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At least 433 records · Page 24Linked to original sources
PubMed1994

Accurate intrapartum estimation of fetal platelet count by fetal scalp samples smear.

Fetal scalp sampling has been used to determine fetal platelet count in early labor. Because platelet clumping may lead to falsely low platelet counts, this pilot study was carried out to evaluate an improved method of scanning an intrapartum fetal scalp smear for platelet estimation. We report 5 years' experience with the use of scanning of the smear for platelet aggregates instead of direct measurement of platelets. In 22 cases, intrapartum examination of the scalp blood smear at low power revealed the great majority of high-power, dry microscopic fields devoid of platelets, whereas isolated fields contained aggregates of more than 10 platelets. In one case, an adequate number of platelets were evenly distributed. Intrapartum fetal platelet estimation by scanning of the smear (using these platelet aggregates) correctly identified an adequate neonatal platelet count in 23 cases (mean, 264,600 +/- 15,000; range, 133,000 to 396,000). Cesarean section was avoided in 82.6% of these cases. In this pilot study, platelet estimation on fetal scalp sample were reliably performed by scanning of the smear for platelet aggregates. When aggregates were seen, platelet adequacy was found in all cases.

Blood Specimen Collection↗
PubMed1992

Response of fetal heart rate to scalp stimulation related to fetal acid-base status.

The correlation of the response of the fetal heart rate (FHR) to scalp stimulation and the acid-base status of the fetal scalp blood (FSB pH) was studied in 104 term fetuses during labor. The mean FHR was determined for the 5-minute period before the preparation for fetal scalp blood pH determination and 1 minute following FSB pH. The analysis was performed for three pH groups: (a) Normal (pH more than 7.25, = 73); (2) preacidotic (pH 7.20 to 7.25, = 16); and (3) acidotic (pH less than 7.20, = 15). The pH was confirmed at delivery by determination of umbilical cord blood acid-base status. Regression analysis of the number of fetuses responding by changing their heart rate against time was significant only for the nonacidotic fetuses. There was no significant difference in the number of subjects whose mean FHR increased, decreased, or remained unchanged between the three pH groups. Furthermore, there was no difference between the three pH groups in the number of fetuses who demonstrated significant mean heart rate changes (p less than 0.05) following the stimulation compared to those who did not. Further analysis between fetuses in the three pH groups who increased FHR 15 beats/min or more following stimulation did not discriminate between groups. We conclude that scalp stimulation results in a FHR response in all three pH categories. However, the net change in the mean heart rate following the stimulation may be negative or positive. The magnitude and the direction of this change in FHR is not significantly related to FSB pH.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid-Base Equilibrium↗
PubMed1996

Skin harvesting on the scalp in children: utopia or reality.

UNLABELLED: Since 1990 we have used systematically the scalp as donor site for split skin graft in children. The aim of this retrospective and prospective study is to analyse the results, advantages, disadvantages, complications and problems of this method. MATERIAL AND METHODS: The series includes 43 children, age: 9 months to 15 years 6 months (mean age 5 years 9 months) who presented burns or other lesions. The surface to be grafted was 0.5% to 35% of the body surface (mean surface: 6.6% TBS). The follow-up was 25 to 1086 days (mean: 304 days). The donor site is prepared by marking of the hair-limit, shaving, disinfection and infiltration with normal saline under the galea of the surface to be harvested. Skin harvesting is done with an electrical dermatome. The donor site is covered with sponges soaked in adrenaline (1/500,000). RESULTS: 1 child required harvesting twice in 2 weeks, another one 3 times in 3 months. All the other children required only one procedure. 4 children needed a meshing of the graft. They required also harvesting from other donor sites. The surface to be grafted represented more than 15% TBS. 5 children with a surface to be grafted between 10 and 15% TBS could be covered in one session, without meshing, taking only the scalp. The healing of the scalp was complete after 7 to 14 days (mean: 9.5 days). There was no mortality in our series. We were not confronted with any infection. No hypertrophic scars or retractions were encountered. 3 children presented zones of alopecia, one had sequelae and needed two surgical procedures. The two other cases were minor cases and did not require further treatment. A certain sparseness of hair was noticed in a black girl, after the third harvesting. The blood losses were estimated as a total and have also to be attributed to the tangential excision of the burn area. CONCLUSION: Skin harvesting from the scalp in children can be recommended as first choice. The advantages, especially the rapid epithelialisation and the lack of visible scars, overcome the problems and the risks.

