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There is a mounting body of evidence that underscores the worldwide and US national need for increased plastic surgery recruitment of trainees. Thus, plastic surgery must attract more applicants while maintaining the high-level qualifications of residency candidates. A total of 250 (w = 197) medical students rated the prototypical plastic surgeon (PS), general practitioner (GP), and craniomaxillofacial surgeon (CMF) with respect to traits derived from a literature review on the general perception of surgery, favorability, and their intention to pursue a respective career. Factor analysis yielded two overarching dimensions of prototype perception in addition to femininity and resilience , one reflecting a coldhearted, narcissistic, competitive character (status primacy; SP), and one reflecting role-model-like traits (hard-working, healthy, admired, and empathetic). Prototypical PSs scored significantly higher on SP than GPs (t(249) = 18.72, p < 0.001, d = 1.26) and CMFs (t(249) = 5.73, p < 0.001, d = 0.36), while receiving significantly less positive evaluations (GP: t(249) = -9.93, p < 0.001, d = -0.63; CMF: t(249) = -3.52, p < 0.001, d = -0.22). The higher participants rated PSs on SP, the more likely a career in plastic surgery was excluded (OR = 0.71, p = 0.03). An opposite relationship with femininity approached significance (OR = 1.32, p = 0.06). Given the growing need for PSs, worldwide and US national task fields have to overcome the outdated traits and highlight the field's pro-bono engagement. Furthermore, plastic surgery should further expand its leading role in promoting female trainees. [ABSTRACT FROM AUTHOR]

In phalloplasty, there is a lack of standardized follow-up examinations of motor function and strength after harvesting oversized radial forearm free flaps (RFFF). We evaluated the donor site of 20 transmen after phalloplasty, using a multimodal, standardized approach, assessing the following parameters: opposition of the thumb, composite range of motion of the finger joints, grip strength, mobility of the wrist, lesion of the superficial branch of the radial nerve, the dorsal branch of the ulnar nerve, the sensation of pain, and cold intolerance. The contralateral, nonoperated forearm was used as a control. No impairment of the mobility of the thumb (Kapandji score median 10, range 5–10) or fingers (all fingers at both sides pulp-to-palm 0 cm, nail-to-table 0 cm) were detected. Grip strength (median 36,3kg, p=0.629) and wrist extension (62.5°vs.70°, p=0.357), flexion (70°vs.70°, p=0.535), pronation (90°vs.90°), supination (90°vs.90°), radial (30°vs.30°, p=0.195), and ulnar deviation (40°vs.50°, p=0.125) did not statistically differ between donor and control hand. Injury of the dorsal branch of the ulnar nerve was uncommon (0% hypoesthesia, 10% positive Tinel's sign). We did not observe any persistent pain of the donor forearm (NRS median 0, range 0–9). We did observe irritation of the superficial branch of the radial nerve (hypoesthesia 40%, neuroma 45%). The harvest of an oversized RFFF for phalloplasty does not cause any significant difference in motor function or strength between the donor and nonoperated hand. A potential risk of injuring the radial nerve branch is to be avoided. An aesthetic impairment could be addressed in future studies. [ABSTRACT FROM AUTHOR]

