bluuebunny/crossref_metadata_2025 huggingface dataset:
Benefits of treatment with rasagiline for fatigue symptoms in patients with early Parkinson's disease
Authors: Stocchi F. ,   The ADAGIO investigators
Published: June 2013

Background and purpose

Fatigue is a common symptom of Parkinson's disease (PD), often considered by patients as one of the most disabling PD symptoms with significant impact on quality of life. Our aim was to assess the benefits of rasagiline treatment on fatigue in early PD patients.

Methods

In this sub‐study of ADAGIO (N Engl J Med 2009; 361: 1268), 1105 untreated PD patients were randomized to receive rasagiline 1 mg/day (n = 270) or 2 mg/day (n = 277) or placebo (n = 558) for 36 weeks. The 16‐item Parkinson Fatigue Scale (PFS) was assessed at baseline and at week 36/early withdrawal visit. Changes from baseline to last observed visit for each rasagiline group were compared with placebo using ancova.

Results

Mean baseline PFS score was 2.2 ± 0.9 units. At 36 weeks, patients receiving placebo showed greater progression of symptoms (0.17 units) from baseline in PFS scores compared with the 1 mg/day (0.03 units) and 2 mg/day rasagiline groups (−0.02 units); the difference versus placebo was significant for both rasagiline groups (P < 0.01).

Conclusions

Symptoms of fatigue can be detected in patients with early PD and progressively worsen over time. Rasagiline was associated with significantly less progression of fatigue compared with placebo over a 9‐month period.
Bell's palsy and sudden deafness associated with Rickettsia spp. infection in Sweden. A retrospective and prospective serological survey including PCR findings
Authors: Nilsson K. , Wallménius K. , Hartwig S. , Norlander T. , Påhlson C.
Published: June 2013

Background and purpose

Sixty patients with facial palsy and 67 with sudden deafness were retrospectively or prospectively examined for serological evidence of rickettsial infection; in six cases where cerebrospinal fluid was available, patients were also examined for presence of rickettsial DNA.

Methods

Rickettsial antibodies were detected in single or paired serum samples using immunofluorescence with Rickettsia helvetica as the antigen and in four cases also using western blot. Using PCR and subsequent direct cycle sequencing, the nucleotide sequences of the amplicons (17 kDa protein gene) in cerebrospinal fluid were analysed.

Results

Five out of 60 (8.3%) patients with facial palsy and eight of 67 (11.9%) with hearing loss showed confirmative serological evidence of infection with Rickettsia spp. An additional three and four patients in the facial palsy and hearing loss groups, respectively, showed evidence of having a recent or current infection or serological findings suggestive of infection. In four cases, the specificity of the reaction was confirmed by western blot. An additional 70 patients were seroreactive with IgG or IgM antibodies higher than or equal to the cut‐off of 1:64, whereas 37 patients were seronegative. Only two of 127 patients had detectable antibodies to Borrelia spp. In three of six patients, rickettsial DNA was detected in the cerebrospinal fluid, where the obtained sequences (17 kDa) shared 100% similarity with the corresponding gene sequence of Rickettsia felis.

Conclusions

These results highlight the importance of considering Rickettsia spp. as a cause of neuritis, and perhaps as a primary cause of neuritis unrelated to neuroborreliosis.
Subthreshold depression and subjective cognitive complaints in Parkinson's disease
Authors: Santangelo G. , Vitale C. , Trojano L. , Angrisano M. G. , Picillo M. , Errico D. , Agosti V. , Grossi D. , Barone P.
Published: June 2013

Background and purpose

Subthreshold depression (SubD) is characterized by clinically relevant depressive symptoms not meeting criteria for major depression. The possible association of SubD with subjective cognitive complaints and/or objective cognitive impairments was investigated in a sample of consecutive, non‐demented Parkinson's disease (PD) outpatients.

Methods

Amongst 115 patients, SubD was identified in 30 patients, major depression in 33; 36 patients were classified as non‐depressed. Enrolled patients were administered tests and questionnaires validated in PD for assessing objective and subjective cognitive dysfunctions.

Results

On objective cognitive measures SubD patients did not differ from non‐depressed patients, whereas depressed patients achieved significantly lower scores than the other two groups. SubD and depressed patients reported more cognitive complaints than non‐depressed patients.

Conclusions

SubD is a non‐motor aspect of PD that is not related to objective cognitive deficits but is associated with subjective cognitive complaints, thus impacting on patients’ well‐being.
Scent‐Mark Identification and Scent‐Marking Behaviour in African Wild Dogs (Lycaon pictus)
Authors: Jordan Neil R. , Golabek Krystyna A. , Apps Peter J. , Gilfillan Geoffrey D. , McNutt John W.
Published: June 2013

Scent‐marking is common in mammals, but where signals are carried by urine and faeces, distinguishing between scent‐marking and mere elimination is problematic. To do so, we documented behaviours and context variables associated with urination and defecation in free‐ranging endangered African wild dogs (Lycaon pictus) and tested whether these were related to the responses of other dogs to deposits. We found that distinct postures were almost uniquely associated with deposits by dominant wild dogs, were more common during urination than defecation, and increased the likelihood that these deposits would be investigated by other wild dogs. The likelihood of investigation depended on the sex and dominance status of the depositor, the type of deposit and the substrate. Urine from dominant females was more likely to be investigated by other wild dogs than any other deposits, and deposits placed on vegetation were more likely to be investigated than those on bare ground. The likelihood that a deposit would be overmarked was affected by the deposit type and the sex and dominance status of the last depositor. Collectively, these results suggest that dominant wild dog urine is of greatest interest to other dogs. Our results show that some deposits by African wild dogs are not scent‐marks and that detailed observations of behaviours and context variables during elimination events can be used to distinguish deposits that are likely to be of communication value.
Lawsonia intracellularis proliferative enteropathy in a 3.5‐year‐old miniature horse
Authors: Mayer J. R. , Fielding C. L. , Pusterla N. , Magdesian K. G. , Higgins J. C.
Published: June 2013

