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Reinnervation of the rat touch dome restores the Merkel cell population reduced after denervation.

By using the fluorescent dye quinacrine as a marker for the Merkel cells in the rat touch dome, we previously showed that a sustained denervation of the dome causes a rapid and persistent loss of about 60% of its Merkel cells [Nurse, Macintyre and Diamond (1984) Neuroscience 11, 521-533]. We now show that if the sensory nerves to the skin are crushed (or cut) in 2-week old pups and allowed to regenerate, the Merkel cell population within touch domes shows a biphasic response; there is an initial loss of Merkel cells associated with the early phase of denervation, followed by an increase, associated with the phase of reinnervation. Physiological tests revealed that many (though not all) domes within initially deafferented skin had become functionally reinnervated and had their Merkel cell numbers either wholly or partially restored some 40-100 days post operatively. In one case an adult reinnervated dome, that appeared normal physiologically and by its complement of quinacrine fluorescent (Merkel) cells, also had normal histological features in toluidine blue sections and normally innervated Merkel cells in the electron microscope. These results, based on the use of quinacrine to visualize the Merkel cell population in the touch dome, suggest that sensory nerves may induce the differentiation of new Merkel cells in domes where these cells have become reduced after denervation.

Animals↗

Touch preparation of breast core needle specimens is a new method for same-day diagnosis.

BACKGROUND: Touch preparation cytology (TPC) has proven to be a quick and accurate intraoperative diagnostic tool for excisional breast biopsy, margins and sentinel nodes. We hypothesized that TPC of core needle biopsy (CNB) specimens can provide a same-day diagnosis in the outpatient setting. METHODS: Outpatients presenting with breast lesions underwent TPC of biopsy cores performed by biopsy gun or vacuum-assisted CNB. The TPC results were compared with the final diagnosis of CNB specimens. RESULTS: In all, 199 CNB and TP were performed between August 1997 and October 2002. Twenty-nine percent of lesions were malignant. Touch preparation was deferred in 21% of cases. In the remaining 157 evaluable cases, TPC had an accuracy of 89% and a false negative rate of 26%. The sensitivity, specificity, positive predictive value and negative predictive value of TPC were 74%, 97%, 93%, and 86% respectively. CONCLUSIONS: Touch preparation cytology on CNB can be performed simply in the outpatient setting. Collaboration between the surgeon and pathologist allows TP to be an accurate means of same-day pathological determination.

Biopsy, Needle↗

Touch imprint cytology and immunohistochemistry for the assessment of sentinel lymph nodes in patients with breast cancer.

AIMS: Accurate evaluation of sentinel nodes is of clinical importance to avoid further surgery for axillary node dissection. A prospective study was carried out to investigate the feasibility and accuracy of touch imprint cytology (TIC) and touch imprint immunohistochemistry (TIHC). METHODS: Two hundred and five sentinel nodes from consecutive 118 patients with primary breast cancer were studied after successful identification of sentinel nodes. Sentinel nodes were sectioned at 2 mm intervals and imprint specimens prepared from all cut surfaces were subjected to Papanicolaou staining and immunohistochemical staining using anti-cytokeratin antibody. RESULTS: Forty-nine sentinel nodes from 40 patients were positive by permanent section. The sensitivity of TIC was 84% (41/49) per sentinel node and 83% (33/40) on a per patient basis. The sensitivity of TIHC was 86% (42/49) per sentinel node and 83% (33/40) on a per patient basis. When the results of TIC and TIHC were combined, the sensitivity was 88% (43/49) per sentinel node and 85% (34/40) on a per patient basis. Among the 156 negative sentinel nodes, four sentinel nodes from four different patients were consistently positive by TIC and TIHC, but only one patient out of 78 node-negative patients was upstaged. CONCLUSIONS: Touch imprint cytology is sufficiently sensitive for intraoperative evaluation of sentinel nodes. A slight improvement in the sensitivity is expected when immunohistochemistry is used. The combination of these methods provides better sensitivity than either method alone.

Adult↗

Fluorescent in situ hybridization in liver cell touch preparations from autopsy.

