bluuebunny/crossref_metadata_2025 huggingface dataset:
Combination treatment with anti‐Nogo‐A and chondroitinase ABC is more effective than single treatments at enhancing functional recovery after spinal cord injury
Authors: Zhao Rong‐Rong , Andrews Melissa R. , Wang Difei , Warren Philippa , Gullo Miriam , Schnell Lisa , Schwab Martin E. , Fawcett James W.
Published: June 2013

Anti‐Nogo‐A antibody and chondroitinase ABC (ChABC) enzyme are two promising treatments that promote functional recovery after spinal cord injury (SCI). Treatment with them has encouraged axon regeneration, sprouting and functional recovery in a variety of spinal cord and central nervous system injury models. The two compounds work, in part, through different mechanisms, so it is possible that their effects will be additive. In this study, we used a rat cervical partial SCI model to explore the effectiveness of a combination of anti‐Nogo‐A, ChABC, and rehabilitation. We found that spontaneous recovery of forelimb functions reflects the extent of the lesion on the ipsilateral side. We applied a combination treatment with acutely applied anti‐Nogo‐A antibody followed by delayed ChABC treatment starting at 3 weeks after injury, and rehabilitation starting at 4 weeks, to accommodate the requirement that anti‐Nogo‐A be applied acutely, and that rehabilitation be given after the cessation of anti‐Nogo‐A treatment. We found that single treatment with either anti‐Nogo‐A or ChABC, combined with rehabilitation, produced functional recovery of similar magnitude. The combination treatment, however, was more effective. Both single treatments produced increases in sprouting and axon regeneration, but the combination treatment produced greater increases. Anti‐Nogo‐A stimulated growth of a greater number of axons with a diameter of > 3 μm, whereas ChABC treatment stimulated increased growth of finer axons with varicosities. These results point to different functions of Nogo‐A and chondroitin sulfate proteoglycans in axonal regeneration. The combination of anti‐Nogo‐A, ChABC and rehabilitation shows promise for enhancing functional recovery after SCI.
The Adaptive Significance of Egg Attendance in a South‐East Asian Tree Frog
Authors: Poo Sinlan , Bickford David P.
Published: June 2013

The arboreal frog, Chiromantis hansenae (Family: Rhacophoridae), is one of only a handful of South‐East Asian amphibian species reported with parental care. We present the first systematic observational and experimental study confirming offspring benefits as a result of this care, which has a number of unusual life‐history characteristics. Eggs are unusually small, breeding takes place in large pools, and females attend the eggs. Field observations and an adult removal experiment demonstrated a critical contribution of egg attendance to offspring survivorship. Harsh environmental conditions for offspring appeared to be the prime mover of parental care in this species, with desiccation as the main source of mortality when attending adults are absent. Results confirm females to be the caregivers, making C. hansenae a rare case of maternal egg attendance in a non‐directly developing anuran.
The Role of Courtship Behavior and Size in Mate Preference in the Sex‐Role‐Reversed Gulf Pipefish, Syngnathus scovelli
Authors: Partridge Charlyn , Boettcher Anne , Jones Adam G.
Published: June 2013

In sex‐role‐reversed species, sexual selection acts more strongly on females than on males, a situation that can result in the evolution of secondary sexual traits in females and strong mating preferences in males. While some research exploring mating preferences in sex‐role‐reversed species has been conducted, overall, this topic remains relatively unexplored. The Gulf pipefish, Syngnathus scovelli, is a highly polyandrous pipefish species. Sexual selection is significantly stronger in females than in males, which has led to the evolution of both morphological and behavioral female secondary sexual traits. However, because males gestate the offspring in specialized pouches and make a substantial investment in embryos during development, females may also benefit from being choosy. The goal of this study was to examine both male and female mating preferences in this species. We found that male mating preference was significantly associated with female courtship behavior. Larger females were also able to maintain these behaviors for longer intervals than smaller females. No evidence of female mating preference in regard to male size was observed but the data suggest that male behaviors may be providing positive reinforcement to courting females. This research provides further insight into how mate preferences vary among sex‐role‐reversed species.
Dental pulp stem cells and regeneration
Authors: Nakashima Misako , Iohara Koichiro , Murakami Masashi
Published: June 2013

Dental pulp‐derived stem cells (DPSCs) are considered to be of great promise for use in tissue repair and regenerative medicine. DPSCs can easily be collected from discarded teeth with little ethical concerns and harvested in a minimally invasive and safe manner. However, unfractionated clonogenic DPSCs are heterogenous and have variations in their phenotype. In this review paper, we summarize further isolation methods of DPSC subpopulations including immunoselection methods and a granulocyte colony‐stimulating factor (G‐CSF) gradient mobilization method for therapeutic clinical applications. The fractionated DPSC subpopulations exhibit stem cell properties in vitro: (i) high expression of pluripotency markers, Oct3/4, Nanog, and Sox2; (ii) high stability in long‐term expansion; (iii) multi‐lineage differentiation capacity; (iv) high migratory activity; and (v) high expression of trophic factors to enhance proliferation, migration, and anti‐apoptotic and immunomodulatory effects as well as angiogenesis and neurite extension. DPSC subpopulations have higher angiogenic, neurogenic, and regenerative potential compared with bone marrow stem cells and adipose stem cells, presenting an alternate versatile stem cell source for cellular therapies. Preclinical efficacy of DPSC subpopulations has also been investigated in various tissue/organ disease models including pulpitis, and currently a few clinical trials are underway to determine their safety and efficacy. Therefore, the major aim of this review is to highlight the recent progress in DPSC biology, trends in preclinical regenerative studies, and future perspectives.
Dentin–pulp regeneration: the primordial role of the microenvironment and its modification by traumatic injuries and bioactive materials
Authors: About Imad
Published: June 2013