• Prenylated flavanones and chalcones from hop inhibit SARS-CoV-2 PLpro in silico and in vitro. • In particular, xanthohumol and 6-prenylnaringenin are inhibitors of SARS-CoV-2 replication in vitro. • Hop compounds represent easily available and well tolerable molecules to develop new antivirals Selected natural compounds exhibit very good antiviral properties. Especially, the medicinal plant Humulus lupulus (hop) contains several secondary plant metabolites some of which have previously shown antiviral activities. Among them, the prenylated chalcone xanthohumol (XN) demonstrated to be a potent inhibitor of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) main protease (Mpro). Following the finding that xanthohumol (XN) is a potent inhibitor of SARS-CoV-2 Mpro, the effect of XN and its major derivatives isoxanthohumol (IXN), 6-prenylnaringenin (6-PN), and 8-prenylnaringenin (8-PN) from hops on SARS-CoV-2 papain-like protease (PLpro) were investigated. The modulatory effect of the hop compounds on PLpro were studied first in silico and then in vitro. In addition, the actual effect of hop compounds on the replication of SARS-CoV-2 in host cells was investigated. In silico docking analysis was used to predict the binding affinity of hop compounds to the active site of PLpro. A recombinant PLpro was cloned, purified, characterized, and analyzed by small-angle X-ray scattering (SAXS), deISGylation assays, and kinetic analyses. Antiviral activity of hop compounds was assessed using the fluorescently labeled wildtype SARS-CoV-2 (icSARS-CoV-2-mNG) in Caco-2 host cells. Our in silico docking suggests that the purified hop compounds bind to the active site of SARS-CoV-2 PLpro blocking the access of its natural substrates. The hop-derived compounds inhibit SARS-CoV-2 PLpro with half maximal inhibitory concentration (IC 50) values in the range of 59–162 µM. Furthermore, we demonstrate that XN and 6-PN, in particular, impede viral replication with IC 50 values of 3.3 µM and 7.3 µM, respectively. In addition to the already known inhibition of Mpro by XN, our results show, for the first time, that hop-derived compounds target also SARS-CoV-2 PLpro which is a promising therapeutic target as it contributes to both viral replication and modulation of the immune system. These findings support the possibility to develop new hop-derived antiviral drugs targeting human coronaviruses. [Display omitted] [ABSTRACT FROM AUTHOR]

Nonsteroidal anti-inflammatory drug–exacerbated respiratory disease (N-ERD) is a chronic inflammatory condition, which is driven by an aberrant arachidonic acid metabolism. Macrophages are major producers of arachidonic acid metabolites and subject to metabolic reprogramming, but they have been neglected in N-ERD. This study sought to elucidate a potential metabolic and epigenetic macrophage reprogramming in N-ERD. Transcriptional, metabolic, and lipid mediator profiles in macrophages from patients with N-ERD and healthy controls were assessed by RNA sequencing, Seahorse assays, and LC-MS/MS. Metabolites in nasal lining fluid, sputum, and plasma from patients with N-ERD (n = 15) and healthy individuals (n = 10) were quantified by targeted metabolomics analyses. Genome-wide methylomics were deployed to define epigenetic mechanisms of macrophage reprogramming in N-ERD. This study shows that N-ERD monocytes/macrophages exhibit an overall reduction in DNA methylation, aberrant metabolic profiles, and an increased expression of chemokines, indicative of a persistent proinflammatory activation. Differentially methylated regions in N-ERD macrophages included genes involved in chemokine signaling and acylcarnitine metabolism. Acylcarnitines were increased in macrophages, sputum, nasal lining fluid, and plasma of patients with N-ERD. On inflammatory challenge, N-ERD macrophages produced increased levels of acylcarnitines, proinflammatory arachidonic acid metabolites, cytokines, and chemokines as compared to healthy macrophages. Together, these findings decipher a proinflammatory metabolic and epigenetic reprogramming of macrophages in N-ERD. [ABSTRACT FROM AUTHOR]

Highlights • Hydrogels of tunable mesh size enable gradual immobilization of magnetic particles. • Brownian rotation is gradually inhibited with particle immobilization states. • Particle heating in alternating magnetic field decreases with immobilization state. • Brownian relaxation contributes at least one third to the overall particle heating. Abstract Magnetic nanoparticles (MNP) applied in magnetic fluid hyperthermia cancer treatment interact with cancerous tissue in various ways. The impact of these interactions on MNP heating efficiency is hard to quantify and strongly depends on the MNP mobility inside the cancerous environment. There, this MNP mobility is inhibited by cell attachment and internalization. In this study, we model this impact and analyze the MNP heating under gradual immobilization of MNP in acrylamide hydrogels with tailored mesh size. Our results confirm a clear particle heating dependency on the state of immobilization of MNP. This state is related to the mean mesh size of the respective hydrogel. From this, the contributions of Brownian and Néel relaxation mechanisms to the overall particle heating are estimated. In fact, the heating efficiency decreases by up to 35% for the highest immobilization state of MNP. This result is discussed in the context of the field-dependent Brownian and Néel relaxation time, showing that the former significantly contributes to the heating efficiency even for small particles under the field parameters employed in this study. [ABSTRACT FROM AUTHOR]

