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Sample records for neck clinicoplathologic correlation

  1. Correlation between Trunk Posture and Neck Reposition Sense among Subjects with Forward Head Neck Postures

    PubMed Central

    Lee, Han Suk; Chung, Hyung Kuk; Park, Sun Wook

    2015-01-01

    Objective. To assess the correlation of abnormal trunk postures and reposition sense of subjects with forward head neck posture (FHP). Methods. In all, postures of 41 subjects were evaluated and the FHP and trunk posture including shoulder, scapular level, pelvic side, and anterior tilting degrees were analyzed. We used the head repositioning accuracy (HRA) test to evaluate neck position senses of neck flexion, neck extension, neck right and left side flexion, and neck right and left rotation and calculated the root mean square error in trials for each subject. Spearman's rank correlation coefficients and regression analysis were used to assess the degree of correlation between the trunk posture and HRA value, and a significance level of α = 0.05 was considered. Results. There were significant correlations between the HRA value of right side neck flexion and pelvic side tilt angle (p < 0.05). If pelvic side tilting angle increases by 1 degree, right side neck flexion increased by 0.76 degrees (p = 0.026). However, there were no significant correlations between other neck motions and trunk postures. Conclusion. Verifying pelvic postures should be prioritized when movement is limited due to the vitiation of the proprioceptive sense of neck caused by FHP. PMID:26583125

  2. Activity-dependent dendritic spine neck changes are correlated with synaptic strength

    PubMed Central

    Araya, Roberto; Vogels, Tim P.; Yuste, Rafael

    2014-01-01

    Most excitatory inputs in the mammalian brain are made on dendritic spines, rather than on dendritic shafts. Spines compartmentalize calcium, and this biochemical isolation can underlie input-specific synaptic plasticity, providing a raison d’etre for spines. However, recent results indicate that the spine can experience a membrane potential different from that in the parent dendrite, as though the spine neck electrically isolated the spine. Here we use two-photon calcium imaging of mouse neocortical pyramidal neurons to analyze the correlation between the morphologies of spines activated under minimal synaptic stimulation and the excitatory postsynaptic potentials they generate. We find that excitatory postsynaptic potential amplitudes are inversely correlated with spine neck lengths. Furthermore, a spike timing-dependent plasticity protocol, in which two-photon glutamate uncaging over a spine is paired with postsynaptic spikes, produces rapid shrinkage of the spine neck and concomitant increases in the amplitude of the evoked spine potentials. Using numerical simulations, we explore the parameter regimes for the spine neck resistance and synaptic conductance changes necessary to explain our observations. Our data, directly correlating synaptic and morphological plasticity, imply that long-necked spines have small or negligible somatic voltage contributions, but that, upon synaptic stimulation paired with postsynaptic activity, they can shorten their necks and increase synaptic efficacy, thus changing the input/output gain of pyramidal neurons. PMID:24982196

  3. Neck Strength Imbalance Correlates With Increased Head Acceleration in Soccer Heading

    PubMed Central

    Dezman, Zachary D.W.; Ledet, Eric H.; Kerr, Hamish A.

    2013-01-01

    Background: Soccer heading is using the head to directly contact the ball, often to advance the ball down the field or score. It is a skill fundamental to the game, yet it has come under scrutiny. Repeated subclinical effects of heading may compound over time, resulting in neurologic deficits. Greater head accelerations are linked to brain injury. Developing an understanding of how the neck muscles help stabilize and reduce head acceleration during impact may help prevent brain injury. Hypothesis: Neck strength imbalance correlates to increasing head acceleration during impact while heading a soccer ball. Study Design: Observational laboratory investigation. Methods: Sixteen Division I and II collegiate soccer players headed a ball in a controlled indoor laboratory setting while player motions were recorded by a 14-camera Vicon MX motion capture system. Neck flexor and extensor strength of each player was measured using a spring-type clinical dynamometer. Results: Players were served soccer balls by hand at a mean velocity of 4.29 m/s (±0.74 m/s). Players returned the ball to the server using a heading maneuver at a mean velocity of 5.48 m/s (±1.18 m/s). Mean neck strength difference was positively correlated with angular head acceleration (rho = 0.497; P = 0.05), with a trend toward significance for linear head acceleration (rho = 0.485; P = 0.057). Conclusion: This study suggests that symmetrical strength in neck flexors and extensors reduces head acceleration experienced during low-velocity heading in experienced collegiate players. Clinical Relevance: Balanced neck strength may reduce head acceleration cumulative subclinical injury. Since neck strength is a measureable and amenable strength training intervention, this may represent a modifiable intrinsic risk factor for injury. PMID:24459547

  4. Endovascular occlusion of intracranial aneurysms with electrically detachable coils: Correlation of aneurysm neck size and treatment results

    SciTech Connect

    Zubillaga, A.F.; Guglielmi, G.; Vinuela, F.; Duckwiler, G.R.

    1994-05-01

    To devise a method to measure aneurysm neck size on angiographic films, and to correlate the sizes obtained with the extent of endovascular aneurysm occlusion, performed with electrically detachable coils. The angiograms of 79 intracranial aneurysms treated by endovascular occlusion using electrically detachable coils were retrospectively analyzed. A method using the average reported caliber of the major intracranial vessels was applied to determine the aneurysm neck sizes on the diagnostic angiograms. The cases were divided into two groups according to neck size, 4 mm being the discriminative value for small and wide necks. The posttreatment angiogram of each case was analyzed to evaluate the degree of occlusion achieved by the technique. Necks were successfully measured in 95% of the aneurysms. Complete aneurysm thrombosis was observed in 85% of the small-necked aneurysms and in 15% of the wide-necked aneurysms. Accurate angiographic measurements of neck diameter can be obtained in most aneurysms. The size of an aneurysm neck correlates well with the results of the endovascular treatment. Small-necked aneurysms can be satisfactorily occluded with this technique. In wide-necked aneurysms this technique should be reserved for lesions having a high surgical risk. 10 refs., 1 fig., 1 tab.

  5. Prevalence and correlates of neck injection among people who inject drugs in Tijuana, Mexico

    PubMed Central

    RAFFUL, CLAUDIA; WAGNER, KARLA D.; WERB, DAN; GONZÁLEZ-ZÚÑIGA, PATRICIA E.; VERDUGO, SILVIA; RANGEL, GUDELIA; STRATHDEE, STEFFANIE A.

    2016-01-01

    Introduction and Aims Injecting drugs in the neck has been related to adverse health conditions such as jugular vein thrombosis, deep neck infections, aneurysm, haematomas, airway obstruction, vocal cord paralysis and wound botulism, among others. We identified prevalence and correlates of neck injection among people who inject drugs (PWID) in Tijuana, Mexico. Design and Methods Beginning in 2011, PWID aged ≥18 years who injected drugs within the last month were recruited into a prospective cohort. At baseline and semi-annually, PWID completed interviewer-administered surveys soliciting data on drug-injecting practices. Logistic regression was used to identify predictors of injecting in the neck as the most frequent injection site at a single visit. Results Of 380 PWID, 35.3% injected in the neck at least once in the past 6 months, among whom 71.6% reported it as their most common injection site, the most common injecting site after the arms (47%). Controlling for age, years injecting and injecting frequency, injecting heroin and methamphetamine two or more times per day and having sought injection assistance were associated with injecting in the neck [adjusted odds ratios (AOR): 2.12; 95% confidence intervals (CI): 1.27–3.53 and AOR: 2.65; 95% CI: 1.52–4.53 respectively]. Discussion and Conclusions Injecting in the neck was very common among PWID in Tijuana and was associated with polydrug use and seeking injection assistance. Tailoring harm reduction education interventions for individuals who provide injection assistance (‘hit doctors’) may allow for the dissemination of safe injecting knowledge to reduce injection-related morbidity and mortality. PMID:25867795

  6. CK8 correlates with malignancy in leukoplakia and carcinomas of the head and neck

    SciTech Connect

    Gires, Olivier . E-mail: olivier.gires@med.uni-muenchen.de; Mack, Brigitte; Rauch, Jens; Matthias, Christoph

    2006-04-28

    Screening of head and neck carcinoma patients with the proteomics-based AMIDA technology yielded a set of tumour-associated antigens, including the intermediate filament protein cytokeratin 8 (CK8). The expression pattern and specificity of CK8 was compared with those of the established markers pan-cytokeratins and CK13, and with that of the proliferation marker Ki67. Expression of CK8 correlated positively with malignancies of the head and neck areas. CK8 was not expressed in healthy epithelium, except for some rare cases of cells of the basal layer and laryngeal tissue. In contrast, the vast majority of head and neck squamous cell carcinomas and metastases strongly expressed CK8. Interestingly, CK8 de novo expression correlated with dysplastic areas of oral leukoplakic lesions, while hyperplastic leukoplakia remained CK8-negative but strongly panCK and CK13 positive. Thus, CK8 is an attractive marker molecule for a differentiated diagnosis of leukoplakia and head and neck carcinomas, which possesses notedly improved specificity as compared with panCK and CK13.

  7. Head and neck neurovascular trauma: Clinical and angiographic correlation

    PubMed Central

    Ssenyonga, Peter Kato; Le Feuvre, David

    2015-01-01

    A retrospective review of all angiograms done for craniocervical trauma, over an eight-year period at Groote Schuur Hospital identified 61 patients out of 823 angiographically studied who had extradural vascular injury and required endovascular treatment. Multiple lesions were identified in nine (14,8%) patients and associated injuries were found in 23 patients (37%). The mechanism of injury was blunt in nine (14.8%) patients and penetrating in 52 (85.2%). There was a statistically significant correlation between the presenting clinical feature and the underlying angiographic lesion. Patients with active bleeding were more likely to have a vessel laceration, an expanding hematoma was associated with false aneurysm and a pulsatile mass with arteriovenous fistula. Endovascular treatment with emphasis on vessel occlusion rather than preservation was successful in all cases except one which required surgical vessel ligation. PMID:25934784

  8. Sites of Basal Cell Carcinomas and Head and Neck Congenital Clefts: Topographic Correlation

    PubMed Central

    Brenta, Federica; Malovini, Alberto; Jaber, Omar; Faga, Angela

    2014-01-01

    Background: The embryologic fusion planes might be related with the sites of onset of basal cell carcinoma (BCC), thus supporting an embryologic role for its pathogenesis. Methods: A study involving 495 patients with 627 BCCs of the head and neck was carried out over a period of 5 years by correlating the distribution of all BCCs with the sites of congenital clefts of the head and neck using (1) the original anatomic diagram of the Tessier classification of craniofacial clefts, (2) the anatomic diagram by Moore et al featuring the paths of the “hairline indicators” of craniofacial clefts that represent the cranial extensions of the Tessier classification, and (3) an anatomical diagram featuring the sites of congenital clefts of the neck. Results: The proportion of BCCs localized within a cleft site was significantly higher than those in the noncleft sites. The age of patients with BCCs localized within the Tessier cleft number 3 was the lowest among all cleft regions. Conclusions: A topographic correspondence between the sites of BCCs and the sites of congenital clefts was demonstrated in the head and neck. This evidence would support the hypothesis of an embryologic role for the pathogenesis of BCC. The existence of clusters of embryological stem cells in the sites of fusion and/or merging of embryonic processes might therefore be proposed. There may be special biology/physiology along these cleft lines that predispose BCC formation. PMID:25289357

  9. Dose-volume factors correlating with trismus following chemoradiation for head and neck cancer

    PubMed Central

    RAO, SHYAM D.; SALEH, ZIAD H.; SETTON, JEREMY; TAM, MOSES; MCBRIDE, SEAN M.; RIAZ, NADEEM; DEASY, JOSEPH O.; LEE, NANCY Y.

    2016-01-01

    Background To investigate the dose-volume factors in mastication muscles that are implicated as possible causes of trismus in patients following treatment with intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy for head and neck cancers. Material and methods All evaluable patients treated at our institution between January 2004 and April 2009 with chemotherapy and IMRT for squamous cell cancers of the oropharynx, nasopharynx, hypopharynx or larynx were included in this analysis (N = 421). Trismus was assessed using CTCAE 4.0. Bi-lateral masseter, temporalis, lateral pterygoid and medial pterygoid muscles were delineated on axial computed tomography (CT) treatment planning images, and dose-volume parameters were extracted to investigate univariate and multimetric correlations. Results Forty-six patients (10.9%) were observed to have chronic trismus of grade 1 or greater. From analysis of baseline patient characteristics, toxicity correlated with primary site and patient age. From dose-volume analysis, the steepest dose thresholds and highest correlations were seen for mean dose to ipsilateral masseter (Spearman’s rank correlation coefficient Rs = 0.25) and medial pterygoid (Rs = 0.23) muscles. Lyman-Kutcher-Burman modeling showed highest correlations for the same muscles. The best correlation for multimetric logistic regression modeling was with V68Gy to the ipsilateral medial pterygoid (Rs = 0.29). Conclusion Chemoradiation-induced trismus remains a problem particularly for patients with oropharyngeal carcinoma. Strong dose-volume correlations support the hypothesis that limiting dose to the ipsilateral masseter muscle and, in particular, the medial pterygoid muscle may reduce the likelihood of trismus. PMID:25920361

  10. Extramedullary plasmacytoma of the head and neck region: clinicopathological correlation in 25 cases.

    PubMed Central

    Susnerwala, S. S.; Shanks, J. H.; Banerjee, S. S.; Scarffe, J. H.; Farrington, W. T.; Slevin, N. J.

    1997-01-01

    Extramedullary plasmacytomas (EMP) of head and neck are rare tumours. Between 1972 and 1993, 25 cases of EMP of head and neck were seen at our institute. The clinical and pathological features and response to treatment are presented. At initial presentation, 23 (92%) patients presented with disease confined to a single extramedullary site only and two patients had in addition clinical involvement of cervical lymph nodes. All except these two patients received radiotherapy to the primary site only as initial treatment. Initial primary control of local disease was obtained in 16 of 24 (67%) patients treated with radical intent. With salvage treatment of further radiotherapy and/or chemotherapy, local disease control was achieved in 21 of 24 (88%) patients. One patient was treated with palliative intent. Conversion to multiple myeloma was seen in two patients (8%). Pathologically, the tumours were classified into low, intermediate and high grade, which correlated closely with outcome. This classification has been used for the first time in extramedullary plasmacytomas and is based on the multiple myeloma grading criteria devised by Bartl et al (1987). Fifteen of eighteen (83%) low-grade tumours and only one of six (17%) intermediate- and high-grade tumours were locally controlled after primary radiotherapy. This is statistically significant for local control (P= 0.0019) but not for overall survival (P= 0.12). The median survival and 5-year overall survival is 68 months and 58.9% respectively. We recommend consideration of adjuvant chemotherapy in patients with higher grade disease. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 PMID:9062417

  11. Correlation of Positron Emission Tomography Standard Uptake Value and Pathologic Specimen Size in Cancer of the Head and Neck

    SciTech Connect

    Burri, Ryan J. Rangaswamy, Balasubramanya; Kostakoglu, Lale; Hoch, Benjamin; Genden, Eric M.; Som, Peter M.; Kao, Johnny

    2008-07-01

    Purpose: To correlate positron emission tomography (PET) standard uptake value (SUV) with pathologic specimen size in patients with head-and-neck cancers. Methods and Materials: Eighteen patients with Stage II-IVB head-and-neck cancer with 27 tumors who underwent PET and computed tomography (CT) imaging of the head and neck followed by surgical resection were selected for this study. Various SUV thresholds were examined, including the software default (SUV{sub def}), narrowing the window by 1 standard deviation (SD) of the maximum (SUV-1SD), and SUV cutoff values of 2.5 or greater (SUV2.5) and 40% or greater maximum (SUV40). Volumetric pathologic data were available for 12 patients. Tumor volumes based on pathologic examination (gold standard), CT, SUV{sub def}, SUV-1SD, SUV2.5, and SUV40 were analyzed. Results: PET identified five tumors not seen on CT. The sensitivity of PET for identifying primary tumors was 94% (17 of 18). The Sensitivity of PET for staging the neck was 90% (9 of 10), whereas the specificity was 78% (7 of 9). The SUV2.5 method was most likely to overestimate tumor volume, whereas SUV{sub def} and SUV-1SD were most likely to underestimate tumor volume. Conclusions: The PET scan provides more accurate staging of primary tumors and nodal metastases for patients with advanced head-and-neck cancer than CT alone. Compared with the gold standard, significant variability exists in volumes obtained by using various SUV thresholds. A combination of clinical, CT, and PET data should continue to be used for optimal treatment planning. The SUV40 method appears to offer the best compromise between accuracy and reducing the risk of underestimating tumor extent.

  12. Neck dissection

    MedlinePlus

    Radical neck dissection; Modified radical neck dissection; Selective neck dissection; Lymph node removal - neck ... spread. There are three main types of neck dissection surgery: Radical neck dissection: All the tissue on the side of ...

  13. Fibroblastic and myofibroblastic tumors of the head and neck: comprehensive imaging-based review with pathologic correlation.

    PubMed

    Hourani, Roula; Taslakian, Bedros; Shabb, Nina S; Nassar, Lara; Hourani, Mukbil H; Moukarbel, Roger; Sabri, Alain; Rizk, Toni

    2015-02-01

    Fibroblastic and myofibroblastic tumors of the head and neck are a heterogeneous group of disorders characterized by the proliferation of fibroblasts, myofibroblasts, or both. These tumors may be further subclassified on the basis of their behavior as benign, intermediate with malignant potential, or malignant. There are different types of fibroblastic and myofibroblastic tumors that can involve the head and neck including desmoid-type fibromatosis, solitary fibrous tumor, myofibroma/myofibromatosis, nodular fasciitis, nasopharyngeal angiofibroma, fibrosarcoma, dermatofibrosarcoma protuberans, fibromatosis coli, inflammatory myofibroblastic tumor, ossifying fibroma, fibrous histiocytoma, nodular fasciitis, fibromyxoma, hyaline fibromatosis and fibrous hamartoma. Although the imaging characteristics of fibroblastic and myofibroblastic tumors of the head and neck are nonspecific, imaging plays a pivotal role in the noninvasive diagnosis and characterization of these tumors, providing information about the constitution of tumors, their extension and invasion of adjacent structures. Correlation with the clinical history may help limit the differential diagnosis and radiologists should be familiar with the imaging appearance of these tumors to reach an accurate diagnosis. PMID:25467227

  14. Body Mass Index May Positively Correlate with Bone Mineral Density of Lumbar Vertebra and Femoral Neck in Postmenopausal Females

    PubMed Central

    Wu, Shi-Feng; Du, Xin-Jie

    2016-01-01

    Background Our study aimed to explore the relationship between body mass index (BMI) and bone mineral density (BMD) of lumbar vertebra and femoral neck in postmenopausal females. Material/Methods From September 2012 to September 2014, 236 healthy postmenopausal females who underwent physical examinations at the Women & Children’s Health Care Hospital of Linyi were enrolled into our study. These subjects were divided into 3 groups: underweight group, normal weight group, and overweight group. In addition, there were 2 age stratifications: <60 years old and ≥60 years old. DPX-L type dual-energy X-ray bone densitometry (American Lunar Company) was used to measure the BMD of lumbar vertebra and femoral neck in the recruited subjects. Pearson test was used for correlation analysis. Results BMDs and T-scores of lumbar vertebra (L1–L4), femoral neck, proximal femur, and Ward’s triangle region among the groups were ranked as follows: underweight group < normal weight group < overweight group. There were significant differences in body weight and BMI among the underweight, normal weight, and overweight groups (P<0.05). The T-scores of all examined anatomic locations showed significant differences between the underweight group and normal weight group, as well as between the underweight group and overweight group (both P<0.05). Only the T-scores of lumbar vertebra L2–L4 had significant differences between the normal weight group and overweight group (P<0.05). The BMDs of all anatomic components under study showed statistical differences in both age stratifications between the overweight group and underweight group, as well as between the overweight group and normal weight group (both P<0.05). When stratified above 60 years old, the BMDs of lumbar vertebra (L1, L2 and L4) showed statistical differences between the normal weight group and underweight group (P<0.05). Various factors could be ranked according to the absolute values of correlation coefficients as below: body weight, BMI, height, and age. Body weight, BMI, and height were positively correlated with the BMDs of all examined anatomic locations (P<0.05). However, age was negatively correlated with the various components of the body (lumbar vertebra L1, L2 and L4, femoral neck, proximal femur, Ward’s triangle region: P<0.05; lumbar vertebra L3: P>0.05). Conclusions Our study provides evidence that body weight and BMI are important factors affecting BMD. Postmenopausal females with low BMI are more likely to have osteopenia, and are likely to develop osteoporosis. BMI can be used as an important index to prevent osteoporosis. PMID:26766815

  15. Clinico-Pathological Correlation of β-Catenin and Telomere Dysfunction in Head and Neck Squamous Cell Carcinoma Patients

    PubMed Central

    Padhi, Swatishree; Saha, Arka; Kar, Madhabananda; Ghosh, Chinmoy; Adhya, Amit; Baisakh, Manas; Mohapatra, Nachiketa; Venkatesan, Shriram; Hande, Manoor Prakash; Banerjee, Birendranath

    2015-01-01

    Background: Tumorigenesis is a complex process of accumulated alteration in function of multiple genes and pathways. Wnt signalling pathway is involved in various differentiation events during embryonic development and is conserved in various species. Objective: A multicentre collaborative initiative is undertaken to study the occurrence, prognosis and molecular mechanism of HNSCC (Head and Neck Squamous Cell Carcinoma) which is highly prevalent in eastern parts of India. From a large cohort of HNSCC tissue repository, 67 cases were selected for multi-parametric investigation. Results: 67 cases showed stable β-catenin expression. We have seen correlation, if any, of the transcription factor - β-catenin, telomere maintenance and shelterin complex proteins - TRF2, Rap1 and hTert with respect to tumor differentiation and telomere dysfunction. Immunohistochemistry of β-catenin protein showed stable and high expression in tumor when compared to stroma. MDSCC (Moderately Differentiated Squamous cell carcinoma) cases expressed nuclear expression of β-catenin in invasive fronts and showed increased genomic instability. Higher frequency of Anaphase bridges was observed ranging from <3% in normal cut margin to 13% in WDSCC (Well differentiated squamous cell carcinoma) and 18% in MDSCC (Moderately differentiated Squamous cell carcinoma). There was significant decrease in telomere length in MDSCC (<4) when compared to the normal cut margin samples (<7). Quantitative Real Time-PCR confirmed a significant correlationship between stable β-catenin expression and poor clinical and pathological outcome. Conclusion: The Stabilisation and accumulation of β-catenin was significant and correlated well with de-differentiation process as well as prognosis and therapy outcome of the patients in the cohort. Expression status of molecular markers such as β-catenin, hTert, TRF2 and RAP1 correlate significantly with the process of tumorigenesis and prognosis and may play a role in therapeutic management of Head and neck patients. PMID:25653721

  16. Genomic Correlate of Exceptional Erlotinib Response in Head and Neck Squamous Cell Carcinoma

    PubMed Central

    Van Allen, Eliezer M.; Lui, Vivian W. Y.; Egloff, Ann Marie; Goetz, Eva M.; Li, Hua; Johnson, Jonas T.; Duvvuri, Umamaheswar; Bauman, Julie E.; Stransky, Nicolas; Zeng, Yan; Gilbert, Breean R.; Pendleton, Kelsey P.; Wang, Lin; Chiosea, Simion; Sougnez, Carrie; Wagle, Nikhil; Zhang, Fan; Du, Yu; Close, David; Johnston, Paul A.; McKenna, Aaron; Carter, Scott L.; Golub, Todd R.; Getz, Gad; Mills, Gordon B.; Garraway, Levi A.; Grandis, Jennifer R.

    2015-01-01

    IMPORTANCE Randomized clinical trials demonstrate no benefit for epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors in unselected patients with head and neck squamous cell carcinoma (HNSCC). However, a patient with stage IVA HNSCC received 13 days of neoadjuvant erlotinib and experienced a near-complete histologic response. OBJECTIVE To determine a mechanism of exceptional response to erlotinib therapy in HNSCC. DESIGN, SETTING, AND PARTICIPANTS Single patient with locally advanced HNSCC who received erlotinib monotherapy in a window-of-opportunity clinical trial (patients scheduled to undergo primary cancer surgery are treated briefly with an investigational agent). Whole-exome sequencing of pretreatment tumor and germline patient samples was performed at a quaternary care academic medical center, and a candidate somatic variant was experimentally investigated for mediating erlotinib response. INTERVENTION A brief course of erlotinib monotherapy followed by surgical resection. MAIN OUTCOMES AND MEASURES Identification of pretreatment tumor somatic alterations that may contribute to the exceptional response to erlotinib. Hypotheses were formulated regarding enhanced erlotinib response in preclinical models harboring the patient tumor somatic variant MAPK1 E322K following the identification of tumor somatic variants. RESULTS No EGFR alterations were observed in the pretreatment tumor DNA. Paradoxically, the tumor harbored an activating MAPK1 E322K mutation (allelic fraction 0.13), which predicts ERK activation and erlotinib resistance in EGFR-mutant lung cancer. The HNSCC cells with MAPK1 E322K exhibited enhanced EGFR phosphorylation and erlotinib sensitivity compared with wild-type MAPK1 cells. CONCLUSIONS AND RELEVANCE Selective erlotinib use in HNSCC may be informed by precision oncology approaches. PMID:26181029

  17. p53 mutation, but not p53 overexpression, correlates with survival in head and neck squamous cell carcinoma.

    PubMed Central

    Mineta, H.; Borg, A.; Dictor, M.; Wahlberg, P.; Akervall, J.; Wennerberg, J.

    1998-01-01

    Survival in squamous cell carcinoma of the head and neck (HNSCC) was compared with overexpression and mutation of the p53 gene. Archival tissue from 77 tumours was analysed for protein expression using immunohistochemistry (IHC) with the monoclonal antibody Do-7, and for the presence of mutation in exons 5-8 using single-stranded conformation polymorphism (SSCP), followed by DNA sequencing in SSCP-positive cases. p53 expression was scored as high (>70% nuclei stained) in 25 (32%) tumours, as intermediate (10-70% nuclei stained) in 19 (25%) tumours and as low (<10% nuclei stained) in 33 (43%) tumours. Twelve (18%) tumours exhibited gene mutation (ten missense and two nonsense mutations) and an additional five tumours contained changes that could not result in amino acid substitution or protein truncation. There was no correlation between gene expression and mutation, mutations being equally frequent in tumours with either high (4/25), intermediate (4/19) or low protein expression (4/33). Fifty-eight patients were eligible for survival analysis. There was a strong correlation between p53 mutation and cause-specific survival; median survival among mutated cases was 12.5 months compared with >160 months among non-mutated patients (P < 0.005). There was no correlation between p53 overexpression and survival. The results suggest that p53 mutation status is an important prognostic factor in HNSCC, and that IHC analysis of protein overexpression is an inadequate measure of gene mutation in these tumours. Images Figure 1 PMID:9792155

  18. Correlating Computed Tomography Perfusion Changes in the Pharyngeal Constrictor Muscles During Head-and-Neck Radiotherapy to Dysphagia Outcome

    SciTech Connect

    Truong, Minh Tam; Lee, Richard; Saito, Naoko; Qureshi, Muhammad M.; Ozonoff, Al; Romesser, Paul B.; Wang, Jimmy; Sakai, Osamu

    2012-02-01

    Purpose: To measure changes in perfusion of the pharyngeal constrictor muscles (PCM) using CT perfusion (CTP) imaging during a course of definitive radiotherapy (RT) in head-and-neck cancer (HNC) patients and correlate with dysphagia outcome after RT. Methods and Materials: Fifteen HNC patients underwent CTP imaging of the PCM at baseline and Weeks 2, 4, and 6 during RT and 6 weeks after RT. Blood flow and blood volume were measured in the PCM, and percentage change from baseline scan was determined. A single physician-based assessment of dysphagia was performed every 3 months after RT using the Common Terminology Criteria for Adverse Events, version 3.0 grading system. Results: With a median follow-up of 28 months (range, 6-44 months), Grade 3 dysphagia was present in 7 of 15 patients, and 8 patients experienced Grade 0-2 dysphagia. The CTP parameters at Week 2 of RT demonstrated an increase in mean PCM blood flow of 161.9% vs. 12.3% (p = 0.007) and an increase in mean PCM blood volume of 96.6% vs. 8.7% (p = 0.039) in patients with 6-month post-RT Grade 3 dysphagia and Grade 0-2 dysphagia, respectively. On multivariate analysis, when adjusting for smoking history, tumor volume, and baseline dysphagia status, an increase in blood flow in the second week of RT was significant for 3- and 6-month Grade 3 dysphagia (p < 0.05). Conclusions: Perfusion changes in the PCM during Week 2 of RT in the PCM may predict the severity of dysphagia after HNC RT.

  19. Expression of IL-1α correlates with distant metastasis in patients with head and neck squamous cell carcinoma.

    PubMed

    León, Xavier; Bothe, Carolina; García, Jacinto; Parreño, Matilde; Alcolea, Sonia; Quer, Miquel; Vila, Luis; Camacho, Mercedes

    2015-11-10

    The presence of IL-1 in human cancers is associated with aggressive tumor biology but its prognostic value is unknown. We studied whether IL-1α expression is a prognostic marker of distant metastasis in patients with head and neck squamous cell carcinoma (HNSCC). IL-1α mRNA and protein levels were determined in tumor samples and cancer cell lines using RT-PCR and ELISA. The effects of constitutive IL-1α expression by tumor lines were characterized. IL-1α mRNA and protein secretion were higher in tumor samples from patients who later developed distant metastasis than in patients who did not. By using distant metastasis as a dependent variable, patients were classified into two categories of IL-1α transcript-levels. The high-IL-1α group had a significantly lower five-year distant metastasis-free survival than the low-IL-1α group [70.0% (CI 95%: 55.9-84.1%) vs 94.7% (CI 95%:90.2-99.2%)]. When IL-1α transcript-levels were combined with clinical factors related to tumor metastasis, the predictive power of the model increased significantly. Additionally, transcript levels of IL-1α correlated significantly with those of the IL-1 family genes and genes related to the metastatic process. IL-1 treatment of microvascular endothelial cells increased adhesion of HNSCC cells but no differences were found based on constitutive IL-1α expression by tumor cells. Nevertheless, IL-1α produced by tumor cells effectively increased their transmigration across the endothelium. We found a significant relationship between IL-1α expression and development of distant metastasis in HNSCC patients. IL-1α expression could help to define a subset of patients at high risk of distant metastasis who could benefit from adjuvant treatment. PMID:26460957

  20. Expression of IL-1α correlates with distant metastasis in patients with head and neck squamous cell carcinoma

    PubMed Central

    León, Xavier; Bothe, Carolina; García, Jacinto; Parreño, Matilde; Alcolea, Sonia; Quer, Miquel

    2015-01-01

    The presence of IL-1 in human cancers is associated with aggressive tumor biology but its prognostic value is unknown. We studied whether IL-1α expression is a prognostic marker of distant metastasis in patients with head and neck squamous cell carcinoma (HNSCC). IL-1α mRNA and protein levels were determined in tumor samples and cancer cell lines using RT-PCR and ELISA. The effects of constitutive IL-1α expression by tumor lines were characterized. IL-1α mRNA and protein secretion were higher in tumor samples from patients who later developed distant metastasis than in patients who did not. By using distant metastasis as a dependent variable, patients were classified into two categories of IL-1α transcript-levels. The high-IL-1α group had a significantly lower five-year distant metastasis-free survival than the low-IL-1α group [70.0% (CI 95%: 55.9-84.1%) vs 94.7% (CI 95%:90.2-99.2%)]. When IL-1α transcript-levels were combined with clinical factors related to tumor metastasis, the predictive power of the model increased significantly. Additionally, transcript levels of IL-1α correlated significantly with those of the IL-1 family genes and genes related to the metastatic process. IL-1 treatment of microvascular endothelial cells increased adhesion of HNSCC cells but no differences were found based on constitutive IL-1α expression by tumor cells. Nevertheless, IL-1α produced by tumor cells effectively increased their transmigration across the endothelium. We found a significant relationship between IL-1α expression and development of distant metastasis in HNSCC patients. IL-1α expression could help to define a subset of patients at high risk of distant metastasis who could benefit from adjuvant treatment. PMID:26460957

  1. Pretreatment anemia is correlated with the reduced effectiveness of radiation and concurrent chemotherapy in advanced head and neck cancer

    SciTech Connect

    Prosnitz, Robert G. . E-mail: robert.prosnitz@duke.edu; Yao, Bin M.S.; Farrell, Catherine L.; Clough, Robert; Brizel, David M.

    2005-03-15

    Purpose: Pretreatment anemia is an adverse prognostic variable in squamous cell head-and-neck cancer (HNC) patients treated with radiotherapy (RT) alone. Tumor hypoxia is an adverse parameter for treatment with RT alone or with RT and concurrent chemotherapy (CCT). Tumor hypoxia is more prevalent in patients who present with pretreatment hemoglobin (Hgb) concentrations less than 13 g/dL. RT/CCT improves survival over RT alone in advanced HNC, and its use is becoming more widespread. This study was performed to evaluate whether pretreatment Hgb less than 13 g/dL was correlated with treatment outcome in patients with advanced HNC treated with a uniform regimen of RT/CCT. Methods and materials: The study population consisted of patients with AJCC Stage III or IV, M0 HNC who were treated with 70 to 72.5 Gy accelerated hyperfractionated RT (1.25 Gy b.i.d.) and CCT consisting of 2 cycles of CDDP (12-20 mg/m{sup 2}/d x 5 days) and continuous infusion 5-FU (600 mg/m{sup 2}/d x 5 days) during Week 1 and Week 6. A planned break in RT occurred during Week 4. These patients were enrolled on the experimental arm of a prospective randomized trial that compared this regimen to hyperfractionated irradiation alone from 1990 to 1996. RT/CCT was delivered as standard therapy from 1996 to 2000. The primary endpoint was failure-free survival (FFS). Secondary endpoints included local-regional control and overall survival. Results: One hundred and fifty-nine patients were treated from 1990 to 2000. The median (25-75%) pretreatment Hgb was 13.6 (12.2-13.5) g/dL. Hgb was 13 g/dL or higher in 105 patients and less than 13 g/dL in 54 patients. Primary tumor sites included oropharynx (43%), hypopharynx/larynx (36%), oral cavity (9%), and nasopharynx (6%). Seventy-eight percent of the patients with Hgb 13 g/dL or higher and 92% of the patients with Hgb less than 13 g/dL had a primary tumor stage of T3 or T4 (p = 0.01). Node-positive disease was present in 74 of 105 (70%) of patients with Hgb 13 g/dL or higher patients and in 36/54 (67%) of patients with Hgb less than 13 g/dL patients. Median follow-up of surviving patients was 42 months (range, 4-128 months). Five-year FFS was 75% for patients with Hgb 13 g/dL or higher vs. 50% for patients with Hgb less than 13 g/dL had a (p < 0.01). A total of 49 failures occurred in both patient cohorts. The median (25-75%) decrease in Hgb during RT/CCT was 2.2 (1.3-3.1) g/dL, both in patients who failed and in those who remained disease-free. Conclusion: Pretreatment Hgb less than 13 g/dL is correlated with adverse outcomes in advanced HNC patients treated with RT/CCT. Whether anemia actually causes poor outcomes remains unknown. The therapeutic effect of anemia correction is being evaluated in prospective trials.

  2. Neck dissection - discharge

    MedlinePlus

    Radical neck dissection - discharge; Modified radical neck dissection - discharge; Selective neck dissection - discharge ... Neck dissection is surgery to remove the lymph nodes in your neck. Cells from cancers in the mouth ...

  3. p16 and p53 expression status in head and neck squamous cell carcinoma: a correlation with histological, histoprognostic and clinical parameters.

    PubMed

    Karpathiou, Georgia; Monaya, Alessandra; Forest, Fabien; Froudarakis, Marios; Casteillo, Francois; Marc Dumollard, Jean; Prades, Jean Michel; Peoc'h, Michel

    2016-06-01

    Different histopathology and prognosis characterise the human papillomavirus (HPV)-related oropharyngeal tumours, but squamous cell carcinomas (SCC) of other localisations have not been exhaustively studied. Tissues from 120 patients with a head and neck SCC were studied for the expression of p16 and p53, and the Brandwein-Gensler (BG) histological risk assessment model. p16 positivity and p53 normal expression were significantly correlated with non-smoking, an earlier T stage and a non-keratinising morphology. The BG risk score was not associated with p16 or p53 expression; p16 expression was associated with a lymphocytic T-cytotoxic response. BG risk score was significantly correlated with overall survival and progression-free survival, while neither p16 nor p53 expression were associated with prognosis. p16 and p53 expression are associated with the histological subtype and the T stage even in non-oropharyngeal-restricted tumours. The BG risk score is not correlated with p16 or p53 and retains its power in non-site-specific SCCs. PMID:27113547

  4. Correlation of Osteoradionecrosis and Dental Events With Dosimetric Parameters in Intensity-Modulated Radiation Therapy for Head-and-Neck Cancer

    SciTech Connect

    Gomez, Daniel R.; Estilo, Cherry L.; Wolden, Suzanne L.; Zelefsky, Michael J.; Kraus, Dennis H.; Wong, Richard J.; Shaha, Ashok R.; Shah, Jatin P.; Mechalakos, James G.; Lee, Nancy Y.

    2011-11-15

    Purpose: Osteoradionecrosis (ORN) is a known complication of radiation therapy to the head and neck. However, the incidence of this complication with intensity-modulated radiation therapy (IMRT) and dental sequelae with this technique have not been fully elucidated. Methods and Materials: From December 2000 to July 2007, 168 patients from our institution have been previously reported for IMRT of the oral cavity, nasopharynx, larynx/hypopharynx, sinus, and oropharynx. All patients underwent pretreatment dental evaluation, including panoramic radiographs, an aggressive fluoride regimen, and a mouthguard when indicated. The median maximum mandibular dose was 6,798 cGy, and the median mean mandibular dose was 3,845 cGy. Patient visits were retrospectively reviewed for the incidence of ORN, and dental records were reviewed for the development of dental events. Univariate analysis was then used to assess the effect of mandibular and parotid gland dosimetric parameters on dental endpoints. Results: With a median clinic follow-up of 37.4 months (range, 0.8-89.6 months), 2 patients, both with oral cavity primaries, experienced ORN. Neither patient had preradiation dental extractions. The maximum mandibular dose and mean mandibular dose of the 2 patients were 7,183 and 6,828 cGy and 5812 and 5335 cGy, respectively. In all, 17% of the patients (n = 29) experienced a dental event. A mean parotid dose of >26 Gy was predictive of a subsequent dental caries, whereas a maximum mandibular dose >70 Gy and a mean mandibular dose >40 Gy were correlated with dental extractions after IMRT. Conclusions: ORN is rare after head-and-neck IMRT, but is more common with oral cavity primaries. Our results suggest different mechanisms for radiation-induced caries versus extractions.

