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Sample records for artery median nerve

  1. Thrombosed persistent median artery causing carpal tunnel syndrome associated with bifurcated median nerve: A case report

    International Nuclear Information System (INIS)

    Background: Carpal tunnel syndrome is a sporadically occurring abnormality due to compression of median nerve. It is exceedingly rare for it to be caused by thrombosis of persistent median artery. Case Report: A forty two year old female was referred for ultrasound examination due to ongoing wrist pain, not relived by pain killers and mild paraesthesia on the radial side of the hand. High resolution ultrasound and Doppler revealed a thrombosed persistent median artery and associated bifurcated median nerve. The thrombus resolved on treatment with anticoagulants. Conclusions: Ultrasound examination of the wrist when done for patients with carpal tunnel syndrome should preferably include looking for persistent median artery and its patency. (authors)

  2. Median nerve's loop in the arm penetrated by a superficial brachial artery: case report and neurosurgical considerations

    Directory of Open Access Journals (Sweden)

    George K. Paraskevas

    2015-08-01

    Full Text Available Median nerve is commonly formed by the union of the lateral and medial cord of the brachial plexus, which embrace the third part of the axillary artery. Formation of a median nerve's loop is a very rare condition. We present a cadaveric case, in which the right median nerve was found at the upper arm forming a fusiform neural loop penetrated by a superficial brachial artery, which continued over the forearm as the radial artery. The literature concerning nerve loops and traversing arteries is discussed, as well as the relevant embryology. We consider that such nerve loops constitute vulnerable sites of the nerve trunk since it is compressed by the pulsation of the abnormal traversing artery. Moreover, neurosurgeons should keep in mind that in case of existing arterial variation, variation of the associated neural structures may co-exist. [Int J Res Med Sci 2015; 3(8.000: 2123-2125

  3. Five Roots Pattern of Median Nerve Formation

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    Konstantinos Natsis

    2016-04-01

    Full Text Available An unusual combination of median nerve’s variations has been encountered in a male cadaver during routine educational dissection. In particular, the median nerve was formed by five roots; three roots originated from the lateral cord of the brachial plexus joined individually the median nerve’s medial root. The latter (fourth root was united with the lateral (fifth root of the median nerve forming the median nerve distally in the upper arm and not the axilla as usually. In addition, the median nerve was situated medial to the brachial artery. We review comprehensively the relevant variants, their embryologic development and their potential clinical applications.

  4. The Ultrasonographic Findings of Bifid Median Nerve

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hee Jin; Park, Noh Hyuck; Joh, Joon Hee [Myoungji Hospital, Gwandong University College of Medicine, Gangneung (Korea, Republic of); Lee, Sung Moon [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2009-09-15

    We wanted to evaluate the ultrasonographic findings of bifid median nerve and its clinical significance. We retrospectively reviewed five cases (three men and two women, mean age: 54 years) of incidentally found bifid median nerve from 264 cases of clinically suspected carpal-tunnel syndrome that were seen at our hospital during last 6 years. Doppler sonography was performed in all five cases and MR angiography was done in one case for detecting a persistent median artery. The difference ({Delta}CSA) between the sum of the cross-sectional areas of the bifid median nerve at the pisiform level (CSA2) and the cross-sectional area proximal to the bifurcation(CSA1) was calculated. The incidence of a bifid median nerve was 1.9%. All the patients presented with a tingling sensation on a hand and two patients had nocturnal pain. All the cases showed bifurcation of the nerve bundle proximal to the carpal tunnel. The margins appeared relatively smooth and each bundle showed a characteristic fascicular pattern. A persistent median artery was noted between the bundles in four cases. {Delta}CSA was more than 2 mm 2 in four cases. Bifid median nerve with a persistent median artery is a relatively rare normal variance and these are very important findings before performing surgical intervention to avoid potential nerve injury and massive bleeding. We highly suggest that radiologists should understand the anatomical characteristics of this anomaly and make efforts to detect it

  5. Median Sacral Artery, Sympathetic Nerves, and the Coccygeal Body: A Study Using Serial Sections of Human Embryos and Fetuses.

    Science.gov (United States)

    Jin, Zhe Wu; Cho, Kwang Ho; Jang, Hyung Suk; Murakami, Gen; Rodríguez-Vázquez, Jose Francisco

    2016-07-01

    To examine how the median sacral artery (MSA) is involved with the coccygeal body or glomus coccygeum, we studied serial frontal or sagittal sections of 14 embryos (approximately 5-6 weeks of gestation) and 12 fetuses (10-18 weeks). At five weeks, the caudal end of the dorsal aorta (i.e., MSA) accompanied putative sympathetic ganglion cells in front of the upper coccygeal and lower sacral vertebrae. At six weeks, a candidate for the initial coccygeal body was identified as a longitudinal arterial plexus involving nerve fibers and sympathetic ganglion cells between arteries. At 10-18 weeks, the MSA exhibited a highly tortuous course at the lower sacral and coccygeal levels, and was attached to and surrounded by veins, nerve fibers, and sympathetic ganglion cells near and between the bilateral origins of the levator ani muscle. Immunohistochemistry demonstrated expression of tyrosine hydroxylase and chromogranin A in the nerves. However, throughout the stages examined, we found no evidence suggestive of an arteriovenous anastomosis, such as well-developed smooth muscle. An acute anterior flexure of the vertebrae at the lower sacrum, as well as regression of the secondary neural tube, seemed to induce arterial plexus formation from an initial straight MSA. Nerves and ganglion cells were likely to be secondarily involved with the plexus because of the close topographical relationship. However, these nerves might play a major role in the extreme change into adult morphology. An arteriovenous anastomosis along the MSA might be an overinterpretation, at least in the prenatal human. Anat Rec, 299:819-827, 2016. © 2016 Wiley Periodicals, Inc. PMID:27149546

  6. Bilateral median nerve palsy in a cyclist.

    OpenAIRE

    Braithwaite, I J

    1992-01-01

    Cyclists are prone to a number of sport-related musculoskeletal injuries, mainly of the lower limb. Nerve compression injuries are relatively rare, though in the hand ulnar nerve compression is well described. We describe a case of bilateral median nerve compression caused by cycling.

  7. Shoulder posture and median nerve sliding

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    Dilley Andrew

    2004-07-01

    Full Text Available Abstract Background Patients with upper limb pain often have a slumped sitting position and poor shoulder posture. Pain could be due to poor posture causing mechanical changes (stretch; local pressure that in turn affect the function of major limb nerves (e.g. median nerve. This study examines (1 whether the individual components of slumped sitting (forward head position, trunk flexion and shoulder protraction cause median nerve stretch and (2 whether shoulder protraction restricts normal nerve movements. Methods Longitudinal nerve movement was measured using frame-by-frame cross-correlation analysis from high frequency ultrasound images during individual components of slumped sitting. The effects of protraction on nerve movement through the shoulder region were investigated by examining nerve movement in the arm in response to contralateral neck side flexion. Results Neither moving the head forward or trunk flexion caused significant movement of the median nerve. In contrast, 4.3 mm of movement, adding 0.7% strain, occurred in the forearm during shoulder protraction. A delay in movement at the start of protraction and straightening of the nerve trunk provided evidence of unloading with the shoulder flexed and elbow extended and the scapulothoracic joint in neutral. There was a 60% reduction in nerve movement in the arm during contralateral neck side flexion when the shoulder was protracted compared to scapulothoracic neutral. Conclusion Slumped sitting is unlikely to increase nerve strain sufficient to cause changes to nerve function. However, shoulder protraction may place the median nerve at risk of injury, since nerve movement is reduced through the shoulder region when the shoulder is protracted and other joints are moved. Both altered nerve dynamics in response to moving other joints and local changes to blood supply may adversely affect nerve function and increase the risk of developing upper quadrant pain.

  8. Intraneural synovial sarcoma of the median nerve

    OpenAIRE

    Rahul Kasukurthi; Pruzansky, Mark E; Mackinnon, Susan E.; Lipira, Angelo B; Ray, Wilson Z.

    2010-01-01

    Synovial sarcomas are soft-tissue malignancies with a poor prognosis and propensity for distant metastases. Although originally believed to arise from the synovium, these tumors have been found to occur anywhere in the body. We report a rare case of synovial sarcoma arising from the median nerve. To our knowledge, this is the twelfth reported case of intraneural synovial sarcoma, and only the fourth arising from the median nerve. Because the diagnosis may not be apparent until after pathologi...

  9. Intraneural synovial sarcoma of the median nerve

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    Rahul Kasukurthi

    2010-06-01

    Full Text Available Synovial sarcomas are soft-tissue malignancies with a poor prognosis and propensity for distant metastases. Although originally believed to arise from the synovium, these tumors have been found to occur anywhere in the body. We report a rare case of synovial sarcoma arising from the median nerve. To our knowledge, this is the twelfth reported case of intraneural synovial sarcoma, and only the fourth arising from the median nerve. Because the diagnosis may not be apparent until after pathological examination of the surgical speci­men, synovial sarcoma should be kept in mind when dealing with what may seem like a benign nerve tumor.

  10. Presence of a median cubital arterial arch associated with high origin of radial artery

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    Shetty SD

    2010-09-01

    Full Text Available Occurrence of a median cubital arterial arch is very rare. We saw a superficially placed median cubital arterial arch associated with high level of origin of radial artery. The radial artery took origin from the brachial artery in the upper third of the arm and crossed median nerve and ulnar artery from medial to lateral side. The course and distribution of the vessels in the forearm was normal. In the cubital fossa, the radial and ulnar arteries were connected to each other by an arterial arch. The variations reported here are very useful for the radiologists as these variations can cause problems in invasive procedures.

  11. Unusual nerve supply of biceps from ulnar nerve and median nerve and a third head of biceps

    OpenAIRE

    Arora L; Dhingra R

    2006-01-01

    Variations in branching pattern of the brachial plexus are common and have been reported by several investigators. Of the four main nerves traversing the arm, namely median, ulnar, radial and musculocutaneous, the ulnar and median nerve do not give any branches to muscles of the arm. Ulnar nerve after taking origin from medial cord of brachial plexus runs distally through axilla on medial side of axillary artery till middle of arm, where it pierces the medial intermuscular septum and enters t...

  12. Intraneural Venous Malformations of the Median Nerve

    Science.gov (United States)

    González Rodríguez, Alba; Midón Míguez, José

    2016-01-01

    Venous malformations arising from the peripheral nerve are a rare type of vascular malformation. We present the first case of an intraneural venous malformation of the median nerve to be reported in a child and review the previous two cases of median nerve compression due to a venous malformation that have been reported. These cases presented with painless masses in the volar aspect of the wrist or with symptoms suggestive of carpal tunnel syndrome. Clinical suspicion should lead to the use of Doppler ultrasonography as the first-line diagnostic tool. Magnetic resonance imaging and histopathology can confirm the diagnosis, as phleboliths are pathognomonic of venous malformations. Surgical treatment appears to be the only modality capable of successfully controlling the growth of an intraneural malformation. Sclerotherapy and radiotherapy have never been used to treat this type of malformation.

  13. The Usefulness of Latency Difference Tests of Median-Ulnar and Median-Radial Nerves in Mild Carpal Tunnel Syndrome

    OpenAIRE

    Berrin LEBLEBİCİ; Adam, Mehmet; BAĞIŞ, Selda; M. Nafiz AKMAN

    2008-01-01

    Objective: To investigate of the usefulness of latency differences of median nerve-ulnar nerve and median nerve-radial nerve in patients with mild idiopathic carpal tunnel syndrome. Materials and Methods: 168 women, 243 hands with the clinical diagnosis of carpal tunel syndrome and 46 healthy women were evaluated. In addition to the conventional electrophysiological measurement, median nerve-ulnar nerve latency differences and median nerve-radial nerve latency differences were also measured. ...

  14. Dual pathology proximal median nerve compression of the forearm.

    LENUS (Irish Health Repository)

    Murphy, Siun M

    2013-12-01

    We report an unusual case of synchronous pathology in the forearm- the coexistence of a large lipoma of the median nerve together with an osteochondroma of the proximal ulna, giving rise to a dual proximal median nerve compression. Proximal median nerve compression neuropathies in the forearm are uncommon compared to the prevalence of distal compression neuropathies (eg Carpal Tunnel Syndrome). Both neural fibrolipomas (Refs. 1,2) and osteochondromas of the proximal ulna (Ref. 3) in isolation are rare but well documented. Unlike that of a distal compression, a proximal compression of the median nerve will often have a definite cause. Neural fibrolipoma, also called fibrolipomatous hamartoma are rare, slow-growing, benign tumours of peripheral nerves, most often occurring in the median nerve of younger patients. To our knowledge, this is the first report of such dual pathology in the same forearm, giving rise to a severe proximal compression of the median nerve. In this case, the nerve was being pushed anteriorly by the osteochondroma, and was being compressed from within by the intraneural lipoma. This unusual case highlights the advantage of preoperative imaging as part of the workup of proximal median nerve compression.

  15. An unusual ulnar nerve-median nerve communicating branch.

    OpenAIRE

    Hoogbergen, M M; Kauer, J M

    1992-01-01

    Branching of the ulnar nerve distal to the origin of the dorsal cutaneous branch was investigated in 25 hands in one of which an anatomical variation was observed. This finding may be of importance in the evaluation of certain entrapment phenomena of the ulnar nerve or unexplained sensory loss after trauma or surgical intervention in that particular area.

  16. Myofibroma in the Palm Presenting with Median Nerve Compression Symptoms

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    Heidi Sarkozy, PA-C, BS

    2014-08-01

    Full Text Available Summary: A myofibroma is a benign proliferation of myofibroblasts in the connective tissue. Solitary myofibromas are a rare finding especially in an adult. We report a case of a 23-year-old man presenting with an enlarging mass over his right palm. The patient is an active weight lifter. He reported numbness and tingling in the median nerve distribution. Nerve conduction studies and magnetic resonance imaging scans suggested a tumor involving or compressing the median nerve. The final diagnosis of myofibroma was made only after the histopathological diagnosis.

  17. FASCICULAR NEURORRHAPHY FOR NEUROMA IN CONTINUITY OF MEDIAN NERVE

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    Manikumar

    2015-10-01

    Full Text Available It is not common for an orthopaedic surgeon to anastomose or repair a peripheral nerve lesion. Fascicular neurorrhaphy has variable out come with median nerve repairs. The recovery by neuropathy as evidenced by NCVS does not correlate with the clinical out come. We treated a post traumatic median nerve neuroma in continuity of right hand proximal to wrist with sensory hyperaesthesisa. It was treated with excision of neuroma internal neurolysis and fascicular neurorrhaphy along with, carpal tunnel release whi ch gave him good relief from pain in the immediate post - operative period.

  18. Epithelioid sarcoma of the median nerve mimicking a peripheral nerve sheath tumour

    International Nuclear Information System (INIS)

    We describe a case of epithelioid sarcoma of the median nerve in a 57-year-old woman presenting with symptoms and signs of carpal tunnel syndrome for 2 years. The clinical examination was suggestive of a wrist ganglion compressing the median nerve. Magnetic resonance imaging (MRI) showed a 5 cm x 3 cm mass involving the median nerve in the carpal tunnel and appearances mimicked a benign peripheral nerve sheath tumour. This report illustrates a rare tumour presenting in a rare location and emphasizes the atypical clinical and MRI features that should alert the radiologist to the possibility of a rare sarcoma mimicking a benign peripheral nerve sheath tumour

  19. Schwannoma of the Median Nerve: Diagnosis Sometimes Delayed

    OpenAIRE

    Monsef Boufettal; Mohamed Azouz; Abdelkarim Rhanim; Mohamed Abouzahir; Mustapha Mahfoud; Ahmed El Bardouni; Mohamed S. Berrada; Moradh El Yaacoubi

    2014-01-01

    Schwannoma is a tumor that develops from nerve sheath. The authors report an unusual case of schwannoma of the median nerve (MN) that remained asymptomatic for four years. The diagnosis was based on MRI (magnetic resonance imaging) and histopathological examination. Surgical removal is usually curative. The asymptomatic character of the tumor and its slow evolution remain an essential factor in diagnosis delays. This tumor has a good prognosis with a low recurrence rate and potential for mali...

  20. Sonoanatomy of the median, ulnar and radial nerves

    International Nuclear Information System (INIS)

    There are 5 nerve roots emerging from the brachial plexus. Three of these are readily seen ultrasonographically and can be followed throughout most of their course. The purpose of this article is twofold - to demonstrate the sonoanatomy of the median, ulnar and radial nerves and to provide background material for understanding the pathologic conditions or abnormalities that may be encountered. Only the most common pathways will be described here; the reader is encouraged to consult anatomy texts for the multitude of variations that can occur. Before delving into the anatomy, the normal ultrasonographic (US) appearance of a nerve will be presented. (author)

  1. Sonoanatomy of the median, ulnar and radial nerves

    Energy Technology Data Exchange (ETDEWEB)

    Loewy, J. [Humber River Regional Hospital, Dept. of Radiology, Toronto, Ontario (Canada)

    2002-02-01

    There are 5 nerve roots emerging from the brachial plexus. Three of these are readily seen ultrasonographically and can be followed throughout most of their course. The purpose of this article is twofold - to demonstrate the sonoanatomy of the median, ulnar and radial nerves and to provide background material for understanding the pathologic conditions or abnormalities that may be encountered. Only the most common pathways will be described here; the reader is encouraged to consult anatomy texts for the multitude of variations that can occur. Before delving into the anatomy, the normal ultrasonographic (US) appearance of a nerve will be presented. (author)

  2. Anatomical peculiarities of sensory tracts of the wrist median nerve pedicled with nutrient vessels transferring to bridge wrist ulnar nerve defect

    Institute of Scientific and Technical Information of China (English)

    Sixin Ouyang; Zhenshan Peng; Jianguo Tan; Tianhong Peng; Jianzhong Xiao

    2006-01-01

    BACKGROUND: Translocation or transplantation of nerve stem has good effect;however, nervous function of donator is completely lost. If some nerve stem is damaged, sensory tracts are intercepted from the near nerve stem by nutrient vessels to regard as neural graft for transferring and bridging which may repair injured nerve and decrease neural functional loss of donator.OBJECTIVE: To observe anatomical peculiarities on sensory tracts of wrist median nerve pedicled with nutrient vessels transferring to bridge wrist ulnar nerve defect, and to investigate its feasibility.DESIGN: Duplicated and measured design.SETTING: Anatomy Department of Medical College affiliated to Nanhua University.MATERIALS: A total of 14 samples of upper limbs were selected from adult unnamed corpse and volunteers.METHODS: The experiment was completed at the Clinical Application Anatomy Laboratory of Medical College affiliated to Nanhua University from September to November 2005. Samples were perfused with red emulsion through artery to observe length, fibrous bands and blood supply of median nerve and ulnar nerve at wrist. Boundary of median nerve at wrist ranged from superficial site between flexor carpi radialis and palmaris longus to branch of common palmar digital nerves. Ulnar nerve at wrist ranged from branch of back of the hand to site of common palmar digital nerves. Proximal boundary of the two nerves was crossed from 1/8 to 2/8 region of forearm. Samples of upper limbs from 1 case were selected to simulate operation on sensory tracts of wrist median nerve pedicled with nutrient vessels transferring to bridge wrist ulnar nerve.MAIN OUTCOME MEASURES: Anatomical peculiarities on sensory tracts of wrist median nerve pedicled with nutrient vessels transferring to bridge wrist ulnar nerve defect.RESULTS: ① The length of wrist median nerves was 7.8 (7.5-8.1) cm. There were 19 to 27 nerve tracts in it and the majority belonged to sensory tracts on the ulnar side, in which non

  3. Hereditary aspects of median-ulnar nerve communications.

    OpenAIRE

    Crutchfield, C. A.; Gutmann, L

    1980-01-01

    Median-ulnar nerve communications, resulting in anomalous innervation of intrinsic hand muscles, was found to occur in 28% of the general population and 62% of family members of five propositi with this variant. This variant appears to be dominantly inherited.

  4. Intraneural hemangioma of the median nerve: A case report

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    Sevinç Teoman

    2008-02-01

    Full Text Available Abstract Hemangiomas of the median nerve are very rare and, so far, only ten cases of intraneural hemangioma of this nerve have been reported in the literature. We present a case of 14-year-old girl who had a soft tissue mass in the region of the left wrist with signs and symptoms of carpal tunnel syndrome. Total removal of the mass was achieved using microsurgical epineural and interfasicular dissection. The symptoms were relieved completely, after this procedure, without any neurologic deficit. On follow-up two years later, no recurrence was observed. Whenever a child or young adult patient presents with CTS the possibility of a hemangioma involving the median nerve should be kept in mind in the differential diagnosis.

  5. Etiology and mechanisms of ulnar and median forearm nerve injuries

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    Puzović Vladimir

    2015-01-01

    Full Text Available Bacgraund/Aim. Most often injuries of brachial plexus and its branches disable the injured from using their arms and/or hands. The aim of this study was to investigate the etiology and mechanisms of median and ulnar forearm nerves injuries. Methods. This retrospective cohort study included 99 patients surgically treated in the Clinic of Neurosurgery, Clinical Center of Serbia, from January 1st, 2000 to December 31st, 2010. All data are obtained from the patients' histories. Results. The majority of the injured patients were male, 81 (81.8%, while only 18 (18.2% were females, both mainly with nerve injuries of the distal forearm - 75 (75.6%. Two injury mechanisms were present, transection in 85 patients and traction and contusion in 14 of the patients. The most frequent etiological factor of nerve injuries was cutting, in 61 of the patients. Nerve injuries are often associated with other injuries. In the studied patients there were 22 vascular injuries, 33 muscle and tendon injuries and 20 bone fractures. Conclusion. The majority of those patients with peripheral nerve injuries are represented in the working age population, which is a major socioeconomic problem. In our study 66 out of 99 patients were between 17 and 40 years old, in the most productive age. The fact that the majority of patients had nerve injuries of the distal forearm and that they are operated within the first 6 months after injury, promises them good functional prognosis.

  6. Right Median Nerve Electrical Stimulation for Acute Traumatic Coma Patients.

    Science.gov (United States)

    Lei, Jin; Wang, Lei; Gao, Guoyi; Cooper, Edwin; Jiang, Jiyao

    2015-10-15

    The right median nerve as a peripheral portal to the central nervous system can be electrically stimulated to help coma arousal after traumatic brain injury (TBI). The present study set out to examine the efficacy and safety of right median nerve electrical stimulation (RMNS) in a cohort of 437 comatose patients after severe TBI from August 2005 to December 2011. The patients were enrolled 2 weeks after their injury and assigned to the RMNS group (n=221) receiving electrical stimulation for 2 weeks or the control group (n = 216) treated by standard management according to the date of birth in the month. The baseline data were similar. After the 2-week treatment, the RMNS-treated patients demonstrated a more rapid increase of the mean Glasgow Coma Score, although statistical significance was not reached (8.43 ± 4.98 vs. 7.47 ± 5.37, p = 0.0532). The follow-up data at 6-month post-injury showed a significantly higher proportion of patients who regained consciousness (59.8% vs. 46.2%, p = 0.0073). There was a lower proportion of vegetative persons in the RMNS group than in the control group (17.6% vs. 22.0%, p = 0.0012). For persons regaining consciousness, the functional independence measurement (FIM) score was higher among the RMNS group patients (91.45 ± 8.65 vs. 76.23 ± 11.02, p < 0.001). There were no unique complications associated with the RMNS treatment. The current study, although with some limitations, showed that RMNS may serve as an easy, effective, and noninvasive technique to promote the recovery of traumatic coma in the early phase. PMID:25664378

  7. Influence of tobacco on median and ulnar nerve in the population of South Rajasthan

    OpenAIRE

    Suman Sharma; Chanchal Shrivastav; M. L. Suhalka; Manjinder Kaur

    2016-01-01

    Background: Chemicals present in tobacco have been implicated in causing subclinical changes in myelin sheaths of peripheral nerves. This may contribute to nerve dysfunction particularly in the form of decreases in nerve conduction velocity. So, present study aims to measure nerve conduction velocity in the median nerve and ulnar nerve among tobacco users. Methods: This was a cross-sectional case-control study involving 50 normal healthy subjects and 150 tobacco users. The nerve conduction...

  8. Median Nerve Palsy Secondary To A Ganglion Cyst: A Case Report

    OpenAIRE

    SERARSLAN, Yurdal; Doğramacı, Yunus; Kalacı, Aydıner; Yanat, Ahmet Nedim; Emir, Anıl

    2009-01-01

    We report a case of ganglion cyst inside the carpal tunnel presenting as median nerve palsy. We consider that the median nerve palsy in this case was due to direct nerve compression within the carpal tunnel caused by a ganglion cyst.

  9. MEDIAN NERVE AS A NERVE OF ANTERIOR COMPARTMENT OF ARM WITH ITS VARIANT FORMATION: A CASE REPORT

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    Charushila D. Shinde

    2015-06-01

    Full Text Available Absence of Musculocutaneous nerve and unusual formation and innervation of Median nerve were noted in left upper limb during anatomical dissection of 60 yr old female cadaver. Median nerve normally does not give any branch in arm but in this case it innervates all the muscles of anterior compartment of arm in place of Musculocutaneous nerve. Here we discussed its embryology. It is important to be aware of such possible anatomical variations in routine clinical practice.

  10. Thrombosis of the persistent median artery as a cause of carpal tunnel syndrome - case study.

    Science.gov (United States)

    Rzepecka-Wejs, Ludomira; Multan, Aleksandra; Konarzewska, Aleksandra

    2012-12-01

    Carpal tunnel syndrome is the most frequent neuropathy of the upper extremity, that mainly occurs in manual workers and individuals, whose wrist is overloaded by performing repetitive precise tasks. In the past it was common among of typists, seamstresses and mechanics, but nowadays it is often caused by long hours of computer keyboard use. The patient usually complains of pain, hypersensitivity and paresthesia of his hand and fingers in the median nerve distribution. The symptoms often increase at night. In further course of the disease atrophy of thenar muscles is observed. In the past the diagnosis was usually confirmed in nerve conduction studies. Nowadays a magnetic resonance scan or an ultrasound scan can be used to differentiate the cause of the symptoms. The carpal tunnel syndrome is usually caused by compression of the median nerve passing under the flexor retinaculum due to the presence of structures reducing carpal tunnel area, such as an effusion in the flexor tendons sheaths (due to overload or in the course of rheumatoid diseases), bony anomalies, muscle and tendon variants, ganglion cysts or tumors. In some cases diseases of upper extremity vessels including abnormalities of the persistent median artery may also result in carpal tunnel syndrome. We present a case of symptomatic carpal tunnel syndrome caused by thrombosis of the persistent median artery which was diagnosed in ultrasound examination. The ultrasound scan enabled for differential diagnosis and resulted in an immediate referral to clinician, who recommended instant commencement on anticoagulant treatment. The follow-up observation revealed nearly complete remission of clinical symptoms and partial recanalization of the persistent median artery. PMID:26676173

  11. Phrenic Nerve Injury during Coronary Artery Bypass

    OpenAIRE

    Guinn, Gene A.; Beall, Arthur C.; Lamki, Neela; Heibig, Jacques; Thornby, John

    1990-01-01

    After coronary artery bypass, some patients have diaphragmatic elevation, usually on the left side. To test our hypothesis that this phenomenon is due to phrenic nerve injury resulting from either 1) dissection of the proximal portion of the left internal mammary artery or 2) topical cooling of the heart with icy slush, we performed the following 2-part study. First, we reviewed our hospital records of 99 coronary artery bypass patients, 55 of whom had received left internal mammary artery gr...

  12. In vivo three-dimensional reconstruction of human median nerves by diffusion tensor imaging

    NARCIS (Netherlands)

    Meek, MF; Stenekes, MW; Hoogduin, HM; Nicolai, JPA

    2006-01-01

    The in vivo assessment of axonal projections of the peripheral nervous system has been severely limited by the lack of noninvasive techniques. We examined whether MR diffusion tensor imaging with fiber tracking of the human median nerve is feasible. The median nerve was examined with a 3-T MRI scann

  13. A case of fibrolipomatous hamartoma of the median nerve with macrodactyly

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    Sathish Arakeri

    2012-07-01

    Full Text Available Fibrolipomatous hamartoma of nerve is a tumor-like lipomatous process principally involving affecting young persons. The median nerve is most commonly affectedinvolved. The lesion is characterized by a soft slowly growing mass, surrounding and infiltrating major nerves and their branches. It may cause symptoms of compression neuropathy and is associated with macrodactyly in one third of cases. Here, we present a case of Fibrolipomatous hamartoma of nerve in the wrist of a young man arising from median nerve. Debulking of the tumour was performed.

  14. Combined radial and median nerve injury in diaphyseal fracture of humerus: a case report

    OpenAIRE

    Rohilla Rajesh; Singla Rohit; Magu Narender Kumar; Singh Roop; Devgun Ashish; Mukhopadhyay Reetadyuti; Gogna Paritosh

    2013-01-01

    【Abstract】Radial nerve palsy is the most common neurological involvement in humeral shaft fractures. But combined radial and median nerve injury in a closed dia- physeal fracture of the humerus is rare. Combined injury to both radial and median nerve can cause significant disability. A detailed clinical examination is therefore necessary fol- lowing humeral shaft fractures. We report a patient with closed diaphyseal humeral fracture (AO 12A-2.3) together with radial an...

  15. A comparison of the accuracy of ulnar versus median nerve stimulation for neuromuscular monitoring

    OpenAIRE

    Lee, Hee Jong; Kim, Kyo Sang; Shim, Jae Chul; Yoon, Sung Wook

    2011-01-01

    Background Inexperienced anesthesiologists are frequently unclear as to whether to stimulate the ulnar or median nerve to monitor the adductor pollicis. The primary purpose of this study was to determine whether monitoring the adductor pollicis by positioning the stimulating electrodes over the median nerve is an acceptable alternative to applying electrodes over the ulnar nerve. Methods In 20 patients anesthetized with propofol and remifentanil, one pair of stimulating electrodes was positio...

  16. Median nerve cross-sectional area and MRI diffusion characteristics: normative values at the carpal tunnel

    Energy Technology Data Exchange (ETDEWEB)

    Yao, Lawrence; Gai, Neville [Clinical Center, Radiology and Imaging Sciences, Bethesda, MD (United States)

    2009-04-15

    Enlargement of the median nerve is an objective potential imaging sign of carpal tunnel syndrome. Diffusion tensor MRI (DTI) may provide additional structural information that may prove useful in characterizing median neuropathy. This study further examines normal values for median nerve cross-sectional area (CSA), apparent diffusion coefficient (ADC), and fractional anisotropy (FA). Twenty-three wrists in 17 healthy volunteers underwent MRI of the wrist at 3 T. In 13 subjects, DTI was performed at a B value of 600 mm{sup 2}/s. Median nerve CSA, ADC, and FA were analyzed at standardized anatomic levels. Mean (SD) median nerve CSA within the proximal carpal tunnel was 10.0 (3.4) mm{sup 2}. The mean (SD) FA of the median nerve was 0.71 (0.06) and 0.70 (0.13) proximal to and within the carpal tunnel, respectively. There was a significant difference between nerve CSA and ADC, but not FA, at the distal forearm and proximal carpal tunnel. Nerve CSA, ADC, and FA did not differ between men and women or between dominant and non-dominant wrists. Nerve CSA at the proximal carpal tunnel was positively correlated with subject age and body mass index. Our results suggest a 90% upper confidence limit for normal median nerve CSA of 14.4 mm{sup 2} at the proximal carpal tunnel, higher than normal limits reported by many ultrasound studies. We observed a difference between the CSA and ADC, but not the FA, of the median nerve at the distal forearm and proximal carpal tunnel levels. (orig.)

  17. Median nerve cross-sectional area and MRI diffusion characteristics: normative values at the carpal tunnel

    International Nuclear Information System (INIS)

    Enlargement of the median nerve is an objective potential imaging sign of carpal tunnel syndrome. Diffusion tensor MRI (DTI) may provide additional structural information that may prove useful in characterizing median neuropathy. This study further examines normal values for median nerve cross-sectional area (CSA), apparent diffusion coefficient (ADC), and fractional anisotropy (FA). Twenty-three wrists in 17 healthy volunteers underwent MRI of the wrist at 3 T. In 13 subjects, DTI was performed at a B value of 600 mm2/s. Median nerve CSA, ADC, and FA were analyzed at standardized anatomic levels. Mean (SD) median nerve CSA within the proximal carpal tunnel was 10.0 (3.4) mm2. The mean (SD) FA of the median nerve was 0.71 (0.06) and 0.70 (0.13) proximal to and within the carpal tunnel, respectively. There was a significant difference between nerve CSA and ADC, but not FA, at the distal forearm and proximal carpal tunnel. Nerve CSA, ADC, and FA did not differ between men and women or between dominant and non-dominant wrists. Nerve CSA at the proximal carpal tunnel was positively correlated with subject age and body mass index. Our results suggest a 90% upper confidence limit for normal median nerve CSA of 14.4 mm2 at the proximal carpal tunnel, higher than normal limits reported by many ultrasound studies. We observed a difference between the CSA and ADC, but not the FA, of the median nerve at the distal forearm and proximal carpal tunnel levels. (orig.)

  18. Synovial Sarcoma Involving the Median Nerve: A Case Report

    Directory of Open Access Journals (Sweden)

    Anna Lisa TOSI

    2012-09-01

    Full Text Available Synovial sarcoma may arise from different and unusual sites. Here a case of biphasic synovial sarcoma arising or invading the radial nerve in a 59-year-old female classically showing chromosomal reciprocal translocation (X; 18 is reported. The differential diagnosis from similar tumors is discussed.

  19. Synovial Sarcoma Involving the Median Nerve: A Case Report

    OpenAIRE

    Anna Lisa TOSI; Orcioni, Giulio Fraternali; Biase, Dario de; Sara COSTANTINI; Ishikawa, Yuko; Eusebi, Vincenzo

    2012-01-01

    Synovial sarcoma may arise from different and unusual sites. Here a case of biphasic synovial sarcoma arising or invading the radial nerve in a 59-year-old female classically showing chromosomal reciprocal translocation (X; 18) is reported. The differential diagnosis from similar tumors is discussed.

  20. Median nerve deformation and displacement in the carpal tunnel during index finger and thumb motion.

    Science.gov (United States)

    van Doesburg, Margriet H M; Yoshii, Yuichi; Villarraga, Hector R; Henderson, Jacqueline; Cha, Stephen S; An, Kai-Nan; Amadio, Peter C

    2010-10-01

    The purpose of this study was to investigate the deformation and displacement of the normal median nerve in the carpal tunnel during index finger and thumb motion, using ultrasound. Thirty wrists from 15 asymptomatic volunteers were evaluated. Cross-sectional images during motion from full extension to flexion of the index finger and thumb were recorded. On the initial and final frames, the median nerve, flexor pollicis longus (FPL), and index finger flexor digitorum superficialis (FDS) tendons were outlined. Coordinate data were recorded and median nerve cross-sectional area, perimeter, aspect ratio of the minimal-enclosing rectangle, and circularity in extension and flexion positions were calculated. During index finger flexion, the tendon moves volarly while the nerve moves radially. With thumb flexion, the tendon moves volarly, but the median nerve moves toward the ulnar side. In both motions, the area and perimeter of the median nerve in flexion were smaller than in extension. Thus, during index finger or thumb flexion, the median nerve in a healthy human subject shifts away from the index finger FDS and FPL tendons while being compressed between the tendons and the flexor retinaculum in the carpal tunnel. We are planning to compare these data with measurements in patients with carpal tunnel syndrome (CTS) and believe that these parameters may be useful tools for the assessment of CTS and carpal tunnel mechanics with ultrasound in the future. PMID:20225286

  1. Combined radial and median nerve injury in diaphyseal fracture of humerus: a case report

    Directory of Open Access Journals (Sweden)

    Rohilla Rajesh

    2013-12-01

    Full Text Available 【Abstract】Radial nerve palsy is the most common neurological involvement in humeral shaft fractures. But combined radial and median nerve injury in a closed dia- physeal fracture of the humerus is rare. Combined injury to both radial and median nerve can cause significant disability. A detailed clinical examination is therefore necessary fol- lowing humeral shaft fractures. We report a patient with closed diaphyseal humeral fracture (AO 12A-2.3 together with radial and median nerve palsy, its management and review of the literature. As the patient had two nerves involved, surgical exploration was planned. Fracture was reduced and fixed with a 4.5 mm narrow dynamic compres- sion plate. There was no external injury to both radial and median nerves on surgical exploration. Neurological reco- very started at 3 weeks’ follow-up. Complete recovery was seen at 12 weeks. Careful clinical examination is of the ut- most importance in early diagnosis of combined nerve injuries, which allows better management and rehabilitation of the patient. Key words: Humeral fractures; Radial nerve; Me- dian nerve; Diaphyses; Paralysis

  2. Multielectrode nerve cuff stimulation of the median nerve produces selective movements in a raccoon animal model.

    Science.gov (United States)

    Walter, J S; Griffith, P; Sweeney, J; Scarpine, V; Bidnar, M; McLane, J; Robinson, C

    1997-04-01

    In this study, an electrode system consisting of twelve small platinum dot electrodes imbedded in a spiral silicone rubber insulating cuff was used to investigate the feasibility of selective (regional) stimulation of the median nerves of the raccoon. Acute experiments in four raccoons consisted of functional responses observations, isometric force recordings from tendon attachments and postmortem fascicular mapping. Functional responses (elbow, wrist and/or digit flexion, pronation and/or thumb abduction) to selective stimulation were noted as dependent upon cuff electrode configuration (longitudinal tripole with and without field steering, as well as a transverse bipolar arrangement) and current level (threshold, 1/2 maximal, maximal). Muscle force recruitment curves (force as a function of stimulus amplitude) were plotted for flexor digitorum superficialis, flexor digitorum profundus, flexor carpi radialis, palmaris longus and pronator teres of three raccoons. Fascicular maps at the level of the nerve cuff were created indicating the approximate position of innervation to each of the aforementioned muscles, as well as other innervation such as paw fascicles, sensory fascicles, and elbow innervation (such as coracobrachialis). The greatest selectivity was observed at or near threshold current levels. In all four raccoons studied, a threshold electrode choice and stimulation strategy could be identified enabling selective production of either digit flexion, wrist flexion and/or digit and wrist flexion. It was possible to elicit a selective pronation response at threshold in three of the four animals. Selective elbow flexion at threshold could be produced in all four experiments. With stronger currents, additional movements were usually induced. The raccoon therefore appears to be a suitable, if challenging, animal model for further development of not only nerve cuff electrode approaches but perhaps other stimulation electrode technologies prior to human

  3. The optimal distance between two electrode tips during recording of compound nerve action potentials in the rat median nerve

    Institute of Scientific and Technical Information of China (English)

    Yongping Li; Jie Lao; Xin Zhao; Dong Tian; Yi Zhu; Xiaochun Wei

    2014-01-01

    The distance between the two electrode tips can greatly inlfuence the parameters used for record-ing compound nerve action potentials. To investigate the optimal parameters for these recordings in the rat median nerve, we dissociated the nerve using different methods and compound nerve action potentials were orthodromically or antidromically recorded with different electrode spac-ings. Compound nerve action potentials could be consistently recorded using a method in which the middle part of the median nerve was intact, with both ends dissociated from the surrounding fascia and a ground wire inserted into the muscle close to the intact part. When the distance be-tween two stimulating electrode tips was increased, the threshold and supramaximal stimulating intensity of compound nerve action potentials were gradually decreased, but the amplitude was not changed signiifcantly. When the distance between two recording electrode tips was increased, the amplitude was gradually increased, but the threshold and supramaximal stimulating intensity exhibited no signiifcant change. Different distances between recording and stimulating sites did not produce signiifcant effects on the aforementioned parameters. A distance of 5 mm between recording and stimulating electrodes and a distance of 10 mm between recording and stimulating sites were found to be optimal for compound nerve action potential recording in the rat median nerve. In addition, the orthodromic compound action potential, with a biphasic waveform that was more stable and displayed less interference (however also required a higher threshold and higher supramaximal stimulus), was found to be superior to the antidromic compound action potential.

  4. Median Nerve Deformation and Displacement in the Carpal Tunnel during Index Finger and Thumb Motion

    OpenAIRE

    van Doesburg, Margriet H. M.; Yoshii, Yuichi; Villarraga, Hector R.; Henderson, Jacqueline; Cha, Stephen s; An, Kai-Nan; Amadio, Peter C.

    2010-01-01

    The purpose of this study was to investigate the deformation and displacement of the normal median nerve in the carpal tunnel during index finger and thumb motion, using ultrasound. Thirty wrists from 15 asymptomatic volunteers were evaluated. Cross-sectional images during motion from full extension to flexion of the index finger and thumb were recorded. On the initial and final frames, the median nerve, flexor pollicis longus (FPL), and index finger flexor digitorum superficialis (FDS) tendo...

  5. Diffusion tensor imaging and tractography of the median nerve in carpal tunnel syndrome: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Khalil, C.; Hancart, C.; Thuc, V.Le; Cotten, A. [Service de Radiologie Osteoarticulaire, Hopital Roger Salengro, CHRU de Lille (France); Chantelot, C. [Clinique d' Orthopedie, Hopital Roger Salengro, CHRU de Lille (France); Chechin, D. [Philips Medical Systems, Suresnes (France)

    2008-10-15

    The purpose was to demonstrate the feasibility of in vivo diffusion tensor imaging (DTI) and tractography of the human median nerve with a 1.5-T MR scanner and to assess potential differences in diffusion between healthy volunteers and patients suffering from carpal tunnel syndrome. The median nerve was examined in 13 patients and 13 healthy volunteers with MR DTI and tractography using a 1.5-T MRI scanner with a dedicated wrist coil. T1-weighted images were performed for anatomical correlation. Mean fractional anisotropy (FA) and mean apparent diffusion coefficient (ADC) values were quantified in the median nerve on tractography images. In all subjects, the nerve orientation and course could be detected with tractography. Mean FA values were significantly lower in patients (p=0.03). However, no statistically significant differences were found for mean ADC values. In vivo assessment of the median nerve in the carpal tunnel using DTI with tractography on a 1.5-T MRI scanner is possible. Microstructural parameters can be easily obtained from tractography images. A significant decrease of mean FA values was found in patients suffering from chronic compression of the median nerve. Further investigations are necessary to determine if mean FA values may be correlated with the severity of nerve entrapment. (orig.)

  6. MRI DIAGNOSIS OF TWO CASES OF FIBROLIPOMATOUS HAMARTOMA OF THE MEDIAN NERVE WITH HISTOPATHOLOGICAL CORRELATION

    Directory of Open Access Journals (Sweden)

    Mary Hazarika

    2015-08-01

    Full Text Available Fibrolipomatous hamartoma is an uncommon congenital disorder, which is characterized by disproportionate hyperplasia of adipose tissue infiltrating along the perineurium, the epineurium and the affected nerve trajectory. 1 The median nerve and its branches are most commonly affected, followed by the radial nerve, ulnar nerve, nerves at the dorsal aspect of the foot, brachial plexus and cranial nerves. 1,2 Magnetic resonance imaging demonstrated a typical fibrolipomatous hamartoma with high signal intensity o f fat on both T1 - weighted and T2 - weighted images, characteristic coaxial cable appearance on axial images, and spaghetti appearance on sagittal images in two of our cases. Fibrolipomatous hamartoma (FLH of nerve is a rare tumor - like condition in which mat ure fat infiltrates the neural sheath, with the majority of the lesions occurring in the median nerve. 3 W e present two cases of Fibrolipomatous hamartoma of median nerve at the wrist with an unusual proximal extension to the forearm in one case.

  7. Electrodiagnostic approach in entrapment neuropathies of the median and ulnar nerves

    OpenAIRE

    GALAMB, ANA MARIA; Minea, Ioan Dan; Rogozea, Liliana

    2015-01-01

    Objective: The present study’s aim was to analyze the late responses’ parameters in order to determine the utility of each one. Methods: The study, conducted on a total of 325 patients with entrapment neuropathy of the median nerve and 36 with entrapment neuropathy of the ulnar nerve, included the bilateral evaluation of the median and the ulnar nerve and analysis of 20 F-wave and 4 A-wave parameters. Results: The authors emphasize the necessity of bilateral examination and that of examining ...

  8. Anatomic Variation of the Common Palmar Digital Nerves and Arteries

    OpenAIRE

    Tian, Dong; Fu, Maoyong

    2015-01-01

    Variations in the course and distribution of common palmar digital nerves and arteries are rare. A classic common palmar digital nerves and arteries are defined as concomitant. During routine dissection classes to undergraduate medical students we observed formation of each common palmar digital nerve divided into 2 or 3 branches and formed a ring enclosing the corresponding common palmar digital artery. Knowledge of the anatomical variations of the common palmar digital nerves and arteries i...

  9. Combined radial and median nerve injury in diaphyseal fracture of humerus: a case report

    Institute of Scientific and Technical Information of China (English)

    Rajesh Rohilla; Rohit Singla; Narender Kumar Magu; Roop Singh; Ashish Devgun; Reetadyuti Mukhopadhyay; Paritosh Gogna

    2013-01-01

    Radial nerve palsy is the most common neurological involvement in humeral shaft fractures.But combined radial and median nerve injury in a closed diaphyseal fracture of the humerus is rare.Combined injury to both radial and median nerve can cause significant disability.A detailed clinical examination is therefore necessary following humeral shaft fractures.We report a patient with closed diaphyseal humeral fracture (AO 12A-2.3) together with radial and median nerve palsy,its management and review of the literature.As the patient had two nerves involved,surgical exploration was planned.Fracture was reduced and fixed with a 4.5 mm narrow dynamic compression pla te.There was no external injury to both radial and median nerves on surgical exploration.Neurological recovery started at 3 weeks' follow-up.Complete recovery was seen at 12 weeks.Careful clinical examination is of the utmost importance in early diagnosis of combined nerve injuries,which allows better management and rehabilitation of the patient.

  10. Use of adjunctive palmaris longus abductorplasty (Camitz) tendon transfer in pediatric median nerve injury.

    Science.gov (United States)

    Baluch, Narges; Borschel, Gregory H

    2013-05-01

    A number of tendon transfers have been described for opponensplasty. Transfer of the palmaris longus (PL) tendon with a palmar fascial extension was initially described by Camitz. This technique has mostly been combined with carpal tunnel release in patients with long standing median neuropathy with atrophy of the thenar muscles. However, the Camitz transfer has not been previously described in the setting of pediatric median nerve injury. We report 4 cases of Camitz transfer in pediatric patients with median nerve injuries. Four children (all female; age range 3-15 yrs) underwent PL tendon transfer following median nerve injury. The causes of injury included trauma, iatrogenic injury, and neuritis of the brachial plexus. The Camitz procedure was performed at the time of median nerve decompression and/or reconstruction. All patients had excellent early return of function. Transfer of the palmaris longus tendon reliably restores palmar abduction, with minimal to no additional morbidity, in carefully selected pediatric patients with median nerve injury undergoing release of the carpal tunnel. PMID:22981385

  11. ONTOGENY RECAPITULATES PHYLOGENY: COMMUNICATION BETWEEN THE MEDIAN AND THE MUSCULOCUTANEOUS NERVE: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Subhra Mandal

    2016-01-01

    Full Text Available Neural variations of the brachium constitute important anatomical and clinical entity.Abnormal variations of median nerve, musculocutaneous nerve and their communicating branches have been reported very frequently by the anatomists in the past. The nerves of the extremities are particularly vulnerable to injury because of their long course and superficial distribution. Present report describes a case of a single abnormal communication between median and musculocutaneous nerve encountered in a 55 year old Indian male cadaver during routine undergraduate dissection. Knowledge of such anatomical variations is important while planning surgery in the region of axilla or arm as these nerves are more liable to be injured during surgical procedures as well as may result in unusual entrapment neuropathies. Clinical significance of such type of variation in the light of its developmental origin has been discussed.

  12. Nerve transfer for treatment of brachial plexus injury: comparison study between the transfer of partial median and ulnar nerves and that of phrenic and spinal accessary nerves

    Institute of Scientific and Technical Information of China (English)

    侯之启; 徐中和

    2002-01-01

    Objective: To compare the effect of using partial median and ulnar nerves for treatment of C5-6 or C5-7 avulsion of the brachial plexus with that of using phrenic and spinal accessary nerves.Methods: The patients were divided into 2 groups randomly according to different surgical procedures. Twelve cases were involved in the first group. The phrenic nerve was transferred to the musculocutaneous nerve or through a sural nerve graft, and the spinal accessary nerve was to the suprascapular nerve. Eleven cases were classified into the second group. A part of the fascicles of median nerve was transferred to be coapted with the motor fascicle of musculocutaneous nerve and a part of fascicles of ulnar nerve was transferred to the axillary nerve. The cases were followed up from 1 to 3 years and the clinical outcome was compared between the two groups. Results: There were 2 cases (16.6%) who got the recovery of M4 strength of biceps muscle in the first group but 7 cases (63.6%) in the second group, and the difference was statistically significant (P<0.025). However, it was not statistically different in the recovery of shoulder function between the two groups. Conclusions: Partial median and ulnar nerve transfer, phrenic and spinal accessary nerve transfer were all effective for the reconstruction of elbow or shoulder function in brachial plexus injury, but the neurotization using a part of median nerve could obtain more powerful biceps muscle strength than that of phrenic nerve transfer procedure.

  13. MRI-Apparent Localized Deformation of the Median Nerve Within the Carpal Tunnel During Functional Hand Loading

    OpenAIRE

    Goetz, Jessica E.; Kunze, Nicole M.; Main, Erin K; Thedens, Daniel R.; Baer, Thomas E.; Lawler, Ericka A.; Brown, Thomas D.

    2013-01-01

    In MR images, the median nerve of carpal tunnel syndrome (CTS) patients frequently appears flatter than in healthy subjects. The purpose of this work was to develop a metric to quantify localized median nerve deformation rather than global nerve flattening, the hypothesis being that localized median nerve deformation would be elevated in CTS patients. Twelve patients with CTS and 12 matched normals underwent MRI scanning in eight isometrically loaded hand conditions. 2D cross sections of the ...

  14. Apparent Transverse Compressive Material Properties of the Digital Flexor Tendons and the Median Nerve in the Carpal Tunnel

    OpenAIRE

    Main, Erin K; Goetz, Jessica E; Rudert, M. James; Goreham-Voss, Curtis M; Thomas D. Brown

    2010-01-01

    Carpal tunnel syndrome is a frequently encountered peripheral nerve disorder caused by mechanical insult to the median nerve, which may in part be a result of impingement by the adjacent digital flexor tendons. Realistic finite element (FE) analysis to determine contact stresses between the flexor tendons and median nerve depends upon the use of physiologically accurate material properties. To assess the transverse compressive properties of the digital flexor tendons and median nerve, these t...

  15. Biomechanics of the Median Nerve During Stretching as Assessed by Ultrasonography.

    Science.gov (United States)

    Martínez-Payá, Jacinto Javier; Ríos-Díaz, José; Del Baño-Aledo, María Elena; García-Martínez, David; de Groot-Ferrando, Ana; Meroño-Gallut, Javier

    2015-12-01

    The objective of this observational cross-sectional study was to investigate the normal motion of the median nerve when stretched during a neurodynamic exercise. In recent years, ultrasonography has been increasingly accepted as an imaging technique for examining peripheral nerves in vivo, offering a reliable and noninvasive method for a precise evaluation of nerve movement. Transverse motion of the median nerve in the arm during a neurodynamic test was measured. A volunteer sample of 22 healthy subjects (11 women) participated in the study. Nerve displacement and deformation were assessed by dynamic ultrasonography. Excellent interobserver agreement was obtained, with kappa coefficient of .7-.8. Ultrasonography showed no lateral motion during wrist extension in 68% of nerves, while 73% moved dorsally, with statistically significant differences between sexes (ORlat = 6.3; 95% CI = 1.4-27.7 and ORdor = 8.3; 95% CI = 1.6-44.6). The cross-sectional area was significantly greater in men (3.6 mm2). Quantitative analysis revealed no other statistically significant differences. Our results provide evidence of substantial individual differences in median nerve transverse displacement in response to a neurodynamic exercise. PMID:26213988

  16. Post-traumatic Median Nerve Neuroma in Wrist. A Case Report and brief review of Literature

    Directory of Open Access Journals (Sweden)

    Ahmet Aslan

    2013-07-01

    Full Text Available Introduction: Distal median nerve masses may be developed post-traumatic or non-traumatic. In this paper, we aim to present a 52 year old female case with a postraumatic neuroma of the median nerve in the left wrist. Case Report: A 52-year-old female patient had accidental incised wound over her left wrist which was primarily sutured. She presented 6 months later with unrelieved pain and growing swelling at the wrist. USG showed solid mass of size 2×3 cms. Intraoperatively the mass was seen to arise from medial nerve and careful excision was done protecting the nerve. At one year follow up the patient is relived of her symptoms with no sensorimotor deficit. Conclusion: Post traumatic neuroma present as unrelieved pain and progressive swelling. A high index of suspicion should be kept in cases of wound that are primarily sutured over an area with superficial nerves. Careful excision of the lesion is very effective in relieving patients symptoms Keywords: Neuroma, wrist, median nerve, nerve ınjury.

  17. Pre- and post-operative diffusion tensor imaging of the median nerve in carpal tunnel syndrome

    International Nuclear Information System (INIS)

    To use pre- and post-operative diffusion tensor imaging (DTI) to monitor median nerve integrity in patients suffering from carpal tunnel syndrome (CTS). Diffusivity and anisotropy images along the median nerve were compared among 12 patients, 12 age-matched and 12 young control subjects and correlated with electrophysiological neurography results. Slice-wise DTI parameter values were calculated to focus on local changes. Results of pre-operative patients and age-matched control subjects differed only in the distal nerve. Moreover, pre-operative patients differed significantly from young controls and post-operative patients. The main abnormalities were increased diffusivity and decreased anisotropy in the carpal tunnel and distal median nerve. Post-operative clinical improvement was reflected in diffusivity, but not in anisotropy. Slice-wise analysis showed high pre-operative diffusivity at the distal nerve. All groups had relatively large inter-subject variation in both diffusivity and anisotropy. DTI can provide information complementary to clinical examination, electrophysiological recordings and anatomical MRI of diseases and injuries of peripheral nerves. However, similar age-related changes in diffusivity and anisotropy may weaken DTI specificity. Slice-wise analysis is necessary for detection of local changes in nerve integrity. circle Diffusion tensor magnetic resonance imaging provides information complementary to conventional diagnostic methods. circle Age caused similar changes to diffusivity and anisotropy as carpal tunnel syndrome. circle Post-operative clinical improvement was reflected in diffusivity, but not in anisotropy. circle Inter-subject variation in diffusivity and anisotropy was considerable. (orig.)

  18. Median Nerve Repair with Autologous Sciatic Nerve Graft: A Case Report

    OpenAIRE

    Ragel, Brian T.; Park, Gregory C.; Sid Brevard

    2011-01-01

    Background. Peripheral nerve injury treatment options are limited to primary nerve repair, nerve grafting, and tendon transfers. In this case, a large suitable donor site was easily accessible and delayed grafting was indicative of poor prognosis. Case Description. A 25-year-old soldier presented to a military hospital in Afghanistan following a roadside bomb attack. The patient had a medial shrapnel wound in the bicipital groove with a cool pulseless hand and catastrophic lower extremity inj...

  19. Epithelioid Sarcoma of the Forearm Arising from Perineural Sheath of Median Nerve Mimicking Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Hiromasa Fujii

    2009-01-01

    Full Text Available We report here a case of epithelioid sarcoma in the forearm of a 33-year-old male presenting with symptoms and signs of carpal tunnel syndrome originating from the direct involvement of the median nerve. Due to the slow growing of the tumor, the patient noticed the presence of tumor mass in his forearm after several months from the initial onset of the symptoms. Magnetic resonance imaging showed an 8×4 cm mass involving the median nerve in the middle part of the forearm, and histological analysis of the biopsy specimen revealed the diagnosis of epithelioid sarcoma. Radical surgical resection was performed in conjunction with adjuvant chemotherapy. The function of the flexors were restored by the multiple tendon transfers (EIP→FDS; ECRL→FDP; BrR→FPL; EDM→opponens with superficial cutaneous branch of radial nerve transfer to the resected median nerve. The function of the affected hand showed excellent with the DASH disability/symptom score of 22.5, and both the grasp power and sensory of the median nerve area has recovered up to 50% of the normal side. The patient returned to his original vocation and alive with continuous disease free at 3.5-year follow-up since initial treatment.

  20. Nociceptive and Histomorphometric Evaluation of Neural Mobilization in Experimental Injury of the Median Nerve

    OpenAIRE

    Marieli Araujo Rossoni Marcioli; Josinéia Gresele Coradini; Regina Inês Kunz; Lucinéia de Fátima Chasko Ribeiro; Rose Meire Costa Brancalhão; Gladson Ricardo Flor Bertolini

    2013-01-01

    The carpal tunnel syndrome is the most common peripheral neuropathy in the upper limb, but its treatment with conservative therapies such as neural mobilization (NM) is still controversial. The aim of this study was to investigate the efficacy of the NM as treatment in a model of median nerve compression. 18 Wistar rats were subjected to compression of the median nerve in the right elbow proximal region. Were randomly divided into G1 (untreated), G2 (NM for 1 minute), and G3 (NM for 3 minutes...

  1. Post-traumatic Median Nerve Neuroma in Wrist. A Case Report and brief review of Literature

    OpenAIRE

    Ahmet Aslan; Mehmet Nuri Konya; Serdar Sargın

    2013-01-01

    Introduction: Distal median nerve masses may be developed post-traumatic or non-traumatic. In this paper, we aim to present a 52 year old female case with a postraumatic neuroma of the median nerve in the left wrist. Case Report: A 52-year-old female patient had accidental incised wound over her left wrist which was primarily sutured. She presented 6 months later with unrelieved pain and growing swelling at the wrist. USG showed solid mass of size 2×3 cms. Intraoperatively the mass was see...

  2. Neurilemoma of the Median Nerve - Surgical Strategies Based on a Case Report

    Directory of Open Access Journals (Sweden)

    Ulatowski Łukasz

    2014-12-01

    Full Text Available The study presented a case of a patient with a neurilemoma of the median nerve. It presented as a six centemeters tumor, at the level of the proximal one third of the arm with only mild paraesthesias within frst to third ray of the hand. MRI showed the relationship of the tumor and the median nerve, and allowed for the preliminary diagnose of a benign peripheral neural sheath tumor (neurilemoma or neurofibroma. During the first operation the tumor has not been excised, because nerve reconstruction technique was not available. During the second procedure excision of the tumor has been performed without resection of the median nerve trunk with no postoperative deficiencies. The paper provides a detailed description of a surgical procedure. The presented case, like current publications shows that peripheral neural sheath tumor may be usually excised without resection of the nerve trunk, although the possibility of nerve fascicles injury or the need to excise them in the case of neurofibroma clearly suggest that these type of operations should be carried out in centers with microsurgical facilities.

  3. Topotecan Delivery to the Optic Nerve after Ophthalmic Artery Chemosurgery

    Science.gov (United States)

    Taich, Paula; Requejo, Flavio; Asprea, Marcelo; Sgroi, Mariana; Gobin, Pierre; Abramson, David H.; Chantada, Guillermo; Schaiquevich, Paula

    2016-01-01

    Extraocular retinoblastoma is a major challenge worldwide, especially in developing countries. Current treatment involves the administration of systemic chemotherapy combined with radiation, but there is a clear need for improvement of chemotherapy bioavailability in the optic nerve. Our aim was to study the ophthalmic artery chemosurgery (OAC) local route for drug delivery assessing ocular and optic nerve exposure to chemotherapy and to compare it to exposure after intravenous infusion (IV) of the same dose in an animal model. Topotecan was used as a prototype drug that is active in retinoblastoma and based on the extensive knowledge of its pharmacokinetics in preclinical and clinical settings. Five Landrace pigs received 4mg of topotecan via OAC as performed in retinoblastoma patients. At the end of the infusion, the eyes were enucleated, the optic nerve and retina were dissected, and the vitreous and plasma were separated. After recovery and a wash-out period, the animals received a 30-min IV infusion of topotecan (4 mg). The remaining eye was enucleated and tissues and fluids were separated. All samples were stored until quantitation using HPLC. A significantly higher concentration of topotecan in the optic nerve, vitreous, and retina was obtained in eyes after OAC compared to IV infusion (p0.05). The median optic nerve-to-plasma ratio after OAC and IV was 44 and 0.35, respectively. Topotecan OAC delivery attained an 80-fold higher concentration in the optic nerve compared to the systemic infusion of the same dose with similar plasma concentrations in a swine model. Patients with retinoblastoma extension into the optic nerve may benefit from OAC for tumor burden by increased chemotherapy bioavailability in the optic nerve without increasing systemic exposure or toxicity. PMID:26959658

  4. High-resolution sonography of the palmar cutaneous branch of the median nerve

    NARCIS (Netherlands)

    A. Tagliafico (Alberto); F. Pugliese (Francesca); S. Bianchi (Stefano); G. Bodner (Gerd); L. Padua (Luca); M. Rubino (Maurizio); C. Martinoli (Carlo)

    2008-01-01

    textabstractOBJECTIVE. The aim of this study was to describe the potential value of high-resolution sonography for evaluation of the palmar cutaneous branch of the median nerve (MN). SUBJECTS AND METHODS. The volar wrists of 12 healthy volunteers and 22 consecutive patients with sensory deficit in t

  5. Magnetic Resonance Imaging Visualizes Median Nerve Entrapment due to Radius Fracture and Allows Immediate Surgical Release

    Directory of Open Access Journals (Sweden)

    Satoshi Yanagibayashi

    2015-01-01

    Full Text Available Median nerve entrapment with forearm fracture is rare, and surgical exploration in the early stage is rarely performed. We report the case of a 19-year-old man presenting with severe pain and numbness of the thumb, index, and middle fingers and half of the ring finger along with weakness of abduction and opposition of the thumb after fracture of the radial shaft. These symptoms remained unimproved despite precise closed reduction and cast immobilization. The radius fracture was barely displaced, but complaints were increasing, particularly when the wrist and/or fingers were stretched. This suggested direct involvement of the median nerve at the fracture site, so magnetic resonance imaging (MRI of the forearm was performed to identify any entrapment. Short tau inversion recovery MRI visualized significant deviation and entrapment of the median nerve at the fracture site. Surgical release of the entrapment was performed immediately, and complaints resolved shortly thereafter. A positive Tinel sign from the palm to the fingertips and recovery of abduction and opposition of the thumb were seen at 6 months postoperatively. This report highlights the utility of MRI for detecting median nerve entrapment at a fracture site, allowing immediate surgical release.

  6. In-continuity neuroma of the median nerve after surgical release for carpal tunnel syndrome: case report

    OpenAIRE

    Depaoli, R.; Coscia, D.R.; Alessandrino, F.

    2014-01-01

    Iatrogenic injuries of the median nerve after surgical release for carpal tunnel syndrome resulting in the formation of a neuroma are rare. We present here the case of two patients, one with a bifid median nerve, showing in-continuity neuroma after surgical release for carpal tunnel syndrome. The patients reported persistent post-operative pain and showing symptoms. In both cases, ultrasound showed an in-continuity neuroma with a hypoechoic and enlarged median nerve at the carpal tunnel. The ...

  7. Fibrolipomatous Hamartoma of Digital Branch of the Median Nerve without Macrodystrophy: Two Case Reports with Magnetic Resonance Imaging Findings

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Woo Sun; Jung, Jee Young; Song, In Sub; Lee, Jae Sung; Lee, Tae Jin; Jung, Yoon Yang [Chung-Ang University Hospital, School of Medicine, Chung-Ang University, Seoul (Korea, Republic of)

    2012-11-15

    Fibrolipomatous hamartoma (FLH) of the nerve is a rare, benign tumor that most commonly originates from the median nerve of the hand. Fibrofatty tissue proliferates around the nerve and infiltrates the epineurium and perineurium. We present two cases of pathologically proven FLH of a digital branch of the median nerve, without macrodystrophy with magnetic resonance imaging, surgical and pathologic findings. Magnetic resonance images of both cases show well-circumscribed mass with fat signal intensity around an enlarged digital branch of the median nerve and characteristic coaxial-cable-like appearance on axial images and spaghetti-like appearance on coronal images.

  8. Cross recurrence quantification analysis of precision grip following peripheral median nerve block

    OpenAIRE

    Li, Ke; Li, Zong-Ming

    2013-01-01

    Background Precision grip by the thumb and index finger is vulnerable to sensorimotor deficits. Traditional biomechanical parameters offer limited insight into the dynamical coordination between digits during precision grip. In this study, the thumb and index finger were viewed as “coupled systems”, and a cross recurrence quantification analysis (CRQA) was used to examine the changes of interdigit dynamics and synchronization caused by peripheral median nerve block. Methods Seven subjects per...

  9. Dipole Source Analyses of Early Median Nerve SEP Components Obtained From Subdural Grid Recordings

    OpenAIRE

    Baumgärtner, Ulf; Vogel, Hagen; Ohara, Shinji; Treede, Rolf-Detlef; Lenz, Fred A.

    2010-01-01

    The median nerve N20 and P22 SEP components constitute the initial response of the primary somatosensory cortex to somatosensory stimulation of the upper extremity. Knowledge of the underlying generators is important both for basic understanding of the initial sequence of cortical activation and to identify landmarks for eloquent areas to spare in resection planning of cortex in epilepsy surgery. We now set out to localize the N20 and P22 using subdural grid recording with special emphasis on...

  10. Recruitment Selectivity of Single and Pairs of Transverse, Intrafascicular, Multi-channel Electrodes (TIME) in the Pig Median Nerve

    OpenAIRE

    Harreby, Kristian Rauhe; Kundu, Aritra; Geng, Bo; Maciejasz, Paweł; Guiraud, David; Stieglitz, Thomas; Boretius, Tim; Yoshida, Ken; Jensen, Winnie

    2012-01-01

    When applied in the rat model the Transverse Intrafascicular Multi-channel Electrode (TIME) showed selective nerve fascicle recruitment. But results from the larger and poly-fasicular median nerves in pigs indicated that a single TIME could not reach the entire nerve and could only selectively recruit a subset of the nerve fascicles. The use of multiple TIME structures could offer a means to achieve highly selective fascicular stimulation while reaching a larger percentage of the fascicles in...

