bluuebunny/crossref_metadata_2025 huggingface dataset:
Practical Phlebology
Authors: de GROOT WALTER P.
Published: June 2013

A practical, step‐by‐step guide for the sclerotherapy of large varicose veins is offered. First, an orientation regarding the place of sclerotherapy and surgery in the total treatment of varicose veins is given, with a practical clinical classification of varicose veins. This is followed by a detailed discussion of patient education before sclerotherapy, material to be used with recommended concentrations, injection technique, compression after sclerotherapy, instructions to the patient after injection, and procedures at subsequent visits.
Iontophoretic Administration of Lidocaine Anesthesia in Office Practice
Authors: MALONEY J. MICHAEL , BEZZANT JOHN L. , STEPHEN ROBERT L. , PETELENZ TOMASZ J.
Published: June 2013

background
: Obtaining anesthesia for dermatologic, office‐based surgeries often involves the pain of needle stick and burning upon injection of local anesthetic agents. No truly effective method for obtaining painless anesthesia is well accepted in the United States.

objective
: A study was carried out using iontophoresis of lidocaine with epinephrine to determine the practicality of this method of delivering local anesthesia prior to invasive procedures in dermatology offices.

methods
: A two‐center, open‐label study was undertaken using iontophoretic administration of 4% lidocaine with epinephrine 1:50,000 before painful procedures occurring in the dermatologists’office.

results
: Ninety‐four procedures in 64 patients were evaluated. Both patients and physicians recorded 51% of procedures as painless, 36% as minor (partial), and 14% causing moderate to severe pain. Iontophoretic local anesthesia was 80 to 100% effective for pain relief for injections, abrasions, laser surgery, and cautery; it was significantly less effective in effecting pain relief for dermal excisions.

conclusions
: Iontophoretic administration of anesthesia is a useful adjunct to the armamentarium of dermatologists performing surgical procedures in their office. J Dermatol Surg Oncol 1992;18:937–940.
Single Hair Transplantation Using the Choi Hair Transplanter
Authors: CHOI YUNG CHUL , KIM JUNG CHUL
Published: June 2013

A new procedure for single hair transplantation using the Choi hair transplanter is presented. This operation provides obvious cosmetic advantages in hairline refinement and the reconstruction of eyebrows, eyelashes, beards, and pubic escutcheon. The surgical technique is described in detail.
Lumps and Bumps of the Eyelids and Their Management
Authors: BERGIN DONALD J.
Published: June 2013

background
. Tumors of the eyelids, because of their location and variety, can present management problems.

objective
. To describe tumors of the eyelid, their identification, and their management.

conclusion
. All tumors and inflammations of the lids, except those that are easily diagnosed, should be biopsied and sent for histologic administration. J Dermatol Surg Oncol 1992;18:1042–1048.
Malignant Lesions of the Eyelids
Authors: PIEST KENNETH L.
Published: June 2013

background
. The ocular adnexal area contains virtually every tissue type; nearly any type of malignant tumor may develop in this area. However, the vast majority of malignant eyelid tumors are carcinomas. Three types of carcinomas produce most of the malignancies in this group. They are: basal cell carcinomas, squamous cell carcinomas, and sebaceous cell carcinomas.

objective
. The management of these three tumors is discussed.

methods
. A review of current treatment options for eyelid malignancies was performed.

results
. A summary of the current treatment of the three most common eyelid carcinomas is discussed.

conclusion
. With early recognition and appropriate management of eyelid malignancies, an extremely favorable prognosis can be obtained. The management is twofold and consists of curing the patient of the malignancy and then restoring the form and function of the eyelid in order to save the eye if possible. J Dermatol Surg Oncol 1992;18:1056–1059.
Extensive Scalp Lifting as a Reconstructive Tool for a Large Scalp Defect
Authors: BRANDY DOMINIC A.
Published: June 2013

Extensive scalp lifting is a relatively new technique for the treatment of alopecia. Because this technique involves the undermining of the entire occipitoparietal scalp down to the hairline of the nape, a significant anterior and medial advancement is accomplished with one operation. This case report describes a patient with a large surgically induced scalp defect that was reconstructed with the use of extensive scalp lifting in combination with coronal brow lifting—thus, the intermediate cosmetic deformity of the more commonly used tissue expansion technique was completely circumvented. Why this technique can be substituted for tissue expansion or multiple rotation‐transposition flaps in certain cases is elaborated. J Dermatol Surg Oncol 1992;18:806–811.
FEATURES: Q‐Szvitched Ruby Laser Treatment of Nevus of Ota
Authors: GOLDBERG DAVID J. , NYCHAY STEPHEN G.
Published: June 2013

Emission of 694‐nm laser energy from a Q‐switched ruby laser causes photodestruction of cutaneous pigment. The 40‐nanosecond pulse duration of Q‐switched ruby laser light initiates specific damage to melanosomes thus allowing selective treatment of benign pigmented lesions. Nevus of Ota is a benign facial oculocutaneous melanosis that has melanosomes lying deeply within the dermis. We report the successful use of the Q‐switched ruby laser in the treatment of two patients with the nevus of Ota. J Dermatol Surg Oncol 1992,18:817–821.
The Ice‐Saline‐Xylocaine Technique
Authors: SWINEHART JAMES M.
Published: June 2013

