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Distinct signaling pathways mediate touch and osmosensory responses in a polymodal sensory neuron.

The Caenorhabditis elegans ASH sensory neurons mediate responses to nose touch, hyperosmolarity, and volatile repellent chemicals. We show here that distinct signaling pathways mediate the responses to touch and hyperosmolarity. ASH neurons distinguish between these stimuli because habituation to nose touch has no effect on the response to high osmolarity or volatile chemicals (1-octanol). Mutations in osm-10 eliminate the response to hyperosmolarity but have no effect on responses to nose touch or to volatile repellents. OSM-10 is a novel cytosolic protein expressed in ASH and three other classes of sensory neurons. Mutations in two other osmosensory-defective genes, eos-1 and eos-2, interact genetically with osm-10. Our analysis suggests that nose touch sensitivity and osmosensation occur via distinct signaling pathways in ASH and that OSM-10 is required for osmosensory signaling.

Amino Acid Sequence↗

An event-related brain potential study of cross-modal links in spatial attention between vision and touch.

Event-related potential (ERP) evidence for the existence of cross-modal links in endogenous spatial attention between vision and touch was obtained in an experiment where participants had to detect tactile or visual targets on the attended side and to ignore the irrelevant modality and stimuli on the unattended side. For visual ERPs, attentional modulations of occipital P1 and N1 components were present when attention was directed both within vision and within touch, indicating that links in spatial attention from touch to vision can affect early stages of visual processing. For somatosensory ERPs, attentional negativities starting around 140 ms poststimulus were present at midline and lateral central electrodes when touch was relevant. No attentional somatosensory ERP modulations were present when vision was relevant and tactile stimuli could be entirely ignored. However, in another task condition where responses were also required to infrequent tactile targets regardless of their location, visual-spatial attention modulated somatosensory ERPs. Unlike vision, touch apparently can be decoupled from attentional orienting within another modality unless it is potentially relevant.

Adult↗

The effect of therapeutic touch on behavioral symptoms of persons with dementia.

BACKGROUND: Approximately 80% of nursing home residents who suffer from Alzheimer's disease and related dementia develop behavioral symptoms of dementia. Given the deleterious side effects of pharmacologic therapy in this population there is an urgent need for clinical trials of nonpharmacologic interventions. OBJECTIVE: To examine the effect of therapeutic touch on the frequency and intensity of behavioral symptoms of dementia. METHOD: A randomized, double-blind, three-group experimental study: experimental (therapeutic touch), placebo (placebo therapeutic touch), and control (usual care). Fifty-seven residents, aged 67 to 93 years, exhibiting behavioral symptoms of dementia, were randomized to one of the three groups within each of three Special Care Units within three Long-Term Care facilities in a western Canadian province. Behavioral observation was completed every 20 minutes from 8:00AM to 6:00PM for three days pre-intervention and for three days post-intervention by trained observers who were blind to group assignment. The intervention consisted of therapeutic touch given twice daily for 5-7 minutes for three days between 10:00AM and 11:30PM and between 3:00PM and 4:30PM (N = 57). The main outcome variable was overall behavioral symptoms of dementia, consisting of six categories of behaviors: manual manipulation (restlessness), escape restraints, searching and wandering, tapping and banging, pacing and walking, and vocalization. RESULTS: Analysis of variance (ANOVA) (F = 3.331, P = .033) and the Kruskal-Wallis test (chi2 = 6.661, P = .036) indicated a significant difference in overall behavioral symptoms of dementia, manual manipulation and vocalization when the experimental group was compared to the placebo and control groups. The experimental (significant) was more effective in decreasing behavioral symptoms of dementia than usual care, while the placebo group indicated a decreasing trend in behavioral symptoms of dementia compared to usual care. CONCLUSIONS: Therapeutic touch offers a nonpharmacological, clinically relevant modality that could be used to decrease behavioral symptoms of dementia, specifically manual manipulation (restlessness) and vocalization, two prevalent behaviors.

