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Right Hand (right + hand)
Selected AbstractsEgocentric mental rotation in Hungarian dyslexic childrenDYSLEXIA, Issue 1 2001Kázmér Karádi Abstract A mental rotation task was given to 27 dyslexic children (mean age 9 years, 2 months) and to 28 non-dyslexic children (mean age 8 years, 8 months). Pictures of right and left hands were shown at angles of 0, 50, 90 and 180 degrees, and the subjects were required to indicate whether what was shown was a right hand or a left hand. It was found that, in this task, the dyslexics did not show the normal pattern of response times at different angles, and also, that they made more errors than the controls. It is argued that this result is compatible with hypothesis that, in typical cases of dyslexia, there is a malfunctioning in the posterior parietal area. Copyright © 2001 John Wiley & Sons, Ltd. [source] Inter-hemispheric inhibition is impaired in mirror dystoniaEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 8 2009S. Beck Abstract Surround inhibition, a neural mechanism relevant for skilled motor behavior, has been shown to be deficient in the affected primary motor cortex (M1) in patients with focal hand dystonia (FHD). Even in unilateral FHD, however, electrophysiological and neuroimaging studies have provided evidence for bilateral M1 abnormalities. Clinically, the presence of mirror dystonia, dystonic posturing when the opposite hand is moved, also suggests abnormal interhemispheric interaction. To assess whether a loss of inter-hemispheric inhibition (IHI) may contribute to the reduced surround inhibition, IHI towards the affected or dominant M1 was examined in 13 patients with FHD (seven patients with and six patients without mirror dystonia, all affected on the right hand) and 12 right-handed, age-matched healthy controls (CON group). IHI was tested at rest and during three different phases of a right index finger movement in a synergistic, as well as in a neighboring, relaxed muscle. There was a trend for a selective loss of IHI between the homologous surrounding muscles in the phase 50 ms before electromyogram onset in patients with FHD. Post hoc analysis revealed that this effect was due to a loss of IHI in the patients with FHD with mirror dystonia, while patients without mirror dystonia did not show any difference in IHI modulation compared with healthy controls. We conclude that mirror dystonia may be due to impaired IHI towards neighboring muscles before movement onset. However, IHI does not seem to play a major role in the general pathophysiology of FHD. [source] Basal ganglia and frontal involvement in self-generated and externally-triggered finger movements in the dominant and non-dominant handEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 6 2009Félix-Etienne François-Brosseau Abstract Although there are a number of functional neuroimaging studies that have investigated self-initiated and externally-triggered movements, data directly comparing right and left hands in this context are very scarce. The goal of this study was to further understand the role of the basal ganglia and prefrontal cortex in the realm of self-initiated and externally-triggered right and left hand movements. Young healthy right-handed adults performed random, follow and repeat conditions of a finger moving task with their right and left hands, while being scanned with functional magnetic resonance imaging. Significant activation of the dorsolateral prefrontal cortex was observed when comparing the self-initiated movements with the repeated control and externally-triggered movements when using either hand in agreement with its role in monitoring. The caudate nucleus activation was found during self-initiated conditions compared with the control condition when either hand was used, showing that it is particularly involved when a new movement needs to be planned. Significant putamen activation was observed in all within-hand contrasts except for the externally-triggered vs. control condition when using the left hand. Furthermore, greater putaminal activation was found for the left vs. the right hand during the control condition, but for the right vs. the left hand subtraction for the self-initiated condition. Our results show that the putamen is particularly involved in the execution of non-routine movements, especially if those are self-initiated. Furthermore, we propose that, for right-handed people performing fine movements, as far as putamen involvement is concerned, the lack of proficiency of the non-dominant hand may prevail over other task demands. [source] Rapid cortical reorganisation and improved sensitivity of the hand following cutaneous anaesthesia of the forearmEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 4 2009Anders Björkman Abstract The cortical representation of various body parts constantly changes based on the pattern of afferent nerve impulses. As peripheral nerve injury results in a cortical and subcortical reorganisation this has been suggested as one explanation for the poor clinical outcome seen after peripheral nerve repair in humans. Cutaneous anaesthesia of the forearm in healthy subjects and in patients with nerve injuries results in rapid improvement of hand sensitivity. The mechanism behind the improvement is probably based on a rapid cortical and subcortical reorganisation. The aim of this work was to study cortical changes following temporary cutaneous forearm anaesthesia. Ten healthy volunteers participated in the