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Publisher: Springer-Verlag   (Total: 2208 journals)

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e & i Elektrotechnik und Informationstechnik     Hybrid Journal   (Followers: 7, SJR: 0.146, h-index: 8)
e-Neuroforum     Hybrid Journal  
Early Childhood Education J.     Hybrid Journal   (Followers: 11, SJR: 0.367, h-index: 12)
Earth Science Informatics     Hybrid Journal   (Followers: 3, SJR: 0.245, h-index: 5)
Earth, Moon, and Planets     Hybrid Journal   (Followers: 3, SJR: 0.436, h-index: 28)
Earthquake Engineering and Engineering Vibration     Hybrid Journal   (Followers: 7, SJR: 0.433, h-index: 17)
Earthquake Science     Hybrid Journal   (Followers: 9, SJR: 0.486, h-index: 7)
East Asia     Hybrid Journal   (Followers: 6, SJR: 0.165, h-index: 9)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 6, SJR: 0.289, h-index: 23)
EcoHealth     Hybrid Journal   (Followers: 1, SJR: 0.651, h-index: 22)
Ecological Research     Hybrid Journal   (Followers: 7, SJR: 0.698, h-index: 38)
Economic Botany     Hybrid Journal   (Followers: 8, SJR: 0.666, h-index: 40)
Economic Bulletin     Hybrid Journal   (Followers: 3)
Economic Change and Restructuring     Hybrid Journal   (Followers: 1, SJR: 0.263, h-index: 6)
Economic Theory     Hybrid Journal   (Followers: 5, SJR: 1.857, h-index: 31)
Economic Theory Bulletin     Hybrid Journal  
Economics of Governance     Hybrid Journal   (Followers: 2, SJR: 0.367, h-index: 12)
Ecosystems     Hybrid Journal   (Followers: 18, SJR: 1.793, h-index: 83)
Ecotoxicology     Hybrid Journal   (Followers: 10, SJR: 1.041, h-index: 53)
Education and Information Technologies     Hybrid Journal   (Followers: 132, SJR: 0.207, h-index: 15)
Educational Assessment, Evaluation and Accountability     Hybrid Journal   (Followers: 11, SJR: 0.519, h-index: 14)
Educational Psychology Review     Hybrid Journal   (Followers: 13, SJR: 1.781, h-index: 52)
Educational Research for Policy and Practice     Hybrid Journal   (Followers: 6, SJR: 0.211, h-index: 8)
Educational Studies in Mathematics     Hybrid Journal   (Followers: 7, SJR: 0.946, h-index: 27)
Educational Technology Research and Development     Partially Free   (Followers: 133, SJR: 1.124, h-index: 45)
Electrical Engineering     Hybrid Journal   (Followers: 8, SJR: 0.352, h-index: 17)
Electrocatalysis     Hybrid Journal   (SJR: 0.542, h-index: 7)
Electronic Commerce Research     Hybrid Journal   (Followers: 3, SJR: 0.636, h-index: 14)
Electronic Markets     Hybrid Journal   (Followers: 5, SJR: 0.326, h-index: 5)
Electronic Materials Letters     Hybrid Journal   (Followers: 2, SJR: 0.566, h-index: 11)
Elemente der Mathematik     Hybrid Journal  
Emergency Radiology     Hybrid Journal   (Followers: 4, SJR: 0.446, h-index: 22)
Empirica     Hybrid Journal   (Followers: 3, SJR: 0.185, h-index: 12)
Empirical Economics     Hybrid Journal   (Followers: 7, SJR: 0.5, h-index: 29)
Empirical Software Engineering     Hybrid Journal   (Followers: 4, SJR: 2.319, h-index: 33)
Employee Responsibilities and Rights J.     Hybrid Journal   (Followers: 2, SJR: 0.21, h-index: 13)
Endocrine     Hybrid Journal   (Followers: 4, SJR: 0.659, h-index: 55)
Endocrine Pathology     Hybrid Journal   (Followers: 2, SJR: 0.555, h-index: 27)
Energy Efficiency     Hybrid Journal   (Followers: 9, SJR: 1.056, h-index: 10)
Energy Systems     Hybrid Journal   (Followers: 8, SJR: 0.589, h-index: 5)
Engineering With Computers     Hybrid Journal   (Followers: 5, SJR: 0.497, h-index: 26)
Entomological Review     Hybrid Journal   (Followers: 3, SJR: 0.128, h-index: 5)
Environment Systems & Decisions     Hybrid Journal   (Followers: 2)
Environment, Development and Sustainability     Hybrid Journal   (Followers: 25, SJR: 0.319, h-index: 26)
Environmental and Ecological Statistics     Hybrid Journal   (Followers: 5, SJR: 0.389, h-index: 29)
Environmental and Resource Economics     Hybrid Journal   (Followers: 16, SJR: 1.651, h-index: 46)
Environmental Biology of Fishes     Hybrid Journal   (Followers: 3, SJR: 0.486, h-index: 53)
Environmental Chemistry Letters     Hybrid Journal   (Followers: 3, SJR: 0.664, h-index: 22)
Environmental Earth Sciences     Hybrid Journal   (Followers: 10, SJR: 0.601, h-index: 55)
