METHODS: This is a retrospective non-randomized study of outcomes and tumor recurrence of all patients diagnosed with mandibular ameloblastoma from August 1997 until August 2017 (20 years) requiring free fibula osteocutaneous flap reconstruction at a single institution. The patients were identified through an electronic operative database; subsequently, their medical records and photo documentation were retrieved.
RESULTS: Twenty-seven patients were included in this study. Eighteen patients were male, while nine were female. The majority of the patients (48.1%) were in their third decade of life when they were diagnosed with ameloblastoma. All of them underwent radical resection of the tumor with a surgical margin of 2 cm (hemimandibulectomy in cases with a large tumor) and immediate mandibular reconstruction with a free fibula osteocutaneous flap. Two patients required revision of a vascular anastomosis due to venous thrombosis postoperatively, while one patient developed a flap recipient site infection. The flap success rate was 100%. There was no tumor recurrence during a mean follow-up period of 5.6 years.
CONCLUSIONS: Mandibular ameloblastoma should be treated with segmental mandibulectomy (with a surgical margin of 2 cm) to reduce the risk of recurrence. Subsequent mandibular and adjacent soft tissue defects should be reconstructed immediately with a free fibula osteocutaneous flap.
MATERIALS AND METHODS: In this prospective cohort study Students were randomized to one of the teaching methods, and their short-term (immediately after teaching) and long-term (i.e., 6 months later) knowledge retention was assessed through multiple choice questions, followed by students feedback which was obtained using Trierer Inventar zur Lehrevaluation questionnaire. P ≤ 0.05 was considered statistically significant.
RESULTS: For short-term learning gains, spaced learning group (165.85) showed highest mean scores, followed by the traditional lecture group (163.70) and flipped classroom group (153.25). P value acquired through the Kruskal-Wallis ANOVA was statistically significant (0.003). For long-term knowledge retention, traditional lecture group has highest mean scores (147.50), followed by spaced learning group (146.90) and flipped classroom group (145.05) with no significant difference (P = 0.657).
CONCLUSION: Spaced learning methodology was better than the traditional lecture method and the flipped classroom concerning knowledge gains when measured immediately after the application of learning method. For long-term knowledge retention, both the flipped classroom and spaced learning teaching methods were comparable to the traditional lecture method.
CASE REPORT: A 29-year-old woman, Gravida 2 Para 1, became pregnant after receiving intrauterine insemination (IUI). She came to our emergency room due to diffuse low abdominal pain at seven weeks of gestational age. Transabdominal sonography (TAS) revealed a quadruplet intrauterine pregnancy with an enlarged left adnexa and intrapelvic fluid accumulation. Simultaneous occurrence of high-order pregnancy and left tubal pregnancy with internal hemorrhage was suspected. The patient received an emergent laparoscopic resection of the affected Fallopian tube and recovered well for the remaining hospitalization course. Afterwards, she received fetal reduction procedure and eventually gave birth to twin babies.
CONCLUSION: Gynecologist should increase the awareness of heterotopic pregnancy in patients receiving ART. On the other hand, reproductive endocrinologist should reduce the risk of high-order pregnancy without compromising pregnancy rate.