  11. Study of recurrent branch of median nerve (Thenar's muscular branch in relation to the flexor retinaculum and median in 64 hands (32 Men

    Directory of Open Access Journals (Sweden)

    Amirsadri R

    1998-07-01

    Full Text Available Variation of recurred branch of median nerve in relation to the median and flexor retinaculum are significant for both hand surgeons and specialists always. In this study, 64 cadaver hands (32 men have been dissected. The median nerve was identified at the proximal edge of the flexor retinaculum, and in order to expose carpal tunnel the ligament was divided, and the above subjects were studied. The results are: 1 The relation of recurrent nerve to the flexor retinaculum was classified into 4 types: A In (53.1% of subjects, this branch arises from the median after the flexor retinaculum. B In (31.3% of subjects, it arises from the median in the carpal tunnel and the moves around the lower edge of flexor retinaculum and enters the thenar region. C In (14.1% of subjects, it arises from the median in the carpal tunnel and pierces the flexor retinaculum. D In (1.56% of subjects it arises, in the carpal tunnel and it divides into two subbranches here. One follows pattern A and the other pattern C. 2 In this step, the relation of the recurrent branch to the median nerve was studied. The results show that inspite of this image even though most often the recurrent branch arises from the lateral side of median, in (68.75% of subjects it arises from it's anterior surface. The MC Nemar test reveals that there is no relation between manifestation of mentioned patterns with right or left hands.

  12. Median ulnar nerves communication in the forearm: a study with autopsy material.

    Science.gov (United States)

    Ballesteros, Luis E; Forero, Pedro L; Quintero, Iván D

    2014-01-01

    The incidence of median-ulnar communication in the forearm presents variability in different population groups. The aim of this study was to determine the incidence and morphologic expression of the median-ulnar communication in a sample of the Colombian population. One hundred and eight forearms of autopsy material at the National Institute of Forensic Medicine of Bucaramanga, Colombia were studied. Using an approach of the flexor compartment of forearm the median and ulnar nerves were dissected and the communications between these two structures were characterized. The communicating branch occurred in 28 (25.9%) forearms. It occurred unilaterally in 12 specimens and bilaterally in 8, with statistically significant difference (P=0.01). The communication between the anterior interosseous and ulnar nerves was most frequent, observed in 13 (46.4%) forearms. The length of the communicating branch was 56.9 +/- 8.3 mm. The distance of the proximal and distal points of the communicating branch to the bi- epicondylar line was 59.6 +/- 15.4 mm and 102.7 +/- 23.5 mm respectively. The length of the forearm was 269.8 +/- 15.9 mm. A projection of the communicating branch from the upper third to the midthird of the forearm was observed. The incidence of the median-ulnar communication in the present study is in the high rank reported in the literature; there is an agreement with prior studies in finding more numerous communicating branches in the right forearm. The median-ulnar communication should be taken into account for surgical approach of the forearm. PMID:26749683

  13. Effects of Whiplash Injury on Median Nerve Mobility: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Muhammad Nazim Farooq

    2012-12-01

    Full Text Available Chronic pain following whiplash injury is a challenging condition for healthcare professionals. Clinical signs of changes in neural mobility have been observed in these patients, which may be responsible for symptoms. The present study used ultrasound imaging to evaluate and compare median nerve movement in subjects who have previously had a whiplash associated disorder (WAD (n=7 with a control group (n=10. Longitudinal and transverse nerve sliding was measured at mid-forearm during neck movement from neutral to contralateral side flexion. Data were analyzed using descriptive and non-parametric statistical methods.Longitudinal nerve movement was reduced by 24% in WAD group compared with control group, where the mean movement was 1.31 (SD=0.49 mm and 1.73 (SD=0.92 mm respectively. Transverse movement was reduced by 66.7% in patient group compared with control group, where the mean movement was -0.06 (SD=0.51 mm and -0.18 (SD=0.54 mm respectively. Overall there was a trend of reduced nerve sliding in whiplash patients but this did not achieve statistical significance. Further research should utilise a larger sample to further evaluate the nature and extend of changes in neural mobility in a patient population.

  14. Lipofibromatous Hamartoma of the Median Nerve with Long-term Follow-up.

    Directory of Open Access Journals (Sweden)

    Chung-Chen Hsu

    2005-02-01

    Full Text Available Lipofibromatous hamartoma is a rare, benign tumor that most often involves the mediannerve. A 16-year-old male with lipofibromatous hamartoma of the median nerve at the wristlevel is described. This patient was a child when the mass was first noted. Although therewere no symptoms or signs of carpal tunnel compression, the growth of the tumor was progressing.In addition to the release of the carpal tunnel, microsurgical intraneural dissectionwas done to preserve the thenar motor branch. Then segmental excision of the residual sensorycomponent with sural nerve grafting was performed. Subjectively the patient did notnotice the minor motor deficit, however, the patient did experience numbness of fingertipsafter surgery. There were no scars or trophic ulcers on fingertips at 3 years of follow-upregardless of the inadequate sensory return. Treatment of this benign tumor is still controversial.The relevant reports in the literature are reviewed.

  15. Review of the dimensions of the median nerve and carpal tunnel using sonography in asymptomatic adults

    International Nuclear Information System (INIS)

    Full text: The study aims to establish the normal range of all sono logic measurements of carpal tunnel (CT) structures in an asymptomatic population. Sonological evaluation of 150 wrists in 75 asymptomatic adults was performed. The cross-sectional area (CSA) of the median nerve at four levels, the flattening ratio (FR) at three levels, the antero-posterior (AP) diameter of the CT and the distance of the transverse carpal ligament (TCL) from the trapezium-hamate (TmH) line were measured. The mean (standard deviation (SD)) CSA of the median nerve at the distal forearm, CT inlet, mid and outlet were 6.8 (1.3), 704 (1.1),7.5 (1.0), 7.1 (1.0) mm2, respectively. The mean (SD) FR at the CT inlet, mid and outlet were 2.66 (0.54), 2.55 (0.54), 3.69 (0.82), respectively. The mean (SD) AP diameter of the CT was lOA mm (1.1). Volar bowing of the retinaculum was seen in 7.3% of normal wrists. The normal range at two SDs of the CSA of the median nerve at the inlet was 5.2-9.6 mm2. The upper limit of volar bowing of the flexor retinaculum was 0.8 mm. The FR overlaps with values obtained in other studies of patients with carpal tunnel syndrome. The mean AP diameter of the CT was lOA mm (SD 1.1). To the best of our knowledge, this is the largest study performed in an asymptomatic population assessing the different sono logical parameters related to the CT.

  16. Electromyography in diagnostic of median nerve lesion in carpal tunnel syndrome of children with mucopolysaccharidoses

    Directory of Open Access Journals (Sweden)

    A. L. Kurenkov

    2015-02-01

    Full Text Available Carpal tunnel syndrome (CTS is a frequent syndrome in adults, but is very rare in children. CTS was described in children with mucopolysaccharidoses (MPS as condition due to the deformation of carpal bones, deposition of glycosaminoglycans in tendosynovial tissue and connective tissue of flexor retinaculum. Electromyography is essential method for diagnostic CTS in children because typical symptoms of CTS (paresthesia, numbness of hand and fingers, atrophy and paresis of certain muscles seen in adults are absent or not realized by children with MPS because of cognitive deficit despite the presence of nerve involvement. EMG results from 40 children with different types of MPS (age 1 year 8 months to 18 years are presented. Neurophysiologic abnormalities related to CTS were found in every child with MPS I, in 80,9 % of cases – with MPS II and in every case – with MPS VI; no EMG signs of median nerve lesions incarpal channel were detected in patients with MPS III and MPS IV. CTS was bilateral in children with MPS I, II and VI, but usuallythere was an asymmetry of changes. We revealed CTS in one patient with MPS II as early as at the age 2 years 11 months. All children with MPS II had already CTS at the age of 4 years except one patient. Children with MPS I and MPS VI were not investigate before the age 4 years old, but one child 4 years old with MPS I had severe CTS. In children with MPS atrophy of thenar eminence muscles developed rapidly as complication of CTS. Therefore we recommend repeating of EMG regularly to identify earliest signs of median nerve disturbance in carpal channel and opportune surgical decompression of the entrapped nerve. It allows preserving normal function of hand that it is very important for adequate child development and quality of life.

  17. Influence of the long term use of a computer on median, ulnar and radial sensory nerves in the wrist region

    Directory of Open Access Journals (Sweden)

    Belgin Bamac

    2014-12-01

    Full Text Available Objectives: Repetitive microtrauma or overuse injuries may often affect upper extremities of the long term computer users. The aim of this study was to compare sensory nerve conduction velocities (SNCV for median, radial and ulnar nerves in the wrist of computer users with the same parameters in controls who do not use computers regularly. Material and Methods: Twenty one male computer users (age: mean (M = 28.3 years ± standard deviation (SD = 7.5 years and 21 male control subjects (age: M±SD = 24.1±4.6 years were recruited for the study. Limb length and the perimeters of the dominant arm and forearm were measured for each subject. The neurophysiological study consisted of measuring sensory nerve conduction of the median, ulnar and radial nerves. Results: The sensory conduction velocities of both median and ulnar nerves were significantly delayed in the dominant arm of the computer users compared to the controls. In addition, sensory conduction velocity of the median nerve was significantly delayed in the dominant extremity of the computer users compared to their non-dominant extremity. Conclusions: This study shows that computer users have a tendency toward developing median and ulnar sensory nerve damage in the wrist region. Mechanism of delayed SNCV in the median and ulnar nerves may be due to sustained extension and ulnar deviation of the wrist during computer mouse use and typing. Reduced SNCV changes were more apparent on the dominant side of the median nerve. This may indicate the increased neural deficits related to an increased use of the dominant side. Further investigation is needed to determine how to reduce potential risk factors at this stage in order to prevent development of median or ulnar neuropathy in the long term computer users.

  18. Carpal arch and median nerve changes during radioulnar wrist compression in carpal tunnel syndrome patients.

    Science.gov (United States)

    Marquardt, Tamara L; Evans, Peter J; Seitz, William H; Li, Zong-Ming

    2016-07-01

    The purpose of this study was to investigate the morphological changes of the carpal arch and median nerve during the application of radiounlarly directed compressive force across the wrist in patients with carpal tunnel syndrome. Radioulnar compressive forces of 10 N and 20 N were applied at the distal level of the carpal tunnel in 10 female patients diagnosed with carpal tunnel syndrome. Immediately prior to force application and after 3 min of application, ultrasound images of the distal carpal tunnel were obtained. It was found that applying force across the wrist decreased the carpal arch width (p 1234-1240, 2016. PMID:26662276

  19. RIGHT MEDIAN NERVE STIMULATION IN TRAUMATIC BRAIN INJURY: EVALUATION OF IMPROVEMENT USING CLINICAL SCALES AND PET SCAN

    OpenAIRE

    Sharma V.; Kapoor J; Gupta D; Chaturvedi D; Arora H

    2014-01-01

    Electrical stimulation may serve as a catalyst to enhance central nervous system functions and the right median nerve has been chosen as a portal to electrically stimulate and help arouse the central nervous system for persons with reduced levels of consciousness. The mechanisms of central action include increased cerebral blood flow and raised levels of dopamine. Right median nerve stimulation (RMNS) is a safe, inexpensive, non-invasive therapy and may help in facilitating recovery from coma...

  20. Resuscitation therapy for traumatic brain injury-induced coma in rats: mechanisms of median nerve electrical stimulation

    OpenAIRE

    Zhen Feng; Ying-jun Zhong; Liang Wang; Tian-qi Wei

    2015-01-01

    In this study, rats were put into traumatic brain injury-induced coma and treated with median nerve electrical stimulation. We explored the wake-promoting effect, and possible mechanisms, of median nerve electrical stimulation. Electrical stimulation upregulated the expression levels of orexin-A and its receptor OX1R in the rat prefrontal cortex. Orexin-A expression gradually increased with increasing stimulation, while OX1R expression reached a peak at 12 hours and then decreased. In additio...

  1. Intensity Sensitive Modulation Effect of Theta Burst Form of Median Nerve Stimulation on the Monosynaptic Spinal Reflex

    OpenAIRE

    Kuei-Lin Yeh; Po-Yu Fong; Ying-Zu Huang

    2015-01-01

    The effects of electrical stimulation of median nerve with a continuous theta burst pattern (EcTBS) on the spinal H-reflex were studied. Different intensities and durations of EcTBS were given to the median nerve to 11 healthy individuals. The amplitude ratio of the H-reflex to maximum M wave (H/M ratio), corticospinal excitability and inhibition measured using motor evoked potentials (MEPs), short-interval intracortical inhibition and facilitation (SICI/ICF), spinal reciprocal inhibition (RI...

  2. Mechanosensitivity of the median nerve in patients with chronic carpal tunnel syndrome.

    Science.gov (United States)

    Jaberzadeh, Shapour; Zoghi, Maryam

    2013-04-01

    The aim was to investigate the relationship between the effects of median nerve strain during the elbow extension component of the upper limb neurodynamic test 1 (ULNT1) and the evoked musculoskeletal changes. 11 patients with chronic carpal tunnel syndrome (CTS) and 11 matched asymptomatic controls participated in the study. In all subjects, elbow extension was carried out in both ULNT1 and neutral positions of the shoulder and arm. From these two starting positions a KIN-COM(®) dynamometer carried out passive elbow extension while EMG activity of 10 arm and shoulder muscles, elbow-flexor resistive torque and elbow extension ROM were measured concurrently. The result showed that, in the ULNT1 position, increased EMG activity of the involved muscles, increased elbow extension resistive torque and pain responses occurred much earlier in the range of elbow extension in the CTS group compared to healthy controls. These findings demonstrated increased mechanosensitivity of the median nerve in CTS patients compared to healthy controls. PMID:23561861

  3. The cholesterol levels in median nerve and post-mortem interval evaluation.

    Science.gov (United States)

    Vacchiano, G; Maldonado, A Luna; Ros, M Matas; Di Lorenzo, P; Pieri, M

    2016-08-01

    Cholesterol levels in the median nerve were studied at various post-mortem intervals (PMIs). Single median nerve samples were collected from the wrists of 36 subjects during forensic autopsies of subjects with known circumstances and times of death. Although the absolute values varied, increments in cholesterol concentration were recorded. Subsequently, 16 subjects who did not suffer of any neurological and/or metabolic diseases with known times and circumstances of death were enrolled. For each enrolled subject, two samples were collected from the wrist at an interval of approximately two hours (t1 and t2). The obtained results revealed a gradual increase in cholesterol level with increasing time since death. The cholesterol concentration data obtained for each subject at t1 and t2 were correlated with the time since death, a linear interpolation was applied, and the PMI was back-calculated. Similar trends were obtained for the samples collected at similar PMIs; thus, three groups were considered: PMIPMIPMI>78h. Good correlation coefficients were obtained, especially for the first group (R(2)=0.9362) for which the PMI could be calculated with an error that ranged from -4 to 5.9h. Although it requires further confirmation via analyses of larger numbers of samples, the method proposed here can currently be applied to PMI determinations. PMID:26826850

  4. Response in primary somatosensory cortex following electrical stimulation of median nerve using fMRI

    International Nuclear Information System (INIS)

    To determine the location of the central sulcus is often clinically important, especially as presurgical information. To identify the central sulcus, we detected the post-central sulcus (primary somatosensory cortex, SI) using fMRI (functional magnetic resonance imaging). Ten healthy volunteers participated in this study. Using 3 Tesla MR imager (Medspec S300, Bruker), box-car design was applied following electrical median nerve stimulation. SPM99 (Welcome Department of Cognitive Neurology, London, UK) was used for the analysis and the statistical threshold was set at P<0.05. Contralateral response on SI was found in 8 out of 10 subjects. This response was divided into two patterns: group 1, SI activation only and group 2, both SI and primary motor cortex (MI) activation. Secondary somatosensory cortex (SII) activation was observed bilaterally in 5 subjects. Ipsilateral response was identified in 6 out of 8 subjects who showed contralateral response of SI. These fMRI findings were useful in defining the SI in the contralateral hemisphere following electrical stimulation of the median nerve, and led to the central sulcus, MI, or both. (author)

  5. Dipole source analyses of early median nerve SEP components obtained from subdural grid recordings.

    Science.gov (United States)

    Baumgärtner, Ulf; Vogel, Hagen; Ohara, Shinji; Treede, Rolf-Detlef; Lenz, Fred A

    2010-12-01

    The median nerve N20 and P22 SEP components constitute the initial response of the primary somatosensory cortex to somatosensory stimulation of the upper extremity. Knowledge of the underlying generators is important both for basic understanding of the initial sequence of cortical activation and to identify landmarks for eloquent areas to spare in resection planning of cortex in epilepsy surgery. We now set out to localize the N20 and P22 using subdural grid recording with special emphasis on the question of the origin of P22: Brodmann area 4 versus area 1. Electroencephalographic dipole source analysis of the N20 and P22 responses obtained from subdural grids over the primary somatosensory cortex after median nerve stimulation was performed in four patients undergoing epilepsy surgery. Based on anatomical landmarks, equivalent current dipoles of N20 and P22 were localized posterior to (n = 2) or on the central sulcus (n = 2). In three patients, the P22 dipole was located posterior to the N20 dipole, whereas in one patient, the P22 dipole was located on the same coordinate in anterior-posterior direction. On average, P22 sources were found to be 6.6 mm posterior [and 1 mm more superficial] compared with the N20 sources. These data strongly suggest a postcentral origin of the P22 SEP component in Brodmann area 1 and render a major precentral contribution to the earliest stages of processing from the primary motor cortex less likely. PMID:20861430

  6. Modified Quad surgery significantly improves the median nerve conduction and functional outcomes in obstetric brachial plexus nerve injury

    OpenAIRE

    Nath, Rahul K; Kumar, Nirupuma; Somasundaram, Chandra

    2013-01-01

    Background Nerve conduction studies or somatosensory evoked potentials (SSEPs) have become an important tool in the investigation of peripheral nerve lesions, and is sensitive in detecting brachial plexus nerve injury, and other nerve injuries. To investigate whether the modified Quad surgical procedure improves nerve conductivity and functional outcomes in obstetric brachial plexus nerve injury (OBPI) patients. Methods All nerves were tested with direct functional electrical stimulation. A P...

  7. From the brachial plexus to the hand, multiple connections between the median and ulnar nerves may serve as bypass routes for nerve fibres.

    Science.gov (United States)

    Yang, H; Gil, Y; Kim, S; Bang, J; Choi, H; Lee, H Y

    2016-07-01

    Axons from the median and ulnar nerves can pass to each other through aberrant connections between them. Multiple interconnections between the nerves may provide a detour route for nerve fibres going to the hand. We investigated the incidence of variations and the associations between them in 90 cadaveric upper limbs. In 91% of upper limbs, one to five variations were found, with several statistically significant associations. The contribution of the C8 nerve to the lateral cord was positively associated with an accessory contribution of the lateral cord to the ulnar nerve. The latter variation showed positive association with the occurrence of any of the variations in the hand itself. Ulnar innervation of the superficial head of the flexor pollicis brevis was positively associated with the Riche-Cannieu communication. The co-existence of the variations and their associations may be the explanation for unusual clinical findings related to median and ulnar conduction, which appear contrary to anatomical knowledge. PMID:26763269

  8. Thrombosis of the persistent median artery as a cause of carpal tunnel syndrome – case study

    OpenAIRE

    Rzepecka-Wejs, Ludomira; Multan, Aleksandra; Konarzewska, Aleksandra

    2012-01-01

    Carpal tunnel syndrome is the most frequent neuropathy of the upper extremity, that mainly occurs in manual workers and individuals, whose wrist is overloaded by performing repetitive precise tasks. In the past it was common among of typists, seamstresses and mechanics, but nowadays it is often caused by long hours of computer keyboard use. The patient usually complains of pain, hypersensitivity and paresthesia of his hand and fingers in the median nerve distribution. The symptoms often incre...

  9. Apparent transverse compressive material properties of the digital flexor tendons and the median nerve in the carpal tunnel.

    Science.gov (United States)

    Main, Erin K; Goetz, Jessica E; Rudert, M James; Goreham-Voss, Curtis M; Brown, Thomas D

    2011-03-15

    Carpal tunnel syndrome is a frequently encountered peripheral nerve disorder caused by mechanical insult to the median nerve, which may in part be a result of impingement by the adjacent digital flexor tendons. Realistic finite element (FE) analysis to determine contact stresses between the flexor tendons and median nerve depends upon the use of physiologically accurate material properties. To assess the transverse compressive properties of the digital flexor tendons and median nerve, these tissues from ten cadaveric forearm specimens were compressed transversely while under axial load. The experimental compression data were used in conjunction with an FE-based optimization routine to determine apparent hyperelastic coefficients (μ and α) for a first-order Ogden material property definition. The mean coefficient pairs were μ=35.3 kPa, α=8.5 for the superficial tendons, μ=39.4 kPa, α=9.2 for the deep tendons, μ=24.9 kPa, α=10.9 for the flexor pollicis longus (FPL) tendon, and μ=12.9 kPa, α=6.5 for the median nerve. These mean Ogden coefficients indicate that the FPL tendon was more compliant at low strains than either the deep or superficial flexor tendons, and that there was no significant difference between superficial and deep flexor tendon compressive behavior. The median nerve was significantly more compliant than any of the flexor tendons. The material properties determined in this study can be used to better understand the functional mechanics of the carpal tunnel soft tissues and possible mechanisms of median nerve compressive insult, which may lead to the onset of carpal tunnel syndrome. PMID:21194695

  10. Improving the radial nerve neurodynamic test: An observation of tension of the radial, median and ulnar nerves during upper limb positioning.

    Science.gov (United States)

    Manvell, Joshua J; Manvell, Nicole; Snodgrass, Suzanne J; Reid, Susan A

    2015-12-01

    The radial nerve neurodynamic test (ULNT2b), used to implicate symptoms arising from the radial nerve, is proposed to selectively increase strain of the nerve without increasing strain of adjacent tissue, though this has not been established. This study aimed to determine the upper limb position that results in: (1) the greatest tension of the radial nerve and (2) the greatest difference in tension between the radial nerve and the other two major nerves of the upper limb: median and ulnar. Tension (N) of the radial, median and ulnar nerves was measured simultaneously using three buckle force transducers during seven upper limb positions in the axilla of ten embalmed whole body human cadavers (n = 20 limbs). Repeated measures analysis of variance (ANOVA) with Bonferroni post-hoc tests determined differences in tension between nerves and between limb positions. A Composite position consisting of ULNT2b (scapular depression, shoulder internal rotation, elbow extension, forearm pronation, wrist flexion) with the addition of shoulder abduction 40° and extension 25°, wrist ulnar deviation and thumb flexion demonstrated significantly greater tension of the radial nerve than any other tested position (mean tension 11.32N; 95% CI 10.25, 12.29, p < 0.01), including ULNT2b (2.20N; 1.84, 2.57; p < 0.01). Additionally, the Composite position demonstrated the greatest difference in tension between the radial and median (mean difference 4.88N; 95% CI 3.16, 6.61; p < 0.01) and radial and ulnar nerves (9.26N, 7.54, 10.99; p < 0.01). This position constitutes a biomechanically plausible test to detect neuropathic pain related to the radial nerve. PMID:25892706

  11. Resuscitation therapy for traumatic brain injury-induced coma in rats:mechanisms of median nerve electrical stimulation

    Institute of Scientific and Technical Information of China (English)

    Zhen Feng; Ying-jun Zhong; Liang Wang; Tian-qi Wei

    2015-01-01

    In this study, rats were put into traumatic brain injury-induced coma and treated with median nerve electrical stimulation. We explored the wake-promoting effect, and possible mechanisms, of median nerve electrical stimulation. Electrical stimulation upregulated the expression levels of orexin-A and its receptor OX1R in the rat prefrontal cortex. Orexin-A expression gradually in-creased with increasing stimulation, while OX1R expression reached a peak at 12 hours and then decreased. In addition, after the OX1R antagonist, SB334867, was injected into the brain of rats after traumatic brain injury, fewer rats were restored to consciousness, and orexin-A and OXIR expression in the prefrontal cortex was downregulated. Our ifndings indicate that median nerve electrical stimulation induced an up-regulation of orexin-A and OX1R expression in the pre-frontal cortex of traumatic brain injury-induced coma rats, which may be a potential mechanism involved in the wake-promoting effects of median nerve electrical stimulation.

  12. Short-Latency Median-Nerve Somatosensory-Evoked Potentials and Induced Gamma-Oscillations in Humans

    Science.gov (United States)

    Fukuda, Miho; Nishida, Masaaki; Juhasz, Csaba; Muzik, Otto; Sood, Sandeep; Chugani, Harry T.; Asano, Eishi

    2008-01-01

    Recent studies have suggested that cortical gamma-oscillations are tightly linked with various forms of physiological activity. In the present study, the dynamic changes of intracranially recorded median-nerve somatosensory-evoked potentials (SEPs) and somatosensory-induced gamma-oscillations were animated on a three-dimensional MR image, and the…

  13. Resuscitation therapy for traumatic brain injury-induced coma in rats: mechanisms of median nerve electrical stimulation

    Directory of Open Access Journals (Sweden)

    Zhen Feng

    2015-01-01

    Full Text Available In this study, rats were put into traumatic brain injury-induced coma and treated with median nerve electrical stimulation. We explored the wake-promoting effect, and possible mechanisms, of median nerve electrical stimulation. Electrical stimulation upregulated the expression levels of orexin-A and its receptor OX1R in the rat prefrontal cortex. Orexin-A expression gradually increased with increasing stimulation, while OX1R expression reached a peak at 12 hours and then decreased. In addition, after the OX1R antagonist, SB334867, was injected into the brain of rats after traumatic brain injury, fewer rats were restored to consciousness, and orexin-A and OXIR expression in the prefrontal cortex was downregulated. Our findings indicate that median nerve electrical stimulation induced an up-regulation of orexin-A and OX1R expression in the prefrontal cortex of traumatic brain injury-induced coma rats, which may be a potential mechanism involved in the wake-promoting effects of median nerve electrical stimulation.

  14. A Rare Case of an Artery Passing through the Median Perforating Canal of the Mandible

    Science.gov (United States)

    Iwanaga, Joe; Watanabe, Koichi; Saga, Tsuyoshi; Tabira, Yoko; Yamaki, Koh-ichi

    2016-01-01

    Along with the popularization of dental implant surgery, there has been considerable research on the lingual foramen using cone-beam computed tomography. Anatomical research has also revealed that the arteries entering the lingual foramina are branches of the submental and sublingual arteries. There have been no reports, however, of the submental or sublingual artery entering the mandible from the lingual foramen, perforating it, and then distributing to the inferior labial region. A 69-year-old man who donated his body to our department in 2015 was dissected. The mandible with overlying soft tissue of the mental region was resected and examined with microcomputed tomography, which showed that the canal perforated from the lingual foramen to the midline of the labial cortical plate. The canal was thus named the median perforating canal. To the best of our knowledge, there have been no other reports of a perforating artery of the mandible, so this case is thought to be rare. Hence, the existence of perforating arteries, such as in the present case, should be taken into consideration in preoperative diagnoses such as for dental implant surgery. Thus, the fusion of anatomical and radiological study is useful and necessary to understand surgical anatomy.

  15. Intraoperative radial nerve injury during coronary artery surgery – report of two cases

    Directory of Open Access Journals (Sweden)

    Tsivgoulis Georgios

    2006-12-01

    Full Text Available Abstract Background Peripheral nerve injury and brachial plexopathy are known, though rare complications of coronary artery surgery. The ulnar nerve is most frequently affected, whereas radial nerve lesions are much less common accounting for only 3% of such intraoperative injuries. Case presentations Two 52- and 50-year-old men underwent coronary artery surgery. On the first postoperative day they both complained of wrist drop on the left. Neurological examination revealed a paresis of the wrist and finger extensor muscles (0/5, and the brachioradialis (4/5 with hypoaesthesia on the radial aspect of the dorsum of the left hand. Both biceps and triceps reflexes were normoactive, whereas the brachioradialis reflex was diminished on the left. Muscles innervated from the median and ulnar nerve, as well as all muscles above the elbow were unaffected. Electrophysiological studies were performed 3 weeks later, when muscle power of the affected muscles had already begun to improve. Nerve conduction studies and needle electromyography revealed a partial conduction block of the radial nerve along the spiral groove, motor axonal loss distal to the site of the lesion and moderate impairment in recruitment with fibrillation potentials in radial innervated muscles below the elbow and normal findings in triceps and deltoid. Electrophysiology data pointed towards a radial nerve injury in the spiral groove. We assume external compression as the causative factor. The only apparatus attached to the patients' left upper arm was the sternal retractor, used for dissection of the internal mammary artery. Both patients were overweight and lying on the operating table for a considerable time might have caused the compression of their left upper arm on the self retractor's supporting column which was fixed to the table rail 5 cm above the left elbow joint, in the site where the radial nerve is directly apposed to the humerus. Conclusion Although very uncommon, external

  16. Formation of median nerve without the medial root of medial cord and associated variations of the brachial plexus

    Directory of Open Access Journals (Sweden)

    Bhanu SP

    2010-02-01

    Full Text Available The anatomical variations in the formation, course and termination of brachial plexus are well documented and have clinical significance to surgeons, neurologists and anatomists. The present case report describes the unusual origin of median nerve, arising directly from the lateral cord without the union of lateral and medial roots of brachial plexus. A communicating branch existed between the ulnar nerve and anterior division of middle trunk. The lateral pectoral nerve was arising from anterior divisions of upper and middle trunks as two separate branches instead from lateral cord. The branches then joined together to form the lateral pectoral nerve. The medial cord instead of its five terminal branches, had only three branches, the ulnar nerve, medial pectoral nerve and a single trunk for the medial cutaneous nerve of arm and forearm which got separated at the middle of the arm. The variations of the lateral cord and its branches make it a complicated clinical and surgical approach which is discussed with the developmental background.

  17. The vascularized sural nerve graft based on a peroneal artery perforator for reconstruction of the inferior alveolar nerve defect.

    Science.gov (United States)

    Hayashida, Kenji; Hiroto, Saijo; Morooka, Shin; Kuwabara, Kaoru; Fujioka, Masaki

    2015-03-01

    The sural nerve has been described for nerve reconstruction of the maxillofacial region since it provides many advantages. We report a case of a vascularized sural nerve graft based on a peroneal artery perforator for immediate reconstruction after the removal of intraosseous neuroma originating in the inferior alveolar nerve. The patient had a neuroma caused by iatrogenic injury to the inferior alveolar nerve. A 4-cm long neuroma existed in the inferior alveolar nerve and was resected. A peroneal perforator was chosen as the pedicle of the vascularized sural nerve graft for the nerve gap. The graft including the skin paddle for monitoring the perfusion supplied by this perforator was transferred to the lesion. The nerve gap between the two stumps of the inferior alveolar nerve was repaired using the 6-cm long vascularized sural nerve. The perforator of the peroneal artery was anastomosed to the branch of the facial artery in a perforator-to-perforator fashion. There was no need to sacrifice any main arteries. The skin paddle with 1 cm × 3 cm in size was inset into the incised medial neck. Perceptual function tests with a Semmes-Weinstein pressure esthesiometer and two-point discrimination in the lower lip and chin at 10 months after surgery showed recovery almost to the level of the normal side. This free vascularized sural nerve graft based on a peroneal artery perforator may be a good alternative for reconstruction of inferior alveolar nerve defects. PMID:25346479

  18. Ultrasonographic measurement of median nerve cross-sectional area reference values in a healthy Han population from Guiyang, China

    Institute of Scientific and Technical Information of China (English)

    Jun Chen; Shan Wu; Jun Ren

    2011-01-01

    High-resolution ultrasonography was used to analyze the nerve cross-sectional area (CSA) of the median nerve at 7 sites: the wrist crease, pisiform bone, hamate bone, 6 cm proximal to the tip of the wrist crease, proximal forearm (where the nerve enters the pronator teres muscle), 4 cm proximal to the tip of the medial epicondyle, and mid-humerus (mid-point between elbow crease and axilla) in 200 healthy volunteers from Guiyang, China. Results showed similar CSA values between the left and right sides, but the CSA 6 cm proximal to the tip of the wrist crease, proximal forearm, 4 cm proximal to tip of the medial epicondyle, and mid-humerus in males was greater than that of females. Moreover, CSA values at the wrist crease, pisiform bone, and hamate bone were greater in the middle-aged and old groups when compared to the young group, and correlated with body mass and height. Thus, reference values of median nerve CSA of the upper limbs can facilitate the analysis of abnormal nerve conditions.

  19. Nerve damage in leprosy: An electrophysiological evaluation of ulnar and median nerves in patients with clinical neural deficits: A pilot study

    Directory of Open Access Journals (Sweden)

    Sumit Kar

    2013-01-01

    Full Text Available Background : Leprosy involves peripheral nerves sooner or later in the course of the disease leading to gross deformities and disabilities. Sadly, by the time it becomes clinically apparent, the nerve damage is already quite advanced. However, if the preclinical damage is detected early in the course of disease, it can be prevented to a large extent. Materials and Methods: We conducted an electrophysiological pilot study on 10 patients with clinically manifest leprosy, in the Dermatology Department of Mahatma Gandhi Institute of Medical Sciences, Sewagram. This study was done to assess the nerve conduction velocity, amplitude and latency of ulnar and median nerves. Results and Conclusion: We found reduced conduction velocities besides changes in latency and amplitude in the affected nerves. Changes in sensory nerve conduction were more pronounced. Also, sensory latencies and amplitude changes were more severe than motor latencies and amplitude in those presenting with muscle palsies. However, further studies are going on to identify parameters to detect early nerve damage in leprosy.

  20. Median Nerve Injury Due to High-Pressure Water Jet Injection: A Case Report and Review of Literature.

    Science.gov (United States)

    Emre, Ufuk; Unal, Aysun

    2009-08-01

    High-pressure injuries that occur accidentally are potentially destructive injuries that often affect the nondominant hands of young men. A variety of products such as paint, gasoline, grease, fuel oil, cement, thinner and solvents have been reported as destructive agents. High-pressure water jet injection injuries to soft tissues have rarely been reported. In this study, we present the first case of median nerve injury due to high-pressure water jet injection by a water spray gun. PMID:26815059

  1. Carpal tunnel syndrome due to a plexiform neurofibroma of the median nerve in a neurofibromatosis type 1 patient: clinical approach

    OpenAIRE

    Freitas, Daniel; Aido, Ricardo; Sousa, Marco; Costa, Luís; Oliveira, Vânia; Cardoso, Pedro

    2013-01-01

    The authors report the case of a 56-year-old male patient with neurofibromatosis type 1 (NF1) diagnosed during adolescence and with an insidious clinical evolution, characterised by an exuberant cutaneous involvement, referred to the orthopaedics outpatient clinic presenting with carpal tunnel syndrome secondary to a plexiform neurofibroma of the median nerve. A comprehensive clinical approach is discussed, considering the natural history of the disease and its potential complications, as wel...

  2. Topography of human ankle joint: focused on posterior tibial artery and tibial nerve

    OpenAIRE

    Kim, Deog-Im; Kim, Yi-Suk; Han, Seung-Ho

    2015-01-01

    Most of foot pain occurs by the entrapment of the tibial nerve and its branches. Some studies have reported the location of the tibial nerve; however, textbooks and researches have not described the posterior tibial artery and the relationship between the tibal nerve and the posterior tibial artery in detail. The purpose of this study was to analyze the location of neurovascular structures and bifurcations of the nerve and artery in the ankle region based on the anatomical landmarks. Ninety f...

  3. Median and Ulnar Nerve Injuries in Children and Adolescents- Long-term outcome and Cerebral reorganisation

    OpenAIRE

    Chemnitz, Anette

    2013-01-01

    A peripheral nerve injury may lead to serious disability and influence the individual´s quality of life. It is considered that children can regain better sensory and motor function after a peripheral nerve injury, but the exact mechanism behind such superior recovery is not known. The aim of the thesis was to study the long-term clinical outcome after a peripheral nerve injury in patients injured in childhood and adolescence and to relate the clinical outcome to changes in the central and ...

  4. MR neurography of the median nerve at 3.0 T: Optimization of diffusion tensor imaging and fiber tractography

    International Nuclear Information System (INIS)

    Objectives: The purpose of this study was to systematically assess the optimal b-value and reconstruction parameters for DTI and fiber tractography of the median nerve at 3.0 T. Methods: Local ethical board approved study with 45 healthy volunteers (15 men, 30 women; mean age, 41 ± 3.4 years) who underwent DTI of the right wrist at 3.0 T. A single-shot echo-planar-imaging sequence (TR/TE 10123/40 ms) was acquired at four different b-values (800, 1000, 1200, and 1400 s/mm2). Two independent readers performed post processing and fiber-tractography. Fractional anisotropy (FA) maps were calculated. Fiber tracts of the median nerve were generated using four different algorithms containing different FA thresholds and different angulation tolerances. Data were evaluated quantitatively and qualitatively. Results: Tracking algorithms using a minimum FA threshold of 0.2 and a maximum angulation of 10° were significantly better than other algorithms. Fiber tractography generated significantly longer fibers in DTI acquisitions with higher b-values (1200 and 1400 s/mm2 versus 800 s/mm2; p 2 (p 2 for DTI of the median nerve at 3.0 T. Optimal reconstruction parameters for fiber tractography should encompass a minimum FA threshold of 0.2 and a maximum angulation tolerance of 10.

  5. Diffusion tensor imaging of the median nerve: intra-, inter-reader agreement, and agreement between two software packages

    International Nuclear Information System (INIS)

    To assess intra-, inter-reader agreement, and the agreement between two software packages for magnetic resonance diffusion tensor imaging (DTI) measurements of the median nerve. Fifteen healthy volunteers (seven men, eight women; mean age, 31.2 years) underwent DTI of both wrists at 1.5 T. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the median nerve were measured by three readers using two commonly used software packages. Measurements were repeated by two readers after 6 weeks. Intraclass correlation coefficients (ICC) and Bland-Altman analysis were used for statistical analysis. ICCs for intra-reader agreement ranged from 0.87 to 0.99, for inter-reader agreement from 0.62 to 0.83, and between the two software packages from 0.63 to 0.82. Bland-Altman analysis showed no differences for intra- and inter-reader agreement and agreement between software packages. The intra-, inter-reader, and agreement between software packages for DTI measurements of the median nerve were moderate to substantial suggesting that user- and software-dependent factors contribute little to variance in DTI measurements. (orig.)

  6. Recurrent isolated abducens nerve paresis associated with persistent trigeminal artery variant.

    Science.gov (United States)

    Nakamagoe, Kiyotaka; Mamada, Naomi; Shiigai, Masanari; Shimizu, Kotone; Koganezawa, Tadachika; Tamaoka, Akira

    2012-01-01

    We report a 74-year-old woman who presented with recurrent isolated abducens nerve paresis. Cranial magnetic resonance imaging revealed that the right abducens nerve was sandwiched between the right internal carotid artery and a persistent trigeminal artery (PTA) variant, which might have led to neurovascular compression of the abducens nerve, resulting in abducens nerve damage. Normal variants of PTA, which are cerebellar arteries originating from a precavernous portion of the internal carotid artery, must be carefully observed as such variants can potentially cause a neurovascular compression of the abducens nerve. PMID:22892506

  7. The best cutoff point for median nerve cross sectional area at the level of carpal tunnel inlet.

    Directory of Open Access Journals (Sweden)

    Payam Sarraf

    2014-08-01

    Full Text Available Carpal tunnel syndrome (CTS is the most common entrapment neuropathy. It accounts 90% of all entrapment neuropathies all over the world. Ultrasound is a non-invasive, cost effective and available para-clinical method which could be applied for CTS diagnosis. Cross-sectional area of the median nerve at the level of the inlet is considered as a diagnostic criterion in CTS cases. In this study, thirty-eight patients with electrophysiologically confirmed idiopathic CTS and 22 healthy controls were enrolled. Seventy-one affected nerves and 42 unaffected nerves were evaluated within 14 days after electrophysiological examination. The largest cross-sectional area (CSA was measured at the level of the carpal tunnel inlet and the maximum nerve perimeter was also recorded by means of the software. Mean CSA and perimeter were 14.02 ± 4.5 mm2 and 1.7±0.28m in all patients and 8.2±2.1 mm2, 1.3±0.19 m in controls (P<0.001, P<0.001. Mean CSA and Perimeter were significantly different between patient's groups and control. The best cut off point for CSA of the tunnel inlet was 10.5 mm2 with sensitivity and specificity of 80% and 76% (AUC (Area under the Curve = 0.9, P<0.001. The best cut off point for inlet perimeter was 1.44 m with sensitivity and specificity of 85% and 77 % (AUC=0.87, P<0.001. Our findings showed that median nerve CSA at carpal tunnel inlet could be used as the diagnostic criteria for CTS.

  8. Validity of F-wave minimal latency of median and ulnar nerves for diagnosis and severity assessment of carpal tunnel syndrome in type II diabetes mellitus

    International Nuclear Information System (INIS)

    Type II diabetes mellitus is a common problem and is sometimes associated with Carpal Tunnel Syndrome (CTS) due to compression of median nerve at wrist. Electrophysiological tests are frequently used for its diagnosis. In this work, F-wave minimal latency (FWML) difference between median and ulnar nerve and F-ratio is used to facilitate the diagnosis and severity of CTS in type II diabetes mellitus (T2DM). Methods: Thirty control cases were selected who were physically fit for normal electrophysiological values. Thirty-two patients with a long history of type II diabetes mellitus were studied for electro-diagnostic tests. All patients had clinical evidence of CTS. Among all diabetics about 20 cases had poor glycaemic control (HbA1c>7.5). F-wave minimal latency (FWML) were measured in median and ulnar nerves and F-ratio of median nerve were also noted. The mean values in different groups were compared using t-test and p greater or equal to 0.05 was considered significant. Results: In control group, the ulnar FWML was either equal or slightly longer that the median FWML value. In CTS group with type II diabetes mellitus the FWML value of median nerve were significantly longer than FWML of the ulnar nerve. Moreover, in uncontrolled diabetic patients the FWML values was very much longer than controlled group. Similarly the F-ratio of median nerve was significantly low. Conclusion: In addition to the specific criteria for CTS diagnosis, the parameters like FWML difference in median and ulnar nerve with reduced F-ratio of median nerve can be useful in establishing the diagnosis and severity of CTS in type II diabetes mellitus. (author)

  9. Examining the effects of age, sex, and body mass index on normative median motor nerve excitability measurements.

    LENUS (Irish Health Repository)

    McHugh, John C

    2012-02-01

    OBJECTIVES: The purpose of this study was to build a large reference database of excitability measures in normal subjects and to examine the effects of age, sex, and BMI. METHODS: One hundred and five healthy subjects had median motor nerve excitability testing performed at the wrist using the automated threshold-tracking program, QTRAC. Statistical linear regression was used to explore relationships between nerve excitability and the independent variables. RESULTS: The main effect of age is a reduced superexcitability. Lesser effects are flattening of the normalized stimulus response curve and reduction in threshold change following strong hyperpolarizing currents. Females have lower thresholds than males and small but significant differences in voltage-gated potassium channel (KCNQ) mediated properties (late subexcitability, accommodation half time, and threshold undershoot following depolarizing electrotonus), as well as a small increase in superexcitability. BMI has no influence on nerve excitability data and does not explain sex-related differences in threshold. CONCLUSIONS: Age and sex have few and small effects on excitability parameters. SIGNIFICANCE: The expression of nodal KCNQ channels appears to be greater in females. Age-related increases in subexcitability may be attributable to changes in the muscle fibre and not the nerve.

  10. Enhancement of Median Nerve Regeneration by Mesenchymal Stem Cells Engraftment in an Absorbable Conduit: Improvement of Peripheral Nerve Morphology with Enlargement of Somatosensory Cortical Representation.

    Directory of Open Access Journals (Sweden)

    Julia Teixeira Oliveira

    2014-10-01

    Full Text Available We studied the morphology and the cortical representation of the median nerve (MN, 10 weeks after a transection immediately followed by treatment with tubulization using a polycaprolactone (PCL conduit with or without bone marrow-derived mesenchymal stem cell (MSC transplant. In order to characterize the cutaneous representation of MN inputs in primary somatosensory cortex (S1, electrophysiological cortical mapping of the somatosensory representation of the forepaw and adjacent body parts was performed after acute lesion of all brachial plexus nerves, except for the MN. This was performed in ten adult male Wistar rats randomly assigned in 3 groups: MN Intact (n=4, PCL-Only (n=3 and PCL+MSC (n=3. Ten weeks before mapping procedures in animals from PCL-Only and PCL+MSC groups, animal were subjected to MN transection with removal of a 4-mm-long segment, immediately followed by suturing a PCL conduit to the nerve stumps with (PCL+MSC group or without (PCL-Only group injection of MSC into the conduit. After mapping the representation of the MN in S1, animals had a segment of the regenerated nerve processed for light and transmission electron microscopy. For histomorphometric analysis of the nerve segment, sample size was increased to 5 animals per experimental group. The PCL+MSC group presented a higher number of myelinated fibers and a larger cortical representation of MN inputs in S1 (3,383±390 fibers; 2.3 mm2, respectively than the PCL-Only group (2,226±575 fibers; 1.6 mm2. In conclusion, MSC-based therapy associated with PCL conduits can improve MN regeneration. This treatment seems to rescue the nerve representation in S1, thus minimizing the stabilization of new representations of adjacent body parts in regions previously responsive to the MN.

  11. Carpal tunnel syndrome due to a plexiform neurofibroma of the median nerve in a neurofibromatosis type 1 patient: clinical approach.

    Science.gov (United States)

    Freitas, Daniel; Aido, Ricardo; Sousa, Marco; Costa, Luís; Oliveira, Vânia; Cardoso, Pedro

    2013-01-01

    The authors report the case of a 56-year-old male patient with neurofibromatosis type 1 (NF1) diagnosed during adolescence and with an insidious clinical evolution, characterised by an exuberant cutaneous involvement, referred to the orthopaedics outpatient clinic presenting with carpal tunnel syndrome secondary to a plexiform neurofibroma of the median nerve. A comprehensive clinical approach is discussed, considering the natural history of the disease and its potential complications, as well as the lack of consensus regarding standard therapeutic options for the compressive peripheral neuropathies in the NF1 disease. PMID:23853185

  12. Sensory Nerves Determine the Pattern of Arterial Differentiation and Blood Vessel Branching in the Skin

    OpenAIRE

    Mukouyama, Yoh-suke; Shin, Donghun; Britsch, Stefan; Taniguchi, Masahiko; Anderson, David J.

    2002-01-01

    Nerves and blood vessels are branched structures, but whether their branching patterns are established independently or coordinately is not clear. Here we show that arteries, but not veins, are specifically aligned with peripheral nerves in embryonic mouse limb skin. Mutations that eliminate peripheral sensory nerves or Schwann cells prevent proper arteriogenesis, while those that disorganize the nerves maintain the alignment of arteries with misrouted axons. In vitro, sensory neurons or Schw...

  13. Neuropathy of ulnar nerve compression due to ulnar artery pseudo-aneurysm in Guyon's canal

    OpenAIRE

    Inan, Yilmaz; Gulgonen, Ayan; Ozkan, Turker

    2004-01-01

    Ulnar nerve entrapment due to an aneurysm of ulnar artery in the Guyon's canal is rarely described in the Iiterature. This article presents a case of ulnar nerve compression at the Guyon's canal caused by a false aneurysm of the ulnar artery secondary by penetration trauma. The aneurysm is usually Iooked over at the stage of diagnosis and seen as a nerve cut. The most reliable therapeutic method is the anastomosis of arteries' ends by microsurgical technics, after the resection of aneurysm. I...

  14. Comparison of High Resolution Ultrasonography and Nerve Conduction Study in the Diagnosis of Carpal Tunnel Syndrome: Diagnostic Value of Median Nerve Cross-Sectional Area

    Directory of Open Access Journals (Sweden)

    A. Mohammadi

    2009-11-01

    Full Text Available Background/Objective: Carpal tunnel syndrome (CTS is a common peripheral entrapment neuropathy. This study was performed to evaluate whether high-resolution ultrasonography may be an alternative diagnostic method for nerve conduction study (NCS in the diagnosis of carpal tunnel syndrome. "nPatients and Methods: 132 wrists of 82 patients and 152 wrists of controls were enrolled in the study. The cross sectional area of the median nerve was measured at the carpal tunnel inlet and outlet in all patients and controls. All patients had a nerve conduction study. Then comparison between ultrasonography and NCS was performed. Combination of clinical diagnosis and NCS was used as the gold standard. "nResults: The mean cross-sectional area (CSA of the median nerve at the tunnel inlet was 11.4±1.7 mm2 for the patient group and 5.78 ±0.9 mm2 for the control group (P<0.001. The mean cross-sectional area at the tunnel outlet was 9.9±1.2 mm2 for the patient group and 4.7±0.7 mm2 for the control group (P<0.001. The best cut-off value of CSA at the tunnel inlet and the outlet was 7.5 mm2. "nConclusion: In patients with clinical diagnosis of CTS we confirmed that the diagnostic value of ultrasonography is similar to NCS and sonography may be used in primary evaluation of CTS.

  15. Schwannoma of the Median Nerve at the Wrist and Palmar Regions of the Hand: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Harun Kütahya

    2013-01-01

    Full Text Available Schwannomas are also known as neurolemmas that are usually originated from Schwann cells located in the peripheric nerve sheaths. They are the most common tumours of the hand (0.8–2%. They usually present solitary swelling along the course of the nerve however multiple lesions may be present in cases of NF type 1, familial neurofibromatosis, and sporadic schwannomatosis. Schwannomas are generally represented as an asymptomatic mass; however pain, numbness and fatigue may take place with the increasing size of the tumour. EMG (electromyelography, MRI (magnetic resonance imagination, and USG (ultrasound are helpful in the diagnosis. Surgical removal is usually curative. In this paper, we present a 24-year-old male referred to our clinic for a lump located at the volar side of the left wrist and a lump located in his left palm and numbness at his 3rd and 4th fingers. Total excision was performed for both lesions. Histopathological examination of the masses revealed typical features of schwannoma. At the 6th-month followup the patient was symptom-free except for slight paresthesia of the 3rd and the 4th fingers. For our knowledge, this is the second case in the literature presenting wrist and palm involvement of the median nerve schwannoma.

  16. Alternation in F-wave parameters of median nerve from unaffected extremity in stroke patients with hemiplegia under dynamic state

    Institute of Scientific and Technical Information of China (English)

    Hang Zhao; Yong Lin; Wenhua Qi; Shuping Yin; Jiachun Feng

    2006-01-01

    BACKGROUND: For many years, the extremities of stroke patients are divided into affected side and unaffected side according to clinical symptoms and body signs. Moreover, previous rehabilitation function training is developed simply aiming to the dysfunction manifested by unaffected extremity. Problems of unaffected extremity are always ignored, such as left- and right- side connection dysfunction, abnormal muscular tension of unaffected side and so on.OBJECTIVE: To observe neurophysiological change characteristics of unaffected extremity of stroke patients with hemiplegia by electromyographical method.DESIGN: Case-control observation.SETTING: First Hospital, Jilin University.PARTICIPANTS: Eighty stroke patients with hemiplegia confirmed by skull CT or MRI, who firstly hospitalized in the Department of Neurology, First Hospital, Jilin University between July 2004 and March 2005, were retrieved. They were scored > 8 points in Glasgow Coma Scale and had stable vital sign. Nineteen normal persons who received healthy examination in the clinic were involved in normal control group. Following the classification criteria of Brunnstrom's Recovery Stages of Stroke (BRSS), 80 stroke patients with hemiplegia were assigned into 3 groups: BRSS Ⅰ -Ⅱ group (n =36), BRSS Ⅲ-Ⅳ group (n =23) and BRSSⅤ-Ⅵ (n=21).METHODS: F-wave parameters of median nerve of unaffected extremity were detected by electromyographical technique. The recording electrode (muscular belly of abductor pollicis brevis) and reference electrode (first finger bone) were connected with grounding electrode. Stimulating electrode was placed in the median part of wrist joint with stimulation intensity of 130% that of threshold stimulation, stimulation frequency of 2 Hz, current pulse width of 0.2 ms, time course of 5 ms and sensitivity of 2 mV. The F-wave of median nerve of affected extremity under the resting stage (static status) and that of unaffected extremity under the maximum resistant contracted

  17. Anatomical Variations in the Arteries and Nerves of the Right Carotid Triangle

    Directory of Open Access Journals (Sweden)

    Quadros LS

    2014-08-01

    Full Text Available Variations of the arteries and nerves are of clinical importance to the clinicians and surgeons in performing the surgeries. During the routine dissection for the undergraduates, variation in the branches of external carotid artery was noted in the right carotid triangle. The superior thyroid artery showed an upward loop from its origin and had a highly tortuous course, the lingual and facial arteries arouse from a common linguo-facial trunk and the ascending pharyngeal artery took origin from the Internal carotid artery. The ansa cervicalis showed absence of inferior root. The second and third cervical spinal nerves joined the superior root separately.

  18. Assessment of the Kinetic Trajectory of the Median Nerve in the Wrist by High-Frequency Ultrasound

    Directory of Open Access Journals (Sweden)

    Yi-Hsun Lin

    2014-04-01

    Full Text Available Carpal tunnel syndrome (CTS is typically diagnosed by physical examination or nerve conduction measurements. With these diagnostics however it is difficult to obtain anatomical information in the carpal tunnel. To further improve the diagnosis of CTS, an attempt using 30 MHz high-frequency ultrasound to noninvasively detect the local anatomical structures and the kinetic trajectory of the median nerve (MN in the wrist was explored. Measurements were performed on the right wrist of 14 asymptomatic volunteers. The kinetic trajectory of the MN corresponding to flexion (from 0° to 90° and extension (from 90° to 0° movements of the fingers were detected by a cross correlation-based motion tracking technique. The average displacements of the MN according to finger movements were measured to be 3.74 and 2.04 mm for male and female subjects, respectively. Moreover, the kinetic trajectory of the MN in both the ulnar-palmar and total directions generally follows a sigmoidal curve tendency. This study has verified that the use of high-frequency ultrasound imaging and a motion tracking technique to sensitively detect the displacement and kinetic trajectory of the MN for the assessment of CTS patients is feasible.

  19. Anatomical Variations in the Arteries and Nerves of the Right Carotid Triangle

    OpenAIRE

    Quadros LS; Pandey AK; D'Souza AS

    2014-01-01

    Variations of the arteries and nerves are of clinical importance to the clinicians and surgeons in performing the surgeries. During the routine dissection for the undergraduates, variation in the branches of external carotid artery was noted in the right carotid triangle. The superior thyroid artery showed an upward loop from its origin and had a highly tortuous course, the lingual and facial arteries arouse from a common linguo-facial trunk and the ascending pharyngeal artery took origin fro...

  20. Ultrasound assessment of the median nerve: a biomarker that can help in setting a treat to target approach tailored for carpal tunnel syndrome patients.

    Science.gov (United States)

    El Miedany, Yasser; El Gaafary, Maha; Youssef, Sally; Ahmed, Ihab; Nasr, Annie

    2015-01-01

    Ultrasonography (US) is a valuable tool for confirming the diagnosis of carpal tunnel syndrome (CTS) as it enables the detection of changes in the median nerve shape and rule out anatomic variants as well as space-occupying lesions such as ganglion cysts or tenosynovitis. This work was carried out aiming at: 1. Ultrasonography assessment of the median nerve and its neurovascular blood-flow in CTS patients before and after management. 2. Verify the possibility of using baseline US parameters as a biomarker to predict likely outcomes and frame a treatment plan for CTS patients. 233 CTS subjects diagnosed based on clinical and electrophysiological (NCS) testing were included in this work. US measures at the tunnel inlet included: cross sectional area, flattening ratio and neural Power Doppler (PD) signals. Patients who had severe NCS outcomes or neurological deficit were referred for open surgical decompression; the remaining patients were given the choice of either conservative or surgical management. The main outcome variable was improvement >70% in CTS symptoms. Assessments were carried out at baseline, 1-week, 1-month and 6-months post treatment. Results revealed an inverse relation between the neural vasculature and CTS severity defined by NCS (r = - 0.648). In CTS cases treated conservatively, the US measures started to improve within 1-week, whereas in the surgically treated cohort there was an initial phase of post-operative nerve measures increase, before settling at 1-month time of follow-up. The risk of poor outcomes was significantly higher (RR 3.3) in patients with high median nerve flattening ratio. This risk was most marked in the cohort with nerve flattening associated with longer duration of illness (RR 4.3) and low PD signal (RR 4.1). The results revealed that in addition to the diagnostic value of US in CTS, the detection of increased median nerve neuro-vasculature has a good prognostic value as an indicator of early median nerve affection. PMID

  1. Peripheral communications of intercostobrachial nerve Peripheral communications of the intercostobrachial nerve in relation to the alar thoracic artery

    Directory of Open Access Journals (Sweden)

    Shaifaly Madan Rustagi

    2015-01-01

    Full Text Available The intercostobrachial nerve (ICBN is often encountered during axillary dissection for axillary lymph node dissection (ALND for diagnostic and therapeutic surgery for mastectomy. The present report is a case observed in the Department of Anatomy at Vardhman Mahavir Medical College, Delhi during routine dissection of the upper extremity of a male cadaver for first year undergraduate medical students. On the right side , the medial cord of brachial plexus gave two medial cutaneous nerves of arm. Both the nerves were seen communicating with the branches of the ICBN. The ICBN and one of its branches were surrounding the termination of an alar thoracic artery. These peripheral neural connections of the ICBN with the branches of the medial cord can be a cause of sensory impairment during axillary procedures done for mastectomy or exploration of long thoracic nerves. The alar thoracic artery found in relation to the ICBN could further be a cause of vascular complications during such procedures.

  2. Absence of superficial palmar arch with associated anomaly of ulnar artery and nerve: a case report with clinical implications

    OpenAIRE

    Shipra Paul; Srijit Das

    2007-01-01

    Normally the ulnar artery and the ulnar nerve pass superficial to the flexor retinaculum of the wrist. In the present study, we describe an ulnar artery and ulnar nerve which passed deep to the flexor retinaculum and an absent superficial palmar arch. Abnormal course of ulnar nerve and ulnar artery passing deep to the flexor retinaculum with absence of a characteristic superficial palmar arch is a rare finding. The ulnar vessels and nerves when passing deep to the flexor retinaculum are vulne...

  3. The effect of tendon excursion velocity on longitudinal median nerve displacement: differences between carpal tunnel syndrome patients and controls.

    Science.gov (United States)

    Filius, Anika; Thoreson, Andrew R; Wang, Yuexiang; Passe, Sandra M; Zhao, Chunfeng; An, Kai-Nan; Amadio, Peter C

    2015-04-01

    The subsynovial connective tissue (SSCT) is a viscoelastic structure connecting the median nerve (MN) and the flexor tendons in the carpal tunnel. Increased strain rates increases stiffness in viscoelastic tissues, and thereby its capacity to transfer shear load. Therefore, tendon excursion velocity may impact the MN displacement. In carpal tunnel syndrome (CTS) the SSCT is fibrotic and may be ruptured, and this may affect MN motion. In this study, ultrasonography was performed on 14 wrists of healthy controls and 25 wrists of CTS patients during controlled finger motions performed at three different velocities. Longitudinal MN and tendon excursion were assessed using a custom speckle tracking algorithm and compared across the three different velocities. CTS patients exhibited significantly less MN motion than controls (p ≤ 0.002). While in general, MN displacement increased with increasing tendon excursion velocity (p ≤ 0.031). These findings are consistent with current knowledge of SSCT mechanics in CTS, in which in some patients the fibrotic SSCT appears to have ruptured from the tendon surface. PMID:25640903

  4. Repeatability and Minimal Detectable Change in Longitudinal Median Nerve Excursion Measures During Upper Limb Neurodynamic Techniques in a Mixed Population: A Pilot Study Using Musculoskeletal Ultrasound Imaging.

    Science.gov (United States)

    Paquette, Philippe; Lamontagne, Martin; Higgins, Johanne; Gagnon, Dany H

    2015-07-01

    This study determined test-retest reliability and minimum detectable change in longitudinal median nerve excursion during upper limb neurodynamic tests (ULNTs). Seven participants with unilateral or bilateral carpal tunnel syndrome and 11 healthy participants were randomly tested with two ULNTs (i.e., tensioner and slider). Each ULNT was performed three times each at 45° and 90° of shoulder abduction on two separate visits. Video sequences of median nerve excursion, recorded by a physical therapist using ultrasound imaging, were quantified using computer software. The generalizability theory, encompassing a G-Study and a D-study, measured the dependability coefficient (Φ) along with standard error of measurement (SEM) accuracy and allowed various testing protocols to be proposed. The highest reliability (Φ = 0.84) and lowest minimal measurement error (SEM = 0.58 mm) of the longitudinal median nerve excursion were reached during the ULNT-slider performed with 45° of shoulder abduction and when measures obtained from three different image sequences recorded during a single visit were averaged. It is recommended that longitudinal median nerve excursion measures computed from three separate image sequences recorded during a single visit be averaged in clinical practice. Ideally, adding a second visit (six image sequences) is also suggested in research protocols. PMID:25868536

  5. Median nerve neuropathy in the forearm due to recurrence of anterior wrist ganglion that originates from the scaphotrapezial joint: Case Report

    Directory of Open Access Journals (Sweden)

    Okada Kiyoshi

    2012-01-01

    Full Text Available Abstract Background Median nerve neuropathy caused by compression from a tumor in the forearm is rare. Cases with anterior wrist ganglion have high recurrence rates despite surgical treatment. Here, we report the recurrence of an anterior wrist ganglion that originated from the Scaphotrapezial joint due to incomplete resection and that caused median nerve neuropathy in the distal forearm. Case presentation A 47-year-old right-handed housewife noted the appearance of soft swelling on the volar aspect of her left distal forearm, and local resection surgery was performed twice at another hospital. One year after the last surgery, the swelling reappeared and was associated with numbness and pain in the radial volar aspect of the hand. Magnetic resonance imaging revealed that the multicystic lesion originated from the Scaphotrapezial joint and had expanded beyond the wrist. Exploration of the left median nerve showed that it was compressed by a large ovoid cystic lesion at the distal forearm near the proximal end of the carpal tunnel. We resected the cystic lesion to the Scaphotrapezial joint. Her symptoms disappeared 1 week after surgery, and complications or recurrent symptoms were absent 13 months after surgery. Conclusions A typical median nerve compression was caused by incomplete resection of an anterior wrist ganglion, which may have induced widening of the cyst. Cases with anterior wrist ganglion have high recurrence rates and require extra attention in their treatment.

  6. Pseudoaneurysm of the cervical internal carotid artery with associated hypoglossal nerve paralysis

    International Nuclear Information System (INIS)

    A case of pseudoaneurysm of the cervical internal carotid artery with associated hypoglossal nerve paralysis resulting from trauma is presented. CT and angiographic manifestations of this pseudoaneurysm and the resulting hypoglossal nerve paralysis are discussed. Correlative CT and angiographic findings of this association have not previously been described in the literature. (orig.)

  7. Ultrasonographic assessment of carpal tunnel syndrome of mild and moderate severity in diabetic patients by using an 8-point measurement of median nerve cross-sectional areas

    Directory of Open Access Journals (Sweden)

    Chen Shu-Fang

    2012-07-01

    Full Text Available Abstract Background Using high-resolution ultrasonography (US to measure the median nerve cross-sectional areas (CSAs such as in the “inching test” conducted in nerve conduction studies is a valuable tool to assess carpal tunnel syndrome (CTS. However, using this US measurement method to assess the median nerve CSA in diabetic patients with CTS has rarely been reported. Therefore, we used this US measurement method in this study to measure median nerve CSAs and to compare the CSAs of idiopathic, diabetic and diabetic polyneuropathy (DPN patients with CTS. Methods 124 hands belonging to 89 participants were included and assigned into four groups: control (32, idiopathic (38, diabetic (38 and DPN (16 CTS. In the latter two groups, only patients with mild and moderately severe CTS were included. The median nerve CSAs were measured at 8 points marked as i4, i3, i2, i1, w, o1, o2, and o3 in the inching test. The measured CSAs in each group of participants were compared. Results Compared with the CSAs of the control group, enlarged CSAs were found in the idiopathic, diabetic and DPN CTS groups. The CSAs were larger at i4, i3 and i2 in the diabetic CTS group compared to the idiopathic CTS group. The CSAs measured at the i1 and w levels of the DPN CTS group were smaller than those of the diabetic CTS group. In the diabetic CTS group, the cut-off values of CSAs measured at the inlet, wrist crease, and outlet were 15.3 mm2, 13.4 mm2 and 10.0 mm2, respectively, and 14.0 mm2, 12.5 mm2 and 10.5 mm2, respectively, in the DPN CTS group. Conclusions Compared with the median nerve CSAs of the control and idiopathic CTS groups, the median nerve CSAs of the diabetic patients with CTS were significantly enlarged. However, compared with the diabetic CTS group, the CSAs were significantly smaller in the DPN CTS group. This US 8-point measurement method can be of value as an important complementary tool for CTS studies and diagnosis among diabetic

  8. [Spontaneous dissection of the internal carotid artery: description of a case with lower cranial nerve palsy].

    Science.gov (United States)

    Macarini, Luca; Zeppa, Pio; Genovese, Eugenio Annibale; Scialpi, Michele; Raucci, Antonio

    2012-11-01

    Spontaneous dissection of the extracranial internal carotid artery is a well recognized cause of headache and juvenile stroke; lower cranial nerve palsy as a complication of dissection is rare. We report the case of a female patient with bilateral dissecting aneurysm of the internal carotid artery, associated with unilateral cranial nerve XII palsy and oculosympathetic palsy. Neuroradiological findings, in particular those obtained by Magnetic Resonance imaging, allow the identification of the dissecting pathology and the correlation of the aneurysmal formation with nerve palsy. PMID:23096747

  9. The relationship between the deep fibular nerve and the dorsalis pedis artery and its surgical importance

    Directory of Open Access Journals (Sweden)

    Chitra R

    2009-01-01

    Full Text Available The aim of this study was to demonstrate the relationship between the deep fibular nerve and the dorsalis pedis artery to provide useful anatomical knowledge for safe surgical approaches in plastic surgery. The dissection of 30 cadaver lower limbs was undertaken to describe the relationship of the deep fibular nerve to the dorsalis pedis artery in the anterior tarsal tunnel and on the dorsum of the foot. The anterior tarsal tunnel is a flattened space between the inferior extensor retinaculum and the fascia overlying the talus and navicular. The deep fibular nerve and its branches pass longitudinally through this fibro-osseous tunnel, deep to the tendons of the extensor hallucis longus and extensor digitorum longus. Four distinct relationships of the deep fibular nerve to the dorsalis pedis artery were determined. The dorsalis pedis neurovascular island flap contains both the dorsalis pedis artery and the deep fibular nerve. Because the design of a neurovascular free flap requires detailed knowledge of the nerve and vascular supply, the data presented here are intended to help surgeons during surgical approaches to the foot and ankle.