Environmental Economics and Policy Studies     Hybrid Journal   (Followers: 5, SJR: 0.35, h-index: 3)
Environmental Evidence     Open Access  
Environmental Fluid Mechanics     Hybrid Journal   (Followers: 2, SJR: 0.732, h-index: 23)
Environmental Geochemistry and Health     Hybrid Journal   (Followers: 2, SJR: 0.909, h-index: 32)
Environmental Geology     Hybrid Journal   (Followers: 11)
Environmental Health and Preventive Medicine     Hybrid Journal   (Followers: 2, SJR: 0.388, h-index: 14)
Environmental Management     Hybrid Journal   (Followers: 29, SJR: 0.773, h-index: 60)
Environmental Modeling & Assessment     Hybrid Journal   (Followers: 11, SJR: 0.413, h-index: 27)
Environmental Monitoring and Assessment     Hybrid Journal   (Followers: 9, SJR: 0.671, h-index: 46)
Environmental Science and Pollution Research     Hybrid Journal   (Followers: 11, SJR: 0.878, h-index: 42)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 1, SJR: 1.002, h-index: 14)
Epileptic Disorders     Hybrid Journal   (Followers: 1, SJR: 0.669, h-index: 34)
EPJ A - Hadrons and Nuclei     Hybrid Journal   (Followers: 1, SJR: 1.435, h-index: 58)
EPJ B - Condensed Matter and Complex Systems     Hybrid Journal   (Followers: 3, SJR: 0.749, h-index: 85)
EPJ direct     Hybrid Journal  
EPJ E - Soft Matter and Biological Physics     Hybrid Journal   (Followers: 1, SJR: 0.661, h-index: 57)
EPMA J.     Open Access   (SJR: 0.161, h-index: 4)
ERA-Forum     Hybrid Journal   (Followers: 1, SJR: 0.13, h-index: 2)
Erkenntnis     Hybrid Journal   (Followers: 11, SJR: 0.62, h-index: 14)
Erwerbs-Obstbau     Hybrid Journal   (SJR: 0.173, h-index: 8)
Esophagus     Hybrid Journal   (SJR: 0.268, h-index: 9)
Estuaries and Coasts     Hybrid Journal   (Followers: 3, SJR: 1.111, h-index: 61)
Ethical Theory and Moral Practice     Hybrid Journal   (Followers: 7, SJR: 0.278, h-index: 8)
Ethics and Information Technology     Hybrid Journal   (Followers: 151, SJR: 0.363, h-index: 20)
Ethik in der Medizin     Hybrid Journal   (SJR: 0.204, h-index: 6)
Euphytica     Hybrid Journal   (Followers: 7, SJR: 0.709, h-index: 57)
Eurasian Soil Science     Hybrid Journal   (Followers: 2, SJR: 0.271, h-index: 10)
EURO J. of Transportation and Logistics     Hybrid Journal   (Followers: 4)
EURO J. on Computational Optimization     Hybrid Journal  
EURO J. on Decision Processes     Hybrid Journal  
Europaisches J. fur Minderheitenfragen     Hybrid Journal  
European Actuarial J.     Hybrid Journal   (Followers: 2)
European Archives of Oto-Rhino-Laryngology     Hybrid Journal   (Followers: 3, SJR: 0.737, h-index: 37)
European Archives of Paediatric Dentistry     Hybrid Journal   (Followers: 1, SJR: 0.446, h-index: 12)
European Archives of Psychiatry and Clinical Neuroscience     Hybrid Journal   (Followers: 2, SJR: 1.334, h-index: 62)
European Biophysics J.     Hybrid Journal   (Followers: 4, SJR: 0.979, h-index: 53)
European Child & Adolescent Psychiatry     Hybrid Journal   (Followers: 4, SJR: 1.269, h-index: 51)
European Clinics in Obstetrics and Gynaecology     Hybrid Journal   (Followers: 4)
European Food Research and Technology     Hybrid Journal   (Followers: 8, SJR: 0.773, h-index: 49)
European J. for Education Law and Policy     Hybrid Journal   (Followers: 5)
European J. for Philosophy of Science     Partially Free   (Followers: 4, SJR: 0.165, h-index: 2)
European J. of Ageing     Hybrid Journal   (Followers: 8, SJR: 0.49, h-index: 17)
European J. of Applied Physiology     Hybrid Journal   (Followers: 7, SJR: 1.044, h-index: 74)
European J. of Clinical Microbiology & Infectious Diseases     Hybrid Journal   (Followers: 9, SJR: 0.958, h-index: 74)
European J. of Clinical Pharmacology     Hybrid Journal   (Followers: 9, SJR: 0.916, h-index: 69)
European J. of Dermatology     Hybrid Journal   (Followers: 7)
European J. of Drug Metabolism and Pharmacokinetics     Hybrid Journal   (Followers: 6, SJR: 0.24, h-index: 25)
European J. of Epidemiology     Hybrid Journal   (Followers: 17, SJR: 1.946, h-index: 60)
European J. of Forest Research     Hybrid Journal   (Followers: 3, SJR: 0.864, h-index: 25)
European J. of Health Economics     Hybrid Journal   (Followers: 9, SJR: 0.67, h-index: 25)
European J. of Law and Economics     Hybrid Journal   (Followers: 147, SJR: 0.242, h-index: 13)

