bluuebunny/crossref_metadata_2025 huggingface dataset:
Overcoming Barriers to Electrical Energy Storage
Authors: Ruz Francisco Castellano , Pollitt Michael G.
Published: February 2017

Multiple market drivers suggest that electrical energy storage (EES) systems are going to be essential for future power systems within the next decade. However, the deployment of the technology is proceeding at very different rates around the world. Whereas the sector is progressing quickly in California, it is not gaining much traction, so far, in Europe. This research aims to examine the prospects for viable business models of EES to emerge, by focusing on the value proposition, value creation and value capture aspects of the technology. The market and regulatory framework in California and Europe are analyzed critically, and changes to overcome the main barriers are recommended.

The research shows that the main barriers to viable business models are: inadequate definition and classification of EES in legislation; lack of markets for some ancillary services; inadequate market design that benefits traditional technologies; and the lack of need for EES in some jurisdictions.

The prospects are better in California because regulation is more advanced and favorable for the technology, and regulators are collaborating with developers and utilities to analyze barriers and solutions for the technology. In Europe, there is a need to study more deeply the necessity of EES, to clarify the definition of EES, create new markets for ancillary services and design technology-neutral market rules.
The significance of trust in the political system and motivation for pupils’ learning progress in politics lessons
Authors: Landwehr Barbara , Weisseno Georg
Published: February 2017

Very little research has been conducted on the contribution of political education to learning progress in Germany. Hence, there is a need for intervention studies measuring performance against the theoretical background of a political competence model. This model comprises three constructs: subject knowledge, motivation and attitudes. According to this model, politics lessons should not only convey knowledge but also arouse subject interest, promote political attitudes and develop problem-solving skills. This study investigates how knowledge acquisition is influenced by intervention using theory-oriented teaching materials on the European Union, intervention using conventional textbooks on the European Union and politics lessons without any reference to the European Union. It further asks how the performance-related self-concept and subject interest in political issues impact political knowledge and whether civic virtue and trust in the system are related to it. The sample comprises 1071 pupils. Theory-oriented politics classes lead to greater growth of pupils’ knowledge than in the control group. As anticipated, this study proves that a positive subject-specific self-concept impacts knowledge. The examination of political attitudes reveals a positive correlation between civic virtue and knowledge. There is no connection between trust in the political system and knowledge.
The role of imaging in the diagnosis of primary prostate cancer
Authors: Harvey Hugh , deSouza Nandita M
Published: February 2017

Ultrasound and magnetic resonance imaging (MRI) are key imaging modalities in prostate cancer diagnosis. MRI offers a range of intrinsic contrast mechanisms (T2, diffusion-weighted imaging (DWI), MR spectroscopy (MRS)) and extrinsic contrast-generating options based on tumour vascular state following injection of weakly paramagnetic agents such as gadolinium. Together these parameters are referred to as multiparametric (mp)MRI and are used for detecting and guiding biopsy and staging prostate cancer. Although sensitivity of mpMRI is <75% for disease detection, specificity is >90% and a standardised reporting system together with MR-guided targeted biopsy is the optimal diagnostic pathway. Shear wave ultrasound elastography is a new technique which also holds promise for future studies. This article describes the developments in imaging the primary site of prostate cancer and reviews their current and future utility for screening, diagnosis and T-staging the disease.
Tracing You: How transparent surveillance reveals a desire for visibility
Authors: Grosser Benjamin
Published: February 2017

Tracing You is an artwork that presents a website's best attempt to see the world from its visitors’ viewpoints. By cross referencing visitor IP addresses with available online data sources, the work traces each visitor back through the network to its possible origin. The end of that trace is the closest available image that potentially shows the visitor’s physical environment. Sometimes what this image shows is eerily accurate; other times it is wildly dislocated. This computational surveillance system thus makes transparent the potential visibility of one’s present location on the Earth, while also giving each site visitor the ability to watch other visitor “traces” in real time. By making its surveillance capacity and intention overt, Tracing You provokes questions about the architecture of networks and how that architecture affects our own visibility both within and outside of the network. Further, reactions to the work reveal attitudes towards surveillance post-Snowden, including, in some cases, an angry desire for more visibility than Tracing You currently provides. This commentary describes how the artwork functions, presents and discusses visitor reactions, and briefly theorizes origins for these reactions within the contexts of surveillance, sousveillance, and transparency in the age of ubiquitous online social networks.
The Sino-Indian border issue as a factor for the development of bilateral relations
Authors: Muratbekova Albina
Published: February 2017

The border issue between China and India has been prominent since the establishment of diplomatic relations between the two countries. Depending on time, an internal and external situation has changed, hence the value of disputed territory also shifted. This article shows the development of the border issue, recent rapprochements, and steps taken to settle the issue.
From ‘no cultural policy’ to ‘centralised market orientation’: The political economy of Hong Kong cultural policy (1997–2015)
Authors: Ho Louis
Published: February 2017