Understanding dentinogenesis and pulp regeneration during physiological and pathological conditions represents a real challenge in the provision of a suitable treatment that ideally leads to the induction of the pulp regenerative potential. This paper focusses on the early steps of dentin–pulp regeneration that appear to be critical after pulp capping procedures. Different models are described in this paper where the interactions between different cell types in vitro illustrate their role in maintaining pulpal homeostasis. After traumatic injuries, the cells modify the local pulpal microenvironment by secreting growth factors that orchestrate and induce the processes required for dentin–pulp regeneration. Applying dental materials onto the injured pulp modifies this local microenvironment and affects the potential for pulpal regeneration. The paper also describes the added value of developing an entire human tooth culture model for understanding these early steps and discusses the interest of its use in evaluating newly developed pulp capping materials through the example of BiodentineTM, developed as a dentin substitute. The growth factors sustained release simulating the local microenvironment is also discussed. Simulating the pulp local environment with a continuous growth factors release is also a basic requirement for establishing future pulp tissue engineering.
Toxic Microcystis (cyanobacteria) inhibit recruitment of the bloom‐enhancing invasive bivalve Limnoperna fortunei
Authors: Boltovskoy Demetrio , Correa Nancy , Bordet Facundo , Leites Valentín , Cataldo Daniel
Published: June 2013

Toxic cyanobacterial blooms and biological invasions are major threats to freshwater systems worldwide. While usually dealt with independently, the two threats can interact to produce synergistic or antagonistic outcomes. The aim of this survey is to analyse interactions between the cyanobacterium Microcystis spp. and the Asian invasive mussel Limnoperna fortunei.

On the basis of 9 years of observational data in a large subtropical reservoir (Salto Grande, Argentina–Uruguay), we analyse causal relationships between recurring summer–early autumn blooms of Microcystis spp. and recruitment by L. fortunei. Reproduction of the mussel was interrupted during dry summers (January–April), coinciding with periods of peak Microcystis spp. growth and low water discharge (which favours build‐up of algal biomass). On the other hand, wet summers with high discharge rates were characterised by low Microcystis spp. densities and high numbers of L. fortunei larvae in the water column.

Of the seven South American waterbodies investigated, Salto Grande was the only one with very marked cyanobacterial blooms and where larval numbers decrease to near zero during January–April; in all others, reproduction peaks in January–April.

The assumption that microcystin‐producing algae are responsible for these troughs during periods when elsewhere larvae are very abundant was reinforced by experimental results indicating that microcystin‐LR is highly toxic to the mussel's larvae, eliminating 58–100% of animals in 48 h at 10–20 μg L−1.

Paradoxically, high concentrations of microcystin in water are probably partly due to L. fortunei's own activity, which enhances growth of Microcystis spp. through modification of nutrient concentrations, selective grazing of solitary Microcystis spp. cells over colonial ones and production of chemical cues that trigger the formation of colonies.

These interactions have important implications for the management of biofouling of industrial raw cooling water facilities by the byssate mussels, as well as policies oriented at curtailing the spread of the invasive bivalve.
Survey of patients' experiences and perceptions of care provided by nurse and pharmacist independent prescribers in primary care
Authors: Tinelli Michela , Blenkinsopp Alison , Latter Sue , Smith Alesha , Chapman Stephen R
Published: June 2013

Background

In the United Kingdom, nurses and pharmacists who have undertaken additional post‐registration training can prescribe medicines for any medical condition within their competence (non‐medical prescribers, NMPs), but little is known about patients' experiences and perceptions of this service.

Objective

to obtain feedback from primary care patients on the impact of prescribing by nurse independent prescribers (NIPs) and pharmacist independent prescribers (PIPs) on experiences of the consultation, the patient–professional relationship, access to medicines, quality of care, choice, knowledge, patient‐reported adherence and control of their condition.

Design

Two cross‐sectional postal surveys.

Setting and participants

Patients prescribed for by either NIPs or PIPs in six general practices from different regions in England.

Results

30% of patients responded (294/975; 149/525 NIPs; 145/450 PIPs). Most said they were very satisfied with their last visit (94%; 87%), they were told as much as they wanted to know about their medicines (88%; 80%), and felt the independent prescriber really understood their point of view (87%; 75%). They had a good relationship with (89%; 79%) and confidence in (84%; 77%) their NMP. When comparing NMP and doctor prescribing services, most patients reported no difference in their experience of care provided, including access to it, control of condition, support for adherence, quality and safety of care.

Discussion and conclusions

Patients had positive perceptions and experience from their NMP visit. NMPs were well received, and patients' responses indicated the establishment of rapport. They did not express a strong preference for care provided by either their non‐medical or medical prescriber.
An interobserver reproducibility study on invasiveness of bladder cancer using virtual microscopy and heatmaps
Authors: Compérat Eva , Egevad Lars , Lopez‐Beltran Antonio , Camparo Philippe , Algaba Ferran , Amin Mahul , Epstein Jonathan I , Hamberg Hans , Hulsbergen‐van de Kaa Christina , Kristiansen Glen , Montironi Rodolfo , Pan Chin‐Chen , Heloir Fabrice , Treurniet Kilian , Sykes Jenna , Van der Kwast Theo H
Published: June 2013

Aims

The distinction between non‐invasive (pTa) and invasive (pT1) non‐muscle invasive bladder cancer (NMIBC) is subject to considerable interobserver variation. We aimed to generate a teaching set of images based on the diagnostic opinions of a panel of expert genitourinary pathologists.

