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Sample records for median nerve entrapment

  1. A study of median nerve entrapment neuropathy at wrist in uremic patients

    OpenAIRE

    2015-01-01

    Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy seen in uremic patients. The study was undertaken to estimate the frequency of CTS in uremic patients and to identify the most sensitive electrodiagnostic test. Study was conducted on 80 subjects of age 30–60 years. End-stage kidney disease patients were recruited for the clinical evaluation, motor nerve conduction studies (NCS), sensory NCS, F wave study and median-versus-ulnar comparison studies (palm-to-wrist mixed compa...

  2. A study of median nerve entrapment neuropathy at wrist in uremic patients.

    Science.gov (United States)

    Shende, V S; Sharma, R D; Pawar, S M; Waghmare, S N

    2015-01-01

    Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy seen in uremic patients. The study was undertaken to estimate the frequency of CTS in uremic patients and to identify the most sensitive electrodiagnostic test. Study was conducted on 80 subjects of age 30-60 years. End-stage kidney disease patients were recruited for the clinical evaluation, motor nerve conduction studies (NCS), sensory NCS, F wave study and median-versus-ulnar comparison studies (palm-to-wrist mixed comparison study, digit 4 sensory latencies study and lumbrical-interossei comparison study). Among three different diagnostic modalities, frequency of CTS was found to be 17.5% with clinical evaluation, 15% with routine NCS studies and 25% with median-versus-ulnar comparison studies. Among the median-versus-ulnar comparison studies, lumbrical-interossei comparison study was found to be most sensitive (90%). The comparative tests for CTS are more sensitive compared to routine NCS and clinical examination. Among the comparative tests, lumbrical-interossei comparison study is the most sensitive. Early diagnosis of CTS may help patients of uremia to seek proper treatment at an appropriate time.

  3. Cutaneous nerve entrapment syndrome

    Institute of Scientific and Technical Information of China (English)

    DongFuhui

    2004-01-01

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

  4. Unilateral axillary arch with two slips entrapping neurovascular bundle in axilla and its innervation by the median nerve

    Directory of Open Access Journals (Sweden)

    Somayaji SN

    2009-10-01

    Full Text Available Axillary arch is an additional muscle bundle of various dimensions extending usually from the latissimus dorsi in the posterior fold of the axilla, to the pectoralis major or other neighboring muscles and bones. In the present case presence of such unusual axillary arch innervated by the median nerve has been reported. During routine dissection of axilla region in one of the upper limbs, the occurrence of axillary arch was observed. The muscle fibers were arising from the belly of latissimus dorsi and were getting inserted to the tendon of coracobrachilais and lateral lip of bicipital groove. As it passed through the axilla it divided into 2 slips, enclosing the axillary vessels and nerves related to them. The fleshy fibers of the axillary arch were innervated by 2 small twigs from the median nerve. Though the occurrence of the axillary arch is very common, axillary arch with 2 slips getting innervated by the median nerve is not been reported so far. Further, a detailed literature review was done and the surgical and clinical importance of the case was discussed.

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

    Institute of Scientific and Technical Information of China (English)

    刘鹏程; 王克利; 宫旭; 路来金; 崔建礼; 蒋子平

    2013-01-01

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

  6. Ulnar nerve entrapment by anconeus epitrochlearis ligament.

    LENUS (Irish Health Repository)

    Tiong, William H C

    2012-01-01

    Ulnar nerve entrapment at the elbow is the second most common upper limb entrapment neuropathy other than carpal tunnel syndrome. There have been many causes identified ranging from chronic aging joint changes to inflammatory conditions or systemic disorders. Among them, uncommon anatomical variants accounts for a small number of cases. Here, we report our experience in managing ulnar nerve entrapment caused by a rare vestigial structure, anconeus epitrochlearis ligament, and provide a brief review of the literature of its management.

  7. Medial and Lateral Plantar Nerve Entrapment

    Science.gov (United States)

    ... Foot Problems Overview of Foot Problems Achilles Tendon Bursitis Achilles Tendon Enthesopathy Bunion Corns and Calluses Damage ... the Foot Freiberg Disease Hammer Toe Inferior Calcaneal Bursitis Medial and Lateral Plantar Nerve Entrapment Metatarsal Joint ...

  8. 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.

  9. Unusual course of the median nerve

    Directory of Open Access Journals (Sweden)

    Vashishtha K

    2010-12-01

    Full Text Available One extremely unusual observation has been reported in this case report. During dissection of left hand of an adult human cadaver we found median nerve passing through the substance of flexor retinaculum. Median nerve coursed through the entire extent of flexor retinaculum in a fascial canal. No other structure was found along with nerve in the fascial canal. After emerging from the flexor retinaculum median nerve took its usual course in the hand. To the best of our knowledge this kind of variant median nerve course has not been described in published literature.

  10. MR imaging evaluation of suprascapular nerve entrapment

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    Ludig, T.; Walter, F.; Roland, J.; Blum, A. [Service d' Imagerie Guilloz, Hopital Central, Nancy (France); Chapuis, D. [Centre de Reeducation Fonctionnelle, Hospitalor, Forbach (France); Mole, D. [Clinique de Traumatologie et d' Orthopedie, Nancy (France)

    2001-11-01

    The aim of this study was to assess the significance of muscular edema, atrophy, and fatty changes in the diagnosis of suprascapular nerve entrapment (SSNE), and to confirm muscular edema as the most significant sign of neuropathy. A retrospective study of 18 patients with suprascapular nerve entrapment was performed. All patients underwent electromyographic studies and MR imaging with a 1.5-T Echo Speed system (General Electric, Milwaukee, Wis.). The diagnosis of muscle edema was reached when muscles presented a high signal on T2-weighted fast spin-echo (SE) fat-suppressed images. Muscular trophicity and fatty changes were analyzed on a sagittal oblique cut using SE T1-weighted images. Intra- and inter-observer reproducibility using kappa test, sensitivity, and specificity were analyzed, together with negative and positive predictive value of each criterion. The topographic diagnosis was correct as edema affected the infraspinatus muscle alone when the suprascapular nerve was entrapped at the spinoglenoid notch. Both the supraspinatus and infraspinatus muscles were affected when nerve was compressed at the suprascapular notch. Sensitivity and specificity of muscular edema were, respectively, 94.5 and 100%. Muscular atrophy sensitivity and specificity were 81 and 80%, respectively. Fatty changes sensitivity and specificity were 25 and 96%, respectively. Muscular edema seems to be a more sensitive sign of SSNE than muscle atrophy and fatty changes when compared with EMG results. Magnetic resonance imaging can reach a positive, topographic, and etiologic diagnosis of SSNE. (orig.)

  11. [Nerve entrapment syndrome of the elbow and forearm].

    Science.gov (United States)

    Allieu, Y; Amara, B

    2002-02-01

    In this study we will discuss entrapment of the median, ulnair, radial and lateral antebrachial nerves of the elbow and the forearm. Compression of the nerves may occur when they traverse a tunnel and an incompatibility exists between the diameter of the tunnel and its contents (e.g. nerves, tendons,...). However, at the elbow and the forearm the nerves are also exposed to particularly dynamic compressions. This is due to anatomical relationships changing between the nerve and its surrounding muscles, tendons and aponevroses during the motion of flexion-extension of the elbow and the prono-supination of the forearm. The possibility of this dynamic factor should be thoroughly explored during the examination through appropriate dynamic tests as described in this study.

  12. Anterior cutaneous nerve entrapment syndrome: management challenges

    Directory of Open Access Journals (Sweden)

    Chrona E

    2017-01-01

    Full Text Available Eleni Chrona,1,2 Georgia Kostopanagiotou,1 Dimitrios Damigos,3 Chrysanthi Batistaki1 1Second Department of Anesthesiology, School of Medicine, National and Kapodistrian University of Athens, “Attikon” Hospital, Athens, 2Department of Anesthesiology, General Hospital of “Ag. Panteleimon,” Piraeus, 3Department of Medical Psychology, Medical School of Ioannina, University of Ioannina, Ioannina, Greece Abstract: Anterior cutaneous nerve entrapment syndrome (ACNES is a commonly underdiagnosed and undertreated chronic state of pain. This syndrome is characterized by the entrapment of the cutaneous branches of the lower thoracoabdominal intercostal nerves at the lateral border of the rectus abdominis muscle, which causes severe, often refractory, chronic pain. This narrative review aims to identify the possible therapeutic strategies for the management of the syndrome. Seventeen studies about ACNES therapy were reviewed; of them, 15 were case–control studies, case series, or case reports, and two were randomized controlled trials. The presently available management strategies for ACNES include trigger point injections (diagnostic and therapeutic, ultrasound-guided blocks, chemical neurolysis, and surgical ­neurectomy, in combination with systemic medication, as well as some emerging techniques, such as radiofrequency ablation and neuromodulation. An increased awareness of the syndrome and the use of specific diagnostic criteria for its recognition are required to facilitate an early and successful management. This review compiles the proposed ­management strategies for ACNES. Keywords: anterior cutaneous nerve entrapment syndrome, intercostal, neuralgia, management

  13. Mandibular nerve entrapment in the infratemporal fossa.

    Science.gov (United States)

    Piagkou, Maria N; Demesticha, T; Piagkos, G; Androutsos, G; Skandalakis, P

    2011-05-01

    The posterior trunk of the mandibular nerve (V(3)) comprises of three main branches. Various anatomic structures may entrap and potentially compress the mandibular nerve branches. A usual position of mandibular nerve (MN) compression is the infratemporal fossa (ITF) which is one of the most difficult regions of the skull base to access surgically. The anatomical positions of compression are: the incomplete or complete ossified pterygospinous (LPs) or pterygoalar (LPa) ligament, the large lamina of the lateral plate of the pterygoid process and the medial fibres of the lower belly of the lateral pterygoid (LPt). A contraction of the LPt, due to the connection between nerve and anatomic structures (soft and hard tissues), might lead to MN compression. Any variations of the course of the MN branches can be of practical significance to surgeons and neurologists who are dealing with this region, because of possibly significant complications. The entrapment of the MN motor branches can lead to paresis or weakness in the innervated muscle. Compression of the sensory branches can provoke neuralgia or paraesthesia. Lingual nerve (LN) compression causes numbness, hypoesthesia or even anaesthesia of the mucous of the tongue, anaesthesia and loss of taste in the anterior two-thirds of the tongue, anaesthesia of the lingual gums, as well as pain related to speech articulation disorders. Dentists should be very suspicious of possible signs of neurovascular compression in the region of the ITF.

  14. The Ultrasonographic Findings of Bifid Median Nerve

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-09-15

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

  15. Shoulder posture and median nerve sliding

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    Dilley Andrew

    2004-07-01

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

  16. Femoral nerve entrapment: a new insight.

    Science.gov (United States)

    Vázquez, M T; Murillo, J; Maranillo, E; Parkin, I G; Sanudo, J

    2007-03-01

    Compression of the femoral nerve in the iliac fossa has been reported as a consequence of several pathologies, but never as a result of muscular compression. Aberrant slips of iliacus, however, have occasionally been reported to cover or split the femoral nerve. This study aimed to assess such variations as potential factors in femoral nerve compression. A large and homogeneous sample of 121 embalmed cadavers (242 specimens) was studied. Statistical comparisons were made using the chi-squared test. Muscular slips from iliacus and psoas, piercing or covering the femoral nerve, were found in 19 specimens (7.9%). No significant differences by sex or side were found. The more frequent variation was piercing of the femoral nerve by a muscular slip (17 specimens, 7.0%). The nerve then entered the thigh as one or more branches. The less frequent variation found was a muscular slip or sheet covering the femoral nerve as it lay on iliacus (2 specimens, 0.8%). Each disposition may be a potential risk for nerve entrapment.

  17. Four communications between median and musculocutaneous nerves

    Directory of Open Access Journals (Sweden)

    Shukla L

    2010-11-01

    Full Text Available The present article is in reference to a case, encountered in routine dissection, displaying four sites of communication between the musculocutaneous and the median nerves, whereas in the literature not more than two communications have been reported.

  18. Anterior cutaneous nerve entrapment syndrome: management challenges

    Science.gov (United States)

    Chrona, Eleni; Kostopanagiotou, Georgia; Damigos, Dimitrios; Batistaki, Chrysanthi

    2017-01-01

    Anterior cutaneous nerve entrapment syndrome (ACNES) is a commonly underdiagnosed and undertreated chronic state of pain. This syndrome is characterized by the entrapment of the cutaneous branches of the lower thoracoabdominal intercostal nerves at the lateral border of the rectus abdominis muscle, which causes severe, often refractory, chronic pain. This narrative review aims to identify the possible therapeutic strategies for the management of the syndrome. Seventeen studies about ACNES therapy were reviewed; of them, 15 were case–control studies, case series, or case reports, and two were randomized controlled trials. The presently available management strategies for ACNES include trigger point injections (diagnostic and therapeutic), ultrasound-guided blocks, chemical neurolysis, and surgical neurectomy, in combination with systemic medication, as well as some emerging techniques, such as radiofrequency ablation and neuromodulation. An increased awareness of the syndrome and the use of specific diagnostic criteria for its recognition are required to facilitate an early and successful management. This review compiles the proposed management strategies for ACNES. PMID:28144159

  19. Chronic nerve root entrapment: compression and degeneration

    Science.gov (United States)

    Vanhoestenberghe, A.

    2013-02-01

    Electrode mounts are being developed to improve electrical stimulation and recording. Some are tight-fitting, or even re-shape the nervous structure they interact with, for a more selective, fascicular, access. If these are to be successfully used chronically with human nerve roots, we need to know more about the possible damage caused by the long-term entrapment and possible compression of the roots following electrode implantation. As there are, to date, no such data published, this paper presents a review of the relevant literature on alternative causes of nerve root compression, and a discussion of the degeneration mechanisms observed. A chronic compression below 40 mmHg would not compromise the functionality of the root as far as electrical stimulation and recording applications are concerned. Additionally, any temporary increase in pressure, due for example to post-operative swelling, should be limited to 20 mmHg below the patient’s mean arterial pressure, with a maximum of 100 mmHg. Connective tissue growth may cause a slower, but sustained, pressure increase. Therefore, mounts large enough to accommodate the root initially without compressing it, or compliant, elastic, mounts, that may stretch to free a larger cross-sectional area in the weeks after implantation, are recommended.

  20. Radial nerve entrapement in osseous tunnel without clinical symptoms

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    Purnima Patni

    2011-01-01

    Full Text Available Entrapment of a nerve in the callus of a healing fracture is not a common entity, but it does exist. The entrapment usually presents without neurological deficit. It is difficult to suspect the radial nerve injury if we need to operate on the same site. We present a case of entrapment of radial nerve in the callus of a supracondylar humerus fracture with cubitus varus deformity. The surgery for correction of the deformity led to the damage of the nerve. In retrospect a careful assessment of the x-rays showed two 3-4 mm diameter holes. Awareness of this finding would have given us sufficient indication of nerve entrapment to prevent this mishap.

  1. Unusual presentation of multiple nerve entrapment: a case report

    OpenAIRE

    2014-01-01

    Cubital tunnel syndrome is the most common form of ulnar nerve entrapment and the second most common entrapment neuropathy of the upper extremity after carpal tunnel syndrome. However, bilateral compressive ulnar neuropathy is a rare condition. Electro diagnostic studies are a valid and reliable means of confirming the diagnosis.

  2. Intraneural fibroma of the median nerve at the wrist.

    Science.gov (United States)

    Burrows, Anthony M; Folpe, Andrew L; Wenger, Doris E; Spinner, Robert J

    2014-06-01

    Distal median neuropathy from carpal tunnel syndrome is the most well known lesion affecting the median nerve. Mass lesions may affect the nerve at the wrist. We present to our knowledge the first histologically confirmed case of an intraneural fibroma.

  3. Outcome of contralateral C7 nerve transferring to median nerve

    Institute of Scientific and Technical Information of China (English)

    GAO Kai-ming; LAO Jie; ZHAO Xin; GU Yu-dong

    2013-01-01

    Background Contralateral C7 (cC7) transfer had been widely used in many organizations in the world,but the outcomes were significantly different.So the purpose of the study was to evaluate the outcome of patients treated with cC7 transferring to median nerve and to determine the factors affecting the outcome of this procedure.Methods A retrospective review of 51 patients with total root avulsion brachial plexus injuries who underwent cC7 transfer was conducted.All of the surgeries were performed with two surgery stages and median nerve was the recipient nerve.The cC7 nerve was used in three different ways.The entire C7 root was used in 11 patients; the posterior division together with the lateral part of the anterior division was used in 15 patients; the anterior or the posterior division alone was used in 25 patients.The mean follow-up period was 6.9 years.Results The efficiency of the surgery in these 51 patients was 49.02% in motor and 62.75% in sensory function.The patients with entire C7 root transfer obtained significantly better recovery in both motor and sensory function than the patients with partial C7 transfer.The best function recovery could be induced if the interval between the two surgery stages was 4-8 months.Conclusions cC7 transfer is an effective procedure in repairing median nerve.But using the entire C7 root transfer can obtain better recovery; so we emphasize using the entire root as the donor.The optimal interval between two surgery stages is 4-8 months.

  4. Concurrent Variations of Lateral Pectoral, Median, and Musculocutaneous Nerves

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    Satheesha B Nayak

    2017-01-01

    Full Text Available Brachial plexus frequently presents variations of its cords and branches. We saw concurrent variations of lateral pectoral, median and musculocutaneous nerves. There were two lateral pectoral nerves. Median nerve was formed by the union of 3 roots; two lateral roots and one medial root. Medial root arose from the ulnar nerve. Musculocutaneous nerve did not pierce the coracobrachialis muscle. There was a thick communicating branch between the musculocutaneous and median nerves. Though there are reports on individual variations mentioned above, it is very rare to see all of them in the same individual. Knowledge of these variations may be handy in axillary lymph node clearance and performing nerve blocks

  5. Lingual Nerve Entrapment in Muscular and Osseous Structures

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    Piagkou, Maria; Demesticha, Theano; Piagkos, Giannoulis; Georgios, Androutsos; Panagiotis, Skandalakis

    2010-01-01

    Running through the infratemporal fossa is the lingual nerve (i.e. the third branch of the posterior trunk of the mandibular nerve). Due to its location, there are various anatomic structures that might entrap and potentially compress the lingual nerve. These anatomical sites of entrapment are: (a) the partially or completely ossified pterygospinous or pterygoalar ligaments; (b) the large lamina of the lateral plate of the pterygoid process; and (c) the medial fibers of the anterior region of the lateral pterygoid muscle. Due to the connection between these nerve and anatomic structures, a contraction of the lateral pterygoid muscle, for example, might cause a compression of the lingual nerve. Any variations in the course of the lingual nerve can be of clinical significance to surgeons and neurologists because of the significant complications that might occur. To name a few of such complications, lingual nerve entrapment can lead to: (a) numbness, hypoesthesia or even anesthesia of the tongue's mucous glands; (b) anesthesia and loss of taste in the anterior two-thirds of the tongue; (c) anesthesia of the lingual gums; and (d) pain related to speech articulation disorder. Dentists should, therefore, be alert to possible signs of neurovascular compression in regions where the lingual nerve is distributed. PMID:21404967

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

    Directory of Open Access Journals (Sweden)

    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

  7. Ulnar nerve stimulation at the palm in diagnosing distal ulnar nerve entrapment.

    Science.gov (United States)

    Wee, A S

    2005-01-01

    Distal entrapment of the ulnar nerve at the wrist and hand (Guyon's syndrome) is a relatively uncommon condition. It may present with a confusing permutation of sensory and motor symptoms, depending on which branches of the ulnar nerve are involved Electrodiagnostic test procedures are often helpful in sorting out this quandary. Electrophysiologic studies that include electrical stimulation of the nerve at the palm, in addition to stimulation of the ulnar nerve at other locations, are useful in demonstrating the focal nerve conduction abnormality that is involved in the entrapment. Sensory and motor recordings from palmar stimulation of the ulnar nerve are not technically difficult procedures, and can be performed routinely.

  8. A RARE CAUSE OF SHOULDER PAIN: SUPRASCAPULAR NERVE ENTRAPMENT NEUROPATHY

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    Mukharjee

    2015-05-01

    Full Text Available Shoulder pain is a common problem with an estimated prevalence of 4% to 26%. 1 Pathology may originate from the neck, glenohumeral joint, acromioclavicular joint, rotator cuff, and other soft tissues around the shoulder girdle. Suprascapular nerve entrapment at spinoglenoid notch is rare but well documented. Kopell and Thompson 2 are credited with providing the first description of the suprascapular nerve entrapment syndrome . 3 This condition is largely underreported, meta - analysis revealed only 88 published reports on suprascapular nerve compression syndrome from 1959 through 2001. We report a case of suprascapular nerve compression at suprascapular foramen the cause of which was not the spinoglenoid cys t or any tumorous swelling like neuroma but a narrow canal at suprascapular foramen, the symptoms of which were relieved after surgical release of transverse scapular ligament.

  9. Superior gluteal nerve entrapment between two bellies of piriformis muscle

    OpenAIRE

    Yadav Y; Mehta V; Roy S; Suri R; Rath G

    2010-01-01

    A double belly composition of piriformis muscle with superior gluteal nerve entrapment between the two muscle masses was detected. Piriformis muscle and its relation to sciatic nerve has been suggested as a cause of piriformis syndrome. Patients suffering from buttock pain are most often diagnosed as having piriformis syndrome, where anatomical variation of the piriformis is an important contributor. The present variation showed two distinct bellies of piriformis muscle. Interestingly the sup...

  10. Entrapment of motor nerves in motor neuron disease: does double crush occur?

    OpenAIRE

    Chaudhry, V; Clawson, L L

    1997-01-01

    OBJECTIVE: To investigate whether "diseased nerves" are more prone to entrapment neuropathy than normal nerves. Nerve conduction studies of human neuropathies have shown that electrophysiological abnormalities are often most prominent at potential sites of nerve entrapment, and entrapments are more common in patients with radiculopathies--a concept designated as "double crush". As entrapment neuropathies commonly occur in otherwise healthy subjects, it is unclear whether this relation is coin...

  11. Electrodiagnostic evaluation of median nerve conduction in Type II ...

    African Journals Online (AJOL)

    MJP

    2015-12-29

    Dec 29, 2015 ... them at high risk of developingdevastating hand and foot .... range in the case of parametric and non- parametric data ... The median value of median nerve velocities. (motor) with ... clinical approaches are, to a large extent,.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-10-15

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

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

    LENUS (Irish Health Repository)

    Murphy, Siun M

    2013-12-01

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

  14. Superior gluteal nerve entrapment between two bellies of piriformis muscle

    Directory of Open Access Journals (Sweden)

    Yadav Y

    2010-12-01

    Full Text Available A double belly composition of piriformis muscle with superior gluteal nerve entrapment between the two muscle masses was detected. Piriformis muscle and its relation to sciatic nerve has been suggested as a cause of piriformis syndrome. Patients suffering from buttock pain are most often diagnosed as having piriformis syndrome, where anatomical variation of the piriformis is an important contributor. The present variation showed two distinct bellies of piriformis muscle. Interestingly the superior gluteal nerve was interposed between the two bellies. Such incidental findings on cadavers may help the clinicians to establish a rare yet important cause of piriformis syndrome. Furthermore, such observations are also relevant to the radiologists while interpreting MRI scans in cases of undiagnosed chronic gluteal pain.

  15. Ulnar nerve entrapment in Guyon's canal due to a lipoma.

    Science.gov (United States)

    Ozdemir, O; Calisaneller, T; Gerilmez, A; Gulsen, S; Altinors, N

    2010-09-01

    Guyon's canal syndrome is an ulnar nerve entrapment at the wrist or palm that can cause motor, sensory or combined motor and sensory loss due to various factors . In this report, we presented a 66-year-old man admitted to our clinic with a history of intermittent pain in the left palm and numbness in 4th and 5th finger for two years. His neurological examination revealed a sensory impairment in the right fifth finger. Also, physical examination displayed a subcutaneous mobile soft tissue in ulnar side of the wrist. Electromyographic examination confirmed the diagnosis of type-1 Guyon's canal syndrome. Under axillary blockage, a lipoma compressing the ulnar nerve was excised totally and ulnar nerve was decompressed. The symptoms were improved after the surgery and patient was symptom free on 3rd postoperative week.

  16. 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

  17. Subsartorial Entrapment of the Saphenous Nerve of a Competitive.

    Science.gov (United States)

    Dumitru, D; Windsor, R E

    1989-01-01

    In brief: A 40-year-old bodybuilder had a six- week history of progressively worsening pain of the medial part of her right knee that did not respond to rest and a nonsteroidal anti-inflammatory drug (NSAID). Somatosensory evoked potential readings suggested that both branches of the right saphenous nerve were entrapped. Management consisting of two intramuscular injections of bupivacaine, administrations of two different NSAIDs, and application of knee wraps around the subsartorial region resolved the patient's symptoms within five weeks. She then resumed an intensive lower-extremity exercise regimen without discomfort, in preparation for a bodybuilding competition.

  18. FASCICULAR NEURORRHAPHY FOR NEUROMA IN CONTINUITY OF MEDIAN NERVE

    Directory of Open Access Journals (Sweden)

    Manikumar

    2015-10-01

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

  19. Pulsed radiofrequency application in the entrapment neuropathy of a sural nerve.

    Science.gov (United States)

    Gozdemir, Muhammet; Usta, Burhanettin; Sert, Huseyin; Muslu, Bunyamin; Demircioglu, Irem Ruveyda; Uras, Ismail

    2010-04-01

    Compressive and entrapment neuropathy of the peroneal nerve is the most common entrapment syndrome in the lower limbs, often caused by mechanical or dynamic compression of a segment of nerve at the level of the fibula head. Because of its special anatomic situation, external compression while under trauma or traction is quite easy. A case of entrapment neuropathy syndrome in a 33-year-old man treated by pulse radiofrequency to the lateral cutaneous branch of the common peroneal nerve is presented.

  20. Pulsed Radiofrequency Application in the Entrapment Neuropathy of a Sural Nerve

    OpenAIRE

    Gozdemir, Muhammet; Usta, Burhanettin; Sert, Huseyin; Muslu,Bunyamin; Demircioglu, Irem Ruveyda; Uras, Ismail

    2010-01-01

    Compressive and entrapment neuropathy of the peroneal nerve is the most common entrapment syndrome in the lower limbs, often caused by mechanical or dynamic compression of a segment of nerve at the level of the fibula head. Because of its special anatomic situation, external compression while under trauma or traction is quite easy. A case of entrapment neuropathy syndrome in a 33-year-old man treated by pulse radiofrequency to the lateral cutaneous branch of the common peroneal nerve is prese...

  1. Entrapment of the sciatic nerve at the linea aspera: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Giovanni Monteleone

    2016-01-01

    Conclusion: The diagnosis of sciatic nerve entrapment at the linea aspera may present considerable difficulties. The clinical history and physical examination sometimes motivate the exploration and neurolysis of the nerve at this site.

  2. Cortical plasticity in response to median nerve trauma

    OpenAIRE

    2016-01-01

    Median nerve injuries in adults, repaired with nerve suture, lead to incomplete functional recovery despite improved surgical technique. This results in a reduction in quality of life, poorer working ability and a considerable expense for society. Misrouting of axons at the suture site connects regenerating axons to the wrong distal end organs. When distorted signals are conveyed to the dorsal root ganglia, spinal cord, thalamus and the somatosensory cortex, somatotopic maps at...

  3. Iatrogenic selective lesion of the median nerve at the elbow.

    Science.gov (United States)

    Di Fabio, Roberto; Casali, Carlo; Pierelli, Francesco

    2010-03-01

    A lesion of the median nerve may occur as a consequence of a compression by a haematoma or for a direct damage of the axons caused by a needle insertion. To date, no investigation reported a very selective lesion of the median nerve at the elbow, with the suffering limited only to the fibres for the first digit. A 53 year-old left-handed violinist underwent an arterial blood gas drawing. The patient complained immediately of an electrical shock impression going down the arm, followed by pin sensation into the first finger. A tingling sensation associated with numbness in the first fingertip and difficulty in the index-thumb pinch became progressively evident. The ENG-EMG findings showed an impairment mainly of the sensory fibres innervating the first digit and a drop of the motor action potential amplitude when the nerve was stimulated at the elbow. We reported a very partial lesion of the left median nerve at the elbow in a violinist who had a selective involvement of the fibres for his first digit. Even minimal lesions of the median nerve may impair severely the quality of life of patients.

  4. Functional anatomy of the mandibular nerve: consequences of nerve injury and entrapment.

    Science.gov (United States)

    Piagkou, Maria; Demesticha, Theano; Skandalakis, Panayiotis; Johnson, Elizabeth O

    2011-03-01

    Various anatomic structures including bone, muscle, or fibrous bands may entrap and potentially compress branches of the mandibular nerve (MN). The infratemporal fossa is a common location for MN compression and one of the most difficult regions of the skull to access surgically. Other potential sites for entrapment of the MN and its branches include, a totally or partially ossified pterygospinous or pterygoalar ligament, a large lamina of the lateral plate of the pterygoid process, the medial fibers of the lower belly of the lateral pterygoid muscle and the inner fibers of the medial pterygoid muscle. The clinical consequences of MN entrapment are dependent upon which branches are compressed. Compression of the MN motor branches can lead to paresis or weakness in the innervated muscles, whereas compression of the sensory branches can provoke neuralgia or paresthesia. Compression of one of the major branches of the MN, the lingual nerve (LN), is associated with numbness, hypoesthesia, or even anesthesia of the tongue, loss of taste in the anterior two thirds of the tongue, anesthesia of the lingual gums, pain, and speech articulation disorders. The aim of this article is to review, the anatomy of the MN and its major branches with relation to their vulnerability to entrapment. Because the LN expresses an increased vulnerability to entrapment neuropathies as a result of its anatomical location, frequent variations, as well as from irregular osseous, fibrous, or muscular irregularities in the region of the infratemporal fossa, particular emphasis is placed on the LN.

  5. STUDY OF COMMUNICATIONS BETWEEN MUSCULOCUTANEOUS NERVE AND MEDIAN NERVE IN ADULT CADAVER

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    Gangulappa Derangula

    2017-07-01

    Full Text Available BACKGROUND Variations of the musculocutaneous nerve and the median nerve, like the communications between the two, may prove valuable in the traumatology of the shoulder joint and upper arm region. These variations are important in the procedure of blocking the brachial plexus and in clinical neurology. MATERIALS AND METHODS The present study was conducted on 100 upper limbs belonging to 50 cadavers (Right 50 &left 50 obtained from the Department of Anatomy, Kakatiya medical college, Warangal, Telangana. Dissection of the infraclavicular part of the brachial plexus was done. The variations in the origin, course and communications with the median nerve were noted. RESULTS In 2% of the limbs the nerve was found to give one communicating branch to the median nerve after piercing the coracobrachialis. CONCLUSION Knowledge of possible variations between musculocutaneous nerve and median nerve is necessary to general surgeons, plastic surgeons, neurologists and orthopaedic surgeons.

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

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    Sevinç Teoman

    2008-02-01

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

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Arora L

    2006-01-01

    Full Text Available Variations in branching pattern of the brachial plexus are common and have been reported by several investigators. Of the four main nerves traversing the arm, namely median, ulnar, radial and musculocutaneous, the ulnar and median nerve do not give any branches to muscles of the arm. Ulnar nerve after taking origin from medial cord of brachial plexus runs distally through axilla on medial side of axillary artery till middle of arm, where it pierces the medial intermuscular septum and enters the posterior compartment of arm. Ulnar nerve enters forearm between two heads of flexor carpi ulnaris from where it continues further. It supplies flexor carpi ulnaris , flexor digitorum profundus and several intrinsic muscles of hand . We recently observed dual supply of biceps muscle from ulnar and median nerves in arm. Musculocutaneous nerve was absent. Although communications between nerves in arm is rare, the communication between median nerve and musculocutaneous nerve were described from the 19th century which could explain innervation of biceps from median nerve. But no accurate description of ulnar nerve supplying biceps could be found in literature. Knowledge of anatomical variation of these nerves at level of upper arm is essential in light of the frequency with which surgery is performed to transfer nerve fascicles from ulnar nerve to biceps in case of brachial plexus injuries. We also observed third head of biceps, our aim is to describe the exact topography of this variation and to discuss its morphological.

  9. Ilioinguinal nerve entrapment after tension-free vaginal tape (TVT) procedure.

    Science.gov (United States)

    Geis, K; Dietl, J

    2002-01-01

    The anatomy of the ilioinguinal nerve makes it vulnerable to entrapment near its exit from the superficial inguinal ring, where it lies almost directly superior to the pubic tubercle. Ilioinguinal nerve entrapment is a documented complication of inguinal herniorrhaphy, inguinal lymph node dissection, appendectomy, Pfannenstiel incision and the needle suspension procedure. It has not previously been described as a complication of the tension-free vaginal tape (TVT) procedure, which is the most recent technique for the treatment of genuine urinary stress incontinence. This paper describes a clinical history to illustrate the diagnosis and management of ilioinguinal nerve entrapment occurring as a complication of tension-free vaginal tape procedure.

  10. Anomalous Innervation of the Median Nerve in the Arm in the Absence of the Musculocutaneous Nerve

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    Khursheed Raza

    2017-03-01

    Full Text Available The brachial plexus innervates the upper extremities. While variations in the formation of the brachial plexus and its terminal branches are quite common, it is uncommon for the median nerve to innervate the muscles of the arm. During the dissection of an elderly male cadaver at the Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India, in 2016, the coracobrachialis muscle was found to be supplied by a direct branch from the lateral root of the median nerve and the musculocutaneous nerve was absent. The branches of the median nerve supplied the biceps brachii and brachialis muscles and the last branch continued as the lateral cutaneous nerve of the forearm. These variations may present atypically in cases of arm flexor paralysis or sensory loss on the lateral forearm. Knowledge of these variations is important in surgeries and during the administration of regional anaesthesia near the shoulder joint and upper arm.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-08-01

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

  12. Peripheral nerve lipoma: Case report of an intraneural lipoma of the median nerve and literature review

    Science.gov (United States)

    Teles, Alisson Roberto; Finger, Guilherme; Schuster, Marcelo N.; Gobbato, Pedro Luis

    2016-01-01

    Adipose lesions rarely affect the peripheral nerves. This can occur in two different ways: Direct compression by an extraneural lipoma, or by a lipoma originated from the adipose cells located inside the nerve. Since its first description, many terms have been used in the literature to mention intraneural lipomatous lesions. In this article, the authors report a case of a 62-year-old female who presented with an intraneural median nerve lipoma and review the literature concerning the classification of adipose lesions of the nerve, radiological diagnosis and treatment. PMID:27695575

  13. Chronic Localized Back Pain Due to Posterior Cutaneous Nerve Entrapment Syndrome (POCNES): A New Diagnosis.

    Science.gov (United States)

    Boelens, Oliver B; Maatman, Robert C; Scheltinga, Marc R; van Laarhoven, Kees; Roumen, Rudi M

    2017-03-01

    Most patients with chronic back pain suffer from degenerative thoracolumbovertebral disease. However, the following case illustrates that a localized peripheral nerve entrapment must be considered in the differential diagnosis of chronic back pain. We report the case of a 26-year-old woman with continuous excruciating pain in the lower back area. Previous treatment for nephroptosis was to no avail. On physical examination the pain was present in a 2 x 2 cm area overlying the twelfth rib some 4 cm lateral to the spinal process. Somatosensory testing using swab and alcohol gauze demonstrated the presence of skin hypo- and dysesthesia over the painful area. Local pressure on this painful spot elicited an extreme pain response that did not irradiate towards the periphery. These findings were highly suggestive of a posterior version of the anterior cutaneous nerve entrapment syndrome (ACNES), a condition leading to a severe localized neuropathic pain in anterior portions of the abdominal wall. She demonstrated a beneficial albeit temporary response after lidocaine infiltration as dictated by an established diagnostic and treatment protocol for ACNES. She subsequently underwent a local neurectomy of the involved superficial branch of the intercostal nerve. This limited operation had a favorable outcome resulting in a pain-free return to normal activities up to this very day (follow-up of 24 months).We propose to name this novel syndrome "posterior cutaneous nerve entrapment syndrome" (POCNES). Each patient with chronic localized back pain should undergo simple somatosensory testing to detect the presence of overlying skin hypo- and dysesthesia possibly reflecting an entrapped posterior cutaneous nerve.Key words: Chronic pain, back pain, posterior cutaneous nerve entrapment, peripheral nerve entrapment, surgical treatment for pain, anterior cutaneous nerve entrapment.

  14. Influence of body mass index on median nerve function, carpal canal pressure, and cross-sectional area of the median nerve.

    Science.gov (United States)

    Werner, Robert A; Jacobson, Jon A; Jamadar, David A

    2004-10-01

    Obese individuals have slowed conduction in the median nerve across the wrist, but the mechanism for this is not established. This case-control study of 27 obese subjects and 16 thin subjects was designed to test the hypothesis that obese individuals have higher carpal canal pressures and more median nerve swelling than thin individuals. All subjects were asymptomatic for hand symptoms, and had measurements of median and ulnar sensory nerve conduction in the nondominant hand, ultrasound measurement of the median nerve cross-sectional area proximal to the carpal canal, and carpal canal pressure measurement. There was no difference in age or gender ratio between the obese and thin groups. The median nerve cross-sectional area was equal in the obese and thin groups (9.3 mm2 vs. 9.4 mm2), as was the carpal canal pressure (16.2 mmHg vs. 15.5 mmHg, respectively). There was a strong correlation between median nerve conduction slowing across the wrist and median nerve cross-sectional area at the wrist (r = 0.55, P = 0.002). Obesity does not influence carpal canal pressure or the size of the median nerve at the wrist. However, there is a strong association between slowed median nerve conduction and increased nerve size which suggests endoneurial edema as a metabolic mechanism; the conduction slowing does not appear to be related to mechanical stress.

  15. Electrodiagnostic Studies of Median and Ulnar Nerves in Cyclists.

    Science.gov (United States)

    Jackson, D L

    1989-09-01

    In brief: Twenty long-distance cyclists (13 men, 7 women) completed a questionnaire and underwent a neurologic examination and electrodiagnostic studies of the median and ulnar nerves. The purpose was to determine the frequency, severity, and clinical significance of numbness or pain in the hand or wrist and to assess the correlation of electrodiagnostic findings with these complaints. Results of the studies were normal for all 20 cyclists, nine of whom reported symptoms. These cyclists attributed their discomfort to prolonged riding without changing hand position, especially on rough road surfaces. They also reported that their symptoms diminished after they modified their cycling technique and adjusted their bicycle to better fit their body dimensions.

  16. Effect of Arm Positioning on Entrapment of Infraclavicular Nerve Block Catheter

    Science.gov (United States)

    Reddy, Rahul; Kendall, Mark C.; Nader, Antoun; Weeks, Jessica J.

    2017-01-01

    Continuous brachial plexus nerve block catheters are commonly inserted for postoperative analgesia after upper extremity surgery. Modifications of the insertion technique have been described to improve the safety of placing an infraclavicular brachial plexus catheter. Rarely, these catheters may become damaged or entrapped, complicating their removal. We describe a case of infraclavicular brachial plexus catheter entrapment related to differences in arm positioning during catheter placement and removal. Written authorization to obtain, use, and disclose information and images was obtained from the patient.

  17. 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 ...

  18. Kinesio tape management for superficial radial nerve entrapment: a case report.

    Science.gov (United States)

    Anandkumar, Sudarshan

    2013-04-01

    This case report describes a 41-year-old female who presented with complaints of pain in the lower lateral one-third of the right radius extending into the first web space. Tinel's sign reproducing the patient's symptoms was elicited 8.2 cm above the radial styloid process. Physical diagnosis for superficial radial nerve entrapment was made based on a positive upper limb neural tension test 2a along with symptom reproduction during resisted isometrics to brachioradialis and wrist extensors. A potential first time successful conservative Kinesio tape (KT) management for entrapment of the superficial radial nerve is described in this report. An immediate improvement in grip strength and functional activities along with a reduction in pain and swelling was noted in this patient after the first treatment session, which was maintained at a 6 month follow-up. A model is proposed describing the mechanism by which KT application could be used to intervene for nerve entrapment interfaces.

  19. Experimental chronic entrapment of the sciatic nerve in adult hamsters: an ultrastructural and morphometric study

    Directory of Open Access Journals (Sweden)

    Prinz R.A.D.

    2003-01-01

    Full Text Available Entrapment neuropathy is a group of clinical disorders involving compression of a peripheral nerve and interference with nerve function mostly through traction injury. We have investigated the chronic compression of peripheral nerves as an experimental procedure for detecting changes in ultrastructural nerve morphology. Adult hamsters (Mesocricetus auratus, N = 30 were anesthetized with a 25% pentobarbital solution and received a cuff around the right sciatic nerve. Left sciatic nerves were not operated (control group. Animals survived for varying times (up to 15 weeks, after which they were sacrificed and both sciatic nerves were immediately fixed with a paraformaldehyde solution. Experimental nerves were divided into segments based upon their distance from the site of compression (proximal, entrapment and distal. Semithin and ultrathin sections were obtained and examined by light and electron microscopy. Ultrastructural changes were qualitatively described and data from semithin sections were morphometrically analyzed both in control and in compressed nerves. We observed endoneurial edema along with both perineurial and endoneurial thickening and also the existence of whorled cell-sparse structures (Renaut bodies in the subperineurial space of compressed sciatic nerves. Morphometric analyses of myelinated axons at the compression sites displayed a remarkable increase in the number of small axons (up to 60% in comparison with the control axonal number. The distal segment of compressed nerves presented a distinct decrease in axon number (up to 40% comparatively to the control group. The present experimental model of nerve entrapment in adult hamsters was shown to promote consistent histopathologic alterations analogous to those found in chronic compressive neuropathies.

  20. Ultrasound-guided surgical treatment for ulnar nerve entrapment: a cadaver study.

    Science.gov (United States)

    Poujade, T; Hanouz, N; Lecoq, B; Hulet, C; Collon, S

    2014-09-01

    Several open and endoscopic techniques for the surgical treatment of ulnar nerve entrapment at the elbow (cubital tunnel syndrome) have been described that provide decompression with or without anterior transposition. Based on our experience with US-guided decompression for carpal tunnel syndrome in our department, we developed a similar surgical technique for the decompression of the ulnar nerve at the elbow. Using sixteen cadaver upper limbs, we performed decompression of all the structures possibly responsible for ulnar nerve compression at the elbow. The structures involved were Struthers' arcade, the cubital tunnel retinaculum, Osborne's fascia and Amadio-Beckenbaugh's arcade. The procedure was followed by anatomical dissection to confirm complete sectioning of the compressive structures, absence of iatrogenic vascular or nervous injuries and absence of nerve dislocation or instability. There were no remaining compressive structures after the release procedure. There was no iatrogenic damage to the nerves and no nerve dislocation was observed during elbow flexion or extension. In 3.4% cases, a thin superficial layer of one or more of the identified structures remained but these did not appear to compress the nerve based on US imaging. Using ultrasonographic visualization of the nerve and compressive structures is easy. Each procedure can be tailored according to the nerve compression sites. Our cadaveric study shows the feasibility of an US-guided percutaneous surgical release for ulnar nerve entrapment.

  1. Entrapment of Common Peroneal Nerve by Surgical Suture following Distal Biceps Femoris Tendon Repair

    Directory of Open Access Journals (Sweden)

    Aki Fukuda

    2016-01-01

    Full Text Available We describe entrapment of the common peroneal nerve by a suture after surgical repair of the distal biceps femoris tendon. Complete rupture of the distal biceps femoris tendon of a 16-year-old male athlete was surgically repaired. Postoperative common peroneal nerve palsy was evident, but conservative treatment did not cause any neurological improvement. Reexploration revealed that the common peroneal nerve was entrapped by the surgical suture. Complete removal of the suture and external neurolysis significantly improved the palsy. The common peroneal nerve is prone to damage as a result of its close proximity to the biceps femoris tendon and it should be identified during surgical repair of a ruptured distal biceps femoris tendon.

  2. Diagnosis of Ulnar Nerve Entrapment at the Arcade of Struthers with Electromyography and Ultrasound

    OpenAIRE

    2016-01-01

    Summary: Ulnar neuropathy is caused by compression of the ulnar nerve in the upper extremity, frequently occurring at the level of the elbow or wrist. Rarely, ulnar nerve entrapment may be seen proximal to the elbow. This report details a case of ulnar neuropathy diagnosed and localized to the arcade of Struthers with electromyography (EMG) and ultrasound (US) imaging and confirmed at time of operative release. US imaging and EMG findings were used to preoperatively localize the level of comp...

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

    Directory of Open Access Journals (Sweden)

    Charushila D. Shinde

    2015-06-01

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

  4. Diagnosis of Ulnar Nerve Entrapment at the Arcade of Struthers with Electromyography and Ultrasound.

    Science.gov (United States)

    Sivak, Wesley N; Hagerty, Sarah E; Huyhn, Lisa; Jordan, Adrienne C; Munin, Michael C; Spiess, Alexander M

    2016-03-01

    Ulnar neuropathy is caused by compression of the ulnar nerve in the upper extremity, frequently occurring at the level of the elbow or wrist. Rarely, ulnar nerve entrapment may be seen proximal to the elbow. This report details a case of ulnar neuropathy diagnosed and localized to the arcade of Struthers with electromyography (EMG) and ultrasound (US) imaging and confirmed at time of operative release. US imaging and EMG findings were used to preoperatively localize the level of compression in a patient presenting with left ulnar neuropathy. In this case, ulnar entrapment 8 cm proximal to the medial epicondyle was diagnosed. Surgical release was performed and verified the level of entrapment at the arcade of Struthers in the upper arm. Alleviation of symptoms was noted at 8-week follow-up; no complications occurred. US imaging can be used in complement with EMG studies to properly diagnose and localize the level of ulnar nerve entrapment. This facilitates full release of the nerve and may prevent the need for revision surgery.

  5. 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.

  6. Ultrasound assessment on selected peripheral nerve pathologies. Part I: Entrapment neuropathies of the upper limb – excluding carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Berta Kowalska

    2012-09-01

    Full Text Available Ultrasound (US is one of the methods for imaging entrapment neuropathies, post-trau‑ matic 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 assess‑ ment 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. Entrap‑ ment 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 tun‑ nel 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 Ultrasonog‑ raphy 2012; 12 (49: 120–163 – Normal and sonographic anatomy of selected peripheral nerves. Part I: Sonohistology and general principles of examination, following the exam‑ ple 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

  7. Accurate nomenclature for forefoot nerve entrapment: a historical perspective.

    Science.gov (United States)

    Larson, Ethan E; Barrett, Stephen L; Battiston, Bruno; Maloney, Christopher T; Dellon, A Lee

    2005-01-01

    Current medical nomenclature is often based on the early history of the condition, when the true etiology of the disease or condition was not known. Sadly, this incorrect terminology can become inextricably woven into the lexicon of mainstream medicine. More important, when this is the case, the terminology itself can become integrated into current clinical decision making and ultimately into surgical intervention for the condition. "Morton's neuroma" is perhaps the most striking example of this nomenclature problem in foot and ankle surgery. We aimed to delineate the historical impetus for the terminology still being used today for this condition and to suggest appropriate terminology based on our current understanding of its pathogenesis. We concluded that this symptom complex should be given the diagnosis of nerve compression and be further distinguished by naming the involved nerve, such as compression of the interdigital nerve to the third web space or compression of the third common plantar digital nerve. Although the nomenclature becomes longer, the pathogenesis is correct, and treatment decisions can be made accordingly.

  8. Role of magnetic resonance imaging in entrapment and compressive neuropathy - what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: Part 2. Upper extremity

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sungjun [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Hanyang University, Kuri Hospital, Department of Diagnostic Radiology, College of Medicine, Kuri City, Kyunggi-do (Korea); Choi, Jin-Young; Huh, Yong-Min; Song, Ho-Taek; Lee, Sung-Ah [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Kim, Seung Min [Yonsei University, Department of Neurology, College of Medicine, Seoul (Korea); Suh, Jin-Suck [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Yonsei University, Research Institute of Radiological Science, College of Medicine, Seoul (Korea)

    2007-02-15

    The diagnosis of nerve entrapment and compressive neuropathy has been traditionally based on the clinical and electrodiagnostic examinations. As a result of improvements in the magnetic resonance (MR) imaging modality, it plays not only a fundamental role in the detection of space-occupying lesions, but also a compensatory role in clinically and electrodiagnostically inconclusive cases. Although ultrasound has undergone further development in the past decades and shows high resolution capabilities, it has inherent limitations due to its operator dependency. We review the course of normal peripheral nerves, as well as various clinical demonstrations and pathological features of compressed and entrapped nerves in the upper extremities on MR imaging, according to the nerves involved. The common sites of nerve entrapment of the upper extremity are as follows: the brachial plexus of the thoracic outlet; axillary nerve of the quadrilateral space; radial nerve of the radial tunnel; ulnar nerve of the cubital tunnel and Guyon's canal; median nerve of the pronator syndrome, anterior interosseous nerve syndrome, and carpal tunnel syndrome. Although MR imaging can depict the peripheral nerves in the extremities effectively, radiologists should be familiar with nerve pathways, common sites of nerve compression, and common space-occupying lesions resulting in nerve compression in MR imaging. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Emanuele Cigna

    2010-01-01

    Full Text Available Introduction. The hypothenar hammer syndrome is a rare traumatic vascular disease of the hand. Method and Materials. We report the case of a 43-years-old man with a painful tumefaction of the left hypothenar region. The ulnar artery appeared thrombosed clinically and radiologically. The patient underwent surgery to resolve the ulnar nerve compression and revascularise the artery. Results. The symptoms disappeared immediately after surgery. The arterial flow was reestablished. Postoperatively on day 20, a new thrombosis of the ulnar artery occurred. Conclusion. Hypothenar hammer syndrome is caused by repetitive trauma to the heel of the hand. The alterations of the vessel due to its chronic inflammation caused an acute compression of the ulnar nerve at the Guyon's canal and, in our case, do not allow a permanent revascularisation of the ulnar artery.

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

    OpenAIRE

    2010-01-01

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

  11. Sensoric Protection after Median Nerve Injury: Babysitter-Procedure Prevents Muscular Atrophy and Improves Neuronal Recovery

    Directory of Open Access Journals (Sweden)

    Benedicta E. Beck-Broichsitter

    2014-01-01

    Full Text Available The babysitter-procedure might offer an alternative when nerve reconstruction is delayed in order to overcome muscular atrophy due to denervation. In this study we aimed to show that a sensomotoric babysitter-procedure after median nerve injury is capable of preserving irreversible muscular atrophy. The median nerve of 20 female Wistar rats was denervated. 10 animals received a sensory protection with the N. cutaneous brachii. After six weeks the median nerve was reconstructed by autologous nerve grafting from the contralateral median nerve in the babysitter and the control groups. Grasping tests measured functional recovery over 15 weeks. At the end of the observation period the weight of the flexor digitorum sublimis muscle was determined. The median nerve was excised for histological examinations. Muscle weight (P<0.0001 was significantly superior in the babysitter group compared to the control group at the end of the study. The histological evaluation revealed a significantly higher diameter of axons (P=0.0194, nerve fiber (P=0.0409, and nerve surface (P=0.0184 in the babysitter group. We conclude that sensory protection of a motor nerve is capable of preserving muscule weight and we may presume that metabolism of the sensory nerve was sufficient to keep the target muscle’s weight and vitality.

  12. Median and ulnar nerve injuries: prognosis and predictors for clinical outcome

    NARCIS (Netherlands)

    J.B. Jaquet (Jean)

    2004-01-01

    textabstractIn chapter 1 the author provide a general introduction on median and ulnar nerve injuries. Furthermore the aims for this thesis, entitled median and ulnar nerve injuries: prognosis and predictors for clinical outcome, are defi ned. Chapter 2 comprises an investigation into the overall fu

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

    NARCIS (Netherlands)

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

    2006-01-01

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

  14. Posterior interosseous nerve entrapment after Monteggia fracture-dislocation in children

    Directory of Open Access Journals (Sweden)

    LI Hai

    2013-06-01

    Full Text Available 【Abstract】Objective: Although most of nerve in-juries associated with Monteggia fracture-dislocation in children are neurapraxias and will recover spontaneously after conservative treatment, surgical exploration of the in-volved nerve is always required in the cases with the en-trapment of posterior interosseous nerve (PIN. However, the necessity and time frame for surgical intervention for specific patterns of nerve dysfunction remains controversial. The aim of the report is to observe and understand the pathology of PIN injury associated with Monteggia frac-ture-dislocation in children, and to propose the possible indication for the exploration of nerve. Methods: Eight cases, six boys and two girls, with Monteggia fracture-dislocation complicated by PIN injury, managed operatively at the authors’ Hospital from 2007 to 2008 were retrospectively reviewed. All the patients under-went the attempted closed reduction before they received exploration of PIN, with open reduction and internal fixation or successful closed reduction. Results: The PIN was found to be trapped acutely posterior to the radiocapitellar joint in 4 out of 5 Type III Bado’s Monteggia fractures. In the remaining cases, since there were longer time intervals from injury to operation, chronic compressive changes and epineural fibrosis of ra-dial nerve were visualized. After a microsurgical neurolysis performed, the complete recovery in the nerve function was obtained in all the cases during the follow-up. Conclusion: The findings from this study suggest that every case of type III Monteggia fracture-dislocation with decreased or absent function of muscles innervated by PIN and an irreducible radial head in children should be viewed as an indication for immediate surgical exploration of the involved nerve to exclude a potential PIN entrapment. Key words: Monteggia’s fracture; Peripheral nerve injuries; Nerve compression syndromes; Pediatrics

  15. MRI shows thickening and altered diffusion in the median and ulnar nerves in multifocal motor neuropathy

    DEFF Research Database (Denmark)

    Haakma, Wieke; Jongbloed, Bas A.; Froeling, Martijn

    2016-01-01

    Objectives To study disease mechanisms in multifocal motor neuropathy (MMN) with magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) of the median and ulnar nerves. Methods We enrolled ten MMN patients, ten patients with amyotrophic lateral sclerosis (ALS) and ten healthy controls...... (HCs). Patients underwent MRI (in a prone position) and nerve conduction studies. DTI and fat-suppressed T2-weighted scans of the forearms were performed on a 3.0T MRI scanner. Fibre tractography of the median and ulnar nerves was performed to extract diffusion parameters: fractional anisotropy (FA...... nerves. CSA was significantly larger in MMN patients compared to ALS patients and HCs (p nerves...

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

    Directory of Open Access Journals (Sweden)

    Sathish Arakeri

    2012-07-01

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

  17. Aberrant course of a communicating branch of the ulnar nerve to the median nerve contributing to hypothenar Hammer syndrome.

    Science.gov (United States)

    Richards, Winston T; Bullocks, Jamal M; Norris, Morgan E

    2007-06-01

    This presentation represents a unique anatomic predisposition to the development of hypothenar hammer syndrome (HHS). In this case, a communicating branch of the ulnar nerve to the median common digital nerve of the ring finger was identified crossing volar to the superficial palmar arch. This relationship caused thrombosis of the superficial palmar arch proximal to this crossing nerve branch. The aberrant course of this nerve created a structural anomaly contributing to HHS, which ultimately mandated surgical intervention.

