Characterization of steel lined with multilayer micro/nano-polymeric composites.

This work studied comparison of the mechanical and barrier resistance properties between different structures of three multilayers polymeric coating on each side of the steel coupons. Epoxy filled with 1 wt%, 2 wt%, and 3 wt% micron or nano-sized alumina (Al2O3) particles represented the coating layers to steel on both sides. Barrier resistance was performed by immersing the coated steel specimens in salt solution and in a citric acid medium. Adding alumina (Al2O3) particles in micron and nano size to epoxy coatings improved the barrier resistance, tensile, and hardness under dry and wet conditions as compared to pure epoxy coating. Further increases in Al2O3 micro/nanoparticles cause deterioration in tensile strength and barrier resistance. The steel lined with epoxy filled with 1 wt% Al2O3 nanoparticles has a maximum tensile strength of 299.5 MPa and 280.9 MPa under dry and wet conditions, respectively. However, the steel lined with epoxy filled with 1 wt% Al2O3 microparticles has a tensile strength of 296.5 MPa and 275.4 MPa under dry and wet conditions, respectively. Good properties were observed with stepwise graded micro/nanocomposite coatings. The steel lined with epoxy filled with 3 wt% Al2O3 nanoparticles has maximum hardness of 46 HV and 40 HV under dry and wet conditions, respectively.

Characterization and performance evaluation of Cu-based/TiO2 nano composites.

Copper and copper alloys are used in industrial applications and food contact surfaces due to their desirable properties; copper metal matrix composites have been exciting researchers' attention in recent years since they can offer many valuable characteristics. The present study investigated the effects of the TiO2 nanoparticles addition with different weight percent on the hardness and corrosion behavior of copper nanocomposites. The powder metallurgy method was used to fabricate the Cu/TiO2 reinforced with different weight fractions of TiO2 nano particles up to 12 wt.%. The corrosion behavior of fabricated specimens is evaluated using potentiodynamic polarization curves and electrochemical impedance spectroscopy in different solutions. These solutions were 3.5wt.% NaCl, 0.5 NaOH and 0.5 M H2SO4 reflected different pH. The results showed that the addition of TiO2 nano particles improves pure copper's hardness. The hardness of pure copper increased from 53 to 91 HV by adding 12 wt.% TiO2. The corrosion current density (Icorr) of copper nanocomposites test specimens was higher than Icorr of pure copper in all test solutions. As TiO2 nano particles increase, the corrosion resistance of Cu nano composites decreased. All test specimens exhibited little corrosion current density in 3.5 wt.% NaCl solution as compared with other test solutions.

Prevalence of and risk factors for non-alcoholic fatty liver disease (NAFLD) and fibrosis among young adults in Egypt.

OBJECTIVE: Limited literature has examined the epidemiology of non-alcoholic fatty liver disease (NAFLD) and fibrosis among young adults in Egypt, a country with one of the highest obesity rates globally. We assessed the prevalence of steatosis and fibrosis among college students in Egypt. DESIGN: In this cross-sectional study, we recruited students unaware of having fatty liver via a call-for-participation at a private university in the Dakahlia governorate of Egypt. Primary outcomes were the prevalence of steatosis as determined by the controlled attenuation parameter component of transient elastography and fibrosis as determined by the liver stiffness measurement component of transient elastography. Secondary outcomes were clinical parameters and socioeconomic factors associated with the presence and severity of steatosis and fibrosis. RESULTS: Of 132 participants evaluated for the study, 120 (91%) were included (median (IQR) age, 20 (19-21) years; 65 (54.2%) female). A total of 38 participants (31.6%) had steatosis, among whom 22 (57.9%) had S3 (severe) steatosis. There was a higher risk for steatosis in persons with overweight (adjusted OR 9.67, 95% CI (2.94 to 31.7, p<0.0001) and obesity (adjusted OR 13.87, 95% CI 4.41 to 43.6, p<0.0001) compared with lean persons. Moreover, higher level of parental education was associated with progressing steatosis stages (S1-S3). Six (5%) participants had transient elastography values equivalent to F2-F3 fibrosis (four with F2 fibrosis (≥7.9 kPa), and two with F3 fibrosis (≥8.8 kPa)). CONCLUSION: In this cohort of college students in Egypt, around 1 in 3 had steatosis, and 1 in 20 had moderate-to-advanced fibrosis, an established risk factor for hepatic and extrahepatic morbidity and mortality. These data underscore the urgency to address the silent epidemic of NAFLD among young adults in the Middle East-North Africa region.

