The effect of delay time between primary melanoma biopsy and sentinel lymph node dissection on sentinel node status, recurrence, and survival.

For primary melanoma, there is a delay between the initial skin biopsy and sentinel lymph node dissection, which may cause anxiety for the patient. The consequences of this delay on disease progression are unknown. The goal of this study was to determine whether delay time for sentinel node dissection from the initial cutaneous melanoma biopsy affects patient outcomes.

The hemitransdomal suture for narrowing the nasal tip.

The classic transdomal (dome-defining) suture successfully reduces tip width but on occasion also causes a pinched tip (concave alar rim) and an inversion of the lateral crus. We present a modification of that suture technique which only reduces the cephalic end of the dome. By suturing only the posterior (deep) part of the cephalic end of the dome, the lateral crus is everted and a pinched tip is minimized.

Superficial temporal artery and vein as recipient vessels for facial and scalp microsurgical reconstruction.

Background: Although free flap transfer is commonly performed to reconstruct defects of the upper two-thirds of the face and scalp, the superficial temporal artery and vein have historically not been considered adequate for microsurgical reconstruction and have rarely been described as recipient vessels. The purpose of this study was to determine the indications for and effectiveness of using the superficial temporal vessels for scalp and face reconstruction.

Methods: Retrospective chart review on all patients undergoing microsurgical reconstruction for defects of the upper two-thirds of the face between 1996 and 2003 revealed 45 free tissue transfers in which the superficial temporal artery and vein were considered for use as recipient vessels.

Jarisch-Herxheimer reaction associated with ciprofloxacin administration for tick-borne relapsing fever.

A 14-year-old girl was seen at a community clinic with a chief complaint of abdominal pain and fevers and was treated with oral ciprofloxacin for presumed pyelonephritis. She became tachycardic and hypotensive after her first dose of antibiotic, and she developed disseminated intravascular coagulation. She was admitted to our hospital for presumed sepsis.