bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Facial Telangiectasia with Sclerotherapy, Laser Surgery, and/or Electrodesiccation: A Review
Authors: GOLDMAN MITCHEL P. , WEISS ROBERT A. , BRODY HAROLD J. , COLEMAN WILLIAM P. , FITZPATRICK RICHARD E. 
Published: June 2013

BACKGROUND. Facial telangiectasia is extremely common in patients with fair complexion. Electrosurgery has been the primary form of treatment in the past.OBJECTIVES. The authors retrospectively evaluated over 300 patients treated with sclerotherapy for facial telangiectasias.METHODS. Retrospective analysis of over 300 patients with facial telangiectasia treated with sclerotherapy and 55 facial spider telangiectasias treated with laser.RESULTS. Sclerotherapy utilizing hypertonic saline, Sclerodex, polidocanol, and sodium tetradecyl sulfate resulted in‐between 50 and 100% resolution of facial telangiectasia with minimal complications.CONCLUSION. The treatment of facial telangiectasia should include sclerotherapy and laser treatment modalities, which effect a higher rate of clearance with less adverse sequela.LEARNING OBJECTIVES. After studying the following article the participants should be able to:
Understand the classification of superficial cutaneous facial vessels and identify their morphology.
Show an awaremenss of the benefits and risks of utilizing microsclerotherapy as a treatment for certain facial telangiectasias.
Recognize the role of laser surgery and electrosurgery as primary or secondary techniques in treating facial telangiectasias.
Two‐Stage Correction of Depressed Glabella and Nasal Root Scar Contracture Utilizing Subcutaneous Tissue Advancement Flaps and a Layered Soft Tissue/Procerus Muscle Transposition Flap
Authors: FIELD LAWRENCE M. 
Published: June 2013

BACKGROUND. A postoperative nasal root and glabellar forehead deformity comprised both vertical and horizontal elements, with scar contracture and fixation across the left medial nose base, extending into the adjacent superior canthal region.METHODS. A two‐stage reconstruction was performed, initially correcting the vertical centrally placed forehead depression by dual subcutaneous flaps advanced centrally and joined. The horizontal nasal root contracture was repaired at a second stage utilizing a procerus muscle transposition flap elevated on the ipsilateral deep contracture side, imbricated in serpentine fashion on itself and sutured into the depression over the scar base.RESULT. Significant improvement followed.CONCLUSION. The careful and precise placement of subcutaneous tissue and muscle can serve to assist in filling certain deep defects and in elevating scar lines.
A Comparison of Copper Vapor and Flashlamp Pumped Dye Lasers in the Treatment of Facial Telangiectasia
Authors: WANER MILTON , DINEHART SCOTT M. , WILSON MATTHEW B. , FLOCK STEPHEN T. 
Published: June 2013

METHODS. Twelve adult patients with bilateral facial telangiectasias were treated with two yellow light lasers. A section of each involved area was treated with a copper vapor laser and a similar section in the same patient was treated with the flashlamp pumped dye laser.RESULTS. Both lasers provided satisfactory clearance at 2 and 6 weeks. Treatment was not painless with either laser; however, no patient needed local or general anesthesia. The time taken to treat equivalent areas was similar for both lasers. Postoperative swelling was greater with the flashlamp pumped dye laser than with the copper vapor laser and the time required for healing was longer with the flashlamp pumped dye laser.CONCLUSION. The larger purpuric macules produced postoperatively by the flashlamp pumped dye laser were less cosmetically acceptable to patients when compared with the thin linear crusting produced by the copper vapor laser. Scarring or textural changes were not seen with either laser.
The Treatment of Advanced Merkel Cell Carcinoma
Authors: FENIG EYAL , LURIE HEDWIG , KLEIN BARUCH , SULKES AARON 
Published: June 2013

BACKGROUND. The optimal management of Merkel cell carcinoma has not been clearly defined.OBJECTIVE. To describe the treatment of eight patients who presented with Merkel cell carcinoma.METHODS. Eight patients with advanced locoregional Merkel cell carcinoma were seen in our institute over a 7‐year period. Four patients were successfully treated by induction chemotherapy after excisional biopsy, followed by radiotherapy. Three patients died from widespread metastases and one from neutropenic sepsis induced by chemotherapy.RESULTS. These cases demonstrate the potential lethality and aggressive nature of this rare skin tumor despite its chemosensitive and radioresponsive character. In all four patients who are alive and disease‐free, chemotherapy was given first and radiotherapy was given as consolidation.CONCLUSION. We suggest that a multimodality treatment approach — chemotherapy followed by radiotherapy — is indicated in patients with advanced Merkel cell carcinoma.
Lateral Rhinotomy Approach for Mohs Micrographic Surgery of the Anterior Septum
Authors: ZILINSKY I. , BORENSTEIN A. , TSUR H. 
Published: June 2013