study. Twenty grams of a local anaesthetic cream (EMLA®) was applied to the volar aspect of the right forearm. Functional magnetic resonance imaging was performed during sensory stimulation of all fingers of the right hand before and during cutaneous forearm anaesthesia. Sensitivity was also clinically assessed before and during forearm anaesthesia. A group analysis of functional magnetic resonance image data showed that, during anaesthesia, the hand area in the contralateral primary somatosensory cortex expanded cranially over the anaesthetised forearm area. Clinically right hand sensitivity in the volunteers improved during forearm anaesthesia. No significant changes were seen in the left hand. The clinically improved hand sensitivity following forearm anaesthesia is probably based on a rapid expansion of the hand area in the primary somatosensory cortex which presumably results in more nerve cells being made available for the hand in the primary somatosensory cortex. [source] Differential cortical activity for precision and whole-hand visually guided grasping in humansEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 4 2007Chiara Begliomini Abstract Effective grasping involves the remarkable ability to implement multiple grasp configurations such as precision grip (PG; opposition between the index finger and thumb) and whole-hand grasp (WHG), depending on the properties of the object grasped (e.g. size, shape and weight). In the monkey brain, different groups of cells in the anterior,lateral bank of the intraparietal sulcus (area AIP) are differentially active for various hand configurations during grasping of differently shaped objects. Visually guided grasping studies in humans suggest the anterior intraparietal sulcus (aIPS) as the homologue of macaque area AIP, but leave unresolved the question of whether activity in human aIPS reflects the relationship between object size and grasp configuration, as in macaques. To address this issue, a human fMRI study was conducted in which objects were grasped with the right hand while object size was varied. The results indicated that the left aIPS was active when the subjects naturally adopted a PG to grasp the small object but showed a much weaker response when subjects naturally adopted a WHG to grasp the large object. The primary motor cortex and somatosensory cortices were active for both PG and WHG. Our results suggest that, in humans, the aIPS is centrally involved in determining the type of grasp. [source] Task-dependent modulation of functional connectivity between hand motor cortices and neuronal networks underlying language and music: a transcranial magnetic stimulation study in humansEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 1 2007R. Sparing Abstract Although language functions are, in general, attributed to the left hemisphere, it is still a matter of debate to what extent the cognitive functions underlying the processing of music are lateralized in the human brain. To investigate hemispheric specialization we evaluated the effect of different overt musical and linguistic tasks on the excitability of both left and right hand motor cortices using transcranial magnetic stimulation (TMS). Task-dependent changes of the size of the TMS-elicited motor evoked potentials were recorded in 12 right-handed, musically naive subjects during and after overt speech, singing and humming, i.e. the production of melody without word articulation. The articulation of meaningless syllables served as control condition. We found reciprocal lateralized effects of overt speech and musical tasks on motor cortex excitability. During overt speech, the corticospinal projection of the left (i.e. dominant) hemisphere to the right hand was facilitated. In contrast, excitability of the right motor cortex increased during both overt singing and humming, whereas no effect was observed on the left hemisphere. Although the traditional concept of hemispheric lateralization of music has been challenged by recent neuroimaging studies, our findings demonstrate that right-hemisphere preponderance of music is nevertheless present. We discuss our results in terms of the recent concepts on evolution of language and gesture, which hypothesize that cerebral networks mediating hand movement and those subserving language processing are functionally linked. TMS may constitute a useful tool to further investigate the relationship between cortical representations of motor functions, music and language using comparative approaches. [source] Direction of cross-modal information transfer affects human brain activation: a PET studyEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 1 2002Ryuta Kawashima Abstract The purpose of this study was to determine the functional organization of the human brain involved in cross-modal discrimination between tactile and visual information. Regional cerebral blood flow was measured by positron emission tomography in nine right-handed volunteers during four discrimination tasks; tactile,tactile (TT), tactile,visual (TV), visual,tactile (VT), and visual,visual (VV). The subjects were asked either to look at digital cylinders of different diameters or to grasp the digital cylinders with the thumb and index finger of the right hand using haptic interfaces. Compared with the motor control task in which the subjects looked at and grasped cylinders of the same diameter, the right lateral prefrontal cortex and the right inferior parietal lobule were activated in all the four discrimination tasks. In