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      • KCI등재

        CT-Guided Percutaneous Biopsy of Intrathoracic Lesions

        Hira Lal,Zafar Neyaz,Alok Nath,Samudra Borah 대한영상의학회 2012 Korean Journal of Radiology Vol.13 No.2

        Percutaneous CT-guided needle biopsy of mediastinal and pulmonary lesions is a minimally invasive approach for obtaining tissue for histopathological examination. Although it is a widely accepted procedure with relatively few complications, precise planning and detailed knowledge of various aspects of the biopsy procedure is mandatory to avert complications. In this pictorial review, we reviewed important anatomical approaches, technical aspects of the procedure, and its associated complications.

      • Intraoperative assessment of the adequacy of the graft length for semitendinosus-alone anterior cruciate ligament reconstruction: a technical note

        Kaustubh Ahuja,Hira Lal Nag 대한정형외과 스포츠의학회 2017 Arthroscopy and Orthopedic Sports Medicine Vol.4 No.2

        Anterior cruciate ligament (ACL) reconstruction surgery rate has widely increased over past few years. Various graft options have been described in literature for reconstruction of ACL. Patellar tendon, semitendinosus alone, semitendinosus with gracilis are commonly used as graft materials. A number of recent studies suggest sacrifice of gracilis tendon for ACL reconstruction adversely affects hamstring strength. Many studies done in this regard have suggested the use of preoperative anthropometric data for estimating the adequacy of semitendinosus tendon alone being used in ACL reconstruction procedures. However there are no studies describing intraoperative assessment of the adequacy of graft length for semitendinosus alone graft for ACL reconstruction. In this note we describe a technique for intraoperative assessment of the adequacy of graft length of semitendinosus tendon for quadrupled semitendinosus alone graft or the need for harvesting gracilis along with semitendinosus tendon.

      • A new method of arthroscopic assisted management of stiff knee: a technical note

        Hemant Bansal,Hira Lal Nag,Nishank Mehta,Arnab Sain 대한정형외과 스포츠의학회 2018 Arthroscopy and Orthopedic Sports Medicine Vol.5 No.2

        Arthrofibrosis of the knee is a commonly encountered entity and often results from prolonged immobilization or delay in postoperative mobilization of knee. Arthroscopic arthrolysis has replaced open arthrolysis as the gold standard in the management of the stiff knee. Several authors have described their techniques and modifications for arthroscopic management of the stiff knee. Rare but devastating complications have also been reported, particularly when forceful manipulation of the knee is done during surgery. We describe a safe method of arthroscopic-assisted management of a stiff knee with our own modifications to avoid catastrophic complications like iatrogenic fracture, tendon rupture or avulsion while simultaneously achieving improved range of flexion.

      • SCOPUSKCI등재

        Autoimmune Sclerosing Cholangitis in Children: A Prospective Case-Control Study

        Kumar, Nagendra,Poddar, Ujjal,Yadav, Rajnikant,Lal, Hira,Pani, Krushna,Yachha, Surender Kumar,Srivastava, Anshu,Pandey, Rakesh The Korean Society of Pediatric Gastroenterology 2021 Pediatric gastroenterology, hepatology & nutrition Vol.24 No.2