Prior to skin surgery, localized cryoanesthesia is initially obtained utilizing Cryogel packs before local anesthesia injection, minimizing or abolishing pain from the piercing of the skin by the injection needle. The surgical field is then infiltrated with benzyl alcohol‐containing normal saline, a painless solution producing moderate local anesthesia. Subsequently, a stronger anesthetic containing a vasoconstrictor or other desired additives can be infiltrated without significant patient discomfort. This simple three‐step method has resulted in excellent patient acceptance, and is potentially useful for a wide range of surgical procedures and medical specialties.
Varicose Veins —Primary Treatment with Sclerotherapy
Authors: GALLAGHER PHILIP G.
Published: June 2013

Varicose veins are a very common condition that presents in a variety of forms. Treatment modalities are variant and beneficial. The author reports on an experience of 25 years treating 20,000 patients using surgery and sclerotherapy with particular results using morrhuate sodium.
Drug Interactions in Dermatologic Surgery
Authors: BROWN CHRISTINE D.
Published: June 2013

Intravenous sedation is a popular method of anesthesia in outpatient cosmetic surgery. To ensure a successful surgical outcome, awareness of potential interactions between intravenous agents and patient medications is essential. The more commonly used intravenous drugs are reviewed, with particular emphasis on their side‐effects and potential for drug interactions.
Full‐Face Cryo‐ (Liquid Nitrogen) Peel
Authors: CHIARELLO STEPHEN E.
Published: June 2013

Full face liquid nitrogen cryo spraying of actinically damaged skin accomplishes not only depth‐controlled destruction of individual actinic keratoses, but also destruction of surrounding, barely perceptible actinic keratoses, removal of unsightly pigmented surfaces, and removal of seborrheic keratoses and large lentigines. Cryo‐peeling imparts a healthier, pinker, smoother, tighter skin surface.
Anorectal Melanoma: A Case Report and Brief Review of the Literature
Authors: FRANK WILLIAM , KURBAN RAMSAY S. , HOOVER HERBERT C. , SOBER ARTHUR J.
Published: June 2013

Anorectal melanoma in an uncommon tumor that has a poor prognosis. We present a case of anorectal melanoma and review the literature pertaining to prognosis and treatment. Although no controlled trials of treatment of anorectal melanoma have been done, the evidence suggests that conservative excision confers comparable survival with less morbidity than radical surgery.
Suppression of the Delayed Type Hypersensitivity Response by Tumor Facilitating Factor of B16 Melanoma
Authors: BURNSTEIN PENINA , BRODY NEIL I.
Published: June 2013

background. Tumor facilitating factor is a cell surface glycoprotein produced by B16 melanoma that has been found to reduce the lethal inoculum for B16. Tumor facilitating factor induces macrophage spreading in vitro, reduces macrophage chemotaxis in vivo, and depresses lymphocyte mitogenesis in vitro.

objective. It is assumed that the immune modifying effects are responsible for tumor facilitation. As tumors may be poor immunogens or inducers of inflammation, studies were conducted to determine whether tumor facilitating factor alters the inflammatory cascade of cells found in infiltrates of delayed type hypersensitivity.

results. Freeze‐thawed B16 cells, used as the source of TFF, caused a suppression of delayed type hypersensitivity measured as ear swelling in the mouse. When culture supernatant was substituted for freeze‐thawed cells as a source of TFF and injected at different time points of the delayed type hypersensitivity response, the greater suppression was with tumor facilitating factor injections at 24 hours pre‐elicitation only (82%), and 24 hours both presensitization and pre‐elicitation (89%). Immunohistological staining demonstrated that tumor facilitating factor decreases ear thickness and cellular infiltrates, specifically Mac‐1 staining cells, to a site of delayed hypersensitivity. Peritoneal cell analysis confirmed these findings.

conclusion. These data are consistent with the hypothesis that tumor facilitating factor alters immune functions including macrophage and lymphocyte mobility and recruitment to a target site, thereby allowing for facilitation of tumor growth.
Medical and Technical Issues in Office Electrolysis and Thermolysis
Authors: WAGNER RICHARD F.
Published: June 2013

background. Most university medical centers do not directly offer electrolysis or thermolysis services to hirsute patients. Little research activity has been focused on these procedures. The successful introduction of a clinical and research electrolysis service into the University of Texas Medical Branch (UTMB) dermatology clinic is described.

objective. The purpose of this communication is to familiarize clinicians with an electrolysis service in a university clinic setting. New advances in permanent hair removal equipment and methods are reviewed.

methods. A description of the UTMB electrolysis clinic is given.

results. Electrolysis services offered by the UTMB dermatology department have been well received by patients, clinical staff, UTMB faculty, UTMB resident physicians, and private physicians.

conclusion. This successful medical model for electrolysis services may provide other university dermatology clinics with background information for the development of their own programs. Future research advances in electrolysis and the management of hirsutism may result from this activity.
The Prevention of Cutaneous Necrosis Following Extravasation of Hypertonic Saline and Sodium Tetradecyl Sulfate
Authors: ZIMMET STEVEN E.
Published: June 2013

background. Most authors have recommended treating extravasation during sclerotherapy by infiltrating the area with 0.9% sodium chloride and/or procaine.

objective. To evaluate interventions in the prevention of necrosis following intradermal injection of 23.4% sodium chloride and 3% sodium tetradecyl sulfate.

