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PubMed1998

[External exposure of hot cell operators in nuclear medicine].

PURPOSE: The coming into effect of decrees No. 626/94, 242/96 and 230/95 has once again brought out the problem of the radiation exposure of hot cell operators in nuclear medicine. MATERIAL AND METHODS: With regard to the activity of the Division of Nuclear Medicine of the Istituto Nazionale Tumori in Milan, a map has been produced of the radiation fields in the hot cell in- and outside the working station by measuring the rate of exposure and evaluating the radiation energy using film dosimeters in multifilter containers. The individual doses were measured with film dosimeters for the sternum, the back of the hand and the wrist, and with thermoluminescent dosimeters for the fingers and forehead. The thermoluminescent ring was worn with the detector towards the palm and towards the back of the hand in order to identify the side that was exposed most; the film dosimeter on the sternum was worn both underneath and above the lead apron to reveal a possible reduction in overall exposure due to attenuation of the lower-energy components. RESULTS: The diffuse radiation field in the hot cell during the usual working activity amounts to 1 microSv/h. Assessment of the energy of the radiation fields within the working station revealed a higher energy (90 to 140 keV) in the source storage area than in the area where the syringes are prepared, the latter being affected by diffuse radiation with components of approximately 35, 90 and 110 keV. The hand of the operator is unevenly exposed to the diffuse radiation field and the fingers are more exposed than the back of the hand and the wrist: when the thermoluminescent ring was worn with the detector towards the palm of the hand the measured values did not show a higher exposure than when it was worn with the detector towards the back of the hand. The equivalent of the overall dose measured underneath the lead apron did not show any relevant reduction of the exposure due to attenuation of the lower-energy component (approx. 35 keV). We report the dosimetric findings regarding the total and partial exposure of four different operators during their regular weekly shift, with the dosimeters for the sternum, ring finger and forehead being replaced daily. The average equivalent of the dose to the hand for the manipulation of 37 GBq of 99mTc, measured with a thermoluminescent ring on the proximal phalanx of the ring finger, ranged 3.9 mSv to 2.0 mSv. Except in one case, the sternum and forehead proved to be well protected by the shielding of the working station. DISCUSSION: The operator who stay in the hot cell for 5 hours/week accumulates, due to the presence of diffuse radiation, 5 microSv/week to the whole body; when his/her hands are inside the working station for 2.5 hours/week in the most unfavorable conditions as regards the presence of radioactive sources, they will be exposed to 1250 microSv/week, independently of dose preparation. The exposure of hot cell personnel is highly dependent on the ergonomics of the operator (build, height, arm spread, hand size, etc.) with respect to the position of the apertures and the inspection windows of the working station; as a consequence, the three dosimetric values (exposure of the sternum, the hands and the forehead) cannot be correlated. The fingers are the most exposed part of the hand, which confirms the appropriateness of our choice of the thermoluminescent ring to measure the partial exposure of the hands. Our results have been compared with those reported in the literature and with statistical data relative to three years of regular activity (1994-1996), during which the hot cell operators were monitored according to the same parameters; female operators proved to be more exposed than males, with average yearly equivalents of the total dose of 2764 microSv and 860 microSv, respectively, and average yearly equivalents of the partial dose to the hands of 32,288 microSv and 9460 microSv, respectively. The average total partial dose equivalent rati

Female↗
PubMed2000

[Clinical and epidemiological aspects of traditional therapeutic scarification in epilepsy in Togo].

