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Objective: The purpose of this article is to explore the effectiveness of B-Mode ultrasound as an auxiliary diagnostic tool for carpal tunnel syndrome (CTS). It aims to demonstrate the advantages of B-Mode ultrasound, including its noninvasive nature and its ability to provide real-time imaging, in localizing nerve compression and predicting postoperative outcomes. Methods: The study included 40 patients who were subjected to preoperative B-ultrasonography. The approach focused on evaluating the consistency of B-Mode ultrasound results with intraoperative findings. It also assessed the importance of employing standardized imaging techniques and emphasized the need for cooperation between hand surgeons and sonographers for accurate diagnosis. Results: B-Mode ultrasound findings in the study were consistent with intraoperative observations, indicating its reliability. Additionally, B-Mode ultrasound was able to identify other anatomical abnormalities within the carpal canal that may contribute to CTS symptoms, such as persistent median arteries, median nerve bifurcation, and space-occupying lesions like cysts and tumors. Conclusion: The article concludes that B-Mode ultrasound should be considered a valuable supplementary diagnostic tool for CTS, particularly in instances where clinical signs and electrophysiological studies do not offer clear results. However, it should not replace established diagnostic methods for CTS. [ABSTRACT FROM AUTHOR]

Objective: Carpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy in the USA. In this study, we define anatomical landmarks to assess symptomatic and asymptomatic cohorts with persistent CTS using MRI imaging. Materials and methods: Distal vs proximal incomplete release was determined using the distal most aspect of the hook of hamate and the distal wrist crease. An incomplete release showed the transverse carpal ligament (TCL) intact at either boundary. Twenty-one patients with persistent CTS were analyzed for incomplete release, median nerve enlargement and T2 signal hyperintensity, and flattening ratio using postoperative wrist MRI. These findings were compared to a ten-patient asymptomatic persistent CTS control group. Fisher's exact and a Student's two-tailed t-tests were used to determine statistical significance. Results: In the symptomatic persistent CTS group, 13 (61.9%) incomplete releases were identified, 5 (38.5%) incomplete distally, and 1 (7.7%) incomplete proximally. There was no statistical significance in the rate of incomplete releases when compared to the asymptomatic group (p = 1.00). T2 signal hyperintensity and enlargement at the site of release showed no statistical significance, (p = 0.319 and p = 0.999, respectively). The mean flattening ratio at the site of release in the symptomatic group (2.45 ± 0.7) was statistically significant compared to the asymptomatic group (1.48 ± 0.46), (p = 0.007). Conclusion: Utilizing the established landmarks, the full length of the TCL can be assessed via MRI. Additionally, evaluation of the median nerve flattening ratio at the level of the incomplete release may be utilized as an aid to the clinical management of persistent CTS. [ABSTRACT FROM AUTHOR]

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy caused by impairment of the median nerve due to compression as it passes through the carpal tunnel. The current gold standard in diagnosing CTS and nerve damage is by electrophysiological nerve conduction study (NCS). However, 10 to 25% of NCS results are falsely negative. Moreover, NCS remains an expensive and time-consuming procedure for patients. Ultrasonography serves as a real-time, well-tolerated, portable, and noninvasive tool for assessing the carpal tunnel. This study aims to assess the role of high-frequency ultrasound of the median nerve at the wrist in evaluating CTS and correlate with NCS to determine whether sonography can be used as an alternative to NCS in diagnosing and grading CTS.