methods. Following intradermal 23.4% sodium chloride (Study I) or 3% sodium tetradecyl sulfate (Study II), subjects (Sprague‐Dawley rats) received either no treatment or injections of 0.9% sodium chloride, sterile water, 1% procaine, or hyaluronidase. Groups were compared regarding incidence and size of necrosis.

results. In study I, hyaluronidase treated groups had significantly fewer and smaller areas of necrosis than other groups. In study II, the hyaluronidase group developed significantly fewer ulcers than the 0.9% sodium chloride group. The 0.9% sodium chloride group had significantly larger ulcers than other groups.

conclusion. In the model studied, hyaluronidase was the only effective treatment in the prevention of necrosis. Following 3% sodium tetradecyl sulfate, 0.9% sodium chloride was associated with larger ulcers than other groups.
Histiocytic Reaction Associated with Topical Aluminum Chloride (Drysol Reaction)
Authors: BARR RONALD J. , ALPERN KENNETH S. , JAY SHIRLENE
Published: June 2013

BACKGROUND. In the past few years, dermatologists have begun to use aluminum chloride (Drysol) as a hemostatic agent for minor surgical procedures. An unusual histiocytic reaction was noted in biopsies of skin previously treated with aluminum chloride. This reaction consisted of a proliferation of histiocytic cells that contained prominent basophilic cytoplasmic granules.

OBJECTIVE. To determine the cause of this reaction and the nature of the basophilic granular material within the histiocytic cells.

METHODS. Four cases are presented in which re‐excised tissue previously treated with aluminum chloride were examined with special histochemistry staining and roentgen diffraction studies.

RESULTS. The granules of these histiocytes stained positively with the aluminon stain, a stain specific for aluminum, although no aluminum was found using the less sensitive roentgen diffraction studies.

CONCLUSION. These studies support the concept that aluminum chloride can cause a proliferative histiocytic reaction when used as a topical cauterizing agent.
Intraoperative Tissue Expansion with the Foley Catheter
Authors: GREENBAUM STEVEN S.
Published: June 2013

BACKGROUND. As surgeons face larger and more complex surgical defects, there is the continual search for more practical, successful, and cosmetically elegant methods for repair. Intraoperative tissue expansion is a relatively new technique built upon the fundamentals of traditional chronic tissue expansion. The Foley catheter is an inexpensive, readily available device that can be used for intraoperative tissue expansion.

OBJECTIVE. The purpose of this article is to explain and demonstrate some of the uses for intraoperative tissue expansion with the Foley catheter.

METHODS. A series of cycles of inflation and deflation of the Foley catheter balloon allows for gradual stretching of the skin over a period of 15 to 20 minutes.

RESULTS AND CONCLUSION. The “tissue gain” achieved via this technique often facilitates wound repair. The Foley catheter is a useful device and a significant addition to the dermatologic surgeon's armamentarium.
Granulomatous Dermatitis to Iron Oxide After Permanent Pigmentation of the Eyebrows
Authors: RUBIANES ELBA I. , SÁNCHEZ JORGE L.
Published: June 2013

background. Tattooing with iron oxide pigment is used to create a permanent line along the eyelid margins and to cause permanent pigmentation of the eyebrows. However inflammatory sequlae can occur.

objective: To present the development and treatment of a granulomatous inflammation as a sequela of iron oxide tattooing in the eyebrows.

method: A skin biopsy was performed, Histopathologic examination revealed deposits of reddish‐brown pigment and a superficial dermal infiltrate consisting of lymphocytes and giant multinucleated cells (Langhan's and foreign body).

result: A patient developed a granulomatous reaction to iron oxide after undergoing permanent pigmentation of the eyebrows. Treatment with systemic and topical steroids resulted in marked improvement at 6‐month follow‐up.

conclusions: This is an unusual complication. A skin test should be performed on any patient who is to undergo tattooing with iron oxide pigment.
Scalp Lifting
Authors: SWINEHART JAMES M. , BRANDY DOMINIC A.
Published: June 2013

background. Extensive scalp lifting, though offering the potential for tremendous benefit to the patient with extensive male‐pattern alopecia, has not been widely accepted or understood.

objective. The anatomic and technical features of extensive scalp lifting are discussed.

methods. The performance of extensive scalp lift surgery must be preceded by a thorough understanding of the specific goals, anatomic considerations, surgical techniques, and specific methods for successful completion of this operation. A knowledge of preoperative preparation, anesthesia, intraoperative methods, undermining, hemostasis, means of scalp advancement, and proper closure are essential for minimizing side effects and complications of this beneficial procedure. One must understand the dynamics of scalp stretching and lifting in order to achieve optimum removal of baldness and to successfully predict the outcome of the operation.

conclusion. Present and future advantages of scalp lifting over traditional scalp reduction have been enumerated and discussed.
Correlation of Serum Ferritin Levels and Postsclerotherapy Pigmentation
Authors: THIBAULT PAUL KENNETH , WLODARCZYK JOHN
Published: June 2013

background. Postsclerotherapy pigmentation is a common sequela of sclerotherapy to varicose and telangiectatic leg veins. This pigmentation is thought to be due to hemosiderin deposition in the dermis. A preliminary study indicated that serum ferritin was a good indicator of susceptibility to postsclerotherapy pigmentation.