This study examines changes in the cultural policy in Hong Kong amid the transformations of political economy in the 1990s, following the handover in 1997, and under the administration of three Chief Executives (and their teams) up to 2015. When reviewing the literature on cultural policies in Hong Kong, this study examines the interaction the policies have with the political-economic development in Hong Kong (within the scope of this study) and subsequently explores changes in the principles of the policies. In other words, this study attempts to understand the conditions under which cultural policies were formulated in Hong Kong (the conditions of the production of local culture). The analytical framework of this study is based on two observations of the political and social changes occurring in Hong Kong (1997–2015): (1) changes in the government’s governance attitude since the handover in 1997, and (2) a series of economic blows Hong Kong has endured since 1998. Differing from the ‘descriptive literature’ defined by Schuster, this study understands that these changes are a result of the influence of a postcolonial state and neo-liberalism on public policy formulation. It is argued that the Hong Kong cultural policy framework has shifted from checks-and-balances towards centralised market orientation.
Heterotopic Salivary Gland Tissue at the Base of the Neck: A Case Report
Authors: Hwang John Muen , Robertson Donald Ian , Magi Enzio
Published: February 2017

A case report of ectopic salivary gland tissue at the base of the neck is presented. Heterotopic salivary gland tissue (HSGT) is found infrequently in the neck. This lesion, present since birth, typically presents as a discharging sinus in the base of the neck. Benign and malignant neoplasms may arise in such HSGT. The origin of HSGT is thought to be heteroplasia of the epithelium of the precervical sinus of His.
Lateral Nasal Osteotomies: Does the Creation of a Periosteal Tunnel Influence the Degree of Postoperative Ecchymosis?
Authors: Bafaqeeh Sameer Ali
Published: February 2017

In a prospective study of 20 consecutive patients, all patients underwent a closed rhinoplasty in which bilateral, lateral nasal osteotomies were performed to close an open roof following dorsal reduction. On one side, the osteotomy was performed without periosteal elevation, and on the other side, an external periosteal tunnel was created before performing the osteotomy. The side of the face with more ecchymosis was determined by another surgeon who was unaware of the side with the periosteal tunnel. Using Fisher's exact test, P=0.1, indicating that the creation of a periosteal tunnel had no significant influence on the degree of postoperative ecchymosis.
Experience with Alternative Sources of Structural Bone Graft for Total Wrist Fusion in Three Rheumatoid Arthritis Patients
Authors: Hopper Richard A , Bogoch Earl R
Published: February 2017

Three cases are presented in which alternative sources of bone graft were used for wrist fusion; in two cases, frozen irradiated allograft was implanted, and in one, stored frozen autogenous bone harvested from the patient during a previous procedure was used. All cases were followed clinically and radiologically for at least one year. The frozen banked allograft and autograft were not successful when used as structural grafts to bridge a defect for wrist fusion; however, allograft implantation resulted in successful wrist fusion where host bone contact across the fusion site was maintained, and the allograft was used to fill a defect. Fresh autogenous bone remains the structural graft of choice for wrist fusion in the rheumatoid patient in the few cases where graft is required for this diagnosis. Morsellized frozen allograft can be employed to fill dead space.
Reliability of Hand Fellows’ Measurements and Classifications from Radiographs of Distal Radius Fractures
Authors: Macdermid Joy C , Richards Robert S , Donner Allan , Bellamy Nick , Roth James H , Hildebrand Kevin A
Published: February 2017

The inter-rater reliability of classification systems and the direct measurement of fracture displacement was evaluated for two hand fellows in 128 radiographs of distal radius fractures. The fracture classifications rated were the Older, Mayo, AO, McMurtry, Universal and Frykman systems. Measurements of displacement were radial tilt, radial shortening and dorsal angulation on pre- and postreduction films. Intraclass correlation coefficients (ICCs) and kappas, and their associated 95% confidence intervals were calculated. Inter-rater reliability for classification systems was poor, with the exception of the Older system (kappa = 0.73). Prereduction measurement of radial inclination, dorsal angulation and radial shortening had excellent reliability (ICC 0.77). Postreduction films exhibited lower reliability in the same measurements (ICC 0.76). Hand fellows reported inconsistent use of classification systems or radiographical measurements in clinical practice. Further training and/or an increased emphasis on direct measurements, rather than classifications, may be warranted.
Preoperative Ethanol Sclerotherapy for Facial Cavernous Hemangioma
Authors: Coban Y Kenan , Kurt Ali
Published: February 2017

Ethanol injection therapy is gaining more acceptance for the treatment of vascular lesions. A case of extensive cavernous hemangioma treated with surgical resection and preoperative sclerotherapy with absolute ethanol is presented. By using magnetic resonance imaging, it was shown that ethanol injections in the vascular channels produced enough sclerosis that excisional surgery with less bleeding was possible.
Self-Esteem in Children with Facial Paralysis: A Review of Measures
Authors: Jugenburg Martin , Hubley Pam , Yandell Holly , Manktelow Ralph T , Zuker Ronald M
Published: February 2017