  10. Primary study on median nerve stimulation therapy in improving the level of consciousness of patients in coma caused by head traumas

    International Nuclear Information System (INIS)

    Objective: To investigate the therapeutic effect of median nerve stimulation in improving the level of consciousness of patients in coma caused by severe head traumas and the possible mechanism of its hastening awakening from coma. Methods: 30 unconscious patients with severe brain traumas were randomly assigned to the treated group (n=15) and the control group (n=15). The patients in the control group were treated routinely. Besides routine therapy the patients in the treated group were treated with median nerve electrical stimulation. As the treated group were treated with initial stimulation, SPECT brain perfusion imaging was performed before and after 30 minutes' median nerve electrical stimulation under the same condition. The changes of the regional cerebral blood flow (rCBF) of lesion spot of brain were compared and analysed with visual method and semi-quantitative method in BFCK% mathematical model. A week after stimulation authors assess the therapeutic effect in the two groups with GCS scores. Results: The patients in the treated group's rCBF of the lesion spot increased significantly after stimulation. A week later the patients in the treated group had improved by average of 4.8 on the GCS in contrast to 2.0 on the GCS in the control group which showed that the GCS scores of the two groups had significant difference (P<0.05). Conclusion: The median nerve electrical stimulation can improve the level of consciousness of patients in coma caused by severe head traumas. The increase of rCBF of lesion spot of brain can be one of mechanisms of its hastening awakening from coma

  11. Schwannoma of the Median Nerve at the Wrist and Palmar Regions of the Hand: A Rare Case Report

    OpenAIRE

    Harun Kütahya; Ali Güleç; Yunus Güzel; Burkay Kacira; Serdar Toker

    2013-01-01

    Schwannomas are also known as neurolemmas that are usually originated from Schwann cells located in the peripheric nerve sheaths. They are the most common tumours of the hand (0.8–2%). They usually present solitary swelling along the course of the nerve however multiple lesions may be present in cases of NF type 1, familial neurofibromatosis, and sporadic schwannomatosis. Schwannomas are generally represented as an asymptomatic mass; however pain, numbness and fatigue may take place with the ...

  12. Microsurgical decompression of the median nerves for treating diabetic peripheral neuropathy in the upper limbs: A 21-month follow-up

    Institute of Scientific and Technical Information of China (English)

    Peng Lin; Li Zhang; Yanbing Yu; Xiaoli Xu; Jiang Liu; Fang Li; Jun Xu

    2007-01-01

    BACKGROUND: Peripheral nerve injured by abnormal glucose metabolism is compressed, which is an important etiological factor of diabetic peripheral neuropathy (DPN). Microsurgical decompression of peripheral nerve maybe effectively releases the symptoms of DPN.OBJECTIVE: To investigate the curative effects of microsurgical decompression of median nerves for treatment of DPN in upper limbs.DESIGN: Case-follow up observation.SETTING: Department of Orthopaedics, Department of Neurosurgery, China-Japan Friendship Hospital,Ministry of Health.PARTICIPANTS: Twelve patients with DPN in upper limbs (19 hands) who received treatment in the Department of Orthopaedics, Department of Neurosurgery, China-Japan Friendship Hospital, Ministry of Public Health between March 2004 and July 2006 were involved in this experiment. The involved patients, 5 male and 7 female, were aged 44 to 77 years, with DPN course of 6 months to 16 years. They all met 1999 WHO diabetic diagnosis criteria. Both two hands had symptom in 7 patients, and only one hand had symptom in 5 patients. Informed consents of detected items were obtained from all the patients, who also received 21 months of follow-up treatment.microscope, transverse carpal ligament was exposed. Subsequently, transverse carpal ligament, forearm superficial fascia and palmar aponeurosis were fully liberated, and then part of them was cut off. Connective tissue around median nerve, superficial flexor muscle of fingers, radial flexor, palmaris longus and other flexor tendons were completely loosened. Finally, epineurium was opened with microinstrument for neurolysis. After tourniquet was loosened, and bipolar coagulator was used to stop bleeding, and the incision distance of two normal points was 3 to 6 mm), nerve conduction velocity and action potential amplitude (short abductor muscle of thumb end Lat < 4.5 ms; Motor nerve conduction velocity of forearm > 50 m/s),etc. of all the patients were followed up.MAIN OUTCOME MEASURES: The

  13. Arterial compression of nerve is the primary cause of trigeminal neuralgia

    OpenAIRE

    Chen, Guo-Qiang; Wang, Xiao-Song; Wang, Lin; Zheng, Jia-ping

    2013-01-01

    Whether arterial or venous compression or arachnoid adhesions are primarily responsible for compression of the trigeminal nerve in patients with trigeminal neuralgia is unclear. The aim of this study was to determine the causes of trigeminal nerve compression in patients with trigeminal neuralgia. The surgical findings in patients with trigeminal neuralgia who were treated by micro vascular decompression were compared to those in patients with hemifacial spasm without any signs or symptoms of...

  14. Accelerated magnetic resonance diffusion tensor imaging of the median nerve using simultaneous multi-slice echo planar imaging with blipped CAIPIRINHA

    Energy Technology Data Exchange (ETDEWEB)

    Filli, Lukas; Kenkel, David; Boss, Andreas; Manoliu, Andrei; Andreisek, Gustav; Runge, Val M.; Guggenberger, Roman [University Hospital of Zurich, University of Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Piccirelli, Marco [University Hospital of Zurich, Department of Neuroradiology, Zurich (Switzerland); Bhat, Himanshu [Siemens Medical Solutions USA Inc, Charlestown, MA (United States)

    2016-06-15

    To investigate the feasibility of MR diffusion tensor imaging (DTI) of the median nerve using simultaneous multi-slice echo planar imaging (EPI) with blipped CAIPIRINHA. After federal ethics board approval, MR imaging of the median nerves of eight healthy volunteers (mean age, 29.4 years; range, 25-32) was performed at 3 T using a 16-channel hand/wrist coil. An EPI sequence (b-value, 1,000 s/mm{sup 2}; 20 gradient directions) was acquired without acceleration as well as with twofold and threefold slice acceleration. Fractional anisotropy (FA), mean diffusivity (MD) and quality of nerve tractography (number of tracks, average track length, track homogeneity, anatomical accuracy) were compared between the acquisitions using multivariate ANOVA and the Kruskal-Wallis test. Acquisition time was 6:08 min for standard DTI, 3:38 min for twofold and 2:31 min for threefold acceleration. No differences were found regarding FA (standard DTI: 0.620 ± 0.058; twofold acceleration: 0.642 ± 0.058; threefold acceleration: 0.644 ± 0.061; p ≥ 0.217) and MD (standard DTI: 1.076 ± 0.080 mm{sup 2}/s; twofold acceleration: 1.016 ± 0.123 mm{sup 2}/s; threefold acceleration: 0.979 ± 0.153 mm{sup 2}/s; p ≥ 0.074). Twofold acceleration yielded similar tractography quality compared to standard DTI (p > 0.05). With threefold acceleration, however, average track length and track homogeneity decreased (p = 0.004-0.021). Accelerated DTI of the median nerve is feasible. Twofold acceleration yields similar results to standard DTI. (orig.)

  15. Anatomical and clinical study of median nerve entrapment at the elbow%肘部正中神经卡压解剖与临床研究

    Institute of Scientific and Technical Information of China (English)

    刘鹏程; 王克利; 宫旭; 路来金; 崔建礼; 蒋子平

    2013-01-01

    Objective To provide anatomic and clinical basis for diagnosis and treatment of median nerve entrapment at the elbow.Methods Microanatomical dissection of the median nerve was done in 10 cadaver upper limb specimens to observe the anatomical factors that cause compression of the median nerve at the elbow and shape of the median nerve.Case analysis was conducted in 14 patients with median nerve entrapment at the elbow who were treated in our department.Results Anatomic studies in the 10 dissected specimens showed three types of relationship between the bicepital aponeurosis and median nerve:complete-covering (2 specimens,20%),partial-covering (1 specimen,10%) and non-covering (7 specimens,70%).Thickened fascia in the superficial layer of pronator teres ulnar head was seen in 9 specimem (90%).Intramuscular tendinous bundles in the anconeus were observed in 2 specimem (20%).The reverse fascia that traversed the median nerve was seen in 6 specimens (60%).The structures of the origins of two heads of the flexor digitorum superficialis (FDS) had three types:intramuscular tendinous bundle (1 specimen,10%),fibrous arch (1 specimen,10%),and conjoined tendinous arch (8 specimens,80%).Of the 14 patients who had median nerve entrapment at the elbow,5 were diagnosed as pronator teres syndrome while 9 were diagnosed as anterior interosseous nerve(AIN) compression.The compression points in the pronator syndrome cases were ulnar side of the thickened and taut bicepital aponeurosis (2 cases),deep tendinous arch of pronator teres (2 cases),and between two heads of pronator teres (1 case).The compression points in the AIN compression cases were deep tendinous arch of pronator teres (2 cases),ulnar head of pronator teres (1 case),between two heads of pronator teres (1 case),and thickened and taut FDS origin (5 cases).Six patients were follow-up.The average follow-up time was 2 years and 4 months.Good to excellent recovery of motor function was achieved in these

  16. Arterial catecholamine levels in morphine-treated rats subjected to sympathetic nerve stimulation.

    OpenAIRE

    Leung, C. M.; S. Dai; Ogle, C. W.

    1989-01-01

    1. The effect of acute or chronic morphine treatment on the changes in arterial noradrenaline and adrenaline levels in response to sympathetic nerve stimulation was studied in rats. 2. Rats which had been chronically treated with morphine in their drinking fluid for 21 days were shown to be morphine-tolerant, as revealed by the tail-immersion test for analgesia. 3. It was found that animals given either acute or chronic morphine treatment had similar basal concentrations of arterial catechola...

  17. Additional Muscle Slip of Flexor Carpi Ulnaris Associated with Anomalous Ulnar Nerve and Ulnar Artery in the Distal Forearm Fascículo Adicional del Músculo Flexor Ulnar del Carpo Asociado con una Variación del Nervio Ulnar y Arteria Ulnar en la Parte Distal del Antebrazo

    OpenAIRE

    Venkata Ramana Vollala; Seetharama Bhat; Vincent Rodrigues; Deepthinath Prasad; Narendra Pamidi

    2008-01-01

    During routine dissection classes to under gradúate medical students, we observed an anomalous flexor carpi ulnaris muscle associated with abnormal ulnar nerve and ulnar artery in the distal part of forearm. There was an additional belly arising from the lower part of the flexor carpi ulnaris muscle and crossed ulnar nerve and vessels, median nerve and ended in a broad aponeurosis which crossed the tendons of flexor digitorum superficialis and merged with the deep f ascia and flexor retinacul...

  18. Serious axillary nerve injury caused by subscapular artery compression resulting from use of backpacks.

    Science.gov (United States)

    Haninec, Pavel; Mencl, Libor; Bačinský, Peter; Kaiser, Radek

    2013-12-01

    A palsy of the brachial plexus elements caused by carrying a heavy backpack is a very rare injury usually occurring in soldiers or hikers, and recovery is usually spontaneous. We describe here the case of male civilian presenting with an isolated serious axillary nerve palsy associated with chronic backpack use. During the surgery, a dumbbell-shaped neuroma-in-continuity was found which was caused by direct pressure from the subscapular artery. After resection of the neuroma, a nerve graft from the sural nerve was used to reconstruct the nerve. Reinnervation was successful and the patient was able to abduct his arm to its full range, with full muscle strength, within 24 months. PMID:23696291

  19. Pudendal Nerve and Internal Pudendal Artery Damage May Contribute to Radiation-Induced Erectile Dysfunction

    International Nuclear Information System (INIS)

    Purpose/Objectives: Erectile dysfunction is common after radiation therapy for prostate cancer; yet, the etiopathology of radiation-induced erectile dysfunction (RI-ED) remains poorly understood. A novel animal model was developed to study RI-ED, wherein stereotactic body radiation therapy (SBRT) was used to irradiate the prostate, neurovascular bundles (NVB), and penile bulb (PB) of dogs. The purpose was to describe vascular and neurogenic injuries after the irradiation of only the NVB or the PB, and after irradiation of all 3 sites (prostate, NVB, and PB) with varying doses of radiation. Methods and Materials: Dogs were treated with 50, 40, or 30 Gy to the prostate, NVB, and PB, or 50 Gy to either the NVB or the PB, by 5-fraction SBRT. Electrophysiologic studies of the pudendal nerve and bulbospongiosus muscles and ultrasound studies of pelvic perfusion were performed before and after SBRT. The results of these bioassays were correlated with histopathologic changes. Results: SBRT caused slowing of the systolic rise time, which corresponded to decreased arterial patency. Alterations in the response of the internal pudendal artery to vasoactive drugs were observed, wherein SBRT caused a paradoxical response to papaverine, slowing the systolic rise time after 40 and 50 Gy; these changes appeared to have some dose dependency. The neurofilament content of penile nerves was also decreased at high doses and was more profound when the PB was irradiated than when the NVB was irradiated. These findings are coincident with slowing of motor nerve conduction velocities in the pudendal nerve after SBRT. Conclusions: This is the first report in which prostatic irradiation was shown to cause morphologic arterial damage that was coincident with altered internal pudendal arterial tone, and in which decreased motor function in the pudendal nerve was attributed to axonal degeneration and loss. Further investigation of the role played by damage to these structures in RI-ED is

  20. Pudendal Nerve and Internal Pudendal Artery Damage May Contribute to Radiation-Induced Erectile Dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Nolan, Michael W., E-mail: mwnolan@ncsu.edu [Department of Clinical Sciences, and Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, North Carolina (United States); Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States); Marolf, Angela J. [Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States); Ehrhart, E.J. [Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado (United States); Rao, Sangeeta [Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado (United States); Kraft, Susan L. [Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States); Engel, Stephanie [Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado (United States); Yoshikawa, Hiroto; Golden, Anne E. [Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States); Wasserman, Todd H. [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); LaRue, Susan M. [Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States)

    2015-03-15

    Purpose/Objectives: Erectile dysfunction is common after radiation therapy for prostate cancer; yet, the etiopathology of radiation-induced erectile dysfunction (RI-ED) remains poorly understood. A novel animal model was developed to study RI-ED, wherein stereotactic body radiation therapy (SBRT) was used to irradiate the prostate, neurovascular bundles (NVB), and penile bulb (PB) of dogs. The purpose was to describe vascular and neurogenic injuries after the irradiation of only the NVB or the PB, and after irradiation of all 3 sites (prostate, NVB, and PB) with varying doses of radiation. Methods and Materials: Dogs were treated with 50, 40, or 30 Gy to the prostate, NVB, and PB, or 50 Gy to either the NVB or the PB, by 5-fraction SBRT. Electrophysiologic studies of the pudendal nerve and bulbospongiosus muscles and ultrasound studies of pelvic perfusion were performed before and after SBRT. The results of these bioassays were correlated with histopathologic changes. Results: SBRT caused slowing of the systolic rise time, which corresponded to decreased arterial patency. Alterations in the response of the internal pudendal artery to vasoactive drugs were observed, wherein SBRT caused a paradoxical response to papaverine, slowing the systolic rise time after 40 and 50 Gy; these changes appeared to have some dose dependency. The neurofilament content of penile nerves was also decreased at high doses and was more profound when the PB was irradiated than when the NVB was irradiated. These findings are coincident with slowing of motor nerve conduction velocities in the pudendal nerve after SBRT. Conclusions: This is the first report in which prostatic irradiation was shown to cause morphologic arterial damage that was coincident with altered internal pudendal arterial tone, and in which decreased motor function in the pudendal nerve was attributed to axonal degeneration and loss. Further investigation of the role played by damage to these structures in RI-ED is

  1. Ultrasonographic median nerve cross-section areas measured by 8-point "inching test" for idiopathic carpal tunnel syndrome: a correlation of nerve conduction study severity and duration of clinical symptoms

    Directory of Open Access Journals (Sweden)

    Chen Shu-Fang

    2011-12-01

    Full Text Available Abstract Background Incremental palmar stimulation of the median nerve sensory conduction at the wrist, the "inching test", provides an assessment with reference to segments proximal and distal to the entrapment. This study used high-resolution ultrasonography (US to measure the median nerve's cross-section areas (CSAs like the "inching test" and to correlate with the nerve conduction study (NCS severity and duration of carpal tunnel syndrome (CTS. Methods Two hundred and twelve (212 "CTS-hands" from 135 CTS patients and 50 asymptomatic hands ("A-hands" from 25 control individuals were enrolled. The median nerve CSAs were measured at the 8-point marked as i4, i3, i2, i1, w, o1, o2, and 03 in inching test. The NCS severities were classified into six groups based on motor and sensory responses (i.e., negative, minimal, mild, moderate, severe, and extreme. Results of US studies were compared in terms of NCS severity and duration of clinical CTS symptoms. Results There was significantly larger CSA of the NCS negative group of "CTS-hands" than of "A-hands". The cut-off values of the CSAs of the NCS negative CTS group were 12.5 mm2, 11.5 mm2 and 10.1 mm2 at the inlet, wrist crease, and outlet, respectively. Of the 212 "CTS-hands", 32 were NCS negative while 40 had minimal, 43 mild, 85 moderate, 10 severe, and two extreme NCS severities. The CSAs of "CTS-hands" positively correlated with different NCS severities and with the duration of CTS symptoms. By duration of clinical symptoms, 12 of the 212 "CTS-hands" were in the 1 month group; 82 in >1 month and ≤12 months group, and 118 in >12 months group. In "inching test", segments i4-i3 and i3-i2 were the most common "positive-site". The corresponding CSAs measured at i4 and i3, but not at i2, were significantly larger than those measured at points that were not "positive-site". Conclusions Using the 8-point measurement of the median nerve CSA from inlet to outlet similar to the "inching test" has

  2. Ultrasonographic median nerve cross-section areas measured by 8-point 'inching test' for idiopathic carpal tunnel syndrome: a correlation of nerve conduction study severity and duration of clinical symptoms

    International Nuclear Information System (INIS)

    Incremental palmar stimulation of the median nerve sensory conduction at the wrist, the 'inching test', provides an assessment with reference to segments proximal and distal to the entrapment. This study used high-resolution ultrasonography (US) to measure the median nerve's cross-section areas (CSAs) like the 'inching test' and to correlate with the nerve conduction study (NCS) severity and duration of carpal tunnel syndrome (CTS). Two hundred and twelve (212) 'CTS-hands' from 135 CTS patients and 50 asymptomatic hands ('A-hands') from 25 control individuals were enrolled. The median nerve CSAs were measured at the 8-point marked as i4, i3, i2, i1, w, o1, o2, and 03 in inching test. The NCS severities were classified into six groups based on motor and sensory responses (i.e., negative, minimal, mild, moderate, severe, and extreme). Results of US studies were compared in terms of NCS severity and duration of clinical CTS symptoms. There was significantly larger CSA of the NCS negative group of 'CTS-hands' than of 'A-hands'. The cut-off values of the CSAs of the NCS negative CTS group were 12.5 mm2, 11.5 mm2 and 10.1 mm2 at the inlet, wrist crease, and outlet, respectively. Of the 212 'CTS-hands', 32 were NCS negative while 40 had minimal, 43 mild, 85 moderate, 10 severe, and two extreme NCS severities. The CSAs of 'CTS-hands' positively correlated with different NCS severities and with the duration of CTS symptoms. By duration of clinical symptoms, 12 of the 212 'CTS-hands' were in the 1 month group; 82 in >1 month and ≤12 months group, and 118 in >12 months group. In 'inching test', segments i4-i3 and i3-i2 were the most common 'positive-site'. The corresponding CSAs measured at i4 and i3, but not at i2, were significantly larger than those measured at points that were not 'positive-site'. Using the 8-point measurement of the median nerve

  3. Sural nerve preservation in reverse sural artery fasciocutaneous flap-a case report

    Directory of Open Access Journals (Sweden)

    Esezobor Emmanuel E

    2012-10-01

    Full Text Available Abstract Background The reverse sural artery flap is a generally accepted means of soft tissue reconstruction for defects of the distal third of the legs. The routine sacrifice of the sural nerve with its consequential temporary loss of sensation on the lateral aspect of the foot can be of concern to early rehabilitation of some patients. Method This is a case report of a 24 years old male who had Gustillo and Anderson type IIIB injury involving the upper part of the distal 3rd and the middle 3rd of tibia. A reverse sural artery flap was raised without transecting the sural nerve to cover the distal part of the defect. Result The distal part of the exposed bone was covered with the reverse sural artery flap without loss of sensation at anytime to the lateral part of the foot. Conclusion The reverse sural artery flap can be raised to cover the upper portion of the distal leg without severing the sural nerve.

  4. Aligned Nanofibers for Regenerating Arteries, Nerves, and Muscles

    Science.gov (United States)

    McClendon, Mark Trosper

    Cells are the fundamental unit of the human body, and therefore the ability to control cell behavior is the most important challenge in regenerative medicine. Peptides are the language of biology which is why synthetic peptide amphiphile (PA) molecules hold great potential as a biomaterial. The work presented in this dissertation explores a variety of liquid crystalline PA nanofibers as a means for directing cell growth. Shaping the alignment of these nanofiber networks requires a deep understanding of their rheological properties which presents a difficult challenge as they exist in complex solid and liquid environments. Using PA molecules that self-assemble into high aspect ratio nanofibers and liquid crystalline solutions, this work investigates the influence of shear flow on macroscopic and microscopic nanofiber alignment. To this end, a shear force applied to PA solutions was systematically varied while the alignment was probed using small angle x-ray scattering. Nanofibers were found to respond to shear flow by aligning parallel to the flow direction. By changing pH and PA chemical sequence it was observed that increasing the interfiber electrostatic repulsive interactions resulted in a greater dependence on shear rate. Nanofiber solutions having greater repulsion did not drastically increase in alignment when the applied strain was increased by two orders of magnitude (1 s -1 to 100 s-1), while solutions with nanofibers having less repulsion increased there alignment four fold with the same strain increase. say exactly what you mean by resulted in greater dependence: did it result in fibers aligning under lower shear rates or higher rates--give the results Anionic PA solutions typically used to encapsulate living cells at neutral pH were found to require minimal shear rates, nerve conduits, and these scaffolds were implanted in a rat sciatic nerve model. Histological and behavioral observations confirmed that PA implants sustained regeneration rates

  5. Diffusion tensor imaging of the median nerve at 3.0 T using different MR scanners: Agreement of FA and ADC measurements

    Energy Technology Data Exchange (ETDEWEB)

    Guggenberger, Roman, E-mail: roman.guggenberger@usz.ch [Department of Radiology, University Hospital, Raemistrasse 100, Zurich, 8091 (Switzerland); Nanz, Daniel, E-mail: Daniel.nanz@usz.ch [Department of Radiology, University Hospital, Raemistrasse 100, Zurich, 8091 (Switzerland); Bussmann, Lorenz, E-mail: Lorenz.bussmann@usz.ch [Department of Radiology, University Hospital, Raemistrasse 100, Zurich, 8091 (Switzerland); Chhabra, Avneesh, E-mail: achhabr6@jhmi.edu [The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, 601 North Caroline Street, JHOC 3262, Baltimore, MD, 21287 (United States); Fischer, Michael A., E-mail: michaelalexander.fischer@usz.ch [Department of Radiology, University Hospital, Raemistrasse 100, Zurich, 8091 (Switzerland); Hodler, Jürg, E-mail: juerg.hodler@usz.ch [Department of Radiology, University Hospital, Raemistrasse 100, Zurich, 8091 (Switzerland); Pfirrmann, Christian W.A., E-mail: Christian.pfirrmann@balgrist.ch [Department of Radiology, Balgrist University Hospital, Forchstrasse 340, Zurich, 8008 (Switzerland); Andreisek, Gustav, E-mail: gustav@andreisek.de [Department of Radiology, University Hospital, Raemistrasse 100, Zurich, 8091 (Switzerland)

    2013-10-01

    Objective: To assess the agreement of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the median nerve on 3.0 T MR scanners from different vendors. Materials and methods: IRB approved study including 16 healthy volunteers (9 women; mean age 30.6 ± 5.3 years). Diffusion tensor imaging (DTI) of the dominant wrist was performed on three 3.0 T MR scanners (GE, Siemens, Philips) using similar imaging protocols and vendor-proprietary hard- and software. Intra-, inter-reader and inter-vendor agreements were assessed. Results: ICCs for intra-/inter-reader agreements ranged from 0.843–0.970/0.846–0.956 for FA, and 0.840–0.940/0.726–0.929 for ADC, respectively. ANOVA analysis identified significant differences for FA/ADC measurements among vendors (p < 0.001/p < 0.01, respectively). Overall mean values for FA were 0.63 (SD ± 0.1) and 0.999 × 10{sup −3} mm{sup 2}/s (SD ± 0.134 × 10{sup −3}) for ADC. A significant negative measurement bias was found for FA values from the GE scanner (−0.05 and −0.07) and for ADC values from the Siemens scanner (−0.053 and −0.063 × 10{sup −3} mm{sup 2}/s) as compared to the remainder vendors Conclusion: FA and ADC values of the median nerve obtained on different 3.0 T MR scanners differ significantly, but are in comparison to the standard deviation of absolute values small enough to not have an impact on larger group studies or when substantial diffusion changes can be expected. However, caution is warranted in an individual patient when interpreting diffusion values from different scanner acquisitions.

  6. Diffusion tensor imaging of the median nerve at 3.0 T using different MR scanners: Agreement of FA and ADC measurements

    International Nuclear Information System (INIS)

    Objective: To assess the agreement of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the median nerve on 3.0 T MR scanners from different vendors. Materials and methods: IRB approved study including 16 healthy volunteers (9 women; mean age 30.6 ± 5.3 years). Diffusion tensor imaging (DTI) of the dominant wrist was performed on three 3.0 T MR scanners (GE, Siemens, Philips) using similar imaging protocols and vendor-proprietary hard- and software. Intra-, inter-reader and inter-vendor agreements were assessed. Results: ICCs for intra-/inter-reader agreements ranged from 0.843–0.970/0.846–0.956 for FA, and 0.840–0.940/0.726–0.929 for ADC, respectively. ANOVA analysis identified significant differences for FA/ADC measurements among vendors (p −3 mm2/s (SD ± 0.134 × 10−3) for ADC. A significant negative measurement bias was found for FA values from the GE scanner (−0.05 and −0.07) and for ADC values from the Siemens scanner (−0.053 and −0.063 × 10−3 mm2/s) as compared to the remainder vendors Conclusion: FA and ADC values of the median nerve obtained on different 3.0 T MR scanners differ significantly, but are in comparison to the standard deviation of absolute values small enough to not have an impact on larger group studies or when substantial diffusion changes can be expected. However, caution is warranted in an individual patient when interpreting diffusion values from different scanner acquisitions

  7. Management of carotid Dacron patch infection: a case report using median sternotomy for proximal common carotid artery control and in situ polytetrafluoroethylene grafting.

    Science.gov (United States)

    Illuminati, Giulio; Calio', Francesco G; D'Urso, Antonio; Ceccanei, Gianluca; Pacilè, Maria Antonietta

    2009-01-01

    We report on a 58-year-old male who presented with an enlarging cervical hematoma 3 months following carotid endarterectomy with Dacron patch repair, due to septic disruption of the Dacron patch secondary to presumed infection. The essential features of this case are the control of the proximal common carotid artery gained through a median sternotomy, because the patient was markedly obese with minimal thyromental distance, and the treatment consisting of in situ polytetrafluoroethylene bypass grafting, due to the absence of a suitable autogenous saphenous vein. Median sternotomy is rarely required in case of reintervention for septic false aneurysms and hematomas following carotid endarterectomy but should be considered whenever difficult control of the common carotid artery, when entering the previous cervicotomy, is anticipated. In situ polytetrafluoroethylene grafting can be considered if autogenous vein material is lacking. PMID:19875014

  8. Mechanisms responsible for the effect of median nerve electrical stimulation on traumatic brain injury-induced coma: orexin-A-mediated N-methyl-D-aspartate receptor subunit NR1 upregulation

    Science.gov (United States)

    Feng, Zhen; Du, Qing

    2016-01-01

    Electrical stimulation of the median nerve is a noninvasive technique that facilitates awakening from coma. In rats with traumatic brain injury-induced coma, median nerve stimulation markedly enhances prefrontal cortex expression of orexin-A and its receptor, orexin receptor 1. To further understand the mechanism underlying wakefulness mediated by electrical stimulation of the median nerve, we evaluated its effects on the expression of the N-methyl-D-aspartate receptor subunit NR1 in the prefrontal cortex in rat models of traumatic brain injury-induced coma, using immunohistochemistry and western blot assays. In rats with traumatic brain injury, NR1 expression increased with time after injury. Rats that underwent electrical stimulation of the median nerve (30 Hz, 0.5 ms, 1.0 mA for 15 minutes) showed elevated NR1 expression and greater recovery of consciousness than those without stimulation. These effects were reduced by intracerebroventricular injection of the orexin receptor 1 antagonist SB334867. Our results indicate that electrical stimulation of the median nerve promotes recovery from traumatic brain injury-induced coma by increasing prefrontal cortex NR1 expression via an orexin-A-mediated pathway.

  9. Neurological Study of Radial Nerve Conduction During Endoscopic Radial Artery Harvesting:An Intra‐Operative Evaluation

    Directory of Open Access Journals (Sweden)

    Gianluigi Bisleri

    2014-08-01

    Full Text Available Endoscopic radial artery harvesting (ERAH is a feasible and attractive minimally invasive approach for conduit procurement, however there have been concerns about a potential neurological damage occurring at the harvest limb site secondary to injury of the radial nerve during endoscopic harvesting. We present a case of ERAH in which we evaluated intraoperatively the characteristics of radial nerve conduction by means of electroneuromyography (ENM during harvesting. No pathological changes of nerve conduction were detected at the harvest limb site during surgery and postoperatively, thereby supporting the benefits of the endoscopic approach in terms of neurological outcomes following radial artery procurements with a less invasive approach.

  10. Internal carotid artery aneurysms, cranial nerve dysfunction and headache: the role of deformation and pulsation

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez-Catarino, M.; Wikholm, G.; Svendsen, P. [Interventional Neuroradiology, Sahlgrenska Hospital, Goeteborg (Sweden); Frisen, L. [Ophthalmology Dept., Sahlgrenska Hospital, Goeteborg (Sweden); Elfverson, J. [Neurosurgery Dept., Sahlgrenska Hospital, Goeteborg (Sweden); Quiding, L. [Medical Physics and Biomedical Engineering Dept., Sahlgrenska Hospital, Goeteborg (Sweden)

    2003-04-01

    Cranial nerve dysfunction and headache may occur with unruptured aneurysms of the cavernous and supraclinoid portions of the internal carotid artery. Nerve deformation (mass effect) and transmitted pulsations have been suggested as pathogenetic mechanisms. Differentiation may be possible by studying effects of endovascular treatment with Guglielmi detachable coils. Symptoms and signs of cranial neuropathy were retrospectively contrasted with angiographic aneurysm volumes before and after treatment in 10 patients. Mean follow-up was 36 months. Symptoms improved in three of four patients with cranial nerve dysfunction and in all patients with headache: None of the other patients, one with cranial nerve dysfunction, and three who were asymptomatic, developed any new symptoms after treatment. Aneurysm volume ranged from 0.1 to 2.7 cm{sup 3} before and 0.2 to 5.7 cm{sup 3} after treatment; the size thus increased by 15 to 110%, a change which was statistically significant (P = 0.004). The consistent increase in aneurysm volume with treatment is not associated with clinical deterioration, suggesting that deformation and displacement play a minor role in cranial neuropathy and that transmitted pulsations may be more important. (orig.)

  11. Internal carotid artery aneurysms, cranial nerve dysfunction and headache: the role of deformation and pulsation

    International Nuclear Information System (INIS)

    Cranial nerve dysfunction and headache may occur with unruptured aneurysms of the cavernous and supraclinoid portions of the internal carotid artery. Nerve deformation (mass effect) and transmitted pulsations have been suggested as pathogenetic mechanisms. Differentiation may be possible by studying effects of endovascular treatment with Guglielmi detachable coils. Symptoms and signs of cranial neuropathy were retrospectively contrasted with angiographic aneurysm volumes before and after treatment in 10 patients. Mean follow-up was 36 months. Symptoms improved in three of four patients with cranial nerve dysfunction and in all patients with headache: None of the other patients, one with cranial nerve dysfunction, and three who were asymptomatic, developed any new symptoms after treatment. Aneurysm volume ranged from 0.1 to 2.7 cm3 before and 0.2 to 5.7 cm3 after treatment; the size thus increased by 15 to 110%, a change which was statistically significant (P = 0.004). The consistent increase in aneurysm volume with treatment is not associated with clinical deterioration, suggesting that deformation and displacement play a minor role in cranial neuropathy and that transmitted pulsations may be more important. (orig.)

  12. Toxicity and median effective doses of oxime therapies against percutaneous organophosphorus pesticide and nerve agent challenges in the Hartley guinea pig.

    Science.gov (United States)

    Snider, Thomas H; Babin, Michael C; Jett, David A; Platoff, Gennady E; Yeung, David T

    2016-01-01

    Anticholinesterases, such as organophosphorus pesticides and warfare nerve agents, present a significant health threat. Onset of symptoms after exposure can be rapid, requiring quick-acting, efficacious therapy to mitigate the effects. The goal of the current study was to identify the safest antidote with the highest therapeutic index (TI = oxime 24-hr LD50/oxime ED50) from a panel of four oximes deemed most efficacious in a previous study. The oximes tested were pralidoxime chloride (2-PAM Cl), MMB4 DMS, HLö-7 DMS, and obidoxime Cl2. The 24-hr median lethal dose (LD50) for the four by intramuscular (IM) injection and the median effective dose (ED50) were determined. In the ED50 study, male guinea pigs clipped of hair received 2x LD50 topical challenges of undiluted Russian VX (VR), VX, or phorate oxon (PHO) and, at the onset of cholinergic signs, IM therapy of atropine (0.4 mg/kg) and varying levels of oxime. Survival was assessed at 3 hr after onset clinical signs. The 3-hr 90th percentile dose (ED90) for each oxime was compared to the guinea pig pre-hospital human-equivalent dose of 2-PAM Cl, 149 µmol/kg. The TI was calculated for each OP/oxime combination. Against VR, MMB4 DMS had a higher TI than HLö-7 DMS, whereas 2-PAM Cl and obidoxime Cl2 were ineffective. Against VX, MMB4 DMS > HLö-7 DMS > 2-PAM Cl > obidoxime Cl2. Against PHO, all performed better than 2-PAM Cl. MMB4 DMS was the most effective oxime as it was the only oxime with ED90 < 149 µmol/kg against all three topical OPs tested. PMID:27432237

  13. [Unilateral visual field defect due to optic nerve compression by sclerotic internal carotid artery: a case report].

    Science.gov (United States)

    Uchino, M; Nemoto, M; Ohtsuka, T; Kuramitsu, T; Isobe, Y

    1999-02-01

    A case of unilateral visual field defect due to optic nerve compression by a sclerotic internal carotid artery was reported. A 71-year-old woman was admitted to our department because of constricted visual field of the right eye. MRI showed elevation of the right optic nerve compressed by an internal carotid artery. The right carotid angiography revealed elevation and distortion of the C1-2 portion. Frontal craniotomy was carried out and the optic nerve was visualized on this side. The right optic nerve was found to have been compressed by the sclerotic internal carotid artery. The optic canal was then unroofed. The post-operative course was uneventful. The visual field was improved. When last seen 6 months after surgery, her visual field remained in the improved condition. Nasal field abnormalities are most frequently encountered in retinal and anterior optic nerve pathology. Our success in improving the visual field disturbance may be accounted for by the fact that the preoperative period was short and the operation was performed before atrophy of ocular fundi occurred. Nasal field loss caused by intracranial lesions of the optic pathway is rare. It is probably impossible to determine degree of the symptomatology caused by direct-pressure compression as opposed to that caused by ischemia secondary to occlusion of small arterial supply branches. Vascular compressive neuropathy of optic nerve should not be diagnosed simply by the radiological finding of the optic nerve dislocation. However, optic nerve compression by surrounding arteries should be remembered as one of the possible causes of visual field defect which needs to be treated surgically. PMID:10065453

  14. Intermittent hypoglossal nerve palsy caused by a calcified persistent hypoglossal artery: an uncommon neurovascular compression syndrome.

    Science.gov (United States)

    Meila, Dan; Wetter, Axel; Brassel, Friedhelm; Nacimiento, Wilhelm

    2012-12-15

    Neurovascular compression is assumed to cause symptoms like trigeminal neuralgia, hemifacial spasm and vestibular paroxysmia. We present a patient with recurrent episodes of transient dysarthria due to isolated right hypoglossal nerve (HN) palsy. We describe the first case of a calcified persistent hypoglossal artery (PHA) as the putative cause of a hypoglossal neurovascular compression syndrome. Our patient received a daily low-dose medication of carbamazepine resulting in complete relief of symptoms. In conclusion, PHA is not only an anatomic variation but also a possible cause of a neurovascular compression syndrome leading to intermittent HN palsy. PMID:23020989

  15. Brain mapping of median nerve somatosensory evoked potential with combined 99mTc-ECD single-photon emission tomography and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Single-photon emission tomography (SPET) was performed during electrical median nerve stimulation and used to detect focal neuronal activation in the somatosensory pathways. Intravenously administered technetium-99m ethyl cysteinate dimer (ECD) was used as a blood flow tracer to obtain baseline and activated images in each of three subjects. After image registration, baseline images were compared voxel by voxel with the activation images. In addition, the mean summation of the activated-state images of the subjects was compared with the mean summation of the baseline-state images of ten normal subjects. Discrete brain regions occupying 0.9%-1.6% of total brain volume showed an increase in signal from 33.6% to 35.0%. For further anatomical localization of regional increases in signal, the MRI scan of each subject was registered and superimposed on the activated-state SPET image. This method may be used to localize lesions in various disorders of the central nervous system. (orig.)

  16. Vasopressin responses to unloading arterial baroreceptors during cardiac nerve blockade in conscious dogs

    Science.gov (United States)

    O'Donnell, C. P.; Keil, L. C.; Thrasher, T. N.

    1992-01-01

    We examined the relative contributions of afferent input from the heart and from arterial baroreceptors in the stimulation of arginine vasopressin (AVP) secretion in response to hypotension caused by thoracic inferior vena caval constriction (TIVCC). Afferent input from cardiac receptors was reversibly blocked by infusing 2% procaine into the pericardial space to anesthetize the cardiac nerves. Acute cardiac nerve blockade (CNB) alone caused a rise in mean arterial pressure (MAP) of 24 +/- 3 mmHg but no change in plasma AVP. If the rise in MAP was prevented by TIVCC, plasma AVP increased by 39 +/- 15 pg/ml, and if MAP was allowed to increase and then was forced back to control by TIVCC, plasma AVP increased by 34 +/- 15 pg/ml. Thus the rise in MAP during CNB stimulated arterial baroreceptors, which in turn compensated for the loss of inhibitory input from cardiac receptors on AVP secretion. These results indicate that the maximum secretory response resulting from complete unloading of cardiac receptors at a normal MAP results in a mean increase in plasma AVP of 39 pg/ml in this group of dogs. When MAP was reduced 25% below control levels (from 95 +/- 5 to 69 +/- 3 mmHg) by TIVCC during pericardial saline infusion, plasma AVP increased by 79 +/- 42 pg/ml. However, the same degree of hypotension during CNB (MAP was reduced from 120 +/- 5 to 71 +/- 3 mmHg) led to a greater (P less than 0.05) increase in plasma AVP of 130 +/- 33 pg/ml. Because completely unloading cardiac receptors can account for an increase of only 39 pg/ml on average in this group of dogs, the remainder of the increase in plasma AVP must be due to other sources of stimulation. We suggest that the principal stimulus to AVP secretion after acute CNB in these studies arises from unloading the arterial baroreceptors.

  17. Restoring motor control and sensory feedback in people with upper extremity amputations using arrays of 96 microelectrodes implanted in the median and ulnar nerves

    Science.gov (United States)

    Davis, T. S.; Wark, H. A. C.; Hutchinson, D. T.; Warren, D. J.; O'Neill, K.; Scheinblum, T.; Clark, G. A.; Normann, R. A.; Greger, B.

    2016-06-01

    Objective. An important goal of neuroprosthetic research is to establish bidirectional communication between the user and new prosthetic limbs that are capable of controlling >20 different movements. One strategy for achieving this goal is to interface the prosthetic limb directly with efferent and afferent fibres in the peripheral nervous system using an array of intrafascicular microelectrodes. This approach would provide access to a large number of independent neural pathways for controlling high degree-of-freedom prosthetic limbs, as well as evoking multiple-complex sensory percepts. Approach. Utah Slanted Electrode Arrays (USEAs, 96 recording/stimulating electrodes) were implanted for 30 days into the median (Subject 1-M, 31 years post-amputation) or ulnar (Subject 2-U, 1.5 years post-amputation) nerves of two amputees. Neural activity was recorded during intended movements of the subject’s phantom fingers and a linear Kalman filter was used to decode the neural data. Microelectrode stimulation of varying amplitudes and frequencies was delivered via single or multiple electrodes to investigate the number, size and quality of sensory percepts that could be evoked. Device performance over time was assessed by measuring: electrode impedances, signal-to-noise ratios (SNRs), stimulation thresholds, number and stability of evoked percepts. Main results. The subjects were able to proportionally, control individual fingers of a virtual robotic hand, with 13 different movements decoded offline (r = 0.48) and two movements decoded online. Electrical stimulation across one USEA evoked >80 sensory percepts. Varying the stimulation parameters modulated percept quality. Devices remained intrafascicularly implanted for the duration of the study with no significant changes in the SNRs or percept thresholds. Significance. This study demonstrated that an array of 96 microelectrodes can be implanted into the human peripheral nervous system for up to 1 month durations. Such an

  18. Case of Behçet's disease complicated by oculomotor nerve palsy associated with internal carotid artery-posterior communicating artery aneurysm.

    Science.gov (United States)

    Yamaoka, Toshifumi; Murota, Hiroyuki; Katayama, Ichiro

    2015-03-01

    Behçet's disease (BD) is a relapsing systemic inflammatory disorder of unknown etiology involving systemic vasculitis. Vasculitis in BD results from the involvement of arteries, veins and blood vessels of all sizes, which leads to the three major manifestations of this condition: venous occlusion, arterial occlusion and aneurysm formation. Therefore, whole-body vascular involvement should always be considered in BD patients. Here, we describe the first appearance of an internal carotid-posterior communicating artery aneurysm, resulting in complete oculomotor nerve palsy in a BD patient. A 44-year-old Japanese man suffered from recurrent episodes of erythema nodosum that had presented on the lower extremities for the past 2 years. His condition was diagnosed as an incomplete type of BD based on relapsing oral and genital ulcers, skin eruptions, such as erythema nodosum and folliculitis, a positive pathergy test and systemic arthralgia. Ten years after his initial clinical presentation, he had manifestations of right-sided ptosis and cyclic dull pain in his right temporal region. Magnetic resonance imaging and angiography revealed a right internal carotid artery-posterior communicating artery aneurysm. Although oculomotor nerve palsy associated with internal carotid artery-posterior communicating artery aneurysm in a BD patient has not been reported previously, our report highlights the fact that this abnormal manifestation should be considered in those with vasculo-BD. PMID:25573207

  19. Skin temperature measured by infrared thermography after specific ultrasound-guided blocking of the musculocutaneous, radial, ulnar, and median nerves in the upper extremity

    DEFF Research Database (Denmark)

    Lange, K H W; Jansen, T; Asghar, S; Kristensen, P L; Skjønnemand, M; Nørgaard, P

    2011-01-01

    Sympathetic block causes vasodilatation and increases in skin temperature (T(s)). However, the T(s) response after specific nerve blocking is unknown. In this study, we hypothesized that T(s) would increase after specific blocking of the nerve innervating that area.......Sympathetic block causes vasodilatation and increases in skin temperature (T(s)). However, the T(s) response after specific nerve blocking is unknown. In this study, we hypothesized that T(s) would increase after specific blocking of the nerve innervating that area....

  20. Skin temperature measured by infrared thermography after specific ultrasound-guided blocking of the musculocutaneous, radial, ulnar, and median nerves in the upper extremity

    DEFF Research Database (Denmark)

    Lange, K H W; Jansen, T; Asghar, S; Kristensen, P L; Skjønnemand, M; Nørgaard, P

    2011-01-01

    Sympathetic block causes vasodilatation and increases in skin temperature (T(s)). However, the T(s) response after specific nerve blocking is unknown. In this study, we hypothesized that T(s) would increase after specific blocking of the nerve innervating that area....

  1. Operative strategy of complex internal carotid artery-posterior communicating artery aneurysms Defensive effect on perioperative nerve injury

    Institute of Scientific and Technical Information of China (English)

    Xinmin Wang; Wende Xiong; Xuqin Li

    2007-01-01

    BACKGROUND: The two problems in treating intracranial aneurysm are the vascular reconstruction and brain protection, especially for complex internal carotid artery-posterior communicating artery (ICA-PComA)aneurysms.OBJECTIVE: To analyze the anatomic features and operative technique of complex ICA-PComA aneurysms, and investigate how to better protect the brain tissue.DESIGN: A retrospective case analysis.SETTING: Department ofNeurosurgery, Dalian Central Hospital.PARTICIPANTS: Totally 154 inpatients with ICA-PComA aneurysms were selected from the Department of Neurosurgery, Dalian Central Hospital from January 1998 to December 2006, including 19 cases (12.3%)of complex ICA-PComA aneurysms, 8 males and 11 females, 38 - 67 years of age. Informed contents for surgery and observation were obtained from all the patients or their relatives.METHODS: The clinical manifestations, including initial symptoms and Hunt&Hess grading, were observed. Corresponding strategies were selected for different types of ICA-PComA aneurysms. The patients were followed up at 3 months postoperatively. According to the results of Glasgow scoring, the curative effects were classified as good (4 - 5 points), bad (2 - 3 points) and dead (1 point). The results at discharge were taken as early results, whereas the follow-up results as late results.MAIN OUTCOME MEASURES: Clinical manifestations and curative effects of the patients.RESULTS: All the 19 patients with ICA-PComA were involved in the analysis of results. For clinical manifestations, the initial symptoms were subarachnoid hemorrhage (n =15), paralysis of oculomotor nerve (n =3), and occasional attack (n =1); The Hunt&Hess grading was grade Ⅰ in 4 cases, grade Ⅱ in 6 cases,grade Ⅲ in 6 cases, grade Ⅳ in 2 cases, and grade Ⅴ in 1 case. The curative effects were that aneurysm breakage and bleeding occurred in 6 cases perioperatively, uncomplete clipping of aneurysm in 2 cases and constriction of parent artery in 1 case. The

  2. The characteristics of median nerve compound nerve action potential at different post injury and repair intervals and their correlation with nerve regeneration in rats%大鼠正中神经修复后不同时段的电生理变化与神经再生的相关性分析

    Institute of Scientific and Technical Information of China (English)

    李永平; 劳杰; 赵新; 刘靖波; 田东; 张凯丽; 朱艺

    2011-01-01

    目的 探讨大鼠正中神经切断缝合后的不同时段,其复合神经动作电位(CNAP)与形态学方面的特点及其相关性分析.方法 在大鼠上臂正中神经中段切断缝合后的不同时间点(2、3、4、6、8和12周)进行CNAP检测,随后取正中神经组织进行形态学检查.结果 术后第2周可以记录到CNAP.术后再生神经记录的CNAP幅度比对照组显著减低(P<0.01),波幅下面积(Area)也显著低于对照组(P<0.01),传导速度(CV)显著慢于对照组(P<0.01).术后2~6周的潜伏期(Lat)均比对照组明显延长(P<0.05);术后2~8周刺激强度,即阈强度(THI)和超大刺激强度(SSI)显著低于对照组.CNAP的第一峰波幅(FPA)、峰-峰波幅(PPA)、Area、CV变化趋势为随时间增加而逐渐增高,而其参数Lat、THI、SSI随时间增加而逐渐降低.神经修复后2周缝合口远端已有少量的新生轴突,随着再生时间延长,越来越多的再生轴突延伸至远端.远端记录的CNAP波幅与其有髓神经纤维计数之间有强的正相关(相关系数为0.953).线性回归分析表明,存在线性关系.术后8周髓鞘趋向于成熟.结论 CNAP是早期诊断和评价损伤神经再生程度的良好指标.正常正中神经的CNAP波幅可能与有髓神经纤维的计数呈线性关系.术后第8周,CNAP参数趋向于稳定,神经髓鞘渐趋向于成熟.%Objective To explore the characteristics of compound nerve action potential (CNAP) after rat median nerve transection and repair,and their correlation with neuromorphometry at various time points. Methods The median nerve was transected and sutured at mid-arm level. At various time points from 2 to 12 weeks postoperatively,CNAP recording was performed and the median nerve was harvested for morphological examination. Results CNAP could be recorded at 2 weeks after nerve repair. The CNAP amplitude,the area below the curve (Area) and conduction velocity (CV) of regenerated nerve were significantly lower than those

  3. MR images of optic nerve compression by the intracranial carotid artery. Including the patients with normal tension glaucoma

    International Nuclear Information System (INIS)

    Twenty-one eyes of 12 patients with MRI-defined optic nerve compression by the intracranial carotid artery were examined to investigate whether the visual field defects result from optic nerve compression or other causes. In 4 affected eyes with 2 patients, we could not distinguish whether the visual field defects were due to optic nerve compression or normal-tension glaucoma. These patients had evidence of glaucoma-like cupping of the optic disc and visual field defects. Nine affected eyes with 7 patients were diagnosed as having compressive optic neuropathy due to unilateral optic nerve compression associated with visual field defects or non-glaucomatous visual field defects. Four of 9 affected eyes were associated with optic disc cupping of various degrees. We suggest that the glaucoma-like visual field defects and optic disc cupping may result from a compressive lesion of the anterior visual pathway. Frequently, this feature caused confusion in the differential diagnosis between optic nerve compression by carotid artery and normal-tension glaucoma. (author)

  4. Real-Time Automatic Artery Segmentation, Reconstruction and Registration for Ultrasound-Guided Regional Anaesthesia of the Femoral Nerve.

    Science.gov (United States)

    Smistad, Erik; Lindseth, Frank

    2016-03-01

    The goal is to create an assistant for ultrasound- guided femoral nerve block. By segmenting and visualizing the important structures such as the femoral artery, we hope to improve the success of these procedures. This article is the first step towards this goal and presents novel real-time methods for identifying and reconstructing the femoral artery, and registering a model of the surrounding anatomy to the ultrasound images. The femoral artery is modelled as an ellipse. The artery is first detected by a novel algorithm which initializes the artery tracking. This algorithm is completely automatic and requires no user interaction. Artery tracking is achieved with a Kalman filter. The 3D artery is reconstructed in real-time with a novel algorithm and a tracked ultrasound probe. A mesh model of the surrounding anatomy was created from a CT dataset. Registration of this model is achieved by landmark registration using the centerpoints from the artery tracking and the femoral artery centerline of the model. The artery detection method was able to automatically detect the femoral artery and initialize the tracking in all 48 ultrasound sequences. The tracking algorithm achieved an average dice similarity coefficient of 0.91, absolute distance of 0.33 mm, and Hausdorff distance 1.05 mm. The mean registration error was 2.7 mm, while the average maximum error was 12.4 mm. The average runtime was measured to be 38, 8, 46 and 0.2 milliseconds for the artery detection, tracking, reconstruction and registration methods respectively. PMID:26513782

  5. Median arcuate ligament syndrome: a nonvascular, vascular diagnosis.

    Science.gov (United States)

    Skeik, Nedaa; Cooper, Leslie T; Duncan, Audra A; Jabr, Fadi I

    2011-07-01

    Median arcuate ligament syndrome (MALS) is often diagnosed when idiopathic, episodic abdominal pain is associated with dynamic compression of the proximal celiac artery by fibers of the median arcuate ligament. The character of the abdominal pain is often postprandial and associated with gradual weight loss from poor food intake, suggestive of chronic mesenteric ischemia. However, the pathognomonic imaging feature of dynamic, ostial celiac artery compression with expiration does not consistently predict clinical improvement from revascularization. Proposed but unproven pathophysiological mechanisms include neurogenic pain from compression of the splanchnic nerve plexus and intermittent ischemia from compression of the celiac artery. Alterations in blood flow and ganglion compression are both associated with delayed gastric emptying, another physiological correlate of the clinical syndrome. Published reports describe a variable response to revascularization and nerve plexus resection suggest a need for translational research to better characterize this poorly understood clinical entity. We illustrate the current gaps in our knowledge of MALS with the case of a 51-year-old woman with a 4-year history of chronic abdominal pain who responded to a combination of ganglion resection and celiac artery reconstruction. PMID:21536596

  6. Arterial baroreceptor reflex control of renal sympathetic nerve activity following chronic myocardial infarction in male, female, and ovariectomized female rats.

    Science.gov (United States)

    Pinkham, Maximilian I; Whalley, Gillian A; Guild, Sarah-Jane; Malpas, Simon C; Barrett, Carolyn J

    2015-07-15

    There is controversy regarding whether the arterial baroreflex control of renal sympathetic nerve activity (SNA) in heart failure is altered. We investigated the impact of sex and ovarian hormones on changes in the arterial baroreflex control of renal SNA following a chronic myocardial infarction (MI). Renal SNA and arterial pressure were recorded in chloralose-urethane anesthetized male, female, and ovariectomized female (OVX) Wistar rats 6-7 wk postsham or MI surgery. Animals were grouped according to MI size (sham, small and large MI). Ovary-intact females had a lower mortality rate post-MI (24%) compared with both males (38%) and OVX (50%) (P < 0.05). Males and OVX with large MI, but not small MI, displayed an impaired ability of the arterial baroreflex to inhibit renal SNA. As a result, the male large MI group (49 ± 6 vs. 84 ± 5% in male sham group) and OVX large MI group (37 ± 3 vs. 75 ± 5% in OVX sham group) displayed significantly reduced arterial baroreflex range of control of normalized renal SNA (P < 0.05). In ovary-intact females, arterial baroreflex control of normalized renal SNA was unchanged regardless of MI size. In males and OVX there was a significant, positive correlation between left ventricle (LV) ejection fraction and arterial baroreflex range of control of normalized renal SNA, but not absolute renal SNA, that was not evident in ovary-intact females. The current findings demonstrate that the arterial baroreflex control of renal SNA post-MI is preserved in ovary-intact females, and the state of left ventricular dysfunction significantly impacts on the changes in the arterial baroreflex post-MI. PMID:25994953

  7. Persistent trigeminal artery supply to an intrinsic trigeminal nerve arteriovenous malformation: a rare cause of trigeminal neuralgia.

    Science.gov (United States)

    Choudhri, Omar; Heit, Jeremy J; Feroze, Abdullah H; Chang, Steven D; Dodd, Robert L; Steinberg, Gary K

    2015-02-01

    Infratentorial arteriovenous malformations (AVM) associated with the trigeminal nerve root entry zone are a known cause of secondary trigeminal neuralgia (TN). The treatment of both TN and AVM can be challenging, especially if the AVM is embedded within the trigeminal nerve. A persistent trigeminal artery (PTA) can rarely supply these intrinsic trigeminal nerve AVM. We present a 64-year-old man with TN from a right trigeminal nerve AVM supplied by a PTA variant. The patient underwent microvascular decompression and a partial resection of the AVM with relief of facial pain symptoms. His residual AVM was subsequently treated with CyberKnife radiosurgery (Accuray, Sunnyvale, CA, USA). A multimodality approach may be required for the treatment of trigeminal nerve associated PTA AVM and important anatomic patterns need to be recognized before any treatment. Herein, we report to our knowledge the third documented patient with a posterior fossa AVM supplied by a PTA and the first PTA AVM presenting as facial pain. PMID:25070632

  8. A Morphometric Study of the Obturator Nerve around the Obturator Foramen

    Science.gov (United States)

    Jo, Se Yeong; Chang, Jae Chil; Bae, Hack Gun; Oh, Jae-Sang; Heo, Juneyoung

    2016-01-01

    Objective Obturator neuropathy is a rare condition. Many neurosurgeons are unfamiliar with the obturator nerve anatomy. The purpose of this study was to define obturator nerve landmarks around the obturator foramen. Methods Fourteen cadavers were studied bilaterally to measure the distances from the nerve root to relevant anatomical landmarks near the obturator nerve, including the anterior superior iliac spine (ASIS), the pubic tubercle, the inguinal ligament, the femoral artery, and the adductor longus. Results The obturator nerve exits the obturator foramen and travels infero-medially between the adductors longus and brevis. The median distances from the obturator nerve exit zone (ONEZ) to the ASIS and pubic tubercle were 114 mm and 30 mm, respectively. The median horizontal and vertical distances between the pubic tubercle and the ONEZ were 17 mm and 27 mm, respectively. The shortest median distance from the ONEZ to the inguinal ligament was 19 mm. The median inguinal ligament lengths from the ASIS and the median pubic tubercle to the shortest point were 103 mm and 24 mm, respectively. The median obturator nerve lengths between the ONEZ and the adductor longus and femoral artery were 41 mm and 28 mm, respectively. Conclusion The obturator nerve exits the foramen 17 mm and 27 mm on the horizontal and sagittal planes, respectively, from the pubic tubercle below the pectineus muscle. The shallowest area is approximately one-fifth medially from the inguinal ligament. This study will help improve the accuracy of obturator nerve surgeries to better establish therapeutic plans and decrease complications.

  9. Arterial baroreflex control of muscle sympathetic nerve activity under orthostatic stress in humans

    Directory of Open Access Journals (Sweden)

    MasashiIchinose

    2012-08-01

    Full Text Available The mechanisms by which blood pressure is maintained against the orthostatic stress caused by gravity’s effect on the fluid distribution within the body are important issues in physiology, especially in humans who usually adopt an upright posture. Peripheral vasoconstriction and increased heart rate are major cardiovascular adjustments to orthostatic stress and comprise part of the reflex response elicited via the carotid sinus and aortic baroreceptors (arterial baroreflex: ABR and cardiopulmonary stretch receptors (cardiopulmonary baroreflex. In a series of studies, we have been characterizing the ABR-mediated regulation of cardiovascular hemodynamics and muscle sympathetic nerve activity (MSNA while applying orthostatic stress in humans. We have found that under orthostatic stress, dynamic carotid baroreflex responses are modulated as exemplified by the increases in the MSNA, blood pressure and heart rate responses elicited by carotid baroreflex unloading and the shorter period of MSNA suppression, comparable reduction and faster recovery of MAP and greater heart rate response to carotid baroreflex stimulation. Our results also show that ABR-mediated beat-to-beat control over burst incidence, burst strength and total MSNA is progressively modulated as orthostatic stress is increased until induction of syncope, and that the sensitivity of ABR control over the aforementioned MSNA variables is substantially reduced during the development of syncope. We suggest that in humans, the modulation of ABR function under orthostatic stress may be one of the mechanisms by which blood pressure is maintained and orthostatic hypotension limited, and impairment of ABR control over sympathetic vasomotor activity leads to the severe hypotension associated with orthostatic syncope.

  10. Arterial stick

    Science.gov (United States)

    ... the main arteries in the forearm (radial and ulnar arteries). The procedure is done as follows: The ... Arteries also have thicker walls and have more nerves. When the needle is inserted, there may be ...

  11. MORPHOLOGY OF ULNAR NERVE IN AXILLA & ARM & ITS VARIATIONS

    Directory of Open Access Journals (Sweden)

    Vijay Kumar S

    2014-11-01

    Full Text Available The ulnar nerve arises from the medial cord (C8, T1; medial cord also receives fibres from the ventral ramus of C7. Lesions of the ulnar nerve occur behind the medial epicondyle & in the cubital tunnel. When muscles are affected due to ulnar nerve dysfunction, there is ulnar neuropathy at the shoulder, arm & elbow. The study was done on 50 embalmed human cadavers (25 right & 25 left of both sexes of South Indian adult population obtained from the Department of Anatomy, Bangalore Medical College and Research Institute, Bangalore. Variations in the ulnar nerve in its presence, origin, relations, distribution & communications were observed. Ulnar nerve was present in all 50 upper limb specimens (100%. Ulnar nerve originated from the medial cord of the brachial plexus in 49 cases (98%. In 1 case (2%, the ulnar nerve received C7 fibers from lateral cord i.e. the lateral root of the median nerve and then later fused with the median root of the median nerve. In 49 specimens (98% ulnar nerve took origin from the tip of the acromion processes. In 1 case (2% it took origin from distal to the tip of the acromion process. 49 specimens (98% showed the normal course, i.e. medial to axillary & brachial artery. 1 case (2% showed ulnar nerve present anterior to the third part of the axillary artery and brachial artery. In the midarm it passed medially as a normal course, then runs distally through the cubital tunnel. The awareness of these variations along the normal pattern are helpful for the interventional radiologists, orthopaedicians and neurologists in preventing untoward iatrogenic injury to the ulnar nerve during radiological procedures or operating on fractured patients or diagnostic therapy.

  12. The anatomical research of grafting ring finger radial digital branch of median nerve for repairing injuried deep branch of ulnar nerve defects%正中神经环指桡侧指神经支移植修复尺神经深支缺损的应用解剖

    Institute of Scientific and Technical Information of China (English)

    王斌; 尹佳丽; 董秀芝; 陈超; 韩海生; 李浩

    2011-01-01

    目的 为研究环指桡侧指神经支移植修复尺神经深支缺损提供解剖学基础. 方法 对16例32侧新鲜成人上肢进行观测.在10倍手术显微镜下对腕部尺神经深支、正中神经旋前方肌支和环指桡侧指神经支进行显微解剖及测量. 结果 正中神经旋前方肌支直径为(1.13±0.02)mm,正中神经环指桡侧指神经支直径为(1.17±0.05)mm,对掌肌管出口处尺神经深支直径为(1.75±0.07)mm.显微镜下分离环指桡侧指神经支,对掌肌管出口处尺神经深支至旋前方肌支入肌长度即移植段神经长度为(104.59±20.25)mm. 结论 环指桡侧指神经支移植为带血运的神经移植,属肌支对肌支的吻合,是修复尺神经深支缺损的有效方法.%Objective To provide anatomical basis of neural transplantation to repair deep branch of ulnar nerve defect with the ring finger radial digital branch. Methods Thirty-two sides of 16 cases fresh forearms were dissected and observed.Microdissect and measure the deep branch of ulnar nerve,quadrate pronator of median nerve and it's ring finger radial digital branch under 10-times operating microscope. Results The diameter of quadrate pronator of median nerve was (1.13 ± 0.02)mm,ring finger radial digital branch of median nerve was (1.17 ± 0.05)mm,mid-palmar section of deep branch of ulnar nerve was(1.75± 0.07)mm.Dissect ring finger radial digital branch of median nerve to muscular branch of quadrate pronator under operating microscope,retaining it's blood supply.The length between the deep branch of ulnar nerve and ring finger radial digital branch was( 104.59 ± 20.25)mm.Conclusion ①Solving the problem of nerve grafting without blood supply before,benefit to the survival of the grafting segment and the regeneration of the neuro fiber,and function restoring.②This kind of grafting is the bridging of muscular branch to muscular branch,abide by the principle of neurophysiology.③Neural transplantation to repair deep

  13. Delayed ulnar nerve palsy secondary to ulnar artery pseudoaneurysm distal to Guyon’s canal following penetrating trauma to the hand

    OpenAIRE

    Dobson, PF; Purushothaman, B.; Michla, Y; England, S; Krishnan, MK; Tourret, L

    2013-01-01

    Compression of the ulnar nerve in Guyon’s canal is an uncommon phenomenon. Reports of ulnar nerve palsy secondary to ulnar artery pseudoaneurysm at this anatomical location are very rare and equivalent pathology just distal to this site is unheard of. Here we present such a case, which featured a delayed onset of symptoms. This followed penetrating trauma to the hand. Our methods for diagnosis, operative planning and surgical treatment are included.

  14. Median Nerve with Intraoperative Monitor and Supramaximal Stimulation by Electrophysiology to Cure Carpal Tunnel Syndrome%术中超强电刺激治疗腕管综合征的临床效果研究

    Institute of Scientific and Technical Information of China (English)

    蒋毅; 张航; 田通; 赵睿

    2015-01-01

    目的:评估正中神经松解术结合术中超强电刺激治疗腕管综合征的临床效果。方法:将40例重度腕管综合征患者随机分为对照组和研究组,每组各纳入20名患者。对照组患者仅行正中神经松解术;研究组患者给予正中神经松解术结合术中超强电刺激治疗(80mA,2Hz,5min)。分别记录两组患者大鱼际肌复合肌肉动作电位(CMAP)的潜伏期及波幅并进行比较。结果:研究组患者正中神经外膜松解加超强电刺激后大鱼际肌CMAP的潜伏期和波幅分别为(7.2±0.5)ms和(2.4±0.3)mV,对照组正中神经外膜松解后大鱼际肌CMAP的潜伏期和波幅分别为(8.3±0.4)ms和(1.9±0.4)mV,两组数据均较术前明显恢复,两组间比较具有统计学意义(P<0.05)。结论:术中超强电刺激对腕管综合征患者的正中神经功能恢复具有辅助治疗作用。%Objective: To evaluate the therapeutic effect of the decompression of median nerve combined with intraoperative supramaximal stimulation.Methods:40 patients, who were diagnosed as carpal tunnel syndrome in severe damage, were randomly divided into the control group and the study group, and each group had 20 patients. Only decompression of median nerve was conducted to the patients in the control group. Decompression of median nerve combined with intraoperative supramaximal stimulation (80mA, 2Hz, 10min) was given to the patients in the study group. Record and analyze the latency period and amplitude of CMAP of the patients’ muscle of thenar in the two groups respectively.Results:In the study group, the latency period and amplitude of CMAP of muscle of thenar after decompression and supramaximal stimulation were (7.2±0.5) ms and (2.4±0.3) mV respectively. In the control group, the latency period and amplitude of CMAP were (8.3±0.4) ms and (1.9±0.4) mV respectively. Compared the study group with the control group, there was significant

  15. Gross anatomical study on the human myocardial bridges with special reference to the spatial relationship among coronary arteries, cardiac veins, and autonomic nerves.

