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Publisher: Springer-Verlag   (Total: 2335 journals)

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Showing 1201 - 1400 of 2335 Journals sorted alphabetically
J. of Community Health     Hybrid Journal   (Followers: 8, SJR: 0.921, h-index: 44)
J. of Comparative Physiology A: Neuroethology, Sensory, Neural, and Behavioral Physiology     Hybrid Journal   (Followers: 7, SJR: 1.087, h-index: 74)
J. of Comparative Physiology B : Biochemical, Systemic, and Environmental Physiology     Hybrid Journal   (Followers: 4, SJR: 1.126, h-index: 59)
J. of Compassionate Health Care     Open Access   (Followers: 1)
J. of Computational Analysis and Applications     Hybrid Journal   (SJR: 0.291, h-index: 19)
J. of Computational Electronics     Hybrid Journal   (Followers: 4, SJR: 0.511, h-index: 20)
J. of Computational Neuroscience     Hybrid Journal   (Followers: 22, SJR: 1.068, h-index: 60)
J. of Computer and Systems Sciences Intl.     Hybrid Journal   (SJR: 0.27, h-index: 13)
J. of Computer Science and Technology     Open Access   (Followers: 5, SJR: 0.437, h-index: 31)
J. of Computer Virology and Hacking Techniques     Hybrid Journal   (Followers: 6, SJR: 0.151, h-index: 2)
J. of Computer-Aided Molecular Design     Hybrid Journal   (Followers: 3, SJR: 0.995, h-index: 78)
J. of Computers in Education     Hybrid Journal   (Followers: 8)
J. of Computing in Higher Education     Hybrid Journal   (Followers: 13, SJR: 0.363, h-index: 21)
J. of Consumer Policy     Hybrid Journal   (Followers: 5, SJR: 0.704, h-index: 30)
J. of Contemporary Mathematical Analysis     Hybrid Journal   (SJR: 0.237, h-index: 5)
J. of Contemporary Physics (Armenian Academy of Sciences)     Hybrid Journal   (Followers: 11, SJR: 0.197, h-index: 6)
J. of Contemporary Psychotherapy     Hybrid Journal   (Followers: 5, SJR: 0.397, h-index: 23)
J. of Control Theory and Applications     Hybrid Journal   (Followers: 2, SJR: 0.359, h-index: 19)
J. of Control, Automation and Electrical Systems     Hybrid Journal   (Followers: 7, SJR: 0.231, h-index: 9)
J. of Crop Science and Biotechnology     Hybrid Journal   (Followers: 7)
J. of Cross-Cultural Gerontology     Hybrid Journal   (Followers: 5, SJR: 0.631, h-index: 29)
J. of Cryptographic Engineering     Partially Free   (Followers: 5, SJR: 0.989, h-index: 11)
J. of Cryptology     Hybrid Journal   (Followers: 2, SJR: 1.443, h-index: 55)
J. of Cultural Economics     Hybrid Journal   (Followers: 4, SJR: 0.539, h-index: 29)
J. of Database Marketing & Customer Strategy Management     Hybrid Journal   (Followers: 8, SJR: 0.149, h-index: 8)
J. of Derivatives & Hedge Funds     Hybrid Journal   (Followers: 9, SJR: 0.114, h-index: 5)
J. of Developmental and Physical Disabilities     Hybrid Journal   (Followers: 8, SJR: 0.574, h-index: 29)
J. of Digital Imaging     Hybrid Journal   (Followers: 9, SJR: 0.578, h-index: 35)
J. of Direct Data and Digital Marketing Practice     Hybrid Journal   (Followers: 8, SJR: 0.154, h-index: 6)
J. of Dynamical and Control Systems     Hybrid Journal   (Followers: 2, SJR: 0.4, h-index: 26)
J. of Dynamics and Differential Equations     Hybrid Journal   (SJR: 1.418, h-index: 31)
J. of Earth Science     Hybrid Journal   (Followers: 8, SJR: 0.483, h-index: 16)
J. of Earth System Science     Open Access   (Followers: 43, SJR: 0.448, h-index: 32)
J. of East Asian Linguistics     Hybrid Journal   (Followers: 5, SJR: 0.537, h-index: 20)
J. of Echocardiography     Hybrid Journal   (Followers: 4, SJR: 0.22, h-index: 3)
J. of Economic Growth     Hybrid Journal   (Followers: 28, SJR: 3.273, h-index: 63)
J. of Economic Interaction and Coordination     Hybrid Journal   (SJR: 0.263, h-index: 12)
J. of Economics     Hybrid Journal   (Followers: 15, SJR: 0.418, h-index: 23)
J. of Economics and Finance     Hybrid Journal   (Followers: 6, SJR: 0.272, h-index: 19)
J. of Educational Change     Hybrid Journal   (Followers: 7, SJR: 0.961, h-index: 21)
J. of Elasticity     Hybrid Journal   (Followers: 5, SJR: 0.851, h-index: 45)
J. of Electroceramics     Hybrid Journal   (SJR: 0.577, h-index: 57)
J. of Electronic Materials     Hybrid Journal   (Followers: 3, SJR: 0.609, h-index: 75)
J. of Electronic Testing     Hybrid Journal   (Followers: 2, SJR: 0.372, h-index: 27)
J. of Electronics (China)     Hybrid Journal   (Followers: 4, SJR: 0.112, h-index: 9)
J. of Elementary Science Education     Hybrid Journal   (Followers: 8)
J. of Engineering Mathematics     Hybrid Journal   (SJR: 0.347, h-index: 37)
J. of Engineering Physics and Thermophysics     Hybrid Journal   (Followers: 1, SJR: 0.288, h-index: 11)
J. of Engineering Research     Open Access   (Followers: 1, SJR: 0.145, h-index: 5)
J. of Engineering Thermophysics     Hybrid Journal   (Followers: 2, SJR: 0.763, h-index: 9)
J. of Environmental Studies and Sciences     Partially Free   (Followers: 2)
J. of Ethology     Hybrid Journal   (Followers: 2, SJR: 0.609, h-index: 25)
J. of Evolution Equations     Hybrid Journal   (SJR: 0.826, h-index: 26)
J. of Evolutionary Biochemistry and Physiology     Hybrid Journal   (SJR: 0.145, h-index: 11)
J. of Evolutionary Economics     Hybrid Journal   (Followers: 8, SJR: 0.492, h-index: 52)
J. of Experimental and Theoretical Physics     Hybrid Journal   (Followers: 3, SJR: 0.458, h-index: 39)
J. of Experimental Criminology     Hybrid Journal   (Followers: 43, SJR: 1.445, h-index: 28)
J. of Failure Analysis and Prevention     Hybrid Journal   (Followers: 5, SJR: 0.261, h-index: 15)
J. of Family and Economic Issues     Hybrid Journal   (Followers: 6, SJR: 0.396, h-index: 32)
J. of Family Violence     Hybrid Journal   (Followers: 35, SJR: 0.639, h-index: 56)
J. of Financial Services Marketing     Hybrid Journal   (Followers: 3, SJR: 0.273, h-index: 10)
J. of Financial Services Research     Hybrid Journal   (Followers: 21, SJR: 0.572, h-index: 36)
J. of Fixed Point Theory and Applications     Hybrid Journal   (SJR: 0.644, h-index: 13)
J. of Fluorescence     Hybrid Journal   (Followers: 3, SJR: 0.465, h-index: 56)
