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At least 487 records · Page 27Linked to original sources
PubMed1991

Scalp infiltration with bupivacaine in pediatric brain surgery.

To evaluate whether local anesthetic scalp infiltration blunts hemodynamic responses to craniotomy in anesthetized children (age, 2-18 yr), two concentrations of bupivacaine (0.125% and 0.25%) with vasoconstrictor (epinephrine 1:400,000) were compared with control data when a solution of vasoconstrictor alone was injected. Arterial plasma levels of bupivacaine were measured by high-pressure liquid chromatography. Statistically significant increases in mean arterial pressure and heart rate above baseline measurements occurred in the control group during the period between scalp incision and dural reflection (P less than 0.05). Both concentrations of bupivacaine prevented these increases. Mean arterial pressure and heart rate during scalp incision and scalp reflection were significantly higher in the control group than in both bupivacaine groups (P less than 0.05). Peak bupivacaine plasma levels (mean +/- SD) occurred either 5 or 10 min after infiltration and were significantly higher in the 0.25% group (0.48 +/- 0.31 microgram/mL) than the 0.125% group (0.14 +/- 0.13 microgram/mL) (P less than 0.05). These results suggest that bupivacaine infiltration blocks the hemodynamic response to craniotomy. A concentration of 0.125% bupivacaine with 1:400,000 epinephrine is as effective as 0.25% bupivacaine with 1:400,000 epinephrine at reducing the hemodynamic response to craniotomy. Because the lower concentration of bupivacaine produces lower blood levels, we recommend 0.125% bupivacaine with 1:400,000 epinephrine as a useful, safe adjunct to general anesthesia in children undergoing craniotomy.

Adolescent↗
PubMed1984

Fetal razor: an aid for scalp sampling.

Scalp sampling to evaluate fetal acid-base status was introduced 20 years ago. In most instances, adequate samples may be obtained without difficulty. Occasionally, however, a region of scalp free of hair cannot be found. As a result, the sample either diffuses along the hairs that are present or clots. Although a "fetal razor" has been incorporated into the kits that are utilized to apply pO2 electrodes to the fetal scalp, none has been devised for routine fetal scalp sampling. We report the modification of a single or double-edged razor for this specific purpose.

Acid-Base Equilibrium↗
PubMed2003

The 5alpha-reductase type 1, but not type 2, gene is expressed in anagen hairs plucked from the vertex area of the scalp of hirsute women and normal individuals.

The aim of the present study was to determine the expression of the genes for type 1 (SDR5A1) and type 2 (SDR5A2) 5alpha-reductase isoenzymes in scalp hairs plucked from 33 hirsute patients (20 with polycystic ovary syndrome and 13 with idiopathic hirsutism) and compare it with that of 10 men and 15 normal women. SDR5A1 and SDR5A2 expression was estimated by RT-PCR using the gene of the ubiquitously expressed protein 2-microglobulin as an internal control. The results are expressed as arbitrary units in relation to beta2-microglobulin absorbance (mean SEM). SDR5A2 expression was not detected in any hair samples analyzed in this study. No differences were found in SDR5A1 mRNA levels between men and normal women (0.78+/-0.05 vs 0.74+/-0.06, respectively). SDR5A1 gene expression in the cells of hair plucked from the scalp of normal women (0.85+/-0.04) and of women with polycystic ovary syndrome (0.78+/-0.05) and idiopathic hirsutism (0.80+/-0.06) was also similar. These results indicate that SDR5A1 gene expression in the follicular keratinocytes from the vertex area of the scalp seems not to be related to the differences in hair growth observed between normal men and women and hirsute patients. Further studies are needed to investigate the expression of the 5alpha-reductase genes in other scalp follicular compartments such as dermal papillae, and also in hair follicles from other body sites, in order to elucidate the mechanism of androgen action on the hair growth process and related diseases.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1977

In-vitro metabolism of [3H]testosterone by scalp and back skin: conversion of testosterone into 5alpha-androstane-3beta, 17beta-diol.