Aged↗

Objective grading of the loss of pain and touch sensations in leprosy patients.

Two new instruments named Pain/Touch Sensation Testing and Grading devices, which provide standardized and graded stimuli of pain and touch, respectively, were employed to grade the sensory loss at the center of 110 lesions in 97 patients. The grades of sensory loss for pain were 0 (no sensory loss) in 8 lesions, 1 in 6 lesions, 2 in 14 lesions, 3 in 26 lesions, 4 in 19 lesions, and 5 (complete loss) in 37 lesions (total 110 lesions). Grades of sensory loss for touch were 0 in 12 lesions, 1 in 3 lesions, 2 in 5 lesions, 3 in 9 lesions, 4 in 15 lesions, and 5 in 22 lesions (total 66 lesions). Reevaluation done after 2-40 weeks in 46 of these lesions revealed that the grade for pain had decreased in 17 lesions, increased in 4, and remained the same in 25. The grade for loss of touch sensation had decreased in 10, increased in 1, and remained the same in 35. Grading of the sensory loss in most of the 1-cm-square areas of the entire lesion, done in 19 patients (26 lesions), revealed that the sensory loss was not uniform all over the lesion and it was also not maximum at the center of the lesion, though generally it was less at the margin in comparison with the central area. Follow up of 11 of these lesions revealed a decrease in the grades in 7 lesions for both pain and touch sensations, while 2 lesions showed a decrease in the grades for touch sensation only.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

Development of an observational instrument to study nurse-patient touch.

A detailed analysis of videotaped data of nurse-patient interactions (NPIs) was used to identify the structure of NPIs and the important behaviors comprising touching interactions that could serve as a basis for the development of an observational instrument to study nurse-patient touch. The resulting coding system enabled observers to record types of nurse attending, eye gaze, proximity, nurse-patient dialogue, nurse activity, patient condition, presence of others in the room, and characteristics of nurse-patient touch. To evaluate this instrument, two samples of videotaped NPIs were selected and coded by three observers. Acceptable levels of interobserver and intraobserver agreement and observer reliability were established and maintained throughout the coding process, with the exception of two categories (i.e., nurse activity and intensity of touch). The two samples were compared to provide further support for the content validity of the coding system and to evaluate the sensitivity of the measure to the same behaviors in different samples of NPIs. It was concluded that this instrument has potential for use in describing the patterns of touch nurses use in a more comprehensive and detailed way than has been done in the past and that this instrument warrants further study in other clinical contexts.

Clinical Nursing Research↗

Interviewing young children about body touch and handling.

Children aged 3-6 years were interviewed following a scheduled pediatric clinic visit to assess the efficacy of two independent variables--interview strategy and number of interviews--on the accuracy, completeness, and consistency of children's reports. Four experimental interviews were created--a verbal interview and three interviews enhanced with anatomically detailed cues (dolls, line drawings, and computer graphics), photographs, and props. Initially, 130 children were interviewed after the clinic event. One month later, 124 were interviewed again, and 74 were interviewed a third time after 6 months. Children's reports were compared to videotapes and medical records of their pediatric visit in order to create three dependent reporting variables--accuracy, completeness, and consistency. In addition, the predictive power of four sets of covariates on reporting was assessed: (1) age and gender, (2) ethnicity, medical history, family stress, and mother's education; (3) number of invasive medical procedures, number of body touches, health status, and child's pain judgments; and (4) number of outpatient and inpatient visits between the initial and the follow-up interviews at 1 and 6 months. Initially, children's spontaneous reports of body touch were highly accurate, but sparse. After a 1-month delay, accuracy and completeness dropped significantly: accuracy was stable from 1 to 6 months; completeness rebounded at 6 months. Three-year-olds' reports of body touch were less complete and less consistent, but rarely less accurate, than those of older age groups. After 1- and 6-month delays, consistently reported information was more accurate than new information. Children's pain ratings contributed positively to predictions of completeness at the initial and 1-month interviews and to completeness and accuracy at 6 months. Complex events were reported more accurately but less consistently. Anatomically detailed cues in the three enhanced interviews increased completeness of reporting of total body and genital touch. Photos elicited more useful information for identification of persons and places than did questions, while medical props initially offered no advantage and subsequently led to errors. Children's feelings also influenced reporting: higher ratings of anger, sadness, and fright were positively related to reporting of extremely painful touch, while some children who failed to report painful, invasive medical procedures displayed shame when interviewed. The relative privacy of the computer-assisted interview holds promise for disclosure of sexual topics.