Research in surgery has traditionally focused on quantitative results, sometimes ignoring the qualitative impact on patients. The purpose of the present review was to identify appropriate measurement tools to assess the psychosocial domains of children undergoing corrective surgery for facial paralysis. More specifically, the construct of self-esteem was explored. The outcome of the present investigation is the recommendation for Harter-based assessment tools for research purposes and the Rosenberg Self-Esteem Scale for clinical use. Using these tools will allow health care professionals to assess the psychosocial issues that are important to children with facial differences and to conduct research on the psychosocial impact of corrective surgery.
Modification of the radioactive microsphere technique for assessment of regional blood flow to the craniofacial skeleton in the New Zealand rabbit
Authors: La Scala Giorgio C , Shenker Robert L , Addison Patrick D , Zhong An-Guo , Pang Cho Y , Neligan Peter C , Forrest Christopher R
Published: February 2017

Background

The radioactive microsphere technique has been used extensively for the accurate measurement of tissue blood flow in experimental animals. However, the need for carotid artery cannulation for injection of microspheres may significantly impair blood flow to the head and neck region.

Objective

This study assessed an alternative technique of injecting microspheres directly into the left ventricle to ensure a symmetric distribution of microspheres to the head.

Methods

Twenty-five New Zealand rabbits (seven to nine weeks of age) underwent blood flow measurement to the orbitozygomatic complex (OZC) regions bilaterally. Under general anesthesia, a sternotomy was performed and a cannula was inserted into the left ventricle. Radioactive microspheres were injected after a stabilization period of 15 min. Blood pressure and cardiac output were measured during the procedure and the animals were sacrificed at the end of the experiment. Tissue samples were harvested bilaterally from the OZC, hemimandibles, masseter muscles and overlying skin for measurement of blood flow.

Results

There was no significant difference in blood flow between the right and left side specimens. Animals were hemodynamically stable during the procedure.

Conclusion

Assessment of blood flow to the craniofacial region in experimental animals using radioactive microspheres may be facilitated by sternotomy and direct intracardiac injection.
Operative repair of a chronic, ulnar proximal interphalangeal dislocation of the little finger with an excellent functional result
Authors: Neumeister Michael W , Mowlavi Arian , Andrews Kris
Published: February 2017

Chronic dislocations of the proximal interphalangeal joint are not common. The instability and physical impairment, however, can render the digit or hand quite dysfunctional. A case report of the reconstruction of a nine-year chronic proximal interphalangeal joint dislocation of the left little finger is presented. The functional recovery is described. A literature review of the treatment of chronic dislocations of the proximal interphalangeal joint is also discussed.
Subungual superficial angiomyxoma
Authors: Malpass Kristian G , Snelling Charles Ft , Trotter Martin J
Published: February 2017

This is the first report of a subungual superficial angiomyxoma. Excision followed 12 months of lesion growth and progressive index nail-plate elevation. The encapsulated mass was separated bluntly from the nail bed undersurface, although sharp dissection was required to split the periosteal interface. Five cases of subungual myxoma have been reported. Histologically, both superficial angiomyxoma and myxoma entities contain spindle and stellate cells within a myxoid stroma. Vascular and cellular elements found only in superficial angiomyxoma were identified in the featured lesion. Recurrence rates following superficial angiomyxoma excision are greater than those of myxoma. This patient did not experience recurrence after 11 postoperative months.
Primary Leiomyosarcoma of the Oral Cavity: A Case Report and Review of the Literature
Authors: Fasanmade A , Barrett Aw , Newman L , Hyde Nc
Published: February 2017

Leiomyosarcoma is a malignant tumour of mesenchymal origin that is uncommon in the head and neck, and particularly uncommon in the oral cavity. This article presents a case of primary leiomyosarcoma affecting the mucosal lining of the cheek in a 35-year-old woman. The need for wide excision is emphasized, and because of the high frequency of regional lymph node metastasis, an ipsilateral neck dissection is advocated, followed by adjuvant radiotherapy for residual microscopic disease.
Contraction of the composite skin graft and autograft
Authors: Gragnani Alfredo , Morgan Jeffrey R , Ferreira Lydia Masako
Published: February 2017

Wound contraction as a result of a delay in grafting or second intention healing in an area that there was no graft take is a serious problem because of the sequela to the burned patient.

The objective of the present study was to evaluate the contraction of the cultured keratinocytes and human acellular dermis composite graft by tracing the graft with transparent film after transplantation to the back of athymic mice.

The evaluation of the contraction of the composite skin grafts and autografts in relation to the original wound area on the back of the athymic mice demonstrated greater contraction of the grafts after the dressings were removed on the seventh day. The composite skin graft contraction was significantly bigger than the autograft contraction.