Highlights • Particle heating measured for varying core sizes, field amplitudes and frequencies. • Stochastic Langevin simulations of particle heating verified by measurements. • Estimation of the effective anisotropy constant for iron oxide nanoparticles. • Simulating optimal particle and field parameters maximizing therapeutic heating. Abstract Magnetic nanoparticles (MNP) have been investigated for generating therapeutic heat when subjected to an alternating magnetic field (AMF) and applied for tumor-confined cancer therapy, so-called magnetic fluid hyperthermia (MFH). For application of MFH, a key requirement is the reduction of MNP dosing by maximizing the heat generation within medically safe limits of the applied AMF. Therefore, reliable and accurate predictions of particle heating are required for the advancement of therapy planning. In this study, we compare size-dependent particle heating data from calorimetric measurements to stochastic Néel-Brown Langevin equation Monte Carlo simulations, finding good agreement between them for various AMF amplitudes and frequencies. Within medical safety constraints of the AMF, our simulations predict maximum particle heating for magnetite particle core sizes above 25 nm with effective anisotropy constants K = 4000 J/m3 at frequencies of ∼ 100 kHz and field amplitudes ∼ 10 mT/μ 0. These simulations could help to predict the optimal combination of medically safe AMF parameters and MNP intrinsic properties, such as core size and effective anisotropy, to maximize heat generation and reduce MNP dosing in the application of MFH. [ABSTRACT FROM AUTHOR]

Summary Introduction Reduction mammoplasty alleviates symptoms of macromastia in various ways. Current study results mainly identify perioperative risk factors for middle aged patients. We investigated a large series of consecutive breast reductions procedures to study whether patients' age at the time of operation is related to the postoperative outcome. Methods We retrospectively reviewed all non-oncologic breast reduction procedures at a single institution over a ten year time period, analyzing patients (age, BMI, comorbidities, medication) and operation specific characteristics' (pedicle, nipple-to-sternal notch, resection weight, complications) to identify risk factors related to patients' age at the time of operation. Patients were therefore divided into three groups, according to their age (group I ≤ 20 years, group II ≥60 years, group III 21 to 59 years). Results 539 patients were included in the study, in total 1065 reduction mammoplasties were performed over a ten year period. The overall complication rate was 33% (n = 175). Excluding minor complications, the total complication rate was 9.5% (n = 51). High body mass index (≥30 kg/m2) (p = 0.02) could be identified as a statistically significant risk factor for major and minor complications. Smoking (p = 0.09) and age ≥ 60 years (p = 0.08) showed a tendency toward higher risk for major and minor complications. Conclusion This study shows an increased risk for complications when performing reduction mammoplasty in older patients, presumably due to the higher prevalence of comorbidities in this patient group as compared to young patients. [ABSTRACT FROM AUTHOR]

Although widely used as a preclinical model for studying venous diseases, there is a scarcity of in vivo characterizations of the naïve murine venous system. Additionally, previous studies on naïve veins ( ex vivo ) have not included the influence of surrounding structures and biomechanical forces. Using MRI, we noninvasively quantified the cross-sectional area, cyclic strain, and circularity of the venous system in young and old, male and female C57BL/6 mice. We investigated the most common venous locations used to perform venous disease research: the common jugular vein, suprarenal inferior vena cava (IVC), infrarenal IVC, common iliac vein, and common femoral vein. Our results elucidate age-dependent changes in venous cross-sectional area, which varied by location. Maximum cyclic strain, a parameter of lumen expansion, showed 10% change across the cardiac cycle, approximately half the magnitude of arteries. Veins demonstrated noncircular shapes, particularly in the core vasculature. The cardiovascular stressor dobutamine had only a small impact on the venous system. Also, our data demonstrate that the peripheral veins tend to decrease in cross-sectional area and circularity with age. Conversely, the IVC tends to increase in size and circularity with age, with males exhibiting larger variability in response to dobutamine compared to females. This work provides a foundation for drawing age and sex comparisons in disease models, and represents the first in vivo characterization of the murine venous system at rest and during the application of a pharmacological exercise surrogate. [ABSTRACT FROM AUTHOR]

