A new manual power grip.

A manual power grip for holding a cylindrical object using a relaxed index finger is described and analysed. In a group of 21 young adult students it provided greater grip strength than the conventional oblique power grip. It allowed a significant increase in the range of adduction-abduction at the wrist. In recent years it appears to have been empirically used by a number of top class racquet players and is the basis of the modern assault rifle grip. A new design of strain gauge dynamometer, in the shape of a cylinder, which permits the testing of a number of grip types and wrist positions is described. Standard grip testing protocol is used with this device which also allows the concomitant use of a goniometer for the assessment of wrist mobility.

The role of the fifth digit in music: discussion paper.

The increasing digital skill made manifest in the development of instrumental music is reviewed and supports the hypothesis that the fifth digit was belatedly used even when a suitable instrument had already become established. With notable exceptions, such as the harp, it appears that progressive improvements in instrument design was influenced by the need to utilize the fifth digits. Its greater use was accomplished in overlapping stages of increasing dexterity, of which the highest is exemplified by the left hand of the violinist. The apparent evolutional background of these observations is discussed. It is proposed that man has an inherent atavistic tendency to ignore the fifth digit and this view agrees with its neglect in gesture and sign language.

Thyroid growth-stimulating immunoglobulins in goitrous disease: relationship to thyroid-stimulating immunoglobulins.

Thyroid growth stimulating immunoglobulins (TGI) were assayed in IgG concentrates prepared from human plasma using a cytochemical bioassay (CBA) based on the measurement of changes in glucose-6-phosphate dehydrogenase (G6PD) activity in guinea pig thyroid follicular cells. TGI was present in all 8 patients studied who had goitrous Graves' disease, in 9 who had toxic diffuse goitres with asymmetric uptake on scintigram and/or symptomatic ophthalmopathy and in 4:8 who had toxic uninodular goitre with autonomously functioning nodules. TGI were also present in 34:54 (64%) of patients who had non-toxic goitres. In contrast, TGI were undetectable in 4 patients who had Graves' disease without palpable goitre and in all 18 euthyroid non-goitrous volunteers. Maximum increases in G6PD activity occurred at an IgG concentration of 50 micrograms/ml in all patients who had goitrous Graves' disease and in 5:7 who had diffuse non-toxic goitres. In contrast, IgG concentrates from 20:27 patients with nodular goitres caused maximum increases in G6PD activity at an IgG concentration of 500 micrograms/ml. A comparison of the prevalence of TGI with that of thyroid stimulating immunoglobulins (TSI), also measured by CBA, in 63 patients showed that although both stimulators were present in 8 patients who had goitrous Graves' disease they were only simultaneously present in 18:43 (42%) who had non-toxic goitres of various aetiologies. Thyrotrophin receptor antibodies (TRAb) were present in 11/44 (25%) of non-toxic goitrous patients but there was no significant correlation with IgG stimulators in such patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Association of thyroid-stimulating immunoglobulins and thyrotropin-releasing hormone responsiveness in women with euthyroid goiter.

Thyroid-stimulating immunoglobulins (TSI) were measured, using a highly sensitive cytochemical bioassay, in plasma from 26 euthyroid women with idiopathic diffuse or multinodular goiter selected on the basis of their serum TSH responses to TRH stimulation. Thirteen were chosen because they were previously identified to have impairment in TRH responsiveness and were compared with 13 consecutive patients who had normal responses to TRH. TSI were present in a significantly greater number of those who had subnormal TRH responses (11:13) compared to those who had normal responses (3:13) P less than 0.005. Although serum T4, T3, and basal TSH values were all within the normal range, mean serum T4 and T3 values were significantly higher and basal TSH significantly lower in the 14 patients who had TSI than in the 12 in whom TSI was absent. The coexistence of impaired TRH responsiveness and TSI was associated with a family history of thyroid disease. The data suggest that TSI in patients with euthyroid goiter cause a modest increase in thyroid secretion sufficient to blunt the TSH response to TRH but not to cause clinical hyperthyroidism.

The prevalence of thyroid-stimulating antibodies in goitrous disease assessed by cytochemical section bioassay.

Thyroid-stimulating antibodies (TSAb) were detectable using a highly sensitive cytochemical section bioassay in plasma from all 56 hyperthyroid patients studied, including those who had either diffuse hyperplasia or nodular goiters. The maximum dilution at which TSAb was detectable ranged from 10(-2) - 10(-6). Six of these patients had scintigraphic evidence of single functioning nodules, and, surprisingly, TSAb was present in all. Of 27 patients who had nontoxic goiter, 14 (52%) had positive titers for TSAb ranging from 10(-2) - 10(-4). The mean serum T3 value in nontoxic goitrous patients who had TSAb was significantly higher than that in subjects in whom TSAb was absent; in contrast, mean serum T4 values were not significantly different in those two groups. It is concluded that idiopathic nontoxic goiter, toxic nodular goiter with functioning nodules (Plummer's disease), and toxic diffuse goiter (Graves' disease) share, in part, a common pathogenesis.

Effect of stilboesterol therapy on thyrotrophin-releasing hormone (TRH) responsiveness in males.

TRH responsiveness was investigated in twenty-four males (aged 66-83 years) undergoing stilboesterol therapy for carcinoma of the prostrate. Twelve were taking 2-6 mg daily by mouth for periods of 5 days to 12 months (mean 5 months) (Group A) and the remainder were on daily i.v. doses of 250-500 mg for periods of 3-10 days (mean 8 days) (Group B). In the former group TRH responsiveness was enhanced compared to age matched controls. A contrary effect was observed in the latter group in that the group mean TRH response was significantly lower than that of Group A or of the control group. Basal serum TSH values were unchanged in Group A compared to controls, but a significant elevation in the basal mean value was observed in Group B. The mechanism of action of stilboesterol in the subjects studied remains to be elucidated. Our data are in keeping with either a hypothalamic or pituitary locus for such actions.