Understanding Breast Implant Illness, Before and After Explantation: A Patient-Reported Outcomes Study.

BACKGROUND: Breast implant illness (BII) after aesthetic breast augmentation remains a poorly defined syndrome encompassing a wide spectrum of symptoms. While previously published series have observed overall symptomatic improvement after breast implant removal, there is a lack of studies evaluating changes in specific symptoms over time. The purpose of this study was to gain an understanding of symptoms associated with BII, and to evaluate how these symptoms change after removal of breast implants and total capsulectomy (explantation). We hypothesized that patients presenting with BII would experience both immediate and sustained improvement in constitutional symptoms after explantation. METHODS: A retrospective study of all patients who underwent explantation by a single surgeon over 2 years was conducted. Repeated-measures analysis of variance accounting for dependency was used to compare symptoms before and after surgery. Multivariate analyses and linear regression models were used to examine the impact of patient- and implant-related factors on changes in symptoms. RESULTS: Seven hundred fifty patients met inclusion criteria. Mean preoperative survey score (26.19 ± 11.24) was significantly different from mean postoperative survey score at less than 30 days (9.49 ± 7.56) and greater than 30 days (9.46 ± 7.82, P < 0.001). Patients with a BMI greater than 30 or those with clinically detectable contracture on examination showed greater improvement on their survey scores (P = 0.039, 0.034, respectively). CONCLUSIONS: Although BII encompasses a large range of symptoms, subjects in this study demonstrated significant and sustained improvement in 11 common symptom domains. This improvement was demonstrable within the first 30 days postoperatively and was maintained beyond 30 days. The study demonstrated a strong association of explantation and specific symptom improvement within the patient population studied. Future investigation will further elucidate possible biologic phenomena to better characterize the pathophysiology and mechanism of BII.

Eleven-Year Follow-Up of Craniopagus Twins After Unsuccessful Attempt at Separation: Are They Better Off?

Craniopagus twins are a rare phenomenon and present numerous challenges in separation. Due to the paucity of data, it is paramount to evaluate outcomes based on case studies to continue improving medical and surgical management of these patients. We present a case report of craniopagus twins cared for by the senior author (A.K.G.). The patients underwent extensive surgical planning and 2 attempts at cerebroendovascular embolization to reroute shared venous sinus drainage. After the 2 endovascular procedures, attempted separation at age 41 months was aborted due to intraoperative hemodynamic instability. Eleven-year follow-up shows the twins to be developing well in regard to social and cognitive development. Nonetheless, they have had numerous physical challenges including a fall in 2016 resulting in C1-C2 subluxation in twin B leading to partial spinal cord ischemia and left-sided weakness. The separation of craniopagus twins is fraught with technical, medical, and ethical challenges. Surgical separation of the twins is not always possible without significant risk of devastating consequences to one or both twins. Follow-up of the twins 11 years later raises the question: are some craniopagus twins better off without separation?

The Incidence of Psychiatric Medication Use and Its Effect on Intraoperative Bleeding in Facial Cosmetic Patients.

PURPOSE: Psychiatric medications, particularly the selective serotonin reuptake inhibitors, have been associated with increased surgical bleeding. This study aims to compare intraoperative surgical bleeding between cosmetic surgery patients who are and are not taking psychiatric medications. METHODS: The charts of 392 consecutive patients who underwent cosmetic facial surgery at the senior author's practice were reviewed. Independent variables included self-reported psychiatric history, psychiatric diagnoses, and psychiatric medications as documented in the preoperative history and physical examination. The primary endpoint was administration of desmopressin (DDAVP), our proxy for increased surgical bleeding. Significant predictors of these endpoints were determined via Chi-squared testing. RESULTS: One hundred and seventeen patients had a psychiatric diagnosis (30%), and 129 patients were taking some class of psychiatric medication (33%). Seventy-two patients received DDAVP (18%). A psychiatric diagnosis did not predict DDAVP administration (14.3% for patients with a psychiatric diagnosis vs. 20.88% for those without, p = 0.14). The use of a psychiatric medication was not associated with DDAVP administration (14.7 vs. 21%, p = 0.14). Male gender significantly predicted DDAVP administration (27.8 vs. 16.9% for females, p = 0.04). CONCLUSION: The use of psychiatric medications does not predict increased intraoperative surgical bleeding. This is useful given the prevalence of psychiatric medication use among this patient population and obviates the need for discontinuation of these medications, which otherwise could be consequential. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Contact Cooling of Random-Pattern Cutaneous Flaps: Does it Increase Necrosis?

