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PubMed1975

Conditioning changes in differential skin temperature.

8 male Ss were presented with visual and auditory analog feedback regarding the difference between forehead and finger temperature. 4 Ss were instructed to raise the temperature of their finger in comparison with the forehead, while a second group of 4 Ss was instructed to lower the temperature of their finger in comparison with the temperature of the forehead. After 12 15-min. training sessions all Ss were able to produce changes in differential skin temperature in the specified direction. Differential changes in skin temperature correlated highly with changes in absolute finger temperature. These results are discussed as relevant to the clinical application of skin temperature control.

Adolescent↗
PubMed1986

Drug- and temperature-induced changes in peripheral circulation measured by laser-Doppler flowmetry and digital-pulse plethysmography.

We measured the effects of a new transdermal nitroglycerin patch (25 mg, 10 cm2) applied for 24 h, norphenephrine (6 mg), prazosin (1 mg) as well as local heat and cold provocation on blood pressure, heart rate, skin blood flow (measured by laser-Doppler flowmetry, L-D) and peripheral arterial resistance (assessed by digital pulse plethysmography, D-P) in 15 healthy volunteers (aged 21-31 years). Heat provocation induced a three-fold increase in skin blood flow in the hand (p less than 0.001) and cold provocation a decrease in flow (p less than 0.05) of about 20%. Forehead skin blood flow did not change. Peripheral arterial resistance showed less consistent changes during the provocation tests. Prazosin increased the forehead skin blood flow (p less than 0.01) and decreased peripheral arterial resistance, while norphenephrine showed an opposite effect. Transdermal nitroglycerin induced an increase of 25% in forehead skin blood flow (p less than 0.05) which persisted for 24 h and a decrease in peripheral arterial resistance (p less than 0.02), but this effect was evident up to 8 h only. We conclude that (1) local heat and cold provocation mainly affected skin blood flow, (2) vasodilative and vasoconstrictive drugs showed marked changes in peripheral arterial resistance, but at different points in time from subject to subject, and (3) transdermal nitroglycerin patches induced haemodynamic changes persisting for up to 8-24 h.

2-Hydroxyphenethylamine↗
PubMed1981

Nasal correction in hyperteleorbitism. The short and the long nose.

The soft tissue deformities associated with hyperteleorbitism often present serious reconstructive problems. Although skeletal correction is the basic preliminary step, the final result depends on the quality of the soft tissue and nasal repair. The patients are not interested in the postoperative intercanthal distance or the appearance of the X-ray film. What they want is a good aesthetic appearance and this is closely related to the shape and size of the nose. The short wide noses of the true hyperteleorbitism must be differentiated from the long noses associated with meningoencephalocele and pseudohypertelorism. For the first group, narrowing of the nose and the use of a forehead flap is indicated according to the severity of the problem. For the second group, shortening of the nose is accomplished by transverse resection of skin via a U shaped incision or skin replacement with a forehead flap. Downward sliding of forehead and brows may be necessary. The indication for each procedure is discussed and the different techniques are described.

Abnormalities, Multiple↗
PubMed2004

Acquired, bilateral nevus of Ota-like macules (ABNOM) associated with Ota's nevus: case report.

Ota's nevus is mongolian spot-like macular blue-black or gray-brown patchy pigmentation that most commonly occurs in areas innervated by the first and second division of the trigeminal nerve. Acquired, bilateral nevus of Ota-like macules (ABNOM) is located bilaterally on the face, appears later in life, is blue-brown or slate-gray in color. It is not accompanied by macules on the ocular and mucosal membranes. There is also debate as to whether ABNOM is part of the Ota's nevus spectrum. We report an interesting case of ABNOM associated with Ota's nevus. A 36-yr-old Korean women visited our clinic with dark bluish patch on the right cheek and right conjunctiva since birth. She also had mottled brownish macules on both forehead and both lower eyelids that have developed 3 yr ago. Skin biopsy specimens taken from the right cheek and left forehead all showed scattered, bipolar or irregular melanocytes in the dermis. We diagnosed lesion on the right cheek area as Ota's nevus and those on both forehead and both lower eyelids as ABNOM by clinical and histologic findings. This case may support the view that ABNOM is a separate entity from bilateral Ota's nevus.

Adult↗
PubMed1999

EMG responses in lower leg muscles elicited by head-taps.

