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At least 1,693 records · Page 94Linked to original sources

PubMed1975

Quantitative examination of neurological function: reliability and learning effects.

During the last five years, a battery of tests measuring neurological function called the Quantitative Examination of Neurological Function (QENF) has been greatly expanded. To evaluate more effectively the efficacy of clinical trials, the results of a study on reliability of test measures and on long- and short-term effects of learning are reported. Of the 113 test measures that were evaluated using 18 young adult normal subjects, only the fatigue and error measures, the vibration sense and two simulated activities of daily living tests were found unreliable. With respect to learning, the largest improvements in performance were found for arm-shoulder pursuit tracking, followed by many of the tests of coordination, particularly those requiring manual and/or finger dexterity. Only slight changes were found for tests of vision, strength, and speed of hand and foot. There were no important differences between short- and long-term learning. Considering this and other studies, patients are not likely to improve their performance appreciably by learning in a clinical trial.

Activities of Daily Living↗

PubMed2002

Robotic assisted kidney transplantation: an initial experience.

PURPOSE: The use of robotics is a recent innovation in surgery. In addition to dexterity enhancement and motion scaling, this new technology opens the horizon of remote surgery. This latter advancement has potential use during surgery involving a high risk of patient-to-professional or professional-to-patient virus transmission. We investigated the feasibility of robotic assisted kidney transplantation. MATERIALS AND METHODS: A right cadaveric kidney was transplanted into a 26-year-old male patient who has been on hemodialysis for 11 years. Surgery was done with the help of the da Vinci robot (Intuitive Surgical, Inc., Mountain View, California) by a remote surgeon, who completely performed vascular dissection and anastomosis as well as ureterovesical anastomosis. The role of the assistant by the side of the patient was limited to access creation, exposure, hemostasis and maintaining traction on the running sutures performed by the robot. RESULTS: Operative time was 178 minutes. Robotic assistance made anastomosis possible by its unique ability of stereoscopic magnification and ultra-precise suturing techniques due to the flexibility of the robotic wristed instruments. Renal perfusion was excellent with immediate diuresis. Postoperative acute tubular necrosis started to resolve after 1 week. CONCLUSIONS: This study demonstrates that robotic assisted kidney transplantation is feasible. Currently technical and cost hindrances limit the routine use of robots. However, with ongoing improvement and future availability of this technology the prevention of patient-to-professional and professional-to-patient viral transmission may become a potential field of application.

Adult↗

PubMed1999

[Changes of neurobehavioral functions in workers exposed to manganese].

The aim of this study was to assess the neurotoxic effects associated with the level of airborne manganese in the work place. A cumulative exposure index(CEI) was calculated for each subject. The neurobehavioral test battery, in terms of choosing reaction time, finger tapping, digit symbol, stylus in hole, Benton visual retention and Santa Ana dexterity was applied in the study. The manganese exposed workers had slower motor and response speed, poorer visuomotor coordination and steadiness. There was a dose-response relationship tendency between the cumulative exposure index and the behavioral function. Hence the neurobehavioral test may be a sensitive method in detecting early changes in motor and cognitive function among manganese-exposed workers. The study also demonstrates that the cumulative exposure of manganese about 1 mg/m3 per year may induce subclinical signs of intoxication.

Adult↗

PubMed1998

[Assessment for effect of low level lead-exposure on neurobehavior in workers of printing house].

WHO Neurobehavioral Core Test Battery (NCTB) was conducted among 28 lead-exposed workers (mean age 24.84, SD2.85) in printing house and 46 controls (mean age 22.78, SD1.45), in order to assess whether low level lead exposure may be related to neurobehavioral dysfunction. The items of test were: 1. Profile of mood state(POMS), (2) Simple reaction time, (3) Digit span, (4) Santa Anna manual dexterity, (5) Digit simbol, (6) Benton visual retention; and Prusuit aiming test. In all the NCTB test values, there was no significant difference between two groups. Multiple stepwise regression analysis shows that exposure duration is related to neurobehavior scores. Mild lead exposure may affect neurobehavior in some degree but not significant.

Adult↗

PubMed2001

Neurosurgical suite of the future. III.

The neurosurgical suite of the future will continue to incorporate developing technologies so that lesion localization, surgical dissection, electrode placement, and cell/drug delivery will be optimized. In this article it was shown that MR technology can be placed into a neurosurgical operating room and used as a surgical adjunct in such a way that surgical, anesthetic, and nursing techniques are not [figure: see text] compromised. Essential to the success was the high magnetic field strength and system mobility. It is now hypothesized that MR technology, coupled to advances in molecular therapies, endovascular techniques, and transplantation, will continue to improve neurosurgical outcome not only for benign pathology but also malignant neoplastic and degenerative CNS disorders. Although these technologies are intriguing and ultimately will improve neurosurgical outcome, it is likely that for the foreseeable future, neurosurgery will continue to require sound clinical judgment and surgical dexterity.

