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This study examined facial expression in the presentation of sarcasm. 60 responses (sarcastic responses = 30, nonsarcastic responses = 30) from 40 different speakers were coded by two trained coders. Expressions in three facial areas--eyebrow, eyes, and mouth--were evaluated. Only movement in the mouth area significantly differentiated ratings of sarcasm from nonsarcasm.
Twenty patients with malignant uveal melanoma were treated at the The Svedbergh cyclotron in Uppsala from 1989 to 1991. Each tumour received a total dose of 54.6 Gy in four equal fractions on four following days. After treatment the melanoma in all eyes showed decrease in size combined with irradiation retinopathy. In eight patients the treatment was successful after five years. Nine eyes had to be enucleated, two due to recurrence and seven due to neovascular glaucoma. Three patients died, two from metastases and one from heart disease. In all patients the visual acuity was dependent on the distance between the irradiation field and the macula or optic nerve. Each patient suffered from transient post irradiation skin erythema and permanent loss of eyelashes and eyebrows when these were included in the irradiation field. The development of secondary glaucoma was positively correlated with tumour volume, but not to the age or sex of the patients. Histological examination of all the enucleated eyes revealed residual viable tumour without obvious radiation damage: mitotic figures were not identified. MRI examination, performed before and after treatment, demonstrated a marked shift in water binding properties after irradiation. The final visual acuity was dependent on the location of the tumour.
Trichotillomania is a disorder of compulsive hair pulling that often results in alopecia. The clinical features include the pulling of hair from the scalp, eyebrows, and eyelashes, sometimes symmetrically; pubic and other bodily hair may also be plucked. The disorder is present in 0.6% of college students. The majority of sufferers who seek treatment are female, with usual age of onset between 11 and 16 years. Trichotillomania can occur in a wide variety of psychiatric disorders, and patients with the condition may be more likely to have a lifetime diagnosis of depression or an anxiety, eating, or substance abuse disorder. Although empirically derived treatment guidelines are still lacking, the current literature suggests that behavior therapy and pharmacotherapy are the most efficacious treatments for adult trichotillomania. Controlled trials with pharmacotherapy (clomipramine) have shown significant reductions in hair pulling over the short term. Controlled investigations of behavior therapy have not been conducted, but several treatment series suggest efficacy. At least three reports also suggest that behavior therapy and pharmacotherapy bring some improvement in childhood trichotillomania, although this has not been empirically studied. A case illustrating the combination of behavior therapy techniques and pharmacotherapy in the treatment of trichotillomania is presented.
The clinical and histological findings in two cases of complete bilateral cryptophthalmos from two families are described. In one family, the genetic mode of transmission is most probably autosomal recessive. The parents were first cousins and from the ten deliveries only two children were alive. Seven offspring died soon after birth. At least two of these had complete bilateral cryptophthalmic features in addition to the described offspring. In the other family, the mode of transmission is unclear as the offspring was the first born of non-consanguineous parents with negative family history. Both cases showed similar external clinical appearance and anomalies. Chromosomal studies revealed normal female (first case) and male (second case) karyotypes. The latter, who died a few minutes after delivery, had bilateral agenesis demonstrating features compatible with Potter's syndrome. Apart from the complete covering of the eye globes with skin, the lack of eyebrows and eyelids, the two patients showed also similar histological ocular findings. The eyes in both cases demonstrated well developed posterior segment architecture including optic nerves, with a complete early arrest of anterior segment development and differentiation.
The ocular findings in a newborn with Peters' anomaly and opacity of the lens led to a search for a chromosomal deletion syndrome, confirmed by DNA autoradiography as a partial monosomy 4, Wolf-Hirschhorn syndrome. The child was followed for 13 months. Multiple physical anomalies were observed including incomplete nasal cleft, cerebellar malformations, congenital heart defects, renal malformations, inguinal hernia, malformations of thumbs and toes. Broad beaked nose, broadened nasal root, epicanthus, defect of the medial half of the eyebrows, right-sided facial hypoplasia were the periocular findings. Bilateral microphthalmos, Peters' anomaly with cataracts, and posterior chambers without evident pathology, were found. If the physical development stays satisfactory, anterior segment reconstructive procedures including lensectomy and corneal grafting may prove successful.
Many subfrontal and orbitofrontal craniotomy techniques have been proposed and developed for anterior cranial fossa lesions. The purpose of this study was to evaluate the surgical experience with the frontolateral keyhole craniotomy through a superciliary skin incision in children. The keyhole craniotomy is a modification of the traditional pterional approach. This modified approach, a craniotomy with a 2.5 x 3-cm bone opening just above the eyebrow through a superciliary incision, has been previously described in adults for many lesions situated in the anterior cranial fossa, including tumors and aneurysms. The authors review their experience in using this approach in 27 children for a variety of intracranial lesions. This approach was used for 28 procedures in children ranging in age from 1 to 16 years (mean age 10 years). The lesions included arachnoid cysts, cerebrospinal fluid fistulas, and tumors; no vascular lesions were treated. The authors have found this craniotomy to be a safe and simple approach for treating anterior cranial fossa and suprasellar lesions in children.