A 3.5‐year‐old miniature horse gelding was evaluated for signs of colic and decreased faecal production. Initial clinical pathology showed severe hypoproteinaemia with an albumin concentration <10 g/l. Abdominal ultrasound identified multiple loops of small intestine with significantly increased wall thickness. Diagnosis of equine proliferative enteropathy was based on clinical and laboratory findings, as well as a positive faecal polymerase chain reaction and positive antibody titre (>1:240) to Lawsonia intracellularis. Treatment with intravenous oxytetracylcine and additional supportive care gradually resolved the clinical and laboratory abnormalities.
Turbulence disturbs vertical refuge use by Chaoborus flavicans larvae and increases their horizontal dispersion
Authors: Joensuu Laura , Pekcan‐Hekim Zeynep , Hellén Noora , Horppila Jukka
Published: June 2013

Small‐scale turbulence is a key factor in increasing encounter rates but also dispersing prey patches of planktonic organisms and can thus contribute to their distribution. Our hypotheses were that turbulence can (i) disturb the vertical refuge use of fourth instar Chaoborus flavicans larvae and (ii) also disperse them horizontally. Both were tested experimentally, across a gradient of turbulence.

The vertical experiments were conducted in 46‐L cylinders, providing the larvae a vertical refuge by darkening the bottom layer. The horizontal experiments were conducted in a 200‐L aquarium, providing them a horizontal refuge by darkening one end of the aquarium.

With both set‐ups, two light treatments were tested: uniform darkness as a control and the bottom layer of the cylinder or either end of the aquarium darkened to provide a refuge. In addition to non‐turbulent treatment, five different root‐mean‐square (RMS) velocities were generated, ranging from 0.6 to 10.2 cm s−1 in the vertical and to 10.9 cm s−1 in the horizontal experiment.

Increasing turbulence had a significant effect on the distribution of C. flavicans larvae in both vertical and horizontal directions and increased the proportion of larvae in the non‐preferred illuminated environment. In the vertical direction, the proportion of larvae in the refuge decreased linearly with increasing turbulence, showing a decline from 84% under calm conditions to 61% at the highest RMS velocity (10.2 cm s−1). The effect of turbulence was more prominent in the horizontal direction; without turbulence, 86% of the larvae occupied the refuge, but the proportion declined to 32% at 5.4 cm s−1 RMS velocity. In experiments with uniform darkness, the distribution of chaoborids was not affected by turbulence either in the vertical or in the horizontal direction.

Our results indicate that turbulence has substantial effects on refuge use and distribution of C. flavicans larvae. Increasing turbulence can greatly diminish the ability of prey species to use their vertical refuges. Once away from their vertical refuge, chaoborids are highly vulnerable to horizontal dispersion, thus upsetting their horizontal escape behaviour. Small‐scale turbulence is therefore likely to have considerable effects on food‐web dynamics in lakes.
Lipid biomarkers in ooids from different locations and ages: evidence for a common bacterial flora
Authors: Summons R. E. , Bird L. R. , Gillespie A. L. , Pruss S. B. , Roberts M. , Sessions A. L.
Published: June 2013

Ooids are one of the common constituents of ancient carbonate rocks, yet the role that microbial communities may or may not play in their formation remains unresolved. To search for evidence of microbial activity in modern and Holocene ooids, samples collected from intertidal waters, beaches and outcrops in the Bahamas and in Shark Bay in Western Australia were examined for their contents of lipid biomarkers. Modern samples from Cat and Andros islands in the Bahamas and from Carbla Beach in Hamelin Pool, Western Australia, showed abundant and notably similar distributions of hydrocarbons, fatty acids (FAs) and alcohols. A large fraction of these lipids were bound into the carbonate matrix and only released on acid dissolution, which suggests that these lipids were being incorporated continuously during ooid growth. The distributions of hydrocarbons, and their disparate carbon isotopic signatures, were consistent with mixed input from cyanobacteria together with small and variable amounts of vascular plant leaf wax [C27–C35; δ13C −25 to −32‰Vienna Pee Dee Belemnite (VPDB)]. The FAs comprised a complex mixture of C12–C18 normal and branched short‐chain compounds with the predominant straight‐chain components attributable to bacteria and/or cyanobacteria. Branched FA, especially 10‐MeC16 and 10‐MeC17, together with the prevalence of elemental sulfur in the extracts, indicate an origin from sulfate‐reducing bacteria. The iso‐ and anteiso‐FA were quite variable in their 13C contents suggesting that they come from organisms with diverse physiologies. Hydrogen isotopic compositions provide further insight into this issue. FAs in each sample show disparate δD values consistent with inputs from autotrophs and heterotrophs. The most enigmatic lipid assemblage is an homologous series of long‐chain (C24–C32) FA with pronounced even carbon number preference. Typically, such long‐chain FA are thought to come from land plant leaf wax, but in this case, their 13C‐enriched isotopic signatures compared to co‐occurring n‐alkanes (e.g., Hamelin Pool TLE FA C24–C32; δ13C −20 to −24.2‰ VPDB; TLE n‐alkanes δ13C −24.1 to −26.2 −‰VPDB) indicate a microbial origin, possibly sulfate‐reducing bacteria. Lastly, we identified homohopanoic acid and bishomohopanol as the primary degradation products of bacterial hopanoids. The distributions of lipids isolated from Holocene oolites from the Rice Bay Formation of Cat Island, Bahamas were very similar to the beach ooids described above and, in total, these modern and fossil biomarker data lead us to hypothesize that ooids are colonized by a defined microbial community and that these microbes possibly mediate calcification.
Compositional shifts in Costa Rican forests due to climate‐driven species migrations
Authors: Feeley Kenneth J. , Hurtado Johanna , Saatchi Sassan , Silman Miles R. , Clark David B.
Published: June 2013