objective. To clarify the relationship between serum ferritin and postsclerotherapy pigmentation using a prospective study.

methods. Serum ferritin levels were taken from 233 consecutive patients prior to commencement of sclerotherapy. Patients were assessed clinically for the presence of pigmentation at 3, 6, and 12 months.

results. There was a linear relationship between pretreatment serum ferritin level and the occurrence of pigmentation at each posttreatment assessment date.

conclusion. The results confirm a relationship between serum ferritin levels and postsclerotherapy pigmentation. This indicates that a significant predisposing factor to the development of persistent postsclerotherapy pigmentation is a high level of total body iron Stores.
Recalling Basal Cell Carcinoma Patients
Authors: EPSTEIN ERNST
Published: June 2013

background. Patients with a basal cell carcinoma (BCC) are at increased risk for developing further BCCs, and long‐term follow‐up has been recommended to detect new cancers at an earlier, more easily treatable stage. The majority of BCCs are treated by dermatologists in their offices; we do not know to what extent they perform long‐term follow up on their patients.

objective. To determine how practicing dermatologists follow up their BCC patients.

methods. A mailed questionnaire survey of 166 practicing members of a regional dermatologic society (the San Francisco Dermatological Society), to which 142 (85%) replied.

results. Two thirds of the respondents recalled BCC patients for screening examinations; of these, 58% followed up non‐responders. Recall efforts were hampered by inefficient, unwieldy, and time‐consuming techniques.

conclusion. Practicing dermatologists are motivated to recall BCC patients for examination, but guidelines and techniques for effective and efficient computerized recalling of skin cancer patients are needed. It is suggested that the American Academy of Dermatology set up a task force to develop guidelines and criteria for effective recall software.
Buffered Local Anesthetics and Epinephrine Degradation
Authors: MURAKAMI CRAIG S. , ODLAND PETER B. , ROSS BRIAN K.
Published: June 2013

Lidocaine with epinephrine is currently the most common local anesthetic agent used for facial soft tissue surgery. This combination is generally safe and effective in providing complete anesthesia and adequate hemostasis. Because epinephrine is unstable at physiologic pH, the commercial preparation is formulated with a low pH (3.5–5.5). Unfortunately, this acidic pH causes significant pain during infiltration. To reduce pain, clinicians sometimes buffer acidic local anesthetic agents with sodium bicarbonate. However, little is known about the stability of epinephrine when the pH of epinephrine is clinically altered. Using high pressure liquid chromatography (HPLC), epinephrine levels were measured after the addition of sodium bicarbonate. Our results indicate a significant amount of epinephrine degradation occurs in some of these specimens. Recommendations regarding the use of buffered local anesthetic agents are made.
Decrease in Skin‐closing Tension Intraoperatively with Suture Tension Adjustment Reel, Balloon Expansion, and Undermining
Authors: LAM ANSON C. , NGUYEN QUAN H. , TAHERY DAN P. , COHEN BERNIE H. , SASAKI GORDON H. , MOY RONALD L.
Published: June 2013

background
. The biomechanical and viscoelastic properties of the skin enable it to be significantly stretched within a relatively short period of time. This property, called mechanical creep, is exploited in various surgical maneuvers for intraoperative closure of large surgical defects. The recently introduced Miami Suture Tension Adjustment Reel (S.T.A.R.) device permits both the precise sutured attachment of a linear cycled load to approximate the edges of widened surgical defects, and the easy measurement of wound edge tension across the defects.

objective
. It was our purpose to compare the relative effects of linear load cycling with the S.T.A.R. device, spherical load cycling with balloon expander, and surgical undermining on the closing tension of surgical defects.

methods
. Surgical wounds were created on the flanks of six pigs and these defects were closed by various methods of repair. The combination of undermining and the S.T.A.R. device was also evaluated.

results
. The average total decreases in skin closing tension were: undermining, 17.8 ± 0.5%; balloon, 28.5 ± 1.6%; S.T.A.R. device, 36.6 ± 4.8%.

conclusions
. Our data showed that all three techniques were effective in lowering the tension required to approximate surgically created defects, with the S.T.A.R. device proving to be most effective. Undermining and the S.T.A.R. device also worked synergistically to decrease skin‐closing tension.
A Disposable Curette for Periosteal Removal
Authors: SMITH STEVEN P. , HARRINGTON ALLAN C. , GRANDE DONALD J.
Published: June 2013

The Acu‐Dispo‐Curette can function as an excellent disposable periosteal elevator for use in Mohs micro‐graphic surgery.
Evaluation of Acetowhitening in Bowen's Disease
Authors: SCHELL BARBARA J. , ROSEN TED
Published: June 2013

background. From a clinical Standpoint, the lesions of Boiven's disease (squamous cell Carcinoma in situ) are generally sharply demarcated. Following excision, however, contiguous extension and/or small foci of Bowen's disease are occasionally found, located outside the clinically apparent margins. Acetowhitening has been suggested as a means of delineating the extent of involvement and identifying subclinical lesions of Condyloma acuminata. More recently, acetowhitening has been similarly reported to be of potential value in the presurgical evaluation of Bowen's disease.

objective. The purpose of this investigation was to further evaluate the use and reliability of acetowhitening both to delineate margins of Bowen's disease and to identify subclinical foci of involvement.

