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Objective: The aim of this study was to identify the relative risk of damage to the inferior dental (ID) and lingual nerves in patients undergoing lower third molar removal., Study Design: A single surgeon reviewed 1,000 patients., Results: Temporary ID neurosensory deficit was highest (11%) when root apices were intimate to the ID nerve and lowest (0.9%) when close or distant from the nerve. Permanent ID neurosensory deficit was 0.4% per tooth but only when intimate to the canal. Bone removal, tooth division, and lingual split technique increase the risk of excessive hemorrhage which appears to be linked to the highest risk of temporary ID neurosensory deficit (20%). Permanent lingual nerve injury was rare (0.06%) and not related to lingual retraction., Conclusions: Preoperative warning for lower third molar removal can be individually tailored depending on the intimacy of the ID canal to the root apices and the anticipated surgical technique., (Crown Copyright © 2013. Published by Mosby, Inc. All rights reserved.)

Introduction: We present a retrospective analysis of 106 radial forearm free flaps (RFFFs) using double venous anastomoses as performed at Northampton General Hospital over an 11-year period. The aim was to assess the failure rate and salvage rate for venous thrombosis of these flaps., Methods: RFFFs were raised with the cephalic vein where possible. The cephalic vein and 1 venae commitantes or 2 venae commitantes (VC) were anastomosed using microscope assistance. The veins were anastomosed end to side on to the internal jugular vein (IJV). Data was collected from patient notes using a proforma and entered onto an Access database., Results: Of the 106 RFFFs there was 1 (0.94%) failure at day 9, a presumed arterial failure. None of the 106 RFFFs were returned to theatre for salvage for venous thrombosis., Conclusion: Our results compare favourably with similar published data. Comparable studies gave a mean failure rate of 4% (range of 0-10%) and 7% (range 3-12.5%). We believe our results are due to: 1--Double venous anastomosis, 2--end to side anastomosis to the IJV using deep and superficial systems, 3--initial anastomosis of the cephalic vein low in the neck to shorten ischaemic time. 4--overnight sedation and ventilation of the patient on the intensive care unit.

Since antioxidants have been shown to play a major role in preventing some of the effects of aging and photoaging in skin, it is important to study this phenomenon in a controlled manner. This was accomplished by developing a simple and reliable in vitro technique to assay antioxidant efficacy. Inhibition of peroxidation by antioxidants was used as a measure of relative antioxidant potential. Liposomes, high in polyunsaturated fatty acids (PUFA), were dispersed in buffer and irradiated with ultraviolet (UV) light. Irradiated liposomes exhibited a significantly higher amount of hydroperoxides than liposomes containing antioxidants in a dose- and concentration-dependent manner. Lipid peroxidation was determined spectrophotometrically by an increase in thiobarbituric acid reacting substances. To further substantiate the production of lipid peroxides, gas chromatography was used to measure a decrease in PUFA substrate. In order of decreasing antioxidant effectiveness, the following results were found among lipophilic antioxidants: BHA greater than catechin greater than BHT greater than alpha-tocopherol greater than chlorogenic acid. Among hydrophilic antioxidants, ascorbic acid and dithiothreitol were effective while glutathione was ineffective. In addition, ascorbic acid was observed to act synergistically with alpha-tocopherol, which is in agreement with other published reports on the interaction of these two antioxidants. Although peroxyl radical scavengers seem to be at a selective advantage in this liposomal/UV system, these results demonstrate the validity of this technique as an assay for measuring an antioxidant's potential to inhibit UV-induced peroxidation.

The role of stratum corneum (SC) constituents in SC barrier properties was assessed directly in vitro in a reaggregated system. Fragments of SC from the sole of the foot (hyperplastic tissue) and from the calf (normal tissue) were reduced, separately, to individual cells and these cells were depleted of lipids by solvent extraction. Lipids taken from the cells themselves or from SC from other areas of the body were then added to the cells. None of the fractions used allowed for reaggregation of plantar SC cells, or of trypsinized calf SC cells. In contrast, calf SC cells reaggregated equally well with all lipids and formed coherent SC sheets. At equal lipid:cell ratios, however, plantar lipid-calf cell SC sheets were about three time more permeable to water than calf lipid-calf cell SC sheets. The effectiveness of the barrier function of the SC sheets was directly proportional to the amount of added lipid. We conclude that in normal SC the extractable lipids are intimately involved in cellular adhesion/dyshesion and in barrier formation.