The in-vitro metabolism of [3H]testosterone by human scalp and back skin was examined for possible differences in enzyme activity in skin from these two areas, both of which contain large sebaceous glands but only one of which, the back, is prone to develop acne. Punch biopsy specimens of skin, obtained from the scalp and back of adult men, were minced and incubated with [3H]testosterone. The metabolic products were diluted with carrier steroids, then separated and measured by thin-layer chromatography and by gas chromatography on an instrument equipped with a splitter. The results showed that of the 5alpha-reduced metabolites identified, a major one in both the scalp and back skin incubations was 5alpha-androstane-3beta,17beta-diol. Formation of the androstanediol was especially pronounced in scalp skin where it accounted for up to 50% of the 5alpha-reduced metabolites produced. This finding that 5alpha-androstane-3beta,17beta-diol is a major product of testosterone metabolism in vitro by human skin containing sebaceous glands, supports the possibility, previously suggested by studies in the rat, that this steroid can stimulate sebum secretion.

Androstane-3,17-diol↗
PubMed2001

Management of scalp psoriasis: guidelines for corticosteroid use in combination treatment.

Scalp psoriasis is a frequent expression of the common skin disease psoriasis, and scaling and itching are the two major complaints. Topical treatments are the mainstay of the treatment of psoriasis of the scalp, with the vehicle as well as the active ingredient relevant to efficacy, tolerability and compliance. Vehicles can be shampoos, lotions, gels, foams, creams and more greasy ointments. Active ingredients are keratolytics, coal tar (liquor carbonis detergens), dithranol, corticosteroids and vitamin D3 analogues. Some effect has also been described from topical or systemic imidazole derivatives. Topical corticosteroids remain the mainstay in the treatment of scalp psoriasis. The effects are rapid, the formulations are patient friendly and the adverse effects seem limited, although no data are available to support safety during prolonged use (more than 4 weeks). Topical vitamin D3 analogues have been available for the treatment of psoriasis since 1992. In the lotion formulation in particular, vitamin D3 analogues are a patient friendly, tolerable and effective alternative to corticosteroids, although the effects are optimal after 8 weeks, in contrast to 2-3 weeks for topical corticosteroids. Facial irritation (often temporary) can also be a disadvantage of vitamin D3 analogues, although only a small proportion of patients stop treatment for this reason. All other treatment options for psoriasis, such as tazarotene, phototherapy and systemic treatment with methotrexate, acitretin and cyclosporin are often not indicated or not suitable for treatment of the scalp. In daily practice, to make a choice from the available therapeutic arsenal for psoriasis, each patient should be examined individually. Deteriorating factors have to be excluded. For scaling, keratolysis is the first step. Subsequently, active treatment can be chosen depending on the clinical picture. When the psoriatic lesions are mainly characterised by inflammation, anti-inflammatory drugs such as topical corticosteroids are indicated. When scaling is the more important clinical feature, vitamin D3 analogues are indicated. Generally, intermittently used topical corticosteroids alternating with vitamin D3 derivatives either combined or not with liquor carbonis detergens containing shampoo is the most suitable treatment for most patients. Because psoriasis capitis is a chronic disease, long term treatment should, in addition to medical advice, also provide patient support and motivation.

Administration, Topical↗
PubMed2003

Distant metastasis of dermatofibrosarcoma protuberans of the scalp--case report.

A 49-year-old man presented with a rare dermatofibrosarcoma protuberans (DFSP) of the scalp associated with local recurrence and distant metastasis to the lung and abdomen. An elastic-hard small mass on the right occipital scalp was initially treated by simple resection in another clinic. Ten years later, recurrent tumor was associated with infiltration to the calvarium, and resection was performed again also in another clinic. Approximately 1.5 years later, the patient was transferred to our clinic because of recurrence with intracranial involvement. Repeated relapses and metastasis to the lung were recognized despite surgery, chemotherapy, and local radiation. Eventually, the patient died of distant metastasis to the abdomen 17 years after the initial diagnosis. Scalp DFSP is very uncommon but is an aggressive scalp tumor, so initial wide local resection and local radiation therapy after surgery are important to prevent local recurrence and distant metastasis.

Abdominal Neoplasms↗
PubMed2005

Management of scalp dermatofibrosarcoma protuberans.

