Comparing touch senses of naïve and expert panels through treated hair swatches: which associated wordings correlate with hair physical properties?

OBJECTIVES: This study (i) compared the sense of touch between a naïve and expert panels, under visual or blind conditions, using differently treated hair swatches and (ii) explored possible common wordings used by both panels and their possible links with some physical properties of hairs. METHODS: Two sets of 15 hair swatches of Caucasian and Chinese origins were differently treated (bleached, permed, brushed, etc.) or organized (root-tip vs. tip-root). These were evaluated by tactile assessments by two panels (105 naïve consumers and 10 hair experts) under visual or blind conditions, in two geographical locations. A series of 17 defined antonym adjectives, as descriptors, allowed responses of each panel to being scored and their preference mappings to being defined on a like-dislike scale. Hair swatches were measured and assessed by various instrumental techniques (bending, diameter, cuticle cohesion, alignments of hair). RESULTS: Apart from a few overlaps, all 15 hair swatches were well differentiated by both panels which showed a global agreement, making experts reliable assessors. Only three descriptors among 17 correlated with some objective measurements. Tactile-visual assessments differ from those performed tactile blind in both panels. Agreements between both panels appear, however, closer under tactile-blind conditions. CONCLUSION: Trained hair experts were confirmed as reliable representatives of a larger and naïve cohort, viewed as consumers. Hair swatches were well differentiated by both panels, with comparable descriptor rankings.

Nasal Tip Reconstruction Using Integra Bilayer Wound Matrix: An Alternative to the Forehead Flap.

UNLABELLED: Large defects of the nasal tip with exposure of the underlying cartilage pose a significant reconstructive challenge to the plastic surgeon. OBJECTIVE: This article presents a case of a large nasal tip defect following basal cell excision that was successfully treated with Integra bilayer wound matrix and skin grafting. METHODS: Following tumor excision, meshed Integra bilayer wound matrix was placed over the exposed nasal tip cartilage. After 4 weeks, the silicone layer was removed and a full-thickness graft placed on the nasal tip. RESULTS: This reconstruction resulted in the restoration of patient's nasal tip with good contour and color match without the need for a forehead flap. CONCLUSION: This demonstrates the reconstructive potential of this modality in patients who are not candidates for reconstruction with a forehead flap.

Categories of axons in mammalian rami communicantes.

The present study is an electron microscope analysis of the rami communicantes and its purpose is to determine the functional categories of unmyelinate axons in these nerves. Our findings indicate that the grey rami of segments T7, T8, or T9 in the cat consist of approximately 5,000 unmyelinated axons and 20 myelinated axons, and that these axons are post-ganglionic sympathetics. Although the numbers are new data, this conclusion confirms classic work. The white rami from the same segments contain approximately 3,200 unmyelinated axons and 1,600 myelinated axons. 80-90% of the myelinated axons are preganglionic sympathetics and the remainder are presumably sensory. This conclusion is also in confirmation of classic work. The new conclusions are that approximately 30% of the unmyelinated axons are preganglionic sympathetics, approximately 60% seem to be post-ganglionic sympathetics and the surprisingly small remainder may be sensory.

Unmyelinated preganglionic fibers in frog ventral roots.

It has been suggested that the preganglionic visceral fibers in the frog are unmyelinated. To obtain further evidence for this suggestion: (1) the percentages of unmyelinated fibers and the myelinated fiber histograms were done for all frog ventral roots, (2) the number of unmyelinated fibers were counted on either side of a chronic section of the seventh ventral root and (3) compound action potentials were obtained for roots 7-10. The results are that slightly more than 80% of the unmyelinated fibers in the seventh ventral root arise in the spinal cord and are presumably unmyelinated preganglionic efferents. Furthermore, a C fiber volley could be followed from the seventh ventral root into caudal parts of the sympathetic chain. Thus this data provides confirmation for the idea that many frog preganglionic fibers are unmyelinated. This study also shows that 24% of the ventral root axons in the frog are unmyelinated and that, on the basis of percentages of unmyelinated fibers and myelinated fiber histograms, there are five categories of frog ventral roots.

Esophageal compression in association with silicosis and Mycobacterium intracellulare.

An enameler with dysphagia was found to have extrinsic compression of the esophagus by enlarged mediastinal lymph nodes. Scalene lymph node biopsy revealed silicosis, and tissue cultures grew Mycobacterium intracellulare. We believe our patient is the first reported to have dysphagia due to silicotic adenopathy complicated by an atypical mycobacteriosis.

Critical pathway methodology: effectiveness in congenital heart surgery.