addition, the dorsal premotor cortex, the ventral premotor cortex, and the inferior temporal cortex of the right hemisphere were activated during VT but not during TV. Our results suggest that the human brain mechanisms underlying cross-modal discrimination have two different pathways depending on the temporal order in which stimuli are presented. [source] Selective visuo-haptic processing of shape and textureHUMAN BRAIN MAPPING, Issue 10 2008Randall Stilla Abstract Previous functional neuroimaging studies have described shape-selectivity for haptic stimuli in many cerebral cortical regions, of which some are also visually shape-selective. However, the literature is equivocal on the existence of haptic or visuo-haptic texture-selectivity. We report here on a human functional magnetic resonance imaging (fMRI) study in which shape and texture perception were contrasted using haptic stimuli presented to the right hand, and visual stimuli presented centrally. Bilateral selectivity for shape, with overlap between modalities, was found in a dorsal set of parietal areas: the postcentral sulcus and anterior, posterior and ventral parts of the intraparietal sulcus (IPS); as well as ventrally in the lateral occipital complex. The magnitude of visually- and haptically-evoked activity was significantly correlated across subjects in the left posterior IPS and right lateral occipital complex, suggesting that these areas specifically house representations of object shape. Haptic shape-selectivity was also found in the left postcentral gyrus, the left lingual gyrus, and a number of frontal cortical sites. Haptic texture-selectivity was found in ventral somatosensory areas: the parietal operculum and posterior insula bilaterally, as well as in the right medial occipital cortex, overlapping with a medial occipital cortical region, which was texture-selective for visual stimuli. The present report corroborates and elaborates previous suggestions of specialized visuo-haptic processing of texture and shape. Hum Brain Mapp 2008. © 2007 Wiley-Liss, Inc. [source] Late-onset Papillon,Lefevre syndrome with pyogenic liver abscesses: report of one caseINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 1 2009Ameneh Yazdanfar MD A 25-year-old woman living in Hamedan, Iran, presented originally at 7 years of age with erythematous, hyperkeratotic lesions on the palms and soles with extension to the dorsal side of the hands and feet. Involvement of the elbows and knees was also seen. From 12 years of age, she started to lose her teeth. At the same age, she experienced fever, chills, malaise, myalgia, and right upper quadrant abdominal pain. With a diagnosis of pyogenic liver abscesses, the patient underwent successful surgical treatment. ,Examination revealed erythematous, hyperkeratotic, scaling plaques on the palms and soles, dorsal side of the hands and feet (Fig. 1), elbows and knees. All the teeth were missing from the mouth (Fig. 2), and she used a dental prosthesis. A surgical scar was observed on the right upper quadrant of the abdomen (Fig. 3). Skull X-ray and computed tomography scan were normal. Skin biopsy of the dorsal right hand demonstrated hyperkeratosis, focal parakeratosis, hypergranulosis, and acanthosis with a mild inflammatory infiltrate around the vessels (Fig. 4). Figure 1. Hyperkeratotic plaques on the hands and feet Figure 2. Loss of permanent teeth Figure 3. Surgical scar on the right upper quadrant of the abdomen and hyperkeratotic plaques on the hand Figure 4. Hyperkeratosis, focal parakeratosis, hypergranulosis, and acanthosis (hematoxylin and eosin, ×40) [source] Nargile (Hubble-Bubble) smoking-induced hand eczemaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2002Meltem Onder MD A 65-year-old retired man with hand eczema presented to the Dermatology clinic in October of 2001. He complained of scaly, fissured plaque-type lesions over the radial margin of his right index finger and thumb (Fig. 1). He first noticed these changes 2 years ago. There was no history of irritation from his occupation. None of the other family members were affected. There was no history of atopy or psoriasis. Figure 1. Hyperkeratotic scaly plaques along the outer margin of the right index finger and thumb related with habit of nargile smoking The physical examination was remarkable for scaly, fissured, hyperkeratotic patches on the palms and palmar surfaces of the finger tips of the right hand. No nail changes were noted. The other fingers were free from lesions. There were no changes on the feet or soles. A diagnosis of eczema was suspected. Hobbies and repeated trauma to the hands were investigated. He had a habit of "nargile" smoking,starting at 35 years of age and he was using this apparatus more than 2 h a day. We performed patch tests with European standart test serial and they were negative. Yeast examination using KOH was negative. The diagnosis of Nargile (Hubble-bubble) eczema was made. It was advised that he stop smoking. Mild topical corticosteroids and emollient with urea were started. Clinical evaluation demonstrated resolution of the lesions after 2 weeks of therapy. [source] A case of nevus comedonicus syndrome associated with neurologic and skeletal abnormalitiesINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2001Young-Joon Seo MD A 12-year-old male was referred to us with recurrent pus discharge from tender nodules on the right axilla dating from the neonatal period. The nodules were black, characterized by scarring with dilated follicular openings and