Hair transplantation and Cylindrocarpon musae: Difference between pages

Cylindrocarpon musae
Scientific classification
Kingdom:	Fungi
Phylum:	Ascomycota
Class:	Sordariomycetes
Subclass:	Hypocreomycetidae
Order:	Hypocreales
Family:	Nectriaceae
Genus:	Cylindrocarpon
Species:	C. musae
Binomial name
	Cylindrocarpon musae; C. Booth & R.H. Stover, (1974)

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Cylindrocarpon musae is a fungal plant pathogen that causes root rot in banana.

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This plant disease article is a stub. You can help Wikipedia by expanding it.

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+{{Taxobox
-'''Hair transplantation''' is a surgical technique that involves moving skin containing [[hair follicles]] from one part of the body (the donor site) to bald or balding parts (the recipient site). It is primarily used to treat [[male pattern baldness]] whereby grafts containing hair follicles that are genetically resistant to [[balding]] are transplanted to bald scalp. However, it is also used to restore eye lashes, eye brows, beard hair, and to fill in scars caused by accidents and surgery such as face lifts and previous hair transplants. Hair transplantation differs from [[skin grafting]] in that 1) grafts contain almost all of the [[epidermis]] and [[dermis]] surrounding the hair follicle, and 2) many tiny grafts are transplanted rather than a single strip of [[skin]].
+| name = ''Cylindrocarpon musae''
+| regnum = [[Fungi]]
+| phylum = [[Ascomycota]]
+| classis = [[Sordariomycetes]]
+| subclassis = [[Hypocreomycetidae]]
+| ordo = [[Hypocreales]]
+| familia = [[Nectriaceae]]
+| genus = ''[[Cylindrocarpon]]''
+| species = '''''C. musae'''''
+| binomial = ''Cylindrocarpon musae''
+| binomial_authority = C. Booth & R.H. Stover, (1974)
+}}
+'''''Cylindrocarpon musae''''' is a [[fungus|fungal]] [[Plant pathology|plant pathogen]] that causes [[root]] rot in [[banana]].
-Its main usage as a treatment for baldness is controversial and is heavily debated among surgeons, medical doctors, dermatologists and patients, especially on the internet. Many medical doctors and dermatologists tend to be highly sceptical of its use in treating baldness. This is because the surgery is generally considered to be unsuccessful, cannot achieve a natural hair density even when there is sufficient donor hair available, produces inconsistent results, usually does not improve a patient’s hair appearance and damages the patients scalp. Also, it has been associated with fraudulent practises by surgeons for many years.
+== External links ==
-Since the turn of the century, and with the internet providing a new arena in which surgeons can attract potential patients, the number of people having hair transplants has increased. In 2007 around 200,000 hair transplants were carried out throughout the world, with the majority being carried out in the [[United States]]<ref>ISHRS Practise Census Survey Report 2007</ref>. However, many patients claim afterwards that they are not happy with the results or that they regret having the procedure done.
+* [http://www.speciesfungorum.org/Names/Names.asp Index Fungorum]<br>
+* [http://nt.ars-grin.gov/fungaldatabases USDA ARS Fungal Database]<br>
+[[Category:Plant pathogens and diseases]]
-==History==
+[[Category:Hypocreales]]
+[[Category:Banana diseases]]
+{{ascomycota-stub}}
-The use of both [[scalp]] flaps, in which a band of tissue with its original blood supply is [[medical grafting|shifted]] to the bald area, and free grafts dates back to the 19th century. Modern transplant techniques began in Japan in the [[1930s]], where surgeons used small grafts, and even "[[hair follicle|follicular unit grafts]]" to replace damaged areas of [[eyebrows]] or lashes. They did not attempt to treat [[baldness]] per se. Their efforts did not receive worldwide attention at the time, and the traumas of World War II kept their advances isolated for another two decades.