  5. Detection of head and neck squamous cell carcinoma with diffusion weighted MRI after (chemo)radiotherapy: Correlation between radiologic and histopathologic findings

    SciTech Connect

    Vandecaveye, Vincent; Keyzer, Frederik de; Nuyts, Sandra; Deraedt, Karen; Dirix, Piet; Hamaekers, Pascal; Vander Poorten, Vincent; Delaere, Pierre; Hermans, Robert . E-mail: Robert.Hermans@uzleuven.be

    2007-03-15

    Purpose: To investigate the value of diffusion weighted magnetic resonance imaging (DW-MRI) in differentiating persistent or recurrent head and neck squamous cell carcinoma (HNSCC) from nontumoral postradiotherapeutic alterations. Methods and Materials: In 26 patients with suspicion of persistent or recurrent HNSCC, MRI of the head and neck was performed, including routine turbo spin-echo (TSE) sequences and an additional echo-planar DW-MRI sequence, using a large range of b-values (0-1000 s/mm{sup 2}). Apparent diffusion coefficient (ADC) maps were calculated. In the suspect areas at the primary site and in the suspect lymph nodes, signal intensity was measured on the native b0 and b1000 images and ADC values were calculated for these tissues. The same was done for surrounding irradiated normal tissue. Imaging results were correlated to histopathology. Results: Signal intensity on native b0 images was significantly lower for HNSCC than for nontumoral postradiotherapeutic tissue (p < 0.0001), resulting in a sensitivity of 66.2%, specificity of 60.8%, and accuracy of 62.4%. Signal intensity on native b1000 images was significantly higher for HNSCC than for nontumoral tissue (p < 0.0001), resulting in a sensitivity of 71.6%, specificity of 71.3%, and accuracy of 71.4%. ADC values were significantly lower for HNSCC than for nontumoral tissue (p < 0.0001), resulting in a sensitivity of 94.6%, specificity of 95.9%, and accuracy of 95.5%. When compared with computed tomography, TSE-MRI and fluorodeoxyglucose-positron emission tomography, DW-MRI yielded fewer false-positive results in persistent primary site abnormalities and in persistent adenopathies, and aided in the detection of subcentimetric nodal metastases. Conclusions: Diffusion weighted-MRI accurately differentiates persistent or recurrent HNSCC from nontumoral tissue changes after (chemo)radiotherapy.

  6. [Fiddler's neck].

    PubMed

    Knierim, C; Goertz, W; Reifenberger, J; Homey, B; Meller, S

    2013-10-01

    The fiddler's neck is an uncommon variant of acne mechanica in violinists and violists. It is a single firm red-brown dermal nodule usually on the left side of neck. This special form of acne mechanica represents a therapeutic challenge since the triggering mechanical factors persist, unless they can be corrected by changes in positioning or modifications of the chin pad. A 72-year-old woman who had played the violin since childhood presented with a red-brown nodule on her neck for 18 months. Cushioning provided no relief. Excision of the affected area with primary closure represented one therapeutic option. Further supportive measures include improved posture to reduce the pressure between skin and instrument and interposing a neck cloth. PMID:23989244

  7. Neck pain

    MedlinePlus

    ... falls can cause severe neck injuries, such as vertebral fractures, whiplash, blood vessel injury, and even paralysis. Other ... fibromyalgia Cervical arthritis or spondylosis Ruptured disk ... spine from osteoporosis Spinal stenosis (narrowing of the spinal ...

  8. Neck lump

    MedlinePlus

    ... or more lumps. This can be due to thyroid disease or cancer. Most cancers of the thyroid gland ... be caused by: Bacterial or viral infection Cancer Thyroid disease Allergic reaction Lumps in the neck due to ...

  9. Neck Pain

    MedlinePlus

    ... also may be from RHEUMATOID ARTHRITIS, an inflammatory joint disease, or FIBROMYALGIA, a chronic condition affecting muscles and ... stiffness every day in your neck, hands, knees, hips or other joints? Yes Your pain may be ...

  10. Correlation of Choline/Creatine and Apparent Diffusion Coefficient values with the prognostic parameters of Head and Neck Squamous Cell Carcinoma.

    PubMed

    Razek, Ahmed Abdel Khalek Abdel; Nada, Nadia

    2016-04-01

    The aim of this study was to measure choline/creatine (Ch/Cr) levels through (1) H-MRS and apparent diffusion coefficient (ADC) values through diffusion-weighted MRI, and to correlate these values with the prognostic parameters of head and neck squamous cell carcinoma (HNSCC). The institutional review board approved this study and informed written consent was obtained from all study participants. A prospective study of 43 patients (31 men and 12 women; mean age, 65 years) with HNSCC was conducted. Single-voxel (1) H-MRS was performed at the tumor or metastatic cervical lymph node with point-resolved spectroscopy (PRESS) at TE = 135 ms. Diffusion-weighted MR images with b values of 0, 500 and 1000 s/mm(2) and contrast MRI of the head and neck were performed. The Ch/Cr levels and ADC values of HNSCC were calculated. The gross tumor volume (GTV) was also calculated. The degree of tumor differentiation was determined through pathological examination. The HNSCC Ch/Cr level was negatively correlated with the ADC value (r = -0.662, p = 0.001). There was a significant difference in the Ch/Cr and ADC values at different degrees of tumor differentiation (p = 0.003 and p = 0.001) and with different GTVs (p = 0.122 and p = 0.001). The following prognostic parameter categories were used: (i) poorly differentiated and undifferentiated versus well differentiated to moderately differentiated; and (ii) HNSCC with GTV < 30 cm(3) versus GTV > 30 cm(3) . The cut-off values for Cho/Cr and ADC for each category were 1.83, 0.95 and 1.94, 0.99, respectively, and the areas under the curve were 0.771, 0.967 and 0.726, 0.795, respectively, for each category. We conclude that the Ch/Cr levels determined using (1) H-MRS and the ADC values are well correlated with several prognostic parameters of HNSCC. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26867020

  11. Mesenchymal stem cells are enriched in head neck squamous cell carcinoma, correlates with tumour size and inhibit T-cell proliferation

    PubMed Central

    Liotta, F; Querci, V; Mannelli, G; Santarlasci, V; Maggi, L; Capone, M; Rossi, M C; Mazzoni, A; Cosmi, L; Romagnani, S; Maggi, E; Gallo, O; Annunziato, F

    2015-01-01

    Background: Cancer is a multifactorial disease not only restricted to transformed epithelium, but also involving cells of the immune system and cells of mesenchymal origin, particularly mesenchymal stem cells (MSCs). Mesenchymal stem cells contribute to blood- and lymph- neoangiogenesis, generate myofibroblasts, with pro-invasive activity and may suppress anti-tumour immunity. Methods: In this paper, we evaluated the presence and features of MSCs isolated from human head neck squamous cell carcinoma (HNSCC). Results: Fresh specimens of HNSCC showed higher proportions of CD90+ cells compared with normal tissue; these cells co-expressed CD29, CD105, and CD73, but not CD31, CD45, CD133, and human epithelial antigen similarly to bone marrow-derived MSCs (BM-MSCs). Adherent stromal cells isolated from tumour shared also differentiation potential with BM-MSCs, thus we named them as tumour-MSCs. Interestingly, tumour-MSCs showed a clear immunosuppressive activity on in vitro stimulated T lymphocytes, mainly mediated by indoelamine 2,3 dioxygenase activity, like BM-MSCs. To evaluate their possible role in tumour growth in vivo, we correlated tumour-MSC proportions with neoplasm size. Tumour-MSCs frequency directly correlated with tumour volume and inversely with the frequency of tumour-infiltrating leukocytes. Conclusions: These data support the concept that tumour-MSCs may favour tumour growth not only through their effect on stromal development, but also by inhibiting the anti-tumour immune response. PMID:25647013

  12. In Vivo Correlation of Glucose Metabolism, Cell Density and Microcirculatory Parameters in Patients with Head and Neck Cancer: Initial Results Using Simultaneous PET/MRI

    PubMed Central

    Kubiessa, Klaus; Boehm, Andreas; Barthel, Henryk; Kluge, Regine; Kahn, Thomas; Sabri, Osama; Stumpp, Patrick

    2015-01-01

    Objective To demonstrate the feasibility of simultaneous acquisition of 18F-FDG-PET, diffusion-weighted imaging (DWI) and T1-weighted dynamic contrast-enhanced MRI (T1w-DCE) in an integrated simultaneous PET/MRI in patients with head and neck squamous cell cancer (HNSCC) and to investigate possible correlations between these parameters. Methods 17 patients that had given informed consent (15 male, 2 female) with biopsy-proven HNSCC underwent simultaneous 18F-FDG-PET/MRI including DWI and T1w-DCE. SUVmax, SUVmean, ADCmean, ADCmin and Ktrans, kep and ve were measured for each tumour and correlated using Spearman’s ρ. Results Significant correlations were observed between SUVmean and Ktrans (ρ = 0.43; p ≤ 0.05); SUVmean and kep (ρ = 0.44; p ≤ 0.05); Ktrans and kep (ρ = 0.53; p ≤ 0.05); and between kep and ve (ρ = -0.74; p ≤ 0.01). There was a trend towards statistical significance when correlating SUVmax and ADCmin (ρ = -0.35; p = 0.08); SUVmax and Ktrans (ρ = 0.37; p = 0.07); SUVmax and kep (ρ = 0.39; p = 0.06); and ADCmean and ve (ρ = 0.4; p = 0.06). Conclusion Simultaneous 18F-FDG-PET/MRI including DWI and T1w-DCE in patients with HNSCC is feasible and allows depiction of complex interactions between glucose metabolism, microcirculatory parameters and cellular density. PMID:26270054

  13. Nuclear NF-κB Expression Correlates With Outcome Among Patients With Head and Neck Squamous Cell Carcinoma Treated With Primary Chemoradiation Therapy

    SciTech Connect

    Balermpas, Panagiotis; Michel, Yvonne; Wagenblast, Jens; Seitz, Oliver; Sipek, Florian; Rödel, Franz; Rödel, Claus; Fokas, Emmanouil

    2013-07-15

    Background: To examine whether nuclear NF-κB expression correlates with outcome in patients with head and neck squamous cell carcinoma (HNSCC) treated with primary chemoradiation therapy (CRT). Methods and Materials: Between 2007 and 2010, 101 patients with locally advanced primary HNSCC were treated with definitive simultaneous CRT. Pretreatment biopsy specimens were analyzed for NF-κB p65 (RelA) nuclear immunoreactivity. A sample was assigned to be positive with more than 5% positive nuclear expression. The predictive relevance of NF-κB and clinicopathologic factors for overall survival (OS), progression-free survival (PFS), local progression-free survival (LPFS), and metastasis-free survival (DMFS) was examined by univariate and multivariate analysis. Results: No significant differences between the groups were observed with regard to age, sex, total radiation dose, fractionation mode, total chemotherapy applied, T stage or grading. Patients with p65 nuclear positive biopsy specimens showed significantly a higher rate of lymph node metastasis (cN2c or cN3 status, P=.034). Within a mean follow-up time of 25 months (range, 2.33-62.96 months) OS, PFS, and DMFS were significantly poorer in the p65 nuclear positive group (P=.008, P=.027, and P=.008, respectively). These correlations remained significant in multivariate analysis. Conclusion: NF-κB/p65 nuclear expression is associated with increased lymphatic and hematogenous tumor dissemination and decreased survival in HNSCC patients treated with primary CRT. Our results may foster further investigation of a predictive relevance of NF-κB/p65 and its role as a suitable target for a molecular-based targeted therapy in HNSCC cancer.

  14. Neck pain

    PubMed Central

    2008-01-01

    Introduction Non-specific neck pain has a postural or mechanical basis and affects about two thirds of people at some stage, especially in middle age. Acute neck pain resolves within days or weeks, but may become chronic in about 10% of people. Whiplash injuries follow sudden acceleration–deceleration of the neck, such as in road traffic or sporting accidents. Up to 40% of people continue to report symptoms 15 years after the accident, although this varies between countries. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for people with non-specific neck pain without severe neurological deficit? What are the effects of treatments for acute whiplash injury? What are the effects of treatments for chronic whiplash injury? What are the effects of treatments for neck pain with radiculopathy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 91 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of the evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, biofeedback, drug treatments (analgesics, antidepressants, epidural steroid injections, muscle relaxants, non-steroidal anti-inflammatory drugs [NSAIDs]), early mobilisation, early return to normal activity, exercise, heat or cold, manipulation (alone or plus exercise), mobilisation, multimodal treatment, patient education, percutaneous radiofrequency neurotomy, physical treatments, postural techniques (yoga, pilates, Alexander technique), pulsed electromagnetic field (PEMF) treatment, soft collars and special pillows, spray and stretch, surgery, traction, and transcutaneous electrical nerve stimulation (TENS). PMID:19445809

  15. Correlating planned radiation dose to the cochlea with primary site and tumor stage in patients with head and neck cancer treated with intensity-modulated radiation therapy

    SciTech Connect

    Zhang, Jeanette; Qureshi, Muhammad M.; Kovalchuk, Nataliya; Truong, Minh Tam

    2014-04-01

    The aim of the study was to determine tumor characteristics that predict higher planned radiation (RT) dose to the cochlea in patients with head and neck cancer (HNC) treated with intensity-modulated radiotherapy (IMRT). From 2004 to 2012, 99 patients with HNC underwent definitive IMRT to a median dose of 69.96 Gy in 33 fractions, with the right and left cochlea-vestibular apparatus contoured for IMRT optimization as avoidance structures. If disease involvement was adjacent to the cochlea, preference was given to tumor coverage by prescription dose. Descriptive statistics were calculated for dose-volume histogram planning data, and mean planning dose to the cochlea (from left or right cochlea, receiving the greater amount of RT dose) was correlated to primary site and tumor stage. Mean (standard deviation) cochlear volume was 1.0 (0.60) cm{sup 3} with maximum and mean planned doses of 31.9 (17.5) Gy and 22.1 (13.7) Gy, respectively. Mean planned dose (Gy) to cochlea by tumor site was as follows: oral cavity (18.6, 14.4), oropharynx (21.7, 9.1), nasopharynx (36.3, 10.4), hypopharynx (14.9, 7.1), larynx (2.1, 0.62), others including the parotid gland, temporal bone, and paranasal sinus (33.6, 24.0), and unknown primary (25.6, 6.7). Average mean planned dose (Gy) to the cochlea in T0-T2 and T3-T4 disease was 22.0 and 29.2 Gy, respectively (p = 0.019). By site, a significant difference was noted for nasopharynx and others (31.6 and 50.7, p = 0.012) but not for oropharynx, oral cavity, and hypopharynx. Advanced T category predicted for higher mean cochlear dose, particularly for nasopharyngeal, parotid gland, temporal bone, and paranasal sinus HNC sites.

  16. Pretreatment Apparent Diffusion Coefficient of the Primary Lesion Correlates With Local Failure in Head-and-Neck Cancer Treated With Chemoradiotherapy or Radiotherapy

    SciTech Connect

    Hatakenaka, Masamitsu; Nakamura, Katsumasa; Yabuuchi, Hidetake; Shioyama, Yoshiyuki; Matsuo, Yoshio; Ohnishi, Kayoko; Sunami, Shunya; Kamitani, Takeshi; Setoguchi, Taro; Yoshiura, Takashi; Nakashima, Torahiko; Nishikawa, Kei; Honda, Hiroshi

    2011-10-01

    Purpose: This study was performed to evaluate whether the apparent diffusion coefficient (ADC) of a primary lesion correlates with local failure in primary head-and-neck squamous cell carcinoma (HNSCC) treated with chemoradiotherapy or radiotherapy. Methods and Materials: We retrospectively studied 38 patients with primary HNSCC (12 oropharynx, 20 hypopharynx, 4 larynx, 2 oral cavity) treated with chemoradiotherapy or radiotherapy with radiation dose to gross tumor volume equal to or over 60 Gy and who underwent pretreatment magnetic resonance imaging, including diffusion-weighted imaging. Ten patients developed local failure during follow-up periods of 2.0 to 9.3 months, and the remaining 28 showed local control during follow-up periods of 10.5 to 31.7 months. The variables that could affect local failure (age, tumor volume, ADC, T stage, N stage, dose, treatment method, tumor location, and overall treatment time) were analyzed using logistic regression analyses for all 38 patients and for 17 patients with Stage T3 or T4 disease. Results: In univariate logistic analysis for all 38 cases, tumor volume, ADC, T stage, and treatment method showed significant (p < 0.05) associations with local failure. In multivariate analysis, ADC and T stage revealed significance (p < 0.01). In univariate logistic analysis for the 17 patients with Stage T3 or T4 disease, ADC and dose showed significant (p < 0.01) associations with local failure. In multivariate analysis, ADC alone showed significance (p < 0.05). Conclusions: The results suggest that pretreatment ADC, along with T stage, is a potential indicator of local failure in HNSCC treated with chemoradiotherapy or radiotherapy.

  17. Correlated responses to long-term selection for clutch length in dwarf brown-egg layers carrying or not carrying the naked neck gene.

    PubMed

    Chen, C F; Tixier-Boichard, M

    2003-05-01

    Two dwarf brown-egg layer lines, differing in their genotype for the naked neck gene (NA), line L2 (NA*NA/*NA) and line L1 (NA*N/*N), have been selected for 16 generations for increased average clutch length. A control line from the same base population, dwarf and segregating for the NA gene, was maintained by random mating. Genetic parameters were estimated by a multivariate derivative-free restricted maximum likelihood procedure, and the NA gene effect was estimated within the unselected control line. The studied traits included clutch traits, egg production traits, abnormal eggs, egg weight at 36 wk, and BW at 42 wk. The average clutch length, egg number, and maximum clutch length were normalized using the Box-Cox transformation. In response to 16 generations of direct selection for increased average clutch length, other egg production traits, such as laying rate and total egg number, have been indirectly improved in a dwarf layer genetic background. The estimated heritabilities were 0.406 to 0.424 for transformed average clutch length (TCL), 0.373 to 0.411 for transformed egg number (TEN), 0.529 to 0.559 for age at first egg (AFE), 0.275 to 0.282 for laying rate (LR), 0.455 for dutch number (CN), and 0.319 for the number of double-yolked eggs (DYEN). The TCL had high genetic correlations with TEN (0.777), LR (0.863), maximum clutch length (0.902), and CN (-0.845). Selection for increased average clutch length was an effective method for increasing egg production. Line L2 showed a higher egg weight than L1, which indicates that the combined effect of NA and DW genes was favorable to maintain egg weight when egg number could be improved. Line L1 showed a higher number of DYEN, suggesting that the regulation of follicular maturation was changed in this line. PMID:12762391

  18. Neck Injuries and Disorders

    MedlinePlus

    ... another common cause of neck pain. Whiplash, a soft tissue injury to the neck, is also called neck sprain or strain. Treatment depends on the cause, but may include applying ice, taking pain relievers, getting physical therapy or wearing ...

  19. Structural Correlation of the Neck Coil with the Coiled-coil (CC1)-Forkhead-associated (FHA) Tandem for Active Kinesin-3 KIF13A.

    PubMed

    Ren, Jinqi; Huo, Lin; Wang, Wenjuan; Zhang, Yong; Li, Wei; Lou, Jizhong; Xu, Tao; Feng, Wei

    2016-02-12

    Processive kinesin motors often contain a coiled-coil neck that controls the directionality and processivity. However, the neck coil (NC) of kinesin-3 is too short to form a stable coiled-coil dimer. Here, we found that the coiled-coil (CC1)-forkhead-associated (FHA) tandem (that is connected to NC by Pro-390) of kinesin-3 KIF13A assembles as an extended dimer. With the removal of Pro-390, the NC-CC1 tandem of KIF13A unexpectedly forms a continuous coiled-coil dimer that can be well aligned into the CC1-FHA dimer. The reverse introduction of Pro-390 breaks the NC-CC1 coiled-coil dimer but provides the intrinsic flexibility to couple NC with the CC1-FHA tandem. Mutations of either NC, CC1, or the FHA domain all significantly impaired the motor activity. Thus, the three elements within the NC-CC1-FHA tandem of KIF13A are structurally interrelated to form a stable dimer for activating the motor. This work also provides the first direct structural evidence to support the formation of a coiled-coil neck by the short characteristic neck domain of kinesin-3. PMID:26680000

  20. Neck curve polynomials in neck rupture model

    SciTech Connect

    Kurniadi, Rizal; Perkasa, Yudha S.; Waris, Abdul

    2012-06-06

    The Neck Rupture Model is a model that explains the scission process which has smallest radius in liquid drop at certain position. Old fashion of rupture position is determined randomly so that has been called as Random Neck Rupture Model (RNRM). The neck curve polynomials have been employed in the Neck Rupture Model for calculation the fission yield of neutron induced fission reaction of {sup 280}X{sub 90} with changing of order of polynomials as well as temperature. The neck curve polynomials approximation shows the important effects in shaping of fission yield curve.

  1. Neck Circumference and Cardio- Metabolic Syndrome

    PubMed Central

    Kumar, Nagendran Vijaya; Ismail, Mohammed H.; M, Girish; Tripathy, Monica

    2014-01-01

    Background: Only few studies about neck circumference (NC) as a measure of cardio metabolic syndrome available from India. Study was conducted to establish an association between neck circumference and cardio metabolic syndrome. Material and Methods: Cross-sectional study was conducted in a tertiary care hospital in South India. NCEP: ATPIII 2001 guideline was used for diagnosis of Cardio-metabolic syndrome among subjects. Neck circumference was measured and it was correlated with Cardio-metabolic syndrome. Results: Mean neck circumference was found to be 36.5 cms. Cardio-metabolic syndrome was present in 272 participants, of which 100 were females and 172 males. Among females 82(82%) had neck circumference >34cms, 18(18%) had <34cms and among males 117(68%)had NC >37cms and 55(32%) had NC<37cms. All individual parameter of cardio metabolic risk factor, i.e., BMI, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, FBS, HDL & TG except waist/hip ratio were correlating with abnormal neck circumference when compared with those with normal neck circumference. Conclusion: Neck circumference with metabolic syndrome correlated better among females than males. Men with NC >37 cm and women with NC >34 cm are more prone for cardio metabolic syndrome and require additional evaluation. Measurement of NC is a simple, time saving, and least invasive measurement tool. PMID:25177592

  2. Perfusion Estimated With Rapid Dynamic Contrast-Enhanced Magnetic Resonance Imaging Correlates Inversely With Vascular Endothelial Growth Factor Expression and Pimonidazole Staining in Head-and-Neck Cancer: A Pilot Study

    SciTech Connect

    Donaldson, Stephanie B.; Betts, Guy; Bonington, Suzanne C.; Homer, Jarrod J.; Slevin, Nick J.; Kershaw, Lucy E.; Valentine, Helen; West, Catharine M.L.; Buckley, David L.

    2011-11-15

    Purpose: To analyze, in a pilot study, rapidly acquired dynamic contrast-enhanced (DCE)-MRI data with a general two-compartment exchange tracer kinetic model and correlate parameters obtained with measurements of hypoxia and vascular endothelial growth factor (VEGF) expression in patients with squamous cell carcinoma of the head and neck. Methods and Materials: Eight patients were scanned before surgery. The DCE-MRI data were acquired with 1.5-s temporal resolution and analyzed using the two-compartment exchange tracer kinetic model to obtain estimates of parameters including perfusion and permeability surface area. Twelve to 16 h before surgery, patients received an intravenous injection of pimonidazole. Samples taken during surgery were used to determine the level of pimonidazole staining using immunohistochemistry and VEGF expression using quantitative real-time polymerase chain reaction. Correlations between the biological and imaging data were examined. Results: Of the seven tumors fully analyzed, those that were poorly perfused tended to have high levels of pimonidazole staining (r = -0.79, p = 0.03) and VEGF expression (r = -0.82, p = 0.02). Tumors with low permeability surface area also tended to have high levels of hypoxia (r = -0.75, p = 0.05). Hypoxic tumors also expressed higher levels of VEGF (r = 0.82, p = 0.02). Conclusions: Estimates of perfusion obtained with rapid DCE-MRI data in patients with head-and-neck cancer correlate inversely with pimonidazole staining and VEGF expression.

  3. Immunohistochemical detection of osteopontin in advanced head-and-neck cancer: Prognostic role and correlation with oxygen electrode measurements, hypoxia-inducible-factor-1{alpha}-related markers, and hemoglobin levels

    SciTech Connect

    Bache, Matthias; Reddemann, Rolf; Said, Harun M.; Holzhausen, Hans-Juergen; Taubert, Helge; Becker, Axel; Kuhnt, Thomas; Haensgen, Gabriele; Dunst, Juergen; Vordermark, Dirk . E-mail: vordermark_d@klinik.uni-wuerzburg.de

    2006-12-01

    Purpose: The tumor-associated glycoprotein osteopontin (OPN) is discussed as a plasma marker of tumor hypoxia. However, the association of immunohistochemical OPN expression in tumor sections with tumor oxygenation parameters (HF5, median pO{sub 2}), the hypoxia-related markers hypoxia-inducible factor-1{alpha} (HIF-1{alpha}) and carbonic anhydrase IX (CAIX), or hemoglobin and systemic vascular endothelial growth factor (VEGF) levels has not been investigated. Methods and Materials: Tumor tissue sections of 34 patients with advanced head-and-neck cancer treated with radiotherapy were assessed by immunochemistry for the expression of OPN, HIF-1{alpha}, and CA IX. Relationship of OPN expression with tumor oxygenation parameters (HF5, median pO{sub 2}), HIF-1{alpha} and CA IX expression, hemoglobin and serum VEGF level, and clinical parameters was studied. Results: Bivariate analysis showed a significant correlation of positive OPN staining with low hemoglobin level (p = 0.02), high HIF-1{alpha} expression (p = 0.02), and high serum vascular endothelial growth factor level (p = 0.02) for advanced head-and-neck cancer. Furthermore, considering the 31 Stage IV patients, the median pO{sub 2} correlated significantly with the OPN expression (p = 0.02). OPN expression alone had only a small impact on prognosis. However, in a univariate Cox proportional hazard regression model, the expression of either OPN or HIF-1{alpha} or CA IX was associated with a 4.1-fold increased risk of death (p = 0.02) compared with negativity of all three markers. Conclusion: Osteopontin expression detected immunohistochemically is associated with oxygenation parameters in advanced head-and-neck cancer. When the results of OPN, HIF-1{alpha}, and CA IX immunohistochemistry are combined into a hypoxic profile, a strong and statistically significant impact on overall survival is found.

  4. Enhanced Response of Human Head and Neck Cancer Xenograft Tumors to Cisplatin Combined With 2-Deoxy-D-Glucose Correlates With Increased {sup 18}F-FDG Uptake as Determined by PET Imaging

    SciTech Connect

    Simons, Andrean L.; Fath, Melissa A.; Mattson, David M.; Smith, Brian J.; Walsh, Susan A.; Graham, Michael M.; Hichwa, Richard D.; Buatti, John M.; Dornfeld, Ken; Spitz, Douglas R.

    2007-11-15

    Purpose: To determine whether the response of human head and neck cancer xenografts to cisplatin (CIS) could be enhanced with 2-deoxy-D-glucose (2DG); whether 2-[{sup 18}F]-fluoro-2-deoxy-D-glucose (FDG) uptake correlated with responses to this drug combination; and whether 2DG would enhance CIS-induced radiosensitization. Methods and Materials: Clonogenic survival responses to CIS + 2DG were determined in FaDu and Cal-27 cells and reduced/oxidized glutathione levels were monitored as parameters indicative of oxidative stress. The efficacy of CIS + 2DG was determined in FaDu and Cal-27 xenografts, and FDG uptake was determined by using positron emission tomography. Results: Use of CIS + 2DG enhanced cell killing of FaDu and Cal-27 cells compared with either drug alone while increasing the percentage of oxidized glutathione in vitro. Use of CIS + 2DG inhibited FaDu and Cal-27 tumor growth and increased disease-free survival compared with either drug alone. The Cal-27 tumors showed greater pretreatment FDG uptake and increased disease-free survival when treated with 2DG + CIS relative to FaDu tumors. Treatment with 2DG enhanced CIS-induced radiosensitization in FaDu tumor cells grown in vitro and in vivo and resulted in apparent cures in 50% of tumors. Conclusions: These results show the enhanced therapeutic efficacy of CIS + 2DG in human head and neck cancer cells in vitro and in vivo compared with either drug alone, as well as the potential for FDG uptake to predict tumor sensitivity to 2DG + CIS. These findings provide a strong rationale for evaluating 2DG + CIS in combined-modality head and neck cancer therapy with radiation in a clinical setting.

  5. Head, Neck, and Oral Cancer

    MedlinePlus

    ... find out more. Head, Neck and Oral Pathology Head, Neck and Oral Pathology Close to 42,000 Americans ... find out more. Head, Neck and Oral Pathology Head, Neck and Oral Pathology Close to 42,000 Americans ...

  6. Head and Neck Cancer

    MedlinePlus

    Head and neck cancer includes cancers of the mouth, nose, sinuses, salivary glands, throat, and lymph nodes in the ... increases your risk. In fact, 85 percent of head and neck cancers are linked to tobacco use, including smoking ...

  7. [Deep neck infections].

    PubMed

    Nowak, Katarzyna; Szyfter, Witold

    2006-01-01

    Deep neck infection is relatively rare but potentially life threatening complication of common oropharyngeal infections. This retrospective study was aimed at analyzing the occurrence of complications, diagnostic methods and proper management of deep neck infection. A review was conducted in 32 cases who were diagnosed as having deep neck infection from 1995 to 2005. The causes of deep neck infections were tonsillitis (16 cases), tooth diseases (6 cases), paratonsillar abscess (4 cases), parotitis (1 case), pussy lymphonodes after tonsillectomy (2 cases), pussy congenital neck cyst (1 case), chronic otitis media (1 case), parotitis (1 case), foreign body of the esophagus (1 case). All the puss bacterial cultivation were positive. All the patients were treated by different ways of chirurgical drainage and use of large dosage of antibiotics. Deep neck infection should be suspected in patients with long lasting fever and painful swelling of the neck and treatment should begin quick as possible. PMID:17152800

  8. Correlational Analysis of neck/shoulder Pain and Low Back Pain with the Use of Digital Products, Physical Activity and Psychological Status among Adolescents in Shanghai

    PubMed Central

    Li, Jipeng; Li, Yangyang; Zhang, Yongxing; Zhao, Qinghua

    2013-01-01

    Purpose This study investigates the neck/shoulder pain (NSP) and low back pain (LBP) among current high school students in Shanghai and explores the relationship between these pains and their possible influences, including digital products, physical activity, and psychological status. Methods An anonymous self-assessment was administered to 3,600 students across 30 high schools in Shanghai. This questionnaire examined the prevalence of NSP and LBP and the level of physical activity as well as the use of mobile phones, personal computers (PC) and tablet computers (Tablet). The CES-D (Center for Epidemiological Studies Depression) scale was also included in the survey. The survey data were analyzed using the chi-square test, univariate logistic analyses and a multivariate logistic regression model. Results Three thousand sixteen valid questionnaires were received including 1,460 (48.41%) from male respondents and 1,556 (51.59%) from female respondents. The high school students in this study showed NSP and LBP rates of 40.8% and 33.1%, respectively, and the prevalence of both influenced by the student’s grade, use of digital products, and mental status; these factors affected the rates of NSP and LBP to varying degrees. The multivariate logistic regression analysis revealed that Gender, grade, soreness after exercise, PC using habits, tablet use, sitting time after school and academic stress entered the final model of NSP, while the final model of LBP consisted of gender, grade, soreness after exercise, PC using habits, mobile phone use, sitting time after school, academic stress and CES-D score. Conclusions High school students in Shanghai showed high prevalence of NSP and LBP that were closely related to multiple factors. Appropriate interventions should be implemented to reduce the occurrences of NSP and LBP. PMID:24147114

  9. How the neck affects the back: changes in regional cervical sagittal alignment correlate to HRQOL improvement in adult thoracolumbar deformity patients at 2-year follow-up.

    PubMed

    Protopsaltis, Themistocles S; Scheer, Justin K; Terran, Jamie S; Smith, Justin S; Hamilton, D Kojo; Kim, Han Jo; Mundis, Greg M; Hart, Robert A; McCarthy, Ian M; Klineberg, Eric; Lafage, Virginie; Bess, Shay; Schwab, Frank; Shaffrey, Christopher I; Ames, Christopher P

    2015-08-01

    OBJECT Regional cervical sagittal alignment (C2-7 sagittal vertical axis [SVA]) has been shown to correlate with health-related quality of life (HRQOL). The study objective was to examine the relationship between cervical and thoracolumbar alignment parameters with HRQOL among patients with operative and nonoperative adult thoracolumbar deformity. METHODS This is a multicenter prospective data collection of consecutive patients with adult thoracolumbar spinal deformity. Clinical measures of disability included the Oswestry Disability Index (ODI), Scoliosis Research Society-22 Patient Questionnaire (SRS-22), and 36-Item Short-Form Health Survey (SF-36). Cervical radiographic parameters were correlated with global sagittal parameters within the nonoperative and operative cohorts. A partial correlation analysis was performed controlling for C-7 SVA. The operative group was subanalyzed by the magnitude of global deformity (C-7 SVA ≥ 5 cm vs < 5 cm). RESULTS A total of 318 patients were included (186 operative and 132 nonoperative). The mean age was 55.4 ± 14.9 years. Operative patients had significantly worse baseline HRQOL and significantly larger C-7 SVA, pelvic tilt (PT), mismatch between pelvic incidence and lumbar lordosis (PI-LL), and C2-7 SVA. The operative patients with baseline C-7 SVA ≥ 5 cm had significantly larger C2-7 lordosis (CL), C2-7 SVA, C-7 SVA, PI-LL, and PT than patients with a normal C-7 SVA. For all patients, baseline C2-7 SVA and CL significantly correlated with baseline ODI, Physical Component Summary (PCS), SRS Activity domain, and SRS Appearance domain. Baseline C2-7 SVA also correlated with SRS Pain and SRS Total. For the operative patients with baseline C-7 SVA ≥ 5 cm, the 2-year C2-7 SVA significantly correlated with 2-year Mental Component Summary, SRS Mental, SRS Satisfaction, and decreases in ODI. Decreases in C2-7 SVA at 2 years significantly correlated with lower ODI at 2 years. Using partial correlations while controlling for C-7 SVA, the C2-7 SVA correlated significantly with baseline ODI (r = 0.211, p = 0.002), PCS (r = -0.178, p = 0.009), and SRS Activity (r = -0.145, p = 0.034) for the entire cohort. In the subset of operative patients with larger thoracolumbar deformities, the change in C2-7 SVA correlated with change in ODI (r = -0.311, p = 0.03). CONCLUSIONS Changes in cervical lordosis correlate to HRQOL improvements in thoracolumbar deformity patients at 2-year follow-up. Regional cervical sagittal parameters such as CL and C2-7 SVA are correlated with clinical measures of regional disability and health status in patients with adult thoracolumbar scoliosis. This effect may be direct or a reciprocal effect of the underlying global deformities on regional cervical alignment. However, the partial correlation analysis, controlling for the magnitude of the thoracolumbar deformity, suggests that there is a direct effect of cervical alignment on health measures. Improvements in regional cervical alignment postoperatively correlated positively with improved HRQOL. PMID:25978077

  10. Neck skin rejuvenation.

    PubMed

    Duplechain, J Kevin

    2014-05-01

    The author of this article uses the pulsed ablative CO2 laser for resurfacing of the neck and face, based on the gold standard status of the CO2 laser and a novel post-treatment plan that greatly reduces adverse effects traditionally associated with fully ablative resurfacing. The croton oil peel is an inexpensive and effective modality for rejuvenating neck skin. The use of either technique as an adjunct to neck lift surgery, with or without facelift surgery, permits surgeons to fulfill the expectations of patients who want the skin of their face and neck to be homogeneous and more attractive. PMID:24745383

  11. Head and Neck Cancer Treatment

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z Head and Neck Cancer Treatment Head and neck cancer overview What ... there any new developments in treating my disease? Head and neck cancer overview The way a particular head and ...

  12. American Head and Neck Society

    MedlinePlus

    American Head & Neck Society Head and Neck Cancer Research & Education About AHNS History AHNS Leadership Past Presidents In Memory Professionalism & Ethics Find A Specialist Humanitarian Efforts AHNS ...

  13. Analysis for Neck Propagation of Plastic Molded Materials (3)

    NASA Astrophysics Data System (ADS)

    Fujikawa, Masaki; Kobayashi, Takaya; Furuichi, Kenji; Kodama, Katsuhiro; Ito, Katsuya; Nonomura, Chisato

    It is very important to estimate the neck formation and neck propagation behavior of plastic molded materials in the field of polymer processing. In a previous paper, to evaluate the results on the neck formation and neck propagation behavior for polybutylene terephthalate (PBT) molding in uniaxial tensile test, a numerical model based on the Finite Element Method (FEM) was developed. However, there are some difficulties in determining material properties. In order to overcome them, the authors developed the determination technique for the material properties from not only load-displacement behavior but also the strain distribution around the necked region analyzed by Digital Image Correlation (DIC). Then, it was confirmed that the numerical results under the calculated elasto-plastic constitutive law show good agreement with both experimental load-displacement behavior and strain distribution around the necked region.

  14. Neck dissections: radical to conservative

    PubMed Central

    Harish, K

    2005-01-01

    Background Neck dissection is an important surgical procedure for the management of metastatic nodal disease in the neck. The gold standard of neck nodal management has been the radical neck dissection. Any modification in the neck dissection is always compared with this standard. Over the last few decades, in order to alleviate the morbidity of radical neck dissection, several modifications and conservative procedures have been advocated. These procedures retain certain lymphatic or non-lymphatic structures and have been shown not to compromise oncological safety. Methods A literature search of the Medline was carried out for all articles on neck dissections. The articles were systematically reviewed to analyze and trace the evolution of neck dissection. These were then categorized to address the nomenclature, management of node positive and node negative neck including those who had received chemoradiation. Results The present article discusses the neck nodal nomenclature, the radical neck dissection, its modifications and migration to more conservative procedures and possible advances in the near future. Conclusion Radical neck dissection is now replaced with modified radical neck dissections in most situations. Attempts are being made to replace modified radical neck dissections with selective neck dissections for early node positivity. Sentinel node biopsy is being studied to address the issue of node negative neck. More conservative surgeries are likely to replace the 'radical' surgeries of bygone era. This process is facilitated by earlier detection of the disease and better understanding of cancer biology. PMID:15836786

  15. Association between neck muscle coactivation, pain, and strength in women with neck pain.

    PubMed

    Lindstrøm, Rene; Schomacher, Jochen; Farina, Dario; Rechter, Lotte; Falla, Deborah

    2011-02-01

    This study investigates the relationship between neck muscle coactivation, neck strength and perceived pain and disability in women with neck pain. Surface electromyography (EMG) was acquired from the sternocleidomastoid (SCM) and splenius capitis (SC) muscles of 13 women with chronic neck pain and 10 controls as they performed 1) maximal voluntary contractions (MVC) in flexion, extension and left and right lateral flexion, 2) ramped contractions from 0% to 50% MVC in flexion and extension and 3) circular contractions in the horizontal plane at 15N and 30N force. Higher values of EMG amplitude were observed for the SC (antagonist) during ramped neck flexion and for the SCM during ramped extension in the patient group (P<0.05). The patients displayed reduced values of directional specificity in the surface EMG of the SCM and SC for the circular contractions (P<0.05). The EMG amplitude of SC during cervical flexion was positively correlated with the patients' pain (R² =0.35, P<0.05) and perceived disability (R² 0.53, P<0.01). An inverse correlation was evident between the amount of activation of SC during cervical flexion and strength (R² =0.54, P<0.01). These observations indicate a relationship between alterations in neuromuscular control in patients with neck pain and functional consequences, including impaired motor performance and increased levels of perceived disability. PMID:20696610

  16. Talar neck fractures.

    PubMed

    Berlet, G C; Lee, T H; Massa, E G

    2001-01-01

    Clinical management of talar neck fractures is complex and fraught with complications. As Gaius Julius Caesar stated: "The die is cast"; often the outcome of a talar neck fracture is determined at the time of injury. The authors believe, however, that better results can be achieved by following some simple guidelines. The authors advocate prompt and precise anatomic surgical reduction, preferring the medial approach with secondary anterolateral approach. Preservation of blood supply can be achieved by a thorough understanding of vascular pathways and efforts to stay within appropriate surgical intervals. The authors advocate bone grafting of medial neck comminution (if present) to prevent varus malalignment and rigid internal fixation to allow for joint mobilization postoperatively. These guidelines may seem simple, but when dealing with the complexity of talar neck fractures, the foot and ankle surgeon needs to focus and rely on easily grasped concepts to reduce poor outcomes. PMID:11465133

  17. Neck-Tongue Syndrome.

    PubMed

    Hu, Nancy; Dougherty, Carrie

    2016-03-01

    Neck-tongue syndrome (NTS) is a headache disorder often initiated by rapid axial rotation of the neck resulting in unilateral neck and/or occipital pain and transient ipsilateral tongue sensory disturbance. In this review, we examine reported cases of NTS since its initial description in 1980 to highlight the significance of this condition in the differential diagnosis of headache in patients presenting with neck pain and altered tongue sensation. The anatomical basis of NTS centers on the C1-C2 facet joint, C2 ventral ramus, and inferior oblique muscle in the atlanto-axial space. NTS may be categorized as complicated (secondary to another disease process) or uncomplicated (hereditary, related to trauma, or idiopathic). Diagnosis is based on clinical suspicion after a thorough history and physical without a pathognomonic radiologic finding. It is typically treated conservatively with medications, local injections, immobilization with cervical collars, or physical therapy; rarely is surgical intervention pursued. PMID:26984539

  18. TCGA head Neck

    Cancer.gov

    Investigators with The Cancer Genome Atlas (TCGA) Research Network have discovered genomic differences – with potentially important clinical implications – in head and neck cancers caused by infection with the human papillomavirus (HPV).

