bluuebunny/crossref_metadata_2025 huggingface dataset:
DEcompressive Surgery plus hypoTHermia for Space-Occupying Stroke (DEPTH-SOS): A Protocol of a Multicenter Randomized Controlled Clinical Trial and a Literature Review
Authors: Neugebauer Hermann , Kollmar Rainer , Niesen Wolf-Dirk , Bösel Julian , Schneider Hauke , Hobohm Carsten , Zweckberger Klaus , Heuschmann Peter U. , Schellinger Peter D. , Jüttler Eric ,   for the DEPTH-SOS Study Group and the IGNITE Study Group
Published: June 2013

Rationale

Although decompressive hemicraniectomy clearly reduces mortality in severe space-occupying middle cerebral artery infarction (so-called malignant middle cerebral artery infarction), every fifth patient still dies in the acute phase and every third patient is left with moderate to severe disability. Therapeutic hypothermia is a neuroprotective and antiedematous treatment option that has shown promising effects in severe stroke. A combination of both treatment strategies may have the potential to further reduce mortality and morbidity in malignant middle cerebral artery infarction, but needs evaluation of its efficacy within the setting of a randomized clinical trial.

Aims

The DEcompressive surgery Plus hypoTHermia for Space-Occupying Stroke (DEPTH-SOS) trial aims to investigate safety and feasibility of moderate therapeutic hypothermia (33°C ± 1) over at least 72 h in addition to early decompressive hemicraniectomy (≤48 hours after symptom onset) in patients with malignant middle cerebral artery infarction.

Design

The DEcompressive surgery Plus hypoTHermia for Space-Occupying Stroke is a prospective, multicenter, open, two-arm (1:1) comparative, randomized, controlled trial.

Study outcomes

The primary end-point is mortality at day 14. The secondary end-points include functional outcome at day 14 and at 12 months follow-up, and complications related to hypothermia.

Discussion

The results of this trial will provide data on safety and feasibility of moderate hypothermia in addition to decompressive hemicraniectomy in malignant middle cerebral artery infarction. Furthermore, efficacy data on early mortality and long-term functional outcome will be obtained, forming the basis of subsequent trials.
Breaking hospitality apart: bad hosts, bad guests, and the problem of sovereignty
Authors: SHRYOCK ANDREW
Published: June 2013

Talk of hospitality often turns to the problem of bad guests and bad hosts. This trend holds whether the speakers are Balga Bedouin in Jordan or political theorists in Europe, and it would seem that bad hospitality accumulates in the gaps created by shifts in scale, as houses absorb other houses, or nation‐states and their citizens compete to control the concepts and practices that define house, host, and guest. Moving from Bedouin history to metropolitan political theory, I show how bad hosts and guests break hospitality apart, revealing its component parts and how they work.

Quand on parle d'hospitalité, que ce soit avec des Bédouins Balga en Jordanie ou avec des politologues européens, le débat s'oriente souvent vers le problème des mauvais hôtes et des mauvais invités. C'est à croire que la mauvaise hospitalité s'accumule dans les vides créés par les changements d'échelle, lorsque les maisons absorbent d'autres maisons, lorsque les États‐nations et leurs citoyens se font concurrence pour contrôler les concepts et les pratiques qui définissent la maison, l'hôte et l'invité. Passant de l'histoire des Bédouins à la théorie politique métropolitaine, je montrerai ici comment les mauvais hôtes et les mauvais invités déconstruisent l'hospitalité, révélant ses composantes et leur manière de fonctionner.
Sympathy and suspicion: torture, asylum, and humanity
Authors: Kelly Tobias
Published: June 2013

This article examines the assessment of claims about torture in the British asylum process. It is compassion in the face of suffering that underlies much of the ethical objection to torture. Yet, at the same time, torture survivors, as with asylum seekers more broadly, are subjected to widespread suspicions about the genuineness of their claims. This article argues that the very process of imagined identification found in compassion can lie behind suspicion. Anthropology has largely treated otherness as a cause of fear and suspicion. However, the denial of another's suffering is not always about a failure to recognize mutual humanity. It can also be a product of a sense of fundamental similarity, based on assumptions about the mutual capacity to dissimulate. Ultimately, though, scepticism is on just as shaky ground as belief, as it is filtered through the lens of imagined identification. Denial is just as vicarious as acknowledgement.
The Treatment of Atypical Lipoma with Liposuction
Authors: SHARMA PARMOD K. , JANNIGER CAMILA K. , SCHWARTZ ROBERT A. , RAUSCHER GREGORY E. , CLARK LAMBERT W.
Published: June 2013

Large lipomas may best be treated with liposuction. Once a lipoma enlarges to 4 cm or more, liposuction has several advantages over conventional surgery. A well‐demarcated lipoma 15 cm in diameter and deep to muscle was treated by liposuction. Biopsy showed an atypical lipoma. Because the entire tumor was removed by liposuction, we feel that the prognosis is excellent. The cosmesis and morbidity results were far superior to those anticipated with conventional exci‐sional surgery. Small superficial lipomas may be treated by suction lipectomy and the surrounding area can be contoured symmetrically at the same time, whereas large ones can be liposuctioned completely without extensive surgical extirpation and morbidity. Because such big lesions may represent atypical lipomas or liposarcomas, care must be taken to remove the entire tumor.
Extensive Bowen's Disease of the Penile Shaft Treated with Fresh Tissue Mohs Micrographic Surgery in Two Separate Operations
Authors: MORITZ DEBORAH L. , LYNCH WILLIAM S.
Published: June 2013

