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Sample records for cts cubital tunnel

  1. Ultrasonographic Findings of the Ulnar Nerves in Cubital Tunnel Syndrome

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    Koh, Young Hwan; Chai, Jee Won; Chung, Se Yeong; Choi, Young Ho; Cha, Joo Hee [Seoul Municipal Boramae Hospital, Seoul (Korea, Republic of)

    2010-06-15

    To determine useful diagnostic criteria of cubital tunnel syndrome (CTS), using ultrasonographic ulnar nerve cross-sectional areas (UNCSA) measurements. The CTS group included 28 patients confirmed with nerve conduction study and the control group included 17 healthy adults. Ulnar nerve cross sectional areas (UNCSA) were measured at the distal 1/3 upper arm level and in the cubital tunnel (CTN). US findings of CTS were ulnar nerve dislocation (n = 2), ulnar nerve subluxation (n = 5), ganglion (n = 1), sever elbow joint osteoarthritis (n = 1) and elbow joint valgus deformity after fracture (n = 1). UNCSA, the ratio of UNCSA in CTN to distal 1/3 upper arm level (CH ratio), and the difference of UNCSA between CTN and distal 1/3 upper arm level (CH difference) were evaluated to obtain the optimal diagnostic cutoff value of CTS, using ROC curve. The mean UNCSA in CTN was 0.168 cm2 in the CTS and 0.067 cm2 in the control. The CTS could be diagnosed when UNCSA, the CH ratio and the CH difference are larger than 0.096 cm2, 1.371 and 0.036 cm2 respectively. The ROC curve area was largest and the sensitivity, specificity was respectively 82.4%, 95.8%, when the CH difference was used as cutoff value. Ultrasound is useful for the detection of CTS pathogenic lesions in CTN. The highest diagnostic accuracy was acquired when the CH difference is larger than 0.036 cm2

  2. Pathogenesis and electrodiagnosis of cubital tunnel syndrome

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    贾志荣; 石昕; 孙相如

    2004-01-01

    Background Cubital tunnel syndrome is a well-recognized clinical condition and is the second most common peripheral compression neuropathy. This study was designed to investigate the causes of cubital tunnel syndrome by surgical means and to assess the clinical value of the neurophysiological diagnosis of cubital tunnel syndrome. Methods Twenty-one patients (involving a total of 22 limbs from 16 men and 5 women, aged 22 to 63, with a mean age of 49 years) with clinical symptoms and signs indicating a problem with their ulnar nerve underwent motor conduction velocity examinations at different sites along the ulnar nerve and examinations of sensory conduction velocity in the hand, before undergoing anterior transposition of the ulnar nerve.Results Electromyographic abnormalities were seen in 21 of 22 limbs [motor nerve conduction velocity (MCV) range (15.9-47.5) m/s, mean 32.7 m/s] who underwent motor conduction velocity examinations across the elbow segment of the ulnar nerve. Reduced velocity was observed in 13 of 22 limbs [MCV (15.7-59.6) m/s, mean 40.4 m/s] undergoing MCV tests in the forearms. An absent or abnormal sensory nerve action potential following stimulation was detected in the little finger of 14 of 22 limbs. The factors responsible for ulnar compression based on observations made during surgery were as follows: 15 cases involved compression by arcuate ligaments, muscle tendons, or bone hyperplasia; 2 involved fibrous adhesion; 3 involved compression by the venous plexus or a concurrent thick vein; 2 involved compression by cysts. Conclusions Factors inducing cubital tunnel syndrome include both common factors that have been reported and rare factors, involving the venous plexus, thick veins, and cysts. Tests of motor conduction velocity at different sites along the ulnar nerve should be helpful in diagnosis cubital tunnel syndrome, especially MCV tests indicating decreased velocity across the elbow segment of the ulnar nerve.

  3. Acute Cubital Tunnel Syndrome Secondary to Anconeus Epitrochlearis Muscle

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    Ying-Kan Law

    2015-12-01

    Full Text Available Cubital tunnel syndrome is the most common type of ulnar nerve entrapment that usually associates with chronic sensory and motor symptoms. Having anconeus epitrochlearis muscle is an uncommon cause of cubital tunnel syndrome. In this paper, the author introduces a case of cubital tunnel syndrome due to anconeus epitrochlearis muscle presenting with acute sensory, motor, and sympathetic symptoms. For such cases, there has been much controversy over the choices of surgical treatment, which can be excision of the muscle alone or together with ulnar nerve anterior transposition.

  4. Cubital tunnel syndrome: A report of two cases

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    Farhana Ebrahim Suleman

    2012-06-01

    Full Text Available Cubital tunnel syndrome is the second most common peripheral neuropathy of the upper limb. This is due to the anatomy of the tunnel, the physiological changes that the nerve undergoes during elbow flexion, as well as pathological conditions that occur within the tunnel. We present two cases of ulnar neuropathy occurring at the level of the cubital tunnel, demonstrating that this entity may occur owing to an identifiable cause or may show only signal alteration without a visible cause on MRI.

  5. Computer professionals and Carpal Tunnel Syndrome (CTS).

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    Ali, K Mohamed; Sathiyasekaran, B W C

    2006-01-01

    Carpal Tunnel Syndrome (CTS) is an important problem among computer professionals. Hence the prevalence of CTS among computer professionals and risk factors were studied. 648 subjects were selected from 4,276 computer professionals from 21 companies by with simple random sampling method. CTS was diagnosed based on clinical features. The prevalence of CTS was found to be 13.1% (95% CI 10.5-15.7%). Subjects with over 8 years of computer work, over 12 hrs of work per day and system administrators were at a higher risk for CTS (OR 3.3, 4.9 and 2.5 respectively). Flexed or extended hand position had higher risk for CTS. Higher risk for CTS was found with higher exposure to computer work. Ergonomic considerations are important in facilitating proper positioning of hand while working with a computer. Further studies on CTS risk factors among computer professionals are essential for planning prevention.

  6. Cubital Tunnel Syndrome Due to Synovial Cyst: A Case Report

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    Zahir Kizilay

    2016-02-01

    Full Text Available We report a rare case of ulnar nerve entrapment caused by a synovial cyst derived from the left elbow joint. A 57-year-old male patient with a seven-month history of pain in his left elbow and a progressive and increasing numbness and weakness complaints in his left hand came to our clinic. Weakness and sensory loss of the 4th and 5th fingers were determined in neurological examination. The results of Tinel’s sign and Phalen’s Test were positive, especially when his left elbow was flexed. In electromyelography, axonal damage and entrapment neuropathy were determined in the left cubital tunnel area. Total excision of the synovial cyst and ulnar nerve anterior subcutaneous transposition were performed in surgical treatment. The patient’s pain decreased immediately after the surgery. In this report, we have discussed the pathopysiology of cubital tunnel syndrome due to synovial cyst and which surgical technique may be suitable as our case report.

  7. Cubital tunnel syndrome caused by hypertrophic burn scarring: Sonographic envisage

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    Alparslan Bayram Carli

    2015-08-01

    Full Text Available In nerve entrapment syndromes, an electrodiagnostic study during physical examination would usually suffice to assess localization of injury. However, in daily clinical practice, sometimes it may be necessary to depict the insight; in other words to use an imaging tool. From this point of view, with its manifold advantages, ultrasound (US is superior to other imaging technologies such as magnetic resonance imaging (MRI. According to a study, US increased the sensitivity of electrodiagnostic studies from 78% to 98%. By presenting a patient with cubital tunnel syndrome caused by hypertrophic scarring, we wanted to highlight the complementary role of US in nerve entrapment syndromes in confirming the entrapment, as well as the usefulness of it in the follow-up period of burn patients. [Hand Microsurg 2015; 4(2.000: 44-46

  8. Diffusion-weighted magnetic resonance imaging of the ulnar nerve in cubital tunnel syndrome.

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    Iba, K; Wada, T; Tamakawa, M; Aoki, M; Yamashita, T

    2010-01-01

    Diffusion-weighted images based on magnetic resonance reveal the microstructure of tissues by monitoring the random movement of water molecules. In this study, we investigated whether this new technique could visualize pathologic lesions on ulnar nerve in cubital tunnel. Six elbows in six healthy males without any symptoms and eleven elbows in ten patients with cubital tunnel syndrome underwent on diffusion-weighted MRI. No signal from the ulnar nerve was detected in normal subjects. Diffusion-weighted MRI revealed positive signals from the ulnar nerve in all of the eleven elbows with cubital tunnel syndrome. In contrast, conventional T2W-MRI revealed high signal intensity in eight elbows and low signal intensity in three elbows. Three elbows with low signal MRI showed normal nerve conduction velocity of the ulnar nerve. Diffusion-weighted MRI appears to be an attractive technique for diagnosis of cubital tunnel syndrome in its early stages which show normal electrophysiological and conventional MRI studies.

  9. Shoulder internal rotation elbow flexion test for diagnosing cubital tunnel syndrome.

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    Ochi, Kensuke; Horiuchi, Yukio; Tanabe, Aya; Waseda, Makoto; Kaneko, Yasuhito; Koyanagi, Takahiro

    2012-06-01

    Shoulder internal rotation enhances symptom provocation attributed to cubital tunnel syndrome. We present a modified elbow flexion test--the shoulder internal rotation elbow flexion test--for diagnosing cubital tunnel syndrome. Fifty-five ulnar nerves in cubital tunnel syndrome patients and 123 ulnar nerves in controls were examined with 5 seconds each of elbow flexion, shoulder internal rotation, and shoulder internal rotation elbow flexion tests before and after treatment (surgery in 18; conservative in others). For the shoulder internal rotation elbow flexion test position, 90° abduction, maximum internal rotation, and 10° flexion of the shoulder were combined with the elbow flexion test position. The test was considered positive if any symptom for cubital tunnel syndrome developed rotation elbow flexion test was evaluated by nerve conduction studies in 10 cubital tunnel syndrome nerves and 7 control nerves. The sensitivities/specificities of the 5-second elbow flexion, shoulder internal rotation, and shoulder internal rotation elbow flexion tests were 25%/100%, 58%/100%, and 87%/98%, respectively. Sensitivity differences between the shoulder internal rotation elbow flexion test and the other two tests were significant. Shoulder internal rotation elbow flexion test results and cubital tunnel syndrome symptoms were significantly correlated. Influence of the shoulder internal rotation elbow flexion test on the ulnar nerve was seen in 8 of 10 cubital tunnel syndrome nerves but not in controls. The 5-second shoulder internal rotation elbow flexion test is specific, easy and quick provocative test for diagnosing cubital tunnel syndrome. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  10. Outcomes of revision surgery for cubital tunnel syndrome.

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    Aleem, Alexander W; Krogue, Justin D; Calfee, Ryan P

    2014-11-01

    To compare both validated patient-rated and objective outcomes of patients following revision cubital tunnel surgery to a similar group of patients who underwent primary surgery. This case-control investigation enrolled 56 patients treated surgically for cubital tunnel syndrome (28 revision cases, 28 primary controls) at a tertiary center. Patients with a minimum of 2 years of follow-up were eligible. All patients completed an in-office study evaluation. Revision participants represented 55% of potential patients in our practice and controls (treated only with primary surgery) were chosen at random from our practice to reach a 1:1 case to control ratio. Preoperative McGowan grading was confirmed similar between the groups. Outcome measures included validated patient outcome questionnaires (Patient-Rated Elbow Evaluation, Levine-Katz questionnaire), symptoms, and physical examination findings. Statistical analyses were conducted to compare the patient groups. Despite 79% of revision patients reporting symptomatic improvement, revision patients reported worse outcomes on all measured standardized questionnaires compared with primary patients. The Levine-Katz questionnaire indicated mild residual symptoms in the primary group (1.6) versus moderate remaining symptoms following revision surgery (2.3). The Patient-Rated Elbow Evaluation also indicated superior results for the control group (9 ± 10) compared with the revision group (32 ± 22). Revision patients had a higher frequency of constant symptoms, elevated 2-point discrimination, and diminished pinch strength. McGowan grading improved after 25% of revision surgeries versus 64% of primary surgeries, and 21% of revision patients had deterioration of their McGowan grade. Subjective and objective outcomes of revision patients in this cohort were inferior to outcomes of similar patients following primary surgery. Revision surgery can be offered in the setting of persistent or recurrent symptoms that are unexplained

  11. The illusion of severe carpal tunnel syndrome (CTS).

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    Gutmann, Ludwig; Nance, Christopher

    2010-02-01

    Thenar atrophy occurs in patients with severe carpal tunnel syndrome (CTS) of long-standing duration. In this report we present a young woman with mild bilateral CTS, based on electrophysiological studies, in whom marked thenar atrophy was on a congenital basis related to the VATER association (vertebral anomalies, anal atresia, tracheoesophageal fistula, and radial or renal abnormalities).

  12. Cubital tunnel syndrome due to heterotrophic ossification caused by radial head fracture: A case report

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    Seyitali Gumustas

    2014-04-01

    Full Text Available Compression of the ulnar nerve in the cubital tunnel is the second most common nerve entrapment syndrome in the upper extremity after carpal tunnel syndrome. Although various etiologies have been described, heterotrophic ossification is rarely seen. Heterotrophic ossification should be kept in mind as a cause of ulnar nerve entrapment after elbow trauma. Early diagnosis and surgical intervention are important in such cases before completion of the maturation phase. We report a case of heterotrophic ossification due to elbow trauma that caused cubital tunnel syndrome. [Hand Microsurg 2014; 3(1.000: 24-28

  13. Ulnar nerve strain at the elbow in patients with cubital tunnel syndrome: effect of simple decompression.

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    Ochi, K; Horiuchi, Y; Nakamura, T; Sato, K; Arino, H; Koyanagi, T

    2013-06-01

    Simple decompression of the ulnar nerve at the elbow has not been shown to reduce nerve strain in cadavers. In this study, ulnar nerve strain at the elbow was measured intraoperatively in 11 patients with cubital tunnel syndrome, before and after simple decompression. Statistical analysis was performed using a paired Student's t-test. Mean ulnar nerve strain before and after simple decompression was 30.5% (range 9% to 69%) and 5.5% (range -2% to 11%), respectively; this difference was statistically significant (p ulnar nerve strain in all patients by an average of 24.5%. Our results suggest that the pathophysiology of cubital tunnel syndrome may be multifactorial, being neither a simple compression neuropathy nor a simple traction neuropathy, and simple decompression may be a favourable surgical procedure for cubital tunnel syndrome in terms of decompression and reduction of strain in the ulnar nerve.

  14. CUBITAL TUNNEL SYNDROME: REVIEW OF 14 ANTERIOR SUBCUTANEOUS TRANSPOSITIONS OF THE VASCULARIZED ULNAR NERVE

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    M. Farzan

    2005-06-01

    Full Text Available Anterior transposition of the ulnar nerve is widely implemented for treatment of cubital tunnel ‎syndrome. However, preservation of the extrinsic blood supply of the ‎ulnar nerve may result in better clinical outcomes. Fourteen patients with cubital tunnel ‎syndrome, 11 ‎men and 3 women, were treated by anterior subcutaneous transposition of the ulnar nerve. The extrinsic blood supply of the ulnar nerve was ‎preserved. The average age at the time of operation was 33 years. The average follow-up period was 44 months. Post-operative outcome assessment by an independent examiner was based on the modified Bishop rating system. Nine patients had excellent or good outcomes. Five patients had a fair outcome. There ‎were no complications or recurrence of symptoms. Anterior subcutaneous ‎transposition of the vascularized ulnar nerve is an effective method of surgical ‎treatment for patients with cubital tunnel syndrome.

  15. Anterior subcutaneous transposition of the ulnar nerve improves neurological function in patients with cubital tunnel syndrome.

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    Huang, Wei; Zhang, Pei-Xun; Peng, Zhang; Xue, Feng; Wang, Tian-Bing; Jiang, Bao-Guo

    2015-10-01

    Although several surgical procedures exist for treating cubital tunnel syndrome, the best surgical option remains controversial. To evaluate the efficacy of anterior subcutaneous transposition of the ulnar nerve in patients with moderate to severe cubital tunnel syndrome and to analyze prognostic factors, we retrospectively reviewed 62 patients (65 elbows) diagnosed with cubital tunnel syndrome who underwent anterior subcutaneous transposition. Preoperatively, the initial severity of the disease was evaluated using the McGowan scale as modified by Goldberg: 18 patients (28%) had grade IIA neuropathy, 20 (31%) had grade IIB, and 27 (42%) had grade III. Postoperatively, according to the Wilson & Krout criteria, treatment outcomes were excellent in 38 patients (58%), good in 16 (25%), fair in 7 (11%), and poor in 4 (6%), with an excellent and good rate of 83%. A negative correlation was found between the preoperative McGowan grade and the postoperative Wilson & Krout score. The patients having fair and poor treatment outcomes had more advanced age, lower nerve conduction velocity, and lower action potential amplitude compared with those having excellent and good treatment outcomes. These results suggest that anterior subcutaneous transposition of the ulnar nerve is effective and safe for the treatment of moderate to severe cubital tunnel syndrome, and initial severity, advancing age, and electrophysiological parameters can affect treatment outcome.

  16. Fascia Wrapping Technique: A Modified Method for the Treatment of Cubital Tunnel Syndrome

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    Hyun Ho Han

    2014-01-01

    Full Text Available Variations of the anterior transposition of the ulnar nerve for cubital tunnel syndrome include subcutaneous, submuscular, intramuscular, and subfascial methods. We introduce a modification of subfascial transposition, which is designed to facilitate nerve gliding by wrapping the nerve with fascia. Twenty patients with wrapping surgery following the diagnosis of cubital tunnel syndrome were reviewed retrospectively. Preoperative electrodiagnostic studies were performed in all patients and all of them were rechecked postoperatively. The preoperative mean value of motor conduction velocity (MCV was 37.1±6.7 m/s within the elbow segment and this result showed a decrease compared to the result of MCV with 53.9±6.9 m/s in the below the elbow-wrist segment with statistical significance (P<0.05. Postoperative mean values of MCV were improved in all of 20 patients to 47.6±5.5 m/s (P<0.05. 19 patients of 20 (95% reported good or excellent clinical outcomes according to a modified Bishop scoring system. The surgical treatment methods for cubital tunnel syndrome have their own advantages and disadvantages, and the preferred method differs depending on the surgeon. The wrapping method of anterior transposition is a newly designed alternative method modified from subfascial transposition. This method could be an alternative option to treat cubital tunnel syndrome.

  17. Anterior subcutaneous transposition of the ulnar nerve improves neurological function in patients with cubital tunnel syndrome

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    Wei Huang

    2015-01-01

    Full Text Available Although several surgical procedures exist for treating cubital tunnel syndrome, the best surgical option remains controversial. To evaluate the efficacy of anterior subcutaneous transposition of the ulnar nerve in patients with moderate to severe cubital tunnel syndrome and to analyze prognostic factors, we retrospectively reviewed 62 patients (65 elbows diagnosed with cubital tunnel syndrome who underwent anterior subcutaneous transposition. Preoperatively, the initial severity of the disease was evaluated using the McGowan scale as modified by Goldberg: 18 patients (28% had grade IIA neuropathy, 20 (31% had grade IIB, and 27 (42% had grade III. Postoperatively, according to the Wilson & Krout criteria, treatment outcomes were excellent in 38 patients (58%, good in 16 (25%, fair in 7 (11%, and poor in 4 (6%, with an excellent and good rate of 83%. A negative correlation was found between the preoperative McGowan grade and the postoperative Wilson & Krout score. The patients having fair and poor treatment outcomes had more advanced age, lower nerve conduction velocity, and lower action potential amplitude compared with those having excellent and good treatment outcomes. These results suggest that anterior subcutaneous transposition of the ulnar nerve is effective and safe for the treatment of moderate to severe cubital tunnel syndrome, and initial severity, advancing age, and electrophysiological parameters can affect treatment outcome.

  18. Simple in situ decompression for idiopathic cubital tunnel syndrome using minimal skin incision

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    Jeon In-Ho

    2010-01-01

    Full Text Available Cubital tunnel syndrome is one of the most frequently occurring compression neuropathy in the upper limb next to carpal tunnel syndrome. Recent minimal invasive technique has prompted us to gain clinical experience with simple in situ decompression with minimal skin incision for idiopathic cubital tunnel syndrome. Sixty six consecutive patients with cubital tunnel syndrome were treated using minimal skin incision technique. The mean age of the patients was 49.7 (range: 15-77 years and average follow up period was 23.9 months (range: 12-60 months. The severity of ulnar neuropathy was classified according to the McGowan classification: there were 17 in grade I , 47 in grade II and 2 in grade III. A preoperative nerve conduction study was done by inching method, which revealed motor conduction delay around the medial epicondyle. All operations were carried out in a day surgery unit under local anesthetics. The postoperative outcome was evaluated by Messina classification. The mean duration of the operation was 12 minutes. The technique was highly satisfactorily esthetic for all. Over 80% of the patients were completely satisfied with the procedure taking into consideration their symptoms. Postoperative outcome measures and patient satisfactions (pain, return to normal activities and work, scar and pillar tenderness were comparable with published series of anterior transposition. The overall satisfactory results were recorded 81% in the patients of McGowan stage I and II. There were 2 cases of hematoma as a postoperative complication. This procedure is comparably effective alternative which involves less surgical trauma, morbidity and rehabilitation time with good surgical outcomes especially in mild and moderate degrees. Minimal skin incision is a simple, safe and effective method to treat patients with idiopathic cubital tunnel syndrome.

  19. Risk factors for dislocation of the ulnar nerve after simple decompression for cubital tunnel syndrome.

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    Murata, K; Omokawa, S; Shimizu, T; Nakanishi, Y; Kawamura, K; Yajima, H; Tanaka, Y

    2014-01-01

    Anterior dislocation of the ulnar nerve is occasionally encountered after simple decompression of the nerve for treatment of cubital tunnel syndrome. The purpose of this study was to determine whether the incidence of dislocation of the nerve following simple decompression of the nerve is correlated with the patient's preoperative characteristics and/or elbow morphology. We studied 51 patients with cubital tunnel syndrome who underwent surgery at our institution. Intraoperatively, we simulated dislocation of the nerve after simple decompression by flexing the elbow after releasing the nerve in each patient. Univariate and multiple logistic regression analysis showed that young age and a small ulnar nerve groove angle are positively correlated with dislocation of the nerve. Our results suggest that patients who are young and/or have a sharply angled ulnar nerve groove identified radiographically have a high probability of experiencing anterior dislocation of the ulnar nerve after simple decompression.

  20. Endoscopic anatomical nerve observation and minimally invasive management of cubital tunnel syndrome.

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    Yoshida, A; Okutsu, I; Hamanaka, I

    2009-02-01

    Experience with the use of the Universal Subcutaneous Endoscope (USE) system in surgical treatment of cubital tunnel syndrome in 35 patients is reported. Patients included in the study had pre- and postoperative clinical and electrophysiological data, and had undergone a minimum follow-up period of 13 months. Mean patient age was 59.5 years and the mean follow-up period was 25.9 months. The operation was performed under local anaesthesia without pneumatic tourniquet and on an out-patient basis. A 1.5 cm portal is made at the cubital tunnel and the USE system is inserted next to the ulnar nerve, first distally and then proximally. The nerve is endoscopically assessed and only the tissue that compresses the nerve is released, in keeping with the principles of minimally invasive treatment. Preoperative tingling sensations disappeared postoperatively in 63% of cases. Pain and sensory disturbance recovered to normal in 92% and 89% of cases, respectively. Abnormal motor nerve conduction velocities improved in 77%. Abductor digiti minimi weakness MMT 0, 1, 2 in 16 hands recovered to MMT 4 or 5 in eight. First-dorsal interosseous weakness in 18 hands recovered to MMT 4 or 5 in seven. There were no complications in this series. The endoscopic approach facilitates inspection of the ulnar nerve so that selective release of the tissue that compresses the nerve can readily be performed. The technique has proven effective in the treatment of cubital tunnel syndrome.

  1. Current diagnostics and treatment of the cubital tunnel syndrome in Austria

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    Harder, Kristina

    2016-01-01

    Full Text Available According to the vote of the Austrian Society for Surgery of the Hand (ÖGH an investigation to collect data on the current state of the treatment of cubital tunnel syndrome was initiated. Over one year a total of 875 patients with cubital tunnel syndrome were operated in Austria, this means an incidence of this nerve entrapment of 0.011%. Most of the operations were done by trauma surgeons (287; 33%. For diagnosis most of the centers rely on clinical symptoms, electroneurophysiology, and elbow X-ray. 40% of the institutions regard conservative therapy as useless and not indicated. If conservative treatment modalities are applied, physiotherapy (97%, non-steroidal anti-inflammatory medication (77%, and glucocorticoid injections (30% are primarily used. In case of simple nerve entrapment most of the surgeons (72% prefer simple nerve decompression. If there is additional pathology subcutaneous cubital nerve transposition is recommended (62%. Endoscopic techniques are only use by 3% of the surgeons. In the postoperative care, physiotherapy is favored in 51%, whereas 24% do not judge any postoperative care as beneficial.The three most often encountered complications were incomplete remission, scar contracture and hypertrophy, and postoperative bleeding.

  2. Postures of upper extremity correlated with carpal tunnel syndrome (CTS

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    Chia-Liang Chiang

    2017-04-01

    Full Text Available Objectives: Non-medical hospital staff members are in frequent contact with patients and therefore are required to perform a wide variety of repetitive and high-frequency activities. The objective of this study was to assess the relationships between upper extremity activity and carpal tunnel syndrome (CTS among non-medical hospital staff members. Material and Methods: Carpal tunnel syndrome in 144 non-medical hospital staff members was diagnosed using the Nordic Musculoskeletal Questionnaire (NMQ, a physician’s diagnosis, physical examination (Tinel’s signs and Phalen test and a nerve conduction velocity (NCV test. In addition, an ergonomic assessment was performed and a video camera was used to record the physical activities at work. Results: The prevalence rate of CTS was highest for the NMQ (51.9%, followed by physician’s diagnosis (49.5% for the right hand, 29.9% for the left hand, physical examination (54.7%, and nerve conduction test (motor nerve 27.5% and 25%, sensory nerve 21.7% and 15%, for right and left hands, respectively. Based on logistic regression models for the NMQ and physician’s diagnoses, there was a dose-dependently higher risk of CTS with the upper extremity index among participants, but this was non-significant based on the physical examination and nerve conduction tests. Conclusions: Nerve conduction velocity is the gold standard in diagnosis of CTS, but use of NMQ and physician’s diagnosis may overestimate the incidence of CTS in workers who have been engaging in repetitive stress activities for a relatively short time. Int J Occup Med Environ Health 2017;30(2:281–290

  3. MR anatomy and pathology of the ulnar nerve involving the cubital tunnel and Guyon's canal.

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    Shen, Luyao; Masih, Sulabha; Patel, Dakshesh B; Matcuk, George R

    2016-01-01

    Ulnar neuropathy is a common and frequent reason for referral to hand surgeons. Ulnar neuropathy mostly occurs in the cubital tunnel of the elbow or Guyon's canal of the wrist, and it is important for radiologists to understand the imaging anatomy at these common sites of impingement. We will review the imaging and anatomy of the ulnar nerve at the elbow and wrist, and we will present magnetic resonance imaging examples of different causes of ulnar neuropathy, including trauma, overuse, arthritis, masses and mass-like lesions, and systemic diseases. Treatment options will also be briefly discussed.

  4. PRESSURE CHANGE OF CUBITAL TUNNEL AT DIFFERENT ELBOW FLEXION ANGLES IN PATIENTS WITH CUBITAL TUNNEL SYNDROME%肘管综合征患者不同屈肘角度的肘管内压力变化

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    孟纬; 潘昊鹏; 朱伟

    2013-01-01

    Objective To investigate the relationship between the elbow flexion angle and the cubital tunnel pressure in patients with cubital tunnel syndrome.Methods Between June 2010 and June 2011,63 patients with cubital tunnel syndrome were treated.There were 47 males and 16 females with an average age of 59 years (range,31-80 years).The lesion was at left side in 18 cases and at right side in 45 cases.During anterior transposition of ulnar nerve,the cubital tunnel pressure values were measured at full elbow extension,elbow flexion of 30,60,and 90°,and full elbow flexion with microsensor.The elbow flexion angle-cubital tunnel pressure curve was drawn.Results The cubital tunnel pressure increased smoothly with increased elbow flexion angle when the elbow flexed less than 60°,and the pressure increased sharply when the elbow flexed more than 90°.The cubital tunnel pressure values were (0.13 ± 0.15),(1.75 ± 0.30),(2.62 ± 0.34),(5.78 ± 0.47),and (11.40 ±0.62) kPa,respectively at full elbow extension,elbow flexion of 30,60,and 90°,and full elbow flexion,showing significant differences among different angles (P < 0.05).Conclusion The cubital tunnel pressure will increase sharply when the elbow flexes more than 90°,which leads to the chronic ischemic damage to ulnar nerve.Long-term ischemic damage will induce cubital tunnel syndrome.%目的 通过测定肘管综合征患者不同屈肘角度时肘管内压力,探讨肘管内压力与屈肘角度间的关系.方法 2010年6月-2011年6月,收治63例单侧肘管综合征患者.男47例,女16例;年龄31~80岁,平均59岁.左侧18例,右侧45例.于尺神经前移术中,采用颅内微型传感器测量最大伸肘位,屈肘30、60、90°和最大屈肘位时肘管内压力,绘制屈肘角度-压力曲线.结果 肘管内压力随屈肘角度增加而增大,屈肘超过90°时显著增大.最大伸肘位,屈肘30、60、90°和最大屈肘位时肘管内压力分别为(0.13±0.15)、(1.75±0.30)、(2.62±0.34)、(5

  5. Tratamento da síndrome do túnel cubital pela técnica de transposição anterior subcutânea: será este método seguro e eficaz? Subcutaneous anterior transposition for treatment of cubital tunnel syndrome: is this method safe and effective?

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    Sara Lima

    2012-01-01

    Full Text Available OBJETIVO: Avaliar os resultados da transposição anterior subcutânea do nervo cubital no tratamento da síndrome do túnel cubital (STC e a influência de fatores de prognóstico, tais como o estádio de McGowan pré-operatório, a idade e a duração dos sintomas. MÉTODOS: Foram avaliados 36 doentes com STC submetidos à transposição anterior subcutânea do nervo cubital entre 2006 e 2009, com um tempo médio de follow-up de 28 meses. A idade média foi de 41,6 anos. Nove doentes foram incluídos no estádio I de McGowan, 18 no estádio II e nove no estádio III. RESULTADOS: Obteve-se melhoria estatisticamente significativa dos défices motores e sensitivos. 78% dos doentes com neuropatia severa melhoraram após a cirurgia. Segundo a escala de Bishop modificada, obtiveram-se 21 (58,3% resultados excelentes, sete (19,4% bons, seis (16,7% satisfatórios e dois maus (5.55%. A taxa de satisfação foi de 86% e 72% dos doentes recuperaram as atividades diárias sem limitações. CONCLUSÕES: A gravidade da neuropatia e a duração pré-operatória dos sintomas, mas não a idade, tiveram uma influência negativa no outcome. A transposição anterior subcutânea do nervo cubital é segura e eficaz no tratamento da STC com diversos graus de gravidade. Tendo em conta os principais fatores de prognóstico identificados, o tratamento cirúrgico deve ser aconselhado logo que a perda axonal se torne clinicamente evidente.OBJECTIVE: To evaluate the results from subcutaneous anterior transposition of the cubital nerve for treating cubital tunnel syndrome (CTS and the influence of prognostic factors such as preoperative McGowan stage, age and duration of symptoms. METHODS: 36 patients with CTS who underwent subcutaneous anterior transposition of the cubital nerve between 2006 and 2009 were evaluated after an average follow-up of 28 months. Their mean age was 41.6 years. Nine patients were in McGowan stage I, 18 in stage II and nine in stage III. RESULTS

  6. Early diagnosis of Carpal Tunnel Syndrome (CTS) in Indian patients by nerve conduction studies

    OpenAIRE

    2010-01-01

    The present study was carried out for early confirmation of clinically diagnosed patients of Carpal Tunnel Syndrome (CTS) by electro-diagnostic tests which included motor conduction, sensory conduction studies and F-wave studies. The aim of the study was early confirmation of clinically suspected patients of CTS by motor and sensory conduction studies of median and ulnar nerves. Eighty subjects of age group 30-50 years (40 clinically suspected patients of CTS, 40 as control group) were studie...

  7. Minimally invasive endoscopic ulnar nerve assessment and surgery for cubital tunnel syndrome patients—Relation between endoscopic nerve findings and clinical symptoms

    Directory of Open Access Journals (Sweden)

    Aya Yoshida

    2014-07-01

    Full Text Available To minimize damage to healthy tissues, we have been performing endoscopically assisted cubital tunnel syndrome surgery based on endoscopic nerve findings since 1995. This is the first study to focus on endoscopic surgery for cubital tunnel syndrome based on endoscopic ulnar nerve findings and the subsequent postoperative clinical results. We analysed 82 upper extremities of 74 cubital tunnel syndrome patients who had undergone endoscopically assisted release surgery using the Universal Subcutaneous Endoscope system. Endoscopic observations of the ulnar nerve were made from a single 1- to 3-cm endoscopic portal incision at the cubital tunnel to 10 cm proximal and 10 cm distal. The abnormal nerve areas were identified and released based on nerve degeneration findings under endoscopic observation. The abnormal areas spread eccentrically from the entrapment point(s. In 82 diseased upper extremities, ulnar nerve entrapment occurred at the cubital tunnel. However, one extremity suffered from entrapment at the arcade of Struthers' in addition to the cubital tunnel. All patients showed improved clinical symptoms following surgery. There is no statistical relation between pre- and postoperative clinical scores of Dellon's Staging and abnormal nerve length findings. Cubital tunnel syndrome is usually caused by entrapment at the cubital tunnel; however, in some cases, there are other point entrapment(s. Our endoscopically assisted procedure avoids any damage to healthy tissues because the surgeon can observe the entrapment point(s prior to release. Postoperative clinical recovery results clearly indicate that endoscopic nerve findings reveal entrapment points and ulnar nerve degeneration can spread maximally 10 cm distally and proximally from the entrapment point(s, even in clinically mild severity cases. All other possible entrapment points should, therefore, be observed and released using our procedure.

  8. Applied anatomical study of the vascularized ulnar nerve and its blood supply for cubital tunnel syndrome at the elbow region

    OpenAIRE

    2015-01-01

    Cubital tunnel syndrome is often accompanied by paresthesia in ulnar nerve sites and hand muscle atrophy. When muscle weakness occurs, or after failure of more conservative treatments, anterior transposition is used. In the present study, the ulnar nerve and its blood vessels were examined in the elbows of 18 adult cadavers, and the external diameter of the nutrient vessels of the ulnar nerve at the point of origin, the distances between the origin of the vessels and the medial epicondyle of ...

  9. Applied anatomical study of the vascularized ulnar nerve and its blood supply for cubital tunnel syndrome at the elbow region.

    Science.gov (United States)

    Li, Mei-Xiu-Li; He, Qiong; Hu, Zhong-Lin; Chen, Sheng-Hua; Lv, Yun-Cheng; Liu, Zheng-Hai; Wen, Yong; Peng, Tian-Hong

    2015-01-01

    Cubital tunnel syndrome is often accompanied by paresthesia in ulnar nerve sites and hand muscle atrophy. When muscle weakness occurs, or after failure of more conservative treatments, anterior transposition is used. In the present study, the ulnar nerve and its blood vessels were examined in the elbows of 18 adult cadavers, and the external diameter of the nutrient vessels of the ulnar nerve at the point of origin, the distances between the origin of the vessels and the medial epicondyle of the humerus, and the length of the vessels accompanying the ulnar nerve in the superior ulnar collateral artery, the inferior ulnar collateral artery, and the posterior ulnar recurrent artery were measured. Anterior transposition of the vascularized ulnar nerve was performed to treat cubital tunnel syndrome. The most appropriate distance that the vascularized ulnar nerve can be moved to the subcutaneous tissue under tension-free conditions was 1.8 ± 0.6 cm (1.1-2.5 cm), which can be used as a reference value during the treatment of cubital tunnel syndrome with anterior transposition of the vascularized ulnar nerve.

  10. Comparison of anterior subcutaneous and submuscular transposition of ulnar nerve in treatment of cubital tunnel syndrome: A prospective randomized trial

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    Abolghassem Zarezadeh

    2012-01-01

    Full Text Available Background: This study was designed to compare two methods of surgery, anterior subcutaneous transposition (ASCT and anterior submuscular transposition (ASMT of the ulnar nerve in treatment of cubital tunnel syndrome. Materials and Methods: This randomized trial study was conducted from October 2008 to March 2009 in the Department of Orthopedic Surgery at University Hospital. Forty-eight patients with confirmed cubital tunnel syndrome were randomized in two groups, and each patient received one of two different surgical treatment methods, either ASCT (n = 24 or ASMT (n = 24. In the ASCT technique, the ulnar nerve was transposed and retained in the subcutaneous bed, whereas in the ASMT, the nerve was retained deep in the transected muscular complex, near the median nerve. Patient outcomes, including pain, sensation, muscle strength, and muscle atrophy were compared between groups. Results: The two groups were similar in baseline characteristics. However, those treated with ASMT had a statistically significant reduction in their pain levels compared with ASCT (21 (87.5% vs 8 (33.3%, P 0.05. Conclusions: Our results indicate that ASMT are more efficient than ASCT for managing cubital tunnel syndrome. In patients who had ASMT, there were significant reductions of pain compared with ASCT.

  11. Applied anatomical study of the vascularized ulnar nerve and its blood supply for cubital tunnel syndrome at the elbow region

    Directory of Open Access Journals (Sweden)

    Mei-xiu-li Li

    2015-01-01

    Full Text Available Cubital tunnel syndrome is often accompanied by paresthesia in ulnar nerve sites and hand muscle atrophy. When muscle weakness occurs, or after failure of more conservative treatments, anterior transposition is used. In the present study, the ulnar nerve and its blood vessels were examined in the elbows of 18 adult cadavers, and the external diameter of the nutrient vessels of the ulnar nerve at the point of origin, the distances between the origin of the vessels and the medial epicondyle of the humerus, and the length of the vessels accompanying the ulnar nerve in the superior ulnar collateral artery, the inferior ulnar collateral artery, and the posterior ulnar recurrent artery were measured. Anterior transposition of the vascularized ulnar nerve was performed to treat cubital tunnel syndrome. The most appropriate distance that the vascularized ulnar nerve can be moved to the subcutaneous tissue under tension-free conditions was 1.8 ± 0.6 cm (1.1-2.5 cm, which can be used as a reference value during the treatment of cubital tunnel syndrome with anterior transposition of the vascularized ulnar nerve.

  12. Applied anatomical study of the vascularized ulnar nerve and its blood supply for cubital tunnel syndrome at the elbow region

    Institute of Scientific and Technical Information of China (English)

    Mei-xiu-li Li; Qiong He; Zhong-lin Hu; Sheng-hua Chen; Yun-cheng Lv; Zheng-hai Liu; Yong Wen; Tian-hong Peng

    2015-01-01

    Cubital tunnel syndrome is often accompanied by paresthesia in ulnar nerve sites and hand muscle atrophy. When muscle weakness occurs, or after failure of more conservative treatments, anterior transposition is used. In the present study, the ulnar nerve and its blood vessels were examined in the elbows of 18 adult cadavers, and the external diameter of the nutrient vessels of the ulnar nerve at the point of origin, the distances between the origin of the vessels and the medial epicondyle of the humerus, and the length of the vessels accompanying the ulnar nerve in the superior ulnar collateral artery, the inferior ulnar collateral artery, and the posterior ulnar recurrent artery were measured. Anterior transposition of the vascularized ulnar nerve was per-formed to treat cubital tunnel syndrome. The most appropriate distance that the vascularized ulnar nerve can be moved to the subcutaneous tissue under tension-free conditions was 1.8 ± 0.6 cm (1.1–2.5 cm), which can be used as a reference value during the treatment of cubital tunnel syndrome with anterior transposition of the vascularized ulnar nerve.

  13. Results after simple decompression of the ulnar nerve in cubital tunnel syndrome.

    Science.gov (United States)

    Harder, Kristina; Lukschu, Sandra; Dunda, Sebastian E; Krapohl, Björn Dirk

    2015-01-01

    Cubital tunnel syndrome represents the second most common compression neuropathy of the upper limb. For more than four decades there has been a controversy about the best surgical treatment modality for cubital tunnel syndrome. In this study the results of 28 patients with simple ulnar nerve decompression are presented. Data analyses refers to clinical examination, personal interview, DASH-questionnaire, and electrophysiological measurements, which were assessed pre- and postoperatively. 28 patients (15 females, 13 males) were included in this study. The average age at time of surgery was 47.78 years (31.68-73.10 years). The period from onset of symptoms to surgery ranged from 2 to 24 months (mean 6 months). The mean follow-up was 2.11 years (0.91-4.16 years). Postoperatively there was a significant decrease in DASH score from 52.6 points to 13.3 points (pnerve conduction velocity increased from 36.0 m/s to 44.4 m/s (p=0.008) and the motor nerve action potential reached 5,470 mV compared to 3,665 mV preoperatively (p=0.018). A significant increase of grip strength from 59% (in comparison to the healthy hand) to 80% was observed (p=0.002). Pain was indicated by means of a visual analog scale from 0 to 100. Preoperatively the median level of pain was 29 and postoperatively it was 0 (p=0.001). The decrease of the two-point-discrimination of the three ulnar finger nerves was also highly significant (p<0.001) from 11.3 mm to 5.0 mm. Significant postoperative improvement was also observed in the clinical examination concerning muscle atrophy (p=0.002), clawing (p=0.008), paresthesia (p=0.004), the sign of Froment (p=0.004), the sign of Hoffmann-Tinel (p=0.021), and clumsiness (p=0.002). Overall nearly 90% of all patients were satisfied with the result of the operation. In 96.4% of all cases, surgery improved the symptoms and in one patient (3.6%) the success was noted as "poor" because the symptoms remained unchanged. In 35.7% the success was graded as "moderate", in 10

  14. Results after simple decompression of the ulnar nerve in cubital tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Harder, Kristina

    2015-12-01

    Full Text Available Cubital tunnel syndrome represents the second most common compression neuropathy of the upper limb. For more than four decades there has been a controversy about the best surgical treatment modality for cubital tunnel syndrome. In this study the results of 28 patients with simple ulnar nerve decompression are presented. Data analyses refers to clinical examination, personal interview, DASH-questionnaire, and electrophysiological measurements, which were assessed pre- and postoperatively.28 patients (15 females, 13 males were included in this study. The average age at time of surgery was 47.78 years (31.68–73.10 years. The period from onset of symptoms to surgery ranged from 2 to (mean 6 months. The mean follow-up was 2.11 years (0.91–Postoperatively there was a significant decrease in DASH score from 52.6 points to 13.3 points (p<0.001. Also the electrophysiological findings improved significantly: motor nerve conduction velocity increased from 36.0 m/s to 44.4 m/s (p=0.008 and the motor nerve action potential reached 5,470 mV compared to 3,665 mV preoperatively (p=0.018. A significant increase of grip strength from 59% (in comparison to the healthy hand to 80% was observed (p=0.002. Pain was indicated by means of a visual analog scale from 0 to 100. Preoperatively the median level of pain was 29 and postoperatively it was 0 (p=0.001. The decrease of the two-point-discrimination of the three ulnar finger nerves was also highly significant (p<0.001 from 11.3 mm to 5.0 mm. Significant postoperative improvement was also observed in the clinical examination concerning muscle atrophy (p=0.002, clawing (p=0.008, paresthesia (p=0.004, the sign of Froment (p=0.004, the sign of Hoffmann-Tinel (p=0.021, and clumsiness (p=0.002.Overall nearly 90% of all patients were satisfied with the result of the operation. In 96.4% of all cases, surgery improved the symptoms and in one patient (3.6% the success was noted as “poor” because the symptoms remained

  15. Diagnostic Usefulness of Ultrasonographic Examination of Cubital Tunnel Syndrome: Analysis of Ulnar Nerve Cross-sectional Area

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Yu Mee; Hong, Suk Joo; Yoon, Joon Shik; Park, Cheol Min [Korea University Guro Hospital, Seoul (Korea, Republic of); Kim, Jung Hyuk [Korea University Auam Hospital, Seoul (Korea, Republic of)

    2006-06-15

    To prospectively evaluate the accuracy of sonography for diagnosis of cubital tunnel syndrome (CUTS) confirmed by electrodiagnostic study. From February 2004 to March 2005, we prospectively analyzed 24 elbows in 19 patients (8 women, 11 men: mean age, 49.2 years: range 23-65 years) with cubital tunnel syndrome, including 5 bilateral cases. Diagnoses of CUTS were confirmed by both clinical symptom and electrodiagnostic study. Sonographic findings of 20 asymptomatic cases served as controls. In sonographic examination, the cross sectional area of the ulnar nerve was measured at the inlet (at the level of medial epicondyle) and outlet (at the level of convergence of flexor carpi ulnaris tendons) of the cubital tunnel. The shape and echogenicity of the ulnar nerve were also evaluated, as were possible causes of entrapment. The accuracy of using ultrasonographic cross sectional area to diagnose CUTS was evaluated with receiver operating characteristic (ROC) analysis. The cross sectional area of the ulnar nerve at the inlet and outlet levels in CUTS patients was increased much more than in the asymptomatic cases. Decreased echogenicity and distortion of normal parallel echotexture of the ulnar nerve were observed in all CUTS patients. At the inlet level, the area under the ROC curve (AUC) was 0.816, and the ideal cut-off value for CUTS diagnosis was 0.08 cm{sup 2} with a sensitivity of 58.3%, specificity of 100%, positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 66.7%. At the distal outlet level, the AUC was 0.785, and the cut-off value was 0.06 cm{sup 2} with a sensitivity of 79.2%, specificity of 70%, PPV of 76%, and NPV of 73.7%. When the summation value of inlet and outlet cross sectional areas was used, the AUC was 0.853, and cut-off value was 0.14 cm{sup 2} with a sensitivity of 70.8%, specificity of 85%, PPV of 85%, and NPV of 70.8%. Measurement of the cross sectional area of the ulnar nerve at the inlet and outlet of the cubital

  16. Associations between ulnar nerve strain and accompanying conditions in patients with cubital tunnel syndrome.

    Science.gov (United States)

    Ochi, Kensuke; Horiuchi, Yukio; Nakamura, Toshiyasu; Sato, Kazuki; Morita, Kozo; Horiuchi, Koichi

    2014-01-01

    Pathophysiology of cubital tunnel syndrome (CubTS) is still controversial. Ulnar nerve strain at the elbow was measured intraoperatively in 13 patients with CubTS before simple decompression. The patients were divided into three groups according to their accompanying conditions: compression/adhesion, idiopathic, and relaxation groups. The mean ulnar nerve strain was 43.5 ± 30.0%, 25.5 ± 14.8%, and 9.0 ± 5.0% in the compression/adhesion, idiopathic, and relaxation groups respectively. The mean ulnar nerve strains in patients with McGowan's classification grades I, II, and III were 18.0 ± 4.2%, 27.1 ± 22.7%, and 33.7 ± 24.7%, respectively. The Jonckheere-Terpstra test showed that there were significant reductions in the ulnar nerve strain among the first three groups, but not in the three groups according to McGowan's classification. Our results suggest that the pathophysiology, not disease severity, of CubTS may be explained at least in part by the presence of ulnar nerve strain.

  17. MR neurography of ulnar nerve entrapment at the cubital tunnel: a diffusion tensor imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, Julia B.; Berzaczy, Dominik; Nemec, Stefan F.; Weber, Michael; Prayer, Daniela; Kasprian, Gregor [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Kranz, Gottfried; Sycha, Thomas [Medical University of Vienna, Department of Neurology, Vienna (Austria); Hold, Alina [Medical University of Vienna, Department of Plastic and Reconstructive Surgery, Vienna (Austria)

    2015-07-15

    MR neurography, diffusion tensor imaging (DTI) and tractography at 3 Tesla were evaluated for the assessment of patients with ulnar neuropathy at the elbow (UNE). Axial T2-weighted and single-shot DTI sequences (16 gradient encoding directions) were acquired, covering the cubital tunnel of 46 patients with clinically and electrodiagnostically confirmed UNE and 20 healthy controls. Cross-sectional area (CSA) was measured at the retrocondylar sulcus and FA and ADC values on each section along the ulnar nerve. Three-dimensional nerve tractography and T2-weighted neurography results were independently assessed by two raters. Patients showed a significant reduction of ulnar nerve FA values at the retrocondylar sulcus (p = 0.002) and the deep flexor fascia (p = 0.005). At tractography, a complete or partial discontinuity of the ulnar nerve was found in 26/40 (65 %) of patients. Assessment of T2 neurography was most sensitive in detecting UNE (sensitivity, 91 %; specificity, 79 %), followed by tractography (88 %/69 %). CSA and FA measurements were less effective in detecting UNE. T2-weighted neurography remains the most sensitive MR technique in the imaging evaluation of clinically manifest UNE. DTI-based neurography at 3 Tesla supports the MR imaging assessment of UNE patients by adding quantitative and 3D imaging data. (orig.)

  18. MR neurography of ulnar nerve entrapment at the cubital tunnel: a diffusion tensor imaging study.

    Science.gov (United States)

    Breitenseher, Julia B; Kranz, Gottfried; Hold, Alina; Berzaczy, Dominik; Nemec, Stefan F; Sycha, Thomas; Weber, Michael; Prayer, Daniela; Kasprian, Gregor

    2015-07-01

    MR neurography, diffusion tensor imaging (DTI) and tractography at 3 Tesla were evaluated for the assessment of patients with ulnar neuropathy at the elbow (UNE). Axial T2-weighted and single-shot DTI sequences (16 gradient encoding directions) were acquired, covering the cubital tunnel of 46 patients with clinically and electrodiagnostically confirmed UNE and 20 healthy controls. Cross-sectional area (CSA) was measured at the retrocondylar sulcus and FA and ADC values on each section along the ulnar nerve. Three-dimensional nerve tractography and T2-weighted neurography results were independently assessed by two raters. Patients showed a significant reduction of ulnar nerve FA values at the retrocondylar sulcus (p = 0.002) and the deep flexor fascia (p = 0.005). At tractography, a complete or partial discontinuity of the ulnar nerve was found in 26/40 (65%) of patients. Assessment of T2 neurography was most sensitive in detecting UNE (sensitivity, 91%; specificity, 79%), followed by tractography (88%/69%). CSA and FA measurements were less effective in detecting UNE. T2-weighted neurography remains the most sensitive MR technique in the imaging evaluation of clinically manifest UNE. DTI-based neurography at 3 Tesla supports the MR imaging assessment of UNE patients by adding quantitative and 3D imaging data. • DTI and tractography support conventional MR neurography in the detection of UNE • Regionally reduced FA values and discontinuous tractography patterns indicate UNE • T2-weighted MR neurography remains the imaging gold standard in cases of UNE • DTI-based ulnar nerve tractography offers additional topographic information in 3D.

  19. An aberrant anatomic variation along the course of the ulnar nerve above the elbow with coexistent cubital tunnel syndrome.

    Science.gov (United States)

    Chow, James C Y; Papachristos, Athanasios A; Ojeda, Alvaro

    2006-10-01

    We report on a patient with an unusual anatomic variation along the course of ulnar nerve above the elbow who had cubital tunnel syndrome. The variation consisted of a cutaneous neural branch that was originating at a distance of approximately 40 mm proximal to the medial epicondyle, and from the radial aspect of the main trunk of ulnar nerve. The branch had a superficial course and it was passing distally, anterior to the medial epicondyle without penetrating the fascia of the flexor muscles origin. Anterior intramuscular transposition of the ulnar nerve was performed leaving the newly found branch over the fascia between the muscles and the adipose subcutaneous tissue.

  20. Current evidence for effectiveness of interventions for cubital tunnel syndrome, radial tunnel syndrome, instability, or bursitis of the elbow: a systematic review.

    Science.gov (United States)

    Rinkel, Willem D; Schreuders, Ton A R; Koes, Bart W; Huisstede, Bionka M A

    2013-12-01

    To provide an evidence-based overview of the effectiveness of interventions for 4 nontraumatic painful disorders sharing the anatomic region of the elbow: cubital tunnel syndrome, radial tunnel syndrome, elbow instability, and olecranon bursitis. The Cochrane Library, PubMed, Embase, PEDro, and CINAHL were searched to identify relevant reviews and randomized clinical trials (RCTs). Two reviewers independently extracted data and assessed the quality of the methodology. A best-evidence synthesis was used to summarize the results. One systematic review and 6 RCTs were included. For the surgical treatment of cubital tunnel syndrome (1 review, 3 RCTs), comparing simple decompression with anterior ulnar nerve transposition, no evidence was found in favor of either one of these. Limited evidence was found in favor of medial epicondylectomy versus anterior transposition and for early postoperative therapy versus immobilization. No evidence was found for the effect of local steroid injection in addition to splinting. No RCTs were found for radial tunnel syndrome. For olecranon bursitis (1 RCT), limited evidence for effectiveness was found for methylprednisolone acetate injection plus naproxen. Concerning elbow instability, including 2 RCTs, one showed that nonsurgical treatment resulted in similar results compared with surgery, whereas the other found limited evidence for the effectiveness in favor of early mobilization versus 3 weeks of immobilization after surgery. In this review no, or at best, limited evidence was found for the effectiveness of nonsurgical and surgical interventions to treat painful cubital tunnel syndrome, radial tunnel syndrome, elbow instability, or olecranon bursitis. Well-designed and well-conducted RCTs are clearly needed in this field.

  1. Early diagnosis of Carpal Tunnel Syndrome (CTS in Indian patients by nerve conduction studies

    Directory of Open Access Journals (Sweden)

    Dr. Geetanjali Sharma MD

    2010-07-01

    Full Text Available The present study was carried out for early confirmation of clinically diagnosed patients of Carpal Tunnel Syndrome (CTS by electro-diagnostic tests which included motor conduction, sensory conduction studies and F-wave studies. The aim of the study was early confirmation of clinically suspected patients of CTS by motor and sensory conduction studies of median and ulnar nerves. Eighty subjects of age group 30-50 years (40 clinically suspected patients of CTS, 40 as control group were studied. Motor and Sensory conduction velocities, distal motor and sensory latencies and F wave latencies of median and ulnar nerves were performed using RMS EMG EP Mark –II. Statistically significant (P < 0.001 slowing of motor conduction velocities for both nerves was seen in the CTS group as compared to control group. Decrease in sensory conduction velocity was more pronounced in CTS group as compared to Control group. Statistically significant (P < 0.001 increase in distal motor and sensory latencies was also observed for both median and ulnar nerves in the CTS group as compared to Control group, with more increase in distal motor latency than sensory latency. Increase in F wave latencies of both nerves was seen in the CTS group. Electrophysiological studies confirmed the early diagnosis of CTS with a high degree of sensitivity. Present results confirm selective slowing of sensory & motor conduction within wrist to palm segment in patients of CTS which is attributable to compression by the transverse carpal ligament or to a disease process of the terminal segment.

  2. Effect of Elbow Position on Short-segment Nerve Conduction Study in Cubital Tunnel Syndrome

    Institute of Scientific and Technical Information of China (English)

    Zhu Liu; Zhi-Rong Jia; Ting-Ting Wang; Xin Shi; Wei Liang

    2016-01-01

    Background:The appropriate elbow position of short-segment nerve conduction study (SSNCS) to diagnose cubital tunnel syndrome (CubTS) is still controversial.The goal of this study was to determine the effect of different elbow positions at full extension and 70° flexion on SSNCS in CubTS.Methods:In this cross-sectional study,the clinical data of seventy elbows from 59 CubTS patients between September,2011 and December,2014 in the Peking University First Hospital were included as CubTS group.Moreover,thirty healthy volunteers were included as the healthy group.SSNCS were conducted in all subjects at elbow lull extension and 70° elbow flexion.Paired nonparametric test,bivariate correlation,Bland-Altman,and Chi-squared test analysis were used to compare the effectiveness of elbow full extension and 70° flexion elbow positions on SSNCS in CubTS patients.Results:Data of upper limit was calculated from healthy group,and abnormal latency was judged accordingly.CubTS group's latency and compound muscle action potential (CMAP) of each segment at 70° elbow flexion by SSNCS was compared with full extension position,no statistically significant difference were found (all P > 0.05).Latency and CMAP of each segment at elbow full extension and 70° flexion were correlated (all P < 0.01),except the latency of segment of 4 cm to 6 cm above elbow (P =0.43),and the latency (P =0.15) and the CMAP (P =0.06) of segment of 2 cm to 4 cm below elbow.Bivariate correlation and Bland-Altman analysis proved the correlation between elbow full extension and 70° flexion.Especially in segments across the elbow (2 cm above the elbow and 2 cm below it),latency at elbow full extension and 70° flexion were strong direct associated (r =0.83,P < 0.01; r =0.55,P < 0.01),and so did the CMAP (r =0.49,P < 0.01; r =0.72,P < 0.01).There was no statistically significant difference in abnormality of each segment at full extension as measured by SSNCS compared with that at 70° flexion (P > 0

  3. A novel technique for the treatment of recurrent cubital tunnel syndrome: ulnar nerve wrapping with a tissue engineered bioscaffold.

    Science.gov (United States)

    Puckett, B N; Gaston, R G; Lourie, G M

    2011-02-01

    The purpose of this study was to assess subjective and objective outcomes in treating recurrent cubital tunnel at secondary neurolysis by nerve wrapping with a tissue engineered three-dimensional biomatrix. Five patients with a mean age of 44.1 years and an average follow-up of 13.3 months were included in the study. All patients had improvement in visual analogue scales. Four patients that had preoperative intrinsic atrophy with clawing had no clawing or intrinsic atrophy at final follow-up. Postoperatively, four of the five patients had two-point discrimination of 5 mm. Grip strength on average increased 90%. Three patients had an excellent outcome, one patient had a good outcome, and one patient had a fair outcome. All five patients said they would have surgery again.

  4. Anterior Subcutaneous versus Submuscular Transposition of the Ulnar Nerve for Cubital Tunnel Syndrome: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Chun-Hua Liu

    Full Text Available To pool reliable evidences for the optimum anterior transposition technique in the treatment of cubital tunnel syndrome by comparing the clinical efficacy of subcutaneous and submuscular anterior ulnar nerve transposition.A comprehensive search was conducted in PubMed MEDLINE, Cochrane Library, EMBASE, Web of Science, OVID AMED, EBSCO and potentially relevant surgical archives. Risk of bias of each included studies was evaluated according to Cochrane Handbook for Systematic Reviews of Interventions. The risk ratio (RR and 95% confidence intervals (CI were calculated for the clinical improvement in function compared to baseline. Heterogeneity was assessed across studies, and subgroup analysis was also performed based on the study type and follow-up duration.Three studies with a total of 352 participants were identified, and the clinically relevant improvement was used as the primary outcomes. Our meta-analysis revealed that no significant difference was observed between two comparison groups in terms of postoperative clinical improvement in those studies (RR 1.04, 95% CI 0.86 to 1.25, P = 0.72. Meanwhile, subgroup analyses by study type and follow-up duration revealed the consistent results with the overall estimate. Additionally, the pre- and postoperative motor nerve conduction velocities were reported in two studies with a total of 326 patients, but we could not perform a meta-analysis because of the lack of concrete numerical value in one study. The quality of evidence for clinical improvement was 'low' or 'moderate' on the basis of GRADE approach.Based on small numbers of studies with relatively poor methodological quality, the limited evidence is insufficient to identify the optimum anterior transposition technique in the treatment of cubital tunnel syndrome. The results of the present study suggest that anterior subcutaneous and submuscular transposition might be equally effective in patients with ulnar neuropathy at the elbow. Therefore

  5. Hand pain other than carpal tunnel syndrome (CTS): the role of occupational factors.

    Science.gov (United States)

    Andréu, José-Luis; Otón, Teresa; Silva-Fernández, Lucía; Sanz, Jesús

    2011-02-01

    Some occupational factors have been implicated in the development of disorders manifested as hand pain. The associations seem to be well documented in processes such as hand-arm vibration syndrome (HAVS) or writer's cramp. There are contradictory data in the literature about the relationships of trigger finger, De Quervain's tenosynovitis (DQT) and tenosynovitis of the wrist with occupational factors. In this article, we review current knowledge about clinical manifestations, case definition, implicated occupational factors, diagnosis and treatment of the most relevant hand pain disorders that have been associated with occupational factors, excluding carpal tunnel syndrome (CTS).

  6. Multiple Regression Analysis for Grading and Prognosis of Cubital Tunnel Syndrome:Assessment of Akahori’s Classification

    Directory of Open Access Journals (Sweden)

    Nishida,Keiichiro

    2013-02-01

    Full Text Available The purpose of this study was to quantitatively evaluate Akahori's preoperative classification of cubital tunnel syndrome. We analyzed the results for 57 elbows that were treated by a simple decompression procedure from 1997 to 2004. The relationship between each item of Akahori's preoperative classification and clinical stage was investigated based on the parameter distribution. We evaluated Akahori's classification system using multiple regression analysis, and investigated the association between the stage and treatment results. The usefulness of the regression equation was evaluated by analysis of variance of the expected and observed scores. In the parameter distribution, each item of Akahori's classification was mostly associated with the stage, but it was difficult to judge the severity of palsy. In the mathematical evaluation, the most effective item in determining the stage was sensory conduction velocity. It was demonstrated that the established regression equation was highly reliable (R=0.922. Akahori's preoperative classification can also be used in postoperative classification, and this classification was correlated with postoperative prognosis. Our results indicate that Akahori's preoperative classification is a suitable system. It is reliable, reproducible and well-correlated with the postoperative prognosis. In addition, the established prediction formula is useful to reduce the diagnostic complexity of Akahori's classification.

  7. Preliminary Study on the Lesion Location and Prognosis of Cubital Tunnel Syndrome by Motor Nerve Conduction Studies

    Directory of Open Access Journals (Sweden)

    Zhu Liu

    2015-01-01

    Full Text Available Background: To study lesions′ location and prognosis of cubital tunnel syndrome (CubTS by routine motor nerve conduction studies (MNCSs and short-segment nerve conduction studies (SSNCSs, inching test. Methods: Thirty healthy subjects were included and 60 ulnar nerves were studied by inching studies for normal values. Sixty-six patients who diagnosed CubTS clinically were performed bilaterally by routine MNCSs and SSNCSs. Follow-up for 1-year, the information of brief complaints, clinical symptoms, and physical examination were collected. Results: Sixty-six patients were included, 88 of nerves was abnormal by MNCS, while 105 was abnormal by the inching studies. Medial epicondyle to 2 cm above medial epicondyle is the most common segment to be detected abnormally (59.09%, P < 0.01. Twenty-two patients were followed-up, 17 patients′ symptoms were improved. Most of the patients were treated with drugs and modification of bad habits. Conclusions: (1 SSNCSs can detect lesions of compressive neuropathy in CubTS more precisely than the routine motor conduction studies. (2 SSNCSs can diagnose CubTS more sensitively than routine motor conduction studies. (3 In this study, we found that medial epicondyle to 2 cm above the medial epicondyle is the most vulnerable place that the ulnar nerve compressed. (4 The patients had a better prognosis who were abnormal in motor nerve conduction time only, but not amplitude in compressed lesions than those who were abnormal both in velocity and amplitude. Our study suggests that SSNCSs is a practical method in detecting ulnar nerve compressed neuropathy, and sensitive in diagnosing CubTS. The compound muscle action potentials by SSNCSs may predict prognosis of CubTS.

  8. Preliminary Study on the Lesion Location and Prognosis of Cubital Tunnel Syndrome by Motor Nerve Conduction Studies

    Institute of Scientific and Technical Information of China (English)

    Zhu Liu; Zhi-Rong Jia; Ting-Ting Wang; Xin Shi; Wei Liang

    2015-01-01

    Background:To study lesions' location and prognosis of cubital tunnel syndrome (CubTS) by routine motor nerve conduction studies (MNCSs) and short-segment nerve conduction studies (SSNCSs,inching test).Methods:Thirty healthy subjects were included and 60 ulnar nerves were studied by inching studies for normal values.Sixty-six patients who diagnosed CubTS clinically were performed bilaterally by routine MNCSs and SSNCSs.Follow-up for 1-year,the information of brief complaints,clinical symptoms,and physical examination were collected.Results:Sixty-six patients were included,88 of nerves was abnormal by MNCS,while 105 was abnormal by the inching studies.Medial epicondyle to 2 cm above medial epicondyle is the most common segment to be detected abnormally (59.09%),P < 0.01.Twenty-two patients were followed-up,17 patients' symptoms were improved.Most of the patients were treated with drugs and modification of bad habits.Conclusions:(1) SSNCSs can detect lesions of compressive neuropathy in CubTS more precisely than the routine motor conduction studies.(2) SSNCSs can diagnose CubTS more sensitively than routine motor conduction studies.(3) In this study,we found that medial epicondyle to 2 cm above the medial epicondyle is the most vulnerable place that the ulnar nerve compressed.(4) The patients had a better prognosis who were abnormal in motor nerve conduction time only,but not amplitude in compressed lesions than those who were abnormal both in velocity and amplitude.Our study suggests that SSNCSs is a practical method in detecting ulnar nerve compressed neuropathy,and sensitive in diagnosing CubTS.The compound muscle action potentials by SSNCSs may predict prognosis of CubTS.

  9. 肘管、腕管的超声解剖及其临床应用%Study on the anatomy and clinical implication of cubital and carpal tunnel with ultrasound

    Institute of Scientific and Technical Information of China (English)

    郭瑞军; 于亚东; 邵新中; 王明花; 田德虎; 张文云; 张经歧; 张晓丽

    2000-01-01

    目的 探讨高频超声对肘管、腕管综合征的诊断价值.方法 /应用高频超声观察30例正常人的肘管及腕管的超声解剖并对20例肘管综合征、10例腕管综合征患者术前行超声检查.结果 高频超声不仅能清晰显示构成肘管及腕管的骨质、软组织及其内容物,而且能够明确肘管和腕管综合征的病因以及尺神经和正中神经的形态学变化.结论 高频超声在肘管、腕管综合征的诊断及鉴别诊断中具有重要价值.%Objective To evaluate the diagnostic value of high frequency ultrasound in cubital and carpal tunnel syndrome. Methods High frequency ultrasonography of normal cubital and carpal tunnel were performed in 30 healthy volunteers. Then sonorgraphic examination was carried out in 20 patients with cubital tunnel syndrome and 10 patients with carpal tunnel syndrome before operation. Results Not only the structure of cubital and carpal tunnel cauld be showed clearly, but also the cause of the cubital and carpal tunnel syndrome could be distinct. Conclusion High frequency ultrasound is of high diagnostic value in cubital and carpal tunnel syndrome.

  10. Cubital Tunnel Syndrome

    Science.gov (United States)

    ... Gardening Safety Turkey Carving Removing a Ring Español Artritis de la base del pulgar Dedo en gatillo ... Gardening Safety Turkey Carving Removing a Ring Español Artritis de la base del pulgar Dedo en gatillo ...

  11. Subcutaneous Versus Submuscular Anterior Transposition of the Ulnar Nerve for Cubital Tunnel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies.

    Science.gov (United States)

    Liu, Chun-Hua; Wu, Shi-Qiang; Ke, Xiao-Bin; Wang, Han-Long; Chen, Chang-Xian; Lai, Zhan-Long; Zhuang, Zhi-Yong; Wu, Zhi-Qiang; Lin, Qin

    2015-07-01

    Subcutaneous and submuscular anterior ulnar nerve transposition have been widely used in patients with cubital tunnel syndrome. However, the reliable evidence in favor of 1 of 2 surgical options on clinical improvement remains controversial. To maximize the value of the available literature, we performed a systematic review and meta-analysis to compare subcutaneous versus submuscular anterior ulnar nerve transposition in patients with ulnar neuropathy at the elbow. PubMed, Cochrane Library, and EMBASE databases were searched for randomized and observational studies that compared subcutaneous transposition with submuscular transposition of ulnar nerve for cubital tunnel syndrome. The primary outcome was clinically relevant improvement in function compared to the baseline. Randomized and observational studies were separately analyzed with relative risks (RRs) and 95% confidence intervals (CIs). Two randomized controlled trials (RCTs) and 7 observational studies, involving 605 patients, were included. Our meta-analysis suggested that no significant differences in the primary outcomes were observed between comparison groups, both in RCT (RR, 1.16; 95% CI 0.68-1.98; P = 0.60; I2= 81%) and observational studies (RR, 1.01; 95% CI 0.95-1.08; P = 0.69; I2 = 0%). These findings were also consistent with all subgroup analyses for observational studies. In the secondary outcomes, the incidence of adverse events was significantly lower in subcutaneous group than in submuscular group (RR, 0.54; 95% CI 0.33-0.87; P = 0.01; I2 = 0%), whereas subcutaneous transposition failed to reveal more superiority than submuscular transposition in static two-point discrimination (MD, 0.04; 95% CI -0.18-0.25; P = 0.74; I = 0%). The available evidence is not adequately powered to identify the best anterior ulnar nerve transposition technique for cubital tunnel syndrome on the basis of clinical outcomes, that is, suggests that subcutaneous and submuscular anterior transposition might be equally

  12. 超声对腕管综合征和肘管综合征的诊断价值%Diagnostic value of ultrasonography for carpal tunnel and cubital tunnel syndrome

    Institute of Scientific and Technical Information of China (English)

    王战业; 曹洪弘; 夏炳兰

    2014-01-01

    Objective To explore the diagnostic value of ultrasonography for carpal tunnel and cubital tunnel syndrome. Method Twenty-five healthy subjects were enrolled as control group and 35 patients with suspected carpal tunnel syndrome and 22 patients with suspected ulnar nerve compression were enrolled as disease group. The median nerve was examined by ultrasonography. The cross sectional area (CSA) at peas bone level and anteroposterior diameters (D1), anteroposterior diameters at hook bone level (D2) and distal level (D3) of median nerve, and CSA of the elbow ulnar nerve were measured. The difference values between D1 and D2 (D), D3 and D2 (d) were calculated. The ultrasonography findings in lesion group were compared with those observed during operation. Results Ultrasonography can display the morphological changes of median and ulnar nerves after compression. The CSA of median and ulnar nerves、D、d in lesion group were bigger than those in control group (P<0.03). The diagnostic accurate rates of ultrasonography for carpal tunnel and cubital tunnel syndromes were 97.9%and 95.4%, respectively. Conclusion High-frequency ultrasonography can diagnose carpal tunnel and cubital tunnel syndromes effectively.%目的:探讨超声对腕管综合征、肘管综合征的诊断价值。方法25例体检健康者为对照组,临床疑诊35例腕管综合征和22例尺神经卡压患者为病变组,超声探查正中神经豌豆骨水平横断面积及其前后径(D1)、钩骨勾水平前后径(D2)、钩骨勾水平远端前后径(D3),肘部尺神经横断面积,计算D1与D2差值(D),D3与D2差值(d),将病变组超声检查结果与术中所见进行比较。结果超声可显示正中神经、尺神经卡压后的形态变化,病变组正中神经横断面积、D、d及尺神经横断面积均大于对照组(P<0.03)。与术中所见比较,超声诊断腕管综合征、肘管综合征准确率分别为97.9%、95.4%。结

  13. 弥可宝对肘管综合征致肘、腕、环指功能障碍恢复的作用%The recovery function of Mikebao on elbow, twist and finger functional disorder caused by cubital tunnel syndrome

    Institute of Scientific and Technical Information of China (English)

    陈越林; 刘淑贞; 管廷进; 王宝滨

    2002-01-01

    @@ 1 Subject and method 1.1 Subject 60 cases of middle and severe cubital tunnel syndrome from 1992 to 2000 were divided into three groups randomly: Group A was the Mikebao group: 20 cases including 17 male cases and 3 female cases, their ages were from 22~ 45 with the average one as 25; Group B was the vitamin B12 group: 19 cases including 17 male cases and 2 female cases, their ages were from 24~ 50 with the average one as 27; Group C was the control group: 21 cases including 19 male cases and 2 female cases, their ages were from 23~ 60 with the average one as 26. all the patients were sick at single sides, 42 cases were on the right side and 18 cases were on the left side. Causes: 15 cases were with elbow injury history and limited elbow movement, others were of no obvious causes. Courses: 5~ 72 months with the average one as 15 months. Clinical manifestation and signs: 49 cases were with elbow sour and swelling, 58 cases were with adductor pollicis muscle atrophy and 54 cases were with claw hand.Electromyography examination: ulnar nerve movement of the 60 cases at the elbows were obviously slow and CMAP (compound muscle active potential) latent periods were prolonged. All the Tinel sign of ulnar nerves were positive, one cases was with muscle paralysis and partial functional disorder at the median nerve domain, it was proven to be CTS after operation.

