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At least 1,135 records · Page 63Linked to original sources
PubMed1999

Laser resurfacing complication.

A 43 year-old woman had full facial laser resurfacing for treatment of multiple actinic keratoses and aging skin. Healing was uneventful on most of the areas treated except the forehead, where a progressive nonhealing wound developed. After seeking numerous consultations around the Southeast, the patient came to our facility, 6 months after the initial laser treatment, with exuberant granulation tissue of the forehead and temples and a painful wound. Many topical treatments had been previously tried. Debridement and split-thickness skin grafting were done using general anesthesia. Pathologic analysis revealed hyperplastic granulation tissue and epidermal appendages. The wound healed with an improved aesthetic result. This case illustrates that seemingly impossible laser complications can be handled by a basic approach to wound healing.

Adult↗
PubMed1999

Aesthetic periocular surgery including brow, midface, and upper face.

Because of the rapid evolution and wide scope of cosmetic surgery in this decade we focus on some of the newer techniques used by oculoplastic surgeons for the rejuvenation of the periorbital area. These procedures may be used alone or as adjuncts to more established plastic surgery techniques. We discuss the role of botulinum toxin in the treatment of facial furrows, new techniques in forehead and brow suspension, the suborbicularis oculi fat suspension, and the role of chemical peels in the periorbital area, upper face, and forehead. All four of these techniques are important in addressing facial rhytids in the periorbital region. It is important to realize that in modern-day cosmetic surgery the best results are achieved using a multidimensional approach incorporating surgical procedures together with nonsurgical techniques or minimally invasive procedures.

Esthetics↗
PubMedDate not supplied

Use of the pericranial flap in medial canthal reconstruction: another application for this versatile flap.

PURPOSE: To describe the use and outcomes of a versatile surgical technique in the reconstruction of deep soft tissue and bony defects of the medial canthus. METHODS: A retrospective review of consecutive cases requiring reconstruction of medial canthal defects involving loss of periosteum or bone by a median forehead pericranial flap and full-thickness skin grafting in a tertiary referral hospital setting. Two techniques were used: an open technique, using a midline forehead incision; and an endoscopic technique, using 2 incisions behind the hairline. RESULTS: Twenty-one cases were identified: 19 open and 2 endoscopic. The average length of follow-up was 13 months (range, 6-50 months). Ten cases required additional oculoplastic procedures including local periosteal flaps and mucous membrane grafts. Two cases (10%) had complete flap failure; one of these was caused by infection. Five (24%) had partial (< 50%) skin graft necrosis. Two cases (10%) have required further surgery. CONCLUSIONS: Our experience shows the pericranial flap to be versatile, robust, and easy to manipulate, offering advantages over alternative techniques when used for the repair of deep medial canthal defects. It is a valuable reconstructive technique that can yield good cosmetic and functional results.

Adult↗
PubMed1985

Measurement of sebum secretion rates in young children.

Sustainable rates of lipid secretion were measured on the foreheads of 24 children, ages 6-8. The method of measurement involved absorption of skin surface lipid into bentonite clay and subsequent separation and measurement of the various lipid classes by quantitative thin-layer chromatography. In 9 of the children, sebum secretion appeared to be virtually nonexistent, judging by the low amounts of lipid recovered and the low percentages of wax esters and squalene, which are purely sebaceous lipid classes. An effect of age on sebum secretion rates was observed with median rates of wax ester secretion, being 7, 28, and 48 micrograms/10 cm2/3 h for 6-, 7-, and 8-year-olds, respectively. These values are well below those of most young adults. The relation between wax ester secretion rate and skin surface lipid composition on the forehead was investigated and found to conform to the formula: microgram wax esters/10 cm2/3 h = 28 X wax esters/(cholesterol + cholesterol esters), with a correlation coefficient (r) of 0.94.

Aging↗
PubMed2006

Quantitative investigation on the distribution of Malassezia species on healthy human skin in Korea.