Bowen's disease or squamous cell carcinoma in situ is uncommon on the penile shaft. While surgical excision is the treatment of choice, the Mohs micrographic surgical approach ensures microscopically controlled tumor‐free margins with preservation of normal tissue. While small‐ or medium‐sized penile excisions heal very well by second intention, large areas of involvement are often grafted to prevent debilitating contractures. We report a case of near circumferential penile Bowen's disease treated by two separate operations that healed by second intention with very good cosmetic and functional results.
Lip Augmentation with Silicone
Authors: ALKEK DAVID S. , GEM SURGICAL
Published: June 2013

More and more patients are coming to cosmetic and dermatologic surgeons for augmentation of their lips. Filling substances are ideal for this procedure. Silicone is the best filling substance for several reasons. Careful attention to technique and aesthetics will reward both patient and doctor.
Macrocheiloplasty
Authors: FIELD LAWRENCE M.
Published: June 2013

Enlarged configurations of one or both lips from hereditary and racial differences are common phenomena. Congenital anamolies and acquired malformations are more unusual. The author reviews the principles of lip size reduction, and demonstrates photographically the serial steps necessary to accomplish that goal on the lower lip.
Treatment of Porokeratosis of Mibelli with CO2 Laser Vaporization Versus Surgical Excision with Split‐Thickness Skin Graft
Authors: RABBIN PHOEBE E. , BALDWIN HILARY E.
Published: June 2013

BACKGROUND. Porokeratosis of Mibelli has been treated with many topical surgical modalities in the past, including cold steel surgical excision and CO2 laser excision. We report a patient with an 8 × 10 cm2 plaque of porokeratosis on the dorsum of his hand, fingers, and web spaces.

OBJECTIVE. To compare the treatment results of CO2 laser vaporization versus cold steel surgical excision with split‐thickness skin graft placement.

METHOD. The portions of the lesion overlying the metacarpophalangeal joints, fingers, and web spaces were treated with CO2 laser vaporization. The remainder of the lesion covering the dorsum of the hand was excised with cold steel, followed by placement of a split‐thickness skin graft over that area.

RESULTS. The portion of the porokeratosis lesion treated with CO2 vaporization healed with results cosmetically and functionally superior to the grafted area.

CONCLUSION. Carbon dioxide laser vaporization, a more superficial treatment modality than CO2 laser excision, should be the preferred treatment modality for porokeratosis lesions.
Glycolic Acid Peels for the Treatment of Wrinkles and Photoaging
Authors: MOY LAWRENCE S. , MURAD HOWARD , MOY RONALD L.
Published: June 2013

BACKGROUND. Glycolic acid is an alpha hydroxyacid that is useful as a chemical peeling agent.

OBJECTIVE. To discuss the techniques using glycolic acid to remove actinic keratoses, fine wrinkles, lentigines, melasma, and seborrheic keratoses.

METHOD. Applied in a carefully timed manner, the depth of penetration can be titrated by the timed duration of application of acid on the skin. Chemical peels are left on the skin for 3 to 7 minutes for most patients. For ideal results, the chemical peel can be repeated 3 to 4 times.

RESULT. Glycolic acid can easily be used to peel skin of all skin types with minimal risk.

CONCLUSION. We have found glycolic acid can be an ideal adjunct to other cosmetic modalities such as soft tissue augmentation.
Collagen Gene Expression and Wound Strength in Normal and Radiation‐Impaired Wounds
Authors: BERNSTEIN ERIC F. , SALOMON GARY D. , HARISIADIS LEON , TALBOT THOMAS , HARRINGTON FRANK , RUSSO ANGELO , UITTO JOUNI
Published: June 2013

background. Poorly healing wounds result in significant morbidity postoperatively. Numerous attempts have been made to study wound healing in vivo to understand better the normal healing process and factors that impair healing. Animal models of wound healing have been developed to evaluate wound healing in a systematic and controlled setting. Incisional wounds are created in animals to mimic the surgical patient. They may then be evaluated by a variety of methods for degree of healing.

objective. To give insight into the mechanisms of wound healing impairment, we developed a model of impaired wound healing in guinea pigs using radiation applied to the skin surfaces only.

methods. Wound bursting strength, a direct measure of the force required to burst apart healing linear incisions, was measured. Collagen content, measured indirectly as collagen gene expression, was measured.

results. Significant reductions in wound bursting strength were noted after radiation administration. Collagen gene expression was decreased in wounds 7 days after radiation, but recovered to control levels 14 days after irradiation. Our model enables the inclusion of irradiated and unirradiated skin flaps within the same animal, thus eliminating intra‐animal variation when comparing impaired and normal wounds.

conclusion. Wound bursting strength analysis, combined with techniques aimed at elucidating changes at the molecular level, provides a useful tool for the study of factors that impair healing and potential treatments for resulting healing deficits.
Klippel‐Trenauny Syndrome and Cutaneous Carcinomas
Authors: SALMAN SALAH M. , PHILLIPS TANIA , ROGERS GARY S.
Published: June 2013

A patient with Klippel‐Trenaunay syndrome who developed basal cell and squamous cell carcinomas on the limb affected by the vascular malformation, is reported. The nature of this association is discussed.
Transcranial Eosinophilic Granuloma Manifested by a Subcutaneous Scalp Mass
Authors: YIANNIAS JAMES A. , BRODLAND DAVID G.
Published: June 2013

background. The differential diagnosis of nodular scalp lesions in a child is surprisingly extensive.

objective. To present a case of eosinophilic granuloma that was manifested by a scalp mass in a pediatric patient.

methods. The case is presented and the relevant literature is reviewed.

conclusions. The seriousness of some of these lesions requires a thorough evaluation, including noninvasive imaging, and carefully planned surgical intervention so that effective diagnosis and treatment are ensured. Surgical exposure of unsuspected central nervous system connections may lead to infection, hemorrhage, seizures, or other significant morbidity and mortality.
Flash Lamp‐Pumped Dye Laser Treatment of Telangiectasia
Authors: RUIZ‐ESPARZA JAVIER , GOLDMAN MITCHEL P. , FITZPATRICK RICHARD E. , LOWE NICHOLAS J. , BEHR KATHLEEN L.
Published: June 2013

BACKGROUND. Although many treatment modalities are effective in the treatment of essential telangiectasia, most have a risk of scarring and or incomplete obliteration of the dilated vessels. The Candela flash lamp‐pumped dye laser has been regarded as highly selective for blood vessel ablation with virtually no risk of scarring.