    Science.gov (United States)

    Watanabe, Yuko; Arakawa, Takamitsu; Kageyama, Ikuo; Aizawa, Yukio; Kumaki, Katsuji; Miki, Akinori; Terashima, Toshio

    2016-04-01

    Coronary arteries are frequently covered by cardiac muscles. This arrangement is termed a myocardial bridge. Previous studies have shown that myocardial bridges can cause myocardial ischemic diseases or cardiac arrhythmia, but the relevant pathogenic mechanisms remain unknown. We examined 60 hearts from Japanese cadavers macroscopically to clarify the spatial relationships among coronary arteries, cardiac veins and autonomic nerves. We found 86 myocardial bridges in 47 hearts from the 60 cadavers examined (78.3%). Next, we dissected out nine hearts with myocardial bridges in detail under the operating microscope. We found no additional branches of coronary arteries on the myocardial bridge surfaces. However, the cardiac veins, which usually accompany the coronary arteries, ran independently on the myocardial bridge surfaces in the same region. Cardiac autonomic nerves comprised two rami: one was associated with the coronary artery under the myocardial bridge and the other ran on the surface of the bridge. Such spatial relationships among the coronary arteries, cardiac veins and cardiac autonomic nerves at the myocardial bridges are quite similar to those in mouse embryo hearts. Clin. Anat. 29:333-341, 2016. © 2015 Wiley Periodicals, Inc. PMID:26506515

  16. Intramedullary fixation of proximal humerus fractures: do locking bolts endanger the axillary nerve or the ascending branch of the anterior circumflex artery? A cadaveric study

    Directory of Open Access Journals (Sweden)

    Sermon An

    2008-12-01

    Full Text Available Abstract Background Proximal humerus fractures are one of the most common fractures. Intramedullary locked nailing is becoming a popular alternative treatment, especially for easier fracture patterns. Although axillary nerve injury has been reported, no study has compared the safety of the proximal locking options relative to the axillary nerve and the ascending branch of the anterior circumflex artery. Method Six different commercially available proximal humeral nails were implanted in 30 shoulders of 18 cadavers. After fluoroscopically guided implantation the shoulders were carefully dissected and the distance between the locking screws, the axillary nerve and the ascending branch of the anterior circumflex artery was measured. Results The course of the axillary nerve varies. A mean distance of 55.8 mm (SD = 5.3 between the lateral edge of the acromions and the axillary nerve at the middle of the humerus in a neutrally rotated position was observed. The minimum distance was 43.4 mm, the maximum 63.9 mm. Bent nails with oblique head interlocking bolts appeared to be the most dangerous in relation to the axillary nerve. The two designs featuring such a bend and oblique bolt showed a mean distance of the locking screw to the axillary nerve of 1 mm and 2.7 mm respectively Sirus (Zimmer® and (Stryker® T2 PHN (Proximal Humeral Nail. Regarding the ascending branch of the anterior circumflex artery, there was no difference between the nails which have an anteroposterior locking option. Conclusion It is of great importance for surgeons treating proximal humerus fractures to understand the relative risk of any procedure they perform. Since the designs of different nailing systems risk damaging the axillary nerve and ascending branch, blunt dissection, the use of protection sleeves during drilling and screw insertion, and individual risk evaluation prior to the use of a proximal humeral nail are advocated.

  17. Isolated median sensory neuropathy after acupuncture.

    Science.gov (United States)

    Lee, Chang Ho; Hyun, Jung Keun; Lee, Seong Jae

    2008-12-01

    A 47-year-old left-handed man presented with pain and numbness in his left thumb and index finger after acupuncture treatment on an acupoint in his left wrist. A technique of herbal acupuncture, involving the use of a needle coated with apricot seed extract, was used. Median nerve conduction study showed an absence of sensory nerve action potential in the left index finger, whereas the results were normal in all other fingers. The radial and ulnar nerves in the left thumb and ring finger, respectively, showed no abnormality. Infrared thermography of the left index finger showed severe hypothermia. The patient was diagnosed as having an isolated injury to the sensory nerve fibers of the median nerve innervating the index finger. This is the first case report of complications from an herbal acupuncture treatment, and it highlights the possibility of focal peripheral nerve injury caused by acupuncture. PMID:19061751

  18. Ipsilateral common iliac artery plus femoral artery clamping for inducing sciatic nerve ischemia/reperfusion injury in rats: a reliable and simple method

    Directory of Open Access Journals (Sweden)

    Barzegar-Fallah Anita

    2008-12-01

    Full Text Available Abstract The aim of this study was to develop a practical model of sciatic ischemia reperfusion (I/R injury producing serious neurologic deficits and being technically feasible compared with the current time consuming or ineffective models. Thirty rats were divided into 6 groups (n = 5. Animal were anesthetized by using ketamine (50 mg/kg and xylazine (4 mg/kg. Experimental groups included a sham-operated group and five I/R groups with different reperfusion time intervals (0 h, 3 h, 1 d, 4 d, 7 d. In I/R groups, the right common iliac artery and the right femoral artery were clamped for 3 hrs. Sham-operated animals underwent only laparotomy without induction of ischemia. Just before euthanasia, behavioral scores (based on gait, grasp, paw position, and pinch sensitivity were obtained and then sciatic nerves were removed for light-microscopy studies (for ischemic fiber degeneration (IFD and edema. Behavioral score deteriorated among the ischemic groups compared with the control group (p

  19. Median nerve somatosensory evoked potentials studies on latency variability as a function of subject height, limb length and nerve conduction velocity: estudos de variabilidade das latências em função da altura, comprimento do membro superior e velocidade de condução nervosa.

    Directory of Open Access Journals (Sweden)

    Joaquim P. Brasil-Neto

    1991-06-01

    Full Text Available Report on the results of regression analysis studies concerning median nerve somatosensory evoked potentials (SEPs latencies, as dependent variables, and subject height, limb length and nerve conduction velocity (NCV, as independent variables. The tests were performed on 23 normal volunteers. Absolute SEP latencies could be predicted by a linear regression model when the independent variable was arm length; when it was subject height, however, both exponential and polynomial models proved better, the Latter showing the best coefficients of determination, R 2. Multiple linear regression with two independent variables (arm length and NCV was found to be better than simple linear regression for predicting P/N13 latency. The regression line for EP-P/N13 latency on height was found to be a polynomial curve; although the regression was found to be significant by the «F» test (alpha= 1%, the model had a low R2 value (0.41. The same applies to the P/N13-N19 interpeak latency regression curve, but the regression was significant for alpha =5% in that case. Although interwave latencies are the most useful parameters for clinical interpretation of median SEPs, absolute latencies may occasionally be important, and should be corrected for body size; in unusually tall subjects, it might be useful to double-check EP-P/N13 interwave latency prolongation by estimating the maximum expected P/N13 latency, using a model that takes into account both limb length and NCV.

  20. Median nerve SEP after a high medullary lesion: preserved N18 and absent P14 components (case report PESS do nervo mediano após lesão bulbar alta: componente N18 preservado e P14 ausente. Relato de caso

    Directory of Open Access Journals (Sweden)

    G. M. MANZANO

    1999-06-01

    Full Text Available Median nerve SEPs recorded from a patient with a high medullary lesion are described. The lesion involved the anteromedial and anterolateral right upper third of the medulla, as documented by MRI. Forty one days after the lesion, left median nerve SEP showed preserved N18 and absent P14 and N20 components; stimulation of the right median nerve evoked normal responses. These findings agree with the proposition that low medullary levels are involved in the generation of the N18 component of the median nerve SEP.Descrevemos os potenciais evocados somatossensitivos obtidos por estimulação dos nervos medianos em um paciente apresentando uma lesão localizada, envolvendo as porções anteromedial e anterolateral do terço superior do bulbo, documentada por ressonância nuclear magnética. Quarenta e um dias após o estabelecimento da lesão os potenciais evocados por estimulação do nervo mediano esquerdo evidenciaram ausência dos componentes P14 e N20 e preservação do componente N18; após estimulação do nervo mediano direito as respostas apresentaram-se normais. Estes achados estão de acordo com a sugestão de que as porções baixas do bulbo estão envolvidas na geração do componente N18.

  1. Treatment of Cervical Internal Carotid Artery Spontaneous Dissection with Pseudoaneurysm and Unilateral Lower Cranial Nerves Palsy by Two Silk Flow Diverters

    International Nuclear Information System (INIS)

    Internal carotid artery (ICA) lesions in the parapharyngeal space (a dissection and a pseudoaneurysm) may present as isolated lower cranial nerves (IX, X, XI, and XII) palsy (Collet–Sicard syndrome). Some arteriopathies such as fibromuscular dysplasia and tortuosity make a vessel predisposed to dissection. Extreme vessel tortuosity makes the treatment by a stent graft impossible. Two Silk stents were used in a 46 year-old man with left lower cranial nerves (IX–XII) palsy for the treatment of left ICA spontaneous dissection with pseudoaneurysm. A follow-up angiogram 5 months later confirmed pseudoaneurysm thrombosis and patency of the left ICA. The patient recovered completely from the deficits

  2. Treatment of Cervical Internal Carotid Artery Spontaneous Dissection with Pseudoaneurysm and Unilateral Lower Cranial Nerves Palsy by Two Silk Flow Diverters

    Energy Technology Data Exchange (ETDEWEB)

    Zelenak, Kamil, E-mail: zelenak@unm.sk [University Hospital, Department of Radiology (Slovakia); Zelenakova, Jana [University Hospital, Department of Neurology (Slovakia); DeRiggo, Julius [University Hospital, Department of Neurosurgery (Slovakia); Kurca, Egon; Kantorova, Ema [University Hospital, Department of Neurology (Slovakia); Polacek, Hubert [University Hospital, Department of Radiology (Slovakia)

    2013-08-01

    Internal carotid artery (ICA) lesions in the parapharyngeal space (a dissection and a pseudoaneurysm) may present as isolated lower cranial nerves (IX, X, XI, and XII) palsy (Collet-Sicard syndrome). Some arteriopathies such as fibromuscular dysplasia and tortuosity make a vessel predisposed to dissection. Extreme vessel tortuosity makes the treatment by a stent graft impossible. Two Silk stents were used in a 46 year-old man with left lower cranial nerves (IX-XII) palsy for the treatment of left ICA spontaneous dissection with pseudoaneurysm. A follow-up angiogram 5 months later confirmed pseudoaneurysm thrombosis and patency of the left ICA. The patient recovered completely from the deficits.

  3. 肌电图在前臂正中神经卡压的诊断和鉴别诊断中的应用价值%THE VALUE APPLIED OF ELECTROMYOGRAM IN DIAGNOSIS OF MEDIAN NERVE ENTRAPMENT IN FOREARM

    Institute of Scientific and Technical Information of China (English)

    田东; 张航; 韩峰

    2011-01-01

    目的:探讨肌电图检测在前臂正中神经卡压诊断和鉴别诊断中的应用价值.方法:回顾分析100例临床诊断并经手术证实的前臂正中神经的神经肌电图检查资料,分析其电生理阳性指标.其中腕管综合症(carpal tunnelsyndrome,CTS)75例,前骨间神经卡压综合征(anterior interosseous entrapment nerve syndrome,AINS) 12例,旋前园肌综合征(pronator teres syndrome,PTS)10例,正中神经返支卡压征(recurrent median nerve entrapment syndrome RMNES)3例.结果:肌电图检测发现CTS患者正中神经腕部潜伏期延长,腕部以下正中神经感觉神经动作电位异常;AINS患者正中神经感觉神经功能正常,拇短展肌EMG正常,前骨间神经支配肌有自发电位或潜伏期延长,波幅降低;PTS患者正中神经支配肘下肌有自发电位,前臂NCV减慢,波幅降低,正中神经干动作电位及感觉神经动作电位异常.正中神经返支卡压综合症仅拇短展肌有异常电位,掌部潜伏期延长,感觉神经功能正常.结论:肌电图技术在诊断和鉴别前臂正中神经卡压疾病中有重要价值.

  4. Superior Hypogastric Nerve Block to Reduce Pain After Uterine Artery Embolization: Advanced Technique and Comparison to Epidural Anesthesia

    International Nuclear Information System (INIS)

    PurposeTo evaluate a modified superior hypogastric nerve block (SHNB) to reduce pain after uterine artery embolization (UAE) compared to epidural anesthesia.Materials and methodsIn this retrospective study, the amount of opiate drugs needed after UAE was compared between SHNB and epidural anesthesia. Eighty one consecutive women (mean age: 43.67 years) were in the SHNB group and 27 consecutive women (mean age: 43.48 years) treated earlier at the same institution in the epidural anesthesia group. UAE was performed from a unilateral femoral artery approach using a 4F catheter. 500–700 or 700–900 μm trisacryl gelatine microspheres were used as embolic agents. The SHNB was performed by advancing a 21G from the abdominal wall below the umbilicus to the anterior portion of the 5th vertebral body. For optimal guidance a cranio-caudal tilt of 5°–15° was used. On a lateral view the correct contrast distribution in front of the vertebral body is confirmed. Then 20 ml local anesthesia (ropivacain 0.75 %) is injected. In case of an asymmetric right–left distribution the needle was repositioned.ResultsAll SHNB were successful without severe complications. The mean time for the SHNB was 4 min 38 s (2 min 38 s–9 min 27 s). The needle was repositioned in average 0.87 times. The opiate dose for the SHNB group was 19.33 ± 22.17 mg which was significantly lower. The average time to receive an opiate drug after SHNB was 4 h 41 min.ConclusionThe SHNB is a safe and minimally time-consuming way to reduce pain after UAE especially within the first 4 h

  5. Superior Hypogastric Nerve Block to Reduce Pain After Uterine Artery Embolization: Advanced Technique and Comparison to Epidural Anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Binkert, Christoph A., E-mail: christoph.binkert@ksw.ch [Kantonsspital Winterthur, Institute of Radiology and Nuclear Medicine (Switzerland); Hirzel, Florian C. [Kantonsspital Winterthur, Department of Gynecology (Switzerland); Gutzeit, Andreas; Zollikofer, Christoph L. [Kantonsspital Winterthur, Institute of Radiology and Nuclear Medicine (Switzerland); Hess, Thomas [Kantonsspital Winterthur, Department of Gynecology (Switzerland)

    2015-10-15

    PurposeTo evaluate a modified superior hypogastric nerve block (SHNB) to reduce pain after uterine artery embolization (UAE) compared to epidural anesthesia.Materials and methodsIn this retrospective study, the amount of opiate drugs needed after UAE was compared between SHNB and epidural anesthesia. Eighty one consecutive women (mean age: 43.67 years) were in the SHNB group and 27 consecutive women (mean age: 43.48 years) treated earlier at the same institution in the epidural anesthesia group. UAE was performed from a unilateral femoral artery approach using a 4F catheter. 500–700 or 700–900 μm trisacryl gelatine microspheres were used as embolic agents. The SHNB was performed by advancing a 21G from the abdominal wall below the umbilicus to the anterior portion of the 5th vertebral body. For optimal guidance a cranio-caudal tilt of 5°–15° was used. On a lateral view the correct contrast distribution in front of the vertebral body is confirmed. Then 20 ml local anesthesia (ropivacain 0.75 %) is injected. In case of an asymmetric right–left distribution the needle was repositioned.ResultsAll SHNB were successful without severe complications. The mean time for the SHNB was 4 min 38 s (2 min 38 s–9 min 27 s). The needle was repositioned in average 0.87 times. The opiate dose for the SHNB group was 19.33 ± 22.17 mg which was significantly lower. The average time to receive an opiate drug after SHNB was 4 h 41 min.ConclusionThe SHNB is a safe and minimally time-consuming way to reduce pain after UAE especially within the first 4 h.

  6. Anatomical Research of the Three-dimensional Route of the Thoracodorsal Nerve, Artery, and Veins in Latissimus Dorsi Muscle

    Directory of Open Access Journals (Sweden)

    Nagahiro Takahashi, MD

    2013-05-01

    Conclusions: The thoracodorsal nerves ran in a shallower layer, and the depth to the nerve in the muscle flap in actual facial reanimation surgery is safe enough to avoid damage to the nerves. The LD muscle may be thinned to half its original thickness safely.

  7. Electrophysiologic study of chronic inflammatory demyelinating polyneuropathy by using segmental stimulation in the median nerve and ulnar nerve%正中神经和尺神经分段刺激在慢性炎性脱髓鞘性多发性神经病中的电生理研究

    Institute of Scientific and Technical Information of China (English)

    王晋荣; 王进华; 叶憬; 杨伟丽

    2013-01-01

    目的 探讨运动神经传导速度(MCV)、复合肌肉动作电位(CMAP)与肌力减退的关系和传导阻滞(CB)在慢性炎性脱髓鞘性多发性神经病(chronic inflammatory demyelinating polyradiculoneuritis,CIDP)中的表现特点.方法 30例CIDP患者在进行常规MCV、远端潜伏期(DML)、F波、感觉神经传导速度(SCV)、肌电图(EMG)测定的基础上,在正中神经采用由远到近的“腕-肘-腋-Erb's点”4点3段刺激,尺神经采用由远到近的“腕-肘下-肘上-腋-Erb's点”5点4段刺激,记录各段刺激后CMAP各参数及MCV的变化.结果 CMAP波幅衰减、面积衰减、时程增加以及MCV减慢与临床肌力减退无相关性,dCMAP波幅与上肢远端肌力呈正相关;患者中80.00%在正中神经、73.33%在尺神经发现了1个或多个节段的CB,且出现节段无明显选择性.结论 dCMAP波幅降低与CIDP患者肌力减退有相关性.在CIDP中CB出现率高,且较为弥散地在各节段中出现.%Objective To investigate the relationship between motor conduction velocity (MCV) and compound muscle action potential (CMAP) and muscle strength impairment; and to study the characteristics of conduction block (CB) in chronic inflammatory demyelinating polyneuropathy (CIDP). Methods 30 patients with CIDP formed the study population. All patients were examined by MCV, distal motor latency (DML), F wave, sensory nerve conduction velocity (SCV) and electromyography (EMG). Stimulations were perfomed at 4 sites of the median nerve from distal to proximal (wrist, elbow, axilla, Erb' s point) and 5 sites of the ulnar nerve (wrist, below elbow, above elbow, axilla, Erb' s point), while all the parameters of CMAP and MCV were recorded. Results There were no correlations between the CAMP amplitude attenuation, area, duration increase, MCV reduction and the clinical muscle strength. However, there was positive correlation between the amplitude of the dCMAP and the distal muscle strength in the upper

  8. Síndrome do túnel do carpo: estudo comparativo entre a medição ultrassonográfica e cirúrgica do nervo mediano nos casos moderados e severos da doença Carpal tunnel syndrome: comparative study between sonographic and surgical measurements of the median nerve in moderate and severe cases of disease

    Directory of Open Access Journals (Sweden)

    Marcelo de Pinho Teixeira Alves

    2013-02-01

    Full Text Available OBJETIVO: Comparar os perímetros ultrassonográfico e cirúrgico do nervo mediano, avaliar o diagnóstico da síndrome do túnel do carpo pela área seccional do nervo mediano, verificar associação entre área seccional do nervo mediano e gravidade da síndrome do túnel do carpo. MATERIAIS E MÉTODOS: Estudo de 30 pacientes com síndrome do túnel do carpo. Mediram-se a área seccional e o perímetro ultrassonográfico do nervo mediano. Avaliaram-se correlação clínica-ultrassonográfica e associação com a gravidade da doença. Compararam-se os perímetros ultrassonográfico e cirúrgico. Compararam-se classificação clínica com perímetro cirúrgico, área seccional e perímetro ultrassonográfico. RESULTADOS: Cinco perdas, 25 pacientes estudados; 60% dos pacientes com doença moderada, 60% de casos graves ultrassonográficos (área seccional > 0,15 cm². Distribuição não normal de perímetro cirúrgico (p = 0,5, distribuição normal de perímetro ultrassonográfico (p = 0. Diferença significativa entre perímetros (teste-t de amostras pareadas; p 0,09 cm² em todos os pacientes. CONCLUSÃO: Não houve associação entre perímetro ultrassonográfico e perímetro cirúrgico do nervo mediano. Área seccional do nervo mediano > 0,09 cm² foi válida para o diagnóstico. Não houve associação entre área seccional e gravidade da doença.OBJECTIVE: To compare sonographic and surgical measured perimeters of the median nerve; to evaluate the diagnosis of carpal tunnel syndrome by median nerve cross-sectional area; to verify the association between cross-sectional area of the median nerve and carpal tunnel syndrome severity. MATERIALS AND METHODS: Thirty patients with established carpal tunnel syndrome were studied. Cross-sectional area and sonographic perimeter of the median nerve were measured. The correlation between clinical and sonographic findings and association with carpal tunnel syndrome severity were evaluated. Sonographic

  9. Reappearance of Cranial Nerve Dysfunction Symptoms Caused by New Artery Compression More than 20 Years after Initially Successful Microvascular Decompression: Report of Two Cases.

    Science.gov (United States)

    Inoue, Hiroto; Kondo, Akinori; Shimano, Hiroshi; Yasuda, Soichiro; Murao, Kenichi

    2016-01-01

    Reappearance of symptoms of cranial nerve dysfunction is not uncommon after successful microvascular decompression (MVD). The purpose of this study was to report two quite unusual cases of recurrent and newly developed hemifacial spasm (HFS) caused by a new conflicting artery more than 20 years after the first successful surgery. In Case 1, the first MVD was performed for HFS caused by the posterior inferior cerebellar artery (PICA) when the patient was 38 years old. After 26 symptom-free years, HFS recurred on the same side of the face due to compression by the newly developed offending AICA. In Case 2, the patient was first operated on for trigeminal neuralgia by transposition of the AICA at 49 years old, but 20 symptom-free years after the first MVD, a new offending PICA compressed the facial nerve on the same side, causing HFS. These two patients underwent reoperation and gained satisfactory results postoperatively. Reappearance of symptoms related to compression of the root exit zone (REZ) by a new offending artery after such a long symptom-free interval since the first effective MVD is rare. Here, we describe two such unusual cases and discuss how to manage and prevent such reappearance of symptoms after a long time interval. PMID:26804190

  10. Towards optimal range medians

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Gfeller, Beat; Jørgensen, Allan Grønlund; Sanders, Peter

    2011-01-01

    We consider the following problem: Given an unsorted array of n elements, and a sequence of intervals in the array, compute the median in each of the subarrays defined by the intervals. We describe a simple algorithm which needs O(nlog k + klog n) time to answer k such median queries. This improv...

  11. Functional Median Polish

    KAUST Repository

    Sun, Ying

    2012-08-03

    This article proposes functional median polish, an extension of univariate median polish, for one-way and two-way functional analysis of variance (ANOVA). The functional median polish estimates the functional grand effect and functional main factor effects based on functional medians in an additive functional ANOVA model assuming no interaction among factors. A functional rank test is used to assess whether the functional main factor effects are significant. The robustness of the functional median polish is demonstrated by comparing its performance with the traditional functional ANOVA fitted by means under different outlier models in simulation studies. The functional median polish is illustrated on various applications in climate science, including one-way and two-way ANOVA when functional data are either curves or images. Specifically, Canadian temperature data, U. S. precipitation observations and outputs of global and regional climate models are considered, which can facilitate the research on the close link between local climate and the occurrence or severity of some diseases and other threats to human health. © 2012 International Biometric Society.

  12. NON RECURRENT LARYNGEAL NERVE WITH RIGHT ABERRANT SUBCLAVIAN ARTERY IN RECURRENT CASE OF PAPILLARY CARCINOMA OF THYROID: AN INTERESTING CLINICAL ENTITY.

    Directory of Open Access Journals (Sweden)

    Sudhir M Naik

    2013-03-01

    Full Text Available Background/objectives: A nonrecurrent laryngeal nerve is a rare anatomical variant and a routine preoperative imaging studies are not indicated. NRLN is related with absence of the brachiocephalic trunk and aberrant (mainly retroesophageal course of theright subclavian artery which is evident on contrast enhanced CT scan of the chest.Case report: The patient presented with a swelling in the neck for 4 months which is slowly increasing in size. Patient gives history of a surgery done in the neck with an old midlinesuprasternal scar which was done 40 years earlier.laryngoscopic mirror examinartion was normal with moving vocal cords. Rest of the oral and oropharyngeal examination along with completeblood picture and biochemical investigations were normal. The patient was not a known diabetic or hypertensive.Conclusion: Accurate knowledge of frequent variations of the nerve along with the non recurrent variant reduces the risk of intraoperative injury. A nonrecurrent laryngealnerve(NRLN is a rare anatomical variant and a routine preoperative imaging studies are not indicated. NRLN is related with absence of the brachiocephalic trunk and aberrant(mainly retroesophageal course of the right subclavian artery which is evident on contrast enhanced CT scan of the chest.

  13. Sosiaalisen median merkitys verkkokauppatoiminnassa

    OpenAIRE

    Nieminen, Kira

    2014-01-01

    Opinnäytetyön aiheena on sosiaalisen median merkitys verkkokauppatoiminnassa. Tavoitteenani on selventää yritysten tarvetta sosiaalisen median palveluihin ja miten sitä voidaan hyödyntää yrityksen toiminnassa. Opinnäytetyön alussa käydään läpi sosiaalinen media terminä ja sen lisäksi mainitaan yritysten yleisimmin käyttämät sosiaalisen median palvelut sekä käydään läpi markkinointiviestinnän käsitettä digitaalisessa mediassa. Työssä pohjustetaan yritysten mediasuunnitteluprosessia ja sen vaih...

  14. Sosiaalisen median vallankumous

    OpenAIRE

    Suomijoki, Riku

    2012-01-01

    Tässä opinnäytetyössä selvitettiin, miten ihmiset toimivat sosiaalisessa mediassa ja käyttävät hyväkseen sen tuomia mahdollisuuksia sekä miten netin käyttäjät osallistuvat erilaisiin verkkopalvelutoimintoihin ja sosiaalisen median käyttöön. Opinnäytetyössä pohdittiin, miten digiaikana kasvanut sukupolvi mahdollisesti erottuu vanhemmista sukupolvista käyttäytymisellään ja minkälaisia arvoja sosiaalisen median mukana kasvaneet nuoret edustavat. Lisäksi tarkasteltiin, onko ihmisen yksityisyy...

  15. Brachiomedian artery (arteria brachiomediana) revisited: a comprehensive review

    Science.gov (United States)

    Kachlik, David; Konarik, Marek; Riedlova, Jitka; Baca, Vaclav

    2016-01-01

    This article reviews in detail the superficial brachiomedian artery (arteria brachiomediana superficialis), a very rare variant of the main arterial trunks of the upper limb. It branches either from the axillary artery or the brachial artery, descends superficially in the arm (similar to the course of the superficial brachial artery) and continues across the cubital fossa, runs superficially in the forearm, approaches the median nerve and enters the carpal canal to reach the hand. It usually terminates in the superficial palmar arch. The first drawing was published, in 1830, and the first description was published, in 1844. Altogether, to our knowledge, only 31 cases of a true, superficial brachiomedian artery have been reported (Some cases are incorrectly reported as superficial brachioradiomedian artery or superficial brachioulnomedian artery). Based on a meta-analysis of known, available studies, the incidence is 0.23% in Caucasians and 1.48% in Mongolians. Knowing whether or not this arterial variant is present is important in clinical medicine and relevant for: The catheterization via the radial or ulnar artery; harvesting the vascular pedicle for a forearm flap based on the radial, ulnar or superficial brachiomedian arteries; the possible collateral circulation in cases of the arterial closure; and the surgical management of carpal tunnel syndrome. Its presence can elevate the danger of an injury to the superficially located variant artery or of an accidental injection. PMID:27131025

  16. Brachiomedian artery (arteria brachiomediana) revisited: a comprehensive review.

    Science.gov (United States)

    Kachlik, David; Konarik, Marek; Riedlova, Jitka; Baca, Vaclav

    2016-01-01

    This article reviews in detail the superficial brachiomedian artery (arteria brachiomediana superficialis), a very rare variant of the main arterial trunks of the upper limb. It branches either from the axillary artery or the brachial artery, descends superficially in the arm (similar to the course of the superficial brachial artery) and continues across the cubital fossa, runs superficially in the forearm, approaches the median nerve and enters the carpal canal to reach the hand. It usually terminates in the superficial palmar arch. The first drawing was published, in 1830, and the first description was published, in 1844. Altogether, to our knowledge, only 31 cases of a true, superficial brachiomedian artery have been reported (Some cases are incorrectly reported as superficial brachioradiomedian artery or superficial brachioulnomedian artery). Based on a meta-analysis of known, available studies, the incidence is 0.23% in Caucasians and 1.48% in Mongolians. Knowing whether or not this arterial variant is present is important in clinical medicine and relevant for: The catheterization via the radial or ulnar artery; harvesting the vascular pedicle for a forearm flap based on the radial, ulnar or superficial brachiomedian arteries; the possible collateral circulation in cases of the arterial closure; and the surgical management of carpal tunnel syndrome. Its presence can elevate the danger of an injury to the superficially located variant artery or of an accidental injection. PMID:27131025

  17. Hyperbolicity in Median Graphs

    Indian Academy of Sciences (India)

    José M Sigarreta

    2013-11-01

    If is a geodesic metric space and $x_1,x_2,x_3\\in X$, a geodesic triangle $T=\\{x_1,x_2,x_3\\}$ is the union of the three geodesics $[x_1 x_2],[x_2 x_3]$ and $[x_3 x_1]$ in . The space is -hyperbolic (in the Gromov sense) if any side of is contained in a -neighborhood of the union of the two other sides, for every geodesic triangle in . If is hyperbolic, we denote by () the sharp hyperbolicity constant of , i.e.,$(X)=\\inf\\{≥ 0: X \\quad\\text{is}\\quad -\\text{hyperbolic}\\}$. In this paper we study the hyperbolicity of median graphs and we also obtain some results about general hyperbolic graphs. In particular, we prove that a median graph is hyperbolic if and only if its bigons are thin.

  18. Median vaikutus nuoren identiteettiin

    OpenAIRE

    Ala-Hakkola, Anu; Alanko, Paula

    2009-01-01

    Opinnäytetyön aiheena oli median vaikutus nuoren identiteettiin. Työssä media on rajattu käsittämään keskeisimmät mediat, joita ovat televisio, lehti, radio sekä internet. Lisäksi työn mediakäsite sisältää mainokset osana mediaa. Työn tavoitteena oli lisätä nuorten tietämystä median vaikutuksista identiteetin muodostumisessa. Johtopäätöksenä työ esitteli nuorten mediatietoisuuden lisäämisen mediakasvatuksen avulla. Työ pohjautuu ajatukseen, että media on luonut identiteetistä kulutustuotteen...

  19. Sosiaalisen median markkinointisuunnitelma ravintolatoiminnassa

    OpenAIRE

    Aholainen, Pia

    2015-01-01

    Opinnäytetyön tarkoituksena oli tutkia sosiaalista mediaa yrityksen ja erityisesti anniskeluravintolan markkinointikanavana. Esimerkkitapauksena käytettiin Helsingissä sijaitsevia pubeja Majava Baaria ja Pub Pikku Kattia. Tutkimusmenetelmänä hyödynnettiin laadullista tutkimusta ja haastatteluin kerättiin aineistomateriaalia. Lähdekirjallisuuden avulla täydennettiin jo saavutettua kokemusta sosiaalisesta mediasta ja teoriaosuudessa tutkittiin sosiaalisen median strategian tärkeyt...

  20. Somatosensory evoked potential monitoring of the brachial plexus to predict nerve injury during internal mammary artery harvest: intraoperative comparisons of the Rultract and Pittman sternal retractors.

    Science.gov (United States)

    Jellish, W S; Martucci, J; Blakeman, B; Hudson, E

    1994-08-01

    Brachial plexus injury after coronary artery bypass grafting (CABG) continues to be a common problem postoperatively. With the use of somatosensory evoked potential monitoring (SSEP), neurologic integrity of the brachial plexus during internal mammary artery (IMA) harvest was assessed and the Rultract and Pittman sternal retractors were compared to determine what effect they had on SSEP characteristics. Results showed that the Rultract and Pittman retractors caused large decreases in SSEP amplitudes after insertion, (1.25 +/- 0.14 versus 0.72 +/- 0.09, P < 0.05; and 1.64 +/- 0.27 versus 0.91 +/- 0.14, P < 0.05) respectively. This decrease was noted in 85% of Rultract and 68.75% of Pittman patients, respectively. Amplitudes increased after retractor removal but never returned to baseline values. Cooley retractor placement in the patients not undergoing IMA harvest (control) produced only mild decreases in amplitude. Waveform latency increased in all groups after retractor placement, but these increases were thought to be clinically insignificant. Postoperatively, three patients in each of the IMA retractor groups had brachial plexus symptoms (18%), whereas only one patient in the control group had symptoms. Somatosensory evoked potential monitoring seems to be a sensitive intraoperative monitor for assessing brachial plexus injury during CABG. The nerve plexus seems to be most at risk for pathologic injury during retraction of the sternum for IMA harvest. Though the Rultract retractor caused greater changes in SSEP characteristics than the Pittman, no clinical outcome differences between the two could be ascertained. Using SSEP monitoring may reduce brachial plexus injury during IMA harvest by allowing early detection of nerve compromise and therapeutic interventions to alleviate the insult while under general anesthesia. PMID:7948794

  1. 高龄冠状动脉旁路移植术患者的中期疗效分析%Analysis of median-term therapeutic effect of coronary artery bypass grafting in the elderly patients

    Institute of Scientific and Technical Information of China (English)

    徐根兴; 郑家豪; 朱洪生; 薛松; 申达甫; 黄日太; 刘沙; 胡振雷; 连锋; 谢波; 叶清

    2009-01-01

    Objective To summarize the clinical experiences and early-to median effect of coronary artery bypass grafting(CABG)in patients aged 70 years or above.Methods From Dec.2006 to Dec.2007,86 patients aged 70 or above underwent CABG,of whom 71 cases underwent off-pump coronary artery bypass grafting(OPCAB),15 cases had CABG with cardiopulmonary bypass(CPB).5 cases underwent mitral valve replacement,3 underwent aortic valve replacement besides CABG,and one case underwent removal of ventricular aneurysm.Their clinical data were retrospectively analyzed.Results There was one case who died of enterobrosis after operation.The average ICU stay time was(77.4±49.6)h,the average postoperative stay time was 15 d,and the average drainage was 530 ml.22 postoperative complications were found.76 cases were followed up for 10-22 months.Follow up effect was better showing cardiac classification I-II and no angina pectoris,myocardial infarction and late death.Conclusion Patients with coronary heart disease in good condition will have not remarkable improvement in mortality as compared with ordinary patients but attention should be paid to their preoperative pulmonary function and angina pectoffs.OPCABG would have encouraging result in reducing the rate of postoperative complications and hospital death,which should be recommended as the first choice for the elderly patients.%目的 总结70岁以上高龄冠心病患者行冠状动脉搭桥术的早、中期结果和经验教训,以期提高手术治疗效果.方法 回顾性分析我院2006年12月至2007年12月86例70岁以上冠心病患者进行冠状动脉旁路移植术(CABG)的临床资料,其中行不停搏CABG 71例,体外循环下CABG 15例,同时行二尖瓣置换5例、主动脉瓣置换3例和室壁瘤切除1例.结果 1例术后死亡,死亡原因为术后肠穿孔.平均术后气管插管时间8 h,ICU停留时间(77.4±49.6)h,术后住院时间15 d,术后引流量平均530 ml.共有22例次术后

  2. Avulsão do plexo braquial em cães - 2: biópsia fascicular e histologia dos nervos radial, mediano, ulnar e musculocutâneo Brachial plexus avulsion in dogs - 2: fascicular biopsy and histology of the radial, median, ulnar and musculocutaneous nerves

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    1997-03-01

    Full Text Available O objetivo deste trabalho foi demonstrar os aspectos clínicos e neurológicos relevantes para o diagnóstico da avulsão do plexo braquial em cães, relacionando estes achados com os resultados da histologia dos nervos radiais, medianos, ulnar e músculo cutânea. A biópsia fascicular destes nervos foi realizada após abordagem cirúrgica às faces lateral e medial do braço afetado. Todos os fascículos submetidos ao exame histológico apresentaram alterações como tumefação axonal, degeneração walleriana e infiltrado inflamatório em graus variados, havendo principalmente nos nervos radial, mediano e ulnar a proliferação de colagem endoneural. A associação destes resultados com as alterações neurológicas e da eletroneuroestimulação (relatados na parte 1 e 3 deste trabalho respectivamente sugeriu envolvimento quase que total das raízes do plexo braquial em todos os casos.The main purposes of this work were the neurological evaluation of dogs with brachial plexus avulsion and correlation of these findings with the results of histology of the radial, median, and ulnar and muscle cutaneous nerves. Fascicular nerve biopsy was performed after surgical approach of medial and lateral aspect of the arm. Ali the submitted fascicles presented histologic alterations compatible with wallerian degeneration, axonal swelling, and inflammatory infiltrate ranging from mild to pronounced, with endoneural collagen proliferation mainly in radial, median and ulnar nerves. The association of these results with neurological and electroneurostimulation exams (respectively described in part 1 and 3 of this work suggested in all cases an almost total involvement of brachial plexus roots.

  3. Role of nitric oxide of the median preoptic nucleus (MnPO in the alterations of salivary flow, arterial pressure and heart rate induced by injection of pilocarpine into the MnPO and intraperitoneally

    Directory of Open Access Journals (Sweden)

    Wilson A. Saad

    2003-07-01

    Full Text Available We investigated the effect of L-NAME, a nitric oxide (NO inhibitor and sodium nitroprusside (SNP, an NO-donating agent, on pilocarpine-induced alterations in salivary flow, mean arterial blood pressure (MAP and heart rate (HR in rats. Male Holtzman rats (250-300 g were implanted with a stainless steel cannula directly into the median preoptic nucleus (MnPO. Pilocarpine (10, 20, 40, 80, 160 µg injected into the MnPO induced an increase in salivary secretion (P<0.01. Pilocarpine (1, 2, 4, 8, 16 mg/kg ip also increased salivary secretion (P<0.01. Injection of L-NAME (40 µg into the MnPO prior to pilocarpine (10, 20, 40, 80, 160 µg injected into the MnPO or ip (1, 2, 4, 8, 16 mg/kg increased salivary secretion (P<0.01. SNP (30 µg injected into the MnPO or ip prior to pilocarpine attenuated salivary secretion (P<0.01. Pilocarpine (40 µg injection into the MnPO increased MAP and decreased HR (P<0.01. Pilocarpine (4 mg/kg body weight ip produced a decrease in MAP and an increase in HR (P<0.01. Injection of L-NAME (40 µg into the MnPO prior to pilocarpine potentiated the increase in MAP and reduced HR (P<0.01. SNP (30 µg injected into the MnPO prior to pilocarpine attenuated (100% the effect of pilocarpine on MAP, with no effect on HR. Administration of L-NAME (40 µg into the MnPO potentiated the effect of pilocarpine injected ip. SNP (30 µg injected into the MnPO attenuated the effect of ip pilocarpine on MAP and HR. The present study suggests that in the rat MnPO 1 NO is important for the effects of pilocarpine on salivary flow, and 2 pilocarpine interferes with blood pressure and HR (side effects of pilocarpine, that is attenuated by NO.

  4. Transfer of pronator teres branch of the median nerve: an anatomical and clinical study%正中神经旋前圆肌肌支移位术的解剖与临床研究

    Institute of Scientific and Technical Information of China (English)

    许彬; 董震; 张成钢

    2014-01-01

    Objective To introduce a new donor nerve and design a new procedure for augmenting finger flexion in middle and lower trunk brachial plexus injuries.Methods The pronator teres branch and anterior interosseous nerve were dissected and measured in 10 fresh cadaveric upper limbs.The anatomic findings were used to design a surgical procedure to transfer the pronator teres branch to the anterior interosseous nerve in combination with the brachialis motor branch transfer to the flexor digitorum superficialis branch.This combined transfer was applied to treat one male patient of lower trunk brachial plexus injury.Results The anatomical study revealed three branching patterns of pronator teres branch.Type Ⅰ (6/10) was defined as a triple-branch pattern,type Ⅱ (2/10) as a double-branch pattern,and Type Ⅲ (2/10) as a single branch pattern.Regardless of its branching pattern,there were always three twigs that entered the pronator teres.Follow-up evaluation of the one case showed no impairment of pronation after the surgery.Moreover,recovery of both the superficial and deep finger flexors was achieved.At 18 months postoperatively muscle power of flexor pollicis longus and flexor digitorum profundus of the index finger reached M4.Muscle power of the flexor digitorum superficialis of the middle and ring fingers recovered to M3.Grip strength was 2.6 kg.Conclusion Transfer the pronator teres branch to the anterior interosseous nerve can effectively augment finger flexion in patients with middle and lower trunk brachial plexus injuries.It is a practical,safe and effective procedure.%目的 臂丛神经中、下干损伤后,在肌皮神经肱肌肌支移位术的基础上,同时引入新的动力神经并设计新的术式,以期加强患者屈指功能的恢复.方法 通过对10侧新鲜尸体上肢标本,观察和测量正中神经旋前圆肌肌支及骨间前神经的解剖学研究.对1例臂丛神经下干损伤的男性患者,设计正中神经旋前圆肌肌支移位

  5. Sosiaalisen median palveluiden tuotteistaminen

    OpenAIRE

    Kyllönen, Caro

    2011-01-01

    Tämän opinnäytetyön tavoitteena on ollut laatia palveluiden tuotteistusopas mainevetoista markkinointia suunnitteleville mainostoimistoille. Sosiaalisessa mediassa yrityksen näkyvyys ja markkinointi poikkeavat perinteisestä markkinoinnista. Tämän vuoksi totutut verkkomarkkinointimenetelmät eivät toimi sellaisenaan. Sosiaalisen median yleistyessä on yritysten yksisuuntainen markkinointiviestintä menettänyt tehoaan ja tilalle on tullut yrityksen ja sidosryhmän välinen dialogi. Mielikuvat yr...

  6. Nerve evoked P2X receptor contractions of rat mesenteric arteries; dependence on vessel size and lack of role of L-type calcium channels and calcium induced calcium release

    OpenAIRE

    Gitterman, D P; Evans, R.J.

    2001-01-01

    Contractile responses to short trains of nerve stimulation have been characterized in small, medium and large arteries from the rat mesenteric circulation (5th – 6th, 2nd – 3rd and 1st order, respectively). In addition, sources of calcium for smooth muscle contraction have been investigated.Nerve stimulation (10 pulses at 10 Hz) evoked reproducible contractions. The P2 receptor antagonist suramin (100 μM) reduced constrictions by 65.3±7.4, 82.7±3.3 and 3.1±6.1% in small, medium and large arte...

  7. Range Selection and Median

    DEFF Research Database (Denmark)

    Jørgensen, Allan Grønlund; Larsen, Kasper Green

    2011-01-01

    several natural special cases thereof. The rst special case is known as range median, which arises when k is xed to b(j 􀀀 i + 1)=2c. The second case, denoted prex selection, arises when i is xed to 0. Finally, we also consider the bounded rank prex selection problem and the xed rank range......Range selection is the problem of preprocessing an input array A of n unique integers, such that given a query (i; j; k), one can report the k'th smallest integer in the subarray A[i];A[i+1]; : : : ;A[j]. In this paper we consider static data structures in the word-RAM for range selection and...... selection problem. In the former, data structures must support prex selection queries under the assumption that k for some value n given at construction time, while in the latter, data structures must support range selection queries where k is xed beforehand for all queries. We prove cell probe lower bounds...

  8. Intracerebral malignant peripheral nerve sheath tumor in a child with neurofibromatosis Type 1 and middle cerebral artery aneurysm treated with endovascular coil embolization.

    Science.gov (United States)

    Ellis, Michael J; Cheshier, Samuel; Sharma, Sunjay; Armstrong, Derek; Hawkins, Cynthia; Bouffet, Eric; Rutka, James T; Taylor, Michael D

    2011-10-01

    Among the neoplastic conditions that affect patients with neurofibromatosis Type 1 (NF1) are malignant peripheral nerve sheath tumors (MPNSTs), which typically arise from peripheral nerves of the limbs, trunk, and lumbar and brachial plexuses. Ionizing radiation is an established risk factor for MPNST development, especially in susceptible patients such as those with NF1. Patients with NF1 are also at risk for intracranial aneurysms, which are increasingly being successfully managed with endovascular therapies. The authors describe the case of a 9-year-old, previously healthy girl who presented in extremis with a right frontal intracerebral hemorrhage resulting from a ruptured right middle cerebral artery (MCA) trifurcation aneurysm. Following urgent decompressive craniectomy, the patient underwent endovascular coil embolization of the MCA aneurysm without complication. Given her mother's history of NF1, the child underwent genetic testing, which disclosed signs positive for NF1. The patient recovered well, but follow-up MR imaging and MR angiography performed at 14 months demonstrated a large frontotemporal mass encasing the right MCA trifurcation. The patient underwent frontotemporal craniotomy and subtotal resection of the mass, which was histologically found to be an intracranial MPNST. The patient received chemotherapy and focal radiation therapy and remains alive at 6 months postresection. To the authors' knowledge, this represents the only known case of intracranial neoplasm arising in the region of an intracranial aneurysm repaired by endovascular coil embolization. While patients with NF1 represent a population with genetic susceptibility to radiation-induced tumors, the pathogenesis of intracerebral MPNSTs remains poorly understood. PMID:21961539

  9. Avulsão do plexo braquial em cães - 3: eletroneuroestimulação dos nervos radial, mediano, ulnar e musculocutâneo Brachial plexus avulsion in dogs - 3: electroneurostimulation of radial, median, ulnar and musculocutaneous nerves

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    1997-03-01

    Full Text Available O objetivo deste trabalho foi relacionar os aspectos clínicos, neurológicos e histopatológicos (descritos nas partes l e 2 deste trabalho com os resultados obtidos após estimulação elétrica dos nervos radiai, mediano, ulnar e musculocutâneo. Realizou-se a estimulação elétrica destes nervos durante o ato cirúrgico no qual foram coletados os fascículos para histopatolo gia. Os nervos radial, mediano e ulnar de todos os cães submetidos à eletroneuroestimulação apresentaram evidências de degenera- ção. enquanto que o nervo musculocutâneo apresentava função próxima do normal em 25% dos casos. A associação dos resultados do exame neurológico, da histologia e da eletroneuroestimulação sugeriu envolvimento quase que total das raízes do plexo braquial, enfatizando a necessidade de continuidade de pesquisas na área, visando principalmente a recuperação das raízes nervosas envolvidas.The purpose ofthis work was to relate lhe clinicai, neurological and histopathotogical aspects (as described in the sections I and 2 ofthis work with the obtained results after the electric stimulation of radial, median, ulnar and musculocutaneous nerrves. The electric stimulation of these nerves was realized during the cirurgic act, when the fascicle were obtained for the histopathologic examination. The radial, median and ulnar nerves of ali dogs submitted to electroneurostimulation presented evidences of degeneration, while the musculocutaneous nerve present almost normal functions in 25% of the cases. The interpretation ofthe results obtained from neurologic, histologic and electroneurostimulation examination suggested the almost total involvement of brachial plexus in ali cases. This work emphasized the need for further research in this área with lhe main purpose of recuperating the involved roots.

  10. Ultrasound-Guided Peripheral Nerve Procedures.

    Science.gov (United States)

    Strakowski, Jeffrey A

    2016-08-01

    Ultrasound guidance allows real-time visualization of the needle in peripheral nerve procedures, improving accuracy and safety. Sonographic visualization of the peripheral nerve and surrounding anatomy can provide valuable information for diagnostic purposes and procedure enhancement. Common procedures discussed are the suprascapular nerve at the suprascapular notch, deep branch of the radial nerve at the supinator, median nerve at the pronator teres and carpal tunnel, lateral cutaneous nerve of the thigh, superficial fibular nerve at the leg, tibial nerve at the ankle, and interdigital neuroma. For each procedure, the indications, relevant anatomy, preprocedural scanning technique, and injection procedure itself are detailed. PMID:27468673

  11. Sosiaalisen median tuloksellisuus poliittisessa markkinoinnissa

    OpenAIRE

    Tahvola, Kairit

    2016-01-01

    Opinnäytetyön tavoitteena oli tarkastella sosiaalisen median tuloksellisuutta markkinointikampanjassa. Tarkastelukohteeksi olen valinnut eduskuntavaalien 2015 sosiaalisen median hyödyntämisen ehdokkaiden kampanjoinnissa. Tarkastelin sosiaalisen median kustannustehokkuutta markkinoinnissa, koska sen käytöllä on ollut tuloksellinen vaikuttavuus Yhdysvaltojen presidenttivaaleissa sekä Suomen presidenttivaaleissa vuonna 2012. Opinnäytetyön tarkoituksena oli selvittää, miten suuri vaikutus sos...

  12. The Diagnostic Value of Nerve Ultrasound in an Atypical Palmar Cutaneous Nerve Lesion.

    Science.gov (United States)

    Zanette, Giampietro; Tamburin, Stefano

    2016-07-01

    Detailed knowledge of the fascicular anatomy of peripheral nerves is important for microsurgical repair and functional electrostimulation.We report a patient with a lesion on the left palmar cutaneous branch of the median nerve (PCBMN) and sensory signs expanding outside the PCBMN cutaneous innervation territory. Nerve conduction study showed the absence of left PCBMN sensory nerve action potential, but apparently, no median nerve (MN) involvement. Nerve ultrasound documented a neuroma of the left PCBMN and a coexistent lateral neuroma of the left MN in the carpal tunnel after the PCBMN left the main nerve trunk.Nerve ultrasound may offer important information in patients with peripheral nerve lesions and atypical clinical and/or nerve conduction study findings. The present case may shed some light on the somatotopy of MN fascicles at the wrist. PMID:26945219

  13. Isolated oculomotor nerve palsy inspontaneous internal carotid artery dissection: case report Paralisia isolada do nervo oculomotor na dissecção de artéria carótida interna: relato de caso

    Directory of Open Access Journals (Sweden)

    Cynthia Resende Campos

    2003-09-01

    Full Text Available Partial oculosympathetic palsy followed by ischemic manifestations in brain or retina are the main symptoms of extracranial internal carotid artery (ICA dissection. Unusually, cranial nerves may be affected. Isolated oculomotor nerve palsy is found only rarely. CASE: We present a 50-year-old nondiabetic man who experienced acute onset of right occipital headache which spread to the right retro-orbital region. Five days later he noticed diplopia and right blurred vision sensation. Neurologic examination disclosed only impaired adduction and upward gaze of right eye, slight ipsilateral pupillary dilatation, without ptosis. Brain MRI was normal. Angiography showed right internal carotid artery dissection with forward occlusion to the base of the skull. Intravenous heparin followed by warfarin was prescribed. The headache and the oculomotor nerve deficit gradually resolved in the next three weeks. DISCUSSION: Isolated oculomotor nerve palsy is underrecognized as a clinical presentation of extracranial ICA dissection. If the angiographic evaluation is incomplete without careful study of extracranial arteries, misdiagnosis may lead to failure to initiate early treatment to prevent thromboembolic complications. For this reason we draw attention to the need for careful evaluation of cervical arteries in patients with oculomotor nerve palsy. Mechanical compression or stretching of the third nerve are possible mechanisms, but the direct impairment of the blood supply to the third nerve seems to be the most plausible explanation.A paralisia oculosimpática parcial (síndrome de Horner seguida por manifestações isquêmicas cerebrais ou retinianas são os principais sintomas da dissecção da artéria carótida interna (ACI extracraniana. O acometimento de nervos cranianos é incomum. Apenas raramente a paralisia isolada do nervo oculomotor pode ser encontrada. CASO: homem de 50 anos, sem diabetes, apresentou cefaléia occipital de início s

  14. Celiac Artery Compression Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammed Muqeetadnan

    2013-01-01

    Full Text Available Celiac artery compression syndrome is a rare disorder characterized by episodic abdominal pain and weight loss. It is the result of external compression of celiac artery by the median arcuate ligament. We present a case of celiac artery compression syndrome in a 57-year-old male with severe postprandial abdominal pain and 30-pound weight loss. The patient eventually responded well to surgical division of the median arcuate ligament by laparoscopy.

  15. Coeliac artery compression syndrome

    OpenAIRE

    OKTAY, Özgür; MEMİŞ, Ahmet; Parildar, Mustafa; Oran, İsmail

    2003-01-01

    Celiac artery compression syndrome, also called median arcuate ligament compression syndrome, causes gastrointestinal ischemia secondary to compression of the proximal portion of the celiac artery just beyond its origin by the median arcuate ligament of the diaphragm. This syndrome is frequently demonstrated on aortography performed in patients without complaints of intestinal angina. Isolated stenosis or even occlusion of the celiac artery is always compensated for by collateral circul...

  16. Pinched Nerve

    Science.gov (United States)

    ... Enhancing Diversity Find People About NINDS NINDS Pinched Nerve Information Page Table of Contents (click to jump ... being done? Clinical Trials Organizations What is Pinched Nerve? The term "pinched nerve" is a colloquial term ...

  17. Nerve biopsy

    Science.gov (United States)

    Biopsy - nerve ... A nerve biopsy is most often done on a nerve in the ankle, forearm, or along a rib. The health care ... feel a prick and a mild sting. The biopsy site may be sore for a few days ...

  18. Sosiaalisen median merkitys maisemasuunnittelutoimiston markkinoinnissa

    OpenAIRE

    Holmstén, Salla

    2013-01-01

    Sosiaalisen median merkitys on kasvanut nopeasti viime vuosien aikana ja nykyään myös moni yritys on lähtenyt hyödyntämään sen palveluita. Tässä opinnäytetyössä käsitellään sosiaalisen median merkitystä maisemasuunnittelutoimistoille tänä päivänä. Työn tavoitteena on selvittää, millainen merkitys sosiaalisen median palveluilla on yritysten markkinoinnissa yleisesti. Käytetäänkö sosiaalisen median palveluita, entä miksi jätetään käyttämättä? Onko käytöstä koettu olevan hyötyä, entä haittaa? Ta...

  19. Sosiaalisen median strategia : tapaus Nitro

    OpenAIRE

    Varjoranta, Sara

    2010-01-01

    Työssä esitetään sosiaalisen median strategia digitaalisen markkinoinnin toimisto Nitrolle. Työssä käsitellään sosiaalista mediaa, markkinointia sosiaalisessa mediassa ja sosiaalisen median käyttöä liiketoiminnallisten tavoitteiden ajamiseen. Työssä hahmotellaan suuntaviivoja taktisten toimenpiteiden ottamiseksi kohti strategiassa määriteltyjä tavoitteita. Strategian luomia suuntaviivoja ja toimintaohjeita voidaan muokaten noudattaa myös kampanjaluonteisessa esiintymisessä osana kokonaisvalta...

  20. 颈总动脉交感神经网剥脱术治疗脑性瘫痪的探讨%Discussion of common carotid artery sympathetic nerve net exfoliation therapy treating cerebral palsy

    Institute of Scientific and Technical Information of China (English)

    尹彪中; 李如求; 成顺成

    2002-01-01

    Objective To discuss mechanism of common carotid artery sympathetic nerve net exfoliation therapy treating sequela of cerebral palsy. Methods Examing and assessing before and after operation, curative effect analysis, Wals value assay and 1 year follow up to 124 patients. Result Score of patients in this group reached excellent 1 week after operation, reached good 1 year after operation, Wals value measure P≤ 0.05. Conclusion This operation had an effect on the promotion of mixed type; athetosis type cerebral palsy, upper limb function disorder and malfunction.

  1. Variant course and branching of right brachial artery: a case study

    Directory of Open Access Journals (Sweden)

    Preeti Goswami

    2013-04-01

    Full Text Available A variant course and branching pattern of the right brachial artery was recorded in a 54-year-old male cadaver during the practical sessions of University College of Medical Sciences, Delhi, India. The right brachial artery divided in the middle third of arm into a medial superficial and lateral deep branch. The superficial medial branch descended anterior to the median nerve and ended by dividing in the cubital fossa into ulnar and radial arteries, whereas the lateral branch descended postero-medial to the median nerve, ending deep to pronator teres as the common interosseous artery. The left brachial artery showed a normal branching pattern by dividing into radial and ulnar arteries in the cubital fossa. The probable origin of such a variation is embryological and familiarity with such variations is imperative as they might affect dynamics of limb function or alter the course of interventional procedures. [Int J Res Med Sci 2013; 1(2.000: 62-65

  2. Ulnar Nerve Compression at Guyon's Canal by an Arteriovenous Malformation

    OpenAIRE

    Kim, Sung Soo; Kim, Jae Hoon; Kang, Hee In; Lee, Seung Jin

    2009-01-01

    Guyon's canal at the wrist is not the common site of ulnar nerve compression. Ganglion, lipoma, anomalous tendon and muscles, trauma related to an occupation, arthritis, and carpal bone fracture can cause ulnar nerve compression at the wrist. However, ulnar nerve compression at Guyon's canal by vascular lesion is rare. Ulnar artery aneurysm, tortous ulnar artery, hemangioma, and thrombosis have been reported in the literature as vascular lesions. The authors experienced a case of ulnar nerve ...

  3. Ulnar Nerve Compression in Guyon's Canal by Ganglion Cyst

    OpenAIRE

    Kwak, Kyung-Woo; Kim, Min-Su; Chang, Chul-Hoon; Kim, Seong-Ho

    2011-01-01

    Compression of the ulnar nerve in Guyon's canal can result from repeated blunt trauma, fracture of the hamate's hook, and arterial thrombosis or aneurysm. In addition, conditions such as ganglia, rheumatoid arthritis and ulnar artery disease can rapidly compress the ulnar nerve in Guyon's canal. A ganglion cyst can acutely protrude or grow, which also might compress the ulnar nerve. So, clinicians should consider a ganglion cyst in Guyon's canal as a possible underlying cause of ulnar nerve c...

  4. Magnetic resonance neurography of median neuropathies proximal to the carpal tunnel

    Energy Technology Data Exchange (ETDEWEB)

    Thawait, Gaurav K. [Johns Hopkins Hospital, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); The Johns Hopkins Hospital, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Subhawong, Ty K.; Eng, John; Carrino, John A.; Chhabra, Avneesh [Johns Hopkins Hospital, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Thawait, Shrey K. [Yale University, Bridgeport Hospital, Department of Radiology, Bridgeport, CT (United States); Andreisek, Gustav [University Hospital Zurich, Department of Radiology, Zurich (Switzerland); Belzberg, Alan J. [Johns Hopkins Hospital, Department of Neurosurgery, Baltimore, MD (United States)

    2012-06-15

    This review provides magnetic resonance neurography (MRN) imaging appearances of median neuropathy proximal to the carpal tunnel. Carpal tunnel syndrome (CTS) and its imaging have been extensively described in the literature; however, there is a relative paucity of information on the MR imaging appearances of different pathologies of the median nerve proximal to the carpal tunnel. (orig.)

  5. Nerve conduction

    Science.gov (United States)

    ... the central nervous system (CNS) and peripheral nervous system (PNS). The CNS contains the brain and the spinal cord and the PNS consists of thousands of nerves that connect the spinal cord to muscles and sensory receptors. A peripheral nerve is composed of nerve ...

  6. Sosiaalisen median opas pienille hotelleille

    OpenAIRE

    Lohtander, Annukka

    2014-01-01

    Tämä työ on produktityyppinen opinnäytetyö, joka koostuu tietoperustasta ja tuotoksesta. Tuotos on sosiaalisen median opas pienille suomalaisille hotelleille. Sosiaalisesta mediasta on tullut osa lähes jokaisen yrityksen toimintaa. Majoitusalalla tärkeimpiä alustoja ovat Facebook, TripAdvisor, Twitter, Foursquare, keskustelufoorumit, blogit sekä kuva- ja videopalvelut. Osassa näistä alustoista on syytä olla mukana niin sisällön tuottajana kuin sen seuraajana ja reagoijanakin. Osa...

  7. Effects of transcutaneous electrical nerve stimulation (TENS) on arterial stiffness and blood pressure in resistant hypertensive individuals: study protocol for a randomized controlled trial

    OpenAIRE

    Vilela-Martin, José Fernando; Giollo-Junior, Luiz Tadeu; Chiappa, Gaspar Rogério; Cipriano-Junior, Gerson; Vieira, Paulo José Cardoso; dos Santos Ricardi, Fábio; Paz-Landim, Manoel Ildefonso; de Andrade, Days Oliveira; Cestário, Elizabeth do Espírito Santo; Cosenso-Martin, Luciana Neves; Yugar-Toledo, Juan Carlos; Cipullo, José Paulo

    2016-01-01

    Background Resistant hypertension (RH) treatment requires an adequate and intense therapeutic approach. However, the results are not always satisfactory despite intensive treatment. Of the different pathophysiological mechanisms involved in the pathogenesis of RH, sympathetic overstimulation and therapies that block the sympathetic system have been widely studied. These approaches, however, are invasive and expensive. Another possible approach is by transcutaneous electrical nerve stimulation...

  8. Cranial nerve involvement in nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Between 1975 and 1989, 23 nasopharyngeal carcinoma patients presenting with cranial nerve involvement (CNI) of one or more nerves at the time of diagnosis were treated and followed-up in our department. All patients were irradiated with curative intent, and total doses of 50 to 70 Gy (median 65 Gy) were delivered to the nasopharynx. Cranial nerves VI, III, V, IV, IX, and XII were the most commonly involved nerves. The total response rate of cranial nerves was 74% in a median follow-up time of 2 years, with the highest rate observed in the third and sixth cranial nerves. All complete responses except two were observed in the first month after radiotherapy. (author)

  9. Repeatability of Nerve conduction Measurements using Automation

    OpenAIRE

    Kong, Xuan; Lesser, Eugene A; Megerian, J. Thomas; Gozani, Shai N

    2006-01-01

    ABSTRACT Objective To quantify nerve conduction study (NCS) reproducibility utilizing an automated NCS system (NC-stat®, NeuroMetrix, Inc.). Method Healthy volunteers without neuropathic symptoms participated in the study. Their median, ulnar, peroneal, and tibial nerves were tested twice (7 days apart) by the same technician with an NC-stat® instrument. Pre-fabricated electrode arrays specific to each nerve were used. Both motor responses (compound motor action potential [CMAP] and F-waves –...

  10. Terminal nerve: cranial nerve zero

    Directory of Open Access Journals (Sweden)

    Jorge Eduardo Duque Parra

    2006-12-01

    Full Text Available It has been stated, in different types of texts, that there are only twelve pairs of cranial nerves. Such texts exclude the existence of another cranial pair, the terminal nerve or even cranial zero. This paper considers the mentioned nerve like a cranial pair, specifying both its connections and its functional role in the migration of liberating neurons of the gonadotropic hormone (Gn RH. In this paper is also stated the hypothesis of the phylogenetic existence of a cerebral sector and a common nerve that integrates the terminal nerve with the olfactory nerves and the vomeronasals nerves which seem to carry out the odors detection function as well as in the food search, pheromone detection and nasal vascular regulation.

  11. Factors that influence peripheral nerve regeneration

    DEFF Research Database (Denmark)

    Krarup, Christian; Archibald, Simon J; Madison, Roger D

    2002-01-01

    median nerve lesions (n = 46) in nonhuman primates over 3 to 4 years, a time span comparable with such lesions in humans. Nerve gap distances of 5, 20, or 50mm were repaired with nerve grafts or collagen-based nerve guide tubes, and three electrophysiological outcome measures were followed: (1) compound...... as outcome predictors. Thus, nerve gap distance and repair type exert their influence through time to muscle reinnervation. These findings emphasize that factors that control early axonal outgrowth influence the final level of recovery attained years later. They also highlight that a time window...... muscle action potentials in the abductor pollicis brevis muscle, (2) the number and size of motor units in reinnervated muscle, and (3) compound sensory action potentials from digital nerve. A statistical model was used to assess the influence of three variables (repair type, nerve gap distance, and time...

  12. Peripheral nerve involvement in Bell's palsy

    Directory of Open Access Journals (Sweden)

    J. A. Bueri

    1984-12-01

    Full Text Available A group of patients with Bell's palsy were studied in order to disclose the presence of subclinical peripheral nerve involvement. 20 patients, 8 male and 12 female, with recent Bell's palsy as their unique disease were examined, in all cases other causes of polyneuropathy were ruled out. Patients were investigated with CSF examination, facial nerve latencies in the affected and in the sound sides, and maximal motor nerve conduction velocities, as well as motor terminal latencies from the right median and peroneal nerves. CSF laboratory examination was normal in all cases. Facial nerve latencies were abnormal in all patients in the affected side, and they differed significantly from those of control group in the clinically sound side. Half of the patients showed abnormal values in the maximal motor nerve conduction velocities and motor terminal latencies of the right median and peroneal nerves. These results agree with previous reports which have pointed out that other cranial nerves may be affected in Bell's palsy. However, we have found a higher frequency of peripheral nerve involvement in this entity. These findings, support the hypothesis that in some patients Bell's palsy is the component of a more widespread disease, affecting other cranial and peripheral nerves.

  13. Terminal nerve: cranial nerve zero

    OpenAIRE

    Jorge Eduardo Duque Parra; Carlos Alberto Duque Parra

    2006-01-01

    It has been stated, in different types of texts, that there are only twelve pairs of cranial nerves. Such texts exclude the existence of another cranial pair, the terminal nerve or even cranial zero. This paper considers the mentioned nerve like a cranial pair, specifying both its connections and its functional role in the migration of liberating neurons of the gonadotropic hormone (Gn RH). In this paper is also stated the hypothesis of the phylogenetic existence of a cerebral sector and a co...

  14. A meta-analysis of studies investigating the effects of lead exposure on nerve conduction

    Energy Technology Data Exchange (ETDEWEB)

    Krieg, Edward F.; Chrislip, David W.; Brightwell, W.S. [National Institute for Occupational Safety and Health, Robert A. Taft Laboratories, Cincinnati, OH (United States)

    2008-08-15

    Group means from nerve conduction studies of persons exposed to lead were used in a meta-analysis. Differences between the control and exposed groups, and the slopes between nerve conduction measurements and log{sub 10} blood lead concentrations were estimated using mixed models. Conduction velocity was reduced in the median, ulnar, and radial nerves in the arm, and in the deep peroneal nerve in the leg. Distal latencies of the median, ulnar, and deep peroneal nerves were longer. No changes in the amplitudes of compound muscle or nerve action potentials were detected. The lowest concentration at which a relationship with blood lead could be detected was 33.0{mu}g/dl for the nerve conduction velocity of the median sensory nerve. Lead may reduce nerve conduction velocity by acting directly on peripheral nerves or by acting indirectly, for example, on the kidney or liver. (orig.)