BACKGROUND: Cooling after surgery reduces pain, swelling and ecchymosis. However, the fear of adverse effects of vasoconstriction caused by cooling may prevent its use when the skin is undermined extensively, for example, after rhytidectomy. The purpose of this study is to determine whether the contact cooling of random-pattern skin flaps increases the area of necrosis observed. METHODS: Twenty-eight random-pattern skin flaps (4 × 10 cm) were raised on four pigs. Flaps were divided into three groups: control, intermittently cooled and continuously cooled. Pads connected to a ThermaZone cooling device delivered local hypothermia in the range of 4-6 °C for 24 h postoperatively. ImageJ software was used to calculate the area of necrosis on each flap on postoperative day 7, confirmed with histological analysis. RESULTS: The average areas of necrosis observed were as follows: control (17.61 cm2; SD 5.23), intermittent cooling (15.65 cm2; SD 3.76) and continuous cooling (14.16 cm2; SD 3.91). An ANOVA revealed no statistically significant differences between the three interventions (p = 0.35). CONCLUSIONS: Postoperative continuous or intermittent cooling does not increase the area of necrosis in random-pattern flaps. In fact, a trend was observed, demonstrating decreasing area of necrosis with increased periods of hypothermia. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors. www.springer.com/00266 .

A Novel Single-Staged Technique for the Treatment of Soft Tissue in an Oblique Facial Cleft.

INTRODUCTION: Oblique facial clefts are extremely rare and cause significant morbidity. Treatment of these clefts is complex and requires a fundamental understanding of cleft classification and techniques used for treatment of clefts. METHODS: We describe a novel single-staged technique to repair the Tessier no. 4 soft tissue cleft and reconstruct the buccal sulcus and bilaminar lower eyelid by preserving normally excised tissue combined with standard procedures. We also present a case report demonstrating the technique in an adolescent female. The procedure incorporates turnover flaps from soft tissue preservation within the cleft, a Mustarde cheek advancement flap, an anatomical subunit lip repair, a dorsal nasal Rieger flap for ala repositioning, and a lateral nasal flag flap. RESULTS: The single-staged soft tissue repair eliminated the Tessier no. 4 cleft while simultaneously reconstructing the bilaminar lower eyelid and buccal lining. Our patient had no complications within the perioperative period. CONCLUSIONS: This novel single-staged technique for the treatment of the soft tissue Tessier no. 4 cleft not only repairs the cleft but also reconstructs the buccal sulcus and bilaminar lower eyelid with turnover flaps preserved from the normally discarded excess soft tissue within the cleft. The novel repair allows for the creation of a deeper fornix to aid with placement of an orbital prosthesis and is ideal for use in underserved or remote locations.

Phase 1 and pharmacokinetic study of everolimus in combination with cetuximab and carboplatin for recurrent/metastatic squamous cell carcinoma of the head and neck.

BACKGROUND: Platinum-based therapy combined with cetuximab is standard first-line therapy for recurrent or metastatic squamous cell carcinoma of the head and neck (RMSCCHN). Preclinical studies have suggested that mammalian target of rapamycin inhibitors may overcome resistance to epidermal growth factor receptor blockers and may augment cetuximab antitumor activity. We conducted a phase 1b trial of carboplatin, cetuximab, and everolimus for untreated RMSCCHN. METHODS: Patients received carboplatin (area under the curve = 2 mg/ml/min; 3 weeks on, 1 week off), cetuximab (with a loading dose of 400 mg/m(2) and then 250 mg/m(2) weekly), and dose-escalating everolimus (2.5, 5.0, 7.5, and 10 mg/day) with a 3+3 design. After 4 cycles, patients without progression continued cetuximab/everolimus until progression or intolerable toxicity. Patients (age ≥ 18 years) had previously untreated, unresectable RMSCCHN not amenable to radiotherapy and an Eastern Cooperative Oncology Group performance status of 0 to 2. RESULTS: The study enrolled 20 patients (male/female = 18/2) with RMSCCHN; the median age was 65 years (44-75 years). Thirteen patients received everolimus (male/female = 92%). Two of 6 patients receiving 2.5 mg/day experienced dose-limiting toxicity (DLT) with grade 3 hyponatremia and nausea. In 7 patients receiving de-escalated everolimus (2.5 mg every other day), grade 3 hyperglycemia produced DLT in 1 of 6 patients. The objective response rate (RR) was 61.5% (all partial responses). Progression-free survival (PFS) was 8.15 months. The pharmacokinetics of everolimus was described with a 2-compartment mixed-effects model. There was a significant correlation between tumor p-p44/42 staining and response (P = .044) and a marginally significant correlation between phosphorylated mammalian target of rapamycin and overall survival. CONCLUSIONS: The maximum tolerated dose of everolimus with cetuximab and carboplatin was 2.5 mg every other day. The regimen was associated with an encouraging RR and PFS, and this suggested possible clinical efficacy in a select group of patients with squamous cell carcinoma of the head and neck.

