Oral cavity reconstruction with the masseter flap.

The purpose of this report is to highlight how an unusual, outdated, unpopular and overlooked reconstructive method such as the masseter flap can be a reliable, straightforward and effective solution for oral reconstruction in selected cases. We report the transposition of the masseter crossover flap in two previously pre-treated patients presenting a second primary oral squamous cell carcinoma; excellent functional results with satisfactory cosmetic appearance were obtained in both cases. In the literature, only 60 cases of oral cavity and oropharyngeal reconstructions using the masseter flap have been reported. The possible clinical utility of this flap, even in modern head and neck reconstructive surgery, is presented and discussed. We believe that the masseter flap should enter in the armamentarium of every head and neck surgeon and be kept in mind as a possible solution since it provides an elegant and extremely simple procedure in suboptimal cases for microvascular reconstruction.

The yeast cell-wall salvage pathway.

The integrity of the cell wall depends on the synthesis and correct assembly of its individual components. Several environmental factors, such as temperature up-shift, treatments with mating factors or with specific cell wall-perturbing drugs, or genetic factors, such as inactivation of cell wall-related genes (for example FKS1 or GAS1) can impair construction of the cell wall. As the cell wall is essential for preserving the osmotic integrity of the cell, several responses are triggered in response to cell-wall damage. This review focuses on the activation of salvage pathways that guarantee cell survival through remodeling of the extracellular matrix. These researches have useful implication for the study of similar pathways in human fungal pathogens, and for the evaluation of the efficacy of new antifungal drugs.

The delayed neurobehavioural sequelae of traumatic brain injury.

This is a comprehensive review of the late-occurring effects of traumatic brain injury (TBI). It appears that TBI increases the risk over basal rates for the general population, to this degree: for depression, by a factor of five or 10; for seizures, by two to five; for psychotic disorders, by the same factor; and for dementia, by four or five. Severe TBI, or injuries with special characteristics, may increase the risk of delayed sequelae even further. One is not able, at this point, to estimate the relative occurrence of a newly described entity--delayed amnesia. An initial TBI increases the risk for subsequent TBI, by a factor of two. A second TBI increases the risk of yet another TBI eightfold.

Methylphenidate and exercise: additive effects on motor performance, variable effects on the neuroendocrine response.

It has been suggested that the effects of intensive environmental stressors and of psychostimulant drugs may be interchangeable. A specific test of this hypothesis was undertaken in a double-blind, placebo controlled, cross-over study of the stimulant drug, methylphenidate (MPH), and of intense exercise, alone and in combination. On measures of motor performance the effects of MPH and of exercise were additive while on measures of neuroendocrine response the individual and interactive effects were variable. The effects of MPH and of intense exercise are probably mediated by mechanisms that overlap to a degree but are by no means identical.