  14. The anatomy and clinical significance of the cubital tunnel and epitrochleo-anconeus%肘管与滑车上肘肌的解剖学研究及其临床意义

    Institute of Scientific and Technical Information of China (English)

    贾科锋; 丁实; 翟丽东; 袁武; 刘庚辰; 李云生

    2011-01-01

    目的 为治疗肘管综合症的原位松解术提供解剖学依据.方法 14例福尔马林固定的成年肘部标本,11例行大体解剖观察肘管特点,3例分别制成1mm厚的水平、冠状和矢状位火棉胶切片.并利用水平切片的图像对肘管等结构进行三维重建.结果 肘管的底南肘关节囊和尺侧副韧带前、后及横束构成,顶由肘管支持带或滑车上肘肌和尺侧腕屈肌的肱尺两头之间的筋膜构成.滑车上肘肌起白内上髁,其上部以筋膜止于鹰嘴内侧缘;中下部分直接止于鹰嘴内侧缘.在尺神经沟水平,有一筋膜蒂将尺神经连于底的后外侧部分.结论 对于滑车上肘肌引起的尺神经卡压者,合理切除此肌肉可以达到理想的治疗效果.筋膜蒂可能有防止尺神经过度运动以及半脱位的作用.%Objective To explore anatomic features of cubital tunnel, and provide reference for the decompression treatment of the cubital tunnel syndrome. Methods 14 formalin-fixed adult elbow specimens were used in this study. 11 of them were dissected to reveal anatomic features of the cubital tunnel, other 3 were embedded by celloidin and performed successive horizontal, coronal and sagittal section with the thickness of 1mm, followed by the cubital tunnel reconstruction adopting successive horizontal sectional images. Results The floor of cubital tunnel was formed by the capsule of elbow and all the three bundles of medial collateral ligament (MCL). The roof of this tunnel was composed of cubital tunnel retinaculum or epitrochleo-anconeus (EA) and the fascia between the two heads of flexor carpi ulnaris muscle. Epitrochleo-anconeus originated from the medial epicondyle. The upper portion of this muscle inserted to the medial margin of the olecranon through a fascia while the lower 2/3 portion directly to it. A fascial pedicle was identified at the level of the retrocondylar groove. It connected the ulnar nerve to the posterolateral portion of the

  15. Tratamento da síndrome do túnel ulnar pela técnica da epicondilectomia parcial medial do cotovelo Treatment of cubital tunnel syndrome using the technique of medial partial epicondylectomy of the elbow

    Directory of Open Access Journals (Sweden)

    Marcio Eduardo de Melo Viveiros

    2008-12-01

    Full Text Available OBJETIVO: Analisamos retrospectivamente os resultados de 21 casos de síndrome cubital tratados cirurgicamente com a técnica da epicondilectomia parcial medial. MÉTODOS: No período de fevereiro de 2001 a outubro de 2006, 21 pacientes com síndrome do canal cubital foram tratados pela técnica da epicondilectomia parcial medial do cotovelo associada à neurólise do nervo ulnar. Destes, 12 (57,1% eram do sexo masculino. O lado direito foi o acometido em 15 (71,4% pacientes. A média da idade dos pacientes foi de 51,6 anos. Pela graduação de McGowan, seis (28,6% pacientes encontravam-se no grau I, 11 (52,3%, no grau II e quatro (19,1%, no grau III do período pré-operatório. RESULTADOS: O tempo médio de acompanhamento pós-operatório foi de 25,7 meses. No pós-operatório, os pacientes foram avaliados conforme a escala de pontos de Bishop, sendo que nove (42,8% apresentavam resultados excelentes, sete (33,3%, bons, três (14,2%, regulares e dois (9,5%, ruins. Nesta série, não se encontraram como complicações a instabilidade em valgo residual, a lesão permanente do nervo ulnar, a recidiva da compressão ou a subluxação do nervo ulnar. As complicações encontradas foram perda do arco de movimento em um (4,7% caso, infecção superficial em um (4,7% e um (4,7% com dor residual. CONCLUSÃO: Os resultados apresentados permitem concluir que a epicondilectomia parcial medial do cotovelo associada à neurólise do nervo ulnar é eficiente e segura para o tratamento da síndrome do canal cubital.OBJECTIVE: The authors made a retrospective analysis of the results of 21 cases of cubital syndrome that were surgically treated with the partial medial epicondylectomy. METHODS: From February 2001 to October 2006, 21 patients with cubital tunnel syndrome were treated with the technique of elbow partial medial epicondylectomy associated to neurolysis of the ulnar nerve. Of these patients, 12 (57.1% were male. The right side was involved in 15 (71

  16. Comparative study on cubital tunnel syndrome and ulnar tunnel syndrome of nerve electro-physiology%肘管综合征与尺管综合征的神经电生理比较研究

    Institute of Scientific and Technical Information of China (English)

    刘英; 邹艺; 李素荣; 胥勋成

    2015-01-01

    Objective:To explore the significance of nerve electrophysiology in cubital tunnel syn‐drome(CuTS) and ulnar tunnel syndrome( UTS) in diagnosis and differential diagnosis .Methods:35 side limbs of 30 cases with CuTS and 5 cases with UTS neuromuscular electrical diagram were tested and ana‐lyzed .Results:In 35 side limbs of 30 cases with CuTS there were 28 cases whose motor nerve conduction velocity(MCV) in the elbon slowed down and compound nerve action potentiat (CMAP) decreased and those in 7 cases were not led out ;those in 8 cases were nerve hunk potential MCV in forearms sloweed down in 29 cases and those not led out in 6 ;Ulnar nerves with uand back sensory nerve conduction veloc‐ity (SCV)and sensory nerve action potential(SNAP) amplitudes declined in 27 cases and not led out . UTS motion elbow ,forearm ulnar trunk potential ,and ulnar nerves with hand back SNAP were normal , just thenerves of side the first interosseous muscle were found damaged and interosseous muscle move‐ment of wrist‐1 latency extended .Conclusion:Neuromuscular electrical diagram is the diagnosis and differ‐ential diagnosis for CuTS and UTS and it can guide clinical further treatment .%目的:探讨神经电生理在肘管综合征(CuTS)与腕尺管综合征(UTS)诊断及鉴别诊断中的意义。方法:对30例35侧肢体经临床初步诊断为CuTS的患者以及5例UTS患者进行神经肌电图检测及分析。结果:30例35侧肢体的CuTS主要表现为尺神经运动肘段运动传导速度(MCV)减慢及复合肌动作电位(CMAP)波幅下降28例和未引出7条;前臂神经干电位MCV减慢29条和未引出6条;尺神经手背支感觉传导速度(SCV)减慢及感觉神经动作电位(SNAP)波幅下降27条和未引出8条。CuTS尺神经运动肘段、前臂神经干电位、尺神经手背支SCV和SNAP属正常范围,仅见背侧第一骨间肌呈失神经损害及腕-第1骨间肌的运动潜伏期延长。结论:神经

  17. Anterior transposition of vascularized ulnar nerve for the treatment of severe cubital tunnel syndrome%带血管尺神经前置术治疗重度肘管综合征

    Institute of Scientific and Technical Information of China (English)

    孙良智; 孙建民; 栾素娴; 徐世民; 衣兰凯; 苏保辉; 石林; 尚小鹏; 李忠

    2013-01-01

    目的 评价带血管尺神经筋膜下前置术治疗重度肘管综合征的疗效.方法 对5例成人尸体上肢标本进行解剖学研究,观察尺神经在肘部的血液供应来源,测量尺神经的营养血管与神经伴行的长度.对38例重度肘管综合征患者,随机分为两组,分别采用带血管尺神经筋膜下前置术和单纯筋膜下前置术,参照中华医学会手外科学会上肢部分功能评定试用标准Lascar分级法和神经电生理测定,对患者的疗效进行评价比较.结果 解剖测量尺神经的营养血管与神经伴行长度:3条动脉伴神经走行的长度分别为尺侧上副动脉(145.0±4.3)mm,尺侧下副动脉(48.6±8.2)mm,尺侧返动脉后支(65.2±9.3)mm.带血管尺神经筋膜下前置术优良率为89.5%,单纯筋膜下前置术优良率为68.4%,两组比较差异有统计学意义.神经电生理检查:不带血管组术前运动神经传导速度(MNCV)平均为(23.3±3.6)m/s,术后(37.5±5.2)m/s;带血管组术前MNCV平均为(22.3±4.4)m/s,术后(45.2±6.0)m/s;两组比较差异有统计学意义.结论 带血管尺神经筋膜下前置术疗效可靠,方法简便,是治疗重度肘管综合征的有效方法.%Objective To evaluate the effect of vascularized ulnar nerve sub-fascial transposition in the treatment of severe cubital tunnel syndrome.Methods Anatomical dissection of 5 embalmed adult upper limb cadaver specimens was carried out to observe the blood supply of the ulnar nerve around the elbow.The accompanying length of its feeding vessels was measured.Thirty-eight cases of severe cubital tunnel syndrome were divided into two groups.In group 1 the ulnar nerve was transposed under the fascia with its feeding blood vessel.In group 2 the ulnar nerve was transposed without the blood vessel.The treatment effect was evaluated using the upper limb function evaluation criteria issued by the Chinese Medical Association,the Lascar classification method and electmphysiologic studies

  18. Treatment of cubital tunnel syndrome with ulnar nerve anterior submuscular transposition and medial epicondyle muscle group in situ reconstruction via a bone tunnel%尺神经肌下前置肱骨内上髁肌群经骨道原位重建治疗肘管综合征

    Institute of Scientific and Technical Information of China (English)

    张小路; 林其仁

    2014-01-01

    Objective To investigate the clinical effectiveness of treating moderate to severe cubital tunnel syndrome with ulnar nerve decompression,anterior submuscular transposition and medial epicondyle muscle group in situ reconstruction via a bone tunnel.Methods The clinical data of 45 cases of moderate to severe cubital tunnel syndrome diagnosed between January 2005 and October 2012 were analyzed.The ulnar nerve was decompressed and its perfnsion by the superior ulnar collateral artery was observed under the surgical microscope intraoperatively.After ulnar nerve was transposed anteriorly,the detached medial epicondyle muscle group was reconstructed in situ through a bone tuunel under direct view.The size of the new ulnar nerve tunnel and mobility of the ulnar nerve were observed.Postoperative recovery was follow-up including pain,sensation,muscular atrophy recovery,claw hand,grip strength,wrist flexion and forearm pronation.Results All 45 cases were follow-up for 6 to 18 months.Intraoperative microscopic observation showed good ulnar nerve perfusion by the superior ulnar collateral artery.Reattachment of the medial epicondyle muscle group was secure.The newly formed cubital tunnel could allow an 8 mm dilator without tension in elbow full extension position.Ulnar nerve could glide freely upon elbow flexion and extension.According to the cubital tunnel syndrome function evaluation standard suggested by Gu Yudong,the results were graded as excellent in 20 cases,good in 17 cases,and fair in 8 cases.The overall excellent and good rate was 82.22%.Wrist flexion and forearm pronation force recovered to preoperative level in all the patients 3 months after the operation.Conclusion Including superior ulnar collateral artery in the anterior transposition of the ulnar nerve provides good blood supply to the nerve and benefits nerve recovery.In situ reconstruction of the medial epicondyle muscle group through a bone tunnel puts the ulnar nerve anderneath flexor carpi ulnaris and

  19. The Cubit: A History and Measurement Commentary

    Directory of Open Access Journals (Sweden)

    Mark H. Stone

    2014-01-01

    Full Text Available Historical dimensions for the cubit are provided by scripture and pyramid documentation. Additional dimensions from the Middle East are found in other early documents. Two major dimensions emerge from a history of the cubit. The first is the anthropological or short cubit, and the second is the architectual or long cubit. The wide geographical area and long chronological period suggest that cubit dimensions varied over time and geographic area. Greek and Roman conquests led to standardization. More recent dimensions are provided from a study by Francis Galton based upon his investigations into anthropometry. The subjects for Galton’s study and those of several other investigators lacked adequate sample descriptions for producing a satisfactory cubit/forearm dimension. This finding is not surprising given the demise of the cubit in today’s world. Contemporary dimensions from military and civilian anthropometry for the forearm and hand allow comparison to the ancient unit. Although there appears no pressing need for a forearm-hand/cubit dimension, the half-yard or half-meter unit seems a useful one that could see more application.

  20. Diagnosis of carpal tunnel syndrome: interobserver reliability of the blinded scratch-collapse test.

    Science.gov (United States)

    Blok, Robin D; Becker, Stéphanie J E; Ring, David C

    2014-06-01

    The reliability of the scratch-collapse test for diagnosis of carpal tunnel syndrome (CTS) has not been tested by independent investigators. This study measured the reliability of the scratch-collapse test comparing the treating hand surgeon and blinded evaluators. We performed a prospective observational study of 41 patients with a provisional diagnosis of CTS or a combination of CTS and cubital tunnel syndrome and prescribed electrodiagnostic testing. The treating hand surgeon performed the scratch-collapse test. Next, the test was administered by one of the six observers, unaware of the patient's symptoms and the diagnosis made by treating hand surgeon. The kappa statistic (κ) was used to calculate the interrater reliability between the treating hand surgeons and blinded scratchers. The agreement between the blinded observers and the hand surgeons on the scratch-collapse test was substantial 0.63 (95 % CI, 0.34-0.87; p scratch test in our sample was 32 %. In a small study with a spectrum bias favoring electrophysiologically confirmed CTS the reliability was lower than that reported by the inventors of the test, but was still substantial. We propose a larger study of patients with a greater variety of electrodiagnostic test results using fewer observers with more experience.

  1. Employees' Knowledge of Carpal Tunnel Syndrome.

    Science.gov (United States)

    Gandy-Goldston, Terrie M.

    A study examined employees' knowledge of the causes of carpal tunnel syndrome (CTS), its prevention, and their legal rights after being diagnosed with CTS. A 24-item questionnaire was administered to a random sample of 30 Chicago-area employees who had been afflicted with CTS. Of those surveyed, 99% considered their CTS injury related to their…

  2. CUBIT mesh generation environment. Volume 1: Users manual

    Energy Technology Data Exchange (ETDEWEB)

    Blacker, T.D.; Bohnhoff, W.J.; Edwards, T.L. [and others

    1994-05-01

    The CUBIT mesh generation environment is a two- and three-dimensional finite element mesh generation tool which is being developed to pursue the goal of robust and unattended mesh generation--effectively automating the generation of quadrilateral and hexahedral elements. It is a solid-modeler based preprocessor that meshes volume and surface solid models for finite element analysis. A combination of techniques including paving, mapping, sweeping, and various other algorithms being developed are available for discretizing the geometry into a finite element mesh. CUBIT also features boundary layer meshing specifically designed for fluid flow problems. Boundary conditions can be applied to the mesh through the geometry and appropriate files for analysis generated. CUBIT is specifically designed to reduce the time required to create all-quadrilateral and all-hexahedral meshes. This manual is designed to serve as a reference and guide to creating finite element models in the CUBIT environment.

  3. Ulnar Nerve Entrapment at the Elbow (Cubital Tunnel Syndrome)

    Science.gov (United States)

    ... of the medial epicondyle. Because this stretching can irritate the nerve, keeping your elbow bent for long ... Over time, this sliding back and forth may irritate the nerve. • Leaning on your elbow for long ...

  4. Bilateral carpal tunnel syndrome in Graves' disease.

    Science.gov (United States)

    Manganelli, P; Pavesi, G; Salaffi, F

    1987-01-01

    Carpal tunnel syndrome (CTS) may be associated with endocrinopathies, such as hypothyroidism and acromegaly. A direct relationship between CTS and hyperthyroidism has recently been suggested. We now report a case in which bilateral CTS developed after treatment of Graves' disease, thus, questioning the possibility of a relationship between these two disease processes.

  5. Cubital compressive neuropathy in the elbow: in situ neurolysis versus anterior transposition – comparative study,

    Directory of Open Access Journals (Sweden)

    Marco Sousa

    2014-12-01

    Full Text Available Objective:To compare the results from two of the most commonly used surgical techniques: in situ decompression and subcutaneous transposition. The processes of patients treated surgically in a public university hospital between January 2004 and December 2011 were reviewed. Cases of proximal compression of the nerve, angular deformity of the elbow and systemic diseases associated with non-compressive neuropathy were excluded.Methods:Ninety-seven cases were included (96 patients. According to the modified McGowan score, 14.4% of the patients presented grade Ia, 27.8% grade II, 26.8% grade IIb and 30.9% grade III. In situ neurolysis of the cubital was performed in 64 cases and subcutaneous anterior transposition in 33.Results:According to the modified Wilson and Knout score, the results were excellent in 49.5%, good in 18.6%, only satisfactory in 17.5% and poor in 14.4%. In comparing the two techniques, we observed similar numbers of excellent and good results. Grades IIb and III were associated with more results that were less satisfactory or poor, independent of the surgical technique.Conclusion:Both techniques were shown to be efficient and safe for treating cubital tunnel syndrome.

  6. Carpal tunnel syndrome - anatomical and clinical correlations.

    Science.gov (United States)

    Iskra, Tomasz; Mizia, Ewa; Musial, Agata; Matuszyk, Aleksandra; Tomaszewski, Krzysztof A

    2013-01-01

    Carpal tunnel syndrome (CTS) is the most common and widely known of the entrapment neuropathies in which the body's peripheral nerves are compressed. Common symptoms of CTS involve the hand and result from compression of the median nerve within the carpal tunnel. In general, CTS develops when the tissues around the median nerve irritate or compress on the nerve along its course through the carpal tunnel, however often it is very difficult to determine cause of CTS. Proper treatment (conservative or surgical) usually can relieve the symptoms and restore normal use of the wrist and hand.

  7. Carpal tunnel syndrome in inherited neuropathies: A retrospective survey.

    Science.gov (United States)

    Panosyan, Francis B; Kirk, Callyn A; Marking, Devon; Reilly, Mary M; Scherer, Steven S; Shy, Michael E; Herrmann, David N

    2017-07-10

    This study evaluates carpal tunnel syndrome (CTS) symptom severity, functional status, and outcome of CTS therapies in patients with inherited neuropathies. Validated questionnaires were used to compare symptom severity and functional status in patients with and without a diagnosis of CTS and a diagnosis of an inherited neuropathy. 309 patients with inherited neuropathies participated in this study. The CTS symptom severity score (SSS) was found to be the most useful tool in assessing CTS severity in patients with inherited neuropathy. Splint therapy and surgery were associated with significant improvement in carpal tunnel symptoms as measured through the SSS. This study provides insight into the assessment of CTS symptom severity and patient-reported outcomes to CTS therapy in individuals with inherited neuropathies. The SSS appears useful for evaluation of CTS symptoms and patient-reported outcomes following CTS interventions in individuals with inherited neuropathies. Muscle Nerve, 2017. © 2017 Wiley Periodicals, Inc.

  8. Electrodiagnosis of carpal tunnel syndrome.

    Science.gov (United States)

    Wang, Leilei

    2013-02-01

    This article discusses the historical aspects related to the understanding of carpal tunnel syndrome (CTS) and its diagnosis, highlighting observations about this disease that have yet to be challenged. This is followed by a discussion regarding the use of electrodiagnostic testing as a diagnostic tool for CTS, as well as the author's approach to making the diagnosis of CTS. Finally, conclusions about future directions in the diagnosis and treatment of this disorder are presented.

  9. Osteopathic manipulative medicine for carpal tunnel syndrome.

    Science.gov (United States)

    Siu, Gilbert; Jaffe, J Douglas; Rafique, Maryum; Weinik, Michael M

    2012-03-01

    Carpal tunnel syndrome (CTS) is 1 of the most common peripheral nerve entrapment disorders. Osteopathic manipulative medicine can be invaluable in diagnosing and managing CTS. Combined with a patient's history and a standard physical examination, an osteopathic structural examination can facilitate localizing the nerve entrapment, diagnosing CTS, and monitoring the disease process. Osteopathic manipulative treatment is noninvasive and can be used to supplement traditional CTS treatment methods. The authors also review the relevant anatomy involving CTS and the clinical efficacy of osteopathic manipulative medicine in the management of this disorder.

  10. Cadillac 2010 CTS Sport Wagon

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2010款CTS Sport Wagon是CTS的五门旅行版,具有Wagon的实用性和全新CTS的精悍造型,车体尺寸大致与轿车版相同,这款Sport Wagon使用了CTS的很多造型同时又增加尾部空间以使得它可以装载更多的东西。这个由Clay Dean领导的设计团队并不仅仅是给轿车加装了一个更长的车顶。他们将车顶线条延伸到了车尾,而尾灯也上升到了车顶,

  11. Post-CTS Delay Insertion

    Directory of Open Access Journals (Sweden)

    Jianchao Lu

    2010-01-01

    clock skew operation is performed only at the clock sinks in order to preserve the structure and the optimizations implemented in the clock tree synthesis stage. The methodology is implemented as a linear programming model amenable to two design objectives: fixing timing violations or optimizing the clock period. Experimental results show that the clock networks of the largest ISCAS'89 circuits can be corrected post-CTS to resolve the timing conflicts in approximately 90% of the circuits with minimal delay insertion (0.159  ×  clock period per clock path on average. It is also shown that the majority of the clock period improvement achievable through unrestricted clock skew scheduling are obtained through very limited insertion (≈43% average improvement through 10% of max insertion.

  12. Energistyring med CTS-anlæg

    DEFF Research Database (Denmark)

    Reinhold, Claus

    Rapporten gennemgår mulighederne for energistyring ved hjælp af anlæg for central tilstandskontrol og styring - de såkaldte CTS-anlæg. Der beskrives grundprincipper og typiske systemopbygninger, samt de praktiske erfaringer fra et stort engelsk forskningsprojekt og fra fire CTS-anlæg i Danmark....

  13. 切风 CTS Coupe Concept

    Institute of Scientific and Technical Information of China (English)

    佳俊

    2008-01-01

    在2008年北美国际车展上,凯迪拉克发布了CTS Coupe概念(CTS Coupe Concept)。CTS Coupe概念车基于CTS的轿车平台。整车采用了硬顶的无B柱设计,在加大车前端前倾幅度的同时,前挡风玻璃的斜切度也更小,有效地降低了车身行驶时的空气阻力,也保证了更

  14. Pharmacotherapy of carpal tunnel syndrome.

    Science.gov (United States)

    de Pablo, Paola; Katz, Jeffrey N

    2003-06-01

    Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome. CTS is a compression neuropathy caused by elevated pressure in the carpal tunnel. CTS has the potential to substantially limit performance of activities of daily living for some individuals. The goal of therapy for CTS is to improve symptoms and reduce signs of the disease, as well as prevent progression and loss of hand function. There are several treatment alternatives to relieve the pressure on the median nerve, both surgical and conservative. The most common measures employed in the initial treatment of CTS are NSAIDs, local and systemic corticosteroids, diuretics and pyridoxine. However, CTS treatment usually includes a combination of pharmacotherapy with other strategies such as splinting and activity modification. Injections of corticosteroids into the carpal tunnel are often employed for cases not responding to conservative treatment. Surgery is superior to conservative therapies for most persistently symptomatic patients. The aim of this paper is to review the pharmacological agents used for relieving the symptoms of CTS.

  15. An overview of the Communications Technology Satellite (CTS) project

    Science.gov (United States)

    Rapp, W.; Ogden, D.; Wright, D.

    1982-01-01

    The Communications Technology Satellite (CTS) project is reviewed. A technical description of the CTS spacecraft and its cognate hardware and operations is included. A historical treatise of the CTS project is provided. Also presented is an overview of the CTS experiments and demonstrations conducted during the course of the project.

  16. 78 FR 66779 - CTS Automotive LLC, a Subsidiary of CTS Corporation Including On-Site Leased Workers From Metro...

    Science.gov (United States)

    2013-11-06

    ... Employment and Training Administration CTS Automotive LLC, a Subsidiary of CTS Corporation Including On- Site... for Worker Adjustment Assistance on September 5, 2013, applicable to workers of CTS Automotive LLC, a subsidiary of CTS Corporation, including on-site leased workers from Metro Staff, Inc., and Aerotek,...

  17. Subclinical carpal tunnel syndrome in acromegaly.

    Science.gov (United States)

    Kameyama, S; Tanaka, R; Hasegawa, A; Tamura, T; Kuroki, M

    1993-08-01

    Median nerve conduction was studied in 16 acromegalic patients with asymptomatic carpal tunnel syndrome (CTS) to examine the incidence of subclinical CTS. Thirteen patients (81%) and 23 hands (72%) demonstrated subclinical CTS, 10 bilaterally and three unilaterally in the dominant hand. The incidence reflects the greater sensitivity of the inching method for detecting focal conduction abnormalities. Two of three patients without subclinical CTS showed normal plasma somatomedin-C concentration despite growth hormone hypersecretion. Following adenomectomy, nerve conduction normalized in only six hands (26%). The postoperative persistence of the conduction delay implies that irreversible narrowing of the carpal tunnel rather than reversible soft tissue edema is the principal cause of CTS associated with acromegaly.

  18. Electrophysiological evaluation of ulnar nerve in carpal tunnel syndrome

    Institute of Scientific and Technical Information of China (English)

    刘娜

    2014-01-01

    Objective To evaluate the impairment of ulnar nerve and its relationship with sensory symptoms in the ulnar territory in patients with carpal tunnel syndrome(CTS)through electrophysiological approach.Methods We retrospectively reviewed 55 cases with CTS admitted in our hospital from January 2012 to February 2013.Patients with CTS were graded as mild-moderate(35 cases)andsevere(20 cases)according to Stevens standard and were divided into symptomatic and non-symptomatic group according

  19. Occurrence of myofascial pain in patients with possible carpal tunnel syndrome - a single-blinded study

    DEFF Research Database (Denmark)

    Qerama, Erisela; Kasch, Helge; Fuglsang-Frederiksen, Anders

    2009-01-01

    There exits some similarity between symptoms of carpal tunnel syndrome (CTS) and myofascial pain related to trigger points (TPs) in the infraspinatus muscle.......There exits some similarity between symptoms of carpal tunnel syndrome (CTS) and myofascial pain related to trigger points (TPs) in the infraspinatus muscle....

  20. CARPAL TUNNEL SYNDROME PADA PEKERJA GARMEN DI JAKARTA

    Directory of Open Access Journals (Sweden)

    Lusianawaty Tana

    2012-10-01

    Full Text Available Carpal tunnel syndrome (CTS is a disorder caused by medianus nerve entrapment in carpal tunnel in the wrist and gives many symptoms as painfully, numbness, hyperesthesia at nerve medianus area. The objective of this study was to asses CTS in garment factory workers and determine the prevalence of CTS, CTS relation to age, sex, workhour, and repeated biomechanical pressure in hand/wrist. A cross sectional design was used in the study conducted in Jakarta in 2002, to 814 person sample with simple random sampling method. Data collection was done through interviews, inspections, and examinations. The study found that prevalence of CTS was 20.3% (n= 814 in work unit. Workers who worked with high repeated biomechanical pressure in right hand/wrist was 74.1%, in left hand/wrist were 65.5%. Carpal tunnel syndrome in female higher than CTS in male (p=0.04. There was 110 significant correlation between increased of age, workhour, repeated biomechanical pressure in hand/wrist and increased of CTS. For confirmation 10% cases CTS were examined by electroneurography and electromyography, and found that CTS was 35,3%.

  1. Carpal tunnel syndrome - electrodiagnostic aspects of fifty seven symptomatic hands.

    OpenAIRE

    1999-01-01

    Electrodiagnostic data of fifty seven symptomatic extremities with carpal tunnel syndrome (CTS) are described. Practice recommendations made by American Academy of Neurology, American Association of Electrodiagnostic Medicine and American Academy of Physical Medicine and Rehabilitation regarding electrodiagnostic studies were considered while confirming CTS diagnosis by electrodiagnostic studies. Median sensory nerve conduction studies were the commonest abnormalities noted. The median orthod...

  2. Colgajo de perforantes de la arteria colateral cubital inferior para defectos por quemadura eléctrica en fosa cubital

    Directory of Open Access Journals (Sweden)

    I. González-Alaña

    2014-09-01

    Full Text Available Las quemaduras eléctricas producen lesiones profundas, especialmente las debidas a la entrada y salida de la corriente y al arco voltaico, que pueden dejar expuestas estructuras nobles y afectar áreas de flexo-extensión, como la fosa antecubital. Los defectos resultantes pueden cubrirse mediante colgajos libres o pediculados de brazo y antebrazo. Entre las distintas opciones quirúrgicas, el colgajo medial del brazo evita la interrupción de los ejes vasculares mayores y la secuela en la zona donante es discreta. Sin embargo, su uso está poco extendido por considerarse un colgajo de difícil disección debido a la variabilidad anatómica de las arterias colaterales cubitales superior e inferior que lo irrigan. Presentamos la cobertura para un defecto secundario a quemadura eléctrica en la fosa antecubital mediante un colgajo medial del brazo basado en las ramas perforantes de la arteria colateral cubital inferior. Aunque confirmamos en este caso la variabilidad vascular, la disección resultó sencilla y el resultado estético y funcional fue excelente.

  3. Comparison of high-resolution sonography and electrophysiology in the diagnosis of carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Meena Angamuthu Kanikannan

    2015-01-01

    Full Text Available Background: The diagnostic accuracy of high-resolution ultrasonography (HRUS in comparison to electro-diagnostic testing (EDX in carpal tunnel syndrome (CTS is debatable. Objective: The aim of this study was to compare the diagnostic accuracy of HRUS with EDX in patients with various grades of CTS and CTS associated with peripheral neuropathy (CTS + PNP. Materials and Methods: A prospective cohort of 57 patients with possible CTS was studied along with matched controls. The cross-sectional area (CSA of the median nerve at the inlet of carpal tunnel was assessed by a sonologist blinded to the clinical and EDX data. Palm wrist distal sensory latency difference (PWDSLD, second lumbrical-interosseus distal motor latency difference (2LIDMLD and CSA were compared in patients with different grades of severity of CTS and CTS+PNP. Results: Total 92 hands of 57 patients met the clinical criteria for CTS. Mean CSA at the inlet of carpal tunnel was 0.11 ± 0.0275 cm 2 . It had the sensitivity, specificity, positive predictive value and negative predictive values of 76.43%, 72.72%, 89.47% and 68%, respectively (P < 0.0001. Overall, HRUS had good correlation with PWDSLD and 2LIDMLD electro-diagnostic studies in all grades of CTS and CTS + PNP. Conclusion: HRUS can be used as a complementary screening tool to EDX. However, EDX has been found to be more sensitive and specific in mild CTS.

  4. A vertical mouse and ergonomic mouse pads alter wrist position but do not reduce carpal tunnel pressure in patients with carpal tunnel syndrome.

    Science.gov (United States)

    Schmid, Annina B; Kubler, Paul A; Johnston, Venerina; Coppieters, Michel W

    2015-03-01

    Non-neutral wrist positions and external pressure leading to increased carpal tunnel pressure during computer use have been associated with a heightened risk of carpal tunnel syndrome (CTS). This study investigated whether commonly used ergonomic devices reduce carpal tunnel pressure in patients with CTS. Carpal tunnel pressure was measured in twenty-one patients with CTS before, during and after a computer mouse task using a standard mouse, a vertical mouse, a gel mouse pad and a gliding palm support. Carpal tunnel pressure increased while operating a computer mouse. Although the vertical mouse significantly reduced ulnar deviation and the gel mouse pad and gliding palm support decreased wrist extension, none of the ergonomic devices reduced carpal tunnel pressure. The findings of this study do therefore not endorse a strong recommendation for or against any of the ergonomic devices commonly recommended for patients with CTS. Selection of ergonomic devices remains dependent on personal preference.

  5. Trophic ulcers in the carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Abelardo Q.-C. Araújo

    1993-09-01

    Full Text Available A patient with carpal tunnel syndrome (CTS and trophic ulcers is described. Despite the healing of the ulcers after surgery for CTS, the severe sensory deficit and the electrophysiological tests have not shown any significant improvement. We think these findings argue against the hypothesis of the sensory deficit being responsible for the trophic ulcers. We favor a major role for the sympathetic disturbances as the main cause for those lesions.

  6. Six-Month CTS Update Report

    Directory of Open Access Journals (Sweden)

    Dennis Bowie

    2004-01-01

    Full Text Available With this report, I hope to bring the membership up-to-date regarding the activities of the Canadian Thoracic Society (CTS during the past six to seven months. We have just had our biannual board meeting in Alberta, which was the most successful one that I have personally attended. This achievement was a result of the marked increase in the business of all the working committees and in the number of reports tabled at this meeting that chronicled the many activities taking place over the past six months.

  7. Sonographic assessment of carpal tunnel syndrome in rheumatoid arthritis: prevalence and correlation with disease activity.

    Science.gov (United States)

    Karadag, Omer; Kalyoncu, Umut; Akdogan, Ali; Karadag, Yesim Sucullu; Bilgen, Sule Apras; Ozbakır, Senay; Filippucci, Emilio; Kiraz, Sedat; Ertenli, Ihsan; Grassi, Walter; Calgüneri, Meral

    2012-08-01

    Carpal tunnel syndrome (CTS) is one of the most frequent extra-articular manifestations of rheumatoid arthritis (RA). High frequency ultrasonography (US) is a sensitive and specific method in diagnosis of CTS. This study is aimed to: firstly assess diameter frequency of CTS in RA with US and compare with a control group; secondly, investigate relationship of CTS with disease activity. One hundred consecutive RA patients (women/men: 78/22) fulfilling ACR 1987 RA criteria and 45 healthy controls (women/control: 34/11) were enrolled into study. Disease activity parameters, RA and CTS patient global assessment and health assessment questionnaire (HAQ-DI) were recorded. Both patient and control group were questioned about secondary causes of CTS, and Katz hand diagram, Boston CTS questionnaire and Phalen ve Tinel tests were applied once for each hand. Wrist joint and carpal tunnel were assessed with US grey scale and power Doppler US, then cross-sectional area of median nerve (CSA) was calculated. Patients with median nerve CSA between 10.0 and 13.0 mm(2) were evaluated with electromyography (EMG). CTS was diagnosed if CSA of median nerve >13.0 mm(2) or CTS was shown with NCS. Although there was no difference between RA patients and controls in age, sex, history of DM (+) and goitre, CTS was more frequent in RA group (respectively, 17.0% vs. 4.4%, P = 0.038). In RA group with CTS, age, history of DM, disease duration, HAQ-DI score, CTS patient global score, Boston symptom severity and functional status scores were elevated compared to without CTS [respectively, 57 (36-73) vs. 50 (24-76), P = 0.041; 35.3% vs. 6.0%, P 0.05). Sensitivity of Katz hand diagram was higher than Tinel and Phalen tests (respectively, 100, 60.0, 66.7%). Boston symptom and functional scores of RA patients with CTS diagnosed by EMG were increased than patients CTS (-) by EMG [respectively, 3.05 (1.90-4.27) vs. 1.55 (1.0-2.90), P = 0.002; 3.25 (1.73-3.82) vs. 1.12 (1.0-2.10), P = 0.008]. CTS

  8. Level-2 Milestone 5213. CTS-1 Contract Award Completed

    Energy Technology Data Exchange (ETDEWEB)

    Leininger, Matt [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-09-24

    This report documents the fact that the first commodity technology (CT) system contract award, CTS-1, has been completed. The description of the milestone is: Based on Tri-Lab CTS-1 process and review, LLNL successfully awards the procurement for the next-generation Tri-Lab Linux CTS-1. The milestone completion criterion is: Signed contract. The milestone was completed on September 24th. 2015.

  9. The US, CT and MR findings of cubital bursitis: a report of five cases

    Energy Technology Data Exchange (ETDEWEB)

    Liessi, G. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy); Cesari, S. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy); Spaliviero, B. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy); Dell`Antonio, C. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy); Avventi, P. [Servizio di Radiologia, Ospedale, I-31033 Castelfranco V.to, Ulss 8 (Tuvalu) (Italy)

    1996-07-01

    Objective. The purpose of the study was to evaluate the appearance of ``cubital bursitis`` on ultrasonography and CT and MR imaging. ``Cubital bursitis`` is a rare pathological condition involving a large swelling of the bicipito-radial or interosseous bursae located at the insertion of the distal biceps tendon on the radial tuberosity. Design and patients. We report on five patients with ``cubital bursitis`` resulting from their work or sporting activities. All patients underwent an ultrasound and MR examination. CT scans were performed on two patients before and after contrast enhancement. Results. Ultrasound studies showed a fusiform anechoic or hypoechoic lesion. CT images showed the lesions but there were some difficulties in determining the exact extent of the bursae. MR imaging showed the enlarged bursae and their fluid content. Four patients each underwent a surgical procedure. Conclusion. Ultrasound and CT were effective in the evaluation of ``cubital bursitis``, but with some diagnostic difficulties. MR imaging is probably the method of choice for determining both the development of the bursae and their fluid content. (orig.)

  10. Electrodiagnostic approach to carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Cherian Ajith

    2006-01-01

    Full Text Available An algorithm for an electrophysiological approach to carpal tunnel syndrome is proposed. This technical note takes into account the standard tests, comparison tests and needle electromyography. If the standard tests are negative, a comparison study can be done to identify cases of minimal or very mild carpal tunnel syndrome (CTS. If comparison studies are negative, CTS can be ruled out and a search for other causes have to be made. If the standard tests are positive, carpal tunnel syndrome can be divided into extreme, severe,moderate and mild cases. Motor comparison study is useful in extreme CTS cases. Needle electromyography is a must in all cases where the standard tests are positive. This streamlined approach allows accurate diagnosis with minimum essential tests.

  11. The Communications Technology Satellite /CTS/ Program

    Science.gov (United States)

    Evans, W. M.; Davies, N. G.; Hawersaat, W. H.

    1976-01-01

    The purposes of the joint Canadian-U.S. Communications Technology Satellite (CTS) Program are (1) to conduct satellite communication systems experiments using the 12- and 14-GHz bands and low-cost transportable ground terminals, (2) to develop and flight test a power amplifier tube having a greater than 50% efficiency with a saturated power output of 200 W at 12 GHz, (3) to develop and flight test a lightweight extendible solar array with an initial power output greater than 1 kW, and (4) to develop and flight test a 3-axis stabilization system to maintain accurate antenna boresight positioning on a spacecraft with flexible appendages. Brief descriptions of these experiments and of the ground facilities are provided.

  12. Effect of Elbow Position on Short-segment Nerve Conduction Study in Cubital Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Zhu Liu

    2016-01-01

    Conclusions: There was no statistically significant difference in the diagnosis of CubTS with the elbow at full extension compared with that at 70° flexion during SSNCS. We suggest that elbow positon at full extension can also be used during SSNCS.

  13. Cubital tunnel syndrome : A comparison of an endoscopic technique with a minimal invasive open technique

    NARCIS (Netherlands)

    Bolster, M. A. J.; Zophel, O. T.; van den Heuvel, E. R.; Ruettermann, M.

    2014-01-01

    Both open and endoscopic methods for ulnar nerve decompression have been described. The purpose of this study is to compare the 6-month results of a minimal invasive open technique with an endoscopic technique. We treated 60 patients with unilateral ulnar neuropathy at the elbow, employing both tech

  14. Anomalies of ulnar nerve conduction in different carpal tunnel syndrome stages.

    Science.gov (United States)

    Ginanneschi, F; Milani, P; Rossi, A

    2008-09-01

    Impairment of ulnar sensory fibers at the wrist has recently been documented in moderate/severe carpal tunnel syndrome (CTS). This has been interpreted as a consequence of compressive forces transmitted to Guyon's canal by high pressure in the carpal tunnel or comorbidity between ulnar neuropathy and CTS. The main aim of the present study was to identify any ulnar nerve conduction impairment in the early stages of CTS. The relation between ulnar and median nerve conduction in all CTS severity stages was also assessed. Ulnar nerve sensory conduction at the wrist was investigated in 580 hands with CTS. Significant changes in ulnar nerve conduction were present even in the early stages of CTS. A significant, positive correlation was also found between CTS severity and conduction abnormalities of ulnar sensory fibers. These findings make the hypothesis of comorbidity weak. Based on the above results and on reports of high pressure in Guyon's canal in CTS, ulnar nerve conduction abnormalities may be caused in part by compressive forces progressively transmitted to the canal by increasing pressure in the carpal tunnel with increasing CTS severity. This does not exclude other causative factors such as subclinical traumatic damage acting on median and ulnar fibers.

  15. Quantitative Muscle Ultrasonography in Carpal Tunnel Syndrome.

    Science.gov (United States)

    Lee, Hyewon; Jee, Sungju; Park, Soo Ho; Ahn, Seung-Chan; Im, Juneho; Sohn, Min Kyun

    2016-12-01

    To assess the reliability of quantitative muscle ultrasonography (US) in healthy subjects and to evaluate the correlation between quantitative muscle US findings and electrodiagnostic study results in patients with carpal tunnel syndrome (CTS). The clinical significance of quantitative muscle US in CTS was also assessed. Twenty patients with CTS and 20 age-matched healthy volunteers were recruited. All control and CTS subjects underwent a bilateral median and ulnar nerve conduction study (NCS) and quantitative muscle US. Transverse US images of the abductor pollicis brevis (APB) and abductor digiti minimi (ADM) were obtained to measure muscle cross-sectional area (CSA), thickness, and echo intensity (EI). EI was determined using computer-assisted, grayscale analysis. Inter-rater and intra-rater reliability for quantitative muscle US in control subjects, and differences in muscle thickness, CSA, and EI between the CTS patient and control groups were analyzed. Relationships between quantitative US parameters and electrodiagnostic study results were evaluated. Quantitative muscle US had high inter-rater and intra-rater reliability in the control group. Muscle thickness and CSA were significantly decreased, and EI was significantly increased in the APB of the CTS group (all pquantitative muscle US parameters may be useful for detecting muscle changes in CTS. Further study involving patients with other neuromuscular diseases is needed to evaluate peripheral muscle change using quantitative muscle US.

  16. Idiopathic Carpal Tunnel Syndrome: Evaluation of the Depth of the Carpal Tunnel by Ultrasonography.

    Science.gov (United States)

    Elsaman, Ahmed Mohammed Mahrous Yousif; Thabit, Mohamed Nasreldin; Radwan, Ahmed Roshdy Al-Agamy; Ohrndorf, Sarah

    2015-11-01

    The objective of the work described here was to evaluate the depth of the carpal tunnel (DCT) in patients with idiopathic carpal tunnel syndrome (CTS) and healthy volunteers by ultrasonography (US), through measurement of the distance from the flexor retinaculum to the surface of the capitate bone at the carpal tunnel outlet, and compare it with other ultrasonographic and electrophysiologic parameters in CTS. The study was conducted in 60 non-diabetic patients with idiopathic carpal tunnel syndrome (unilateral n = 37, bilateral n = 23) evidenced by electrophysiologic diagnosis according to the criteria of the American Association of Electrodiagnostic Medicine (AAEM). Furthermore, 40 hands from 20 healthy volunteers were examined. Median nerve cross-sectional area (CSA); flattening ratio (FR), the ratio of the length to the width of the median nerve; and DCT at the canal outlet were measured for all participants. The mean age was 35.6 ± 9.48 y. The female-to-male ratio was 47:13 in the CTS patients. The sensitivity and specificity were 82% and 95% for CSA, 75% and 60% for FR and 75% and 87.5% for DCT, respectively. Differences between patients and healthy controls were significant for all three parameters, greatest for DCT, followed by CSA and then FR. We conclude that DCT increased in CTS and this new parameter is comparable in sensitivity and specificity to CSA and FR. DCT increased independently of the cause of the CTS (decrease in size of canal or increase in contents).

  17. Yoga Asanas for the Relief and Prevention of Carpal Tunnel Syndrome.

    Science.gov (United States)

    Beleu, Steve

    This collection of yoga asanas (exercises) can help relieve the pain of carpal tunnel syndrome (CTS) and help prevent CTS among people who work on computer terminals. For maximum benefit, the exercises should be practiced daily or on as regular a schedule as possible. They are not intended to replace surgery or a physician's prescribed care. They…

  18. Long-term trends in carpal tunnel syndrome.

    Science.gov (United States)

    Gelfman, R; Melton, L J; Yawn, B P; Wollan, P C; Amadio, P C; Stevens, J C

    2009-01-06

    To assess temporal trends in carpal tunnel syndrome (CTS) incidence, surgical treatment, and work-related lost time. Incident CTS and first-time carpal tunnel release among Olmsted County, Minnesota, residents were identified using the medical records linkage system of the Rochester Epidemiology Project; 80% of a sample were confirmed by medical record review. Work-related CTS was identified from the Minnesota Department of Labor and Industry. Altogether, 10,069 Olmsted County residents were initially diagnosed with CTS in 1981-2005. Overall incidence (adjusted to the 2000 US population) was 491 and 258 per 100,000 person-years for women vs men (p < 0.0001) and 376 per 100,000 for both sexes combined. Adjusted annual rates increased from 258 per 100,000 in 1981-1985 to 424 in 2000-2005 (p < 0.0001). The average annual incidence of carpal tunnel release surgery was 109 per 100,000, while that for work-related CTS was 11 per 100,000. An increase in young, working-age individuals seeking medical attention for symptoms of less severe CTS in the early to mid-1980s was followed in the 1990s by an increasing incidence in elderly people. The incidence of medically diagnosed carpal tunnel syndrome (CTS) accelerated in the 1980s. The cause of the increase is unclear, but it corresponds to an epidemic of CTS cases resulting in lost work days that began in the mid-1980s and lasted through the mid-1990s. The elderly present with more severe disease and are more likely to have carpal tunnel surgery, which may have significant health policy implications given the aging population.

  19. Stochastic Analysis of Mean Interference for RTS/CTS Mechanism

    CERN Document Server

    Zhong, Yi

    2012-01-01

    The RTS/CTS handshake mechanism in WLAN is studied using stochastic geometry. The effect of RTS/CTS is treated as a thinning procedure for a spatially distributed point process that models the potential transceivers in a WLAN, and the resulting concurrent transmission processes are described. Exact formulas for the intensity of the concurrent transmission processes and the mean interference experienced by a typical receiver are established. The analysis yields useful results for understanding how the design parameters of RTS/CTS affect the network interference.

  20. ORIENTACIONES CURRICULARES CON EL ENFOQUE CTS

    Directory of Open Access Journals (Sweden)

    Miguel Corchuelo

    2010-11-01

    Full Text Available Considerando que el propósito de la educación con un enfoque CTS propende por abordar problemas contextualizados socialmente, se busca construir una propuesta desde la práctica, con el fi n de fortalecer la formación para la participación ciudadana. Encontramos que abordar el tratamiento de las relaciones entre deporte, nutrición humana y motricidad convierte al cuerpo humano en un objeto de estudio vigente. En la ciudad de Popayán (Cauca, Colombia se vive una de las más altas tasas de bulimia y anorexia en adolescentes del país, al igual que de consumo de drogas ilícitas. Además, el bajo rendimiento de los deportistas caucanos en los últimos Juegos Nacionales, los casos de dopaje en atletas olímpicos, entre otros, abre interrogantes sobre la formación integral de nuestros estudiantes. Con el fi n de acercar la escuela a estas problemáticas locales y nacionales, se asume un trabajo interdisciplinario basado en la resolución de problemas socialmente relevantes. En esta oportunidad compartiremos los resultados del camino recorrido en torno a la pregunta: “El deporte: ¿emancipación o alienación?”.

  1. Effects of carpal tunnel syndrome on dexterous manipulation are grip type-dependent.

    Science.gov (United States)

    Zhang, Wei; Johnston, Jamie A; Ross, Mark A; Sanniec, Kyle; Gleason, Elizabeth A; Dueck, Amylou C; Santello, Marco

    2013-01-01

    Carpal tunnel syndrome (CTS) impairs sensation of a subset of digits. Although the effects of CTS on manipulation performed with CTS-affected digits have been studied using precision grip tasks, the extent to which CTS affects multi-digit force coordination has only recently been studied. Whole-hand manipulation studies have shown that CTS patients retain the ability to modulate multi-digit forces to object mass, mass distribution, and texture. However, CTS results in sensorimotor deficits relative to healthy controls, including significantly larger grip force and lower ability to balance the torques generated by the digits. Here we investigated the effects of CTS on multi-digit force modulation to object weight when manipulating an object with a variable number of fingers. We hypothesized that CTS patients would be able to modulate digit forces to object weight. However, as different grip types involve the exclusive use of CTS-affected digits ('uniform' grips) or a combination of CTS-affected and non-affected digits ('mixed' grips), we addressed the question of whether 'mixed' grips would reduce or worsen CTS-induced force coordination deficits. The former scenario would be due to adding digits with intact tactile feedback, whereas the latter scenario might occur due to a potentially greater challenge for the central nervous system of integrating 'noisy' and intact tactile feedback. CTS patients learned multi-digit force modulation to object weight regardless of grip type. Although controls exerted the same total grip force across all grip types, patients exerted significantly larger grip force than controls but only for manipulations with four and five digits. Importantly, this effect was due to CTS patients' inability to change the finger force distribution when adding the ring and little fingers. These findings suggest that CTS primarily challenges sensorimotor integration processes for dexterous manipulation underlying the coordination of CTS-affected and non

  2. Effects of carpal tunnel syndrome on dexterous manipulation are grip type-dependent.

    Directory of Open Access Journals (Sweden)

    Wei Zhang

    Full Text Available Carpal tunnel syndrome (CTS impairs sensation of a subset of digits. Although the effects of CTS on manipulation performed with CTS-affected digits have been studied using precision grip tasks, the extent to which CTS affects multi-digit force coordination has only recently been studied. Whole-hand manipulation studies have shown that CTS patients retain the ability to modulate multi-digit forces to object mass, mass distribution, and texture. However, CTS results in sensorimotor deficits relative to healthy controls, including significantly larger grip force and lower ability to balance the torques generated by the digits. Here we investigated the effects of CTS on multi-digit force modulation to object weight when manipulating an object with a variable number of fingers. We hypothesized that CTS patients would be able to modulate digit forces to object weight. However, as different grip types involve the exclusive use of CTS-affected digits ('uniform' grips or a combination of CTS-affected and non-affected digits ('mixed' grips, we addressed the question of whether 'mixed' grips would reduce or worsen CTS-induced force coordination deficits. The former scenario would be due to adding digits with intact tactile feedback, whereas the latter scenario might occur due to a potentially greater challenge for the central nervous system of integrating 'noisy' and intact tactile feedback. CTS patients learned multi-digit force modulation to object weight regardless of grip type. Although controls exerted the same total grip force across all grip types, patients exerted significantly larger grip force than controls but only for manipulations with four and five digits. Importantly, this effect was due to CTS patients' inability to change the finger force distribution when adding the ring and little fingers. These findings suggest that CTS primarily challenges sensorimotor integration processes for dexterous manipulation underlying the coordination of CTS

  3. Lumbrical and interossei recording in carpal tunnel syndrome.

    Science.gov (United States)

    Preston, D C; Logigian, E L

    1992-11-01

    Median motor studies are commonly "normal" in mild carpal tunnel syndrome (CTS). This reflects either the sparing of motor compared to sensory fibers, or the inability of conventional studies to detect an abnormality. A novel approach to demonstrate early motor fiber involvement in CTS is the placement of the same active electrode lateral to the third metacarpal, allowing recording from the second lumbrical or the deeper interossei, when stimulating the median or ulnar nerves at the wrist, respectively. We compared the difference between these latencies in 51 normal control hands to 107 consecutive patient hands referred with symptoms and signs suggestive of CTS, who were subsequently proven to have electrophysiologic CTS by standard nerve conduction criteria. A prolonged lumbrical-interossei latency difference (> 0.4 ms) was found to be a sensitive indicator of CTS in all patient groups. It was also helpful in patients with coexistent polyneuropathy, where localization at the wrist was otherwise difficult.

  4. MTB-USDH Compensation Tracking System (MTB-CTS)

    Data.gov (United States)

    US Agency for International Development — MTB-USDH Compensation Tracking System: is the USDH Compensation Tracking System (MTB-CTS) to assist managers in monitoring their payroll costs for U.S. direct hires....

  5. 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.)

  6. Critical analysis of the manoeuvres proposed for the diagnosis of the tunnel carpal syndrome

    Directory of Open Access Journals (Sweden)

    T. Vangelista

    2011-09-01

    Full Text Available Carpal tunnel syndrome (CTS is the most common entrapment neuropathy. It is mainly due to the compression of median nerve at the wrist and it may be idiopathic or secondary to different rheumatic or non rheumatic diseases, including occupational activities. Since signs and symptoms of CTS are characteristic, a careful examination of the affected patient may be very satisfactory for the diagnosis, in particular by mean of some manoeuvres. In this review we described and commented the tests considered most useful in the diagnosis of CTS. We also analysed the diagnostic values of electromiography, the most important electrodiagnostic study for the CTS.

  7. Advance in Diagnosis for Carpal Tunnel Syndrome (review)%腕管综合征的诊断进展①

    Institute of Scientific and Technical Information of China (English)

    李洋; 朱向阳; 黄怀宇

    2013-01-01

    Carpal tunnel syndrome (CTS) is a common peripheral neuropathy, which include a series of symptoms results from median nerve injury. Electrical physical examination is the gold standard for diagnosis of CTS. More new technology, such as high frequency ultra-sound and magnetic resonance imaging, provides more information for the diagnosis of CTS.%  腕管综合征(CTS)是常见的周围神经病,是正中神经损伤后出现的一组临床症状。目前诊断 CTS 的金标准为电生理检查。高频超声和磁共振等影像学技术为 CTS 的诊断提供了新方法,能有效提高 CTS 诊断的敏感性和特异性。

  8. Carpal Tunnel Syndrome in ARL Libraries.

    Science.gov (United States)

    Thornton, Joyce K.

    1997-01-01

    A survey of 72 member libraries in the Association of Research Libraries revealed the incidence of carpal tunnel syndrome (CTS) and the measures taken to cope with it. Recommends implementing proactive ergonomics programs; soliciting staff input for solutions; providing report guidelines; using external help; stressing preventive measures and…

  9. Efficacy of kinesiotaping in patients with the initial signs of carpal tunnel syndrome

    OpenAIRE

    I. G. Mikhaylyuk; N. N. Spirin; E. V. Sal’nikov

    2016-01-01

    Background. Carpal tunnel syndrome (CTS) is one of the most common tunnel neuropathies. Early symptoms are often limited by periodic and slight discomfort in the area of innervation of a median nerve on the hand, so the patients are not willing to be treated invasively. Thus, a noninvasive therapy, such as kinesiotaping, could be perspective.Objective. Assessment of the efficiency of a kinesiotaping monotheraphy of patients on initial stage of CTS.Materials and methods. We included 120 patien...

  10. Practical approach to electrodiagnosis of the carpal tunnel syndrome: A review

    Directory of Open Access Journals (Sweden)

    Keivan Basiri

    2015-01-01

    Full Text Available Despite being the most common entrapment neuropathy and the most common reason for referral to the electromyography (EMG laboratory, the diagnosis of carpal tunnel syndrome (CTS continues to be challenging due to a large number of electrodiagnostic (EDX tests available. We present a flowchart and propose a practical approach to the diagnosis of CTS using the available literature and the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM guidelines and the Practice Parameter for Electrodiagnostic Studies in Carpal Tunnel Syndrome.

  11. Practical approach to electrodiagnosis of the carpal tunnel syndrome: A review.

    Science.gov (United States)

    Basiri, Keivan; Katirji, Bashar

    2015-01-01

    Despite being the most common entrapment neuropathy and the most common reason for referral to the electromyography (EMG) laboratory, the diagnosis of carpal tunnel syndrome (CTS) continues to be challenging due to a large number of electrodiagnostic (EDX) tests available. We present a flowchart and propose a practical approach to the diagnosis of CTS using the available literature and the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) guidelines and the Practice Parameter for Electrodiagnostic Studies in Carpal Tunnel Syndrome.

  12. Prevalence of Asymptomatic Neurophysiological Carpal Tunnel Syndrome in 130 Healthy Individuals

    Science.gov (United States)

    Alrawashdeh, Omar

    2016-01-01

    Diagnosis of carpal tunnel syndrome (CTS) is frequently confirmed by performing nerve conduction studies. Previous studies demonstrated that abnormal nerve conduction study (NCS) is suggestive of CTS among asymptomatic individuals. However, previous studies included individuals with risk factors for the syndrome. A NCS was performed on the median and ulnar nerves in 130 healthy individuals. About 15% of individuals in this study demonstrated electrodiagnostic evidence of carpal tunnels syndrome. Four cases have shown signs of isolated median neuropathy with normal median sensory component. Results indicated that the most widely used method for confirming diagnosis of CTS may have up to 15% of false positives. However, most of those showed changes of minimal CTS. Isolated prolongation of the median motor latency should be investigated further as they are usually classified as moderate to severe CTS and may undergo unnecessary surgeries. PMID:27994828

  13. Prevalence of asymptomatic neurophysiological carpal tunnel syndrome in 130 healthy individuals

    Directory of Open Access Journals (Sweden)

    Omar Alrawashdeh

    2016-11-01

    Full Text Available Diagnosis of carpal tunnel syndrome (CTS is frequently confirmed by performing nerve conduction studies. Previous studies demonstrated that abnormal nerve conduction study (NCS is suggestive of CTS among asymptomatic individuals. However, previous studies included individuals with risk factors for the syndrome. A NCS was performed on the median and ulnar nerves in 130 healthy individuals. About 15% of individuals in this study demonstrated electrodiagnostic evidence of carpal tunnels syndrome. Four cases have shown signs of isolated median neuropathy with normal median sensory component. Results indicated that the most widely used method for confirming diagnosis of CTS may have up to 15% of false positives. However, most of those showed changes of minimal CTS. Isolated prolongation of the median motor latency should be investigated further as they are usually classified as moderate to severe CTS and may undergo unnecessary surgeries.

  14. Lesões do nervo cubital em costureiras de calçados: abordagem medico-social

    Directory of Open Access Journals (Sweden)

    Lutero Arno Renck

    1981-12-01

    Full Text Available Foram estudadas 19 pacientes que apresentavam lesão traumática do nervo cubital. Todas eram costureiras de calçados e apoiavam o cotovelo sobre a mesa de trabalho, causando microtraumatismos ao nervo cubital. Os exames eletromiográficos revelaram lesão do neurônio motor periférico. A velocidade de condução nervosa estava diminuída em todos os casos. O tratamento constou de afastamento do serviço, uso de analgésicos, complexo B, corticóide e fisioterapia. Não havendo melhora era preconizada cirurgia, com transposição do nervo cubital. São esplanadas medidas preventivas para este acidente profissional.

  15. Increased pain sensitivity is not associated with electrodiagnostic findings in women with carpal tunnel syndrome.

    Science.gov (United States)

    de la Llave-Rincón, Ana Isabel; Fernández-de-las-Peñas, César; Laguarta-Val, Sofia; Alonso-Blanco, Cristina; Martínez-Perez, Almudena; Arendt-Nielsen, Lars; Pareja, Juan A

    2011-01-01

    To determine the differences in widespread pressure pain and thermal hypersensitivity in women with minimal, moderate, and severe carpal tunnel syndrome (CTS) and healthy controls. A total of 72 women with CTS (19 with minimal, 18 with moderate, and 35 with severe) and 19 healthy age-matched women participated. Pressure pain thresholds were bilaterally assessed over the median, ulnar, and radial nerves, the C5 to C6 zygapophyseal joint, the carpal tunnel, and the tibialis anterior muscle. In addition, warm and cold detection thresholds and heat and cold pain thresholds were bilaterally assessed over the carpal tunnel and the thenar eminence. All outcome parameters were assessed by an assessor blinded to the participant's condition. No significant differences in pain parameters among patients with minimal, moderate, and severe CTS were found. The results showed that PPT were significantly decreased bilaterally over the median, ulnar, and radial nerve trunks, the carpal tunnel, C5 to C6 zygapophyseal joint, and the tibialis anterior muscle in patients with minimal, moderate, or severe CTS as compared with healthy controls (all, P<0.001). In addition, patients with CTS also showed lower heat pain threshold and reduced cold pain threshold compared with controls (P<0.001). No significant sensory differences between minimal, moderate, or severe CTS were found. The similar widespread pressure and thermal hypersensitivity in patients with minimal, moderate, or severe CTS and pain intensity suggests that increased pain sensitivity is not related to electrodiagnostic findings.

  16. Sumatriptan does not affect arteriovenous oxygen differences in jugular and cubital veins in normal human subjects

    DEFF Research Database (Denmark)

    Wienecke, T.; Hansen, J.M.; Petersen, J.;

    2008-01-01

    Arteriovenous anastomoses (AVAs) may open up during migraine attacks. In studies with anaesthetized and bilaterally vagosympatectomized pigs, triptans reduce AVA blood flow and increase the arteriovenous O-2 difference (AVDO(2)). To investigate whether subcutaneous sumatriptan 6 mg could induce...... changes in the AVDO(2), we measured the AVDO(2) in the external jugular vein in healthy subjects. We also measured the AVDO(2) in the internal jugular and cubital veins. There were no changes in AVDO(2) after subcutaneous sumatriptan, probably because AVA blood flow is limited in humans with an intact...

  17. Association Between Carpal Tunnel Syndrome and Abdominal Obesity

    Directory of Open Access Journals (Sweden)

    Ertuğrul Uzar

    2010-12-01

    Full Text Available OBJECTIVE: Obesity has been suggested as a risk factor for carpal tunnel syndrome (CTS. Previous studies on the association of CTS and obesity have generally considered body mass index (BMI. However, the relationships between CTS and waist circumference or waist-to-hip ratio (WHR, which are known as more sensitive measures for abdominal obesity, have not been studied previously. In this study, it was aimed to evaluate the role of BMI and abdominal obesity in patients with CTS. METHODS: Female patients who applied to the neurology outpatient clinics with pain, numbness, paresthesia, or dysesthesia in the hands were included. The patients were divided into two groups, according to the clinical evaluation, as CTS or non-CTS. CTS diagnosis was electrophysiologically confirmed in 44 patients. Thirty-one subjects who were not diagnosed as CTS electrophysiologically were recruited as the control group. Clinical findings, nerve conduction studies and anthropometric measurements (height, weight, BMI, hip circumference, waist circumference and WHR of CTS patients were compared with those of the control group. RESULTS: The CTS group had significantly higher BMI, waist circumference and WHR values compared to the control group (for each parameter, p< 0.0001. The rates of obesity in the CTS group were 55.8%, 47.7% and 34.9%, respectively, according to waist circumference, BMI and WHR measurements. In the CTS group, 16% of the patients, who were defined as non-obese according to BMI, were determined as obese according to waist circumference. In the CTS group, significant positive correlations were found between BMI and WHR and median-ulnar sensory interpeak latency of the fourth digit (r= 0.26, p< 0.05; r= 0.25, p< 0.05, respectively. CONCLUSION: In this study, it was found that abdominal obesity is an important risk factor for CTS, and nerve conduction may be affected by waist circumference, BMI and WHR. In addition to general obesity, abdominal obesity may

  18. Quantitative Muscle Ultrasonography in Carpal Tunnel Syndrome

    Science.gov (United States)

    2016-01-01

    Objective To assess the reliability of quantitative muscle ultrasonography (US) in healthy subjects and to evaluate the correlation between quantitative muscle US findings and electrodiagnostic study results in patients with carpal tunnel syndrome (CTS). The clinical significance of quantitative muscle US in CTS was also assessed. Methods Twenty patients with CTS and 20 age-matched healthy volunteers were recruited. All control and CTS subjects underwent a bilateral median and ulnar nerve conduction study (NCS) and quantitative muscle US. Transverse US images of the abductor pollicis brevis (APB) and abductor digiti minimi (ADM) were obtained to measure muscle cross-sectional area (CSA), thickness, and echo intensity (EI). EI was determined using computer-assisted, grayscale analysis. Inter-rater and intra-rater reliability for quantitative muscle US in control subjects, and differences in muscle thickness, CSA, and EI between the CTS patient and control groups were analyzed. Relationships between quantitative US parameters and electrodiagnostic study results were evaluated. Results Quantitative muscle US had high inter-rater and intra-rater reliability in the control group. Muscle thickness and CSA were significantly decreased, and EI was significantly increased in the APB of the CTS group (all p<0.05). EI demonstrated a significant positive correlation with latency of the median motor and sensory NCS in CTS patients (p<0.05). Conclusion These findings suggest that quantitative muscle US parameters may be useful for detecting muscle changes in CTS. Further study involving patients with other neuromuscular diseases is needed to evaluate peripheral muscle change using quantitative muscle US. PMID:28119835

  19. 2016 Cadillac CTS-V NewCars 2016款凯迪拉克CTS-V

    Institute of Scientific and Technical Information of China (English)

    吴韧彦

    2015-01-01

    凯迪拉克推出了2016款CTS-V,这是品牌112年历史上动力最为强劲的产品。全新CTS-V搭载了一台6.2升的V8机械增压发动机,最大功率为640马力,峰值扭矩为855牛·米,极速为320公里/小时,可在3.8秒内完成百公里加速。繁多升级使CTS-V实际上是将两辆车并为一辆,它既是一辆豪华轿车,又是一辆运动赛车。

  20. Evaluation of the function status of the ulnar nerve in carpal tunnel syndrome.

    Science.gov (United States)

    Zhang, J; Liu, N; Wang, Y W; Zhang, Z C; Zheng, L N; Zhu, J

    2015-04-17

    Many carpal tunnel syndrome (CTS) patients have symptoms in both the median and ulnar digits more frequently than in the median digits alone. This is possibly because of close anatomical contiguity of the carpal tunnel and Guyon's canal, and the high pressure may also affect the latter, causing indirect compression of ulnar nerve fibers. Thus, we evaluated the functional status of the ulnar nerve in patients with CTS in order to investigate the relationship between ulnar nerve impairment and sensory symptoms of the ulnar territory. Electrophysiological studies were conducted in CTS patients and healthy controls. CTS patients were divided into the mild/moderate group and severe group; they were further divided into the symptomatic and asymptomatic subgroups according to the sensory symptom of the fifth digit region. The findings suggest that CTS patients could have coexisting ulnar nerve wrist entrapments that might exacerbate the severity of CTS. Sensory impairment in the ulnar territory was observed more frequently in the mild/moderate stage of CTS, which is associated with ulnar nerve involvement. These findings also suggest that damage to the ulnar nerve fibers caused by compression forces in Guyon's canal may underlie the ulnar spread of symptoms in CTS.

  1. Efficacy of high frequency ultrasound in postoperative evaluation of carpal tunnel syndrome treatment

    Directory of Open Access Journals (Sweden)

    Katarzyna Kapuścińska

    2016-03-01

    Full Text Available Carpal tunnel syndrome (CTS is the most common entrapment neuropathy and a frequent cause of sick leave because of work-related hand overload. The main treatment is operation. Aim: The aim of the study is to assess the usefulness of high frequency ultrasound in the postoperative evaluation of CTS treatment efficacy. Material and methods: Sixty-two patients (50 women and 12 men aged 28–70, mean age 55.2 underwent surgical treatment of CTS. Ultrasound examinations of the wrist in all carpal tunnel sufferers were performed 3 months after the procedure with the use of a high frequency broadband linear array transducer (6–18 MHz, using 18 MHz band of MyLab 70/Esaote. On the basis of the collected data, the author has performed multiple analyses to confirm the usefulness of ultrasound imaging for postoperative evaluation of CTS treatment efficacy. Results: Among all 62 patients, 3 months after surgical median nerve decompression: in 40 patients, CTS symptoms subsided completely, and sonographic evaluation did not show median nerve entrapment signs; in 9 patients, CTS symptoms persisted or exacerbated, and ultrasound proved nerve compression revealing preserved flexor retinaculum fibers; in 13 patients, scar tissue symptoms occurred, and in 5 of them CTS did not subside completely (although ultrasound showed no signs of compression. Conclusions: Ultrasound imaging with the use of a high frequency transducer is a valuable diagnostic tool for postoperative assessment of CTS treatment efficacy.

  2. A digitally implemented communications experiment utilizing the Hermes /CTS/ satellite

    Science.gov (United States)

    Jackson, H. D.; Fiala, J.

    1977-01-01

    Attention is given to an investigation being conducted by NASA-Lewis and Comsat Laboratories which uses the Hermes (CTS) satellite to explain digital link implementation and the advantages it provides over conventional analog systems. The experiment concentrates on developing several video, audio, and data digital communications techniques.

  3. Prevalence of carpal tunnel syndrome in cases with migraine and tension type headache

    Directory of Open Access Journals (Sweden)

    Volkan Solmaz

    2015-02-01

    Full Text Available Background: Carpal Tunnel Syndrome (CTS is the most frequent entrapment neuropathy; also Tension Type Headache (TTH and migraine headache are the most common forms of headaches. The aim of this study is to determine whether there is a relationship between carpal tunnel syndrome and migraine and/or TTH, and if so, to determine the factors causing this relationship. Methods: This study included 201 patients who were electro-physiologically diagnosed with idiopathic CTS and 100 controls. In addition to being examined for headaches, each patient's Body Mass Index (BMI was determined, and each was evaluated with Boston Questionnaire Form (BQF and a Beck Depression Scale (BDS. Results: The CTS group had significantly more patients with TTH and migraine headache than did the control group. In addition, the CTS group had a significantly higher frequency of headaches, and significantly higher BDS and BMI than did the controls. There were no significant differences in headache type and frequency of headache between those with mild CTS and those with mild-serious CTS. In addition, the Boston scores of CTS patients with headache were higher than those CTS patients without headache. Further, the monthly income levels of patients with CTS were lower than those of the control group. Conclusion: We found that primary headache is more frequent in CTS patients than in controls. This may be due to somato-autonomic reflexes and other common risk factors that can be seen in both CTS patients and those with headache, including obesity, depression and low level of income. [Int J Res Med Sci 2015; 3(2.000: 456-460

  4. Sensitivities of conventional and new electrophysiological techniques in carpal tunnel syndrome and their relationship to body mass index

    Directory of Open Access Journals (Sweden)

    Kuyucu Mutlu

    2009-07-01

    Full Text Available Abstract The purpose of this study is to evaluate prospectively the sensitivities of conventional and new electrophysiological techniques and to investigate their relationship with the body mass index (BMI in a population of patients suspected of having carpal tunnel syndrome (CTS. In this study, 165 hands of 92 consecutive patients (81 female, 11 male with clinical diagnosis of CTS were compared to reference population of 60 hands of 30 healthy subjects (26 female and 4 male. Extensive sensory and motor nerve conduction studies (NCSs were performed in the diagnosis of subtle CTS patients. Also, the patients were divided into subgroups and sensitivities were determined according to BMI. The mean BMI was found to be significantly higher in the CTS than in the control group (p The newer nerve conduction techniques and combining different NCSs tests are more sensitive than single conventional NCS test for the diagnosis of suspected CTS. Meanwhile, CTS is associated with increasing BMI.