Nose elongation: a review and description of the septal extension tongue-and-groove technique.

Several articles have been published about the short nose, many of which begin with a statement about the difficulty and complexity that this deformity poses for the rhinoplasty surgeon. Regardless of the challenges, many surgeons have undertaken the task of elongating the short nose and have subsequently shared with the rhinoplasty community the subtle techniques they have developed through their experience. The authors present a review of the literature that has contributed to the understanding of the etiology, evaluation, assessment, and operative procedures in the reconstruction of the short nose, specifically with regard to septal extension grafts. Additionally, the senior author's (BG) technique and experience of nearly 30 years of practice is described.

Novel Use of a Closed Liposuction System: Treatment of an Acute Morel-Lavallée Lesion of the Upper Extremity.

Morel-Lavallée lesions (MLL) are closed post-traumatic soft tissue shear injuries that occur between fascial planes and may result in tissue loss. Current treatment options for MLL include percutaneous drainage and open irrigation and debridement. A few cases of suction-assisted lipectomy (SAL) have been described for subacute and chronic MLL of the lower extremity. We present the first case report of using a closed SAL system to treat an acute MLL of the upper extremity. A 78-year-old female with right forearm MLL presented after blunt force trauma while on apixaban. After inpatient monitoring and anticoagulant drug clearance, a closed system SAL was performed to evacuate the hematoma and prevent ischemia of overlying soft tissues. Treatment outcomes were measured by clinical exam and CT imaging. Pre-operative diagnostic CT scan demonstrated a 4.8 x 6.6 x 13 cm fluid collection between fascial layers of the right forearm. SAL resulted in the evacuation of 300 cc of coagulated blood. Post-operative CT imaging of the right upper extremity did not show any measurable fluid collection. Clinical exam demonstrated resolution of swelling and soft tissue compromise. The patient reported significant pain reduction, resumed her anticoagulation, and was discharged home. There were no notable complications at her three month post-operative visit. Consideration of a constant low-pressure SAL system can successfully treat MLL in the acute period. This system is relatively minimally invasive, results in faster healing times compared to open debridement, and still results in effective hematoma evacuation.

A cautionary tale: fatal outcome of methotrexate therapy given for management of ectopic pregnancy.

BACKGROUND: Medical therapy with methotrexate is a standard practice for the commonly encountered problem of ectopic pregnancy. Methotrexate is excreted predominantly by the kidney and should be used with extreme caution in renal insufficiency. All physicians who administer methotrexate must understand its mechanism of action, distribution, and elimination to minimize potential risks to the patient. CASE: A young, dialysis-dependent woman received a standard dose of methotrexate for an ectopic pregnancy. Prolonged methotrexate exposure resulted. The consequences-pancytopenia, desquamation, acute respiratory distress syndrome, and profound bowel ischemia-ultimately led to her death. CONCLUSION: Methotrexate, even at extremely low doses, can be fatal in patients with renal insufficiency. Alternative means of therapy should be sought for women with ectopic pregnancy and renal failure.

Periorbital and Orbital Aging: Senile Enophthalmos as a Cause of Upper Eyelid Ptosis.