there were black papules filled with comedo-like keratin plugs in both axillae. Physical examination revealed a bowing deformity of the right third finger and retardation in language ability. The patient was referred to the Departments of Neurology and Orthopedics in Chungnam National University Hospital, Korea. Histologic examination of one of the black comedo-like lesions showed a bulbous and dilated infundibulum that contained laminated keratin, indicating a diagnosis of nevus comedonicus. A CT scan of the brain revealed dysgenesis of the corpus callosum. The IQ (intelligence quotient) score of the patient, measured by the Korean Wechsler Intelligence Scale for Children-Revised, was 94. The only difficulty noted for ordinary life was learning language. A radiograph of the right hand revealed hyperextension and an ulnar drift deformity of the right middle finger. Corrective osteotomy with external fixation and an iliac bone autograft were performed. Intermittent neurologic follow-up visits were ordered for the noted language deficit. At present the patient only exhibits difficulty in calculation. Oral antibiotics were administered to the skin lesions on occasion for secondary infections and inflammation of the cysts and comedones. Extraction of the comedones was performed as needed. [source] The treatment of leprosy in 19th-century London: a case study from St Marylebone cemeteryINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 3 2009D. WalkerArticle first published online: 19 MAY 200 Abstract A young adult male, context [825], exhibiting a suite of proliferative and erosive skeletal changes, was excavated from the old burial ground of St Marylebone, London, in 2005 by the Museum of London Archaeology Service (MoLAS). Although pathognomonic rhinomaxillary changes were absent, a number of lesions were of a type previously recorded in individuals suffering from lepromatous leprosy, including resorption of the alveolar process of the maxillae and the digits of the right hand, osteomyelitis in the left ulna and collapse of the left ankle. Whilst this infectious disease was widespread in medieval Britain, it had declined by the 19th century, and has been identified in only one other post-medieval archaeological context. The right leg of [825] had been surgically amputated. This form of intervention was a recognised treatment for the complications of the disease, where neuropathic damage of limbs led to life-threatening infection. The healing of the amputation demonstrates the success of the operation, and the skill of the surgeon. Although the identity of the affected individual is unknown, burial within St Marylebone cemetery implies a level of status not frequently associated with leprosy sufferers in the past. Copyright © 2008 John Wiley & Sons, Ltd. [source] Amyloidosis: a rheumatological perspective on diagnosis, further investigation and treatmentINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 1 2008S. K. L. LAM Abstract In this Grand Round, we present a 58-year-old man with a presumptive diagnosis of rheumatoid arthritis (RA) who was being managed by a plastic surgery unit for a dorsal swelling of his right hand. While awaiting surgery for this lesion, he sustained a pathological fracture of his left neck of femur. This necessitated a total hip joint replacement and pathology revealed amyloidosis. Excision of the hand swelling also revealed amyloidosis as the cause. We discuss the ways in which amyloidosis can mimic musculoskeletal disease as well as the importance and some potential pitfalls of further investigation and management once the diagnosis of amyloidosis has been made. [source] The efficacy of ,0.05% Clobetasol + 2.5% zinc sulphate' cream vs. ,0.05% Clobetasol alone' cream in the treatment of the chronic hand eczema: a double-blind studyJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2008G Faghihi Abstract Background, Many therapeutic modalities have been suggested for treatment of the chronic hand eczema. Despite good immediate efficacy of some of these treatments, there is high recurrence of the dermatitis following cessation of the treatment. Aim, Regarding the beneficial effects of the zinc sulfate on the skin, we designed a double blind study to evaluate the efficacy of the ,0.05% Clobetasol + 2.5% zinc sulphate' cream versus ,0.05% Clobetasol alone' cream in the treatment of the chronic hand eczema. Subjects and Methods, This study was a double-blind, right to left, prospective, clinical trial. In total, 47 patients with chronic hand eczema admitted to dermatology center of Isfahan University of Medical Sciences were selected and their right hand or left hand were selected at random to be treated with either the ,0.05% Clobetasol + 2.5% zinc sulphate' cream or ,0.05% Clobetasol alone' cream twice daily for 2 weeks. All of the patients were treated for 2 weeks and were followed up at weeks 2, 4, 6 and 8 after starting the treatment. For determining the severity of chronic hand eczema, we assessed and scored 4 different characteristics of the lesions including redness; scaling; lichenification and pruritus. The data were analyzed using SPSS program (release 13) and statistical tests including Mann-Whitney test. Results, Overall, 47 patients (94 samples) were evaluated. All of these patients had similar and symmetrical lesions on their right and left hands. Out of them, 35 patients were females and 12 patients were male. In all of the evaluated characterisitics, the ,0.05% Clobetasol + 2.5% zinc sulphate' cream was