Forehead-taps elicited short-latency motor responses in the lower leg muscle which, together with vestibulocollic reflexes, might contribute to multisensory control of posture. We tested this paradigm in human subjects standing upright in order to determine if the responses differed depending on whether the taps were to the forehead or temporal bone. Forehead-taps elicited short-latency inhibitory EMG responses in both gastrocnemius muscles with a mean latency of 48 to 99 ms. The right or left temporal bone-taps elicited short-latency inhibitory EMG responses in the ipsilateral gastrocnemius muscle of 47 to 77 ms, short-latency excitatory EMG responses in the contralateral gastrocnemius muscle of 46 to 78 ms, and short-latency excitatory EMG responses in the contralateral tibialis anterior muscle of 48 to 78 ms. The temporal bone-taps elicited short-latency inhibitory EMG responses in the ipsilateral gastrocnemius muscle and excitatory EMG responses in the contralateral gastrocnemius muscle, which were thought to be generated by vestibular afferents and convergent with vestibular input for the multisensory control of posture.

Adult↗
PubMed2001

The use of skin grafts for nasal lining.

The satisfactory replacement of missing nasal lining often determines the aesthetic and functional result of a nasal reconstruction. Although full-thickness skin grafts have been employed for lining in the prefabricated forehead flap technique, the results are unpredictable because they remain largely unsupported and subject to contraction. Advances in the understanding of the vasculature of the forehead flap, the use of primary and delayed cartilage grafts, and the appropriate use of operative staging permit full-thickness skin grafts to be combined with a forehead flap at the time of transfer, with little risk of loss. The technique is especially useful in the elderly or debilitated patient when a shortened operative time and less intranasal manipulation is appropriate, or when previous injury or rhinoplasty has interfered with septal blood supply, making the use of intranasal lining flaps unreliable.

Humans↗
PubMed2002

Morphological traits in peoples of Mongolian nationality of the Hulunbuir league, Inner Mongolia, China.

A sample of 947 Mongolians of Bargud, Elute and Buriat was investigated on 9 indexes (hair form, forehead hair-ledge point, eyefold of the upper eyelid, Mongoloid fold, ear lobe type, nasal profile, nostril type, front teeth type, and chin projection) in the Hulunbuir league, Inner Mongolia in September 1997. The results are as follows: 1. Most of the Mongolians in Hulunbuir league are characterised by straight hair, forehead hair-ledge point absence, eyefold eyelid, Mongoloid fold appearance, shovel-shaped front teeth, straight nose, wide nostril, free ear lobe, non-projecting chin. 2. The frequencies of the forehead hair-ledge point appearance, shovel-shaped front teeth appearance and projecting chin showed significant differences between the three groups. 3. The incidence of ear lobe type, nasal profile and front teeth type showed obvious sexual differences. 4. Correlations did not occur between most of the nine traits.

Adolescent↗
PubMed2003

Transcutaneous bilirubinometry during and after phototherapy.

AIM: To evaluate the reliability of transcutaneous bilirubinometry (TcB) during and after phototherapy. METHODS: TcB was performed on the forehead and chest of infants with neonatal jaundice when capillary blood was sampled for bilirubin determination in a control group of 240 neonates. In a second group of 70 neonates exposed to phototherapy the same procedure was performed after at least 24 h of exposure: on the forehead, TcB was done in the centre of the unexposed area and also on the adjacent exposed area, and the exposed chest. During the post-phototherapy period, TcB was again done during the first and second days, at least 18-24 h after cessation of phototherapy. The results were then statistically evaluated and regression curves were plotted. RESULTS: A close correlation between TcB values and bilirubin levels was observed in the control group. In the phototherapy group, a correlation was also found between the TcB and the bilirubin values, but this correlation was significantly poorer than that of the controls; the correlation for the covered part of the forehead was significantly better than that of the exposed part but still poorer than that of the controls, though the difference was no longer significant. Skin colour recovered during the post-phototherapy period and correlation was better than that during exposure and no longer significantly different from that of the controls. CONCLUSION: Through its bleaching effect on the skin, phototherapy affects the correlation between TcB and the bilirubin values, but does not totally eliminate it. The unexposed parts show a better correlation, though this was still poorer than that of the controls. Recovery of skin colour occurred within 18-24 h after cessation of exposure.

Administration, Cutaneous↗
PubMed2004

Endoscopic aesthetic facial surgery: technique and results.

