateral sabre-like tibial deformity is reported.
Biomedical subjects
Publications and source records attributed to N Khandelwal.
A girl aged 12 years having early acquired syphilis with a rare bilateral sabre-like tibial deformity is reported.
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Real time sonography followed by splenoportography was performed in 38 cases with non-cirrhotic portal hypertension. Eleven of these cases, in whom porto-systemic shunt surgery was done, were also evaluated by real time sonography post-operatively. The ultrasound findings correlated well in 37 cases (98%) with splenoportography. All the post-operative cases also revealed a patent portosystemic shunt on sonography. Ultrasonography, a valuable, non-invasive, initial investigation of portal hypertension, may thus be used as the only investigation to distinguish intra- from extra-hepatic obstruction and to evaluate patency of surgically created porto-systemic shunts. Invasive portography may be performed only if surgical treatment is anticipated.
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PURPOSE: We report the use of sonography to guide fine-needle aspiration biopsies (FNABs) of lytic lesions of the spine. METHODS: Twenty-nine patients with lytic vertebral lesions with or without associated extraosseous soft-tissue extension underwent sonographically guided FNAB. Twelve cervical, 7 thoracic, 7 lumbar, and 3 sacral lesions were biopsied. Tissue samples were taken from either the bony lesion through a break in the cortex (n = 9) or the associated soft-tissue extension (n = 20). RESULTS: Adequate diagnostic material obtained in 27 cases (93%) revealed an inflammatory (n = 13) or malignant process (n = 14). Of the 2 patients with inconclusive FNAB findings, 1 patient was lost to follow-up, and the other underwent surgery, which revealed tuberculosis. No complications of FNAB were encountered. CONCLUSIONS: We conclude that sonography is a safe and effective guidance modality for FNAB of lytic lesions of the spine, especially for lesions in the cervical region. In the thoracic, lumbar, and sacral regions, however, the role of sonographically guided FNAB is limited to lesions affecting the posterior elements.
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Two cases with ruptured supratentorial dermoid cysts are presented. Computerised tomography and magnetic resonance findings are illustrated. The pathology and differential diagnosis is discussed.
Myxomas are benign soft tissue neoplasms, which usually involve the heart, skin and subcutaneous tissues, and rarely the ocular adnexa. We present a rare case of orbital myxoma with magnetic resonance imaging (MRI) findings and a review of the literature.
A 17 year-old girl with polyostotic fibrous dysplasia and hypophosphatemia had inappropriately low tubular reabsorption of phosphate. She had radiological evidence of rickets and osteomalacia. The patient showed clinical improvement after treatment with phosphate supplementation, active vitamin D (calcitriol) and alendronate. It is postulated that either a phosphaturic substance elaborated from the dysplastic bone or target-organ (kidney) unresponsiveness may interfere with phosphate reabsorption in the renal tubule.
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BACKGROUND AND PURPOSE: An increased incidence of intestinal helminthic infections has been observed in patients with viral encephalitis in endemic areas. Both Japanese B encephalitis (JE) and neurocysticercosis (NCC) share some common socio-demographic and ecologic factors, and pigs act as the intermediate carrier for both. Our purpose was to show the coexistence of JE and NCC in brain on MR images and highlight the possible role of NCC as an amplifier of JE. METHODS: MR images from 10 cases of coexistent JE and NCC were studied retrospectively. T1-weighted axial and sagittal, proton T2-weighted axial and coronal, and T2-weighted fluid-attenuated inversion recovery axial and coronal sections of the brain were evaluated. NCC was diagnosed on the basis of neuroimaging. Diagnostic serologic testing for JE was conducted using paired blood and CSF samples. RESULTS: The JE changes were bilateral and asymmetrical and were more severe on the side harboring the solitary cyst or the side bearing the greater number of cysts or lodging the degenerating cyst. In each of nine of 10 cases, at least one degenerating cyst was found on the side of predominant JE pathologic abnormality. CONCLUSION: The study suggests that the co-occurrence of JE and NCC is not just a chance coincidence. NCC apparently predisposes a person to JE infection and is a positive modulator of the encephalitic process. The study shows a spectrum of MR imaging findings of coexistent JE and NCC.
This report describes the use of transendoscopic fine needle aspiration cytology in the diagnosis of three cases of hepatocellular carcinoma who had presented with large nodular liver and mass impression on the left border of the stomach at endoscopy. Using a 21G, 1.0 cm needle catheter, transendoscopic fine needle aspiration was done under direct endoscopic vision. The aspirate confirmed the diagnosis of hepatocellular carcinoma in all of them.
Polyarteritis nodosa (PAN) is a multisystem necrotizing inflammatory vasculitis of medium-sized muscular arteries. Hepatobiliary complications secondary to thrombosis or aneurysm formation in PAN are rare and are associated with poor outcome. We describe an 18-year-old man with PAN who presented with hemobilia secondary to rupture of a hepatic artery aneurysm, which was successfully managed with coil embolization followed by immunosuppressive therapy.
Primary amebic meningoencephalitis and granulomatous amebic meningoencephalitis are central nervous system infections caused by free-living amebae. We describe the neuroimaging findings in 5 such cases on CT and MR imaging. A spectrum of findings was seen in the form of multifocal parenchymal lesions, pseudotumoral lesions, meningeal exudates, hemorrhagic infarcts, and necrosis in the brain. Familiarity with the imaging findings is important for the diagnosis and management of this nearly universally fatal disease.
This study was undertaken to determine the morphologic changes occurring in the pulmonary vasculature in congenital heart disease. Autopsy was performed in twenty cases of congenital heart disease ranging in age from newborn (full term) to 14 years. Postmortem arteriography was performed in most of them followed by histomorphometry. It was found that medial hypertrophy of the muscular pulmonary arteries was the most consistent change and the smallest muscular arteries were the most severely affected. The lesions were focal and randomly distributed. Hence, morphologic observations on open lung biopsies may not be accurate.