The range of movement of the thumb.

PURPOSE: The movements at each thumb joint are flexion and extension (called radial abduction in the CMCJ) and additional movements of anteposition, retroposition and opposition at the CMCJ, due to the saddle shape of the articulation. Our study was designed to provide a means of thumb movement measurement and provide a range for each. METHODS: A prospective cohort study was performed looking at 100 consecutive individuals without thumb pathology to determine thumb joint range of movements and evaluate the reliability of such measurements. RESULTS: The mean age was 26 (range of 18-37) with 62 female individuals. The mean range of movement of the IPJ was flexion of 88 ° (80-90 °) and extension of 12 ° (0-45 °). That of the MCPJ was flexion of 60 ° (43-70 °) and extension of 8.1 ° (0-15 °). That of the CMCJ was anteposition of 61.2 ° (50-71 °), retroposition of 31.1 mm (25-38 mm), radial abduction of 62.9 ° (53-71 °), opposition Kapandji grade 9 (grades 9-10) and adduction of 10.2 ± 4 ° (5-20 °). CMC adduction was difficult to measure with a poor intra- and inter-observer correlation (inter-reliability correlation coefficient of 0.02 and intra-reliability coefficient of 0.04). For the remaining measurements, the mean inter-reliability correlation coefficient was 0.82 (p < 0.01) while the mean intra-reliability correlation coefficient was 0.93 (p < 0.01). There was negative correlation identified between IPJ extension and MCPJ extension (-0.50) and between CMCJ radial abduction and MCPJ extension (-0.60). CONCLUSIONS: Having established the normal ranges of movements for the thumb joints and shown that our measurement methods are reliable and reproducible, we have identified that a reduction in certain thumb joint movements appears to be compensated for by an increased movement range in the other joints.

Determinants of the intention to use condoms in a sample of French adolescents.

OBJECTIVE: To identify the determinants of the intention to use and actual use of condoms in a sample of French adolescents based on Ajzen's Theory of Planned Behaviour. METHOD: Two-hundred-and-thirty French secondary-school students (mean age: 17.68 years; SD = 1.08) completed a questionnaire about condom use intention. RESULTS: 'Perceived behavioural control', 'individual attitudes', 'subjective socio-cultural norms' and 'subjective norms of close friends and relatives' are the main factors explaining 33% of variance of condom use intention. For girls, intention is essentially associated with perceived control, subjective norms ('close friends and relatives', and then, 'socio-cultural norms') and individual attitudes, whereas for boys, it is more closely linked to individual attitudes and to subjective socio-cultural norms. The best predictors of the intention to use a condom are perceived control and individual attitudes for girls while, for boys, individual attitudes come before perceived control. CONCLUSION: In order to design effective programmes for prevention of sexually transmitted infections, the determinants of the intention to use condoms must be considered.

Bilateral hip reconstruction in severe whole-body cerebral palsy: ten-year follow-up results.

The results of a functional, clinical and radiological study of 30 children (60 hips) with whole-body cerebral palsy were reviewed at a mean follow-up of 10.2 years (9.5 to 11). Correction of windsweep deformity of the hips was performed by bilateral simultaneous combined soft-tissue and bony surgery at a mean age of 7.7 years (3.1 to 12.2). We were able to recall 22 patients; five had died of unrelated causes and three were lost to follow-up. Evaluation involved interviews with patients/carers and clinical and radiological examination. The gross motor functional classification system was used to assess overall motor function and showed improvement in seven patients. Of the 12 patients thought to have pain pre-operatively, only one had pain post-operatively. Improved handling was reported in 18 of 22 patients (82%). Those with handling problems were attributed by the carers to growth of the patients. All patients/carers considered the procedure worthwhile. The range of hip movements improved, and the mean windsweep index improved from 50 pre-operatively to 36 at follow-up. The migration percentage and centre-edge angle were assessed on plain radiographs. Radiological containment improved, the mean migration percentage improved from 50 pre-operatively to 20 at follow-up and the mean centre-edge angle improved from -5 degrees to 29 degrees . No statistical difference was noted between the three-year and ten-year follow-up results, indicating that the improvements in clinical and radiological outcome had been maintained.

Haemopericardium causing cardiac tamponade: a late complication of pectus excavatum repair.

A 24 year old man presented to the emergency department with clinical signs of cardiac tamponade requiring emergency surgery. The cause was a sternal wire from a pectus excavatum repair two years previously that had fractured and migrated through the pericardium causing an epicardial injury and a haemopericardium.

Distal recurrence of periosteal osteosarcoma after complete excision of proximal primary tumour with good excision margins.

We present this case of an unusual recurrence of a periosteal osteosarcoma in the distal right tibia 2 years after a successful proximal right tibia primary periosteal osteosarcoma excision with a successful fibular graft. This recurrence lead to a right below-knee amputation.

Characterisation and partial purification of the GABA(B) receptor from the rat cerebellum using the novel antagonist [3H]CGP 62349.

The novel GABA(B) receptor antagonist [3H]CGP 62349 binds rat cerebellar synaptosomal membranes with high affinity at a single population of sites (K(d) = 0.9 nM, B(max) = 760 fmol/mg protein). Solubilisation with 1% Triton X-100/0.5 M NaCl/10% glycerol resulted in a marked increase in [3H]CGP 62349 binding (K(d) = 0.5 nM, B(max) = 1285 fmol/mg protein). Competition of [3HCGP 35348 = CGP 36742. The GABA(A) ligand isoguvacine did not displace [3H]CGP 62349 binding. Partial purification of [3H]CGP 62349 binding sites was obtained by sucrose density centrifugation and a predominant protein in the peak binding fraction was recognised by an anti-GABA(B) receptor antibody and had a molecular weight similar to the recombinant expressed GABA(B)R1a. These results demonstrate that [3H]CGP 62349 provides a useful additional tool for further characterisation of the pharmacology and biochemistry of the native GABA(B) receptor.