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PubMed1976

Microsporum racemosum: first isolation in the United States.

What is believed to be the first isolation in the United States of the dermatophyte Microsporum racemosum (2) was obtained from a 79 year old white male. The patient had numerous excoriations on the forehead, scalp, and nape of the neck. (Fig. 1) A culture of scrapings from the forehead grew out a flat, granular, cream-colored colony with a red cherry-colored pigment on the reverse. (Fig. 2). The growth was exceedingly rapid, reaching a thallus of 40 mm. in diameter within 15 days. On microscopic examination the organism was found to produce numerous echinulated macroaleuriospores, (Fig. 3,5) as well as numerous microaleuriospores which are striking in appearance, occurring in wand-like clusters and being frequently stalked. (Fig. 4,5) The macroaleuriospores are quite large, achieving over 60 microns in length and 15-16 microns in diameter. The colony and microscopic appearance was consistent with Borelli's description, with the exception of the wall of the macroaleuriospore. Borelli described the wall as being thin and very similar to M. gypsum, while in the isolation from Illinois, the wall was moderately thick. Drs. Ajello and Padhye of the U.S. Public Health Service, Center for Disease Control, Atlanta, Georgia confirmed the identification.

Aged↗
PubMed1981

Effects of alternative control procedures for electromyographic biofeedback relaxation training.

Twenty-four college students participated in a single session of electromyographic (EMG) biofeedback in a comparison of three experimental control procedures commonly employed in biofeedback relaxation training research. One group received contingent EMG biofeedback from the forehead area, and each subject in this group served as his or her own control. Subjects in a second group received noncontingent EMG feedback from a tape recorder but were instructed to use the feedback signal to relax their forehead muscles (single blind). Subjects in a third group received the same auditory feedback as those in the second group but were not told the purpose or source of the feedback stimulus (yoked control). The contingent feedback group showed significantly less EMG activity when compared to the other two groups. However, this group did not exhibit significant EMG level decrements from the beginning to end of the session. This seemingly contradictory finding may have been due to statistically capitalizing on the artifactually high EMG level of the experimental and control groups, although the single-blind and yoked-control groups showed nonsignificant increases across the session. The single-blind group's data had a variance several times larger than the other two groups' variance. Findings are discussed with respect to a "probing" hypothesis as opposed to the previously offered frustration hypothesis. Of the three control procedures, the data suggest the yoked control as the procedure of choice for EMG biofeedback relaxation research.

Adolescent↗
PubMed1991

Sustained effects of biofeedback-assisted relaxation therapy in essential hypertension.

The usefulness of biofeedback-assisted relaxation as an adjunct or substitute for pharmacotherapy in essential hypertension can be enhanced if the effects are shown to persist after formal treatment has ended. Patients with essential hypertension successfully treated with biofeedback-assisted relaxation were recalled for follow-up yearly after the termination of treatment. Twenty-six of 40 patients met the BP criterion for success. At one-, two-, and three-year follow-up, 31%, 38%, and 27% of the successful completers continued to meet the criterion for success. The pretreatment-posttreatment decreases in BP were accompanied by decreases in forehead muscle tension and urinary cortisol. Forehead muscle tension, urinary cortisol, and anxiety levels were significantly lower than pretreatment one year after the end of treatment. Self-report data were used to assess continued relaxation practice. No relationship was found between practice and any other dependent measure. It appears that some patients trained in biofeedback-assisted relaxation can maintain lowered blood pressure, muscle tension, anxiety, and cortisol levels over the long term; however, the role of relaxation practice in maintaining these lowered levels remains unclear.

Adult↗
PubMed1982

A psychophysiological study of post traumatic stress disorder in Vietnam veterans.

