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PART 1

Pre-Reading

Skim the article and say what the subject of the article is and try to understand the general idea of it.

Digestive Diseases and Sciences, Vol. 40, No, 7 (July 1995), pty. 1420-1422

Dermatoglyphic Patterns in Children with Chronic Constipation

ROBERT A. DRONGOWSKI, MS and ARNOLD G. CORAN, MD

Dermatoglyphic patterns, an analysis of the fine ridge configurations on the digits of the palms and soles, theoretically could be used in the diagnostic evaluation of certain medical disorders, since formation of these patterns is under genetic influence (1, 2). Since Galton (3) first systematically studied fingerprints and identified the fundamental formations (arches, loops and whorls), it has been established that certain dermatoglyphic patterns are associated with a number of congenital anomalies (4-9).

A recent report has documented that a specific fingerprint pattern (arches) is seen in association with constipation and abdominal pain. These authors claimed that the fingerprint pattern was useful in distinguishing between functional constipation and constipation secondary to various organic disorders (10). Since we treat a large number of children with constipation (11), we decided to analyze the dermatoglyphic patterns in these patients in an attempt to confirm or refute the above reported association (arches).

MATERIALS AND METHODS

The palmar dermatoglyphic patterns of 161 children with a primary diagnosis of either inguinal hernia (N = 84, controls) or constipation (functional, N = 39; organic, N = 38), seen in the pediatric surgery clinic, were examined. Each digit print was recorded as either an arch, whorl, or ulnar or radial loop (12). Each patient’s fingers were examined with a handheld magnifying glass and permanent records were obtained by using either a standard photocopying machine or the 3M Identifier System (St. Paul, Minnesota), an inkless fingerprint system.

Following each patient’s clinic visit, his/her hospital record was reviewed for the following information: previous medical history, sex, and age. Patients were divided into the following groups: functional constipation (N = 39), organic constipation (N = 38), [secondary to Hirschprung’s Disease (N = 17), im­perforate anus (N = 15) and other intestinal malfor­mations (N = 6)] and inguinal hernia (N = 84). Constipation was defined as a bowel frequency of less than once every two days with associated fecal incon­tinence for a period of no less than three months. All patients with constipation were referred to the pedi­atric surgical service following failed treatment by their referring physicians. Patients with inguinal her­nia had a negative history of constipation determined by hospital record review.

Children were further subdivided into arch posi­tive, ie, those having at least one arch identified on any digit of either hand, and arch negative, ie, those having any combination of loops and/or whorls on all 10 digits.

Informed consent was obtained from the parents in accordance with the standards established by the Hu­man Use Committee prior to data collection.

Statistical analysis was performed on the Michigan Interactive Data Analysis System (MIDAS), using analysis of variance and chi-square contingency table analysis with P < 0.05 considered significant.

RESULTS

There was no statistically significant correlation between arch positivity and functional constipation, organic constipation, and inguinal hernia (P = 0.9211) (Table 1).

There were no significant differences in mean age between the three study groups (P = 0.1822). Addi­tionally, no significant correlation between arch pos­itivity and sex was evident (P = 0.1607) (Table 2).

DISCUSSION

Numerous studies have attempted to correlate dermatoglyphic patterns with various medical conditions, both congenital (1, 4-6) and acquired (7, 13, 14) in origin. The rationale behind such inquiry is obvious: a quick, noninvasive method with which to screen pa­tients suspected of having some predisposition to a variety of diseases. However, in spite of the fact that several papers have been published demonstrating a correlation between dermatoglyphic patterns and specific medical conditions, including sexual dimor­phism (15, 16), the practical application of dermatoglyphics to medical diagnosis has not occurred. This is probably due, in large part, to skepticism by the medical community, a lack of well-controlled confir­matory studies, and the fact that several investigators defined a large number of medical conditions that could be categorized by dermatoglyphic patterns, thus ensuring nonspecificity. Follow-up studies to confirm the association of dermatoglyphic patterns with such disorders as duodenal ulcer (7), rubella (8), fetal wastage (17), pseudohypoparathyroidism (4), and congenital heart disease (9) have been rare. However, a study of dermatoglyphics and leukemia (18) failed to confirm the association of leukemia with a variety of unusual dermatoglyphic patterns reported by pre­vious investigators (19, 20).