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Journal Cover European Journal of Plastic Surgery
   [4 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  [2208 journals]   [SJR: 0.227]   [H-I: 13]
  • Plastic surgery—a blend of art and science
    • PubDate: 2014-08-01
       
  • Primary thinning of the anterolateral thigh flap in Caucasians is a safe
           technique
    • Abstract: Background The anterolateral thigh (ALT) perforator flap is a well-described and versatile flap, regularly used for resurfacing and reconstructing soft tissue defects, but it is often too bulky to produce an aesthetically satisfactory result. Although primary thinning of the ALT has been successful in Eastern populations, studies have demonstrated that this may be inadvisable in Caucasians. This is the biggest clinical study demonstrating the clinical safety of primary thinning of ALT flaps in Caucasians. Methods A retrospective analysis was performed between January 2009 and August 2011 on 57 patients (mean age 43) undergoing ALT free flap reconstruction by three surgeons. They were all thinned via sharp dissection using loupe magnification except for 1–2 cm around the perforator by removing the larger fat globules of deep fascia and preserving the superficial fat layer. The resultant flap thickness was approximately 6 mm. Results In 77 % of cases, the flap was used for lower limb, 16 % for upper limb and 7 % for head and neck reconstruction. The mean flap surface area was 124 cm2. There was one flap loss (1.8 %) and three flaps returned to theatre for perioperative complications. Conclusions Careful primary thinning of ALT flaps is safe in Caucasian populations and can achieve improved cosmetic results. Level of Evidence: Level IV, risk/prognostic study.
      PubDate: 2014-08-01
       
  • Hidden risks of electronic cigarettes to patients undergoing plastic
           surgery
    • PubDate: 2014-08-01
       
  • Autologous breast reconstruction with the transverse myocutaneous gracilis
           flap: aesthetic improvements with tissue expansion before free flap
           transfer
    • Abstract: Abstract The transverse myocutaneous gracilis (TMG) flap provides an alternative to commonly used free flaps from the lower abdomen and buttocks for breast reconstruction. Excellent aesthetic results can be achieved in primary breast reconstruction after subcutaneous and skin-sparing mastectomy. However, in delayed breast reconstruction after mastectomy, an obvious skin island and conspicuous scars often compromise the final appearance. A two-stage approach with tissue expansion of the skin followed by free deepithelialised TMG flap reconstruction avoids these disadvantages and leads to improved aesthetic results. We treated two patients who asked for an autologous breast reconstruction after mastectomy due to primary breast cancer. Reconstruction with lower abdominal tissue was not feasible in one patient because of a previous abdominoplasty and in the other because of insufficient lower abdominal tissue. Both patients declined an implant-based breast reconstruction as well as a procedure using a flap from the buttock, favouring reconstruction with autologous tissue from the superior inner thigh. In the first stage, a tissue expander was inserted endoscopically assisted via a transaxillary approach. The expander was gradually filled over a 3-month period and finally replaced by a free deepithelialised TMG flap. The postoperative period was uneventful in both patients. We achieved satisfying results in both patients with good breast symmetry and uniform colour of the breast skin. Disadvantages and limitations of traditional one-stage breast reconstructions by free TMG flaps can be avoided by this two-stage approach. This reconstructive procedure leads to inconspicuous scars and a matching skin colour of both breasts. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-08-01
       
