Residual Hair Research Articles

Current treatment and recycling processes of industrial waste from tanneries in Ecuador and the world

This study aims to investigate the recycling and reuse processes of the waste generated by tanneries in Ecuador and the world. High-impact publications and government databases were used to gather relevant information on the topic and, thus, achieve the objective of the study. Several recycling and reuse processes of tannery solid waste were identified, including the production of adhesives, collagen, gelatin, amino acids, biofuels, biogas, and leather lubricants. Additionally, it was found that it is possible to recover chromium salts from wastewater and reuse them. The study also revealed that countries like India, Bangladesh, and China, the primary producers of leather, apply advanced recycling technologies in their tanneries. In contrast, countries like Italy, Germany, and Spain focus more on the chemical conversion of tannery solid waste. In Ecuador, there is a lack of publications on tannery waste recycling, and the few available ones focus on the reuse of trimmings, leather scraps, and the extraction of keratin from residual hair. This lack of interest in proper waste management in tanneries may be attributed to informality and the country's lax enforcement of environmental legislation. In conclusion, it is crucial to regulate the tannery industry sector in Ecuador and promote recycling and reuse processes that will bring economic benefits and sustainability to these industries. This study highlights the need to improve waste management in Ecuadorian tanneries and follow the example of countries that have implemented advanced recycling technologies.

Diffuse Alopecia and Thyroid Atrophy in Sheep.

Simple SummaryThyroid dysfunction substantially affects quality of life, causing disturbances in different organs. A low intake of selenium and zinc can predispose to thyroid changes, resulting in hypothyroidism. A deficiency of selenium and zinc causes thyroid dysfunction and skin lesions. This paper describes natural cases of diffuse alopecia and thyroid abnormalities in sheep with selenium and zinc deficiency. The sheep had severe alopecia, and the thyroid hormones serum concentrations were below the reference values for the species. Zinc and Se concentrations were low in the serum and liver, and the thyroid gland was smaller than normal size. The present study is important as it is the first study examining zinc and Se deficiencies causing hypothyroidism in sheep. Furthermore, thyroid disorders affect the quality of life of humans and animals, and are associated with many organ-specific and non-organ-specific disorders.Thyroid dysfunction substantially affects the quality of life due to its association with various disorders in different organs. A low intake of selenium and zinc can predispose to thyroid alterations, resulting in hypothyroidism. A deficiency of selenium and zinc causes direct and indirect skin lesions, both by the action of free radicals on the skin and by thyroid dysfunction. The aim of this study was to describe natural cases of diffuse alopecia and thyroid abnormalities in sheep with selenium and zinc deficiency. Five adult sheep presented marked and diffuse alopecia, and the residual hairs were dry and brittle. The skin was thick and crusty, with marked peeling. The triiodothyronine (T3) and thyroxine (T4) serum concentrations were below reference values for the species. Zinc and Se concentrations were low in both the serum and liver. During necropsy, cachexia associated with serous fat atrophy was observed, and the thyroid glands showed marked atrophy. Microscopically, the thyroid presented multifocal to coalescent atrophy, with atrophied and dilated follicles, macrophage infiltration, and the presence of fibrous connective tissue. The skin revealed hyperkeratosis and edema. It is concluded that thyroid atrophy, alopecia, and hyperkeratosis are associated with low serum and liver concentrations of zinc and selenium in sheep.

Advances in hearing preservation in cochlear implant surgery.

Advancements in cochlear implant surgical approaches and electrode designs have enabled preservation of residual acoustic hearing. Preservation of low-frequency hearing allows cochlear implant users to benefit from electroacoustic stimulation, which improves performance in complex listening situations, such as music appreciation and speech understanding in noise. Despite the relative high rates of success of hearing preservation, postoperative acoustic hearing outcomes remain unpredictable. Thin, flexible, lateral wall arrays are preferred for hearing preservation. Both shortened and thin, lateral wall arrays have shown success with hearing preservation and the optimal implant choice is an issue of ongoing investigation. Electrocochleography can monitor cochlear function during and after insertion of the electrode array. The pathophysiology of hearing loss acutely after cochlear implant may differ from that involved in delayed hearing loss following cochlear implant. Emerging innovations may reduce cochlear trauma and improve hearing preservation. Hearing preservation is possible using soft surgical techniques and electrode arrays designed to minimize cochlear trauma; however, a subset of patients suffer from partial to total loss of acoustic hearing months to years following surgery despite evidence of residual apical hair cell function. Early investigations in robotic-assisted insertion and dexamethasone-eluting implants show promise.

