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Second Finger (second + finger)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Difficult laparoscopic cholecystectomy in acute cholecystitis: use of ,finger port', a new approach

HPB, Issue 3 2003
R Sinha
Background Adhesions in acute cholecystitis tax even the more experienced operator during laparoscopic cholecystectomy. Blunt and sharp dissection, electrocautery, laser, hydrodissection, and ultrasonic dissection may all have their limitations. Thus there is a need for an alternative and more effective method. Method Laparoscopic cholecystectomy was carried out in 281 patients with acute cholecystitis. Separation of the gallbladder from the adherent structures was carried out in 13 patients, using the forefinger of the left hand introduced through the right hypochondrial port. In two patients a second finger was introduced through the epigastric port. Results The mean time required for the dissection was 7.9 minutes. Finger dissection failed in three patients because of dense adhesions on a high subcostal position of the gallbladder. Discussion Finger dissection is easy, fast, and limits injury because of the direct vision and tactile sensation, which are missing in other methods of laparoscopic dissection. [source]

Finger pebbles in a diabetic patient: Huntley's papules

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2005
Claudio Guarneri MD
A 60-year-old obese man was referred to our department from the internal medicine unit. He had a 20-year history of poorly controlled diabetes (no other cases in the family), and was admitted to hospital because of respiratory and consequent heart failure. Skin examination showed diffuse xerosis and a rough, sandpaper-like appearance of the skin of the finger, of approximately 15 years' duration, consisting of multiple, minute, hyperkeratotic papules grouped in a miniature "cobblestone" pattern on the dorsum of the distal phalanges (Fig. 1), more dense over the knuckles and the interphalangeal joints. No pruritus was present. Figure 1. Pebbly pattern of the skin on the dorsum of the second digit He was a pensioner, who had been physically inactive for months previously, and this condition had occurred progressively in the absence of any known trauma. No other cutaneous manifestations were evident. Histologic examination was performed using hematoxylin and eosin staining of a biopsy specimen taken from the left second finger; it displayed a hyperorthokeratotic epidermis with enlarged dermal papillae, thickened and vertically oriented collagen bundles, few elastic fibers, and a mild perivascular inflammatory infiltrate (Fig. 2). Figure 2. Histologic view of a biopsy specimen of the skin of the finger: the epidermis is hyperkeratotic, the dermal papillae are enlarged and there are thickened vertical collagen bundles, elastic fibers, and a mild perivascular inflammatory infiltrate (hematoxylin and eosin stain; original magnification, ×100) [source]

Abnormal peripheral vascular response to occlusion provocation in normal tension glaucoma patients

ACTA OPHTHALMOLOGICA, Issue 2007
J WIERZBOWSKA
Purpose: To assess peripheral vascular reactive hyperemia in response to occlusion provocation test, using two-channels laser Doppler probe in patients with normal tension glaucoma (NTG) and normal subjects. Methods: 15 patients with NTG (12 women and 4 men), mean aged 58,9 and 15 control subjects (13 women and 2 men), mean aged 60,6 were subjected to an occlusion test. The experiment comprised following steps: 1/ a 5-minute baseline-period 2/ a 2-minute occlusion of the left hand using a 15 cm wide cuff located directly over the elbow (the pressure in the cuff was 50 mmHg higher than the systolic pressure measured on the arm 3/ a 15- minute final recovery period after occlusion. Finger hyperemia was assessed by two-channels laser-Doppler flowmeter MBF-3d, Moor Instruments, Ltd., continuously during the experiment. For measurements of hyperemia two surface probes were attached to the pulp of the second finger (mean probe) and third finger (basic probe) of the left hand. The following hyperemia parameters were measured: RF (rest flow), BZ (biological zero), TM (time to peak flow), TH (half-time of hyperemia), MAX (maximum of hyperemia) and hyperemia amplitude (MAX-RF)/RF 100% was calculated. Kruskal-Wallis test analysis was used to test the differences between the group of patients and normal subjects for TM1,MXF1 (basic probe) and TM2, MXF2 (mean probe) parameters. Results: In NTG patients, TM1 was significantly higher comparing with healthy subjects whereas MAX was significantly lower as compared to the control group. Conclusions: Occlusion provocation test elicits a different systemic hyperemia response in patients with NTG compared with healthy subjects. [source]

High prevalence of vasomotor reflex impairment in newly diagnosed leprosy patients

EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 10 2005
X. Illarramendi
Abstract Background, Initial nerve damage in leprosy occurs in small myelinated and unmyelinated nerve fibers. Early detection of leprosy in the peripheral nervous system is challenging as extensive nerve damage may take place before clinical signs of leprosy become apparent. Patients and methods, In order to determine the prevalence of, and factors associated with, peripheral autonomic nerve dysfunction in newly diagnosed leprosy patients, 76 Brazilian patients were evaluated prior to treatment. Skin vasomotor reflex was tested by means of laser Doppler velocimetry. Blood perfusion and reflex vasoconstriction following an inspiratory gasp were registered on the second and fifth fingers. Results, Vasomotor reflex was impaired in at least one finger in 33/76 (43%) patients. The fifth fingers were more frequently impaired and suffered more frequent bilateral alterations than the second fingers. Multivariate regression analysis showed that leprosy reaction (adjusted odds ratio = 8·11, 95% confidence interval: 1·4,48·2) was associated with overall impaired vasomotor reflex (average of the four fingers). In addition, palmar erythrocyanosis and an abnormal upper limb sensory score were associated with vasomotor reflex impairment in the second fingers, whereas anti-phenolic glycolipid-I antibodies, ulnar somatic neuropathy and a low finger skin temperature were associated with impairment in the fifth fingers. Conclusions, A high prevalence of peripheral autonomic dysfunction as measured by laser Doppler velocimetry was observed in newly diagnosed leprosy patients, which is clinically evident late in the disease. Autonomic nerve lesion was more frequent than somatic lesions and was strongly related to the immune-inflammatory reaction against M. leprae. [source]