Critical pathway methodology has been demonstrated to provide producible reduction in average length of stay (ALOS) in adults in certain diagnostic-related groups and operations such as coronary artery bypass grafting. The efficacy of this approach in congenital heart surgery was explored. Two hundred eighty-six consecutive patients from a health maintenance organization treated by a single surgeon since the institution of diagnostic-related group coding at that health maintenance organization constituted the study group. One hundred fourteen patients were treated at a university hospital without critical pathway methodology (group 1) and 172, subsequently at the health maintenance organization institution using the methodology (group 2). Operation/lesion, age, and diagnostic-related group matching was possible in 61 pairs. Examination of the ALOS Hospital (operative and postoperative days) for the entire cohort revealed a 43.8% reduction in ALOS Hospital (p < 0.0001) and a 39.0% reduction in ALOS Intensive Care Unit (p < 0.0001). There was also significant reduction in ALOS Hospital and ALOS Intensive Care Unit in the operation/lesion-matched subsets. Outcome measures including operative and late mortality, readmission, unscheduled emergency room and clinic visits, and health maintenance organization family assessment survey demonstrated no improvement in outcome with increased hospital stay. Thus, critical pathway methodology when used in patients undergoing a congenital heart operation produces a significant reduction in hospital stay and intensive care unit stay as well as quality patient care with uniformity of outcome.

Decreasing risk of pregnancy loss following chorionic villus sampling. Elimination of transabdominal chorionic villus sampling during the ninth week of pregnancy.

Chorionic villus sampling (CVS) is a method of obtaining fetal cells in the first trimester of pregnancy for genetic analysis. The transcervical (TC) approach was the first technique to be widely used. In the National Institute of Child Health and Human Development collaborative study the absolute loss rate following CVS (the total number of spontaneous abortions and neonatal deaths following CVS) was 4%. More recently the transabdominal (TA) approach has been introduced. This study compares the loss rates for the two approaches at various gestational ages for three 6-month periods following the addition of the TA approach with each other and with the loss rates prior to the introduction of TA CVS. We found that the percentage of pregnancy losses following TA CVS during the ninth week of gestation (63-69 days) was consistently higher than for TC CVS performed at the same gestational age. The loss rate for TC CVS has steadily decreased since the introduction of TA CVS after remaining the same for the two years prior to the introduction of the TA approach. After minimizing the number of TA CVS performed during the ninth week of gestation, the overall loss rate during the most recent 6-month period has been reduced to 0.94%. We conclude that the lowest loss rate following CVS can be obtained if both the TA and TC methods are available, and that the number of TA procedures performed during the ninth week of gestation is minimized.

Drug toxicity and visual fields.

Many drugs used in the treatment of systemic pathologies may cause retinal or neurotoxic side effects which effect visual fields. This paper discusses the role of the drug history, personal health history, and testing procedures in evaluating these toxic visual fields. Specific drugs are cited which may cause toxic visual field defects.

Development of a standardized data base for clinical evaluation.

This paper offers a frank discussion of the difficulties involved in developing a standardized data base. These difficulties include: agreement on diagnostic coding, compliance in input of data, philosophical differences among the schools and colleges of optometry, assessment of clinical competence, and comparison among institutions.

Reye syndrome without initial hepatic involvement.

We report Reye syndrome in an 11-year-old boy whose first symptoms were generalized convulsions and coma without clinical or laboratory evidence of liver disease. Serum glutamic oxaloacetic transaminase and lactate dehydrogenase (LDH) values increased strikingly on the third day after the onset of coma. These enzymatic changes were associated with prolongation of prothrombin time. A rise in blood ammonia concentrations began on the fourth day of coma. The diagnosis of Reye syndrome was confirmed by a liver biopsy and at autopsy. This case demonstrates that encephalopathy in Reye syndrome can develop prior to detectable hepatic involvement, and suggests that factors unrelated to generalized liver damage may occasionally play a role in the pathogenesis of this obscure disorder.

Use of diagnostic pharmaceutical agents and incidence of adverse effects.

A drug registry was established at Southern California College of Optometry (SCCO) to study use rates and incidence of adverse side effects of the nine pharmaceutical agents in the California optometry law. Data were gathered in clinics of SCCO for 6 months and offices of 20 private practitioners for 3 months. Data included drugs used, the strength and dosage, patient age, sex, and racial or ethnic origin. Adverse drug reactions were reported in detail, including objective and subjective findings, duration of the reaction, and case disposition. A total of 12,493 drug applications were reported. A low incidence of adverse reactions, eight cases (0.208%), which produced no permanent effects, is sound evidence regarding the risk/benefit ratio in support of the use of pharmaceutical agents by optometrists.