Abstract Background High-resolution ultrasound (HRUS) is a rapidly developing technology that is gaining popularity for the evaluation of the ulnar nerve. Objective To evaluate the role of dynamic HRUS for the detection of different abnormalities of ulnar nerve entrapment at the elbow. Patients and Methods Sixty-two elbows divided into 23 elbows with symptomatic and sonographic findings (symptomatic group), 39 elbows as a control group, which were further subdivided into 24 which were clinically and sonographically free (control group), and 15 subjects as a case nonmanifest group who were clinically free, but has sonographic findings (asymptomatic UNE group), were studied. The ulnar nerve cross-sectional area (CSA) was measured at the Guyon canal, mid-forearm, and maximal swelling (MS) point around the elbow. We assessed also the flattening ratio at the elbow by measuring the widest transverse and anteroposterior diameters during elbow extension and flexion. Results There was a statistically significant difference of the cross-sectional area and flattening ratio of the ulnar nerve at the elbow during extension and flexion between the three groups (symptomatic, case nonmanifest, and healthy control elbows) (P value = 0.05). Conclusion Dynamic HRUS is a highly accurate, sensitive diagnostic modality for the ulnar nerve entrapment syndrome at the elbow.

Objective: The purpose of this article is to explore the effectiveness of B-Mode ultrasound as an auxiliary diagnostic tool for carpal tunnel syndrome (CTS). It aims to demonstrate the advantages of B-Mode ultrasound, including its non-invasive nature and its ability to provide real-time imaging, in localizing nerve compression and predicting postoperative outcomes., Methods: The study included 40 patients who were subjected to preoperative B-ultrasonography. The approach focused on evaluating the consistency of B-Mode ultrasound results with intraoperative findings. It also assessed the importance of employing standardized imaging techniques and emphasized the need for cooperation between hand surgeons and sonographers for accurate diagnosis., Results: B-Mode ultrasound findings in the study were consistent with intraoperative observations, indicating its reliability. Additionally, B-Mode ultrasound was able to identify other anatomical abnormalities within the carpal canal that may contribute to CTS symptoms, such as persistent median arteries, median nerve bifurcation, and space-occupying lesions like cysts and tumors., Conclusion: The article concludes that B-Mode ultrasound should be considered a valuable supplementary diagnostic tool for CTS, particularly in instances where clinical signs and electrophysiological studies do not offer clear results. However, it should not replace established diagnostic methods for CTS., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chen, Zou, Xia, Hu, Chen and Zheng.)

Back ground: Carpal tunnel syndrome is the most commonly diagnosed entrapment neuropathy of the upper extremity. Ultrasound has emerged as an alternative confirmatory test for Carpal tunnel syndrome, however, its potential role is limited by lack of adequate data for sensitivity and specificity. Aim of study: to assess the usefulness of ultrasound in the diagnosis of carpal tunnel syndrome for cases their diagnosis confirmed by surgery. Patients and Methods: a prospective study during a period from August 2014 to August 2015, in which 40 patients with a clinical diagnosis of carpal tunnel syndrome, all patients were subjected to examination by high-resolution ultrasound and then all were operated upon by fasciatomy to confirm diagnosis, then sensitivity, specificity and accuracy of ultrasound were calculated. Results: the present study included 40 patients; 36 females and 4 males, 5 left hand and 35 right, age range 20-50 years; mean±SD (37.28±9), Sensitivity for PD and FR were 90% and 75% respectively, specificity for PD and FR were77.5% and 85% respectively, and accuracy for PD and FR were 84% and 83% respectively. Conclusions: The present study included 40 patients 36 females and 4 males, 5 left hand and 35 right, age range 20-50 years; mean±SD (37.28±9), sensitivity for PD and FR were 90% and 75% respectively, specifity for PD and FR were 77.5% and 85% respectively and accuracy for PD and FR were 84% and 83% respectively. Conclusion; ultrasound is a useful method for confirming diagnosis of median nerve involvement in patients with carpal tunnel syndrome. [ABSTRACT FROM AUTHOR]