OBJECTIVE. To present a study of 182 patients who underwent this treatment.

RESULTS. Good to excellent response was seen in 97.5% of these patients. No scars were seen in any of the patients studied. Patients described the degree of discomfort as mild to moderate and found the post‐treatment purpura an acceptable phase of healing, if advised preoperatively.

CONCLUSION. We found the laser to be safe and effective in the treatment of facial telangiectasia.
Histology and Physiology of Tissue Expansion
Authors: JOHNSON TIMOTHY M. , LOWE LORI , BROWN MARC D. , SULLIVAN MICHAEL J. , NELSON BRUCE R.
Published: June 2013

BACKGROUND: Tissue expansion is a concept based on the skin's natural ability to stretch in response to an underlying force.

OBJECTIVE: The purpose of this article is to review the histological and physiological changes that occur within the soft tissue and underlying structures during tissue expansion.

METHODS: An extensive search of the literature reviewing these changes is summarized herein.

RESULTS: Conventional tissue expansion may result in epidermal hypertrophy, decreased dermal, muscle, and adipose thickness, and bone resorption. A vascular capsule and angiogenesis provides a highly vascular flap and improves flap viability. Few soft tissue changes occur during rapid tissue expansion. The ability of the skin to increase in surface area during conventional tissue expansion is primarily because of biological tissue creep. Rapid expansion may result from mechanical tissue creep.

CONCLUSION: Many soft tissue changes occur during tissue expansion. Most of these changes return to the pre‐expansion state over time following discontinuation of the expansion process.
Tissue Expansion and Mohs Micrographic Surgery
Authors: CARRUTHERS ALASTAIR
Published: June 2013

Tissue expansion is of value in the repair of some defects produced by Mohs micrographic surgery. In particular, defects of the nose, forehead, temple and scalp as well as extensive defects in other areas may require expansion. Tissue expansion should be considered prior to Mohs micrographic surgery in these cases. Intraoperative and rapid expansion are useful adjuncts to other repair options. Complications of expansion are frequent and must be anticipated.
Primary Reconstruction of Congenital Facial Lesion Defects with Tissue Expansion
Authors: FRODEL JOHN L. , WHITAKER DUANE C.
Published: June 2013

BACKGROUND. Congenital facial lesions may require surgical intervention to correct deformity or to decrease the potential for malignant degeneration.

OBJECTIVE. Hemangiomata and melanocytic and sebaceous nevi are among the most common congenital facial defects. The techniques and outcome of serial tissue expansion in the management of facial lesions were evaluated.

METHODS. Seven pediatric patients had congenital facial defects treated with tissue expansion and subsequent excision and reconstruction.

RESULTS. All patients had a satisfactory outcome. Complications are reviewed, and in this patient population were minor.

CONCLUSIONS. Tissue expansion has a role in surgical management of congenital facial lesions. Staged excision, skin grafting and nonintervention are also options which must be individualized to the case at hand. J Dermatol Surg Oncol 1993;19:1110‐1116.
Cool Laser Optics Treatment of Large Telangiectasia of the Lower Extremities
Authors: CHESS CYRUS , CHESS QUINTUS
Published: June 2013

background. Lower extremity telangiectases have been traditionally treated using sclerotherapy. However, because of significant side effects from sclerotherapy, laser treatments have been investigated. Results from laser treatments have been generally unsatisfactory.

objective. This study was based on the premise that simultaneous cooling and lasing would permit more effective treatment.

methods. Thirty lower extremity telangiectases on 13 patients were treated by a technique of simultaneous cooling and lasing. Argon (488/514 nm) and argon dye (577 nm, 585 nm) laser light were delivered through a new cooling device to telangiectatic vessels of approximately 1‐mm diameter on the thigh and leg. Pulsed and continuous beam treatments were utilized at high levels of irradiance.

results. Sixty‐seven percent of treated sites were improved; half of these were completely or nearly completely cleared. There were no complications. In only 2 of 30 (7%) treated sites were there persistent pigmentary changes.

conclusion. These results compare favorably with other methods for treatment of lower extremity telangiectases. Successful treatment of large lower extremity telangiectases by simultaneous cooling and lasing with minimal side effects suggests a reduction of thermal injury to nonvascular tissue while allowing destruction of ectatic vasculature.
A Double‐Blind Placebo Controlled Study of a 5% Lidocaine/Prilocaine Cream (EMLA) for Topical Anesthesia During Thermolysis
Authors: Wagner Richard F. , Flores C. Ann , Argo Lydia F.
Published: June 2013

background. Electrolysis and thermolysis are commonly used electrosurgical methods for the permanent destruction of unwanted hair. However, patient fear of pain during treatment may interfere with or even prevent desired treatment of hirsutism on sensitive areas such as the upper lip.

objective. This study was conducted to assess the efficacy of EMLA (Eutectic Mixture of Local Anesthetics), a 5% lidocaine/prilocaine cream, as a topically applied local anesthetic during thermolysis on the upper lip.

