![]() I told you that the drink was similar to a whiskey sour but as you can see we miss the egg white! It doesn't need it. This will give you a lusher and richer mouthfeel. The key ingredient to cutting through whiskey and honey is fresh lemon juice. It adds balance to the cocktail. However, if you prefer a richer tasting drink, you can add more honey to the water. This is similar to simple syrup but with honey replacing the sugar. You can make a one-to-one mixture that works well. Alternate base spirits were mixed into tried-and-true recipes and rules were often broken. This era saw many great success stories. The Penicillin cocktail was also developed at Milk & Honey in this era! Ingredients & TipsĪ good bourbon should have a bit of age when you make the gold rush. It is not necessary to choose one that is too aged, as the oak can overwhelm the other ingredients. The 4-to-8-year age range is sufficient. Instead of squirting honey directly into your shaker, you can make a honey syrup. Bartenders tried out new recipes and tweaked old ones. You could try new liqueurs, but you also had to drink them liberally. It has since been widely popularized worldwide and is often considered a pre-Prohibition favorite. This modern invention was made at a time when important drinks were popping up all across the USA. In the early aughts, the gold rush cocktail was created in New York City's Milk & Honey bar. The gold rush is an easy drink to make. It is a combination of honey syrup, bourbon, and fresh lemon juice. This drink is very similar to a whiskey sour cocktail, but the whiskey-honey combo transforms the cocktail's taste and mouthfeel, making it a gold rush cocktail! We respect your privacy and appreciate your trust.The gold rush cocktail is a simple drink built with bourbon whiskey, honey syrup, and lemon juice! Gold Rush Cocktail Info! And don't worry, any information we collect from you is stored on a secure server that’s only accessible to us. We offer this so that you don't have to spend so much time typing information in each time you visit. The cookie is visit triggered, so that if you haven't visited the site in a while, it will automatically remove itself off of your computer. Once you enter your personal information in any form on the website, such as when you choose “remember me” on the age gate verification page, it is cached on your computer. We will never sell, trade, or rent your personal information. Will share my information with anyone?Ībsolutely not. And, we will always provide you with an option to stop receiving updates as part of every communication we send you. In the event that you have signed up to receive updates like product announcements or event details, we'll use only the information you provided to us, such as your e-mail address. How does use the information it collects? Additionally, any information you do provide us with is stored on a secure sever that is only accessible to us. ![]() We only collect information about you specifically by providing fields and forms on our website that you would have to manually type into in order to share, for example, your name, address, or e-mail address. We do not collect any information about you specifically that you don't know about. We here at Domaine de Canton respect your privacy.īelow you will find answers to frequently asked questions regarding our privacy policy. We understand that you may be apprehensive to provide any personal information to any website because you are concerned about someone misusing your information or being inconvenienced by unwanted solicitations, emails or spam. Your privacy is also very important to us. We understand that your privacy is important to you.
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![]() “There's an untapped revenue opportunity,” she noted. Storck added that in heterosexual households, women generally manage most of the family’s money, giving them huge purchasing power, a potential advantage for female-run leagues. Women make up half the population, but “also 50% of the folks that are walking into the stadium at Dodger Stadium, or your NFL fans are just about 50% women,” noted Erin Storck, a panelist and senior analyst at Los Angeles-based Elysian Park Ventures. In 2023, the average size of an LA Sparks crowd swelled to 10,396 people, up from 4,701 people. WNBA openers this year saw a 21% spike in attendance, with some teams including the LA Sparks reporting triple-digit ticket sales growth, about 121% over 2022’s total. In 2022, the first 32 games of the NCAA tournament had record attendance levels, breaking records set back in 2004, and largely driven by the new and rapidly growing women’s NCAA tournament. We are thrilled she has signed on to host this fun new take on a tried-and-true format,” Barry Poznick, president of alternative television & Orion TV at MGM, told Deadline Thursday. “Wanda Sykes is one of the biggest names in comedy and beloved by fans across the globe. Ring Nation secures permissions for each video from the owner and anyone identifiable in the video or from companies that hold the rights to the clips."