The endoscopic approach to forehead and midface lifting has become popular method of face rejuvenation with minimal incisions. We have performed 67 endoscopic facelift procedures in the last four years. Forehead lifting technique included five small scalp incisions, wide subperiosteal elevation, endoscopic myotomy and forehead tissue fixation with srews, superficial temporal fascia (STF) suture to deep temporal fascia (DTF). Midface lifting technique included temporal 2.5 cm and 1.5 cm vertical intraoral incision, midface subperiosteal undermining and midface elevation with cable sutures Bichat's fat to DTF. Age mediana of patients who underwent endoscopic front lift was 46, patients who had endoscopic front lift and midface lift procedure age mediana was 40. Postoperative complication rate was 7.5% and included frontal branch weakness (n=2), hematoma (n=1), infraorbital nerve paresthesia (n=1) and asymmetrical smile (n=1). The main question is the quality of the results. We have reviewed 49 patients who were followed 6 months or more. Preoperative and postoperative life-size photographs were analyzed. The mean elevation mediana at medial canthus was 2.2 mm, at medial limbus 2.3 mm, at lateral limbus 2.5 mm, at lateral canthus 2.9 mm. Midface - lift effect resulted cheek elevation from 1.07 till 4.71 mm lip corner elevation 1.03 mm to 3.27 mm. We observed cheek elevation, improving nasolabial line, increasing volume of malar region, elevating lip angles in patients after endoscopic midface lift. We have found that important advantage of subperiosteal midface lift, when performed in conjunction with endoscopic brow lift, is its ability to move the cosmetic eye unit, proportionally, leading to a harmonious facial appearance. Endoscopic facelift is effective procedure for face rejuvenation especially for eyebrows and cheek elevation.

Adult↗
PubMed2004

Preservation of tap vestibular evoked myogenic potentials despite resection of the inferior vestibular nerve.

Sound and skull-tap induced vestibular evoked myogenic potentials (VEMP) were studied in a 43-year-old man following inferior vestibular neurectomy. Surgery was performed because of a small acoustic neuroma. Postoperative caloric testing suggested sparing of superior vestibular nerve function on the operated side. In response to sound stimulation there were no VEMP on the operated side, irrespective of whether sounds were presented by air- or bone-conduction. This suggests sound-induced VEMP to be critically dependent on inferior vestibular nerve function and this is in agreement with present knowledge. However, VEMP were obtained in response to forehead skull taps, i.e. positive-negative VEMP not only on the healthy side but also on the operated side. This suggests remnant vestibular function on the operated side of importance for forehead skull tap VEMP, because with complete unilateral vestibular loss there are no (positive-negative) VEMP on the lesioned side. Thus, forehead skull-tap VEMP depend, at least partly, on the superior vestibular nerve function.

Acoustic Stimulation↗
PubMed2004

Hypergravity and dehydration-induced shifts of interstitial fluid in the skin monitored by ultrasound.

INTRODUCTION: Spaceflight is associated with a shift of interstitial fluid toward the skin of the head and a fluid loss that can decrease superficial tissue thickness (TT). To collect the physiological data needed to develop techniques for monitoring the hydration status of astronauts during spaceflight, we investigated the changes in TT induced by a 12-h nil-by-mouth period and a 30-min period of +2 Gz hypergravity measured at forehead and tibia. METHODS: There were 16 male volunteers who were twice subjected to 30 min of +2 Gz acceleration in a human centrifuge, once following an oral fluid load of 250 ml x h(-1) (procedure A), and once following a nil-by-mouth period of 12 h (procedure B). The TT at the forehead (TT-f) and tibia (TT-t) was measured before (t0), after 10 min (t10), and after 30 min (t30) of hypergravity using a miniature 10 MHz A-mode ultrasound device. The bodyweight, hematocrit (HCT), and plasma viscosity (PVS) were measured at tO and t0. RESULTS: The nil-by-mouth period induced a significant weight loss and increase in HCT and PVS. A significant increase was noted in TT-t, but not in TT-f (p < 0.05). Following both procedures, exposure to hypergravity produced declines in TT-f at t10 and t30 compared with baseline (p < 0.05), whereas TT-t was not influenced. CONCLUSIONS: Changes in interstitial fluid load of superficial tissues can be tracked by A-mode ultrasonography. Fluid loss-induced changes are best detected at the tibia, hypergravity-induced changes at the forehead.

Adult↗
PubMed2006

The sweating foot: local differences in sweat secretion during exercise-induced hyperthermia.