methods. A double‐blind placebo control study was conducted by the University of Texas Medical Branch thermolysis clinic. Thirty women with idiopathic hirsutism of the upper lip were studied. Pain was measured with a 100 mm visual analog scale (VAS).

results. Total paired VAS score differences comparing the placebo VAS scores to the EMLA VAS scores were significant by paired t‐test (P = .0001). Adverse reactions were mild and transient.

conclusion. EMLA cream may have multiple applications to the practice of dermatologic surgery, including topically achieved local anesthesia during thermolysis and electrolysis.
Utility of Topical Benzoyl Peroxide for Prevention of Surgical Skin Wound Infection
Authors: BencinI Pier Luca , Galimberti Michela , Signorini Massimo
Published: June 2013

background. Benzoyl peroxide is a powerful oxiding agent with broad spectrum germicidal activity and good liposolubility. Therefore, it may represent a good agent for prevention of wound infection in areas with high density of sebaceous glands.

objective. The aim of this study was to analyze the effectiveness of topical benzolyl peroxide gel for prevention of surgical skin wound infections in the centrofacial area.

methods. A prospective study was performed on 673 patients. The patients were divided into two groups. Group A, 335 patients, was given no antibacterial prophylaxis. In group B, 338 patients, prophylactic medication with a gel containing 10% benzoyl peroxide was performed once a day for the 7 days before the surgery.

results. Thirteen of 673 patients had wound infections (2.93%). Eleven of these 13 patients were in group A (3.24%) and two were in group B (0.59%) (P < .01).

conclusions. Topical benzoyl peroxide is an efficacious, harmless, and inexpensive agent for prevention of wound infections in seborrheic regions.
Cutaneous Malignancy and Leprosy
Authors: RATOOSH SHERI L. , COHEN PHILIP R. , TRONCOSO PATRICIA
Published: June 2013

background. Leprosy is a chronic systemic infection caused by the bacillus Mycobacterium leprae. Cutaneous neoplasms have been observed in patients with leprosy. Also, albeit less commonly, M. leprae have been documented in the lesions of skin cancer.

objective. To describe a 62‐year‐old man with chronic sun exposure and exposure to armadillos who subsequently developed lepromatous leprosy, to discuss the cutaneous malignancies that have occurred in patients with leprosy, and to review the literature concerning the concurrent presence of an infectious pathogen and a cutaneous neoplasm in the same lesion.

methods. Our patient's basal cell carcinomas were excised, his abdominal plaques were biopsied, and his leprosy infection was treated with dapsone and rifampin. The types of cutaneous malignancies in leprosy patients and infectious pathogens concurrently found in lesions of skin tumors were summarized after evaluating previously published reports.

results. Skin biopsies from our patient demonstrated M. leprae bacilli not only in his abdominal plaques, but also in all of his basal cell carcinoma lesions. Fungal, mycobacterial, and viral pathogens have concurrently been observed in skin lesions of basal cell carcinomas, Kaposi's sarcoma, melanoma, mycosis fungoides, and squamous cell carcinoma.

conclusion. Patients with leprosy can develop skin cancers and the histologic interpretation of those skin cancers can show evidence of leprosy. It is uncertain to what degree the decreased cell‐mediated immunity in patients with lepromatous leprosy either enhances their susceptibility to and/or influences the course of their cutaneous neoplasms; also, in these patients, the coexistence ofM. leprae organisms and cutaneous malignancy in the same lesion is likely to be secondary to the high bacillary load that is present.
A Reevaluation of the Effect of Occlusion on the Trichloroacetic Acid Peel
Authors: PEIKERT JOHANN M. , KAYE VALDA N. , ZACHARY CHRISTOPHER B.
Published: June 2013

background. Prior studies have demonstrated reduced wounding with trichloracetic acid (TCA) peels after tape occlusion. It is therefore reasonable to question whether or not other types of occlusion may have similar effects, particularly those used in routine postoperative care.

objective. To reevaluate the effect of occlusion after TCA peels in multiple human models using various forms of dressings, at various times postoperatively, and to make recommendations regarding wound care that will not adversely affect the efficacy of the peel.

methods. Equal‐sized sections of anterior alopecic scalps of four patients were peeled with 50% TCA, occluded with bacitracin, Vigilon, or Tegaderm at various times postoperatively, and biopsied 1 day later. Depths of necrosis were measured and compared with nonoccluded controls.

results. Bacitracin ointment and Vigilon did not lessen TCA wounding, and sometimes actually enhanced it. Conversely, Tegaderm lessened the degree of the TCA wound. Timing of application played a role in the case of occlusion with Vigilon.

conclusion. Occlusives used in conjunction with TCA peels do not have a uniform effect on depth of necrosis. Ointments and Vigilon can be used without reducing the efficacy of the TCA peel. Multiple subjects and rigid control of variables are necessary in studies of TCA‐induced necrosis.
Cutaneous and Subcutaneous Endometriosis
Authors: PURVIS ROBERT S. , TYRING STEPHEN K.
Published: June 2013

background. Cutaneous or subcutaneous endometriosis is a rare entity that should be suspected in any female presenting with cyclic pain emanating from a mass in the vicinity of an abdominal surgical scar or the umbilicus.

objective. The purpose of this report is to examine the diagnostic procedures for endometriosis and to review the therapeutic value of surgical excision alone or in combination with hormonal treatment.

methods. Endometriosis presenting cutaneously in an infraumbilical laparoscopy scar and endometriosis occurring subcutaneously in a cesarean section scar were both diagnosed via incisional biopsy. Both lesions were treated with hormonal therapy followed by surgical excision.

