Partial Excision and Ablative Carbon Dioxide Fractional Laser Therapy for Multiple Apocrine Hidrocystomas on the Periorbital Regions and Cheeks.

A 51-year-old Japanese woman presented with translucent papules on the periorbital area and cheeks that had progressively enlarged over five years. She underwent a skin biopsy and was diagnosed with multiple apocrine hidrocystomas. Her lesions became more pronounced and obscured her vision when her body warmed up, such as during bathing. To alleviate her symptoms, we began treatment by partially resecting the tumors on the lower eyelids. After surgery, her vision was no longer obscured. Approximately 1.5 years later, she underwent ablative 10,600 nm carbon dioxide fractional laser therapy for the mildly enlarged apocrine hidrocystomas on her lower eyelids and cheeks. At roughly six months of follow-up, the symptoms had improved, and the cosmetic results were satisfactory, although minor scarring and hypopigmentation were still evident. These case findings underscore the effectiveness of ablative carbon dioxide fractional lasers in treating apocrine hidrocystomas.

Reshaping the eyebrow by follicular unit transplantation from excised eyebrow in extended infrabrow excision blepharoplasty.

PURPOSE: We report the reshaping of the eyebrow by follicular unit transplantation from excised eyebrow skin in extended infrabrow excision blepharoplasty. METHODS: The method was carried out in two patients with moderate or significant dermatochalasis. The areas to be excised from the infrabrow and intrabrow skin were decided upon and the area of hair transplantation was planned in the suprabrow area and the tail of the eyebrow. The skin was removed and the excised intrabrow skin was dissected into single follicular units. Tiny incisions were made with a scalpel, and grafts were inserted using fine forceps. RESULTS: Almost all transplanted eyebrow follicles took successfully, resulting in eyebrows of a desirable shape as planned preoperatively. The reshaped eyebrows had a natural appearance since the transplanted hairs were similar to those of the original eyebrow. The eyelids still looked youthful rather than operated-on. Finally, the evidence of blepharoplasty was hardly visible and patient satisfaction was quite high. The patients felt more ease in opening their eyes and obtained a wider visual field. CONCLUSION: Our study demonstrated excellent results with hair transplantation from eyebrow to eyebrow, a finding which, to our knowledge, has not been previously reported. Our method can be used for selected patients, especially men, with moderate to severe dermatochalasis, who find a reduction or change in the shape of the eyebrow unacceptable.

Extended infrabrow excision blepharoplasty for dermatochalasis in asians.

OBJECTIVE: To describe extended infrabrow excision blepharoplasty (IBEB), whereby skin excision is extended to a substantial part of intrabrow skin and the intrabrow incision is made perpendicular to the hair shaft. METHODS: A total of 194 Asian patients with moderate to severe dermatochalasis underwent extended IBEB. The mean width of excised skin at its widest was 12.8 mm (range, 6-22 mm). RESULTS: Extended IBEB significantly reduced eyelid laxity but produced a natural-looking eyelid because it did not damage the eyelid framework. With application of eyebrow makeup by women, routine social activity was resumed soon after surgery. Infrabrow scarring became inconspicuous in patients with thick eyebrows after regrowth. CONCLUSIONS: Extended IBEB is recommended for middle-aged and older Asian women with moderate to severe dermatochalasis. With precise incision and fine suturing, regrowth alleviates eyebrow reduction and scarring among Asians who do not use makeup (male patients and young female patients).

Effect of pharmaceutical excipients on the stability of trichlormethiazide tablets under humid conditions.

The stability of trichlormethiazide (TCM) and the drug in the nine products available on the market (the original tablet (B) and 8 generic tablets (G1-G8)) were investigated under humid conditions. TCM was non-hygroscopic and was not degraded under humid conditions. Drug degradation in aqueous ethanol was accelerated with increased water concentration, and the drug stability in buffer solution was improved with decreased pH. TCM decomposition was not detected in each unwrapped tablet at low relative humidity. However, rapid degradation was observed for products G1 and G2, while product B and G7 showed higher stability at high relative humidity. The stability of products G1 and G2 decreased with increasing humidity. The same results were observed for the tablets in press-through packages (PTP), but the degradation rate was much slower than tablets without PTP packages. These results suggested that the adsorbed moisture by excipients cause TCM degradation. Various pharmaceutical excipients are added to TCM tablets and these vary between different pharmaceutical companies. Intact drug and pharmaceutical excipients, including lactose, microcrystalline cellulose, corn starch, hydroxypropylcellulose (HPC), low substituted HPC (L-HPC), calcium stearate, and light anhydrous silicic acid, were mixed, and the sample mixtures were stored in humid conditions. It was found that the TCM content decreased significantly in a binary mixture of TCM/HPC 1 : 1.

Effect of titanium dioxide on photostability of solid-state mequitazine.

TiO(2) has been widely used in pharmaceutical products, and it also has been used as a photocatalyst. In this study, the influence of photocatalytic activity on the stability of solid-state mequitazine, an H(1)-blocker, was investigated. The photo-degradation of mequitazine with TiO(2) occurred under irradiation with both light sources. The degree of degradation of mequitazine with anatase was higher than that of rutile. The degradation was significantly enhanced with increasing relative humidity. The relationship between the apparent degradation rate constant and water vapor pressure could be clearly described by a simple power law. The major photo-degradation products of mequitazine, resulting from photocatalytic activity of TiO(2), were mequitazine-S-oxide and mequitazine-sulphone. A remarkable degradation of mequitadine occurred with addition of TiO(2), and its photocatalytic activity was controlled by water vapor pressure. The photo-degradation of mequitazine with TiO(2) is a different process from mequitazine without TiO(2), because mequitazine-S-oxide and mequitazine-sulphone are not formed with normal photo-degradation of mequitazine.

Do multiple venous anastomoses reduce risk of thrombosis in free-flap transfer? Efficacy of dual anastomoses of separate venous systems.

Whether or not multiple venous anastomoses reduce the risk of free-flap failure is a subject of controversy. We report here, for the first time, on the importance of selecting 2 separate venous systems of the flap for dual anastomoses. The efficacy of multiple anastomoses was verified through a retrospective review of 310 cases of the free radial forearm flap transfer. Dual anastomoses of separate venous systems (the superficial and the deep) showed a lower incidence of venous insufficiency than single anastomosis did (0.7% versus 7.5%; P < 0.05). On the other hand, dual anastomoses of a sole venous system showed no significant difference in the incidence of venous insufficiency compared with single anastomosis (11.5% versus 7.5%; P = 0.48). Our results suggest that dual venous anastomoses of separate venous systems is conducive to reduced risk of flap failure and affords protection against venous catastrophe through a self-compensating mechanism that obviates thrombosis of either anastomosis.