The first case was 7-month-old immunodeficiency girl in whom the diagnosis of Acanthamoeba pneumonia was established by culture of a bronchial washing. The patient had been ill for a month when she was admitted due to neonatal thrombocytopenia with respiratory difficulty and treated with gammaglobulin and steroid. Her chest X-ray showed diffuse alveolar consolidation on the left lung with interstitial hazziness and a partial sign of hyperinflation on the right lung. Laboratory tests showed that the Candida antigen was negative and Pneumocystis carinii was not detected. Mycoplasma antigen was negative. All the immunoglobulin levels (IgG, IgA, IgM) were below the normal range. Five days later the patient expired. The second case was an immunosuppressed 7-year-old boy in whom Acanthamoeba trophozoites were found in the skin biopsy, followed by meningitis leading to death. About five days after a laceration on the region of the left eyebrow, a painful bean-sized nodule developed at the suture site and it was treated with antibiotics and corticosteroid. The skin biopsy showed severe inflammatory cell infiltration. Trophozoites were scattered near the blood vessels throughout the inflammatory zone. From one weak prior to admission, the patient had suffered from vomiting, indigestion and mild fever. Skin nodules with tenderness appeared all over his body surface. Examination of cerebrospinal fluid showed clear, Gram stain was negative, bacterial culture negative, India ink preparation negative, and organism on wet smear negative. On admission day 10, focal seizure of the left extremity occurred. Brain CT revealed calcific density on the left parietal lobe area and hypodensity on the left basal ganglia. He became comatous and died immediately after discharge. Until now in Korea, two cases that are described in this paper, one Acanthamoeba meningoencephalitis case and seven Acanthamoeba keratitis cases including two unreported keratitis cases that are reported in this paper have been presented.
Changes taking place in both Qi Gong Masters and their patients during Qi Gong treatment were evaluated using the Bi-Digital O-Ring Test. During the Qi Gong state, on the Qi-Gong Master's body, as well as the body of the patient being treated, acupuncture points CV5 (Shi Men) and CV6 (Qi Hai)-- located below the umbilicus-- show changes from +4 in the pre-Qi Gong state to between -3 and -4 during the Qi Gong state. Before and after the Qi Gong, there is a normal +4 response to the Bi-Digital O-Ring Test at these acupuncture points. Similar changes were also observed on acupuncture points CV17 (Shan Zhong), CV 22 (Tian Tu), Yin Tang (at an area just between the eyebrows: the pituitary gland representation area, colloquially known as the "third eye") and GV20(Bai Hui), the entire pericardium meridian & triple burner meridian, their acupuncture points, the adrenal glands, testes, ovaries and perineum, as well as along the entire spinal vertebrae, particularly on and above the 12th thoracic vertebra, medulla oblongata, pons, and the intestinal representation areas of the brain located just above and behind the upper ear. Using these findings as criteria for evaluating the effectiveness of reaching the Qi Gong state, we were able to reproduce during the experimental trials similar changes in ourselves and the patient being treated with therapeutic effects comparable to those of the Qi Gong Master. Beneficial effects of external Qi Gong treatment given by a Qi Gong practitioner 1 to 3 times for 10-20 seconds each (although most Qi Gong masters take 3-20 minutes per treatment) often resulted in improvement of circulation and lowering of high blood pressure, as well as relaxation of spastic muscles, relief of pain, and enhanced general well-being, all of which resemble acupuncture effects. In order to reproduce the same procedure with others, we selected 4 children ranging between 8 and 11 years of age who had no knowledge of Qi Gong or Oriental medicine. One of these four children, the 8 year old, was able to consistently reach the same Qi Gong state after less than a half day and another child, 11, after less than 2 days. Within a week, the other two were sometimes able to reproduce the Qi Gong state but not always. Using the Qi Gong state thus obtained, it was found that this type of Qi Gong energy is directed to specific directions from the hand and can even penetrate wooden or metal doors.(ABSTRACT TRUNCATED AT 400 WORDS)
Chronic inflammatory sinus disease is a common process, sometimes requiring nasal and paranasal sinus surgery. Extraocular muscle dysfunction is a rare surgical complication of sinus surgery, but has been reported. Previous studies have been concerned with trauma to the medial rectus muscle resulting in severe paralysis or restriction. This study reports five patients with acquired strabismus and symptomatic vertical diplopia secondary to sinus surgery. In all patients, the resultant diplopia was disabling. Four patients had frontal sinus window surgery performed, with incisions placed in the supero-nasal quadrant of the orbit, below the eyebrow (a modified Lynch incision). Three patients acquired a superior oblique paresis and the fourth developed a Brown's syndrome. The location of the skin incision was critical to injury in the trochlear area. The fifth patient underwent a nasal polypectomy and antrostomy with secondary orbital hemorrhage and proptosis. A mild inferior rectus paresis was the result.
