The self-mutilative nature of severe onychophagia: a comparison with self-cutting.

OBJECTIVE: To investigate the psychophysiological pattern associated with severe and mild onychophagia, and to compare this pattern with that demonstrated by previous research on self-cutting. METHOD: Comparisons between the psychophysiological responses accompanying 3 behaviours were made using a guided imagery methodology. Imagery of nail-related, skin-cutting, and neutral events were presented in 4 stages. RESULTS: Experiment I distinguished participants exhibiting severe and mild onychophagia by the severity and frequency of nail-biting and by the pattern of psychophysiological response across the stages. Experiment II indicated that the change in psychophysiological arousal accompanying severe onychophagia was not as dramatic as that demonstrated for skin-cutting. The behaviour seems to be less effective in reducing tension. CONCLUSION: Severe onychophagia appears to manage the level of tension experienced by an individual, instead of dramatically reducing it in times of crisis. Such a process is consistent with that demonstrated in individuals with obsessive-compulsive disorder.

Severe morbid onychophagia: the classification as self-mutilation and a proposed model of maintenance.

OBJECTIVES: The aim of this review is to make a distinction between a mild and a severe form of onychophagia (nailbiting) that has not been adequately recognised in clinical research. Furthermore, the aim is to emphasise the need for greater understanding of the motivation for such self-injury as occurs in the severe form. The purpose of making the distinction is to evaluate whether a label of self-mutilation can be applied to the severe form. If this is the case, the tension-reduction model of self-mutilation can be proposed as the mechanism which may maintain the behaviour in the face of serious social and physical consequences. METHOD: Examination was made of the literature relating to onychophagia and to self-mutilation. Treatment studies of onychophagia were examined to evaluate the mechanisms by which the behaviour may be maintained. RESULTS: Considering the self-mutilative nature of the severe form and the common theme of tension reduction in the literature on onychophagia, application of the tension-reduction model of self-mutilation is warranted. CONCLUSION: There is a need for empirical research as to the tension-reducing nature of severe onychophagia.

Wheelchair-mounted integrated control systems for multiply handicapped people.

Integrated control systems allow disabled people access to multiple functions from a single input device (for example a set of switches). Multiply handicapped users are thereby able to switch efficiently between wheelchair control, communication, computer access and control of their environment, without third-party help. Integrated systems have been developed for multiply handicapped children and adults in the Barnsley area. The design philosophy has concentrated upon utilizing, wherever possible, commercially available assistance devices and remotely controlling these via logic-based integrated control systems tailored to the needs and abilities of the individual client. This approach presents few problems as the inputs to commercially available devices are often based on simple switch control. The systems already supplied have proved, after an initial training period, to be easy to operate and have led to a considerable improvement in quality of life for the users. Computer-based, wheelchair-mounted integrated systems are now being developed. A prototype system currently emulates the logic-based controllers described above, employing the screen to display information on the current status of the system. Future development will move toward a more flexible system which will be able to read a variety of input signals and control a large number of outputs. The system will also have the facility to utilize software-based communications, keyboard emulation and environmental control packages as well as business and education software. Such a system could be easily set up, via software, for use by any disabled person.

A microcomputer keyboard substitute for the disabled.

A microcomputer keyboard substitute for use by the disabled is described. The system displays the characters of a standard keyboard as a matrix where each character is enunciated by an LED. The matrix of characters is scanned by two simple switches until the desired character is reached. This is then entered into the computer using one of the two switches. The system is designed for use on the BBC Model B microcomputer but is relatively easily adapted for use on other machines. It operates in parallel with the conventional keyboard and does not depend on additional system software. It does not use any of the standard computer interfaces, and the character grid can be changed to suit the needs of a particular user.

Repeated skin tests in guinea pigs with fluorescein visualization.

A method is presented for immediate hypersensitivity skin testing of guinea pigs using fluorescein as a contrast medium. The method allows repeated skin tests of individual animals. Results are compared with those obtained using Evans blue dye, which leaves animals unsuitable for later skin testing. The two methods give very similar direct skin test results.