BACKGROUND: The aim of this study was to assess the effects of orbital aging over a prolonged period. METHODS: The orbit and periorbital region were assessed in 21 adult patients over 6 to 24 years with medical-quality facial photographs. The anteroposterior and lateral photographs were evaluated for orbital changes, including enophthalmos and upper eyelid position. Quantitative analysis was performed on the anteroposterior photographs, and qualitative analysis was used to assess enophthalmos. RESULTS: The mean age of the patients was 40 years at initial photography and 57 years at the time of secondary photography. At initial photography, eight of the 21 patients had ptosis: six had bilateral mild ptosis (<2 mm), one had bilateral moderate (2 to 3 mm) ptosis, and one had unilateral mild ptosis. At the second time point, only two patients did not have ptosis: four had unilateral mild, seven had bilateral mild, and eight had bilateral moderate ptosis. One patient had unilateral and two patients had bilateral enophthalmos at the initial photography. Nineteen of the 21 patients had relative enophthalmos at the second time point, and all 19 of the patients had eyelid ptosis (p < 0.00001). CONCLUSIONS: This study demonstrates the development of age-related enophthalmos and eyelid ptosis and the strong association between age-related enophthalmos and upper eyelid ptosis, which is commonly undetected.

Separation of Craniopagus Twins over the Past 20 Years: A Systematic Review of the Variables That Lead to Successful Separation.

BACKGROUND: Attempted separation of craniopagus twins has continued to be associated with devastating results since the first partially successful separation with one surviving twin in 1952. To understand the factors that contribute to successful separation in the modern era of neuroimaging and modern surgical techniques, the authors reviewed and analyzed cases reported since 1995. METHODS: All reported cases of craniopagus twin separation attempts from 1995 to 2015 were identified using PubMed (n = 19). In addition, the Internet was searched for additional unreported separation attempts (n = 5). The peer-reviewed cases were used to build a categorical database containing information on each twin pair, including sex; date of birth; date of surgery; multiple- versus single-stage surgery; angular versus vertical conjoining; nature of shared cerebral venous system; and the presence of other comorbidities identified as cardiovascular, genitourinary, and craniofacial. The data were analyzed to find factors associated with successful separation (survival of both twins at postoperative day 30). RESULTS: Vertical craniopagus is associated with successful separation (p < 0.001). No statistical significance was attributed to the nature of the shared cerebral venous drainage or the other variables examined. Multiple-stage operations and surgery before 12 months of age are associated with a trend toward statistical significance for successful separation. CONCLUSIONS: The authors' analysis indicates that vertical craniopagus twins have the highest likelihood of successful separation. Additional factors possibly associated with successful separation include the nature of the shared sinus system, surgery at a young age, and the use of staged separations. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

A Prospective Randomized Outcomes Comparison of Two Temple Migraine Trigger Site Deactivation Techniques.

BACKGROUND: The authors compared the reduction of migraine headache frequency, days, severity, and duration after surgical decompression versus avulsion of the zygomaticotemporal branch of the trigeminal nerve for treatment of temporal migraine headache. METHODS: Twenty patients with bilateral temporal migraine headache were randomized to undergo avulsion of the zygomaticotemporal branch of the trigeminal nerve on one side and decompression via fasciotomy and removal of the zygomaticotemporal artery on the other side. Results were analyzed after a minimum of 12 months of follow-up. RESULTS: Nineteen patients completed the study. The patients experienced greater than 50 percent improvement in frequency, migraine days, severity, and duration in 34 of the 38 operative sites (89 percent). Complete elimination of symptoms was noted in 21 of the 38 operative sites (55 percent). In the decompression group, migraine frequency was reduced from 14.6 to 2.2 per month, migraine days from 14.1 to 2.3, severity from 7.0 to 2.9, duration from 9.6 to 4.8 hours, and Migraine Headache Index score from 42 to 2.9. In the neurectomy group, frequency decreased from 14.2 to 1.9 per month, migraine days from 14.1 to 2.3, severity from 6.8 to 2.6, migraine duration from 10.1 to 5.3 hours, and the Migraine Headache Index score from 41 to 2.5. There was no statistical significance in reduced migraine headache frequency, days, severity, and duration between the two groups. CONCLUSIONS: Neurectomy and decompression of the zygomaticotemporal branch of the trigeminal nerve are both appropriate treatment for temporal migraine headache. If decompression fails to provide sufficient relief, neurectomy is another option. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, I.

Small molecule inhibition of the CHFR-PARP1 interaction as novel approach to overcome intrinsic taxane resistance in cancer.