  18. Ultrasound assessment of selected peripheral nerves pathologies. Part II: Entrapment neuropathies of the lower limb.

    Science.gov (United States)

    Kowalska, Berta; Sudoł-Szopińska, Iwona

    2012-12-01

    Similarly to entrapment neuropathies of upper extremities, the ultrasound constitutes a valuable supplementation of diagnostic examinations performed in patients with suspicions of nerve entrapment syndromes of the lower limb. For many years, it was claimed that such pathologies were rare. This probably resulted from the lack of proper diagnostic tools (including high frequency ultrasound transducers) as well as the lack of sufficient knowledge in this area. In relation to the above, the symptoms of compression neuropathies were frequently interpreted as a manifestation of pathologies of the lumbar part of the spine or a other orthopedic disease (degenerative or overuse one). Consequently, many patients were treated ineffectively for many months and even, years which led to irreparable neurological changes and changes in the motor organ. Apart from a clinical examination, the diagnostics of entrapment neuropathies of lower limb is currently based on imaging tests (ultrasound, magnetic resonance) as well as functional assessments (electromyography). Magnetic resonance imaging is characterized by a relatively low resolution (as compared to ultrasound) which results in limited possibilities of morphological evaluation of the visualized pathology. Electromyography allows for the assessment of nerve function, but does not precisely determine the type and degree of change. This article presents examples of the most common entrapment neuropathies of the lower limb concerning the following nerves: sciatic, femoral, lateral femoral cutaneous, obturator, fibular and its branches, tibial and its branches as well as sural. The pathomorphological basis of the neuropathies as well as corresponding ultrasound images are presented in this paper. Attention has been drawn to echogenicity, degree of vascularization and bundle presentation of the trunk of a pathological peripheral nerve.

  19. Ulnar nerve entrapment neuropathy at the elbow: relationship between the electrophysiological findings and neuropathic pain.

    Science.gov (United States)

    Halac, Gulistan; Topaloglu, Pinar; Demir, Saliha; Cıkrıkcıoglu, Mehmet Ali; Karadeli, Hasan Huseyin; Ozcan, Muhammet Emin; Asil, Talip

    2015-07-01

    [Purpose] Ulnar nerve neuropathies are the second most commonly seen entrapment neuropathies of the upper extremities after carpal tunnel syndrome. In this study, we aimed to evaluate pain among ulnar neuropathy patients by the Leeds assessment of neuropathic symptoms and signs pain scale and determine if it correlated with the severity of electrophysiologicalfindings. [Subjects and Methods] We studied 34 patients with clinical and electrophysiological ulnar nerve neuropathies at the elbow. After diagnosis of ulnar neuropathy at the elbow, all patients underwent the Turkish version of the Leeds assessment of neuropathic symptoms and signs pain scale. [Results] The ulnar entrapment neuropathy at the elbow was classified as class-2, class-3, class-4, and class-5 (Padua Distal Ulnar Neuropathy classification) for 15, 14, 4, and 1 patient, respectively. No patient included in class-1 was detected. According to Leeds assessment of neuropathic symptoms and signs pain scale, 24 patients scored under 12 points. The number of patients who achieved more than 12 points was 10. Groups were compared by using the χ(2) test, and no difference was detected. There was no correlation between the Leeds assessment of neuropathic symptoms and signs pain scale and electromyographic findings. [Conclusion] We found that the severity of electrophysiologic findings of ulnar nerve entrapment at the elbow did not differ between neuropathic and non-neuropathic groups as assessed by the Leeds assessment of neuropathic symptoms and signs pain scale.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-04-15

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

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

    Institute of Scientific and Technical Information of China (English)

    侯之启; 徐中和

    2002-01-01

    Objective:To compare the effect of using partial median and ulnar nerves for treatment of C5-6 orC5-7 avulsion of the brachial plexus with that of using phrenic and spinal accessary nerves.Methods:The patients were divided into 2groups randomly according to different surgical procedures.Twelve cases were involved in the first group.The phrenic nerve was transferred to the musculocutaneous nerve or through a sural nerve graft,and the spinal accessary nerve was to the suprascapular nerve.Eleven cases were classified into the second group.A part of the fascicles of median nerve was transferred to be coapted with the motor fascicle of musculocutaneous nerve and a part of fascicles of ulnar nerve was transferred to the axillary nerve.The cases were followed up from 1to 3years and the clinical outcome was compared between the two groups.

  2. 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.

  3. Effects of smartphone overuse on hand function, pinch strength, and the median nerve.

    Science.gov (United States)

    İnal, Esra Erkol; Demİrcİ, kadİr; Çetİntürk, Azİze; Akgönül, Mehmet; Savaş, Serpİl

    2015-08-01

    In this study we investigated the flexor pollicis longus (FPL) tendon and median nerve in smartphone users by ultrasonography to assess the effects of smartphone addiction on the clinical and functional status of the hands. One hundred two students were divided into 3 groups: non-users, and high or low smartphone users. Smartphone Addiction Scale (SAS) scores and grip and pinch strengths were recorded. Pain in thumb movement and rest and hand function were evaluated on the visual analog scale (VAS) and the Duruöz Hand Index (DHI), respectively. The cross-sectional areas (CSAs) of the median nerve and the FPL tendon were calculated bilaterally using ultrasonography. Significantly higher median nerve CSAs were observed in the dominant hands of the high smartphone users than in the non-dominant hands (PSmartphone overuse enlarges the median nerve, causes pain in the thumb, and decreases pinch strength and hand functions. © 2015 Wiley Periodicals, Inc.

  4. Development of Kinematic Graphs of Median Nerve during Active Finger Motion: Implications of Smartphone Use.

    Directory of Open Access Journals (Sweden)

    Hoi-Chi Woo

    Full Text Available Certain hand activities cause deformation and displacement of the median nerve at the carpal tunnel due to the gliding motion of tendons surrounding it. As smartphone usage escalates, this raises the public's concern whether hand activities while using smartphones can lead to median nerve problems.The aims of this study were to 1 develop kinematic graphs and 2 investigate the associated deformation and rotational information of median nerve in the carpal tunnel during hand activities.Dominant wrists of 30 young adults were examined with ultrasonography by placing a transducer transversely on their wrist crease. Ultrasound video clips were recorded when the subject performing 1 thumb opposition with the wrist in neutral position, 2 thumb opposition with the wrist in ulnar deviation and 3 pinch grip with the wrist in neutral position. Six still images that were separated by 0.2-second intervals were then captured from the ultrasound video for the determination of 1 cross-sectional area (CSA, 2 flattening ratio (FR, 3 rotational displacement (RD and 4 translational displacement (TD of median nerve in the carpal tunnel, and these collected information of deformation, rotational and displacement of median nerve were compared between 1 two successive time points during a single hand activity and 2 different hand motions at the same time point. Finally, kinematic graphs were constructed to demonstrate the mobility of median nerve during different hand activities.Performing different hand activities during this study led to a gradual reduction in CSA of the median nerve, with thumb opposition together with the wrist in ulnar deviation causing the greatest extent of deformation of the median nerve. Thumb opposition with the wrist in ulnar deviation also led to the largest extent of TD when compared to the other two hand activities of this study. Kinematic graphs showed that the motion pathways of median nerve during different hand activities were complex

  5. Determination of Median Nerve Somatosensory Evoked Potentials in 27 Patients with Hemiplegia

    Institute of Scientific and Technical Information of China (English)

    刘雅丽; 尤春景; 黄杰; 刘培玲

    2002-01-01

    Summary: Twenty-seven in-patients with hemiplegia following brain injury were studied by using up per extremity median nerve somatosensory evoked patentials (SVEP), Brunnstrom assessment in hemiplegic hand and assessment of the patients' activities of daily lioing (ADL) (Barthel index). The upper extremity median nerve SEP on the affected and normal sides was determined. By using Kovin dba standard, upper extremity median nerve SEP was graded in accordance with N20. The correla tion between the differences of SEP N20 amplitude and the latencies on the both sides and the Barthel index scores was analyzed. A Spearman correlation analysis was made between the median nerve SEP N20 grades and Brunnstrom stages in hand or ADL on the affected side. The results showed that up per extremity median nerve SEP grades were positively correlated with those of the Brunnstrom stages in hand (r1 =0. 6925, P1<0. 01). The correlation coefficient between SEP N20 grades and patients' ADL grades was r2= 0. 5015, P2<0.01. It was concluded that upper extremity median nerve SEP could be used as a sensitive electrophysiological predictor to clinically assess hemiplegic hand function. SEP N20 might play a role in predicting the ADL of the patients with hemiplegia to some extent, but could not be used as a sensitive predictor to directly observe and predict the ADL of the patients.

  6. Transverse Ultrasound Assessment of Median Nerve Deformation and Displacement in the Human Carpal Tunnel during Wrist Movements

    OpenAIRE

    2013-01-01

    The symptoms of carpal tunnel syndrome, a compression neuropathy of the median nerve at the wrist, are aggravated by wrist motion, but the effect of these motions on median nerve motion are unknown. In order to better understand the biomechanics of the abnormal nerve, it is first necessary to understand normal nerve movement. The purpose of this study was to evaluate the deformation and displacement of the normal median nerve at the proximal carpal tunnel level on transverse ultrasound images...

  7. Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space

    Energy Technology Data Exchange (ETDEWEB)

    Hernando, Moises Fernandez; Cerezal, Luis; Perez-Carro, Luis; Abascal, Faustino; Canga, Ana [Diagnostico Medico Cantabria (DMC), Department of Radiology, Santander, Cantabria (Spain); Valdecilla University Hospital, Orthopedic Surgery Department Clinica Mompia (L.P.C.), Santander, Cantabria (Spain); Valdecilla University Hospital, Department of Radiology, Santander, Cantabria (Spain)

    2015-03-05

    Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included ''piriformis syndrome,'' a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes. The concept of fibrous bands playing a role in causing symptoms related to sciatic nerve mobility and entrapment represents a radical change in the current diagnosis of and therapeutic approach to DGS. The development of periarticular hip endoscopy has led to an understanding of the pathophysiological mechanisms underlying piriformis syndrome, which has supported its further classification. A broad spectrum of known pathologies may be located nonspecifically in the subgluteal space and can therefore also trigger DGS. These can be classified as traumatic, iatrogenic, inflammatory/infectious, vascular, gynecologic and tumors/pseudo-tumors. Because of the ever-increasing use of advanced magnetic resonance neurography (MRN) techniques and the excellent outcomes of the new endoscopic treatment, radiologists must be aware of the anatomy and pathologic conditions of this space. MR imaging is the diagnostic procedure of choice for assessing DGS and may substantially influence the management of these patients. The infiltration test not only has a high diagnostic but also a therapeutic value. This article describes the subgluteal space anatomy, reviews known and new etiologies of DGS, and assesses the role of the radiologist in the diagnosis, treatment and postoperative evaluation of sciatic nerve entrapments, with emphasis on MR imaging and endoscopic correlation. (orig.)

  8. Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space.

    Science.gov (United States)

    Hernando, Moisés Fernández; Cerezal, Luis; Pérez-Carro, Luis; Abascal, Faustino; Canga, Ana

    2015-07-01

    Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included "piriformis syndrome," a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes. The concept of fibrous bands playing a role in causing symptoms related to sciatic nerve mobility and entrapment represents a radical change in the current diagnosis of and therapeutic approach to DGS. The development of periarticular hip endoscopy has led to an understanding of the pathophysiological mechanisms underlying piriformis syndrome, which has supported its further classification. A broad spectrum of known pathologies may be located nonspecifically in the subgluteal space and can therefore also trigger DGS. These can be classified as traumatic, iatrogenic, inflammatory/infectious, vascular, gynecologic and tumors/pseudo-tumors. Because of the ever-increasing use of advanced magnetic resonance neurography (MRN) techniques and the excellent outcomes of the new endoscopic treatment, radiologists must be aware of the anatomy and pathologic conditions of this space. MR imaging is the diagnostic procedure of choice for assessing DGS and may substantially influence the management of these patients. The infiltration test not only has a high diagnostic but also a therapeutic value. This article describes the subgluteal space anatomy, reviews known and new etiologies of DGS, and assesses the role of the radiologist in the diagnosis, treatment and postoperative evaluation of sciatic nerve entrapments, with emphasis on MR imaging and endoscopic correlation.

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

  10. Compression of the median nerve in the proximal forearm by a giant lipoma: A case report

    Directory of Open Access Journals (Sweden)

    O'Toole Greg A

    2008-06-01

    Full Text Available Abstract Background Compression of the median nerve by a tumour in the elbow and forearm region is rare. We present a case of neuropathy of the median nerve secondary to compression by giant lipoma in the proximal forearm. Case presentation A 46-year-old man presented with a six month history of gradually worsening numbness and paresthesia on the palmar aspect of the left thumb and thenar eminence. Clinical examination reveals a hypoaesthesia in the median nerve area of the left index and thumb compared to the contralateral side. Electromyography showed prolonged sensory latency in the distribution of the median nerve corresponding to compression in the region of the pronator teres (pronator syndrome. Radiological investigations were initially reported as normal. Conservative treatment for one month did not result in any improvement. Surgical exploration was performed and a large intermuscular lipoma enveloped the median nerve was found. A complete excision of the tumour was performed. Postoperative revaluation the X-ray of the elbow was seen to demonstrate a well-circumscribed mass in the anterior aspect of the proximal forearm. At follow-up, 14 months after surgery, the patient noted complete return of the sensation and resolution of the paresthesia. Conclusion In case of atypical findings or non frequent localization of nerve compression, clinically interpreted as an idiopathic compression, it is recommended to make a pre-operative complementary Ultrasound or MRI study.

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

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    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.

  12. Acute radial nerve entrapment at the spiral groove: detection by DTI-based neurography.

    Science.gov (United States)

    Jengojan, Suren; Kovar, Florian; Breitenseher, Julia; Weber, Michael; Prayer, Daniela; Kasprian, Gregor

    2015-06-01

    This study evaluated the potential of three-tesla diffusion tensor imaging (DTI) and tractography to detect changes of the radial (RN) and median (MN) nerves during transient upper arm compression by a silicon ring tourniquet. Axial T2-weighted and DTI sequences (b = 700 s/mm(2), 16 gradient encoding directions) of 13 healthy volunteers were obtained. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the MN and RN were measured at the spiral groove and further visualized in 3D by deterministic tractography (thresholds: FA = .15, angle change = 27°). Local/lesional RN FA values increased (p = 0.001) and ADC values decreased (p = 0.02) during a 20-min upper arm compression, whereas no significant FA (p = 0.49) or ADC (p = 0.73) changes of the MN were detected. There were no T2-w nerve signal changes or alterations of nerve trajectories in 3D. Acute nerve compression of the RN leads to changes of its three-tesla DTI metrics. Peripheral nerve DTI provides non-invasive insights into the "selective" vulnerability of the RN at the spiral groove. • DTI-based neurography detects nerve changes during acute nerve compression. • Compression leads to a transient increase in local radial nerve FA values. • DTI provides insights into radial nerve vulnerability at the spiral groove.

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

    Directory of Open Access Journals (Sweden)

    Ahmet Aslan

    2013-07-01

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

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

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    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.)

  15. Preinguinal Splitting and Reunion of Femoral Nerve Entrapping the Fleshy Fibres of Iliacus Muscle - A Case Report.

    Science.gov (United States)

    Ashwini, L S; Somayaji, S Nagabhooshana; Rao, Mohandas; Marpalli, Sapna

    2017-04-01

    Division of nerves close to their origin and muscular entrapments by nerves in the limbs is not very common. Femoral nerve is the largest branch of the lumbar plexus and arises from dorsal divisions of ventral rami of L2 to L4 spinal nerves. During routine cadaveric dissection for first year medical students at Melaka Manipal Medical College (Manipal Campus), Karnataka, India, we observed a variation in the division and course of left femoral nerve in about 65-year-old male cadaver. The femoral nerve was split into two divisions above the inguinal ligament after its origin from the lumbar plexus. The lower division of the nerve passed deep to the iliopsoas muscle fibres and the upper division ran superficial to iliacus muscle deep to fascia iliaca. Both the divisions joined just above the inguinal ligament to form the trunk of the femoral nerve. Further course and distribution of the nerve was normal. The reports have shown that compression neuropathies of femoral nerve in the limbs are caused by neoplastic masses, vascular abnormalities and also by different anomalous muscles. Such neuropathies may also result from indirect compression of femoral nerve between the fibres of psoas major muscle and lateral pelvic wall. The potential clinical importance of above mentioned variations in the division of femoral nerve would emphasize the surgeons to diagnose the neuromuscular entrapments and consequent alterations of sensation in the anterior and medial aspects of the thigh.

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

    Institute of Scientific and Technical Information of China (English)

    侯之启; 徐中和

    2002-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

  18. Cannieu-Riche anastomosis of the ulnar to median nerve in the hand: case report.

    Science.gov (United States)

    Paraskevas, G; Ioannidis, O; Martoglou, S

    2010-01-01

    We observed in a male cadaver the presence of a new type of very long Cannieu-Riche anastomosis between the proximal portion of the deep branch of the ulnar nerve for the adductor pollicis and ramus of the recurrent branch of the median nerve to the superficial head of the flexor pollicis brevis. The clinical relevance of such a communication is the possible preservation of the function of all or part of thenar muscles from the ulnar nerve in case of median nerve lesion. The ignorance of that anomaly can induce obscure clinical, surgical and electroneuromyographical findings. We report on the incidence, the double innervation and the clinical significance of Cannieu-Riche anastomosis and provide a new classification of the various types of this nerval connection.

  19. Variation in nerve autograft length increases fibre misdirection and decreases pruning effectiveness: an experimental study in the rat median nerve.

    Science.gov (United States)

    Bertelli, J A; Taleb, M; Mira, J C; Ghizoni, M F

    2005-09-01

    In the clinical set, autologus nerve grafts are the current option for reconstruction of nerve tissue losses. The length of the nerve graft has been suggested to affect outcomes. Experiments were performed in the rat in order to test this assumption and to detect a possible mechanism to explain differences in recovery. The rat median nerve was repaired by ulnar nerve grafts of different lengths. Rats were evaluated for 12 months by behavioural assessment and histological studies, including ATPase myofibrillary histochemistry and retrograde neuronal labelling. It was demonstrated that graft length interferes in behavioural functional recovery that here correlates to muscle weight recovery. Short nerve grafts recovered faster and better. Reinnervation was not specific either at the trunk level or in the muscle itself. The normal mosaic pattern of Type I muscle fibres was never restored and their number remained largely augmented. An increment in the number of motor fibres was observed after the nerve grafting in a predominantly sensory branch in all groups. This increment was more pronounced in the long graft group. In the postoperative period, about a 20% reduction in the number of misdirected motor fibres occurred in the short nerve graft group only. Variation in the length of nerve grafts interferes in behavioural recovery and increases motor fibres misdirection. Early recovery onset was related to a better outcome, which occurs in the short graft group.

  20. 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.

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

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    Hiromasa Fujii

    2009-01-01

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

  3. Effects of Wrist Posture and Fingertip Force on Median Nerve Blood Flow Velocity

    Science.gov (United States)

    Wilson, Katherine E.; Tat, Jimmy

    2017-01-01

    Purpose. The purpose of this study was to assess nerve hypervascularization using high resolution ultrasonography to determine the effects of wrist posture and fingertip force on median nerve blood flow at the wrist in healthy participants and those experiencing carpal tunnel syndrome (CTS) symptoms. Methods. The median nerves of nine healthy participants and nine participants experiencing symptoms of CTS were evaluated using optimized ultrasonography in five wrist postures with and without a middle digit fingertip press (0, 6 N). Results. Both wrist posture and fingertip force had significant main effects on mean peak blood flow velocity. Blood flow velocity with a neutral wrist (2.87 cm/s) was significantly lower than flexed 30° (3.37 cm/s), flexed 15° (3.27 cm/s), and extended 30° (3.29 cm/s). Similarly, median nerve blood flow velocity was lower without force (2.81 cm/s) than with force (3.56 cm/s). A significant difference was not found between groups. Discussion. Vascular changes associated with CTS may be acutely induced by nonneutral wrist postures and fingertip force. This study represents an early evaluation of intraneural blood flow as a measure of nerve hypervascularization in response to occupational risk factors and advances our understanding of the vascular phenomena associated with peripheral nerve compression.

  4. Effects of Wrist Posture and Fingertip Force on Median Nerve Blood Flow Velocity

    Directory of Open Access Journals (Sweden)

    Katherine E. Wilson

    2017-01-01

    Full Text Available Purpose. The purpose of this study was to assess nerve hypervascularization using high resolution ultrasonography to determine the effects of wrist posture and fingertip force on median nerve blood flow at the wrist in healthy participants and those experiencing carpal tunnel syndrome (CTS symptoms. Methods. The median nerves of nine healthy participants and nine participants experiencing symptoms of CTS were evaluated using optimized ultrasonography in five wrist postures with and without a middle digit fingertip press (0, 6 N. Results. Both wrist posture and fingertip force had significant main effects on mean peak blood flow velocity. Blood flow velocity with a neutral wrist (2.87 cm/s was significantly lower than flexed 30° (3.37 cm/s, flexed 15° (3.27 cm/s, and extended 30° (3.29 cm/s. Similarly, median nerve blood flow velocity was lower without force (2.81 cm/s than with force (3.56 cm/s. A significant difference was not found between groups. Discussion. Vascular changes associated with CTS may be acutely induced by nonneutral wrist postures and fingertip force. This study represents an early evaluation of intraneural blood flow as a measure of nerve hypervascularization in response to occupational risk factors and advances our understanding of the vascular phenomena associated with peripheral nerve compression.

  5. The usefulness of ICG video angiography in the surgical treatment of superior cluneal nerve entrapment neuropathy: technical note.

    Science.gov (United States)

    Kim, Kyongsong; Isu, Toyohiko; Chiba, Yasuhiro; Morimoto, Daijiro; Ohtsubo, Seiji; Kusano, Mitsuo; Kobayashi, Shiro; Morita, Akio

    2013-11-01

    Superior cluneal nerve (SCN) entrapment neuropathy is a known cause of low back pain. Although surgical release at the entrapment point of the osteofibrous orifice is effective, intraoperative identification of the thin SCN in thick fat tissue and confirmation of sufficient decompression are difficult. Intraoperative indocyanine green video angiography (ICG-VA) is simple, clearly demonstrates the vascular flow dynamics, and provides real-time information on vascular patency and flow. The peripheral nerve is supplied from epineurial vessels around the nerve (vasa nervorum), and the authors now present the first ICG-VA documentation of the technique and usefulness of peripheral nerve neurolysis surgery to treat SCN entrapment neuropathy in 16 locally anesthetized patients. Clinical outcomes were assessed with the Roland-Morris Disability Questionnaire before surgery and at the latest follow-up after surgery. Indocyanine green video angiography was useful for identifying the SCN in fat tissue. It showed that the SCN penetrated and was entrapped by the thoracolumbar fascia through the orifice just before crossing over the iliac crest in all patients. The SCN was decompressed by dissection of the fascia from the orifice. Indocyanine green video angiography visualized the SCN and its termination at the entrapment point. After sufficient decompression, the SCN was clearly visualized on ICG-VA images. Low back pain improved significantly, from a preoperative Roland-Morris Questionnaire score of 13.8 to a postoperative score of 1.3 at the last follow-up visit (p < 0.05). The authors suggest that ICG-VA is useful for the inspection of peripheral nerves such as the SCN and helps to identify the SCN and to confirm sufficient decompression at surgery for SCN entrapment.

  6. Transverse ultrasound assessment of median nerve deformation and displacement in the human carpal tunnel during wrist movements

    NARCIS (Netherlands)

    Y. Wang (Yuexiang); C. Zhao; S.M. Passe (Sandra); A. Filius (Anika); A.R. Thoreson (Andrew); P. An (Ping); P.C. Amadio (Peter )

    2014-01-01

    textabstractThe symptoms of carpal tunnel syndrome, a compression neuropathy of the median nerve at the wrist, are aggravated by wrist motion, but the effect of these motions on median nerve motion are unknown. To better understand the biomechanics of the abnormal nerve, it is first necessary to und

  7. Transverse ultrasound assessment of median nerve deformation and displacement in the human carpal tunnel during wrist movements

    NARCIS (Netherlands)

    Y. Wang (Yuexiang); C. Zhao; S.M. Passe (Sandra); A. Filius (Anika); A.R. Thoreson (Andrew); P. An (Ping); P.C. Amadio (Peter )

    2014-01-01

    textabstractThe symptoms of carpal tunnel syndrome, a compression neuropathy of the median nerve at the wrist, are aggravated by wrist motion, but the effect of these motions on median nerve motion are unknown. To better understand the biomechanics of the abnormal nerve, it is first necessary to und

  8. Pudendal and median nerve sensory perception threshold: a comparison between normative studies.

    Science.gov (United States)

    Quaghebeur, Jörgen; Wyndaele, Jean Jacques

    2014-12-01

    For the evaluation of sensory innervation, normative data are necessary as a comparison. To compare our current perception thresholds (CPTs) with normative data from other research. Healthy volunteers were assessed for 2000, 250, and 5 Hz CPTs of the median and pudendal nerve and data were compared with other studies. Normative data in the studied group n = 41 (male: 21; female: 20) for the median nerve, 2 kHz, 250 Hz, and 5 Hz were respectively: 241.85 ± 67.72 (140-444); 106.27 ± 39.12 (45-229); 82.05 ± 43.40 (13-271). Pudendal nerve CPTs 250 Hz were: 126.44 ± 69.46 (6-333). For men 2 kHz: 349.95 ± 125.76 (100-588); 5 Hz: 132.67 ± 51.81 (59-249) and women 2 kHz:226.20 ± 119.65 (64-528); 5 Hz: 92.45 ± 44.66 (35-215). For the median nerve no statistical differences for gender were shown. For the pudendal nerve, only 250 Hz showed no difference for gender (t-test: 0.516). Comparison of our data with CPTs of other normative data showed no agreement for the pudendal nerve. For the median nerve only 2 kHz showed agreement in three studies and for 5 Hz with one study. Comparing normative data of multiple studies shows a variety of results and poor agreement. Therefore, referring to normative data of other studies should be handled with caution.

  9. Acceptable differences in sensory and motor latencies between the median and ulnar nerves.

    Science.gov (United States)

    Grossart, Elizabeth A; Prahlow, Nathan D; Buschbacher, Ralph M

    2006-01-01

    The median and ulnar nerves are often studied during the same electrodiagnostic examination. The sensory and motor latencies of these nerves have been compared to detect a common electrodiagnostic entity: median neuropathy at the wrist. However, this comparison could also be used to diagnose less common ulnar pathology. For this reason, it is important to establish normal values for comparing median and ulnar sensory and motor latencies. Previous research deriving these differences in latency has had some limitations. The purpose of this study was to derive an improved normative database for the acceptable differences in latency between the median and ulnar sensory and motor nerves of the same limb. Median and ulnar sensory and motor latencies were obtained from 219 and 238 asymptomatic risk-factor-free subjects, respectively. An analysis of variance was performed to determine whether physical characteristics, specifically age, race, gender, height, or body mass index (as an indicator of obesity), correlated with differences in latency. Differences in sensory latencies were unaffected by physical characteristics. The upper limit of normal difference between median and ulnar (median longer than ulnar) onset latency was 0.5 ms (97th percentile), whereas the peak latency value was 0.4 ms (97th percentile). The upper limit of normal difference between ulnar-versus-median (ulnar longer than median) onset latency was 0.3 ms (97th percentile), whereas the peak-latency value was 0.5 ms (97th percentile). The mean difference in motor latencies correlated with age, with older subjects having a greater variability. In subjects aged 50 and over, the mean difference in median-versus-ulnar latency was 0.9 ms +/- 0.4 ms. The upper limit of normal difference (median longer than ulnar) was 1.7 ms (97th percentile). The upper limit of normal ulnar motor latency is attained if the ulnar latency comes within 0.3 ms of the median latency. In individuals less than 50 years of age, the

  10. A wakeboarding injury presented as acute carpal syndrome and median nerve contusion after wrist strangulation: a case report

    Science.gov (United States)

    2009-01-01

    Background We present a case of combined median nerve contusion with immediate loss of sensation after the strangulation with a wakeboarding rope and prolonged referral to our department 72 hours after the injury accompanied by an acute carpal tunnel syndrome with immediate relief of numbness of a significant proportion of the median nerve following surgical decompression. Case presentation The palmar branch of the median nerve was surrounded by a significant haematoma in addition to the strangulation damage caused by its more superficial location in contrast to the median nerve. Conclusion In case of acute median neuropathy, urgent surgical intervention with exploration, decompression of both, the median nerve and the superficial branch of the median nerve, accompanied by compartment measurements of the forearm should be performed to regain or re-establish neurological integrity. PMID:19178709

  11. Cadaveric Study of Anatomic Far Distal Musculocutaneous and Median Nerve Communication.

    Science.gov (United States)

    Hussain, Namath S

    2016-06-02

    One of the more commonly reported variations in musculocutaneous and median nerves is a communication between the two. Such communications have been noted in the literature for well over a century, and numerous studies have attempted to quantify their rate of incidence and classify their different patterns. Most communications occur close to the brachial plexus in the proximal arm; communications distal to the musculocutaneous nerve perforation of the coracobrachialis have been reported with less frequency, and several rare and unique communication patterns have been reported as case studies. This paper describes a case of a communicating branch between the musculocutaneous and median nerves, distal to the origin of the brachialis muscle. This communication was found during a routine educational dissection and is closer to the level of the elbow than previously documented communications that are distal to the musculocutaneous perforation of the coracobrachialis. Identification and documentation of the variety of musculocutaneous and median nerve communications is relevant to clinical diagnosis of peripheral nerve pathologies, as well as for planning surgical approaches and procedures.

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

    NARCIS (Netherlands)

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

    2010-01-01

    The purpose of this study was to investigate the deformation and displacement of the normal median nerve in the carpal tunnel during index finger and thumb motion, using ultrasound Thirty wrists from 15 asymptomatic volunteers were evaluated Cross-sectional images during motion from full extension t

  13. Effect of the Steindler procedure on the median nerve branches to the medial epicondylar muscles.

    Science.gov (United States)

    Chantelot, C; Feugas, C; Migaud, H; Guillem, F; Chapnikoff, D; Fontaine, C

    2000-06-01

    Usually the median nerve gives off six branches to the muscles arising from the medial epicondyle, which could be tightened during Steindler's procedure. We studied these branches before and after Steindler's procedure in 20 fresh cadavers and observed a considerable variation in the origin of the branches. The muscular branches arising from the median nerve did not seem to limit the mobilization of the medial epicondyle when performing Steindler's transfer. The limitation of the flexion observed after Steindler's procedure was mainly related to the tension of the transferred forearm flexor muscles. The variability of the origin of the branch to the flexor digitorum superficialis muscle could explain a lesion of this branch when Steindler's procedure is carried out with Brunelli's modification. The lateral transfer and the anterior transfer on to the humeral shaft did not influence the limitation of elbow flexion or result in tightness in any nerve branch to the transferred muscles.

  14. Pudendal Neuralgia Due to Pudendal Nerve Entrapment: Warning Signs Observed in Two Cases and Review of the Literature.

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    Ploteau, Stephanie; Cardaillac, Claire; Perrouin-Verbe, Marie-Aimee; Riant, Thibault; Labat, Jean-Jacques

    2016-03-01

    Pudendal neuralgia is a chronic neuropathic pelvic pain that is often misdiagnosed and inappropriately treated. The Nantes criteria provide a basis for the diagnosis of pudendal neuralgia due to pudendal nerve entrapment. The 5 essential diagnostic criteria are pain situated in the anatomical territory of the pudendal nerve, worsened by sitting, the patient is not woken at night by the pain, and no objective sensory loss is detected on clinical examination. The fifth criterion is a positive pudendal nerve block. We have also clarified a number of complementary diagnostic criteria and several exclusion criteria that make the diagnosis unlikely. When pudendal neuralgia due to pudendal nerve entrapment is diagnosed according to the Nantes criteria, no further investigation is required and medical or surgical treatment can be proposed. Nevertheless, a number of warning signs suggesting other possible causes of pudendal neuralgia must not be overlooked. These warning signs (red flags) are waking up at night, excessively neuropathic nature of the pain (for example, associated with hypoesthesia), specifically pinpointed pain, which can suggest neuroma and pain associated with neurological deficit. In these atypical presentations, the diagnosis of pain due to pudendal nerve entrapment should be reconsidered and a radiological examination should be performed. The 2 cases described in this report (tumor compression of the pudendal nerve) illustrate the need to recognize atypical pudendal neuralgia and clarify the role of pelvic magnetic resonance imaging (MRI), as MRI provides very valuable information for the evaluation of diseases involving the ischiorectal fossa. The presence of red flags must be investigated in all cases of pudendal neuralgia to avoid missing pudendal neuralgia secondary to a mechanism other than nerve entrapment.

  15. Neuropathy of motor branch of median or ulnar nerve induced by midpalm ganglion.

    Science.gov (United States)

    Kobayashi, N; Koshino, T; Nakazawa, A; Saito, T

    2001-05-01

    Two cases of neuropathy of a motor branch caused by a midpalmal ganglion are presented. In the first case the ganglion originated from the midcarpal joint, protruded into the thenar muscle, and compressed the motor branch of the median nerve. In the second case the ganglion, distal to the fibrous arch of the hypothenar muscles, originated from the third carpometacarpal joint and compressed the motor branch of the ulnar nerve. In both cases muscle weakness and finger deformity recovered well after resection of the ganglion. This clinical condition is rare compared with carpal tunnel syndrome and Guyon's tunnel syndrome, which are caused by a ganglion in the wrist.

  16. Recurrent Suprascapular Nerve Entrapment By Spinoglenoid Notch Cyst: A Case Report

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    Cigdem Guner

    2014-02-01

    Full Text Available In this case, a patient who applied to our outpatient clinics with left shoulder pain spreading to the neck and elbow is presented. Her complaints were not responsive to nonsteroidal antiinflammatory drugs. A magnetic resonance imaging (MRI of the left shoulder reported a 2x2cm size, lobulated contoured, septal cystic lesion, which was considered as a ganglion cyst, at the spinoglenoid notch, with elongation to posterior superior glenoid. Fatty degeneration consistent with denervation atrophy in infraspinatus muscle was detected, which may be secondary to the suprascapular nerve entrapment due to ganglion cyst at the spinoglenoid notch. Although there was somewhat symptomatic relief, the patient%u2019s complaints persisted after ultrasound-guided cyst aspiration. The recurrent cyst was observed in control of left shoulder MRI which was taken after four months. This case is presented to remind that suprascapular nerve neuropathy secondary to spinoglenoid notch cyst should be also considered in the differential diagnosis of nonspesific shoulder pain.

  17. Acute radial nerve entrapment at the spiral groove: detection by DTI-based neurography

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    Jengojan, Suren; Breitenseher, Julia; Weber, Michael; Prayer, Daniela; Kasprian, Gregor [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Neuro- and Musculosceletal Radiology, Vienna (Austria); Kovar, Florian [Medical University of Vienna, Department of Trauma-Surgery, Vienna (Austria)

    2015-06-01

    This study evaluated the potential of three-tesla diffusion tensor imaging (DTI) and tractography to detect changes of the radial (RN) and median (MN) nerves during transient upper arm compression by a silicon ring tourniquet. Axial T2-weighted and DTI sequences (b = 700 s/mm{sup 2}, 16 gradient encoding directions) of 13 healthy volunteers were obtained. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the MN and RN were measured at the spiral groove and further visualized in 3D by deterministic tractography (thresholds: FA =.15, angle change = 27 ). Local/lesional RN FA values increased (p = 0.001) and ADC values decreased (p = 0.02) during a 20-min upper arm compression, whereas no significant FA (p = 0.49) or ADC (p = 0.73) changes of the MN were detected. There were no T2-w nerve signal changes or alterations of nerve trajectories in 3D. Acute nerve compression of the RN leads to changes of its three-tesla DTI metrics. Peripheral nerve DTI provides non-invasive insights into the ''selective'' vulnerability of the RN at the spiral groove. (orig.)

  18. Median and ulnar nerve compression at the wrist caused by anomalous muscles.

    Science.gov (United States)

    De Smet, L

    2002-12-01

    Compression of the median and ulnar nerves at the wrist is frequently encountered. Carpal tunnel syndrome usually occurs without any obvious extrinsic cause; several cases have however been reported caused by anomalous or hypertrophic muscles. A survey of the literature shows that compression neuropathy of the median nerve has been reported in relation with anomalies affecting three muscles: the first (or second) lumbrical, the palmaris longus and its anatomic variants and the superficial flexor of the index finger. In the ulnar tunnel the situation is thoroughly different: so-called idiopathic ulnar tunnel syndrome is rare and an extrinsic compressing structure can usually be disclosed. Anomalous muscles belong to the palmaris longus/abductor digiti minimi group; the flexor carpi ulnaris is sometimes involved. One can suspect the presence of such an anomalous muscle when the compression syndrome concerns a patient who is not within the "usual" age group with symptoms initiated or aggravated by physical exercise.

  19. Pigmented villonodular synovitis of the elbow with rdial, median and ulnar nerve compression

    Science.gov (United States)

    Lu, Hui; Chen, Qiang; Shen, Hui

    2015-01-01

    Pigmented villonodular synovitis (PVNS) is a rare, idiopathic proliferative disorder of the synovium. While, PVNS of elbow is extremely rare. We report an 82-year-old female patient with 20-year-history of gradually increased PVNS in her left elbow. The multiple masses were located in anterior, medial and lateral of elbow. Her radial, median and ulnar nerves were compressed by the tumor. We resected tumor of extra-articular part piecemeally and released the compression of nerves. After the surgery, the patient gained a functional recovery. Two years after surgery she had a tumor recurrence, but without any symptoms of nerve compression syndromes. We discussed its clinical diagnosis, radiological features, MRI findings, pathophysiology, and treatment. PMID:26823718

  20. Recurrent Primary Synovial Sarcoma of Median Nerve: A Case Report and Literature Review.

    Science.gov (United States)

    Bhat, A K; Jayakrishnan, K N; Acharya, A M

    2016-10-01

    We report a case of intraneural synovial sarcoma of the median nerve in a 39 year old lady with multiple local recurrences over thirteen years with no distant metastasis. The diagnosis of biphasic type of synovial sarcoma was confirmed by histopathology and immunohistochemistry. At the time of the fourth recurrence below elbow amputation was performed. This case is being reported for its rarity and propensity for local recurrence without distant metastasis.

  1. Effect of different cuff widths on the motor nerve conduction of the median nerve: an experimental study

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    Sandhu Jaspal S

    2008-01-01

    Full Text Available Abstract Background A bloodless operative field is considered mandatory for most surgical procedures on the upper and lower extremity. This is accomplished by using either an Esmarch bandage or a pneumatic tourniquet, but a number of complications are associated with both. Nerve palsy is one of the most frequently encountered complications of this procedure. Wider cuffs have been found to cause reduced risk of tourniquet induced injury to the underlying soft tissues than the narrower ones due to the fact that lower occlusion pressures are caused by the former. To address and investigate this question, conduction in the median nerve has been measured proximal to tourniquet as well as distal to the tourniquet. Parameters of nerve conduction measured are nerve conduction velocity, latency and amplitude. Methods Sphygmomanometer cuffs with widths 14 cm and 7 cm were applied to the upper extremities of 20 healthy, normotensive volunteers (9 males and 11 females with age ranging from 22 to 27. Systolic blood pressure was measured first and then the cuff was inflated to about 20–30 mm Hg above it and was kept inflated for 15 minutes. Recordings were done prior to, for the period of tourniquet inflation, and following release of the tourniquet. Results Nerve conduction was found to be more severely affected by the 14 cm cuff than the 7 cm cuff. Conclusion Wider cuffs resulted in more severe changes in the nerve. This brings us to the conclusion that though lower inflation pressures are required for the occlusion of the blood supply using wider cuffs, the nerve conduction is more severely affected by the wider ones. Both electrophysiological changes and occlusion pressure should be kept in mind while choosing the width of the cuff.

  2. Cross-chest median nerve transfer: a new model for the evaluation of nerve regeneration across a 40 mm gap in the rat.

    Science.gov (United States)

    Sinis, Nektarios; Schaller, Hans-Eberhard; Becker, Stephan Thomas; Lanaras, Tatjana; Schulte-Eversum, Caterina; Müller, Hans-Werner; Vonthein, Reinhard; Rösner, Harald; Haerle, Max

    2006-09-30

    A new animal model for the study of nerve regeneration in rats across a 40 mm gap between both median nerves is described. For autologous grafting, the ulnar nerves were dissected and sutured together. From the left median nerve, they were transplanted across the chest to the right median nerve. Animals having undergone this operation were observed for 12 months and periodically assessed using the grasping test and measurements of body-weight. For histological analysis rats were sacrificed after this period and axon counts were determined at the suture points of operated animals and in the median nerve of non-operated animals. Functional recovery could be seen, although partially, beginning as early as the fifth postoperative month, as demonstrated by the grasping test. Quantification of the number of axons demonstrated axonal regeneration across all three coaptation points. This model provides a new approach for analysis of long distance peripheral nerve regeneration without impairment of behaviour.

  3. Laser Therapy After Repair of the Distal Half of the Median Nerve; a Comparative Study

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    Seyed Forootan

    2015-05-01

    Full Text Available Background Nerve injuries resulting from major or minor trauma often cause some disabilities for patients. Neurotmesis, characterized by complete anatomical rupture of the nerve, is the most severe form of the injury which will not recover without reconstructive surgery and nowadays such neural damages are improved by microsurgical procedures. Some studies have used low power laser for nerve cell growth in order to improve the rehabilitation results of peripheral nerves. Low power laser can complement the reformation of postsurgical nerve injuries. Objectives The current study aimed to assess the effects of laser therapy after repair of median nerve rupture in the distal third of the forearm and to compare the results with that of the standard method. Patients and Methods The current study was a case-control clinical trial of 36 patients with volar surface rupture of the distal third of forearm admitted to the emergency ward of Hazrat-e-Fatemeh Hospital within 72 hours of injury, they had anesthesia in the first, second, and third fingers as a result of Median Nerve Injury. Patients were divided into two groups. The first group included subjects treated with standard methods and the second group included those treated with low power laser therapy (LT along with the standard method. The same surgeon operated the subjects in the two groups. The second group underwent 10 sessions of LT every other day. Clinical Examination, Electromyography and Nerve Conduction Velocity (NCV were done after six months and the results were compared. Results In the two -point discrimination- test, there was no significant difference between the two groups in the thumbs but a significant improvement was observed in the index finger of the LT group. Improvement of muscular examinations such as opposition and thumb abduction supported the usage of laser in the second group. Regarding electromyography and NCV, significant statistical difference was observed in the motor

  4. A rare cause of ulnar nerve entrapment at the elbow area illustrated by six cases: The anconeus epitrochlearis muscle.

    Science.gov (United States)

    Fernandez, J; Camuzard, O; Gauci, M-O; Winter, M

    2015-12-01

    Ulnar nerve entrapment is the second most common compressive neuropathy after carpal tunnel syndrome. The accessory anconeus epitrochlearis muscle - present in 4% to 34% of the general population - is a known, but rare cause of ulnar nerve entrapment at the elbow. The aim of this article was to expand our knowledge about this condition based on six cases that we encountered at our hospital between 2011 and 2015. Every patient had a typical clinical presentation: hypoesthesia or sensory deficit in the fourth and fifth fingers; potential intrinsics atrophy of the fourth intermetacarpal space; loss of strength and difficulty with fifth finger abduction. Although it can be useful to have the patient undergo ultrasonography or MRI to aid in the diagnosis, only electromyography (EMG) was performed in our patients. EMG revealed clear compression in the ulnar groove, with conduction block and a large drop in nerve conduction velocity. Treatment typically consists of conservative treatment first (splint, analgesics). Surgical treatment should be considered when conservative treatment has failed or the patient presents severe neurological deficits. In all of our patients, the ulnar nerve was surgically released but not transposed. Five of the six patients had completely recovered after 0.5 to 4years follow-up. Ulnar nerve entrapment at the elbow by the anconeus epitrochlearis muscle is not common, but it must not be ignored. Only ultrasonography, MRI or, preferably, surgical exploration can establish the diagnosis. EMG findings such as reduced motor nerve conduction velocity in a short segment of the ulnar nerve provides evidence of anconeus epitrochlearis-induced neuropathy.

  5. Intrinsic hand muscle reinnervation by median-ulnar end-to-side bridge nerve graft: case report.

    Science.gov (United States)

    Magdi Sherif, M; Amr, Adel H

    2010-03-01

    Recovery of either the motor or sensory functions has not been consistently achieved in upper extremity end-to-side neurorrhaphy; this technique was only indicated when more conventional nerve repair was not possible. In most studies, the whole median or ulnar nerve was used for end-to-side neurotization. In this report, we present 4 cases of high-median or ulnar nerve laceration in which a nerve graft was placed end-to-side between the median and ulnar motor fascicles close to the wrist. At 4 months after surgery, 3 of 4 patients began to recover active movement of the affected small muscles of the hand. EMG and nerve conduction studies confirmed that nerve conduction was through the nerve grafts.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  7. Effect of Wrist Deviation on Median Nerve Cross-Sectional Area at Proximal Carpal Tunnel Level

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    Ping Yeap LOH

    2015-10-01

    Full Text Available Background: Carpal tunnel syndrome (CTS is one of the most common musculoskeletal disorders among computer users. Computer users exhibit various wrist angles while typing. Dynamic changes of wrist angle may cause different degrees of median nerve compression. The objective of this study was thus to investigate the effects of the combination of wrist flexion-extension with wrist deviation on median nerve cross-sectional area (MNCSA.Methods:  Eight right-handed participants were recruited in this study. Both wrists were examined by sonographic ultrasound (US at the proximal carpal tunnel level in the transverse plane. A total of nine wrist positions were examined, including wrist neutral (WN, wrist flexion (WF30°, and wrist extension (WE30°, together with three wrist deviation conditions, namely, without radial deviation (RD and ulnar deviation (UD, with maximal RD and with maximal UD. MNCSA was measured by tracing method with ImageJ.Results: Paired t-test showed a significant difference of WN MNCSA between the dominant hand (7.93 ± 0.63 mm2 and the non-dominant hand (6.98 ± 0.42 mm2 (P<0.001. Two-way repeated-measures ANOVA (handedness as an independent factor showed that WF30° and WE30° caused significant differences of MNCSA when compared with WN (P<0.001. However, wrist RD/UD did not have a significant interaction with the changes of MNCSA in WN, WF and WE positions.Conclusion: The results indicate a significant reduction of MNCSA when WN changed to WF and WE. Wrist RD and UD did not cause significant changes of MNCSA at different wrist positions. Keywords: Median nerve, Ultrasound, Wrist active holding, Nerve deformation

  8. MRI shows thickening and altered diffusion in the median and ulnar nerves in multifocal motor neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Haakma, Wieke [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Aarhus University, Department of Forensic Medicine and Comparative Medicine Lab, Aarhus (Denmark); Jongbloed, Bas A.; Goedee, H.S.; Berg, Leonard H. van den; Pol, W.L. van der [University Medical Center Utrecht, Brain Centre Rudolf Magnus, Department of Neurology and Neurosurgery, Utrecht (Netherlands); Froeling, Martijn; Bos, Clemens; Hendrikse, Jeroen [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Leemans, Alexander [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)

    2017-05-15

    To study disease mechanisms in multifocal motor neuropathy (MMN) with magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) of the median and ulnar nerves. We enrolled ten MMN patients, ten patients with amyotrophic lateral sclerosis (ALS) and ten healthy controls (HCs). Patients underwent MRI (in a prone position) and nerve conduction studies. DTI and fat-suppressed T2-weighted scans of the forearms were performed on a 3.0T MRI scanner. Fibre tractography of the median and ulnar nerves was performed to extract diffusion parameters: fractional anisotropy (FA), mean (MD), axial (AD) and radial (RD) diffusivity. Cross-sectional areas (CSA) were measured on T2-weighted scans. Forty-five out of 60 arms were included in the analysis. AD was significantly lower in MMN patients (2.20 ± 0.12 x 10{sup -3} mm{sup 2}/s) compared to ALS patients (2.31 ± 0.17 x 10{sup -3} mm{sup 2}/s; p < 0.05) and HCs (2.31± 0.17 x 10{sup -3} mm{sup 2}/s; p < 0.05). Segmental analysis showed significant restriction of AD, RD and MD (p < 0.005) in the proximal third of the nerves. CSA was significantly larger in MMN patients compared to ALS patients and HCs (p < 0.01). Thickening of nerves is compatible with changes in the myelin sheath structure, whereas lowered AD values suggest axonal dysfunction. These findings suggest that myelin and axons are diffusely involved in MMN pathogenesis. (orig.)

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

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    Amirsadri R

    1998-07-01

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

  10. Influence of a 50 Hz-1 mT Magnetic Field on Human Median Nerve

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    Özlem COŞKUN

    2009-02-01

    Full Text Available With the increasing use of magnetic fields in recent five decades, the health effects of nonionized electromagnetic radiation is an important investigation subject. While the magnetic field is well known, it is difficult to investigate the health effects of radiation, because of the complex metabolism of human body. However, by the experimental and theorical studies, a lot of significant health effects of magnetic fields have been discovered. But, there are probabilities that can have much more adverse health effects. The purpose of this study is to evaluate the effect of 50 Hz-1 mT magnetic field on human median motor nerve conduction parameters. At this frequency, 1 mT value of magnetic field intensity is known and accepted as the marginal value where biological interaction starts. Standard nerve conduction techniques using constant measured distances were applied to evaluate the median nerve. Consequently in the measures conducted using the device of 4 channel NCS/EMG/ EPS there was a significant decrease in motor distal amplitude after the magnetic field application in comparison to the one during the application (p=0,000573 and also in the motor distal amplitude/ proximal amplitude in comparison to the ones before the application (p=0,037418.

  11. Diffusion-weighted MR neurography of median and ulnar nerves in the wrist and palm

    Energy Technology Data Exchange (ETDEWEB)

    Bao, Hongjing; Wang, Shanshan; Wang, Guangbin; Hasan, Mansoor-ul; Yao, Bin; Wu, Chao; Wu, Lebin [Shandong University, Department of MR, Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jinan, Shandong (China); Yang, Li [Fudan University, Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Shanghai (China); Zhang, Xu [Shandong Chest Hospital, Department of Radiology, Jinan, Shandong (China); Chen, Weibo; Chan, Queenie [Philips Healthcare, Shanghai (China); Chhabra, Avneesh [UT Southwestern Medical Center, Dallas, TX (United States)

    2017-06-15

    To investigate the feasibility of diffusion-weighted magnetic resonance neurography (DW-MRN) in the visualisation of extremity nerves in the wrist and palm. Thirty-two volunteers and 21 patients underwent imaging of the wrist and palm on a 3-T MR scanner. In all subjects, two radiologists evaluated the image quality on DW-MRN using a four-point grading scale. Kappa statistics were obtained for inter-observer performance. In volunteers, the chi-squared test was used to assess the differences in nerve visualisation on DW-MRN and axial fat-suppressed proton density weighted imaging (FS-PDWI). In volunteers, the mean image quality scores for the median nerve (MN) and ulnar nerve (UN) were 3.71 ± 0.46 and 3.23 ± 0.67 for observer 1, and 3.70 ± 0.46 and 3.22 ± 0.71 for observer 2, respectively. The inter-observer agreement was excellent (k = 0.843) and good (k = 0.788), respectively. DW-MRN provided significantly improved visualisations of the second and the third common palmar digital nerves and three branches of UN compared with FS-PDWI (P < 0.05). In patients, the mean image quality scores for the two observers were 3.24 ± 0.62 and 3.10 ± 0.83, inter-observer performance was excellent (k = 0.842). DW-MRN is feasible for improved visualisation of extremity nerves and their lesions in the wrist and palm with adequate image quality, thereby providing a supplementary method to conventional MR imaging. (orig.)

  12. Speckled lentiginous nevus syndrome with median nerve paresis: A rare syndrome with a new association

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    Vibhu Mendiratta

    2013-01-01

    Full Text Available Speckled lentiginous nevus (SLN represents a mosaic phenotype which consists of café au lait macule superimposed by melanocytic nevi. Recently, SLN syndrome has been characterized where ipsilateral neurological abnormalities have been reported in association with SLN with papular type of melanocytic nevi only. This case describes the presence of ipsilateral thenar muscle atrophy with median nerve paresis in nevus spilus which had melanocytic nevi of the macular type alone, thus delineating a new association in SLN syndrome, hitherto unreported.

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

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    Belgin Bamac

    2014-12-01

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

  14. Acute effects of neural mobilization and infrared on the mechanics of the median nerve

    Science.gov (United States)

    Nunes, Monara Kedma; Fontenele dos Santos, Gabrielly; Martins e Silva, Diandra Caroline; Mota de Freitas, Ana Cláudia; Henriques, Isadora Ferreira; Andrade, Peterson Marco; Machado, Dionis de Castro; Teixeira, Silmar; Neves, Marco Orsini; Dias, Gildário; Silva-Júnior, Fernando; Bastos, Victor Hugo

    2016-01-01

    [Purpose] This study analyzed the acute effects of infrared and neural mobilization on the median nerve on the range of elbow extension of the dominant limb. [Subjects and Methods] Forty participants from university, neurologically asymptomatic, 12 males and 28 females (22.8 ± 1.9 years), were randomly divided into four groups: Group 1 (control) rested for 25 minutes in the supine position; Group 2 received the specific neural mobilization for the median nerve; Group 3 received an application of infrared for 15 minutes on the forearm; Group 4 received the same application of infrared followed by neural mobilization. The goniometric parameters of elbow extension were evaluated after the intervention. [Results] Significant differences of extension value were observed between Group 1 and Group 3 (15.75 degrees), and between Group 1 and Group 4 (14.60 degrees), and the average higher in Group 3 (26.35 degrees). [Conclusion] This research provides new experimental evidence that NM in relation to superficial heat produces an immediate effect on elbow range of motion versus NM isolated. PMID:27390402

  15. Transverse ultrasound assessment of median nerve deformation and displacement in the human carpal tunnel during wrist movements.

    Science.gov (United States)

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

    2014-01-01

    The symptoms of carpal tunnel syndrome, a compression neuropathy of the median nerve at the wrist, are aggravated by wrist motion, but the effect of these motions on median nerve motion are unknown. To better understand the biomechanics of the abnormal nerve, it is first necessary to understand normal nerve movement. The purpose of this study was to evaluate the deformation and displacement of the normal median nerve at the proximal carpal tunnel level on transverse ultrasound images during different wrist movements, to have a baseline for comparison with abnormal movements. Dynamic ultrasound images of both wrists of 10 asymptomatic volunteers were obtained during wrist maximal flexion, extension and ulnar deviation. To simplify the analysis, the initial and final shape and position of the median nerve were measured and analyzed. The circularity of the median nerve was significantly increased and the aspect ratio and perimeter were significantly decreased in the final image compared with the first image during wrist flexion with finger extension, wrist flexion with finger flexion and wrist ulnar deviation with finger extension (p nerve displacement vector between finger flexion, wrist flexion with finger extension and wrist ulnar deviation with finger extension (all p's nerve motion in wrist flexion with finger extension (2.36 ± 0.79 normalized units [NU]), wrist flexion with finger flexion (2.46 ± 0.84 NU) and wrist ulnar deviation with finger extension (2.86 ± 0.51 NU) were higher than those in finger flexion (0.82 ± 0.33 NU), wrist extension with finger extension (0.77 ± 0.46 NU) and wrist extension with finger flexion (0.81 ± 0.58 NU) (p ulnar deviation could induce significant transverse displacement and deformation of the median nerve.

  16. Comparison of assessment tools to score recovery of function after repair of traumatic lesions of the median nerve

    NARCIS (Netherlands)

    Wong, K. H.; Coert, J. H.; Robinson, P. H.; Meek, M. F.

    2006-01-01

    In this paper the recovery after repair of the median nerve has been used to compare different assessment tools for evaluation of peripheral nerve function: touch ( moving 2-point discrimination (2PD); Semmes-Weinstein ( SW) monofilament, motor ( Medical Research Council (MRC) scale), combined motor

  17. A comparative clinical and electromyographic study of median and ulnar nerve injuries at the wrist in children and adults.