Since our general pediatric surgery practice in­volves the care of a large number of children with chronic constipation (12), the study correlating der­matoglyphic patterns with early-onset constipation and abdominal pain aroused our interest (10). How­ever, in our study, no statistical correlation between arches and functional or organic constipation could be shown.

Correlations with sexual dimorphism (15, 16) have been previously reported; however, our study did not show any significant sex differences in the fingerprint analysis.

In conclusion, this study has demonstrated that no significant correlation exists between dermatoglyphic patterns and constipation, both functional and or­ganic. Therefore, the presence of arches on any digit of either hand cannot be used as a screening device for organically caused constipation.

REFERENCES

1. Alter M: Dermatoglyphic analysis as a diagnostic tool. Medi­cine 46:35-56, 1966

2. Cummins H, Midlo C: Fingerprints, Palms and Soles. New York, Doyer, 1961

3. Galton F: Fingerprints. London, Macmillan, 1892

4. Forbes AP: Fingerprints and palm prints (dermatoglyphics) and palmar-flexion creases in gonadal dysgenesis, pseudohypo­parathyroidism and Klinefelter’s syndrome. N Engl J Med 270:1268-1277, 1964

5. Preuss M, Fraser FC: Dermatoglyphics and syndromes. Am J Dis Child 124:933-943, 1972

6. Crawfurd M: Dermatoglyphics in partial C trisomies. Lancet 1:1195-1196, 1968

7. Habibullah CM, Mujahid M, Shivaprakash M, Iqbal MA, Ishaq M: Fingertip and palmar patterns in duodenal ulcer. Hum Hered 32:432-434, 1982

8. Swartz MH, Herman MV, Teichholz LE: Dermatoglyphic pat­terns in patients with mitral valve prolapse: A clue to patho­genesis. Am J Cardiol 38:588-593, 1976

9. Sanchez Cascos A: Finger-print patterns in congenital heart disease. Br Heart J 26:524-527, 1964

10. Gottlieb SH, Schustcr MM: Dermatoglyphic (fingerprint) evi­dence for a congenital syndrome of early onset constipation and abdominal pain. Gastroenterology 91:428-432, 1986

11. Katz C, Drongowski RA, Coran AG: Long-term management of chronic constipation in children. J Pediatr Surg 22:976-978, 1987

12. Hall JG, Froster-Iskenius UG, Allanson JE: Dermatoglyphics and trichoglyphics. In Handbook of Normal Physical Measure­ments. Oxford, Oxford University Press, 1989

13. Miller JR, Giroux J: Dermatoglyphics in pediatric practice. J Pediatr 69:302-312, 1966

14. Achs R, Harper RG, Siegel M: Unusual dermatoglyphic find­ings associated with Rubella embryopathy. N Engl J Med 274:148-150. 1966

15. Balgir RS: Dermatoglyphic studies in affective disorders: An appraisal. Biol Psychiatry 17:69-82, 1982

16. Penrose LS: Memorandum on dermatoglyphic nomenclature. Birth Defects 4:1-13, 1968

17. Rose LI, Gabbe SG, Teichholz LE, Villee DB, Williams GH: Dermatoglyphics associated with fetal wastage. N Engl J Med 287:451-452. 1972

18. Berka L, McClure PD, Sonley MJ, Thompson MW: Dermato­glyphics in childhood leukemia. Can Med Assoc J 105:476 — 482. 1971

19. Verbov JL: Dermatoglyphics in leukaemia. J Med Genet 7:125-131, 1970

20. Rosner F: Dermatoglyphics in leukaemia. Lancet 2:882-883, 1970

Prepare control reading and translation of the extracts in bold.

1. The following coordinators and conjunction words can help you in better understanding of the extracts.

2. Find in the article sentences with the coordinators and conjunction words from 2.1 (5-10 sentences) and translate them into Russian.