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PubMed1979

[Arterial patterns in congenital deformities of the hand (author's transl)].

Etiology of congenital deformities of the hand is still unknown in most cases. But anomalous development of arteries has been suspected to play a role in faulty development of the hands. Senior (1926) and Singer (1933) have reported arterial anomalies in the developmental stage of these vessels. Between 1968 and 1978, 367 patients with 453 congenital deformities of the hand visited the hand service of Kyoto University Hospital. These hand anomalies were classified according to Swanson's classification. Angiography was performed on 74 hands of 70 patients in this series, and attempts were made to correlate these with the types of the deformities. From the standpoint of embryological development of arteries, it is concluded that failure of formation of parts (arrest of development), failure of differentiation (separation) of parts and duplication are generated in the same stage from 48 days postovulatory (18 mm embryo), overgrowth (gigantism) of the hand and congenital constriction band syndrome are generated after 52 days postovulatory (23 mm embryo). Generalized skeletal anomalies are considered to be generated in the various developmental stages depending on the each malformed hands. Developmental stage of malformed hands with generalized skeletal abnormalities is discussed with special reference to the embryological development of other anomalies.

Adolescent↗
PubMed1982

Microbiological aspects of washing hands in slaughter-houses.

The hand hygiene of workers in a number of chicken-, pig-, calf- and cattle slaughter-houses was investigated. The number of E. coli and salmonellae on hands was determined before and after washing hands in order to measure the washing effect on the number of these faecal bacteria. All workers examined carried E. coli on their hands during work. The average logarithmic E. coli count on hands before washing was about 5.0 in chicken-and calf-slaughter-houses, about 3.5 in pig-and 3.0 in cattle-slaughter-houses. Hand washing decreased the E. coli count per hand by about 1.5 log cycle. Salmonellae were isolated from the hands in chicken- (59 pos./145 samples), pig-(42 pos./116 samples) and calf-slaughter-houses (11 pos./68 samples). Even after washing salmonellae were found to be present. Generally 'normal' washing causes a considerable reduction in the number of transient bacteria on hands. The presence of E. coli and Salmonella after washing, however, indicates that the effectiveness of the procedure needs to be improved.

Abattoirs↗
PubMed1998

Hand dermatitis and symptoms from the fingers among Swedish dental personnel.

Hand dermatitis among dental personnel has been an issue in recent years. Dental personnel manually handle polymer materials which are known to irritate skin, and also cause allergy. In addition, dental personnel wash their hands frequently, and use latex gloves, and are therefore at risk to develop hand dermatitis. To survey the occurrence of hand dermatitis among dental personnel, questionnaires were sent to all dental teams (dentist + chair assistant) working in the two northern Swedish counties. Referents were; researchers, teachers, and secretaries from a university and high schools, from the same geographical area. The response rate was 76% for dental teams, and 66% for referents. The results show that male dentists reported a significantly higher prevalence of hand dermatitis than male reference. In contrast to chair assistants and referents, dentists (both male and female) reported a higher extent of hand dermatitis on the left than on the right hand. There was an association between hand dermatitis among dental personnel and; age, eczema in childhood, and hay fever but, not with; sex, asthma, frequent washing of the hands, and glove use. Whitening of the fingers increased with increasing age among dental personnel. Pricking was also associated with frequent glove use. Pricking of the fingers was associated with sex, and 3.5 times more common among female dental personnel than male dentists. Numbness of the fingers, and finger pain was reported by more dentists than chair assistants and referents.

Adult↗
PubMed2002

Improving hand function in chronic stroke.