+{{plant-disease-stub}}
-The modern era of hair transplantation in the western world was ushered in the late [[1950s]], when New York [[dermatologist]] [[Norman Orentreich]] began to experiment with free donor [[grafts]] to balding areas in patients with [[male pattern baldness]]. Previously it had been thought that transplanted hair would thrive no more than the original hair at the "recipient" site. Dr. Orentreich demonstrated that such grafts were "donor dominant," as the new hairs grew and lasted just as they would have at their original home.  Today Dr. Orentreich's practice still performs hair transplants.
-For the next twenty years, surgeons worked on transplanting smaller grafts, but results were only minimally successful, with 2-4 mm "plugs" leading to a doll's head-like appearance. In the 1980s, Uebel in Brazil popularized using large numbers of small grafts, while in the United States Rassman began using thousands of “micrografts” in a single session.
-In the late 1980s, Limmer introduced the use of the stereo-microscope to dissect a single donor strip into small micrografts.  In 1995, Bernstein and Rassman published the first paper on "[[Follicular Unit Transplantation]]," where hair is transplanted exclusively in naturally occurring groups of 1-4 hairs.  With microscopic dissection of donor pieces from an excised portion of scalp, individual follicular units containing but 1-4 hairs could be prepared and individually relocated into needle punctures in the recipient areas. Since the transplanted hair mimics the way hair grows in nature, close to natural results were attainable.
-The follicular unit hair transplant procedure has continued to evolve, becoming more refined and minimally invasive as the size of the graft incisions have become smaller. These smaller and less invasive incisions enable surgeons to place a larger number of follicular unit grafts into a given area. With the new "gold standard" of [[follicular unit transplantation|ultra refined follicular unit hair transplantation]], over 50 grafts can be placed per square centimeter, when appropriate for the patient.
-Surgeons have also devoted more attention to the angle and orientation of the transplanted grafts. The adoption of the “lateral slit” technique in the early 2000s, enabled hair transplant surgeons to orient 2 to 4 hair follicular unit grafts so that they splay out across the scalp's surface. This enabled the transplanted hair to lie better on the scalp and provide better coverage to the bald areas. One disadvantage however, is that lateral incisions also tend to disrupt the scalp's vascularity more than sagitals.  Thus sagital incisions transect less hairs and blood vessels assuming the cutting instruments are of the same size.  One of the big advantages of sagitals is that they do a much better job of sliding in and around existing hairs to avoid follicle transection. This certainly makes a strong case for physicians who do not require shaving of the recipient area.  The lateral incisions bisect existing hairs perpendicular (horizontal) like a T while sagital incisions run parallel (vertical) along side and in between existing hairs.  The use of perpendicular (lateral/coronal) slits verses parallel (sagital) slits however, has been heavily debated on patient based hair transplant communities.  Many elite hair transplant surgeons typically adopt a combination of both methods depending on what is best for the patient.
-==Modern techniques==
-There are two main ways in which donor grafts are extracted today. These are the Strip Harvesting Technique and the Follicular Unit Extraction (FUE) Technique.
-The Strip Harvesting Technique involves removing a strip containing a large group of follicular units from the donor area - almost always from the back and sides of the scalp. The strip is then divided into grafts (or follicular units) containing 1 to 4 follicles.
-The Follicular Unit Extraction (FUE) Technique involves removing one follicular unit at a time directly from the donor area – usually the back and sides, but also sometimes from the chest, legs or face (beard hair) - using a small punch usually of between 0.5mm and 1mm in diameter.
-==The procedure==
-At an initial consultation, the surgeon analyzes the patient's scalp, discusses his preferences and expectations, and advises him/her on the best approach (e.g.,single vs. multiple sessions) and what results might reasonably be expected.
-For several days prior to surgery the patient refrains from using any medicines, or alcohol, which might result in intraoperative bleeding and resultant poor "take" of the grafts. Pre-operative [[antibiotic]]s are commonly prescribed to prevent wound or graft [[infection]]s.
