bluuebunny/crossref_metadata_2025_split huggingface dataset:
AAEM case report #2: The carpal tunnel syndrome
Authors: Ross Mark A. , Kimura Jun 
Published: January 2005

AbstractThe symptoms and sings which constitute the carpal tunnel syndrome (CTS) result from entrapment or compression of the median nerve within the carpal tunnel. Electrodiagnostic studies may objectively document the presence of median neuropathy within the carpal tunnel and help distinguish CTS from other disorders such as cervical radiculopathy, neurogenic thoracic outlet syndrome, proximal median nerve compression syndromes, and polyneuropathy which may either mimic or occasionally coexist with CTS. Recording median nerve responses with wrist and palm stimulation allows determination of the wrist segment conduction velocity which is a more sensitive nerve conduction parameter than wrist latency measurements. Electrodiagnostic testing permits estimation of severity and relative contribution of axonal versus demyelinative nerve injury. This information can provide prognostic information and help guide therapeutic decisions. © 1995 Mark A. Ross, MD and Jun Kimura, MD. Published John Wiley & Sons, Inc.
Does ulnar neuropathy predispose to focal dystonia?
Authors: Ross Majorie H. , Charness Michael E. , Lee D. , Logigian Eric L. 
Published: January 2005

AbstractWe have observed a high incidence of ulnar neuropathy in musicians with dystonic flexion of the ipsilateral little and ring fingers. To investigate the relationship between ulnar neuropathy and focal dystonia, we compared the patterns of surface EMG activity in extensor digitorum communis (EDC4) and flexor digitorum superficialis (FDS4) during tapping of the ring finger in normal controls and patients with ulnar neuropathy or local dystonia. Ten of 10 normal subjects exhibited wellformed alternating EMG bursts in EDC4 and FDS4 separated by clear silent periods. Seven of 7 patients with dystonic flexion of the little and ring fingers showed loss of silent periods between poorly formed bursts in FDS or EDC. Surprisingly, 9 of 10 patients with ulnar neuropathy showed burst pattern abnormalities qualitatively similar to those observed in the dystonic patients. These data suggest that ulnar neuropathy alters the execution of a motor task involving multiple peripheral nerves. © 1995 John Wiley & Sons, Inc.
Altered muscle calcium channel binding kinetics in autoimmune motoneuron disease
Authors: Smith R. Glenn , Kimura Fumiharu , Harati Yadollah , McKinley Kevin , Stefani Enrico , Appel Stanley H. 
Published: January 2005

AbstractWhile skeletal muscle is not apparently affected directly in amyotrophic lateral sclerosis (ALS), immunoglobulin G fractions purified from patients with ALS (ALS IgG) bind dihydropyridine (DHP)‐sensitive L‐type voltage‐gated calcium channel (VGCC) antigen isolated from skeletal muscle in ELISA and Western immunoblot, and alter VGCC function in vitro. To determine whether muscle VGCC properties are altered in ALS, VGCC‐enriched subsarcolemmal membrane fractions were prepared from biopsied quadriceps muscle of patients with ALS, with other neurologic diseases, or without apparent muscle disease, and tested for DHP binding with [3H]PN200‐110. ALS muscle VGCCs from muscle fractions of most other patients, independent of denervation‐induced increases in DHP binding site number. Similarly elevated DHP binding affinities were observed in specimens from patients with autoimmune motor neuropathies, suggesting that ALS and immunemediated motoneuron disease share skeletal muscle L‐type VGCC alterations. © 1995 John Wiley & Sons, Inc.
Site‐dependent pathological differences in smooth muscles and skeletal muscles of the adult MDX mouse
Authors: Boland B. , Himpens B. , Denef J. F. , Gillis J. M. 
Published: January 2005

AbstractThis study presents a survey of the morphometric characteristics, the regeneration rate, and the extent of muscle dystrophy in several smooth and skeletal muscles from adult mdx mice, an animal model of the Duchenne muscular dystrophy (DMD). Smooth muscles from adult mdx mice showed neither cell necrosis nor fibrosis. As compared to control C57 mice, the thickness of the mdx smooth muscle was normal in the vascular and urogenital layers but significantly reduced in the digestive layers, a finding relevant to clinical reports of gastrointestinal dilatation in DMD patients, and suggesting that gastrointestinal dysfunctions should be systemically searched for in DMD patients. Adult mdx skeletal muscles, however, presented different patterns of muscle suffering: either absent (esophagus); very mild (trunk and limb muscles); or severe (diaphragm). In these three conditions we studied the fiber diameters, the nuclei locations, and the regeneration rate. From this comparative study, it seems that severe dystrophy occurs in muscle tissues showing large fiber diameter and peripheral location of the nuclei. We showed that this combination occurs in the mouse diaphragm which is thus a realistic model for human DMD muscles. © 1995 John Wiley & Sons, Inc.
Dynamic electromyography and muscle biopsy changes in a 4‐year follow‐up: Study of patients with a history of polio
Authors: Stålberg Erik , Grimby Gunnar 
Published: January 2005