J. of Food Measurement and Characterization     Hybrid Journal   (SJR: 0.307, h-index: 4)
J. of Food Science and Technology     Hybrid Journal   (Followers: 6, SJR: 0.441, h-index: 29)
J. of Forest Research     Hybrid Journal   (Followers: 3, SJR: 0.495, h-index: 27)
J. of Forestry Research     Hybrid Journal   (Followers: 6, SJR: 0.304, h-index: 14)
J. of Fourier Analysis and Applications     Hybrid Journal   (Followers: 1, SJR: 1.18, h-index: 42)
J. of Friction and Wear     Hybrid Journal   (Followers: 6, SJR: 0.373, h-index: 7)
J. of Fusion Energy     Hybrid Journal   (Followers: 3, SJR: 0.387, h-index: 19)
J. of Gambling Studies     Hybrid Journal   (Followers: 4, SJR: 1.171, h-index: 57)
J. of Gastroenterology     Hybrid Journal   (Followers: 11, SJR: 1.651, h-index: 88)
J. of Gastrointestinal Cancer     Hybrid Journal   (Followers: 3, SJR: 0.304, h-index: 39)
J. of Gastrointestinal Surgery     Hybrid Journal   (Followers: 6, SJR: 1.64, h-index: 99)
J. of General Internal Medicine     Hybrid Journal   (Followers: 15, SJR: 1.804, h-index: 134)
J. of General Plant Pathology     Hybrid Journal   (SJR: 0.554, h-index: 22)
J. of Genetic Counseling     Hybrid Journal   (Followers: 5, SJR: 0.902, h-index: 39)
J. of Genetics     Open Access   (Followers: 4, SJR: 0.458, h-index: 28)
J. of Geodesy     Hybrid Journal   (Followers: 8, SJR: 2.173, h-index: 56)
J. of Geographical Sciences     Hybrid Journal   (Followers: 1, SJR: 0.8, h-index: 23)
J. of Geographical Systems     Hybrid Journal   (Followers: 4, SJR: 0.822, h-index: 39)
J. of Geometric Analysis     Hybrid Journal   (SJR: 1.491, h-index: 27)
J. of Geometry     Hybrid Journal   (Followers: 1, SJR: 0.272, h-index: 15)
J. of Global Optimization     Hybrid Journal   (Followers: 4, SJR: 0.992, h-index: 60)
J. of Global Policy and Governance     Hybrid Journal   (Followers: 8)
J. of Grid Computing     Hybrid Journal   (SJR: 1.414, h-index: 37)
J. of Hand and Microsurgery     Hybrid Journal   (Followers: 1)
J. of Happiness Studies     Hybrid Journal   (Followers: 20, SJR: 0.881, h-index: 39)
J. of Hematopathology     Hybrid Journal   (Followers: 4, SJR: 0.2, h-index: 13)
J. of Heuristics     Hybrid Journal   (Followers: 5, SJR: 1.308, h-index: 50)
J. of High Energy Physics     Hybrid Journal   (Followers: 19, SJR: 1.052, h-index: 153)
J. of Homotopy and Related Structures     Hybrid Journal   (SJR: 0.232, h-index: 2)
J. of Housing and the Built Environment     Hybrid Journal   (Followers: 7, SJR: 0.648, h-index: 28)
J. of Huazhong University of Science and Technology [Medical Sciences]     Hybrid Journal   (SJR: 0.344, h-index: 19)
J. of Ichthyology     Hybrid Journal   (Followers: 3, SJR: 0.304, h-index: 10)
J. of Immigrant and Minority Health     Hybrid Journal   (Followers: 10, SJR: 0.759, h-index: 37)
J. of Inclusion Phenomena and Macrocyclic Chemistry     Hybrid Journal   (Followers: 1, SJR: 0.331, h-index: 46)
J. of Indian Philosophy     Hybrid Journal   (Followers: 12, SJR: 0.127, h-index: 12)
J. of Indian Prosthodontic Society     Open Access   (SJR: 0.164, h-index: 7)
J. of Industrial Microbiology and Biotechnology     Hybrid Journal   (Followers: 14, SJR: 0.966, h-index: 80)
J. of Industry, Competition and Trade     Hybrid Journal   (Followers: 8, SJR: 0.327, h-index: 15)
J. of Infection and Chemotherapy     Hybrid Journal   (Followers: 1, SJR: 0.673, h-index: 46)
J. of Information Technology     Hybrid Journal   (Followers: 52, SJR: 1.474, h-index: 55)
J. of Information Technology Teaching Cases     Hybrid Journal   (Followers: 8)
J. of Infrared, Millimeter and Terahertz Waves     Hybrid Journal   (Followers: 2, SJR: 1.25, h-index: 36)
J. of Inherited Metabolic Disease     Hybrid Journal   (Followers: 2, SJR: 1.389, h-index: 77)
J. of Inorganic and Organometallic Polymers and Materials     Partially Free   (Followers: 8, SJR: 0.338, h-index: 33)
J. of Insect Behavior     Hybrid Journal   (Followers: 9, SJR: 0.569, h-index: 39)
J. of Insect Conservation     Hybrid Journal   (Followers: 10, SJR: 0.872, h-index: 43)
J. of Intelligent and Robotic Systems     Hybrid Journal   (Followers: 2, SJR: 0.629, h-index: 43)
J. of Intelligent Information Systems     Hybrid Journal   (Followers: 1, SJR: 0.691, h-index: 43)
J. of Intelligent Manufacturing     Hybrid Journal   (Followers: 4, SJR: 1.397, h-index: 54)
J. of Interventional Cardiac Electrophysiology     Hybrid Journal   (SJR: 0.93, h-index: 43)
J. of Intl. Business Studies     Hybrid Journal   (Followers: 29, SJR: 4.208, h-index: 130)
J. of Intl. Entrepreneurship     Hybrid Journal   (Followers: 9, SJR: 0.549, h-index: 23)
J. of Intl. Migration and Integration / Revue de l integration et de la migration internationale     Hybrid Journal   (Followers: 12, SJR: 0.308, h-index: 13)
J. of Intl. Relations and Development     Hybrid Journal   (Followers: 20, SJR: 0.793, h-index: 22)
J. of Labor Research     Hybrid Journal   (Followers: 17, SJR: 0.394, h-index: 27)
J. of Logic, Language and Information     Hybrid Journal   (Followers: 7, SJR: 0.288, h-index: 25)
J. of Low Temperature Physics     Hybrid Journal   (Followers: 2, SJR: 0.531, h-index: 52)
J. of Machinery Manufacture and Reliability     Hybrid Journal   (Followers: 2, SJR: 0.203, h-index: 7)
J. of Mammalian Evolution     Hybrid Journal   (Followers: 5, SJR: 1.134, h-index: 37)
J. of Mammary Gland Biology and Neoplasia     Hybrid Journal   (Followers: 1, SJR: 2.252, h-index: 83)
J. of Management and Governance     Hybrid Journal   (Followers: 13, SJR: 0.805, h-index: 33)
J. of Management Control     Hybrid Journal   (Followers: 5, SJR: 0.605, h-index: 6)
J. of Marine Science and Application     Hybrid Journal   (Followers: 3, SJR: 0.439, h-index: 11)
J. of Marine Science and Technology     Hybrid Journal   (Followers: 3, SJR: 0.235, h-index: 19)
J. of Maritime Archaeology     Hybrid Journal   (Followers: 21, SJR: 0.228, h-index: 8)
J. of Market-Focused Management     Hybrid Journal   (Followers: 2)