Response of primary auditory neurons to stimulation with infrared light in vitro

Objective. Infrared light can be used to modulate the activity of neuronal cells through thermally-evoked capacitive currents and thermosensitive ion channel modulation. The infrared power threshold for action potentials has previously been found to be far lower in the in vivo cochlea when compared with other neuronal targets, implicating spiral ganglion neurons (SGNs) as a potential target for infrared auditory prostheses. However, conflicting experimental evidence suggests that this low threshold may arise from an intermediary mechanism other than direct SGN stimulation, potentially involving residual hair cell activity. Approach. Patch-clamp recordings from cultured SGNs were used to explicitly quantify the capacitive and ion channel currents in an environment devoid of hair cells. Neurons were irradiated by a 1870 nm laser with pulse durations of 0.2–5.0 ms and powers up to 1.5 W. A Hodgkin-Huxley-type model was established by first characterising the voltage dependent currents, and then incorporating laser-evoked currents separated into temperature-dependent and temperature-gradient-dependent components. This model was found to accurately simulate neuronal responses and allowed the results to be extrapolated to stimulation parameter spaces not accessible during this study. Main results. The previously-reported low in vivo SGN stimulation threshold was not observed, and only subthreshold depolarisation was achieved, even at high light exposures. Extrapolating these results with our Hodgkin-Huxley-type model predicts an action potential threshold which does not deviate significantly from other neuronal types. Significance. This suggests that the low-threshold response that is commonly reported in vivo may arise from an alternative mechanism, and calls into question the potential usefulness of the effect for auditory prostheses. The step-wise approach to modelling optically-evoked currents described here may prove useful for analysing a wider range of cell types where capacitive currents and conductance modulation are dominant.

Trichobiolight: A new, effective protocol in the treatment of androgenetic alopecia and telogen effluvium.

Androgenetic alopecia (AGA) with its precursor miniaturization of anagen phase (MA) and telogen effluvium (TE) represent nonscarring hair loss diseases which causes moderate to severe aesthetic and psychologic discomfort in affected people. Several therapeutic approaches have been tested through the latest decades, with different degree of success. In this study we aim to analyze the efficacy and outcome of an innovative therapeutic protocol, named TRICHOBIOLIGHT, a combination of active principles conveyed by mesotherapy directly on the scalp with a subsequent photobiostimulation session with LED light (630 nm). About 107 patients (49 women, 58 men, mean age 45-year-old) with clinical and trichoscopic diagnosis of MA, AGA, and TE have been enrolled at Skin Center of L'Aquila, Avezzano and Pescara (Italy) and subsequently treated with the TRICHOBIOLIGHT protocol. 4 patients dropped out at the beginning of the study: 2 patients because of an histological diagnosis of scarring alopecia and lichen scleroatrophicus, and 2 patients dropped out because of adverse reaction to the treatment. Excellent to good outcome have been reached in the 82.5% of patients (85/103), 9 patients (8.7%) reached a sufficient result while 7 patients (6.8%) partially respond to the treatment. Two patients (2%) did not respond at all. TRICHOBIOLIGHT is a promising protocol, working through the combined action of the active principles and the photobiostimulation, that lead to a strengthening and thickening of the residual hair, giving an optical thickening effect that provides high quality aesthetic results and, consequently, appreciable psychological results.

Residual Hair Cell Responses in Electric-Acoustic Stimulation Cochlear Implant Users with Complete Loss of Acoustic Hearing After Implantation.