BACKGROUND. Neoplasms of the nasal septum and internal alar surface are very difficult to treat. This is because of the complicated surface, proximity to important anatomic structures, and technical difficulty—both to resection and follow up. Mohs micrographic surgery might be the ideal mode of treatment for such tumors; however, it is very difficult to accomplish through the nostril.OBJECTIVE. To resect the tumor on the nasal septum and internal alar surface using Mohs micrographic surgery.METHODS. Lateral rhinotomy was performed as a preparatory stage to Mohs micrographic surgery of the anterior septum and intranasal alar surface.RESULTS. The ala nasi was detached from the cheek, thus exposing the anterior nasal cavity — enabling direct access to the neoplasms and allowing excellent visualization.CONCLUSION. Lateral rhinotomy, as described in this article, is a simple office procedure and in most cases heals with no visible scar.
Phase Contrast Microscopy for Identifying Epidermal Margins in Unstained Cryosections for Mohs Micrographic Surgery
Authors: SATO KENZO , KENNARD CHARLES D. 
Published: June 2013

BACKGROUND. Mohs fresh tissue micrographic surgery has been accepted as the most reliable therapeutic modality for the eradication of recurrent cutaneous malignancies or those skin cancers that are difficult to treat otherwise.OBJECTIVE. We have developed a method to ascertain the presence of the epidermis and other edges in the tissue sections before staining the cryosections and microscopically searching them for cancer cells.METHODS. Our method for screening the cryosections for the epidermis can be done quickly and easily using relatively inexpensive phase contrast optics.RESULTS. Use of this method allows easy visualization of freshly cut cryosections, especially the presence of the epidermis and other edges of the tissue, in just a matter of seconds instead of a half hour to stain and recut the sections.CONCLUSIONS. Phase contrast microscopy and/or dark field illumination are instrumental in screening unstained cryosections for the presence of the tissue borders, especially the epidermis, before they are stained with hematoxylin and eosin. This method saves a great deal of time and effort both for the surgeon and the patient.
Role of Tissue Undermining in the Trapdoor Effect of Transposition Flaps
Authors: KAUFMAN ANDREW J. , KIENE KEVIN L. , MOY RONALD L. 
Published: June 2013

background. The trapdoor or pincushioning effect is a frequent complication of transposition flaps. Several explanations have been proposed for its occurrence, including lymphatic or venous obstruction, scar hypertrophy, excessive subcutaneous fat or flap tissue, and scar contracture.objective. To study the effects of tissue undermining and scar contracture using a guinea pig animal model.methods. Circular wounds on the dorsal surface of guinea pigs were repaired with transposition paps. Half of the recipient beds were undermined widely and half were not undermined. Animals were observed for evidence of the trapdoor phenomenon.results. Only animals in the group without undermining demonstrated evidence of the trapdoor effect.conclusion. Tissue undermining may prevent the development of the trapdoor effect in transposition flaps.
Full‐Thickness Mucous Membrane Grafts from the Vestibular (Oral Labial) Mucosa of the Lip
Authors: FIELD LAWRENCE M. , GEISS JOHN K. , CHRISMAN HOLLY 
Published: June 2013

background. Full thickness mucous membrane coverage is desired for a variety of reconstructive tasks involving the oral cavity and vermilion area of the lips.objective. This article will inform the readership that the vestibular (oral labial) mucosal area of the lower lip close to the sulcus may provide adequate full‐thickness mucous membrane graft tissue for such purposes.method. A series of photographs from a number of representative cases with accompanying commentary will enable the surgeon to easily incorporate this technique into hislher practice.conclusion. The lips vestibular mucosa will be found to be an invaluable ally in accomplishing non‐deforming coverage of superficial mucosal defects without unnecessary surgical invasion of visible lip/chin structures.
Partial Retransplantation
Authors: Lucas Manfred W.G. 
Published: June 2013