The experimental data suggested that the contraction appeared after dressing removal, but that the macroscopic aspect of the composite skin graft remained normal with no distortion of the graft or the surrounded murine skin.
A comparison of pulse oximetry and laser Doppler flowmetry in monitoring sequential vascular occlusion in a rabbit ear model
Authors: Hallock Geoffrey G , Rice David C
Published: February 2017

The ultimate success of any free flap transfer depends not only on the experience of the given surgical team, but also requires constant vigilance in the perioperative period to assure continued anastomotic patency. Clinical acumen remains the ‘industry’ standard, but adjunctive monitoring devices are important to reinforce these subjective evaluations. We routinely use laser Doppler flowmetry in spite of known drawbacks, including expense. On the other hand, we know that pulse oximetry is a possible and readily available alternative. The efficacy of these two monitoring systems was directly compared in a New Zealand white rabbit central artery and vein ear model. Arterial occlusion was immediately recognized by a precipitous drop in flow and oxygen saturation (SaO2). A rapid drop in flow after venous occlusion with a trend to zero was also noted with laser Doppler flowmetry. The SaO2 had a very slow but steady gradual decline, but values remained in the range of normoxemia for a prolonged time. Because a minimum threshold of SaO2 for predicting venous occlusion was elusive, the usefulness of pulse oximetry for monitoring microsurgical composite tissue transfers is limited.
Synovial chondromatosis of the hand: Three case reports and literature review
Authors: Wong Sarah Hew-Ming , Salama Sam , Thoma Achilleas
Published: February 2017

Synovial chondromatosis is a rare condition that is probably caused by synovial connective tissue metaplasia. It is very rare in the hand and wrist and because of its low prevalence and nonspecific symptoms, synovial chondromatosis can present diagnostic difficulties for the hand surgeon and may lead to a delay in treatment. We review the literature and report three additional cases of synovial chondromatosis in the hand.
A Giant Lymphangioma Circumscriptum on the Anterior Axilla: A Case Report
Authors: Askar Ibrahim , Kilinc Nihal , Aytekin Sema
Published: February 2017

Lymphangioma is a rare benign proliferative lymphatic lesion that appears in chronic lymphedematous states in a variety of settings. Lymphangioma circumscriptum consists of clinically thin-walled, translucent vesicles appearing in groups most commonly located on the axilla, chest, mouth, and tongue. A 12-year-old male patient had been suffering from itching, pink-red colored, translucent vesicular lesions overlying the anterior axilla since birth. The lesions had slow-ly grown in size and number over the years. The patient had no history of trauma, or cellulites. The physical examination revealed clusters of pink-red colored vesicles, which released a clear exudate when punctured. The lesion was 50×120 mm in size. The lesion was totally excised and repaired with Z-plasty. Histopathological examination revealed slight epidermal acanthosis and enlarged lymph in the upper dermis, impinging directly onto the epidermis. These lymphatics were lined only by endothelium. The lower dermis and sub-cutis contained abnormally large muscle-coated vessels containing a proteinaceous fluid. Six months later, there was no recurrence and a cosmetically and functionally acceptable postoperative result was obtained.
Use of Distant V-Y Plasty in Reconstruction of Defects on the Nasal Dorsum: A New Modification of V-Y Plasty
Authors: Askar Ibrahim , Oktay M Faruk
Published: February 2017

Nasal reconstruction requires a good aesthetic outcome because the nose is located in the centre of the face. Two problems commonly occur after reconstruction of the nose: abnormal appearance of the new nose, and nasal airway obstruction. The nasal dorsum should be treated as a separate unit. Several local flaps have been described for reconstruction of tissue defects on the dorsum of the nose. Most of these techniques have some disadvantages, such as colour mismatch, dog-ear formation, thickness of flaps and requirement of surgery for revision. Two patients in whom the nasal dorsum was reconstructed with distant V-Y plasty are presented. Six months later, cosmetically acceptable results were obtained. The authors believe that the distant V-Y plasty is an effective alternative to the current techniques in reconstruction of the nasal dorsum. The advantages of this technique include the following: distant V-Y plasty is a safe and useful way to reconstruct medium and large defects of the nasal dorsum; it provides good texture and colour match; the resultant scar cannot cause contour deformity because it is not a bulky flap; there are no formation of dog-ear; it can be used to cover larger defects in elderly patients; it can be used under local anesthesia in almost all cases; it requires a shorter period of operating time and hospitalization; and it is less costly.
Transfer of Either Index Finger Extensor Tendon to the Extensor Pollicis Longus Tendon
Authors: Meads Bryce M , Bogoch Earl R
Published: February 2017

Background:

Extensor pollicis longus (EPL) tendon ruptures have been treated succesfully with the transfer of the extensor indicis proprius (EIP) tendon. Situations exist in which, due to intraoperative observations, another tendon transfer may be considered preferable to the standard EIP transfer method.

Objectives:

To determine whether transfer of the extensor digitorum communis II (EDC II) tendon from the index finger to the EPL tendon, leaving the EIP tendon to the index finger intact, would serve as an equally efficient transfer and not adversely affect the function of the hand.

Methods:

Two patients who had the EDC II tendon transferred to the ruptured EPL tendon, and two patients who had the EIP tendon transferred, were retrospectively reviewed. In each transfer type, one patient had suffered an EPL tendon rupture after a Colles’ fracture, and the other had rheumatoid arthritis. The rupture occurred on the non-dominant side in one patient in each transfer type. Each patient was examined and subjected to range of motion and power testing at least one year following surgery.