methods. Eight patients with histologically confirmed Bowen's disease were studied. Six percent acetic acid was applied to the lesions and the surrounding skin. Histologie examination of acetowhite lesions and adjacent acetowhite skin as well as adjacent, nonwhitened normal appearing skin was performed.

results. Our results were inconsistent, and included both false positives and false negatives.

conclusions. Acetowhitening is unreliable in identification of Bowen's disease. Clinically normal, acetowhite‐negative skin adjacent to a lesion of Bowen's disease may be involved.
Healing Impairment of Open Wounds by Skin Irradiation
Authors: BERNSTEIN ERIC F. , HARISIADIS LEON , SALOMON GARY D. , MITCHELL FRANK HARRINGTON JAMES B. , UITTO JOUNI , GLATSTEIN ELI , RUSSO ANGELO
Published: June 2013

background. Ionizing radiation isfrequently usedfor the treatment of malignancy. Sequelae of therapeutic radiation frequently present clinical problems in the form of poor wound healing and easy injury of treated tissue in response to mild trauma.

objecitve. We describe a radiation‐impaired wound healing model in guinea pigs, developed to determine the effect of cutaneous Irradiation on wound contraction.

methods. Guinea pigs were anesthetized and a flap of skin was isolated and treated with x‐rays to 18 Gy. Circular wounds of identical size were made in irradiated and control skin, and average wound size was recorded.

results. Our results demonstrate that a statistically significant wound healing deficit is produced in open wounds by surface irradiation of skin.

conclusion. Radiation of skin results in slower healing of open wounds, andprovides an in vivo System for evaluation of topical dressings and growth factors in radiation‐impaired wounds.
The Relationship between Basal Cell Epithelioma and Seborrheic Keratosis
Authors: RAO BABAR K. , FREEMAN ROBERT G. , POULOS EVANGELOS G. , ARBESFELD LISA , RENDON MARTA
Published: June 2013

background. Various skin tumors can be seen rarely in association with seborrheic keratosis. We present 60 cases of seborrheic keratosis related to a basal cell epithelioma in the same specimen.

objective. To report association of basal cell epithelioma with seborrheic keratosis and discuss the possibility of malignant change in seborrheic keratosis.

methods. Sixty cases of seborrheic keratosis associated with basal cell epithelioma were studied. Tissues were fixed in neutral buffered formalin, processed, and stained with Standard hematoxylin and eosin techniques.

results. Histological evaluation showed a seborrheic keratosis associated with basal cell epithelioma in all of the cases. Basal cell epithelioma was attached with seborrheic keratosis in a majority of the cases (40/60) and appeared to represent a part of the same tumor. Both tumors were lying adjacent to each other in the rest of the cases (20/60).

conclusion. Malignant change in seborrheic keratosis is controversial. We recommend the histological evaluation of seborrheic keratosis especially when inflamed or atypical in appearance. This should not be taken as a mandate for pathological evaluation or for treatment of every seborrheic keratosis as though it was potentially malignant.
Sclerosing Sweat Duct Carcinoma in an 11‐year‐old Boy
Authors: McALVANY JOANNE P. , STONECIPHER MARCUS R. , LESHIN BARRY , PRICHARD ELIZABETH , WHITE WAIN
Published: June 2013

background. Sclerosing sweat duct Carcinoma, or microcystic adnexal Carcinoma, is a rare neoplasm of the skin with both pilar and eccrine differentiation. Previously this neoplasm has been reported only in adults. We describe a case of sclerosing sweat duct Carcinoma in an 11‐year‐old white male.

objective. Description of Mohs surgical procedure for successful management of sclerosing sweat duct Carcinoma in a child.

methods. Mohs micrographic surgery was performed on this rare neoplasm.

results. The described procedure resulted in successful excision of this uncommon neoplasm.

conclusion. We present a case of sclerosing sweat duct Carcinoma, an unusual cutaneous neoplasm, in an 11‐year‐old male that was successfully managed using Mohs micrographic surgery.
A Technique for the Biopsy of Oral Lesions
Authors: ALINOVI ALBERTO , ALLEGRA FULVIO
Published: June 2013

background. Biopsy of mucosal lesions can be carried out by means of several methods.

objective. To describe a combination technique for the biopsy of mucosal lesions.

methods. The combined effect of a chalazion forceps with a 4‐mm punch allows the physicians to work on a stabilized, bloodless, and therefore simplified field.

results. A preliminary suture with a 4‐0 catgut chromic is the key step in assuring a safe post‐operative hemostasis.

conclusion. This technique allows us to perform accurate and safe oral mucosal biopsies without any major side effects.
The Removal of Cutaneous Pigmented Lesions with the Q‐switched Ruby Laser and the Q‐switched Neodymium: Yttrium‐Aluminum‐Garnet Laser
Authors: TSE YARDY , LEVINE VICKI J. , MCCLAIN STEVE A. , ASHINOFF ROBIN
Published: June 2013

background. The Q‐switched ruby laser (QSRL) (694 nm) has been used successfully in the removal of tattoos and a variety of cutaneous pigmented lesions. The frequency‐doubled Q‐switched neodymium:yttrium‐aluminum‐garnet laser (QSNd: YAG) (1064 and 532 nm) has also been shown to be effective in the treatment of tattoos, however, little has been published regarding the QSNd:YAG laser in the removal of cutaneous pigmented lesions.

