Biomedical subjects
Publications and source records attributed to K W Paine.
Two cases of primary intracranial chondrosarcoma are presented. The cases were similar in that they both arose from the temporal bone, contained both myxomatous tissue and material of cartilaginous consistency, and were avascular. Histological studies excluded the diagnosis of chondroid chordoma. A brief review of the subject is presented.
A study of 114 surgically treated patients with intracranial meningiomas was carried out to evaluate factors influencing recurrence. The data of the initial surgery extended over a 24-year period from January, 1956, to December, 1979. The patients ranged in age from 1 1/2 years to 82 years. Seventy-one (62.3%) were females and 43 (37.7%) were males. The surgical procedure was graded according to Simpson's classification from 1 to 5 (Grade 1 = complete excision, Grade 5 = simple decompression). In this series, 33 procedures (28.9%) were Grade 1, 55 (48.2%) were Grade 2, seven (6.1%) were Grade 3, 18 (15.8%) were Grade 4, and one (0.9%) was Grade 5. There were eight (7%) postoperative deaths. Approximately 60% of the tumors were located in the sphenoid wing (23.7%), convexity (21.1%), and parasagittally (14.9%). Histological diagnosis in 96% of the patients was transitional (42.1%), syncytial (34.2%), and fibroblastic (20.2%) meningiomas. Eight (7%) patients received postoperative radiotherapy. There was evidence of recurrence in 22 patients (19.3%). Twenty-one underwent a second surgical procedure. Using survival analysis, it was determined that 80% of the patients were free of recurrence 5 years after the initial surgery, and approximately 50% showed no recurrence 20 years after the initial surgery. Only the grade of the initial surgery had a statistically significant influence on recurrence. Sex of patients, site and histology of the tumor, and postoperative radiotherapy had no statistically significant influence on recurrence. Angioblastic and malignant meningiomas were rare (only four cases), and recurred relatively quickly.
Explore the source record for details and available documents.
The presenting symptomatology and clinical findings of 464 patients with the carpal tunnel syndrome are reviewed. The results of decompression by section of the transverse carpal ligament are presented, with particular reference to the use of the Paine retinaculotome. Approximately 90% of patients achieved very satisfactory results and complications were minimal. The commonest reason for failure is incomplete division of the flexor retinaculum. The detailed procedure is presented.
Analysis of computed tomography (CT) of the lumbar spine and myelography in 48 of 52 consecutive patients with the clinical diagnosis of disc herniation, confirmed at surgery, showed CT to be superior to myelography in diagnosis. We suggest that CT should replace myelography in assessing most patients with possible disc herniation.
The authors report 235 cases of ulnar neuropathy at the elbow. The treatment was simple decompression in 115 cases and anterior transposition in 120 cases. Men were affected 3 times as often as women. The average age of presentation was 54.5 years. The nondominant arm was involved more frequently. The etiology of ulnar neuropathy was diverse, but one-third of the cases fell into the idiopathic category. Numbness and paresthesia were the most common complaints. Examination revealed hypalgesia of the little finger and the medial half of the ring finger, with weakness and wasting of the intrinsic muscles of the hand. Electromyography and nerve conduction studies are important for early diagnosis. Young men with a symptom duration of 1 year or less have a better chance of improvement after the operation. Both simple decompression and anterior transposition result in improvement in 82% of the cases; however, a higher percentage of full recovery was seen in the cases treated by simple decompression. This is explained by the facts that the nerve is not handled and its vital blood supply is left intact.
The authors report a patient with a right sphenoid wing meningioma 16 years after a left convexity meningioma was removed. She had no evidence of von Recklinghausen's disease. Both tumors were benign. The literature on multiple meningiomas is reviewed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
For myelography to convey the maximum information regarding theca size and relationships, and to avoid flow artifacts and other false positives, the theca must be filled to the L1-L2 level and X-rays taken with the patient upright thus ensuring a static column of dye.