Child↗

Touch during preterm infant resuscitation.

Preterm infants frequently require resuscitation in the delivery room. Under the intense circumstances of providing lifesaving interventions, caregivers may be unaware of the amount and kind of touch an infant receives. The purpose of this qualitative, ethologic study was to describe the kinds of touch that occur during resuscitation of premature infants immediately after delivery as viewed on videotape. The convenience sample consisted of ten videotapes of premature infant resuscitation performed at a tertiary care center. Using Spradley's Developmental Research Sequence, a description of kinds of touch--including mechanical and human touch--was developed. Descriptive research conceptualizing touch promotes awareness of current practice and may lead to alterations in clinical practice that best support the adaptive response in the depressed infant.

Humans↗

Sensory function assessment. A pilot comparison study of touch pressure threshold with texture and tactile discrimination.

The purpose of this study was to determine if a correlation exists between touch-pressure threshold testing and sensory discrimination function, specifically tactile gnosis for texture and object recognition. Twenty-nine patients diagnosed with carpal tunnel syndrome (CTS), as confirmed by electromyography or nerve conduction velocity tests, were administered three sensibility tests: the Semmes-Weinstein monofilament test, a texture discrimination test, and an object identification test. Norms were established for texture and object recognition tests using 100 subjects (50 females and 50 males) with normal touch-pressure thresholds as assessed by the Semmes-Weinstein monofilament test. The CTS patients were grouped into three categories of sensibility as determined by their performance on the Semmes-Weinstein monofilament test: normal, diminished light touch, and diminished protective sensation. Through an independent t test statistical procedure, each of the three categories mean response times for identification of textures of objects were compared with the normed response times. Accurate responses were given for identification of all textures and objects. No significant difference (p < .05) was noted in mean response times of the CTS patients with normal touch-pressure thresholds. A significant difference (p < .05) in response times by those CTS patients with diminished light touch was detected in identification in four out of six objects. Subjects with diminished protective sensation had significantly longer response times (p < .05) for identification of the textures of cork, coarse and fine sandpaper, and rubber. Significantly longer response times were recorded by the same subjects for identification of such objects as a screw and a button, and for the shapes of a square, triangle, and oval.

Carpal Tunnel Syndrome↗

No-touch isolation technique in colon cancer: a controlled prospective trial.

In order to assess the effect of the no-touch isolation technique, in the treatment of large bowel cancers, on the site of first recurrence and disease-free and overall survival, 236 patients were prospectively and randomly assigned to either the no-touch isolation technique (117 patients) or to a conventional resection technique (119 patients). No patient with distant metastases or unresectable disease entered the study. The two treatment groups were comparable with regard to patient characteristics. Pre- and postoperative complications (including mortality within 30 days) were similar in both groups. After a complete follow-up of 5 years, a tendency for reduction in the number of, and time to, occurrences of liver metastases was seen in the no-touch isolation group (P = 0.14). This effect was most obvious in the sigmoid colon with angio-invasive growth. Overall (P = 0.42) and corrected (P = 0.25) survival did not differ significantly among the treatment groups although in every analysis the survival data of the no-touch isolation group were superior. The data do suggest a limited benefit of the no-touch isolation technique. This observation is important since the morbidity and mortality of surgery were equal in both groups.

Aged↗

Actions of nicotine on the acquisition of an autoshaped lever-touch response in rats.

