Patients with severe carpal tunnel syndrome may be characterised by an atypical clinical picture. They assess complaints as becoming less bothersome than in the past. It seems that this may influence the diagnostic value of some clinical tests used in physical examinations. was the selection of the most reliable clinical tests in a group of patients with severe carpal tunnel syndrome. Material and methods. The material comprised 38 cases of severe form of the disease in a group of 37 prospective patients. The methods consisted in the evaluation of the rate of positive results of selected clinical tests, and in the comparison of their statistical correlation with selected parameters of median nerve conduction. Results. The study results indicated that high incidence of two-point discrimination disorders showed a correlation with the sensory conduction parameters, including the median-ulnar sensory latency difference. The Durkan's and Phalen's tests were positive in almost all patients with advanced carpal tunnel. The Katz hand diagram revealed significantly enhanced sensitivity in the “probable” pattern. Conclusions. We speculate that the two-point discrimination, evaluated with the use of a simple paper clip, enables the selection of a group of patients with severe form of the syndrome for further differentiation. The tool used for facilitating the differential diagnosis is the Katz hand diagram. The Durkan's and Phalen's tests have an equally high value. However, they show no correlation with the conduction parameters, as measured by EMG.
The paper shows the modelling process of a 3D digital model of the human radius bone based on its external and internal geometry. The obtained numeral characteristics of the model of the chosen mathematical functions can be used for further static and dynamic analysis of the bone subjected to external forces of different magnitudes.
The paper presents numerical simulation of an ambulance transport system which consists of three elements: the stretcher, the frame which holds the stretcher and a part of the ambulance. The model was designed with the use of SolidWorks 2013 software. The numerical analysis was done with the use of ANSYS Workbench 13 software. During the first stage the natural frequencies and the forms of vibrations of the model were determined. During the second stage the dynamic excitations on the transport system were simulated.
The paper presents numerical simulation of an ambulance transport system which consists of three elements: the stretcher, the frame which holds the stretcher and a part of the ambulance. The model was designed with the use of SolidWorks 2013 software. The numerical analysis was done with the use of ANSYS Workbench 13 software. During the first stage the natural frequencies and the forms of vibrations of the model were determined. During the second stage the dynamic excitations on the transport system were simulated.
This paper presents floristic characterization of xerothermic plant associations and analysis of changes of flora within Broczówka steppe reserve. The floristic research was carried out in 2004-2009. Numerous species that were noted here almost 30 years ago were not found in the present study, the size of other populations decreased. Nevertheless, many plant species occurring in the reserve are rare, endangered or protected. Six major plant associations, impoverished form of two ones and one plant community are distinguished in the whole area of the reserve. Occurrence of two plant associations was not confirmed.
The aim of the study was to assess the influence of neoadjuvant radiotherapy and resection of the rectum on the functional parameters of anal sphincters.Material and methods. 20 patients with rectal cancer, qualified for low anterior rectal resection with neoadjuvant radiotherapy were enrolled in the study group. The study protocol included an anorectal manometry, electromyography and fecal incontinence questionnaire (FISI) before radiotherapy, after radiotherapy, and after the operation.Results. Of the 20 patients 12 were included in the final analysis, because 8 patients were re-qualified to abdomino-perineal resection of the rectum after neoadjuvant treatment. There were no significant changes in anal pressures assessed 5 to 8 days after radiotherapy. In 3 cases (25%) pathological changes in RAIR reflex were found in the manometric examination. After low anterior resection mean basal anal pressures were significantly lower, whereas squeeze anal pressures did not change significantly. In 7 patients (58%) the RAIR reflex was pathological or even absent after low anterior resection. Changes in manometric parameters correlated with FISI incontinence assessment after the operation. In electromyographic examination action potentials of motoric units of the external anal sphincter were still present both after radiotherapy, and after operation.Conclusions. Fecal incontinence after low anterior resection of the rectum seems to be caused mostly by changes in autonomic functionality of anal sphincters and lack of compliance of the neorectum, since the influence of neoadjuvant radiotherapy and the operation itself on the somatic innervation of anal sphincters seems to be minimal.
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