  5. The prevalence and severity of carpal tunnel syndrome during pregnancy

    Directory of Open Access Journals (Sweden)

    Saeid Khosrawi

    2012-01-01

    Full Text Available Background: Carpal tunnel syndrome (CTS is the most common compression neuropathy of median nerve, which can occur or aggravate during pregnancy and sometimes needs surgery. Since early diagnosis leads to simpler and less risky treatments, this study evaluated the frequency and severity of CTS in pregnancy. Materials and Methods: In this descriptive cross-sectional study, 100 pregnant women who came to gynecology clinic of university hospitals were randomly selected. At first, they were asked for presence of clinical symptoms, and then clinical tests including Phalen and Tinel were conducted to diagnose CTS. Then, electrodiagnostic studies including sensory and motor distal latencies of median nerve were measured and compared with those of ulnar nerve, and then, nerve conduction velocity of median nerve across wrist was evaluated. Results: Among the studied pregnant women, 19% had CTS, out of whom 47.5% were bilateral and 26.3% had severe CTS. The prevalence in the first, second, and third trimesters were 11%, 26%, and 63%, respectively, and 42% were asymptomatic. Sensitivity and specificity of clinical signs as compared with electrodiagnostic findings were 52% and 23%, respectively. Conclusions: The prevalence of CTS is relatively high in pregnant women. The prevalence and severity of CTS increase and the rate of asymptomatic cases reduces with the age of pregnancy. Clinical examination and history taking could not diagnose all cases, and their sensitivity and specificity are much less than electrodiagnostic tests. Therefore, it is recommended that electrodiagnostic studies be conducted in pregnant women during the third trimester.

  6. Pyridoxine metabolism in carpal tunnel syndrome with and without peripheral neuropathy.

    Science.gov (United States)

    Byers, C M; DeLisa, J A; Frankel, D L; Kraft, G H

    1984-11-01

    The role of insufficient pyridoxine as an etiologic factor in the development of carpal tunnel syndrome (CTS) has been reported and has led to the empirical use of pyridoxine to treat CTS. Previous studies have not employed standardized electrodiagnostic criteria to objectively determine the presence of CTS or to rule out peripheral neuropathy (PN). The present study categorized subjects with symptoms suggestive of CTS into four groups by standardized electrodiagnostic criteria: (1) CTS, (2) PN, (3) CTS and PN, (4) normal. At least seven subjects were in each group. Erythrocyte glutamine oxaloacetic acid transaminase (EGOT) activity with and without in vitro enhancement with pyridoxal phosphate was used as a means of identifying subjects with and without pyridoxine metabolic abnormalities. A significant difference in pyridoxine metabolic activity (PMA) was found between groups by both chi square (p less than 0.05) and analysis of variance (p less than 0.05). Further evaluation showed that this difference was associated with the presence or absence of PN (p less than 0.05). There was no difference in PMA when groups were separated on the basis of CTS. Results showed that a PMA abnormality was a factor highly correlated with the presence of PN but not CTS. This finding suggested that the positive response reported previously in subjects with CTS taking supplemental pyridoxine may actually be related to an unrecognized PN, which was compounding the symptomatology.

  7. 78 FR 69131 - Importer of Controlled Substances; Notice of Registration; Catalent CTS, LLC

    Science.gov (United States)

    2013-11-18

    ... Enforcement Administration Importer of Controlled Substances; Notice of Registration; Catalent CTS, LLC By..., Catalent CTS, LLC., 10245 Hickman Mills Drive, Kansas City, Missouri 64137, made application to the Drug...) and 952(a) and determined that the registration of Catalent CTS, LLC., to import the basic classes...

  8. 78 FR 39338 - Importer of Controlled Substances; Notice of Registration; Catalent CTS., Inc.

    Science.gov (United States)

    2013-07-01

    ...; Notice of Registration; Catalent CTS., Inc. By Notice dated April 10, 2013, and published in the Federal Register on April 19, 2013, 78 FR 23594, Catalent CTS., Inc., 10245 Hickman Mills Drive, Kansas City... U.S.C. 823(a) and 952(a) and determined that the registration of Catalent CTS., Inc., to import...

  9. Ulnar nerve entrapment in Guyon's canal due to recurrent carpal tunnel syndrome: case report.

    Science.gov (United States)

    Ozdemir, Ozgur; Calisaneller, Tarkan; Gulsen, Salih; Caner, Hakan

    2011-01-01

    Guyon's canal syndrome is a compression neuropathy of the ulnar nerve entrapment at the wrist. Compression of the ulnar nerve at the wrist by a ganglion, lipomas, diseases of the ulnar artery, fractures of the hamate and trauma are common etiologcal factors. Unlike Guyon's canal syndrome, carpal tunnel syndrome (CTS) is the most common nerve entrapment of the upper extremity. Although, open (OCTR) or endoscopic carpal tunnel release (ECTR) is highly effective in relieving pain, failure with carpal tunnel release is seldom seen. In this paper, we presented a patient with ulnar nerve entrapment associated with recurrent CTS and discussed the possible pathomechanism with a review of current literature.

  10. Supracubital perineurioma misdiagnosed as carpal tunnel syndrome: case report

    Directory of Open Access Journals (Sweden)

    Schols Ludger

    2004-11-01

    Full Text Available Abstract Background Perineuriomas have been defined as tumorous lesions of the peripheral nerves which derive from perineurial cell proliferation and may be associated with abnormalities on chromosome 22. Case presentation Three years after a painful cubital vein procaine injection, a 33 year-old man developed a median nerve lesion, initially diagnosed as carpal tunnel syndrome. Symptoms progressed despite appropriate surgery. Clinical and electrophysiological re-evaluation revealed a fusiform mass at the distal upper arm, confirmed by MRI. Immunohistochemical studies classified the tumor as a mixed perineurioma and neuroma. Conclusions Perineurioma mixed with neuroma may potentially caused by the previous trauma or cytotoxic effects of procaine.

  11. Description, reliability and validity of a novel method to measure carpal tunnel pressure in patients with carpal tunnel syndrome.

    Science.gov (United States)

    Coppieters, Michel W; Schmid, Annina B; Kubler, Paul A; Hodges, Paul W

    2012-12-01

    Elevated carpal tunnel pressure is an important pathomechanism in carpal tunnel syndrome (CTS). Several invasive methods have been described for direct measurement of carpal tunnel pressure, but all have two important limitations. The pressure gauge requires sterilisation between uses, which makes time-efficient data collection logistically cumbersome, and more importantly, the reliability of carpal tunnel pressure measurements has not been evaluated for any of the methods in use. This technical note describes a new method to measure carpal tunnel pressure using inexpensive, disposable pressure sensors and reports the within and between session reliability of the pressure recordings in five different wrist positions and during typing and computer mouse operation. Intraclass correlation coefficients (ICC[3,1]) were calculated for recordings within one session for healthy participants (n = 7) and patients with CTS (n = 5), and for recordings between two sessions for patients with CTS (n = 5). Overall, the reliability was high. With the exception of two coefficients, the reliability of the recordings at different wrist angles varied from 0.63 to 0.99. Reliability for typing and mouse operation ranged from 0.86 to 0.99. The new method described in this report is inexpensive and reliable, and data collection can be applied more efficiently as off-site sterilisation of equipment is not required. These advances are likely to promote future research into carpal tunnel pressure, such as investigation of the therapeutic mechanisms of various conservative treatment modalities that are believed to reduce elevated carpal tunnel pressure.

  12. CTS TEP thermal anomalies: Heat pipe system performance

    Science.gov (United States)

    Marcus, B. D.

    1977-01-01

    A part of the investigation is summarized of the thermal anomalies of the transmitter experiment package (TEP) on the Communications Technology Satellite (CTS) which were observed on four occasions in 1977. Specifically, the possible failure modes of the variable conductance heat pipe system (VCHPS) used for principal thermal control of the high-power traveling wave tube in the TEP are considered. Further, the investigation examines how those malfunctions may have given rise to the TEP thermal anomalies. Using CTS flight data information, ground test results, analysis conclusions, and other relevant information, the investigation concentrated on artery depriming as the most likely VCHPS failure mode. Included in the study as possible depriming mechanisms were freezing of the working fluid, Marangoni flow, and gas evolution within the arteries. The report concludes that while depriming of the heat pipe arteries is consistent with the bulk of the observed data, the factors which cause the arteries to deprime have yet to be identified.

  13. A digitally implemented communications experiment utilizing the Hermes (CTS) satellite

    Science.gov (United States)

    Jackson, H. D.; Fiala, J. L.

    1977-01-01

    The Hermes (CTS) experiment program made possible a significant effort directed toward new developments which will reduce the costs associated with the distribution of satellite services. Advanced satellite transponder technology and small inexpensive earth terminals were demonstrated as part of the Hermes program. Another system element that holds promise for reduced transmission cost is associated with the communication link implementation. An experiment is described which uses CTS to demonstrate digital link implementation and its advantages over conventional analog systems. A Digitally Implemented Communications experiment which demonstrates the flexibility and efficiency of digital transmission of television video and audio, telephone voice and high-bit-rate data is also described. Presentation of the experiment concept which concentrates on the evaluation of full-duplex digital television in the teleconferencing environment is followed by a description of unique equipment that was developed.

  14. Multidimensional ultrasound imaging of the wrist: Changes of shape and displacement of the median nerve and tendons in carpal tunnel syndrome

    NARCIS (Netherlands)

    A. Filius (Anika); M. Scheltens-De Boer (Marjan); H.G. Bosch (Hans); P.A. van Doorn (Pieter); H.J. Stam (Henk); S.E.R. Hovius (Steven); P.C. Amadio (Peter ); R.W. Selles (Ruud)

    2015-01-01

    textabstractDynamics of structures within the carpal tunnel may alter in carpal tunnel syndrome (CTS) due to fibrotic changes and increased carpal tunnel pressure. Ultrasound can visualize these potential changes, making ultrasound potentially an accurate diagnostic tool. To study this, we imaged th

  15. Caso clínico: tratamiento quirúrgico de la neuropatía cubital por pseudoartrosis del gancho del hueso ganchoso

    Directory of Open Access Journals (Sweden)

    A. León Garrigosa

    2017-03-01

    Conclusiones: El dolor en el margen cubital de la mano, con tenosinovitis flexora de los tendones del cuarto y quinto dedos y/o manifestaciones de neuropatía cubital distal, cuando se produce en pacientes que practican deporte de empuñadura, obliga a realizar tomografía axial computerizada, y, si hay pseudoartrosis del gancho del hueso ganchoso, intentar su osteosíntesis.

  16. High power 303 GHz gyrotron for CTS in LHD

    Science.gov (United States)

    Yamaguchi, Y.; Kasa, J.; Saito, T.; Tatematsu, Y.; Kotera, M.; Kubo, S.; Shimozuma, T.; Tanaka, K.; Nishiura, M.

    2015-10-01

    A high-power pulsed gyrotron is under development for 300 GHz-band collective Thomson scattering (CTS) diagnostics in the Large Helical Device (LHD). High-density plasmas in the LHD require a probe wave with power exceeding 100 kW in the sub-terahertz region to obtain sufficient signal intensity and large scattering angles. At the same time, the frequency bandwidth should be less than several tens of megahertz to protect the CTS receiver using a notch filter against stray radiations. Moreover, duty cycles of ~ 10% are desired for the time domain analysis of the CTS spectrum. At present, a 77 GHz gyrotron for electron cyclotron heating is used as a CTS wave source in the LHD. However, the use of such a low-frequency wave suffers from refraction, cutoff and absorption at the electron cyclotron resonance layer. Additionally, the signal detection is severely affected by background noise from electron cyclotron emission. To resolve those problems, high-power gyrotrons in the 300 GHz range have been developed. In this frequency range, avoiding mode competition is critical to realizing high-power and stable oscillation. A moderately over-moded cavity was investigated to isolate a desired mode from neighbouring modes. After successful tests with a prototype tube, the practical one was constructed with a cavity for TE22,2 operation mode, a triode electron gun forming intense laminar electron beams, and an internal mode convertor. We have experimentally confirmed single mode oscillation of the TE22,2 mode at the frequency of 303.3 GHz. The spectrum peak is sufficiently narrow. The output power of 290 kW has been obtained at the moment.

  17. The CTS 11.7 GHz angle of arrival experiment

    Science.gov (United States)

    Kwan, B. W.; Hodge, D. B.

    1981-01-01

    The objective of the experiment was to determine the statistical behavior of attenuation and angle of arrival on an Earth-space propagation path using the CTS 11.7 GHz beacon. Measurements performed from 1976 to 1978 form the data base for analysis. The statistics of the signal attenuation and phase variations due to atmospheric disturbances are presented. Rainfall rate distributions are also included to provide a link between the above effects on wave propagation and meteorological conditions.

  18. Ulnar sensory nerve impairment at the wrist in carpal tunnel syndrome.

    Science.gov (United States)

    Ginanneschi, Federica; Milani, Paolo; Mondelli, Mauro; Dominici, Federica; Biasella, Alessia; Biasella, Alessio; Rossi, Alessandro

    2008-02-01

    In previous studies, changes in impulse transmission of ulnar motor axons have been documented in patients with carpal tunnel syndrome (CTS). We examined ulnar sensory conduction in 144 CTS hands. In particular, conduction parameters of the dorsal ulnar cutaneous branch (DUC) running outside Guyon's canal were compared with those of the superficial sensory branches (U4 and U5) passing through the canal. U4 and U5 response amplitudes and U5 conduction velocity were significantly lower than in controls. Conduction parameters of the DUC were similar in both groups. Patients with more severely impaired median conduction had smaller ulnar sensory action potentials. We propose that the ulnar nerve may be subject to compression in Guyon's canal as a consequence of high pressure in the carpal tunnel of CTS patients. This may provide insights into the mechanisms underlying extra-median spread of sensory symptoms in CTS patients.

  19. Diagnostic properties of nerve conduction tests in population-based carpal tunnel syndrome

    OpenAIRE

    2003-01-01

    Abstract Background Numerous nerve conduction tests are used for the electrodiagnosis of carpal tunnel syndrome (CTS), with a wide range of sensitivity and specificity reported for each test in clinical studies. The tests have not been assessed in population-based studies. Such information would be important when using electrodiagnosis in epidemiologic research. The purpose of this study was to compare the diagnostic accuracy of various nerve conduction tests in population-based CTS and deter...

  20. Catecholamines in plasma from artery, cubital vein, and femoral vein in patients with cirrhosis. Significance of sampling site

    DEFF Research Database (Denmark)

    Henriksen, J H; Ring-Larsen, H; Christensen, N J

    1986-01-01

    The concentration of noradrenaline (NA) and adrenaline (A) was measured in arterial, cubital venous and femoral venous plasma in order to determine possible differences in different vascular beds in the peripheral circulation. In patients with cirrhosis, arterial plasma NA (median 2.54 nmol/l, n ...... the skin of forearm and hand). To assess circulating levels of catecholamines, the importance of arterial sampling is stressed as peripheral venous samples may also reflect local factors....

  1. Relationship of age, body mass index, wrist and waist circumferences to carpal tunnel syndrome severity.

    Science.gov (United States)

    Komurcu, Hatice Ferhan; Kilic, Selim; Anlar, Omer

    2014-01-01

    Carpal tunnel syndrome (CTS) has a multifactorial etiology involving systemic, anatomical, idiopathic, and ergonomic characteristics. In this study, an investigation of the relationship between the CTS degree established by electrophysiological measurements in patients with clinical CTS prediagnosis, and age, gender, body mass index (BMI), hand wrist circumference, and waist circumference measurements has been done. On 547 patients included in the study, motor and sensory conduction examinations of the median and ulnar nerve were done on one or two upper extremities thought to have CTS. In terms of CTS severity, the patients were divided into four groups (normal, mild, medium, and severe CTS). A total of 843 electrophysiological examinations were done consisting of 424 on the right hand wrist and 419 on the left hand wrist. When the age group of 18-35 years is taken as the reference group, the CTS development risk independent of BMI has been found to have increased by a factor of 1.86 for ages 36-64 years, and by 4.17 for ages 65 years and higher after adjustment for BMI. With respect to normal degree CTS group, the BMI were significantly different in groups with mild, medium, and severe CTS. The waist circumferences of groups with mild, medium, and severe CTS severity were found to be significantly higher in comparison to the normal reference group. When this value was corrected with BMI and re-examined the statistically significant differences persisted. The study identified a significant relationship between the CTS severity and age, BMI, waist circumference.

  2. [Etiological factors for developing carpal tunnel syndrome in people who work with computers].

    Science.gov (United States)

    Lewańska, Magdalena; Wagrowska-Koski, Ewa; Walusiak-Skorupa, Jolanta

    2013-01-01

    Carpal tunnel syndrome (CTS) is the most frequent mononeuropathy of upper extremities. From the early 1990's it has been suggested that intensive work with computers can result in CTS development, however, this relationship has not as yet been proved. The aim of the study was to evaluate occupational and non-occupational risk factors for developing CTS in the population of computer-users. The study group comprised 60 patients (58 women and 2 men; mean age: 53.8 +/- 6.35 years) working with computers and suspected of occupational CTS. A survey as well as both median and ulnar nerve conduction examination (NCS) were performed in all the subjects. The patients worked with use of computer for 6.43 +/- 1.71 h per day. The mean latency between the beginning of employment and the occurrence of first CTS symptoms was 12.09 +/- 5.94 years. All patients met the clinical and electrophysiological diagnostic criteria of CTS. In the majority of patients etiological factors for developing CTS were non-occupational: obesity, hypothyroidism, oophorectomy, past hysterectomy, hormonal replacement therapy or oral contraceptives, recent menopause, diabetes, tendovaginitis. In 7 computer-users etiological factors were not identified. The results of our study show that CTS is usually generated by different causes not related with using computers at work.

  3. Etiological factors for developing carpal tunnel syndrome in people who work with computers

    Directory of Open Access Journals (Sweden)

    Magdalena Lewańska

    2013-02-01

    Full Text Available Background: Carpal tunnel syndrome (CTS is the most frequent mononeuropathy of upper extremities. From the early 1990's it has been suggested that intensive work with computers can result in CTS development, however, this relationship has not as yet been proved. The aim of the study was to evaluate occupational and non-occupational risk factors for developing CTS in the population of computer-users. Material and Methods: The study group comprised 60 patients (58 women and 2 men; mean age: 53.8±6.35 years working with computers and suspected of occupational CTS. A survey as well as both median and ulnar nerve conduction examination (NCS were performed in all the subjects. Results: The patients worked with use of computer for 6.43±1.71h per day. The mean latency between the beginning of employment and the occurrence of first CTS symptoms was 12.09±5.94 years. All patients met the clinical and electrophysiological diagnostic criteria of CTS. In the majority of patients etiological factors for developing CTS were non-occupational: obesity, hypothyroidism, oophorectomy, past hysterectomy, hormonal replacement therapy or oral contraceptives, recent menopause, diabetes, tendovaginitis. In 7 computer-users etiological factors were not identified. Conclusion: The results of our study show that CTS is usually generated by different causes not related with using computers at work. Med Pr 2013;64(1:37–45

  4. Ultrasound features of carpal tunnel syndrome: a prospective case-control study

    Energy Technology Data Exchange (ETDEWEB)

    Sernik, Renato A.; Abicalaf, Claudia A.; Cerri, Giovanni G. [University of Sao Paulo, Department of Radiology, Sao Paulo (Brazil); Pimentel, Benedito F. [University of Taubate, Department of Orthopedics, Sao Paulo (Brazil); Braga-Baiak, Andresa [University of Sao Paulo, Post Graduation Program, Department of Radiology, Sao Paulo (Brazil); Braga, Larissa [University of Nebraska Medical Center, Omaha, NE (United States)

    2008-01-15

    The purpose of the study was to examine the most adequate cut-off point for median nerve cross-sectional area and additional ultrasound features supporting the diagnosis of carpal tunnel syndrome (CTS). Forty wrists from 31 CTS patients and 63 wrists from 37 asymptomatic volunteers were evaluated by ultrasound. All patients were women. The mean age was 49.1 years (range: 29-78) in the symptomatic and 45.1 years (range 24-82) in the asymptomatic group. Median nerve cross-sectional area was obtained using direct (DT) and indirect (IT) techniques. Median nerve echogenicity, mobility, flexor retinaculum measurement and the anteroposterior (AP) carpal tunnel distance were assessed. This study was IRB-approved and all patients gave informed consent prior to examination. In CTS the median nerve cross-sectional area was increased compared with the control group. Median nerve cross-sectional area of 10 mm{sup 2} (DT) and 9 mm{sup 2} (IT) had high sensitivity (85% and 88.5%, respectively), specificity (92.1% and 82.5%) and accuracy (89.3% and 82.5%) in the diagnosis of CTS. CTS patients had an increased carpal tunnel AP diameter, flexor retinaculum thickening, reduced median nerve mobility and decreased median nerve echogenicity. Ultrasound assists in the diagnosis of CTS using the median nerve diameter cut-off point of 10 mm{sup 2} (DT) and 9 mm{sup 2} (IT) and several additional findings. (orig.)

  5. Invited commentary on: Flexor retinaculum division: does it contribute to the success of carpal tunnel release of Krieger Y et al. International J of Ther and Rehab, March 2011, Vol. 18, no.3, p.139-42

    NARCIS (Netherlands)

    Huisstede, Bionka; Hoogvliet, Peter

    2011-01-01

    Aims: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Open decompression of the median nerve is considered the standard surgical treatment for CTS. This article describes a study to assess and compare the clinical efficacy of operative treatment performed by transverse carpal

  6. Optimal management of carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Shimpei Ono

    2010-08-01

    Full Text Available Shimpei Ono, Philip J Clapham, Kevin C ChungSection of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USAAbstract: In order to improve health care efficiency and effectiveness, treatments should provide disease improvement or resolution at a reasonable cost. The American Academy of Orthopedic Surgeons (AAOS published a guideline for treatment of carpal tunnel syndrome (CTS in 2009 based on review of the literature up to April 6, 2007. We have now reviewed the material published since then. Through reviewing evidence-based articles published during this period, this paper examines the current options and trends for treating CTS. We performed a systematic review of the randomized controlled trials, meta-analyses, systematic reviews, and practice guidelines to present the outcomes of current treatments for this disease. Twenty-five studies met our inclusion criteria. Thirteen randomized, controlled trials and 12 systematic reviews, including three Cochrane database systematic reviews, were retrieved. Our review revealed that most of the recent studies support the AAOS guideline. However, the recent literature demonstrates a trend towards recommending early surgery for CTS cases with or without median nerve denervation, although the AAOS guideline recommends early surgical treatment only for cases with denervation. The usefulness of splinting and steroids as initial treatments for improving patients’ symptoms are also supported by the recent literature, but these effects are temporary. The evidence level for ultrasound treatment is still low, and further studies are needed to determine the effectiveness of this treatment. Finally, our review revealed a paucity of articles comparing the costs of CTS diagnosis and treatment. With the recent focus on health care reform and rising costs, attention to the direct and indirect costs of health care is important for all conditions. Future well designed studies

  7. Primary somatosensory/motor cortical thickness distinguishes paresthesia-dominant from pain-dominant carpal tunnel syndrome.

    Science.gov (United States)

    Maeda, Yumi; Kettner, Norman; Kim, Jieun; Kim, Hyungjun; Cina, Stephen; Malatesta, Cristina; Gerber, Jessica; McManus, Claire; Libby, Alexandra; Mezzacappa, Pia; Mawla, Ishtiaq; Morse, Leslie R; Audette, Joseph; Napadow, Vitaly

    2016-05-01

    Paresthesia-dominant and pain-dominant subgroups have been noted in carpal tunnel syndrome (CTS), a peripheral neuropathic disorder characterized by altered primary somatosensory/motor (S1/M1) physiology. We aimed to investigate whether brain morphometry dissociates these subgroups. Subjects with CTS were evaluated with nerve conduction studies, whereas symptom severity ratings were used to allocate subjects into paresthesia-dominant (CTS-paresthesia), pain-dominant (CTS-pain), and pain/paresthesia nondominant (not included in further analysis) subgroups. Structural brain magnetic resonance imaging data were acquired at 3T using a multiecho MPRAGE T1-weighted pulse sequence, and gray matter cortical thickness was calculated across the entire brain using validated, automated methods. CTS-paresthesia subjects demonstrated reduced median sensory nerve conduction velocity (P = 0.05) compared with CTS-pain subjects. In addition, cortical thickness in precentral and postcentral gyri (S1/M1 hand area) contralateral to the more affected hand was significantly reduced in CTS-paresthesia subgroup compared with CTS-pain subgroup. Moreover, in CTS-paresthesia subjects, precentral cortical thickness was negatively correlated with paresthesia severity (r(34) = -0.40, P = 0.016) and positively correlated with median nerve sensory velocity (r(36) = 0.51, P = 0.001), but not with pain severity. Conversely, in CTS-pain subjects, contralesional S1 (r(9) = 0.62, P = 0.042) and M1 (r(9) = 0.61, P = 0.046) cortical thickness were correlated with pain severity, but not median nerve velocity or paresthesia severity. This double dissociation in somatotopically specific S1/M1 areas suggests a neuroanatomical substrate for symptom-based CTS subgroups. Such fine-grained subgrouping of CTS may lead to improved personalized therapeutic approaches, based on superior characterization of the linkage between peripheral and central neuroplasticity.

  8. CADILLAC CTS COUPE “美臀”诱惑

    Institute of Scientific and Technical Information of China (English)

    白帆

    2011-01-01

    如果说线条让凯迪拉克CTS更多地表现出的是硬朗,那么CTS COUPE则无疑为它注入了相当多的性感因子。没错,这个拥有着一个万分迷人"臀部"的轿跑车,已经通过性感的硬朗而逐渐表现出超越普通版CTS的势头。

  9. Preliminary Calculations of Shutdown Dose Rate for the CTS Diagnostics System

    DEFF Research Database (Denmark)

    Klinkby, Esben Bryndt; Nonbøl, Erik; Lauritzen, Bent

    2015-01-01

    DTU and IST 2 are partners in the design of a collective Thomson Scattering (CTS) diagnostics for ITER through a contract with F4E. The CTS diagnostic utilizes probing radiation of ~60 GHz emitted into the plasma and, using a mirror, collects the scattered radiation by an array of receivers. Having...... a direct and unshielded view to the plasma, the first mirror will be subject to significant radiation and among the first tasks in the CTS design, is to determine whether the mirror will need active cooling. At present the CTS is in the conceptual design phase and the related neutronics calculations focus...

  10. An evaluation of radial and ulnar artery flow characteristics in diabetic patients with carpal tunnel syndrome and the diagnostic value of ultrasonography in these patients

    Directory of Open Access Journals (Sweden)

    Ahmet Boyacı

    2014-06-01

    Full Text Available Objectives: This study aimed to research the value of ultrasonography in the diagnosis of carpal tunnel syndrome (CTS in patients with diabetes mellitus (DM and to examine the flow characteristics of the radial and ulnar arteries in diabetic patients with CTS. Methods: A total of 23 diabetic hands diagnosed with CTS from electrophysiological evaluation (DM-CTS, 47 asymptomatic diabetic hands (DM and 50 healthy hands (C as the control group were evaluated with high resolution ultrasonography. The median nerve was measured in the cross-sectional area (CSA, flattening ratio (FR and at the level of the carpal tunnel inlet [proximal (p] and the wrist crease [distal (d]. The radial and ulnar arteries were evaluated with both hands in a neutral position. Results: In the DM-CTS group, the CSA-p and CSA-d values were statistically signficantly greater compared to the DM and C groups (p0.05. The radial artery diameter was determined to be statistically significantly greater in the DM-CTS group than the C group (p<0.05. Conclusion: The median nerve CSA is significantly greater in diabetic CTS patients compared to patients with diabetes only and healthy controls. In the evaluation of CTS in diabetic patients, CSA measured with ultrasonography may be a diagnostic tool. J Clin Exp Invest 2014; 5 (2: 179-185

  11. Levels of endocrine hormones and lipids in male patients with carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Hülya Uzkeser

    2011-12-01

    Full Text Available Objectives: This study was performed to evaluate the relationship between endocrine hormones, lipid levels and clinical parameters in male patients with carpal tunnel syndrome (CTS.Materials and methods: Fifteen male patients with CTS and 16 healthy controls were included in the study. Serum free T3, free T4, thyroid-stimulating hormone (TSH, free testosterone, dehydroepiandrosterone sulfate, triglyceride and total cholesterol levels were analyzed. Symptom severity and hand function were assessed using the Boston Carpal Tunnel Questionnaire in clinical examination.Results: Serum free T3, free T4, TSH, free testosterone, dehydroepiandrosterone sulfate, triglyceride and total cholesterol levels were similar between CTS patients and controls (p> 0.05. Also, there was no statistically significant correlation between laboratory parameters and clinical characteristics in patients with CTS (p> 0.05.Conclusion: The serum free T3, free T4, TSH, free testosterone, dehydroepiandrosterone sulfate, triglyceride and total cholesterol levels seem within normal range in male CTS patients. Further studies are needed to investigate association endocrine factors, lipid levels such as triglyceride and total cholesterol with CTS in male and female patients.

  12. Efficacy of kinesiotaping in patients with the initial signs of carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    I. G. Mikhaylyuk

    2016-01-01

    Full Text Available Background. Carpal tunnel syndrome (CTS is one of the most common tunnel neuropathies. Early symptoms are often limited by periodic and slight discomfort in the area of innervation of a median nerve on the hand, so the patients are not willing to be treated invasively. Thus, a noninvasive therapy, such as kinesiotaping, could be perspective.Objective. Assessment of the efficiency of a kinesiotaping monotheraphy of patients on initial stage of CTS.Materials and methods. We included 120 patients with the initial stage of CTS: 51 men and 69 women aged from 24 till 54 years old. The main group included 70 people, and the control group – 50 patients. The main group was treated within 2 months by kinesiotaping only, control group was observed without any therapeutic intervention.Results. 60 % of the patients from the main group reported beneficial effect of kinesiotaping on clinical symptoms of the CTS.Conclusions. Kinesiotaping monotherapy at initial stages of CTS in our cohort relieves subjective symptoms in the majority of patients. To recommend kinesiotaping as an effective and safe method on initial stages of CTS to patients unwilling to undergo standard invasive treatment methods, a larger multicenter study is needed.

  13. Pyridoxine hydrochloride treatment of carpal tunnel syndrome: a review.

    Science.gov (United States)

    Aufiero, Elaine; Stitik, Todd P; Foye, Patrick M; Chen, Boqing

    2004-03-01

    It has been hypothesized that idiopathic carpal tunnel syndrome (CTS) is a manifestation of vitamin B6 deficiency. Some claim that B6 supplementation can alleviate symptoms. Others argue that pain relief occurs because of vitamin B6's anti-nociceptive properties or because B6 supplementation addresses an unrecognized peripheral neuropathy. Few studies on CTS and B6 employed electrodiagnostic techniques in diagnosis, and few showed a correlation between symptoms and improved electrodiagnostic parameters with supplementation. Other studies failed to measure or estimate B6 levels. Nevertheless, it appears reasonable to recommend vitamin B6 supplementation to people with CTS. Some patients will improve symptomatically with low risks of toxicity in recommended doses.

  14. 78 FR 23594 - Importer of Controlled Substances; Notice of Application; Catalent CTS., Inc.

    Science.gov (United States)

    2013-04-19

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF JUSTICE Drug Enforcement Administration Importer of Controlled Substances; Notice of Application; Catalent CTS., Inc..., Catalent Cts., Inc., 10245 Hickman Mills Drive, Kansas City, Missouri 64137, made application by renewal...

  15. 78 FR 52800 - Importer of Controlled Substances; Notice of Application; Catalent CTS., LLC.

    Science.gov (United States)

    2013-08-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF JUSTICE Drug Enforcement Administration Importer of Controlled Substances; Notice of Application; Catalent CTS., LLC..., Catalent CTS., LLC., 10245 Hickman Mills Drive, Kansas City, Missouri 64137, made application to the...

  16. Positional cloning of a gene responsible for the cts mutation of the silkworm, Bombyx mori.

    Science.gov (United States)

    Ito, Katsuhiko; Kidokoro, Kurako; Katsuma, Susumu; Shimada, Toru; Yamamoto, Kimiko; Mita, Kazuei; Kadono-Okuda, Keiko

    2012-07-01

    The larval head cuticle and anal plates of the silkworm mutant cheek and tail spot (cts) have chocolate-colored spots, unlike the entirely white appearance of the wild-type (WT) strain. We report the identification and characterization of the gene responsible for the cts mutation. Positional cloning revealed a cts candidate on chromosome 16, designated BmMFS, based on the high similarity of the deduced amino acid sequence between the candidate gene from the WT strain and the major facilitator superfamily (MFS) protein. BmMFS likely encodes a membrane protein with 11 putative transmembrane domains, while the putative structure deduced from the cts-type allele possesses only 10-pass transmembrane domains owing to a deletion in its coding region. Quantitative RT-PCR analysis showed that BmMFS mRNA was strongly expressed in the integument of the head and tail, where the cts phenotype is observed; expression markedly increased at the molting and newly ecdysed stages. These results indicate that the novel BmMFS gene is cts and the membrane structure of its protein accounts for the cts phenotype. These expression profiles and the cts phenotype are quite similar to those of melanin-related genes, such as Bmyellow-e and Bm-iAANAT, suggesting that BmMFS is involved in the melanin synthesis pathway.

  17. Tomography of fast-ion velocity-space distributions from synthetic CTS and FIDA measurements

    DEFF Research Database (Denmark)

    Salewski, Mirko; Geiger, B.; Nielsen, Stefan Kragh;

    2012-01-01

    We compute tomographies of 2D fast-ion velocity distribution functions from synthetic collective Thomson scattering (CTS) and fast-ion D (FIDA) 1D measurements using a new reconstruction prescription. Contradicting conventional wisdom we demonstrate that one single 1D CTS or FIDA view suffices to...

  18. Evaluation of the scratch collapse test for the diagnosis of carpal tunnel syndrome.

    Science.gov (United States)

    Makanji, H S; Becker, S J E; Mudgal, C S; Jupiter, J B; Ring, D

    2014-02-01

    This prospective study measured and compared the diagnostic performance characteristics of various clinical signs and physical examination manoeuvres for carpal tunnel syndrome (CTS), including the scratch collapse test. Eighty-eight adult patients that were prescribed electrophysiological testing to diagnose CTS were enrolled in the study. Attending surgeons documented symptoms and results of standard clinical manoeuvres. The scratch collapse test had a sensitivity of 31%, which was significantly lower than the sensitivity of Phalen's test (67%), Durkan's test (77%), Tinel's test (43%), CTS-6 lax (88%), and CTS-6 stringent (54%). The scratch test had a specificity of 61%, which was significantly lower than the specificity of thenar atrophy (96%) and significantly higher than the specificity of Durkan's test (18%) and CTS-6 lax (13%). The sensitivity of the scratch collapse test was not superior to other clinical signs and physical examination manoeuvers for CTS, and the specificity of the scratch collapse test was superior to that of Durkan's test and CTS-6 lax. Further studies should seek to limit the influence of a patient's clinical presentation on scratch test performance and assess the scratch test's inter-rater reliability.

  19. Incidence of trapezius myofascial trigger points in patients with the possible carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Hamid Azadeh

    2010-01-01

    Full Text Available Background: Patients with carpal tunnel syndrome (CTS often complain of prominent pain in shoulder and arm, also there are patients that have pain in their shoulder and arm which is due to myofascial trigger point (MTP located in their upper trapezius muscle. Despite the frequency of this observation, few studies have previously sought to establish possible relationship between the CTS and MTP in shoulder area. Methods: Samples were 160 patients (221 hands consist of 130 females and 30 males, with suspected diagnosis of CTS, from March 2008 to October 2008. In this study after performing electrodiagnosis searches, another evaluation was performed to find out if there was any sign of myofascial trigger point. The correlation between these two was sought. Results: It was found that all of 36 hands with normal electrodiagnostic findings had myofascial trigger points in their upper trapezius muscle. Out of 185 hands, 130 hands (70% with electrophysiological evidences of CTS showed myofascial trigger points in their trapezius muscles. Statistical analysis revealed significant (p < 0.001 reverse correlation between the severity of CTS and the presence of MTP. Conclusions: The findings of this study imply the significant correlation between occurrence of CTS and MTP. It is suggested that clinicians consider the probability of existence of MTP in patients referred for diagnosis of CTS.

  20. Incidence of trapezius myofascial trigger points in patients with the possible carpal tunnel syndrome

    Science.gov (United States)

    Azadeh, Hamid; Dehghani, Mohammad; Zarezadeh, Abolghasem

    2010-01-01

    BACKGROUND: Patients with carpal tunnel syndrome (CTS) often complain of prominent pain in shoulder and arm, also there are patients that have pain in their shoulder and arm which is due to myofascial trigger point (MTP) located in their upper trapezius muscle. Despite the frequency of this observation, few studies have previously sought to establish possible relationship between the CTS and MTP in shoulder area. METHODS: Samples were 160 patients (221 hands) consist of 130 females and 30 males, with suspected diagnosis of CTS, from March 2008 to October 2008. In this study after performing electrodiagnosis searches, another evaluation was performed to find out if there was any sign of myofascial trigger point. The correlation between these two was sought. RESULTS: It was found that all of 36 hands with normal electrodiagnostic findings had myofascial trigger points in their upper trapezius muscle. Out of 185 hands, 130 hands (70%) with electrophysiological evidences of CTS showed myofascial trigger points in their trapezius muscles. Statistical analysis revealed significant (p < 0.001) reverse correlation between the severity of CTS and the presence of MTP. CONCLUSIONS: The findings of this study imply the significant correlation between occurrence of CTS and MTP. It is suggested that clinicians consider the probability of existence of MTP in patients referred for diagnosis of CTS. PMID:21526092

  1. Formações venosas superficiais da fossa cubital: aspectos de interesse para a prática da Enfermagem Formaciones venosas superficiales de la fosa cubital: aspectos de interés para la práctica de Enfermería Superficial venous formation of the cubital fossa: aspects of interest for nursing practice

    Directory of Open Access Journals (Sweden)

    Nilton Alves

    2012-12-01

    Full Text Available O objetivo deste estudo é contribuir para o conhecimento que auxilie o profissional de enfermagem na identificação dos tipos mais comuns de formações venosas da região da fossa cubital e, ainda, enfocar a importância de estar sempre atento aos casos pouco comuns como o aqui relatado. Através de uma revisão bibliográfica, constatamos que as formações venosas dessa região podem ser classificadas em 5 tipos mais comuns, sendo o tipo II o mais frequente. Constatamos ainda, que a VICo é o local de punção mais indicado, seguido pela VIB. Descrevemos também uma variação anatômica, onde observamos ausência de comunicação entre VC e VB no nível da fossa cubital e VIA drenando na VB, estando presente a VCA.El objetivo de esta investigación es contribuir al conocimiento que auxilie al profesional de enfermería en la identificación de los tipos más comunes de formaciones venosas de la fosa cubital, además de advertir sobre la importancia de fijar la atención a los casos poco comunes, como lo aquí reportado. A través de la revisión bibliográfica, clasificamos las formaciones venosas de esta región en cinco tipos más comunes, siendo lo más frecuente el Tipo II. La utilización de la VICo se recomienda como el mejor sitio de punción, seguido por la VIB. Además, describimos una variación anatómica, donde se observó la ausencia de comunicación entre VC y VB a nivel de fosa cubital y VIA drenando en VB, con presencia de la VCA.The aim of this study is to contribute to the knowledge to assists the nursing staff to identify the most common types of venous formations of the cubital fossa region, and also focus on the importance of always being alert to unusual cases as that reported here. Through a literature review, we found that the venous formations of this region can be classified into five common types, bring the Type II the was most frequent. We also found that MCV is considered the best puncture site, followed by MBV

  2. Recent results of collective Thomson scattering on TEXTOR and plans for CTS on ITER

    DEFF Research Database (Denmark)

    Korsholm, Søren Bang; Bindslev, Henrik; Furtula, Vedran;

    Moving towards the era of burning fusion plasmas, a better knowledge of the physics of highly energetic particles, such as fusion born alpha particles, becomes essential. Diagnosing the fast ions in a fusion plasma is a challenging task, but the technique of collective Thomson scattering (CTS......) provides the possibility of revealing the velocity distribution of the confined fast ions along a given direction – resolved both in time and space. Recently, the ITER baseline design has been expanded to include the enabling of the front end of a fast ion CTS diagnostic system resolving dynamics...... perpendicular to the magnetic field. The feasibility study and conceptual design of this diagnostic was provided by the CTS group at Risø DTU. The development of the ITER CTS diagnostic builds on the experiences and expertise gained from the construction and current operation of the CTS diagnostic systems...

  3. PAR Corneal Topography System (PAR CTS): the clinical application of close-range photogrammetry.

    Science.gov (United States)

    Belin, M W; Cambier, J L; Nabors, J R; Ratliff, C D

    1995-11-01

    The PAR Corneal Topography System (CTS) is a computer-driven corneal imaging system which uses close-range photogrammetry (rasterphotogrammetry) to measure and produce a topographic map of the corneal surface. The PAR CTS makes direct point-by-point measurements of surface elevation using a stereo-triangulation technique. The CTS uses a grid pattern composed of horizontal and vertical lines spaced about 0.2 mm (200 microns) apart. Each grid intersection comprises a surface feature which can be located in multiple images and used to generate an (x,y,z) coordinate. Unlike placido disc-based videokeratoscopes, the PAR CTS requires neither a smooth reflective surface nor precise spatial alignment for accurate imaging. In addition to surface elevation, the PAR CTS computes axial and tangential curvatures and refractive power. Difference maps are available in all curvatures, refractive power, and in absolute elevation.

  4. Infrared thermography based on artificial intelligence as a screening method for carpal tunnel syndrome diagnosis.

    Science.gov (United States)

    Jesensek Papez, B; Palfy, M; Mertik, M; Turk, Z

    2009-01-01

    This study further evaluated a computer-based infrared thermography (IRT) system, which employs artificial neural networks for the diagnosis of carpal tunnel syndrome (CTS) using a large database of 502 thermal images of the dorsal and palmar side of 132 healthy and 119 pathological hands. It confirmed the hypothesis that the dorsal side of the hand is of greater importance than the palmar side when diagnosing CTS thermographically. Using this method it was possible correctly to classify 72.2% of all hands (healthy and pathological) based on dorsal images and > 80% of hands when only severely affected and healthy hands were considered. Compared with the gold standard electromyographic diagnosis of CTS, IRT cannot be recommended as an adequate diagnostic tool when exact severity level diagnosis is required, however we conclude that IRT could be used as a screening tool for severe cases in populations with high ergonomic risk factors of CTS.

  5. Laser evoked potentials in carpal tunnel syndrome.

    Science.gov (United States)

    de Tommaso, Marina; Libro, Giuseppe; Difruscolo, Olimpia; Sardaro, Michele; Serpino, Claudia; Calabrese, Rita; Vecchio, Eleonora; Livrea, Paolo

    2009-02-01

    The aim of this study was to evaluate the function of Adelta fibers at the hand level in patients with clinical symptoms of Carpal Tunnel Syndrome (CTS) using CO(2) laser evoked potentials (LEPs), in light of the intensity and distribution of sensory symptoms and pain. Thirty-four CTS outpatients (62 hands) were compared to 23 sex- and age-matched control subjects (46 hands). The periungueal skin of the first, second, third and fifth fingers, and the dorsum of the hands were stimulated in random order. The latency and amplitude of the N2, P2 and N1 components were evaluated with respect to the Nerve Conduction Study (NCS) data, clinical scales, pain intensity and glove-like symptoms distribution. The amplitude of the N2-P2 complex was significantly reduced in CTS hands compared to normal hands after stimulation of the second and third fingers, even in patients with mild nerve conduction impairment. No significant fifth finger LEP abnormalities were found in patients with glove-like distribution symptoms. The N2-P2 amplitude at the second and third fingers was positively correlated with the severity of sensory symptoms. The involvement of median nerve Adelta fibers in CTS seems to be an early phenomenon, which concurs with the impairment of large motor and sensory afferents and is linked to the severity of the disease. The finding of reduced sensory symptoms in patients with severe thin afferents damage, may suggest a slight expression of central sensitisation phenomena in the advanced stage of CTS syndrome.

  6. Electrophysiological studies in mild idiopathic carpal tunnel syndrome.

    Science.gov (United States)

    Girlanda, P; Quartarone, A; Sinicropi, S; Pronestì, C; Nicolosi, C; Macaione, V; Picciolo, G; Messina, C

    1998-02-01

    Many techniques have been reported to improve the diagnosis of carpal tunnel syndrome (CTS), but there is no agreement on the diagnostic yield of these different methods. We used an electrophysiological protocol including the assessment of the orthodromic sensory conduction velocity of the median nerve along the carpal tunnel, comparison of median and ulnar sensory conduction between the ring finger and wrist, short segment incremental median sensory nerve conduction across the carpal tunnel recording from the III digit ('inching test'), the study of the refractory period of transmission (RPT) and calculation of the distoproximal ratio obtained by dividing the nerve conduction velocity in the median nerve between the third digit and the palm and between the palm and wrist in 41 patients with mild CTS (75 symptomatic hands) and in 45 control subjects. The distoproximal ratio calculation was the most sensitive technique (81%), but was also the least specific. The 'inching test', even though less sensitive, had the advantage of localising focal abnormalities of the median nerve along the carpal tunnel. RPT was abnormal in patients with recent symptoms. Combining the different techniques, an overall sensitivity of 92% was reached, 11% higher than the yield of the single best test suggesting that a multimodal approach could be useful. The best procedure for electrodiagnosis of mild CTS was to combine the median/ulnar comparison test with calculation of the disto-proximal ratio.

  7. Ulnar nerve entrapment at wrist associated with carpal tunnel syndrome.

    Science.gov (United States)

    Gozke, E; Dortcan, N; Kocer, A; Cetinkaya, M; Akyuz, G; Us, O

    2003-11-01

    In this study, ulnar nerve entrapments at the wrist were investigated using nerve conduction studies in cases with established diagnosis of carpal tunnel syndrome (CTS). Cases with cervical radiculopathy and polyneuropathy as well as patients with ulnar nerve entrapment at elbow were excluded from the study. Fifty-three cases (46 females, seven males) whose ages ranged between 20 and 72 years (mean: 49.31 +/- 13.78) were evaluated. Among 53 cases, 12 (22.6%) bilateral and 41 (77.3%) unilateral CTS were detected. Totally 65 wrists evaluated and prolongation of median nerve wrist-3rd digit distal sensory latencies (DSL; N: 59; 90.7%) and wrist-abductor pollicis brevis distal motor latencies (N: 48; 73.8%) were seen. In six wrists, diagnoses were established with the detection of an increase in the differences between wrist-4th digit DSL of median and ulnar nerve. This test was used if other test results were in normal limits. Prolongation of ulnar nerve wrist-5th digit DSL were found in 12 wrists (18.4%) in cases with CTS. Among these 12 wrists mild (N: 2), moderate (N: 7) and severe (N: 3) CTS were detected. Ulnar nerve motor conduction studies provided normal results. In conclusion, we are in the opinion that for the detection of associated ulnar nerve wrist entrapments, ulnar nerve conduction studies paying special attention to DSL convey importance in established cases with CTS.

  8. Concoradance of clinical and neurophysiologic diagnoses of carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Martić Vesna

    2015-01-01

    Full Text Available Introduction/Aim. Clinical presentation and neurophysiological examination are crucial in diagnosing carpal tunnel syndrome (CTS. The aim of this study was to determine sensitivity and specificity of clinical examination for diagnosing of CTS in relation to neurophysiological evaluation. Methods. The sample included 181 patients referred to the neurologist for further diagnosis of pain and parestesias in the arm (81 women and 100 men mean age 42 ± 14 years and 52 ± 16 years, respectively. All the patients were neurophysiologicly tested. Results. Out of 181 patients, clinical findings were considered positive for CTS in 37 patients. The neurophysiological findings for CTS were positive in 60 patients. Both clinical and neurophysiological findings were positive in 31 patients and both findings were negative in 115 patients (sensitivity 0,51; specificity 0,95. Conclusion. Low sensitivity and high specificity suggest that it is easier to exclude rather than to accurately diagnose CTS based on clinical examination alone. Thus, there is the need for neurophysiological evaluation of patients with complains in the arm.

  9. Formações venosas superficiais da fossa cubital: aspectos de interesse para a prática da Enfermagem

    Directory of Open Access Journals (Sweden)

    Nilton Alves

    Full Text Available O objetivo deste estudo é contribuir para o conhecimento que auxilie o profissional de enfermagem na identificação dos tipos mais comuns de formações venosas da região da fossa cubital e, ainda, enfocar a importância de estar sempre atento aos casos pouco comuns como o aqui relatado. Através de uma revisão bibliográfica, constatamos que as formações venosas dessa região podem ser classificadas em 5 tipos mais comuns, sendo o tipo II o mais frequente. Constatamos ainda, que a VICo é o local de punção mais indicado, seguido pela VIB. Descrevemos também uma variação anatômica, onde observamos ausência de comunicação entre VC e VB no nível da fossa cubital e VIA drenando na VB, estando presente a VCA.

  10. Formações venosas superficiais da fossa cubital: aspectos de interesse para a prática da Enfermagem

    Directory of Open Access Journals (Sweden)

    Nilton Alves

    2012-12-01

    Full Text Available O objetivo deste estudo é contribuir para o conhecimento que auxilie o profissional de enfermagem na identificação dos tipos mais comuns de formações venosas da região da fossa cubital e, ainda, enfocar a importância de estar sempre atento aos casos pouco comuns como o aqui relatado. Através de uma revisão bibliográfica, constatamos que as formações venosas dessa região podem ser classificadas em 5 tipos mais comuns, sendo o tipo II o mais frequente. Constatamos ainda, que a VICo é o local de punção mais indicado, seguido pela VIB. Descrevemos também uma variação anatômica, onde observamos ausência de comunicação entre VC e VB no nível da fossa cubital e VIA drenando na VB, estando presente a VCA.

  11. Repeater F waves: a comparison of sensitivity with sensory antidromic wrist-to-palm latency and distal motor latency in the diagnosis of carpal tunnel syndrome.

    Science.gov (United States)

    Macleod, W N

    1987-05-01

    Thirty-five thousand six hundred supramaximal shocks were applied to 209 healthy and 147 entrapped median nerves (carpal tunnel syndrome--CTS) to characterize the backfiring behavior of the alpha motor neuron pool of abductor pollicis brevis in health and the modifying effect of a compressive neuropathy. A contraction of the normal subpopulation of active F-wave generators was found in CTS, while active neurons backfired at higher than normal frequencies (p less than 0.001). These modifications in spinal behavior are reflected in the % Repeater F-wave value, whose sensitivity in the detection of CTS approaches that of sensory wrist-to-palm latency estimation. This technique offers an alternative to latency measurement in the diagnosis of CTS. An economical strategy for the electrodiagnosis of CTS is proposed.

  12. Short tunnels.

    NARCIS (Netherlands)

    Schreuder, D.A.

    1965-01-01

    Before dealing with the question of lighting short tunnels, it is necessary define what is meant by a tunnel and when it should be called 'short'. Confined to motorized road traffic the following is the most apt definition of a tunnel: every form of roofing-over a road section, irrespective of it le

  13. CTS United States experiments - A progress report. [Communications Technology Satellite for high power broadcasting

    Science.gov (United States)

    Robbins, W. H.; Donoughe, P. L.

    1976-01-01

    The Communications Technology Satellite (CTS) is a high-power broadcast satellite launched by NASA on January 17, 1976. CTS is the first satellite to operate at a frequency of 12 gigahertz and incorporates technology making possible new satellite telecommunications services. CTS is a cooperative program of the United States and Canada. This paper presents the results of the United States experimental activity to date. Wide segments of the population are involved in the Experiments Program, including the scientific community, other government agencies, industry, and the education and health entities. The experiments are associated with both technological objectives and the demonstration of new community and social services via satellite.

  14. A New Radar TBD Method Based on RD-CTS

    Institute of Scientific and Technical Information of China (English)

    MOLi; WUSiliang; MAOErke

    2005-01-01

    Track-before-detect (TBD) is a useful strategy for weak target detection that manages to integrate target energy along candidate trajectories and test whether the summation is large enough to declare a target. Several methods have been proposed to apply TBD in radar weak target detection, but none of them could make profitable use of the inherent characteristic of radar data. A simple and time saving radar TBD method is proposed, which is unique in an innovative Range-Doppler Candidate trajectories structure (RD-CTS). A number of candidate trajectories are hypothesized off-line, taking advantage of the correlation of the Doppler and range of each “root” image cell. Measurements along possible target trajectories are then integrated and a target is declared if the measurement sum, or merit function, exceeds a threshold. The CFAR (Constant false alarm rate) detection and false alarm probability determination are analyzed as well. Under a practical set of radar parameters, good detection performances are presented that at about 100% detection probability, 7.5dB SNR gain is achieved through 15-frame non-coherent integration.

  15. Wrist Ultrasonography vs. Electrophysiological Studies in the Diagnosis of Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Amirhossein Hashemi Attar

    2009-01-01

    Full Text Available   "nIntroduction: The carpal tunnel syndrome (CTS is the most common entrapment neuropathy and is caused by compression of the median nerve in the carpal tunnel. It is characterized by pain or paresthesia in areas innervated by the median nerve. Electrophysiological studies are gold standard diagnostic tests for CTS. The objective of this study was to compare ultrasonography and electrophysiological studies in the diagnosis of CTS. "nMaterials and Methods: This cross sectional study was conducted on 100 wrists of 50 consecutive patients referred to 22-Bahman hospital (Mashhad with the clinical diagnosis of CTS from spring 2007 to summer 2008. These patients suspicious for CTS in at least one of their wrists (based on their complaints and neurological examination including Tinel’s test and Phallen test, were referred for electrophysiological studies including nerve conduction velocity and electromyography. All the patients underwent ultrasonography of both wrists within a week after electrophysiological studies. Ultrasonographies were performed by a radiologist using a high frequency (12 MHz linear probe (PHILIPS Envisor C. The cross sectional area of the median nerve was measured at the carpal tunnel. Measurements equal or more than 10 mm2 were considered as the CTS. Ultrasonographic findings and also clinical examination (Tinel’s test and Phalen’s test were compared with electrophysiological studies (as the gold standard diagnostic test for each wrist separately. "nResults: Of the 100 wrists (50 patients, 53 wrists were diagnosed as CTS based on the electrophysiological studies. Ninety one percent of the wrists with CTS were in female patients. The mean age was 52.1 years (23-75 years. There was no predisposing factor for most cases; however, 6% were affected by diabetes, 6% by hypertriglyceridemia, and 2% by hypothyroidism. The sensitivity, specificity and accuracy of clinical examination (Tinel’s test and Phalen’s test were 59%, 88

  16. Flexor tendon and synovial gliding during simultaneous and single digit flexion in idiopathic carpal tunnel syndrome.

    NARCIS (Netherlands)

    Ettema, A.M.; An, K.N.; Zhao, C.; O'Byrne, M.M.; Amadio, P.C.

    2008-01-01

    The characteristic pathological finding in carpal tunnel syndrome (CTS) is non-inflammatory fibrosis of the subsynovial connective tissue (SSCT), which lies between the flexor tendons and the visceral synovium (VS). How this fibrosis might affect tendon function is unknown. To better understand the

  17. Gliding characteristics of flexor tendon and tenosynovium in carpal tunnel syndrome: a pilot study.

    NARCIS (Netherlands)

    Ettema, A.M.; Zhao, C.; Amadio, P.C.; O'Byrne, M.M.; An, K.N.

    2007-01-01

    The characteristic pathological finding in carpal tunnel syndrome (CTS) is noninflammatory fibrosis of the synovium. How this fibrosis might affect tendon function, if at all, is unknown. The subsynovial connective tissue (SSCT) lies between the flexor tendons and the visceral synovium (VS) of the

  18. Dynamic sonographic measurements at the carpal tunnel inlet: Reliability and reference values in healthy wrists

    NARCIS (Netherlands)

    A. Filius (Anika); J.-W.H. Korstanje (Jan-Wiebe); R.W. Selles (Ruud); S.E.R. Hovius (Steven); H.P. Slijper

    2013-01-01

    textabstractIntroduction: Reliability and reference values are not well-established for most dynamic sonographic measurements of the median nerve (MN) and flexor tendons that may be used for diagnosing carpal tunnel syndrome (CTS). Methods: Wrists of 20 healthy participants were imaged using ultraso

  19. Gliding characteristics of flexor tendon and tenosynovium in carpal tunnel syndrome: a pilot study.

    NARCIS (Netherlands)

    Ettema, A.M.; Zhao, C.; Amadio, P.C.; O'Byrne, M.M.; An, K.N.

    2007-01-01

    The characteristic pathological finding in carpal tunnel syndrome (CTS) is noninflammatory fibrosis of the synovium. How this fibrosis might affect tendon function, if at all, is unknown. The subsynovial connective tissue (SSCT) lies between the flexor tendons and the visceral synovium (VS) of the u

  20. Ultrasonic Assessment of Females with Carpal Tunnel Syndrome Proved by Nerve Conduction Study

    Directory of Open Access Journals (Sweden)

    Ihsan M. Ajeena

    2013-01-01

    Full Text Available Introduction. Carpal tunnel syndrome (CTS is the most commonly diagnosed entrapment neuropathy of the upper extremity. The objective of this study was to diagnose CTS and to assess its severity using high resolution ultrasound (HRUS depending on the results of nerve conduction study (NCS. Methods. A prospective cross-sectional study, in which HRUS was performed at 63 wrists of 35 female patients with different severity of CTS (as proved by NCS. Furthermore, 40 healthy volunteers (80 wrists underwent the same tests as the patients and have been chosen to match the patients in gender, age, and body mass index (BMI. The cross section area (CSA of the median nerve (MN was obtained using HRUS at the carpal tunnel inlet by direct tracing method. Results. There was a significant difference in the CSA of the MN at the tunnel inlet in CTS patients when compared with the control group. In fact, the CSA of the control group showed a significant difference from each of patients subgroups. Furthermore, a significant difference in the CSA was seen in between these subgroups. In conclusion, the US examination of the MN seems to be a promising method in diagnosing and grading of carpal tunnel syndrome.

  1. Multidimensional ultrasound imaging of the wrist: Changes of shape and displacement of the median nerve and tendons in carpal tunnel syndrome.

    Science.gov (United States)

    Filius, Anika; Scheltens, Marjan; Bosch, Hans G; van Doorn, Pieter A; Stam, Henk J; Hovius, Steven E R; Amadio, Peter C; Selles, Ruud W

    2015-09-01

    Dynamics of structures within the carpal tunnel may alter in carpal tunnel syndrome (CTS) due to fibrotic changes and increased carpal tunnel pressure. Ultrasound can visualize these potential changes, making ultrasound potentially an accurate diagnostic tool. To study this, we imaged the carpal tunnel of 113 patients and 42 controls. CTS severity was classified according to validated clinical and nerve conduction study (NCS) classifications. Transversal and longitudinal displacement and shape (changes) were calculated for the median nerve, tendons and surrounding tissue. To predict diagnostic value binary logistic regression modeling was applied. Reduced longitudinal nerve displacement (p≤ 0.019), increased nerve cross-sectional area (p≤ 0.006) and perimeter (p≤ 0.007), and a trend of relatively changed tendon displacements were seen in patients. Changes were more convincing when CTS was classified as more severe. Binary logistic modeling to diagnose CTS using ultrasound showed a sensitivity of 70-71% and specificity of 80-84%. In conclusion, CTS patients have altered dynamics of structures within the carpal tunnel.

  2. SU-E-J-241: Creation of Ventilation CT From Daily 4D CTs Or 4D Conebeam CTs Acquired During IGRT for Thoracic Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Tai, A; Ahunbay, E; Li, X [Medical College of Wisconsin, Milwaukee, WI (United States)

    2014-06-01

    Purpose: To develop a method to create ventilation CTs from daily 4D CTs or 4D KV conebeam CTs (4DCBCT) acquired during image-guided radiation therapy (IGRT) for thoracic tumors, and to explore the potential for using the ventilation CTs as a means for early detection of lung injury during radiation treatment. Methods: 4DCT acquired using an in-room CT (CTVision, Siemens) and 4DCBCT acquired using the X-ray Volume Imaging (XVI) system (Infinity, Elekta) for representative lung cancer patients were analyzed. These 4D data sets were sorted into 10 phase images. A newly-available deformable image registration tool (ADMIRE, Elekta) is used to deform the phase images at the end of exhale (EE) to the phase images at the end of inhale (EI). The lung volumes at EI and EE were carefully contoured using an intensity-based auto-contour tool and then manually edited. The ventilation images were calculated from the variations of CT numbers of those voxels masked by the lung contour at EI between the registered phase images. The deformable image registration is also performed between the daily 4D images and planning 4DCT, and the resulting deformable field vector (DFV) is used to deform the planning doses to the daily images by an in-house Matlab program. Results: The ventilation images were successfully created. The tide volumes calculated using the ventilation images agree with those measured through volume difference of contours at EE and EI, indicating the accuracy of ventilation images. The association between the delivered doses and the change of lung ventilation from the daily ventilation CTs is identified. Conclusions: A method to create the ventilation CT using daily 4DCTs or 4D KV conebeam CTs was developed and demonstrated.

  3. The dose-dependent efficiency of radial shock wave therapy for patients with carpal tunnel syndrome: a prospective, randomized, single-blind, placebo-controlled trial

    OpenAIRE

    Ke, Ming-Jen; Chen, Liang-Cheng; Chou, Yu-Ching; Li, Tsung-Ying; Chu, Heng-Yi; Tsai, Chia-Kuang; Wu, Yung-Tsan

    2016-01-01

    Recently, extracorporeal shock wave therapy (ESWT) has been shown to be a novel therapy for carpal tunnel syndrome (CTS). However, previous studies did not examine the diverse effects of different-session ESWT for different-grades CTS. Thus, we conducted a randomized, single-blind, placebo-controlled study. Sixty-nine patients (90 wrists) with mild to moderate CTS were randomized into 3 groups. Group A and C patients received one session of radial ESWT (rESWT) and sham eESWT per week for 3 co...

  4. A História Dominante do Movimento CTS e o seu Papel no Subcampo Brasileiro de Pesquisa em Ensino de Ciências CTS

    OpenAIRE

    Ribeiro,Thiago Vasconcelos; Santos, Aliny Tinoco; Genovese, Luiz Gonzaga Roversi

    2017-01-01

    O presente artigo tem por objetivo problematizar e analisar alguns elementos destacados na literatura nacional a respeito da história dominante de origem do movimento Ciência-Tecnologia-Sociedade (CTS). Entende-se que esta “história dominante”, assim caracterizada por ser tratada de forma relativamente padronizada pelos principais trabalhos na área, desempenha um papel importante nas lutas no interior do Subcampo Brasileiro de Pesquisa em Ensino de Ciências CTS. Para a construção do objeto de...

  5. 凯迪拉克宣布CTS 2.8L价格

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005年4月6日.上海通用正式公布了凯迪拉克CTS 2.8L的价格为43.8万元,发布当日即在全国范围内接受订单。CTS 2.8L的推出,让凯迪拉克产品结构得以扩充,目前中国市场已经有CTS 3.6L、CTS 2.8L、SRX 4.6L V8、SRX 3.6L V6 4款产品。

  6. 驾控升级——测试凯迪拉克CTS Coupe

    Institute of Scientific and Technical Information of China (English)

    LAIYI; LAIWI(摄影)

    2011-01-01

    原本我想使用一个表示CTS Coupe如何如何“亮骚”的词作为标题,但是转念一想关于CTS Coupe的美一眼便知,但它大大优于普通CTS的操控才是我真正应该直接告诉你们的。

  7. Effects of Pain and Disability on Quality of Life in Patients with Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Ayhan Öztürk1

    2013-09-01

    Full Text Available Objective: To evaluate the association between severity of carpal tunnel syndrome (CTS, pain, disability and to assess their effects on quality of life. Methods: CTS patients whose diagnosis were confirmed with nerve conduction studies were classified as “mild”, “moderate”, and “severe”. Pain evaluation was performed by “Pain Quality Assessment Scale (PQAS” in all patients. Short form-36 (SF-36 was used to assess quality of life and “Brief Disability Scale” was used in the evaluation of disability. Results: 93.1% of the patients were women, and 6.9% were men. Mean age was 44.20±8.76 years (range= 29–62. Mean duration of symptoms was 6.67±3.00 months (range=3-12 months. Most common symptom was paresthesia. Electrophysiological evaluations revealed moderate CTS in 43.8%, mild CTS in 44.8%, severe CTS in 6.9% of the patients. There was no significant association between CTS severity and time course subgroup of PQAS (p=0.222. But there was a statistically significant difference in the general pain subgroup and total scores of PQAS between moderate and severe CTS patients (p<0.05. There was a statistically significant difference in the mean scores of Brief Disability Questionnaire between patients with mild and severe CTS (4,46±3,61 and 11,50±4,94, p<0.05, respectively. A statistically significant negative correlation was found between the level of disability and physical function, pain, vitality, social function and mental health domains of SF-36. Conclusion: Quality of life is variably affected in patients with CTS due to the severity of CTS. On this aspect, it is important to diagnose and treat CTS on time to improve the quality of life of patients with CTS in early period, which is the best known and common compression neuropathy of upper extremity in community.

  8. A longitudinal study of industrial and clerical workers: incidence of carpal tunnel syndrome and assessment of risk factors.

    Science.gov (United States)

    Gell, Nancy; Werner, Robert A; Franzblau, Alfred; Ulin, Sheryl S; Armstrong, Thomas J

    2005-03-01

    This study followed workers over an extended period of time to identify factors which may influence the onset of Carpal Tunnel Syndrome (CTS). The purpose was to evaluate incidence of CTS and to create a predictive model of factors that play a role in the development of CTS. This prospective study followed 432 industrial and clerical workers over 5.4 years. Incident cases were defined as workers who had no prior history of CTS at baseline testing and were diagnosed with CTS during the follow-up period or at the follow-up screening. On the basis of logistic regression, significant predictors for CTS include baseline median-ulnar peak latency difference, a history of wrist/hand/finger tendonitis, a history of numbness, tingling, burning, and/or pain in the hand, and work above the action level of the peak force and hand activity level threshold limit value. This longitudinal study supports findings from previous cross-sectional studies identifying both work related ergonomic stressors and physical factors as independent risk factors for CTS.

  9. Thermal Properties and Thermal Degradation of Cellulose Tri-Stearate (CTs

    Directory of Open Access Journals (Sweden)

    Feng-Yuan Huang

    2012-04-01

    Full Text Available Cellulose tri-stearate (CTs was synthesized employing trifluoroacetic anhydride (TFAA, stearic acid (SA, with microcrystal cellulose (MCC and characterized with FT-IR and 1H-NMR. The degree of substitution of CTs was determined by the traditional saponification method and 1H-NMR. The thermal properties of CTs were investigated by the thermogravimetric analysis (TGA under Ar flow in dynamic heating conditions. Thermal stability, activation energy, as well as the degradation mechanism of the decomposition process were revealed. The results showed that the thermal stability of CTs is superior to that of raw materials-MCC, and that the degradation of CTs in argon is a first-order weight loss; the initial decomposition temperature and the temperature corresponding to maximum degradation rate (Tp increase with an increase in heating rate. The activation energy values were calculated with the Ozawa method, Coats-Redfern method and Kinssinger method, respectively. Analyses of experimental results suggest that the degradation mechanism 0.10 < α < 0.80 is F2 type, A3 for α < 0.1, and R3 for α > 0.80. The degradation mechanism of CTs in the whole conversion range is a complex mechanism, and is the combination of A3, F2 and R3.

  10. Bilateral hand/wrist heat and cold hyperalgesia, but not hypoesthesia, in unilateral carpal tunnel syndrome.

    Science.gov (United States)

    de la Llave-Rincón, Ana Isabel; Fernández-de-las-Peñas, César; Fernández-Carnero, Josué; Padua, Luca; Arendt-Nielsen, Lars; Pareja, Juan A

    2009-10-01

    The aim of the current study was to evaluate bilaterally warm/cold detection and heat/cold pain thresholds over the hand/wrist in patients with carpal tunnel syndrome (CTS). A total of 25 women with strictly unilateral CTS (mean 42 +/- 10 years), and 20 healthy matched women (mean 41 +/- 8 years) were recruited. Warm/cold detection and heat/cold pain thresholds were assessed bilaterally over the carpal tunnel and the thenar eminence in a blinded design. Self-reported measures included both clinical pain history (intensity, location and area) and Boston Carpal Tunnel Questionnaire. No significant differences between groups for both warm and cold detection thresholds in either carpal tunnel or thenar eminence (P > 0.5) were found. Further, significant differences between groups, but not between sides, for both heat and cold pain thresholds in both the carpal tunnel and thenar eminence were found (all P < 0.001). Heat pain thresholds (P < 0.01) were negatively correlated, whereas cold pain thresholds (P < 0.001) were positively correlated with hand pain intensity and duration of symptoms. Our findings revealed bilateral thermal hyperalgesia (lower heat pain and reduced cold pain thresholds) but not hypoesthesia (normal warm/cold detection thresholds) in patients with strictly unilateral CTS when compared to controls. We suggest that bilateral heat and cold hyperalgesia may reflect impairments in central nociceptive processing in patients with unilateral CTS. The bilateral thermal hyperalgesia associated with pain intensity and duration of pain history supports a role of generalized sensitization mechanisms in the initiation, maintenance and spread of pain in CTS.

  11. Responsiveness of the Korean version of the Michigan Hand Outcomes Questionnaire after carpal tunnel release.

    Science.gov (United States)

    Wi, Seung Myung; Gong, Hyun Sik; Bae, Kee Jeong; Roh, Young Hak; Lee, Young Ho; Baek, Goo Hyun

    2014-06-01

    The Korean version of the Michigan Hand Outcomes Questionnaire (K-MHQ) was recently validated; however, the questionnaire's responsiveness as well as the degree to which the instrument is sensitive to change has not been thoroughly evaluated in a specific condition in Koreans. We evaluated the responsiveness of the K-MHQ in a homogenous cohort of patients with carpal tunnel syndrome (CTS) and we compared it with that of the Korean version of the Disability of the Arm, Shoulder, and Hand Questionnaire (K-DASH), which was found to have a large degree of responsiveness after carpal tunnel release for Korean patients with CTS. Thirty-seven patients with CTS prospectively completed the K-MHQ and the K-DASH before and 6 months after surgery. The responsiveness statistics were assessed for both the K-MHQ and the K-DASH by using the standardized response mean (SRM), which was defined as the mean change of the original scores after surgery divided by the standard deviation of the change. All domains of the K-MHQ significantly improved after carpal tunnel release (p responsiveness of ≥ 0.8. The aesthetics scale showed medium responsiveness of 0.6. The combined function/symptom scale of the K-DASH significantly improved after surgery (p responsiveness of 0.9. The K-MHQ was found to have a large degree of responsiveness after carpal tunnel release for Korean patients with CTS, which is comparable not only to the K-DASH, but also to the original version of the MHQ. The region-specific K-MHQ can be useful for outcomes research related to carpal tunnel surgery, especially for research comparing CTS with various other hand and wrist health conditions.

  12. High-resolution MRI predicts steroid injection response in carpal tunnel syndrome patients

    Energy Technology Data Exchange (ETDEWEB)

    Aoki, Takatoshi; Oki, Hodaka; Kinoshita, Shunsuke; Yamashita, Yoshiko; Takahashi, Hiroyuki; Hayashida, Yoshiko; Korogi, Yukunori [University of Occupational and Environmental Health School of Medicine, Department of Radiology, Kitakyushu (Japan); Oshige, Takahisa; Sakai, Akinori [University of Occupational and Environmental Health School of Medicine, Department of Orthopaedic Surgery, Kitakyushu (Japan); Matsuyama, Atsushi; Hisaoka, Masanori [University of Occupational and Environmental Health School of Medicine, Department of Pathology and Oncology, Kitakyushu (Japan)

    2014-03-15

    To correlate median nerve T2 signal and shape at the carpal tunnel with steroid injection (SI) response in carpal tunnel syndrome (CTS) patients. One hundred and sixty-three CTS wrists of 92 consecutive patients who were scheduled to undergo SI were prospectively evaluated with 3-T magnetic resonance imaging (MRI) and a nerve conduction study. All patients underwent axial high-resolution T2-weighted MRI (in-plane resolution of 0.25 x 0.25 mm). The CTS wrists were classified into three groups according to the nerve T2 signal and the flattening ratio at the hook of hamate level: group 1, high and oval; group 2, high and flat; group 3, low and flat. Clinical response to SI was evaluated at 6 months after injection. One hundred and thirteen of the 163 wrists (69.3 %) responded well to SI. The percentage of improvement was 81.7 % (49/60) in group 1, 69.9 % (51/73) in group 2, and 43.3 % (13/30) in group 3 (P < 0.01). On stepwise logistic regression analysis high-resolution MRI was the only significant independent factor for SI response in CTS patients (P < 0.01). High-resolution MRI correlates well with SI response in CTS patients and seems useful for predicting SI response. (orig.)