J. of Marketing Analytics     Hybrid Journal   (Followers: 3)
J. of Material Cycles and Waste Management     Hybrid Journal   (Followers: 3, SJR: 0.449, h-index: 22)
J. of Materials Engineering and Performance     Hybrid Journal   (Followers: 22, SJR: 0.544, h-index: 40)
J. of Materials Science     Hybrid Journal   (Followers: 19, SJR: 0.836, h-index: 123)
J. of Materials Science : Materials in Electronics     Hybrid Journal   (Followers: 3)
J. of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 5)
J. of Mathematical Biology     Hybrid Journal   (Followers: 12, SJR: 1.011, h-index: 71)
J. of Mathematical Chemistry     Hybrid Journal   (Followers: 5, SJR: 0.497, h-index: 45)
J. of Mathematical Fluid Mechanics     Hybrid Journal   (Followers: 6, SJR: 1.22, h-index: 22)
J. of Mathematical Imaging and Vision     Hybrid Journal   (Followers: 4, SJR: 0.901, h-index: 53)
J. of Mathematical Modelling and Algorithms     Hybrid Journal   (Followers: 2, SJR: 0.414, h-index: 23)
J. of Mathematical Sciences     Hybrid Journal   (SJR: 0.272, h-index: 23)
J. of Mathematics Teacher Education     Hybrid Journal   (Followers: 14, SJR: 1.062, h-index: 20)
J. of Maxillofacial and Oral Surgery     Hybrid Journal   (Followers: 1)
J. of Mechanical Science and Technology     Hybrid Journal   (Followers: 5, SJR: 0.589, h-index: 26)
J. of Medical and Biological Engineering     Hybrid Journal   (Followers: 1, SJR: 0.387, h-index: 18)
J. of Medical Humanities     Hybrid Journal   (Followers: 22, SJR: 0.299, h-index: 18)
J. of Medical Systems     Hybrid Journal   (Followers: 1, SJR: 0.717, h-index: 44)
J. of Medical Toxicology     Hybrid Journal   (Followers: 4, SJR: 0.874, h-index: 28)
J. of Medical Ultrasonics     Hybrid Journal   (Followers: 2, SJR: 0.18, h-index: 13)
J. of Medicine and the Person     Hybrid Journal  
J. of Membrane Biology     Hybrid Journal   (Followers: 2, SJR: 0.738, h-index: 82)
J. of Micro-Bio Robotics     Hybrid Journal   (SJR: 0.28, h-index: 3)
J. of Microbiology     Hybrid Journal   (Followers: 7, SJR: 0.741, h-index: 43)
J. of Mining Science     Hybrid Journal   (Followers: 5, SJR: 0.317, h-index: 16)
J. of Molecular Evolution     Hybrid Journal   (Followers: 9, SJR: 0.952, h-index: 108)
J. of Molecular Histology     Hybrid Journal   (Followers: 2, SJR: 0.755, h-index: 48)
J. of Molecular Medicine     Hybrid Journal   (Followers: 15, SJR: 2.165, h-index: 113)
J. of Molecular Modeling     Hybrid Journal   (Followers: 4, SJR: 0.466, h-index: 50)
J. of Molecular Neuroscience     Partially Free   (Followers: 10, SJR: 0.988, h-index: 69)
J. of Mountain Science     Hybrid Journal   (Followers: 4, SJR: 0.418, h-index: 15)
J. of Muscle Research and Cell Motility     Hybrid Journal   (Followers: 1, SJR: 1.264, h-index: 55)
J. of Nanoparticle Research     Hybrid Journal   (Followers: 4, SJR: 0.583, h-index: 84)
J. of Natural Medicines     Hybrid Journal   (SJR: 0.602, h-index: 28)
J. of Near-Death Studies     Hybrid Journal   (Followers: 2)
J. of Nephrology     Hybrid Journal   (Followers: 5, SJR: 0.689, h-index: 55)
J. of Network and Systems Management     Hybrid Journal   (SJR: 0.466, h-index: 26)
J. of Neural Transmission     Hybrid Journal   (Followers: 2, SJR: 1.034, h-index: 86)
J. of Neuro-Oncology     Hybrid Journal   (Followers: 4, SJR: 1.274, h-index: 90)
J. of Neuroimmune Pharmacology     Hybrid Journal   (Followers: 1, SJR: 1.662, h-index: 45)
J. of Neurology     Hybrid Journal   (Followers: 13, SJR: 1.429, h-index: 105)
J. of NeuroVirology     Hybrid Journal   (Followers: 1, SJR: 0.979, h-index: 69)
J. of Nondestructive Evaluation     Hybrid Journal   (Followers: 9, SJR: 0.863, h-index: 27)
J. of Nonlinear Science     Hybrid Journal   (Followers: 1, SJR: 1.887, h-index: 42)
J. of Nonverbal Behavior     Hybrid Journal   (Followers: 5, SJR: 0.723, h-index: 47)
J. of Nuclear Cardiology     Hybrid Journal   (SJR: 1.024, h-index: 68)
J. of Nutrition, Health and Aging     Hybrid Journal   (Followers: 19, SJR: 0.919, h-index: 60)
J. of Obstetrics and Gynecology of India     Hybrid Journal   (Followers: 6, SJR: 0.214, h-index: 6)
J. of Occupational Rehabilitation     Hybrid Journal   (Followers: 16, SJR: 0.811, h-index: 51)
J. of Ocean Engineering and Marine Energy     Hybrid Journal   (Followers: 1)
J. of Ocean University of China (English Edition)     Hybrid Journal   (Followers: 1, SJR: 0.237, h-index: 11)
J. of Oceanography     Hybrid Journal   (Followers: 10, SJR: 0.796, h-index: 52)
J. of Ocular Biology, Diseases, and Informatics     Hybrid Journal   (SJR: 0.183, h-index: 11)
J. of Optical and Fiber Communications Reports     Hybrid Journal   (Followers: 3)
J. of Optics     Hybrid Journal   (Followers: 8, SJR: 0.214, h-index: 8)
J. of Optimization Theory and Applications     Hybrid Journal   (Followers: 4, SJR: 0.898, h-index: 65)
J. of Ornithology     Hybrid Journal   (Followers: 21)
J. of Orofacial Orthopedics / Fortschritte der Kieferorthopädie     Hybrid Journal   (SJR: 0.574, h-index: 33)
J. of Orthopaedic Science     Hybrid Journal   (Followers: 5, SJR: 0.708, h-index: 48)
J. of Paleolimnology     Hybrid Journal   (Followers: 5, SJR: 0.984, h-index: 64)
J. of Parasitic Diseases     Hybrid Journal   (Followers: 2, SJR: 0.298, h-index: 9)
J. of Pediatric Neuropsychology     Hybrid Journal   (Followers: 3)
J. of Pest Science     Hybrid Journal   (Followers: 2, SJR: 1.341, h-index: 28)
J. of Pharmaceutical Health Care and Sciences     Open Access  
J. of Pharmaceutical Innovation     Hybrid Journal   (Followers: 8, SJR: 0.524, h-index: 17)
J. of Pharmaceutical Investigation     Hybrid Journal   (Followers: 1, SJR: 0.331, h-index: 6)
J. of Pharmacokinetics and Pharmacodynamics     Hybrid Journal   (Followers: 18, SJR: 0.708, h-index: 46)
J. of Phase Equilibria and Diffusion     Hybrid Journal   (Followers: 18, SJR: 0.433, h-index: 36)
J. of Philosophical Logic     Hybrid Journal   (Followers: 8, SJR: 0.704, h-index: 26)
J. of Physiology and Biochemistry     Hybrid Journal   (Followers: 3, SJR: 0.87, h-index: 33)