The Impact Of Human Skin Allograft As A Temporary Substitute For Early Coverage Of Major Burn Wounds On Clinical Outcomes And Mortality.

The aim of the study was to evaluate the application of different types of skin allograft as a skin substitute for coverage of major deep burn wounds, and their effect on the clinical outcomes and mortality of burned patients. This prospective study was conducted on 36 patients admitted to the Burn Unit from August 2016 to November 2019. The number and percentage of patients that needed auto-grafting after surgical intervention was 9 (100%) in Group I (allograft coverage not available), 13 (86.66%) in Group II (allograft source was from unrelated patients) and 8 (66.7%) in Group III (allograft from a first-degree relative). Patient survival was 55.6% in Group I, 86.7% in Group II and 91.7% in Group III. There was significant difference between the groups regarding time to complete healing, with P1 = 0.034* and P2 < 0.0001*. Human skin allograft harvested from living first-degree relatives is freshly donated at maximum viability and does not require complex preparation or preservation. It shows prolongation of graft survival that helps to improve general condition, decrease microbial wound contamination, improve vascularization and prepare the wound bed with healthy granulation tissue. This promotes wound healing and subsequent autograft take, and decreases mortality rate among burned patients.

Cet étude a pour but d'évaluer différents types d'allogreffes et de substituts cutanés utiliser pour couvrir des brûlures étendues profondes et leurs conséquences sur l'évolution et la mortalité des patients. Cette étude a été réalisée auprès de 36 patients hospitalisés entre août 2016 et novembre 2019. Neuf patients (groupe II) ont été autogreffés d'emblée, faute de disponibilité d'allogreffes ; 13 (86,6%) patients ayant reçu une allogreffe non familiale (groupe II) et 8 (66,7%) de ceux ayant reçu une allogreffe familiale ont reçu ensuite une autogreffe. Les taux de survie ont été de 55,6% dans le groupe I, 86,7% dans le groupe II et 91,7% dans le groupe III. Les différences de délai de cicatrisation étaient significatives avec P1 = 0,034 et P2< 0,0001. L'allogreffe prélevée sur un proche vivant a une viabilité élevée et ne nécessite pas de préparation ni de conservation. Ceci prolonge la durée de couverture ce qui permet d'améliorer l'état général, de diminuer la contamination bactérienne, d'améliorer la vascularisation, de préparer ainsi au mieux l'autogreffe et, in fine, d'accélérer la cicatrisation et diminuer la mortalité.

Base Deficit, Serum Albumin Level And Blood Haemoglobin Concentration Can Be Used As Predictor Factors For Mortality In Major Burn Patients.

Hypoalbuminemia as seen in major burn injury results in widespread endothelial dysfunction. Base deficit provides the best estimate for degree of tissue anoxia. Acute blood loss describes anemia present in burn patients. Controversy focuses on the administration of protein-based colloids: whether to provide them, which solutions to use, and when to begin? The aim of this study was to determine whether alteration of gas exchange, excess base deficit, hypoalbuminemia and anemia could predict mortality in major burn patients, whether to provide protein-based colloids, and when to begin fluid resuscitation. The prospective study included 42 major burn patients. All the patients were admitted to the burn intensive care unit at Menoufia University Hospital. Serum albumin level, hemoglobin concentration, arterial blood gases and base deficit were measured at admission, third day and after one week. Average serum albumin on admission was 3.33 ± 0.44, after 3 days 2.85 ± 0.54 and after 1 week 2.46 ± 0.67 gm./dL, while hemoglobin concentration was 14.79 ± 2.13, 12.25 ± 1.99, and 10.24 ± 2.47 gm./dl respectively. However, base deficit was 5.75 ± 2.40, 5.24 ± 2.05 and 5.45 ± 2.76 respectively, with significant statistical difference (p<0.001) between the death and survivor groups. Binary logistic regression analysis for independent predictors of mortality declared that base deficit, albumin and hemoglobin serum levels were independent predictors for mortality with an odds ratio of 2.23, 95% CI, 1.66-16.75 for base deficit, 3.56, 95% CI, 1.88-12.59 for albumin and 2.21, 95% CI, 1.56-13.54 for hemoglobin. Hypoalbuminemia, anemia and excess base deficit can be used as prognostic factors for mortality in major burn patients.