Comparisons were made between a group of male Vietnam veterans suffering from Post-Traumatic Stress Disorder (PTSD) (n = 11) and an age and sex matched group of non-veteran controls (n = 11) on their psychophysiological responding (heart rate (HR), blood pressure (BP), forehead EMG, skin resistance level, and peripheral temperature) to mental arithmetic and an audiotape of combat sounds played at gradually increasing volume levels. The two groups responded differently to the combat sounds in terms of HR, systolic BP, and forehead EMG. The HR response could correctly classify 95.5% of the combined sample. Implications of these findings for the basis of PTSD are discussed.

Adult↗
PubMed1994

Effects of group relaxation training and thermal biofeedback on blood pressure and related physiological and psychological variables in essential hypertension.

One hundred and one patients, 70 experimental and 31 controls, with a diagnosis of essential hypertension, were examined for the effects of group relaxation training and thermal biofeedback on blood pressure and on other psychophysiologic measures: heart rate, forehead muscle tension, finger temperature, depression, anxiety, plasma aldosterone, plasma renin activity, and plasma and urinary cortisol. Eighty percent of the participants were medicated. Treatment yielded a short-term success rate, defined as a decrease in mean arterial pressure of 5 mm Hg, of 49% in the experimental group. Other significant short-term changes included a reduction of forehead muscle tension, state anxiety, plasma aldosterone, and increased finger temperature. Follow-up measurements were made approximately 10 months after treatment in 36 patients, 51% of the treatment completers. Twenty of the 36 were short-term treatment failures, while 16 were treatment succeeders. Thirty-seven percent of the short-term succeeders continued to meet blood pressure criterion at follow-up. In short-term succeeders, continued practice of relaxation may influence long-term maintenance of decreased blood pressure. It is suggested that group relaxation training can be beneficial for short-term and long-term adjunctive treatment of essential hypertension in selected individuals.

Biofeedback, Psychology↗
PubMed1994

The effect of instructions on cognitive strategies and performance in biofeedback.

An experimental study was conducted in which 40 subjects, randomly assigned to four groups, were given differing instructions about using auditory biofeedback to lower forehead muscle tension. During each of three sessions, measures were taken of forehead electromyograph (EMG) and ability to discriminate and control muscle tension in order to measure learning during biofeedback. Cognitive strategies used by subjects were measured by taped verbal reports which were judged using four criteria based on two models of learning in biofeedback: "feedforward" and "feedback." Data were analyzed by chi-square, ANOVA, ANCOVA, and content analysis. Results indicate that subjects used predominantly a feedforward type of learning strategy in all four groups. Implications for teaching during biofeedback are discussed.

Adolescent↗
PubMed1991

Comparative study of dermabrasion, phenol peel, and acetic acid peel.

Six areas of the face and forehead of a 36-year-old white female presenting with a benign congenital blue nevus of the skin were treated by dermabrasion, bichloracetic acid, and the classic phenol peel. Comparative results at six months showed each of these methods to be approximately equal in the depth of penetration and in the quality of skin on healing. However, in these small test sites, dermabrasion appeared to remove pigment slightly more efficiently. Therefore, her forehead and cheeks were treated with dermabrasion and subsequently with chemical peel. An attempt was made to touch up the dermabraded areas with acetic acid. Full thickness burns occurred, which resulted in thick scarring that required many months to finally heal. We conclude that at least in the treatment of pigmented lesions, the modalities of phenol, acetic acid, and dermabrasion are approximately equal.

Adult↗
PubMed2005

Real-time ocular artifact suppression using recurrent neural network for electro-encephalogram based brain-computer interface.