  • Total mandibular reconstruction using four free flap transfers in a
           patient with large mandibular osteosarcoma
    • Abstract: Abstract Mandibular reconstructions with composite defects are complex procedures that aim to achieve soft tissue closure, bony support and to restore facial contours. When large defects are present, multiple flaps may be required for optimal aesthetic and functional outcomes. Facial reconstruction using multiple flaps has been described. In 1993, Sanger et al. reported the use of three free flaps in a patient with osteoradionecrosis of the mandible. However, the feasibility of using more than three free flaps in a mandibular reconstruction remained to be determined. In this report, we describe the use of bilateral deep circumflex iliac artery (DCIA) iliac crest flaps and two radial forearm free flaps for the mandibular reconstruction in a 19-year-old male with radical excision of mandibular osteosarcoma and total mandibulectomy. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-07-29
       
  • Penile epidermal inclusion cyst: the importance of surgical care
    • PubDate: 2014-07-27
       
  • Predisposing factors, clinical presentation and outcome of treatment of
           avulsive human bites on the face: a case series analysis from Abuja,
           Nigeria
    • Abstract: Background Human bite can be classified as occlusive or non-occlusive. Occlusive bites are seldom reported to occur outside the facial region. This study aims to analyze cases of avulsive human bite and find which part of the face is the most frequently involved in such cases. The findings may indicate which part of the face is generally perceived as the most critical in judging attractiveness. Methods This retrospective study was carried out using a data review of all consecutive avulsive facial human bite cases seen in the maxillofacial surgery unit, National Hospital Abuja, between February 2001 and January 2014. Uniform protocol of prophylactic oral antibiotic and anti-tetanus cover was ensured throughout the study period. Results Seventeen cases were included in this study. Amorous jealousy was the cause of altercation in 15 (88.2 %) cases. Twelve (70.6 %) cases involved the lip. There were eight female and nine male victims. There were nine female and eight male assailants. Conclusions The lip is the most frequently affected region of the face in avulsive human bite attacks in our environment. This may be because it is considered the most important anatomical region of the face on which judgment of attractiveness is based. Level of evidence: Level IV, prognostic/risk study.
      PubDate: 2014-07-25
       
  • Management of facial and periocular dog bites: a review of 104 cases
    • Abstract: Background Dog bites are a frequent cause of facial and periocular injuries in both children and adults. This aim of this study is to review current practice in the management of facial and periorbital dog bite injuries and to examine the current evidence-base for such treatment strategies. Methods Five hundred eighty-seven patients with dog bite injuries requiring surgical intervention were identified from operating theatre records in one tertiary centre over a 9-year period. A retrospective case note review of 104 patients with facial and periorbital dog bite injuries was performed. Data on patient demographics, type of injury, treatment, and outcome was collected and analysed. Results The majority of patients were children, with a mean age of 11 years (range 1–91 years). Injuries involved the cheek in 57 cases (55 %), eyelids in 17 cases (16 %), lips in 24 cases (23 %) and nose in 8 cases (8 %). No facial fractures, canalicular, or globe injuries were recorded. All patients underwent irrigation, debridement, and primary wound closure. Surgical repair occurred within 24 h in 19 cases (18.2 %), within 48 h in 71 cases (68.3 %) and within 5 days in 14 cases (13.4 %). Three patients (2.9 %) developed a wound infection. Two patients (1.9 %) required scar revision surgery. Conclusions Periorbital and facial dog bite injuries may result in considerable morbidity. However, the majority of injuries are superficial and canalicular injury and bony injury is uncommon. Early wound irrigation, debridement and primary closure results in a good cosmetic outcome with a low risk of infection. Level of Evidence: Level IV, risk/prognostic study.
      PubDate: 2014-07-20
       