Variations in drug metabolism may alter drug efficacy and cause toxicity; better understanding of the mechanisms and risks shall help to practice precision medicine. At the 21 st International Symposium on Microsomes and Drug Oxidations held in Davis, California, USA, in October 2–6, 2016, a number of speakers reported some new findings and ongoing studies on the regulation mechanisms behind variable drug metabolism and toxicity, and discussed potential implications to personalized medications. A considerably insightful overview was provided on genetic and epigenetic regulation of gene expression involved in drug absorption, distribution, metabolism, and excretion (ADME) and drug response. Altered drug metabolism and disposition as well as molecular mechanisms among diseased and special populations were presented. In addition, the roles of gut microbiota in drug metabolism and toxicology as well as long non-coding RNAs in liver functions and diseases were discussed. These findings may offer new insights into improved understanding of ADME regulatory mechanisms and advance drug metabolism research. [ABSTRACT FROM AUTHOR]

Objective: To improve the donor-site morbidity of the radial forearm flap through coverage with a free vascularized groin flap and comparing this flap coverage to the current standard, a full-thickness skin graft (FTSG).Materials and Methods: A retrospective analysis of all free radial forearm flap phalloplasties for transgender surgery at our institution was performed. We examined patient characteristics, donor site defects, surgical procedure, and clinical courses.Results: Between October 2013 and February 2016, 27 consecutive patients underwent phalloplasty for female-to-male reassignment surgery with free radial forearm flaps. A total of 7 free groin flaps (group A) and 20 full-thickness skin graft from the groin region (group B) for donor-site defect coverage of the forearm were performed. The mean age in group A was 28.4 years with a mean body mass index of 21.6 kg/m(2) and a mean follow-up time of 10.6 months. The mean surgery time was 724 minutes. The mean patients' functional rating was 3.6 accompanied by the mean patients' aesthetical rating of 3.7. The mean age in group B was 30.5 years with a mean body mass index of 23.7 kg/m(2) and a mean follow-up time of 13.4 months. The mean surgery time was 563 minutes. The mean patients' functional rating was 3.1 accompanied by the mean patients' aesthetical rating of 2.9.Conclusion: We suggest that the free microvascular groin flap should be considered for immediate defect closure after phalloplasty with a radial forearm flap due to its beneficial functional and aesthetic results and the low rate of complications. [ABSTRACT FROM AUTHOR]

The ligand-activated nuclear receptor pregnane X receptor (PXR, NR1I2) and the constitutive androstane receptor (CAR, NR1I3) are two master transcriptional regulators of many important drug metabolizing enzymes and transporter genes (DMET) in response to xenobiotics including many drugs. The peroxisome proliferator-activated receptor alpha (PPARα, NR1C1), the target of lipid lowering fibrate drugs, primarily regulates fatty acid catabolism and energy-homeostasis. Recent research has shown that there are substantial overlaps in the regulated genes of these receptors. For example, both CAR and PXR also modulate the transcription of key enzymes involved in lipid and glucose metabolism and PPARα also functions as a direct transcriptional regulator of important DMET genes including cytochrome P450s CYP3A4 and CYP2C8. Despite their important and widespread influence on liver metabolism, comparative data are scarce, particularly at a global level and in humans. The major objective of this study was to directly compare the genome-wide transcriptional changes elucidated by the activation of these three nuclear receptors in primary human hepatocytes. Cultures from six individual donors were treated with the prototypical ligands for CAR (CITCO), PXR (rifampicin) and PPARα (WY14,643) or DMSO as vehicle control. Genomewide mRNA profiles determined with Affymetrix microarrays were analyzed for differentially expressed genes and metabolic functions. The results confirmed known prototype target genes and revealed strongly overlapping sets of coregulated but also distinctly regulated and novel responsive genes and pathways. The results further specify the role of PPARα as a regulator of drug metabolism and the role of the xenosensors PXR and CAR in lipid metabolism and energy homeostasis. This article is part of a Special Issue entitled: Xenobiotic nuclear receptors: New Tricks for An Old Dog, edited by Dr. Wen Xie. [ABSTRACT FROM AUTHOR]