results. Hormonal therapy with danazol or with leuprolide resulted in reduction of symptoms but was associated with amenorrhea in both cases and with dyspareunia in the second patient. Subsequent laparoscopy and surgical excision of the endometrioma were curative.

conclusion. Preoperative hormonal therapy, although sometimes associated with such side effects as amenorrhea, may be used in cases of large endometriotic masses to reduce the size of the surgical defect, but surgical excision remains the treatment of choice.
Hypertonic Saline Destruction of Multiple Glomus Tumors
Authors: SIEGLE RONALD J. , SPENCER DAVID M. , DAVIS LORETTA S.
Published: June 2013

background. Multiple glomus tumors are uncommon cutaneous neoplasms. Therapeutic destructive alternatives include excision, argon or CO2 laser treatment, and sclerotherapy with sodium tetradecyl sulphate.

objective. A case report is presented using a previously unreported technique of therapy, specifically hypertonic saline.

methods. 23.4% NaCl was injected intraluminally in four sessions over a 6‐month period.

conclusion. Serial hypertonic saline injections should be added to the list of effective treatment alternatives for multiple glomus tumors.
The Efficacy of Various Degreasing Agents Used in Trichloroacetic Acid Peels
Authors: PEIKERT JOHANN M. , KRYWONIS NANCY A. , REST ELLEN B. , ZACHARY CHRISTOPHER B.
Published: June 2013

background. Adequate preparation of the skin is necessary for a successful chemical peel. Little detailed attention has been given to the effect of degreasing on the efficacy of the peel.

objective. To assess the influence of degreasers on the peel, compare their flammabilities, and discuss alternatives.

methods. Six patients with androgenetic alopecia and wide‐spread actinic keratoses of the scalp were treated with 35% trichloroacetic acid. Scalps were divided into sections and degreased with acetone, rubbing alcohol, Freon Skin Degreaser, or Hibiclens. The influence of these degreasers on trichloroacetic acid peels was assessed by clinical and histologic examination.

conclusion. Acetone was not found to be superior to the other agents. Furthermore, the flashpoint of acetone is markedly lower than the others, making it more flammable and hazardous in the workplace. The use of alternative degreasers may lessen or eliminate this hazard.
Venoscopic Obliteration of Variceal Tributaries Using Monopolar Electrocautery
Authors: GRADMAN WAYNE S.
Published: June 2013

background. Retrograde saphenous venoscopy has a diagnostic and potentially therapeutic role in the treatment of truncal varices.

objective. To determine whether venoscopic electrocautery of saphenous vein tributaries can eliminate reflux into varices and reduce the need for further variceal evulsion or sclerotherapy.

methods. Twelve patients with truncal varices underwent ligation of the saphenofemoral junction, retrograde venoscopy of the saphenous vein trunk, and endoscopic electrocautery obliteration of selected tributaries and varices.

results. Postoperative color‐flow duplex studies revealed that the saphenous vein trunk was completely preserved in nine patients (75%). Portions of three saphenous vein trunks (25%) near the cannulated tributaries were thrombosed. Four patients (33.3%) did not require further sclerotherapy. These four patients usually had a cluster of varices arising from a single tributary that lay close to the saphenous vein. Seven of the eight remaining patients (58.3%) reported significant improvement from the operative procedure alone, but required additional treatment with sclerotherapy to make the results satisfactory. One patient (8.3%) experienced little improvement.

conclusion: Venoscopic obliteration of variceal tributaries is feasible and may prove useful in the treatment of truncal varices. In selected patients, 4 of 12 (33.3%), no further treatment with sclerotherapy or evulsion was needed.
The Use of Hyaluronidase as an Adjunct to Surgical Procedures
Authors: CLARK LANI E. , MELLETTE J. RAMSEY
Published: June 2013

background. Although the use of hyaluronidase as an adjunct to anesthesia is frequently described for plastic surgery and ophthalmologic procedures, its use in dermatologic surgery has not been well investigated.

objective. In this report we review the advantages and disadvantages of using hyaluronidase in dermatologic procedures.

methods. The effect of adding hyaluronidase to local anesthesia was evaluated in 72 Operations performed over a 1‐year period.

results. Although the duration of anesthesia is slightly decreased, the addition of hyaluronidase to local anesthesia offers the benefits of minimizing loss of surface contour and enhanced ease in undermining and dissection through subeutaneous tissue planes. The onset of anesthesia using hyaluronidase is immediate and the area of anesthesia appears increased over anesthesia without hyaluronidase.

conclusion. We therefore recommend the adjunct of hyaluronidase to local anesthesia as a useful advancement in surgical technique.
The Price of Anarchy — On the Roads and in Football
Authors: Skinner Brian , Carlin Brad
Published: June 2013

City traffic can sometimes move faster when a road is closed. A football team can sometimes play better without its best player. The two are linked. Anarchy say Brian Skinner and Brad Carlin, is freedom to be counterproductive.
Intravenous Thrombolysis for Acute Ischemic Stroke Patients Presenting with Mild Symptoms
Authors: Strbian Daniel , Piironen Katja , Meretoja Atte , Sairanen Tiina , Putaala Jukka , Tiainen Marjaana , Artto Ville , Rantanen Kirsi , Häppölä Olli , Kaste Markku , Lindsberg Perttu J. ,   for the Helsinki Stroke Thrombolysis Registry Group
Published: June 2013

Background

Thrombolysis of ischemic stroke patients presenting with mild symptoms is controversial.

Aim

We aimed to describe the clinical outcome and frequency of infarcts and symptomatic intracerebral hemorrhages on follow-up imaging of such thrombolysis-treated patients.

