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A technique using cotton gloves to lift the heart up out of the pericardial cavity is described. The fingers can be used to widen the arteriotomy and to blot blood or cardioplegia solution in the arteriotomy.
We report a typical case of papular-purpuric "gloves and socks" syndrome (PPGSS) in which primary infection by parvovirus B19 was demonstrated by seroconversion to this virus; parvovirus B19 DNA was also identified by polymerase chain reaction (PCR) methods in the sera of the patient and in the cutaneous biopsy specimen, both taken 4 days after the onset of clinical manifestations. To our knowledge, this is the fourth published case in which parvovirus B19 DNA has been recovered from the skin by PCR. Serologic studies and PCR investigations in cutaneous biopsy for other viruses including herpes simplex virus types 1 and 2, varicella zoster virus, Epstein-Barr virus, cytomegalovirus, and human herpesvirus 6, 7, and 8 were negative. Clinically, our case presented some additional features, which have not been previously described in cases of PPGSS, namely dysuria with vulvar edema and erythema, and unilateral petechial rash on the breast. The histopathologic findings of our case were nonspecific and consisted of an interface dermatitis with slight vacuolar degeneration at the dermoepidermal junction and a superficial perivascular inflammatory infiltrate mostly composed of lymphocytes, with numerous extravasated erythrocytes. We review the cases of PPGSS published in the literature with respect to the different viruses that have been proposed as etiologic agents and conclude that acute infection by parvovirus B19 is the only one that has been adequately proved.
OBJECTIVE: The purpose of this investigation was to assess whether glove and/or splint use could effectively reduce hyperextension at the wrist during wheelchair propulsion, thus potentially reducing the conditions predisposing to median nerve dysfunction, and to evaluate the overall effects of these interventions on wheeling mechanics. DESIGN: This investigation used a randomized experimental design. BACKGROUND: The upper extremities are used for weight bearing and propulsion by individuals who are wheelchair dependent. High intracarpal pressures created by hyper-extension of the wrist and repetitive high force stresses of the hands against the wheel are suggested causes of median nerve dysfunction. METHODS: The wheeling performances of 13 subjects were recorded using two SVHS video-cameras under four different glove/splint conditions. Each subject was analysed on two wheeling cycles under all four conditions. Wrist and elbow angles, joint range of motions and wheeling speed were determined. Data were analysed using a one-way analysis of variance (ANOVA), followed by Scheffé post-hoc comparisons at the 0.05 level of significance. RESULTS: The splint and the glove/splint combination significantly reduced wrist extension during wheeling, but did not alter elbow motion or maximal wheeling speed. CONCLUSIONS: Hand and wrist protection in the form of a splint or glove/splint combination can reduce hyperextension of the wrist, and therefore may be of functional value for wheelchair users. This form of protection may therefore be useful in various orthopedic conditions of the wrist or hand commonly seen in wheelchair-dependent individuals without seriously interfering with wheeling quality.
This article introduces the use of a hand glove splint for attachment of various dynamic components. It is inexpensive, easy to make, adaptable, and well accepted by patients. The author discusses its fabrication and clinical use.
A new table tennis glove to enable a tetraplegic to hold a table tennis bat is described and discussed. It is much easier to apply than to bandage the bat to the hand.
Type I allergy to natural rubber latex can be an important health problem for latex-exposed individuals (e.g., health care workers, spina bifida children). Also beyond these risk groups, a high sensitization rate of varying and partly unknown clinical relevance has been reported. Atopy represents a risk factor for latex allergy and recent studies indicate that patients suffering from pollen allergies may have pollen allergen-specific IgE antibodies which cross-react with latex allergens. In order to investigate whether sensitization to pollen allergens can have priming effects on the production of IgE antibodies against latex in vivo, a mouse model was established. Groups of 10 BALB/C mice were immunized with Al(OH)3-adsorbed pollen extracts from timothy grass, ragweed, mugwort, or birch. For control purposes, one additional group received adjuvant only and another group was not immunized. Half of the mice of each group were subsequently immunized with Al(OH)3-adsorbed latex glove extract, the other half with adjuvant only. Pollen and latex-specific IgE- and IgG1-antibody responses were analyzed by enzyme-linked immunosorbent assay and statistically evaluated by analysis of variance. Antibody responses to cross-reactive antigens were investigated by immunoblotting. We found significantly increased IgE reactivities to latex after pollen sensitization and vice versa. Moreover, mice immunized with timothy grass pollen extract alone - without subsequent latex immunization - displayed IgE reactivity to latex. Cross-reactive antibodies were directed against pollen antigens of approximately 60 kDa molecular weight. Our results thus demonstrate a mutual boosting effect of pollen and latex sensitization in vivo which may be also operative in polysensitized plant allergic patients.
