Outcomes of the treatment of head and neck sarcomas in a tertiary referral center.

Head and neck sarcomas are a rare and heterogeneous group of tumors that pose management challenges. We report our experience with these tumors. Forty consecutive patients treated for 44 head and neck sarcomas between 1997 and 2014 were culled from our prospectively maintained head and neck database.

Angiolymphoid hyperplasia with eosinophilia developing within a port wine stain.

A 19-year-old male with a port wine stain on the base of his neck presented with a 5-month history of gradual thickening of the involved skin which interfered with clothing and caused repeated bleeding. The lesion was excised and histopathologic examination revealed angiolymphoid hyperplasia with eosinophilia (ALHE) arising from the pre-existing port wine stain - a rare finding with only one previously reported case. Additionally the lesion was associated with elevated serum renin levels which virtually normalized following excision of the lesion.

Lymph node grafting in the treatment of upper limb lymphoedema: a clinical trial.

Background: Microvascular lymph node transfer has been shown to improve the severity of lymphoedema. However, microvascular surgery is not suitable for all patients. Simple lymph node grafting does not require general anaesthetic or significant surgical resources and is a technique that has been tested in animal models only until this point.

Characterisation of subpopulations of myeloid cells in infantile haemangioma.

Aims: Cells expressing markers of mast cells, macrophages and dendritic cells have previously been demonstrated within the interstitium of infantile haemangioma (IH). This study characterised these myeloid cellular subpopulations within IH.

Methods: Immunohistochemical staining was performed on proliferating and involuted IHs for the expression of Nanog, tryptase, CD163, DC-SIGN and CD45.

Gallstone pancreatitis secondary to a pathological cystic duct stump in a setting of chronic pain syndrome: a diagnostic dilemma.

A 32-year-old woman presented with epigastric pain. She was a patient with chronic pain syndrome and had visited the emergency department several times over the past year. She did not drink alcohol.

Angiotensin II causes cellular proliferation in infantile haemangioma via angiotensin II receptor 2 activation.

Aims: To investigate the effect of the angiotensin peptides and their agonists and antagonists on cellular proliferation in proliferating infantile haemangioma (IH) in vitro explants.

Methods: Proliferating IH samples from six patients were cultured in vitro in the presence of angiotensin I (ATI) alone, or AT1 and the ACE inhibitor, ramipril, or ATII alone, or ATII with the ATII receptor 1 (ATIIR1) blocker, losartan, or ATII with the ATIIR2 blocker, PD123319, or the ATIIR2 agonist, CGP42112. After 6 days in culture, the IH tissue pieces were harvested, formalin-fixed and paraffin-embedded.

Biology of infantile hemangioma.

Infantile hemangioma (IH), the most common tumor of infancy, is characterized by an initial proliferation during infancy followed by spontaneous involution over the next 5-10 years, often leaving a fibro-fatty residuum. IH is traditionally considered a tumor of the microvasculature. However, recent data show the critical role of stem cells in the biology of IH with emerging evidence suggesting an embryonic developmental anomaly due to aberrant proliferation and differentiation of a hemogenic endothelium with a neural crest phenotype that possesses the capacity for endothelial, hematopoietic, mesenchymal, and neuronal differentiation.

Is post-pneumonia chest X-ray for lung malignancy useful? Results of an audit of current practice.

Background/aim: Patients with community-acquired pneumonia (CAP) are often screened with repeat chest X-ray within 6-12 weeks following an admission. This practice is aimed to detect underlying lung malignancy, which can be difficult to identify initially when an acute infiltrate is present on X-ray. We conducted a study on the use of follow-up chest X-rays after an admission with CAP to determine the yield of suspected or diagnosed cancer.

Safe duration of postoperative monitoring for malignant hyperthermia patients administered non-triggering anaesthesia: an update.