Species are predicted to shift their distributions upslope or poleward in response to global warming. This prediction is supported by a growing number of studies documenting species migrations in temperate systems but remains poorly tested for tropical species, and especially for tropical plant species. We analyzed changes in tree species composition in a network of 10 annually censused 1‐ha plots spanning an altitudinal gradient of 70–2800 m elevation in Costa Rica. Specifically, we combined plot data with herbarium records (accessed through GBIF) to test if the plots' community temperature scores (CTS, average thermal mean of constituent species weighted by basal area) have increased over the past decade as is predicted by climate‐driven species migrations. In addition, we quantified the contributions of stem growth, recruitment, and mortality to the observed patterns. Supporting our a priori hypothesis of upward species migrations, we found that there have been consistent directional shifts in the composition of the plots, such that the relative abundance of lowland species, and hence CTS, increased in 90% of plots. The rate of the observed compositional shifts corresponds to a mean thermal migration rate (TMR) of 0.0065 °C yr−1 (95% CI = 0.0005–0.0132 °C yr−1). While the overall TMR is slower than predicted based on concurrent regional warming of 0.0167 °C yr−1, migrations were on pace with warming in 4 of the 10 plots. The observed shifts in composition were driven primarily by mortality events (i.e., the disproportionate death of highland vs. lowland species), suggesting that individuals of many tropical tree species will not be able to tolerate future warming and thus their persistence in the face of climate change will depend on successful migrations. Unfortunately, in Costa Rica and elsewhere, land area inevitably decreases at higher elevations; hence, even species that are able to migrate successfully will face heightened risks of extinction.
Regulation of nuclear envelope dynamics via APC/C is necessary for the progression of semi‐open mitosis in Schizosaccharomyces japonicus
Authors: Aoki Keita , Shiwa Yuh , Takada Hiraku , Yoshikawa Hirofumi , Niki Hironori
Published: June 2013

Three types of mitosis, which are open, closed or semi‐open mitosis, function in eukaryotic cells, respectively. The open mitosis involves breakage of the nuclear envelope before nuclear division, whereas the closed mitosis proceeds with an intact nuclear envelope. To understand the mechanism and significance of three types of mitotic division in eukaryotes, we investigated the process of semi‐open mitosis, in which the nuclear envelope is only partially broken, in the fission yeast Schizosaccharomyces japonicus. In anaphase‐promoting complex/cyclosome (APC/C) mutants of Sz. japonicus, the nuclear envelope remained relatively intact during anaphase, resulting in impaired semi‐open mitosis. As a suppressor of apc2 mutant, a mutation of Oar2, which was a 3‐oxoacyl‐[acyl carrier protein] reductase, was obtained. The level of the Oar2, which had two destruction‐box motifs recognized by APC/C, was increased in APC/C mutants. Furthermore, the defective semi‐open mitosis observed in an apc2 mutant was restored by mutated oar2+. Based on these findings, we propose that APC/C regulates the dynamics of the nuclear envelope through degradation of Oar2 dependent on APC/C during the metaphase‐to‐anaphase transition of semi‐open mitosis in Sz. japonicus.
Pharmacist intervention in improving hypertension‐related knowledge, treatment medication adherence and health‐related quality of life: a non‐clinical randomized controlled trial
Authors: Saleem Fahad , Hassali Mohamed A. , Shafie Asrul A. , Ul Haq Noman , Farooqui Maryam , Aljadhay Hisham , Ahmad Fiaz Ud Din
Published: June 2013

Objective

The study evaluated whether a pharmaceutical care intervention can result in better understanding about hypertension, increase medication adherence to antihypertensive therapy and improve overall health‐related quality of life.

Methods

A non‐clinical randomized control trial was conducted whereby participants received an educational intervention through hospital pharmacists. Hypertension knowledge, medication adherence and health‐related quality of life were measured by means of self‐administered questionnaires. Descriptive statistics were used to describe the demographic and disease characteristics of the patients. Inferential statistics were used for inter‐ and intragroup comparisons. SPSS 17 was used for data analysis.

Results

Three hundred and eighty‐five hypertensive patients were randomly assigned (192 in the control group and 193 in the intervention group) to the study. No significant differences were observed in either group for age, gender, income, locality, education, occupation or duration of disease. There was, however, a significant increase in the participants' levels of knowledge about hypertension and medication adherence among the interventional group after completing the intervention. Significantly lower systolic and diastolic blood pressure levels were also observed among the interventional group after completion of the intervention. The interventional group, however, reported decreased yet significant health‐related quality of life at the end of the interventional programme.

Conclusion

Pharmacist intervention can significantly increase disease‐related knowledge, blood pressure control and medication adherence in patients with hypertension. However, further research is needed to address the decreased health‐related quality of life after completion of the study.
Precursor‐derived versus de‐novo carcinogenesis depends on lineage‐specific mucin phenotypes of intramucosal gland‐forming gastric neoplasms
Authors: Nishimura Rie , Mukaisho Ken‐ichi , Yamamoto Hiroto , Sonoda Ayano , Andoh Akira , Fujiyama Yoshihide , Hattori Takanori , Sugihara Hiroyuki
Published: June 2013

Aims

To clarify the lineage‐specific carcinogenesis of gland‐forming gastric neoplasms, by characterizing mucin phenotypes and proliferation patterns immunohistochemically using monoclonal antibodies against MUC2, MUC5AC, MUC6, CD10 and Ki67.