This study concerns a culture research based on the data gathered from Korean subjects to examine distribution of Malassezia yeast. Malassezia yeast were cultivated out of samples from scalp, forehead, chest, arm and thigh. Malassezia restricta was recovered more frequently in the teens and young adults, while M. globosa was the predominant species in subjects older than 50 years of age. The population density of Malassezia yeast was significantly higher in the age group (AG) of 21-30 years compared with other AGs (P < 0.05). It was also significantly higher in the chest compared with the forehead, arm and thigh (P < 0.05). The key is to recognise the existence of a difference in the amount and type of Malassezia species in different AGs as well as body areas, which reflects differing skin lipid levels in various AGs and different body areas.

Adolescent↗
PubMed1991

Transcutaneous bilirubinometry: effect of postnatal age.

The purpose of this study was to determine whether the postnatal age might affect the accuracy and reliability of transcutaneous bilirubin measurements. A total of 576 transcutaneous bilirubin measurements were performed on 336 Japanese full-term breast-fed newborn infants during the first 12 days of life. We divided them into three groups according to postnatal age and studied the effect of postnatal age on the accuracy and reliability of TcB measurements. Our study revealed that the most reliable site for transcutaneous bilirubin measurements changed from the forehead to the sternum with advancing postnatal age (i.e. forehead for 0-3 days, chest for 4-5 days, sternum for 6 days and later).

Age Factors↗
PubMed1993

The cold pressor test: vascular and myocardial response patterns and their stability.

The purposes of the present study were to compare the cardiovascular response patterns evoked by three versions of the cold pressor test (either forehead stimulation or hand or foot immersion) and to determine the reproducibility of the responses over a 2-week interval. Blood pressure, heart rate, stroke volume, cardiac output, total peripheral resistance, and systolic time intervals were obtained during rest and during the cold pressor test in 42 young men. Across conditions, the pressor response was supported by peripheral resistance increases with concomitant stroke volume decreases. Although the response patterns were generally similar across sites, exceptions were apparent for heart rate. Forehead stimulation was characterized by no significant change in heart rate, whereas limb (hand or foot) immersion was associated with significant heart rate acceleration. The responses elicited by the three cold pressor test conditions were reliable and showed little evidence of attenuation over the test-retest interval.

Adolescent↗
PubMed1997

The effect of adrenergic blockade on blushing and facial flushing.

The effect of adrenergic blockade on vascular responses in the forehead was assessed during stressful mental arithmetic, singing, and moderate exercise in 21 frequent blushers and 21 infrequent blushers. Adrenergic antagonists were introduced into a small site on the forehead by iontophoresis, and vascular responses were monitored bilaterally with laser Doppler flowmetry. Beta blockade prevented increases in blood flow in infrequent blushers during mental arithmetic and partially inhibited vasodilatation during singing, indicating minor participation of beta-adrenoceptors in blushing. Alpha blockade did not affect blushing but augmented vasodilatation during exercise. Despite higher ratings of self-consciousness in frequent than in infrequent blushers, vascular responses were similar in both groups. Thus, blushing propensity does not appear to be related to the density of alpha- or beta-adrenoceptors in facial vessels and may have a psychological basis.

Adolescent↗
PubMed1999

Potential mechanisms of susceptibility to periodontitis in tobacco smokers.

