Apraxia.

Unlabelled: The term apraxia refers to 'higher level' disorders of motor control. Apraxia differs from other motor symptoms of unilateral brain damage by the bilaterality of symptoms following unilateral lesions. Lesions causing apraxia are located predominantly in the left hemisphere and apraxia is frequently, although not invariably, associated with aphasia.

Hypoxia-based strategies for angiogenic induction: the dawn of a new era for ischemia therapy and tissue regeneration.

Therapeutic angiogenesis promises to aid the healing and regeneration of tissues suffering from a compromised vascular supply. Ischaemia therapy has so far primarily focused on delivering isolated angiogenic growth factors. The limited success of these strategies in clinical trials, however, is increasingly forcing researchers to recognize the difficulties associated with trying to mimic the angiogenic process, due to its natural complexity.

Apraxia in left-handers.

In typical right-handed patients both apraxia and aphasia are caused by damage to the left hemisphere, which also controls the dominant right hand. In left-handed subjects the lateralities of language and of control of the dominant hand can dissociate. This permits disentangling the association of apraxia with aphasia from that with handedness.

Annual cost of hospitalization, inpatient rehabilitation and sick leave of anal cancer in Germany.

Objective: Literature on the economic burden of anal cancer in Germany is scarce. About 84% of these cancers are associated with human papillomavirus infection. This study, therefore, aimed to assess the annual costs of human papillomavirus-related anal cancer incurred by hospitalization, inpatient rehabilitation, and sick leave in 2008 in Germany.

Brief report: identification of the great auricular nerve by ultrasound imaging and transcutaneous nerve stimulation.

Superficial cervical plexus neuropathy after interscalene brachial plexus block affects about 8% of patients postoperatively. One of the nerves involved in superficial cervical plexus neuropathy is the great auricular nerve. We report success in identification of the great auricular nerve with ultrasound and transcutaneous nerve stimulation in a clinical setting in the majority of cases (95% lower confidence limit 63%).

From pantomime to actual use: how affordances can facilitate actual tool-use.

The main goal of the study was to investigate whether the presence of affordances, such as physical properties of given objects and resulting movement constraints, induce a performance increase in actual tool-use compared to demonstrating it with only the tool or pantomiming it without the tool and recipient object. In the present study the perception of affordances was manipulated by omission or supply of contextual information. The three execution modes - pantomiming, demonstration and actual use, - were investigated concerning the actions hammering and scooping in 25 patients with left unilateral brain damage and 10 healthy controls.

Non-verbal communication in severe aphasia: influence of aphasia, apraxia, or semantic processing?

Patients suffering from severe aphasia have to rely on non-verbal means of communication to convey a message. However, to date it is not clear which patients are able to do so. Clinical experience indicates that some patients use non-verbal communication strategies like gesturing very efficiently whereas others fail to transmit semantic content by non-verbal means.

Different left brain regions are essential for grasping a tool compared with its subsequent use.

Tool use engages a left hemispheric network including frontal, temporal and parietal regions. Patients with left brain lesions (LBD patients) exhibit deficits when demonstrating use of a single tool (apraxia). When attempting to use a tool, some apraxic patients show errors in the preceding grasping movement.

Writing kinematics and pen forces in writer's cramp: effects of task and clinical subtype.

Objective: Writer's Cramp (WC) is defined as a task-specific form of focal-hand-dystonia generating hypertonic muscle co-contractions resulting in impaired handwriting. Little is known about kinematic and dynamic characteristics in handwriting in the different subtypes of WC.

Methods: In this study, kinematic and force analyses were used to compare handwriting capacity of 14 simple, 13 dystonic WC-patients and 14 healthy subjects.

Circadian rhythms in handwriting kinematics and legibility.

The aim of the present study was to analyze the circadian rhythmicity in handwriting kinematics and legibility and to compare the performance between Dutch and German writers. Two subject groups underwent a 40 h sleep deprivation protocol under Constant Routine conditions either in Groningen (10 Dutch subjects) or in Berlin (9 German subjects). Both groups wrote every 3h a test sentence of similar structure in their native language.

Circadian rhythm in force tracking and in dual task costs.

The present study determined a circadian rhythm in force control during a visually guided tracking task under single task conditions (i.e., tracking task presented alone) and dual task conditions (i.

Plantar vein thrombosis due to busy night duty on intensive care unit.

A 32-year-old woman with severe foot pain came to our emergency department after a busy night duty in hospital followed by an extended sleep period. Physical examination revealed a discrete swelling of the medial aspect of the right foot and a painful plantar arch during digital examination. Magnetic resonance imaging (MRI) with intravenous gadolinium showed filling defects in the lateral plantar vein.

Superficial cervical plexus neuropathy after single-injection interscalene brachial plexus block.