Summary Introduction Body-contouring (BC) procedures after massive weight loss (MWL) are extensive and numerous. Currently, inconsistent data exist regarding quality-of-life (QoL) scales, and long-term analysis is lacking. The aim of this study was to investigate the long-term outcome of patients who elect to have BC procedures after MWL. Methods Post-bariatric patients and patients who had dietary weight loss with no history of bariatric surgery (BS) (BC group) were included. Patients after BS with similar demographic characteristics but no BC procedures served as the control group (BS group). The results were compared with severely obese patients who have not yet undergone BS or BC surgery (obese group). Outcome measures include the type of BC surgery with the rates of the associated procedures and outcome satisfaction evaluated after the Moorehead–Ardelt questionnaire (range −3.0 to +3.0). Results Fifty-six female and 10 male Caucasian patients with a mean age of 50 years (14 years) who underwent BC procedures between February 1999 and October 2009 were included. Of those, 23 patients completed the survey in 2014 (20 female and three male patients, mean age of 53 years (14 years)) at a final follow-up of 8 years (3 years). Two years (range 1–3 years) after MWL, a total of 51 BC procedures were performed. The most frequent interventions were abdominoplasty ( n = 20), followed by rectus plication and liposuction ( n = 7 and n = 6, respectively). QoL scores revealed a high overall patient satisfaction in the BC group, which was comparable with the BS group ( n = 23). The obese group ( n = 17) had a significantly lower overall QoL and lower health-related QoL (HRQoL) subdomains compared with the BC and BS group. Conclusion BC procedures lead to high and durable patient satisfaction. However, the appropriate management of expectations before surgery is mandatory. [ABSTRACT FROM AUTHOR]

Background Multiple symmetric lipomatosis (MSL) is a rare condition leading to grotesque disfigurement. Complete removal is almost impossible and recurrences inevitable. The objective of this study was to evaluate powered-assisted liposuction (PAL) for the treatment of MSL. Methods Magnetic resonance imaging (MRI) was performed before and after surgery for quality assessment. To exclude malignancy incisional biopsies were taken before surgery. Outcome measures included aspiration volumes, duration of surgery, early morbidity, recurrence rates, and overall patient satisfaction. Results Seven male patients aged between 43 and 70 years were identified. The mean liposuction volume equaled 2948±1566 mL, the mean surgery time 74±28 minutes. One hematoma was observed, whereas 1 recurrence rate was noticed after a mean follow-up of 14 months. Malignancy was excluded by histology in 5 patients. Preoperative MRI confirmed the diagnosis with no signs for malignancy and showed an efficient removal of the lesions. After a mean follow-up of 18 months, a high patient satisfaction was achieved. Conclusion PAL can serve as an efficient method for the treatment of MSL. It has a significant effect on tightening of the skin, leading to a high patient satisfaction. [ABSTRACT FROM AUTHOR]