BACKGROUND: Recovery of function following stroke plateaus in about 1 year, typically leaving upper arm function better than that in the hand. Since there is competition among body parts for territory in the sensorimotor cortex, even limited activity of the upper arm might prevent the hand from gaining more control, particularly when the territory is reduced in size because of the stroke. Deafferentation of a body part in a healthy brain enhances cortical representations of adjacent body parts, and this effect is markedly increased by voluntary activity of the adjacent part. OBJECTIVE: To explore whether deafferentation of the upper arm, produced by a new technique of regional anesthesia during hand motor practice, helps recovery of hand function in patients with long-term stable weakness of their hand following stroke. METHODS AND RESULTS: Deafferentation, produced by a new technique of regional anesthesia of the upper arm during hand motor practice, dramatically improved hand motor function including some activities of daily living. The improvement was associated with an increase in transcranial magnetic stimulation-evoked motor output to the practice hand muscles. CONCLUSION: This is a novel therapeutic strategy that may help improve hand function in patients with long-term weakness after stroke.

Afferent Pathways↗
PubMed1991

Hand and foot length in Prader-Willi syndrome.

Small hands and feet (acromicria) are often cited as manifestations in the Prader-Willi syndrome (PWS), but it has been our experience that these are not universal findings. To address this issue, we obtained longitudinal and cross-sectional data, retrospectively and prospectively, including height, hand length, and foot length, on 56 patients with PWS who are followed in the multidisciplinary PWS clinic at the University of Connecticut Health Center. Hand and foot lengths were plotted using two published sets of normative data. In addition, height age was calculated on each measurement of stature so that the corresponding hand and foot measurements could be compared to those expected for height, rather than age, as many PWS individuals are short. Foot length was proportionately smaller than hand length in all individuals; this difference was more striking in females. By age 12 years, almost all individuals had a foot length less than 25th centile for chronological age and less than 50th centile for height age. Female hand length was also less than 25th centile for chronological by age 12 years and less than 50th centile for height age in almost all cases. Male hand length data appeared to fall more within the normal range until adulthood, although fewer data were available. Black individuals with PWS had relatively larger hands and feet than their Caucasian counterparts. Many people with PWS had hand and foot lengths which fell within the normal range, particularly those under the age of 12 years and those whose height was greater than 50th centile for age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2004

Association of radiographic hand osteoarthritis with radiographic knee osteoarthritis after meniscectomy.

OBJECTIVE: To evaluate the association between radiographic hand osteoarthritis (OA), a disease with marked heredity, and radiographic knee OA in patients treated with meniscectomy. METHODS: We retrospectively identified 170 patients (mean age 54 years [range 33-87 years], 23% women) who had undergone isolated meniscectomy an average of 20 years earlier (range 17-22 years). Patients with cruciate ligament injury were excluded. All subjects were examined by standardized knee and hand radiography. Individual joints were considered to have OA when displaying radiographic features corresponding to a Kellgren/Lawrence (K/L) grade > or =2. Hand OA was considered present if at least 1 of the following criteria was fulfilled: the presence of radiographic OA (K/L grade > or =2) in at least 1 interphalangeal joint in each hand symmetrically, or in at least 2 distal or proximal interphalangeal joints in the same hand in a pattern consistent with primary OA (in the same row or ray), or in the first carpometacarpal joint bilaterally. The association between radiographic hand OA and radiographic knee OA was evaluated using logistic regression. RESULTS: Radiographic hand OA was present in 57 patients (34%) and radiographic knee OA was identified in 105 patients (62%), within 94 index knees (55%) and 47 contralateral knees (28%). In a multivariate model, radiographic hand OA was associated with an increased likelihood of radiographic OA in the index knee (odds ratio [OR] 3.0, 95% confidence interval [95% CI] 1.2-7.5) and in the nonoperated contralateral knee (OR 3.5, 95% CI 1.0-12.2). CONCLUSION: The presence of radiographic hand OA is associated with an increased frequency of radiographic knee OA after meniscectomy. This finding confirms and extends that of a single previous study showing an interaction between hereditary and environmental risk factors for OA, a common and genetically complex disease. Accordingly, the development of OA following a meniscal tear and the resulting meniscal surgery should not be regarded to be of secondary origin only.

Arthroscopy↗
PubMed2002

Coupling of ligand binding and dimerization of helix-loop-helix peptides: spectroscopic and sedimentation analyses of calbindin D9k EF-hands.

