How environment and lifestyle choices influence the aging process.

Differences in the physical appearance of identical twins attributable to aging were studied. Because these individuals are identical genetically, any differences found were believed to result from external factors. Twins showing the greatest discrepancies in visible aging signs also had the greatest degree of discordance between personal lifestyle choices and habits. The most notable exogenous factors influencing degree of aging were sun exposure and smoking. Other possibly contributory lifestyle factors include alcohol consumption, stress, diet, exercise, disease, and medication. In summary, the genetic influences on aging may be highly overrated, with lifestyle choices exerting far more important effects on physical aging.

Arteriovenous fistulae following hair transplantation: collective review and report of a case.

Hair transplantation has become one of the most common cosmetic procedures in men. Complications are reported to be rare. Eight cases of arteriovenous fistulae following the procedure have been recorded in the literature, occurring anywhere from a few weeks to several months after the transplantation. This presentation, the ninth case, is of a 33-year-old man whose procedure was performed in a dermatology clinic and who first saw signs of an enlarged, pulsating blood vessel in the temporal region some 7 weeks later. A photograph of the lesion is presented and the method of treatment of the fistula is described.

Further refinements on the triangular flap closure of the cleft lip.

Refinements in the triangular flap closure of the unilateral cleft lip are presented. Randall's mathematical interpretation of the Tennison repair has been extended by using a series of arcs to determine the crucial points which form the triangular flap. Using this easily taught method, an isosceles triangular flap can be plotted which will interdigitate into the noncleft side of the lip. Two symmetrical vertical distances on either side of the cleft are thus formed. This allows for a standardized repair which may be more readily taught than the rotation-advancement technique. In addition, flaps are created which are turned medically toward the cleft and are used to accentuate the philtral pout, close the nostril floor, and reinforce the lip repair, allowing closure of even extremely wide clefts in one stage. These refinements in using the triangular flap closure for the repair of the unilateral cleft lip are diagrammatically presented. We believe that these refinements enhance the results of this closure.