    Science.gov (United States)

    Duteille, F; Petry, D; Poure, L; Dautel, G; Merle, M

    2001-02-01

    The outcome of 38 median and ulnar nerve injuries at the wrist in 15 adults and 15 children were studied with a follow-up of at least 1 year. Each patient was assessed clinically and with nerve conduction studies. The results confirm a markedly superior sensory recovery in children. However the children had persistent motor deficiencies. This difference in the clinical results of adults and children was not reflected in the nerve conduction results which were similar in both groups.

  18. 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

  19. A widely displaced Galeazzi-equivalent lesion with median nerve compromise.

    Science.gov (United States)

    Galanopoulos, Ilias; Fogg, Quentin; Ashwood, Neil; Fu, Katherine

    2012-08-18

    We present the case of a 14-year-old boy with a right distal radial fracture accompanied by a severely displaced complete distal ulnar physeal separation and associated median nerve compromise. This injury is known as Galeazzi-equivalent lesion in children and is an extremely rare injury associated with growth arrest. Recognition of the lesion can be difficult but wide displacement may be associated with other significant injuries such as neurovascular compromise. Prompt intervention reversed the neurological symptoms. At 10-month postoperation there was neither growth arrest nor loss of motion. Complete separation of the ulna physis remains often because of soft tissue interposition or capsule problems and prompt reduction is recommended in the literature as a priority.

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

    Science.gov (United States)

    Kar, Sumit; Krishnan, Ajay; Singh, Neha; Singh, Ramji; Pawar, Sachin

    2013-04-01

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

  1. Morphological and Radiological Study of Ossified Superior Transverse Scapular Ligament as Potential Risk Factor of Suprascapular Nerve Entrapment

    Directory of Open Access Journals (Sweden)

    Michał Polguj

    2014-01-01

    Full Text Available The suprascapular notch is covered superiorly by the superior transverse scapular ligament. This region is the most common place of suprascapular nerve entrapment formation. The study was performed on 812 specimens: 86 dry scapulae, 104 formalin-fixed cadaveric shoulders, and 622 computer topography scans of scapulae. In the cases with completely ossified superior transverse scapular ligament, the following measurements were performed: proximal and distal width of the bony bridge, middle transverse and vertical diameter of the suprascapular foramen, and area of the suprascapular foramen. An ossified superior transverse scapular ligament was observed more often in men and in the right scapula. The mean age of the subjects with a completely ossified superior transverse scapular ligament was found to be similar than in those without ossification. The ossified band-shaped type of superior transverse scapular ligament was more common than the fan-shaped type and reduced the space below the ligament to a significantly greater degree. The ossified band-shaped type should be taken into consideration as a potential risk factor in the formation of suprascapular nerve entrapment. It could explain the comparable frequency of neuropathy in various populations throughout the world despite the significant differences between them in occurrence of ossified superior transverse scapular ligament.

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

    Science.gov (United States)

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

    2015-12-01

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

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

    OpenAIRE

    2014-01-01

    Objectives: Repetitive microtrauma or overuse injuries may often affect upper extremities of the long term computer users. The aim of this study was to compare sensory nerve conduction velocities (SNCV) for median, radial and ulnar nerves in the wrist of computer users with the same parameters in controls who do not use computers regularly. Material and Methods: Twenty one male computer users (age: mean (M) = 28.3 years ± standard deviation (SD) = 7.5 years) and 21 male control subjects (age:...

  4. Synergistic effects of compound physical factor treatment on neurological outcome after peripheral nerve entrapment surgery A randomized controlled study

    Institute of Scientific and Technical Information of China (English)

    Gaofeng Li; Dehu Tian; Jianli Yu; Wenzhi Li; Jie Meng

    2008-01-01

    BACKGROUND: Iatrophysics can improve the velocity of local microcirculation at peripheral nerve injured sites and promote the recovery from injury. Research has shown that simultaneous application of two physical factors has synergistic effects on the recovery of peripheral nerve function.OBJECTIVE: To treat patients that received peripheral nerve entrapment surgery with comprehensive rehabilitation by decimeter wave therapy and electrical stimulation, and to observe the clinical effects of promoting nerve function recovery. DESIGN: Randomized controlled study.SETTINGS: Department of Orthopaedics, the Third Hospital of Baoding; Department of Hand Surgery, the Third Hospital of Hebei Medical University; Woman-Children Healthcare Center, Southern District, Baoding. PARTICIPANTS: A total of 124 patients, who received peripheral nerve entrapment surgery, were selected from the Department of Orthopaedics, the Third Hospital of Baoding between July 2001 and May 2007. All patients met the diagnostic standard of peripheral nerve entrapment syndrome defined by Doctor Chen in 1995. All subjects gave informed consent for treatments and conditions involved. The experiment was approved by a local ethics committee. All patients were randomly divided into four groups: electrical stimulation group, decimeter wave group, compound physical factor group, and control group, with 31 subjects in each group. METHODS: Patients received neurolysis at an appropriate interval after hospitalization. ① Multi-form wave therapeutic equipment made in China was used to treat patients in the electrical stimulation group after neurolysis. Wave form, stimulus width, interval time, and stimulus intensity were regulated based on the grade of nerve injury. The details were as follows: mild nerve injury: 50–100-ms stimulus width and 1 500–2 000-ms intervals; moderate nerve injury: 100–200-ms stimulus width and 3 000–4 000-ms intervals; severe nerve injury: 200–300-ms stimulus width and 3 000

  5. High frequency oscillations after median nerve stimulations in healthy children and adolescents.

    Science.gov (United States)

    Zanini, Sergio; Del Piero, Ivana; Martucci, Lucia; Restuccia, Domenico

    2017-10-01

    The aim of the present research was to address somatosensory high frequency oscillations (400-800Hz) in healthy children and adolescents in comparison with healthy adults. We recorded somatosensory evoked potentials following median nerve stimulation in nineteen resting healthy children/adolescents and in nineteen resting healthy adults with eyes closed. We administered six consecutive stimulation blocks (500 sweeps each). The presynaptic component of high frequency oscillations amplitudes was smaller in healthy children/adolescents than in healthy adults (no difference between groups was found as far as the postsynaptic component was concerned). Healthy children/adolescents had smaller presynaptic component than the postsynaptic one (the postsynaptic component amplitude was 145% of the presynaptic one), while healthy adults showed the opposite (reduction of the postsynaptic component to 80% of the presynaptic one). No habituation phenomena concerning high frequency oscillation amplitudes were registered in neither healthy children/adolescents nor healthy adults. These findings suggest that healthy children/adolescents present with significantly different pattern of somatosensory high frequency oscillations compared with healthy adults' ones. This different pattern is reasonably expression of higher cortical excitability of the developing brain cortex. Copyright © 2017 ISDN. Published by Elsevier Ltd. All rights reserved.

  6. Incidence of Upper Extremity Nerve Entrapments In Veterans With Major Limb Amputations

    Science.gov (United States)

    2009-03-01

    epicondyle and above- elbow stimulation was performed with the elbow flexed to 90 degrees at a distance of 4cm proximal to medial epicondyle (6, 8, 11...deep tendon reflexes, strength testing, sensory testing with pinprick and light touch, Tinel’s test at the elbow and wrist, and Phalen’s test. All...subjects had ulnar entrapment neuropathy across the elbow (22/38 affected limbs, 6 subjects with unilateral and 8 subjects with bilateral findings

  7. Reliability of the grip strength coefficient of variation for detecting sincerity in normal and blocked median nerve in healthy adults.

    Science.gov (United States)

    Wachter, N J; Mentzel, M; Hütz, R; Gülke, J

    2017-04-01

    In the assessment of hand and upper limb function, detecting sincerity of effort (SOE) for grip strength is of major importance to identifying feigned loss of strength. Measuring maximal grip strength with a dynamometer is very common, often combined with calculating the coefficient of variation (CV), a measure of the variation over the three grip strength trials. Little data is available about the relevance of these measurements in patients with median nerve impairment due to the heterogeneity of patient groups. This study examined the reliability of grip strength tests as well as the CV to detect SOE in healthy subjects. The power distribution of the individual fingers and the thenar was taken into account. To assess reliability, the measurements were performed in subjects with a median nerve block to simulate a nerve injury. The ability of 21 healthy volunteers to exert maximal grip force and to deliberately exert half-maximal force to simulate reduced SOE in a power grip was examined using the Jamar(®) dynamometer. The experiment was performed in a combined setting with and without median nerve block of the same subject. The force at the fingertips of digits 2-5 and at the thenar eminence was measured with a sensor glove with integrated pressure receptors. For each measurement, three trials were recorded subsequently and the mean and CV were calculated. When exerting submaximal force, the subjects reached 50-62% of maximal force, regardless of the median nerve block. The sensor glove revealed a significant reduction of force when exerting submaximal force (P1 sensor) with (P<0.032) and without median nerve block (P<0.017). An increase in CV at submaximal force was found, although it was not significant. SOE can be detected with the CV at the little finger at using a 10% cut-off (sensitivity 0.84 and 0.92 without and with median nerve block, respectively). These findings suggest low reliability of the power grip measurement with the Jamar(®) dynamometer, as

  8. Usefulness of combination of grey-scale and color Doppler ultrasound findings in the diagnosis of ulnar nerve entrapment syndrome

    Directory of Open Access Journals (Sweden)

    Mohammad Ebrahim Ghanei

    2015-01-01

    Full Text Available Background: Ulnar nerve entrapment (UNE has been diagnosed with clinical examination and electrodiagnostic studies. This study was designed to determine the value of a combination of grey-scale and color Doppler ultrasound findings in the diagnosis of patients with UNE. Materials and Methods: During May to August 2013 41 patients with UNE (proven by electrodiagnostic studies and 44 healthy volunteers were evaluated by ultrasound study. Three cross-sectional area (CSA of ulnar nerve around cubital fossa was determined and measured in both groups. The maximum and minimum diameter of ulnar nerve was measured for calculating flattening ratio index (FRI. Vascularity of ulnar nerve around cubital fossa was also examined in proper color Doppler setting. Results: The mean CSA of nerve at all proximal, middle and distal levels were greater in patients with UNE than in controls (P = 0.02, <0.001 and 0.34 respectively. A cut-off point of 10.5 mm 2 for CSA (in the level of the cubital fossa yielded a sensitivity and specificity of 92.7% and 93.2%, respectively. Mean FRI was 3.1 ± 0.6 in patients with UNE group and 1.4 ± 0.2 in the control group with a significant difference (P < 0.001. FRI with cutoff point 2.15 has been shown as an important parameter for the detection of UNE. The vascularity in UNE has a sensitivity and specificity of 66% and 93.2%, respectively, and has a higher probability of being positive in severe UNE. Conclusion: Combination of grey-scale and color Doppler ultrasound may provide valuable diagnostic criteria and severity assessment of UNE.

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Zhen Feng

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  12. Median nerve deformation in differential finger motions : Ultrasonographic comparison of carpal tunnel syndrome patients and healthy controls

    NARCIS (Netherlands)

    van Doesburg, Margriet H. M.; Henderson, Jacqueline; Yoshii, Yuichi; van der Molen, Aebele B. Mink; Cha, Stephen S.; An, Kai-Nan; Amadio, Peter C.

    2012-01-01

    We investigated the median nerve deformation in the carpal tunnel in patients with carpal tunnel syndrome and controls during thumb, index finger, middle finger, and a four finger motion, using ultrasound. Both wrists of 29 asymptomatic volunteers and 29 patients with idiopathic carpal tunnel syndro

  13. [Clinical observation on superior cluneal nerve entrapment syndrome treated by relaxation therapy of in-row multi-needling technique].

    Science.gov (United States)

    Li, Chang-Fa; Zhang, Jie; Wang, Jun-Ru

    2012-11-01

    To observe the clinical efficacy on superior cluneal nerve entrapment syndrome treated by relaxation therapy of in-row multi-needling technique. One hundred and twenty cases were randomized into a multi-needling group, an acupotomy group and a conventional acupuncture group, 40 cases in each one. In the multi-needling group, the perpendicular or oblique puncture was applied to the affected area of the lumbar and gluteal region. The chief needling sites were determined in terms of the strong response of acupuncture to be the chief points. The in-row multi-needling technique was applied around the chief needling sites, with lifting, thrusting penetrating method to different directions. Two chief points were connected with the G6805 low frequency pulse therapeutic apparatus. In the acupotomy group, the acupotomy was applied to 3 to 4 affected sites in each treatment. In the conventional acupuncture group, Shenshu (BL 23), Dachangshu (BL 25), Jiaji (EX-B 2) in the lumbar region, Zhibian (BL 54) and the others were selected and connected with the G6805 low frequency pulse therapeutic apparatus. The cases in each group were treated for 4 weeks. The improvements of pain score, therapeutic efficacy and comprehensive satisfaction assessment were compared among 3 groups in 2 and 4 weeks of treatment separately. The pain scores in each group were reduced apparently in 2 and 4 weeks of treatment separately (all Prelaxation therapy of in-row multi-needling technique achieves the definite therapeutic effect on superior cluneal nerve entrapment syndrome. The efficacy is superior to acupotomy and the conventional acupuncture. The therapeutic effect is better for the cases of the extensive affected scope, unclear location and large distribution in patches caused by the adhesion of muscles and fascia especially.

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

    Directory of Open Access Journals (Sweden)

    Bhanu SP

    2010-02-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Jun Chen; Shan Wu; Jun Ren

    2011-01-01

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

  16. Hamartoma fibrolipomatoso de nervo mediano: relato de caso Fibrolipomatous hamartoma of the median nerve: case report

    Directory of Open Access Journals (Sweden)

    Paulo José Lorenzoni

    2005-09-01

    Full Text Available O hamartoma fibrolipomatoso é neoplasia benigna rara que em alguns casos esta associada com macrodactilia. Descrevemos o caso de homem de 31 anos que apresentava desde o nascimento aumento de volume em região de punho, segundo e terceiro quirodáctilos da mão esquerda. Aos 23 anos iniciou dor contínua, de forte intensidade, predominante no período noturno e de evolução progressiva em mão esquerda. Associada à dor havia hipoestesia e parestesias de predomínio nos segundo e terceiro quirodáctilos esquerdos. A investigação complementar com radiografia, ultrassonografia, estudo eletrofisiológico e ressonância magnética de mão e punho esquerdos confirmaram a suspeita de síndrome do túnel do carpo secundária a macrodactilia com hamartoma fibrolipomatoso do nervo mediano. O paciente foi submetido à descompressão cirúrgica do túnel do carpo esquerdo devido a ausência de resposta ao tratamento clínico e evoluiu com melhora dos sintomas em avaliação após três meses do procedimento.Fibrolipomatous hamartoma is a rare benign neoplasm that in some cases is associated with macrodactylia. We describe a 31-years-old man who had a tissue enlargement in the wrist, second and third fingers of the left hand since infancy. At 23-years-old he began with continuous, progressive and high intensity pain that occurred more frequently at night, localized in the left hand. It was associated with paraesthesias and hypostesias predominantly at the fingers described above. Investigation with X-ray, ultrasonography, electrodiagnosis, magnetic resonance image of the left wrist and hand showed carpal tunnel syndrome with macrodactylia by fibrolipomatous hamartoma of the median nerve. The patient did not a have good response to clinical therapy, so he was submitted to a surgical decompression of the left carpal tunnel, and after three months of follow up is asymptomatic.

  17. Sciatic nerve entrapment in the upper thigh caused by an injury sustained during World War II at the battle of Anzio. Case report.

    Science.gov (United States)

    Oldershaw, John B; Salem, Ayman; Storrs, Bruce B; Milner, Brenton; Omer, George E

    2004-03-01

    The authors present an unusual case of sciatic nerve entrapment due to a World War II shrapnel injury to the left thigh suffered during the battle of Anzio in 1943. The patient presented for evaluation of left lower-extremity pain in the sciatic nerve distribution. Magnetic resonance imaging of the lumbosacral spine revealed a disc bulge at L5-S1 that would not explain severe sciatica. A positive Tinel sign was present in the posterior aspect of the upper thigh at the site of a scar resulting from a World War II shrapnel injury. The patient underwent exploratory external neurolysis of the area, and the sciatic nerve was released from fibrous adhesive entrapment. The patient improved dramatically following surgery. During a 3-year follow-up period, no recurrence of symptoms was noted.

  18. 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.)

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

    Directory of Open Access Journals (Sweden)

    Sumit Kar

    2013-01-01

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

  20. 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.

  1. Hereditary neuropathy with liability to pressure palsies in a Turkish patient (HNPP): a rare cause of entrapment neuropathies in young adults.

    Science.gov (United States)

    Celik, Yahya; Kilinçer, Cumhur; Hamamcioğlu, M Kemal; Balci, Kemal; Birgili, Bariş; Cobanoğlu, Sebahattin; Utku, Ufuk

    2008-01-01

    Hereditary neuropathy with liability to pressure palsies (HNPP) is an autosomal dominant nerve disease usually caused by 1,5 Mb deletion on chromosome 17p11.2.2-p12, the region where the PMP-22 gene is located. The patients with HNPP usually have relapsing and remitting entrapment neuropathies due to compression. We present a 14-year-old male who had acute onset, right-sided ulnar nerve entrapment at the elbow. He had electrophysiological findings of bilateral ulnar nerve entrapments (more severe at the right side) at the elbow and bilateral median nerve entrapment at the wrist. Genetic tests of the patient demonstrated deletions in the 17p11.2 region. The patient underwent decompressive surgery for ulnar nerve entrapment at the elbow and completely recovered two months after the event. Although HNPP is extremely rare, it should be taken into consideration in young adults with entrapment neuropathies.

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

    Science.gov (United States)

    Emre, Ufuk; Unal, Aysun

    2009-08-01

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

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

    Science.gov (United States)

    Guggenberger, Roman; Nanz, Daniel; Puippe, Gilbert; Rufibach, Kaspar; White, Lawrence M; Sussman, Marshall S; Andreisek, Gustav

    2012-08-01

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

  4. Role of magnetic resonance imaging in entrapment and compressive neuropathy - what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 1. Overview and lower extremity

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sungjun [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Hanyang University, Kuri Hospital, Department of Diagnostic Radiology, College of Medicine, Kuri City, Kyunggi-do (Korea); Choi, Jin-Young; Huh, Yong-Min; Song, Ho-Taek; Lee, Sung-Ah [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Kim, Seung Min [Yonsei University, Department of Neurology, College of Medicine, Seoul (Korea); Suh, Jin-Suck [Yonsei University, Department of Diagnostic Radiology, College of Medicine, Seoul (Korea); Yonsei University, Research Institute of Radiological Science, College of Medicine, Seoul (Korea)

    2007-01-15

    The diagnosis of nerve entrapment and compressive neuropathy has been traditionally based on the clinical and electrodiagnostic examinations. As a result of improvements in the magnetic resonance (MR) imaging modality, it plays not only a fundamental role in the detection of space-occupying lesions but also a compensatory role in clinically and electrodiagnostically inconclusive cases. Although ultrasound has undergone further development in the past decades and shows high resolution capabilities, it has inherent limitations due to its operator dependency. We review the general concepts that should be known to evaluate the entrapment and compressive neuropathy in MR imaging. We also review the course of normal peripheral nerves, as well as various clinical demonstrations and pathological features of compressed and entrapped nerves in the lower extremities on MR imaging, according to the nerves involved. The common sites of nerve entrapment of the lower extremity are as follows: sciatic nerve around the piriformis muscle; tibial nerve at the popliteal fossa and tarsal tunnel, common peroneal nerve around the fibular neck, and digital nerve near the metatarsal head. Although MR imaging can depict the peripheral nerves in the extremities effectively, radiologists should be familiar with nerve pathways, common sites of nerve compression, and common space-occupying lesions resulting in nerve compression in MR imaging. (orig.)

  5. Meralgia paresthetica caused by entrapment of the lateral femoral subcutaneous nerve at the fascia lata of the thigh: a case report and literature review.

    Science.gov (United States)

    Omichi, Yasuyuki; Tonogai, Ichiro; Kaji, Shinsuke; Sangawa, Teruaki; Sairyo, Koichi

    2015-01-01

    Meralgia paresthetica (MP) causes tingling, stinging or a burning sensation in the anterolateral part of the thigh, usually as a result of entrapment of the lateral femoral cutaneous nerve (LFCN) at the inguinal ligament (IL) due to mechanical or iatrogenic injury. However, there are few reports on MP caused by entrapment of the LFCN at a more distal site from the IL. We report here a rare case of MP caused by entrapment of the LFCN at the fascia lata of the thigh level. A 23-year-old man felt numbness and sharp pain at the anterolateral aspects of both thighs soon after direct repair surgery for L5 isthmic spondylolisthesis. Although his symptoms were relieved a few days later, numbness and sharp pain in the right thigh recurred 6 months after the surgery. A diagnosis of MP was made, and decompression of the LFCN was performed because conservative treatment for MP was inadequate. Intraoperatively, it was noted that the LFCN was entrapped underneath the fascia lata of the thigh, not at the IL level. His symptoms disappeared after LFCN was released. This case demonstrates that it is necessary to consider the possibility of entrapment of the LFCN at the fascia lata at the thigh level in MP.

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

    LENUS (Irish Health Repository)

    McHugh, John C

    2012-02-01

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

  7. Ultrasonographic nerve enlargement of the median and ulnar nerves and the cervical nerve roots in patients with demyelinating Charcot-Marie-Tooth disease: distinction from patients with chronic inflammatory demyelinating polyneuropathy.

    Science.gov (United States)

    Sugimoto, Takamichi; Ochi, Kazuhide; Hosomi, Naohisa; Takahashi, Tetsuya; Ueno, Hiroki; Nakamura, Takeshi; Nagano, Yoshito; Maruyama, Hirofumi; Kohriyama, Tatsuo; Matsumoto, Masayasu

    2013-10-01

    Demyelinating Charcot-Marie-Tooth disease (CMT) and chronic inflammatory demyelinating polyneuropathy (CIDP) are both demyelinating polyneuropathies. The differences in nerve enlargement degree and pattern at multiple evaluation sites/levels are not well known. We investigated the differences in nerve enlargement degree and the distribution pattern of nerve enlargement in patients with demyelinating CMT and CIDP, and verified the appropriate combination of sites/levels to differentiate between these diseases. Ten patients (aged 23-84 years, three females) with demyelinating CMT and 16 patients (aged 30-85 years, five females) with CIDP were evaluated in this study. The nerve sizes were measured at 24 predetermined sites/levels from the median and ulnar nerves and the cervical nerve roots (CNR) using ultrasonography. The evaluation sites/levels were classified into three regions: distal, intermediate and cervical. The number of sites/levels that exhibited nerve enlargement (enlargement site number, ESN) in each region was determined from the 24 sites/levels and from the selected eight screening sites/levels, respectively. The cross-sectional areas of the peripheral nerves were markedly larger at all evaluation sites in patients with demyelinating CMT than in patients with CIDP (p demyelinating CMT and CIDP were 0.90 and 0.94, respectively, with the cut-off value set at four. Nerve ultrasonography is useful to detect nerve enlargement and can clarify morphological differences in nerves between patients with demyelinating CMT and CIDP.

  8. [Evaluation of grip strength in normal and obese Wistar rats submitted to swimming with overload after median nerve compression].

    Science.gov (United States)

    Coradinia, Josinéia Gresele; Kakihata, Camila Mayumi Martin; Kunz, Regina Inês; Errero, Tatiane Kamada; Bonfleur, Maria Lúcia; Bertolini, Gladson Ricardo Flor

    2015-01-01

    To verify the functionality through muscle grip strength in animals with obesity induced by monosodium glutamate (MSG) and in control animals, which suffered compression of the right median nerve, and treated with swimming with overload. During the first five days of life, neonatal Wistar rats received subcutaneous injections of MSG. The control group received a hypertonic saline solution. Forty-eight rats were divided into six groups: G1 (control); G2 (control + injury); G3 (control + injury + swimming); G4 (obese); G5 (obese + injury); G6 (obese + injury + swimming). The animals in groups G2, G3, G5 and G6 were submitted to compression of the median nerve and G3 and G6 groups were treated, after injury, with swimming exercise with load for three weeks. The swimming exercise had a progressive duration, according to the week, of 20, 30 and 40minutes. Muscle strength was assessed using a grip strength meter preoperatively and on the 3rd, 7th, 14th and 21st days after surgery. The results were expressed and analyzed using descriptive and inferential statistics. When the grip strength was compared among assessments regardless of group, in the second assessment the animals exhibited lower grip strength. G1 and G4 groups had greater grip strength, compared to G2, G3, G4 and G6. The swimming exercise with overload has not been effective in promoting improvement in muscle grip strength after compression injury of the right median nerve in control and in obese-MSG rats. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Julia Teixeira Oliveira

    2014-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Harun Kütahya

    2013-01-01

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

  11. The Role of median nerve terminal latency index in the diagnosis of carpal tunnel syndrome in comparison with other electrodiagnostic parameters

    Directory of Open Access Journals (Sweden)

    Babak Vahdatpour

    2016-01-01

    Conclusion: Although in early stages of CTS, we usually expect only abnormalities in the sensory studies, but TLI may better demonstrate the effect on median nerve motor fiber even in mild cases of CTS.

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

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  13. Diffusion tensor imaging and fiber tractography of the median nerve at 1.5T: optimization of b value

    Energy Technology Data Exchange (ETDEWEB)

    Andreisek, Gustav [University of Toronto, Division of Musculoskeletal Imaging, Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, Toronto, Ontario (Canada); University Hospital Zuerich, Institute of Diagnostic Radiology, Zuerich (Switzerland); White, Lawrence M. [University of Toronto, Division of Musculoskeletal Imaging, Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, Toronto, Ontario (Canada); Kassner, Andrea [University of Toronto, Department of Medical Imaging, University Health Network, Toronto (Canada); Tomlinson, George [Toronto General Hospital, Division of Clinical Decision-Making and Health Care, Department of Public Health Sciences, University of Toronto, Toronto, Ontario (Canada); Sussman, Marshall S. [University of Toronto, Department of Medical Imaging, Toronto General Hospital, Toronto (Canada)

    2009-01-15

    The objective of this study was to systematically assess the optimal b value for diffusion tensor imaging and fiber tractography of the median nerve at 1.5 T. This is a prospective study which was carried out with institutional review board approval and written informed consent from the study subjects. Fifteen healthy volunteers (seven men, eight women; mean age, 31.2 years) underwent diffusion tensor imaging of the wrist. A single-shot spin-echo-based echo-planar imaging sequence (TR/TE, 7000/103 ms) was performed in each subject at eight different b values ranging from 325 to 1,550 s/mm{sup 2}. Number and length of reconstructed fiber tracts, fiber density index (FDi), fractional anisotropy (FA), and apparent diffusion coefficient (ADC) were calculated for the median nerve. Signal-to-noise ratio (SNR) was also calculated for each acquisition. The overall image quality was assessed by two readers in consensus by ranking representative fiber tract images for each subject using a scale range from 1 to 8 (1 = best to 8 = worst image quality). Longest fibers were observed for b values between 675 and 1,025 s/mm{sup 2}. Maximum FDi was found at b values of 1,025 s/mm{sup 2}. FA was between 0.5 and 0.6 for all b values. ADC gradually decreased from 1.44 x 10{sup -3} to 0.92 x 10{sup -3} mm{sup 2}/s with increasing b values. Maximum SNR {+-} standard deviation (175.4 {+-} 72.6) was observed at the lowest b value and decreased with increasing b values. SNR at b values of 1,025 s/mm{sup 2} was 48.5% of the maximum SNR. Optimal fiber tract image quality was found for b values of 1,025 s/mm{sup 2}. The optimal b value for diffusion tensor imaging and fiber tractography of the median nerve at 1.5 T was 1,025 s/mm{sup 2}. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Yi-Hsun Lin

    2014-04-01

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

  15. Sleep deprivation aggravates median nerve injury-induced neuropathic pain and enhances microglial activation by suppressing melatonin secretion.

    Science.gov (United States)

    Huang, Chun-Ta; Chiang, Rayleigh Ping-Ying; Chen, Chih-Li; Tsai, Yi-Ju

    2014-09-01

    Sleep deprivation is common in patients with neuropathic pain, but the effect of sleep deprivation on pathological pain remains uncertain. This study investigated whether sleep deprivation aggravates neuropathic symptoms and enhances microglial activation in the cuneate nucleus (CN) in a median nerve chronic constriction injury (CCI) model. Also, we assessed if melatonin supplements during the sleep deprived period attenuates these effects. Rats were subjected to sleep deprivation for 3 days by the disc-on-water method either before or after CCI. In the melatonin treatment group, CCI rats received melatonin supplements at doses of 37.5, 75, 150, or 300 mg/kg during sleep deprivation. Melatonin was administered at 23:00 once a day. Male Sprague-Dawley rats, weighing 180-250 g (n = 190), were used. Seven days after CCI, behavioral testing was conducted, and immunohistochemistry, immunoblotting, and enzyme-linked immunosorbent assay were used for qualitative and quantitative analyses of microglial activation and measurements of proinflammatory cytokines. In rats who underwent post-CCI sleep deprivation, microglia were more profoundly activated and neuropathic pain was worse than those receiving pre-CCI sleep deprivation. During the sleep deprived period, serum melatonin levels were low over the 24-h period. Administration of melatonin to CCI rats with sleep deprivation significantly attenuated activation of microglia and development of neuropathic pain, and markedly decreased concentrations of proinflammatory cytokines. Sleep deprivation makes rats more vulnerable to nerve injury-induced neuropathic pain, probably because of associated lower melatonin levels. Melatonin supplements to restore a circadian variation in melatonin concentrations during the sleep deprived period could alleviate nerve injury-induced behavioral hypersensitivity. © 2014 Associated Professional Sleep Societies, LLC.

  16. The Neurophysiologic Frequency of Hereditary Neuropathy with Liability to Pressure Palsy in Entrapment Neuropathies

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    F Gökçem Yıldız

    2016-12-01

    Full Text Available Objective: Hereditary neuropathy with liability to pressure palsy (HNPP needs to be differentiated from entrapment neuropathies due to differences in the treatment management. Materials and Methods: Among 5075 patients with entrapment neuropathy, we retrospectively evaluated the neurophysiologic results of 20 patients with three or more entrapments. Results: Ten patients were diagnosed as having HNPP according to their genetic or nerve biopsy results; eight (80% had bilateral Carpal tunnel syndrome, nine (90% had bilateral ulnar entrapment neuropathy, eight (80% had bilateral median and ulnar entrapment together; and three (30% had one-sided peroneal neuropathy. Conclusion: Our data suggest that analyzing the neurophysiologic studies and keeping HNPP in mind are essential to characterize underdiagnosed patients with HNPP referred for entrapment neuropathy.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. 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

  19. Neuromuscular electrical stimulation of the median nerve facilitates low motor cortex excitability in patients with spinocerebellar ataxia.

    Science.gov (United States)

    Chen, Chih-Chung; Chuang, Yu-Fen; Yang, Hsiao-Chu; Hsu, Miao-Ju; Huang, Ying-Zu; Chang, Ya-Ju

    2015-02-01

    The neuromodulation of motor excitability has been shown to improve functional movement in people with central nervous system damage. This study aimed to investigate the mechanism of peripheral neuromuscular electrical stimulation (NMES) in motor excitability and its effects in people with spinocerebellar ataxia (SCA). This single-blind case-control study was conducted on young control (n=9), age-matched control (n=9), and SCA participants (n=9; 7 SCAIII and 2 sporadic). All participants received an accumulated 30 min of NMES (25 Hz, 800 ms on/800 ms off) of the median nerve. The central motor excitability, measured by motor evoked potential (MEP) and silent period, and the peripheral motor excitability, measured by the H-reflex and M-wave, were recorded in flexor carpi radialis (FCR) muscle before, during, and after the NMES was applied. The results showed that NMES significantly enhanced the MEP in all 3 groups. The silent period, H-reflex and maximum M-wave were not changed by NMES. We conclude that NMES enhances low motor excitability in patients with SCA and that the mechanism of the neuromodulation was supra-segmental. These findings are potentially relevant to the utilization of NMES for preparation of motor excitability. The protocol was registered at Clinicaltrials.gov (NCT02103075).

  20. Entrapment neuropathies in sports medicine

    OpenAIRE

    2001-01-01

    The more frequent entrapment neuropathies related to sport are described: thoracic outlet syndrome in aquatic athletes and pitchers, long thoracic neuropathy in tennis players, suprascapular neuropathy in volleyball and tennis players, ulnar nerve entrapment at the elbow in pitchers and at the wrist in cyclists, Morton's syndrome in runners and dancers. Peer reviewed

  1. Comparison of the effects of flexion and extension of the thumb and fingers on the position and cross-sectional area of the median nerve.

    Directory of Open Access Journals (Sweden)

    Yasushi Toge

    Full Text Available OBJECTIVE: To assess the separate effects of thumb and finger extension/flexion on median nerve position and cross-sectional area. METHODS: Ultrasonography was used to assess median nerve transverse position and cross-sectional area within the carpal tunnel at rest and its movement during volitional flexion of the individual digits of the hand. Both wrists of 165 normal subjects (11 men, 4 women, mean age, 28.6, range, 22 to 38 were studied. RESULTS: Thumb flexion resulted in transverse movement of the median nerve in radial direction (1.2 ± 0.6 mm, whereas flexion of the fingers produced transverse movement in ulnar direction, which was most pronounced during flexion of the index and middle fingers (3.2 ± 0.9 and 3.1 ± 1.0 mm, respectively. Lesser but still statistically significant movements were noted with flexion of the ring finger (2.0 ± 0.8 mm and little finger (1.2 ± 0.5 mm. Flexion of the thumb or individual fingers did not change median nerve cross-sectional area (8.5 ± 1.1 mm(2. CONCLUSIONS: Volitional flexion of the thumb and individual fingers, particularly the index and middle fingers, produced significant transverse movement of the median nerve within the carpal tunnel but did not alter the cross-sectional area of the nerve. The importance of these findings on the understanding of the pathogenesis of the carpal tunnel syndrome and its treatment remains to be investigated.

  2. Does the ratio of the carpal tunnel inlet and outlet cross-sectional areas in the median nerve relfect carpal tunnel syndrome severity?

    Institute of Scientific and Technical Information of China (English)

    Li Zhang; Aierken Rehemutula; Feng Peng; Cong Yu; Tian-bin Wang; Lin Chen

    2015-01-01

    Although ultrasound measurements have been used in previous studies on carpal tunnel syn-drome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately relfects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5–17 MHz was used to assess 77 pa-tients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Signiifcant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-section-al areas of the median nerve was 1.29 between mild and more severe (moderate and severe) carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% speciifcity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% speciifcity. These results suggest that the inlet-to-outlet ratio relfected the severity of carpal tunnel syndrome.

  3. Does the ratio of the carpal tunnel inlet and outlet cross-sectional areas in the median nerve reflect carpal tunnel syndrome severity?

    Directory of Open Access Journals (Sweden)

    Li Zhang

    2015-01-01

    Full Text Available Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately reflects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5-17 MHz was used to assess 77 patients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Significant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.29 between mild and more severe (moderate and severe carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% specificity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% specificity. These results suggest that the inlet-to-outlet ratio reflected the severity of carpal tunnel syndrome.

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

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    Okada Kiyoshi

    2012-01-01

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

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

    Science.gov (United States)

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

    2015-07-01

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

  6. Transverse Plane Tendon and Median Nerve Motion in the Carpal Tunnel : Ultrasound Comparison of Carpal Tunnel Syndrome Patients and Healthy Volunteers

    NARCIS (Netherlands)

    van Doesburg, Margriet H. M.; Henderson, Jacqueline; van der Molen, Aebele B. Mink; An, Kai-Nan; Amadio, Peter C.

    2012-01-01

    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: Tra

  7. Whole-head MEG analysis of cortical spatial organization from unilateral stimulation of median nerve in both hands: No complete hemispheric homology

    NARCIS (Netherlands)

    Theuvenet, Peter J.; Dijk, van Bob W.; Peters, Maria J.; Ree, van Jan M.; Lopes da Silva, Fernando L.; Chen, Andrew C.N.

    2005-01-01

    We examined the contralateral hemispheric cortical activity in MEG (151 ch) after unilateral median nerve stimulation of the right and left hand in twenty healthy right-handed subjects. The goal was to establish parameters to describe cortical activity of the hemispheric responses and to study the p

  8. Treatment of proximal hamstring tendinopathy-related sciatic nerve entrapment: presentation of an ultrasound-guided “Intratissue Percutaneous Electrolysis” application

    Science.gov (United States)

    Mattiussi, Gabriele; Moreno, Carlos

    2016-01-01

    Summary Background Proximal Hamstring Tendinopathy-related Sciatic Nerve Entrapment (PHTrSNE) is a neuropathy caused by fibrosis interposed between the semimembranosus tendon and the sciatic nerve, at the level of the ischial tuberosity. Methods Ultrasound-guided Intratissue Percutaneous Electrolysis (US-guided EPI) involves galvanic current transfer within the treatment target tissue (fibrosis) via a needle 0.30 to 0.33 mm in diameter. The galvanic current in a saline solution instantly develops the chemical process of electrolysis, which in turn induces electrochemical ablation of fibrosis. In this article, the interventional procedure is presented in detail, and both the strengths and limits of the technique are discussed. Results US-guided EPI eliminates the fibrotic accumulation that causes PHTrSNE, without the semimembranosus tendon or the sciatic nerve being directly involved during the procedure. The technique is however of limited use in cases of compression neuropathy. Conclusion US-guided EPI is a technique that is quick to perform, minimally invasive and does not force the patient to suspend their activities (work or sports) to make the treatment effective. This, coupled to the fact that the technique is generally well-tolerated by patients, supports use of US-guided EPI in the treatment of PHTrSNE. PMID:27900300

  9. [Surgical therapy for entrapment neuropathy].

    Science.gov (United States)

    Tachibana, Shigekuni

    2012-01-01

    Entrapment neuropathy is not uncommon, and surgical treatment is followed by favorite result. Therefore, to obtain an accurate diagnosis based on precise knowledge of the peripheral nervous system is very important. The most popular and useful symptoms and signs of the entrapment neuropathy is paresthesia, dysesthesia and Tinel's like sign at the lesion site. Nerve conduction study is also valuable for the accurate diagnosis. For the last 30 years, the author operated on 1,399 lesions of entrapment neuropathy. They consist of 877 carpal tunnel syndrome (63%), 284 tarsal tunnel syndrome (20%), 135 ulnar neuropathy at the elbow (10%), 53 piriformis syndrome (4%), 15 thoracic outlet syndrome (1%), and others. From the pathophysiological point to view, except for the carpal tunnel syndrome, several locations and factors come into play producing the entrapment of the nerve. The author would like to stress that the entrapment neuropathy is not severe disease, though, it strongly insult the patient's quality of life.

  10. Sonography assessment of the median nerve during cervical lateral glide and lateral flexion. Is there a difference in neurodynamics of asymptomatic people?

    Science.gov (United States)

    Brochwicz, Peter; von Piekartz, Harry; Zalpour, Christoff

    2013-06-01

    There is clinical evidence that cervical lateral glide (CLG) improves neurodynamics and alleviates pain in patients who suffer from neurogenic arm pain. Cervical lateral flexion (CLF) is also a treatment method and a means of testing neurodynamics. However, for both techniques nerve movement has not yet been investigated using ultrasound imaging (US). The purpose of this study was to quantify median nerve movement in the arm during CLG and CLF. For this study 27 healthy participants were recruited. Longitudinal movement of the median nerve was measured using US during CLG and CLF with the shoulder in 30° abduction in the middle and distal forearm (Fad). Data could be obtained from 11 participants (6 women and 5 men, average age 25.6 years, ± 2.25) at the middle forearm (Fam) and from 9 participants (5 women and 4 men, average age 27.2 years, ± 2.75) at the Fad. When applying CLF, the median nerve moved 2.3 mm (SEM ± 0.1 mm) at the Fam. At the same measuring point the median nerve moved 3.3 mm (SEM ± 0.3 mm, p = 0.005) by applying CLG. At the Fad the difference between CLF and CLF amounted to 0.6 mm (CLF: 1.9 mm (SEM ± 0.2 mm, CLG: 2.5 mm (SEM ± 0.2 mm, p ≤ 0.05). The movements during CLG are larger than during CLF. This difference is statistically significant. However, the statistical relevance cannot be extrapolated to a clinical relevance.

  11. Normal and sonographic anatomy of selected peripheral nerves. Part I: Sonohistology and general principles of examination, following the example of the median nerve

    Directory of Open Access Journals (Sweden)

    Berta Kowalska

    2012-06-01

    Full Text Available Ultrasonography is an established method for imaging peripheral nerves. It serves to supplement the physical examination, electromyography, and magnetic resonance imaging. It enables the identification of post-traumatic changes of nerves, neuropathies secondary to compression syndromes, inflammatory or neoplastic nerve lesions as well as the evaluation of postoperative complications. In certain situations, this technique is the imaging method of choice. It is increasingly used in anesthesiology for regional anesthesia. As in the case of other ultrasound imaging studies, the examination of peripheral nerves is non-invasive, well-tolerated by patients, and relatively inexpensive. This article presents the histological structure of peripheral nerves and their appearance in ultrasonography. It also presents the examination technique, following the example of the median nerve, and includes a series of diagrams and ultrasound images. The interpretation of the shape, echogenicity, thickness and vascularity of nerves is described, as well as their relation to the surrounding tissues. The “elevator technique”, which consists of locating a set nerve at a characteristic anatomic point, and following it proximally or distally, has been explained. The undisputed benefits of the ultrasound examination have been presented, including its advantages over other diagnostic methods. These advantages include the dynamic component of the ultrasound examination and the possibility of correlating the patient’s symptoms with the ultrasound images. As an example, the proper anatomy and the ultrasonographic appearance of the median nerve were described. This nerve’s course is presented, its divisions, and characteristic reference points, so as to facilitate its location and identification, and enable subsequent use of the aforementioned “elevator technique”. This article opens a series of publications concerning anatomy, technique of examination and

  12. Uncommon Dorsal Radiocarpal Fracture Dislocation Complicated With Median Nerve Palsy: Case Report, Review of the Literature, and a New Classification System Guiding the Management

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    Hing-Cheong Wong

    2012-06-01

    Full Text Available We report the case of a 36-year-old lorry driver who sustained left dorsal radiocarpal fracture dislocation and left median nerve injury in a traffic accident in 2010. Emergency operation of closed reduction, cross-wrist-bridging external fixation, percutaneous transradial styloid Kirschner wire fixation, decompression of left median nerve, and repair of the partially torn palmar radiocarpal ligament were performed under general anaesthesia. Because of the persistent depressed dorsal articular rim fracture of left distal radius, another operation of open reduction, corticocancellous bone grafting, and dorsal buttress plating was performed 5 days after the initial operation. Six months after the operation, the patient enjoyed good range of wrist motion but weak twisting power, especially in supination. There was no radiological feature of radiocarpal subluxation.

  13. A study of retrograde degeneration of median nerve forearm segment in carpal tunnel syndrome of variable severities

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    Mona Mokhtar El Bardawil

    2014-12-01

    Conclusions: Retrograde degeneration exists in patients with CTS. Forearm median motor NCV and median mixed conduction study are valid electrophysiologic tools for the assessment of RGD in patients with CTS. Retrograde degeneration is not related to grade of severity of CTS.

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

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

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

    2016-06-15

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

  16. Effect of Median Nerve Compression Test on the Nerve Conduction Speed in Carpal Tunnel Syndrome%正中神经压迫试验对腕管综合征神经传导速度的影响

    Institute of Scientific and Technical Information of China (English)

    许惊飞; 王劲松; 何成奇

    2011-01-01

    目的 比较正中神经压迫试验对腕管综合征(carpal tunnel syndrome,CTS)患者正中神经传导速度的影响.方法 设置CTS组和对照组两个组别,共29例受试者纳入研究.CTS组为14例CTS患者,对照组为15例健康受试者.神经传导速度测定包括正中神经和尺神经的感觉传导末端潜伏期(distal sensory latency,DSL)、感觉神经动作电位(sensory nerve action potential,SNAP)、跨腕关节感觉传导速度(sensory conduction velocity,SCV)、运动传导末端潜伏期(distal motor latency,DML)及复合肌肉动作电位(compound muscle action potential,CMAP).先测感觉传导,再测运动传导.正中神经压迫试验5 min后再次测量上述指标.结果 正中神经压迫试验前后电生理检查考虑诊断CTS分别为22侧和24侧.压迫正中神经后,CTS组正中神经DSL较压迫前显著延长(P<0.05).CTS组尺神经和对照组正中神经及尺神经的各参数在压迫前后均无显著改变(P>0.05).与对照组相比,在压迫试验前后CTS组的正中神经DSL和DML均明显延长(P<0.05),尺神经DSL和DML均无显著改变(P>0.05).结论 正中神经压迫试验5 min能使CTS患者正中神经的感觉传导末端潜伏时明显延长,有助于提高神经传导测定对早期CTS的诊断率.%Objective To determine the effect of median nerve compression on median nerve conduction speed in patients with carpal tunnel syndrome (CTS). Methods In this case-control study, 29 subjects were enrolled. CTS group included 14 patients (22 hands) with CTS confirmed by electrodiagnostic studies, while the control group included 15 healthy subjects (30 hands). The across wrist nerve conduction of median and ulnar nerve was measured when the wrist was in neutral position. Measured parameters included distal sensory latency (DSL), sensory nerve action potential (SNAP), sensory conduction velocity (SCV), distal motor latency (DML) and compound muscle action potential (CMAP). Sensory nerve

  17. 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.

  18. BA3b and BA1 activate in a serial fashion after median nerve stimulation: direct evidence from combining source analysis of evoked fields and cytoarchitectonic probabilistic maps.

    Science.gov (United States)

    Papadelis, Christos; Eickhoff, Simon B; Zilles, Karl; Ioannides, Andreas A

    2011-01-01

    This study combines source analysis imaging data for early somatosensory processing and the probabilistic cytoarchitectonic maps (PCMs). Human somatosensory evoked fields (SEFs) were recorded by stimulating left and right median nerves. Filtering the recorded responses in different frequency ranges identified the most responsive frequency band. The short-latency averaged SEFs were analyzed using a single equivalent current dipole (ECD) model and magnetic field tomography (MFT). The identified foci of activity were superimposed with PCMs. Two major components of opposite polarity were prominent around 21 and 31 ms. A weak component around 25 ms was also identified. For the most responsive frequency band (50-150 Hz) ECD and MFT revealed one focal source at the contralateral Brodmann area 3b (BA3b) at the peak of N20. The component ~25 ms was localised in Brodmann area 1 (BA1) in 50-150 Hz. By using ECD, focal generators around 28-30 ms located initially in BA3b and 2 ms later to BA1. MFT also revealed two focal sources - one in BA3b and one in BA1 for these latencies. Our results provide direct evidence that the earliest cortical response after median nerve stimulation is generated within the contralateral BA3b. BA1 activation few milliseconds later indicates a serial mode of somatosensory processing within cytoarchitectonic SI subdivisions. Analysis of non-invasive magnetoencephalography (MEG) data and the use of PCMs allow unambiguous and quantitative (probabilistic) interpretation of cytoarchitectonic identity of activated areas following median nerve stimulation, even with the simple ECD model, but only when the model fits the data extremely well.

  19. Upper limb tendinitis and entrapment neuropathy in coal miners.

    Science.gov (United States)

    Özdolap, Senay; Emre, Ufuk; Karamercan, Ayşe; Sarikaya, Selda; Köktürk, Fürüzan

    2013-05-01

    It is well-known that work-related upper limb musculoskeletal disorders, particularly tendinitis and nerve entrapment, remain a difficult and costly problem in industrialized countries. The aim of this study was to evaluate tendinitis and entrapment neuropathy of the upper limb of Turkish coal miners. Eighty coal miners and 43 age-matched clerical workers were included in the study. The evaluation procedures included collection of personal and clinical data, physical examination and bilateral electrodiagnostic testing. Subjects were examined to diagnose tendinitis and nerve entrapment of the upper limb. Bilateral median and ulnar nerves conduction tests were performed on all subjects. Data were collected between August 2011 and December 2011. There were 33 subjects with lateral epicondylitis, 10 with medial epicondylitis, and 22 with De Quervain's disease among the coal miners. There were seven subjects with lateral epicondylitis, eight with medial epicondylitis, and four with De Quervain's disease in the control group. The two groups significantly differed in the prevalences of lateral epicondylitis and De Quervain's disease (P = 0.024 and P =0.029, respectively). Sixteen subjects in the coal miners and 12 subjects in the controls had carpal tunnel syndrome (P = 0.66). Thirty-seven subjects in the coal miners had ulnar neuropathy of the elbow (UNE), while four subjects in the controls had UNE; this difference was statistically significant (P Quervain disease, and ulnar neuropathy are common work-related upper limb disorders among coal miners. Copyright © 2013 Wiley Periodicals, Inc.

  20. Comparison of the occurrence rates of cervical nerve entrapment at cervical intervertebral foramen and spinal nervous sulcus%颈神经在椎间孔与脊神经沟处受嵌压的出现率比较

    Institute of Scientific and Technical Information of China (English)

    李英平; 郭瑞芳; 温海青

    2005-01-01

    背景:椎间盘髓核向侧后方脱出以及神经根管内的软组织炎性肿胀可直接或间接压迫神经根,但颈神经在椎间孔及脊神经沟处的嵌压因素与严重性待进一步研究.目的:探讨颈神经在椎间孔及脊神经沟处受嵌压的出现率与颈椎病严重程度关系.设计:单一样本研究.单位:承德医学院解剖教研室、附属医院老年病科、教务处.对象:实验选用承德医学院解剖教研室提供的经甲醛固定成尸60具,男28,女32;共120侧.方法:取60具成尸,测量颈椎间孔及其脊神经根的外径以及对脊神经沟外口宽度及其沟内段脊神经前支横径,数据进行统计学处理.主要观察指标:颈神经前支横径/脊神经沟宽度和颈神经根外径/椎间孔大小的均值,比值≥1的出现率.结果:颈神经根与椎间孔之比值明显大于脊神经与脊神经沟之比值(t=2.66,P<0.01);颈神经在椎间孔处受压的出现率(24.6%)明显高于脊神经沟处(6.3%),二者比较差异有非常显著性意义(x2=6.95,P<0.01).结论:颈神经在颈椎间孔和脊神经沟处均可受累,颈神经在椎间孔处受累的严重性明显大于在脊神经沟处.临床诊治颈椎病在充分考虑椎间孔处神经受累的同时,也不可忽视颈椎脊神经沟处神经受累的可能性.%BACKGROUND: Nerve root could be directly or indirectly entrapped due to lateral backward prolapse of nucleus pulposus of intervertebral disc, as well as parenchymal inflammatory tumefaction of the soft tissues in nerve root tube. But the factors and their severity related to cervical nerve entrapment at cervical intervertebral foramen and spinal nervous sulcus still need further studies.OBJECTIVE: To investigate the relationship between the occurrence rate of cervical nerve entrapment at cervical intervertebral foramen and spinal nervous sulcus and the severity of cervical syndrome.DESIGN: A single sample study.SETTING: Department of Anatomy, Department of

  1. The utility of a forehead-to-inion derivation in recording the subcortical far-field potential (P14) during median nerve somatosensory-evoked potential testing.

    Science.gov (United States)

    Fried, Stephen J; Legatt, Alan D

    2012-04-01

    American Clinical Neurophysiology Society (ACNS) guidelines recommend recording P14 between an ipsilateral centroparietal electrode (CPi) and a noncephalic reference, typically the contralateral Erb's point (EPc) (American Clinical Neurophysiology Society. Guideline 9D: guidelines on short-latency somatosensory evoked potentials. J Clin Neurophysiol. 2006;23(2):168-179). We investigated the utility of a forehead (Fpz)-to-inion derivation for recording P14. We analyzed 74 median nerve somatosensory-evoked potential (SEP) studies (148 nerves) with bilaterally normal peripheral and central conductions. The presence of an identifiable P14 and its amplitude and latency were assessed in both the CPi-EPc and Fpz-inion derivations. In 7 of the 148 recordings, P14 was not identifiable in either derivation. The P14 was only identifiable in CPi-EPc in 9 recordings, and only identifiable in Fpz-inion in 4 recordings. In the remaining 128 recordings, the mean P14 latency was 13.2 ± 1.1 ms in both derivations. The mean P14 amplitude using CPi-EPc was 2.0 ± 0.6 µV, significantly larger than that using Fpz-inion, 1.2 ± 0.6 µV (P derivation and the Fpz-inion derivation both record the same P14 component, and latency norms based on either derivation are interchangeable. Although the CPi-EPc derivation typically yields a larger and more identifiable P14, occasionally Fpz-inion yields a larger P14, and rarely P14 is only identifiable using Fpz-inion. Thus, recording of the Fpz-inion derivation may be a useful adjunct during median nerve SEP testing.

  2. Entrapment Neuropathies of the Foot and Ankle.

    Science.gov (United States)

    Ferkel, Eric; Davis, William Hodges; Ellington, John Kent

    2015-10-01

    Posterior tarsal tunnel syndrome is the result of compression of the posterior tibial nerve. Anterior tarsal tunnel syndrome (entrapment of the deep peroneal nerve) typically presents with pain radiating to the first dorsal web space. Distal tarsal tunnel syndrome results from entrapment of the first branch of the lateral plantar nerve and is often misdiagnosed initially as plantar fasciitis. Medial plantar nerve compression is seen most often in running athletes, typically with pain radiating to the medial arch. Morton neuroma is often seen in athletes who place their metatarsal arches repetitively in excessive hyperextension.

  3. Lipofibromatous hamartoma of the median nerve: report of a case and review of the literature; Hamartoma fibrolipomatoso del nervio mediano: descripcion de un caso y revision de la bibliografia

    Energy Technology Data Exchange (ETDEWEB)

    Lopez, G.; Ruiz, F.; Rodriguez, C.; Carcia, E. [Hospital Universitario Virgen de las Nieves. Granada (Spain)

    2001-07-01

    Lipofibromatous hamartoma is a rare benign lesion that affects peripheral nerves. The predominant site is median nerve, although it has been reported in other locations. It usually presents prior to the third decade of life, and is associated with motor cycled in up to one third of cases. We describe a case involving median nerve in a 24-year-old man who underwent ultrasound and magnetic resonance, followed by surgical confirmation of the diagnosis. A brief review of the literature is also provided. The magnetic resonance findings are virtually pathognomonic of this disease and, thus, the diagnosis can be reached without the need to perform biopsy. (Author) 12 refs.