Methods

Our cohort included 1398 consecutive ischemic stroke patients treated with intravenous thrombolysis at the Helsinki University Central Hospital, years 1995–2010. We analyzed the patients according to baseline National Institutes of Health Stroke Scale: ≤2, 3–4, 5–6, and >6. In our institution, visualization of an artery occlusion or perfusion deficit is required for thrombolysis with National Institutes of Health Stroke Scale ≤ 2. We used univariate and multivariable methods to describe the cohort and study associations between the variables. Excellent three-month outcome was defined as modified Rankin Scale 0–1.

Results

Fifty-eight (4·1%) patients were treated with National Institutes of Health Stroke Scale ≤ 2, another 194 (13·6%) with 3–4 points, and 236 (16·5%) with 5–6 points. With National Institutes of Health Stroke Scale ≤ 2, 45 (78%) of the patients had excellent three-month outcome, achieved in 116 (59%) patients with National Institutes of Health Stroke Scale 3–4, in 130 (55%) with National Institutes of Health Stroke Scale 5–6, and in 241 (26%) with National Institutes of Health Stroke Scale > 6. Frequencies of symptomatic intracerebral hemorrhage (European Cooperative Acute Stroke Study-2) were 0%, 2·6%, 2·1%, and 8·1%, and visible infarcts on follow-up imaging 48%, 43%, 48%, and 74%, respectively. In patients with baseline National Institutes of Health Stroke Scale ≤ 6, poor outcome was associated with previous stroke, diabetes, elevated admission blood glucose, and development of intracerebral hemorrhage.

Conclusions

Half of patients presenting with National Institutes of Health Stroke Scale 0–6 developed an infarction despite thrombolysis, and 40% had poor outcome, which was associated with glucose metabolism and hemorrhagic complications. Managing thrombolysis candidates with mild symptoms warrants individual consideration often supported by multimodal imaging.
Finding the Benefits: Estimating the Impact of The South African Child Support Grant
Authors: Coetzee Marisa
Published: June 2013

This paper estimates the impact of the South African Child Support Grant (CSG) on child health, nutrition and education. Data from the 2008 South African National Income Dynamics Study are used to estimate the impact of the CSG on six different outcomes measuring child well‐being. We find a positive treatment effect of the CSG on children's height‐for‐age, progress through the school system, as well as household expenditure on food items using a continuous treatment estimator developed by Hirano and Imbens. Robustness analysis using the inverse probability weighting approach by Flores and Mitnik is also implemented. Although these estimates provide some evidence of a positive impact resulting from the CSG, they are not conclusive in showing that the cash transfers are spent mainly on improving the lives of beneficiary children, as the treatment effects are quite small.
African Stock Markets: Efficiency and Relative Predictability
Authors: Smith Graham , Dyakova Aneta
Published: June 2013

The weak form of the efficient markets hypothesis is tested for eight African stock markets using three finite‐sample variance ratio tests. A rolling window captures short‐horizon predictability, tracks changes in predictability and is used to rank markets by relative predictability. These stock markets experience successive periods when they are predictable and then not predictable; this is consistent with the adaptive markets hypothesis. The degree of predictability varies widely: the least predictable African stock markets are those located in Egypt, South Africa and Tunisia, while the most predictable are in Kenya, Zambia and Nigeria.
GDP in the Dutch Cape Colony: The National Accounts of a Slave‐Based Society
Authors: Fourie Johan , van Zanden Jan Luiten
Published: June 2013

New estimates of the gross domestic product of the Dutch Cape Colony (1652‐1795) suggest that the Cape was one of the most prosperous regions during the eighteenth century. This stands in sharp contrast to the perceived view that the Cape was an “economic and social backwater,” a slave economy with slow growth and little progress. Following a national accounts framework, we find that Cape settlers' per capita income is similar to the most prosperous countries of the time – Holland and England. We trace the roots of this result, showing that it is partly explained by a highly skewed population structure and very low dependency ratio of slavery, and attempt to link the eighteenth‐century Cape Colony experience to twentieth‐century South African income levels.
Solving the Robot-World/Hand-Eye Calibration Problem Using the Kronecker Product
Authors: Shah Mili
Published: June 2013

This paper constructs a separable closed-form solution to the robot-world/hand-eye calibration problem AX = YB. Qualifications and properties that determine the uniqueness of X and Y as well as error metrics that measure the accuracy of a given X and Y are given. The formulation of the solution involves the Kronecker product and the singular value decomposition. The method is compared with existing solutions on simulated data and real data. It is shown that the Kronecker method that is presented in this paper is a reliable and accurate method for solving the robot-world/hand-eye calibration problem.
BigBrain: An Ultrahigh-Resolution 3D Human Brain Model
Authors: Amunts Katrin , Lepage Claude , Borgeat Louis , Mohlberg Hartmut , Dickscheid Timo , Rousseau Marc-Étienne , Bludau Sebastian , Bazin Pierre-Louis , Lewis Lindsay B. , Oros-Peusquens Ana-Maria , Shah Nadim J. , Lippert Thomas , Zilles Karl , Evans Alan C.
Published: June 2013

Reconstructing the Human Brain

Reference brains have become a standard tool in human brain research. Reference brains presently in the public domain provide a spatial framework at the macroscopic level.

Amunts
et al.