  15. Prevalence of nerve-vessel contact at cisternal segments of the oculomotor nerve in asymptomatic patients evaluated with magnetic resonance images

    Institute of Scientific and Technical Information of China (English)

    WANG Jin; GONG Xiang-yang; SUN Yi; HU Xing-yue

    2010-01-01

    Background Some studies indicated that cases of idiopathic oculomotor nerve palsy can be explained by vascular compression of the oculomotor nerve. Vascular contact with or compression to the cisternal segment of the oculomotor nerve has been reported frequently in asymptomatic individuals. In this study, we retrospectively analyzed the relationship between the oculomotor nerve's cisternal segment and adjacent arteries in asymptomatic patients and the prevalence of this occurrence via magnetic resonance imaging (MRI).Method MRI of bilateral oculomotor nerves in 93 asymptomatic patients were reviewed. The oculomotor nerve-artery relationship was evaluated and classified from levels 1 to 3, representing the degrees of contact on oblique transverse and oblique sagittal reconstructed MRI. Prevalence of the nerve-artery relationship at each level was described. The correlation between the nerve-vessel relationship (levels) and the age was analyzed by Spearman's rank correlation analysis.Results Cisternal segment of the oculomotor nerve did not have contact with any artery (level 1) in 27.4% (51/186) nerves. One hundred nerves made contact with at least one artery (level 2), but their shapes or configurations were not changed; 35 nerves (18.8%) were displaced or distorted due to artery compression (level 3). The posterior cerebral artery had the greatest incidence of making contact with or compressing the cisternal segment of the oculomotor nerve (58.1%). No significant correlation between nerve-vessel relationship (levels) and the age was found in this study. Conclusions Whether oculomotor nerve contact with or compression by one or more arteries is of high prevalence in asymptomatic individuals as evidenced by MRI examination. There is no correlation with individual age. Discretion should be used when making an etiological diagnosis of vascular compression for patients with oculomotor nerve palsy. Further investigation of other causes is warranted.

  16. Localization of nerve depolarization with magnetic stimulation.

    Science.gov (United States)

    Odderson, I R; Halar, E M

    1992-06-01

    The specific location on the magnetic stimulation (MS) coil that may correspond to the area of nerve depolarization has not been determined. In order to localize such an area, MS with 9-cm and 5-cm diameter coils was compared with conventional percutaneous electric stimulation (ES). On the 9-cm coil the distribution of points of nerve depolarization corresponded to that quarter of the coil which was placed over and parallel to the median nerve, whereas on the 5-cm coil, this area also extended outside the coil. The points of median nerve depolarization with MS were distributed over a distance of 7 cm on the stimulator head and was nearly identical for the 2 coil sizes at the wrist and elbow. Ulnar nerve costimulation was less frequent with the smaller coil at the wrist. A calculated reference point on the coil is suggested for more accurate NCV determinations. PMID:1508235

  17. Clinical application of first dorsal metacarpal artery radial cutaneous branch and superficial radial nerve flap%第一掌骨背动脉桡侧皮支蒂桡神经浅支皮瓣的临床应用

    Institute of Scientific and Technical Information of China (English)

    沈小芳; 芮永军; 许亚军; 糜菁熠; 赵刚

    2012-01-01

    目的 介绍应用第一掌骨背动脉桡侧皮支蒂桡神经浅支皮瓣修复拇指软组织缺损的体会.方法 2006年6月至2009年8月,对9例拇指桡侧软组织缺损患者,应用以第一掌骨背动脉桡侧皮支为轴心血管并携带桡神经浅支皮瓣进行修复,切取面积4.0 cm×2.0cm~7.0 cm× 3.5 cm.结果 术后9例皮瓣全部存活,6例获得随访,3例失访,随访时间为11~34个月.皮瓣质地良好,感觉恢复至S2~S3+,供区植皮愈合良好,轻度色素沉着,无痛性神经瘤发生.结论 第一掌骨背动脉桡侧皮支蒂桡神经浅支皮瓣血供可靠,成活率高,方法简单,可修复拇指全指腹缺损,是修复拇指软组织缺损的方法之一.%Objective To explore the clinical outcomes of applying first dorsal metacarpal artery radial cutaneous branch and superficial radial nerve flap to repair soft tissue defects of the thumb. Methods Nine cases of soft tissue defects in the thumb were treated from June 2006 to August 2009 with a flap using the first dorsal metacarpal artery radial cutaneous branch as the axial vessel and including the superficial radial nerve.The size of the raised flaps ranged from 4.0 cm× 2.0 cm to 7.0 cm× 3.5 cm. Results All the flaps survived after the surgery.Follow-up time ranged from 11 to 34 months in 6 cases.Three cases were lost to follow-up.The flaps had good texture.Protective sensation was restored from S2 to S3 +.The donor site skin graft healed well with slight pigmentation.There were on painful neuroma in these 6 cases. Conclusion First dorsal metacarpal artery radial cutaneous branch and superficial radial nerve flap has a high survival rate and reliable blood supply.It is easy to operate and can cover large defects.This flap is an ideal flap for repair of soft tissue defects in the thumb.

  18. GRP nerves in pig antrum

    DEFF Research Database (Denmark)

    Holst, J J; Poulsen, Steen Seier

    We extracted gastrin-releasing peptide (GRP) and its C-terminal decapeptide corresponding to 6.4 and 6.8 pmol/g from pig antrum mucosa. By immunohistochemistry GRP was localized to mucosal, submucosal, and myenteric nerve fibers. A few nerve cell bodies were also identified. Using isolated perfused...... pig antrum with intact vagal innervation, we found concomitant, atropine-resistant release of GRP and gastrin during electrical stimulation of the vagal nerves. Intra-arterial GRP at 10(-11)-10(-10) mol/l caused up to fivefold, dose-dependent increases in gastrin secretion; higher doses were less...... response to GRP and abolished the effect of vagal stimulation. The available evidence strongly suggests that GRP nerves are responsible for the stimulatory vagal effects on gastrin secretion in the pig....

  19. Microvascular Cranial Nerve Palsy

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Microvascular Cranial Nerve Palsy Sections What Is Microvascular Cranial Nerve Palsy? ... Microvascular Cranial Nerve Palsy Treatment What Is Microvascular Cranial Nerve Palsy? Aug. 02, 2012 Microvascular cranial nerve palsy ( ...

  20. Stimuli of sensory-motor nerves terminate arterial contractile effects of endothelin-1 by CGRP and dissociation of ET-1/ET(A)-receptor complexes

    DEFF Research Database (Denmark)

    Meens, Merlijn J P M T; Compeer, Matthijs G; Hackeng, Tilman M;

    2010-01-01

    BACKGROUND: Endothelin-1 (ET-1), a long-acting paracrine mediator, is implicated in cardiovascular diseases but clinical trials with ET-receptor antagonists were not successful in some areas. We tested whether the quasi-irreversible receptor-binding of ET-1 (i) limits reversing effects of the...... antagonists and (ii) can be selectively dissociated by an endogenous counterbalancing mechanism. METHODOLOGY/PRINCIPAL FINDINGS: In isolated rat mesenteric resistance arteries, ET(A)-antagonists, endothelium-derived relaxing factors and synthetic vasodilators transiently reduced contractile effects of ET-1...

  1. Lipomatosis of the sciatic nerve: typical and atypical MRI features

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Bernadette Zhi Ying [Mayo Clinic School of Medicine, Rochester, MN (United States); University College London, Royal Free and University College Medical School, London (United Kingdom); Amrami, Kimberly K.; Wenger, Doris E. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Dyck, P. James B. [Mayo Clinic, Department of Neurology, Rochester, MN (United States); Scheithauer, Bernd W. [Mayo Clinic, Department of Pathology, Rochester, MN (United States); Spinner, Robert J. [Mayo Clinic, Department of Neurologic Surgery, Rochester, MN (United States); Mayo Clinic, Department of Orthopedics, Rochester, MN (United States)

    2006-03-15

    Lipomatosis of nerve, also known as fibrolipomatous hamartoma, is a rare condition of nerve, usually affecting the median nerve. The MRI appearance is characteristic. We describe two cases of lipomatosis of nerve involving the sciatic nerve, an extremely unusual location for this lesion, in patients with sciatic neuropathy. These cases share the typical features previously described in the literature for other nerves, but also contain atypical features not previously highlighted, relating to the variability in distribution and extent of the fatty deposition. Recognition of the MRI appearance of this entity is important in order to avoid unnecessary attempts at surgical resection of this lesion. (orig.)

  2. Lipomatosis of the sciatic nerve: typical and atypical MRI features

    International Nuclear Information System (INIS)

    Lipomatosis of nerve, also known as fibrolipomatous hamartoma, is a rare condition of nerve, usually affecting the median nerve. The MRI appearance is characteristic. We describe two cases of lipomatosis of nerve involving the sciatic nerve, an extremely unusual location for this lesion, in patients with sciatic neuropathy. These cases share the typical features previously described in the literature for other nerves, but also contain atypical features not previously highlighted, relating to the variability in distribution and extent of the fatty deposition. Recognition of the MRI appearance of this entity is important in order to avoid unnecessary attempts at surgical resection of this lesion. (orig.)

  3. Microsurgical anatomy of the abducens nerve.

    Science.gov (United States)

    Joo, Wonil; Yoshioka, Fumitaka; Funaki, Takeshi; Rhoton, Albert L

    2012-11-01

    The aim of this study is to demonstrate and review the detailed microsurgical anatomy of the abducens nerve and surrounding structures along its entire course and to provide its topographic measurements. Ten cadaveric heads were examined using ×3 to ×40 magnification after the arteries and veins were injected with colored silicone. Both sides of each cadaveric head were dissected using different skull base approaches to demonstrate the entire course of the abducens nerve from the pontomedullary sulcus to the lateral rectus muscle. The anatomy of the petroclival area and the cavernous sinus through which the abducens nerve passes are complex due to the high density of critically important neural and vascular structures. The abducens nerve has angulations and fixation points along its course that put the nerve at risk in many clinical situations. From a surgical viewpoint, the petrous tubercle of the petrous apex is an intraoperative landmark to avoid damage to the abducens nerve. The abducens nerve is quite different from the other nerves. No other cranial nerve has a long intradural path with angulations and fixations such as the abducens nerve in petroclival venous confluence. A precise knowledge of the relationship between the abducens nerve and surrounding structures has allowed neurosurgeon to approach the clivus, petroclival area, cavernous sinus, and superior orbital fissure without surgical complications. PMID:22334502

  4. Coronary Artery Bypass

    Directory of Open Access Journals (Sweden)

    Kadri Ceberut

    2011-01-01

    Full Text Available Ancient schwannoma is a rare variant of neural tumors though rarely seen in the thorax. The combination with coronary artery diseases is also rare. Here we describe a 66 year-old male who had undergone one-stage combined surgery for thoracic ancient schwannomas removal and coronary artery disease. The masses were, respectively, 13 cm in the middle mediastinum and 5 cm in diameter originating from the intercostal nerve. The tumors were successfully removed using sternotomy, and then a coronary artery bypass grafting was performed. Here we discuss this rare tumor in relation to the relevant literature.

  5. Sosiaalisen median mahdollisuudet markkinoinnissa Case: Bluebird

    OpenAIRE

    Kinnunen, Mikko

    2014-01-01

    Opinnäytetyön aiheena oli tutkia sosiaalisen median markkinointimahdollisuuksia yrityksille. Lisäksi tavoitteena oli löytää sopivat sosiaalisen median palvelut, joissa kohdeyritys voi toteuttaa markkinointiaan. Tavoitteena oli löytää kustannustehokkaita sosiaalisen median palveluita, jotka tehostavat yrityksen markkinointia ja tuo sille lisänäkyvyyttä verkossa. Opinnäytetyön kohdeyritys oli newschool-lasketteluun erikoistunut jälleenmyyntiliike, Bluebird. Tutkimuksen teoriaosuudessa tutus...

  6. Sosiaalisen median raportointityökalu

    OpenAIRE

    Ollonen, Annika

    2014-01-01

    Insinöörityön tarkoitus oli rakentaa sosiaalisen median raportointityökalu, joka koostaa mahdollisimman automatisoidusti kuukausiraportin yrityksen menestymisestä tietyssä sosiaalisen median kanavassa. Työkaluun liitettiin tässä versiossa sosiaalisen median kanavista ainoastaan Facebook, josta haettiin tietoja neljästä eri osa-alueesta: yhteisö, aktiivisuus, tavoittavuus ja käytetty mediabudjetti. Raporttiin tulevat mittarit valittiin huolellisesti siten, että ne kuvastavat mahdollisimman kok...

  7. Advanced median method for timing jitter compensation

    Institute of Scientific and Technical Information of China (English)

    Wang Chen; Zhu Jiangmiao; Jan Verspecht; Liu Mingliang; Li Yang

    2008-01-01

    Timing jitter is one of the main factors that influence on the accuracy of time domain precision measurement. Timing jitter compensation is one of the problems people concern. Because of the flaws of median method, PDF deconvolution method and synthetic method, we put forward a new method for timing jitter compensation, which is called advanced median method. The theory of the advanced median method based on probability and statistics is analyzed, and the process of the advanced median method is summarized in this paper. Simulation and experiment show that compared with other methods, the new method could compensate timing jitter effectively.

  8. Sosiaalisen median strategia : Case Yritys X

    OpenAIRE

    Tuomola, Miikka

    2015-01-01

    Tämän opinnäytetyön tarkoituksena oli luoda sosiaalisen median strategia Yritys X:n käyttöön. Tavoitteena oli löytää suomalaiselle telekommunikaatioalalla toimivalle yritykselle sopivat sosiaalisen median kanavat, jotka tarjoavat väylän markkinoinnin tehostamiseen ja yrityksen imagon vahvistamiseen. Toimeksiantaja keskittyy liiketoiminnassaan B2B-liiketoimintaan. Strategia oli ajankohtainen sosiaalisen median roolin jatkuvan kasvun vuoksi. Sosiaalisen median merkitys ja rooli on merkittäv...

  9. Ulnar Nerve Compression in Guyon's Canal by Ganglion Cyst.

    Science.gov (United States)

    Kwak, Kyung-Woo; Kim, Min-Su; Chang, Chul-Hoon; Kim, Seong-Ho

    2011-02-01

    Compression of the ulnar nerve in Guyon's canal can result from repeated blunt trauma, fracture of the hamate's hook, and arterial thrombosis or aneurysm. In addition, conditions such as ganglia, rheumatoid arthritis and ulnar artery disease can rapidly compress the ulnar nerve in Guyon's canal. A ganglion cyst can acutely protrude or grow, which also might compress the ulnar nerve. So, clinicians should consider a ganglion cyst in Guyon's canal as a possible underlying cause of ulnar nerve compression in patients with a sudden decrease in hand strength. We believe that early decompression with removal of the ganglion is very important to promote complete recovery. PMID:21519507

  10. ULNAR NERVE, ITS TERMINATION AND SUPERFICIAL BRANCHES IN HAND: A CADAVERIC STUDY

    OpenAIRE

    A Priyadarshini; Sudakshina Chakrabarti; Gunapriya Raghunath

    2015-01-01

    Introduction: Nerves supplying the hand are notoriously variable in their divisions and their course; do not follow any standard pattern. The palmar aspect of hand is supplied by median and ulnar nerve. The clinical importance of Guyon's canal is emphasized due to the various branching patterns of the ulnar nerve in this canal. The palmar aspect of hand is usually supplied by ulnar nerve and median nerve. Medial one and a half fingers are supplied by ulnar nerve and lateral three and a half f...

  11. LOCAL MEDIAN ESTIMATION OF VARIANCE FUNCTION

    Institute of Scientific and Technical Information of China (English)

    杨瑛

    2004-01-01

    This paper considers local median estimation in fixed design regression problems. The proposed method is employed to estimate the median function and the variance function of a heteroscedastic regression model. Strong convergence rates of the proposed estimators are obtained. Simulation results are given to show the performance of the proposed methods.

  12. Clinical and radiologic review of uncommon cause of profound iron deficiency anemia: Median arcuate ligament syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Gunduz, Yasemin; Asil, Kiyasrttin; Aksoy, Yakup Ersel; Ayhan, Lacin Tatli [Dept. of Radiology, Sakarya University Medical Faculty, Sakarya (Turkmenistan)

    2014-08-15

    Median arcuate ligament syndrome is an anatomic and clinical entity characterized by dynamic compression of the proximal celiac artery by the median arcuate ligament, which leads to postprandial epigastric pain, vomiting, and weight loss. These symptoms are usually nonspecific and are easily misdiagnosed as functional dyspepsia, peptic ulcer disease, or gastropathy. In this report, we presented a 72-year-old male patient with celiac artery compression syndrome causing recurrent abdominal pain associated with gastric ulcer and iron deficiency anemia. This association is relatively uncommon and therefore not well determined. In addition, we reported the CT angiography findings and three-dimensional reconstructions of this rare case.

  13. Cutaneous nerve entrapment syndrome

    Institute of Scientific and Technical Information of China (English)

    DongFuhui

    2004-01-01

    The cutaneous nerve entrapment syndrome is named that, the cutaneous nerve's functional disorder caused by some chronic entrapment, moreover appears a series of nerve's feeling obstacle,vegetative nerve function obstacle, nutrition obstacle, even motor function obstacle in various degree.

  14. Nerve biopsy (image)

    Science.gov (United States)

    Nerve biopsy is the removal of a small piece of nerve for examination. Through a small incision, a sample ... is removed and examined under a microscope. Nerve biopsy may be performed to identify nerve degeneration, identify ...

  15. Median Approximations for Genomes Modeled as Matrices.

    Science.gov (United States)

    Zanetti, Joao Paulo Pereira; Biller, Priscila; Meidanis, Joao

    2016-04-01

    The genome median problem is an important problem in phylogenetic reconstruction under rearrangement models. It can be stated as follows: Given three genomes, find a fourth that minimizes the sum of the pairwise rearrangement distances between it and the three input genomes. In this paper, we model genomes as matrices and study the matrix median problem using the rank distance. It is known that, for any metric distance, at least one of the corners is a [Formula: see text]-approximation of the median. Our results allow us to compute up to three additional matrix median candidates, all of them with approximation ratios at least as good as the best corner, when the input matrices come from genomes. We also show a class of instances where our candidates are optimal. From the application point of view, it is usually more interesting to locate medians farther from the corners, and therefore, these new candidates are potentially more useful. In addition to the approximation algorithm, we suggest a heuristic to get a genome from an arbitrary square matrix. This is useful to translate the results of our median approximation algorithm back to genomes, and it has good results in our tests. To assess the relevance of our approach in the biological context, we ran simulated evolution tests and compared our solutions to those of an exact DCJ median solver. The results show that our method is capable of producing very good candidates. PMID:27072561

  16. MR imaging of the cranial nerves and the intracranial vessels using 3D-SPGR

    International Nuclear Information System (INIS)

    MR angiography (MRA) has developed rapidly, but it is still insufficient to demonstrate the detail of the intracranial vascular anatomy. We found that original images of MRA render more information than MRA images about not only intracranial vessels but also cranial nerves. We have tried to demonstrate cranial nerves and intracranial vessels on 26 patients and evaluated using real time reformation of original images of MRA. MR images were obtained by SPGR (3DFT) after injection of Gd-DTPA. The optic nerve, the oculomotor nerve, the trigeminal nerve, the facial nerve and the vestibulocochlear nerve were visualized clearly on almost patients and detectabilities of these nerves were 100%, 98%, 100%, 94% and 100%, respectively. The abducent nerve was also detectable in 76%. The trochlear nerve, which could not be observed by any modality, was detected at prepontine cistern in 10%. Arteries around brain stem such as the superior cerebellar artery (SCA), the anterior inferior cerebellar artery (AICA), the posterior inferior cerebellar artery (PICA) and the posterior communicating artery (PcomA) were clearly visible, and branching of these arteries and anatomical detail were completely coincide with angiogram on 12 patients. The basal vein of Rosenthal and the petrosal vein were confirmed in 100% and their anastomose were demonstrated obviously. We concluded that this method was extremely useful to observe cranial nerves and intracranial small vessels. (author)

  17. ANATOMICAL PRINCIPLES BEHIND PRESERVATION OF LARYNGEAL NERVES DURING THYROIDECTOMY

    Directory of Open Access Journals (Sweden)

    O. Fabian

    2011-08-01

    Full Text Available This paper presents the anatomical principles behind preservation of inferior laryngeal nerve and of the external branch of superior laryngeal nerve during thyroidectomy. The embryological development of thyroid and recurrent laryngeal nerves explains the constant relationship between Zuckerkandl’s tuberculum and the recurrent laryngeal nerve, while anomalies in development of the aortic arches explain the presence of rare anatomical variants, with a high risk of nerve injury, of non-recurrent course of the inferior laryngeal nerve. Good knowledge of the relationship between the external branch of superior laryngeal nerve and the superior thyroid artery makes possible to avoid transection of this branch during ligature around superior thyroid artery and vein. Anatomical landmarks used to identify the recurrent laryngeal nerve (tracheo-oesophageal sulcus, the cross-over with the inferior thyroid artery, Berry’s ligament, Zuckerkandl’s tuberculum and variations in the extra-laryngeal branching of the nerve are discussed based on data from the literature. The anatomical variants when the inferior laryngeal nerve doesn’t have a recurrent course are also discussed

  18. Nerve conduction velocity in hypertensive patients.

    Science.gov (United States)

    Halar, E M; Stewart, D T; Venkatesh, B; Chrissian, S A

    1978-01-01

    Due to conflicting reports in the literature regarding nerve conduction velocities (NCVs) in hypertensives, peroneal and sural NCVs and facial nerve conduction latencies were studied in 30 hypertensives and in 30 controls. An improved technique of NCV measurement was used. Twenty-one of the hypertensives were retested after five weeks, and five of them were tested for motor and sensory NCVs of the median nerve during a short period of partial occlusion of blood flow in the arm. No changes were found that could be related to blood pressure, duration of hypertension, eyeground changes, or partial restriction of blood flow. PMID:619818

  19. [An autopsy case of neuronal type Charcot-Marie-Tooth disease (HMSN type II) with nerve deafness and psychiatric symptoms].

    Science.gov (United States)

    Yoshimura, I; Yoshimura, N; Hanazono, T; Usutani, S; Muramoto, Y; Fukushima, Y

    1992-06-01

    The clinical and pathological findings of a 41-year-old male patient with atypical Charcot-Marie-Tooth disease were reported. There were 3 cases of subarachnoid haemorrhage, 2 nerve deafness and 2 hereditary motor and sensory neuropathy (HMSN) in his family. He had suffered from progressive nerve deafness since 5 years old and gait disturbance since 37 years old. He had been admitted to the psychiatric hospital 3 times because of hallucinatory-delusional state and behavior abnormalities. Neurological examinations at 39 years old revealed that he had mental deterioration (IQ 66), nerve deafness, diffuse muscle atrophy, most marked distally, sensory disturbance, areflexia, positive Romberg's sign, orthostatic hypotension, dysphagia and slurred speech. MCV of median nerve was 27.8 m/sec, and SCV was not evoked. EEG revealed nonspecific dysfunction of the brain. He died of ileus-like condition at 41 years old. General autopsy showed haemorrhagic infarction of the jejunum and ileum due to compression of the superior mesenteric artery and vein by an adhesion band of connective tissue formed after previous appendectomy. Neuropathological examinations revealed axonal degeneration and loss of myelinated fibers with schwannosis of anterior and posterior spinal nerve roots as well as peripheral nerves. The posterior roots were more severely affected than the anterior ones. Ganglion cells of the posterior root ganglia showed remarkable degeneration and loss. There was severe degeneration of the posterior columns, especially in the gracilis, of the spinal cord. Nerve cells in the anterior horns and Clarke's columns also displayed conspicuous atrophy or central chromatolysis followed by gliosis. There was slight degeneration of the posterior spinocerebellar tracts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1389565

  20. ULNAR NERVE, ITS TERMINATION AND SUPERFICIAL BRANCHES IN HAND: A CADAVERIC STUDY

    Directory of Open Access Journals (Sweden)

    A Priyadarshini

    2015-12-01

    Full Text Available Introduction: Nerves supplying the hand are notoriously variable in their divisions and their course; do not follow any standard pattern. The palmar aspect of hand is supplied by median and ulnar nerve. The clinical importance of Guyon's canal is emphasized due to the various branching patterns of the ulnar nerve in this canal. The palmar aspect of hand is usually supplied by ulnar nerve and median nerve. Medial one and a half fingers are supplied by ulnar nerve and lateral three and a half fingers are supplied by the median nerve. The branches of ulnar nerve are notoriously variable morphologically and no standard pattern can be given regarding the course of these branches. Presence of trifurcation of ulnar nerve or communications of superficial branches to median nerve do not cause symptoms usually but becomes important during surgical and orthopaedic interventions. Material and Methods: The study was conducted on 40 hands (20 left and 20 right of preserved adult human cadavers.The roof of the Guyon's canal was opened with care not to disturb the stuctures. The ulnar nerve observed for its terminal branches, the course of its superficial branches was observed. The point of division of superficial branch into digital branches was measured from bistyloid line. The point of origin of superficial communicating branch from superficial branch or digital branch of ulnar nerve to median nerve was observed from bistyloid line. Observations: In 29 hands the ulnar nerve showed bifurcation, in 10 hands it trifurcated in the Guyon's canal and in 1 right hand of a male cadaver there was higher division of the ulnar nerve and trifurcation.The superficial branch was observed for its course and division from bistyloid line. The superficial branch gave rise to 2 digital branches in 27 hands and it gave 3 branches i.e. 2 digital branches and 1 communicating branch to medialmost digital branch of median nerve in 13 hands. The typical ramus communicans from

  1. Median topographic maps for biomedical data sets

    CERN Document Server

    Hammer, Barbara; Rossi, Fabrice; 10.1007/978-3-642-01805-3_6

    2009-01-01

    Median clustering extends popular neural data analysis methods such as the self-organizing map or neural gas to general data structures given by a dissimilarity matrix only. This offers flexible and robust global data inspection methods which are particularly suited for a variety of data as occurs in biomedical domains. In this chapter, we give an overview about median clustering and its properties and extensions, with a particular focus on efficient implementations adapted to large scale data analysis.

  2. Phrenic nerve conduction time in Guillain-Barré syndrome.

    OpenAIRE

    M Gourie-Devi; Ganapathy, G R

    1985-01-01

    Phrenic nerve conduction was studied in 28 patients with Guillain-Barré syndrome. Conduction time was prolonged in 18 (64.3%) patients and serial studies showed progressive improvement with restoration of normal values in the majority by 12 weeks. The conduction abnormalities had a positive correlation with the extent of the disease, morbidity and mortality. Phrenic nerve conduction time was found to be a more sensitive parameter than vital capacity or median nerve motor conduction velocity i...

  3. Reflex effects of aerosolized histamine on phrenic nerve activity.

    OpenAIRE

    Pack, A I; Hertz, B C; Ledlie, J F; Fishman, A. P.

    1982-01-01

    Studies were conducted in anesthetized, paralyzed dogs on the effect of aerosolized histamine on phrenic nerve activity. The paralyzed dogs were ventilated in phase with their recorded phrenic nerve activity at a constant inspiratory flow-rate, using a cycle-triggered ventilator. Phrenic nerve activity was measured before and during administration of aerosolized histamine while the inspiratory flow-rate and arterial blood gases were kept constant. In addition, before and after histamine, phre...

  4. Arterial Catheterization

    Science.gov (United States)

    ... version AMERICAN THORACIC SOCIETY Patient Information Series Arterial Catheterization An arterial catheter is a thin, hollow tube ... PHYSICIANS: AND COPY Why Do I Need Arterial Catheterization? Common reasons an arterial catheterization is done include: ■ ...

  5. The morphological substrate for Renal Denervation : Nerve distribution patterns and parasympathetic nerves. A post-mortem histological study

    NARCIS (Netherlands)

    van Amsterdam, Wouter A C; Blankestijn, Peter J; Goldschmeding, Roel; Bleys, Ronald L A W

    2015-01-01

    BACKGROUND: Renal Denervation as a possible treatment for hypertension has been studied extensively, but knowledge on the distribution of nerves surrounding the renal artery is still incomplete. While sympathetic and sensory nerves have been demonstrated, there is no mention of the presence of paras

  6. Three-dimensional Reconstruction of Peripheral Nerve Internal Fascicular Groups.

    Science.gov (United States)

    Zhong, Yingchun; Wang, Liping; Dong, Jianghui; Zhang, Yi; Luo, Peng; Qi, Jian; Liu, Xiaolin; Xian, Cory J

    2015-01-01

    Peripheral nerves are important pathways for receiving afferent sensory impulses and sending out efferent motor instructions, as carried out by sensory nerve fibers and motor nerve fibers. It has remained a great challenge to functionally reconnect nerve internal fiber bundles (or fascicles) in nerve repair. One possible solution may be to establish a 3D nerve fascicle visualization system. This study described the key technology of 3D peripheral nerve fascicle reconstruction. Firstly, fixed nerve segments were embedded with position lines, cryostat-sectioned continuously, stained and imaged histologically. Position line cross-sections were identified using a trained support vector machine method, and the coordinates of their central pixels were obtained. Then, nerve section images were registered using the bilinear method, and edges of fascicles were extracted using an improved gradient vector flow snake method. Subsequently, fascicle types were identified automatically using the multi-directional gradient and second-order gradient method. Finally, a 3D virtual model of internal fascicles was obtained after section images were processed. This technique was successfully applied for 3D reconstruction for the median nerve of the hand-wrist and cubital fossa regions and the gastrocnemius nerve. This nerve internal fascicle 3D reconstruction technology would be helpful for aiding peripheral nerve repair and virtual surgery. PMID:26596642

  7. Switching non-local vector median filter

    Science.gov (United States)

    Matsuoka, Jyohei; Koga, Takanori; Suetake, Noriaki; Uchino, Eiji

    2016-04-01

    This paper describes a novel image filtering method that removes random-valued impulse noise superimposed on a natural color image. In impulse noise removal, it is essential to employ a switching-type filtering method, as used in the well-known switching median filter, to preserve the detail of an original image with good quality. In color image filtering, it is generally preferable to deal with the red (R), green (G), and blue (B) components of each pixel of a color image as elements of a vectorized signal, as in the well-known vector median filter, rather than as component-wise signals to prevent a color shift after filtering. By taking these fundamentals into consideration, we propose a switching-type vector median filter with non-local processing that mainly consists of a noise detector and a noise removal filter. Concretely, we propose a noise detector that proactively detects noise-corrupted pixels by focusing attention on the isolation tendencies of pixels of interest not in an input image but in difference images between RGB components. Furthermore, as the noise removal filter, we propose an extended version of the non-local median filter, we proposed previously for grayscale image processing, named the non-local vector median filter, which is designed for color image processing. The proposed method realizes a superior balance between the preservation of detail and impulse noise removal by proactive noise detection and non-local switching vector median filtering, respectively. The effectiveness and validity of the proposed method are verified in a series of experiments using natural color images.

  8. Improved Median Polish Kriging for Simulation Metamodeling

    OpenAIRE

    Rekabi, Firas Al; Sheikh, Asim El

    2013-01-01

    In simulation, Median Polish Kriging is a technique used to predict unobserved data points in two-dimensional space. The linear behavior of the traditional Median Polish Kriging in the estimation of the mean function in a high grid makes the interpolation of O(1) which has a low order in the prediction and that leads to a high prediction error. Therefore, an improvement in the estimation of the mean function has been introduced using Biharmonic spline interpolation and the new technique has b...

  9. Suunnitteluprosessina sosiaalisen median strategia : Case: Osuuskauppa Arina

    OpenAIRE

    Rintala, Markus

    2016-01-01

    Opinnäytetyön tarkoituksena on selvittää sosiaalista mediaa, sen hyötyjä ja haasteita yrityksille, miten sitä hyödynnetään muuten suomalaisissa yrityksissä, kuinka se on vaikuttanut yritysviestintään sekä, mistä sosiaalisen median strategia koostuu ja miten se voidaan ottaa osaksi yritystä. Työn tietoperustassa on käytetty lähteinä kirjallisuutta, verkkolähteitä, sosiaalisen median asiantuntijoiden Harto Pöngän ja Juha Huovisen sekä Osuuskauppa Arinan markkinointijohtaja Pasi Ruuskasen haasta...

  10. Sosiaalisen median toimintasuunnitelma, case Guild Travel Ltd

    OpenAIRE

    Vanhanen, Anni

    2014-01-01

    Tämän työn tarkoituksena on luoda käyttökelpoinen sosiaalisen median markkinointi-suunnitelma lontoolaiselle matkatoimistolle, joka myy matkoja Suomeen. Työn toimek-siantaja on Guild Travel Ltd. Työ toteutettiin vuoden 2014 keväällä. Työssä esitellään toimeksiantaja matkailualan toimijana ja perehdytään markkinoinnin teoriaan. Käsittelyssä ovat useat eri markkinoinnin teoriat, kuten SOSTAC, SMART ja marketing mix. Näitä malleja hyödyntäen luodaan yrityksen sosiaalisen median toimin-tasuun...

  11. 手掌部浅血管神经层与屈肌支持带关系的观测%Observation on the Relationship between the Layer of Superficial Vessels and Nerves and Flexor Retinaculum in Palm of Hand

    Institute of Scientific and Technical Information of China (English)

    杨开明; 王勇; 杨新文

    2000-01-01

    目的:为腕管松解术及掌中间隙引流术提供解剖学基础。方法:18例(男12、女6)36侧成人固定上肢标本上对手掌部屈肌支持带、正中神经、尺神经在腕掌部分支点和掌浅弓最高点与屈肌支持带下缘的距离以及尺动脉终末支与正中神经间距观测。结果:正中神经掌部分支点距屈肌支持带下缘9±3mm。尺神经掌部分支点距屈肌支持带下缘5±2mm。正中神经干与尺动脉终末支间距为10±2mm。结论:在手掌部掌长肌腱与第三指蹼尺侧缘连线尺侧1.0cm,腕横韧带下缘远侧2.5cm内确有无血管、神经的相对安全区。%Objective: To provide the anatomy basis for the carpal canal released and the middle palamar space drainaged. Methods: We observed the support points of the flexor retinacultm, median nerve and ulnar nerve in palm of hand, the distance between the top of superficial plamar arch and the low edge of flexor retinaculum, and the distance between the ulnar artery endness branch and median nerve in 18 cases of adult specimens (male 12,female 6) Results: The distance between median nerve ramis point in palm of hand and the low edge of flexor retinaculum was 9.0 ±+ 3.0 mm. The distance between ulnar nerve ramis point in palm of hand and the low edge of flexor retinaculum was 5.0±+ 2.0. The distance between median nerve trunk and ulnar artery endness branch was 10.0 + 2.0. Conclusions: There is a security related territory where is situated between long palmar muscle tendon and lunar interior of the third digit about 1.0 crm, distal 2.5 cm of flexor retinaculum lacking of vessels and nerves in the palm of hand.

  12. A novel method of selective ablation of afferent renal nerves by periaxonal application of capsaicin

    OpenAIRE

    Foss, Jason D.; Wainford, Richard D.; Engeland, William C.; Fink, Gregory D.; Osborn, John W.

    2014-01-01

    Renal denervation has been shown to lower arterial pressure in some hypertensive patients, yet it remains unclear whether this is due to ablation of afferent or efferent renal nerves. To investigate the role of afferent renal nerves in arterial pressure regulation, previous studies have used methods that disrupt both renal and nonrenal afferent signaling. The present study was conducted to develop and validate a technique for selective ablation of afferent renal nerves that does not disrupt o...

  13. Use of superficial peroneal nerve graft for treating peripheral nerve injuries

    Directory of Open Access Journals (Sweden)

    Samuel Ribak

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the clinical results from treating chronic peripheral nerve injuries using the superficial peroneal nerve as a graft donor source. METHODS: This was a study on eleven patients with peripheral nerve injuries in the upper limbs that were treated with grafts from the sensitive branch of the superficial peroneal nerve. The mean time interval between the dates of the injury and surgery was 93 days. The ulnar nerve was injured in eight cases and the median nerve in six. There were three cases of injury to both nerves. In the surgery, a longitudinal incision was made on the anterolateral face of the ankle, thus viewing the superficial peroneal nerve, which was located anteriorly to the extensor digitorum longus muscle. Proximally, the deep fascia between the extensor digitorum longus and the peroneal longus muscles was dissected. Next, the motor branch of the short peroneal muscle (one of the branches of the superficial peroneal nerve was identified. The proximal limit of the sensitive branch was found at this point. RESULTS: The average space between the nerve stumps was 3.8 cm. The average length of the grafts was 16.44 cm. The number of segments used was two to four cables. In evaluating the recovery of sensitivity, 27.2% evolved to S2+, 54.5% to S3 and 18.1% to S3+. Regarding motor recovery, 72.7% presented grade 4 and 27.2% grade 3. There was no motor deficit in the donor area. A sensitive deficit in the lateral dorsal region of the ankle and the dorsal region of the foot was observed. None of the patients presented complaints in relation to walking. CONCLUSIONS: Use of the superficial peroneal nerve as a graft source for treating peripheral nerve injuries is safe and provides good clinical results similar to those from other nerve graft sources.

  14. Use of superficial peroneal nerve graft for treating peripheral nerve injuries☆

    Science.gov (United States)

    Ribak, Samuel; da Silva Filho, Paulo Roberto Ferreira; Tietzmann, Alexandre; Hirata, Helton Hiroshi; de Mattos, Carlos Augusto; da Gama, Sérgio Augusto Machado

    2016-01-01

    Objective To evaluate the clinical results from treating chronic peripheral nerve injuries using the superficial peroneal nerve as a graft donor source. Methods This was a study on eleven patients with peripheral nerve injuries in the upper limbs that were treated with grafts from the sensitive branch of the superficial peroneal nerve. The mean time interval between the dates of the injury and surgery was 93 days. The ulnar nerve was injured in eight cases and the median nerve in six. There were three cases of injury to both nerves. In the surgery, a longitudinal incision was made on the anterolateral face of the ankle, thus viewing the superficial peroneal nerve, which was located anteriorly to the extensor digitorum longus muscle. Proximally, the deep fascia between the extensor digitorum longus and the peroneal longus muscles was dissected. Next, the motor branch of the short peroneal muscle (one of the branches of the superficial peroneal nerve) was identified. The proximal limit of the sensitive branch was found at this point. Results The average space between the nerve stumps was 3.8 cm. The average length of the grafts was 16.44 cm. The number of segments used was two to four cables. In evaluating the recovery of sensitivity, 27.2% evolved to S2+, 54.5% to S3 and 18.1% to S3+. Regarding motor recovery, 72.7% presented grade 4 and 27.2% grade 3. There was no motor deficit in the donor area. A sensitive deficit in the lateral dorsal region of the ankle and the dorsal region of the foot was observed. None of the patients presented complaints in relation to walking. Conclusions Use of the superficial peroneal nerve as a graft source for treating peripheral nerve injuries is safe and provides good clinical results similar to those from other nerve graft sources. PMID:26962502

  15. Peripheral nerve injuries in the athlete.

    Science.gov (United States)

    Feinberg, J H; Nadler, S F; Krivickas, L S

    1997-12-01

    outcome. Proximal nerve injuries have a poorer prognosis for neurological recovery. The most common peripheral nerve injury in the athlete is the burner syndrome. Though primarily a football injury, burners have been reported in wrestling, hockey, basketball and weight-lifting as a result of acute head, neck and/or shoulder trauma. Most burners are self-limiting, but they occasionally produce permanent neurological deficits. The axillary nerve is commonly injured with shoulder dislocations but is also susceptible to injury by direct compression. The sciatic and common peroneal nerves can be injured by trauma. The suprascapular, musculocutaneous, ulnar, median and tibial nerves are susceptible to entrapment. The long thoracic and femoral nerves can be injured by severe traction. PMID:9421863

  16. The median forehead flap reviewed: a histologic study on vascular anatomy.

    Science.gov (United States)

    Skaria, A M

    2015-05-01

    Local skin flaps can be divided into two types: random flaps and axial flaps. An axial flap is defined as a flap containing a named artery in its pedicle. For the paramedian forehead flap (PMFF) a lot of surgeons insist on the point that the pedicle must contain the supratrochlear artery. To demonstrate that median forehead flaps (MFF) need not contain a named artery, we selected first 8 patients with a PMFF and further 12 patients who had undergone reconstructive surgery using a MFF. After division, we analysed the pedicle of the flap histologically and measured the diameter of the arteries or arterioles and compared them to anatomical descriptions of the frontal arteries. In none of the 12 cases could we find a functional artery of approximately 1 mm in diameter that could correspond to the supratrochlear artery. The MFF is an axial flap but not in accordance with the current definition of this term. In contrast to published literature, we show that only in a part of cases a named artery was present in the pedicle. Despite this fact, the MFF is a secure flap for full thickness defect repair on the nose. PMID:24756613

  17. Cervical Radiculopathy (Pinched Nerve)

    Science.gov (United States)

    ... the seven small vertebrae that form the neck. Spinal nerve root. AAOS does not endorse any treatments, procedures, ... whether your symptoms are caused by pressure on spinal nerve roots and nerve damage or by another condition ...

  18. Nerve conduction velocity

    Science.gov (United States)

    Nerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. ... surface electrodes are placed on the skin over nerves at different spots. Each patch gives off a ...

  19. Optic Nerve Imaging

    Science.gov (United States)

    ... News About Us Donate In This Section Optic Nerve Imaging email Send this article to a friend ... measurements of nerve fiber damage (or loss). The Nerve Fiber Analyzer (GDx) uses laser light to measure ...

  20. Femoral nerve damage (image)

    Science.gov (United States)

    The femoral nerve is located in the leg and supplies the muscles that assist help straighten the leg. It supplies sensation ... leg. One risk of damage to the femoral nerve is pelvic fracture. Symptoms of femoral nerve damage ...

  1. Ulnar nerve damage (image)

    Science.gov (United States)

    The ulnar nerve originates from the brachial plexus and travels down arm. The nerve is commonly injured at the elbow because of elbow fracture or dislocation. The ulnar nerve is near the surface of the body where ...

  2. Ultrasound in the diagnosis of a median neuropathy in the forearm: case report

    Directory of Open Access Journals (Sweden)

    Yoon Joon-Shik

    2007-12-01

    Full Text Available Abstract Background Electrodiagnostic studies are traditionally used in the diagnosis of focal neuropathies, however they lack anatomical information regarding the nerve and its surrounding structures. The purpose of this case is to show that high-resolution ultrasound used as an adjunct to electrodiagnostic studies may complement this lack of information and give insight to the cause. Case presentation A 60-year-old male patient sustained a forearm traction injury resulting in progressive weakness and functional loss in the first three digits of the right hand. High-resolution ultrasound showed the presence of an enlarged nerve and a homogenous soft-tissue structure appearing to engulf the nerve. The contralateral side was normal. Surgery revealed fibrotic bands emanating from the flexor digitorum profundus muscle compressing the median nerve thus confirming the ultrasound findings. Conclusion A diagnostically challenging case of median neuropathy in the forearm is presented in which high-resolution ultrasound was valuable in establishing an anatomic etiology and directing appropriate management.

  3. Giant Serpentine Internal Carotid Artery Aneurysm: Endovascular Parent Artery Occlusion: A Pediatric Case Report

    OpenAIRE

    Prochazka, V.; Chmelova, J.; Cizek, V.; Skoloudik, D.; Hrbac, T.

    2007-01-01

    We report on a case of a 14-year-old boy with a giant serpentine aneurysm of the left internal carotid artery cavernous segment with symptoms of acute mass-effect cranial nerve dysfunction. After a balloon occlusion test of the collateral circulation, the patient underwent parent artery occlusion with platinum Guglielmi detachable coils and fibered coils. An optimal angiographic result and successful clinical outcome were achieved with resolution of IIIrd, IVth and Vlth cranial nerve ischemic...

  4. The symptomatology of megadolicho basilar artery.

    Science.gov (United States)

    Herpers, M; Lodder, J; Janevski, B; van der Lugt, P J

    1983-01-01

    Cranial nerve dysfunction, obstruction hydrocephalus, signs of brain stem dysfunction, and signs of a space-occupying lesion in the posterior fossa are presumed to be related to a megadolicho basilar artery, if present. Since there are no large series of patients with such vascular anomaly, a bias in relating symptoms with the presence of a megadolicho basilar artery is not excluded. We therefore studied retrospectively the incidence of megadolicho and dolicho basilar artery on cranial CT-scan of 3332 patients of 50 years and older. Patient records were reviewed for the above mentioned symptoms. 12 out of 22 patients with a megadolicho basilar artery and 2 patients out of 40 with a dolicho basilar artery had one or two of these symptoms. It is concluded that a megadolicho basilar artery can cause cranial nerve dysfunction, obstruction hydrocephalus, signs of brain stem dysfunction, and signs of a space-occupying lesion in the posterior fossa. PMID:6317247

  5. Therapeutic Management of Hypothenar Hammer Syndrome Causing Ulnar Nerve Entrapment

    OpenAIRE

    Nicolò Scuderi; Liliana De Santo; Giampaolo Monacelli; Mauro Tarallo; Anna Maria Spagnoli; Emanuele Cigna

    2010-01-01

    Introduction. The hypothenar hammer syndrome is a rare traumatic vascular disease of the hand. Method and Materials. We report the case of a 43-years-old man with a painful tumefaction of the left hypothenar region. The ulnar artery appeared thrombosed clinically and radiologically. The patient underwent surgery to resolve the ulnar nerve compression and revascularise the artery. Results. The symptoms disappeared immediately after surgery. The arterial flow was reestablished. Postoperatively ...

  6. Median Citation Index vs Journal Impact Factor

    Science.gov (United States)

    Antonoyiannakis, Manolis

    2015-03-01

    The Journal Impact Factor is an arithmetic mean: It is the average number of citations, in a year, to a journal's articles that were published the previous two years. But for the vast majority of scholarly journals, the distribution of these citations is skewed (non-symmetric). We argue that a more representative member of the skewed distribution of citations is its median, not the mean. We thus introduce the Median Citation Index (MCI) and compare it to the journal Impact Factor (JIF) as a potentially more suitable choice of the ``center'' of the distribution, or its typical value. Unlike the JIF, the MCI is far less sensitive to outlier (very highly cited) papers or to gaming, and does not lend itself to the hype of calculating it to three decimal digits.

  7. COLOUR IMAGE STEGANOGRAPHY USING MEDIAN MAINTENANCE

    Directory of Open Access Journals (Sweden)

    S. Arivazhagan

    2011-08-01

    Full Text Available Steganographic algorithms in the recent past have been producing stego images with perceptual invisibility, better secrecy and certain robustness against attacks like cropping, filtering etc. Recovering a good quality secret from a good quality stego image may not always be possible. The method proposed in this paper works in transform domain and attempts to extract the secret almost as same as the embedded one maintaining minimal changes to the cover image by using techniques like median maintenance, offset and quantization.

  8. Sosiaalisen median kampanjan viestintäsuunnitelma

    OpenAIRE

    Linna, Niina; Mäkinen, Joni

    2015-01-01

    Tämän opinnäytetyön tarkoituksena on suunnitella sosiaalisen median kampanja Oulun kansainväliselle lasten- ja nuortenelokuvien festivaalille. Toimeksiantajana on Oulun elokuvakeskus. Työn tavoitteena on suunnitella toimiva ja toteutuskelpoinen kampanja, jota toimeksiantaja voi hyödyntää tulevilla festivaaleilla. Kampanjan on tarkoitus olla edullinen tai kokonaan maksuton, nykyaikainen ja kohderyhmälleen sopiva. Kampanjan tavoitteena on lisätä festivaalin tunnettuutta ja asiakassuhteita. ...

  9. Portfolio optimization using median-variance approach

    Science.gov (United States)

    Wan Mohd, Wan Rosanisah; Mohamad, Daud; Mohamed, Zulkifli

    2013-04-01

    Optimization models have been applied in many decision-making problems particularly in portfolio selection. Since the introduction of Markowitz's theory of portfolio selection, various approaches based on mathematical programming have been introduced such as mean-variance, mean-absolute deviation, mean-variance-skewness and conditional value-at-risk (CVaR) mainly to maximize return and minimize risk. However most of the approaches assume that the distribution of data is normal and this is not generally true. As an alternative, in this paper, we employ the median-variance approach to improve the portfolio optimization. This approach has successfully catered both types of normal and non-normal distribution of data. With this actual representation, we analyze and compare the rate of return and risk between the mean-variance and the median-variance based portfolio which consist of 30 stocks from Bursa Malaysia. The results in this study show that the median-variance approach is capable to produce a lower risk for each return earning as compared to the mean-variance approach.

  10. Isolated abducens nerve palsy with hyperhomocysteinemia: Association and outcomes

    Directory of Open Access Journals (Sweden)

    Virender Sachdeva

    2013-01-01

    Full Text Available Ischemic abducens nerve palsy usually presents as isolated cranial nerve palsy in the middle aged and elderly patients with known risk factors such as diabetes mellitus, hypertension, dyslipidemia, carotid artery disease, etc., In this report, we describe four patients with isolated abducens nerve palsy who presented with an acute onset diplopia whose detailed history and examination were suggestive of an ischemic etiology. Detailed systemic and laboratory evaluation revealed hyperhomocysteinemia as the only potential risk factor. To the best of our knowledge this is the first report of association of hyperhomocysteinemia and isolated abducens nerve palsy.

  11. The gross anatomy of the renal sympathetic nerves revisited.

    Science.gov (United States)

    Mompeo, Blanca; Maranillo, Eva; Garcia-Touchard, Arturo; Larkin, Theresa; Sanudo, Jose

    2016-07-01

    Catheter-based renal denervation techniques focus on reducing blood pressure in resistant hypertension. This procedure requires exact knowledge of the anatomical interrelation between the renal arteries and the targeted renal nervous plexus. The aim of this work was to build on classical anatomical studies and describe the gross anatomy and anatomical relationships of the renal arteries and nerve supply to the kidneys in a sample of human cadavers. Twelve human cadavers (six males and six females), age range 73 to 94 years, were dissected. The nervous fibers and renal arteries were dissected using a surgical microscope. The renal plexus along the hilar renal artery comprised a fiber-ganglionic ring surrounding the proximal third of the renal artery, a neural network along the middle and distal thirds, and smaller accessory ganglia along the course of the nerve fibers. The fibers of the neural network were mainly located on the superior (95.83%) and inferior (91.66%) surfaces of the renal artery and they were sparsely interconnected by diagonal fibers. Polar arteries were present in 33.33% of cases and the renal nerve pattern for these was similar to that of the hilar arteries. Effective renal denervation needs to target the superior and inferior surfaces of the hilar and polar arteries, where the fibers of the neural network are present. Clin. Anat. 29:660-664, 2016. © 2016 Wiley Periodicals, Inc. PMID:27090982

  12. Surgical outcomes following nerve transfers in upper brachial plexus injuries

    Directory of Open Access Journals (Sweden)

    Bhandari P

    2009-01-01

    Full Text Available Background: Brachial plexus injuries represent devastating injuries with a poor prognosis. Neurolysis, nerve repair, nerve grafts, nerve transfer, functioning free-muscle transfer and pedicle muscle transfer are the main surgical procedures for treating these injuries. Among these, nerve transfer or neurotization is mainly indicated in root avulsion injury. Materials and Methods: We analysed the results of various neurotization techniques in 20 patients (age group 20-41 years, mean 25.7 years in terms of denervation time, recovery time and functional results. The inclusion criteria for the study included irreparable injuries to the upper roots of brachial plexus (C5, C6 and C7 roots in various combinations, surgery within 10 months of injury and a minimum follow-up period of 18 months. The average denervation period was 4.2 months. Shoulder functions were restored by transfer of spinal accessory nerve to suprascapular nerve (19 patients, and phrenic nerve to suprascapular nerve (1 patient. In 11 patients, axillary nerve was also neurotized using different donors - radial nerve branch to the long head triceps (7 patients, intercostal nerves (2 patients, and phrenic nerve with nerve graft (2 patients. Elbow flexion was restored by transfer of ulnar nerve motor fascicle to the motor branch of biceps (4 patients, both ulnar and median nerve motor fascicles to the biceps and brachialis motor nerves (10 patients, spinal accessory nerve to musculocutaneous nerve with an intervening sural nerve graft (1 patient, intercostal nerves (3rd, 4th and 5th to musculocutaneous nerve (4 patients and phrenic nerve to musculocutaneous nerve with an intervening graft (1 patient. Results: Motor and sensory recovery was assessed according to Medical Research Council (MRC Scoring system. In shoulder abduction, five patients scored M4 and three patients M3+. Fair results were obtained in remaining 12 patients. The achieved abduction averaged 95 degrees (range, 50 - 170

  13. Dorsal penile nerves and primary premature ejaculation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hai-feng; ZHANG Chun-ying; LI Xing-hua; FU Zhong-ze; CHEN Zhao-yan

    2009-01-01

    Background Based on our clinical experience, the number of dorsal penile nerves in patients with primary premature ejaculation (PPE) is not consistent with the average number (2 branches). In this study, we evaluated the number and distribution of dorsal penile nerves among healthy Chinese adults and patients with PPE.Methods The dorsal nerve of the penis, the deep dorsal vein of the penis, and the dorsal artery of the penis between the deep fascia of the penis and the albuginea penis were carefully educed, observed, and counted in 38 adult autopsy specimens. The number and distribution of the dorsal penile nerve in 128 surgical patients with PPE were determined. Results The numbers of dorsal penile nerves of the 38 cases were as follows:7 branches in 1 case; 6 branches in 1 case; 5 branches in 6 cases; 4 branches in 9 cases; 3 branches in 14 cases; and 2 branches in 7 cases. Most of the dorsal nerves were parallel to each other and in the dorsum of the penis. In only 8 cases, the branches were connected by some communicating branches. In 4 cases, 1 or 2 thin dorsal nerves continued their pathway over the ventral aspect of the penis. The average number of branches of the dorsal penile nerve in patients with PPE was 7.16. Conclusions Based on the study of 38 cases, the average number of dorsal penile nerves was 3.55 branches and that of patients with PPE was greater. These preliminary results suggest that the excessive dorsal penile nerves may have an impact on PPE via increased sensitivity and provide topographic data for the possible treatment of PPE.

  14. Case report: Double nerve transfer of the anterior and posterior interosseous nerves to treat a high ulnar nerve defect at the elbow.

    Science.gov (United States)

    Delclaux, S; Aprédoaei, C; Mansat, P; Rongières, M; Bonnevialle, P

    2014-10-01

    Double neurotization of the deep branch of ulnar nerve (DBUN) and superficial branch of ulnar nerve using the anterior interosseous nerve (AIN) and the recurrent (thenar) branch of the median nerve was first described by Battiston and Lanzetta. This article details the postoperative results after 18 months of a patient who underwent this technique using the posterior interosseous nerve (PIN) instead of the recurrent branch of the median nerve for sensory reconstruction. A 35-year-old, right-handed man suffered major trauma to his right upper limb following a serious motor vehicle accident. One year later, a pseudocystic neuroma of the ulnar nerve was evident on ultrasound examination and MRI. After the neuroma had been resected, the nerve defect was estimated at 8 cm. One and a half years after the initial trauma, with the patient still at M0/S0, we transferred the AIN and PIN onto the deep and superficial branches of the ulnar nerve respectively. Nerve recovery was monitored clinically every month and by electromyography (EMG) every three months initially and then every six months. At 18 months postoperative, 5th digit abduction/adduction was 28 mm. Sensation was present at the base of the 5th digit. The patient was graded M3/S2. Clear re-innervation of the abductor digiti minimi was demonstrated by EMG (motor conduction velocity 50 m/s). Given that the ulnar nerve could not be excited at the elbow, this re-innervation had to be the result of the double nerve transfer. Neurotization of the DBUN using the AIN produces functional results as early as 1 year after surgery. Using PIN for sensory neurotization is easy to perform, has no negative consequences for the donor site, and leads to good recovery of sensation (graded as S2) after 18 months. PMID:25260763

  15. Changes in retinal nerve fiber layer thickness after spinal surgery in the prone position: a prospective study

    Directory of Open Access Journals (Sweden)

    Baran Gencer

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: Changes in ocular perfusion play an important role in the pathogenesis of ischemic optic neuropathy. Ocular perfusion pressure is equal to mean arterial pressure minus intraocular pressure. The aim of this study was to evaluate the changes in the intraocular pressure and the retinal nerve fiber layer thickness in patients undergoing spinal surgery in the prone position. METHODS: This prospective study included 30 patients undergoing spinal surgery. Retinal nerve fiber layer thickness were measured one day before and after the surgery by using optical coherence tomography. Intraocular pressure was measured by tonopen six times at different position and time-duration: supine position (baseline; 10 min after intubation (Supine 1; 10 (Prone 1, 60 (Prone 2, 120 (Prone 3 min after prone position; and just after postoperative supine position (Supine 2. RESULTS: Our study involved 10 male and 20 female patients with the median age of 57 years. When postoperative retinal nerve fiber layer thickness measurements were compared with preoperative values, a statistically significant thinning was observed in inferior and nasal quadrants (p = 0.009 and p = 0.003, respectively. We observed a statistically significant intraocular pressure decrease in Supine 1 and an increase in both Prone 2 and Prone 3 when compared to the baseline. Mean arterial pressure and ocular perfusion pressure were found to be significantly lower in Prone 1, Prone 2 and Prone 3, when compared with the baseline. CONCLUSIONS: Our study has shown increase in intraocular pressure during spinal surgery in prone position. A statistically significant retinal nerve fiber layer thickness thinning was seen in inferior and nasal quadrants one day after the spinal surgery.

  16. Aldose reductase inhibition improves nerve conduction velocity in diabetic patients.

    Science.gov (United States)

    Judzewitsch, R G; Jaspan, J B; Polonsky, K S; Weinberg, C R; Halter, J B; Halar, E; Pfeifer, M A; Vukadinovic, C; Bernstein, L; Schneider, M; Liang, K Y; Gabbay, K H; Rubenstein, A H; Porte, D

    1983-01-20

    To assess the potential role of polyol-pathway activity in diabetic neuropathy, we measured the effects of sorbinil--a potent inhibitor of the key polyol-pathway enzyme aldose reductase--on nerve conduction velocity in 39 stable diabetics in a randomized, double-blind, cross-over trial. During nine weeks of treatment with sorbinil (250 mg per day), nerve conduction velocity was greater than during a nine-week placebo period for all three nerves tested: the peroneal motor nerve (mean increase [+/- S.E.M.], 0.70 +/- 0.24 m per second, P less than 0.008), the median motor nerve (mean increase, 0.66 +/- 0.27, P less than 0.005), and the median sensory nerve (mean increase, 1.16 +/- 0.50, P less than 0.035). Conduction velocity for all three nerves declined significantly within three weeks after cessation of the drug. These effects of sorbinil were not related to glycemic control, which was constant during the study. Although the effect of sorbinil in improving nerve conduction velocity in diabetics was small, the findings suggest that polyol-pathway activity contributes to slowed nerve conduction in diabetics. The clinical applicability of these observations remains to be determined, but they encourage further exploration of this approach to the treatment or prevention of diabetic neuropathy. PMID:6401351

  17. Solitary median maxillary central incisor (SMMCI) syndrome

    OpenAIRE

    Hall Roger K

    2006-01-01

    Abstract Solitary median maxillary central incisor syndrome (SMMCI) is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s) operating in utero about the 35th–38th day(s) from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F) at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; i...

  18. Sosiaalisen median markkinointiopas voittoa tavoittelemattomille organisaatioille

    OpenAIRE

    Niemi, Sonja

    2013-01-01

    Opinnäytetyön tavoite oli tuottaa sosiaalisen median markkinointiopas voittoa tavoittelemattomille järjestöille. Tehtävänanto liittyy Kouvolan Nuorkauppakamarin Mahdollisuuksien Kouvola -projektiin, jonka tarkoitus on edistää positiivista kuvaa Kouvolasta yrittäjyyskaupunkina. Mahdollisuuksien Kouvola -projektilla on oma verkkosivustonsa Kouvolassa.net ja saman niminen Facebook-sivu. Markkinointiopas tulee ensisijaisesti Kouvolan Nuorkauppakamarin käyttöön ja on tarkoitettu käytettäväksi ...

  19. Hyperdensity of the Basilar Artery on Postmortem CT: A Potential Indicator for Basilar Artery Thrombosis.

    Science.gov (United States)

    Garland, Jack; Tse, Rexson; Beh, Raymond J; Lyons, Timothy J; Cala, Allan D

    2016-06-01

    Basilar artery thrombosis constitutes 1% of all types of stroke, carries a mortality rate of up to 90%, and is one of the rarer causes of sudden death. It leads to brain stem ischemia and commonly presents with impaired consciousness, cranial nerve palsy, hemiplegia or quadriplegia, and sudden collapse. Clinically, the diagnosis of basilar artery thrombosis is made on clinical symptoms, along with a hyperdense basilar artery in antemortem computed tomography (CT) scan. To our knowledge, whether a hyperdense basilar artery indicates basilar artery thrombosis on postmortem CT scan is not documented in the literature. We present a case report of a 55-year-old man who on postmortem CT scan showed a hyperdense basilar artery and was subsequently confirmed to be a fatal basilar artery thrombosis. We suggest that a hyperdense basilar artery on postmortem CT should prompt the pathologist to consider basilar artery thrombosis. PMID:27049662

  20. Complete oculomotor palsy caused by persistent trigeminal artery.

    Science.gov (United States)

    Bosco, Domenico; Consoli, Domenico; Lanza, Pier Luigi; Plastino, Massimiliano; Nicoletti, Francesco; Ceccotti, Claudio

    2010-10-01

    Primitive trigeminal artery (PTA) is the most frequent embryonic communication between the carotid and vertebro-basilar system. PTA is a pathophysiology phenomenon which has been implicated as a rare cause of cranial nerve dysfunction. We report the case of a 40-year-old woman who developed a complete oculomotor nerve palsy caused by a persistent ecstatic trigeminal artery. Brain MRI and MRA studies documented a neurovascular conflict between the oculomotor nerve and a PTA. To the best of our knowledge there is no report about complete third cranial nerve palsy NC due to a PTA. A role of this rare vascular condition is discussed. PMID:20552240

  1. Gestational pulmonary arterial hypertension

    OpenAIRE

    Moll, Matthew; Payne, Julie G.; Tukey, Melissa H.; Farber, Harrison W.

    2015-01-01

    Pulmonary arterial hypertension (PAH) is a progressive disease marked by the irreversible pulmonary vascular changes of vasoconstriction, thrombosis, and proliferation of smooth muscle and endothelial cells. The untreated clinical course is characterized by progressive dyspnea and a median survival of less than 3 years. Many of these patients are of child-bearing age; however, pregnancy leads to physiologic changes that are particularly poorly tolerated in PAH, conferring a 30%–56% mortality....

  2. Circle of Willis variant analogous to fetal type primitive trigeminal artery

    International Nuclear Information System (INIS)

    Primitive caroticobasilar anastomoses are uncommon embryonic arterial connections between the carotid (anterior) and vertebrobasilar (posterior) circulations. With the exception of extracranial proatlantal intersegmental arteries, these embryonic arterial anastomoses are named according to the cranial nerves which they parallel. In this report, a previously undescribed variant circle of Willis with supraclinoid caroticobasilar anastomosis, functionally equivalent to a fetal type primitive trigeminal artery, is presented. (orig.)

  3. Ulnar Nerve Tendon Transfers for Pinch.

    Science.gov (United States)

    Cook, Shane; Gaston, R Glenn; Lourie, Gary M

    2016-08-01

    Power and tip pinch are an integral part of intrinsic hand function that can be significantly compromised with dysfunction of the ulnar nerve. Loss of power pinch is one component that can significantly affect an individual's ability to perform simple daily tasks. Tip pinch is less affected, as this task has significant contributions from the median nerve. To restore power pinch, the primary focus must be on restoring the action of the adductor pollicis primarily, and if indicated the first dorsal interosseous muscle and flexor pollicis brevis. PMID:27387080

  4. Vascularized Nerve Bypass Graft: A Case Report of an Additional Treatment for Poor Sensory Recovery.

    Science.gov (United States)

    Usami, Satoshi; Tanaka, Kentaro; Ohkubo, Alisa; Okazaki, Mutsumi

    2016-04-01

    End-to-side neurorrhaphy has proven effective in basic research and in clinical application. One of the methods of end-to-side neurorrhaphy, nerve bypass technique, has been reported and axon regeneration has been proven. In clinical application, the utility of the nerve bypass technique has been revealed in some cases; however, these bypasses were performed using nonvascularized nerves. We initially used the vascularized nerve bypass graft technique with the sural nerve as a secondary clinical procedure after median nerve injury in a 61-year-old patient and achieved motor and sensory nerve regeneration, as supported by a nerve conduction study and clinical sensory test. This technique has the potential to become one of the choices for salvage procedure of severe nerve injury. PMID:27200248

  5. Retrobulbar diameter of optic nerve in glaucoma

    Directory of Open Access Journals (Sweden)

    Stefanović Ivan

    2009-01-01

    Full Text Available Introduction. The ultrasound diagnostics of the optic nerve includes the analysis of the optic nerve disc (PNO and measuring of its retrobulbar diameter. With B-scan, by Schraeder's method, it is possible to measure very precisely the optic nerve, the pial diameter, the normal values for the pial diameter being 2.8-4.1 mm. In glaucoma, the disease that is most frequently associated with higher intraocular pressure, there comes the destruction of nerve fibres, which can be visualized as the excavation of the optic nerve disc. Objective. In this paper, we were interested in finding whether in glaucoma, and in what phase of the disease, the optic nerve starts growing thinner. Aware of many forms of this very complex disease, we were interested in knowing if the visualization of excavation on the optic nerve disc is related to diminishing of the pial diameter of the retrobulbar nerve part. Methods. There were treated the patients who had already had the diagnosis of glaucoma and the visualized excavation of the optic disc of various dimensions. Echographically, there was measured the thickness of the retrobulbar part of the optic nerve and the finding compared in relation to the excavation of the optic disc. Results. In all eyes with glaucoma, a normal size of the retrobulbar part of the optic nerve was measured, ranging from 3.01 to 3.91 mm with the median of 3.36 mm. Also, by testing the correlation between the thickness of the optic nerve and the excavation of the PNO, by Pearson test, we found that there was no correlation between these two parameters (r=0.109; p>0.05. Conclusion. In the patients with glaucoma, the retrobulbar part of the optic nerve is not thinner (it has normal values, even not in the cases with a totally excavated optic disc. There is no connection between the size of the PNO excavation and the thickness of the retrobulbar part of the optic nerve.

  6. Recurrent ulnar nerve entrapment at the elbow: Correlation of surgical findings and 3-Tesla magnetic resonance neurography

    OpenAIRE

    Chhabra, Avneesh; Wadhwa, Vibhor; Thakkar, Rashmi S; John A Carrino; Dellon, A. Lee

    2013-01-01

    The authors describe the correlation between 3-Tesla magnetic resonance neurography (MRN) and surgical findings in two patients who underwent multiple previous failed ulnar nerve surgeries. MRN correctly localized the site of the abnormality. Prospectively observed MRN findings of perineural fibrosis, ulnar nerve re-entrapment abnormalities, medial antebrachial cutaneous neuroma and additional median nerve entrapment were confirmed surgically.