Methods and results

Twenty‐five transurethral resection specimens initially reported as pT1 NMIBC from two university hospitals were selected on the basis of potential uncertainty of stromal invasion. Digitized slides were reviewed independently by a panel of eight genitourinary pathologists, who annotated any invasive area if present. Annotations were reviewed by the lead panel, and heatmaps of annotated areas were constructed. Reasons for discrepancies were analysed, and kappa scores were calculated to determine agreement among the eight panellists. Full agreement by the eight panellists was obtained in 11 of 25 cases (44%), with a multi‐rater (Fleiss) kappa of 0.47 (P < 0.0001). After joint review of the seven discordant (agreement <75% of panellists) cases, consensus was obtained for six cases, and a teaching set of images was generated.

Conclusions

Interobserver agreement among the panellists in the selected cases was moderate, but consensus could be reached in almost all cases. Heatmaps proved to be instrumental in generating a teaching set of images for standardization of histological criteria for NMIBC invasion.
Phylogenetic analysis of the Blephariceromorpha, with special reference to mountain midges (Diptera: Deuterophlebiidae)
Authors: COURTNEY GREGORY W.
Published: June 2013

Abstract. A cladistic analysis of the Blephariceromorpha (here including the Nymphomyiidae, Deuterophlebiidae and Blephariceridae) and related Diptera provides a test of the phylogenetic hypotheses of Rohdendorf (1964, 1974), Hennig (1973), Wood & Borkent (1989) and Courtney (1990a). In particular, monophyly of the Blephariceroidea and Blephariceromorpha (sensu Wood & Borkent), and their relationship to other Diptera, is tested. Evaluation of larval, pupal and adult characters supports the hypothesis of Wood & Borkent, as modified by Courtney. Four larval features suggest that the Blephariceromorpha + Psychodomorpha form a monophyletic group, although an alternate hypothesis predicting that the Blephariceromorpha is the sister group of the Psychodomorpha + (Ptychopteromorpha + Culicomorpha), is discussed. Monophyly of the Blephariceromorpha (Nymphomyioidea + Blephariceroidea) is supported by one adult and five larval characters. Monophyly of the Blephariceroidea (Deuterophlebiidae + Blephariceridae) is supported by thirteen synapotypies, including features of the larva (six), pupa (three) and adult (four). Nineteen, nineteen and nine hypothesized synapotypies support monophyly of the Nymphomyiidae, Deuterophlebiidae and Blephariceridae, respectively.
Pupae in nomenclature and identification: West Palaearctic Orthocladius s.str. (Diptera: Chironomidae) revised
Authors: LANGTON P. H. , CRANSTON P. S.
Published: June 2013

Abstract. Orthocladius (Orthocladius) is a subgenus of one of the more speciose genera amongst the Holarctic chironomids of the subfamily Orthocladiinae. Although many names have been applied, adult males are difficult to distinguish. However, the immature stages often are known, and pupae discriminate taxa reliably.

Based predominantly upon examination of exuviae, Orthocladius atripluma Kieffer and Orthocladius mitisi Goetghebuer are syn.n. of Orthocladius glabripennis (Goetghebuer); Orthocladius smolandicus Brundin a syn.n. of Orthocladius holsatus Goetghebuer; Orthocladius lenzi Kieffer a syn.n. of Orthocladius oblidens (Walker); Orthocladius rhyacobius Kieffer, Orthocladius rhyacophilus Kieffer and Orthocladius excavatus Brundin are syn.n. of Orthocladius obumbratus Johannsen; Orthocladius saxicola Kieffer and Orthocladius curtiseta Sæther are syn.n. of Orthocladius rubicundus (Meigen).

Orthocladius (Orthocladius) vaillanti is described as sp.n., based upon distinctive pupal exuviae. Lectotypes are designated for Orthocladius rhyacobius Kieffer, Orthocladius rhyacophilus Kieffer, Orthocladius rivinus Kieffer, Chironomus rubicundus Meigen and Orthocladius saxicola Kieffer.

A key to the thirteen western palaearctic species is given.
New evidence on the phylogeny and biogeography of the Amphizoidae: Discovery of a new species from China (Coleoptera)
Authors: PEIYU YU , STORK NIGEL E.
Published: June 2013

Abstract. A new species, Amphizoa sinica, is described from Chang bei shan in Northern China. A revised key is provided for this and the other four species of this monogeneric and enigmatic group. Phylogcnetic and zoogeographic relationships are discussed.
Carbon Dioxide (CO2) Laser Vaporization of Multiple Facial Syringomas
Authors: WHEELAND RONALD G. , BAILIN PHILIP L. , REYNOLDS OWEN D. , RATZ JOHN L.
Published: June 2013

Abstract
The technique for using the carbon dioxide laser in the vaporization mode to treat multiple lesions of syringoma of the face without adverse scarring, textural changes, or recurrence is described.
Micrographic Surgery for Satellites and In‐Transit Metastases of Malignant Melanoma
Authors: MOHS FREDERIC E.
Published: June 2013

Abstract. Satellites and in‐transit metastases do not always forebode the systemic dissemination of malignant melanoma. Five patients with varying numbers of these lesions were successfully treated with the fixed‐tissue technique of micrographic surgery. This method permits the excision of these embolic foci with a minimal risk of further dissemination. It is important that the lesions be detected and removed as early as possible.
Nonsurgical Management of an Electrical Burn of the Scalp
Authors: SHELLEY E. DORINDA , SHELLEY WALTER B.
Published: June 2013

Abstract. The remarkable regenerative capability of the scalp reduces the need for skin grafting in electrical burns of this area. We report on a deep 7.5 cm electrical burn of the scalp which healed completely under conservative management with 20% urea compresses, benzoyl peroxide gel, and systemic erythromycin.
Metastatic Basal Cell Carcinoma
Authors: MIKHAIL GEORGE R.
Published: June 2013