  13. Carpal tunnel syndrome and the use of computer mouse and keyboard: A systematic review

    Directory of Open Access Journals (Sweden)

    Atroshi Isam

    2008-10-01

    Full Text Available Abstract Background This review examines evidence for an association between computer work and carpal tunnel syndrome (CTS. Methods A systematic review of studies of computer work and CTS was performed. Supplementary, longitudinal studies of low force, repetitive work and CTS, and studies of possible pathophysiological mechanisms were evaluated. Results Eight epidemiological studies of the association between computer work and CTS were identified. All eight studies had one or more limitation including imprecise exposure and outcome assessment, low statistical power or potentially serious biases. In three of the studies an exposure-response association was observed but because of possible misclassification no firm conclusions could be drawn. Three of the studies found risks below 1. Also longitudinal studies of repetitive low-force non-computer work (n = 3 were reviewed but these studies did not add evidence to an association. Measurements of carpal tunnel pressure (CTP under conditions typically observed among computer users showed pressure values below levels considered harmful. However, during actual mouse use one study showed an increase of CTP to potentially harmful levels. The long term effects of prolonged or repeatedly increased pressures at these levels are not known, however. Conclusion There is insufficient epidemiological evidence that computer work causes CTS.

  14. Pre-surgery Disability Compensation Predicts Long-Term Disability among Workers with Carpal Tunnel Syndrome

    Science.gov (United States)

    Spector, June T.; Turner, Judith A.; Fulton-Kehoe, Deborah; Franklin, Gary

    2012-01-01

    Background We sought to identify early risk factors for work disability compensation prior to and after carpal tunnel syndrome (CTS) surgery, and to determine whether pre-surgery disability compensation is associated with long-term disability. Methods Washington State workers’ compensation administrative data and data from interviews with workers 18 days (median) after submitting new workers’ compensation claims for CTS were examined. Baseline risk factors for pre-surgery disability compensation and for long-term disability (≥365 days of work disability compensation prior to two years after claim filing) were evaluated for workers who underwent CTS surgery and had at least one day of disability compensation (N=670). Results After adjustment for baseline long-term disability risk factors, workers with pre-surgery disability compensation had over five times the odds of long-term disability. Baseline factors in multiple domains, including job, psychosocial, clinical, and worker pain and function, were associated with both pre-surgery disability compensation and long-term disability. Conclusions Risk factors for work disability prior to and after CTS surgery are similar, and early work disability is a risk factor for long-term CTS-related disability. An integrated approach to CTS-related disability prevention could include identifying and addressing combined risk factors soon after claim filing, more efficient use of conservative treatments and appropriate work modifications to minimize early work loss, and, when indicated, timely surgical intervention. PMID:22392804

  15. Diagnostic value of quantitative sensory testing (QST) in carpal tunnel syndrome.

    Science.gov (United States)

    Borg, K; Lindblom, U

    1988-12-01

    The initial sensory symptoms of carpal tunnel syndrome (CTS) are usually intermittent and the clinical neurological examination is often normal. The aim of the present study was to determine the rate of impairment of different somatosensory modalities in CTS by means of the following tests: vibrametry, tactile pulses, von Frey hairs, two-point discrimination (2-PD), graphesthesia and warm and cold perception thresholds. The material consisted of 33 hands with CTS from 22 patients. Each of the first 3 tests was abnormal with elevated thresholds in 17 CTS hands (52%), 2-PD was abnormal in 10 hands (30%), graphesthesia in 8 hands (24%), and warm and cold thresholds in only 5 hands (15%). There was an overlap so that at least one test was abnormal in 27 of the 33 CTS hands (82%). Thus, impairment of sensibility can be demonstrated in a majority of patients with CTS if more than one test is applied. Vibrametry and von Frey hairs are recommended instead of the commonly used 2-PD, since abnormality was more often revealed and since they are equally easy to apply. No individual test was sensitive enough to qualify as a diagnostic criterion when it was applied with the hand in resting position. A significant increase in both sensitivity and specificity can be expected for any test if it is combined with provocation, such as wrist flexion, as has been demonstrated for vibrametry.

  16. Can widespread hypersensitivity in carpal tunnel syndrome be substantiated if neck and arm pain are absent?

    Science.gov (United States)

    Schmid, A B; Soon, B T C; Wasner, G; Coppieters, M W

    2012-02-01

    Recent studies demonstrated that patients with carpal tunnel syndrome (CTS) have signs of thermal and mechanical hyperalgesia in extra-median territories suggesting an involvement of central pain mechanisms. As previous studies included patients with shoulder/arm symptoms or neck pain, a potential influence of these coexisting disorders cannot be excluded. This study therefore evaluated whether widespread sensory changes (hypoesthesia or hyperalgesia) are present in patients with unilateral CTS in the absence of coexisting disorders. Twenty-six patients with unilateral CTS with symptoms localised to their hand and 26 healthy controls participated in the study. A comprehensive quantitative sensory testing (QST) protocol including thermal and mechanical detection and pain thresholds was performed over the hands (median, ulnar and radial innervation area), lateral elbows, neck and tibialis anterior muscle. Patients with CTS demonstrated thermal and mechanical hypoesthesia in the hand but not at distant sites. Thermal or mechanical hyperalgesia was not identified at any location with traditional QST threshold testing. However, patients with CTS rated the pain during thermal pain testing significantly higher than healthy participants. This was especially apparent for heat pain ratings which were elevated not only in the affected hand but also in the neck and tibialis anterior muscle. In conclusion, CTS alone in the absence of coexisting neck and arm pain does not account for sensory changes outside the affected hand as determined by traditional QST threshold testing. Elevated pain ratings may however be an early indication of central pain mechanisms.

  17. The Effect of Provocative Tests on Electrodiognosis of Clinical Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    MR Emad

    2006-04-01

    Full Text Available ABSTRACT: Introduction & Objective: Nerve conduction study is the most sensitive test for diagnosis of carpal tunnel syndrome (CTS. This test is normal in some patients with mild CTS. Median nerve conduction study evaluation after a provocative test (e.g. wrist flexion may be helpful for diagnosis of mild CTS. This study aimed to determine the effect of wrist flexion on median nerve conduction in patients suspected to CTS and in healthy subjects. Materials & Methods: In this case-controlled study, 20 patients (20 hands with clinical signs of CTS and normal routine electrodiagnosis test results and 20 healthy subjects were investigated. Measured parameters included: median nerve distal sensory latency (DSL, nerve conduction velocity (NCV, compound nerve action potential (CNAP, distal motor latency (DML and compound muscle action potential amplitude (CMAP AMP. The above noted parameters were measured before and after 5 minutes of full wrist flexion. Data were collected by filling out a questionnaire and were analyzed using Paired T-test. Results: Distal Sensory Latency increment and NCV decrement after 5 minutes wrist flexion in the patients group were statistically significant (p<0.05. The same parameters did not show a significant incremental or decremental change in the control group. Conclusion: Median nerve DSL and NCV measurement after 5 minutes wrist flexion may be helpful in determining more sensitive parameters in the electrodiagnosis of CTS.

  18. Test-retest reliability of transcarpal sensory NCV method for diagnosis of carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Seyed Mostafa Jazayeri

    2015-01-01

    Full Text Available Background: Carpal Tunnel Syndrome (CTS is the most frequent entrapment neuropathy affecting the upper extremity. There are a variety of electrodiagnostic methods available for documenting median neuropathy in CTS. In some studies, determining the sensory NCV across the palm-wrist segment has been introduced as the most sensitive diagnostic procedure for CTS. The aim of this study was to investigate the test-retest reliability of transcarpal median sensory NCV method for the diagnosis of CTS. Materials and Methods: Twenty-three patients with clinical symptoms of CTS were tested two times by two different practitioners in one session and again by the first practitioner after one week. Stimulation of the median nerve was performed in the wrist and palm, with a conduction distance maximum of 7 cm, reliabilities of median nerves sensory nerve action potential latencies with stimulation at wrist and palm (W-SNAP, P-SNAP and its transcarpal NCV were assessed with intraclass correlation coefficient (ICC. Results: Comparison of the obtained values, which were done by two practitioners in one session showed ICC of W-SNAP latency, P-SNAP latency and transcarpal NCV of 0.93, 0.88 and 0.87, respectively and values that were done by one practitioner in two sessions with one-week interval showed ICC of 0.60, 0.50 and 0.47, respectively. Conclusion: Our findings suggest excellent interpractitioner test-retest reliability of transcarpal median sensory NCV method for diagnosing CTS.

  19. Predictors of normal electrodiagnostic testing in the evaluation of suspected carpal tunnel syndrome.

    Science.gov (United States)

    Watson, Jeffrey; Zhao, Meijuan; Ring, David

    2010-12-01

    Electrodiagnostic studies (electromyography and nerve conduction velocity; EMG/NCV) are used to confirm the diagnosis of carpal tunnel syndrome (CTS) and to evaluate its severity. We investigated the hypothesis that normal electrodiagnostic median nerve testing is predicted by 1) Physician pre-test confidence in the diagnosis of CTS, and 2) Puzzling patient factors. One hundred and forty consecutive patients who underwent electrodiagnostic testing to evaluate for possible CTS were reviewed retrospectively. Both physician confidence in the diagnosis of CTS and puzzling patient factors (heightened illness concern, disproportionate complaints, and vague/nonanatomical/noncharacteristic symptoms) were recorded. Electrodiagnostic testing was used as the reference standard for diagnosis of CTS. Electrodiagnostic testing confirmed CTS in 115 patients and was within normal limits in 25 patients. Low physician confidence in the diagnosis of CTS was highly predictive of a normal electrodiagnostic test (p < 0.001), with high sensitivity (97%), moderate specificity (40%), and high overall accuracy (87%). Puzzling patient factors were moderately predictive of normal electrodiagnostic testing (p < 0.001), with low sensitivity (16%), high specificity (96%), and high overall accuracy (81%). The best multivariable model retained younger age, negative Phalen's test, and low physician confidence as the best predictors of normal electrodiagnostic testing and explained 35% of the variation in test results. A model with low confidence alone explained 19% of the variation in test results. Physician intuition as recorded in the medical record in terms of puzzlement and low confidence are very specific and accurate predictors of normal electrodiagnostic testing in the setting of suspected carpal tunnel syndrome.

  20. Activation in the hypothalamic-pituitary-adrenocortical axis and sympathetic nervous system in women with carpal tunnel syndrome.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Díaz-Rodríguez, Lourdes; Salom-Moreno, Jaime; Galiano-Castillo, Noelia; Valverde-Herreros, Lis; Martínez-Martín, Javier; Pareja, Juan A

    2014-08-01

    The aim of this study is to investigate the differences in salivary cortisol (hypothalamic-pituitary-adrenocortical [HPA] axis), α-amylase activity (sympathetic nervous system [SNS]), and immunoglobulin A (IgA; immune system) concentrations between women with carpal tunnel syndrome (CTS) and healthy women. A cross-sectional study. Activation of HPA, SNS, and immune system in CTS has not been clearly determined. One hundred two women (age: 45 ± 7 years) with electrodiagnostic and clinical diagnosis of CTS and 102 matched healthy women. The intensity of the pain was assessed with a Numerical Pain Rating Scale (0-10), and disability was determined with Boston Carpal Tunnel Questionnaire. Salivary cortisol concentration, α-amylase activity, salivary flow rate, and IgA concentration were collected from nonstimulated saliva. Women with CTS exhibited lower salivary flow rate (P  0.2) were found between groups as a total. Women with severe CTS exhibited lower salivary flow rate (P < 0.001), higher α-amylase activity (P = 0.002), and higher cortisol concentration (P = 0.03) than healthy women and than those with minimal/moderate CTS (P < 0.05). Within women with CTS, significant positive associations between α-amylase activity and the intensity of pain were found: the highest the level of pain, the higher the α-amylase activity, i.e., higher SNS activation. These results suggest that women with severe CTS exhibit changes in activation in the HPA axis and SNS but not in the humoral immune system. Activation of the SNS was associated with the intensity of pain. Future studies are needed to elucidate the direction of this relationship. Wiley Periodicals, Inc.

  1. Carpal tunnel syndrome assessed with diffusion tensor imaging: Comparison with electrophysiological studies of patients and healthy volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Chien-Kuo, E-mail: n044206@mail.hosp.ncku.edu.tw [Department of Radiology, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan 701, Taiwan (China); Jou, I-Ming, E-mail: jming@mail.ncku.edu.tw [Department of Orthopedics, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan 701, Taiwan (China); Huang, Han-Wei, E-mail: veivei@mail.ncku.edu.tw [Department of Neurology, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan 701, Taiwan (China); Chen, Pei-Yin, E-mail: chenpeiyin@gmail.com [Department of Internal Medicine, National Cheng Kung University Hospital Dou-Liou Branch, 345 Zhuangjing Road, Douliu City, Yunlin County 640, Taiwan (China); Tsai, Hong-Ming, E-mail: sjfhmt@mail.ncku.edu.tw [Department of Radiology, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan 701, Taiwan (China); Liu, Yi-Sheng, E-mail: sanderz@ms60.url.com.tw [Department of Radiology, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan 701, Taiwan (China); Lin, Chou-Ching K., E-mail: cxl45@mail.ncku.edu.tw [Department of Neurology, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan 701, Taiwan (China)

    2012-11-15

    The main goal of this study was to investigate the applicability of parameters derived from diffusion tension imaging (DTI) in diagnosing carpal tunnel syndrome (CTS). Forty subjects were recruited, of which 19 were normal controls and 21 belonged to the CTS group. DTI of median nerves evaluated at 4 levels of the wrist (distal radius, pisiform bone, middle portion of the carpal tunnel, and hamate bone) and conventional MRI of the wrist was performed in normal and CTS subjects in two finger postures (extension and flexion). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were derived from DTI, and parameters related to abnormal hyperintensity of the median nerve were derived from conventional MRI. Electrophysiological tests, including nerve conduction velocity and F wave were also performed for comparison. The results of FA and ADC measurements did not depend on the measuring location and finger posture. Mean FA was decreased while mean ADC was increased by CTS. FA and ADC at the middle portion of the carpal tunnel was 0.47 {+-} 0.05 and 1.37 {+-} 0.12 ( Multiplication-Sign 10{sup -3} mm{sup 2}/s) for the control group and 0.42 {+-} 0.04 and 1.50 {+-} 0.15 ( Multiplication-Sign 10{sup -3} mm{sup 2}/s) for the CTS group, respectively. The linear correlations of FA and ADC versus electrophysiological indicators of CTS were significant (R{sup 2} ranged from 0.09 to 0.36), indicating FA and ADC from DTI had significant correlation with the existence and severity of CTS.

  2. Effects of carpal tunnel syndrome on adaptation of multi-digit forces to object weight for whole-hand manipulation.

    Directory of Open Access Journals (Sweden)

    Wei Zhang

    Full Text Available The delicate tuning of digit forces to object properties can be disrupted by a number of neurological and musculoskeletal diseases. One such condition is Carpal Tunnel Syndrome (CTS, a compression neuropathy of the median nerve that causes sensory and motor deficits in a subset of digits in the hand. Whereas the effects of CTS on median nerve physiology are well understood, the extent to which it affects whole-hand manipulation remains to be addressed. CTS affects only the lateral three and a half digits, which raises the question of how the central nervous system integrates sensory feedback from affected and unaffected digits to plan and execute whole-hand object manipulation. We addressed this question by asking CTS patients and healthy controls to grasp, lift, and hold a grip device (445, 545, or 745 g for several consecutive trials. We found that CTS patients were able to successfully adapt grip force to object weight. However, multi-digit force coordination in patients was characterized by lower discrimination of force modulation to lighter object weights, higher across-trial digit force variability, the consistent use of excessively large digit forces across consecutive trials, and a lower ability to minimize net moments on the object. Importantly, the mechanical requirement of attaining equilibrium of forces and torques caused CTS patients to exert excessive forces at both CTS-affected digits and digits with intact sensorimotor capabilities. These findings suggest that CTS-induced deficits in tactile sensitivity interfere with the formation of accurate sensorimotor memories of previous manipulations. Consequently, CTS patients use compensatory strategies to maximize grasp stability at the expense of exerting consistently larger multi-digit forces than controls. These behavioral deficits might be particularly detrimental for tasks that require fine regulation of fingertip forces for manipulating light or fragile objects.

  3. Effects of carpal tunnel syndrome on adaptation of multi-digit forces to object weight for whole-hand manipulation.

    Science.gov (United States)

    Zhang, Wei; Johnston, Jamie A; Ross, Mark A; Smith, Anthony A; Coakley, Brandon J; Gleason, Elizabeth A; Dueck, Amylou C; Santello, Marco

    2011-01-01

    The delicate tuning of digit forces to object properties can be disrupted by a number of neurological and musculoskeletal diseases. One such condition is Carpal Tunnel Syndrome (CTS), a compression neuropathy of the median nerve that causes sensory and motor deficits in a subset of digits in the hand. Whereas the effects of CTS on median nerve physiology are well understood, the extent to which it affects whole-hand manipulation remains to be addressed. CTS affects only the lateral three and a half digits, which raises the question of how the central nervous system integrates sensory feedback from affected and unaffected digits to plan and execute whole-hand object manipulation. We addressed this question by asking CTS patients and healthy controls to grasp, lift, and hold a grip device (445, 545, or 745 g) for several consecutive trials. We found that CTS patients were able to successfully adapt grip force to object weight. However, multi-digit force coordination in patients was characterized by lower discrimination of force modulation to lighter object weights, higher across-trial digit force variability, the consistent use of excessively large digit forces across consecutive trials, and a lower ability to minimize net moments on the object. Importantly, the mechanical requirement of attaining equilibrium of forces and torques caused CTS patients to exert excessive forces at both CTS-affected digits and digits with intact sensorimotor capabilities. These findings suggest that CTS-induced deficits in tactile sensitivity interfere with the formation of accurate sensorimotor memories of previous manipulations. Consequently, CTS patients use compensatory strategies to maximize grasp stability at the expense of exerting consistently larger multi-digit forces than controls. These behavioral deficits might be particularly detrimental for tasks that require fine regulation of fingertip forces for manipulating light or fragile objects.

  4. Finite element simulation of the mechanical impact of computer work on the carpal tunnel syndrome.

    Science.gov (United States)

    Mouzakis, Dionysios E; Rachiotis, George; Zaoutsos, Stefanos; Eleftheriou, Andreas; Malizos, Konstantinos N

    2014-09-22

    Carpal tunnel syndrome (CTS) is a clinical disorder resulting from the compression of the median nerve. The available evidence regarding the association between computer use and CTS is controversial. There is some evidence that computer mouse or keyboard work, or both are associated with the development of CTS. Despite the availability of pressure measurements in the carpal tunnel during computer work (exposure to keyboard or mouse) there are no available data to support a direct effect of the increased intracarpal canal pressure on the median nerve. This study presents an attempt to simulate the direct effects of computer work on the whole carpal area section using finite element analysis. A finite element mesh was produced from computerized tomography scans of the carpal area, involving all tissues present in the carpal tunnel. Two loading scenarios were applied on these models based on biomechanical data measured during computer work. It was found that mouse work can produce large deformation fields on the median nerve region. Also, the high stressing effect of the carpal ligament was verified. Keyboard work produced considerable and heterogeneous elongations along the longitudinal axis of the median nerve. Our study provides evidence that increased intracarpal canal pressures caused by awkward wrist postures imposed during computer work were associated directly with deformation of the median nerve. Despite the limitations of the present study the findings could be considered as a contribution to the understanding of the development of CTS due to exposure to computer work.

  5. Correlation of segmental carpal tunnel pressures with changes in hand and wrist positions in patients with carpal tunnel syndrome and controls.

    Science.gov (United States)

    Luchetti, R; Schoenhuber, R; Nathan, P

    1998-10-01

    We investigated pressures at 1 cm intervals along the carpal tunnel in 39 patients with carpal tunnel syndrome (CTS) and 12 controls. Pressures were measured for relaxed and gripping hand positions in combination with neutral, extended, and flexed wrist positions. Patient pressures exceeded control pressures, were below the previously reported 30 mmHg threshold for four of five locations in the relaxed neutral position and were typically greater in extension than in flexion. In the neutral position, both patient and control pressures were slightly above threshold levels just distal to the tunnel. Maximum intratunnel pressures were generally found in the central part of the tunnel and minimum pressures in the distal tunnel. Gripping hand pressures in the tunnel were lowest with the wrist flexed. In both controls and CTS patients, only in the neutral wrist and relaxed hand positions were pressures highest at the point where nerve conduction studies have indicated the nerve is most likely to be compromised (in the midpalm just distal to the distal margin of the carpal tunnel).

  6. RESEARCH PROGRESS OF TREATMENT OF CARPAL TUNNEL SYNDROME%腕管综合征治疗研究进展

    Institute of Scientific and Technical Information of China (English)

    冯仕明; 高顺红

    2011-01-01

    Objective To review the progress in the treatment method of carpal tunnel syndrome (CTS). Methods Recent literature concerning the treatment method of CTS was extensively reviewed, analyzed, and summarized. Results Wrist splinting and local steroid injection are effective in patients with mild to moderate CTS in the short-term. however, patients with recurrent CTS have to accept surgical treatment. The main operative patterns include open carpal tunnel release (OCTR), mini-OCTR, and endoscopic carpal tunnel release. Conclusion The final conclusion of the most effective method to treat CTS needs more clinical researches, and surgical treatment is one method recommended by some scholars.%目的 对腕管综合征(carpal tunnel syndrome,CTS)的治疗研究现状作一综述.方法 查阅近年来国内外CTS治疗的相关文献,进行分析总结.结果 腕夹板、类固醇适用于轻、中度CTS患者,近期效果显著;治疗后复发的CTS患者需采取手术治疗.主要术式为腕管松解术,包括腕管切开松解减压术(传统型和小切口型)、内镜下腕管松解减压术等.结论 CTS的最佳治疗方法 尚无定论,部分学者推荐首选手术治疗.

  7. CellLab-CTS 2015: continuous-time stochastic cellular automaton modeling using Landlab

    Science.gov (United States)

    Tucker, Gregory E.; Hobley, Daniel E. J.; Hutton, Eric; Gasparini, Nicole M.; Istanbulluoglu, Erkan; Adams, Jordan M.; Siddartha Nudurupati, Sai

    2016-02-01

    CellLab-CTS 2015 is a Python-language software library for creating two-dimensional, continuous-time stochastic (CTS) cellular automaton models. The model domain consists of a set of grid nodes, with each node assigned an integer state code that represents its condition or composition. Adjacent pairs of nodes may undergo transitions to different states, according to a user-defined average transition rate. A model is created by writing a Python code that defines the possible states, the transitions, and the rates of those transitions. The code instantiates, initializes, and runs one of four object classes that represent different types of CTS models. CellLab-CTS provides the option of using either square or hexagonal grid cells. The software provides the ability to treat particular grid-node states as moving particles, and to track their position over time. Grid nodes may also be assigned user-defined properties, which the user can update after each transition through the use of a callback function. As a component of the Landlab modeling framework, CellLab-CTS models take advantage of a suite of Landlab's tools and capabilities, such as support for standardized input and output.

  8. Structural, phenotypic and functional maturation of bone marrow dendritic cells (BMDCs) induced by Chitosan (CTS).

    Science.gov (United States)

    Jia, Lihui; Gao, Xinghua; Wang, Yiqing; Yao, Na; Zhang, Xiaodong

    2014-11-01

    The objective of the present work was to explore the effect of CTS on structural, phenotypic and functional maturation of murine bone marrow derived dendritic cells (BMDCs). The maturity of BMDCs post treatment with CTS was evaluated using transmission electron microscopy (TEM) for structure changes, flow cytometry (FCM) for changes of key surface molecules, FITC-dextran bio-assay for phagocytosis, test of acid phosphatase activity (ACP) for biochemical changes and enzyme linked immunosorbent assay (ELISA) for cytokine level. We found that CTS downregulated the numbers of phagosomes inside the BMDCs, up-regulated the expression of MHC II, CD40, CD83, CD80 and CD86 molecules on BMDCs, decreased activity of ACP and phagocytosis by BMDCs, and induced production of higher levels of IL-12 and TNF-α. It was therefore confirmed that CTS could effectively promote the maturation of BMDCs. Our study provided more detailed evidence and rationale to support the application of CTS as an immune stimulator for enhancing host immunity and as an adjuvant in the design of DC-based vaccines.

  9. Design of the Collective Thomson scattering (CTS) system by using 170-GHz gyrotron in the KSTAR

    Science.gov (United States)

    Park, Min; Kim, Sun-Ho; Kim, Sung-Kyu; Lee, Kyu-Dong; Wang, Son-Jong

    2014-10-01

    The physics of energetic ions is one of the primary subjects to be understood toward the realization of a nuclear fusion power plant. Collective Thomson scattering (CTS) offers the possibility to diagnose the fast ions and the alpha particles in burning plasmas. Spatially- and temporally-resolved one-dimensional velocity distributions of the fast ions can be obtained from the scattered radiation with fewer geometric constraints by utilizing millimeter waves from a high-power gyrotron as a probe beam. We studied the feasibility of CTS fast-ion measurements in the KSTAR by calculating the spectral density functions. Based on that, we suggest a design for the CTS system that uses the currently-operating 170-GHz gyrotron for electron cyclotron heating (ECH) and electron cyclotron current drive (ECCD) in the KSTAR. The CTS system is presented as two subsystems: the antenna system and the heterodyne receiver system. The design procedure for an off-axis ellipsoidal mirror is described, and the CTS system requirements are discussed.

  10. Towards cost effective metal precursor sources for future photovoltaic material synthesis: CTS nanoparticles

    Science.gov (United States)

    Lokhande, A. C.; Gurav, K. V.; Jo, Eunjin; He, Mingrui; Lokhande, C. D.; Kim, Jin Hyeok

    2016-04-01

    Copper tin sulfide (CTS) is an emerging candidate for solar application due to its favorable band gap and higher optical absorption coefficient. Kuramite-Tetragonal Cu3SnS4 (CTS) monodisperse nanoparticles are prepared by hot injection technique involving cost effective sulfate metal precursor source. A protocol for controlled crystal structure has been demonstrated by variation of cationic Cu:Sn ratio. The crystal structure, size, phase purity, atomic composition, oxidation state and optical properties of the nanoparticles are confirmed from X-ray diffraction (XRD), transmission electron microscopy (TEM), Raman, energy dispersive X-ray spectroscopy (EDX), X-ray photoelectron spectroscopy (XPS) and UV-visible spectroscopy, respectively. Hexagonal shaped particles within the size distribution of 7-9 nm with an optimal band gap of 1.28 eV are obtained. XPS study shows the Cu1+, Sn4+ and S2- oxidation states. The effects of influential factors such as metal precursor ratio, metal precursor source, reaction time, heating rate and solvents have been demonstrated systematically on the synthesis of CTS nanoparticles. The plausible mechanism of the formation of CTS nanoparticles has been proposed. The obtained results provide new insight for applying CTS nanoparticles in photovoltaic applications.

  11. Etiological factors of carpal tunnel syndrome in subjects occupationally exposed to monotype wrist movements

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    Magdalena Lewańska

    2014-04-01

    Full Text Available Background: Carpal tunnel syndrome (CTS is the most common neuropathy of upper limbs and a leading cause of upper extremity musculoskeletal disorders, in terms of work exposure, repetitive and forceful exertions of the hand and use of vibrating hand tools. The aim of the study was to evaluate etiological factors of carpal tunnel syndrome in subjects occupationally exposed to monotype movements in wrist. Material and Methods: We conducted the retrospective analysis of 300 patients (261 women, 39 men, mean age 52 years (standard deviation: ±6.93 hospitalized with the suspicion of occupational CTS. Results: The study revealed high percentage (68.7% of diseases and systemic factors involved in the pathogenesis of CTS in the analyzed population, especially obesity (32%, thyroid diseases (28.7%, hormone replacement therapy and/or oophorectomy (16.3% and diabetes mellitus (12%. In 111 patients the coexistence of at least a couple of potential etiological factors of the neuropathy was recognized. Clinical analysis and occupational exposure allowed to diagnose occupational carpal tunnel syndrome in 18 (6% patients only. The undeniable long-term (20.2±9.3 years occupational exposure to repetitive, forceful movements in the wrist was observed in this group. Conclusion: The results of our study indicated that non-occupational etiological factors of CTS predominated and in 37% of patients at least several factors were found. The analysis showed the high prevalence of CTS in workers employed in various sectors of industry, including so called "blue collar" workers. Our study confirmed the multifactorial etiology of carpal tunnel syndrome, however, occupational agents contributed to only 6% of cases. Med Pr 2014;65(2:261–270

  12. The Incidence of Complex Regional Pain Syndrome in Simultaneous Surgical Treatment of Carpal Tunnel Syndrome and Dupuytren Contracture.

    Science.gov (United States)

    Buller, Mitchell; Schulz, Steven; Kasdan, Morton; Wilhelmi, Bradon J

    2017-07-01

    To determine the incidence of complex regional pain syndrome (CRPS) in the concurrent surgical treatment of Dupuytren contracture (DC) and carpal tunnel syndrome (CTS) through a thorough review of evidence available in the literature. The indices of 260 hand surgery books and PubMed were searched for concomitant references to DC and CTS. Studies were eligible for inclusion if they evaluated the outcome of patients treated with simultaneous fasciectomy or fasciotomy for DC and carpal tunnel release using CRPS as a complication of treatment. Of the literature reviewed, only 4 studies met the defined criteria for use in the study. Data from the 4 studies were pooled, and the incidence of recurrence and complications, specifically CRPS, was noted. The rate of CRPS was found to be 10.4% in the simultaneous treatment group versus 4.1% in the fasciectomy-only group. This rate is nearly half the 8.3% rate of CRPS found in a randomized trial of patients undergoing carpal tunnel release. Our analysis demonstrates a marginal increase in the occurrence of CRPS by adding the carpal tunnel release to patients in need of fasciectomy, contradicting the original reports demonstrating a much higher rate of CRPS. This indicates that no clear clinical risk is associated with simultaneous surgical treatment of DC and CTS. In some patients, simultaneous surgical management of DC and CTS can be accomplished safely with minimal increased risk of CRPS type 1.

  13. Transverse plane tendon and median nerve motion in the carpal tunnel: ultrasound comparison of carpal tunnel syndrome patients and healthy volunteers.

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    Margriet H M van Doesburg

    Full Text Available BACKGROUND: The median nerve and flexor tendons are known to translate transversely in the carpal tunnel. The purpose of this study was to investigate these motions in differential finger motion using ultrasound, and to compare them in healthy people and carpal tunnel syndrome patients. METHODS: Transverse ultrasounds clips were taken during fist, index finger, middle finger and thumb flexion in 29 healthy normal subjects and 29 CTS patients. Displacement in palmar-dorsal and radial-ulnar direction was calculated using Analyze software. Additionally, the distance between the median nerve and the tendons was calculated. RESULTS: We found a changed motion pattern of the median nerve in middle finger, index finger and thumb motion between normal subjects and CTS patients (p<0.05. Also, we found a changed motion direction in CTS patients of the FDS III tendon in fist and middle finger motion, and of the FDS II and flexor pollicis longus tendon in index finger and thumb motion, respectively (p<0.05. The distance between the median nerve and the FDS II or FPL tendon is significantly greater in patients than in healthy volunteers for index finger and thumb motion, respectively (p<0.05. CONCLUSION: Our results suggest a changed motion pattern of the median nerve and several tendons in carpal tunnel syndrome patients compared to normal subjects. Such motion patterns may be useful in distinguishing affected from unaffected individuals, and in studies of the pathomechanics of carpal tunnel syndrome.

  14. The dose-dependent efficiency of radial shock wave therapy for patients with carpal tunnel syndrome: a prospective, randomized, single-blind, placebo-controlled trial.

    Science.gov (United States)

    Ke, Ming-Jen; Chen, Liang-Cheng; Chou, Yu-Ching; Li, Tsung-Ying; Chu, Heng-Yi; Tsai, Chia-Kuang; Wu, Yung-Tsan

    2016-12-02

    Recently, extracorporeal shock wave therapy (ESWT) has been shown to be a novel therapy for carpal tunnel syndrome (CTS). However, previous studies did not examine the diverse effects of different-session ESWT for different-grades CTS. Thus, we conducted a randomized, single-blind, placebo-controlled study. Sixty-nine patients (90 wrists) with mild to moderate CTS were randomized into 3 groups. Group A and C patients received one session of radial ESWT (rESWT) and sham eESWT per week for 3 consecutive weeks, respectively; Group B patients received a single session of rESWT. The night splint was also used in all patients. The primary outcome was Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) points, whereas secondary outcomes included the sensory nerve conduction velocity and cross-sectional area of the median nerve. Evaluations were performed at 4, 10, and 14 weeks after the first session of rESWT. Compared to the control group, the three-session rESWT group demonstrated significant BCTQ point reductions at least 14 weeks, and the effect was much longer lasting in patients with moderate CTS than mild CTS. In contrast, the effect of single-session rESWT showed insignificant comparison. rESWT is a valuable strategy for treating CTS and multiple-session rESWT has a clinically cumulative effect.

  15. CTS digital video college curriculum-sharing experiment. [Communications Technology Satellite

    Science.gov (United States)

    Lumb, D. R.; Sites, M. J.

    1974-01-01

    NASA-Ames Research Center, Stanford University, and Carleton University, Ottawa, Canada, are participating in a joint experiment to evaluate the feasibility and effectiveness of college curriculum sharing using compressed digital television and the Communications Technology Satellite (CTS). Each university will offer televised courses to the other during the 1976-1977 academic year via CTS, a joint program by NASA and the Canadian Department of Communications. The video compression techniques to be demonstrated will enable economical interconnection of educational institutions using existing and planned domestic satellites.

  16. Use of provincial health insurance plan billing data to estimate carpal tunnel syndrome morbidity and surgery rates.

    Science.gov (United States)

    Liss, G M; Armstrong, C; Kusiak, R A; Gailitis, M M

    1992-01-01

    Following a work refusal at a plant manufacturing ice cream novelties in Ontario, we were asked to document cases of cumulative trauma disorders (CTDs) and carpal tunnel syndrome (CTS) in this workplace. There were 17 employees with possible hand and wrist problems identified from Workers Compensation Board (WCB) Forms, and from a list prepared at the time of the refusal. After obtaining consents, confirmations of the diagnoses of CTDs, CTS, and of surgical procedures for CTS were obtained from the physicians involved. The relative risk for these disorders among plant employees was estimated in two ways: 1) the rate of CTS operations between 1979 and 1990 was compared to that in the general population using Ontario Health Insurance Plan (OHIP) data on physicians' billings for these operations; and 2) the frequency of WCB first payment claims for tendinitis and CTS during 1987 to 1989 at the plant was compared to that among the entire labor force of Ontario. CTDs had been diagnosed in all 17 workers: 9 had had operations for CTS, but one had had this operation prior to working at the plant. Compared to the remaining 8 workers who had CTS operations, an estimated 0.08 CTS operations would be expected among the 150 employees on the plant's seniority lists between 1979 and 1990, if the estimated rates in the general population were present at the plant, giving a Standardized Morbidity Ratio of 10.0 (95% confidence interval [CI] 4.3-19.7; one-sided p = 2.1 x 10(-6)). There were 6 WCB claims for tendinitis and CTS among plant employees during 1987 through 1989. This frequency was about 68 times that in the entire Ontario labor force (95% CI 24.7-150). This investigation has shown that CTDs, and particularly CTS, documented by medical records, have occurred at least 10 times more frequently than expected at this plant. Use of health insurance billing data to estimate CTS operation rates represents a simple method for estimating the burden of illness at the individual

  17. Value of F-wave studies on the electrodiagnosis of carpal tunnel syndrome

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    Alemdar M

    2015-08-01

    Full Text Available Murat Alemdar Sakarya University Education and Research Hospital, Sakarya, Turkey Background: F waves are late electrophysiological responses to antidromic activation of motor neurons and are used to evaluate the conduction along the whole length of peripheral nerves. We aimed to determine the diagnostic efficacies of minimum median nerve F-wave latency (FWL and median-to-ulnar nerve F-wave latency difference (FWLD on carpal tunnel syndrome (CTS. Materials and methods: The electrophysiological studies consisted of sensory and motor nerve conduction and F-wave studies of the median and ulnar nerves. The best cut-off points of minimum median nerve FWL and FWLD for the diagnosis of CTS were detected for the whole study group and for different height subgroups (Group 1: 150–159 cm, Group 2: 160–169 cm, and Group 3: over 170 cm. The diagnostic efficacies of minimum median nerve FWL and FWLD were calculated for the whole CTS group and for the mild CTS group, separately. Results: The best cut-off point of minimum median nerve FWL on the diagnosis of CTS was determined as 24.60 ms for the whole group. It was 23.90 ms for Group 1, 24.80 ms for Group 2, and 28.40 ms for Group 3. The usage of these stratified cut-off points yielded a higher total diagnostic efficacy rate than single cut-off point usage (79.9% vs 69%, respectively; P=0.02. The best cut-off point of FWLD on the diagnosis of CTS was 0.80 ms for the whole group. It was 0.55 ms for Group 1, 0.30 ms for Group 2, and 0.85 ms for Group 3. Both the single cut-off point usage and the stratified chart usage for FWLD had equal diagnostic efficacy (85.1%. In the mild CTS group, diagnostic efficacy was 55.5% for minimum median nerve FWL and 78.8% for FWLD (P=0.0001. Conclusion: Median-to-ulnar nerve FWLD yields a higher diagnostic efficacy than minimum median nerve FWL on the diagnosis of CTS. However, the sensitivities of both parameters are not satisfactory for the extremities with mild CTS

  18. Effect of body mass index on ulnar nerve conduction velocity, ulnar neuropathy at the elbow, and carpal tunnel syndrome.

    Science.gov (United States)

    Landau, Mark E; Barner, Kristen C; Campbell, William W

    2005-09-01

    Both high and low body mass index (BMI) have been reported as risk factors for ulnar neuropathy at the elbow (UNE), and a high BMI as a risk factor for carpal tunnel syndrome (CTS). To determine whether the extremes of BMI are risk factors for UNE or CTS, and whether BMI affects calculation of median and ulnar motor nerve conduction velocity (NCV), we retrospectively analyzed the electrodiagnostic records of control patients, UNE patients, and CTS patients. The BMI was calculated for 50 patients with a sole diagnosis of UNE and compared to the BMI of 50 patients with CTS and 50 control subjects. The mean BMIs were 25.9 +/- 4.4, 30.1 +/- 5.5, and 28.3 +/- 5.6 for the UNE, CTS, and controls, respectively. By one-way analysis of variance, the difference in BMI between the UNE patients and the normal patients was significant (P ulnar motor NCV across the elbow but not with forearm NCV. Across-elbow (AE) ulnar motor NCV may be falsely increased in patients with a high BMI, probably due to distance measurement factors. Not only do relatively slender individuals have comparatively slower AE ulnar NCVs, they are also at increased risk for developing UNE. Patients with a high BMI are at increased risk for CTS.

  19. Resolución microquirúrgica de aneurisma de arteria cubital en paciente pediátrico

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    A. Aguilera-Salgado

    2015-09-01

    Full Text Available Presentamos el caso clínico de un paciente varón de 6 años de edad con antecedente de caída desde su propia altura un mes antes de su valoración en consulta, en donde se identifica una tumoración pulsátil en región hipotenar de mano derecha, no dolorosa y no fija a planos profundos. El ultrasonido doppler informa de una tumoración con pared definida, heterogénea, con flujo sanguíneo a través de la misma. En base a los antecedentes y a los resultados del ultrasonido se decide intervenir quirúrgicamente para evitar posibles complicaciones, encontrando un aneurisma de la arteria cubital de 3 x 3 cm de diámetro, no trombosado, que resecamos, practicando reconstrucción mediante injerto venoso término-terminal. El paciente evolucionó sin complicaciones.

  20. Assessment of Median Nerve Mobility by Ultrasound Dynamic Imaging for Diagnosing Carpal Tunnel Syndrome.

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    Tai-Tzung Kuo

    Full Text Available Carpal tunnel syndrome (CTS is the most common peripheral neuropathy and is characterized by median nerve entrapment at the wrist and the resulting median nerve dysfunction. CTS is diagnosed clinically as the gold standard and confirmed with nerve conduction studies (NCS. Complementing NCS, ultrasound imaging could provide additional anatomical information on pathological and motion changes of the median nerve. The purpose of this study was to estimate the transverse sliding patterns of the median nerve during finger movements by analyzing ultrasound dynamic images to distinguish between normal subjects and CTS patients. Transverse ultrasound images were acquired, and a speckle-tracking algorithm was used to determine the lateral displacements of the median nerve in radial-ulnar plane in B-mode images utilizing the multilevel block-sum pyramid algorithm and averaging. All of the averaged lateral displacements at separate acquisition times within a single flexion-extension cycle were accumulated to obtain the cumulative lateral displacements, which were curve-fitted with a second-order polynomial function. The fitted curve was regarded as the transverse sliding pattern of the median nerve. The R2 value, curvature, and amplitude of the fitted curves were computed to evaluate the goodness, variation and maximum value of the fit, respectively. Box plots, the receiver operating characteristic (ROC curve, and a fuzzy c-means clustering algorithm were utilized for statistical analysis. The transverse sliding of the median nerve during finger movements was greater and had a steeper fitted curve in the normal subjects than in the patients with mild or severe CTS. The temporal changes in transverse sliding of the median nerve within the carpal tunnel were found to be correlated with the presence of CTS and its severity. The representative transverse sliding patterns of the median nerve during finger movements were demonstrated to be useful for

  1. A manual therapy intervention improves symptoms in patients with carpal tunnel syndrome: a pilot study.

    Science.gov (United States)

    Maddali Bongi, Susanna; Signorini, Massimo; Bassetti, Massimo; Del Rosso, Angela; Orlandi, Martina; De Scisciolo, Giuseppe

    2013-05-01

    In carpal tunnel syndrome (CTS), manual therapy interventions (MTI) reduce tissue adhesion and increase wrist mobility. We evaluated the efficacy of a MTI in relieving CTS signs and symptoms. Twenty-two CTS patients (pts) (41 hands) were treated with a MTI, consisting in 6 treatments (2/week for 3 weeks) of soft tissues of wrist and hands and of carpal bones. Pts were assessed for hand sensitivity, paresthesia, hand strength, hand and forearm pain, night awakening; Phalen test, thenar eminence hypotrophy and Boston Carpal Tunnel Questionnaire (BCTQ) Symptom Severity Scale (SSS) and Functional Status Scale (FSS). Median nerve was studied by sensory nerve conduction velocity (SNCV) and distal motor latency (DML). CTS was scored as minimal, mild, medium, severe and extreme. We considered as control group the same pts assessed before treatment: at baseline (T0a) and after 12 weeks (T0b). Pts were evaluated at the end of treatment (T1) and after 24-week (T2) follow-up. At T0b, versus T0a, forearm pain and Phalen test positivity were increased and hand strength reduced (p < 0.05). BCTQ-SSS and BCTQ-FSS scores improved at T1 versus T0b (p < 0.05) with the amelioration maintained at T2. At T1, the number of pts with paresthesia, night awakening, hypoesthesia, Phalen test, hand strength reduction and hand sensitivity was reduced with the lacking of symptoms maintained at T2 (p < 0.05). No changes in SNCV, DML and CTS scoring were shown. MTI improved CTS signs and symptoms, with benefits maintained at follow-up. Thus, it may be valid as a conservative therapy.

  2. Carpal tunnel syndrome - electrodiagnostic aspects of fifty seven symptomatic hands.

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    Murthy J

    1999-10-01

    Full Text Available Electrodiagnostic data of fifty seven symptomatic extremities with carpal tunnel syndrome (CTS are described. Practice recommendations made by American Academy of Neurology, American Association of Electrodiagnostic Medicine and American Academy of Physical Medicine and Rehabilitation regarding electrodiagnostic studies were considered while confirming CTS diagnosis by electrodiagnostic studies. Median sensory nerve conduction studies were the commonest abnormalities noted. The median orthodromic sensory latencies were prolonged in 86% and sensory nerve action potential amplitude abnormalities were seen in 82%. Prolongation of the conduction in the short segment across the wrist in the median nerve was seen in 96.5% and the difference in the conduction between median and ulnar nerve across the wrist was significant in all the 57 extremities. The median motor latencies were prolonged in 67% of hands. Higher incidence of electrodiagnostic abnormalities observed in this study might be due to inclusion of patients with severe disease.

  3. Subjective symptoms of carpal tunnel syndrome correlate more with psychological factors than electrophysiological severity

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    Firosh Khan

    2017-01-01

    Full Text Available Aim: Carpal tunnel syndrome (CTS is the most common entrapment neuropathy and is one of the most common requests for electrodiagnosis. We aimed to note the relationship of subjective symptom severity of CTS, with objective electrophysiological severity and psychological status of patients. Patients and Methods: One hundred and forty-four consecutive patients of CTS referred to neurophysiology laboratory of a tertiary care hospital over 1 year were prospectively studied. Boston CTS Assessment Questionnaire (BCTSAQ and visual analog scale (VAS were used to assess subjective symptom severity. Psychological status was assessed by Hospital Anxiety and Depression Scale (HADS. Electrophysiological severity of CTS was estimated by median motor distal latency and median to ulnar peak sensory latency difference across the wrist. Each parameter in both hands was scored from 0 to 3 depending on the severity grade, and a composite electrophysiological severity score (CEPSS was calculated for each patient by summing up the scores in both hands. Statistical analysis was done by Spearman's rank correlation test. Results: There was significant correlation of BCTSAQ with VAS (P = 0.001, HADS anxiety score (P < 0.001, and HADS depression score (P = 0.01. CEPSS had no significant correlation with VAS (P = 0.103, HADS anxiety score (P = 0.211, or HADS depression score (P = 0.55. CEPSS had a borderline correlation with BCTSAQ (P = 0.048. Conclusions: While the subjective symptoms of CTS are well correlated with psychological factors, their correlation with objective electrophysiological severity is weak. Hence, prompt treatment of psychological comorbidity is important in symptomatic management of CTS; decision about surgical intervention should be based on electrophysiological severity rather than symptom severity.

  4. The association of Raynaud's syndrome with carpal tunnel syndrome: a meta-analysis.

    Science.gov (United States)

    Hartmann, Peter; Mohokum, Melvin; Schlattmann, Peter

    2012-03-01

    Carpal tunnel syndrome (CTS) has traditionally been included among the diseases associated with Raynaud's syndrome (RS). The prevalence of RS in patients suffering from CTS is not well defined. The objective of this paper was to assess the prevalence of RS in patients with CTS-a meta-analysis of published data was performed. The PubMed database of the National Library of Medicine and ISI Web of Knowledge was used for studies dealing with RS and CTS. The studies provided sufficient data to estimate the prevalence of RS in patients of CTS. A forest plot was determined by the revealed prevalence. Statistical analysis was based on methods for a random effects meta-analysis and a finite mixture model for proportions. Publication bias was investigated with the linear regression test (Egger's method). A meta-regression was conducted by the year of publication. Eight eligible studies, contributing data on 675 subjects, were included in this meta-analysis. For CTS, a pooled prevalence of 15.5% and 95% CI (95% CI 0.043, 0.318) were obtained. Statistically publication bias was present (P value 0.143). A mixture model analysis found five latent classes. The meta-regression indicated that the estimated prevalence increased when the year of commencement increased, too. Within the decade (1957-1967), the odds ratio increased from 1 (95% CI 1.065, 1.112) to 2.340 (95% CI 1.886, 2.903). Despite some heterogeneity, there is a possible indication of an association between RS and patients with CTS.

  5. Screening for Acromegaly in Patients with Carpal Tunnel Syndrome: A Prospective Study (ACROCARP).

    Science.gov (United States)

    Zoicas, F; Kleindienst, A; Mayr, B; Buchfelder, M; Megele, R; Schöfl, C

    2016-07-01

    Early diagnosis of acromegaly prevents irreversible comorbidities and facilitates surgical cure. Carpal tunnel syndrome (CTS) is common in acromegaly and patients have often undergone surgery for CTS prior to the diagnosis of acromegaly. We hypothesized that screening CTS-patients for acromegaly could facilitate active case-finding. We prospectively enrolled 196 patients [135 women, 56.9 (range 23-103) years] who presented with CTS for surgery. Patients were asked about 6 symptoms suggestive of acromegaly using a questionnaire calculating a symptom score (0-6 points), and insulin-like-growth factor 1 (IGF-1) was measured. If IGF-1 was increased, IGF-1 measurement was repeated, and random growth hormone (GH) and/or an oral glucose tolerance test (OGTT) with assessment of GH-suppression were performed. The mean symptom score was 1.7±1.3 points. Three patients reported the maximal symptom score of 6 points, but none of them had an increased IGF-1. There was no correlation between the symptom score and IGF-1-SDS (standard deviation score) (r=0.026; p=0.71). Four patients had an IGF-1>2 SDS. In 2 patients acromegaly was ruled out using random GH and OGTT. One patient had normal IGF-1 and random GH at follow-up. One patient refused further diagnostics. In this prospective cohort of patients with CTS, the observed frequency of acromegaly was at most 0.51% (95% CI 0.03 to 2.83%). In this prospective study, none of the 196 patients with CTS had proven acromegaly. Thus, we see no evidence to justify general screening of patients with CTS for acromegaly.

  6. Personal risk factors for carpal tunnel syndrome in female visual display unit workers

    Directory of Open Access Journals (Sweden)

    Matteo Riccò

    2016-12-01

    Full Text Available Objectives: Carpal tunnel syndrome (CTS is the most common nerve entrapment syndrome, which since the beginning of the seventies has been linked to the keyboard and visual display unit (VDU. The objective of this study was to investigate the prevalence and personal factors associated with CTS in female VDU workers in Italy. Material and Methods: Participants in this study were female adult subjects, working ≥ 20 h/week (N = 631, mean age 38.14±7.81 years, mean working age 12.9±7.24 years. Signs and symptoms were collected during compulsory occupational medical surveillance. The binary logistic regression was used to estimate adjusted odds ratios for the factors of interest. Results: Diagnosis of CTS was reported in 48 cases (7.6%, 11 of them or 1.7% after a surgical correction for the incidence of 5.94/1000 person-years. In general, signs and symptoms of CTS were associated with the following demographic factors: previous trauma of upper limb (adjusted odds ratio (ORa = 8.093, 95% confidence interval (CI: 2.347–27.904, history (> 5 years of oral contraceptives therapy/hormone replacement therapy (ORa = 3.77, 95% CI: 1.701–8.354 and cervical spine signs/symptoms (ORa = 4.565, 95% CI: 2.281–9.136. Conclusions: The prevalence of CTS was similar to the estimates for the general population of Italy. Among personal risk factors, hormone therapy, previous trauma of the upper limb and signs/symptoms of the cervical spine appeared to be associated with a higher risk of CTS syndrome. Eventually, the results reinforce interpretation of CTS in VDU workers as a work-related musculoskeletal disorder rather than a classical occupational disease. Int J Occup Med Environ Health 2016;29(6:927–936

  7. Personal risk factors for carpal tunnel syndrome in female visual display unit workers.

    Science.gov (United States)

    Riccò, Matteo; Cattani, Silvia; Signorelli, Carlo

    2016-11-18

    Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome, which since the beginning of the seventies has been linked to the keyboard and visual display unit (VDU). The objective of this study was to investigate the prevalence and personal factors associated with CTS in female VDU workers in Italy. Participants in this study were female adult subjects, working ≥ 20 h/week (N = 631, mean age 38.14±7.81 years, mean working age 12.9±7.24 years). Signs and symptoms were collected during compulsory occupational medical surveillance. The binary logistic regression was used to estimate adjusted odds ratios for the factors of interest. Diagnosis of CTS was reported in 48 cases (7.6%, 11 of them or 1.7% after a surgical correction) for the incidence of 5.94/1000 person-years. In general, signs and symptoms of CTS were associated with the following demographic factors: previous trauma of upper limb (adjusted odds ratio (ORa) = 8.093, 95% confidence interval (CI): 2.347-27.904), history (> 5 years) of oral contraceptives therapy/hormone replacement therapy (ORa = 3.77, 95% CI: 1.701-8.354) and cervical spine signs/symptoms (ORa = 4.565, 95% CI: 2.281-9.136). The prevalence of CTS was similar to the estimates for the general population of Italy. Among personal risk factors, hormone therapy, previous trauma of the upper limb and signs/symptoms of the cervical spine appeared to be associated with a higher risk of CTS syndrome. Eventually, the results reinforce interpretation of CTS in VDU workers as a work-related musculoskeletal disorder rather than a classical occupational disease. Int J Occup Med Environ Health 2016;29(6):927-936.

  8. Observation of short time-scale spectral emissions at millimeter wavelengths with the new CTS diagnostic on the FTU tokamak

    DEFF Research Database (Denmark)

    Bruschi, A.; Alessi, E.; Bin, W.

    2017-01-01

    On the FTU tokamak, the collective Thomson scattering (CTS) diagnostic was renewed for investigating the possible excitation of parametric decay instabilities (PDI) by electron cyclotron (EC) or CTS probe beams in presence of magnetic islands and measure their effects on the EC power absorption...

  9. Carpal tunnel syndrome: Assessment of correlation between clinical, neurophysiological and ultrasound characteristics

    Directory of Open Access Journals (Sweden)

    B Hemeshwar Rao

    2012-01-01

    Full Text Available Objectives: To evaluate the relationship between symptoms, clinical severity, neurophysiological characteristics with median nerve cross-sectional area (CSA at the level of carpal tunnel inlet at ultrasonography (USG and its utility in diagnosis of carpal tunnel syndrome (CTS. Materials and Methods: Prospective study of 30 patients with symptoms of CTS, attending to the Neurology out patient department (OPD at University Teaching Hospital. A multidimensional assessment of CTS was done using historic and objective scale (Hi-Ob scale for clinical severity, Boston carpal tunnel questionnaire (BCTQ for patient-oriented measures, neuro physiologic studies of median nerve at wrist and USG to measure median nerve CSA at carpal tunnel inlet. Results: Thirty patients included in the study (22 women and 8 men. Mean of CSA was 12.69 mm 2 (SD2.67. Association between BCTQ score value and inlet values was assessed by Karl Pearson correlation coefficient ( r = 0.376, P = 0.04. There was positive association with BCTQ scores and CSA of median nerve at carpal tunnel inlet. To compare clinical severity scale (Hi-Ob and USG CSA, analysis of variance was performed (F value and Scheffe′s multiple comparison test was used to find group difference (grades 1 and 2 P < 0.001, grades1 and 2P P < 0.001, grade 2 differs with grade 2P P < 0.006. As the number of patients is less in minimal, mild and severe groups, the difference between neurophysiological groups and mean of CSA was not statistically significant. Conclusion: A positive correlation exists between USG findings and all the conventional measures of CTS severity.

  10. A prospective study of carpal tunnel syndrome: workplace and individual risk factors

    Science.gov (United States)

    Burt, Susan; Deddens, James A; Crombie, Ken; Jin, Yan; Wurzelbacher, Steve; Ramsey, Jessica

    2015-01-01

    Objectives To quantify the risk for carpal tunnel syndrome (CTS) from workplace physical factors, particularly hand activity level and forceful exertion, while taking into account individual factors including age, gender, body mass index (BMI), and pre-existing medical conditions. Methods Three healthcare and manufacturing workplaces were selected for inclusion on the basis of range of exposure to hand activity level and forceful exertion represented by their jobs. Each study participants job tasks were observed and evaluated ’ onsite and videotaped for further analysis, including frequency and duration of exertion and postural deviation. Individual health assessment entailed electrodiagnostic testing of median and ulnar nerves, physical examination and questionnaires at baseline with annual follow-up for 2 years. Results The incidence of dominant hand CTS during the study was 5.11 per 100 person-years (29 cases). Adjusted HRs for dominant hand CTS were as follows: working with forceful exertion ≥20% but job strain. Conclusions Workplace and individual risk factors both contribute to the risk for CTS. Time spent in forceful exertion can be a greater risk for CTS than obesity if the job exposure is high. Preventive workplace efforts should target forceful exertions. PMID:23788614

  11. CTS 11.7 GHz isolation data for the calendar year 1978

    Science.gov (United States)

    Bostian, C. W.; Dent, J. R.

    1979-01-01

    Monthly and annual percent-of-time data on polarization isolation measured for the CTS spacecraft 11.7 GHz downlink are presented. The relationship between isolation and attenuation and the degree to which isolation can be predicted from attenuation data are discussed.

  12. Synthesis of antibacterial film CTS/PVP/TiO2/Ag for drinking water system.

    Science.gov (United States)

    Zhang, Liang; Bai, Xue; Tian, Hua; Zhong, Lvling; Ma, Cailian; Zhou, Yuanzhen; Chen, Shuangli; Li, Dongliang

    2012-08-01

    A CTS/PVP/TiO2/Ag functional film was prepared as an antibacterial composite used in storing drinking water. The orthogonal experiment showed that the optimal conditions for preparing membranes with best antibacterial activity and tensile strength are c(AgNO3)=0.08%, c(TiO2)=0.20%, c(CTS)=2.25%, and c(PVP)=3.00%. The FT-IR spectrum implies that hydrogen bands are formed between acetyl in PVP and hydroxyl in CTS molecule, and -NH and -OH of CTS have some interactions with sliver nano-particles (nano-Ags) which were reduced in situ. The SEM images show that the TiO2 particles are displayed on the surface and embedded in the film. And nano-Ags are further proved through XRD and SEM images. The DSC curves show that the film has a favorable compatibility and heat stability. In application study, it is proved that this film has sustainable antibacterial activity and is safe in use.

  13. Applying unconventional secretion of the endochitinase Cts1 to export heterologous proteins in Ustilago maydis.

    Science.gov (United States)

    Stock, Janpeter; Sarkari, Parveen; Kreibich, Saskia; Brefort, Thomas; Feldbrügge, Michael; Schipper, Kerstin

    2012-10-15

    The demand on the biotechnological production of proteins for pharmaceutical, medical and industrial applications is steadily growing. For the production of challenging proteins, we aim to establish a novel expression platform in the well characterized eukaryotic microorganism Ustilago maydis. In filaments of this fungus, secretion of the endochitinase Cts1 depends on mRNA transport along microtubules, which is mediated by the key RNA-binding protein Rrm4. Here, we report two important findings: (i) Cts1 secretion occurs via a novel unconventional route and (ii) this secretory mechanism can be exploited for the export of active heterologous proteins. Initially, we used β-glucuronidase (Gus) as a reporter for unconventional secretion. This bacterial enzyme is inactivated by N-glycosylation during its passage through the conventional eukaryotic secretory pathway. By contrast, in our system Gus was exported in its active form by fusion to Cts1 confirming its secretion by an unconventional route. As a proof-of-principle for economically important biopharmaceuticals we expressed an active single-chain antibody. Importantly, the novel protein export pathway circumvents N-glycosylation which is advantageous in many applications, e.g., to avoid undesired immune reactions in humans. Thus, the unconventional Cts1 secretion machinery has a high potential for the production of biotechnologically relevant proteins.

  14. Development and Determination of Reliability and Validity of Professional Learning Community Collaborative Team Survey (CTS)

    Science.gov (United States)

    Colvin, Joshua A.

    2013-01-01

    The study of transformative learning within collaborative teams was conducted to gain new applicable knowledge used to influence overall school improvement and implementation of professional learning communities. To obtain this new knowledge, the Professional Learning Community Collaborative Team Survey (CTS) was developed and psychometrically…

  15. Fast ion measurements by collective Thomson scattering in TEXTOR and ASDEX Upgrade and proposal for the ITER CTS system

    DEFF Research Database (Denmark)

    Korsholm, Søren Bang; Bindslev, Henrik; Furtula, Vedran;

    Moving towards the era of burning fusion plasmas, a better knowledge of the physics of highly energetic particles, such as fusion born alpha particles, becomes essential. Diagnosing the fast ions in a fusion plasma is a challenging task, but the technique of collective Thomson scattering (CTS......) provides the possibility of revealing the velocity distribution of the confined fast ions along a given direction – resolved both in time and space. Recently, the ITER baseline design has been expanded to include the enabling of the front end of a fast ion CTS diagnostic system resolving dynamics...... perpendicular to the magnetic field. The feasibility study and conceptual design of this diagnostic was provided by the CTS group at Risø DTU. The development of the ITER CTS diagnostic builds on the experiences and expertise gained from the construction and current operation of the CTS diagnostic systems...

  16. The effect of excess body mass on the risk of carpal tunnel syndrome: a meta-analysis of 58 studies.

    Science.gov (United States)

    Shiri, R; Pourmemari, M H; Falah-Hassani, K; Viikari-Juntura, E

    2015-12-01

    We aimed to estimate the effects of overweight and obesity on carpal tunnel syndrome (CTS), and to assess whether sex modifies the associations. Literature searches were conducted in PubMed, Embase, Web of Science, Scopus, Google Scholar and ResearchGate databases from 1953 to February 2015. Fifty-eight studies consisting of 1,379,372 individuals qualified for a meta-analysis. We used a random-effects meta-analysis, assessed heterogeneity and publication bias, and performed sensitivity analyses. Overweight increased the risk of CTS or carpal tunnel release 1.5-fold (pooled confounder-adjusted odds ratio [OR] = 1.47, 95% CI 1.37-1.57, N = 1,279,546) and obesity twofold (adjusted OR = 2.02, 95% CI 1.92-2.13, N = 1,362,207). Each one-unit increase in body mass index increased the risk of CTS by 7.4% (adjusted OR = 1.074, 95% CI 1.071-1.077, N = 1,258,578). Overweight and obesity had stronger effects on carpal tunnel release than CTS. The associations did not differ between men and women, and they were independent of study design. Moreover, the associations were not due to bias or confounding. Excess body mass markedly increases the risk of CTS. As the prevalence of overweight and obesity is increasing globally, overweight-related CTS is expected to increase. Future studies should investigate whether a square-shaped wrist and exposure to physical workload factors potentiate the adverse effect of obesity on the median nerve.

  17. Identification of Subgroups of Women with Carpal Tunnel Syndrome with Central Sensitization.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Fernández-Muñoz, Juan J; Navarro-Pardo, Esperanza; da-Silva-Pocinho, Ricardo F; Ambite-Quesada, Silvia; Pareja, Juan A

    2016-09-01

    Identification of subjects with different sensitization mechanisms can help to identify better therapeutic strategies for carpal tunnel syndrome (CTS). The aim of the current study was to identify subgroups of women with CTS with different levels of sensitization. A total of 223 women with CTS were recruited. Self-reported variables included pain intensity, function, disability, and depression. Pressure pain thresholds (PPT) were assessed bilaterally over median, ulnar, and radial nerves, C5-C6 joint, carpal tunnel, and tibialis anterior to assess widespread pressure pain hyperalgesia. Heat (HPT) and cold (CPT) pain thresholds were also bilaterally assessed over the carpal tunnel and the thenar eminence to determine thermal pain hyperalgesia. Pinch grip force between the thumb and the remaining fingers was calculated to determine motor assessment. Subgroups were determined according to the status on a previous clinical prediction rule: PPT over the affected C5-C6 joint 66 points. The ANOVA showed that women within group 1 (positive rule, n = 60) exhibited bilateral widespread pressure hyperalgesia (P < 0.001) and bilateral thermal thresholds (P < 0.001) than those within group 2 (negative rule, n = 162). Women in group 1 also exhibited higher depression than those in group 2 (P = 0.023). No differences in self-reported variables were observed. This study showed that a clinical prediction rule originally developed for identifying women with CTS who are likely to respond favorably to manual physical therapy was able to identify women exhibiting higher widespread pressure hyper-sensitivity and thermal hyperalgesia. This subgroup of women with CTS exhibiting higher sensitization may need specific therapeutic programs. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Conservative treatment of carpal tunnel syndrome: comparison between laser therapy and Fascial Manipulation(®).

    Science.gov (United States)

    Pratelli, Elisa; Pintucci, Marco; Cultrera, Pina; Baldini, Enrico; Stecco, Antonio; Petrocelli, Antonio; Pasquetti, Pietro

    2015-01-01

    The etiopathogenesis of Carpal Tunnel Syndrome (CTS) is multifactorial and most cases are classified as idiopathic (Thurston 2013). A randomized controlled trial was performed to compare the effectiveness of Fascial Manipulation(®) (FM) and Low-Level Laser Therapy (LLLT) for CTS. This prospective trial included 42 patients (70 hands with symptoms) with clinical and electroneuromyographic diagnosis of CTS. The patients were randomly assigned to receive multiple sessions of FM or multiple session of LLLT. The Visual Analogic Scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ) were performed at baseline, end of treatment and after three months. The group that received FM showed a significant reduction in subjective pain perception and an increased function assessed by BCTQ at the end of the treatment and follow-up. The group that received LLLT showed an improvement in the BCTQ at the end of the treatment but the improvement level was not sustained at the three month follow-up. FM is a valid alternative treatment for CTS.

  19. Efficacy of paraffin wax bath for carpal tunnel syndrome: a randomized comparative study

    Science.gov (United States)

    Ordahan, Banu; Karahan, Ali Yavuz

    2017-08-01

    Carpal tunnel syndrome (CTS) is the most frequently diagnosed neuropathy of upper extremity entrapment neuropathies. We aimed to investigate the effectiveness of paraffin therapy in patients with CTS. Seventy patients diagnosed with mild or moderate CTS were randomly divided into two groups as splint treatment (during the night and day time as much as possible for 3 weeks) alone and splint (during the night and day time as much as possible for 3 weeks) + paraffin treatment (five consecutive days a week for 3 weeks). Clinical and electrophysiological assessments were performed before and 3 weeks after treatment. The patients were assessed by using visual analog scale (VAS) for pain, electroneuromyography (ENMG), and Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ). The significant improvement was found in VAS scores in both groups when compared with pretreatment values (p 0.05), whereas a significant improvement was noted in the BCTQ symptom severity scale score in the splint group (p 0.05), and the difference in these parameters between the groups was statistically significant (p < 0.05). In conclusion, using splinting alone in patients with CTS is an effective treatment for reducing symptoms in the early stages. Paraffin treatment with splint increases the recovery in functional and electrophysiological parameters.

  20. Vibration Response Characteristics of the Cross Tunnel Structure

    Directory of Open Access Journals (Sweden)

    Jinxing Lai

    2016-01-01

    Full Text Available It is well known that the tunnel structure will lose its function under the long-term repeated function of the vibration effect. A prime example is the Xi’an cross tunnel structure (CTS of Metro Line 2 and the Yongningmen tunnel, where the vibration response of the tunnel vehicle load and metro train load to the structure of shield tunnel was analyzed by applying the three-dimensional (3D dynamic finite element model. The effect of the train running was simulated by applying the time-history curves of vibration force of the track induced by wheel axles, using the fitted formulas for vehicle and train vibration load. The characteristics and the spreading rules of vibration response of metro tunnel structure were researched from the perspectives of acceleration, velocity, displacement, and stress. It was found that vehicle load only affects the metro tunnel within 14 m from the centre, and the influence decreases gradually from vault to spandrel, haunch, and springing. The high-speed driving effect of the train can be divided into the close period, the rising period, the stable period, the declining period, and the leaving period. The stress at haunch should be carefully considered. The research results presented for this case study provide theoretical support for the safety of vibration response of Metro Line 2 structure.

  1. 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.

  2. Exposure-response relationships between movements and postures of the wrist and carpal tunnel syndrome among male and female house painters

    DEFF Research Database (Denmark)

    Heilskov-Hansen, Thomas; Mikkelsen, Sigurd; Svendsen, Susanne Wulff

    2016-01-01

    OBJECTIVES: To investigate exposure-response relationships between measured movements and postures of the wrist and the incidence of carpal tunnel syndrome (CTS), and any modifications by sex. METHODS: In 2011, we established a historical cohort of 9364 members of the Painters' Union in Denmark. ...

  3. MD-CTS: An integrated terminology reference of clinical and translational medicine.

    Science.gov (United States)

    Ray, Will; Finamore, Joe; Rastegar-Mojarad, Majid; Kadolph, Chris; Ye, Zhan; Bohne, Jacquie; Xu, Yin; Burish, Dan; Sondelski, Joshua; Easker, Melissa; Finnegan, Brian; Bartkowiak, Barbara; Smith, Catherine Arnott; Tachinardi, Umberto; Mendonca, Eneida A; Weichelt, Bryan; Lin, Simon M

    2016-01-01

    New vocabularies are rapidly evolving in the literature relative to the practice of clinical medicine and translational research. To provide integrated access to new terms, we developed a mobile and desktop online reference-Marshfield Dictionary of Clinical and Translational Science (MD-CTS). It is the first public resource that comprehensively integrates Wiktionary (word definition), BioPortal (ontology), Wiki (image reference), and Medline abstract (word usage) information. MD-CTS is accessible at http://spellchecker.mfldclin.edu/. The website provides a broadened capacity for the wider clinical and translational science community to keep pace with newly emerging scientific vocabulary. An initial evaluation using 63 randomly selected biomedical words suggests that online references generally provided better coverage (73%-95%) than paper-based dictionaries (57-71%).

  4. MD-CTS: An integrated terminology reference of clinical and translational medicine

    Directory of Open Access Journals (Sweden)

    Will Ray

    2016-01-01

    Full Text Available New vocabularies are rapidly evolving in the literature relative to the practice of clinical medicine and translational research. To provide integrated access to new terms, we developed a mobile and desktop online reference—Marshfield Dictionary of Clinical and Translational Science (MD-CTS. It is the first public resource that comprehensively integrates Wiktionary (word definition, BioPortal (ontology, Wiki (image reference, and Medline abstract (word usage information. MD-CTS is accessible at http://spellchecker.mfldclin.edu/. The website provides a broadened capacity for the wider clinical and translational science community to keep pace with newly emerging scientific vocabulary. An initial evaluation using 63 randomly selected biomedical words suggests that online references generally provided better coverage (73%-95% than paper-based dictionaries (57–71%.

  5. Pain, depression and sleep disorders in patients with diabetic and nondiabetic carpal tunnel syndrome: a vicious cycle

    Directory of Open Access Journals (Sweden)

    Nermin Tanik

    2016-03-01

    Full Text Available ABSTRACT Carpal tunnel syndrome (CTS is a condition involving nerve entrapment that often leads to chronic neuropathic pain. We aimed to evaluate sleep quality and related parameters in diabetic and non-diabetic CTS patients. Method This study included a total of 366 patients with chronic CTS. These patients’ sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI and depression using the Beck Depression Inventory (BDI. The severity of neuropathic pain was evaluated using the Douleur Neuropathique-4 (DN4 questionnaire and a visual analogue scale (VAS. Results In the non-diabetic patient group, the total PSQI score was found to affect BDI and VAS, while in the diabetic patient group, the duration of symptoms affected VAS, BDI and fasting glucose levels. Conclusion For diabetic patients, hyperglycemia depression and chronification of neuropathic pain may lead to deterioration of sleep quality. Therefore, consideration of these parameters in the treatment may break a vicious cycle.

  6. Association of Dental Practice as a Risk Factor in the Development of Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Borhan Haghighi A.

    2013-03-01

    Full Text Available Statement of Problem: Carpal tunnel syndrome (CTS is an important cause of work disability. There is controversy over the relation between carpal tunnel syndrome and occupation. The aim of this study was to assess the relationship between the time-span of practicing dentistry and the role of dominant hands in the development of carpal tunnel syndrome.Materials and Method: In this descriptive cross sectional study, 40 dentists and dental students (15 women and 25 men undertook the electroneuro-diagnostic test in both hands by an electromyogram (EMG and they were also evaluated in terms of self- reported clinical symptoms.Results: 17.5% of participants were diagnosed to have decreased nerve conduction velocity while10% had reported clinical symptoms of CTS. Both dominant and non-dominant hands were involved. Within cases who were diagnosed as having median nerve neuropathy, 87.5% worked more than 20 hours per week. 57% had 17-23 years of dental practice experience and 14.2% of cases had10-16 years of practice in dentistry.Conclusion: The high rate of CTS symptoms, in both dominant and non-dominant hand among dental practitioners with more years of dental practice, indicates a prequisite for particular attention, then sufficient education on the major risk factors causing this problem. Early diagnosis of these symptoms may improve the future management of the disease.