L'hypoalbuminémie du brûlé est la conséquence d'un dysfonctionnement endothélial généralisé. Les pertes sanguines occasionnent une anémie. Il persiste une controverse quant à l'utilisation des colloïdes naturels chez ces patients : faut il les utiliser et, si oui, lesquels et quand ? Les buts de ce travail étaient d'étudier si les altérations des échanges gazeux, le déficit de base, l'hypoalbuminémie et l'anémie étaient corrélés à la mortalité, s'il fallait utiliser des colloïdes naturels et quand. Il s'agit d'une étude prospective réalisée sur 42 patients admis en réanimation du CTB du CHU de Menoufia. L'albuminémie, le taux d'hémoglobine, la gazométrie et le déficit de base étaient mesurés à l'entrée, J3 et J7. L'albuminémie moyenne était de 33,3 ± 4,4 g/L à l'entrée, 28,5 ± 5,4 g/L à J3 et 24,6 ± 6,7 à J7. L'hémoglobine était à 14,79 ± 2,13 g/dL à l'entrée ; 12,25 ± 1,99 à J3 et 12,04 ± 2,47 à J7. Le déficit de base était respectivement de 5,75 ± 2,4 ; 5,24 ± 2,05 et 5,45 ± 2,76, avec une différence significative (p<0,001) entre vivants et décédés. En régression logistique binaire, le déficit de base (OR 2,23 ; IC 95 1,66-16,75) ; l'albuminémie (OR 3,56 ; IC 95 1,88-12,59) et l'anémie (OR 2,21 ; IC 95 1,56-13,54) apparaissent comme des variables indépendantes de mortalité. Ces 3 paramètres peuvent donc être utilisés pour prédire la mortalité d'un brûlé grave.

Congenital laryngomalacia: Is it an inflammatory disease? The role of vitamin D.

OBJECTIVES/HYPOTHESIS: Laryngomalacia is the most common cause of stridor in infants. The exact pathophysiology is still not well understood. Our objective was to investigate whether laryngomalacia is an inflammatory disease, focusing on the possible role of vitamin D. STUDY DESIGN: Case-control study. METHODS: Sixty Egyptian infants and 60 mothers were included in this study. They were divided into four equal groups (n = 30 for each): infants with laryngomalacia (LM-infants), control infants (C-infants), mothers of the infants with laryngomalacia (LM-mothers), and mothers of the control infants (C-mothers). Laryngoscopy was performed and serum 25-hydroxyvitamin D (25[OH]-vitamin-D) and interleukin 6 (IL-6) were estimated. RESULTS: Significant increase of serum IL-6 associated with a significant decrease in serum 25(OH)-vitamin D was observed in the LM-infants compared to the C-infants (P < .001 for both). LM-mothers had significantly lower 25(OH)-vitamin D status compared to C-mothers (P < .001). CONCLUSIONS: Deficiency of 25(OH)-vitamin D in LM-infants may result in dysregulation of the immune responses with elevation of a proinflammatory cytokine (IL-6). Laryngomalacia could be an inflammatory disease due to 25(OH)-vitamin D deficiency as evidenced by the high level of IL-6. This finding may open the door to the appropriate prevention, diagnosis, and treatment, especially for moderate to severe laryngomalacia. LEVEL OF EVIDENCE: 3b Laryngoscope, 130:448-453, 2020.

Is insufficient pulmonary air support the cause of dysphonia in chronic obstructive pulmonary disease?