Abstract. Metastatic basal cell carcinoma (BCC) is rare and the cutaneous lesions in such cases are long‐standing and grossly neglected. In order to establish the diagnosis, certain criteria have to be satisfied. A case of BCC of the scalp that metastasized to the lungs is here reported.
Erosive Adenomatosis of the Nipple
Authors: HIGGINBOTHAM LINDA H. , MIKHAIL GEORGE R.
Published: June 2013

Abstract. Erosive adenomatosis of the nipple is a benign lesion that clinically mimics Paget's disease of the nipple but has the histologic features of syringocystadenoma papilliferum. Some cases have been mistaken for intraductal papilloma or well‐differentiated adenocarcinoma, and unnecessary mastectomies have been performed. Recognition of this lesion is important because it is benign and conservative excision is curative.
Hutchinson's Sign
Authors: MIKHAIL GEORGE R.
Published: June 2013

Abstract. Hutchinson's sign—pigmentation of the periungual tissues—is a valuable clue to the diagnosis of subungual melanoma. When present, this sign indicates malignant melanoma, however minimal the pigmentation or the histology may be. An illustrative case is presented.
Squamous Cell Carcinoma in Hemangioma of Lip
Authors: MIKHAIL GEORGE R.
Published: June 2013

Abstract. A deeply invasive squamous cell carcinoma of the right vermilion border of the lip superposed on a nevus flammeus (port‐wine stain) was excised by the Mohs micrographic surgery, fixed‐tissue technique. The course was uneventful and the final cosmesis was good.
Carcinoma of the External Auditory Canal: Removal and Prevention of Stenosis
Authors: BUECKER JOSEPH W. , PHELAN JOHN T.
Published: June 2013

Abstract. The external auditory canal represents an area of high risk for recurrence of tumors. Therefore, carcinomas involving this region should be removed by Mohs chemosurgery. Healing by granulation can result in stenosis of the canal. We report a method of reconstruction to prevent stenosis of the auditory canal after chemosurgery.
Infiltrating Angiolipoma: Report of Two Cases and Review of the Literature
Authors: PUIG LLUIS , MORENO ABELARDO , DE MORAGAS JOSÉ M.
Published: June 2013

Abstract. Infiltrating angiolipoma is an infrequent cutaneous tumor, with skeletal muscle infiltration that should be differentiated from the common encapsulated angiolipoma. We present two cases in young women, and review the literature. Infiltrating angiolipoma may be a locally aggressive neoplasm, which makes its clinicopathologic recognition and appropriate therapy important.
Treatment of Mycosis Fungoides with Isotretinoin
Authors: FITZPATRICK JAMES E. , MELLETTE J. RAMSEY
Published: June 2013

Abstract. A 56‐year‐old man with a 7‐year history of well‐documented mycosis fungoides is reported. Because the patient was a treatment failure with topical nitrogen mustard due to severe allergic contact dermatitis, and because of recent reports of the efficacy of retinoid compounds, he was treated with a 6‐month course of isotretinoin with total clearing of his skin lesions. Previous case reports and possible mechanisms of action are reviewed.
Adjuvant Techniques in Punch Graft Hair Transplantation
Authors: SADICK NEIL S. , HITZIG GARY S.
Published: June 2013

Abstract. The authors present a study of 150 patients treated for male pattern alopecia by autograft punch transplantation. Factors found to improve results were diminished epinephrine concentration, use of a template spacing device, tunnelling, lack of fat trimming, saline instillation for harvesting donor grafts, injection of long‐acting anesthetics, and blend grafting.
Surface Landmarks for the Identification of Key Anatomic Structures of the Face and Neck
Authors: BERNSTEIN GERALD
Published: June 2013

Abstract. The location of many deep anatomic structures of the face and neck can be identified by their relationship to surface landmarks. By systematically identifying the important anatomic landmarks, one can perform surgical operations with greater confidence of avoiding inadvertent damage to underlying structures.
Giant Epidermoid Cyst: Clinical Aspect and Surgical Management
Authors: ARIZPE S. RIOS , CANDIANI J. OCAMPO
Published: June 2013

Abstract. A patient presented with a giant epidermoid cyst on the sternum region with the appearance of a well‐developed mammary gland. Its clinical aspect and surgical management are illustrated.
Cryosurgical Treatment of a Large Keloid
Authors: LUÍS CIRNE de CASTRO JOSÉ , PEREIRA dos SANTOS ANTÓNIO , PEDRO MORAIS CARDOSO JOÄO , RIBEIRO RUI
Published: June 2013

Abstract. The cryosurgical treatment of a patient with a large keloid on the nuchal region is reported. The tumor was frozen under local anesthesia with minimal discomfort. The temperatures beneath the lesion were monitored in order to achieve a deep freezing. Twelve months after the treatment the tumor has not recurred.
Survival of Herpes Simplex Virus during Cryosurgery with Liquid Nitrogen
Authors: BURKE WILLIAM A. , BADEN T. JAMES , WHEELER CLAYTON E. , BOWDRE JEAN H.
Published: June 2013

