Perceived, Actual, and Seasonal Changes in the Shape of the Face, Hands and Legs

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(1)APPLIED HUMAN SCIENCE Journal of Physiological Anthropology. Perceived, Actual, and Seasonal Changes in the Shape of the Face, Hands and Legs Motoko Murakami 1), 2) , Seiichi Arai 1) and Yutaka Tochihara 2) 1) Kanebo, Ltd., Cosmetics Laboratory 2) Kyushu Institute of Design. Abstract. In this study, we measured the shape of the face, legs, hands and fingers during the course of a day to determine the amount of swelling. We examined the relationship between the perception of swelling and the degree of actual swelling, and considered the influence of seasonal factors. The topology of the face was measured using the 3D curved shape measuring apparatus, VOXELAN, while the circumference of the legs and fingers and the volume of the hands were also recorded. The measurements were used to determine the amount of change in each parameter, which was then used to determine the degree of swelling. The subjects for the experiment were 10 healthy Japanese women aged 24 to 30 years of standard build (BMI: 19.3–25.0). Measurements were carried out twice a day in the mornings and afternoon, first between 8:30 and 10:00 a.m. and then between 4:00 and 5:30 p.m. At each measurement session, subjects were asked if they perceived swelling to have occurred. We investigated the relationship between the degree of actual swelling and the reported perception of swelling. We also investigated the influence of seasonal factors by conducting the same tests on the same subjects in summer (August 1997) and in winter (February–March 1998). The relationship between perceived and actual swelling differs depending on the part of the body. For the face, actual swelling correlates strongly with perceived swelling. This trend is particularly noticeable for the upper eyelids. For the thigh and lower leg, on the other hand, there was no significant difference. The frequency with which subjects reported the perception of swelling varied depending on the area of the body, and was generally extremely low for the thighs, hands and fingers. With respect to seasonal variation, swelling in the face, hands and feet tended to be more pronounced during the summer. In the facial region, the biggest difference was in the lower eyelid, where swelling increased more than five times. This level of variation suggests that the atmospheric temperature is the main factor affecting swelling. (Appl Human Sci, 18 (6): 195-201, 1999). Keywords: body shape, swelling, perception, seasonal changes, 3D curved shape. Introduction The human body shape is constantly undergoing change. Swelling, a localized physiological phenomenon, is just one of the many changes experienced by the body shape. In the course of a single day, change in shape associated with swelling can arise and subside repeatedly. Previous studies (Murakami et al., 1998; Krijnen et al., 1998; Winkel, 1986; Winkel, 1981; Pottier et al., 1969) have quantitatively measured swelling in terms of change in the circumference and topology of specific areas of the body, particularly the face, legs, hands and fingers. As well as physical change in shape, swelling tends to create fatigue by making the relevant part of the body feel heavy and/or sluggish. Eliminating fatigue and swelling is an issue of very great importance for working women (Tezuka et al., 1996; Orbach, 1979), as evidenced by the number of experimental studies in this area (Tezuka et al., 1996; Sato and Hirano, 1991). In a study of swelling perception conducted on 141 healthy females in their 20s (Murakami et al., 1998), 72% reported perceptions of swelling in the lower leg, 32% in the hands and fingers, and over 20% in the face. In this study, subjects were asked to fill in self-completion questionnaires. The results were compared with observations of actual swelling taken through the day to determine the relationship between the subject’s perception of swelling and the actual degree of swelling. Lee et al. (1987) reports that daily variation in swelling in the lower leg is greater in summer than in winter, clearly demonstrating the effect of the ambient temperature on swelling (i.e., swelling increases with temperature). As we mentioned earlier, the shape of the hands, face and fingers changes during the day in the same way as that of the legs; swelling in these regions has been demonstrated by Murakami et al. (1998). However, the relationship with seasonal change in swelling in the face, hands and fingers.

