A Rare Case of Epithelioid Haemangioendothelioma of the Lateral Orbit in a 22-Year-Old Patient.

Epithelioid haemangioendothelioma (EHE) is a rare vascular neoplasm characterised by proliferation of vascular endothelial and pre-endothelial cells. The prevalence is less than one in a million people. It is principally observed in the soft tissues of the extremities but can also occur in the bone, brain, liver, lung and lymph nodes.

Prosthetic Condyle with Concurrent Microvascular Reconstruction for Mandibular Disarticulation Defects: A Retrospective Series.

Introduction: Reconstruction of mandibular disarticulation defects is a challenging area of head and neck surgery, with a variety of options available for replacement of the condylar head. The gold standard is autogenous reconstruction of the condyle-ramus unit. The use of a prosthetic condylar head is controversial, but in challenging cases, and those with a likely poor prognosis it may be considered and can achieve a good functional result.

Evaluating the role of the self-assembling topical haemostat PuraBond® in Transoral Robotic Surgery (TORS) for oropharyngeal cancer: A case series.

Background: Transoral Robotic Surgery (TORS) has been increasingly employed in head and neck surgery for the assessment and treatment of malignancies over the last two decades. PuraBond® is a self-assembling viscous solution that forms a transparent hydrogel 3-D matrix to promote local haemostasis. This study aimed to assess the utility of PuraBond® in patients undergoing TORS for Human Papilloma Virus (HPV) positive oropharyngeal squamous cell carcinoma (OPSCC).

Association of low skeletal muscle mass and systemic inflammation with surgical complications and survival after microvascular flap reconstruction in patients with head and neck cancer.

Background: Skeletal muscle mass (SMM) and chronic inflammation are associated with postoperative complications and survival.

Methods: Patients with head and neck cancer (HNC) undergoing microvascular free flap reconstruction were included. SMM and neutrophil-to-lymphocyte ratio (NLR) were measured and their association with treatment outcomes analyzed.

Current Practices in and Barriers to Physiotherapists' Use of Resistance Exercise with Older Adults in Acute Care.

The purpose of this cross-sectional study was to describe physiotherapists' current use of resistance exercise (REx) with older adults in acute care and to identify barriers to its use with this population. We developed an online questionnaire guided by the theoretical domains framework and distributed it to physiotherapists across British Columbia. We used thematic analysis to code open-text questionnaire responses.

Retropharyngeal lymph node metastasis in oral cancer. Systematic review and survival analysis.

Introduction: Metastasis to retropharyngeal lymph nodes (RPLN) from oral squamous cell carcinoma is rare and associated with poor outcomes. The poor prognosis of RPLN is multifactorial and includes the clinicopathological aggressiveness of the primary disease and the late presentation. The aim of this systematic review is to assess the evidence on RPLN in patients diagnosed with oral squamous cell carcinoma (OSCC), the quality of the diagnostic modalities and the available treatment options.

An evaluation of the clinical utility of C-reactive protein and antibiotic use in patients undergoing major head and neck reconstructive surgery with outcome assessment.

Purpose: This ambispective observational study aims to evaluate the local utility of peri-operative CRP testing and prophylactic antibiotics in relation to post-operative complications in patients who have undergone major head and neck oncological reconstructive surgery.

Results: A total of 79 patients were identified for inclusion; CRP testing was undertaken within the first 3 days postoperatively in 78/79 cases. Results demonstrated no benefit of extended prophylactic antibiotic use in reducing post-operative infection.

Tongue: the unusual site in malignant pleural mesothelioma.

Malignant mesotheliomas (MMs) are malignancies of the mesothelium, with primary deposits originating in the pleura, peritoneum, pericardium and the tunica vaginalis (ie, testicular). Metastatic spread is commonly reported to affect the liver, adrenal glands, kidney and contralateral lung (in cases of malignant pleural mesothelioma). Metastases to distant sites are uncommon.

Novel In-House Design for Fibula Cutting Guide With Detachable Connecting Arm for Head and Neck Reconstruction.

The use of in-house 3D planning and manufacture has become more common in high-volume head and neck reconstructive centers worldwide. Various fibula cutting guides have been designed to allow for accurate and predictable head and neck reconstruction. In this paper, we describe the design, manufacture, and operative technique for use of a novel fibula cutting guide with detachable connecting arms.

Management update of potentially premalignant oral epithelial lesions.

The term oral potentially malignant disorders, proposed at the World Health Organization workshop in 2005, has now been renamed potentially premalignant oral epithelial lesions (PPOELs). It is important to differentiate among PPOELs, which is a broad term to define a wide variety of clinical lesions, and oral epithelial dysplasia, which should be reserved specifically for lesions with biopsy-proven foci of dysplasia. PPOELs encompass lesions that include leukoplakia, erythroplakia, erythroleukoplakia, lichen planus, and oral submucous fibrosis.

Case Report: An Unusual Finding of a Solitary Bone Cyst in a Patient with a Fractured Mandible.

Solitary bone cysts are uncommon. They have a reported incidence of 0.6% and are commonest in the mandible.

UK temporomandibular joint replacement database: report on baseline data.

Our goal is to establish the long-term collection of data on temporomandibular joint replacement from all centres in the UK where this is done. Currently, 16 surgeons have been identified, and 13 of them had entered data when this paper was being prepared. Data are entered online through the Snap Survey and then analysed annually.