BACKGROUND: Dermatofibrosarcoma protuberans is a relatively rare, locally aggressive soft tissue tumor. Less than 5% of these tumors are located on the scalp; however, the recurrence rates for this region are high compared with those of more common locations, such as the trunk and proximal extremities. Standards for the management of dermatofibrosarcoma protuberans in general have been established in the literature, including wide local excision and Mohs micrographic surgery. OBJECTIVE: To describe optimum treatment options for primary and recurrent dermatofibrosarcoma protuberans of the scalp based on cases from Roswell Park Cancer Institute (RPCI) and from the literature. METHODS: Five cases from RPCI and 23 cases from the literature were reviewed. Age, sex, history, tumor size and level of invasion, treatment, reconstruction method, and follow-up were compiled from each case. RESULTS: Twenty-eight cases of scalp dermatofibrosarcoma protuberans were found; 13 were primary, 8 were recurrent, and 3 had persistent positive margins. Fifty-eight percent had classic histologic findings; seven tumors invaded beyond the periosteum. Twenty tumors were treated by surgical excision, whereas eight tumors were treated with Mohs micrographic surgery, requiring between two and four layers. Advanced surgical reconstruction was used in most cases to close the defects. Four patients experienced one tumor recurrence, whereas three other patients had several local recurrences. One patient died of his disease, and one died during surgical treatment of dermatofibrosarcoma protuberans. CONCLUSIONS: Mohs micrographic surgery or a modified version may be the best treatment option for scalp dermatofibrosarcoma protuberans to ensure complete removal of tumor and minimize recurrence. Surgeons should be prepared for advanced reconstruction following tumor removal.

Adolescent↗
PubMed1995

The hair root pattern after calcipotriol treatment for scalp psoriasis.

Scalp psoriasis is associated with hair loss and an increased telogen/anagen ratio. Topical treatment of scalp psoriasis (with corticosteroids, dithranol or tar) results in decreased scaling, induration and erythema of the plaques. Calcipotriol is effective in the treatment of psoriasis vulgaris. However, the potent growth-inhibiting potential of this compound might theoretically induce hair loss. A study was designed to find out to what extent calcipotriol treatment modulates the percentage of anagen and telogen hair during treatment of scalp psoriasis. A group of 26 patients participated in a placebo-controlled dose-finding study on the efficacy of calcipotriol in scalp psoriasis. Hair plucks before and after treatment were taken. The telogen/anagen ratio remained unaffected during 6 weeks of calcipotriol treatment. No correlation was demonstrated between efficacy of treatment and quantification of telogen/anagen ratio. It can be concluded that the growth-inhibiting potential of calcipotriol is not reflected in the in vivo hair growth pattern during calcipotriol treatment.

Adult↗
PubMed1985

Frontal subcutaneous blood flow, and epi- and subcutaneous temperatures during scalp cooling in normal man.

Cooling of the scalp has been found to prevent hair loss following cytostatic treatment, but in order to obtain the hair preserving effect the subcutaneous temperature has to be reduced below 22 degrees C. In order to establish the relationship between epicutaneous and subcutaneous temperatures during cooling and rewarming and to measure the effect of scalp cooling on subcutaneous scalp blood flow, subcutaneous blood flow and epi- and subcutaneous temperatures were measured in the frontal region at the hairline border before and during cooling with a cooling helmet, during spontaneous rewarming of the cooling helmet and after removal of the rewarmed helmet in 10 normal subjects. Subcutaneous blood flow was reduced to about 25% of the postcooling control level during cooling. The flow was constantly reduced until the subcutaneous temperature exceeded 30-32 degrees C. A linear relationship between epicutaneous and subcutaneous temperatures could be demonstrated with the regression equation: s = 0.9 c + 4.9 (r = 0.99). In eight of the 10 subjects the subcutaneous temperature could be reduced below 22 degrees C with the applied technique. It is concluded that the hair preserving effect of scalp cooling during cytostatic treatment is mainly due to the metabolic effect of cooling, and only to a minor extent due to the flow reducing effect.

Adult↗
PubMedDate not supplied

Non-invasive multielectrode array for high resolution sampling of scalp-recorded potential fields.