INTRODUCTION: Little is known regarding local differences in foot sweat secretion. Since such information is important to our understanding of sweat gland control for thermoregulatory modeling and for the design of footwear we explored this topic. METHODS: Local sweat rates were investigated across core temperatures from 37-39 degrees C, achieved using endogenous (cycling) and exogenous heat (water-perfusion garment: 46 degrees C). Six healthy adults (three men, three women) performed one-legged, incremental cycling in a heated, climate-controlled chamber (36 degrees C, 60% relative humidity). Sweat rates were measured at the forehead and stationary (left) foot (capsules 3.16 cm2): three dorsal sites (base of toes, second metatarsal, and mid point), the lateral, and the central plantar surfaces. RESULTS: Terminal core temperatures ranged between 38.3-39.1 oC, with peak heart rates of 155-187 bpm. Most foot sweat rates were < 50% of that observed at the forehead: dorsal 1 (38%); dorsal 2 (54%); dorsal 3 (37%); lateral (24%); and plantar surfaces (18%). When averaged across the trial, local sweat rates were: 2.61 (forehead); 0.98 (dorsal 1); 1.39 (dorsal 2); 0.95 (dorsal 3); 0.62 (lateral); and 0.47 mg cm2 2 min-1 (plantar). CONCLUSION: Two key observations emerged. First, sweat secretion from the experimental foot averaged 30 ml x h(-1), peaking in the last 5 min at 50 ml x h(-1). Second, approximately 70% of the measured sweat flow emanated from the upper skin surfaces, with only 30% coming from the plantar surface.

Adult↗
PubMed1990

[The evaluation of tracheal temperature to monitor core temperature in various operations].

Tracheal temperature was evaluated to monitor core temperature during cardiac, upper abdominal and lower abdominal operations. The tracheal temperature was measured by a thermistor attached to the intra-cuff of the tracheal tube. In cardiac surgery, there was a good correlation between tracheal temperature and forehead deep temperature (r = 0.93) before and after cardiopulmonary bypass, and also between tracheal temperature and the temperature of blood from the cardiopulmonary bypass (r = 1.00) during cardiopulmonary bypass. These results indicate that tracheal temperature accurately reflects carotid artery temperature. In upper abdominal operations, the tracheal temperature showed good correlations with forehead core, esophageal, bladder and rectal temperatures (r = 0.81-0.90). On the other hand, bladder and rectal temperatures were different from forehead deep (r = 0.43, 0.55) and tracheal temperatures in lower abdominal operations. These results suggest that the tracheal temperature is valuable to monitor core temperature.

Abdomen↗
PubMed1989

[Craniosynostoses in Egypt: clinical forms and treatment methods. A study of 55 surgically treated patients].

The relative incidence of the various craniosynostosis deformities in Egypt is given on a total of 55 patients who were operated upon. The most common deformity was oxycephaly, 25 cases (i.e. 45%). Various surgical methods have been applied depending on the deformity present. In isolated scaphocephalic deformities (9 cases), 3 pairs of strip craniectomies also called "the triple strip" were sufficient and gave satisfactory results. For other types of deformities, an attempt was made to improve the aesthetic results following simple forehead advancement, which was done for the first five cases. A newly suggested combined procedure of multiple craniectomies and forehead advancement was applied on 41 patients. This combined "three flap procedure" has been previously presented by the authors (Gheita and Assaad, 1987). In this study it has been further modified so as to be suitable for infantile as well as adult deformities, thus defining them as type I and type II variations. The principle of the technique consists of combining the forehead advancement flap with two pairs of strip craniectomies: a pair of para-sagittal ones and another pair of spheno-temporal ones going to the cranial base as far as the edge of the foramen ovale. This is known as type I. In the type II variety the median strip of bone overlying the sagittal sinus is broken posteriorly so as to lower the vault of the skull whenever necessary, and the spheno-temporal craniectomy is not carried as far downward to the foramen ovale but stops at the level of the zygomatic arch. The details of these techniques are demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Squamous cell carcinoma of the frontal sinus caused osteomyelitis of the frontal bone].

