Side Of Right Hand Research Articles

Gene mutation analysis of congenital skin defects: a case report

A female infant presented with skin defects and blisters for 2 hours after birth. Physical examination showed asymmetric skin defects on both lower extremities and left wrist, a thin-walled blister on the dorsal side of the right hand, and partial loss of the oral mucosa. No other abnormal signs were found. Genetic testing showed a heterozygous pathogenic mutation c.481C > T (p. Gln161*) in exon 4 of the COL7A1 (NM-000094) gene and a heterozygous pathogenic mutation c.1837C > T (p. Arg613*) in exon 14 of the COL7A1 (NM-000094) gene, which were also identified in the patient′s father and mother respectively. The infant was diagnosed with congenital skin defects. The patient received protective isolation, focal washing with 0.9% sodium chloride physiological solution, topical epidermal growth factor and comprehensive treatment for infection prevention. After 6-day treatment, the patient was discharged with dry and non-exudative skin lesions. This case prompted that abnormal heterozygosis mutation at C.481 and C.1837 sites on the COL7A1 (NM-000094) gene could form compound heterozygote, acting as pathogenic mutation. Key words: Focal dermal hypoplasia; Genetic testing; Epidermolysis bullosa; Genetic diseases, inborn; COL7A1 gene

Treatment of Multiple Congenital Peripheral Aneurysms of Upper Extremity – A Case Report

Congenital true aneurisms of peripheral arteries especially on the hand are rare and idiopathic. The present case is focused on the multiple aneurysms of a young boy on both radial and ulnar arteries since birth. The clinical indications include painful ulcers on the right middle finger, discoloration and swelling of dorsum of ulnar side of right hand. In addition, patchy necrosis of fifth finger with increased intensity of pain was observed. Here we successfully treated both aneurysms with partial amputation of the digit and the growth of the skin on both sides of the palm was restored by groin flap.

Danger Assessment of a Spring-Gun Device (Muzzleloader) Loaded Only With Black Powder

We report a case involving a spring-gun device (muzzleloader) loaded solely with gunpowder, installed next to shoes to prevent the neighbors' puppy from removing them. The booby trap was triggered by the 15-year-old dog-owners son when he tried to put the shoes out of the reach of the puppy. The boy suffered second degree superficial burns located mainly at the dorsal side of the right hand and fingers. To estimate the danger of the used weapon, several tests were undertaken on soap blocks from different distances and with different loads of black powder. The particle density per mm and the depth of black powder tattooing in the soap was compared with the boy's injuries, and found conclusive with the gun-owners statement regarding the loading of the weapon. Furthermore, our experiments indicated that the gunpowder load involved was not able to inflict permanent damage, not even to the eyes, at the here estimated firing distance.

The Treatment of Delayed Rejection after Boosting of Mononuclear Cells of Her Mother and Chronic Graft Versus Host Disease in Leukemia Recipient Who Underwent Allogeneic Hyplo-Identical Transplantation in Second Remission with Therapeutic Plasma Exchange.

Patient is a Chinese girl of 13 years. She had fever, weakness, headache, and was hospitalized on Feb 20th, 2003. There were 0.89 leukemic monocytes in her bone marrow smear at diagnosis. She was diagnosed acute monoblastic leukemia (M5b) according to FAB classification. The immunophenotyping of bone marrow cells showed CD13 0.579, CD15 0.289, CD33 0.78, cMPO 0.27. After the second remission, she underwent hyplo-identical, ABO-matched combination transplantation of bone marrow and peripheral blood stem cells of her donor mother with T-cell deletion in Aug. 2005. Her hemapoiesis recovered at +10d after transplantation. The while complete blood cell count recovered at +31d when the TCR-PCR DNA gene map was showed the chimera. The rejection appeared at +60d. Her blood picture showed Hb 63g/L, Plt 1.0×109/L, WBC 0.4×109/L. The bone marrow picture showed hypo-cellular as same as in severe aplastic anemia. The TCR-PCR DNA gene map showed the 3/16 locus of recipient. The schedule of treatment of delayed rejection was the combination of Cyclosporin A (CsA), Mycophemolate Mofeil (MMF) and Methylprednisolone (MP). She boosted the G-CSF-primed peripheral mononuclear cells of her mother. The cell dose was 4.3×108/kg without T-deletion. Then she received the stimulation of G-CSF 250 ug daily. One week later, she suffered from Herpes Zoster Virus (HZV) infection. There was characteristic HZV varicella in full right side of head, right face, right eye, and right hand with high fever, malaise. She felt severe postherpetic neuralgia. Only morphine or remain acupuncture can relieve her severe neuralgia. She had also severe pancytopenia, gastrointestinal bleeding. We had to transfuse backed red cell and platelet concentration every week. She received first TPE at +130d and second TPE at +137d after transplantation. Dramatic results were gotten after the two TPE. After TPE she did not need transfusion again. After the third TPE, she was discharged then had treated small dose of CsA for half year. The STR-PCR DNA gene map showed the gene type from her mother. At +311d she suffered from chronic graft versus disease (cGVHD). The skin lesion involved her whole body skin about was about 50% body surface area. The effect had not received after treatment with TPE. The cGVHD had not controlled after the basic treatment with CsA or Sirolimus (FK506), MMF, MP, and Thalidomide 100–400 mg/d. So we added with ultraviolet-B irradiation (UV-B) therapy with dose of narrowbank UV-B, twice a week. The lichenification planum was disappearing. The mechanism of TPE on delayed rejection in ABO-unmatched, allogeneic stem cell transplantation has been clear. But, it is still not clear in ABO-matched and hyplo-identical allogeneic stem cell transplantation. It may be cause humoral rejection as same as ABO-incompatible stem cell or solid organ transplantation. The antibodies have resulted from hyplo-identical allogeneic stem cell of her mother. The mechanism of cGVHD results from donor T-lymphocyte activated and involves skin, liver, gut and so on. It is effective of treatment of cGVHD with immune inhibitor drugs but with TPE. Recently reported ECP is effective because the method result in suppressing the activated T-lymphocyte in recipient.