The objective of the present study was to develop a simplified and low-cost protocol for the investigation of congenital anomalies of chromosomal etiology by fluorescent in situ hybridization (FISH) using probes for chromosomes X, 18, 13/21 in liver cell touch preparations obtained from autopsies performed at the University Hospital of the Faculty of Medicine of Ribeirão Preto. Liver touch preparations were obtained from 11 autopsy cases and fixed in 95% ethanol or methanol:acetic acid (3:1). The FISH technique was carried out according to the protocol of Pinkel with modifications, using probes for chromosomes X, 18, 13/21. There was no significant difference in labeling intensity, quantity of nuclei, or number of signals present per nucleus between the materials fixed with the two fixatives. Similar results were obtained with different times of storage up to 14 months at -20 degrees C. We concluded that the use of touch preparations pretreated with acetic acid and fixed in 95% ethanol represents an efficient, practical, and low-cost method of cell preparation for FISH analysis.

Adult↗

Does the toe-touch test predict hamstring injury in Australian Rules footballers?

This prospective cohort study evaluated the relationship of hamstring and lumbar spine flexibility to hamstring injury. Sixty-seven senior male Australian Rules footballers were videotaped while performing a toe-touch test from erect standing. The Peak Motion Measurement System was used to obtain measurements of end range hip flexion, lumbar flexion, toe-touch distance (TTD) and the ratio of lumbar spine flexion to hip flexion. Over the following football season, eight subjects (11.9 per cent) sustained a hamstring strain. Results showed no significant difference between the hamstring injured or uninjured players for any of the measured variables with no variable able to predict the likelihood of injury (p > 0.05). In this cohort, the toe-touch test would not appear to be a useful screening tool to identify footballers at risk for hamstring strain.

Journal Article↗

Intraoperative mitomycin-C without conjunctival and Tenon's capsule touch in primary trabeculectomy.

OBJECTIVE: To verify whether intraoperative mitomycin C (MMC) without conjunctival and Tenon's touch is effective in inhibiting the development of thin, avascular blebs in eyes undergoing primary trabeculectomy. DESIGN: Noncomparative, interventional study. PARTICIPANTS: Fifteen eyes of 15 consecutive patients undergoing primary trabeculectomy. INTERVENTION: All eyes underwent trabeculectomy with intraoperative MMC (0.25 mg/ml for 3 minutes) without either conjunctival or Tenon's touch. Patients were examined 1 month, 3 months, 6 months, and 12 months after surgery. Intraocular pressure (IOP) and number of medications were evaluated at each examination. The appearance of the bleb was classified at the last examination into one of three groups: flat and vascularized; elevated but not avascular; or elevated, thin, and avascular. MAIN OUTCOME MEASURES: Intraocular pressure, number of antiglaucoma medications, and appearance of the bleb. RESULTS: Preoperative mean IOP was 30.57 +/- 10.92 mmHG: Statistically significant IOP reductions were observed 1 month, 3 months, 6 months, and 1 year after surgery (P < 0.01). Twelve months after surgery, the mean IOP was 14.92 +/- 6.53 mmHG: Five eyes (33.3%) showed an IOP less than 15 mmHg without antiglaucoma medication at the 12-month examination. The bleb was considered elevated, thin, and avascular in 12 of 15 eyes (80%) at the end of follow-up. CONCLUSIONS: Intraoperative MMC at 0.25 mg/ml for 3 minutes without either conjunctival or Tenon's touch was not effective in eliminating the development of thin, avascular blebs in eyes undergoing primary trabeculectomy.

Conjunctiva↗

Does "Touching Four" on the Worth 4-dot test indicate fusion in young children? A computer simulation.

PURPOSE: "Touching four" dots on the Worth 4-dot test is used sometimes as an indication of fusion in young children. The authors examined the reliability of this test. METHODS: A computer simulation of the Worth 4-dot test generated images representing fusion, suppression, and alternate fixation. Sixteen children, ranging in age from 32 to 48 months, were examined using this test. RESULTS: None of the children could accurately describe the images verbally. Alternate fixation could not be distinguished from fusion by asking the subjects to touch the dots. Monocular suppression was identified accurately in all subjects. CONCLUSION: Touching four dots on the Worth 4-dot test does not distinguish fusion from alternate fixation in children with normal ocular alignment. This has important implications regarding the diagnosis of monofixation syndrome and assessment of the response to a prism adaptation trial in young children.

Adaptation, Ocular↗

The efficacy of a filtered handheld far-ultraviolet disinfection device for decontamination of high-touch surfaces in healthcare settings: a genomic bacterial analysis.