A 2-year-old female infant with a presumed diagnosis of infantile hemangioma of the left eyebrow developed acute proptosis of the left eye several days after a mild orbital trauma. Computerized axial tomography (CAT) and carotid angiography confirmed the presence of a vascularized mass in the retrobulbar space, spreading anteriorly to the orbital rim and the frontal area. Due to progression of the proptosis and the development of exposure keratitis, surgical intervention was necessary. A large vascular tumor and a massive hemorrhage occupying the orbit were removed. The pathological examination confirmed the diagnosis of a vascular malformation of the orbit, most probably orbital varices. A relatively good visual acuity was achieved after surgery by occlusion therapy.
There have been many reports on the synkinesis of mimic muscles following facial palsy, and many efforts have been made to evaluate the degree of synkinesis. Even in normal cases, associated movements of facial muscles can been seen. Empirically, mimic muscles move in association, e.g., when the lips are opened to grin, the lateral portion of the eyebrow moves, or when the mouth is moved as in whistling, tension around the root of the nose subconsciously builds up. Our purpose was to evaluate the movements of facial mimic muscles quantitatively, to analyze them in various facial expressions, and to obtain basic data to the objective evaluation of associated movement in normal subjects. Thirty-seven normal subjects (18 males and 19 females, aged 20 to 40 years) were included in the study. A total of 24 markers were stuck to each subject's face. The threshold image process which revealed only the markers, made it possible to trace and measure the markers on the face. The shifting positions of the markers showed that they moved in accordance with the facial movement from the stationary phase to the maximum stage of movement. These positions were measured and the traces plotted on the coordinate axis. The shifting of the markers were then numerically expressed as trajectory investigation. The facial movements examined in this study consisted of eye closing, forehead wrinkling, whistling, and grinning. We found that, quantitatively, certain groups of mimic muscles might work together to make one facial expression in all the above mentioned facial movements. In normal individuals, at least 15-20% of other mimic muscle collaboration is needed in addition to main muscles to create a facial expression. This result can serve as a reference for the evaluation of abnormal associated facial movement.
A 12-year-old boy born of a nonconsanguineous marriage presented with dry rough skin and photophobia since birth. His growth and developmental milestones were normal and there was no history of any neurological problem, hearing deficit or scarring around the hair follicles. Cutaneous examination revealed diffuse thinning of scalp hair with loss of eyebrows and eyelashes and a sandpapery texture of the skin all over the body, suggestive of ichthyosis follicularis with alopecia and photophobia syndrome.
This study assessed the thresholds of orofacial touch and pressure sensation in children and compared them with those in adults. Child subjects who were outpatients of TMDU Dental Hospital and who had no particular systemic diseases other than dental problems, were classified into 4 groups: preschool children (4-5 y, n=26), lower-grade elementary school pupils (6-9 y, n=100), higher-grade elementary school pupils (10-12 y, n=36), and junior high school pupils (13-15 y, n=26). Adult subjects were TMDU students (23-31 y, n=37). The thresholds of touch and pressure sensation were measured with a Semmes-Weinstein pressure aesthesiometer which consisted of 20 filaments with different marking values (Fm). Stimulation was applied with the thinner 10 filaments with lower values ranging from 1.65 to 4.31 Fm (0.0045-2.052 gw). The measurements were carried out on the following 10 points in the orofacial area in all the subjects: the upper lip, gingiva of upper anterior teeth, palate, lower lip, gingiva of lower anterior teeth, buccal mucous membrane, tongue tip, skin above eyebrow, cheek skin and mentum skin. The thresholds in the child subjects were not different from those in the adult subjects on most measurement points, but were significantly different on the gingiva and palate. The lower the age, the lower the thresholds on the gingiva. Since these measurement points are located in the chewing mucous membrane, it is considered that the threshold changes occurred due to histological alterations with growth. It is suggested that the threshold values of orofacial touch and pressure sensation obtained from this study could be used as the standard values for an indicator of the development of oral function and structure in children.
Several features related to waterfowl carcasses were studied at Eyebrow Lake, Saskatchewan, Canada, during a botulism epizootic in the summer of 1989. Dummy carcasses, constructed by stretching duck skins over wooden forms, were used to assess the reaction of waterbirds to carcasses. There was no significant difference in the number of American coots, ducks, grebes, or total birds present when dummy carcasses were or were not present. Only one of 42 freshly-dead bird carcasses marked and observed twice each day was removed by a scavenger prior to the development of large maggots. Maggots developed in all carcasses and were visible externally a mean of 3.9 days after placement of the carcasses. The effectiveness of carcass collection and disposal operations was tested by marking carcasses on the day prior to two scheduled clean-ups. Only 32% of marked carcasses were recovered. Large carcasses and carcasses on or near islands were recovered at a higher frequency than were small carcasses and carcasses not near islands, respectively.