  4. A study of the effects of anomalous innervation on the diagnosis of median or ulnar nerve injury%异位支配对正中神经尺神经损伤诊断影响的研究

    Institute of Scientific and Technical Information of China (English)

    黎鸣; 李归宿; 林敏婷

    2009-01-01

    Objective To study the effects on the diagnosis of median or ulnar nerve injury by the presence of anomalous anastomosis between median and ulnar nerves in the forearm and the palm of the hand, including the anastomosis from median nerve in the forearm to the ulnar nerve (Martin-Gruber anastomosis, MGA), the anastomosis from ulnar nerve in the forearm to the median nerve(reversed Martin-Gruber anastomosis, RMGA), and the anastomosis from median nerve in the palm of the hand to the ulnar nerve (Riche-Cannieu anastomosis, RCA). Methods An 160 cases of median or ulnar nerve injury with the presence of anomalous anastomosis were assigned to three groups: 65 cases of ulnar nerve lesion with MGA, 8 cases of median nerve lesion with RMGA, and 87 cases of median nerve lesion with RCA. The anatomical bases, clinical manifestations, electrophysiological data and diagnosis were discussed. Results In the case of median or ulnar nerve lesion, the function of the muscle which was controlled by the injured nerve can be compensated due to the existence of the anomalous anastomosis. This could result in discrepancy between the clinical symptoms and the degree of nerve lesion and electrophysiological findings. Conclusion Thorough understanding of the characteristics of these three types of anomalous innervation between median and ulnar nerves is crucial to the clinical diagnosis and treatment of median or ulnar nerve injuries, as well as to the correct interpretation of the electrophysiological data.%目的 了解正中神经和尺神经之间交通支的存在对前臂这两条神经损伤诊断的影响,前臂正中神经至尺神经的交通支(Martin-Gruber anastomosis,MGA)、前臂尺神经至正中神经的交通支(reversed Martin-Gruber anastomosis,RMGA)和手部尺神经至正中神经的交通支(Riche-Cannieu anastomosis,RCA).方法 将160例正中神经或尺神经损伤合并存在异常交通支的患者分为三组:尺神经损伤并MGA组65

  5. 双侧正中神经、尺神经多节段运动神经传导各参数正常值的建立%Establishment of normative value of multiple segments motor nerve conduction velocity of bilateral median nerve and ulnar nerve

    Institute of Scientific and Technical Information of China (English)

    张朔; 郑菊阳

    2009-01-01

    目的:建立双侧正中神经、尺神经多节段运动神经传导速度(MCV)、潜伏期(LAT)和波幅(AMP)的正常值.方法:200例健康志愿者,男100例,女100例,分别按年龄分成5组,正中神经记录点在拇短展肌,刺激点分别为掌点、腕点、肘点、腋点、Erb点;尺神经记录点在小指展肌,刺激点分别为腕点、肘下点、肘上点、腋点、Erb点,记录各段MCV、LAT、AMP值.结果:正中神经、尺神经多节段MCV、LAT、AMP与性别、侧别无相关性;年龄与正中神经各段MCV、LAT、AMP及尺神经AMP有关.结论:双侧正中神经、尺神经多节段运动神经传导的准确检测对临床疾病诊断有重要价值.%Objective: To establish normative value of multiple segments motor nerve conduction of bilateral median nerve and ulnar nerve, including motor nerve conduction velocity (MCV)、latency (LAT)and amplitude (AMP). Method: Two hundred normal volunteers were divided into 5 groups according to different ages. Median nerve was examined at multiple points: palm, wrist, elbow, axilla and Erb's. Ulnar nerve was examined at multiple points: wrist, below elbow, above elbow, axilla and Erb's. The values of segmental MCV, LAT and AMP were recorded. Result: Gender and sidedness had no effect on MCV, LAT and AMP of median nerve and ulnar nerve. However, age had significant effects on MCV, LAT and AMP of median nerve and AMP of ulnar nerve. Conclusion: The examination of multiple segments motor nerve conduction of bilateral median nerve and ulnar nerve possess important value in diagnosis.

  6. 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

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

    Directory of Open Access Journals (Sweden)

    Zhen Feng

    2016-01-01

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

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

    OpenAIRE

    2013-01-01

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

  9. ELECTRODIAGNOSTIC ASSESSMENT OF PERIPHERAL NERVE INJURIES IN KICK-BOXERS

    Directory of Open Access Journals (Sweden)

    M.R EMAD

    2002-06-01

    Full Text Available Introducti0n. Peripheral nerve injuries are one of the common traumas in various sport fields. Nowadays, thera are a growing tendency to Martial arts among young people. Insufficient knowlodage about the biomechanics and true skills in these sports can expose the athletes to many neuromusculoskeletal injuries including peripheral nerve injuries. The aim of this study was assessment of peripheral nerve injuries among Kick-boxers. Methods. The research was done on 30 male kick-boxers Aged between 17-28 years. Ulnar, tibial and median nerves were studied for the presence of unlar nerve entrapment on elbow, trasal tunnel syndrom and carpal tunnel syndrom. Results. Ulnar neuropathy was observed in 12 cases. Tibial entrapment was detected in 13 cases. No median nerve intrapment of CTS was detected. There was a significant correlation between the age of the participants and nerve entrapment. Discussion. Peripheral nerve injuries should be considered in athletes and should be trained to apply preventive and thrapeutic procedures.

  10. Entrapment neuropathies in diabetes mellitus

    Science.gov (United States)

    Rota, Eugenia; Morelli, Nicola

    2016-01-01

    Neuropathy is a common complication of diabetes mellitus (DM) with a wide clinical spectrum that encompasses generalized to focal and multifocal forms. Entrapment neuropathies (EN), which are focal forms, are so frequent at any stage of the diabetic disease, that they may be considered a neurophysiological hallmark of peripheral nerve involvement in DM. Indeed, EN may be the earliest neurophysiological abnormalities in DM, particularly in the upper limbs, even in the absence of a generalized polyneuropathy, or it may be superimposed on a generalized diabetic neuropathy. This remarkable frequency of EN in diabetes is underlain by a peculiar pathophysiological background. Due to the metabolic alterations consequent to abnormal glucose metabolism, the peripheral nerves show both functional impairment and structural changes, even in the preclinical stage, making them more prone to entrapment in anatomically constrained channels. This review discusses the most common and relevant EN encountered in diabetic patient in their epidemiological, pathophysiological and diagnostic features. PMID:27660694

  11. Entrapment neuropathies in diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    Eugenia; Rota[1; Nicola; Morelli[1

    2016-01-01

    Neuropathy is a common complication of diabetes mellitus (DM) with a wide clinical spectrum that encompasses generalized to focal and multifocal forms. Entrapment neuropathies (EN), which are focal forms,are so frequent at any stage of the diabetic disease, that they may be considered a neurophysiological hallmark of peripheral nerve involvement in DM. Indeed, EN may be the earliest neurophysiological abnormalities in DM,particularly in the upper limbs, even in the absence of a generalized polyneuropathy, or it may be superimposed on a generalized diabetic neuropathy. This remarkable frequency of EN in diabetes is underlain by a peculiar pathophysiological background. Due to the metabolic alterations consequent to abnormal glucose metabolism, the peripheral nerves show both functional impairment and structural changes, even in the preclinical stage, making them more prone to entrapment in anatomically constrained channels. This review discusses the most common and relevant EN encountered in diabetic patient in their epidemiological, pathophysiological and diagnostic features.

  12. Músculo pronador redondo: variações anatômicas e predisposição para a compressão do nervo mediano Pronator teres muscle: anatomical variations and predisposition for the compression of the median nerve

    Directory of Open Access Journals (Sweden)

    Vilma Clóris de Carvalho

    2002-05-01

    Full Text Available O nervo mediano pode ser comprimido em nível de músculo pronador redondo (MPR, resultando na síndrome do pronador redondo. Objetivou-se analisar a constituição do MPR e sua relação com o nervo mediano na dissecação de 100 membros superiores humanos, oriundos de laboratórios de anatomia. Em 72% dos casos, o nervo mediano passou entre as cabeças umeral e ulnar do MPR. Em 15% a cabeça ulnar esteve ausente, com o nervo mediano passando posteriormente a cabeça umeral ou através dela. Em 9% a cabeça ulnar se fez representar por um feixe fibroso. Em 2% o nervo mediano passou através da cabeça ulnar e em 2% através da cabeça umeral, mesmo na presença da cabeça ulnar. Os dados sugerem que as variações na relação músculo/nervo representam fatores potenciais para a compressão do nervo mediano, por tornarem mais restrita a passagem desse nervo no antebraço.The median nerve can be compressed at the level of pronator teres muscle (PTM, resulting in the pronator teres syndrome. This work aim was to analyze the PTM and its relationship with the median nerve. In order to do so, we have dissected 100 human upper limbs from anatomy laboratories. In 72% of the cases, the median nerve passed between the umeral and ulnar heads of PTM. In 15% of the cases, the ulnar head was absent, with the median nerve passing behind the umeral head or through it. In 9%, a fibrous bundle represented the ulnar head. In 2%, the median nerve passed through the ulnar head and in 2% through the umeral head, even in the presence of the ulnar head. The data suggest that the variations in the relationship muscle/nerve represent potential factors for the median nerve compression, for they make the passage for this nerve in the forearm even narrower.

  13. Range Medians

    OpenAIRE

    Har-Peled, Sariel; Muthukrishnan, S.

    2008-01-01

    We study a generalization of the classical median finding problem to batched query case: given an array of unsorted $n$ items and $k$ (not necessarily disjoint) intervals in the array, the goal is to determine the median in {\\em each} of the intervals in the array. We give an algorithm that uses $O(n\\log n + k\\log k \\log n)$ comparisons and show a lower bound of $\\Omega(n\\log k)$ comparisons for this problem. This is optimal for $k=O(n/\\log n)$.

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

    Science.gov (United States)

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

    2016-06-01

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

  15. 腕管内正中神经变异的声像图表现及其临床意义%Sonographic appearance and clinical significance of anatomic variation of carpal tunnel median nerve

    Institute of Scientific and Technical Information of China (English)

    傅强; 崔立刚; 李志强; 王金锐; 陈文; 贾建文

    2012-01-01

    Objective To investigate the incidence,sonographic appearance of the anatomic variation of carpal tunnel median nerve and its accompanying structures in healthy volunteers and explore the value of this variation in carpal tunnel syndrome.Methods A total of 360 hands of 180 healthy volunteers were included in the study.The full course of the median nerve in the forearm and carpal tunnel was examined with high-frequency ultrasound.The median nerve was first located in cross section at wrist and then with continuous cross-sectional scanning to observe the the full course of the median nerve in the forearm and carpal tunnel with high-frequency ultrasound.Results Anatomic variation of carpal tunnel median nerve and its accompanying structures were observed:① High division median nerve were found in 2 wrists (0.56 %) ;②Bifid median nerve were found in 17 wrists (4.72%) ;③Persistent median artery were found in 22 wrists (6.11%),and 2 wrists (0.56%) were also found accompanied vein.Aanatomic variation of carpal tunnel median nerve accompanied with persistent median artery were observed in 16 wrists (4.44 %).Conclusions High-frequency ultrasound was sensitive to diagnose the anatomic variation of carpal tunnel median nerve and its accompanying structures.Recognition of these variations can help us to make correct diagnosis of carpal tunnel syndrome.%目的 探讨腕管正中神经及伴行结构变异在人群中的发生率、超声表现及其在腕管综合征诊断中的意义.方法 对180位健康志愿者的360只手腕部腕管结构及前臂进行高频超声检查.检查前臂和腕部正中神经走行,先进行腕管结构的横断面扫查,确认正中神经位置后,采用连续横断面扫查法向近端前臂进行动态观察并适当结合纵断面扫查,记录图像资料.结果 腕管正中神经及伴行结构变异:①正中神经高位分叉2例(0.56%);②正中神经裂17例(4.72%);③腕部正中神

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

    DEFF Research Database (Denmark)

    Lange, K H W; Jansen, T; Asghar, S

    2011-01-01

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

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

    DEFF Research Database (Denmark)

    Lange, K H W; Jansen, T; Asghar, S

    2011-01-01

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

  18. Neurophysiological study to assess the severity of each site through the motor neuron fiber in entrapment neuropathy

    Directory of Open Access Journals (Sweden)

    Kawai Hideo

    2009-06-01

    Full Text Available Abstract Background The double crush hypothesis (DCH that had been widely accepted seems to have been dismissed recently. Prior to the DCH, retrograde changes in the proximal median nerve in carpal tunnel syndrome (CTS were reported. There has been no report of quantitative analyzing about the effect of one site's compression on another site all through the same peripheral nerve in CTS patients. Methods We measured the central motor conduction time (CMCT, motor conduction latency of the cervical root region (CRL, peripheral path latency from the rootlet to the wrist (PL and motor distal latency (MDL in the median nerve and ulnar nerves, respectively in CTS patients. Results MDL, PL and CRL were prolonged selectively in the median nerve, but not in the ulnar nerve of CTS patients. And in the median nerve measurement, MDL was high (r = 0.59, p Conclusion Dual entrapment lesions did not unexpectedly exaggerate the vulnerability or total damage. The vulnerability and the damage were proportional to the severity of each lesion. If the DCH term presented to an unexpectedly exaggerated degree, the cases of double crush symdrome in the CTS patients were rare, but if the term DCH refers to only this linear relationship, the DCH should not be dismissed.

  19. Long-term outcome of muscle strength in ulnar and median nerve injury: Comparing manual muscle strength testing, grip and pinch strength dynamometers and a new intrinsic muscle strength dynamometer

    OpenAIRE

    Schreuders, Ton; Roebroeck, Marij; Jaquet, Jean; Hovius, Steven; Stam, Henk

    2004-01-01

    textabstractObjective: To compare the outcome of muscle strength with manual muscle strength testing grip and pinch strength measurements and a dynamometer which allows for measurements of the intrinsic muscles of the hand in isolation (the Rotterdam Intrinsic Hand Myometer, RIHM). Methods: Thirty-four patients more than 2 years after ulnar and/or median nerve injury. Muscle strength was evaluated using manual muscle strength testing (MMST), grip, pinch and intrinsic muscle strength measureme...

  20. Median nerve conduction velocity and central conduction time measured with somatosensory evoked potentials in thyroxine-treated infants with Down syndrome

    NARCIS (Netherlands)

    van Trotsenburg, A. S. Paul; Smit, Bert J.; Koelman, Johannes H. T. M.; Sloot, Marijke Dekker-van der; Ridder, Jeannette C. D.; Tijssen, Jan G. P.; de Vijlder, Jan J. M.; Vulsma, Thomas

    2006-01-01

    OBJECTIVE. The aim of this study was to determine whether thyroxine treatment would improve nerve conduction in infants with Down syndrome. METHODS. A single-center, nationwide, randomized, double-blind, clinical trial was performed. Neonates with Down syndrome were assigned randomly to thyroxine (N

  1. 椎孔外颈神经卡压综合征与颈椎病的鉴别%Differentiation of cervical nerve entrapment syndrome at extravertebral foramen with cervical spondylopathy

    Institute of Scientific and Technical Information of China (English)

    陈德松; 方有生; 陈琳; 彭峰

    2001-01-01

    Objective To assess reason of misdiagnosis of cervical nerveentrapment syndrome at extravetebral foramen as cervical spondylopathy and their differentiation. Methods 44 cases of cervical nerve entrapment syndrome at extravetebral foramen misdiagnosed as cervical spondylopathy were involved in the study. Differential characteristics showed as follows : (1) Cervical spondylopathy : it was most commonly seen at middle aged and senile patients. The principal symptoms were aching pain at cervical part and shoulder, special pain occurring when rotation of cervical part at a certain angle and patient’s not knowing where to right put his head and neck. Sign presented as tenderness at interspinal areas , sensory disturbance at 1 or 2 nerve root(s) distributing areas and occasionally at posterosuperior medial aspect. Local block at tenderness point at cervical part was inefficient. (2) Cervical nerve entrapment syndrome at extravertebral foramen: it occurred in senile, middle aged , juvernile and adolescent patients. The main symptoms were discomfort at cervical and shoulder areas, tingling of extremity and patients not knowing where to pose his upper extremity. Significant pressure pain point occurred at middle point of posterior edge of sternoleidomastoid muscle. There was pressure pain point at the back at the lateral part of spine, radiating at affected part. Sensory disturbance included commonly C1 to T1 innervating areas and commonly in combination with postosuperior medial aspect of forearm and the face . Immediate efficiency occurred after local block at tenderness point at neck with improved sensation and muscle strength. Results Diagnosing treatment ,i.e. local block of tenderness at neck , was an important procedure for differentiating cervical nerve entrapment syndrome at extravertebral foramen with cervical spondylopathy. Conclusions Cervical nerve entrapment syndrome at extravertebral foramen was commonly confused with cervical spondylopathy . It was

  2. 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

  3. Detection of catecholamine and luteinizing hormone-releasing hormone (LH-RH) containing nerve endings in the median eminence and the organon vasculosum laminae terminalis by fluorescence histochemistry and immunohistochemistry on the same microscopic sections.

    Science.gov (United States)

    Ibata, Y; Watanabe, K; Kinoshita, H; Kubo, S; Sano, Y; Sin, S; Hashimura, E; Imagawa, K

    1979-02-01

    Distribution of catecholamine (CA) and LH-RH nerve endings in the median eminence (ME) and the organon vasculosum laminae terminalis (OVLT) of the rat was investigated by application of fluorescence histochemistry and immunohistochemistry on the same sections of the tissue. In the ME, those two kinds of endings coexisted in the lateral portion of the middle part of ME, and in the wall of tuberoinfundibular sulcus, where they might be considered to have functional correlation. In the OVLT they were also distributed in fairly near distance, but they were not so closely associated as observed in the ME.

  4. 正中神经松解范围对重度腕管综合征术后疗效的临床研究%Clinical research on influence of relaxation extent in median nerve on results of surgical treatment for serious carpal tunnel syndrome

    Institute of Scientific and Technical Information of China (English)

    魏锦辉; 谭伟欣

    2013-01-01

    Objective To explore the relationship between the scope of surgery to loosen median nerve entrapment with serious carpal tunnel syndrome and the curative effect after surgery.Methods Referencing to patients' condition and results of Electromyologram,we classified the serious ones from the patients with carpal tunnel syndrome.According to the patients' condition,they were randomly divided into 2 groups before the surgery.Every group had 20 cases.Every group had different scope of surgery.Follow up evaluation was carried out after surgery.Electromyologram (EMG) was applied regularly,and then we observed the clinical symptoms.Results By comparison in the two groups,managed by t-test,there were significant differences in the two groups (P < 0.01).Through the statistical analysis of the results,cases in group which were released transverse carpal ligament and nerve,displayed that the latency of compound muscle action potential (CMAP) in the abductor pollicis hrevis and sensory nerve action potential (SNAP)of ring finger has recovered most quickly through the EMG.The way of group C relieving clinical symptoms was best.Conclusions The scope of surgery which were released transverse carpal ligament and nerve,not only released the median nerve effectively,but also protected the continuity of nerve and the blood supply of nerve.It enhanced the recovery of CMAP and SNAP obviously.It also promoted the recovery of the sense in the peripheral part and the motor functions of the nerve.It was a simple and effective therapy for severe carpal tunnel syndrome.But concerning the complete damage to the median nerve,with muscular atrophy of abductions,it can only promote the sense in the peripheral part after treatment,not the motor functions.%目的 研究临床上重度腕管综合征正中神经卡压的手术松解范围与术后疗效的关系.方法 根据病情及电生理检测分度,筛选出腕管综合征中重度压迫者,随机分为两组,每组20例,给予不同的手

  5. Popliteal artery entrapment syndrome.

    LENUS (Irish Health Repository)

    O'Leary, D P

    2010-01-01

    Popliteal artery entrapment syndrome is a rare abnormality of the anatomical relationship between the popliteal artery and adjacent muscles or fibrous bands in the popliteal fossa. The following is a case report of a 19 year old female, in whom popliteal artery entrapment syndrome was diagnosed, and successfully treated surgically. A review of literature is also presented and provides details on how PAES is classified, diagnosed both clinically and radiologically, and treated surgically.

  6. PERSISTENT MEDIAN ARTERY IN THE CARPAL TUNNEL

    Directory of Open Access Journals (Sweden)

    Raviprasanna.K.H

    2014-09-01

    Full Text Available Introduction: Persistent median artery originates from the anterior interosseous artery in proximal one-third of the forearm and accompanies median nerve. Median artery may regress in the forearm or enter palm through the carpal tunnel deep to flexor retinaculum of wrist and supply palm by anastomosing with the superficial palmar arch. Objective: In present study the objective was to study presence of persistent median artery accompanying median nerve and its termination Materials and Methods: The study included 50 human cadaver upper limb specimens at the Department of Anatomy, Mysore Medical College & Research Institute, Mysore during 2011-13. These specimens fixed in 10% formalin were finely dissected and persistent median artery was traced from origin to termination. Results: Out of 50 human cadaver specimens, persistent median artery was present in 4 specimens (8%. All the 4 median arteries originated from anterior interosseous artery and were of palmar type which reached palm. Out of 4 median arteries, 3 median arteries (6% took part in completion of superficial palmar arch, supplying the distal aspect of palm and 1 median artery (2% directly supplied radial two and half fingers without forming arch. Conclusion: Knowledge of unusual variations helps in proper treatment of disorders of the median nerve. Presence of persistent median artery usually will be asymptomatic but may cause symptoms of carpal tunnel syndrome or pronator teres syndrome when subjected to compression. Rarely this artery can be taken for reconstruction

  7. Application of short-segment nerve conduction studies in the entrapment of the peroneal nerve across the fibular head%短节段神经传导检测法在腓总神经腓骨小头部位嵌压性损伤中的应用价值

    Institute of Scientific and Technical Information of China (English)

    左星; 张蓓; 林涛; 高瑛; 徐堂辉; 王丹; 李亚军

    2016-01-01

    Objective To evaluate the usefulness of the short-segment nerve conduction studies (SSCSs,inching test) of the peroneal nerve across the fibular head in order to diagnose and localize the site of entrapment of the nerve.Methods Fifty-four patients with suspected peroneal nerve palsy and 30 controls were studied.The symptoms all occurred in unilateral leg,involving 25 left legs and 29 right legs.Both long segment motor nerve conduction studies (LSMCs) and SSCSs were performed in all patients and controls.SSCSs were obtained at 2 cm intervals,starting 6 cm proximal (P6,P4 and P2) and 4 cm distal (D2 and D4) ending to the fibular head prominence (P).Results When nerve conduction of the entire 10 cm segment across the fibular head was tested by the conventional method,only 40 showed reduction in amplitude or slowing of motor conduction velocity or both.However,with SSCSs,54 peroneal nerves were all discovered abnormal.The results of comparison of conventional methods suggested that there were significant differences in conduction velocity between the fibular head-Ankle segment and the knee-fibular head segment in the case group,the latter ((33.63 ± 9.29) m/s) being slower than the former ((47.92 ± 4.04) m/s;t =9.776,P =0.000),while there was no obvious abnormality in the control group.The results of the control group detected by SSCSs showed that there was no significant difference between the left and right sides of the mean amplitude of the stimulation points and the mean time of segmental nerve conduction.Therefore,we set the exception criteria as the segmental nerve conduction time is longer than the corresponding control group (i + 2 s),and the CMAP amplitude of proximal stimulation point decreased by more than 20% than the adjacent distal segment.In accordance with this standard,we found that the lesions were located in P6 to P4 in 2/54 (3.7%) legs,P4 to P2 in 4/54 (7.4%) legs,P2 to P in 43/54 (79.6%) legs,P to D2 in 12/54 (22.2%) legs,D2 to D4 in 3

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

    Institute of Scientific and Technical Information of China (English)

    王斌; 尹佳丽; 董秀芝; 陈超; 韩海生; 李浩

    2011-01-01

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

  9. Popliteal artery entrapment syndrome

    DEFF Research Database (Denmark)

    Altintas, Ümit; Helgstrand, Ulf Johan Vilhelm; Hansen, Marc A;

    2013-01-01

    The purpose of this study was to report our experience with popliteal artery entrapment syndrome (PAES) with special emphasis on the applicability of duplex ultrasound scanning (DUS) when diagnosing PAES. In addition to examining the correlation between DUS and intraoperative findings...

  10. Fastklemt nerve som årsag til svære postoperative smerter fra arvæv

    DEFF Research Database (Denmark)

    Møller, Michael; Venzo, Alessandro

    2014-01-01

    Entrapment of a cutaneous nerve in a surgical scar may cause chronic post-operative pain. The condition presents with similar symptoms as a traumatic neuroma or as an anterior cutaneous nerve entrapment syndrome, which, however, is often idiopathic. We present a case, where entrapment of a cutane......Entrapment of a cutaneous nerve in a surgical scar may cause chronic post-operative pain. The condition presents with similar symptoms as a traumatic neuroma or as an anterior cutaneous nerve entrapment syndrome, which, however, is often idiopathic. We present a case, where entrapment...... of a cutaneous nerve in a laparotomy scar caused chronic pain. The symptoms were immediately relieved after selective neurectomy....

  11. Regional anatomy of median nerve palmar cutaneous branch and its clinical significance%正中神经掌皮支的局部解剖与临床意义

    Institute of Scientific and Technical Information of China (English)

    丁洁; 梁炳生; 贾英伟; 达志峰; 朱志祥

    2013-01-01

    目的 为避免腕、掌部手术切口损伤正中神经掌皮支提供解剖学资料.方法 对52例成人上肢标本正中神经掌皮支的来源、走行、分支、分布、血管显微解剖等进行解剖测量.结果 52例标本均有掌皮支,50例自正中神经桡侧发出,2例自尺侧发出,走行在掌长肌腱和桡侧腕屈肌腱之间的深层.发出点距离0点(远侧腕横纹中点)为(45.2±21.2)mm,穿出前臂深筋膜处距离0点(19.8±12.3)mm,穿出掌腱膜处距离0点(8.2±4.3)mm,掌皮支主干长(49.2±24.2)mm,起点处宽(1.2±0.7)mm,掌皮支与舟骨结节中点的垂直距离为(8.3±2.8) mm.掌皮支分3支者31例(占59.6%),分2支者15例(占28.9%),1支者6例(占11.5%).掌皮支主要分布于鱼际区和掌中区,以直入式、伴入式和肌支式进入神经.结论 掌皮支的来源、行程均较恒定.为避免伤及正中神经掌皮支及其营养血管,在腕部手术切口应选在尺侧半(环指纵轴的尺侧),在掌部应靠近第四掌骨作纵切口.%Objective To provide anatomic data for avoiding injury of the palmar cutaneous branch (PCB) of the median nerve during operation around the wrist and palm.Methods The origin,course,branching,distribution and blood supply of the PCB of the median nerve were observed and measured in dissections of 52 adult cadaver upper extremity specimens.Results PCB existed in all 52 specimens originating from the radial side of the median nerve in 50 and from the ulnar side in 2.PCB ran in the deep side between the palmaris longus and flexor carpi radialis tendon.The distance from PCB origin to the zero point (the midpoint of the distal wrist crease) was (45.2 ± 21.2) mm.The point where PCB piercing the forearm deep fascia was (19.8 ± 12.3) mm from the zero point,while the point where PCB piercing the palm aponeurosis was (8.2 ± 4.3) mm from the zero point.The length of PCB before branching was (49.2 ± 24.2) mm,while the width at its beginning was (1.2 ± 0.7) mm

  12. The prevalence of median neuropathy at wrist in systemic sclerosis patients at Srinagarind Hospital

    Directory of Open Access Journals (Sweden)

    Thanaporn Nimitbancha

    2015-01-01

    Full Text Available Objectives: To determine the prevalence and factor related with median neuropathy at wrist (MNW in systemic sclerosis patients. Study Design: Cross-sectional study. Setting: Srinagarind Hospital, Khon Kaen, Thailand. Participants: Systemic sclerosis patients who attended the Scleroderma Clinic, Srinagarind Hospital. Materials and Methods: Seventyfive systemic sclerosis patients were prospectively evaluated by questionnaire, physical examination, and electrodiagnostic study. The questionnaire consisted of the symptoms, duration, and type of systemic sclerosis. The physical examination revealed skin score of systemic sclerosis, pinprick sensation of median nerve distribution of both hands, and weakness of both abductor pollicis brevis muscles. The provocative test which were Tinel′s sign and Phalen′s maneuver were also examined. Moreover, electrodiagnostic study of the bilateral median and ulnar nerves was conducted. Results: The prevalence of MNW in systemic sclerosis patients was 44% - percentage of mild, moderate, and severe were 28%, 9.3%, and 6.7%, respectively. The prevalence of asymptomatic MNW was 88%. There were no association between the presence of MNW and related factors of systemic sclerosis. Conclusions: MNW is one of the most common entrapment neuropathies in systemic sclerosis patients. Systemic sclerosis patients should be screened for early signs of MNW.

  13. Potenciales Evocados Somatosensitivos (PESS obtenidos por estimulación del nervio Mediano (registros espinal y craneano en caninos Somatosensory Evoked Potentials Obtained by Stimulating the Median Nerve (Spinal Cord and Cranial Recordings in Dogs

    Directory of Open Access Journals (Sweden)

    F.C Pellegrino

    2005-12-01

    Full Text Available Se investigaron los PESS espinal y craneano y su génesis por estimulación del nervio mediano en 22 perros sanos cuya edad promedio fue 7 años. La velocidad de conducción (VC del nervio surgió del cociente entre la distancia desde el estímulo al registro espinal y la latencia del pico negativo de la onda obtenida. Se obtuvo el tiempo de conducción central (TCC midiendo la diferencia entre las latencias de los potenciales craneano y espinal. Se emplearon electrodos de aguja entre C7-T1 y en la piel del cráneo contralateralmente al estímulo. El potencial espinal mostró una primera deflexión positiva, seguida por una negativa finalizando con una positiva.La latencia media al pico negativo fue de 4.95+/-0.92ms. La media para la VC del nervio fue 60.79+/-13.53m/s. El potencial craneano tuvo forma de "w". La latencia media al pico negativo fue de 14.62+/-1.83ms. El TCC medio fue de 9.67+/-2.02ms. En 6 perros la estimulación se hizo también más distalmente, permitiendo medir la VC segmentaria del nervio; la media obtenida fue de 59.83+/-21.44m/s, que no difirió significativamente de la primera. El potencial espinal probablemente surja de la sumación espacial de la actividad de diferentes estructuras ubicadas en el lugar del registro, mientras que el obtenido en el cráneo sea debido a la acción de las conexiones tálamo-corticales y de la corteza de recepción.We investigated SSEPs in 22 normal dogs of both sexes (12 females, aged between 3 and 14 years (mean: 7 +/- 4 years old by recording the electrical signal at the spinal cord (L7-S1 and L5-L6 and at the scalp (frontoparietal region in response to median nerve stimulation. Conduction velocity (CV of median nerve and its roots was calculated, measuring the distance between the stimulating cathode and the recording electrode, and dividing it into the latency of the of the spinal cord arrival corresponding negative peak. Central conduction time (CCT was estimated subtracting the

  14. Estudo anatômico da projeção cutânea do nervo mediano através de pontos topográficos =Anatomic study of the branching of the median nerve through topographic points

    Directory of Open Access Journals (Sweden)

    Rocha, Rogério Porto da et al.

    2006-01-01

    and 10 left and operated on 10 pacients with Tunnel Carpal Syndrome. Never mind the morphometric differences of the different individuals. Results: In all studied pieces , It had been identificated an accurate point, named X, was achieved, so that from this point on not only the distal edge of the RF has been localized, but also the emergency of the branching of the median nerve. Conclusion: It had been observed in all the studied cases the correspondence between the X point and the emergency median nerve in the edge of RF.

  15. Whole cell entrapment techniques.

    Science.gov (United States)

    Trelles, Jorge A; Rivero, Cintia W

    2013-01-01

    Microbial whole cells are efficient, ecological, and low-cost catalysts that have been successfully applied in the pharmaceutical, environmental, and alimentary industries, among others. Microorganism immobilization is a good way to carry out the bioprocess under preparative conditions. The main advantages of this methodology lie in their high operational stability, easy upstream separation and bioprocess scale-up feasibility. Cell entrapment is the most widely used technique for whole cell immobilization. This technique-in which the cells are included within a rigid network-is porous enough to allow the diffusion of substrates and products, protects the selected microorganism from the reaction medium, and has high immobilization efficiency (100 % in most cases).

  16. Association between Computer Use and Entrapment Neuropathies in the Wrist Region

    Science.gov (United States)

    Colak, S.; Bamac, B.; Colak, T.; Ozbek, A.

    2013-01-01

    There is general consensus in the literature that computer use is often associated with an increased prevalence of hand and wrist disorders. Symptoms may be associated with specific clinical entities such as peripheral nerve entrapment. Motor and sensory nerve conduction velocity and vibration threshold in the hand of computer users have been…

  17. 正中神经指浅屈肌肌支修复尺神经手内在肌肌支的临床应用研究%The clinical research of flexor digitorum superiicialis muscle branch of the median nerve to repair the hand intrinsic muscle branch of the ulnar nerve

    Institute of Scientific and Technical Information of China (English)

    于亚东; 马涛; 田方涛; 孙庆禄; 曹冉; 崔海斌

    2016-01-01

    Objective To investigate the clinical application of flexor digitorum superiicialis muscle branch of the median nerve to repair the hand intrinsic muscle branch of the ulnar nerve. Methods From June, 2006 to June,.2010, 7 volunteers of level ulanr never pure injuries near to the elbow were treated by transferring flexor dig-itorum superiicialis muscle branch of the median nerve to the hand intrinsic muscle branch of the ulnar nerve.The follow-up period ranged from 3 months to 5.5 years,with an average of 1.5 years..The shape and the musle power of hand intrinsic musle ,the sensory fuction of ulnar nerve ,and the results of EMG after operation were observed. Results The pinkie finger sensory recovery time was about 1.5 years ,.and two-point discrimination test showed that the sensory of the wounded hand recovered effectively ,.but was significantly worse than the healthy side. And the other sesory recover well. 7 months later , the motion relevant to ulnar nerve began to recover. The adduction and abduction functions of little finger recovered firstly. The ring , middle and index finger followed. Finally , the func tion of adductor muscle recovered. 1.5 years later , the intrinsic muscle strength grade was about 2-4 , paper clip test experiment (-), Froment sign(-). There were no obvious claw hand deformity in 6 cases,and the atrophy with varying degrees of adductor muscle occurred in 3 cases. Conclusion Flexor digitorum superiicialis muscle branch of the median nerve transfer to the hand intrinsic muscle branch of the ulnar nerve combined with functional exer-cise can effectively treated and slow down the intrinsic muscles atrophy.%目的:探讨正中神经指浅屈肌肌支修复尺神经手内在肌肌支的临床应用。方法自2006年6月至2010年6月,我们对肘关节以近的单纯尺神经高位损伤的7例志愿者患者,在常规修复尺神经的同时,采用正中神经指浅屈肌肌支的第4肌支移位修复尺神

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

    Institute of Scientific and Technical Information of China (English)

    王晋荣; 王进华; 叶憬; 杨伟丽

    2013-01-01

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

  19. What is the place of electroneuromyographic studies in the diagnosis and management of pudendal neuralgia related to entrapment syndrome?

    Science.gov (United States)

    Lefaucheur, J-P; Labat, J-J; Amarenco, G; Herbaut, A-G; Prat-Pradal, D; Benaim, J; Aranda, B; Arne-Bes, M-C; Bonniaud, V; Boohs, P-M; Charvier, K; Daemgen, F; Dumas, P; Galaup, J-P; Sheikh Ismael, S; Kerdraon, J; Lacroix, P; Lagauche, D; Lapeyre, E; Lefort, M; Leroi, A-M; Opsomer, R-J; Parratte, B; Prévinaire, J-G; Raibaut, P; Salle, J-Y; Scheiber-Nogueira, M-C; Soler, J-M; Testut, M-F; Thomas, C

    2007-01-01

    Entrapment of the pudendal nerve may be at the origin of chronic perineal pain. This syndrome must be diagnosed because this can result in the indication of surgical decompression of the entrapped nerve for pain relief. Electroneuromyographic (ENMG) investigation is often performed in this context, based on needle electromyography and the study of sacral reflex and pudendal nerve motor latencies. The limits of ENMG investigation, owing to various pathophysiological and technical considerations, should be known. The employed techniques do not assess directly the pathophysiological mechanisms of pain but rather correlate to structural alterations of the pudendal nerve (demyelination or axonal loss). In addition, only direct or reflex motor innervation is investigated, whereas sensory nerve conduction studies should be more sensitive to detect nerve compression. Finally, ENMG cannot differentiate entrapment from other causes of pudendal nerve lesion (stretch induced by surgical procedures, obstetrical damage, chronic constipation...). Thus, perineal ENMG has a limited sensitivity and specificity in the diagnosis of pudendal nerve entrapment syndrome and does not give direct information about pain mechanisms. Pudendal neuralgia related to nerve entrapment is mainly suspected on specific clinical features and perineal ENMG examination provides additional, but no definitive clues, for the diagnosis or the localization of the site of compression. In fact, the main value of ENMG is to assess objectively pudendal motor innervation when a surgical decompression is considered. Perineal ENMG might predict the outcome of surgery but is of no value for intraoperative monitoring.

  20. Bubble entrapment through topological change

    KAUST Repository

    Thoroddsen, Sigurdur T.

    2010-05-03

    When a viscousdrop impacts onto a solid surface, it entraps a myriad of microbubbles at the interface between liquid and solid. We present direct high-speed video observations of this entrapment. For viscousdrops, the tip of the spreading lamella is separated from the surface and levitated on a cushion of air. We show that the primary mechanism for the bubble entrapment is contact between this precursor sheet of liquid with the solid and not air pulled directly through cusps in the contact line. The sheet makes contact with the solid surface,forming a wetted patch, which grows in size, but only entraps a bubble when it meets the advancing contact line. The leading front of this wet patch can also lead to the localized thinning and puncturing of the liquid film producing strong splashing of droplets.

  1. Surgical management of Guyon's canal syndrome, an ulnar nerve entrapment at the wrist: report of two cases Síndrome de compressão do nervo ulnar a nível do punho (síndrome do canal de Guyon: relato de dois casos

    Directory of Open Access Journals (Sweden)

    Paulo Henrique Aguiar

    2001-03-01

    Full Text Available Guyon's canal syndrome, an ulnar nerve entrapment at the wrist, is a well-recognized entity. The most common causes that involve the ulnar nerve at the wrist are compression from a ganglion, occupational traumatic neuritis, a musculotendinous arch and disease of the ulnar artery. We describe two cases of Guyon's canal syndrome and discuss the anatomy, aetiology, clinical features, anatomical classification, diagnostic criteria and treatment. It is emphasized that the knowledge of both the surgical technique and anatomy is very important for a satisfactory surgical result.A síndrome do canal de Guyon, um encarceramento do nervo ulnar a nível do punho, é bem conhecida. Ela é causada por neurite ocupacional traumática, doenças e traumas do arco músculo-tendíneo e doença de artéria ulnar. Descrevemos dois casos de síndrome do canal de Guyon e discutimos os aspectos anatômicos e etiológicos, suas características clínicas, classificação anatômica e critérios de diagnóstico, bem como fazemos uma análise crítica do tratamento imposto. Enfatizamos também que, para obter um resultado cirúrgico satisfatório, é importante conhecer bem tanto as técnicas cirúrgicas como sua anatomia.

  2. Towards optimal range medians

    DEFF Research Database (Denmark)

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

    2011-01-01

    that in the cell-probe model, any data structure which supports updates in O(logO(1)n) time must have Ω(log n/loglog n) query time. Our approach naturally generalizes to higher-dimensional range median problems, where element positions and query ranges are multidimensional - it reduces a range median query...... to a logarithmic number of range counting queries....

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

    Directory of Open Access Journals (Sweden)

    Marcelo de Pinho Teixeira Alves

    2013-02-01

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

  4. Functional Median Polish

    KAUST Repository

    Sun, Ying

    2012-08-03

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

  5. The role of diagnostic radiology in compressive and entrapment neuropathies

    Energy Technology Data Exchange (ETDEWEB)

    Spratt, J.D.; Stanley, A.J.; Hide, I.G.; Campbell, R.S.D. [Department of Radiology, James Cook University Hospital, Middlesbrough, TS4 3BW (United Kingdom); Grainger, A.J. [Department of Radiology, Leeds General Infirmary, Leeds (United Kingdom)

    2002-09-01

    Diagnostic imaging is increasingly being utilised to aid the diagnosis of compression and entrapment neuropathies. Cross-sectional imaging, primarily ultrasound and magnetic resonance imaging, can provide exquisite anatomical detail of peripheral nerves and the changes that may occur as a result of compression. Imaging can provide a useful diagnostic aid to clinicians, which may supplement clinical evaluation, and may eventually provide an alternative to other diagnostic techniques such as nerve conduction studies. This article describes the abnormalities that may be demonstrated by current imaging techniques, and critically analyses the impact of imaging in diagnosis of peripheral compressive neuropathy. (orig.)

  6. Robustifying Vector Median Filter

    Directory of Open Access Journals (Sweden)

    Valentín Gregori

    2011-08-01

    Full Text Available This paper describes two methods for impulse noise reduction in colour images that outperform the vector median filter from the noise reduction capability point of view. Both methods work by determining first the vector median in a given filtering window. Then, the use of complimentary information from componentwise analysis allows to build robust outputs from more reliable components. The correlation among the colour channels is taken into account in the processing and, as a result, a more robust filter able to process colour images without introducing colour artifacts is obtained. Experimental results show that the images filtered with the proposed method contain less noisy pixels than those obtained through the vector median filter. Objective measures demonstrate the goodness of the achieved improvement.

  7. 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.

  8. Anatomy and Clinical Application of Transfer of Pronator Quadratus Muscle Branch of Anterior Interosseous Nerve in Repairing Thrhenar Muscle Branch of Median Nerve and Deep Branch of Ulnar Nerve%骨间前神经旋前方肌支转位修复鱼际肌支和尺神经深支的解剖学观察和临床应用

    Institute of Scientific and Technical Information of China (English)

    李长青; 费起礼

    2001-01-01

    目的:了解有关应用骨间前神经旋前方肌支转位修复正中神经鱼际肌支和尺神经深支的解剖,总结应用此方法的临床效果。方法:观察6具成人上肢标本,测量其旋前方肌支、正中神经鱼际肌支和尺神经深支的横径,以及正中神经鱼际肌支起始处、尺神经深支起始处至旋前方肌上缘的距离。1996年4月~1997年3月,临床应用5例。旋前方肌支转位修复陈旧性尺神经损伤3例,陈旧性正中神经损伤1例,急性正中神经损伤1例,其中3例需游离神经移植。结果:骨间前神经旋前方肌支在旋前方肌上缘处、正中神经鱼际肌支起始处、尺神经深支起始处,神经干横径分别为1.3~1.9、1.5~2.3、1.8~2.3mm。正中神经鱼际肌支起始处、尺神经深支起始处至旋前方肌上缘的距离分别是75.2~84.8 mm、53.5~74.0 mm。临床应用经12~23个月随访,4例手内在肌功能恢复M3~M4级,1例未见恢复。结论:骨间前神经旋前方肌支转位修复正中神经鱼际肌支和尺神经深支可达到肌支-肌支修复的设想,缩短再生距离和时间,有利于手内在肌的功能恢复。%Objective:To introduce the anatoamy and clinical application of transfer of the pronator quadratus muscle(PQ)branch of anterior interosseous nerve(AIN)in repairing thenar muscle branch of median nerve (MN) and deep branch of ulnar nerve (UN). Methods: The nerve stem diameter of PQ branch of AIN, thenar muscle branch of MN, and deep branch of the UN,as well as distance between the upper margin of PQ and the origin of thenar muscle branch and deep branch of UN were measured in 6 adult forearm specimens respectively. The surgical procedures were performed in 5 cases from April 1996 to March 1997, which included 3 cases of old injury of ulnar nerve,and 1 case of old and 1 case of fresh injury of median nerve.Nerve graft was used in 3 cases. Results:The nerve stem diameter of PQ

  9. Hyperbolicity in Median Graphs

    Indian Academy of Sciences (India)

    José M Sigarreta

    2013-11-01

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

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

    Science.gov (United States)

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

    2013-05-25

    The distribution of sensory symptoms in carpal tunnel syndrome is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment is still unclear. In this study, we measured ulnar nerve function in 82 patients with carpal tunnel syndrome. The patients were divided into group I with minimal carpal tunnel syndrome (n = 35) and group II with mild to moderate carpal tunnel syndrome (n = 47) according to electrophysiological data. Sixty-one age- and sex-matched subjects without carpal tunnel syndrome were used as a control group. There were no significant differences in ulnar sensory nerve peak latencies or conduction velocities from the 4(th) and 5(th) fingers between patients with carpal tunnel syndrome and the control group. The ulnar sensory nerve action potential amplitudes from the 4(th) and 5(th) fingers were lower in patients with carpal tunnel syndrome than in the control group. The ratios of the ulnar sensory nerve action potential amplitudes from the 4(th) and 5(th) fingers were almost the same in patients with carpal tunnel syndrome as in the control group. These findings indicate that in patients with minimal to moderate carpal tunnel syndrome, there is some electrophysiological evidence of traction on the adjacent ulnar nerve fibers. The findings do not indicate axonal degeneration of the ulnar nerve.

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

    Institute of Scientific and Technical Information of China (English)

    Radwa Mahmoud Azmy; Amira Ahmed Labib; Saly Hassan Elkholy

    2013-01-01

    The distribution of sensory symptoms in carpal tunnel syndrome is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment is still unclear. In this study, we measured ulnar nerve function in 82 patients with carpal tunnel syndrome. The patients were divided into group I with minimal carpal tunnel syndrome (n = 35) and group II with mild to moderate carpal tunnel syndrome (n = 47) according to electrophysiological data. Sixty-one age- and sex-matched subjects without carpal tunnel syndrome were used as a control group. There were no significant differences in ulnar sensory nerve peak latencies or conduction velocities from the 4th and 5th fingers between patients with carpal tunnel syndrome and the control group. The ulnar sensory nerve action potential amplitudes from the 4th and 5th fingers were lower in patients with carpal tunnel syndrome than in the control group. The ratios of the ulnar sensory nerve action potential amplitudes from the 4th and 5th fingers were almost the same in patients with carpal tunnel syndrome as in the control group. These findings indicate that in patients with minimal to moderate carpal tunnel syndrome, there is some electrophysiological evidence of traction on the adjacent ulnar nerve fibers. The findings do not indicate axonal degeneration of the ulnar nerve.

  12. 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.

  13. A clinical study on prevention of median nerve injury in endoscopic carpal tunnel release%腕管综合征内窥镜手术预防正中神经损伤的临床研究

    Institute of Scientific and Technical Information of China (English)

    姜晓琪; 陈臣; 叶作舟; 王斌; 史其林

    2011-01-01

    目的 介绍腕管综合征内窥镜手术(endoscopic carpal tunnel release,ECTR)预防正中神经损伤并发症的方法.方法 利用彩色多普勒超声仪(B超)对37例74手患者术前进行检测.结果 71例正中神经走行在桡侧腕屈肌腱与掌长肌腱之间,3例走行在掌长肌腱与尺侧腕屈肌腱之间,并术中确认.结论 正中神经变异走行在掌长肌腱与尺侧腕屈肌腱之间是ECTR的禁忌证,B超能准确定位正中神经与掌长肌腱关系,避免内窥镜手术损伤正中神经,更具有简单、经济、方便可靠等优点.%Objective To introduce a method of preventing median never injury during endoscopic carpal tunnel release (ECTR). Methods Ultrasonography of both wrists was done to 37 patients of carpal tunnel syndrome who were going to undergo open release of the transverse carpal ligament. Structures in the carpal tunnel were visualized to guide surgical decision-making. Results Ultrasonography showed that median never lies between the tendon of flexor carpi radialis and palmaris longus in 71 patients and lies between the tendon of palmaris longus and flexor carpi ulnaris in 3 patients. These findings were confirmed during the surgeries. Conclusion It is a contraindication of ECTR if median never lies between palmaris longus and flexor carpi ulnaris. Ultrasonography can accurately reveal the relative position of median never to the palmaris longus tendon. Pre-operative ultrasonography of the wrist is a simple, inexpensive and convenient method to exclude these contraindications and thus prevent median never injuries in ECTR.

  14. Multiple Sites Ultrasonography of Peripheral Nerves in Differentiating Charcot–Marie–Tooth Type 1A from Chronic Inflammatory Demyelinating Polyradiculoneuropathy

    Directory of Open Access Journals (Sweden)

    Jingwen Niu

    2017-05-01

    Full Text Available IntroductionMultiple sites measurement of cross-sectional areas (CSA by ultrasound was performed to differentiate Charcot–Marie–Tooth type 1A (CMT1A and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP.MethodsNine patients with CMT1A, 28 patients with CIDP, and 14 healthy controls (HC were recruited prospectively. Consecutive ultrasonography scanning was performed from wrist to axilla on median and ulnar nerves. CSAs were measured at 10 predetermined sites of each nerve.ResultsCMT1A had significantly larger CSAs at all sites of median and ulnar nerves (p < 0.01. In CMT1A, CSAs increased gradually and homogeneously from distal to proximal along the nerve, except potential entrapment sites. CIDP displayed three different morphological patterns, including mild enlargement in 15 patients, prominent segmental enlargement in 12, and slight enlargement in 1, among which different treatment responses were observed. All patients with mild nerve enlargement treated with intravenous immunoglobulin were responsive (7/7, while less than half of those with prominent segmental enlargement (3/7 were responsive (p < 0.01.DiscussionConsecutive scan along the nerve and multiple sites measurement by ultrasound could supply more detailed morphological feature of the nerve and help to differentiate CMT1A from CIDP.

  15. Range Selection and Median

    DEFF Research Database (Denmark)

    Jørgensen, Allan Grønlund; Larsen, Kasper Green

    2011-01-01

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

  16. The role of ultrasound imaging in the evaluation of peripheral nerve in systemic sclerosis (scleroderma)

    Energy Technology Data Exchange (ETDEWEB)

    Tagliafico, Alberto, E-mail: atagliafico@sirm.org [Department of Radiology, University of Genova, Genova (Italy); Panico, Nicoletta [Division of Immunology, Department of Internal Medicine, University of Genoa, Genoa (Italy); Resmini, Eugenia [Department of Endocrinological and Medical Sciences (DiSEM), Center of Excellence for Biomedical Research, University of Genova, Genova (Italy); Derchi, Lorenzo E. [Department of Radiology, University of Genova, Genova (Italy); Ghio, Massimo [Division of Immunology, Department of Internal Medicine, University of Genoa, Genoa (Italy); Martinoli, Carlo [Department of Radiology, University of Genova, Genova (Italy)

    2011-03-15

    Background: Patients affected by scleroderma may complain of sensory disturbances especially in the hands. Purpose: To study the imaging features of upper limb nerves in patients affected by scleroderma (SSc). Materials and method: Twenty-five patients affected only by SSc were prospectively evaluated with high-resolution US and magnetic resonance (MRI) or computer tomography (CT) when necessary (2 patients). Median and ulnar nerves were evaluated bilaterally. Nerve conduction studies were performed in the symptomatic patients (n = 10). Results of imaging studies were correlated with disease duration, autoimmunity and immunosuppression. Nerves of SSc patients were compared with a control group of 90 patients matched for age and body mass index. Results: The prevalence of sensory disturbances revealed by clinical examination was 40%. In symptomatic SSc patients (n = 10) US evaluation revealed nerve abnormalities in 70% of cases (n = 7/10). n = 2 had a carpal tunnel syndrome. n = 5 had cubital tunnel syndrome. In two of them CT and MR were necessary to identify the compressed nerve at the level of the elbow due to the presence of calcifications. There was no association between the presence of an entrapment neuropathy and disease duration, autoantibodies and immunosuppression. Conclusion: Ultrasound, CT and MR may detect nerve abnormalities in 70% of SSc patients complaining of neurologic disturbances in the hands. The results of imaging studies support the hypothesis of a vascular dependent neuropathy in SSc.

  17. Anatomic study and clinical application of neuromyocutaneous flap based on nutritional vessel of median nerve palmar cutaneous branch%正中神经掌皮支营养血管远端蒂肌皮复合瓣解剖学研究及临床应用

    Institute of Scientific and Technical Information of China (English)

    陶圣祥; 喻爱喜; 郑晓晖; 余国荣

    2008-01-01

    目的 探讨正中神经掌皮支营养血管肌皮瓣转移术修复拇指组织缺损的解剖学依据及临床效果.方法 对30侧成人尸体手标本进行解剖,系统观测正中神经掌皮支营养血管链的组成、分支、分布及其同大鱼际肌相互交通吻合的情况.2007年2月以来,临床应用正中神经掌皮支营养血管远端蒂肌皮瓣转移术修复拇指组织缺损17例.结果 桡动脉掌浅支恒定地向拇短展肌和拇短屈肌发出3~5支肌皮穿支,节段性参与正中神经掌皮支营养血管链,肌皮穿支平均外径为[(0.3±0.1)mm,x±s,下同],均有1条静脉伴行.17例术后肌皮瓣全部存活,拇指外观及功能满意,11例患者在术后1周皮瓣两点分辨觉为(6.1~8.2)mm.结论 正中神经掌皮支营养血管链同拇短展肌和拇短屈肌肌皮穿支恒定吻合,该肌皮瓣是修复拇指组织缺损的良好供区.%Objective To investigate the anatomical features of neuromyocutaneous flap based on nutritional vessel of median nerve palmar cutaneous branch and evaluate the clinical application of this flap for repairing soft tissue defect of the thumb. Methods Thirty adult cadaver hand specimens were dissected after red Latex perfusion. The configuration, branches, and distributions of the nutritional vessel of median nerve palmar cutaneous branch and its anastomoses with thenar musole vessels were observed. Since February 2007, neuromyocutaneous flap distally based on the nutritional vessel of median nerve palmar cutaneous branch was transferred to repair soft tissue defect of 17 thumbs. Results Superficial palmar branch of the radial artery gives out 3-5 myocutaneous perforators to abductor pollicis brevis and flexor pollicis brevis. Those perforators form the nutrient vessel chain of palmar cutaneous branch of the median nerve. The external diameter of the perforators was (0.3±0.1 )mm on average. It is accompanied by one. vein. All of the 17 cases of neuromyocutaneous flap

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

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    1997-03-01

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

  19. Nerve conduction and electromyography studies.

    Science.gov (United States)

    Kane, N M; Oware, A

    2012-07-01

    Nerve conduction studies (NCS) and electromyography (EMG), often shortened to 'EMGs', are a useful adjunct to clinical examination of the peripheral nervous system and striated skeletal muscle. NCS provide an efficient and rapid method of quantifying nerve conduction velocity (CV) and the amplitude of both sensory nerve action potentials (SNAPs) and compound motor action potentials (cMAPs). The CV reflects speed of propagation of action potentials, by saltatory conduction, along large myelinated axons in a peripheral nerve. The amplitude of SNAPs is in part determined by the number of axons in a sensory nerve, whilst amplitude of cMAPs reflects integrated function of the motor axons, neuromuscular junction and striated muscle. Repetitive nerve stimulation (RNS) can identify defects of neuromuscular junction (NMJ) transmission, pre- or post-synaptic. Needle EMG examination can detect myopathic changes in muscle and signs of denervation. Combinations of these procedures can establish if motor and/or sensory nerve cell bodies or peripheral nerves are damaged (e.g. motor neuronopathy, sensory ganglionopathy or neuropathy), and also indicate if the primary target is the axon or the myelin sheath (i.e. axonal or demyelinating neuropathies). The distribution of nerve damage can be determined as either generalised, multifocal (mononeuropathy multiplex) or focal. The latter often due to compression at the common entrapment sites (such as the carpal tunnel, Guyon's canal, cubital tunnel, radial groove, fibular head and tarsal tunnel, to name but a few of the reported hundred or so 'entrapment neuropathies').