Adolescent↗
PubMed2002

Hair counts from scalp biopsy specimens in Asians.

BACKGROUND: Differences in hair density have been described according to the ethnic background in whites and blacks. Asians are known to have fewer hairs than whites. OBJECTIVE: We performed this study to assess the normal values of hair counts in scalp biopsy specimens from Koreans. METHODS: A total of 35 subjects with clinically normal occipital scalps (13 patients with androgenetic alopecia, 20 with patchy alopecia areata, and 2 healthy volunteers) were included. Horizontal sections of 4-mm punch biopsy specimens from clinically normal occipital scalps were examined at various levels from the papillary dermis to the subcutis, and follicular counts of terminal/vellus hairs and anagen/telogen hairs were obtained. RESULTS: The numbers of total hairs, terminal and vellus hairs, and terminal anagen hairs were significantly lower (P <.05) in Koreans compared with the published data of whites and blacks. Percent ratio of terminal anagen and telogen hairs were similar to whites and blacks. Follicular density was significantly lower (P <.05) in Koreans than in whites and blacks. In Koreans, female subjects had a significantly higher number of terminal hairs than male subjects (P <.05). CONCLUSION: Hair density is significantly lower in Koreans than in whites or blacks. Slight sexual difference exists in follicular counts in Koreans. Our data could be used as a guideline for determining normalcy in interpreting horizontal sections of scalp biopsy specimens from Asians.

Adolescent↗
PubMed2003

Scalp psoriasis: synergy between the Malassezia yeasts and skin irritation due to calcipotriol.

To investigate if there is a synergy between the presence of the Malassezia yeasts and the adverse reaction during treatment of scalp psoriasis with calcipotriol scalp solution, patients were treated with itraconazole to reduce the number of Malassezia yeasts. This study was a double-blind, placebo-controlled parallel group study between oral itraconazole or placebo for 8 weeks in patients with scalp psoriasis. After 2 weeks, calcipotriol scalp solution was applied twice daily for 6 weeks. Altogether 137 patients, 67 in the itraconazole group and 70 in the placebo group, comprised the intention-to-treat population. There were 13 (19.4%) patients with local skin irritation in the itraconazole group compared to 33 (47.1%) in the placebo group (p < 0.001). The skin irritation was significantly lower in patients with a low number of cultured Malassezia yeasts (p = 0.017). Thus, when Malasessia was eliminated or the numbers reduced, the irritation produced by calcipotriol was significantly diminished.

Administration, Oral↗
PubMed2005

Clobetasol propionate shampoo 0.05% and calcipotriol solution 0.005%: a randomized comparison of efficacy and safety in subjects with scalp psoriasis.

BACKGROUND: Scalp involvement in psoriatic patients represents a common issue. Treatment of the hairy skin requires adequate pharmaceutical formulations; hence, a new specific shampoo formulation of clobetasol propionate 0.05% was developed by Galderma R&D, Inc. METHODS: For this multicenter, randomized, investigator-masked, parallel group study, 151 subjects with moderate to severe scalp psoriasis were randomized to 4 weeks of treatment with clobetasol propionate shampoo or calcipotriol solution. RESULTS: Clobetasol propionate demonstrated significantly superior efficacy to calcipotriol solution (total severity score: mean difference 0.51, 95% CI 0.05-0.97, p = 0.028; global severity score: mean difference 0.43, 95% CI 0.08-0.78, p = 0.016). Adverse events were more common in the calcipotriol group than in the clobetasol propionate shampoo group. Telangiectasia and skin atrophy did not differ significantly between treatments; however, a burning sensation was significantly more common in the calcipotriol solution group. CONCLUSIONS: Short contact therapy of scalp psoriasis with this new shampoo formulation of clobetasol propionate was significantly more effective and better tolerated than calcipotriol solution for the treatment of scalp psoriasis.