Changes in cochlear implant (CI) design and surgical techniques have enabled the preservation of residual acoustic hearing in the implanted ear. While most Nucleus Hybrid L24 CI users retain significant acoustic hearing years after surgery, 6-17 % experience a complete loss of acoustic hearing (Roland et al. Laryngoscope. 126(1):175-81. (2016), Laryngoscope. 128(8):1939-1945 (2018); Scheperle et al. Hear Res. 350:45-57 (2017)). Electrocochleography (ECoG) enables non-invasive monitoring of peripheral auditory function and may provide insight into the pathophysiology of hearing loss. The ECoG response is evoked using an acoustic stimulus and includes contributions from the hair cells (cochlear microphonic-CM) as well as the auditory nerve (auditory nerve neurophonic-ANN). Seven Hybrid L24 CI users with complete loss of residual hearing months after surgery underwent ECoG measures before and after loss of hearing. While significant reductions in CMs were evident after hearing loss, all participants had measurable CMs despite having no measurable acoustic hearing. None retained measurable ANNs. Given histological data suggesting stable hair cell and neural counts after hearing loss (e.g., Quesnel et al. Hear Res. 333:225-234. (2016)), the loss of ECoG and audiometric hearing may reflect reduced synaptic input. This is consistent with the theory that residual CM responses coupled with little to no ANN responses reflect a "disconnect" between hair cells and auditory nerve fibers (Fontenot et al. Ear Hear. 40(3):577-591. 2019). This "disconnection" may prevent proper encoding of auditory stimulation at higher auditory pathways, leading to a lack of audiometric responses, even in the presence of viable cochlear hair cells.

A Simple Technique for Intraoperative Scalp Skin Graft Depilation Using Dermabond®.

Skin grafting is an essential aspect of burn and wound reconstruction. Split-thickness skin grafts (STSGs) harvested from the scalp are used for wound and burn reconstruction. Skin grafts from the scalp bear hair and hair particles. Residual hair fragments and pieces of hair in the graft have been associated with many complications, including foreign body reaction similar to pseudofolliculitis and chronic inflammation that can lead to infections. It is important to remove the hair and the hair particles from the scalp graft before its application to the donor site. Traditionally, surgeons have employed some techniques including saline agitation and mechanical removal of the hair particles with forceps. These techniques are time consuming and can subject the graft to mechanical damage. There is another technique that has been described using an adhesive tape. This technique uses Ioban™ (3M Healthcare, St. Paul, MN), followed by a saline wash to remove hair from grafts prior to grafting. In this paper, we introduce a novel technique for intraoperative hair depilation prior to graft application to recipient site. We used Dermabond® (Ethicon, Bridgewater, NJ) to remove residual hair particles from the STSG donor. Our technique has several advantages: it is expeditious, it allows minimal mechanical damage to the graft, and can be used for patients with allergies to Ioban. Intraoperative Dermabond depilation of scalp STSGs is safe, easy, and effective.

Composting treatment of fur waste originating from tannery

The tanning industry generates effluents with a high contaminant load represented in a considerable amount of liquid, solid, and gaseous waste. Solid waste, such as residual hair, fat, and meat, are dumped directly in landfills, triggering serious environmental problems. The objective of this research was to compost this waste, previously desulfurized, in a mixture with remnants from pruning as a bulking agent. This low-cost strategy may reduce the total amount of waste. A composting pile was created using residual hair and pruning remnants in a proportion of 3:1 (w/w) and then an inoculum was added. The waste degrading process ran for 141 days, followed by a maturation period of 64 days. Throughout the process, the temperature, moisture, pH, and electrical conductivity (EC) were monitored. The highest temperature reached was 69.7°C, which secured good disinfection. The EC was 0.27 dS/cm, having lower values than Spanish regulations, possibly due to the salt removal over the irrigation periods. The organic matter content decreased continuously, to reach an endpoint of 42%; this result agrees with the high organic matter content of the tannery waste and the pruning remnants. Germination index was 43.55%, which indicates the presence of phytotoxic substances. As compared to the initial value (10.73%) there was partial degrading of these substances. The challenge is to improve this parameter by identifying new mixtures and adding efficient microorganisms that help to degrade phytotoxic substances.