Methods and results

We analysed 49 gland‐forming intramucosal neoplasms, including 15 non‐invasive low‐grade neoplasms (group A), 10 non‐invasive high‐grade neoplasms (group B) and 24 intramucosal adenocarcinomas (group C). The mode of gland‐forming gastric carcinoma development was different between the intestinal and gastric lineages. The pure intestinal‐type accounted for 93% of group A, 50% of group B and 4.2% of group C tumours. A zonal pattern of cell proliferation was well retained in group A tumours and was lost size‐dependently in group B tumours. These findings suggest that non‐invasive low‐grade neoplasms of the intestinal lineage progress to non‐invasive high‐grade neoplasms, but rarely to intramucosal adenocarcinomas. In tumours of the gastric lineage, which exhibited pure gastric or mixed phenotypes, the polarity of cell proliferation and differentiation was well retained in small (≦5 mm) tumours but was lost in larger tumours in groups B and C.

Conclusions

Intramucosal adenocarcinomas of the gastric lineage may often arise de novo, develop in the proper gastric mucosa, and are partially derived from non‐invasive high‐grade neoplasms.
Down‐regulation of EMP1 is associated with epithelial hyperplasia and metaplasia in nasal polyps
Authors: Yu Xue Min , Li Chun Wei , Li Ying Ying , Liu Jing , Lin Zhi Bin , Li Tian Ying , Zhao Li , Pan Xin Liang , Shi Li , Wang De Yun
Published: June 2013

Aims

The aim of this study was to assess protein and mRNA expression of epithelial membrane protein 1 (EMP1) in the nasal mucosa of patients with nasal polyps (NP), and to determine what changes occur in response to glucocorticosteroid (GC) treatment.

Methods and results

NP tissue was obtained from 55 patients, 18 of whom were treated with nasal GCs (i.e. these 18 patients had NP biopsies taken before and after treatment). Biopsies of inferior turbinate mucosa from 30 healthy subjects were used as controls. Quantitative PCR and immunohistochemistry were performed to determine the expression levels of EMP1. EMP1 mRNA expression was significantly lower (2.77‐fold) in tissues from NP patients before GC treatment when compared to controls, but was increased in these patients after GC treatment. EMP1 staining in nasal epithelium co‐localized with both basal (p63+) and differentiated (CK18+) epithelial cells. Their immunoreactivity was significantly greater in controls than NP patients. EMP1 mRNA levels were lower in the epithelium with severe hyperplasia (1.79‐fold) or with metaplasia (1.85‐fold) as compared to those with mild to moderate hyperplasia or non‐metaplastic epithelium, respectively. Positive correlations between EMP1 and other epithelial cell‐related gene (e.g. JUN, PTGS2, AREG etc.) mRNAs were observed.

Conclusions

EMP1 could be a biomarker for aberrant epithelial remodelling and metaplasia in chronic inflammatory upper airway mucosa (e.g. NP).
Inter‐ and intra‐specific differences in butterfly behaviour at boundaries
Authors: Kallioniemi Eveliina , Zannese Audrey , Tinker Julia E. , Franco Aldina M.A.
Published: June 2013

To plan effective conservation measures and to predict which species will be able to change distribution in response to climate change, there is an increasing need for understanding species dispersal abilities and how species move in complex landscapes. Responses to habitat boundaries affect emigration rates from habitat and are therefore important determinants of species dispersal. There are, however, few studies linking dispersal parameters to likelihood of crossing barriers across several species.

In this study, dispersal and likelihood of crossing boundaries, which are presented here as tall and dense tree plantation, were investigated for seven butterfly species. Effects of adult age and sex on the dispersal and behaviour at boundaries were also analysed.

Our results demonstrate differences in movements and response to habitat boundaries between species belonging to different butterfly families. Pieridae species were the most likely to cross boundaries and most mobile, whilst with the Lycaenidae species only a small fraction of individuals crossed the tall dense boundary.

Individuals and species that moved with longer move bouts (i.e. steps) were more likely to cross boundaries. Therefore, we propose using step length, which is relatively easy to measure, as a proxy for butterfly dispersal at the landscape level.

Female butterflies moved less than males within habitat but crossed boundaries more often than males, indicating that dispersal data needs to be collected for the two sexes separately to provide more accurate estimates of species ability to colonise new areas.
Extracorporeal photopheresis for the treatment of erythrodermic cutaneous T‐cell lymphoma: a single center clinical experience with long‐term follow‐up data and a brief overview of the literature
Authors: Quaglino Pietro , Knobler Robert , Fierro Maria T. , Savoia Paola , Marra Elena , Fava Paolo , Bernengo Maria G.
Published: June 2013

Extracorporeal photopheresis (ECP) is a therapeutic procedure in which leukapheresed peripheral blood mononuclear cells are exposed to ultraviolet A in the presence of the photosensitizer 8‐methoxypsoralen and then reinfused. Several guidelines recommend ECP as a treatment of choice in erythrodermic primary cutaneous T‐cell lymphomas (E‐CTCL). However, the level of evidence is low due to the rarity of this disease and the lack of randomized controlled trials. We performed a review of the English literature, restricting our analysis to studies including erythrodermic patients and more than 10 cases. Based on these criteria, we identified 28 studies, with a total of 407 patients. The median response rate in erythrodermic patients was 63% (range 31–86%), with a complete response rate ranging between 0 and 62% (median 20%). In our experience, we treated 51 patients with E‐CTCL since 1992. A clinical response was obtained in 32 of 51 patients (63%), with a 16% complete response rate. The median time for response induction was eight months (range: 1–23). The median response duration was 22.4 months (range six months to 11 years). The treatment was generally well tolerated without systemic toxicities grade III–IV. The pretreatment parameters significantly associated with a higher likelihood to obtain a clinical response were the B‐score in the peripheral blood, CD4/CD8 ratio, and amount of circulating CD3+CD8+ cells. Literature data together with our personal experience clearly support the clinical activity and tolerability of ECP in patients with E‐CTCL. Prospective controlled clinical trials are strongly recommended to better document the evidence.
Expanded Role of the Argon Laser in Plastic Surgery
Authors: APFELBERG DAVID B. , MASER MORTON R. , LASH HARVEY , FLORES JASMIN
Published: June 2013