(2) Perceived, Actual, and Seasonal Changes in the Shape of the Face, Hands and Legs. 196. has not yet been studied. We therefore decided to include in this study an investigation of the influence of seasonal factors on swelling in the face, hands and fingers in addition to our study of the relationship between perceived and actual swelling. The subjects were ten healthy females in their 20s. The same subjects were used for the summer and winter observations.. Methods Subjects The subjects were ten females between 24 and 30 years of age. Table 1 shows the basic bodily statistics for the subjects in summer and in winter. Body fat was measured using the body fat meter HBF-300 (OMURON). The body statistics for the subject group were typical for Japanese women in general, and did not differ significantly between summer and winter for any of the subjects. The measurements were therefore used without modification for the purpose of comparison.. Table 1 The characteristics of the subjects 1998. Feb.–Mar. Winter Height (cm) Weight (kg) Fat (%) BMI BSA (m 2 ). 160.7 56.5 27.7 21.9 1.33. – – – – –. 5.8 3.3 3.0 1.6 0.05. 1997. Aug. Summer 159.9 56.6 27.5 22.2 1.54. – – – – –. 5.1 4.5 3.8 2.1 0.07. Values are means – SD.. Fig. 1 Measurement points on the face. Procedures Observations of perceived and actual swelling were taken over a seven-day period during February-March 1998 nominated by each subject. To test for seasonal variation, a set of summer observations was taken in August 1997 prior to the winter observations in February-March 1998. In order to take the estrus cycle into account (Keates and Fitesgerald, 1969, Lee et al., 1987), we used observations from the three-day luteal phase beginning ten days after the end of menstruation. As in several previous studies on swelling in healthy subjects, swelling was measured in terms of the change in shape in various parts of the body during the day. Observations were taken twice daily, in the morning (between 8:30 and 10:00 a.m.) and afternoon (between 4:00 and 5:30 p.m.). The degree of swelling was determined from the difference between morning and afternoon measurements. Measurement Observations were taken of the face, legs, hands and fingers. The measurement points on the face (as shown in Fig. 1) were those found to be significant with respect to daily change in an earlier study by Murakami et al. (1998). Facial topology was measured using the 3D curved shape measuring apparatus, VOXELAN (NKV-300DS: Hamano Engineering). Fig. 2 shows measurement in progress. VOXELAN is a non-contact system that determines the shape of an object as a set of 3D coordinates (Ikeuchi et al., 1996). A central point on the face was chosen as the origin and marked with an oil-based pen for the morning observations. The pen mark was left on all day for the afternoon observations. The threedimensional images for the morning and afternoon were then overlaid around the central point using the matching method of 3D Rugle program. By calculating spatial. Fig. 2 3D curved shape measuring apparatus (VOXELAN).

(3) Murakami, M et al.. distances, the software determines the difference between z coordinates—i.e., the distance in the height direction— for nine points on a centimeter scale, as shown in Fig. 1: upper eyelids = A1, B1 and C1; lower eyelids = B3 and C3; cheeks = B4, C4, B5, B6 and C6. This information is then used to calculate the degree of swelling. The A2 corresponds to the inner corner of the eye. Fig. 3 shows measurement points on the leg. Again, the measurement points were those deemed significant in the 1998 study by Murakami et al. The thigh was defined as above ① the patella, while the lower leg was divided at 5 cm into five sections below ② the patella. Circumferences were measured using a steel measure. During measurement, subjects were asked to adopt an erect posture with both legs spread 10 cm apart in order to ensure uniform distribution of weight (Lee et al., 1987). Observations were taken of the left leg only. Position marking and measurement was performed simultaneously by a single skilled researcher. The hands were also measured using the 3D curved shape measuring apparatus, VOXELAN. With the palm open, a circle was marked around the wrist just below the hand. The subject’s hand was placed on the measuring bench with the fingers splayed, and measured from directly above using laser slit beams. The aforementioned 3D Rugle program was used to calculate the volume of the hand (i.e., the section above the bench surface) for both right and left hands. A ring gauge (Meiko sha) was also used to measure the ring size, and hence circumference, of each finger on. 197. both hands. Finally, the observations were correlated with the corresponding responses regarding perception of swelling in the hands, thighs, lower legs, hands and fingers recorded in the questionnaire administered at the point of measurement. Data analysis Change in swelling during the day was calculated using the method developed previously by the authors and described in Murakami et al. (1998). Swelling in the face, hands and fingers was defined as the morning measurement less the afternoon measurement, while swelling in the legs was defined as the afternoon circumference less the morning circumference. To assess the relationship between perceived and actual swelling, we classified the measurements by questionnaire response. Then, for each subject, we calculated the average value for days when swelling was reported and the average value for days when swelling was not reported. When considering the impact of seasonal factors, observations were taken over three days for each subject during the luteal phase ten days after the subject’s period in order to reflect the impact of the menstrual cycle on swelling, and observations for the three days were averaged. The Student’s t-test was used to test for significant differences between averages values, and the difference was considered significant only at a p<0.10.. Results. Fig. 3 Measurement points on the leg. Relationship between perceived and actual swelling 1) Frequency of perceived swelling Table 2 shows the total number of measurements for all subjects classified by response (yes/no) to the perception of swelling question. Morning responses are used for the face, hands and fingers and afternoon responses for the thighs and lower legs. While the results are fairly evenly divided for the face and lower legs, reports of swelling in the thighs, hands and fingers represent only around 10% of the total. Thus, swelling of the face is perceived relatively frequently in the morning, as is swelling of the lower legs in the afternoon, whereas swelling of the hands and fingers is perceived relatively rarely in the morning, and likewise for swelling of the thighs in the afternoon. 2) Perceived versus actual swelling Fig. 4 shows average and standard deviation swelling values, categorized by subject response, for each measurement point on the face. With the exception of point C3 (lower eyelid), it can be seen that actual swelling is greater on days when the subject reports the perception of swelling. The correlation is particularly pronounced for the upper eyelid. Point A1 exhibits a statistically significant difference (p<0.05), with swelling more than.