-===Cost===
-In recent years hair transplants have become less expensive. Prices typically range from $3.00 to $7.00 per graft, with $4 to $5 per graft being about average. Normally the price per graft also drops as the size of the surgical session increases. Depending on the needs of the patient a typical surgical session can range from 1,500 to over 4,000 grafts, resulting in a total cost of approximately $6000 to $15,000. A few clinics offer larger sessions of up to 6000 grafts in one sitting.
-===Surgery===
-Transplant operations are performed on an outpatient basis, with mild [[sedation]] (optional) and injected topical [[anesthesia]], and typically last about four hours. The scalp is shampooed and then treated with an antibacterial chemical prior to the donor scalp being harvested.
-In the usual follicular unit procedure, the surgeon harvests a strip of skin from the posterior scalp, in an area of good hair growth. The excised strip is about 1-1.5 x 15-30 cm in size. While closing the resulting wound, assistants begin to dissect individual follicular unit grafts from the strip. Working with binocular [[microscope]]s, they carefully remove excess fibrous and fatty tissue while trying to avoid damage to the follicular cells that will be used for grafting.
-The surgeon then uses a fine needle to puncture the sites for receiving the grafts, placing them in a predetermined density and pattern, and angling the wounds in a consistent fashion to promote a realistic hair pattern. The assistants generally do the final part of the procedure, inserting the individual grafts in place.
-===Post-operative care===
-Advances in wound care allow for semi-permeable dressings, which allow seepage of blood and tissue fluid, to be applied and changed at least daily. The vulnerable recipient area must be shielded from the sun, and shampooing is started two days after the surgery.  Some surgeons will have you shampoo the day after surgery. Shampooing is important to prevent scabs from occurring around the hair shaft.  Scabs adhere to the hair shaft and increase the risk of losing newly transplanted hair follicles during the first 7 to 10 days post-op.
-During the first ten days, virtually all of the transplanted hairs, inevitably traumatized by their relocation, will fall out ("shock loss"). After two to three months new hair will begin to grow from the moved follicles. The patient's hair will grow normally, and continue to thicken through the next six to nine months. Any subsequent hair loss is likely to be only from untreated areas. Some patients elect to use medications to retard such loss, while others plan a subsequent transplant procedure to deal with this eventuality.
-==Side effects==
-Hair thinning,  known as "shock loss", is a common side effect that is usually temporary. Bald patches are also common, as fifty to a hundred hairs can be lost each day.
-Other side effects include swelling of areas such as the scalp and forehead. If this becomes uncomfortable, medication may ease the swelling. Additionally, the patient must be careful if his scalp starts itching, as scratching will make it worse and cause scabs to form. A moisturizer or massage shampoo may be used in order to relieve the itching.
-==Problems==
-Hair transplantation has many problems associated with it that have not yet been overcome by surgeons, and possibly never will be. Some of the problems include:
-. Transplanted hair can differ from original hair and be thin, kinky or wiry like the fibres in a [[Brillo Pad]]. It can different in colour and texture, and have an unnatural, fake appearance. The hair is rarely ever the same texture again.
-. There may be poor or no growth and grafts may [[atrophy]].
-. The surgery leaves permanent scars in both the donor and recipient sites. Strip surgery leaves a linear scar that in some cases can stretch to a wide hairless scar along the back and sides of the scalp. FUE leaves small circular scars in the donor site which can result in a moth-eaten appearance, particularly if hair is not taken evenly and symmetrically over the whole donor area. In the recipient site, pitting often occurs and circular plug-like scars can be seen where the follicle has been inserted. This can be less visible if there is sufficient hair to cover the skin; otherwise it is a serious cosmetic problem, particularly along the hairline. Even where single hair follicles of small diameter (< 0.7mm) are transplanted scarring is unavoidable due to the natural healing process of skin when wounded.
-. Hair transplants cause temporary or permanent shock loss and in all cases the patient will end up with a lower overall hair count (because a 100% success rate is not achievable).