Isolated Ca2+-binding EF-hand peptides have a tendency to dimerize. This study is an attempt to account for the coupled equilibria of Ca2+-binding and peptide association for two EF-hands with strikingly different loop sequence and net charge. We have studied each of the two separate EF-hand fragments from calbindin D9k. A series of Ca2+-titrations at different peptide concentrations were monitored by CD and fluorescence spectroscopy. All data were fitted simultaneously to both a complete model of all possible equilibrium intermediates and a reduced model not including dimerization in the absence of Ca2+. Analytical ultracentrifugation shows that the peptides may occur as monomers or dimers depending on the solution conditions. Our results show strikingly different behavior for the two EF-hands. The fragment containing the N-terminal EF-hand shows a strong tendency to dimerize in the Ca2+-bound state. The average Ca2+-affinity is 3.5 orders of magnitude lower than for the intact protein. We observe a large apparent cooperativity of Ca2+ binding for the overall process from Ca2+-free monomer to fully loaded dimer, showing that a Ca2+-free EF-hand folds upon dimerization to a Ca2+-bound EF-hand, thereby presenting a preformed binding site to the second Ca2+-ion. The C-terminal EF-hand shows a much smaller tendency to dimerize, which may be related to its larger net negative charge. In spite of the differences in dimerization behavior, the Ca2+ affinities of both EF-hand fragments are similar and in the range lgK = 4.6-5.3.

Amino Acid Sequence↗
PubMed1997

Hand skill asymmetry in professional musicians.

Hand skill asymmetry on two handedness tasks was examined in consistent right-handed musicians and nonmusicians as well as mixed-handed and consistent left-handed nonmusicians. Musicians, although demonstrating right-hand superiority, revealed a lesser degree of hand skill asymmetry than consistent right-handed nonmusicians. Increased left-hand skill in musicians accounted for their reduced asymmetry. Musicians predominantly playing keyboard instruments demonstrated superior tapping performance than musicians playing predominantly string instruments, although they did not differ with respect to hand skill asymmetry. Since the diminished tapping asymmetry in musicians was related to early commencement but not duration of musical training, results are interpreted as an adaptation process due to performance requirements interacting with cerebral maturation during childhood.

Adult↗
PubMed1998

Motor representation of the hand in the human cortex: an f-MRI study with a conventional 1.5 T clinical unit.

The purpose of this study was to show a gradient of possible bilateral activation for movements of the non-dominant vs. dominant hand, as well as for areas involved in complex vs. simple hand movements. A standard 1.5 T magnetic resonance imaging (MRI) system has been utilized to localize the cortical motor hand areas, using the blood oxygen level dependent contrast (BOLDc) technique and single-section fast low-angle shot (FLASH) imaging. Ten normal right-handed subjects volunteered for the study. The motor tasks consisted of simple (flexion-extension) finger movements of either hand, and complex movements (finger-to-thumb opposition in a repeating, pre-planned sequence) of the non-dominant hand. Simple movements caused contralateral activation of the primary motor area (MA); ipsilateral activation was observed for the non-dominant hand only. Supplementary motor area (SMA) was also activated, with a clear contralateral prevalence. The ratio of bilateral activation of MA did not change with complex movements of the non-dominant hand, while SMA as well as lateral premotor area were largely bilaterally activated in this task. In conclusion, the ipsilateral MA is activated for movements--even simple--performed with the non-dominant hand. There is widespread functional activity, involving both contralateral and ipsilateral SMA, for complex movements.

Adult↗
PubMed1993

Treatment of rheumatoid hand synovitis with a regional block technique.