Abstract. Because many viruses can survive extremely cold temperatures for extended periods of time, transmission of viral diseases from person to person using improper cryosurgical techniques might conceivably occur. To investigate the survivability of herpes simplex virus during cryotherapy, virus was first inoculated onto cotton‐tipped applicators from either tissue cultures or from active lesions on patients, and then frozen for variable times in liquid nitrogen (‐196°C). After thawing, the applicators were cultured for the virus. The virus survived 12 hours of freezing (the maximum time of freezing in the study), which suggests that herpes simplex could be transmitted between cryosurgical patients if care is not taken to use separate cotton‐tipped applicators and liquid nitrogen containers for each case.
Residents' Corner: Blastomycosis‐like Pyoderma‐ Report of a Case Responsive to Combination Therapy Utilizing Minocycline and Carbon Dioxide Laser Debridement
Authors: SAWCHUK WILLIAM S. , HEALD PETER W.
Published: June 2013

Abstract. Blastomycosis‐like pyoderma is an uncommon reaction pattern to a superficial bacterial infection in persons with a variety of predisposing conditions such as chronic ethanol use and poor nutrition. We are reporting a case that initially responded poorly to previously described treatment regimens but responded well to combination treatment with carbon dioxide laser debridement and long‐term minocycline.
Extravascular Effects of Sclerosants in Rabbit Skin: A Clinical and Histologic Examination
Authors: GOLDMAN MITCHEL P. , KAPLAN RICHARD P. , OKI LISA N. , BENNETT RICHARD G. , STRICK RICHARD A.
Published: June 2013

Abstract. Sclerotherapy refers to the injection of a material for the purpose of obliterating a blood vessel. During this procedure a small quantity of sclerosing solution may be unintentionally injected into the tissues surrounding the vessel, either by missing the vessel or leakage of sclerosant upon withdrawal of the needle. Occasionally, the sclerosant may be intentionally injected into an extravascular site in the hope of reducing telangiec‐tatic mats (best described as multiple, grouped, extremely fine telangiectatic vessels). The various sclerosants in use appear to vary in their potential to cause necrosis of perivascular tissues as a complication.

This study examines the clinical and histologic effects of the intradermal injection of 0.1 ml of 0.25, 0.5, and 1.0% Aethoxysklerol (AES); 0.5% Sotradecol (SOT); and 23.4% hypertonic saline (HS) in rabbit skin. All three agents produced some clinical necrosis with intradermal injection. AES in all three concentrations produced the least clinical necrosis, no histologic necrosis, and resolved faster than SOT or HS.
Malignant Melanoma Arising Intradermally in a Small Congenital Nevus of an Adult
Authors: PAULL WILLIAM H. , POLLEY DENNIS , FITZPATRICK JAMES E.
Published: June 2013

Abstract. The occurrence of a malignant melanoma in a small congenital nevus is a rare event. A malignant melanoma arising intradermally in a small congenital nevus in an adult has not been previously reported. The clinical implications and known information about the prognosis of intradermal malignant melanomas are discussed.
A Bullous Variant of Kaposi's Sarcoma in an Elderly Female
Authors: RECHT BERNARD , NICKOLOFF BRIAN J. , WOOD GARY S.
Published: June 2013

Abstract. We report the case of Kaposi's Sarcoma (KS) in an elderly Italian female that has slowly progressed and evolved clinically with bullous formation. The skin biopsy was diagnostic of KS, showing the typical spindle cell formations, but at the same time showing a labyrinthlike collection of vessels that correlated with the bullous nature of the clinical lesions. Immunohistochemical staining for factor VIII antigens demonstrated strong reactivity of non‐neoplastic blood vessel endothelium but virtually no staining of tumor cells. This is similar to the reactivity of normal lymphatic endothelial cells and supports the notion that these labyrinth‐like vessels are derived from lymphatic endothelium.
Electrosurgery Using Insulated Needles: Treatment of Telangiectasias
Authors: KOBAYASHI TOSHIO
Published: June 2013

Abstract. This paper deals mainly with operative techniques and clinical aspects of treating telangiectasias using insulated needles. The specialized needle is insulated at its base as well as on one half of the needle surface. The results have proven to be very satisfying, and this method shows promise not only in the treatment of superficial telangiectasias but also in deeper lesions as well.
Pseudocyst of the Auricle: Compression Suture Therapy
Authors: KARAKASHIAN GARY V. , LUTZ‐NAGEY LINDA L. , ANDERSON REGINA
Published: June 2013

Abstract. Pseudocyst of the auricle is an uncommon, asymptomatic swelling of the ear, resulting from an accumulation of fluid within an unlined intracartilaginous cavity. Numerous therapeutic approaches have been employed in the past with variable success. In this paper we utilized a procedure comprising aspiration of the cystic structure followed by compression with bolstered sutures, with complete resolution of the lesion.
A Ten‐Year‐Old Boy with Dermatofibrosarcoma Protuberans of the Face
Authors: SAGI AMIRAM , BEN‐YAKAR YONA , MAHLER DAN
Published: June 2013

Abstract. A rare case of dermatofibrosarcoma protuberans on the face of a 10‐year‐old boy is presented. The patient's young age and the localization of the tumor led to limited excisions that resulted in two local recurrences. Primary wide excision with 2.5 cm of free margins is recommended to avoid local recurrences that are otherwise frequent.
Modern Dermabrasion Techniques: A Personal Appraisal
Authors: FULTON JAMES E.
Published: June 2013

Abstract. Improvements in dermabrasion techniques have upgraded the therapeutic results for the removal of acne scars, sun‐damaged skin, and related skin lesions in selected patients. To help patient compliance and therapeutic response, and to avoid pitfalls, extensive step‐by‐step predermabrasion evaluation and patient selection procedures are helpful. Standard checklists, operative techniques, and patient follow‐up procedures have improved the results. Currently, the optimal dermabrasion procedure consists not only of an extensive facial planing, but the use of Loo punch or scalpel excision and the suturing of large cysts and scars during the procedure and the filling of valley‐like depressions with liquid collagen or silicone after the procedure. These methods of extensive standard procedures and protocols, rigid patient selection, and pre‐, during, and postdermabrasion follow‐ups are presented so medical staffs can avoid common pitfalls.
Subclinical Syringoma Coexisting with Basal Cell Carcinoma
Authors: SPITZ DEBORAH F. , STADECKER MIGUEL J. , GRANDE DONALD J.
Published: June 2013