  • Towards a global plastic surgery research network
    • PubDate: 2014-07-18
       
  • Injection solution dyeing for verification of needle position in tissue
           expansion
    • Abstract: Background When inflating multiple tissue expanders in an outpatient basis, correct location of the expander port can be sometimes perplexing, even for experienced personnel. Herein, we review a series of patients whose expanders were dyed with soluble dye added to the injected solution as a further means of verification of needle position during serial expansions. Methods Thirty patients with a total of 81 expanders were followed. The expanders were filled with methylene blue dyed solution in the initial operative procedure. Data regarding patient demographics, surgery etiology, number and location of implanted expanders, and postoperative complications were collected for analysis. Results At total of 80 (98.7 %) expansions were completed successfully with subsequent reconstructions. Three patients required treatment for surgical site infections, one patient had a wound dehiscence, and one patient required drainage of a postoperative hematoma. One expander was removed due to extrusion. None of the patients had complications related to expander rupture or puncture. None were noted to have side effects related to methylene blue exposure. During subsequent outpatient expander inflations, medical staffs reported a higher confidence in port location thus simplifying the inflation procedure. Conclusions Although many surgeons currently use methylene blue dyeing technique to facilitate tissue expansion, there are no reports to attest to the safety of this method. The short series presented herein serves to further outline the safe application of this technique to tissue expansion. Level of Evidence: Level IV, risk/prognostic study.
      PubDate: 2014-07-18
       
  • Commentary on "A new device for nerve approximation in traumatic
           injuries of extremities" by K.S. Forootan et al.
    • PubDate: 2014-07-09
       
  • An unusual variant of infected median sternotomy wound: an addition to the
           Pairolero classification
    • PubDate: 2014-07-05
       
  • Surgical site fire caused by alcohol and diathermy
    • PubDate: 2014-07-04
       
  • Giant plexiform neurofibroma of the upper limb
    • PubDate: 2014-07-01
       
  • Pseudoangiomatous stromal hyperplasia: case report in a young patient and
           review of the literature
    • Abstract: Abstract Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast pathology, ranging from focal microscopic findings to clinical and mammographically evident masses, characterized by abnormal proliferation of the mammary stroma. Hormonal factors contribute probably to this pathology, since the average age of patients has been reported to be 40 years and can occur in postmenopausal patients who are on hormone replacement therapy. Notwithstanding, the etiology remains unclear and controversial. Usually, it is characterized by solitary, mobile, and slow-growing nodules. Notwithstanding, it may also occur as nodules or diffuse masses with rapid growth, simulating a malignant tumor. The recommended treatment is a wide excision of the lesion, with adequate free margins of resection, avoiding local recurrences. Herein, authors present a rare case of PASH in a 14-year-old patient, that produced severe breast deformity and assymetry. After complete excision, the breast was reconstructed by applying concepts of vertical scar breast reduction to restore breast symmetry. Level of Evidence: Level V, therapeutic study.
      PubDate: 2014-05-25
       
  • Bilateral pectoralis muscle advancement flap in the management of deep
           sternal wound infection: a single clinic study of clinical outcome and
           postoperative quality of life
    • Abstract: Background Poststernotomy mediastinitis is a serious complication after open heart surgery. There are currently no specific guidelines with regards to standard treatment. Methods This is a prospective cohort study using a source population of 7842 patients who underwent open heart surgery. Between 1999 and 2010, 83 patients were diagnosed with mediastinitis, of which 24 patients underwent reconstruction with bilateral pectoralis major advancement flap. All surviving patients were seen at follow-up, and postoperative functional level was examined. The closing date was October 1, 2011. Results Median follow-up time from primary operation was 6.0 (1.6–15.5) years. Median follow-up from postsurgical mediastinitis was26 5.4 (0.4–12.4)years. There was no early mortality, and 22 patients were discharged with complete wound closure and infection control. Quality of life questionnaires revealed significant morbidity with chronic pain and reduced mobility, but despite this, patients were satisfied with their overall health outcome. Conclusions Mediastinitis remains a serious postoperative complication after open heart surgery accounting for significant morbidity and mortality. Treatment of deep sternal wound infection by pectoralis major flap reconstruction gives excellent wound closure. Follow-up showed that these patients were multimorbid with reduced quality of life as measured. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2014-05-23
       
  • Complex incisional hernias repaired in conjunction with the Bony Anchoring
           Reinforcement System (BARS) prevents hernia recurrence
    • Abstract: Background Complex abdominal wall reconstruction and incisional hernia repair have been plagued by high recurrence rates, especially after multiple repair attempts and in those patients with high body mass index. We present an adjunct technique to validated procedures of hernia repair. Methods This study is a retrospective analysis of 63 patients between January 2006 and August 2012. Patients had bony suture anchoring of synthetic polypropylene mesh to the anterior superior iliac spine bilaterally, and the pubic symphysis after the abdominal fascia was reconstructed. Results Patient mean follow-up was 3.1 years (range 6 months to 6 years). None of the 63 patients had recurrent abdominal wall hernias. One patient, from early in the series, had post-operative bulging, which was retreated successfully using the current revised bone anchoring protocol. Five patients developed mesh infections; none of whom required radical debridement or removal of mesh. Conclusions The BARS technique for abdominal wall reconstruction provides an excellent reinforcement of fascial reconstruction with decreased hernia recurrence rates. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2014-05-18
       
