A Ramle mother of five who suddenly clenched her left hand and was "unable" to open it again for 18 months has been saved from severe harm by surgery at Kaplan Medical Center in Rehovot that opened it again and will prevent her rare "clenched-fist syndrome" from reappearing. But she will need physiotherapy to maximize the function of her hand, said Dr. Avraham Hass, head of the hospital's hand surgery department. The woman, a former immigrant from Kazakhstan who is a university maintenance worker, suddenly felt severe pain in her hand during work, clenched her fist, and said she "couldn't reopen her hand," said Hass. She did not seek help for many months, while her nails grew more than six centimeters in length; these dug into her skin and caused a serious infection. When the patient finally went to a health fund surgeon, he referred her to Kaplan for immediate treatment. Clenched-hand syndrome is considered a psychiatric problem; the victim subconsciously "cannot" open his fist, and if anyone tries to do it for him, it causes severe pain. The condition, which mimics a physical condition called reflex sympathetic dystrophy but has no physical basis, is rare, but some people have been known to hide it. Hass said he tried to open the hand, but the woman screamed in pain. "I remember only one or two such cases in my 30 years in the field," he said. Under general anesthesia, Hass and colleagues cut the taut ligaments in her fingers to give her free movement and prevent her from closing her fist. Plastic surgery also had to be performed, as well as the trimming of her nails with a bone cutter, as they were so thick and hard. Her fingers were put in splints to hold them straight, and she will need a long course of rehabilitation, said Dr. Mordechai Weizentlit, a hand-surgery expert in the department. "The syndrome is an enigma ," concluded Hass. "The reason for a person to refuse to open his hand is not understood, but the damage that results can be very serious and require urgent treatment. We are doing all we can so that our patient will be satisfied when discharged." SMOKELESS IN JAIL Prisoners who smoke should be separated from non-smoking prisoners, according to a lawsuit filed by Physicians for Human Rights-Israel and the Israel Cancer Association (ICA) against the Israel Prison Service in the High Court of Justice. The two organizations said they have received complaints from non-smoking prisoners exposed to smoke in their cells and communal facilities. Many countries, including Britain and numerous states in the US, hold smoking and non-smoking prisoners in different cells. Anat Litvin, director of PHR-Israel's prisoner department, said the Prison Service is harming the health of those for whom it is responsible. Even though incarcerated, a person shouldn't be forced to inhale toxins from a fellow prisoner's cigarettes, she said. ICA chairman Prof. Eliezer Robinson added that everyone has the right not to be exposed to cigarette smoke, which contains 4,000 chemicals, many of them carcinogenic. As prisons are public places, he said, they are covered by laws barring smoking in public places. VITAMIN B12 ISGOOD FOR ORAL SORES A medical team at Ben-Gurion University of the Negev have discovered that a nightly dose of vitamin B12 is a simple, effective and low-risk therapy to prevent recurrent aphthous stomatitis (RAS), better known as "canker sores," which are one of the most common lesions in the mouth. According to lead researcher Dr. Ilia Volkov, as many as a quarter of the public will at some time suffer from them - but until now, there has been no optimal therapeutic approach. Their findings were reported in the January/February issue of the Journal of the American Board of Family Medicine . Volkov, a primary care physician for Clalit Health Services and lecturer at BGU in Beersheba, and colleagues tested the effect of vitamin B12 on 58 randomly selected RAS patients who received either an oral dose of 1,000 mcg of B12 at bedtime or a placebo, and were tested over six months. About three-quarters of the patients in the treated group and only a third of the control group had achieved remission by the end of the study. The average outbreak duration and the average number of ulcers per month decreased in both groups during the first four months of the trial. However, the duration of outbreaks, the number of ulcers and the level of pain were reduced significantly at five and six months of treatment with vitamin B12, regardless of initial vitamin B12 levels. Treated patients expressed greater comfort and reported less pain, fewer ulcers and shorter outbreaks during the six months, while among the control group the average pain level decreased during the first half of the period but increased during the second half. CLINICAL TRIALS IN OXYGEN CHAMBER Assaf Harofeh Medical Center in Tzifin is looking for patients with neurological deficits as a result of traumatic brain injury who want to participate in clinical trials that involve experimental treatment with hyperbaric (high-pressure) oxygen. The trials, which have been approved by the hospital's Helsinki Committee on Human Experimentation, require the patient to sit for an hour at a time in Assaf Harofeh's hyperbaric oxygen chamber, which is conventionally used to treat exposure to carbon monoxide, diabetic foot and "the bends" in divers. Forty sessions of high-pressure oxygen are involved. Applicants must be 16 or older; not have claustrophobia; not have suffered damage to the chest or have inner-ear disease. Would-be patients should call Dr. Shai Efrati at 057-734-6364.