Administration, Topical↗
PubMed2006

A randomized, investigator-masked clinical evaluation of the efficacy and safety of clobetasol propionate 0.05% shampoo and tar blend 1% shampoo in the treatment of moderate to severe scalp psoriasis.

The clinical benefit of currently available tar blend shampoos for the treatment of scalp psoriasis is restricted due to their limited efficacy, low cosmetic appeal and potential for carcinogenicity. This 4-week multicentre, randomized, parallel-group, investigator-masked study included 162 subjects and aimed to compare the efficacy, safety and cosmetic acceptability of clobetasol propionate 0.05% shampoo versus a currently marketed tar blend 1% shampoo in subjects with moderate to severe scalp psoriasis. Clobetasol propionate shampoo was superior to tar blend shampoo with respect to all efficacy variables tested (p<0.001): Total and Global Severity Score; erythema; plaque thickening; desquamation; pruritus; total scalp area involved; and the subject's global assessment of clinical improvement. Both treatments were safe and well-tolerated. Furthermore, more subjects indicated that clobetasol propionate shampoo was more cosmetically acceptable than tar blend shampoo. Clobetasol propionate 0.05% shampoo is a good alternative to tar blend shampoo in the treatment of moderate to severe scalp psoriasis.

Administration, Cutaneous↗
PubMed2004

Distribution characteristics of rare earth elements in children's scalp hair from a rare earths mining area in southern China.

In order to demonstrate the validity of using scalp hair rare earth elements (REEs) content as a biomarker of human REEs exposure, data were collected on REEs exposure levels from children aged 11-15 years old and living in an ion-adsorptive type light REEs (LREEs) mining and surrounding areas in southern China. Sixty scalp hair samples were analyzed by ICP-MS for 16 REEs (La Lu, Y and Sc). Sixteen REEs contents in the samples from the mining area (e.g., range: La: 0.14-6.93 microg/g; Nd: 0.09-5.27 microg/g; Gd: 12.2-645.6ng/g; Lu: 0.2-13.3 ng/g; Y: 0.03-1.27 microg/g; Sc: 0.05-0.30 microg/g) were significantly higher than those from the reference area (range: La: 0.04-0.40 microg/g; Nd: 0.04-0.32 microg/g; Gd: 8.3-64.6 ng/g; Lu: 0.4-3.3ng/g; Y: 0.03-0.29 microg/g; Sc: 0.11-0.36 microg/g) and even much higher than those published in the literature. The distribution pattern of REEs in scalp hair from the mining area was very similar to that of REEs in the mine and the atmosphere shrouding that area. In conclusion, the scalp hair REEs contents may indicate not only quantitatively but also qualitatively (distribution pattern) the absorption of REEs from environmental exposure into human body. The children living in this mining area should be regarded as a high-risk group with REEs (especially LREEs) exposure, and their health status should be examined from a REEs health risk assessment perspective.

Absorption↗
PubMed1992

Detection of cerebral ischaemia in the anaesthetised rat by impedance measurement with scalp electrodes: implications for non-invasive imaging of stroke by electrical impedance tomography.

The possible use of impedance measurement with scalp electrodes to detect cerebral ischemia non-invasively was investigated in the anaesthetised rat. Global cerebral ischaemia was induced by diathermy of both vertebral arteries and reversible occlusion of the carotid arteries. Impedance was measured at 50 kHz by a four electrode method. With cortical electrodes in various positions, reversible impedance increases of 15 - 60% were recorded during episodes of cerebral ischaemia which lasted for 5 - 30 min. With electrodes placed in overlying positions in the scalp, impedance increases had a similar time course but their amplitudes were about 10 - 20% of the increases measured on the cortex. These were not due solely to changes in temperature which accompanied cerebral ischaemia or local changes in the scalp. These findings suggest that it may be possible to image cerebral ischaemia in human subjects non-invasively with Electrical Impedance Tomography and scalp electrodes.

Anesthesia, Inhalation↗
PubMed1996

The effect of scalp ischaemia on measurement of cerebral blood volume by near-infrared spectroscopy.

