ObjectiveTo determine the value of gray-scale and power Doppler ultrasonography in the evaluation of carpal tunnel syndrome (CTS).Materials and MethodsMedian nerves at the carpal tunnel were evaluated by using gray-scale and power Doppler ultrasonography and by using accepted and new criteria in 42 patients with CTS (62 wrists) confirmed by electromyogram and 33 control subjects. We evaluated the cross-sectional area of the nerve just proximal to the tunnel inlet (CSAa), and at mid level (CSAb). We then calculated the percentage area increase of CSAb, and area difference (CSAb-CSAa). We measured two dimensions of the nerve at the distal level to calculate the flattening ratio. The power Doppler ultrasonography was used to assess the number of vessels, which proceeded to give a score according to the vessel number, and lastly evaluated the statistical significance by comparing the means of patients with control subjects by the Student t test for independent samples. Sensitivities and specificities were determined for sonographic characteristics mentioned above. We obtained the receiver operating characteristic (ROC) curve to assess the optimal cut-off values for the diagnosis of CTS.ResultsA statistically significant difference was found between patients and the control group for mean CSAb, area difference, percentage area increase, and flattening ratio (p < 0.001, p < 0.001, p < 0.001, p < 0.05, respectively). From the ROC curve we obtained optimal cut-off values of 11 mm2 for CSAb, 3.65 for area difference, 50% for the percentage of area increase, and 2.6 for the flattening ratio. The mean number of vessels obtained by power Doppler ultrasonography from the median nerve was 1.2. We could not detect vessels from healthy volunteers. Mean CSAbs related to vascularity intensity scores were as follows: score 0: 12.3 ± 2.8 mm2, score 1: 12.3 ± 3.1 mm2, score 2: 14.95 ± 3.5 mm2, score 3: 19.3 ± 3.8 mm2. The mean PI value in vessels of the median nerve was 4.1 ± 1.ConclusionGray-scale and power Doppler ultrasonography are useful in the evaluation of CTS.

Objective-To identify the risk factors for falling after stroke, to establish the relation with lesion localisation, and to evaluate the incidence of falling. Methods-The falling history and the mood of 293 patients with stroke were investigated by a standard questionnaire. Other information (time since stroke, risk factors, and CT) about patients was obtained from their hospital records. Results-Increasing age, depression, and heart disease were significant risk factors for falling (heart disease had a negative influence). A right hemispheric infarct was significantly more common among the falling group. Conclusion-This study suggests clues for possible modifications of the management of patients with stroke during the recovery period. 1-5 A very high incidence of falls (15.9/1000 patients/day) has been reported from a geriatric unit for stroke rehabilitation. 6 The aim of this study was to investigate the incidence of falling, to identify the risk factors for falling after stroke, and to evaluate the relation between lesion localisation and falling. Materials and methodsThe participants of the study were patients with ischaemic or haemorrhagic stroke who were followed up in our stroke unit between the years of 1992-6.The exclusion criteria were history of a transient ischaemic attack, epilepsy, orthopaedic problems, major psychiatric problems, and intracranial operations. Two hundred and ninety three patients were eligible for the study. A standard questionnaire was posted to the patients or their relatives to obtain information about falling. Questions were asked about the number of falls, and the patient's psychiatric status and functional capability. Falling was described as losing balance under conditions such as during standing up from a lying position, walking, changing position, or descending stairs, without any change of consiousness.On the questionnaire form, patients were asked to fill out the Montgomery and Asberg rating scale and Barthel index functional status forms to evaluate their mood and functional status. Other information about stroke type and severity, CT and MRI findings, and risk factors for stroke were screened from their hospital recordings. A neurologist checked all questionnaire forms and the patients were separated into two groups; falling patients and non-falling patients.DATA ANALYSES Data were collected on standard proformas for analyses using SPSS version 7.5 for Windows 95 (SPSS Inc). We used 2 tests (categorical variables) and Student's t test as appropriate (continuous variables) to investigate the relation between each question and demographic variables and outcomes. Results are reported as arithmetic mean and simple SD. Variables considered for questions were Barthel index, Montgomery and Asberg rating scale, age, and sex. Each patient's risk factors, age, and the hemisphere involved in ischaemia were assessed. Statistical significance was accepted at the 0.05 level. ResultsWe registered 131 falling (44% of all patients, mean (SD) age 62.5 (10.3)) and 162 non-fallin...

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Amyloid β42 (Aβ42) and proinflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) have been suggested to contribute to the pathogenesis of Alzheimer's disease (AD) and vascular dementia (VaD). Our aim was to examine whether the changes in these parameters would be able to discriminate the patients with AD from those with VaD and from healthy individuals. We have analyzed the levels of Aβ42, IL-6 and TNF-α in the serum of newly diagnosed 28 AD patients, 16 VaD patients and 26 healthy non-demented controls. We also investigated whether there is an association between Aβ42, IL-6 and TNF-α levels and mini-mental state examination (MMSE) scores and body mass indexes (BMI) of patients. Our data showed a significant decrease in serum Aβ-42 levels in AD patients compared to VaD patients and controls. Levels of IL-6 and TNF-α were not different between AD patients, VaD patients and controls. We observed a correlation between Aβ-42 levels and MMSE scores and BMI levels in both AD and VaD patients. However, Aβ-42 levels were not correlated with IL-6 and TNF-α levels. Significantly lower levels of Aβ42 found in the serum of AD patients than that of VaD patients and controls suggests that it can be a specific biochemical marker for AD.

We advocate that removal of RA does not lead to any major neurologic hand complications in the presence of adequate collateral arterial blood supply. ENMG studies confirmed minimal conduction alterations with no statistical significance, even if neurologic symptoms were stated.