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Journal Cover European Journal of Plastic Surgery
  [SJR: 0.203]   [H-I: 16]   [7 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1435-0130 - ISSN (Online) 0930-343X
   Published by Springer-Verlag Homepage  [2335 journals]
  • Reconstruction of an extensive iliac thigh defect with a giant combined
           thigh perforator free flap
    • Authors: Saito Masami; Kimura Naohiro; Kanasyoji Mari; Saiga Atsuomi; Ueda Kazuki
      Abstract: Abstract Cases with vast skin defects that cannot be covered by a single flap use the combination of two neighboring flaps. An extensive iliac thigh degloving injury was reconstructed with the combined flap formed by the anterolateral thigh flap and the tensor fasciae latae perforator flap, resulting in a functionally and aesthetically good outcome. This combined flap has minimum donor site morbidity and can be thinned as required. The combined flap consisting of the anterolateral thigh flap and the tensor fasciae latae perforator flap is considered suitable for the repair of massive skin soft tissue defects. Level of Evidence: Level V, therapeutic study.
      PubDate: 2017-01-09
      DOI: 10.1007/s00238-016-1266-7
       
  • Fatty degeneration of mammary glands in female-to-male transsexuals
    • Authors: Taro Makino; Tadayoshi Fujita; Tomoka Nakano
      Abstract: Background Subcutaneous mastectomy is an accepted procedure for surgical reassignment in female-to-male (FtM) transsexuals. However, fatty degeneration of the mammary gland (FDMG) is sometimes observed in FtM transsexuals, with implications for mastectomy outcomes. In this study, we describe the characteristics and risk factors of FDMG. Methods A total of 48 FtM transsexual patients underwent bilateral subcutaneous mastectomies (96 subcutaneous mastectomies) at our clinics from January 2015 to February 2016. The patients were divided into FDMG and non-FDMG groups after evaluation of the cut surface of the resected mammary gland. The groups were compared in terms of age, smoking, hormonal therapy (testosterone), body mass index (BMI), breast size (top–under perimeter), distance between sternal notch and nipple–areolar complex (NAC), breast ptosis grade, weight of resected breast tissue, and complication rate. FDMG tissue specimens were examined histologically. Results Comparing the FDMG and non-FDMG groups, hormonal therapy was more common (91.3 vs. 72.0%, p = 0.049), BMI was higher (24.3 vs. 21.1%, p < 0.001), and distance between the sternal notch and NAC was longer (20.5 vs. 18.8%, p = 0.03). Conclusions Hormonal therapy, high BMI, and long distance from the sternal notch to the NAC are risk factors for FDMG and should be considered prior to mastectomy in FtM transsexuals. Level of Evidence: Level III, risk/prognostic study
      PubDate: 2017-01-07
      DOI: 10.1007/s00238-016-1269-4
       