Near-infrared spectroscopy (NIRS) is a noninvasive method of quantifying changes in cerebral haemodynamics from changes in the absorption of near-infrared light by oxyhaemoglobin and deoxyhaemoglobin. Measurement of neonatal cerebral blood volume (CBV) by NIRS was described in 1990 but it has been suggested that, in adults, scalp and skull blood content contribute a significant amount to the cerebral haemodynamic variables quantifiable by NIRS. To investigate this, CBV was measured in nine adult subjects, in the frontal region of the head, before and after inflating a pneumatic tourniquet proximal to the measurement site. Because a change in scalp blood content could potentially alter the pathlength of light passing through the head and hence affect the measured CBV, the optical pathlength factor was therefore also measured before and after tourniquet inflation. Blood flow occlusion was confirmed by laser Doppler velocimetry. The results showed that tourniquet inflation had no effect on the estimated value of CBV or the differential pathlength factor. We conclude that, provided the distance between light entry and exit on the surface of the scalp is sufficiently large, changes in scalp blood flow have no effect on NIRS measurement of cerebral haemodynamics.

Adult↗
PubMed1984

Sclerosing lipogranuloma of the scalp. A report of two cases.

The authors report two cases of sclerosing lipogranuloma of the scalp diagnosed postmortem. The first was suspected to have acquired the lipid material from a grease gun injury to the scalp, while the second had received injections of an unidentified lipid for treatment of baldness. In each, the resultant sclerosing lipogranuloma extended laterally beneath the scalp from the vertex of the skull. The histologic reaction was round to oval cystic spaces within a dense collagenous stroma typical of the "swiss cheese" pattern of sclerosing lipogranuloma. Punctate, ringlike, or globoid densities were seen on roentgenograms of a 5-mm-thick transmural section of scalp in the first case.

Granuloma↗
PubMed2005

Prevention of chemotherapy-induced hair loss by scalp cooling.

BACKGROUND: Chemotherapy-induced temporary hair loss is one of the most common and distressing side-effects of cancer therapy. Scalp cooling to reduce this hair loss is a controversial issue for many doctors and nurses. This may be due to inadequate knowledge. METHODS: This review from 53 publications and three personal communications focuses on the efficacy of the treatment, side-effects, possible disadvantages and the controversies in these areas. RESULTS: Scalp cooling has become an increasingly effective method to prevent hair loss, especially when anthracyclines or taxanes are used. Unfortunately, many studies were small and badly designed and are therefore difficult to compare. There is a considerable variation in the success rates in the various studies. This remains unexplained, but the cooling time, the chemotherapy used and the temperature seem to be influential. Scalp cooling should not be used if chemotherapy is given with a curative intent in patients with generalised haematogenic metastases. The majority of patients tolerate cooling very well. CONCLUSION: Scalp cooling is effective but not for all chemotherapy patients. Further psychological, clinical and biophysical research is needed to determine exact indications for cooling and to improve the effect, tolerance, side-effects and the cooling procedure. Multicentre trials should be carried out to gather this information.

Alopecia↗
PubMed1999

Focal ictal direct current shifts in human epilepsy as studied by subdural and scalp recording.

In order to clarify further the characteristics of ictal direct current (DC) shifts in human epilepsy, we investigated them by subdural and scalp recording in six and three patients, respectively, both having mainly neocortical lobe epilepsy (five with frontal lobe epilepsy, two with parietal lobe epilepsy and two with temporal lobe epilepsy). By using subdural electrodes made of platinum, ictal DC shifts were observed in 85% of all the recorded seizures (89 seizures) among the six patients, and they were localized to just one or two electrodes at which the conventional initial ictal EEG change was also observed. They were closely accompanied by the electrodecremental pattern in all patients except for one in whom 1 Hz rhythmic activity was superimposed on clear negative slow shifts. Seizure control after resection of the cortex, including the area showing DC shifts, was favourable irrespective of histological diagnosis. Scalp-recorded ictal slow shifts were observed in 23% of all the recorded seizures (60 seizures) among the three patients. They were, like the subdurally recorded ones, mainly surface-negative in polarity, closely related to the electrodecremental pattern and consistent in their location. It seems that scalp-recorded DC shifts were detected particularly when seizures were clinically intense, while no slow shifts were observed in small seizures. It is concluded that at least subdurally recorded ictal slow shifts are clinically useful before epilepsy surgery to delineate more specifically an epileptogenic area as well as to further confirm the conventional initial ictal EEG change, and that scalp-recorded ictal slow shifts also have high specificity although their low sensitivity is to be taken into account.