N-butyl-2-cyanoacrylate (NBCA) tissue adhesive as a haemostatic agent in a venous malformation of the mandible.

Cyanoacrylate tissue glue has many uses. We describe a case involving a 27-year-old man with a low-flow venous malformation that affected the right side of his face including the mandible. After extraction of the lower right eight, torrential haemorrhage was successfully arrested using N-butyl-2-cyanoacrylate (NBCA) glue.

Comparison of a novel thin-layer chromatographic-fluorescence detection method with a spectrofluorometric method for the determination of 7-hydroxycoumarin in human urine.

A novel method for the determination of 7-hydroxycoumarin in human urine which combines thin-layer chromatography (TLC) with fluorescence detection (FD) has been devised. The limit of detection (1 ng/ml) enables determination of 7-hydroxycoumarin after both administration of coumarin and environmental exposure to this fragrance material. When compared to a spectrofluorometric method of analysis, the TLC-FD method proved to be more selective for the analysis of 7-hydroxycoumarin in human urine.

Genetic and metabolic criteria for the assignment of debrisoquine 4-hydroxylation (cytochrome P4502D6) phenotypes.

A randomly selected population of 73 volunteers, together with 22 previously established poor metabolisers of debrisoquine, were phenotyped for their ability to 4-hydroxylate debrisoquine and were also analysed for a number of mutations in the CYP2D6 gene. Genotyping was performed using both restriction fragment length polymorphism with the restriction enzyme Xba I, together with two separate polymerase chain reaction assays. Together, these assays detected 98% of mutant alleles in the poor metaboliser group which corresponded to positive identification of 95% of this group.

Urinary nicotine concentrations in cigarette and pipe smokers.

Urinary concentrations of nicotine were studied in men who did not smoke (27) and in men who smoked cigarettes only (145) or pipes only (48). The median urinary nicotine concentrations were less than 50 ng/ml (the detection limit of the assay for urine tests) in the non-smokers, 1393 ng/ml in the cigarette smokers, and 1048 ng/ml in the pipe smokers. These values were standardised for urinary pH and creatinine concentration to allow for the fact that nicotine excretion is influenced by the acidity of the urine and by urinary flow rate.

Inhaling and lung cancer: an anomaly explained.

An objective index of inhaling cigarette smoke based on carboxyhaemoglobin concentrations and the carbon monoxide yields of cigarettes was used to investigate possible systematic differences in the extent of inhaling among light and heavy smokers when classified according to their self described inhaling habits. A total of 2108 men who smoked cigarettes were studied. Heavy smokers (20 or more cigarettes a day) had a higher average inhaling index than light smokers (fewer than 20 cigarettes a day) both among those who said that they inhaled and among those who said that they did not.

Serum cotinine levels in pipe smokers: evidence against nicotine as cause of coronary heart disease.

Serum levels of cotinine (a principal metabolite of nicotine) were studied in men who did not smoke (28), and in men who smoked cigarettes only (150), cigars only (70), and pipes only (56). The mean cotinine level for pipe smokers was 389 ng/ml, significantly higher than the mean level for cigarette and cigar smokers (306 and 121 ng/ml, respectively); no cotinine was detected in the serum from any of the non-smokers. Large prospective studies have shown that pipe smokers have no material excess risk of coronary heart disease but cigarette smokers do, so that our observations indicate that nicotine is unlikely to be the major cause of the excess coronary heart disease mortality in cigarette smokers.

Carbon monoxide in breath in relation to smoking and carboxyhaemoglobin levels.

Carboxyhaemoglobin (COHb) levels were studied in 11 249 men. The distribution among the 2613 men who smoked cigarettes was well separated from that in 6641 non-smokers (including ex-smokers). The distribution for 2005 cigar and pipe smokers was intermediate, though some of the highest COHb levels occurred in cigar smokers.

The importance of tar and nicotine in determining cigarette smoking habits.

Cigarette consumption and inhaling, assessed using carboxyhaemoglobin levels, were studied in 1786 men to investigate the importance of tar and nicotine as determinants of smoking habits. No prior warning was given that smoking habits would be studied. Neither nicotine nor tar yields materially influenced the number of cigarettes smoked a day.

Inhaling habits among smokers of different types of cigarette.

Inhaling habits were studied in 1316 men who freely smoked their usual brands of cigarette. An index of inhaling was calculated for each person by dividing the estimated increase in carboxyhaemoglobin level from a standard number of cigarettes by the carbon monoxide yield of the cigarette smoked. Smokers of ventilated filter cigarettes inhaled 82% more than smokers of plain cigarettes (p less than 0.

Low serum-vitamin-A and subsequent risk of cancer. Preliminary results of a prospective study.

In a prospective study of about 16 000 men, serum samples were collected and stored. Vitamin-A (retinol) levels were later measured in the stored samples from the 86 men who were subsequently notified as having developed cancer and in the stored samples from 172 controls who did not develop cancer. Low retinol levels were associated with an increased risk of cancer.

Carboxyhaemoglobin levels and inhaling habits in cigarette smokers.

In 520 men who currently smoked only cigarettes, carboxyhaemoglobin (COHb) levels were measured as a method of estimating the extent to which cigarette smoke was inhaled and the results were compared with the smokers' own assessment of their inhaling habits. The mean COHb level after standardising for the number of cigarettes smoked before the blood test on the day of the test was 4.0% in self-described non-inhalers.