(p.
1472
) present a high-resolution (20 µm) three-dimensional reconstruction of a human brain. The tool will be freely available to help with interpreting functional neuroimaging studies, fiber tract analyses, and assigning molecular and gene expression data.
A Consortium of Aggregatibacter actinomycetemcomitans, Streptococcus parasanguinis, and Filifactor alocis Is Present in Sites Prior to Bone Loss in a Longitudinal Study of Localized Aggressive Periodontitis
Authors: Fine Daniel H. , Markowitz Kenneth , Fairlie Karen , Tischio-Bereski Debbie , Ferrendiz Javier , Furgang David , Paster Bruce J. , Dewhirst Floyd E.
Published: June 2013

Aggregatibacter actinomycetemcomitans-induced localized aggressive periodontitis (LAP) in African-American adolescents has been documented but is poorly understood. Two thousand fifty-eight adolescents aged 11 to 17 years were screened for their periodontal status and the presence ofA. actinomycetemcomitansin their oral cavity. Seventy-oneA. actinomycetemcomitans-negative and 63A. actinomycetemcomitans-positive periodontally healthy subjects were enrolled, sampled, examined, and radiographed yearly for 3 years. Gingival and periodontal pocket depth and attachment levels were recorded. Disease presentation was characterized by bone loss (BL). Subgingival sites were sampled every 6 months to assess (i) the role ofA. actinomycetemcomitansin BL and (ii) the association ofA. actinomycetemcomitansand other microbes in their relationships to BL. Sixteen of 63 subjects withA. actinomycetemcomitansdeveloped BL (the other 47 subjects withA. actinomycetemcomitanshad no BL). NoA. actinomycetemcomitans-negative subjects developed BL. Human oral microbe identification microarray (HOMIM) was used for subgingival microbial assessment. On a subject level, pooled data fromA. actinomycetemcomitans-positive subjects who remained healthy had higher prevalences ofStreptococcusandActinomycesspecies, whileA. actinomycetemcomitans-positive subjects with BL had higher prevalences ofParvimonas micra,Filifactor alocis,A. actinomycetemcomitans, andPeptostreptococcussp. human oral taxon 113 (HOT-113). At vulnerable sites,A. actinomycetemcomitans,Streptococcus parasanguinis, andF. alocislevels were elevated prior to BL. In cases where the three-organism consortium (versusA. actinomycetemcomitansalone) was detected, the specificity for detecting sites of future BL increased from 62% to 99%, with a sensitivity of 89%. We conclude that detecting the presence ofA. actinomycetemcomitans,S. parasanguinis, andF. alocistogether indicates sites of future BL in LAP. A synergistic interaction of this consortium in LAP causation is possible and is the subject of ongoing research.
Analysis of Inteins in the Candida parapsilosis Complex for Simple and Accurate Species Identification
Authors: Prandini Tâmara Heloísa Rocha , Theodoro Raquel Cordeiro , Bruder-Nascimento Ariane C. M. O. , Scheel Christina M. , Bagagli Eduardo
Published: June 2013

Inteins are coding sequences that are transcribed and translated with flanking sequences and then are excised by an autocatalytic process. There are two types of inteins in fungi, mini-inteins and full-length inteins, both of which present a splicing domain containing well-conserved amino acid sequences. Full-length inteins also present a homing endonuclease domain that makes the intein a mobile genetic element. These parasitic genetic elements are located in highly conserved genes and may allow for the differentiation of closely related species of the
Candida parapsilosis
(psilosis) complex. The correct identification of the three psilosis complex species
C. parapsilosis
,
Candida metapsilosis
, and
Candida orthopsilosis
is very important in the clinical setting for improving antifungal therapy and patient care. In this work, we analyzed inteins that are present in the vacuolar ATPase gene
VMA
and in the threonyl-tRNA synthetase gene
ThrRS
in 85 strains of the
Candida
psilosis complex (46
C. parapsilosis
, 17
C. metapsilosis
, and 22
C. orthopsilosis
). Here, we describe an accessible and accurate technique based on a single PCR that is able to differentiate the psilosis complex based on the VMA intein. Although the ThrRS intein does not distinguish the three species of the psilosis complex by PCR product size, it can differentiate them by sequencing and phylogenetic analysis. Furthermore, this intein is unusually present as both mini- and full-length forms in
C. orthopsilosis
. Additional population studies should be performed to address whether this represents a common intraspecific variability or the presence of subspecies within
C. orthopsilosis
.
Reliability of Automated Biochemical Identification of Burkholderia pseudomallei Is Regionally Dependent
Authors: Podin Yuwana , Kaestli Mirjam , McMahon Nicole , Hennessy Jann , Ngian Hie Ung , Wong Jin Shyan , Mohana Anand , Wong See Chang , William Timothy , Mayo Mark , Baird Robert W. , Currie Bart J.
Published: June 2013

Misidentifications of
Burkholderia pseudomallei
as
Burkholderia cepacia
by Vitek 2 have occurred. Multidimensional scaling ordination of biochemical profiles of 217 Malaysian and Australian
B. pseudomallei
isolates found clustering of misidentified
B. pseudomallei
isolates from Malaysian Borneo. Specificity of
B. pseudomallei
identification in Vitek 2 and potentially other automated identification systems is regionally dependent.
An Intact Sialoadhesin (Sn/SIGLEC1/CD169) Is Not Required for Attachment/Internalization of the Porcine Reproductive and Respiratory Syndrome Virus
Authors: Prather Randall S. , Rowland Raymond R. R. , Ewen Catherine , Trible Benjamin , Kerrigan Maureen , Bawa Bhupinder , Teson Jennifer M. , Mao Jiude , Lee Kiho , Samuel Melissa S. , Whitworth Kristin M. , Murphy Clifton N. , Egen Tina , Green Jonathan A.
Published: June 2013