Abstract. We report three cases of clinically unapparent syringoma found incidentally on horizontal frozen tissue sections from patients undergoing Mohs micrographic excision of basal cell carcinoma (BCC). In the first case, the syringoma and BCC were admixed; in the other two cases, they were seen in close approximation to one another. In all cases, the tumors were detected on the faces of elderly women. The potential existence of a benign syringoma in association with BCC should be borne in mind, particularly in connection with Mohs micrographic excision. These tumors must be distinguished from one another in order to avoid excessive surgery beyond adequate resection of the basal cell carcinoma.
The Technique and Current Status of Pinch Grafting
Authors: WHEELAND RONALD G.
Published: June 2013

Abstract Small split‐thickness skin grafts, also known as pinch grafts, can provide an effective form of therapy for recalcitrant ulcers of the skin. Several of the new surgical dressings can be combined with the traditional pinch grafting technique to shorten the time for the development of granulation tissue within a clean ulcer base and improve the survival of the grafts themselves. This paper will summarize the surgical technique employed in pinch grafting.
Contouring of Donor Skin in Full‐Thickness Skin Grafting
Authors: HILL THOMAS G.
Published: June 2013

Abstract Different areas which are multiply contoured require individualized approaches to reconstruction. The contouring of the donor skin specimen is important to the final appearance of full‐thickness skin grafts. Graft‐bed contours can be matched by trimming the reverse contour on the underside of the donor specimen. The reconstruction of defects on the nasal tip, lateral nose and ala, helical rim of the ear, and eyelid and medial canthal areas are discussed.
Surgical Gem: Simplified Surgery with Surgical Punches
Authors: UNIS MARK E.
Published: June 2013

Abstract Expedient and simple surgery with excellent cosmetic results can be accomplished by use of Robbins punches. Techniques for excision of very small basal cell carcinomas from the nose, with and without grafting, and rapid excision of multiple lesions such as dysplastic nevi are outlined.
Carbon Dioxide Laser abrasion: A New Approach to Management of Familial Benign Chronic Pemphigus (Hailey‐Hailey Disease)
Authors: DON PHILIP C. , CARNEY PATRICK S. , LYNCH WILLIAM S. , ZAIM M. TARIF , HASSAN MEDHAT O.
Published: June 2013

Familial benign chronic pemphigus (FBCP), or Hailey‐Hailey disease, can be a debilitating condition. Treatment is palliative and only excision of lesional skin followed by split‐thickness grafting may be curative. The success of surgery is attributed to the removal of adnexal structures and a decrease in sweating and maceration. This is the first report of successful carbon dioxide (CO2) laserabrasion of a patient with FBCP. The procedure spared the underlying adnexae which contributed to the reepithelialization of the epidermis. The selective destructive property of the CO2 laser may contribute to understanding the pathophysiology of FBCP.
Malignant Melanoma with Desmoplasia and Neurotropism
Authors: KIBBI ABDUL‐GHANI , MIHM MARTIN C.
Published: June 2013

Desmoplastic (DMM) and neurotropic (NMM) malignant melanoma are two variants of the vertical growth phase of malignant melanoma. Both lesions commonly present clinically as firm nodules that are often mistaken for fibromas. Histologically, they are associated with a pleomorphic spindle cell population of cells that widely infiltrate the dermis. An accompanying fibrosis is present. DMM usually lies beneath a lentiginous proliferation of a typical melanocytes, whereas NMM may arise without obvious epidermal involvement. Because the lesions infiltrate widely, adequate therapy results only when complete extirpation is performed. Otherwise, there may be recurrence. Recurrent lesions act more aggressively.
Hyperplastic Acral Keratoses—Association with Invasive Squamous Cell Carcinoma
Authors: RABKIN MICHAEL S. , WEEMS WILLIAM S.
Published: June 2013

We have observed hyperplastic epidermal lesions in sun‐damaged skin on the backs of the hands, wrists, and forearms that, in some examples, contain foci of invasive squamous cell carcinoma. Atypia in these lesions is focal or absent. Because of their bland histology, physicians are likely to interpret small or superficial biopsies as indicating a benign lesion. However, careful clinical correlation and follow‐up are recommended, as residual tissue may contain invasive carcinoma or its precursor.
Flap Elevation and Mobilization by Blunt Liposuction Cannula Dissection to Repair Temple Defect
Authors: FIELD LAWRENCE M. , NOVY FREDERICK G.
Published: June 2013

Abstract. After Mohs micrographically controlled removal of a recurrent squamous cell carcinoma, a 6 × 7‐cm defect of the temple was closed with a large cheek and neck flap elevated and mobilized by blunt liposuction cannula dissection techniques and rotated into the defect. An excellent cosmetic and functional result was obtained.
Malignant Proliferating Trichilemmal Tumors—Report of Three Cases
Authors: MEHREGAN AMIR H. , LEE K.C.
Published: June 2013

Abstract. We are reporting three patients with recent history of rapid enlargement of long standing nodular scalp lesions. Histologic sections revealed areas of relatively benign proliferation of pilar sheath epithelium and foci of trichilemmal keratinization characteristic of a proliferating trichilemmal cyst. There were also extensive areas of severe cellular dysplasia and surrounding dermal invasion indicating malignant transformation.
Merkel Cell Tumor of the Thigh
Authors: LINDAE MARY L. , NICKOLOFF BRIAN J. , GREENE IRA
Published: June 2013

