as the rest of the fingers.5 Additionally, the thumb may be triphalanged, absent, or simply longer than normal in association with a short forearm which displays limited supination and pronation. All these upper extremity features are combined with an ostium secundum atrial septal defect, thereby completing the salient anatomy of the condition. The patient under current investigation did not ha...

THE ASSOCIATION of atrial septal defect and anomalies of the upper extremities specifically involving one or both thumbs was first reported by Holt and Oram in 1960.1 In that same year, McKusick2 referred to this association in one family and used the term "atriodigital dysplasia" as well as the "HoltOram syndrome." Since that time one family has been reported by Zetterqvist,3 one family by Kuh...

Fatigue has increasingly been viewed by society as a safety hazard. This has lead to increased regulation of fatigue by governments. The most common control process has been compliance with prescriptive rule sets. Despite the frequent use of prescriptive rule sets, there is an emerging consensus that they are hazard control, based on poor scientific defensibility and lack of operational flexibi...

OBJECTIVE Sialography is an important means for evaluating parotid gland damage in patients with Sjögren's syndrome (SS). However, 'conventional' X-ray sialography is invasive and sometimes difficult to perform and repeat, especially for young patients. Recently, magnetic resonance (MR) sialography has been used in adult SS patients. In this study, we investigated the usefulness of MR sialograp...