Background: Interscalene brachial plexus block (ISB) using the modified lateral approach provides a well-established method of anesthesia and analgesia for patients undergoing shoulder surgery. Considering the neural anatomy at the site of injection, the superficial cervical plexus may be at risk of injury. We evaluated the incidence and characteristics of superficial cervical plexus neuropathy.

Circadian rhythm in handwriting.

The aim of the present study was to determine whether the motor process of handwriting is influenced by a circadian rhythm. Nine healthy young male subjects underwent a 40-h sleep deprivation protocol under constant routine conditions. Starting at 09:00 hours, subjects performed every 3 h two handwriting tasks of different complexity.

Severity of neglect predicts accuracy of imitation in patients with right hemisphere lesions.

Goldenberg [Goldenberg, G. (1996). Defective imitation of gestures in patients with damage in the left or right hemisphere.

Circadian variations in the kinematics of handwriting and grip strength.

The present study determined whether the motor process of handwriting is influenced by a circadian rhythm during writing tasks of high everyday relevance and analyzed the relationship to the circadian rhythm of grip strength. Ten healthy young male subjects underwent a 40 h sleep-deprivation protocol under constant routine conditions. Starting at 09:00 h, subjects performed three handwriting tasks of increasing perceptual-motor complexity (writing a sentence, writing one's signature, and copying a text for 3 min) and assessed grip strength of both hands every 3 h.

Interindividual variability of the SIEA Angiosome: effects on operative strategies in breast reconstruction.

Background: The vascular territory of the superficial inferior epigastric artery (SIEA) remains to be clarified. The SIEA flap has traditionally been classified as a hemiabdominal flap, but recent evidence points to the fact that a sizable superficial artery is capable of supplying the entire abdominal ellipse.

Methods: Twenty-five patients who met the anatomical criteria for undergoing SIEA flap surgery were studied.

Grasping tools: effects of task and apraxia.

In patients with apraxia the ability to access tool-use-knowledge and to integrate it into a movement plan is frequently disturbed. The present study investigated potential differences between a 'transport'- and a 'use'-task as well as the influence of apraxia on the preceding grasping movement, when the tool is presented with its handle pointing away from the participant. 20 controls, 10 patients with right brain damage (RBD-group) and 17 patients with left brain damage (LBD-group) were tested.

Apraxia and the parietal lobes.

The widely held belief in a central role of left parietal lesions for apraxia can be traced back to Liepmann's model of a posterior to anterior stream converting mental images of intended action into motor execution. Although this model has undergone significant changes, its modern descendants still attribute the parietal contribution to the existence of mental representations of intended movements which precede and direct their motor execution. They predict that pantomime of tool use should be particularly vulnerable to parietal lesions.

Neurological presentation of Whipple's disease after long-term antibiotic treatment: a case report.

Introduction: Whipple's disease is a rare systemic infectious disorder caused by Tropheryma whipplei.

Case Presentation: We report a 68-year-old male with Whipple's disease of the central nervous system following long-term antibiotic therapy and many years after the initial clinical onset.

Conclusion: The combination of trimethoprim and sulphamethoxazole does not prevent or cure involvement of the central nervous system in all patients with Whipple's disease.

Time-of-day effects on force control during object manipulation.

The aim of this study was to determine time-of-day variations of grip force control during a manipulative task. In particular, we repeatedly tested continuous up and down movements of a hand held instrumented object on two consecutive days. The movements caused fluctuations in the load that had to be compensated for by adequate grip forces.

The impact of dysexecutive syndrome on use of tools and technical devices.

We present two studies aimed at elucidating why patients with dysexecutive syndrome encounter difficulties with the use of tools and technical devices. Two different groups of patients with dysexecutive syndrome took part in them. Their results were compared with those of two groups of normal controls and in the first study also with those of patients with posterior left or right brain lesions.

Pantomime of tool use depends on integrity of left inferior frontal cortex.

Pantomime of tool use is a frequently used test for apraxia. For basic cognitive neuroscience, pantomime of tool use is of interest because it constitutes a link between instrumental and communicative manual actions. We used lesion subtraction analysis to determine the locations specifically associated with defective pantomime of tool use in patients with left-brain damage and aphasia.

The neural basis of imitation is body part specific.

Imitation is an important constituent of the behavioral repertoire of human beings. We use imitation for learning motor skills, for facilitating comprehension of other persons' actions and mental states, and as a communicative reference to actions or people. Although some non-human species display imitative behaviors, none of them equals the versatility and perfection of human imitation.

White wine and beer induce gastro-oesophageal reflux in patients with reflux disease.

Background: An induction of gastro-oesophageal reflux has been reported after ingestion of alcoholic beverages in healthy volunteers. However, it is unknown whether reflux in gastro-oesophageal reflux disease patients will be enhanced by the ingestion of alcoholic beverages.

Aim: To investigate the effects of wine and beer on postprandial reflux in reflux patients.