ĭeadline first reported the news and noted that in addition to Siminoff, executive producers of “Ring Nation” include Mark Burnett, Barry Poznick, Karni Baghdikian, Dan Cesareo, Lucilla D’Agostino, Bret Calvert and Jordana Starr. Many of these have been previously shared online. In an email statement, a Ring spokesperson told dot.LA it is only pulling from footage its users have already shared, noting, "'Ring Nation' features videos from a variety of sources, including home videos, Video doorbells, and Cameras. Ring defended this practice and told dot.LA in June that “the law authorizes companies like Ring to provide information to government entities if the company believes that an emergency involving danger of death or serious physical injury to any person, such as a kidnapping or an attempted murder, requires disclosure without delay… Ring faithfully applies that legal standard.” He will likely continue to keep a tight rein on the company’s portrayal in the show, especially given recent backlash over Ring’s relationship with law enforcement and its tendency to share users’ footage with cops without obtaining court orders. “Ring Nation” will be executive produced by Ring CEO Jamie Siminoff. So Big Bezos is combining the two, hoping the camera technology responsible for some viral moments online (people stopping package thefts, marriage proposals, military reunions, or pranks caught on camera) can translate that interest into a TV show.Įngadget recently called the upcoming show “what happens when ‘America's Funniest Home Videos’ meets ‘Black Mirror,’” which is a pretty apt description. ![]() Amazon forked over $1 billion to buy Ring in 2018 and paid nearly $8.5 billion this March to purchase the classic studio MGM. Sure, this seems to be a creepy twist on hidden-camera shows like “You’ve Been Framed!” or “Punk’d” that have captivated audiences for decades – But it’s also a case of corporate synergy. The primetime Emmy winner and star of Netflix’s “The Upshaws” will host a show called “Ring Nation.” Produced by Big Fish Entertainment and Amazon-owned MGM and Ring, it will use footage from people’s doorbell and smart home cameras across the country. ![]() Mavel and The Upshaws has been enlisted to host the show and will be providing commentary over the clips.Īs for the content, Barry Poznick, president of alternative television & Orion TV at MGM says we can expect everything "from the incredible, to the hilarious and uplifting must-see viral moments from around the country every day, Ring Nation offers something for everyone watching at home.Comedian Wanda Sykes’ latest venture is turning video from your smart home network into a TV show.\ Hilarious comedian Wanda Sykes, who you may know from The Marvelous Mrs. Yep, that's not just video doorbell footage, we're pretty sure it'll be exclusively Ring doorbells - since the Amazon-owned manufacturer is producing the show.Ĭompleting the trifecta of Amazon-owned producers are MGM Studios and Big Fish Entertainment, quite the team they've put together. Ring Nation is a clip show akin to America's Funniest Home Videos or You've Been Framed, with the key difference being that it focuses entirely on Ring doorbell footage. ![]() Not content with just selling the doorbells, Amazon wants another slice of the pie and is bringing out a clip show called Ring Nation. With several hundred thousand FREE hacks, cheats and bots, over 4 million members strong, a free and open marketplace and a great community, what else is there to ask for? 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Welcome to MPGH - MultiPlayer Game Hacking, the world's leader in Game Hacks, Game Cheats, Trainers, Combat Arms Hacks & Cheats, Crossfire Hacks & Cheats, WarRock Hacks & Cheats, SoldierFront Hacks & Cheats, Project Blackout Hacks & Cheats, Operation 7 Hacks & Cheats, Blackshot Hacks & Cheats, A.V.A.If you are having any issues, shoot us an email, Contact MPGH Support. ![]() Ads are removed, almost completely ad free browsing.Let your voice be heard! You can post, reply, and share whatever is on your mind.Active marketplace for gamers and people like you, with thousands of contributors and over half a million posts.Interact with our great community, and make new friends with our members.Free access to tutorials, resources, information, tools, trainers, cheats and hacks.Access to our large gaming community with millions of discussions to participate in.REGISTER now for full benefits of our site, it's completely FREE to join: ![]() The heart of Pandora is the underlying Pandora Music Genome Project database. Pandora uses musical traits to deliver music If this is one of your key markets, you will definitely want to get your music on the music streaming platform. Global radio operation laws have prevented Pandora from launching its radio service in any countries other than Australia, New Zealand, and the US in the past. Update: This article has been updated with more recent catalog and data figures submitted to us by Pandora.Pandora is only available in the United StatesĪfter previously being available in Australia and New Zealand, Pandora is now only available in the United States. At first blush, though, it does look like a serious competitor, a useful addition