Loss of inner hair cell ribbon synapses and auditory nerve fiber regression in Cldn14 knockout mice

Proper functioning of the auditory nerve is of critical importance for auditory rehabilitation by cochlear implants. Here we used the Cldn14−/− mouse to study in detail the effects of Claudin 14 loss on auditory synapses and the auditory nerve. Mutations in the tight junction protein Claudin 14 cause autosomal recessive non-syndromic hearing loss (DFNB29) in humans and mice, due to extensive degeneration of outer and inner hair cells. Here we show that massive inner hair cell loss in Cldn14−/− mice starts after the third postnatal week. Immunohistochemical analysis, using presynaptic Ribeye and postsynaptic GluR2 or PSD 95 as markers, revealed the degeneration of full ribbon synapses in inner hair cells from apical cochlear regions already at postnatal day 12 (P12). At P20, significant reduction in number of ribbon synapses has been observed for all cochlear regions and the loss of synaptic ribbons becomes even more prominent in residual inner hair cells from middle and apical cochlear regions at P45, which by then lost more than 40% of all ribbon synapses. In contrast to excessive noise exposure, loss of Claudin 14 does not cause an increase in “orphan” ribbons with no postsynaptic counterpart due to a reduction of postsynaptic structures. Hair cell loss in Cldn14−/− mice is associated with regression of peripheral auditory nerve processes, especially of outer radial fibers, which normally innervate the outer hair cells. The number of spiral ganglion neurons per area, however, was unchanged between the genotypes. Different effects were observed in the cochlear nucleus complex (CNC), the central projection area of the auditory nerve. While the dorsal cochlear nucleus (DCN) showed a significant 19.7% volume reduction, VGLUT-1 input was reduced by 34.4% in the ventral cochlear nucleus (VCN) but not in the DCN of Cldn14−/− mice. Taken together, massive inner hair cell loss starts after the third postnatal week in Cldn14−/− mice, but is preceded by the loss of ribbon synapses, which may be a first sign of an ongoing degeneration process in otherwise morphologically inconspicuously inner hair cells. In addition to the regression of peripheral nerve processes, reduced levels of VGLUT-1 in the VCN of Cldn14−/− mice suggests that Claudin 14 loss does not only cause hair cell loss but also affects peripheral and central connectivity of the auditory nerve.

Laser hair removal following forehead flap for nasal reconstruction.

The forehead flap is a dependable option for nasal reconstruction owing to its reliability and anatomic likeness to nasal skin. For patients with low hairlines, the vertical design of the paramedian forehead flap can intrude into the scalp, thus incorporating hair into the nasal reconstruction. The inadequate length of the forehead flap or shift to an oblique design may result in eyebrow elevation and asymmetry. Therefore, laser hair removal (epilation) on the forehead flap has been proposed to improve esthetic results. An alexandrite laser (755nm, 10 to 20ms, 18-mm spot size) with a Dynamic Cooling Device™ (DCD™) cooling system was used for hair removal in 22 patients (16 male and 6 female patients) after nasal reconstructions using forehead flaps from December 2011 to September 2016. All patients received cryogen spray cooling laser treatment (CSC-LT). The mean follow-up period was 24months, with a range between 18 and 50months. The average duration of treatment was 1.8months (range, 1-5months). The energy density ranged from 14 to 18J/cm2 with an average of 17.2J/cm2. The number of treatments ranged from 2 to 4 (mean 2.8). Patients had satisfactory esthetic results over 11.1months (range, 8-18months). Residual white hairs were observed in 3 patients, and 4 patients had tiny black residual hairs without deteriorating cosmesis. Using an alexandrite laser to remove hair on the forehead is safe and reliable in nasal reconstruction with superior recipient site cosmesis.