One of the major problems of epilepsy in Africa are its social implications. Prejudice against the disease is common and epileptics are marginalised. Epilepsy is concealed from all non-family members. The very pronunciation of the word "falling disease" (as epilepsy is called) is taboo, the disease being regarded as supernatural. This unfavourable context introduces considerable bias in hospital and population-based studies. Traditional doctors are consulted by patients especially when they have such a "supernatural" disease. Traditional scarifications are used for the treatment of epileptics in Togo. We examined the skin of 36,000 patients in the neurological department of Lomé's teaching hospital between 1985 and 1995 and conducted a similar, population-based study on about 20,000 inhabitants in the Kloto district of south-western Togo and on 10,000 inhabitants in the Tone district of northern Togo. Interviews with 40,000 traditional doctors revealed that forehead scarifications are characteristic of epilepsy treatment. More than 80% of epileptics have forehead scarifications. When the seizures are rare, scarifications are slim, short (1-3 mm), near the roots of hair on the forehead and concealed; but when they are frequent, known by many people, scarifications are large, long, visible on forehead, the patient showing the sign of his social sentence.. On the skin of epileptics in Togo, is written the diagnosis of his affection. It only needs to look at it.

Adult↗
PubMed2003

[Sudomotor dysfunction in Parkinson's disease].

Autonomic dysfunction is often associated with the progression of Parkinson's disease (PD). The most frequent manifestations of autonomic dysfunction are cardiovascular symptoms, bladder and bowel dysfunction, and sudomotor dysfunction. However, sudomotor dysfunction in PD remains poorly understood. To evaluate sudomotor function in PD, we quantitatively measured sweating during untreated conditions in 20 patients with PD (age, 62 +/- 5 years) and in 10 age-matched control subjects (60 +/- 6 years). An evaporimeter can measure small amounts of water (g/m2h) evaporated from the body. This device was used to quantify sweating at different sites of the skin (forehead, arm, dorsal part of hand, chest wall, femur, and dorsal part of foot). Sweating demonstrated as amount of evaporated water (mean +/- SD g/m2h) was less in the patients with PD than in the control participants on the dorsal parts of the hand (13.7 +/- 5.2 vs. 23.9 +/- 5.5, p < 0.001) and foot (16.0 +/- 6.0 vs. 22.1 +/- 8.3, p < 0.05). On the dorsal part of the hand, sweating in the patients with PD at Yahr stages I and II was less than that in the control-Participants (15.2 +/- 6.3 vs. 23.9 +/- 5.5, p < 0.05). Sweating in the patients with PD at Yahr stages III and IV was less than that in the control participants on the dorsal parts of the hand (10.8 +/- vs. 2.7 vs. 23.9 +/- 5.5, p < 0.001), and foot (10.9 +/- 2.3 vs. 22.1 +/- 8.3, p < 0.005). Sweating on the dorsal part of the foot was less in the patients with PD at Yahr stages III and IV than that in those at Yahr stages I and II (10.9 +/- 2.3 vs. 18.4 +/- 6.1, p < 0.05). Sweating on the forehead in the patients with PD at Yahr stages I and II stage was slightly but not significantly less than that in the control participants (21.8 +/- 3.8 vs. 32.7 +/- 11.9, p < 0.2). Sweating on the forehead in the patients with PD at Yahr stages III and IV was sightly but not significantly greater than that in those at Yahr stages I and II (25.4 +/- 5.6 vs. 21.8 +/- 3.8, p < 0.2). Increased sweating on the forehead skin might compensate for decreased sweating on the extremital skin. Our results suggest that sudomotor dysfunction in PD primarily affects the distal parts of the upper and lower extremities. Sudomotor dysfunction affecting distal parts of the extremities worsens with increased severity of PD.

Aged↗
PubMedDate not supplied

Relationship between physical parameters and blood flow in human facial skin.

