Doubly Fused Unsymmetrical Calixdicarbahexaphyrins.

Three novel doubly fused unsymmetrical calixdicarbahexaphyrins were synthesized by mild acid-catalyzed (4+2) condensation of dicarbatetrapyrrane with dipyrroethene diol followed by oxidation. The condensation formed doubly fused calixdicarbahexaphyrins instead of π-conjugated dicarbahexaphyrins, due to the unusual fusion of the pyrrole N with the α-carbon of the adjacent pyrrole ring to form a tripentacyclic ring and one usual fusion of the pyrrole N with the adjacent phenylene C to form a fused moiety containing two pentacycles and one hexacycle ring. Both fusions occurred on one side of the macrocycle, making the macrocycles unsymmetric. The crystal structure obtained for one of the macrocycles exhibited a saddle-shaped structure with two benzene rings and four pyrrole rings connected via two ethylene and four methene meso-carbon atoms. The crystal structure also revealed unusual fusions in the macrocyclic framework and the presence of one sp3 carbon that disrupts the π-electron delocalization. 1H, 1H-1H COSY, NOESY, 13C, and HMBC NMR techniques were used to characterize the macrocycles. The absorption spectra of the macrocycles showed one intense sharp band at ∼485 nm along with a shoulder in the lower-energy region, suggesting its non-aromatic nature. Electrochemical studies indicated their electron rich nature, and DFT/TD-DFT studies corroborated the experimental observations.

Moustache reconstruction using an extended midline forehead flap.

A new method for reconstruction of the upper lip and moustache is presented. An extended midline forehead flap is described, which is a modification of the classical midline forehead flap in which the flap is extended into the hair-bearing scalp. Simultaneously, a nasal alar defect was reconstructed using the non-hair-bearing forehead skin in a patient with cancrum oris. The flap is reliable, technically easy to raise, does not require any special expertise and causes minimal donor site deformity. However, it is a multistage procedure and hence causes prolonged morbidity.

Isolated Tessier no. 1 cleft of the nose.

We report 3 patients with isolated cleft or coloboma of the nose--an extremely rare occurrence. This entity belongs to no. 1 of Tessier's classification of craniofacial clefts. Excessive separation of the medial and lateral nasal processes of the frontonasal process may be the genesis of this condition. Management should address two points: the cleft and the associated malformations of the cartilaginous nasal framework.

An inexpensive self fabricated pressure clip for the ear lobe.

Pressure therapy is an integral part of keloid treatment. There are certain areas of the body which are prone to keloid formation but are not amenable to pressure therapy. The ear lobe is one such area. A simple, self fabricated and inexpensive pressure clip has been used for applying postoperative pressure to the ear lobe. This is fabricated with cold-cure poly methyl methacrylate and orthodontic wire. This has been used in 41 ear lobe keloids in 26 patients along with postexcisional triamcinolone acetonide therapy, 5 ear lobe reconstructions and 2 cases of ear lobe clefts over a period of 8 years. Although these clips are not very aesthetic, still the acceptability is very high as the patients were well motivated. A total of 27 ear lobes in 18 patients of ear lobe keloids have undergone ear boring after 6-18 months of pressure therapy. The only complication noticed is in the form of pressure ulcer due to continuous pressure in two patients at the beginning of our experience with these clips. These healed well after temporarily stopping the use of the clip.

Primary reconstruction of major human bite wounds of the face.

Primary reconstruction of 36 major human bite wounds of the face without clinical infection has been carried out successfully as late as the fourth day after the initial injury. Primary healing was achieved in all patients. The postoperative period was free from major infection in all patients except one, including the latecomers. Extensive bacteriologic studies reveal that the infection in human bite wounds occurs secondarily as invasion to devitalized tissue. We therefore consider that debridement of wound edges to eliminate the crushed devitalized tissue is the key to success.

Xeroderma pigmentosum: resurfacing versus dermabrasion.

Three patients of Xeroderma Pigmentosum (XP) have been managed for recurrent tumours. Improvement in pigment pattern was observed at both the donor as well as the recipient sites. An attempt has been made to prevent further occurrence of tumours over the exposed parts of the body by resurfacing and also by dermabrasion. A comparative study of the two procedures is being carried out and the preliminary results are discussed. Deep dermabrasion appears to be preferable as a prophylactic procedure.