Abstract It has been proven that intense argon laser light is very useful in the treatment of port‐wine hemangiomas and tattoos. However, lasers can successfully treat many other benign cutaneous lesions. This article reports the first use of the argon laser for granuloma faciale and hereditary hemorrhagic telangiectasia. In addition, we have also successfully treated venous lakes, senile angiomas, pyogenic granulomas, acne rosacea, and nevus of Ota.
Basal‐Cell Carcinoma Arising in a Burn Scar: Case Report
Authors: WHITE STEPHEN W.
Published: June 2013

Abstract This report describes a multicentric basal‐cell carcinoma which arose in a thermal burn scar 51 years after injury. Suspicious changes in a burn scar warrant biopsy.
Plantar Split‐Thickness Skin Grafts for Coverage of Superficial Pressure Ulcers of the Foot
Authors: WEXLER MENACHEM R. , BARLEV AVINOAM , PELED ISAAC J.
Published: June 2013

Abstract The use of plantar skin for split‐thickness grafts is advocated to cover skin loss in the plantar area and over the dorsal aspect of the foot if these areas must bear the pressure of shoes and braces. This method was ued in two patients with resultant good protection and postoperative follow‐up.
Cryosurgical Treatment of Large Basal‐Cell Carcinomas on the Trunk
Authors: KUFLIK EMANUEL G.
Published: June 2013

Abstract. Cryosurgery is an effective and safe procedure for the eradication of large basal‐cell carcinomas on the trunk. It may be used for recurrent as well as primary lesions.
CRYO CORNER: Cryosurgery for Cutaneous Leishmaniasis
Authors: FABER WILLIAM R.
Published: June 2013

Abstract. Various treatment modalities have been advocated for cutaneous leishmaniasis. Cryosurgery appears to be an appropriate therapy for this condition.
Treatment Site Reactions to Zyderm Collagen Implantation
Authors: SWANSON NEIL A. , STONER JOHN G. , SIEGLE RONALD J. , SOLOMON ALVIN R.
Published: June 2013

Abstract. Two cases of treatment site granulomatous reaction to Zyderm Collagen Implant that occurred in spite of a negative skin test are reported. A delayed hypersensitivity reaction to ZCI is suggested by the clinical time course and the histologic findings of hypersensitivity granulomas. Humoral immunity is also implicated in the reaction since elevated anti‐Zyderm serum antibodies and plasma cell infiltrates are present. Resolution of the clinical signs and symptoms occurred over several months with no treatment. The physician using ZCI should be aware of this rare adverse reaction.
Treatment of Ischemic Digital Ulcers with Nitroglycerin Ointment
Authors: WHEELAND RONALD G. , GILCHRIST RONALD W. , YOUNG JACK
Published: June 2013

Abstract. The effectiveness of topical application of nitroglycerin ointment for the treatment of ischemic digital ulcers is described.
Keloids of the Earlobes: A Surgical Technique
Authors: SALASCHE STUART J. , GRABSKI WILLIAM J.
Published: June 2013

Abstract. “Core” excision of dumbbell‐shaped keloids of the earlobe is described. This technique combined with in‐tralesionaf steroids resulted in an apparent cure of six patients followed for over 1 year. The cosmetic results have been excellent.
Vapor‐Permeable Membrane Therapy for Ulcers of Osteomyelitis
Authors: ANGERMEIER MARLA C. , ALPER JOSEPH C. , URBANIAK HENRY S.
Published: June 2013

Abstract. Two patients with chronic ulcerations secondary to arterial insufficiency of the distal extremities were found to have concomitant osteomyelitis immediately beneath the ulcers. An adjunctive wound care regimen is described in which local excision or debridement of the involved bone with subsequent systemic antibiotic therapy was the initial treatment. The resultant cutaneous defect was then covered with a vapor‐permeable membrane and allowed to close by secondary intention. Rapid and complete healing occurred in both cases in spite of the compromised arterial supply to both areas. This technique is a useful adjunct to the treatment of ulcerations associated with chronic osteomyelitis.
Cutaneous Manifestations in Chronic Lymphocytic Leukemia
Authors: BONVALET D. , FOLDES C. , CIVATTE J.
Published: June 2013

Abstract Cutaneous lesions arising during the course of chronic lymphocytic leukemia (CLL), generally of the B‐cell type, are frequent. Three types of cutaneous manifestations must be differentiated: (1) specific lesions, (2) cutaneous manifestations closely related to the disease but without a leukemoid infiltrate and (3) associations with various dermatologic conditions. The various clinical features are discussed.
Germinal Center Cell‐Derived Lymphomas of the Skin
Authors: KERL HELMUT , KRESBACH HANS
Published: June 2013

Abstract Germinal center cell‐derived (GCC) malignant lymphomas are B‐cell tumors that represent neoplastic equivalents of normal lymphoid follicles. These lymphomas include, in the Kiel classification, three main types: centrocytic lymphoma, centroblastic‐centrocytic lymphoma, and centroblastic lymphoma. We have diagnosed 13 cases of germinal center cell‐derived cutaneous lymphomas among 178 evaluated malignant lymphomas of the skin. Some clinical, histologic, and immunologic aspects are discussed in this article.
Alkaline Phosphatase Activity in Non‐Hodgkin's Lymphomas and Pseudolymphomas of the Skin
Authors: GEERTS MARIE‐LOUISE , BURG GÜNTER , SCHMOECKEL CHRISTIAN , OTTO BRAUN‐FALCO M.D.
Published: June 2013

Abstract Alkaline phosphatase enzyme activity was studied histochemically in 60 non‐Hodgkin lymphomas and 10 pseudolymphomas of the skin. Among the 37 B‐cell lymphomas, membrane‐bound alkaline phosphatase activity was demonstrated in 8 cases. In none of the 23 cutaneous T‐cell lymphomas studied could membrane‐bound alkaline phosphatase be detected. Among the pseudolymphomas, 2 cases revealed alkaline phosphatase activity.

