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Biomedical subjects

N M Gupta

Publications and source records attributed to N M Gupta.

At least 55 records · Page 3Linked to original sources

Modified ultrasound-guided percutaneous transgastric drainage of pancreatic pseudocysts.

We describe a modified ultrasound-guided transgastric drainage technique for pancreatic pseudocysts. Using a water-filled stomach to improve visualization, we have successfully drained pseudocysts in ten patients. This report also describes the use of a stiffening cannula to assist transgastric catheter placement. We emphasize the value of constant real-time tracking of the dilator and guidewire to ensure correct positioning of the drainage catheter.

Adolescent↗

Procoagulant activity of human tumours: existence of Xa and thrombin-like activities.

We have analysed 15 infiltrating duct carcinomas of the breast, 10 gastrointestinal adenocarcinomas, one each of the thyroid and larynx, and four mesenchymal tumours for the presence and the nature of procoagulant activity (PCA). The metastatic tumours had a significantly higher PCA (P = 0.01-0.001) as compared to the non-metastatic tumours in the respective groups, and almost 20-25 times the activity as compared to normal tissue (P = 0.001). Although the majority of the tumours had FVII-dependent tissue thromboplastin-like activity, some of the tumour homogenates revealed the presence of an FVII-independent PCA. Unlike the known alternate PCA, which acts via factor X activation, this PCA was factor X independent. It caused clot formation in FX-deficient plasma (six cases) and purified fibrinogen solution (four cases), indicating the presence of a Xa-like enzyme or a thrombin-like activity respectively.

Adenocarcinoma↗

Fine needle aspiration cytology of rectal masses.

This paper describes the results of transproctoscopic fine needle aspiration cytology in the diagnosis of rectal lesions. Fifty one consecutive patients referred with a presumptive diagnosis of rectal mass were subjected to proctoscopic examination when fine needle aspiration cytology, brush cytology and biopsy samples were taken. Of the 30 patients of malignancy of rectum in whom all the three sampling techniques were applied, the biopsy was positive in 27 (90%), brush cytology in 25 (83.3%) and fine needle aspiration cytology in 29 (96.6%). A combination of fine needle aspiration cytology with brush cytology gave a positive yield in 96.6% while that fine needle aspiration cytology with brush cytology gave a yield of 100%. Fine needle aspiration cytology was most helpful in infiltrative tumours. All 10 patients with secondaries in the pouch of Douglas or rectovesical pouch, and the single patient with submucosal rectal carcinoma were correctly diagnosed at fine needle aspiration cytology. There were no false positive results with fine needle aspiration cytology and no complications were encountered with the procedure.

Adenocarcinoma↗

Occult carcinoma esophagus metastatic to spine producing paraplegia--a case report and review of literature.

An extremely rare case of asymptomatic squamous cell carcinoma of the esophagus metastatic to the spine leading to paraplegia is reported. The rarity of such an event signifies the relationship between hypercalcaemia and carcinoma of the esophagus. Its occurrence as a second silent primary neoplasm and its association with a negative esophagogram is highlighted.

Carcinoma, Squamous Cell↗

Transhiatal esophagectomy.

Transhiatal esophagectomy without thoracotomy was performed on 40 patients with cancer of the esophagus and two with corrosive stricture. The resection and esophagogastric anastomosis in the neck were done in a single stage. The 30-day mortality was 12%. Complications included intraoperative pneumothorax (71%), transient hoarseness (19%), anastomotic leak (17%) and pulmonary complications requiring respiratory assistance (7%). Two patients required surgery for internal hemorrhage, but there was no bleeding from the posterior mediastinum. Short operating time and avoidance of thoracotomy are the clear advantages of this procedure. As experience was gained, mortality and morbidity diminished. Transhiatal esophagectomy is a safe and well-tolerated surgical procedure.

Adenocarcinoma↗

Endoscopic management of chronic organoaxial volvulus of the stomach.

Endoscopic correction of the chronic organoaxial volvulus of the stomach was attempted in seven cases of primary and three cases of secondary volvulus. Endoscopic correction was successful in six cases of primary volvulus and one case of volvulus secondary to duodenal carcinoma. This paper describes the details of the technique of endoscopic correction of gastric volvulus, and documentation of correction of the volvulus by barium meal study with a follow-up of 5-26 months.

Adult↗

Primary choledochal echinococcosis.

Hydatid cysts involving organs other than liver and lungs are rather uncommon. A case of primary hydatid cyst of the common bile duct producing obstructive jaundice due to extrinsic compression of the bile duct is reported.

Adult↗

Esophageal exclusion and gastric bypass for unresectable carcinoma of the thoracic esophagus.

Total esophageal exclusion and substernal gastric bypass were performed on eight patients with unresectable carcinoma of the thoracic esophagus who had received radiotherapy as the primary treatment. One patient died postoperatively. Three patients developed cervical anastomotic leaks which settled with conservative treatment. Average survival after the surgery was eight months and all seven survivors were able to eat normally. The simplicity and effectiveness of the operation have been emphasized.

Adult↗

Pseudomyxoma peritonei. A report of three cases.

Pseudomyxoma peritonei is an infrequently encountered clinical entity which presents mainly with abdominal distension. We present here our experience with three such cases and emphasize on the aggressive combined operative and chemotherapeutic approach in this disease.

Adenocarcinoma, Mucinous↗

Association of Candida with carcinoma of esophagus.

Twenty-five patients with carcinoma of the esophagus (group I) and 25 patients suffering from non-ulcer dyspepsia with normal endoscopy (group II) were studied to know the incidence of isolation of Candida from their esophagus. Endoscopic brushings were taken from the esophagus in both groups and studied by smear examination and culture. Fungal organisms could be detected in 75% of cases of group I and 32% of cases of group II by culture techniques, and 45.8% and 12% respectively by smear examination. The difference was statistically significant (p less than 0.05) for both the techniques. Candida albicans was the commonest species isolated. No correlation was found between Candida agglutination titres and density of Candida growth on culture. We conclude that an association exists between carcinoma esophagus and the occurrence of Candida in the esophagus.

Candida albicans↗

Chronic intermittent gastric volvulus within the foramen of Morgagni.

Hernia through the foramen of Morgagni is uncommon in adults. Chronic gastric volvulus within the foramen of Morgagni is very rare. In this report, we describe a patient who presented with symptoms of gastric outlet obstruction due to chronic intermittent gastric volvulus in the foramen of Morgagni.

Chronic Disease↗

Non-surgical treatment of jejunogastric intussusception.

Three cases of retrograde jejunogastric intussusception who were managed endoscopically are described. The diagnosis was made by means of endoscopy in one case and contrast radiology of the stomach in the other two. Endoscopic management consisted of reduction of the intussusception, followed by placement of a feeding tube deep in the intussuscepting segment. The patients responded very well and surgery could be avoided in all of them.

Adult↗

Towards the mechanism of protection against indomethacin induced gastro-intestinal ulceration by naloxone.

Activities of lysosomal hydrolases have been evaluated in relation to indomethacin and naloxone, using purified lysosomal fractions from rat intestinal mucosa. Indomethacin treatment significantly decreased (p less than 0.001) lysosomal enzyme activities in purified lysosomes, while an increase in the activities was observed in intestinal homogenates. However, indomethacin could not affect lysosomal system in animals pretreated with naloxone, thereby establishing that naloxone neutralises the effect of indomethacin.

Animals↗