to Apple's iTunes empire, and a new tool for music fans to discover great music. With iTunes Radio still months away from becoming a reality, it's too early to tell what it will mean for Pandora and its listeners. Like Spotify, its direct label relationships should keep it from getting bogged down by the same laws that govern Pandora. We've yet to see what real limitations are part of iTunes Radio. Another limitation to Pandora is that users are limited to 12 total song skips every 24 hours. You can't just call up a specific song and have it play on-demand. Also, songs from the same artist or album are not allowed to play back to back. This means that features such as rewind or repeat are not permitted. Personally speaking, that's a business model that resonates a little better with me as a listener and a fan of independent music, but maybe I'm just being preemptively cynical about how Apple works with its major label partners.īecause Pandora operates without any direct label deals, it is forced to abide by the laws governing Internet radio. Its goal is to keep you glued as a habitual listener. ![]() It has no financial motivation to play a major label artist over an independent one. Pandora's endgame is to replace the role of terrestrial music radio in the hearts and minds of its listeners. It sells ads and it sells subscriptions, and it passes off purchases to iTunes and Amazon. Pandora, on the other hand, is not in the business of selling music. Watch this: Apple rethinks music with new-streaming radio service ![]() Apple could recoup its losses by selling an ad or two or getting listeners to convert to iTunes Match subscribers, but the bet that it's making is that the more good music it plays for you, the more of it you'll be inspired to buy. The purpose of iTunes Radio is to sell more music. I know its sounds like an odd criteria, but I think the most telling distinction between these two services comes down to their motivating philosophy. That functionality may reveal itself once we begin to play with iTunes Radio, but there is no mention of it in the preview material or images.Īnd while Pandora is certainly no Spotify when it comes to getting social with your song plays and playlists, it has recently modernized itself with a number of Twitter- and Facebook-friendly features, shown in the video above. At first glance, there appears to be no way to share iTunes Radio stations among friends or tweet your currently playing iTunes Radio song. Having recovered from its poorly conceived Ping service, Apple has seemingly refortified iTunes from the outside world. Pandora customers must pay $36 per year for Pandora's premium Pandora One service, which both removes ads and improves audio quality. For iTunes Radio, the subscription price is $24.99 per year for Apple's iTunes Match service, which includes ad-free iTunes radio. Pandora offers up to 192Kbps (AAC) for premium subscribers, whereas free users are capped at 128Kbps (AAC) for computers and connected appliances, and 64Kbps (AAC) for mobile.īoth iTunes Radio and Pandora can be used as free, ad-supported services, as well as offering a premium, ad-free, subscription-based tier. ![]() It can be found on both iOS and Android, as well as standalone premium apps for Mac and PC, and a number of connected appliances, such as TVs.Īpple has yet to publish specs on the streaming-audio quality of iTunes Radio, and until the service is available, we can't even offer a subjective take on the audio quality. Its best feature, arguably, is its ubiquity. While Pandora has never been a service with many bells and whistles, it is still the first name that springs to mind when you think of Internet radio. The world's a lot better for the erotically powerful images you've both put out into the world. You turn me ON everytime I see you in your amazing nudes, to where I have to take care of myself. Kizu, I'm buying your DVDs, and thank you Yulia, for sharing your perfect breasts and body with us. The results of his organizing and artistic skills are a large set of timeless pictures that blow our minds and our libidos, as we are in the presence of a loving fertile goddess in her prime, Yulia, who understands and enjoys us men climaxing over the sight of her, as her playfulness and sincerity invite us to be ourselves, our sexual selves around her, as she is being natural and sexual around us. ![]() It cost money to stay in Moscow, it cost money to arrange the beauty contest from which he would select Yulia out of over one thousand applicants, it cost money to pay the Russian-to-Japanese translator, money to hire the wardrobe, hair and makeup assistants, money to shop with Yulia to find good clothes to fit her incredible figure well, money to search for the dachau to photograph her in, money to rent it, money to rent additional lighting equipment, money to pay for the food, ground transportation, etc., etc. Kizu risked spending thousands of his own dollars flying to Moscow to conduct a talent search to find a world-class model he would love to photograph, and who he could make a livelihood from. ![]() But so is Satoshi Kizu, who after all, discovered her and convinced her to pose. You