  7. CTS attenuation and cross-polarization measurements at 11.7 GHz

    Science.gov (United States)

    Vogel, W. J.; Straiton, A. W.

    1977-01-01

    The results of data obtained 80 days preceding the solar eclipse shutdown of the CTS 11.7 GHz righthand circularly polarized beacon transmitter are presented. Attenuation and cross polarization isolation were measured. It was determined that depolarization presents a serious limitation to satellite system reliability when frequency reuse by polarization diversity is employed. A 27 db isolation margin would reduce reliability below 99.95%. For the same percentage the required fade margin was below 3 db.

  8. Carpal tunnel syndrome - Part II (treatment,

    Directory of Open Access Journals (Sweden)

    Michel Chammas

    2014-10-01

    Full Text Available The treatments for non-deficit forms of carpal tunnel syndrome (CTS are corticoid infiltration and/or a nighttime immobilization brace. Surgical treatment, which includes sectioning the retinaculum of the flexors (retinaculotomy, is indicated in cases of resistance to conservative treatment in deficit forms or, more frequently, in acute forms. In minimally invasive techniques (endoscopy and mini-open, and even though the learning curve is longer, it seems that functional recovery occurs earlier than in the classical surgery, but with identical long-term results. The choice depends on the surgeon, patient, severity, etiology and availability of material. The results are satisfactory in close to 90% of the cases. Recovery of strength requires four to six months after regression of the pain of pillar pain type. This surgery has the reputation of being benign and has a complication rate of 0.2–0.5%.

  9. Preparation and drug release mechanism of CTS-TAX-NP-MSCs drug delivery system.

    Science.gov (United States)

    Dai, Tian; Yang, Enyun; Sun, Yongjun; Zhang, Linan; Zhang, Li; Shen, Ning; Li, Shuo; Liu, Lei; Xie, Yinghua; Wu, Shaomei; Gao, Zibin

    2013-11-01

    Targeting delivery of anticancer agents is a promising field in anticancer therapy. Inherent tumor-tropic and migratory properties of mesenchymal stem cells (MSCs) make them potential vehicles for targeting drug delivery systems for tumors. Although, MSCs have been successfully studied and discussed as a vehicle for cancer gene therapy, they have not yet been studied adequately as a potential vehicle for traditional chemical anticancer drugs. In this study, we have engineered MSCs as a potential targeting delivery vehicle for paclitaxel (TAX)-loaded nanoparticles (NPs). The size, surface charge, starving time of MSCs, incubating time and concentration of NPs could influence the efficiency of NPs uptake. In vitro release of TAX from CTS (chitosan)-TAX-NP-MSCs and the expression of P-glycoprotein demonstrated that release of TAX from MSCs might involve both passive diffusion and active transport. In vitro migration assays indicated that MSCs at passage number 3 have the highest migrating ability. Although, the migration ability of CTS-TAX-NP-MSCs could be inhibited by uptake of CTS-TAX-NPs, this ability could recover 6 days after the internalization.

  10. Transforming growth factor-β (TGF-β) expression is increased in the subsynovial connective tissues of patients with idiopathic carpal tunnel syndrome.

    Science.gov (United States)

    Chikenji, Takako; Gingery, Anne; Zhao, Chunfeng; Passe, Sandra M; Ozasa, Yasuhiro; Larson, Dirk; An, Kai-Nan; Amadio, Peter C

    2014-01-01

    Non-inflammatory fibrosis of the subsynovial connective tissue (SSCT) is a hallmark of carpal tunnel syndrome (CTS). The etiology of this finding and its relationship to the development of CTS remain poorly understood. Recent studies have found that transforming growth factor-β (TGF-β) plays a central role in fibrosis. The purpose of this study was to investigate the expression of TGF-β and connective tissue growth factor (CTGF), a downstream mediator of TGF-β, in the pathogenesis of CTS. We compared SSCT specimens from 26 idiopathic CTS patients with specimens from 10 human cadaver controls with no previous diagnosis of CTS. Immunohistochemistry was performed to determine levels TGF-β1, CTGF, collagen 1(Col1) and collagen 3 (Col3) expression. TGF-β1 (p tissue. In addition, a strong positive correlation was found between TGF-β1 and CTGF, (R(2) = 0.80, p < 0.01) and a moderate positive correlation between Col3 and TGF-β1 (R(2) = 0.49, p < 0.01). These finding suggest that there is an increased expression of TGF-β and CTGF, a TGF-β regulated protein, and that this TGF-β activation may be responsible for SSCT fibrosis in CTS patients.

  11. Characteristics of the electrophysiological activity of muscles attached to the transverse carpal ligament in carpal tunnel syndrome.

    Science.gov (United States)

    Horiguchi, Gen; Aoki, Takafumi; Ito, Hiromoto

    2011-01-01

    The main cause of carpal tunnel syndrome (CTS) remains unknown. Stiffness of the subcutaneous area of the volar aspect of the carpal tunnel is present in many patients and suggests that the stiffness of muscles attached to the transverse carpal ligament is increased. We performed an electrophysiological study to investigate muscle activities and to clarify whether the stiffness of muscles attached to the transverse carpal ligament is involved in the pathogenesis of CTS. The subjects of this study included 16 patients with early CTS showing no motor dysfunction. Both thenar muscles (opponens pollicis, abductor pollicis brevis, and flexor pollicis brevis) and hypothenar muscles (opponens digiti minimi, abductor digiti minimi, flexor digiti minimi brevis) were investigated. Surface electrodes were placed on each muscle, and maximum voluntary contractions with the thumb and little finger in opposition were maintained for 3 seconds in all patients and in 7 control subjects. Electromyographs were subjected to fast Fourier transform analysis, and the root mean square (RMS) and the mean power frequency (MPF) were determined for each muscle. The RMS of the opponens pollicis was significantly less in hands affected by CTS (292.8 µV) than in healthy hands (405.9 µV). The RMS did not differ between affected hands and healthy hands for the other 2 thenar muscles but did differ significantly for the hypothenar muscles. The MPF did not differ between affected hands and healthy hands for any muscle. The results show that electrophysiological differences are present among muscles innervated by the median nerve and that hypothenar muscles originally unrelated to median nerve dysfunction are also affected in early CTS. These results suggest that modulation of muscles attached to the transverse carpal ligament is involved in the pathogenesis of CTS.

  12. Effect of Vitamin B6 on Clinical Symptoms and Electrodiagnostic Results of Patients with Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Mahnaz Talebi

    2013-08-01

    Full Text Available Purpose: Carpal tunnel syndrome (CTS refers to a cluster of signs and symptoms that stems from compression of the median nerve traveling through carpal tunnel. Surgery is a definite treatment for CTS; however, many conservative therapies have been proposed. The present study set out to assess the effect of vitamin B6 in patients with CTS. Methods: Forty patients (67 hands with mild-moderate CTS were initially selected and randomly assigned into two groups as follows: 1 Case group with 20 subjects (32 affected hands receiving vitamin B6 (120 mg/day for 3 months and splinting. 2 Control group with 19 subjects (35 affected hands only received splinting. One subject from the control group dispensed with continuing participation in the research. Daily symptoms and electrodiagnostic (NCV-EMG results were assessed at baseline and after 3 months. Results: Nocturnal awakening frequency due to pain, daily pain, daily pain frequency, daily pain persistence, hand numbness, hand weakness, hand tingling, severity of nocturnal numbness and tingling, nocturnal awakening frequency owing to hand numbness and tingling, and clumsiness in handling objects improved significantly in the vitamin B6-treated patients; even so, only problem with opening a jam bottle and handling phone significantly reduced in the control group. The median nerve sensory latency mean decreased following the treatment; and the median nerve sensory amplitude mean and sensory conduction velocity mean increased. Conclusion: The present study suggests that vitamin B6 treatment improves clinical symptoms and sensory electrodiagnostic results in CTS patients, and thus is recommended for CTS treatment.

  13. Cultural Resources, CTS Mail, Published in 2009, 1:24000 (1in=2000ft) scale, Tooele County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Cultural Resources dataset, published at 1:24000 (1in=2000ft) scale, was produced all or in part from Other information as of 2009. It is described as 'CTS...

  14. Tax Area Boundaries, CTS Tax areas, Published in 2009, 1:24000 (1in=2000ft) scale, Tooele County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Tax Area Boundaries dataset, published at 1:24000 (1in=2000ft) scale, was produced all or in part from Other information as of 2009. It is described as 'CTS Tax...

  15. Building Footprints, CTS Building, Published in 2009, 1:24000 (1in=2000ft) scale, Tooele County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Building Footprints dataset, published at 1:24000 (1in=2000ft) scale, was produced all or in part from Other information as of 2009. It is described as 'CTS...

  16. Conservative treatment in patients with mild to moderate carpal tunnel syndrome: A systematic review.

    Science.gov (United States)

    Jiménez Del Barrio, S; Bueno Gracia, E; Hidalgo García, C; Estébanez de Miguel, E; Tricás Moreno, J M; Rodríguez Marco, S; Ceballos Laita, L

    2016-07-22

    Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy. It is characterised by the compression of the median nerve in the carpal tunnel. CTS presents a high prevalence and it is a disabling condition from the earliest stages. Severe cases are usually treated surgically, while conservative treatment is recommended in mild to moderate cases. The aim of this systematic review is to present the conservative treatments and determine their effectiveness in mild-to-moderate cases of CTS over the last 15 years. A systematic review was performed according to PRISMA criteria. We used the Medline, PEDro, and Cochrane databases to find and select randomised controlled clinical trials evaluating the effects of conservative treatment on the symptoms and functional ability of patients with mild to moderate CTS; 32 clinical trials were included. There is evidence supporting the effectiveness of oral drugs, although injections appear to be more effective. Splinting has been shown to be effective, and it is also associated with use of other non-pharmacological techniques. Assessments of the use of electrotherapy techniques alone have shown no conclusive results about their effectiveness. Other soft tissue techniques have also shown good results but evidence on this topic is limited. Various treatment combinations (drug and non-pharmacological treatments) have been proposed without conclusive results. Several conservative treatments are able to relieve symptoms and improve functional ability of patients with mild-to-moderate CTS. These include splinting, oral drugs, injections, electrotherapy, specific manual techniques, and neural gliding exercises as well as different combinations of the above. We have been unable to describe the best technique or combination of techniques due to the limitations of the studies; therefore, further studies of better methodological quality are needed. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S

  17. Early diagnosis of carpal tunnel syndrome: comparison of digit 1 with wrist and distoproximal ratio.

    Science.gov (United States)

    Sharma, K R; Rotta, F; Romano, J; Ayyar, D R

    2001-01-01

    Our objective in this study was to compare the sensitivity and specificity of the median sensory nerve conduction velocity (SNCV) from digit 1 to wrist with those of the distoproximal (D/P) ratio of the median SNCV from palm to digit 3/palm to wrist in the diagnosis of mild carpal tunnel syndrome (CTS) by using a receiver operating characteristic (ROC) curve. To achieve this objective, we studied prospectively (January 1997-October 1998) 370 patients referred for CTS. One hundred forty-two patients (38.4%) with moderate to severe CTS and 15 patients (4.1%) with multiple (> or = 3) compressive neuropathies in upper limbs with subclinical peripheral neuropathy were excluded. The remaining 213 patients (302 hands with mild CTS; 167 women; mean age, 50 y +/- 12 y) and 38 controls (71 hands; 25 women; mean age, 47 y +/- 13 y) had median and ulnar nerve conduction studies. ROC curves were constructed for median SNCV digit 1 to wrist and median SNCV D/P ratio from the patients' and controls' data. The median SNCV at or = 1.12, corresponding to an optimal cutoff point on ROC curve, discriminated 67.2% of mild CTS from controls with specificity of 97.2%. Of the 10.3% (31/302) of hands in which digit 1 to wrist was within normal limits at the selected optimal cutoff value ( or = 1.12), and 3.3% (10/302) had a normal electrophysiologic examination. The likelihood ratio (true-positive ratio to false-positive ratio, assessing the discriminative power of a test) of the median SNCV digit 1 to wrist, at an optimal point on ROC curve (63.9), was higher than that of the median SNCV D/P ratio (23.9, chi2 = 36.9, P wrist is more sensitive than the median SNCV D/P ratio in the diagnosis of mild CTS.

  18. Third trimester of pregnancy: Carpal tunnel syndrome, anxiety and depression

    Directory of Open Access Journals (Sweden)

    Tupković Emir

    2013-03-01

    Full Text Available This study measured the frequency of carpal tunnel syndrome (CTS and the levels of anxiety and depression in the third trimester of healthy pregnant women having regular prenatal visits. The study was performed at the Department of Neurophysiology Health Centre Tuzla in the period of January through April 2006. The group consisted of 40 pregnant women in the third trimester of pregnancy, age range of 25.6 ± 4.9 years. The control group consisted of healthy women, ages 31.1 ± 4.4 years. The electrophysiological parameters n. medians, the Beck Depression Inventory (BDI and Beck Anxiety Inventory (BAI were measured. The diagnosis of CTS is neurophysiologically confirmed in 12 pregnant women (30% and 75% showed clinical signs and symptoms of disease. Pain was measured by subjective pain scale ranked from 0 (absence of pain to 10 (severe pain. The mean value of BAI in control group was 8.6 ± 6.5, while in the group of pregnant women was 12.9 ± 6.9, which was significantly higher (p = 0.011. The mean value of BDI in control group was 4.2 ±4.4 and in the group of pregnant women was 8.7 ±5.9. which was significantly higher (p = 0.0008, The mean value of BAI in the group of women with CTS was 12.25 ± 6.7 which was not significantly higher than the compared to the control group (p = 0.113. The mean value of BDI in the group of pregnant women with CTS was 7.9 ± 6.4,which was significantly higher when compared to the control group (p = 0.037. The subjective assessment of pain in the group of women with CTS was 2.4 ±2.1. There was a slight correlation between pain intensity and degree of BAI (r = 0.289 and a negative correlation with the level of depression (r = - 0.297. The conclusion is that pregnant women with normal risk should make an extra effort in the treatment of unpleasant conditions such as CTS, anxiety and depression, which may impair the quality of life and have physical and psychological side effects on the future mother.

  19. Motor nerve conduction velocity and function in carpal tunnel syndrome following neural mobilization: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Manu Goyal

    2016-01-01

    Full Text Available Introduction: Carpal tunnel syndrome (CTS is the most common nerve entrapment syndrome in the upper extremity leading to the functional disability. The consequence of the entrapment is the poor health of the nerve (conduction, mobility, and blood flow. Purpose of the Study: The aim of the study is to evaluate the effect of neural mobilization on the motor nerve conduction velocity and function in the CTS patients. Methods: Thirty CTS patients (only females were scrutinized on the basis of the inclusion and exclusion criteria. They were randomized into two groups A (n = 15 and B (n = 15 using simple random sampling. Group A patients were treated with the conventional physiotherapy regimen and Group B were provided neural mobilization. Results: The data analysis was done using SPSS version 22. The t-test reveals that there was statistically significant improvement in posttreatment values of Group B for numeric pain rating scale, symptom severity scale, function status scale, motor nerve conduction latency, and velocity at P≤ 0.05. Conclusions: Neural mobilization in the CTS patients improves the motor nerve conduction and functional status. It may be incorporated in the physiotherapy treatment protocol of CTS patients.

  20. Association between the catechol-o-methyltransferase val158met polymorphism with susceptibility and severity of carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Erkol İnal E

    2015-12-01

    Full Text Available Carpal tunnel syndrome (CTS is the most common entrapment neuropathy of the upper extremity. In this study, we aimed to clarify the relationships between the catechol-O-methyltransferase (COMT gene Val158Met (rs4680 polymorphism and development, functional and clinical status of CTS. Ninety-five women with electro diagnostically confirmed CTS and 95 healthy controls were enrolled in the study. The functional and clinical status of the patients was measured by the Turkish version of the Boston Questionnaire and intensity of pain related to the past 2 weeks was evaluated on a visual analog scale (VAS. The Val158Met polymorphism was determined using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP, method. We divided patients according to the genotypes of the Val158Met polymorphism as Val/Val, Val/Met and Met/Met. There were not any significant differences in terms of Val158Met polymorphisms between patients and healthy controls (p >0.05. We also did not find any relationships between the Val158Met polymorphism and CTS (p >0.05. In conclusion, although we did not find any relationships between CTS and the Val158Met polymorphism, we could not generalize this result to the general population. Future studies are warranted to conclude precise associations.

  1. Carpal tunnel syndrome: a case-control study evaluating its relationship with body mass index and hand and wrist measurements.

    Science.gov (United States)

    Farmer, J E; Davis, T R C

    2008-08-01

    This case-control study investigated the associations between the body mass index (BMI), hand and wrist measurements and carpal tunnel syndrome (CTS). The hands and wrists of 50 patients with CTS and 50 age- and sex-matched controls were measured. The right and left wrist indices (wrist depth/wrist width) were significantly greater in CTS patients (mean = 0.71. SD = 0.04) than in the controls (mean = 0.69 SD = 0.04). The hand index (hand length/palm width) and BMI were not significantly different in the two groups. The hand, but not the wrist, index was found to correlate with the BMI. These results provide some support for a causative association between wrist morphometry, as measured by the wrist index, and CTS, but this difference is too small to be of diagnostic value in clinical or epidemiological practice. The results could also suggest that the previously reported association between CTS and the hand index may be secondary to differences in the BMI.

  2. 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.

  3. Job Stress Reactivity and Work-Related Musculoskeletal Symptoms

    Science.gov (United States)

    2007-11-02

    comparison between two different forms of work organization. Journal of Organizational Behavior, 20, 47-61. Melzack, R. (1989). Phantom limbs , the...self, and the brain. Canadian Psychology, 30, 1- 16. Melzack, R. (1995). Phantom limb pain and the brain. In B.Bromm and J.E. Desmedt (Eds.), Pain and...related disorders (e.g., tendonitis, epicondylitis and neck torsion syndrome ) and nerve-related disorders (e.g., carpal tunnel syndrome [CTS], cubital

  4. Demographic Characteristics of Our Patients with Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Ebru Umay

    2011-09-01

    Full Text Available Aim: Carpal tunnel (CTS is the most common trap neuropathy but, still fully understood the cause of this and effective factors. In this study was aimed to the evaluation demographic features of the cases with CTS admitted to our electroneuromyography (ENMG laboratory. Material and Methods: In the study, 119 patients with CTS to evaluate our ENMG laboratory were received. All patients age, sex, dominant and affected hand, duration of education, marital status, height, weight, additional diseases, occupational, hand and wrist repetitive motion made, use of computer and smoking status was assessed. Patients’ body mass index (BMI was calculated. Results: 102 cases (85.7% females, mean age was 46.32 years ± 12: 18. While in 115 (96.6% cases using the right hand is dominant, in 85 cases (76.6% with bilateral involvement were at hand. While the rate of patient who between five to eight year duration of education had was 47.1%, 84% patients were married. Also, BMI were determined as 29.33± 3.01. According to the state in 22 patients with additional diseases, diabetes mellitus in 22, hypothyroidism in 4, also 1 patient had arthritis. The majority of our patients (70.6% housewives formed. The 67.2% rate of repetetive activities as making crafts, the computer usage at a rate of 11.8% had history. The rate of smoking was 19.3%.  Conclusions:  As a result, CTS, especially in middle-aged housewives and obese is a common syndrome. Despite many reasons to be reported in the etiology of idiopathic 85%. At a rate of 25.4% of women in our society is considered paid work, especially in terms of determining the etiology of the more detailed studies are needed to ousewives.

  5. Computer use and carpal tunnel syndrome: A meta-analysis.

    Science.gov (United States)

    Shiri, Rahman; Falah-Hassani, Kobra

    2015-02-15

    Studies have reported contradictory results on the role of keyboard or mouse use in carpal tunnel syndrome (CTS). This meta-analysis aimed to assess whether computer use causes CTS. Literature searches were conducted in several databases until May 2014. Twelve studies qualified for a random-effects meta-analysis. Heterogeneity and publication bias were assessed. In a meta-analysis of six studies (N=4964) that compared computer workers with the general population or other occupational populations, computer/typewriter use (pooled odds ratio (OR)=0.72, 95% confidence interval (CI) 0.58-0.90), computer/typewriter use ≥1 vs. computer/typewriter use ≥4 vs. computer/typewriter use (pooled OR=1.34, 95% CI 1.08-1.65), mouse use (OR=1.93, 95% CI 1.43-2.61), frequent computer use (OR=1.89, 95% CI 1.15-3.09), frequent mouse use (OR=1.84, 95% CI 1.18-2.87) and with years of computer work (OR=1.92, 95% CI 1.17-3.17 for long vs. short). There was no evidence of publication bias for both types of studies. Studies that compared computer workers with the general population or several occupational groups did not control their estimates for occupational risk factors. Thus, office workers with no or little computer use are a more appropriate comparison group than the general population or several occupational groups. This meta-analysis suggests that excessive computer use, particularly mouse usage might be a minor occupational risk factor for CTS. Further prospective studies among office workers with objectively assessed keyboard and mouse use, and CTS symptoms or signs confirmed by a nerve conduction study are needed. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Carpal Tunnel Syndrome

    Science.gov (United States)

    ... arm. Just a passing cramp? It could be carpal tunnel syndrome. The carpal tunnel is a narrow passageway of ligament and ... difficult. Often, the cause is having a smaller carpal tunnel than other people do. Other causes include ...

  7. Clinical characteristics, neurophysiological grade and outcome of patients with carpal tunnel syndrome A retrospective study

    Institute of Scientific and Technical Information of China (English)

    Jingxia Dang

    2007-01-01

    BACKGROUND: Carpal tunnel syndrome (CTS) is diagnosed mainly according to clinical symptoms, physical sign and neurodiagnostic laboratory examination. The therapeutic effect of conservative management and surgical operation in treating CTS need to be further observed and evaluated. OBJECTIVE: To analyze the clinical characteristics, neurophysiological grade and outcome in patients with CTS.DESIGN: Retrospective case-analysis.SETTING: Department of Neurology, First Affiliated Hospital, Medical College, Xi'an Jiaotong University. PARTICIPANTS: Totally 161 patients with suspected CTS from National Neuroscience Institute of Singapore referred to the Neurodiagnostic Laboratory for the confirmatory testing between January and September 2002. The involved patients, 137 male and 24 female, were aged 21-85 years. METHODS:①The condition of diabetes mellitus complicated by abnormal thyroid function was observed.②The effect on predominant hand, and paraesthesia were observed.③Neuroelectrophysiological studies were performed and the results were graded into mild, moderate and severe CTS according to the American Association of Electrodiagnostic Medicine (AAEM) criteria.④Conservative management and surgical intervention were followed up 3 months later, and symptoms and physical sign basically disappeared, and function was basically recovered, which indicated that disease condition improved.MAIN OUTCOME MEASURES:①Condition of CTS complicated by metabolic disease;②Effects on predominant hand and paraesthesia;③Electrophysiological grading; ④Prognosis.RESULTS: Totally 161 patients participated in the final analysis.①Condition of CTS complicated by metabolic disease: Among 161 patients, 17.4% (28/161) were documented to have diabetes mellitus and 7(4.3%) had hypothyroidism.②Effects on predominant hand and paraesthesia: Dominant hand involvement was present in 134 patients (83.2%) and more than 75% had onset of symptoms in the dominant hand. Sensory symptoms like

  8. Upper Limb Neurodynamic Test 1 and symptoms reproduction in carpal tunnel syndrome. A validity study.

    Science.gov (United States)

    Vanti, Carla; Bonfiglioli, Roberta; Calabrese, Monica; Marinelli, Francesco; Guccione, Andrew; Violante, Francesco Saverio; Pillastrini, Paolo

    2011-06-01

    The aim of this study was to estimate the validity of the Upper Limb Neurodynamic Test 1 (ULNT1) for the diagnosis of Carpal Tunnel Syndrome (CTS) with blind comparison to a reference criterion of a compatible clinical presentation and abnormal nerve conduction. 47 subjects with suspected CTS were enrolled. All patients were tested with nerve conduction studies and ULNT1. Considering results as positive in the presence of reproduction of symptoms on affected upper limb, or side-to-side differences in elbow extension, or symptoms modified by lateral neck side-bending, we estimated sensitivity as 91.67%, specificity as 15%, positive likelihood ratio as 1.0784, negative likelihood ratio as 0.5556, and post-test probability for negative test as 40%. Using a new criterion, i.e. the reproduction of symptoms only in the first three digits of the affected hand, we estimated sensitivity as 54.17%, specificity as 70%, positive and negative likelihood ratios as 1.8056 and 0.6548, respectively, and post-test probability for positive test as 68%. Our investigation suggests that the reproduction of the typical current CTS symptoms in the affected hand during ULNT1 testing, improves estimation of the probability of the presence of this condition, even if this test alone cannot be used to diagnose CTS.

  9. Carpal tunnel syndrome: Analysis of online patient information with the EQIP tool.

    Science.gov (United States)

    Frueh, F S; Palma, A F; Raptis, D A; Graf, C P; Giovanoli, P; Calcagni, M

    2015-06-01

    Patients suffering from carpal tunnel syndrome (CTS) actively search for medical information on the Internet. The World Wide Web represents the main source of patient information. The aim of this study was to systematically assess the quality of patient information about CTS in the Internet. A qualitative and quantitative assessment of websites was performed with the modified Ensuring Quality Information for Patients (EQIP) tool that contains 36 standardized items. Five hundred websites with information on CTS treatment options were identified through Google, Bing, Yahoo, Ask.com and AOL. Duplicates and irrelevant websites were excluded. One hundred and ten websites were included. Only five websites addressed more than 20 items; quality scores were not significantly different between the various providing groups. A median of 15 EQIP items was found, with the top website addressing 26 out of 36 items. Major complications such as median nerve injury were reported in 27% of the websites and their treatment in only 3%. This analysis revealed several critical shortcomings in the quality of the information provided to patients suffering from CTS. There is a collective need to provide interactive, informative and educational websites for standard procedures in hand surgery. These websites should be compatible with international quality standards for hand surgery procedures.

  10. Diagnostic Value of Ultrasound Compared to Electro Diagnosis in Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Seyed Mansour Rayegani

    2014-10-01

    Full Text Available Introduction: Carpal Tunnel Syndrome (CTS is one of the main causes of disability. The diagnosis of CTS confirm by electrodiagnostic tests. Sonography is an alternative method for diagnosis of CTS that can investigate anatomy and probable pathology. The aim of this study is to investigate the multiple sonographic diagnostic criteria and compare its diagnostic value with electrodiagnosis. Materials and Methods:In this descriptive-cross sectional study, 84 wrists (42 patients with CTS and 42 individuals without any clinical signs in upper limb were investigated. Symptomatic patients underwent clinical examination, standard electrodiagnostic evaluation of upper limb and sonographic investigation of median nerve in forearm and wrist. The control group underwent sonographic investigation. Results: Cross Sectional Area (CSA of Median nerve at distal wrist crease, at the level of Hamate hook and Trapezium, the amount of flexor retinaculum bowing, ratio of CSA at the forearm to distal wrist crease and ratio of CSA at the Pisiform level to distal wrist crease had significant difference in the case group compared to the control group (P-value

  11. The value of ultrasonographic measurement in carpal tunnel syndrome in patients with negative electrodiagnostic tests

    Energy Technology Data Exchange (ETDEWEB)

    Koyuncuoglu, Hasan Rifat [Department of Neurology, School of Medicine, Suleyman Demirel University, Isparta (Turkey); Kutluhan, Suleyman [Department of Neurology, School of Medicine, Suleyman Demirel University, Isparta (Turkey)]. E-mail: skutluhan@hotmail.com; Yesildag, Ahmet [Department of Radiology, School of Medicine, Suleyman Demirel University, Isparta (Turkey); Oyar, Orhan [Department of Radiology, School of Medicine, Suleyman Demirel University, Isparta (Turkey); Guler, Kezban [Department of Neurology, School of Medicine, Suleyman Demirel University, Isparta (Turkey); Ozden, Ahmet [Department of Radiology, School of Medicine, Suleyman Demirel University, Isparta (Turkey)

    2005-12-15

    The diagnosis of carpal tunnel syndrome (CTS) is mainly based on clinical findings and electrodiagnostic tests (EDT). However, EDT results do not support clinical findings in some cases. It has been recently suggested that ultrasonography (US) can be used to diagnose CTS. In this study, we aimed to investigate whether US has a diagnostic value for CTS in patients with negative EDT findings or not. EDT was performed on 319 wrists with clinical CTS findings in electrophysiology laboratory. Median and ulnar nerve conduction velocities were measured in all cases and electromyography was performed in patient with tenar atrophy and having suspicion involvement of brachial plexus as EDT. Fifty-nine wrists with negative EDT (study group) and 30 wrists from 15 healthy individuals (control group) were examined using US. The mean of cross-sectional areas (CSAs) measurements were found 8.83 {+-} 3.05 mm{sup 2} by tracing method (TM) and 8.51 {+-} 3.13 mm{sup 2} by ellipsoid formula (EF) in study group, and 7.63 {+-} 1.52 mm{sup 2} by TM and 7.66 {+-} 1.42 mm{sup 2} by EF in control group. The differences between study group and control group according to both TM and EF were significant (t-test p = 0.0079, p = 0.0460, respectively). In study group, CSAs were larger than 10.5 mm{sup 2} in 18 (30.51%) and 16 (27.12%) wrists according to TM and EF findings, respectively, and in only one wrist (3.33%) in control group by both TM and EF. The differences of ultrasonographic CTS numbers between study group and control group were significant (p = 0.0024 by TM, p = 0.0086 by EF). We confirmed the usefulness of quantitative US assessment in the diagnosis of CTS in the patients with negative EDT findings. If EDT findings are inadequate to confirm the CTS in the patients with clinical CTS, US studies may be helpful to diagnose.

  12. Diagnostic properties of nerve conduction tests in population-based carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Johnsson Ragnar

    2003-05-01

    Full Text Available Abstract Background Numerous nerve conduction tests are used for the electrodiagnosis of carpal tunnel syndrome (CTS, with a wide range of sensitivity and specificity reported for each test in clinical studies. The tests have not been assessed in population-based studies. Such information would be important when using electrodiagnosis in epidemiologic research. The purpose of this study was to compare the diagnostic accuracy of various nerve conduction tests in population-based CTS and determine the properties of the most accurate test. Methods In a population-based study a questionnaire was mailed to a random sample of 3,000 persons. Of 2,466 responders, 262 symptomatic (numbness/tingling in the radial fingers and 125 randomly selected asymptomatic responders underwent clinical and electrophysiologic examinations. A standardized hand diagram was administered to the symptomatic persons. At the clinical examination, the examining surgeon identified 94 symptomatic persons as having clinically certain CTS. Nerve conduction tests were then performed on the symptomatic and the asymptomatic persons by blinded examiners. Analysis with receiver operating characteristic (ROC curves was used to compare the diagnostic accuracy of the nerve conduction tests in distinguishing the persons with clinically certain CTS from the asymptomatic persons. Results No difference was shown in the diagnostic accuracy of median nerve distal motor latency, digit-wrist sensory latency, wrist-palm sensory conduction velocity, and wrist-palm/forearm sensory conduction velocity ratio (area under curve, 0.75–0.76. Median-ulnar digit-wrist sensory latency difference had a significantly higher diagnostic accuracy (area under curve, 0.80. Using the optimal cutoff value of 0.8 ms for abnormal sensory latency difference shown on the ROC curve the sensitivity was 70%, specificity 82%, positive predictive value 19% and negative predictive value 98%. Based on the clinical diagnosis

  13. Enfoque Ciencia, Tecnología y Sociedad (CTS: perspectivas educativas para Colombia

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Quintero Cano

    2010-01-01

    Por esta razón, se busca innovar el área de tecnología e informática en la asignatura de Ciencia y Tecnología, aportando un enfoque innovador a partir del diseño de material curricular CTS, en el cual se proporcione un contenido que parta de los conocimientos e intereses del alumnado, sin dejar a un lado la formación científica y lograr una mejor internalización del aprendizaje para su desempeño ciudadano con mayor sentido social.

  14. Investigation of a CTS solar cell test patch under simulated geomagnetic substorm charging conditions

    Science.gov (United States)

    Bogus, K. P.

    1977-01-01

    The CTS solar array technology experiment which consists of a solar cell test patch on the Kapton-substrate solar array and the appertaining electronics unit has been operating in geostationary orbit for nearly 1 year without any malfunction although it is expected to be strongly influenced by charging effects on the array surface. The results of a post-launch test program show that the experiment would not survive a discharge due to electrostatic charging in the test patch area. In a simulated substorm, environment discharges were obtained only below a temperature threshold of about 30 C. With solar illumination, this threshold is reduced below 0 C.

  15. Preliminary report on the CTS transient event counter performance through the 1976 spring eclipse season

    Science.gov (United States)

    Stevens, N. J.; Lovell, R. R.; Klinect, V. W.

    1977-01-01

    The transient event counter is described, defining its operational characteristics, and presenting the preliminary results obtained through the first 90 days of operation including the Spring 1976 eclipse season. The results show that the CTS was charged to the point where discharges have occurred. The discharge induced transients have not caused any anomalous events in spacecraft operation. The data indicate that discharges can occur at any time during the day without preference to any local time quadrant. The number of discharges occurring in the 1 sec sample interval are greater than anticipated.

  16. Accelerated life tests of specimen heat pipe from Communication Technology Satellite (CTS) project

    Science.gov (United States)

    Tower, L. K.; Kaufman, W. B.

    1977-01-01

    A gas-loaded variable conductance heat pipe of stainless steel with methanol working fluid identical to one now on the CTS satellite was life tested in the laboratory at accelerated conditions for 14 200 hours, equivalent to about 70 000 hours at flight conditions. The noncondensible gas inventory increased about 20 percent over the original charge. The observed gas increase is estimated to increase operating temperature by about 2.2 C, insufficient to harm the electronic gear cooled by the heat pipes in the satellite. Tests of maximum heat input against evaporator elevation agree well with the manufacturer's predictions.

  17. CTS and CZTS for solar cells made by pulsed laser deposition and pulsed electron deposition

    DEFF Research Database (Denmark)

    Ettlinger, Rebecca Bolt

    , which make them promising alternatives to the commercially successful solar cell material copper indium gallium diselenide (CIGS). Complementing our group's work on pulsed laser deposition of CZTS, we collaborated with IMEM-CNR in Parma, Italy, to deposit CZTS by pulsed electron deposition for the first...... time. We compared the results of CZTS deposition by PLD at DTU in Denmark to CZTS made by PED at IMEM-CNR, where CIGS solar cells have successfully been fabricated at very low processing temperatures. The main results of this work were as follows: Monoclinic-phase CTS films were made by pulsed laser...

  18. O legado de Madame Curie : uma abordagem CTS para o ensino da radioatividade

    OpenAIRE

    Jucelino Cortez

    2014-01-01

    Nesta dissertação relatamos uma experiência de ensino de Radioatividade motivada na abordagem Ciência, Tecnologia e Sociedade (CTS) e trabalhada com os estudantes do terceiro ano da Escola Estadual de Ensino Médio Ponche Verde, em Sertão, Rio Grande do Sul, em 2013. A vida e o legado de Marie Curie foram usados como mote central para uma introdução multidisciplinar ao conteúdo de Radioatividade, que envolveu Biologia, História, Química, Filosofia, Sociologia, Matemática, Medicina, além de Fís...

  19. Evaluation of the Criterion Task Set. Part 1. CTS Performance and Swat Data - Baseline Conditions

    Science.gov (United States)

    1990-01-01

    Values Format Interval Production Data Base IPINT number of tapping intervals F4.0 IPMN tapping interval mean F4.0 IPSD tapping interval std. dev. F4.0...measures selected for presentation and analysis were the mean interval length ( IPMN ), the standard deviation of interval length ([PSD), the CTS...Females Males Trial 06 08 Both 06 08 Both IPMN 515 520 517 512 494 503 (104) (114) (108) (149) (119) (135) IPD52 49 50 52 52 52 IPD(25) (41) (3) (43) (41

  20. Signos clínicos del nervio cubital en el canal epitroclear del codo en una población normal

    OpenAIRE

    2014-01-01

    Introducción: El síndrome del túnel cubital (STCU) del codo es subdiagnosticado por su similitud con la epicondilitis medial. Presenta con frecuencia variabilidad en las pruebas de provocación. Se quiere determinar en una población sana asintomática la aparición de estos signos. Materiales y métodos: En 380 codos de 190 estudiantes de 18 a 35 años, se les realizó la prueba de Tinel, la prueba de Flexión del Codo, de Rotación interna y flexión del codo, el Scratch- Collapse y una nueva prueba ...

  1. Electron tunnel sensor technology

    Science.gov (United States)

    Waltman, S. B.; Kaiser, W. J.

    1989-01-01

    The recent development of Scanning Tunneling Microscopy technology allows the application of electron tunneling to position detectors for the first time. The vacuum tunnel junction is one of the most sensitive position detection mechanisms available. It is also compact, simple, and requires little power. A prototype accelerometer based on electron tunneling, and other sensor applications of this promising new technology are described.

  2. CellLab-CTS 2015: a Python library for continuous-time stochastic cellular automaton modeling using Landlab

    Science.gov (United States)

    Tucker, G. E.; Hobley, D. E. J.; Hutton, E.; Gasparini, N. M.; Istanbulluoglu, E.; Adams, J. M.; Nudurupati, S. S.

    2015-11-01

    CellLab-CTS 2015 is a Python-language software library for creating two-dimensional, continuous-time stochastic (CTS) cellular automaton models. The model domain consists of a set of grid nodes, with each node assigned an integer state-code that represents its condition or composition. Adjacent pairs of nodes may undergo transitions to different states, according to a user-defined average transition rate. A model is created by writing a Python code that defines the possible states, the transitions, and the rates of those transitions. The code instantiates, initializes, and runs one of four object classes that represent different types of CTS model. CellLab-CTS provides the option of using either square or hexagonal grid cells. The software provides the ability to treat particular grid-node states as moving particles, and to track their position over time. Grid nodes may also be assigned user-defined properties, which the user can update after each transition through the use of a callback function. As a component of the Landlab modeling framework, CellLab-CTS models take advantage of a suite of Landlab's tools and capabilities, such as support for standardized input and output.

  3. Promoter swapping unveils the role of the Citrobacter rodentium CTS1 type VI secretion system in interbacterial competition.

    Science.gov (United States)

    Gueguen, Erwan; Cascales, Eric

    2013-01-01

    The type VI secretion system (T6SS) is a versatile secretion machine dedicated to various functions in Gram-negative bacteria, including virulence toward eukaryotic cells and antibacterial activity. Activity of T6SS might be followed in vitro by the release of two proteins, Hcp and VgrG, in the culture supernatant. Citrobacter rodentium, a rodent pathogen, harbors two T6SS gene clusters, cts1 and cts2. Reporter fusion and Hcp release assays suggested that the CTS1 T6SS was not produced or not active. The cts1 locus is composed of two divergent operons. We therefore developed a new vector allowing us to swap the two divergent endogenous promoters by P(tac) and P(BAD) using the λ red recombination technology. Artificial induction of both promoters demonstrated that the CTS1 T6SS is functional as shown by the Hcp release assay and confers on C. rodentium a growth advantage in antibacterial competition experiments with Escherichia coli.

  4. 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.

  5. An epidemiological profile of cashiers holders carpal tunnel syndrome in a grocery store chain.

    Science.gov (United States)

    Costa, R; Barros, R; Campos, D; Lima, D; Barbosa, Geórgia

    2012-01-01

    Occupational diseases are those acquired in the work. Statistics show an increase number of cases, victims like typists, telephone's operators, cashiers and many others with varied levels of involvement. It is composed of disorders affecting the upper limbs being recognized by the Ministry of Social Welfare. Among these diseases stands out for its high occurrence Carpal Tunnel Syndrome (CTS). It has been considered a disease of the century, because its incidence has increased in 40.8% of repetitive stress disorders, with prevalence in females, and predominant age ranging from 25 to 40 years. It is characterized by pain and paresthesia in the first four fingers and wrists, and arm pain, weakness, numbness in the territory of the median nerve, preserving or not the palmar sensation and numbness in the median sensory distribution. This study aims to assess functional capacity and severity of symptoms presented by cashiers diagnosed with CTS. It is a descriptive and quantitative in nature. The population consists of 13 grocery store cashiers of both sexes, with a workload of 42 hours. We will be used as an instrument called the Boston Carpal Tunnel Questionnaire. That purports to be an effective means of measuring the numbness and pain in hands and wrists. Exclusion criteria we consider the subjects who have other diseases associated with CTS. The collection is with the possibility of partial results to be entered in a spreadsheet in Microsoft Excel for data analysis and subsequent discussion and correlation with the current literature.

  6. WiFi Localization Based on IEEE 802.11 RTS/CTS Mechanism

    Directory of Open Access Journals (Sweden)

    Zhe Cui

    2015-11-01

    Full Text Available Location Based Services are providing one of the fastest growing market segments today. While the most common technique for location determination is GPS, several alternative approaches have been proposed for Wi-Fi environments, based on time of flight, signal strength, etc. Time based techniques not only require accurate timestamping mechanisms, but also precise and synchronized clocks, which is quite difficult and expensive in industry. On the other hand, signal strength based methods need a lot of ground truth data. These method also require time consuming work and efforts before the system comes into use. In considerations of costs and time consumption, we present in this paper an approach for determining the location of a general Wi-Fi device combining RTS/CTS and TDoA techniques. The proposed model is deployable in various environments and contains two different methods, with clock mapping functions and asynchronized clocks. We also explain limitations of current round trip time (RTT based RTS/CTS systems. Extensive experiments have been conducted and demonstrated how an accuracy of about one foot can be obtained and also the assumption of RTT measurements have been verified.

  7. ClpE from Lactococcus lactis promotes repression of CtsR-dependent gene expression

    DEFF Research Database (Denmark)

    Varmanen, P.; Vogensen, F.K.; Hammer, Karin;

    2003-01-01

    The heat shock response in bacterial cells is characterized by rapid induction of heat shock protein expression, followed by an adaptation period during which heat shock protein synthesis decreases to a new steady-state level. In this study we found that after a shift to a high temperature the Clp...... ATPase (ClpE) in Lactococcus lactis is required for such a decrease in expression of a gene negatively regulated by the heat shock regulator (CtsR). Northern blot analysis showed that while a shift to a high temperature in wild-type cells resulted in a temporal increase followed by a decrease......E by Western blot analysis revealed that at a high temperature CIpE is subjected to ClpP-dependent processing and that disruption of the zinc finger domain renders GpE more susceptible. Interestingly, this domain resembles the N-terminal region of McsA, which was recently reported to interact with the Cts...

  8. Difficulty of pinching behind the back: an atypical symptom of carpal tunnel syndrome related to a specific wrist position. Two case reports.

    Science.gov (United States)

    Shimizu, Satoru; Tachibana, Shigekuni; Fujii, Kiyotaka

    2012-01-01

    Carpal tunnel syndrome (CTS) may be overlooked in the absence of typical sensory symptoms. Two patients with CTS lacked the attendant sensory symptoms but experienced difficulties performing a pinching action behind the back (manipulation of the buckle of a baby sling or the hook of a brassiere), a mode of pinching that required wrist flexion. The causative mechanism was probably exacerbation of a latent weakness of the intrinsic muscles of the thumb by wrist flexion, in which the strength of the extrinsic flexors of the thumb and index finger were decreased due to loosening of the tendons. Such symptoms, induced by a specific wrist position, may be help to diagnose a latent weakness in the intrinsic muscles of the thumb, present in patients with CTS.

  9. Effects of perineural steroid injections on median nerve conduction during the carpal tunnel release

    Directory of Open Access Journals (Sweden)

    Stepić Nenad

    2008-01-01

    Full Text Available Background/Aim. The treatment outcome of the median nerve compressive neuropathy in the carpal zone due to carpal tunnel syndrome (CTS is represented by recovering the nerves sensibility, conductivity, condition and strength. Perineural application of betamethasone during the surgical decompression might result in faster recovery of compressed median nerve's conduction speed. Methods. In this study 40 patients with CTS were randomly divided in the two groups. In the first group (n = 20 we performed the surgical decompression of the median nerve by the open release of the carpal tunnel, and in the second group (n = 20 we applicated a perineural injection of 1 ml of betamethason immediately after the surgical decompression. We performed the electrodiagnostic (ED examinations 7, 30 and 90 days after the surgery, and measured the conduction speed of the median nerve in the carpal tunnel zone and the sensitivity conduction speed of the median nerve. Results. Significant differences in examined ED respective variable values in different time intervals were obtained. At the final measurements, 90 days after the surgical procedure, both groups evidenced a full recovery of the conduction speed in the carpal tunnel with statistically significant better results in the second group of the patients (t = -2.116; p = 0.043. Conclusion. Intraoperative application of the corticosteroid injection during the surgical decompression results in faster regaining of conduction speed of the median nerve.

  10. The Value of Median Nerve Sonography as a Predictor for Short- and Long-Term Clinical Outcomes in Patients with Carpal Tunnel Syndrome: A Prospective Long-Term Follow-Up Study

    Science.gov (United States)

    Marschall, Alexander; Ficjian, Anja; Husic, Rusmir; Zauner, Dorothea; Seel, Werner; Simmet, Nicole E.; Klammer, Alexander; Heizer, Petra; Brickmann, Kerstin; Gretler, Judith; Fürst-Moazedi, Florentine C.; Thonhofer, Rene; Hermann, Josef; Graninger, Winfried B.; Quasthoff, Stefan; Dejaco, Christian

    2016-01-01

    Objectives To investigate the prognostic value of B-mode and Power Doppler (PD) ultrasound of the median nerve for the short- and long-term clinical outcomes of patients with carpal tunnel syndrome (CTS). Methods Prospective study of 135 patients with suspected CTS seen 3 times: at baseline, then at short-term (3 months) and long-term (15–36 months) follow-up. At baseline, the cross-sectional area (CSA) of the median nerve was measured with ultrasound at 4 levels on the forearm and wrist. PD signals were graded semi-quantitatively (0–3). Clinical outcomes were evaluated at each visit with the Boston Questionnaire (BQ) and the DASH Questionnaire, as well as visual analogue scales for the patient’s assessment of pain (painVAS) and physician’s global assessment (physVAS). The predictive values of baseline CSA and PD for clinical outcomes were determined with multivariate logistic regression models. Results Short-term and long-term follow-up data were available for 111 (82.2%) and 105 (77.8%) patients, respectively. There was a final diagnosis of CTS in 84 patients (125 wrists). Regression analysis revealed that the CSA, measured at the carpal tunnel inlet, predicted short-term clinical improvement according to BQ in CTS patients undergoing carpal tunnel surgery (OR 1.8, p = 0.05), but not in patients treated conservatively. Neither CSA nor PD assessments predicted short-term improvement of painVAS, physVAS or DASH, nor was any of the ultrasound parameters useful for the prediction of long-term clinical outcomes. Conclusions Ultrasound assessment of the median nerve at the carpal tunnel inlet may predict short-term clinical improvement in CTS patients undergoing carpal tunnel release, but long-term outcomes are unrelated to ultrasound findings. PMID:27662617

  11. Barrier characteristics of biopolymer-based organic/inorganic Au/CTS/n-InP hybrid junctions

    Science.gov (United States)

    Abay, Bahattin

    2015-11-01

    Thin film of biopolymeric compound chitosan (CTS) has been surfaced on moderately doped n-InP substrate as an interfacial layer by means of spin coating for the electronic modification of Au/n-InP structure. Electrical characterization of Au/CTS/n-InP hybrid junction has been performed by I-V and C-V measurements at room temperature. An effective barrier height (BH) value of 0.678 eV and an ideality factor of n = 1.665 have been obtained for the hybrid junction. The CTS interfacial layer has been found to reduce the reverse bias leakage current of the junction by about three orders of magnitude and enhance the BH by about 0.213 eV. Furthermore, the BH value of the hybrid junction has been obtained as 0.693 eV by C-V measurement. Good performance of the device could be ascribed to the passivation effect of the CTS interfacial layer between Au and n-InP. The BH values of 0.678 and 0.693 eV for the hybrid junction have been significantly higher than that of the conventional Au/n-InP junction (~0.465 eV). The results indicated that biopolymeric thin interfacial CTS layer might lead to the modification of the potential barrier for metal/n-InP junctions. Moreover, band gap of the CTS layer has been determined as 4.60 eV via UV-vis spectroscopy.

  12. Is the Control of Applied Digital Forces During Natural Five-digit Grasping Affected by Carpal Tunnel Syndrome?

    Science.gov (United States)

    Chen, Po-Tsun; Jou, I-Ming; Lin, Chien-Ju; Chieh, Hsiao-Feng; Kuo, Li-Chieh; Su, Fong-Chin

    2015-07-01

    The impaired sensory function of the hand induced by carpal tunnel syndrome (CTS) is known to disturb dexterous manipulations. However, force control during daily grasping configuration among the five digits has not been a prominent focus of study. Because grasping is so important to normal function and use of a hand, it is important to understand how sensory changes in CTS affect the digit force of natural grasp. We therefore examined the altered patterns of digit forces applied during natural five-digit grasping in patients with CTS and compared them with those seen in control subjects without CTS. We hypothesized that the patients with CTS will grasp by applying larger forces with lowered pair correlations and more force variability of the involved digits than the control subjects. Specifically, we asked: (1) Is there a difference between patients with CTS and control subjects in applied force by digits during lift-hold-lower task? (2) Is there a difference in force correlation coefficient of the digit pairs? (3) Are there force variability differences during the holding phase? We evaluated 15 female patients with CTS and 15 control subjects matched for age, gender, and hand dominance. The applied radial forces (Fr) of the five digits were recorded by respective force transducers on a cylinder simulator during the lift-hold-lower task with natural grasping. The movement phases of the task were determined by a video-based motion capture system. The applied forces of the thumb in patients with CTS (7 ± 0.8 N; 95% CI, 7.2-7.4 N) versus control subjects (5 ± 0.8 N; 95% CI, 5.1-5.3 N) and the index finger in patients with CTS (3 ± 0.3 N; 95% CI, 3.2-3.3 N) versus control subjects (2 ± 0.3 N; 95% CI, 2.2-2.3 N) observed throughout most of the task were larger in the CTS group (p ranges 0.035-0.050 for thumb and 0.016-0.050 for index finger). In addition, the applied force of the middle finger in patients with CTS (1 ± 0.1 N; 95% CI, 1.3-1.4

  13. Incidence rates of in-hospital carpal tunnel syndrome in the general population and possible associations with marital status

    Directory of Open Access Journals (Sweden)

    Melani Carla

    2008-10-01

    Full Text Available Abstract Background Carpal tunnel syndrome (CTS is a socially relevant condition associated with biomechanical risk factors. We evaluated age-sex-specific incidence rates of in-hospital cases of CTS in central/northern Italy and explored relations with marital status. Methods Seven regions were considered (overall population, 14.9 million over 3–6-year periods between 1997 and 2002 (when out-of-hospital CTS surgery was extremely rare. Incidence rates of in-hospital cases of CTS were estimated based on 1 codified demographic, diagnostic and intervention data in obligatory discharge records from all Italian public/private hospitals, archived (according to residence on regional databases; 2 demographic general population data for each region. We compared (using the χscore test age-sex-specific rates between married, unmarried, divorced and widowed subsets of the general population. We calculated standardized incidence ratios (SIRs for married/unmarried men and women. Results Age-standardized incidence rates (per 100,000 person-years of in-hospital cases of CTS were 166 in women and 44 in men (106 overall. Married subjects of both sexes showed higher age-specific rates with respect to unmarried men/women. SIRs were calculated comparing married vs unmarried rates of both sexes: 1.59 (95% confidence interval [95% CI], 1.57–1.60 in women, and 1.42 (95% CI, 1.40–1.45 in men. As compared with married women/men, widows/widowers both showed 2–3-fold higher incidence peaks during the fourth decade of life (beyond 50 years of age, widowed subjects showed similar trends to unmarried counterparts. Conclusion This large population-based study illustrates distinct age-related trends in men and women, and also raises the question whether marital status could be associated with CTS in the general population.

  14. The Acupuncture Effect on Median Nerve Morphology in Patients with Carpal Tunnel Syndrome: An Ultrasonographic Study.

    Science.gov (United States)

    Ural, Fatma Gülçin; Öztürk, Gökhan Tuna

    2017-01-01

    The aim of this study was to explore the acupuncture effect on the cross-sectional area (CSA) of the median nerve at the wrist in patients with carpal tunnel syndrome (CTS) and, additionally, to identify whether clinical, electrophysiological, and ultrasonographic changes show any association. Forty-five limbs of 27 female patients were randomly divided into two groups (acupuncture and control). All patients used night wrist splint. The patients in the acupuncture group received additional acupuncture therapy. Visual analog scale (VAS), Duruöz Hand Index (DHI), Quick Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire scores, electrophysiologic measurements, and median nerve CSAs were noted before and after the treatment in both groups. VAS, DHI, Quick DASH scores, and electrophysiological measurements were improved in both groups. The median nerve CSA significantly decreased in the acupuncture group, whereas there was no change in the control group. After acupuncture therapy, the patients with CTS might have both clinical and morphological improvement.

  15. Spatial-temporal features of thermal images for Carpal Tunnel Syndrome detection

    Science.gov (United States)

    Estupinan Roldan, Kevin; Ortega Piedrahita, Marco A.; Benitez, Hernan D.

    2014-02-01

    Disorders associated with repeated trauma account for about 60% of all occupational illnesses, Carpal Tunnel Syndrome (CTS) being the most consulted today. Infrared Thermography (IT) has come to play an important role in the field of medicine. IT is non-invasive and detects diseases based on measuring temperature variations. IT represents a possible alternative to prevalent methods for diagnosis of CTS (i.e. nerve conduction studies and electromiography). This work presents a set of spatial-temporal features extracted from thermal images taken in healthy and ill patients. Support Vector Machine (SVM) classifiers test this feature space with Leave One Out (LOO) validation error. The results of the proposed approach show linear separability and lower validation errors when compared to features used in previous works that do not account for temperature spatial variability.

  16. Wheelchair ergonomic hand drive mechanism use improves wrist mechanics associated with carpal tunnel syndrome.

    Science.gov (United States)

    Zukowski, Lisa A; Roper, Jaimie A; Shechtman, Orit; Otzel, Dana M; Hovis, Patty W; Tillman, Mark D

    2014-01-01

    Among conventional manual wheelchair (CMW) users, 49% to 63% experience carpal tunnel syndrome (CTS) that is likely induced by large forces transmitted through the wrist and extreme wrist orientations. The ergonomic hand drive mechanism (EHDM) tested in this study has been shown to utilize a more neutral wrist orientation. This study evaluates the use of an EHDM in terms of wrist orientations that may predispose individuals to CTS. Eleven adult full-time CMW users with spinal cord injury participated. Motion data were captured as participants propelled across a flat surface, completing five trials in a CMW and five trials in the same CMW fitted with the EHDM. Average angular wrist orientations were compared between the two propulsion styles. Use of the EHDM resulted in reduced wrist extension and ulnar deviation. The shift to more neutral wrist orientations observed with EHDM use may reduce median nerve compression.

  17. Effect of extracorporeal shock wave therapy on the treatment of patients with carpal tunnel syndrome

    Science.gov (United States)

    Vahdatpour, Babak; Kiyani, Abolghasem; Dehghan, Farnaz

    2016-01-01

    Background: The carpal tunnel syndrome (CTS) is the most common neuropathy. The aim of this study was to evaluate the effect of a new and noninvasive treatment including extracorporeal shock wave therapy (ESWT) in the treatment of CTS. Materials and Methods: This study is a clinical trial conducted on 60 patients with moderate CTS in selected health centers of Isfahan Medical University from November 2014 to April 2015. Patients with CTS were randomly divided into two groups. Conservative treatment including wrist splint at night for 3 months, consumption of nonsteroidal anti-inflammatory drugs for 2 weeks, and oral consumption of Vitamin B1 for a month was recommended for both groups. The first group was treated with ESWT, one session per week for 4 weeks. Focus probe with 0.05, 0.07, 0.1, and 0.15 energy and shock numbers 800, 900, 1000, and 1100 were used from the first session to the fourth, respectively. The evaluated parameters were assessed before treatment and after 3 and 6 months. Data were analyzed using SPSS version 19, Student’s t-test, and Chi-square test. Results: All parameters were significantly decreased in the ESWT group after 3 months. These results remained almost constant after 6 months compared with 3 months after treatment. However, only two parameters considerably improved after 3 months of treatment in the control group. The entire indexes in the control group implicated the regression of results in long-term period. Conclusion: It is recommended to use ESWT as a conservative treatment in patients with CTS. PMID:27563630

  18. Effectiveness of low-level laser on carpal tunnel syndrome

    Science.gov (United States)

    Li, Zhi-Jun; Wang, Yao; Zhang, Hua-Feng; Ma, Xin-Long; Tian, Peng; Huang, Yuting

    2016-01-01

    Abstract Background: Low-level laser therapy (LLLT) has been applied in the treatment of carpal tunnel syndrome (CTS) for an extended period of time without definitive consensus on its effectiveness. This meta-analysis was conducted to evaluate the effectiveness of low-level laser in the treatment of mild to moderate CTS using a Cochrane systematic review. Methods: We conducted electronic searches of PubMed (1966–2015.10), Medline (1966–2015.10), Embase (1980–2015.10), and ScienceDirect (1985–2015.10), using the terms “carpal tunnel syndrome” and “laser” according to the Cochrane Collaboration guidelines. Relevant journals or conference proceedings were searched manually to identify studies that might have been missed in the database search. Only randomized clinical trials were included, and the quality assessments were performed according to the Cochrane systematic review method. The data extraction and analyses from the included studies were conducted independently by 2 reviewers. The results were expressed as the mean difference (MD) with 95% confidence intervals (CI) for the continuous outcomes. Results: Seven randomized clinical trials met the inclusion criteria; there were 270 wrists in the laser group and 261 wrists in the control group. High heterogeneity existed when the analysis was conducted. Hand grip (at 12 weeks) was stronger in the LLLT group than in the control group (MD = 2.04; 95% CI: 0.08–3.99; P = 0.04; I2 = 62%), and there was better improvement in the visual analog scale (VAS) (at 12 weeks) in the LLLT group (MD = 0.97; 95% CI: 0.84–1.11; P 95% in the calculation of these 3 parameters. There were no statistically significant differences in the other parameters between the 2 groups. Conclusion: This study revealed that low-level laser improve hand grip, VAS, and SNAP after 3 months of follow-up for mild to moderate CTS. More high-quality studies using the same laser intervention protocol are needed to

  19. COMPARATIVE EFFECT OF CARPAL BONE MOBILIZATION VERSUS NEURAL MOBILIZATION IN IMPROVING PAIN, FUNCTIONAL STATUS AND SYMPTOMS SEVERITY IN PATIENTS WITH CARPAL TUNNEL SYNDROME

    Directory of Open Access Journals (Sweden)

    Vikranth .G .R

    2015-06-01

    Full Text Available Background: Carpal tunnel syndrome (CTS is a constellation of symptoms associated with compression of the median nerve at the wrist in carpal tunnel. The Purpose of this study is to find the comparative effective of carpal bone mobilization and neural mobilization in improving pain, Functional Status and Symptom Severity in patients with CTS. Method: An experimental study design, 30 subjects with carpal tunnel syndrome were randomized into 2 groups with 15 subjects each in Group A and Group B. Subjects in Group A received carpal bone mobilization and subjects in Group B received median nerve mobilization. The duration of intervention was for two weeks. Outcome measurements such as pain using VAS, The Functional Status Score (FSS and Symptom Severity Score (SSS using the Boston’s questionnaire for CTS were measured before and after two weeks of intervention. Results: Analysis using paired ‘t’ test found that there is a statistically significant improvement (p<0.05 in pain, Functional Status score and Symptom Severity score within the groups. Comparative analysis using independent ‘t’ test found that there is no statistically significant difference in improving pain, Functional Status score and Symptom Severity score between both the groups. Conclusion: It is concluded that median nerve mobilization and carpal bone mobilization shown to be effective on improving pain, Functional Status and Symptom Severity in the treatment of patients presenting with carpal tunnel syndrome. However there is no significant difference in improvements obtained between the neural mobilization and carpal bone mobilisation.

  20. Carpal Tunnel Release in Diabetic and Non-Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Mohammad H Ebrahimzadeh

    2013-09-01

    Full Text Available Background: Carpal tunnel syndrome (CTS is a compression neuropathy that causes paresthesia, pain or numbness in the territory of median nerve. The aim of this study is to compare the open surgery outcome and patients` satisfaction in carpal tunnel syndrome among diabetic and non-diabetic patients. Methods: In a retrospective cohort study from April 2011 to June 2012, patients suffered from carpal tunnel syndrome at least 6 months, without response to conservative treatment, who had the inclusion and exclusion criteria, were evaluated by the usage of MHQ and WHOQOL-BREEF tests, one month before surgery and three months after that. Carpal tunnel decompression surgery was performed by two surgeons, experienced in hand surgery, which used the same surgical method. Statistical analysis was performed by SPSS 19.0. Results: 24 of patient (34.2% were male and 46 (65.8% were female and there was no significant difference between two groups (P>0.05. MHQ total score before and after surgery was respectively 50.22±7.13 and 63.49±11.28 and this difference was significant (P

  1. Transforming growth factor-β (TGF-β) expression is increased in the subsynovial connective tissue in a rabbit model of carpal tunnel syndrome.

    Science.gov (United States)

    Chikenji, Takako; Gingery, Anne; Zhao, Chunfeng; Vanhees, Matthias; Moriya, Tamami; Reisdorf, Ramona; An, Kai-Nan; Amadio, Peter C

    2014-01-01

    Carpal tunnel syndrome (CTS) is an idiopathic disease that results from increased fibrosis of the subsynovial connective tissue (SSCT). A recent study found overexpression of both transforming growth factor-β (TGF-β) and connective tissue growth factor (CTGF) in the SSCT of CTS patients. This study investigated TGF-β and CTGF expression in a rabbit model of CTS, in which SSCT fibrosis is induced by a surgical injury. Levels of TGF-β1 and CTGF at 6, 12, 24 weeks after injury were determined by immunohistochemistry A significant increase in TGF-β1 and a concomitant significant increase in CTGF were found at 6 weeks, in addition to higher cell density compared to normal (all p<0.05), Interestingly, CTGF expression was reduced at 12 and 24 weeks, suggesting that an initial insult results in a time limited response. We conclude that this rabbit model mimics the fibrosis found in human CTS, and may be useful to study pathogenetic mechanisms of CTS in vivo.

  2. Correlation between Female Sex Hormones and Electrodiagnostic Parameters and Clinical Function in Post-menopausal Women with Idiopathic Carpal Tunnel Syndrome

    Science.gov (United States)

    Mohammadi, Azam; Naseri, Mahshid; Namazi, Hamid; Ashraf, Mohammad Javad

    2016-01-01

    Objectives To investigate the role of sex-hormonal changes in idiopathic carpal tunnel syndrome (CTS) among post-menopausal women through measuring estrogen receptor (ER) expression in their transverse carpal ligament (TCL) and serum estrogen level, as well as determine the correlation between these factors and electrodiagnostic parameters and Boston score. Methods Biopsy samples of TCL were collected from 12 postmenopausal women who had undergone surgery for severe idiopathic CTS; control specimens were collected from 10 postmenopausal women without CTS who had undergone surgery for the other hand pathologies. To determine the distributions of ER in TCL, histological and immunohistochemical examinations were performed. Serum estrogen level was also measured. Electrodiagnosis and Boston questionnaire were used for CTS severity and determination of the patients' function. Results ER expression in TCL and serum estrogen level were not significantly different in the case group compared to the control group (P = 0.79 and P = 0.88, respectively). Also, there was no correlation between ER expression or serum estrogen level and electrodiagnostic parameters or Boston score. Conclusions Sex hormones cannot still be considered as the etiology of idiopathic CTS in postmenopausal women. The role of other factors such as wrist ratio and narrower outlet in females compared to the males should be considered along with hormonal changes. PMID:27617242

  3. A study of interpolation method in diagnosis of carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Alireza Ashraf

    2013-01-01

    Full Text Available Context: The low correlation between the patients′ signs and symptoms of carpal tunnel syndrome (CTS and results of electrodiagnostic tests makes the diagnosis challenging in mild cases. Interpolation is a mathematical method for finding median nerve conduction velocity (NCV exactly at carpal tunnel site. Therefore, it may be helpful in diagnosis of CTS in patients with equivocal test results. Aim: The aim of this study is to evaluate interpolation method as a CTS diagnostic test. Settings and Design: Patients with two or more clinical symptoms and signs of CTS in a median nerve territory with 3.5 ms ≤ distal median sensory latency <4.6 ms from those who came to our electrodiagnostic clinics and also, age matched healthy control subjects were recruited in the study. Materials and Methods: Median compound motor action potential and median sensory nerve action potential latencies were measured by a MEDLEC SYNERGY VIASIS electromyography and conduction velocities were calculated by both routine method and interpolation technique. Statistical Analysis Used: Chi-square and Student′s t-test were used for comparing group differences. Cut-off points were calculated using receiver operating characteristic curve. Results: A sensitivity of 88%, specificity of 67%, positive predictive value (PPV and negative predictive value (NPV of 70.8% and 84.7% were obtained for median motor NCV and a sensitivity of 98.3%, specificity of 91.7%, PPV and NPV of 91.9% and 98.2% were obtained for median sensory NCV with interpolation technique. Conclusions: Median motor interpolation method is a good technique, but it has less sensitivity and specificity than median sensory interpolation method.

  4. Short-distance sensory stimulation technique in the early diagnosis of carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Betül Çevik

    2013-12-01

    Full Text Available Aim. Normal results obtained from nerve conduction studies do not exclude the diagnosis of carpal tunnel syndrome (CTS. We intended to increase diagnostic sensitivity of nerve conduction studies in the early stage CTS by stimulating shorter palm-wrist segment, and excluding distal region outside the entrapment site of the median nerve which is unaffected from pathologic changes. Methods. In this prospective study, 41 patients (66 hands with clinically diagnosed CTS with normal conventional electrophysiologic examinations were stimulated with electrodes placed at 8, 7, 6, 5, 4 cm from the distal wrist crease (DWC on the palm-wrist segment, and the conduction velocities, latencies, and the differential latencies (conduction delay were compared with those of 34 patients (68 hands in the control group. Results. Conduction delay recorded between 4-5, 5-6, 6-7, 7-8 cm. away from DWC of both groups was statistically insignificant (p>0.1, while the conduction velocities and the latencies obtained from the electrodes placed on 4, 5, 6, 7, and 8 cm away from DWC differed statistically significantly between two groups (p<0.001. Conclusion. In electrophysiologic examinations performed to confirm the diagnosis of CTS, assessment of shorter palm-wrist segment, and stimulation of a predetermined location 4 or 5 cm distal to DWC are sufficient to detect a slight and localized conduction delay in the carpal tunnel. This method eliminated slowing-down effect of distal segment on normal nerve conduction velocities yielding higher degrees of (up to 92.4 % sensitivity.

  5. A comparison of the performance of anatomical MRI and DTI in diagnosing carpal tunnel syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Sung Hye [Department of Radiology, Hallym University Sacred Heart Hospital, Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do, 431-796 (Korea, Republic of); Department of Radiology, Kangwon National University Hospital, Baengnyeong-ro 156, Chuncheon-Si, Gangwon-Do, 200-722 (Korea, Republic of); Kwon, Bong Cheol, E-mail: hallymradms@gmail.com [Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do, 431-796 (Korea, Republic of); Park, Chanyeong [Department of Radiology, Hallym University Sacred Heart Hospital, Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do, 431-796 (Korea, Republic of); Hwang, Su Yeon; Lee, Joon Woo [Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro, 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707 (Korea, Republic of); Kim, Sam Soo [Department of Radiology, Kangwon National University Hospital, Baengnyeong-ro 156, Chuncheon-Si, Gangwon-Do, 200-722 (Korea, Republic of)

    2014-11-15

    Highlights: • The good parameters of both scans in CTS diagnosis were CSA(P1), FA(P1) and FA(P0). • Median nerve signal intensity and flexor retinacular bowing were not significantly different between CTS and controls. • The prestenotic swelling of median nerve of CTS was demonstrated as relatively large CSA and low FA value at P1 level. • Combination of both scans in evaluation of carpal tunnel increased diagnostic performance, and provided merits of both scans. - Abstract: Purpose: To compare the performance of anatomical magnetic resonance imaging (MRI) with that of diffusion tensor imaging (DTI) in the diagnosis of carpal tunnel syndrome (CTS). Materials and methods: We performed 3T anatomical MRI and DTI on 42 patients and 42 age-matched controls. The median nerve cross-sectional area (CSA), relative median nerve signal intensity, and palmar bowing of the flexor retinaculum, assessed with anatomical MRI, and fractional anisotropy (FA) and apparent diffusion coefficient of the median nerve, assessed with DTI, were measured at four locations: the hamate level, the pisiform level (P0), the level located 1 cm proximal to the P0 level (P1), and the distal radioulnar joint level (DR). Adding the ratios and differences of the median nerve parameters between the measurements at the DR and other locations to the diagnostic parameters, we evaluated the area under the receiver operating characteristic curves (AUCs) of all the diagnostic parameters of both scans. Results: The AUCs of FA(P1) (0.814) and FA(P0) (0.824) in DTI were larger than the largest AUC for anatomical MRI, CSA(P1) (0.759). However, the receiver operating characteristics of the three parameters were not significantly different (P > 0.1). The sensitivity and specificity of CSA(P1) (76.2% and 73.8%) and FA(P1) (73.8% and 76.2%) increased after inclusive and exclusive combination to 90.5% each. Conclusion: The individual performances of both scans were not significantly different in diagnosing CTS

  6. Running SW4 On New Commodity Technology Systems (CTS-1) Platform

    Energy Technology Data Exchange (ETDEWEB)

    Rodgers, Arthur J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Petersson, N. Anders [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Pitarka, Arben [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Sjogreen, Bjorn [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-08-30

    We have recently been running earthquake ground motion simulations with SW4 on the new capacity computing systems, called the Commodity Technology Systems - 1 (CTS-1) at Lawrence Livermore National Laboratory (LLNL). SW4 is a fourth order time domain finite difference code developed by LLNL and distributed by the Computational Infrastructure for Geodynamics (CIG). SW4 simulates seismic wave propagation in complex three-dimensional Earth models including anelasticity and surface topography. We are modeling near-fault earthquake strong ground motions for the purposes of evaluating the response of engineered structures, such as nuclear power plants and other critical infrastructure. Engineering analysis of structures requires the inclusion of high frequencies which can cause damage, but are often difficult to include in simulations because of the need for large memory to model fine grid spacing on large domains.

  7. CTS-type variable conductance heat pipes for SEP FM/PPU

    Science.gov (United States)

    Antoniuk, D.; Luedke, E. E.

    1978-01-01

    The development effort for, and the fabrication and testing of, six CTS-type variable conductance heat pipes is described. The heat pipes are constructed of stainless steel, use methanol as a working fluid, and a nitrogen/helium mixture as the control gas. The wicking structure consists of interior wall grooves, a metal-felt diametral slab wick, and two wire-mesh arteries. The heat pipes are used to cool two Functional Model/Power Processing Units in a Solar Electric Propulsion prototype BIMOD thruster subsystem assembly. The Power Processing Units convert the electric power from a spacecraft solar array system to the voltages required to operate the electric thrusters which are part of the BIMOD assembly.

  8. Summary of the CTS Transient Event Counter data after one year of operation. [Communication Technology Satellite

    Science.gov (United States)

    Stevens, N. J.; Klinect, V. W.; Gore, J. V.