objective. The purpose of this study is to compare the efficacy and side effect profile of the QSRL and the frequency‐doubled QSNd:YAG lasers in the removal of cutaneous pigmented lesions, including lentigines, café‐au‐lait macules, nevus of Ota, nevus spilus, Becker's nevus, postinflammatory hyperpigmentation, and melasma.

methods. Twenty patients with pigmented lesions were treated with the QSRL and the frequency‐doubled QSNd:YAG lasers. Clinical lightening of the lesion was assessed 1 month after a Single treatment. Side effects and patient satisfaction were also evaluated.

results. A minimum of 30% lightening was achieved in all patients after only one treatment with either the QSRL or the frequency‐doubled QSNd.YAG laser. The QSRL seems to provide a slightly better treatment response than the QSNd:YAG laser. Neither laser caused scarring or textural change of the skin. Most patients found the QSRL to be more painful during treatment, but the QSNd:YAG laser caused more postoperative discomfort.

conclusion. Both the QSRL and the frequency‐doubled QSND:YAG laser are safe and effective methods of treatment of epidermal and dermal pigmented lesions.
Risk Measurement and Management of Operational Risk in Insurance Companies from an Enterprise Perspective
Authors: Gatzert Nadine , Kolb Andreas
Published: June 2013

Operational risk can substantially impact an insurer's risk situation and is now increasingly in the focus of insurance companies, especially due to new European risk‐based regulatory framework Solvency II. The aim of this article is to model and examine the effects of operational risk on fair premiums and solvency capital requirements under Solvency II. In particular, three different approaches of deriving solvency capital requirements are analyzed: the Solvency II standard model, a partial internal model, and a full internal model. This analysis is not only of relevance for Solvency II, but also regarding an insurer's Own Risk and Solvency Assessment (ORSA) that is not only planned in Solvency II, but also by the NAIC in the United States. The analysis emphasizes that diversification plays a central role and that operational risk measurement and management is highly relevant for insurers and should be integrated in an enterprise risk management framework.
Asymmetric Information, Self‐selection, and Pricing of Insurance Contracts: The Simple No‐Claims Case
Authors: Donnelly Catherine , Englund Martin , Nielsen Jens Perch , Tanggaard Carsten
Published: June 2013

This article presents an optional bonus‐malus contract based on a priori risk classification of the underlying insurance contract. By inducing self‐selection, the purchase of the bonus‐malus contract can be used as a screening device. This gives an even better pricing performance than both an experience rating scheme and a classical no‐claims bonus system. An application to the Danish automobile insurance market is considered.
Alcohol, Babies and the Death Penalty: Saving Lives by Analysing the Shape of the Brain
Authors: Mardia Kanti , Bookstein Fred , Kent John
Published: June 2013

Alcohol can damage the brains of unborn babies. Shape analysis can assess the damage in fetal alcohol spectrum disorders. Kanti Mardia, Fred Bookstein and John Kent explain how it works, and how it can help babies and even murderers.
An Integrated Corporate Governance Framework and Financial Performance in South African‐Listed Corporations
Authors: Ntim Collins G.
Published: June 2013

This paper investigates the relationship between an integrated corporate governance (CG) index and financial performance using a sample of 169 South African (SA)‐listed corporations between 2002 and 2007. We find a statistically significant and positive association between a broad set of good CG practices and financial performance. In a series of sensitivity analyses, we find that our results are robust to endogeneity, different financial performance proxies, alternative CG weighting scheme and firm‐level fixed effects. We further distinctively examine the link between complying with SA context‐specific stakeholder CG provisions and financial performance. In line with political cost and resource dependence theories, our results reveal a statistically significant and positive nexus between compliance with stakeholder CG provisions and financial performance.
Measuring the Carbon Intensity of the South African Economy
Authors: Arndt Channing , Davies Rob , Makrelov Konstantin , Thurlow James
Published: June 2013

We estimate the carbon intensity of industries, products and households in South Africa using data from a high resolution supply‐use table. Direct and indirect carbon usage is measured using multiplier methods that capture inter‐industry linkages and multi‐product supply chains. Carbon intensity is found to be high for exports but low for major employing sectors. Middle‐income households are the most carbon‐intensive consumers. These results suggest that carbon pricing policies (without border tax adjustments) would adversely affect export earnings, but should not disproportionately hurt workers or poorer households. Seven percent of emissions arise through marketing margins, implying that carbon pricing should be accompanied by supporting public policies and investments.
How European Union Politicization can Emerge through Contestation: The Constitution Case
Authors: Statham Paul , Trenz Hans‐Jörg
Published: June 2013

This article takes the European Union's constitution‐making as a case study to examine ‘how’ politicization can emerge through contestation by political actors in response to political opportunities. It advances understanding of the conditions and processes through which politicization emerges by undertaking empirical analysis. The primary data source is an original sample of political actors' claims‐making over European integration issues retrieved from news samples in France, Germany and Britain during the constitution event (2000–05). Main tenets of prominent theories on politicization are unpacked and tested in relation to the evidence from the claims‐making analysis. The findings demonstrate the transformative impact of the French referendum as a specific opportunity: politicization was largely restricted to internal national contestation by French actors; political party competition was the prominent contestation form; and the Socialists mobilized against the constitution by advocating ‘Social Europe’. This transformed the political space by introducing competition over Europe into the party system's core.
The National–Transnational Wage‐Setting Nexus in Europe: What have We Learned from the Early Years of Monetary Integration?
Authors: Ramskogler Paul
Published: June 2013