-. They do not treat the cause of hair loss and unless medication is also used to treat further hair loss (and even medication is not a guarantee), the patient will continue to lose hair due to the progressive nature of [[androgenetic alopecia]].
-. They can leave a permanent sensation of awkwardness and pain in both the donor and recipient areas long after the surgery has taken place and healing is complete. Where strip surgery has been performed the skin can feel stretched or tight. Implanted grafts can bleed through contact with a comb or by scratching the skin even several years after the surgery has been carried out.
-== Fraud ==
-The most common fraudulent practise adopted by Hair Transplant surgeons is the use of fake photography and fake before and after photos as a sales tool. In such instances, a change in the lighting, angle of the patient and a change in the patient’s physical appearance is used to give the impression that the patient looks better after the surgery. Even the removal of a patient’s [[eye glasses]] in after photos has been tried by surgeons to try and give the impression of a better appearance of the patient after the surgery. When such tactics have to be employed, then this is a clear indication that there is something fundamentally wrong with the surgery.
-The second most common fraudulent practise adopted by Hair Transplant surgeons and clinics is the transplanting of fewer grafts than the patient has paid for. This is sometimes difficult for the patient to spot because if the patient pays to have 100 grafts transplanted to a one square centimetre area of bald scalp, this would give a density of 100 grafts per square centimetre, in other words 10 x 10 grafts. However, the surgeon can easily transplant 7 x 7 grafts in this 1 square centimetre area giving a total of 49 grafts. The patient may not realise this has happened or he may feel uncomfortable about mentioning it to the surgeon. Surgeons do this to save time or to ensure the patient will have to pay for further treatment later on or both. This practise was adopted by the Bosley Medical Institute who eventually ended up with a successful lawsuit bought against them by a group of patients. This practise was not restricted solely to Bosley however.
-A further more worrying twist on this practise is that of deliberately transplanting less grafts than have been extracted. Implanting grafts usually takes much more time than extracting grafts, and when a surgeon carries out the implanting of the grafts – rather than a technician – he or she transplants only some of the grafts and the rest are effectively thrown in the trash can. This not only causes a financial loss to the patient, but also a loss of healthy hair follicles.
-Another deceptive tactic used by surgeons, usually in addition to the above, is that of making unrealistic claims about what can be achieved, and convincing patients to make large financial commitments for very poor surgery. The deception usually starts with a claim about having invented a new technique that has taken years to develop. This may also be coupled by the further claim that it takes a team of surgeons a whole day just to transplant a few hundred grafts. The idea is to give the patient the impression that they are paying for many long hours of state-of-the-art surgery, when in fact they are paying for just a few hours of poor surgery. The surgery is usually spread throughout the day with the surgeon performing surgery on other patients and carrying out consultations.
-In general, there is very little – if any - improvement any surgeon can make over the existing techniques that are already employed by surgeons to move grafts around the scalp.
-The reason some surgeons resort to such deception is because, despite the fact that over 200,000 hair transplants are carried out each year, only a small fraction of the millions of men and women who suffer from hair loss resort to surgery. Given, also, that there are many thousands of hair transplant surgeons worldwide, this does not leave many patients per surgeon. Therefore, it is in the surgeon’s own interest to try to milk as much money out of each patient as possible.
-== References ==
-* {{cite journal |author=Bernstein RM, Rassman WR, Seager D, ''et al'' |title=Standardizing the classification and description of follicular unit transplantation and mini-micrografting techniques. The American Society for Dermatologic Surgery, Inc |journal=Dermatol Surg |volume=24 |issue=9 |pages=957–63 |year=1998 |pmid=9754083 |doi= |url=}}
-* {{eMedicine|derm|559}}
-{{Operations and other procedures of the integumentary system}}
-[[Category:Hair loss]]
-[[Category:Plastic surgery]]
-[[de:Haartransplantation]]
-[[no:Hårtransplantasjon]]
-[[ru:Пересадка волос]]