To evaluate the role of skin care products that contain a copper tripeptide complex, glycyl-L-histidyl-L-lysine-Cu 2ϩ (GHK-Cu), in treating carbon dioxide (CO 2) laser-resurfaced skin. Methods: Patients meeting the inclusion criteria underwent circumoral skin resurfacing using a CO 2 laser at standard settings. Patients were then randomized to receive posttreatment skin regimens with or without GHK-Cu. Evaluations for erythema throughout the posttreatment period were performed using computer software and blinded evaluators. In addition, overall improvement in wrinkles and overall improvement in skin appearance 12 weeks after treatment were assessed. Patients completed a validated questionnaire before and 12 weeks after treatment. Results: Thirteen patients completed the study. Computer analysis and blinded evaluators found no statistically significant differences between groups for earlier resolution of erythema. All the patients experienced significant improvement in wrinkles and overall skin quality, but no differences were found between groups. The results of the questionnaire indicated a significant difference in the posttreatment improvement of overall skin quality for patients using GHK-Cu (P =.04). Conclusions: Copper tripeptide complex (GHK-Cu) skin care products placed on CO 2 laser-resurfaced skin offered no significant reduction or resolution of posttreatment erythema. Objective evaluation found no significant improvement in wrinkles or overall skin quality. However, patient satisfaction was significantly higher for those who used GHK-Cu skin care products after CO 2 laser skin resurfacing.

Figu re 1. The ea r-piercing hole ill this pa tient has become undesirab ly large. Enlarged pierc ed-ear openings are problem atic for patients beca use they limi t j ewe lry se lection. Patient s ' mo st comm on complai nt is dissatisfaction w ith thei r inability to wear ear studs. Additiona lly, significant enlarge ment makes possible the developm ent ofa throu gh-and-through cleft because only a nar row br idge of tissue remai ns at the inferior edge of the ear lobule (figure I). The tec hnique for repair is base d on the size of the hole. Simp le circumferent ial removal ofthe inner epithe lial borders wit h subse que nt reapproxi matio n o f the deepitheli alized edges ca n rep ai r most mildl y to moderately enlarged holes. However, for pati ents w ith larger openings , clos ing the entire length o f the hole will resul t in the creation ofa notc h at the infer ior border o f the ea r lobule seco nda ry to sca r contrac tion. To prevent notching, a sca r-lengthening procedure, suc h as a Z-plasty, is adde d to the repa ir.

One hundred four patients with epidermoid carcinoma of the pyriform fossa were reviewed retrospectively. Survival, local recurrence and metastatic rates were all compiled for the purpose of comparing the efficacy of combined therapy with radiation therapy and surgery alone in treating such lesions. Combined therapy consisted of 4500 rad Cobalt60 therapy at 200 rads per day preoperatively. All lesions were staged according to AJC classification. There was a similar stage distribution of patients in each therapeutic category. Three‐year determinate survival rates were as follows: radiation therapy—10%, surgery—56%, and combined therapy—40%. Evaluation of the local recurrence rate revealed it to be: radiation threapy—19/33 (58%), surgery—1/19 (5%), and combined therapy—9/32 (28%). We interpret this data to suggest that preoperative irradiation impaired the determination of adequate resection margins, despite the use of frozen sections from those margins at the time of surgery. The incidence of late contralateral palpable nodes was greatest in the surgery group—5/19 (26%), compared with radiation therapy—0/33, and combined therapy—1/32 (3%) . This supports other studies which indicate that radiation therapy is very effective in controlling subclinical nodal metastases.

This project was designed to determine whether cleft lip repair has an influence on facial growth. To study this, 62 rabbits were divided into four groups: control, control without repair, Millard-type repair, and Bardach-type repair. Surgical clefts of the lip, alveolus, and the palate were created in 6-week-old rabbits. Periodic measurements were made of the pressure exerted by the lip on the maxillary alveolus. The animals were killed 20 weeks postoperatively. The skulls were processed and measurements were taken from the skulls. The pressure measurements showed a definite increase in lip pressure on the maxillary alveolus for the lip repair group. This pressure was high soon after surgery, rapidly returned toward the control level, but never reached it. Skull measurements indicate an inhibition in anterior maxillary growth for the “control without repair” group. This inhibition was even more profound in the two lip repair groups. No significant differences were found in maxillary width or mandibular length. When correlations were made to see if increased lip pressure resulted in decreased anterior maxillary growth, a significant correlation was found for both lip repair groups. This means that as the pressure of the lip repair increased, it resulted in a decrease in anterior maxillary growth. The data reported here indicates that cleft lip surgery must be considered as having a definite influence on anterior maxillary growth inhibition observed in the cleft lip and palate population. Further studies are indicated to determine the role of cleft palate repair on facial growth.

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