The paper presents an adaptive noise canceller (ANC) filter using an artificial neural network for real-time removal of electro-oculogram (EOG) interference from electro-encephalogram (EEG) signals. Conventional ANC filters are based on linear models of interference. Such linear models provide poorer prediction for biomedical signals. In this work, a recurrent neural network was employed for modelling the interference signals. The eye movement and eye blink artifacts were recorded by the placing of an electrode on the forehead above the left eye and an electrode on the left temple. The reference signal was then generated by the data collected from the forehead electrode being added to data recorded from the temple electrode. The reference signal was also contaminated by the EEG. To reduce the EEG interference, the reference signal was first low-pass filtered by a moving averaged filter and then applied to the ANC. Matlab Simulink was used for real-time data acquisition, filtering and ocular artifact suppression. Simulation results show the validity and effectiveness of the technique with different signal-to-noise ratios (SNRs) of the primary signal. On average, a significant improvement in SNR up to 27 dB was achieved with the recurrent neural network. The results from real data demonstrate that the proposed scheme removes ocular artifacts from contaminated EEG signals and is suitable for real-time and short-time EEG recordings.

Artifacts↗
PubMed1990

Mapping the cardiogenic impedance signal on the thoracic surface.

The cardiogenic impedance signal from band electrodes placed in the traditional position around the neck and lower thorax was studied by mapping the location of the signal on the sternum using 10 cm strip electrodes in eight male subjects. The band current electrodes on the neck and waist were replaced with 10 cm strip electrodes on the forehead and 10 cm below the xiphisternal joint, respectively, with only small changes in the dZ/dt peak amplitude and Z0. Similarly, using a strip voltage pickup electrode at the level of the xiphisternal joint resulted in very small changes in the waveform. The amplitude of dZ/dt measured between the xiphisternal joint and points along the sternum remains small until approximately 10 cm below the suprasternal notch, after which it increased linearly to the top of the neck. An average of 17 per cent and 24 per cent of the dZ/dt signal and 24 per cent and 22 per cent of the Z0 signal for supine and standing, respectively, occurs above the suprasternal notch. Replacing the current electrodes with strip electrodes on the forehead and waist caused only small changes in the signal. The position of the neck strip electrode is more critical.

Adult↗
PubMed1996

[Laser Doppler flow signal frequency analysis in physiological and drug modified nasal flow motion].

The term "flow motion" stands for the phenomenon of spontaneous and autonomous rhythmic variations of the contractile state of the smooth muscles of small dermal vessels. There also have been a few observations of variations in the microcirculation of the mucosa, but they have not been evaluated in detail to date. The aims of this study were to develop a method for investigation flow motion, especially in the nasal mucosa; to compare nasal flow motion to that of other skin and mucosal areas; to evaluate the influence of normal saline solution, as well as a sympathomimetic agent and histamine on flow motion. The microcirculation of the nasal mucosa of 40 healthy volunteers was measured under standardized conditions. In a first series of investigations, the microcirculations of the forehead, lobule of the ear, nose and oral mucosa were compared. In the second series, the microcirculation of the nasal mucosa was measured with laser-Doppler flowmetry before and after provocation with 0.9% saline solution, 0.25 mg oxymetazoline hydrochloride as sympathicomimetic preparation and 0.085 mg histamine in 0.5 ml of 0.9% saline solution. Evaluation of the data included signal analysis of the microcirculatory variations using fast-Fourier transformation and its changes before and after the pharmacological stimulations. Distribution of the power spectra showed that the nasal mucosa was significantly different from that of the skin of the forehead and the ear. Oxymetazoline hydrochloride led to a clear increase and histamine to a significant reduction in the frequencies of the flow motion. The results of this study demonstrated that nasal flow motion could be detected and evaluated with laser-Doppler flowmetry and a special analysis of the data recorded. Specific patterns of the flow motion frequencies could be detected in the nasal mucosa that were distinctive from those of the skin. The pattern of the flow motion frequencies reacted very sensitively to the pharmacological provocations used.

Adult↗
PubMed2000

[Functional and esthetic results of osteoplastic frontal sinus operations and profile reconstruction with bitemporal coronal incision].