  19. Melanoma - neck (image)

    MedlinePlus

    This melanoma on the neck is variously colored with a very darkly pigmented area found centrally. It has irregular ... be larger than 0.5 cm. Prognosis in melanoma is best defined by its depth on resection.

  20. J incision in neck dissections.

    PubMed

    Acar, A; Dursun, G; Aydin, O; Akbaş, Y

    1998-01-01

    Metastasis in the neck lymph system of primary tumours of the head and neck is frequently seen. In order to prevent this metastasis, neck dissection is carried out by various types of skin incisions. In this study, types of skin incision used in neck dissections were defined, and the advantages, disadvantages and results of J incisions, which have been performed on 320 radical neck dissection patients in our clinic between 1985-1996, were compared with those of other incision types. PMID:9538447

  1. Clinical impact of radiographic carotid artery involvement in neck metastases from head and neck cancer.

    PubMed

    Teymoortash, A; Rassow, S; Bohne, F; Wilhelm, T; Hoch, S

    2016-04-01

    The treatment of lymph node metastases involving the carotid artery is controversial. The aim of the present study was to determine the outcomes of head and neck cancer patients with radiographic carotid artery involvement in neck metastases. A total of 27 patients with head and neck cancer and radiologically diagnosed advanced metastases involving the common carotid artery or internal carotid artery were enrolled. All patients underwent a primary or salvage neck dissection and surgical carotid peeling. The oncological outcome and survival of all patients were analyzed. Loco-regional control was observed in 13 of the 27 patients (48.1%). During follow-up, five patients (18.5%) developed second primaries and 11 (40.7%) developed distant metastases. The survival time was poor independent of regional control. The median overall survival was 1.55 years and disease-free survival was 0.71 year. Radiographic carotid artery involvement in neck metastases in head and neck cancer appears to correlate with a poor long-term prognosis, with a high rate of distant metastases despite loco-regional control. PMID:26723499

  2. Crile's neck dissection.

    PubMed

    Silver, Carl E; Rinaldo, Alessandra; Ferlito, Alfio

    2007-11-01

    George Crile, after a long experience with treatment of head and neck cancer and study of a large number of cases, appreciated that these tumors almost always drained through the lymphatic pathways of the neck, rarely metastasized distantly, and were thus theoretically curable by resection of the primary tumor and its lymphatic draining shed. After evaluation of his early failures, he found that a block resection of all of the lymph node-bearing tissue of the neck in addition to resection of the primary tumor was the most effective means of obtaining a cure, particularly in patients with clinical evidence of spread of disease to the neck. Such radical surgery, at the time, was fraught with difficulty because of the lack of blood transfusion, antibiotics, and endotracheal anesthesia, but Crile devised several strategies for combating these obstacles. Crile performed 36 such block resections with a determinate 3-year survival of 75% compared with 19% 3-year survival in patients who had not undergone block resection. The surgical precepts developed by Crile laid the foundation for the effective modern surgical treatment of head and neck cancer. PMID:17828045

  3. US-guided Biopsy of Neck Lesions: The Head and Neck Neuroradiologist's Perspective.

    PubMed

    Learned, Kim O; Lev-Toaff, Anna S; Brake, Bonnie J; Wu, Roseann I; Langer, Jill E; Loevner, Laurie A

    2016-01-01

    Ultrasonographically (US) guided percutaneous biopsy of a neck lesion is a cost-effective, safe, and diagnostically effective procedure without radiation exposure. The benefit of real-time visualization of the needle location allows for instantaneous maneuvering of the needle trajectory for safe and accurate tissue sampling with short procedural time. Effective US-guided biopsy requires technical experience, strong clinical acumen, and skillful biopsy technique. A neuroradiologist's knowledge of head and neck anatomy and pathology allows correlation with cross-sectional imaging and enhances the understanding of US imaging evaluation. Familiarity with a spectrum of neck surgeries and reconstructions and expertise in imaging evaluation of the treated neck are invaluable in accurate identification of the target for biopsy in patients with treatment-related altered anatomy using US guidance. After thyroid nodules, the common adult neck masses are lymphadenopathy, head and neck cancer, salivary neoplasms, nerve sheath tumors, and inflammatory and infectious pseudomasses. Diagnostic expertise in the imaging characteristics of these individual pathologic conditions and their differential diagnoses also play an important role in choosing the biopsy technique and in procuring an adequate sample for diagnosis, including material for ancillary laboratory testing. Using an anatomic zone approach, this article illustrates the practical considerations in patient selection, the methodical analysis of preprocedure cross-sectional imaging and its correlation with real-time US evaluation, general principles for optimizing US instrumentation, and biopsy technique. In skillful hands, the versatility and portability of US make it the valuable modality for histologic sampling of superficial head and neck lesions. Online supplemental material is available for this article. (©)RSNA, 2016. PMID:26761538

  4. Bilateral neck paragangliomas.

    PubMed

    Mumoli, N; Cei, M; Pauletti, M; Ferrito, G; Scazzeri, F

    2009-10-01

    Paragangliomas of the head and neck are rare neoplasms presented as cervical mass, generally bilateral, that arise from chemoreceptors located at the carotid bifurcation (carotid body tumors), along the vagus nerve (vagal paragangliomas), and in the jugular fossa and tympanic cavity (jugulotympanic paragangliomas). They are typically asymptomatic at the beginning, highly vascular, slow-growing and compressing the surrounding anatomic structures. Only radical surgery is the curative treatment for paragangliomas. We present a case of a 62- year-old woman with a diagnosis of bilateral neck paragangliomas where surgical removal was judged burdened by excessive risk because of the size of the tumor. PMID:19622673

  5. The Relationship Between Neck Pain and Physical Activity

    PubMed Central

    Cheung, Janice; Kajaks, Tara; MacDermid, Joy C.

    2013-01-01

    Neck pain is a significant societal burden due to its high prevalence and healthcare costs. While physical activity can help to manage other forms of chronic musculoskeletal pain, little data exists on the relationship between physical activity and neck pain. The purpose of this study was to compare physical activity levels between individuals with neck pain and healthy controls, and then to relate disability, fear of movement, and pain sensitivity measures to physical activity levels in each of the two participant groups. 21 participants were recruited for each of the two participant groups (n = 42). Data collection included the use of the Neck Disability Index, the Tampa Scale for Kinesiophobia, electrocutaneous (Neurometer® CPT) and pressure stimulation (JTech algometer) for quantitative sensory testing, and 5 days of subjective (Rapid Assessment of Physical Activity) and objective (BioTrainer II) measurements of physical activity. Analysis of Variance and Pearson’s Correlation were used to determine if differences and relationships exist between dependent variables both within and between groups. The results show that individuals with mild neck pain and healthy controls do not differ in subjectively and objectively measured physical activity. While participants with neck pain reported higher neck disability and fear of movement, these factors did not significantly relate to physical activity levels. Perceived activity level was related to pain threshold and tolerance at local neck muscles sites (C2 paraspinal muscle and upper trapezius muscle), whereas measured activity was related to generalized pain sensitivity, as measured at the tibialis anterior muscle site. PMID:24133553

  6. Understanding selection for long necks in different taxa.

    PubMed

    Wilkinson, David M; Ruxton, Graeme D

    2012-08-01

    There has been recent discussion about the evolutionary pressures underlying the long necks of extant giraffes and extinct sauropod dinosaurs. Here we summarise these debates and place them in a wider taxonomic context. We consider the evolution of long necks across a wide range of (both living and extinct) taxa and ask whether there has been a common selective factor or whether each case has a separate explanation. We conclude that in most cases long necks can be explained in terms of foraging requirements, and that alternative explanations in terms of sexual selection, thermoregulation and predation pressure are not as well supported. Specifically, in giraffe, tortoises, and perhaps sauropods there is likely to have been selection for high browsing. It the last case there may also have been selection for reaching otherwise inaccessible aquatic plants or for increasing the energetic efficiency of low browsing. For camels, wading birds and ratites, original selection was likely for increased leg length, with correlated selection for a longer neck to allow feeding and drinking at or near substrate level. For fish-eating long-necked birds and plesiosaurs a small head at the end of a long neck allows fast acceleration of the mouth to allow capture of elusive prey. A swan's long neck allows access to benthic vegetation, for vultures the long neck allows reaching deep into a carcass. Geese may be an unusual case where anti-predator vigilance is important, but so may be energetically efficient low browsing. The one group for which we feel unable to draw firm conclusions are the pterosaurs, this is in keeping with the current uncertainty about the biology of this group. Despite foraging emerging as a dominant theme in selection for long necks, for almost every taxonomic group we have identified useful empirical work that would increase understanding of the selective costs and benefits of a long neck. PMID:22171805

  7. Restraining and neck cutting or stunning and neck cutting of veal calves.

    PubMed

    Lambooij, E; van der Werf, J T N; Reimert, H G M; Hindle, V A

    2012-05-01

    Brain and heart activities were measured in 31 veal calves during restraining and rotating followed by neck cutting with or without stunning to evaluate welfare. After neck cutting correlation dimension analyses and %power of EEG beta wave fraction decreased gradually to lower values resulting in an induction of unconsciousness lasting on average 80s. Corneal reflex response ceased 135±57s after neck cutting. The CD scores and the %power of beta waves fell immediately after post-cut captive bolt and pre-cut electrical stunning to levels indicating unconsciousness. Heart rate in lairage increased upon entrance to the restrainer and again after rotation, heart rate variability decreased. Rotating the restrainer 90°, 120° or 180° compromised veal calf welfare and should be avoided. It is recommended to use post-cut captive bolt stunning or pre-cut electrical stunning inducing immediate unconsciousness. PMID:22209298

  8. Angiosarcoma of the Head and Neck

    PubMed Central

    Mullins, Brandon; Hackman, Trevor

    2015-01-01

    Introduction Angiosarcoma of the head and neck is a rare vascular sarcoma associated with high rates of local recurrence and distant metastasis and a poor prognosis. Objective We describe our experience treating patients with angiosarcoma of the head and neck to evaluate the outcomes, patterns of failure, and current treatments. Methods We identified six patients with angiosarcoma of the head and neck and treated at our institution between 2000 and 2013. We compared our results to the literature from 1979 to 2013. Results Mean follow-up was 42 months. Local recurrence rate was 50% with disease-specific survival and 2-year disease-free survival rates of 33.3 and 20%, respectively. Prognostic factors included tumor size > 5 cm and surgical margin status, with no correlation between histologic grade and survival. Combined-modality therapy was only used for aggressive tumors with positive surgical margins but is suggested to improve local control and overall survival. Conclusions Our data series supports that angiosarcoma of the head and neck has a high rate of recurrence and is associated with a poor prognosis, despite current combined-modality therapy. The study highlights the importance of attaining negative margins during surgical resection, the utility of adjuvant therapies, as well as the need for continued research in developing new management strategies. PMID:26157490

  9. Stereotactic Body Radiotherapy for Head and Neck Tumors

    ClinicalTrials.gov

    2016-04-18

    Squamous Cell Carcinoma of the Head and Neck; Nasopharyngeal Carcinoma; Salivary Gland Cancer; Head and Neck Sarcoma; Paraganglioma of Head and Neck; Chordoma of Head and Neck; Chondrosarcoma of Head and Neck; Angiofibroma of Head and Neck

  10. Jaw Dysfunction Is Associated with Neck Disability and Muscle Tenderness in Subjects with and without Chronic Temporomandibular Disorders

    PubMed Central

    Silveira, A.; Gadotti, I. C.; Armijo-Olivo, S.; Biasotto-Gonzalez, D. A.; Magee, D.

    2015-01-01

    Purpose. Tender points in the neck are common in patients with temporomandibular disorders (TMD). However, the correlation among neck disability, jaw dysfunction, and muscle tenderness in subjects with TMD still needs further investigation. This study investigated the correlation among neck disability, jaw dysfunction, and muscle tenderness in subjects with and without chronic TMD. Participants. Forty females between 19 and 49 years old were included in this study. There were 20 healthy controls and 20 subjects who had chronic TMD and neck disability. Methods. Subjects completed the neck disability index and the limitations of daily functions in TMD questionnaires. Tenderness of the masticatory and cervical muscles was measured using an algometer. Results. The correlation between jaw disability and neck disability was significantly high (r = 0.915, P < 0.05). The correlation between level of muscle tenderness in the masticatory and cervical muscles with jaw dysfunction and neck disability showed fair to moderate correlations (r = 0.32–0.65). Conclusion. High levels of muscle tenderness in upper trapezius and temporalis muscles correlated with high levels of jaw and neck dysfunction. Moreover, high levels of neck disability correlated with high levels of jaw disability. These findings emphasize the importance of considering the neck and its structures when evaluating and treating patients with TMD. PMID:25883963

  11. Neck range of motion and use of computer head controls.

    PubMed

    LoPresti, Edmund F; Brienza, David M; Angelo, Jennifer; Gilbertson, Lars

    2003-01-01

    Head controls provide an alternative means of computer access. This study determined whether neck movement limitations are associated with reduced performance with such head controls. This study also identified features of the cursor movement path that could aid in assessing computer access limitations. Fifteen subjects without disabilities and ten subjects with disabilities received neck range of motion evaluations and performed computer exercises using head controls. Reduced neck range of motion was correlated with reduced accuracy (R2 = 93.5%) and speed (R2 = 79.5%) in icon selection. A model was developed with the use of cursor positioning time and number of velocity peaks to identify when a person was having difficulty with target acquisition (kappa = 0.81). Models such as this may allow head controls to adapt to a user's needs, accommodating difficulties resulting from neck range of motion limitations. PMID:14582524

  12. Clinical Results of Internal Fixation of Subcapital Femoral Neck Fractures

    PubMed Central

    Moon, Kyoung Ho; Shin, Joong Sup; Shin, Eun Ho; Ahn, Chi Hoon; Choi, Geon Hong

    2016-01-01

    Background Subcapital femoral neck is known to cause many complications, such as avascular necrosis (AVN) of the femoral head or nonunion, compared with other femoral neck fractures. The purpose of this study was to analyze the incidence of AVN and fixation failures in patients treated with internal fixation using cannulated screws for the subcapital femoral neck fractures. Methods This study targeted a total of 84 cases of subcapital femoral neck fractures that underwent internal fixation using cannulated screws. The average follow-up time after surgery was 36.8 months (range, 24 to 148 months). Results Nine hips (10.7%) showing AVN of the femoral head and 6 hips (7.1%) showing fixation failures were observed. The factors affecting the incidence of AVN of the femoral head after sustaining fractures correlated well with fracture types in the Garden classification (p = 0.030). The factors affecting fixation failure were the degree of reduction (p = 0.001) measured by the Garden alignment index and firm fixation (p = 0.009) assessed using the technique of 3-point fixation through the inferomedial cortical bone of the femoral neck. Conclusions The complication rates for subcapital femoral neck fractures were lower than those previously reported; hence, internal fixation could be a primary treatment option for these fractures.

  13. Influence of neck rotation and neck lateroflexion on mandibular equilibrium.

    PubMed

    Schindler, H J; Lenz, J; Türp, J C; Schweizerhof, K; Rues, S

    2010-05-01

    Neuromuscular interaction between neck and jaw muscles has been reported in several studies. However, the influence of experimentally modified posture of the neck on jaw muscle activity during isometric biting was not investigated so far. The aim of the present study was to test by the aid of simultaneous electromyographic and intraoral bite force measurements whether neck rotation and lateroflexion, in contrast to a straightforward neck position, change the isometric cocontraction patterns of masticatory muscles under identical submaximum bite forces of 50-200 N. Electric muscle activity of all masticatory muscles and changes of the reduction point (RP) of the resultant bite force vectors were examined. An anteroposterior displacement of the RPs could be observed for the rotated and lateroflexed neck position in comparison with the straightforward position. On the other hand, the results revealed no significant differences between bilateral muscle activation under the different test conditions. These findings suggest a force transmission between the neck and the masticatory system, but no essential activity changes in the masticatory muscles under short time posture modification of the neck. PMID:20180896

  14. Necking of Q&P steel during uniaxial tensile test with the aid of DIC technique

    NASA Astrophysics Data System (ADS)

    Ding, Lei; Lin, Jianping; Min, Junying; Pang, Zheng; Ye, You

    2013-05-01

    A lot of research has been focused on the necking process during the plastic deformation of sheet metals, but the localized necking is rarely distinguished form diffused necking by experiments, due to the limit of measurement equipment and method. Quenching and Partitioning (Q&P) steel is a 3rd generation advanced high strength steel (AHSS). Its good combination of high strength and ductility ensures potential application in automobile industry. Uniaxial tensile tests of QP980 steel sheet at five strain rates are performed to investigate the necking process and the effect of strain rate on necking behavior of Q&P steel. Digital image correlation (DIC) method is applied during tensile tests, and evolutions of major strain, minor strain and normal strain distributions along gauge section of the tensile specimens are obtained. The diffused and localized necking strains are determined according to SWIFT necking theory and HILL necking theory respectively. The test results indicate that with the increasing of strain rate in the investigated range, the diffused necking strain decreases from 0.152 to 0.120 and localized necking strain decreases from 0.245 to 0.137. Meanwhile, the difference of the two strains decreases form 0.096 to 0.017. Thus it can be concluded that strain rate has an influence on both necking strains during the deformation of QP980 steel sheet. Diffused and localized necking strains are determined by uniaxial tensile tests with the aid of DIC technique and the effect of strain rate on necking strains is evaluated.

  15. Head-Neck Biomechanics in Simulated Rear Impact

    PubMed Central

    Yoganandan, Narayan; Pintar, Frank A.; Cusick, Joseph F.; Kleinberger, Michael

    1998-01-01

    The first objective of this study is to present an overview of the human cadaver studies aimed to determine the biomechanics of the head-neck in a simulated rear crash. The need for kinematic studies to better understand the mechanisms of load transfer to the human head-neck complex is emphasized. Based on this need, a methodology is developed to delineate the dynamic kinematics of the human head-neck complex. Intact human cadaver head-neck complexes were subjected to postero-anterior impact using a mini-sled pendulum device. The integrity of the soft tissues including the musculature and skin were maintained. The kinematic data were recorded using high-speed photography coupled with retroreflective targets placed at various regions of the human head-neck complex. The overall and segmental kinematics of the entire head-neck complex, and the localized facet joint motions were determined. During the initial stages of loading, a transient decoupling of the head occurred with respect to the neck exhibiting a lag of the cranium. The upper cervical spine-head undergoes local flexion concomitant with a lag of the head while the lower cervical spinal column is in local extension. This establishes a reverse curvature to the cervical head-neck complex. With continued loading, head motion ensues and approximately at the end of the loading phase, the entire head-neck complex is under the extension mode with a single curvature. In contrast, the lower cervical spine facet joint kinematics show varying compression and sliding. While both the anterior and posterior-most regions of the facet joint slide, the posterior-most region (mean: 2.84 mm) of the joint compresses more than the anterior-most (mean: 2.02 mm) region. These varying kinematics at the ends of the facet joint result in a pinching mechanism. These biomechanical kinematic findings may be correlated to the presence of headaches and neck pain (Lord, Bogduk et al. 1992; Barnsley, Lord et al. 1995), based on the unique human head-neck anatomy at the upper cervical spine region and the associated facet joint characteristics, and clinical studies.

  16. Cancer in the neck: Evaluation and treatment

    SciTech Connect

    Larson, D.L.; Ballantyne, A.J.

    1986-01-01

    This book contains 21 selections. Some of the titles are: Role of radiation therapy in the treatment of melanoma; Basic principles of radiobiology in head and neck oncology; Head and neck cancer: Radiotherapeutic precepts in the management of the neck; and Morbidity of modified neck dissection.

  17. The Tampa Scale of Kinesiophobia and neck pain, disability and range of motion: a narrative review of the literature

    PubMed Central

    Hudes, Karen

    2011-01-01

    Background: The Tampa Scale of Kinesiophobia (TSK) that was developed in 1990 is a 17 item scale originally developed to measure the fear of movement related to chronic lower back pain. Objective: To review the literature regarding TSK and neck pain, perceived disability and range of motion of the cervical spine. Methods: Medline, MANTIS, Index to Chiropractic Literature and CINAHL were searched. Results: A total of 16 related articles were found and divided into four categories: TSK and Neck Pain; TSK, Neck Pain and Disability; TSK, Neck Pain, Disability and Strength; and TSK, Neck Pain and Surface Electromyography. Conclusion: The fear avoidance model can be applied to neck pain sufferers and there is value from a psychometric perspective in using the TSK to assess kinesiophobia. Future research should investigate if, and to what extent, other measureable factors commonly associated with neck pain, such as decreased range of motion, correlate with kinesiophobia. PMID:21886284

  18. Childhood Head and Neck Irradiation

    MedlinePlus

    American Thyroid Association ® www.thyroid.org Childhood Head & Neck Irradiation What is the thyroid gland? The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front ...

  19. Headache and neck.

    PubMed

    Vincent, Maurice B

    2011-08-01

    Cervicogenic headache (CeH) is a relatively common syndrome. The paroxysmal and rather intense head pain usually is unilateral, spreading from the back of the head to the frontal and temporal regions, and triggered by certain movements or sustained provocative head positions. Digital pressure over triggering areas at the upper nuchal area reproduces the spontaneous pain pattern. Available clinical criteria differentiate this picture from other headache disorders, although superposition may be present in some cases. The neck is involved with other pain disorders apart from CeH. Migraine may be induced by cervical trigger factors in some cases, and whiplash lesions produce CeH-like symptoms as well as others. Occipital neuralgia refers to pain restricted to the distribution of the affected nerve and should not be mistaken as CeH. There is no definite, universal treatment for CeH yet. Options include physical therapy, preventive medicines, anesthetic blocks, denervation procedures, and surgery. The treatment choice must be performed on individual basis. PMID:21465114

  20. Analysis of deep tissue hypersensitivity to pressure pain in professional pianists with insidious mechanical neck pain

    PubMed Central

    2011-01-01

    Background The aim of this study was to investigate whether pressure pain hyperalgesia is a feature of professional pianists suffering from neck pain as their main playing-related musculoskeletal disorder. Methods Twenty-three active expert pianists, 6 males and 17 females (age: 36 ± 12 years) with insidious neck pain and 23 pianists, 9 males and 14 females (age: 38 ± 10 years) without neck pain the previous year were recruited. A numerical pain rate scale, Neck Disability Index, hand size and pressure pain thresholds (PPT) were assessed bilaterally over the C5-C6 zygapophyseal joint, deltoid muscle, the second metacarpal and the tibialis anterior muscle in a blinded design. Results The results showed that PPT levels were significantly decreased bilaterally over the second metacarpal and tibialis anterior muscles (P < 0.05), but not over C5-C6 zygapophyseal joint and deltoid muscle (P > 0.10), in pianists with neck pain as compared to healthy pianists. Pianists with neck pain had a smaller (P < 0.05) hand size (mean: 181.8 ± 11.8) as compared to pianists without neck pain (mean: 188. 6 ± 13.1). PPT over the tibialis anterior muscles was negatively correlated with the intensity of neck pain. Conclusions Our findings revealed pressure pain hypersensitivity over distant non-symptomatic distant points but not over the symptomatic areas in pianists suffering from neck pain. In addition, pianists with neck pain also had smaller hand size than those without neck pain. Future studies are needed to further determine the relevance of these findings in the clinical course of neck pain as playing-related musculoskeletal disorder in professional pianists. PMID:22111912

  1. Age-dependence of power spectral density and fractal dimension of bone mineralized matrix in atomic force microscope topography images: potential correlates of bone tissue age and bone fragility in female femoral neck trabeculae

    PubMed Central

    Milovanovic, Petar; Djuric, Marija; Rakocevic, Zlatko

    2012-01-01

    There is an increasing interest in bone nano-structure, the ultimate goal being to reveal the basis of age-related bone fragility. In this study, power spectral density (PSD) data and fractal dimensions of the mineralized bone matrix were extracted from atomic force microscope topography images of the femoral neck trabeculae. The aim was to evaluate age-dependent differences in the mineralized matrix of human bone and to consider whether these advanced nano-descriptors might be linked to decreased bone remodeling observed by some authors and age-related decline in bone mechanical competence. The investigated bone specimens belonged to a group of young adult women (n = 5, age: 20–40 years) and a group of elderly women (n = 5, age: 70–95 years) without bone diseases. PSD graphs showed the roughness density distribution in relation to spatial frequency. In all cases, there was a fairly linear decrease in magnitude of the power spectra with increasing spatial frequencies. The PSD slope was steeper in elderly individuals (−2.374 vs. −2.066), suggesting the dominance of larger surface morphological features. Fractal dimension of the mineralized bone matrix showed a significant negative trend with advanced age, declining from 2.467 in young individuals to 2.313 in the elderly (r = 0.65, P = 0.04). Higher fractal dimension in young women reflects domination of smaller mineral grains, which is compatible with the more freshly remodeled structure. In contrast, the surface patterns in elderly individuals were indicative of older tissue age. Lower roughness and reduced structural complexity (decreased fractal dimension) of the interfibrillar bone matrix in the elderly suggest a decline in bone toughness, which explains why aged bone is more brittle and prone to fractures. PMID:22946475

  2. Age Moderates the Relationships between Family Functioning and Neck Pain/Disability

    PubMed Central

    Guzy, Grażyna; Polczyk, Romuald; Szpitalak, Malwina; Vernon, Howard

    2016-01-01

    This cross-sectional clinical study was designed to explore the relationships between family functioning, coping styles, and neck pain and neck disability. It was hypothesized that better family functioning and more effective coping styles would be associated with less pain and pain-related disability. It also was hypothesized that these relationships would be stronger in older people because they have fewer resources, more limited coping styles, and may depend more on their family for support. In this study, 88 women with chronic non-traumatic neck pain completed the Family Assessment Measure (FAM), Coping Inventory for Stressful Situations (CISS), Neck Disability Index (NDI), and a Visual-Analogue Scale (VAS) measuring the subjective intensity of neck pain. Zero-order and partial correlations and hierarchical stepwise regression were performed. CISS was not correlated with the NDI orVAS. Good family functioning was correlated with lower NDI and VAS scores. Age was found to moderate the relationship between the FAM and both NDI and VAS. This relationship was significant and positive in older patients, but non-significant in younger patients. It was concluded that better family functioning is associated with lower neck disability and pain intensity, especially in the case of older women suffering from non-traumatic neck pain. PMID:27078854

  3. Age Moderates the Relationships between Family Functioning and Neck Pain/Disability.

    PubMed

    Guzy, Grażyna; Polczyk, Romuald; Szpitalak, Malwina; Vernon, Howard

    2016-01-01

    This cross-sectional clinical study was designed to explore the relationships between family functioning, coping styles, and neck pain and neck disability. It was hypothesized that better family functioning and more effective coping styles would be associated with less pain and pain-related disability. It also was hypothesized that these relationships would be stronger in older people because they have fewer resources, more limited coping styles, and may depend more on their family for support. In this study, 88 women with chronic non-traumatic neck pain completed the Family Assessment Measure (FAM), Coping Inventory for Stressful Situations (CISS), Neck Disability Index (NDI), and a Visual-Analogue Scale (VAS) measuring the subjective intensity of neck pain. Zero-order and partial correlations and hierarchical stepwise regression were performed. CISS was not correlated with the NDI orVAS. Good family functioning was correlated with lower NDI and VAS scores. Age was found to moderate the relationship between the FAM and both NDI and VAS. This relationship was significant and positive in older patients, but non-significant in younger patients. It was concluded that better family functioning is associated with lower neck disability and pain intensity, especially in the case of older women suffering from non-traumatic neck pain. PMID:27078854

  4. Multiple head and neck malignancies.

    PubMed

    Odette, J; Szymanowski, R T; Nichols, R D

    1977-01-01

    Case histories of 47 patients with multiple head and neck neoplasms were reviewed at the Henry Ford Hospital. Data were obtained on the site of the malignancy and treatment program. Follow-up data have been good, utilizing clinic records. Several patients have had more than two malignancies of the head and neck, and one patient has just completed treatment for his fifth epidermoid carcinoma. The incidence of carcinoma of the esophagus is high in this series (16 of 47 patients). The literature is reviewed in relation to the present findings. Follow-up care is described at the Henry Ford Hospital. PMID:919150

  5. Neck pain or spasms - self care

    MedlinePlus

    ... Neck stiffness-self-care; Cervicalgia-self-care; Whiplash-self-care ... improve blood flow to your muscles and promote healing. They also ... neck stretching and strengthening exercises and how to do them.

  6. New Modelling of Localized Necking in Sheet Metal Stretching

    NASA Astrophysics Data System (ADS)

    Bressan, José Divo

    2011-01-01

    Present work examines a new mathematical model to predict the onset of localized necking in the industrial processes of sheet metal forming such as biaxial stretching. Sheet metal formability is usually assessed experimentally by testing such as the Nakajima test to obtain the Forming Limit Curve, FLC, which is an essential material parameter necessary to numerical simulations by FEM. The Forming Limit Diagram or "Forming Principal Strain Map" shows the experimental FLC which is the plot of principal true strains in the sheet metal surface, ɛ1 and ɛ2, occurring at critical points obtained in laboratory formability tests or in the fabrication process. Two types of undesirable rupture mechanisms can occur in sheet metal forming products: localized necking and shear induced fracture. Therefore, two kinds of limit strain curves can be plotted: the local necking limit curve FLC-N and the shear fracture limit curve FLC-S. Localized necking is theoretically anticipated to initiate at a thickness defect ƒin = hib/hia inside the grooved sheet thickness hia, but only at the instability point of maximum load. The inception of grooving on the sheet surface evolves from instability point to localized necking and final rupture, during further sheet metal straining. Work hardening law is defined for a strain and strain rate material by the effective stress σ¯ = σo(1+βɛ¯)n???ɛM. The average experimental hardening law curve for tensile tests at 0°, 45° and 90°, assuming isotropic plasticity, was used to analyze the plasticity behavior during the biaxial stretching of sheet metals. Theoretical predicted curves of local necking limits are plotted in the positive quadrant of FPSM for different defect values ƒin and plasticity parameters. Limit strains are obtained from a software developed by the author. Some experimental results of forming limit curve obtained from experiments for IF steel sheets are compared with the theoretical predicted curves: the correlation is good.

  7. 49 CFR 572.17 - Neck.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Neck. 572.17 Section 572.17 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 3-Year-Old Child § 572.17 Neck. (a)(1) The neck for use with the head...

  8. 49 CFR 572.7 - Neck.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Neck. 572.7 Section 572.7 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 50th Percentile Male § 572.7 Neck. (a) The neck consists of the assembly shown...

  9. 49 CFR 572.7 - Neck.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Neck. 572.7 Section 572.7 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 50th Percentile Male § 572.7 Neck. (a) The neck consists of the assembly shown...

  10. 49 CFR 572.17 - Neck.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Neck. 572.17 Section 572.17 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 3-Year-Old Child § 572.17 Neck. (a)(1) The neck for use with the head...

  11. The eleventh nerve in radical neck surgery.

    PubMed

    Brandenburg, J H; Lee, C Y

    1981-11-01

    The greatest morbidity associated with the radical neck dissection has been the "shoulder syndrome" due to the sacrifice of the spinal accessory nerve. Despite the fact that the XIth nerve can be spared by a careful dissection of the postcervical triangle, to do so remains a controversial issue. The 125 radical neck dissections performed at the University of Wisconsin Clinical Science Center from 1970 through 1975 were carefully evaluated to determine the incidence of recurrent tumor in the operated-on neck. In 60 cases the spinal accessory nerve was resected with the neck specimen, and in 65 cases the nerve was preserved. A second study was then undertaken involving 245 neck dissections performed from 1975-1978 in the Wisconsin Head and neck Cancer Control Network Hospitals. In 69 instances the spinal accessory nerve was spared. The total number of neck dissections (370 cases) from both studies were analyzed. The overall rate for recurrent tumor in the neck with the classical neck dissection was 12%. When the spinal accessory nerve was spared, the recurrent rate was 6%. On the basis of these observations we propose that the classical neck dissection can be modified to preserve the spinal accessory nerve without jeopardizing the chances for a cure in elective neck dissections and selected therapeutic neck dissections. PMID:7300535

  12. Neck Circumference May Be a Better Alternative to Standard Anthropometric Measures.

    PubMed

    Joshipura, Kaumudi; Muñoz-Torres, Francisco; Vergara, José; Palacios, Cristina; Pérez, Cynthia M

    2016-01-01

    This paper evaluates neck circumference as a metabolic risk marker. Overweight/obese, nondiabetic Hispanics, 40-65 years old, who are free of major cardiovascular diseases, were recruited for the San Juan Overweight Adults Longitudinal Study (SOALS). Baseline exams were completed by 1,206 participants. Partial correlation coefficients (r) and logistic models adjusted for age, gender, smoking status, and physical activity were computed. Neck circumference was significantly correlated with waist circumference (r = 0.64), BMI (r = 0.66), and body fat % (r = 0.45). Neck circumference, highest (compared to lowest) tertile, had higher association with prediabetes: multivariable OR = 2.30 (95% CI: 1.71-3.06) compared to waist circumference OR = 1.97 (95% CI: 1.48-2.66) and other anthropometric measures. Neck circumference showed higher associations with HOMA, low HDL-C, and triglycerides, multivariable OR = 8.42 (95% CI: 5.43-13.06), 2.41 (95% CI: 1.80-3.21), and 1.52 (95% CI: 1.14-2.03), but weaker associations with hs-CRP and hypertension, OR = 3.61 (95% CI: 2.66-4.90) and OR = 2.58 (95% CI: 1.90-3.49), compared to waist circumference. AIC for model fit was generally similar for neck or waist circumference. Neck circumference showed similar or better associations with metabolic factors and is more practicable than waist circumference. Hence, neck circumference may be a better alternative to waist circumference. PMID:26981543

  13. Treatment of advanced neck metastases

    PubMed Central

    Spriano, G; Pellini, R; Manciocco, V; Ruscito, P

    2006-01-01

    Summary Despite the use of aggressive single or multimodality treatment protocols, patients with advanced cervical metastases, N2 and N3, have a poor prognosis because of their high risk of regional and distal failure. Moreover, N3 class does not allow resectability and curability to be defined. Numerous trials have been carried out in order to improve the oncological outcomes of patients with advanced metastases to the neck using a variety of multimodality therapy. At present, there is a trend toward the use of a definitive radiochemotherapy followed, or not, by neck dissection. In order to offer a panoramic view of the treatment protocols in use, data available in the literature, regarding the management of advanced neck disease using surgery, radiotherapy and chemotherapy, in different associations, have been reviewed and our experience reported. The presence of advanced cervical metastases is a very poor prognostic factor. The combined treatment modality offers better chances of cure than single modality treatment. Surgery followed by radiotherapy or chemo-radiation therapy is an effective and well standardized approach. The use of planned neck dissection following chemoradiation is still debated. PMID:17633156

  14. Penetrating injuries of the neck.

    PubMed Central

    Demetriades, D.; Stewart, M.

    1985-01-01

    A review of 271 patients with penetrating wounds of the neck is presented. A policy of selective conservative management appears totally justified in view of the low mortality and morbidity in this series. Particular attention has been paid to the presentation and surgical approach to the injured vertebral artery. Images Fig. 3 PMID:3977261

  15. The Tip of the Iceberg: Clinical Implications of Genomic Sequencing Projects in Head and Neck Cancer

    PubMed Central

    Birkeland, Andrew C.; Ludwig, Megan L.; Meraj, Taha S.; Brenner, J. Chad; Prince, Mark E.

    2015-01-01

    Recent genomic sequencing studies have provided valuable insight into genetic aberrations in head and neck squamous cell carcinoma. Despite these great advances, certain hurdles exist in translating genomic findings to clinical care. Further correlation of genetic findings to clinical outcomes, additional analyses of subgroups of head and neck cancers and follow-up investigation into genetic heterogeneity are needed. While the development of targeted therapy trials is of key importance, numerous challenges exist in establishing and optimizing such programs. This review discusses potential upcoming steps for further genetic evaluation of head and neck cancers and implementation of genetic findings into precision medicine trials. PMID:26506389

  16. Case report: Multimodality imaging of van Neck-Odelberg disease.

    PubMed

    Macarini, Luca; Lallo, Tania; Milillo, Paola; Muscarella, Silvana; Vinci, Roberta; Stoppino, Luca P

    2011-04-01

    Synchondrosis ischiopubic syndrome (SIS), also known as van Neck-Odelberg disease, is a syndrome characterized by an atypical ossification pattern of the ischiopubic synchondrosis. Its radiological features may mimic stress fracture, neoplasm, osteomyelitis, or posttraumatic osteolysis, causing problems in diagnosis, sometimes leading to unnecessary workup. We report two cases in which the correlation between the clinical and multimodality imaging data enabled the correct diagnosis of SIS. PMID:21799592

  17. Immunotherapy With MK-3475 in Surgically Resectable Head and Neck Squamous Cell Carcinoma

    ClinicalTrials.gov

    2016-04-27

    Cancer of Head and Neck; Head and Neck Cancer; Neoplasms, Head and Neck; Carcinoma, Squamous Cell of Head and Neck; Squamous Cell Carcinoma of the Head and Neck; Squamous Cell Carcinoma, Head and Neck

  18. The Relationship between Neck Pain and Cervical Alignment in Young Female Nursing Staff

    PubMed Central

    Kim, Jang-Hun; Kim, Joo Han; Kim, Jong-Hyun; Kwon, Taek-Hyun; Park, Yoon-Kwan

    2015-01-01

    Objective Degenerative changes in the cervical spine are commonly accompanied by cervical kyphosis which can cause neck pain. This study examined the relationship between neck pain and cervical alignment. Methods A total of 323 female nursing staff from our hospital were enrolled. Sagittal radiographs of the cervical spine, Body Mass Index (BMI), Visual Analogue Scale (VAS) measures of neck and arm pain, Neck Disability Index (NDI) and the Short Form (36) Health Survey (SF-36 scores) were obtained and reviewed retrospectively. Global lordosis (GL) of the cervical spine was measured on radiograph images. Correlations between GL and questionnaire scores were investigated using the following three methods : 1) correlation between GL and questionnaire scores among the entire sample; 2) subgroup analysis of patients with "kyphosis (KYP) : GL scores<0" vs. those with "lordosis (LOR) : GL scores>0" on questionnaire measures; and 3) subgroup analysis of patients with pain vs. those without pain, on GL and questionnaire measures. Results There was no significant correlation between GL and any questionnaire measure. There was a significant difference between the mean GLs of the KYP and LOR groups, but there were no group differences in BMI, age or any questionnaire measures. There was no difference between the pain (n=92) and pain-free (n=231) groups in age, BMI or GL, but there were differences in neck, and arm pain, and physical function and NDI scores. Conclusions Our data suggest that kyphotic deformity was not associated with neck pain. PMID:26539266

  19. Neck Dissection Through a Facelift Incision

    PubMed Central

    Melvin, Thuy-Anh N.; Eliades, Steven J.; Ha, Patrick K.; Fakhry, Carole; Saunders, John M.; Califano, Joseph A.; Blanco, Ray G. F.

