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Development of subcutaneous wound oxygen measurement in humans: contributions of Thomas K Hunt, MD.

When, in the early 1960s, Thomas K. Hunt, MD began investigating the role of oxygen in wound healing, he recognized that translation to humans would require the ability to measure oxygen tension in human wounds. This article will review his contributions to the development of subcutaneous tissue oxygen measurement and to the understanding of wound physiology and oxygen delivery, particularly through use of oxygen measurement. Hunt's major contributions to the field include the observations that all wounds show some degree of hypoxia, while many are severely hypoxic; the degree of hypoxia in wounds is sufficient to impair wound healing, and particularly bacterial killing by neutrophils, collagen deposition, angiogenesis, and epithelization; the sympathetic nervous system plays a central role in decreasing wound oxygen supply; and wound oxygen delivery and wound healing capacity can be increased by controlling the sympathetic nervous system. All these observations required tissue oxygen measurement, and, in particular, translation of basic scientific observations to clinical research required a method of measuring wound oxygen tension in humans.

Cell Hypoxia↗

The tolosa-hunt syndrome: report of two cases.

The Tolosa-Hunt Syndrome consists of intermittent painful ophthalmoplegia resulting from a non-specific inflammatory process in the cavernous sinus and superior orbital fissure, which responds to steroid therapy. We report two additional cases to the literature of the Tolosa-Hunt Syndrome and we are interested in pointing out the importance of orbital venography in the diagnosis of this syndrome. Orbital venography demonstrates the partial occupation of the cavernous sinus and the lack of visualization of the 3rd segment of the superior ophthalmic vein.

Adrenal Cortex Hormones↗

Swelling of the intratemporal facial nerve in Ramsay Hunt syndrome.

Although Ramsay Hunt syndrome is one of the most important diseases causing peripheral facial palsy, the detailed pathology of the disease in the intratemporal facial nerve remains unclear. The purpose of this study was to increase knowledge of the pathogenesis of the syndrome by means of surgical findings. Between April 1976 and March 1997 we performed subtotal decompression of the facial nerve in 74 patients with severe Ramsay Hunt syndrome. The grade of nerve swelling was assessed using a microscope and recorded in a standardized form. The relationships between nerve swelling, the timing of surgery and the swelling of each segment were analyzed. Pronounced neural swelling, involving the geniculate ganglion and the horizontal segment, was consistent finding in the acute phase. Although the incidence of pronounced swelling of the horizontal segment gradually declined with time after onset, in most cases nerve swelling persisted even beyond the 16th week after onset. These data suggest that diffuse viral neuritis occurs throughout the intratemporal facial nerve. We assume that the viral inflammatory swelling involving the geniculate ganglion and horizontal segment is mostly responsible for the acute facial palsy in the acute phase.

Adult↗

The prevalence and epidemiology of cestodes in dogs in Clwyd, Wales. II. Hunting dogs.

Studies of a foxhound pack and gundog kennel in Clwyd, Wales showed 47 of 162 foxhounds (29%) and six of 25 gundogs (24%) to be infested with cestodes. Taeniia species were found in both groups, T. hydatigena being most common. Echinococcus granulosus and Dipylidium caninum were found in hounds only. The husbandry of the dogs was investigated and close relationships were found between diet, worming procedures and cestode infestation. These dogs play an important role in disseminating cestode eggs in the environment. Recommendations for control of the problem are made. Foxhounds and other hunting dogs play a particularly important role in the life-cycle of cestodes because their diet frequently includes uncooked carcasses and because they hunt over large areas of countryside, facilitating the widespread dissemination of infective eggs.

Animal Husbandry↗

TMB-Hunt: a web server to screen sequence sets for transmembrane beta-barrel proteins.