  20. 紫杉醇联合卡铂化疗致双侧正中神经损害%Bilateral median nerve injuries after chemotherapy with paclitaxel and carboplatin

    Institute of Scientific and Technical Information of China (English)

    杨水源; 吴宏; 曾泗宇; 童艳丽; 梅清华

    2015-01-01

    A 50-year-old female patient with serious borderline tumor received chemotherapy with paclitaxel and carboplatin(an IV infusion of paclitaxel 198 mg and carboplatin 395 mg on the first day of treatment,the cycle of treatment was 21 d)after undergoing total hysterectomy,bilateral ovarian,and greater omentum resection. After the IV infusion of third chemotherapy cycle,the patient developed persistent and progressive numbness and pain of fingers which could radiate to the elbow. After treatment with carbamazepine and mecobalamin,the symptoms were not relieved. Thus it was considered that the adverse reactions may be caused by chemotherapy drugs. So the chemotherapy was paused temporarily,and prednisone,rebamipide,mouse nerve growth factor for injection,and mecobalamin were given. After 14 d of treatments,the patientˊ s symptoms were alleviated apparently. At half a year of follow-up,the patient developed slight atrophy in the right thenar muscle and hypoesthesia in bilateral index finger and middle finger palm.%1例50岁卵巢浆液性交界性肿瘤患者行全子宫、双侧附件及大网膜部分切除术后接受紫杉醇联合卡铂化疗(紫杉醇198 mg、卡铂395 mg 静脉滴注,第1天;21 d 为1个周期)。第3周期化疗静脉给药后,患者出现双手手指麻痛,呈持续性、进行性加重,放射至肘关节。给予口服卡马西平和甲钴胺后未缓解。考虑患者症状与化疗药物有关,暂停辅助化疗,给予泼尼松、瑞巴派特、注射用鼠神经生长因子、甲钴胺等对症治疗。14 d 后,患者疼痛症状减轻。半年后随访,患者右侧大鱼际肌轻度萎缩,双侧食指和中指掌面感觉减退。

  1. Decreased Nerve Conduction Velocity in Football Players

    Directory of Open Access Journals (Sweden)

    Daryoush Didehdar

    2014-06-01

    Full Text Available Background: Lower limbs nerves are exposed to mechanical injuries in the football players and the purpose of this study is to evaluate the influence of football on the lower leg nerves. Materials and Methods: Nerve conduction studies were done on 35 male college students (20 football players, 15 non active during 2006 to 2007 in the Shiraz rehabilitation faculty. Standard nerve conduction techniques using to evaluate dominant and non dominant lower limb nerves. Results: The motor latency of deep peroneal and tibial nerves of dominant leg of football players and sensory latency of superficial peroneal, tibial and compound nerve action potential of tibial nerve of both leg in football players were significantly prolonged (p<0.05. Motor and sensory nerve conduction velocity of tibial and common peroneal in football players were significant delayed (p<0.05. Conclusion: It is concluded that football is sport with high contact and it causes sub-clinical neuropathies due to nerve entrapment.

  2. 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.

  3. Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve and Release of the Plantar Aponeurosis for Chronic Heel Pain

    OpenAIRE

    Lui, Tun Hing

    2016-01-01

    Entrapment of the first branch of the lateral plantar nerve is a commonly missed cause of recalcitrant plantar heel pain. The diagnosis is made on a clinical ground with maximal tenderness at the site of nerve entrapment. Treatment of the nerve entrapment is similar to that for plantar fasciitis, with rest, activity modification, nonsteroidal anti-inflammatory drugs, stretching exercise, and local steroid injection. Surgical release of the deep abductor hallucis fascia is indicated when conse...

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

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    1997-03-01

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

  5. Piriformis syndrome surgery causing severe sciatic nerve injury.

    Science.gov (United States)

    Justice, Phillip E; Katirji, Bashar; Preston, David C; Grossman, Gerald E

    2012-09-01

    Piriformis syndrome is a controversial entrapment neuropathy in which the sciatic nerve is thought to be compressed by the piriformis muscle. Two patients developed severe left sciatic neuropathy after piriformis muscle release. One had a total sciatic nerve lesion, whereas the second had a predominantly high common peroneal nerve lesion. Follow-up studies showed reinnervation of the hamstrings only. We conclude that piriformis muscle surgery may be hazardous and result in devastating sciatic nerve injury.

  6. Median Nerve Conduction in Healthy Nigerians: Normative Data

    African Journals Online (AJOL)

    Data on peripheral nervous system function may be of use in providing ... Background: Because of lack of local normative data, electrodiagnostic laboratories in Nigeria ... study design, a total of 200 healthy volunteers were selected after clinical evaluation to ... was used to obtain and record action potentials for motor and.

  7. A study of retrograde degeneration of median nerve forearm ...

    African Journals Online (AJOL)

    Mona Mokhtar El Bardawil

    2013-10-22

    Oct 22, 2013 ... forearm segment in patients with CTS and its relation to variable severity of CTS in Egyptian patients. Patients ... Retrograde degeneration is not related to grade of severity of CTS. .... dominant hand using NEUROPACK 2 Electroneuromyog- ... was evaluated using Fisher Exact and Monte Carlo test.18,19.

  8. Compound palmar ganglion causing compressive neuropathy of the median nerve

    Directory of Open Access Journals (Sweden)

    Tribhuwan Narayan Singh Gaur

    2017-01-01

    Full Text Available Tuberculosis (TB of synovial sheath of tendon is uncommon, it is a severe form of extrapulmonary TB, diagnosis is obvious on clinical grounds in later stages, but is always confirmed by histopathology. Here, we are presenting a case of a 50-year-old female, who presented to us with gradual increasing swelling in her left hand and wrist and numbness over left thenar eminence. The patient was successfully treated with debulking operation and anti-tubercular drugs. Tubercular tenosynovitis of wrist and hand is a severe form of extrapulmonary TB. Intraoperatively, the presence of rice body or melon seed bodies is pathognomonic for confirming the diagnosis. Early diagnosis and intervention give good prognosis.

  9. [Entrapment of herbal extracts in biodegradable microcapsules].

    Science.gov (United States)

    Borodina, T N; Rumsh, L D; Kunizhev, S M; Sukhorukov, G B; Vorozhtsov, G N; Fel'dman, B M; Rusanova, A V; Vasil'eva, T V; Strukova, S M; Markvicheva, E A

    2007-01-01

    The microcapsules with entrapped herbal water-soluble extracts Plantago major and Calendula officinalis L. (HE) were prepared by LbL-adsorption of carrageenan and modificated chitosan onto CaCO3 microparticles with their subsequent dissolving after the treatment of EDTA. Entrapment of HE was performed by adsorption and co-precipitation techniques. The co-precipitation provided better entrapment of HE compared to adsorption. In vitro release kinetics in an artificial gastric juice (AGJ) was studied. The HE release was shown to accelerate gastric ulcer treatment in a rat model.

  10. Factors that influence peripheral nerve regeneration

    DEFF Research Database (Denmark)

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

    2002-01-01

    median nerve lesions (n = 46) in nonhuman primates over 3 to 4 years, a time span comparable with such lesions in humans. Nerve gap distances of 5, 20, or 50mm were repaired with nerve grafts or collagen-based nerve guide tubes, and three electrophysiological outcome measures were followed: (1) compound...

  11. Ultrasonographic Evaluation of Peripheral Nerves.

    Science.gov (United States)

    Ali, Zarina S; Pisapia, Jared M; Ma, Tracy S; Zager, Eric L; Heuer, Gregory G; Khoury, Viviane

    2016-01-01

    There are a variety of imaging modalities for evaluation of peripheral nerves. Of these, ultrasonography (US) is often underused. There are several advantages of this imaging modality, including its cost-effectiveness, time-efficient assessment of long segments of peripheral nerves, ability to perform dynamic maneuvers, lack of contraindications, portability, and noninvasiveness. It can provide diagnostic information that cannot be obtained by electrophysiologic or, in some cases, magnetic resonance imaging studies. Ideally, the neurosurgeon can use US as a diagnostic adjunct in the preoperative assessment of a patient with traumatic, neoplastic, infective, or compressive nerve injury. Perhaps its most unique use is in intraoperative surgical planning. In this article, a brief description of normal US nerve anatomy is presented followed by a description of the US appearance of peripheral nerve disease caused by trauma, tumor, infection, and entrapment.

  12. Assessment of the utility of ultrasonography with high-frequency transducers in the diagnosis of entrapment neuropathies.

    Science.gov (United States)

    Kowalska, Berta

    2014-12-01

    The primary aim of this paper was to assess the relevance of high-frequency ultra-sound examination in qualifying patients for either surgical or conservative treatment of peripheral entrapment neuropathies. The study was conducted in a group of 55 patients aged 7-83 (mean age 43.6), including 28 males and 27 females, who in 2009-2011 were referred to an ultrasound examination due to a clinical suspicion of entrapment neuropathies. For the purposes of the analysis, the patients were divided into four groups: carpal tunnel syndrome (1), ulnar nerve entrapment (2) (cubital tunnel syndrome and Guyon's canal syndrome), posterior interosseous nerve syndrome (3) and other entrapment neuropathies (4). The cases of isolated idiopathic carpal tunnel syndrome were excluded from the analysis. All patients underwent the interview, physical examination and ultrasound examination. Ultrasound examinations were performed with Esaote MyLab 50 and MyLab 60 systems using high-frequency broadband linear transducers: 6-18 MHz. Sixty-seven percent of patients (37 persons) underwent a neurophysiological test. Nerve echostructure, its hyperemia as well as nerve cross-sectional area or, in the case of small nerves, diameter were assessed in all patients. Furthermore, the following were assessed in individual groups: notch sign in group 1, nerve instability in a dynamic ultrasound examination in group 2, nerve angulation in a dynamic ultrasound examination and tenderness on nerve compression at the site of the visualized pathology in group 3. The analyses of the collected material were performed by means of descriptive statistics. The results of clinical and surgical verification were consistent with ultrasound findings in 96.4%. The results indicate that high-frequency ultrasonography is a valuable method in qualifying patients for various types of treatment of peripheral neuropathies resulting from compression.

  13. Assessment of the utility of ultrasonography with high-frequency transducers in the diagnosis of entrapment neuropathies

    Directory of Open Access Journals (Sweden)

    Berta Kowalska

    2014-12-01

    Full Text Available The primary aim of this paper was to assess the relevance of high-frequency ultrasound examination in qualifying patients for either surgical or conservative treatment of peripheral entrapment neuropathies. The study was conducted in a group of 55 patients aged 7–83 (mean age 43.6, including 28 males and 27 females, who in 2009–2011 were referred to an ultrasound examination due to a clinical suspicion of entrapment neuropathies. For the purposes of the analysis, the patients were divided into four groups: carpal tunnel syndrome (1, ulnar nerve entrapment (2 (cubital tunnel syndrome and Guyon’s canal syndrome, posterior interosseous nerve syndrome (3 and other entrapment neuropathies (4. The cases of isolated idiopathic carpal tunnel syndrome were excluded from the analysis. All patients underwent the interview, physical examination and ultrasound examination. Ultrasound examinations were performed with Esaote MyLab 50 and MyLab 60 systems using high-frequency broadband linear transducers: 6–18 MHz. Sixty-seven percent of patients (37 persons underwent a neurophysiological test. Nerve echostructure, its hyperemia as well as nerve cross-sectional area or, in the case of small nerves, diameter were assessed in all patients. Furthermore, the following were assessed in individual groups: notch sign in group 1, nerve instability in a dynamic ultrasound examination in group 2, nerve angulation in a dynamic ultrasound examination and tenderness on nerve compression at the site of the visualized pathology in group 3. The analyses of the collected material were performed by means of descriptive statistics. The results of clinical and surgical verification were consistent with ultrasound findings in 96.4%. The results indicate that high-frequency ultrasonography is a valuable method in qualifying patients for various types of treatment of peripheral neuropathies resulting from compression.

  14. An IIR median hybrid filter

    Science.gov (United States)

    Bauer, Peter H.; Sartori, Michael A.; Bryden, Timothy M.

    1992-01-01

    A new class of nonlinear filters, the so-called class of multidirectional infinite impulse response median hybrid filters, is presented and analyzed. The input signal is processed twice using a linear shift-invariant infinite impulse response filtering module: once with normal causality and a second time with inverted causality. The final output of the MIMH filter is the median of the two-directional outputs and the original input signal. Thus, the MIMH filter is a concatenation of linear filtering and nonlinear filtering (a median filtering module). Because of this unique scheme, the MIMH filter possesses many desirable properties which are both proven and analyzed (including impulse removal, step preservation, and noise suppression). A comparison to other existing median type filters is also provided.

  15. GPU Accelerated Vector Median Filter

    Science.gov (United States)

    Aras, Rifat; Shen, Yuzhong

    2011-01-01

    Noise reduction is an important step for most image processing tasks. For three channel color images, a widely used technique is vector median filter in which color values of pixels are treated as 3-component vectors. Vector median filters are computationally expensive; for a window size of n x n, each of the n(sup 2) vectors has to be compared with other n(sup 2) - 1 vectors in distances. General purpose computation on graphics processing units (GPUs) is the paradigm of utilizing high-performance many-core GPU architectures for computation tasks that are normally handled by CPUs. In this work. NVIDIA's Compute Unified Device Architecture (CUDA) paradigm is used to accelerate vector median filtering. which has to the best of our knowledge never been done before. The performance of GPU accelerated vector median filter is compared to that of the CPU and MPI-based versions for different image and window sizes, Initial findings of the study showed 100x improvement of performance of vector median filter implementation on GPUs over CPU implementations and further speed-up is expected after more extensive optimizations of the GPU algorithm .

  16. Non-Local Euclidean Medians.

    Science.gov (United States)

    Chaudhury, Kunal N; Singer, Amit

    2012-11-01

    In this letter, we note that the denoising performance of Non-Local Means (NLM) can be improved at large noise levels by replacing the mean by the Euclidean median. We call this new denoising algorithm the Non-Local Euclidean Medians (NLEM). At the heart of NLEM is the observation that the median is more robust to outliers than the mean. In particular, we provide a simple geometric insight that explains why NLEM performs better than NLM in the vicinity of edges, particularly at large noise levels. NLEM can be efficiently implemented using iteratively reweighted least squares, and its computational complexity is comparable to that of NLM. We provide some preliminary results to study the proposed algorithm and to compare it with NLM.

  17. 排针攒刺松解疗法治疗臀上皮神经卡压综合征%Clinical observation on superior cluneal nerve entrapment syndrome treated by relaxation therapy of in-row multi-needling technique

    Institute of Scientific and Technical Information of China (English)

    李常法; 张杰; 王军茹

    2012-01-01

    Objective To observe the clinical efficacy on superior cluneal nerve entrapment syndrome treated by relaxation therapy of in-row multi-needling technique. Methods One hundred and twenty cases were randomized into a multi-needling group, an acupotomy group and a conventional acupuncture group, 40 cases in each one. In the multi-needling group, the perpendicular or oblique puncture was applied to the affected area of the lumbar and gluteal region. The chief needling sites were determined in terms of the strong response of acupuncture to be the chief points. The in-row multi-needling technique was applied around the chief needling sites, with lifting, thrusting penetrating method to different directions. Two chief points were connected with the G6805 low frequency pulse therapeutic apparatus. In the acupotomy group, the acupotomy was applied to 3 to 4 affected sites in each treatment. In the conventional acupuncture group, Shenshu (BL 23) , Dachangshu (BL 25) , Jiaji (EX-B 2) in the lumbar region, Zhibian (BL 54) and the other were selected and connected with the G6805 low frequency pulse therapeutic apparatus. The cases in each,group were treated for 4 weeks. The improvements of pain score, therapeutic efficacy and comprehensive satisfaction assessment were compared among 3 groups in 2 and 4 weeks of treatment separately. Results The pain scores in each group were reduced apparently in 2 and 4 weeks of treatment separately (all P<0. 05) , and the pain score in the acupotomy group was lower than that in the conventional acupuncture group in 2 weeks of treatment. In 4 weeks of treatment, the pain scores in the multi-needling group and the acupotomy group were lower than that in the conventional acupuncture group (both P<0. 05) and the pain score in the multi-needling group was lower than that in the acupotomy group (P<0. 05). In 2 weeks of treatment, the remarkable effective rate in the acupotomy group was 62. 5% (25/40) , which was superior significantly to 25. 0% (10

  18. Nerve conduction studies after decompression in painful diabetic polyneuropathy

    NARCIS (Netherlands)

    Macare van Maurik, JFM; Franssen, Hessel; Millin, Daniel W.; Peters, Edgar J G; Kon, Moshe

    2015-01-01

    Purpose: To investigate the influence of nerve decompression at potential entrapment sites in the lower extremity in painful diabetic polyneuropathy on nerve conduction study variables. Methods: Forty-two patients with painful diabetic polyneuropathy were included in this prospective randomized cont

  19. Median statistics cosmological parameter values

    Energy Technology Data Exchange (ETDEWEB)

    Crandall, Sara, E-mail: sara1990@ksu.edu; Ratra, Bharat, E-mail: ratra@phys.ksu.edu

    2014-05-01

    We present median statistics central values and ranges for 12 cosmological parameters, using 582 measurements (published during 1990–2010) collected by [9]. On comparing to the recent Planck Collaboration [1] estimates of 11 of these parameters, we find good consistency in ten cases.

  20. Documenting neuropathy of the lateral femoral cutaneous nerve using the pressure-specified sensory testing device

    NARCIS (Netherlands)

    Coert, JH; Dellon, AL

    Entrapment of the lateral femoral cutaneous nerve has been difficult to document. The variability of the anatomic location of this nerve makes it difficult to measure with traditional electrodiagnostic studies. At the same time, anatomic variability increases the likelihood for this nerve to become

  1. Diagnostic nerve ultrasonography; Diagnostische Nervensonographie

    Energy Technology Data Exchange (ETDEWEB)

    Baeumer, T. [Universitaet zu Luebeck CBBM, Haus 66, Institut fuer Neurogenetik, Luebeck (Germany); Grimm, A. [Universitaetsklinikum Tuebingen, Klinik und Poliklinik fuer Neurologie, Tuebingen (Germany); Schelle, T. [Staedtisches Klinikum Dessau, Neurologische Klinik, Dessau (Germany)

    2017-03-15

    For the diagnostics of nerve lesions an imaging method is necessary to visualize peripheral nerves and their surrounding structures for an etiological classification. Clinical neurological and electrophysiological investigations provide functional information about nerve lesions. The information provided by a standard magnetic resonance imaging (MRI) examination is inadequate for peripheral nerve diagnostics; however, MRI neurography is suitable but on the other hand a resource and time-consuming method. Using ultrasonography for peripheral nerve diagnostics. With ultrasonography reliable diagnostics of entrapment neuropathies and traumatic nerve lesions are possible. The use of ultrasonography for neuropathies shows that a differentiation between different forms is possible. Nerve ultrasonography is an established diagnostic tool. In addition to the clinical examination and clinical electrophysiology, structural information can be obtained, which results in a clear improvement in the diagnostics. Ultrasonography has become an integral part of the diagnostic work-up of peripheral nerve lesions in neurophysiological departments. Nerve ultrasonography is recommended for the diagnostic work-up of peripheral nerve lesions in addition to clinical and electrophysiological investigations. It should be used in the clinical work-up of entrapment neuropathies, traumatic nerve lesions and spacy-occupying lesions of nerves. (orig.) [German] Fuer die Diagnostik von Nervenlaesionen ist ein bildgebendes Verfahren zur Darstellung des peripheren Nervs und seiner ihn umgebenden Strukturen fuer eine aetiologische Einordnung erforderlich. Mit der klinisch-neurologischen Untersuchung und Elektrophysiologie ist eine funktionelle Aussage ueber die Nervenlaesion moeglich. In der Standard-MRT-Untersuchung wird der periphere Nerv nur unzureichend gut dargestellt. Die MRT-Neurographie ist ein sehr gutes, aber auch zeit- und ressourcenintensives Verfahren. Nutzung des Ultraschalls fuer die

  2. Resveratrol entrapped niosomes as yoghurt additive.

    Science.gov (United States)

    Pando, D; Beltrán, M; Gerone, I; Matos, M; Pazos, C

    2015-03-01

    Nanodesign of niosomes containing resveratrol (RSV) was carried out using food-grade surfactants with dodecanol to stabilise the membrane. Niosomes were prepared using a modified thin film hydration method. A factorial design analysis was carried out to reduce the number of experiments. The response factors were: mean size, polydispersity index (PDI) and entrapment efficiency (EE). Agitation speed and surfactant to dodecanol weight ratio were selected as key parameters for niosomes preparation. Parameter contribution was determined using a statistical analysis of variance (ANOVA). Niosomes formulated with Span 60 or Maisine 35-1 as surfactants, and dodecanol as stabiliser, were able to incorporate RSV. These niosomes exhibited a small mean size, narrow size distribution, high RSV entrapment efficiency and good stability. RSV addition did not involve changes in the textural properties of regular yoghurt demonstrating that RSV entrapped niosomes are suitable additives in these dairy products. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. A review of nerve conduction studies in cases of suspected compression neuropathies of the upper limb.

    LENUS (Irish Health Repository)

    Neligan, A

    2010-01-01

    Entrapment neuropathies, particularly those affecting upper limbs, are common reasons for referral for nerve conduction studies (NCS). However, concordance between clinical findings and NCS findings, especially in patients being considered for intervention including decompressive surgery, has not been assessed.

  4. Neural Organization of the Median Ocellus of the Dragonfly

    Science.gov (United States)

    Dowling, John E.; Chappell, Richard L.

    1972-01-01

    Two types of presumed synaptic contacts have been recognized by electron microscopy in the synaptic plexus of the median ocellus of the dragonfly. The first type is characterized by an electron-opaque, button-like organelle in the presynaptic cytoplasm, surrounded by a cluster of synaptic vesicles. Two postsynaptic elements are associated with these junctions, which we have termed button synapses. The second synaptic type is characterized by a dense cluster of synaptic vesicles adjacent to the presumed presynaptic membrane. One postsynaptic element is observed at these junctions. The overwhelming majority of synapses seen in the plexus are button synapses. They are found most commonly in the receptor cell axons where they synaptically contact ocellar nerve dendrites and adjacent receptor cell axons. Button synapses are also seen in the ocellar nerve dendrites where they appear to make synapses back onto receptor axon terminals as well as onto adjacent ocellar nerve dendrites. Reciprocal and serial synaptic arrangements between receptor cell axon terminals, and between receptor cell axon terminals and ocellar nerve dendrites are occasionally seen. It is suggested that the lateral and feedback synapses in the median ocellus of the dragonfly play a role in enhancing transients in the postsynaptic responses. PMID:5049076

  5. Sensory nerve conduction studies in neuralgic amyotrophy.

    Science.gov (United States)

    van Alfen, Nens; Huisman, Willem J; Overeem, S; van Engelen, B G M; Zwarts, M J

    2009-11-01

    Neuralgic amyotrophy is a painful, episodic peripheral nerve disorder localized to the brachial plexus. Sensory symptoms occur in 80% of the patients. We assessed the frequency of abnormalities in sensory nerve conduction studies of the lateral and medial antebrachial cutaneous, radial sensory, median sensory, and ulnar sensory nerves in 112 patients. Sensory nerve conduction studies showed abnormalities in nerves, even when the nerve was clinically affected. The lateral and medial antebrachial cutaneous nerves were most often abnormal, in 15% and 17% of nerves. No correlation with the presence or localization of clinical deficits was found. Brachial plexus sensory nerve conduction studies seem to be of little diagnostic value in neuralgic amyotrophy. Our findings also indicate that some sensory lesions may be in the nerve roots instead of the plexus. An examination of normal sensory nerve conduction studies does not preclude neuralgic amyotrophy as a diagnosis.

  6. Endoscopic Decompression of the First Branch of the Lateral Plantar Nerve and Release of the Plantar Aponeurosis for Chronic Heel Pain.

    Science.gov (United States)

    Lui, Tun Hing

    2016-06-01

    Entrapment of the first branch of the lateral plantar nerve is a commonly missed cause of recalcitrant plantar heel pain. The diagnosis is made on a clinical ground with maximal tenderness at the site of nerve entrapment. Treatment of the nerve entrapment is similar to that for plantar fasciitis, with rest, activity modification, nonsteroidal anti-inflammatory drugs, stretching exercise, and local steroid injection. Surgical release of the deep abductor hallucis fascia is indicated when conservative treatment failed. Endoscopic release of the nerve through the dorsal and plantar portals, as well as endoscopic plantar aponeurosis release, is a feasible approach.

  7. Nerve biopsy

    Science.gov (United States)

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

  8. CROSSING ANASTOMOSIS OF NERVE BUNDLES NEAR INNERVATED ORGANS TO TREAT IRREPARABLE NERVE INJURIES

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To study the therapeutical effects of crossing anastomosis of nerve on the peripheral and central nerve injuries.Methods Twelve kinds of central and peripheral nerve disorders and their complications were treated with 11 kinds of crossing anastomosis of nerve bundles near the innervated organs. After nerve injury and repair, somatosensory evoked potentials (SEPs) and horseradish peroxidase (HRP) retrograde tracing studies were used to investigate the rabbit's nerve function and morphology.Results The ulcers of all patients healed. Sensation, voluntary movement, and joint function recovered. Four weeks after the anastomosis of distal stump of radialis superficialis nerve and median nerve, pain sensation regained and SEPs appeared. HRP retrograde tracing studies demonstrated sensory nerve ending of medial nerve formed new connection with the body of neuron.Conclusion Crossing anastomosis of nerve is an effective method to treat peripheral and central nerve injuries.

  9. T2-signal of ulnar nerve branches at the wrist in guyon's canal syndrome.

    Directory of Open Access Journals (Sweden)

    Jennifer Kollmer

    Full Text Available OBJECTIVE: To evaluate T2-signal of high-resolution MRI in distal ulnar nerve branches at the wrist as diagnostic sign of guyon's-canal-syndrome (GCS. MATERIALS AND METHODS: 11 GCS patients confirmed by clinical/electrophysiological findings, and 20 wrists from 11 asymptomatic volunteers were prospectively included to undergo the following protocol: axial T2-weighted-fat-suppressed and T1-weighted-turbo-spin-echo-sequences (3T-MR-scanner, Magnetom/Verio/Siemens. Patients were examined in prone position with the arm extended and wrist placed in an 8-channel surface-array-coil. Nerve T2-signal was evaluated as contrast-to-noise-ratios (CNR from proximal-to-distal in ulnar nerve trunk, its superficial/sensory and deep/motor branch. Distal motor-nerve-conduction (distal-motor-latency (dml to first dorsal-interosseus (IOD I and abductor digiti minimi muscles was correlated with T2-signal. Approval by the institutional review-board and written informed consent was given by all participants. RESULTS: In GCS, mean nerve T2-signal was strongly increased within the deep/motor branch (11.7±4.8 vs.controls:-5.3±2.4;p = 0.001 but clearly less and not significantly increased in ulnar nerve trunk (6.8±6.4vs.-7.4±2.5;p = 0.07 and superficial/sensory branch (-2.1±4.9vs.-9.7±2.9;p = 0.08. Median nerve T2-signal did not differ between patients and controls (-9.8±2.5vs.-6.7±4.2;p = 0.45. T2-signal of deep/motor branch correlated strongly with motor-conduction-velocity to IOD I in non-linear fashion (R(2 = -0.8;p<0.001. ROC-analysis revealed increased nerve T2-signal of the deep/motor branch to be a sign of excellent diagnostic performance (area-under-the-curve 0.94, 95% CI: 0.85-1.00; specificity 90%, sensitivity 89.5%. CONCLUSIONS: Nerve T2-signal increase of distal ulnar nerve branches and in particular of the deep/motor branch is highly accurate for the diagnostic determination of GCS. Furthermore, for the first time it was found in nerve entrapment

  10. 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.)

  11. Missed ulnar nerve injury and closed forearm fracture in a child

    Directory of Open Access Journals (Sweden)

    Amit Batra

    2013-08-01

    Full Text Available 【Abstract】Ulnar nerve injury in closed fracture of forearm in children is uncommon. Commonly, neurapraxia is the reason for this palsy but other severe injuries or nerve entrapment has been reported in some cases. The impor-tance of diagnosis concerning the types of the nerve injury lies in the fact that they have totally different management. We present a case of ulnar nerve deficit in a child following a closed fracture of the forearm bones. It is imperative to diagnose exact cause of palsy as it forms the basis for treatment. MRI scan can help diagnosis and accordingly guide the management. Simple nerve contusion should be treated conservatively, and exploration with fixation of the fracture should be done in lacerations and entrapments of the nerve. Surgery is not the treatment of choice in cases that could be managed conservatively. Key words: Ulnar nerve; Peripheral nerve injuries; Forearm injuries; Child

  12. The surgery of peripheral nerves (including tumors)

    DEFF Research Database (Denmark)

    Fugleholm, Kåre

    2013-01-01

    Surgical pathology of the peripheral nervous system includes traumatic injury, entrapment syndromes, and tumors. The recent significant advances in the understanding of the pathophysiology and cellular biology of peripheral nerve degeneration and regeneration has yet to be translated into improved...... surgical techniques and better outcome after peripheral nerve injury. Decision making in peripheral nerve surgery continues to be a complex challenge, where the mechanism of injury, repeated clinical evaluation, neuroradiological and neurophysiological examination, and detailed knowledge of the peripheral...... nervous system response to injury are prerequisite to obtain the best possible outcome. Surgery continues to be the primary treatment modality for peripheral nerve tumors and advances in adjuvant oncological treatment has improved outcome after malignant peripheral nerve tumors. The present chapter...

  13. Medical image of the week: lung entrapment

    Directory of Open Access Journals (Sweden)

    Natt B

    2016-07-01

    Full Text Available No abstract available. Article truncated at 150 words. A 74-year-old woman with a history of breast cancer 10 years ago treated with lumpectomy and radiation presented for evaluation of shortness of breath. She was diagnosed with left sided pleural effusion which was recurrent requiring multiple thoracenteses. There was increased pleural fludeoxyglucose (FDG uptake on PET-CT indicative of recurrent metastatic disease. She underwent a medical pleuroscopy since the pleural effusion analysis did not reveal malignant cells although the suspicion was high and tunneled pleural catheter placement as adjuvant chemotherapy was initiated. Figure 1 shows a pleurscopic view of the collapsed left lung and the effusion in the left hemi thorax. Figure 2 shows extensive involvement of the visceral pleura with metastatic disease preventing complete lung inflation. Figure 3 shows persistent pneumothorax-ex-vacuo despite pleural catheter placement confirming the diagnosis of entrapment. Incomplete lung inflation can be due to pleural disease, endobronchial lesions or chronic telecasts. Lung entrapment and trapped lung ...

  14. Drop impact entrapment of bubble rings

    CERN Document Server

    Thoraval, M -J; Etoh, T G; Thoroddsen, S T

    2012-01-01

    We use ultra-high-speed video imaging to look at the initial contact of a drop impacting onto a liquid layer. We observe experimentally the vortex street and the bubble-ring entrapments predicted numerically, for high impact velocities, by Thoraval et al. [Phys. Rev. Lett. 108, 264506 (2012)]. These dynamics occur mostly within 50 {\\mu}s after the first contact, requiring imaging at 1 million frames/sec. For a water drop impacting onto a thin layer of water, the entrapment of isolated bubbles starts through azimuthal instability, which forms at low impact velocities, in the neck connecting the drop and pool. For Re above about 12 000, up to 10 partial bubble-rings have been observed at the base of the ejecta, starting when the contact is about 20% of the drop size. More regular bubble rings are observed for a pool of ethanol or methanol. The video imaging shows rotation around some of these air cylinders, which can temporarily delay their breakup into microbubbles. The different refractive index in the pool l...

  15. Drop impact entrapment of bubble rings

    KAUST Repository

    Thoraval, M.-J.

    2013-04-29

    We use ultra-high-speed video imaging to look at the initial contact of a drop impacting on a liquid layer. We observe experimentally the vortex street and the bubble-ring entrapments predicted numerically, for high impact velocities, by Thoraval et al. (Phys. Rev. Lett., vol. 108, 2012, article 264506). These dynamics mainly occur within 50 -s after the first contact, requiring imaging at 1 million f.p.s. For a water drop impacting on a thin layer of water, the entrapment of isolated bubbles starts through azimuthal instability, which forms at low impact velocities, in the neck connecting the drop and pool. For Reynolds number Re above -12 000, up to 10 partial bubble rings have been observed at the base of the ejecta, starting when the contact is -20% of the drop size. More regular bubble rings are observed for a pool of ethanol or methanol. The video imaging shows rotation around some of these air cylinders, which can temporarily delay their breakup into micro-bubbles. The different refractive index in the pool liquid reveals the destabilization of the vortices and the formation of streamwise vortices and intricate vortex tangles. Fine-scale axisymmetry is thereby destroyed. We show also that the shape of the drop has a strong influence on these dynamics. 2013 Cambridge University Press.

  16. Endoscopic Sciatic Nerve Decompression in the Prone Position-An Ischial-Based Approach.

    Science.gov (United States)

    Jackson, Timothy J

    2016-06-01

    Deep gluteal syndrome is described as sciatic nerve entrapment in the region deep to the gluteus maximus muscle. The entrapment can occur from the piriformis muscle, fibrous bands, blood vessels, and hamstrings. Good clinical outcomes have been shown in patients treated by open and endoscopic means. Sciatic nerve decompression with or without piriformis release provides a surgical solution to a difficult diagnostic and therapeutic problem. Previous techniques have used open methods that can now performed endoscopically. The technique of an endoscopic approach to sciatic nerve decompression in the prone position is described as well as its advantages and common findings. Through this ischial-based approach, a familiar anatomy is seen and areas of sciatic nerve entrapment can be readily identified and safely decompressed.

  17. The nerves around the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Blum, Alain, E-mail: alain.blum@gmail.com [Service d’Imagerie GUILLOZ, CHU Nancy, Nancy 54000 (France); Lecocq, Sophie; Louis, Matthias; Wassel, Johnny; Moisei, Andreea; Teixeira, Pedro [Service d’Imagerie GUILLOZ, CHU Nancy, Nancy 54000 (France)

    2013-01-15

    Neuropathies of the shoulder are considered to be entrapment syndromes. They are relatively common, accounting for about 2% of cases of sport-related shoulder pain. Many instances involve suprascapular neuropathy, but the clinical diagnosis is often delayed because of nonspecific symptoms. Classically, EMG is the gold standard investigation but MRI currently reveals muscular abnormality in 50% of cases. Muscle edema, the most characteristic symptom, is nonspecific. In general, the topography of edema, the presence of a lesion compressing the nerve and clinical history contribute to the diagnosis. Although atrophy and fatty degeneration may persist after the disappearance of edema, they are rarely symptomatic. The main differential diagnosis is Parsonage–Turner syndrome. Evidence of a cyst pressing on a nerve may prompt puncture-infiltration guided by ultrasonography or CT-scan.

  18. Ulnar nerve paralysis after forearm bone fracture.

    Science.gov (United States)

    Schwartsmann, Carlos Roberto; Ruschel, Paulo Henrique; Huyer, Rodrigo Guimarães

    2016-01-01

    Paralysis or nerve injury associated with fractures of forearm bones fracture is rare and is more common in exposed fractures with large soft-tissue injuries. Ulnar nerve paralysis is a rare condition associated with closed fractures of the forearm. In most cases, the cause of paralysis is nerve contusion, which evolves with neuropraxia. However, nerve lacerations and entrapment at the fracture site always need to be borne in mind. This becomes more important when neuropraxia appears or worsens after reduction of a closed fracture of the forearm has been completed. The importance of diagnosing this injury and differentiating its features lies in the fact that, depending on the type of lesion, different types of management will be chosen.

  19. Ulnar nerve paralysis after forearm bone fracture

    Directory of Open Access Journals (Sweden)

    Carlos Roberto Schwartsmann

    2016-08-01

    Full Text Available ABSTRACT Paralysis or nerve injury associated with fractures of forearm bones fracture is rare and is more common in exposed fractures with large soft-tissue injuries. Ulnar nerve paralysis is a rare condition associated with closed fractures of the forearm. In most cases, the cause of paralysis is nerve contusion, which evolves with neuropraxia. However, nerve lacerations and entrapment at the fracture site always need to be borne in mind. This becomes more important when neuropraxia appears or worsens after reduction of a closed fracture of the forearm has been completed. The importance of diagnosing this injury and differentiating its features lies in the fact that, depending on the type of lesion, different types of management will be chosen.

  20. Missed ulnar nerve injury and closed forearm fracture in a child

    Institute of Scientific and Technical Information of China (English)

    Batra Amit; Devgan Ashish; Verma Vinit; Singh Raj; Batra Shivani; Magu Narender; Singla Rohit

    2013-01-01

    Ulnar nerve injury in closed fracture of forearm in children is uncommon.Commonly,neurapraxia is the reason for this palsy but other severe injuries or nerve entrapment has been reported in some cases.The importance of diagnosis concerning the types of the nerve injury lies in the fact that they have totally different management.We present a case of ulnar nerve deficit in a child following a closed fracture of the forearm bones.It is imperative to diagnose exact cause of palsy as it forms the basis for treatment.MRI scan can help diagnosis and accordingly guide the management.Simple nerve contusion should be treated conservatively,and exploration with fixation of the fracture should be done in lacerations and entrapments of the nerve.Surgery is not the treatment of choice in cases that could be managed conservatively.

  1. A new diagnostic approach to popliteal artery entrapment syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Charles; Kennedy, Dominic; Bastian-Jordan, Matthew; Hislop, Matthew; Cramp, Brendan; Dhupelia, Sanjay [Queensland X-Ray, Sunnybank, Queensland, 4109 (Australia)

    2015-09-15

    A new method of diagnosing and defining functional popliteal artery entrapment syndrome is described. By combining ultrasonography and magnetic resonance imaging techniques with dynamic plantarflexion of the ankle against resistance, functional entrapment can be demonstrated and the location of the arterial occlusion identified. This combination of imaging modalities will also define muscular anatomy for guiding intervention such as surgery or Botox injection.

  2. Factors Affecting Entrapment in Escalating Conflicts: The Importance of Timing.

    Science.gov (United States)

    Brockner, Joel; And Others

    1982-01-01

    Conducted two studies to test the notion that various factors, i.e., situation-personal, may differentially affect degrees of entrapment (amount invested) depending upon the point in time at which they are introduced. The results of both studies suggest amount invested depends upon timing in the entrapment process. (RC)

  3. Properties of gel-entrapped glucoamylase

    Energy Technology Data Exchange (ETDEWEB)

    Krauze, J.; Wawrzyniak, B.

    1988-08-01

    Glucoamylase from Aspergillus niger was immobilized by entrapping in glutaraldehyde crosslinked gelatin. Preparations were prepared in the form of beads and thin layers on activated glass, polyester and aluminium foils. Immobilization did not cause changes of pH and temperature optimum. However, it increased thermal stability additionally stabilized by the presence of a substrate. The most stable preparations acted without change in activity for 34 days at a temperature of 50/sup 0/C. Obtained preparations hydrolyzed ..cap alpha..-amylase liquefied starch to a DE value of about 97%. The preparations of glucoamylase immobilized in a thin layer of gelatin on the polyester and aluminium foil were used in a thin layer-flow reactor for hydrolysis of 10% starch solution.

  4. Sosiaalisen median strategia : Case Yritys X

    OpenAIRE

    Tuomola, Miikka

    2015-01-01

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

  5. Advanced median method for timing jitter compensation

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  6. Evaluation of left renal vein entrapment using multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Poyraz, Ahmet K.; Onur, Mehmet R. [Dept. of Radiology, Firat Univ. School of Medicine, Elazig (Turkey)], e-mail: akursadpoyraz@yahoo.com.tr; Firdolas, Fatih [Dept. of Urology, Firat Univ. School of Medicine, Elazig (Turkey); Kocakoc, Ercan [Dept. of Radiology, Bezmialem Vakif Univ., School of Medicine, Istanbul (Turkey)

    2013-03-15

    Background: Nutcracker syndrome, also called left renal vein entrapment syndrome, is a cause of non-glomerular hematuria with difficulties in diagnosis. Multidetector computed tomography (MDCT) is a powerful tool to prevent unnecessary diagnostic procedures. Purpose: To retrospectively determine the prevalence of nutcracker phenomenon and nutcracker syndrome seen in MDCT in consecutive patients. Material and Methods: The institutional review board approved the study and waived the requirement for informed consent. Abdominal contrast-enhanced MDCT scans were reviewed from 1000 consecutive patients. MDCT scan assessment included renal vein diameter measurements and evaluation for the presence of anterior or posterior left renal vein entrapment. Electronic medical records and urine analysis reports of patients with left renal vein entrapment were reviewed. Student's t test was used to assess differences in renal vein diameter in patients with left renal vein entrapment. Results: Left renal vein entrapment was observed in 10.9% (109), retroaortic left renal vein in 6.5% (65), entrapment of left renal vein between superior mesenteric artery and aorta in 4.1% (41), and circumaortic left renal vein in 0.3% (3) of patients. Mean diameters of right (8.8 {+-} 1.9 mm) and unentrapped left (8.9 {+-} 1.8 mm) renal veins were not significantly different (P = 0.1). The mean diameter of anterior entrapped left renal veins (10.3 {+-} 2 mm) was significantly greater (P = 0.04) than contralateral renal veins (8.6 {+-} 2.1 mm) in their widest portion. In 8.8% of patients with the left renal vein entrapment, urine analysis showed isomorphic hematuria or proteinuria with no other known cause. Varicocele and pelvic congestion were seen in 5.5% of patients with the left renal vein entrapment. Conclusion: Left renal vein entrapment is not a rare entity and renal nutcracker phenomenon might be underdiagnosed.

  7. Comparative neuro tissue engineering using different nerve guide implants.

    Science.gov (United States)

    Sinis, N; Schaller, H E; Schulte-Eversum, C; Lanaras, T; Schlosshauer, B; Doser, M; Dietz, K; Rösner, H; Müller, H W; Haerle, M

    2007-01-01

    At the moment autologous nerve grafting remains the only reasonable technique for reconstruction of peripheral nerve defects. Unfortunately, this technique has a lot of complications and disadvantages. These problems are related to the autologous nerve that is harvested for this procedure. Donor site morbidity with loss of sensitivity, painful neuroma formation and of course the restricted availability of autologous nerves stimulates the idea for alternative techniques on that field. In this paper we describe our experience with different graft materials for reconstruction of a 2 cm nerve gap in a median nerve model in rats. After implantation of various materials (biological/synthetic) the main experiments were conducted with a synthetic, biodegradable nerve conduit seeded with autologous Schwann cells. With this material we were able to reconstruct successfully a 2 cm gap in the rat median nerve. Regeneration with this material was found to be equally to an autologous nerve graft.

  8. Adaptive Marginal Median Filter for Colour Images

    Directory of Open Access Journals (Sweden)

    Almanzor Sapena

    2011-03-01

    Full Text Available This paper describes a new filter for impulse noise reduction in colour images which is aimed at improving the noise reduction capability of the classical vector median filter. The filter is inspired by the application of a vector marginal median filtering process over a selected group of pixels in each filtering window. This selection, which is based on the vector median, along with the application of the marginal median operation constitutes an adaptive process that leads to a more robust filter design. Also, the proposed method is able to process colour images without introducing colour artifacts. Experimental results show that the images filtered with the proposed method contain less noisy pixels than those obtained through the vector median filter.

  9. Imaging of the nerves of the knee region

    Energy Technology Data Exchange (ETDEWEB)

    Damarey, B., E-mail: benjdam@hotmail.com [Service de Radiologie et d’Imagerie musculosquelettique, CCIAL, Hôpital Roger Salengro, CHRU de Lille, Rue Emile Laine, 59037 Lille Cedex (France); Laboratoire d’anatomie, Faculté de médecine, CHRU de Lille, 1 Place de Verdun, 59045 Lille Cedex (France); Demondion, X. [Service de Radiologie et d’Imagerie musculosquelettique, CCIAL, Hôpital Roger Salengro, CHRU de Lille, Rue Emile Laine, 59037 Lille Cedex (France); Laboratoire d’anatomie, Faculté de médecine, CHRU de Lille, 1 Place de Verdun, 59045 Lille Cedex (France); Wavreille, G. [Laboratoire d’anatomie, Faculté de médecine, CHRU de Lille, 1 Place de Verdun, 59045 Lille Cedex (France); Service d’orthopédie, Hôpital Roger Salengro, CHRU de Lille, Rue Emile Laine, 59037 Lille Cedex (France); Pansini, V.; Balbi, V.; Cotten, A. [Service de Radiologie et d’Imagerie musculosquelettique, CCIAL, Hôpital Roger Salengro, CHRU de Lille, Rue Emile Laine, 59037 Lille Cedex (France)

    2013-01-15

    Peripheral neuropathies are a frequent, but often underdiagnosed, cause of pain and functional impairment. The clinical symptoms can be subtle, and other neurologic or non neurologic clinical entities are often evoked. MRI and ultrasonography are the imaging modalities of choice for depicting nerves and assessing neuropathies. Common neuropathies in the knee area involve the saphenous, the tibial, the common peroneal and the sural nerves. The most frequent mechanisms of nerve injury in this area are nerve entrapment and nerve stretching. A perfect knowledge of the normal imaging anatomy is essential for accurate assessment of neuropathies. In this article, we will review the anatomy of the nerves around the knee, and their normal and pathological appearance.

  10. On the use of upper extremity proximal nerve action potentials in the localization of focal nerve lesions producing axonotmesis.

    Science.gov (United States)

    White, J C

    1997-09-01

    Ulnar, median, and radial proximal nerve action potentials (PNAPs) were recorded from the axilla and supraclavicularly, with stimulation of the nerves at the elbow or the radial groove, in 30 control subjects for each nerve. In addition to routine nerve conduction studies, wrist to elbow median nerve action potentials were recorded proximal to the lesion in 76 patients with carpal tunnel syndrome of varying degrees of severity to determine the effect that the distal lesion might have on more proximal nerve conduction. Utilizing this information, PNAPs, standard nerve conduction studies, and needle electrode examinations were carried out in patients with focal elbow area nerve or brachial plexus lesions producing axonotmesis. PNAPs confirmed the site of the lesions producing axonotmesis when localization was possible with standard nerve conduction and/or needle electrode studies and were the sole means by which localization of the lesions producing only sensory axonotmesis was accomplished.

  11. Nerve Ultrasound in Peripheral Neuropathies: A Review.

    Science.gov (United States)

    Kerasnoudis, Antonios; Tsivgoulis, Georgios

    2015-01-01

    Peripheral neuropathies are one of the most common reasons for seeking neurological care in everyday practice. Electrophysiological studies remain fundamental for the diagnosis and etiological classification of peripheral nerve impairment. The recent technological development though of high resolution ultrasound has allowed the clinician to obtain detailed structural images of peripheral nerves. Nerve ultrasound mainly focuses on the evaluation of the cross sectional area, cross sectional area variability along the anatomical course, echogenity, vascularity and mobility of the peripheral nerves. An increase of the cross sectional area, hypervascularity, disturbed fascicular echostructure and reduced nerve mobility are some of the most common findings of entrapments neuropathies, such as the carpal or cubital tunnel syndrome. Both the cross-sectional area increase and the hypervascularity detected with the Doppler technique seem to correlate significantly with the clinical and electrophysiological severity of the later mononeuropathies. Significantly greater cross sectional area values of the clinically affected cervical nerve root are often detected in cases of cervical radiculopathy. In such cases, the ultrasound findings seem also to correlate significantly with disease duration. On the other hand, multifocal cross sectional area enlargement of cervical roots and/or peripheral nerves is often documented in cases of immune-mediated neuropathies. None of the later pathological ultrasound findings seem to correlate significantly with the electrophysiological parameters or the functional disability. The aim of this review is to provide a timely update on the role of neuromuscular ultrasound in the diagnostic of the most common entrapment and immune-mediated peripheral neuropathies in clinical practice. Copyright © 2015 by the American Society of Neuroimaging.

  12. 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.

  13. [Damage of teres minor branch of axillary nerve].

    Science.gov (United States)

    Kallio, Mika; Kovala, Tero; Niemelä, Erkki; Tolonen, Uolevi

    2010-01-01

    Atrophy demarcating to musculus teres minor is seen in magnetic resonance imaging of the shoulder region in 3 to 5.5% of investigations. We describe seven patients with prolonged or recurrent pain of the shoulder region, who were diagnosed in ENMG with damage of the axillary nerve brand to m. teres minor. Probable causes included tear of the rotator cuff, luxation of the shoulder joint, nerve entrapment in the quadrilateral space, neuritis of the brachial plexus and iatrogenic damage associated with shoulder arthroscopy. This nerve damage cannot be proved clinically.

  14. Effects of Thai Dancing on Median Neurodynamic Response During 4-Hour Computer Use.

    Science.gov (United States)

    Mekhora, Keerin; Septham, Chatdao; Jalayondeja, Wattana

    2015-06-01

    To investigate the effects of Thai dancing on median neurodynamic response during 4-hour computer use. Twenty-four healthy participants aged 20-30 years performed 5 minutes of Thai dancing including Prom See Na, Yoong Fon Hang, Sod Soy Mala, Lor Keaw and Cha Nee Rai Mai during a 10-minute break of 4-hour computer use. All participants were assessed for nerve tension by elbow range of motion ofupper limb neurodynamic test 1 (ULNT1) and components of quick test. The discomfort was measured by visual analogue discomfort scale (VADS). These measurements were assessed before and after computer work. The statistical analyses employed paired t-test for continuous outcome and Friedman's test. The median nerve tension (indicated by elbow range of motion) was significantly reduced at before and after work, when 5 minutes of Thai dancing was introduced during the break. While components of the quick test emphasized that Thai dance immediately helped reduce the median nerve tension. The VADS in eight body areas increased over the period of 4 hours, but decreased after performing Thai dancing (pdancing helped relieve median nerve tension and body discomfort. It may be recommended as an exercise during break for computer users who continuously work to prevent WMSDs.

  15. Prostaglandin E1 alleviates neuropathic pain and neural dysfunction from entrapment neuropathy associated with diabetes mellitus.

    Science.gov (United States)

    Natsume, Tadahiro; Iwatsuki, Katsuyuki; Nishizuka, Takanobu; Arai, Tetsuya; Yamamoto, Michiro; Hirata, Hitoshi

    2014-10-01

    In this report, we present the results of investigation of the effects of prostaglandin E1 (PGE1) on entrapment neuropathy using a diabetic rat. A total of 60 male Sprague-Dawley rats were used in the study. The model of tibial nerve entrapment neuropathy associated with diabetes mellitus was created by streptozotocin-induced diabetic rats reared in cages with wire grid flooring. Rats were assigned to four groups: nondiabetic (n = 15), untreated diabetic (n = 15), diabetic treated with 30 μg/kg PGE1 (n = 15), and diabetic treated with 100 μg/kg PGE1 (n = 15). Pain tests and electrophysiological tests were performed at 0, 2, and 4 weeks, and assessments of gait, histology, and mRNA expression levels were performed at 4 weeks after initiating the PGE1 administration. In the 30 and 100 μg groups, the mechanical withdrawal thresholds measured by pain tests at 4 weeks (36.2 ± 16.4 g and 31.7 ± 15.3 g, respectively) and the motor conduction velocity (24.0 ± 0.2 m/s and 24.4 ± 0.3 m/s, respectively) were significantly higher than the untreated diabetic group (all P < 0.05) and lower than the nondiabetic group (all P < 0.001). In the gait analysis, the mean intensities in the 30 and 100 μg group (128.0 ± 20.1 a.u. and 109.0 ± 27.8 a.u., respectively) were significantly higher than the untreated diabetic (P < 0.01) and were not significantly different from the nondiabetic group (P = 0.81). Fiber density (P = 0.46) and fiber diameter (P = 0.15) did not show any significant differences. PGE1 significantly decreased nerve growth factor (NGF) mRNA and increased vascular endothelial growth factor (VEGF) mRNA in the tibial nerve (both P < 0.01). In conclusion, neurological deteriorations of diabetic rats were alleviated with PGE1, which is associated with inhibition of NGF and enhancement of VEGF at the entrapment site.

  16. Drop impact splashing and air entrapment

    KAUST Repository

    Thoraval, Marie-Jean

    2013-03-01

    Drop impact is a canonical problem in fluid mechanics, with numerous applications in industrial as well as natural phenomena. The extremely simple initial configuration of the experiment can produce a very large variety of fast and complex dynamics. Scientific progress was made in parallel with major improvements in imaging and computational technologies. Most recently, high-speed imaging video cameras have opened the exploration of new phenomena occurring at the micro-second scale, and parallel computing allowed realistic direct numerical simulations of drop impacts. We combine these tools to bring a new understanding of two fundamental aspects of drop impacts: splashing and air entrapment. The early dynamics of a drop impacting on a liquid pool at high velocity produces an ejecta sheet, emerging horizontally in the neck between the drop and the pool. We show how the interaction of this thin liquid sheet with the air, the drop or the pool, can produce micro-droplets and bubble rings. Then we detail how the breakup of the air film stretched between the drop and the pool for lower impact velocities can produce a myriad of micro-bubbles.

  17. Preparation of vesicles entrapped lycopene extract.

    Science.gov (United States)

    Luxsuwong, Dhitaree; Indranupakorn, Ratana; Wongtrakul, Paveena

    2014-01-01

    Lycopene, a lipophilic carotenoid, has been known as an effective antioxidant in supporting the cutaneous defensive system. However, it is unstable when exposed to light and water. In this study, lycopene was isolated from tomatoes and a vesicular delivery system was developed to entrap and stabilize the lycopene in the aqueous system. A simple process, maceration in ethyl acetate, was used to extract lycopene from the tomatoes. The extract was then chromatographed on the Sephadex LH20 column using acetone as a solvent system to yield 995 μg of lycopene per gram of dried tomato weight. The vesicular delivery system was prepared from a combination of ascorbic acid-6-palmitate (AP), cholesterol and dicetyl phosphate using a thin film hydration method. The formulation was composed of AP, cholesterol and dicetyl phosphate at a 44:44:12 molar ratio and with 2.12 μmol/ml of the isolated lycopene. Both blank vesicles and lycopene loaded vesicles were kept for a period of 3 months at 4±2°C and at the room temperature (28±2°C) to evaluate the effect of the encapsulation on the characteristic of the vesicles and on the antioxidant activity of the encapsulated lycopene. The result implied that lycopene could be stabilized in the vesicles and its scavenging activity against DPPH free radicals was superior to that of the free lycopene solution.

  18. Allegheny County Median Age at Death

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The median age at death is calculated for each municipality in Allegheny County. Data is based on the decedent's residence at the time of death, not the location...

  19. Peripheral nerve involvement in Bell's palsy

    Directory of Open Access Journals (Sweden)

    J. A. Bueri

    1984-12-01

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

  20. PERSISTENT MEDIAN ARTERY ASSOCIATED WITH SUPERFICIA L RADIAL ARTERY AT THE WRIST- A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Jayasabarinathan

    2013-02-01

    Full Text Available ABSTRACT: Vascular variations are usually the result of deve lopmental anomaly during the formation of blood vessels in any respective part of the body. In this case a rare unilateral variation was found on the left upper limb during rou tine dissection in the Department of Anatomy. Brachial artery divided into radial artery and a common trunk. The common trunk in turn divided into ulnar, median and common inteross eous artery. The median artery was palmar type, had two proper palmar digital branches in t he palm. The radial artery had normal course in the forearm till the junction between upper two third and lower one third where it turned dorsally and reached the anatomical snuff bo x and ran superficial to the abductor pollicis longus, extensor carpi radialis brevis and extensor carpi radialis longus along the cephalic vein medially and superficial branch of radial nerve late rally. The median artery, arose from the common trunk, had pierced the median nerve about 4cm from its origin then ran along the median nerve in the forearm thereby reached the palm where it gave off two common palmar digital branches but did not anastomose with the ul nar artery hence formed incomplete superficial palmar arch. But on the right side no suc h variations found. These vascular variations have been studied in detail and their cl inical implications and embryological significance are emphasized.

  1. Selective measurement of digital nerve conduction velocity.

    Science.gov (United States)

    Terai, Y; Senda, M; Hashizume, H; Nagashima, H; Inoue, H

    2001-01-01

    We developed a new method to measure the nerve conduction velocity of a single digital nerve. In 27 volunteers (27 hands), we separately stimulated each digital nerve on the radial and ulnar sides of the middle and ring fingers. A double-peaked potential was recorded above the median nerve at the wrist joint when either the radial-side nerve or the ulnar-side nerve of the middle finger was stimulated. The first peak of this potential had disappeared after the digital nerve was blocked under the stimulating electrodes, and the peak appeared again coinciding with the decrease of anesthesia. Shifting the stimulating electrodes on the digital nerve resulted in no significant difference in the peak conduction velocity. It is possible that each peak of the potential was attributable to conduction of an action potential along one of the two digital nerves. This new method allows the assessment of a single digital nerve, and may be clinically useful for assessing the rupture of a digital nerve and the sensory nerve action potentials in carpal tunnel syndrome.