Abstract: Background: Endothelial cell recovery requires replenishment of primary cells from the endothelial lineage. However, recent evidence suggests that cells of the innate immune system enhance endothelial regeneration. Methods and results: Focusing on mature CD11b+-monocytes, we analyzed the fate and the effect of transfused CD11b+-monocytes after endothelial injury in vivo. CD11b-diphtheria-toxin-receptor-mice – a mouse model in which administration of diphtheria toxin selectively eliminates endogenous monocytes and macrophages – were treated with WT-derived CD11b+-monocytes from age-matched mice. CD11b+-monocytes improved endothelium-dependent vasoreactivity after 7days while transfusion of WT-derived CD11b−-cells had no beneficial effect on endothelial function. In ApoE−/−-CD11b-DTR-mice with a hypercholesterolemia-induced chronic endothelial injury transfusion of WT-derived CD11b+-monocytes stimulated by interferon-γ (IFNγ) decreased endothelial function, whereas interleukin-4-stimulated (IL4) monocytes had no detectable effect on vascular function. Bioluminescent imaging revealed restriction of transfused CD11b+-monocytes to the endothelial injury site in CD11b-DTR-mice depleted of endogenous monocytes. In vitro co-culture experiments revealed significantly enhanced regeneration properties of human endothelial outgrowth cells (EOCs) when cultured with preconditioned-media (PCM) or monocytes of IL4-stimulated-subsets compared to the effects of IFNγ-stimulated monocytes. Conclusion: CD11b+-monocytes play an important role in endothelial cell recovery after endothelial injury by homing to the site of vascular injury, enhancing reendothelialization and improving endothelial function. In vitro experiments suggest that IL4-stimulated monocytes enhance EOC regeneration properties most likely by paracrine induction of proliferation and cellular promotion of differentiation. These results underline novel insights in the biology of endothelial regeneration and provide additional information for the treatment of vascular dysfunction. [Copyright &y& Elsevier]

Abstract: Thermokarst lakes and basins are major components of ice-rich permafrost landscapes in East Siberian coastal lowlands and are regarded as indicators of regional climatic changes. We investigate the temporal and spatial dynamics of a 7.5km2, partly drained thermokarst basin (alas) using field investigations, remote sensing, Geographic Information Systems (GIS), and sediment analyses. The evolution of the thermokarst basin proceeded in two phases. The first phase started at the Pleistocene/Holocene transition (13 to 12ka BP) with the initiation of a primary thermokarst lake on the Ice Complex surface. The lake expanded and persisted throughout the early Holocene before it drained abruptly about 5.7ka BP, thereby creating a >20m deep alas with residual lakes. The second phase (5.7ka BP to present) is characterized by alternating stages of lower and higher thermokarst intensity within the alas that were mainly controlled by local hydrological and relief conditions and accompanied by permafrost aggradation and degradation. It included diverse concurrent processes like lake expansion and stepwise drainage, polygonal ice-wedge growth, and the formation of drainage channels and a pingo, which occurred in different parts of the alas. This more dynamic thermokarst evolution resulted in a complex modern thermokarst landscape. However, on the regional scale, the changes during the second evolutionary phase after drainage of the initial thermokarst lakes were less intense than the early Holocene extensive thermokarst development in East Siberian coastal lowlands as a result of a significant regional change to warmer and wetter climate conditions. [Copyright &y& Elsevier]

Abstract: Before undergoing repair of zygomaticomaxillary complex fractures, most patients are worried about their postoperative appearance. Furthermore, there is an ongoing discussion about the selection of the surgical approach to the inferior orbita and resulting eyelid deformities. We present a photo-assisted postoperative evaluation of zygomaticomaxillary complex fracture repair based on reference anthropometric data. Two hundred and twenty-one patients underwent zygomaticomaxillary complex fracture repair. An analysis of standardized postoperative photographs included measurements of eye fissure width and height, lid sulcus height, upper lid height, upper and lower coverage, position of cornea to palpebra inferior, canthal tilt, scleral show, ectropion and entropion. It was clearly distinguished between operated and contralateral eyelid, and whether a transconjunctival or a subciliary approach was performed. Surgery per se significantly influenced eyelid deformities as measured by its impact on eye fissure index, lower iris coverage and rate of scleral show and ectropion. The surgical approach selected significantly affected eye fissure index, lower iris coverage and rate of scleral show, indicating distortion of the lower eyelid. Investigations regarding orbital fractures should clearly differentiate the type of fracture. The subciliary approach included the highest risk of postoperative lower eyelid deformity in zygomaticomaxillary complex fracture repair. The standardized measurements described here are accurate and objective to evaluate postoperative results. [Copyright &y& Elsevier]

