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At least 73 records · Page 4Linked to original sources
PubMed1993

Fundamental patterns and characteristics of the laser-Doppler skin blood flow waves recorded from the finger or toe.

Three different components, Basic Wave (BW), Cardiac Wave (CW) and Reflex Wave (RW), among the laser-Doppler (L-D) skin blood flow waves on the finger- or toe-tip, were studied in 32 healthy volunteers. The cycle of the rhythmic BW was 8.1 +/- 1.7.min-1 and was independent of respiratory movements. The BW was synchronous with the baseline fluctuation in the digit-photoplethysmogram. Power spectral analysis of rhythmic fluctuations in the simultaneously recorded R-R interval on ECG, systolic blood pressure, and L-D skin blood flow disclosed that the BW was correspondent with the Mayer wave, i.e., low frequency component. The cycle of the CW was consistent with the heart rate and was superimposed on the BW. The RW was a transient marked reduction in blood flow, which was induced by a deep inspiration or various sensory stimuli. A sympathetic skin response on the palm and a venoconstrictive response on the occluded arm were observed concomitantly with the RW. Good synchronization was observed in each component of the L-D skin flow waves between the fingers and toes. These findings suggest that the BW and the RW on the finger- or toe-tip are predominantly driven by tonic and reflex phasic activities of descending sympathetic outflows via the supraspinal center, respectively.

Adult↗
PubMed2001

Toe-to-finger transfer for post-traumatic reconstruction of the fingerless hand.

OBJECTIVE: To assess the utility of toe-to-finger transfers (TFTs) for post-traumatic reconstruction of the fingerless hand. DESIGN: A case series. SETTING: A regional trauma centre. PATIENTS: Eight men, mean age was 36 years (range from 25-59 yr), who had lost all the fingers from a hand due to a crush-degloving injury (6 patients), frostbite (1 patient) or a burn injury (1 patient). INTERVENTION: TFT. Twelve TFTs were cone and the mean time from injury to reconstruction was 17.2 months. MAIN OUTCOME MEASURES: Objective (range of motion, moving 2-point discrimination, grip strength, key pinch, Jebsen-Taylor hand assessment, return to work) and subjective (activities of daily living and a questionnaire) measures. RESULTS: Eleven of the 12 transfers survived. Six of the 7 in whom the transfer was successful were available for follow-up (mean 45 mo). Range of motion was 10 degrees at the distal interphalangeal joint, 18 degrees at the proximal interphalangeal joint and 59 degrees at the metacarpophalangeal joint. Sensation was protective in all. Grip strength and key pinch were 26.1% and 70.2% of the contralateral hand respectively. Jebsen-Taylor assessment indicated that basic activities were possible but slowed. All 6 patients returned to work and could perform 92.6% of the activities of daily living unassisted. Hand and foot symptoms were mild. Two-thirds were appearance conscious, 5 of the 6 went on to altered vocations and all reported overall satisfaction as high. CONCLUSION: This study supports TFT for reconstruction of the fingerless hand in that, although transferred toe function may be poorer than a normal finger, the hand is restored to a useful, sensate and versatile functional unit, such that global hand and patient function, as well as patient satisfaction, are very good.

Adult↗
PubMed2005

[Value of the radiographic criteria "fingers and toes" in the early diagnosis of psoriatic arthritis].

PURPOSE: To assess the value of Fournie's radiological criteria "fingers and toes" in the early diagnosis of psoriatic arthritis. MATERIALS AND METHODS: 47 patients with psoriatic arthritis were studied retrospectively. Clinical and radiological features at the hands and fingers were assessed. Radiographic analysis was performed using Fournie's criteria. RESULTS: Of 47 patients studied, 25 patients developed hand and finger involvement. Asymmetrical joint distribution was observed in 76% of cases. Distal interphalangeal arthritis was noted in 60% of cases. Nail lesions were present in 11 cases and dactylitis in 3 cases. Eight patients had erosions of the distal interphalangeal joints. Osteolysis with pencil-in-cup deformity was noted in 3 cases. Ankylosis of interphalangeal joints was found in 7 cases and acro-osteolysis in 3 cases. CONCLUSION: Psoriatic arthritis frequently affects the small joints of the hands and fingers. Asymmetrical and distal interphalangeal joint involvement are a characteristic feature of this arthropathy. Some radiological lesions are suggestive and contribute to the early diagnosis of psoriatic arthritis.

Adult↗
PubMed1995

Second toe-to-finger transfer in hand mutilations.