Objectives: Diagnosis of carpal tunnel syndrome (CTS) is based on the clinical symptoms and nerve conduction study. Magnetic resonance imaging (MRI) is non-invasive objective tool for assessing the median nerve and carpal tunnel. The purpose of this study was to evaluate MRI changes in patients with CTS, and compare them with healthy subjects., Materials and Methods: Forty-three CTS patients and 43 age matched control were included and scanned in a 3T MRI scanner. Cross-sectional areas (CSA) of median nerve were measured at the level of distal radio-ulnar joint level (CSA1), proximal row of carpal bone (CSA2), and hook of hamate (CSA3). Flattening ratio (FR) of median nerve, thickness of flexor retinaculum, median nerve signal intensity, and thenar muscles were assessed. Fractional anisotropy (FA), average diffusion coefficient (ADC), and radial diffusivity (RD) of median nerve of CTS patients were obtained from diffusion tensor imaging (DTI) and compared with those of controls., Results: Thirty-three patients (76.7%) were female. Mean duration of the pain was 7.4 ± 2.6 months. The mean CSA1 (13.2 ± 4.2 mm 2 ), CSA2 (12.5 ± 3.5 mm 2 ), and CSA3 (9.2 ± 1.5 mm 2 ) in CTS patients were significantly higher compared to control group: CSA1 (10.15 ± 1.64 mm 2 ), CSA2 (9.38 ± 1.37 mm 2 ), and CSA3 (8.4 ± 0.9 mm 2 ), ( P = 0.001 in all). The mean FR of median nerve and thickness of flexor retinaculum were increased in CTS patients. The mean FA was reduced in CTS patients compared to control proximal to carpal tunnel and within the tunnel. Mean ADC and RD values were higher in CTS patients as compared to control for both levels., Conclusion: MRI can detect subtle changes in the median nerve and thenar muscles in CTS and may be useful in equivocal cases and to exclude secondary causes of CTS. DTI shows reduced FA and increased ADC and RD in CTS patients., Competing Interests: There is no conflict of interest., (© 2023 Published by Scientific Scholar on behalf of Journal of Neurosciences in Rural Practice.)

Impact of palladium clusters with different sizes on a zirconium surface at various incident velocities was investigated by molecular dynamics simulation at the room temperature. The impact process was characterized by impacting of the cluster on the surface, intermixing and relaxation of the cluster and substrate atoms. Furthermore, the deformation compression ratio, flattening ratio and embedding depth of the palladium clusters were examined. Additionally, one region of the substrate surface impacting by the cluster was defined to study the evolution of the local surface temperature and stress with time during the impact process. It is found that the penetrating atoms of palladium clusters almost diffuse from the central area to the edge with increasing the collision velocity due to the ultrahigh hardness of the zirconium substrate. Compared to the lower incident velocity, the cluster with a higher incident velocity could generate much stronger shear stress. When the impact velocity reached up to 1100 m/s, the local temperatures was not high enough to melt the zirconium substrate. The local shear stress and heating promoted the combination between the cluster and substrate, but the local melting of the substrate does not emerge. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the cross-sectional shape and size variation of the yarn in fabric depending on the structural parameters of fabric. For this reason, the dimensions of the yarns that are in the different regions of the weave unit have been determined by achieving the cross-sectional images of the fabrics, which were woven with different weave types and at different weft settings. The variation in the cross-section of the yarn has been evaluated by using the flattening ratio. Consequently, it has been observed that the structural factors which determine the geometry of the fabric, such as weave type and setting, affect the cross-sectional properties of the yarn along the yarn path. [ABSTRACT FROM PUBLISHER]

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy caused by impairment of the median nerve due to compression as it passes through the carpal tunnel. The current gold standard in diagnosing CTS and nerve damage is by electrophysiological nerve conduction study (NCS). However, 10 to 25% of NCS results are falsely negative. Moreover, NCS remains an expensive and time-consuming procedure for patients. Ultrasonography serves as a real-time, well-tolerated, portable, and noninvasive tool for assessing the carpal tunnel. This study aims to assess the role of high-frequency ultrasound of the median nerve at the wrist in evaluating CTS and correlate with NCS to determine whether sonography can be used as an alternative to NCS in diagnosing and grading CTS., Competing Interests: Conflict of Interest Nil., (Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