AbstractEighteen patients who had had polio 29–56 years prior to the first investigation were studied on two occasions, 4 years apart. Isokinetic and isometric strength measurements and Macro EMG were performed in 28 legs. Muscle biopsy specimens were obtained on both occasions from 11 legs. On average the muscle strength was 56% of control values at the first examination, and decreased by another 8% during the observation period. The muscle fiber area was increased compared to that of controls and did not change significantly. Macro EMG, comprising muscle fiber area and number of muscle fibers, and/or single fiber EMG showed clear signs of reinnervation in all legs. The motor units at the first examination were increased 11‐fold, on average, compared with age‐matched control values. During the observation period, reinnervation continued and the size of motor units increased by another 56% as a result of ongoing denervation, that is, loss of neurons. This compensation was particularly pronounced in patients with stable conditions. The parameters studied did not reveal any definite pattern predicting future development of new muscle weakness in individual subjects. © 1995 John Wiley & Sons, Inc.
Motor conduction parameters in neuropathies associated with anti‐mag antibodies and other types of demyelinating and axonal neuropathies
Authors: Trojaborg W. , Hays A. P. , Van Den Berg L. , Younger D. S. , Latov N. 
Published: January 2005

AbstractWe measured residual latency (RL), motor conduction velocity (MCV), and terminal latency index (TLI) in 15 patients with neuropathy and anti‐MAG or SGPG antibodies and compared these to values obtained in 103 patients with other types of polyneuropathy (PN) and to 57 normal subjects. Ten patients had anti‐MAG antibody titers of 25,600 or higher, and 5 had titers between 800 and 12,600. Patients with the highest titers had longer RL, slower MCV and shorter TLI than those with lower titers, acute or chronic inflammatory demyelinating PN, hereditary neuropathy, and metabolic or axonal neuropathy. In contrast F‐wave latencies did not contribute to the differentiation between the groups of demyelinating neuropathies. RL and TLI correlated best with anti‐MAG antibody titers, whereas there was a poor correlation with anti‐SGPG titers suggesting that MAG more than SGPG may be the antigen in PN, and that the distal nerves are affected more than their proximal segments. The RL rather than TLI turned out to be the best variable to classify the demyelinating type of anti‐MAG neuropathy. Sural nerve biopsy in 5 of the patients with the highest titer of anti‐MAG antibodies showed deposits of lgM and C3 on the myelin sheaths, pronounced demyelination and widening of the myelin lamellae. In 4 of the patients with lower titers demyelination was absent or less pronounced. © 1995 John Wiley & Sons, Inc.
Pretreatment of myoblast cultures with basic fibroblast growth factor increases the efficacy of their transplantation in mdx mice
Authors: Kinoshita Ikuo , Vilquin Jean‐Thomas , Tremblay Jacques P. 
Published: January 2005