(4) 198. Perceived, Actual, and Seasonal Changes in the Shape of the Face, Hands and Legs Table 2 Perception of swelling yes Face Hand and finger Thigh Lower leg. (morning) (morning) (afternoon) (afternoon). no. 38 days (52.8%) 8 (11.1) 5 ( 6.9) 34 (47.2). 32 days (44.4%) 62 (86.1) 65 (90.3) 36 (50.0). Table 3 Actual versus perceived swelling—thigh and lower leg (cm) Perception of swelling yes no Thigh. ①. Lower leg ② ③ ④ ⑤ ⑥. 0.52 – 0.15. 0.45 – 0.44. N.S.. 0.43 0.50 0.50 0.50 0.47. 0.39 0.40 0.33 0.42 0.38. N.S. N.S. N.S. N.S. N.S.. – – – – –. 0.24 0.20 0.12 0.26 0.22. – – – – –. 0.33 0.18 0.26 0.26 0.21. Values are means – SD.. Fig. 4 Actual versus perceived swelling—face. Table 4 Actual versus perceived swelling—hands and fingers (1) Volume changes in hands (cm 3). double (0.55 mm versus 0.23 mm). Table 3 shows average and standard deviation swelling values, categorized by subject response, for each measurement point on the thigh and lower leg. No significant differences were found in any of the measurement points on the thigh or lower leg. Swelling varies in the range 0.33–0.52 cm irrespective of subject response. Table 4 shows average and standard deviation swelling values, categorized by subject response, for the hands and fingers. Actual swelling is much the same on all days, and no significant difference was noted. 3) The influence of BMI and body fat% on swelling of perception Table 5 shows average and standard deviation values of BMI and body fat percent measured, categorized by subject response, to examine the influence of BMI or body fat percent on swelling perception. The analysis were done on the face and lower leg where the response of perception were fairly evenly divided. Values of BMI and body fat percent are much the same irrespective of subject response, and no significant difference was noted. Variation of BMI and body fat percent did not affected perception of swelling. Seasonal change in swelling Fig. 5 shows average and standard deviation swelling values in winter and summer, for each measurement point on the face. With the exception of C1, the summer values are higher for all points. A statistically significant. Perception of swelling yes no Right Hand Left Hand. 4.0 – 8.5 6.1 – 11. 4.5 – 10.7 4.0 – 11.1. N.S. N.S.. Values are means – SD. (2) Ring size (#) Perception of swelling yes no Right Hand Finger 1 Finger 2 Finger 3 Finger 4 Finger 5 Left Hand Finger 1 Finger 2 Finger 3 Finger 4 Finger 5. 0.5 0.3 0.3 0.3 0.3. – – – – –. 0.5 0.4 0.4 0.7 0.4. 0.3 0.3 0.3 0.2 0.4. – – – – –. 0.4 0.5 0.5 0.4 0.6. N.S. N.S. N.S. N.S. N.S.. 0.4 0.3 0.6 0.3 0.1. – – – – –. 0.5 0.4 0.5 0.4 0.3. 0.4 0.3 0.4 0.3 0.2. – – – – –. 0.6 0.6 0.6 0.6 0.5. N.S. N.S. N.S. N.S. N.S.. Values are means – SD.. difference (p<0.05) was found for A1 (upper eyelid), C3 (lower eyelid) and B4, C4 and B5 (cheek). Swelling in the upper eyelid (A1) more than doubled from 0.55 mm in winter to 1.11 mm in summer. The most pronounced increase was in the lower eyelid (C3), where swelling increased more than five times from 0.16 mm in winter to 0.84 mm in summer. Swelling in the cheeks (B4, C4 and.