    1977-01-01

    The environmental charging of satellite surfaces during geomagnetic substorms is the apparent cause of a significant number of anomalous events occurring on geosynchronous satellites since the early 1970's. Electromagnetic pulses produced in connection with the differential charging of insulators can couple into the spacecraft harness and cause electronic switching anomalies. An investigation conducted to determine the response of the spacecraft surfaces to substorm particle fluxes makes use of a harness transient detector. The harness transient detector, called the Transient Event Counter (TEC) was built and integrated into the Canadian-American Communications Technology Satellite (CTS). A description of the TEC and its operational characteristics is given and the obtained data are discussed. The data show that the satellite surfaces appear to be charged to the point that discharges occur and that the discharge-induced transients couple into the wire harnesses.

  9. Actitudes frente a la relación cts de estudiantes de licenciatura en ciencias naturales

    Directory of Open Access Journals (Sweden)

    Edelmira Ochoa Camacho

    2013-01-01

    Full Text Available El trabajo de investigación que presenta este artículo se desarrolló en el marco de la tesis de Maestría en Educación de la Universidad Pedagógica y Tecnológica de Colombia entre los años 2010 y 2012. Uno de sus objetivos fue evaluar las actitudes de los estudiantes universitarios de primer semestre de la Licenciatura en Ciencias Naturales y Educación Ambiental frente a la relación Ciencia, Tecnología y Sociedad (CTS, y su diseño metodológico se enmarcó dentro de la investigación cuantitativa, con enfoque descriptivo, que permitió a la vez hacer análisis cualitativos, para conocer e identificar puntos fuertes y débiles de las actitudes hacia dichos temas. Para tal propósito los estudiantes diligenciaron el Cuestionario de Opiniones de Ciencia Tecnología y Sociedad (COCTS y se realizó el análisis de la información. Los resultados globales exhiben actitudes con valores cercanos a cero y el análisis detallado por cuestiones, categorías y frases permite identificar diversidad de creencias que configuran las actitudes previas de los estudiantes involucrados. Se concluyó que la utilización del COCTS y su análisis aporta a una mejor comprensión e identificación de las actitudes de los estudiantes encuestados sobre la relación CTS.

  10. debates, encrucijadas y críticas desde el enfoque CTS

    Directory of Open Access Journals (Sweden)

    César Pérez Jiménez

    2006-01-01

    Full Text Available La educación ha asumido la incorporación de las Tecnologías de la Información y Comunicación (TIC, presuponiendo la transformación sustancial del currículum, la formación permanente de docentes, y la adecuación social-estructural de la escuela como escenario pedagógico. Este trabajo busca analizar las posibilidades de desarrollo socio-cultural de la educación, desde la perspectiva de las oportunidades locales de accesibilidad y aprovechamiento de los recursos telemáticos, enfatizando la construcción de identidades individuales y colectivas sustentadas en representaciones sobre aspectos tecnocientíficos, que permitan la integración de conocimientos disciplinares y saberes sociales en las acciones pedagógicas. Su estructura da cuenta de la organización de una serie de presupuestos conductores del discurso emancipatorio, el cual busca asidero en el marco de las racionalidades educativas a la luz de los desarrollos tecnocientíficos actuales. Se discute la vinculación entre ciencia, tecnología y sociedad (CTS, la alianza entre la educación y las TIC, así como los retos que se plantean como resultado de esta dialéctica, y la valoración del enfoque CTS como clave para la reformulación de una educación democrática orientada a la legitimación de las ciudadanías sociales. Finalmente, se subraya la necesidad de un proyecto político-educativo sustentado en el sentido ético-social para la democratización de las TIC

  11. Guyon's tunnel syndrome during pregnancy with concomitant anomalous arch of the ulnar nerve: a case report.

    Science.gov (United States)

    Janmohammadi, Nasser

    2014-01-01

    Numerous causes are reported for ulnar nerve compression at the wrist, known as Guyon's tunnel syndrome. In the present article, a patient with Guyon's tunnel syndrome during pregnancy concomitant with an anomaly of ulnar nerve is described. A 29-year-old Iranian woman presented with clinical features of Guyon's tunnel syndrome (pain and paresthesia in the fifth finger of the left hand and atrophy of the first dorsal interosseus muscle). Symptoms of the patient appeared during the third trimester of pregnancy. Electro diagnostic studies confirmed Guyon's tunnel syndrome. Surgical exploration revealed an anomalous arch of the ulnar nerve passing through the flexor carpi ulnaris (FCU) tendon. The anomalous arch of the ulnar nerve was released by resection of the segment of FCU tendon passing through the ulnar nerve arch. Therefore, in patients with Guyon's tunnel syndrome, the ulnar nerve anomaly should be kept in mind as a cause. Moreover, pregnancy may have a provocative effect on Guyon's tunnel syndrome similar to carpal tunnel syndrome (CTS).

  12. Guyon's tunnel syndrome during pregnancy with concomitant anomalous arch of the ulnar nerve: a case report.

    Directory of Open Access Journals (Sweden)

    Nasser Janmohammadi

    2014-07-01

    Full Text Available Numerous causes are reported for ulnar nerve compression at the wrist, known as Guyon's tunnel syndrome. In the present article, a patient with Guyon's tunnel syndrome during pregnancy concomitant with an anomaly of ulnar nerve is described. A 29-year-old Iranian woman presented with clinical features of Guyon's tunnel syndrome (pain and paresthesia in the fifth finger of the left hand and atrophy of the first dorsal interosseus muscle. Symptoms of the patient appeared during the third trimester of pregnancy. Electro diagnostic studies confirmed Guyon's tunnel syndrome. Surgical exploration revealed an anomalous arch of the ulnar nerve passing through the flexor carpi ulnaris (FCU tendon. The anomalous arch of the ulnar nerve was released by resection of the segment of FCU tendon passing through the ulnar nerve arch. Therefore, in patients with Guyon's tunnel syndrome, the ulnar nerve anomaly should be kept in mind as a cause. Moreover, pregnancy may have a provocative effect on Guyon's tunnel syndrome similar to carpal tunnel syndrome (CTS.

  13. Hypersonic Tunnel Facility (HTF)

    Data.gov (United States)

    Federal Laboratory Consortium — The Hypersonic Tunnel Facility (HTF) is a blow-down, non-vitiated (clean air) free-jet wind tunnel capable of testing large-scale, propulsion systems at Mach 5, 6,...

  14. Transonic Dynamics Tunnel (TDT)

    Data.gov (United States)

    Federal Laboratory Consortium — The Transonic Dynamics Tunnel (TDT) is a continuous flow wind-tunnel facility capable of speeds up to Mach 1.2 at stagnation pressures up to one atmosphere. The TDT...

  15. Road and Railroad Tunnels

    Data.gov (United States)

    Department of Homeland Security — Tunnels in the United States According to the HSIP Tiger Team Report, a tunnel is defined as a linear underground passageway open at both ends. This dataset is based...

  16. Quantum theory of tunneling

    CERN Document Server

    Razavy, Mohsen

    2014-01-01

    In this revised and expanded edition, in addition to a comprehensible introduction to the theoretical foundations of quantum tunneling based on different methods of formulating and solving tunneling problems, different semiclassical approximations for multidimensional systems are presented. Particular attention is given to the tunneling of composite systems, with examples taken from molecular tunneling and also from nuclear reactions. The interesting and puzzling features of tunneling times are given extensive coverage, and the possibility of measurement of these times with quantum clocks are critically examined. In addition by considering the analogy between evanescent waves in waveguides and in quantum tunneling, the times related to electromagnetic wave propagation have been used to explain certain aspects of quantum tunneling times. These topics are treated in both non-relativistic as well as relativistic regimes. Finally, a large number of examples of tunneling in atomic, molecular, condensed matter and ...

  17. Hypersonic Tunnel Facility (HTF)

    Data.gov (United States)

    Federal Laboratory Consortium — The Hypersonic Tunnel Facility (HTF) is a blow-down, non-vitiated (clean air) free-jet wind tunnel capable of testing large-scale, propulsion systems at Mach 5, 6,...

  18. VizieR Online Data Catalog: CTS C30.10 SALT long-slit spectra (Modzelewska+, 2014)

    Science.gov (United States)

    Modzelewska, J.; Czerny, B.; Hryniewicz, K.; Bilicki, M.; Krupa, M.; Swieton, A.; Pych, W.; Udalski, A.; Adhikari, T. P.; Petrogalli, F.

    2014-08-01

    Five spectra of the quasar CTS C30.10 taken at different dates with SALT telescope. Spectra are in the rest frame, corrected for the Galaxy extinction. The five spectra are taken on December 6, 2012, January 21, 2013, March 20, 2013, August 4, 2013, and March 5, 2014. (1 data file).

  19. The Measuring and Protection Method for the Abnormal Rise of Magnetizing Inrush Current in a Divided Type 3 CTs System

    Science.gov (United States)

    Iwasaki, Fumio; Ibe, Masayuki; Ninohei, Koichiro; Okamura, Seichiro

    This paper describes the measuring and protection method for the abnormal rise of magnetizing inrush current in a divided type 3 CTs system. By divided type 3 CTs system, it is possible to measure the primary phase current and zero phase current at the same time. In this reason, the divided type 3 CTs system is widely used for the measurement of high voltage distribution line by simply clamping the each phase lines with 3CTs. For the accurate measurement of the phase current and zero phase current, the internal residual current in CT should be small as possible. It is reported that the abnormal rise of the residual current is generated in the practical field use and several ten ampere (converted to the primary current value) is observed in some case. The abnormal rise of the residual current is caused by the primary magnetizing inrush current or by the sum of the influence by electromagnetic field of the nearby conductors. The magnetizing inrush current is caused by the magnetic saturation of the core of CT. It is difficult to eliminate the abnormal residual current by using the bigger size of core. In our test, we used the active elements and independent feed back coils around the right and left core of CT. By using the feed back current from these coils it was observed that the magnetic saturation of the core is improved and the magnetizing inrush current can be controlled.

  20. The Tunnels of Samos

    Science.gov (United States)

    Apostol, Tom M. (Editor)

    1995-01-01

    This 'Project Mathematics' series video from CalTech presents the tunnel of Samos, a famous underground aquaduct tunnel located near the capital of Pithagorion (named after the famed Greek mathematician, Pythagoras, who lived there), on one of the Greek islands. This tunnel was constructed around 600 BC by King Samos and was built under a nearby mountain. Through film footage and computer animation, the mathematical principles and concepts of why and how this aquaduct tunnel was built are explained.

  1. Progesterone - new therapy in mild carpal tunnel syndrome? Study design of a randomized clinical trial for local therapy

    Directory of Open Access Journals (Sweden)

    Ginanneschi Federica

    2010-04-01

    Full Text Available Abstract Background Local corticosteroid injection for carpal tunnel syndrome (CTS provides greater clinical improvement in symptoms one month after injection compared to placebo but significant symptom relief beyond one month has not been demonstrated and the relapse of symptoms is possible. Neuroprotection and myelin repair actions of the progesterone was demonstrated in vivo and in vitro study. We report the design of a randomized controlled trial for the local injection of cortisone versus progesterone in "mild" idiopathic CTS. Methods Sixty women with age between 18 and 60 years affected by "mild" idiopathic CTS, diagnosed on the basis of clinical and electrodiagnostic tests, will be enrolled in one centre. The clinical, electrophysiological and ultasonographic findings of the patients will be evaluate at baseline, 1, 6 and 12 months after injection. The major outcome of this study is to determine whether locally-injected progesterone may be more beneficial than cortisone in CTS at clinical levels, tested with symptoms severity self-administered Boston Questionnaire and with visual analogue pain scale. Secondary outcome measures are: duration of experimental therapy; improvement of electrodiagnostic and ultrasonographic anomalies at various follow-up; comparison of the beneficial and harmful effects of the cortisone versus progesterone. Conclusion We have designed a randomized controlled study to show the clinical effectiveness of local progesterone in the most frequent human focal peripheral mononeuropathy and to demonstrate the neuroprotective effects of the progesterone at the level of the peripheral nervous system in humans.

  2. Associations of cardiovascular risk factors, carotid intima-media thickness and manifest atherosclerotic vascular disease with carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Liira Helena

    2011-04-01

    Full Text Available Abstract Background The role of atherosclerosis in carpal tunnel syndrome (CTS has not previously been addressed in population studies. The aim of this study was to investigate the associations of cardiovascular risk factors, carotid artery intima-media thickness (IMT, and clinical atherosclerotic diseases with CTS. Methods In this cross sectional study, the target population consisted of subjects aged 30 or over who had participated in the national Finnish Health Survey in 2000-2001. Of the 7977 eligible subjects, 6254 (78.4% were included in our study. Carotid IMT was measured in a sub-sample of subjects aged 45 to 74 (N = 1353. Results Obesity (adjusted odds ratio (OR 2.4, 95% confidence interval (CI 1.1-5.4, high LDL cholesterol (OR 3.8, 95% CI 1.6-9.1 for >190 vs. 200 vs. Conclusions Our findings suggest an association between CTS and cardiovascular risk factors in young people, and carotid IMT and clinical atherosclerotic vascular disease in older people. CTS may either be a manifestation of atherosclerosis, or both conditions may share similar risk factors.

  3. Magnetic tunnel junctions (MTJs)

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    We review the giant tunnel magnetoresistance (TMR) in ferromagnetic-insulator-ferromagnetic junctions discovered in recent years, which is the magnetoresistance (MR) associated with the spin-dependent tunneling between two ferromagnetic metal films separated by an insulating thin tunnel barrier. The theoretical and experimental results including junction conductance, magnetoresistance and their temperature and bias dependences are described.

  4. The real role of forearm mixed nerve conduction velocity in the assessment of proximal forearm conduction slowing in carpal tunnel syndrome.

    Science.gov (United States)

    Chang, Ming-Hong; Lee, Yee-Chung; Hsieh, Peiyuan F

    2008-12-01

    The decrease of forearm median motor conduction velocity (CV) in carpal tunnel syndrome (CTS) is a common electrodiagnostic finding in clinical practice and is possibly secondary to either conduction block at wrist or retrograde conduction slowing (RCS). This study is attempted to confirm the existence of RCS and to explore why this controversy occurs for a long time. Eighty CTS patients and controls were recruited. In addition to conventional electrodiagnosis, subjects received further electrodiagnostic protocol. First, a recording electrode was placed over the wrist and then at elbow with palm stimulation to calculate indirect forearm mixed nerve CV (forearm-mix CV) that represented real measurement of nerve fibers through the carpal tunnel. Then, direct measurement of forearm-mix CV was performed with recording at the elbow and stimulation at the wrist. CTS patients had markedly prolonged distal motor and sensory latencies and significantly prolonged wrist-palm sensory and motor conduction. There was a significant decrease in forearm median motor CV; however, there was no difference in ulnar distal motor latency and forearm motor CV. The mild decrease of forearm median motor CV was not proportional to the marked reduction of W-P MCV and there was no demonstrated conduction block at wrist, implying the reduction of forearm median motor CV is unlikely due to conduction blockage or slowing of the large myelinating fibers at the wrist and RCS really occurs over the forearm median nerve. In addition, the direct Forearm-mix CV was similar in CTS and controls; however, there was a significant decrease in indirect forearm-mix CV only in the CTS. Moreover, the difference between direct and indirect forearm-mix CV was significantly greater and poor consistency of direct and indirect forearm-mix CV in CTS, suggesting that direct and indirect forearm-mix CV represent CV from quite different nerve fibers. Therefore, we conclude that RCS really does occur in CTS and the

  5. Proton tunneling in solids

    Energy Technology Data Exchange (ETDEWEB)

    Kondo, J.

    1998-10-01

    The tunneling rate of the proton and its isotopes between interstitial sites in solids is studied theoretically. The phonons and/or the electrons in the solid have two effects on the tunneling phenomenon. First, they suppress the transfer integral between two neighbouring states. Second, they give rise to a finite lifetime of the proton state. Usually the second effect is large and the tunneling probability per unit time (tunneling rate) can be defined. In some cases, however, a coherent tunneling is expected and actually observed. (author)

  6. Issues in the diagnosis and treatment of carpal tunnel syndrome and cubital tunnel syndrome%腕管综合征与肘管综合征诊治中的有关问题

    Institute of Scientific and Technical Information of China (English)

    顾玉东

    2010-01-01

    @@ 腕管与肘管综合征是手外科临床中最常见的二类周围神经卡压征,如何规范它们的诊治标准是进一步开展临床研究的必要条件,为此笔者将近期有关资料进行综合,并提出相关的诊治标准,供全国同道讨论、修改与参考.

  7. Value of Power Doppler and Gray-Scale US in the Diagnosis of Carpal Tunnel Syndrome: Contribution of Cross-Sectional Area just before the Tunnel Inlet as Compared with the Cross-Sectional Area at the Tunnel

    Energy Technology Data Exchange (ETDEWEB)

    Akcar, Nevbahar; Ozkan, Serhat; Mehmetoglu, Ozlem; Calisir, Cuneyt; Adapinar, Baki [Osmangazi University Hospital, Eskisehir (Turkmenistan)

    2010-12-15

    To determine the value of gray-scale and power Doppler ultrasonography in the evaluation of carpal tunnel syndrome (CTS). Median nerves at the carpal tunnel were evaluated by using gray-scale and power Doppler ultrasonography and by using accepted and new criteria in 42 patients with CTS (62 wrists) confirmed by electromyogram and 33 control subjects. We evaluated the cross-sectional area of the nerve just proximal to the tunnel inlet (CSAa), and at mid level (CSAb). We then calculated the percentage area increase of CSAb, and area difference (CSAb-CSAa). We measured two dimensions of the nerve at the distal level to calculate the flattening ratio. The power Doppler ultrasonography was used to assess the number of vessels, which proceeded to give a score according to the vessel number, and lastly evaluated the statistical significance by comparing the means of patients with control subjects by the Student t test for independent samples. Sensitivities and specificities were determined for sonographic characteristics mentioned above. We obtained the receiver operating characteristic (ROC) curve to assess the optimal cut-off values for the diagnosis of CTS. A statistically significant difference was found between patients and the control group for mean CSAb, area difference, percentage area increase, and flattening ratio (p < 0.001, p < 0.001, p < 0.001, p < 0.05, respectively). From the ROC curve we obtained optimal cut-off values of 11 mm{sup 2} for CSAb, 3.65 for area difference, 50% for the percentage of area increase, and 2.6 for the flattening ratio. The mean number of vessels obtained by power Doppler ultrasonography from the median nerve was 1.2. We could not detect vessels from healthy volunteers. Mean CSAbs related to vascularity intensity scores were as follows: score 0: 12.3 {+-} 2.8 mm{sup 2}, score 1: 12.3 {+-} 3.1 mm{sup 2}, score 2: 14.95 {+-} 3.5 mm{sup 2}, score 3: 19.3 {+-} 3.8 mm{sup 2}. The mean PI value in vessels of the median nerve was 4

  8. The Effects of Hypertonic Dextrose Injection on Connective Tissue and Nerve Conduction through the Rabbit Carpal Tunnel

    Science.gov (United States)

    Yoshii, Yuichi; Zhao, Chunfeng; Schmelzer, James D.; Low, Phillip A.; An, Kai-Nan; Amadio, Peter C.

    2009-01-01

    Objective To investigate the effects of hypertonic dextrose injection on the subsynovial connective tissue (SSCT) in a rabbit model. We hypothesized that dextrose injection would induce proliferation of the SSCT, hinder median nerve conduction, and alter SSCT mechanical properties similar to what is observed in patients with carpal tunnel syndrome (CTS). Design Randomized, controlled prospective study. Setting Not applicable. Participants New Zealand white rabbits (N=28) weighing 4.0 to 4.5kg. Intervention One fore paw was randomly injected with 0.1ml of 10% dextrose solution. The contralateral paw was injected with a similar amount of 0.9% saline solution as a control. Animals were sacrificed at 12 weeks after injection. Main Outcome Measures Animals were evaluated by electrophysiology (EP), mechanical testing, and histology. EP was evaluated by distal motor latency and amplitude. Shear force was evaluated when the middle digit flexor digitorum superficialis tendon was pulled out from the carpal tunnel. The ultimate tensile load and the energy absorption were also measured. Tissue for histology was evaluated qualitatively. Results EP demonstrated significant prolongation of distal motor latency. The energy absorption and stiffness were also significantly increased in the dextrose group. Histologically, the dextrose group showed thickening of the collagen bundles and vascular proliferation within the SSCT compared to the saline group. Conclusions These results are consistent with the findings in CTS patients and suggest that hypertonic dextrose injection has the potential to create a novel animal model in which to study the evolution of CTS. PMID:19236989

  9. Carpal tunnel syndrome during pregnancy%妊娠合并腕管综合征

    Institute of Scientific and Technical Information of China (English)

    孙丽洲; 刘丽萍

    2009-01-01

    文章提出了腕管综合征的病因与妊娠期水肿及体内激素水平变化有关,阐述了其临床表现、分级以及诊断,且目前以保守治疗为主.%The paper presents the etiology of carpal tunnel syndrome (CTS) is more likely to be rehted to edema and hormonal changes during pregnancy, and emphasizes the elinieal manifestation, classification and diagnosis. Conservative therapies are the most common initial treatments, especially during pregnancy.

  10. 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.

  11. Clinical and electrophysiological evaluation of neutral wrist nocturnal splinting in patients with carpal tunnel syndrome.

    Science.gov (United States)

    Weng, Chao; Dong, Hongjuan; Chu, Hong; Lu, Zuneng

    2016-08-01

    [Purpose] To prospectively assess the effectiveness of neutral wrist nocturnal splinting in patients with carpal tunnel syndrome (CTS) by using clinical scores and nerve conduction studies (NCS). [Subjects and Methods] Forty-one patients enrolled in the study were clinically evaluated by a symptom severity scale (SSS) and functional status scale (FSS), and were electrophysiologically evaluated by conventional NCS; distal motor latency (DML), sensory conduction velocity (SCV), and difference in sensory latency between the median and ulnar nerves (ΔDSL) were measured. Subjects were treated with wrist splinting. Patients who showed no improvement in symptoms were treated with other conservative treatments, the remaining patients continued to wear splints. SSS, FSS, and NCS were evaluated after splinting as well. [Results] The follow-up was completed in 20 patients (31 wrists) with splinting. SSS and FSS decreased, the DML shortened and ΔDSL decreased significantly after splinting for 3.03 ± 1.16 months. There were significant correlations between SSS and DML, SCV of wrist digit 2, and SCV of wrist digit 4. No correlations were found between SSS and ΔDSL, and FSS and the parameters of NCS. [Conclusion] Neutral wrist nocturnal splinting is effective in at least short term for CTS patients. There is a weak correlation between clinical scores and NCS, which suggests that both approaches should be used to effectively assess the therapeutic effect of CTS treatment.

  12. Clinical and electrophysiological evaluation of neutral wrist nocturnal splinting in patients with carpal tunnel syndrome

    Science.gov (United States)

    Weng, Chao; Dong, Hongjuan; Chu, Hong; Lu, Zuneng

    2016-01-01

    [Purpose] To prospectively assess the effectiveness of neutral wrist nocturnal splinting in patients with carpal tunnel syndrome (CTS) by using clinical scores and nerve conduction studies (NCS). [Subjects and Methods] Forty-one patients enrolled in the study were clinically evaluated by a symptom severity scale (SSS) and functional status scale (FSS), and were electrophysiologically evaluated by conventional NCS; distal motor latency (DML), sensory conduction velocity (SCV), and difference in sensory latency between the median and ulnar nerves (ΔDSL) were measured. Subjects were treated with wrist splinting. Patients who showed no improvement in symptoms were treated with other conservative treatments, the remaining patients continued to wear splints. SSS, FSS, and NCS were evaluated after splinting as well. [Results] The follow-up was completed in 20 patients (31 wrists) with splinting. SSS and FSS decreased, the DML shortened and ΔDSL decreased significantly after splinting for 3.03 ± 1.16 months. There were significant correlations between SSS and DML, SCV of wrist digit 2, and SCV of wrist digit 4. No correlations were found between SSS and ΔDSL, and FSS and the parameters of NCS. [Conclusion] Neutral wrist nocturnal splinting is effective in at least short term for CTS patients. There is a weak correlation between clinical scores and NCS, which suggests that both approaches should be used to effectively assess the therapeutic effect of CTS treatment. PMID:27630413

  13. Our results of mini open approach in patients with carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Azad Yıldırım

    2015-12-01

    Full Text Available Objective: In this study, we aimed to evaluate the results of patients underwent surgical release with mini open surgical method due to Carpal tunnel syndrome (CTS and the surgical technique. Methods: 50 wrists of the 42 patients that we could reach after they were applied mini open surgical method between 2009- 2013 were analyzed retrospectively. After surgery, patients were followed for an average 47.4 months. CTS was detected in 26 of the patients in right hand, in 10 of the patients in left hand and in seven of them bilaterally. In 27 Preoperative patients advanced in 21 intermediate and in 2 mild Electromyography (EMG findings compliant with CTS were found. Results: We did not apply a second operation to any of our patients. None of the patients showed any post operative sensitivity on scar tissue and there was no neurovascular damage in any patients during the surgery. The patients returned to their daily activities average on the 10th day after the surgery [range 7-15 days]. In their follow up EMG was not done on a routine basis to the patients. Patients were followed clinically. Conclusion: The advantages of the surgery process we conducted with over pillar mini incision compared to other techniques that there is less pillar region pain and less scar tenderness, shorter return to work and the technique is efficient, cheap and easy to apply.

  14. CTS Trials Network: Surgical ablation of atrial fibrillation during mitral valve surgery - many questions unanswered.

    Science.gov (United States)

    Afifi, Ahmed

    2015-01-01

    A disease that is associated with stroke and mortality, atrial fibrillation (AF) complicates 30 to 50% of mitral valve disease patients admitted for surgery.(1) Since the introduction of the Cox maze III procedure in 1992 many efforts have been made to come up with modified lesion sets and/or energy sources to surgically treat AF. This lead to the recently published American Heart Association (AHA)- American College of Cardiology (ACC)-Heart Rhythm Society (HRS) guidelines(2) stating that it is reasonable to perform atrial fibrillation ablation in selected patients undergoing other types of cardiac surgery. The effectiveness of different techniques in conversion to sinus rhythm and the clinical impact of freedom from AF remain a question. The CTS Trials Network have undertaken a trial to answer these questions. The first year results of their randomized trial comparing AF ablation at the time of mitral valve surgery with mitral valve surgery alone were published recently in The New England Journal of Medicine.(3).

  15. On-orbit performance of the 12 GHz, 200 watt transmitter experiment package for CTS

    Science.gov (United States)

    Alexovich, R. E.

    1977-01-01

    Performance characteristics from on-orbit tests of the Transmitter Experiment Package (TEP) for the Communications Technology Satellite (CTS) are presented. The TEP consists of a Power Processing System (PPS), an Output Stage Tube (OST), and a Variable Conductance Heat Pipe System (VCHPS), all of which are described. The OST is a coupled-cavity traveling-wave tube with a multistage depressed collector and a stepped velocity-tapered slow-wave structure for efficiency enhancement. It has an RF output power of 240 W and an overall efficiency of 51.5% at a center band frequency of 12.080 GHz. The PPS provides the required operating voltages, regulation, control, and protection for the OST. It has a measured dc-dc conversion efficiency of 86.5% to 88.5%. The VCHPS consists of a fin radiator and three dual-artery stainless steel heat pipes using methanol and a mixture of inert gases. Test results presented include efficiencies, RF output power, frequency response, and performance with single and multiple (two) carriers frequency-modulated by video signals.

  16. Performance of almost edgeless silicon detectors in CTS and 3D-planar technologies

    Science.gov (United States)

    Alagoz, E.; Anelli, G.; Antchev, G.; Avati, V.; Bassetti, V.; Berardi, V.; Boccone, V.; Bozzo, M.; Brücken, E.; Buzzo, A.; Catanesi, M. G.; Cuneo, S.; Da Vià, C.; Deile, M.; Dinapoli, R.; Eggert, K.; Eremin, V.; Ferro, F.; Hasi, J.; Haug, F.; Heino, J.; Jarron, P.; Kalliopuska, J.; Kašpar, J.; Kenney, C.; Kok, A.; Kundrát, V.; Kurvinen, K.; Lauhakangas, R.; Lippmaa, E.; Lokajíček, M.; Luntama, T.; Macina, D.; Macrí, M.; Minutoli, S.; Mirabito, L.; Niewiadomski, H.; Noschis, E.; Oljemark, F.; Orava, R.; Oriunno, M.; Österberg, K.; Parker, S.; Perrot, A.-L.; Radermacher, E.; Radicioni, E.; Ruggiero, G.; Saarikko, H.; Santroni, A.; Sette, G.; Siegrist, P.; Smotlacha, J.; Snoeys, W.; Taylor, C.; Watts, S.; Whitmore, J.

    2013-06-01

    The physics programme of the TOTEM experiment requires the detection of very forward protons scattered by only a few microradians out of the LHC beams. For this purpose, stacks of planar Silicon detectors have been mounted in moveable near-beam telescopes (Roman Pots) located along the beamline on both sides of the interaction point. In order to maximise the proton acceptance close to the beams, the dead space at the detector edge had to be minimised. During the detector prototyping phase, different sensor technologies and designs have been explored. A reduction of the dead space to less than 50 μm has been accomplished with two novel silicon detector technologies: one with the Current Terminating Structure (CTS) design and one based on the 3D edge manufacturing. This paper describes performance studies on prototypes of these detectors, carried out in 2004 in a fixed-target muon beam at CERN's SPS accelerator. In particular, the efficiency and accuracy in the vicinity of the beam-facing edges are discussed.

  17. PENYUSUNAN MEDIA PEMBELAJARAN BERBANTUAN KOMPUTER UNTUK PBL DAN KEEFEKTIFANNYA TERHADAP CTS PESERTA DIDIK SMA

    Directory of Open Access Journals (Sweden)

    Atik Kurniawati

    2015-04-01

    Full Text Available This study aims to investigate: (1 the feasibility of computer-assisted learning media based problem based learning (PBL on Environmental Pollution materials for high school students of class X, and (2 the effectiveness of instructional media for improving of critical thinking skill (CTS learners class X SMA Negeri 5 Magelang. This research was adapted from the ADDIE model of development that includes analyze, design, develop, implement, and evaluate. Products validated by subject matter experts, media experts, educators of Biology, and peer reviewer. Subject of this study is tenth grade students of SMA Negeri 5 Magelang. Collecting data was using questionnaires, observation sheets, and test critical thinking skills. The media according to the validator and the students is classified to the category of good. Instructional media was improved to learners' critical thinking skills effectively, which demonstrated by the significant value of 0:00. This results showed that media computer-assisted learning based PBL is effective for improving of the critical thinking skills of learners.

  18. CTS focus about the information and communication technologies on the development of Angola

    Science.gov (United States)

    Patrocínio, Gilberto; Ferreira, Orlando Rodrigues; Schimiguel, Juliano; Silveira, Ismar; Voelzke, Marcos Rincon

    2012-10-01

    This paper aims at developing a systematic analysis on the Information and Communication Technologies (ICT) and Distance Learning in the development of Angola. Currently Angola as one of the most important African countries, the protagonist of the African Union (AU), is in extensive development and rebuilding themselves socially, economically and politically. In the process, Education becomes essential and, together with a proposal to insert through the Information and Communication Technologies (ICTs), proceeds to the achievement of a future process where science and technology apply in favor of a society, a real action CTS. In this effort we analyzed the most sensitive aspects of the Angolan reality, trying to identify the main points that require dependence on imports in the ICT sector, were also exposed fundamental strategies and initiatives for the implementation of an ICT industry in Angola. It also presented the main center of the Angolan Network for Distance Learning (NDL) and its major partners. And as a proposed application, was taken into consideration the statement of partnership between Southern Cross University and the University Agostinho Neto (UAN) for Distance Education.

  19. Ensino de conceitos químicos em um enfoque CTS a partir de saberes populares

    Directory of Open Access Journals (Sweden)

    Ricardo Luiz Zanotto

    Full Text Available Resumo: O presente artigo objetiva apresentar resultados de um estudo realizado sobre a utilização de saberes populares como ponto de partida para o ensino de conceitos químicos, articulando os diversos saberes sob o enfoque CTS. O trabalho foi realizado com 30 alunos da 3ª série do ensino médio de um colégio da rede estadual de ensino, da região sul do Paraná, Brasil. A abordagem metodológica foi a qualitativa, de natureza interpretativa, com observação participante. A coleta de dados se deu por meio de questionários, apresentação e discussão dos resultados das pesquisas bibliográficas, elaboração e análise de mapas conceituais, produção de infográficos (historinhas. A pesquisa demonstrou que a utilização dos saberes populares se constituiu num fator motivador e de apoio para a aprendizagem, possibilitando a contextualização dos conteúdos, tornando o ensino de Química mais atraente e significativo, facilitando, dessa maneira, a criação de estruturas cognitivas e mudanças de perfil conceitual.

  20. Feasibility of a novel functional sensibility test as an assisted examination for determining precision pinch performance in patients with carpal tunnel syndrome.

    Directory of Open Access Journals (Sweden)

    Hsiu-Yun Hsu

    Full Text Available To understand the feasibility of a novel functional sensibility test for determining precision pinch performance in patients with carpal tunnel syndrome, this study investigates the validity, sensitivity and specificity of functional sensibility derived from a pinch-holding-up activity (PHUA test. Participants include 70 clinically defined carpal tunnel syndrome (CTS patients with 119 involved hands and 70 age- and gender-matched controls. To examine the discriminating ability of the functional sensibility test, the differences in the ability of pinch force adjustments to the inertial load of handling object between CTS and control subjects are analyzed. The results of functional sensibility are correlated with the severity of CTS to establish concurrent validity. The receiver operating characteristic (ROC curve is constructed to demonstrate the accuracy of the proposed test. The functional sensibility score significantly discriminates the patients and control groups (respectively, 12.94±1.72 vs. 11.51±1.15N in peak pinch force (FPPeak, p<0.001; 2.92±0.41 vs. 2.52±0.24 in force ratio, p<0.001 and is moderately correlated (r = 0.42-0.54, p<0.001 with the results of traditional sensibility tests (touch-pressure threshold and two-point discrimination test. In addition, there is a statistical difference in the results of functional sensibility (p<0.001 among the subgroups of CTS severity based on electrophysiological study. The sensitivity and specificity are 0.79 and 0.76, respectively, for the functional sensibility test. The areas under the ROC curve are 0.85 and 0.80 for the force ratio and FPPeak, respectively. In conclusion, the functional sensibility test could be feasibly used as a clinical tool for determining both the sensibility and precision pinch performance of hands for the patients with CTS.

  1. Bilateral deficits in fine motor control and pinch grip force are not associated with electrodiagnostic findings in women with carpal tunnel syndrome.

    Science.gov (United States)

    de la Llave-Rincón, Ana Isabel; Fernández-de-Las-Peñas, César; Pérez-de-Heredia-Torres, Marta; Martínez-Perez, Almudena; Valenza, Marie Carmen; Pareja, Juan A

    2011-06-01

    : The aim of this study was to analyze the differences in deficits in fine motor control and pinch grip force between patients with minimal, moderate/mild, or severe carpal tunnel syndrome (CTS) and healthy age- and hand dominance-matched controls. : A case-control study was conducted. The subtests of the Purdue Pegboard Test (one-hand and bilateral pin placements and assemblies) and pinch grip force between the thumb and the remaining four fingers of the hand were bilaterally evaluated in 66 women with minimal (n = 16), moderate (n = 16), or severe (n = 34) CTS and in 20 age- and hand-matched healthy women. The differences among the groups were analyzed using different mixed models of analysis of variance. : A two-way mixed analysis of variance revealed significant differences between groups, not depending on the presence of unilateral or bilateral symptoms (side), for the one-hand pin placement subtest: patients showed bilateral lower scores compared with controls (P < 0.001), without differences among those with minimal, moderate, or severe CTS (P = 0.946). The patients also exhibited lower scores in bilateral pin placement (P < 0.001) and assembly (P < 0.001) subtests, without differences among them. The three-way analysis of variance revealed significant differences among groups (P < 0.001) and fingers (P < 0.001), not depending on the presence of unilateral/bilateral symptoms (P = 0.684), for pinch grip force: patients showed bilateral lower pinch grip force in all fingers compared with healthy controls, without differences among those with minimal, moderate, or severe CTS. : The current study revealed similar bilateral deficits in fine motor control and pinch grip force in patients with minimal, moderate, or severe CTS, supporting that fine motor control deficits are a common feature of CTS not associated with electrodiagnostic findings.

  2. How to make electrodiagnosis of carpal tunnel syndrome with normal distal conductions?

    Science.gov (United States)

    Lee, Wei-Ju; Liao, Yi-Chu; Wei, Shiew-Jue; Tsai, Chi-Wei; Chang, Ming-Hong

    2011-02-01

    The purpose of this study is to investigate which electrodiagnostic techniques are better in clinically diagnosed patients with carpal tunnel syndrome (CTS) and patients with CTS with normal distal conduction study. A total of 230 clinically diagnosed patients with CTS and 100 normal control subjects were enrolled. All subjects were evaluated by eight electrodiagnostic techniques, including conventional conduction studies: median distal sensory latency and distal motor latency; short distance conduction studies across wrist, including wrist-palm sensory conduction time and wrist-palm motor conduction velocity; comparison of median sensory conduction across the wrist with radial or ulnar nerves in the same limb (median-radial sensory latency difference [M-R] or median-ulnar sensory latency difference [M-U]); and comparison of median wrist-palm and palm-index conduction, including distoproximal conduction time difference and distoproximal conduction time ratio. Normal limits were derived by calculating the mean ± 2 standard deviations from the data of the controls. The sensitivity, specificity, positive predictive value, negative predictive value, and the area under the receiver operating characteristic curve with 95% confidence interval of each test were calculated. In clinically diagnosed patients with CTS, M-R is the best diagnostic technique with significant difference in area under the receiver operating characteristic curve (0.912) compared with other tests except that of M-U. The sensitivity, specificity, positive predictive value, and negative predictive value of M-R were 84.3%, 98%, 99%, and 73.1%, respectively. Further evaluation of patients with CTS with normal distal latencies also revealed the best diagnostic value of M-R and M-U with significance to other tests in area under the receiver operating characteristic curve. In clinical practice, after conventional median distal sensory latency and distal motor latency studies, the authors suggest performing

  3. Resonance Enhanced Tunneling

    CERN Document Server

    Matsumoto, S; Matsumoto, Sh.

    2000-01-01

    Time evolution of tunneling in thermal medium is examined using the real-time semiclassical formalism previously developed. Effect of anharmonic terms in the potential well is shown to give a new mechanism of resonance enhanced tunneling. If the friction from environment is small enough, this mechanism may give a very large enhancement for the tunneling rate. The case of the asymmetric wine bottle potential is worked out in detail.

  4. A novel porous aspirin-loaded (GO/CTS-HA)n nanocomposite films: Synthesis and multifunction for bone tissue engineering.

    Science.gov (United States)

    Ji, Mingxiang; Li, Han; Guo, Hailin; Xie, Anjian; Wang, Shaohua; Huang, Fangzhi; Li, Shikuo; Shen, Yuhua; He, Jiacai

    2016-11-20

    A novel porous graphene oxide (GO)/chitosan (CTS)-hydroxyapatite (HA) nanocomposite film was successfully prepared for the first time by combining layer-by-layer (LBL) assembly technology with biomimetic mineralization method. The LBL technology was used to control the thickness of film as well as induce the biomimetic mineralization of biocompatible HA. The obtained (GO/CTS-HA)n film provided ideal platform for the proliferation of mouse mesenchymal stem cells (mMSCs). The pore size in the film is about 300nm, and the porous architecture made the film have high aspirin loading efficiency. Also the accumulated loading dosage could be adjusted by the film thickness, and the sustained release of aspirin could ensure well anti-inflammatory effect. The above advantages may alleviate the pain of patients and give the better environment for bone regeneration. This multifunctional aspirin-loaded (GO/CTS-HA)n film provided an inspiration for the synthesis of novel porous inorganic/biomacromolecule nanocomposite films as the biocoatings applied in bone tissue engineering.

  5. Combination of inquiry learning model and computer simulation to improve mastery concept and the correlation with critical thinking skills (CTS)

    Science.gov (United States)

    Nugraha, Muhamad Gina; Kaniawati, Ida; Rusdiana, Dadi; Kirana, Kartika Hajar

    2016-02-01

    Among the purposes of physics learning at high school is to master the physics concepts and cultivate scientific attitude (including critical attitude), develop inductive and deductive reasoning skills. According to Ennis et al., inductive and deductive reasoning skills are part of critical thinking. Based on preliminary studies, both of the competence are lack achieved, it is seen from student learning outcomes is low and learning processes that are not conducive to cultivate critical thinking (teacher-centered learning). One of learning model that predicted can increase mastery concepts and train CTS is inquiry learning model aided computer simulations. In this model, students were given the opportunity to be actively involved in the experiment and also get a good explanation with the computer simulations. From research with randomized control group pretest-posttest design, we found that the inquiry learning model aided computer simulations can significantly improve students' mastery concepts than the conventional (teacher-centered) method. With inquiry learning model aided computer simulations, 20% of students have high CTS, 63.3% were medium and 16.7% were low. CTS greatly contribute to the students' mastery concept with a correlation coefficient of 0.697 and quite contribute to the enhancement mastery concept with a correlation coefficient of 0.603.

  6. Tunnelling in Dante's Inferno

    Science.gov (United States)

    Furuuchi, Kazuyuki; Sperling, Marcus

    2017-05-01

    We study quantum tunnelling in Dante's Inferno model of large field inflation. Such a tunnelling process, which will terminate inflation, becomes problematic if the tunnelling rate is rapid compared to the Hubble time scale at the time of inflation. Consequently, we constrain the parameter space of Dante's Inferno model by demanding a suppressed tunnelling rate during inflation. The constraints are derived and explicit numerical bounds are provided for representative examples. Our considerations are at the level of an effective field theory; hence, the presented constraints have to hold regardless of any UV completion.

  7. Microsystem Aeromechanics Wind Tunnel

    Data.gov (United States)

    Federal Laboratory Consortium — The Microsystem Aeromechanics Wind Tunnel advances the study of fundamental flow physics relevant to micro air vehicle (MAV) flight and assesses vehicle performance...

  8. Ulnar tunnel syndrome.

    Science.gov (United States)

    Bachoura, Abdo; Jacoby, Sidney M

    2012-10-01

    Ulnar tunnel syndrome could be broadly defined as a compressive neuropathy of the ulnar nerve at the level of the wrist. The ulnar tunnel, or Guyon's canal, has a complex and variable anatomy. Various factors may precipitate the onset of ulnar tunnel syndrome. Patient presentation depends on the anatomic zone of ulnar nerve compression: zone I compression, motor and sensory signs and symptoms; zone II compression, isolated motor deficits; and zone III compression; purely sensory deficits. Conservative treatment such as activity modification may be helpful, but often, surgical exploration of the ulnar tunnel with subsequent ulnar nerve decompression is indicated.

  9. Dor e parestesias nos membros superiores e diagnóstico da síndrome do túnel do carpo Pain and numbness in the arms and hands and carpal tunnel syndrome diagnosis

    Directory of Open Access Journals (Sweden)

    Valéria Ribeiro Nogueira Barbosa

    2006-12-01

    Full Text Available Nós avaliamos a freqüência e localização de dor e parestesias em pacientes com síndrome do túnel do carpo (STC e em indivíduos da população geral, pareados por gênero e idade. Determinamos a sensibilidade e a especificidade desses sintomas para o diagnóstico de STC. Dor foi um sintoma comum nos dois grupos de pacientes. Parestesia ocorreu com mais freqüência em pacientes com STC (p75% quando são localizadas nas mãos.We studied the frequency and localization of pain and numbness in patients with carpal tunnel syndrome (CTS, in comparison with individuals of the general population, matched for sex and age, and we determined the sensitivity and the specificity of these symptoms for the CTS diagnosis. Pain was a common symptom in the two groups of patients. Numbness occurred more frequently in CTS group (p<0.05. In CTS patients, pain complaints were present in neck (42.8%, arms (36.8% and hands (82.8%. Among controls, pain was more common in head (11.4%, trunk (37.1%, legs (22.8%. In our casuistics, in relation to the CTS diagnosis, the presence of pain and numbness have low sensitivity and high specificity when they occur in the arms, and high sensitivity and specificity when they occur in the hands.

  10. Sonography and electrodiagnosis in carpal tunnel syndrome diagnosis, an analysis of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Seror, P. [Laboratoire d' electromyographie, 146, avenue Ledru-Rollin, Paris 75011 (France)], E-mail: p.seror@wanadoo.fr

    2008-07-15

    We present a review of the international literature concerning sonography for the diagnosis of carpal tunnel syndrome (CTS). Analysis of the results and comparison with electrodiagnostic data provide a sensible albeit personal view on the relevance of sonography and whether it competes or is complementary to electrodiagnosis (EDX). Although EDX is considered as the gold standard for CTS diagnosis, one author chose surgical results to define CTS. The normal and threshold mean values for sonography are particularly variable from one study to another. The standard deviation (S.D.), when compared to mean values, makes normal and abnormal data overlap considerably and produces many false negatives when the specificity is high, and many false positives when the sensitivity is high. In fact, sonography is non-interpretable in only 10 to 15% of the population, and it affirms the median nerve lesion at the wrist in 55% of cases when EDX does it in more than 90% with common tests. Further more the specificity of sonography leads to a false positive diagnosis in 1 case out of 5 versus 1 out of 40 with EDX. The main conclusion is that there is no competition but rather a complementarity between sonography and EDX: sonography is certainly an efficient imaging technique but cannot replace proper EDX performed for upper limb paresthesiae. Namely, sonography can answer only one out of the 8 questions a complete EDX answer: Are sonographic images compatible with a median nerve lesion at the wrist? The answer to this solely question can be obtain with a partial EDX using a single conduction test (motor or sensitive), then duration and cost will be comparable to sonography but will be both more sensitive and specific. Finally, one must kept in mind that the final aim of all examinations in CTS is to determine the cause(s) of upper limb paresthesiae, not simply if there is a median nerve lesion at wrist or not.

  11. Measurements of the fast-ion distribution function at ASDEX upgrade by collective Thomson scattering (CTS) using active and passive views

    Science.gov (United States)

    Nielsen, S. K.; Stejner, M.; Rasmussen, J.; Jacobsen, A. S.; Korsholm, S. B.; Leipold, F.; Maraschek, M.; Meo, F.; Michelsen, P. K.; Moseev, D.; Salewski, M.; Schubert, M.; Stober, J.; Suttrop, W.; Tardini, G.; Wagner, D.

    2015-03-01

    Collective Thomson scattering (CTS) can provide measurements of the confined fast-ion distribution function resolved in space, time and 1D velocity space. On ASDEX Upgrade, the measured spectra include an additional signal which previously has hampered data interpretation. A new set-up using two independent heterodyne receiver systems enables subtraction of the additional part from the total spectrum, revealing the resulting CTS spectrum. Here we present CTS measurements from the plasma centre obtained in L-mode and H-mode plasmas with and without neutral beam injection (NBI). For the first time, the measured spectra agree quantitatively with the synthetic spectra in periods with and without NBI heating. For the discharges investigated, the central velocity distribution of neutral beam ions can be described by classical slowing down. These results will have a major impact on ITER physics exploration, since CTS is presently the only diagnostic to measure the confined alpha particles produced by the fusion reactions.

  12. 凯迪拉克CTS 2.8L上市 定价43.8万元

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    继SRX 4.6LV8、SRX 3.6LV6联袂登场之后.上海通用汽车今天又将凯迪拉克CTS 2.8L推向前台.定价为43.8万元。发布当日即在全国范围内接受定单,其全国11家品牌授权销售服务中心,也同步启动销售工作。CTS 2.8L让凯迪拉克产品结构得以有力扩充.目前中国市场已经有CTS 3.6L,CTS 2.8L,SRX 4.6LV8,SRX 3.6LV6四款产品。

  13. Virtual photons in macroscopic tunneling

    CERN Document Server

    Aichmann, Horst; Bruney, Paul

    2015-01-01

    Tunnelling processes are thought to proceed via virtual waves due to observed superluminal (faster than light) signal speeds. Some assume such speeds must violate causality. These assumptions contradict, for instance, superluminally tunnelled music and optical tunnelling couplers applied in fiber communication. Recently tunnelling barriers were conjectured to be cavities, wherein the tunnelled output signal is not causally related with the input. The tests described here resolve that tunnelling waves are virtual, propagations are superluminal, and causality is preserved.

  14. Central sensitization does not identify patients with carpal tunnel syndrome who are likely to achieve short-term success with physical therapy.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Cleland, Joshua A; Ortega-Santiago, Ricardo; de-la-Llave-Rincon, Ana Isabel; Martínez-Perez, Almudena; Pareja, Juan A

    2010-11-01

    The aim of the current study was to identify whether hyperexcitability of the central nervous system is a prognostic factor for individuals with carpal tunnel syndrome (CTS) likely to experience rapid and clinical self-reported improvement following a physical therapy program including soft tissue mobilization and nerve slider neurodynamic interventions. Women presenting with clinical and electrophysiological findings of CTS were involved in a prospective single-arm trial. Participants underwent a standardized examination and then a physical therapy session. The physical therapy sessions included both soft tissue mobilization directed at the anatomical sites of potential median nerve entrapment and a passive nerve slider neurodynamic technique targeted to the median nerve. Pressure pain thresholds (PPT) over the median, radial and ulnar nerves, C5-C6 zygapophyseal joint, carpal tunnel and tibialis anterior muscle were assessed bilaterally. Additionally, thermal detection and pain thresholds were measured over the carpal tunnel and thenar eminence bilaterally to evaluate central nervous system excitability. Subjects were classified as responders (having achieved a successful outcome) or non-responders based on self-perceived recovery. Variables were entered into a stepwise logistic regression model to determine the most accurate variables for determining prognosis. Data from 72 women were included in the analysis, of which 35 experienced a successful outcome (48.6%). Three variables including PPT over the C5-C6 joint affected side 66 points were identified. If 2 out of 3 variables were present (LR + 14.8), the likelihood of success increased from 48.6 to 93.3%. We identified 3 factors that may be associated with a rapid clinical response to both soft tissue mobilization and nerve slider neurodynamic techniques targeted to the median nerve in women presenting with CTS. Our results support that widespread central sensitization may not be present in women with CTS who

  15. Tunnel fire dynamics

    CERN Document Server

    Ingason, Haukur; Lönnermark, Anders

    2015-01-01

    This book covers a wide range of issues in fire safety engineering in tunnels, describes the phenomena related to tunnel fire dynamics, presents state-of-the-art research, and gives detailed solutions to these major issues. Examples for calculations are provided. The aim is to significantly improve the understanding of fire safety engineering in tunnels. Chapters on fuel and ventilation control, combustion products, gas temperatures, heat fluxes, smoke stratification, visibility, tenability, design fire curves, heat release, fire suppression and detection, CFD modeling, and scaling techniques all equip readers to create their own fire safety plans for tunnels. This book should be purchased by any engineer or public official with responsibility for tunnels. It would also be of interest to many fire protection engineers as an application of evolving technical principles of fire safety.

  16. STUDY OF COMPLICATIONS OF COLLES FRACTURE TO FIND OUT THE TRUE INCIDENCE OF EXTENSOR POLLICIS LONGUS TENDON RUPTURE AND CARPAL TUNNEL SYNDROME IN INDIAN POPULATION

    Directory of Open Access Journals (Sweden)

    Kulkarni

    2015-02-01

    Full Text Available Colles‟ fracture is confined to adult and usually is seen in women over the age of fifty who have fallen on the outstretched hand. EPL tendon is the most common extensor tendon to rupture after colles‟ fracture. To our belief the incidenc e of median nerve injury and EPL tendon rupture given in literature are much higher than what we see now a days, so with this aim we carried this study to find out the true incidence of CTS and EPL tendon rupture in Indian population. AIMS AND OBJECTIVES: To study 100 patients with colles‟ fracture for true incidence of Extensor Pollicis Longus (EPL Tendon rupture and Carpal Tunnel Syndrome (CTS in Indian Population. MATERIALS AND METHODS: In our study 100 patients with colles fracture were followed up at regural intervals and were evaluated clinically and radiogrphically to rule out complications like EPL tendon rupture and CTS. OBSERVATION AND RESULTS: In our study, we found 0% incidence of CTS and EPL tendon rupture. CONCLUS ION: Proper division of patients into displaced and un displaced fracture and treatment of displaced fracture being closed reduction and internal fixation with „K‟ wires and then cast application in neutral position i.e. supination without flexion at wrist joint and properly advised physiotheraphy after cast removal at one and half month should be advocated

  17. Surgery is more cost-effective than splinting for carpal tunnel syndrome in the Netherlands: results of an economic evaluation alongside a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Adèr Herman J

    2006-11-01

    Full Text Available Abstract Background Carpal tunnel syndrome (CTS is a common disorder, often treated with surgery or wrist splinting. The objective of this economic evaluation alongside a randomized trial was to evaluate the cost-effectiveness of splinting and surgery for patients with CTS. Methods Patients at 13 neurological outpatient clinics with clinically and electrophysiologically confirmed idiopathic CTS were randomly allocated to splinting (n = 89 or surgery (n = 87. Clinical outcome measures included number of nights waking up due to symptoms, general improvement, severity of the main complaint, paraesthesia at night and during the day, and utility. The economic evaluation was performed from a societal perspective and involved all relevant costs. Results There were no differences in costs. The mean total costs per patient were in the surgery group EURO 2,126 compared to EURO 2,111 in the splint group. After 12 months, the success rate in the surgery group (92% was significantly higher than in the splint group (72%. The acceptability curve showed that at a relatively low ceiling ratio of EURO 2,500 per patient there is a 90% probability that surgery is cost-effective. Conclusion In the Netherlands, surgery is more cost-effective compared with splinting, and recommended as the preferred method of treatment for patients with CTS.

  18. Progression of Carpal Tunnel Syndrome According to Electrodiagnostic Testing in Nonoperatively Treated Patients

    Directory of Open Access Journals (Sweden)

    Mark van Suchtelen

    2014-09-01

    Full Text Available Background:  This study tested the null hypothesis that nonoperatively treated patients would not show disease progression of carpal tunnel syndrome (CTS over time according to median nerve distal motor latency (DML on two electrodiagnostic tests.   Methods:  This retrospective study analyzed sixty-two adult nonoperatively treated patients who were diagnosed with CTS confirmed by a minimum of two electrodiagnostic tests at our institution between December 2006 and  tober 2012. A Wilcoxon signed-rank test was conducted to test the difference between electrodiagnostic measurements between the first and last test. Results: The mean time between the first and last electrodiagnostic test was 26±12 months (range, 12 to 55 months. The only electrodiagnostic measurement that increased significantly was the difference between median and ulnar DML on the same side (r=0.19, P =0.038. The time between the electrodiagnostic tests was significantly longer for patients with at least 10% worsening of the DML at the second test compared to cases of which the DML did not worsen or improve a minimum of 10% (P =0.015.  Conclusions: There is evidence that—on average—idiopathic median neuropathy at the carpal tunnel slowly progresses over time, and this can be measured with electrodiagnostics, but studies with a much longer interval between lectrodiagnostic tests may be needed to determine if it always progresses.

  19. The effect of polarized polychromatic noncoherent light (bioptron) therapy on patients with carpal tunnel syndrome.

    Science.gov (United States)

    Raeissadat, Seyed Ahmad; Rayegani, Seyed Mansoor; Rezaei, Sajad; Sedighipour, Leyla; Bahrami, Mohammad Hasan; Eliaspour, Dariush; Karimzadeh, Afshin

    2014-01-01

    To study the effects of Polarized Polychromatic Noncoherent Light (Bioptron) therapy on patients with carpal tunnel syndrome (CTS). This study was designed as a randomized clinical trial. Forty four patients with mild or moderate CTS (confirmed by clinical and electrodiagnostic studies) were assigned randomly into two groups (intervention and control goups). At the beginning of the study, both groups received wrist splinting for 8 weeks. Bioptron light was applied for the intervention group (eight sessions, for 3/weeks). Bioptron was applied perpendicularly to the wrist from a 10 centimeter sdistance. Pain severity and electrodiagnostic measurements were compared from before to 8 weeks after initiating each treatment. Eight weeks after starting the treatments, the mean of pain severity based on Visual Analogue Scale (VAS) scores decreased significantly in both groups. Median Sensory Nerve Action Potential (SNAP) latency decreased significantly in both groups. However, other electrophysiological findings (median Compound Motor Action Potential (CMAP) latency and amplitude, also SNAP amplitude) did not change after the therapy in both groups. There was no meaningful difference between two groups regarding the changes in the pain severity. Bioptron with the above mentioned parameters led to therapeutic effects equal to splinting alone in patients with carpal tunnel syndrome. However, applying Bioptron with different therapeutic protocols and light parameters other than used in this study, perhaps longer duration of therapy and long term assessment may reveal different results favoring Bioptron therapy.

  20. Application of CTS2 Railroad Switch and NEK-K/E Switch Snow-melting Installment%CTS2转辙机及NEK-K/E道岔融雪装置的应用

    Institute of Scientific and Technical Information of China (English)

    严虎仲; 莫雪婷

    2007-01-01

    通过CTS2转辙机及NEK-K/E道岔融雪装置在青藏线(格拉段)的反复试验和试用,对格拉段惟一的信号轨旁设备进行了机械和电气两方面特性的测试和检验,就其先进性、优越性和尚待解决的问题进行了客观的分析.

  1. The usefulness of terminal latency index of median nerve and f-wave difference between median and ulnar nerves in assessing the severity of carpal tunnel syndrome.

    Science.gov (United States)

    Park, Kang Min; Shin, Kyong Jin; Park, Jinse; Ha, Sam Yeol; Kim, Sung Eun

    2014-04-01

    The calculated electrophysiological parameters, such as terminal latency index (TLI), residual latency, modified F ratio, and F-wave inversion, have been investigated as a diagnostic tool for detection of early stage of carpal tunnel syndrome (CTS) in the literature. However, the correlation of these calculated electrophysiological parameters with the clinical severity of CTS has not been reported. The aim of this study was to determine the correlation of the calculated electrophysiological parameters and clinical severity in patients with CTS. A retrospective study was performed with 212 hands of 106 CTS patients. The CTS hands were classified as asymptomatic, mild, moderate, and severe according to the clinical severity. The distal motor latency and distal motor conduction velocity of median nerve, minimal F-wave latency of median and ulnar nerves, and sensory nerve conduction velocity in the finger-wrist and palm-wrist segment of median nerve (SNCV f-w and SNCV p-w) were obtained in a conventional nerve conduction study. The TLI, residual latency, and modified F ratio of the median nerve and the difference of minimal F-wave latencies between the median and ulnar nerves (F-diff M-U) were calculated. The distal motor latency, residual latency, and F-diff M-U were significantly increased according to the clinical severity of CTS. The motor conduction velocity, SNCV p-w, SNCV f-w, TLI, and modified F ratio were significantly decreased according to the clinical severity of CTS. In analyses of variance and Kruskal-Wallis test, we used the Scheffe test as a post-hoc comparison analysis. The TLI, F-diff M-U, and SNCV f-w showed a significant difference among all groups of each CTS severity. The sensitivity, specificity, and cut-off value of TLI, F-diff M-U, and SNCV f-w between asymptomatic and mild, mild and moderate, and moderate and severe CTS groups were calculated by using receiver operating characteristic curve analysis. The cut-off values of TLI, F-diff M-U, and

  2. Ultrafast scanning tunneling microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Botkin, D.A. [California Univ., Berkeley, CA (United States). Dept. of Physics]|[Lawrence Berkeley Lab., CA (United States)

    1995-09-01

    I have developed an ultrafast scanning tunneling microscope (USTM) based on uniting stroboscopic methods of ultrafast optics and scanned probe microscopy to obtain nanometer spatial resolution and sub-picosecond temporal resolution. USTM increases the achievable time resolution of a STM by more than 6 orders of magnitude; this should enable exploration of mesoscopic and nanometer size systems on time scales corresponding to the period or decay of fundamental excitations. USTM consists of a photoconductive switch with subpicosecond response time in series with the tip of a STM. An optical pulse from a modelocked laser activates the switch to create a gate for the tunneling current, while a second laser pulse on the sample initiates a dynamic process which affects the tunneling current. By sending a large sequence of identical pulse pairs and measuring the average tunnel current as a function of the relative time delay between the pulses in each pair, one can map the time evolution of the surface process. USTM was used to measure the broadband response of the STM`s atomic size tunnel barrier in frequencies from tens to hundreds of GHz. The USTM signal amplitude decays linearly with the tunnel junction conductance, so the spatial resolution of the time-resolved signal is comparable to that of a conventional STM. Geometrical capacitance of the junction does not appear to play an important role in the measurement, but a capacitive effect intimately related to tunneling contributes to the measured signals and may limit the ultimate resolution of the USTM.

  3. SU-E-J-105: Evaluating Auto-Contouring of Prostate KV Conebeam CTs.

    Science.gov (United States)

    Godley, A; Olsen, L Sheplan; Stephans, K

    2012-06-01

    Auto-contouring of daily kV conebeam CTs (kVCBCT) is critical for online adaptive radiotherapy. We surveyed a set of geometric and dosimetric measures to determine which best assess the suitability of kVCBCT contouring algorithms for use in prostate region adaptive planning. Six patients with daily kVCBCT undergoing IMRT of the prostate to 78 Gy were selected. Dose was recalculated with patient density forced to water. Contours were generated on nine kVCBCT for each patient using ABAS (Elekta Ltd.) and also by a physician. The prostate mean dose, D100, D98, where determined and V70 (% and cc) and mean dose for the bladder and rectum for both physician and auto contours. The Dice's Coefficient (DC) was calculated between auto and physician contours, as well as a restricted DC (rDC) which combines geometric and dosimetric information by comparing only the volume within a high dose region. Prostate accuracy can only be discerned with D100, additionally there is no correlation (R2=0.036) between D100 and DC. For all organs, mean dose does not reflect contour suitability. There is large variation in V70 (% and cc) for rectum and bladder, implying V70 is a sensitive indicator of contour suitability. There is however no correlation of V70 with DC. A dose region (>57 Gy) to calculate rDC was chosen to provided optimal correlation (R2>0.81) to V70 (% and cc, rectum and bladder). V70 for rectum and bladder shows the most sensitivity to contour suitability, by concentrating on where accuracy is most vital. Prostate contouring is less critical due to treatment margins, D100 provides the most discerning metric. DC and mean dose are not useable. In lieu of V70, rDC could be used. The rDC can be approximated by limiting to within 2-3 cm of the prostate contour, alleviating the need to calculate dose. A research version of ABAS was provided by Elekta. © 2012 American Association of Physicists in Medicine.

  4. Regulating drug release from pH- and temperature-responsive electrospun CTS-g-PNIPAAm/poly(ethylene oxide) hydrogel nanofibers.

    Science.gov (United States)

    Yuan, Huihua; Li, Biyun; Liang, Kai; Lou, Xiangxin; Zhang, Yanzhong

    2014-08-18

    Temperature- and pH-responsive polymers have been widely investigated as smart drug release systems. However, dual-sensitive polymers in the form of nanofibers, which is advantageous in achieving rapid transfer of stimulus to the smart polymeric structures for regulating drug release behavior, have rarely been explored. In this study, chitosan-graft-poly(N-isopropylacrylamide) (CTS-g-PNIPAAm) copolymer was synthesized by using 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC) and N-hydroxy succinimide (NHS) as grafting agents to graft carboxyl-terminated PNIPAAm (PNIPAAm-COOH) chains onto the CTS biomacromolecules, and then CTS-g-PNIPAAm with or without bovine serum albumin (BSA) was fabricated into nanofibers through electrospinning using poly(ethylene oxide) (PEO, 10 wt%) as a fiber-forming facilitating additive. The BSA laden CTS-g-PNIPAAm/PEO hydrogel nanofibers were tested to determine their drug release profiles by varying pH and temperature. Finally, cytotoxicity of the CTS-g-PNIPAAm/PEO hydrogel nanofibers was evaluated by assaying the L929 cell proliferation using the MTT method. It was found that the synthesized CTS-g-PNIPAAm possessed a temperature-induced phase transition and lower critical solution temperature (LCST) at 32° C in aqueous solutions. The rate of BSA release could be well modulated by altering the environmental pH and temperature of the hydrogel nanofibers. The CTS-g-PNIPAAm/PEO hydrogel nanofibers supported L929 cell growth, indicative of appropriate cytocompatibility. Our current work could pave the way towards developing multi-stimuli responsive nanofibrous smart materials for potential applications in the fields of drug delivery and tissue engineering.

  5. The OSU self-phased array for propagation measurements using the 11.7 GHz CTS beacon

    Science.gov (United States)

    Theobold, D. M.; Hodge, D. B.

    1976-01-01

    A self phased array was developed for propagation measurements on an earth-space path. The 11.7 GHz CTS beacon was used as the signal source. The self phased array was used to measure angle of arrival as well as attenuation and scintillation statistics. The performance of the array is described, and sample data are presented. The tracking capability of the self phased array was also studied. This technique permits fully electronic, nonmechanical satellite tracking, thus simplifying unmanned operation and eliminating severe weather tracking constraints.

  6. Characterization of the CTS 12 and 14 GHz communications links - Preliminary measurements and evaluation. [Communications Technology Satellite

    Science.gov (United States)

    Ippolito, L. J.

    1976-01-01

    The Communications Link Characterization Experiment is designed to characterize the radio frequency links of the Communications Technology Satellite. The experiment is twofold: (1) it will study the natural characteristics in the CTS frequency bands (14 GHz uplink, and 12 GHz downlink) including attenuation and signal degradation due primarily to absorption and scattering induced by precipitation, and (2) it will perform environmental measurements for the characterization of man-made, earth-based signals which could interfere with the uplink frequency bands of the satellite.

  7. Virtual photons in macroscopic tunneling

    OpenAIRE

    Aichmann, Horst; Nimtz, Guenter; Bruney, Paul

    2015-01-01

    Tunnelling processes are thought to proceed via virtual waves due to observed superluminal (faster than light) signal speeds. Some assume such speeds must violate causality. These assumptions contradict, for instance, superluminally tunnelled music and optical tunnelling couplers applied in fiber communication. Recently tunnelling barriers were conjectured to be cavities, wherein the tunnelled output signal is not causally related with the input. The tests described here resolve that tunnelli...

  8. Wind Tunnel Testing Facilities

    Data.gov (United States)

    Federal Laboratory Consortium — NASA Ames Research Center is pleased to offer the services of our premier wind tunnel facilities that have a broad range of proven testing capabilities to customers...

  9. INCAS TRISONIC WIND TUNNEL

    Directory of Open Access Journals (Sweden)

    Florin MUNTEANU

    2009-09-01

    Full Text Available The 1.2 m x 1.2 m Trisonic Blowdown Wind Tunnel is the largest of the experimental facilities at the National Institute for Aerospace Research - I.N.C.A.S. "Elie Carafoli", Bucharest, Romania. The tunnel has been designed by the Canadian company DSMA (now AIOLOS and since its commissioning in 1978 has performed high speed aerodynamic tests for more than 120 projects of aircraft, missiles and other objects among which the twin jet fighter IAR-93, the jet trainer IAR-99, the MIG-21 Lancer, the Polish jet fighter YRYDA and others. In the last years the wind tunnel has been used mostly for experimental research in European projects such as UFAST. The high flow quality parameters and the wide range of testing capabilities ensure the competitivity of the tunnel at an international level.

  10. Quantum tunneling with friction

    Science.gov (United States)

    Tokieda, M.; Hagino, K.

    2017-05-01

    Using the phenomenological quantum friction models introduced by P. Caldirola [Nuovo Cimento 18, 393 (1941), 10.1007/BF02960144] and E. Kanai [Prog. Theor. Phys. 3, 440 (1948), 10.1143/ptp/3.4.440], M. D. Kostin [J. Chem. Phys. 57, 3589 (1972), 10.1063/1.1678812], and K. Albrecht [Phys. Lett. B 56, 127 (1975), 10.1016/0370-2693(75)90283-X], we study quantum tunneling of a one-dimensional potential in the presence of energy dissipation. To this end, we calculate the tunneling probability using a time-dependent wave-packet method. The friction reduces the tunneling probability. We show that the three models provide similar penetrabilities to each other, among which the Caldirola-Kanai model requires the least numerical effort. We also discuss the effect of energy dissipation on quantum tunneling in terms of barrier distributions.

  11. Water Tunnel Facility

    Data.gov (United States)

    Federal Laboratory Consortium — NETL’s High-Pressure Water Tunnel Facility in Pittsburgh, PA, re-creates the conditions found 3,000 meters beneath the ocean’s surface, allowing scientists to study...

  12. Wind Tunnel Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This ARDEC facility consists of subsonic, transonic, and supersonic wind tunnels to acquire aerodynamic data. Full-scale and sub-scale models of munitions are fitted...

  13. Gravity Tunnel Drag

    CERN Document Server

    Concannon, Thomas

    2016-01-01

    The time it takes to fall down a tunnel through the center of the Earth to the other side takes approximately 42 minutes, but only when given several simplifying assumptions: a uniform density Earth; a gravitational field that varies linearly with radial position; a non-rotating Earth; a tunnel evacuated of air; and zero friction along the sides of the tunnel. Though several papers have singularly relaxed the first three assumptions, in this paper we relax the final two assumptions and analyze the motion of a body experiencing these types of drag forces in the tunnel. Under such drag forces, we calculate the motion of a transport vehicle through a tunnel of the Earth under uniform density, under constant gravitational acceleration, and finally under the more realistic Preliminary Reference Earth Model (PREM) density data. We find the density profile corresponding to a constant gravitational acceleration better models the motion through the tunnel compared to the PREM density profile, and the uniform density m...

  14. High Resolution Ultrasonography of Carpal Tunnel Syndrome Before and After Endoscopic Release of the Transverse Carpal Ligament: Correlation of Ultrasonography (US)Findings with Surgical Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Jang Gyu; Im, Soo Bin; Seok, Hyun; Yi, Beom Ha; Choi, Na Mi; Lee, Hae Kyung [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Jin, Wook [East-West Neo Medical Center, Kyung Hee University, Seoul (Korea, Republic of)

    2008-03-15

    The aim of this study is to evaluate morphological changes of the medial nerve in patients with carpal tunnel syndrome (CTS) before and after endoscopic release of the transverse carpal ligament, and to correlate the ultrasonography (US) findings with the use of high resolution US and the surgical outcome for the median nerve. Thirty patients with CTS confirmed by a clinical and electrophysiological study underwent high resolution US. The US instrumentation was equipped with a high frequency linear transducer to measure the cross sectional area, flattening ratio and swelling ratio of the medial nerve at the distal radioulnar joint, proximal and distal carpal tunnel before and three months after surgery. The cross sectional area (CSA) of the median nerve at the distal radioulnar level showed a decrease from 0.13 {+-} 0.03 cm2 before surgery to 0.11 {+-} 0.03 cm2 after surgery, and the CSA of the proximal carpal tunnel showed a decrease from 0.17 {+-} 0.07 cm2 to 0.14 {+-} 0.05 cm2: these differences were statistically significant. There was no statistically significant correlation between the morphological change and symptom improvement. This study confirmed a decreasing CSA of the medial nerve at the distal radioulnar and proximal carpal tunnel in a postoperative patient with CTS, as determined by the use of high resolution US. No association was found between a change in the CSA of the median nerve and symptom improvement. A further study based on multiple measurements of the median nerve with a longer period is necessary to establish the association between a change in the CSA of the median nerve and symptom improvement

  15. Identification and characterization of the chromium (VI) responding protein from a newly isolated Ochrobactrum anthropi CTS-325.

