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Biomedical subjects

P Lander

Publications and source records attributed to P Lander.

At least 55 records · Page 3Linked to original sources
PubMed1992

The effect of chymopapain on low back pain.

One hundred and fifteen patients underwent chymopapain treatment for acute disc protrusion between 1980 and 1988. Sixty-six patients who were treated with single-level injection were reviewed retrospectively with clinical follow-up from 2 to 10 years (mean, 4.6 years). All patients met modified McCulloch criteria (not all patients had leg pain greater than back pain). The presence of pre-existing chronic low back pain (LBP) was recorded in 33 patients and compared to their present low back symptomatology and functional limitations. Patients with pre-existing chronic LBP had a success rate of 52%, whereas patients meeting all the McCulloch criteria without chronic LBP had a success rate of 52%, whereas patients meeting all the McCulloch criteria without chronic LBP had a success rate of 85%. The overall effect of chemonucleolysis on LBP demonstrated no change in 18% and a mild increase in 45% of the patients (even though they had a successful outcome). The pre-existing disc space narrowing and the postoperative change of disc space height of 33 patients assessed on lateral roentgenograms showed no correlation to the clinical response. Temporal sequential computed tomography scan assessment of 56 patients following chemonucleolysis demonstrated little change of disc herniation in the first 3 months, with only a gradual and incomplete resolution in the ensuing 12 months.

Adult↗
PubMed1991

Intradiscal invasion of Paget's disease of the spine.

A retrospective study of 84 patients with Paget's disease of the spine revealed 9 who developed pagetic intradiscal invasion from the adjacent vertebral bodies. Two patients were asymptomatic. One patient had back pain, one had symptomatic intraforaminal stenosis without back pain, and five had clinical and radiologic spinal stenosis and spine pain; of these five, one demonstrated clinical and radiologic findings indistinguishable from spondylodiscitis. The incidence of intradiscal transgression in Paget's disease of the spine was 10.7%. Spinal pain was present in 67% patients; 22% were asymptomatic. This study shows that disc pathology is not invariably associated with spinal pain.

Aged↗
PubMed1991

Paget disease of the spine.

Seventy patients who had the radiographic features of Paget disease of the spine were evaluated clinically and with computed tomography, with the objective of correlation of the symptoms with the lesions. Of forty-five symptomatic patients, twenty-one had only pain in the back or neck and twenty-four patients had spinal stenosis with or without pain in the back or neck. Seven patients had a neurological deficit without pain, nineteen had so-called mechanical or arthritic pain, nine had pain that was attributable to the Paget lesion, and ten had a combination of the two types of pain. The most common cause of the spinal stenosis was expansion of bone that led to compression of the thecal sac and its neural elements. In one patient, the cord was compromised further by a pathological fracture of the eighth thoracic vertebra. There was a strong correlation between the presence of symptoms and the findings of spinal stenosis and arthropathy of the facets (zygapophyseal joints) on computed tomography. The spinal stenosis and the arthropathy of the facets were caused by the abnormal, hyperactive bone-remodeling, which resulted in the expansion of the osseous elements of the involved vertebra or vertebrae.

Aged↗
PubMed1991

Pseudonotch of the atlas vertebra simulating fracture with computed tomographic diagnosis. A case report.

Pseudonotch of the atlas represents a normal variation of the atlas related to a notched protuberance of the medial surface of its lateral masses. A case is presented in which cervical spine roentgenography revealed a prominent pseudonotch that mimicked a fracture of the lateral masses of the atlas. Minimal rotation of C-1 on C-2 was present without apophyseal joint subluxation. Computed tomography imaging provided an accurate diagnosis.

Adult↗
PubMed1990

Spectrotemporal analysis of ventricular late potentials.