Experimentally naive male, Sprague-Dawley rats maintained at 85% of their original body weight were trained to touch a retractable lever that was presented on a random interval 48-s schedule. The lever retracted when touched or after 15 s had elapsed, and one 45 mg food pellet was delivered simultaneously with lever retraction or after an 8-s delay. Rats received ten daily sessions each consisting of ten lever presentations. Nicotine (0.25-0.8 mg/kg SC) administration, either 15 min prior to (pre-session) or immediately after (post-session) the daily autoshaping sessions, caused a significant dose-related impairment of acquisition with the post-session injections having the greater effect. Low doses of nicotine (0.025-0.1 mg/kg SC) had little effect on acquisition when injected pre-session or post-session. Injections of 0.45 mg/kg nicotine either immediately (t = 0) or at +5 min after the daily sessions impaired acquisition of the lever-touch response. Nicotine injected at +15, +30, +60, or +120 min had no effect on acquisition. A single intraventricular injection of the ganglionic blocker chlorisondamine (5 micrograms) 2 weeks prior to autoshaping blocked the impairment produced by 0.45 mg/kg nicotine. Post-session injections of nicotine did not alter the lever-touch behavior of well-trained animals, but suppressed responding in animals that were partially trained. Thus, nicotine-induced impairment of the autoshaped lever-touch response is dose dependent, centrally mediated, occurs within 5 min of a SC injection, and may interfere with post-training consolidation processes.

Animals↗

"No-touch" submuscular saline breast augmentation technique.

This article represents a retrospective view of the author's 17-year experience with 2863 saline implants in 1327 patients and details his "no-touch" technique. The experience included almost an equal number of submammary and subpectoral procedures. The submammary procedures were done early on and were replaced with subpectoral procedures, done exclusively at the present time. There were significantly less complications--capsules, wrinkling (visible folds), and deflations--with the subpectoral procedures. Followup is longer for submammary procedures which could be the reason for the slight difference in number of deflations. Analyzing the results from three different periods, during which the technique changed, the last period in which the no-touch subpectoral technique was used had markedly fewer complications. The no-touch technique, which had been introduced in orthopedic surgery over 50 years ago, was added to the augmentation procedure in an attempt to eliminate any possible contact with skin or breast bacteria. There were no infections in the entire series, and, during the no-touch period, capsules were almost eliminated (0.6%). Saline implants can achieve excellent results when placed subpectorally using the no-touch technique.

Adult↗

No-touch aorta off-pump coronary surgery: the effect on stroke.

OBJECTIVE: Studies examining the neuroprotective effects of off-pump coronary artery bypass grafting have shown inconsistent results. Most studies, however, have not differentiated between clampless and clamp off-pump techniques. The aim of this study was to evaluate the effect of avoiding aortic manipulation on major neurologic outcomes after off-pump coronary artery bypass grafting. METHODS: A total of 700 consecutive patients undergoing multiple-vessel off-pump coronary artery bypass grafting between 2000 and 2003 were included. The 429 patients undergoing aortic no-touch technique were compared with 271 patients in whom partial aortic clamps were applied. The aorta was screened by manual palpation, and epiaortic ultrasonography was used selectively. RESULTS: The frequency of detected atherosclerotic aortic disease was higher in the no-touch group (17.4% vs 5.1%, P < .0001). No-touch revascularization was achieved with arterial conduits, arranged in T-graft or in situ configurations (50%). The respective graft/patient ratios were 2.5 +/- 0.6 and 2.6 +/- 0.6 in the side-clamp and no-touch groups ( P = .009); however, revascularization of the posterolateral myocardial territory was comparable (87% vs 90%, difference not significant). The incidence of stroke (0.2% vs 2.2%, P = .01) was significantly lower in the no-touch group (1/429). Logistic regression identified partial aortic clamping as the only independent predictor of stroke (odds ratio 28.5, confidence interval 0.22-333, P = .009), increasing this risk 28-fold. Peripheral vascular disease ( P = .068), diabetes ( P = .072), and history of stroke ( P = .074) trended toward stroke. CONCLUSIONS: Avoiding partial aortic clamping during off-pump coronary artery bypass grafting provides superior neurologic outcome. The results are reproducible and irrespective of the severity of aortic disease or the method of aortic screening. This technique is recommended whenever technically feasible.