TMB-Hunt is a program that uses a modified k-nearest neighbour (k-NN) algorithm to classify protein sequences as transmembrane beta-barrel (TMB) or non-TMB on the basis of whole sequence amino acid composition. By including differentially weighted amino acids, evolutionary information and by calibrating the scoring, a discrimination accuracy of 92.5% was achieved, as tested using a rigorous cross-validation procedure. The TMB-Hunt web server, available at www.bioinformatics.leeds.ac.uk/betaBarrel, allows screening of up to 10,000 sequences in a single query and provides results and key statistics in a simple colour coded format.

Algorithms↗

Is Tolosa-Hunt syndrome a limited form of Wegener's granulomatosis? Report of two cases with anti-neutrophil cytoplasmic antibodies.

Two patients with recurrent painful ophthalmoplegia due to granulomatous involvement of the intracavernous sinus (Tolosa-Hunt syndrome) had circulating anti-neutrophil cytoplasmic antibodies with a granular cytoplasmic immunofluorescence pattern during a flare-up of the disease. The presence of these antibodies suggests that Tolosa-Hunt syndrome might be regarded as a localized form of Wegener's granulomatosis.

Adult↗

Ramsay-Hunt syndrome and high-resolution 3DFT MRI.

A case of Ramsay-Hunt syndrome has been studied with pre- and postcontrast MR imaging, using a three-dimensional Fourier transform fast imaging with steady precession sequence with axially oriented sections and coronal reformatted images. A clear demonstration of the abnormal enhancement of the labyrinth and of the intratemporal cranial nerves was obtained. This demonstration assisted us in establishing the diagnosis of Ramsay-Hunt syndrome.

Adult↗

Different hunting strategies select for different weights in red deer.

Much insight can be derived from records of shot animals. Most researchers using such data assume that their data represents a random sample of a particular demographic class. However, hunters typically select a non-random subset of the population and hunting is, therefore, not a random process. Here, with red deer (Cervus elaphus) hunting data from a ranch in Toledo, Spain, we demonstrate that data collection methods have a significant influence upon the apparent relationship between age and weight. We argue that a failure to correct for such methodological bias may have significant consequences for the interpretation of analyses involving weight or correlated traits such as breeding success, and urge researchers to explore methods to identify and correct for such bias in their data.

Age Factors↗

Electric organ discharge patterns during group hunting by a mormyrid fish.

Weakly electric fish emit and receive low-voltage electric organ discharges (EODs) for electrolocation and communication. Since the discovery of the electric sense, their behaviours in the wild have remained elusive owing to their nocturnal habits and the inaccessible environments in which they live. The transparency of Lake Malawi provided the first opportunity to simultaneously observe freely behaving mormyrid fish and record their EODs. We observed a piscivorous mormyrid, Mormyrops anguilloides, hunting in small groups in Lake Malawi while feeding on rock-frequenting cichlids of the largest known vertebrate species flock. Video recordings yielded the novel and unexpected finding that these groups resembled hunting packs by being largely composed of the same individuals across days. We show that EOD accelerations accompany prey probing and size estimation by M. anguilloides. In addition, group members occasionally synchronize bursts of EODs with an extraordinary degree of precision afforded by the mormyrid echo response. The characteristics and context of burst synchronization suggest that it may function as a pack cohesion signal. Our observations highlight the potential richness of social behaviours in a basal vertebrate lineage, and provide a framework for future investigations of the neural mechanisms, behavioural rules and ecological significance of social predation in M. anguilloides.

Action Potentials↗

Information flow, opinion polling and collective intelligence in house-hunting social insects.