(5) Murakami, M et al.. 199. Table 5 Relationship between perception of swelling and BMI or body fat percent Perception of swelling in face yes no BMI Fat% #. 22.2 – 2.0 27.6 – 4.0. Values are means – SD.. 22.1 – 2.1 27.6 – 3.8 #. Perception of swelling in lower leg yes no N.S. N.S.. 22.2 – 2.0 27.6 – 3.8. 22.2 – 2.0 27.6 – 3.9. N.S. N.S.. : Body Fat Meter HBF-300 (OMURON).. Table 6 Seasonal changes in swelling—thigh and lower leg (cm). Thigh. ①. Lower leg ② ③ ④ ⑤ ⑥. Summer. Winter. 0.44 – 0.39. 0.48 – 0.31. N.S.. 0.33 0.46 0.35 0.38 0.34. 0.34 0.51 0.47 0.46 0.20. N.S. N.S. N.S. N.S. N.S.. – – – – –. 0.20 0.23 0.24 0.28 0.37. – – – – –. 0.21 0.25 0.26 0.26 0.23. Values are means – SD.. Fig. 5 Seasonal changes in swelling—face. Table 7 Seasonal changes in swelling—hands and fingers (1) Volume changes of hands (cm 3). B5) rose from approximately 0.2 mm to approximately 0.6 mm. Table 6 shows average and standard deviation swelling values in winter and summer, for each measurement point on the thigh and lower leg. None of the points demonstrated any difference between seasons; swelling in the legs was generally the same in summer and winter. Table 7 shows average and standard deviation swelling values for the hands and fingers in winter and summer. Swelling of the hands was greater in summer, at 5.7 cm3 for the right hand and 8.0 cm3 for the left hand compared to 2.8 cm3 and 3.3 cm3 respectively in winter. Swelling was greater in summer than in winter for all fingers except the fifth finger of the right hand and the third finger of the left hand. Thus, swelling tends to be greater in summer than in winter for the face, hands and fingers, suggesting the influence of seasonal factors.. Discussion As well as physical change in shape, swelling tends to create fatigue by making the relevant part of the body feel heavy and/or sluggish. Eliminating fatigue and swelling is an issue of very great importance for working women (Tezuka et al., 1996; Orbach, 1979), as evidenced by the number of experimental studies in this area (Tezuka et al., 1996; Sato and Hirano, 1991). This study clarified the influence of seasonal factors on swelling in the face, hands and fingers in addition to our study of the relationship between perceived and actual swelling and seasonal. Right Hand Left Hand. Summer. Winter. 5.7 – 7.0 8.0 – 10.8. 2.8 – 5.2 3.3 – 8.1. N.S. +. Values are means – SD. +: p<0.10 (Significant differences between value of summer and value of winter). (2) Ring size (#) Summer Right Hand Finger 1 Finger 2 Finger 3 Finger 4 Finger 5 Left Hand Finger 1 Finger 2 Finger 3 Finger 4 Finger 5. Winter. 0.4 0.4 0.3 0.4 0.3. – – – – –. 0.3 0.3 0.4 0.4 0.3. 0.4 0.4 0.2 0.2 0.5. – – – – –. 0.4 0.3 0.4 0.3 0.3. N.S. N.S. N.S. N.S. N.S.. 0.6 0.7 0.2 0.3 0.4. – – – – –. 0.6 0.4 0.3 0.4 0.2. 0.4 0.4 0.3 0.3 0.2. – – – – –. 0.4 0.4 0.3 0.4 0.3. N.S. + N.S. N.S. +. Values are means – SD. +: p<0.10 (Significant differences between value of summer and value of winter).. changes. The measurement points chosen for this study—the face, legs, hands and fingers—have been demonstrated previously as showing significant variation in shape during the course of normal daily activities. Morning swelling in the face hands and fingers and afternoon swelling in the legs has already been demonstrated by Murakami et al. (1998). The present study found that the degree of correlation between change in shape and the perception.