This study reports a novel technique for treating painful rheumatoid hand synovitis using a regional block technique. Nine patients with symptomatic rheumatoid hand synovitis were treated. Assessments of symptoms, grip strength and synovial swelling were made in each hand before the injection, and at 1 and 4 weeks after the procedure. A sphygmomanometer cuff was inflated, on the side of the patients most symptomatic hand, to 220mmHg and a solution of hydrocortisone sodium succinate 50mgs and lignocaine 10mls 0.5% was injected intravenously. The cuff was deflated slowly after 20 minutes. The injected hand improved symptomatically in 7 patients at 1 week, and further improvement was reported in 6 of these 7 at 1 month. Mean grip strength increased significantly in the injected hand both at 1 week (p = 0.01) and 1 month (p = 0.018). There was no change in the other hand. This technique is safe, reduced hand pain and improved grip strength in these patients with rheumatoid hand synovitis.

Arthritis, Rheumatoid↗
PubMed1998

[Complex trauma of the hand].

The hand is very exposed to injuries in the daily man's work. The multiple functions of the hand are based on vitality, sensibility, motor function and stability. In severe hand injuries the functional results of the repair are often very poor. In a complex injury of the hand we are faced with the damage of the soft tissue and bone and the loss of vitality and function of the hand. The cause of hand injuries are mainly a crush trauma or the rotating saw. Basically, we recommend an extended primary repair. After the radical debridement we have to reconstruct the damaged structures. We start doing the osteosynthesis and stabilization of the joints. Thereafter, suturing of extensor and flexor tendons. Then, we do the microsurgical reconstructions of vessels and nerves. In case tendons and bones are exposed we have to cover the defect with a pedicled or a free flap. In a long ischemic time we have to change our concept and do the reconstruction of the vessels first. Our results in vitality and sensibility are listed. In the result of a complex hand injury each single functional restoration is very important. Therefore, it is necessary that severe hand injuries are treated at well established centres for hand surgery.

Accidents, Occupational↗
PubMed2004

Fooling the brain into thinking it sees both hands moving enhances bimanual spatial coupling.

This study examined the hypothesis that the mirror reflection of one hand's movement directly influences motor output of the other (hidden) hand, during performance of bimanual drawing. A mirror was placed between the two hands during bimanual circle drawing, with one hand and its reflection visible and the other hand hidden. Bimanual spatial coupling was enhanced by the mirror reflection, as shown by measures of circle size. Effects of the mirror reflection differed significantly from effects of vision to one hand alone, but did not differ from a control task performed in full vision. There was no evidence of a consistent phase lead of the visible hand, which indicates that the observed effects on spatial coupling were immediate and not based on time-consuming feedback processes. We argue that visual mirror symmetry fools the brain into believing it sees both hands moving rather than one. Consequently, the spatial properties of movement of the two hands become more similar through a process that is virtually automatic.

Adolescent↗
PubMed2006

Hand orientation is insufficiently compensated for in haptic spatial perception.

What humans haptically perceive as parallel is often far from physically parallel. These deviations from parallelity are highly significant and very systematic. There exists accumulating evidence, both psychophysical and neurophysiological, that what is haptically parallel is decided in a frame of reference intermediate to an allocentric and an egocentric one. The central question here concerns the nature of the egocentric frame of reference. In the literature, various kinds of egocentric reference frames are mentioned for haptic spatial tasks, such as hand-centered, arm-centered, and body-centered frames of reference. Thus far, it has not been possible to distinguish between body-centered, arm-centered, and hand-centered reference frames in our experiments, as hand and arm orientation always covaried with distance from the body-midline. In the current set of experiments the influence of body-centered and hand-centered reference frames could be dissociated. Subjects were asked to make a test bar haptically parallel to a reference bar in five different conditions, in which their hands were oriented straight ahead, rotated to the left, rotated to the right, rotated outward or rotated inward. If the reference frame is body-centered, the deviations should be independent of condition. If, on the other hand, the reference frame is hand-centered, the deviations should vary with condition. The results show that deviation size varies strongly with condition, exactly in the way predicted by the influence of a hand-centered egocentric frame of reference. Interestingly, this implies that subjects do not sufficiently take into account the orientation of their hands.

Adult↗
PubMed1999

Effects of short-term adaptation of saccadic gaze amplitude on hand-pointing movements.

