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The cross-modal correlations between auditory and visual language lateralization were examined as a function of the subject variables of handedness, sex, familial sinistrality, and handwriting posture. In this study, left-handers showed a significantly greater correlation between visual and auditory language processing asymmetries than right-handers, contradicting previous reports.
Two experiments are presented which demonstrate asymmetrical transfer for tactual recognition of individual braille letters in sighted subjects, a task usually associated with right hemisphere specialization. Right-handers were studied in Experiment 1, left- and right-handers in Experiment 2. Poor transfer of training from the right hand to the left hand was observed for right-handed subjects in both experiments. The same was true for one group of left-handers (who wrote with the "inverted" position). For another group (who wrote with the "noninverted" position), no disadvantage was associated with opposite-hand training for either hand. The role of hemispheric specialization of function in determining the direction of greater transfer is discussed, and it is argued that handwriting posture may be an index of the degree of functional "connectedness" of the two hemispheres in left-handers.
Experimental workstations for oral reporting and synchronized image filing have been developed and evaluated by radiologists and referring physicians. The file media is a 5.25-inch rewritable magneto-optical disk of 600-Mb capacity whose file format is in accordance with the IS&C specification. The results of evaluation tell that this system is superior to other existing methods of the same kind such as transcribing, dictating, handwriting, typewriting and key selections. The most significant advantage of the system is that images and their interpretation are never separated. The first practical application to the teaching file and the teaching conference is contemplated in the Osaka University Hospital. This system is a complete digital system in terms of images, voices and demographic data, so that on-line transmission, off-line communication or filing to any database will be easily realized in a PACS environment. We are developing an integrated system of a speech recognizer connected to this digitized oral system.
Brain damage can selectively disrupt or distort information and ability across the range of human behaviors. One domain that has not been considered as an independent attribute consists of acquisition and maintenance of personal relevant entities such as "familiar" faces, persons, voices, names, linguistic expressions, handwriting, topography, and so on. In experimental studies of normal mentation, personal relevance is revealed in studies of emotion, arousal, affect, preference and familiarity judgments, and memory. Following focal brain damage, deficits and distortions in the experience of personal relevance, as well as in recognizing formerly personally relevant phenomena, are well known to occur. A review and interpretation of these data lead to a proposal that the right hemisphere has a special role in establishing, maintaining, and processing personally relevant aspects of the individual's world.
The cerebral involvement of a 13-yr-old boy with Wilson's disease was serially evaluated during the first 18 mo of D-penicillamine treatment. An ultra-low-field magnetic resonance imaging (ULF MRI) system, operating at 0.02 T, with computerized image processing was used. The half-yr period prior to the clinical diagnosis was set, the patient had showed poor school performance, emotional lability, deteriorating handwriting, progressively slow, gross, and fine motor functions, and a fixed rigid smile. No overt signs of liver disease were found. With D-penicillamine treatment (1-1.5 g/d) a continuous improvement was seen. The pretreatment MRI investigation showed pronounced pathological transformation in the basal ganglia. However, changes were seen also in most other parts of the brain indicating diffuse involvement. During treatment the computerized MR images became gradually more normal. The current magnetic resonance imaging system with computerized image processing is a sensitive and simple method for evaluation of subtle parenchymal changes of the brain.
Stimulant therapy is usually contraindicated in patients with movement disorders such as tics or chorea. A young boy is reported who had benign hereditary chorea and attention deficit disorder, whose chorea, handwriting, and independent ambulation paradoxically improved with methylphenidate treatment.
We describe 2 patients, one with cervical dystonia (CD) combined with focal hand dystonia (writer's cramp) and another with idiopathic CD, who were unresponsive to oral medications and became resistant to botulinum toxin type A and B injections. Both patients were successfully treated with high cervical (C1-3) continuously infused intrathecal baclofen (ITB). Neck range of motion (ROM) was measured by using a 3-dimensional electromagnetic cervical ROM system. Pain, disability, and severity were assessed by using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). The patient with CD and writer's cramp did well on a continuous baclofen dose of 186.1 microg/d. Her total TWSTRS score improved significantly, her electromagnetic measurements showed an increased in total neck flexion and extension, and her handwriting improved. Unfortunately, this patient (a heavy smoker) developed small cell carcinoma of the lung and died 9 months after her pump was placed. Total TWSTRS score and electromagnetic measurements also significantly improved after pump implant in the patient with CD. He continues to do well on a periodic bolus dose using a combination of 50 microg of baclofen and 25 microg of hydromorphone (Dilaudid) every 4 hours. Our findings suggest the potential usefulness of this therapy in other patients with focal dystonia. To our knowledge, this is the first reported successful treatment of CD and CD combined with writer's cramp with high cervical continuously infused ITB.