AbstractThe effect of pretreatment of cultures with basic fibroblast growth factor (bFGF) on myoblast allotransplantation to C57BL/10ScSn mdx/mdx mouse (mdx mouse) muscles not previously damaged and not irradiated was studied. Transgenic CD1 mice which have a β‐galactosidase gene under the control of the promoter of the quail fast skeletal muscle troponin I gene, were used as donors. The myoblasts were grown with 100 ng/mL bFGF during the last 2 days before injecting them in the left tibialis anterior (TA) muscles of mdx mice. Myoblasts from the same primary cultures were also grown without bFGF and injected in the right TA muscles as control. The recipient mice were immunosuppressed with FK 506. Twenty‐eight days after myoblast transplantation, the percentage of β‐galactosidase‐positive fibers was significantly higher (more than fourfold) following culture with bFGF than without bFGF. Almost all β‐galactosidase‐positive fibers were also dystrophin positive. Direct intramuscular injections of bFGF or of Hank's balanced salt solution (HBSS) at the time of myoblast transplantation and at several intervals afterwards were also investigated. The percentage of β‐galactosidase‐positive fibers did not differ significantly following intramuscular injection of bFGF from controls injected with HBSS. In vitro, this high concentration of bFGF significantly reduced the formation of myotubes, and the percentage of mononuclear cells which were myoblasts was significantly increased by 34%. These observations alone do not account for the fourfold increase in transplantation success. The presence of bFGF in the culture did not significantly increase the cell survival 3 days after their transplantation. Our results indicate that culture of myoblasts with bFGF permits to obtain a high percentage of hybrid muscle fibers following myoblast transplantation without using damaging treatments such as notexin injection and irradiation. This suggests that such pretreatment may be helpful for myoblast transplantation in humans. The mechanism of this effect is still unclear. © 1995 John Wiley & Sons, Inc.
Peroneal nerve repetitive nerve stimulation test: Its value in diagnosis of myasthenia gravis and Lambert–Eaton myasthenic syndrome
Authors: Oh Shin J. , Head Thomas , Fesenmeier James , Claussen Gwendolyn 
Published: January 2005

AbstractWe have developed a repetitive nerve stimulation (RNS) technique for the peroneal nerve. Normal limits for the decremental responses for the anterior tibialis and extensor digitorum brevis muscles are 6–21% at the low rate of stimulation and 44–70% at the high rate of stimulation. These values exceed the normal limits for other commonly tested muscles. This may be due to the lower safety factor for neuromuscular transmission for the anterior tibialis and extensor digitorum brevis muscles. We present 4 cases in which the peroneal nerve RNS test was crucial for the diagnosis of the limb‐girdle form of MG or LEMS. Thus, we conclude that, in a small number of patients with neuromuscular transmission disorders, the peroneal nerve RNS test is needed for confirmation of disease. © 1995 John Wiley & Sons, Inc.
The utility of various sensory nerve conduction responses in assessing brachial plexopathies
Authors: Ferrante Mark A. , Wilbourn Asa J. 
Published: January 2005

AbstractTo determine which sensory nerve conduction studies (S‐NCS) are helpful in detecting supraclavicular axon loss brachial plexopathies, we selected 53 cases (of 417 reviewed) in whom complicating factors were absent and which, by needle electrode examination findings, involved only a single “truncal” element (upper, middle, or lower) of the brachial plexus. Extensive S‐NCS included: median, recording thumb (Med‐D1), index (Med‐D2), and middle fingers (Med‐D3); ulnar, recording fifth finger (Uln‐D5); dorsal ulnar cutaneous, recording dorsum of the hand (DUC); radial, recording base of thumb; and both medial and lateral antebrachial cutaneous (MABC, LABC), recording forearm. Except for the median sensory fibers, the “cord” elements traversed by the sensory fibers assessed during the S‐NOS listed above are anatomically defined (i.e., the sensory fibers enter the brachial plexus at only one cord). In regard to the median sensory fibers, however, there are two possible pathways through the infraclavicular plexus: (1) the lateral cord and/or (2) the medial cord. Because the lower trunk is only accessible via the medial cord, any sensory fibers found to be traversing the lower trunk had to first traverse the medial cord. Similarly, those traversing the upper and middle trunks must first be a component of the lateral cord. The frequency that the various S‐NCS responses were abnormal (unelicitable, below laboratory normal value, or ≤ 50% of the contralateral response) for a given brachial plexus element lesion was as follows: (1) upper trunk (UT): 25 of 26 Med‐D1, 25 of 26 LABC, 15 of 26 radial, 5 of 26 Med‐D2, 2 of 26 Med‐D3; (2) middle trunk (MT): 1 of 1 Med‐D3; (3) lower trunk (LT): 25 of 26 Uln‐D5, 22 of 23 DUC, 11 of 17 MABC, 3 of 23 Med‐D3. With lower trunk brachial plexopathies, both “routine” (Uln‐D5) and “uncommon” (DUC; MABC) S‐NCS are abnormal. With upper trunk brachial plexopathies, in contrast, only the “uncommon” S‐NCS (Med‐D1; LABC) are consistently affected. The “routine” median S‐NCS recording digit 2 (Med‐D2) is far less reliable than the median S‐NCS recording digit 2 (Med‐D1) in detecting upper trunk axon loss brachial plexopathies. Additionally, the various pathways traversed by the fibers contributing to the individual S‐NCS responses can be predicted, an important point when the full extent of a brachial plexus lesion is sought. © 1995 John Wiley & Sons, Inc.
AAEM case report #29: Prolonged paralysis after neuromuscular blockade
Authors: Gooch Judith L. 
Published: January 2005