more effective than ,0.05% Clobetasol alone' cream (P < 0.05). The recurrence rate of eczema was significantly lower in the group treated with this combination treatment (P < 0.05). Conclusion, With regard to the encouraging results of the combination treatment with Clobetasol + zinc sulphate, we suggest that in a more extensive clinical trial, the efficacy of this treatment against chronic hand dermatitis be evaluated. In addition, evaluation of this combination therapy against other inflammatory dermatosis seems to be logical. [source] Etiological musculo-skeletal factor in focal dystonia in a musician's hand: A case study of the right hand of a guitaristMOVEMENT DISORDERS, Issue 12 2007Joris N.A.L. Leijnse PhD Abstract A case study is presented in which a focal hand dystonia seems to have developed in the right hand of a classical guitarist as a result of a neuromuscular peripheral defect caused by trauma. The trauma was a near total perforation of the first web space by a splinter. Healing was uneventful without apparent functional complications. Two years later the patient noticed difficulties in extending the index in playing, for which he received various unsuccessful treatments during seven years. However, we found more severe dystonic symptoms (cocontractions) in the thumb than in the index during playing, which correlated with an undiagnosed insufficiency in the flexor pollicis brevis (FPB). This defect allowed proposing a biomechanical analysis of compensations for diminished thumb control in playing, which would explain the dysfunction in the index in playing as overcompensation for the thumb problem. If this analysis is correct, the etiology of the case can be traced back to underlying multiarticular control problems in the thumb caused by an insufficient FPB. This defect was considered irrepairable. It was concluded that even with knowledge of the underlying cause, a potentially successful treatment of the dystonia might not exist in this case. The case would demonstrate that task-specific hand dystonias can arise as overcompensations for (peripheral) neuro-musculoskeletal defects. The case is illustrated by videos of playing and functional thumb tests. © 2007 Movement Disorder Society [source] Coexistence of movement disorders and epilepsia partialis continua as the initial signs in probable Creutzfeldt,Jakob diseaseMOVEMENT DISORDERS, Issue 9 2005Berril Donmez MD Abstract Movement disorders and epilepsy rarely occur in the early stage of Creutzfeldt,Jakob disease (CJD) but have not been reported concurrently. We report on a 47-year-old patient with probable CJD who presented with generalized chorea and focal dystonia with myoclonic jerks on the right hand. Myoclonic jerks progressed to epilepsia partialis continua within 5 days of admission to the hospital. The diagnosis of our patient was compatible with probable CJD on the basis of clinical course, electroencephalogram, and diffusion-weighted magnetic resonance imaging findings, and presence of 14-3-3 protein in cerebrospinal fluid. To our knowledge, this is the first report of a case developing both movement disorders and epilepsia partialis continua in the early stage of the disease. © 2005 Movement Disorder Society [source] Deficits of temporal discrimination in dystonia are independent from the spatial distance between the loci of tactile stimulationMOVEMENT DISORDERS, Issue 2 2002Michele Tinazzi MD Abstract To assess whether spatial variables influence deficits of temporal somesthetic discrimination in dystonic patients, 10 patients with idiopathic dystonia and 12 healthy controls were tested with pairs of non-noxious electrical stimuli separated by different time intervals. Stimuli were delivered: (1) to the pad of the index finger (same-point condition), (2) to the pad and to the base of the index finger (same-finger condition), and (3) to the pad of the index and ring fingers (different-finger condition). Subjects were asked to report whether they perceived single or double stimuli in the first condition and synchronous or asynchronous stimuli in the second and third conditions. Somesthetic temporal discrimination thresholds (STDTs) were obtained by computing the shortest time interval at which stimuli, applied to the left or the right hand, were perceived as separate in the first condition or asynchronous in the second and third conditions. STDTs were significantly higher in dystonic patients than controls in all three conditions. In both dystonia patients and controls, STDTs resulted highest in conditions whereby stimuli were maximally separated in space. Results extend current knowledge of deficits of somesthetic temporal discrimination in dystonia by showing that temporal deficits are not influenced by spatial variables. © 2002 Movement Disorder Society. [source] Action hand dystonia after cortical parietal infarction,MOVEMENT DISORDERS, Issue 6 2001J.A. Burguera MD A 46-year-old patient with a pure left cortical infarct affecting mainly the gyrus postcentralis developed action dystonia in the right hand. Mechanisms involved in the genesis of focal secondary dystonia are discussed with emphasis on abnormal cortical sensory processing. © 2001 Movement Disorder Society. [source] Practice and endpoint accuracy with the left and right hands of old adults: The right-hemisphere aging modelMUSCLE AND NERVE, Issue 3 2008Brach Poston PhD Abstract The purpose of the study was to quantify the aging-related differences in endpoint accuracy during isometric contractions of the left and