Correction of the cornrow hair transplant and other common problems in surgical hair restoration

Hair on a man's head is an important emblem of health, youth, and vitality. As in all areas of cosmetic surgery, the refinements of surgical technique and instrumentation have improved the results of hair transplantation. The state of the art in hair grafting today produces a result that is undetectable as being a surgical hair transplant. Many earlier techniques of plug hair transplantation are not aesthetically acceptable by today's standards. This is especially true in the face of progressive hair loss, which can unmask previously camouflaged cornrow plugs. A technique to reduce the plugs and recycle the grafts into smaller grafts is described. The recycled hair grafts can be combined with scalp lifting, scalp reductions, and occipital harvesting of grafts to improve the results of cornrow appearing hair transplants and other problems of surgical hair restoration.     

Temporal bone morphology after systemic arterial perfusion or intralabyrinthine in situ immersion—I. Hair cells of the vestibular organs and the cochlea

The morphological preservation of hair cells of the inner ear was analysed following fixation with intra-arterial perfusion or local intralabyrinthine in situ immersion using six different fixatives of glutaraldehyde (441–876mosm/kg), three fixatives with combinations of glutaraldehyde/paraformaldehyde (917–1196mosm/kg) and 1% osmic tetroxide (346mosm/kg). The influence of added macromolecules such as dextran to the buffer solution was investigated with regard to fixation technique and type of fixative.The best results were obtained when using a direct (local) immersion of the labyrinth with 1% osmic tetroxide. Vascular perfusion is not recommended, independent of type of fixative used. Cochlear outer hair cells and vestibular hair cells type I are more vulnerable to alterations of osmolality and fixation technique than are inner hair cells and hair cells type II.     

A comparison of trace-elemental composition of natural color and gray hair

In order to get some information on the possible causes of graying of hair, we have used the technique of X-ray fluorescence (XRF) analysis for comparing the trace element contents of natural color and gray hair from a number of subjects. The technique of XRF was preferred to other analytical methods for this kind of comparative studies since it appeared to be simple, convenient, quick, and contamination free. Natural color and gray hair from each subject were obtained from the same scalp region. The hair samples were washed in the recommended fashion. The natural color and gray hair from different subjects were mounted separately on hollow plastic cylindrical sample holders, assuring that the hair were parallel to, and not on top of one another. The samples were analyzed in a commercial wave length dispersive XRF system, with different X-ray tubes being used for obtaining maximum sensitivity for different elements. The scattered X-ray peak from each sample was also monitored and gave a measure of the sample volume being investigated. So far, hair samples from 10 subjects have been analyzed. Their results are presented in the paper, and advantages of XRF, for trace element analysis on hair are discussed.     

Depression of the melting temperature by moisture for alpha-form crystallites in human hair keratin

DSC thermal analysis has been carried out for human hair samples with various moisture contents to investigate the melting temperature depression behavior of alpha-form crystallites in human hair. This is achieved by adopting a novel technique using silicon oil as the thermal medium, which permits hair samples to retain a range of moisture contents in between completely dry and fully saturated. The results show that the melting temperature of the alpha-form crystallites in human hair varies with moisture content from 205 degrees C for dry hair to 155 degrees C for the hair sample with moisture content of 23%. These experimental results are particularly useful for clarification of the conceptual ambiguities associated with the molecular properties of alpha-helices and alpha-form crystallites. Furthermore, the Flory-Huggins theory was employed to determine the water-helix interaction parameter (chi = 4.5) and the alpha-form crystallinity of human hair (22%), a figure consistent with that obtained by the XRD method (21%).     

Protein biosynthesis in cultured human hair follicle cells

A new technique has been used for culturing human keratinocytes. The cells grow on the basement membrane-like capsules of bovine lenses. Lens cells were removed from the capsules by rigid trypsinization. In order to exclude any contamination with remaining living cells the isolated capsules were irradiated with X-rays at a dose of 10,000 rad. In this way human epithelial cells can be brought in culture from individual hair follicles. Since feeder cells are not used in this culture technique, the biosynthesis of keratinocyte proteins can be studied in these cultures. The newly synthesized proteins can be separated into a water-soluble, a urea-soluble, and a urea-insoluble fraction. Product analysis has been performed on the first two fractions revealing protein patterns identical to those of intact hair follicles. Product analysis of the urea-soluble fractions of microdissected hair follicles shows that the protein pattern of the cultured keratinocytes resembles the protein pattern of the hair follicle sheath. Studies on the metabolism of benzo(a)pyrene revealed that the enzyme aryl hydrocarbon hydroxylase (AHH) is present in cultured hair follicle cells. A possible use of our culture system for eventual detection of inherited predisposition for smoking-dependent lung cancer is discussed.     