Wage growth has become increasingly interdependent in the European monetary and economic union but a stubborn differential in wage growth rates of some European countries persists. Can peculiarities of national wage‐bargaining systems explain this situation? The article develops the idea that wage growth differentials across Europe are due to differences in wage‐bargaining systems. It is demonstrated that wage growth in the exposed industry is restrained by competition. Spillovers from the exposed sector of the economy to the public sector thus can induce overall wage restraint. However, it is shown that spillovers from the exposed to the public sector differ according to the wage‐bargaining system. Pattern‐setting regimes lead to substantial spillovers and thus induce higher wage restraint than other wage‐bargaining systems.
Europeanization beyond Contested Statehood: The European Union and Turkish‐Cypriot Civil Society
Authors: Kyris George
Published: June 2013

This article investigates the impact of the European Union (EU) on the Turkish‐Cypriot civil society, pegged to the Europeanization debate. The article contributes to the discussion on Europeanization and the role of the EU in contested states, which remains a neglected topic in the literature. The argument advanced is that a series of factors that relate to the contested statehood of the Turkish‐Cypriot case mediate the occurrence of Europeanization and they often contribute to an exceptional EU impact on domestic civil society. In this regard, the Turkish‐Cypriot example has strong comparative value for the study of the international role of the EU, the Europeanization of contested states and the importance that the EU places on contacts with civil society, as an alternative avenue to relations with states.
Fewer invited talks by women in evolutionary biology symposia
Authors: Schroeder J. , Dugdale H. L. , Radersma R. , Hinsch M. , Buehler D. M. , Saul J. , Porter L. , Liker A. , De Cauwer I. , Johnson P. J. , Santure A. W. , Griffin A. S. , Bolund E. , Ross L. , Webb T. J. , Feulner P. G. D. , Winney I. , Szulkin M. , Komdeur J. , Versteegh M. A. , Hemelrijk C. K. , Svensson E. I. , Edwards H. , Karlsson M. , West S. A. , Barrett E. L. B. , Richardson D. S. , van den Brink V. , Wimpenny J. H. , Ellwood S. A. , Rees M. , Matson K. D. , Charmantier A. , dos Remedios N. , Schneider N. A. , Teplitsky C. , Laurance W. F. , Butlin R. K. , Horrocks N. P. C.
Published: June 2013

Lower visibility of female scientists, compared to male scientists, is a potential reason for the under‐representation of women among senior academic ranks. Visibility in the scientific community stems partly from presenting research as an invited speaker at organized meetings. We analysed the sex ratio of presenters at the European Society for Evolutionary Biology (ESEB) Congress 2011, where all abstract submissions were accepted for presentation. Women were under‐represented among invited speakers at symposia (15% women) compared to all presenters (46%), regular oral presenters (41%) and plenary speakers (25%). At the ESEB congresses in 2001–2011, 9–23% of invited speakers were women. This under‐representation of women is partly attributable to a larger proportion of women, than men, declining invitations: in 2011, 50% of women declined an invitation to speak compared to 26% of men. We expect invited speakers to be scientists from top ranked institutions or authors of recent papers in high‐impact journals. Considering all invited speakers (including declined invitations), 23% were women. This was lower than the baseline sex ratios of early‐mid career stage scientists, but was similar to senior scientists and authors that have published in high‐impact journals. High‐quality science by women therefore has low exposure at international meetings, which will constrain Evolutionary Biology from reaching its full potential. We wish to highlight the wider implications of turning down invitations to speak, and encourage conference organizers to implement steps to increase acceptance rates of invited talks.
Functional Ecology of the Ciliate Glaucomides bromelicola, and Comparison with the Sympatric Species Bromeliothrix metopoides
Authors: Weisse Thomas , Scheffel Ulrike , Stadler Peter , Foissner Wilhelm
Published: June 2013

We investigated the ecology and life strategy of Glaucomides bromelicola (family Bromeliophryidae), a very common ciliate in the reservoirs (tanks) of bromeliads, assessing its response to food quality and quantity and pH. Further, we conducted competition experiments with the frequently coexisting species Bromeliothrix metopoides (family Colpodidae). In contrast to B. metopoides and many other colpodean ciliates, G. bromelicola does not form resting cysts, which jeopardizes this ciliate when its small aquatic habitats dry out. Both species form bactivorous microstomes and flagellate‐feeding macrostomes. However, only G. bromelicola has a low feeding threshold and is able to adapt to different protist food. The higher affinity to the local bacterial and flagellate food renders it the superior competitor relative to B. metopoides. Continuous encystment and excystment of the latter may enable stable coexistence of both species in their natural habitat. Both are tolerant to a wide range of pH (4–9). These ciliates appear to be limited to tank bromeliads because they either lack resting cysts and vectors for long distance dispersal (G. bromelicola) and/or have highly specific food requirements (primarily B. metopoides).
Histories of legal scholars: the power of possibility
Authors: Bartie Susan
Published: June 2013