right hands based on the prediction that declines in motor performance with aging may be greater for muscles controlled by the right hemisphere. Twelve young (6 men, 25 ± 5 years) and 12 old (6 men, 76 ± 6 years) adults performed a task that involved matching the peak of a force,time trajectory to a target. The old adults were less accurate than the young men and exhibited greater endpoint error with the left hand than the right hand on day 1, but not on days 2 and 3. Although electromyographic amplitude was similar between hands, old adults exhibited greater timing variability. These findings indicate that given sufficient practice there was no difference in endpoint accuracy between the left and right hands of old adults, which is not consistent with the prediction of an asymmetrical decline in motor performance by the right-hemisphere aging model. Conversely, an inability by an old adult to achieve similar accuracy with both hands during such tasks likely indicates an underlying motor impairment. Muscle Nerve, 2007 [source] Role of Biphosphonates and Lymphatic Drainage Type Leduc in the Complex Regional Pain Syndrome (Shoulder,Hand Syndrome)PAIN MEDICINE, Issue 1 2009Andrea Santamato MD ABSTRACT Background., Complex regional pain syndrome (CRPS) is a clinical entity that has been termed in numerous ways in the last years. Clinically, CRPS describes an array of painful conditions that are characterized by a continuing (spontaneous and/or evoked) regional pain that is seemingly disproportionate in time or degree to the usual course of any known trauma or other lesion. The pain is regional and usually has a distal predominance of abnormal sensory, motor, sudomotor, vasomotor, and/or trophic findings. Design., Case report. Setting., University Medical Center. Patients., In this report, we described the case of a 68-year-old hemiplegic female affected by cerebrovascular accident that presented a clinical case of CRPS shoulder,hand syndrome (CRPS-SHS) at the right hand after a hemorrhagic stroke. Interventions., This report evaluated the effects of biphosphonates and lymphatic drainage type Leduc in CRPS-SHS. Outcome Measures., The pain level of the patients was measured with the visual analog scale. A scoring system for the clinical severity of CRPS-SHS, laboratory tests, and X-ray films were also performed. Results., We reported in this patient a great improvement of pain and edema of the right hand, with a significant reduction of bone demineralization. Conclusions., This combined treatment may be a viable alternative for this syndrome; however, further investigation is needed to determine its reproducibility in large case series. [source] Axillary brachial plexus block with patient controlled analgesia for complex regional pain syndrome type I: a case report. (National Cheng Kung University, Tainan, Taiwan) Reg Anesth Pain Med 2001;26:68,71.PAIN PRACTICE, Issue 4 2001Li-Kai Wang A 32-year-old man who suffered from complex regional pain syndrome type I (CRPS I) of the right upper limb after surgical release of carpal tunnel syndrome of the right hand is the subject of this case report. Symptoms and signs over the right hand were alleviated under rehabilitation and conventional pharmacological management, but severe painful swelling of the right wrist persisted. Axillary brachial plexus block (BPB) with patient controlled analgesia (PCA) was performed on the 32nd postoperative day, which soon resulted in significant reduction of pain with gradual improvement of function of the right wrist. Conclude that axillary BPB with PCA may provide patients with CRPS I of the upper limb a feasible and effective treatment. [source] Herpetic Infection in Epidermolysis BullosaPEDIATRIC DERMATOLOGY, Issue 4 2006Adam I. Rubin M.D. Standard wound care practices advocate the use of special dressings on open erosions as well as antibiotic topical medications to treat and prevent cutaneous infections. We report a child with recessive dystrophic epidermolysis bullosa admitted to our institution because of fevers at home. She was treated with multiple antibiotics for a cutaneous infection of the right hand. During her hospital stay, she sustained persistent fevers, and oral erosions developed, with progressive hemorrhagic crusting. Viral culture of the lip grew herpes simplex virus type 1, consistent with a diagnosis of herpetic gingivostomatitis. We present this patient to illustrate the importance of investigating wounds of epidermolysis bullosa patients for viral agents when faced with managing a child with an unclear source of fever. To the best of our knowledge, although this is the first report of herpetic gingivostomatitis in association with epidermolysis bullosa, it is likely to be more prevalent than the literature could suggest. [source] Meta-analysis of digit ratio 2D:4D shows greater sex difference in the right handAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 5 2010Johannes Hönekopp Objectives: Our aims are, first, to describe the sex difference in the length ratio of the second and fourth digits (2D:4D), which likely reflects prenatal testosterone levels in humans. Second, to infer the loss of reliability observed in 2D:4D based on self-measured finger lengths. Methods: We used random-effects meta-analysis of 2D:4D based on expert-measured finger lengths (116 samples with 13,260 females and 11,789 males). Results: We find a moderate sex difference (with lower 2D:4D for males), which shows substantial heterogeneity (which is unrelated to age). The sex