Spatial organization in the saccule and lagena of a teleost: hair cell pattern and innervation

The relationship between the hair cell orientation pattern and innervation in the saccule and lagena of the teleost Helostoma temmincki (the kissing gourami) was investigated with scanning electron microscopy and the Winkelmann-Schmitt silver impregnation technique. The hair cell pattern in the saccule consists of four orthogonally oriented groups. The anterior two groups are oriented along the animal's rostrocaudal axis, and the posterior two are oriented along its dorsoventral axis. The pattern of hair cell orientations in the lagena is a typical bidirectional one. Two divisions of the eighth nerve innervate the saccule. The anterior division innervates the horizontally oriented hair cell groups, and the posterior division innervates the dorsoventrally oriented groups. A single nerve innervates the lagena, with the majority of fibers innervating one or the other of the two lagenar hair cell groups. The segregated pattern of innervation according to hair cell orientation groups in the saccule was confirmed in other species. Individual types of axonal terminations appear to innervate hair cells of specific ciliary bundle types.     

Scanning Electron Microscopic Observation of Symbiotic Relationship of Azolla-Anabaena AzoUae During the Vegetative Growth

The occurrence and development of the hair ceils on the shoot tips and in the leaf cavities of A. filiculoides, A. microphylla, A. pinnata and their algae-free cultures were examined by means of scanning electron microscopy with microdissect technique. The patterns of Anabacna moving into the leave cavities from the shoot tips were investigated on three species of Azolla during their vegetative growth. The results showed that the patterns of symbiotic Anabaena infecting the leaf cavities are similarity among three species of Azolla and may be divided to the four phases which are summarized as follows: 1. occurrence of primary branched hair and adhesion of Anabaena; 2. development of primary branched hair and spreding of Anabaena; 3. building of hair bridge and entrance of Anabaena into the cavities; 4. formation of secondary simple hair and transference of Anabaena within the cavity. These observations resulted in a hypothesis that hair induces and leads its partner. It is suggested that the hair cell is likely to be a structure of Azolla for attracting and recognizing its symbiont in addition to transport substance between fern and algae.     

Electrochemical determination of femtomole amounts of free reduced and oxidized glutathione: Application to human hair follicles

A simple and sensitive high-performance liquid chromatographic technique has been developed for the quantification of free reduced and free oxidized glutathione in biological samples. After acidic extraction and isocratic separation of the compounds of interest on a reversed-phase column, both forms of glutathione are quantified with a coulometric detector working in the oxidative mode. The limit of detection is 125 fmol for reduced glutathione and 400 fmol for the oxidized form (signal-to-noise ratio of 3). This sensitivity allows the measurement of the small amount of glutathione present in a single hair follicle. The technique is well adapted to microsamples, i.e. for non-invasive sampling technique (hair, skin, tears, etc.) and can be adapted to various cells or tissues.     

Ultrastructural localization of S100A3, a cysteine-rich, calcium binding protein, in human scalp hair shafts revealed by rapid-freezing immunocytochemistry.

We have characterized the subcellular distribution of S100A3, a cysteine-rich calcium binding protein, in human scalp hair shaft. This was accomplished using rapid-freezing immunocytochemistry, a technique that combines rapid-freezing, freeze-substitution fixation without chemical fixatives, and subsequent electron microscopic detection of immunocytochemical labeling. This technique preserves both the antigenicity and the ultrastructural integrity of fully keratinized tissues, which are highly unmanageable when prepared for immunoelectron microscopy. In the hair shaft, S100A3 was primarily identified in the endocuticle and was also present in the intermacrofibrillar matrix surrounding macrofibril bundles of intermediate filament keratins in cortex cells. Double immunolabeling of S100A3 and hair keratins revealed the in situ spatial relationship between them. In the endocuticle, S100A3 was present on the inner portion of the endocuticle adjacent to the cell membrane complex, whereas hair keratins were present on the outer portion. These results provide the first ultrastructural evidence that an S100 protein is localized in specific subcompartments in human hair cells. (J Histochem Cytochem 47:525-532, 1999)     

Immunocytochemical detection of triphosphoinositide in vestibular hair cells

Triphosphoinositide (TPI), an aminoglycoside receptor and a possible regulator of cationic permeation through its ability to bind with Ca++, was localized by the protein-A gold technique in vestibular sensory epithelia using an antibody highly specific to TPI. TPI was detected on the stereocilia, kinocilia, and cuticular plate of hair cells, and in the reticular membrane of supporting cells. The cilia of hair cells are damaged by aminoglycosides at a relatively early stage of toxicity. Ca++-regulated bioactivity in this area is probably involved.     

