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PubMed2001

Optimizing the correction of severe postburn hand deformities by using aggressive contracture releases and fasciocutaneous free-tissue transfers.

Severe postburn hand deformities were classified into three major patterns: hyperextension deformity of the metacarpophalangeal joint of the fingers with dorsal contracture of the hand, adduction contracture of the thumb with hyperextension deformity of the interphalangeal joint, and flexion contracture of the palm. Over the past 6 years, 18 cases of severe postburn hand deformities were corrected with extensor tenotomy, joint capsulotomy, and release of volar plate and collateral ligament. The soft-tissue defects were reconstructed with various fasciocutaneous free flaps, including the arterialized venous flap (n = 4), dorsalis pedis flap (n = 3), posterior interosseous flap (n = 3), first web space free flap (n = 3), and radial forearm flap (n = 1). Early active physical therapy was applied. All flaps survived. Functional return of pinch and grip strength was possible in 16 cases. In 11 cases of reconstruction of the dorsum of the hand, the total active range of motion in all joints of the fingers averaged 140 degrees. The mean grip strength was 16.5 kg and key pinch was 3.5 kg. In palm reconstruction, the wider contact area facilitated the grasping of larger objects. In thumb reconstruction, key-pinch increased to 5.5 kg and the angle of the first web space increased to 45 degrees. Jebsen's hand function test was not possible before surgery; postoperatively, it showed more functional recovery in gross motion and in the dominant hand. Aggressive contracture release of the bone,joints, tendons, and soft tissue is required for optimal results in the correction of severe postburn hand deformities. Various fasciocutaneous free flaps used to reconstruct the defect provide early motion, appropriate thinness, and excellent cosmesis of the hand.

Adolescent↗
PubMed1985

Hand eczema among hard-metal workers.

Seven hundred seventy-six of 800 workers in a hard-metal factory were investigated. The prevalence of hand eczema and irritant reactions of the hands was 10% and 15% respectively. Of 1,006 workers who had left the industry during the previous ten years, 87 had had hand eczema. The cumulative incidence of hand eczema for these ten years was estimated to be 17%. Fifty-two percent of the hand eczemas and 67% of the irritant reactions started during the first year of work. The majority of both the hand eczemas and the irritant reactions first appeared in grinding activities. Wet grinding and oil grinding entailed the highest risks of hand eczema. Hand eczema was significantly more common in individuals with an atopic background. Eighteen percent of the individuals with present or previous hand eczema had positive patch-test reactions. Positive patch tests were equally common among individuals with irritant reactions and those with normal skin.

Dermatitis, Contact↗
PubMed2002

Patterns of lateralized hand use in an arboreal primate, Simias concolor.

Studies of hand use in nonhuman primates suggest that several species exhibit hand preferences for a variety of tasks. The majority of studies, however, focus on the lateralized hand use of captive nonhuman primate populations. Although captive settings offer a more controlled environment for assessing hand preferences, studies of wild populations provide important insights into how handedness is affected by natural environmental conditions and thus potential insights into the evolution of handedness. To investigate handedness in a population of wild nonhuman primates, we studied patterns of lateralized hand use during feeding in four simakobu monkeys (Simias concolor), an arboreal species inhabiting the Mentawai Islands, Indonesia. Our data show that individual variation in hand preferences for feeding existed among our study animals. In addition, each simakobu expressed a significant hand preference for supporting itself on a branch during feeding, an uncoordinated bimanual task. This bias was most prevalent when the branch used for support was a main branch rather than a terminal branch. When both hands were employed in a coordinated bimanual feeding activity (bimanual manipulation), only two subjects showed a significant bias for feeding. Our data suggest that these individuals are more likely to express significant hand preferences when feeding from stable, rather than precarious, positions within the canopy.

Animals↗
PubMed2002

Motor sequence learning with the nondominant left hand. A PET functional imaging study.