BACKGROUND AND OBJECTIVES: Enhanced environmental disinfection is linked to reduced hospital-acquired infection rates. In this study, we aimed to evaluate the efficacy of an emerging disinfection technology, a filtered far-UV-C handheld (FFUHH) device, for reducing bacterial loads on high-touch surfaces in shared clinical workrooms, and to isolate, identify and characterize clinically significant environmental pathogens. METHODS: We compared samples from high-touch items (dictation device, mouse, armchair, desk, and keyboard) before and after FFUHH treatment. Samples were collected weekly: contact plates for colony counts and swabs before and after intervention on standardized adjacent areas for each surface, respectively. The swabs were enriched and cultured on selective media to isolate pathogens. Environmental samples, as well as clinical samples collected from patients during the study period, were validated using MALDI-TOF and whole genome sequencing. RESULTS: Among the 440 collected plates (220 before and 220 after treatment), the highest mean colony count pre-treatment was detected from armchairs, and the lowest from keyboards. The mean reduction of colony-forming units ranged 53% and 83% and was statistically significant (P < 0.05) across all surfaces except for the keyboard. We characterized multidrug-resistant Staphylococcus epidermidis ST5 and ST16 strains, a carbapenem-resistant Acinetobacter baumannii, and a Klebsiella pneumoniae genetically related to a clinical isolate with a rare sequence type not previously detected in our institution. CONCLUSION: The FFUHH effectively reduced the microbial burden on high-touch surfaces. It can offer an advantage for surface disinfection and an alternative to routinely used biocides.

Humans↗

Exact Touch: a new device for cervical cytology. Comparison with Ayre spatula plus Cytobrush.

Exact Touch is a new plastic device for the collection of cells from the ectocervix and endocervix. A total of 189 consecutive women were evaluated, 94 with the Ayre/cytobrush and 95 with Exact Touch. Sampling was performed by only one clinician, and the slides were analysed by only one cytotechnologist, who had no information about the sampling method. Our results showed that more endocervical and metaplastic cells were collected by Exact Touch than by Ayre/cytobrush.

Adult↗

Comparison of two vertical condensation obturation techniques: Touch 'n Heat modified and System B.

AIM: The aims of this study were firstly to compare the area of canal occupied by gutta-percha, sealer or voids using the System B heating device with that obtained by a modified vertical condensation technique using the Touch 'n Heat: and secondly to compare the temperature changes at the root canal wall and external root surface during obturation with the above techniques. METHODOLOGY: Forty-five resin blocks, each with a standardized, simulated, prepared main root canal and five lateral canals, were assigned to three equal experimental groups. The canals were obturated using either the System B technique at two different temperature settings, or vertical condensation with a Touch 'n Heat instrument as the heat source. A heat transfer model was used to simultaneously record internal and external root surface temperature elevations during obturation by the three techniques. Data were analysed using unpaired Student's t-test and Mann-Whitney U-test. RESULTS: Both obturation techniques produced root fillings consisting of over 90% gutta-percha at most levels, although the percentages of sealer and voids 2-3 mm from the working length following System B obturation were higher than those found following modified vertical condensation. Modified vertical condensation resulted in more gutta-percha in lateral canals. Obturation was accomplished more quickly using the System B, and temperature elevations produced during obturation with the System B were significantly less (P < 0.001) than with vertical condensation. An elevation of external root surface temperature by more than 10 degrees C occurred during vertical condensation. CONCLUSIONS: The results suggest that the System B may produce an acceptable obturation and that the use of a Touch 'n Heat source during vertical condensation may result in damage to the periodontium.

Gutta-Percha↗

Evaluation of triple touch. An assessment of program delivery.

Triple Touch is a breast health education program developed by the Florida Division of the American Cancer Society in 1994. The program reaches more Florida women each year, and has a larger group of volunteers, than any other breast cancer program sponsored by this American Cancer Society division. The purpose of the evaluation of Triple Touch was to assess and evaluate the program delivery methods of the program. The specific objectives were to identify and describe instructor characteristics, program delivery patterns, and satisfaction with the program. Results will be used for the following purposes: 1) for the future development and implementation of the Triple Touch program; and 2) for building greatly needed research-based knowledge on program implementation and delivery methods. Last, important lessons were learned from using the Collaborative Evaluation Fellows Project model to conduct evaluation research from all perspectives, including those of the evaluation fellow, the evaluation faculty, and the evaluation facilitator.