A new non-invasive electrode array has been devised to record electrical signals on the scalp. The electrodes are arranged every 10 mm in a 4 x 8 grid, thus totalling 32. Electrical coupling is assured by a column of conductor gel with a diameter of 2 mm. The electrode array has been used to record multichannel scalp potentials evoked by stimulation of the median nerve at the wrist. It was positioned on the parietal region with the midline corresponding to the external acoustic meatus. The high spatial resolution of this device allows a detailed spatial sampling of the scalp potential field where the electrical activity arising from the parietal and premotor cortex is predominant. Scalp potentials with the system are compared with those with the 10/20 system. The improved spatial resolution allows more precise localization of minimum and maximum of the potential field, though the overall distortion introduced by aliasing in the 10/20 system is not striking. Instead, the amplitudes of the fields are considerably affected by insufficient spatial sampling.

Analog-Digital Conversion↗
PubMed1989

Localization of brain tumors with a simple scalp-mounted fiducial device. Technical note.

A method is described for marking the site of a tumor on the scalp based on information from computerized tomography (CT) scans. The technique employs a syrinx-shaped array of radiopaque catheters of varying length taped to the patient's scalp for visualization on the CT scan. Fiducial markings on the CT images allow the transfer of the tumor's location directly onto the scalp. The device can be placed anywhere on the scalp, including in a parasagittal position.

Brain Neoplasms↗
PubMed2004

Managing scalp defects in sub-Saharan Africa.

OBJECTIVES: To determine the common aetiological factors of scalp defects, and outcome of management. DESIGN: A two year prospective study. SETTING: Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. SUBJECTS: All consecutive patients with scalp defect from January 2001 to December 2002. MAIN OUTCOME MEASURES: Size of defect, associated bone loss, osteomyelitis, type of surgery, duration of hospital stay and complications of surgery. INTERVENTIONS: Patients went through a simple management protocol involving history, clinical examination, relevant tests and appropriate treatment, including surgery. RESULTS: A total of 27 patients were studied out of which 15 were males and 12 females, giving a male to female ratio of 1.25:1. The age range was seven months-42 years (mean = 13.9 years). Road Traffic Accidents (RTAs) was the commonest cause of scalp defects (81.5%). The temporo-parietal area was involved in over 50% of patients. Chronicity and osteomyelitis were common complications of the defects. Over 50% of the patients had local flap reconstruction. CONCLUSIONS: Management of scalp defects remains a major challenge in our environment. The importance of continuing education of colleagues and other health workers in peripheral health units on the importance of proper initial wound debridement and early referral cannot be overemphasised.

Adolescent↗
PubMed1992

The hair root pattern in psoriasis of the scalp.

Several reports suggest that a localized effluvium of scalp hair may occur in patients with psoriasis. The percentages of telogen and catagen hair have been claimed to be normal or increased in isolated cases. In the present study the anagen/telogen ratio was quantified under standardized conditions in psoriatic plaques and uninvolved areas of the scalp in 22 patients and the scalp of 22 normal controls. This assessment was carried out by light microscopic analysis of hair roots, obtained by the hair pluck-method. A consistent increase in the percentages of telogen and catagen hair was shown in psoriatic plaques, compared with the uninvolved areas. Compared with the scalp of normal controls, this percentage was significantly increased in psoriatic plaques, but not in the uninvolved areas.

Aged↗
PubMedDate not supplied

[Scalp pediculosis in school environment in the city of Abidjan: prevalence and influence of socioeconomic conditions].

Hair samples from 2,209 children aged between 4 and 15 years were analyzed in March and April 1997 in an epidemiological study. We found that the prevalence of scalp pediculosis in schools in Abidjan was 18.51%. The girls were more frequently infected than the boys (24.88% for girls and 11.85% for boys). The children most frequently affected were those aged 14 to 15 years (24%) or 6 to 7 years (23. 21%). The children least affected were those aged 12 to 13 years (15. 21%) or 10 to 11 years (16.21%). Socioeconomic conditions, particularly the monthly incomes of the parents, cramped conditions and the collective use of washing facilities and bedding affected the prevalence of scalp pediculosis. Measures to deal with scalp pediculosis in schools should take into account socioeconomic and psychological factors, which are as important as the drug treatment for scalp pediculosis.

Adolescent↗
PubMed1997

[Effects of scalp acupuncture on focal cerebral ischemia in rats].