Abstract. This case of a Merkel cell carcinoma is unusual due to the occurrence of the tumor on the thigh; most Merkel cell tumors have been found on the sun‐exposed region of the head and neck. Histologically, the nodule was composed of sheets of uniform, poorly differentiated cells with a high nuclear to cytoplasmic ratio. Electron miscroscopy revealed perinuclear filaments, scattered dense core granules, and complex, interdigitating processes within cytoplasmic membranes. Treatment consisted of surgical excision of the tumor with a wide margin.
Bilateral Chondroma of the Auricle
Authors: QUERCETANI ROBERTO , GELLI RICCARDO , PIMPINELLI NICOLA , REALI UMBERTO M.
Published: June 2013

Abstract. Benign extraosseous cartilaginous lesions are uncommon and favor mainly the soft tissues of the hands and feet. We report a case of chondroma of both auricles. This localization has not been previously reported in the literature.
Fat Transfer—A “Pinch” Technique for Accurate Placement of Donor Tissue
Authors: BISACCIA EMIL , SCARBOROUGH DWIGHT A. , SWENSEN RICHARD D.
Published: June 2013

Abstract. A useful and simple technique for fat transfer requiring bilateral pressure prior to injection for effective correction of cosmetic defects is described.
Neutralized Lidocaine with Epinephrine for Local Anesthesia
Authors: STEWART JAMES H. , COLE GARY W. , KLEIN JEFFREY A.
Published: June 2013

Abstract. The pain of infiltrating lidocaine with epinephrine into skin is reduced by the addition of sodium bicarbonate. The effect of varied concentrations of sodium bicarbonate on pain of infiltration of 1% lidocaine with epinephrine 1:100,000 was measured. Sodium bicarbonate at 40 and 100 meq/L of anesthetic solution caused significantly less pain than did 0 or 10 meq/L. The stability of epinephrine in a solution at pH 7.3 was also determined. Epinephrine concentration declined approximately 25% per week in anesthetic solution containing 100 meq/L sodium bicarbonate.
Pemphigus and Kaposi's Sarcoma
Authors: KAPLAN RICHARD P. , ISRAEL STUART R. , AHMED A. RAZZAQUE
Published: June 2013

Abstract. A 77‐year‐old woman developed Kaposi's sarcoma (KS) during prednisone therapy for pemphigus foliaceus. There are 7 prior reports in the literature of KS occurring in association with pemphigus. There are multiple reports of KS occurring in patients without pemphigus who are immunosuppressed either by malignancy or by chemotherapy for various disorders. Although the relationship between KS and pemphigus is a real one, KS is more likely related to therapeutically induced immunosuppression in certain predisposed individuals rather than primarily to pemphigus itself.
Exogenous Electric Current Can Reduce the Formation of Hypertrophic Scars
Authors: WEISS DARRYL S. , EAGLSTEIN WILLIAM H. , FALANGA VINCENT
Published: June 2013

Abstract. Exogenous electric current has been shown to influence the healing of wounds in both human subjects and animal models. We examined the effect of positive polarity electrical stimulation on the resultant scar thickness of surgically induced wounds, and report that electrotherapy can reduce scar thickness and hypertrophic scar formation.
Surgical Amelioration of Dercum's Disease: A Report and Review
Authors: HELD JONATHAN L. , ANDREW JAMES A. , KOHN STEVEN R.
Published: June 2013

Abstract. Dercum's disease, or adiposis dolorosa, is a rare condition characterized by painful lipomas, usually on the extremities of obese postmenopausal women. At present, there are no treatments known to alter the progressive course of this often incapacitating disease. Surgical intervention, while not preventive, is useful in ameliorating local symptoms of pain. We report a characteristic 15‐year course of Dercum's disease.
Facial Nerve Palsy as a Result of Squamous Cell Carcinoma of the Skin
Authors: NELSON BRUCE R. , GOLDBERG LEONARD H.
Published: June 2013

Abstract. Perineural invasion is increasingly recognized as a significant mode of tumor spread in squamous cell carcinoma (SCC) of the skin. Clinically, it is very difficult to diagnose perineural involvement in the majority of patients due to the lack of symptoms. The occasional propensity for perineural invasion from SCCs of the skin of the head and neck region is well documented and, although SCCs arising from actinically damaged skin reportedly have a low incidence of metastasis or deep invasion, failure to recognize this potential mode of spread could result in fatal consequences.
Frigipoint: A New Cryosurgical Instrument
Authors: KARAKASHIAN GARY V. , SWEREN RONALD J.
Published: June 2013

Abstract. Frigipoint, a new handheld dipstick cryoprobe, will be introduced. This apparatus has three components: (1) a thermal conductive housing chamber (reservoir) tapered to tips with diameters of 2–10 mm (applicator); (2) a cryogen absorbent member within the housing chamber; and (3) a low‐thermal conductivity handle, which is threaded onto the housing chamber. Laboratory experiments employing a gelatin medium showed that the delivery of the cryogen is uniform over the area of application, producing a flat‐bottom ice ball. In animal studies, liquid nitrogen spray produced greater depth of destruction and inflammation than Frigipoint. In preliminary clinical studies, 68 lesions, including actinic keratosis, molluscum contagiosum, verruca plana, solar lentigo, seborrheic keratosis, and verruca vulgaris, were treated in 16 patients. All but one resolved after cryosurgery with Frigipoint. Frigipoint is an effective, safe, and easily portable cryosurgical instrument that has a wide spectrum of dermatologic applications. It provides efficient, well‐controlled focal cryosurgical treatment of multiple lesions with one immersion of the probe in liquid nitrogen. In addition, its simple operation is met with high patient and physician acceptance.
Refinements of the Island Median Forehead Flap for Reconstruction of the Medial Canthal Area
Authors: SAKAI SHIGENOBU , SOEDA SHUGO , MATSUKAWA ATARU
Published: June 2013