BACKGROUND AND OBJECTIVE: The majority of inflammatory frontal sinus diseases requiring operative intervention can now be managed successfully by endonasal surgery. In problematic cases, however, optimal exposure of the entire frontal sinus and possibly complete mucous membrane removal combined with sinus obliteration must be achieved. In these cases, external frontal sinus surgery is indicated. PATIENTS/METHODS: The operative approach and findings of 35 osteoplastic sinusotomy operations and 5 forehead reconstruction operations with porous polyethylene are reviewed. Median follow-up was 3.7 years, ranging from 1 to 7 years. Indications for surgery were trauma (12), infections (8), tumors (11), muco- or pyoceles (4), and frontal deformities (5). RESULTS: The overall functional and esthetic result was excellent. No recurrent infection was noted. None of the patients have required revision surgery so far, and no serious complications occurred. Abnormal forehead sensation was reported by 12 patients (30%). Temporary double vision was described in 3 cases (7.5%). CONCLUSIONS: Due to optimal sinus exposure and advantageous incision, osteoplastic frontal sinusotomy leads to excellent functional and esthetic results. Porous polyethylene demonstrates superior material properties and seems to be, in comparison with other implants, the current material of choice in frontal reconstruction.

Adult↗
PubMedDate not supplied

High-tech facelift.

Recent technological advances in our specialty have made us reappraise the way we approach facial rejuvenation. Some of these technological interfaces have made it possible, in the author's experience, to improve results and to tackle difficult aesthetic problems. The purpose of this paper is to report how we combine these technological advances in an effort to improve the aesthetic outcomes. These technological advances are: laser skin resurfacing, endoscopy, newer fat grafting procedures, and new alloplastic materials for bone augmentation. Other technological advances are consultations via the Internet, computer imaging for simulation of possible outcomes, etc. Endoscopy is routinely used in our facial rejuvenative procedures, almost always for the forehead, often for the midface and less often for the neck. Fat grafting procedures using newly adapted concepts are used for the brow, glabella, tear trough deformity, cheeks, lips, chin, nasolabial folds, marionette lines, and other areas of soft tissue depressions apparent before or after the lifting procedures. This has allowed us to restore the tridimensional volume and treat the soft tissue atrophy. Patients with significant skeletal soft tissue disproportion due to aging, loss of dentition, prior trauma or congenital defects may receive one or more of the following implants: glabella, cheek, piriformis, angle of the mandible, mandibular body glove type of implant, prejawl implant, chin overlay or a glove type of implant. Our preference is for a porous polyethylene material because of its tissue ingrowth inductiveness. Individuals who have damaged skin due to solar exposure, aging, smoking, etc., may receive Ultrapulse CO2 laser resurfacing at the same operative setting (more often) or in a delayed fashion. The Versapulse laser is also needed for the treatment of some skin changes secondary to aging such as telangiectasias (Variable Pulse Green) and brown spots (Q-Switch 532). The high-tech facelift has allowed us to treat the severely damaged skin, fat atrophy, bone atrophy in many patients, at the same time that the lifting procedure is performed. This provides a more comprehensive approach to facial rejuvenation. The combination of different techniques and technologies maximizes the effectiveness and minimizes the potential side effects of each one. Scars in the forehead and scalp are avoided. Incision and fat removal in the lower eyelid are often unnecessary. It provides a more precise vertical lifting with correction of the tear trough deformity and gives a tridimensional restoration of the facial volume. The facial disharmony is treated at every level starting from the facial skeletal support to the most external envelope (skin). Over 200 patients have been treated this way with a minimal rate of complications. The high-tech facial rejuvenation has allowed us to improve the surgical results of our patients compared with previous isolated techniques. The combination of each one of the techniques require a precise understanding of the limits and benefits of each. Case examples of the different combinations will be shown.

Adult↗
PubMed1999

Midface surgery from Tessier to distraction.