This report describes a 14-year-old boy with petechial gloves and socks syndrome associated with acute parvovirus B19 infection. This represents only the second child reported with this distinctive exanthem.
PURPOSE: Phenytoin (PHT) has been widely used intravenously for the treatment of seizures since 1956, and for many years, it has been considered first-line therapy for status epilepticus. It is routinely administered intravenously in emergency departments and hospitals for patients who have had isolated seizures and for many patients undergoing neurosurgical procedures who are unable to receive oral medication. Adverse reactions from PHT have been widely studied for years, but in the past decade, new adverse reactions have been identified. One of these adverse reactions is the purple glove syndrome (PGS), characterized by edema, discoloration, and pain distal to the site of i.v. administration of PHT. Because there have been no prospective reports of the incidence of PGS, the objective of the study was to report the incidence of this syndrome. METHODS: We enrolled 179 consecutive exposures to i.v. PHT at Henry Ford Hospital. Distal portions of the upper extremities were examined and digitally photographed by one of the authors (J.G.B.). The photos were blindly evaluated by the third author (G.L.B.) for PGS. Demographic and pertinent medical history was recorded for all patients, and outcome for those who experienced PGS was recorded. Associations between PGS, demographic, and medical history information were assessed. RESULTS: In only three of the 179 exposures did PGS develop. In both patients, the severity of the clinical picture was mild and did not required prolonged hospitalization or specialized treatment. CONCLUSIONS: PGS is an infrequent and mild adverse effect of i.v. PHT administration.
Grip strength measurements with the aid of dynamometers are dependent on the cooperation and motivation of the individual examined. Recognising a simulated loss of grip is a hitherto unresolved problem. With a sensor glove developed at the Berlin University of Technology, the force distribution pattern of any form of grip can be captured via ten pressure sensors and evaluated by computer. In five subjects, the force distribution patterns at submaximum and maximum force of five different grips were determined in three successive measurements each. The data were recorded in force-time diagrams. For each act of grasping, the measurements produced a curve with near-constant measuring signals within a defined period (plateau). The difference in the plateau heights of successive grips and the structures of the individual plateaux (oscillation, standard deviation) were used as distinguishing criteria. The dynamics of the measuring signals showed statistically significant differences between grips with submaximum and maximum force (p < 0.0001).
HISTORY AND ADMISSION FINDINGS: A 37-year-old woman, known since childhood to suffer from generalized seizures, was sent to the intensive care unit in status epilepticus. On admission tonic-clonic seizures persisted even after intravenously administration of clonazepam, 2 x 1 mg. She was unconscious and reacted unfocused to painful stimuli. TREATMENT AND COURSE: Further seizures occurred with vomiting and respiratory failure threatened. After intubation phenytoin was given intravenously (initially 250 mg over 10 min, then 750 mg over 24 h) into a vein on the dorsum of the hand. The seizures stopped. Within a few hours a livid swelling developed at the site of the needle puncture on the right hand, which spread to the lower arm (purple glove syndrome) and the patients could no longer move her arm because of pain. The condition improved with anti-inflammatory treatment and antibiotics as well as local measures. On discharge she was able to make a first without pain. However, she was re-admitted 3 weeks later because of renewed painful impairment of right hand movement and the picture of early Sudeck's atrophy. Under regional anaesthesia complete mobility and freedom from pain was achieved within 2 weeks. CONCLUSION: Administration of phenytoin into a peripheral vein, especially of the hand, can cause soft tissue damage and should be avoided. Primarily the oral route is to be preferred.
Prevention and treatment of hypertrophic scars and contractures is usually obtained by the use of compression suits. The compression hood for the burned face is unaesthetical and often refused by the child. A better compression can be obtained by the use of a clear transparent plastic mask. It offers a better view and looks better, thus increasing the cooperation of the patient. Compression gloves and stockings are difficult to adapt to. It is easier to make mittens and boots out of silicone. These two techniques meet the criteria of efficiency: early application of compression, good tolerance, splint support, individually moulded splints for optimum pressure and cooperation.