Object of the investigation is: (1) the analysis of the behaviour observed in adults between 18 and 23 years of age regarding cleanliness, body hygiene and changing of underwear,and a comparison of the results with those for 1968; (2) Differential "diagnosis" of the relationship between the degree of cleanliness and the various styles of the upbringing received at the hands of the parents, the different assessment of the personal body image and of cleanliness-related values ("cleanliness ideology"). Main results of the investigation (1) In 1976, too, women remain cleaner than men; the latter, however, have clearly improved their daily washing habits (lower part of the body, feet) and have taken to changing their underwear, night clothes and coloured shirts more frequently. With respect to the frequency with which women change their underwear there has been no change. (2) With respect to body hygiene and cosmetic care, women are found to be making increasing use of mouth-wash, foam bath agents, face lotions and face milk, nail polish, while men are making more use of mouth-wash, bubble bath agents as well as deodorants. In contrast, women are making less use of lip-sticks, eyebrow pencils, Eau de Cologne, (3) Women's behaviour with respect to the observed and evaluated parental upbringing and to their own body image is more differentiated: The 4-factor solution for women contrasts with the 3-factor solution for men. (4) Only a form of cleanliness training involving corporal punishment and associated with a tense or hostile relationship towards the mother or father cannot be correlated to a desirable observance of cleanliness. Other possible forms of cleanliness training including supervisory forms, do not prevent the learning and adoption of desirable practices for achieving cleanliness. (5) Less clean women show a generally less pronounced body-feeling as manifested in active physical exercise in some sports disciplines and in body care. There is also a tendency towards a less motivating criticism of the figure and a lower degree of positive bodily sensibility. As far as men are concerned, the intensity of body hygiene is positively linked with the degree of superficial good grooming and the simultaneous dissatisfaction with the figure. (6) Cleanliness-related concepts (cleanliness ideology) e.g. health, work, generosity rectitude, authority, attractiveness, integrity etc., are, in their evaluation, influenced both by sex and by the hygienic behavior practiced.
Imagine being able to turn on lights, open doors and operate your radio and television set by merely moving your eyebrows up and down. Assistive technology is described as any device that empowers an individual to perform a certain activity that he or she could not perform or would have difficulty performing. It is changing the quality of life for persons with disabilities, enabling them to participate in gainful employment, enjoy recreational activities, return to school, and engage in other activities of independent daily living.
Leprosy in children is more frequent than generally thought. Diagnosis is not easily made because early signs of the diseases are overlooked. Statistic data from the Dermatologic Clinic Pascua of Mexico City reveal that early signs are cutaneous in 67% of cases: hypochromic and anesthetic infiltration, nodules, and alopecia of eyebrows and eyelashes. Neurological symptoms such as anesthesis, facial paralysis, thickening of nerves and trophic problems are present in 19.3% of cases. The nose mucosae are congested in 9.2% of cases. Systemic manifestations may be present in 4% of cases. Examination of contacts living with lepromatous patients is stressed as the best way to discover the early signs of the disease. Dermatological consultation in general and pediatric hospitals is also recommended. If diagnosis is delayed, leprosy can induce physical, psychological and social disabilitation of the patient.
We report a study of 55 subjects with Smith-Magenis syndrome, aged 9 months to 35 years. Each person has been evaluated with an assessment of "gestalt" and detailed facial measurement, using previously published methodology, with compilation of Z score pattern profiles. The facial phenotype of SMS is quite distinctive, even in the young child. The overall face shape is broad and square. The brows are heavy, with excessive lateral extension of the eyebrows. The eyes slant upwards and appear close set and deep set. The nose has a depressed root and, in the young child, a scooped bridge. With time, the bridge becomes more ski jump shaped. The height of the nose is markedly reduced while the nasal base is broad and the tip of the nose is full. The shape of the mouth and upper lip are most distinctive. The mouth is wide with full upper and lower lips. The central portion of the upper lip is fleshy and everted with bulky philtral pillars, producing a tented appearance that, in profile, is striking. With age, mandibular growth is greater than average and exceeds that of the maxilla. This leads to increased jaw width and protrusion and marked midface hypoplasia. Craniofacial pattern analysis supports these subjective impressions. After mid-childhood, mandibular dimensions consistently exceed their maxillary counterparts. Craniofacial widths are greater than corresponding depths and heights. Nasal height is reduced while nasal width is increased. There is mild brachycephaly. The most marked age related changes are increased width of the nose and lower face (mandibular width) with reduction in nasal height and midfacial depth.