A case of the squamous cell carcinoma of the frontal sinus complicated with osteomyelitis of the frontal bone was reported. A 47-year-old male was admitted to Asahikawa Medical College Hospital because of a bulging of forehead and remittent fever of a six-month history and general convulsive seizures on the day before admission. On physical examination, a bulging of forehead with redness, tenderness and fluctuation was noted. Sense of smell diminished bilaterally. Oto-laryngological examination disclosed paranasal sinusitis. Skull X-P and CT scan suggested osteomyelitis of the frontal bone secondary to frontal sinusitis. However, a frontal sinus tumor with osteomyelitis was also possible. Operation was performed and a granulomatous mass attached to the dura with thick epidural abscess was noted. The mass and affected bone edge were removed. Pathological examination of the specimens disclosed findings of squamous cell carcinoma and osteomyelitis. Recurrence of the tumor rapidly occurred and reoperation was performed a month after the first operation. Postoperative irradiation and chemotherapy with pepleomycin were done but failed to control the growth and recurrence occurred immediately. The tumor penetrated the skin of the forehead and the patient died of cachexy 7 months after the first surgery. Osteomyelitis usually occurred in the metaphysis of long tubular bone and rarely in short bone or flat bone such as a skull. This is attributed to the difference of distribution of the bone marrow vessels. Embolization and subsequent growth of bacteria in the blood flow is less liable to occur in short bone and flat bone.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Squamous Cell↗
PubMed1984

[Is baldness a thermoregulatory adaptive process?].

In 100 adult men the area of the face and neck where beard was growing was measured and compared to that of glabrous skin on the forehead and calvaria. In the population as a whole, forehead area was found to be proportional to bearded area. Forehead and calvaria sweat rate was measured on 10 baldheaded male subjects and compared with that of 10 hairy control subjects during mild hyperthermia. Bald skin was found to sweat more than twice as much as hairy skin. In the light of these results the hypothesis that baldness is a thermoregulatory adaptative process is proposed.

Adaptation, Physiological↗
PubMed1980

[Basic techniques of flap formation and their application (author's transl)].

The different type of soft tissue defect in the face can be rehabilitated by means of classical local flaps, either by advancement, rotation or transposition. The excellent blood supply of the face permits of create a flap by its length which may extended up to 5 times of its diameter, and secondarily, may be turned up to an angle of 180 degree (median forehead flap). Typical donar areas besides the forehead are the nasolabial and submandibular area with the advantage of closure in correlation to the skin tension lines. By using a flap and transposing to the neighbourhood disfigurement of natural apertura, like mouth, nose and eyes, can be eadily avoided. Typical smaller and larger defects are demonstrated on patients following excisional tumor surgery in the forehead, naso-frontal-orbital angle, at the nose, the naso-labial-buccal region. Different ways of flap rehabilitation are analyzed for te same or similar type of defect, which is followed by the surgical and functional end-result. Attention is paid to the W-plasty, whereby a rhomboid defect is created and which can be eliminated with additional W-type incision lines. The results are excellent. Combinations of different types of flaps are possible, when f.e. a total loss of the upper lip and a most subtotal loss of the nose is present.

Face↗
PubMed1981

[Flap-reconstruction in mouth and oropharynx. A clinical comparison of methods (author's transl)].

The possible methods for plastic reconstruction after resection of malignant tumors in the mouth and oropharynx are reported. A total of 165 patients, operated upon between 1973 and 1980, has been reviewed. The tumor was located 26 times in the tongue, 4 times within the base of the tongue, 27 times in the floor of the mouth, 10 times in the floor of the mouth and in the tongue and 80 times in the tonsils. For reconstruction 8 times the deltopectoral flap, 51 times the forehead flap, 42 times the tongue flap, 7 times the myocutaneous sternocleido-mastoideus island flap were used. 8 times other methods were applied, like for instance skin grafts, and in 41 cases a primary closure of the defect was possible. Complete necrosis of the flap were rare, more frequent in contrast were partial dehiscences with or without a fistula. Thus in the forehead flap 5 times a necrosis occurred whereas in 15 cases a dehiscence was seen. Even better results were achieved for the deltopectoral- and tongue flap. In contrast, the skin island of the myocutaneous sternocleidomastoideus flaps all became necrotic, but only once a temporary fistula developed. Of the pectoralis myocutaneous island flaps the first two became necrotic, probably due to lack of surgical experience. Taking into account the surgical expenditure, the functional as well as cosmetical results, the methods may be scaled according to clinical value as follows: The pectoralis major myocutaneous island flap and the tongue flap equally range on the first place, followed by the myocutaneous sternocleidomastoideus island flap, and on the 3. and 4. place by the deltopectoral and forehead flap.

Humans↗