    Science.gov (United States)

    Cheng, Yangjian; Xie, Yongming; Zheng, Jing; Wu, Zhaoxian; Chen, Zhi; Ma, Xiaoyan; Li, Bin; Lin, Zhang

    2009-01-01

    A Gram-negative, chromium(VI) tolerant and reductive strain CTS-325, isolated from a Chinese chromate plant, was identified as Ochrobactrum anthropi based on its biochemical properties and 16S rDNA sequence analysis. It was able to tolerate up to 10 mmol/L Cr(VI) and completely reduce 1 mmol/L Cr(VI) to Cr(III) within 48 h. When the strain CTS-325 was induced with Cr(VI), a protein increased significantly in the whole cell proteins. Liquid chromatography tandem mass spectrometry (LC-MS/MS) analysis revealed that this protein was a superoxide dismutase (SOD) homology. The measured superoxide dismutase activity was 2694 U/mg after three steps of purification. The SOD catalyzes the dismutation of the superoxide anion (O2*-) into hydrogen peroxide and molecular oxygen. This protein is considered to be one of the most important anti-oxidative enzymes for O. anthropi as it allows the bacterium to survive high oxygen stress environments, such as the environment produced during the reduction process of Cr(VI).

  16. Traditional Medicine Collection Tracking System (TM-CTS): a database for ethnobotanically driven drug-discovery programs.

    Science.gov (United States)

    Harris, Eric S J; Erickson, Sean D; Tolopko, Andrew N; Cao, Shugeng; Craycroft, Jane A; Scholten, Robert; Fu, Yanling; Wang, Wenquan; Liu, Yong; Zhao, Zhongzhen; Clardy, Jon; Shamu, Caroline E; Eisenberg, David M

    2011-05-17

    Ethnobotanically driven drug-discovery programs include data related to many aspects of the preparation of botanical medicines, from initial plant collection to chemical extraction and fractionation. The Traditional Medicine Collection Tracking System (TM-CTS) was created to organize and store data of this type for an international collaborative project involving the systematic evaluation of commonly used Traditional Chinese Medicinal plants. The system was developed using domain-driven design techniques, and is implemented using Java, Hibernate, PostgreSQL, Business Intelligence and Reporting Tools (BIRT), and Apache Tomcat. The TM-CTS relational database schema contains over 70 data types, comprising over 500 data fields. The system incorporates a number of unique features that are useful in the context of ethnobotanical projects such as support for information about botanical collection, method of processing, quality tests for plants with existing pharmacopoeia standards, chemical extraction and fractionation, and historical uses of the plants. The database also accommodates data provided in multiple languages and integration with a database system built to support high throughput screening based drug discovery efforts. It is accessed via a web-based application that provides extensive, multi-format reporting capabilities. This new database system was designed to support a project evaluating the bioactivity of Chinese medicinal plants. The software used to create the database is open source, freely available, and could potentially be applied to other ethnobotanically driven natural product collection and drug-discovery programs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  17. Traditional Medicine Collection Tracking System (TM-CTS): A Database for Ethnobotanically-Driven Drug-Discovery Programs

    Science.gov (United States)

    Harris, Eric S. J.; Erickson, Sean D.; Tolopko, Andrew N.; Cao, Shugeng; Craycroft, Jane A.; Scholten, Robert; Fu, Yanling; Wang, Wenquan; Liu, Yong; Zhao, Zhongzhen; Clardy, Jon; Shamu, Caroline E.; Eisenberg, David M.

    2011-01-01

    Aim of the study. Ethnobotanically-driven drug-discovery programs include data related to many aspects of the preparation of botanical medicines, from initial plant collection to chemical extraction and fractionation. The Traditional Medicine-Collection Tracking System (TM-CTS) was created to organize and store data of this type for an international collaborative project involving the systematic evaluation of commonly used Traditional Chinese Medicinal plants. Materials and Methods. The system was developed using domain-driven design techniques, and is implemented using Java, Hibernate, PostgreSQL, Business Intelligence and Reporting Tools (BIRT), and Apache Tomcat. Results. The TM-CTS relational database schema contains over 70 data types, comprising over 500 data fields. The system incorporates a number of unique features that are useful in the context of ethnobotanical projects such as support for information about botanical collection, method of processing, quality tests for plants with existing pharmacopoeia standards, chemical extraction and fractionation, and historical uses of the plants. The database also accommodates data provided in multiple languages and integration with a database system built to support high throughput screening based drug discovery efforts. It is accessed via a web-based application that provides extensive, multi-format reporting capabilities. Conclusions. This new database system was designed to support a project evaluating the bioactivity of Chinese medicinal plants. The software used to create the database is open source, freely available, and could potentially be applied to other ethnobotanically-driven natural product collection and drug-discovery programs. PMID:21420479

  18. Personal and occupational risk factors for carpal tunnel syndrome in meat processing industry workers in Northern Italy

    Directory of Open Access Journals (Sweden)

    Matteo Riccò

    2017-04-01

    Full Text Available Background: Carpal tunnel syndrome (CTS is a musculoskeletal condition that often impairs the fitness to work. Our aim is to retrospectively evaluate the association between physical exposures in meat processing industry in Northern Italy and the CTS, taking into account non-occupational factors. Material and Methods: A cross-sectional study was performed to include 434 workers (236 males, 198 females, 37.0±10.6 years old, working age: 12.6±10.8 years from meat processing industries. Signs and symptoms were collected at the compulsory occupational medical surveillance. Occupational risk factors were assessed through a questionnaire and direct assessment by investigators. Adjusted odds ratios (ORadj for factors of interest were estimated through binary logistic regression. Results: Diagnosis of the CTS was reported for 61 out of 434 subjects (14.1% for an incidence of 11.3/1000 person- years. In general, signs and symptoms for the CTS were associated with the following demographic factors: smoking history (OR = 1.909, 95% confidence interval (CI: 1.107–3.293, previous traumas of the upper limb (OR = 3.533, 95% CI: 1.743–7.165, hypothyroidism status (OR = 7.897, 95% CI: 2.917–21.38 and, in the case of female participants only, previous pregnancies (OR = 2.807, 95% CI: 1.200–6.566 as well as a personal history of oral contraceptive therapy and/or steroidal replacement therapy (OR = 11.57, 95% CI: 4.689–28.56. The carpal tunnel syndrome cases were associated with the following occupational factors (> 4 h/day: forceful hand exertion (ORadj = 3.548, 95% CI: 1.379–9.131, repeated trauma of the hand (ORadj = 3.602, 95% CI: 1.248– 10.395, repeated movements of the wrist (ORadj = 2.561, 95% CI: 1.100–5.960. Conclusions: Increasing levels of hand activity and force were associated with the increased CTS prevalence among participants. Recommendations have to be provided in order to reduce occupational exposure to these risk factors and

  19. Personal and occupational risk factors for carpal tunnel syndrome in meat processing industry workers in Northern Italy.

    Science.gov (United States)

    Riccò, Matteo; Signorelli, Carlo

    2017-03-24

    Carpal tunnel syndrome (CTS) is a musculoskeletal condition that often impairs the fitness to work. Our aim is to retrospectively evaluate the association between physical exposures in meat processing industry in Northern Italy and the CTS, taking into account non-occupational factors. A cross-sectional study was performed to include 434 workers (236 males, 198 females, 37.0±10.6 years old, working age: 12.6±10.8 years) from meat processing industries. Signs and symptoms were collected at the compulsory occupational medical surveillance. Occupational risk factors were assessed through a questionnaire and direct assessment by investigators. Adjusted odds ratios (ORadj) for factors of interest were estimated through binary logistic regression. Diagnosis of the CTS was reported for 61 out of 434 subjects (14.1%) for an incidence of 11.3/1000 person- years. In general, signs and symptoms for the CTS were associated with the following demographic factors: smoking history (OR = 1.909, 95% confidence interval (CI): 1.107-3.293), previous traumas of the upper limb (OR = 3.533, 95% CI: 1.743-7.165), hypothyroidism status (OR = 7.897, 95% CI: 2.917-21.38) and, in the case of female participants only, previous pregnancies (OR = 2.807, 95% CI: 1.200-6.566) as well as a personal history of oral contraceptive therapy and/or steroidal replacement therapy (OR = 11.57, 95% CI: 4.689-28.56). The carpal tunnel syndrome cases were associated with the following occupational factors (> 4 h/day): forceful hand exertion (ORadj = 3.548, 95% CI: 1.379-9.131), repeated trauma of the hand (ORadj = 3.602, 95% CI: 1.248- 10.395), repeated movements of the wrist (ORadj = 2.561, 95% CI: 1.100-5.960). Increasing levels of hand activity and force were associated with the increased CTS prevalence among participants. Recommendations have to be provided in order to reduce occupational exposure to these risk factors and improve medical surveillance. Med Pr 2017;68(2):199-209.

  20. Suppression of tunneling rate fluctuations in tunnel field-effect transistors by enhancing tunneling probability

    Science.gov (United States)

    Mori, Takahiro; Migita, Shinji; Fukuda, Koichi; Asai, Hidehiro; Morita, Yukinori; Mizubayashi, Wataru; Liu, Yongxun; O’uchi, Shin-ichi; Fuketa, Hiroshi; Otsuka, Shintaro; Yasuda, Tetsuji; Masahara, Meishoku; Ota, Hiroyuki; Matsukawa, Takashi

    2017-04-01

    This paper discusses the impact of the tunneling probability on the variability of tunnel field-effect transistors (TFETs). Isoelectronic trap (IET) technology, which enhances the tunneling current in TFETs, is used to suppress the variability of the ON current and threshold voltage. The simulation results show that suppressing the tunneling rate fluctuations results in suppression of the variability. In addition, a formula describing the relationship between the tunneling rate fluctuations and the electric field strength is derived based on Kane’s band-to-band tunneling model. This formula indicates that the magnitude of the tunneling rate fluctuations is proportional to the magnitude of the fluctuations in the electric field strength and a higher tunneling probability results in a lower variability. The derived relationship is universally valid for any technologies that exploit enhancement of the tunneling probability, including IET technology, channel material engineering, heterojunctions, strain engineering, etc.

  1. Pressure pain sensitivity topographical maps reveal bilateral hyperalgesia of the hands in patients with unilateral carpal tunnel syndrome.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Madeleine, Pascal; Martínez-Perez, Almudena; Arendt-Nielsen, Lars; Jiménez-García, Rodrigo; Pareja, Juan A

    2010-08-01

    To assess topographical pressure pain sensitivity maps of the hand in patients with unilateral carpal tunnel syndrome (CTS) as compared with healthy subjects. A total of 20 women with CTS (ages 32-52 years) and 20 healthy matched women (ages 32-51 years) were recruited. Pressure pain thresholds (PPTs) were measured bilaterally over 30 locations of the palm of each hand by an assessor blinded to the subjects' conditions. Patients showed lower PPTs in both hands in all of the measurement points as compared with controls (P < 0.001 for all). PPTs were lower in those points over the proximal phalanx of the fingers and the thenar eminency as compared with those points located over the distal phalanx of the fingers (P < 0.001). CTS patients showed lower PPT levels in dermatomes C6, C7, and C8 when compared with healthy controls (P < 0.001 for all), but without differences between dermatomes (P = 0.4). PPT was negatively correlated with both hand pain intensity and duration of symptoms (P < 0.001 for all). Our findings revealed bilateral generalized pressure pain hyperalgesia in unilateral CTS because lower PPT levels were found in all of the points. The pressure pain hyperalgesia was not uniformly distributed since PPTs were lower in points over the proximal phalanx of the fingers and the thenar eminency as compared with those points located over the distal phalanx of the fingers. The decrease in PPT levels was associated with the intensity and the duration of the pain symptoms, supporting a role of both peripheral and central sensitization mechanisms in this pain condition.

  2. Effects of Carpal Tunnel Syndrome on adaptation of multi-digit forces to object mass distribution for whole-hand manipulation

    Directory of Open Access Journals (Sweden)

    Zhang Wei

    2012-11-01

    Full Text Available Abstract Background Carpal tunnel syndrome (CTS is a compression neuropathy of the median nerve that results in sensorimotor deficits in the hand. Until recently, the effects of CTS on hand function have been studied using mostly two-digit grip tasks. The purpose of this study was to investigate the coordination of multi-digit forces as a function of object center of mass (CM during whole-hand grasping. Methods Fourteen CTS patients and age- and gender-matched controls were instructed to grasp, lift, hold, and release a grip device with five digits for seven consecutive lifts while maintaining its vertical orientation. The object CM was changed by adding a mass at different locations at the base of the object. We measured forces and torques exerted by each digit and object kinematics and analyzed modulation of these variables to object CM at object lift onset and during object hold. Our task requires a modulation of digit forces at and after object lift onset to generate a compensatory moment to counteract the external moment caused by the added mass and to minimize object tilt. Results We found that CTS patients learned to generate a compensatory moment and minimized object roll to the same extent as controls. However, controls fully exploited the available degrees of freedom (DoF in coordinating their multi-digit forces to generate a compensatory moment, i.e., digit normal forces, tangential forces, and the net center of pressure on the finger side of the device at object lift onset and during object hold. In contrast, patients modulated only one of these DoFs (the net center of pressure to object CM by modulating individual normal forces at object lift onset. During object hold, however, CTS patients were able to modulate digit tangential force distribution to object CM. Conclusions Our findings suggest that, although CTS did not affect patients’ ability to perform our manipulation task, it interfered with the modulation of specific grasp

  3. Early times in tunneling

    CERN Document Server

    García-Calderón, G; Garcia-Calderon, Gaston; Villavicencio, Jorge

    2000-01-01

    Exact analytical solutions of the time-dependent Schr\\"odinger equation with the initial condition of an incident cutoff wave are used to investigate the traversal time for tunneling. The probability density starts from a vanishing value along the tunneling and transmitted regions of the potential. At the barrier width it exhibits, at early times, a distribution of traversal times that typically has a peak $\\tau_p$ and a width $\\Delta \\tau$. Numerical results for other tunneling times, as the phase-delay time, fall within $\\Delta \\tau$. The B\\"uttiker traversal time is the closest to $\\tau_p$. Our results resemble calculations based on Feynman paths if its noisy behaviour is ignored.

  4. Tunneling Through Black Rings

    Institute of Scientific and Technical Information of China (English)

    ZHAO Liu

    2007-01-01

    Hawking radiation of black ring solutions to 5-dimensional Einstein-Maxwell-dilaton theory is analyzed by use of the Parikh-Wilczek tunneling method. To get the correct tunneling amplitude and emission rate, we adopt and develop the Angheben-Nadalini-Vanzo-Zerbini covariant approach to cover the effects of rotation and electronic discharge all at once, and the effect of back reaction is also taken into account. This constitutes a unified approach to the tunneling problem. Provided the first law of thermodynamics for black rings holds, the emission rate is proportional to the exponential of the change of Bekenstein-Hawking entropy. Explicit calculation for black ring temperatures agrees exactly with the results obtained via the classical surface gravity method and the quasi-local formalism.

  5. Femtosecond scanning tunneling microscope

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, A.J.; Donati, G.P.; Rodriguez, G.; Gosnell, T.R.; Trugman, S.A.; Some, D.I.

    1998-11-01

    This is the final report of a three-year, Laboratory Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). By combining scanning tunneling microscopy with ultrafast optical techniques we have developed a novel tool to probe phenomena on atomic time and length scales. We have built and characterized an ultrafast scanning tunneling microscope in terms of temporal resolution, sensitivity and dynamic range. Using a novel photoconductive low-temperature-grown GaAs tip, we have achieved a temporal resolution of 1.5 picoseconds and a spatial resolution of 10 nanometers. This scanning tunneling microscope has both cryogenic and ultra-high vacuum capabilities, enabling the study of a wide range of important scientific problems.

  6. Tunneling in Axion Monodromy

    CERN Document Server

    Brown, Jon; Shiu, Gary; Soler, Pablo

    2016-01-01

    The Coleman formula for vacuum decay and bubble nucleation has been used to estimate the tunneling rate in models of axion monodromy in recent literature. However, several of Coleman's original assumptions do not hold for such models. Here we derive a new estimate with this in mind using a similar Euclidean procedure. We find that there are significant regions of parameter space for which the tunneling rate in axion monodromy is not well approximated by the Coleman formula. However, there is also a regime relevant to large field inflation in which both estimates parametrically agree. We also briefly comment on the applications of our results to the relaxion scenario.

  7. Tunneling in axion monodromy

    Science.gov (United States)

    Brown, Jon; Cottrell, William; Shiu, Gary; Soler, Pablo

    2016-10-01

    The Coleman formula for vacuum decay and bubble nucleation has been used to estimate the tunneling rate in models of axion monodromy in recent literature. However, several of Coleman's original assumptions do not hold for such models. Here we derive a new estimate with this in mind using a similar Euclidean procedure. We find that there are significant regions of parameter space for which the tunneling rate in axion monodromy is not well approximated by the Coleman formula. However, there is also a regime relevant to large field inflation in which both estimates parametrically agree. We also briefly comment on the applications of our results to the relaxion scenario.

  8. Long distance tunneling

    CERN Document Server

    Ivlev, B I

    2005-01-01

    Quantum tunneling between two potential wells in a magnetic field can be strongly increased when the potential barrier varies in the direction perpendicular to the line connecting the two wells and remains constant along this line. A periodic structure of the wave function is formed in the direction joining the wells. The resulting motion can be coherent like motion in a conventional narrow band periodic structure. A particle penetrates the barrier over a long distance which strongly contrasts to WKB-like tunneling. The whole problem is stationary. The coherent process can be influenced by dissipation.

  9. Breaking through the tranfer tunnel

    CERN Multimedia

    Laurent Guiraud

    2001-01-01

    This image shows the tunnel boring machine breaking through the transfer tunnel into the LHC tunnel. Proton beams will be transferred from the SPS pre-accelerator to the LHC at 450 GeV through two specially constructed transfer tunnels. From left to right: LHC Project Director, Lyn Evans; CERN Director-General (at the time), Luciano Maiani, and Director for Accelerators, Kurt Hubner.

  10. Estudio anatómico de la transferencia de los nervios accesorio y toracodorsal al nervio cubital en el gato Anatomic study of spinal accesory and thoracodorsal nerves transfer to ulnar nerve in cats

    Directory of Open Access Journals (Sweden)

    J.R. Martínez-Méndez

    2008-09-01

    Full Text Available Las lesiones del plexo braquial son una de las patologías más graves y con mayor número de secuelas del miembro superior. En el momento actual las transferencias nerviosas se encuentran en primera línea del armamento terapéutico para reconstruir funciones proximales del miembro superior. En el estudio que presentamos se realizaron 20 transferencias nerviosas al nervio cubital del gato común, tomando bien el nervio accesorio del espinal (10 casos o bien el nervio toracodorsal (10 casos. Como grupo control se utilizó el lado contralateral al intervenido. Durante el año siguiente, se evaluó la reinervación mediante estudios electromiográficos, histológicos de nervio y músculo, así como histoquímicos de médula espinal. Tras el análisis de los resultados encontramos que las motoneuronas de ambos nervios donantes son capaces de conseguir reinervaciones parciales del territorio cubital.A brachial plexus injury is one of the most severe pathologies of the upper limb, and also has severe sequels. In the actual state of the art, nerve transfers are being used as first line of therapeutic approach in the reconstruction of proximal functions of the upper limb. In this study 20 nerve transfers were made to the ulnar nerve of the cat, using the spinal accessory nerve (10 cases or the thoracodorsal nerve (10 cases. The opposite side was used as control. During next year, reinnervation was assessed by electromyography, nerve and muscle histology and histochemical evaluation of the spinal cord. We found that motoneurons of both donor nerves are able to make partial reinervation of the ulnar nerve territory.

  11. The effectiveness of low-level laser therapy on pain, self-reported hand function, and grip strength compared to placebo or "sham" treatment for adults with carpal tunnel syndrome: A systematic review.

    Science.gov (United States)

    Burger, Marlette; Kriel, Réna; Damon, Andrea; Abel, Amy; Bansda, Anisha; Wakens, Marinique; Ernstzen, Dawn

    2017-03-01

    Carpal tunnel syndrome (CTS) is one of the most common peripheral neuropathies in the upper extremity. The aim of this review was to systematically and critically appraise the available literature for the effectiveness of Low-Level Laser Therapy (LLLT) on pain, self-reported hand function, and grip strength compared to placebo treatment in adults with CTS. Seven databases were searched from 2000 to March 2015 namely: Cinahl, Cochrane Library, EBSCOhost, PEDro, PubMed, Science Direct, and Scopus. Key search terms were: CTS, LLLT, and physiotherapy. Specific inclusion and exclusion criteria were applied. The methodological quality was appraised with the PEDro scale. Data were extracted and captured on an Excel spreadsheet. The nine included randomized control trials (RCTs) had an average score of 8.2/11 according to the PEDro scale. The heterogeneity of the LLLT regimes used made statistical pooling inappropriate for this review and results were described narratively. No strong evidence exists concerning the effects of LLLT on CTS in adults. Studies that used 780-860 nm Lasers and energy dosages of 9-11 J/cm(2) or 10.8 J reported a more favorable outcome for pain, symptom severity, and functional ability as well as grip strength at the end of treatment and short-term follow up.

  12. [Using CTS and PK-PD models to predict the effect of uncertainty about population parameters on clinical trial power].

    Science.gov (United States)

    Zhu, Ling; Shi, Xinling; Liu, Yajie

    2009-02-01

    The traditional clinical trail designs always depend on expert opinions and lack statistical evaluations. In this article, we present a method and illustrate how population parameter uncertainty may be incorporated in the overall simulation model. Using the techniques of clinical trail simulation (CTS) and setting up predictions on the basis of pharmacokinetics-pharmacodynamics (PK-PD) models, we advance the modeling methods for simulation, for treatment effects, and for the clinical trail power under the given PK-PD conditions. Then we discuss the model of uncertainty, suggest an ANOVA-based method, add eta2 statistics for sensitivity analysis, and canvass the effect of uncertainty about population parameters on clinical trail power. The results from simulations and the indices derived from this type of sensitivity analysis may be used for grading the influence on the prediction quality of uncertainty about different population parameters. The experiment results are satisfactory and the approach presented has practical value in clinical trails.

  13. The effect of local corticosteroid injection on F-wave conduction velocity and sympathetic skin response in carpal tunnel syndrome.

    Science.gov (United States)

    Deniz, Orhan; Aygül, Recep; Kotan, Dilcan; Ozdemir, Gökhan; Odabaş, Faruk Omer; Kaya, M Dursun; Ulvi, Hızır

    2012-05-01

    The aim of this study was to evaluate the efficacy of steroid injection for the treatment of the carpal tunnel syndrome (CTS), with F-wave parameters and sympathetic skin response (SSR). Seventeen hands of 10 women patients were treated with local steroid injection with 2-month follow-up. All patients underwent single injection into the carpal tunnel. Response to injection was measured nerve conduction studies (NCSs), median nerve F waves, and SSR before and after treatment. To determine the normal values, 42 hands of 21 healthy women were also studied. There was a significant improvement of sensory and motor nerve conduction values when compared to baseline values (P sensory distal latency and the sensory latency differences between the median and the ulnar nerve were improved 35 and 65%, respectively. The maximum, mean F-wave amplitudes and chronodispersion showed a slight improvement with respect to baseline values and controls, but statistical significance was not achieved after treatment. Although no statistically significant improvements were observed in SSR parameters, slightly decreased amplitudes and increased habituation of SSR were noted at the end of the treatment. The present study shows that the local steroid injection results in improvement in NCSs values, but the F-wave parameters were not effectual in short-term outcome of CTS treatment. These findings suggest that the sensory latency differences between the median and the ulnar wrist-to-digit 4 are better parameters in the median nerve recovery after treatment than the median sensory distal latency. Furthermore, the SSR does not seem to be a sensitive method in follow-up of CTS treatment.

  14. Amelioration by mecobalamin of subclinical carpal tunnel syndrome involving unaffected limbs in stroke patients.

    Science.gov (United States)

    Sato, Yoshihiro; Honda, Yoshiaki; Iwamoto, Jun; Kanoko, Tomohiro; Satoh, Kei

    2005-04-15

    Our previous study showed that overuse of the nonparetic hand and wrist of the nonparetic side following stroke result in significantly more abnormal on the nonparetic side than on the hemiparetic side in terms of electrophysiologic indices of median nerve function. The purpose of this study was to evaluate the effects of the orally administered mecobalamin, an analogue of vitamin B12, for carpal tunnel syndrome (CTS) in the nonparetic side in patients following stroke. In a randomized open label and prospective study of stroke patients, 67 received of 1500 mug mecobalamin daily for 2 years, and the remaining 68 (untreated group) did not. At baseline, sensory nerve conduction velocity, motor nerve conduction velocity, sensory nerve action potentials (SNAP) at the wrist, palm-to-wrist distal sensory latency, palm-to-wrist SNAP, motor nerve conduction velocity compound motor action potentials, and distal motor latency of median nerve were significantly more abnormal on the nonparetic side than on the hemiparetic side or in controls. Before the treatment 21 patients (31%) of untreated and 20 patients (30%) of treated group met electrophysiologic criteria for CTS. Sensory impairment of the nonparetic side had lessened in the treated group. After 2 years, all electrophysiologic indices of nonparetic side were significantly improved in the treated group compared with those in the untreated group. The improvement from baseline of electrophysiologic parameters in sensory nerve in the treated group was greater than the improvement measured in motor nerve. There were no side effects. Oral mecobalamin treatment is a safe and potentially beneficial therapy for CTS in stroke patients.

  15. The construct validity and responsiveness of sensory tests in patients with carpal tunnel syndrome.

    Science.gov (United States)

    Cheung, Derek K M; MacDermid, JoyC; Walton, Dave; Grewal, Ruby

    2014-01-01

    Sensory evaluation is fundamental to evaluation of patients with Carpal Tunnel Syndrome (CTS). The purpose of this study was to determine the construct validity and responsiveness for sensory threshold tests in patients with CTS. Sixty-three patients diagnosed with CTS were evaluated prior to orthotic intervention and again at follow up at 6 and 12 weeks. Sensory tests included touch threshold PSSD (Pressure Specified Sensory Device) and vibration threshold (Vibrometer). Construct validity was assessed by comparing sensory tests to hand function, and dexterity testing using Spearman rho (rs). Patients were classified as either responders or non-responders to orthotic intervention based on the change score of the Symptom Severity Scale (SSS) of 0.5. Responsiveness of the sensory tools was measured using ROC (receiver operating characteristic) curves, SRM (Standardized Response Mean), and ES (Effect Sizes). The PSSD had low to moderate correlations (rs ≤ 0.32) while Vibrometer scores had moderate correlations (rs = 0.36 - 0.41) with dexterity scores. The Clinically Important Difference (CID) for the PSSD was estimated at 0.15 g/mm(2) but was not discriminative. The Vibrometer demonstrated moderate responsiveness, with a SRM = 0.61 and an ES = 0.46 among responders. The PSSD had a SRM = 0.09 and an ES = 0.08 and showed low responsiveness for patients with a clinically important improvement in symptoms. Measurement properties suggest that the Vibrometer was preferable to the PSSD because it was more correlated to hand function, and was more responsive. Clinicians may choose use the Vibrometer opposed to the PSSD for determining important change in sensation after orthotic intervention.

  16. Electrodiagnostic evaluation of patients with carpal tunnel syndrome regarding the presence of subjective and physical findings.

    Science.gov (United States)

    Radovic, Diana; Lazovic, Milica; Nikolic, Dejan; Radosavljevic, Natasa; Hrkovic, Marija

    2014-03-01

    The aim of our study was to evaluate the changes of median nerve conduction velocities by electrodiagnostic procedure in carpal tunnel syndrome (CTS) patients with and without present subjective and physical findings. We have evaluated 116 patients that were diagnosis with CTS. Subjective findings: weakness, numbness and night pain were analyzed. Further physical findings were evaluated: Tinels sign, muscles hypotrophy and weakness according to muscle manual test (MMT). Duration of complaints was evaluated as well. Electroneurographic findings included: estimation of median nerve motor terminal latency (mMTL), sensory velocity (mSV) and motor velocity (mMV). Significantly longer complaints were present in patients who experienced night pain (p=0.015) and those with muscles weakness on MMT (p=0.016). Statistically significant increase for mMTL values was noticed for patients with Tinels sign (p=0.045), present muscles hypotrophy (p=0.001) and weakness on MMT (p=0.001). There is significant decrease for mMV in group with present Tinels sign (p=0.048), muscle hypotrophy (p=0.003) and weakness on MMT (p=0.002), and for mSV in group with present muscle hypotrophy (p=0.008) and group with weakness on MMT (p=0.019). Multivariate logistic regressional analysis shown that only for hypotrophy, mMTL variable presents significant independent contributor (p=0.009). For the diagnosis confirmation and treatment planning along with elecroneurography it is necessary to evaluate patients with CTS clinically, since different clinical manifestations are correlating in different degree with electroneurographic findings.

  17. Reliability of the Infraspinatus Test in Carpal Tunnel Syndrome: A Clinical Study.

    Science.gov (United States)

    Meder, Marek A; Amtage, Florian; Lange, Ruediger; Rijntjes, Michel

    2017-05-01

    Recently, a standardized provocation tests for the infraspinatus muscle, the Infraspinatus test (IsT), aimed at clinically confirming Carpal Tunnel Syndrome (CTS), was validated in a multiple-blind, controlled study. The present study was conducted to investigate inter-rater reliability of the IsT under conditions as they occur in daily clinical practice, since this is essential for acceptance of any new test. Two raters from different medical disciplines used the IsT in the same group of subjects at different localities and with an interval of two to four weeks. Arms with symptoms of CTS were examined and compared with a control group of arms without symptoms. Nerve conduction studies were performed in all the subjects. Statistical analysis was performed with Cohen's Kappa (for inter-rater reliability) and McNemar's test (for determining dependencies between arms and raters). A total of 34 subjects (age 35-86 years) were investigated with the IsT by two raters in a blinded fashion. There was a high agreement between raters with a Kappa statistic of κ=0.868, when performing this new provocation test. The McNemar test did not reveal dependencies between Rater A and Rater B (p=0.6171), nor between the left and right arms of subjects (Rater A: p=0.4533, Rater B: p=0.5023). The new provocation test of the infraspinatus muscle is not only capable of confirming CTS, as was shown before, but is also a reliable method for use by different examiners under customary conditions.

  18. Tunnelling with wormhole creation

    Energy Technology Data Exchange (ETDEWEB)

    Ansoldi, S. [National Institute of Nuclear Physics (INFN) (Italy); Tanaka, T., E-mail: tanaka@yukawa.kyoto-u.ac.jp [Kyoto University, Department of Physics (Japan)

    2015-03-15

    The description of quantum tunnelling in the presence of gravity shows subtleties in some cases. We discuss wormhole production in the context of the spherically symmetric thin-shell approximation. By presenting a fully consistent treatment based on canonical quantization, we solve a controversy present in the literature.

  19. INCAS SUBSONIC WIND TUNNEL

    Directory of Open Access Journals (Sweden)

    Corneliu STOICA

    2009-09-01

    Full Text Available The INCAS Subsonic Wind Tunnel is a closed circuit, continuous, atmospheric pressure facility with a maximum speed of 110 m/s. The test section is octagonal ,of 2.5 m wide, 2.0 m high and 4 m long. The tunnel is powered by a 1200 kW, air cooled variable speed DC motor which drives a 12 blade, 3.5 m diameter fan and is equipped with a six component pyramidal type external mechanical balance with a 700 Kgf maximum lift capacity.The angle of attack range is between -45º and +45º while the yaw angle range is between -140º and +216º .The data acquisition system has been modified recently to allow the recording of all test data on a PC - type computer using LABVIEW and a PXI – type chassis containing specialized data acquisition modules.The tunnel is equipped with a variable frequency electrical supply system for powered models and a 10 bar compressed air supply for pneumatic flow control applications.In the recent years the subsonic wind tunnel has been intensively used for tests within several European projects (AVERT, CESAR and others.

  20. Early Identification of Transformation in the Proficiency Level of Critical Thinking Skills (CTS) for the First Semester Associate Degree Nursing (ADN) Student

    Science.gov (United States)

    Swing, Velmarie K.

    2014-01-01

    Critical thinking (CT) in the new nursing graduate continues to be a topic of concern in the academic and acute care settings. While research studies have analyzed critical thinking skills (CTS) at the beginning and end of nursing programs, few have focused on early program evaluation of CT. In this non-experimental, explanatory, quantitative…

  1. Early Identification of Transformation in the Proficiency Level of Critical Thinking Skills (CTS) for the First Semester Associate Degree Nursing (ADN) Student

    Science.gov (United States)

    Swing, Velmarie K.

    2014-01-01

    Critical thinking (CT) in the new nursing graduate continues to be a topic of concern in the academic and acute care settings. While research studies have analyzed critical thinking skills (CTS) at the beginning and end of nursing programs, few have focused on early program evaluation of CT. In this non-experimental, explanatory, quantitative…

  2. Measurements of the fast-ion distribution function at ASDEX upgrade by collective Thomson scattering (CTS) using active and passive views

    DEFF Research Database (Denmark)

    Nielsen, Stefan Kragh; Stejner Pedersen, Morten; Rasmussen, Jesper;

    2015-01-01

    , the measured spectra agree quantitatively with the synthetic spectra in periods with and without NBI heating. For the discharges investigated, the central velocity distribution of neutral beam ions can be described by classical slowing down. These results will have a major impact on ITER physics exploration......, since CTS is presently the only diagnostic to measure the confined alpha particles produced by the fusion reactions....

  3. Factor Structure and Reliability of the Revised Conflict Tactics Scales' (CTS2) 10-Factor Model in a Community-Based Female Sample

    Science.gov (United States)

    Yun, Sung Hyun

    2011-01-01

    The present study investigated the factor structure and reliability of the revised Conflict Tactics Scales' (CTS2) 10-factor model in a community-based female sample (N = 261). The underlying factor structure of the 10-factor model was tested by the confirmatory multiple group factor analysis, which demonstrated complex factor cross-loadings…

  4. Classical trajectories and quantum tunneling

    CERN Document Server

    Ivlev, B I

    2003-01-01

    The problem of inter-band tunneling in a semiconductor (Zener breakdown) in a nonstationary and homogeneous electric field is solved exactly. Using the exact analytical solution, the approximation based on classical trajectories is studied. A new mechanism of enhanced tunneling through static non-one-dimensional barriers is proposed in addition to well known normal tunneling solely described by a trajectory in imaginary time. Under certain conditions on the barrier shape and the particle energy, the probability of enhanced tunneling is not exponentially small even for non-transparent barriers, in contrast to the case of normal tunneling.

  5. A novel Fuzzy Expert System for the identification of severity of carpal tunnel syndrome.

    Science.gov (United States)

    Kunhimangalam, Reeda; Ovallath, Sujith; Joseph, Paul K

    2013-01-01

    The diagnosis of carpal tunnel syndrome, a peripheral nerve disorder, at the earliest possible stage is very crucial because if left untreated it may cause permanent nerve damage reducing the chances of successful treatment. Here a novel Fuzzy Expert System designed using MATLAB is proposed for identification of severity of CTS. The data used were the nerve conduction study data obtained from Kannur Medical College, India. It consists of thirteen input fields, which include the clinical values of the diagnostic test and the clinical symptoms, and the output field gives the disease severity. The results obtained match with the expert's opinion with 98.4% accuracy and high degrees of sensitivity and specificity. Since quantification of the intensity of CTS is a crucial step in the electrodiagnostic procedure and is important for defining prognosis and therapeutic measures, such an expert system can be of immense use in those regions where the service of such specialists may not be readily available. It may also prove useful in combination with other systems in providing diagnostic and predictive medical opinions and can add value if introduced into the routine clinical consultations to arrive at the most accurate medical diagnosis in a timely manner.

  6. Anatomical study of the treatment of cubital tunnel syndrome by endoscope%内窥镜下微创治疗肘管综合征的相关解剖学研究

    Institute of Scientific and Technical Information of China (English)

    郭泉; 庄永青; 魏瑞鸿; 熊洪涛; 姜浩力; 张轩

    2016-01-01

    目的:为内窥镜下进行肘管尺神经减压并前移术提供临床应用解剖基础。方法10例新鲜尸体标本、20例临床病例传统手术中尺神经在臂部、前臂游离长度,尺神经第1肌支距离肱骨内上髁的距离、尺神经前移距离。在4例新鲜尸体标本上模拟手术。结果此术式尺神经前臂、臂部游离距离为(3.90±0.145)cm(3.64~4.23 cm)、(4.21±0.18)cm(3.80~4.53 cm),前移距离(1.49±0.05)cm(1.39~1.57 cm),尺神经第1肌支距离肱骨内上髁距离(2.18±0.38)cm(1.13~2.72cm)。此术式入路点、轴线、层面:肱骨内上髁与尺骨鹰嘴间长约2 cm纵行切口;肱骨内上髁与尺骨鹰嘴之间中点与豌豆骨连线上约7cm长的轴线,肱骨内上髁与尺骨鹰嘴之间中点与肱二头肌内侧肌间隔中点连线上长8cm的轴线;奥本斯韧带、前臂尺侧腕屈肌之间纤维弓形组织表面,臂部深筋膜表面。模拟手术成功。结论研究证实此术式可行,达预期效果。%Objective To provide clinical anatomy for the way of endoscopic anterior ulnar nerve subcutaneous transposition. Methods the length of ulnar nerve free in the forearm and the upper arm,the distance from the first motor branch to the flexor carpi ulnaris muscle tothe medial epicondyle were measured in ten fresh limbs from fresh cadavers and twenty patients. Simulative surgery were performed on four limbs from cadavers. Results In this surgery ,the length of ulnar nerve free in the forearm was(3.90 ± 0.145)cm (3.64~4.23 cm),free in the upper arm was(4.21±0.18)cm(3.80~4.53 cm),the first motor branch to the flexor carpi ulnaris muscle was(2.18 ± 0.38)cm(1.13~2.72 cm)away from the medial humoral epicondyle. In this surgery, the surgical incision was 2 cm longitudinal incision between the medial epicondyle and the olecranon, the forearm axis of the endoscopic operation was about 7 cm line on the line connecting the midpoint between the medial epicondyle and the olecranon to the pisiform,the upper arm axis was about an 8cm line on the line connecting the midpoint on the medial epicondyle and the olecranon to the midpoint on the medial septum of biceps;the suitable and the olecranon regional the endoscopic operation tissue level was the surface of arcuate ligament of Osborne , flexor carpi ulnaris muscle in the forearm and deep fascia in the upper arm. Simulative surgery was successful. Conclusion This study confirmed this surgical approach was feasible, and could achieve the desired results.

  7. 肘管综合征的临床病因学探讨及神经电生理检查%Pathogenesis and electrodiagnosis of cubital tunnel syndrome

    Institute of Scientific and Technical Information of China (English)

    贾志荣; 石昕; 孙相如

    2003-01-01

    目的探讨肘管综合征的发病原因,评价尺神经传导速度(NCV)检查在术前诊断肘管综合征的临床价值.方法对临床上伴有尺神经分布区受损症状及体征的患者,进行尺神经感觉神经传导速度(SCV)及运动神经传导速度(MCV)分段测定,并对这些患者进行尺神经前移术治疗.结果共有21例(22肢)行尺神经传导速度分段测定并手术治疗.尺神经SCV测定,14例(14肢)异常,其中12例未引出电位; MCV肘上至肘下段测定,20例(21肢)减慢.手术证实尺神经受压原因为:韧带、肌腱及骨质增生压迫尺神经15肢, 粘连2肢, 扩张静脉及静脉丛压迫3肢, 囊性肿物压迫2肢.结论本组肘管综合征发病原因,除文献报道的常见病因外,还有其他少见原因,包括充盈的静脉丛,粗大静脉,囊肿压迫尺神经等.尺神经肘段运动神经传导速度减慢对肘管综合征有一定诊断价值.

  8. Educational Wind Tunnel

    Directory of Open Access Journals (Sweden)

    Juozas Bielskus

    2012-12-01

    Full Text Available The paper analyzes an educational wind tunnel produced by the Department of Building Energetics (DBE of Vilnius Gediminas Technical University. The equipment could be used for performing laboratory works and simple research. The article presents the projection of inflow and outlet velocity in the working chamber of DBE wind tunnel and carries out actual noise level measurement. The received data are compared with information on the level of noise generated by the fan considering instructions provided by the manufacturer. In order to assess the reliability of the computer program, simulation applying PHOENICS software has been conducted. The aim of modeling is to simulate a pilot model and to compare the obtained results with those of an analogous test presented in scientific articles.Article in Lithuanian

  9. "Phantom" carpal tunnel syndrome.

    Science.gov (United States)

    Braverman, D L; Root, B C

    1997-10-01

    Phantom sensation is ubiquitous among persons who have had amputation; however, if it develops into phantom pain, a thorough clinical investigation must ensue. We illustrate this with the case of a 49-year-old woman, 14 years after traumatic amputation of her left 2nd through 5th fingers, and 10 years after traumatic left transfemoral amputation. She had had phantom sensation in her absent fingers for years and developed progressive pain in her phantom fingers 3 months before presentation. Nerve conduction study revealed a high-normal distal motor latency of the left median nerve and a positive Bactrian test (sensitivity 87%). She was diagnosed with "phantom" carpal tunnel syndrome and treated with a resting wrist splint, decreased weight bearing on the left upper limb, and two corticosteroid carpal tunnel injections with marked improvement. Clinicians should recognize that phantom pain may be referred from a more proximal region and may be amenable to conservative management.

  10. Carpal tunnel syndrome treatment

    Directory of Open Access Journals (Sweden)

    Emilio Filippucci

    2011-09-01

    Full Text Available Carpal tunnel syndrome, the most common peripheral neuropathy, results from compression of the median nerve at the wrist, and is a cause of pain, numbness and tingling in the upper extremities and an increasingly recognized cause of work disability. If carpal tunnel syndrome seems likely, conservative management with splinting should be initiated. Moreover, it has suggested that patients reduce activities at home and work that exacerbate symptoms. Pyridoxine and diuretics, since are largely utilised, are no more effective than placebo in relieving the symptoms. Non steroidal anti-inflammatory drugs and orally administered corticosteroids can be effective for short-term management (two to four weeks, but local corticosteroid injection may improve symptoms for a longer period. Injection is especially effective if there is no loss of sensibility or thenar-muscle atrophy and weakness, and if symptoms are intermittent rather than constant. If symptoms are refractory to conservative measures, the option of surgical therapy may be considered.

  11. [Carpal tunnel syndrome treatment].

    Science.gov (United States)

    De Angelis, Rossella; Salaffi, Fausto; Filippucci, Emilio; Grassi, Walter

    2006-01-01

    Carpal tunnel syndrome, the most common peripheral neuropathy, results from compression of the median nerve at the wrist, and is a cause of pain, numbness and tingling in the upper extremities and an increasingly recognized cause of work disability. If carpal tunnel syndrome seems likely, conservative management with splinting should be initiated. Moreover, it has suggested that patients reduce activities at home and work that exacerbate symptoms. Pyridoxine and diuretics, since are largely utilised, are no more effective than placebo in relieving the symptoms. Non steroidal anti-inflammatory drugs and orally administered corticosteroids can be effective for short-term management (two to four weeks), but local corticosteroid injection may improve symptoms for a longer period. Injection is especially effective if there is no loss of sensibility or thenar-muscle atrophy and weakness, and if symptoms are intermittent rather than constant. If symptoms are refractory to conservative measures, the option of surgical therapy may be considered.

  12. Programmable ferroelectric tunnel memristor

    Directory of Open Access Journals (Sweden)

    Andy eQuindeau

    2014-02-01

    Full Text Available We report an analogously programmable memristor based on genuine electronic resistive switching combining ferroelectric switching and electron tunneling. The tunnel current through an 8 unit cell thick epitaxial Pb(Zr[0.2]Ti[0.8]O[3] film sandwiched between La[0.7]Sr[0.3]MnO[3] and cobalt electrodes obeys the Kolmogorov-Avrami-Ishibashi model for bidimensional growth with a characteristic switching time in the order of 10^-7 seconds. The analytical description of switching kinetics allows us to develop a characteristic transfer function that has only one parameter viz. the characteristic switching time and fully predicts the resistive states of this type of memristor.

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

    Energy Technology Data Exchange (ETDEWEB)

    Hiltunen, Jaana [Aalto University School of Science, Brain Research Unit, Low Temperature Laboratory, Aalto (Finland); Aalto University School of Science, Advanced Magnetic Imaging Centre, Aalto (Finland); Kirveskari, Erika [Aalto University School of Science, Brain Research Unit, Low Temperature Laboratory, Aalto (Finland); Helsinki University Central Hospital, Department of Clinical Neurophysiology, Helsinki (Finland); Numminen, Jussi [Aalto University School of Science, Brain Research Unit, Low Temperature Laboratory, Aalto (Finland); University of Helsinki, Helsinki Medical Imaging Center, Helsinki (Finland); Lindfors, Nina; Goeransson, Harry [Helsinki University Central Hospital, Department of Hand Surgery, Helsinki (Finland); Hari, Riitta [Aalto University School of Science, Brain Research Unit, Low Temperature Laboratory, Aalto (Finland); Aalto University School of Science, Advanced Magnetic Imaging Centre, Aalto (Finland); Helsinki University Central Hospital, Department of Clinical Neurophysiology, Helsinki (Finland)

    2012-06-15

    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.)

  14. The beam dump tunnels

    CERN Multimedia

    Patrice Loïez

    2002-01-01

    In these images workers are digging the tunnels that will be used to dump the counter-circulating beams. Travelling just a fraction under the speed of light, the beams at the LHC will each carry the energy of an aircraft carrier travelling at 12 knots. In order to dispose of these beams safely, a beam dump is used to extract the beam and diffuse it before it collides with a radiation shielded graphite target.

  15. Carpal tunnel release

    DEFF Research Database (Denmark)

    Larsen, Morten Bo; Sørensen, A I; Crone, K L;

    2013-01-01

    A single-blind, randomized, controlled trial was done to compare the results of carpal tunnel release using classic incision, short incision, or endoscopic technique. In total, 90 consecutive cases were included. Follow-up was 24 weeks. We found a significantly shorter sick leave in the endoscopi...... incision could be found. There were no serious complications in either group. The results indicate that the endoscopic procedure is safe and has the benefit of faster rehabilitation and return to work....

  16. Acute Effect of Topical Menthol on Chronic Pain in Slaughterhouse Workers with Carpal Tunnel Syndrome: Triple-Blind, Randomized Placebo-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Emil Sundstrup

    2014-01-01

    Full Text Available Topical menthol gels are classified “topical analgesics” and are claimed to relieve minor aches and pains of the musculoskeletal system. In this study we investigate the acute effect of topical menthol on carpal tunnel syndrome (CTS. We screened 645 slaughterhouse workers and recruited 10 participants with CTS and chronic pain of the arm/hand who were randomly distributed into two groups to receive topical menthol (Biofreeze or placebo (gel with a menthol scent during the working day and 48 hours later the other treatment (crossover design. Participants rated arm/hand pain intensity during the last hour of work (scale 0–10 immediately before 1, 2, and 3 hours after application. Furthermore, global rating of change (GROC in arm/hand pain was assessed 3 hours after application. Compared with placebo, pain intensity and GROC improved more following application of topical menthol (P=0.026 and P=0.044, resp.. Pain intensity of the arm/hand decreased by −1.2 (CI 95%: −1.7 to −0.6 following topical menthol compared with placebo, corresponding to a moderate effect size of 0.63. In conclusion, topical menthol acutely reduces pain intensity during the working day in slaughterhouse workers with CTS and should be considered as an effective nonsystemic alternative to regular analgesics in the workplace management of chronic and neuropathic pain.

  17. Efficacy, safety, and cost of surgical versus nonsurgical treatment for carpal tunnel syndrome

    Science.gov (United States)

    Ren, Yi-Ming; Wang, Xi-Shan; Wei, Zhi-Jian; Fan, Bao-You; Lin, Wei; Zhou, Xian-Hu; Feng, Shi-Qing

    2016-01-01

    Abstract Background: Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disease. Either surgical or conservative intervention for CTS patients is needed to choose. We conducted this systematic review and meta-analysis to compare the clinical efficacy, safety, and cost of surgical versus nonsurgical intervention. Methods: The eligible studies were acquired from PubMed, Medline, Embase, Web of Science, Google, and Cochrane Library. The data were extracted by 2 of the coauthors independently and were analyzed by RevMan5.3. Standardized mean differences (SMDs), odds ratios (ORs), and 95% confidence intervals (CIs) were calculated. Cochrane Collaboration Risk of Bias Tool and Newcastle–Ottawa Scale were used to assess risk of bias. Results: Thirteen studies including 9 randomized controlled trials (RCTs) and 4 observational studies were assessed. The methodological quality of the trials ranged from moderate to high. The difference of clinical efficacy was statistically significant between surgical and nonsurgical intervention, and nonsurgical treatment was more effective (OR = 2.35, 95%CI = 1.18–4.67, P = 0.01). Meanwhile, different results were discovered by subgroup analysis. The pooled results of function improvement, symptom improvement, neurophysiological parameters improvement, and cost of care at different follow-up times showed that the differences were not statistically significant between the 2 interventions. The difference of complications and side-effects was statistically significant and conservative treatment achieved better result than surgery (OR = 2.03, 95%CI = 1.28–3.22, P = 0.003). Sensitivity analysis proved the stability of the pooled results. Conclusion: Both surgical and conservative interventions had benefits in CTS. Nonsurgical treatment was more effective and safety than surgical treatment, but there were no significant differences in function improvement, symptom improvement, neurophysiological

  18. SALT long-slit spectroscopy of CTS C30.10: two-component Mg II line

    Science.gov (United States)

    Modzelewska, J.; Czerny, B.; Hryniewicz, K.; Bilicki, M.; Krupa, M.; Świȩtoń, A.; Pych, W.; Udalski, A.; Adhikari, T. P.; Petrogalli, F.

    2014-10-01

    Context. Quasars can be used as a complementary tool to SN Ia to probe the distribution of dark energy in the Universe by measuring the time delay of the emission line with respect to the continuum. The understanding of the Mg II emission line structure is important for cosmological application and for the black hole mass measurements of intermediate redshift quasars. Aims: Knowing the shape of Mg II line and its variability allows for identifying which part of the line should be used to measure the time delay and the black hole mass. We thus aim at determining the structure and the variability of the Mg II line, as well as the underlying Fe II pseudo-continuum. Methods: We performed five spectroscopic observations of a quasar CTS C30.10 (z = 0.9000) with the SALT telescope between December 2012 and March 2014, and we studied the variations in the spectral shape in the 2700 Å-2900 Å rest frame. Results: We show that the Mg II line in this source consists of two kinematic components, which makes the source representative of type B quasars. Both components were modeled well with a Lorentzian shape, and they vary in a similar way. The Fe II contribution seems to be related only to the first (blue) Mg II component. Broad band spectral fitting instead favor the use of the whole line profile. The contribution of the narrow line region to Mg II is very low, below 2%. The Mg II variability is lower than the variability of the continuum, which is consistent with the simple reprocessing scenario. The variability level of CTS C30.10 and the measurement accuracy of the line and continuum is high enough to expect that further monitoring will allow the time delay between the Mg II line and continuum to be measured. Based on observations made with the Southern African Large Telescope (SALT) under program 2012-2-POL-003 and 2013-1-POL-RSA-002 (PI: B. Czerny).Spectra shown in Figs. 3 and 4 are only available in electronic form at the CDS via anonymous ftp to http

  19. Power grip, pinch grip, manual muscle testing or thenar atrophy – which should be assessed as a motor outcome after carpal tunnel decompression? A systematic review

    Directory of Open Access Journals (Sweden)

    Kale Swati

    2007-11-01

    Full Text Available Abstract Background Objective assessment of motor function is frequently used to evaluate outcome after surgical treatment of carpal tunnel syndrome (CTS. However a range of outcome measures are used and there appears to be no consensus on which measure of motor function effectively captures change. The purpose of this systematic review was to identify the methods used to assess motor function in randomized controlled trials of surgical interventions for CTS. A secondary aim was to evaluate which instruments reflect clinical change and are psychometrically robust. Methods The bibliographic databases Medline, AMED and CINAHL were searched for randomized controlled trials of surgical interventions for CTS. Data on instruments used, methods of assessment and results of tests of motor function was extracted by two independent reviewers. Results Twenty-two studies were retrieved which included performance based assessments of motor function. Nineteen studies assessed power grip dynamometry, fourteen studies used both power and pinch grip dynamometry, eight used manual muscle testing and five assessed the presence or absence of thenar atrophy. Several studies used multiple tests of motor function. Two studies included both power and pinch strength and reported descriptive statistics enabling calculation of effect sizes to compare the relative responsiveness of grip and pinch strength within study samples. The study findings suggest that tip pinch is more responsive than lateral pinch or power grip up to 12 weeks following surgery for CTS. Conclusion Although used most frequently and known to be reliable, power and key pinch dynamometry are not the most valid or responsive tools for assessing motor outcome up to 12 weeks following surgery for CTS. Tip pinch dynamometry more specifically targets the thenar musculature and appears to be more responsive. Manual muscle testing, which in theory is most specific to the thenar musculature, may be more

  20. Inelastic tunneling in superconducting junctions

    Energy Technology Data Exchange (ETDEWEB)

    Hlobil, Patrik Christian

    2016-06-10

    In this dissertation a theoretical formalism of elastic and inelastic tunneling spectroscopy is developed for superconductors. The underlying physical processes behind the different two tunneling channels and their implications for the interpretation of experimental tunneling data are investigated in detail, which can explain the background conductance seen in the cuprate and iron-based superconductors. Further, the properties of the emitted light from a superconducting LED are investigated.

  1. The CtsR regulator controls the expression of clpC, clpE and clpP and is required for the virulence of Enterococcus faecalis in an invertebrate model.

    Science.gov (United States)

    Cassenego, Ana Paula Vaz; de Oliveira, Naira Elane Moreira; Laport, Marinella Silva; Abranches, Jaqueline; Lemos, José A; Giambiagi-deMarval, Marcia

    2016-09-01

    The intrinsic ruggedness of Enterococcus faecalis is responsible for its widespread distribution in nature and is often viewed as an important virulence determinant. Previously, we showed that the ClpB ATPase is negatively regulated by CtsR and is required for thermotolerance and virulence in a Galleria mellonella invertebrate model. Here, we used in silico, Northern blot and quantitative real-time PCR analyses to identify additional members of the CtsR regulon, namely the clpP peptidase and the clpC and clpE ATPases. When compared to the parent strain, virulence of the ΔctsR strain in G. mellonella was significantly attenuated.

  2. SALT long-slit spectroscopy of CTS C30.10: two-component Mg II line

    CERN Document Server

    Modzelewska, J; Hryniewicz, K; Bilicki, M; Krupa, M; Swieton, A; Pych, W; Udalski, A; Adhikari, T P; Petrogalli, F

    2014-01-01

    Quasars can be used as a complementary tool to SN Ia to probe the distribution of dark energy in the Universe by measuring the time delay of the emission line with respect to the continuum. The understanding of the Mg II emission line structure is important for cosmological application and for the black hole mass measurements of intermediate redshift quasars. The knowledge of the shape of Mg II line and its variability allows to determine which part of the line should be used to measure the time delay and the black hole mass. We thus aim at determination of the structure and the variability of the Mg II line as well as of the underlying Fe II pseudo-continuum. We performed five spectroscopic observations of a quasar CTS C30.10 (z = 0.9000) with the SALT telescope between December 2012 and March 2014, and we studied the variations of the spectral shape in the 2700 - 2900 A rest frame. We showed that the Mg II line in this source consists of two kinematic components, which makes the source representative of typ...

  3. A contribution to computer analysis of coupled-cavity traveling wave tubes. [design study for CTS satellite

    Science.gov (United States)

    Connolly, D. J.; Omalley, T. A.

    1977-01-01

    A flexible accurate large-signal computer program has been developed for the design of coupled-cavity traveling wave tubes. The program is written for a TSS-360 time sharing system. The beam is described by a disk model and the slow wave structure by a sequence of cavities or cells. The computational approach is arranged so that each cavity may have different geometrical or electrical parameters than its neighbors. This allows the program user to simulate a tube of almost arbitrary complexity. Input and output couplers, severs, complicated velocity tapers, and other features peculiar to one or a few cavities may be modeled by a correct choice of input data. The beam-wave interaction is handled by a new approach in which the RF fields are expanded in solutions to the TM wave equation retaining all significant space harmonics. The program was used to perform a design study of the TWT developed for the CTS satellite. Good agreement was obtained between the predictions of the program and the measured performance of the flight tube. The internal check on power balance was satisfied within plus or minus 0.2 per cent of input beam power.

  4. [Psychometric properties of the Conflict Tactics Scales (CTS-2) in a Spanish sample of partner-violent men].

    Science.gov (United States)

    Loinaz, Ismael; Echeburúa, Enrique; Ortiz-Tallo, Margarita; Amor, Pedro J

    2012-02-01

    Intimate partner violence is a complex problem that requires the update of the available assessment tools. The aim of the study is to test the revised Conflict Tactics Scales (CTS-2) in partner-violent men. Its structure and other psychometric properties are analyzed in 173 convicted offenders from Brians-2 and Alhaurín de la Torre penitentiaries. Discriminant validity is also assessed by comparing offenders with 108 males from the general population. The internal consistency for the 39 items of perpetration is .88 (varying from .59 to .83 among the subscales). The validity data indicate that the scale is useful to discriminate between batterers and general population in physical and psychological violence, although there is an overlap between different types of violence, and it is difficult to compare self-reports with external criteria such court decisions. The results of confirmatory factorial analysis do not support the original five-factor structure. Using exploratory factorial analysis, four components with good internal consistency were identified: Physical (.86), Sexual (.75), and Psychological Violence (.82), and Negotiation (.83). Recommendations for use and a reference guide of rating scores in samples of offenders are suggested.

  5. Gap anisotropy and tunneling currents. [MPS3

    DEFF Research Database (Denmark)

    Lazarides, N.; Sørensen, Mads Peter

    1996-01-01

    The tunneling Hamiltonian formalism is applied to calculate the tunnelingcurrents through a small superconducting tunnel junction. The formalism isextended to nonconstant tunneling matrix elements. The electrodes of thejunction are assumed to...

  6. Engineers win award for Swiss tunnel

    CERN Multimedia

    2003-01-01

    A Derby engineering consultancy has won the Tunnelling Industry Award 2003 for Excellence in Tunnel Design, offered by the British Tunnelling Society, for its work on the LHC in Geneva, Switzerland (1/2 page).

  7. Multi-channel Dual Clocks three-dimensional probability Random Multiple Access protocol for Wireless Public Bus Networks based on RTS/CTS mechanism

    Directory of Open Access Journals (Sweden)

    Zhou Sheng Jie

    2016-01-01

    Full Text Available A MAC protocol for public bus networks, called Bus MAC protocol, designed to provide high quality Internet service for bus passengers. The paper proposed a multi-channel dual clocks three-demission probability random multiple access protocol based on RTS/CTS mechanism, decreasing collisions caused by multiple access from multiple passengers. Use the RTS/CTS mechanism increases the reliability and stability of the system, reducing the collision possibility of the information packets to a certain extent, improves the channel utilization; use the multi-channel mechanism, not only enables the channel load balancing, but also solves the problem of the hidden terminal and exposed terminal. Use the dual clocks mechanism, reducing the system idle time. At last, the different selection of the three-dimensional probabilities can make the system throughput adapt to the network load which could realize the maximum of the system throughput.

  8. Scanning Tunneling Microscopy

    Science.gov (United States)

    1992-03-17

    and c. M. Bertoni, J, Phys. C10, 1911 (1977); J, D. Joannoroulos and M.-r. Cohen, Phys. Rev. B10 , 5075 (1974); E. J, Mele and J. D. JOannopoulos...igh ’""f! nif ~<:ation.l’rc~mn.•hiy a pn.ltruJing ’-·luster or tJtnlp o{ a1onh at tb .. c:nd of ihis fint!t:r ad~ ~1s the tunnelling ti;". N ano

  9. A virtual detector approach to tunnel ionization and tunneling times

    CERN Document Server

    Teeny, Nicolas; Bauke, Heiko

    2016-01-01

    Tunneling times in atomic ionization is studied theoretically by a virtual detector approach. A virtual detector is a hypothetical device that allows to monitor the wave-function's density with spatial and temporal resolution during the ionization process. With this theoretical approach, it becomes possible to define unique moments when the electron enters and leaves with highest probability the classically forbidden region from first principles and a tunneling time can be specified unambiguously. It is shown that neither the moment when the electron enters the tunneling barrier nor when it leaves the tunneling barrier coincide with the moment when the external electric field reaches its maximum. Under the tunneling barrier as well as at the exit the electron has a nonzero velocity in electric field direction. This nonzero exit velocity has to be incorporated when the free motion of the electron is modeled by classical equations of motion.

  10. Tunnel face stability and ground settlement in pressurized shield tunnelling

    Institute of Scientific and Technical Information of China (English)

    苏艺; 汪国锋; 周庆宏

    2014-01-01

    An analysis of the stability of large-diameter circular tunnels and ground settlement during tunnelling by a pressurized shield was presented. An innovative three-dimensional translational multi-block failure mechanism was proposed to determine the face support pressure of large-shield tunnelling. Compared with the currently available mechanisms, the proposed mechanism has two unique features: (1) the supporting pressure applied to the tunnel face is assumed to have a non-uniform rather than uniform distribution, and (2) the method takes into account the entire circular excavation face instead of merely an inscribed ellipse. Based on the discrete element method, a numerical simulation of the Shanghai Yangtze River Tunnel was carried out using the Particle Flow Code in two dimensions. The immediate ground movement during excavation, as well as the behaviour of the excavation face, the shield movement, and the excavated area, was considered before modelling the excavation process.

  11. Magnetic tunnel junctions with monolayer hexagonal boron nitride tunnel barriers

    Energy Technology Data Exchange (ETDEWEB)

    Piquemal-Banci, M.; Galceran, R.; Bouzehouane, K.; Anane, A.; Petroff, F.; Fert, A.; Dlubak, B.; Seneor, P. [Unité Mixte de Physique, CNRS, Thales, Univ. Paris-Sud, Université Paris-Saclay, Palaiseau 91767 (France); Caneva, S.; Martin, M.-B.; Weatherup, R. S.; Kidambi, P. R.; Robertson, J.; Hofmann, S. [Department of Engineering, University of Cambridge, Cambridge CB21PZ (United Kingdom); Xavier, S. [Thales Research and Technology, 1 avenue Augustin Fresnel, Palaiseau 91767 (France)

    2016-03-07

    We report on the integration of atomically thin 2D insulating hexagonal boron nitride (h-BN) tunnel barriers into Co/h-BN/Fe magnetic tunnel junctions (MTJs). The h-BN monolayer is directly grown by chemical vapor deposition on Fe. The Conductive Tip Atomic Force Microscopy (CT-AFM) measurements reveal the homogeneity of the tunnel behavior of our h-BN layers. As expected for tunneling, the resistance depends exponentially on the number of h-BN layers. The h-BN monolayer properties are also characterized through integration into complete MTJ devices. A Tunnel Magnetoresistance of up to 6% is observed for a MTJ based on a single atomically thin h-BN layer.

  12. Residual HIV-1 DNA Flap-independent nuclear import of cPPT/CTS double mutant viruses does not support spreading infection

    Directory of Open Access Journals (Sweden)

    Iglesias Candela

    2011-11-01

    Full Text Available Abstract Background The human immunodeficiency virus type 1 (HIV-1 central DNA Flap is generated during reverse transcription as a result of (+ strand initiation at the central polypurine tract (cPPT and termination after a ca. 100 bp strand displacement at the central termination sequence (CTS. The central DNA Flap is a determinant of HIV-1 nuclear import, however, neither cPPT nor CTS mutations entirely abolish nuclear import and infection. Therefore, to determine whether or not the DNA Flap is essential for HIV-1 nuclear import, we generated double mutant (DM viruses, combining cPPT and CTS mutations to abolish DNA Flap formation. Results The combination of cPPT and CTS mutations reduced the proportion of viruses forming the central DNA Flap at the end of reverse transcription and further decreased virus infectivity in one-cycle titration assays. The most affected DM viruses were unable to establish a spreading infection in the highly permissive MT4 cell line, nor in human primary peripheral blood mononuclear cells (PBMCs, indicating that the DNA Flap is required for virus replication. Surprisingly, we found that DM viruses still maintained residual nuclear import levels, amounting to 5-15% of wild-type virus, as assessed by viral DNA circle quantification. Alu-PCR quantification of integrated viral genome also indicated 5-10% residual integration levels compared to wild-type virus. Conclusion This work establishes that the central DNA Flap is required for HIV-1 spreading infection but points to a residual DNA Flap independent nuclear import, whose functional significance remains unclear since it is not sufficient to support viral replication.

  13. The transcription factor Ace2 and its paralog Swi5 regulate ethanol production during static fermentation through their targets Cts1 and Rps4a in Saccharomyces cerevisiae.

    Science.gov (United States)

    Wu, Yao; Du, Jie; Xu, Guoqiang; Jiang, Linghuo

    2016-05-01

    Saccharomyces cerevisiae is the most widely used fermentation organism for ethanol production. However, the gene expression regulatory networks behind the ethanol fermentation are still not fully understood. Using a static fermentation model, we examined the ethanol yields on biomass of deletion mutants for 77 yeast genes encoding nonessential transcription factors, and found that deletion mutants for ACE2 and SWI5 showed dramatically increased ethanol yields. Overexpression of ACE2 or SWI5 in wild type cells reduced their ethanol yields. Furthermore, among the 34 target genes regulated by Ace2 and Swi5, deletion of CTS1,RPS4a,SIC1,EGT2,DSE2, or SCP160 led to increased ethanol yields, with the former two showing higher effects. Overexpression of CTS1 or RPS4a in both ace2/ace2 and swi5/swi5 mutants reduced their ethanol yields. In contrast, deletion of MCR1 or HO significantly decreased ethanol yields, with the former one showing the highest effect. Therefore, Ace2 and Swi5 are two negative regulators of ethanol yield during static fermentation of yeast cells, and both CTS1 and RPS4a are major effectors mediating these two transcription factors in regulating ethanol production.

  14. Educação com enfoque CTS em documentos curriculares regionais: o caso das diretrizes curriculares de física do estado do Paraná

    Directory of Open Access Journals (Sweden)

    Silmara Alessi Guebur Roehrig

    2014-12-01

    Full Text Available Acreditando que a consolidação do movimento que prioriza as relações entre ciência, tecnologia e sociedade (CTS na educação científica perpassa as decisões curriculares, buscamos compreender como esta vertente se insere nas Diretrizes Curriculares de física do Estado do Paraná (DCE/PR. Após caracterizarmos Educação com enfoque CTS, a partir de Ziman, Aikenhead e Yager, utilizamos a metodologia da Análise Textual Discursiva para estabelecer categorias de análise. A constituição dos dados se deu a partir da análise documental das DCE/PR de Física e de entrevistas com autores. Deste processo, emergiram as seguintes categorias de análise: aplicação da ciência, interdisciplinaridade, enfoques histórico, filosófico e sociológico, problematização, contextualização, tomada de decisões, currículo orientado no aluno, e cidadania. Os resultados apontam que, mesmo não tendo sido elaboradas com o propósito de favorecer a Educação com enfoque CTS, as DCE/PR de Física contemplam elementos que remetem às dimensões supracitadas.

  15. Ex vivo expansion of human T cells for adoptive immunotherapy using the novel Xeno-free CTS Immune Cell Serum Replacement.

    Science.gov (United States)

    Smith, Corey; Økern, Grethe; Rehan, Sweera; Beagley, Leone; Lee, Sau K; Aarvak, Tanja; Schjetne, Karoline W; Khanna, Rajiv

    2015-01-01

    The manufacture of clinical grade cellular products for adoptive immunotherapy requires ex vivo culture and expansion of human T cells. One of the key components in manufacturing of T cell therapies is human serum (HS) or fetal bovine serum (FBS), which can potentially expose immunotherapy recipient to adventitious infectious pathogens and are thus considered as non-cGMP compliant for adoptive therapy. Here we describe a novel xeno-free serum replacement (SR) with defined components that can be reproducibly used for the production of clinical grade T-cell therapies in combination with several different cell culture media. Dynabeads CD3/CD28 Cell Therapy System (CTS)-activated or antigen-specific T cells expanded using the xeno-free SR, CTS Immune Cell SR, showed comparable growth kinetics observed with cell culture media supplemented with HS or FBS. Importantly the xeno-free SR supplemented medium supported the optimal expansion of T cells specific for subdominant tumour-associated antigens and promoted expansion of T cells with central memory T-cell phenotype, which is favourable for in vivo survival and persistence following adoptive transfer. Furthermore, T cells expanded using xeno-free SR medium were highly amenable to lentivirus-mediated gene transduction for potential application for gene-modified T cells. Taken together, the CTS Immune Cell SR provides a novel platform strategy for the manufacture of clinical grade adoptive cellular therapies.

  16. Tunneling Ionization of Diatomic Molecules

    DEFF Research Database (Denmark)

    Svensmark, Jens Søren Sieg

    2016-01-01

    barriers, an ability classical particles do not possess. Tunnelling is a fundamental quantum mechanical process, a process that is distinctly non-classical, so solving this tunnelling problem is not only relevant for molecular physics, but also for quantum theory in general. In this dissertation the theory...

  17. The Effectiveness of Manual Therapy Versus Surgery on Self-reported Function, Cervical Range of Motion, and Pinch Grip Force in Carpal Tunnel Syndrome: A Randomized Clinical Trial.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Cleland, Joshua; Palacios-Ceña, María; Fuensalida-Novo, Stella; Pareja, Juan A; Alonso-Blanco, Cristina

    2017-03-01

    Study Design Randomized parallel-group trial. Background Carpal tunnel syndrome (CTS) is a common pain condition that can be managed surgically or conservatively. Objective To compare the effectiveness of manual therapy versus surgery for improving self-reported function, cervical range of motion, and pinch-tip grip force in women with CTS. Methods In this randomized clinical trial, 100 women with CTS were randomly allocated to either a manual therapy (n = 50) or a surgery (n = 50) group. The primary outcome was self-rated hand function, assessed with the Boston Carpal Tunnel Questionnaire. Secondary outcomes included active cervical range of motion, pinch-tip grip force, and the symptom severity subscale of the Boston Carpal Tunnel Questionnaire. Patients were assessed at baseline and 1, 3, 6, and 12 months after the last treatment by an assessor unaware of group assignment. Analysis was by intention to treat, with mixed analyses of covariance adjusted for baseline scores. Results At 12 months, 94 women completed the follow-up. Analyses showed statistically significant differences in favor of manual therapy at 1 month for self-reported function (mean change, -0.8; 95% confidence interval [CI]: -1.1, -0.5) and pinch-tip grip force on the symptomatic side (thumb-index finger: mean change, 2.0; 95% CI: 1.1, 2.9 and thumb-little finger: mean change, 1.0; 95% CI: 0.5, 1.5). Improvements in self-reported function and pinch grip force were similar between the groups at 3, 6, and 12 months. Both groups reported improvements in symptom severity that were not significantly different at all follow-up periods. No significant changes were observed in pinch-tip grip force on the less symptomatic side and in cervical range of motion in either group. Conclusion Manual therapy and surgery had similar effectiveness for improving self-reported function, symptom severity, and pinch-tip grip force on the symptomatic hand in women with CTS. Neither manual therapy nor surgery resulted

  18. Tunneling magnetic force microscopy

    Science.gov (United States)

    Burke, Edward R.; Gomez, Romel D.; Adly, Amr A.; Mayergoyz, Isaak D.

    1993-01-01

    We have developed a powerful new tool for studying the magnetic patterns on magnetic recording media. This was accomplished by modifying a conventional scanning tunneling microscope. The fine-wire probe that is used to image surface topography was replaced with a flexible magnetic probe. Images obtained with these probes reveal both the surface topography and the magnetic structure. We have made a thorough theoretical analysis of the interaction between the probe and the magnetic fields emanating from a typical recorded surface. Quantitative data about the constituent magnetic fields can then be obtained. We have employed these techniques in studies of two of the most important issues of magnetic record: data overwrite and maximizing data-density. These studies have shown: (1) overwritten data can be retrieved under certain conditions; and (2) improvements in data-density will require new magnetic materials. In the course of these studies we have developed new techniques to analyze magnetic fields of recorded media. These studies are both theoretical and experimental and combined with the use of our magnetic force scanning tunneling microscope should lead to further breakthroughs in the field of magnetic recording.