We evaluated the association between the cutaneous blood flow and the three-dimensional morphology of the skin by measuring various aspects of blood flow (resting blood flow, mean blood flow during cooling, minimum blood flow during cooling, mean blood flow after cooling, and maximum blood flow after cooling) of the cheeks and foreheads of 40 healthy women (aged 60-77 years). We also analyzed the three-dimensional morphology of the skin surface (sWa, sWp, sWt, sWq) in replicas obtained from foreheads, cheeks, and other sites on the faces of those subjects. In addition, we measured the skin elasticity and water content of the stratum corneum on the cheeks of those women. No correlation was observed between the parameters of the blood flow and the surface morphology of the forehead. On the cheek, however, significant negative correlations were observed between those parameters. Among the blood flow parameters, the resting blood flow and the mean blood flow during cooling showed particularly high correlations. Concerning the surface morphology parameters, high correlations were observed in parameters related to local changes such as sWp and sWt. None of the cutaneous properties examined (including the skin elasticity and water content of the stratum corneum) correlated with the blood flow or the surface morphology parameters of the cheek. Facial wrinkles are classified into linear grooves, which develop at the corner of the eye and on the forehead, and glyphic wrinkles, which develop as deep grooves in areas such as the cheek. These results suggest that a reduction in blood flow is one of the putative causes of local irregularities observed in the cheek, that is, the glyphic wrinkles, of elderly women.

Aged↗
PubMed2005

Transcutaneous bilirubinometer in assessment of neonatal jaundice in northern India.

This study was undertaken from April 2002 to March 2003 to find out the correlation of transcutaneous bilirubinometer index with serum bilirubin levels in term, pre-term, small for gestation age babies, with and without phototherapy in neonates with jaundice. Another aim was to evaluate the transcutaneous bilirubinometer as a screening device for neonatal hyperbilirubinemia by finding the action levels for TcBI at forehead and sternum at which sample for serum bilirubin estimation should be taken. A total of 104 neonates were evaluated. Mean (SD) age (hours), birth weight (grams) and gestational age (weeks) were 100.4 (37.90), 2264.9 (634.4) and 36.8 (2.9) respectively. Mean serum bilirubin was 16.6 (6) mg/dL. Overall a correlation coefficient of 0.878 at forehead and 0.859 at sternum was observed. On excluding infants receiving phototherapy coefficients of 0.900 at forehead and 0.908 at sternum were noted. Correlation coefficient over forehead and sternum was found to drop from 0.85 to as low as 0.33 with duration of phototherapy exceeding 48 hrs. Lastly the determined action levels had a sensitivity of 77.8 to 100 % in assessing the need for serum bilirubin estimation in various groups.

Administration, Cutaneous↗
PubMed2006

BiliCheck transcutaneous bilirubinometer: a screening tool for neonatal jaundice in the Chinese population.

OBJECTIVE: To verify the usefulness of the BiliCheck transcutaneous bilirubin meter as a screening device for neonatal jaundice in a Chinese population compared with the Minolta bilirubin meter. DESIGN: A prospective correlation study that compared transcutaneous bilirubin measurements with serum bilirubin levels. SETTING: Obstetric ward and a neonatal unit of a regional hospital in Hong Kong. PATIENTS: Neonates with gestation above 32 weeks with neonatal jaundice who were admitted between April 2001 and February 2002. MAIN OUTCOME MEASURES: Transcutaneous measurements of serum bilirubin obtained from the forehead and the sternum with two instruments: BiliCheck and Minolta Airshields JM 102. RESULTS: A total of 77 term and six near-term babies (gestation, 32-37 weeks) were recruited. The mean age at the time of data collection was 3.96 days (range, 2-9 days). The correlations between serum bilirubin and transcutaneous bilirubin measurements of the two devices at the two sites were high, with a coefficient of 0.718 (95% confidence interval, 0.610-0.800; n=100) for forehead measurements, and 0.814 (95% confidence interval, 0.740-0.870; n=99) for sternum using the Minolta Airshields JM 102; and a coefficient of 0.757 (95% confidence interval, 0.657-0.827; n=98) for forehead measurements, and 0.794 (95% confidence interval, 0.700-0.862; n=92) for sternum using the BiliCheck. For BiliCheck, a cut-off point of 250 micromol/L at the forehead and 260 micromol/L at the sternum had a specificity of 61.9% and 70.0%, respectively with a sensitivity of 100% for the detection of serum bilirubin concentrations of 250 micromol/L or higher. This level is commonly used as the level for initiation of treatment such as phototherapy. CONCLUSION: BiliCheck is a useful screening tool for neonatal jaundice in the Chinese population and is comparable with the Minolta Airshields JM 102.

