How Point-of-Care Ultrasound Led to a Diagnosis of May-Thurner Syndrome.

A 65-year-old man with a history of a left-sided inguinal hernia presented with three days of left-sided groin pain worsened with exertion and fatigue. The patient was afebrile but tachycardic, and physical examination revealed a tender, erythematous immobile bulge in his left groin. Laboratory studies revealed leukocytosis.

Epidemiology, Risk Factors and Outcomes of Pneumomediastinum in Patients with Coronavirus Disease 2019: A Case-Control Study.

Since the beginning of the ongoing Coronavirus Disease 2019 (COVID-19) pandemic, pneumomediastinum has been reported in patients with COVID-19 pneumonia and acute respiratory distress syndrome. It has been suggested that pneumomediastinum may portend a worse outcome in such patients although no investigation has established this association definitively. We hypothesized that the finding of pneumomediastinum in the setting of COVID-19 disease may be associated with a worse clinical outcome.

The Rise and Fall of the Pale Puffy Lower Eyelid Pillow.

This case series demonstrates an exaggerated form of the clinical presentation of a known distressing late complication of retained hyaluronic acid filler – the “pale puffy pillow.” This presentation is often, unfortunately for the patient, misdiagnosed as festoons. However, the correction with liberal hyaluronidase is simple.

Pulsed Dye Laser Treatment of Port-Wine Stains in Infancy Without the Need for General Anesthesia.

Importance: Recent concerns regarding repetitive use of general anesthesia in children younger than 3 years have placed greater importance on the controversy surrounding the timing of the initiation of port-wine stain (PWS) laser treatment.

Objective: To evaluate the use of PWS treatments at the age of 1 year or younger in the office setting without general anesthesia.

Design, Setting, And Participants: Retrospective cohort study based on medical record reviews at a single, high-volume laser center for children who started pulsed dye laser treatment at the age of 1 year or younger for their PWS between 2000 and 2017.

Micrographic Surgery and Dermatologic Oncology Fellowship Selection Criteria.

Background: Obtaining a fellowship position for Micrographic Surgery and Dermatologic Oncology (MSDO) is becoming very competitive. Applicant qualities desired by MSDO fellowship directors have not been previously explored in a systematic way.

Objective: To characterize the prevailing practices of selecting MSDO fellows.

Efficient and self-adaptive in-situ learning in multilayer memristor neural networks.

Memristors with tunable resistance states are emerging building blocks of artificial neural networks. However, in situ learning on a large-scale multiple-layer memristor network has yet to be demonstrated because of challenges in device property engineering and circuit integration. Here we monolithically integrate hafnium oxide-based memristors with a foundry-made transistor array into a multiple-layer neural network.

Successful and safe use of Q-switched lasers in the treatment of nevus of Ota in children with phototypes IV-VI.

Objective: Nevus of Ota represents congenital dermal melanocytosis in a trigeminal distribution, most commonly occurring in Asian individuals and other individuals with skin of color. Evidence suggests early treatment is beneficial. Multiple reports have shown efficacy and safety of Q-switched laser treatment in adults.

A novel true random number generator based on a stochastic diffusive memristor.

The intrinsic variability of switching behavior in memristors has been a major obstacle to their adoption as the next generation of universal memory. On the other hand, this natural stochasticity can be valuable for hardware security applications. Here we propose and demonstrate a novel true random number generator utilizing the stochastic delay time of threshold switching in a Ag:SiO diffusive memristor, which exhibits evident advantages in scalability, circuit complexity, and power consumption.

Response to Laser Treatment of Café au Lait Macules Based on Morphologic Features.

Importance: Response to laser treatment for café au lait macules (CALMs) is inconsistent and difficult to predict.

Objective: To test the hypothesis that irregularly bordered CALMs of the "coast of Maine" subtype respond better to treatment than those of the smooth-bordered "coast of California" subtype.

Design, Setting, And Participants: This retrospective case series included patients from 2 multiple-clinician US practices treated from 2005 through 2016.

An Anatomical Approach to Evaluating and Treating Cellulite.

Cellulite is the common rippling or dimpling of skin of the thighs and buttocks of women, formed from a confluence of skin laxity, tethering fibrous septa, and fat herniation. We describe an anatomical approach to evaluating the cellulite patient and selecting the best treatment from among available non-invasive, minimally invasive, and invasive therapies. It is crucial to consider the anatomy of the patient and the morphology of cellulite while choosing a treatment.

Radiographic imaging for skin cancer.

Radiographic imaging is important for the full evaluation of high-risk cutaneous tumors. The correct modality should be chosen based on tumor subtype and clinical question. Locally advanced tumors may require imaging to evaluate the extent of disease, such as bony involvement, orbital infiltration, or perineural invasion.

An animal explant model for the study of human cutaneous squamous cell carcinoma.

We established a human tissue explant model to facilitate study of cutaneous squamous cell carcinoma. We accomplished this by implanting debulked SCC, from surgical discard, into nude rats. Human SCC remained viable and continued to proliferate for at least 4 weeks and showed evidence of neovascularization.

CD200 upregulation in vascular endothelium surrounding cutaneous squamous cell carcinoma.

Objective: To characterize the presence of CD200 and CD200 receptor (CD200R) in the human cutaneous squamous cell carcinoma (SCC) microenvironment and to define a possible role for the CD200 axis in immune evasion by SCC.

Design: Gene expression in SCC vs normal skin was studied. Laser capture microdissection was used to determine differential expression of CD200 in normal skin vs actinic keratosis vs SCC in situ vs invasive SCC.

Combined use of laser capture microdissection and cDNA microarray analysis identifies locally expressed disease-related genes in focal regions of psoriasis vulgaris skin lesions.

Psoriasis vulgaris is a complex disease characterized by alterations in growth and differentiation of epidermal keratinocytes, as well as a marked increase in leukocyte populations. Lesions are known to contain alterations in messenger RNAs encoding more than 1,000 products, but only a very small number of these transcripts has been localized to specific cell types or skin regions. In this study, we used laser capture microdissection (LCM) and gene array analysis to study the gene expression of cells in lesional epidermis (EPI) and dermis, compared with the corresponding non-lesional regions.

Mathematical modeling and frequency gradient analysis of cellular and vascular invasion into integra and strattice: toward optimal design of tissue regeneration scaffolds.

Background: Rapid, effective host cell invasion and vascularization is essential for durable incorporation of avascular tissue-replacement scaffolds. In this study, the authors sought to qualitatively and quantitatively determine which of two commercially available products (i.e.

Mohs surgery for squamous cell carcinoma.

Cutaneous squamous cell carcinoma (SCC) is the second most common human cancer and can behave aggressively. Mohs micrographic surgery offers the highest cure rates for high-risk SCCs and is particularly useful for SCCs on challenging anatomic sites.

Tumor-associated macrophages in the cutaneous SCC microenvironment are heterogeneously activated.

Tumor-associated macrophages (TAMs) may have an important role in tumor immunity. We studied the activation state of TAMs in cutaneous SCC, the second most common human cancer. CD163 was identified as a more abundant, sensitive, and accurate marker of TAMs when compared with CD68.

Hydrogen sulfide protects against ischemia-reperfusion injury in an in vitro model of cutaneous tissue transplantation.

Background: Ischemia-reperfusion injury (IRI) is a source of morbidity and mortality in many clinical scenarios, and has as one of its many consequences the induction of cellular apoptosis. Hydrogen sulfide (H2S) may decrease cellular metabolism in a reversible, nontoxic manner. An in vitro model of cutaneous tissue transplantation was developed to assess whether H2S could ameliorate cellular injury caused by IRI.