Adolescent↗
PubMed2002

Potential changes with gamma-band oscillation at the frontal scalp elicited by intravenous olfactory stimulation in humans.

Intravenous olfaction is a unique stimulation method often used in Japan to diagnose olfactory disturbances. Odorant is injected into a vein and transported by blood flow and respiration to the upper air tract. The intravenous olfaction might allow the potential at the frontal scalp to be recorded without contamination from electromyograms, such as those caused by sniffing. We injected Alinamin (thiamine propyldisulphide) into healthy subjects according to a standard protocol for clinical intravenous olfaction testing and we simultaneously recorded potential changes at the frontal scalp. When Alinamin was injected into the right median cubital vein over a 20 s period, the potential changes with gamma-band oscillations were detected 17.6 +/- 6.7 s (mean +/- SD) after the start of the injection. The main frequency component of this gamma-band oscillation is 30-160 Hz. The gamma-band oscillation elicited by intravenous olfactory stimulation (VOP) was similar to the induced wave of the olfactory bulb. Mapping the VOPs on the frontal scalp of a subject with less developed frontal sinuses and the relation between the thickness of the frontal sinuses and VOP amplitude suggest an intracranial source, possibly the olfactory bulb. The gamma-band potential at the frontal scalp is a useful measure of central disturbance.

Adult↗
PubMed1989

Total scalp excision and auricular resurfacing for dermal cylindroma (turban tumor).

Dermal cylindroma is a benign neoplasm of the eccrine sweat glands, which presents in the head and neck area in 91% of cases. In its most florid presentation, the entire scalp can be involved, leading to the descriptive label turban tumor. We present the case of a 30-year-old woman with dermal cylindroma extensively involving her forehead and scalp and whose family was affected in three consecutive generations. She underwent total scalp and forehead excision with coverage by split-thickness skin grafts from the thigh. Seven years later, because of progressive external ear involvement, auricular resurfacing was performed. Her scalp and forehead have remained tumor free in the eight-year follow-up period and the auricles at one year. Total excision has led to a cosmetic and functional improvement, and the possibility of malignant degeneration is theoretically decreased.

Adult↗
PubMed1981

Open wounds of the scalp: an account of methods of repair.

Scalp wounds attended by loss of substance are commonly managed either by direct skin grafting or a large transposition flap of adjacent scalp and skin grafting of the donor site defect. Either of these methods has all of the inherent disadvantages of the results of skin grafting: insensate, glabrous surface devoid of hair, recurrent ulceration after minor trauma, and, finally, abnormal appearance. In the past 5 years 23 patients at Emory Affiliated Hospitals have undergone a procedure whereby all existing scalp has been mobilized by fashioning arterialized flaps and the scalp reconstructed with normal hairbearing skin. Multiple relaxing incisions in the galea are requisite to the success of the method. An underlying defect in the bony calvaria can be reconstructed at a second stage by multiple split rib grafts.

Adult↗
PubMed2002

Mycoplasma hominis scalp abscess in the newborn.

Scalp abscess in the newborn is usually a complication of fetal scalp monitoring and is typically polymicrobial, reflecting maternal vaginal flora. We present a newborn with no apparent scalp trauma who developed scalp abscess that yielded pure growth of Mycoplasma hominis. The clue to diagnosis was the growth of pinpoint translucent colonies on blood agar that were Gram stain-negative. Abscess drainage and systemic clindamycin were curative.

Abscess↗
PubMed1986

A review of scalp split-thickness skin grafts and potential complications.

A review of 113 patients who underwent 178 scalp split-thickness skin graft procedures is presented. Although our study confirms some of the work of previous authors, we found that the scalp donor site has potential complications which should be considered. These complications are minor in the adult population. In the pediatric population, however, excessive blood loss due to the relatively large surface area of the scalp limits the use of the scalp as a preferred donor site.

Adolescent↗