The wall separating the face and the cranium was broken by Paul Tessier and Gérard Guiot in the 1960s, making it possible to perform a combined operation around the orbits and forehead, and opening up close cooperation between plastic surgeons and neurosurgeons, especially for treatment of the major malformations such as hypertelorism of major facial retrusions. The principles of mobilization of the orbits to correct teleorbitism or orbital dystopia are recalled with reference to the different variations and with clinical examples. Facial advancement to correct the retrusions created by faciocraniosynostosis is explained with the many possible variants, combined with a intracranial approach or not, with or without a bipartition. The indications are discussed as is the risk linked to combined advancement of face and forehead. The progressive bone elongation principle introduced by Ilizarov for the limbs has been applied to the face at the mandibular level by McCarthy, with great success. The distraction of bone structures is now also applied at the level of the midface and makes it possible to overcome the retraction of soft tissues and lower the risk of relapse of facial retrusion. Many technical problems have still to be solved, but the results are already very promising. Many other applications of the distraction principle will be developed for the midface level, with other technical improvements such as the use of absorbable mini-plates and screws.

Craniofacial Abnormalities↗
PubMed2006

Comparison of sebum secretion, skin type, pH in humans with and without acne.

Differences of skin type and pH between subjects with and without acne have not been investigated. In addition, the relationship between sebum secretion and pH in these populations has not been determined. This study assessed the differences in objective and subjective skin types between these two groups. Secondly, this study evaluated the difference in pH on five facial areas (forehead, nose, chin, right and left cheeks) between the two populations. Lastly, the relationship between pH and sebum secretion was analyzed in each population. Sebum casual levels (CL) of the five facial areas in 36 Koreans with acne and 47 Koreans without acne were measured by using a Sebumeter SM 815 and subjects were classified into objective skin types by CL. Subjects reported the type of skin they believed they had, which determined the subjective skin type. The pH levels of the five facial areas were measured by the Skin-pH-Meter PH 905. Data were assessed with adequate statistical tests depending on data type and distribution. Among the five areas, the nose of the subjects with acne showed a significantly higher CL, compared to the subjects without acne. This difference in CL on the nose resulted in the difference in CL on the T-zone and mean facial sebum excretions (MFSE). Although CL differed, objective skin types did not differ between the two groups (P > 0.05), but the subjective skin types differed significantly (P = 0.001). In addition, the objective skin types were significantly different than the subjective skin types in subjects with acne (P = 0.001), whereas the two skin types did not differ in subjects without acne. Subjects with acne actually overestimated their skin types and stated their skin types were "oilier" than they were. In respect to pH, none of the five areas differed significantly between the two groups. Among the five sites in subjects with acne, CL showed a significant negative correlation with pH on the left (r (2 )=0.12) and right (r ( 2 )=0.15) cheeks, which resulted in a significant negative correlation on the U-zone (r ( 2 )=0.14). In contrast, in subjects without acne, there was a significant negative correlation between CL and pH on the forehead (r ( 2 )=0.10) and chin (r ( 2 )=0.16), which led to a significant negative correlation on the T-zone (r ( 2 )=0.14).

Acne Vulgaris↗
PubMed2000

A solitary manifestation of mastocytosis in the head and neck.

Solitary mastocytosis in adulthood is a rare finding. Only two such lesions have been reported in the head and neck. We describe a 27-year-old woman who had a 10-year history of a forehead swelling that had fluctuated in size. Light trauma or pressure on the lesion resulted in an increase in its size. A mass was found to be situated just below the galea and was successfully removed surgically using a high forehead lift. Histologically, the specimen contained predominantly mast cells. A systemic mastocytosis was excluded by a multidisciplinary diagnostic approach and measurement of the 24-h urinary excretion of histamine metabolites. After 36 months of follow-up there has been no recurrence.

Adult↗
PubMed2001

Suicide by more than 90 stab wounds including perforation of the skull.

A man committed suicide in his bathroom using a small pocket knife. At the autopsy a total of 92 stab wounds on the forehead, in both temples, the anterior aspect of the neck, the back of the neck, the chest and the sides of the trunk were found. In addition, repeated stabbing had caused a large soft tissue defect on the forehead. The frontal bone showed 3 perforations but no brain injury was present and two ribs were severed in the bony part, one of which carried a star-like pattern from repeated stabbing. No major vessels were injured and the cause of death was exsanguination after a considerable survival time. The large number of stab wounds, the perforation of bone and some injury sites, especially the head and back of the neck, are extraordinary findings in suicides which were probably favoured by insufficient anatomical knowledge and the use of a short-bladed knife. A psychiatric history could not be verified.

