Detailed Anatomy of Osteoperiosteal Ligamentous Structures in the Forehead.

This study aimed to present the anatomic characteristics of osteoperiosteal ligamentous attachments of the forehead and provide a better understanding of lateral eyebrow descent for safe and effective foreheadplasty. Anatomic dissections of the face were performed in 10 fresh Korean adult cadavers (20 hemifaces) using 2.5× magnification surgical loupes. Supraorbital, inferomedial orbital, and frontonasal osteoperiosteal ligamentous attachments were identified as fibrous tissues originating from a bone, and their tensile strengths were measured. The supraorbital osteoperiosteal ligamentous attachment had medial and lateral parts. It can be classified into 4 subtypes. It was located 11.0 ±â€Š6.6 mm lateral to the midline and 9.2 ±â€Š12.3 mm superior to the superior orbital margin. The inferomedial orbital osteoperiosteal ligamentous attachment was located 16.2 ±â€Š3.9 mm lateral to the midline and 2.2 ±â€Š2.7 mm inferior to the superior orbital margin, whereas the frontonasal osteoperiosteal ligamentous attachment was located 5.4 ±â€Š2.3 mm lateral to the midline and 1.4 ±â€Š8.5 mm superior to the superior orbital margin. Tensile strengths of all the osteoperiosteal ligamentous attachments in the forehead were above 10 N. These results indicate that osteoperiosteal ligamentous attachments develop in the rather medial region of the eyebrow and have a tensile strength adequate enough to maintain the medial eyebrow. Thus, the current study provides surgeons with detailed anatomic information that can be used as a valuable reference for forehead rejuvenation procedures.

An Innovative Scalp-Dyeing Technique with Gentian Violet Solution During Follicular Unit Extraction for White-Haired Follicular Units.

There exist some restrictions and difficulties in performing follicular unit extraction (FUE) in white-haired patients, for several reasons. In this paper, we introduce a novel technique for visualizing white hair during the punching procedure and graft preparation in FUE for white-haired patients. In white-haired older male patients, we dyed the surrounding scalp skin purple with a gentian violet solution-stained toothpick. Our method has several advantages: surgeons can easily focus on the center of the follicular unit and rapidly perform punching, they can recognize the condition of the harvested follicular units during FUE, and the hair transplant team can secure a clear view for trimming and loading into the implanter. We suggest that scalp dyeing in difficult FUE procedures, especially in patients with white hair, may be a simple method that provides a good visualization for donor site harvesting and for microdissection.

Hidden Transection of Follicular Unit Extraction in Donor Site.

BACKGROUND: When calculating the transection rate in follicular unit extraction (FUE), many surgeons did not consider damages that may arise in the donor site through FUE punching. OBJECTIVE: The authors investigated what changes and/or damages are happened to the hair follicles surrounding a punched hole. MATERIALS AND METHODS: Two to 4 study boxes were marked on the donor strip and 8 follicular units were harvested using FUE from each study box. Follicular unit extraction was performed by the expert for 10 patients and by the beginner for 10 patients. After the strip harvesting, each study box was separated. Then, the 2 cross sections along the punched line and follicular units obtained from each study box were analyzed under a 20-power digital microscope. RESULTS: The authors found various transections through this analysis. Among them, some transections were hidden under the scalp surface, keeping the shaft alignment. The authors named this occurrence "hidden transection." Although 2 surgeons harvested with similar transection rate, there was a significant difference in hidden transection rate: 2% for the expert and 8% for the beginner. CONCLUSION: The main finding of this study is that a correct way to calculate the real-transection rate in FUE is to consider both extracted follicular transection and hidden transection.

Toward an objective indexing system for ADHD-screening using children's activity monitoring.

Signs of ADHD are discernible in specific situations, and usually assessed according to subjective impressions. We performed a preliminary comparative study from children's activity at a natural classroom environment with 3-axis accelerator for a feasible objective index. From a total of 157 children (7-9 yrs) and clinically diagnosed 24 children out of them, variances in 1-min epoch mean activity had shown significant differences among the subgroups: (1) ADHD=.0194, Other Diseases=.0080, Normal=.0009; (2) ADHD=.0194, non-ADHD=.0057(p<.01, respectively). There were also significant differences in high-level activity (>1.6G) features among subgroups with the same order (p<.01, respectively). ADHD patients exhibited more dispersed activities and higher high-level activity ratio than normal. Activity features can be useful to build an objective indexing system for screening ADHD patients.