GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW最新文献

{"title":"Pigmented (melanotic) diffuse neurofibroma of the back in neurofibromatosis type 1.","authors":"Reinhard E Friedrich,&nbsp;Christian Hagel","doi":"10.3205/iprs000124","DOIUrl":"https://doi.org/10.3205/iprs000124","url":null,"abstract":"<p><p>Neurofibromatosis type 1 (NF1) is a tumor predisposition disease. Multiple neurofibromas are among the characteristic tumors of NF1. The report describes the diagnosis and treatment of a large spinal neurofibroma in a NF1 patient. The tumor showed a striking pigmentation and was diagnosed as pigmented (melanotic) neurofibroma. The distinction between this rare tumor variant and other pigmented tumors, especially malignant melanoma, is of primary importance.</p>","PeriodicalId":43347,"journal":{"name":"GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW","volume":"7 ","pages":"Doc04"},"PeriodicalIF":0.4,"publicationDate":"2018-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36401104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of donor site infections in split-thickness skin graft with water-filtered infrared-A (wIRA).","authors":"Anas Aljasir,&nbsp;Thomas Pierson,&nbsp;Gerd Hoffmann,&nbsp;Henrik Menke","doi":"10.3205/iprs000123","DOIUrl":"https://doi.org/10.3205/iprs000123","url":null,"abstract":"<p><p>Infection of donor sites in split-thickness skin grafts is one of the complications of skin transplantation. Nutrition status and associated diseases play important roles in healing of donor sites. There are different ways used to treat infected donor sites. Water-filtered infrared-A (wIRA), as a special form of heat radiation with a high tissue penetration and a low thermal load to the skin surface, can improve the healing of acute and chronic wounds both by thermal and thermic as well as by non-thermal and non-thermic effects. Water-filtered infrared-A (wIRA) increases tissue temperature, tissue oxygen partial pressure and tissue perfusion. These three factors are decisive for a sufficient supply of tissue with energy and oxygen and consequently also for wound healing and infection defense. This was confirmed in a case with a late severe healing disturbance of the donor sites after skin transplantation.</p>","PeriodicalId":43347,"journal":{"name":"GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW","volume":"7 ","pages":"Doc03"},"PeriodicalIF":0.4,"publicationDate":"2018-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/iprs000123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36288342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-term results of two-stage revision of total knee arthroplasty using a mobile (dynamic) cement spacer in the treatment of periprosthetic infections.","authors":"Mohamed Ghanem,&nbsp;Christina Pempe,&nbsp;Dirk Zajonz,&nbsp;Andreas Roth,&nbsp;Christoph-Eckhard Heyde,&nbsp;Christoph Josten","doi":"10.3205/iprs0000122","DOIUrl":"https://doi.org/10.3205/iprs0000122","url":null,"abstract":"<p><p><b>Introduction:</b> Infection of the knee joint after primary total knee arthroplasty is a serious complication. In this work, we would like to evaluate the mid-term results after two-stage revision of total knee replacement in periprosthetic infection using dynamic spacer, in particular with regard to the function of the knee joint after reimplantation. <b>Patients and methods:</b> In this retrospective study, we included patients who were treated in our clinic between 2005 and 2013 due to infection of the knee after total knee arthroplasty. All patients included have had a mobile antibiotic-coated cement spacer implanted after surgical debridement and removal of the components of total knee replacement. Subsequently, reimplantation of total knee replacement was performed when no clinical or paraclinical signs of infection were found. We analyzed all included cases for potential reinfection, examined the range of motion of the knee joint and evaluated the Merle d'Aubigné-Postel score. Statistical evaluation was performed with SPSS 24.0. <b>Results:</b> This study group contains 16 patients (9 women and 7 men) with an average age of 72.0 ± 8.3 years. All patients were followed up for at least 6 months with an average follow-up of 22.5 ± 16.6 months. In all patients a pathogen was isolated intraoperatively during the first-stage surgery (explantation of the knee). <i>Staphylococci</i> were detected in 94% of the cases, <i>streptococci</i> in only one patient. Reimplantation was carried out after 6.2 ± 5.2 months. The average knee flexion in the group of patients without relapse of infection was 103.3° ± 17.1°. Only 3 patients showed extension deficit of max. 20°. The Merle d'Aubigné-Postel Score was 14.4 ± 1.9. <b>Conclusion:</b> Two-stage surgery of total knee replacement with the use of a mobile spacer has its high value in the treatment of periprosthetic infections. The mobile spacers contribute to an advantageous range of motion of the knee joint after reimplantation of a total knee endoprosthesis. However, further studies are required that compare the results after using mobile or static spacer, but with the inclusion of homogeneous patient collective.