AbstractNondepolarizing neuromuscular blocking agents (NMBA) are being used with increasing frequency in critically ill patients. Recently, many centers have described patients with prolonged muscle weakness after long‐term use of these agents, either alone or in combination with other agents or disorders. Brief weakness lasting several hours to several days is probably the result of prolonged neuromuscular blockade, while more prolonged weakness lasting several weeks to months is, in all likelihood, caused by a myopathy. Patients with this myopathic disorder have flaccid paralysis with intact cognition and sensation. Electrodiagnostic findings include decreased M‐wave amplitudes, positive waves and fibrillations, and rapid recruitment of small amplitude short duration, polyphasic motor unit potentials. Muscle biopsy findings include atrophy of type I and type II fibers, myofiber necrosis, and selective loss of thick myofilaments. The myopathy is believed to be related to the prolonged use of NMBA either alone or in combination with other disorders or medications, particularly corticosteroids. The weakness experienced by these patients leads to additional respiratory compromise, difficulty weaning from the ventilator, and prolonged hospitalization. © 1995 John Wiley & Sons, Inc.
Lateral rectus emg and contractile responses elicited by cat abducens motoneurons
Authors: Shall Mary S. , Goldberg Stephen J. 
Published: January 2005

AbstractStimulation of 41 single, abducens nucleus motoneurons in the cat evoked electromyographic (EMG) and contractile responses in the ipsilateral lateral rectus muscle. Separate, bipolar, fine wire EMG recording electrodes in the global and orbital muscle layers showed that 22 muscle units were confined to the global layer, 8 to the orbital layer, and 11 units were contained in both (“bilayer”) muscle layers. “Bilayer” units demonstrated significantly greater twitch (P ≤ 0.002) and maximum tetanic (P ≤ 0.001) tensions as well as faster fusion frequencies (P ≤ 0.022) than either global or orbital units. “Bilayer” units also showed the lowest average kt values (the slope of the linear relationship between motoneuron stimulation frequency and isometric tetanic tension). “Bilayer” units were predominantly fast fatigable (FF). Global units displayed all muscle unit types including all the nonwitch (NT) units. Orbital units were identified as slow fatigable (SF) and fast fatigue resistant (FR). © 1995 John Wiley & Sons, Inc.
Thoracic spinal nerve and root conduction: A magnetic stimulation study
Authors: Chokroverty Sudhansu , Deutsch Alan , Guha Chandralekha , Gonzalez Andres , Kwan Peter , Burger Robert , Goldberg Jerucham 
Published: January 2005

AbstractWe describe a technique of magnetic coil (MC) stimulation of the thoracic spinal nerves and roots in 12 normal subjects and a patient with diabetes mellitus. We kept the MC flat against the vertebral column in the midline over T‐7, T‐8, and T‐9 spinous processes and obtained compound muscle action potentials from the upper rectus abdominis, external oblique, and intercostal muscles. We obtained mean latencies to these muscles after stimulation in the posterior axillary line. We noted that the onset latencies remained fixed despite increasing the intensity of stimulation from 30% to 100% and on moving the coil up to 3 cm lateral to the spinous processes suggesting that the stimulation of the fastest conducting fibers was occurring at a fixed site, most likely at the intervertebral foramina. Prolonged latencies in the diabetic patient confirmed the diagnosis of radiculoneuropathy. © 1995 John Wiley & Sons, Inc.
Conduction study of digital nerve function recovery following toe‐to‐digit transplantation and a comparison with digit‐to‐digit replantation
Authors: Chu Nai‐Shin , Chu Eric C. , Yu Jia‐Ming 
Published: January 2005

AbstractRecovery of digital nerve function following toe‐to‐digit transplantation was studied by nerve conduction in 16 patients, and a comparison was made with digit‐to‐digit replantation in 7 patients. For toe transplantation and digit replantation, the mean interval between injury and surgery was 7 months and 8 h, respectively, while the mean interval between surgery and study was 39 months and 25 months, respectively. Sensory nerve action potentials (NAPs) from digital nerve stimulation were recorded at the wrist and the elbow, whereas mixed NAPs from median nerve stimulation at the wrist were recorded at the elbow. Sensory NAPs from stimulation of the transplanted toe were detectable in 14 patients and showed reduced amplitude, prolonged latency, and slowed conduction velocity. There was retrograde amplitude reductiond in the median nerve and in the proximal segment of the digital nerve. Sensory NAPs from the replanted digit were not different from those of to normal digit, nor was a retrograde effect observed. The present data indicate that digital nerve function recovery was incomplete in toe transplantation and nearly complete in digit replantation. The reasons for the differences in recovery following two types of nerve repair are discussed. © John Wiley & Sons, Inc.
Comparison of digital sensory studies in patients with carpal tunnel syndrome
Authors: Kothari M. J. , Rutkove S. B. , Caress J. B. , Hinchey J. , Logigian E. L. , Preston D. C. 
Published: January 2005