    2013-01-01

    Obectives/Hypothesis To determine the feasibility and safety of neck dissection through a facelift incision. Study Design Prospective case series. Methods Cadavers and live subjects underwent neck dissection using a facelift incision with and without endoscopic assistance. In the live facelift neck dissection (FLND), the preoperative surgical indications, staging, adjuvant therapy, intraoperative technical procedure, pathology reports on lymph nodes, and short-term outcomes were reviewed. Results FLND was successfully performed in four cadavers and four live subjects, including selective (less than five neck levels removed) and comprehensive (levels I–V removed) neck dissections. All levels were accessible through this approach, with additional retraction required for levels I and IV. Endoscopic assistance was required in one neck dissection for adequate visualization. Short-term complications and number of excised lymph nodes were comparable to those from traditional neck dissection approaches. Conclusions Open neck dissection through a facelift incision is feasible and offers an alternate approach to traditional incisions. This can be performed without requiring robotic assistance and with endoscopic assistance only in certain cases. Endoscopic assistance can offer enhanced visualization of the surgical field and complement open direct approaches in neck dissection. Although FLND offers improved cosmetic outcomes when compared to those of traditional neck incisions, further study is required to determine its efficacy and indications. PMID:23023877

  20. A historical prospective cohort study of carotid artery stenosis after radiotherapy for head and neck malignancies

    SciTech Connect

    Brown, Paul D. . E-mail: brown.paul@mayo.edu; Foote, Robert L.; McLaughlin, Mark P.; Halyard, Michele Y.; Ballman, Karla V.; Collie, A. Craig; Miller, Robert C.; Flemming, Kelly D.; Hallett, John W.

    2005-12-01

    Purpose: To determine carotid artery stenosis incidence after radiotherapy for head-and-neck neoplasms. Methods and Materials: This historical prospective cohort study comprised 44 head-and-neck cancer survivors who received unilateral neck radiotherapy between 1974 and 1999. They underwent bilateral carotid duplex ultrasonography to detect carotid artery stenosis. Results: The incidence of significant carotid stenosis (8 of 44 [18%]) in the irradiated neck was higher than that in the contralateral unirradiated neck (3 of 44 [7%]), although this difference was not statistically significant (p = 0.13). The rate of significant carotid stenosis events increased as the time after radiotherapy increased. The risk of ipsilateral carotid artery stenosis was higher in patients who had undergone a neck dissection vs. those who had not. Patients with significant ipsilateral stenosis also tended to be older than those without significant stenosis. No other patient or treatment variables correlated with risk of carotid artery stenosis. Conclusions: For long-term survivors after neck dissection and irradiation, especially those who are symptomatic, ultrasonographic carotid artery screening should be considered.

  1. Quantitation of intracranial aneurysm neck size from diagnostic angiograms based on a biomathematical model.

    PubMed

    Hademenos, G J; Massoud, T F; Viñuela, F

    1995-10-01

    Accurate measurement of the aneurysm neck size from diagnostic angiograms is crucial in the consideration and implementation of interventional embolotherapeutic procedures. Due to inherent problems in angiography, aneurysm morphology and location, and obstruction by overlying structures, accurate measurement of the aneurysm neck size is difficult. We are proposing a method for the angiographic measurement of aneurysm neck size based on a biomathematical model of an aneurysm. A biomathematical model of an intracranial saccular aneurysm was developed based on Laplace's law for a spherical elastic object, given by: Stress = Pressure x Radius/2 x Wall thickness. In addition, another biomechanical parameter used to describe an elastic sphere is the strain: Strain = delta R/Ri = (R-Ri)/Ri where R is the current aneurysm radius and Ri is the initial radius prior to aneurysm development. The stress and strain of an elastic structure are used to describe the elastic modulus, E: E = stress/strain = [PR/2h]/[(R-Ri)/Ri] = [PRRi]/[2hR-2hri]. It is assumed at this point that no additional tissue growth occurs through the developmental course of the aneurysm. The expression for E is now solved for Ri which, in essence, represents the radius of the aneurysm neck: Ri = [2hER]/[PR + 2hE]. Thus, the diameter of the neck, Dn, is given by Dn = 2 + i = 2 ([2hER]/[PR + 2hE]). During diagnostic angiography, the radius, R, and pressure, P, are easily obtained during the examination procedure. However, it is not possible to angiographically determine the elastic modulus, E, and the wall thickness, h. In this case, the following average values are used: E = 1.0 MPa and h = 50 microns. From the diagnostic angiograms and hospital records of 23 patients, the aneurysm neck size was determined using the biomathematical model and compared to the results obtained from the correlative relationship between the measured and accepted ratios of neck size to diameter of parent artery. The neck diameter as measured from the accepted ratios of neck size to parent artery diameter for the 23 patients ranged from 1.5 mm to 8.7 mm. The angiographically measured neck sizes were in excellent agreement with those obtained from the biomathematical model, particularly for the wide-necked aneurysms, as evidenced by the fact that all but two chi 2 values were < 1.0. We have described a simple yet accurate method for obtaining aneurysm neck size measurements from diagnostic angiograms using a biomathematical model. The model requires knowledge of only the aneurysm radius and blood pressure and becomes particularly important in characterizing wide-necked aneurysms. PMID:8584121

  2. Head and neck position sense.

    PubMed

    Armstrong, Bridget; McNair, Peter; Taylor, Denise

    2008-01-01

    Traumatic minor cervical strains are common place in high-impact sports (e.g. tackling) and premature degenerative changes have been documented in sports people exposed to recurrent impact trauma (e.g. scrummaging in rugby) or repetitive forces (e.g. Formula 1 racing drivers, jockeys). While proprioceptive exercises have been an integral part of rehabilitation of injuries in the lower limb, they have not featured as prominently in the treatment of cervical injuries. However, head and neck position sense (HNPS) testing and re-training may have relevance in the management of minor sports-related neck injuries, and play a role in reducing the incidence of ongoing pain and problems with function. For efficacious programmes to be developed and tested, fundamental principles associated with proprioception in the cervical spine should be considered. Hence, this article highlights the importance of anatomical structures in the cervical spine responsible for position sense, and how their interaction with the CNS affects our ability to plan and execute effective purposeful movements. This article includes a review of studies examining position sense in subjects with and without pathology and describes the effects of rehabilitation programmes that have sought to improve position sense. In respect to the receptors providing proprioceptive information for the CNS, the high densities and complex arrays of spindles found in cervical muscles suggest that these receptors play a key role. There is some evidence suggesting that ensemble encoding of discharge patterns from muscle spindles is relayed to the CNS and that a pattern recognition system is used to establish joint position and movement. Sensory information from neck proprioceptive receptors is processed in tandem with information from the vestibular system. There are extensive anatomical connections between neck proprioceptive inputs and vestibular inputs. If positional information from the vestibular system is inaccurate or fails to be appropriately integrated in the CNS, errors in head position may occur, resulting in an inaccurate reference for HNPS, and conversely if neck proprioceptive information is inaccurate, then control of head position may be affected. The cerebellum and cortex also play a role in control of head position, providing feed-forward and modulatory influences depending on the task requirements. Position-matching tasks have been the most popular means of testing position sense in the cervical spine. These allow the appreciation of absolute, constant and variable errors in positioning and have been shown to be reliable. The results of such tests indicate that errors are relatively low (2-5 degrees). It is apparent that error is not consistently affected by age, a finding similar to studies undertaken in peripheral joints. Furthermore, the range of motion in which subjects are tested does not consistently affect accuracy in a predictable manner. However, it is evident that impairments in position sense are observed in individuals who have experienced whiplash-type injuries and individuals with chronic head and neck pain of non-traumatic origin (e.g. cervical spondylosis). While researchers advocate comprehensive retraining protocols, which include eye and neck motion targeting tasks and coordination exercises, as well as co-contraction exercises to reduce such impairments, some studies show that more general exercises and manipulation may be of benefit. Overall, there is limited information concerning the efficacy of treatment programmes. PMID:18201114

  3. LONG-TERM RESULTS OF BODY AND NECK TALUS FRACTURES

    PubMed Central

    Gomes de Sousa, Ricardo Jorge; Teixeira de Oliveira Massada, Marta Maria; Gonçalves Pereira, Manuel Alexandre Negrais Pinho; Gonçalves Costa, Isabel Maria; da Costa e Castro, José Fernando Souzellas

    2015-01-01

    Objectives: Talar neck and body fractures are unusual fractures. The purpose of this study is to determine the prevalence of long term results. Material and Methods: A retrospective analysis was carried out including 11 patients that underwent surgical treatment for body or neck talus fractures between January 1997 and December 2005. Final follow-up examination included a clinical evaluation (AOFAS score) and standard radiographs. Results: The mean follow-up time was 58.5 months. The prevalence of associated fractures was 60% (6/10). Overall AOFAS score averaged 72 [19-100]. Avascular necrosis and post-traumatic arthritis were present in half of the patients. Quality of surgical reduction, body fractures and absence of degenerative changes were correlated with better functional results. Neck fractures, osteonecrosis and posttraumatic arthritis led to inferior results. Conclusion: There is a great potential for long term functional impairment due to posttraumatic arthritis and chronic pain in this kind of fracture. Anatomic surgical reduction is the best chance to avoid them but it is not infallible. The avascular necrosis rate correlates with initial fracture displacement, but its occurrence in each specific case is unpredictable. PMID:27004192

  4. Anatomic Variations in Head and Neck Reconstruction

    PubMed Central

    Tan, Bien-Keem; Wong, Chin-Ho; Chen, Hung-Chi

    2010-01-01

    Head and neck reconstruction is a technically challenging procedure. Variations encountered in the recipient vessels and commonly used flaps add to the complexity of surgery. This article reviews the commonly encountered variations in the recipient vessels in the neck with emphasis on alternatives and techniques to circumvent these variations. Flaps commonly used in head and neck reconstruction are also reviewed in detail. Furthermore, safety, potential pitfalls, and technical pearls are highlighted. PMID:22550436

  5. Direct and remote constriction of membrane necks

    NASA Astrophysics Data System (ADS)

    Božič, Bojan; Guven, Jemal; Vázquez-Montejo, Pablo; Svetina, Saša

    2014-05-01

    The physical properties of membrane necks are relevant in vesiculation, a process that plays an essential role in cellular physiology. Because the neck's radius is, in general, finite, membrane scission and the consequent pinching off of the vesicle can only occur if it is narrowed to permit the necessary membrane topological reformation. Here we examine, in a simple single phase lipid vesicle, how external forces can promote neck constriction not only by direct compression at the neck but also, counterintuitively, by dilation at remote locations. These results provide a new perspective on the role played by actin polymerization in the process of endocytosis.

  6. A Lump in the Neck

    PubMed Central

    de Souza, F. M.; Perkin, R. L.

    1981-01-01

    A lump in the neck presents the physician with a stimulating diagnostic challenge. Management of such a patient requires thoughtful analysis of the clinical findings. Investigation should result in an expeditious diagnosis with a minimum of morbidity, inconvenience and hospitalization. Diagnostic tools available today make some of these idealistic goals attainable but do not substitute for sound clinical judgment. This article reports our rationale in managing patients who have a cervical mass. ImagesFig. 1Fig. 3Fig. 4Fig. 5Fig. 6 PMID:21289668

  7. Genetics Home Reference: head and neck squamous cell carcinoma

    MedlinePlus

    ... Health Conditions head and neck squamous cell carcinoma head and neck squamous cell carcinoma Enable Javascript to view the ... body cavities such as the airways and intestines. Head and neck squamous cell carcinoma (HNSCC) develops in the mucous ...

  8. Head and Neck Radiation Treatment and Your Mouth

    MedlinePlus

    ... Head and Neck Radiation Treatment and Your Mouth Head and Neck Radiation Treatment and Your Mouth Main Content Are ... Being Treated With Radiation for Cancer in Your Head or Neck? If so, this booklet can help you. While ...

  9. Inter-Vertebral Flexibility of the Ostrich Neck: Implications for Estimating Sauropod Neck Flexibility

    PubMed Central

    Cobley, Matthew J.; Rayfield, Emily J.; Barrett, Paul M.

    2013-01-01

    The flexibility and posture of the neck in sauropod dinosaurs has long been contentious. Improved constraints on sauropod neck function will have major implications for what we know of their foraging strategies, ecology and overall biology. Several hypotheses have been proposed, based primarily on osteological data, suggesting different degrees of neck flexibility. This study attempts to assess the effects of reconstructed soft tissues on sauropod neck flexibility through systematic removal of muscle groups and measures of flexibility of the neck in a living analogue, the ostrich (Struthio camelus). The possible effect of cartilage on flexibility is also examined, as this was previously overlooked in osteological estimates of sauropod neck function. These comparisons show that soft tissues are likely to have limited the flexibility of the neck beyond the limits suggested by osteology alone. In addition, the inferred presence of cartilage, and varying the inter-vertebral spacing within the synovial capsule, also affect neck flexibility. One hypothesis proposed that flexibility is constrained by requiring a minimum overlap between successive zygapophyses equivalent to 50% of zygapophyseal articular surface length (ONP50). This assumption is tested by comparing the maximum flexibility of the articulated cervical column in ONP50 and the flexibility of the complete neck with all tissues intact. It is found that this model does not adequately convey the pattern of flexibility in the ostrich neck, suggesting that the ONP50 model may not be useful in determining neck function if considered in isolation from myological and other soft tissue data. PMID:23967284

  10. Cervical Spondylosis (Arthritis of the Neck)

    MedlinePlus

    ... the muscles in your neck to rest. A soft collar should only be worn for a short period of time since long-term wear may decrease the strength of the muscles in your neck. Ice, heat, and other modalities. Your doctor may recommend ...

  11. 49 CFR 572.113 - Neck assembly.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) Using neck brackets 78051-303 and -307, mount the head/neck assembly to the part 572 pendulum test... to the plane of motion of the pendulum's longitudinal centerline (see § 572.33, Figure 20, except... (horizontal surface at the base of the skull) rotation with respect to the pendulum's longitudinal...

  12. 49 CFR 572.113 - Neck assembly.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) Using neck brackets 78051-303 and -307, mount the head/neck assembly to the part 572 pendulum test... to the plane of motion of the pendulum's longitudinal centerline (see § 572.33, Figure 20, except... (horizontal surface at the base of the skull) rotation with respect to the pendulum's longitudinal...

  13. 49 CFR 572.113 - Neck assembly.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) Using neck brackets 78051-303 and -307, mount the head/neck assembly to the part 572 pendulum test... to the plane of motion of the pendulum's longitudinal centerline (see § 572.33, Figure 20, except... (horizontal surface at the base of the skull) rotation with respect to the pendulum's longitudinal...

  14. 49 CFR 572.113 - Neck assembly.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) Using neck brackets 78051-303 and -307, mount the head/neck assembly to the part 572 pendulum test... to the plane of motion of the pendulum's longitudinal centerline (see § 572.33, Figure 20, except... (horizontal surface at the base of the skull) rotation with respect to the pendulum's longitudinal...

  15. 49 CFR 572.113 - Neck assembly.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) Using neck brackets 78051-303 and -307, mount the head/neck assembly to the part 572 pendulum test... to the plane of motion of the pendulum's longitudinal centerline (see § 572.33, Figure 20, except... (horizontal surface at the base of the skull) rotation with respect to the pendulum's longitudinal...

  16. Head and Neck Cancer: Symptoms and Signs

    MedlinePlus

    ... your screen to choose another section to continue reading this guide. ‹ Head and Neck Cancer - Screening up Head and Neck Cancer - Diagnosis › f t g e P + H Types of Cancer Navigating Cancer Care Coping With Cancer Research and Advocacy Survivorship Blog About Us Head and ...

  17. Recent advances in therapeutic exercise for the neck: implications for patients with head and neck pain.

    PubMed

    O'Leary, S; Falla, D; Jull, G

    2003-12-01

    There have been recent advances in the rehabilitation of the muscles that control the head and neck. These advances are based on evidence of specific neck muscle dysfunction in individuals with persistent head and neck pain. Traditional rehabilitation strategies have focused predominantly on muscle strength and endurance under high loads. New evidence suggests that in people with neck pain there are underlying neuromuscular problems that may require more immediate attention and may not be adequately addressed by simple strength and high-load endurance retraining. Evidence of altered coordination between the deep and superficial neck muscles, greater neck muscle fatigue under sustained low loads, and deficits in kinaesthetic sense have been identified in symptomatic individuals. There is evidence to indicate that addressing these muscle control problems, with specific gentle exercise strategies, results in a reduction in neck pain and associated symptoms. PMID:14700399

  18. The impact of surgical technique on neck dissection nodal yield: making a difference.

    PubMed

    Lörincz, Balazs B; Langwieder, Felix; Möckelmann, Nikolaus; Sehner, Susanne; Knecht, Rainald

    2016-05-01

    The nodal yield of neck dissections is an independent prognostic factor in several types of head and neck cancer. The authors aimed to determine whether the applied dissection technique has a significant impact on nodal yield. This is a single-institution, prospective study with internal control group (level of evidence: 2A). Data of 150 patients undergoing 223 neck dissections between February 2011 and March 2013 have been collected in a comprehensive cancer centre. Eighty-two patients underwent neck dissection with unwrapping the cervical fascia from lateral to medial, while 68 patients were operated without specifically unwrapping the fascia, in a caudal to cranial fashion. The standardised, horizontal neck dissection technique along the fascial planes resulted in a significantly higher nodal count in Levels I, II, III and IV, as well as in terms of overall nodal yield (mean: n = 22.53) than that of the vertical dissection applied in the control group (mean: n = 15.00). This is the first publication showing a direct correlation between neck dissection nodal yield and surgical technique. Therefore, it is paramount to optimise the applied surgical concept to maximise the oncological benefit. PMID:25784183

  19. ADC biomarker for head and neck tumors

    NASA Astrophysics Data System (ADS)

    Pacheco-Bravo, Irlanda; Hidalgo-Tobon, Silvia; Zaragoza, Kena; Reynoso-Noverón, Nancy; De Celis-Alonso, Benito; Delgado-Hernandez, Rosa

    2014-11-01

    According to the World Cancer Report, by 2020, global incidence of cancer may increase by 50%, which means 15 million new cases. In 2000, malignant tumors were the cause of 12% of the almost 56 million deaths worldwide due to all causes[1-4]. 18 men and 19 women, with an average age of 53 ± 14 years with diagnosis of head and neck cancer were scanned using a 1.5-T MR imaging unit (Signa HDxt; GE Medical Systems). Echo-planar DW imaging was performed in the transverse plane before the contrast material injection. Three b values were applied: 40, 100, and 800 sec/mm2. Primary tumors and nodes were evaluated, with diameters greater than 43 ± 15mm. In our study, ADC data for b-values of 40 showed correlation for identification of malignancy in primary tumors, and in the case of nodes there is a tendency toward malignancy in sequences in which a b-value of 800 is used.

  20. Neck Circumference May Be a Better Alternative to Standard Anthropometric Measures

    PubMed Central

    Joshipura, Kaumudi; Muñoz-Torres, Francisco; Vergara, José; Palacios, Cristina; Pérez, Cynthia M.

    2016-01-01

    This paper evaluates neck circumference as a metabolic risk marker. Overweight/obese, nondiabetic Hispanics, 40–65 years old, who are free of major cardiovascular diseases, were recruited for the San Juan Overweight Adults Longitudinal Study (SOALS). Baseline exams were completed by 1,206 participants. Partial correlation coefficients (r) and logistic models adjusted for age, gender, smoking status, and physical activity were computed. Neck circumference was significantly correlated with waist circumference (r = 0.64), BMI (r = 0.66), and body fat % (r = 0.45). Neck circumference, highest (compared to lowest) tertile, had higher association with prediabetes: multivariable OR = 2.30 (95% CI: 1.71–3.06) compared to waist circumference OR = 1.97 (95% CI: 1.48–2.66) and other anthropometric measures. Neck circumference showed higher associations with HOMA, low HDL-C, and triglycerides, multivariable OR = 8.42 (95% CI: 5.43–13.06), 2.41 (95% CI: 1.80–3.21), and 1.52 (95% CI: 1.14–2.03), but weaker associations with hs-CRP and hypertension, OR = 3.61 (95% CI: 2.66–4.90) and OR = 2.58 (95% CI: 1.90–3.49), compared to waist circumference. AIC for model fit was generally similar for neck or waist circumference. Neck circumference showed similar or better associations with metabolic factors and is more practicable than waist circumference. Hence, neck circumference may be a better alternative to waist circumference. PMID:26981543

  1. The spine neck filters membrane potentials

    PubMed Central

    Araya, Roberto; Jiang, Jiang; Eisenthal, Kenneth B.; Yuste, Rafael

    2006-01-01

    Dendritic spines receive most synaptic inputs in the forebrain. Their morphology, with a spine head isolated from the dendrite by a slender neck, indicates a potential role in isolating inputs. Indeed, biochemical compartmentalization occurs at spine heads because of the diffusional bottleneck created by the spine neck. Here we investigate whether the spine neck also isolates inputs electrically. Using two-photon uncaging of glutamate on spine heads from mouse layer-5 neocortical pyramidal cells, we find that the amplitude of uncaging potentials at the soma is inversely proportional to neck length. This effect is strong and independent of the position of the spine in the dendritic tree and size of the spine head. Moreover, spines with long necks are electrically silent at the soma, although their heads are activated by the uncaging event, as determined with calcium imaging. Finally, second harmonic measurements of membrane potential reveal an attenuation of somatic voltages into the spine head, an attenuation directly proportional to neck length. We conclude that the spine neck plays an electrical role in the transmission of membrane potentials, isolating synapses electrically. PMID:17093040

  2. Treatment of neglected femoral neck fracture

    PubMed Central

    Jain, Anil K; Mukunth, R; Srivastava, Amit

    2015-01-01

    Intra-capsular femoral neck fractures are seen commonly in elderly people following a low energy trauma. Femoral neck fracture has a devastating effect on the blood supply of the femoral head, which is directly proportional to the severity of trauma and displacement of the fracture. Various authors have described a wide array of options for treatment of neglected/nonunion (NU) femoral neck fracture. There is lack of consensus in general, regarding the best option. This Instructional course article is an analysis of available treatment options used for neglected femoral neck fracture in the literature and attempt to suggest treatment guides for neglected femoral neck fracture. We conducted the “Pubmed” search with the keywords “NU femoral neck fracture and/or neglected femoral neck fracture, muscle-pedicle bone graft in femoral neck fracture, fibular graft in femoral neck fracture and valgus osteotomy in femoral neck fracture.” A total of 203 print articles were obtained as the search result. Thirty three articles were included in the analysis and were categorized into four subgroups based on treatment options. (a) treated by muscle-pedicle bone grafting (MPBG), (b) closed/open reduction internal fixation and fibular grafting (c) open reduction and internal fixation with valgus osteotomy, (d) miscellaneous procedures. The data was pooled from all groups for mean neglect, the type of study (prospective or retrospective), classification used, procedure performed, mean followup available, outcome, complications, and reoperation if any. The outcome of neglected femoral neck fracture depends on the duration of neglect, as the changes occurring in the fracture area and fracture fragments decides the need and type of biological stimulus required for fracture union. In stage I and stage II (Sandhu's staging) neglected femoral neck fracture osteosynthesis with open reduction and bone grafting with MPBG or Valgus Osteotomy achieves fracture union in almost 90% cases. However, in stage III with or without AVN, the results of osteosynthesis are poor and the choice of treatment is replacement arthroplasty (hemi or total). PMID:25593354

  3. [Examination of neck pain in adults].

    PubMed

    Arokoski, Jari; Karppinen, Jaro; Kankaanpää, Markku; Kaukinen, Päiivi; Laimi, Katri

    2014-01-01

    An accurate diagnosis is not obtained for most patients suffering from neck symptoms. Benign nonspecific pain is most common. Knowledge of functional anatomy and neuroanatomy forms the basis of clinical examination. Anamnesis and clinical examination are utilized to explore the need for further investigation and therapy. No particular instrumental investigations are needed in the exploration of the pain, unless the symptoms and clinical findings indicate any severe or specific illness. In clinical work it is practical to divide neck pain into four groups: a severe or specific illness, nerve root entrapment, nonspecific neck pain and whiplash injury. PMID:25558608

  4. Endovascular Embolization of Head and Neck Tumors

    PubMed Central

    Lazzaro, Marc A.; Badruddin, Aamir; Zaidat, Osama O.; Darkhabani, Ziad; Pandya, Dhruvil J.; Lynch, John R.

    2011-01-01

    Endovascular tumor embolization as adjunctive therapy for head and neck cancers is evolving and has become an important part of the tools available for their treatment. Careful study of tumor vascular anatomy and adhering to general principles of intra-arterial therapy can prove this approach to be effective and safe. Various embolic materials are available and can be suited for a given tumor and its vascular supply. This article aims to summarize current methods and agents used in endovascular head and neck tumor embolization and discuss important angiographic and treatment characteristics of selected common head and neck tumors. PMID:22022319

  5. Imaging evaluation of the suprahyoid neck.

    PubMed

    Gamss, Caryn; Gupta, Ajay; Chazen, J Levi; Phillips, C Douglas

    2015-01-01

    Evaluating the complex anatomy of the suprahyoid neck on imaging studies can be a daunting task without a sound understanding of anatomy and a systematic approach. In this article, the suprahyoid neck is divided into characteristic anatomic spaces, which allow for the accurate localization of both normal structures and abnormal pathology in the neck. Once a lesion is localized to a specific suprahyoid space, imaging characteristics and clinical data can be used in a logical fashion to provide a clinically useful imaging differential diagnosis. PMID:25476177

  6. Thyroid rupture secondary to blunt neck trauma.

    PubMed

    Sow, Yih-Liang; Aziz, Nora Abdul; Ng, Khoon-Leong

    2013-04-01

    Rupture of the thyroid gland is uncommon in cases of blunt neck trauma. We report a case of thyroid rupture after a motor vehicle accident in a patient without a preexisting goiter. He presented with a painful anterior neck swelling associated with dysphagia and hoarseness of voice. Computed tomographic scans showed lacerations of the right thyroid lobe and isthmus with features suggestive of slow active bleeding. Neck exploration was subsequently performed, and a ruptured right thyroid lobe was found with ongoing venous hemorrhage. A right hemithyroidectomy was performed, and the patient recovered without complications. PMID:23399341

  7. The relationship between lower neck shear force and facet joint kinematics during automotive rear impacts.

    PubMed

    Stemper, Brian D; Yoganandan, Narayan; Pintar, Frank A; Maiman, Dennis J

    2011-04-01

    A primary goal of biomechanical safety research is the definition of localized injury thresholds in terms of quantities that are repeatable and easily measureable during experimentation. Recent biomechanical experimentation using human cadavers has highlighted the role of lower cervical facet joints in the injury mechanism resulting from low-speed automotive rear impacts. The present study was conducted to correlate lower neck forces and moments with facet joint motions during simulated rear impacts in an effort to define facet joint injury tolerance thresholds that can be used to assess automobile safety. Four male and four female intact head-neck complexes were obtained from cadaveric specimens and subjected to simulated automotive rear impacts using a pendulum-minisled device. Cervical spine segmental angulations and localized facet joint kinematics were correlated to shear and axial forces, and bending moments at the cervico-thoracic junction using linear regression. R(2) coefficients indicated that spinal kinematics correlated well with lower neck shear force and bending moment. Correlation slope was steeper in female specimens, indicating greater facet joint motions for a given loading magnitude. This study demonstrated that lower neck loads can be used to predict lower cervical facet joint kinematics during automotive rear impacts. Higher correlation slope in female specimens corresponds to higher injury susceptibility in that population. Although lower neck shear force and bending moment demonstrated adequate correlation with lower cervical facet joint motions, shear force is likely the better predictor due to similarity in the timing of peak magnitudes with regard to maximum facet joint motions. PMID:21433081

  8. Timely management of penetrating neck trauma: Report of three cases

    PubMed Central

    Kaya, Kamil Hakan; Koç, Arzu Karaman; Uzut, Mahmut; Altintaş, Ahmet; Yeğin, Yakup; Sayın, İbrahim; Kayhan, Fatma Tülin

    2013-01-01

    In head and neck surgery, penetrating neck injuries are uncommon. The neck contains many important structures, so such trauma can cause significant morbidity and mortality. A patient with penetrating neck trauma should be examined promptly in the emergency room. If possible, damaged tissue and organ fragments should be preserved carefully. PMID:24339665

  9. Neck muscle function in violinists/violists with and without neck pain.

    PubMed

    Steinmetz, Anke; Claus, Andrew; Hodges, Paul W; Jull, Gwendolen A

    2016-04-01

    Neck pain is associated with changes in neuromuscular control of cervical muscles. Violin and viola playing requires good function of the flexor muscles to stabilize the instrument. This study investigated the flexor muscle behaviour in violin/viola players with and without neck pain using the craniocervical flexion test (CCFT). In total, 12 violin/viola players with neck pain, 21 violin/viola players without neck pain in the preceding 12 weeks and 21 pain-free non-musicians were included. Activity of the sternocleidomastoid muscles (SCM) was measured with surface electromyography (EMG) during the CCFT. Violin/viola players with neck pain displayed greater normalised SCM EMG amplitudes during CCFT than the pain-free musicians and non-musicians (P < 0.05). Playing-related neck pain in violinists/violists is associated with altered behaviour of the superficial neck flexor muscles consistent with neck pain, despite the specific use of the deep and superficial neck flexors during violin playing. PMID:26175099

  10. Prevention of complications in neck dissection

    PubMed Central

    Kerawala, Cyrus J; Heliotos, Manolis

    2009-01-01

    Background The neck dissection has remained a pivotal aspect of head and neck cancer management for over a century. During this time its role has expanded from a purely therapeutic option into an elective setting, in part promoted by efforts to reduce its morbidity. Objectives This review will consider the potential complications of neck dissection and on the basis of the available evidence describe both their management and prevention. Conclusion Although the neck dissection continues to provide clinicians with a method of addressing cervical disease, its reliability and safety can only be assured if surgeons remain cognisant of the potential complications and aim to minimise such morbidity by appropriate management in the peri-operative period. PMID:19822010

  11. Drugs Approved for Head and Neck Cancer

    Cancer.gov

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for head and neck cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

  12. Synergistic Approaches to Neck Rejuvenation and Lifting.

    PubMed

    Weinkle, Allison P; Sofen, Bryan; Emer, Jason

    2015-11-01

    There is an increasing trend shifting the aesthetic focus downward from the face with a significant number of new treatments aimed at the aging neck and below. Clinical characteristics of neck youth include clear skin texture and tone without laxity or fat, in addition to a well-defined cervicomental angle and distinct mandibular border. Similarly to treating facial aging, the neck requires a comprehensive assessment of all factors involved in the aging process--loss of volume, increased skin laxity, worsening texture and clarity, and crepe skin/wrinkling--as each requires a combination approach for improvement. It is essential to address each above factors for more than minimal improvement. A multitude of options including neuromodulators, energy based devices, surgery, and injectable agents for fat reduction are available in our armamentarium and understanding these options solo, or ideally in combination, is essential for best practice and optimal results. Herein, we describe synergic approaches to the treatment of neck aging. PMID:26580870

  13. Aging small Canada geese by neck plumage

    USGS Publications Warehouse

    Higgins, K.F.; Schoonover, L.J.

    1969-01-01

    The neck plumage method, a new technique for separating immature from adult Canada geese (Branta canadensis) in the hand, was evaluated by comparison with the notched tail feather and cloacal examination methods. Two (1.4 percent) of 141 geese examined were misaged, resulting in a 6 percent error in the immature-adult ratio obtained by the neck plumage method. The neck plumage method is a rapid aging method and reasonable accuracy (94 percent) can be obtained. It can also be used to differentiate immatures from adults on the ground at distances up to 175 yards, but was almost impossible to use when geese were in flight. As yet, the neck plumage method has only been tested on the subspecies (B. c. hutchinsii-parvipes complex) in the Tall-Grass Prairie population of small Canada geese.

  14. Chronic Neck Pain and Cervico-Craniofacial Pain Patients Express Similar Levels of Neck Pain-Related Disability, Pain Catastrophizing, and Cervical Range of Motion

    PubMed Central

    Muñoz-García, Daniel; Gil-Martínez, Alfonso; López-López, Almudena; Lopez-de-Uralde-Villanueva, Ibai; La Touche, Roy; Fernández-Carnero, Josué

    2016-01-01

    Background. Neck pain (NP) is strongly associated with cervico-craniofacial pain (CCFP). The primary aim of the present study was to compare the neck pain-related disability, pain catastrophizing, and cervical and mandibular ROM between patients with chronic mechanical NP and patients with CCFP, as well as asymptomatic subjects. Methods. A total of 64 participants formed three groups. All participants underwent a clinical examination evaluating the cervical range of motion and maximum mouth opening, neck disability index (NDI), and psychological factor of Pain Catastrophizing Scale (PCS). Results. There were no statistically significant differences between patients with NP and CCFP for NDI and PCS (P > 0.05). One- way ANOVA revealed significant differences for all ROM measurements. The post hoc analysis showed no statistically significant differences in cervical extension and rotation between the two patient groups (P > 0.05). The Pearson correlation analysis shows a moderate positive association between NDI and the PCS for the group of patients with NP and CCFP. Conclusion. The CCFP and NP patient groups have similar neck disability levels and limitation in cervical ROM in extension and rotation. Both groups had positively correlated the NDI with the PCS. PMID:27119020

  15. Improved Jänecke mass formula

    NASA Astrophysics Data System (ADS)

    He, Z.; Bao, M.; Zhao, Y. M.; Arima, A.

    2014-11-01

    In this paper we improve an empirical mass formula constructed by Jänecke and collaborators. This formula is enlightened by the Garvey-Kelson mass relations. The new version of the Jänecke formula reproduces 2275 atomic masses with neutron number N ≥10 and proton number Z ≥6 , at an average accuracy of 128 keV, by employing 576 parameters. The predictive power of our formula is exemplified by comparison with predicted results of other mass models.

  16. Migratory foreign body in the neck.

    PubMed

    Sreetharan, S S; Prepageran, Narayanan; Singh, Satwant

    2005-04-01

    Oesophageal penetration and migration of foreign bodies are fairly rare occurrences. Most reported cases in the literature involve fish bones, which are eventually found in the lateral neck soft tissue or thyroid lobule. We present a case of a migrating fish bone in an elderly female which was found embedded in her right sternocleidomastoid muscle. The fish bone was successfully removed via neck exploration. Appropriate literature is reviewed. PMID:15851369

  17. Head and Neck Cancer: An Overview

    PubMed Central

    Stepnick, David; Gilpin, David

    2010-01-01

    Ablative surgery for malignancies of the upper aerodigestive tract is the most common reason why the reconstructive surgeon is called upon to reconstruct adult head and neck defects. An understanding of the pathophysiology and treatment of head and neck malignancy is vital to the reconstructive surgeon so that restoration of both form and function can be achieved. It is important to understand the behavior of cancers of each head and neck subsite, as staging and ultimately the treatment of tumors from each subsite is different. Historically, the standard treatment of head and neck cancer was surgery and/or primary radiation therapy with surgical salvage for failure. Beginning in the 1980s, advances in chemotherapy and concurrent delivery with radiation offered new options to standard surgical therapy. Over the past two decades, the concept of organ preservation using chemotherapy together with radiation therapy has been definitively established. Yet, even with the strides made over these two decades with chemoradiation, surgical treatment of head and neck cancer and reconstruction thereof will be an important treatment option for the foreseeable future. Therefore, the relationship between the extirpative and reconstructive surgeon is vital, and a clear understanding of the biology and behavior of head and neck malignancy is crucial to successful patient outcomes. PMID:22550431

  18. Neck strength: a protective factor reducing risk for concussion in high school sports.

    PubMed

    Collins, Christy L; Fletcher, Erica N; Fields, Sarah K; Kluchurosky, Lisa; Rohrkemper, Mary Kay; Comstock, R Dawn; Cantu, Robert C

    2014-10-01

    As the number of high school students participating in athletics continues to increase, so will the number of sports-related concussions unless effective concussion prevention programs are developed. We sought to develop and validate a cost-effective tool to measure neck strength in a high school setting, conduct a feasibility study to determine if the developed tool could be reliably applied by certified athletic trainers (ATs) in a high school setting, and conduct a pilot study to determine if anthropometric measurements captured by ATs can predict concussion risk. In the study's first phase, 16 adult subjects underwent repeated neck strength testing by a group of five ATs to validate the developed hand-held tension scale, a cost effective alternative to a hand-held dynamometer. In the second phase, during the 2010 and 2011 academic years, ATs from 51 high schools in 25 states captured pre-season anthropometric measurements for 6,704 high school athletes in boys' and girls' soccer, basketball, and lacrosse, as well as reported concussion incidence and athletic exposure data. We found high correlations between neck strength measurements taken with the developed tool and a hand-held dynamometer and the measurements taken by five ATs. Smaller mean neck circumference, smaller mean neck to head circumference ratio, and weaker mean overall neck strength were significantly associated with concussion. Overall neck strength (p < 0.001), gender (p < 0.001), and sport (p = 0.007) were significant predictors of concussions in unadjusted models. After adjusting for gender and sport, overall neck strength remained a significant predictor of concussion (p = 0.004). For every one pound increase in neck strength, odds of concussion decreased by 5 % (OR = 0.95, 95 % CI 0.92-0.98). We conclude that identifying differences in overall neck strength may be useful in developing a screening tool to determine which high school athletes are at higher risk of concussion. Once identified, these athletes could be targeted for concussion prevention programs. PMID:24930131

  19. Diagnostic value of sentinel lymph node biopsy in head and neck cancer: a meta-analysis.

    PubMed

    Thompson, C F; St John, M A; Lawson, G; Grogan, T; Elashoff, D; Mendelsohn, A H

    2013-07-01

    This study aimed to evaluate the diagnostic reliability of sentinel lymph node biopsy in patients with squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx by reviewing the published literature. A systematic literature review was performed using MEDLINE from 1970 to 2011. With Boolean search strings, search terms included sentinel node, supraglottic, supraglottis, tongue, head and neck, oral, pharynx, laryngeal, and larynx. Additional studies were identified through article references. Duplicate data and articles were excluded based on treating institution and study inclusion time period. Additional studies were excluded if the head and neck subsite or tumor stage was not specifically identified or if the sentinel lymph node biopsy occurred in previously treated necks. All patients had sentinel lymph node biopsy performed followed by a concurrent neck dissection. Twenty-six studies met our inclusion criteria (n = 766 patients). The pooled sensitivity and negative predictive value of SLNB for all head and neck tumors was 95 % (95 % CI 91-99 %) and 96 % (95 %CI 94-99 %), respectively. The overall sensitivity and negative predictive value of SLNB in the subset of oral cavity tumors (n = 631) was 94 % (95 % CI 89-98 %) and 96 % (95 % CI 93-99 %), respectively. One-hundred percent of oropharyngeal (n = 72), hypopharyngeal (n = 5), and laryngeal (n = 58) tumor sentinel lymph biopsy results correlated with subsequent neck dissections giving a negative predictive value of 100 %, showing that, sentinel lymph node biopsy is a valid diagnostic technique to correctly stage regional metastases in patients with head and neck squamous cell carcinoma. PMID:23263205

  20. Lessons learned from next-generation sequencing in head and neck cancer

    PubMed Central

    Loyo, Myriam; Li, Ryan J.; Bettegowda, Chetan; Pickering, Curtis R.; Frederick, Mitchell J.; Myers, Jeffrey N.; Agrawal, Nishant

    2013-01-01

    Scientific innovation has enabled whole exome capture and massively parallel sequencing of cancer genomes. In head and neck cancer, next-generation sequencing has granted us further understanding of the mutational spectrum of squamous cell carcinoma. As a result of these new technologies, frequently occurring mutations were identified in NOTCH1, a gene that had not previously been implicated in head and neck cancer. The current review describes the most common mutations in head and neck cancer: TP53, NOTCH1, HRAS, PIK3CA, and CDKN2A. Emphasis is placed on the involved cellular pathways, clinical correlations, and potential therapeutic interventions. Additionally, the implications of human papillomavirus on mutation patterns are discussed. PMID:22907887

