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At least 181 records · Page 10Linked to original sources
PubMed2004

Comparing the AUSCAN Osteoarthritis Hand Index, Michigan Hand Outcomes Questionnaire, and Sequential Occupational Dexterity Assessment for patients with rheumatoid arthritis.

OBJECTIVE: The Australian Canadian Osteoarthritis Hand Index (AUSCAN), Michigan Hand Outcomes Questionnaire (MHQ), and the Sequential Occupational Dexterity Assessment (SODA) are assessments of hand function. Investigation of psychometric properties, administration, acceptability, and content of an assessment add strength to the findings of research and treatment. We evaluated the validity and reliability of the AUSCAN, MHQ, and the SODA for assessing disability in patients with rheumatoid arthritis (RA). METHODS: Sixty-two patients with RA completed the AUSCAN (visual analog scale version), the MHQ, and the SODA. Seventeen patients repeated the assessments within one week. RESULTS: The assessments recorded high variability within the sample of 62 patients with RA. The AUSCAN and MHQ provided patient and context-specific information, while the SODA provided more impairment information that could be readily compared between patients. Seventeen patients were tested twice within 5 days, showing good reliability of all assessments. Unlike the MHQ, AUSCAN and SODA do not provide information about individual hands or hand dominance. The physical function scales of the AUSCAN and the SODA were related (r = 0.81), and the AUSCAN and MHQ pain scales were related (r = 0.68). CONCLUSION: Clinicians and researchers should decide whether impairment, ability, or handicap outcome is the goal of assessment, and whether bilateral function or the function of one hand is of interest before choosing a hand assessment. The AUSCAN and MHQ are valid and reliable for assessment of hand disability in patients with RA, and they allow the patients to answer questions about their home environment. The SODA is also valid and reliable for assessing disability in a clinical situation that cannot be generalized to the home.

Activities of Daily Living↗
PubMed1992

Can Dexter cultures support stem cell proliferation?

The in vitro culture of mouse bone marrow (Dexter cultures) has allowed a detailed analysis of the biology of murine hematopoiesis. However, attempts to develop stable long-term human bone marrow cultures have been unsuccessful. Available culture systems all have finite and relatively short lifetimes. The reasons for the limited longevity are unknown. Utilizing computer-assisted integration techniques, we have theoretically simulated culture cell production kinetics to help identify factors that may be responsible for culture decay, as well as to suggest possible means of improving culture longevity. The simulation demonstrates that removal of stem cells is a possible mechanism leading to culture decline. Under the standard bone marrow culture conditions, even with a high stem cell renewal rate, the cultures appear to be destined to fail. Thus, the development of proper sampling techniques or improved stem cell retention may be critical to obtain successful long-term cultures.

Animals↗
PubMed2005

[Dexterously use four branch vessel prosthesis on aortic surgery].

OBJECTIVE: To review the experience of various positions aortic replacement by four branch prosthesis vessel. METHODS: From August 2003 to May 2005, we finished aortic procedures with four branch prosthesis vessel for 142 patients, aged (44 +/- 12) (22-78) years, weighted (72 +/- 20) kg (49-130 kg). We performed ascending aorta and total aortic arch replacement for 85 cases during right axillary artery cannulation for cardiopulmonary bypass and selected antegrade cerebral perfusion. 38 patients underwent one-stage total thoracoabdominal aortic replacement during deep hypothermic bypass and subsection circulatory arrest. 8 patients underwent one-stage total or subtotal aortic replacement during deep hypothermic bypass and selected antegrade cerebral perfusion and subsection circulatory arrest. We performed totally aortic arch replacement without utilizing cardiopulmonary bypass and hypothermic for 11 cases. RESULTS: The mortality was 4.2%. Cerebral complications occurred in 16 (11.3%). 2 patients suffered from permanence spinal cord dysfunction. 4 patients suffered from temporary spinal cord dysfunction. CONCLUSION: The four branch vessel prosthesis can be used on aortic surgery dexterously. The approach may shorten she time of aortic arrest and arterial construction.

Adult↗
PubMed1993

Corticospinal terminations in two new-world primates: further evidence that corticomotoneuronal connections provide part of the neural substrate for manual dexterity.