try it sometime with a woman like that, and you'll appreciate the skills better of the master. ![]() It seems that Kizu's distribution model is incredibly outdated, in that you can't download the videos digitally, but have to order a DVD. She trusted him because he is the real deal - a man who knows how to get close to a natural big-breasted 18-year-old girl and make her feel good about herself instead of self-conscious, and permit her to give the full force of her sexual allure to his camera. Quartz said: It's incredible that Yulia's Japanese photographer, Sotashi Kizu, is still releasing video footage 20 years after he originally filmed Yulia. She trusted only him, and she had many good offers during and after the time that she decided not to model anymore. But almost no one can take a beautiful picture of an exceptionally beautiful woman who finally agrees to take her clothes off and be seen by the world.įew high-class, intelligent women and cosmically erotic women like Yulia would ever do that. Watch Yulia - Nova Sauna on SpankBang now - Yulia Nova, Sauna, Big T Its Porn - SpankBang. I hear many people underestimating the great Satoshi Kizu, a member of the Japan Professional Photographers Society, who for many decades has specialized in photographing nude women beautifully.Īnyone can take a picture of a woman. He selected the sets, the camera angles, the lighting, and. The director, Michael Curtiz made the film. Did the movie make itself? Did the actors create the film? When using a search engine such as Google, Bing or Yahoo check the safe search settings where you can exclude adult content sites from your search results Īsk your internet service provider if they offer additional filters īe responsible, know what your children are doing online.Consider the great movie "Casablanca". Trending Upcoming New Popular 15m Shy Skeptical Asian ended up being an AMAZING fuck. Use family filters of your operating systems and/or browsers Watch Yulia Nova 01 on SpankBang now - Yulia Nova, Big Tits, Natural Tits Porn - SpankBang. Other steps you can take to protect your children are: More information about the RTA Label and compatible services can be found here. Parental tools that are compatible with the RTA label will block access to this site. We use the "Restricted To Adults" (RTA) website label to better enable parental filtering. Protect your children from adult content and block access to this site by using parental controls. PARENTS, PLEASE BE ADVISED: If you are a parent, it is your responsibility to keep any age-restricted content from being displayed to your children or wards. Furthermore, you represent and warrant that you will not allow any minor access to this site or services. ![]() This website should only be accessed if you are at least 18 years old or of legal age to view such material in your local jurisdiction, whichever is greater. You are about to enter a website that contains explicit material (pornography). She began her career as a fashion model, landing her first of sixteen American Vogue covers at the age of eighteen. ![]() Rag and Bone RBW 9 zipper jeans, Riding boots or a high-heeled ankle boot, Vivienne Westwood backpacks, Sway pursesĪmber Evangeline Valletta (born February 9, 1974) is an American supermodel and actress. The Seychelles and Egadi Islands off of Sicily Shalom Harlow, Karen Mulder, Yasmeen Ghauri, Niki Taylor, Helena Christensen, Carla Bruni, Angie Harmon, Stella Tennant fashion/models/avaletta/ambervalletta/, /models/Amber-Valletta/, /london/women/model?mid=11906, /ambervalletta/?hl=en, /ambervalletta, /, Friend ![]() IMG Models - London, The Society Management - New York, View Management - Barcelona, Women Management - Paris, Women Management - Milan, 3 Arts Entertainment Talent ManagementĬalvin Klein Print Ad (1994), Print ad for Rolfs (1994), Print ad for Calvin Klein's Eternity Fragrence (1991), Print ad for Gucci (1995, Print ad for Versace (1995), Print ad for Carpezio Handbags (1997), Print ad for Calvin Klein (1998), Print ad for Prada (1998), Print ad for Armani (1998), Print ad for Fendi (1998), Print ad for Prada (1997), Print ad for Armani (1997), Print ad for Bottega Veneta (1998), Print ad for BCBG Clothing (1999), Print ad for JOOP! (1996), Print ad for Anne Klein (1996), Print ad for Versace (1996), Face of Elizabeth Arden(1996-present), (2012) Print advertisement for British giant Marks and Spencer's "Per Una" women's line of clothing and accessories Madison in What Lies Beneath (2000), Allegra Cole in Hitch (2005) ![]() Perfectly shaped figure, Grey eyes, Good looksīooker T. Amber Evangeline Valletta, Amber Valletta It was announced at the Cygames Next 2016 event in Tokyo. His responsibilities include designing and directing the action aspects of the game, while striving to ensure the highest quality possible. Granblue Fantasy: Relink is an upcoming action RPG developed by Cygames for the Playstation 4 and Playstation 5. In April 2019, when development was transferred to Cygames, Yasuyuki joined the company and continued his role as director. While there, Yasuyuki also served as the director for Granblue Fantasy: Relink from its inception. As a former lead