Abstract: Cytochromes P450 (CYP) are a major source of variability in drug pharmacokinetics and response. Of 57 putatively functional human CYPs only about a dozen enzymes, belonging to the CYP1, 2, and 3 families, are responsible for the biotransformation of most foreign substances including 70–80% of all drugs in clinical use. The highest expressed forms in liver are CYPs 3A4, 2C9, 2C8, 2E1, and 1A2, while 2A6, 2D6, 2B6, 2C19 and 3A5 are less abundant and CYPs 2J2, 1A1, and 1B1 are mainly expressed extrahepatically. Expression of each CYP is influenced by a unique combination of mechanisms and factors including genetic polymorphisms, induction by xenobiotics, regulation by cytokines, hormones and during disease states, as well as sex, age, and others. Multiallelic genetic polymorphisms, which strongly depend on ethnicity, play a major role for the function of CYPs 2D6, 2C19, 2C9, 2B6, 3A5 and 2A6, and lead to distinct pharmacogenetic phenotypes termed as poor, intermediate, extensive, and ultrarapid metabolizers. For these CYPs, the evidence for clinical significance regarding adverse drug reactions (ADRs), drug efficacy and dose requirement is rapidly growing. Polymorphisms in CYPs 1A1, 1A2, 2C8, 2E1, 2J2, and 3A4 are generally less predictive, but new data on CYP3A4 show that predictive variants exist and that additional variants in regulatory genes or in NADPH:cytochrome P450 oxidoreductase (POR) can have an influence. Here we review the recent progress on drug metabolism activity profiles, interindividual variability and regulation of expression, and the functional and clinical impact of genetic variation in drug metabolizing P450s. [Copyright &y& Elsevier]

Abstract: Before undergoing facial tumour resection and reconstruction, especially of the eyelids, patients are worried about their postoperative appearance. “Eye-balling” of postoperative results may not be sufficient to adequately judge surgical results. Reference anthropometric measurements for the eyelids are available. We present an evaluation of a series of tumour resection and reconstructive procedures of the eyelids on standardized photographs based on reference anthropometric data. 51 patients underwent eyelid reconstruction with different established techniques after resection of local eyelid tumours. Analysis included intercanthal width, biocular width, eye fissure width, eye fissure height, lid sulcus height, upper lid height, upper iris coverage, lower iris coverage, position of cornea to palpebra inferior, scleral show, ectropion, and canthal tilt. We clearly differentiated between resections including eyelid margin or not. Time (p = 0.04) and surgery (p = 0.03) showed a significant association with decreased values of lower eyelid coverage. Resection of the eyelid margin showed no significant influence on the values investigated. In all the patients analysed the indices were reproducible and reliable. Not surprisingly an association between surgery and lower eyelid retraction was found. Resection of the eyelid margin does not seem to cause a greater risk of eyelid deformity. The standard measurements described are accurate and objective to evaluate postoperative results. [Copyright &y& Elsevier]

Abstract: Before undergoing a reconstructive procedures of the nose most patients ask how they will look postoperatively. Anthropometric measurements of the nose described by Farkas represent standard values. A comparison of pre- and postoperative anthropometric measurements may help to double-check the correctness of intraoperative “eye-balling” measurements with regards to postoperative appearance. Sixty-three patients underwent reconstruction of nasal ala, tip or dorsum. An analysis of standardized pre- and postoperative photographs included measurements of nose width, nose height, nasal tip protrusion, columella width, ala length, intercanthal width, mouth width, philtrum width, upper lip height, lateral upper lip height, cutaneous upper lip height and upper face height. Preoperative measurements were compared to data given by Farkas in young adults. Postoperative changes were evaluated clearly distinguishing between reconstruction of nasal ala, tip and dorsum. All anthropometric indices showed significant differences compared to the Farkas population. There was no significant pre- to postoperative change in any reconstructed region observed, indicating adequate intraoperative measurements. The application of Farkas’ anthropometric measurements described in this study showed reliable and objective results and can help to double-check the previous intraoperative measurements. The correct application of these surgical techniques leads to a satisfying and near to normal postoperative look of the patient. [Copyright &y& Elsevier]