Bilirubin↗
PubMed2006

[Endoscopic method of the face rejuvenation].

Technical aspects of endoscopic aesthetic interventions, conducted in 65 patients with various signs of early ageing of the face and neck tissues and aesthetic defects in 1996-2005 yrs, are stated. In general four types of endoscopic operations were performed: complete (subperiostal) lifting of forehead, the forehead and middle zone of face lifting, the forehead and face lifting, cervicoplasty, the forehead lifting and the twoplane lifting of face. There were presented possible complications of endoscopic operations, which are less frequent and severe than after performance of open interventions.

Adult↗
PubMed1990

[Cutaneous microbiologic profiles of Japanese adults residing in the United States of America].

Quantitative cutaneous bacteriological profile analysis was performed on 20 healthy Japanese adults. Five ecologically different sites were cultured, the forehead, anterior nares, axilla, perineum, and fourth interspace. Antibiotic sensitivity patterns were determined for the various species of coagulase negative cocci (CNS). Aerobic organisms were found in densities exceeding 10(6) per sample for all sites except the forehead (10(4)), while anaerobic Propionibacteria were found in quantities ranging from 10(5) to 10(6) per sample except for the toe web space, which was devoid of anaerobic organisms. CNS were ubiquitous. Staphylococcus aureus varied from 15% to 35%. Lipophilic diphtheroids were found in 50% of the subjects on the forehead and nearly 100% on other sites, whereas multiple antibiotic resistant lipophilic diphtheroids (Group JK) were found in the perineum of 35% and in the toe space of 15%. Gram negative bacilli were uncommon on the forehead, axilla, and the toe web space, but were found in 50% or more in the anterior nares and perineum. Penicillin and ampicillin resistant CNS were commonly seen, while oxacillin and cephalosporin resistance were uncommon. Tetracycline and erythromycin resistance was seen in 35% to 40%.

Adult↗
PubMed1996

Doppler-assisted vascular pedicle flaps in eyelid and periorbital reconstruction.

The use of a transcutaneous ultrasonic Doppler flow detector to identify the supratrochlear and superficial temporal arteries permits the design of narrow-based, thin-tipped forehead flaps for use in medial canthal and eyelid reconstruction. In the 13 cases described, the axial, vascular supply of a proposed myocutaneous forehead flap was determined with a transcutaneous ultrasonic Doppler flow detector permitting narrow-based pedicle widths of 0.8 to 1.2 cm. The design of the distal portion of the flap was determined by the primary defect. The width of the flap varied from 1.5 to 4.0 cm, with the flap's axial length limited only by the hairline. This use of the ultrasonic Doppler flow detector, permitting narrow-based, thin-tipped vascular pedicle flaps, has assisted in refining the concept of forehead flaps and has made these flaps an acceptable primary reconstructive technique in the periorbital region.

Aged↗
PubMed1983

Current concepts of browpexy.

The excess skin of the upper lid is not uncommonly secondary to the ptosis of the eyebrows. Blepharoplasty not only fails to correct this deformity but, in fact, may aggravate the sagging of the eyebrow, imparting a sad and elderly appearance to the face. A gracefully arching eyebrow at or slightly above the supraorbital rim renders the face more alert and beautiful. Of many procedures described, three browpexy techniques have withstood the test of time, each with its own set of advantages and limitations: (1) direct, (2) midforehead, and (3) frontal lift. Particular emphasis is given to the coronal-type forehead lift which, in addition to browpexy, can deal with the ptosis of the forehead, transverse forehead wrinkles, and glabellar rhytids.

Blepharoptosis↗
PubMedDate not supplied

Open frontal lift: a conservative approach.

