British authors are the natural heirs to Charles Dickens and Graham Greene.) Nevertheless there are advantages to British readers in a British book especially, for instance, in the chapter on social paediatrics and occasionally as regards therapeutics. The new Forfar and Arneil is, like its predecessors, a good book. There are many new authors and much of it has been completely rewritten. Each chapter has a long list of references, many of them to further reading in books and important 'landmark' papers rather than to very recent original work, and that seems appropriate for a textbook of this nature. It is up to date, including references to topics such as oesophageal pH monitoring in gastrooesophageal reflux, the value of steroids in bacterial meningitis, a full account of the peroxisomal disorders, the significance of dystrophin in muscular dystrophy, the importance of vitamin A in reducing mortality in third world countries, and the use of sumatriptan in migraine and of vigabatrin and lamotrigine in epilepsy. Surprisingly, neither in this nor in Nelson's textbook could I find any reference to Angelman's syndrome. Some topics chosen at random such as Prader-Willi syndrome or haemolytic uraemic syndrome were discussed more fully in the British textbook. There is a surprising omission, however, and that is the chapter on disorders ofear, nose, and throat. Adenoids, glue ear or secretory otitis media, tonsillitis, and tonsillectomy have all been dropped from the index and deafness is dealt with in the chapter on neurology. If you look up 'tonsils' you will be referred to any entry which reads: 'Tonsils: size, presence of infection, exudate, pitting, peritonsillar swelling?'. The index entry 'ear, nose and throat problems' refers to a brief account of such problems in children with cleft palate. It is one of those crazy facts of modern life that the American book costs £60, the British £125. Who will read this new edition? I shall, and I suppose many other consultant paediatricians will also use it as a standard reference book. Undergraduate students will need a more compact text for their basic reading but should use it to look up specific topics, and doctors studying for the MRCP in paediatrics should make a systematic assault on it to provide them with a personal database to be supplemented by journals and monographs. As a textbook of British paediatrics it has no competition and it remains an excellent work of reference which must be available in all paediatric departments in Britain, but the absence of the chapter on ear, nose, and throat disorders must surely be an error and there is clearly a marketing problem for British publishers faced with American competition. If we want British textbooks, and I would not like to think that the time will be forced upon us when we shall have no choice, then it looks as if we must be prepared to pay for the privilege. DOUG ADDY Consultant paediatrician

https://adc.bmj.com/content/archdischild/68/3/435.2.full.pdf

Syndromes of the Head and Neck

Although referred to in passing in several places, there have been few attempts to specify the functions of the human olfactory system. This article presents an initial effort at identifying and categorizing these functions, using 3 sources of information as a guide: 1) losses experienced by anosmic participants; 2) olfactory function in other mammals; and 3) capacity, namely, whether the human olfactory system can support the suggested function and whether there is evidence that it does. Three major classes of function were identified, relating to Ingestion (Detection/identification prior to ingestion; Detection of expectancy violations; Appetite regulation; Breast orientation and feeding), Avoiding environmental hazards (Fear related; Disgust related), and Social communication (Reproductive [inbreeding avoidance, fitness detection in prospective mates]; Emotional contagion [fear contagion, stress buffering]). These suggested functions were then examined with respect to 1) issues of ecological validity in human olfactory research; 2) their impact on olfactory loss; and 3) their general and specific implications for the study of human olfaction.

/pdf/an-initial-evaluation-of-the-functions-of-human-olfaction-2weocuy188.pdf

An Initial Evaluation of the Functions of Human Olfaction

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1600-6143.2008.02541.x

Early Hepatic Artery Thrombosis after Liver Transplantation: A Systematic Review of the Incidence, Outcome and Risk Factors

Nearly every bone in the body is invested in periosteum. The periosteum is in some ways poorly understood and has been a subject of controversy and debate. This tissue has a major role in bone growth and bone repair and has an impact on the blood supply of bone as well as skeletal muscle. Despite the importance of the periosteum is has received little attention in the literature in recent years.

/pdf/the-periosteum-what-is-it-where-is-it-and-what-mimics-it-in-3e25d8o979.pdf

The periosteum: what is it, where is it, and what mimics it in its absence?

Cutaneous squamous cell carcinoma (SCC) includes many subtypes with widely varying clinical behaviors, ranging from indolent to aggressive tumors with significant metastatic potential. However, the tendency for pathologists and clinicians alike is to refer to all squamoid neoplasms as generic SCC. No definitive, comprehensive clinicopathological system dividing cutaneous SCCs into categories based upon their aggressiveness has yet been promulgated. Therefore, we have proposed the following based upon the malignant potential of SCC variants, separating them into categories of low (< or = 2% metastatic rate), intermediate (3-10%), high (greater than 10%), and indeterminate behavior. Low-risk SCCs include SCC arising in actinic keratosis, HPV-associated SCC, tricholemmal carcinoma, and spindle cell SCC (unassociated with radiation). Intermediate-risk SCCs include adenoid (acantholytic) SCC, intraepidermal epithelioma with invasion, and lymphoepithelioma-like carcinoma of the skin. High-risk subtypes include de novo SCC, SCC arising in association with predisposing factors (radiation, burn scars, and immunosuppression), invasive Bowen's disease, adenosquamous carcinoma, and malignant proliferating pilar tumors. The indeterminate category includes signet ring cell SCC, follicular SCC, papillary SCC, SCC arising in adnexal cysts, squamoid eccrine ductal carcinoma, and clear-cell SCC. Subclassification of SCC into these risk-based categories, along with enumeration of other factors including tumor size, differentiation, depth of invasion, and perineural invasion will provide prognostically relevant information and facilitate the most optimal treatment for patients.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.0303-6987.2006.00516-t1.x