AbstractElectrodiagnosis of carpal tunnel syndrome (CTS) often depends on the demonstration of focal slowing of median sensory fibers across the wrist. We compared the relative sensitivity of the four median innervated digits in demonstrating focal slowing in patients with CTS. Antidromic sensory studies of digits 1, 2, 3, and 4 were performed on 30 control subjects to develop normative data. Fifty‐nine consecutive patients with CTS were then studied to determine the sensitivity of focal slowing of each median innervated digit. In the 26 CTS patients with a normal distal motor latency (DML) to abductor pollicis brevis, digit 1 was abnormal in 81%, digit 2 in 42%, digit 3 in 54%, and digit 4 in 38%. In the 33 CTS patients with a prolonged DML, digit 1 was abnormal in 94%, digit 2 in 88%, digit 3 in 91%, and digit 4 in 88%. We conclude that in milder cases of CTS with a normal DML, digit 1 is the most sensitive in identifying focal slowing of sensory conduction across the wrist. However, in patients with a prolonged DML, the sensitivity of sensory conduction is not significantly different among the four digits. © John Wiley & Sons, Inc.
Influence of recording site withing the muscle on motor unit potentials
Authors: Falck Björn , Stålberg Erik , Bischoff Christian 
Published: January 2005

AbstractThe influence of the recording site on the motor unit potentials (MUPs) was investigated in the brachial biceps muscle of 8 healthy subjects. The MUPs were recorded with a concentric needle electrode and analyzed with a new decomposition EMG program we call multi‐MUP analysis. MUPs had shorter durations and smaller amplitudes at superficial recording sites than at deeper sites in the muscle. This is mainly due to the cannula of the concentric electrode, which records a higher potential at superficial recording sites and partially cancels the recorded potentials from the tip in a differential recording. The MUPs had longer durations and higher amplitudes distally than in the middle of the muscle. The longer durations and spike durations are probably due to increased temporal dispersion at a greater distance from the endplate zone. We do not have an adequate explanation for the larger amplitudes distally in the biceps, they may be due to anatomical factors. To increase the diagnostic sensitivity of quantitative MUP analysis the recordings should be obtained from standardized recording sites. © 1995 John Wiley & Sons, Inc.
Beneficial versus adverse effects of long‐term use of clenbuterol in mdx mice
Authors: Dupont‐Versteegden Esther E. , Katz Michael S. , McCarter Roger J. 
Published: January 2005

AbstractLong‐term administration of the β2‐adrenergic agonist clenbuterol in mdx mice was used to test the hypothesis that increasing contractile protein content in skeletal muscle will decrease the progression of muscular dystrophy. C57BL/10SNJ (control) and dystrophic (mdx) mice were given clenbuterol (1.0–1.5 mg/kg body weight/day) in the drinking water. Ventilatory function and morphological and functional characteristics of soleus (SOL) and diaphragm (DIA) muscles were evaluated. Clenbuterol administration was associated with increased SOL muscle weight, and SOL muscle weight to body weight ratio in control and mdx mice at both ages. There was a 22% increase in myosin concentration of mdx DIA at 1 year of age, correlating well with increased normalized active tension in mdx DIA at this age. Also, absolute tetanic tension increased in control and mdx SOL with clenbuterol at both ages. Ventilatory function was significantly impaired in mdx mice at both ages and clenbuterol administration did not alleviate this. Clenbuterol treatment was associated with a 30–40% increase in fatigability in DIA and SOL muscles of control and mdx mice at both ages. Furthermore, 1‐year‐old mdx mice receiving clenbuterol exhibited deformities in hindlimbs and spine. These results suggest that long‐term clenbuterol treatment has a positive effect on muscle growth and force generation, but has adverse side effects such as increased muscle fatigability and development of deformities. © 1995 John Wiley & Sons, Inc.