Adolescent↗

PubMed2002

Creating a professional image in the laboratory.

Professional image is important for all members of the health-care team, including laboratory technicians. The image of individual members not only makes a statement about the competency of the team and the self-regard of its members, but also speaks of the way the individual represents the profession. Dexterity and skill, appearance and dress, and skills in communication all contribute to the impression a patient will have of the services received and the public image of the health-care agency. Laboratory technicians play a significant role as members of the interdisciplinary team regarding patient satisfaction in health care.

Humans↗

PubMed2002

[Post-traumatic brain injury behavioural sequelae: the man who lost his charm].

We portray a case of traumatic brain injury followed by symptoms of disexecutive or frontal lobe syndrome: apathy, lack of pragmatism and loss of previous abilities, specially those concerning social interaction - in particular with opposite sex - resulting in impairment of his characteristic charm. The results of the neuropsychological examination included retrieval anemic deficits with normal recognition, impaired motor dexterity and cognitive flexibility in the presence of normal intelligence. The cognitive-behavioural symptomatology contrasted with a normal neurologic examination.

Adult↗

PubMed2002

Brain regions controlling nonsynergistic versus synergistic movement of the digits: a functional magnetic resonance imaging study.

Human hand dexterity depends on the ability to move digits independently and to combine these movements in various coordinative patterns. It is well established that the primary motor cortex (M1) is important for skillful digit actions but less is known about the role played by the nonprimary motor centers. Here we use functional magnetic resonance imaging to examine the hypothesis that nonprimary motor areas and the posterior parietal cortex are strongly activated when healthy humans move the right digits in a skillful coordination pattern involving relatively independent digit movements. A task in which flexion of the thumb is accompanied by extension of the fingers and vice versa, i.e., a learned "nonsynergistic" coordination pattern, is contrasted with a task in which all digits flex and extend simultaneously in an innate synergistic coordination pattern (opening and closing the fist). The motor output is the same in the two conditions. Thus, the difference when contrasting the nonsynergistic and synergistic tasks represents the requirement to fractionate the movements of the thumb and fingers and to combine these movements in a learned coordinative pattern. The supplementary (and cingulate) motor area, the bilateral dorsal premotor area, the bilateral lateral cerebellum, the bilateral cortices of the postcentral sulcus, and the left intraparietal cortex showed stronger activity when the subjects made the nonsynergistic flexion-extension movements of the digits than when the synergistic movements were made. These results suggest that the human neural substrate for skillful digit movement includes a sensorimotor network of nonprimary frontoparietal areas and the cerebellum that, in conjunction with M1, control the movements of the digits.

Adult↗

PubMed2002

Evaluation of transurethal alprostadil for safety and efficacy in men with erectile dysfunction.

A multicenter study conducted in 5 trial centers, for the safety and efficacy of transurethral alprostadil (Pellet) in 90 subjects. The end results show quite good and the product was satisfactory and safe for all ages. Although there are multiple side effects that seemed to discourage the participants and caused them to dropout, MUSE does work but needs good understanding of the use of the device. MUSE is another alternatives for those who unable to use oral medication or those who require immediate action but need some dexterity.

Adult↗

PubMed2002

Biomimetic actuators in prosthetic and rehabilitation applications.

Where humans and mechanical systems operate in close proximity there is a need to provide drive systems that combine the positive attributes of conventional actuator design with a 'softer' safer interaction capacity. This is achieved by natural muscle, and engineering emulation of this functionality could have a significant benefits in many areas, but particularly the medical domain. This work will study the use of compliance regulated and controlled pairs of antagonistic pneumatic Muscle Actuators (pMAs) in two medical scenarios; i) The construction of dexterous prosthetic hands having a high power and low mass potential, ii) The construction of a power assist device that can be used to augment the strength of those suffering from degenerative muscle wasting diseases.

Amputation, Surgical↗

PubMed2002

Totally endoscopic atrial septal defect closure with a robotic system: experience with seven cases.