  1. The relationship between cervical flexor endurance, cervical extensor endurance, VAS, and disability in subjects with neck pain

    PubMed Central

    2014-01-01

    Background Several tests have been suggested to assess the isometric endurance of the cervical flexor (NFME) and extensors (NEE) muscles. This study proposes to determine whether neck flexors endurance is related to extensor endurance, and whether cervical muscle endurance is related to disability, pain amount and pain stage in subjects with neck pain. Methods Thirty subjects (18 women, 12 men, mean ± SD age: 43 ± 12 years) complaining of neck pain filled out the Visual Analogue Scale (VAS) and the Neck Pain and Disability Scale-Italian version (NPDS-I). They also completed the timed endurance tests for the cervical muscles. Results The mean endurance was 246.7 ± 150 seconds for the NEE test, and 44.9 ± 25.3 seconds for the NMFE test. A significant correlation was found between the results of these two tests (r = 0.52, p = 0.003). A positive relationship was also found between VAS and NPDS-I (r = 0.549, p = 0.002). The endurance rates were similar for acute/subacute and chronic subjects, whereas males demonstrated significantly higher values compared to females in NFME test. Conclusions These findings suggest that neck flexors and extensors endurance are correlated and that the cervical endurance is not significantly altered by the duration of symptoms in subjects with neck pain. PMID:24581272

  2. Femoral neck shortening after internal fixation of a femoral neck fracture.

    PubMed

    Zielinski, Stephanie M; Keijsers, Noël L; Praet, Stephan F E; Heetveld, Martin J; Bhandari, Mohit; Wilssens, Jean Pierre; Patka, Peter; Van Lieshout, Esther M M

    2013-07-01

    This study assesses femoral neck shortening and its effect on gait pattern and muscle strength in patients with femoral neck fractures treated with internal fixation. Seventy-six patients from a multicenter randomized controlled trial participated. Patient characteristics and Short Form 12 and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were collected. Femoral neck shortening, gait parameters, and maximum isometric forces of the hip muscles were measured and differences between the fractured and contralateral leg were calculated. Variables of patients with little or no shortening, moderate shortening, and severe shortening were compared using univariate and multivariate analyses. Median femoral neck shortening was 1.1 cm. Subtle changes in gait pattern, reduced gait velocity, and reduced abductor muscle strength were observed. Age, weight, and Pauwels classification were risk factors for femoral neck shortening. Femoral neck shortening decreased gait velocity and seemed to impair gait symmetry and physical functioning. In conclusion, internal fixation of femoral neck fractures results in permanent physical limitations. The relatively young and healthy patients in our study seem capable of compensating. Attention should be paid to femoral neck shortening and proper correction with a heel lift, as inadequate correction may cause physical complaints and influence outcome. PMID:23823040

  3. MRI of cerebrum and cervical columna within two days after whiplash neck sprain injury.

    PubMed

    Borchgrevink, G; Smevik, O; Haave, I; Haraldseth, O; Nordby, A; Lereim, I

    1997-01-01

    The present study was undertaken to evaluate if MRI within 2 days of a motor vehicle accident could reveal pathology of importance for understanding long-term disability after whiplash neck-sprain injuries. As part of a prospective study cervical and cerebral MRI was performed on 40 neck sprain patients with whiplash injury after car accidents. The imaging was done within 2 days of the injury to make sure that any neck muscle bleeding, oedema or other soft tissue injuries could be detected. The MRI findings from the patients were both correlated to reported symptoms 6 months after the accident and compared to a control group of 20 volunteers. The MRI of both brain and neck revealed no significant differences between the patients and the control group. When the patients were grouped according to the main MRI findings at intake and compared according to the development of subjective symptoms reported by the patients, the only significant difference was more headaches at 6 months in the groups with disk pathology or spondylosis when compared to the group with no pathology. In conclusion, MRI within 2 days of the whiplash neck-sprain injury could not detect pathology connected to the injury nor predict symptom development and outcome. PMID:9764227

  4. Modelling fluid accumulation in the neck using simple baseline fluid metrics: implications for sleep apnea.

    PubMed

    Vena, Daniel; Yadollahi, A; Bradley, T Douglas

    2014-01-01

    Obstructive sleep apnea (OSA) is a common respiratory disorder among adults. Recently we have shown that sedentary lifestyle causes an increase in diurnal leg fluid volume (LFV), which can shift into the neck at night when lying down to sleep and increase OSA severity. The purpose of this work was to investigate various metrics that represent baseline fluid retention in the legs and examine their correlation with neck fluid volume (NFV) and to develop a robust model for predicting fluid accumulation in the neck. In 13 healthy awake non-obese men, LFV and NFV were recorded continuously and simultaneously while standing for 5 minutes and then lying supine for 90 minutes. Simple regression was used to examine correlations between baseline LFV, baseline neck circumference (NC) and change in LFV with the outcome variables: change in NC (ΔNC) and in NFV (ΔNFV90) after lying supine for 90 minutes. An exhaustive grid search was implemented to find combinations of input variables which best modeled outcomes. We found strong positive correlations between baseline LFV (supine and standing) and ΔNFV90. Models developed for predicting ΔNFV90 included baseline standing LFV, baseline NC combined with change in LFV after lying supine for 90 minutes. These correlations and the developed models suggest that a greater baseline LFV might contribute to increased fluid accumulation in the neck. These results give more evidence that sedentary lifestyle might play a role in the pathogenesis of OSA by increasing the baseline LFV. The best models for predicting ΔNC include baseline LFV and NC; they improved accuracies of estimating ΔNC over individual predictors, suggesting that a combination of baseline fluid metrics is a good predictor of the change in NC while lying supine. Future work is aimed at adding additional baseline demographic features to improve model accuracy and eventually use it as a screening tool to predict severity of OSA prior to sleep. PMID:25569948

  5. Neck Rejuvenation with Fractional CO2 Laser

    PubMed Central

    Oram, Yasemin

    2014-01-01

    Objective: To assess the effectiveness of 10,600nm fractional CO2 laser for neck aging at one month and one year after treatment. Design/Setting/Participants/Measurement: Twenty patients underwent 10,600nm fractional CO2 laser treatment over the entire neck. Clinical features of the patients were classified according to Baker classification. The degrees of skin laxity, jowling, fat deposition, and horizontal neck lines were evaluated using a 9-point scale, prior to treatment at one month and one year after the treatment. The patients were independently assessed by the authors at two different times in a blinded fashion. Results: Skin laxity, jowling, fat deposition, and horizontal neck lines scores were significantly lower than the baseline values at one month and one year. One-year follow-up values of the same parameters were still significantly lower than the baseline. No persistent complication developed after treatment. Conclusion: The results of this study confirm that fractional CO2 neck rejuvenation is an effective treatment option with long-term efficacy for patients who mainly have skin laxity and jowling together with skin surface pigmentation. PMID:25161757

  6. Radiotherapy for Head and Neck Cancer

    PubMed Central

    Yeh, Shyh-An

    2010-01-01

    Treatment for patients with head and neck cancer requires a multidisciplinary approach. Radiotherapy is employed as a primary treatment or as an adjuvant to surgery. Each specific subsite dictates the appropriate radiotherapy techniques, fields, dose, and fractionation scheme. Quality of life is also an important issue in the management of head and neck cancer. The radiation-related complications have a tremendous impact on the quality of life. Modern radiotherapy techniques, such as intensity-modulated radiotherapy and image-guided radiotherapy, can offer precise radiation delivery and reduce the dose to the surrounding normal tissues without compromise of target coverage. In the future, efforts should be made in the exploration of novel strategies to improve treatment outcome in patients with head and neck cancer. PMID:22550433

  7. Head and neck manifestations in HIV infection.

    PubMed

    Hillel, Alexander; O'Mara, William; Nemechek, Andrew; Mushatt, David M

    2004-01-01

    Diseases of the head and neck often are the first sign of Human Immunodeficiency Virus (HIV) infection. As current treatment increases the survival time of HIV-positive patients, the physician may encounter patients with a greater variety and number of diseases related to the primary HIV infection. Some entities are harbingers of HIV infection, such as Kaposi's sarcoma and parotid cystic enlargement. Other manifestations, such as Mycobacterium avium complex infection, may be used to determine the stage of HIV infection. The advent of highly active anti-retroviral therapy (HAART) has transformed the prevalence of HIV-associated head and neck disease. This article reviews the clinical presentations and treatments of common and uncommon head and neck manifestations in HIV infection. Accurate assessment of these conditions may allow the physician to identify HIV infection in previously undiagnosed patients, and, as a result, provide more timely treatment. PMID:15554094

  8. Neck kinematics and sternocleidomastoid muscle activation during neck rotation in subjects with forward head posture.

    PubMed

    Kim, Man-Sig

    2015-11-01

    [Purpose] The present study investigated differences in the kinematics of the neck and activation of the sternocleidomastoid (SCM) muscle during neck rotation between subjects with and without forward head posture (FHP). [Subjects and Methods] Twenty-eight subjects participated in the study (14 with FHP, 14 without FHP). Subjects performed neck rotation in two directions, left and right. The kinematics of rotation-lateral flexion movement patterns were recorded using motion analysis. Activity in the bilateral SCM muscles was measured using surface electromyography. Differences in neck kinematics and activation of SCM between the groups were analyzed by independent t-tests. [Results] Maintaining FHP increased the rotation-lateral flexion ratio significantly in both directions. The FHP group had significantly faster onset time for lateral flexion movement in both directions during neck rotation. Regarding the electromyography of the SCM muscles during neck rotation in both directions, the activity values of subjects with FHP were greater than those of subjects without FHP for the contralateral SCM muscles. [Conclusion] FHP can induce changes in movement in the frontal plane and SCM muscle activation during neck rotation. Thus, clinicians should consider movement in the frontal plane as well as in the sagittal plane when assessing and treating patients with forward head posture. PMID:26696712

  9. Neck kinematics and sternocleidomastoid muscle activation during neck rotation in subjects with forward head posture

    PubMed Central

    Kim, Man-Sig

    2015-01-01

    [Purpose] The present study investigated differences in the kinematics of the neck and activation of the sternocleidomastoid (SCM) muscle during neck rotation between subjects with and without forward head posture (FHP). [Subjects and Methods] Twenty-eight subjects participated in the study (14 with FHP, 14 without FHP). Subjects performed neck rotation in two directions, left and right. The kinematics of rotation-lateral flexion movement patterns were recorded using motion analysis. Activity in the bilateral SCM muscles was measured using surface electromyography. Differences in neck kinematics and activation of SCM between the groups were analyzed by independent t-tests. [Results] Maintaining FHP increased the rotation-lateral flexion ratio significantly in both directions. The FHP group had significantly faster onset time for lateral flexion movement in both directions during neck rotation. Regarding the electromyography of the SCM muscles during neck rotation in both directions, the activity values of subjects with FHP were greater than those of subjects without FHP for the contralateral SCM muscles. [Conclusion] FHP can induce changes in movement in the frontal plane and SCM muscle activation during neck rotation. Thus, clinicians should consider movement in the frontal plane as well as in the sagittal plane when assessing and treating patients with forward head posture. PMID:26696712

  10. The prognostic value of cyclin D1 expression in head and neck squamous cell carcinoma.

    PubMed

    Gioacchini, Federico M; Alicandri-Ciufelli, Matteo; Kaleci, Shaniko; Magliulo, Giuseppe; Presutti, Livio; Re, Massimo

    2016-04-01

    The correlation between cyclin D1 overexpression and the clinical outcome of head and neck cancer is not defined. The aim of this meta-analysis was to evaluate the prognostic value of cyclin D1 in patients with head and neck cancer. A search thorough Ovid MEDLINE was performed to enroll all eligible articles. Twenty-two studies comprising a total of 1,929 patients with different head and neck cancers were included. Cyclin D1 overexpression was significantly associated with lymph node metastasis [OR 2.25; 95 % confidence interval (CI) 1.76-2.87] and worse disease-free survival (OR 3.06; 95 % CI 2.42-3.87]. Subgroup analysis revealed that cyclin D1 overexpression correlated significantly with nodal metastasis for laryngeal cancer (OR 2.26; 95 % CI 1.61-3.16) and was a significant poor predictor for nasopharyngeal cancer (OR 4.44; 95 % CI 1.89-10.42). Our meta-analysis suggests that cyclin D1 overexpression could represent an important prognostic indicator for patients with head and neck cancer. PMID:25516222

  11. Prediction of Neck Dissection Requirement After Definitive Radiotherapy for Head-and-Neck Squamous Cell Carcinoma

    SciTech Connect

    Thariat, Juliette; Ahamad, Anesa; Williams, Michelle D.; Myers, Jeffrey N.; El-Naggar, Adel K.; Ginsberg, Lawrence E.; Rosenthal, David I.; Glisson, Bonnie S.; Weber, Randal S.; Garden, Adam S.

    2012-03-01

    Background: This analysis was undertaken to assess the need for planned neck dissection in patients with a complete response (CR) of involved nodes after irradiation and to determine the benefit of a neck dissection in those with less than CR by tumor site. Methods: Our cohort included 880 patients with T1-4, N1-3M0 squamous cell carcinoma of the oropharynx, larynx, or hypopharynx who received treatment between 1994 and 2004. Survival curves were calculated by the Kaplan-Meier Method, comparisons of rates with the log-rank test and prognostic factors by Cox's proportional hazard model. Results: Nodal CR occurred in 377 (43%) patients, of whom 365 patients did not undergo nodal dissection. The 5-year actuarial regional control rate of patients with CR was 92%. Two hundred sixty-eight of the remaining patients (53%) underwent neck dissections. The 5-year actuarial regional control rate for patients without a CR was 84%. Those who had a neck dissection fared better with 5-year actuarial regional control rates of 90% and 76% for those operated and those not operated (p < 0.001). Variables associated with poorer regional control rates included higher T and N stage, non-oropharynx cancers, non-CR, both clinical and pathological. Conclusions: With 92% 5-year neck control rate without neck dissection after CR, there is little justification for systematic neck dissection. The addition of a neck dissection resulted in higher neck control after partial response though patients with viable tumor on pathology specimens had poorer outcomes. The identification of that subgroup that benefits from additional treatment remains a challenge.

  12. Prediction of Neck Dissection Requirement After Definitive Radiotherapy for Head and Neck Squamous Cell Carcinoma

    PubMed Central

    Thariat, Juliette; Ang, K. Kian; Allen, Pamela K.; Ahamad, Anesa; Williams, Michelle D.; Myers, Jeffrey N.; El-Naggar, Adel K.; Ginsberg, Lawrence E.; Rosenthal, David I.; Glisson, Bonnie S.; Morrison, William H.; Weber, Randal S.; Garden, Adam S.

    2014-01-01

    BACKGROUND This analysis was undertaken to assess the need for planned neck dissection in patients with a complete response (CR) of involved nodes after irradiation, and to determine the benefit of a neck dissection in those with less than CR by tumor site. METHODS Our cohort included 880 patients with T1-4, N1-3M0 squamous cell carcinoma of the oropharynx, larynx or hypopharynx who received treatment between 1994 and 2004. Survival curves were calculated by the Kaplan-Meier Method, comparisons of rates with the log-rank test and prognostic factors by Cox analyses. RESULTS Nodal CR occurred in 377 (43%) patients of whom 365 patients did not undergo nodal dissection. The 5-year actuarial regional control rate of patients with CR was 92%. Two hundred sixty-eight of the remaining patients (53%) underwent neck dissections. The 5-year actuarial regional control rate for patients without a CR was 84%. Those who had a neck dissection fared better with 5-year actuarial regional control rates of 90% and 76% for those operated and those not operated (p <.001). Variables associated with poorer regional control rates included higher T and N stage, non-oropharynx cancers, non-CR, both clinical and pathological. CONCLUSIONS With 92% 5-year neck control rate without neck dissection after CR, there is little justification for systematic neck dissection. The addition of a neck dissection resulted in higher neck control after partial response though patients with viable tumor on pathology specimens had poorer outcomes. The identification of that subgroup that benefits from additional treatment remains a challenge. PMID:22284033

  13. Approach to intensely enhancing neck nodes

    PubMed Central

    Karandikar, Amit; Gummalla, Krishna Mohan; Loke, Siu Cheng; Goh, Julian; Tan, Tiong Yong

    2016-01-01

    Cervical node evaluation is one of the most common problems encountered by a radiologist. Here, we present a pictorial review of intensely enhancing neck nodes. While enhancement in a cervical node is a common radiologic finding on contrast-enhanced computed tomography scan, only few conditions cause intense enhancement in cervical nodes. We discuss the common causes of intensely enhancing neck nodes along with pertinent radiologic features and key differentiating points that aid radiologists in reaching a diagnosis. In addition, we discuss certain potential non-nodal mimics, which need to be excluded. PMID:26782154

  14. Hyperparathyroidism following head and neck irradiation

    SciTech Connect

    Rao, S.D.; Frame, B.; Miller, M.J.; Kleerskoper, M.; Block, M.A.; Parfitt, A.M.

    1980-02-01

    A history of head and neck irradiation in childhood or adolescence was found in 22 of 130 patients with primary hyperparathyroidism compared with only 12 of 400 control patients. Among 200 patients with a known history of childhood irradiation, biochemical or surgical evidence of hyperparathyroidism was found in ten, a prevalence of 5%. This is at least 30 times the prevalence of hyperparathyroidism in the general population. The data indicate that head and neck irradiation should be regarded as an important risk factor in the subsequent development of hyperparathyroidism.

  15. PET-CT–Guided Surveillance of Head and Neck Cancers

    Cancer.gov

    Patients with advanced squamous cell carcinoma of the head and neck who underwent PET-CT–guided surveillance had fewer operations but similar overall survival rates to those of patients who underwent planned neck dissection.

  16. Add Neck Problems to Reasons Not to Smoke

    MedlinePlus

    ... with age, and this degeneration can lead to neck pain. This new study found that smoking seems to ... and there are lifestyle factors associated with chronic neck pain," said lead investigator Dr. Mitchel Leavitt. He is ...

  17. An Advanced Quantitative Echosound Methodology for Femoral Neck Densitometry.

    PubMed

    Casciaro, Sergio; Peccarisi, Marco; Pisani, Paola; Franchini, Roberto; Greco, Antonio; De Marco, Tommaso; Grimaldi, Antonella; Quarta, Laura; Quarta, Eugenio; Muratore, Maruizio; Conversano, Francesco

    2016-06-01

    The aim of this paper was to investigate the clinical feasibility and the accuracy in femoral neck densitometry of the Osteoporosis Score (O.S.), an ultrasound (US) parameter for osteoporosis diagnosis that has been recently introduced for lumbar spine applications. A total of 377 female patients (aged 61-70 y) underwent both a femoral dual X-ray absorptiometry (DXA) and an echographic scan of the proximal femur. Recruited patients were sub-divided into a reference database used for ultrasound spectral model construction and a study population for repeatability assessments and accuracy evaluations. Echographic images and radiofrequency signals were analyzed through a fully automatic algorithm that performed a series of combined spectral and statistical analyses, providing as a final output the O.S. value of the femoral neck. Assuming DXA as a gold standard reference, the accuracy of O.S.-based diagnoses resulted 94.7%, with k = 0.898 (p < 0.0001). Significant correlations were also found between O.S.-estimated bone mineral density and corresponding DXA values, with r(2) up to 0.79 and root mean square error = 5.9-7.4%. The reported accuracy levels, combined with the proven ease of use and very good measurement repeatability, provide the adopted method with a potential for clinical routine application in osteoporosis diagnosis. PMID:27033331

  18. Parameters influencing AIS 1 neck injury outcome in frontal impacts.

    PubMed

    Jakobsson, Lotta; Norin, Hans; Svensson, Mats Y

    2004-06-01

    In order to gain more knowledge of the neck injury scenario in frontal impacts, a statistical study of parameters influencing incidences of AIS 1 neck injuries was performed. The data set consisted of 616 occupants in Volvo cars. Information regarding the crash, the safety systems, occupant characteristics (including prior neck problems), behavior and sitting posture at the time of impact, and neck symptoms (including duration) was collected and analyzed. Occupant characteristics (mainly gender, weight, and age), kinematics (head impacts) and behavior at the time of impact were identified as the most prominent parameter areas with regard to AIS 1 neck injury outcome. Specifically, women had a significantly higher AIS 1 neck injury rate as compared to men, occupants under the age of 50 had a significantly higher AIS 1 neck injury rate as compared to those above 50 and occupants weighing less than 65 kg have a significantly higher AIS 1 neck injury rate than heavier occupants. Drivers stating that they impacted their head against a frontal interior structure had a significantly higher AIS 1 neck injury rate than those without head impact. Also, occupants who stated they had tensed their neck muscles at the time of impact, had a significantly higher AIS 1 neck injury rate as compared to occupants who did not. Occupant activities, such as tightly gripping the steering wheel or straightening their arms showed a significantly increased AIS 1 neck injury rate, indicating that occupant behavior at time of impact could be influential with respect to AIS 1 neck injury outcome. Also, occupants reporting prior neck problems had a higher rate of persistent symptoms (>1 year) but no difference with respect to passing symptoms (<3 months) as compared to those without prior neck problems. Additionally, there was no distinct pattern for the duration of neck symptoms. PMID:15203952

  19. Myofascial trigger points, neck mobility and forward head posture in unilateral migraine.

    PubMed

    Fernández-de-Las-Peñas, C; Cuadrado, M L; Pareja, J A

    2006-09-01

    This paper describes the differences in the presence of myofascial trigger points (TrPs) in the upper trapezius, sternocleidomastoid, temporalis and suboccipital muscles between unilateral migraine subjects and healthy controls, and the differences in the presence of TrPs between the symptomatic side and the non-symptomatic side in migraine subjects. In addition, we assess the differences in the presence of both forward head posture (FHP) and active neck mobility between migraine subjects and healthy controls and the relationship between FHP and neck mobility. Twenty subjects with unilateral migraine without side-shift and 20 matched controls participated. TrPs were identified when there was a hypersensible tender spot in a palpable taut band, local twitch response elicited by the snapping palpation of the taut band and reproduction of the referred pain typical of each TrP. Side-view pictures were taken in both sitting and standing positions to measure the cranio-vertebral angle. A cervical goniometer was employed to measure neck mobility. Migraine subjects showed a significantly greater number of active TrPs (P<0.001), but not latent TrPs, than healthy controls. Active TrPs were mostly located ipsilateral to migraine headaches (P<0.01). Migraine subjects showed a smaller cranio-vertebral angle than controls (P<0.001), thus presenting a greater FHP. Neck mobility in migraine subjects was less than in controls only for extension (P=0.02) and the total range of motion in flexion/extension (P=0.01). However, there was a positive correlation between the cranio-vertebral angle and neck mobility. Nociceptive inputs from TrPs in head and neck muscles may produce continuous afferent bombardment of the trigeminal nerve nucleus caudalis and, thence, activation of the trigeminovascular system. Active TrPs located ipsilateral to migraine headaches might be a contributing factor in the initiation or perpetuation of migraine. PMID:16919056

  20. Evidence of a hypermineralised calcified fibrocartilage on the human femoral neck and lesser trochanter

    PubMed Central

    SHEA, J. E.; VAJDA, E. G.; BLOEBAUM, R. D.

    2001-01-01

    Femoral neck fractures are a major cause of morbidity and mortality in elderly humans. In addition to the age-related loss of cancellous bone, changes to the microstructure and morphology of the metaphyseal cortex may be a contributing factor in osteoporotic hip fractures. Recent investigations have identified a hypermineralised tissue on the neck of the femur and trochanteric region that increases in fractional area with advancing age in both males (Boyce & Bloebaum, 1993) and females (Vajda & Bloebaum, 1999). The aim of this study was to determine if the hypermineralised tissue previously observed on the proximal femur is calcified fibrocartilage. Regional variations in the fractional area of hypermineralised tissue, cortical bone, and porosity of the cortical bone along the neck of the femur and lesser trochanter were also quantified. Comparison of back scattered electron and light microscope images of the same area show that regions of hypermineralised tissue correlate with the regions of calcified fibrocartilage from tendon and capsular insertions. The hypermineralised tissue and calcified fibrocartilage had similar morphological features such as the interdigitations of the calcified fibrocartilage into the bone, lacunar spaces, and distinctly shaped pores adjacent to the 2 tissues. Regions of the neck that did not contain insertions were covered with periosteum. There were no regional differences (P > 0.05) on the superior and inferior femoral neck in terms of the percentage area of hypermineralised calcified fibrocartilage, cortical bone, or cortical bone porosity. The lesser trochanter exhibited regional differences in the fractional area of hypermineralised calcified fibrocartilage (P = 0.007) and cortical bone (P = 0.007) but not porosity of the cortical bone (P > 0.05). The effects of calcified fibrocartilage on femoral neck periosteal expansion, repair, and mechanics are unknown, but may play a role in osteoporotic fractures and intracapsular fracture healing. PMID:11273040

  1. The relationship between survival and socio-economic status for head and neck cancer in Canada

    PubMed Central

    2014-01-01

    Background Human papilloma virus (HPV) is emerging as the primary cause for some head and neck cancers. The objective of this study was to investigate the association between head and neck cancer (HNC) survival and socioeconomic status (SES) in Canada, and to investigate changes in the relationship between HNC survival and SES from 1992 to 2005. Methods Cases were drawn from the Canadian Cancer Registry (1992–2005), and were categorized into three subsites: oropharynx, oral cavity, and “other” (hypopharynx, larynx, and nasopharynx). Demographic and socioeconomic information were extracted from the Canadian Census of Population data for the study period, which included three census years: 1991, 1996 and 2001. We linked cases to income quintiles (InQs) according to patients’ postal codes. Results Overall survival, without controlling for smoking, for oropharyngeal cancer increased dramatically from 1992–2005 in Canada. This increase in survival for oropharynx cancer was eliminated by the introduction of controls for smoking. Survival for all head and neck cancer subsites was strongly correlated with SES, as measured by income quintile, with lower InQ’s having lower survival than higher. Lastly, the magnitude of the difference in survival between the highest and lowest income quintiles increased significantly over the time period studied for oropharynx cancer, but did not statistically significantly change for oral cavity cancer or other head and neck cancers. Conclusions These data confirm a significant impact of socioeconomic deprivation on overall survival for head and neck cancers in Canada, and may provide indirect evidence that HPV-positive head and neck cancers are more common in higher socioeconomic groups. PMID:24422754

  2. Neck circumference as a new anthropometric indicator for prediction of insulin resistance and components of metabolic syndrome in adolescents: Brazilian Metabolic Syndrome Study

    PubMed Central

    da Silva, Cleliani de Cassia; Zambon, Mariana Porto; Vasques, Ana Carolina J.; Rodrigues, Ana Maria de B.; Camilo, Daniella Fernandes; Antonio, Maria Ângela R. de G. M.; Cassani, Roberta Soares L.; Geloneze, Bruno

    2014-01-01

    OBJECTIVE: To evaluate the correlation between neck circumference and insulin resistance and components of metabolic syndrome in adolescents with different adiposity levels and pubertal stages, as well as to determine the usefulness of neck circumference to predict insulin resistance in adolescents. METHODS: Cross-sectional study with 388 adolescents of both genders from ten to 19 years old. The adolescents underwent anthropometric and body composition assessment, including neck and waist circumferences, and biochemical evaluation. The pubertal stage was obtained by self-assessment, and the blood pressure, by auscultation. Insulin resistance was evaluated by the Homeostasis Model Assessment-Insulin Resistance. The correlation between two variables was evaluated by partial correlation coefficient adjusted for the percentage of body fat and pubertal stage. The performance of neck circumference to identify insulin resistance was tested by Receiver Operating Characteristic Curve. RESULTS: After the adjustment for percentage body fat and pubertal stage, neck circumference correlated with waist circumference, blood pressure, triglycerides and markers of insulin resistance in both genders. CONCLUSIONS: The results showed that the neck circumference is a useful tool for the detection of insulin resistance and changes in the indicators of metabolic syndrome in adolescents. The easiness of application and low cost of this measure may allow its use in Public Health services. PMID:25119754

  3. 27 CFR 9.109 - Northern Neck George Washington Birthplace.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Northern Neck George... Viticultural Areas § 9.109 Northern Neck George Washington Birthplace. (a) Name. The name of the viticultural area described in this section is “Northern Neck George Washington Birthplace.” (b) Approved maps....

  4. 49 CFR 572.163 - Neck assembly and test procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Hybrid III Six-Year-Old Weighted Child Test Dummy § 572.163 Neck assembly and test procedure. The neck assembly is assembled and tested as specified in 49 CFR 572.123 (Subpart N). ... 49 Transportation 7 2010-10-01 2010-10-01 false Neck assembly and test procedure. 572.163...

  5. 27 CFR 9.109 - Northern Neck George Washington Birthplace.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Northern Neck George... Viticultural Areas § 9.109 Northern Neck George Washington Birthplace. (a) Name. The name of the viticultural area described in this section is “Northern Neck George Washington Birthplace.” (b) Approved maps....

  6. 49 CFR 572.163 - Neck assembly and test procedure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Hybrid III Six-Year-Old Weighted Child Test Dummy § 572.163 Neck assembly and test procedure. The neck assembly is assembled and tested as specified in 49 CFR 572.123 (Subpart N). ... 49 Transportation 7 2011-10-01 2011-10-01 false Neck assembly and test procedure. 572.163...

  7. 49 CFR 572.83 - Head-neck.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Head-neck. 572.83 Section 572.83 Transportation..., DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 9-Month Old Child § 572.83 Head-neck. The head-neck assembly shown in drawing 1049/A consists of parts specified as items 1 through 16...

  8. 49 CFR 572.83 - Head-neck.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Head-neck. 572.83 Section 572.83 Transportation..., DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 9-Month Old Child § 572.83 Head-neck. The head-neck assembly shown in drawing 1049/A consists of parts specified as items 1 through 16...

  9. 49 CFR 572.83 - Head-neck.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Head-neck. 572.83 Section 572.83 Transportation..., DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 9-Month Old Child § 572.83 Head-neck. The head-neck assembly shown in drawing 1049/A consists of parts specified as items 1 through 16...

  10. 49 CFR 572.83 - Head-neck.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Head-neck. 572.83 Section 572.83 Transportation..., DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 9-Month Old Child § 572.83 Head-neck. The head-neck assembly shown in drawing 1049/A consists of parts specified as items 1 through 16...

  11. 49 CFR 572.83 - Head-neck.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Head-neck. 572.83 Section 572.83 Transportation..., DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 9-Month Old Child § 572.83 Head-neck. The head-neck assembly shown in drawing 1049/A consists of parts specified as items 1 through 16...

  12. Head and neck response of a finite element anthropomorphic test device and human body model during a simulated rotary-wing aircraft impact.

    PubMed

    White, Nicholas A; Danelson, Kerry A; Gayzik, F Scott; Stitzel, Joel D

    2014-11-01

    A finite element (FE) simulation environment has been developed to investigate aviator head and neck response during a simulated rotary-wing aircraft impact using both an FE anthropomorphic test device (ATD) and an FE human body model. The head and neck response of the ATD simulation was successfully validated against an experimental sled test. The majority of the head and neck transducer time histories received a CORrelation and analysis (CORA) rating of 0.7 or higher, indicating good overall correlation. The human body model simulation produced a more biofidelic head and neck response than the ATD experimental test and simulation, including change in neck curvature. While only the upper and lower neck loading can be measured in the ATD, the shear force, axial force, and bending moment were reported for each level of the cervical spine in the human body model using a novel technique involving cross sections. This loading distribution provides further insight into the biomechanical response of the neck during a rotary-wing aircraft impact. PMID:25085863

  13. Neck proprioceptors contribute to the modulation of muscle sympathetic nerve activity to the lower limbs of humans.

    PubMed

    Bolton, P S; Hammam, E; Macefield, V G

    2014-07-01

    Several different strategies have now been used to demonstrate that the vestibular system can modulate muscle sympathetic nerve activity (MSNA) in humans and thereby contribute to the regulation of blood pressure during changes in posture. However, it remains to be determined how the brain differentiates between head-only movements that do not require changes in vasomotor tone in the lower limbs from body movements that do require vasomotor changes. We tested the hypothesis that neck movements modulate MSNA in the lower limbs of humans. MSNA was recorded in 10 supine young adult subjects, at rest, during sinusoidal stretching of neck muscles (100 cycles, 35° peak to peak at 0.37 ± 0.02 Hz) and during a ramp-and-hold (17.5° for 54 ± 9 s) static neck muscle stretch, while their heads were held fixed in space. Cross-correlation analysis revealed cyclical modulation of MSNA during sinusoidal neck muscle stretch (modulation index 45.4 ± 5.3 %), which was significantly less than the cardiac modulation of MSNA at rest (78.7 ± 4.2 %). Interestingly, cardiac modulation decreased significantly during sinusoidal neck displacement (63.0 ± 9.3 %). By contrast, there was no significant difference in MSNA activity during static ramp-and-hold displacements of the neck to the right or left compared with that with the head and neck aligned. These data suggest that dynamic, but not static, neck movements can modulate MSNA, presumably via projections of muscle spindle afferents to the vestibular nuclei, and may thus contribute to the regulation of blood pressure during orthostatic challenges. PMID:24691758

  14. International Federation of Head Neck Oncology Society 5th World Congress/American Head Neck Society 2014 update

    PubMed Central

    Sharma, Shilpi; Chaukar, Devendra A.

    2014-01-01

    Head neck cancer is an important health problem with high morbidity and mortality. Early detection and adequate treatment improve prognosis significantly. Thus creating awareness among clinicians is an important step toward control of head neck cancer and reducing its overall burden. We here provide an update on the International Federation of Head Neck Oncology Society/American Head Neck Society 2014 held between July 26, 2014 and July 30, 2014 in New York. PMID:25336796

  15. 49 CFR 572.193 - Neck assembly.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... environment as specified in 49 CFR 572.200(j); (2) Attach the neck-headform assembly, as shown in Figure V2-A or V2-B in appendix A to this subpart, to the 49 CFR Part 572 pendulum test fixture (Figure 22, 49 CFR 572.33) in either the left or right lateral impact orientations, respectively, so that...

  16. 49 CFR 572.193 - Neck assembly.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... environment as specified in 49 CFR 572.200(j); (2) Attach the neck-headform assembly, as shown in Figure V2-A or V2-B in appendix A to this subpart, to the 49 CFR Part 572 pendulum test fixture (Figure 22, 49 CFR 572.33) in either the left or right lateral impact orientations, respectively, so that...

  17. 49 CFR 572.193 - Neck assembly.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... environment as specified in 49 CFR 572.200(j); (2) Attach the neck-headform assembly, as shown in Figure V2-A or V2-B in appendix A to this subpart, to the 49 CFR Part 572 pendulum test fixture (Figure 22, 49... CFR Part 572 Figure 15, at the instant the pendulum makes contact with the decelerating mechanism;...

  18. 49 CFR 572.193 - Neck assembly.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... environment as specified in 49 CFR 572.200(j); (2) Attach the neck-headform assembly, as shown in Figure V2-A or V2-B in appendix A to this subpart, to the 49 CFR Part 572 pendulum test fixture (Figure 22, 49... CFR Part 572 Figure 15, at the instant the pendulum makes contact with the decelerating mechanism;...

  19. 49 CFR 572.193 - Neck assembly.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... environment as specified in 49 CFR 572.200(j); (2) Attach the neck-headform assembly, as shown in Figure V2-A or V2-B in appendix A to this subpart, to the 49 CFR Part 572 pendulum test fixture (Figure 22, 49... CFR Part 572 Figure 15, at the instant the pendulum makes contact with the decelerating mechanism;...

  20. Penetrated Arrow Shot Injury in Anterior Neck

    PubMed Central

    Aremu, Shuaib K.; Dike, Benjamin

    2011-01-01

    Background: Although gunshot injuries are the most common penetrating anterior neck injuries in the developed world, this finding is not the case in the developing world, where knives, spears, arrows, and machetes are the preferred weapons, particularly in tribal societies. Aim: To present the case report of a patient with arrow shot injury to the anterior neck. Method: A 48 year old cattle rearer in a village in northern part of Nigeria presented with 3 hr history of an arrow shot in anterior part of the neck which he sustained the while trying to prevent some armed robbers from stealing his cow. There was scanty bleeding from the site with the arrow in-situ sealing the wound. Result: The entrance point of the arrow, about 1 cm in diameter, was just at the anterior border of the right sternocleidomastoid muscle; about 4 cm above the medial end of the right clavicle. There was a small skin bruise with slight swelling and tenderness around the opening but no active bleeding and no crepitus. Conclusion: Penetrating neck trauma from arrow shot may lead to potentially life-threatening injuries. A prompt diagnosis, a systematic treatment protocol, and an experienced trauma team are necessary to prevent a potential catastroph. PMID:23675224

  1. Epigenetics in head and neck cancer.

    PubMed

    Bakhtiar, Syeda Marriam; Ali, Amjad; Barh, Debmalya

    2015-01-01

    Epigenetics refers to the study of heritable changes in gene expression that occur without a change in DNA sequence. Research has shown that epigenetic mechanisms provide an "extra" layer of transcriptional control that regulates how genes are expressed. These mechanisms are critical components in the normal development and growth of cells. Epigenetic abnormalities have been found to be causative factors in cancer, genetic disorders, and pediatric syndromes. Head and neck cancers are a group of malignancies with diverse biological behaviors and a strong, well-established association with environmental effects. Although the hunt for genetic alterations in head and neck cancer has continued in the past two decades, with unequivocal proof of a genetic role in multistage head and neck carcinogenesis, epigenetic alteration in association with promoter CpG islands hypermethylation has emerged in the past few years as one of the most active areas of cancer research. Silencing of the genes by hypermethylation or induction of oncogenes by promoter hypomethylation is a frequent mechanism in head and neck cancer and achieves increasing diagnostic and therapeutic importance. In this context it is important for clinicians to understand the principles of epigenetic mechanisms and how these principles relate to human health and disease. It is important to address the use of epigenetic pathways in new approaches to molecular diagnosis and novel targeted treatments across the clinical spectrum. PMID:25421690

  2. Head and Neck Cancer Stem Cells

    PubMed Central

    Krishnamurthy, S.; Nör, J.E.

    2012-01-01

    Most cancers contain a small sub-population of cells that are endowed with self-renewal, multipotency, and a unique potential for tumor initiation. These properties are considered hallmarks of cancer stem cells. Here, we provide an overview of the field of cancer stem cells with a focus on head and neck cancers. Cancer stem cells are located in the invasive fronts of head and neck squamous cell carcinomas (HNSCC) close to blood vessels (perivascular niche). Endothelial cell-initiated signaling events are critical for the survival and self-renewal of these stem cells. Markers such as aldehyde dehydrogenase (ALDH), CD133, and CD44 have been successfully used to identify highly tumorigenic cancer stem cells in HNSCC. This review briefly describes the orosphere assay, a method for in vitro culture of undifferentiated head and neck cancer stem cells under low attachment conditions. Notably, recent evidence suggests that cancer stem cells are exquisitely resistant to conventional therapy and are the “drivers” of local recurrence and metastatic spread. The emerging understanding of the role of cancer stem cells in the pathobiology of head and neck squamous cell carcinomas might have a profound impact on the treatment paradigms for this malignancy. PMID:21933937

  3. Is Planned Neck Dissection Necessary for Head and Neck Cancer After Intensity-Modulated Radiotherapy?

    SciTech Connect

    Yao Min |. E-mail: min-yao@uiowa.edu; Hoffman, Henry T.; Funk, Gerry F. |; Chang, Kristi; Smith, Russell B. |; Tan Huaming; Clamon, Gerald H.; Dornfeld, Ken |; Buatti, John M. |

    2007-07-01

    Purpose: The objective of this study was to determine regional control of local regional advanced head and neck squamous cell carcinoma (HNSCC) treated with intensity-modulated radiotherapy (IMRT), along with the role and selection criteria for neck dissection after IMRT. Methods and Materials: A total of 90 patients with stage N2A or greater HNSCC were treated with definitive IMRT from December 1999 to July 2005. Three clinical target volumes were defined and were treated to 70 to 74 Gy, 60 Gy, and 54 Gy, respectively. Neck dissection was performed for selected patients after IMRT. Selection criteria evolved during this period with emphasis on post-IMRT [{sup 18}F] fluorodeoxyglucose positron emission tomography in recent years. Results: Median follow-up for all patients was 29 months (range, 0.2-74 months). All living patients were followed at least 9 months after completing treatment. Thirteen patients underwent neck dissection after IMRT because of residual lymphadenopathy. Of these, 6 contained residual viable tumor. Three patients with persistent adenopathy did not undergo neck dissection: 2 refused and 1 had lung metastasis. Among the remaining 74 patients who were observed without neck dissection, there was only 1 case of regional failure. Among all 90 patients in this study, the 3-year local and regional control was 96.3% and 95.4%, respectively. Conclusions: Appropriately delivered IMRT has excellent dose coverage for cervical lymph nodes. A high radiation dose can be safely delivered to the abnormal lymph nodes. There is a high complete response rate. Routine planned neck dissection for patients with N2A and higher stage after IMRT is not necessary. Post-IMRT [{sup 18}F] fluorodeoxyglucose positron emission tomography is a useful tool in selecting patients appropriate for neck dissection.