Tobacco smoking is probably the most important, controllable environmental risk factor in periodontitis. It results in changes in the vascular, inflammatory, immune and healing responses. The degree of exposure to tobacco smoking can be measured in pack years or by measuring serum cotinine and nicotine levels. In a previous paper we reported elevated levels of serum soluble intercellular adhesion molecule-1 (sICAM-1) in smokers, regardless of periodontal status. Elevated sICAM-1 has been found to be a risk marker for cardiovascular disease. In the present paper we report the short-term effects of an episode of smoking on blood flow and levels of sICAM-1. Human volunteers included non-smokers, light smokers and heavy smokers. Relative blood flow was monitored in the gingivae and forehead skin using a laser Doppler flowmeter and serum levels of sICAM-1, cotinine and nicotine measured before during and up to 60 min following an episode of smoking. We could not provide evidence to support the theory that there is localized vasoconstriction within the gingival tissues. In contrast, there was a significant increase in blood flow in the forehead skin of light smokers which was not observed in non-smoking controls or in heavy smokers, suggesting a long-term tolerance in this latter group. The level of sICAM-1 remained unchanged during this episode, further suggesting a long-term effect. In a parallel group of subjects, we were able to demonstrate a direct significant correlation between sICAM and serum cotinine levels. These observations may be relevant to aetiological mechanisms in periodontitis and other smoking-associated diseases.

Cotinine↗
PubMed1990

Sympathetic discharges in the human supraorbital nerve and their relation to sudo- and vasomotor responses.

1. Sympathetic nerve activity occurring as bursts of multi-unit impulses was recorded with tungsten microelectrodes in the supraorbital nerve of awake healthy subjects. Within the fascicular innervation zone on the forehead, skin resistance was measured as an indicator of sweat gland activity, and skin blood flow was measured with laser-doppler flowmetry. 2. At room temperature, there was little or no background burst activity, but arousal stimuli or mental stress evoked bursts followed by a vasodilator response. Provided repeated arousal stimuli were delivered, individual bursts were followed by a decrease in skin resistance. 3. Body heating induced increasing background burst activity. After an initial period without associated electrodermal activity, there were decreases in skin resistance, which showed a positive linear correlation with the amplitude of the preceding burst. Individual bursts were followed by a vasodilator response with an average onset latency of 2.8 s and an average duration of 9.1 s, and rapid increases in blood flow coincided with a marked increase in burst activity. Arousal stimuli evoked bursts followed by both vasodilator and skin resistance responses. 4. During body cooling, there was no background burst activity, but signs of relatively weak, probably neurally mediated vasoconstriction were observed and arousal-evoked bursts were reduced or abolished, as were the associated vasodilator and skin resistance responses. 5. It is concluded that body heating induces active sympathetic vasodilatation in the skin of the human forehead, and that this is either sudomotor-mediated or caused by vasodilator fibres firing in synchrony with sudomotor fibres. A similar sympathetic mechanism probably underlies the vasodilator responses evoked by arousal stimuli and mental stress.

Adult↗
PubMed1997

Capillary refilling time in newborn babies: normal values.

AIM: To assess the normal values of capillary refilling time (CRT) in healthy newborn babies; to assess the effect of different nursery containers (incubator, radiant warmer, crib), phototherapy, birthweight, gestational age, size for gestational age and sex on CRT; to compare CRT at different body sites as well as to assess the variation between observers. METHODS: Healthy neonates (n = 469) of different gestational ages and different sizes for gestational age, were studied 1 to 7 days after birth. CRT was measured in four of the most suitable sites-namely, midpoints of the sternum and the forehead, the palm of the hand and the plantar surface of the heel (defined as chest, head, palm and heel, respectively). The applied pressing time was 5 seconds. CRT was measured with a manual stopwatch. RESULTS: Only the chest and the head distribution curves followed the Gaussian curve. The mean values and standard deviation of CRT in all tested nursery containers, including phototherapy for the chest, ranged from 1.82 (0.34) seconds to 2.01 (0.423) seconds, and for the head from 1.59 (0.36) seconds to 1.83 (0.31) seconds. The mean value of chest CRT was always longer than the head CRT for all parameters. Significant differences were found between different nursery containers, receivers, and non-receivers of phototherapy and between observers. No difference was found between sex, birthweight, gestational age and size for gestational age. CONCLUSIONS: The upper limit of normal for neonatal CRT was 3 seconds. Nursery containers, phototherapy, and observers produced significantly different results, but the differences were not clinically important. CRT values of the midpoints of the sternum and the forehead are the most consistent.

