The inferior trapezius musculocutaneous flap in head and neck reconstruction

The trapezius musculocutaneous flap based on the descending branch of the transverse cervical vessels has been used to reconstruct a variety of large and complex defects in the head and neck region. Forty-three flaps were performed in 41 patients over a period of 26 months. Excellent reconstruction was achieved in 37 patients. Six total and nine partial flap failures were noted. There were 8 deaths during this time, 2 attributable directly to flap failure. Patient positioning during surgery and the tedious dissection are disadvantageous. The advantages of this flap are its thinness, long reach, and a posterior donor defect. These attributes are ideally suited for certain complex reconstructive endeavors in the head and neck.     

Controlled in vivo release of nicorandil from a carvone-based transdermal therapeutic system in human volunteers

The aim of our present study was to prepare and evaluate a carvone-based transdermal therapeutic system (TTS) of nicorandil to find its ability in providing the desired in vivo controlled release profile on dermal application to human volunteers. The effect of EVA 2825, and adhesive-coated EVA 2825, and adhesive-coated EVA 2825-rat skin composite on the in vitro permeation of nicorandil from a carvone-based HPMC gel drug reservoir was studied against a control (rat abdominal skin alone). The carvone-based drug reservoir system was sandwiched between adhesive-coated EVA 2825-release liner composite and a backing membrane. The resultant drug reservoir sandwich was heat-sealed to produce a circle-shaped TTS (20 cm²) that was subjected to in vivo evaluation on dermal application to human volunteers against oral administration of immediate-release tablets of nicorandil. The carvone-based TTS provided a steady-state plasma concentration of 20.5 ng/ml for ∼24 hr in human volunteers. We concluded that the carvone-based TTS of nicorandil provided the desired in vivo controlled-release profile of the drug for the predetermined period of time.     

Enhancing of tuberculin allergy by previous tuberculin testing

A controlled study on the enhancing of tuberculin allergy by one or more earlier tuberculin tests was carried out in a previously untested and unvaccinated population, in an area where the prevalence of non-specific allergy was known to be high. The results have shown that a test with 1 TU of PPD RT 23 in Tween 80 diluent causes subsequent tests to elicit significantly larger reactions. This enhancing effect is more marked among those with initial reactions of 8-13 mm to 1 TU or 10 mm and more to 20 TU. There is practically no enhancement among those whose reactions to 20 TU measure 0-4 mm or even 0-9 mm. Even in the group with reactions of 10 mm and more to 20 TU only some individuals show evidence of enhancement. The enhancing of allergy increases with age.