Breast↗

A comparison of touch imprint cytology and Mohs frozen-section histology in the evaluation of Mohs micrographic surgical margins.

BACKGROUND: Touch imprint cytology (TIC) is commonly used in the diagnosis of tumors and has been applied to margin analysis of breast lumpectomy specimens with good success. OBJECTIVE: Our purpose was to determine the diagnostic adequacy of TIC for identifying positive and negative Mohs surgical margins for basal cell carcinoma (BCC) excisions, compared with the "gold" standard, Mohs tangential sectioning. METHODS: Fifty-eight patients undergoing 69 Mohs micrographic surgical procedures for biopsy-proven BCC were included in this study between October 1998 and January 1999. Patients were excluded if the neoplasms were of another histologic type, including BCCs with squamous features. One hundred sixty-six touch imprint slides were prepared from 166 fragments of skin tissue excised during MMS. Touch imprint slides were evaluated blindly and independently by two pathologists, one of whom was also a cytopathologist. The slides were diagnosed as positive for tumor, negative for tumor, or, rarely, atypical but suspect for tumor. Discrepancies between the pathologists' interpretations were re-evaluated with the use of a two-headed microscope and a consensus was reached. After all cytologic interpretation was completed, the results were compared with the histologic diagnosis rendered for each fragment of tissue by the Mohs surgeon. RESULTS: The prevalence of a positive margin by histologic confirmation was 55% overall, 60% for recurrent or sclerosing lesions, and 51% for nonsclerosing or recurrent lesions. The overall accuracy of this technique in identifying true positive and true negative margins was 71%. The sensitivity of TIC for identifying a positive margin was approximately 50% for all BCC types. The specificity was approximately 90% for all BCC types. CONCLUSION: TIC is inadequate for identifying positive margins compared with the "gold" standard, MMS.

Adult↗

A biomechanical analysis of the last stride, touch-down and take-off characteristics of the women's long jump.

This study was concerned with the measurement of a selection of performance variables from competitors in the women's long jump final of the World Student Games held in Sheffield, UK in July 1991. Several performances of each of six finalists were recorded on cine-film at 100 Hz. Resulting planar kinematic data were obtained for the last stride, touch-down and take-off. For the analysis, the point of maximum knee flexion was established and this was used to represent the point at which the compression phase had ended. A variety of variables describing the position, velocity and angular changes are presented as descriptive data. In addition, these were used to compute energies on the basis of a whole body model. The data were interpreted on the basis of a technique model of long jumping established from the literature. It was confirmed that take-off velocity was a function of touch-down velocity, and that there was an increase in vertical velocity at the expense of a reduction of horizontal velocity. An attempt was made to identify the mechanisms acting during the touch-down to take-off phase which were responsible for generating vertical velocity. It was concluded that there was evidence for mechanical, biomechanical and muscular mechanisms. The former relates to the generation of vertical velocity by the body riding over the base of support; the second is the elastic re-utilization of energy; and the third is the contribution by concentric muscular contraction.

Biomechanical Phenomena↗

"No-touch" technique using saphenous vein harvested with its surrounding tissue for coronary artery bypass grafting maintains an intact endothelium.

Spasm and consequent dilation of the saphenous vein (SV) for coronary artery bypass grafting (CABG) can be avoided if the vein is harvested with its surrounding tissue. Morphologic techniques, including scanning and transmission electron microscopy, were used to compare endothelial cell integrity using three SV harvesting procedures: conventional (adventitial stripping of the vein, manual distention and storing in saline); intermediate (after adventitial stripping, the vein was left in situ, covered with a papaverine-soaked compress, and stored in heparinized blood); and "no-touch" (SV dissected with its surrounding tissue was left in situ, covered with a saline-soaked compress and stored in heparinized blood). Preservation of endothelial cell integrity was greater with the "no-touch" procedure than with the other methods. Since endothelial cell integrity of SV grafts may affect the patency rate, we conclude that the "no-touch" preparation should improve the results of CABG.

Anticoagulants↗

Rapid cytologic diagnosis of cytomegalovirus interstitial pneumonia on touch imprints from open-lung biopsy.