Capillaries↗
PubMed1991

Percutaneous penetration of methyl nicotinate at three anatomic sites: evidence for an appendageal contribution to transport?

Percutaneous absorption of the vasodilator methyl nicotinate (MN) was evaluated in human volunteers at three anatomic sites (forehead, forearm and palm) using the technique of laser Doppler flowmetry (LDF). The experiments were designed to test the hypothesis that the kinetics and extent of skin penetration are dependent upon the appendageal density at the site of application. The LDF technique measured the increase in skin blood flow elicited by topically applied MN once the chemical had penetrated to the microvasculature. Significant differences in the measured LDF responses at the three sites were found, and further analysis of the data suggested that MN penetration was greatest through forehead skin, least through the palm and intermediate across the skin of the forearm. A correlation therefore existed between apparent MN absorption and appendageal density.

Administration, Cutaneous↗
PubMed1985

Agitation-increased electromyogram activity in the corrugator muscle region: a possible explanation of the "Omega sign"?

The corrugator muscle region of the forehead has special significance in producing facial expressions associated with depression. Darwin observed in 1872 that contractions in the corrugator region produce peculiarly formed wrinkles on the forehead, referred to as "Omega Melancholium." In the present study, results from 61 right-handed, drug-free women with major depressive disorder showed a significant positive correlation between facial corrugator EMG values and psychomotor agitation. Results were not due to differences in severity of depression. These data offer preliminary evidence that agitation is reflected in corrugator muscle activity and may explain the "Omega sign" of melancholia.

Adult↗
PubMed2004

Intercompartmental fluid volume shifts during cardiopulmonary bypass measured by A-mode ultrasonography.

To investigate the time course of fluid extravasation during cardiopulmonary bypass (CPB), we measured the peripheral tissue thickness (TT) by A-mode ultrasound in 34 patients undergoing elective cardiac surgery. TT of the forehead was determined by a handheld A-mode ultrasound device and 10 MHz Transducer at nine defined intervals, from the night before surgery until the first postoperative day. Mean calculated loss of 1700 +/- 40 mL (SEM) water during the fasting period resulted in a significant reduction of TT by 0.28 +/- 0.03 mm. From induction to start of CPB, rehydration with 1000 mL of fluid was performed and TT increased to baseline. After 60 min of extracorporal circulation, forehead TT increased significantly by 0.75 +/- 0.08 mm and remained unchanged until the end of surgery when the measured fluid gain was 1580 +/- 138 mL. At discharge from ICU, negative fluid regimen resulted in a balance of -127 +/- 146 mL whereas TT declined significantly to +0.16 +/- 0.09 mm compared to baseline. Dehydration due to fasting and the marked interstitial fluid extravasation during CPB could be detected by the changes of the peripheral TT. We conclude that parts of the fluid load during CPB are shifted from the intravascular compartment to the interstitial space in a time-dependent manner.

Aged↗
PubMed2002

Bone conduction hearing on the teeth of the lower jaw.

Bone conduction stimulation of the teeth of the lower jaw initiates auditory sensations. However the lower jaw is only loosely coupled to the skull by the temporo-mandibular joint. Therefore the 'classical' bone conduction pathway involving skull vibration transmission entirely along bone to the temporal-petrous bone requires further consideration. Bone conduction hearing thresholds to stimulation at the forehead and at the teeth of the upper and lower jaw were determined in human subjects. Thresholds on the teeth were better than those on the forehead and there was no difference between the thresholds measured following stimulation of the upper and lower teeth. Experiments in guinea-pigs provided evidence that vibration of the teeth leads to transmission of the audio-frequency vibrations by means of soft tissue, through skull foramina, into the skull cavity (brain and CSF) and from there by fluid channels directly into inner ear fluids, exciting the cochlea.