background. In hair transplantation, the availability of a limited number of grafts for a conventional transplantation can pose a serious problem. The result can be a so‐called “bunch” or “brush” appearance in the recipient area.objective. We therefore developed a new method that allows this effect to be minimized. METHOD. 77ns method is based on the use of a punch (1.6–1.7 mm in diameter) that allows small grafts to be extracted from already established standard grafts. We then transplant the resulting minigrafts in between the established standard grafts, which have now decreased in size.results. The immediate reduction in the size of the standard grafts and the simultaneous generation of minigrafts produce the desired result: the “minigraft exclusively” look.conclusion. Thus, patients with previously poor results in standard hair transplantation can now benefit from the modern method of mini‐ and micrograft transplantation.
Rapid Cytokeratin Stains Enhance the Sensitivity of Mohs Micrographic Surgery for Squamous Cell Carcinoma
Authors: Zachary Christopher B. , Rest Ellen B. , Furlong Shawn M. , Arcedo Perico N. C. , Mcgeorge Bruce C. L. , Kist David A. 
Published: June 2013

background. Recurrence of squamous cell carcinoma (SCC) following Mohs micrographic surgery is uncommon. However, such cases do exist, presumably because of incomplete excision. Identification of single cells or small clumps of SCC tumor may be extremely difficult and can be compromised by inflammatory reaction.objective. The purpose of this study was to evaluate the benefits of incorporating rapid cytokeratin (CK) stains into Mohs technique.methods. Simple modification of standard immunoenzyme techniques allows keratin‐specific staining to be achieved in less than 90 minutes on Mohs cryostat sections. We used the rapid labeled streptavidin biotin anticytokeratin method at the stage when no tumor was apparent by hematoxylin and eosin staining in 20 patients with large, aggressive, or recurrent invasive SCCs.results. In eight cases, single cells or small clumps of SCC tumor were identified utilizing AE‐1 monoclonal antibody. These patients subsequently underwent further surgery, including wider tumor resection, superficial parotidectomy, or postoperative radiation therapy.conclusion. The rapid CK antibody staining technique enhances the sensitivity of tumor identification in Mohs micrographic surgery, and should reduce tumor recurrence rates.
Ineffective Treatment of Refractory Melasma and Postinflammatory Hyperpigmentation by Q‐switched Ruby Laser
Authors: TAYLOR CHARLES R. , ANDERSON R. ROX 
Published: June 2013

background. Melasma and postinflammatory pigmentation are cosmetic problems with limited options for treatment.objective. To determine whether selective photothermolysis of pigmented cells by Q‐switched ruby laser treatment would produce clinical benefit in these disorders.methods. Eight subjects with melasma or postinflammatory hyperpigmentation refractory to traditional treatments were treated with Q‐switched ruby laser pulses (694 nm, 40 nanoseconds) at fluences of 15–7.5 J/cm2, and followed. Histology was obtained before and after treatment.results. Regardless of fluence, no permanent improvement and, in some cases, darkening was seen in each type of lesion. Except for small depression at high fluences in black patients, there were no textural changes after healing. Immediately after treatment, there was epidermal and dermal injury, with extracellular melanin. Several months later, epidermal pigmentation had returned to baseline and dermal macrophages were apparently focally increased.conclusions. The Q‐switched ruby laser by itself does not provide an effective treatment for refractory melasma or postinflammatory hyperpigmentation.
Utilization of No‐Kor Needles for Slit‐Micrografting
Authors: BRANDY DOMINIC A. , MESHKIN MICHAEL 
Published: June 2013

background. This article introduces the No‐Kor vented needle as an excellent tool for micrograft recipient site development.objective. To show that No‐Kor vented needles are better than conventional hypodermic needles (with and without dilators) and Bard Parker blades for micrograft recipient site development.method. Comparisons with hypodermic needles (with and without dilators) and Bard Parker blade incisions are made.results. When compared with hypodermic needles (with and without dilators, the No‐Kor needles show less scarring, allow easier placement, take less surgical time, and are less expensive. When compared with Bard Parker blade incisions, the No‐Kor needles demonstrate less scarring, more precision, and less expense.conclusion. The No‐Kor vented needle is an excellent tool for the development of micrograft recipient sites. It demonstrates advantages over both hypodermic needles and Bard Parker blades.
Metastatic Malignant Melanoma with Spontaneous and Complete Regression of the Primary Lesion
Authors: SHAI AVI , AVINOACH ILANA , SAGI AMIRAM 
Published: June 2013