difference is moderated by the type of finger length measurement and by hand. Measurement involving the distortion of soft tissue leads to a significantly larger sex difference than finger length measurement avoiding this. The sex difference in 2D:4D is larger in the right hand than in the left. The reliability of self-measured 2D:4D in the BBC internet study, by far the largest study on 2D:4D, is estimated to be 46% of that of expert-measured 2D:4D. Conclusions: Right-hand 2D:4D might be a better indicator of prenatal androgenisation than left-hand 2D:4D. The view that 2D:4D has allometric properties (Kratochvil L, Flegr J. 2009. Differences in 2nd to 4th digit length ratio in humans reflect shifts along the common allometric line. Biol Lett 5:643,646.) is not supported. Bone lengths contribute to the sex difference in 2D:4D. In addition, there might be a sex difference in fingers' soft tissue, which should be investigated. Because of measurement unreliability, correlations between 2D:4D and variables of interest are about one-third smaller in the BBC internet study than in studies in which 2D:4D is based on expert-measured finger lengths. Am. J. Hum. Biol. 22:619,630, 2010. © 2010 Wiley-Liss, Inc. [source] Action monitoring in motor control: ERPs following selection and execution errors in a force production taskPSYCHOPHYSIOLOGY, Issue 5 2003Ellen R. A. De Bruijn Abstract Action monitoring has been studied in many tasks by means of measuring the error-related negativity (Ne/ERN), but never in a motor control task requiring precise force production. Errors in discrete choice reaction tasks are the result of incorrect selections, but errors in force production can also arise from incorrect executions. ERPs were obtained while participants produced low or high isometric forces with their left or right hand. As expected, incorrect choices of hand elicited an Ne/ERN. Interestingly, Ne/ERNs were also present in the less discrete selection error of an incorrect choice of force, but only when erroneously a low instead of a high force was chosen. In both force ranges, no Ne/ERNs were found after errors in execution. These errors showed a large positivity in feedback ERPs and, similar to correct responses, a prolonged negativity in response ERPs. We propose that, compared to selection errors, the time uncertainty aspects of execution errors and the resulting changing response representations prohibit error detection by the internal monitoring system responsible for generating the Ne/ERN. [source] Brief communication: Familial resemblance in digit ratio (2D:4D)AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 2 2009Martin Voracek Abstract Familial resemblance in the second-to-fourth digit ratio (2D:4D), a proxy for prenatal androgen action, was studied in 1,260 individuals from 235 Austrian families. In agreement with findings from twin studies of 2D:4D, heritability estimates based on parent,child and full-sib dyad similarity indicated substantial genetic contributions to trait expression (57% for right hand, 48% for left hand 2D:4D). Because twin studies have found nonadditive genetic as well as shared environmental effects on 2D:4D to be negligible or nil, these family-based estimates in all likelihood reflect the narrow-sense (additive genetic) heritability of the trait. Directional (right-minus-left) asymmetry in 2D:4D was only weakly heritable (6%). The pattern of same-sex and different-sex parent,child and full-sib correlations yielded no evidence for X-linked inheritance. This is surprising, considering evidence for associations of male 2D:4D with sensitivity to testosterone (functional variants of the X-linked androgen receptor gene). 2D:4D was particularly strongly heritable through male lines (father,son and brother,brother correlations), thus raising the possibility that Y-linked genes (such as the sex-determining region SRY) might influence 2D:4D expression. Am J Phys Anthropol, 2009. © 2009 Wiley-Liss, Inc. [source] Epithelioid sarcoma presenting as pulmonary cysts with cancer antigen 125 expressionRESPIROLOGY, Issue 6 2006Eiki KIKUCHI Abstract: A 39-year-old Japanese woman presented with a swollen right hand and a right-sided pneumothorax. Chest CT revealed bilateral multiple pulmonary thin-walled cysts measuring ,1 cm in diameter and small nodules. An initial skin biopsy led to a misdiagnosis of metastatic adenocarcinoma, as tumour cells were positive for cytokeratin, epithelial membrane antigen, carcinoembryonic antigen and cancer antigen 125. However, chemotherapy proved ineffective, and the skin biopsy was repeated. A final diagnosis of epithelioid sarcoma (ES) was made. Open lung biopsy showed that the pulmonary nodules represented metastases of ES. Although the pulmonary cyst walls did not contain tumour cells, bronchiolar wall adjacent to the cysts had been infiltrated by tumour cells. These findings suggested that pulmonary cysts, a rare form of pulmonary metastases from soft tissue sarcomas, had developed through a ball-valve effect of metastatic tumour in small airways. However, presence of cancer antigen 125 hindered obtaining a correct diagnosis of ES. [source] Effect and persistency of botulinum toxin iontophoresis in the treatment of palmar hyperhidrosisAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 2 2008Sanaz Davarian SUMMARY The purpose of this study was to investigate the efficacy and persistence of the hypohidrosis induced by iontophoresis of botulinum toxin type A in patients with palmar hyperhidrosis. Eight patients