(6) 200. Perceived, Actual, and Seasonal Changes in the Shape of the Face, Hands and Legs. of swelling varied depending on the part of the body. To begin with, the frequency with which subjects reported the perception of swelling varied enormously depending on the part of the body (Table 2). And although our study clearly demonstrated shape changes in the hands and fingers and thigh during the course of the day, the perception of swelling in these areas was reported by 11% and 7% of respondents respectively. Swelling of the face and lower leg, on the other hand, was reported on nearly half the days. For the lower leg, the degree of actual swelling was the same irrespective of whether or not the subject reported swelling, but for the face, an increase actual swelling corresponded with subject reporting of swelling (Table 3). The correlation was particularly strong for the upper eyelid (Fig. 4). It is thought that the brain’s ability to perceive swelling in each region may contribute to this variation. An earlier perception study on healthy female subjects (Murakami et al., 1998) found that facial swelling could be equated with perceptions such as puffy, swelling and filled, whereas swelling of the lower leg was very closely related to perceptual changes such as feeling weary and heaviness in addition to actual change in shape. Swelling of the face is only perceived in terms of change in shape; in this connection, it is worth remembering that we are much more likely to look at our faces after getting up or at some stage during the morning than at other parts of the body. Women in particular are more likely to look at their faces more often, for instance when putting on make-up. Thus, we can conclude that subjects were aware of swelling in their own faces on those occasions when pronounced swelling actually occurred in the upper eyelids; this would explain the strong correlation between perceived and actual swelling. Krijnen et al. (1998) reported about measuring the shape of the lower leg and complaints about the legs of 197 male workers with a standing profession. They found that increase in volume of lower leg after work was reported by 42% and the perceptions such as tired and heavy feeling was reported by 52% of respondents. Pierson et al. (1983) and Sato and Hirano (1991) studied that clinical effects of the compressed support-stocking to edema or gestational edema of legs reported that the amount of change in the circumference of the leg and complaints about the legs were decreased for graded compression. As we recognized in field of labor hygienics or clinical medicine, that the change of the shape corresponds with perceptions of fatigue, such as weariness and heaviness in the leg. Conversely, our results clarified in the lower leg perceptions of fatigue, such as weariness and heaviness, do not correspond as consistently to actual change in shape. We consider that this difference is derived from characteristics of subject groups differed. Because the measurement methods was different, values of measuring actual change in shape were not compared. But judging. from workers with labor environment such as standing position at work and patients of edema, there is a great difference in the amount of swelling from our survey. And one of the factors to be considered is that in previous reports no attempt has been made to correspond exactly the perception of swelling and the degree of actual swelling in each subject, in method of our study. Our results revealed marked seasonal variation in swelling in the face, with more swelling in summer than in winter (Fig. 5). Greater swelling in summer was also noticed in the hands and fingers (Table 7). Swelling is related to the balance of body fluids, which accounts for some 60% of total body weight, moving through capillary walls. Swelling is caused by an abnormal increase in interstitial fluid, a form of extracellular fluid, and is closely connected to the mechanism of blood circulation (Fukuda and Yasuda, 1998; Mani et al., 1995). The phenomenon of capillary resistance exhibits seasonal variation, being lower in summer and higher in winter (Mano, 1950; Kramar et al., 1956). Furthermore, in summer, when the ambient temperature is hot, the blood vessels regulate the body temperature by expanding to dissipate heat, which reduces resistance within the capillary vessels and increases the volume of circulating blood (Asano, 1958). Thus, increased swelling during the summer can be attributed to the increased volume of blood circulating in the body, which alters the balance of body fluids moving through the capillary walls and increases the volume of interstitial fluid. This is particularly true for the subcutaneous tissue of the face, which is particularly susceptible to buildup of interstitial fluid between cells (Oresajo et al., 1987), contains a tightly-packed network of cells (Tucker and Linberg, 1994) and has a thinner skin covering than most other parts of the body and is therefore constantly exposed to the elements. For these reasons, the face is considered more vulnerable to the atmospheric temperature than the legs, hands or fingers. Seasonal change of swelling in the leg during the course of the day has been reported by Lee et al. (1987), who found swelling to be greater during the summer. However, the results in the present study did not reveal seasonal variation (Table 6). One factor which could explain this, chilliness of limb, is, like swelling, closely related to blood circulation. Miyamoto et al. (1995) studied chilliness of limb in Japanese females and found that, in recent years, the symptoms are occurring in summer as well as in winter. This could be attributed to the recent proliferation of advanced heating and cooling systems to the extent that atmospheric conditions are now controlled in nearly all places where people go, including homes and public and private transport as well as of office buildings, which is destroying the natural annual rhythm of blood circulation and sweating in the limbs. These factors may be related to the results of the present study; this topic is worthy of further investigation..