Whereas the human right hemisphere is active during execution of contralateral hand movements, the left hemisphere is engaged for both contra- and ipsilateral movements, at least for right-handed subjects. Whether this asymmetry is also found during motor learning remains unknown. Implicit sequence learning by the nondominant left hand was examined with the serial reaction time (SRT) task during functional brain imaging. As learning progressed, increases in brain activity were observed in left lateral premotor cortex (PMC) and bilaterally in supplementary motor areas (SMA), with the increase significantly greater in the left hemisphere. The left SMA site was similar to one previously identified with right-hand learning, suggesting that this region is critical for representing a sequence independent of effector. Learning with the left hand also recruited a widespread set of temporal and frontal regions, suggesting that motor skill learning with the nondominant hand develops within both cognitive and motor-related functional networks. After skill acquisition, subjects performed the SRT task with their right hands, and sequence transfer was tested with the original and a mirror-ordered sequence. With the original sequence, the stimulus sequence and series of response locations remained unchanged, but the finger movements were different. With the mirror-ordered sequence, the response sequence involved finger movements homologous to those used during training. Performance of the original and mirror sequence by the right hand was significantly better than with random stimuli. Mirror transformation of the sequence by the right hand was associated with a marked increase in regional activity in the left motor cortex, consistent with a role for sequential transformation at this level of the motor output pathway.

Adult↗
PubMed2002

The highly conserved cardiogenic bHLH factor Hand is specifically expressed in circular visceral muscle progenitor cells and in all cell types of the dorsal vessel during Drosophila embryogenesis.

The highly conserved basic helix-loop-helix transcription factor Hand plays a crucial role in cardiogenesis, limb formation and other developmental processes of vertebrates. Humans, mice and other higher vertebrates have two related genes, dHand (also known as Hand2, Hed, Thing2) and eHand (also known as Hand1, Hxt, Thing1), whereas fish and Drosophila have only a single hand gene. We cloned Drosophila hand and studied the embryonic expression in detail by using various tissue-specific markers that allowed us to analyze the identity of hand-expressing cells. We found hand to be expressed in the entire heart, including all cardioblasts and pericardial cells, in the progenitors of the circular visceral muscles, the lymph gland and garland cells, and in a few cells in the CNS. The expression of Drosophila hand starts after the inductive activity of the early regulators in these tissues, e.g. Tinman and Bagpipe, suggesting a role of Hand in differentiation rather than in tissue determination. In many aspects the expression pattern of Drosophila hand resembles the patterns of its vertebrates orthologues, for instance in cardiac tissues. We assume that Hand proteins might play a highly conserved role throughout evolution.

Amino Acid Sequence↗
PubMed2001

Hand-assisted laparoscopic surgery: an emerging technique.

BACKGROUND: Some surgeons are finding that the placement of one hand in the abdomen during laparoscopic procedures returns tactile feedback lost during purely laparoscopic surgery and facilitates dissection, retraction, and control of bleeding. Studies comparing patient postoperative discomfort after laparoscopic and hand-assisted laparoscopic procedures have not found a significant difference. METHODS: This article is a review of the current literature on hand-assisted laparoscopic surgery and of the different hand-assisted devices on the market. Included in the review are opinions of expert laparoscopic surgeons who have used hand-assisted devices. RESULTS: More than 100 hand-assisted laparoscopic procedures have been described in the literature. At least four different companies are involved in hand-assisted laparoscopic devices. Three of these companies currently are Food and Drug Administration (FDA) approved in the United States. CONCLUSIONS: Hand-assisted laparoscopic surgery is not necessary for all laparoscopic procedures. Hand-assisted laparoscopic technique is advantageous for certain procedures and clinical situations such as en bloc resections and removal of solid organ tumors, large colon tumors, and the kidney after donor nephrectomy. This technique offers benefits when a large incision is necessary to complete surgery such an open colon anastomosis.

Equipment Design↗
PubMed2004

A prospective randomized trial of hand-sutured versus mechanically stapled anastomoses for gastroduodenostomy after distal gastrectomy.