Over the last decades, the importance of technical and scientific evidence for the criminal justice system has been steadily increasing. Unfortunately, the weight of forensic evidence is not always easy for the trier of fact to assess, as appears from a brief discussion of some recent cases in which the weight of expert evidence was either grossly over- or understated. Also, in recent years, questions surrounding the value of forensic evidence have played a major role in the appeal and revision stages of a number of highly publicized criminal cases in several countries, including the UK and the Netherlands. Some of the present confusion is caused by the different ways in which conclusions are formulated by experts working within the traditional approach to forensic identification, as exemplified by (1) dactyloscopy and (2) the other traditional forensic identification disciplines like handwriting analysis, firearms analysis and fibre analysis, as opposed to those working within the modern scientific approach used in forensic DNA analysis. Though most clearly expressed in the way conclusions are formulated within the diverse fields, these differences essentially reflect the scientific paradigms underlying the various identification disciplines. The types of conclusions typically formulated by practitioners of the traditional identification disciplines are seen to be directly related to the two major principles underpinning traditional identification science, i.e. the uniqueness assumption and the individualization principle. The latter of these is shown to be particularly problematic, especially when carried to its extreme, as embodied in the positivity doctrine, which is almost universally embraced by the dactyloscopy profession and allows categorical identification only. Apart from issues arising out of the interpretation of otherwise valid expert evidence there is growing concern over the validity and reliability of the expert evidence submitted to courts. While in various countries including the USA, Canada and the Netherlands criteria have been introduced which may be used as a form of input or output control on expert evidence, in England and Wales expert evidence is much less likely to be subject to forms of admissibility or reliability testing. Finally, a number of measures are proposed which may go some way to address some of the present concerns over the evaluation of technical and scientific evidence.
A methodology based on Fourier descriptors that was previously validated has been applied to 13 writers in order to quantify the polymorphism degree of the shape of the loops of the handwritten characters a, d, o and q. In a first step, the discriminating power of the parameters extracted from these letters was investigated. The loop of the letter d appeared to be the most discriminant with a correct classification rate of 82.4%, whereas the least discriminant one was the loop of the letter o (69.7%). The second aim of the study was to extract grouping characteristics which make it possible to discriminate between writer sets, whatever the letter. Trends in the writing of loops could effectively be shown: the 13 writers of the study were separated into five main groups according to the shape and surface of their loops. The most discriminating features between the writer groups were the importance of the loops elongation and the surface of the loops. Finally, the differences between writers belonging to distinct groups could be characterized more precisely, and differences between writers belonging to the same group were revealed; the individual writings were distinguished by the variability of the parameters of shape and surface of their loops and the morphological distances between its different letters. The correct classification rates reached in this study suggest that carrying out an expertise of fragmentary samples of handwriting comprising only some loops is completely possible.
In the practice of forensic handwriting experts, the size of the writing on a questioned document may be different from that of known samples. In this study, the hypothesis of shape invariance of handwritten closed loops across size increasing was tested. A Fourier methodology was applied to 2325 small letters (591 a loops, 547 d loops, 596 o loops and 591 q loops) and 692 enlarged letters (162 a loops, 173 d loops, 173 o loops and 184 q loops), in a population of 13 writers who were asked to write letters in their usual size and about three times larger. Most of the writers presented similar modifications when increasing the size of the loops; they produced enlarged loops significantly more round and less slanted towards the right or the left. Furthermore, a discrimination was demonstrated between the writers on the basis of the enlarged loops, with a correct classification rate superior to 90%, whatever the letter (a, d, o or q). A classification of the enlarged loops in their corresponding writer was then possible. On the contrary, when comparing the enlarged loops to the small ones, almost one half of the enlarged loops were allocated to a wrong writer. Shape invariance was thus not supported for this particular application. Consequently, when comparing documents with a different writing size, differences in loops shape should be interpreted cautiously because they may be due to a different writer, but they may also be due to an enlargement of the loops. Therefore, reference material of similar writing size to that of the questioned writing should be requested for the comparison of handwritten loops.
Developmental dyslexia is diagnosed when literacy skills are not commensurate with a person's general cognitive ability and education. While the most common difficulty found in dyslexia is poor phonological processing, many dyslexics are reported to be clumsy, with poor handwriting, suggesting that there may be a motor deficit in dyslexia. To establish whether the motor difficulties described in dyslexic children persist into adulthood, we tested 18 dyslexic adults and 22 control participants on Annett's peg-moving task. The dyslexic participants performed significantly slower than control adults on the peg-moving task with their dominant hands (p=0.004). Furthermore, response times (RTs) during tasks testing component literacy skills correlated with peg-moving ability in the dominant hand in the entire group (orthographic r=0.448, p=0.005; phonological r=0.383, p=0.025). These results indicate that a motor speed deficit in dyslexia may not be simply a sign of developmental delay, but may persist into adulthood. Furthermore, motor speed may be related to the speed at which literacy information is processed.