  4. Quantitative Ultrasonic Nakagami Imaging of Neck Fibrosis After Head and Neck Radiation Therapy

    SciTech Connect

    Yang, Xiaofeng; Yoshida, Emi; Cassidy, Richard J.; Beitler, Jonathan J.; Yu, David S.; Curran, Walter J.; Liu, Tian

    2015-06-01

    Purpose: To investigate the feasibility of ultrasound Nakagami imaging to quantitatively assess radiation-induced neck fibrosis, a common sequela of radiation therapy (RT) to the head and neck. Methods and Materials: In a pilot study, 40 study participants were enrolled and classified into 3 subgroups: (1) a control group of 12 healthy volunteers; (2) an asymptomatic group of 11 patients who had received intensity modulated RT for head and neck cancer and had experienced no neck fibrosis; and (3) a symptomatic group of 17 post-RT patients with neck fibrosis. Each study participant underwent 1 ultrasound study in which scans were performed in the longitudinal orientation of the bilateral neck. Three Nakagami parameters were calculated to quantify radiation-induced tissue injury: Nakagami probability distribution function, shape, and scaling parameters. Physician-based assessments of the neck fibrosis were performed according to the Radiation Therapy Oncology Group late morbidity scoring scheme, and patient-based fibrosis assessments were rated based on symptoms such as pain and stiffness. Results: Major discrepancies existed between physician-based and patient-based assessments of radiation-induced fibrosis. Significant differences in all Nakagami parameters were observed between the control group and 2 post-RT groups. Moreover, significant differences in Nakagami shape and scaling parameters were observed among asymptomatic and symptomatic groups. Compared with the control group, the average Nakagami shape parameter value increased by 32.1% (P<.001), and the average Nakagami scaling parameter increased by 55.7% (P<.001) for the asymptomatic group, whereas the Nakagami shape parameter increased by 74.1% (P<.001) and the Nakagami scaling parameter increased by 83.5% (P<.001) for the symptomatic group. Conclusions: Ultrasonic Nakagami imaging is a potential quantitative tool to characterize radiation-induced asymptomatic and symptomatic neck fibrosis.

  5. Noninvasive analysis of human neck muscle function

    NASA Technical Reports Server (NTRS)

    Conley, M. S.; Meyer, R. A.; Bloomberg, J. J.; Feeback, D. L.; Dudley, G. A.

    1995-01-01

    STUDY DESIGN. Muscle use evoked by exercise was determined by quantifying shifts in signal relaxation times of T2-weighted magnetic resonance images. Images were collected at rest and after exercise at each of two intensities (moderate and intense) for each of four head movements: 1) extension, 2) flexion, 3) rotation, and 4) lateral flexion. OBJECTIVE. This study examined the intensity and pattern of neck muscle use evoked by various movements of the head. The results will help elucidate the pathophysiology, and thus methods for treating disorders of the cervical musculoskeletal system. SUMMARY OF BACKGROUND DATA. Exercise-induced contrast shifts in T2 has been shown to indicate muscle use during the activity. The noninvasive nature of magnetic resonance imaging appears to make it an ideal approach for studying the function of the complex neuromuscular system of the neck. METHODS. The extent of T2 increase was examined to gauge how intensely nine different neck muscles or muscle pairs were used in seven subjects. The absolute and relative cross-sectional area of muscle showing a shift in signal relaxation was assessed to infer the pattern of use among and within individual neck muscles or muscle pairs. RESULTS. Signal relaxation increased with exercise intensity for each head movement. The absolute and relative cross-sectional area of muscle showing a shift in signal relaxation also increased with exercise load. Neck muscles or muscle pairs extensively used to perform each head movement were: extension--semispinalis capitis and cervicis and splenius capitis; flexion--sternocleidomastoid and longus capitis and colli; rotation--splenius capitis, levator scapulae, scalenus, semispinalis capitis ipsilateral to the rotation, and sternocleidomastoid contralateral; and lateral flexion--sternocleidomastoid CONCLUSION. The results of this study, in part, agree with the purported functions of neck muscles derived from anatomic location. This also was true for the few selected muscles that have been examined in human electromyographic studies. Neck muscle function and morphology can be studied at a detailed level using exercise-induced shifts in magnetic resonance images.

  6. Why sauropods had long necks; and why giraffes have short necks

    PubMed Central

    Wedel, Mathew J.

    2013-01-01

    The necks of the sauropod dinosaurs reached 15 m in length: six times longer than that of the world record giraffe and five times longer than those of all other terrestrial animals. Several anatomical features enabled this extreme elongation, including: absolutely large body size and quadrupedal stance providing a stable platform for a long neck; a small, light head that did not orally process food; cervical vertebrae that were both numerous and individually elongate; an efficient air-sac-based respiratory system; and distinctive cervical architecture. Relevant features of sauropod cervical vertebrae include: pneumatic chambers that enabled the bone to be positioned in a mechanically efficient way within the envelope; and muscular attachments of varying importance to the neural spines, epipophyses and cervical ribs. Other long-necked tetrapods lacked important features of sauropods, preventing the evolution of longer necks: for example, giraffes have relatively small torsos and large, heavy heads, share the usual mammalian constraint of only seven cervical vertebrae, and lack an air-sac system and pneumatic bones. Among non-sauropods, their saurischian relatives the theropod dinosaurs seem to have been best placed to evolve long necks, and indeed their necks probably surpassed those of giraffes. But 150 million years of evolution did not suffice for them to exceed a relatively modest 2.5 m. PMID:23638372

  7. Pre-operative segmentation of neck CT datasets for the planning of neck dissections

    NASA Astrophysics Data System (ADS)

    Cordes, Jeanette; Dornheim, Jana; Preim, Bernhard; Hertel, Ilka; Strauss, Gero

    2006-03-01

    For the pre-operative segmentation of CT neck datasets, we developed the software assistant NeckVision. The relevant anatomical structures for neck dissection planning can be segmented and the resulting patient-specific 3D-models are visualized afterwards in another software system for intervention planning. As a first step, we examined the appropriateness of elementary segmentation techniques based on gray values and contour information to extract the structures in the neck region from CT data. Region growing, interactive watershed transformation and live-wire are employed for segmentation of different target structures. It is also examined, which of the segmentation tasks can be automated. Based on this analysis, the software assistant NeckVision was developed to optimally support the workflow of image analysis for clinicians. The usability of NeckVision was tested within a first evaluation with four otorhinolaryngologists from the university hospital of Leipzig, four computer scientists from the university of Magdeburg and two laymen in both fields.

  8. Why sauropods had long necks; and why giraffes have short necks.

    PubMed

    Taylor, Michael P; Wedel, Mathew J

    2013-01-01

    The necks of the sauropod dinosaurs reached 15 m in length: six times longer than that of the world record giraffe and five times longer than those of all other terrestrial animals. Several anatomical features enabled this extreme elongation, including: absolutely large body size and quadrupedal stance providing a stable platform for a long neck; a small, light head that did not orally process food; cervical vertebrae that were both numerous and individually elongate; an efficient air-sac-based respiratory system; and distinctive cervical architecture. Relevant features of sauropod cervical vertebrae include: pneumatic chambers that enabled the bone to be positioned in a mechanically efficient way within the envelope; and muscular attachments of varying importance to the neural spines, epipophyses and cervical ribs. Other long-necked tetrapods lacked important features of sauropods, preventing the evolution of longer necks: for example, giraffes have relatively small torsos and large, heavy heads, share the usual mammalian constraint of only seven cervical vertebrae, and lack an air-sac system and pneumatic bones. Among non-sauropods, their saurischian relatives the theropod dinosaurs seem to have been best placed to evolve long necks, and indeed their necks probably surpassed those of giraffes. But 150 million years of evolution did not suffice for them to exceed a relatively modest 2.5 m. PMID:23638372

  9. Imaging of connective tissue diseases of the head and neck.

    PubMed

    Abdel Razek, Ahmed Abdel Khalek

    2016-06-01

    We review the imaging appearance of connective tissue diseases of the head and neck. Bilateral sialadenitis and dacryoadenitis are seen in Sjögren's syndrome; ankylosis of the temporo-mandibular joint with sclerosis of the crico-arytenoid joint are reported in rheumatoid arthritis and lupus panniculitis with atypical infection are reported in patients with systemic lupus erythematosus. Relapsing polychondritis shows subglottic stenosis, prominent ear and saddle nose; progressive systemic sclerosis shows osteolysis of the mandible, fibrosis of the masseter muscle with calcinosis of the subcutaneous tissue and dermatomyositis/polymyositis shows condylar erosions and autoimmune thyroiditis. Vascular thrombosis is reported in antiphospholipid antibodies syndrome; cervical lymphadenopathy is seen in adult-onset Still's disease, and neuropathy with thyroiditis reported in mixed connective tissue disorder. Imaging is important to detect associated malignancy with connective tissue disorders. Correlation of the imaging findings with demographic data and clinical findings are important for the diagnosis of connective tissue disorders. PMID:26988082

  10. Emerging technology in head and neck ultrasonography.

    PubMed

    Holtel, Michael R

    2010-12-01

    Increased use of ultrasonography of the head and neck by clinicians has resulted from more compact, higher resolution ultrasound machines that can be more readily used in the office setting. Palm-sized machines are already used for vascular access and bladder assessment. As the resolution of these machines becomes adequate for head and neck assessment, ultrasonography is likely to become a routine adjunct to the office physical examination. Further techniques to reduce artifact beyond spatial compounding, second harmonics, and broadband inversion techniques are likely to be developed to improve ultrasound images. Manual palpation using the ultrasound transducer or "sound palpation," using sound to recreate vibration provides information on tissue "stiffness," which has been successfully used to distinguish between benign and malignant lesions in the head and neck (particularly thyroid nodules). Microbubble contrast-enhanced ultrasound provides improved resolution of ultrasound images. Three- and four-dimensional ultrasonography provides for more accurate diagnosis. The ability of microbubbles with ligands affixed to their outer surface to target specific tissue makes them excellent delivery vehicles. DNA plasmids, chemotherapy agents, and therapeutic drugs can be released at a specific anatomic site. The motion of microbubbles stimulated by ultrasound can be used to increase drug penetration through tissues and has been shown to be effective in breaking up clots in stroke patients (without increased risk). High-intensity focused ultrasound can be used to create coagulation necrosis without significant damage to adjacent tissue. It has been effectively used in neurosurgery and urology, but its effectiveness in the head and neck is still being determined. A prototype for surgical navigation with ultrasound has been developed for the head and neck, which allows real-time imaging of anatomic surgical changes. PMID:21044741

  11. Epidermal growth factor receptor-targeted molecular therapeutics for head and neck squamous cell carcinoma.

    PubMed

    Egloff, Ann Marie; Grandis, Jennifer

    2006-10-01

    Several molecular-targeted therapeutics have been tested in clinical trials for the treatment of head and neck squamous cell carcinoma (HNSCC). Of these, therapeutics targeting the epidermal growth factor receptor (EGFR) have been studied most extensively and some agents have demonstrated measurable clinical effectiveness. However, molecular studies designed to define HNSCC patient subcohorts of likely responders to EGFR-targeted therapy have not identified molecular signatures that correlate with clinical response. Here, the authors summarise the relevant clinical findings and highlight reported molecular correlative studies for EGFR-targeted therapeutics for HNSCC. The authors focus especially on molecular markers evaluated for association with clinical response and include data from EGFR-targeted clinical studies in other cancer sites that they anticipate will be of interest to the head and neck cancer research and treatment communities. PMID:16981821

  12. Osteotomies of the Talar Neck for Posttraumatic Malalignment.

    PubMed

    Barg, Alexej; Suter, Thomas; Nickisch, Florian; Wegner, Nicholas J; Hintermann, Beat

    2016-03-01

    A talar neck malunion is one of the major complications following operative or nonoperative treatment of talar neck fractures. The most common posttraumatic talar malunion results in varus malalignment of the talar neck and can lead to painful overload of the lateral foot and substantial impairment of hindfoot function. Secondary procedures in patients with painful malunited talar neck fracture include salvage procedures and anatomic reconstruction procedures. Anatomic reconstruction of the talar neck is a reliable surgical treatment to regain function, decrease pain, and restore hindfoot alignment and range of motion. PMID:26915780

  13. Femoral neck anteversion measurement using linear slot scanning radiography.

    PubMed

    Chimhundu, Chipo; Sivarasu, Sudesh; Steiner, Stefan; Smit, Julian; Douglas, Tania S

    2016-02-01

    Measurements between anatomical landmarks on radiographs are useful for diagnosis and treatment planning in the orthopedic field. Direct measurement on single radiographic images, however, does not truly reflect spatial relationships, as depth information is lost. We used stereo images from a slot scanning X-ray machine to estimate coordinates of three-dimensional (3D) bony landmarks for femoral neck anteversion (FNA) measurement. A set of 7 landmarks consisting of the centre of the femoral head; the centre of the base of the femoral neck; the medial and lateral condyles; the medial and lateral posterior condyles; and finally the centre of the knee; were found to be identifiable and suitable for radiographic measurement. The reconstructed 3D coordinates were then used to define the 3D geometry of the anatomical axes required to estimate FNA. Stereophotogrammetric measurements on a sample of 30 dry right adult femurs were compared to reference values obtained using the Kingsley Olmstead method applied to photographic images. A strong positive correlation (0.998) was found and the mean ± standard deviation of the stereophotogrammetric approach (13.08 ± 6.87)° was comparable to that of the Kingsley Olmstead method (13.14 ± 6.88)°. Intra- and inter-observer reliability were high, with the lower bound of the 95% confidence interval above 0.98 for the intra-class correlation coefficient. The results merit further validation against three dimensional imaging technology such as computed tomography, to confirm stereophotogrammetry as a suitable alternative for FNA measurement. PMID:26776374

  14. Japanese Board Certification System for head and neck surgeons.

    PubMed

    Yoshimoto, Seiichi; Nakashima, Torahiko; Fujii, Takashi; Matsuura, Kazuto; Otsuki, Naoki; Asakage, Takahiro; Fujimoto, Yasushi; Hanai, Nobuhiro; Homma, Akihiro; Monden, Nobuya; Okami, Kenji; Sugasawa, Masashi; Hasegawa, Yasuhisa; Nibu, Ken-ichi; Kamata, Shin-etsu; Kishimoto, Seiji; Kohno, Naoyuki; Fukuda, Satoshi; Hisa, Yasuo

    2014-08-01

    The Japan Society for Head and Neck Surgery (JSHNS) started a board certification system for head and neck surgeons in 2010. To become certified, the following qualification and experiences are required: (1) board certification as otorhinolaryngologist, (2) 2 years of clinical experience in a board-certified training facility, (3) clinical care of 100 patients with head and neck cancer under the supervision of board-certified faculty and (4) surgical experience in 50 major head and neck surgical procedures, including 20 neck dissections, under the supervision of board-certified faculty. The following scientific activities are also required during the preceding 5 years: (1) two clinical papers on head and neck cancers presented at major scientific meetings, (2) one clinical paper on head and neck cancer published in a major journal, (3) attendance at two annual meetings of JSHNS and (4) enrolment in three educational programs approved by JSHNS. The qualifying examination consists of multiple choice tests and oral examinations. A total of 151 head and neck surgeons were certified in 2010 followed by 43 in 2011 and 34 in 2012, while the membership of JSHNS dramatically increased from 1201 in 2007 to 1748 in 2013. Although the board certification system for head and neck surgeons was started only recently, it has encouraged many residents and fellows as well as established head and neck surgeons. We believe that this system will contribute to further advancement in the clinical practice for head and neck cancers in Japan. PMID:24581685

  15. Evaluation of jaw and neck muscle activities while chewing using EMG-EMG transfer function and EMG-EMG coherence function analyses in healthy subjects.

    PubMed

    Ishii, Tomohiro; Narita, Noriyuki; Endo, Hiroshi

    2016-06-01

    This study aims to quantitatively clarify the physiological features in rhythmically coordinated jaw and neck muscle EMG activities while chewing gum using EMG-EMG transfer function and EMG-EMG coherence function analyses in 20 healthy subjects. The chewing side masseter muscle EMG signal was used as the reference signal, while the other jaw (non-chewing side masseter muscle, bilateral anterior temporal muscles, and bilateral anterior digastric muscles) and neck muscle (bilateral sternocleidomastoid muscles) EMG signals were used as the examined signals in EMG-EMG transfer function and EMG-EMG coherence function analyses. Chewing-related jaw and neck muscle activities were aggregated in the first peak of the power spectrum in rhythmic chewing. The gain in the peak frequency represented the power relationships between jaw and neck muscle activities during rhythmic chewing. The phase in the peak frequency represented the temporal relationships between the jaw and neck muscle activities, while the non-chewing side neck muscle presented a broad range of distributions across jaw closing and opening phases. Coherence in the peak frequency represented the synergistic features in bilateral jaw closing muscles and chewing side neck muscle activities. The coherence and phase in non-chewing side neck muscle activities exhibited a significant negative correlation. From above, the bilateral coordination between the jaw and neck muscle activities is estimated while chewing when the non-chewing side neck muscle is synchronously activated with the jaw closing muscles, while the unilateral coordination is estimated when the non-chewing side neck muscle is irregularly activated in the jaw opening phase. Thus, the occurrence of bilateral or unilateral coordinated features in the jaw and neck muscle activities may correspond to the phase characteristics in the non-chewing side neck muscle activities during rhythmical chewing. Considering these novel findings in healthy subjects, EMG-EMG transfer function and EMG-EMG coherence function analyses may also be useful to diagnose the pathologically in-coordinated features in jaw and neck muscle activities in temporomandibular disorders and whiplash-associated disorders during critical chewing performance. PMID:27059322

  16. Prediction of Difficult Laryngoscopy in Obese Patients by Ultrasound Quantification of Anterior Neck Soft Tissue1

    PubMed Central

    Ezri, T.; Gewürtz, G.; Sessler, D.I.; Medalion, B.; Szmuk, P.; Hagberg, C.; Susmallian, S.

    2005-01-01

    Prediction of difficult laryngoscopy in obese patients is challenging. In 50 morbidly obese patients, we quantified the neck soft tissue from skin to anterior aspect of trachea at the vocal cords using ultrasound. Thyromental distance <6 cm, mouth opening <4 cm, limited neck mobility, Mallampati score >2, abnormal upper teeth, neck circumference >45 cm, and sleep apnoea were considered predictors of difficult laryngoscopy. Of the nine (18%) difficult laryngoscopy cases, seven had obstructive sleep apnoea history; whereas, only 2 of the 41 easy laryngoscopy patients did (P<0.001). Difficult laryngoscopy patients had larger neck circumference [50 (3.8) vs. 43.5 (2.2) cm; P<0.001] and more pre-tracheal soft tissue [28 (2.7) mm vs. 17.5 (1.8) mm; P<0.001] [mean (SD)]. Soft tissue values completely separated difficult and easy laryngoscopies. None of the other predictors correlated with difficult laryngoscopy. Thus, an abundance of pretracheal soft tissue at the level of vocal cords is a good predictor of difficult laryngoscopy in obese patients. PMID:14616599

  17. National survey of back & neck pain amongst consultant ophthalmologists in the United Kingdom.

    PubMed

    Hyer, Jonathan N; Lee, Richard M; Chowdhury, Haziq R; Smith, Henry B; Dhital, Anish; Khandwala, Mona

    2015-12-01

    Repetitive tasks, awkward or prolonged working postures, and high cognitive load are risk factors for occupational musculoskeletal disorders. Ophthalmologists may be vulnerable given that they are exposed to a combination of these factors. This national study assesses the prevalence, severity and associations of back and neck pain amongst UK consultant ophthalmologists. A postal survey was conducted using addresses supplied by the Royal College of Ophthalmologists. Statistical analysis was performed using Pearson correlation coefficient, two-tailed probability testing, analysis of variance (ANOVA) and Dunn's multiple comparison test. 518 responses were received (50.3 % response rate). Back and neck pain were reported by 50.6 % (262/518) and 31.8 % (165/518) of respondents, respectively, with 62.4 % (323/518) reporting one or both. 33.6 % (174/518) reported pain whilst operating, of whom 78.7 % (137/174) found operating exacerbated their pain. 31.7 % (164/518) reported pain when using the slit lamp, of whom 71.3 % (117/164) found it exacerbated their pain. Individual subspecialties showed a significant relative risk of back or neck pain in some circumstances, when compared to ophthalmologists as a whole. Occupational back and neck pain remains a problem amongst ophthalmologists. Recommendations are made for modifications to the working environment, and consideration should be given to improving education for trainees. PMID:25609503

  18. The influence of flow diverter's angle of curvature across the aneurysm neck on its haemodynamics.

    PubMed

    Karunanithi, Kaavya; Lee, Chang Joon; Chong, Winston; Qian, Yi

    2015-08-01

    Flow diverter stents have provided a new method of endovascular reconstruction for large and complex aneurysms. Understanding the impact of the flow diverter's angle of curvature across the neck and its metal coverage rate on the haemodynamics of aneurysm is crucial to maximize the mass flow reduction inside the aneurysm, post-deployment. The aim of this study is to understand the correlation between the angle of curvature of flow diverter across the aneurysm neck and the metal coverage rate, and the aneurysm's haemodynamics, using computational fluid dynamics. Varying the flow diverter angle resulted in varying metal coverage rate across the aneurysm neck for two patient vessel geometries, A (straight artery) and B (curved artery) with aspect ratios of 3.1 and 2.9, respectively. The results indicate that there exists a relationship between the aneurysm's haemodynamics and the flow diverter's angle of curvature across its neck. Moreover, the calculations indicated that cases with a moderately curved flow diverter, with an associated metal coverage rate of 50%-60%, achieve maximum flow reduction inside the aneurysm due to a stable flow resistance in the direction normal to the blood flow. PMID:26238789

  19. Capability of a neck worn device to measure sleep/wake, airway position, and differentiate benign snoring from obstructive sleep apnea.

    PubMed

    Levendowski, Daniel J; Veljkovic, Bratislav; Seagraves, Sean; Westbrook, Philip R

    2015-02-01

    To evaluate the accuracy of a neck-worn device in measuring sleep/wake, detecting supine airway position, and using loud snoring to screen for obstructive sleep apnea. Study A included 20 subjects who wore the neck-device during polysomnography (PSG), with 31 records obtained from diagnostic and split-night studies. Study B included 24 community-based snorers studied in-home for up to three-nights with obstructive sleep apnea (OSA) severity measured with a validated Level III recorder. The accuracy of neck actigraphy-based sleep/wake was measured by assessing sleep efficiency (SE). Differences in sleep position measured at the chest and neck during PSG were compared to video-editing. Loud snoring acquired with an acoustic microphone was compared to the apnea-hypopnea index (AHI) by- and acrosspositions. Over-reported SE by neck actigraphy was inversely related to OSA severity. Measurement of neck and chest supine position were highly correlated with video-edits (r=0.93, 0.78). Chest was bias toward over-estimating supine time while the majority of neck-device supine position errors occurred during CPAP titrations. Snoring was highly correlated with the overall, supine, and non-supine PSG-AHI (r=0.79, 0.74, 0.83) and was both sensitive and specific in detecting overall, supine, and non-supine PSGAHI>10 (sensitivity=81, 88, 82%; specificity=87, 79, 100%). At home sleep testing-AHI>10, the sensitivity and specificity of loud snoring was superior when users were predominantly non-supine as compared to baseline (sensitivity=100, 92%; specificity=88, 77%). Neck actigraphy appears capable of estimating sleep/wake. The accuracy of supine airway detection with the neck-device warrants further investigation. Measurement of loud snoring appears to provide a screening tool for differentiating positional apneic and benign snorers. PMID:24599632

  20. Relationships between vocal function measures derived from an acoustic microphone and a subglottal neck-surface accelerometer

    PubMed Central

    Mehta, Daryush D.; Van Stan, Jarrad H.; Hillman, Robert E.

    2016-01-01

    Monitoring subglottal neck-surface acceleration has received renewed attention due to the ability of low-profile accelerometers to confidentially and noninvasively track properties related to normal and disordered voice characteristics and behavior. This study investigated the ability of subglottal neck-surface acceleration to yield vocal function measures traditionally derived from the acoustic voice signal and help guide the development of clinically functional accelerometer-based measures from a physiological perspective. Results are reported for 82 adult speakers with voice disorders and 52 adult speakers with normal voices who produced the sustained vowels /a/, /i/, and /u/ at a comfortable pitch and loudness during the simultaneous recording of radiated acoustic pressure and subglottal neck-surface acceleration. As expected, timing-related measures of jitter exhibited the strongest correlation between acoustic and neck-surface acceleration waveforms (r ≤ 0.99), whereas amplitude-based measures of shimmer correlated less strongly (r ≤ 0.74). Additionally, weaker correlations were exhibited by spectral measures of harmonics-to-noise ratio (r ≤ 0.69) and tilt (r ≤ 0.57), whereas the cepstral peak prominence correlated more strongly (r ≤ 0.90). These empirical relationships provide evidence to support the use of accelerometers as effective complements to acoustic recordings in the assessment and monitoring of vocal function in the laboratory, clinic, and during an individual’s daily activities. PMID:27066520

  1. Neck muscle atrophy and soft-tissue fibrosis after neck dissection and postoperative radiotherapy for oral cancer

    PubMed Central

    Kim, Jinu; Shin, Eun Seow; Kim, Jeong Eon; Yoon, Sang Pil

    2015-01-01

    Late complications of head and neck cancer survivors include neck muscle atrophy and soft-tissue fibrosis. We present an autopsy case of neck muscle atrophy and soft-tissue fibrosis (sternocleidomastoid, omohyoid, digastric, sternohyoid, sternothyroid, and platysma muscles) within the radiation field after modified radical neck dissection type I and postoperative radiotherapy for floor of mouth cancer. A 70-year-old man underwent primary tumor resection of the left floor of mouth, left marginal mandibulectomy, left modified radical neck dissection type I, and reconstruction with a radial forearm free flap. The patient received adjuvant radiotherapy. The dose to the primary tumor bed and involved neck nodes was 63 Gy in 35 fractions over 7 weeks. Areas of subclinical disease (left lower neck) received 50 Gy in 25 fractions over 5 weeks. Adjuvant chemotherapy was not administered. PMID:26756035

  2. Neck muscle atrophy and soft-tissue fibrosis after neck dissection and postoperative radiotherapy for oral cancer.

    PubMed

    Kim, Jinu; Shin, Eun Seow; Kim, Jeong Eon; Yoon, Sang Pil; Kim, Young Suk

    2015-12-01

    Late complications of head and neck cancer survivors include neck muscle atrophy and soft-tissue fibrosis. We present an autopsy case of neck muscle atrophy and soft-tissue fibrosis (sternocleidomastoid, omohyoid, digastric, sternohyoid, sternothyroid, and platysma muscles) within the radiation field after modified radical neck dissection type I and postoperative radiotherapy for floor of mouth cancer. A 70-year-old man underwent primary tumor resection of the left floor of mouth, left marginal mandibulectomy, left modified radical neck dissection type I, and reconstruction with a radial forearm free flap. The patient received adjuvant radiotherapy. The dose to the primary tumor bed and involved neck nodes was 63 Gy in 35 fractions over 7 weeks. Areas of subclinical disease (left lower neck) received 50 Gy in 25 fractions over 5 weeks. Adjuvant chemotherapy was not administered. PMID:26756035

  3. [Fracture arthroplasty of femoral neck fractures].

    PubMed

    Braun, K F; Hanschen, M; Biberthaler, P

    2016-04-01

    A paradigm shift in the treatment of elderly patients has recently taken place leading to an increase in joint replacement surgery. The aim of this article is to highlight new developments and to present a treatment algorithm for femoral neck fractures. The age limit must be individually determined considering the comorbidities and perioperative risk profile. Pertrochanteric femoral fractures are nearly exclusively treated by osteosynthesis regardless of age. The situation for femoral neck fractures is more complex. Patients younger than 65 years should generally be treated by osteosynthesis but patients older than 65 years benefit from hemiarthroplasty or total hip arthroplasty. In patients aged between 65 and 75 years with high functional demands and a justifiable perioperative risk, total joint replacement is the treatment of choice. In physically less active patients older than 75 years and poor general condition, preference should be given to hemiarthroplasty. PMID:27000204

  4. Melioidosis of the head and neck.

    PubMed

    Lim, W K; Gurdeep, G S; Norain, K

    2001-12-01

    Melioidosis is a potentially deadly infection that can affect any organ system. Reports of melioidosis of the ENT/head and neck region are relatively uncommon. Four cases are presented: (i) parotid abscess evolving into necrotising fasciitis, (ii) acute sinusitis and parapharyngeal cellulitis resulting in upper airway obstruction, (iii) acute suppurative lymphadenitis (iv) and chronic suppurative otitis media causing meningoencephalitis. Three of the four cases are believed to be unique, as a literature review of melioidosis in ENT/head and neck is also presented. Some practical issues of management are also discussed. Not suspecting melioidosis does not change contemporary empirical broadspectrum antibiotic therapy. The value of suspicion or on confirmation of diagnosis lies in anticipating and planning for rapid change. PMID:12014768

  5. Neck and back pain in bicycling.

    PubMed

    Mellion, M B

    1994-01-01

    Back and neck problems in bicyclists should be managed by a combination of bicycle adjustment or modification, technique change, and medical treatment. The bicycle should be checked for proper fit. Often it is necessary to relieve the rider's extended position by using handlebars with less drop, using a stem with a shorter extension, raising the stem, or moving the seat forward. Changing hand positions on the handlebars frequently, riding with the elbows "unlocked," varying head position, using padded gloves and handlebars, and riding on wider tires all reduce the effects of road shock. Initial medical management includes ice, massage stretching, and nonsteroidal anti-inflammatory drugs or acetaminophen. Definitive treatment is neck and back rehabilitation based on dynamic muscular stabilization. It involves three progressive and overlapping parts: (1) establishing range of motion, (2) finding and stabilizing the neutral position, and (3) adapting the neutral position to exercise. PMID:8111848

  6. Cortical Bone Morphological and Trabecular Bone Microarchitectural Changes in the Mandible and Femoral Neck of Ovariectomized Rats

    PubMed Central

    Hsu, Pei-Yu; Tsai, Ming-Tzu; Wang, Shun-Ping; Chen, Ying-Ju; Wu, Jay; Hsu, Jui-Ting

    2016-01-01

    Objective This study used microcomputed tomography (micro-CT) to evaluate the effects of ovariectomy on the trabecular bone microarchitecture and cortical bone morphology in the femoral neck and mandible of female rats. Materials and Methods Twelve female Wister rats were divided into two groups: the control and ovariectomized groups. The rats in the ovariectomized group received ovariectomy at 8 weeks of age; all the rats were sacrificed at 20 weeks of age, and their mandibles and femurs were removed and scanned using micro-CT. Four microstructural trabecular bone parameters were measured for the region below the first mandibular molar and the femoral neck region: bone volume fraction (BV/TV), trabecular thickness (TbTh), trabecular separation (TbSp), and trabecular number (TbN). In addition, four cortical bone parameters were measured for the femoral neck region: total cross-sectional area (TtAr), cortical area (CtAr), cortical bone area fraction (CtAr/TtAr), and cortical thickness (CtTh). The CtTh at the masseteric ridge was used to assess the cortical bone morphology in the mandible. The trabecular bone microarchitecture and cortical bone morphology in the femoral necks and mandibles of the control group were compared with those of the ovariectomized group. Furthermore, Spearman’s correlation (rs) was conducted to analyze the correlation between the osteoporosis conditions of the mandible and femoral neck. Results Regarding the trabecular bone microarchitectural parameters, the BV/TV of the trabecular bone microarchitecture in the femoral necks of the control group (61.199±11.288%, median ± interquartile range) was significantly greater than that of the ovariectomized group (40.329±5.153%). Similarly, the BV/TV of the trabecular bone microarchitecture in the mandibles of the control group (51.704±6.253%) was significantly greater than that of the ovariectomized group (38.486±9.111%). Furthermore, the TbSp of the femoral necks in the ovariectomized group (0.185±0.066 mm) was significantly greater than that in the control group (0.130±0.026mm). Similarly, the TbSp of the mandibles in the ovariectomized group (0.322±0.047mm) was significantly greater than that in the control group (0.285±0.041mm). However, the TbTh and TbN trends for the mandibles and femoral necks were inconsistent between the control and ovariectomized groups. Regarding the cortical bone morphology parameters, the TtAr of the femoral necks in the ovariectomized group was significantly smaller than that in the control group. There was no significant difference in the TtAr, CtAr, or CtTh of the femoral necks between the control and ovariectomized groups, and no significant difference in the CtTh of the mandibles between the control and ovariectomized groups. Moreover, the BV/TV and TbSp of the mandibles were highly correlated with those of the femurs (rs = 0.874 and rs = 0.755 for BV/TV and TbSp, respectively). Nevertheless, the TbTh, TbN, and CtTh of the mandibles were not correlated with those of the femoral necks. Conclusion After the rats were ovariectomized, osteoporosis of the trabecular bone microarchitecture occurred in their femurs and mandibles; however, ovariectomy did not influence the cortical bone morphology. In addition, the parametric values of the trabecular bone microarchitecture in the femoral necks were highly correlated with those of the trabecular bone microarchitecture in the mandibles. PMID:27127909

  7. Head, neck, and brain tumor embolization guidelines

    PubMed Central

    Duffis, E Jesus; Prestigiacomo, Charles Joseph; Abruzzo, Todd; Albuquerque, Felipe; Bulsara, Ketan R; Derdeyn, Colin P; Fraser, Justin F; Hirsch, Joshua A; Hussain, Muhammad Shazam; Do, Huy M; Jayaraman, Mahesh V; Meyers, Philip M; Narayanan, Sandra

    2012-01-01

    Background Management of vascular tumors of the head, neck, and brain is often complex and requires a multidisciplinary approach. Peri-operative embolization of vascular tumors may help to reduce intra-operative bleeding and operative times and have thus become an integral part of the management of these tumors. Advances in catheter and non-catheter based techniques in conjunction with the growing field of neurointerventional surgery is likely to expand the number of peri-operative embolizations performed. The goal of this article is to provide consensus reporting standards and guidelines for embolization treatment of vascular head, neck, and brain tumors. Summary This article was produced by a writing group comprised of members of the Society of Neurointerventional Surgery. A computerized literature search using the National Library of Medicine database (Pubmed) was conducted for relevant articles published between 1 January 1990 and 31 December 2010. The article summarizes the effectiveness and safety of peri-operative vascular tumor embolization. In addition, this document provides consensus definitions and reporting standards as well as guidelines not intended to represent the standard of care, but rather to provide uniformity in subsequent trials and studies involving embolization of vascular head and neck as well as brain tumors. Conclusions Peri-operative embolization of vascular head, neck, and brain tumors is an effective and safe adjuvant to surgical resection. Major complications reported in the literature are rare when these procedures are performed by operators with appropriate training and knowledge of the relevant vascular and surgical anatomy. These standards may help to standardize reporting and publication in future studies. PMID:22539531

  8. Marfanoid habitus, dysmorphic features, and web neck.

    PubMed

    Lee, Y C; Wilson, C J; Winship, I M; Veale, A G

    2000-12-01

    Bilateral pneumothoraces and aortic dilatation developed in a 25-year-old white man with marfanoid habitus, dysmorphic features, web neck, and intellectual impairment. He had physical features suggestive of Shprintzen-Goldberg syndrome. We review the common characteristics of Marfan and Shprintzen-Goldberg syndromes and compare them with our case. Physicians should beware of potential cardiovascular abnormalities in patients with marfanoid habitus and dysmorphic features. PMID:11142456

  9. [Brachytherapy of head and neck cancer].

    PubMed

    Takácsi Nagy, Zoltán; Kásler, Miklós

    2008-06-01

    In the non-surgical treatment of head and neck tumours, the "organ preserving" modalities have become more and more important. At present radiotherapy is the most important means of this kind of treatment. In the radiotherapy of head and neck cancer local dose escalation is an important factor in increasing local tumour control. However, with sole external beam irradiation it is difficult to spare adjacent normal tissues. Interstitial brachytherapy (BT) is ideally suited to deliver a high dose limited to the volume of the primary tumour, thus maximizing tumour control while minimizing complications. Low-dose-rate (LDR) BT, which has been applied for a long time in the treatment of these tumours, is now challenged by high-dose-rate (HDR) and pulsed-dose-rate (PDR) BT. The purpose of this work is to show the role and the indications of BT in tumours of the head and neck region and to offer general and site-specific recommendations based upon the available information from the literature. PMID:18640890

  10. Talar Neck Fracture after United Tibiotalar Fusion

    PubMed Central

    Platt, W.; Welck, M.; Rudge, B.

    2015-01-01

    Tibiotalar arthrodesis is a well-established treatment for tibiotalar arthritis, for example, in younger high demand patients. Talar neck fractures are less common though well-recognised sequelae of foot ankle trauma. Here we present the clinical case of a 69-year-old male who presented to our institution with a nonunion of a talar neck fracture, having undergone a left tibiotalar fusion 24 years previously. To the authors' knowledge, this injury has only been described once previously in the literature. However, the original case described a fracture sustained in the very early postoperative period following tibiotalar fusion, postulated to be secondary to postimmobilisation osteopaenia or stress risers from metalwork. The aetiology in this case is likely due to axial compression transmitted to the talar neck via the calcaneus. The predisposing factors for nonunion are discussed, highlighting the importance of vigilance for this injury in any patient with concomitant tibiotalar fusion and foot trauma. The management of this patient is discussed. PMID:26491589

  11. Acoustic estimation of neck fluid volume.

    PubMed

    Yadollahi, A; Rudzicz, F; Mahallati, S; Coimbra, M; Bradley, T D

    2014-10-01

    Recently we showed that fluid accumulation in the neck can narrow the upper airway (UA) and increase its collapsibility, which may exacerbate obstructive sleep apnea (OSA). However, the available methods for measuring neck fluid volume (NFV) are inconvenient and expensive. Narrowing of the UA due to fluid accumulation could change acoustic characteristics of respiratory sounds. In this study, we developed a novel approach for non-invasive estimation of NFV from acoustic measurements. Twenty-eight healthy subjects lay awake and supine for 90 min while NFV and tracheal sounds were measured simultaneously using bioimpedance and a microphone, respectively. Sets of tracheal sound features were calculated in time and frequency domains and were reduced using methods based on regression and minimum-redundancy-maximum-relevance. The resulting feature sets were applied to a multi-linear regression and a mixture-density neural network to estimate NFV. Our results show very small relative estimation errors of 1.25 and 3.23%, based on the regression and neural network methods, respectively. These results support the practical application of this technology in diagnosing fluid accumulation in the neck and its possible contributions to the pathogenesis of OSA. PMID:25103604

  12. Experimental Injury Biomechanics of the Pediatric Neck

    NASA Astrophysics Data System (ADS)

    Nightingale, Roger W.; Luck, Jason F.