This study aimed to demonstrate that during an open frontal lift, transection of the galea is not necessary. The forehead is elevated, and the ptotic brow is raised after a strip of skin or scalp is removed by folding of the galea. The marcation is penciled on the skin according to the amount of skin--scalp the surgeon estimates it is necessary to remove. Local anesthesia is profusely injected, separating all layers and facilitating surgery. The skin is stripped off the galea, and then through a small incision in the middle, a large dissector separates the galea from the periosteum of the forehead and temporal regions. This dissection can be completed from the temporal area or from the blepharoplasty incisions. With a long pair of scissors, the orbital borders are reached and opened perpendicularly to the bone, releasing the fascia and muscle attachments from the orbital rim without anything being cut. During the coronal approach, once the scalp and forehead are completely mobile, the galea is folded with a continuous running 3/0 Vicryl suture, which after five or six big bites is strongly pulled to fold the galea. The wound then is sutured without tension using staples. When the incision is precapillary, the folding is fixed with Vicryl 3/0 uncolored thread, and the skin is sutured with mononylon 6/0. Complementary corrugator transections are performed from the blepharoplasty incision or by use of the endoscope. With the coronal approach, the surgery requires about 20 min, whereas the precapillary approach requires about 40 min. When only the skin is removed, bleeding is scarce and frontal postoperative edema is minimal. The author has used these techniques in 22 precapillary cases and the intracapillary procedure in 28 cases, some of which had a 4-year follow-up period. With the precapillary approach, temporary paresthesia occurred in some cases, but in all cases, sensibility was recovered within the first 2 to 6 months. With this simple and brief technique, the galea is not transected, no branches of the sensitive nerves are sectioned, and temporal and frontal arteries and veins that supply the scalp are not interrupted. Thereafter, wound healing is fast, allowing a quick recovery without areas of permanent numbness. As a result of this technique, the position of the eyebrows is the same as when frontal lifts are performed with transection of the galea and eversion of the flap, but without the side effects.

Contraindications↗
PubMed2006

Validity of pressure pain thresholds in female workers with and without recurrent low back pain.

Recurrent low back pain (LBP) is a common pain condition in elderly workers in a variety of occupations, but little is known about its origin and the mechanisms leading to an often disabling sensation of pain that may be persistent or intermittent. In the present study we evaluated the pressure pain thresholds (PPTs) in subjects suffering from recurrent LBP, as well as in healthy controls, to investigate if recurrent LBP is associated with an increased sensitivity of the muscular and ligamentous structures located on the lower back. One hundred and six female workers, aged between 45 and 62 years and working either in administrative or nursing professions were examined. The subjects were classified into LBP cases and controls based on the Nordic questionnaire. Subjects indicating 8-30 or more days with LBP during the past 12 months were graded as cases. PPTs were measured on 12 points (six on each side of the body) expected to be relevant for LBP (paravertebral muscles, musculus quadratus lumborum, os ilium, iliolumbar ligament, musculus piriformis and greater trochanter), as well as on a reference point (middle of the forehead) using a digital dolorimeter. The PPTs on all points on the lower back highly correlated with each other and a high internal consistency was found with a Cronbach alpha coefficient > 0.95. There was a moderate and significant correlation of the PPT on the forehead with the PPT on the lower back with correlation coefficients ranging from 0.36 to 0.49. In LBP cases from administrative professions, the PPT on the forehead was significantly decreased (P < 0.05). The PPT on the lower back did not significantly differ between the four groups studied, namely nurses and administrative workers with and without recurrent LBP. These results give evidence that recurrent LBP is not associated with an altered sensitivity of the muscular and myofascial tissues in the lumbar region. Furthermore, they raise questions about the value of reference point measurements in recurrent LBP.

Administrative Personnel↗
PubMed1997

Responses in skin microcirculation to vestibular stimulation before and during motion sickness.