A series of 68 second toe-to-long finger transfers in 55 patients, including 52 transfers in 41 patients with mutilating injuries and 16 transfers in 14 patients with congenital deformities, was reviewed. Mean followup was 6.7 years. The failure rate was 6%, and secondary procedures were done in 18% of the patients. In the group with traumatic injuries, mean flexion was 36 degrees, with a mean extension lag of 33 degrees. Two-point discrimination was an average of 11 mm. Grasp was 47% of that for the normal contralateral side, and pinch was 38%. Of the manual workers, 62.5% returned to the same job. Analysis of the congenital series was more difficult. Although mobility was not significantly better in these patients, discrimination was a mean 5 mm (10 patients were tested). Growth plates remained open in 86% of the patients. All patients were able to use their finger to pinch.

Adolescent↗
PubMed1994

Effects of neural blockade and general anesthesia on the laser-Doppler skin blood flow waves recorded from the finger or toe.

Effects of neural blockade and general anesthesia on the basic wave (BW) and the reflex wave (RW) among the laser-Doppler (L-D) skin blood flow waves recorded on the finger or toe were studied in 2 volunteers and 42 patients. The BW was continuous, rhythmic and independent of respiratory movements. The RW, which was induced by a deep inspiration or a snapping sound, was a transient marked reduction in blood flow. The BW was almost flattened and the RW was no longer induced at the finger under complete wrist block (n = 2), or under cervical or upper thoracic epidural anesthesia extended caudally over T7 (n = 2). On the other hand, the BW was still detected with reducing frequency and the RW could be provoked with one exception at the finger on the side with a sympathetic ganglion block at the C6 vertebral level (n = 14). The BW and RW at the toe were retained under lumbar subdural anesthesia (n = 6) as well. However, under the combination of lumbar subdural anesthesia and lower thoracic epidural anesthesia extending rostrally over T4 (n = 6), both the BW and the RW disappeared at the toe. In the course of deepening nitrous oxide/enflurane anesthesia (n = 10), the BW gradually reduced in frequency until it was almost flattened, and it became difficult to provoke the RW. L-D flowmetry of the finger or toe could be a useful clinical measure for detecting the presence or absence of sympathetic function controlling cutaneous vasomotion.

Adult↗
PubMed1998

Ontogeny of two-point discrimination for fingers and toes in children (ages 7 through 15 years).

Accuracies of two-point discrimination (successive 2-min increments between 0 and 10 mm) for the middle fingers and the middle toes for 87 children from ages 7 through 15 years were measured to obtain normative data. The finer discriminative capacity for the fingers rather than the toes was evident. Whereas discriminative accuracy approached the asymptote with distances equal to or greater than 4 mm for the fingers, distances equal to or greater than 8 mm were required for the toes. For this ontogenetic range, the effects for toes vs fingers was much greater than the effect size for age.

Adolescent↗
PubMedDate not supplied

Microvascular second toe to finger transfer: a statistical analysis of 55 transfers.

A series of 55 second toe to long finger transfers in 42 patients are reviewed. The mean age is 17 years. The mean follow-up is more than 4 years. Two-point discrimination averages 8 mm. The sensibility is influenced by age, amputation score, ischaemic time, number of arteries, level of amputation, mobility, compensation injury and sensory re-education. The mean mobility is 33 degrees of flexion with a mean extension lack of 34.5 degrees. The mobility is influenced by dominance, amputation score, ischaemic time, number of arteries, level of amputation and compensation injury. There are four failures (7.2%). This rate of complication is influenced by tobacco, age, number of arteries and level of vascular anastomosis.

Adolescent↗
PubMed1986

Handedness, footedness and finger and toe movement-related cerebral potentials.

Sixteen right-handed and 16 left-handed subjects were compared with respect to their foot dominance and the topography of their pre-movement cerebral potentials (Bereitschaftspotential, BP). First, righthanders were usually also found to be right-footed. Lefthanders showed a similar trend in preferring their left foot. Second, the BP prior to volitional self-paced movements of fingers and toes on either side was examined. For finger movements, the BP always showed higher amplitudes over the contralateral hemisphere as compared to the ipsilateral one (contralateral preponderance of negativity, CPN). For toe movements a significant ipsilateral preponderance of negativity (IPN) occurred in all subjects. The CPN was larger for finger movements of the dominant hand than it was for finger movements on the non-dominant side. By contrast, the IPN was larger prior to movements of the "non-dominant toes" than it was for movements of the dominant toes. This can be explained by assuming that the hemisphere contralateral to the dominant hand, generates more negativity than the one contralateral to the non-dominant hand. This assumption is further discussed in the context of a vector model for the BP.

