Independent effect of various facial mimetic muscles on the nasolabial fold

1992 ◽  
Vol 16 (2) ◽  
pp. 167-171 ◽  
Author(s):  
Joel E. Pessa ◽  
Forst Brown
Author(s):  
David E.E. Holck ◽  
Joel Kopelman

Facial rhytidectomy is a rejuvenative surgical procedure designed to improve the aging changes in the lower third of the face and neck. It can significantly improve jowling, the jaw line, and the portion of the neck from the hyoid bone to the jaw line (the cervicomental angle). It is less successful at improving the midface or nasolabial folds. Rhytidectomy optimizes the age-appropriate aesthetic but does not stop the normal aging progression after surgery. While a wellperformed rhytidectomy is extremely gratifying for both patient and surgeon, it is elective and invasive, with prolonged rehabilitation and potential morbidity. Complications are poorly tolerated, and therefore pitfalls should be meticulously avoided. Fundamental steps in facial rhytidectomy include incision planning, skin flap dissection, addressing the superficial musculo-aponeurotic system (SMAS) and platysma, liposuction or direct lipectomy, skin redraping, and wound closure. These are standard in lower-third facial and neck rejuvenation. Face lifting is an imperfect procedure: the surgeon takes advantage of camouflaged incisions and healing patterns to obtain optimal rejuvenation. The facial anatomy of the lower third of the face and neck is complex but may be best viewed in a layered approach. Facial skin varies in thickness, with eyelid skin being the thinnest and cheek skin the thickest. The skin of the face is nourished via a dermal plexus, which must be maintained in rhytidectomy surgery. Beneath the skin lies facial subcutaneous fat. This fat is lobulated and enclosed by fibrous septa, which connect the superficial fascia to the dermis. The thickest portion of subcutaneous fat is the malar fat pad, bounded by the infraorbital rim above, the nasolabial fold medially, and the zygomaticus major muscle laterally. Minimal subcutaneous fat is located in the lower eyelid region and in the perioral region. Below the level of the subcutaneous fat is the SMAS. This fibromuscular sheet is continuous with the superficial temporalis fascia and galea cranially and the platysma muscle caudally. The SMAS envelops and connects the superficial mimetic muscles to the dermis, expanding the range of facial expression to the skin via distribution of force.


2020 ◽  
Vol 51 (5) ◽  
pp. 354-359 ◽  
Author(s):  
Yavor Paunov ◽  
Michaela Wänke ◽  
Tobias Vogel

Abstract. Combining the strengths of defaults and transparency information is a potentially powerful way to induce policy compliance. Despite negative theoretical predictions, a recent line of research revealed that default nudges may become more effective if people are informed why they should exhibit the targeted behavior. Yet, it is an open empirical question whether the increase in compliance came from setting a default and consequently disclosing it, or the provided information was sufficient to deliver the effect on its own. Results from an online experiment indicate that both defaulting and transparency information exert a statistically independent effect on compliance, with highest compliance rates observed in the combined condition. Practical and theoretical implications are discussed.


1975 ◽  
Vol 33 (02) ◽  
pp. 354-360 ◽  
Author(s):  
Heinrich Patscheke ◽  
Reinhard Brossmer

SummaryConcanavalin A (CON A) causes platelets to aggregate. A Ca++-independent effect of CON A could be separated from a main effect which depends on Ca++. The main effect probably is a consequence of the CON A-induced platelet release reaction and therefore is platelet-specific. The weak residual effect observed in the presence of Na2EDTA may be due to a similar mechanism as has been demonstrated for CON A-induced aggregations of several other normal and malignant transformed animal cells.Na2EDTA did not inhibit the carbohydrate-specific binding capacity of CON A. Therefore, Na2EDTA appears not to demineralize the CON A molecules under these experimental conditions.α-methyl-D-glucoside inhibits the Ca++-independent as well as the Ca++-dependent effect of CON A.Pretreatment by neuraminidase stimulated the platelet aggregation induced by CON A. It is possible that removal of terminal sialic acid residues makes additional receptors accessible for the binding of CON A.


2018 ◽  
Vol 15 (14) ◽  
pp. 1354-1360 ◽  
Author(s):  
Ping-Song Chou ◽  
Yi-Hui Kao ◽  
Meng-Ni Wu ◽  
Mei-Chuan Chou ◽  
Chun-Hung Chen ◽  
...  