background. Spontaneous regression of malignant melanoma is characterized by a partial or complete disappearance of the neoplasm. Partial regression of melanoma has been documented in large series, but complete regression is reported as occurring only sporadically.objective. To describe a case of metastatic malignant melanoma where the primary lesion underwent spontaneous and complete regression and to review the literature pertaining to regression of melanoma.methods. The patient was examined clinically. Wide excision of the skin with the lesion was preformed as well as left inguinal lymph node dissection.results. Histologic examination of the lesion revealed complete regression of malignant melanoma. Examination of the lymph node dissected from the adjacent inguinal area revealed matastatic melanoma.conclusions. Greater attention should be devoted to identification of regression in melanoma, clinically and histologically, evaluating the prognostic implications which regression might indicate.
Photodynamic Therapy for the Treatment of Squamous Cell Carcinoma Using Benzoporphyrin Derivative
Authors: MARCUS JEFFREY , GLASSBERG EDWARD , DIMINO‐EMME LYNN , YAMAMOTO RICHARD , MOY RONALD L. , VARI SANDOR G. , PAPAIOANNOU THANASSIS , PERGADIA VANI R. , SNYDER WENDY J. , GRUNDFEST WARREN S. , LASK GARY P. 
Published: June 2013

background
. Photodynamic therapy (PDT) involves laser light excitation of a tumor‐localizing photosensitizer to destroy neoplasms. Benzoporphyrin derivative (BPD) is a new photosensitizer with several favorable characteristics.
objective
. Studies were designed to: 1) assess the efficacy of BPD‐mediated PDT in treating in vivo squamous cell carcinomas (SCC); 2) obtain dosimetry data for BPD and laser parameters; and 3) establish clinical and histologic correlates of BPD‐induced tumor regression.
methods
. Human SCC was implanted into nude mice. One group received BPD followed by laser light of 150 J/cm2 from an argon‐pumped dye laser at 690 nm. Three control groups included laser energy alone, BPD alone, and no treatment.
results
. At day 21 posttreatment only PDT‐treated tumors showed a statistically significant decrease in tumor volume and complete cure rate. Clinical resolution (scar) correlated perfectly with histologic resolution (scar).
conclusions
. Human SCC in a nude mouse model responds to BPD‐mediated PDT.
Flashlamp‐pumped Pulsed Dye Laser Treatment of Port‐Wine Status
Authors: FITZPATRICK RICHARD E. , LOWE NICHOLAS J. , GOLDMAN MITCHEL P. , BORDEN HERMAN , BEHR KATHLEEN L. , RUIZ‐ESPARZA JAVIER 
Published: June 2013

background. Port‐wine stains, or capillary malformations, occur in 0.3–0.5% of newborns and have been shown to be very responsive to treatment with a pulsed dye laser (585 nm, 450 microseconds). Lesional characteristics that may help predict the ease of response to therapy have not been delineated. There exists a great range of Variation in response to treatment.objective. A retrospective study of 233 patients with 140 port‐wine stain malformations being treated with the flashlamp‐pumped pulsed dye laser was undertaken. Lesion characteristics such as color and location, patient age, and skin type were evaluated as to their correlation with clinical response. Adverse sequelae were evaluated as well.methods. Charts of treated patients were reviewed and results tabulated. Thefive treating physicians were each responsible for reviewing and evaluating their own patients. Patients were treated at 8–12‐week intervals using slightly overlapping pulses with fluences from 5.5 to 7.5 J/cm.2results. Factors favoring a positive clinical response were pink lesion color, lesion location of the head and neck, patient age less than 10 years, and patient skin types I‐III. Factors having a more negative impact on clinical result include purple lesion color, lesion location on the distal extremities, patient age > 50 years, and skin types IV and V.conclusion. Examination of various patient and lesional characteristics shows trends that may be useful in a predictive manner regarding ease of treatment with the flashlamp‐pumped pulsed dye laser.
Combining Manual Dermasanding with Low Strength Trichloroacetic Acid to Improve Actinically Injured Skin
Authors: HARRIS DAVID R. , NOODLEMAN F. RICHARD 
Published: June 2013