</p>","PeriodicalId":43347,"journal":{"name":"GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW","volume":"7 ","pages":"Doc02"},"PeriodicalIF":0.4,"publicationDate":"2018-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36238606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coverage of the scrotum after Fournier's gangrene.","authors":"Ahmed Hassan El-Sabbagh","doi":"10.3205/iprs000121","DOIUrl":"https://doi.org/10.3205/iprs000121","url":null,"abstract":"<p><p><b>Background:</b> Fournier's gangrene is a necrotizing fasciitis caused by mixed aerobic and anaerobic bacteria and results in loss of skin and subcutaneous tissue in the perineal area. Coverage of testis varies from closure of the defect primarily, burying inside the thigh, using the remnants of the scrotum for tissue expansion and coverage by flaps. In this manuscript, scrotal advancement flaps and pudendal thigh flaps were used for coverage of the testis unilaterally or bilaterally according to the size of the defect following Fournier gangrene. <b>Patients and methods:</b> From June 2015 to March 2017, twelve cases were admitted to our department. The patients' ages ranged from 37-59 years and they all had suffered from Fournier's gangrene in the perineal area. <b>Results:</b> Of the twelve cases, two cases showed penile involvement. A skin graft was used for coverage of the penile shaft with excellent take. Four cases were closed primarily. This was applied to cases where loss of skin was less than 50%. The rest of the cases were reconstructed by pudendal thigh flap. The reconstructed cases were covered by bilateral pudendal thigh flap (4 cases) and unilateral pudendal thigh flap (4 cases). The follow-up extended up to 16 months. <b>Conclusion:</b> Scrotal advancement flap was suitable for small and medium size defects due to the elasticity of the scrotal skin. Pudendal thigh flap was efficient for the reconstruction of large defects of the scrotum.</p>","PeriodicalId":43347,"journal":{"name":"GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW","volume":"7 ","pages":"Doc01"},"PeriodicalIF":0.4,"publicationDate":"2018-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/iprs000121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35813553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex functional and epithetic rehabilitation after ablation of recurrent retroauricular basal cell carcinoma - a case study.","authors":"Waldemar Reich,&nbsp;Anika Exner,&nbsp;Eileen Winter,&nbsp;Bilal Al-Nawas,&nbsp;Alexander Walter Eckert","doi":"10.3205/iprs000120","DOIUrl":"https://doi.org/10.3205/iprs000120","url":null,"abstract":"<p><p>The reconstruction of extended defects of the concha poses a complex challenge for plastic surgeons. In cases of subtotal ablation, an alternative method designed especially for elderly oncological patients consists of epithetic rehabilitation. However, inserting an implant-retained concha epithesis proves challenging in patients with antecedents of deep resections involving the mastoid process. In the present case study, we report on the long-term treatment course (2009-2017) of a 79-year-old male patient suffering from a recurrent basal cell carcinoma of the retroauricular region. Following tumor resection, along with lateral mastoidectomy, reconstruction, and adjuvant radiotherapy, functional and esthetic deficits primarily due to peripheral facial nerve palsy were successfully managed using a multistep procedure. The procedure was completed by inserting an implant-retained concha epithesis, resulting in improved quality of life. Due to prior lateral mastoidectomy, ultra-short implants (4 mm) were inserted, partially at atypical positions. For maintaining healthy periimplant soft tissue, aftercare comprised cold plasma treatment. This oncologic case demonstrates the therapeutic necessity of using a broad spectrum of reconstructive procedures, along with their limitations, in a critical anatomic region. Specific features include the presentation of a workflow using ultra-short implants in a compromised mastoid region. Surgeons should consider alternative implant positions in the event of any compromised mastoid process. A particular emphasis has been put on meticulous aftercare to preserve healthy periimplant soft tissues.</p>","PeriodicalId":43347,"journal":{"name":"GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW","volume":"6 ","pages":"Doc18"},"PeriodicalIF":0.4,"publicationDate":"2017-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/iprs000120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35813552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of extracorporeal shock wave therapy (ESWT) on bone turnover markers in organisms with normal and low bone mineral density during fracture healing: a randomized clinical trial.","authors":"Christoph Wölfl,&nbsp;Laura Schuster,&nbsp;Bernd Höner,&nbsp;Sarah Englert,&nbsp;Roman Klein,&nbsp;Christoph Hirche,&nbsp;Matthias Münzberg,&nbsp;Paul Alfred Grützner,&nbsp;Ulrich Kneser,&nbsp;Leila Harhaus","doi":"10.3205/iprs000119","DOIUrl":"https://doi.org/10.3205/iprs000119","url":null,"abstract":"<p><p><b>Background:</b> Low bone mineral density (BMD) leads to metaphyseal fractures, which are considered of delayed, qualitatively reduced healing resulting in prolonged care phases and increased socioeconomic costs. Extracorporeal shockwave therapy (ESWT) is already approved to support bone healing of pseudarthrosis and delayed unions. With this study, we examined its influence on bone turnover markers (BTM) during fracture healing in patients with low and normal