Adult↗

Diagnosis of visceral pleural invasion by lung cancer using intraoperative touch cytology.

BACKGROUND: Invasion to the visceral pleura is an important component of lung cancer staging and an independent prognostic factor. However, the accuracy of pathologic examination depends on how the sections are made, and the pathologist may miss the most invaded part of the pleura. Therefore, we have designed "touch" cytology in an effort to more accurately diagnose the pleural invasion by lung cancer. METHODS: Immediately after thoracotomy, the surface of the visceral pleura just above the tumor was gently touched by a glass slide without scrubbing in 100 patients who simultaneously underwent pleural lavage cytology or cytology of the subclinical pleural effusion. RESULTS: Seventeen percent of the tumors were diagnosed as invading the visceral pleura by touch cytology. Lavage cytology was found to be positive in 7%. In reference to the pathologic examination of the tumor specimen, touch cytology was found to be positive in all of p3, 5 out of 6 of p2, 5 out of 30 of p1, and 5 out of 62 of p0 cases. Touch cytology correctly diagnosed all the positive cases detected by lavage or effusion cytology. CONCLUSIONS: This study suggests that our method is useful in detecting the visceral pleural invasion and raises a possibility that pathologic p0 and p1 lung cancers include a subset of patients with tumor cells exposed on the pleural surface.

Adenocarcinoma↗

Computer-aided video analysis of vertebrofemoral motion during toe touching in healthy subjects.

OBJECTIVE: Despite widespread use of the toe touch test, the relative contribution from vertebral and hip movements has not been clearly established, largely because of unsatisfactory measurement techniques. This study aimed to reinvestigate the kinematics of toe touching by combining computerized videotape analysis with a new model of reference marker placement. METHOD: Twenty-two subjects were videotaped during active toe touching from upright standing. Computer software was then used to derive the sagittal thoracic, lumbar, and hip angles at .02-sec intervals throughout the movement. RESULTS: Hip flexion was directly proportional to toe touch distance (TTD) (r2 = .71) but not lumbar flexion (r2 = .17) or thoracic (r2 = .20) excursion. On average there was .8 degree of thoracolumbar flexion for every 1 degree of hip flexion; however, there were wide variations between subjects. In 19 of 22 subjects the thoracic spine flexed and extended relatively equal amounts during the test resulting in a small total thoracic excursion of 4.8 degrees flexion in unsuccessful toe touchers and 4.0 degrees extension in successful toe touchers. CONCLUSION: The separate contributions of hip, lumbar, and thoracic mobility to toe touching or any other vertebrofemoral motion can only be accurately determined by a measurement strategy that uses the plane of the pelvis to separate vertebral from hip motion and uses tangents at the limits of the thoracic and lumbar regions to separate lumbar from thoracic motion. Using this model the authors found that TTD is not a reliable indicator of either vertebral or hip mobility.

Adolescent↗

Touch-preparation cytologic examination of breast core biopsy specimens: accuracy in predicting benign or malignant core histologic results.

