Leadership and organization development in health-care: lessons from the Cleveland Clinic.

Leaders in health-care today are faced with a wide array of complex issues. This chapter describes an innovative physician leadership development program at the Cleveland Clinic intended to enhance the leadership capacities of individuals and the organization. Propositions regarding the program's impact on organizational innovation, organizational commitment, social capital, and the human element of physician practice are offered for future examination.

History of Mohs surgery.

Mohs micrographic surgery (MMS) has become the gold standard for treating many forms of primary and recurrent contiguous skin cancers and offers the highest cure rates and maximum tissue conservation compared with other modalities. Developed by Dr Frederic E. Mohs in the 1930s, it was initially called chemosurgery and used zinc chloride paste in a process called fixed tissue technique.

Noninvasive fluorescence monitoring of protoporphyrin IX production and clinical outcomes in actinic keratoses following short-contact application of 5-aminolevulinate.

Topical 5-aminolevulinic acid (ALA) is widely used in photodynamic therapy (PDT) of actinic keratoses (AK), a type of premalignant skin lesion. However, the optimal time between ALA application and exposure to light has not been carefully investigated. Our objective is to study the kinetics of protoporphyrin IX (PpIX) accumulation in AK after short contact ALA and relate this to erythemal responses.

Physician management and leadership education at the Cleveland Clinic Foundation: program impact and experience over 14 years.

As the challenges of leading in healthcare become more complex, healthcare institutions have increasingly emphasized the importance of leadership training for physicians. Several institutions have offered in-house training programs. This paper describes the 14-year experience and evolution of physician leadership development training at the Cleveland Clinic.

Topical protease therapy as a novel method of epidermal ablation: preliminary report.

Background: For more than 50 years, proteolytic enzymes have been extensively used in laboratory settings for the purposes of in vitro epidermal separation and keratinocyte isolation. However, the topical, in vivo pharmacologic properties of these enzymes are virtually unknown. Previous therapeutic applications for topically applied proteases have been limited to wound debridement.

Primary melanoma of the umbilicus: report of a case and review of the relevant anatomy.

Background: Malignant melanoma presenting on the umbilicus is rare. Treatment of melanoma on the umbilicus is difficult because of the unusual anatomy of the umbilicus.

Objective: To present the case of a patient with a primary malignant melanoma of the umbilicus and to discuss treatment concerns that are relevant to the umbilical anatomy.

Metastatic basal cell carcinoma presenting as unilateral axillary lymphadenopathy: report of a case and review of the literature.

Background: Although basal cell carcinoma (BCC) is one of the most common forms of cancer worldwide, the incidence of metastatic basal cell carcinoma (MBCC) is exceedingly low. Of reported cases, it is estimated that up to 85% arise in the head and neck region.

Objective: Case presentation of a BCC measuring 1.