BMD. <b>Methods:</b> Within a period of 2 years, patients with a metaphyseal fracture of the distal radius or the proximal humerus, requiring surgical osteosynthesis were included into the study. Patients were randomized within their fracture groups whether they received ESWT after surgery or not. ESWT was applied once after surgery with an energy flux density (EFD) of 0.55 mJ/mm² à 3000 shockwaves. In addition, serum levels of vitamin D3, parathyroid hormone (iPTH), bone alkaline phosphatase (BAP), c-telopeptide of type-I-collagen (β-CTX) and serum band 5 tartrate-resistant acid phosphate (TRAP5b) were determined before surgery and post-operatively in week 1, 4, 8, 52. T-score levels as an indicator of the BMD were measured with dual-energy X-ray absorptiometry (DXA). <b>Results:</b> 49 patients (40 females, 9 males; mean age 62 years) with fractures of the metaphyseal distal radius (n=25) or the proximal humerus (n=24) were included in the study. The follow-up time was one year. 24 of them were diagnosed of having low BMD, whereas 25 had a normal BMD. During follow-up time serum levels of bone turnover markers, as well as vitamin D3 and iPTH, showed no significant changes; however, ESWT approaches the decreased serum levels of patients with low BMD to the level of healthy organisms. <b>Conclusions:</b> ESWT as treatment option of fractures in patients with low BMD can lead to an equilibration of levels of bone turnover markers to the levels of patients with normal BMD.</p>","PeriodicalId":43347,"journal":{"name":"GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW","volume":"6 ","pages":"Doc17"},"PeriodicalIF":0.4,"publicationDate":"2017-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/iprs000119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35714974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pay for performance - motivation to succeed in Advanced Trauma Life Support courses - a question of background or funding?","authors":"Roman Klein,&nbsp;Wolfgang Armbruster,&nbsp;Martin Grotz,&nbsp;Bernd Höner,&nbsp;Matthias Münzberg,&nbsp;Paul Alfred Grützner,&nbsp;Christoph Georg Wölfl","doi":"10.3205/iprs000118","DOIUrl":"https://doi.org/10.3205/iprs000118","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To correlate students' performance with their professional background and motivation to take part in Advanced Trauma Life Support (ATLS) courses. We base our analysis on the self-determination theory that differentiates intrinsic (ambition to perform by individual itself) from extrinsic motivation (incentive by external stimuli). &lt;b&gt;Design:&lt;/b&gt; We present a non-blinded, monocentric, non-randomized descriptive study of 376 students taking part in an ATLS course at one course site in Germany. Part of a two-day ATLS course are two written tests; we correlate test scores with background information provided by the students in a questionnaire of 13 items (age, sex, adress, board certification, specialty, subspecialty, position, hospital level of care, hospital operator and hospital participation in trauma network, motivation, funding source, condition of funding). &lt;b&gt;Setting:&lt;/b&gt; The students were recuited at the BG Trauma Center Ludwigshafen (Germany), a large 528-bed trauma center and one of 13 ATLS course sites in Germany. &lt;b&gt;Participants:&lt;/b&gt; 449 ATLS course students taking part in ATLS courses at the above-mentioned course site from February 2009 to May 2010 were sent a questionnaire asking for their background. All 449 course students were eligible to participate. 376 (83.7%) questionnaires were returned, pre- and post-test results of all students aquired and included into our calculations. 312 (83%) were male and 64 (17%) female. The majority (59.3%) of recruited students came from trauma surgery, 21.8% from anesthesiology, 8% from general surgery, 4% from abdominal surgery, 0.5% from vascular or thoracic surgery each and 5.9% from other specialties. &lt;b&gt;Results:&lt;/b&gt; Neither age, sex, subspecialty, hospital level of care, hospital operator, or hospital participation in trauma network played a role with respect to motivation or test results. The high degree of intrinsic motivation of consultants (92.3%) had no impact on their test results. Anesthesiologists were higher motivated (75.6% intrinsically motivated) in contrast to all surgical colleagues (63.6%), which showed significant differences in the pre- (89.8% vs. 85.3%, p=0.03) but not the post-test. Of all 13.6% students who were self-payers, 94.1% were intrinsically motivated; the 86.2% whose course fee was accounted for were less likely to be intrinsically motivated (63.9%). Sponsoring however did not have a negative impact on test results. Conditional funding (sponsored only on passing both tests) was detrimental to motivation: 0% of these individuals were intrinsically motivated and they scored significantly lower (82.5%) than all other students in the post-test (86.9%, p=0.002). Overall, intrinsically motivated students overtopped extrinsically motivated students in the post-test (88.0% vs. 83.4%, p&lt;0.001). &lt;b&gt;Conclusions:&lt;/b&gt; ATLS course participation is not compulsory for medical doctors in Germany. Intrinsic motivation to take part in these courses is a key pre","PeriodicalId":43347,"journal":{"name":"GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW","volume":"6 ","pages":"Doc16"},"PeriodicalIF":0.4,"publicationDate":"2017-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5717918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35231301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral nerve sheath tumors of the upper extremity and hand in patients with neurofibromatosis type 1: topography of tumors and evaluation of surgical treatment in 62 patients.","authors":"Reinhard E Friedrich,&nbsp;Caroline Diekmeier","doi":"10.3205/iprs000117","DOIUrl":"https://doi.org/10.3205/iprs000117","url":null,"abstract":"<p><p><b>Objective:</b> Neurofibromatosis type 1 (NF1) is an autosomal dominant tumor predisposition syndrome with a tendency to develop peripheral nerve sheath tumors (PNST). Plexiform neurofibromas (PNF) are detected in a high proportion of affected patients. The tumors can lead to severe disfigurement and are classified as precancerous. This study examines the surgical procedures that have been performed on large PNST of the upper limb and hand, and investigates whether a specific distribution pattern of the tumors can be detected in surgically treated cases. <b>Methods:</b> Surgical procedures on the upper extremity and hand performed on patients with NF1 were evaluated at an interval of 25 years (1992-2016). Topography of the tumors was classified according to dermatomes. The number of interventions per patient, duration of operations, and complications of the interventions were registered. An overview of the surgical treatment of PNST of the upper limb and hand was obtained from the literature, with special consideration of the genetic background of treated tumors. <b>Results:</b> One hundred and sixty-three surgical interventions on the upper limb and hand were performed in 62 patients with NF1 for the treatment of large PNST, predominantly PNF (age: mean value: 27.33 years, male: 33, female: 29; right side: 25, left side: 26, bilateral: 7). Surgical procedures lasted an average of 72.47 minutes. In approximately half of the patients, one surgical procedure was sufficient. Duration of stay in hospital was on average 7-11 days. Neurological complications were rarely noted and occurred only temporarily. There were no dermatomes affected by PNF with particular frequency. However, some dermatomes were more often simultaneously affected by a PNF at the same time as others. <b>Conclusion:</b> Although the distribution pattern shows some accumulation of tumor localization, tumors are distributed evenly and show very variable size and extent in individual cases. Surgical treatment of PNF of the upper limb and hand helps alleviate the physical discomfort that these patients have from their disfiguring disease. Repeated interventions are necessary relatively often in order to adapt the tumorous region to the outline of the limb and to improve its function.</p>","PeriodicalId":43347,"journal":{"name":"GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW","volume":"6 ","pages":"Doc15"},"PeriodicalIF":0.4,"publicationDate":"2017-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/iprs000117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35231300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large thoracic defect due to shotgun violation - surgical emergency management.","authors":"Holger Rupprecht,&nbsp;Katharina Gaab","doi":"10.3205/iprs000116","DOIUrl":"https://doi.org/10.3205/iprs000116","url":null,"abstract":"<p><p>Shotgun injuries from a short distance (<3 m) may cause massive bleeding and tissue destruction. Only immediate aggressive (surgical) therapy prevents lethal outcome. We report about a 27-year-old patient, who was wounded on the left chest wall by a straight-cut shotgun from a short distance. In cases of this special traumatic pattern damage control measures are necessary. The measures should take place in preclinical emergency management (by the on-site emergency physician). We report about the emergency management from admission to our hospital and the following surgical treatment until discharge from the hospital.</p>","PeriodicalId":43347,"journal":{"name":"GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW","volume":"6 ","pages":"Doc14"},"PeriodicalIF":0.4,"publicationDate":"2017-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5566116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35470191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of severe acute necrotizing pancreatitis in a 38-year-old woman postpartum due to a parathyroid adenoma.","authors":"Holger Rupprecht,&nbsp;Julia Reinfelder,&nbsp;Alp Turkoglu","doi":"10.3205/iprs000115","DOIUrl":"https://doi.org/10.3205/iprs000115","url":null,"abstract":"<p><p>Lethal necrotizing pancreatitis postpartum due to primary hyperparathyroidism caused by a parathyroid adenoma can be considered as a rarity. Due to the unspecific clinical signs and uncommonness this disorder may be overseen very easily. The reported case illustrates the very importance of early diagnosis of this endocrine disorder in pregnancy in order to avoid a lethal course.</p>","PeriodicalId":43347,"journal":{"name":"GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW","volume":"6 ","pages":"Doc13"},"PeriodicalIF":0.4,"publicationDate":"2017-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5566115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35470190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}