Changes over time in the electrically evoked compound action potential (ECAP) interphase gap (IPG) effect following cochlear implantation in Guinea pigs

The electrically-evoked compound action potential (ECAP) is correlated with spiral ganglion neuron (SGN) density in cochlear implanted animals. In a previous study, we showed that ECAP amplitude growth function (AGF) linear slopes for stimuli with a constant interphase gap (IPG) changed significantly over time following implantation. Related studies have also shown that 1) IPG sensitivity for ECAP measures (“IPG Effect”) is related to SGN density in animals and 2) the ECAP IPG Effect is related to speech recognition performance in humans with cochlear implants. The current study examined how the ECAP IPG Effect changed following cochlear implantation in four non-deafened guinea pigs with residual inner hair cells (IHCs) and 5 deafened, neurotrophin-treated guinea pigs. Simple impedances were measured on the same days as the ECAP measures. Generally, non-deafened implanted animals with higher SGN survival demonstrated higher ECAP AGF linear slope and peak amplitude values than the deafened, implanted guinea pigs. The ECAP IPG Effect for the AGF slopes and peak amplitudes was also larger in the hearing animals. The N1 latencies for a constant IPG were not different between groups, but the N1 latency IPG Effect was smaller in the non-deafened, implanted animals. Similar to previously reported results, ECAP measures using a fixed or changing IPG required as many as three months after implantation before a stable point could be calculated, but this was dependent on the animal and condition. For all ECAP measures most animals showed greater variance in the first 30 days post-implantation. Post-implantation changes in ECAPs and impedances were not correlated with one another. Results from this study are helpful for estimating the mechanisms underlying ECAP characteristics and have implications for clinical application of the ECAP measures in long-term human cochlear implant recipients. Specifically, these measures could help to monitor neural health over a period of time, or during a time of stability these measures could be used to help select electrode sites for activation in clinical programming.

A Side-by-Side Study of FUT vs. FUE Graft Availability in the Same Patients and Its Implications on Lifetime Donor Supply and Management

Introduction: One of a patient9s most important goals is meeting expectations of coverage and density. Limited donor supply is a handicap in many patients with respect to achieving this goal. Choosing an approach that maximizes lifetime donor supply would be beneficial. Controversy exists over which technique, or combination of techniques, is best for maximizing donor supply. Some feel that FUE alone is sufficient, while others feel that the use of FUT in combination with FUE may be better in patients requiring greater numbers of grafts. Objective: The goal of this study is to get a better understanding of the difference in donor supply available with FUE only, FUT only, or Combination (“combo”) FUT/FUE. Study Design: A side-by-side study was done in which two patients had FUE only harvested from one side (half) of the head, and FUT only from the other side (half). This “side by side” harvesting was done two times one year apart. The number of hair (grafts) obtained per technique on each side (after two sessions) was recorded along with the “residual hair” density on both sides. From this data, the total amount of hair that FUE only, FUT only, and Combination FUT/FUE could potentially obtain was calculated and compared. Hair Mass Index and Coverage Value were also determined to support the findings. Conclusion: More hair and grafts were obtained using combination FUT followed by FUE than by either technique alone. Although many practitioners feel that using FUE only can take care of the hair loss needs of most patients, there may yet be a population of patients who will benefit from the ability to harvest a higher number of grafts. It is important for hair transplant surgeons to have options available to give patients maximal donor if desired.

A case of folliculotropic mycosis fungoides

A 24-year old man complained that he had been suffered from hair lost on his right occipital scalp for nineteen years. Physical examination showed a localized irregular erythema with hair lost on his right occipital scalp. The lesion was covered with tiny scale,and its temperature was slightly high. Few residual vellus hairs could be seen around the erythema. Histopathological examination showed inflammatory cells (mainly lymphocyte ) infiltrated into follicles and epidermis. Pautrier microabscess could be seen within the follicles. The infiltrated cell were positive for CD3,CD45Ro,LCA,however, negative for CD20 and alcian blue stain. Diagnosis of folliculotropic mycosis fungoides was made.

Decontamination and Management of Contaminated Hair following a CBRN or HazMat Incident.