  • The outcome of primary brachial plexus reconstruction in extended Erb’s
           obstetric palsy when two roots are available for intraplexus neurotization
           
    • Authors: Mohammad M. Al-Qattan; Amel A.F El-Sayed
      Abstract: Background The outcome of primary brachial plexus reconstruction in extended Erb’s obstetric palsy with single root avulsion has not been specifically documented in the literature. Methods A series of 46 consecutive cases of extended Erb’s obstetric palsy with single root avulsion was retrospectively reviewed. The upper and middle trunks were reconstructed with nerve grafts from the available two roots. No nerve transfers were used. The percentage of a satisfactory motor recovery was documented. Results The postoperative motor recovery was excellent (over 97%) satisfactory outcome for elbow flexion, elbow extension, and digital extension. A satisfactory wrist extension was noted in 84.8% of children. The lowest rates of satisfactory outcomes were for shoulder external rotation (65.2%) and shoulder abduction (56.5%). Conclusions In extended Erb’s obstetric palsy with single root avulsion, two ruptured roots are available for intraplexus neurotization of the upper and middle trunks. The surgeon gives a priority to elbow flexion and this is translated in an excellent outcome for elbow flexion. The triceps and digital extensors get a major contribution form the unaffected C8 root, and this is also translated in an excellent outcome for these two functions. Fewer cable grafts are available for reconstruction of the posterior division of upper trunk and the middle trunk, resulting in a lower rate of satisfactory outcomes at the shoulder for wrist extension. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2017-01-06
      DOI: 10.1007/s00238-016-1267-6
       
  • Analysis of the two-point discrimination test in daily routine practice
    • Authors: Cedric E Boesch; Fabian Medved; Manuel Held; Dominik Bender; Hans-Eberhard Schaller; Thomas Fuchsberger
      Abstract: Background Finger nerve lesions lead to a sensory deficit with para-anesthesia or anesthesia and impair hand functions. In daily clinical practice, the diagnosis of an injured finger nerve can be challenging. This study aims at evaluating if the two-point discrimination (2PD) test is a good predictor of nerve lesions to indicate operative treatments in hand trauma patients. Methods Based on the record of patients with an acute hand and finger injury, it was evaluated whether a pathological 2PD test in the clinical examination corresponds to the intraoperative findings of a severed nerve. From 2008 and 2014, patients with isolated finger nerve lesions were included, while patients with concomitant bone or tendon injuries were excluded. Results As many as 113 patients with a total of 131 nerve injuries of the hand and fingers were suitable for this study. The statistical analysis revealed a sensitivity of 98% among them for the 2PD test. Further, a positive predictive value of 96% was demonstrated. Conclusions The results of our study showed that the 2PD test is a valuable examination to diagnose nerve injuries of fingers in hand trauma patients. It is a simple, reliable, and available examination tool and therefore can be suggested in daily clinical practice. Level of Evidence: Level III, diagnostic study.
      PubDate: 2017-01-04
      DOI: 10.1007/s00238-016-1265-8
       
  • Predictability of anthropomorphic measurements in implant selection for
           breast reconstruction: a retrospective cohort study
    • Authors: Egidio Riggio; Ilaria Ardoino; Caroline E. Richardson; Elia Biganzoli
      Abstract: Background Preoperative implant planning for breast reconstruction is often at risk of being changed perioperatively. This study examined which factors are associated with a change of implant selection. Methods Women who had unilateral two-stage breast reconstruction between 2002 and 2007 were studied. Inclusion criteria were photographic evidence of preoperative skin markings indicating breast dimensions and a selected implant model. Multivariable logistic regression was used to identify variables associated with a changed selection. Results Among the 496 women studied, 308 preoperative implant choices (62.1%) were changed during surgery. A change in plan was significantly associated with symmetrization surgery involving contralateral reduction mammaplasty (OR = 1.92; 95% CI, 1.12 to 3.29) and contralateral mastopexy (OR = 2.26; 95% CI, 1.29 to 3.96), but not with BMI. The required implant width changed more than 0.5 cm in 70 cases (14.1%) while height changed more than 0.5 cm in 215 cases (43.2%). The likelihood of a change was high for large preoperative widths (OR = 9.66 for 15.5 cm) and small preoperative heights (OR = 2.97 for 10.5 cm). At a mean follow-up of 16.6 months, patient satisfaction was good or average in 92.1% of cases and 5.9% of implants had been replaced with another model, indicating that the perioperative implant selection was usually appropriate. Conclusions This study documents the frequency with which implant choices, despite accurate preoperative planning, are changed perioperatively as a result of relatively small differences in anthropomorphic measurements. Perioperative recalculation of breast dimensions may have an advantage in terms of patient reoperation rates. Changes in width were less frequent than changes in height and projection. Contralateral surgery, large width, and small height were the most influential factors. Level of Evidence: Level IV, risk / prognostic study.
      PubDate: 2017-01-03
      DOI: 10.1007/s00238-016-1261-z
       