level designer at PlatinumGames, he has previously contributed to titles such as Metal Gear Rising: Revengeance, Bayonetta 2, and NieR: Automata. Yasuyuki Kaji is the director for Granblue Fantasy: Relink. As Cygames continues to venture into the console market, Tetsuya’s diverse skillset has proven invaluable for the development of Granblue Fantasy: Relink and Granblue Fantasy Versus: Rising. He joined Cygames in 2012, where he first worked on Rage of Bahamut before becoming Granblue Fantasy’s creative director, a role he has served for nine years. ![]() Tetsuya Fukuhara is the general director for the Granblue Fantasy IP. Action RPG Granblue Fantasy: Relink will launch for PlayStation 5 in addition to its previously announced PlayStation 4 version in 2022, publisher and. Title: Dive into the world of Granblue Fantasy! Djeeta, Katalina, Io, and Rosetta in action. Granblue Fantasy: Relink Game Reveals 2nd Trailer, More Playable Characters posted on 03:33 EST by Crystalyn Hodgkins Action RPG slated for this year on PS4, PS5, Steam. ![]() Their livestream detailed some of that history, clearly outlining the timeline of. Cygames has a long and a bit of a bump history behind it on the journey to bring Relink to the public. ![]() Come on board, fellow skyfarers! Join us as we uncover the world of Granblue Fantasy: Relink and Granblue Fantasy Versus: Rising, together with Granblue Fantasy General Director Tetsuya Fukuhara, and Granblue Fantasy: Relink Director Yasuyuki Kaji. Granblue Fantasy: Relink Just Grand Granblue Fantasy: Relink finally gets a new trailer, is probably out this year Originally slated for 2022, the JRPG should be out some time this year. The project has been largely silent lately, but a new video from their event, Granblue Fantasy Fes 2020, promised a new release window of 2022 on PS4 and PS5. ![]() ![]() Builder I don't think scales quickly enough, and mayor is a only good because laborers are so easy to get huge early, which gives you a lot of freedom. Although this might change, I think shaman is crazy weak without getting lucky, and general is far too slow of a buildup. I haven't really played every leader a lot on Pol 20, but my ranking would be: scientist, navigator, mayor, builder, general, shaman. Keep a fire station close to your base for faster recovery. Community Hub Ratropolis A fusion of roguelite, tower defense, city-building, and deck-building We created a new kind of real time strategy game filled with addictive and fast-paced gameplay. Place them near your base, not on the far walls, this way you can move them all to the side that's needed. Make sure you have units that can deal with it way before they come. You can't always hold out for the tulip to get a perfect economy. The tags customers have most frequently applied to Ratropolis have also been applied to these products: 24.99. In lower pollutions you can hold out for the cards you want, but as you get higher, you have to take worse cards that you need. I tend to take it over even great things like library if I'm not in a super comfortable position.ĭestruction? (Think that's the name, destroy a building and add a copy to your hand) is also nearly a guaranteed pick for me and an instant upgrade, at level 2 you can use it to upgrade all your buildings. ![]() My endgame strategy for scientist usually ends with me have nothing defending the walls, I do nearly all the killing with skills, but I still sometimes take a bad unit with high hp, just to stay alive.Ĭlown adviser is usually a win, same reason the building that delays the wave is crazy good. When the weasels bosses start coming, move units back before the round starts in case of battering ram. For example, when the fat green guys with ranged attacks start coming, you need to move your ranged back and then manually move each back to the wall, this will allow them to attack still without getting wiped out. General advice is, keep your units alive, and bad units are better than no units. Sorry, my mind has gone blank on the names of everything right now. I get scientist pol20 win pretty consistently, navigator (think that's the name) I also seem to find relatively easy. ![]() In the meantime, stream Usher's second new single of the week, Crash. You might’ve seen them performing this song for first-time at this year’s 2016 BET Awards, and now Young Thug and Usher unveil the official music video for their smooth, club-ready cut, No. ![]() The stream of No Limit is a TIDAL exclusive for now - listen here. On June 9, 2016, RCA made it available for online streaming. The first of two new singles this week, No Limit proves Usher's been listening closely to the radio the past few months, ditching his vibrato'd R&B vocals and delivering his best sung-rap Drake impression before dipping into Ty Dolla $ign-soundalike vocal effects on the chorus.Īnd while another rapper's phoned-in verse could've relegated No Limit to a forgettable one-off, instead we get the endlessly entertaining Young Thug, who no sooner starts his subdued verse before flipping it into a gonzo exercise in pitch-shifting. Usher, an American singer, collaborated with Young Thug, an American rapper, on the song No Limit. A remix of the song was made by Travis Scott.Usher is one of R&B's most dependable figures, dutifully delivering radio-ready smoothness and pounding club anthems and pulling off his dance moves with a smile.