The mitotic checkpoint protein CHFR has emerged as a major mediator of taxane resistance in cancer. Here we show that CHFR's PAR-binding zinc finger domain (PBZ) mediates a protein interaction with poly-ADP ribosylated PARP1 leading to stabilization of CHFR. Disruption of the CHFR-PARP1 interaction through either PARP1 shRNA-mediated knockdown or overexpression of a PBZ domain peptide induces loss of CHFR protein expression. In an attempt to exploit this observation therapeutically, and to develop compounds with synthetic lethality in combination with taxanes, we performed a high-throughput computational screen of 5,256,508 chemical structures against the published crystal structure of the CHFR PBZ domain to identify candidate small molecule CHFR protein-protein interaction inhibitors. The 10 compounds with the best docking scores (< -9.7) were used for further in vitro testing. One lead compound in particular, termed 'A3', completely disrupted the protein-protein interaction between CHFR and PARP1, resulting in the inhibition of mitotic checkpoint function, and led to therapeutic synergy with docetaxel in cell viability and colony formation assays. In mouse xenografts, i.p. administration of 'A3' led to a significant reduction in nuclear CHFR protein expression with a maximal effect 4 hours after administration, confirming relevant pharmacodynamics following the peak of 'A3' plasma concentration in vivo. Furthermore, combination of A3 and taxane led to significant reduction of implanted tumor size without increase in hematological, hepatic or renal toxicity. These findings provide a proof-of-principle that small molecule inhibition of CHFR PBZ domain interaction is a novel potential therapeutic approach to increase the efficacy of taxane-based chemotherapy in cancer.

Use of negative pressure wound therapy with instillation in the management of cervical necrotizing fasciitis.

BACKGROUND: Cervical necrotizing fasciitis is an aggressive infection that can be rapidly fatal if aggressive therapies are not initiated early. Negative pressure wound therapy has been established as an effective tool in promoting wound healing, but its use in the acutely infected wound has been avoided because it limits frequent irrigations and standard dressing changes. METHODS: We discuss a novel application of negative pressure wound therapy with instillation in an immunocompromised patient with extensive cervical necrotizing fasciitis. RESULTS: The negative pressure wound therapy with instillation provided pain relief by minimizing the frequency of dressing changes, increased the speed of healing, helped to control infection, and facilitated the development of a healthy wound bed sufficient for reconstruction with a split thickness skin graft. CONCLUSION: The role of negative pressure wound therapy with instillation continues to expand and can be used in the management of both acute and chronic wounds in the head and neck.

The phylogeography of Amazonia revisited: new evidence from riodinid butterflies.

A fully resolved cladogram for 19 species in the Charis cleonus group of riodinid butterflies, which have closely parapatric ranges throughout the Amazon basin, is used to derive an area cladogram for the region. This represents the first comprehensive species-level analysis using insects and results in a hypothesis of Amazonian area relationships that is the most detailed to date. The Charis area cladogram is interpreted as supporting an historical vicariant split between the Guianas and the remainder of the Amazon and then between the upper and lower Amazon. The latter two clades can be further divided into the six most widely recognized areas of endemism and even smaller endemic centers within these, some of which, especially along the Madeira and lower Amazon Rivers, have never been previously hypothesized for butterflies. The overall pattern of historical interrelationships indicated is Guiana + ((Rondjnia + (Pará + Belém)) + (Imeri + (Napo + Inambari))). The area relationships for riodinid butterflies show substantial congruence with those presented from the literature for amphibians, reptiles, birds, primates, rodents, and marsupials, suggesting a common vicariant history for these organisms. A summary area cladogram generated by combining area cladograms for all the aforementioned groups of organisms indicated the pattern of historical interrelationships to be (Guiana + (Rondjnia + (Pará + Belém))) + (Imeri + (Napo + Inambari)). Charis cleonus group species distributions are noticeably larger around the upland periphery of Amazonia and smaller in the central and lower regions. A significant positive correlation between the proportion of range area above 100 m and total range size for each species is used to suggest that past sea-level rises may explain smaller range sizes in low-lying regions and that riverine barriers have been important in shaping the current distribution of C. cleonus group species.

Extinction and biogeography in the Caribbean: new evidence from a fossil riodinid butterfly in Dominican amber.