BACKGROUND: Although mechanical stapling is now an established alternative to conventional hand suturing for the construction of gastrointestinal anastomoses, its role in gastroduodenostomy remains to be defined. We compared the clinical outcome after mechanical stapling with that after hand suturing in patients who underwent gastroduodenostomy after distal gastrectomy. METHODS: From April 2000 through August 2001, a total of 187 patients with gastric cancer who received distal gastrectomy were randomly assigned to reconstruction by mechanically stapled or by hand-sutured gastroduodenal anastomoses. RESULTS: The baseline clinical characteristics were similar in the patients with mechanically stapled and those with hand-sutured anastomoses. There was no in-hospital mortality in either group. One patient (1.1%) in the mechanically stapled group ( n = 92) and 2 (2.1%) in the hand-sutured group ( n = 95) had anastomotic leakage. Anastomotic stenosis developed in 4 patients (4.3%) who underwent mechanical stapling, as compared with 6 (6.3%) who underwent hand suturing. Anastomotic bleeding occurred in 1 patient (1.1%) who under-went mechanical stapling and 1 patient in the hand-sutured group (1.1%). Mechanical stapling of the anastomoses was significantly quicker than hand-suturing of the anastomoses (median time, 14 vs 25 min; p = 0.02). The two groups were comparable with respect to other outcome measures, including incidence of general complications, recovery of gastrointestinal function, duration of postoperative hospital stay, and radiological diameter of the anastomosis. CONCLUSION: In patients with gastric cancer who undergo gastroduodenostomy after distal gastrectomy, mechanical stapling is quicker than hand suturing. These procedures are similar with respect to anastomotic complications and other outcome measures.

Aged↗
PubMed2006

The sex ratio of older siblings in non-right-handed homosexual men.

This study tested the prediction, based on prior research, that non-right-handed homosexual men will report fewer than expected older brothers. Participants were 2486 heterosexual and homosexual, right-handed and non-right-handed, male and female adults, representing five samples collected for various projects by the second author. Data on sibship composition, sexual orientation, and hand-preference were gathered in the original research using on-line (Internet) or self-administered paper-and-pencil questionnaires. The non-right-handed homosexual men reported 83 older brothers per 100 older sisters, which was significantly lower than the human sex ratio of 106 live-born males per 100 live-born females. In contrast, the right-handed homosexual men reported 125 older brothers per 100 older sisters, which was significantly higher than the expected ratio. One possible explanation of these results is that older brothers increase the odds of homosexuality in right-handed males but decrease the odds of homosexuality in non-right-handed males. A second possibility is that older brothers decrease the probability that non-right-handed homosexual males will be represented in survey research. The latter scenario could arise if the combination of some biological factor associated with older brothers and some biological factor associated with non-right-handedness is so toxic that it kills the fetus or predisposes the individual to a condition (e.g., mental retardation, major mental illness) that makes him less likely to be available for research recruitment at Gay Pride parades (etc.) than other members of the gay community.

Birth Order↗
PubMed1991

Chimaeric myosin regulatory light chains: sub-domain switching experiments to analyse the function of the N-terminal EF hand.

The regulatory light chains (RLCs) located on the myosin head, regulate the interaction of myosin with actin in response to either Ca2+ or phosphorylation signals. The RLCs belong to a family of calcium binding proteins and are composed of four "EF hand" ancestral calcium binding motifs (numbered I to IV). To determine the role of the first EF hand (EF hand I) in the regulatory process, chimaeric light chains were constructed by protein engineering, by switching this region between smooth muscle and skeletal muscle myosin RLCs. For example, chimaera G(I)S consisted of EF hand I of the smooth muscle (gizzard) RLC and EF hands II to IV of the skeletal muscle RLC, whereas chimaera S(I)G consisted of EF hand I of the skeletal muscle RLC and EF hands II to IV of the smooth muscle RLC. The chimaeric RLCs were expressed in Escherichia coli using the pLcII expression system, and after isolation and purification their regulatory properties were compared with those of wild-type smooth and skeletal muscle myosin RLCs. The chimaeric RLCs bound to the myosin heads in scallop striated muscle myofibrils from which the endogenous RLCs had been removed ("desensitized" myofibrils) with similar affinities to those of the wild-type smooth and skeletal muscle RLCs. Both chimaeric RLCs were able to regulate the actin-activated Mg(2+)-ATPase activity of scallop myosin: G(I)S inhibited the ATPase in the presence and absence of Ca2+, like the wild-type skeletal muscle RLC, while S(I)G inhibited the myosin ATPase in the absence of Ca2+, and this inhibition was relieved on Ca2+ addition, in the same way as the wild-type smooth muscle RLC. Thus the type of regulation that the RLCs confer on the myosin is determined by the source of EF hands II to IV rather than that of EF hand I.