This paper makes two claims. First, it claims that there are various trends within academic law that discourage legal scholars from learning about their predecessors. These trends are explained. Secondly, it claims that there are a number of benefits which could flow from addressing this neglect. Several of these benefits have been acknowledged elsewhere. For example, some scholars maintain that ideas are best treated historically before being dealt with analytically. The more scholars read whole bodies of their predecessors' works, the better their interpretations and understandings of such works become, thus strengthening the intellectual integrity of the discipline. While agreeing with this argument, the purpose of the second section of this paper is to articulate other, perhaps less obvious, benefits. It is argued that by learning about a wider range of past academic endeavour, legal scholars are encouraged to challenge existing notions of academic standing and consider not only what the legal academy has become but also what it ought to be. Learning about scholarly predecessors could help scholars better contextualise current challenges. Such learning could be empowering in the context of a discipline whose scholarly practices have meant that there has been little reason to look to the past.
Hiatus Resolution in Spanish: Motivating Forces, Constraining Factors, and Research Methods
Authors: Garrido Marisol
Published: June 2013

In this paper, I review previous research on the tendency to resolve hiatus vowel sequences in Spanish, a phenomenon of language variation, especially reported in Latin American varieties. I report on the main factors that motivate and constrain the observed variability, including the force of internal linguistic principles as well as the external factors (social variables) that mediate on language variation and change. I conclude this paper by discussing some unexplored topics and methodological issues to be considered in future research.
Approaches to Deponency
Authors: Müller Gereon
Published: June 2013

The aim of this article is to give an overview of theoretical approaches to (generalized) deponency, i.e., morpho‐syntactic phenomena in the world's languages that resemble deponent verbs in Latin (where passive morphology accompanies active syntax) in that a ‘wrong form’ is apparently used. The paper has three parts. First, the concept of deponency is introduced. Second, a new taxonomy of approaches is developed that extends Stump's original classification by adding two further groups: (i) form deponency, (ii) property deponency, (iii) spurious morpho‐syntactic deponency, and (iv) spurious morphomic deponency. The discussion yields interesting results concerning preferred choices among (i)–(iv) in the literature (with (i) emerging as surprisingly rare and (iv) as surprisingly widespread), and concerning potential correlations between analysis type and overall grammatical framework (there aren't any). In the third part, I sketch a version of what is arguably a fairly straightforward approach to deponency (even though an actual instantiation so far appears to be outstanding): an optimality‐theoretic analysis that takes the hypothesis that deponency involves ‘wrong forms’ literally.
Genetic relatedness does not retain spatial pattern across multiple spatial scales: dispersal and colonization in the coral, Pocillopora damicornis
Authors: Gorospe Kelvin D. , Karl Stephen A.
Published: June 2013

Patterns of isolation by distance are uncommon in coral populations. Here, we depart from historical trends of large‐scale, geographical genetic analyses by scaling down to a single patch reef in Kāne‘ohe Bay, Hawai‘i, USA, and map and genotype all colonies of the coral, Pocillopora damicornis. Six polymorphic microsatellite loci were used to assess population genetic and clonal structure and to calculate individual colony pairwise relatedness values. Our results point to an inbred, highly clonal reef (between 53 and 116 clonal lineages of 2352 genotyped colonies) with a much skewed genet frequency distribution (over 70% of the reef was composed of just seven genotypes). Spatial autocorrelation analyses revealed that corals found close together on the reef were more genetically related than corals further apart. Spatial genetic structure disappears, however, as spatial scale increases and then becomes negative at the largest distances. Stratified, random sampling of three neighbouring reefs confirms that reefs are demographically open and inter‐reef genetic structuring was not detected. Attributing process to pattern in corals is complicated by their mixed reproductive strategies. Separate autocorrelation analyses, however, show that the spatial distribution of both clones and nonclones contributes to spatial genetic structure. Overall, we demonstrate genetic structure on an intrareef scale and genetic panmixia on an inter‐reef scale indicating that, for P. damicornis, the effect of small‐ and large‐scale dispersal processes on genetic diversity are not the same. By starting from an interindividual, intrareef level before scaling up to an inter‐reef level, this study demonstrates that isolation‐by‐distance patterns for the coral P. damicornis are limited to small scales and highlights the importance of investigating genetic patterns and ecological processes at multiple scales.
Samter's triad in childhood: a warning for those prescribing NSAIDs
Authors: Ameratunga Rohan , Randall Nicholas , Dalziel Stuart , Anderson Brian J.
Published: June 2013

Aspirin‐exacerbated respiratory disease (AERD) has been recognized in adults with chronic asthma. Samter's triad is a subset of AERD where adult patients develop nasal polyps, asthma, and sensitivity to aspirin. This condition is thought not to occur before the third decade of life. We report a 13‐year‐old boy with nasal polyps who suffered a life‐threatening exacerbation of asthma during a graded aspirin challenge. Resuscitation required positive pressure ventilation and inotropic support. Our observations confirm that classical Samter's triad can occur in children. We suggest that graded aspirin challenges in children are undertaken in a facility with equipment and staff trained for resuscitation. Consideration should be given to this rare complication when prescribing nonsteroidal anti‐inflammatory drugs in the perioperative period. Suspicion of this condition merits referral to an immunologist for desensitization to aspirin.