  • Nose clefts: own experience of treatment with different types of
           congenital nasal anomalies
    • Authors: Marta Fijałkowska; Bogusław Antoszewski
      Pages: 409 - 414
      Abstract: Background Nose cleft is a rare congenital malformation. According to the Tessier classification, it can appear as a part of craniofacial cleft numbers 0, 1, 2, or 3. However, it can also be observed as an isolated nose cleft. The aim of this study was to present our experience in the treatment of isolated cleft nasal deformity. Methods A retrospective study of all patients with isolated nose cleft treated at our clinic between years 1995 and 2015 was undertaken. The collected data included age, sex, type of cleft, coexisting malformations, and methods of treatment. Results Over a period of 20 years, 28 patients with isolated cleft nasal deformity (11 males and 17 females)were treated. In the examined group, there were 21 patients with median nose cleft and seven with cleft of the ala nasi. Patients from the median nose cleft group were operated on in two or three stages. In the first stage, a procedure involving soft tissue and nose cartilage was performed, while in the second phase, rhinoplasty with osteotomy was performed. One patient had his treatment accomplished in three stages. Patients from the ala nasi cleft group underwent procedures performed with methods of local plasty or flap rotation. Conclusions Nose clefts are characterized by a variable clinical picture (midline cleft vs ala nasi cleft and total cleft vs partial cleft). The nose cleft is not always a part of craniofacial clefts as isolated forms of such malformations can also occur. This type of congenital anomaly requires always an individual treatment plan. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2016-12-01
      DOI: 10.1007/s00238-016-1220-8
      Issue No: Vol. 39, No. 6 (2016)
       
  • Forehead lipoma excision: a comparative study of open versus endoscopic
           technique
    • Authors: Hui Wen Ng; Yew Ming Samuel Ho; Siyun Michelle Ho; Sze-Wei Matthew Yeo; Thien Chong Marcus Wong
      Pages: 415 - 420
      Abstract: Background Endoscopic excision of forehead lipoma is increasingly utilized for its inconspicuous scarring, good intraoperative visualization and low complication rates. Currently, studies comparing outcomes from endoscopic and open excision of forehead lipomas are lacking. This retrospective study compares the surgical outcomes of the two techniques. Methods The authors retrospectively reviewed medical records of all patients who had undergone forehead lipoma excision at a single institution between 2010 and 2015. Data collected included patient demographics, lesion size, mean operative time and postoperative complications. A comparison was made between the two groups of patients. Results Sixty-two patients underwent excision of their forehead lipoma (38 endoscopic and 24 open excisions). Patient groups were similar in terms of sex ratios, size of lesion, choice of anaesthesia, mean operative time and duration of follow-up. Swelling beyond 1 week in the endoscopic group was 1/38 (2.6 %) compared to 4/24 (16.7 %) in the open excision group (p = 0.07). Postoperative scalp numbness in the endoscopic group was 2/38 (5.2 %) versus 2/24 (8.3 %) in the open excision group (p = 0.64). Incidence of haematoma in the endoscopic group was 1/38 (2.6 %) compared to 2/24 (4.2 %) in the open excision group (p = 1). All 38 patients in the endoscopic group were satisfied with their scars compared with 4/24 (16.7 %) in the open excision group who reported dissatisfaction (p = 0.02). Conclusions Complication rates of both surgical techniques are similar. Given that the endoscopic technique results in cosmetically superior outcomes, with no increase in morbidity, the authors recommend the use of endoscopic technique for forehead lipoma excision. Level of Evidence: Level III, therapeutic study.
      PubDate: 2016-12-01
      DOI: 10.1007/s00238-016-1225-3
      Issue No: Vol. 39, No. 6 (2016)
       
  • Versatility of lateral arm flap for hand reconstruction—a clinical
           experience
    • Authors: Qutaibah Al-Kandari; Abeer Kalandar; Hisham Burezq
      Pages: 435 - 440
      Abstract: Background The lateral arm free flap (LAFF) has several advantages in hand reconstruction due to multiple factors. We aimed to show the versatility of LAFF in treating hand defects. Methods A retrospective analysis of all LAAF for hand reconstruction carried out at our institutions between August 2006 and August 2012 was undertaken. Clinical records were reviewed with respect to patients’ age and gender, size and location of defect, type and size of flaps, and complications. Results Twenty-four hand defects were reconstructed using LAFF. These included 15 cutaneous flaps, 8 fascial flaps, and 1 osteocutaneous flap. All flaps survived well except for one case that developed arterial insufficiency and required anastomotic revision. Primary closure of the donor site was possible in all patients. No complications occurred during the healing procedure. Conclusions The free lateral arm flap is a versatile and reliable option for defect coverage at the hand for small- and medium-size defects. It can be raised as a cutaneous, fascial, or osteocutaneous flap. Several advantages favor the use of lateral arm flap in hand reconstruction. These include preservation of major arm blood vessels, its constant vascular anatomy, long pedicle, and low donor site morbidity. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2016-12-01
      DOI: 10.1007/s00238-016-1211-9
      Issue No: Vol. 39, No. 6 (2016)
       
  • An original technique for the correction of congenital inverted conchal
           bowl deformity in an adult
    • Authors: Omer Ahmed Osmani; Richard Matthews
      Pages: 449 - 452
      Abstract: Abstract Common congenital deformities of the ear include varying degrees of prominent ears and of microtia. Inverted conchal bowl is a very rare congenital deformity. In this condition, the anterior concavity of the concha is replaced by convexity, resulting in an abnormal appearance, as well as functional problems in the of use earpiece devices. This condition has been reported only once in a series of four paediatric cases, wherein a cartilage scoring technique, suitable for pliable cartilage in that age group, is described. No cases have been reported in an adult. We describe a simple and effective technique of managing this rare deformity in an adult, for the first time. The principle of the technique is the use an autologous cartilage graft. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-12-01
      DOI: 10.1007/s00238-016-1207-5
      Issue No: Vol. 39, No. 6 (2016)
       