Results:

All four patients showed a minimal extension lag with the lift off test, but there was no noticeable difference in range of motion, pinch grip and hand grip strength between the transfer types. Both EDC II transfer patients demonstrated an 8° to 15° loss of thumb interphalangeal joint flexion compared with the unoperated side; EIP transfer patients demonstrated less than a 5° loss. Three patients demonstrated a minor extension lag in the index finger and middle finger. Extension power of the thumb and index finger in all patients varied with wrist flexion and extension and ranged from 50% to 150% of the unoperated side.

Conclusions:

These case reports suggest that either index finger tendon may be successfully transferred in EPL tendon ruptures.
Johanson-Blizzard Syndrome: A Challenge in Nasal Reconstruction
Authors: Timoney Norma , Weinberg Michael J , Ross David A , Thomson Hugh G
Published: February 2017

Johanson-Blizzard syndrome is rare and involves multiple congenital anomalies, including bilateral absence or deficiency of the nasal alae, giving the affected infant a characteristic appearance.

Two cases are described that illustrate the difficulties of nasal reconstruction in young children. Surgical options and the timing of intervention are discussed.
Posterior Interosseous Nerve Compression Secondary to a Parosteal Lipoma: Case Report and Literature Review
Authors: Avram Bsc Ronen , Hynes Nicolas M
Published: February 2017

An unusual case of limited radial nerve palsy secondary to a parosteal lipoma is presented, along with a thorough review of the literature. Palsy of the posterior interosseous nerve secondary to compression by a lipoma is a rare occurrence. Most cases tend to occur in the fifth to eighth decades of life. The pattern of physical symptoms may be quite variable. A high degree of suspicion must be maintained in the setting of unexplained symptoms. The literature review revealed the presence of a diagnostic proximal forearm radiolucent mass in 13 of 15 patients. Although they are used as diagnostic aids, computed tomography and magnetic resonance imaging have not been shown to alter management. Though benign tumours constitute a minority of such cases, a plain radiograph is recommended in addition to electromyographic and nerve conduction studies.
Scalp Ulceration From a Circumferential Head Dressing After Craniotomy: Case Report of An Uncommon Complication Due to Human Error
Authors: Singhal Ashutosh , Bray Peter W , Bernstein Mark
Published: February 2017

The present paper describes a previously unpublished complication of the application of a circumferential head dressing after cranial neurosurgery. A 34-year-old woman developed a large area of skin necrosis on her forehead from a circumferential head dressing applied after the surgical removal of a colloid cyst. Neurological recovery was excellent but plastic surgical repair of her iatrogenic cosmetic injury was required.
Severe Myositis Ossificans in a Paraplegic Trauma Patient: Influence in Pressure Sore Management
Authors: Parker Wendy Lynne , Hodge Jacqueline C , Lessard Marie-Lucie
Published: February 2017

Myositis ossificans (MO) is a benign, progressive, ossifying lesion that displays a characteristic zonal histological appearance. MO traumatica is a localized form of heterotopic bone formation, associated with repetitive micro- and/or macrotrauma in the majority of cases. The importance of imaging to differentiate MO from sarcomatous change and to determine maturity of the lesion is identified because suboptimal operative intervention on immature MO inevitably results in recurrence. A severe case of MO in a 24-year-old paraplegic man with chronic bilateral greater trochanteric pressure sores is presented, and the importance of the MO in the etiology and treatment of this case is discussed. An extensive review of the literature is included and integrated.
Cutaneous Ganglioneuroma Within a Giant Congenital Nevus
Authors: Jaeger Marcos Ro , Viero Sandra , Zuker Ronald M
Published: February 2017

Cutaneous ganglioneuroma has only occasionally been reported in the literature. Cutaneous ganglioneuroma is seen even more rarely in association with a giant congenital nevus. Differential diagnosis includes malignancies, especially melanoma and metastatic neuroblastoma.

It is essential to rule out malignancy in a solid lesion within a congenital nevus. The present report is possibly the first relating ganglioneuroma and a congenital nevus to a cervical mass detected during routine prenatal ultrasound.
Use of the Mayfield Horseshoe Headrest for Management of Burns of the Neck
Authors: Balakrishnan Chenicheri , Pane Thomas A
Published: February 2017

Proper positioning of a patient facilitates access and decreases frustration during surgical debridement of circumferential burns of the neck. The Mayfield swivel horseshoe headrest (Integra, USA) provides cranial support in either the supine or prone position for excision and skin grafting of the circumferential burns of the neck. This headrest can also be used during reconstruction of the neck.
Nasal Dorsum Skin Expansion for Reconstruction of Saddle Nose Due to Gunshot Injury: A Case Report
Authors: Ozturk Serdar , Zor Fatih , Sengezer Mustafa
Published: February 2017