īut the songs where he strays from the script and plays with more contemporary trends - like on 2012's sparse, stunning Diplo collaboration Climax - breathe new life into his music. ![]() On June 10, 2016, the musician made “Crash” available for digital download on platforms like iTunes, Amazon, Google Play, and YouTube as well as for online streaming on Tidal, Apple Music, Spotify, and Spotify. Nas and Bibi Bourelly are featured on Raymond’s social justice song “Chains,” which was released in October 2015. Despite the globe tour and the singles “Good Kisser,” “She Came To Give It To You,” and “I Don’t Mind,” no album was issued. Now, they deliver the music video exclusively on TIDAL. His eighth studio album, due for release in 2014, has been teased by him. Usher and Young Thug s collab 'No Limit' initially dropped in early June. UPDATE: The video is now out on YouTube so non-Tidal members can enjoy. Watch the music video and discover trivia about this classic R&B song. It has special cameos from Ty Dolla ign, Boosie Badazz and Gucci Mane. The Usher album Looking 4 Myself from 2012 has been out for four years. In 2016 the 46 R&B song in the charts was No Limit by Usher Featuring Young Thug. The song makes reference to Master P’s 1997 No Limit Records album Ghetto D single “Make ‘Em Say Uhh,” which features the lyrics “Make you say uh, no limit / Got that Master P, no limit girl.” The song peaked at number 32 on the US Billboard Hot 100 and number nine on the Hot R&B/Hip-Hop Songs chart in North America. His ninth studio album, Hard II Love, has the lead track, “No Limit.” Usher, Rock City, Young Thug, Brandon “B.A.M.” Hodge, and Christopher “Talent” Perry all contributed to the song’s composition, while the latter three also oversaw its production. ![]() Careful dissection is made subcutaneously to the pronator teres fascia (Fig. A 2–3-cm transverse incision is placed in the flexion crease of the cubital fossa, from 1 cm medial of the biceps tendon to 2 cm lateral of the medial epicondyle (see Fig. ![]() The surgery is performed with the patient awake and no tourniquet. In the case of PMNE, these patterns have been determined to primarily correlate to weakness in the flexor pollicis longus (FPL), flexor digitorum profundus II (FDP II), and the flexor carpi radialis (FCR). The principle is easy: distal to the level of nerve affliction, distinct patterns of muscle weaknesses will be clinically present. The efficacy (sensitivity and specificity) of manual muscle testing of antagonist muscles to determine levels of focal neuropathies in the upper extremities have been established in randomized, blinded validity studies to 88–93 %, respectively. ![]() Similarly, the earliest publications on PMNE describe the need of thorough physical examination to diagnose the patient, in particular the presence of weakness in muscles innervated by the median nerve both in the hand and the forearm. The objective of this manuscript is to revisit the clinical findings and diagnosis of PMNE, as well as describe an in situ approach to surgical decompression of the median nerve at the elbow, with video guidance.Īlready in 1874, Erb emphasized the importance of clinical diagnosis for determination of level of nerve affliction in the upper extremity. More recently, magnetic resonance imaging (MRI) has been suggested as a potential aid in proximal entrapment diagnosis, but in the case of PMNE, the MRI findings are usually normal until there is evident axonal degeneration and muscle wasting of the forearm. The shortcomings of electrodiagnostic studies lies in the fact that a nerve may be compressed and cause symptoms distal to the level of compression due to changes in axonal transport and intraneural circulation, but the pressure levels of compression are too low to actually cause axonal injury and thus no visible changes in EMG/NCS. In the case of PMNE, however, there is a conundrum in that proximal median EMG/NCS often is normal or inconclusive, may simulate CTS, and has an unreliable specificity of 30–70 %. In what lies the elusiveness of this diagnosis? In this age of insurance-driven medicine, the dependency on so-called objective measurements, i.e., electromyography (EMG) and nerve conduction studies (NCS), is brought to the forefront of medicine whereas clinical diagnosis and examination is often considered subjective, biased, and unreliable. This disparity has led surgeons to claim that PMNE is an “extremely rare diagnosis” and a “diagnosis of belief or disbelief”, as objective measurements of PMNE can seldom be retrieved. The pronator syndrome, or proximal median nerve entrapment (PMNE) at the level of the elbow, was first described in literature in the 1950s, but unlike its distal counterpart-the carpal tunnel syndrome (CTS)-there are only around 50 publications on the diagnosis and treatment of PMNE, whereas a PubMed search on CTS will result in >7,500 publications. |
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