This in vitro study evaluated the “triple protocol” of dry decontamination, the ladder pipe system (a method for gross decontamination), and technical decontamination for the decontamination of hair following chemical contamination. First, we assessed the efficacy of the 3 protocols, alone or in combination, on excised porcine skin and human hair contaminated with either methyl salicylate (MS), phorate (PHR), sodium fluoroacetate (SFA), or potassium cyanide (KCN). A second experiment investigated the residual hair contamination following decontamination with the triple protocol at different intervals postexposure. In a third experiment, hair decontaminated after exposure to MS or PHR was evaluated for off-gassing. Though skin decontamination was highly effective, a substantial proportion (20%–40%) of the lipophilic compounds (MS and PHR) remained within the hair. The more water-soluble contaminants (SFA and KCN) tended to form much smaller reservoirs within the hair. Interestingly, substantial off-gassing of MS, a medium volatility chemical, was detectable from triple-decontaminated hair up to 5 days postexposure. Overall, the decontamination strategies investigated were effective for the decontamination of skin, but less so for hair. These findings highlight the importance of contaminated hair serving as a source of potential secondary contamination by contact or inhalation. Therefore, consideration should be given to the removal of contaminated hair following exposure to toxic chemicals.

Laparoscopic-assisted removal of gastric trichobezoar by a Novel Technique

Abstract Trichobezoar are mass of hair in the digestive tract caused by ingestion of hairs (trichophagia) mostly as a result of psychiatric disorders. The management of Trichobezoar includes psychiatric treatment to stop trichophagia and removal of trichobezoar for the GIT. Several techniques have been used for removal of Trichobezoar from the gut including endoscopy, laparotomy and laparoscopy. Laparoscopic retrieval is associated with minimal trauma and early recovery. The conventional laparoscopic removal of whole mass of hairs using endobag is associated with contamination of abdominal cavity, larger scars and possible infection. We suggest a simple laparoscopic assisted technique of Trichobezoar removal. In this technique two ports are used one umbilical port and one right abdomen port. The stomach is visualized with the right port used as camera port. Using umbilical port stomach is grasped in an avascular area and pulled out through the umbilicus. The umbilical incision is about 1.5 cm. The stomach is opened along the greater curvature away from the marginal vessels and temporary sutured to umbilical wound. Two langenbeck retractors are used to open the wound A strong grasper is then used to remove the hairs from the stomach piecemeally undirect vision. Any residual hairs are removed by direct visualization of the stomach lumen by the laparoscope. It is possible to retrieve the whole mass by this technique leaving minimal scarring and early recovery. We are reporting this technique in two patient with excellent recovery and minimal scarring.

Virally Mediated Overexpression of Glial-Derived Neurotrophic Factor Elicits Age- and Dose-Dependent Neuronal Toxicity and Hearing Loss.

Contemporary cochlear implants (CI) are generally very effective for remediation of severe to profound sensorineural hearing loss, but outcomes are still highly variable. Auditory nerve survival is likely one of the major factors underlying this variability. Neurotrophin therapy therefore has been proposed for CI recipients, with the goal of improving outcomes by promoting improved survival of cochlear spiral ganglion neurons (SGN) and/or residual hair cells. Previous studies have shown that glial-derived neurotrophic factor (GDNF), brain-derived neurotrophic factor, and neurotrophin-3 can rescue SGNs following insult. The current study was designed to determine whether adeno-associated virus vector serotype 5 (AAV-5) encoding either green fluorescent protein or GDNF can transduce cells in the mouse cochlea to express useful levels of neurotrophin and to approximate the optimum therapeutic dose(s) for transducing hair cells and SGN. The findings demonstrate that AAV-5 is a potentially useful gene therapy vector for the cochlea, resulting in extremely high levels of transgene expression in the cochlear inner hair cells and SGN. However, overexpression of human GDNF in newborn mice caused severe neurological symptoms and hearing loss, likely due to Purkinje cell loss and cochlear nucleus pathology. Thus, extremely high levels of transgene protein expression should be avoided, particularly for proteins that have neurological function in neonatal subjects.