OBJECTIVE: Optimal pulmonary air support is essential pre-requisite for efficient phonation. The objective is to correlate pulmonary and vocal functions in chronic obstructive pulmonary disease (COPD) to find out whether the reduced pulmonary function per se could induce dysphonia. METHODS: In this prospective case-control study, sixty subjects with stable COPD underwent evaluation of pulmonary and vocal functions. The pulmonary functions measured include {Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC ratio, peak expiratory flow (PEF), maximum mid-expiratory flow (MMEF)}. The vocal functions were {jitter, shimmer, noise-to-harmonic ratio, pitch perturbation quotient, amplitude perturbation quotient, maximum phonation time (MPT), sound pressure level, phonatory efficiency, resistance and power. A control group (n=35) underwent the same measurements. These functions were compared between subjects and controls. Also, correlation of the vocal and pulmonary functions was conducted. RESULTS: Thirty five (58.3%) of COPD subjects have dysphonia. The pulmonary functions were lower in all COPD group than in the control group (P<0.001 for all parameters). Also, the FVC, FEV1, PEF and MMEF % of predicted values were significantly lower in subjects with dysphonia (n=35) than those without dysphonia (n=25) with P values 0.0018, <0.001, 0.0011 and 0.0026 respectively. In addition, the MPT in all subjects showed positive correlations to the 5 pulmonary functions (P=0.004 for FEV1/FVC ratio and P<0.001 for the rest). Also, the phonatory efficiency showed significant positive correlations with the pulmonary functions FVC, FEV1, PEF and MMEF (P=0.001, 0.001, 0.002 and 0.001 respectively). Unlike efficiency, the phonatory resistance revealed significant negative correlations with these pulmonary functions in the same order (P=0.001, 0.003, 0.002, 0.001 respectively). CONCLUSION: Dysphonia is a common comorbidity with COPD which attributed to multifactorial etiologies. The lower the pulmonary function in COPD patients is the more likely to have dysphonia. Decreased pulmonary function was associated with reduced MPT and phonatory efficiency but with increased phonatory resistance. The reduced pulmonary functions in COPD can be the underlying cause of the altered vocal function and dysphonia. Great part of this dysphonia is functional, and hence, can be corrected by voice therapy in compensated subjects. Further researches are needed to evaluate the efficacy of voice therapy in these patients.

[Lichenoid drug reactions]. / Lichenoide Arzneimittelreaktionen.

Lichenoid drug reactions are rare compared to typical morbilliform drug exanthema or urticaria. They are associated with specific drugs or drug families like gold, antimalarial drugs, ß­blockers and angiotensin-converting-enzyme inhibitors. Recent observations included associations with novel drugs such as biologics (e. g. tumour necrosis factor antagonists) and immune checkpoint inhibitors (anti-programme cell death protein 1 antibodies). Lichenoid drug reactions most often resemble lichen planus mainly in areas of ultraviolet-light exposed skin, but also mucosal lichen planus and even bullous lesions may occur.

Successful treatment of bullous pemphigoid with omalizumab as corticosteroid-sparing agent: report of two cases and review of literature.

BACKGROUND: Bullous pemphigoid (BP) is an autoimmune blistering disease that is characterized by formation of subepidermal bullae due to functional disturbance of the hemidesmosomal proteins on the keratinocytes at the basal membrane zone. In recent years, several studies have emphasized the important role of IgE autoantibodies in the pathogenesis of BP. Consequently, a therapeutic approach using IgE depleting antibodies, such as a humanized monoclonal anti-IgE antibody (e.g. omalizumab) may represent a new option for treatment of this autoimmune disease. METHODS: In this paper, we report about the successful treatment of BP with omalizumab in two patients and provide a review of the current literature on the relationship between IgE antibodies and this autoimmune blistering disease. RESULTS: Two patients with therapy-resistant BP were treated with humanized monoclonal anti-IgE antibody omalizumab 300 mg subcutaneously every 3 weeks as corticosteroid-sparing agent. Under this therapy, both patients experienced a significant improvement of skin condition and almost complete resolution of pruritus. The treatment was well tolerated. CONCLUSION: Until recently IgG autoantibodies against the basal membrane proteins BP180 und BP230 were considered to be causative in the pathogenesis of BP. However, new in vitro studies as well as data from experimental mouse models have indicated that in addition to specific IgG, also IgE antibodies against BP180 and BP230 play a role in the development of this disease. Based on these new findings, new treatment modalities of BP became possible.

Study of the risk factors and complications of diabetes mellitus after live kidney donation.

OBJECTIVES: Kidney donors, similar to the general population, are at risk for developing type 2 diabetes mellitus (T2DM). The course of donors who develop T2DM has not been well studied. This work estimates the incidence of diabetes after kidney donation, and some risk factors and complications of diabetes mellitus postdonation. MATERIALS AND METHODS: This study examined the records of 2267 donors who donated one of their kidneys between 1976 and 2014 at the Urology and Nephrology Center, Mansoura University, Egypt, and who were regularly followed up at its outpatient clinic. A total of 388 donors were included in the study, and their medical records were revised. RESULTS: Postdonation weight gain and family history of diabetes mellitus were statistically significant for the development of diabetes mellitus, high or very high albuminuria, and/or decreased creatinine clearance. Metformin and insulin use seemed to significantly reduce the protein excretion and creatinine clearance decline in the studied group. CONCLUSIONS: There is a significant impact of a family history of diabetes mellitus on the development of high or very high albuminuria and/or decreased creatinine clearance.