Increasing evidence suggests that somatosensory information is modulated cortically for task-specific sensory inflow: Several studies report short-term adaptation of representational maps in primary somatosensory cortex (SI) due to attention or induced by task-related motor activity such as handwriting. Recently, it has been hypothesized that the frontal or prefrontal cortex may modulate SI. In order to test this hypothesis, we studied the functional organization of SI while subjects performed the Tower of Hanoi task. This task is known to be related to activation of frontal or prefrontal areas. The functional organization of SI while performing the Tower of Hanoi task was compared to the organization of SI during performing the same movements but without the Tower of Hanoi task and with rest. Topography of SI was assessed using neuromagnetic source imaging based on tactile stimulation of the first (D1) and fifth digits (D5). Performing the Tower of Hanoi task was accompanied by plastic changes in SI as indicated by significant shifts in the cortical representations of D1 and D5: They moved further apart during the Tower of Hanoi task compared to the control task containing the same movements but without the cognitive characteristic. Thus, we conclude that SI maps undergo dynamic modulation depending on motor tasks with different cognitive demands. The results suggest that this short-term plasticity may be regulated by a prefrontal-cortical sensory gating system.
Patients with occupational hand dystonias have task-specific involuntary co-contraction and overflow of activity to inappropriate muscles. This interferes with highly skilled movements such as handwriting (writer's cramp) or playing a musical instrument (musician's cramp). Transcranial stimulation methods that probe mechanisms of synaptic plasticity in the motor cortex show an abnormal modifiability of sensorimotor circuits in patients with writer's cramp, probably because homeostatic control of the range of modification is deficient. We argue that during skilled motor practice, this leads to an excessive tendency to form associations between sensory inputs and motor outputs (abnormal potentiation) and to a failure to weaken already existing associations (deficient depotentiation). Deficient homeostatic control might be an important mechanism that triggers maladaptive reorganization and produces symptoms of occupational hand dystonias.
The perioperative record maintains accurate communication between the OR and the postoperative care nurse. For example, the nurse can easily verify the type and placement of a drain by checking the area labeled "Potential for infection." The check-off format also makes the information consistent and easy-to-read, and the nurse does not have to decipher any handwriting. Another advantage of this format is that it is easy to retrieve data for nursing research. It is also suitable for computerization.
This paper reports the case of a patient with a peripheral spelling impairment who is much more severely impaired at writing in lower-case letters than in upper-case letters. This pattern can be observed when writing both words and single letters of the alphabet. Despite this, his problems in writing lower-case letters are no longer present when he is writing cursively. This case therefore indicates that the ability to print letters in lower-case can be selectively impaired in the absence of similar problems in printing upper-case letters or in writing lower-case letters cursively. In terms of the model of writing put forward by Ellis (1982, 1988), this suggests that allographic level representations for print handwriting styles can be functionally dissociated from allographic representations for cursive styles.
We used an infra-red device to study the effects of gender and handwriting preference on manual asymmetry in tapping rate and intertap variability. Our sample (n=102) consisted of approximately equal number of subjects with respect to gender (52 women and 50 men) and handedness (52 right-handers and 50 left-handers). Data on overall performance indicated that men performed more quickly and regularly than women. The index used for measuring manual asymmetry was the difference between the hands as a proportion of the total. Therefore, the asymmetry index was adjusted to remove the influence of overall performance. The analyses based on asymmetry scores indicated a significant handedness effect: right-handers showed greater manual asymmetries than left-handers for both tapping rate and intertap variability. In addition, right handers exhibited a significant greater asymmetry for intertap variability than tapping rate. Taken together, these data may reflect greater hemispheric differences in right-handers, specially for intertap variability.
Documentation remains the key factor that leads to success or failure of a claim in a significant number of cases. Since the time of a trial is often years later, an accurate memory can only be reflected by the records kept by the physician in question. This article focuses on developing good habits of documentation in areas such as medical record maintenance, handwriting, informed consent, and record tampering. Guidelines for improved record keeping are also presented in this article.
Hand-arm vibration syndrome has been specially addressed in the Scandinavian countries in recent years, but the syndrome is still not sufficiently recognized in many countries. The object of this preliminary study was to describe the nature and character of vibration-induced impairment in the hands of exposed workers. Twenty symptomatic male workers (aged 28 to 65 years) subjected to vibration by hand-held tools were interviewed about subjective symptoms and activities of daily living and were assessed with a battery of objective tests for sensibility, dexterity, grip function, and grip strength. The test results were compared with normative data. The majority of patients complained of cold intolerance, numbness, pain, sensory impairment, and difficulties in handling manual tools and in handwriting. The various objective tests showed considerable variation in indications of pathologic outcome, revealing differences in sensitivity to detect impaired hand function. Semmes-Weinstein monofilament testing for perception of light touch-deep pressure sensation, the small-object shape identification test, and moving two-point discrimination testing for functional sensibility provided the most indications of pathologic outcomes. The authors conclude that vibration-exposed patients present considerable impairment in hand function.