  • Negative pressure wound therapy using gauze and foam: histological,
           immunohistochemical, and ultrasonography morphological analysis of
           granulation and scar tissues
    • Abstract: Background Negative pressure wound therapy (NPWT) is becoming routine for the preparation of wounds prior to grafting for wound closure. With this purpose, we have been using both foam and gauze-based NPWT obtaining similar proportions of closed wounds and observing less pliable scar tissue on the foam-treated patients. The aim of this study was to compare this two different fillers and to identify if there are different indications for their use according to anatomical areas in relation to the type of granulation and scar tissue obtained. Methods Both foam and gauze patients were compared in terms of depth and wound location, patients' age, and comorbidities. All foam patients were treated at 125 mmHg for an average of 25 days before skin grafting, while gauze patients were treated at 80 mmHg for an average of 21 days before skin grafting. Biopsies of granulation and scar tissues were taken and stained with hematoxylin-eosin and Masson's trichrome stainings, investigating vascular endothelial growth factor (VEGF) and metalloproteinase (MMP). An ultrasound analysis of the closed wounds was also conducted. Results Histological, immunohistochemical, and ultrasonographical results after gauze-based NPWT showed a minor tissue thickness and disorganization and less sclerotic components. Conclusions These results support the hypothesis that different fillers generate different scar tissues. The choice of the filler to apply negative pressure should be dictated by the anatomical areas affected by the lesion. Level of Evidence: Level IV, therapeutic study.
      PubDate: 2014-05-16
       
  • Merkel cell carcinoma: a single-centre experience
    • Abstract: Background For patients with merkel cell carcinoma (MCC), the status of regional lymph nodes at presentation is the single most important prognosticating tool, and the procedure is used for managing MCC patients with early stage disease identifying regional nodal micrometastasis. Methods A retrospective study was conducted of MCC patients treated at the University Hospital of Aarhus, Denmark, between 1998 and 2013. Outcomes of interest included the time and type of first recurrence after first treatment. In 2010, our institution began using sentinel lymph node biopsy (SLNB) for MCC patients with clinically early stage disease. Results Thirty four patients were identified, 61.8 % of the patients presented with stage I disease, 21.5 % with stage II, 11.8 % with stage III and 5.9 % with stage IV. Thirteen patients (38.2 %) had disease recurrence, with local recurrence in three patients, regional recurrence in seven patients and distant recurrence in three patients. Median length of follow-up for all patients was 14.5 months (range 0–86). Since 2010, SLNB has been performed in seven patients; all with negative sentinel lymph nodes (SLN). Three patients had tumour located to the head and neck, three patients to the extremities and one patient to the truncus. Nodal recurrence developed in one of these patients after 5.9 months. Conclusions The majority of patients develop recurrence within the first 2 years after initial treatment, most representing with nodal metastasis. The introduction of SLNB may hopefully detect nodal involvement in an early stage, improving the outcome for patients with MCC. Level of Evidence: Level IV, risk/prognostic study.
      PubDate: 2014-05-09
       
  • Unusual midline mandibular fistula
    • Abstract: Abstract Congenital midline upper lip sinus is a rare lesion. However, congenital midline mandibular skin tag combined lower lip fistula is very rarely reported and described. Therefore, a case report of a congenital midline sinus of the mandibular area in a 6-year-old female is presented. A 6-year-old girl presented with a nipple-like swelling on the mandibular area. Physical examination revealed about 5 × 5 mm protruding round mass with just a small opening that was non-tender to palpation. The tract is excised using probe and dye as the guide. Postoperatively, simple radiologic finding shows retained bony spur on the mandibular symphysis. Microscopic examination of the resected mass revealed the fistulous tract itself, consisting of fibrous connective tissue covered with stratified squamous epithelium, was observed in the center of the sample and especially showed dental component in the peripheral specimen. In the 6-month follow-up, this patient had a good result which was obtained by the method of the excision of the mass and fistulectomy. Level of Evidence: Level V, diagnostic study.
      PubDate: 2014-05-09
       
 
 
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