  7. Sosiaalisen median paikallismarkkinointisuunitelma : case: Lahden Kellokeskus Oy

    OpenAIRE

    Hiukka, Piia

    2015-01-01

    Tämä opinnäytetyö käsittelee markkinointiviestinnän tehokkuutta ja siihen liittyviä ilmiöitä sosiaalisessa mediassa. Työn tavoitteena oli löytää vaikuttavimmat sisällöt, joiden avulla case-yritys Lahden Kellokeskus voi parantaa paikallista näkyvyyttään Facebookissa. Opinnäytetyössä ei puututtu erilaisten sosiaalisen median kanavien teknisiin ominaisuuksiin tai niiden hyödyntämiseen, vaan tavoittena oli löytää tehokkaimmat markkinointiviestinnän sisällöt, joita voidaan julkaista sähköisesti. ...

  8. Popliteal Artery Pseudoaneurysm Following Primary Total Knee Arthroplasty

    OpenAIRE

    Shin, Young-Soo; Hwang, Yeok-Gu; Savale, Abhijit Prakash; Han, Seung-Beom

    2014-01-01

    An early diagnosis of popliteal artery pseudoaneurysm-a sequela of popliteal artery trauma-is difficult owing to its late presentation following total knee arthroplasty. The incidence of a popliteal artery pseudoaneurysm with a hematoma presenting only a peripheral nerve injury after total knee arthroplasty is also uncommon in the absence of common diagnostic features such as a pulsatile swelling with an audible bruit on auscultation. In the present report, we describe popliteal artery pseudo...

  9. Electromyography in diagnostic of median nerve lesion in carpal tunnel syndrome of children with mucopolysaccharidoses

    OpenAIRE

    A. L. Kurenkov; T. V. Podkletnova; Kuzenkova, L.M.; B. I. Bursagova; S. S. Nikitin; A. K. Gevorkyan; Vashakmadze, N.D.

    2015-01-01

    Carpal tunnel syndrome (CTS) is a frequent syndrome in adults, but is very rare in children. CTS was described in children with mucopolysaccharidoses (MPS) as condition due to the deformation of carpal bones, deposition of glycosaminoglycans in tendosynovial tissue and connective tissue of flexor retinaculum. Electromyography is essential method for diagnostic CTS in children because typical symptoms of CTS (paresthesia, numbness of hand and fingers, atrophy and paresis of certain muscles) se...

  10. Pain Catastrophizing predicts Pain Intensity during a Neurodynamic Test for the Median Nerve in Healthy Participants

    OpenAIRE

    Beneciuk, Jason M.; Bishop, Mark D; George, Steven Z.

    2010-01-01

    Psychological factors within the Fear-Avoidance Model of Musculoskeletal Pain (FAM) predict clinical and experimental pain in both symptomatic and asymptomatic individuals. Clinicians routinely examine individuals with provocative testing procedures that evoke symptoms. The purpose of this study was to investigate which FAM factors were associated with evoked pain intensity, non-painful symptom intensity, and range of motion during an upper-limb neurodynamic test. Healthy participants (n = 62...

  11. Different effects of transcutaneous electric nerve stimulation and electroacupuncture at ST36–ST37 on the cerebral cortex

    OpenAIRE

    Kang, Yu-Tien; Liao, Yi-Sheng; Hsieh, Ching-Liang

    2014-01-01

    Background The effects of transcutaneous electric nerve stimulation (TENS) and electroacupuncture (EA) on the cerebral cortex are largely unclear. The purpose of the present study was to investigate the effect of TENS and EA on the cerebral cortex by examining their effect on the median nerve-somatosensory evoked potentials (MN-SEPs). Methods Twenty volunteers were studied. The cortical and cervical spinal potentials were recorded by median nerve stimulation at the left wrist. Sham TENS, 2 Hz...

  12. Pulmonary Artery Denervation Reduces Pulmonary Artery Pressure and Induces Histological Changes in an Acute Porcine Model of Pulmonary Hypertension

    OpenAIRE

    Rothman, A.M.K.; Arnold, N D; Chang, W.; Watson, O.; Swift, A J; Condliffe, R; Elliot, C A; Kiely, D. G.; Suvarna, S K; Gunn, J.; Lawrie, A.

    2015-01-01

    Background— Pulmonary arterial hypertension is a devastating disease with high morbidity and mortality and limited treatment options. Recent studies have shown that pulmonary artery denervation improves pulmonary hemodynamics in an experimental model and in an early clinical trial. We aimed to evaluate the nerve distribution around the pulmonary artery, to determine the effect of radiofrequency pulmonary artery denervation on acute pulmonary hypertension induced by vasoconstriction, and to de...

  13. Duration of symptomatology and median segmental sensory latency in 993 carpal tunnel syndrome hands (668 cases

    Directory of Open Access Journals (Sweden)

    KOUYOUMDJIAN JOAO ARIS

    1999-01-01

    Full Text Available According to median sensory nerve action potential onset-latency to index finger in a 140 mm fixed distance, 993 carpal tunnel syndrome (CTS hands from 668 patients were grouped into MIld (3.0 to 3.5 ms, 384 hands, MOderate (3.6 to 4.4 ms, 332 hands, SEvere (> 4.4 ms, 135 hands and UNrecordable (142 hands and correlated with CTS symptomatology duration. All patients have sensory antidromic median-radial latency difference (MRD e > or = 1.0 ms without any doubt about CTS diagnosis. Patients with systemic disease, trauma or previous surgery were excluded. There is a remarkable cumulative percentage increase from 1 to 12 months in group UN (3.5% to 38.7%, 11 folds, much less than the group MI (13.8% to 54.6%, 3.9 folds. There is also a remarkable non-cumulative percentage increase in group UN, from 1 to 4-12 months; the group MI had a relatively uniform distribution in all symptomatic duration groups from 1 to > 60 months. The conclusion is that median nerve compression at carpal tunnel can lead to unrecordable potentials in a relatively short period from 1 to 12 months of evolution, suggesting acute/subacute deterioration. Electrophysiological evaluation must be done periodically in patients that underwent clinical treatment, since cumulative 38.7% of group UN was found in 12 months period.

  14. Epicardial ultrasound in coronary artery bypass surgery

    OpenAIRE

    Budde, R.P.J.

    2005-01-01

    Chapter 1 Coronary artery bypass surgery (CABG) is traditionally performed via a median sternotomy approach on cardiopulmonary bypass (arrested heart). Since the mid 1990ties, beating heart, minimally invasive and even totally endoscopic CABG are (re)explored. In all approaches to CABG, the surgeon may face several intraoperative difficulties: 1. Localization of the target coronary artery for bypass grafting. 2. Selection of the optimal anastomotic site on the target coronary artery. 3. Asses...

  15. Treatment of kid foot soft tissue defect with reverse flap with cutaneous branch of fibular artery combine with sural nerve nutritional vessel axial%腓动脉皮支与腓肠神经联合远端蒂皮瓣修复小儿足踝部皮肤缺损

    Institute of Scientific and Technical Information of China (English)

    喻伟光; 邵新中; 吕莉; 苏晓清; 石硕

    2010-01-01

    Objective To investigate the clinical efficiency of kid foot soft tissue defect with reverse flap with cutaneous branch of fibular artery combine with sural nerve nutritional vessel axial. Methods From Feb. 2006 to Feb. 2009, according to the position and size of the soft tissue defects, the sural nerve nutritional vessel flap combine with the cutaneous branch of the peroneal artery were desingned and obtained to repair the 5 cases soft tissue defects of the foot. The flap size ranged from 8 cm × 7 cm to 18 cm × 10 cm. The vessel pedicle of cutaneous branches ranged from 1.7 cm to 3.0 cm. The distribution of the vessel pedicle of cutaneous branches ranged from 4.5 cm to 8.0 cm on the lateral malleolus. Results All flaps survived completely in 6 cases. The outline and function were satisfactory during 6-18 months follow-up. Among of 6 cases, the sural nerve were anastomosed with the acceptor sensory nerve in all cases. The skin sense were sat-isfactory after 1 year of operation and 2-point discrimination was 10-13 mm. Conclusion The blood supply of this flap is reliable without sacrifice of major arteries. Flap elevation is easy. It can reverse to a long dis-tance and can repair large skin defects. Especially this flap could have some sensory nerve. It is very useful in repairing kid foot large soft tissue defect.%目的 探讨腓动脉皮支与腓肠神经营养血管联合远端蒂皮瓣逆行修复小儿足踝部皮肤缺损的临床应用效果.方法 根据缺损部位及大小设计以腓动脉下段皮支与腓肠神经营养血管的联合远端蒂及旋转点,沿腓肠神经营养血管轴线切取皮瓣,逆行移位修复小儿足踝部皮肤软组织缺损6例.皮瓣切取范围8.0 cm × 7.0 cm~18.0 cm×10.0 cm,联合血管蒂长1.7~3.0 cm,血管蒂发出部位位于外踝上4.0~8.0 cm.结果 术后6例皮瓣其中5例完全成活,创面Ⅰ期愈合.1例远端1.0 cm发生干性坏死,面积约2.0 cm×1.0 cm,经换药后愈合.随访6~18个月,

  16. Geometric median for missing rainfall data imputation

    Science.gov (United States)

    Burhanuddin, Siti Nur Zahrah Amin; Deni, Sayang Mohd; Ramli, Norazan Mohamed

    2015-02-01

    Missing data is a common problem faced by researchers in environmental studies. Environmental data, particularly, rainfall data are highly vulnerable to be missed, which is due to several reasons, such as malfunction instrument, incorrect measurements, and relocation of stations. Rainfall data are also affected by the presence of outliers due to the temporal and spatial variability of rainfall measurements. These problems may harm the quality of rainfall data and subsequently, produce inaccuracy in the results of analysis. Thus, this study is aimed to propose an imputation method that is robust towards the presence of outliers for treating the missing rainfall data. Geometric median was applied to estimate the missing values based on the available rainfall data from neighbouring stations. The method was compared with several conventional methods, such as normal ratio and inverse distance weighting methods, in order to evaluate its performance. Thirteen rainfall stations in Peninsular Malaysia were selected for the application of the imputation methods. The results indicated that the proposed method provided the most accurate estimation values compared to both conventional methods based on the least mean absolute error. The normal ratio was found to be the worst method in estimating the missing rainfall values.

  17. Diabetes and nerve damage

    Science.gov (United States)

    Nerve damage that occurs in people with diabetes is called diabetic neuropathy. This condition is a complicaiton ... In people with diabetes, the body's nerves can be damaged by ... sugar level . This condition is more likely when the blood sugar ...

  18. Degenerative Nerve Diseases

    Science.gov (United States)

    Degenerative nerve diseases affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Many ... viruses. Sometimes the cause is not known. Degenerative nerve diseases include Alzheimer's disease Amyotrophic lateral sclerosis Friedreich's ...

  19. Radial nerve dysfunction (image)

    Science.gov (United States)

    The radial nerve travels down the arm and supplies movement to the triceps muscle at the back of the upper arm. ... the wrist and hand. The usual causes of nerve dysfunction are direct trauma, prolonged pressure on the ...

  20. Chitosan crosslinked flat scaffolds for peripheral nerve regeneration.

    Science.gov (United States)

    Fregnan, F; Ciglieri, E; Tos, P; Crosio, A; Ciardelli, G; Ruini, F; Tonda-Turo, C; Geuna, S; Raimondo, S

    2016-01-01

    Chitosan (CS) has been widely used in a variety of biomedical applications, including peripheral nerve repair, due to its excellent biocompatibility, biodegradability, readily availability and antibacterial activity. In this study, CS flat membranes, crosslinked with dibasic sodium phosphate (DSP) alone (CS/DSP) or in association with the γ-glycidoxypropyltrimethoxysilane (CS/GPTMS_DSP), were fabricated with a solvent casting technique. The constituent ratio of crosslinking agents and CS were previously selected to obtain a composite material having both adequate mechanical properties and high biocompatibility. In vitro cytotoxicity tests showed that both CS membranes allowed cell survival and proliferation. Moreover, CS/GPTMS_DSP membranes promoted cell adhesion, induced Schwann cell-like morphology and supported neurite outgrowth from dorsal root ganglia explants. Preliminary in vivo tests carried out on both types of nerve scaffolds (CS/DSP and CS/GPTMS_DSP membranes) demonstrated their potential for: (i) protecting, as a membrane, the site of nerve crush or repair by end-to-end surgery and avoiding post-operative nerve adhesion; (ii) bridging, as a conduit, the two nerve stumps after a severe peripheral nerve lesion with substance loss. A 1 cm gap on rat median nerve was repaired using CS/DSP and CS/GPTMS_DSP conduits to further investigate their ability to induce nerve regeneration in vivo. CS/GPTMS_DSP tubes resulted to be more fragile during suturing and, along a 12 week post-operative lapse of time, they detached from the distal nerve stump. On the contrary CS/DSP conduits promoted nerve fiber regeneration and functional recovery, leading to an outcome comparable to median nerve repaired by autograft. PMID:27508969

  1. Relationships between the Brook Street Terrane and Median Tectonic Zone (Median Batholith) : evidence from Jurassic conglomerates

    International Nuclear Information System (INIS)

    U-Pb zircon ages of 237-180 Ma and c. 280 Ma of seven granitoid clasts from the Rainy River Conglomerate which lies within the eastern Median Tectonic Zone (Median Batholith) in Nelson, and the Barretts Formation of the Brook Street Terrane in Southland, constrain the depositional ages of both units to be no older than c. 180-200 Ma (Early Jurassic). The minimum age of the Rainy River Conglomerate is constrained by the 147 +2 -1 Ma (Latest Jurassic) emplacement age of the One Mile Gabbronorite (new name: previously western Buller Diorite). The ages and chemistry of five of the granitoid clasts are broadly compatible with derivation from rocks that are now represented by Triassic plutons of the Median Tectonic Zone (Median Batholith), although ages as young as 180 Ma are slightly outside the range of the latter as currently exposed in New Zealand. The age (273-290 Ma, 237 +/- 3 Ma) and chemistry of the other two clasts (one each from Rainy River Conglomerate and Barretts Formation) suggest derivation from the Brook Street Terrane. Similarity in stratigraphic age, depositional characteristics, granitoid clast ages and composition between Rainy River Conglomerate and Barretts Formation suggests that they are broadly correlative and collectively overlapped a combined Brook Street Terrane - Median Batholith (MTZ) before the Late Jurassic (147 +2 -1 Ma). Sedimentary overlap may also have continued across to Middle Jurassic conglomeratic strata in the Murihiku Terrane to the east of the Brook Street Terrane. A U-Pb zircon age of 261 +/- 2 Ma is reported for Pourakino Trondhjemite of the Brook Street Terrane. (author). 56 refs., 10 figs., 4 tabs

  2. Estimulação elétrica nervosa transcutânea após cirurgia de revascularização miocárdica Transcutaneous electrical nerve stimulation after coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Paula Monique Barbosa Lima

    2011-12-01

    Full Text Available INTRODUÇÃO: Após a cirurgia cardíaca, os pacientes apresentam limitação na força muscular respiratória, o que favorece a instalação de complicações pulmonares. OBJETIVO: Analisar a eficácia da estimulação elétrica nervosa transcutânea sobre o processo doloroso e força muscular respiratória em pacientes submetidos à cirurgia de revascularização do miocárdio (CRM. MÉTODOS: Foram inclusos pacientes em pós-operatório de CRM por meio de esternotomia, com uso de circulação extracorpórea, anestesia geral, sem estar sob efeito de bloqueio neuromuscular, uso de drenos de tórax e mediastino, extubados até 6 horas pós-procedimento e apresentando índice igual ou superior a três na escala analógica visual da dor (EVA, estando no primeiro dia de pós-operatório (1º DPO. Foram recrutados 20 pacientes, divididos em dois grupos, sem predomínio de sexo: Grupo Controle (n=10, que recebeu terapia analgésica mais fisioterapia; e Grupo TENS, que recebeu terapia analgésica, fisioterapia e TENS. A TENS foi aplicada por 30 minutos, três vezes ao dia, num intervalo de 3 horas cada aplicação. RESULTADOS: Para o grau de dor, houve uma média inicial e final, respectivamente, de 7,0 e 1,0 para o Grupo TENS e 7,0 e 8,0 para o Grupo Controle. Para a Pimáx, a média inicial e final foi de, respectivamente, -102,5 cmH2O e -141,17 cmH2O para o Grupo TENS e -97,0 cmH2O e -100,3 cmH2O para o Controle. Quanto a Pemáx, a média inicial e final foi de, respectivamente, 63 cmH2O e 125 cmH2O para o Grupo TENS e 55,3 cmH2O e 53,2 cmH2O para o Grupo Controle. CONCLUSÃO: A TENS demonstrou eficácia significativa na redução da algia e no aumento das forças musculares respiratórias no 1º DPO de CRM.INTRODUCTION: After cardiac surgery, patients have a limitation in respiratory muscle strength, which favors the appearing of pulmonary complications. OBJECTIVE: To evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS

  3. Sensory nerves and pancreatitis

    OpenAIRE

    Li, Qingfu; PENG, JIE

    2014-01-01

    Sensory nerves are a kind of nerve that conduct afferent impulses from the periphery receptors to the central nervous system (CNS) and are able to release neuromediators from the activated peripheral endings. Sensory nerves are particularly important for microcirculatory response, and stimulation of pancreatic sensory nerves releases a variety of neuropeptides such as substance P (SP), calcitonin gene-related peptide (CGRP), etc., leading to neurogenic inflammation characterized as the local ...

  4. The Furcal Nerve Revisited

    OpenAIRE

    Harshavardhana, Nanjundappa S.; Harshad V. Dabke

    2014-01-01

    Atypical sciatica and discrepancy between clinical presentation and imaging findings is a dilemma for treating surgeon in management of lumbar disc herniation. It also constitutes ground for failed back surgery and potential litigations thereof. Furcal nerve (Furcal = forked) is an independent nerve with its own ventral and dorsal branches (rootlets) and forms a link nerve that connects lumbar and sacral plexus. Its fibers branch out to be part of femoral and obturator nerves in-addition to t...

  5. The superficial ulnar artery: development and clinical significance Artéria ulnar superficial: desenvolvimento e relevância clínica

    Directory of Open Access Journals (Sweden)

    Srinivasulu Reddy

    2007-09-01

    Full Text Available The principal arteries of the upper limb show a wide range of variation that is of considerable interest to orthopedic surgeons, plastic surgeons, radiologists and anatomists. We present here a case of superficial ulnar artery found during the routine dissection of right upper limb of a 50-year-old male cadaver. The superficial ulnar artery originated from the brachial artery, crossed the median nerve anteriorly and ran lateral to this nerve and the brachial artery. The superficial ulnar artery in the arm gave rise to a narrow muscular branch to the biceps brachii. At the elbow level the artery ran superficial to the bicipital aponeurosis where it was crossed by the median cubital vein. It then ran downward and medially superficial to the forearm flexor muscles, and then downward to enter the hand. At the palm, it formed the superficial and deep palmar arches together with the branches of the radial artery. The presence of a superficial ulnar artery is clinically important when raising forearm flaps in reconstructive surgery. The embryology and clinical significance of the variation are discussed.As principais artérias do membro superior apresentam uma ampla variação, que é relativamente importante a cirurgiões ortopédicos e plásticos, radiologistas e anatomistas.Apresentamosumcaso de artéria ulnar superficial encontrada durante dissecção de rotina de membro superior direito de um cadáver masculino de 50 anos de idade.Aartéria ulnar superficial originava-se da artéria braquial, cruzava o nervo mediano anteriormente e percorria lateralmente esse nervo e a artéria braquial. A artéria ulnar superficial no braço deu origem a um ramo muscular estreito do músculo bíceps braquial. Ao nível do cotovelo, a artéria percorria superficialmente a aponeurose bicipital, onde era cruzada pela veia cubital mediana. Percorria, então, em sentido descendente e medialmente superficial aos músculos flexores do antebraço, e então descendia para

  6. The Physics of Nerves

    CERN Document Server

    Heimburg, Thomas

    2010-01-01

    The accepted model for nerve pulse propagation in biological membranes seems insufficient. It is restricted to dissipative electrical phenomena and considers nerve pulses exclusively as a microscopic phenomenon. A simple thermodynamic model that is based on the macroscopic properties of membranes allows explaining more features of nerve pulse propagation including the phenomenon of anesthesia that has so far remained unexplained.

  7. Intraparotid facial nerve schwannoma.

    OpenAIRE

    Shah H; Kantharia C; Shenoy A

    1997-01-01

    Intraparotid facial nerve schwannoma are uncommon. Preoperative diagnosis of parotid tumour as schwannoma is difficult when facial nerve function is normal. A rare case of solitary schwannoma involving the upper branch of the facial nerve is described and the literature on the subject is reviewed.

  8. Laryngeal nerve damage

    Science.gov (United States)

    Laryngeal nerve damage is injury to one or both of the nerves that are attached to the voice box. ... Injury to the laryngeal nerves is uncommon. When it does occur, it can be from: A complication of neck or chest surgery (especially thyroid, lung, ...

  9. Optic Nerve Pit

    Science.gov (United States)

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Optic Nerve Pit What is optic nerve pit? An optic nerve pit is a ... may be seen in both eyes. How is optic pit diagnosed? If the pit is not affecting ...

  10. Solitary median maxillary central incisor (SMMCI) syndrome.

    Science.gov (United States)

    Hall, Roger K

    2006-01-01

    Solitary median maxillary central incisor syndrome (SMMCI) is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s) operating in utero about the 35th-38th day(s) from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F) at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Congenital nasal malformation (choanal atresia, midnasal stenosis or congenital pyriform aperture stenosis) is positively associated with SMMCI. The presence of an SMMCI tooth can predict associated anomalies and in particular the serious anomaly holoprosencephaly. Common congenital anomalies associated with SMMCI are: severe to mild intellectual disability, congenital heart disease, cleft lip and/or palate and less frequently, microcephaly, hypopituitarism, hypotelorism, convergent strabismus, oesophageal and duodenal atresia, cervical hemivertebrae, cervical dermoid, hypothyroidism, scoliosis, absent kidney, micropenis and ambiguous genitalia. Short stature is present in half the children. Diagnosis should be made by eight months of age, but can be made at birth and even prenatally at 18-22 weeks from the routine mid-trimester ultrasound scan. Management depends upon the individual anomalies present. Choanal stenosis requires emergency surgical treatment. Short stature may require growth hormone therapy. SMMCI tooth itself is mainly an aesthetic problem, which is ideally managed by combined orthodontic, prosthodontic and oral surgical treatment; alternatively, it can be left untreated. PMID:16722608

  11. Solitary median maxillary central incisor (SMMCI syndrome

    Directory of Open Access Journals (Sweden)

    Hall Roger K

    2006-04-01

    Full Text Available Abstract Solitary median maxillary central incisor syndrome (SMMCI is a complex disorder consisting of multiple, mainly midline defects of development resulting from unknown factor(s operating in utero about the 35th–38th day(s from conception. It is estimated to occur in 1:50,000 live births. Aetiology is uncertain. Missense mutation in the SHH gene (I111F at 7q36 may be associated with SMMCI. The SMMCI tooth differs from the normal central incisor, in that the crown form is symmetric; it develops and erupts precisely in the midline of the maxillary dental arch in both primary and permanent dentitions. Congenital nasal malformation (choanal atresia, midnasal stenosis or congenital pyriform aperture stenosis is positively associated with SMMCI. The presence of an SMMCI tooth can predict associated anomalies and in particular the serious anomaly holoprosencephaly. Common congenital anomalies associated with SMMCI are: severe to mild intellectual disability, congenital heart disease, cleft lip and/or palate and less frequently, microcephaly, hypopituitarism, hypotelorism, convergent strabismus, oesophageal and duodenal atresia, cervical hemivertebrae, cervical dermoid, hypothyroidism, scoliosis, absent kidney, micropenis and ambiguous genitalia. Short stature is present in half the children. Diagnosis should be made by eight months of age, but can be made at birth and even prenatally at 18–22 weeks from the routine mid-trimester ultrasound scan. Management depends upon the individual anomalies present. Choanal stenosis requires emergency surgical treatment. Short stature may require growth hormone therapy. SMMCI tooth itself is mainly an aesthetic problem, which is ideally managed by combined orthodontic, prosthodontic and oral surgical treatment; alternatively, it can be left untreated.

  12. Sosiaalisen median käyttö autokaupassa

    OpenAIRE

    Herrala, Matti; Leppä, Teemu

    2015-01-01

    Tämän opinnäytetyön tarkoituksena oli laatia sosiaalisen median hyödyntämisen suunnitelma J. Rinta-Jouppi Oy:lle. Opinnäytetyön ensimmäisenä tavoitteena oli perehtyä sosiaalisen median käyttöön autoalalla sekä tutustua sosiaalisen median eri kanaviin. Toisena tavoitteena oli perehtyä sosiaalisen median suunnitteluprosessiin ja analysoida J. Rinta-Jouppi Oy:n sosiaalisen median käytön nykytilaa. Kolmantena tavoitteena oli laatia sosiaalisen median käytön suunnitelma J. Rinta-Jouppi Oy:lle. ...

  13. Nerve regeneration following implantation of axotomized nerves pretreated with gamma radiation

    Institute of Scientific and Technical Information of China (English)

    Xinyuan Wang; Dehai Chang; Shihua Xie; Chunming Han; Jinsheng Sheng

    2008-01-01

    BACKGROUND: It has been shown that irradiation to the neurolemma can reduce immunogenicity. However, it is still poorly understood whether the degenerated nerve can affect peripheral nerve regeneration.OBJECTIVE: To observe the effect of radiation-damaged nerve transplantation on functional recovery of the peripheral nerve.DESIGN, TIME AND SETTING: Self-control animal trial was performed at the Experimental Center of Orthopedics, Tangdu Hospital of Fourth Military Medical University from January to October 2005.MATERIALS: Fifty-four healthy, Chinese rabbits, irrespective of gender, were randomly divided into experimental (n = 36) and control (n = 18) groups. A60 Co γ -radiation machine and NDI-200 nerve electromyograph were provided by the Experimental Center of Orthopedics, Tangdu Hospital of Fourth Military Medical University.METHODS: A median incision was made in the posterior right thigh of rabbits after abdominal anesthesia. A 30-mm segment of sciatic nerve was excised from the inferior margin of the piriform muscle to the tibiofibular intersection. The sciatic nerve in the experimental group was sterilely radiated with 350 Gy for 9.5 minutes. The damaged nerve segment was then re-transplanted. In the control group, the sciatic nerve was re-transplanted directly following excision. Nerve conduction velocity was determined at 4, 6, and 8 months post-surgery.MAIN OUTCOME MEASURES: Functional assessments, such as gait, nutritional status of skin on dorsum of foot, toe spreading reflex, and foot holding, were made between 1 and 180 days post-surgery. The common peroneal nerve and tibial nerve reflexes under clamping were observed at 4, 6, and 8 months post-surgery to evaluate functional restoration of the peripheral nerve. Eiectromyogram was performed to observe nerve conduction velocity.RESULTS: From postoperative days 1 to 26, the limbs that were transplanted with irradiated nerve exhibited dragged walking, foot drop, sole ulcers, depilation, self

  14. Angiography of a hand with symptoms of an ulnar nerve entrapment syndrome

    International Nuclear Information System (INIS)

    An angiography of the hand was performed on a pianist suffering from symptoms of an ulnar nerve entrapment syndrome. The examination revealed in the hand a rare anomalous arterial pattern, which explains the patient's symptoms. (orig.)

  15. THE USE OF PROTECTOR MADE OF REPEREN IN MICROVASCULAR DECOMPRESSION OF TRIGEMINAL NERVE

    OpenAIRE

    Sheludyakov А.Y.; Tikhomirov S.Е.; Stupak Y.А.

    2014-01-01

    For the first time there was used an isolating protector made of Reperen aiming to resolve a neurovascular conflict between superior cerebellar artery and trigeminal nerve root — a leading cause of trigeminal neuralgia.

  16. The Use of Protector Made of Reperen in Microvascular Decompression of Trigeminal Nerve

    Directory of Open Access Journals (Sweden)

    Sheludyakov А.Y.

    2014-03-01

    Full Text Available For the first time there was used an isolating protector made of Reperen aiming to resolve a neurovascular conflict between superior cerebellar artery and trigeminal nerve root — a leading cause of trigeminal neuralgia.

  17. Angiography of a hand with symptoms of an ulnar nerve entrapment syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kinnunen, J.; Toetterman, S.; Rindell, K.; Tervahartialla, P.; Slatis, P.

    1984-08-01

    An angiography of the hand was performed on a pianist suffering from symptoms of an ulnar nerve entrapment syndrome. The examination revealed in the hand a rare anomalous arterial pattern, which explains the patient's symptoms.

  18. The Median Voter and the Median Consumer: Local Private Goods and Residential Sorting

    OpenAIRE

    Joel Waldfogel

    2006-01-01

    When a product's product provision entails fixed costs, it will be made available only if a sufficient number of people want it. Some products are produced and consumed locally, so that provision requires not only a large group favoring the product but a large number nearby. Just as one has an incentive to sort into community whose median voter shares his preferences for local public goods, product markets may provide an analogous incentive to sort into a community whose consumers tend to sha...

  19. Arterial Ageing

    OpenAIRE

    Lee, Seung-Jun; Park, Sung-Ha

    2013-01-01

    Arterial ageing is characterized by age associated degeneration and sclerosis of the media layer of the large arteries. However, besides ageing, clinical conditions, which enhance oxidative stress and inflammation act to accelerate the degree of arterial ageing. In this review, we summarized the pathophysiology and contributing factors that accelerate arterial ageing. Among them, we focused on hypertension, the renin-angiotensin-aldosterone system and vascular inflammation which are modifiabl...

  20. Association between internal carotid artery dissection and arterial tortuosity

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Piga, Mario [Azienda Ospedaliero Universitaria (A.O.U.), Department of Radiology, Monserrato, Cagliari (Italy); Argiolas, Giovanni Maria; Siotto, Paolo [Azienda Ospedaliero Brotzu (A.O.B.), Department of Radiology, di Cagliari (Italy); Sumer, Suna; Wintermark, Max [Neuroradiology Division, Neuroradiology, UVA Department of Radiology, Charlottesville, VA (United States); Raz, Eytan [New York University School of Medicine, Department of Radiology, New York, NY (United States); Sapienza University of Rome, Department of Neurology and Psychiatry, Rome (Italy); Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria (A.O.U.), Department of Vascular Surgery, di Cagliari (Italy)

    2014-10-18

    Carotid artery dissection is an important cause of ischemic stroke in all age groups, particularly in young patients. The purpose of this work was to assess whether there is an association between the presence of an internal carotid artery dissection (ICAD) and the arterial tortuosity. This study considered 124 patients (72 males and 52 females; median age 57 years) with CT/MR diagnosis of ICAD of the internal carotid artery were considered in this multi-centric retrospective study. The arterial tortuosity was evaluated and, when present, was categorized as elongation, kinking, or coiling. For each patient, both the right and left sides were considered for a total number of 248 arteries in order to have the same number of cases and controls. Fisher's exact test was applied to test the association between elongation, kinking, coiling, dissection, and the side affected by CAD. Fisher's exact test showed a statistically significant association between the ICAD and kinking (p = 0.0089) and coiling (p = 0.0251) whereas no statistically significant difference was found with arterial vessel elongation (p = 0.444). ICAD was more often seen on the left side compared to the right (p = 0.0001). These results were confirmed using both carotid arteries of the same patient as dependent parameter with p = 0.0012, 0.0129, and 0.3323 for kinking, coiling, and elongation, respectively. The presence of kinking and coiling is associated with ICAD. (orig.)

  1. Optic nerve oxygenation

    DEFF Research Database (Denmark)

    Stefánsson, Einar; Pedersen, Daniella Bach; Jensen, Peter Koch;

    2005-01-01

    The oxygen tension of the optic nerve is regulated by the intraocular pressure and systemic blood pressure, the resistance in the blood vessels and oxygen consumption of the tissue. The oxygen tension is autoregulated and moderate changes in intraocular pressure or blood pressure do not affect the...... optic nerve oxygen tension. If the intraocular pressure is increased above 40 mmHg or the ocular perfusion pressure decreased below 50 mmHg the autoregulation is overwhelmed and the optic nerve becomes hypoxic. A disturbance in oxidative metabolism in the cytochromes of the optic nerve can be seen at...... similar levels of perfusion pressure. The levels of perfusion pressure that lead to optic nerve hypoxia in the laboratory correspond remarkably well to the levels that increase the risk of glaucomatous optic nerve atrophy in human glaucoma patients. The risk for progressive optic nerve atrophy in human...

  2. [Ganglia of peripheral nerves].

    Science.gov (United States)

    Tatagiba, M; Penkert, G; Samii, M

    1993-01-01

    The authors present two different types of ganglion affecting the peripheral nerves: extraneural and intraneural ganglion. Compression of peripheral nerves by articular ganglions is well known. The surgical management involves the complete removal of the lesion with preservation of most nerve fascicles. Intraneural ganglion is an uncommon lesion which affects the nerve diffusely. The nerve fascicles are usually intimately involved between the cysts, making complete removal of all cysts impossible. There is no agreement about the best surgical management to be applied in these cases. Two possibilities are available: opening of the epineural sheath lengthwise and pressing out the lesion; or resection of the affected part of the nerve and performing a nerve reconstruction. While in case of extraneural ganglion the postoperative clinical evolution is very favourable, only long follow up studies will reveal in case of intraneural ganglion the best surgical approach. PMID:8128785

  3. Long-term outcomes of internal carotid artery disease treated using radial artery graft

    International Nuclear Information System (INIS)

    Complex internal carotid artery disease presents a surgical challenge because limitations and difficulty are encountered with either clipping or endovascular treatment. Our review of previous reports suggests that no current vascular assessment can accurately predict occurrence of ischemic complications after internal carotid artery ligation. The present study concerns long-term clinical outcome of radial artery grafting followed by parent artery trapping or proximal occlusion for management of these difficult lesions. Between September 1997 and October 2007, we performed radial artery grafting followed immediately by parent artery occlusion in 20 sides of 19 patients with complex internal carotid arteries disease with follow-up for more than 36 months (5 men, 14 women; mean follow-up duration, 62 months). All patients underwent postoperative MRI and MR angiography (MRA) every year to assess graft patency, ischemic complications, and de novo aneurysm. Another 20 carotid aneurysms with visual disturbance were assessed concerning outcome. Among 13 patients with cranial nerve (III and VI) disturbances, all dysfunctions were improved in cases treated within 8 months of onset to operation. On the other hand, patients with second cranial nerve disturbances were not improved in cases treated after 4 months of onset. No long-term complications were discovered with MRI and MRA. With appropriate attention to surgical technique, radial artery grafting followed by acute parent artery occlusion is a safe treatment for complex internal carotid artery aneurysms. Long-term safety is satisfactory, with no delayed complications such as graft stenosis, ischemic complications or de novo aneurysm formations in follow-up periods of more than 3 years. Good clinical outcome of cranial nerve palsy was achieved in patients treated within 8 months of onset for cranial nerve (CN) III and VI, and 4 of CN II palsy. (author)

  4. Assessment of nerve morphology in nerve activation during electrical stimulation

    Science.gov (United States)

    Gomez-Tames, Jose; Yu, Wenwei

    2013-10-01

    The distance between nerve and stimulation electrode is fundamental for nerve activation in Transcutaneous Electrical Stimulation (TES). However, it is not clear the need to have an approximate representation of the morphology of peripheral nerves in simulation models and its influence in the nerve activation. In this work, depth and curvature of a nerve are investigated around the middle thigh. As preliminary result, the curvature of the nerve helps to reduce the simulation amplitude necessary for nerve activation from far field stimulation.

  5. Anatomic and pathologic features of third cranial nerve disorders according to magnetic resonance studies

    International Nuclear Information System (INIS)

    The objective of this report is to demonstrate the utility of magnetic resonance (MR) in the diagnosis of disorders involving the third cranial nerves. We have selected MR studies corresponding to patients with an anomaly affecting the third cranial nerves, whether alone or in combination with other cranial nerves. In order to better study the pathology of these cranial nerves, we considered four different segments of the nerves: mesencephalic, cisternal, cavernous and orbital. We present the MR features of the anatomy of the third cranial nerves and the most representative lesions affecting the different intracranial segments: infraction, multiple sclerosis, glioma and cavernoma in the mesencephalon; posterior communicating artery aneurysm, neuritis, neurinomas and meningioma in the cisternal segment; aneurysm of the internal carotid artery, cavernous carotid fistula, metastasis and meningioma in the cavernous sinus and Tolosa-Hunt syndrome in the orbital apex. (Author) 11 refs

  6. Semi-skeletonized Internal Mammary Grafts and Phrenic Nerve Injury: Cause-and-effect analysis

    Institute of Scientific and Technical Information of China (English)

    DENG Yongzhi; SUN Zongquan; MA Jie; Hugh S PATERSON

    2006-01-01

    Phrenic nerve injury after cardiac surgery increases postoperative pulmonary complications. The purpose of this study was to analyze the causes and effects of phrenic nerve injury after cardiac surgery. Prospectively collected data on 2084 consecutive patients who underwent cardiac surgery from Jan. 1995 to Feb. 2002 were analyzed. Twenty-eight preoperative and operation related variables were subjected to logistic analysis with the end point being phrenic nerve injury. Then phrenic nerve injury and 6 perioperative morbidities were included in the analysis as variables to determine their independent predictive value for perioperative pulmonary morbidity. An identical approach was used to identify the independent risk factors for perioperative mortality. There were 53 phrenic nerve injuries (2.5 %). There was no phrenic nerve injury in non-coronary surgery or coronary surgery using conduits other than the internal mammary artery. The independent risk factors for phrenic nerve injury were the use of internal mammary artery (Odds ratio (OR)=14.5) and the presence of chronic obstructive pulmonary disease (OR=2.9). Phrenic nerve injury was an independent risk factor (OR=8.1) for perioperative pulmonary morbidities but not for perioperative mortality. Use of semi-skeletonized internal mammary artery harvesting technique and drawing attention to possible vascular or mechanical causes of phrenic nerve injury may reduce its occurrence. Unilateral phrenic nerve injury, although rarely life-threatening, is an independent risk factor for postoperative respiratory complications. When harvesting internal mammary arteries, it should be kept in mind avoiding stretching, compromising, or inadvertently dissecting phrenic nerve is as important as avoiding damage of internal mammary artery itself.

  7. Neuromuscular block after intra-arterially injected acetylcholine. 1. Introduction, methods, and technique.

    Science.gov (United States)

    Tonali, P; Gambi, D

    1973-04-01

    The neuromuscular depolarizing block induced by intra-arterially injected ACh was studied to determine the variability in the same subject and in different subjects without disorders at the motor end-plate. Amplitude of action potentials of the opponens pollicis muscle evoked by intermittent repetitive supramaximal stimulation of the median nerve at the wrist were recorded for one hour from the beginning of ACh injection. The features of prompt and late depression stages after the injection were analysed statistically. Re-testing of the same subjects after a while shows that, in spite of all efforts to maintain the same experimental conditions, variations do occur in late depression. Time course and duration are particularly affected, while the degree of depression is altered but slightly. The presence of such variations limits this test to evaluation of the influence of other factors only within their already established statistical limits. PMID:4350703

  8. Anterior humeral circumflex artery avulsion with brachial plexus injury following an isolated traumatic anterior shoulder dislocation.

    Science.gov (United States)

    Shah, Rohi; Koris, Jacob; Wazir, Akhlaq; Srinivasan, Shyamsundar S

    2016-01-01

    A 70-year-old man presented to accident and emergency with an isolated anteriorly dislocated shoulder, in the absence of a concomitant fracture. There was no neurovascular deficit at presentation, and the shoulder was reduced under sedation, using the Kocher's technique. Following this, the patient developed signs of hypovolaemic shock. Clinical examination revealed an expanding fullness in the deltopectoral area, with compromise of the limb neurovascular status. CT imaging confirmed an expanding haematoma from the axillary vessels, restricting left lung expansion. Once resuscitated, the patient was transferred to theatre for exploration of the bleeding vessels. Intraoperative findings included an avulsed anterior circumflex humeral artery that was subsequently ligated. Postoperatively, the patient developed axillary, radial, median and ulnar nerve neuropraxia, which improved clinically prior to discharge. The patient was ultimately discharged home after a lengthy inpatient stay. PMID:26969353

  9. The Heterogeneous P-Median Problem for Categorization Based Clustering

    Science.gov (United States)

    Blanchard, Simon J.; Aloise, Daniel; DeSarbo, Wayne S.

    2012-01-01

    The p-median offers an alternative to centroid-based clustering algorithms for identifying unobserved categories. However, existing p-median formulations typically require data aggregation into a single proximity matrix, resulting in masked respondent heterogeneity. A proposed three-way formulation of the p-median problem explicitly considers…

  10. EMG MEDIAN POWER FREQUENCY IN AN EXHAUSTING EXERCISE

    NARCIS (Netherlands)

    AMENT, W; BONGA, GJJ; HOF, AL; VERKERKE, GJ

    1993-01-01

    EMG median power frequency of the calf muscles was investigated during an exhausting treadmill exercise. This exercise was an uphill run, the average endurance time was 1.5 min. Median power frequency of the calf muscles declined by more than 10% during this exercise. In addition EMG median power fr

  11. Nerve conduction abnormalities in untreated maturity-onset diabetes: relation to levels of fasting plasma glucose and glycosylated hemoglobin.

    Science.gov (United States)

    Graf, R J; Halter, J B; Halar, E; Porte, D

    1979-03-01

    The role of metabolic abnormalities in the development of diabetic neuropathy is controversial. To investigate the influence of hyperglycemia on nerve conduction, we studied 20 untreated maturity-onset diabetic patients and 23 normal control subjects of similar age. Nerve conduction velocity of motor (median, peroneal, and tibial) and sensory (median and sural) nerves in diabetic patients was significantly slowed and H-reflex latency time prolonged. Levels of fasting plasma glucose in diabetic subjects were correlated with slowed motor conduction velocity of the median, peroneal, and tibial nerves but not with sensory nerve conduction velocities. Levels of glycosylated hemoglobin, an index of long-term glycemia, were correlated with slowing of peroneal motor conduction velocity in diabetic patients. These associations could not be explained by patient age or duration of diabetes. These findings suggest that the degree of hyperglycemia of untreated maturity-onset diabetes contributes to the motor nerve conduction abnormalities in this disease. PMID:426398

  12. Fusiform aneurysm of a persistent trigeminal artery associated with rare intracranial arterial variations and subarachnoid hemorrhage.

    Science.gov (United States)

    Kimball, David; Ples, Horia; Kimball, Heather; Miclaus, Gratian D; Matusz, Petru; Loukas, Marios

    2015-01-01

    The trigeminal artery is one of four primitive anastomoses between the internal carotid artery and vertebrobasilar system that regresses in the sixth week of fetal development. A persistent trigeminal artery (PTA) is generally an incidental finding but may also be associated with intracranial vascular pathologies such as aneurysms, arteriovenous malformations, and cranial nerve compression syndromes. We present an extremely rare case of a right PTA with an associated bleeding fusiform aneurysm located in the carotidian (lateral) part of the PTA. In addition, this rare anatomic variation was associated with bilateral absence of the posterior communicating arteries, a left posterior cerebral artery originating from the left internal carotid artery, and agenesis of the A1 segment of the left anterior cerebral artery. PMID:25053265

  13. Lipomatous macrodystrophy of the ulnar nerve: Role of magnetic resonance in the diagnosis

    International Nuclear Information System (INIS)

    Lipomatous macrodystrophy is a rare cause of macrodactyly that can be included among the bening adipose tissue tumors of the peripheral nerves. We present a case involving ulnar nerve, which is an unusual location since most of the reported cases correspond to median nerve. the magnetic resonance (MR) images are analyzed, and their role in the characterization and definition of the extension of these lesions is assessed. 4 refs

  14. COMPARISON OF MOTOR AND SENSORY NERVE CONDUCTION IN UPPER LIMB OF DIABETICS AND NON DIABETICS

    OpenAIRE

    Ajay; Neelu; Ritu; Seema

    2015-01-01

    The physiological properties of nerve and muscle are usually modified due to patho physiological changes resulting from many diseases like diabetes. Impaired mobility and compromised dexterity leading to difficulties in daily life. Hand function in diabetes is affected mainly due to involvement of median nerve. Diabetic neuropathy the c ommon complication of diabetes can be assessed electro physiologically by nerve conduction studies. Therefore, we analyzed both motor and se...

  15. Axonal degeneration of the ulnar nerve secondary to carpal tunnel syndrome: fact or fiction?☆

    OpenAIRE

    Azmy, Radwa Mahmoud; Labib, Amira Ahmed; Elkholy, Saly Hassan

    2013-01-01

    The distribution of sensory symptoms in carpal tunnel syndrome is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment is still unclear. In this study, we measured ulnar nerve function in 82 patients with carpal tunnel syndrome. The patients were divided into group I with minimal carpal tunnel syndrome (n = 35) and group II with mild to moderate carpal tunnel syndrome (n = 47) accord...

  16. Imaging the trigeminal nerve

    International Nuclear Information System (INIS)

    Of all cranial nerves, the trigeminal nerve is the largest and the most widely distributed in the supra-hyoid neck. It provides sensory input from the face and motor innervation to the muscles of mastication. In order to adequately image the full course of the trigeminal nerve and its main branches a detailed knowledge of neuroanatomy and imaging technique is required. Although the main trunk of the trigeminal nerve is consistently seen on conventional brain studies, high-resolution tailored imaging is mandatory to depict smaller nerve branches and subtle pathologic processes. Increasing developments in imaging technique made possible isotropic sub-milimetric images and curved reconstructions of cranial nerves and their branches and led to an increasing recognition of symptomatic trigeminal neuropathies. Whereas MRI has a higher diagnostic yield in patients with trigeminal neuropathy, CT is still required to demonstrate the bony anatomy of the skull base and is the modality of choice in the context of traumatic injury to the nerve. Imaging of the trigeminal nerve is particularly cumbersome as its long course from the brainstem nuclei to the peripheral branches and its rich anastomotic network impede, in most cases, a topographic approach. Therefore, except in cases of classic trigeminal neuralgia, in which imaging studies can be tailored to the root entry zone, the full course of the trigeminal nerve has to be imaged. This article provides an update in the most recent advances on MR imaging technique and a segmental imaging approach to the most common pathologic processes affecting the trigeminal nerve.

  17. Imaging the trigeminal nerve

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [Radiology Department, Instituto Portugues de Oncologia Francisco Gentil, Centro de Lisboa, Rua Prof. Lima Basto, 1093, Lisboa (Portugal)], E-mail: borgalexandra@gmail.com; Casselman, Jan [Department of Radiology, A. Z. St Jan Brugge and A. Z. St Augustinus Antwerpen Hospitals (Belgium)

    2010-05-15

    Of all cranial nerves, the trigeminal nerve is the largest and the most widely distributed in the supra-hyoid neck. It provides sensory input from the face and motor innervation to the muscles of mastication. In order to adequately image the full course of the trigeminal nerve and its main branches a detailed knowledge of neuroanatomy and imaging technique is required. Although the main trunk of the trigeminal nerve is consistently seen on conventional brain studies, high-resolution tailored imaging is mandatory to depict smaller nerve branches and subtle pathologic processes. Increasing developments in imaging technique made possible isotropic sub-milimetric images and curved reconstructions of cranial nerves and their branches and led to an increasing recognition of symptomatic trigeminal neuropathies. Whereas MRI has a higher diagnostic yield in patients with trigeminal neuropathy, CT is still required to demonstrate the bony anatomy of the skull base and is the modality of choice in the context of traumatic injury to the nerve. Imaging of the trigeminal nerve is particularly cumbersome as its long course from the brainstem nuclei to the peripheral branches and its rich anastomotic network impede, in most cases, a topographic approach. Therefore, except in cases of classic trigeminal neuralgia, in which imaging studies can be tailored to the root entry zone, the full course of the trigeminal nerve has to be imaged. This article provides an update in the most recent advances on MR imaging technique and a segmental imaging approach to the most common pathologic processes affecting the trigeminal nerve.

  18. Acute arterial occlusion - kidney

    Science.gov (United States)

    ... arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury ...

  19. Diffusion-weighted magnetic resonance imaging of symptomatic nerve root of patients with lumbar disk herniation

    Energy Technology Data Exchange (ETDEWEB)

    Eguchi, Yawara; Ohtori, Seiji; Yamashita, Masaomi; Yamauchi, Kazuyo; Suzuki, Munetaka; Orita, Sumihisa; Kamoda, Hiroto; Arai, Gen; Ishikawa, Tetsuhiro; Miyagi, Masayuki; Ochiai, Nobuyasu; Kishida, Shunji; Inoue, Gen; Takahashi, Kazuhisa [Chiba University, Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba (Japan); Masuda, Yoshitada; Ochi, Shigehiro; Kikawa, Takashi [Chiba University Hospital, Department of Radiology, Chiba (Japan); Toyone, Tomoaki [Teikyo University Chiba Medical Center, Department of Orthopaedic Surgery, Chiba (Japan); Takaso, Masashi [Kitasato University, Department of Orthopaedic Surgery, School of Medicine, Sagamihara City, Kanagawa (Japan); Aoki, Yasuchika [Chiba Rosai Hospital, Department of Orthopedic Surgery, Ichihara, Chiba (Japan)

    2011-09-15

    Diffusion-weighted imaging (DWI) can provide valuable structural information that may be useful for evaluating pathological changes of the lumbar nerve root. Diffusion-weighted magnetic resonance (MR) neurography has recently been introduced as an alternative way to visualize nerves, but to date, quantitative DWI and MR neurography have not been applied to evaluate the pathology of lumbar nerve roots. Our purpose was to visualize lumbar nerve roots and to analyze their morphology by MR neurography, and to measure the apparent diffusion coefficient (ADC) of lumbar nerve roots compressed by herniated disks using 1.5-T MR imaging. Ten consecutive patients (median age, 48.0 and range, 20-72 years) with monoradicular symptoms caused by a lumbar herniated disk and 14 healthy volunteers were studied. Regions of interests were placed on the lumbar roots at dorsal root ganglia (DRG) and distal spinal nerves on DWI to quantify mean ADC values. The spinal nerve roots were also visualized by MR neurography. In the patients, mean ADC values were significantly greater in the compressed DRG and distal spinal nerves than in intact nerves. MR neurography also showed abnormalities such as nerve swelling at and below the compression in the symptomatic nerve root. Increased ADC values were considered to be because of edema and Wallerian degeneration of compressed nerve roots. DWI is a potential tool for analysis of the pathophysiology of lumbar nerve roots compressed by herniated disks. (orig.)

  20. Diffusion-weighted magnetic resonance imaging of symptomatic nerve root of patients with lumbar disk herniation

    International Nuclear Information System (INIS)

    Diffusion-weighted imaging (DWI) can provide valuable structural information that may be useful for evaluating pathological changes of the lumbar nerve root. Diffusion-weighted magnetic resonance (MR) neurography has recently been introduced as an alternative way to visualize nerves, but to date, quantitative DWI and MR neurography have not been applied to evaluate the pathology of lumbar nerve roots. Our purpose was to visualize lumbar nerve roots and to analyze their morphology by MR neurography, and to measure the apparent diffusion coefficient (ADC) of lumbar nerve roots compressed by herniated disks using 1.5-T MR imaging. Ten consecutive patients (median age, 48.0 and range, 20-72 years) with monoradicular symptoms caused by a lumbar herniated disk and 14 healthy volunteers were studied. Regions of interests were placed on the lumbar roots at dorsal root ganglia (DRG) and distal spinal nerves on DWI to quantify mean ADC values. The spinal nerve roots were also visualized by MR neurography. In the patients, mean ADC values were significantly greater in the compressed DRG and distal spinal nerves than in intact nerves. MR neurography also showed abnormalities such as nerve swelling at and below the compression in the symptomatic nerve root. Increased ADC values were considered to be because of edema and Wallerian degeneration of compressed nerve roots. DWI is a potential tool for analysis of the pathophysiology of lumbar nerve roots compressed by herniated disks. (orig.)

  1. Changes of medium-latency SEP-components following peripheral nerve lesion

    Directory of Open Access Journals (Sweden)

    Straschill Max

    2006-10-01

    Full Text Available Abstract Background Animal studies have demonstrated complex cortical reorganization following peripheral nerve lesion. Central projection fields of intact nerves supplying skin areas which border denervated skin, extended into the deafferentiated cortical representation area. As a consequence of nerve lesions and subsequent reorganization an increase of the somatosensory evoked potentials (SEPs was observed in cats when intact neighbouring nerves were stimulated. An increase of SEP-components of patients with nerve lesions may indicate a similar process of posttraumatic plastic cortical reorganization. Methods To test if a similar process of post-traumatic plastic cortical reorganization does occur in humans, the SEP of intact neighbouring hand nerves were recorded in 29 patients with hand nerve lesions. To hypothetically explain the observed changes of SEP-components, SEP recording following paired stimulation of the median nerve was performed in 12 healthy subjects. Results Surprisingly 16 of the 29 patients (55.2% showed a reduction or elimination of N35, P45 and N60. Patients with lesions of two nerves showed more SEP-changes than patients with a single nerve lesion (85.7%; 6/7 nerves; vs. 34.2%; 13/38 nerves; Fisher's exact test, p Conclusion The results of the present investigation do not provide evidence of collateral innervation of peripherally denervated cortical neurons by neurons of adjacent cortical representation areas. They rather suggest that secondary components of the excitatory response to nerve stimulation are lost in cortical areas, which surround the denervated region.

  2. EDGE PRESERVATION OF ENHANCED FUZZY MEDIAN MEAN FILTER USING DECISION BASED MEDIAN FILTER

    Directory of Open Access Journals (Sweden)

    Amanpreet Kaur

    2016-02-01

    Full Text Available Image noise refers to random variations in the basic characteristics of image like brightness, intensity or color difference. These variations are not present in the image which is captured but may occur due to environmental conditions like sensor temperature or due to circuit of the scanner or other similar issues. Basically noise means unwanted signals in the image. Various filters have been designed for removal of almost all types of noise. It has been seen in most of the cases that as a result of high amount of filtering or repetitive filtering of image for the removal of noise, edges of images mostly get distorted or smeared out. It means that most of the filtering techniques lead to loss of fine edges of the images which needs to be preserved in order to enhance the quality of image. This paper has focused on to improve the enhanced fuzzy median mean filter so that fine edges get preserved in a better way. Experiments have been performed in MATLAB. Comparative analysis have been done on the basis of PSNR, MSE, BER and RMSE and it has shown that border correction applied on images improves the results of enhanced fuzzy median mean filter.

  3. Superselective arterial infusion and concomitant radiotherapy for advanced head and neck cancer

    International Nuclear Information System (INIS)

    Superselective arterial infusion for patients with advanced head and neck cancer has increasingly been applied in Japan. We analyzed our experiences and evaluated the efficacy and safety of this treatment. Forty-four patients, who were considered contraindicated for surgery or rejected radical surgery, received superselective intra-arterial infusion therapy of cisplatin (100-120 mg/m2/week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity, and conventional concomitant extrabeam radiotherapy (65 Gy/26 f/6.5 weeks). During the median follow-up period of 17 months, 2-year progression-free survival rate of primary lesion was 66.9%, and that of patients with T4b diseases 57%. The 2-year overall survival rate was 52.4%. Although acute toxic effects were considered acceptable, severe toxic events occurred in some cases, namely, cranial nerve palsy, Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia, sepsis, and osteoradionecrosis. We confirmed the high effectiveness of superselective arterial infusion and concomitant radiotherapy, which can concentrate the attack of decadose cisplatin on locoregional disease. Moreover, even patients with unresectable disease can be cured. We must clarify the treatment results and late side effects, and establish the indications for this treatment. (author)

  4. Sciatic nerve injection injury.

    Science.gov (United States)

    Jung Kim, Hyun; Hyun Park, Sang

    2014-06-11

    Nerve injury is a common complication following intramuscular injection and the sciatic nerve is the most frequently affected nerve, especially in children, the elderly and underweight patients. The neurological presentation may range from minor transient pain to severe sensory disturbance and motor loss with poor recovery. Management of nerve injection injury includes drug treatment of pain, physiotherapy, use of assistive devices and surgical exploration. Early recognition of nerve injection injury and appropriate management are crucial in order to reduce neurological deficit and to maximize recovery. Sciatic nerve injection injury is a preventable event. Total avoidance of intramuscular injection is recommended if other administration routes can be used. If the injection has to be administered into the gluteal muscle, the ventrogluteal region (gluteal triangle) has a more favourable safety profile than the dorsogluteal region (the upper outer quadrant of the buttock). PMID:24920643

  5. The furcal nerve revisited

    Directory of Open Access Journals (Sweden)

    Nanjundappa S. Harshavardhana

    2014-10-01

    Full Text Available Atypical sciatica and discrepancy between clinical presentation and imaging findings is a dilemma for treating surgeon in management of lumbar disc herniation. It also constitutes ground for failed back surgery and potential litigations thereof. Furcal nerve (Furcal = forked is an independent nerve with its own ventral and dorsal branches (rootlets and forms a link nerve that connects lumbar and sacral plexus. Its fibers branch out to be part of femoral and obturator nerves in-addition to the lumbosacral trunk. It is most commonly found at L4 level and is the most common cause of atypical presentation of radiculopathy/sciatica. Very little is published about the furcal nerve and many are unaware of its existence. This article summarizes all the existing evidence about furcal nerve in English literature in an attempt to create awareness and offer insight about this unique entity to fellow colleagues/ professionals involved in spine care.

  6. The Furcal Nerve Revisited

    Science.gov (United States)

    Dabke, Harshad V.

    2014-01-01

    Atypical sciatica and discrepancy between clinical presentation and imaging findings is a dilemma for treating surgeon in management of lumbar disc herniation. It also constitutes ground for failed back surgery and potential litigations thereof. Furcal nerve (Furcal = forked) is an independent nerve with its own ventral and dorsal branches (rootlets) and forms a link nerve that connects lumbar and sacral plexus. Its fibers branch out to be part of femoral and obturator nerves in-addition to the lumbosacral trunk. It is most commonly found at L4 level and is the most common cause of atypical presentation of radiculopathy/sciatica. Very little is published about the furcal nerve and many are unaware of its existence. This article summarizes all the existing evidence about furcal nerve in English literature in an attempt to create awareness and offer insight about this unique entity to fellow colleagues/professionals involved in spine care. PMID:25317309

  7. Arterial baroreflex buffering of sympathetic activation during exercise-induced elevations in arterial pressure.

    OpenAIRE

    Scherrer, U; Pryor, S L; Bertocci, L A; Victor, R G

    1990-01-01

    Static muscle contraction activates metabolically sensitive muscle afferents that reflexively increase sympathetic nerve activity and arterial pressure. To determine if this contraction-induced reflex is modulated by the sinoaortic baroreflex, we performed microelectrode recordings of sympathetic nerve activity to resting leg muscle during static handgrip in humans while attempting to clamp the level of baroreflex stimulation by controlling the exercise-induced rise in blood pressure with pha...

  8. Paralisia de prega vocal esquerda secundária à lesão do nervo laríngeo recorrente após cirurgia de ligadura do canal arterial: relato de caso Parálisis de pliegue vocal izquierdo secundario a la lesión del nervio laríngeo recurrente después de cirugía de ligadura del canal arterial: relato de caso Paralysis of the left vocal cord secondary to left recurrent nerve lesion following surgery for ligation of the arterial canal: case report

    Directory of Open Access Journals (Sweden)

    Marcius Vinícius M. Maranhão

    2002-07-01

    .800 g, sometida a cirugía para ligadura del canal arterial. Recibió como medicación pré-anestésica, midazolam (0,8 mg.kg-1, sesenta minutos antes de la cirugía. La inducción y la manutención de la anestesia fueron hechas con sevoflurano, alfentanil y pancuronio. La disección del canal arterial fue realizada con dificultad. En el 4º día del pós-operatorio presentó disfonia persistente. La videolarin- goscopia mostró parálisis de pliegue vocal izquierdo y pequeña abertura paramediana. CONCLUSIONES: Por su íntima relación con el canal arterial, el nervio laríngeo recurrente izquierdo puede ser lesionado, durante la cirugía correctiva, principalmente cuando existen dificultades en la disección y ligadura del canal arterial. Diferentemente de las disfonias decurrentes de la intubación y extubación traqueal, surgen más tardíamente y permanecen por largos períodos, pudiendo inclusive ser irreversibles.BACKGROUND AND OBJECTIVES: Postoperative dysphonia is commonly associated to tracheal intubation and extubation complications, but other causal factors may be involved, including surgical procedures. This article aimed at reporting a late postoperative dysphonia as a consequence of left vocal cord paralysis secondary to left recurrent laryngeal nerve injury during ductus arteriosus ligation procedure. CASE REPORT: Female patient, 6 years old, physical status ASA II, 18.8 kg, submitted to ductus arteriosus ligation. Patient was premedicated with oral midazolam (0.8 mg.kg-1 60 minutes before surgery. Anesthesia was induced and maintained with sevoflurane, alfentanil and pancuronium. The ductus arteriosus was difficult to dissect. In the 4th postoperative day, patient presented with persistent dysphonia. Videolaryngoscopy has evidenced paralysis of the left vocal cord and a small paramedian gap. CONCLUSIONS: For its close relationship with the ductus arteriosus, the left recurrent laryngeal nerve may be damaged during corrective procedures, especially when

  9. Spinal accessory nerve neurilemmoma

    International Nuclear Information System (INIS)

    A neurilemmoma of the spinal accessory nerve extending from the lower brain stem to the high cervical region, without typical jugular foramen syndome is presented. Preoperative diagnosis is difficult but should be considered in the differential diagnosis of a high cervical intradural extramedullary lesion in patients with lower cranial nerve(s) dysfunction. The value of intrathecal and intravenous contrast enhancement computed tomography (CT) myelogram is emphasized. 13 refs.; 3 figs

  10. Facial Nerve Neuroma Management

    OpenAIRE

    Weber, Peter C; Osguthorpe, J. David

    1998-01-01

    Three facial nerve neuromas were identified in the academic year 1994-1995. Each case illustrates different management dilemmas. One patient with a grade III facial nerve palsy had a small geniculate ganglion neuroma with the dilemma of decompression versus resection clear nerve section margins. The second patient underwent facial neuroma resection with cable graft reconstruction, but the permanent sections were positive. The last patient had a massive neuroma in which grafting versus other f...

  11. Angiolymphoid hyperplasia with eosinophilia and entrapment of the ulnar nerve

    Science.gov (United States)

    Di Vitantonio, Hambra; De Paulis, Danilo; Ricci, Alessandro; Raysi, Soheila Dehcordi; Marzi, Sara; Del Maestro, Mattia; Galzio, Renato Juan

    2016-01-01

    Background: The angiolymphoid hyperplasia with eosinophilia (ALHE) is a sporadic vasoproliferative lesion of uncertain etiology involving the skin and the subcutaneous tissue. Occasionally, it involves also the large arteries compressing the near nerves. ALHE is commonly confused with Kimura's disease because of their clinical and histological similarities. Case Description: We report a case of a 52-year-old female suffering from a 6-month pain and paresthesias in the fourth and fifth finger of the right hand. The angiography showed a pseudoaneurysm in the proximal third of the right ulnar artery. A complete surgical excision of the vascular lesion was undertaken. The lesion forced the right ulnar nerve. The histopathological diagnosis deposed for ALHE. Conclusion: Up to now, literature has described 8 cases of ALHE involving the arteries, and only one case originating from the ulnar nerve. The authors report a case of a female with ALHE involving the ulnar artery that compressed the ulnar nerve. Clinical aspects, radiological features, surgical treatment, and operative findings are discussed reviewing the pertinent literature. PMID:27069750

  12. NORMATIVE DATA OF UPPER LIMB NERVE CONDUCTION IN YOUNG POPULATION IN AND AROUND BARPETA TOWN, ASSAM

    Directory of Open Access Journals (Sweden)

    Dipti

    2015-12-01

    Full Text Available INTRODUCTION Goal of our work was to establish the data of normal nerve conduction velocity (NCV for the median and the ulnar nerves in normal healthy adults in Barpeta town area, Assam, India. METHODS Nerve conduction studies were performed prospectively in the upper limbs of 100 carefully screened, healthy individuals of either sex, who were between the ages of 20 and 60 years, by using a standardized technique. RESULTS: MOTOR STUDIES The median distal latency (DL in men was 3.48 (0.26 ms, the amplitude (CMAPA was 9.86 (1.92 mV, the conduction velocity (MNCV was 55.94 (2.94 m/s and the F-wave (min latency was 26.86 (2.12 minute. In the ulnar nerve, the motor DL was 2.3 (0.26 ms, the amplitude (CMAPA was 9.97 (3.90 mV, MNCV was 62.97 (3.90 m/s and the F-Wave (min latency was 25.98±2.41. In the sensory studies, the median nerve DL was 1.89 (0.25 ms, SNCV was 53.14±3.80 m/s and the amplitude (SNAPA was 42.69 (20.48 μV for was. For the ulnar nerve the DL was 1.89 (0.36 ms, SNCV was 56.86 (6.23 m/s and the amplitude (SNAPA was 40.92 (168.4 μV. CONCLUSION The normative conduction parameters of the commonly tested nerves in the upper limb were established in research laboratory of physiology department of our institute. The mean motor nerve conduction parameters for the median and the ulnar nerves correlated favorably with the existing literature data. However, for the sensory nerves, a higher value for the nerve action potential amplitude was demonstrated in this study.