OBJECTIVE: To observe the effect of scalp acupuncture on focal cerebral ischemia in rats. METHODS: Focal cerebral ischemia was produced in rats by the occlusion of right middle cerebral artery. The therapeutic action of scalp acupuncture on focal cerebral ischemia was studied by investigating the change of weight, neurologic symptoms, passive conditional reflex, hemorheology, infarct size of brain and pathology of brain tissue. RESULTS: Scalp acupuncture could not only improve obviously neurologic symptoms, prolong latent period of the passive conditional reflex and lower blood viscosity, but also lessen infarct size, promote proliferation and repair of neogenetic capillary and gliocyte in the malactic and necrotic regions and reduce the edema and inflammatory reaction around the necrotic region. CONCLUSION: Scalp acupuncture have therapeutic action on acute focal cerebral ischemia.

Acupuncture Therapy↗
PubMed1999

The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia.

BACKGROUND: Data suggest that androgenetic alopecia is a process dependent on dihydrotestosterone (DHT) and type 2 5alpha-reductase. Finasteride is a type 2 5alpha-reductase inhibitor that has been shown to slow further hair loss and improve hair growth in men with androgenetic alopecia. OBJECTIVE: We attempted to determine the effect of finasteride on scalp skin and serum androgens. METHODS: Men with androgenetic alopecia (N = 249) underwent scalp biopsies before and after receiving 0.01, 0.05, 0.2, 1, or 5 mg daily of finasteride or placebo for 42 days. RESULTS: Scalp skin DHT levels declined significantly by 13.0% with placebo and by 14.9%, 61.6%, 56. 5%, 64.1%, and 69.4% with 0.01, 0.05, 0.2, 1, and 5 mg doses of finasteride, respectively. Serum DHT levels declined significantly (P <.001) by 49.5%, 68.6%, 71.4%, and 72.2% in the 0.05, 0.2, 1, and 5 mg finasteride treatment groups, respectively. CONCLUSION: In this study, doses of finasteride as low as 0.2 mg per day maximally decreased both scalp skin and serum DHT levels. These data support the rationale used to conduct clinical trials in men with male pattern hair loss at doses of finasteride between 0.2 and 5 mg.

5-alpha Reductase Inhibitors↗
PubMed1999

Experience in treating recalcitrant scalp psoriasis with automated shampooing and debridement.

We report the cumulative clinical experience and financial implications of treating severe scalp psoriasis in an outpatient phototherapy center by means of an automated scalp debridement unit. Benefits of this approach included increased patient and staff satisfaction, enhanced response of recalcitrant scalp psoriasis, and detection of scalp dermatoses mimicking psoriasis.

Adolescent↗
PubMed1999

[Congenital arteriovenous malformation of the scalp with a drainage to the transverse sinus: a case report].

Arteriovenous malformation (AVM) of the scalp is uncommon, and a subtype which has connection with the intracranial dural sinus is extremely rare. Only 3 cases have been reported. We present a case of congenital AVM of the scalp which was connected with the intracranial venous sinus. A 27-year-old woman had been noted as having a pulsatile soft mass in the midline of the occipital region since her birth. She visited our hospital because of pain and enlargement of the mass. The patient had had no history of trauma. Physical examination revealed a pulsatile scalp mass in the midline of the occipital region, measuring 3.5 x 3.5 x 1 cm. A loud bruit was ausculated. Tenderness was noted. The skin over the mass was slightly reddish. No focal neurological deficits were noted. Plain skull films demonstrated a round defect in the midline of the occipital bone. Magnetic resonance imaging (MRI) demonstrated a subcutaneous mass with low signal intensity and an infratentorial mass with flow void. 3D CT angiograms demonstrated a subcutaneous vascular mass with a single large vein draining into the right transverse sinus. External carotid angiograms revealed a vascular lesion within the scalp with supply from the branches of the bilateral occipital arteries and the meningeal arteries. The nidus penetrated the skull and connected to a dilated varix, which had a draining vein shunting into the right transverse sinus. After embolization of the right meningeal feeding arteries, surgery was performed. The vascular lesion penetrated the skull and the dura. The infratentorial mass was in the epiarachnoid space and was fed by a small pial artery. The mass was excised completely after interruption of the pial artery and the draining vein. Postoperative course was uneventful. Histologically, the subcutaneous mass and infratentorial vascular mass were shown to be AVM and varix, respectively.

Adult↗