Acoustic Stimulation↗
PubMedDate not supplied

[Bone conduction auditory brainstem responses in normal hearing individuals].

BACKGROUND: bone conduction auditory brainstem responses (ABR) in normal hearing individuals. AIM: to evaluate the clinical applicability of bone conduction ABR, characterizing normality and determining an assessment protocol. METHOD: participants of this study were 22 individuals with normal hearing (20dB NA), with ages between 20 and 30 years, 14 female and 8 male. All individuals were assessed using air and bone (vibrator positioned on the forehead and mastoid) conduction ABR. EP25 equipment, Interacoustic; 3A insertion phone; B-71 bone vibrator; click stimulus. RESULTS: it was possible to evaluate the bone conduction ABR in all individuals. The results demonstrate that the electrophysiological threshold obtained when the vibrator was positioned on the forehead (32.69+/-5.63 and 32.5+/-7.07dB nHL) was higher than that obtained when the vibrator was positioned on the mastoid (25.00+/-7.33 and 30.00+/-5.34dB nHL) for both genders respectively. For this reason the vibrator was positioned on the mastoid. The electrophysiological threshold obtained by bone conduction was higher than that obtained by air conduction for both genders and also when all individuals were grouped together. Thus it is necessary to use a correction factor, according to the results, of 10dB nHL. The latency-intensity values of the V wave in the ipsilateral and contralateral recordings differed statistically according to gender, and should be considered separately. The value of 26.81+/-6.99dB nHL was adopted as being the normal threshold for bone conduction ABR. CONCLUSION: it is possible to evaluate bone conduction ABR in the clinical environment. These results, when considered along with the air conduction ABR, increase the chances of a more precise diagnosis regarding the type of hearing loss.

Adult↗
PubMed1990

Trigonocephaly: clinical and cephalometric assessment of craniofacial morphology in operated and nontreated patients.

Craniofacial parameters were studied clinically and by cephalometry in 11 trigonocephalic patients from infancy to 4 years of age. Six of the most severe patients had surgery between 6 and 18 months of age. Analysis of morphology indicated that bony interorbital distance was reduced in patients selected for surgery and hypotelorism persisted at final examination. All patients demonstrated orbital width measurements above the mean for the norm, while orbital height was essentially normal. All but one of the patients had a variably prominent forehead bony ridge that was eliminated or reduced as a result of surgery and/or growth. However, the forehead of most patients, whether operated or not, was too narrow when compared to normal skulls. Thus, although some of the striking features of trigonocephaly are eliminated, minor characteristics of the anomaly still persevere at 4 years of age.

Cephalometry↗
PubMed1982

Human skin androgen metabolism and preliminary evidence for its control by two forms of 17 beta-hydroxysteroid oxidoreductase.

Human forehead skin incubated in vitro is known to metabolize testosterone to 17-oxosteroids faster than the reverse reaction, while axillary skin rapidly metabolizes androstenedione to 17 beta-hydroxysteroids, such as testosterone and 5 alpha-dihydrotestosterone. While this has been confirmed using a larger number of patients, some indication has been found that 17 beta-hydroxysteroid oxidoreductase activity declines with age in the axilla. The relative rates of 17 beta-oxidation and reduction (direction of operation of skin 17 beta-hydroxysteroid oxidoreductase activity) were not altered by variety of incubation conditions. Large amounts of a membrane-bound 17 beta-hydroxysteroid oxidoreductase, showing preference for NAD as coenzyme and testosterone (rather than androstenedione) as steroid substrate, were found in forehead skin from one patient. On the other hand, the main axillary skin enzyme in skin from another patient was soluble and showed preference for NADP and androstenedione. It is postulated that 17 beta-oxidation and reduction in skin is controlled by the relative amount, the coenzyme preferences and the kinetic properties of these two enzymes.

17-Hydroxysteroid Dehydrogenases↗