Study of the risk factors and complications of diabetes mellitus after live kidney donation.

OBJECTIVES: Kidney donors, similar to the general population, are at risk for development of type 2 diabetes mellitus. The course of donors who develop type 2 diabetes mellitus has not been well studied. This work is aimed at estimating the incidence of diabetes after kidney donation, and study some risk factors and some complications of diabetes mellitus after donation. MATERIALS AND METHODS: The material of this record based work comprised the records 2267 donors who donated 1 of their kidneys between 1976 and 2014 in the Urology and Nephrology Center, Mansoura University, Egypt, and regularly followed-up at its outpatient clinic. There were 388 donors included in the study and their medical records were revised. RESULTS: Postdonation weight gain and family history of diabetes mellitus were statistically significant on both the development of diabetes mellitus, high, very high albuminuria, and/or decreased creatinine clearance. Metformin and insulin use seemed to significantly reduce the protein excretion, and creatinine clearance decline in the studied group. CONCLUSIONS: There is a significant effect of the family history of diabetes mellitus on the development of high, very high albuminuria, and/or decreased creatinine clearance.

[Atypical fibroxanthoma of the scalp: overview and recent developments]. / Atypisches Fibroxanthom am Capillitium: Überblick und aktuelle Erkenntnisse.

Atypical fibroxanthoma (AFX) is a rare, low-malignant, mesenchymal tumor of the dermis and is assigned to the group of fibrohistiocytic tumors. The tumor occurs especially in photodamaged skin on the scalp of elderly men. A clinical diagnosis is not possible due to a multitude of possible differential diagnoses (leiomyosarcoma, squamous cell carcinoma, spindle cell malignant melanoma, dermatofibrosarcoma protuberans). Immunohistochemical and histological examinations should be performed to confirm the diagnosis. The tumor shows a very good prognosis after complete excision. Micrographically controlled surgery is considered as the treatment of choice.

[Bullous pemphigoid: a new look at a well-known disease]. / Bullöses Pemphigoid: Ein neuer Blick auf eine bekannte Krankheit.

BACKGROUND: Bullous pemphigoid is an autoimmune blistering disease that is associated with appearance of subepidermal blisters. IgG antibodies against components of the epithelial basement membrane (BP 180 and 230 antigens) can be typically found in serum of patients. Direct immunofluorescence reveals usually a linear deposition of IgG and/or C3 along the basement membrane, but other immunoglobulins may also be present. CASE PRESENTATION: Our patient had no detectable formation of tense blisters of his skin; instead, the clinical picture was rather compatible with a prurigo simplex subacuta or a pruritic variant of atopic dermatitis. He also had a markedly elevated total serum IgE level. The diagnosis was confirmed by detection of circulating IgG against BP 180 in patient's serum in ELISA and detection of linear IgG deposits along the basement membrane zone of epidermis in the direct immunofluorescence. CONCLUSION: Atypical clinical presentations of bullous pemphigoid without blister formation are possible. Recent studies show that an increased total IgE level in serum of patients may occur frequently. The aim of this report is to provide the reader with a brief insight in the new findings in pathogenesis and therapy of bullous pemphigoid.

[Double sensitization to PR10 and PR-14 proteins]. / Doppelsensibilisierung auf PR-10- und PR-14-Proteine.

A patient with mild oral allergy syndrome presented with a history of anaphylaxis induced by both hazelnuts and peaches. The ensuing work-up showed a double sensitization to proteins in both pathogenesis-related group 10 (e.g. Bet v1, Cor a1, Pru p1) and 14 (e.g. Pru p3, Cor a8). Such double sensitization profiles are increasingly being recognized in Europe.

[Folliculotropic mycosis fungoides]. / Follikulotrope Mycosis fungoides.