  2. Adaptation of median partial sternotomy in head and neck surgery.

    Science.gov (United States)

    Shpitzer, Thomas; Saute, Milton; Gilat, Hanna; Raveh, Eyal; Koren, Ilan; Shvero, Jacob; Bahar, Gideon; Feinmesser, Raphael

    2007-12-01

    Upper mediastinum involvement in diseases of the head and neck may require a sternal split. This study describes our adaptation of the upper median or "minimal" sternotomy technique for the treatment of head and neck pathologies. Between April 2002 and October 2005, 17 patients aged 4 to 82 years underwent minimal sternotomy in our institution for a variety of head and neck pathologies. The 17 patients included 11 adults with metastatic thyroid disease (six metastatic papillary thyroid carcinoma, two medullary carcinoma, and one Hiirthle cell carcinoma) and huge retrosternal goiter (n = 2), four adults with parathyroid disease (two primary parathyroid adenoma, one secondary hyperplasia, and one parathyroid carcinoma), and two children with lymphangioma and huge thymic cyst (one each). Average hospitalization was 8 days. Four patients needed a thoracic drain for 2 days, one had recurrent laryngeal nerve palsy, and one had phrenic nerve paresis. There were no postoperative deaths. Minimal sternotomy appears to be an excellent alternative for surgical exploration of the mediastinum and may be used in head and neck surgery for a range of indications.

  3. Nerve transfer helps repair brachial plexus injury by increasing cerebral cortical plasticity

    Institute of Scientific and Technical Information of China (English)

    Guixin Sun; Zuopei Wu; Xinhong Wang; Xiaoxiao Tan; Yudong Gu

    2014-01-01

    In the treatment of brachial plexus injury, nerves that are functionally less important are trans-ferred onto the distal ends of damaged crucial nerves to help recover neuromuscular function in the target region. For example, intercostal nerves are transferred onto axillary nerves, and accessory nerves are transferred onto suprascapular nerves, the phrenic nerve is transferred onto the musculocutaneous nerves, and the contralateral C7 nerve is transferred onto the median or radial nerves. Nerve transfer has become a major method for reconstructing the brachial plexus after avulsion injury. Many experiments have shown that nerve transfers for treatment of brachi-al plexus injury can help reconstruct cerebral cortical function and increase cortical plasticity. In this review article, we summarize the recent progress in the use of diverse nerve transfer methods for the repair of brachial plexus injury, and we discuss the impact of nerve transfer on cerebral cortical plasticity after brachial plexus injury.

  4. Hydrodynamical entrapment of ciliates at the air-liquid interface

    Science.gov (United States)

    Ferracci, Jonathan; Ueno, Hironori; Numayama-Tsuruta, Keiko; Imai, Yohsuke; Yamaguchi, Takami; Ishikawa, Takuji

    2012-11-01

    We found the new phenomenon of the entrapment of ciliates at the air-water interface, though they are not trapped by a solid interface. We first characterize the behaviours of cells at the interface by comparing it to those away from interfaces. The results showed that the cell's swimming velocity is considerably reduced at the air-water interface. In order to experimentally verify the possible physiological causes of the entrapment, we observed their behaviours in absence of positive chemotaxis for oxygen and the negative geotaxis. The results illustrated that the entrapment phenomenon was not dependent on these physiological conditions. The experiments using surfactant revealed that the entrapment phenomenon was strongly affected by the velocity-stress conditions at the interface. This fact was confirmed numerically by a boundary element method, i.e. the stress-free condition at the air-liquid interface is one of the main mechanisms of the entrapment phenomenon found in the experiments. Since the entrapment phenomenon found in this study affects the cell-cell interactions and the mass transport at the interface, the knowledge obtained in this study is useful for better understanding the complex behaviours of swimming microorganisms in nature. PhD student in the Physiological Flow Studies Laboratory.

  5. Iatrogenic Ulnar Nerve Injury post Laceration Suturing – An Unusual Presentation

    Directory of Open Access Journals (Sweden)

    Murali Mothilal

    2013-07-01

    Full Text Available Introduction: Nerve entrapment while suturing a lacerated wound is a complication that is easily avoidable. We report a case low ulnar nerve palsy due to nerve entrapment while suturing a lacerated wound. Case Report: A 48 year old lady came with complaints of pain and a lacerated wound over the dorsomedial aspect of lower third of the left forearm. The lacerated wound was sutured elsewhere one week back. She had fracture of lower third of the ulna which was stabilised with plates and screws using a separate dorsal incision. She developed ulnar claw hand on the third postoperative day. Strength duration curve revealed neurotmesis of ulnar nerve. Ulnar nerve exploration was done and the nerve was found to be ligated at the site of original laceration. The ligature was released and nerve was found to be thinned out at the site. There was no neurological recovery at 5 months follow up and reconstruction procedures in form of tendon tranfer are planned for the patient. Conclusion: This is a case of iatrogenic ulnar nerve palsy which is very rare in our literature. This can be easily avoided if proper care is taken while suturing the primary laceration. A nerve can be mistakenly sutured for a bleeding vein and proper exposure while suturing will be necessary especially at areas where nerves are superficial. Keywords: Iatrogenic, ulnar nerve palsy

  6. [Inter-examiner reliability of nerve conduction measurements].

    Science.gov (United States)

    Hasegawa, O; Mimura, E; Kirigaya, N; Wada, N; Tsumura, M; Iino, M; Matsumoto, S

    1999-12-01

    A total of 122 patients were performed motor and sensory nerve conduction studies of the upper limb by two examiners (1. doctor, 2. medical technician) to know the inter-examiner reliability of nerve conduction measurements. Subjects contained normal individuals and various types of neuropathy patients. Motor nerve conduction studies were carried out in the median nerve, and antidromic sensory nerve conduction studies were performed in the median and ulnar nerves. F-wave latency of the median nerve and sensory conduction velocity between finger and wrist of the median and ulnar nerves presented the equal mean value between two examiners. A relatively good correlation between two examiners was pointed out in the distal motor latency and F-wave latency. Inappropriate measurements were caused by the differences in the site of placement of stimulating or recording electrodes and effects of submaximum stimuli or stimulus spread to other nerves. In sensory nerve conduction studies, especially in the ulnar nerve, careful attention should be paid to avoid the influence of motor artifact in giving supramaximum stimuli. Amplitude measurements showed larger inter-examiner difference than latency or velocity measurements. We reported the present condition of measurement reliability. We should do our best to minimize the error.

  7. Rare anatomical variation of the musculocutaneous nerve - case report

    Directory of Open Access Journals (Sweden)

    Sergio Ricardo Rios Nascimento

    2016-06-01

    Full Text Available ABSTRACT The clinical and surgical importance of anatomical knowledge of the musculocutaneous nerve and its variations is due to the fact that one of the complications in many upper-limb surgical procedures involves injury to this nerve. During routine dissection of the right upper limb of a male cadaver, we observed an anatomical variation of this nerve. The musculocutaneous nerve originated in the lateral cord and continued laterally, passing under the coracobrachialis muscle and then continuing until its first branch to the biceps brachialis muscle. Just after this, it supplied another two branches, i.e. the lateral cutaneous nerve of the forearm and a branch to the brachialis muscle, and then it joined the median nerve. The median nerve followed the arm medially to the region of the cubital fossa and then gave rise to the anterior intermediate nerve of the forearm. The union between the musculocutaneous nerve and the median nerve occurred approximately at the midpoint of the arm and the median nerve. Given that either our example is not covered by the classifications found in the literature or that it fits into more than one variation proposed, without us finding something truly similar, we consider this variation to be rare.

  8. Median nail dystrophy involving the thumb nail

    Directory of Open Access Journals (Sweden)

    Rahulkrishna Kota

    2016-01-01

    Full Text Available Median canaliform dystrophy of Heller is a rare entity characterized by a midline or a paramedian ridge or split and canal formation in nail plate of one or both the thumb nails. It is an acquired condition resulting from a temporary defect in the matrix that interferes with nail formation. Habitual picking of the nail base may be responsible for some cases. Histopathology classically shows parakeratosis, accumulation of melanin within and between the nail bed keratinocytes. Treatment of median nail dystrophy includes injectable triamcinalone acetonide, topical 0.1% tacrolimus, and tazarotene 0.05%, which is many a times challenging for a dermatologist. Psychiatric opinion should be taken when associated with the depressive, obsessive-compulsive, or impulse-control disorder. We report a case of 19-year-old male diagnosed as median nail dystrophy.

  9. Sosiaalisen median toimintasuunnitelma, case Guild Travel Ltd

    OpenAIRE

    Vanhanen, Anni

    2014-01-01

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

  10. Sosiaalisen median merkitys asiakkaan ravintolan valinnalle

    OpenAIRE

    Virtanen, Tessa

    2014-01-01

    Tässä opinnäytetyössä tutkittiin sosiaalisen median merkitystä asiakkaan ravintolan valintaan. Opinnäytetyön toimeksiantajana oli HOK-Elanto. Opinnäytetyön tarkoituksena oli tuottaa tietoa ja ymmärrystä HOK-Elannolle sosiaalisen median vaikutuksesta asiakkaan ravintolapäätöksen tekoon HOK-Elannon ravintoloissa Opinnäytetyön tavoitteena oli selvittää, millainen ja kuinka suuri merkitys on sosiaalisella medialla ja sen erilaisilla yhteisöillä asiakkaan ostopäätökseen eli käyntiin HOK-Elanno...

  11. UNILATERAL HIGH DIVISION OF SCIATIC NERVE AND ITS RELATION TO BIFID PIRIFORMIS

    Directory of Open Access Journals (Sweden)

    Rashmi C. Goshi

    2015-03-01

    Full Text Available Background: The sciatic Nerve can rarely be separated into tibial and common fibular Nerve within the Pelvis. In such cases the tibial nerve and common fibular nerve leave the pelvis through different routes. Materials and Method: The variation found during routine dissection for MBBS students in a 30 yr old male cadaver in the department of Anatomy, JJM Medical college Davangere, Karnataka, India. Result: The variation is High division of sciatic Nerve unilaterally on right side in 30yrs old male cadaver. Common peroneal Nerve is found passing between the two divisions of bifid piriformis while tibial Nerve passed below the inferior piriformis Conclusion: Knowledge of this variation is important clinically in sciatic nerve entrapment resulting in non-discogenic sciatica and also requires reviewing of the piriformis syndrome

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-03-15

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

  13. Epidural catheter fragment entrapment: a case report

    Directory of Open Access Journals (Sweden)

    Mohammadi M

    2010-07-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Epidural catheters are seldom difficult to remove from patients. The breakage of the catheters is uncommon, troublesome and occasionally dangerous. "n"nCase presentation: A lumbar epidural catheter inserted in a 17 year-old man for applying anesthesia for internal fixation of femur fracture and subsequent postoperative epidural analgesia. In the third postoperative day, during unsuccessful attempt for removing the catheter, it was broken and was retained in his back. A CT- scan was performed and shows a fragment of catheter in the sub- laminar ligament between L3 and L4 without any connection with epidural space. As the patient had no complaint the fractured fragment was left in site and he was just followed up in the clinic."n"nConclusion: The knowledge of practical method in locating the retained epidural catheter, and the indication for surgical removal are very important. CT- scan is useful in showing the mechanism and locating the epidural catheter entrapment and facilitating surgical follow-up.

  14. Migration and entrapment of mercury in porous media

    Science.gov (United States)

    Devasena, M.; Nambi, Indumathi M.

    2010-09-01

    Elemental mercury is an immiscible liquid with high density and high interfacial tension with water. Its movement in the saturated subsurface region is therefore considered as a case of two phase flow involving mercury and water and is expected to be governed by gravity, viscous, hydrodynamic and capillary forces. This paper investigates the migration and capillary entrapment of mercury in the subsurface based on controlled laboratory capillary pressure-saturation experiments. In the first place, entrapment of mercury was observed in homogeneous porous media. Residual mercury saturation and van Genuchten's parameters for mercury entrapment were generated. These data will provide vital inputs for mercury migration and entrapment models. Secondly, the dependency of residual saturation on fluid properties was brought out in this work by comparing the experimental results of mercury-water system and DNAPL-water systems. Capillary forces were large enough in mercury-water systems to counteract the high gravity forces and caused the entrapment of mercury. Large density differences between mercury and water lead to a high Bond number and thus a low residual mercury saturation was obtained which corroborates with existing DNAPL theories. However, the inverse relationship between residual saturation and capillary number established for NAPL-water systems cannot be compared with mercury-water systems. Moreover, the critical capillary numbers and Bond numbers to mobilize DNAPLs may not be applicable to mercury since mercury has a low capillary number and high Bond number. This work has enabled the understanding of the process of migration and entrapment of mercury and provided useful inputs for two phase flow models specific to mercury-water systems. It has also highlighted the influence of fluid properties on entrapment and mobilization particularly for highly dense, viscous fluid which also possesses high interfacial tension with water.

  15. Radial plus musculocutaneous nerve stimulation for axillary block is inferior to triple nerve stimulation with 2% mepivacaine.

    Science.gov (United States)

    Rodríguez, Jaime; Taboada, Manuel; Oliveira, Juan; Ulloa, Beatriz; Bascuas, Begoña; Alvarez, Julián

    2008-06-01

    To compare the extent of sensory and motor block with two different nerve stimulation techniques in axillary blocks. Prospective, randomized, investigator-blinded study. Ambulatory surgery unit of a university hospital. 60 ASA physical status I, II, and III patients undergoing surgery at or below the elbow. Patients receiving axillary block were randomized into two nerve stimulation groups with either radial plus musculocutaneous or triple nerve stimulation (radial, median, and musculocutaneous nerves). Thirty milliliters of plain 2% mepivacaine was given to all patients either in a single or fractionated dosing for radial or for radial and median nerves, according to group assignment. Five milliliters of plain 1% mepivacaine for the musculocutaneous nerve was given to all patients. Blocks were assessed at 10, 20, and 30 minutes. Rates of supplementation given as a result of insufficient surgical anesthesia were also noted. Statistically significantly higher rates of anesthesia at the cutaneous distributions of median and medial cutaneous of the arm nerves with multiple nerve stimulation at 30 minutes were found as compared with radial plus musculocutaneous nerve stimulation. The rate of supplementation was lower with multiple nerve stimulation. Radial plus musculocutaneous nerve stimulation showed lower efficacy of axillary block than did triple nerve stimulation when using 2% mepivacaine.

  16. Median Citation Index vs Journal Impact Factor

    Science.gov (United States)

    Antonoyiannakis, Manolis

    2015-03-01

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

  17. Median sternotomy closure: review and update research

    Institute of Scientific and Technical Information of China (English)

    Hua Kun; Yang Xiubin

    2009-01-01

    Cardiac surgery is a very common operation nowadays all over the world. Median stemotomy is a routine procedure required for cardiac access during open heart surgery. The complications of this procedure after the cardiac surgery range from 0.7% to 1.5% of all cases, and bear a high mortality rate if they occur. Every individual surgeon must pay great attention on every detail during the sternal closure. This article shows the details as to conventional information and updated progress on median sternotomy closure. The update contents involve in biomechanics, number of wires twists, biomaterial and so on.According to our experience, we recommend four peristernal single/double steel wires for sternal closure as our optimal choice.

  18. COLOUR IMAGE STEGANOGRAPHY USING MEDIAN MAINTENANCE

    Directory of Open Access Journals (Sweden)

    S. Arivazhagan

    2011-08-01

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

  19. Portfolio optimization using median-variance approach

    Science.gov (United States)

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

    2013-04-01

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

  20. Dendrimer-entrapped metal colloids as imaging agents.

    Science.gov (United States)

    Li, Du; Wen, Shihui; Shi, Xiangyang

    2015-01-01

    This review reports the recent advances in dendrimer-entrapped metal colloids as contrast agents for biomedical imaging applications. The versatile dendrimer scaffolds with 3-dimensional spherical shape, highly branched internal cavity, tunable surface conjugation chemistry, and excellent biocompatibility and nonimmunogenicity afford their uses as templates to create multifunctional dendrimer-entrapped metal colloids for mono- or multi- mode molecular imaging applications. In particular, multifunctional dendrimer-entrapped gold nanoparticles with different surface modifications have been used for fluorescence imaging, targeted tumor computed tomography (CT) imaging, enhanced blood pool CT imaging, dual mode CT/MR imaging, and tumor theranostics (combined CT imaging and chemotherapy) will be introduced and discussed in detail. © 2015 Wiley Periodicals, Inc.

  1. Ulnar nerve dysfunction

    Science.gov (United States)

    Neuropathy - ulnar nerve; Ulnar nerve palsy; Mononeuropathy; Cubital tunnel syndrome ... neuropathy occurs when there is damage to the ulnar nerve. This ... syndrome may result. When damage destroys the nerve covering ( ...

  2. Nerve biopsy (image)

    Science.gov (United States)

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

  3. Vagus Nerve Stimulation

    Science.gov (United States)

    Vagus nerve stimulation Overview By Mayo Clinic Staff Vagus nerve stimulation is a procedure that involves implantation of a device that stimulates the vagus nerve with electrical impulses. There's one vagus nerve on ...

  4. Changes in entrapped gas content and hydraulic conductivity with pressure.

    Science.gov (United States)

    Marinas, Maricris; Roy, James W; Smith, James E

    2013-01-01

    Water table fluctuations continuously introduce entrapped air bubbles into the otherwise saturated capillary fringe and groundwater zone, which reduces the effective (quasi-saturated) hydraulic conductivity, K(quasi), thus impacting groundwater flow, aquifer recharge and solute and contaminant transport. These entrapped gases will be susceptible to compression or expansion with changes in water pressure, as would be expected with water table (and barometric pressure) fluctuations. Here we undertake laboratory experiments using sand-packed columns to quantify the effect of water table changes of up to 250 cm on the entrapped gas content and the quasi-saturated hydraulic conductivity, and discuss our ability to account for these mechanisms in ground water models. Initial entrapped air contents ranged between 0.080 and 0.158, with a corresponding K(quasi) ranging between 2 and 6 times lower compared to the K(s) value. The application of 250 cm of water pressure caused an 18% to 26% reduction in the entrapped air content, resulting in an increase in K(quasi) by 1.16 to 1.57 times compared to its initial (0 cm water pressure) value. The change in entrapped air content measured at pressure step intervals of 50 cm, was essentially linear, and could be modeled according to the ideal gas law. Meanwhile, the changes in K(quasi) with compression-expansion of the bubbles because of pressure changes could be adequately captured with several current hydraulic conductivity models. © Ground Water 2012 and © Her Majesty the Queen in Right of Canada 2012. Ground Water © 2012, National Ground Water Association.

  5. Device entrapment: a rare complication of percutaneous coronary intervention.

    Science.gov (United States)

    Rehman, Abdul; Rehman, Abdur; Khan, Javaid Arif; Sial, Javaid A; Baloch, Zafar Haleem

    2011-10-01

    Device entrapment is a rare complication of percutaneous coronary intervention. It has hazardous potentials for the patient. Emergent cardiac surgery is the only option after failure of retrieval devices. We have described here a case of a 55 years old male. During percutaneous coronary intervention, the balloon inflated only partially at its ends and entrapped in the lesion along with the stent. Multiple attempts at inflation failed and the patient developed severe chest pain for few minutes. Surgery was contemplated but final attempt at inflation was successful and the patient stabilized. It was an emergent situation and could have led to fatal outcome, although this patient escaped narrowly from any fatal outcome.

  6. Intra-Aortic Balloon Pump Rupture and Entrapment

    Directory of Open Access Journals (Sweden)

    Artan Jahollari

    2014-01-01

    Full Text Available Intra-aortic balloon pump is used frequently to support a failing myocardium in cardiac patients. Due to the invasive nature of this device, usage is accompanied by consistent risk of complications. Balloon rupture, although it occurs rarely, may lead to entrapment if diagnosis delays. A 78-year male who underwent cardiac surgery experienced balloon rupture and entrapment in the right femoral artery during the postoperative follow-up. Surgical extraction under local anesthesia was performed and the patient had an uneventful course. Fast and gentle solution of the problem is necessary to prevent further morbidity or mortality related to a retained balloon catheter in these delicate patients.

  7. Propuesta de una vía de abordaje y técnica para el tratamiento de los síndromes de atrapamiento nervioso lumbar postcirugía (SANLPC, como alternativa a las técnicas de adhesiolisis o epidurolisis Proposal for a new approach and technique for the treatment of post-surgery lumbar nerve entrapment syndromes, as an alternative to adhesiolysis or epidu-ral lysis techniques

    Directory of Open Access Journals (Sweden)

    R. González-Durán

    2006-08-01

    -za una sección de entre 10 y 15 cm del catéter y se verifica su permeabilidad. Finalmente se colocaron los filtros bacterianos del catéter. Con el catéter colocado y tunelizado se siguieron pautas de tratamiento con diferentes fármacos que se inyectaron a través del catéter 2 días a la semana durante 5 semanas, o sea, se realizaron 10 administraciones de fármacos. Después de la inyección de las dosis se lavó el catéter con 1 mL de lidocaína 1% s/a y se realizaron curas diarias de la inserción del catéter. Resultados: Los resultados del uso de la técnica presentan como única complicación en dos de los casos la salida del catéter, a lo largo del tiempo del tratamiento, sin complicaciones en el acto de colocación. Refieren mejoría subjetiva de 50% o más de disminución del dolor 5 de los 8 pacientes. Conclusiones: En nuestra experiencia, utilizando la técnica de abordaje caudal descrita en la literatura, se presentan múltiples complicaciones y resultados muy limitados. Especialmente se han producido complicaciones graves, una de ellas consistió en una severa afectación de las raíces S2 y S3, con parálisis de esfínter vesical y detrusor, así como afectación de esfínter rectal con abolición de sensibilidad. También se presentaron casos de anestesia en silla de montar, en uno de ellos con una evolución prolongada. Adicionalmente, los resultados del tratamiento con epidurolisis caudal, cuando presenta mejoría, son limitados temporalmente a pocos meses de mejoría de la sintomatología dolorosa.Aim: To describe a supra scar approach and technique for epi-dural lysis of adhesions and/or repeated radicular blocks in pain syndromes due to posterior nerve entrapment caused by scar tissue after low back surgery, as an alternative to caudal epidural lysis of adhesions as described in literature. Considering that it may present fewers complications and better outcomes. Material and method: 8 patients presenting pain after lumbar spine surgery, as

  8. Ultrasound-guided Lateral Femoral Cutaneous Nerve Block in Meralgia Paresthetica.

    Science.gov (United States)

    Kim, Jeong Eun; Lee, Sang Gon; Kim, Eun Ju; Min, Byung Woo; Ban, Jong Suk; Lee, Ji Hyang

    2011-06-01

    Meralgia paresthetica is a rarely encountered sensory mononeuropathy characterized by paresthesia, pain or sensory impairment along the distribution of the lateral femoral cutaneous nerve (LFCN) caused by entrapment or compression of the nerve as it crossed the anterior superior iliac spine and runs beneath the inguinal ligament. There is great variability regarding the area where the nerve pierces the inguinal ligament, which makes it difficult to perform blind anesthetic blocks. Ultrasound has developed into a powerful tool for the visualization of peripheral nerves including very small nerves such as accessory and sural nerves. The LFCN can be located successfully, and local anesthetic solution distribution around the nerve can be observed with ultrasound guidance. Our successfully performed ultrasound-guided blockade of the LFCN in meralgia paresthetica suggests that this technique is a safe way to increase the success rate.

  9. Ultrasound-guided perineural injection for nerve blockade: Does a single-sided injection produce circumferential nerve coverage?

    Science.gov (United States)

    Nwawka, O Kenechi; Miller, Theodore T; Jawetz, Shari T; Saboeiro, Gregory R

    2016-10-01

    Our current clinical technique for sonographic-guided perineural injection consists of two-sided perineural needle placement to obtain circumferential distribution of the injectate. This study aimed to determine if a single-side needle position will produce circumferential nerve coverage. Fresh-frozen cadaveric specimens were used for this study. In six upper extremities, a needle was positioned along the deep surface of median, radial, and ulnar nerves in the carpal tunnel, radial tunnel, and cubital tunnel, respectively, and 2 ml of contrast was injected for each nerve. In three pelvic specimens, a needle was positioned deep to the sciatic nerves bilaterally, and 5 ml of contrast was injected. An additional four median nerve injections were performed using superficial surface needle position. The specimens then underwent CT scanning to assess the distribution of the perineural contrast medium. One hundred percent of the radial, ulnar, and sciatic nerves demonstrated circumferential distribution on CT. Only 50% of the median nerve injections with the needle placed deep to the nerve produced circumferential coverage, whereas 100% of median nerves injected with the needle between the nerve and retinaculum demonstrated circumferential coverage. The average length of spread of perineural injectate was 11.6 cm in the upper extremity and 10.3 cm for the sciatic nerves. Using clinical volumes of fluid, needle positioning at the deep surface of upper extremity and sciatic nerves was sufficient to produce circumferential coating of the nerve, except in the carpal tunnel, where placement of the needle between the nerve and flexor retinaculum is recommended. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:465-469, 2016. © 2016 Wiley Periodicals, Inc.

  10. Nerve injuries about the elbow.

    Science.gov (United States)

    Hariri, Sanaz; McAdams, Timothy R

    2010-10-01

    The ulnar, radial, median, medial antebrachial cutaneous, and lateral antebrachial cutaneous nerves are subject to traction and compression in athletes who place forceful, repetitive stresses across their elbow joint. Throwing athletes are at greatest risk, and cubital tunnel syndrome (involving the ulnar nerve) is clearly the most common neuropathy about the elbow. The anatomy and innervation pattern of the nerve involved determines the characteristic of the neuropathy syndrome. The most important parts of the work-up are the history and physical examination as electrodiagnostic testing and imaging are often not reliable. In general, active rest is the first line of treatment. Tailoring the surgery and rehabilitation protocol according to the functional requirements of that athlete's sport(s) can help optimize the operative outcomes for recalcitrant cases.

  11. Outcome following nerve repair of high isolated clean sharp injuries of the ulnar nerve.

    Directory of Open Access Journals (Sweden)

    René Post

    Full Text Available OBJECTIVE: The detailed outcome of surgical repair of high isolated clean sharp (HICS ulnar nerve lesions has become relevant in view of the recent development of distal nerve transfer. Our goal was to determine the outcome of HICS ulnar nerve repair in order to create a basis for the optimal management of these lesions. METHODS: High ulnar nerve lesions are defined as localized in the area ranging from the proximal forearm to the axilla just distal to the branching of the medial cord of the brachial plexus. A meta-analysis of the literature concerning high ulnar nerve injuries was performed. Additionally, a retrospective study of the outcome of nerve repair of HICS ulnar nerve injuries at our institution was performed. The Rotterdam Intrinsic Hand Myometer and the Rosén-Lundborg protocol were used. RESULTS: The literature review identified 46 papers. Many articles presented outcomes of mixed lesion groups consisting of combined ulnar and median nerves, or the outcome of high and low level injuries was pooled. In addition, outcome was expressed using different scoring systems. 40 patients with HICS ulnar nerve lesions were found with sufficient data for further analysis. In our institution, 15 patients had nerve repair with a median interval between trauma and reconstruction of 17 days (range 0-516. The mean score of the motor and sensory domain of the Rosen's Scale instrument was 58% and 38% of the unaffected arm, respectively. Two-point discrimination never reached less then 12 mm. CONCLUSION: From the literature, it was not possible to draw a definitive conclusion on outcome of surgical repair of HICS ulnar nerve lesions. Detailed neurological function assessment of our own patients showed that some ulnar nerve function returned. Intrinsic muscle strength recovery was generally poor. Based on this study, one might cautiously argue that repair strategies of HICS ulnar nerve lesions need to be improved.

  12. Medians and means in Finsler geometry

    CERN Document Server

    Arnaudon, Marc

    2010-01-01

    We investigate existence and uniqueness of p-means and the median of a probability measure on a Finsler manifold, in relation with the convexity of the support of the measure. We prove that the p-mean is the limit point of a continuous time gradient flow. Under some additional condition which is always satisfied for larger than or equal to 2, a discretization of this path converges to the p-mean. This provides an algorithm for determining those Finsler center points.

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

    Directory of Open Access Journals (Sweden)

    Yoon Joon-Shik

    2007-12-01

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

  14. Robust non-local median filter

    Science.gov (United States)

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

    2017-04-01

    This paper describes a novel image filter with superior performance on detail-preserving removal of random-valued impulse noise superimposed on natural gray-scale images. The non-local means filter is in the limelight as a way of Gaussian noise removal with superior performance on detail preservation. By referring the fundamental concept of the non-local means, we had proposed a non-local median filter as a specialized way for random-valued impulse noise removal so far. In the non-local processing, the output of a filter is calculated from pixels in blocks which are similar to the block centered at a pixel of interest. As a result, aggressive noise removal is conducted without destroying the detailed structures in an original image. However, the performance of non-local processing decreases enormously in the case of high noise occurrence probability. A cause of this problem is that the superimposed noise disturbs accurate calculation of the similarity between the blocks. To cope with this problem, we propose an improved non-local median filter which is robust to the high level of corruption by introducing a new similarity measure considering possibility of being the original signal. The effectiveness and validity of the proposed method are verified in a series of experiments using natural gray-scale images.

  15. Inference with the Median of a Prior

    Directory of Open Access Journals (Sweden)

    Ali Mohammad-Djafari

    2006-06-01

    Full Text Available We consider the problem of inference on one of the two parameters of a probability distribution when we have some prior information on a nuisance parameter. When a prior probability distribution on this nuisance parameter is given, the marginal distribution is the classical tool to account for it. If the prior distribution is not given, but we have partial knowledge such as a fixed number of moments, we can use the maximum entropy principle to assign a prior law and thus go back to the previous case. In this work, we consider the case where we only know the median of the prior and propose a new tool for this case. This new inference tool looks like a marginal distribution. It is obtained by first remarking that the marginal distribution can be considered as the mean value of the original distribution with respect to the prior probability law of the nuisance parameter, and then, by using the median in place of the mean.

  16. Entrapment and escape of liquid lubricant in metal forming

    DEFF Research Database (Denmark)

    Bech, Jakob Ilsted; Bay, Niels; Eriksen, Morten

    1999-01-01

    Using a transparent tool entrapment, compression and eventual escape of liquid lubricant in surface pockets is observed in plane strip drawing. The two mechanisms of lubricant escape. Micro Plasto HydroDynamic and Hydrostatic Lubrication (MPHDL and MPHSL), are observed and quantified experimentally...

  17. Toxicity of doxorubicin entrapped within long-circulating liposomes

    NARCIS (Netherlands)

    Daemen, T; Regts, J; Meesters, M; TenKate, MT; BakkerWoudenberg, IAJM; Scherphof, GL

    1997-01-01

    We studied the effect of doxorubicin entrapped within long-circulating liposomes (Dox-LCL) on the phagocytic capacity and bacterial blood clearance capacity of rat liver macrophages. Dox-LCL (125 nm in diameter) were composed of egg phosphatidylcholine (PC), cholesterol (CH) and poly(ethyleneglycol)

  18. Excursion of the Sciatic Nerve During Nerve Mobilization Exercises: An In Vivo Cross-sectional Study Using Dynamic Ultrasound Imaging.

    Science.gov (United States)

    Coppieters, Michel W; Andersen, Line S; Johansen, Runar; Giskegjerde, Per K; Høivik, Mona; Vestre, Siv; Nee, Robert J

    2015-10-01

    Controlled laboratory cross-sectional study using single-group, within-subject comparisons. To determine whether different types of neurodynamic techniques result in differences in longitudinal sciatic nerve excursion. Large differences in nerve biomechanics have been demonstrated for different neurodynamic techniques for the upper limb (median nerve), but recent findings for the sciatic nerve have only revealed small differences in nerve excursion that may not be clinically meaningful. High-resolution ultrasound imaging was used to quantify longitudinal sciatic nerve movement in the thigh of 15 asymptomatic participants during 6 different mobilization techniques for the sciatic nerve involving the hip and knee. Healthy volunteers were selected to demonstrate normal nerve biomechanics and to eliminate potentially confounding variables associated with dysfunction. Repeated-measures analyses of variance were used to analyze the data. The techniques resulted in markedly different amounts of nerve movement (Pmovements. Consistent with current theories and findings for the median nerve, different neurodynamic exercises for the lower limb resulted in markedly different sciatic nerve excursions. Considering the continuity of the nervous system, the movement and position of adjacent joints have a large impact on nerve biomechanics.

  19. Robust Mediation Analysis Based on Median Regression

    Science.gov (United States)

    Yuan, Ying; MacKinnon, David P.

    2014-01-01

    Mediation analysis has many applications in psychology and the social sciences. The most prevalent methods typically assume that the error distribution is normal and homoscedastic. However, this assumption may rarely be met in practice, which can affect the validity of the mediation analysis. To address this problem, we propose robust mediation analysis based on median regression. Our approach is robust to various departures from the assumption of homoscedasticity and normality, including heavy-tailed, skewed, contaminated, and heteroscedastic distributions. Simulation studies show that under these circumstances, the proposed method is more efficient and powerful than standard mediation analysis. We further extend the proposed robust method to multilevel mediation analysis, and demonstrate through simulation studies that the new approach outperforms the standard multilevel mediation analysis. We illustrate the proposed method using data from a program designed to increase reemployment and enhance mental health of job seekers. PMID:24079925

  20. Ultra Low-Power Analog Median Filters

    Directory of Open Access Journals (Sweden)

    A. Diaz-Sanchez

    2013-09-01

    Full Text Available The design and implementation of three analog median filter topologies, whose transistors operate in the deep weak-inversion region, is described. The first topology is a differential pairs array, in which drain currents are driven into two nodes in a differential fashion, while the second topology is based on a wide range OTA, which is used to maximize the dynamic range. Finally, the third topology uses three range-extended OTAs. The proposed weak-inversion filters were designed and fabricated in ON Semiconductor 0.5 micrometer technology through MOSIS. Experimental results of three-input fabricated prototypes for all three topologies are show, where power consumptions of 90nW in the first case, and 270nW in the other two cases can be noticed. A dual power supply +/-1.5 Volts were used.

  1. 骨间前神经卡压的解剖学研究及临床分析%Anatomic study and clinical analysis of anterior interosseous nerve compression syndrome

    Institute of Scientific and Technical Information of China (English)

    刘志刚; 刘宏君; 刘彬

    2009-01-01

    almost always sandwiched between the two heads of pronator teres. The tendinous arch of flexor digitorurn superficialis of the index and middle fingers occurred in 41.7% (5 specimens). Accessory head of flexor pollicis longus occurred in 58.3% (7 specimens). The incidence of abnormal vessels across the median nerve and the anterior interosseous nerve was 66.7% (8 specimens). The 7 cases treated with additional ligation of the abnormal vessels running across the anterior interosseous nerve had better results than those treated only with nerve decompression and resection of the tendinous or fibrous structures. Conclusion Anterior interoaseous nerve compression syndrome is the result of multiple factors. All the structures that can cause entrapment of the nerve on its anatomic course should he released in order to achieve satisfactory results.

  2. Analysis of proximal radial nerve injury in the arm

    Directory of Open Access Journals (Sweden)

    Duz Bulent

    2010-01-01

    Full Text Available Background: Radial nerve is the most frequently injured major nerve in the upper extremity. Proximal part of the radial nerve involvement can result from a humerus fracture, direct nerve trauma, compression and rarely from tumors. Objectives: The aim of the study is to determine the clinical characteristics and electrodiagnostic findings in patients with proximal radial nerve injuries, and also the outcome of surgical treatment. Materials and Methods: The study subjects included 46 patients with radial nerve injuries seen between June 2000 and June 2008 at our hospital. The analysis included demographics, clinical features, etiology, pre-and postoperative EMNG (Electromyoneurography findings. Results: Surgical decompression resulted in neurological improvement in patients with radial entrapment neuropathies. Good neurological recovery was observed from decompression of callus of old humeral fracture. The worst results were observed in the direct missile injuries of the radial nerve. Conclusions: A detailed clinical and electrodiagnostic evaluation is of importance in patients with radial nerve injury to ensure an appropriate treatment. The choice of treatment, conservative or surgical, depends on the clinical presentation and the type of injury.

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

    OpenAIRE

    Gourie-Devi, M; Ganapathy, G R

    1985-01-01

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

  4. Pain catastrophizing predicts pain intensity during a neurodynamic test for the median nerve in healthy participants.

    Science.gov (United States)

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

    2010-08-01

    Psychological factors within the Fear-Avoidance Model of Musculoskeletal Pain (FAM) predict clinical and experimental pain in both symptomatic and asymptomatic individuals. Clinicians routinely examine individuals with provocative testing procedures that evoke symptoms. The purpose of this study was to investigate which FAM factors were associated with evoked pain intensity, non-painful symptom intensity, and range of motion during an upper-limb neurodynamic test. Healthy participants (n = 62) completed psychological questionnaires for pain catastrophizing, fear of pain, kinesiophobia, and anxiety prior to neurodynamic testing. Pain intensity, non-painful sensation intensity, and elbow range of motion (ROM) were collected during testing and served as dependent variables in separate simultaneous regression models. All the psychological predictors in the model accounted for 18% of the variance in evoked pain intensity (p = .02), with only pain catastrophizing (beta = .442, p neurodynamic testing for healthy subjects. Although these findings cannot be directly translated to clinical practice, the influence of pain catastrophizing on evoked pain responses should be considered during neurodynamic testing.

  5. Sleep deprivation affects somatosensory cortex excitability as tested through median nerve stimulation.

    Science.gov (United States)

    Gorgoni, Maurizio; Ferlazzo, Fabio; Moroni, Fabio; D'Atri, Aurora; Donarelli, Stefania; Fanelli, Stefania; Gizzi Torriglia, Isabella; Lauri, Giulia; Ferrara, Michele; Marzano, Cristina; Rossini, Paolo Maria; Bramanti, Placido; De Gennaro, Luigi

    2014-01-01

    Changes of cortical excitability after sleep deprivation (SD) in humans have been investigated mostly in motor cortex, while there is little empirical evidence concerning somatosensory cortex, and its plastic changes across SD. To assess excitability of primary somatosensory cortex (S1) and EEG voltage topographical characteristics associated with somatosensory evoked potentials (SEPs) during SD. Across 41 h of SD, 16 healthy subjects participated in 4 experimental sessions (11.00 a.m. and 11.00 p.m. of the 1st and 2nd day) with: a) subjective sleepiness ratings; b) EEG recordings; c) SEPs recordings; d) behavioral vigilance responses. A clear enhancement of cortical excitability after SD was indexed by: (a) an amplitude increase of different SEPs component in S1; (b) higher voltage in occipital (around 35-43 ms) and fronto-central areas (around 47-62 ms). Circadian fluctuations did not affect cortical excitability. Voltage changes in S1 were strongly related with post-SD fluctuations of subjective and behavioral sleepiness. Sleep may have a role in keeping cortical excitability at optimal (namely below potentially dangerous) levels for the human brain, rebalancing progressive changes in cortical responsiveness to incoming inputs occurred during time spent awake. On the other hand, higher level of cortical responsiveness after sleep loss may be one of the mechanisms accounting for post-SD alterations in vigilance and behavior. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. [Relationship between ultrasound measurements of the median nerve and electrophysiological severity in carpal tunnel syndrome].

    Science.gov (United States)

    Bueno-Gracia, Elena; Tricás-Moreno, José Miguel; Fanlo-Mazas, Pablo; Malo-Urriés, Miguel; Haddad-Garay, María; Estébanez-de-Miguel, Elena; Hidalgo-García, César; Ruiz-de-Escudero Zapico, Alazne

    2015-11-16

    Introduccion. La ecografia es una herramienta que ha experimentado un gran desarrollo en el diagnostico de patologias compresivas neurales, como el sindrome del tunel carpiano (STC). Para planificar el tratamiento es importante establecer la gravedad de la patologia, por lo que seria relevante conocer la capacidad de la ecografia para discriminar el grado de afectacion del nervio mediano a este nivel. Objetivo. Investigar la correlacion de las mediciones ecograficas con la gravedad electrofisiologica en pacientes con STC. Pacientes y metodos. Se realizaron mediciones ecograficas en 59 sujetos (97 muñecas) remitidos para recibir un electroneurograma (ENG) por sospecha de STC. Segun el ENG, los sujetos se clasificaron como sanos, STC leve, moderado o grave. Posteriormente, se analizo la relacion entre las mediciones ecograficas y los resultados del ENG segun su gravedad. Tambien se calcularon las curvas ROC (receiver operaing characteristic) para los valores de corte optimos en cada grupo atendiendo a su gravedad. Resultados. Ambas mediciones ecograficas mostraron correlacion con la gravedad del STC determinada por el ENG. El area de seccion transversal del nervio mediano en la muñeca (AST-M) mostro la mayor correlacion (r = 0,613). Conclusiones. Existe relacion entre las mediciones ecograficas del nervio mediano, especialmente en el AST-M, y la gravedad del STC en un contexto clinico. Dichas mediciones podrian ser complementarias para diagnosticar el STC y determinar su gravedad.

  7. Deep gluteal space problems: piriformis syndrome, ischiofemoral impingement and sciatic nerve release

    Science.gov (United States)

    Carro, Luis Perez; Hernando, Moises Fernandez; Cerezal, Luis; Navarro, Ivan Saenz; Fernandez, Ana Alfonso; Castillo, Alexander Ortiz

    2016-01-01

    Summary Background Deep gluteal syndrome (DGS) is an underdiagnosed entity characterized by pain and/or dysesthesias in the buttock area, hip or posterior thigh and/or radicular pain due to a non-discogenic sciatic nerve entrapment in the subgluteal space. Multiple pathologies have been incorporated in this all-included “piriformis syndrome”, a term that has nothing to do with the presence of fibrous bands, obturator internus/gemellus syndrome, quadratus femoris/ischiofemoral pathology, hamstring conditions, gluteal disorders and orthopedic causes. Methods This article describes the subgluteal space anatomy, reviews known and new etiologies of DGS, and assesses the role of the radiologist and orthopaedic surgeons in the diagnosis, treatment and postoperative evaluation of sciatic nerve entrapments. Conclusion DGS is an under-recognized and multifactorial pathology. The development of periarticular hip endoscopy has led to an understanding of the pathophysiological mechanisms underlying piriformis syndrome, which has supported its further classification. The whole sciatic nerve trajectory in the deep gluteal space can be addressed by an endoscopic surgical technique. Endoscopic decompression of the sciatic nerve appears useful in improving function and diminishing hip pain in sciatic nerve entrapments, but requires significant experience and familiarity with the gross and endoscopic anatomy. Level of evidence IV. PMID:28066745

  8. Solitary median maxillary central incisor (SMMCI syndrome

    Directory of Open Access Journals (Sweden)

    Hall Roger K

    2006-04-01

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

  9. Tongue entrapment by chew toys in two dogs.

    Science.gov (United States)

    Rubio, A; Van Goethem, B; Verhaert, L

    2010-10-01

    Compression of a chew toy during regular play activity can create a vacuum effect eventually causing entrapment of oral tissues. Two cases of tongue entrapment are described, which resulted in severe tissue swelling, oedema and vascular obstruction. In the first dog, the toy was removed by the veterinary surgeon under general anaesthesia. Damage to the tongue proved to be reversible and the dog recovered uneventfully. In the second patient, the toy was forcefully removed by the owner. The resulting tongue necrosis required partial amputation. Treatment of this emergency condition consists of elimination of the negative pressure inside the toy by piercing it or even by insufflation of positive pressure inside the toy, and of an atraumatic manipulation to prevent further damage to the compromised tissues.

  10. Cheese production using kefir culture entrapped in milk proteins.

    Science.gov (United States)

    Dimitrellou, Dimitra; Kandylis, Panagiotis; Kourkoutas, Yiannis; Koutinas, Athanasios A; Kanellaki, Maria

    2015-05-01

    The aim of the present study was to evaluate the use of kefir culture entrapped in casein and in whey protein as starter cultures for the production of Feta-type cheese. Microbiological analysis showed that counts of enterobacteria, coliforms, and staphylococci were significantly reduced due to kefir culture. In addition, the effect of kefir culture on the formation of volatile compounds, such as esters, organic acids, alcohols, carbonyl compounds, and lactones, was also investigated using the SPME GC/MS technique. Cheese samples produced with kefir culture entrapped in milk proteins presented improved profile of aroma-related compounds. Principal component analysis of the results indicated that the volatile composition of the different cheese types was dependent on the nature of the starter culture. Finally, the sensory evaluation showed that the products produced with kefir culture had a soft, fine taste, and were of improved quality.

  11. Entrapment of victims of spousal abuse in Ghana

    DEFF Research Database (Denmark)

    Adjei, Stephen Baffour

    2017-01-01

    Drawing on discursive psychology and positioning theory, this study explores the influence of cultural and familial value orientations on battered women’s identity, agency and decision to leave or stay in abusive conjugal relationship in Ghana. Two semi-structured focus group discussions and four...... in-depth personal interviews were conducted with 16 victims of husband-to-wife abuse from rural and urban Ghana. The findings indicate that entrapment of victims of spousal abuse in Ghana reflects their social embeddedness and that battered women’s identities and agency are expressed in the context...... of familial and cultural value orientations. The primacy of family identity and victims’ apparent implicit moral obligation to preserve the social image of their extended family influence their entrapment. Participants’ discursive accounts further suggest that stay/leave decisions of battered women in Ghana...

  12. Compression neuropathy of the ulnar digital nerves in the thumbs of a massage therapist.

    Science.gov (United States)

    Chen, Chien-Chang; Chien, Hsiung-Fei; Chen, Chien-Lian

    2014-01-01

    Compression neuropathies of digital nerves, caused by hypertrophied or anomalous muscles, are rare compared with such occurrences above the wrist. We reported a case of compression neuropathy of the ulnar digital nerves in bilateral thumbs of a massage therapist. Entrapment of the digital nerves by the hypertrophied first dorsal interosseous and adductor pollicis muscles over the first web space of the right hand was detected by magnetic resonance imaging. Surgical debulking of the muscles and neurolysis were performed on the dominant right hand. The left hand was successfully treated with botulinum toxin. No recurrence was noted in a follow-up of 36 months.

  13. Nuclear electric quadrupole interactions in liquids entrapped in cavities

    Energy Technology Data Exchange (ETDEWEB)

    Furman, Gregory B., E-mail: gregoryf@bgu.ac.il; Meerovich, Victor M.; Sokolovsky, Vladimir L. [Ben Gurion University of the Negev, Physics Department (Israel)

    2016-12-15

    Liquids entrapped in cavities and containing quadrupole nuclei are considered. The interaction of the quadrupole moment of a nucleus with the electric field gradient is studied. In such a system, molecules are in both rotational and translational Brownian motions which are described by the diffusion equation. Solving this equation, we show that the intra- and intermolecular nuclear quadrupole interactions are averaged to zero in cavities with the size larger than several angstroms.

  14. Testing a German Adaption of the Entrapment Scale and Assessing the Relation to Depression

    Directory of Open Access Journals (Sweden)

    Manuel Trachsel

    2010-01-01

    Full Text Available The construct of entrapment is used in evolutionary theory to explain the etiology of depression. The perception of entrapment can emerge when defeated individuals want to escape but are incapable. Studies have shown relationships of entrapment to depression, and suicidal tendencies. The aim of this study was a psychometric evaluation and validation of the Entrapment Scale in German (ES-D. 540 normal subjects completed the ES-D along with other measures of depressive symptoms, hopelessness, and distress. Good reliability and validity of the ES-D was demonstrated. Further, whereas entrapment originally has been regarded as a two-dimensional construct, our analyses supported a single-factor model. Entrapment explained variance in depressive symptoms beyond that explained by stress and hopelessness supporting the relevance of the construct for depression research. These findings are discussed with regard to their theoretical implications as well as to the future use of the entrapment scale in clinical research and practice.

  15. Bubble entrapment during sphere impact onto quiescent liquid surfaces

    KAUST Repository

    Marston, Jeremy

    2011-06-20

    We report observations of air bubble entrapment when a solid sphere impacts a quiescent liquid surface. Using high-speed imaging, we show that a small amount of air is entrapped at the bottom tip of the impacting sphere. This phenomenon is examined across a broad range of impact Reynolds numbers, 0.2 a Re = (DU0/Il) a 1.2\\' 105. Initially, a thin air pocket is formed due to the lubrication pressure in the air layer between the sphere and the liquid surface. As the liquid surface deforms, the liquid contacts the sphere at a finite radius, producing a thin sheet of air which usually contracts to a nearly hemispherical bubble at the bottom tip of the sphere depending on the impact parameters and liquid properties. When a bubble is formed, the final bubble size increases slightly with the sphere diameter, decreases with impact speed but appears independent of liquid viscosity. In contrast, for the largest viscosities tested herein, the entrapped air remains in the form of a sheet, which subsequently deforms upon close approach to the base of the tank. The initial contact diameter is found to conform to scalings based on the gas Reynolds number whilst the initial thickness of the air pocket or adimplea scales with a Stokes\\' number incorporating the influence of the air viscosity, sphere diameter and impact speed and liquid density. © 2011 Cambridge University Press.

  16. Transport and Entrapment of Particles in Steel Continuous Casting

    Science.gov (United States)

    Thomas, Brian G.; Yuan, Quan; Mahmood, Sana; Liu, Rui; Chaudhary, Rajneesh

    2013-08-01

    A particle-capture model based on local force balances has been developed, implemented into computational models of turbulent fluid flow and particle transport, and applied to simulate the entrapment of slag inclusions and bubbles during the continuous casting of steel slabs. Turbulent flow of molten steel is computed in the nozzle and mold using transient computational fluid flow models, both with and without the effects of argon gas injection. Next, the transport and capture of many particles are simulated using a Lagrangian approach. Particles touching the dendritic interface may be pushed away, dragged away by the transverse flow, or captured into the solidifying shell according to the results of a local balance of ten different forces. This criterion was validated by reproducing experimental results in two different systems. The implications of this criterion are discussed quantitatively. Finally, the fluid flow/particle transport model results and capture criterion are applied together to predict the entrapment distributions of different sized particles in a typical slab caster. More large particles are safely removed than small ones, but the entrapment rate into the solidifying shell as defects is still very high.

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

    Directory of Open Access Journals (Sweden)

    Samuel Ribak

    2016-02-01

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

  18. Cardiovascular and behavioral effects produced by administration of liposome-entrapped GABA into the rat central nervous system.

    Science.gov (United States)

    Vaz, G C; Bahia, A P C O; de Figueiredo Müller-Ribeiro, F C; Xavier, C H; Patel, K P; Santos, R A S; Moreira, F A; Frézard, F; Fontes, M A P

    2015-01-29

    Liposomes are nanosystems that allow a sustained release of entrapped substances. Gamma-aminobutyric acid (GABA) is the most prevalent inhibitory neurotransmitter of the central nervous system (CNS). We developed a liposomal formulation of GABA for application in long-term CNS functional studies. Two days after liposome-entrapped GABA was injected intracerebroventricularly (ICV), Wistar rats were submitted to the following evaluations: (1) changes in mean arterial pressure (MAP), heart rate (HR) and renal sympathetic nerve activity (RSNA) to ICV injection of bicuculline methiodide (BMI) in anesthetized rats; (2) changes in cardiovascular reactivity to air jet stress in conscious rats; and (3) anxiety-like behavior in conscious rats. GABA and saline-containing pegylated liposomes were prepared with a mean diameter of 200 nm. Rats with implanted cannulas targeted to lateral cerebral ventricle (n = 5-8/group) received either GABA solution (GS), empty liposomes (EL) or GABA-containing liposomes (GL). Following (48 h) central microinjection (2 μL, 0.09 M and 99 g/L) of liposomes, animals were submitted to the different protocols. Animals that received GL demonstrated attenuated response of RSNA to BMI microinjection (GS 48 ± 9, EL 43 ± 9, GL 11 ± 8%; P nervous system. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

  19. Migration And Entrapment Of Mercury In The Subsurface

    Science.gov (United States)

    M, D.; Nambi, I. M.

    2009-12-01

    Elemental mercury is an immiscible liquid with high density and high surface tension. The movement of mercury in the saturated subsurface region is therefore considered a case of two phase flow involving mercury and water and is expected to be governed by gravity, viscous and capillary forces. Fundamental investigation into the migration and capillary entrapment of mercury in the subsurface was done by controlled laboratory capillary pressure saturation experiments using mercury and water as non wetting and wetting fluid respectively. Residual mercury saturation and van Genuchten’s capillary entrapment parameters were determined independently for different sizes of porous media. Based on the experimental data, theoretical investigations were done on the role of the three predominant forces and their influence on mercury migration and entrapment. The effects of fluid density and interfacial tension and the influence of Capillary and Bond number on mercury entrapment were analyzed with the help of similar capillary pressure - saturation experiments using Tetrachloroethylene (PCE)-water fluid pair. Mercury-water systems exhibited a low residual saturation of 0.02 and 0.07 as compared to 0.16 and 0.27 for PCE-water systems. Less residual mercury saturation, lack of apparent hysteresis in capillary pressure saturation curves and large variation in van Genuchten’s parameters 'α'(inverse of displacement pressure) and ‘n’ (pore size distribution index) for mercury-water systems compared to PCE-water systems were observed. These anomalies between the two systems elucidate that the capillary trapping is equally dependent on the fluid characteristics especially for high density immiscible fluids. Gravity force nevertheless a predominant controlling factor in the migration of highly dense mercury, is counteracted by not less trivial capillary force which was 1.22x104 times higher than gravity force. The capillary forces thus surmount the gravity forces and cause

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    Vijay Kumar S

    2014-11-01

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

  2. Ulnar Nerve Injury as a Result of Galeazzi Fracture: A Case Report and Literature Review.

    Science.gov (United States)

    Roettges, Paul; Turker, Tolga

    2017-09-01

    Sparse documentation of Galeazzi fracture with associated nerve injury exists in the medical literature. The purpose of this report is to review the available literature in regard to incidence, nerve injury type, treatment strategies, and expected outcomes. We present a classic Galeazzi fracture dislocation with associated complete ulnar nerve transection injury at the level of the wrist. After rigid internal bony stabilization, allograft nerve repair was performed. The patient's presentation, operative management, recovery, and a thorough literature review are discussed. Fracture union was attained with near full wrist and elbow range of motion. Despite lack of ulnar nerve function return, the patient was able to resume manual labor occupation. Despite its close proximity to the dislocating distal radioulnar joint (DRUJ), thorough review reveals rare associated ulnar nerve palsy. If there is suspicion for nerve injury in the setting of open DRUJ dislocation, the nerve should be explored to identify possible entrapment or transection. Literature supports likely return of nerve function in cases of intact nerve; however, management of nerve transection remains debatable.

  3. Remodeling of motor units after nerve regeneration studied by quantitative electromyography

    DEFF Research Database (Denmark)

    Krarup, Christian; Boeckstyns, Michel; Ibsen, Allan

    2016-01-01

    OBJECTIVE: Peripheral nerve has the capacity to regenerate after nerve lesions; during reinnervation of muscle motor units are gradually reestablished. The aim of this study was to follow the time course of reestablishing and remodeling of motor units in relation to recovery of force after...... different types of nerve repair. METHODS: Reinnervation of muscle was compared clinically and electrophysiologically in complete median or ulnar nerve lesions with short gap lengths in the distal forearm repaired with a collagen nerve conduit (11 nerves) or nerve suture (10 nerves). Reestablishment of motor...... and the number of motor units recovered to approximately 20% of normal. There was weak evidence of CMAP amplitude recovery after suture ahead of conduit repair but without treatment related differences at 2 years. CONCLUSIONS: Surgical repair of nerve lesions with a nerve conduit or suture supported recovery...