• Flattening ratio of a particular splat can be obtained by image analysis software. • The formula for calculating the overall fattening ratio is proposed. • The higher the FR, the better the wear performance, only applies to similar composite coatings. Cold spray is one of the promising coating deposition techniques for fabricating anti-wear composite coatings. These composite coatings contain an even distribution of the two phases, they are Ti-6Al-4V and Al splats if referring to the current study. With the help of image analysis software (Fiji), the flattening ratio (FR) of Al splats was found to be larger than that of Ti-6Al-4V in different composite coatings. The overall FR is more comprehensively correlated to fracture toughness and wear performance for the entire composite structure, rather than comparing the particular FR of Ti-6Al-4V or Al splats only. The higher the FR of the composite coating, the better its wear performance, but this phenomenon only applies to the same type of composite coating, because different composite coatings respond differently to wear. [ABSTRACT FROM AUTHOR]

The flattening ratio, ε, is an important diagnostic measurement of particle deformability and coating quality assessment in cold spray. However, the experimental determination of ε and correlation of it to experimental parameters (particle size, velocity) is not straightforward from observations of cold-sprayed coatings. Here we present a series of direct site-specific measurements of ε for well-known particle sizes and velocities, without the many complications involved in a full cold spray experiment. This approach permits us to identify mechanistic transitions separating three apparent regimes of behavior. In regime I, at lower velocities just high enough to cause bonding, an impacting particle flattens largely unhindered. In regime II, at somewhat higher velocities, the substrate develops a significant crater, which in turn constrains lateral particle flattening as the particle burrows more deeply into the substrate. In regime III, at very high velocities, hydrodynamic particle penetration is observed, distinguished by deep burrowing of the particle, which adopts a concave-saucer shape, with large petals of substrate ejected backwards out of the surface. While direct measurements in regimes I and II show that deformed particles can be reasonably modeled as oblate spheroids, that assumption fails in regime III. To the extent that particle flattening is deemed desirable, this analysis suggests a more nuanced view of the velocities used in cold spray. Unlabelled Image • We present a series of direct site-specific measurements of particle flattening ratio for Cu-Cu and Al-Al matched impacts. • We identify mechanistic transitions separating three apparent regimes of flattening behavior. • Regime I at low velocities sees particles flatten largely unhindered against the substrate. • In Regime II, the substrate develops a crater large enough to constrain lateral particle flattening. • In Regime III, the contact problem is dominated by hydrodynamic flow leading to deep particle penetration. [ABSTRACT FROM AUTHOR]

To investigate the effects of static hand postures during various finger and wrist positions on morphological changes of the median nerve within the carpal tunnel in intensive and nonintensive electronic device users. Forty-eight university students, equally divided into intensive and nonintensive users (≥5 h/d and <5 h/d of electronic device usage, respectively), were randomly selected after questionnaire responses and evaluated clinically and by ultrasonography. Intensive users reported more wrist/hand pain with a high severity score than nonintensive users. They also had larger median nerve cross-sectional areas, flattening ratios, and perimeters than nonintensive users, and showed less median nerve deformation under various finger and wrist positions. Compared with the neutral wrist position with all fingers extended for both intensive and nonintensive users, the cross-sectional areas decreased under finger flexion and grip, as well as wrist extension-flexion and radial-ulnar deviation. Overall, the average median nerve size of the dominant hand was much larger than that of the nondominant hand, especially for intensive users. Wrist deviation from neutral can lead to more pronounced deformation of the median nerve than finger flexion for both intensive and nonintensive users. To minimize compression on the median nerve, it is important to keep the wrist as near to the neutral position as possible during computer-related work and avoid keeping the thumb and fingers in a static flexed position when using mobile devices, especially for single-hand use. On the basis of this observational study, intensive users had enlarged and flattened median nerves as well as decreased nerve deformation during hand motions compared with nonintensive users. As overuse of electronic devices may adversely affect the median nerve, caution may be warranted. [ABSTRACT FROM AUTHOR]