  • Bowtie technique—a novel approach to correct the widened ventral labia
           majora after male-to-female gender reassignment surgery
    • Authors: D. G. Liang; J. R. Dusseldorp; C. van Schalkwyk; P. A. Haertsch
      Pages: 453 - 458
      Abstract: Abstract Male-to-female gender reassignment surgery is a procedure that has evolved significantly since its inception. To create an aesthetic and functional vagina is the primary focus. Despite its evolutions, second stage revisions are frequently utilised to correct labial and clitoral hood defects (e.g. loss of clitoral hood, widening of the ventral labia major and exposure of the anterior commissure). Our objective is to present a simple and effective surgical step in the male-to-female gender reassignment operation in order to reduce the need for second stage interventions. The Bowtie technique is performed as the last step to the male-to-female gender reassignment procedure and aims to emphasise the clitoral hood, reduce the space of the ventral labia major and diminish the exposure of the anterior commissure. Having been performed by the senior author since 1992, outcomes have been satisfactory with no need for secondary procedures in those patients for the described defects. The Bowtie technique is a beneficial addition in male-to-female reconstructive surgery, which allows for the procedure to be performed in one stage without the need to correct common post-operative aesthetic defects. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-12-01
      DOI: 10.1007/s00238-016-1191-9
      Issue No: Vol. 39, No. 6 (2016)
       
  • Signet ring adenocarcinoma of the colon presenting as an orbital
           metastasis
    • Authors: Charlotte R. Foster; Adam J. Cohen
      Pages: 459 - 462
      Abstract: Abstract A 67-year-old woman was referred after MRI imaging revealed an infiltrative, diffusely enhancing left intraconal lesion. Ophthalmic examination revealed a left proptosis, resistance to globe retropulsion, and restriction of extraocular motility in all fields of gaze. The result of a biopsy via an orbitotomy was consistent with signet ring adenocarcinoma. PET scanning was significant for lytic vertebral and rib lesions and activity within the cecum. Colonoscopy confirmed the diagnosis of stage 4 colonic adenocarcinoma. Although colon carcinoma presenting as an extraconal orbital metastasis has been reported, this is the first reported case of signet ring adenocarcinoma of the colon presenting as an intraconal orbital metastasis without eyelid involvement. Orbital metastatic disease from known primary malignancies is uncommon and in particular from carcinomas arising from the gastrointestinal tract. When metastatic orbital disease is found, studies have reported that as high as 42 % of these patients have an undiagnosed primary malignancy. This allows orbital surgery to play a role detecting as yet undiagnosed carcinomas. Level of Evidence: Level V, diagnostic study.
      PubDate: 2016-12-01
      DOI: 10.1007/s00238-016-1222-6
      Issue No: Vol. 39, No. 6 (2016)
       
  • The facial artery musculomucosal flap in the reconstruction of the
           cocaine-induced hard palate fistula
    • Authors: Alexandra Bucknor; Adam Sawyer; Duncan Atherton
      Pages: 463 - 466
      Abstract: Abstract The versatility of the facial artery musculomucosal (FAMM) flap has been employed in the reconstruction of a number of defects in the head and neck region. Closure of the cocaine-induced palatal fistula is complex, in particular because of the poor quality local tissue. To date, the FAMM flap has yet to be reported in this situation. We describe our experience with one such case, detailing our rationale for choosing the FAMM flap, intra-operative technique, and recommendations for other surgeons with similar cases. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-12-01
      DOI: 10.1007/s00238-016-1206-6
      Issue No: Vol. 39, No. 6 (2016)
       
  • Ischaemic peripheral polyneuropathy in the upper limb as a result of steal
           phenomenon in an arteriovenous malformation
    • Authors: Felicity Page; A. Harb; G. Titley
      Pages: 467 - 470
      Abstract: Abstract We present the case of a 38-year-old right-hand-dominant female with a longstanding extensive high flow arteriovenous malformation (AVM) affecting the left hand and forearm. The patient’s main complaints were altered sensation in the left hand and difficulty with co-ordination. Clinical examination revealed reduced global sensibility in the hand and evidence of a vascular steal phenomenon resulting in a cold thumb and small finger without trophic changes. Subsequent nerve conduction studies identified peripheral neuropathy affecting the median, ulnar and radial nerves. There was no evidence of entrapment neuropathy and the findings were attributed to nerve ischemia as a result of the steal phenomenon. This case represents an unusual complication of an AVM of the upper limb which has not been reported previously to our knowledge. Patients with complex AVMs presenting with atypical peripheral neuropathies should be assessed for the possibility of steal phenomenon. Level of Evidence: Level V, risk/prognostic study.
      PubDate: 2016-12-01
      DOI: 10.1007/s00238-016-1202-x
      Issue No: Vol. 39, No. 6 (2016)
       
  • Median poststernotomy dehiscence reconstruction—a new classification for
           selection of the best procedure
    • Authors: Diana Monteiro; Ricardo Horta; José Amarante; Pedro Silva; Álvaro Silva
      Pages: 471 - 472
      PubDate: 2016-12-01
      DOI: 10.1007/s00238-016-1210-x
      Issue No: Vol. 39, No. 6 (2016)
       
  • Fascio-cutaneous flaps for chest wall reconstruction after massive
           inflammatory breast cancer: a case series
    • Authors: Renzo Panizza; Marco Ghiglione; Michela Massa; Emanuela Grosso; Enrico Zingarelli; Silvia Scarrone
      Abstract: Background Inflammatory breast cancer represents a rare condition that presents poor prognosis with high risk of recurrences and greatly affects patients’ quality of life. The resective surgical treatment frequently requires challenging reconstructive solutions to restore a proper tissue layer for the chest wall. Reconstructive methods are nowadays still matter of debate. Methods A retrospective review of all cases of massive inflammatory breast cancer that underwent mastectomy and reconstruction with fasciocutaneous flaps from October 2009 to September 2014 was performed at our department. Patient demographics, indications, flap specifics, complications, and number of operations were collected. Results Our review identified five cases. A lateral thoracic flap was planned in two cases, a modified lateral thoraco-dorsal flap in one case, a combination of scapular and pubic flaps in other case, and a thoraco-epigastric and lateral thoracic flap association in the remaining case. The mean patient age was 60 years (range, 35 to 76 years). Flap dimensions ranged from 9cm to 14 cm in width and 20 to 24 cm in length. Partial necrosis of the flap distal part occurred in two cases requiring minor flap revision. Conclusions Resective surgical treatment of inflammatory breast cancer might require a challenging reconstructive planning. In this scenario, fasciocutaneous flaps are an interesting option due to their versatility, easiness of harvesting, low morbidity, and complications rate. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2016-12-28
      DOI: 10.1007/s00238-016-1257-8
       