The sharing and collective processing of information by certain insect societies is one of the reasons that they warrant the superlative epithet 'super-organisms' (Franks 1989, Am. Sci. 77, 138-145). We describe a detailed experimental and mathematical analysis of information exchange and decision-making in, arguably, the most difficult collective choices that social insects face: namely, house hunting by complete societies. The key issue is how can a complete colony select the single best nest-site among several alternatives? Individual scouts respond to the diverse information they have personally obtained about the quality of a potential nest-site by producing a recruitment signal. The colony then deliberates over (i.e. integrates) different incoming recruitment signals associated with different potential nest-sites to achieve a well-informed collective decision. We compare this process in honeybees and in the ant Leptothorax albipennis. Notwithstanding many differences - for example, honeybee colonies have 100 times more individuals than L. albipennis colonies - there are certain similarities in the fundamental algorithms these societies appear to employ when they are house hunting. Scout honeybees use the full power of the waggle dance to inform their nest-mates about the distance and direction of a potential nest-site (and they indicate the quality of a nest-site indirectly through the vigour of their dance), and yet individual bees perhaps only rarely make direct comparisons of such sites. By contrast, scouts from L. albipennis colonies often compare nest-sites, but they cannot directly inform one another of their estimation of the quality of a potential site. Instead, they discriminate between sites by initiating recruitment sooner to better ones. Nevertheless, both species do make use of forms of opinion polling. For example, scout bees that have formerly danced for a certain site cease such advertising and monitor the dances of others at random. That is, they act without prejudice. They neither favour nor disdain dancers that advocate the site they had formerly advertised or the alternatives. Thus, in general the bees are less well informed than they would be if they systematically monitored dances for alternative sites rather than spending their time reprocessing information they already have. However, as a result of their lack of prejudice, less time overall will be wasted in endless debate among stubborn and potentially biased bees. Among the ants, the opinions of nest-mates are also pooled effectively when scouts use a threshold population of their nest-mates present in a new nest-site as a cue to switch to more rapid recruitment. Furthermore, the ants' reluctance to begin recruiting to poor nest-sites means that more time is available for the discovery and direct comparison of alternatives. Likewise, the retirement of honeybee scouts from dancing for a given site allows more time for other scouts to find potentially better sites. Thus, both the ants and the bees have time-lags built into their decision-making systems that should facilitate a compromise between thorough surveys for good nest-sites and relatively rapid decisions. We have also been able to show that classical mathematical models can illuminate the processes by which colonies are able to achieve decisions that are relatively swift and very well informed.

Animal Communication↗

Pyogranulomatous pleuritis with empyema in hunting dogs.

Nine hunting breed dogs were treated for thoracic empyema of undetermined origin. Seven dogs returned to normal health after combined pleural drainage by modified Seldinger technique and long-term chemotherapy. Two were destroyed in the early phase of treatment. One died and one was destroyed due to recurrence. Associated signs in four of the dogs included thoracic wall swellings. In two of these, very small foreign bodies of plant origin were found intrathoracically at surgery. Predominantly anaerobic commensals of the mucous membranes were isolated from pleural exudate. Post-mortem examination in the four cases showed productive, pyogranulomatous intrathoracic inflammation and pleural adhesions. It is proposed that inhaled small plant parts, by synergism with endogenous microorganisms of mucous membrane origin, may be of aetiologic importance in seemingly idiopathic pyogranulomatous pleuritis with empyema in hunting dogs.

Animals↗

Ramsay Hunt syndrome with mental disorder.

This is a case of Ramsay Hunt syndrome with mental disorder. The patient had action myoclonus, grand mal seizure and severe cerebellar ataxia. Schizophrenia-like symptoms including delusion of persecution and self-reference, auditory hallucination and incoherence were characteristically observed before the neurological disturbance became manifest. Subsequently, euphoria, disinhibition, moria and mild dementia appeared with neurological symptoms. The possibility of Ramsay Hunt syndrome to accompany organic mental syndromes and the relationship between cerebellar dysfunction and psychiatric symptoms are discussed.

Adult↗

Hormone replacement therapy and headache prevalence in postmenopausal women. The Head-HUNT study.