Abstract. Extensive excision of malignant tumors in the medial portion of the eyelids involving the medial canthal tendon and orbicularis oculi muscle results in the lateral displacement of the eyelids and forward drift of the medial canthal region during the healing process if they are not repaired. We present three successful cases of reconstruction of an extensive defect in the medial portion of the eyelids by the island median forehead flap with frontal muscle and frontal galea aponeurotica to repair the medial canthal tendon and orbicularis oculi muscle. This improved technique successfully avoids lateral displacement of the eyelids and forward drift of the medial canthal region, and is a treatment choice for the extensive medial canthal defect.
Pseudoepitheliomatous Hyperplasia Following Mohs Micrographic Surgery
Authors: WEBER PAUL J. , JOHNSON BERNETT L. , DZUBOW LEONARD M.
Published: June 2013

Abstract. Pseudoepitheliomatous hyperplasia may arise secondarily in a number of cutaneous disorders. Herein we discuss this entity and describe its occurrence in a post Mohs micrographic surgery wound. We will also relate the subsequent histopathologic confusion engendered by its presence.
Oral Condyloma Acuminatum
Authors: ZUNT SUSAN L. , TOMICH CHARLES E.
Published: June 2013

Abstract. Fifty‐one cases of oral condyloma acuminatum are reported, bringing the total number in the English medical/dental literature to approximately 156 cases. Ninety‐five percent of the 59 new cases were in males. Eighty‐one percent occurred in the age range of 21–40 years. The most common locations were upper lip, lingual frenum, dorsum of the tongue, and lower lip. Thirty‐four percent presented with multiple lesions.
Advances in Diagnostic Technique
Authors: ROGERS GARY S.
Published: June 2013

Technetium‐Labeled Monoclonal Antibodies for Imaging Metastatic Melanoma: Results of a Multicenter Clinical Study. D Salk and the Multicenter Study Group. Semin Oncol 15:608–616, 1988.
Cryosurgical Treatment of Nodular Neurodermatitis with Refrigerant 12
Authors: McDOW RONALD A. , WESTER MARY M.
Published: June 2013

Abstract. Neurodermatitis is a relatively common skin condition characterized by patches of scaly, pruritic skin in one or more of several classic locations. It can be treated with cryosurgery using Refrigerant 12 with successful clinical and aesthetic results.
Treatment of Pseudomonas aeruginosa Auricular Perichondritis with Oral Ciprofloxacin
Authors: NOEL STELLA BOUSTANY , SCALLAN PERRY , MEADORS MICHAEL C. , MEEK TOM J. , PANKEY GEORGE A.
Published: June 2013

Abstract. Pseudomonas aeruginosa auricular perichondritis can be a serious and expensive postoperative infection requiring prolonged hospitalization and intravenous administration of antibiotics. Oral antimicrobial agents have not been effective in the treatment of serious P. aeruginosa infections. Recently completed clinical trials have shown that oral ciprofloxacin, one of the new fluoroquinolone antimicrobials, is effective in the treatment of certain P. aeruginosa infections. We report two cases of P. aeruginosa auricular perichondritis successfully treated as outpatients with oral ciprofloxacin. This article also reviews the salient features of the new fluoroquinolones and their impact on antimicrobial therapy of serious skin and skin‐structure infections.
A recipe for revolution: Could 1968 happen today?
Authors: Gildea Robert
Published: June 2013

Historian Robert Gildea looks back at the actions and consequences of 1968, and asks whether modern protest movements have the means and motivation to spark a revolutionary repeat.
Editorial: Are you speaking my language? Raising awareness of language learning impairments in developmental psychopathology
Authors: Norbury Courtenay Frazier
Published: June 2013

Language impairments affect 3–7% of the population (Norbury & Paul, 2013), yet receive very little public attention, research interest or research funding (Bishop, 2010). This is quite surprising given that language is central to our everyday lives; we use language to learn and to work, to communicate with our friends and loved ones and to access leisure activities such as reading and television. Additionally, language is a fantastic resource for problem solving, negotiating and managing our thoughts, feelings and behaviour.
Stress‐related Responses in Alexandrium tamarense Cells Exposed to Environmental Changes
Authors: Jauzein Cecile , Erdner Deana L.
Published: June 2013

Organisms tend to be sensitive to drastic changes in environmental conditions. For unicellular microorganisms, variations in physico‐chemical conditions are particularly challenging and may result in acclimation, entrance into quiescence, or death through necrotic or autocatalytic pathways. This study focuses on the thecate dinoflagellate Alexandrium tamarense. Cellular responses to oxidative, thermal, and nutrient stress were characterized using stress indicators, such as pigment content, efficiency of photosystem II or production of reactive oxygen species (ROS), as well as hallmarks of apoptosis including activity of caspase‐like enzymes and expression of a metacaspase gene homolog. The formation of temporary cysts, a survival strategy of short‐term quiescence, was also monitored. Cellular responses appeared to depend on multifactorial influences where type and intensity of stimulus as well as position in cell cycle may act in combination. Sequences of events observed implicate ROS production as a key determinant of stress‐related pathways, playing potential roles in intracellular signaling, formation of temporary cysts, or cellular damage. Variations observed in caspase‐like activities and metacaspase gene expression did not appear to be associated with programmed cell death pathways; our results suggest a wider range of functions for these proteases in phytoplankton cells, including roles in survival pathways and cell cycle progression.