Saddle nose deformity due to gunshot injury is a challenging problem for the maxillofacial surgeon. Because of the severe damage to the soft and bony tissues, the reconstructive options are very limited. In the present case report, a saddle nose deformity sustained from gunshot injury was reconstructed with a porous polyethylene nasal implant after a successful expansion of the nasal dorsum skin. Healing was uneventful at two-year follow-up, with superior patient satisfaction. Nasal dorsum skin expansion should be considered as an option in the reconstruction of moderately sized soft tissue deficits of the nose.
Traumatic Intratendinous Flexor Digitorum Profundus Rupture: A Case Report
Authors: Krishnamurthy Ashok , Golla Dinakar , Lee Wp Andrew , Rubin J Peter
Published: February 2017

Intratendinous ruptures of a flexor digitorum profundus tendon are rare in patients who do not have rheumatoid arthritis. A case of a patient with no history of autoimmune disease who suffered a traumatic rupture of the flexor digitorum profundus tendon to the ring finger in the mid-palm is reported.
Cutaneous Furuncular Myiasis: Human Infestation By the Botfly
Authors: Jacobs Bryan , Brown David L
Published: February 2017

Dermatobia hominis, the botfly, is indigenous to Central and South America. Its usual host is a mammal, often a horse or cow. Cutaneous furuncular myiasis, human infestation by the botfly, has rarely been reported. Symptoms of infestation include a locally painful, firm furuncular lesion, often with a centrally located pore. Due to their infrequent occurrence, these lesions are often misdiagnosed as cellulitis, leishmaniasis, furunculosis, staphylococcal boil, insect bite or sebaceous cyst – conditions with similar presentations. The present case reiterates the need to think of ‘zebras’ when hearing hoof beats’ that may have originated in a different land.
Significance of Early Diagnosis of Abdominal Compartment Syndrome in Major Burns
Authors: Levis C , Ali F
Published: February 2017

Four cases of abdominal compartment syndrome in patients suffering major burns, who were treated at Hamilton General Hospital, Hamilton, Ontario, from January 1998 to June 2003, are reported. The pathophysiological changes, and the high morbidity and mortality associated with this condition are also described. The significance of early diagnosis of this syndrome is discussed. The literature is reviewed and a protocol is suggested for measuring urinary bladder pressure when managing major burns.
Evaluation of sun protection behaviour in patients following excision of a skin lesion
Authors: Novak Christine B , Young Diana S , Lipa Joan E , Neligan Peter C
Published: February 2017

The present prospective study evaluated sun exposure and sun protection behaviours in patients diagnosed with a precancerous or cancerous skin lesion. Following signed informed consent, patients were given a questionnaire regarding sun protection and sun exposure behaviour. There were 50 patients (27 men, 23 women) with a mean age of 59 years. Following diagnosis of a cancerous or precancerous lesion, there was a significant increase (P<0.001) in sunscreen use, use of sun protection factor greater than 30, wearing a hat and avoidance of sun between 10:00 and 14:00. There were significantly more women who used sunscreen (P=0.04) and limited daily activities (P=0.03). There were significantly more patients with nonmelanoma lesions who wore hats (P<0.04) and more patients with melanoma who limited daily activities (P<0.04). While many patients in the present study did alter their sun protection and exposure behaviour, there were many patients who continued in risk-taking sun behaviour. Therefore, patients with precancerous or cancerous skin lesions who are not compliant with sun protective behaviour may benefit from more comprehensive patient education to encourage better sun protection behaviour.
Rate of pediatric tap water scald injuries in eastern Ontario
Authors: Barnsley G Philip , Barnsley Shannon E
Published: February 2017

Background

Tap water scalds can be devastating and are entirely preventable. This topic has received notable attention in Canada in recent years, with a national campaign in 2001 directed at parents recommending that they lower the water temperature of their home water heater. This campaign has been evaluated and reported as a successful population-based intervention.

Objectives

The present study evaluated the rate of pediatric tap water scalds in Ottawa, Ontario over the 10-year period from 1993 to 2002 in an attempt to identify the impact of this national awareness campaign.

Methods

Data from the Children's Hospital of Eastern Ontario available in the Canadian Hospitals Injury Reporting and Prevention Program database were used to calculate the yearly incidence density of tap water scalds among children younger than 15 years in the city of Ottawa.

Results

It was found that there was no statistically significant change in the rate of pediatric tap water scalds following the national campaign, and that the rate of these injuries was already very low (3.73 per 100,000 person-years over the study period). Of these, only 17% required observation or admission to hospital.

