Letter: 99mTc-pertechnetate scanning in capsulitis.
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Biomedical subjects
Publications and source records attributed to M G Wright.
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Vertebral trephine biopsy is a safe and swift method of diagnosis of vertebral abnormality. The procedure is no more disturbing for the patient than lumbar puncture, and saves the patient, radiologist and clinician, considerable time and effort.
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A shape-posting task was studied in 30 control, eight hemiplegic and 10 diplegic children, to determine how differences in object manipulation between such children could be quantified. Conical, cylindrical and triangular-shaped objects were posted through a hole in a perspex screen, three times each with both preferred and non-preferred hands. Four variables were defined to describe kinematic aspects of the task: adjustment inefficiency, mean transport velocity, adjustment distance to be completed in the placing phase and adjustment velocity in the placing phase. As expected, total task time was increased in subjects with cerebral palsy and with more complex shapes, and reduced by repetition. The four kinematic variables reduced the variation in task time between individual children by 79%, between sets of like objects by 62%, and the residual variation by 63%. Adjustment inefficiency was increased and mean transport velocity reduced in subjects with cerebral palsy, whereas repetition had the opposite effect. It is suggested that combined alterations in adjustment inefficiency and transport velocity reflect changes in the intrinsic uncertainty of a movement and that this quantity is decreased by repetition and increased in cerebral palsy.
The kinematics of the wrist and a manipulated object were studied in a posting task in 30 control, eight hemiplegic and 10 diplegic children. Statistical analyses using 'mixed' models examined the effects of subject group, hand, object shape and repeated trials, together with all possible interaction terms. During transport to the posting hole, the number of significant peaks/troughs in the velocity/time profile of the wrist in the transport ('z') direction were increased in subjects with cerebral palsy, as were adjustment error and the distances moved by the object relative to the wrist, reflecting more unpredictable object movement. In the placing phase, relative object/wrist normalized 'z' distances and number of wrist 'z' velocity peaks increased with increasing object complexity, reflecting the need for more adjustment movements. The number of wrist 'z' velocity peaks/troughs and adjustment error were increased in cerebral palsy subjects, reflecting ineffective adjustment. Relative object/wrist distances and number of wrist 'z' velocity troughs were reduced in both phases with repeated trials. It is suggested that such variables may provide a quantitative measure of poor movement 'quality' in children with Cerebral Palsy and that these findings reflect reduced mechanical stability of the hand and arm during movement.
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