RATIONALE AND OBJECTIVES: The purpose of this study was to determine the accuracy of touch-preparation cytologic examination of breast core biopsy specimens in predicting benign or malignant core histologic results. MATERIALS AND METHODS: One hundred two core biopsies were performed on 88 women with stereotactic or ultrasonographic (US) guidance. Slides were prepared by smearing one core sample on each slide, spraying the slides with fixative, and staining them with the Papanicolaou technique. Slides were blindly reviewed by a cytopathologist. Cytologic results were categorized as positive for malignancy, not diagnostic for malignancy, or insufficient for diagnosis. Results were correlated with histologic results from all specimens obtained during the core biopsy. RESULTS: Imaging depicted the lesions sampled for biopsy as masses (n = 70), clustered calcifications (n = 29), focal asymmetries (n = 2), or architectural distortion (n = 1). Touch-preparation slides of 87 (85%) lesions contained sufficient material for diagnosis. Cytologic results correctly identified 12 of 16 (three of five intraductal and nine of 11 invasive) malignancies in 10 of 13 masses and two of three clusters of calcifications. Two false-positive results occurred, both with fibroadenomas. Overall, touch-preparation studies produced 69 true-negative and four false-negative results. Excluding slides with insufficient material, the sensitivity, specificity, and accuracy of touch-preparation results were 75%, 97%, and 93%, respectively. Including insufficient samples, accuracy was 79%. CONCLUSION: Although touch-preparation cytologic examination of breast core biopsy specimens is fairly accurate in prediction of benign or malignant core histologic results, its correlation with histologic results is not sufficient to justify routine use in immediate counseling and treatment planning.

Adult↗

Preserved endothelial integrity and nitric oxide synthase in saphenous vein grafts harvested by a 'no-touch' technique.

BACKGROUND: The saphenous vein is the most commonly used conduit for coronary artery bypass surgery, but 1-year occlusion rates as high as 30 per cent have been reported. In conventional surgery, considerable damage to the vein occurs during harvesting. The aim of this study was to compare endothelial integrity and nitric oxide synthase (NOS) in saphenous veins harvested by a novel 'no-touch' technique and veins harvested conventionally. METHODS: Immunohistochemistry was used to study endothelial integrity, and a combination of histochemistry and autoradiography was employed to identify NOS in human saphenous veins harvested by conventional and no-touch techniques. RESULTS: The endothelial lining of conventional grafts was reduced compared with that of no-touch grafts (52 versus 73 per cent; P = 0.04). This was associated with a concomitant reduction of NOS availability; NOS was also present in the adventitial vasa vasorum of no-touch vessels. CONCLUSION: Some of the sites with potential for nitric oxide release in vivo are removed during conventional saphenous vein harvesting. These sites were preserved after no-touch harvesting, suggesting the potential to improve coronary artery bypass graft patency.

Aged↗

Genetic interactions affecting touch sensitivity in Caenorhabditis elegans.

At least 13 genes (mec-1, mec-2, mec-4-10, mec-12, mec-14, mec-15, and mec-18) are needed for the response to gentle touch by 6 touch receptor neurons in the nematode Caenorhabditis elegans. Several, otherwise recessive alleles of some of these genes act as dominant enhancer mutations of temperature-sensitive alleles of mec-4, mec-5, mec-6, mec-12, and mec-15. Screens for additional dominant enhancers of mec-4 and mec-5 yielded mutations in previously known genes. In addition, some mec-7 alleles showed allele-specific, dominant suppression of the mec-15 touch-insensitive (Mec) phenotype. The dominant enhancement and suppression exhibited by these mutations suggest that the products of several touch genes interact. These results are consistent with a model, supported by the known sequences of these genes, that almost all of the touch function genes contribute to the mechanosensory apparatus.

Alleles↗

Touch-Sensitive NADH Oxidase Activity of Pea and Cucumber Tendrils and Soybean Hypocotyl Sections.

The cell surface reduced nicotinamide adenine dinucleotide (NADH) oxidase activity of soybean stems and of pea and cucumber tendrils responded to touch with a several-fold increase in activity. The increase in NADH oxidase persisted for 20 min or longer, and further touch stimulation during this period did not alter activity. With soybean sections, the specific activities in response to touch approximated those achieved maximally by auxin. Where the NADH oxidase was fully stimulated by 2,4-d, the NADH oxidase failed to respond further to touch. The findings indicate that the NADH oxidase of the plant cell surface is involved in the growth response to touch and in tendril coiling.

Journal Article↗