Conclusions

Given the low incidence of these injuries, their priority as a public health concern needs to be re-evaluated. If they continue to be a priority, new preventive strategies need to be used. It is thought that resources used to lobby for legislation of lower hot water temperatures may be more effective in reducing the incidence of these injuries.
Facial neurothekeoma in a 10-year-old child
Authors: Koumanis Dimitri J , Glickman Laurence T
Published: February 2017

Neurothekeoma is a rare and benign tumour that occurs most frequently on the head and neck. It is classified as a nerve sheath tumour and epidemiologically occurs in young adults. It is rare to find these tumours occurring in children. The following report describes a case of neurothekeoma in a young girl, its treatment and a review of the literature. Specific histological analysis may reveal atypical and aggressive features, which, in turn, affect resection and reconstructive options.
An uncommon folliculosebaceous cystic hamartoma on the lower extremity
Authors: Emsen Ilteris Murat , Livaoglu Ayten
Published: February 2017

Background

Folliculosebaceous cystic hamartomas (FSCH) are a recently recognized cutaneous hamartoma comprised of follicular, sebaceous and mesenchymal elements. Only nine cases have been previously reported. The authors present a case of FSCH on the lower extremity in addition to a literature review.

Objective

To further characterize the clinical, histological and immunohistological features of FSCH.

Methods

The clinical, histological and immunohistological features of FSCH were evaluated and the literature reviewed. RESULTS: This lesion uncommonly presents as exophytic papules or nodules on the leg, and most commonly presents on the central part of the face. Clinical differential diagnoses included nevus, neurofibroma and adnexal tumour. The diagnostic microscopic features of infundibular cystic structures with attached sebaceous glands and characteristic stroma were present in all lesions. Many of the stromal spindle cells were CD34–positive.

Conclusion

The FSCH is a recently recognized hamartoma comprised of follicular, sebaceous and mesenchymal elements. Although reported only rarely, its incidence is likely much higher. In the present patient, the FSCH was located in femoral region, which is very rare.
Minimal Inframammary Incision for Breast Augmentation
Authors: Fanous Nabil , Tawilé Caroline , Brousseau Valérie J
Published: February 2017

The inframammary approach in breast augmentation, still the most popular technique among plastic surgeons, has always been hampered by the undesirable appearance of its scar. The present paper describes a modified approach to inframammary augmentation with saline-filled prostheses. This approach uses a very short incision, thus resulting in a much less noticeable scar. The surgical technique is easy to learn, simple to execute, does not necessitate any special equipment and gives consistent results. Decreasing the scar length to an absolute minimum ensures higher patient and surgeon satisfaction.
Breast Necrosis: Calciphylaxis a Rare Cause
Authors: Thornton Joseph J , Dolph James
Published: February 2017

Calciphylaxis is a small vessel vasculopathy characterized by significant calcium deposition in the vessel walls and tissue of renal failure patients. The process leads to progressive, painful, ischemic wounding. Management is generally medical; however, superinfection requires surgical intervention. A case of calciphylaxis of the breast is presented. Calciphylaxis of the breast is atypical – the wounds are usually located on the abdomen and thighs. A discussion of the process, its progression, identification and surgical management is presented. A case is made for appropriate debridement and vacuum-assisted wound therapy.
Compression Neuropathy of the Peroneal Nerve Secondary to a Ganglion Cyst
Authors: Greer-Bayramoglu Rebecca J , Nimigan André S , Gan Bing Siang
Published: February 2017

Peripheral neuropathies caused by ganglion cysts are rare, particularly in the lower extremities. The case of a 45-year-old man with a two-month history of foot drop and swelling in the region of the right fibular head is presented. Physical examination and electromyogram studies verified a peroneal nerve palsy. Magnetic resonance imaging revealed a lobulated, multilocular, cystic-appearing mass extending around the fibular neck. Surgical decompression of the nerve with removal of the mass and careful articular branch ligation was performed. Surgical pathology reports confirmed the diagnosis of a ganglion cyst. The patient regained full function within four months of the decompression. Pertinent findings on physical examination are discussed, as well as electromyogram and magnetic resonance imaging results. If symptoms persist, early surgical decompression (between the third and fourth months) is recommended.
Incidence of Capsular Contracture in Silicone Versus Saline Cosmetic Augmentation Mammoplasty: A Meta-Analysis
Authors: El-Sheikh Yasser , Tutino Roberto , Knight Casey , Farrokhyar Farough , Hynes Nicolas
Published: February 2017

Introduction

Capsular contracture after augmentation mammoplasty occurs at a rate of 15% to 45%. The purpose of the present study was to determine the effect of implant core type (silicone versus saline) on the rate of capsular contracture in augmentation mammoplasty.

Methods

A systematic review was conducted through a search of three electronic databases. Two reviewers independently scanned titles yielded by the search and identified potentially relevant papers. Inter-reviewer variability and the scientific quality of the articles were assessed. Meta-analysis was performed.

Results

Eighty-eight titles of potential relevance were selected from the 393 articles yielded by the search. Inter-rater agreement for selection of potentially relevant articles was 84% (κ=0.54). Four comparative studies were included in the analysis. Scientific quality scores of the included studies ranged from 5 of 14 to 9 of 14. Three of the four studies reported a higher rate of capsular contracture in patients with silicone implants. A combined odds ratio calculated on two of the studies found a 2.25-fold increased risk of capsular contracture in patients who received silicone implants. Eight series of patients who received cohesive gel silicone implants reported rates of capsular contracture from 0% to 13.6%.