BACKGROUND: Observation of physiological changes during motion sickness is required to quantify the degree of sickness. The review of the literature does not show unifying results. An objective symptom of motion sickness is facial pallor. It reflects changes in skin microcirculation which have not been measured so far. METHODS: Eleven healthy volunteers susceptible to motion sickness were subjected to eccentric vertical axis rotation. The dynamics and the correspondence of the changes in skin blood flow in two segments, forehead and finger, were measured by laser Doppler flowmeter. RESULTS AND CONCLUSIONS: The difference in the microcirculatory skin blood flow across the phases of motion sickness is significant for the forehead but not for the fingertip: the established dynamics of the forehead blood flow during motion sickness will be of benefit in quantifying the degree of sickness; there is no correlation between the blood flow changes in both measured areas; the rhythmic blood flow fluctuation increases during motion sickness; there is a difference between the blood flow responses to vestibular stimulation before the appearance of motion sickness and in the course of the sickness. Laser Doppler flowmetry is a reliable method in quantifying the degree of motion sickness.

Adult↗
PubMed2003

Hyperaemic response to cigarette smoking in healthy gingiva.

BACKGROUND AND AIM: Cigarette smoking is currently considered as a risk factor for periodontal disease. Controversy exists as to whether the vasoconstrictive property of nicotine is one of the pathogenic mechanisms. To this end we tested the hypothesis that cigarette smoking is causing vasoconstriction in the healthy human gingiva. MATERIALS AND METHODS: Gingival blood flow was continuously measured with laser Doppler flowmetry in healthy (n=13) casual consumers of tobacco. Simultaneously, recordings were made of skin blood flow in the forehead and the thumb as well as heart rate (HR) and blood pressure (BP). In another session infraorbital nerve block anaesthesia (INB) with 1.0 ml of Carbocain without vasoconstrictive additives was used to identify nervously mediated vascular responses to cigarette smoking (n=8). RESULTS: Cigarette smoking induced a modest hyperaemic response in the gingiva that was lower than the relative increases in BP and HR, and the calculated gingival vascular conductance decreased. In the forehead, flow responses were similar to those in the gingiva, while in the thumb a powerful vasoconstriction was observed. During the later part of the 10-min recovery period, BP and HR tended to decrease while blood flow in the gingiva and forehead remained high. INB potentiated the hyperaemic response to cigarette smoking in gingiva. CONCLUSIONS: The present results help to shed some light on the understanding of the vasoactive mechanisms induced by cigarette smoking, and to support the hypothesis that cigarette smoking causes nervously mediated vasoconstriction in the healthy human gingiva. However, the degree of vasoconstriction was far less than in the thumb skin, and in our subjects was overcome by the evoked rise in arterial perfusion pressure. As a consequence, gingival blood flow increased during smoking. It is speculated that small repeated vasoconstrictive attacks due to cigarette smoking may in the long run contribute to gingival vascular dysfunction and periodontal disease.

Adult↗
PubMed2000

Effective treatment of frontal hyperhidrosis with botulinum toxin A.

BACKGROUND: Focal hyperhidrosis is a common condition mostly confined to the axillae, palms and soles. In some individuals, predominantly men, increased sweating of the forehead may be the major complaint and may interfere with the person's quality of life. Botulinum toxin A has been shown to be a very effective treatment for focal hyperhidrosis of the axillae and palms. OBJECTIVES: To assess the response in 10 men suffering from frontal hyperhidrosis treated with botulinum toxin A. METHODS: Botulinum toxin A Botox was injected at multiple sites evenly distributed over the forehead (mean dose 86 mouse units). RESULTS: The mean +/- SEM amount of sweat was significantly reduced, 4 weeks after treatment, from 173.8 +/- 38.6 mg min(-1) to 53.7 +/- 17.6 mg min(-1). The effect lasted at least 5 months in nine of the 10 patients. All patients subjectively judged the treatment as very effective. Minor side-effects included painful injections and a transient weakness of forehead muscles without ptosis. CONCLUSIONS: In this study, we provide evidence that botulinum toxin A is an effective and safe treatment for frontal hyperhidrosis.

