Pitfalls in diagnosing carpal tunnel syndrome.

The aim of this paper is to point out the differential diagnosis be-tween a thumb hypoplasia type 1/11 and a carpal tunnel syndrome. Both syndromes have symptoms in common. Two children and an adult with hypoplastic thumbs were sent to our department with the diagnosis carpal tunnel syndrome. In both children, the diagnosis was changed after an exact history and examination, and in one child an opponensplasty was done. The adult patient had already been operated unsuccessfully for a carpal tunnel syndrome elsewhere and again at our department.The exact diagnosis was only made after the second operation,when an extended questioning was done. This shows how important a careful history taking, an exact clinical examination, X-ray examinations of both hands, knowledge of type 1/11 hypoplasia, and finally electroneurography and sonography are important for a correct diagnosis.     

Mechanoreceptors in human myotendinous junction

The sensory-nerve-ending system of 40 myotendinous junctions of human palmaris longus and plantaris muscles was studied histologically. All the known four types of nerve endings were identified. The Ruffini corpuscles could be found in equally small numbers (one to five) in both the muscular and tendineal sites of the junction. Also the free nerve endings were distributed equally on both sites. The Pacini corpuscles were frequent in the tendineal site (six to 14), but rare in the muscular site (one to three). The Golgi tendon organs were, in turn, frequent in the muscular site (nine to 12) but rare in the tendineal site (one to four), respectively. Within the muscle and tendon parts of the junction, the distance between two mechanoreceptors was always more than 250 m?m and the receptor distribution was homogeneous. Further studies are needed to give functional explanation for these anatomic findings. © 1993 John Wiley & Soncs, Inc.     

Amnionitis and T strain mycoplasmemia

A 32-year-old woman was admitted during the seventh month of her first pregnancy which was achieved by insemination with donor semen. A twin pregnancy was diagnosed, and the water bag of one of the fetuses had ruptured spontaneously. The woman was afebrile during 7 days with penicillin-ampicillin treatment. Thereafter she developed symptoms of a generalized infection. Two successive blood cultures were positive for T strain Mycoplasma. After delivery the same organism was isolated from the blood of one of the infants and from throat and vulva smears from the other one, as well as from the urine of the sperm donor, while a urethral smear from the patient's husband was negative. Histologic examination showed focal purulent amnionitis of the water bag that was intact until delivery. This is the second reported case of T strain mycoplasmemia which demonstrates the potential virulence of this organism.     

Correlation of in vitro and in vivo methodology for evaluation of antacids.

The rate and extent of acid consumption of an antacid suspension and tablet were evaluated by in vitro and in vivo techniques. Four different test procedures were used to estimate in vitro antacid reactivity. In vivo effects were determined in the fasted and postcibal states in normal human subjects by a radiotelemetry procedure. The duration of elevation of intragastric pH greater than 3 was in agreement with in vitro estimates of total acid consumption of the antacid. There was also good correlation between onset, extent, and duration of in vivo antacid activity and a modified in vitro Beekman antacid test procedure. There was no significant difference in antacid activity of the tablet or suspension in either in vitro or in vivo test procedures. A wide variation in antacid activity was observed between subjects and also in the fasted versus postcibal states. These studies emphasize the requirements for standardization of antacid products by comparactive in vitro and in vivo evaluations to facilitate individualized dose titration of the antacid in each patient and correlation of the acid secretion rate in various types of GI disease with the antacid dose.