  13. The clinical course of non-operated peripheral nerve tumor

    International Nuclear Information System (INIS)

    Peripheral nerve tumors are routinely removed by operation, however, complete enucleation is not always possible with schwannomas. Even if such tumors were completely enucleated, neurological deficits may still appear. Recently, a few studies have described the clinical course of spinal cord tumors but, there has been no study showing the clinical course of non-operated peripheral nerve tumors. This study reviewed the clinical course of non-operated peripheral nerve tumors. Ten tumors diagnosed as peripheral nerve tumors by clinical findings and MR images (MRI) were studied semiannually. The patients included seven males and three females with a mean age of 59 (range 20 to 89) years at final follow-up. The involved nerves were the radial nerve in four cases, the brachial plexus in three cases, and the median nerve, the femoral nerve, the tibial nerve in one case each. The mean follow-up interval was 43 (range 24-81) months. One patient was followed for four years and three patients were followed over six years. The initial complaint was of a palpable mass in eight cases. The mean time from clinical presentation to the first examination was 16.1 (range 1-48) months. No tumors caused sensory deficit although two tumors caused objective muscle weakness by Medical Research Council (MRC) grading. All ten tumors demonstrated a positive Tinel's sign over the mass. The mean tumor size on MRI was 36.8 (range 20-85) mm. In this study, there was no significant change of the clinical findings and the size on MRI in the peripheral nerve tumors in the follow-up of over two years. All ten tumors were static in size when examined by MRI. Only one of the ten patients experienced slightly increased pain. We conclude that the decision to operate on peripheral nerve tumors should be considered more carefully, since in patients with no or little symptoms, tumor size and symptoms did not increase. (author)

  14. From basilar artery dolichoectasia to basilar artery aneurysm: natural history in images.

    Science.gov (United States)

    Zis, Panagiotis; Fragkis, Stylianos; Lykouri, Maria; Bageris, Ioannis; Kolovos, Georgios; Angelidakis, Panagiotis; Tavernarakis, Antonios

    2015-05-01

    Dolichoectasia is a medical term used to describe elongated and dilated vessels that follow a tortuous and windy course with frequent loops and curves. We are presenting the natural history in images of a normal basilar artery becoming dolichoectatic, followed by the formation of an aneurysm, over a period of many years, in 60-year-old Caucasian man with a long history of secondary progressive multiple sclerosis and uncontrolled arterial hypertension, who was diagnosed with dolichoectasia of basilar artery in 2008. Although relatively stable at this point, eventually his mobility deteriorated and signs from the cranial nerves, such as trigeminal neuralgia and bilateral palsy of the VI and the VII nerves were added in the clinical picture. In 2014, both computed tomography and magnetic resonance imaging of the brain revealed the formation of an unruptured aneurysm of the basilar artery. PMID:25765208

  15. Fractionated Stereotactic Radiotherapy for Facial Nerve Schwannomas.

    Science.gov (United States)

    Shi, Wenyin; Jain, Varsha; Kim, Hyun; Champ, Colin; Jain, Gaurav; Farrell, Christopher; Andrews, David W; Judy, Kevin; Liu, Haisong; Artz, Gregory; Werner-Wasik, Maria; Evans, James J

    2016-02-01

    Purpose Data on the clinical course of irradiated facial nerve schwannomas (FNS) are lacking. We evaluated fractionated stereotactic radiotherapy (FSRT) for FNS. Methods Eight consecutive patients with FNS treated at our institution between 1998 and 2011 were included. Patients were treated with FSRT to a median dose of 50.4 Gy (range: 46.8-54 Gy) in 1.8 or 2.0 Gy fractions. We report the radiographic response, symptom control, and toxicity associated with FSRT for FNS. Results The median follow-up time was 43 months (range: 10-75 months). All patients presented with symptoms including pain, tinnitus, facial asymmetry, diplopia, and hearing loss. The median tumor volume was 1.57 cc. On the most recent follow-up imaging, five patients were noted to have stable tumor size; three patients had a net reduction in tumor volume. Additionally, six patients had improvement in clinical symptoms, one patient had stable clinical findings, and one patient had worsened House-Brackmann grade due to cystic degeneration. Conclusion FSRT treatment of FNS results in excellent control of growth and symptoms with a small rate of radiation toxicity. Given the importance of maintaining facial nerve function, FSRT could be considered as a primary management modality for enlarging or symptomatic FNS. PMID:26949592

  16. Sosiaalisen median strategia nonprofit-organisaatiolle : Suomen Ratsastajainliitto ry

    OpenAIRE

    Toivonen, Eveliina

    2011-01-01

    Opinnäytetyön tavoitteena oli luoda Suomen Ratsastajainliitolle sosiaalisen median strategia. Alaongelmina pohdittiin sosiaalisen median luomia haasteita ja mahdollisuuksia sekä sitä, että minkälaista sisältöä sinne kannattaa tuottaa. Työn taustalla oli keväällä 2011 Suomen Ratsastajainliitossa käynnistetty sosiaalisen median pilottihanke, jossa luotiin organisaatiolle Facebookprofiili. Pilottihanke onnistui hyvin, mutta sosiaalisen median jatkohyödyntämiselle tarvittiin vielä lisää rakennusp...

  17. Treatment of complex internal carotid artery aneurysms using radial artery grafts. Surgical technique, perioperative complications, and results in 17 patients

    International Nuclear Information System (INIS)

    Complex giant or large internal carotid artery aneurysms present a surgical challenge because limitations and difficulty are encountered with either clipping or endovascular treatment. Our review of previous reports suggests that no current vascular assessment can accurately predict the occurrence of ischemic complications after internal carotid artery ligation. The present study concerns surgical technique, complications, and clinical outcome of radial artery grafting followed by parent artery trapping or proximal occlusion for management of these difficult lesions. Between September 1997 and October 2005, we performed radial artery grafting followed immediately by parent artery occlusion in 17 patients with giant or large complex intracranial carotid aneurysms (3 men, 14 women; mean follow-up duration, 62 months). All patients underwent postoperative digital subtraction angiography to assess graft patency and aneurysm obliteration. All 17 aneurysms were excluded from the cerebral circulation, with all radial artery grafts patent. Among 4 patients with cranial nerve disturbances, dysfunction was temporary in 5; in the others, oculomotor nerve paresis persisted. No perioperative cerebral infarction occurred. Sensory aphasia reflecting cerebral contusions caused by temporal lobe retraction resolved within 2 months, as did hemiparesis from a postoperative epidural hematoma. With appropriate attention to surgical technique, radial artery grafting followed by acute parent artery occlusion is a safe treatment for complex internal carotid artery aneurysms. Graft patency and aneurysm thrombosis were achieved in all patients. Cranial nerve dysfunction (III, VI) caused by altered blood flow from the internal carotid artery after occlusion was the most common complication and typically was temporary. In our experience with these difficult aneurysms, not only clipping but also reconstruction of the internal carotid artery was required, especially for wide-necked symptomatic

  18. Intraoperative vagal nerve monitoring.

    Science.gov (United States)

    Leonetti, J P; Jellish, W S; Warf, P; Hudson, E

    1996-08-01

    A variety of benign and malignant neoplasms occur in the superior cervical neck, parapharyngeal space or the infratemporal fossa. The surgical resection of these lesions may result in postoperative iatrogenic injury to the vagus nerve with associated dysfunctional swallowing and airway protection. Anatomic and functional preservation of this critical cranial nerve will contribute to a favorable surgical outcome. Fourteen patients with tumors of the cervical neck or adjacent skull base underwent intraoperative vagal nerve monitoring in an attempt to preserve neural integrity following tumor removal. Of the 11 patients with anatomically preserved vagal nerves in this group, seven patients had normal vocal cord mobility following surgery and all 11 patients demonstrated normal vocal cord movement by six months. In an earlier series of 23 patients with tumors in the same region who underwent tumor resection without vagal nerve monitoring, 18 patients had anatomically preserved vagal nerves. Within this group, five patients had normal vocal cord movement at one month and 13 patients demonstrated normal vocal cord movement at six months. This paper will outline a technique for intraoperative vagal nerve monitoring utilizing transcricothyroid membrane placement of bipolar hook-wire electrodes in the vocalis muscle. Our results with the surgical treatment of cervical neck and lateral skull base tumors for patients with unmonitored and monitored vagal nerves will be outlined. PMID:8828272

  19. UNILATERAL VARIATION IN THE BRANCHING PATTERN OF RIGHT AXILLARY ARTERY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    A.K.Manicka Vasuki

    2015-09-01

    Full Text Available Axillary artery and its branches are prone to have variations in their course. Knowledge about such variations are important for Radiologists in imaging techniques, Surgeons,Orthopedicians and Anesthetists in performing surgeries in the axilla and giving regional nerve blocks in the axilla.During dissection of a cadaver in the department of Anatomy, PSG IMS &R, Coimbatore, We observed a variation in the third part of right Axillary artery. From the common trunk, Subscapular artery, Anterior and Posterior circumflex humeral arteries and Profunda brachii artery arose. Third part of Axillary artery continued down as brachial artery. We are highlighting the variation in this study.

  20. Typology of the arteries in the human scalenus region, with special reference to the accessory ascending cervical artery.

    Directory of Open Access Journals (Sweden)

    Su WD

    2000-12-01

    Full Text Available The accessory ascending cervical artery (Murakami et al., 1996, which arises from the subclavian artery and ascends between the scalenus anterior and medius muscles, was studied in 87 Japanese adult cadavers (174 sides, with special attention being given to its origin, distribution, and relationship to other arteries at the cervical or scalenus region. In 154 sides (88.5%, the accessory ascending cervical artery was found to originate from the subclavian artery behind the scalenus anterior muscle, and to branch out to the scalenus anterior and medius muscles as well as those entering the 5th and 6th intervertebral foramens along the 6th and 7th cervical nerves. This artery arose independently in 105 sides. The accessory ascending cervical artery issued off or formed a common trunk with the transverse cervical artery and/or costocervical trunk in 49 sides. In cases lacking the accessory ascending cervical artery, it was usually compensated for by the costocervial trunk and/or transverse cervical artery (18 sides. Common trunk formation with the vertebral, internal thoracic, or suprascapular arteries was not observed. The authors suggest that the accessory ascending cervical artery, the transverse cervical artery, and the costocervical trunk should be grouped into one arterial system, a system that may be a remnant of the precostal longitudinal anastomoses of intersegmental arteries of the dorsal aorta behind the scalenus anterior muscle.

  1. Preoperative transcutaneous electrical nerve stimulation for localizing superficial nerve paths.

    Science.gov (United States)

    Natori, Yuhei; Yoshizawa, Hidekazu; Mizuno, Hiroshi; Hayashi, Ayato

    2015-12-01

    During surgery, peripheral nerves are often seen to follow unpredictable paths because of previous surgeries and/or compression caused by a tumor. Iatrogenic nerve injury is a serious complication that must be avoided, and preoperative evaluation of nerve paths is important for preventing it. In this study, transcutaneous electrical nerve stimulation (TENS) was used for an in-depth analysis of peripheral nerve paths. This study included 27 patients who underwent the TENS procedure to evaluate the peripheral nerve path (17 males and 10 females; mean age: 59.9 years, range: 18-83 years) of each patient preoperatively. An electrode pen coupled to an electrical nerve stimulator was used for superficial nerve mapping. The TENS procedure was performed on patients' major peripheral nerves that passed close to the surgical field of tumor resection or trauma surgery, and intraoperative damage to those nerves was apprehensive. The paths of the target nerve were detected in most patients preoperatively. The nerve paths of 26 patients were precisely under the markings drawn preoperatively. The nerve path of one patient substantially differed from the preoperative markings with numbness at the surgical region. During surgery, the nerve paths could be accurately mapped preoperatively using the TENS procedure as confirmed by direct visualization of the nerve. This stimulation device is easy to use and offers highly accurate mapping of nerves for surgical planning without major complications. The authors conclude that TENS is a useful tool for noninvasive nerve localization and makes tumor resection a safe and smooth procedure. PMID:26420473

  2. Partial oculomotor nerve palsy in a 7-year-old child

    Science.gov (United States)

    Israni, Anil; Chakrabarty, Biswaroop; Kumar, Atin; Gulati, Sheffali

    2016-01-01

    Oculomotor nerve palsy can be due to varied causes that include diabetic neuropathy, myasthenia gravis, brainstem infarction, demyelinating conditions, and cerebral aneurysms. Among the aneurysmal causes of oculomotor nerve palsy, aneurysm of the posterior communicating artery has been observed to be the most common. Pupillary dysfunction is considered to be an important feature of aneurysmal oculomotor nerve paresis. A case of a 7-year-old boy with partial oculomotor nerve palsy with pupillary sparing is being reported here, the etiology of which is tortuous and ectatic distal internal carotid artery. This is a rare cause of oculomotor nerve paresis and to the best of our knowledge has not yet been reported in children. Ischemia rather than compression seems to be the most plausible cause in this case.

  3. Head rotation and sound image localization in the median plane

    Institute of Scientific and Technical Information of China (English)

    RAO Dan; XIE Bosun

    2005-01-01

    The effect of head rotation on median plane sound source (or image) localization is studied. It is suggested that, at low frequency, the change of interaural time difference (ITD) caused by head rotation supplies information for determining sound source direction in the median plane. Based on the suggestion, the summed sound image localization equations for multiple loudspeakers arranged in the median plane are derived. Especially, for a pair of loudspeakers arranged front-back symmetrically in the median plane, the localization equations are similar to that of stereophonic sound in horizontal plane. A sound image localization experiment was carried out to prove the theoretical analysis. The results of this paper are not only available to virtual spatial auditory, but also supply a quantitative validation of the hypothesis that head rotation is a cue for sound source localization in the median plane at low frequency.

  4. Robust p-median problem in changing networks

    Directory of Open Access Journals (Sweden)

    Štefan PEŠKO

    2015-09-01

    Full Text Available The robust p-median problem in changing networks is a version of known discrete p-median problem in network with uncertain edge lengths where uncertainty is characterised by given interval. The uncertainty in edge lengths may appear in travel time along the edges in any network location problem. Several possible future scenarios with respect to the lengths of edges are presented. The planner will want a strategy of positioning p medians that will be working “as well as possible" over the future scenarios. We present MILP formulation of the problem and the solution method based on exchange MILP heuristic. The cluster of each median is presented by rooted tree with the median as root. The performance of the proposed heuristic is compared to the optimal solution found via Gurobi solver for MILP models through some illustrative instances of Slovak road network in Žilina.

  5. Adaptive Threshold Median Filter for Multiple-Impulse Noise

    Institute of Scientific and Technical Information of China (English)

    JIANG Bo; HUANG Wei

    2007-01-01

    Attenuating the noises plays an essential role in the image processing. Almost all the traditional median filters concern the removal of impulse noise having a single layer, whose noise gray level value is constant. In this paper, a new adaptive median filter is proposed to handle those images corrupted not only by single layer noise. The adaptive threshold median filter(ATMF) has been developed by combining the adaptive median filter (AMF) and two dynamic thresholds. Because of the dynamic threshold being used, the ATMF is able to balance the removal of the multiple-impulse noise and the quality of image. Comparison of the proposed method with traditional median filters is provided. Some visual examples are given to demonstrate the performance of the proposed Filter.

  6. Optic nerve oxygenation

    DEFF Research Database (Denmark)

    Stefánsson, Einar; Pedersen, Daniella Bach; Jensen, Peter Koch;

    2005-01-01

    glaucoma patients is six times higher at a perfusion pressure of 30 mmHg, which corresponds to a level where the optic nerve is hypoxic in experimental animals, as compared to perfusion pressure levels above 50 mmHg where the optic nerve is normoxic. Medical intervention can affect optic nerve oxygen...... through a mechanism of vasodilatation and lowering of the intraocular pressure. Carbonic anhydrase inhibition reduces the removal of CO2 from the tissue and the CO2 accumulation induces vasodilatation resulting in increased blood flow and improved oxygen supply. This effect is inhibited by the cyclo...

  7. Radial Nerve Tendon Transfers.

    Science.gov (United States)

    Cheah, Andre Eu-Jin; Etcheson, Jennifer; Yao, Jeffrey

    2016-08-01

    Radial nerve palsy typically occurs as a result of trauma or iatrogenic injury and leads to the loss of wrist extension, finger extension, thumb extension, and a reduction in grip strength. In the absence of nerve recovery, reconstruction of motor function involves tendon transfer surgery. The most common donor tendons include the pronator teres, wrist flexors, and finger flexors. The type of tendon transfer is classified based on the donor for the extensor digitorum communis. Good outcomes have been reported for most methods of radial nerve tendon transfers as is typical for positional tendon transfers not requiring significant power. PMID:27387076

  8. Should we routinely expose recurrent laryngeal nerve(s) during thyroid surgery

    International Nuclear Information System (INIS)

    Objective: To compare the frequency of recurrent laryngeal nerve(s) (RLNs) palsy after various thyroid procedures with and without identification of recurrent laryngeal nerve during the operation. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Surgery, Military Hospital, Rawalpindi, from August 2008 to April 2010. Methodology: Patients undergoing indirect laryngoscopy with normal vocal cords and those with carcinoma and re-do surgery having normal vocal cord were included in the study. Patients with hoarseness of voice, abnormal vocal cord movements and with solitary nodule in the isthmus were excluded. These patients were randomly divided into 2 groups of 50 each using random number tables. RLN was identified by exposing the inferior thyroid artery and traced along its entire course in group-A. Whereas, in group-B, nerves were not identified during the operations. Immediate postoperative direct laryngoscopy was performed by a surgeon with the help of an anaesthesiologist for the assessment of vocal cords. Patients with persistent hoarseness of voice were followed-up with indirect laryngoscopy at 3 and 6 months. Results: Temporary unilateral recurrent laryngeal nerve palsies occurred in 2 (4%) patients in group-A where the voice and cord movements returned to normal in 6 months. In group-B, it occurred in 8 (16%) patients, 2 bilateral (4%) injuries requiring tracheostomy and 6 unilateral injuries (12%). Among the 2 bilateral recurrent laryngeal nerve injuries, the tracheostomy was removed in one case after 6 months with persistent hoarseness of voice but no respiratory difficulty during routine activities. Tracheostomy was permanent in the other case. Among the 6 cases of unilateral nerve injuries, the voice improved considerably in 4 cases within 6 months but in 2 cases hoarseness persisted even after 6 months. Frequency of recurrent laryngeal nerve palsies was significantly lower in group-A as compared to group-B (p = 0

  9. Clinical application of branch artery of the sural medial gastrocnemius muscle flap combine with sural nerve nutritional vessel axial%腓肠肌内侧头穿支动脉与腓肠神经营养血管联合蒂肌皮瓣的临床应用

    Institute of Scientific and Technical Information of China (English)

    邵新中; 喻伟光; 王巧君; 王英彩; 吕莉; 王立; 孙建涛

    2011-01-01

    Objective To investigate the clinical efficiency of branch artery of the sural medial gastrocnemius muscle flap combine with sural nerve nutritional vessel axial.Methods From February 2006to March 2010,according to the position and size of the soft tissue defects,the muscle flap combined with branch artery of the sural medial gastrocnemius and sural nerve nutritional vessel axial were desingned and obtained to repair 7 cases of sofi tissue defects of the upper-region of the tibial.The flap size ranged from 8.0 cm × 8.0 cm to 12.0 cm × 10.0 cm.The vessel pedicle of branches ranged from 1.8-3.0 cm.The distribution of the vessel pedicle of branches ranged from 10.0-17.0 cm on the distant popliteal fossa,and ranged from 2.0-5.0 cm on the back of medial line.Results The outline and function were satisfactory during 6-15 months follow-up.Conclusion The blood supply of this flap is reliable without sacrifice of major arteries.Flap elevation is easy.It can transfer to a long distance and can repair large skin defects.It is very useful in repairing upper-region of the tibial large soft tissue defect.%目的 探讨腓肠肌内侧头穿支动脉与腓肠神经营养血管联合蒂肌皮瓣的临床应用效果.方法 自2006年2月至2010年3月,根据缺损部位及大小设计以腓肠肌内侧头穿支动脉与腓肠神经营养血管轴的联合蒂,沿腓肠肌内侧头血管轴切取皮瓣,顺行移位修复膑前及胫骨上段皮肤及软组织缺损7例.皮瓣切取范围8.0 cm×8.0 cm~12.0 cm×10.0 cm,联合血管蒂长1.8~3.0 cm,联合血管蒂发出位于腘褶皱以远10.0 ~ 17.0 cm,距后正中线2.0~5.0 cm的范围内.结果 6例伤口一期愈合.1例发生皮瓣远端表浅干性坏死,面积约1 cm×2 cm,经换药后逐渐愈合.随访6~ 15个月,无任何并发症,肌皮瓣质地优良,外观满意.结论 腓肠肌内侧头穿支动脉与腓肠神经营养血管联合蒂肌皮瓣手术操作简便,血供可靠且不牺牲主要动脉,切取面

  10. High Ulnar Nerve Injuries: Nerve Transfers to Restore Function.

    Science.gov (United States)

    Patterson, Jennifer Megan M

    2016-05-01

    Peripheral nerve injuries are challenging problems. Nerve transfers are one of many options available to surgeons caring for these patients, although they do not replace tendon transfers, nerve graft, or primary repair in all patients. Distal nerve transfers for the treatment of high ulnar nerve injuries allow for a shorter reinnervation period and improved ulnar intrinsic recovery, which are critical to function of the hand. PMID:27094893

  11. Management of Trigeminal Neuralgia Caused by an Intraneural Spiral Trigeminocerebellar Artery: A Case Report

    OpenAIRE

    WAKUTA, Naoki; Abe, Hiroshi; NONAKA, Masani; Higashi, Toshio; UEBA, Tetsuya; Inoue, Tooru

    2015-01-01

    The trigeminocerebellar artery (TCA) is a branch of the basilar artery that may have an intraneural course and may cause trigeminal neuralgia. We report a case of trigeminal neuralgia with right vertebral artery aneurysm caused by an intraneural TCA that compressed the trigeminal nerve in multiple places. We performed proximal trapping for the fusiform aneurysm with extra-intracranial bypass to preserve flow of the posterior inferior cerebellar artery, followed by microvascular decompression ...

  12. Diabetic Nerve Problems

    Science.gov (United States)

    ... at the wrong times. This damage is called diabetic neuropathy. Over half of people with diabetes get ... you change positions quickly Your doctor will diagnose diabetic neuropathy with a physical exam and nerve tests. ...

  13. Kilpailuedun saavuttaminen sosiaalisen median markkinoinnilla : case: Kauppakeskus Willa

    OpenAIRE

    Mäentausta, Miia

    2013-01-01

    Sosiaalinen media on nykyaikaa, ja yritykset siirtyvät yhä enemmän sinne, missä asiakkaat ovat. Kauppakeskus Willa on lähtenyt mukaan sosiaaliseen mediaan, mutta Willalla ei ole suunnitelmaa siitä, missä ja miten täytyy toimia. Opinnäytetyön aiheena oli tehdä sosiaalisen median markkinointisuunnitelma Kauppakeskus Willalle. Tutkimuskysymyksinä oli selvittää, miten sosiaalisen median markkinoinnilla voi saavuttaa kilpailuetua ja miten sosiaalisen median markkinoinnin kohderyhmä tavoitetaan. En...

  14. Sosiaalisen median strategia B2B-yritykselle

    OpenAIRE

    Johansson, Mia

    2013-01-01

    Opinnäytetyössä perehdyttiin sosiaaliseen mediaan ja sen hyödyntämiseen B2B-näkökulmasta. Opinnäytetyön tarkoitus oli selvittää, miten B2B-yritys voi hyödyntää sosiaalista mediaa osana liiketoimintaansa ja miten sosiaalisen median strategia käytännössä toteutetaan. Työn aikana opinnäytetyön tekijä oli osana sosiaalisen median strategian suunnittelua ja valmistumista case-yrityksessä. Case-yritys on oululainen informaatioteknologian alalla toimiva B2B-yritys. Sosiaalisen median avulla...

  15. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    la Cour, M; Kiilgaard, Jens Folke; Eysteinsson, T;

    2000-01-01

    To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide.......To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide....

  16. Neurovascular compression syndrome of the eighth cranial nerve

    International Nuclear Information System (INIS)

    Neurovascular compression syndrome (NVCS) involves neuropathy due to intracranial blood vessels compressing the cranial nerves. NVCS of the eighth cranial nerve is less reportedly established as a clinical entity than that of the fifth and seventh cranial nerves. We report 17 cases of NVCS of the eighth cranial nerve and their clinical features. Clinical symptoms and test findings among our subjects indicated that most were aged more than 65 years, were unilateral, had intermittent tinnitus, suffered attacks lasting a few seconds dozens of times a day, experienced dizziness concomitantly with tinnitus, aggravated tinnitus and dizziness when tilting the head toward the affected side and looking downward (positional tinnitus, positional dizziness), heard specific tinnitus sounds such as crackling differing from those in cochlear tinnitus, had mild or no hearing loss, were diagnosed with retrocochlear hearing disturbance due to an interpeak latency delay between waves I and III of the auditory brainstem response (ABR), often had no nystagmus or canal paresis (CP), were found in constructive interference steady state magnetic resonance imaging (CISS MRI) to have compression of the eighth cranial nerve by the vertebral artery (VA) or the anterior inferior cerebellar artery (AICA), rarely had concomitant facial spasms, and had tinnitus and dizziness markedly suppressed by carbamazepine. With the number of elderly individuals continuing to increase, cases of NVCS due to arteriosclerotic changes in cerebral blood vessels are expected to increase, making it necessary to consider NVCS in elderly subjects with dizziness, tinnitus, and hearing loss. (author)

  17. Dopamine D1 and D2 receptor immunoreactivities in the arcuate-median eminence complex and their link to the tubero-infundibular dopamine neurons

    Directory of Open Access Journals (Sweden)

    W. Romero-Fernandez

    2014-07-01

    Full Text Available Dopamine D1 and D2 receptor immunohistochemistry and Golgi techniques were used to study the structure of the adult rat arcuate-median eminence complex, and determine the distribution of the dopamine D1 and D2 receptor immunoreactivities therein, particularly in relation to the tubero-infundibular dopamine neurons. Punctate dopamine D1 and D2 receptor immunoreactivities, likely located on nerve terminals, were enriched in the lateral palisade zone built up of nerve terminals, while the densities were low to modest in the medial palisade zone. A codistribution of dopamine D1 receptor or dopamine D2 receptor immunoreactive puncta with tyrosine hydroxylase immunoreactive nerve terminals was demonstrated in the external layer. Dopamine D1 receptor but not dopamine D2 receptor immnunoreactivites nerve cell bodies were found in the ventromedial part of the arcuate nucleus and in the lateral part of the internal layer of the median eminence forming a continuous cell mass presumably representing neuropeptide Y immunoreactive nerve cell bodies. The major arcuate dopamine/ tyrosine hydroxylase nerve cell group was found in the dorsomedial part. A large number of tyrosine hydroxylase immunoreactive nerve cell bodies in this region demonstrated punctate dopamine D1 receptor immunoreactivity but only a few presented dopamine D2 receptor immunoreactivity which were mainly found in a substantial number of tyrosine hydroxylase cell bodies of the ventral periventricular hypothalamic nucleus, also belonging to the tubero-infundibular dopamine neurons. Structural evidence for projections of the arcuate nerve cells into the median eminence was also obtained. Distal axons formed horizontal axons in the internal layer issuing a variable number of collaterals classified into single or multiple strands located in the external layer increasing our understanding of the dopamine nerve terminal networks in this region.  Dopamine D1 and D2 receptors may therefore directly

  18. Nerve Conduction Studies and Electromyography

    OpenAIRE

    Keyes, Robert D.

    1990-01-01

    Nerve conduction studies and electromyography can aid in the diagnosis of peripheral nervous system disease. The author reviews various techniques used during electromyography and nerve conduction studies. He reviews briefly peripheral nerve and muscle neuroanatomy and neurophysiology. The author defines terms used in nerve conduction studies and electromyography and relates terminology to the underlying pathophysiology and histopathology. He also reviews briefly typical nerve conduction and ...

  19. Otic artery: a review of normal and pathological features.

    Science.gov (United States)

    Vasović, Ljiljana; Arsić, Stojanka; Vlajković, Slobodan; Jovanović, Ivan; Jovanović, Predrag; Ugrenović, Sladjana; Andjelković, Zlatibor

    2010-05-01

    Three primitive arteries - the trigeminal, otic and hypoglossal take the names according to their close relation with the V, VIII and XII cranial nerves, while at the cervical level, the first segmental artery is named the primitive proatlantal intersegmental artery. When the human embryo is 4 mm long, these arteries serve as transitory anastomoses between primitive internal carotid arteries and bilateral longitudinal neural arterial plexus, which is the precursor of future basilar artery. Normal and/or abnormal morphofunctional aspects of the prenatal and postnatal forms of the otic artery are described according to the personal and literature data. Many (ab) normal arteries are also noted in differential diagnosis of the otic artery. Postnatally, individual incidence rates of the carotid-vertebrobasilar anastomoses have been found to be inversely related to their order of disappearance. The persistent trigeminal artery has a reported incidence from 0.06-0.6%, whereas the persistent primitive otic artery has been convincingly documented only in minor rates. Persistent carotid-vertebrobasilar anastomoses between the anterior and posterior cranial circulation are important to recognize during angiography for endovascular and surgical planning. Most frequently, the otic artery was an incidental finding. PMID:20424561

  20. Median Analysis on the TNCs Financial Characteristics of China

    Directory of Open Access Journals (Sweden)

    LU Diqian

    2012-04-01

    Full Text Available The purpose of this empirical study is to study the basic characteristics of Chinese TNCs in the background of economic globalization. Based on the theory of modern TNCs, with data of Chinese listed companies financial statements in 2009, we constructed quantitative analysis system by using more steady statistics which included median, Median Average Difference (MAD, median average difference of dispersion coefficient and median regression model fitted by two-stage least absolute derivation. Then empirical study was carried out on financial characteristics of Chinese TNCs. The results show that Chinese TNCs have advantages relative to other types of companies, ultra big company size is Chinese TNCs' essential requirements, fast capital expansion is Chinese TNCs salient feature and concept of financial management lag is Chinese TNCs' major defect and so on.

  1. Study of the anatomical position of the femoral nerve by magnetic resonance imaging in patients with fractured neck of femur: relevance to femoral nerve block.

    LENUS (Irish Health Repository)

    Mehmood, Shehzad

    2012-01-31

    STUDY OBJECTIVE: To determine the anatomical location of the femoral nerve in patients who have sustained fracture of the neck of femur, and its relevance to femoral nerve block technique. DESIGN: Prospective, observational clinical study. SETTING: Orthopedic and Radiology departments of a regional hospital. SUBJECTS: 10 consecutive adult ASA physical status II and III patients (mean age, 78.5 yrs) and 4 adult healthy volunteers. INTERVENTIONS: A T1 magnetic resonance imaging scan was performed of both upper thighs in patients and healthy volunteers successfully. MEASUREMENTS: The distance (mm) between the midpoint of the femoral artery and the midpoint of the femoral nerve, and the distance of the femoral nerve from the skin was measured at the mid-inguinal ligament, the pubic tubercle, and at the mid-inguinal crease. Data are shown as means (SD). Differences between both sides were compared using paired Student\\'s t-tests. P < 0.05 was significant. MAIN RESULTS: In patients the mean distance (mm) between the midpoint of the femoral nerve from the midpoint of femoral artery at the mid-inguinal crease on the fractured and non-fractured sides was 10.7 and 11.0, respectively (P = 0.87). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the mid-inguinal ligament on the fractured and non-fractured sides was 9.64 and 12.5, respectively (P = 0.03). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the pubic tubercle on the fractured and non-fractured sides was 8.74 and 10.49, respectively (P = 0.18). CONCLUSIONS: Blockade of the femoral nerve may be easier to perform at the mid-inguinal crease in patients with fractured neck of femur.

  2. Median Graph Shift: A New Clustering Algorithm for Graph Domain

    OpenAIRE

    Jouili, Salim; Tabbone, Salvatore; Lacroix, Vinciane

    2010-01-01

    n the context of unsupervised clustering, a new algorithm for the domain of graphs is introduced. In this paper, the key idea is to adapt the mean-shift clustering and its variants proposed for the domain of feature vectors to graph clustering. These algorithms have been applied successfully in image analysis and computer vision domains. The proposed algorithm works in an iterative manner by shifting each graph towards the median graph in a neighborhood. Both the set median graph and the gene...

  3. An approximate algorithm for median graph computation using graph embedding

    OpenAIRE

    Ferrer Sumsi, Miquel; Valveny, Ernest; Serratosa Casanelles, Francesc; Riesen, Kaspar; Bunke, Horst

    2008-01-01

    Graphs are powerful data structures that have many attractive properties for object representation. However, some basic operations are difficult to define and implement, for instance, how to obtain a representative of a set of graphs. The median graph has been defined for that purpose, but existing algorithms are computationally complex and have a very limited applicability. In this paper we propose a new approach for the computation of the median graph based on graph embedding in vector spac...

  4. Sosiaalisen median markkinoinnin vuosikello Weecos Oy:lle

    OpenAIRE

    Heinämäki, Lotta; Huuskonen, Leena

    2015-01-01

    Opinnäytetyön tarkoitus oli luoda kokonaisvaltainen ja selkeä suunnitelma Weecos Oy:n markkinointitoimenpiteille valituissa sosiaalisen median kanavissa. Weecos on vuonna 2012 perustettu ekologisia yrityksiä yhteen keräävä verkkokauppa-alusta. Pienestä koostaan johtuen se ei ole pystynyt toteuttamaan sosiaalisen median markkinointia toivomallaan tavalla ja markkinoinnin suunnittelu ja toteutus on ollut epäsäännöllistä. Markkinointisuunnitelman tavoitteena oli helpottaa yrityksen markkinoi...

  5. Side-to-side range of movement variability in variants of the median and radial neurodynamic test sequences in asymptomatic people.

    Science.gov (United States)

    Stalioraitis, Vaidas; Robinson, Kim; Hall, Toby

    2014-08-01

    Side-to-side discrepancy in range of motion (ROM) during upper limb neurodynamic testing is used in part to identify abnormal peripheral nerve mechanosensitivity and is one of three factors to consider in determining a positive test. Large side-to-side variability is reported for some variants of the upper limb neurodynamic test sequences, however discrepancies for other test variants are unknown. Hence the purpose of this study was to evaluate side-to-side discrepancy in elbow flexion ROM during two variants of upper limb neurodynamic test sequence for the median and radial nerves. 51 asymptomatic subjects (26 females, mean age 29.69 years) were evaluated. A uniaxial electrogoniometer was used to measure elbow flexion ROM at onset of resistance (R1) and onset of discomfort (P1) during the median and radial neurodynamic tests on each side. Reliability was determined by testing 20 subjects twice and was found to be good (ICC greater than 0.88 and SEM less than 4.02°). There was no significant difference in mean ROM between sides. Lower-bound scores indicate that intra-individual, inter-limb differences of more than 15° for the median nerve and 11° for the radial nerve exceeds the range of normal ROM asymmetry on neurodynamic testing at R1 and P1. Correlation of ROM between limbs was significant with R(2) values of 0.62 and 0.85 for the median and radial nerves respectively. These finding provide clinicians with information regarding normal side-to-side variability in ROM during two commonly used variants of neurodynamic tests. PMID:24703935

  6. Testing the gravity p-median model empirically

    Directory of Open Access Journals (Sweden)

    Kenneth Carling

    2015-12-01

    Full Text Available Regarding the location of a facility, the presumption in the widely used p-median model is that the customer opts for the shortest route to the nearest facility. However, this assumption is problematic on free markets since the customer is presumed to gravitate to a facility by the distance to and the attractiveness of it. The recently introduced gravity p-median model offers an extension to the p-median model that account for this. The model is therefore potentially interesting, although it has not yet been implemented and tested empirically. In this paper, we have implemented the model in an empirical problem of locating vehicle inspections, locksmiths, and retail stores of vehicle spare-parts for the purpose of investigating its superiority to the p-median model. We found, however, the gravity p-median model to be of limited use for the problem of locating facilities as it either gives solutions similar to the p-median model, or it gives unstable solutions due to a non-concave objective function.

  7. Enhancement of the facial nerve at MR imaging

    International Nuclear Information System (INIS)

    In the few cases studied, normal facial nerves are reported to show no MR enhancement. Because this did not fit clinical experience, the authors designed a retrospective imaging review with anatomic correlation. Between June 1989 and June 1990, 175 patients underwent focused temporal bone MR imaging before and after administration of intravenous gadopentetate dimeglumine (0.1 mmol/kg). Exclusion criteria for the study included facial nerve dysfunction (subjective or objective); facial nerve mass; central nervous system infection, inflammation, or trauma; neurofibromatosis; or previous cranial surgery of any type. The following sequences were reviewed: GE 1.5-T axial spin-echo TR 567 msec, TE 20 msec, 256 x 192, 2.0 excitations, 20-cm field of view, 3-mm section thickness. Imaging analysis was a side-by side comparison of the images and region-of-interest quantified signal intensity. Anatomic correlation included a comparison with dissection and axial histologic sections. Ninety-three patients (aged 15-75 years) were available for imaging analysis after the exclusionary criteria were applied. With 46 patients (92 facial nerves) analyzed, they found that 76 nerves (83%) showed easily visible gadopentetate dimeglumine enhancement, especially about the geniculate ganglia. Sixteen (17%) of the 92 nerves did not show visible enhancement, but region-of-interest analysis showed increased intensity after gadopentetate dimeglumine administration. Sixteen patients (42%) showed right-to-left asymmetry in facial nerve enhancement. The facial nerves showed enhancement in the geniculate, tympanic, and fallopian portions; the facial nerve within the IAC showed no enhancement. This corresponded exactly with the topographic features of a circummeural arterial/venous plexus seen on the anatomic preparations

  8. The role of sensory nerve conduction study of the palmar cutaneous nerve in the diagnosis of carpal tunnel syndrome in patients with polyneuropathy

    Directory of Open Access Journals (Sweden)

    Ayse Tokcaer

    2007-01-01

    Full Text Available Background: Conventional methods in the diagnosis of carpal tunnel syndrome (CTS in patients with polyneuropathy (PNP are insufficient. Aims: We suggest that the comparison of the conduction of the median nerve with that of the neighboring peripheral nerves may be more beneficial in the diagnosis of entrapment neuropathy. Setting and Design: The median nerve sensory conduction in healthy volunteers, in cases of CTS, PNP cases without CTS and in cases of PNP in whom clinical findings point to CTS, were compared by palmar cutaneous nerve (PCN sensory conduction. Materials and Methods: Comparative parameters were difference of PCN-1st digits′ nerve conduction velocities (NCV, PCN/1st digit NCVs ratio, difference of 5th-2nd digits′ NCVs and 5th/2nd digits′ NCVs ratio. Statistical Analysis: The statistical analysis was performed by the SPSS package for statistics. Student t test and receiver operating characteristic were used. Results: Although the ratio of PCN-1st digit did not differ significantly between the control group and the polyneuropathy group, there was a significant difference between CTS and PNP+CTS groups and the control group ( P < 0.001 and P < 0.001, respectively. The ratio of PCN-1st digit nerve conduction velocity was also significantly different between polyneuropathy and PNP+CTS groups ( P < 0.001. Conclusion: To diagnose CTS on a background of polyneuropathy in mild cases in which sensory conduction is preserved, the ratio of sensory nerve conduction velocities of the palmar cutaneous nerve and the median nerve 1st digit-wrist segment may be a criterion.

  9. Epicardial ultrasound in coronary artery bypass surgery

    NARCIS (Netherlands)

    Budde, R.P.J.

    2005-01-01

    Chapter 1 Coronary artery bypass surgery (CABG) is traditionally performed via a median sternotomy approach on cardiopulmonary bypass (arrested heart). Since the mid 1990ties, beating heart, minimally invasive and even totally endoscopic CABG are (re)explored. In all approaches to CABG, the surgeo

  10. [Biophysics of nerve excitation].

    Science.gov (United States)

    Kol'e, O R; Maksimov, G V

    2010-01-01

    The studies testifying to the presence of the interrelation between the physiological functions of the organism and physical and chemical processes in nerves are discussed. Changes in some physical and chemical parameters observed both upon elicited rhythmic exaltation of nerves and during the spontaneous rhythmic activity of neurons are analyzed. Upon rhythmic exaltation, a complex of physical and chemical processes is triggered, and reversible structural and metabolic rearrangements at the subcellular and molecular levels occur that do not take place during the generation of a single action potential. Thus, only in conditions of rhythmic exaltation of a nerve, it is possible to reveal those processes that provide exaltation of nerves in the organism. The future possibilities of the investigations combining the biophysical and physiological approaches are substantiated. Characteristic changes in physicochemical parameters are observed in nerves during the generation of a series of action potentials of different frequency and duration ("frequency dependence") under normal physiological conditions, as well as in extreme situations and in nerve pathology. The structural and metabolic rearrangements are directly related to the mode of rhythmic exaltation and proceed both in the course of rhythmic exaltation and after its termination. Participation and the basic components of the nervous fulcrum (an axon, Shwan cell, myelin, subcellular organelles) in the realization of rhythmic exaltation is shown. In the coordination of all processes involved in rhythmic exaltation, the main role is played by the systems of redistribution and transport of intercellular and endocellular calcium. The idea is put forward that myelin of nerve fibers is not only an isolator, but also an "intercellular depot" of calcium and participates in the redistribution of different ions. Thus, the rhythmic excitation is of great importance in the realization of some physiological functions, the

  11. Clinical Features and Management of a Median Cleft Lip

    Science.gov (United States)

    Kim, Do Yeon; Oh, Tae Suk

    2016-01-01

    Background Median cleft lip is a rare anomaly consisting of a midline vertical cleft through the upper lip. It can also involve the premaxillary bone, the nasal septum, and the central nervous system. In our current report, we present the clinical features of 6 patients with a median cleft lip and their surgical management according to the accompanying anomalies. Methods From December 2010 to January 2014, 6 patients with a median cleft lip were reviewed. Five of these cases underwent surgical correction; alveolar bone grafting was performed in a patient with a median alveolar cleft. The surgical technique included inverted-U excision of the upper lip and repair of the orbicularis oris muscle. The mean follow-up period was 20.4 months (range, 7.4–44.0 months). Results The study patients presented various anomalous features. Five patients received surgical correction, 4 with repair of the median cleft lip, and one with iliac bone grafting for median alveolar cleft. A patient with basal sphenoethmoidal meningocele was managed with transoral endoscopic surgery for repair of the meningocele. Successful surgical repair was achieved in all cases with no postoperative complications. Conclusions Relatively mild forms of median cleft lip can be corrected with inverted-U excision with good aesthetic outcomes. In addition, there is a broad spectrum of clinical features and various anomalies, such as nasal deformity, alveolar cleft, and short upper frenulum, which require close evaluation. The timing of the operation should be decided considering the presence of other anomalies that can threaten patient survival. PMID:27218021

  12. Diffusion tensor imaging of peripheral nerve in patients with chronic inflammatory demyelinating polyradiculoneuropathy: a feasibility study

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the clinical feasibility of diffusion tensor imaging (DTI) for the evaluation of peripheral nerves in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Using a 3-T magnetic resonance imaging scanner, we obtained DTI scans of the tibial nerves of 10 CIDP patients and 10 sex- and age-matched healthy volunteers. We prepared fractional anisotropy (FA) maps, measured the FA values of tibial nerves, and compared these values in the two study groups. In nine patients, we also performed tibial nerve conduction studies and analyzed the correlation between the FA values and parameters of the nerve conduction study. The tibial nerve FA values in CIDP patients (median 0.401, range 0.312-0.510) were significantly lower than those in healthy volunteers (median 0.530, range 0.469-0.647) (Mann-Whitney test, p < 0.01). They were significantly correlated with the amplitude of action potential (Spearman correlation coefficient, p = 0.04, r = 0.86) but not with nerve conduction velocity (p = 0.79, r = 0.11). Our preliminary data suggest that the noninvasive DTI assessment of peripheral nerves may provide useful information in patients with CIDP. (orig.)

  13. Diffusion tensor imaging of peripheral nerve in patients with chronic inflammatory demyelinating polyradiculoneuropathy: a feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Kakuda, Takako; Fukuda, Hiroshi; Tanitame, Keizo; Takasu, Miyuki; Date, Shuji; Awai, Kazuo [Hiroshima University, Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima (Japan); Ochi, Kazuhide; Ohshita, Tomohiko; Matsumoto, Masayasu [Hiroshima University, Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical Science, Hiroshima (Japan); Kohriyama, Tatsuo [Department of Neurology, Hiroshima City Hospital, Hiroshima (Japan); Ito, Katsuhide [Department of Radiology, Onomichi General Hospital, Onomichi, Hiroshima-ken (Japan)

    2011-12-15

    The purpose of this study was to assess the clinical feasibility of diffusion tensor imaging (DTI) for the evaluation of peripheral nerves in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Using a 3-T magnetic resonance imaging scanner, we obtained DTI scans of the tibial nerves of 10 CIDP patients and 10 sex- and age-matched healthy volunteers. We prepared fractional anisotropy (FA) maps, measured the FA values of tibial nerves, and compared these values in the two study groups. In nine patients, we also performed tibial nerve conduction studies and analyzed the correlation between the FA values and parameters of the nerve conduction study. The tibial nerve FA values in CIDP patients (median 0.401, range 0.312-0.510) were significantly lower than those in healthy volunteers (median 0.530, range 0.469-0.647) (Mann-Whitney test, p < 0.01). They were significantly correlated with the amplitude of action potential (Spearman correlation coefficient, p = 0.04, r = 0.86) but not with nerve conduction velocity (p = 0.79, r = 0.11). Our preliminary data suggest that the noninvasive DTI assessment of peripheral nerves may provide useful information in patients with CIDP. (orig.)

  14. Identification of a persistent primitive trigeminal artery following the transposition technique for trigeminal neuralgia: A case report

    Science.gov (United States)

    Kato, Naoki; Tanaka, Toshihide; Sakamoto, Hiroki; Arai, Takao; Hasegawa, Yuzuru; Abe, Toshiaki

    2011-01-01

    A patient who presented with trigeminal neuralgia associated with a persistent primitive trigeminal artery (PPTA) is presented. A 62-year-old woman suffering from right orbital pain was admitted to the hospital. Medical treatment for three months was ineffective, and her neuralgia had deteriorated and gradually spread in the maxillary division. Magnetic resonance imaging demonstrated the flow void signal attached to the right trigeminal nerve. Thus, microvascular decompression was performed. The superior cerebellar artery was the responsible artery, and it was transposed to decompress the trigeminal nerve. After this manoeuvre, an artery was identified running parallel to the trigeminal nerve toward Meckel’s cave. The artery, which turned out to be a PPTA, communicated with the basilar artery. The PPTA was carefully observed, and it was found not to be the artery causing the neuralgia because it did not compress the nerve at surgical observation. No additional procedure between the PPTA and the trigeminal nerve was performed. The patient’s symptom improved dramatically following surgery, and her postoperative course was uneventful. Postoperative three-dimensional computed tomography showed the PPTA. The findings in the present case suggest that transposition of the responsible artery effectively decompresses the root entry zone and assists in determining whether the PPTA is affecting the trigeminal nerve. PMID:22059208

  15. Identification of a persistent primitive trigeminal artery following the transposition technique for trigeminal neuralgia: a case report.

    Science.gov (United States)

    Kato, Naoki; Tanaka, Toshihide; Sakamoto, Hiroki; Arai, Takao; Hasegawa, Yuzuru; Abe, Toshiaki

    2011-01-01

    A patient who presented with trigeminal neuralgia associated with a persistent primitive trigeminal artery (PPTA) is presented. A 62-year-old woman suffering from right orbital pain was admitted to the hospital. Medical treatment for three months was ineffective, and her neuralgia had deteriorated and gradually spread in the maxillary division. Magnetic resonance imaging demonstrated the flow void signal attached to the right trigeminal nerve. Thus, microvascular decompression was performed. The superior cerebellar artery was the responsible artery, and it was transposed to decompress the trigeminal nerve. After this manoeuvre, an artery was identified running parallel to the trigeminal nerve toward Meckel's cave. The artery, which turned out to be a PPTA, communicated with the basilar artery. The PPTA was carefully observed, and it was found not to be the artery causing the neuralgia because it did not compress the nerve at surgical observation. No additional procedure between the PPTA and the trigeminal nerve was performed. The patient's symptom improved dramatically following surgery, and her postoperative course was uneventful. Postoperative three-dimensional computed tomography showed the PPTA. The findings in the present case suggest that transposition of the responsible artery effectively decompresses the root entry zone and assists in determining whether the PPTA is affecting the trigeminal nerve. PMID:22059208

  16. The new technique of using the epigastric arteries in renal transplantation with multiple renal arteries

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Amirzargar

    2013-01-01

    Full Text Available The most common anatomic variant seen in the donor kidneys for renal transplantation is multiple renal arteries (MRA, which can cause an increased risk of complications. We describe the long-term outcomes of 16 years of experience in 76 kidney transplantations with MRAs. In a new reconstruction technique, we remove arterial clamps after anastomosing the donor to the recipient′s main renal vessels, which cause backflow from accessory arteries to prevent thrombosis. By this technique, we reduce the ischemic times as well as the operating times. Both in live or cadaver donor kidneys, lower polar arteries were anastomosed to the inferior epigastric artery and upper polar arteries were anastomosed to the superior epigastric arteries. Injection of Papaverine and ablation of sympathic nerves of these arteries dilate and prevent them from post-operative spasm. Follow-up DTPA renal scan in all patients showed good perfusion and function of the transplanted kidney, except two cases of polar arterial thrombosis. Mean creatinine levels during at least two years of follow-up remained acceptable. Patient and graft survival were excellent. No cases of ATN, hypertension, rejection and urologic complications were found. In conclusion, this technique can be safely and successfully utilized for renal transplantation with kidneys having MRAs, and may be associated with a lower complication rate and better graft function compared with the existing techniques.

  17. Diagnostic signs of motor neuropathy in MR neurography: Nerve lesions and muscle denervation

    International Nuclear Information System (INIS)

    To investigate the diagnostic contribution of T2-w nerve lesions and of muscle denervation in peripheral motor neuropathies by magnetic resonance neurography (MRN). Fifty-one patients with peripheral motor neuropathies underwent high-resolution MRN by large coverage axial T2-w sequences of the upper arm, elbow, and forearm. Images were evaluated by two blinded readers for T2-w signal alterations of median, ulnar, and radial nerves, and for denervation in respective target muscle groups. All 51 patients displayed nerve lesions in at least one of three nerves, and 43 out of 51 patients showed denervation in at least one target muscle group of these nerves. In 21 out of 51 patients, the number of affected nerves matched the number of affected target muscle groups. In the remaining 30 patients, T2-w lesions were encountered more frequently than target muscle group denervation. In 153 nerve-muscle pairs, 72 showed denervation, but only one had increased muscle signal without a lesion in the corresponding nerve. MRN-based diagnosis of peripheral motor neuropathies is more likely by visualization of peripheral nerve lesions than by denervation in corresponding target muscles. Increased muscular T2-w signal without concomitant nerve lesions should raise suspicion of an etiology other than peripheral neuropathy. (orig.)

  18. Diagnostic signs of motor neuropathy in MR neurography: Nerve lesions and muscle denervation

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, Daniel; Pham, Mirko; Bendszus, Martin; Baeumer, Philipp [Heidelberg University Hospital, Department of Neuroradiology, Heidelberg (Germany); Weiler, Markus [Heidelberg University Hospital, Department of Neurology, Heidelberg (Germany); German Cancer Research Center (DKFZ), Clinical Cooperation Unit Neurooncology, Heidelberg (Germany); Heiland, Sabine [Heidelberg University Hospital, Section of Experimental Radiology, Department of Neuroradiology, Heidelberg (Germany)

    2015-05-01

    To investigate the diagnostic contribution of T2-w nerve lesions and of muscle denervation in peripheral motor neuropathies by magnetic resonance neurography (MRN). Fifty-one patients with peripheral motor neuropathies underwent high-resolution MRN by large coverage axial T2-w sequences of the upper arm, elbow, and forearm. Images were evaluated by two blinded readers for T2-w signal alterations of median, ulnar, and radial nerves, and for denervation in respective target muscle groups. All 51 patients displayed nerve lesions in at least one of three nerves, and 43 out of 51 patients showed denervation in at least one target muscle group of these nerves. In 21 out of 51 patients, the number of affected nerves matched the number of affected target muscle groups. In the remaining 30 patients, T2-w lesions were encountered more frequently than target muscle group denervation. In 153 nerve-muscle pairs, 72 showed denervation, but only one had increased muscle signal without a lesion in the corresponding nerve. MRN-based diagnosis of peripheral motor neuropathies is more likely by visualization of peripheral nerve lesions than by denervation in corresponding target muscles. Increased muscular T2-w signal without concomitant nerve lesions should raise suspicion of an etiology other than peripheral neuropathy. (orig.)

  19. Carotid Artery Screening

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Carotid Artery Screening What is carotid artery screening? Who should consider ... about carotid artery screening? What is carotid artery screening? Screening examinations are tests performed to find disease ...

  20. Cranial nerve palsies

    International Nuclear Information System (INIS)

    This paper evaluates the utility of multiplanar reconstructions (MPRs) of three-dimensional (3D) MR angiography data sets in the examination of patients with cranial nerve palsies. The authors hypothesis was that 3D data could be reformatted to highlight the intricate spatial relationships of vessels to adjacent neural tissues by taking advantage of the high vessel-parenchyma contrast in high-resolution 3D time-of-flight sequences. Twenty patients with cranial nerve palsies and 10 asymptomatic patients were examined with coronal T1-weighted and axial T2-weighted imaging plus a gadolinium-enhanced 3D MRA sequence (40/7/15 degrees, axial 60-mm volume, 0.9-mm isotropic resolution). Cranial nerves II-VIII were subsequently evaluated on axial and reformatted coronal and/or sagittal images

  1. Innervation of the human middle meningeal artery

    DEFF Research Database (Denmark)

    Edvinsson, L; Gulbenkian, S; Barroso, C P;

    1998-01-01

    The majority of nerve fibers in the middle meningeal artery and branching arterioles are sympathetic, storing norepinephrine and neuropeptide Y (NPY). A sparse supply of fibers contain acetylcholinesterase activity and immunoreactivity toward vasoactive intestinal peptide (VIP), peptidine histidine...... methionine (PHM), and calcitonin gene-related peptide (CGRP). Only few substance P and neuropeptide K immunoreactive fibers are noted. Electronmicroscopy shows axons and terminals at the adventitial medial border of the human middle meningeal artery, with a fairly large distance to the smooth muscle cells...

  2. Sosiaalinen media markkinoinnin kanavana : suunnitelma Lycka Reklamin sosiaalisen median aktivoimiseen

    OpenAIRE

    Tuomenoksa, Michaela

    2016-01-01

    Tämä opinnäytetyö käsittelee sosiaalista mediaa yrityksen näkökulmasta. Miten yritys voi hyödyntää sosiaalista mediaa toiminnassaan ja markkinoinnissa? Mitä eroa on sosiaalisen median kanavissa ja mitä kanavat mahdollistavat? Pohdin myös, minkälainen sisältö on kiinnostavaa ja mitä asioita pitää ottaa huomioon sosiaalisen median viestinnässä. Opinnäytetyössäni pureudun myös yksinomaisesti Lycka Reklamin sosiaalisen median käyttöön – mitkä kanavat ovat hyödyll...

  3. Sosiaalisen median strategia pienelle b2b-yritykselle

    OpenAIRE

    Surkko, Antti

    2012-01-01

    Sosiaalinen media on tänä päivänä tärkeä osa ihmisten elämää ja yritysten kannattaa siksi käyttää sitä hyödykseen markkinointitoimissaan. Aihe opinnäytetyöhön tuli toimeksiantajalta, joka on jo mukana sosiaalisen median palveluissa. Toimeksiantajayritys ei kuitenkaan tiedä, miten hyödyntää sosiaalisen median palveluiden täysi potentiaali markkinointikanavana. Opinnäytetyön tarkoituksena oli selvittää, mitä pienen b2b-yrityksen pitäisi ottaa huomioon sosiaalisen median markkinointitoimia aloi...

  4. Feasibility and safety of ultrasound-guided nerve block for management of limb injuries by emergency care physicians

    Directory of Open Access Journals (Sweden)

    Sanjeev Bhoi

    2012-01-01

    Full Text Available Background: Patients require procedural sedation and analgesia (PSA for the treatment of acute traumatic injuries. PSA has complications. Ultrasound (US guided peripheral nerve block is a safe alternative. Aim: Ultrasound guided nerve blocks for management of traumatic limb emergencies in Emergency Department (ED. Setting and Design: Prospective observational study conducted in ED. Materials and Methods: Patients above five years requiring analgesia for management of limb emergencies were recruited. Emergency Physicians trained in US guided nerve blocks performed the procedure. Statistical analysis: Effectiveness of pain control, using visual analogue scale was assessed at baseline and at 15 and 60 minutes after the procedure. Paired t test was used for comparison. Results: Fifty US guided nerve blocks were sciatic- 4 (8%, femoral-7 (14%, brachial- 29 (58%, median -6 (12%, and radial 2 (4% nerves. No patients required rescue PSA. Initial median VAS score was 9 (Inter Quartile Range [IQR] 7-10 and at 1 hour was 2(IQR 0-4. Median reduction in VAS score was 7.44 (IQR 8-10(75%, 1-2(25% (P=0.0001. Median procedure time was 9 minutes (IQR 3, 12 minutes and median time to reduction of pain was 5 minutes (IQR 1,15 minutes. No immediate or late complications noticed at 3 months. Conclusion: Ultrasound-guided nerve blocks can be safely and effectively performed for upper and lower limb emergencies by emergency physicians with adequate training.

  5. Nerve Transfers in Tetraplegia.

    Science.gov (United States)

    Fox, Ida K

    2016-05-01

    Hand and upper extremity function is instrumental to basic activities of daily living and level of independence in cervical spinal cord injury (SCI). Nerve transfer surgery is a novel and alternate approach for restoring function in SCI. This article discusses the biologic basis of nerve transfers in SCI, patient evaluation, management, and surgical approaches. Although the application of this technique is not new; recent case reports and case series in the literature have increased interest in this field. The challenges are to improve function, achieve maximal gains in function, avoid complications, and to primum non nocere. PMID:27094894

  6. Landscaping of highway medians and roadway safety at unsignalized intersections.

    Science.gov (United States)

    Chen, Hongyun; Fabregas, Aldo; Lin, Pei-Sung

    2016-05-01

    Well-planted and maintained landscaping can help reduce driving stress, provide better visual quality, and decrease over speeding, thus improving roadway safety. Florida Department of Transportation (FDOT) Standard Index (SI-546) is one of the more demanding standards in the U.S. for landscaping design criteria at highway medians near intersections. The purposes of this study were to (1) empirically evaluate the safety results of SI-546 at unsignalized intersections and (2) quantify the impacts of geometrics, traffic, and landscaping design features on total crashes and injury plus fatal crashes. The studied unsignalized intersections were divided into (1) those without median trees near intersections, (2) those with median trees near intersections that were compliant with SI-546, and (3) those with median trees near intersections that were non-compliant with SI-546. A total of 72 intersections were selected, for which five-year crash data from 2006-2010 were collected. The sites that were compliant with SI-546 showed the best safety performance in terms of the lowest crash counts and crash rates. Four crash predictive models-two for total crashes and two for injury crashes-were developed. The results indicated that improperly planted and maintained median trees near highway intersections can increase the total number of crashes and injury plus fatal crashes at a 90% confidence level; no significant difference could be found in crash rates between sites that were compliant with SI-546 and sites without trees. All other conditions remaining the same, an intersection with trees that was not compliant with SI-546 had 63% more crashes and almost doubled injury plus fatal crashes than those at intersections without trees. The study indicates that appropriate landscaping in highway medians near intersections can be an engineering technology that not only improves roadway environmental quality but also maintains intersection safety. PMID:26922287

  7. Physical activity: its influence on nerve conduction velocity.

    Science.gov (United States)

    Halar, E M; Hammond, M C; Dirks, S

    1985-09-01

    In a group of 40 healthy subjects, distal and proximal latencies of the median, tibial, and peroneal motor, and sural sensory nerves and their respective skin surface temperatures (Tsk) were measured before and after walking or bicycling. The baseline tests were performed 30 minutes after resting in a constant room temperature of 24C. The ambulation or bicycling task was continued for 30 minutes at a constant rate. Postactivity tests were performed within 30 minutes and between 45 to 60 minutes after termination of activity. Another test was done 75 to 90 minutes after bicycle exercise. After walking, there was a significant increase in Tsk in all lower extremity nerves tested (p less than 0.01). The increases were accompanied by faster distal and proximal latencies in both testing periods (p less than 0.01). Median nerve Tsk, distal and proximal latencies did not differ significantly from baseline values initially, but 45 minutes after walking Tsk was elevated and proximal latency had become faster (p less than 0.01). Following bicycling, lower extremity Tsk was significantly reduced over tibial, peroneal, and sural nerves by the third testing period (p less than 0.01) but only sural latencies were significantly prolonged (p less than 0.05) by this time. In the upper extremities median Tsk was significantly elevated and distal latency had become significantly faster 45 minutes after bicycling. Our data suggest that activity significantly influences nerve conduction latency results due to tissue temperature alteration. In addition, 30 minutes of rest after activity may not be sufficient time for the lower extremity temperatures to become stable. PMID:4038026

  8. Somesoppa : Sosiaalisen median kehittämissuunnitelma ravintola Rustikille

    OpenAIRE

    Hartikainen, Lotta

    2016-01-01

    Tämän opinnäytetyön tarkoituksena oli tehdä Ravintola Rustikille sosiaalisen median kehittämissuunnitelma. Kehittämissuunnitelmaa varten ideoita ja kehittämiskohtia kerättiin kolmen eri keinon avulla. Ensimmäiseksi tehtiin vertaileva kirjoituspöytätutkimus neljän muun ravintolan toiminnasta sosiaalisessa mediassa ja etsittiin muiden toiminnasta vinkkejä Rustikia varten. Seuraavaksi tehtiin kartoitus Rustikin toiminnasta sosiaalisessa mediassa. Rustikin käyttämät sosiaalisen median alustat ova...

  9. SOSIAALISEN MEDIAN HYÖDYNTÄMINEN PROJEKTITOIMINNASSA : Case: ERKKERI

    OpenAIRE

    Ahola, Mari; Haarala, Merja

    2010-01-01

    Opinnäytetyön tavoitteena oli tutkia sosiaalisen median hyödynnettävyyttä projektitoiminnan näkökulmasta. Tutkimuksessa selvitettiin Web 2.0 -teknologian mukaista toimintaympäristöä sekä saatavana olevia sosiaalisen median palveluohjelmia. Opinnäytetyön kohteena oli Jyväskylän ammattikorkeakoulun ammatillisen opettajakorkeakoulun hallinnoima valtakunnallinen ERKKERIprojekti. ERKKERI on aikuisohjaajien ohjaustaitojen sekä moniammatillisen verkostotyön kehittämisprojekti, joka kuuluu valt...

  10. Sosiaalisen median käyttö matkan eri vaiheissa

    OpenAIRE

    Nuottimäki, Iina

    2015-01-01

    Tämä opinnäytetyö on tehty toimeksiantona suomalaiselle matkailumedialle Rantapallo Oy:lle. Opinnäytetyö kartoitti matkaprosessin eri vaiheissa käytettyjä sosiaalisen median kanavia sekä niiden käyttötarkoitusta. Vastaajilta kysyttiin myös, kuinka paljon sosiaalisesta mediasta hankittu tieto vaikuttaa heidän ostopäätöksiinsä ja mitä matkailutiedon lähteitä sekä sosiaalisen median kanavia he pitävät luotettavimpina lähteinä matkan suunnittelussa. Tutkimukseen sisältyi yhteensä 11 suosittua sos...

  11. Satakunnan ammattikorkeakoulun verkkomarkkinoinnin kehittäminen sosiaalisen median keinoin

    OpenAIRE

    Gratschew, Maarit

    2010-01-01

    Tämän opinnäytetyön aiheena oli Satakunnan ammattikorkeakoulun verkkomarkkinoinnin kehittäminen sosiaalisen median keinoin. Tavoitteena oli selvittää SAMKin kannalta uusia verkkomarkkinoinnin mahdollisuuksia erilaisissa yhteisöissä ja palveluissa sekä viedä eteenpäin jo olemassa olevia verkkomarkkinoinnin käytänteitä. Opinnäytetyö pyrki myös selvittämään oikeiden sosiaalisten markkinointikanavien ja yhteisöjen valintaan liittyvää ongelmaa. Opinnäytetyössä esiteltiin sosiaalisen median käyttöä...

  12. Sosiaalisen median markkinointiviestintäsuunnitelma : Markkinointiviestintäsuunnitelma

    OpenAIRE

    Mikkonen, Maria

    2015-01-01

    Tämän opinnäytetyön toimeksiantona oli luoda sosiaalisen median markkinointiviestintäsuunnitelma yksityiselle toiminimen omistavalle helsinkiläiselle valokuvaajalle. Työn toimeksiantaja halusi markkinointiviestintäsuunnitelman antavan käytännöllisiä vinkkejä yrityksen markkinointiviestinnän toteuttamiseen. Suunnitelman haluttiin vaativan vain vähän rahallisia resursseja, minkä vuoksi tavoitteena on ollut luoda markkinointiviestintäsuunnitelma sosiaalisen median maksuttomia palveluita hyödyntä...

  13. Outcome of free digital artery perforator flap transfer for reconstruction of fingertip defects

    Directory of Open Access Journals (Sweden)

    Lei Zhu

    2014-01-01

    Full Text Available Background: Fingertip defect can be treated with many flaps such as random pattern abdominal flap, retrograde digital artery island flap, V-Y advancement flap, etc. However, swelling in the fingertip, dysfunction of sensation, flexion and extension contracture or injury in the hemi-artery of the finger usually occurs during the recovery phase. Recently, digital artery perforator flaps have been used for fingertip reconstructions. With the development of super microsurgery techniques, free flaps can be more effective for sensory recovery and durability of the fingertip. Materials and Methods: Six cases (six fingers of fingertip defects were treated with free digital artery perforator flaps of appropriate size and shape from the proximal phalanx. During surgery, the superficial veins at the edge of flap were used as reflux vessels and the branches of the intrinsic nerve and dorsal digital nerve toward the flap were used as sensory nerves. The proximal segment of the digital artery (cutaneous branches towards the flap was cut off to form the pedicled free flap. The fingertips were reconstructed with the free flap by anastomosing the cutaneous branches of digital artery in the flap with the distal branch or trunk of the digital artery, the flap nerve with the nerve stump and the veins of the flap with the digital artery accompanying veins or the superficial veins in the recipient site. Results: Six flaps survived with successful skin grafting. Patients were followed up for 6-9 months. The appearance and texture of the flaps was satisfactory. The feeling within the six fingers recovered to S4 level (BMRC scale and the two point discrimination was 3-8 mm. Conclusion: Free digital artery perforator flap is suitable for repairing fingertip defect, with good texture, fine fingertip sensation and without sacrificing the branch of the digital artery or nerve.

  14. COMPARISON OF NERVE CONDUCTION VELOCITY IN TEENAGERS WITH DIFFERENT IQ

    OpenAIRE

    Khosravi, S

    2002-01-01

    Introduction. Correlation between nerve conduction velocity (NCV) in peripheral and central nervous systems and intelligence has been investigated during recent years with different results. To determine whether there is any correlation between peripheral NCV and IQ, we tested median and ulnar NCV in three groups of teenagers with different IQs. Methods. 144 normal subjects aged between 12-17 years were studied in three groups. Group I, with IQ more than 120 (measured with the Wechsler i...