The diagnostic utility of Wright-Giemsa-stained touch imprints for identifying cytomegalovirus (CMV) in open-lung biopsies from marrow transplant recipients was studied. Of 41 consecutive biopsy specimens, 18 had culturally proven CMV, and 15 had typical intranuclear and intracytoplasmic inclusion bodies on permanent histologic sections. Wright-Giemsa-stained touch imprints from ten of the 15 biopsy specimens with CMV had characteristically enlarged cells containing 20-75 round to oval intracytoplasmic inclusions while only rarely containing intranuclear inclusions. The diagnosis of CMV from Wright-Giemsa-staining imprints (10/15) was superior to hematoxylin and eosin (H & E)-stained touch imprints (5/15) and H & E-stained frozen sections (2/15). Two cases of CMV had Papanicolaou-stained imprints that also demonstrated both intranuclear and intracytoplasmic inclusions. This simple technic of examining cytologic imprints from open-lung biopsy specimens will rapidly identify more than 50% of all confirmed cases of CMV, allowing earlier and possibly more successful antiviral therapy.

Biopsy↗

Accuracy of touch imprint cytology in diagnosing lung cancer.

A 3-year study assessed the diagnostic accuracy of touch imprint smears in the diagnosis of lung cancer. Touch imprint smears were prepared from 90 computerized tomographic-guided core needle lung biopsies. Cytological diagnosis of touch imprint smears were correlated with the histological diagnosis of the corresponding core needle biopsy specimen, which was taken as the gold standard. The sensitivity, specificity, positive predictive value and negative predictive value of imprint smear results were 89%, 100%, 100% and 68%, respectively. There were no false positives, and all patients with small cell lung cancer were correctly diagnosed with this technique. Imprint cytology can be used to provide a rapid, preliminary diagnosis of lung cancer.

Adult↗

The cultural and philosophical aspects of pressure, massage, and touch healing as alternative therapies.

Integrative medicine is becoming more popular, not only in developing nations, but also in countries such as the United States. Acupuncture, which is practiced more than any other kind of alternative medicine, is based on the philosophy and culture of old Chinese healing. Pressure, massage, and touch healing depend on stimulation by the fingers rather than needles, although they are based on acupuncture principles. Touch has social, educational, cultural, and humanitarian aspects. Touch therapy has been shown to have excellent effects on children's growth, development, and emotional well-being. In adults, a 15-minute rubdown by fingertips can lead to relaxation and sleep. It is also useful for premature babies. Such therapies were practiced in the Old World, but have been rediscovered in the New World. They represent some aspects of the old, noble art of healing.

Acupressure↗

Development and evaluation of a quantitative, touch-down, real-time PCR assay for diagnosing Pneumocystis carinii pneumonia.

A rapid (time to completion, <4 h, including DNA extraction) and quantitative touch-down (QTD) real-time diagnostic Pneumocystis carinii PCR assay with an associated internal control was developed, using fluorescence resonance energy transfer (FRET) probes for detection. The touch-down procedure significantly increased the sensitivity of the assay compared to a non-touch-down procedure. Tenfold serial dilutions of a cloned target were used as standards for quantification. P. carinii DNA has been detected in respiratory specimens from patients with P. carinii pneumonia (PCP) and from patients without clinical evidence of PCP. The latter probably represents colonization or subclinical infection. It is logical to hypothesize that quantification might prove helpful in distinguishing between infected and colonized patients: the latter group would have lower copy numbers than PCP patients. A blinded retrospective study of 98 respiratory samples (49 lower respiratory tract specimens and 49 oral washes), from 51 patients with 24 episodes of PCP and 34 episodes of other respiratory disease, was conducted. PCR-positive samples from colonized patients contained a lower concentration of P. carinii DNA than samples from PCP patients: lower respiratory tract samples from PCP and non-PCP patients contained a median of 938 (range, 2.4 to 1,040,000) and 2.6 (range, 0.3 to 248) (P < 0.0004) copies per tube, respectively. Oral washes from PCP and non-PCP patients contained a median of 49 (range, 2.1 to 2,595) and 6.5 (range, 2.2 to 10) (P < 0.03) copies per tube, respectively. These data suggest that this QTD PCR assay can be used to determine if P. carinii is present in respiratory samples and to distinguish between colonization and infection.

Bronchoalveolar Lavage Fluid↗