Conclusions

Higher rates of capsular contracture were found in patients who received silicone implants when compared with those who received saline implants. However, the scientific quality of the comparative studies to date on this subject is poor. Recent series evaluating cohesive gel implants report relatively low rates of capsular contracture. A randomized controlled trial comparing rates of capsular contracture in cohesive gel and saline implants is recommended.
Nora'S Lesion: Case Report and Literature Review of a Bizarre Parosteal Osteochondromatous Proliferation of a Small Finger
Authors: Gursel Eti , Jarrahnejad Payam , Arneja Jugpal S , Malamet Matthew , Akinfolarin Josephine , Chang Yeon-Jeen
Published: February 2017

A case of a left small finger tumour that was diagnosed on histopathological review as Nora's lesion (bizarre parosteal osteochondromatous proliferation) is reported. There have been fewer than 150 cases reported in the literature to date and its pathophysiology is yet to be defined. Due to its rare presentation, Nora's lesion can easily go unrecognized and therefore inappropriately managed.
Infrared surface temperature monitoring in the postoperative management of free tissue transfers
Authors: Papillion Paul , Wong Lesley , Waldrop Jimmy , Sargent Larry , Brzezienski Mark , Kennedy Woody , Rehm Jason
Published: February 2017

Background

Early identification of failing free flaps may allow for potential intervention and flap salvage. The predictive ability of flap temperature monitoring has been previously questioned. The present study investigated the ability of an infrared surface temperature monitoring device to detect trends in flap temperature and correlation with anastomotic thrombosis and flap failure.

Methods

Postoperative measurement of surface temperature was obtained in 47 microvascular free flaps. Differences in temperature between survival and failure groups were evaluated for statistical significance using Student's t test (P<0.05). In addition, a single variable analysis was performed on 30 different flap characteristics to evaluate their prediction of flap failure.

Results

In total, eight flaps failed. Five of these were re-explored, of which one was salvaged. The three other flaps died a progressive death secondary to presumed thrombosis of the microcirculation despite adequate Doppler signals. Temperatures of the flap failure group during the last 24 h yielded a mean difference of 2°C (3.56°F) compared with surviving flaps (P<0.05). The temperature of the failing flaps began to decline at the eighth postoperative hour. Single variable analysis identified prior radiation to be a predictor of flap failure.

Conclusions

A surface temperature measurement device provides reproducible digital readings without physical contact with the flap. Technical difficulties encountered in previous research with implantable or surface contact temperature probes are obviated with this noncontact technique. Flap temperature monitoring revealed a trend in temperature that correlates with anastomotic thrombosis and eventual flap failure.
Nipple reduction – An adjunct to augmentation mammaplasty
Authors: Fanous Nabil , Tawile Carolyne , Fanous Amanda
Published: February 2017

Nipple hypertrophy is an occasional deformity in Asians and a rare one in Caucasians. Lately, it has been showing up more often in plastic surgeons' offices across North America and elsewhere, owing to the influx of Asian immigration worldwide, as well as to the rising interest in esthetic surgery among Asian communities.

A simplified technique for nipple reduction is described herein. It is very easy to execute, delivers accurate results and is extremely safe. It tackles both the excessive ‘projection’ and the less frequent excessive ‘width’ of the nipple. It may be used separately or incorporated as an adjunct to mammary augmentation or mastopexy. Excellent esthetic results are obtained, while both the nipple innervation and its lactiferous ducts are preserved. The patient's and surgeon's satisfaction is high.
Use of botulinum toxin in cheiloplasty: A new method to decrease tension
Authors: Galárraga Iván Marcelo Cueva
Published: February 2017

Objective

To determine if the use of botulinum toxin during cheiloplasty could help in the management of tension at the surgical wound level.

Interventions

Five children younger than six months of age, who were born with complete cleft lip and palate, were treated with a dose of 10 units of botulinum toxin injected into the upper lip during surgery. Before the surgery, an electromyographic study was carried out on the patients' upper lips. A Millard-type cheiloplasty was performed and 10 days later, a second electromyographic study was performed on the upper lips of all the patients.

Results

There was a significant change (P<0.039) in the electromyo-graphic tracing obtained after the application of botulinum toxin, especially during rest.

Conclusion

As confirmed by electromyography, botulinum toxin effectively inhibits the action of the orbicularis oris muscle, especially when at rest; consequently, the tension is decreased at the level of the surgical wound.
Ehlers-Danlos Syndrome Associated with Cleft Lip and Palate
Authors: Tan Pearlie Ww , Song Colin , Lalonde Donald
Published: February 2017

Ehlers-Danlos syndrome (EDS) is a hereditary connective tissue disorder caused by abnormal collagen synthesis and presents with classic features of hyperextensibility, fragility of skin and joint hypermobility. It has not been commonly described as being associated with cleft lip and/or palate, and a literature search has disclosed only one case (1984) of type IV EDS with cleft lip and palate. The authors have seen another case of EDS associated with cleft lip and palate. The etiology and clinical features of this syndrome are discussed alongside the clinical picture of cleft lip and palate.