  19. Carpal tunnel syndrome in association with hand-arm vibration syndrome: a review of claimants seeking compensation in the Mining Industry.

    Science.gov (United States)

    Burke, F D; Lawson, I J; McGeoch, K L; Miles, J N V; Proud, G

    2005-05-01

    Twenty six thousand eight hundred and forty-two miners seeking compensation were clinically assessed for vascular and neurosensory impairment arising from exposure to occupational hand-arm vibration (Hand-Arm Vibration Syndrome). They were also assessed clinically for Carpal Tunnel Syndrome which, if present, would result in additional compensation. Fifteen per cent were assessed as having both HAVS and CTS. Thirty-eight per cent of claimants had nocturnal wakening, 1.3% wasting of abductor pollicis brevis, 15% had a positive Tinel's test and 20% had a positive Phalen's test. The 15% prevalence reported is lower than the rates cited previously in several small population studies of workers exposed to vibration. This paper reports the results of the assessment process and discusses the difficulty of discriminating Carpal Tunnel Syndrome from diffuse neurosensory impairment arising from HAVS.

  20. Carpal tunnel syndrome and acromegaly.

    Science.gov (United States)

    Baum, H; Lüdecke, D K; Herrmann, H D

    1986-01-01

    50 patients with acromegaly and carpal tunnel syndrome have been examined electrophysiologically before and after transnasal operation of the pituitary adenoma. 32 of the 50 patients (64%) had symptoms of carpal tunnel syndrome. 13 of them had neurological deficits. 28 of the examined patients had pathological neurographical findings only. About 1 week post-operatively DL was decreased in 43%; in 10 out of 13 patients with neurological deficits DL decreased. GH was normalized in 80% and reduced to 5-10 micrograms/l in a further 10%. The investigation did not show whether the carpal tunnel syndrome only depended on a GH increase or on other factors also such as e.g., on the duration of symptoms or tissue changes. None of the patients had the transversal carpal ligament operated on. The coincidence between acromegaly and carpal tunnel syndrome was 64%. In 3 cases the carpal tunnel syndrome was the leading sign to the diagnosis of acromegaly.

  1. Tunnel electroresistance through organic ferroelectrics

    Science.gov (United States)

    Tian, B. B.; Wang, J. L.; Fusil, S.; Liu, Y.; Zhao, X. L.; Sun, S.; Shen, H.; Lin, T.; Sun, J. L.; Duan, C. G.; Bibes, M.; Barthélémy, A.; Dkhil, B.; Garcia, V.; Meng, X. J.; Chu, J. H.

    2016-05-01

    Organic electronics is emerging for large-area applications such as photovoltaic cells, rollable displays or electronic paper. Its future development and integration will require a simple, low-power organic memory, that can be written, erased and readout electrically. Here we demonstrate a non-volatile memory in which the ferroelectric polarisation state of an organic tunnel barrier encodes the stored information and sets the readout tunnel current. We use high-sensitivity piezoresponse force microscopy to show that films as thin as one or two layers of ferroelectric poly(vinylidene fluoride) remain switchable with low voltages. Submicron junctions based on these films display tunnel electroresistance reaching 1,000% at room temperature that is driven by ferroelectric switching and explained by electrostatic effects in a direct tunnelling regime. Our findings provide a path to develop low-cost, large-scale arrays of organic ferroelectric tunnel junctions on silicon or flexible substrates.

  2. High-resolution tunnel fluctuoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Glatz, A.; Varlamov, A. A.; Vinokur, V. M.

    2014-08-01

    Electron tunneling spectroscopy pioneered by Esaki and Giaever offered a powerful tool for studying electronic spectra and density of states (DOS) in superconductors. This led to important discoveries that revealed, in particular, the pseudogap in the tunneling spectrum of superconductors above their critical temperatures. However, the phenomenological approach of Giaever and Megerle does not resolve the fine structure of low-bias behavior carrying significant information about electron scattering, interactions, and decoherence effects. Here we construct a complete microscopic theory of electron tunneling into a superconductor in the fluctuation regime. We reveal a non-trivial low-energy anomaly in tunneling conductivity due to Andreev-like reflections of injected electrons from superconducting fluctuations. Our findings enable real-time observation of fluctuating Cooper pairs dynamics by time-resolved scanning tunneling microscopy measurements and open new horizons for quantitative analysis of the fluctuation electronic spectra of superconductors.

  3. Gene expression profile in a glioma cell line resistant to cell death induced by the chimeric tumor suppressor-1 (CTS-1), a dominant-positive variant of p53--the role of NFkappaB.

    Science.gov (United States)

    Seznec, Janina; Weit, Simone; Naumann, Ulrike

    2010-03-01

    The identification of genes involved in carcinogenesis and tumor progression is of great interest since these genes might be feasible as candidates for new tumor-targeted therapy strategies. Chimeric tumor suppressor-1 (CTS-1), an artificial synthetic variant of p53, resists common p53 inactivation and could therefore be defined as a dominant-positive p53 variant. Overexpression of CTS-1 induces caspase-independent cell death. We used whole-genome microarray expression analysis in a parental (229(P)) and a CTS-1-resistant glioma cell line (229(Res)) to analyze alterations in gene expression in Ad-CTS-1-infected and in uninfected parental and resistant cells. In total, 700 genes were differentially expressed in infected and 313 genes in uninfected 229(Res) versus 229(P) cells. Ingenuity Pathway Analysis determined a variety of differentially expressed genes in Ad-CTS-1-infected cells that were members of intracellular networks with central tumor-involved players such as nuclear factor-kappaB (NFkappaB), protein kinase B/AKT or transforming growth factor-beta. Here we focused on the function of NFkappaB in Ad-CTS-1-mediated cell death in glioma. NFkappaB was activated in Ad-CTS-1-infected 229(P) but not 229(Res) cells. NFkappaB activation was accompanied by the induction of cell death in parental cells. Inhibition of NFkappaB activity by expression of an IkappaB super repressor or upregulation of the NFkappaB-linked gene Bex protected parental cells to Ad-CTS-1-induced cell death, whereas knockdown of Bex sensitized both parental and resistant cells. Taken together, these data suggest that activation of the normally antiapoptotic protein NFkappaB does not always necessarily protect cells from apoptosis but, in the glioma cell lines tested so far, and in an environment where p53 is constitutively active, also leads to the induction of cell death.

  4. D1-3: Marshfield Dictionary of Clinical and Translational Science (MD-CTS): An Online Reference for Clinical and Translational Science Terminology

    Science.gov (United States)

    Finamore, Joe; Ray, William; Kadolph, Chris; Rastegar-Mojarad, Majid; Ye, Zhan; Jacqueline, Bohne; Tachinardi, Umberto; Mendonça, Eneida; Finnegan, Brian; Bartkowiak, Barbara; Weichelt, Bryan; Lin, Simon

    2014-01-01

    Background/Aims New terms are rapidly appearing in the literature and practice of clinical medicine and translational research. To catalog real-world usage of medical terms, we report the first construction of an online dictionary of clinical and translational medicinal terms, which are computationally generated in near real-time using a big data approach. This project is NIH CTSA-funded and developed by the Marshfield Clinic Research Foundation in conjunction with University of Wisconsin - Madison. Currently titled Marshfield Dictionary of Clinical and Translational Science (MD-CTS), this application is a Google-like word search tool. By entering a term into the search bar, MD-CTS will display that term’s definition, usage examples, contextual terms, related images, and ontological information. A prototype is available for public viewing at http://spellchecker.mfldclin.edu/. Methods We programmatically derived the lexicon for MD-CTS from scholarly communications by parsing through 15,156,745 MEDLINE abstracts and extracting all of the unique words found therein. We then ran this list through several filters in order to remove words that were not relevant for searching, such as common English words and numeric expressions. We then loaded the resulting 1,795,769 terms into SQL tables. Each term is cross-referenced with every occurrence in all abstracts in which it was found. Additional information is aggregated from Wiktionary, Bioportal, and Wikipedia in real-time and displayed on-screen. From this lexicon we created a supplemental dictionary resource (updated quarterly) to be used in Microsoft Office® products. Results We evaluated the utility of MD-CTS by creating a list of 100 words derived from recent clinical and translational medicine publications in the week of July 22, 2013. We then performed comparative searches for each term with Taber’s Cyclopedic Medical Dictionary, Stedman’s Medical Dictionary, Dorland’s Illustrated Medical Dictionary, Medical

  5. Cost-Utility of Interventions in Patients with Carpal Tunnel Syndrome in a Universitary Hospital in Cali, Colombia

    Directory of Open Access Journals (Sweden)

    César Augusto Guevara

    2015-05-01

    Full Text Available Introduction: Although there are several treatments for carpal tunnel syndrome (CTS, the efficiency of these has not evaluated in Colombia. Objective: Determine the incremental cost-utility ratio (ICUR of medical and surgical treatment in patients with CTS. Material and methods: A cost utility analysis was conducted from the societal perspective with patients older than 18 years diagnosed with CTS who received medical or surgical treatment. Quality-adjusted life-years (QALYs were calculated using the EQ-5D. Costs were obtained from the ISS national tariff 2001+30 %. The results were extrapolated to long term through a Markov model with a discount rate of 3,5 %. A probabilistic sensitivity analysis using Monte Carlo simulation was performed. Results: Fifty- three patients participated, women (71,7 %; mean age: 55,5 years. 79 % of patients received medical treatment. The most frequent treatment was medical observation (66,7 % and NSAIDs (16,6 %. Medical treatment provided 0,33 QALYs (± 0,11 and surgery 0,37 (± 0,10. The average total cost of medical treatment at 6 months and 20 years was COP 132 006 (95 % CI: COP 70 255 - 425 341 and COP 483 440 (95 % CI: COP 104 310 - 862 570 respectively. The cost of surgery was COP 1 972 644 (95 % CI: COP 981 204 - 8 517 065 and COP 979 585 (95 %: COP 684 912 - 1 274 258. The surgery was dominated by 6 months. The ICUR at 20 years was COP 1 033 635/QALY additional (95 % CI: COP 840 179 - 1 235 323/additional QALY with a 80 % of probability that surgery be cost-utility when there is a willingness to pay COP 5 000 000. Conclusion: The medical treatment is cost-effective with regard to the surgery in short term. However, in the long term the surgery is cost effective with respect to the medical treatment.

  6. Efficacy of low-level laser therapy in carpal tunnel syndrome management: a systematic review and meta-analysis.

    Science.gov (United States)

    Bekhet, Amira Hassan; Ragab, Basma; Abushouk, Abdelrahman Ibrahim; Elgebaly, Ahmed; Ali, Olfat Ibrahim

    2017-08-01

    We performed this meta-analysis to investigate the efficacy of low-level laser therapy (LLLT), a physiotherapy modality with anti-inflammatory and analgesic effects, in the management of mild-to-moderate carpal tunnel syndrome (CTS). We searched PubMed, Web of Knowledge, Scopus, Cochrane Central, and Virtual Health Library for randomized controlled trials (RCTs) that compared the effects of LLLT with or without splinting versus placebo on functional and electromyographic outcomes in CTS. All outcomes were pooled as mean differences (MD) under the inverse variance or random effects model, using the statistical add-in (MetaXL, version 5.0). Eight RCTs (473 patients/631 wrists) were eligible for the final analysis. The overall effect estimates did not favor LLLT therapy group over placebo in all primary outcomes: visual analogue scale (MD -1.11, 95% CI [-2.58, 0.35]), symptom severity scale score (MD -1.41, 95% CI [-5.12, 2.29]), and functional status scale score (MD -1.33, 95% CI [-3.27, 0.61]). However, LLLT was superior to placebo in terms of grip strength (MD 2.19, 95% CI [1.63, 2.76]) and inferior to placebo in terms of sensory nerve action potential (MD -2.74, 95% CI [-3.66, -1.82]). Laser therapy is superior to placebo in terms of improving the grip strength; however, no significant difference was found between both groups in terms of functional status improvement, pain reduction, or motor electrodiagnostic evaluations. Further high-quality trials with longer follow-up periods are required to establish the efficacy of LLLT for CTS treatment.

  7. Mutations in CTC1, encoding the CTS telomere maintenance complex component 1, cause cerebroretinal microangiopathy with calcifications and cysts.

    Science.gov (United States)

    Polvi, Anne; Linnankivi, Tarja; Kivelä, Tero; Herva, Riitta; Keating, James P; Mäkitie, Outi; Pareyson, Davide; Vainionpää, Leena; Lahtinen, Jenni; Hovatta, Iiris; Pihko, Helena; Lehesjoki, Anna-Elina

    2012-03-09

    Cerebroretinal microangiopathy with calcifications and cysts (CRMCC) is a rare multisystem disorder characterized by extensive intracranial calcifications and cysts, leukoencephalopathy, and retinal vascular abnormalities. Additional features include poor growth, skeletal and hematological abnormalities, and recurrent gastrointestinal bleedings. Autosomal-recessive inheritance has been postulated. The pathogenesis of CRMCC is unknown, but its phenotype has key similarities with Revesz syndrome, which is caused by mutations in TINF2, a gene encoding a member of the telomere protecting shelterin complex. After a whole-exome sequencing approach in four unrelated individuals with CRMCC, we observed four recessively inherited compound heterozygous mutations in CTC1, which encodes the CTS telomere maintenance complex component 1. Sanger sequencing revealed seven more compound heterozygous mutations in eight more unrelated affected individuals. Two individuals who displayed late-onset cerebral findings, a normal fundus appearance, and no systemic findings did not have CTC1 mutations, implying that systemic findings are an important indication for CTC1 sequencing. Of the 11 mutations identified, four were missense, one was nonsense, two resulted in in-frame amino acid deletions, and four were short frameshift-creating deletions. All but two affected individuals were compound heterozygous for a missense mutation and a frameshift or nonsense mutation. No individuals with two frameshift or nonsense mutations were identified, which implies that severe disturbance of CTC1 function from both alleles might not be compatible with survival. Our preliminary functional experiments did not show evidence of severely affected telomere integrity in the affected individuals. Therefore, determining the underlying pathomechanisms associated with deficient CTC1 function will require further studies.

  8. Frequency driven inversion of tunnel magnetoimpedance and observation of positive tunnel magnetocapacitance in magnetic tunnel junctions

    Science.gov (United States)

    Parui, Subir; Ribeiro, Mário; Atxabal, Ainhoa; Bedoya-Pinto, Amilcar; Sun, Xiangnan; Llopis, Roger; Casanova, Fèlix; Hueso, Luis E.

    2016-08-01

    The relevance for modern computation of non-volatile high-frequency memories makes ac-transport measurements of magnetic tunnel junctions (MTJs) crucial for exploring this regime. Here, we demonstrate a frequency-mediated effect in which the tunnel magnetoimpedance reverses its sign in a classical Co/Al2O3/NiFe MTJ, whereas we only observe a gradual decrease in the tunnel magnetophase. Such effects are explained by the capacitive coupling of a parallel resistor and capacitor in the equivalent circuit model of the MTJ. Furthermore, we report a positive tunnel magnetocapacitance effect, suggesting the presence of a spin-capacitance at the two ferromagnet/tunnel-barrier interfaces. Our results are important for understanding spin transport phenomena at the high frequency regime in which the spin-polarized charge accumulation due to spin-dependent penetration depth at the two interfaces plays a crucial role.

  9. Frequency driven inversion of tunnel magnetoimpedance and observation of positive tunnel magnetocapacitance in magnetic tunnel junctions

    Energy Technology Data Exchange (ETDEWEB)

    Parui, Subir, E-mail: s.parui@nanogune.eu, E-mail: l.hueso@nanogune.eu; Ribeiro, Mário; Atxabal, Ainhoa; Llopis, Roger [CIC nanoGUNE, 20018 Donostia-San Sebastian (Spain); Bedoya-Pinto, Amilcar [CIC nanoGUNE, 20018 Donostia-San Sebastian (Spain); Max Planck Institute of Microstructure Physics, D-06120 Halle (Germany); Sun, Xiangnan [CIC nanoGUNE, 20018 Donostia-San Sebastian (Spain); National Center for Nanoscience and Technology, 100190 Beijing (China); Casanova, Fèlix; Hueso, Luis E., E-mail: s.parui@nanogune.eu, E-mail: l.hueso@nanogune.eu [CIC nanoGUNE, 20018 Donostia-San Sebastian (Spain); IKERBASQUE, Basque Foundation for Science, 48011 Bilbao (Spain)

    2016-08-01

    The relevance for modern computation of non-volatile high-frequency memories makes ac-transport measurements of magnetic tunnel junctions (MTJs) crucial for exploring this regime. Here, we demonstrate a frequency-mediated effect in which the tunnel magnetoimpedance reverses its sign in a classical Co/Al{sub 2}O{sub 3}/NiFe MTJ, whereas we only observe a gradual decrease in the tunnel magnetophase. Such effects are explained by the capacitive coupling of a parallel resistor and capacitor in the equivalent circuit model of the MTJ. Furthermore, we report a positive tunnel magnetocapacitance effect, suggesting the presence of a spin-capacitance at the two ferromagnet/tunnel-barrier interfaces. Our results are important for understanding spin transport phenomena at the high frequency regime in which the spin-polarized charge accumulation due to spin-dependent penetration depth at the two interfaces plays a crucial role.

  10. An Association between Carpal Tunnel Syndrome and Migraine Headaches—National Health Interview Survey, 2010

    Directory of Open Access Journals (Sweden)

    Huay-Zong Law, MD

    2015-03-01

    Conclusions: This study is the first to demonstrate an association between CTS and migraine headache. Longitudinal and genetic studies with physician verification of migraine headaches and CTS are needed to further define this association.

  11. Simulations in quantum tunneling

    Science.gov (United States)

    Smith, Kevin; Blaylock, Guy

    2017-10-01

    We study the timing effects of nonrelativistic wave packet tunneling through a barrier using a numerical simulation readily accessible to an undergraduate audience. We demonstrate that the peak of the transmitted packet can sometimes emerge from the barrier ahead of the peak of an undisturbed wave packet that does not encounter a barrier. Under the right circumstances, this effect can give the appearance that transmission through the barrier occurs at superluminal speeds. We demonstrate that this seemingly paradoxical effect is not all that puzzling. Rather, components from the front of the incoming wave packet are preferentially transmitted, forming a transmitted packet ahead of the average of the incoming wave packet but not ahead of the leading edge of that packet. Our studies also show how the timing depends on barrier height and width, consistent with expectations based on the different energy components of the wave packet.

  12. Tunneling of atoms, nuclei and molecules

    CERN Document Server

    Bertulani, C A

    2015-01-01

    This is a brief review of few relevant topics on tunneling of composite particles and how the coupling to intrinsic and external degrees of freedom affects tunneling probabilities. I discuss the phenomena of resonant tunneling, different barriers seen by subsystems, damping of resonant tunneling by level bunching and continuum effects due to particle dissociation.

  13. Tunnel fire testing and modeling the Morgex North tunnel experiment

    CERN Document Server

    Borghetti, Fabio; Gandini, Paolo; Frassoldati, Alessio; Tavelli, Silvia

    2017-01-01

    This book aims to cast light on all aspects of tunnel fires, based on experimental activities and theoretical and computational fluid dynamics (CFD) analyses. In particular, the authors describe a transient full-scale fire test (~15 MW), explaining how they designed and performed the experimental activity inside the Morgex North tunnel in Italy. The entire organization of the experiment is described, from preliminary evaluations to the solutions found for management of operational difficulties and safety issues. This fire test allowed the collection of different measurements (temperature, air velocity, smoke composition, pollutant species) useful for validating and improving CFD codes and for testing the real behavior of the tunnel and its safety systems during a diesel oil fire with a significant heat release rate. Finally, the fire dynamics are compared with empirical correlations, CFD simulations, and literature measurements obtained in other similar tunnel fire tests. This book will be of interest to all ...

  14. Tunnel Cost-Estimating Methods.

    Science.gov (United States)

    1981-10-01

    8 ae1e 066 c LINING CALCULATES THE LINING COSTS AND THE FORMWORK COST FOR A 982928 ees C TUNNEL OR SHAFT SEGMENT 682636 0066...AD-AIO . 890 ARMY ENGINEER WATERWAYS EXPERIMENT STATION VICKSBURGETC F/B 13/13 TUNNEL COST-ESTIMATING METNDS(U) OCT 81 R D BENNETT UNCLASSIFIED WES...TR/L-81-101-3lEEEEEE EIIIl-IIIIIIIu IIIIEIIIEIIIIE llllEEEEllEEEI EEEEEEEEEIIII C EllTE-CHNICAL RGPORT GL-81-10 LI10 TUNNEL COST-ESTIMATING METHODS by

  15. Quantum Tunneling and Complex Trajectories

    Science.gov (United States)

    Meynig, Max; Haggard, Hal

    2017-01-01

    In general, the semiclassical approximation of quantum mechanical tunneling fails to treat tunneling through barriers if real initial conditions and trajectories are used. By analytically continuing classical dynamics to the complex plane the problems encountered in the approximation can be resolved. While, the complex methods discussed here have been previously explored, no one has exhibited an analytically solvable case. The essential features of the complex method will be discussed in the context of a novel, analytically solvable problem. These methods could be useful in quantum gravity, with applications to the tunneling of spacetime geometries.

  16. Tunneling Ionization of Diatomic Molecules

    DEFF Research Database (Denmark)

    Svensmark, Jens Søren Sieg

    2016-01-01

    When a molecule is subject to a strong laser field, there is a probability that an electron can escape, even though the electrons are bound by a large potential barrier. This is possible because electrons are quantum mechanical in nature, and they are therefore able to tunnel through potential...... of tunneling ionizaion of molecules is presented and the results of numerical calculations are shown. One perhaps surprising result is, that the frequently used Born-Oppenheimer approximation breaks down for weak fields when describing tunneling ionization. An analytic theory applicable in the weak-field limit...

  17. Dynamical tunneling theory and experiment

    CERN Document Server

    Keshavamurthy, Srihari

    2011-01-01

    A prominent aspect of quantum theory, tunneling arises in a variety of contexts across several fields of study, including nuclear, atomic, molecular, and optical physics and has led to technologically relevant applications in mesoscopic science. Exploring mechanisms and consequences, Dynamical Tunneling: Theory and Experiment presents the work of international experts who discuss the considerable progress that has been achieved in this arena in the past two decades.Highlights in this volume include:A historical introduction and overview of dynamical tunneling, with case histories ranging from

  18. Prevalence of low back pain and carpal tunnel syndrome among dental practitioners in Dakshina Kannada and Coorg District

    Directory of Open Access Journals (Sweden)

    D Anupama Prasad

    2017-01-01

    Full Text Available Context: Dental practitioners who usually have to work for long durations in a particular fixed posture are more prone to musculoskeletal disorders (MSDs, particularly those involving the hand and wrist and also of the lower back. Aims: To study the prevalence of carpal tunnel syndrome (CTS and low back pain (LBP among dental practitioners and to correlate the symptoms with the duration of practice. Subjects and Methods: A closed-end questionnaire was distributed to 100 dental practitioners from Dakshina Kannada and Coorg districts of Karnataka, India. Statistical Analysis Used: Analyses were carried out using Chi-square test and Fisher's exact test. Results: The study found that 86% of the total population of dentists practicing for more than 5 years showed symptoms of CTS and 54.0% experienced LBP. Conclusion: Symptoms of MSDs related to hands, wrists, and low back is widely prevalent among the dentists, which severely impact their work efficiency. Precautionary measures early in the clinical practice such as proper ergonomics in the operating field and few strengthening exercises as described in this study can reduce the onset and progression of the symptoms.

  19. The relationship between physical factors (Wrist ratio and electrophysiologic factors of median nerve in carpal tunnel syndrome in women

    Directory of Open Access Journals (Sweden)

    Oliaiy Gh

    1997-08-01

    Full Text Available Carpal tunnel syndrome (CTS is considered by researchers because of its high prevalence, and several studies have been done to find the causes and factors which increase the chance for the syndrome. These studies have shown relationships between this syndrome with some physical parameters like wrist dimensions, weight and systemic conditions. There is no investigation on risk factors in CTS in our country. So the main goal of this research is to find and introduce predisposing factors for carpal tunnel syndrome. Methods: Seventy patients and 33 controls 22 to 70 years old were studied. Standard methods for median and ulnar nerve studies were used and questionnaires included physical measurements, history of diseases and personal information were completed for each person. Results: Patients had higher wrist ratio (mean difference, 0.0267, P<0.001, weight (mean difference: 6.098, P<0.001 and body mass index (mean difference: 3.376, P<0.001. Regression analysis showed strong positive relation between wrist ratio and median latencies. The strongest correlation was found between wrist ratio and median minus ulnar distal sensory latencies (Y2=0.4014, P<0.0001. No relation was found between weight and body mass index with median latencies. Seventy-nine percent of patients and 48.5% of controls had wrist ratio of 0.7 or greater (P<0.05. Seventy-two percent of patients with repetetive hand activities and 78% with associated conditions had wrist ratio of 0.7 or greater. Seventy-six percent had wrist ratio less than 0.7. No relationship was found between obesity, diabetes, thyroid disorders, rheumatoid arthritis, taking oral contraceptive, hysterectomy, oophorectomy, menopause and repetetive hand activities with involvement of carpal tunnel syndrome. Discussion: Wrist dimensions seem to be an important predictor for carpal tunnel syndrome also in patients with associated conditions. If individuals with squarer wrists are involved in special conditions

  20. Application of high-frequency ultrasound in the diagnosis of diabetic carpal tunnel syndrome%高频超声诊断糖尿病腕管综合征研究进展

    Institute of Scientific and Technical Information of China (English)

    李红波

    2015-01-01

    糖尿病(Diabetes mellitus,DM)能够引起多种神经系统并发症,导致自主神经、周围神经和中枢神经等病变,其发病机制尚不明确,DM患者出现腕管综合征(carpal tunnel syndrome,CTS)的概率高达40%,早期确诊率较低,极易漏诊或误诊.笔者就高频超声诊断糖尿病性腕管综合征的进展简要综述.

  1. Free Surface Water Tunnel (FSWT)

    Data.gov (United States)

    Federal Laboratory Consortium — Description: The Free Surface Water Tunnel consists of the intake plenum, the test section and the exit plenum. The intake plenum starts with a perforated pipe that...

  2. Flatback airfoil wind tunnel experiment.

    Energy Technology Data Exchange (ETDEWEB)

    Mayda, Edward A. (University of California, Davis, CA); van Dam, C.P. (University of California, Davis, CA); Chao, David D. (University of California, Davis, CA); Berg, Dale E.

    2008-04-01

    A computational fluid dynamics study of thick wind turbine section shapes in the test section of the UC Davis wind tunnel at a chord Reynolds number of one million is presented. The goals of this study are to validate standard wind tunnel wall corrections for high solid blockage conditions and to reaffirm the favorable effect of a blunt trailing edge or flatback on the performance characteristics of a representative thick airfoil shape prior to building the wind tunnel models and conducting the experiment. The numerical simulations prove the standard wind tunnel corrections to be largely valid for the proposed test of 40% maximum thickness to chord ratio airfoils at a solid blockage ratio of 10%. Comparison of the computed lift characteristics of a sharp trailing edge baseline airfoil and derived flatback airfoils reaffirms the earlier observed trend of reduced sensitivity to surface contamination with increasing trailing edge thickness.

  3. Self-Organizing Tunnel Peers

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Tunneling is an important approach in IPv6 transition techniques. The tunnel broker model provides a way to build virtual IPv6 networks without manual configuration.However, neither it adapts performance variation on the IPv4 infrastructure,nor it is a scalable solution for a wide-area IPv6 networking environment. In this paper, a self-organizing tunnel peer (SOTP)model is presented. Tunnel peers are clustered in the SOTP system so that optimization is scalable. Four primitive operations related to cluster construction - arrest,release,division and death - endow the system with the nature of self-organization.Occurrence and behavior of the operations are decided by criteria on the IPv4 end-to-end performance; hence measurement is an indispensable component of the system. The metabolism of cluster relaxes the requirement to accuracy of measurement and optimization.

  4. The Statistics of Chaotic Tunnelling

    CERN Document Server

    Creagh, S C; Creagh, Stephen C.; Whelan, Niall D.

    2000-01-01

    We discuss the statistics of tunnelling rates in the presence of chaotic classical dynamics. This applies to resonance widths in chaotic metastable wells and to tunnelling splittings in chaotic symmetric double wells. The theory is based on using the properties of a semiclassical tunnelling operator together with random matrix theory arguments about wave function overlaps. The resulting distribution depends on the stability of a specific tunnelling orbit and is therefore not universal. However it does reduce to the universal Porter-Thomas form as the orbit becomes very unstable. For some choices of system parameters there are systematic deviations which we explain in terms of scarring of certain real periodic orbits. The theory is tested in a model symmetric double well problem and possible experimental realisations are discussed.

  5. Copper tin sulfide (CTS) absorber thin films obtained by co-evaporation: Influence of the ratio Cu/Sn

    Energy Technology Data Exchange (ETDEWEB)

    Robles, V., E-mail: victor.robles@ciemat.es; Trigo, J.F.; Guillén, C.; Herrero, J.

    2015-09-05

    Highlights: • Copper tin sulfide (CTS) thin films were grown by co-evaporation at different Cu/Sn atomic ratios. • Smooth Cu{sub 2}SnS{sub 3} layers with large grains are obtained at Cu/Sn ⩾ 1.5 and T ⩾ 350 °C. • At 450 °C, the cubic Cu{sub 2}SnS{sub 3} phase changes to tetragonal phase. • Cu{sub 2}SnS{sub 3} presents suitable optical and electrical properties for use as photovoltaic absorbers. - Abstract: Copper tin sulfide thin films have been grown on soda-lime glass substrates from the elemental constituents by co-evaporation. The synthesis was performed at substrate temperatures of 350 °C and 450 °C and different Cu/Sn ratios, adjusting the deposition time in order to obtain thicknesses above 1000 nm. The evolution of the morphological, structural, chemical, optical and electrical properties has been analyzed as a function of the substrate temperature and the Cu/Sn ratio. For the samples with Cu/Sn ⩽ 1, Cu{sub 2}Sn{sub 3}S{sub 7} and Cu{sub 2}SnS{sub 3} have been observed by XRD. Increasing the Cu/Sn to 1.5, the Cu{sub 2}SnS{sub 3} phase was the majority, being the formation completed at Cu/Sn ratio around 2. The increment of the substrate temperature leads to a change of cubic structure to tetragonal of the Cu{sub 2}SnS{sub 3} phase. The chemical treatment with KCN was effective to eliminate CuS excess detected in the samples with Cu/Sn > 2.2. The samples with Cu{sub 2}SnS{sub 3} structure show a band gap energy increasing from 0.9 to 1.25 eV and an electrical resistivity decreasing from 7 ∗ 10{sup −2} Ω cm to 3 ∗ 10{sup −3} Ω cm when the Cu/Sn atomic ratio increases from 1.5 to 2.2.

  6. SU-D-BRA-04: Fractal Dimension Analysis of Edge-Detected Rectal Cancer CTs for Outcome Prediction

    Energy Technology Data Exchange (ETDEWEB)

    Zhong, H; Wang, J; Hu, W; Shen, L; Wan, J; Zhou, Z; Zhang, Z [Fudan University Shanghai Cancer Center, Shanghai (China)

    2015-06-15

    Purpose: To extract the fractal dimension features from edge-detected rectal cancer CTs, and to examine the predictability of fractal dimensions to outcomes of primary rectal cancer patients. Methods: Ninety-seven rectal cancer patients treated with neo-adjuvant chemoradiation were enrolled in this study. CT images were obtained before chemoradiotherapy. The primary lesions of the rectal cancer were delineated by experienced radiation oncologists. These images were extracted and filtered by six different Laplacian of Gaussian (LoG) filters with different filter values (0.5–3.0: from fine to coarse) to achieve primary lesions in different anatomical scales. Edges of the original images were found at zero-crossings of the filtered images. Three different fractal dimensions (box-counting dimension, Minkowski dimension, mass dimension) were calculated upon the image slice with the largest cross-section of the primary lesion. The significance of these fractal dimensions in survival, recurrence and metastasis were examined by Student’s t-test. Results: For a follow-up time of two years, 18 of 97 patients had experienced recurrence, 24 had metastasis, and 18 were dead. Minkowski dimensions under large filter values (2.0, 2.5, 3.0) were significantly larger (p=0.014, 0.006, 0.015) in patients with recurrence than those without. For metastasis, only box-counting dimensions under a single filter value (2.5) showed differences (p=0.016) between patients with and without. For overall survival, box-counting dimensions (filter values = 0.5, 1.0, 1.5), Minkowski dimensions (filter values = 0.5, 1.5, 2.0, 2,5) and mass dimensions (filter values = 1.5, 2.0) were all significant (p<0.05). Conclusion: It is feasible to extract shape information by edge detection and fractal dimensions analysis in neo-adjuvant rectal cancer patients. This information can be used to prognosis prediction.

  7. Treatment of carpal tunnel syndrome with atgesia%感觉过敏型腕管综合征的治疗

    Institute of Scientific and Technical Information of China (English)

    顾玉东; 史其林; 陈德松; 王涛; 张丽银

    2008-01-01

    Objective To report the treatment of 7 cases of carpal tunnel syndrome(CTS)with algesia.Methods One hundred and twenty eight cases of carpal tunnel syndrome within the period of March 2002 and March 2005 were retrospectively analyzed.There were 7 cases(4 female and 3 male)had algesia,4 cases were treated with endoscopic management of carpal tunnel release (ECTR) and 3 cases were treated with open management of carpal tunnel release(OCTR).These 7 cases were followed-up 1-4years(average 1.5 years)postoperatively.Results Two ECTR cases and 2 OCTR cases had bad therapeutic effect and the others had good effect.Both 2 bad-effect ECTR cases feel special pain when insert the catheter.Only inject Triamcinolone Acetonide-A within epineurium after completely release in the goodeffect OCTR ease.Conclusion CTS with algesia is a special type of CTS,the key to treat it is to protect epineurium.%目的 报道7例感觉过敏型腕管综合征的诊治特点.方法 收集与分析2002年3月至2005年3月间128例腕管综合征中感觉过敏型7例的病情及治疗特点.其中女性4例、男性3例.4例应用内镜治疗,3例切开治疗,经1~4年随访,平均随访时间1.5年.结果 内镜治疗中2例疗效差,均在术中插入扩张导管时出现异常疼痛,另外2例基本满意.3例切开治疗中,2例疗效差,1例基本满意.3例基本满意中,2例内镜插入导管时均未出现疼痛,另1例为单纯切断腕横韧带,并在神经外膜下注射激素.结论 感觉过敏型腕管综合征是一组特殊病例,保护神经外膜是治疗关键.

  8. Expression of the stress-response regulators CtsR and HrcA in the uropathogen Staphylococcus saprophyticus during heat shock.

    Science.gov (United States)

    Rossi, Ciro César; de Oliveira, Lorayne Lauria; de Carvalho Rodrigues, Deivid; Ürményi, Turán Peter; Laport, Marinella Silva; Giambiagi-deMarval, Marcia

    2017-08-01

    The uropathogen Staphylococcus saprophyticus is an ubiquitous bacterium but little is known about mechanisms that allow its persistence in diverse environments. Here we evaluated S. saprophyticus growth and survival during heat shock, the expression of stress response regulators ctsR and hrcA through qRT-PCR and heat shock protein synthesis through (35)S-Met metabolic labeling. S. saprophyticus does not tolerate temperatures much higher than the optimal 37 °C, as its growth is greatly affected at 42 °C, though viability is maintained up to 48 °C. At 42 °C, the expression of ctsR and hrcA repressor genes approximately triple when compared to 37 °C and continue to increase together with temperature till 48 °C. Expression of hrcA peaks after 20 min of heat shock and decreases significantly after 30 min, indicating that heat stress response regulated by this gene may last 20-30 min. An increase in temperature is accompanied by the synthesis of at least eight proteins, three of which are likely the chaperones DnaK, GroEL and ClpB. In silico analysis indicate that the groEL gene may be regulated by HrcA, clpB by CtsR and dnaK by both repressors. This is the first work to discuss heat stress response in S. saprophyticus and a step forward in the understanding of mechanisms that make this a widespread and emergent pathogen.

  9. ANASTOMOSIS ENTRE LA RAMA PROFUNDA DEL NERVIO CUBITAL Y EL NERVIO MEDIANO EN LA MANO. Anastomosis between the deep branch of the ulnar nerve and the median nerve in the hand

    Directory of Open Access Journals (Sweden)

    Luis E Criado del Río

    2016-03-01

    Full Text Available Introducción: La anastomosis de Riche-Cannieu (ARC es una variación anatómica formada entre la rama tenar del nervio mediano (NM y la rama profunda del nervio cubital (NC. Debido a la importancia clínica y electromiográfica su descripción anatómica es de gran interés, ya que debido a esta variación anatómica existen distintas formas de inervación motora a nivel de la mano. Materiales y Métodos: Se realizaron disecciones cadavéricas en 38 manos (19 cadáveres de ambos sexos formolizados en solución al 5 %, de entre 50 y 70 años de edad. Se utilizó instrumental y técnicas convencionales de disección. Resultados: En la rama profunda del NC no se evidenciaron variaciones y finalizaba su recorrido en el músculo aductor del pulgar. En el 86,84%  de los casos emerge una rama que se anastomosa con el NM de diferentes formas. Esta rama anastomótica, en el 50% de las manos, era una arcada nerviosa de considerable calibre entre el NC y NM, que daba ramas motoras a los músculos de la eminencia tenar. Discusión: El conocimiento de esta anastomosis es muy importante ya que, en casos de lesión del nervio mediano o cubital, puede causar confusión clínica, quirúrgica y en los hallazgos electromiográficos. Debido a su alta frecuencia fue considerada un rasgo anatómico normal. Introduction: The Riche-Cannieu anastomosis (RCA is an anatomic variation formed between the thenar branch of the median nerve and the deep branch of the ulnar nerve. Its anatomical description is of great interest because of its clinical and electromyographic relevance. Due to the RCA, there are various types of hand motor innervation. Materials and Methods: Thirty eight hands from 19 corpses (formolized in a 5% solution whose ages ranged from 50 to 70 years old were dissected. Conventional instruments and techn-iques were used. Results: The pathway of the deep branch of the ulnar nerve did not show variations and ended at the adductor pollicis muscle. In 86

  10. DISPLASIA CUBITAL, PRESENTACIÓN CLÍNICA Y RESULTADOS EN UNA SERIE RETROSPECTIVA DE DIEZ AÑOS A ten year retrospective series of ulnar dysplasia: clinical presentation and treatment results

    Directory of Open Access Journals (Sweden)

    Enrique Vergara-Amador

    2010-01-01

    Full Text Available Antecedentes. La displasia cubital es una alteración en el desarrollo embriológico del lado cubital del antebrazo y la mano. Las deformidades comprometen manos, muñecas y codos; sólo el 11% de los pacientes tienen dedos completos y hasta el 38% de los casos cursan con sindactilias. Objetivo. Describir el perfil epidemiológico y las características clínicas, radiológicas y el tratamiento y los resultados en 14 niños. Material y métodos. Es un estudio descriptivo tipo serie de casos, retrospectivo 14 niños (18 miembros superiores, se evaluaron las características clínicas y radiológicas. Resultados. El compromiso bilateral fue del 28.5 %. Los tipos II y IV de Bayne fueron los predominantes con un 66.5%. Las cirugías múltiples fueron el 41%. Funcionalmente no fue posible homogeneizar un instrumento pre y posoperatorio. El tipo de pinza mejoró de lateral a bidigital o tridigital en el 72.2% de los pacientes, indicador de un progreso funcional significativo. El 84% presentó prensión buena y mejoría en las actividades básicas cotidianas. Conclusión. No existe una clasificación que pueda integrar la diversidad de anomalías. A pesar que la clasificación de Bayne engloba a una gran cantidad de ellos, hay unas difíciles de encasillar como algunos casos con similitud a focomelias y deficiencias transversas del antebrazo. El manejo es específico para cada caso en particular. Sabemos que el compromiso del codo y del primer metacarpiano, son determinantes en el pronóstico funcional. La mejoría de la pinza fue lograda en el 72.2% de los casos llevados a cirugía.Background. The ulnar deficiency is an alteration in the embryological development of the ulnar side of the forearm and the hand. The deformities affect hand, wrist and elbows; only 11% of the patients had complete fingers and 38% of the cases had syndactyly. Objective. Described the epidemiological profile and the clinical and radiological features and the results of

  11. 5-foot Vertical Wind Tunnel

    Science.gov (United States)

    1932-01-01

    The researcher is sitting above the exit cone of the 5-foot Vertical Wind Tunnel and is examining the new 6-component spinning balance. This balance was developed between 1930 and 1933. It was an important advance in the technology of rotating or rolling balances. As M.J. Bamber and C.H. Zimmerman wrote in NACA TR 456: 'Data upon the aerodynamic characteristics of a spinning airplane may be obtained in several ways; namely, flight tests with full-scale airplanes, flight tests with balanced models, strip-method analysis of wind-tunnel force and moment tests, and wind-tunnel tests of rotating models.' Further, they note: 'Rolling-balance data have been of limited value because it has not been possible to measure all six force and moment components or to reproduce a true spinning condition. The spinning balance used in this investigation is a 6-component rotating balance from which it is possible to obtain wind-tunnel data for any of a wide range of possible spinning conditions.' Bamber and Zimmerman described the balance as follows: 'The spinning balance consists of a balance head that supports the model and contains the force-measuring units, a horizontal turntable supported by streamline struts in the center of the jet and, outside the tunnel, a direct-current driving motor, a liquid tachometer, an air compressor, a mercury manometer, a pair of indicating lamps, and the necessary controls. The balance head is mounted on the turntable and it may be set to give any radius of spin between 0 and 8 inches.' In an earlier report, NACA TR 387, Carl Wenzinger and Thomas Harris supply this description of the tunnel: 'The vertical open-throat wind tunnel of the National Advisory Committee for Aeronautics ... was built mainly for studying the spinning characteristics of airplane models, but may be used as well for the usual types of wind-tunnel tests. A special spinning balance is being developed to measure the desired forces and moments with the model simulating the actual

  12. La introducción de las interacciones CTS en la enseñanza de las ciencias y su evolución

    OpenAIRE

    2000-01-01

    Summary In this work we research the use of the relationship STS in the Physics & Chemistry classes and we submit a proposal as well as the results derived from it. Then we analize how educative reforms introduce STS relatinships although teachers tend not to make any use of it. Resumen En este trabajo analizamos la utilización de las relaciones CTS en las clases de Física y Química y presentamos una propuesta para su intreoducción y los resultados obtenidos con ella. A continuación vemos cóm...

  13. Articulações entre o enfoque CTS e a pedagogia de Paulo Freire como base para o ensino de ciências

    OpenAIRE

    Tatiana Galieta Nascimento; Irlan von Linsingen

    2006-01-01

    En este artículo se presentan unas relaciones teóricas entre el enfoque CTS y la filosofía educacional de Paulo Freire. Se explotan tres puntos de convergencia que por supuesto no agotan las posibilidades de articulación en tre estas frentes pedagógicas y que no se quedan cerradas en sí mismas sino que dialogan en tre sí. Son ellos: (i) el abordaje temática y la selección de los contenidos y materiales didácticos; (ii) la perspectiva interdisciplinar del trabajo pedagógico y el papel de la ...

  14. Effects of CTS-PVA and P(AA-AM) water retaining agent on soil properties and growth of peanut seedlings%CTS-PVA和P(AA-AM)保水剂对土壤性质及花生生长的影响

    Institute of Scientific and Technical Information of China (English)

    陈嘉恒; 吴国杰; 陈宗发; 谢丰振; 何麟; 陈倩瑜

    2013-01-01

    利用土壤盆栽试验,就不同质量分数的壳聚糖-聚乙烯醇(Chitosan-Polyvinylalcohol,CTS-PVA)、聚丙烯酸-丙烯酰胺(Poly(acrylamide-co-acrylic acid),P(AA-AM))保水剂对土壤电导率、有机质含量,以及其对花生苗叶绿素、氮、磷、钾、铁、钙含量和植株生物量的影响.结果表明,于土壤中加入P(AA-AM),可使土壤的有机质含量和花生苗的叶绿素、氮、磷、钾、铁、钙含量和植株生物量等因素随着P(AA-AM)用量的增加而显著降低,并呈极显著的负相关,土壤的电导率随其用量的增加而增加.而于土壤中加入CTS-PVA,可使花生苗的叶绿素、氮、磷、钾、铁、钙含量和生物量等因素随着CTS-PVA的用量增加而显著增加,并呈极显著的正相关.当CTS-PVA用量超过质量分数2%时,各项指标开始下降,同时土壤有机质含量随其用量的增加而增加,电导率随其用量增加而降低.

  15. A Comparison of Boosting Tree and Gradient Treeboost Methods for Carpal Tunnel Syndrome

    Directory of Open Access Journals (Sweden)

    Gülhan OREKİCİ TEMEL

    2014-10-01

    Full Text Available Objective: Boosting is one of the most successful combining methods. The principal aim of these combining algorithms is to obtain a strong classifier with small estimation error from the combination of weak classifiers. Boosting based on combining tree has many advantages. Data sets can contain mixtures of nominal, ordinal and numerical variables. AdaBoost and Gradient TreeBoost are commonly used boosting procedure. Both methods are a stage wise additive model fitting procedure. Our goal in this study is to explain the both method and to compare the algorithm results on a neurology data set on the purpose of classification. Material and Methods: The data set consists of 4076 incidences in total. The condition of being a patient with Carpal Tunnel Syndrome (CTS or not was considered as the dependent variable. Boosting Tree and Gradient TreeBoost applications were conducted in Statistica 7.0 and Salford Predictive Modeler: TreeNet (R trial version 6.6.0.091. Results: In AdaBoost and Gradient TreeBoost algorithm, multiple trees are grown of the training data. 200 trees are produced for both models. 70 trees in the AdaBoost Algorithm and 196 trees in the Gradient TreeBoost algorithm are chosen as the optimal trees. Conclusion: The sensitivity or specify values in the test data of Gradient TreeBoost are high indicates that they can be used as a successful method in CTS diagnosis. . It is believed that the boosting methods will become very more and more popular in health science due to its easy implementation and high predictive performance.

  16. Submucosal tunneling techniques: current perspectives

    Directory of Open Access Journals (Sweden)

    Kobara H

    2014-04-01

    Full Text Available Hideki Kobara,1 Hirohito Mori,1 Kazi Rafiq,2 Shintaro Fujihara,1 Noriko Nishiyama,1 Maki Ayaki,1 Tatsuo Yachida,1 Tae Matsunaga,1 Johji Tani,1 Hisaaki Miyoshi,1 Hirohito Yoneyama,1 Asahiro Morishita,1 Makoto Oryu,1 Hisakazu Iwama,3 Tsutomu Masaki1 1Department of Gastroenterology and Neurology, 2Department of Pharmacology, 3Life Science Research Center, Faculty of Medicine, Kagawa University, Miki-cho, Kita-Gun, Kagawa, Japan Abstract: Advances in endoscopic submucosal dissection include a submucosal tunneling technique, involving the introduction of tunnels into the submucosa. These tunnels permit safer offset entry into the peritoneal cavity for natural orifice transluminal endoscopic surgery. Technical advantages include the visual identification of the layers of the gut, blood vessels, and subepithelial tumors. The creation of a mucosal flap that minimizes air and fluid leakage into the extraluminal cavity can enhance the safety and efficacy of surgery. This submucosal tunneling technique was adapted for esophageal myotomy, culminating in its application to patients with achalasia. This method, known as per oral endoscopic myotomy, has opened up the new discipline of submucosal endoscopic surgery. Other clinical applications of the submucosal tunneling technique include its use in the removal of gastrointestinal subepithelial tumors and endomicroscopy for the diagnosis of functional and motility disorders. This review suggests that the submucosal tunneling technique, involving a mucosal safety flap, can have potential values for future endoscopic developments. Keywords: submucosal endoscopy, submucosal tunneling method, natural orifice transluminal endoscopic surgery, peroral endoscopic myotomy, gastrointestinal subepithelial tumor, functional and motility disorders

  17. The diagnosis value of high frequency ultraosonographic measurements of the peng uplift rate of transverse carpal ligaments in CTS patients%超声检测腕横韧带膨隆率对腕管综合征的诊断意义

    Institute of Scientific and Technical Information of China (English)

    郭璇妍; 卢漫; 贺凡丁

    2013-01-01

    目的 探讨高频超声测量腕横韧带膨隆率对腕管综合征(carpal tunnel syndrome,CTS)的诊断意义.方法 42例经肌电图证实的CTS患者为观察组,同期健康自愿者36例为对照组,应用高频超声测量两组患者腕横韧带膨隆率,并进行比较.结果观察组豌豆骨水平腕横韧带膨隆率与对照组比较差异有显著统计学意义(P<0.01).结论 超声测量豌豆骨水平腕横韧带膨隆率是诊断CTS的一种新的有价值的方法,对治疗方式的选择有重要意义.

  18. A systematic review of outcomes assessed in randomized controlled trials of surgical interventions for carpal tunnel syndrome using the International Classification of Functioning, Disability and Health (ICF as a reference tool

    Directory of Open Access Journals (Sweden)

    Leite José

    2006-12-01

    Full Text Available Abstract Background A wide range of outcomes have been assessed in trials of interventions for carpal tunnel syndrome (CTS, however there appears to be little consensus on what constitutes the most relevant outcomes. The purpose of this systematic review was to identify the outcomes assessed in randomized clinical trials of surgical interventions for CTS and to compare these to the concepts contained in the International Classification of Functioning, Disability and Health (ICF. Methods The bibliographic databases Medline, AMED and CINAHL were searched for randomized controlled trials of surgical treatment for CTS. The outcomes assessed in these trials were identified, classified and linked to the different domains of the ICF. Results Twenty-eight studies were retrieved which met the inclusion criteria. The most frequently assessed outcomes were self-reported symptom resolution, grip or pinch strength and return to work. The majority of outcome measures employed assessed impairment of body function and body structure and a small number of studies used measures of activity and participation. Conclusion The ICF provides a useful framework for identifying the concepts contained in outcome measures employed to date in trials of surgical intervention for CTS and may help in the selection of the most appropriate domains to be assessed, especially where studies are designed to capture the impact of the intervention at individual and societal level. Comparison of results from different studies and meta-analysis would be facilitated through the use of a core set of standardised outcome measures which cross all domains of the ICF. Further work on developing consensus on such a core set is needed.

  19. SECUENCIAS DIALÓGICAS, LA DIMENSIÓN CTS Y ASUNTOS SOCIO-CIENTÍFICOS EN LA ENSEÑANZA DE LA QUÍMICA

    Directory of Open Access Journals (Sweden)

    Blanca Estela Zenteno-Mendoza

    2010-01-01

    Full Text Available Este trabajo describe el uso de secuencias de enseñanza y aprendizaje como una estrategia, basada en asuntos socio-científicos (ASC y argumentación, para introducir la dimensión CTS en un curso de química. En un aula-laboratorio del Colegio de Ciencias y Humanidades (CCH de la Universidad Nacional Autónoma de México(UNAM fueron aplicadas dos secuencias a un grupo de 30 estudiantes del tercer curso de bachillerato (17-18 años: la primera, sobre toxicología de metales pesados, en la unidad “Industria minero-metalúrgica: herencia no aprovechada” y la segunda sobre síntesis de polímeros en la unidad “El mundo de los polímeros”. El trabajo describe las secuencias de enseñanza-aprendizaje utilizadas en el aula y brinda algunas recomendaciones didácticas para su ulterior utilización como estrategia de enseñanza.Finalmente analiza la utilidad de este tipo de secuencias para la introducción de la dimensión CTS y de ASC vía la argumentación como una forma de enseñar en los cursos de química.

  20. Cross-cultural measurement equivalence of the Revised Conflict Tactics Scales (CTS2 Portuguese version used to identify violence within couples

    Directory of Open Access Journals (Sweden)

    Claudia Leite Moraes

    2002-06-01

    Full Text Available Following a previous evaluation of concept, item and semantic equivalences, this paper assesses the measurement equivalence between a Portuguese version of Revised Conflict Tactics Scales (CTS2 and the original instrument conceived in English. The CTS2 has been widely used to tap violence between couples. An intra-observer reliability evaluation involved 165 replications carried out within a 24-48 hour period. Kappa point-estimates were above 0.75 for all scales except sexual coercion. The analysis of internal consistency concerned 768 subjects with complete sets of items. Kuder-Richardson-20 estimates ranged from 0.65 to 0.86. Results were similar to those found in the original instrument in English for the negotiation, psychological aggression and physical violence scales, yet not so for the sexual coercion and injury scales. Factor analysis identified factors with a recognizable correspondence to the underlying dimensions, although a few inconsistencies were detected. For the assessment of construct validity (n = 528 associations between the instrument's scales were evaluated, as well as the relationships between violence and putative underlying dimensions. Overall, the findings suggest that the version can be used in the Brazilian context, although further investigation should be carried out to unveil some important remaining issues.

  1. Current noise in tunnel junctions

    Energy Technology Data Exchange (ETDEWEB)

    Frey, Moritz; Grabert, Hermann [Physikalisches Institut, Universitaet Freiburg, Hermann-Herder-Strasse 3, 79104, Freiburg (Germany)

    2017-06-15

    We study current fluctuations in tunnel junctions driven by a voltage source. The voltage is applied to the tunneling element via an impedance providing an electromagnetic environment of the junction. We use circuit theory to relate the fluctuations of the current flowing in the leads of the junction with the voltage fluctuations generated by the environmental impedance and the fluctuations of the tunneling current. The spectrum of current fluctuations is found to consist of three parts: a term arising from the environmental Johnson-Nyquist noise, a term due to the shot noise of the tunneling current and a third term describing the cross-correlation between these two noise sources. Our phenomenological theory reproduces previous results based on the Hamiltonian model for the dynamical Coulomb blockade and provides a simple understanding of the current fluctuation spectrum in terms of circuit theory and properties of the average current. Specific results are given for a tunnel junction driven through a resonator. (copyright 2016 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  2. 腕管综合征与尺神经腕部卡压相关性的神经电生理学分析%Electrophysiological analysis of relationship between carpal tunnel syndrome and ulnar nerve entrapment at wrist

    Institute of Scientific and Technical Information of China (English)

    刘晓琳; 殷文靖; 盛加根

    2011-01-01

    Objective To investigate the relationship between carpal tunnel syndrome (CTS) and ulnar nerve entrapment at wrist with neural eleetrophysiological methods. Methods Twenty patients ( 22 wrists) with CTS ( CTS group) and 20 healthy adults (20 wrists) (control group) were selected. Sensory conduction velocity, motor conduction velocity, distal sensory latency and distal motor latency of median nerve and ulnar nerve were measured and compared between two groups, and the differences in distal sensory latency between median nerve and ulnar nerve were calculated and compared between groups. Pearson correlation analysis was performed between sensory conduction velocity of median nerve and that of ulnar nerve in CTS group. Results Compared with control group, the sensory conduction velocity and motor conduction velocity of median nerve and the sensory conduction velocity of ulnar nerve were slower ( P 0.05). The difference in distal sensory latency between median nerve and ulnar nerve in CTS group was significantly larger than that in control group ( P < 0.05). Pearson correlation analysis revealed that the sensory conduction velocity of median nerve was significantly positively related to that of ulnar nerve in CTS group (r = 0. 802, P = 0.002). Conclusion There is correlation between CTS and ulnar nerve entrapment at wrist, and ulnar nerve entrapment at wrist should be attached great importance when dealing with patients with CTS.%目的 采用神经电生理学方法探讨腕管综合征(CTS)与尺神经腕部卡压的相关性.方法 选择20例(22腕)CTS患者(CTS组)和20名(20腕)健康成年志愿者(对照组),测量并比较两组正中神经和尺神经感觉传导速度、运动传导速度、感觉远端潜伏期和运动远端潜伏期,计算并比较正中神经与尺神经感觉远端潜伏期差值,对CTS组正中神经与尺神经感觉传导速度行Pearson相关分析.结果 与对照组比较,CTS组正中神经感觉和运动传导速度及尺神经

  3. Carpal tunnel syndrome with cervical spondylotic radiculopathy:a clinical and electrophysiological study%腕管综合征合并神经根型颈椎病的临床与电生理特点

    Institute of Scientific and Technical Information of China (English)

    汪仁斌; 刘尊敬; 汪伟; 董明睿; 孙少杰; 毛坤; 焦劲松; 严莉

    2015-01-01

    Objective To study the clinical and electrophysiological characteristics of carpal tunnel syndrome (CTS) with cervical spondylotic radiculopathy (CSR) and simple-CTS,and compare the effect of double crush with that of simple entrapment on a nerve and investigate the association between CTS and CSR.Method From January 2011 to August 2014,clinical data from 96 patients with double crush syndrome (DCS,CTS with CSR) and 165 patients with simple-CTS were examined,and the electrophysiologic parameters of median nerve in patients with DCS were compared with that in patients with simple-CTS.Results In 96 patients with DCS,most of them were female;neck and shoulder pain or simultaneously accompanied by numbness and pain of upper limb was observed in 34 patients,upper limb symptoms and hand weakness and muscle atrophy were observed in the other 62 patients,124 median nerves with abnormal conduction were found in these DCS patients,including 68 cases with unilateral abnormalities and 28 cases with bilateral abnormalities.Cervical radiculopathies of the C5-7 mainly involved in patients with DCS.223 median nerves with abnormal conduction found in the 165 patients with simple-CTS,including 107 cases with unilateral abnormalities and 58 cases with bilateral abnormalities.The average sensory nerve conduction velocity (SCV),motor nerve conduction velocity (MCV) and distal motor latency (DML) of median nerve for DCS and simple-CTS were(32 ±7) m/s vs (35 ±5) m/s,(55 ±7) m/s vs (57 ±5) m/s and (4.6 ± 1.6) ms vs (4.0 ± 0.8) ms,respectively,and their corresponding amplitudes were 6.4 μV vs 9.5 μV,10.9 mV vs 13.1 mV and 11.3 mV vs 14.1 mV,respectively.The SCV,MCV and DML and their corresponding amplitude of DCS were significantly greater decreased than that of simple-CTS (P < 0.01).Conclusion DCS is a common clinical syndrome,and patients with DCS may have neck and shoulder symptoms in addition to the common manifestations of simple-CTS.Abnormal conduction of median nerve of

  4. TunnelVision: LHC Tunnel Photogrammetry System for Structural Monitoring

    CERN Document Server

    Fallas, William

    2014-01-01

    In this document an algorithm to detect deformations in the LHC Tunnel of CERN is presented. It is based on two images, one represents the ideal state of the tunnel and the other one the actual state. To find the differences between both, the algorithm is divided in three steps. First, an image enhancement is applied to make easier the detection. Second, two different approaches to reduce noise are applied to one or both images. And third, it is defined a group of characteristics about the type of deformation desired to detect. Finally, the conclusions show the effectiveness of the algorithm in the experimental results.

  5. Clinical value of CTS-guided percutaneous transthoracic biopsy in elder patients with lung cancer%CT模拟定位系统引导下经皮肺穿刺在老年肺癌的应用价值

    Institute of Scientific and Technical Information of China (English)

    Zhijun Yuan; Yi Luo

    2009-01-01

    Objective: To evaluate the value of CTS-guided percutaneous transthoracic biopsy for the diagnosis of pulmo-nary lesions in elder patients. Methods: The intact data of 78 elder patients underwent percutaneous pulmonary biopsy with a spring-core biopsy needle under CTS guidance were analyzed. The diagnosis of all the cases was confirmed by pathology and follow-up. Results: Ninety-five lung biopsies were performed in 78 cases and satisfactory tissue specimens obtained in all cases, the success rate was 100%. The diagnosis for malignant tumors and benign lesions was 72 and 6, respectively. The overall accuracy rate was 100%. Pneumothorax was noted in 5 cases (6.4%) and hemoptysis seen in 10 patients (12.8%). Conclusion: CTS-guided percutaneous transthoracic biopsy with a spring-core biopsy needle are accurate, safe and quick for pulmonary lesions in elder patients.

  6. Design of tunneling injection quantum dot lasers

    Institute of Scientific and Technical Information of China (English)

    JIA Guo-zhi; YAO Jiang-hong; SHU Yong-chun; WANG Zhan-guo

    2007-01-01

    To implement high quality tunneling injection quantum dot lasers,effects of primary factors on performance of the tunneling injection quantum dot lasers were investigated. The considered factors were tunneling probability,tunneling time and carriers thermal escape time from the quantum well. The calculation results show that with increasing of the ground-state energy level in quantum well,the tunneling probability increases and the tunneling time decreases,while the thermal escape time decreases because the ground-state energy levelis shallower. Longitudinal optical phonon-assisted tunneling can be an effective method to solve the problem that both the tunneling time and the thermal escape time decrease simultaneously with the ground-state energy level increasing in quantum well.

  7. Tunneling field effect transistor technology

    CERN Document Server

    Chan, Mansun

    2016-01-01

    This book provides a single-source reference to the state-of-the art in tunneling field effect transistors (TFETs). Readers will learn the TFETs physics from advanced atomistic simulations, the TFETs fabrication process and the important roles that TFETs will play in enabling integrated circuit designs for power efficiency. · Provides comprehensive reference to tunneling field effect transistors (TFETs); · Covers all aspects of TFETs, from device process to modeling and applications; · Enables design of power-efficient integrated circuits, with low power consumption TFETs.

  8. Quantum Cosmology for Tunneling Universes

    CERN Document Server

    Kim, Sang Pyo

    2004-01-01

    In a quantum cosmological model consisting of a Euclidean region and a Lorentzian region, Hartle-Hawking's no-bounary wave function, and Linde's wave function and Vilenkin's tunneling wave function are briefly described and compared with each other. We put a particular emphasis on semiclassical gravity from quantum cosmology and compare it with the conventional quantum field theory in curved spacetimes. Finally, we discuss the recent debate on catastrophic particle production in the tunneling universe between Rubakov and Vilenkin within the semiclassical gravity.

  9. Spin tunnelling in mesoscopic systems

    Indian Academy of Sciences (India)

    Anupam Garg

    2001-02-01

    We study spin tunnelling in molecular magnets as an instance of a mesoscopic phenomenon, with special emphasis on the molecule Fe8. We show that the tunnel splitting between various pairs of Zeeman levels in this molecule oscillates as a function of applied magnetic field, vanishing completely at special points in the space of magnetic fields, known as diabolical points. This phenomena is explained in terms of two approaches, one based on spin-coherent-state path integrals, and the other on a generalization of the phase integral (or WKB) method to difference equations. Explicit formulas for the diabolical points are obtained for a model Hamiltonian.

  10. Tunneling in high-K isomeric decays

    CERN Document Server

    Shizuma, T; Shimizu, Y R

    2002-01-01

    We have systematically investigated highly-K-forbidden transitions observed in the Hf, W and Os region, using the gamma-tunneling model in which low-K and high-k states interact through a process of quantum tunneling. The measured hindrance factors are compared with the values calculated using the gamma-tunneling model. Isotope dependences of gamma-tunneling probabilities particularly for neutron-rich nuclei and the relation to stimulated decays of isomers are discussed. (author)

  11. Drill and blast tunnelling; Konvensjonell drift av tunneler

    Energy Technology Data Exchange (ETDEWEB)

    Roenn, Paal-Egil

    1997-12-31

    This thesis treats drill and blast tunnelling. The rapid technological advance necessitates revised and updated design criteria, quality requirements and quality control. In situ blast experiments were carried out in order to test new methods and improve the basis for calculation and design. The main topics of the experiments were (1) longer rounds and increased drillhole diameter, (2) emulsion slurry as explosives in tunnelling, and (3) electronic detonators in contour blasting. The experiments show that it is technically feasible to blast rounds of up to 8.6 m length. Using current technology, the economical optimum round length is substantially shorter. Dust, low visibility, noise and toxic fumes are occupational environmental strains for the tunnel workers. Several of the environmental factors are strongly influenced by the type of explosives used. For example, emulsion slurry resulted in 4 to 5 times better visibility than Anolit and the concentration of respirable dust and total dust was reduced by 30-50 %. Electronic detonators were tested and found to give a higher percentage of remaining drillholes in the contour than Nonel detonators. The thesis includes a chapter on economic design of hydropower tunnels. 42 refs., 83 figs., 45 tabs.

  12. Ultrasound assessment on selected peripheral nerve pathologies. Part I: Entrapment neuropathies of the upper limb - excluding carpal tunnel syndrome.

    Science.gov (United States)

    Kowalska, Berta; Sudoł-Szopińska, Iwona

    2012-09-01

    Ultrasound (US) is one of the methods for imaging entrapment neuropathies, post-traumatic changes to nerves, nerve tumors and postoperative complications to nerves. This type of examination is becoming more and more popular, not only for economic reasons, but also due to its value in making accurate diagnosis. It provides a very precise assessment of peripheral nerve trunk pathology - both in terms of morphology and localization. During examination there are several options available to the specialist: the making of a dynamic assessment, observation of pain radiation through the application of precise palpation and the comparison of resultant images with the contra lateral limb. Entrapment neuropathies of the upper limb are discussed in this study, with the omission of median nerve neuropathy at the level of the carpal canal, as extensive literature on this subject exists. The following pathologies are presented: pronator teres muscle syndrome, anterior interosseus nerve neuropathy, ulnar nerve groove syndrome and cubital tunnel syndrome, Guyon's canal syndrome, radial nerve neuropathy, posterior interosseous nerve neuropathy, Wartenberg's disease, suprascapular nerve neuropathy and thoracic outlet syndrome. Peripheral nerve examination technique has been presented in previous articles presenting information about peripheral nerve anatomy [Journal of Ultrasonography 2012; 12 (49): 120-163 - Normal and sonographic anatomy of selected peripheral nerves. Part I: Sonohistology and general principles of examination, following the example of the median nerve; Part II: Peripheral nerves of the upper limb; Part III: Peripheral nerves of the lower limb]. In this article potential compression sites of particular nerves are discussed, taking into account pathomechanisms of damage, including predisposing anatomical variants (accessory muscles). The parameters of ultrasound assessment have been established - echogenicity and echostructure, thickness (edema and related increase

  13. Axonal degeneration in association with carpal tunnel syndrome Degeneração axonal na síndrome do túnel do carpo

    Directory of Open Access Journals (Sweden)

    Marcelo Ribeiro Caetano

    2003-03-01

    Full Text Available Median nerve entrapment in the palm to wrist segment is known as carpal tunnel syndrome (CTS. Electromyography is the best evaluation test to confirm the disease, as it shows a median reduced conduction velocity and/or conduction block; however, the usual CTS electrodiagnostic tests do not separate segmental demyelination alone from segmental demyelination plus secondary axonal degeneration. We studied 100 hands from CTS patients (classified as mild, moderate, and severe, and 50 hands from normal subjects. The median palmar sensory nerve action potential (SNAP amplitude was measured and compared between the two groups. It would be expected that SNAP was normal if no axonal degeneration had occurred. The results showed that in mild CTS group and part of moderate CTS group SNAP amplitude was normal, whereas in severe CTS group, and part of moderate group SNAP amplitude was reduced, proving that axonal degeneration was involved. As it is well stated that axonal lesions have worse prognosis than segmental demyelinating ones, this simple test may help to preditic the CTS outcome and treatment.A compressão do nervo mediano no segmento punho-palma produz uma entidade clínica conhecida como síndrome do túnel do carpo (STC. A eletroneuromiografia é o exame de escolha para o diagnóstico da STC, através da identificação de diminuição de velocidade e/ou bloqueio de condução quando estudamos a neurocondução do nervo mediano, no trecho do punho. Entretanto, as técnicas comumente usadas não conseguem separar a lesão em mielínica focal com ou sem degeneração axonal secundária. Avaliamos 100 mãos de pacientes com STC e comparamos com 50 mãos de um grupo controle. Medimos a amplitude do potencial de ação do nervo sensitivo do mediano, com estímulo na palma e captação no dedo, e comparamos entre os grupos controle e de pacientes (o grupo de STC foi subdividido em leve, moderado e grave. Era esperado que a amplitude do potencial

  14. Fiber coupled ultrafast scanning tunneling microscope

    DEFF Research Database (Denmark)

    Keil, Ulrich Dieter Felix; Jensen, Jacob Riis; Hvam, Jørn Märcher

    1997-01-01

    We report on a scanning tunneling microscope with a photoconductive gate in the tunneling current circuit. The tunneling tip is attached to a coplanar transmission line with an integrated photoconductive switch. The switch is illuminated through a fiber which is rigidly attached to the switch...

  15. Tunnel Face Stability & New CPT Applications

    NARCIS (Netherlands)

    Broere, W.

    2001-01-01

    Nearly all tunnels bored in soft soils have encountered problems with the stability of the tunnel face. In several cases these problems led to an extended stand-still of the boring process. A better understanding of the face stability, and of the soil conditions around the tunnel boring machine, can

  16. A Wind Tunnel Captive Aircraft Testing Technique

    Science.gov (United States)

    1976-04-01

    Flight/Wind Tunnel Correlation of Aircraft Longitudinal Motion ....................................... 14 10. Fright/Wind Tunnel Correlation of...I 2 3 4 5 6 T IME, s e c Figure 9. Flight/wind tunnel correla- tion of aircraft longitudinal motion. ’ D A n ~ v i i i | ~ 0 0 - 4 0

  17. Femtosecond tunneling response of surface plasmon polaritons

    DEFF Research Database (Denmark)

    Keil, Ulrich Dieter Felix; Ha, Taekjip; Jensen, Jacob Riis

    1998-01-01

    We obtain femtosecond (200 fs) time resolution using a scanning tunneling microscope on surface plasmon polaritons (SPPs) generated by two 100 fs laser beams in total internal reflection geometry. The tunneling gap dependence of the signal clearly indicates the tunneling origin of the signal...

  18. The road safety of motorway tunnels.

    NARCIS (Netherlands)

    2009-01-01

    This fact sheet discusses the safety of motorway tunnels in the Netherlands. Broadly speaking, it is not certain whether crashes in the Netherlands are relatively more frequent in tunnels than on open road stretches. However, there are certain factors that increase the risk in tunnels, such as the p

  19. 腕管综合征279例神经电生理分析%Electrophysiological study on 279 patients with carpal tunnel syndrome

    Institute of Scientific and Technical Information of China (English)

    羊洁; 刘英; 邹艺; 李素荣; 胥勋成; 冯建华

    2016-01-01

    目的:探讨电生理检查指标在腕管综合征( CTS)诊断中的应用价值。方法以CTS患者279例为观察组,健康志愿者228例为对照组,行神经电生理检测。结果两组末梢运动潜伏期(DML)、复合肌肉动作电位(CMAP)波幅、前臂段运动传导速度(fMCV)、感觉神经动作电位(SNAP)波幅及腕-食指感觉传导速度(SCV)比较,差异均有统计学意义(P<0.05);尺神经电生理指标间差异均无统计学意义(P>0.05)。结论 CTS的诊断需要结合多项电生理检查指标以减少疾病的漏诊。%Objective To evaluate the application value of the electrophysiological examination index in the diagnosis of carpal tunnel syndrome ( CTS) .Methods Total of 279 CTS patients were used as observation group and 228 healthy volunteers were served as control group.Routine nerve conduction studies were performed in the both groups.Results There were significant differences in distal motor lantency ( DML) ,compound muscle action potential ( CMAP) amplitude,forearm period of motor conduction velocity ( FM-CV),sensory nerve action potential (SNAP) amplitude and finger-wrist sensory conduction velocity (SCV) between the two groups (P0.05).Conclusion We need the combination of a number of electro-physiological parameters to improve the diagnostic technology of CTS.

  20. Time tunnels meet warped passages

    CERN Multimedia

    Kushner, David

    2006-01-01

    "Just in time for its 40th anniversary, the classic sci-fi television show "The time tunnel" is out on DVD. The conceit is something every engineer can relate to: a pulled plug. Scientists in an underground lab are working on a secret government experiment in time travel. (1 page)