Left Palm Research Articles

Human Responses to a Workload Change

Twenty male students performed three 5-minute trials of a PC-based multi-task which consisted of three independent tasks, i.e., resource management task, system monitoring (vigilance reaction time) task and compensatory tracking task. Participants were instructed to perform only one task (tracking) during the second trial. Tracking task performance, subjective workload, mood scores and physiological parameters (Tissue Blood Volume, Hemodynamics, Systolic Time Intervals, Heart Rate Variability and Skin Potential Level (SPL))were obtained. The task performance was significantly improved and subjective workloads evaluated by NASA-TLX were significantly low in the second trial. SPL measured on the left palm showed a significantly high value in the low workload trial when compared to high workload trials. No other physiological parameter showed such workload related significant changes among the trials. This result suggested that SPL is sensitive to the workload change although that the electrode must be attached to a palm so that it may disturb task performance.

The first isolation in Japan of Trichophyton mentagrophytes var. erinacei causing tinea manuum

The first isolation in Japan of <i>Trichophyton mentagrophytes</i> var. <i>erinacei</i> causing tinea manuum

Neonate with a fibrosarcoma and consumptive coagulopathy

We report a case of a neonate with a congenital tumor on the left palm. The patient had a grapefruit-sized tumor and coagulopathy at birth and was presumed to have a hemangioendothelioma with associated Kasabach-Merritt phenomenon. When the tumor failed to respond to systemic steroids, a biopsy specimen was taken, revealing a fibrosarcoma. We describe this case to highlight the importance of including rare tumors, such as fibrosarcomas, in the clinical differential when evaluating a congenital tumor with associated coagulopathy. We discuss subtle differences in clinical presentations that might aid in differentiating vascular tumors from fibrosarcomas.

Occupational Allergic Contact Dermatitis from Antioxidant Amines in a Dental Technician

We describe an 18-year-old dental technician who presented with dry hyperkeratotic lesions on his left palm that were limited to an area that was in contact with a container in which he had prepared the molds for a dental prosthesis. On patch testing, he had a positive reaction to black rubber mix and its components N-cyclohexyl-N'-phenyl-4-phenylenediamine, N,N'-diphenyl-4-phenylenediamine, and N-isopropyl-N'-phenyl-4-phenylenediamine, as well as to a piece of the rubber container. Thin-layer chromatography (TLC) of a piece of the rubber container confirmed the presence of the para-phenylenediamine mix. Results of patch-testing with TLC were positive after 48 and 96 hours. The lesions resolved when the patient stopped using the container. The patient was diagnosed with occupational allergic contact dermatitis. We also review the dermatoses caused by antioxidant amines.

A fatal search for worms—a peculiar electrical accident

A 32-year-old man used a self-made electrical instrument to collect earthworms for fishing. It consisted of a metal stick with a plastic handle. The stick was connected to a 10 m long wire which ended in a single-phase plug. After watering the lawn and connecting the plug to one phase of a socket (AC 220 V), he touched both the handle and the metal stick, presumably while trying to push it deeper into the soil. Through this procedure he closed the electrical circuit from his left hand to his bare feet standing on the wet lawn and was killed instantly. The autopsy revealed burn marks only on the left palm. Petechiae were found in the facial skin and the mucous membranes. The inner organs showed intensive signs of blood congestion. Toxicological analysis of blood, urine, gastric contents, liver and bile was negative. The calculated current of about 111 mA flowing through the body exceeded the range of 80–100 mA generally considered to be lethal.

HNPP due to a novel missense mutation of the PMP22 gene

Hereditary neuropathy with liability to pressure palsy (HNPP) is an autosomal dominant peripheral neuropathy characterized by compressive focal neuropathies and an underlying sensorimotor demyelinative polyneuropathy . 1-3⇓⇓ It is usually caused by a 1.5-Mb deletion of the PMP22 gene (17p11.2), but several point mutations have been reported. We describe a novel missense mutation of the PMP22 gene in a family with HNPP. A 17-year-old girl noted a 2-week history of persistent numbness and tingling of her left 4th and 5th digits and left hand weakness that developed acutely after 1 hour of leaning on her left palm. At age 9 years, she had a 2-month episode of right foot drop and numbness of the right lateral lower leg after sleeping with her legs crossed. On examination, she appeared to have ulnar neuropathy at the wrist (UNW) with mild weakness in the left first dorsal interosseous muscle (FDI) and the abductor digiti minimi, with normal strength in the left …