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

    Directory of Open Access Journals (Sweden)

    Bhandari P

    2009-01-01

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

  5. Normal and sonographic anatomy of selected peripheral nerves. Part III: Peripheral nerves of the lower limb

    Directory of Open Access Journals (Sweden)

    Berta Kowalska

    2012-06-01

    Full Text Available The ultrasonographic examination is currently increasingly used in imaging peripheral nerves, serving to supplement the physical examination, electromyography and magnetic resonance imaging. As in the case of other USG imaging studies, the examination of peripheral nerves is non-invasive and well-tolerated by patients. The typical ultrasonographic picture of peripheral nerves as well as the examination technique have been discussed in part I of this article series, following the example of the median nerve. Part II of the series presented the normal anatomy and the technique for examining the peripheral nerves of the upper limb. This part of the article series focuses on the anatomy and technique for examining twelve normal peripheral nerves of the lower extremity: the iliohypogastric and ilioinguinal nerves, the lateral cutaneous nerve of the thigh, the pudendal, sciatic, tibial, sural, medial plantar, lateral plantar, common peroneal, deep peroneal and superficial peroneal nerves. It includes diagrams showing the proper positioning of the sonographic probe, plus USG images of the successively discussed nerves and their surrounding structures. The ultrasonographic appearance of the peripheral nerves in the lower limb is identical to the nerves in the upper limb. However, when imaging the lower extremity, convex probes are more often utilized, to capture deeply-seated nerves. The examination technique, similarly to that used in visualizing the nerves of upper extremity, consists of locating the nerve at a characteristic anatomic reference point and tracking it using the “elevator technique”. All 3 parts of the article series should serve as an introduction to a discussion of peripheral nerve pathologies, which will be presented in subsequent issues of the “Journal of Ultrasonography”.

  6. Intra-epithelially entrapped blood vessels in ameloblastoma.

    Science.gov (United States)

    Siar, Chong Huat; Ishak, Ismadi; Ng, Kok Han

    2015-05-01

    The ameloblastoma is a benign but locally aggressive odontogenic neoplasm with a high recurrence rate. While significant progress has been made in our understanding regarding the role of tumoral vasculature relative to the diverse behavioral characteristics of this tumor, no attention has been paid to a distinct subset of blood vessels entrapped within its epithelial compartment. As vascular niches are known to influence tumoral growth, clarification of these vessels is important. The objectives of this study were to investigate the morphologic characteristics of intra-epithelially entrapped blood vessels (IEBVs) in ameloblastoma and to speculate on their relevance. Here, we evaluated the frequency, microvessel density (MVD), morphology, and distribution pattern of IEBVs in 77 ameloblastoma of different subtypes based on their immunoreactivity for endothelial markers (CD34, CD31, CD105), vascular tight junction protein (claudin-5), pericyte [α-smooth muscle actin (α-sma)], and vascular basement membrane (collagen IV). IEBVs were heterogeneously detected in ameloblastoma. Their mean MVD (CD34 = 15.46 ± 7.25; CD31 = 15.8 ± 5.04; CD105 = 0.82 ± 0.51) showed no significant correlation with different subtypes, and between primary and recurrent tumors (P > 0.05). These microvessels may occur as single/clusters of capillary sprouts, or formed compressed branching/non-branching slits entrapped within the epithelial compartment, and in direct apposition with polyhedral/granular neoplastic epithelial cells. They expressed proteins for endothelial tight junctions (claudin-5-positive) and pericytes (α-sma-positive) but had deficient basement membrane (collagen IV weak to absent). Aberrant expression for CD34, CD31, and CD105 in tumor epithelium was variably observed. Although rare in occurrence, identification of IEBVs in ameloblastoma could potentially represent a new paradigm for vascular assessment of this neoplasm. © 2014 John Wiley & Sons A/S. Published by John

  7. Application of living microbial cells entrapped with synthetic resin prepolymers.

    Science.gov (United States)

    Fukui, S; Tanaka, A

    1989-12-01

    Living and growing microbial cells were immobilized by entrapping in synthetic resin gels prepared from their prepolymers, and used in the production of various useful substances. The production of the desired metabolites and also both the activity and the stability of the catalytic systems were seriously affected by the physico-chemical properties of the prepolymers, and those of the resin gels subsequently formed, such as gel network, hydrophilicity-hydrophobicity balance and ionic nature, as well as by the type of bioreactors. Hydroxylation of steroids and production of antibiotics, polypeptides and other biologically active substances, and the effects of gel properties on them are discussed as examples.

  8. Dipolar Rings of Microscopic Ellipsoids: Magnetic Manipulation and Cell Entrapment

    Science.gov (United States)

    Martinez-Pedrero, Fernando; Cebers, Andrejs; Tierno, Pietro

    2016-09-01

    We study the formation and the dynamics of dipolar rings composed by microscopic ferromagnetic ellipsoids, which self-assemble in water by switching the direction of the applied field. We show how to manipulate these fragile structures and control their shape via the application of external static and oscillating magnetic fields. We introduce a theoretical framework which describes the ring deformation under an applied field, allowing us to understand the underlying physical mechanism. Our microscopic rings are finally used to capture, entrap, and later release a biological cell via a magnetic command, i.e., performing a simple operation which can be implemented in other microfluidic devices which make use of ferromagnetic particles.

  9. Unilateral Entrapment of the Renal Artery by Diaphragmatic Crus

    Directory of Open Access Journals (Sweden)

    Shruthi B N

    2013-08-01

    Full Text Available Extrinsic compression of one or both renal arteries by the diaphragmatic crura, which is known as renal entrapment syndrome, is rare. Compression by fibres forming part of the crus of the diaphragm impinging on the renal artery by verticalisation of the root of the renal artery. This results in stenosis, the present case report add to the long list of variety of variations of renal artery. Knowledge of possible variations among renal vessels is essential for radiologists and surgeons. [Natl J Med Res 2013; 3(4.000: 412-413

  10. Alginate and Chitosan Gel Nanoparticles for Efficient Protein Entrapment

    Science.gov (United States)

    Masalova, O.; Kulikouskaya, V.; Shutava, T.; Agabekov, V.

    Alginate and chitosan nanoparticles were synthesized by ionic gelation of the polymers in the presence of stabilizers (PEG 1500, PEG 6000, TWEEN 80). The stability of 210-240 nm Ca-alginate colloids is affected by nanoparticles ageing and by the presence of a stabilizer. The diameter of chitosan nanoparticles is in the range of 180 to 260 nm and depends on polymer concentration in the reaction mixture, its molecular weight, and stabilizer type. The nanoparticles efficiently entrap a model protein, bovine serum albumin, in the amount up to 0.24 mg per 1 mg of polysaccharide.

  11. The Entrapment of Unfree Labor: Theory and Examples from India

    OpenAIRE

    Olsen, W; Morgan, J.

    2015-01-01

    In this article we explore some aspects of contemporary unfree labor in rural south India. We draw on 130 case studies and (informally) extensive field research. We do so in order to make the central point that the conditions of unfreedom are variable and subject to change but that the basic vulnerabilities are significant. Being unfree in a labor relationship is a contingent effect of a set of factors. We stress the role of (a) entrapment of laborers, (b) immiseration within bondage, and (c)...

  12. The Entrapment of Unfree Labour: Theory and Examples From India

    OpenAIRE

    Olsen, Wendy Kay; Morgan, Jamie

    2015-01-01

    In this paper we explore some aspects of contemporary unfree labour in rural South India. We draw on 130 case studies and (informally) extensive field research. We do so in order to make the central point that the conditions of unfreedom are variable and subject to change but that the basic vulnerabilities are significant. Being unfree in a labour relationship is a contingent effect of a set of factors. We stress the role of (a) entrapment of labourers, (b) immiseration within bondage, and (c...

  13. [Popliteal artery entrapment syndrome in 3 young athletes].

    Science.gov (United States)

    Delgado Daza, R; Moga Donadeu, L L; Muncunill Gil, J; Mañosa Bonamich, J; Vidal Conde, V

    1993-01-01

    Three cases of entrapment of the popliteal arteries from three young patients are reported. In all cases, the symptomatology was erroneously attributed to several muscular injuries produced in practice of a sport: Basketball, Football and Roller Hockey, respectively. In all cases, symptoms were progressing for 6 months as a minimum. The roads followed by these patients until they were visited in a Vascular Surgery Department is described. Clinical picture, the results from the different examinations practiced and the applied treatments to each patients are described.

  14. Stability, Chaos and Entrapment of Stars in Very Wide Pairs

    Science.gov (United States)

    2012-01-01

    irregular moons by the Sun– Jupiter sys- tem, which can only happen in the thin layer of chaotic motion separating the regions of scattering and stability...Entrapment Of Stars In Very Wide Pairs 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) 5d. PROJECT NUMBER 5e. TASK NUMBER...5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) US Naval Observatory,3450 Massachusetts Avenue, NW,Washington,DC,20392 8

  15. EMG MEDIAN POWER FREQUENCY IN AN EXHAUSTING EXERCISE

    NARCIS (Netherlands)

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

    1993-01-01

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

  16. EMG MEDIAN POWER FREQUENCY IN AN EXHAUSTING EXERCISE

    NARCIS (Netherlands)

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

    1993-01-01

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

  17. Preoperative evaluation of peripheral nerve injuries: What is the place for ultrasound?

    Science.gov (United States)

    Toia, Francesca; Gagliardo, Andrea; D'Arpa, Salvatore; Gagliardo, Cesare; Gagliardo, Giuseppe; Cordova, Adriana

    2016-09-01

    OBJECTIVE The purpose of this study was to evaluate the usefulness of ultrasound in the preoperative workup of peripheral nerve lesions and illustrate how nerve ultrasonography can be integrated in routine clinical and neurophysiological evaluation and in the management of focal peripheral nerve injuries. The diagnostic role and therapeutic implications of ultrasonography for different neuropathies are described. METHODS The authors analyzed the use of ultrasound in 119 entrapment, tumoral, posttraumatic, or postsurgical nerve injuries of limbs evaluated in 108 patients during 2013 and 2014. All patients were candidates for surgery, and in all cases the evaluation included clinical examination, electrodiagnostic studies (nerve conduction study and electromyography), and ultrasound nerve study. Ultrasound was used to explore the nerve fascicular echotexture, continuity, and surrounding tissues. The maximum cross-sectional area (CSA) and the presence of epineurial hyperechogenicity or intraneural hyper- or hypoechogenicity, of anatomical anomalies, dynamic nerve dislocations, or compressions were recorded. The concordance rate of neurophysiological and ultrasonographic data was analyzed, classifying ultrasound findings as confirming, contributive, or nonconfirming with respect to electrodiagnostic data. The correlation between maximum nerve CSA and neurophysiological severity degree in entrapment syndromes was statistically analyzed. RESULTS Ultrasonography confirmed electrodiagnostic findings in 36.1% of cases and showed a contributive role in the diagnosis and surgical planning in 53.8% of all cases; the findings were negative ("nonconfirming") in only 10.1% of the patients. In 16% of cases, ultrasound was not only contributive, but had a key diagnostic role in the presence of doubtful electrodiagnostic findings. The contributive role differed according to etiology, being higher for tumors (100%) and for posttraumatic or postsurgical neuropathies (72.2%) than for

  18. Effect of local anesthetics on perioperative oxidative stress injury and nerve conduction function in diabetic or non-diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Dong-Yang Zhu; Ping Li

    2016-01-01

    Objective:To study the effect of local anesthetics on perioperative oxidative stress injury and nerve conduction function in diabetic or non-diabetic patients.Methods:A total of 100 c diabetic patients and 100 non-diabetic patients who received selective surgery under intraspinal block anesthesia were selected as the research subjects, diabetic patients were selected as observation group, non-diabetic patients were selected as control group, serum and urine were collected respectively before and after operation, and reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), 8-hydroxy-2 deoxyguanosine (8-OHdG) levels were determined; electromyography was carried out, and the motor nerve conduction velocity of median nerve and common peroneal nerve as well as sensory nerve conduction velocity of median nerve and superficial peroneal nerve were determined.Results:One day before operation and 1 day after operation, serum ROS and MDA levels and urine 8-OHdG levels of observation group were significantly higher than those of control group, and serum SOD levels were significantly lower than those of control group; ROS, MDA, SOD and 8-OHdG levels of observation group before and after operation changed more significantly than those of control group. 1 week after operation, MNCV of median nerve and common peroneal nerve as well as SNCV of median nerve and superficial peroneal nerve of observation group were significantly lower than those before operation, and MNCV of median nerve and common peroneal nerve as well as SNCV of median nerve and superficial peroneal nerve of control group were not significantly different from those before operation.Conclusions: Local anesthetics can cause peripheral nerve conduction function impairment in diabetic patients, and the possible molecular mechanism is that local anesthetics activate perioperative oxidative stress more significantly in diabetic patients than in non-diabetic patients.

  19. Reflections on the contributions of Harvey Cushing to the surgery of peripheral nerves.

    Science.gov (United States)

    Tubbs, R Shane; Patel, Neal; Nahed, Brian Vala; Cohen-Gadol, Aaron A; Spinner, Robert J

    2011-05-01

    By the time Harvey Cushing entered medical school, nerve reconstruction techniques had been developed, but peripheral nerve surgery was still in its infancy. As an assistant surgical resident influenced by Dr. William Halsted, Cushing wrote a series of reports on the use of cocaine for nerve blocks. Following his residency training and a hiatus to further his clinical interests and intellectual curiosity, he traveled to Europe and met with a variety of surgeons, physiologists, and scientists, who likely laid the groundwork for Cushing's increased interest in peripheral nerve surgery. Returning to The Johns Hopkins Hospital in 1901, he began documenting these surgeries. Patient records preserved at Yale's Cushing Brain Tumor Registry describe Cushing's repair of ulnar and radial nerves, as well as his exploration of the brachial plexus for nerve repair or reconstruction. The authors reviewed Harvey Cushing's cases and provide 3 case illustrations not previously reported by Cushing involving neurolysis, nerve repair, and neurotization. Additionally, Cushing's experience with facial nerve neurotization is reviewed. The history, physical examination, and operative notes shed light on Cushing's diagnosis, strategy, technique, and hence, his surgery on peripheral nerve injury. These contributions complement others he made to surgery of the peripheral nervous system dealing with nerve pain, entrapment, and tumor.

  20. Microbial Cretaceous park: biodiversity of microbial fossils entrapped in amber

    Science.gov (United States)

    Martín-González, Ana; Wierzchos, Jacek; Gutiérrez, Juan C.; Alonso, Jesús; Ascaso, Carmen

    2009-05-01

    Microorganisms are the most ancient cells on this planet and they include key phyla for understanding cell evolution and Earth history, but, unfortunately, their microbial records are scarce. Here, we present a critical review of fossilized prokaryotic and eukaryotic microorganisms entrapped in Cretaceous ambers (but not exclusively from this geological period) obtained from deposits worldwide. Microbiota in ambers are rather diverse and include bacteria, fungi, and protists. We comment on the most important microbial records from the last 25 years, although it is not an exhaustive bibliographic compilation. The most frequently reported eukaryotic microfossils are shells of amoebae and protists with a cell wall or a complex cortex. Likewise, diverse dormant stages (palmeloid forms, resting cysts, spores, etc.) are abundant in ambers. Besides, viral and protist pathogens have been identified inside insects entrapped in amber. The situation regarding filamentous bacteria and fungi is quite confusing because in some cases, the same record was identified consecutively as a member of these phylogenetically distant groups. To avoid these identification errors in the future, we propose to apply a more resolute microscopic and analytical method in amber studies. Also, we discuss the most recent findings about ancient DNA repair and bacterial survival in remote substrates, which support the real possibility of ancient DNA amplification and bacterial resuscitation from Cretaceous resins.

  1. Electrochemical Properties of Carbon Nanoparticles Entrapped in Silica Matrix

    Science.gov (United States)

    Bok, Sangho; Lubguban, Arnold A.; Gao, Yuanfang; Bhattacharya, Shantanu; Korampally, Venu; Hossain, Maruf; Gillis, Kevin D.; Gangopadhyay, Shubhra

    2008-01-01

    Carbon-based electrode materials have been widely used for many years for electrochemical charge storage, energy generation, and catalysis. We have developed an electrode material with high specific capacitance by entrapping graphite nanoparticles into a sol-gel network. Films from the resulting colloidal suspensions were highly porous due to the removal of the entrapped organic solvents from sol-gel matrix giving rise to high Brunauer-Emmett-Teller (BET) specific surface areas (654 m2/g) and a high capacitance density (∼37 F/g). An exponential increase of capacitance was observed with decreasing scan rates in cyclic voltammetry studies on these films suggesting the presence of pores ranging from micro (< 2 nm) to mesopores. BET surface analysis and scanning electron microscope images of these films also confirmed the presence of the micropores as well as mesopores. A steep drop in the double layer capacitance with polar electrolytes was observed when the films were rendered hydrophilic upon exposure to a mild oxygen plasma. We propose a model whereby the microporous hydrophobic sol-gel matrix perturbs the hydration of ions which moves ions closer to the graphite nanoparticles and consequently increase the capacitance of the film. PMID:18953420

  2. Immunological Effect of Subunit Influenza Vaccine Entrapped by Liposomes

    Institute of Scientific and Technical Information of China (English)

    SHUI-HUA ZHANG; JIA-XU LIANG; SHU-YAN DAI; XIAO-LIN QIU; YAN-RONG YI; YUN PAN

    2009-01-01

    Objective To elevate the immunological effect of subunit influenza vaccine in infants and aged people (over 60) using liposomal adjuvant in the context of its relatively low immunity and to investigate the relation between vaccine antigens and liposomal characteristics. Methods Several formulations of liposomal subunit influenza vaccine were prepared. Their relevant characteristics were investigated to optimize the preparation method. Antisera obtained from immunizinged mice were used to evaluate the antibody titers of various samples by HI and ELISA. Results Liposomal trivalent influenza vaccine prepared by film evaporation in combinedation with freeze-drying significantly increased its immunological effect in SPF Balb/c mice. Liposomal vaccine stimulated the antibody titer of H3N2, H1N1, and B much stronger than conventional influenza vaccine. As a result, liposomal vaccine (mean size: 4.5-5.5 μm, entrapment efficiency: 30%-40%) significantly increased the immunological effect of subunit influenza vaccine. Conclusion The immune effect of liposomal vaccine depends on different antigens, and enhanced immunity is not positively correlated with the mean size of liposome or its entrapped efficiency.

  3. Entrapment in phospholipid vesicles quenches photoactivity of quantum dots.

    Science.gov (United States)

    Generalov, Roman; Kavaliauskiene, Simona; Westrøm, Sara; Chen, Wei; Kristensen, Solveig; Juzenas, Petras

    2011-01-01

    Quantum dots have emerged with great promise for biological applications as fluorescent markers for immunostaining, labels for intracellular trafficking, and photosensitizers for photodynamic therapy. However, upon entry into a cell, quantum dots are trapped and their fluorescence is quenched in endocytic vesicles such as endosomes and lysosomes. In this study, the photophysical properties of quantum dots were investigated in liposomes as an in vitro vesicle model. Entrapment of quantum dots in liposomes decreases their fluorescence lifetime and intensity. Generation of free radicals by liposomal quantum dots is inhibited compared to that of free quantum dots. Nevertheless, quantum dot fluorescence lifetime and intensity increases due to photolysis of liposomes during irradiation. In addition, protein adsorption on the quantum dot surface and the acidic environment of vesicles also lead to quenching of quantum dot fluorescence, which reappears during irradiation. In conclusion, the in vitro model of phospholipid vesicles has demonstrated that those quantum dots that are fated to be entrapped in endocytic vesicles lose their fluorescence and ability to act as photosensitizers.

  4. Covalently Cross-Linked Arabinoxylans Films for Debaryomyces hansenii Entrapment

    Directory of Open Access Journals (Sweden)

    Ramsés González-Estrada

    2015-06-01

    Full Text Available In the present study, wheat water extractable arabinoxylans (WEAX were isolated and characterized, and their capability to form covalently cross-linked films in presence of Debaryomyces hansenii was evaluated. WEAX presented an arabinose to xylose ratio of 0.60, a ferulic acid and diferulic acid content of 2.1 and 0.04 µg∙mg−1 WEAX, respectively and a Fourier Transform Infra-Red (FT-IR spectrum typical of WEAX. The intrinsic viscosity and viscosimetric molecular weight values for WEAX were 3.6 dL∙g−1 and 440 kDa, respectively. The gelation of WEAX (1% w/v with and without D. hansenii (1 × 107 CFU∙cm−2 was rheologically investigated by small amplitude oscillatory shear. The entrapment of D. hansenii decreased gel elasticity from 1.4 to 0.3 Pa, probably by affecting the physical interactions between WEAX chains. Covalently cross-linked WEAX films containing D. hansenii were prepared by casting. Scanning electron microscopy images show that WEAX films containing D. hansenii were porous and consisted of granular-like and fibre microstructures. Average tensile strength, elongation at break and Young’s modulus values dropped when D. hansenii was present in the film. Covalently cross-lined WEAX containing D. hansenii could be a suitable as a functional entrapping film.

  5. Entrapment in phospholipid vesicles quenches photoactivity of quantum dots

    Directory of Open Access Journals (Sweden)

    Generalov R

    2011-09-01

    Full Text Available Roman Generalov1,2, Simona Kavaliauskiene1, Sara Westrøm1, Wei Chen3, Solveig Kristensen2, Petras Juzenas11Department of Radiation Biology, Institute for Cancer Research, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway; 2School of Pharmacy, University of Oslo, Oslo, Norway; 3Department of Physics, The University of Texas at Arlington, Arlington, TX, USAAbstract: Quantum dots have emerged with great promise for biological applications as fluorescent markers for immunostaining, labels for intracellular trafficking, and photosensitizers for photodynamic therapy. However, upon entry into a cell, quantum dots are trapped and their fluorescence is quenched in endocytic vesicles such as endosomes and lysosomes. In this study, the photophysical properties of quantum dots were investigated in liposomes as an in vitro vesicle model. Entrapment of quantum dots in liposomes decreases their fluorescence lifetime and intensity. Generation of free radicals by liposomal quantum dots is inhibited compared to that of free quantum dots. Nevertheless, quantum dot fluorescence lifetime and intensity increases due to photolysis of liposomes during irradiation. In addition, protein adsorption on the quantum dot surface and the acidic environment of vesicles also lead to quenching of quantum dot fluorescence, which reappears during irradiation. In conclusion, the in vitro model of phospholipid vesicles has demonstrated that those quantum dots that are fated to be entrapped in endocytic vesicles lose their fluorescence and ability to act as photosensitizers.Keywords: fluorescence lifetime, free radicals, liposomes, lipodots, reactive oxygen species

  6. End-to-side neurorrhaphy as a salvage procedure for irreparable nerve injuries. Technical note.

    Science.gov (United States)

    Oğün, Tunç C; Ozdemir, Mustafa; Senaran, Hakan; Ustün, Mehmet E

    2003-07-01

    After a few reports on end-to-side nerve repair at the beginning of the last century, the technique was put aside until its recent reintroduction. The authors present their results in three patients with median nerve defects that were between 15 and 22 cm long and treated using end-to-side median-to-ulnar neurorrhaphy through an epineurial window. The follow-up times were between 32 and 38 months. Sensory evaluation involved superficial touch, pinprick, and two-point discrimination tests. Motor evaluation was completed by assessing the presence of opposition and by palpating the abductor pollicis brevis muscle. Sensory recovery was observed in all patients in the median nerve dermatome, and motor recovery was absent, except in Case 1. End-to-side nerve repair can be a viable alternative to nerve grafting in patients with long gaps between the ends of the injured nerve.

  7. Effects of Pulsed Ultrasound Therapy on Sensory Nerve Conduction Parameters and the Pain Threshold Perceptions in Humans.

    Science.gov (United States)

    Schuhfried, Othmar; Vukanovic, Damir; Kollmann, Christian; Pieber, Karin; Paternostro-Sluga, Tatjana

    2017-08-01

    Therapeutic ultrasound is an often-used clinical modality in the nonsurgical treatment of entrapment neuropathies. To date, the possible mechanism of action of pulsed ultrasound therapy on the peripheral nerve in the treatment of entrapment neuropathies is unclear. To examine the effects of pulsed ultrasound therapy on peripheral nerve conduction parameters. A prospective, randomized, single blind, crossover study. Outpatient clinic of a university department of physical medicine and rehabilitation. Twelve healthy volunteers between 22 and 38 years of age (8 male, 4 female). Each patient (blinded) received ultrasound therapy (1W/cm(2), pulsed: 1:5; over the course of the superficial branch of the radial nerve of the nondominant arm) and placebo (intensity: zero). The interval between the individual interventions was 1 week. The sensory nerve conduction velocity, sensory nerve action potential, supramaximal stimulation intensity of the sensory fibers of the radial nerve, and the pressure pain threshold in the sensory area of the radial nerve before and after an ultrasound-therapy and placebo intervention. To compare the results of the intervention with placebo, a paired-samples t test was applied. Compared with placebo, a significant increase after pulsed ultrasound therapy was found for the supramaximal stimulation intensity (P = .02). For the other primary outcome parameters, a significant difference was not found. The immediate effect of pulsed ultrasound therapy on a sensory nerve is minimal. Therefore, the previously reported benefit of pulsed ultrasound therapy in entrapment neuropathies might be not due to its effect on the sensory nerve. I. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  8. Retrobulbar diameter of optic nerve in glaucoma

    Directory of Open Access Journals (Sweden)

    Stefanović Ivan

    2009-01-01

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

  9. Occupational exposure to pesticides and nerve conduction studies among Korean farmers.

    Science.gov (United States)

    Park, Su Kyeong; Kong, Kyoung Ae; Cha, Eun Shil; Lee, Young Joo; Lee, Gyu Taek; Lee, Won Jin

    2012-01-01

    This study aimed to determine whether occupational exposure to pesticides was associated with decreased nerve conduction studies among farmers. On 2 separate occasions, the authors performed a cross-sectional study of a group of 31 male farmers who periodically applied pesticides. The study included questionnaire interviews and nerve conduction studies on the median, ulnar, posterior tibial, peroneal, and sural nerves. Although all mean values remained within laboratory normal limits, significant differences between the first and second tests were found in sensory conduction velocities on the median and sural nerves, and motor conduction velocities on the posterior tibial nerve. Lifetime days of pesticide application was negatively associated with nerve conduction velocities at most nerves after adjusting for potential confounders. These findings may reflect a link between occupational pesticide exposure and peripheral neurophysiologic abnormality that deserves further evaluation.

  10. Vapor intrusion from entrapped NAPL sources and groundwater plumes

    Science.gov (United States)

    Illangasekare, Tissa H.; Sakaki, Toshihiro; Christ, John; Petri, Bejamin; Sauck, Carolyn; Cihan, Abdullah

    2010-05-01

    Volatile organic compounds (VOC) are commonly found entrapped as non-aqueous phase liquids (NAPLs) in the soil pores or dissolved in groundwater at industrial waste sites and refineries. Vapors emitted from these contaminant sources readily disperse into the atmosphere, into air-filled void spaces within the soil, and migrate below surface structures, leading to the intrusion of contaminant vapors into indoor air through basements and other underground structures. This process referred to as vapor intrusion (VI) represents a potential threat to human health, and is a possible exposure pathway of concern to regulatory agencies. To assess whether this exposure pathway is present, remediation project managers often rely in part on highly simplified screening level models that do not take into consideration the complex flow dynamics controlled by subsurface heterogeneities and soil moisture conditions affected by the mass and heat flux boundary conditions at the land/atmospheric interface. A research study is under way to obtain an improved understanding of the processes and mechanisms controlling vapor generation from entrapped NAPL sources and groundwater plumes, their subsequent migration through the subsurface, and their attenuation in naturally heterogeneous vadose zones under various natural physical, climatic, and geochemical conditions. Experiments conducted at multiple scales will be integrated with analytical and numerical modeling and field data to test and validate existing VI theories and models. A set of preliminary experiments where the fundamental process of vapor generation from entrapped NAPL sources and dissolved plumes under fluctuating water were investigated in small cells and two-dimensional test tanks. In another task, intermediate scale experiments were conducted to generate quantitative data on how the heat and mass flux boundary conditions control the development of dynamic VI pathways. The data from the small cell and tank experiments were

  11. Medians and means in Riemannian geometry: existence, uniqueness and computation

    CERN Document Server

    Arnaudon, Marc; Yang, Le

    2011-01-01

    This paper is a short summary of our recent work on the medians and means of probability measures in Riemannian manifolds. Firstly, the existence and uniqueness results of local medians are given. In order to compute medians in practical cases, we propose a subgradient algorithm and prove its convergence. After that, Fr\\'echet medians are considered. We prove their statistical consistency and give some quantitative estimations of their robustness with the aid of upper curvature bounds. We also show that, in compact Riemannian manifolds, the Fr\\'echet medians of generic data points are always unique. Stochastic and deterministic algorithms are proposed for computing Riemannian p-means. The rate of convergence and error estimates of these algorithms are also obtained. Finally, we apply the medians and the Riemannian geometry of Toeplitz covariance matrices to radar target detection.

  12. Lung ICAM-1 and ICAM-2 support spontaneous intravascular effector lymphocyte entrapment but are not required for neutrophil entrapment or emigration inside endotoxin-inflamed lungs.

    Science.gov (United States)

    Petrovich, Ekaterina; Feigelson, Sara W; Stoler-Barak, Liat; Hatzav, Miki; Solomon, Adam; Bar-Shai, Amir; Ilan, Neta; Li, Jin-Ping; Engelhardt, Britta; Vlodavsky, Israel; Alon, Ronen

    2016-05-01

    The pulmonary vasculature constitutively expresses the integrin lymphocyte function-associated antigen-1 ligands intercellular adhesion molecule (ICAM)-1 and -2. In this study, effector T cells were temporarily entrapped by the lung vasculature on their way to inflamed lymph nodes, and this entrapment was strongly reduced in ICAM-1 and -2 double-deficient mice (79 and 86% reduction for CD8(+) and CD4(+) effectors, respectively, compared with wild-type mice). Although the pulmonary vasculature has been suggested to be masked by the heparan sulfate-containing glycocalyx, which is susceptible to heparanase-mediated shedding, lung and lymphocyte heparanase have been found to be unnecessary for this entrapment. Systemic LPS induced rapid neutrophil entrapment in the lung vasculature, but in contrast to T-cell entrapment, this sequestration was ICAM-1, ICAM-2, and heparanase independent. Furthermore, neutrophil migration into the bronchoalveolar space induced by LPS inhalation and LPS-induced leakage of red blood cells into this space were not dependent on lung ICAMs or heparanase activity. Nevertheless, heparanase was critical for neutrophil accumulation in smoke-exposed lungs. Our results indicate that, whereas T cells use ICAM-1 and -2 for temporary pulmonary entrapment, neutrophils get sequestered and extravasate into inflamed lungs independent of ICAMs. This is the first demonstration that the pulmonary vasculature is differentially recognized by T cells and neutrophils.-Petrovich, E., Feigelson, S. W., Stoler-Barak, L., Hatzav, M., Solomon, A., Bar-Shai, A., Ilan, N., Li, J.-P., Engelhardt, B., Vlodavsky, I., Alon, R. Lung ICAM-1 and ICAM-2 support spontaneous intravascular effector lymphocyte entrapment but are not required for neutrophil entrapment or emigration inside endotoxin-inflamed lungs.

  13. Some properties of Fr\\'echet medians in Riemannian manifolds

    CERN Document Server

    Yang, Le

    2011-01-01

    The consistency of Fr\\'echet medians is proved for probability measures in proper metric spaces. In the context of Riemannian manifolds, assuming that the probability measure has more than a half mass lying in a convex ball and verifies some concentration conditions, the positions of its Fr\\'echet medians are estimated. It is also shown that, in compact Riemannian manifolds, the Fr\\'echet sample medians of generic data points are always unique.

  14. Nerve conduction velocity

    Science.gov (United States)

    ... to measure the speed of the nerve signals. Electromyography (recording from needles placed into the muscles) is ... Often, the nerve conduction test is followed by electromyography (EMG). In this test, needles are placed into ...

  15. Common peroneal nerve dysfunction

    Science.gov (United States)

    ... toe-out movements Tests of nerve activity include: Electromyography (EMG, a test of electrical activity in muscles) Nerve ... Peroneal neuropathy. In: Preston DC, Shapiro BE, eds. Electromyography and Neuromuscular Disorders . 3rd ed. Philadelphia, PA: Elsevier; ...

  16. Acoustical and optical characterization of air entrapment in piezo-driven inkjet printheads

    NARCIS (Netherlands)

    de Jong, J.; de Jong, J.; Reinten, H.; van den Berg, M.; Wijshoff, H.; Wijshoff, H.; Versluis, Andreas Michel; de Bruin, G.J.; de Jong, N.; Lohse, Detlef

    2005-01-01

    Air bubbles can cause nozzle failures in piezo-driven inkjet printheads [1]. The time development of the entrapped air bubbles has experimentally been studied [2]. It was found that the air bubble has a radius of 5μm just after the entrapment. The bubble then grows by rectified diffusion due to the

  17. Irradiation modes' impact on radical entrapment in photoactive resins.

    Science.gov (United States)

    Leprince, J G; Lamblin, G; Devaux, J; Dewaele, M; Mestdagh, M; Palin, W M; Gallez, B; Leloup, G

    2010-12-01

    Different irradiation protocols are proposed to polymerize dental resins, and discordances remain concerning their impact on the material. To improve this knowledge, we studied entrapment of free radicals in unfilled Bis-GMA/TEGDMA (50:50 wt%) resin after light cure. The tested hypothesis was that various irradiation parameters (curing time, irradiance, and radiant exposure) and different irradiation modes (continuous and pulse-delay) led to different amounts of trapped free radicals. The analysis of cured samples (n = 3) by electron paramagnetic resonance (EPR) revealed that the concentrations of trapped free radicals significantly differed according to the curing protocol. When continuous modes with similar radiant exposure were compared, higher concentrations of trapped free radicals were measured for longer times with lower irradiance. Concerning pulse modes, the delay had no influence on trapped radical concentration. These results give new insights into the understanding of the photopolymerization process and highlight the relevance of using EPR when studying polymerization of dimethacrylate-based materials.

  18. Entrapment and Enmeshment Schemes Used by Sex Traffickers.

    Science.gov (United States)

    Reid, Joan A

    2016-09-01

    Emerging research suggests that sex traffickers/pimps control the majority of trafficked girls in the United States. The youthfulness of these victims and their lack of psychosocial maturity severely diminish their ability to detect exploitative motives or withstand manipulation of traffickers. A review of 43 cases of sexually exploited girls involving non-relative traffickers and 10 semi-structured interviews with social service providers revealed numerous scripts and schemes used by sex traffickers to entrap and entangle victims including boyfriend/lover scripts, ruses involving debt bondage, friendship or faux-family scripts, threats of forced abortion or to take away children, and coerced co-offending. These findings inform potential prevention efforts and highlight the need for multi-systemic, victim-centered approaches to intervention.

  19. A BOD monitoring disposable reactor with alginate-entrapped bacteria.

    Science.gov (United States)

    Villalobos, Patricio; Acevedo, Cristian A; Albornoz, Fernando; Sánchez, Elizabeth; Valdés, Erika; Galindo, Raúl; Young, Manuel E

    2010-10-01

    Biochemical oxygen demand (BOD) is a measure of the amount of dissolved oxygen that is required for the biochemical oxidation of the organic compounds in 5 days. New biosensor-based methods have been conducted for a faster determination of BOD. In this study, a mathematical model to evaluate the feasibility of using a BOD sensor, based on disposable alginate-entrapped bacteria, for monitoring BOD in situ was applied. The model considers the influences of alginate bead size and bacterial concentration. The disposable biosensor can be adapted according to specific requirements depending on the organic load contained in the wastewater. Using Klein and Washausen parameter in a Lineweaver-Burk plot, the glucose diffusivity was calculated in 6.4 × 10(-10) (m2/s) for beads of 1 mm in diameter and slight diffusion restrictions were observed (n = 0.85). Experimental results showed a correlation (p BOD test. The biosensor response was representative of BOD.

  20. Phenol removal by soluble and alginate entrapped turnip peroxidase

    Directory of Open Access Journals (Sweden)

    Ahmed Azizi

    2014-12-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 This paper is a comparative study of phenol biodegradation by soluble and alginate entrapped turnip (Brassica rapa peroxidase. The effects of relevant factors on the process such as pH, temperature, concentration of H2O2, phenol concentration, enzyme activity and contact time were evaluated in order to optimize the conditions for maximum phenol removal.  Results showed that the obtained average removal yield under optimal conditions was 93%.  The process duration was 3 hours. The reaction is conducted in aqueous medium under optimal pH 7 and temperature of 40 °C. The highest removal percentage was obtained for phenol concentrations of 80 and 46 mg L-1 with soluble and entrapped enzyme respectively.  /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  1. Extracellular entrapment and degradation of single-walled carbon nanotubes

    Science.gov (United States)

    Farrera, Consol; Bhattacharya, Kunal; Lazzaretto, Beatrice; Andón, Fernando T.; Hultenby, Kjell; Kotchey, Gregg P.; Star, Alexander; Fadeel, Bengt

    2014-05-01

    Neutrophils extrude neutrophil extracellular traps (NETs) consisting of a network of chromatin decorated with antimicrobial proteins to enable non-phagocytic killing of microorganisms. Here, utilizing a model of ex vivo activated human neutrophils, we present evidence of entrapment and degradation of carboxylated single-walled carbon nanotubes (SWCNTs) in NETs. The degradation of SWCNTs was catalyzed by myeloperoxidase (MPO) present in purified NETs and the reaction was facilitated by the addition of H2O2 and NaBr. These results show that SWCNTs can undergo acellular, MPO-mediated biodegradation and imply that the immune system may deploy similar strategies to rid the body of offending microorganisms and engineered nanomaterials.Neutrophils extrude neutrophil extracellular traps (NETs) consisting of a network of chromatin decorated with antimicrobial proteins to enable non-phagocytic killing of microorganisms. Here, utilizing a model of ex vivo activated human neutrophils, we present evidence of entrapment and degradation of carboxylated single-walled carbon nanotubes (SWCNTs) in NETs. The degradation of SWCNTs was catalyzed by myeloperoxidase (MPO) present in purified NETs and the reaction was facilitated by the addition of H2O2 and NaBr. These results show that SWCNTs can undergo acellular, MPO-mediated biodegradation and imply that the immune system may deploy similar strategies to rid the body of offending microorganisms and engineered nanomaterials. Electronic supplementary information (ESI) available: Suppl. Fig. 1 - length distribution of SWCNTs; suppl. Fig. 2 - characterization of pristine vs. oxidized SWCNTs; suppl. Fig. 3 - endotoxin evaluation; suppl. Fig. 4 - NET characterization; suppl. Fig. 5 - UV-Vis/NIR analysis of biodegradation of oxidized SWCNTs; suppl. Fig. 6 - cytotoxicity of partially degraded SWCNTs. See DOI: 10.1039/c3nr06047k

  2. The Physics of Nerves

    CERN Document Server

    Heimburg, Thomas

    2010-01-01

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

  3. Transient Flow in Rapidly Filling Air-Entrapped Pipelines with Moving Boundaries

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yongliang; K. Vairavamoorthy

    2006-01-01

    A mathematical model is presented for transient flow in a rapidly filling pipeline with an entrapped air pocket. The influence of transient shear stress between the pipe wall and the flowing fluid is taken into account. A coordinate transformation technique is employed to generate adaptive moving meshes for the multiphase flow system as images of the time-independent computational meshes in auxiliary domains. The method of characteristics is used to reduce the coupled nonlinear hyperbolic partial differential equations governing the motion of the filling fluid, entrapped air, and blocking fluid to ordinary differential equations.Numerical solution of resulting equations shows that the transient shear stresses have only a small damping effect on the pressure fluctuations. The peak pressure in the entrapped air pocket decreases significantly with increasing initial entrapped air volume, but decreases slightly with increasing initial entrapped air pressure.

  4. Water modeling of mold powder entrapment in slab continuous casting mold

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The optimal parameters were determined by the water modeling of slab casting. It was found that there are mainly three types of mold powder entrapment in slab continuous casting, i.e., the entrapment caused by the shearing flow near the narrow face of mold, the entrapment caused by vortexes around the submerged entry nozzle (SEN), and the entrapment caused by the Ar bubbling.Both the velocity of the surface flow and the level fluctuation of the liquids are enlarged with increasing the casting speed, reducing the submersion depth of SEN, decreasing the downward angles of the nozzle outlets, and increasing the Ar flowrate, all of which increase the tendency of mold powder entrapment. Among the four above-mentioned factors, casting speed has the largest effect.

  5. Adaptive Threshold Median Filter for Multiple-Impulse Noise

    Institute of Scientific and Technical Information of China (English)

    JIANG Bo; HUANG Wei

    2007-01-01

    Attenuating the noises plays an essential role in the image processing. Almost all the traditional median filters concern the removal of impulse noise having a single layer, whose noise gray level value is constant. In this paper, a new adaptive median filter is proposed to handle those images corrupted not only by single layer noise. The adaptive threshold median filter(ATMF) has been developed by combining the adaptive median filter (AMF) and two dynamic thresholds. Because of the dynamic threshold being used, the ATMF is able to balance the removal of the multiple-impulse noise and the quality of image. Comparison of the proposed method with traditional median filters is provided. Some visual examples are given to demonstrate the performance of the proposed Filter.

  6. Head rotation and sound image localization in the median plane

    Institute of Scientific and Technical Information of China (English)

    RAO Dan; XIE Bosun

    2005-01-01

    The effect of head rotation on median plane sound source (or image) localization is studied. It is suggested that, at low frequency, the change of interaural time difference (ITD) caused by head rotation supplies information for determining sound source direction in the median plane. Based on the suggestion, the summed sound image localization equations for multiple loudspeakers arranged in the median plane are derived. Especially, for a pair of loudspeakers arranged front-back symmetrically in the median plane, the localization equations are similar to that of stereophonic sound in horizontal plane. A sound image localization experiment was carried out to prove the theoretical analysis. The results of this paper are not only available to virtual spatial auditory, but also supply a quantitative validation of the hypothesis that head rotation is a cue for sound source localization in the median plane at low frequency.

  7. Post-natal development of the median eminence of the guinea pig.

    Science.gov (United States)

    Silverman, A J; Desnoyers, P

    1975-11-01

    The ultrastructure of the median eminence of neonatal (newborn) 1-, 3-, 5-, and 10-day old) and adult guinea pigs was studied to determine the dynamic changes occurring in this structure during early life. At birth the portal vasculature consists of the Mantelplexus and a few, non-fenestrated capillary loops. The number of ansae and the degree of fenestration increase rapidly after birth. The abundance of cytoplasmic and ciliary projections into the ventricular recess and the large numbers of organelles indicate that the ependymal cells are more active in the neonatal period than in the adult male. Moreover, the ependymal endfeet cover most of the surface area of the primary portal plexus during this time. The neuronal layers of the median eminence are difficult to distinguish at birth due to the lack of myelinated fibers in the zona interna. Significant myelination appears on day 3 but is not complete until day 10. There is a progressive increase in the numbers of Herring bodies and large neuro-secretory granules (1,500-1,700 A) during this same time period. In the zona externa, few nerve terminals abut on the perivascular space until day 3. Increases in numbers of granules per axon profile were noted for each day after birth. Despite the relatively long gestation period of the guinea pig (68-72 days), the morphologic appearance of the median eminence at birth suggests that the neurovascular link controlling anterior pituitary function is not yet complete.

  8. A case of isolated abducens nerve paralysis in maxillofacial trauma

    Science.gov (United States)

    Keskin, Elif Seda; Keskin, Ekrem; Atik, Bekir; Koçer, Abdülkadir

    2015-01-01

    Nervus abducens is a pure motor nerve located in the pons. It retracts the eyeball laterally by stimulating rectus lateralis muscle. In case of their paralysis, diplopia and restriction in the eye movements while looking sideways, are seen. Since the same signs are seen due to the muscle entrapment in blowout fractures, its differential diagnosis has importance in terms of the treatment protocol and avoiding unnecessary operations. In this article, we present a 22-year-old male patient who was referred to our department due to the prediagnosis of blowout fracture following maxillofacial trauma. However, he was diagnosed with abducens nerve paralysis after the consultations and analysis and his restriction of movement was resolved via systemic steroid treatment instead of unnecessary operation. PMID:26981484

  9. Optic nerve oxygenation

    DEFF Research Database (Denmark)

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

    2005-01-01

    at similar levels of perfusion pressure. The levels of perfusion pressure that lead to optic nerve hypoxia in the laboratory correspond remarkably well to the levels that increase the risk of glaucomatous optic nerve atrophy in human glaucoma patients. The risk for progressive optic nerve atrophy in human...... glaucoma patients is six times higher at a perfusion pressure of 30 mmHg, which corresponds to a level where the optic nerve is hypoxic in experimental animals, as compared to perfusion pressure levels above 50 mmHg where the optic nerve is normoxic. Medical intervention can affect optic nerve oxygen......-oxygenase inhibitor, indomethacin, which indicates that prostaglandin metabolism plays a role. Laboratory studies suggest that carbonic anhydrase inhibitors might be useful for medical treatment of optic nerve and retinal ischemia, potentially in diseases such as glaucoma and diabetic retinopathy. However, clinical...

  10. Optic nerve oxygenation

    DEFF Research Database (Denmark)

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

    2005-01-01

    at similar levels of perfusion pressure. The levels of perfusion pressure that lead to optic nerve hypoxia in the laboratory correspond remarkably well to the levels that increase the risk of glaucomatous optic nerve atrophy in human glaucoma patients. The risk for progressive optic nerve atrophy in human...... glaucoma patients is six times higher at a perfusion pressure of 30 mmHg, which corresponds to a level where the optic nerve is hypoxic in experimental animals, as compared to perfusion pressure levels above 50 mmHg where the optic nerve is normoxic. Medical intervention can affect optic nerve oxygen......-oxygenase inhibitor, indomethacin, which indicates that prostaglandin metabolism plays a role. Laboratory studies suggest that carbonic anhydrase inhibitors might be useful for medical treatment of optic nerve and retinal ischemia, potentially in diseases such as glaucoma and diabetic retinopathy. However, clinical...

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  12. Stretch-induced nerve injury: a proposed technique for the study of nerve regeneration and evaluation of the influence of gabapentin on this model

    Directory of Open Access Journals (Sweden)

    J.A. Machado

    2013-11-01

    Full Text Available The rat models currently employed for studies of nerve regeneration present distinct disadvantages. We propose a new technique of stretch-induced nerve injury, used here to evaluate the influence of gabapentin (GBP on nerve regeneration. Male Wistar rats (300 g; n=36 underwent surgery and exposure of the median nerve in the right forelimbs, either with or without nerve injury. The technique was performed using distal and proximal clamps separated by a distance of 2 cm and a sliding distance of 3 mm. The nerve was compressed and stretched for 5 s until the bands of Fontana disappeared. The animals were evaluated in relation to functional, biochemical and histological parameters. Stretching of the median nerve led to complete loss of motor function up to 12 days after the lesion (P<0.001, compared to non-injured nerves, as assessed in the grasping test. Grasping force in the nerve-injured animals did not return to control values up to 30 days after surgery (P<0.05. Nerve injury also caused an increase in the time of sensory recovery, as well as in the electrical and mechanical stimulation tests. Treatment of the animals with GBP promoted an improvement in the morphometric analysis of median nerve cross-sections compared with the operated vehicle group, as observed in the area of myelinated fibers or connective tissue (P<0.001, in the density of myelinated fibers/mm2 (P<0.05 and in the degeneration fragments (P<0.01. Stretch-induced nerve injury seems to be a simple and relevant model for evaluating nerve regeneration.

  13. Normal and sonographic anatomy of selected peripheral nerves. Part II: Peripheral nerves of the upper limb

    Directory of Open Access Journals (Sweden)

    Berta Kowalska

    2012-06-01

    Full Text Available The ultrasonographic examination is frequently used for imaging peripheral nerves. It serves to supplement the physical examination, electromyography, and magnetic resonance imaging. As in the case of other USG imaging studies, the examination of peripheral nerves is non-invasive, well-tolerated by patients, and relatively inexpensive. Part I of this article series described in detail the characteristic USG picture of peripheral nerves and the proper examination technique, following the example of the median nerve. This nerve is among the most often examined peripheral nerves of the upper limb. This part presents describes the normal anatomy and ultrasound picture of the remaining large nerve branches in the upper extremity and neck – the spinal accessory nerve, the brachial plexus, the suprascapular, axillary, musculocutaneous, radial and ulnar nerves. Their normal anatomy and ultrasonographic appearance have been described, including the division into individual branches. For each of them, specific reference points have been presented, to facilitate the location of the set trunk and its further monitoring. Sites for the application of the ultrasonographic probe at each reference point have been indicated. In the case of the ulnar nerve, the dynamic component of the examination was emphasized. The text is illustrated with images of probe positioning, diagrams of the normal course of the nerves as well as a series of ultrasonographic pictures of normal nerves of the upper limb. This article aims to serve as a guide in the ultrasound examination of the peripheral nerves of the upper extremity. It should be remembered that a thorough knowledge of the area’s topographic anatomy is required for this type of examination.

  14. Differences in excitability between median and superficial radial sensory axons.

    Science.gov (United States)

    Fujimaki, Yumi; Kanai, Kazuaki; Misawa, Sonoko; Shibuya, Kazumoto; Isose, Sagiri; Nasu, Saiko; Sekiguchi, Yukari; Ohmori, Shigeki; Noto, Yu-ichi; Kugio, Yumiko; Shimizu, Toshio; Matsubara, Shiro; Lin, Cindy S Y; Kuwabara, Satoshi

    2012-07-01

    The aim of this study was to investigate differences in excitability properties of human median and superficial radial sensory axons (e.g., axons innervating the glabrous and hairy skin in the hand). Previous studies have shown that excitability properties differ between motor and sensory axons, and even among sensory axons between median and sural sensory axons. In 21 healthy subjects, threshold tracking was used to examine excitability indices such as strength-duration time constant, threshold electrotonus, supernormality, and threshold change at the 0.2 ms inter-stimulus interval in latent addition. In addition, threshold changes induced by ischemia for 10 min were compared between median and superficial radial sensory axons. Compared with radial sensory axons, median axons showed shorter strength-duration time constant, greater threshold changes in threshold electrotonus (fanning-out), greater supernormality, and smaller threshold changes in latent addition. Threshold changes in both during and after ischemia were greater for median axons. These findings suggest that membrane potential in human median sensory axons is more negative than in superficial radial axons, possibly due to greater activity of electrogenic Na(+)/K(+) pump. These results may reflect adaptation to impulses load carried by median axons that would be far greater with a higher frequency. Biophysical properties are not identical in different human sensory axons, and therefore their responses to disease may differ. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  15. The infertility trap: how defeat and entrapment affect depressive symptoms.

    Science.gov (United States)

    Galhardo, A; Moura-Ramos, M; Cunha, M; Pinto-Gouveia, J

    2016-02-01

    Does the perception of failure without a solution or way forward of infertile couples have a mediator role between the importance couples attribute to parenthood and depressive symptoms? The perception of failure without a solution or way forward, assessed by feelings of entrapment and defeat, mediates the effect of the importance of parenthood on depressive symptoms of infertile men and women. Research has documented that the heightened importance of parenthood affects infertile couples' adjustment to infertility and medical treatments. However, it remains unclear which psychological mechanisms and perceptions may underlie the association between having parenthood as a nuclear aspect of life and presenting depressive symptoms related to difficulties in accomplishing that important life goal. Although these links have been scantly addressed in infertility, previous studies have pointed to the role that perceptions of defeat and entrapment have in several psychopathological conditions. The study was cross-sectional. Couples pursuing medical treatment for their fertility problems were invited to participate by their doctors in several public and private clinics. Data collection took place between July 2009 and 2011. One hundred forty-seven infertile couples consented to participate in the study. Both couple members (147 women and 147 men) completed a set of self-report instruments for the assessment of depressive symptoms, perceptions of defeat and entrapment, importance of parenthood and rejection of a childfree lifestyle. Analyses were conducted through Structural Equation Modeling and followed a dyadic analysis strategy, allowing for controlling the interdependence of the data. The hypothesized tested model showed a very good fit to the data [(χ(2) = 68.45, P = 0.014, comparative fit index = 0.98, standardized root-mean-square residual = 0.06 and root mean square error of approximation = 0.06] and explained 67 and 58% of the variability in depressive symptoms in

  16. Median age at death as an indicator of premature mortality

    OpenAIRE

    Jannerfeldt, Eric; Hörte, Lars-Gunnar

    1988-01-01

    The median age at death from certain diseases was calculated for each year for 1969-85 and compared with that at death from all causes. The results indicated the impact of these diseases in terms of premature mortality and changes over time. Cancer was a more important cause of premature mortality among women than among men. For cancer of the cervix the median age at death increased appreciably whereas for cancer of the lung in women it slightly decreased. The median age at death is easy to c...

  17. A theoretical analysis of the median LMF adaptive algorithm

    DEFF Research Database (Denmark)

    Bysted, Tommy Kristensen; Rusu, C.

    1999-01-01

    Higher order adaptive algorithms are sensitive to impulse interference. In the case of the LMF (Least Mean Fourth), an easy and effective way to reduce this is to median filter the instantaneous gradient of the LMF algorithm. Although previous published simulations have indicated that this reduces...... the speed of convergence, no analytical studies have yet been made to prove this. In order to enhance the usability, this paper presents a convergence and steady-state analysis of the median LMF adaptive algorithm. As expected this proves that the median LMF has a slower convergence and a lower steady...

  18. Effects of stuttering severity and therapy involvement on role entrapment of people who stutter.

    Science.gov (United States)

    Gabel, Rodney M; Hughes, Stephanie; Daniels, Derek

    2008-01-01

    The primary purpose of this study was to examine whether a group of university students would report role entrapment of people who stutter (PWS) in the form of occupational stereotyping. The study also examined whether severity of stuttering (mild or severe) and level of therapy involvement (choosing or not choosing to attend therapy) affected the perceptions of role entrapment. To examine these issues, 260 students completed the Vocational Advice Scale (VAS) [Gabel, R. M., Blood, G. W., Tellis, G., & Althouse, M. T. (2004). Measuring role entrapment of people who stutter. Journal of Fluency Disorders, 29, 27-49]. Results suggested that stuttering severity and the level of therapy involvement did not appear alter the judges' reports for all of the careers except for the career of speech therapist. For the career of speech therapist, therapy involvement improved the participants' reports and stuttering severity had no effect. Additionally, findings suggested that university students reported that 16 of the careers listed on the VAS were appropriate choices for people who stutter and were less certain about advising for 27 of the careers. Thus, the findings from this study do not support the notion that stuttering leads to role entrapment in the form vocational stereotyping and variations in therapy involvement or stuttering severity do not change perceptions of role entrapment. LEARNER OUTCOMES: The reader will be able to (1) identify common stereotypes of PWS, (2) describe the possible effects of stereotyping and role entrapment, and (3) describe the effects of severity and therapy involvement of role entrapment of PWS.

  19. Polyacrylamide Gel-Entrapped Maltase: An Excellent Design of Using Maltase in Continuous Industrial Processes.

    Science.gov (United States)

    Nawaz, Muhammad Asif; Aman, Afsheen; Rehman, Haneef Ur; Bibi, Zainab; Ansari, Asma; Islam, Ziaul; Khan, Ishtiaq Ahmad; Qader, Shah Ali Ul

    2016-06-01

    Bacterial maltase catalyzes the hydrolysis of maltose and is known as one of the most significant hydrolases. It has several applications in different industrial processes but widely used in food fermentation technology and alcohol production. In the current study, entrapment technique was comprehensively examined using polyacrylamide gel as a matrix support to improve the stability and catalytic efficiency of maltase for continuous use. Maximum entrapment yield of maltase was achieved at 10 % polyacrylamide concentration with 3.0-mm bead size. Optimized conditions indicated an increase in the reaction temperature from 45 to 55 °C after maltase entrapment while no change was observed in the reaction time and pH. An increase in the K m value of entrapped maltase was attained whereas V max value decreased from 8411.0 to 6813.0 U ml(-1) min(-1) with reference to its free counterpart. Entrapped maltase showed remarkable thermal stability and retained 16 % activity at 70 °C even after 120.0 min. Entrapped maltase also exhibited excellent recycling efficiency up to eight consecutive reaction cycles. With respect to economic feasibility, entrapped maltase indicates its high potential to be used in various biotechnological applications.