A Life Cycle Assessment on the Dehairing of Rawhides: Chemical Treatment versus Enzymatic Recovery through Solid State Fermentation

SummaryThe leather industry needs to switch from the traditional chemically based dehairing process to an environmentally friendly one so that the overall burdens to the environment are reduced. The primary goal of the work was thus to compare the chemical leather dehairing process to an enzymatically based one using the enzymes that are extracted after the application of solid state fermentation (SSF) on hair wastes generated after dehairing. The environmental burdens of the dehairing stage were determined using a life cycle assessment (LCA) approach by comparing the two aforementioned management scenarios. The first scenario was the commonly used technology in which hair is removed via a chemical process and then composted in open piles. This scenario included two subscenarios where hair waste is either incinerated or landfilled. In the second scenario, the proteolytic enzymes extracted during the SSF of the residual hair are used to dehair the new rawhides instead of chemicals. Industrial and laboratory data were combined with international databases using the SimaPro 8.0 LCA software to make comparisons. The environmental impacts associated with the enzymatic dehairing were significantly lower than the ones associated to the conventional chemical dehairing process. This difference is attributed to the impacts associated with the original production of the chemicals and to the electricity consumed in the conventional method. A sensitivity analysis revealed that the results are affected by the amounts of chemicals used during dehairing.

The Benefits of Residual Hair Cell Function for Speech and Music Perception in Pediatric Bimodal Cochlear Implant Listeners.

Objective The aim of this study was to investigate the benefits of residual hair cell function for speech and music perception in bimodal pediatric Mandarin-speaking cochlear implant (CI) listeners. Design Speech and music performance was measured in 35 Mandarin-speaking pediatric CI users for unilateral (CI-only) and bimodal listening. Mandarin speech perception was measured for vowels, consonants, lexical tones, and sentences in quiet. Music perception was measured for melodic contour identification (MCI). Results Combined electric and acoustic hearing significantly improved MCI and Mandarin tone recognition performance, relative to CI-only performance. For MCI, performance was significantly better with bimodal listening for all semitone spacing conditions (p < 0.05 in all cases). For tone recognition, bimodal performance was significantly better only for tone 2 (rising; p < 0.05). There were no significant differences between CI-only and CI + HA for vowel, consonant, or sentence recognition. Conclusions The results suggest that combined electric and acoustic hearing can significantly improve perception of music and Mandarin tones in pediatric Mandarin-speaking CI patients. Music and lexical tone perception depends strongly on pitch perception, and the contralateral acoustic hearing coming from residual hair cell function provided pitch cues that are generally not well preserved in electric hearing.

Study on External Stimulation and Toxicity of Swelling Analgesic Agent Babu

Through the observation of irritation and allergic swelling analgesic agent Babu, safety evaluation of swelling analgesic agent Babu, and provide experimental basis for clinical application. Intact and damaged skin irritation test and toxicity test in healthy rabbits； To paste the drug into the back of Kunming mice and the experimental group members on the forearm wrist 5cm, Observation of rabbit skin edema and erythema, behavior, fur luster, diet, weight and death; rat hair cover patch area and patch on the residual hair of volunteers, and record the subjects whether the skin white, itching, and comfortable in 24h.Compared with the control group, no obvious swelling analgesic agent Babu plaster irritation to rabbit skin. Residual swelling analgesic agents on Babu rat hair number were significantly decreased (P < 0.01).The number of hairs on the residual Babu agent between the groups showed a relatively balanced. Babu did not show the swelling analgesic agent, itching of skin white.Toxicological study results show that the swelling analgesic agent Babu is safe and non-toxic, compared with rubber swelling analgesic ointment, the advantages of the skin irritation swelling analgesic agent has prominent small Babu, the low rate of allergy and sticking is comfortable, and has a good mucoadhesive property.

Trichotillomania in celiac disease patient refractory to iron replacement

Trichotillomania is characterized by recurring hair pulling behavior and repeated attempts to decrease or stop the behavior. This behavior can cause a trichobezoar, which is a mass of hair found in the stomach. Patients with diagnosed celiac disease may have an urge to swallow their hair due to iron or folat deficiency, which is called pica. We report a case of an 11-year old girl with celiac disease who has had trichotillomania for a duration of 2 years, and required an operation due to residual gastric hair mass. In this case trichotillomania was more likely caused by behavioral disorders secondary to celiac disease, rather than the iron deficiency due to malabsorption.