Anterograde transport of 2-10% WGA-HRP was used to examine the pattern of termination of efferents from the primary motor cortex to cervical segments of the spinal cord in cebus (Cebus apella) and squirrel (Saimiri sciureus) monkeys. We have compared the pattern of termination in these monkeys because of marked differences in their manipulative abilities. Both primates have pseudo-opposable thumbs; however, only cebus monkeys use independent finger movements to pick up small objects. We found that corticospinal terminations in cervical segments of the cebus monkey are located in three main zones: a dorsolateral region of the intermediate zone, a dorsomedial region of the intermediate zone, and the ventral horn. The projection to the ventral horn in these monkeys is particularly dense at C8-T1 segments, where terminations form a "ring" that encircles the lateral motoneuronal cell group. In contrast, there are only two main zones of terminations in the squirrel monkey: a dorsolateral region of the intermediate zone and a dorsomedial region of the intermediate zone. As others have noted, efferents from the primary motor cortex of squirrel monkeys have, at best, only sparse terminations within the ventral horn. Thus, there are marked differences between cebus and squirrel monkeys in the extent of corticospinal terminations within the ventral horn. These observations provide further support for the concept that monosynaptic projections from the primary motor cortex to motoneurons in the ventral horn provide part of the neural substrate for dexterous movements of the fingers.

Animals↗
PubMed1993

[Echocardiography in cor triatriatum dexter].

"Cor triatriatum dexter" (CTD) is an unusual cyanotic cardiac defect in which the right atrium is subdivided into two distinct chambers due to the persistence of the "sinus venosus" valve. Two patients with CTD ho were evaluated and treatment in 1979 and 1992 are described: the first one, had total anomalous pulmonary venous return to the coronary sinus or "cor triatriatum sinister" as preoperative diagnosis based on M-mode echocardiographic findings. The presence of a membrane inside the right atrium was suspected on cineangiogram. The other one had a preoperative diagnosis of CTD. Anatomic relationships and physiological effects were established by two dimensional and Doppler ultrasonography and confirmed at cardiac catheterization and surgery. High resolution two dimensional echocardiography coupled with Doppler ultrasonography has a definite role in the study of this heart defect.

Child↗
PubMed1997

Protective gloves for use in high-risk patients: how much do they affect the dexterity of the surgeon?

Twenty-five orthopaedic surgeons underwent eight motor and sensory tests while using four different glove combinations and without gloves. As well as single and double latex, surgeons wore a simple Kevlar glove with latex inside and outside and then wore a Kevlar and Medak glove with latex inside and outside, as recommended by the manufacturers. The effect of learning with each sequence was neutralised by randomising the glove order. The time taken to complete each test was recorded and, where appropriate, error rates were noted. Simple sensory tests took progressively longer to perform so that using the thickest glove combination led to the completion times being doubled. Error rates increased significantly. Tests of stereognosis also took longer and use of the thickest glove combination caused these tests to take three times as long on average. Error rates again increased significantly. However, prolongation of motor tasks was less marked. We conclude that, armed with this quantitative analysis of sensitivity and dexterity impairment, surgeons can judge the relative difficulties that may be incurred as a result of wearing the gloves against the benefits that they offer in protection.

Clinical Competence↗
PubMedDate not supplied

Hand-assisted laparoscopic transhiatal esophagectomy using the dexterity pneumo sleeve.

BACKGROUND: As the use of laparoscopic techniques have expanded to more complicated procedures, limitations of laparoscopy have begun to be realized. To help regain the ability to palpate and bluntly dissect tissues, and handle larger organs, surgeons have begun to utilize devices which allow the surgeon's hand to be inserted into the abdomen during laparoscopic procedures. One such devices is the Dexterity Pneumo Sleeve, which was used here to perform transhiatal esophagectomy in two patients. METHODS: Two patients with adenocarcinoma of the esophagus underwent hand-assisted laparoscopic transhiatal esophagectomy. The stomach mobilization was carried out using laparoscopic technique facilitated by the use of the surgeon's hand. Blunt dissection of the esophagus through the hiatus was then carried out. Dissection of the proximal esophagus and creation of a cervical esophagogastric anastomosis was then performed in the neck through a cervical incision. RESULTS: The Pneumo Sleeve proved useful for handling the stomach, as well as, blunt dissection of the esophagus while still maintaining the benefits of laparoscopy, including small incisions, and no postoperative ileus. CONCLUSION: Hand-assisted laparoscopic esophagectomy can be carried out with good, early, postoperative recovery.

Adenocarcinoma↗
PubMed1990

Lewis Dexter.

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History, 20th Century↗