We investigated whether and how adaptive changes in saccadic amplitudes (short-term saccadic adaptation) modify hand movements when subjects are involved in a pointing task to visual targets without vision of the hand. An experiment consisted of the pre-adaptation test of hand pointing (placing the finger tip on a LED position), a period of adaptation, and a post-adaptation test of hand pointing. In a basic task (transfer paradigm A), the pre- and post-adaptation trials were performed without accompanying eye and head movements: in the double-step gaze adaptation task, subjects had to fixate a single, suddenly displaced visual target by moving eyes and head in a natural way. Two experimental sessions were run with the visual target jumping during the saccades, either backwards (from 30 to 20 degrees, gaze saccade shortening) or onwards (30 to 40 degrees, gaze saccade lengthening). Following gaze-shortening adaptation (level of adaptation 79+/-10%, mean and s.d.), we found a statistically significant shift (t-test, error level P<0.05) in the final hand-movement points, possibly due to adaptation transfer, representing 15.2% of the respective gaze adaptation. After gaze-lengthening adaptation (level of adaptation 92+/-17%). a non-significant shift occurred in the opposite direction to that expected from adaptation transfer. The applied computations were also performed on some data of an earlier transfer paradigm (B, three target displacements at a time) with gain shortening. They revealed a significant transfer relative to the amount of adaptation of 18.5< or = 17.5% (P<0.05). In the coupling paradigm (C), we studied the influence of gaze saccade adaptation of hand-pointing movements with concomitant orienting gaze shifts. The adaptation levels achieved were 59+/-20% (shortening) and 61+/-27% (lengthening). Shifts in the final fingertip positions were congruent with internal coupling between gaze and hand, representing 53% of the respective gaze-amplitude changes in the shortening session and 6% in the lengthening session. With an adaptation transfer of less than 20% (paradigm A and B), we concluded that saccadic adaptation does not "automatically" produce a functionally meaningful change in the skeleto-motor system controlling hand-pointing movements. In tasks with concomitant gaze saccades (coupling paradigm C), the modification of hand pointing by the adapted gaze comes out more clearly, but only in the shortening session.

Adaptation, Physiological↗
PubMed1999

Do patients with neglect show abnormal hand velocity profiles during tactile exploration of peripersonal space?

It has been suggested that the movement impairments experienced by patients with neglect are not restricted to spatial disorders, but also affect higher-order kinematics (velocity and acceleration) to the extent that movements towards the neglected side are slower than movements away from it. In a recent study, we could not confirm this hypothesis, but found that patients with unilateral neglect exhibited no distinct direction-specific deficits in hand velocity when performing goal-directed reaching movements. Here we investigated whether neglect patients might reveal direction-specific deficits during exploratory hand movements. Six patients with left-sided neglect and six age-matched healthy control subjects scanned with their right hands the surface of a large table searching for a (non-existent) tactile target. Movements were performed in darkness. Time-position data of the hand were recorded with an optoelectronic camera system. Median activity of the patients' exploratory hand movements was shifted to the right (Karnath and Perenin 1998). Hand trajectories were partitioned into sections of leftward/rightward or, along the sagittal plane, into sections of near/far movements. For each movement section average and peak velocities were computed. The patients' hand movements were bradykinetic when compared with the control group. However, we found no evidence that average or peak velocities of leftward intervals were systematically lower than during rightward motion. Direction-specific deficits in velocity were also not observed for movements to and away from the body (sagittal plane). In conclusion, we found evidence for general bradykinesia in neglect patients but not for a direction-specific deficit in the control of hand velocity during exploratory hand movements.

Aged↗
PubMed1999

[Lifelong heavy agricultural work and development of arthrosis of the hand--a case study].