background: Motor‐driven dermabrasion or deeper chemosurgical peeling improves photodamaged facial skin. However, these procedures each pose disadvantages that we felt could be largely ameliorated by combining manual dermasanding with low strength trichloroacetic acid peeling.objective: To evaluate the effectiveness, safety, and reproducibility of a technique combining manual dermasanding and light peeling in treating actinically injured facial skin.methods: Manual abrasion with moistened silicone‐carbide sandpaper followed by application of a 25% trichloro‐acetic acid solution was performed on over 300 patients followed as long as 7 years.results: Improvement was uniformly noted in luster, brightness, dyschromia, and rhytids. The procedure was easily mastered and results were reproducible. Postoperative pigmentary problems and scarring were extremely rare.conclusions: The technique demands minimal skill and experience, while providing pleasing results. There is no splatter or sharp lines of demarcation, and results suggest distinct advantages over motor‐driven dermabrasion or deep peeling procedures.
Dermabrasion Using Tumescent Anesthesia
Authors: GOODMAN GREG 
Published: June 2013

background. Dermabrasion is a very useful and versatile technique. However, it suffers from side effects and difficulties that limit its popularity among operating dermatologic surgeons and the public.objective. To show that it is possible to eliminate the need for chlorofluorocarbons, improve the Standard dermabrasion technique, decrease the healing time, improve its side effect profile, and reduce risks to the operating surgeon.methods. Tumescent fluid containing dilute Xylocaine, bicar‐bonate, and epinephrine in saline was infiltrated before coarse wire brush dermabrasion. Eutectic mixture of local anesthetic (EMLA) was also used topically. The first 14 patients derma‐braded by this method are reported on here. Their healing, progress, side effects, and results are described. A patient questionnaire was completed by 22 of the patients who describe the procedure and results from the patient's viewpoint.results. The procedure was found to be effective in producing anesthesia, eliminating the use of freezing the skin, and limiting the necessity for sedatives, narcotics, and other anesthesia. It gives a firm surface to dermabrade against, makes the procedure more rapid and technically easier, and produces less splatter and therefore less risk for the surgeon. The results subjectively and objectively would appear to be at least as good as Standard techniques. The healing in this small sample would appear to be faster both to reepithelialization and to reestablishment of normal color. There was only one case of transient hyperpigmentation lasting less than 1 week. Otherwise there were no cases of pigmentary or scarring side effects.conclusion. Tumescent dermabrasion is safe, effective, and has many benefits over traditional methods.
Split Skin Grafting on Severely Damaged Skin
Authors: ZAKI IRSHAD , SCERRI LAWRENCE , MILLARD LESLIE 
Published: June 2013

background. Patients with severely damaged skin are more likely to develop skin malignancies. However, suturing following excision of tumors is difficult due to their fragile skin.objective. To evaluate the effectiveness of a technique using butyl‐2‐cyanoacrylate tissue adhesive in split skin grafts in patients with severely damaged skin.method. The technique was used in 19 patients with 24 skin tumors. Two patients also had multiple skin biopsies to assess the biodegradability of the adhesive.results. Split skin grafts were applied successfully in all patients. The adhesive was completely absorbed without a foreign body reaction within 6 months.conclusion. We recommend the use of butyl‐2‐cyanoacrylate in split skin grafting patients with severely damaged skin.
Blowin' in the Wind
Authors: Hirst Bill , Jonathan Philip , Randell David 
Published: June 2013

Abstract
It is increasingly important to quantify emissions of environmentally sensitive gases into the atmosphere. Bill Hirst, Philip Jonathan, David Randell and colleagues1 show that provided you understand how the atmosphere mixes as it moves, the answer to “who is emitting what, how much and where” is literally blowing in the wind.
A New Method for Low‐Temperature Decomposition of Chromites and Dichromium Trioxide using Bromic Acid Evaluated by Chromium Isotope Measurements
Authors: Chrastný Vladislav , Rohovec Jan , Čadková Eva , Pašava Jan , Farkaš Juraj , Novák Martin 
Published: June 2013

In recent years, routine application of the stable isotope determination of chromium (Cr) in environmental and health protection research has led to the search for simpler chromite decomposition techniques. As the range of Cr isotope abundance ratios in nature is very narrow, conventional chromite decomposition techniques are no longer suitable, due to the relatively high risk of contamination during laboratory procedures. We have developed a protocol for the decomposition of chromites based on oxidation by bromic acid at room temperature. The procedure takes 15 d and requires two doses of bromic acid during the reaction period (day 1 and 8), due to the limited stability of the reagent. Chromium extracted by alkaline oxidative fusion and by bromic acid decomposition yielded statistically indistinguishable δ53Cr values, measured by multi‐collector inductively coupled plasma‐mass spectrometry following addition of a 50Cr‐54Cr double‐spike.