Amino Acid Sequence↗
PubMed1992

Parallels between asymmetries of Planum temporale and of hand skill.

Relationships between the skill of each hand and differences between the hands are described for a sample of 14-15-year-olds representative of the general population. The description is modelled on the account of Galaburda et al. (Neuropsychologia 25, 853-868, 1987) of relationships between asymmetries of the Planum Temporale (PT) and measures of PT area on each side, in order to show parallels between findings for the two types of asymmetry. For both PT and hand skill, the extent of asymmetry appears to depend on the greater variability of the weaker side rather than of the larger or "better" side. The findings are also described as a replication of the study of hand skill in children by Annett and Manning (Br. J. Psychol. 80, 213-226, 1989). As no score transformations were needed in the present sample, the grounds for doubt raised by Bishop (Handedness and Developmental Disorder, Blackwell, Oxford, 1990) about the earlier sample are removed. Repetition of the analyses for right-handed and left-handed writers separately demonstrates very close similarities for findings in the two hand preference groups. Theories about the mechanisms responsible for asymmetries appear to require the presence of factors which reduce brain area and hand skill on one side. For most people the reduction is to the right PT and to the left hand.

Adolescent↗
PubMed2006

Cultural and environmental pressure against left-hand preference in urban and semi-urban Malawi.

The study assessed views of teachers, pupils and their guardians on left-hand preference. Seventy-five percent of the responders indicated that the left hand should not be preferred for habitual activities and 87.6% of them indicated that left-handers should be forced to change the hand. Gender had significant effect on the view on left hand preference (df = 1, OR (odds ratio) = 0.465, p = 0.027). Giving a handshake when greeting a person, drawing and writing were the three top target activities against left-hand preference. An assumption that the left hand is less skilled and less powerful than the right one was the most common reason for negative view on left-hand use. Most of volunteers reported that parents and close relatives were the primary group of people who usually discourage left-hand use. Eighty point one percent of the responders indicated that people should stop preferring the left hand as soon as somebody noticed their left-handedness. The results indicated that cultural and environmental pressures might significantly affect visibility of left-handedness in urban Malawian populations.

Adolescent↗
PubMed2006

An analysis of women's and men's surgical priorities and willingness to have rheumatoid hand surgery.

PURPOSE: Our prior national study showed gender differences in the rates of rheumatoid arthritis hand surgery. This project evaluated whether men's versus women's preferences, as opposed to physician biases, contribute to these variations. METHODS: A self-administered questionnaire was administered to 126 patients with rheumatoid arthritis at our institution; 117 (93%) of these patients completed the questionnaire. Chi-square tests, t tests, the Wilcoxon rank sum test, and multiple logistic regressions were used for the analyses. The results were compared with our national mailed survey of 500 rhematologists and 500 hand surgeons in the United States that evaluated physicians' attitudes toward the indications and outcomes of rheumatoid hand surgery. RESULTS: When we asked physicians who values hand aesthetics more, 378 (73%) chose women compared with less than 2 (1%) who chose men; when asked who values hand function more, 35 (7%) chose women, 83 (16%) chose men, and 396 (77%) thought there was no difference; and when asked who is more willing to have hand surgery, 219 (43%) chose women compared with 6% who chose men. In this patient survey, however, women and men were equally willing to have hand surgery, and they placed equal value in hand appearance, function, and pain. Women, however, appeared more risk adverse and concerned about the potential pain and inconvenience from surgery. CONCLUSIONS: Physicians' biases appear to conflict with patient preferences regarding rheumatoid hand surgery. Physicians should understand patients' preferences during the shared decision-making process for surgery.

