Orientation of multi-hair follicles in nonbald men: perpendicular versus parallel.

BACKGROUND: There has been much debate about the orientation of multi-hair grafts in order to obtain an appearance of fullness after the hair transplantation. OBJECTIVES: To analyze natural orientation of multi-hair follicles and the influence of hair flow from the crown swirl. METHODS: Natural orientation of follicles was analyzed microscopically in 100 nonbald men: a clockwise whorl flow group (50 men) and a counterclockwise group (50 men). RESULTS: The majority of multi-hair follicles were oriented perpendicular to the radial line from the whorl in both the groups. The percentage of perpendicular orientation was large in the peripheral and middle scalp areas (49-79%), and it decreased in the vertex (38-49%, p<.05 or .01). The percentages of parallel, right oblique, and left oblique orientation were small in the peripheral area with a slight increase in the vertex (3-12% vs. 14-24%, p<.05 or .01). CONCLUSION: Original orientation of multi-hair follicles was mainly perpendicular to the radial line from the whorl irrelevant to the crown swirl hair flow. Multi-hair grafts transplanted perpendicularly would look similar to the natural hair follicles in the front half of the scalp.

Successful trapdoor technique for two separate coronary ostia in a single aortic sinus in arterial switch operation for complete transposition of the great arteries.

Two separate origins of coronary arteries from a single aortic sinus remains a rare but significant congenital anomaly for surgical repair. We experienced a case of a newborn with complete transposition of the great arteries with unusual coronary arteries with two separate ostia positioned close to each other in the same right aortic sinus, and the left coronary artery coursing behind the pulmonary artery. No description of this case in the English literature has been published to our knowledge. Precise anatomical diagnosis was made at operation, and these anomalous coronaries were successfully transferred by the trapdoor technique with delicate adjustment after transfer. Postoperative catheterization and angiogram done 14 months after the arterial switch operation showed no coronary artery stenosis along with normal chamber pressures. The infant is asymptomatic and shows normal development for his age.

Pulmonary-to-systemic blood flow ratio oriented management after repair of obstructive total anomalous pulmonary venous connection in neonates with single ventricle.

Caval oxygen saturation was monitored to estimate pulmonary-to-systemic blood flow ratio after relief of obstructive total anomalous pulmonary venous connection in two neonates with single ventricle. Distribution between systemic and pulmonary blood flow was manipulated by pharmacologic, ventilatory, and surgical interventions aimed at achieving pulmonary-to-systemic blood flow ratio of 0.5 to 1.0. Monitoring of pulmonary-to-systemic blood flow ratio facilitates appropriate balancing between tissue perfusion and oxygenation, and detects redundant ventricular volume-load.