    Motor vehicle related crashes rank as the most common cause of spinal related injuries in the pediatric population (Platzer et al. 2007; Brown et al. 2001; Kokoska et al. 2001; Eleraky et al. 2000; Hamilton and Myles 1992a; Bonadio 1993; Babcock 1975). Pediatric spinal related trauma accounts for between 1 and 12 % of all spinal related injuries (Hamilton and Myles 1992a; Hadley et al. 1988; Aufdermaur 1974). Cervical spine trauma in children accounts for approximately 2 % of all cervical spinal injuries (Henrys et al. 1977). Approximately 1-2 % of all children admitted for traumatic injury are related to injuries to the cervical spine (Platzer et al. 2007; Brown et al. 2001; Kokoska et al. 2001; Orenstein et al. 1994; Rachesky et al. 1987). Overall, pediatric neck injury rates are significantly lower than adult rates; however, the neck injury rate in children between the ages of 11 and 15 years approaches the adult rate of 18.8 per 100,000 (McGrory et al 1993; Myers and Winkelstein 1995). For children less than 11 years of age, neck injuries are relatively rare (1.2 per 100,000), but have particularly devastating consequences (McGrory et al. 1993). The overall mortality rate amongst victims of pediatric spinal trauma is approximately 16-41 % but considerably higher for the youngest ages (Platzer et al. 2007; Brown et al. 2001; Kokoska et al. 2001; Eleraky et al. 2000; Givens et al. 1996; Orenstein et al. 1994; Hamilton and Myles 1992b).

  13. Incorporation of lower neck shear forces to predict facet joint injury risk in low-speed automotive rear impacts.

    PubMed

    Stemper, Brian D; Storvik, Steven G

    2010-06-01

    Lower neck shear force remains a viable candidate for a low-velocity automotive rear-impact injury criterion. Data were previously reported to demonstrate high correlations between the magnitude of lower neck shear force and lower cervical spine facet joint motions. The present study determined the ability of lower neck shear force to predict soft-tissue injury risk in simulated automotive rear impacts. Rear-impact tests were conducted at two velocities and with two seatback orientations using a Hybrid III anthropomorphic test device (ATD) and stock automobile seats from 2007 model year vehicles. Higher velocities and more vertical seatback orientations were associated with higher injury risk based on computational modeling simulations performed in this study. Six cervical spine injury criteria including NIC, Nij, Nkm, LNL, and lower neck shear force and bending moment, increased with impact velocity. NIC, Nij, and shear force were most sensitive to changes in impact velocity. Four metrics, including Nkm, LNL, and lower neck shear force and bending moment, increased for tests with more vertical seatback orientations. Shear force was most sensitive to changes in seatback orientation. Peak values for shear force, NIC, and Nij occurred approximately at the time of head restraint contact for all four test conditions. Therefore, of the six investigated metrics, lower neck shear force was the only metric to demonstrate consistency with regard to injury risk and timing of peak magnitudes. These results demonstrate the ability of lower neck shear force to predict injury risk during low velocity automotive rear impacts and warrant continued investigation into the sensitivity and applicability of this metric for other rear-impact conditions. PMID:20544575

  14. Influence of excisional or incisional biopsy of metastatic neck nodes on the management of head and neck cancer

    SciTech Connect

    Parsons, J.T.; Million, R.R.; Cassisi, N.J.

    1985-08-01

    Between November 1964 and December 1981, 80 patients who had undergone an open biopsy of a cervical lymph node containing squamous cell carcinoma were treated with curative intent in the University of Florida Division of Radiation Therapy. Irradiation was the initial step in the definitive treatment of all patients, followed by neck dissection and/or primary resection, as indicated. The patients were divided into two groups. (a) NX (no gross residual neck disease) (25 patients). No neck dissections were added following irradiation in this group of patients. The absolute 5 year disease-free survival in the NX group was 79%, and the rate of neck disease control was 96%. (b) Gross residual neck disease (55 patients). The absolute 5 year disease-free survival in this group of patients was 31%, and the rate of neck disease control was 64%. The more consistent addition of a neck dissection in recent years has resulted in improved neck control rates in this group. There are some differences in the rates of neck control, control above the clavicles, survival, distant metastasis, and complications between this series and other reported series in which open neck-node biopsy preceded definitive treatment. Possible reasons for these differences are discussed.

  15. Neck Effects on the Potential Energy of Superdeformed nuclei

    SciTech Connect

    Abdul-Latif, Aladdin M.

    2005-03-17

    The neck effects on the deformation energy of the two superdeformed nuclei ' 152 Dy, and 190Hg ' have been studied within the liquid drop model including a proximity energy term. The nuclear shape is considered to be two spheroids connected with a hyperboloid in the neck region. The energy is calculated as a function of a necking in parameter at different values of the ratio between the two axis of the hyperboloid. The calculated results show a strong dependence of the deformation energy on the neck geometry. The inclusion of proximity interaction in the neck region has an exciting result of producing minima in the energy curve with certain neck geometry. Such pockets in the energy allow the nuclei to exist in deformation states.

  16. Effect of Occupant and Impact Factors on Forces within Neck: II. Analysis of Specific Subsets

    NASA Astrophysics Data System (ADS)

    Shaibani, Saami J.

    2000-03-01

    The forces generated in the cervical spine were evaluated for a substantial number of motor-vehicle occupants in an associated study.[1] Correlation between these forces and various occupant- and impact-related parameters was generally not high for the broad groupings of the population considered at that time. In this research, smaller subsets with more elements in common were extracted from the data to try to detect any underlying relationships that might exist for the neck force. Although correlation coefficients for these subsets were higher than those for the previous groupings in more than three-quarters of the matches undertaken, the values still did not indicate consistently good fits. This suggests that there is no simple relationship for the force within the cervical spine and this, in turn, means that the potential for neck injury has to be evaluated on a case-by-case basis. 1. Effect of Occupant and Impact Factors on Forces within Neck: I. Overview of Large Population, Bull. Am. Phys. Soc. in press (2000).

  17. Effects of neck pain on reaching overhead and reading: a case–control study of long and short neck flexion

    PubMed Central

    2013-01-01

    Background Reaching overhead and reading are tasks that many individuals encounter daily. The level of difficulty of these tasks increases if an individual has neck pain. This study determined the neck movement patterns during these two tasks by comparing neck flexion of individuals with and without neck pain. Methods This case control study used the portable video technology, Dartfish ProSuite 5.5 Video Software, to analyse neck flexion movement patterns. Healthy individuals and individuals with neck pain were videotaped while they completed two tasks: reaching overhead from a standing position and reading from a sitting position. A single position of interest was selected for analysis from both tasks. The degree of neck flexion presented by the participant in this position at the beginning and end of the task was recorded. The angle change between these two time points was calculated for each participant. Differences between groups were determined by comparing the average flexion angle changes in groups by t-tests. Results The average angle change experienced by controls and neck pain participants during the overhead reaching tasks were very similar and a significant difference was not observed. The average angle changes experienced by the two groups during the reading task were more variable, but not significantly different. A t-test comparing average neck flexion angle change during dominant arm elevation for controls (m = −5.28˚, sd = 31.14) and neck pain participants (m = 5.07˚, sd = 32.41) revealed a mean between group difference of −10.34˚ (t17 = −0.688, p = 0.5003). The average neck flexion angle change during long neck flexion was not statistically different between controls (m = 10.08˚, sd = 18.89) and neck pain participants (m = 4˚, sd = 18.18); although the mean between group difference was 6.08˚ (t17 = 0.6856, p = 0.5022). Conclusions Task performance is highly variable between individuals making it difficult to assess the impact of neck pain on small samples even with detailed motion analysis. Despite this, there was a difference in neck posture during reaching activities between controls and patients with neck pain. Neck pain can therefore influence the movement patterns used during daily activities. This has implications for primary and secondary prevention. PMID:24119534

  18. Longitudinal evaluation of time related femoral neck narrowing after metal-on-metal hip resurfacing

    PubMed Central

    Wang, Wenbao; Geller, Jeffrey A; Hasija, Rohit; Choi, Jung Keun; Patrick, David A Jr.; Macaulay, William

    2013-01-01

    AIM: To track the short-term neck narrowing changes in Birmingham metal-on-metal hip resurfacing (MOMHR) patients. METHODS: Since 2001, the Center for Hip and Knee Replacement started a registry to prospectively collect data on hip and knee replacement patients. From June 2006 to October 2008, 139 MOMHR were performed at our center by two participate surgeons using Birmingham MOMHR prosthesis (Smith Nephew, United States). It is standard of care for patients to obtain low, anteriorposterior (LAP) pelvis radiographs immediately after MOMHR procedure and then at 3 mo, 1 year and 2 year follow up office visits. Inclusion criteria for the present study included patients who came back for follow up office visit at above mentioned time points and got LAP radiographs. Exclusion criteria include patients who missed more than two follow up time points and those with poor-quality X-rays. Two orthopaedic residency trained research fellows reviewed the X-rays independently at 4 time points, i.e., immediate after surgery, 3 mo, 1 year and 2 year. Neck-to-prosthesis ratio (NPR) was used as main outcome measure. Twenty cases were used as subjects to identify the reliability between two observers. An intraclass correlation coefficient at 0.8 was considered as satisfied. A paired t-test was used to evaluate the significant difference between different time points with P < 0.05 considered to be statistically significant. RESULTS: The mean NPRs were 0.852 ± 0.056, 0.839 ± 0.052, 0.835 ± 0.051, 0.83 ± 0.04 immediately, 3 mo, 1 year and 2 years post-operatively respectively. At 3 mo, NPR was significantly different from immediate postoperative X-ray (P < 0.001). There was no difference between 3 mo and 1 year (P = 0.14) and 2 years (P = 0.53). Femoral neck narrowing (FNN) exceeding 10% of the diameter of the neck was observed in only 4 patients (5.6%) at two years follow up. None of these patients developed a femoral neck fracture (FNF). CONCLUSION: Femoral neck narrowing after MOMHR occurred as early as 3 mo postoperatively, and stabilized thereafter. Excessive FNN was not common in patients within the first two years of surgery and was not correlated with risk of FNF. PMID:23610755

  19. Unusual head and neck injury in elevator: autopsy study.

    PubMed

    Eren, B; Türkmen, N; Dokgöz, H

    2012-10-01

    Industrial injuries related to auto-load-carrying vehicles were not frequently reported in the literature. Presented case was, 31-year-old male furniture worker. Deceased was found in awkward position in furniture workshop. Victim was observed on his knees in front of the elevator, head and neck lodged within openings of the elevator, and head and neck structures compressed-guillotined by the lower platform of the elevator were detected. We presented rare case of head and neck compression by elevator. Key words: head - neck - accidents - elevator - autopsy. PMID:23121036

  20. Determinants of +Gz-related neck pain: a preliminary survey.

    PubMed

    Hämäläinen, O; Vanharanta, H; Bloigu, R

    1993-07-01

    The aim of the present study was to detect determinants of acute inflight neck pain in a cohort of 27 student fighter pilots frequently exposed to high +Gz forces. Strenuousness of work, job satisfaction, psychological distress, smoking habits, and frequency of muscle strength, muscle endurance, and aerobic training regimens were inquired about by questionnaire. Physical examination determined the subjects' height, body weight, body mass index, head and neck circumference, passive cervical range of motion, grip strength, and isometric strength of neck muscles. The frequency of muscle endurance training was the only possible determinant related to experienced acute inflight neck pain. PMID:8357321

  1. Ipsilateral Acetabular and Femoral Neck and Shaft Fractures

    PubMed Central

    Irifune, Hideto; Hirayama, Suguru; Takahashi, Nobuyuki; Narimatsu, Eichi

    2015-01-01

    Floating hip injuries and ipsilateral femoral neck and shaft fractures are rare. Additionally, the simultaneous occurrence of these injuries is extremely rare, and only one case report of the simultaneous occurrence of these injuries has been published. Here, we report the case of a patient with ipsilateral acetabular and femoral neck and shaft fractures following a suicide attempt. The patient experienced nonunion of the femoral neck and shaft after the initial operation and therefore underwent reconstruction using a femoral head prosthesis with a long stem and interlocking screws. Our procedure may be used in primary and/or secondary reconstruction for ipsilateral acetabular and femoral neck and shaft fractures. PMID:26171267

  2. Neck muscle activity in skydivers during parachute opening shock.

    PubMed

    Lo Martire, R; Gladh, K; Westman, A; Lindholm, P; Nilsson, J; Äng, B O

    2016-03-01

    This observational study investigated skydiver neck muscle activity during parachute opening shock (POS), as epidemiological data recently suggested neck pain in skydivers to be related to POS. Twenty experienced skydivers performed two terminal velocity skydives each. Surface electromyography quantified muscle activity bilaterally from the anterior neck, the upper and lower posterior neck, and the upper shoulders; and two triaxial accelerometers sampled deceleration. Muscle activity was normalized as the percentage of reference maximum voluntary electrical activity (% MVE); and temporal muscle activity onset was related to POS onset. Our results showed that neck muscle activity during POS reached mean magnitudes of 53-104% MVE, often exceeding reference activity in the lower posterior neck and upper shoulders. All investigated muscle areas' mean temporal onsets occurred <50 ms after POS onset (9-34 ms latencies), which is consistent with anticipatory motor control. The high muscle activity observed supports that the neck is under substantial strain during POS, while temporal muscle activation suggests anticipatory motor control to be a strategy used by skydivers to protect the cervical spine from POS. This study's findings contribute to understanding the high rates of POS-related neck pain, and further support the need for evaluation of neck pain preventative strategies. PMID:25754941

  3. Patterns of sexual, bilateral and interpopulational variation in human femoral neck-shaft angles

    PubMed Central

    ANDERSON, JOHN Y.; TRINKAUS, ERIK

    1998-01-01

    Data on femoral neck-shaft angles were collected for 30 modern, historic and prehistoric human population samples, and analysed with respect to sexual dimorphism, bilateral asymmetry, geographical patterning and general economic level. Although some samples had modest sexual dimorphism in this angle, and some individuals exhibited clear asymmetry, there were no consistent patterns of sexual or side differences across human populations. Similarly, there was no evidence for geographic differences, since broad regional groups lacked significant differences and mean angles were not correlated with latitude. However, there is a significant increase in mean neck-shaft angles across populations with an increasingly sedentary existence and with mechanisation. The last reflects the developmental plasticity of this feature with respect to habitual load levels during ontogeny of the hip region. PMID:9643428

  4. Early-onset dropped head syndrome after radiotherapy for head and neck cancer: dose constraints for neck extensor muscles

    PubMed Central

    Inaba, Koji; Nakamura, Satoshi; Okamoto, Hiroyuki; Kashihara, Tairo; Kobayashi, Kazuma; Harada, Ken; Kitaguchi, Mayuka; Sekii, Shuhei; Takahashi, Kana; Murakami, Naoya; Ito, Yoshinori; Igaki, Hiroshi; Uno, Takashi; Itami, Jun

    2016-01-01

    Dropped head syndrome (DHS) is a famous but unusual late complication of multimodality treatment for head and neck carcinoma. We reported this early-onset complication and analyzed the dose to the neck extensor muscles. We examined the records of three patients with DHS after radiotherapy. The doses to the neck extensor muscles were compared between three patients with DHS and nine patients without DHS. The mean dose to the neck extensor muscles of the three patients with DHS were 58.5 Gy, 42.3 Gy and 60.9 Gy, while the dose was <50 Gy in all nine patients in the control group. The onset of this syndrome was 5 months, 6 months and 15 months. The early-onset DHS may have something to do with dose to the neck extensor muscles. The proposed dose to the neck extensor muscles might be <46 Gy (or at least <50 Gy). PMID:26684338

  5. Approaches of robot-assisted neck dissection for head and neck cancer: a review.

    PubMed

    Zhou, Shanghui; Zhang, Chenping; Li, Daqing

    2016-04-01

    Robot-assisted surgery is being increasingly used by surgeons because of its enhancement of visualization, precision, and articulation compared with conventional minimally invasive techniques. In recent years, robot-assisted neck dissection (RAND) has begun to be used as an alternative method of neck dissection, one of the classic surgical procedures in the area of head and neck surgery. Currently, there are four kinds of approaches for RAND: (1) modified facelift or retroauricular incision, (2) combined transaxillary and retroauricular incision, (3) transaxillary incision, and (4) transoral incision. RAND may help perform minimally invasive surgery and achieve excellent cosmetic results as well as the desired oncologic outcomes, and this requires selecting an appropriate approach based on the different needs of neck dissections. Although experienced surgeons wishing to avoid large cervical incisions in patients can safely perform RAND, there are still quite a few limitations; in particular, surgical morbidity and oncologic outcomes should be verified by further prospective clinical trials with longer follow-up periods. Also, RAND needs to be standardized and its use disseminated. In this review, we introduce the applications of different approaches for RAND and their indications and determine whether RAND can be more beneficial compared with conventional surgeries. PMID:26768074

  6. Histomorphometric analysis of the femoral neck in patients with and without femoral neck fracture

    PubMed Central

    de Souza, Caio Gonçalves; Jorgetti, Vanda; dos Reis, Luciene Machado; Croci, Alberto Tesconi

    2015-01-01

    OBJECTIVE: To determine, through bone histomorphometry in femoral neck, whether there are differences in the cancellous bone of the proximal femur from female patients over 60 years old who had femoral neck fracture and similar patients who did not have such fracture. METHODS: We analyzed the trabecular part of the femur of 13 female patients, aged over 60 years old, by the bone histomorphometry method. Seven of these patients had femoral neck fracture. All of them were subjected to hip arthroplasty. RESULTS: Bone densitometry showed no significant difference. There was no significant difference on the average thickness of the trabecular bone (124.38µm versus 147.09µm). The number of bone trabeculae was lower (1.52, versus 1.88) and the separation between them was larger (541,19µm versus 391,14µm) in the fracture group. CONCLUSION: A difference in histomorphometric parameters of cancellous bone of the femur neck was observed among patients who had fractures as compared to patients who had not. Level of Evidence II, Diagnostic Studies.

  7. [HPV associated head and neck cancers].

    PubMed

    Vourexakis, Zacharias; Dulguerov, Pavel

    2011-10-01

    The incidence of oropharyngeal squamous cell carcinoma is rising and this increase is linked to sexual behaviors. Viral and epidemiological studies have linked tonsillar and base of tongue carcinoma with a human papilloma virus (HPV) infection. The patients involved are usually younger and do not exhibit other risk factors such as smoking and alcohol abuse. HPV positive squamous cell carcinoma are associated with a better prognosis than other head and neck carcinoma. Differences in the carcinogenesis mechanisms open options for different and specific oncologic treatments and the potential for prevention of these HPV-related carcinoma by vaccination. PMID:22046680

  8. Cutaneous malignancy of the head and neck.

    PubMed

    Mydlarz, Wojciech K; Weber, Randal S; Kupferman, Michael E

    2015-07-01

    Most skin cancers of the head and neck are nonmelanoma skin cancers (NMSCs). Basal cell carcinoma and squamous cell carcinoma are the most frequent types of NMSCs. Treatment options including wide local excision, Mohs surgery, sentinel lymph node biopsy, and cervical lymphadenectomy and adjuvant radiation when warranted offer a high cure rate, while balancing excellent functional and cosmetic outcomes. Evaluation by a multidisciplinary team is highly recommended with advanced and aggressive lesions. Avoidance of sunburns and acute sun damage, sunscreen protection, and early identification and evaluation of suspicious lesions remain the first line of defense against skin cancers. PMID:25979402

  9. Imaging for head and neck cancer.

    PubMed

    Abraham, Jesty

    2015-07-01

    Imaging is an essential tool in the management of head and neck cancer. Oral, oropharyngeal, laryngeal, and hypopharyngeal lesions are initially imaged with computed tomography (CT) because it allows rapid image acquisition and reduces artifacts related to respiration and swallowing, which can degrade image quality and limit evaluation. Sinonasal, nasopharyngeal, and salivary gland tumors are better approached with MRI because it allows for better delineation of tumor extent. PET/CT is usually reserved for advanced disease to evaluate for distant metastatic disease and posttreatment residual and recurrent disease. Imaging is best used in combination with expert clinical and physical examination. PMID:25979394

  10. 42 CFR 84.139 - Head and neck protection; supplied-air respirators; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Head and neck protection; supplied-air respirators... PROTECTIVE DEVICES Supplied-Air Respirators § 84.139 Head and neck protection; supplied-air respirators... neck....

  11. 42 CFR 84.139 - Head and neck protection; supplied-air respirators; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Head and neck protection; supplied-air respirators... PROTECTIVE DEVICES Supplied-Air Respirators § 84.139 Head and neck protection; supplied-air respirators... neck....

  12. 78 FR 65451 - Agency Information Collection (Neck (Cervical Spine) Conditions Disability Benefits Questionnaire...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-31

    ... AFFAIRS Agency Information Collection (Neck (Cervical Spine) Conditions Disability Benefits Questionnaire... oira_submission@omb.eop.gov . Please refer to ``OMB Control No. 2900-- NEW (Neck (Cervical Spine...- ] NEW (Neck (Cervical Spine) Conditions Disability Benefits Questionnaire).'' SUPPLEMENTARY...

  13. Diagnosis and management of neck metastases from an unknown primary

    PubMed Central

    Calabrese, L; Jereczek-Fossa, BA; Jassem, J; Rocca, A; Bruschini, R; Orecchia, R; Chiesa, F

    2005-01-01

    Summary Neck lymph node metastases from occult primary constitute about 5%-10% of all patients with carcinoma of unknown primary site. Metastases in the upper and middle neck (levels I-II-III-V) are generally attributed to head and neck cancers, whereas the lower neck (level IV) involvement is often associated with primaries below the clavicles. Diagnostic procedures include a careful clinical evaluation and a fiberoptic endoscopic examination of the head and neck mucosa, biopsies from all suspicious sites or blindly from the sites of possible origin of the primary, computerized tomography scan, and magnetic resonance. The most frequent histological finding is Squamous Cell Carcinoma, particularly when the upper neck is involved. In these cases, a systematic tonsillectomy in the absence of suspicious lesions is discussed since up to 25% of primary tumours can be detected in this site. Thoracic, and abdominal primaries (especially from lung, oesophagus, stomach, ovary or pancreas) should be sought in the case of adenocarcinoma and involvement of the lower neck. Positron emission tomography with fluoro-2-deoxy-D-glucose allows detection of primary tumour in about 25% of cases, but this procedure is still considered investigational. Therapeutic approaches include surgery (neck dissection), with or without post-operative radiotherapy, radiotherapy alone and radiotherapy followed by surgery as reported by several guide-lines. In early stages (N1), neck dissection and radiotherapy seem to have similar efficacy, whereas more advanced cases (N2, N3) require combined approaches. The extent of radiotherapy (irradiation of bilateral neck and mucosa versus ipsilateral neck radiotherapy) remains debatable. A potential benefit from extensive radiotherapy should be weighed against its acute and late morbidity and difficulties in re-irradiation in the case of subsequent primary emergence. The role of other methods, such as chemotherapy and hyperthermia, remains to be determined. PMID:16080309

  14. Phenylbutyrate interferes with the Fanconi anemia and BRCA pathway and sensitizes head and neck cancer cells to cisplatin

    PubMed Central

    Burkitt, Kyunghee; Ljungman, Mats

    2008-01-01

    Background Cisplatin has been widely used to treat head and neck cancer. One of the clinical limitations with this treatment, however, is that tumors that are initially responsive to cisplatin later acquire resistance. We have recently shown that a subset of head and neck cancer cell lines has a defective Fanconi anemia DNA damage response pathway and this defect correlates to cisplatin sensitivity. We have also shown that the histone deacetylase inhibitor phenylbutyrate sensitize human cells to cisplatin. In this study we explored whether phenylbutyrate may sensitize head and neck cancer cells by interfering with the Fanconi anemia pathway. Results We found that the phenylbutyrate sensitizes head and neck cancer cell lines to cisplatin. This sensitization by phenylbutyrate correlated to a significant decrease in the formation of cisplatin-induced FANCD2 nuclear foci, which is a functional read out of the Fanconi anemia and BRCA (FA/BRCA) pathway. This abrogation of the FA/BRCA pathway by phenylbutyrate was not due to loss of FANCD2 monoubiquitylation but rather correlated to a phenylbutyrate-mediated reduction in the expression of the BRCA1 protein. Furthermore, we found that cancer cells defective in the FA pathway were also sensitized to cisplatin by phenylbutyrate suggesting that phenylbutyrate targets additional pathways. Conclusion The results from this study suggest that phenylbutyrate may have therapeutic utility as a cisplatin sensitizer in head and neck cancer by inhibiting the FA/BRCA pathway through the down regulation of BRCA1 as well as by an FA/BRCA-independent mechanism. PMID:18325101

  15. Fatigue During Head-And-Neck Radiotherapy: Prospective Study on 117 Consecutive Patients

    SciTech Connect

    Jereczek-Fossa, Barbara Alicja . E-mail: barbara.fossa@ieo.it; Santoro, Luigi; Alterio, Daniela; Franchi, Benedetta; Fiore, Maria Rosaria; Fossati, Piero; Kowalczyk, Anna; Canino, Paola; Ansarin, Mohssen; Orecchia, Roberto

    2007-06-01

    Purpose: Fatigue is an underevaluated cancer-related and treatment-related symptom. We analyzed fatigue in head and neck cancer patients undergoing radiotherapy (RT). Methods and Materials: A total of 117 patients were enrolled (mean age, 58 years). Radiation therapy (median dose, 66 Gy) was given with either exclusive or postoperative intent in 52 and 65 patients, respectively. Chemotherapy (CT) was added before and/or during RT in 61 patients. The patients completed a 20-item questionnaire (Multidimensional Fatigue Inventory [MFI-20]) before, during (weekly), and after RT. The impact of patient-, tumor-, and treatment-related factors on fatigue was evaluated with unifactorial and multifactorial tests. Results: Fatigue level increased during RT reaching a maximum at Week 6 and then slowly decreased. In multivariate stepwise regression analysis age (inversely related, p < 0.05), psychologic disorders (p < 0.005), and previous head-and-neck surgery (inversely related, p < 0.005) were correlated with higher pre-RT fatigue level. Pre-RT fatigue score (p < 0.0001), induction and/or concomitant CT (p = 0.035), need of cortisone during RT (p = 0.005), and thyroid disorders (p = 0.032) were correlated with higher during-RT fatigue level. Pre-RT fatigue score (p < 0.0001), induction and/or concomitant CT (p < 0.001), and need of cortisone during RT (p < 0.005) were correlated with higher post-RT fatigue level. No impact of gender, performance status, comorbidities other than psychologic and thyroid, tumor stage/site, RT intent, dose, volume, duration, or toxicity was observed. Conclusion: Fatigue affects all patients undergoing RT for head-and-neck cancer, reaches maximum score at the 6th week of RT, and slowly decreases thereafter. Age, thyroid dysfunction, psychologic disorders, pre-RT fatigue score, CT, and cortisone use are correlated with RT-related fatigue levels.

  16. [Imaging of the head and neck region].

    PubMed

    Lell, M; Mantsopoulos, K; Uder, M; Wuest, W

    2016-02-01

    Tumors of the head and neck are predominantly squamous cell carcinomas and those of the salivary glands are predominantly adenocarcinomas, adenoid cystic carcinomas and mucoepidermoid carcinomas. In 2011 the incidence of tumors of the oral cavity and pharynx in Germany was 6839 (5026 male and 1813 female) and of the larynx 1878 (1642 male and 236 female). The incidence of tumors of the nose and paranasal sinuses (467) and salivary glands (470) were much lower ( www.krebsdaten.de/abfrage ). The primary aim of imaging in head and neck cancer is staging of the disease and a precise assessment of tumor invasion. This information is essential for therapy decision-making (i. e. surgery or radiochemotherapy), planning of the extent of resection and subsequent reconstructive measures and also estimation of functional deficits after therapy. Computed tomography (CT) and magnetic resonance imaging (MRI) are the imaging modalities of choice but both have specific advantages and disadvantages. In certain cases both CT and MRI need to be performed for accurate treatment planning. PMID:26825063

  17. [Imaging of the head and neck region].

    PubMed

    Lell, M; Mantsopoulos, K; Uder, M; Wuest, W

    2016-03-01

    Tumors of the head and neck are predominantly squamous cell carcinomas and those of the salivary glands are predominantly adenocarcinomas, adenoid cystic carcinomas and mucoepidermoid carcinomas. In 2011 the incidence of tumors of the oral cavity and pharynx in Germany was 6839 (5026 male and 1813 female) and of the larynx 1878 (1642 male and 236 female). The incidence of tumors of the nose and paranasal sinuses (467) and salivary glands (470) were much lower ( www.krebsdaten.de/abfrage ). The primary aim of imaging in head and neck cancer is staging of the disease and a precise assessment of tumor invasion. This information is essential for therapy decision-making (i. e. surgery or radiochemotherapy), planning of the extent of resection and subsequent reconstructive measures and also estimation of functional deficits after therapy. Computed tomography (CT) and magnetic resonance imaging (MRI) are the imaging modalities of choice but both have specific advantages and disadvantages. In certain cases both CT and MRI need to be performed for accurate treatment planning. PMID:26923486

  18. Altered fractionation for head and neck cancer.

    PubMed

    Garden, A S

    2001-10-01

    A conventional course of radiation for squamous cell carcinoma in the United States is generally 70 Gy in 7 weeks, with a once-daily dose of 1.8 to 2 Gy. This schedule has a modest success rate in curing head and neck cancer. The past several decades have seen numerous investigations into altering this schedule to optimize the results of radiation. Two approaches, founded on radiobiologic principles and clinical observations, have been tested with overlap between both concepts. Hyperfractionation is based on the ability to deliver radiotherapy in small fractions and increased total doses, while not adding to late toxicity. Accelerated fractionation is based on the observations that radiation injury causes accelerated tumor clonogen repopulation and that shortening the overall treatment time helps overcome this phenomenon. Both approaches have been shown to result in modest gains when tested in randomized trials, culminating with the completion of a Radiation Therapy Oncology Group trial (RTOG 9003). This randomized trial of more than 1,000 patients addressed various fractionation schedules proposed to improve results for head and neck cancer patients treated with radiation. PMID:11702960

  19. Photodynamic therapy of head and neck tumors

    NASA Astrophysics Data System (ADS)

    Vakoulovskaya, Elena G.; Shental, Victor V.; Abdoullin, N. A.; Kuvshinov, Yury P.; Tabolinovskaia, T. D.; Edinak, N. J.; Poddubny, Boris K.; Lioubaev, V. L.; Boikov, V. P.; Kondratjeva, T. T.; Meerovich, Gennadii A.; Stratonnikov, Alexander A.; Linkov, Kirill G.; Agafonov, Valery V.

    1996-12-01

    This paper deals with the results of stage 1 clinical trials for sulfated aluminum phthalocyanine (PHS) (Photosens, Russia) in 1994-1996. The results of photodynamic therapy (PDT) of head and neck tumors (HNT), side effects and ways of their correction and prevention, as well as changes in doses of injected photosensitizer (PS), regimes of light irradiation, choice of laser and type of irradiation (surface or interstitial) are discussed. PDT have been provided in 42 patients (93 tumor sites) with different head and neck tumors. Fluorescent diagnostics of tumor, accumulation of PS in tumor, adjacent tissue has been fulfilled. Total 78 PDT sessions have been done. As a source of light we used: quantoscope, solid laser, krypton laser, tunable dye laser, He-Ne-laser. In 38 tumor sites (21 patients) -- 40.8% -- we had clinical response, in 27 tumor sites (16 patients) -- 29.0% -- we had partial response, in 28 tumor sites (8 patients) -- 30.2% -- we had no response. Our experience shows pronounced efficacy of PDT for HNT, except of melanoma. Providing PDT twice with the interval 24 - 72 hours when retention of PS is sufficient for treatment, did additive effect to the tumor, but didn't increase adjacent tissue damage.

  20. A case of neck ectopic meningioma.

    PubMed

    Sanei, Mohammad Hossein; Berjis, Nezamaldin; Mahzouni, Parvin; Naimi, Azar

    2008-04-01

    Primary extra cranial and extra spinal meningioma is rare and is usually limited to the head and neck region or to the paravertebral soft tissues. Histologic diagnosis (in particular for fresh specimens) is often difficult. A 16-year-old girl with a cervical mass is presented. It was a relatively large mass with an approximate diameter of 5 cm. It was diagnosed in fine needle aspiration as a pleomorphic adenoma. Intra-operative diagnosis was paraganglioma and frozen section suggested an infiltrative tumor. Histologically, the lesion showed uniform spindle cell proliferation separated by hyalinized collagen bundles. The cells were often arranged in sweeping fascicles and concentrically wrapped in tight whorls. Immunohistochemically, tumor cells were positive for epithelial membrane antigen and vimentin, while showing no reaction for cytokeratin, chromogranin, neuron-specific enolase and thyroglobulin. A diagnosis of ectopic meningioma was established based on microscopic appearance and immunohistochemical profile of the tumor. Despite its rarity, ectopic meningioma should be considered in differential diagnosis of any mass lesion in head and neck regions, containing spindle cells. PMID:18179413

  1. [Immunotherapy in head and neck cancer].

    PubMed

    Kansy, B; Hussain, T; Mattheis, S; Wollenberg, B; Brandau, S; Lang, S

    2015-11-01

    The physiological immune response to malignant cells is based on the interaction of antigen-presenting cells, such as dendritic cells and macrophages, with T and B lymphocytes. CD8(+) effector and natural killer cells are primarily responsible for tumor cell lysis. Tumor cells exploit several mechanisms to influence the body's immune system and promote development and progress of solid head and neck malignancies. Via regulatory T cells, myeloid-derived suppressor cells, tumor-associated macrophages, and cancer-associated fibroblasts, tumor cells promote development of suppressive signaling pathways that enable tumor progression. Novel immune therapeutics aim to influence these signaling pathways. Current studies are investigating agents which influence immune-stimulating or immune-suppressive cytokines, as well as drug-based Toll-like receptor activation and vaccination in head and neck cancer. Development of monoclonal antibodies allows for direct and highly specific binding of therapeutics to cell receptors - recently discovered immune checkpoint receptors are particularly intriguing targets. Monoclonal antibodies directed specifically toward T cell-stimulating receptors such as CD28 and CD134, or immunosuppressive receptors CTLA-4 and PD-1, are currently under investigation and have shown promising results. PMID:26452491

  2. Neck Proprioception Shapes Body Orientation and Perception of Motion

    PubMed Central

    Pettorossi, Vito Enrico; Schieppati, Marco

    2014-01-01

    This review article deals with some effects of neck muscle proprioception on human balance, gait trajectory, subjective straight-ahead (SSA), and self-motion perception. These effects are easily observed during neck muscle vibration, a strong stimulus for the spindle primary afferent fibers. We first remind the early findings on human balance, gait trajectory, SSA, induced by limb, and neck muscle vibration. Then, more recent findings on self-motion perception of vestibular origin are described. The use of a vestibular asymmetric yaw-rotation stimulus for emphasizing the proprioceptive modulation of motion perception from the neck is mentioned. In addition, an attempt has been made to conjointly discuss the effects of unilateral neck proprioception on motion perception, SSA, and walking trajectory. Neck vibration also induces persistent aftereffects on the SSA and on self-motion perception of vestibular origin. These perceptive effects depend on intensity, duration, side of the conditioning vibratory stimulation, and on muscle status. These effects can be maintained for hours when prolonged high-frequency vibration is superimposed on muscle contraction. Overall, this brief outline emphasizes the contribution of neck muscle inflow to the construction and fine-tuning of perception of body orientation and motion. Furthermore, it indicates that tonic neck-proprioceptive input may induce persistent influences on the subject’s mental representation of space. These plastic changes might adapt motion sensitiveness to lasting or permanent head positional or motor changes. PMID:25414660

  3. Doing Great Things in Great Neck, New York

    ERIC Educational Resources Information Center

    Olson, Catherine Applefeld

    2007-01-01

    This article features Joe Rutkowski, an instrumental music director at Great Neck North School in New York. Rutkowski had been teaching for 17 years at Great Neck North and is quite popular for the way he makes his students deeply involved with music. Rutkowski, who is a fourth-generation musician in a family of instrumentalists, received…

  4. Conversation about Necks--and Minds and Bodies.

    ERIC Educational Resources Information Center

    Jeffers, Carol S.

    2000-01-01

    States that by considering necks in a literal sense it may be possible to envision new metaphors for understanding minds, bodies, and ways of knowing. Discusses necks as important signs for such ideas as beauty or fragility. Focuses on views of epistemology, such as the disembodied way of knowing. (CMK)

  5. 49 CFR 572.73 - Neck assembly and test procedure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Neck assembly and test procedure. 572.73 Section 572.73 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 6-Year-Old Child § 572.73 Neck assembly and...

  6. 49 CFR 572.73 - Neck assembly and test procedure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Neck assembly and test procedure. 572.73 Section 572.73 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES 6-Year-Old Child § 572.73 Neck assembly and...

  7. Necrotizing fasciitis in patients with head and neck cancer.

    PubMed

    Malik, Akshat; Chakrabarty, Swagnik; Nair, Sudhir; Nair, Deepa; Chaturvedi, Pankaj

    2015-04-01

    Necrotizing fasciitis is a severe polybacterial infection characterized by necrosis of the fascia and adjacent soft tissues with rapid expansion of the infection along the fascial planes. It is a rare and potentially fatal entity in the head and neck region. We present 2 patients with head and neck cancers who developed necrotizing fasciitis during the postoperative period. PMID:25721060

  8. Neck Injuries and Disorders - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Are Here: Home → Multiple Languages → All Health Topics → Neck Injuries and Disorders URL of this page: https://www.nlm.nih. ... V W XYZ List of All Topics All Neck Injuries and Disorders - Multiple Languages To use the sharing features on ...

  9. Kinematics of a Head-Neck Model Simulating Whiplash

    ERIC Educational Resources Information Center

    Colicchia, Giuseppe; Zollman, Dean; Wiesner, Hartmut; Sen, Ahmet Ilhan

    2008-01-01

    A whiplash event is a relative motion between the head and torso that occurs in rear-end automobile collisions. In particular, the large inertia of the head results in a horizontal translation relative to the thorax. This paper describes a simulation of the motion of the head and neck during a rear-end (whiplash) collision. A head-neck model that

  10. Unravelling the complexity of muscle impairment in chronic neck pain.

    PubMed

    Falla, D

    2004-08-01

    Exercise interventions are deemed essential for the effective management of patients with neck pain. However, there has been a lack of consensus on optimal exercise prescription, which has resulted from a paucity of studies to quantify the precise nature of muscle impairment, in people with neck pain. This masterclass will present recent research from our laboratory, which has utilized surface electromyography to investigate cervical flexor muscle impairment in patients with chronic neck pain. This research has identified deficits in the motor control of the deep and superficial cervical flexor muscles in people with chronic neck pain, characterized by a delay in onset of neck muscle contraction associated with movement of the upper limb. In addition, people with neck pain demonstrate an altered pattern of muscle activation, which is characterized by reduced deep cervical flexor muscle activity during a low load cognitive task and increased activity of the superficial cervical flexor muscles during both cognitive tasks and functional activities. The results have demonstrated the complex, multifaceted nature of cervical muscle impairment, which exists in people with a history of neck pain. In turn, this has considerable implications for the rehabilitation of muscle function in people with neck pain disorders. PMID:15245706

  11. A Modified Dissection Method to Preserve Neck Structures

    ERIC Educational Resources Information Center

    Hankin, Mark H.; Stoller, Jeremy L.