  15. 颈总动脉周围交感神经网剥脱切除术治疗脑性瘫痪患儿的效果及对其认知功能的影响%Effect of excision of peripheral sympathetic nerve network in common carotid artery in children with cerebral palsy and its effect on their cognitive function

    Institute of Scientific and Technical Information of China (English)

    赵家鹏; 王家勤; 常崇旺; 王玉峰; 马世江; 冯宇飞

    2015-01-01

    Objective To explore the clinical effect of excision of peripheral sympathetic nerve network in common carotid artery on children with cerebral palsy (CP)and the effect on their cognitive function. Methods A ret-rospective study method was admitted to preschool children with CP in 69 cases in Center of Brain Disease,the Third Hospital Affiliated to Xinxiang Medical University from July 2008 to August 2014, the common carotid artery sympathetic with the surrounding network stripping off resection treatment of 43 cases ( surgery group) ,without the use of surgery in the treatment of children with 26 cases ( no operation group) . The muscle tension improved, movement to improve the ability of 2 groups before and after treatment 6 months were detected and compared. Developmental quotient ( DQ) ,intelligence quotient ( IQ) ,bilateral middle cerebral artery ( MCA) hemodynamic index difference were deter-mined between 2 groups before and after treatment 6 months. Results After treatment 6 months,the muscle tension score and walking ability score of the surgery group were significantly better than those of no operation group [(2. 2± 1. 1) scores vs (4. 5±0. 6)scores,(3. 5±0. 7) scores vs (2. 7±0. 8) scores,all P<0. 05],and significantly improved compared with before treatment[(4. 8±0. 6)scores,(2. 2±0. 9)scores,all P<0. 05]. After treatment 6 months,the IQ score,fine motor, social adaptation, personal social, language score and MCA mean velocity ( MV ) , peak velocity ( PV) ,resistance index ( RI) ,pulsatility index ( PI) determination value of the surgery group were significantly higher than those of no operation group and before treatment (all P<0. 05). Conclusions Excision of peripheral sympathetic nerve network on common carotid artery has a good clinical effect in the treatment of CP , and can significantly improve the cognitive function of children with CP .%目的:探讨颈总动脉周围交感神经网剥脱切除术治疗脑性瘫痪( CP )患儿的临床

  16. Thyroid artery embolization for hyperthyroidism

    International Nuclear Information System (INIS)

    Objective: To evaluate the method and result of thyroid artery embolization as a new therapy for hyperthyroidism. Methods: Twenty-two patients with hyperthyroidism underwent selective thyroid artery embolization. Totally 52 thyroid arteries were embolized with microspheres. The indications to this therapy were following: hyperthyroid patients having indications to surgical and 131I therapy, clinically being difficult to complete the preparation for subtotal thyroidectomy and having high risk for surgical process because of their huge thyroid gland. Results: Serum level of thyroid hormones dropped significantly [median T3 from 8.8 nmol/L (4.3-43.0 nmol/L) to 4.0 nmol/L (1.1-9.2 nmol/L), median T4 from 206.4 nmol/L (77.4-748.2 nmol/L) to 144.5 nmol/L (25.8-279.9 nmol/L), P 131I treatment of hyperthyroidism. A long term follow-up study is still needed

  17. Human sensory nerve compound action potential amplitude: variation with sex and finger circumference.

    OpenAIRE

    Bolton, C F; Carter, K M

    1980-01-01

    The amplitude of human, antidromic, sensory compound action potentials (CAP) recorded from median and ulnar digital nerves is greater in females than males. This sex difference is probably due entirely to females having digits of smaller circumference, resulting in digital nerves being closer to the recording ring electrode enclosing the digit. The negative linear correlation between CAP amplitude and circumference holds true for persons of the same sex.

  18. Marked lateral deviation of the phrenic nerve due to variant origin and course of the thyrocervical trunk: a cadaveric study.

    Science.gov (United States)

    Ogami, Keiko; Saiki, K; Okamoto, K; Wakebe, T; Manabe, Y; Imamura, T; Tsurumoto, T

    2016-05-01

    Phrenic nerve impairment can often lead to serious respiratory disorders under various pathological conditions. During routine dissection of an 88-year-old Japanese male cadaver, a victim of heart failure, we recognized an extremely rare variation of the right thyrocervical trunk arising from the subclavian artery laterally to the anterior scalene muscle. In addition to that, the ipsilateral phrenic nerve was drawn and displaced remarkably laterad by this vessel. We examined all of the branches arising from subclavian arteries, phrenic nerves and diaphragm muscles. The embryological background of this arterial variation is considered. The marked displacement with prolonged strain had a potential to cause phrenic nerve impairment with an atrophic change of the diaphragm muscle. Recently many image diagnostic technologies have been developed and are often used. However, it is still possible that rare variations like this case may be overlooked and can only be recognized by intimate regional examination while keeping these rare variations in mind. PMID:26438272

  19. Origin and distribution of the thoracodorsal nerve in pig fetuses of the lineage Pen Ar Lan

    OpenAIRE

    Eleusa Marta Mendonça Tavares; Juliana França Ortega; Angelita das Graças de Oliveira Honorato; Lázaro Antônio dos Santos; Frederico Ozanam Carneiro e Silva

    2012-01-01

    Considering the importance of the nerves that make up the brachial plexus, the aim was to study the origin and distribution of the thoracodorsal nerve. Thus, 30 pig fetuses from the lineage Pen Ar Lan obtained from natural abortions in breedings of the Triangulo Mineiro region were used. The specimens were prepared through the injection of 50% Neoprene Latex “450” and 10% formaldehyde solutions in the descending aorta artery, and immersion in the same solution for least 48 hours. The dissecti...

  20. A rare case of intraneural ganglion cyst involving the tibial nerve

    OpenAIRE

    Patel, Purvak; Schucany, William G.

    2012-01-01

    Cystic lesions around the knee are a relatively common occurrence. Several types of cysts have been reported, including synovial, bursal, and ganglion. Ganglion cysts are not lined by synovial cells. Their location is highly variable, with occurrences described in the fat pads near the tibia or femur, muscles, nerves, and arteries. Intraneural ganglia are rare nonneoplastic cysts caused by the accumulation of thick mucinous fluid within the epineurium of peripheral nerves, encased in a dense ...

  1. Delayed appearance of hypaesthesia and paralysis after femoral nerve block

    Directory of Open Access Journals (Sweden)

    Stefan Landgraeber

    2012-03-01

    Full Text Available We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colour duplex sonography of the femoral artery and computed tomography of the lumbar spine and pelvis yielded no pathological findings. Overnight the neurological deficits decreased without therapy and were finally no longer detectable. We speculate that during the administration of the local anaesthetic a depot formed, localised in the medial femoral intermuscular septa, which was leaked after first mobilisation. To our knowledge no similar case has been published up to now. We conclude that patients who are treated with a nerve block should be informed and physician should be aware that delayed neurological deficits are possible.

  2. Nonrecurrent inferior laryngeal nerves and anatomical findings during thyroid surgery: report of three cases.

    Science.gov (United States)

    Kato, Kumiko; Toriumi, Yasuo; Kamio, Makiko; Nogi, Hiroko; Shioya, Hisashi; Takeyama, Hiroshi

    2016-12-01

    A nonrecurrent inferior laryngeal nerve (NRILN) is found more frequently on the right side than on the left, and it is closely associated with an aberrant right subclavian artery. The presence of the aberrant right subclavian artery on preoperative computed tomography (CT) scan suggests NRILN; however, different types of branching locations and pathways exist. Here, we report three NRILN cases with different pathways where the vagus nerve arises more medial than usual and a review of the literature. Case 1: A 30-year-old Japanese female presented with papillary thyroid carcinoma. Preoperative CT scan revealed an aberrant right subclavian artery, and an operation was performed under suspicion of NRILN. During the operation, the vagus nerve was found to arise more medially than usual and two NRILNs originated from it at the level of the cricoid cartilage and at a more caudal position; the two NRILNs were preserved. Case 2: A 33-year-old Japanese female with a thyroid nodule of increased size underwent surgery. Preoperative CT scan revealed an aberrant right subclavian artery, which suggested NRILN. During the operation, the vagus nerve was identified to run more medially than usual and NRILN was found to originate at the level of the cricoid cartilage; NRILN was preserved. Case 3: A 78-year-old Japanese female underwent an operation with a diagnosis of papillary thyroid carcinoma. Preoperative CT scan showed an aberrant right subclavian artery. During the operation, NRILN was found to originate from the vagus nerve at the level of the lower pole of the thyroid gland, and the vagus nerve ran medial to the common carotid artery at the caudal level. PMID:27188389

  3. Neuromuscular Ultrasound of Cranial Nerves

    OpenAIRE

    Tawfik, Eman A.; Walker, Francis O.; Cartwright, Michael S.

    2015-01-01

    Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few re...

  4. High division of sciatic nerve

    OpenAIRE

    Tripti Shrivastava; Lalit Garg; B. K. Mishra; Neeta Chhabra

    2014-01-01

    Background: The Sciatic nerve is the largest and thickest nerve in the human body with a long course in the inferior extremity. It divides into tibial and common peroneal nerves which can occur at any level from the sacral plexus to the inferior part of the popliteal space. Sciatic nerve variations are relatively common. These variations may contribute to clinical conditions ex sciatica, coccygodynia and piriformis syndrome and have important clinical implications in anaesthesiology, neurolog...

  5. Celiac artery stenosis/occlusion treated by interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, Osamu [Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1, Honjo Kumamoto 860-8505 (Japan)], E-mail: osamu-3643ik@do9.enjoy.ne.jp; Tamura, Yoshitaka; Nakasone, Yutaka; Yamashita, Yasuyuki [Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1, Honjo Kumamoto 860-8505 (Japan)

    2009-08-15

    Severe stenosis/occlusion of the proximal celiac trunk due to median arcuate ligament compression (MALC), arteriosclerosis, pancreatitis, tumor invasion, and celiac axis agenesis has been reported. However, clinically significant ischemic bowel disease attributable to celiac axis stenosis/occlusion appears to be rare because the superior mesenteric artery (SMA) provides for rich collateral circulation. In patients with celiac axis stenosis/occlusion, the most important and frequently encountered collateral vessels from the SMA are the pancreaticoduodenal arcades. Patients with celiac artery stenosis/occlusion are treated by interventional radiology (IR) via dilation of the pancreaticoduodenal arcade. In patients with dilation of the pancreaticoduodenal arcade on SMA angiograms, IR through this artery may be successful. Here we provide several tips on surmounting these difficulties in IR including transcatheter arterial chemoembolization for hepatocellular carcinoma, an implantable port system for hepatic arterial infusion chemotherapy to treat metastatic liver tumors, coil embolization of pancreaticoduodenal artery aneurysms, and arterial stimulation test with venous sampling for insulinomas.

  6. Celiac artery stenosis/occlusion treated by interventional radiology

    International Nuclear Information System (INIS)

    Severe stenosis/occlusion of the proximal celiac trunk due to median arcuate ligament compression (MALC), arteriosclerosis, pancreatitis, tumor invasion, and celiac axis agenesis has been reported. However, clinically significant ischemic bowel disease attributable to celiac axis stenosis/occlusion appears to be rare because the superior mesenteric artery (SMA) provides for rich collateral circulation. In patients with celiac axis stenosis/occlusion, the most important and frequently encountered collateral vessels from the SMA are the pancreaticoduodenal arcades. Patients with celiac artery stenosis/occlusion are treated by interventional radiology (IR) via dilation of the pancreaticoduodenal arcade. In patients with dilation of the pancreaticoduodenal arcade on SMA angiograms, IR through this artery may be successful. Here we provide several tips on surmounting these difficulties in IR including transcatheter arterial chemoembolization for hepatocellular carcinoma, an implantable port system for hepatic arterial infusion chemotherapy to treat metastatic liver tumors, coil embolization of pancreaticoduodenal artery aneurysms, and arterial stimulation test with venous sampling for insulinomas.

  7. Trigeminal neuralgia and persistent trigeminal artery

    OpenAIRE

    Conforti, Renata; Parlato, Raffaele Stefano; De Paulis, Danilo; Cirillo, Mario; Marrone, Valeria; Cirillo, Sossio; Moraci, Aldo; Parlato, Ciro

    2012-01-01

    We report a case of trigeminal neuralgia caused by persistent trigeminal artery (PTA) associated with asymptomatic left temporal cavernoma. Our patient presented unstable blood hypertension and the pain of typical trigeminal neuralgia over the second and third divisions of the nerve in the right side of the face. The attacks were often precipitated during physical exertion. MRI and Angio-MRI revealed the persistent carotid basilar anastomosis and occasionally left parietal cavernoma. After dr...

  8. Progress of peripheral nerve repair

    Institute of Scientific and Technical Information of China (English)

    陈峥嵘

    2002-01-01

    Study on repair of peripheral nerve injury has been proceeding over a long period of time. With the use of microsurgery technique since 1960s,the quality of nerve repair has been greatly improved. In the past 40 years, with the continuous increase of surgical repair methods, more progress has been made on the basic research of peripheral nerve repair.

  9. Tumors of the optic nerve

    DEFF Research Database (Denmark)

    Lindegaard, Jens; Heegaard, Steffen

    2009-01-01

    the nerve (e.g., astrocytes and meningothelial cells). The optic nerve may also be invaded from tumors originating elsewhere (secondary tumors), invading the nerve from adjacent structures (e.g., choroidal melanoma and retinoblastoma) or from distant sites (e.g., lymphocytic infiltration and distant...

  10. New sonographic measures of peripheral nerves: a tool for the diagnosis of peripheral nerve involvement in leprosy

    Directory of Open Access Journals (Sweden)

    Marco Andrey Cipriani Frade

    2013-05-01

    Full Text Available To evaluate ultrasonographic (US cross-sectional areas (CSAs of peripheral nerves, indexes of the differences between CSAs at the same point (∆CSAs and between tunnel (T and pre-tunnel (PT ulnar CSAs (∆TPTs in leprosy patients (LPs and healthy volunteers (HVs. Seventy-seven LPs and 49 HVs underwent bilateral US at PT and T ulnar points, as well as along the median (M and common fibular (CF nerves, to calculate the CSAs, ∆CSAs and ∆TPTs. The CSA values in HVs were lower than those in LPs (p 80% and ∆TPT had the highest specificity (> 90%. New sonographic peripheral nerve measurements (∆CSAs and ∆TPT provide an important methodological improvement in the detection of leprosy neuropathy.

  11. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    Kiilgaard, Jens Folke; Pedersen, D B; Eysteinsson, T;

    2004-01-01

    The authors have previously reported that carbonic anhydrase inhibitors such as acetazolamide and dorzolamide raise optic nerve oxygen tension (ONPO(2)) in pigs. The purpose of the present study was to investigate whether timolol, which belongs to another group of glaucoma drugs called beta...

  12. Management of sternal osteomyelitis and mediastinal infection following median sternotomy

    Institute of Scientific and Technical Information of China (English)

    GAO Ju; WANG Wen-zhang; WANG You-li; LU Shu-qiang; CAI Ai-bing; YANG Zhi-fu; HAN Zhi-yi; LI Jiu-jiang; WEN Yu-ming; GENG Feng-yong

    2010-01-01

    Background Median sternotomy is considered the most usually performed procedure in cardiac operations. This study aimed to assess clinical effectiveness of bilateral pectoralis major muscle flaps (BPMMF) for management of sternal osteomyelitis and mediastinal infection following median sternotomy.Methods Clinical data were collected and retrospectively analyzed from twelve patients who underwent the BPMMF transposition for management of sternal osteomyelitis and mediastinal infection following median sternotomy from January 2006 to June 2009. Procedure consisted of rigorous debridement of necrotic tissues, dead space obliteration using the BPMMF, and placement of drainage tubes connected to a negative pressures generator for adequate drainage.Results No patients died of drainage, and all 12 patients had viable BPMMF when discharged from hospital. At 1 week post discharge, 2 patients presented with sternal infection but recovered following local debridement and medication. No patients showed infection recurrence during the follow-up period over 10 months.Conclusions Sternal osteomyelitis and mediastinal infection following median sternotomy may be effectively managed through rigorous debridement of infected soft tissues, resection of the damaged stermal segment, transposition of the BPMMF to fill the damaged sternum resulting from debridement, and adequate postoperative drainage.

  13. Estimation of Transition Probabilities Using Median Absolute Deviations

    OpenAIRE

    Kim, C. S.; Schaible, Glenn D.

    1988-01-01

    The probability-constrained minimum absolute deviations (MAD) estimator appears to be superior to the probability-constrained quadratic programming estimator in estimating transition probabilities with limited aggregate time series data Futhermore, one can reduce the number of columns in the probability-constrained MAD simplex tableau by adopting the median property

  14. Brain malformation in single median maxillary central incisor

    DEFF Research Database (Denmark)

    Kjaer, I; Wagner, Aa; Thomsen, L L;

    2009-01-01

    Clinical and radiographic examinations and MR scan of a 12-year-old girl with SMMCI (single median maxillary central incisor) showed impaired growth and a midline defect involving the central incisor, cranium and the midline structures in the brain, falx cerebri and pituitary gland. She had a...

  15. A novel image inpainting technique based on median diffusion

    Indian Academy of Sciences (India)

    Rajkumar L Biradar; Vinayadatt V Kohir

    2013-08-01

    Image inpainting is the technique of filling-in the missing regions and removing unwanted objects from an image by diffusing the pixel information from the neighbourhood pixels. Image inpainting techniques are in use over a long time for various applications like removal of scratches, restoring damaged/missing portions or removal of objects from the images, etc. In this study, we present a simple, yet unexplored (digital) image inpainting technique using median filter, one of the most popular nonlinear (order statistics) filters. The median is maximum likelihood estimate of location for the Laplacian distribution. Hence, the proposed algorithm diffuses median value of pixels from the exterior area into the inner area to be inpainted. The median filter preserves the edge which is an important property needed to inpaint edges. This technique is stable. Experimental results show remarkable improvements and works for homogeneous as well as heterogeneous background. PSNR (quantitative assessment) is used to compare inpainting results.

  16. Multichromosomal median and halving problems under different genomic distances

    Directory of Open Access Journals (Sweden)

    Zheng Chunfang

    2009-04-01

    Full Text Available Abstract Background Genome median and genome halving are combinatorial optimization problems that aim at reconstructing ancestral genomes as well as the evolutionary events leading from the ancestor to extant species. Exploring complexity issues is a first step towards devising efficient algorithms. The complexity of the median problem for unichromosomal genomes (permutations has been settled for both the breakpoint distance and the reversal distance. Although the multichromosomal case has often been assumed to be a simple generalization of the unichromosomal case, it is also a relaxation so that complexity in this context does not follow from existing results, and is open for all distances. Results We settle here the complexity of several genome median and halving problems, including a surprising polynomial result for the breakpoint median and guided halving problems in genomes with circular and linear chromosomes, showing that the multichromosomal problem is actually easier than the unichromosomal problem. Still other variants of these problems are NP-complete, including the DCJ double distance problem, previously mentioned as an open question. We list the remaining open problems. Conclusion This theoretical study clears up a wide swathe of the algorithmical study of genome rearrangements with multiple multichromosomal genomes.

  17. Deficiency in monocarboxylate transporter 1 (MCT1) in mice delays regeneration of peripheral nerves following sciatic nerve crush

    KAUST Repository

    Morrison, Brett M.

    2015-01-01

    Peripheral nerve regeneration following injury occurs spontaneously, but many of the processes require metabolic energy. The mechanism of energy supply to axons has not previously been determined. In the central nervous system, monocarboxylate transporter 1 (MCT1), expressed in oligodendroglia, is critical for supplying lactate or other energy metabolites to axons. In the current study, MCT1 is shown to localize within the peripheral nervous system to perineurial cells, dorsal root ganglion neurons, and Schwann cells by MCT1 immunofluorescence in wild-type mice and tdTomato fluorescence in MCT1 BAC reporter mice. To investigate whether MCT1 is necessary for peripheral nerve regeneration, sciatic nerves of MCT1 heterozygous mice are crushed and peripheral nerve regeneration was quantified electrophysiologically and anatomically. Compound muscle action potential (CMAP) recovery is delayed from a median of 21. days in wild-type mice to greater than 38. days in MCT1 heterozygote mice. In fact, half of the MCT1 heterozygote mice have no recovery of CMAP at 42. days, while all of the wild-type mice recovered. In addition, muscle fibers remain 40% more atrophic and neuromuscular junctions 40% more denervated at 42. days post-crush in the MCT1 heterozygote mice than wild-type mice. The delay in nerve regeneration is not only in motor axons, as the number of regenerated axons in the sural sensory nerve of MCT1 heterozygote mice at 4. weeks and tibial mixed sensory and motor nerve at 3. weeks is also significantly reduced compared to wild-type mice. This delay in regeneration may be partly due to failed Schwann cell function, as there is reduced early phagocytosis of myelin debris and remyelination of axon segments. These data for the first time demonstrate that MCT1 is critical for regeneration of both sensory and motor axons in mice following sciatic nerve crush.

  18. Using Sensory Substitution of Median Sensory Deficits in the Traumatized Hand to Develop an Innovative Home-Based Hand Rehabilitation System

    OpenAIRE

    Semere, Alessandro; Payan, Yohan; Cannard, Francis; Diot, Bruno; Vuillerme, Nicolas

    2015-01-01

    Post-traumatic median nerve sensitive deficits are frequent. They are a source of permanent handicap that dramatically decreases the level of autonomy and the quality of life of persons suffering from these deficits. Surgical repair is possible, but the results are not always functionally useful. Therefore, prosthetic approaches do represent an alternative solution that needs to be explored. Along these lines, this paper describes an innovative home-based hand rehabilitation system device tha...

  19. Comparable three months' outcome of total arterial revascularization versus conventional coronary surgery: Copenhagen Arterial Revascularization Randomized Patency and Outcome trial

    DEFF Research Database (Denmark)

    Damgaard, S.; Lund, J.T.; Lilleor, N.B.; Perko, M.J.; Sander, K.; Dimo, B.; Jensen, Maiken Brit; Madsen, Jan Kyst; Kelbaek, H.; Steinbruchel, D.A.

    2008-01-01

    single-center trial, 331 patients underwent total arterial revascularization using single or bilateral internal thoracic and radial arteries versus conventional revascularization using the left internal thoracic artery and saphenous vein grafts. We report the results from 3 months' follow-up. RESULTS......OBJECTIVE: The in-hospital safety of total arterial revascularization for coronary artery bypass surgery seems to be comparable to conventional revascularization, but randomized trials evaluating this are few and data on complications in the postoperative months are sparse. METHODS: In a randomized......: The mean age of patients was 59 +/- 8 years, and 39 were women (12%). The median EuroSCORE was 2 (interquartile range 1-4). The arterial group comprised 161 patients, and the conventional group comprised 170 patients. The mean number of bypasses in the arterial group was 2.9 +/- 0.9 versus 3.2 +/- 0...

  20. Pseudoaneurysm of the Posterior Tibial Artery After Posterior Tibial Tendon Transfer.

    Science.gov (United States)

    Elabdi, Monsef; Roukhsi, Redouane; Tijani, Youssef; Chtata, Hassan; Jaafar, Abdeloihab

    2016-01-01

    Pseudoaneurysm of the posterior tibial artery is an uncommon condition that, left untreated, can lead to hemorrhage, thrombosis, or emboli. We present the case of a 54-year-old male who developed pseudoaneurysm of the posterior tibial artery 4 months after undergoing tibialis posterior tendon transfer for management of peroneal nerve palsy, which had developed as a complication of hip arthroplasty. PMID:26972754

  1. Pathology of the vestibulocochlear nerve

    Energy Technology Data Exchange (ETDEWEB)

    De Foer, Bert [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: bert.defoer@GZA.be; Kenis, Christoph [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: christophkenis@hotmail.com; Van Melkebeke, Deborah [Department of Neurology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Deborah.vanmelkebeke@Ugent.be; Vercruysse, Jean-Philippe [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: jphver@yahoo.com; Somers, Thomas [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Thomas.somers@GZA.be; Pouillon, Marc [Department of Radiology, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: marc.pouillon@GZA.be; Offeciers, Erwin [University Department of ENT, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium)], E-mail: Erwin.offeciers@GZA.be; Casselman, Jan W. [Department of Radiology, AZ Sint-Jan AV Hospital, Ruddershove 10, Bruges (Belgium); Consultant Radiologist, Sint-Augustinus Hospital, Oosterveldlaan 24, 2610 Wilrijk (Belgium); Academic Consultent, University of Ghent (Belgium)], E-mail: jan.casselman@azbrugge.be

    2010-05-15

    There is a large scala of pathology affecting the vestibulocochlear nerve. Magnetic resonance imaging is the method of choice for the investigation of pathology of the vestibulocochlear nerve. Congenital pathology mainly consists of agenesis or hypoplasia of the vestibulocochlear nerve. Tumoral pathology affecting the vestibulocochlear nerve is most frequently located in the internal auditory canal or cerebellopontine angle. Schwannoma of the vestibulocochlear nerve is the most frequently found tumoral lesion followed by meningeoma, arachnoid cyst and epidermoid cyst. The most frequently encountered pathologies as well as some more rare entities are discussed in this chapter.

  2. Jarak antara Saraf Femoralis dan Arteri Femoralis pada Daerah Lipat Inguinal Orang Dewasa dengan Menggunakan Pencitraan Ultrasonografi untuk Panduan Letak Penyuntikan Blokade Saraf Femoralis

    OpenAIRE

    Nur Intan Nasution; Dedi Fitri Yadi; A. Muthalib Nawawi

    2015-01-01

    The femoral nerve block is one the peripheral nerve block methods that are used to falicitate lower extremity surgical procedures. The advantages of femoral nerve block include an effective perioperative analgesia with minimum systemic side effects, lower dosage of opioids, early mobilization and cost effective. This study aimed to measure the distance from the mid point of the femoral nerve to the mid point of the femoral artery at the level of inguinal crease of adults with ultrasound guida...

  3. Angiographic Evaluation of Popliteal Artery Trauma

    Directory of Open Access Journals (Sweden)

    H.Gh. Nosratinia

    2007-05-01

    Full Text Available Background and Objective: Popliteal artery injuries are uncommon in developed countries, but it may be common in our country and is associated with poor rates of limb salvage, as well as high levels of morbid-ity. The aim of the present study was to determine the causes of popliteal artery injuries. Materials and Methods: Twenty patients with pop-liteal artery injuries during 3.5 years were studied by angiography in Imam Khomeini Hospital of Tabriz. Results: There were 18 male and two female patients with a median age of 34/00±15/68 years (range 15 – 70 years. The most common cause of trauma in this study was traffic accidents and the most common in-jury was complete occlusion. Conclusion: Popliteal artery injuries are more com-mon in our country and the most common cause is blunt trauma, especially motorcycle accidents.

  4. Nerve sonography in multifocal motor neuropathy and chronic inflammatory demyelinating polyneuropathy

    Directory of Open Access Journals (Sweden)

    D. S. Druzhinin

    2016-01-01

    Full Text Available The quantitative ultrasound characteristics (USC of the median, ulnar nerve at different levels and the spinal nerves in patients with multifocal motor neuropathy (MMN; n=13; 40,4 ± 12,6 years old and chronic inflammatory demyelinating polyneuropathy (CIDP; n = 7; 47,3 ± 11,2 year old did not reveal statistical difference in cross sectional area (CSA between analyzed groups. Patients with MMN have more pronounced asymmetry of CSA in comparison with CIDP patients which have a symmetrical pattern of diffuse nerve involvement. Quantitative USC has shown to be not informative enough in differentiation of MMN and CIDP. The qualitative analysis (QA according to 3 described types of nerve changes has shown that CIDP is characterized by the prevalence of type 3 pattern (85.8 % while MMN – by type 2 (69.2 %. The sensitivity and specificity of proposed QA patterns in nerve USC need to be analyzed in additional investigations. 

  5. Glycemic control and nerve conduction abnormalities in non-insulin-dependent diabetic subjects.

    Science.gov (United States)

    Graf, R J; Halter, J B; Pfeifer, M A; Halar, E; Brozovich, F; Porte, D

    1981-03-01

    The influence of therapy of hyperglycemia on the progression of diabetic neuropathy is unclear. We studied variables of glycemia and motor and sensory nerve conduction velocity in a group of 18 non-insulin-dependent diabetic subjects before and after institution of diabetes therapy. Diabetes therapy significantly reduced variables of glycemia after 1, 3, 6, and 12 months. Conduction velocity of the median motor nerve was improved from baseline at each time tested during treatment. In addition, peroneal and tibial motor nerve conduction velocities improved in patients whose levels of hyperglycemia were lowered. Moreover, extent of improvement of conduction velocity of some motor nerves was related to the degree of reduction of hyperglycemia. Sensory nerve conduction velocity was not altered by diabetes therapy. These findings support the hypothesis of a metabolic component to diabetic neuropathy and suggest that optimal glycemic control may be beneficial to patients with this disorder. PMID:7013592

  6. Functional mapping of the cardiorespiratory effects of dorsal and median raphe nuclei in the rat

    Directory of Open Access Journals (Sweden)

    R.M. Alvarenga

    2005-11-01

    Full Text Available The dorsal (DRN and median (MRN raphe nuclei are important sources of serotonergic innervation to the forebrain, projecting to sites involved in cardiovascular regulation. These nuclei have been mapped using electrical stimulation, which has the limitation of stimulating fibers of passage. The present study maps these areas with chemical stimulation, investigating their influence on cardiorespiratory parameters. Urethane-anesthetized (1.2 g/kg, iv male Wistar rats (280-300 g were instrumented for pulsatile and mean blood pressure (MBP, heart rate, renal nerve activity, and respiratory frequency recordings. Microinjections of L-glutamate (0.18 M, 50-100 nl with 1% Pontamine Sky Blue were performed within the DRN or the MRN with glass micropipettes. At the end of the experiments the sites of microinjection were identified. The majority of sites within the MRN (86.1% and DRN (85.4% evoked pressor responses when stimulated (DRN: deltaMBP = +14.7 ± 1.2; MRN: deltaMBP = +13.6 ± 1.3 mmHg. The changes in renal nerve activity and respiratory rate caused by L-glutamate were +45 ± 11 and +42 ± 9% (DRN; P < 0.05%, +40 ± 10 and +29 ± 7% (MRN, P < 0.05, respectively. No significant changes were observed in saline-microinjected animals. This study shows that: a the blood pressure increases previously observed by electrical stimulation within the raphe are due to activation of local neurons, b this pressor effect is due to sympathoexcitation because the stimulation increased renal sympathetic activity but did not produce tachycardia, and c the stimulation of cell bodies in these nuclei also increases the respiratory rate.

  7. Ultrasonographic evaluation of the iatrogenic peripheral nerve injuries in upper extremity

    International Nuclear Information System (INIS)

    The aim of our study is to assess the efficiency of the ultrasonography (US) in the diagnosis of peripheral nerve injury. This study includes nine patients (six radial, one median and two posterior interosseous (PIO) nerves) with peripheral nerve injury diagnosed by clinical and electrophysiological methods in the last 3 years. Preoperatively, an ultrasonographic examination was performed and correlated with physical exam and surgical findings. Five patients, who were diagnosed as peripheral nerve transection by US, underwent surgery. The ultrasonographic findings were concordant with the intraoperative findings. Axonal swelling alone was found in the remaining three patients, who were treated conservatively because of preserved nerve continuity without display of nerve compression. In one patient, we were unable to visualize the nerve due to obesity and soft tissue edema. High-resolution US provide morphological information about the exact location, intensity and extent of the nerve injuries, facilitating the preoperative diagnosis. Thus, US may be a useful method for planning optimal treatment strategy in especially iatrogenic nerve injuries.

  8. Progesterone and peripheral nerve regeneration

    Institute of Scientific and Technical Information of China (English)

    Fei Fan; Haichao Li; Yuwei Wang; Yanglin Zheng; Lianjun Jia; Zhihui Wang

    2006-01-01

    OBJECTIVE: To explore the effect of progesterone on peripheral nerve regeneration.DATA SOURCES: An online search of Medline and OVID databases was under taken to identify articles about progesterone and peripheral nerve regeneration published in English between January 1990 and June 2004 by using the keywords of "peripheral nerve, injury, progesterone, regeneration".STUDY SELECTION: The data were primarily screened, those correlated with progesterone and peripheral nerve regeneration were involved, and their original articles were further searched, the repetitive studies or reviews were excluded.DATA EXTRACTION: Totally 59 articles about progesterone and peripheral nerve regeneration were collected, and 26 of them were involved, the other 33 excluded ones were the repetitive studies or reviews.DATA SYNTHESIS: Recent researches found that certain amount of progesterone could be synthetized in peripheral nervous system, and the expression of progesterone receptor could be found in sensory neurons and Schwann cells. After combined with the receptor, endogenous and exogenous progesterone can accelerate the formation of peripheral nerve myelin sheath, also promote the axonal regeneration.CONCLUSION: Progesterone plays a role in protecting neurons, increasing the sensitivity of nerve tissue to nerve growth factor, and accelerating regeneration of nerve in peripheral nerve regeneration, which provides theoretical references for the treatment of demyelinated disease and nerve injury, as well as the prevention of neuroma, especially that the in vivo level of progesterone should be considered for the elderly people accompanied by neuropathy and patients with congenital luteal phase defect, which is of positive significance in guiding the treatment.

  9. Sensory deficits of a nerve root lesion can be objectively documented by somatosensory evoked potentials elicited by painful infrared laser stimulations: a case study.

    OpenAIRE

    Lorenz, J.; Hansen, H C; Kunze, K; Bromm, B.

    1996-01-01

    Somatosensory evoked potentials (SEPs) in response to painful laser stimuli were measured in a patient with a unilateral sensory deficit due to radiculopathy at cervical levels C7 and C8. Laser evoked potentials (LEPs) were compared with SEPs using standard electrical stimulation of median and ulnar nerves at the wrist and mechanical stimulation of the fingertips by means of a mechanical stimulator. Early and late ulnar and median nerve SEPs were normal. Mechanical stimulation resulted in w s...

  10. Ulnar nerve injuries of the hand producing intrinsic muscle denervation of magnetic resonance imaging

    International Nuclear Information System (INIS)

    Muscle and nerve injuries in the hand may be difficult to detect and diagnose clinically. Two cases are reported in which magnetic resonance imaging showed ulnar nerve injury and intrinsic hand muscle denervation. The clinical, anatomical and radiological features of injury to the deep motor branch of the ulnar nerve and associated muscle denervation are discussed and illustrated. Compression of the deep motor branch of the ulnar nerve is a rare cause of hand dysfunction. This condition produces a clinical syndrome characterized by weakness of the muscles innervated by the deep branch of the ulnar nerve, with normal sensation in the hand. Denervation of the intrinsic hand muscles is variable, depending on the site and severity of the nerve injury. The anatomy of the ulnar nerve is complex and ulnar nerve compression syndrome is difficult to detect and localize clinically. Multiple causes exist, including ganglions; repeated trauma, typically occupationally related; calcification adjacent to the pisiform and the pisotriquetral joint; anomalous muscle bellies; fractures or dislocations affecting the ulnar side of the wrist; vascular anomalies of the ulnar artery; and oedema of the hand, requiring differing surgical treatments. We report two patients who presented with ulnar nerve compression syndrome secondary to post-traumatic neuromas as a result of blunt trauma to the palm. Copyright (1999) Blackwell Science Pty Ltd

  11. Ulnar nerve injuries of the hand producing intrinsic muscle denervation of magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Barberie, J.E.; Connell, D.G.; Munk, P.L.; Janzen, D.L. [Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia, (Canada). Department of Radiology

    1999-08-01

    Muscle and nerve injuries in the hand may be difficult to detect and diagnose clinically. Two cases are reported in which magnetic resonance imaging showed ulnar nerve injury and intrinsic hand muscle denervation. The clinical, anatomical and radiological features of injury to the deep motor branch of the ulnar nerve and associated muscle denervation are discussed and illustrated. Compression of the deep motor branch of the ulnar nerve is a rare cause of hand dysfunction. This condition produces a clinical syndrome characterized by weakness of the muscles innervated by the deep branch of the ulnar nerve, with normal sensation in the hand. Denervation of the intrinsic hand muscles is variable, depending on the site and severity of the nerve injury. The anatomy of the ulnar nerve is complex and ulnar nerve compression syndrome is difficult to detect and localize clinically. Multiple causes exist, including ganglions; repeated trauma, typically occupationally related; calcification adjacent to the pisiform and the pisotriquetral joint; anomalous muscle bellies; fractures or dislocations affecting the ulnar side of the wrist; vascular anomalies of the ulnar artery; and oedema of the hand, requiring differing surgical treatments. We report two patients who presented with ulnar nerve compression syndrome secondary to post-traumatic neuromas as a result of blunt trauma to the palm. Copyright (1999) Blackwell Science Pty Ltd 12 refs., 2 figs.

  12. An investigation of an autonomic innervation of the vertebral artery using monoamine histofluorescence

    Directory of Open Access Journals (Sweden)

    JA Mitchell

    2009-06-01

    Full Text Available Blood flow to the hindbrain, via the paired vertebral arteries, must be uncompromised for adequate neurological functioning of its vital centres. Therefore, it would seem unlikely that the intracranial vertebral artery would need to vasoconstrict, thus reducing its blood flow. In order to investigate the existence and location of a noradrenaline-mediated constrictor mechanism in the wall of the intracranial vertebral artery, transverse sections of ten baboon and ten monkey vessels were stained with sucrose-potassium phosphate-glyoxylic acid (counterstained with malachite-green. This method allows the visualisation of catecholaminergic nerves when the sections are exposed to ultraviolet light. In this study of primate vascular tissue, however, none of the monkey or baboon vertebral artery sections showed the presence of noradrenergic nerves in the tunica media – tunica adventitia junction or penetrating the tunica media of the arteries. These findings indicate that the intracranial vertebral artery does not have a neurogenic vasomotor function in primates.

  13. Trigeminal neuralgia: how often are trigeminal nerve-vessel contacts found by MRI in normal volunteers

    International Nuclear Information System (INIS)

    Purpose: To assess prospectively how often contacts are found between the trigeminal nerve and arteries or veins in the perimesencephalic cistern via MRI in normal volunteers. Materials and methods: 48 volunteers without a history of trigeminal neuralgia were examined prospectively (MRI at 1.5T; T2-CISS sequence, coronal orientation, 0.9 mm slice thickness). Two radiologists decided by consensus whether there was a nerve-vessel contact in the perimesencephalic cistern. Results: In 27% of the volunteers, no contact was found between the trigeminal nerve and regional vessels, while in 73%, such a contact was present. In 61% of the cases, the offending vessel was an artery, in 39%, it was a vein. In 2 volunteers, a deformation of the nerve was noted. Conclusion: Contrary to what has been suggested by retrospective studies, the majority of normal volunteers, if studied prospectively, do show a contact between the trigeminal nerve and local vessels. A close proximity between the nerve and regional vessels is thus normal and is not necessarily proof of a pathological nerve-vessel conflict. (orig.)

  14. Phorbol esters potentiate rapid dopamine release from median eminence and striatal synaptosomes

    International Nuclear Information System (INIS)

    In the present study, we investigated the ability of phorbol esters to potentiate Ca2+-dependent depolarization-induced release of tritium-labeled dopamine ([3H]DA) from median eminence and striatal synaptosomes. Phorbol esters potentiated [3H]DA release in a concentration-dependent manner in both kinds of dopaminergic nerve terminals and with a potency series similar to that reported for stimulation of protein kinase-C (PKC) activity in other cell systems. Evoked [3H]DA release was increased by 12-O-tetradecanoylphorbol-13-acetate (TPA; 10(-7) M) after 1, 3, 5, and 10 sec of depolarization. The effect of TPA was suppressed by sphingosine, a PKC inhibitor. TPA enhanced [3H]DA release evoked by high K+, veratridine or the Ca2+ ionophore A23187. Phorbol ester potentiation was found to be depolarization dependent, as it was present from 30-75 mM, but not at 5-20 mM external K+. Potentiation was seen at all external Ca2+ concentrations studied between 0.01-3 mM. However, in the absence of external free Ca2+ (i.e. with 0.1 mM EGTA), the phorbol effect was not present. These data indicate that an increase in intrasynaptosomal Ca2+ concentration is necessary for the enhancement of [3H]DA release by phorbol esters to occur. The combination of TPA and the Ca2+ ionophore A23187 does not show the marked synergism observed in some other systems, that is maximal release was not reinstated. This suggests that in dopaminergic nerve terminals, activation of PKC has a modulatory, rather than a mediating, effect on release. Recently, we have shown that hyperprolactinemia stimulated [3H]DA release from median eminence synaptosomes by an external Ca2+-independent mechanism which might involve the PKC pathway. However, in the present work we found that the TPA and PRL effects on evoked [3H]DA release were additive, suggesting that two independent mechanisms are involved

  15. Phorbol esters potentiate rapid dopamine release from median eminence and striatal synaptosomes

    Energy Technology Data Exchange (ETDEWEB)

    Shu, C.; Selmanoff, M.

    1988-06-01

    In the present study, we investigated the ability of phorbol esters to potentiate Ca2+-dependent depolarization-induced release of tritium-labeled dopamine ((3H)DA) from median eminence and striatal synaptosomes. Phorbol esters potentiated (3H)DA release in a concentration-dependent manner in both kinds of dopaminergic nerve terminals and with a potency series similar to that reported for stimulation of protein kinase-C (PKC) activity in other cell systems. Evoked (3H)DA release was increased by 12-O-tetradecanoylphorbol-13-acetate (TPA; 10(-7) M) after 1, 3, 5, and 10 sec of depolarization. The effect of TPA was suppressed by sphingosine, a PKC inhibitor. TPA enhanced (3H)DA release evoked by high K+, veratridine or the Ca2+ ionophore A23187. Phorbol ester potentiation was found to be depolarization dependent, as it was present from 30-75 mM, but not at 5-20 mM external K+. Potentiation was seen at all external Ca2+ concentrations studied between 0.01-3 mM. However, in the absence of external free Ca2+ (i.e. with 0.1 mM EGTA), the phorbol effect was not present. These data indicate that an increase in intrasynaptosomal Ca2+ concentration is necessary for the enhancement of (3H)DA release by phorbol esters to occur. The combination of TPA and the Ca2+ ionophore A23187 does not show the marked synergism observed in some other systems, that is maximal release was not reinstated. This suggests that in dopaminergic nerve terminals, activation of PKC has a modulatory, rather than a mediating, effect on release. Recently, we have shown that hyperprolactinemia stimulated (3H)DA release from median eminence synaptosomes by an external Ca2+-independent mechanism which might involve the PKC pathway. However, in the present work we found that the TPA and PRL effects on evoked (3H)DA release were additive, suggesting that two independent mechanisms are involved.

  16. Respiratory influences on muscle sympathetic nerve activity and vascular conductance in the steady state

    OpenAIRE

    Limberg, Jacqueline K.; Morgan, Barbara J.; Schrage, William G.; Dempsey, Jerome A.

    2013-01-01

    In patients with hypertension, volitional slowing of the respiratory rate has been purported to reduce arterial pressure via withdrawal of sympathetic tone. We examined the effects of paced breathing at 7, 14, and 21 breaths/min, with reciprocal changes in tidal volume, on muscle sympathetic nerve activity, forearm blood flow, forearm vascular conductance, and blood pressure in 21 men and women, 8 of whom had modest elevations in systemic arterial pressure. These alterations in breathing freq...

  17. Lapset median käyttäjinä

    OpenAIRE

    Jalonen, Taru; Suomela, Sonja

    2010-01-01

    Laurea-ammattikorkeakoulu Tiivistelmä Hyvinkää Sosiaali-, terveys- ja liikunta-ala Hoitotyön koulutusohjelma Terveydenhoitaja AMK Sairaanhoitaja AMK Taru Jalonen, Sonja Suomela Lapset median käyttäjinä Vuosi ‎2010‎ Sivumäärä ‎63‎ Tämän opinnäytetyön tarkoituksena oli selvittää lasten tottumuksia ja kokemuksia mediasta sekä ‎niiden herättämiä tunteita. Lisäksi selvitimme lasten käyttämiä mediaympäristöjä sekä median ‎näkymistä lasten leikeissä. Tämä työ on os...

  18. Solitary median maxillary central incisor: a report of 2 cases.

    Science.gov (United States)

    Sekerci, Ahmet Ercan; Uçar, Faruk Izzet; Gümüş, Hüsniye; Aydınbelge, Mustafa; Sisman, Yildiray

    2012-01-01

    A single median maxillary central incisor (SMMCI) is a rare dental anomaly that may occur alone or be associated with growth deficiency or other systemic abnormalities. The best known association is with holoprosencephaly (HPE). HPE is a complex brain malformation that affects both the forebrain and the face. Early diagnosis of SMMCI is important, since it may be a sign of other severe congenital or developmental abnormalities. Therefore, systematic follow-up and close monitoring of the growth and development of SMMCI patients is crucial. The purpose of this paper was to report the cases of 2 children, each with a single median maxillary central incisor, and describe important symptoms of this syndrome that have not yet been reported. PMID:22583889

  19. Sosiaalisen median ja internet-tiedonhaun opas lasten kasvattajille

    OpenAIRE

    Köntti, Maija

    2010-01-01

    Tämän opinnäytetyönä tekemäni oppaan tarkoituksena on toimia lasten kasvattajien apuvälineenä. Oppaassa perehdytään internetin osa-alueisiin, joihin jokaisen vanhemman ja opettajan olisi hyvä tutustua. Sosiaalisen median merkitys korostuu etenkin lasten ja nuorten internet-käyttäytymisessä. Koska lapset käyttävät suurimman osan internetissä viettämästään ajasta sosiaalisen median parissa, on kasvattajien hyvä olla tietoisia, mitä sivustot pitävät sisällään ja mitä vaaroja niihin mahdollisesti...

  20. Surgical repair of the isolated incomplete median cleft lip.

    Science.gov (United States)

    Topkara, A; Özkan, A; Özcan, R H; Öksüz, M

    2016-02-01

    Median cleft lip refers to a vertical cleft on the midline of the upper lip. It is a rare congenital craniofacial anomaly brought about by a fusion failure in the medial nasal prominence. A novel surgical approach to median cleft lips and their repair is reported herein, with reference to a clinical case. The patient had a cleft in the lower half of the upper lip. There were no other craniofacial anomalies in this patient other than the cleft. Within the framework of the patient's surgical treatment, a functional and cosmetically satisfactory result was achieved by performing a V-Y advancement flap on the columella base, Z-plasty in the vermillion zone, and Z pattern muscular tissue repair, without having to resort to any tissue excisions. PMID:26364580

  1. Sosiaalisen median sopassa : Sopassa.fi-palvelun lanseeraus

    OpenAIRE

    Savela, Anna; Tukiainen, Taru

    2010-01-01

    Tämä opinnäytetyö käsittelee ruoka-aiheisen sopassa.fi-palvelun lanseerausta sosiaalisen median avulla. Työ on tehty parityönä. Opinnäytetyö on toiminnallinen opinnäytetyö, jossa on kirjallisen osan lisäksi teososana sopassa.fi-verkkopalvelu ja siihen liittyvä blogi. Työssä käsitellään sosiaalisen median käsitettä sekä teoriassa että käytännössä, markkinointisuunnitelman luomista CREF-mallia apuna käyttäen ja sopassa.fi:n markkinointiprosessia. Työssä on myös kiinnitetty huomiota palvelun löy...

  2. Robust optic nerve segmentation on clinically acquired CT

    Science.gov (United States)

    Panda, Swetasudha; Asman, Andrew J.; DeLisi, Michael P.; Mawn, Louise A.; Galloway, Robert L.; Landman, Bennett A.

    2014-03-01

    The optic nerve is a sensitive central nervous system structure, which plays a critical role in many devastating pathological conditions. Several methods have been proposed in recent years to segment the optic nerve automatically, but progress toward full automation has been limited. Multi-atlas methods have been successful for brain segmentation, but their application to smaller anatomies remains relatively unexplored. Herein we evaluate a framework for robust and fully automated segmentation of the optic nerves, eye globes and muscles. We employ a robust registration procedure for accurate registrations, variable voxel resolution and image fieldof- view. We demonstrate the efficacy of an optimal combination of SyN registration and a recently proposed label fusion algorithm (Non-local Spatial STAPLE) that accounts for small-scale errors in registration correspondence. On a dataset containing 30 highly varying computed tomography (CT) images of the human brain, the optimal registration and label fusion pipeline resulted in a median Dice similarity coefficient of 0.77, symmetric mean surface distance error of 0.55 mm, symmetric Hausdorff distance error of 3.33 mm for the optic nerves. Simultaneously, we demonstrate the robustness of the optimal algorithm by segmenting the optic nerve structure in 316 CT scans obtained from 182 subjects from a thyroid eye disease (TED) patient population.

  3. The median Genocchi numbers, Q-analogues and continued fractions

    OpenAIRE

    Feigin, Evgeny

    2011-01-01

    The goal of this paper is twofold. First, we review the recently developed geometric approach to the combinatorics of the median Genocchi numbers. The Genocchi numbers appear in this context as Euler characteristics of the degenerate flag varieties. Second, we prove that the generating function of the Poincar\\' e polynomials of the degenerate flag varieties can be written as a simple continued fraction. As an application we prove that the Poincar\\' e polynomials coincide with the $q$-version ...

  4. Leviathan or Median-Voter: Who Runs City Hall?

    OpenAIRE

    Rexford E. Santerre

    1991-01-01

    This study examines the effect of interjurisdictional competition and city age, as a proxy for special interest group activities, on the size of city government. Unlike previous studies on the Leviathan theory, the empirical analysis is well grounded in a median-voter model. The empirical results find mixed support for a Leviathan in city hall. On the one hand, city expenditures are found to be higher rather than lower with more intense competition. On the other hand, longer periods of democr...

  5. Quadratic Assignment of Hubs in p-Hub Median Problem

    DEFF Research Database (Denmark)

    Gelareh, Shahin

    We introduce Generalized p-Hub Median Problem (GpHMP) that seeks to locate p hub nodes and install p distinct hub facilities/operators on the hubs while discount factor resulted by consolidation of flow on the hub links depends on the facilities/operators that are installed/operating on both hub ......-points. The mathematical model is presented and numerical results on the instances of CAB and AP data sets are reported....

  6. Biofabrication and testing of a fully cellular nerve graft

    International Nuclear Information System (INIS)

    Rupture of a nerve is a debilitating injury with devastating consequences for the individual's quality of life. The gold standard of repair is the use of an autologous graft to bridge the severed nerve ends. Such repair however involves risks due to secondary surgery at the donor site and may result in morbidity and infection. Thus the clinical approach to repair often involves non-cellular solutions, grafts composed of synthetic or natural materials. Here we report on a novel approach to biofabricate fully biological grafts composed exclusively of cells and cell secreted material. To reproducibly and reliably build such grafts of composite geometry we use bioprinting. We test our grafts in a rat sciatic nerve injury model for both motor and sensory function. In particular we compare the regenerative capacity of the biofabricated grafts with that of autologous grafts and grafts made of hollow collagen tubes by measuring the compound action potential (for motor function) and the change in mean arterial blood pressure as consequence of electrically eliciting the somatic pressor reflex. Our results provide evidence that bioprinting is a promising approach to nerve graft fabrication and as a consequence to nerve regeneration. (paper)

  7. Relationships of Nerve Conduction Parameters with the Thyroid Hormones in Hypothyroid Patients

    Directory of Open Access Journals (Sweden)

    Sabina Yeasmin, ,

    Full Text Available Background: Impairment of nerve conduction may occur in hypothyroidism which usually develops insidiously over a long period of time due to irregular taking of drugs or lack of thyroid hormone replacement.Objectives: To evaluate the thyroid hormone status and the clinical and electrophysiological changes in hypothyroid patients in order to observe their relationships with nerve conduction changes.Methods: Thirty healthy euthyroid subjects with the age range from 20 to 50 years of both sexes were as control and 15 hypothyroids with TSH with <60 MIU /L and the duration of 6 months to 5 years were as experimental. Serum TT3, TT4 were measured by RIA and IRMA method. The distal latency (D L and Nerve Conduction Velocities (NCV for sensory and motor function were measured by a standard electrophysiological technique in median and ulnar nerve for upper limb and for lower limb, in sural nerve for sensory function and common peroneal nerve for motor function. Data were analyzed statistically by unpaired ’t’ test, Z test, Pearson’s correlation coefficient test.Results: Both TT3, TT4 levels were significantly (P<0.001 lower in hypothyroids. Again, 60% hypothyroids and 10% euthyroids (P<.001 had abnormal NCV. The relationships of TSH with both the median and ulnar sensory and motor distal latencies, common peroneal motor and sural sensory distal latencies and ulnar sensory conduction velocity were positive. But these relationships were negative with the median and common peroneal motor nerve conduction velocities, sural sensory conduction velocities. Only the relationships between median sensory distal latency and TSH was statistically significant (P <0.05. Again, a positive correlation of TT3 and TT4 with the median, and sural sensory and common peroneal motor conduction velocities, but negative correlation with median motor and sural sensory latencies were found. In addition, positive correlation between TT3 and ulnar sensory and between TT4 and

  8. Median Robust Extended Local Binary Pattern for Texture Classification.

    Science.gov (United States)

    Liu, Li; Lao, Songyang; Fieguth, Paul W; Guo, Yulan; Wang, Xiaogang; Pietikäinen, Matti

    2016-03-01

    Local binary patterns (LBP) are considered among the most computationally efficient high-performance texture features. However, the LBP method is very sensitive to image noise and is unable to capture macrostructure information. To best address these disadvantages, in this paper, we introduce a novel descriptor for texture classification, the median robust extended LBP (MRELBP). Different from the traditional LBP and many LBP variants, MRELBP compares regional image medians rather than raw image intensities. A multiscale LBP type descriptor is computed by efficiently comparing image medians over a novel sampling scheme, which can capture both microstructure and macrostructure texture information. A comprehensive evaluation on benchmark data sets reveals MRELBP's high performance-robust to gray scale variations, rotation changes and noise-but at a low computational cost. MRELBP produces the best classification scores of 99.82%, 99.38%, and 99.77% on three popular Outex test suites. More importantly, MRELBP is shown to be highly robust to image noise, including Gaussian noise, Gaussian blur, salt-and-pepper noise, and random pixel corruption. PMID:26829791

  9. Persistent primitive trigeminal artery associated with cerebrovascular diseases and other cerebrosis

    International Nuclear Information System (INIS)

    Persistent primitive trigeminal artery (PPTA) is the most common permanent abnormal vascular anastomosis between carotid artery and basilar artery. PPTA is a rare cerebrovascular variation and is often associated with cerebrovascular disease (CVD). Clinically, PPTA manifests itself in symptoms such as trigeminal neuralgia, oculomotor paralysis, abducens nerve paralysis, subarachnoid hemorrhage, etc. This paper aims to review 116 PPTA cases with CVD and other cerebrosis, which have ever been reported since 1983 in English or Chinese medical literature. (authors)

  10. Resolution of trigeminal neuralgia by coil embolization of a persistent primitive trigeminal artery aneurysm

    OpenAIRE

    Ladner, Travis R; Ehtesham, Moneeb; Davis, Brandon J; Khan, Imad S; Ghiassi, Mayshan; Ghiassi, Mahan; Singer, Robert J

    2013-01-01

    The persistent primitive trigeminal artery (PTA) is a rare anastomosis between the carotid artery and basilar artery. While most PTAs are asymptomatic, lateral variants can occasionally compress the trigeminal nerve and precipitate trigeminal neuralgia. Aneurysms of the PTA are exceptionally rare in the literature and have not previously been associated with trigeminal neuralgia. We present the first case of an aneurysm of the PTA causing trigeminal neuralgia. The patient underwent coil embol...

  11. Tolerance of cranial nerves of the cavernous sinus to radiosurgery

    International Nuclear Information System (INIS)

    Stereotactic radiosurgery is becoming a more accepted treatment option for benign, deep seated intracranial lesions. However, little is known about the effects of large single fractions of radiation on cranial nerves. This study was undertaken to assess the effect of radiosurgery on the cranial nerves of the cavernous sinus. The authors examined the tolerance of cranial nerves (II-VI) following radiosurgery for 62 patients (42/62 with meningiomas) treated for lesions within or near the cavernous sinus. Twenty-nine patients were treated with a modified 6 MV linear accelerator (Joint Center for Radiation Therapy) and 33 were treated with the Gamma Knife (University of Pittsburgh). Three-dimensional treatment plans were retrospectively reviewed and maximum doses were calculated for the cavernous sinus and the optic nerve and chiasm. Median follow-up was 19 months (range 3-49). New cranial neuropathies developed in 12 patients from 3-41 months following radiosurgery. Four of these complications involved injury to the optic system and 8 (3/8 transient) were the result of injury to the sensory or motor nerves of the cavernous sinus. There was no clear relationship between the maximum dose to the cavernous sinus and the development of complications for cranial nerves III-VI over the dose range used (1000-4000 cGy). For the optic apparatus, there was a significantly increased incidence of complications with dose. Four of 17 patients (24%) receiving greater than 800 cGy to any part of the optic apparatus developed visual complications compared with 0/35 who received less than 800 cGy (p = 0.009). Radiosurgery using tumor-controlling doses of up to 4000 cGy appears to be a relatively safe technique in treating lesions within or near the sensory and motor nerves (III-VI) of the cavernous sinus. The dose to the optic apparatus should be limited to under 800 cGy. 21 refs., 4 tabs

  12. Optic nerve hypoplasia

    Directory of Open Access Journals (Sweden)

    Savleen Kaur

    2013-01-01

    Full Text Available Optic nerve hypoplasia (ONH is a congenital anomaly of the optic disc that might result in moderate to severe vision loss in children. With a vast number of cases now being reported, the rarity of ONH is obviously now refuted. The major aspects of ophthalmic evaluation of an infant with possible ONH are visual assessment, fundus examination, and visual electrophysiology. Characteristically, the disc is small, there is a peripapillary double-ring sign, vascular tortuosity, and thinning of the nerve fiber layer. A patient with ONH should be assessed for presence of neurologic, radiologic, and endocrine associations. There may be maternal associations like premature births, fetal alcohol syndrome, maternal diabetes. Systemic associations in the child include endocrine abnormalities, developmental delay, cerebral palsy, and seizures. Besides the hypoplastic optic nerve and chiasm, neuroimaging shows abnormalities in ventricles or white- or gray-matter development, septo-optic dysplasia, hydrocephalus, and corpus callosum abnormalities. There is a greater incidence of clinical neurologic abnormalities in patients with bilateral ONH (65% than patients with unilateral ONH. We present a review on the available literature on the same to urge caution in our clinical practice when dealing with patients with ONH. Fundus photography, ocular coherence tomography, visual field testing, color vision evaluation, neuroimaging, endocrinology consultation with or without genetic testing are helpful in the diagnosis and management of ONH. (Method of search: MEDLINE, PUBMED.

  13. Optic nerve hypoplasia.

    Science.gov (United States)

    Kaur, Savleen; Jain, Sparshi; Sodhi, Harsimrat B S; Rastogi, Anju; Kamlesh

    2013-05-01

    Optic nerve hypoplasia (ONH) is a congenital anomaly of the optic disc that might result in moderate to severe vision loss in children. With a vast number of cases now being reported, the rarity of ONH is obviously now refuted. The major aspects of ophthalmic evaluation of an infant with possible ONH are visual assessment, fundus examination, and visual electrophysiology. Characteristically, the disc is small, there is a peripapillary double-ring sign, vascular tortuosity, and thinning of the nerve fiber layer. A patient with ONH should be assessed for presence of neurologic, radiologic, and endocrine associations. There may be maternal associations like premature births, fetal alcohol syndrome, maternal diabetes. Systemic associations in the child include endocrine abnormalities, developmental delay, cerebral palsy, and seizures. Besides the hypoplastic optic nerve and chiasm, neuroimaging shows abnormalities in ventricles or white- or gray-matter development, septo-optic dysplasia, hydrocephalus, and corpus callosum abnormalities. There is a greater incidence of clinical neurologic abnormalities in patients with bilateral ONH (65%) than patients with unilateral ONH. We present a review on the available literature on the same to urge caution in our clinical practice when dealing with patients with ONH. Fundus photography, ocular coherence tomography, visual field testing, color vision evaluation, neuroimaging, endocrinology consultation with or without genetic testing are helpful in the diagnosis and management of ONH. (Method of search: MEDLINE, PUBMED). PMID:24082663

  14. Trigeminal Neuralgia Caused by Persistent Primitive Trigeminal Artery

    Science.gov (United States)

    Park, Chang Kyu; Lee, Sung Ho; Rhee, Bong Arm

    2014-01-01

    A 66-year-old man presented with typical trigeminal neuralgia (TN). Magnetic resonance angiography (MRA) revealed a primitive trigeminal artery (PTA) that came into contact with the trigeminal nerve. Based on MRA, we performed microvascular decompression (MVD). In the operational field, we confirmed the PTA location and performed MVD successfully. Postoperatively, the patient's pain subsided without any complications. PMID:25368776

  15. Trigeminal neuralgia caused by persistent primitive trigeminal artery.

    Science.gov (United States)

    Park, Chang Kyu; Choi, Hyuk Jai; Lee, Sung Ho; Rhee, Bong Arm

    2014-09-01

    A 66-year-old man presented with typical trigeminal neuralgia (TN). Magnetic resonance angiography (MRA) revealed a primitive trigeminal artery (PTA) that came into contact with the trigeminal nerve. Based on MRA, we performed microvascular decompression (MVD). In the operational field, we confirmed the PTA location and performed MVD successfully. Postoperatively, the patient's pain subsided without any complications. PMID:25368776

  16. Trigeminal Neuralgia Caused by Persistent Primitive Trigeminal Artery

    OpenAIRE

    Park, Chang Kyu; Choi, Hyuk Jai; Lee, Sung Ho; Rhee, Bong Arm

    2014-01-01

    A 66-year-old man presented with typical trigeminal neuralgia (TN). Magnetic resonance angiography (MRA) revealed a primitive trigeminal artery (PTA) that came into contact with the trigeminal nerve. Based on MRA, we performed microvascular decompression (MVD). In the operational field, we confirmed the PTA location and performed MVD successfully. Postoperatively, the patient's pain subsided without any complications.

  17. Internal Carotid Artery Aneurysm Mimicking Peritonsillar Abscess

    Directory of Open Access Journals (Sweden)

    Jacek Brzost

    2015-01-01

    Full Text Available The extracranial internal carotid artery aneurysm (EICAA is an uncommon arterial lesion. Patients typically present with neurologic symptoms resulting from impaired cerebral perfusion and compression symptoms of cranial nerves. Often EICAA presents as a pulsatile neck mass, which is otherwise asymptomatic. We present a case of an 84-year-old female, who was initially referred to the Emergency Department for Otolaryngology with suspected peritonsillar abscess. The patient had a history of recent upper airway infection and cardiovascular comorbidities, including hypertension and ischaemic stroke complicated by extensive neurologic deficits. Physical examination revealed a compact, nonpulsatile mass in the lateral parapharyngeal space and local erythema of the mucosa. Duplex Doppler Ultrasonography and Computed Tomography revealed an atherosclerotic aneurysm of the right internal carotid artery, measuring 63×55×88 mm, stretching from the skull base to the angle of the mandible.

  18. Nerve conduction and excitability studies in peripheral nerve disorders

    DEFF Research Database (Denmark)

    Krarup, Christian; Moldovan, Mihai

    2009-01-01

    counterparts in the peripheral nervous system, in some instances without peripheral nervous system symptoms. Both hereditary and acquired demyelinating neuropathies have been studied and the effects on nerve pathophysiology have been compared with degeneration and regeneration of axons. SUMMARY: Excitability....... Studies of different metabolic neuropathies have assessed the influence of uremia, diabetes and ischemia, and the use of these methods in toxic neuropathies has allowed pinpointing damaging factors. Various mutations in ion channels associated with central nervous system disorders have been shown to have......PURPOSE OF REVIEW: The review is aimed at providing information about the role of nerve excitability studies in peripheral nerve disorders. It has been known for many years that the insight into peripheral nerve pathophysiology provided by conventional nerve conduction studies is limited. Nerve...

  19. Distribution and property of nerve fibers in human long bone tissue

    Institute of Scientific and Technical Information of China (English)

    CHEN Bin; PEI Guo-xian; JIN Dan; WEI Kuan-hai; QIN Yu; LIU Qing-si

    2007-01-01

    Objective:To observe the distribution of the nerve fibers in the bone tissue and the entry points of these fibers into the bone. Methods:The adult tibia was used for the ground sections which were afterwards made into the slice sections by decalcification in ethylenediamine tetraacetic acid (EDTA).The ground sections were stained in silver and the slice sections were stained in silver and haematoxylin and eosin (HE) respectively.Then,the samples of the transmission electron microscope and the atomic force microscope were made and observed. Results:In the human long bone tissue,many nerve fibers were distributed in the membrane,cortical bone,cancellous bone and marrow.The nerve fibers entered the bone from the nutrient foramen,and passed through the nutrient canal,Haversian's canal and Volkmann's canal,and finally into the bone marrow.In the nutrient canal,the nerve fibers,mainly the medullary nerve fibers,followed the blood vessel into the bone.In the cortical bone,the nerve fibers also followed the blood vessels and were mainly distributed along Haversian's canal and Volkmann's canal.In the bone trabecular and bone marrow,there were many nerve fiber endings arranged around the blood vessels,mainly around the tunica media of medium-size arteries in the marrow and around capillary blood vessels,and a few scattered in the bone marrow. There were sporadic nerve endings in epiphyseal plate and no nerve fibers permeated epiphysis to diaphysis.No distribution of nerve fibers could be found in cartilaginous part.Conclusions:There are many nerve fibers in bone and the nerve passageway is nutrient foramen,Volkman's canal,Haversian's canal and bone marrow.

  20. The adductor part of the adductor magnus is innervated by both obturator and sciatic nerves.

    Science.gov (United States)

    Takizawa, Megumi; Suzuki, Daisuke; Ito, Hajime; Fujimiya, Mineko; Uchiyama, Eiichi

    2014-07-01

    The hip adductor group, innervated predominantly by the obturator nerve, occupies a large volume of the lower limb. However, case reports of patients with obturator nerve palsy or denervation have described no more than minimal gait disturbance. Those facts are surprising, given the architectural characteristics of the hip adductors. Our aim was to investigate which regions of the adductor magnus are innervated by the obturator nerve and by which sciatic nerve and to consider the clinical implications. Twenty-one lower limbs were examined from 21 formalin-fixed cadavers, 18 males and 3 females. The adductor magnus was dissected and was divided into four parts (AM1-AM4) based on the locations of the perforating arteries and the adductor hiatus. AM1 was supplied solely by the obturator nerve. AM2, AM3, and AM4 received innervation from both the posterior branch of the obturator nerve and the tibial nerve portion of the sciatic nerve in 2 (9.5%), 20 (95.2%), and 6 (28.6%) of the cadavers, respectively. The double innervation in more than 90% of the AM3s is especially noteworthy. Generally, AM1-AM3 corresponds to the adductor part, traditionally characterized as innervated by the obturator nerve, and AM4 corresponds to the hamstrings part, innervated by the sciatic nerve. Here, we showed that the sciatic nerve supplies not only the hamstrings part but also the adductor part. These two nerves spread more widely than has generally been believed, which could have practical implications for the assessment and treatment of motor disability. PMID:23813615