Intramuscular Metastasis of Cutaneous Squamous Cell Carcinoma: A Case Report

Cutaneous squamous cell carcinoma (SCC) is a common cancer. Although most patients with primary cutaneous SCC have an excellent prognosis, for those with metastatic disease, the long-term prognosis is poor. The most common sites of metastasis are regional lymph nodes, lung, liver, brain, skin, and bone. However, metastatic soft tissue SCC from cutaneous lesions is extremely rare, with only two reported cases. We report a case in which the patient had a primary SCC lesion on his left palm in 1986. A second primary SCC on his left forearm was confirmed in 2001, with subsequent metastasis to the proximal muscles and bone invasion in spite of the initial wide excision.

Neurophysiological evaluation of late paraphrenia: Comparison with chronic schizophrenia and dementia of the Alzheimer type

AbstractBackground: Late paraphrenia (LP) is a clinical entity first proposed by Roth in 1955. Recently, neuroimaging studies have described the organic changes in the brain that are associated with LP. We performed a neurophysiological study on patients with LP, chronic schizophrenics and patients with dementia of the Alzheimer type (DAT) to examine the cognitive function of patients with LP and to differentiate LP patients from these other groups.Methods: We investigated somatosensory‐evoked response (SER), contingent negative variation (CNV) and P300 in 30 LP patients, 22 chronic schizophrenics and 31 patients with DAT. Thirty‐four age‐matched healthy volunteers served as a control group. SER was performed by applying a mechanical stimulus to the right or left palm. CNV was performed by presenting a clicking sound (S1) and a flash of light (S2) to the subjects, with an interval between S1 and S2 of 2 s. P300 was performed using an auditory oddball paradigm.Results: The mean N3 peak latency of SER was significantly prolonged in patients with LP and in patients with DAT, compared with the control group. The mean CNV amplitude was significantly decreased in schizophrenics compared with the control group, but it did not decrease in patients with LP. The mean N200 and P300 latencies were significantly prolonged in patients with DAT compared with the control group, LP patients and schizophrenics, but the latencies of patients with LP were not prolonged compared with the control group.Conclusion: Based on these results, we propose that patients with LP have impaired cerebral reactivity to the stimulus, but their attention, motivation, recognition and differentiation are relatively intact. The present findings are consistent with former investigations, indicating that patients with LP are less likely to show negative symptoms, such as personality deterioration, and more likely to show organic changes in the brain relative to schizophrenics arising in early life.

Physiological Changes Associated with Neiyang Qigong

Qigong is a method adopted by many people for their health maintenance and therapy at present. But up to this day, there is still no detailed conclusion as to the physiological state of Qigong or how to define it. This study tries to explore and provide a definition for Qigong state. The subject applied Neiyang Gong to enter Qigong state. We used a multifunctional physiological recorder to record the difference of various physiological parameters before and after entering Qigong state. The results showed that when the subject entered Qigong, the alpha brain wave at the left forehead of the cerebrum was concentrated. Temperature of the left palm rose extensively. There were large fluctuations in the electromyogram (EMG) base line of the left hand dorsum. Finger pulse amplitude (FPA) pulse appeared very frequent and the amplitude increased. Skin conductance level (SCL), increased evidently. These physiological parameter variations showed that the subject is under a certain emotional state. Also, exploration of the three characteristics of Qigong showed that Qigong should be a kind of emotional state: we can see that there were several kinds of reactionary methods in the behavioral reactions of Qigong, some people can enter Qigong state in an instant, and after having learnt certain methods and having entered Qigong state, it becomes easier to enter Qigong emotional state continuingly. By understanding the mechanical system of Qigong, we are able to develop a Qigong method that is more effective to physical health maintenance.