Arthritis, Rheumatoid↗
PubMed2005

A survey of left-handed helices in protein structures.

All naturally occurring amino acids with the exception of glycine contain one or more chiral carbon atoms and can therefore occur in two different configurations, L (levo, left-handed) and D (dextro, right-handed). Proteins are almost exclusively built from L-amino acids. The stereochemical bias of nature is further reflected at the secondary structure level where right-handed helices are strongly preferred over left-handed helices. The handedness of helices has not received much attention in the past and is often overlooked during the analysis, description and deposition of experimentally solved protein structures. Therefore, an extensive survey of left-handed helices in the Protein Data Bank (PDB) was undertaken to analyse their frequency of occurrence, length, amino acid composition, conservation and possible structural or functional role. All left-handed helices (of four or more residues) in a non-redundant subset of the PDB, were identified using hydrogen-bonding analysis, comparison of related structures, and experimental electron density assessment to filter out likely spurious and artefactual hits. This analysis yielded 31 verified left-handed helices in a set of 7284 proteins. The phi angles of the residues in the left-handed helices lie between 30 degrees and 130 degrees and the psi angles lie between -50 degrees and 100 degrees . Most of the helices are short (four residues) and for 87% of them, it was possible to determine that they are important for the stability of the protein, for ligand binding, or as part of the active site. This suggests that, even though left-handed helices are rare, when they do occur, they are structurally or functionally significant. Four secondary structure assignment programs were tested for their ability to identify the handedness of the helices. Of these programs, only DSSP correctly assigns the handedness.

Amino Acid Sequence↗
PubMed2005

CPR for children: one hand or two?

AIMS: Current guidelines for chest compressions in CPR advocate a one handed technique in children (1-8 years old) and a two handed technique in adults (>8 years old). No previous study has examined whether these two techniques generate different compression pressures. This study assesses the relative difference in intrathoracic compression pressures generated by one- and two handed chest compression techniques in a paediatric manikin. METHODS: Randomised crossover design. Subjects performed both types of chest compressions on an adapted paediatric resuscitation manikin connected to a pressure transducer and personal computer. Ethical approval was granted. RESULTS: A 30 volunteer subjects (9 male, 21 female) participated in the study. Their mean age was 30.8 years (S.D. 8.6), and mean weight was 70.5 kg (S.D. 12.8). The mean compression pressure was 86.6 mmHg (S.D. 13.68) for two handed and 75.1 mmHg (S.D. 12.02) for one handed (P < 0.001, paired t-test). The average peak compression pressure was 133.5 mmHg (S.D. 26.36) for two handed and 116.8 mmHg (S.D. 21.48) for one handed (P = 0.001, paired t-test); 29 found the two handed technique easier to perform. CONCLUSION: Two handed chest compression CPR seems to be easier to perform on a paediatric resuscitation manikin and produces significantly higher mean and peak pressures. Further work is needed to determine the comparative effects on children and which technique produces better clinical outcomes.

Adult↗
PubMed2006

Concurrent counting and typing: lateralized interference depends on a difference between the hands in motor skill.

In previous demonstrations of differences between left- and right-handers in dual-task performance, participants' hand preference has been confounded with asymmetry of manual skill. The present study was designed to disentangle those two factors as sources of lateralized interference in the concurrent-task paradigm. Forty-eight normal adults (24 females and 24 males) counted backward by ones or by twos while typing an easy or difficult sequence of letters with either hand. When participants were grouped according to self-reported hand preference, both groups showed bilaterally symmetric slowing, relative to single-task conditions. However, when the same participants were grouped according to manual asymmetry in the baseline condition, the cognitive task interfered significantly more with the faster hand than with the slower hand. Baseline typing rate, averaged across hands, did not influence dual-task interference. Both self-reported left-hand preference and left-hand superiority in baseline typing were associated with reduced interference on the cognitive task, and the reduced interference in those groups seemed to reflect relatively loose coupling between manual and cognitive tasks. The results support and extend Caroselli et al.'s (1997) findings regarding the effect of baseline manual asymmetry on the pattern of dual-task interference. Irrespective of the participant's hand preference, the presence or absence of baseline asymmetry may be sufficient to determine whether dual-task interference is lateralized.