Cutaneous squamous cell carcinoma: a comprehensive clinicopathologic classification. Part One

Epidermoid carcinoma in nonhealing scar tissue, known as Marjolin's ulcer, is not uncommon and is thought to behave in a more aggressive fashion than those from other causes. Between 1982 and 1997, 56 patients with Marjolin's ulcer were treated at our center, Ege University Medical School, Izmir, Turkey. All lesions were secondary to various kinds of burns. Forty of these patients could be followed up 5 years or more. These 40 patients' medical records were reviewed retrospectively.

Marjolin's ulcers arising in burn scars.

The aims of this study were to locate the infraorbital foramen and to determine the frequency and location of any accessory foramen, which may be troublesome during anesthetization of this region. In 45 cadavers, the infraorbital foramen was dissected according to classic principles for location. The line between the angulus oculi medialis and the angulus oculi lateralis was divided into three equal pieces, and a second line was drawn downward, perpendicular to the point uniting the internal and medial thirds. The position of the infraorbital foramen was determined in relation to that line and the infraorbital margin. For the right and left sides, the infraorbital foramen was found to be on that line in 75.6% and 68.9% of the specimens, respectively. The infraorbital foramen was 10.9 mm and 8.3 mm under the infraorbital margin in men and women, respectively. Regarding accessory foramen, 119 crania and 229 maxilla were observed (a total of 467 infraorbital foramen), and it was found that single accessory foramen were present in 11.5% of specimens and double accessory foramen were present in 1.28% of specimens. In 79.6% of specimens with single accessory foramen, the accessory foramen was superior and medial to the main opening. These results are helpful in decreasing anesthetic complications.

Anatomic variations of the infraorbital foramen.

The formation of neoplastic changes in the scar tissue of chronically ulcerating wounds is a well-known process. This condition is most commonly seen after the postburn scars, but it may be seen after many kinds of scars. The term "Marjolin's ulcer" is used to describe this type of carcinoma. Although many different cell types can be seen in these lesions, the most commonly seen is squamous cell carcinoma. Squamous cell carcinomas resulting from the Marjolin's ulcer have a much greater tendency to metastasize than squamous cell carcinomas resulting from the other causes. Confusion continues about the precise pathophysiology of this lesion and the clinical behavior of this neoplasm, and the mortality and morbidity rates are also conflicting. As would be expected, there is a wide variety of suggested treatment protocols for this disease. This article, through case reports and review of the literature, offers criteria for the treatment of the Marjolin's ulcers that arise on the scalp, which is an uncommon site.

Marjolin's Ulcer of the Scalp: Report of 5 Cases and Review of the Literature

In this current study, the clinical data and postoperative follow-up findings of 118 patients with a primary lower lip carcinoma who were treated between 1983 and 1999 in the Department of Plastic and Reconstructive Surgery are presented. Medical records were reviewed retrospectively and data were collected concerning age, gender, followup period, location of lesion on the lip, cervical metastasis at presentation, preoperative biopsy results, histological grade, initial treatment, reconstruction type, pathological outcome, local recurrence, regional lymph node metastasis, treatment of local recurrence and regional lymph node metastasis, and postoperative treatment. The prognostic value of clinical stages in relation with recurrence and mortality from disease was investigated. The overall rate of recurrence was calculated as being 39.8%, and the determinate survival rate was found to be 72.9% at 5-year follow-up. The data concerning the above-mentioned parameters, together with risk factors that might play a role in the development of lip cancer, are discussed in light of the current literature.

Management of lower lip cancer: a retrospective analysis of 118 patients and review of the literature.

The aim of this study was to observe the course of the marginal mandibular branch of the facial nerve (MMBFN) in relation to the inferior border of the mandible and parotid gland and its relevance to surgical procedures such as rhytidectomy and parotid gland surgery. In this study, 50 specimens were dissected. The relationships between the MMBFN and the inferior border of the mandible were recorded and analyzed. We found that posterior to the facial artery, the MMBFN ran above the inferior border of the mandible in 37 (74%) of the specimens. In 11 (22%) specimens, below the inferior border of the mandible it was divided into two branches at the crossing point with the facial artery. In 2 (4%) specimens the MMBFN divided into two branches at the point of emergence from the parotid gland. There were no statistical differences between the left and right sides, and both sexes. The MMBFN is one of the most vulnerable branches to surgical injury because of its location. For this reason, the surgeons who are willing to operate on this area, especially for the rhytidectomies, should have a true knowledge about the anatomy of this branch.

Localization of the marginal mandibular branch of the facial nerve

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