It was not possible to draw any particular clinically significant conclusions from the membrane‐bound alkaline phosphatase reactions. Looking for the microenvironmental conditions of lymphoproliferative processes in the skin, alkaline phosphatase‐positive capillaries were seen predominantly in the T‐cell lymphomas. The stromal reaction showing a proliferation of alkaline phosphatase‐positive fibroblasts was more pronounced in cutaneous B‐cell lymphomas.

In conclusion, membrane‐bound alkaline phosphatase in lymphoproliferative processes in the skin, as in the lymph node, characterize a distinct group of B lymphocytes related to follicle center cells. The clinical relevance of this finding remains to be determined.
Treatment of Retroauricular Keratinous Cysts
Authors: MEVORAH BARUKH , BOVET RENÉ
Published: June 2013

Abstract The excision method for the removal of keratinous cysts was modified and used for the treatment of such cysts in the retroauricular region. In 14 patients, 17 lesions were excised in this fashion with good to excellent results. The reasons for choosing this therapeutic modality and its modifications are discussed. In our opinion, the excision technique described here is the best treatment for keratinous cysts in this common location.
Carbon Dioxide Laser Treatment of Verrucae Vulgares
Authors: McBURNEY ELIZABETH I. , ROSEN DEBORAH A.
Published: June 2013

Abstract A report is presented on the use of the carbon dioxide (CO2) laser for the removal of recalcitrant warts of hands and feet of 27 patients. Of the 27 patients 22 (81%) required only one laser treatment to eradicate warts and remain free of lesions at the 6‐month follow‐up visit. The other patients required up to 3 retreatments with the laser during the first 6 months to remain free of lesions at a 6‐month follow‐up. The CO2 laser provided a bloodless surgical field, accurate control, minimal postoperative pain, and decreased postoperative infection. The authors conclude that, while the CO2 laser is not without its disadvantages, it should be considered an important adjunct in the treatment of difficult, widespread, or recalcitrant verrucae.
Effect of Freezing the Helix and the Rim or Edge of the Human and Pig Ear
Authors: BURGE SUSAN M. , SHEPHERD JONATHAN P. , DAWBER RODNEY P. R.
Published: June 2013

Abstract We have studied the effect of increasing freeze times on the normal pig's ear and on a variety of lesions of the human ear. The clinical and laboratory data suggest that cartilage necrosis secondary to cryosurgery is a dose‐related phenomenon and is uncommon with the freeze times used in clinical practice. Cryosurgery is an effective and cosmetically acceptable treatment for superficial skin lesions of the ear.
Methoxyflurane Analgesia for Office Surgery
Authors: LEWIS LEONARD A.
Published: June 2013

Abstract The use of methoxyflurane as a preoperative analgesic is discussed as an inexpensive and safe method for use in office surgery.
A Solitary Subcutaneous Nodule as a Presenting Sign of Metastatic Malignant Melanoma
Authors: SARIG A. , TAUBE E. , KAPLAN I. , BEN‐BASSAT M.
Published: June 2013

Abstract Two patients were referred because of an innocent‐appearing solitary subcutaneous nodule; excision revealed metastasis of malignant melanoma, but comprehensive investigation failed to disclose the primary tumor. In neither patient was there subsequent evidence of local recurrence but both died of disseminated disease—the first 2 years and the second 10 months after the excision.
Radiation‐Induced Basal‐Cell Carcinoma
Authors: ALLISON J. RICHARD
Published: June 2013

Abstract Four patients developed 129 basal‐cell carcinoma (BCC) in areas of prior radiation without evidence of radiation damage. The time lag between radiation and appearance of the cancers was 20 years. It is proposed that we are dealing with a subset of the population not previously recognized. These patients were not related to other groups, such as the nevoid basal‐cell carcinoma syndrome.
Focal Salabrasion for Removal of Linear Tattoos
Authors: SHELLEY WALTER B. , SHELLEY E. DORINDA
Published: June 2013

Abstract The use of a power‐driven, cotton‐tipped, wooden applicator permits precision salabrasion of small or linear tattoos. Such focal salabrasion is facilitated by prior removal of the overlying epidermis by means of a rotating dental burr.
Injectable Collagen Update
Authors: KLEIN ARNOLD W. , RISH DAVID C.
Published: June 2013

Abstract Injectable collagen (Zyderm Collagen Implant) has proved to be an effective means of treating certain soft tissue contour defects. A highly concentrated form of the material (65 mg/ml) is now available, and several contraindications to the use of injectable collagen have been removed or changed. This article reviews these changes and provides updated information regarding the safety of this material, the treatment of adverse reactions, and injection techniques that enhance correction.
Chemosurgical Reports: Super Widefield Microscopy in Mohs Surgery
Authors: HANKE C. WILLIAM
Published: June 2013