Adult↗
PubMed2005

Dermal exposure to cyclophosphamide in hospitals during preparation, nursing and cleaning activities.

OBJECTIVES: To determine levels of potential and actual dermal exposure to cyclophosphamide (CP) during performance of oncology-related tasks in hospitals and to investigate the relationship with potential sources and surface contamination levels of CP. METHODS: Dermal exposure to CP was determined for tasks with potential exposure to CP: preparation of CP, decanting of patients' urine, washing of the patient, removal of bed sheets of treated patients and cleaning of patients' toilets on oncology wards. Exposure was assessed by the collection of nitrile and latex protective medical gloves (potential exposure), washing of hands (actual exposure), from cotton pads attached to (un)covered forearms (potential or actual exposure) and a wipe sample of the forehead (actual exposure). Bulk samples (i.e. application fluids and patients' excreta) and possible contact surfaces were monitored to assess the amount of CP available for dermal exposure. RESULTS: Pharmacy technicians, oncology nurses and cleaning personnel showed actual and potential dermal exposure to CP during performance of their daily duties. Exposure occurred predominantly on the hands and sporadically on the forehead and forearms. Although all nurses used gloves during handling of patients' urine and sometimes during the other nursing tasks, skin underneath gloves was repeatedly contaminated. Results of tests on bulk and surface contamination samples confirmed that patients intravenously treated with CP excrete the unmetabolised drug, which could subsequently lead to dermal exposure of hospital personnel. A clear relationship was found between dermal exposure levels and direct sources of exposure for all tasks, except for handling patients' urine. CONCLUSIONS: We demonstrated for the first time that actual dermal exposure to CP is common among oncology nurses working with patients treated with this anti-neoplastic drug. Pharmacy technicians and cleaning personnel, on the other hand, are potentially exposed to CP, and protection provided by gloves seemed to be sufficient.

Antineoplastic Agents, Alkylating↗
PubMed2000

Experimental exposure to methylformate and its neurobehavioral effects.

OBJECTIVES: The aim of the study was to investigate the acute effects of experimental methylformate exposure on the nervous system. METHODS: In an exposure chamber, 20 subjects were exposed to methylformate at 100 ppm [Swiss maximum allowable concentration (MAC)] for 8 h. The same number of subjects with the same ages (between 20 and 30 years), gender and education level (university) were examined by the same procedure as a control group. The subjects did not know if they were exposed or not. Three times (morning, noon, evening) during these 8 h, mood [Profile of Mood States (POMS)], neurobehavioral performance (reaction, Stroop, nonverbal learning, determination, tracking; Wiener Test System), vision (visual acuity, contrast sensitivity, color sensitivity) and postural sway were tested. During an undemanding test (POMS) and a demanding performance task (determination test), pulse, electromyography (EMG) of the forehead and of the neck were recorded. In the morning and evening spirometry [forced vital capacity (FVC), forced one-second expiration volume (FEV), medium expiration flow (MEF) and peak expiration flow (PEF)] and the odor perception threshold were measured. RESULTS: In the evening, in the exposed group, fatigue was significantly increased and the EMG of the forehead during a demanding task showed a different development during exposure. The other tests showed no significant solvent effect, but 16 of 43 test parameters showed a significant effect of time. CONCLUSIONS: The results of this study indicate a possible effect of methylformate exposure on the subjective feeling of fatigue after 8 h exposure at 100 ppm in young and healthy subjects, without measurable impairment of neurobehavioral performance. We assume that a similar effect in normal work, combined with a heavy workload and shift work, can lead to an impairment of productivity, and increase the risk of accidents.

Adult↗