In the present study, we illustrate the use of an electrophysiological classification as a guide to the treatment of carpal tunnel syndrome (CTS). A total of 113 CTS patients were assessed with symptom severity scores, hand functional scores and electrophysiological studies. By setting criteria of electrophysiological tests, 179 hands in 113 patients were classified into mild, moderate and severe degrees of CTS. Of these, the 41 hands with severe CTS were referred for surgery. The 58 hands with moderate CTS and 80 hands with mild CTS received conservative treatment. The improvement ratios in the severe group were greater than that in the moderate and mild groups, both at 6 months and at 1 year. Eighteen hands with moderate or mild CTS returned to normal electrophysiology with the conservative treatments. No patient recovered to normal electrophysiology in the severe group. This electrophysiological classification is objective and it may serve as a useful guide for non-surgical and surgical treatment of CTS.
The Trömner sign is commonly used as a clinical neurological examination for upper motor neuron lesions above the fifth or sixth cervical segments of the spinal cord. This study aims to assess and quantify the Trömner signs utilizing electrophysiological test, and correlate to the severity of cord compression in cervical spondylotic myelopathy (CSM). We enlisted 46 CSM patients, and 30 healthy persons as controls. Manual Trömner and Hoffmann signs were tested in all subjects. By using a self-designed instrument, we performed electrophysiological assessments for the Trömner signs in patients and controls. Parameters of conduction latencies and amplitude of muscle action potentials were measured and compared with the cord compression ratios in CSM patients. The results showed a greater diagnostic sensitivity for the quantified Trömner signs in comparison to those of manual Trömner signs and Hoffmann signs. We found a positive correlation between the amplitude of muscle action potentials obtained in the Trömner signs and the cord compression ratios in the patients with CSM. In conclusion, the Trömner signs can be measured by electrophysiological assessments. We demonstrate a new quantification method for an established neurological sign. Not only is Trömner sign a highly sensitive test in clinical neurological examination, the electrophysiological assessment of this sign can also serve as an objective marker for evaluation of the severity of cervical cord compression.
e development of a novel type of a sampling/ionization kit for use in electrospray ionization/mass spectrometry is reported. Using a small calligraphy-brush-style synthetic hair pen (nylon-brush), and analogous to paper-spray mass spectrometry, the analytes can be collected, elution/desorption and then ionized from the surface of the nylon-brush. e body of the kit was produced by means of a commercial 3D-printer, in which ABS (acrylonitrile butadiene styrene) was used as the starting material. Meanwhile, a small nylonbrush was embedded inside a 3D-printed plastic cell, in which a solvent was supplied to rinse the brush by means of capillary action. e size and weight of the kit were 1 g and 4 cm, respectively. e kit is disposable and it has various functions, including non-invasive sampling, sample-evaporation and ionization. As a result, when a type of pesticide was selected as the test sample (dimethoate; C 5 H 12 NO 3 PS 2 ), the limit of detection was determined to be 0.1 µg/mL. Collecting the pesticide from a leaf-surface (lettuce) was also successful. e process for fabricating the nylon-brush kit and the optimized experimental conditions are reported herein.
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