Seasonal Hair Growth in the Adult Domestic Cat (Felis catus)

Determination of amino acid requirements by the factorial method requires an estimate of the amount of amino acids required for the replacement of hair. Hair growth rates in a total of 39 adult male and female domestic short-haired cats were determined throughout the year using the mid-side patch technique. The ratio of hair on the mid-side area to total hair on the body was also determined to allow conversion of mid-side hair growth rates to hair growth rates over the entire body. The mid-side hair growth rate showed a sinusoidal pattern throughout the year, similar to that found for day length and daily mean air temperature, with a maximum hair growth rate of 289 μg/cm²/day in summer and a minimum hair growth rate of 62 μg/cm²/day in winter. The peak hair growth rate for the female cats was reached earlier than that for the male cats. Sine-functions describing day length, minimum and maximum daily air temperatures and daily hair growth rates are presented. Adult domestic short-haired cats were found to grow 32.7 g of hair per kg body weight per year. Monthly amounts of hair growth per unit of body weight and body surface area are calculated.     

Involvement of follicular stem cells in forming not only the follicle but also the epidermis

The location of follicular and epidermal stem cells in mammalian skin is a crucial issue in cutaneous biology. We demonstrate that hair follicular stem cells, located in the bulge region, can give rise to several cell types of the hair follicle as well as upper follicular cells. Moreover, we devised a double-label technique to show that upper follicular keratinocytes emigrate into the epidermis in normal newborn mouse skin, and in adult mouse skin in response to a penetrating wound. These findings indicate that the hair follicle represents a major repository of keratinocyte stem cells in mouse skin, and that follicular bulge stem cells are potentially bipotent as they can give rise to not only the hair follicle, but also the epidermis.     

The in vitro use of the hair follicle closure technique to study the follicular and percutaneous permeation of topically applied drugs

Recent studies on follicular permeation emphasise the importance of hair follicles as diffusion pathways, but only a limited amount of data are available about the follicular permeation of topically applied drugs. This study examines the use of a hair follicle closure technique in vitro, to determine the participation of hair follicles in transdermal drug penetration. Various substances, with different lipophilicities, were tested: caffeine, diclofenac, flufenamic acid, ibuprofen, paracetamol, salicylic acid and testosterone. Diffusion experiments were conducted with porcine skin, the most common replacement material for human skin, in Franz-type diffusion cells over 28 hours. Different experimental settings allowed the differentiation between interfollicular and follicular permeation after topical application of the test compounds. A comparison of the apparent permeability coefficients of the drugs demonstrates that the percutaneous permeations of caffeine and flufenamic acid were significantly higher along the hair follicles. In the cases of paracetamol and testosterone, the follicular pathway appears to be of importance, while no difference was found between interfollicular and follicular permeation for diclofenac, ibuprofen and salicylic acid. Thus, the hair follicle closure technique represents an adequate in vitro method for gaining information about follicular or percutaneous permeation, and can replace in vivo testing in animals or humans.     

Dissection of Adult Mouse Utricle and Adenovirus-mediated Supporting-cell Infection

Hearing loss and balance disturbances are often caused by death of mechanosensory hair cells, which are the receptor cells of the inner ear. Since there is no cell line that satisfactorily represents mammalian hair cells, research on hair cells relies on primary organ cultures. The best-characterized in vitro model system of mature mammalian hair cells utilizes organ cultures of utricles from adult mice (Figure 1) ^1-6. The utricle is a vestibular organ, and the hair cells of the utricle are similar in both structure and function to the hair cells in the auditory organ, the organ of Corti. The adult mouse utricle preparation represents a mature sensory epithelium for studies of the molecular signals that regulate the survival, homeostasis, and death of these cells.Mammalian cochlear hair cells are terminally differentiated and are not regenerated when they are lost. In non-mammalian vertebrates, auditory or vestibular hair cell death is followed by robust regeneration which restores hearing and balance functions ^{7, 8}. Hair cell regeneration is mediated by glia-like supporting cells, which contact the basolateral surfaces of hair cells in the sensory epithelium ^{9, 10}. Supporting cells are also important mediators of hair cell survival and death ¹¹. We have recently developed a technique for infection of supporting cells in cultured utricles using adenovirus. Using adenovirus type 5 (dE1/E3) to deliver a transgene containing GFP under the control of the CMV promoter, we find that adenovirus specifically and efficiently infects supporting cells. Supporting cell infection efficiency is approximately 25-50%, and hair cells are not infected (Figure 2). Importantly, we find that adenoviral infection of supporting cells does not result in toxicity to hair cells or supporting cells, as cell counts in Ad-GFP infected utricles are equivalent to those in non-infected utricles (Figure 3). Thus adenovirus-mediated gene expression in supporting cells of cultured utricles provides a powerful tool to study the roles of supporting cells as mediators of hair cell survival, death, and regeneration.     