  20. Quantification of human upper extremity nerves and fascicular anatomy.

    Science.gov (United States)

    Brill, Natalie A; Tyler, Dustin J

    2017-09-01

    In this study we provide detailed quantification of upper extremity nerve and fascicular anatomy. The purpose is to provide values and trends in neural features useful for clinical applications and neural interface device design. Nerve cross-sections were taken from 4 ulnar, 4 median, and 3 radial nerves from 5 arms of 3 human cadavers. Quantified nerve features included cross-sectional area, minor diameter, and major diameter. Fascicular features analyzed included count, perimeter, area, and position. Mean fascicular diameters were 0.57 ± 0.39, 0.6 ± 0.3, 0.5 ± 0.26 mm in the upper arm and 0.38 ± 0.18, 0.47 ± 0.18, 0.4 ± 0.27 mm in the forearm of ulnar, median, and radial nerves, respectively. Mean fascicular diameters were inversely proportional to fascicle count. Detailed quantitative anatomy of upper extremity nerves is a resource for design of neural electrodes, guidance in extraneural procedures, and improved neurosurgical planning. Muscle Nerve 56: 463-471, 2017. © 2016 Wiley Periodicals, Inc.

  1. Imaging the trigeminal nerve

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-05-15

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

  2. Electric stimulation and decimeter wave therapy improve the recovery of injured sciatic nerves

    Institute of Scientific and Technical Information of China (English)

    Feng Zhao; Wei He; Yingze Zhang; Dehu Tian; Hongfang Zhao; Kunlun Yu; Jiangbo Bai

    2013-01-01

    Drug treatment, electric stimulation and decimeter wave therapy have been shown to promote the repair and regeneration of the peripheral nerves at the injured site. This study prepared a Mackin-non’s model of rat sciatic nerve compression. Electric stimulation was given immediately after neurolysis, and decimeter wave radiation was performed at 1 and 12 weeks post-operation. Histo-logical observation revealed that intraoperative electric stimulation and decimeter wave therapy could improve the local blood circulation of repaired sites, al eviate hypoxia of compressed nerves, and lessen adhesion of compressed nerves, thereby decreasing the formation of new entrapments and enhancing compressed nerve regeneration through an improved microenvironment for rege-neration. Immunohistochemical staining results revealed that intraoperative electric stimulation and decimeter wave could promote the expression of S-100 protein. Motor nerve conduction velocity and amplitude, the number and diameter of myelinated nerve fibers, and sciatic functional index were significantly increased in the treated rats. These results verified that intraoperative electric stimulation and decimeter wave therapy contributed to the regeneration and the recovery of the functions in the compressed nerves.

  3. Electric stimulation and decimeter wave therapy improve the recovery of injured sciatic nerves.

    Science.gov (United States)

    Zhao, Feng; He, Wei; Zhang, Yingze; Tian, Dehu; Zhao, Hongfang; Yu, Kunlun; Bai, Jiangbo

    2013-07-25

    Drug treatment, electric stimulation and decimeter wave therapy have been shown to promote the repair and regeneration of the peripheral nerves at the injured site. This study prepared a Mackinnon's model of rat sciatic nerve compression. Electric stimulation was given immediately after neurolysis, and decimeter wave radiation was performed at 1 and 12 weeks post-operation. Histological observation revealed that intraoperative electric stimulation and decimeter wave therapy could improve the local blood circulation of repaired sites, alleviate hypoxia of compressed nerves, and lessen adhesion of compressed nerves, thereby decreasing the formation of new entrapments and enhancing compressed nerve regeneration through an improved microenvironment for regeneration. Immunohistochemical staining results revealed that intraoperative electric stimulation and decimeter wave could promote the expression of S-100 protein. Motor nerve conduction velocity and amplitude, the number and diameter of myelinated nerve fibers, and sciatic functional index were significantly increased in the treated rats. These results verified that intraoperative electric stimulation and decimeter wave therapy contributed to the regeneration and the recovery of the functions in the compressed nerves.

  4. An exact solver for the DCJ median problem.

    Science.gov (United States)

    Zhang, Meng; Arndt, William; Tang, Jijun

    2009-01-01

    The "double-cut-and-join" (DCJ) model of genome rearrangement proposed by Yancopoulos et al. uses the single DCJ operation to account for all genome rearrangement events. Given three signed permutations, the DCJ median problem is to find a fourth permutation that minimizes the sum of the pairwise DCJ distances between it and the three others. In this paper, we present a branch-and-bound method that provides accurate solution to the multichromosomal DCJ median problems. We conduct extensive simulations and the results show that the DCJ median solver performs better than other median solvers for most of the test cases. These experiments also suggest that DCJ model is more suitable for real datasets where both reversals and transpositions occur.

  5. Sorption of chrysoidine by row cork and cork entrapped in calcium alginate beads

    Directory of Open Access Journals (Sweden)

    Valeria M. Nurchi

    2014-01-01

    The influence on the sorption of pH, initial dye concentration, and particle size, as well as the efficiency of the entrapment, have been investigated. The maximum sorption was found for cork samples of fine particle size (FC, in both row and entrapped forms, at pH 7; conversely, at pH 4 the difference is significant (0.12 mmol/g for row cork and 0.20 mmol/g for entrapped cork, evoking a cooperation of alginate in binding the positively charged chrysoidine molecule.

  6. A Rare Anatomical Variation of the Brachial Plexus Characterized by the Absence of the Musculocutaneous Nerve

    Directory of Open Access Journals (Sweden)

    Alireza Ebrahimzadeh-Bideskan

    2013-10-01

    Full Text Available Knowing of anatomical variations is very important during surgery, autopsy and cadaver dissection in the axillary region. In this study, a unilateral variation of the brachial nerve plexus, which is characterized by the absent of the musculocutaneous nerve (MCN, was found in the right arm of a male cadaver. The MCN normally originates from the lateral cord of the brachial nerve plexus and innervates the anterior brachial compartment muscles and lateral coetaneous of the forearm. In this case, the lateral cord of the brachial plexus was joined to the median nerve at the level of coracoid process with no evidence of any nerve braches from lateral cord to the anterior brachial compartment muscles. These muscles were innervated from some branches of median nerve directly.

  7. Ulnar nerve excursion and strain at the elbow and wrist associated with upper extremity motion.

    Science.gov (United States)

    Wright, T W; Glowczewskie, F; Cowin, D; Wheeler, D L

    2001-07-01

    Significant excursion of the ulnar nerve is required for unimpeded upper extremity motion. This study evaluated the excursion necessary to accommodate common motions of daily living and associated strain on the ulnar nerve. The 2 most common sites of nerve entrapment, the cubital tunnel and the entrance of Guyon's canal, were studied. Five fresh-frozen, thawed transthoracic cadaver specimens (10 arms) were dissected and the nerve was exposed at the elbow and wrist only enough to be marked with a microsuture. Excursion was measured with a laser mounted on a Vernier caliper fixed to the bone and aligned in the direction of nerve motion. A Microstrain (Burlington, VT) DVRT strain device was applied to the nerve at both the elbow and wrist. Nerve excursion associated with motion of the shoulder, elbow, wrist, and fingers (measured by goniometer) was measured at the wrist and elbow. An average of 4.9 mm ulnar nerve excursion was required at the elbow to accommodate shoulder motion from 30 degrees to 110 degrees of abduction, and 5.1 mm was needed for elbow motion from 10 degrees to 90 degrees. When the wrist was moved from 60 degrees of extension to 65 degrees of flexion, 13.6 mm excursion of the ulnar nerve was required at the wrist. When all the motions of the wrist, fingers, elbow, and shoulder were combined, 21.9 mm of ulnar nerve excursion was required at the elbow and 23.2 mm at the wrist. Ulnar nerve strain of 15% or greater was experienced at the elbow with elbow flexion and at the wrist with wrist extension and radial deviation. Any factor that limits excursion at these sites could result in repetitive traction of the nerve and possibly play a role in the pathophysiology of cubital tunnel syndrome or ulnar neuropathy at Guyon's canal.

  8. Dorsal clitoral nerve injury following transobturator midurethral sling

    Directory of Open Access Journals (Sweden)

    Moss CF

    2016-09-01

    Full Text Available Chailee F Moss,1 Lynn A Damitz,2 Richard H Gracely,3 Alice C Mintz,3 Denniz A Zolnoun,2–4 A Lee Dellon5 1Department of Obstetrics and Gynecology, Ohio State University School of Medicine, Columbus, OH, USA; 2Department of Surgery, University of North Carolina at Chapel Hill, NC, USA; 3Department of Endodontics, University of North Carolina at Chapel Hill, NC, USA; 4Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA; 5Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA Introduction: Transobturator slings can be successfully used to treat stress urinary incontinence and improve quality of life through a minimally invasive vaginal approach. Persistent postoperative pain can occur and pose diagnostic and therapeutic dilemmas. Following a sling procedure, a patient complained of pinching clitoral and perineal pain. Her symptoms of localized clitoral pinching and pain became generalized over the ensuing years, eventually encompassing the entire left vulvovaginal region.Aim: The aim of this study was to highlight the clinical utility of conventional pain management techniques used for the evaluation and management of patients with postoperative pain following pelvic surgery. Methods: We described a prototypical patient with persistent pain in and around the clitoral region complicating the clinical course of an otherwise successful sling procedure. We specifically discussed the utility of bedside sensory assessment techniques and selective nerve blocks in the evaluation and management of this prototypical patient. Results: Neurosensory assessments and a selective nerve block enabled us to trace the source of the patient’s pain to nerve entrapment along the dorsal nerve of the clitoris. We then utilized a nerve stimulator-guided hydrodissection technique to release the scar contracture Conclusion: This case

  9. Nerve conduction and excitability studies in peripheral nerve disorders

    DEFF Research Database (Denmark)

    Krarup, Christian; Moldovan, Mihai

    2009-01-01

    PURPOSE OF REVIEW: The review is aimed at providing information about the role of nerve excitability studies in peripheral nerve disorders. It has been known for many years that the insight into peripheral nerve pathophysiology provided by conventional nerve conduction studies is limited. Nerve...

  10. REGRESI KUANTIL MEDIAN UNTUK MENGATASI HETEROSKEDASTISITAS PADA ANALISIS REGRESI

    Directory of Open Access Journals (Sweden)

    IDA AYU PRASETYA UTHAMI

    2013-01-01

    Full Text Available In regression analysis, the method used to estimate the parameters is Ordinary Least Squares (OLS. The principle of OLS is to minimize the sum of squares error. If any of the assumptions were not met, the results of the OLS estimates are no longer best, linear, and unbiased estimator (BLUE. One of the assumptions that must be met is the assumption about homoscedasticity, a condition in which the variance of the error is constant (same. Violation of the assumptions about homoscedasticity is referred to heteroscedasticity. When there exists heteroscedas­ticity, other regression techniques are needed, such as median quantile regression which is done by defining the median as a solution to minimize sum of absolute error. This study intended to estimate the regression parameters of the data were known to have heteroscedasticity. The secondary data were taken from the book Basic Econometrics (Gujarati, 2004 and analyzing method were performed by EViews 6. Parameter estimation of the median quantile regression were done by estimating the regression parameters at each quantile ?th, then an estimator was chosen on the median quantile as regression coefficients estimator. The result showed heteroscedasticity problem has been solved with median quantile regression although error still does not follow normal distribution properties with a value of R2 about 71 percent. Therefore it can be concluded that median quantile regression can overcome heteroscedasticity but the data still abnormalities.

  11. REGRESI KUANTIL MEDIAN UNTUK MENGATASI HETEROSKEDASTISITAS PADA ANALISIS REGRESI

    Directory of Open Access Journals (Sweden)

    IDA AYU PRASETYA UTHAMI

    2013-03-01

    Full Text Available In regression analysis, the method used to estimate the parameters is Ordinary Least Squares (OLS. The principle of OLS is to minimize the sum of squares error. If any of the assumptions were not met, the results of the OLS estimates are no longer best, linear, and unbiased estimator (BLUE. One of the assumptions that must be met is the assumption about homoscedasticity, a condition in which the variance of the error is constant (same. Violation of the assumptions about homoscedasticity is referred to heteroscedasticity. When there exists heteroscedas­ticity, other regression techniques are needed, such as median quantile regression which is done by defining the median as a solution to minimize sum of absolute error. This study intended to estimate the regression parameters of the data were known to have heteroscedasticity. The secondary data were taken from the book Basic Econometrics (Gujarati, 2004 and analyzing method were performed by EViews 6. Parameter estimation of the median quantile regression were done by estimating the regression parameters at each quantile ?th, then an estimator was chosen on the median quantile as regression coefficients estimator. The result showed heteroscedasticity problem has been solved with median quantile regression although error still does not follow normal distribution properties with a value of R2 about 71 percent. Therefore it can be concluded that median quantile regression can overcome heteroscedasticity but the data still abnormalities.

  12. Testing the gravity p-median model empirically

    Directory of Open Access Journals (Sweden)

    Kenneth Carling

    2015-12-01

    Full Text Available Regarding the location of a facility, the presumption in the widely used p-median model is that the customer opts for the shortest route to the nearest facility. However, this assumption is problematic on free markets since the customer is presumed to gravitate to a facility by the distance to and the attractiveness of it. The recently introduced gravity p-median model offers an extension to the p-median model that account for this. The model is therefore potentially interesting, although it has not yet been implemented and tested empirically. In this paper, we have implemented the model in an empirical problem of locating vehicle inspections, locksmiths, and retail stores of vehicle spare-parts for the purpose of investigating its superiority to the p-median model. We found, however, the gravity p-median model to be of limited use for the problem of locating facilities as it either gives solutions similar to the p-median model, or it gives unstable solutions due to a non-concave objective function.

  13. Phloxine B as a Probe for Entrapment in Microcrystalline Cellulose

    Directory of Open Access Journals (Sweden)

    Enrique San Román

    2012-02-01

    Full Text Available The photophysical behaviour of phloxine B adsorbed onto microcrystalline cellulose was evaluated by reflectance spectroscopy and laser induced time-resolved luminescence in the picosecond-nanosecond and microsecond-millisecond ranges. Analysis of the absorption spectral changes with concentration points to a small tendency of the dye to aggregate in the range of concentrations under study. Prompt fluorescence, phosphorescence and delayed fluorescence spectral decays were measured at room temperature and 77 K, without the need of sample degassing because cellulose protects triplet states from oxygen quenching. In all cases, spectral changes with time and lifetime distribution analysis were consistent with the dye coexisting in two different environments: dyes tightly entrapped between polymer chains in crystalline regions of cellulose showed longer fluorescence and phosphorescence lifetimes and more energetic triplet states, while dyes adsorbed in more amorphous regions of the support showed shorter lifetimes and less energetic triplet states. This behaviour is discussed in terms of the different dye-support interactions in both kinds of adsorption sites.

  14. Biodistribution of liposome-entrapped human gamma-globulin.

    Science.gov (United States)

    García-Santana, María A; Duconge, Jorge; Sarmiento, María E; Lanio-Ruíz, María E; Becquer, María A; Izquierdo, Luís; Acosta-Domínguez, Armando

    2006-09-01

    The present study was aimed at the preparation and performance evaluation of Intacglobin-loaded liposomes for selective drug presentation to the lungs. Egg phosphatidylcholine- and cholesterol-based liposomes (1:1 and 1:0.25 mol/mol) were prepared by a dehydration-rehydration procedure. A tissue distribution study after single intranasal administration of 0.5 microCi 125I-Intacglobin-loaded liposomes was conducted in Balb/c mice. The efficiencies of drug entrapment (30%) and the average diameters did not differ significantly between the two liposome formulations. However, liposomes composed of an increased cholesterol amount showed a lower in vitro drug release rate. The airway penetration efficiency of the liposomal formulation was determined by the cumulative percentage of the dose reaching the lungs (AUC) and its sojourn time therein, and were 1.7- and 2.2-times higher compared with the plain 125I- Intacglobin solution-based formulation, respectively. A significantly greater (p<0.001) drug localization index after 24 h was found at the lungs in comparison with the other tissues (p<0.01), although similar values were detected between groups following administration of either liposomes or control solutions, despite the formulations attributes. In conclusion, it is suggested that longer Intacglobin exposure at the pulmonary region is observed after administration of the liposomal formulation. The results open future perspectives in assessing local passive immunization for the treatment of respiratory infectious diseases.

  15. ENTRAPMENT OF FLUORESCENT E. COLI CELLS IN ALGINATE GEL

    Directory of Open Access Journals (Sweden)

    T. VINTILA

    2013-07-01

    Full Text Available By this experiment we will demonstrate the possibility to obtain genetically modified microbial strains that can be used as markers in different studies. The trait transferred in this study is the fluorescence in UV light expressed by a gene isolated from jellyfish. This gene was insered into a plasmid carrying ampiciline resistance and in the operon for arabinose fermentation. The plasmid was called pGLO. E coli HB101 K-12, ampicillin resistant colonies has been obtained. The colonies on the LB/amp/ara plate fluoresce green under UV light and the transformed colonies can grow on ampicillin. Transformation efficiency = 362 transformed colonies/ μg DNA. The cells where immobilized by entrapment in alginate gel to study the phenomenon involved in cells immobilization. After immobilization in alginate gel, 5x104 cells of E. coli pGLO / capsule and 1,4 x 105 cells of E. coli HB101/capsule has been found. Fluorescent microscopy revealed the presence of pGLO carrying cells into the capsules. After cultivation of alginate capsules containing E. coli in LB broth, and fluorescent microscopy of the capsule sections, several observations of the phenomenon involved in continuous fermentation using biocatalysts in has been made. These cells grow and migrate to the cortical part of the matrix where they are immobilized.

  16. ENTRAPMENT OF FLUORESCENT E. COLI CELLS IN ALGINATE GEL

    Directory of Open Access Journals (Sweden)

    V. IGNA

    2009-05-01

    Full Text Available By this experiment we will demonstrate the possibility to obtain genetically modifiedmicrobial strains that can be used as markers in different studies. The traittransferred in this study is the fluorescence in UV light expressed by a gene isolatedfrom jellyfish. This gene was insered into a plasmid carrying ampiciline resistanceand in the operon for arabinose fermentation. The plasmid was called pGLO. E coliHB101 K-12, ampicillin resistant colonies has been obtained. The colonies on theLB/amp/ara plate fluoresce green under UV light and the transformed colonies cangrow on ampicillin. Transformation efficiency = 362 transformed colonies/ μg DNA.The cells where immobilized by entrapment in alginate gel to study the phenomenoninvolved in cells immobilization. After immobilization in alginate gel, 5x104 cells ofE. coli pGLO / capsule and 1,4 x 105 cells of E. coli HB101/capsule has been found.Fluorescent microscopy revealed the presence of pGLO carrying cells into thecapsules. After cultivation of alginate capsules containing E. coli in LB broth, andfluorescent microscopy of the capsule sections, several observations of thephenomenon involved in continuous fermentation using biocatalysts in has beenmade. These cells grow and migrate to the cortical part of the matrix where they areimmobilized.

  17. Large Extremity Peripheral Nerve Repair

    Science.gov (United States)

    2016-12-01

    Photochemical bond- ing required clear access 5 mm proximal and dis- tal to coaptation sites. As a result, the maximum achievable nerve gap before...rodents for nerve gap reconstruction. Induction and maintenance anesthesia was achieved using isoflurane (Baxter Healthcare Corp., Deerfield, Ill...injury, nerve gap , nerve wrap, PTB, photosealing, Rose Bengal, amnion, nerve conduit, crosslinking, allograft, photochemistry. 3. Accomplishments

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

    Directory of Open Access Journals (Sweden)

    Straschill Max

    2006-10-01

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

  19. Towards successful bioaugmentation with entrapped cells as a soil remediation technology

    DEFF Research Database (Denmark)

    Owsianiak, Mikolaj; Dechesne, Arnaud; Binning, Philip John

    2010-01-01

    Soil remediation technologies are proposed that rely on inoculation with degrading microorganisms entrapped in protective carriers. A mathematical model developed to model entrapped cell bioaugmentation describes the 3-D diffusion-driven mass transfer of benzoate, and its mineralization by Pseudo......Soil remediation technologies are proposed that rely on inoculation with degrading microorganisms entrapped in protective carriers. A mathematical model developed to model entrapped cell bioaugmentation describes the 3-D diffusion-driven mass transfer of benzoate, and its mineralization...... saturation 7%) and agree satisfactory well with model predictions. In contrast, much larger mineralization rates are measured for wet conditions (water saturation of 68%). This discrepancy originates from extensive cell dispersal, not accounted for in the model, which occurs in wet conditions...

  20. Ca-alginate-entrapped nanoscale iron: arsenic treatability and mechanism studies

    Science.gov (United States)

    Bezbaruah, Achintya N.; Kalita, Harjyoti; Almeelbi, Talal; Capecchi, Christopher L.; Jacob, Donna L.; Ugrinov, Angel G.; Payne, Scott A.

    2014-01-01

    The use of nanoscale zero-valent iron (NZVI, diameter 10-90 nm with an average value of 35 nm) entrapped in calcium (Ca)-alginate beads shows great promise for aqueous arsenic treatment. This research evaluated Ca-alginate-entrapped NZVI as an advanced treatment technique for aqueous arsenic removal. Arsenic is a serious threat to human health and millions of people are affected by arsenic contamination in various parts of the world including the USA. In bench scale batch studies with initial As(V) concentrations of 1-10 mg L-1, 85-100 % arsenic removal was achieved within 2 h. While the reaction kinetics differ between bare and entrapped NZVI, the overall reductions of arsenic are comparable. Surface area-normalized arsenic reduction reaction rate constants ( k sa) for bare and entrapped NZVI were 3.40-5.96 × 10-3 and 3.92-4.43 × 10-3 L m-2 min-1, respectively. The entrapped NZVI removed 100 μg L-1 As(V) to below detection limit within 2 h and groundwater with 53 μg L-1 As(V) was remediated to below instrument detection limit (10 μg L-1) within 1 h. The presence of Na+, Ca2+, Cl-, and HCO3^{ - }did not affect arsenic removal by entrapped NZVI and there was no leaching of iron from the beads. X-ray diffraction and Fourier transform infrared spectroscopic techniques have been used to understand the mechanism of arsenic removal by the entrapped NZVI. Ca-alginate polymer is an excellent choice as an entrapment medium as it is non-toxic and has little solubility in water.

  1. Atypical presentation of popliteal artery entrapment syndrome: involvement of the anterior tibial artery.

    Science.gov (United States)

    Bou, Steven; Day, Carly

    2014-11-01

    Popliteal artery entrapment syndrome (PAES) is a rare condition that should be suspected in a young patient with exertional lower extremity pain. We report the case of an 18-year-old female volleyball player with bilateral exertional lower extremity pain who had been previously diagnosed with tendinitis and periostitis. Diagnostic studies showed entrapment of the left popliteal artery and the left anterior tibial artery. To our knowledge, there has only been 1 previous report of anterior tibial artery involvement in PAES.

  2. Poly 3,4-ethylenedioxythiophene as an entrapment support for amperometric enzyme sensor

    OpenAIRE

    Fabiano, Silvia; Tran-Minh, Canh; Piro, Benoît; Anh Dang, Lan; Chau Pham, Minh; Vittori, Olivier

    2002-01-01

    International audience; A conducting polymer of poly 3,4-ethylenedioxythiophene (PEDT) was used as a matrix for entrapment of enzymes onto a platinum electrode surface in order to construct amperometric biosensors. Glucose oxidase (GOD) was used as an example, and it was entrapped in the polymer during the electrochemical polymerization. Glucose in oxygenated solutions was tested by amperometric measurements at +650 mV (vs. SCE) in a batch system. The influence of several experimental paramet...

  3. A Novel Approach for Entrapment of Biopolymers in Silica Matrix by Sol-gel Technique

    Institute of Scientific and Technical Information of China (English)

    Yu.Shchipunov

    2007-01-01

    1 Results The entrapment of biopolymers into silica by the sol-gel technique meets with incompatibility of inorganic and bioorganic components. The aim was to develop a compatible procedure biomimicking the biomineralization processes in the living nature. A suggested solution in Ref.[1-2] for the biopolymer entrapment into silica matrix is based on a novel silica precursor. The developed approach is distinguished from the common technique for fabrication of hybrid biopolymer-silica nanocomposite materi...

  4. Adaptive weighted median filter utilizing impulsive noise detection

    Science.gov (United States)

    Ishihara, Jun; Meguro, Mitsuhiko; Hamada, Nozomu

    1999-10-01

    The removal of noise in image is one of the current important issues. It is also useful as a preprocessing for edge detection, motion estimation and so on. In this paper, an adaptive weighted median filter utilizing impulsive noise detection is proposed for the removal of impulsive noise in digital images. The aim of our proposed method is to eliminate impulsive noise effectively preserving original fine detail in images. This aim is same for another median-type nonlinear filters try to realized. In our method, we use weighted median filter whose weights should be determined by balancing between the signal preserving ability and noise reduction performance. The trade off between these two inconsistent properties is realized using the noise detection mechanism and optimized adaptation process. In the previous work, threshold value between the signal and the output of the median filter have to be decided for the noise detection. Adaptive algorithm for optimizing WM filters uses the teacher image for training process. In our method, following two new approaches are introduced in the filtering. (1) The noise detection process uses the discriminant method to the histogram distribution of the derivation from median filter output. (2) Filter weights which have been learned by uncorrupted pixels and their neighborhood without the original image are used for the restoration filtering for noise corrupted pixels. The validity of the proposed method is shown through some experimental results.

  5. The ulnar test: a method for the quantitative functional assessment of posttraumatic ulnar nerve recovery in the rat.

    Science.gov (United States)

    Papalia, Igor; Tos, Pierluigi; Scevola, Anna; Raimondo, Stefania; Geuna, Stefano

    2006-06-30

    The assessment of recovery of the neuromuscular function following nerve lesion and repair is one of the main goals of peripheral nerve researchers. The forelimb model has recently seen an increase in its employment for experimental nerve repair studies especially because of the availability of the grasping test for assessing the functional recovery of one of its major nerves, the median nerve. Nerve repair studies sometimes require the use of more than one nerve to simulate severe clinical situations and, in this case, the ulnar nerve is often used together with the median nerve. However, a test for assessing ulnar nerve functional recovery is yet not available. To fill this gap, we have developed and experimentally tested a method for the functional assessment of posttraumatic ulnar nerve recovery in the rat. Animal testing using this method is simple, quick and provides the animal with minimal distress. The method proved to be effective in detecting the date on which recovery starts after ulnar nerve impairment and in following its improvement, over time. The availability of this new test is expected to further increase the employment of forelimb experimental nerve models instead of the more disabling hindlimb models.

  6. Evaluation of diffusion in gel entrapment cell culture within hollow fibers

    Institute of Scientific and Technical Information of China (English)

    Dan-Qing Wu; Guo-Liang Zhang; Chong Shen; Qian Zhao; Hui Li; Qin Meng

    2005-01-01

    AIM: To investigate diffusion in mammalian cell culture by gel entrapment within hollow fibers.METHODS: Freshly isolated rat hepatocytes or human oral epidermoid carcinoma (KB) cells were entrapped in type Ⅰ collagen solutions and statically cultured inside microporous and ultrafiltration hollow fibers. During the culture time collagen gel contraction, cell viability and specific function were assessed. Effective diffusion coefficients of glucose in cell-matrix gels were determined by lag time analysis in a diffusion cell.R ESULTS: Significant gel contractions occurred in the collagen gels by entrapment of either viable hepatocytes or KB cells. And the gel contraction caused a significant reduction on effective diffusion coefficient of glucose. The cell viability assay of both hepatocytes and KB cells statically cultured in hollow fibers by collagen entrapment further confirmed the existence of the inhibited mass transfer by diffusion. Urea was secreted about 50% more by hepatocytes entrapped in hollow fibers with pore size of 0.1 pm than that in hollow fibers with MWCO of 100 ku.CONCLUSION: Cell-matrix gel and membrane pore size are the two factors relevant to the limited mass transfer by diffusion in such gel entrapment of mammalian cell culture.

  7. Volatile metabolites produced from agro-industrial wastes by Na-alginate entrapped Kluyveromyces marxianus

    Directory of Open Access Journals (Sweden)

    Onur Güneşer

    Full Text Available Abstract The aim of this study was to evaluate the effects of alginate entrapment on fermentation metabolites of Kluyveromyces marxianus grown in agrowastes that served as the liquid culture media. K. marxianus cells entrapped in Na-alginate were prepared using the traditional liquid-droplet-forming method. Whey and pomaces from processed tomatoes, peppers, and grapes were used as the culture media. The changes in the concentrations of sugar, alcohol, organic acids, and flavor compounds were analyzed using gas chromatography-mass spectrometry (GC-MS and high pressure liquid chromatography (HPLC. Both free and entrapped, K. marxianus were used individually to metabolize sugars, organic acids, alcohols, and flavor compounds in the tomato, pepper, grape, and acid whey based media. Marked changes in the fermentation behaviors of entrapped and free K. marxianus were observed in each culture. A 1.45-log increase was observed in the cell numbers of free K. marxianus during fermentation. On the contrary, the cell numbers of entrapped K. marxianus remained the same. Both free and entrapped K. marxianus brought about the fermentation of sugars such as glucose, fructose, and lactose in the agrowaste cultures. The highest volume of ethanol was produced by K. marxianus in the whey based media. The concentrations of flavor compounds such as ethyl acetate, isoamyl alcohol, isoamyl acetate, 2-phenylethyl isobutyrate, phenylethyl acetate, and phenylethyl alcohol were higher in fermented agrowaste based media compared to the control.

  8. Water infiltration in an aquifer recharge basin affected by temperature and air entrapment

    Directory of Open Access Journals (Sweden)

    Loizeau Sébastien

    2017-09-01

    Full Text Available Artificial basins are used to recharge groundwater and protect water pumping fields. In these basins, infiltration rates are monitored to detect any decrease in water infiltration in relation with clogging. However, miss-estimations of infiltration rate may result from neglecting the effects of water temperature change and air-entrapment. This study aims to investigate the effect of temperature and air entrapment on water infiltration at the basin scale by conducting successive infiltration cycles in an experimental basin of 11869 m2 in a pumping field at Crepieux-Charmy (Lyon, France. A first experiment, conducted in summer 2011, showed a strong increase in infiltration rate; which was linked to a potential increase in ground water temperature or a potential dissolution of air entrapped at the beginning of the infiltration. A second experiment was conducted in summer, to inject cold water instead of warm water, and also revealed an increase in infiltration rate. This increase was linked to air dissolution in the soil. A final experiment was conducted in spring with no temperature contrast and no entrapped air (soil initially water-saturated, revealing a constant infiltration rate. Modeling and analysis of experiments revealed that air entrapment and cold water temperature in the soil could substantially reduce infiltration rate over the first infiltration cycles, with respective effects of similar magnitude. Clearly, both water temperature change and air entrapment must be considered for an accurate assessment of the infiltration rate in basins.

  9. Landscaping of highway medians and roadway safety at unsignalized intersections.

    Science.gov (United States)

    Chen, Hongyun; Fabregas, Aldo; Lin, Pei-Sung

    2016-05-01

    Well-planted and maintained landscaping can help reduce driving stress, provide better visual quality, and decrease over speeding, thus improving roadway safety. Florida Department of Transportation (FDOT) Standard Index (SI-546) is one of the more demanding standards in the U.S. for landscaping design criteria at highway medians near intersections. The purposes of this study were to (1) empirically evaluate the safety results of SI-546 at unsignalized intersections and (2) quantify the impacts of geometrics, traffic, and landscaping design features on total crashes and injury plus fatal crashes. The studied unsignalized intersections were divided into (1) those without median trees near intersections, (2) those with median trees near intersections that were compliant with SI-546, and (3) those with median trees near intersections that were non-compliant with SI-546. A total of 72 intersections were selected, for which five-year crash data from 2006-2010 were collected. The sites that were compliant with SI-546 showed the best safety performance in terms of the lowest crash counts and crash rates. Four crash predictive models-two for total crashes and two for injury crashes-were developed. The results indicated that improperly planted and maintained median trees near highway intersections can increase the total number of crashes and injury plus fatal crashes at a 90% confidence level; no significant difference could be found in crash rates between sites that were compliant with SI-546 and sites without trees. All other conditions remaining the same, an intersection with trees that was not compliant with SI-546 had 63% more crashes and almost doubled injury plus fatal crashes than those at intersections without trees. The study indicates that appropriate landscaping in highway medians near intersections can be an engineering technology that not only improves roadway environmental quality but also maintains intersection safety.

  10. Suprascapular nerve palsy.

    Science.gov (United States)

    Moskowitz, E; Rashkoff, E S

    1989-11-01

    Isolated traumatic suprascapular nerve palsy without associated fracture is a rare occurrence. Localized segmental muscle atrophy limited to the supraspinatus and infraspinatus muscles associated with weakness in initiating abduction and in external rotation of the shoulder should suggest the diagnosis. Electromyography will confirm the diagnosis by excluding nerve root and brachial plexus involvement with denervation potentials limited to the supraspinatus and infraspinatus muscles.

  11. Imaging the hypoglossal nerve

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Pedro [Department of Radiology, Centro Hospitalar de Lisboa Central-Hospital de Sao Jose, Rua Jose Antonio Serrano, 1150-199 Lisboa Codex (Portugal)], E-mail: tojais.pedro@gmail.com

    2010-05-15

    The hypoglossal nerve is a pure motor nerve. It provides motor control to the intrinsic and extrinsic tongue muscles thus being essential for normal tongue movement and coordination. In order to design a useful imaging approach and a working differential diagnosis in cases of hypoglossal nerve damage one has to have a good knowledge of the normal anatomy of the nerve trunk and its main branches. A successful imaging evaluation to hypoglossal diseases always requires high resolution studies due to the small size of the structures being studied. MRI is the preferred modality to directly visualize the nerve, while CT is superior in displaying the bony anatomy of the neurovascular foramina of the skull base. Also, while CT is only able to detect nerve pathology by indirect signs, such as bony expansion of the hypoglossal canal, MRI is able to visualize directly the causative pathological process as in the case of small tumors, or infectious/inflammatory processes affecting the nerve. The easiest way to approach the study of the hypoglossal nerve is to divide it in its main segments: intra-axial, cisternal, skull base and extracranial segment, tailoring the imaging technique to each anatomical area while bearing in mind the main disease entities affecting each segment.

  12. Median and Ulnar Neuropathy Assessment in Parkinson’s Disease regarding Symptom Severity and Asymmetry

    Directory of Open Access Journals (Sweden)

    Nilgul Yardimci

    2016-01-01

    Full Text Available Background. While increasing evidence suggests comorbidity of peripheral neuropathy (PNP and Parkinson’s disease (PD, the pathogenesis of PNP in PD is still a debate. The aim of this article is to search the core PD symptoms such as rigidity and tremor as contributing factors to mononeuropathy development while emphasizing each individual patient’s asymmetric symptom severity. Methods. We studied 62 wrists and 62 elbows of 31 patients (mean age 66.48±10.67 and 64 wrists and 64 elbows of 32 age-gender matched healthy controls (mean age 62.03±10.40, p=0.145. The Hoehn and Yahr disability scale and Unified Parkinson’s Disease Rated Scale were used to determine the severity of the disease. Results. According to electrodiagnostic criteria, we confirmed median neuropathy in 16.12% (bilateral in two-thirds of the patients and ulnar neuropathy in 3.22% of the PD group. While mean age (p=0.003, age at PD onset (p=0.019, and H&Y scores (p=0.016 were significant, tremor and rigidity scores were not. The comparison of the mean indices of electrophysiologic parameters indicated subclinical median and ulnar nerve demyelination both at the wrist and at the elbow in the patient groups where a longer disease duration and mild tremor and rigidity scores are prominent, remarkably. Conclusion. A disease related peripheral neurodegeneration beyond symptom severity occurs in PD.

  13. Somesoppa : sosiaalisen median kehittämissuunnitelma ravintola Rustikille

    OpenAIRE

    Hartikainen, Lotta

    2016-01-01

    Tämän opinnäytetyön tarkoituksena oli tehdä Ravintola Rustikille sosiaalisen median kehittämissuunnitelma. Kehittämissuunnitelmaa varten ideoita ja kehittämiskohtia kerättiin kolmen eri keinon avulla. Ensimmäiseksi tehtiin vertaileva kirjoituspöytätutkimus neljän muun ravintolan toiminnasta sosiaalisessa mediassa ja etsittiin muiden toiminnasta vinkkejä Rustikia varten. Seuraavaksi tehtiin kartoitus Rustikin toiminnasta sosiaalisessa mediassa. Rustikin käyttämät sosiaalisen median alustat ova...

  14. The Median Solution of the Newsvendor Problem and Some Observations

    Directory of Open Access Journals (Sweden)

    Sinha Pritibhushan

    2015-09-01

    Full Text Available We consider the median solution of the Newsvendor Problem. Some properties of such a solution are shown through a theoretical analysis and a numerical experiment. Sometimes, though not often, median solution may be better than solutions maximizing expected profit, or maximizing minimum possible, over distribution with the same average and standard deviation, expected profit, according to some criteria. We discuss the practical suitability of the objective function set and the solution derived, for the Newsvendor Problem, and other such random optimization problems.

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

    Directory of Open Access Journals (Sweden)

    Dipti

    2015-12-01

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

  16. Use of intercostal nerves for different target neurotization in brachial plexus reconstruction

    Science.gov (United States)

    Lykissas, Marios G; Kostas-Agnantis, Ioannis P; Korompilias, Ananstasios V; Vekris, Marios D; Beris, Alexandros E

    2013-01-01

    Intercostal nerve transfer is a valuable procedure in devastating plexopathies. Intercostal nerves are a very good choice for elbow flexion or extension and shoulder abduction when the intraplexus donor nerves are not available. The best results are obtained in obstetric brachial plexus palsy patients, when direct nerve transfer is performed within six months from the injury. Unlike the adult posttraumatic patients after median and ulnar nerve neurotization with intercostal nerves, almost all obstetric brachial plexus palsy patients achieve protective sensation in the hand and some of them achieve active wrist and finger flexion. Use in combination with proper muscles, intercostal nerve transfer can yield adequate power to the paretic upper limb. Reinnervation of native muscles (i.e., latissimus dorsi) should always be sought as they can successfully be transferred later on for further functional restoration. PMID:23878776

  17. PERFORATION OF INFERIOR ALVEOLAR NERVE BY MAXILLARY ARTERY. Perforation of inferior alveolar nerve by maxillary artery

    Directory of Open Access Journals (Sweden)

    Prakash B Billakanti

    2016-03-01

    the inferior alveolar nerve, and the nerve was fixed between the foramen ovale and mandibular foramen, neurovascular entrapment may cause pain numbness or headache and may interfere with the injection of local anesthetics into the infratemporal fossa. Anatomical variations in this region should be kept in mind, particularly in cases of failed treatment of trigeminal neuralgia.

  18. Biological and artificial nerve conduit for repairing peripheral nerve defect

    Institute of Scientific and Technical Information of China (English)

    Xuetao Xie; Changqing Zhang

    2006-01-01

    OBJECTIVE: Recently, with the development of biological and artificial materials, the experimental and clinical studies on application of this new material-type nerve conduit for treatment of peripheral nerve defect have become the hotspot topics for professorial physicians.DATA SOURCES: Using the terms "nerve conduits, peripheral nerve, nerve regeneration and nerve transplantation" in English, we searched Pubmed database, which was published during January 2000 to June 2006, for the literatures related to repairing peripheral nerve defect with various materials. At the same time, we also searched Chinese Technical Scientific Periodical Database at the same time period by inputting" peripheral nerve defect, nerve repair, nerve regeneration and nerve graft" in Chinese.STUDY SELECTION: The materials were firstly selected, and literatures about study on various materials for repairing peripheral nerve defect and their full texts were also searched. Inclusive criteria: nerve conduits related animal experiments and clinical studies. Exclusive criteria: review or repetitive studies.DATA EXTRACTION: Seventy-nine relevant literatures were collected and 30 of them met inclusive criteria and were cited.DATA SYNTHESTS: Peripheral nerve defect, a commonly seen problem in clinic, is difficult to be solved. Autogenous nerve grafting is still the gold standard for repairing peripheral nerve defect, but because of its application limitation and possible complications, people studied nerve conduits to repair nerve defect. Nerve conduits consist of biological and artificial materials.CONCLUSION: There have been numerous reports about animal experimental and clinical studies of various nerve conduits, but nerve conduit, which is more ideal than autogenous nerve grafting, needs further clinical observation and investigation.

  19. Management of sternal osteomyelitis and mediastinal infection following median sternotomy

    Institute of Scientific and Technical Information of China (English)

    GAO Ju; WANG Wen-zhang; WANG You-li; LU Shu-qiang; CAI Ai-bing; YANG Zhi-fu; HAN Zhi-yi; LI Jiu-jiang; WEN Yu-ming; GENG Feng-yong

    2010-01-01

    Background Median sternotomy is considered the most usually performed procedure in cardiac operations. This study aimed to assess clinical effectiveness of bilateral pectoralis major muscle flaps (BPMMF) for management of sternal osteomyelitis and mediastinal infection following median sternotomy.Methods Clinical data were collected and retrospectively analyzed from twelve patients who underwent the BPMMF transposition for management of sternal osteomyelitis and mediastinal infection following median sternotomy from January 2006 to June 2009. Procedure consisted of rigorous debridement of necrotic tissues, dead space obliteration using the BPMMF, and placement of drainage tubes connected to a negative pressures generator for adequate drainage.Results No patients died of drainage, and all 12 patients had viable BPMMF when discharged from hospital. At 1 week post discharge, 2 patients presented with sternal infection but recovered following local debridement and medication. No patients showed infection recurrence during the follow-up period over 10 months.Conclusions Sternal osteomyelitis and mediastinal infection following median sternotomy may be effectively managed through rigorous debridement of infected soft tissues, resection of the damaged stermal segment, transposition of the BPMMF to fill the damaged sternum resulting from debridement, and adequate postoperative drainage.

  20. Mean, Median and Mode from a Decision Perspective

    Science.gov (United States)

    Holt, Melinda Miller; Scariano, Stephen M.

    2009-01-01

    The classroom activity described here allows mathematically mature students to explore the role of mean, median and mode in a decision-making environment. While students discover the importance of choosing a measure of central tendency, their understanding of probability distributions, maximization, and prediction is reinforced through active…

  1. A novel image inpainting technique based on median diffusion

    Indian Academy of Sciences (India)

    Rajkumar L Biradar; Vinayadatt V Kohir

    2013-08-01

    Image inpainting is the technique of filling-in the missing regions and removing unwanted objects from an image by diffusing the pixel information from the neighbourhood pixels. Image inpainting techniques are in use over a long time for various applications like removal of scratches, restoring damaged/missing portions or removal of objects from the images, etc. In this study, we present a simple, yet unexplored (digital) image inpainting technique using median filter, one of the most popular nonlinear (order statistics) filters. The median is maximum likelihood estimate of location for the Laplacian distribution. Hence, the proposed algorithm diffuses median value of pixels from the exterior area into the inner area to be inpainted. The median filter preserves the edge which is an important property needed to inpaint edges. This technique is stable. Experimental results show remarkable improvements and works for homogeneous as well as heterogeneous background. PSNR (quantitative assessment) is used to compare inpainting results.

  2. Elementary School Teachers' Understanding of the Mean and Median

    Science.gov (United States)

    Jacobbe, Tim

    2012-01-01

    This study provides a snapshot of elementary school teachers' understanding of the mean and median. The research is presented in light of recent work regarding preservice teachers' understanding of the mean. Common misconceptions are identified which lead to potential implications for teacher preparation programs. One of the primary concerns…

  3. Side-to-side range of movement variability in variants of the median and radial neurodynamic test sequences in asymptomatic people.

    Science.gov (United States)

    Stalioraitis, Vaidas; Robinson, Kim; Hall, Toby

    2014-08-01

    Side-to-side discrepancy in range of motion (ROM) during upper limb neurodynamic testing is used in part to identify abnormal peripheral nerve mechanosensitivity and is one of three factors to consider in determining a positive test. Large side-to-side variability is reported for some variants of the upper limb neurodynamic test sequences, however discrepancies for other test variants are unknown. Hence the purpose of this study was to evaluate side-to-side discrepancy in elbow flexion ROM during two variants of upper limb neurodynamic test sequence for the median and radial nerves. 51 asymptomatic subjects (26 females, mean age 29.69 years) were evaluated. A uniaxial electrogoniometer was used to measure elbow flexion ROM at onset of resistance (R1) and onset of discomfort (P1) during the median and radial neurodynamic tests on each side. Reliability was determined by testing 20 subjects twice and was found to be good (ICC greater than 0.88 and SEM less than 4.02°). There was no significant difference in mean ROM between sides. Lower-bound scores indicate that intra-individual, inter-limb differences of more than 15° for the median nerve and 11° for the radial nerve exceeds the range of normal ROM asymmetry on neurodynamic testing at R1 and P1. Correlation of ROM between limbs was significant with R(2) values of 0.62 and 0.85 for the median and radial nerves respectively. These finding provide clinicians with information regarding normal side-to-side variability in ROM during two commonly used variants of neurodynamic tests.

  4. Assessment of the trauma degree and spinal cord function of para-median minimally invasive and open TLIF for single segmental lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    Zheng Bo-long; He Bao-rong; Yang Xiao-bin; Yang Ming; Yan Liang; Bai Xiao-fan; Hao Ding-jun

    2016-01-01

    Objective:To study the trauma degree of para-median minimally invasive and open TLIF for single segmental lumbar degenerative disease and the effect on spinal cord function.Methods:A total of 78 cases of patients with single segmental lumbar disc herniation who received TLIF treatment in our hospital were selected as the research subjects and randomly divided into two groups, minimally invasive group received para-median minimally invasive TLIF and open group received open TLIF. Perioperative serum levels of oxidative stress indicators and pain mediators as well as spinal cord function were compared between two groups.Results: 1 d and 3 d after operation, serum SOD, GSH-Px and SP levels of minimally invasive group were significantly higher than those of open group, and MDA, AOPP, NO,β-EP, PGE2 and CGRP levels were significantly lower than those of open group; 1 week after operation, NCV and DL of common peroneal nerve and tibial nerve of two groups were not different from those before operation; 4 weeks and 16 weeks after operation, NCV of common peroneal nerve and tibial nerve of both groups were higher than those before operation while DL were lower than those before operation, and NCV of common peroneal nerve and tibial nerve of minimally invasive group were significantly higher than those of open group while DL were significantly lower than those of open group.Conclusion:The trauma degree of para-median minimally invasive TLIF for single segmental lumbar degenerative disease is less and the postoperative spinal cord function recovery is more ideal.

  5. Synthetic nanoparticles of bovine serum albumin with entrapped salicylic acid

    Directory of Open Access Journals (Sweden)

    Bronze-Uhle ES

    2016-12-01

    chemical morphology characterization and in vitro release studies indicated the potential use of these NPs as drug carriers in biological systems requiring a fast release of SA. Keywords: albumin nanoparticles, drug delivery, salicylic acid entrapped, nano-carriers

  6. Species-specific toxicity of troglitazone on rats and human by gel entrapped hepatocytes

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Chong [College of Materials Science and Chemical Engineering, Zhejiang University, Zhejiang 310027 (China); Meng, Qin, E-mail: mengq@zju.edu.cn [College of Materials Science and Chemical Engineering, Zhejiang University, Zhejiang 310027 (China); Zhang, Guoliang [Institute of Biological and Environmental Engineering, Zhejiang University of Technology, Zhejiang 310012 (China)

    2012-01-01

    Troglitazone, despite passing preclinical trials on animals, was shortly withdrawn from market due to its severe hepatotoxicity in clinic. As rat hepatocyte monolayer consistently showed sensitive troglitazone toxicity as human hepatocyte monolayer in contrast to the species-specific toxicity in vivo, this paper utilized both hepatocytes in three-dimensional culture of gel entrapment to reflect the species difference on hepatotoxicity. Rat hepatocytes in gel entrapment did not show obvious cellular damage even under a long-term exposure for 21 days while gel entrapped human hepatocytes significantly displayed oxidative stress, steatosis, mitochondrial damage and cell death at a short exposure for 4 days. As a result, the detected species-specific toxicity of troglitazone between gel entrapped rat and human hepatocytes consisted well with the situation in vivo but was in a sharp contrast to the performance of two hepatocytes by monolayer culture. Such contradictory toxicity of rat hepatocytes between monolayer and gel entrapment culture could be explained by the fact that troglitazone was cleared more rapidly in gel entrapment than in monolayer culture. Similarly, the differential clearance of troglitazone in rat and human might also explain its species-specific toxicity. Therefore, gel entrapment of hepatocytes might serve as a platform for evaluation of drug toxicity at early stage of drug development by reducing costs, increasing the likelihood of clinical success and limiting human exposure to unsafe drugs. -- Highlights: ► Species-specific toxicity of troglitazone reflected by rat/human hepatocytes ► 3D hepatocytes in 21 days’ long-term culture used for drug hepatotoxicity ► Oversensitive toxicity in hepatocyte monolayer by slow troglitazone clearance.

  7. Contributing Causes of Injury or Death in Grain Entrapment, Engulfment, and Extrication.

    Science.gov (United States)

    Issa, Salah Fuad; Field, William E; Schwab, Charles V; Issa, Fadi S; Nauman, Eric A

    2017-01-01

    Grain entrapments and engulfments are one of most common hazards associated with grain storage facilities, with over 1,140 such entrapments/engulfments documented since the 1970s. The objective of the study was to determine the factors that contribute to injury or death in grain entrapment, engulfment, and extrication cases. A literature review, including data contained in the Purdue Agricultural Confined Spaces Incident Database (PACSID), was conducted to determine the conditions that the body experiences during an entrapment or engulfment in grains and during extrication efforts. Based on the review, the conditions a human body faces during an entrapment, engulfment, or extraction can be split into two broad categories-environmental and physiological/psychological. The environmental factors depend on the grain's properties, depth of entrapment or engulfment, position of the victim's body, and characteristics of the storage unit, which include the grain's lateral pressure, vertical pressure, and weight, as well as friction, oxygen availability and diffusion rate, and grain temperature. The physiological and psychological factors are related to the individual's age and physical and psychological conditions, and manifest themselves in terms of oxygen consumption, asphyxiation (including aspiration, lack of oxygen, compression or splinting of the thorax), blood flow, and heart rate. Of all the above factors, a review of fatality data contained in the PACSID indicate that aspiration, asphyxiation, grain weight, and lateral pressure are most likely the primary cause of death for most entrapment victims. Research gaps found by this study include an understanding of the impact of lateral pressure on lung expansion and oxygen availability and consumption rate, and the need for more case studies to accurately determine cause of death.

  8. Alcohol neurolysis of lateral femoral cutaneous nerve for recurrent meralgia paresthetica.

    Science.gov (United States)

    Chen, Chee Kean; Phui, Vui Eng; Saman, Mat Ariffin

    2012-01-01

    Meralgia paresthetica is an entrapment mononeuropathy of lateral femoral cutaneous nerve, which results in localized area of paresthesia and numbness on the anterolateral aspect of the thigh. We describe the use of alcohol neurolysis of lateral femoral cutaneous nerve in a 74-year-old female who presented with paresthesia over antero-lateral aspect of her left thigh, which was consistent with meralgia paresthetica. Diagnostic block with local anaesthetic confirmed the diagnosis but only archieved temporary pain relief. Alcohol neurolysis was then offered and patient responded well with no complication. The patient experienced prolonged pain relief at 6-month follow-up, with return of ability to ambulate and perform daily activity. Alcohol neurolysis of lateral femoral cutaneous nerve is safe, effective and able to provide sustained pain relief for recurrent meralgia paresthetica.

  9. [Paralysis of the femoral nerve complicating ilio-psoas hemorrhage after iliac bone transplantation (author's transl)].

    Science.gov (United States)

    Mestdagh, H

    1982-03-11

    The author reported an unusual complication of iliac bone transplantation for grafting of a tibial pseudarthrosis. In a patient having anticoagulant therapy, a large iliac haematoma developed in the donor site and extended deep to the iliacus muscle and through the osteomuscular gap into the retroperitoneal space. Moreover it spread downwards and entrapped the femoral nerve as it lies behind the iliac fascia, above the inguinal ligament. Both a paralytic ileus and a femoral nerve injury commanded surgical exploration through an oblique iliac approach; emptying of the clotted haematoma, section of the inguinal ligament and liberation of the femoral nerve enable to avoid definitive sequelae to the quadriceps but the time required is varying: three years after the accident, recovery is not complete in the operated patient probably owing to delayed surgery (three weeks).

  10. Normal threshold values for a monofilament sensory test in sural and radial cutaneous nerves in Indian and Nepali volunteers.

    Science.gov (United States)

    Wagenaar, Inge; Brandsma, Wim; Post, Erik; Richardus, Jan Hendrik

    2014-12-01

    The monofilament test (MFT) is a reliable method to assess sensory nerve function in leprosy and other neuropathies. Assessment of the radial cutaneous and sural nerves, in addition to nerves usually tested, can help improve diagnosis and monitoring of nerve function impairment (NFI). To enable the detection of impairments in leprosy patients, it is essential to know the monofilament threshold of these two nerves in normal subjects. The radial cutaneous, sural, ulnar, median and posterior tibial nerves of 245 volunteers were tested. All nerves were tested at three sites on both left and right sides. Normal monofilament thresholds were calculated per test-site and per nerve. We assessed 490 radial cutaneous and 482 sural nerves. The normal monofilament was 2 g (Filament Index Number (FIN) 4.31) for the radial cutaneous and 4 g (FIN 4.56) for the sural nerve, although heavy manual laborers demonstrated a threshold of 10 g (FIN 5.07) for the sural nerve. For median and ulnar nerves, the 200 mg (FIN 3.61) filament was confirmed as normal while the 4 g (FIN 4.56) filament was normal for the posterior tibial. Age and occupation have an effect on the mean touch sensitivity but do not affect the normal threshold for the radial cutaneous and sural nerves. The normal thresholds for the radial cutaneous and sural nerves are determined as the 2 g (FIN 4.31) and the 4 g (FIN 4.56) filaments, respectively. The addition of the radial cutaneous and sural nerve to sensory nerve assessment may improve the diagnosis of patients with impaired sensory nerve function.

  11. Changes in nerve microcirculation following peripheral nerve compression

    Institute of Scientific and Technical Information of China (English)

    Yueming Gao; Changshui Weng; Xinglin Wang

    2013-01-01

    Following peripheral nerve compression, peripheral nerve microcirculation plays important roles in regulating the nerve microenvironment and neurotrophic substances, supplying blood and oxygen and maintaining neural conduction and axonal transport. This paper has retrospectively analyzed the articles published in the past 10 years that addressed the relationship between peripheral nerve compression and changes in intraneural microcirculation. In addition, we describe changes in different peripheral nerves, with the aim of providing help for further studies in peripheral nerve microcirculation and understanding its protective mechanism, and exploring new clinical methods for treating peripheral nerve compression from the perspective of neural microcirculation.

  12. 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.

  13. Topography and extent of pulmonary vagus nerve supply with respect to transthoracic oesophagectomy.

    Science.gov (United States)

    Weijs, Teus J; Ruurda, Jelle P; Luyer, Misha D P; Nieuwenhuijzen, Grard A P; van