BACKGROUND: The development of minimally invasive cardiac surgery has shown good clinical results with shorter recovery time and better cosmetic results. The introduction of the robotic systems can further reduce the surgical trauma and improve the surgical dexterity. We report seven cases of complete closed chest atrial septal defect closure using the "da Vinci" Surgical System (Intuitive Surgical, Mountain View, CA). METHODS: Following peripheral cannulation for cardiopulmonary bypass (CPB), aortic occlusion and cardioplegia delivery, five patients with atrial septal defect (ASD) and two patients with patent forame ovale (PFO) with atrial septal aneurysm (ASA) were successfully treated using the robotic system. Two robotic arms and an endoscopic camera were inserted through ports in the right hemithorax and an accessory port was placed for blood suction and ancillary instruments insertion. The defect closure was carried out with interrupted stitches in one patient and with a continuous suture in the others. RESULTS: Mean cardiopulmonary bypass and cross clamp time were 101.8 +/- 39.6 and 63.4 +/- 21.9 minutes respectively. Extubation was carried out within the seventh postoperative hour. All patients returned to normal lifestyle in one week. CONCLUSION: Complete closed chest ASD closure can be carried out using robotic technique with rapid postoperative recovery and excellent cosmetic result.

Adult↗

PubMed1975

[The value of motor tests in neuro-developmental diagnosis].

Recording and judgment of (psycho) motor behavior are important tools in developmental and neuropediatric diagnosis: During infancy and early childhood the developmental course of various motor functions has to be registered, and the alterations of spontaneous or provoked movements have to be assessed by neuropediatric evaluation. Present knowledge of underlying neurophysiological mechanisms is scarce; therefore, in the stage of collecting data, it is essential to gather information about motor phenomena by a valid and comprehensive assessment of motor skills and movement patterns together with the modifying and influencing variables. Motoscopic methods are useful in recording motor skills and movement patterns; however, they are influenced by subjective errors depending on the examiner's training and experience. Motometric tests yield information about the coordinative functions and gross motor skills (e.g. body coordination test; KTK) or about manual dexterity and fine motor functions (e.g. the "insertion test"; Gleiss). For an objective recording of motor performance and particularly for assessment of the course of movements in performing motor tasks motographic methods are necessary (e.g. diadochometry). Problems and possibilities of these (psycho) motor tests are discussed briefly. Development and application of motodiagnostic methods are still in an early stage so that conclusions about underlying neurophysiological mechanisms have to be drawn very carefully, e.g. in the diagnosis of so-called cerebral dysfunction.

Brain Damage, Chronic↗

PubMedDate not supplied

Are behaviour and motor performances of rheumatoid arthritis patients influenced by subclinical cognitive impairments? A clinical and neuroimaging study.

OBJECTIVE: To determine whether some behavioural manifestations and poor motor performances in patients affected by rheumatoid arthritis (RA) are due to subclinical cognitive defects. METHODS: We performed a psychometric assessment of 30 patients affected by RA exploring several cognitive domains such as memory, visual-spatial integration, motor planning, mental flexibility, relating performances with morphological and functional neuroimaging (MRI and SPECT). We also related the cognitive data with the Ritchie and Lee indexes and other clinical parameters. RESULTS: We found an impairment in visual-spatial tasks in 71% of patients with a high correlation to activity and disease severity as expressed by the Ritchie and Lee indexes (p < 0.005; p < 0.01). Furthermore, we detected in 38% of patients some difficulties in mental flexibility related to the Lee Index (p < 0.05). These poor performances are related to hypoperfusion of the frontal and parietal lobes as detected by brain SPECT; this finding is more evident in patients with brain white matter alterations on MRI. CONCLUSIONS: Our data allow us to hypothesize that manual dexterity could be due to a disconnection between subcortical white matter and parietal-frontal lobes because of microangiopathy; furthermore, a chronic reduction in sensorial stimuli by impaired joints could lead to produce an alteration in motor planning cognitive processes.

Adult↗

PubMed1975

A note on the quantitative anatomical study of the trachea in the Indian buffalo (Bubalus bubalis).

A quantitative study of the trachea in buffalo has been made. The trachea is found to be about 37.9 +/- 1.8 cm long. It weighs 219.8 +/- 34.08 gm and its capacity is 188.4 +/- 29.3 ml. Its length, weight and capacity appear to be significantly interrelated. The bronchus principalis dexter is found to be diverging at 23.5 degrees +/- 4.6 degrees angle, whereas the bronchus principalis sinister at 34.1 degrees +/- 8.4 degrees. Apart from the first tracheal ring, the trachea has the greatest outer transverse, outer vertical, inner transverse and inner vertical diameters from the fifth to the twentieth tracheal rings. Thereafter, these diameters gradually decrease upto the last tracheal ring, which has the shortest corresponding diameters. The vertical diameter is greater than the transverse diameter throughout the length of the trachea.

Animals↗

PubMed2002

Virtual reality-augmented rehabilitation for patients following stroke.