Conflicting evidence exists whether hormone replacement therapy (HRT) is a risk factor for headache. The aim of the study was to examine the prevalence of headache and migraine amongst postmenopausal women using HRT. In the Nord-Trøndelag Health Study 1995-97 (HUNT 2), 18,323 (62%) out of 29,679 women aged 40 years or more responded to headache questions (Head-HUNT). Amongst the 6007 postmenopausal women, 5507 (92%) responded to questions regarding use of HRT (2375 used or had used it) and questions related to headache (2407 had complaints). There was a significant association between headache and present use of HRT, both with local [odds ratio (OR) = 1.4, 95% confidence intervals (CI) 1.1-1.7] and systemic (OR = 1.6, 95% CI 1.4-1.9) application. This was found for non-migrainous headache (OR = 1.3, 95% CI 1.1-1.5) and migraine (OR = 1.6, 95% CI 1.4-1.9). Both migraine and non-migrainous headache were more probably amongst users of postmenopausal HRT than amongst those who had never used HRT. Whether HRT caused headache or was used partly because of headache cannot be determined in this cross-sectional study.

Aged↗

Hunting behavior of a marine mammal beneath the antarctic fast Ice

The hunting behavior of a marine mammal was studied beneath the Antarctic fast ice with an animal-borne video system and data recorder. Weddell seals stalked large Antarctic cod and the smaller subice fish Pagothenia borchgrevinki, often with the under-ice surface for backlighting, which implies that vision is important for hunting. They approached to within centimeters of cod without startling the fish. Seals flushed P. borchgrevinki by blowing air into subice crevices or pursued them into the platelet ice. These observations highlight the broad range of insights that are possible with simultaneous recordings of video, audio, three-dimensional dive paths, and locomotor effort.

Journal Article↗

Prognosis of the Ramsay Hunt syndrome.

Thirty-six cases of herpes zoster complicated by facial paralysis (the Ramsay Hunt syndrome) seen over 10 years were reviewed to determine the subjective degree of recovery (ascertained by questionnaire) and residual disability (ascertained by re-examination). Eighteen patients made a full recovery, most within three months; 14 patients were left with only mild residual signs. In only four patients was the final result regarded as unsatisfactory. Outcome was not adversely influenced by age. The facial paralysis of the Ramsay Hunt syndrome thus carries a generally favourable prognosis.

Adult↗

Remittent painful ophthalmoplegia: the Tolosa-Hunt syndrome? A report of seven cases and review of the literature.

Seven patients with remittent painful ophthalmoplegia for which no specific local cause was found were seen during a period of five years. One had coincidental rheumatoid arthritis, and another had actinomycosis of the ipsilateral middle ear and contralateral parotid gland. The other five had no evidence of generalised autoimmune disease nor any other systemic disorder, two having separate episodes affecting each side. A history of relapsing and remitting painful ophthalmoplegia is suggestive of the Tolosa-Hunt syndrome, but it is rarely possible to confirm that the lesion in the cavernous sinus is the result of non-specific granulomatous infiltration so that the diagnosis remains one of exclusion. Carotid arteriography may show narrowing of the intracavernous part of the internal carotid artery. Orbital venography may also be helpful, particularly when the carotid arteriogram is normal. We believe that the Tolosa-Hunt syndrome is more common in England than is generally realised, but that its clinical features do not necessarily indicate a single pathological entity. Its recognition is important since the response to steroids, although not specific, is rapid in most patients, and the prognosis for complete recovery is relatively good.

Actinomycosis↗

Auditory dysfunction in Ramsay Hunt syndrome.

A 48-year-old woman with a Ramsay Hunt syndrome due to herpes zoster had a hearing deficit. Brainstem auditory evoked potentials (BAEPs) localised the site of dysfunction to the ipsilateral eighth nerve. Clinical improvement was associated with improvement of the BAEP. Conventional audiological studies and BAEPs provided no evidence of involvement of the cochlea or the brainstem. In Ramsay Hunt syndrome, BAEPs may help to localise the site of involvement within the auditory pathway and follow the course of the disease.

Auditory Pathways↗