  • Effect of neoadjuvant chemotherapy on women undergoing breast cancer
           surgery and immediate breast reconstruction with latissimus dorsi flap and
           silicone implants
    • Authors: Gabriel Salum D’Alessandro; Alejandro Povedano; Lauren Klas Iurk Leme dos Santos; Alexandre Mendonça Munhoz; Rolf Gemperli; João Carlos de Sampaio Góes
      Abstract: Abstract The use of the latissimus dorsi flap in immediate breast reconstruction is a relatively simple procedure using a flap with a very reliable and consistent vascularity. Neoadjuvant chemotherapy improves local surgical conditions; however, most chemotherapeutic agents are cytotoxic and may increase the risk of postoperative complications. This study evaluated the effects of neoadjuvant chemotherapy on women with cancer who underwent immediate breast reconstruction with latissimus dorsi flap and silicone implants. Data were collected from medical records of 102 patients with cancer who had undergone immediate breast reconstruction with latissimus dorsi flap and silicone implants from August 2010 to December 2014. Thirty-three patients received neoadjuvant chemotherapy (study group) and 69 patients underwent primary surgical treatment (control group). Three (2.9%) patients in the study group had a major postoperative complication (two cases of hematoma requiring surgical drainage and a case of flap necrosis), which was the only variable showing a significant difference between groups (P = 0.032). Neoadjuvant chemotherapy followed by cancer surgery with immediate breast reconstruction with latissimus dorsi flap and silicone implants was not associated with an increased risk of postoperative surgical and clinical minor complications. It was associated with a significant increase in postoperative major complications, despite the small number of cases. However, patients who received neoadjuvant chemotherapy had a significantly more aggressive disease and advanced-stage cancer, and required a more extensive cancer surgery. Level of Evidence: Level III, risk / prognostic study.
      PubDate: 2016-12-26
      DOI: 10.1007/s00238-016-1263-x
       
  • The V-shaped mini flap method for microform cleft lip repair
    • Authors: Naoshige Iida; Ayako Watanabe
      Abstract: Background We have devised a new operative technique for microform cleft lip repair via the use of a V-shaped flap method. From 2006 to 2015, nine patients with unilateral cleft lip diagnosed as mini-microform cleft lip or microform cleft lip by the classification of Yuzuriha and Mulliken, were recorded. Methods With our procedure, a V-shaped mini flap with the vermillion border serving as the vertex is inserted into the incised area along the vermillion border on the affected side, thereby allowing reliable correction of the vermillion border notch. When this procedure is applied to cases of microform cleft lip, the white lip’s linear mark is resected totally, followed by overlap suturing of the orbicularis oris muscle from the incised area to correct philtrum ridge deviation and nasal alar base lateral deviation. In cases of mini-microform cleft lip, the extent of resection of the skin and mucosa is reduced to the minimum necessary level to reduce the scar size as far as possible. Results This procedure was used for the treatment of microform cleft lip in six cases and mini-microform cleft lip in three cases. The mean age at operation was 13.3 months (range 6–45 months). There were no postoperative complications; moreover, no patient required additional surgery. Conclusions Regarding postoperative clinical findings, the scar was not evident because it was identical to the philtrum ridge. Furthermore, the cupid’s bow was symmetrical, and constriction at the vermillion’s free margin had been corrected. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2016-12-20
      DOI: 10.1007/s00238-016-1262-y
       
  • Upper-third ear reduction with a posterior approach
    • Authors: Carlos Cuesta-Romero; José María García-Sánchez
      Abstract: Abstract Anomalies in the complex topography of the pinna are often associated with disproportionate distances between the dimensions of its thirds, even with respect to the middle third of the face, forming macrotias that must be identified. If such correction is not carried out properly, the original deformation may even worsen in the postoperative period. For the reconstruction of auricular defects, different techniques have been described, involving excisions of the skin and cartilage with advancements, in order to regain a proportionate morphology. In the present work, we report a specific technique for the reduction of the upper third with a posterior approach, based on resection of the scapha and remodeling of the posterior skin surplus, associated with combined techniques of otoplasty to prevent the stigmata from previous surgery. Level of Evidence: Level V, therapeutic study.
      PubDate: 2016-12-15
      DOI: 10.1007/s00238-016-1264-9
       
  • Thoracic outlet syndrome: evaluation of clinical features and long-term
           outcomes after escalenotomy
    • Authors: Mindaugas Jasinskas; Tautvydas Urbonas; Mindaugas Minderis
      Abstract: Background Thoracic outlet syndrome (TOS) is a very complicated and diverse pathology including a range of symptoms related to the upper limb, neck, head, and other symptoms. This study was aimed to evaluate the long-term results of anterior scalenotomy in patients with TOS. Methods We examined patients that were operated on 2007–2011. The rate of symptoms was evaluated from medical records. Changes in pain, tactile sensation, strength of a handgrip, muscle wasting and patient’s satisfaction were evaluated postoperatively. Results Seventy-seven patients returned to follow-up evaluation (23 patients were treated for bilateral plexopathy). The mean follow-up was 50.3 months. Preoperative complaints (%) were as follows: upper extremity pain (93.0), numbness/paresthesia (93.7), decrease in hand strength (90.0) and headaches (53.8). Postoperatively, upper extremity pain disappeared in 81.7, numbness in 86.7 and headaches in 42.9 % of cases. Hand strength increased from 16.1 to 19.68 kg on average. Patients’ satisfaction with the results was evaluated as (%) follows: excellent (50.0), good (33.0), fair (15.0) and poor (2.0). Conclusions Anterior scalenotomy is an effective operative method to treat TOS. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2016-12-06
      DOI: 10.1007/s00238-016-1255-x
       
  • Pragmatic clinical trials: translating research into practice
    • Authors: Krishna S. Vyas; Sibi Rajendran; Samir Mardini
      PubDate: 2016-12-01
      DOI: 10.1007/s00238-016-1258-7
       
 
 
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