The authors introduce a new technique for the analysis of ventricular late potentials: spectrotemporal mapping. Spectrotemporal mapping displays a signal in both the time and frequency domains simultaneously, overcoming some of the limitations of single domain analysis. Spectrotemporal analysis of late potentials was developed from a critique of classical spectral analysis methods. Several examples of spectrotemporal analysis of signal-averaged ECG waveforms are presented. These include cases in which spectrotemporal mapping was able to represent late potentials that were not seen after conventional time-domain processing. Spectrotemporal mapping reveals that ventricular late potentials have a time-varying energy spectrum, which theoretically would preclude the use of classical Fourier analysis techniques. Both the vector magnitude and Fourier transformations are a reduced representation of the information available in the signal average. Spectrotemporal mapping combines time and frequency information in a way that is compatible with the basic statistical structure of late potentials.

Electrocardiography↗
PubMed1989

Use of high-pass filtering to detect late potentials in the signal-averaged ECG.

The authors investigate the use of digital filters for analysis of the signal-averaged ECG. They consider the basic types of digital filters and examine respective advantages and disadvantages for ECG analysis. An approach to analyzing the signal-averaged ECG using separate filters for measuring QRS offset and amplitudes is proposed. A study of 19 subjects explores the use of filters to detect low-level activity anywhere in the QRS complex.

Action Potentials↗
PubMed1988

[Stress fractures of the femoral neck].

Four young patients who developed a fatigue fracture of the femoral neck are presented. The clinical features of pain with movement are described. The role of nuclear medicine is discussed with emphasis on its importance in the early diagnosis of this entity. The radiologic stages based on the site and time of presentation are analyzed: 1) normal, 2) sclerotic bands perpendicular to the trabeculations, 3) incomplete fracture, 4) complete fracture.

Adult↗
PubMed1987

Allografts in orthopedic surgery: a case report and literature review.

Recent advances in orthopedic surgery have reawakened interest in the use of osteochondral allografts. A case is presented of a 32-year-old man who was spared a hemipelvectomy for a huge chondrosarcoma of the pelvis by receiving a massive pelvic allograft. This is apparently the first report of such a procedure being performed in Canada. A history of allografting as well as the fate and immunologic aspects of bone grafts are presented. Bone-banking procedures and the clinical application of allografts in 1986 are discussed.

Adult↗
PubMed1987

Hand function in the elderly: relation to osteoarthritis.

Hand function and osteoarthritis (OA) were assessed in 32 subjects, over 60-years-old. The Smith Hand Function Test bore a relation to age, coordination and hand strength but not to the degree of OA. Hand strength also was not related to OA. Subjective hand disability, measured with the Stanford Health Assessment Questionnaire, correlated with radiographic OA and joint tenderness as well as with sex and hand strength. OA does not contribute significantly to the objective decline in hand function in the elderly but may contribute to a subjective sense of functional limitation.

Aged↗
PubMed1986

Pagetic arthritis. Pathophysiology and management.

A review of the records of 112 patients demonstrate modern concepts of pathogenesis and treatment of Paget's disease. Pain from Pagetic arthritis should initially be treated by medical treatment aimed at modulation of bone blood flow. Patients, even with impressive arthritic reactions, can respond dramatically. Pain persists in patients with end-stage destruction of articular cartilage and/or stress microfractures. Patients with deformity without joint space loss may be candidates for osteotomy. Advanced cartilage destruction is treated by total arthroplasty and continuation of anti-Pagetic therapy after surgery, possibly to reduce the incidence of component loosening. Articular cartilage erosion and subchondral bone destruction are attributable to the disease process. Vascular invasion and joint surface collapse are associated with cartilage thinning and sequestration.

Arthritis↗
PubMed1985

Hip pinning, past and present: Richards' compression-screw fixation versus Ender's nailing.

The authors trace the operative treatment of intertrochanteric hip fractures from the earliest to the most modern methods and describe how current fixation devices evolved. The operative and perioperative morbidity, mortality and outcome in 57 patients treated by Ender's nailing were compared with those of 51 patients treated by Richards' compression-screw fixation. Results were comparable to those found in an extensive review of the literature except for a higher mortality in the group managed by Ender's nailing. The authors conclude that both methods of treatment are acceptable and that the ultimate choice of fixation device should be based on the surgeon's experience tailored to the individual patient's needs.

Bone Nails↗