High-dose combined-modality therapy and autologous bone marrow transplantation in resistant cancer.

Fourteen patients with resistant cancers received high-dose chemotherapy and total body irradiation followed by rescue with autologous cryopreserved bone marrow cells. In seven patients, disease has remained in remission for periods up to two years. These data indicate that effectiveness of high-dose combined-modality therapy and bone marrow autotransplantation in patients with resistant cancer. The high incidence of non-marrow toxicity may be reduced by the use of this modality before patients have received extensive therapy.

Respiratory hypersensitivity to Ascaris extract in guinea pigs sensitized by aerosol.

Guinea pigs exposed via the respiratory route to Ascaris suum extract in aerosol form became hypersensitive. The hypersensitivity was detectable by inhalational bronchial provocation testing using a noninvasive plethysmography, by chopped lung histamine release, and by passive cutaneous anaplylaxis. The antibody responsible for the hypersensitivity seems to be directly associated with pulmonary tissue. A locally produced cytotropic pulmonary antibody, probably IgG or IgE may be causal. Histopathology included only a moderate pulmonary eosinophilia. Individual variability in susceptibility to experimental allergic asthma may be controlled by both physiologic and immunologic reactivities.

A noninvasive technique for measurement of changes in specific airway resistance.

A simple noninvasive technique for measuring specific airway resistance (airway resistance X thoracic gas volume) in unanesthetized guinea pigs is described. Specific airway resistances measured by this technique correlated well (r = 0.81) with the resistances obtained using a pleural catheter pressure measurement over a wide range of airway resistances. This range of resistances was generated by exposing the pigs to an aerosolized histamine bronchial challenge. The average specific airways resistance in unchallenged pigs was 1.24 +/- 3.47 cmH2O/s, somewhat lower than found by others, probably reflecting in part our larger pigs and in part some uncertainty in the absolute value of resistance inherent in our measurement technique. This technique is particularly useful in bronchial challenge experiments because of its sensitivity to acute changes in airway resistance.

A surgical procedure to prevent tracheo-innominate artery erosion.

The innominate artery of a patient requiring prolonged mechanical ventilation was palpated in the inferior portion of his tracheostomy wound. Life-threatening hemorrhage was prevented by rotation of a local muscle flap the protect the artery and rotation of pedicled skin flaps to create a permanent tracheostomy.

Studies of the paw test and tumor-associated immunosuppression in mice.

Specific paw test reactivity to tumor cells was transferred to normal mice using lymphoid cells or serum from mice with a growing or surgically excised methylcholanthrene-induced transplantable sarcoma. When the donors had been sensitized to PPD and to tumor, normal recipients of lymphoid cells became reactive by specific paw test to tumor cells and PPD. Normal recipients of serum from the same donors also became reactive to tumor cells. Normal recipients of serum from tumor-bearing mice developed depressed PHA paw tests. Adoptive transfer with cells or serum of paw test reactivity to tumor and PPD was unsuccessful when recipients had large tumors. This was the case when the recipients had either tumor of the same line or that of a separate line that did not cross-react antigenically.

Correction of severe hemifacial atrophy with a free dermis-flat from the lower abdomen.

A case of hemifacial atrophy was corrected with a free dermal-fat flap, based on the inferior epigastric vessels. Microvascular anastomosis to the facial vessels was used. Ancillary "tailoring" procedures were done later to complete the work.

Relationship between the response to complete freund adjuvant, phytohemagglutinin, and subsequent tumor growth in mice.

Groups of inbred C3H mice selected on the basis of strong or weak PPD reactions after sensitization with complete Freund adjuvant had significantly different reactions to PHA. The growth rate of a methylcholanthrene-induced tumor, previously shown to elicit a cell-mediated immune response, was significantly different in these two groups of mice. The basis for the marked variation observed between members of an inbred mouse strain in response to CFA is not understood but may bear an important potential relationship to tumor growth.