Adult↗
PubMed2001

Influence of body water distribution on skin thickness: measurements using high-frequency ultrasound.

BACKGROUND: Although it is known that the skin acts as a water reservoir and participates in the fluid content of the whole body, no method has been established to quantify the fluid shifts in superficial tissue. OBJECTIVES: The aim of this study was to investigate changes in dermal and subcutis thickness and echodensity at the forehead and lower leg by high-frequency (20 MHz) ultrasound under various physiological conditions influencing water balance. METHODS: These parameters were measured in the skin of 20 healthy male volunteers at baseline and successively at 30 min after lying down, in a head-down position, after physical activity and after infusion of 10 mL kg-1 body weight of Ringer's solution. RESULTS: Dermal thickness at the forehead showed a significant increase from baseline to a horizontal position and a further increase in the head-down position. Physical activity did not lead to further changes, whereas after fluid infusion the dermal thickness also increased markedly. The echodensity showed inverse changes, with decreasing values. The thickness of the subcutis increased slightly from baseline to a lying position and decreased in the head-down position and after fluid infusion. At the lower leg, skin thickness decreased slightly in the head-down position with elevated legs, and increased after fluid infusion. CONCLUSIONS: Our results show that slight changes in the water distribution of the body influence the thickness and the echodensity of the dermis. Changes are more pronounced at the forehead than on the lower legs. Further, the fluid storage takes place mainly in the dermis and not in the subcutis. High-frequency ultrasound is able to quantify these effects and is a sensitive method for measuring fluid intake and balance during anaesthesia and therapy.

Adult↗
PubMed1999

Head, neck and trunk movements accompanying jaw tapping.

Several studies have examined the functional relationship between mandibular movement and head or body posture, but head and body motion during jaw movement have not been extensively investigated. Ten healthy participants performed repetitive jaw tapping movement. Piezoelectric accelerometers were attached on the surfaces of the participant's forehead, mentum, and over the spinous processes of the sixth cervical, twelfth thoracic and third lumbar vertebrae. The direction in which the antero-posterior acceleration signals appeared around the onsets of jaw opening and closing were observed for the period from the 6th to the 25th strokes of the jaw tapping. Around the onset of jaw opening, the forehead and the lumbar vertebra tended to move posteriorly, but the cervical and thoracic vertebrae moved anteriorly with significant frequencies. The directions of the motions of these locations reversed themselves at the beginning of jaw closing; so the motions of the forehead and the lumbar vertebra were opposed again to the ones of the cervical and thoracic vertebrae. The results suggest that the head extend-flex motion often accompanied the jaw open-close movement, and the motions of the neck and trunk existed, which would serve the purpose of promoting the mandible to move smoothly.

Acceleration↗
PubMed1986

Chronic paroxysmal hemicrania. X. On the autonomic involvement.

In four patients with chronic paroxysmal hemicrania, two of whom could precipitate attacks mechanically, various autonomic function tests were carried out in connection with attacks. Not all features could be studied in all patients. Forehead sweating and temperature were measured. Sweating, tearing, and nasal secretion were studied after systemic atropine administration, which reduced attack-related sweating, tearing, and nasal secretion markedly. Intra-ocular pressure was measured before and after the topical administration of an alpha-receptor blocking agent, thymoxamine. After topical thymoxamine no definite intra-ocular pressure increase occurred during precipitated attacks. In attacks precipitated by head movements, forehead sweating occurred seconds (up to 30 sec) before the pain. This study indicates that at least in some CPH cases, forehead sweating is not caused by the pain. Nor is the pain secondary to increase in intra-ocular pressure. The thymoxamine experiments seem to indicate that alpha-receptors in some way may be connected with the intra-ocular pressure increase during attack.

Atropine↗