Acute Renal Failure Caused by Low-tension Electrical Burn Injury- A Case Report

To our knowledge and clinical experiences, acute renal failure (ARF) is a major complication of electrical injury but it is rarely found after low-tension electrical burn injury. We reported one case, a 29 year-old male, who was an elevator-repairing worker for seven years. This large-scaled elevator was powered by 380 volts direct current. After the incidence, he was saved and removed from the conductor after 20 minutes later. On the scenery, he was found in the status of unconsciousness, drooping and incontinence. He was sent to our emergent department within 10 minutes. When he received 12-leads EKG examination, he returned to alert consciousness spontaneously. The entrances of electrical current were over left palm and distal phalanx of middle finger and the exits located in neck and right dorsal forearm. The severe metabolic acidosis, mild to moderate elevation of blood urea nitrogen (BUN), serum creatinine, myoglobulin and creatine phosphokinase (CPK) were found in the primary biochemical survey. The gross hematuria was noted initially and turned to tea-color urine soon. The non-oligouric ARF combined with acute respiratory distress syndrome and multiple organs dysfunction were found after admission. The continuous veno-venous hemodialysis (CVVHD) was performed for his renal function support. The symptoms were freed after two days hemodialysitic therapy and the renal function tests (BUN and Creatinine) returned to normal limit after six days.

The cerebellum is involved in predicting the sensory consequences of action.

We used H2(15)O PET to examine neural responses to parametrically varied degrees of discrepancy between the predicted and actual sensory consequences of movement. Subjects used their right hand to move a robotic arm. The motion of this robotic arm determined the position of a second foam-tipped robotic arm, which made contact with the subject's left palm. Using this robotic interface, computer controlled delays were introduced between the movement of the right hand and the tactile stimulation on the left. Activity in the right lateral cerebellar cortex showed a positive correlation with delay. These results suggest the cerebellum is involved in signalling the sensory discrepancy between the predicted and actual sensory consequences of movements.

Skin Metastasis of Neuroendocrine Carcinoma Derived from the Mediastinum

We report a 46-year-old Japanese man with a metastatic skin tumor on his left palmar region. He underwent resection for a mediastinal neuroendocrine carcinoma in February of 1998. After the operation, he immediately noticed an elevated tumor on his left palm. In September 1999, a brain tumor was discovered. The skin and brain tumors were subsequently removed surgically. Neuron specific enolase (NSE) in the serum was elevated to 25 ng/ml. A skin biopsy specimen from the left palmar site revealed multiple tumor nests which showed the same histological features as the primary mediastinal tumor. Immunostaining was positive for chromogranin, synaptophysin, and NSE but negative for S-100 protein and CD57. To our knowledge, this is the first report of cutaneous metastasis of a neuroendocrine tumor derived from the mediastinum.

頬粘膜部に転移を認めたエックリン汗孔癌の１例

An extremely rare case of an eccrine porocarcinoma that metastasized to the buccal mucosa in an 80-year-old man is presented. The patient was referred to our department 1 week after surgery for a tumor of the left palm, because of tenderness of the left buccal mucosa. Examination revealed a 2.2×2.2cm firm, well demarcated mass with a bank-like margin, located from the left upper labial mucosa to the left buccal mucosa. Biopsy showed features similar to an eccrine porocarcinoma of the left palm. The lesion of the buccal mucosa was diagnosed to be an eccrine porocarcinoma that had metastasized to the buccal mucosa. The buccal tumor was excised, and the defect was reconstructed with nasolabial and the buccal mucosal flaps. Tenderness disappeared and the quality of life of the patient improved.

