1024
superior. Cefotaxime (and all the aminoglycosides) are ineffective against Strep.faecalis. Cefotaxime is more active against Enterobacteriaceae than are other cephalosporins, acylureido-penicillins, and aminoglycosides. Further clinical studies are necessary the excellent in-vitro properties of cefotaxime replace the aminoglycosides.
to
show whether that it can
mean
Institute of Medical Microbiology, Technical University, D-8000 Munich 80, West Germany
I. BRAVENY H. DICKERT
PRIMARY CARPAL STENOSIS AS A CAUSE OF "IDIOPATHIC" CARPAL-TUNNEL SYNDROME
SIR,-The carpal-tunnel syndrome is the
most common
nerve-entrapment syndrome and may be caused by widely differing lesions. In about 50% of patientsthe aetiology is not clear. Such patients with "idiopathic" carpal-tunnel syndrome are often females approaching the menopause. The symptoms tend to be bilateral but commonly more severe in the dominant limb.’ Stenosis of the carpal canal as a result of trauma, osteoarthritis of the wrist joint, and neoplasms have all been recorded as leading to carpal tunnel syndrome.2 We therefore examined the cross-sectional areas of the carpal canal in seven female patients with "idiopathic" carpal-tunnel syndrome and in a group of twelve age-matched female and six male controls by computerised axial tomography (CT 1010 F3C). The diagnosis of carpal-tunnel syndrome was based on clinical history and findings and electrodiagnostic studies. Patients who may have had one of the recognised lesions leading to the carpal-tunnel syndrome were excluded. Both hands of each patient and of controls were examined. The radiographs of the cross-sections were mounted and projected to a table digitiser connected to a computer (Digital Equipment Corporation PDP 31/34). Because the flexor retinaculum was not always clearly visible on the radiographs, a line was drawn from the scaphoid tubercle to the pisiform bone and from the trapezium to the hook of the hemate corresponding to the anatomical attachments of the carpal ligament. The area enclosed by the carpal bones and this line was measured from the radiographs. The proximal carpal-tunnel cross-sectional area (pisiform bone to the tubercle of the scaphoid) of the female patients was 1428±4.6 mm2 (mean+SEM), and this was significantly smaller (p
superior. Cefotaxime (and all the aminoglycosides) are ineffective against Strep.faecalis. Cefotaxime is more active against Enterobacteriaceae than are other cephalosporins, acylureido-penicillins, and aminoglycosides. Further clinical studies are necessary the excellent in-vitro properties of cefotaxime replace the aminoglycosides.
to
show whether that it can
mean
Institute of Medical Microbiology, Technical University, D-8000 Munich 80, West Germany
I. BRAVENY H. DICKERT
PRIMARY CARPAL STENOSIS AS A CAUSE OF "IDIOPATHIC" CARPAL-TUNNEL SYNDROME
SIR,-The carpal-tunnel syndrome is the
most common
nerve-entrapment syndrome and may be caused by widely differing lesions. In about 50% of patientsthe aetiology is not clear. Such patients with "idiopathic" carpal-tunnel syndrome are often females approaching the menopause. The symptoms tend to be bilateral but commonly more severe in the dominant limb.’ Stenosis of the carpal canal as a result of trauma, osteoarthritis of the wrist joint, and neoplasms have all been recorded as leading to carpal tunnel syndrome.2 We therefore examined the cross-sectional areas of the carpal canal in seven female patients with "idiopathic" carpal-tunnel syndrome and in a group of twelve age-matched female and six male controls by computerised axial tomography (CT 1010 F3C). The diagnosis of carpal-tunnel syndrome was based on clinical history and findings and electrodiagnostic studies. Patients who may have had one of the recognised lesions leading to the carpal-tunnel syndrome were excluded. Both hands of each patient and of controls were examined. The radiographs of the cross-sections were mounted and projected to a table digitiser connected to a computer (Digital Equipment Corporation PDP 31/34). Because the flexor retinaculum was not always clearly visible on the radiographs, a line was drawn from the scaphoid tubercle to the pisiform bone and from the trapezium to the hook of the hemate corresponding to the anatomical attachments of the carpal ligament. The area enclosed by the carpal bones and this line was measured from the radiographs. The proximal carpal-tunnel cross-sectional area (pisiform bone to the tubercle of the scaphoid) of the female patients was 1428±4.6 mm2 (mean+SEM), and this was significantly smaller (p
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