Reversibility of extensive liver damage in galactosemia.

An infant with galactosemia is reported in whom extensive liver damage developed by 1 month of age. Liver biopsy obtained prior to treatment indicated extensive periportal and intralobular fibrosis, ductular cysplasia. "pseudoglandular" transformation, and distortion of periportal vasculature. Three months after institution of a galactose-free diet, clinical and biological evidence of liver disease disappeared, and follow-up biopsy at 5 months of age showed normal hepatic histology. These findings demonstrate that functional and histological abnormalities consistent with cirrhosis can be completely reversed by dietary management in galactosemia.

Effects of accommodation and repeated applanation tonometry on intraocular pressure.

Previous research on the effects of accommodation and repeated corneal applanations on intraocular pressure (IOP) has yielded inconsistent and conflicting results. Using 30 subjects, this study compares the effects of repeated Goldmann applanation tonometry with accommodation relaxed and with accommodation stimulated. IOP's were also measured after various amounts of long- and short-term accommodation. Repeated applanations with accommodation relaxed had a negligible effect on IOP. However, there was a significant reduction in IOP with accommodation stimulated. These results indicate that the effects of accommodation should be considered in the clinical measurements of IOP.

Achalasia of the esophagus. Pneumatic dilatation in a four-year old boy.

A four-year old boy with achalasia of the esophagus was successfully treated with pneumatic dilatation, using the standard Browne-McHardy dilator, without incident. His subsequent course over 10 months has been uneventful.

Organization of peripheral nerves and spinal roots of the Atlantic stingray, Dasyatis sabina.

1. The sizes and numbers of axons in peripheral nerves and spinal roots were investigated in the stingray, Dasyatis sabina. 2. The axons of the dorsal and ventral roots do not mingle in peripheral nerves of this animal as they do in higher vertebrates. Thus, it was usually possible to split the peripheral nerve into two portions, one containing only dorsal root axons, the other containing only ventral root axons. This feature was useful for the analysis of certain aspects of spinal cord organization. 3. The fact that dorsal and ventral root axons were segregated in peripheral nerves enabled us to demonstrate, without experimental surgery, that the central processes of the dorsal root ganglion cells and the proximal ventral root axons were 10-20% narrower, on the average, than the distal processes of the same dorsal root ganglion cells or the distal parts of the same ventral root axons. 4. The stingray is remarkable in having very few unmyelinated axons in the dorsal roots, ventral roots, or peripheral nerves. This paucity of unmyelinated axons distinguishes the Atlantic stingrays from all other vertebrates whose roots and nerves have been examined for unmyelinated fibers. 5. Similar findings were obtained for one spotted eagle ray (Aetobatus narinari) and two cow-nose rays (Rhinoptera bonasus).

Abnormalities of carbamyl phosphate synthetase and ornithine transcarbamylase in liver of patients with Reye's syndrome.

Urea cycle function was evaluated in liver obtained from six patients with Reye's syndrome and from five control subjects. Reye's syndrome patients demonstrated normal activities for the extramitochondrial portion of the urea cycle, but showed marked abnormalities of the mitochondrial enzymes, i.e., carbamyl phosphate synthetase (CPS) and ornithine transcarbamylase (OTC) (Tables 2,3). CPS activity was reduced to less than 15% of control values in all four patients from whom tissues was obtained during the first 72 hr after the onset of encephalopathy. Two patents from whom tissue was not obtained until after 9 days of symptoms showed no reduction in CPS activity. The OTC activity was also reduced (3-67% of control values) in the four patients from whom tissue was obtained early in the illness. In addition, greater than 60% reduction in Vmax and Km for carbamyl phosphate was noted in all four patients in whom sample size permitted kinetic analysis, including both patients in whom CPS and OTC activity were not markedly reduced. The same kinetic abnormality as well as decreased CPS activity were experimentally produced in normal rate liver incubated in the presence of 1.0 mM 4-pentenoic acid, a short chain fatty acid and known hepatic mitochondrial toxin (Table 4).

Unmyelinated axons in human ventral roots, a possible explanation for the failure of dorsal rhizotomy to relieve pain.

Human ventral roots were examined in the light and electron microscopes. The noteworthy finding is that all roots contain large numbers of unmyelinated axons, and that they make up 27 per cent of the total population of ventral root axons. The function of these unmyelinated axons is not known, but for various reasons it is probable that a significant number are sensory. If so these axons might explain the failure of dorsal rhizotomy to relieve pain, and dorsal root gangionectomy, which would remove both dorsal and ventral root afferents, might be the procedure of choice for those patients where rhizotomy is contemplated.