Surface expression of SIGLEC1, also known as sialoadhesin or CD169, is considered a primary determinant of the permissiveness of porcine alveolar macrophages for infection by porcine reproductive and respiratory syndrome virus (PRRSV).In vitro, the attachment and internalization of PRRSV are dependent on the interaction between sialic acid on the virion surface and the sialic acid binding domain of theSIGLEC1gene. To test the role of SIGLEC1 in PRRSV infection, aSIGLEC1gene knockout pig was created by removing part of exon 1 and all of exons 2 and 3 of theSIGLEC1gene. The resulting knockout ablated SIGLEC1 expression on the surface of alveolar macrophages but had no effect on the expression of CD163, a coreceptor for PRRSV. After infection, PRRSV viremia inSIGLEC1−/−pigs followed the same course as inSIGLEC1−/+andSIGLEC1+/+littermates. The absence of SIGLEC1 had no measurable effect on other aspects of PRRSV infection, including clinical disease course and histopathology. The results demonstrate that the expression of theSIGLEC1gene is not required for infection of pigs with PRRSV and that the absence of SIGLEC1 does not contribute to the pathogenesis of acute disease.
The growing value of age: exploring economic gains from age-specific harvesting in the Northeast Arctic cod fishery
Authors: Diekert Florian K.
Published: June 2013

The importance of a fish stock’s age structure is increasingly recognized in economics and ecology. Still, current policies predominately rely on measures of the aggregate biomass. Here, a detailed bio-economic model is calibrated on the Northeast Arctic cod (Gadus morhua) fishery to assess the efficiency gains from controlling gear selectivity and explore them under a suite of different scenarios. While the absolute size of economic gains varies drastically with the particular biological modeling assumptions, the relative economic gains from age-differentiated management show that it is high time to move beyond traditional reference points.
RADIAL MEASUREMENTS OF GAS DISCHARGE PARAMETERS OF ATMOSPHERIC PRESSURE MICROPLASMA
Authors: CAETANO R. , HOYER Y. D. , BARBOSA I. M. , GRIGOROV K. G. , SISMANOGLU B. N.
Published: June 2013

In this work Abel inversion technique was used for radial measurements of the microplasma in Ar-2%H2 flow at open atmosphere. The gas discharge parameters were investigated using spatially resolved high resolution optical emission spectroscopy (OES) to allow acquisition of OH (A 2Σ+, ν = 0 →X 2Π, ν′ = 0) rotational bands at 306.357 nm, Ar I 603.213 nm line and N2(C3∏u, ν = 0 →B3∏g, ν′ = 0) second positive system with the band head at 337.13 nm. The nonthermal plasma was generated between microhollow anode (~500 μm inner diameter) and a cathode copper foil, fed by direct current source for a current ranging from 20 mA to 100 mA (Townsend discharge from 20 mA to 30 mA, normal glow discharge from 30 mA to 80 mA at 210 V and abnormal discharge beyond 90 mA). The 1.5 mm length cylindrical-shape plasma has an outspread bright disk (negative glow region) near the cathode surface. Besides the gas temperature, the excitation temperature was measured radially for a current ranging from 20 mA to 100 mA, either from Boltzmann-plot of Ar I 4p – 4s and 5p – 4s transitions of excited argon or from Cu I two lines method of excited cuprum atoms released from the cathode surface. The measurements showed a nearly bell-shaped distribution of these temperatures, peaked at 120 μm from the center with the minimum at the plasma border. The average excitation temperature was about ~8000 K (maximum ~10,000 K) and the average rotational temperature was about 650 K (maximum ~800 K) from 20 K to 100 K. For the N2 second positive system with Δν = -2 it was estimated the vibrational temperature for the bright disk (1500 K to 5000 K). Hβ line Stark broadening was employed to define the electron number density of the negative glow (1015 cm -3).
High Precision Evaluation of Gas Composition and Current Efficiency for High Temperature H2O and CO2 Electrolysis
Authors: Tanaka Yohei , Sato Katsutoshi , Nozaki Ken , Kato Tohru , Yamamoto Atsushi
Published: June 2013

A method to evaluate current efficiency was developed for high temperature electrolysis using solid oxide cells (SOECs). For a fuel electrode, depending on range, our gas analysis system achieved ±0.4-0.6% uncertainty for 10-90% mole fraction analysis of H2 and H2O. For an air electrode, O2 and N2 was measured with ± 0.2% and ±0.4% uncertainty, respectively. Case studies for both electrodes clarified that current efficiency can be evaluated with ±1.1-2.8% uncertainty at practical 90-50% steam utilizations in the case of ± 1.0% uncertainty in gas-flow-rate measurement.
Study of Alkaline Water Electrolysis (II)
Authors: Manabe Akiyoshi , Hashimoto Terumi , Kashiwase Masaharu , Kurosaki Masahiro , Hayashida Toshikazu , Hirao Kazuhiro , Shimomura Ikuo , Nagashima Ikuo
Published: June 2013

There are four main factors in the Alkaline Water Electrolysis (AWE) for contributing to the cell performance. One is cell structure which is related to the uniform electrolyte concentration with proper internal circulation of electrolyte in the cell room or the out gassing from electrode, separator and cell chamber. Second is cathode property such as low cathode overpotential and long life. Third is anode property as cathode. Forth is the characteristic of separator which is the most significant influence for total cell performance (cell voltage, hydrogen gas purity and life). Then, various separators and several anode materials were evaluated to confirm the performance. Although, thin IEM (25μm thickness) of polyethylene base showed the lowest cell voltage 1.7V at 0.4A/cm2, the film did not have durability against continuous operation because of deterioration of base film. Raney Ni coating and Spinel type coating for anode achieved 100mV and 50mV, respectively.