        Purpose: In children overlap of autoimmune hepatitis (AIH) and primary sclerosing cholangitis is labelled as autoimmune sclerosing cholangitis (ASC). The only prospective pediatric study showed a high prevalence of ASC by using endoscopic retrograde cholangiopancreatography. Aims of our study were to find the prevalence of ASC by using magnetic resonance cholangiography (MRC) in AIH and in non-AIH cirrhosis and to compare clinical presentation and outcome of AIH and ASC. Methods: Prospectively we did MRC in 38 children with AIH (cases) and 19 disease controls (Wilson disease). Multiple biliary strictures with proximal dilatation on MRC were taken as definitive changes of ASC. Detail clinical, laboratory parameters, liver histopathology and treatment outcome were recorded. Results: The median age of cases was 11.5 (3-18) years, 22 (57.9%) were girls and 28 (73.7%) were diagnosed as type 1 AIH. MRC was done in 11 children (28.9%) at the time of diagnosis and in 27 (71.1%) after a median follow-up of 2.5 (0.3-10) years. Abnormal MRC changes were seen in 14/38 (36.8%) of AIH and 8/19 (42.1%) of controls. However, definite changes of ASC were present in four (10.5%) children in AIH and none in controls. None of the clinical, laboratory, histological parameters and treatment response were significantly different between ASC and AIH groups. Conclusion: The prevalence of ASC in children with AIH was just 10.5%. We suggest MRC in select group with cholestatic features, inflammatory bowel disease and in those who showed poor response to immunosuppression instead of all children with AIH.

      • KCI등재후보

        Ease of sutures management of suspensory fixation devices in anterior cruciate ligament reconstruction: a technical note

        Sai Krishna M L V,Hira Lal Nag,Anupam Gupta 대한정형외과 스포츠의학회 2022 Arthroscopy and Orthopedic Sports Medicine Vol.9 No.1

        In this technical note, we used a quadrupled hamstring graft and an endobutton continuous loop (CL; Smith & Nephew, Andover, MA, USA) as an implant for fixation of the graft on the femoral side and a bioscrew on the tibial side. The standard endobutton CL has a continuous loop for graft suspension and two high tensile sutures for shuttling through the tunnels. The unloading or entanglement of these sutures is a common complication during the passage of the endobutton through the tunnels. In this technical note, we described a simple method for unlooping the looped high tensile sutures of the endobutton CL on the femoral side, which helps to avoid the aforementioned complication.

      • KCI등재

        A Universal Craniometric Index for Establishing the Diagnosis of Basilar Invagination

        Jayesh Sardhara,Sanjay Behari,Suyash Singh,Arun K. Srivastava,Gaurav Chauhan,Hira Lal,Kuntal K. Das,Kamlesh Singh Bhaisora,Anant Mehrotra,Prabhakar Mishra,Awadhesh K. Jaiswal 대한척추신경외과학회 2021 Neurospine Vol.18 No.1

        Objective: The conventional criteria for defining the basilar invagination (BI) focus on the relationship of odontoid tip to basion and opisthion, landmarks that are intrinsically variable especially in presence of occipitalised atlas. A universal single reference line is proposed that helps in unequivocally establishing the diagnosis of BI, may be relevant in establishing both Goel types A and B BI, as well as in differentiating a ‘very high’ from ‘regular’ BI. Methods: Study design – case-control study. In 268 patients (group I with BI [n=89] including Goel type A BI [n=66], Goel type B BI [n=23], and group II controls [n=179]), the perpendicular distance between odontoid tip and line subtended between posterior tip of hard palate-internal occipital protuberance (P-IOP line) was measured. Logistic regression analysis determined factors influencing the proposed parameter (p<0.05). Results: In patients with a ‘very high’ BI (n=5), the odontoid tip intersected/or was above the P-IOP line. In patients with a ‘regular’ BI (n=84), the odontoid tip was 6.56±3.9mm below the P-IOP line; while in controls, this distance was 12.53±4.28 mm (p<0.01). In Goel type A BI, the distance was 7.01±3.78 mm and in type B BI, it was 5.07±4.19 mm (p=0.004). Receiver-operating characteristic curve analysis identified 9.0 mm (8.92–9.15 mm) as the cut-point for diagnosing BI using the odontoid tip-P-IOP line distance as reference. Conclusion: The odontoid tip either intersecting the P-IOP line (very high BI) or being <9 mm below the P-IOP line (Goel types A and B BI) is recommended as highly applicable criteria to establish the diagnosis of BI. This parameter may be useful in establishing the diagnosis in all varieties of BI.

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