We describe a new species of extinct riodinid butterfly, Voltinia dramba, from Oligo-Miocene Dominican amber (15-25 Myr ago). This appears to be the first butterfly to be taxonomically described from amber, and the first adult riodinid fossil. The series of five specimens represents probably the best-preserved fossil record for any lepidopteran. The phenomenon of extant Voltinia females ovipositing on arboreal epiphytes probably explains the discovery of multiple female V. dramba specimens in amber. Voltinia dramba appears to be one of many extinct butterfly species on Hispaniola. The northwestern Mexican distribution of the explicitly hypothesized sister species, the extant V. danforthi, supports the hypothesis that V. dramba reached Hispaniola by the 'proto-Greater Antillean arc', dating the divergence of V. dramba and V. danforthi to 40-50 Myr ago. This date is contemporaneous with the oldest known butterfly fossils, and implies a more ancient date of origin for many of the higher-level butterfly taxa than is often conceded.

A new species of Euptychia Hübner, 1818 (Lepidoptera: Nymphalidae: Satyrinae: Satyrini) from Mount Roraima, Guyana.

A new nymphalid species in the subtribe Euptychiina, Euptychia roraima Nakahara, Fratello & Harvey n. sp., is described from Mount Roraima, Guyana. Both internal and external morphology of E. roraima are compared against several Euptychia species and the relationship between E. roraima and congeners is briefly discussed. A strong case is put forth for further and extensive exploration of the Pantepui region concerning its poorly known butterfly fauna.

Unilateral congenital blepharoptosis repair by anterior levator advancement and resection: an educational review.

BACKGROUND: Simple congenital blepharoptosis is caused by levator muscle dysgenesis and commonly presents unilaterally. A complete preoperative evaluation, including ophthalmic, neurologic, and levator function examinations, is essential for ensuring proper diagnosis and selecting the correct procedure. Correction is frequently delayed until the anatomical structures of the eye are fully developed and the child can cooperate with the preoperative examination between the ages of 3 and 5 years, except in cases of visual disturbances. After the preoperative evaluation, the proper treatment can be selected from commonly described procedures, including levator advancement, tarsomyectomy, and frontalis suspension. METHODS: The authors provide a description of the pediatric levator advancement procedure and demonstrate the procedure with supplemental video content. RESULTS: Levator advancement provides appropriate correction for moderate blepharoptosis repair in pediatric patients with fair to good levator function. CONCLUSIONS: Levator advancement in children presents unique challenges because of difficulty performing the preoperative examination and the inability of the patient to provide intraoperative cooperation for proper lid placement because of general anesthesia.

Sample introduction in gas chromatography using a coiled wire filament.

A simple device for field sampling and concentration of analytes for subsequent introduction into an injection port for gas chromatographic (GC) analysis has been developed. It consists of a tiny, coiled platinum wire filament (CWF) that is attached to a retractable plunger wire, which fits inside a syringe needle housing. Sampling is accomplished by dipping the end of the CWF in a liquid sample, which is drawn into the wire coil by capillary action, and introducing it into the injection port either before or after allowing the solvent to evaporate. The CWF can be used with or without a nonvolatile chemical coating. A major advantage of this sampling device is that nonvolatile sample matrix components remain on the wire coil, reducing the required injection port and liner cleaning frequency and contamination of the head of the chromatographic column. The coil itself can be easily cleaned between analyses by rinsing and/or burning off residual material in a small flame. The sampling coil facilitates specifically designed chemical reactions in the injection port, such as thermochemolysis and methylation. Applications demonstrated in this work include: (1) direct introduction of samples with little or no pre-treatment, (2) simultaneous thermochemolysis and methylation of lipid-containing samples such as bacteria and bacterial endospores for analysis of biomarkers, and (3) solid phase micro-extraction (SPME) using temporary wire coatings. The CWF allowed for significant reduction in sample preparation time, in most cases to less than a few minutes. The peak shapes examined for polycyclic aromatic hydrocarbon analytes (PAHs) were significantly better (asymmetry factors <1.3) when using the CWF sampling technique compared to splitless and on-column injection techniques (asymmetry factors >1.3). Extraction efficiencies for SPME (especially for high boiling point components such as PAHs) improved by an average of 2.5 times when using the CWF compared to the performance of commercially available SPME fibers. Coiled wire filaments and GC injection port liners were used for more than 100 Bacillus endospore thermochemolysis methylation analyses without the need for cleaning or replacement.