The postoperative care of malignant hyperthermia (MH) patients is subject to international variation, with a paucity of data in the literature to guide management. Over a series of three studies, our aim was to evaluate whether MH-susceptible patients (and relatives who had not yet been investigated), who had received a non-triggering anaesthetic, could be managed in the same way as the standard surgical population. Following a retrospective study, 206 anaesthetics were administered in a prospective second study to MH-susceptible/related individuals who were monitored for a minimum of one hour in the post anaesthesia care unit and a further 90 minutes in a step-down facility.

Mouth opening and trismus in patients undergoing curative treatment for head and neck cancer.

This study documents mouth opening and the incidence of and factors contributing to trismus (<35 mm mouth opening), as well as the associated impact on quality of life, following curative treatment for head and neck cancer. Patient demographics, cancer type and location, and treatments were documented. Mouth opening was measured at >6 months after treatment completion.

Orbital immunoglobulin IgG4-related inflammatory fibrosclerosing lesion treated with pentoxifylline and α-tocopherol: case report.

Immunoglobulin G4 (IgG4)-related disease is a distinct group of disorders that are characterised by intense infiltration of an organ with IgG4(+) cells, subsequent inflammation, fibrosis, and masses. We report a new treatment of orbital IgG4-related disease with pentoxyphylline and α-tocopherol, both of which are anti-inflammatory and antifibrotic agents.

Ethanol sclerotherapy for venous malformation.

Background: Ethanol sclerotherapy (ES) is the preferred treatment for venous malformation (VM) with surgery playing an adjunctive role. Results of ES, however, are not well documented in the literature.

Methods: VM patients were identified from our vascular anomalies database from 1996 to 2011.

A Prospective Multi-Center Audit of Nutrition Support Parameters Following Burn Injury.

The importance of nutrition support delivery to the severe burn-injured patient is well recognized, however, nutrition provision to the patient may be sub optimal in practice. The aim of this study was to conduct a prospective multi-center audit across Australia and New Zealand using the Joanna Briggs Institute Burns Node Nutrition audit criteria. Thirty-four patients with severe burn injury (≥20% TBSA in adults and ≥10% TBSA in children) were identified on admission or on referral to the Dietitian at the eight participating Burn Units between February 1, 2012 and April 30, 2012 for inclusion in the study.

Correlation between vectorcardiographic measures and cardiac magnetic resonance imaging of the left ventricle in an implantable cardioverter defibrillator population.

Background: Measures of vectorcardiographic changes and LV remodelling have been associated with arrhythmic risk. However the correlation between the two modalities is not well characterised.

Methods: We correlated spatial QRS-T angle and ventricular gradient with cardiac MRI derived LV global measures and scar pattern in 66 ICD recipients.

Intrapartum care quality indicators: a systematic approach for achieving consensus.

Objective: To identify published maternity intrapartum quality indicators and rationalise them to a core set.

Study Design: Prospective qualitative consensus group exercise. A literature search identified sets of intrapartum quality indicators in the English language.

Gold weight implantation and lateral tarsorrhaphy for upper eyelid paralysis.

Background: Upper eyelid paralysis leads to lagophthalmos with the risk of exposure keratitis, corneal ulceration and blindness.

Methods: Consecutive patients undergoing gold weight implantation and/or lateral tarsorrhaphy were identified from our prospective database and reviewed.

Results: Sixty-three patients were identified, 36 of whom underwent immediate reanimation procedure either during cancer excision (n = 35) or repair of facial laceration (n = 1).

Spontaneously reduced isolated orbital roof fracture.

We report a case of a spontaneously reduced isolated orbital roof blow-in fracture with resolution of associated diplopia and blepharoptosis highlighting the need for a low threshold for reimaging this cohort of facial fracture patients.

Early oral intake after reconstruction with a free flap for cancer of the oral cavity.

To allow healing of the surgical wound patients are traditionally given nothing by mouth for 6-12 days after resection and reconstruction of a cancer of the oral cavity. Our aim was to assess the impact of introducing oral intake within 6 days postoperatively. Consecutive patients who had resection and reconstruction of a cancer of the oral cavity with a free flap within an 8-year period were selected from the head and neck database.