Abstract The super widefield microscope can increase the efficiency of the Mohs surgeon in evaluating frozen tissue sections. The increased microscopic viewing area allows more of the operator's visual fields to be used. The super widefield microscope is especially useful when multiple and/or large frozen sections are to be examined.
Treatment of Leg Ulcers with Split‐Thickness Skin Grafts
Authors: VAN DEN HOOGENBAND H. M.
Published: June 2013

Abstract A comparison is made between two groups of patients (Group A and Group B) suffering from chronic leg ulcers who were treated by split‐thickness skin grafting. Group B was preoperatively treated with silver sulfadiazine cream; the healing results in this group were better than in Group A.
Basal‐Cell Carcinoma of the Eyebrow Region
Authors: DZUBOW LEONARD M.
Published: June 2013

Abstract Five women (21 to 43 years of age), each with a basal‐cell carcinoma involving the eyebrow region, are presented. The implications of the clinical situation in terms of therapy and reconstruction are discussed.
Verrucous Bowen's Disease of the Plantar Foot
Authors: GREKIN ROY C. , SWANSON NEIL A.
Published: June 2013

Abstract A patient is presented with a recurrent plantar tumor present for 15 years. This hyperkeratotic exophytic tumor behaved historically and appeared clinically to be a verrucous carcinoma. Biopsy revealed Bowen's disease. The tumor was successfully treated with Mohs surgery. The tumor is presented due to its unusual location and its appearance that closely resembled verrucous carcinoma. The Mohs technique allows for total tumor ablation with maximal preservation of tissue in this important functional area.
How to Obtain the “Perfect” Plug
Authors: PINSKI JAMES BERNARD
Published: June 2013

Abstract
In order to obtain the “perfect” plug, distortion of the skin produced by the punch must be eliminated by reducing the pressure exerted. This can be accomplished by using a power‐driven, exquisitely sharp punch and by proper saline infiltration. Other factors are also reviewed.
Possible Use of the Radovan Tissue Expander in Hair Replacement Surgery
Authors: PIERCE HAROLD E.
Published: June 2013

Inelastic scalps in patients with male pattern baldness tax the ingenuity of the dermatologic surgeon in executing a satisfactory donor site closure without tension and subsequent wound dehiscence. The Radovan tissue expander permits the scalp to stretch slowly and facilitates the reconstruction of large scalp defects. Two cases are presented, illustrating this technique and its complications of pressure necrosis and expander extrusion. It is believed that this represents a significant advance in the field of hair replacement surgery.
The Surgical Treatment of Hypertrophic Darier's Disease
Authors: WHEELAND RONALD G. , GILMORE WILLIAM A.
Published: June 2013

Simple surgical debridement under local anesthesia of a recalcitrant case of severe hypertrophic Darier's disease provided symptomatic and cosmetic improvement for 2 years.
Facial and Scalp Lipomas: Case Reports and Study of Prevalence
Authors: TRUHAN ANDREW P. , GARDEN JEROME M. , CARO WILLIAM A. , ROENIGK HENRY H.
Published: June 2013

Abstract Lipomas of the face and scalp are reportedly rare, comprising less than 2% of lipomas. Three such cases have recently been diagnosed in our clinic. Among 110 lipomas in our files, a total of 16 (14.5%) involved the face and scalp. The clinician rarely considered lipoma as the primary preoperative diagnosis. Often mistaken clinically for epidermal cysts, face and scalp lipomas appear more common than the literature would indicate.
Nevus Sebaceus, Syringocystadenoma Papilliferum, and Basal Cell Epithelioma
Authors: ROSENBLUM GERALD A.
Published: June 2013

Abstract This case report illustrates the pluripotential nature of the hair matrix cells in nevus sebaceus. Syringocystadenoma papilliferum and basal cell epithelioma both developed in the same scalp lesion. The staged surgical excision is illustrated.
FIRST PRIZE: Treatment of Earlobe Keloids with Carbon Dioxide Laser Excision: A Report of 16 Cases
Authors: KANTOR GARY R. , WHEELAND RONALD G. , BAILIN PHILIP L. , WALKER NEIL P.J. , RATZ JOHN L.
Published: June 2013

Abstract A technique for treating keloids of the earlobes using a focused carbon dioxide laser and postoperative intralesional steroids with partial healing by secondary intention is described.
Malignant Melanoma and Lymph Nodes
Authors: TRITSCH HELMUT
Published: June 2013

Abstract: A total of 226 cases of malignant melanoma of the skin (MM), clinical stage I disease, located on the leg (87), arm (36), or trunk (103), were treated with elective regional node dissection (ERND). The axillary lymph nodes were dissected by a T‐shaped skin incision line, whereas the inguinal nodes were removed with the help of a spindle‐shaped skin excision. Both techniques, without mortality, offered the precondition for extirpation of the lymph nodes en bloc and guaranteed well‐healing wounds.
Punch Grafting: An Easy Office Procedure
Authors: CABANISS W. HARVEY
Published: June 2013

Abstract. A method to repair defects of the skin following excisional tumor surgery is presented. A modification of pinch grafts, called punch grafting, allows contouring of difficult areas such as the anterior portion of the pinna, quickly, inexpensively, with low morbidity, and good cosmesis.
Congenital Smooth Muscle Hamartoma Masquerading as Congenital Pigmented Nevus
Authors: HANKE C. WILLIAM , O'BRIAN JEFFREY J. , PETERS WADE C. , HORNEY DEBRA A. , LOGAN PATRICK C.
Published: June 2013

Smooth muscle hamartomas are rare benign tumors of the skin, characterized by proliferation of large interlacing bundles of nonstriated muscle within the reticular dermis. The lesions may masquerade as one of several clinical entities. In this report, we describe two patients with congenital smooth muscle hamartomas masquerading as congenital pigmented nevi. Review of the literature indicates that these cases represent the ninth and tenth reported cases of congenital smooth muscle hamartoma. Our second case represents the largest lesion reported to date.
The Dynamics of Dog‐Ear Formation and Correction
Authors: DZUBOW LEONARD M.
Published: June 2013