Immunocytochemical detection of triphosphoinositide in vestibular hair cells

Summary Triphosphoinositide (TPI), an aminoglycoside receptor and a possible regulator of cationic permeation through its ability to bind with Ca⁺⁺, was localized by the protein-A gold technique in vestibular sensory epithelia using an antibody highly specific to TPI. TPI was detected on the stereocilia, kinocilia, and cuticular plate of hair cells, and in the reticular membrane of supporting cells. The cilia of hair cells are damaged by aminoglycosides at a relatively early stage of toxicity. Ca⁺⁺-regulated bioactivity in this area is probably involved.     

Freeze-fracture study of the lateral-line canal organ of the Japanese sea eel,Lincozymba nystromi

Summary Specializations of apical surfaces of hair cells, supporting cells and marginal cells in the lateral-line canal organ of Japanese sea eel, Lincozymba nystromi, were examined with a freeze-fracture technique. Apical surfaces of hair cells have a lower density of intramembrane particles (IMP) than those of the surrounding supporting cells. Density of IMP on the streocilia is almost the same as that on the apical surface of hair cells. Junctions between hair and supporting cells were tighter than those between two supporting cells; those between supporting and marginal cells were tighter than those between hair and supporting cells, and those between two marginal cells were the tightest in the lateral-line canal organ.     

Formation of hair follicles from a single-cell suspension of embryonic rat skin by a two-step procedure in vitro

Summary A technique for culturing skin was devised whereby hair follicles in a normal state were generated from a single-cell suspension of embryonic rat skin. Dissociated cells obtained by trypsinization of the day-15 embryonic lip were cultured by a two-step procedure in vitro. Reorganization of hair-follicle rudiments was accompanied by reaggregation of the cells during a 24-hour initial culture with rotation, and the rudiments differentiated into hair follicles within a week during subsequent subculture of the cell aggregates by floatation. The light-microscopic features and the size of the follicles were similar to those of day-18 vibrissa follicles during normal development in vivo. Furthermore, the stratification of cells, including subcellular differentiation, and the ultrastructure of the hair follicles generated in vitro were similar to those of normal hair follicles with well-keratinized hair shafts. The present system appears to be a useful model for analytical studies in vitro on the formation of hair follicles and for studies designed to facilitate the transplantation of human hair.     

Assaying progesterone,estradiol and cortisol concentrations in hair of Père David deer hinds: an alternative way to reflect seasonality of steroid secretion

The use of a hair hormone concentration assay is increasingly recognized as a useful and noninvasive technique for monitoring the endocrinological status of animals. However, few studies have focused on reproductive and stress hormones together. We used a chemiluminescent immunoassay to determine whether the progesterone, estradiol, and cortisol concentrations could be measured from hair and whether these hormone concentrations varied in different hair segments of captive Père David deer hinds. We found that progesterone, estradiol, and cortisol could be measured in the hair samples and that the progesterone concentration varied but the estradiol and cortisol concentrations did not among different hair segments. Contrary to the segmental decline in hair cortisol found in many studies, we found that progesterone concentration was higher near the tip than at the base of hair in Père David deer. This suggests that the variation in segmental hair steroid hormone concentration in seasonal molting animals may be mainly due to internal reproductive cycles and that hair steroid hormones may reflect long-term physiological changes and can thus be used for the conservation and management of wildlife.     

Responses of hair cells to statocyst rotation

A new technique is described for stimulating hair cells of the Hermissenda statocyst. The preparation and recording apparatus can be rotated at up to 78 rpm while recording intracellular potentials. Hair cells in front of the centrifugal force vector depolarize in response to rotation. Hair cells in back of the centrifugal force vector hypoerpolarize in response to rotation. Mechanisms by which the hair cell generator potential might arise are examined.     

Hair transplantation for men with advanced degrees of hair loss

In the field of surgical hair restoration, there is probably no greater challenge than treating the individual with advanced male pattern hair loss. Recent developments in follicular unit grafting and recognition of the natural appearance of the transplanted frontal forelock have now made it possible to obtain excellent, undetectable results in these patients. Over a 22-month period, the onset correlating with the time when the author began to use the technique of follicular unit grafting, 61 of 322 hair transplant procedures (approximately 20 percent) performed for male pattern hair loss were on men with, or at high risk of developing, advanced male pattern hair loss. Uniformly, the creation of some type of frontal forelock provided excellent results and high patient satisfaction. The concept of the frontal forelock is not new. Developments in aesthetic principles, enhanced understanding of its applicability, and the applied advantages of follicular unit grafting allow for the first time, truly undetectable results.