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Tyler S. Cole, Kaith K. Almefty, Jakub Godzik, Amy H. Muma, Randall J. Hlubek, Eduardo Martinez-del-Campo, Nicholas Theodore, U. Kumar Kakarla and Jay D. Turner

neurological disease were excluded. All aspects of this study protocol were approved by the local institutional review board prior to patient enrollment. Informed consent for study enrollment was obtained from all patients. Study participation had no bearing on surgical decision-making. Functional Hand Testing All patients were tested by a licensed occupational therapist who performed 3 tests to assess hand function. These tests included palmar dynamometry to measure grip strength, the hydraulic pinch gauge test to measure pinch strength, and the 9-hole peg test (9-HPT) to

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H. Alan Crockard, Turgut Koksel and Nigel Watkin

left side. Its neck lay posterolaterally behind the origin of a very dominant AICA. On the surface of the brain was the sixth nerve arising from its nucleus, which was judged to be distorted and damaged by the aneurysm. The neck of the aneurysm was occluded with a curved variangle McFadden clip using the rotating pistol-grip aneurysm clip applier * that had been especially developed for transoral vascular surgery ( Fig. 2 ). The applier shaft has the capability of axial rotation through 360°, which, in combination with the varied angle capability of the clip

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Kenichi Kono and Tomoaki Terada

obtained in 2008 show vascular malformation through the right posterior communicating artery. Later Presentation Four years after the initial onset of epilepsy, the patient's left-hand grip strength gradually decreased from 60 kg to 0 kg in the course of 1 year. In 2013, the patient could not move his left fingers to any degree. This neurological deficit was localized in his grip, and he had no arm weakness or sensory disturbance. The MRI sequences showed no infarcts ( Fig. 4 ). Angiography studies obtained in 2013 demonstrated that a fuzzy nidus became denser

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Edward D. Hall, Patricia A. Yonkers, John M. McCall and J. Mark Braughler

head-injured mice was examined by means of a grip test. The mice were individually picked up by the tail and placed on a taut string 60 cm in length suspended between two upright metal bars 40 cm above a padded table. Care was taken that both front paws came in contact with the string, thus allowing each mouse an equal chance to grasp the string. The tail was gently released, at which time the mouse either fell, due to inability to hold on, or remained on the string. The length of time the mice could remain on the string in some manner (that is, using one to four

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Susan E. Mackinnon, Brandon Roque and Thomas H. Tung

function and a pinch/grip strength of 6/20 lbs on the right and 11/42 lbs on the left. Multiple treatment options and their risks and benefits were reviewed. The patient was concerned about the morbidity of nerve grafting, the likelihood of poor recovery given the time since injury, and the numerous scars required for tendon transfers as well as nerve graft harvest. She was informed that although a median to radial nerve transfer was a new option, 11 , 12 it was the best chance for her wrist and finger extensors to be reinnervated in a timely fashion. It was decided to

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Tomokazu Takakura, Yoshihiro Muragaki, Manabu Tamura, Takashi Maruyama, Masayuki Nitta, Chiharu Niki and Takakazu Kawamata

function was evaluated before surgery and 1 week, 3 weeks, and 3 months after surgery by an examiner, a board-certified physiatrist. The motor function of each patient was assessed with manual muscle testing (MMT) of shoulder flexion, elbow flexion, wrist dorsiflexion, little finger abduction, and thumb abduction (where 0 indicates no movement and 5 indicates normal strength). 21 Hand motor function was assessed with a grip strength dynamometer (T.K.K.5401, Takei Scientific Instrument Co.). As a numerical index of motor recovery of the contralesional hand, relative

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Bin Xu, Zhen Dong, Cheng-Gang Zhang and Yu-Dong Gu

extension, a brachioradialis muscle transfer is performed for thumb opposition. Through this strategy, patients with C7–T1 brachial plexus palsies have recovered finger flexion, finger extension, and thumb opposition, which has led to successful grasping and pinching motions. 13 However, finger flexion strength after brachialis motor branch transfer has only corresponded to Medical Research Council (MRC) Grades M2–M3, lowering the grip strength and practical value of the reconstructed hand. We determined that the need for finger flexion strength was greater than the need

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Shinji Yamamoto, Ryu Kurokawa and Phyo Kim

solution (compression + vehicle, n = 13 rats); and Group D, the rats underwent polymer sheet implantation and received cilostazol (compression + cilostazol, n = 13 rats). Evaluations of Motor Function Voluntary Exercise Rotations of the wheel attached to the cage were cumulatively recorded in either direction using an odometer. The count was recorded every week. The amount of voluntary exercise after surgery was expressed as a percentage of the average recorded during the 2-week period immediately before the surgery. Forepaw Grip Strength Forepaw grip

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Hirotaka Ito, Keisuke Takai and Makoto Taniguchi

Duration of Symptoms (mos) Presentation Grip Strength (rt/lt, kg) Location of Muscle Atrophy Abnormal EMG Findings (neurogenic changes) 1 20, M 81 lt hand weakness 34/7 lt forearm, hand NA 2 19, M 36 bilat hand weakness 21/25 bilat hands bilat Tri, FCR, FCU, FDI 3 17, M 15 bilat hand weakness 18/3 bilat forearms, hands lt FDI, APB, FCR 4 15, M 6 rt hand weakness 6/30 rt hand rt FCR, EDC, FDI 5 18, M 37 bilat hand weakness 6/19 rt forearm, hand rt FCR, FCU, FDI, EDC, APB 6 23

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Huan Wang, Robert J. Spinner and Anthony J. Windebank

. Results of 5 trials were acquired at each checkpoint for each rat. Grasping Test Grip strength was measured using a previously described method. 33 A grip strength meter (model 1027DSR, Columbus Instruments) with a custom-made, horizontally oriented mesh pull-bar assembly was used to measure grip power of the left forepaw ( Fig. 3A ). The mesh measured 3 × 4.75 in with 1-in 2 grids. The bars of the grids were 0.125 in thick. The digital force gauge had an accuracy limit within 0.25% of the full scale. F ig . 3. Grasping task for measurement of grip