(7) Murakami, M et al.. Variation range of BMI are a minimum of change 1.1 (25.6–26.7) and maximum of change 1.6 (22.4–24.0) in subjects of this research. And variation range of body fat percent are a minimum of change 0.0% (22.0–22.0) and maximum of change 0.6% (20.8–21.4%) in subjects of this research. In this study, significant changes of BMI and body fat percent were not detected. Our studies found that variation of BMI and body fat percent did not affected perception of swelling (Table 5). However it is considered body composition is a factor that influences diurnal and seasonal shape changes, or perception of shape change. In the future, it is necessary to control for body composition and body characteristics, body volume or absolute or relative fatness, for future study and discussion.. References Asano M (1958) Effects of muscular exercise and season in healthy subjects. Bull Inst Publ Health 7 (2): 6976 Fukuda H, Yasuda H (1998) Edema. Gendai Iryo 20: 21-25 Ikeuchi H, Usui K, Mataki S, Kurosaki N (1996) Study on measuring of the facial form using 3-D curved shape measurement apparatus. J J Conce Dent 39 (1): 163167 Keates JS, Fitesgerald DE (1969) Limb volume and blood flow changes during the menstrual cycle. Angiology 20: 618-623 Kramar J, Meyers VW, Kramar MS (1956) Contribution to the physiology of capillary resistance in the human. J Lab Clin Med 47 (3): 423-436 Krijnen RMA, Boer EM, Ader HJ, Bruynzeel DP (1998) Diurnal volume changes of lower legs in healthy males with a profession that requires standing. Skin Res Technol 4: 18-23 Lee YS, Ohno S, Fukuda A (1987) The seasonal, Menstrual and daily changes of lower leg surface areas and lower leg volumes in the women. J Home Economic of Japan 38 (3): 205-212 Mani R, Ross JN, Keefe M (1995) Measurements of limb oedema in chronic venous disease. Skin Res Technol 1: 51-54 Mano J (1950) Studies on the influence of season and. 201. environmental temperature on the function of smallblood vessels of the normal human skin. Med Biol 17 (4): 238-241 Miyamoto N, Aoki T, Muto N, Inaba R, Iwata H (1995) Relationship between chilliness of the limbs and dailylife conditions in young females. J J Hyg 49: 1004-1012 Murakami M, Endo M, Arai S, Iizuka S, Tochihara Y (1998) Study of female body shape—Daily changes of form in the leg, hands and face. J J Physiol Anthrop 3: 109118 Orbach EJ (1979) Compression of vein and lymph vessel desease of the lower extremities. Angiology 30: 95103 Oresajo C, Dickens M, Znaiden A (1987) Eye area problems puffiness, bags, dark circles and crowsfeet. Cosmet Toilet 102 (7): 29-34 Pierson S, Pierson D, Swallow R, Johnson G (1983) Efficacy of graded elastic compression in the lower leg. JAMA 14: 242-243 Pottier M, Dubreuil A, Monod H (1969) The effects of sitting on the volume of the foot. Ergonomics 12: 753758 Sato K, Hirano M (1991) Clinical effects of the stepweise compressing support-stocking to gestational edema and varix. The Clinical Report 25 (8): 2579-2586 Tezuka K, Sato R, Igarashi T, Sugishita T (1996) The effect of pneumatic massage on the leg circumferences of healthy women. The Clinical Report 30 (2): 407413 Tucker SM, Linberg JV (1994) Vascular anatomy of the eyelids. Ophthalmology 101 (6): 1118-1121 Winkel J (1981) Swelling of the lower leg in sedentary work—A pilot study. J Human Ergol 10: 139-149 Winkel J (1986) Evaluation of foot swelling and lowerlimb temperatures in relation to leg activity during long-term seated office work. Ergonomics 29: 313328 Received: May 18, 1999 Accepted: August 6, 1999 Correspondence to: Motoko Murakami, Kanebo, Ltd., Cosmetics Laboratory, 5-3-28 Kotobuki-cho, Odawaracity, Kanagawa 250-0002, Japan e-mail: motoko@oda.cos.kanebo.co.jp.

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