Background: Cerebrovascular pathologies and hypertension could play a vital role in Alzheimer disease (AD) progression. However, whether cerebrovascular pathologies and hypertension accelerate the AD progression through an independent or interaction effect is unknown. Objective: To investigate the effect of the interactions of cerebrovascular pathologies and hypertension on AD progression. Method: A retrospective longitudinal study was conducted to compare AD courses in patients with different severities of cerebral White Matter Changes (WMCs) in relation to hypertension. Annual comprehensive psychometrics were performed. WMCs were rated using a rating scale for Age-related WMCs (ARWMC). Results: In total, 278 patients with sporadic AD were enrolled in this study. The mean age of the patients was 76.6 ± 7.4 years, and 166 patients had hypertension. Among AD patients with hypertension, those with deterioration in clinical dementia rating-sum of box (CDR-SB) and CDR had significantly severe baseline ARWMC scales in total (CDR-SB: 5.8 vs. 3.6, adjusted P = 0.04; CDR: 6.4 vs. 4.4, adjusted P = 0.04) and frontal area (CDR-SB: 2.4 vs. 1.2, adjusted P = 0.01; CDR: 2.4 vs. 1.7, adjusted P < 0.01) compared with those with no deterioration in psychometrics after adjustment for confounders. By contrast, among AD patients without hypertension, no significant differences in ARWMC scales were observed between patients with and without deterioration. Conclusion: The effect of cerebrovascular pathologies on AD progression between those with and without hypertension might differ. An interaction but not independent effect of hypertension and WMCs on the progression of AD is possible.


2020 ◽  

Purpose: Pain is a major symptom for patients to seek medical services, but limited evidence supports the applicability and usage of facial expressions as a pain measurement strategy in the emergency department (ED). In this study, we explored possible differences in facial expressions before and after pain management and compared these differences with those in a self-reported pain scale. Methods: In this observational study, convenience sampling of patients admitted to the ED was conducted. Two video sessions of facial expressions were recorded for each participant, and participants rated their painon a self-reported numeric rating scale (NRS). A total of 25 facial parameters were extracted per frame. The main outcome measurements were the differences in facial parameters, and their correlation with changes in NRS scores was examined. Results: This study included 163 participants. A stronger reduction in NRS scores was associated with differences in systolic blood pressure (sBPr = 0.247, P = 0.011) and the following changes in facial features: eye opening (left: r = -0.210, P = 0.007; right: r = -0.206, P = 0.008), eye aspect ratio (left: r = -0.382, P < 0.001; right: r = -0.305, P < 0.001), and head rotation angle (r = 0.218, P = 0.005). Pain improvement (a difference of ≥ 4 in NRS scores) was associated with differences in BP (sBP, odds ratio [OR] = 0.973, 95%confidence interval [CI]: 0.949-0.998, P = 0.034; dBP, OR = 1.078, 95% CI: 1.026-1.113, P = 0.003), eye aspect ratio (Left: β = 5.613, 95% CI: 2.234-14.104, P < 0.001; Right: β = 2.743, 95% CI: 1.395-5.391, P = 0.003), and nasolabial fold variation (β = 0.548, 95% CI: 0.306-0.982, P = 0.043), after adjustment for variables Conclusions: Intraindividual changes in facial expressions can be used to track clinically relevant differences in pain. Facial expressions alone cannot be used as a pain measurement strategy in the ED.


2018 ◽  
Vol 104 (5) ◽  
pp. 1766-1776 ◽  
Author(s):  
Freja Bach Kampmann ◽  
Anne Cathrine Baun Thuesen ◽  
Line Hjort ◽  
Sjurdur Frodi Olsen ◽  
Sara Monteiro Pires ◽  
...  

Abstract Context and Objective Being born small or large for gestational age and intrauterine exposure to gestational diabetes (GDM) increase the risk of type 2 diabetes in the offspring. However, the potential combined deleterious effects of size at birth and GDM exposure remains unknown. We examined the independent effect of size at birth and the influence of GDM exposure in utero on cardiometabolic traits, body composition, and puberty status in children. Design, Participants, and Methods The present study was a longitudinal birth cohort study. We used clinical data from 490 offspring of mothers with GDM and 527 control offspring aged 9 to 16 years, born singleton at term from the Danish National Birth Cohort with available birthweight data. Results We found no evidence of a U-shaped association between size at birth (expressed as birthweight, sex, and gestational age adjusted z-score) and cardiometabolic traits. Body size in childhood and adolescence reflected the size at birth but was not reflected in any metabolic outcome. No synergistic adverse effect of being born small or large for gestational age and exposure to GDM was shown. However, GDM was associated with an adverse metabolic profile and earlier onset of female puberty in childhood and adolescence independently of size at birth. Conclusion In childhood and adolescence, we found GDM was a stronger predictor of dysmetabolic traits than size at birth. The combination of being born small or large and exposed to GDM does not exacerbate the metabolic profile in the offspring.


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