Adolescent↗
PubMed1977

Congenital claw-like fingers and toes. Case report of two siblings.

A report is given of two siblings with a congenital claw-like deformity of the fingers and toes, which is extremely rare. The deformity is similar to the claw of lower animals, and perhaps its cause is atavistic. The long-suppressed characteristic might have come to expression by interactions among the genes, perhaps influenced by some unknown environmental factors.

Abnormalities, Multiple↗
PubMedDate not supplied

Pulse oximeter waveforms from the finger and toe during lumbar epidural anesthesia.

BACKGROUND AND OBJECTIVES: To determine whether lumbar epidural anesthesia affects pulse oximeter signals in the upper or lower extremity, 13 ASA I patients were studied. METHODS: Temperature and pulse oximeter probes were placed on the finger and the toe. RESULTS: After epidural injection, the amplitude of the pulse oximeter waveform on the toe increased eight-fold but declined by 50% in the finger. The increase in amplitude of the pulse oximeter waveform in the foot preceded the temperature rise. CONCLUSIONS: More reliable pulse oximeter signals may be obtained from the toe than the finger during lumbar epidural anesthesia. Furthermore, the increase in the pulse amplitude from the toe may aid in the early detection of successful epidural block.

Adolescent↗
PubMed2003

The relationships between otoacoustic emissions and relative lengths of fingers and toes in humans.

Both otoacoustic emissions (OAEs) and the relative length of the index and ring fingers (the 2D:4D ratio) exhibit large sex differences, and both exhibit masculinization effects in female homosexuals and bisexuals. Because these sex differences exist in young children, the implication is that both types of measure are affected by prenatal androgen exposure, but it has been unknown to what degree these two types of measure are related. Accordingly, OAEs and the relative lengths of the fingers and the toes were measured in 59 heterosexual females, 55 heterosexual males, 29 homosexual females, and 33 homosexual males. The correlations between the two types of measure were unexpectedly quite low in both the heterosexual and nonheterosexual groups. For example, the correlation between number of spontaneous OAEs per ear and 2D:4D was less than 0.25, for both sexes and both sexual orientations. One interpretation of these results is that the prenatal hormonal mechanisms producing the sex differences in OAEs differ in quality, degree, or timing from those producing the sex differences in relative finger length. That is, OAEs and 2D:4D may be windows onto slightly different prenatal processes or times during prenatal development. Measures of mental-rotation ability also were obtained on these participants, and those correlations with relative finger length also were small.

Acoustic Stimulation↗
PubMed1996

Sneddon's syndrome (livedo racemosa and cerebral infarction) presenting psychiatric disturbance and shortening of fingers and toes.

A 24-year-old man with livedo racemosa and psychiatric disturbances, manifesting as low intelligence (IQ 80) and delusions, had anti-cardiolipin antibody and showed shortening of the fingers and toes. A skin biopsy of the livedo lesion revealed endoarteritis obliterans, being compatible with Sneddon's syndrome. MRI of the brain demonstrated multiple infarction and moderate cortical atrophy. A single photon emission tomography of the brain showed a marked reduction of the blood flow in the front-temporal lobe. These findings might relate to the psychiatric disturbance. After intravenous administration of cyclophosphamide and the start of oral prednisolone, the anti-cardiolipin antibody level decreased and his physical condition improved. However, a low dose of haloperidol is still necessary to maintain his mental condition.

Adult↗
PubMedDate not supplied

Discrepancy in skin capillary circulation between fingers and toes in patients with type 1 diabetes.

The aim of the present study was to investigate skin microcirculation in patients with diabetes to see if any differences in microvascular reactivity could be found between a skin area with low (fingers) or high risk (toes) of complications. Twelve male patients with type 1 diabetes were investigated, the age was 34.7 +/- 8.5 years, and diabetes duration 12.8 +/- 7.7 years (mean +/- SD). Twelve healthy male subjects served as controls. Capillary blood cell velocity (CBV) in the nailfolds of the great toe and left fourth finger was investigated with videophotometric capillaroscopy, and total skin microcirculation with laser Doppler fluxmetry (LDF). CBV and LDF were studied during rest, and following a 1-min arterial occlusion at the proximal phalanx of the digit. Skin temperature was similar in patients and controls. The diabetic patients showed normal CBV and LDF values in skin microcirculation of the fingers, while a reduced (p < 0.01) CBV was found during reactive hyperemia in the toes. The ratio between CBV and LDF was decreased (p < 0.01), indicating a maldistribution of blood between skin capillaries and subpapillary vessels in the toes of diabetic patients. These disturbances may be of importance for the development of foot complications in diabetic patients.

Adult↗