左手掌のａｃａｎｔｈｏｌｙｔｉｃ ｓｑｕａｍｏｕｓ ｃｅｌｌ ｃａｒｃｉｎｏｍａ 早期に転移・死亡した症例

Acantholytic squamous cell carcinoma (ASCC) was first described under title of “adeno-acanthoma of sweat glands” by Lever in 1947. Today it recognizes one type of the squamous cell carcinoma. The tumor commomly occurred in exposed areas, particularly near the head and neck regions in elderly persons. The microscopic feature of ASCC is acantholysis with formation of lumens containing dyskeratotic cells toward the center of the lobule. Johnson et al. reported there was metastasis in 3 patients among 155 patients. But Nappi et al. described cases did metastasize widely and prove fatal were 19%. The tumor size of greater than 1.5 cm correlate with the risk of an adverse outcome. We had experienced a case of 80-year-old male who had raised tumor on the left palm and one year after first operation he was dead to metastasize lymphnode of axilla, liver, kidney and costal bone. Histological finding of palm's tumor showed acantholysis with the lumens containing dyskeratotic cells. But lymphnode's histology showed adenoid carcinoma pattern. Further immunohistochemical examination proved metastatic cells in lymphnode was ASCC. We have discussed the importance of early surgical treatment and lymphnode dissection of ASCC compared with SCC. [Skin Cancer (Japan) 2000; 15: 108-112]

Ipsilateral Movement-Evoked Fields Reconsidered

The generation mechanism of movement-evoked fields (MEFs) is poorly known and the existence of ipsilateral MEFs is still in dispute. We recorded whole-scalp neuromagnetic activity from eight subjects who were pressing response keys alternately with the right 2nd and 4th digits, while keeping the left palm on the table containing the keys. Clear ipsilateral MEFs peaked 58 ± 2 ms after the key touch, with sources in the hand area of the right primary somatosensory cortex. The ipsilateral MEFs decreased to half size when the resting left hand was palm up on the table. However, very similar responses were obtained when another person operated the response keys and the subjects just kept their left palm on the table. No signals were elicited when the subjects only viewed these actions with no hand contact to the table. The results indicate that the MEFs receive a strong contribution from tactile input. In our experiment the ipsilateral sensorimotor activation was triggered by the movement-related vibrations transmitted to the resting hand.

Hypothenar Hammer Syndrome

Hypothenar hammer syndrome is an underdiagnosed disorder that classically has been associated with repetitive occupational trauma. However, a substantial portion of cases can arise from recreational activities or a single acute event. A 15-year-old drummer presented with a 6-month history of a bulge over the hypothenar eminence of his left palm. An angiogram showed a 1.5 x 2.0 cm pseudoaneurysm arising from the ulnar artery just distal to the deep palmar branch and extending into the proximal portion of the superficial palmar arch. The aneurysm was resected and reconstructed with a primary end-to-end anastomosis. The symptoms of hypothenar hammer syndrome are variable and can be related to poor inflow, distal spasm, or emboli. Careful history and physical examination with consideration of anatomical relationships will reveal the diagnosis. Recommendations for further diagnostic testing and specific treatment strategy vary owing to increased understanding of this syndrome combined with a paucity of controlled studies. Clinical aspects and management of this case are discussed in light of the current literature.

Malignant melanoma in association with palmoplantar keratoderma

A case of malignant melanoma arising on the hyperkeratotic little finger of a 46-year-old patient with palmoplantar keratoderma is reported. A pigmented lesion had been present since childhood, over a period of two years it became larger and darker and had occasionally bled over the past two months. Histopathologic investigation revealed hyperkeratosis, hypergranulosis, and acanthosis on the left palm and malignant melanoma on the macule of the left little finger.

Modifications of the EEG activity upon activation of peripheral thermoreceptors in humans

In 12 tested subjects, we studied changes in the frequency-amplitude EEG characteristics evoked by thermostimulation of the left palm (its immersion in a pool of water with a changing temperature); temperatures of 24 and 42°C provided cooling and heating stimulations. Cooling of the palm resulted in an increase of the power of fast EEG oscillations, especially in the parietal and occipital regions and in the right temporal zone. Heating of the palm skin evoked an increase in the power of α- and θ-waves, and the latter component was most noticeably intensified in the frontal and right temporal regions. Possible mechanisms responsible for EEG modifications under conditions of thermostimulation of the skin are discussed.

Acute Onset of Dermatitis, Hepatitis, and Eosinophilia

A 48-year-old man presented to the emergency department complaining of fever, chills, myalgias, and diffuse abdominal discomfort of four days' duration. A nonpruritic rash had developed on his left palm, arms, legs, and buttocks on the fourth day. He had not had respiratory symptoms, nausea, vomiting, or diarrhea.

8 - REMOVED: UNIFORM SAMPLING AND RECONSTRUCTION

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