The psychological significance of changes in skin temperature

Thirty-two female undergraduates were presented with varied, mildly stressful incentives while the temperatures of their face and hands were recorded with infrared telethermography. There was an increase of hand skin temperature to film clips intended to generate a happy affect but cooling to threatening personal questions. There was no significant skin temperature change in response to cognitive tasks or fear eliciting film clips. Larger temperature changes occurred on the hands than on the face, and most subjects were cooler on the left side of the face and the left hand than on the right side of face and right hand.

Comparative study on the muscular load of the arms using hair driers.

The purpose of the present study was to evaluate the muscular load of the arm when combing the hair using different "kuru-kuru" type of hair driers. Ten female students (20-24 years old) volunteered as subjects. Five combing patterns were conducted as follows: 1) comb outer layer of right side of hair using right hand, 2) comb outer layer of left side of hair using right hand, 3) comb inner layer of left side of hair using right hand, 4) comb outer layer of back hair using right hand, and 5) comb inner layer of right side of hair using left hand. Surface EMGs were recorded from M. flexor carpi ulnaris, M. brachioradialis, M. biceps brachii, M. triceps brachii, M. deltoideus and M. trapezius of both sides of body. Integrated EMGs (iEMGs) were used to evaluate muscular load for each of the seven different types of hair driers used. The relationship between iEMGs and weight, center of gravity, diameter, length, and circumference of each hair drier were examined. The weight of hair driers tended to be the effective factor on the muscular load. Muscular load also had a tendency to be affected by the shape of the grips. With regard to the hand size, the longer the thumb length, the smaller is the muscular load. It was suggested that a relatively large diameter of the bulb-shaped grip of the drier gave a smaller muscular load among the hair driers examined in the present experiment.

圧覚に及ぼす附加圧刺激の効果

Pressure and touch are often described as the same kind of sensation because they are elicited by similar mechanical stimulation. But they are quite different subjectively as well as electro-physiologically. The author discriminated between them by the difference of subjective sensation, and studied the effects of additional side-pressure applied to relatively broad surface of the body upon pressure sensation.The sensitivity of pressure sensation was measured by the number of pressure spots within a given area of the skin. In normal resting subjects, the localization of pressure spots changes from one examination to another (Fig. 1), but the number is always nearly constant (Table 1). The author studied how side-pressure by a weight given to various parts of the body surface influenced upon the pressure sensitivity in the dorsal side of right forearm, and obtained the following results:1) Side-pressure caused the decrease of pressure sensitivity in general.2) The nearer was the location of side-pressure to the test area, the greater was it's decreasing effect (Table 2).3) However, the decreasing effect of side-pressure applied to the dorsal side of right hand (distal from the test area) was less than that to the dorsal side of right forearm (proximal from the test area), even if both distances from the test area were nearly equal. This difference of the effect may be explained by the dermatome: the skin of the hand was innervated by the spinal nerve differing from that of the test area, whereas the forearm was innervated by the same nerve. But there is a problem on such simplified explanation.4) The effect increased as the size and intensity of side-pressure increased.Side-pressure given on the forearm by a cuff also depressed the pressure sensitivity. In this procedure, the asphyxia took place and the sensation subjectively differed from the former case. So, in the latter case another mechanism might be considered.5) The effect of side-pressure showed the maximum value within 1min. after pressure application (Fig. 2), regardless of intensity and location of applied pressure. Consequently, it may not be considered that the effect of side-pressure spreads around from the pressed area.6) The after-effect was recognized and it disappeared within 1min. (Fig. 3).The obtained results can not be simply explained by the pressure block of the peripheral nerve trunks. The sensitivity of pressure sensation is depressed also by the other stimulation of the central nervous system, especially the effects of stimuli, depressing the clarity of consciousness, are very similar to side-pressure's. It may be followed that side-pressure on the skin causes the inhibitory effect on the central nervous system including the cerebral cortex.It is concluded that the depression of pressure sensitivity is not of peripheral origin, such as pressure nerve block, but results from the induction in a level or levels of the central nervous system.