Adolescent↗
PubMed2005

Calbindin D28k EF-hand ligand binding and oligomerization: four high-affinity sites--three modes of action.

Calbindin D28k, a highly conserved protein with Ca2+-sensing and Ca2+-buffering capabilities, is abundant in brain and sensory neurons. This protein contains six EF-hand subdomains, four of which bind Ca2+ with high affinity. Calbindin D28k can be reconstituted from six synthetic peptides corresponding to the six EF-hands, indicating a single-domain structure with multiple interactions between the EF-hand subdomains. In this study, we have undertaken a detailed characterization of the Ca2+-binding and oligomerization properties of each individual EF-hand peptide using CD spectroscopy and analytical ultracentrifugation. Under the conditions tested, EF2 is monomeric and does not bind Ca2+, whereas EF6, which binds Ca2+ weakly, aggregates severely. We have therefore focused this study on the high-affinity binding sites, EF-hands 1, 3, 4, and 5. Our sedimentation equilibrium data show that, in the presence of Ca2+, EF-hands 1, 3, 4, and 5 all form dimers in solution in which the distribution between the monomer, dimer, and higher order oligomers differs. The processes of Ca2+ binding and oligomerization are linked to different degrees, and three main mechanisms emerge. For EF-hands 1 and 5, the dimer binds Ca2+ more strongly than the monomer and Ca2+ binding drives dimerization. For EF-hand 4, dimer formation requires only one of the monomers to be Ca2+-bound. In this case, the Ca2+ affinity is independent of dimerization. For EF-hand 3, dimerization occurs both in the absence and presence of Ca2+, while oligomerization increases in the presence of Ca2+.

Amino Acid Sequence↗
PubMed1989

Note on hand use in the manipulation of joysticks by rhesus monkeys (Macaca mulatta) and chimpanzees (Pan troglodytes).

In a recent article MacNeilage, Studdert-Kennedy, and Lindblom (1987) proposed that nonhuman primate handedness may be contingent on the specific task requirements with visual-spatial tasks yielding left-hand preferences and fine motor tasks producing right-hand preferences. This study reports hand preferences in the manipulation of joysticks by 2 rhesus monkeys (Macaca mulatta) and 3 chimpanzees (Pan troglodytes). Reach data were also collected on these same subjects and served as a basis for comparison with preference data for manipulation of the joystick. The data indicated that all 5 subjects demonstrated significant right-hand preferences in manipulating the joystick. In contrast, no significant hand preferences were found for the reach data. Reaction time data also indicated that the right hand could perform a perceptual-motor task better than the left hand in all 5 subjects. Overall, the data indicate that reach tasks may not be sensitive enough measures to produce reliable hand preferences, whereas tasks that assess fine motor control produce significant hand preferences.

Animals↗
PubMed1996

Hand preference for a bimanual task in tufted capuchins (Cebus apella) and rhesus macaques (Macaca mulatta).

This research examined hand preference for a bimanual task in 45 tufted capuchin (Cebus apella) and 55 rhesus macaque (Macaca mulatta) monkeys. Investigators presented subjects with plastic tubes lined with food and noted which hand the animals used to hold the tubes and which hand the animals used to remove the food. Several significant findings emerged from this investigation. First, rhesus macaques, but not tufted capuchins, exhibited a population-level bias toward use of the right hand (although the difference in direction of hand preference between species was not significant). Second, capuchins exhibited greater hand preference strength than did macaques. Third, among capuchins, but not among macaques, hand preference strength was greater for adults than for immatures. Finally, both species used their index digit to remove food most frequently when compared with other digits. Findings of hand preference direction and strength in this study were compared with other findings noted for chimpanzees which performed a bimanual tube task in a previous study. The authors conclude that using the same procedure to compare hand preference across species represents a powerful research tool that can lead to a more complete understanding of the evolution and ontogenesis of primate handedness.

Age Factors↗