Three HIV-positive women showed clinical signs of papular-purpuric gloves and socks syndrome and serologic evidence of acute Parvovirus B19 infection. The course of the disease was complicated by anemia and persistent skin lesions, probably related to inadequate immune response. Because anemia in AIDS patients may be due to many causes, the history of recent Parvovirus B19 infection is helpful in suggesting the etiologic diagnosis.
BACKGROUND: Gloves and socks syndrome (GSS) is a recently described exanthem, most commonly caused by parvovirus B19. OBJECTIVE: Our purpose was to describe both early and late histopathologic features of GSS. METHODS: We performed histopathologic examination of biopsy specimens from a case of GSS and reviewed all the English-language literature reports of GSS to compare the reported histologic descriptions. RESULTS: A total of 46 cases of GSS have been reported in the English-language literature. In 18 of those, the pathologic features were described. The histologic features of the current case evolved from a nonspecific superficial perivascular lymphocytic infiltrate to a vacuolar interface dermatitis with necrotic keratinocytes, erythrocyte extravasation, and a superficial perivascular and interstitial lymphocytic infiltrate. CONCLUSION: Early lesions of GSS show nonspecific features common to viral exanthems. The late features, of a fully evolved exanthem, demonstrate a vacuolar interface dermatitis with necrotic keratinocytes, a superficial perivascular and interstitial infiltrate, and dermal hemorrhage. These late pathologic features, together with the clinical appearance of GSS, may help distinguish it from other entities.
The papular-purpuric "gloves and socks" syndrome (PPGSS) is a unique exanthem characterized by petechiae with painful edema of the hands and feet extending proximally with less severity. Constitutional symptoms of fever, lethargy, and arthralgia have also been described. Human parvovirus B19 has been implicated in most cases as the causative agent. We describe a mother and her daughter presenting with the characteristic findings of PPGSS and demonstrating the seroconversion of human parvovirus B19 a few days after the onset of their illness. Additional clinical findings of cutaneous vesicles, bullae, and conjunctivitis are reported in the mother's case. To our knowledge, these are the first 2 cases of PPGSS in a household setting.
The case of a young teenager with manifestations consistent with both Henoch-Schönlein purpura and papular-purpuric gloves-and-socks syndrome is described. The illness was associated with acute parvovirus infection. Similarities and differences among the two conditions are discussed.
This paper proposes a new learning set-up in the field of control systems for multifunctional hand prostheses. Two male subjects with a traumatic one-hand amputation performed simultaneous symmetric movements with the healthy and the phantom hand. A data glove on the healthy hand was used as a reference to train the system to perform natural movements. Instead of a physical prosthesis with limited degrees of freedom, a virtual (computer-animated) hand was used as the target tool. Both subjects successfully performed seven different motoric actions with the fingers and wrist. To reduce the training time for the system, a tree-structured, self-organizing, artificial neural network was designed. The training time never exceeded 30 seconds for any of the configurations used, which is three to four times faster than most currently used artificial neural network (ANN) architectures.
This paper describes the permeation process as related to protective clothing materials and some new applications of physical-chemical tools which may help to furnish the industrial hygienist with some predictive techniques. Values for the three-dimensional solubility parameter (3-DSP) for ten polymers are reported, and new developments regarding this parameter and its relation to glove selection are discussed. Limitation of the use of 3-DSP and future attempts to resolve the problem of proper protective clothing selection are also discussed.
A method is described to evaluate the permeation characteristics of glove materials by chemical solvents. The collecting medium (helium) is continuously monitored by a flame ionization detector (FID) of a gas chromatograph (GC). Immediately following a steady-state condition, quantitative data are acquired on-line by a computer. A two-position GC sampling valve and computer-controlled data acquisition and analysis require minimal operator attention. For the 8 materials and 6 solvents investigated, thickness-normalized breakthrough times and steady-state permeation rates ranged from 9.10 min/mil to greater than 4 hr/mil and from 0.2048 to 9112 micrograms/min/cm2/mil, respectively. A modification of the procedure which allowed the determination of the effect of temperature on permeation for 4 glove/solvent pairs was evaluated also.