Dog‐ears are tissue redundancies secondar length inequalities, rotation or contour changes. An understanding of the mechanics of dog‐ear formation provides a logical foundation for approaching treatment.
Cryosurgery Effective for Granuloma Faciale
Authors: ZACARIAN SETRAG A.
Published: June 2013

Abstract. Various treatments have been advocated for granuloma faciale, but experience has demonstrated that cryosurgery is extremely effective and simple in application.
Laboratory Evaluation of Skin Refrigerants Used in Dermabrasion
Authors: HANKE C. WILLIAM , O'BRIAN JEFFREY J. , SOLOW ELIZABETH B.
Published: June 2013

Abstract. Six skin refrigerants were evaluated for maximum cooling temperature. The temperatures produced correlated well with the chemical components and also the gelatin freeze‐thaw times. Freon 114 and Freon 114‐ethyl chloride mixtures are time‐tested, safe skin refrigerants. Some of the newer skin refrigerants are pure sources of Freon 12 or mixtures of Freon 12 and Freon 11. These newer, colder products have the potential to damage the skin and represent a hazard to successful dermabrasion.
Microscopically Controlled Surgery for Periorbital Melanoma: Fixed‐Tissue and Fresh‐Tissue Techniques
Authors: MOHS FREDERIC E.
Published: June 2013

Abstract. In the treatment of periorbital melanoma, microscopically controlled surgery not only provides great assurance of eradicating the primary melanoma and managing possible satellites, but it also permits maximal sparing of adjacent normal tissues, a benefit of particular value around such important structures as the eyes. The fixed‐tissue technique is employed when there is no involvement of the lid margins or bulbar conjunctiva, but if these structures are invaded the fresh‐tissue technique with chemical cauterization of the incisional surface is used.
Dermabrasion: State of the Art
Authors: ROENIGK HENRY H.
Published: June 2013

Abstract. Dermabrasion was developed to remove acne scars but has now been utilized for other cosmetic and therapeutic problems. New instruments, anesthesia, and postoperative dressings have given rise to improved results. Complications and contraindications are emphasized. There is an increased popularity in dermabrasion.
Hair Transplantation
Authors: ORENTREICH DAVID S. , ORENTREICH NORMAN
Published: June 2013

Abstract. The history of hair transplantation and its recent developments are reviewed. The procedures, risks and benefits, avoidance of complications, and treatment of sequelae are discussed.
Substances for Soft Tissue Augmentation: Collagen and Silicone
Authors: KLEIN ARNOLD WILLIAM , RISH DAVID CHARLES
Published: June 2013

Abstract. Zyderm injectable collagen and silicone are both used for soft tissue augmentation. Neither is perfect. Critical factors associated with their use include lesion selection and injection technique. Both may have immediate and delayed adverse reactions.
Mohs Surgery for Periocular Basal Cell Carcinomas
Authors: ROBINS PERRY , RODRÍIGUEZ‐SAINS RENÉE , RABINOVITZ HAROLD , RIGEL DARRELL
Published: June 2013

Abstract. Cure rates for 631 periocular basal cell carcinomas treated by Mohs surgery proved to be 98.1% for primary lesions and 93.6% for previously treated lesions. All recurrences of primary lesions post‐Mohs surgery were located in the medial canthus. Among lesions previously treated, recurrence rates after Mohs surgery were twice as high for medial canthal lesions as for other periocular basal cell carcinomas, 9.5 and 4.5%, respectively. A threefold increased risk of recurrence was observed for medial canthal lesions (post‐Mohs surgery) previously treated by radiation as compared to all other treatment modalities. This high recurrence rate may reflect past practices of treating large medial canthal basal cell carcinomas with radiation rather than by other means. Results of our study indicate that primary basal cell carcinomas in the medial canthus can be treated by microscopically controlled excision with excellent results.
Occult Adenocarcinoma Metastatic to a Skin Graft Donor Site
Authors: GRENIER DANA JO , KAPLAN RICHARD P.
Published: June 2013

Abstract. Internal malignancies present with metastases to the skin 0.4% of the time.1 Cutaneous metastases not uncommonly develop in areas of damaged skin such as radiodermatitis2 and surgical scars.3 This report involves a 78‐year‐old male with metastatic adenocarcinoma from an unknown primary site that presented in a split‐thickness skin graft donor site. This appears to be the first reported case of internal malignancy metastatic to skin altered by grafting.
Surgical Treatment of Skin Depigmentation Caused By Burn Injuries
Authors: TAKI TADASHI , KOZUKA SADAO , IZAWA YOHEI , USUDA TOSHIKAZU , HIRAMATSU MITSUYOSHI , MATSUDA TOSHIKI , YOKOO KAZUHISA , FUKAYA YOSHIHIDE , TSUBONE MIKIO , AOKI JIYUHJI
Published: June 2013

Abstract. Thin split‐skin autografts of normal color were performed on depigmented skin caused by second‐ and third‐degree burns in 32 patients. Repigmentation appeared in almost all the recipient areas soon after grafting and no depigmentation occurred again in the treated area.
Subungual Basal Cell Carcinoma
Authors: MIKHAIL GEORGE R.
Published: June 2013

Abstract. Subungual basal cell carcinoma is rare. Only eight cases, all involving fingers, are on record. Two additional cases are reported in this paper. One lesion was on a toe, the only one observed at this site. As the lesion may simulate a number of conditions, most of which are benign, the importance of obtaining a biopsy from a recalcitrant lesion of the nail organ cannot be overemphasized.