BACKGROUND AND PURPOSE: Recent evidence indicates that intensive massed practice may be necessary to modify neural organization and effect recovery of motor skills in patients following stroke. Virtual reality (VR) technology has the capability of creating an interactive, motivating environment in which practice intensity and feedback can be manipulated to create individualized treatments to retrain movement. CASE DESCRIPTION: Three patients (ML, LE, and DK), who were in the chronic phase following stroke, participated in a 2-week training program (3 1/2 hours a day) including dexterity tasks on real objects and VR exercises. The VR simulations were targeted for range of motion, movement speed, fractionation, and force production. OUTCOMES: ML's function was the most impaired at the beginning of the intervention, but showed improvement in the thumb and fingers in range of motion and speed of movement. LE improved in fractionation and range of motion of his thumb and fingers. DK made the greatest gains, showing improvement in range of motion and strength of the thumb, velocity of the thumb and fingers, and fractionation. Two of the 3 patients improved on the Jebsen Test of Hand Function. DISCUSSION: The outcomes suggest that VR may be useful to augment rehabilitation of the upper limb in patients in the chronic phase following stroke.

Aged↗

PubMed2002

[Relationship of normal levels of activity of daily living and daily habits among elderly women at home].

PURPOSE: The relationship of activities of daily living (ADL) with daily habits and age was investigated with a focus on the results of measurements of the normal speed (ordinary level: OL) and maximum speed (maximum capacity: MC) in performing items on a functional fitness test. The significance of the measurement of the ordinary level was also discussed. METHODS: The subjects were 69 women, aged 60-90 years old, who participated in a health workshop for the elderly sponsored by a local municipality and who performed at least 4 items on a functional fitness test. Public health nurses asked subjects about habitual life style, subjective health status and degree of satisfaction in daily life. The ADL level was measured using the tests of functional fitness developed by Oida et al and partially revised by ourselves and physical fitness tests (grip strength, sit and reach, and balancing on one leg with opened eyes). OL was measured as the time needed to perform functional fitness items at normal speed, and MC as the time needed when performing these tasks as quickly as possible. RESULTS: All functional fitness items were accomplished significantly faster with MC than OL. Correlation coefficient values between OL and MC were high significant. Age was found to be significantly related to the hand working test (Hand-T) to evaluate dexterity and the rope working test (Rope-T) to evaluate self-care, except with the MC. An analysis of covariance with age as the covariant revealed that, with OL, there were relationships between Hand-T and Rope-T and the item "active at home," and between the zigzag walking (Zigzag-T) and Rope-T and "walking or riding a bicycle to go shopping." With MC, there were relationships between Hand-T and "active at home," and between Zigzag-T and "walking of riding a bicycle to go shopping." Regarding physical capacity, relationships were seen between both hands and "high level of physical fitness" and "walking fast" and grip strength (Left hand), respectively. CONCLUSION: The ADL items measured in the preset study were related to the daily activities of elderly people. As the OL and MC results demonstrated a high correlation and the ADL items related with OL were found to have almost the same link with MC, we conclude that OL is suitable for testing with the advantage of safety. However, we could not explain differences in relationships between measurements and daily activities, pointing to a need for further research. Elderly people must maintain their capacity for ADL to support a good quality of life, and we have demonstrated the utility of measurements that include normal levels of activity as indicators.

Activities of Daily Living↗

PubMed2002

Review: complications of minimally invasive spinal surgery.

Complications of minimally invasive spinal surgery can be related to anesthesia, patient positioning, and surgical technique. The performance of successful minimally invasive spinal surgery is beset with several technical challenges, including the limited tactile feedback, two-dimensional video image quality of three-dimensional anatomy, and the manual dexterity needed to manipulate instruments through small working channels, which all account for a very steep learning curve. Knowledge of possible complications associated with particular minimally invasive spinal procedures can aid in their avoidance. This article reviews complications associated with minimally invasive spinal surgery in the cervical, thoracic, and lumbar spine by reviewing reported data of sufficient detail or with sufficient numbers of patients. In addition, possible complications associated with anesthesia use, patient positioning, and surgical techniques during thoracoscopic and laparoscopic spinal procedures are reviewed.

Endoscopes↗

PubMed2002

[Technical aspects of laparoscopic splenectomy].

For the period of four years 22 patients were operated on for surgical disease of spleen, using laparoscopic technologies. Laparoscopic splenectomy was performed in 12 patients, manually assisted laparoscopic splenectomy using the Pneumo Sleeve (Dexterity firm) system and with application of the self made construction pneumosleeve--in 10. The operation duration was from 110 to 220 minutes. The hospital stay of the patient after the operation had constituted 2-4 days. The experience of laparoscopic splenectomy performance gained witnesses the possibility of successful application of the method for the treatment of surgical diseases of spleen.

Adolescent↗