BACKGROUND: Folliculotropic mycosis fungoides represents a rare variant of the CD4-positive cutaneous T-cell lymphoma mycosis fungoides. It is characterized by tropism of the lymphocytic infiltrate for hair follicle and other adnexal structures. CASE PRESENTATION: Our patient presented with a 20-year history of pruritic skin lesions, which had been diagnosed as atopic dermatitis. The diagnosis of folliculotropic mycosis fungoides was confirmed by skin biopsy. Since topical therapy was ineffective, systemic therapy was initiated promptly. Treatment with pegylated interferon alpha-2b 25 µg/week led to significant improvement of the skin condition. CONCLUSION: Due to its polymorphic clinical presentation, folliculotropic mycosis fungoides is diagnosed with delay and in a later stage than classical mycosis fungoides. Thus we recommend an early skin biopsy in patients with therapy-resistant pruritic skin lesions.

Arytenoid adduction with nerve-muscle pedicle transfer vs arytenoid adduction with and without type I thyroplasty in paralytic dysphonia.

IMPORTANCE: Optimal glottal closure as well as symmetrical vocal fold masses and tensions are essential prerequisites for normal voice production. Successful phonosurgery depends on restoring these prerequisites to achieve long-term improvement. OBJECTIVE: To evaluate the efficacy of the laryngeal framework surgical treatments (arytenoid adduction with and without thyroplasty type I [AA ± Th-I]) compared with arytenoid adduction combined with nerve-muscle pedicle flap transfer (AA + NMP) in unilateral vocal fold paralysis. Patterns of voice outcome were compared over a 2-year period. DESIGN, SETTING, AND PARTICIPANTS: Retrospective review of clinical records of 22 patients who presented to an institutional practice with severe paralytic dysphonia between March 1999 and December 2008, who received 2 different treatments. Postoperative follow-up was conducted over 2 years. INTERVENTIONS: Eleven patients were treated with AA ± Th-I and 11 patients were treated with AA + NMP. MAIN OUTCOMES AND MEASURES: Vocal function was evaluated preoperatively and at 3, 12, and 24 months postoperatively. Vocal parameters evaluated were jitter, shimmer, harmonics to noise ratio (HNR), maximum phonation time (MPT), and overall grade and breathiness grade of the Grade-Roughness-Breathiness-Asthenia-Strain (GRBAS) voice scale. The outcomes of voice measurements were compared within each group across time and among the 2 groups at each time point. RESULTS: All voice parameters showed initial postoperative improvement in both groups after 3 months. Moreover, the AA + NMP group showed significant steady improvement over the 2-year follow-up, which did not occur in the AA ± Th-I group. In the AA + NMP group, MPT increased from a mean (SD) of 5.4 (2.1) s at preoperative assessment to 21.5 (7.0) s at 24 months; jitter decreased from 8.6% (5.3%) to 1.2% (0.7%); shimmer decreased from 13.1% (6.0%) to 4.0% (1.6%); HNR increased from 3.8 (3.3) to 9.0 (0.8); overall grade of GRBAS decreased from 2.4 (0.9) to 0.2 (0.4); and breathiness grade of GRBAS decreased from 2.0 (1.0) to 0.1 (0.3). CONCLUSIONS AND RELEVANCE: Unlike the conventional laryngeal framework surgical treatments, AA + NMP provided long-term voice improvement with nearly normal voice quality. Thus, it can be considered an effective surgical treatment for paralytic dysphonia due to unilateral vocal fold paralysis associated with large glottal gap.

[Squamous cell carcinoma as the most common oral carcinoma. Diagnosis and therapy]. / Plattenepithelkarzinom als das häufigste Mundhöhlenkarzinom. Diagnostik und Therapie.

BACKGROUND: About 5 % of all malignant tumors affect oral cavity. With a share of 95% squamous cell carcinoma is the most common type of the malignant tumors of oral mucosa. CASE REPORT: In our case the patient developed a squamous cell carcinoma of buccal mucosa about 2 years after excision of verrucous leukoplakia with epithelial dysplasia at the same location. Although chronic alcohol abuse, tobacco use and infection with HPV 16 are the most important risk factors for development of squamous cell carcinoma of the oral cavity, our patient had none of these risk factors. We treated the patient in accordance with current guidelines by complete excision of the tumor as well as an elective neck dissection of the ipsilateral side. Untill the present time the patient is free of recurrence. CONCLUSIONS: Although rare, squamous cell carcinoma of oral mucosa may also occur in patients that have no risk factors for it. Therefore, every dental and medical examination in each patient should include an inspection of the entire oral mucosa.