Heavy physical work load is a known determinant of osteoarthritis of the hip, which may account for the high risk observed among farmers. On the other hand, the data on influence of heavy manual work in the pathogenesis of hand osteoarthritis are still controversial. We examined 25 retired farm laborers who strenuously worked for more than 50 years. The investigation included a history of professional activity, clinical and radiological examination of the hands, hips and knees, MRI of hand and laboratory evaluation of 4 participants. Interestingly, the farm laborers with osteoarthritis of the hands, hardly complained. In many of the proximal interphalangeal joints, a discrepancy was observed between the clinical hypertrophic changes and the radiological osteoarthritis which was weak or absent. This difference was less pronounced in the distal interphalangeal joints. Furthermore the distribution pattern of the osteoarthritis of the hand was striking with an over-proportional involvement of the metacarpophalangeal joints and less pronounced of the intercarpal joints. Most often both hands have been affected and the typical localization of the metacarphophalangeal joint osteoarthritis was the first, second and third finger. In all but one participant we found at least unilateral osteoarthritis of the hip and compared to the hands, complaints were more severe. Our findings support the hypothesis that the distribution of osteoarthritis in the hand is affected by lifelong farming. As shown by the data on proximal interphalangeal joints, the periarticular tissue can adapt to the mechanical load in the strength grip.

Aged↗
PubMed1993

Regional cerebral blood flow changes of cortical motor areas and prefrontal areas in humans related to ipsilateral and contralateral hand movement.

The regional cerebral blood flow (rCBF) was measured with positron emission tomography (PET) in ten normal right-handed volunteers with the purpose of comparing rCBF changes related to movements of the dominant (right) and non-dominant (left) hand. The hand movement task consisted of sequential opposition of the thumb to each finger. The rCBF measured was compared with a rest state. Movements of the dominant hand and the non-dominant hand, increased CBF significantly in the contralateral motor area (MA) and the premotor area (PMA) with small increases in rCBF in the supplementary motor area (SMA). However, movements of the non-dominant hand also elicited significant ipsilateral increases in rCBF in the MA and PMA (6.3% and 5.0%, respectively). Superior part of the prefrontal area (PFA) of the left hemisphere showed significant CBF increases to both left and right hand movement. Our findings indicate that rCBF changes in the motor areas and the PFA of one hemisphere are not related simply to movement of the contralateral hand. Non-dominant hand movement may in addition require activation of ipsilateral motor areas. That is, there appears to be functional asymmetry in the MA and PFA in humans even in this relatively simple and symmetric motor task.

Adult↗
PubMed2005

Rapid opening and closing of the hand as a measure of early neurologic recovery in the upper extremity after surgery for cervical spondylotic myelopathy.

OBJECTIVE: To compare the results of a simple bedside test with the Jebsen-Taylor hand function test, in the assessment of early improvement of neurologic function after surgery for cervical spondylotic myelopathy (CSM). DESIGN: Case series comparing the bedside test with the Jebsen-Taylor test of hand function as the criterion standard in a blinded comparison. SETTING: Referral center, institutional practice, hospitalized care. PARTICIPANTS: One hundred referent subjects and 26 consecutive patients undergoing surgery for CSM. INTERVENTION: Decompressive cervical spine surgery. Main outcome measures Complete, rapid opening and closing of the hand was timed for 20, 40, and 60 repetitions, the Rapid Hand Flick Time (RHFT), preoperatively and in the first week postoperatively. The results of this test were correlated with the Jebsen-Taylor test. RESULTS: There was a 40% to 50% prolongation in the RHFT compared with age-matched referent subjects. Postoperatively, there was a 3.84-second mean improvement in the RHFT for 20 repetitions in the right hand and 2.8 seconds in the left hand. A paired-samples t test, comparing the preoperative and postoperative day 1 and day 7 timings, showed a statistically significant improvement (P<.001). There was no significant change from postoperative day 1 to day 7. In the Jebsen-Taylor test, patients showed a significant postoperative improvement (P<.01) in the writing test, in simulated feeding, and in transfer of small objects in both hands. Pearson correlation coefficient testing for correlation between the RHFT and the Jebsen-Taylor subtests were low, which indicates that, although they both record an improvement after surgery, they probably do not test the same aspects of hand function. CONCLUSIONS: The RHFT is a simple and reliable method of assessing early improvement in hand function and spasticity in patients after surgery for CSM.

Adult↗