with severe palmar hyperhidrosis participated in this study. Iontophoresis of botulinum toxin was applied to the patients' dominant (right) hand and the other hand was the control treated with normal saline. Gravimetry and iodine,starch tests were performed to evaluate the rate of sweating. The evaluation sessions were at baseline, 2 and 4 days, 1, 2, 3, 4, 8 and 12 weeks after treatment. The patients were also asked to fill out the Dermatology Life Quality Index questionnaire at 2, 4, 8 and 12 weeks after treatment. The mean sweating rate significantly reduced at the first, second, third and fourth week and the second and third month (P < 0.05) after the treatment in the right hand, and the third and fourth week (P < 0.05) after treatment in the left hand. Iontophoresis of botulinum toxin rapidly induced a quick reduction of sweating rate for at least 3 months with no pain, muscle weakness or other side-effects. [source] Periungual lesions in pyoderma gangrenosumCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 5 2009A. Reich Summary Pyoderma gangrenosum (PG) is a progressive cutaneous necrosis of unknown origin. We report a case of PG presenting with periungual lesions. A 57-year-old woman was on treatment with ciclosporin A for PG. During tapering of the ciclosporin A dose, proliferating periungual lesions developed on the third and fourth finger of the left hand, the fourth finger of the right hand, and on the right great toe and the left fifth toe. All lesions appeared within a 4-week period. These abnormalities were ulcerated, involved about one-third of the distal part of the lateral nail folds including the part of nail fold bordering on the free edge of the nails, and were very painful. The skin biopsy was consistent with that seen in PG. Increasing the ciclosporin A dose led to significant improvement in the periungual lesions within the next few weeks and complete resolution within 6 months. [source] Screening for duct-dependent congenital heart disease with pulse oximetry: A critical evaluation of strategies to maximize sensitivityACTA PAEDIATRICA, Issue 11 2005ANNE DE-WAHL GRANELLI Abstract Aim: To evaluate the feasibility of detecting duct-dependent congenital heart disease before hospital discharge by using pulse oximetry. Design: Case-control study. Setting: A supra-regional referral centre for paediatric cardiac surgery in Sweden. Patients: 200 normal term newborns with echocardiographically normal hearts (median age 1.0 d) and 66 infants with critical congenital heart disease (CCHD; median age 3 d). Methods: Pulse oximetry was performed in the right hand and one foot using a new-generation pulse oximeter (NGoxi) and a conventional-technology oximeter (CToxi). Results: With the NGoxi, normal newborns showed a median postductal saturation of 99% (range 94,100%); intra-observer variability showed a mean difference of 0% (SD 1.3%), and inter-observer variability was 0% (SD 1.5%). The CToxi recorded a significantly greater proportion of postductal values below 95% (41% vs 1%) in the normal newborns compared with NGoxi (p < 0.0001). The CCHD group showed a median postductal saturation of 90% (45,99%) with the NGoxi. Analysis of distributions suggested a screening cut-off of < 95%; however, this still gave 7/66 false-negative patients, all with aortic arch obstruction. Best sensitivity was obtained by adding one further criterion: saturation of < 95% in both hand and foot or a difference of > ± 3% between hand and foot. These combined criteria gave a sensitivity of 98.5%, specificity of 96.0%, positive predictive value of 89.0% and negative predictive value of 99.5%. Conclusion: Systematic screening for CCHD with high accuracy requires a new-generation oximeter, and comparison of saturation values from the right hand and one foot substantially improves the detection of CCHD. [source] Norms for grip strength in children aged 4,16 yearsACTA PAEDIATRICA, Issue 6 2002C Häger-Ross The aim of this study was to provide norms for grip strength in children. A total of 530 Swedish 4,16-y-olds was tested with the instrument Grippit®. The instrument estimates peak grip strength over a 10 s period, and sustained grip strength averaged across the 10 s. The increase in grip strength with age was approximately parallel for boys and girls until 10 y of age, after which boys were significantly stronger than girls. Strong correlations existed between grip strength and the anthropometric measures weight, height and, in particular, hand length. Right-handed children were significantly stronger in their dominant hand, while left-handers did not show any strength difference between the hands. It is therefore suggested that when evaluating grip strength in left-handed children both hands should be assumed to be about equally strong, while right-handed children are expected to be up to 10% stronger with their right hand. Sustained grip strength was consistently about 80,85% of peak grip strength, with somewhat lower values in younger children. The present normative data for peak grip strength were slightly lower than 1980s' data from the USA and Australia, probably because of divergences in age grouping and in instruments used. Conclusion: Norms for grip strength including estimates of variation were provided for children aged 4,16 y. These data will enable therapists and physicians to compare a patient's score with the scores of normally developed children according to age, gender, handedness and body measures. 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