Congenital Bilateral Anomaly of the Flexor Pollicis Longus Tendon Without Thenar Atrophy: A Case Report.

In this case report, we describe an adult patient with bilateral congenital absence of the m. flexor pollicis longus (FPL) without any other anomalies or thenar atrophy. The FPL muscle acts to flex the thumb and is innervated by the anterior interosseous nerve. Impaired function of the FPL muscle may have several causes. A bilateral anomaly of the FPL tendon is a rare phenomenon, with only a few cases having been reported. This case report does not only demonstrate the diagnosis of bilateral FPL tendon anomaly by physical examination and magnetic resonance imaging, it also includes the embryological development of the FPL muscle and tendon.

The use of WhatsApp Messenger: an important tool in modern neurological examination.

WhatsApp Messenger is one of the most popular and still growing mobile applications worldwide in telemedicine. WhatsApp Messenger can be used as a communication tool and an adjunctive tool within telemedicine, but it is the ability or inability to use WhatsApp Messenger correctly that provides a powerful clinical neurological function tool. The easy use and the application's popularity make it extremely useful in obtaining clues in patients' neurological history. Dystextia or dystypia, the inability to send correct text messages, can be used as an indicator of neurological deficits, and is an upcoming term in neurological vascular pathology. In this case series, we present three cases in which the inability to send text messages were the clue for neurological pathology. This easy and useful evaluation of the ability to use a text message program should be incorporated in standard neurological history taking and examination, as it can provide clues for underlying neurological pathology.

Localised cutaneous microvascular adaptation to exercise training in humans.

PURPOSE: Exercise training induces adaptation in conduit and resistance arteries in humans, partly as a consequence of repeated elevation in blood flow and shear stress. The stimuli associated with intrinsic cutaneous microvascular adaptation to exercise training have been less comprehensively studied. METHODS: We studied 14 subjects who completed 8-weeks cycle ergometer training, with partial cuff inflation on one forearm to unilaterally attenuate cutaneous blood flow responses during each exercise-training bout. Before and after training, bilateral forearm skin microvascular dilation was determined using cutaneous vascular conductance (CVC: skin flux/blood pressure) responses to gradual localised heater disk stimulation performed at rest (33, 40, 42 and 44 °C). RESULTS: Cycle exercise induced significant increases in forearm cutaneous flux and temperature, which were attenuated in the cuffed arm (2-way ANOVA interaction-effect; P < 0.01). We found that forearm CVC at 42 and 44 °C was significantly lower in the uncuffed arm following 8-weeks of cycle training (P < 0.01), whereas no changes were apparent in the contralateral cuffed arm (P = 0.77, interaction-effect P = 0.01). CONCLUSIONS: Lower limb exercise training in healthy young men leads to lower CVC-responses to a local heating stimulus, an adaptation mediated, at least partly, by a mechanism related to episodic increases in skin blood flow and/or skin temperature.

Reproducibility of Cutaneous Vascular Conductance Responses to Slow Local Heating Assessed Using seven-Laser Array Probes.

OBJECTIVE: Gradual local heating of the skin induces a largely NO-mediated vasodilatation. However, use of this assessment of microvascular health is limited because little is known about its reproducibility. METHODS: Healthy volunteers (n = 9) reported twice to the laboratory. CVC, derived from laser Doppler flux and mean arterial pressure, was examined in response to a standardized local heating protocol (0.5°C per 150 second from 33°C to 42°C, followed by 20 minutes at 44°C). Skin responses were examined at two locations on the forearm (between-site). Heating was repeated after a break of 24-72 hours (between-day). Reproducibility of skin responses at 33-42°C is presented for absolute CVC and relative CVC responses corrected for maximal CVC at 44°C (%CVCmax ). RESULTS: Between-day reproducibility of baseline CVC and %CVCmax for both sites was relatively poor (22-30%). At 42°C, CVC and %CVCmax responses showed less variation (9-19%), whilst absolute CVC responses at 44°C were 14-17%. Between-day variation for %CVCmax increased when using data from site 1 on day 1, but site 2 on the subsequent day (25%). CONCLUSION: Day-to-day reproducibility of baseline laser Doppler-derived skin perfusion responses is poor, but acceptable when absolute and relative skin perfusion to a local gradual heating protocol is utilized and site-to-site variation is minimized.