    2009-01-01

    The neck is not only one of the more challenging anatomical regions to dissect but also has important application to clinical conditions, diseases, and procedures. In this study, we describe two simple modifications for dissection of the neck that (1) aid in the identification and preservation of the cutaneous branches of the cervical plexus and…

  12. Kinematics of a Head-Neck Model Simulating Whiplash

    ERIC Educational Resources Information Center

    Colicchia, Giuseppe; Zollman, Dean; Wiesner, Hartmut; Sen, Ahmet Ilhan

    2008-01-01

    A whiplash event is a relative motion between the head and torso that occurs in rear-end automobile collisions. In particular, the large inertia of the head results in a horizontal translation relative to the thorax. This paper describes a simulation of the motion of the head and neck during a rear-end (whiplash) collision. A head-neck model that…

  13. The equine neck and its function during movement and locomotion.

    PubMed

    Zsoldos, Rebeka R; Licka, Theresia F

    2015-10-01

    During both locomotion and body movements at stance, the head and neck of the horse are a major craniocaudal and lateral balancing mechanism employing input from the visual, vestibular and proprioceptive systems. The function of the equine neck has recently become the focus of several research groups; this is probably also feeding on an increase of interest in the equine neck in equestrian sports, with a controversial discussion of specific neck positions such as maximum head and neck flexion. The aim of this review is to offer an overview of new findings on the structures and functions of the equine neck, illustrating their interplay. The movement of the neck is based on intervertebral motion, but it is also an integral part of locomotion; this is illustrated by the different neck conformations in the breeds of horses used for various types of work. The considerable effect of the neck movement and posture onto the whole trunk and even the limbs is transmitted via bony, ligamentous and muscular structures. Also, the fact that the neck position can easily be influenced by the rider and/or by the employment of training aids makes it an important avenue for training of new movements of the neck as well as the whole horse. Additionally, the neck position also affects the cervical spinal cord as well as the roots of the spinal nerves; besides the commonly encountered long-term neurological effects of cervical vertebral disorders, short-term changes of neural and muscular function have also been identified in the maximum flexion of the cranial neck and head position. During locomotion, the neck stores elastic energy within the passive tissues such as ligaments, joint capsules and fasciae. For adequate stabilisation, additional muscle activity is necessary; this is learned and requires constant muscle training as it is essential to prevent excessive wear and tear on the vertebral joints and also repetitive or single trauma to the spinal nerves and the spinal cord. The capability for this stabilisation decreases with age in the majority of horses due to changes in muscle tissue, muscle coordination and consequently muscle strength. PMID:26163862

  14. +Gz-related neck pain: a follow-up study.

    PubMed

    Hämäläinen, O; Vanharanta, H; Bloigu, R

    1994-01-01

    This epidemiologic study was aimed at detecting determinants of acute inflight neck pain. It followed a cohort of 66 student fighter pilots from 1 to 3 years. These pilots were frequently exposed to high +Gz forces. The number of flight hours, strenuousness of work, job satisfaction, symptoms suggesting psychologic distress, smoking habits, and the frequency of muscle strength, muscle endurance, and aerobic training were investigated by questionnaires at the beginning and end of the follow-up period. Physical examination, consisting of measurement of height, body weight, body mass index, head and neck circumference, passive cervical range of motion, grip strength, and isometric strength of neck muscles was done only at the beginning of the study. The cumulative incidence of acute inflight neck pain was 37.9%. The number of flight hours was found to be the only significant determinant of acute inflight neck pain. PMID:8117219

  15. Neuromuscular adaptation in experimental and clinical neck pain.

    PubMed

    Falla, Deborah; Farina, Dario

    2008-04-01

    The purpose of this brief review is to present evidence from experimental and clinical neck pain studies of pain-induced neuromuscular adaptations. It has been shown that clinical neck pain is associated with a substantial reorganization in the control strategies of cervical muscles during static and dynamic tasks. Experimental neck pain models allow local elicitation of nociceptive afferents, mimicking the sensory aspects of clinical pain, without major changes in muscle properties. These models may help understand the physiological mechanisms underlying the observations from clinical neck pain studies. The knowledge obtained from the interpretation of clinical findings with experimental pain models has relevance for the development of therapeutic interventions for the rehabilitation of patients with neck pain disorders. PMID:17196826

  16. A Pilot Study of the Inability to Fit Hands Around Neck as a Predictor of Obstructive Sleep Apnea

    PubMed Central

    Edmonds, Peter J; Edmonds, Lee C

    2015-01-01

    Background: Considering the high estimates of undiagnosed and untreated obstructive sleep apnea (OSA), there is a need for simple and accurate diagnostic tests. Neck circumference has long been correlated with OSA, but its usefulness as a diagnostic tool has been limited. Aims: We proposed to evaluate the value of a simple neck grasp test to help identify OSA. We hypothesized that the inability of a patient in a sleep clinic to fit their hands around their neck is predictive of OSA. Materials and Methods: A retrospective review of medical records of patients evaluated in a general sleep clinic was performed. Easy sleep apnea predictor (ESAP) positive was defined as the inability to place the hands around the neck with digits touching in the anterior and posterior. ESAP negative was the ability to place hands around the neck. Positive for OSA in this symptomatic sleep clinic population was defined as an apnea–hypopnea index (AHI) of ≥5. Results: A total of 47 subjects (36% female) had ESAP data available, which were reviewed. The mean age was 51.6 years (SD 14.4, range 29-81 years). The mean body mass index (BMI) was 38.8 (SD 9.9, range 20.4-69.5). Review showed 87.2% (N = 41) tested positive for OSA by AHI of ≥5. The sensitivity and specificity of ESAP were 68.3% and 100%, respectively. The positive predictive power was 100% and the negative predictive power was 31.6%. Conclusion: As we hypothesized, ESAP positive (inability to span neck) was predictive of OSA in a population of sleep clinic patients. An ESAP positive test was 100% predictive of the presence of OSA (AHI of ≥5). ESAP shows promise for ease of clinical use to predict the presence of OSA in a general sleep clinic population. PMID:26942131

  17. Swing of the Surgical Pendulum: A Return to Surgery for Treatment of Head and Neck Cancer in the 21st Century?

    SciTech Connect

    Holsinger, F. Christopher Weber, Randal S.

    2007-10-01

    Treatment for head and neck cancer has evolved significantly during the past 100 years. Beginning with Bilroth's total laryngectomy on New Year's Day in 1873, 'radical' surgery remained the only accepted treatment for head and neck cancer when optimal local and regional control was the goal. Bigger was still better when it came to managing the primary tumor and the neck. The 'commando' procedure and radical neck dissection were the hallmarks of this first generation of treatments of head-and-neck cancer. With the advent of microvascular reconstructive techniques, larger and more comprehensive resections could be performed. Despite these large resections and their 'mutilating' sequelae, overall survival did not improve. Even for intermediate-stage disease in head-and-neck cancer, the 5-year survival rate did not improve >50%. Many concluded that more than the scalpel was needed for optimal local and regional control, especially for intermediate- and advanced-stage disease. Most important, the multidisciplinary teams must identify and correlate biomarkers in the tumor and host that predict for a response to therapy and for optimal functional recovery. As the pendulum swings back, a scientific approach using tissue biomarkers for the response to treatment in the setting of multidisciplinary trials must emerge as the new paradigm. In the postgenomic era, treatment decisions should be made based on functional and oncologic parameters-not just to avoid perceived morbidity.

  18. Full-field OCT for fast diagnostic of head and neck cancer

    NASA Astrophysics Data System (ADS)

    De Leeuw, Frederic; Casiraghi, Odile; Ben Lakhdar, Aïcha; Abbaci, Muriel; Laplace-Builhé, Corinne

    2015-02-01

    Full-Field OCT (FFOCT) produces optical slices of tissue using white light interferometry providing in-depth 2D images, with an isotropic resolution around 1 micrometer. These optical biopsy images are similar to those obtained with established histological procedures, but without tissue preparation and within few minutes. This technology could be useful when diagnosing a lesion or at the time of its surgical management. Here we evaluate the clinical value of FFOCT imaging in the management of patients with Head and Neck cancers by assessing the accuracy of the diagnosis done on FFOCT images from resected specimen. FFOCT images from Head and Neck samples were first compared to the gold standard (HES-conventional histology). An image atlas dedicated to the training of pathologists was built and diagnosis criteria were identified. Then, we performed a morphological correlative study: both healthy and cancerous samples from patients who undergo Head and Neck surgery of oral cavity, pharynx, and larynx were imaged. Images were interpreted in a random way by two pathologists and the FFOCT based diagnostics were compared with HES (gold standard) of the same samples. Here we present preliminary results showing that FFOCT provides a quick assessment of tissue architecture at microscopic level that could guide surgeons for tumor margin delineation during intraoperative procedure.

  19. True stress-strain curve acquisition for irradiated stainless steel including the range exceeding necking strain

    NASA Astrophysics Data System (ADS)

    Kamaya, Masayuki; Kitsunai, Yuji; Koshiishi, Masato

    2015-10-01

    True stress-strain curves were obtained for irradiated 316L stainless steel by a tensile test and by a curve estimation procedure. In the tensile test, the digital image correlation technique together with iterative finite element analysis was applied in order to identify curves for strain larger than the necking strain. The true stress-strain curves were successfully obtained for the strain of more than 0.4 whereas the necking strain was about 0.2 in the minimum case. The obtained true stress-strain curves were approximated well with the Swift-type equation including the post-necking strain even if the exponential constant n was fixed to 0.5. Then, the true stress-strain curves were estimated by a curve estimation procedure, which was referred to as the K-fit method. Material properties required for the K-fit method were the yield and ultimate strengths or only the yield strength. Some modifications were made for the K-fit method in order to improve estimation accuracy for irradiated stainless steels.

  20. Necking and notch strengthening in metallic glass with symmetric sharp-and-deep notches

    PubMed Central

    Sha, Z. D.; Pei, Q. X.; Liu, Z. S.; Zhang, Y. W.; Wang, T. J.

    2015-01-01

    Notched metallic glasses (MGs) have received much attention recently due to their intriguing mechanical properties compared to their unnotched counterparts, but so far no fundamental understanding of the correlation between failure behavior and notch depth/sharpness exists. Using molecular dynamics simulations, we report necking and large notch strengthening in MGs with symmetric sharp-and-deep notches. Our work reveals that the failure mode and strength of notched MGs are strongly dependent on the notch depth and notch sharpness. By increasing the notch depth and the notch sharpness, we observe a failure mode transition from shear banding to necking, and also a large notch strengthening. This necking is found to be caused by the combined effects of large stress gradient at the notch roots and the impingement and subsequent arrest of shear bands emanating from the notch roots. The present study not only shows the failure mode transition and the large notch strengthening in notched MGs, but also provides significant insights into the deformation and failure mechanisms of notched MGs that may offer new strategies for the design and engineering of MGs. PMID:26022224

  1. Towards automatic measurement of anteversion and neck-shaft angles in human femurs using CT images.

    PubMed

    Casciaro, Mariano E; Craiem, Damian

    2014-01-01

    Automatic assessment of human femur morphology may provide useful clinical information with regard to hip and knee surgery, prosthesis design and management of hip instability. To this end, neck-shaft and anteversion angles are usually used. We propose a full automatic method to estimate these angles in human femurs. Multislice CT images from 18 dried bones were analysed. The algorithm fits 3D cylinders to different regions of the bone to estimate the angles. A manual segmentation and a conventional angle assessment were used for validation. We found anteversion angle as 20 ± 7° and neck-shaft angle as 130 ± 9°. Mean distances from femur surface to cylinders were 5.5 ± 0.6, 3.5 ± 0.6 and 2.4 ± 0.4 mm for condyles, diaphysis and neck regions, respectively. Automatic and conventional angles were positively correlated (r(2)>0.85). Manual and automatic segmentations did not differ. The method was fast and 100% reproducible. A robust in vivo segmentation algorithm should be integrated to advance towards a clinically compliant methodology. PMID:22463682

  2. Modelling of Local Necking and Fracture in Aluminium Alloys

    NASA Astrophysics Data System (ADS)

    Achani, D.; Eriksson, M.; Hopperstad, O. S.; Lademo, O.-G.

    2007-05-01

    Non-linear Finite Element simulations are extensively used in forming and crashworthiness studies of automotive components and structures in which fracture need to be controlled. For thin-walled ductile materials, the fracture-related phenomena that must be properly represented are thinning instability, ductile fracture and through-thickness shear instability. Proper representation of the fracture process relies on the accuracy of constitutive and fracture models and their parameters that need to be calibrated through well defined experiments. The present study focuses on local necking and fracture which is of high industrial importance, and uses a phenomenological criterion for modelling fracture in aluminium alloys. As an accurate description of plastic anisotropy is important, advanced phenomenological constitutive equations based on the yield criterion YLD2000/YLD2003 are used. Uniaxial tensile tests and disc compression tests are performed for identification of the constitutive model parameters. Ductile fracture is described by the Cockcroft-Latham fracture criterion and an in-plane shear tests is performed to identify the fracture parameter. The reason is that in a well designed in-plane shear test no thinning instability should occur and it thus gives more direct information about the phenomenon of ductile fracture. Numerical simulations have been performed using a user-defined material model implemented in the general-purpose non-linear FE code LS-DYNA. The applicability of the model is demonstrated by correlating the predicted and experimental response in the in-plane shear tests and additional plane strain tension tests.

  3. Outcome With Neck Dissection After Chemoradiation for N3 Head-and-Neck Squamous Cell Carcinoma

    SciTech Connect

    Igidbashian, Levon; Fortin, Bernard; Guertin, Louis; Soulieres, Denis; Coulombe, Genevieve; Belair, Manon; Charpentier, Danielle; Tabet, Jean-Claude; Nguyen-Tan, Phuc Felix

    2010-06-01

    Purpose: To evaluate the role of neck dissection (ND) after chemoradiation therapy (CRT) for head and neck squamous cell carcinoma (HNSCC) with N3 disease. Methods and Materials: From March 1998 to September 2006, 70 patients with HNSCC and N3 neck disease were treated with concomitant CRT as primary therapy. Response to treatment was assessed using clinical examination and computed tomography 6 to 8 weeks posttreatment. Neck dissection was not routinely performed and considered for those with less than complete response. Of the patients, 26 (37.1%) achieved clinical complete response (cCR) after CRT. A total of 31 (44.3%) underwent ND after partial response (cPR-ND). Thirteen patients (29.5%) did not achieve cCR and did not undergo ND for the following reasons: incomplete response/progression at primary site, refusal/contraindication to surgery, metastatic progression, or death. These patients were excluded from the analysis. Outcomes were computed using Kaplan-Meier curves and were compared with log rank tests. Results: Comparing the cCR and cPR-ND groups at 2 years, the disease-free survival was respectively 62.7% and 84.9% (p = 0.048); overall survival was 63.0% and 79.4% (p = 0.26), regional relapse-free survival was 87.8% and 96.0% (p = 0.21); and distant disease-free survival was 67.1% and 92.6% (p = 0.059). In the cPR-ND group, 71.0% had no pathologic evidence of disease (PPV of 29.0%). Conclusions: Patients with N3 disease achieving regional cPR and primary cCR who underwent ND seemed to have better outcomes than patients achieving global cCR without ND. Clinical assessment with computed tomography is not adequate for evaluating response to treatment. Because of the inherent limitations of our study, further confirmatory studies are warranted.

  4. Less may be more: nodal treatment in neck positive head neck cancer patients.

    PubMed

    Studer, Gabriela; Huber, Gerhard F; Holz, Edna; Glanzmann, Christoph

    2016-06-01

    Ongoing debates about the need and extent of planned neck dissection (PND), and required nodal radiation doses volumes lead to this evaluation. Aim was to assess nodal control after definitive intensity modulated radiation therapy (IMRT ± systemic therapy) followed by PND in our head neck cancer cohort with advanced nodal disease. Between 01/2005 and 12/2013, 99 squamous cell cancer HNC patients with pre-therapeutic nodal metastasis ≥3 cm were treated with definitive IMRT followed by PND. In addition, outcome in 103 patients with nodal relapse after IMRT and observation only (no-PND cohort) were analyzed. Prior to PND, PET-CT, fine needle aspirations, ultrasound and palpation were assessed regarding its predictive value. Patterns of nodal relapse were assessed in patients with isolated neck failure after definitive IMRT alone. 70/99 (70 %) PND specimens showed histopathological complete response (hCR), which translated into statistically significantly superior survival compared with partial response (hPR) with 4-year overall survival, disease specific survival and nodal control rates of 90/83/96 vs 67/60/78 % (p = 0.002/0.001/0.003). 1/99 patient developed isolated subsequent nodal disease. 64/2147 removed nodes contained viable tumor (3 %). Predictive information of the performed diagnostic investigations was not reliable. 17/70 hCR patients showed true negative findings in available three to four investigations (0/29 hPR). 27/103 no-PND patients developed isolated neck disease (26 %) with successful salvage in 21/24 [88 %, or 21/27 (78 %)]. Nearly all failures occurred in the prior nodal gross tumor volume area. A more restrictive approach regarding PND and/or nodal IMRT dose-volumes may be justified. PMID:25920604

  5. Statistical analysis of 4 types of neck whiplash injuries based on classical meridian theory.

    PubMed

    Chen, Yemeng; Zhao, Yan; Xue, Xiaolin; Li, Hui; Wu, Xiuyan; Zhang, Qunce; Zheng, Xin; Wang, Tianfang

    2015-01-01

    As one component of the Chinese medicine meridian system, the meridian sinew (Jingjin, (see text), tendino-musculo) is specially described as being for acupuncture treatment of the musculoskeletal system because of its dynamic attributes and tender point correlations. In recent decades, the therapeutic importance of the sinew meridian has become revalued in clinical application. Based on this theory, the authors have established therapeutic strategies of acupuncture treatment in Whiplash-Associated Disorders (WAD) by categorizing four types of neck symptom presentations. The advantage of this new system is to make it much easier for the clinician to find effective acupuncture points. This study attempts to prove the significance of the proposed therapeutic strategies by analyzing data collected from a clinical survey of various WAD using non-supervised statistical methods, such as correlation analysis, factor analysis, and cluster analysis. The clinical survey data have successfully verified discrete characteristics of four neck syndromes, based upon the range of motion (ROM) and tender point location findings. A summary of the relationships among the symptoms of the four neck syndromes has shown the correlation coefficient as having a statistical significance (P < 0.01 or P < 0.05), especially with regard to ROM. Furthermore, factor and cluster analyses resulted in a total of 11 categories of general symptoms, which implies syndrome factors are more related to the Liver, as originally described in classical theory. The hypothesis of meridian sinew syndromes in WAD is clearly supported by the statistical analysis of the clinical trials. This new discovery should be beneficial in improving therapeutic outcomes. PMID:25980049

  6. Clinical manifestations of head and neck irradiation.

    PubMed

    Zlotolow, I M

    1997-01-01

    Treatment of squamous cell carcinoma of the oral cavity, salivary gland tumors, and Hodgkin's disease may include radiation therapy to the head and neck region. This therapy has treatment-related sequelae to the oral cavity and can contribute to increased rates of dental caries in these patients. To prevent radiation-induced caries, patients are instructed to use a high-potency fluoride application in addition to their standard dentifrice during radiation therapy and the postradiation phases of their treatment. Traditionally, patients are prescribed a 5,000-ppm fluoride (F) gel that is applied using mouthguards. However, due to oral postoperative conditions, many patients are not complaint with this treatment. In many cases, the availability of a fluoride product that is easier to use could result in successful patient compliance. PMID:12090075

  7. [Brachytherapy in head and neck cancers].

    PubMed

    Mazeron, J J; Noël, G; Simon, J M; Racadot, S; Jauffret, E

    2003-02-01

    Experience accumulated over several decades with radiation of Head and Neck tumours by irradiation has demonstrated the need for a high tumour dose to achieve local control. With external beam irradiation alone, it is difficult to spare adjacent normal tissues, resulting in undesirable late effects on the salivary glands, mandible, and muscles of mastication. Interstitial implantation is ideally suited to deliver a high dose limited to the volume of the primary tumor, thus minimizing sequels. A large experience has been accumulated with low dose rate (LDR) brachytherapy in treatment of carcinoma of oral cavity, oropharynx, and nasopharynx. Recent analysis of large clinical series provided data indicating that modalities of low dose rate brachytherapy should be optimized in treating these tumors for increasing therapeutic ratio. Low dose rate brachytherapy is now challenged by high dose rate (HDR) brachytherapy and pulsed dose rate (PDR) brachytherapy. Preliminary results obtained with these two last modalities are discussed regarding to those of low dose rate brachytherapy. PMID:12648718

  8. Quackery in head and neck cancer.

    PubMed

    Amin, M; Hughes, J; Timon, C; Kinsella, J

    2008-03-01

    Most human beings will do almost anything to prolong their existence or to relieve the suffering of disease. Others will do anything to exploit these desires by selling what they claim to be pain killing remedies or life prolongation nostrums. We present three cases of head and neck cancer patients; two used complementary and alternative medicine (CAM) prior to presenting to our service and the third declined conventional treatment to seek CAM instead. We discuss here the diagnosis, the time delay between CAM and commencement of conventional treatment, and the outcome in each case. Our aim is to define Quacks and to heighten public awareness of the potential harm they can cause. PMID:18540546

  9. Spontaneous stress fractures of the femoral neck

    SciTech Connect

    Dorne, H.L.; Lander, P.H.

    1985-02-01

    The diagnosis of spontaneous stress fractures of the femoral neck, a form of insufficiency stress fracture, can be missed easily. Patients present with unremitting hip pain without a history of significant trauma or unusual increase in daily activity. The initial radiographic features include osteoporosis, minor alterations of trabecular alignment, minimal extracortical or endosteal reaction, and lucent fracture lines. Initial scintigraphic examinations performed in three of four patients showed focal increased radionuclide uptake in two and no focal abnormality in one. Emphasis is placed on the paucity of early findings. Evaluation of patients with persistent hip pain requires a high degree of clinical suspicion and close follow-up; the sequelae of undetected spontaneous fractures are subcapital fracture with displacement, angular deformity, and a vascular necrosis of the femoral head.

  10. Myxedema megacolon after external neck irradiation

    SciTech Connect

    Borrie, M.J.; Cape, R.D.; Troster, M.M.; Fung, S.T.

    1983-04-01

    Myxedema megacolon is a rare manifestation of hypothyroidism. It may respond to appropriate treatment but is sometimes irreversible, resulting in fatal complications. Two possible mechanisms to explain the colonic atony include (1) myxomatous infiltration of the submucosa with separation of the muscular fibers from the ganglia of Auerbach's plexus, and (2) severe autonomic neuropathy affecting the extrinsic nerves to the colon and the myenteric plexus. Histology from our case supports the first proposed mechanism. Urecholine challenge and manometric measure response may help predict reversibility of colonic atony. Treatment should be individualized and should include factors such as age, duration of symptoms, and other medical illness. Low-dose oral or intravenous triiodothyronine is effective. Hypothyroidism following external radiation of the neck for lymphoma is not uncommon, and the risk increases following one or more lymphangiograms. Such patients should be followed up with regular TSH estimations for at least three years.

  11. Neck after vertical hemilaryngectomy: computed tomographic study

    SciTech Connect

    DiSantis, D.J.; Balfe, D.M.; Hayden, R.; Sessions, D.; Sagel, S.S.

    1984-06-01

    Computed tomographic scans in 22 postoperative vertical hemilaryngectomy patients were analyzed retrospectively to determine the normal postoperative appearance and to evaluate the role of CT in assessing recurrent neoplasm. Twelve patients without clinical evidence of recurrence illustrated the normal postoperative changes. In the six patients with recurrent neoplasm, the CT manifestations included increased width of the remaining true vocal cord, convexity of the surgically formed pseudocord at glottic level, subglottic tumor, and extralaryngeal neck masses. Recurrence was mimicked in four patients by bulky soft tissue at the endolaryngeal operative site at both CT and laryngoscopy. CT supplemented the physical examination and indirect laryngoscopy, providing information regarding the presence and extent of tumor that was useful in planning the mode or scope of subsequent therapy.

  12. Postirradiation sarcomas of the head and neck

    SciTech Connect

    Maisel, R.H.; Manivel, J.C.; Porto, D.P.; Stanley, M.

    1989-09-01

    We discuss four cases of postirradiation sarcomas of the head and neck. Two cases were metachronous sarcomas that appeared after operation and irradiation for primary sarcomas, 1 case was a mandibular malignant fibrous histiocytoma that developed on the opposite side of the jaw from a malignant histiocytic neoplasm that was irradiated 8 years previously, and 1 case was a laryngeal tumor that appeared 5 years after combined operative and radiation therapy for a laryngeal squamous carcinoma. Immunohistochemical studies more precisely defined and classified these tumors, and assisted in determining a therapeutic protocol. The therapy for postirradiation sarcomas includes extirpative operation when possible, but the role of chemotherapy is uncertain. The aggressive behavior of these neoplasms was attested to by the death of three patients within 18 months of their operations.

  13. [Plasmacytomas of the head and neck].

    PubMed

    Marzetti, E; Marzetti, A; Palma, O; Pezzuto, R W

    1996-02-01

    Neoplastic proliferation of plasma cells results in a population of immunologically homogeneous cells that can produce diffuse (multiple myeloma) or localized (extramedullary plasmacytomas and solitary plasmacytoma of bone) disease. In otorhinolaryngologic literature these neoplasms are rarely described and their nosological arrangement is often confused. The presence of a plasma cell neoplasm can be a surprise and sometimes a diagnostic challenge to the head and neck surgeon. Proper management of such lesions needs to be individualized according to their expected biologic behaviour. The recent observation of a case of maxillary sinus plasmacytoma suggested the Authors to carefully review the literature, drawing their attention mainly on the current histogenetic hypotheses and their consequences in therapeutic strategy. The correct diagnostic procedure is also explained, highlighting the difficulties due to both the protean nature of the disease and the still existing nosological confusion. The possibility of a plasma cell tumour should be never forgotten in presence of an head and neck neoplasm. Because these neoplasms may signal the presence of multiple mieloma, full evaluation is required to exclude disseminated disease. In light of recent histogenetic acquisitions it is suggested that extramedullary plasmacytomas can be classified among the so-called "mucosa-associated" lymphomas. Possible following differences in therapeutic approach and long-term follow-up are also indicated, stressing the role of surgery in managing these disorders. Surgical excision of extramedullary plasmacytomas followed by complementary radiotherapy on the site of tumour is proposed as the best treatment for these kind of neoplasms. This is in opposition with "classical" statement considering radiotherapy the only treatment for this kind of disorders. PMID:8984843

  14. The Articulation of Sauropod Necks: Methodology and Mythology

    PubMed Central

    Stevens, Kent A.

    2013-01-01

    Sauropods are often imagined to have held their heads high atop necks that ascended in a sweeping curve that was formed either intrinsically because of the shape of their vertebrae, or behaviorally by lifting the head, or both. Their necks are also popularly depicted in life with poses suggesting avian flexibility. The grounds for such interpretations are examined in terms of vertebral osteology, inferences about missing soft tissues, intervertebral flexibility, and behavior. Osteologically, the pronounced opisthocoely and conformal central and zygapophyseal articular surfaces strongly constrain the reconstruction of the cervical vertebral column. The sauropod cervico-dorsal vertebral column is essentially straight, in contrast to the curvature exhibited in those extant vertebrates that naturally hold their heads above rising necks. Regarding flexibility, extant vertebrates with homologous articular geometries preserve a degree of zygapophyseal overlap at the limits of deflection, a constraint that is further restricted by soft tissues. Sauropod necks, if similarly constrained, were capable of sweeping out large feeding surfaces, yet much less capable of retracting the head to explore the enclosed volume in an avian manner. Behaviorally, modern vertebrates generally assume characteristic neck postures which are close to the intrinsic curvature of the undeflected neck. With the exception of some vertebrates that can retract their heads to balance above their shoulders at rest (e.g., felids, lagomorphs, and some ratites), the undeflected neck generally predicts the default head height at rest and during locomotion. PMID:24205266

  15. The articulation of sauropod necks: methodology and mythology.

    PubMed

    Stevens, Kent A

    2013-01-01

    Sauropods are often imagined to have held their heads high atop necks that ascended in a sweeping curve that was formed either intrinsically because of the shape of their vertebrae, or behaviorally by lifting the head, or both. Their necks are also popularly depicted in life with poses suggesting avian flexibility. The grounds for such interpretations are examined in terms of vertebral osteology, inferences about missing soft tissues, intervertebral flexibility, and behavior. Osteologically, the pronounced opisthocoely and conformal central and zygapophyseal articular surfaces strongly constrain the reconstruction of the cervical vertebral column. The sauropod cervico-dorsal vertebral column is essentially straight, in contrast to the curvature exhibited in those extant vertebrates that naturally hold their heads above rising necks. Regarding flexibility, extant vertebrates with homologous articular geometries preserve a degree of zygapophyseal overlap at the limits of deflection, a constraint that is further restricted by soft tissues. Sauropod necks, if similarly constrained, were capable of sweeping out large feeding surfaces, yet much less capable of retracting the head to explore the enclosed volume in an avian manner. Behaviorally, modern vertebrates generally assume characteristic neck postures which are close to the intrinsic curvature of the undeflected neck. With the exception of some vertebrates that can retract their heads to balance above their shoulders at rest (e.g., felids, lagomorphs, and some ratites), the undeflected neck generally predicts the default head height at rest and during locomotion. PMID:24205266

  16. Clinimetric properties of the Turkish translation of a modified neck disability index

    PubMed Central

    2012-01-01

    Background Neck pain is a common problem that can greatly affect a person's activities of daily living. Functional status questionnaires are important in assessing this effect, and are used to follow up neck pain management programs. The Neck Disability Index (NDI) is the first-created scale for neck pain-related disability and is widely translated and in common used in many countries. Our aim is investigate to clinometric properties of a Turkish version of modified NDI and to give a choice in daily practise of versions to be used. Methods The modified NDI was applied to 30 patients for reliability. 185 patients participated in the validity study. All patients were recruited from the outpatient clinic of our department. The scale was translated by the forward and backward translation procedure according to the COSMIN criteria. The test was repeated at 48 hours interval for reliability study. SPSS-10.0, software was used for statistical analyses. The Intraclass correlation coefficient was used for the test- retest reliability of the modified NDI. Cronbach α was used for internal consistency. Factor analysis was used for construct validity. The validity of the modified NDI with respect to the SF-36, HAD, VAS pain, VAS disability was assessed using Spearman correlations. Results The Intraclass correlation coefficient between first and second (within 48 hours) evaluation of test (rs) was 0.92. Questions 1,4,6,8,10 were shown to have excellent reliability. (rs > 0.9). Question 10 was the most frequently challenged question because "recreational and social activities" do not have not the same meanings in Turkey than in western countries. This required that detailed explanations be provided by the investigators. Cronbach's alpha for the total index was 0.88. A single factor accounting for 80.2% of the variance was obtained. Validity studies demonstrated good and moderate correlations (rs) among NDI, HAD, VAS, physical function subtitle of SF 36 (0.62, 0.76, 0.68). Conclusions The modified NDI-Turkish version is a reliable and valid test and is suitable for daily practise. PMID:22353546

  17. Interfractional Displacement Analysis of the Spinal Cord for 21 Head & Neck Cases in Radiation Therapy Planning

    NASA Astrophysics Data System (ADS)

    Stoll, Armin; Giske, Kristina; Stoiber, Eva; Bendl, Rolf

    A monomodal slice-based displacement analysis of the spinal cord for three-dimensional computer tomography imaging in radiation therapy planning is presented. In total, 21 head and neck cases with tumor indications close to the spinal cord are studied and evaluated. Two-dimensional cross-correlation is applied to propagate manually segmented contours of the spinal cord from a high-resolution planning CT to subsequently acquired control CTs. The method and the fully automatic implementation turned out to be reliable and robust. A very few manual corrections on the resulting contours remained necessary in single transversal slices.

  18. Neck Circumference as a Useful Marker for Screening Overweight and Obesity in Children and Adolescents

    PubMed Central

    Taheri, Mehri; Kajbaf, Tahereh Ziaei; Taheri, Mohammad-Reza; Aminzadeh, Majid

    2016-01-01

    Objectives Overweight and obesity at an early age are an important criterion for predicting chronic diseases. Each anthropometric method available to assess obesity has its limitations. Recently, one of the indices proposed to better detect this complication is neck circumference (NC). The aim of this study was to investigate the relationship between NC, and body mass index (BMI), and to find a cutoff NC size to identify children with a high BMI. Methods In this cross-sectional study, we enrolled 864 students aged 6–17 years from the schools in Ahvaz, Iran. Measurements, including height, weight, neck, mid-arm, and waist circumference (WC), and clinical information were collected by trained physicians. Pearson’s correlation coefficient was calculated between NC and other obesity indices, and receiver operating characteristic curve analysis was used to determine the best cutoff value of NC in predicting high BMI. Results NC in both genders was significantly correlated with BMI, WC, and mid-arm circumference. The best cutoff value of NC to identify boys with a high BMI was 27.5–38.3 cm, and for girls was 26.7–33.4 cm. Conclusions NC is significantly correlated with overweight and obesity. It can be used with great reliability to screen overweight and obesity in children, and to identify those with a high BMI. PMID:27162586

  19. Characteristics of visual disturbances reported by subjects with neck pain.

    PubMed

    Treleaven, Julia; Takasaki, Hiroshi

    2014-06-01

    Visual symptoms are often reported by patients with neck pain. The aim of the study was to report on the prevalence and most troublesome visual disturbances in subjects with neck pain. Seventy subjects with neck pain and seventy healthy control subjects answered questions about the presence and magnitude (/12) - product of frequency (0-4) and intensity (0-3) of each of 16 visual symptoms noted to be associated with neck pain and other possible causes. A visual complaint index (VCI) (/168) was generated from the sum of the magnitude rating of 14 significant symptoms. The neck pain group had significantly (P > 0.05) greater prevalence and magnitude of 14/16 visual complaints and VCI (mean 27.4) compared to control subjects (mean 6.2). The most prevalent symptoms were 'need to concentrate to read' (70%) and 'sensitivity to light' (58.6%). The least prevalent were 'double vision' (28.6%) and 'dizzy reading' (38.6%). The most troublesome symptoms (greatest magnitude) were 'need to concentrate to read' (3.4/12), 'visual fatigue' (3/12), 'difficulty judging distances' (2.1/12) and 'sensitivity to light' (2.1/12) while the least troublesome complaints were 'double vision' (0.5/12), 'red eyes' (1/12) and 'spots and words moving' (1/12). The characteristics of the visual symptoms were mostly consistent for those previously associated with neck pain. Subjects with traumatic neck pain had a significantly higher VCI compared to those with idiopathic neck pain. The results could help with differential diagnosis. The visual symptoms might be related to eye movement control disturbances in neck pain, however further research is required. PMID:24521926

  20. Sauropod necks: are they really for heat loss?

    PubMed

    Henderson, Donald M

    2013-01-01

    Three-dimensional digital models of 16 different sauropods were used to examine the scaling relationship between metabolism and surface areas of the whole body, the neck, and the tail in an attempt to see if the necks could have functioned as radiators for the elimination of excess body heat. The sauropod taxa sample ranged in body mass from a 639 kg juvenile Camarasaurus to a 25 t adult Brachiosaurus. Metabolism was assumed to be directly proportional to body mass raised to the ¾ power, and estimates of body mass accounted for the presence of lungs and systems of air sacs in the trunk and neck. Surface areas were determined by decomposing the model surfaces into triangles and their areas being computed by vector methods. It was found that total body surface area was almost isometric with body mass, and that it showed negative allometry when plotted against metabolic rate. In contrast, neck area showed positive allometry when plotted against metabolic rate. Tail area show negative allometry with respect to metabolic rate. The many uncertainties about the biology of sauropods, and the variety of environmental conditions that different species experienced during the groups 150 million years of existence, make it difficult to be absolutely certain about the function of the neck as a radiator. However, the functional combination of the allometric increase of neck area, the systems of air sacs in the neck and trunk, the active control of blood flow between the core and surface of the body, changing skin color, and strategic orientation of the neck with respect to wind, make it plausible that the neck could have functioned as a radiator to avoid over-heating. PMID:24204747

  1. Sauropod Necks: Are They Really for Heat Loss?

    PubMed Central

    Henderson, Donald M.

    2013-01-01

    Three-dimensional digital models of 16 different sauropods were used to examine the scaling relationship between metabolism and surface areas of the whole body, the neck, and the tail in an attempt to see if the necks could have functioned as radiators for the elimination of excess body heat. The sauropod taxa sample ranged in body mass from a 639 kg juvenile Camarasaurus to a 25 t adult Brachiosaurus. Metabolism was assumed to be directly proportional to body mass raised to the ¾ power, and estimates of body mass accounted for the presence of lungs and systems of air sacs in the trunk and neck. Surface areas were determined by decomposing the model surfaces into triangles and their areas being computed by vector methods. It was found that total body surface area was almost isometric with body mass, and that it showed negative allometry when plotted against metabolic rate. In contrast, neck area showed positive allometry when plotted against metabolic rate. Tail area show negative allometry with respect to metabolic rate. The many uncertainties about the biology of sauropods, and the variety of environmental conditions that different species experienced during the groups 150 million years of existence, make it difficult to be absolutely certain about the function of the neck as a radiator. However, the functional combination of the allometric increase of neck area, the systems of air sacs in the neck and trunk, the active control of blood flow between the core and surface of the body, changing skin color, and strategic orientation of the neck with respect to wind, make it plausible that the neck could have functioned as a radiator to avoid over-heating. PMID:24204747

  2. Noninvasive assessment of tumor microenvironment using dynamic contrast enhanced MRI and 18F- fluoromisonidazole PET imaging in neck nodal metastases

    PubMed Central

    Jansen, Jacobus F. A.; Schöder, Heiko; Lee, Nancy Y.; Wang, Ya; Pfister, David. G.; Fury, Matthew G.; Stambuk, Hilda. E.; Humm, John L.; Koutcher, Jason A.; Shukla-Dave, Amita

    2009-01-01

    Purpose Pretreatment multimodality imaging can provide useful anatomical and functional data about tumors, including perfusion and possibly hypoxia status. The purpose of our study was to assess non-invasively the tumor microenvironment of neck nodal metastases in patients with head and neck (HN) cancer by investigating the relationship between tumor perfusion measured using Dynamic Contrast Enhanced MRI (DCE-MRI) and hypoxia measured by 18F-fluoromisonidazole (18F-FMISO) PET. Methods and Materials Thirteen newly diagnosed HN cancer patients with metastatic neck nodes underwent DCE-MRI and 18F-FMISO PET imaging prior to chemotherapy and radiation therapy. The matched regions of interests from both modalities were analyzed. To examine the correlations between DCE-MRI parameters and standard uptake value (SUV) measurements from 18F-FMISO PET, the non-parametric Spearman correlation coefficient was calculated. Furthermore, DCE-MRI parameters were compared between nodes with 18F-FMISO uptake and nodes with no 18F-FMISO uptake using Mann-Whitney U tests. Results For the 13 patients, a total of 18 nodes were analyzed. The nodal size strongly correlated with the 18F-FMISO SUV (ρ=0.74, p<0.001). There was a strong negative correlation between the median kep (ρ=−0.58, p=0.042) and the 18F-FMISO SUV. Hypoxic nodes (moderate to severe 18F-FMISO uptake) had significantly lower median Ktrans (p=0.049) and median kep (p=0.027) values than did non-hypoxic nodes (no 18F-FMISO uptake). Conclusion This initial evaluation of the preliminary results support the hypothesis that in metastatic neck lymph nodes, hypoxic nodes are poorly perfused (i.e., have significantly lower kep and Ktrans values) compared to non-hypoxic nodes. PMID:19906496

  3. Pocket atlas of head and neck MRI anatomy

    SciTech Connect

    Lufkin, R.B.; Hanafee, W.N.

    1989-01-01

    This pocket atlas depicts the anatomy of the head and neck as seen in magnetic resonance (MR) images. The collection of 140 high-resolution images covers all major areas - neck, larynx, oropharynx, tongue, nasopharynx, skull base, sinuses, and temporal bone - displayed in sagittal, axial, and coronal MR image planes. The images show maximum fat/muscle contrast for better visualization of fascial planes. In certain areas of the anatomy, such as the neck and temporal bone, surface coils were used to achieve significant advantages in image quality over standard head or body coils.

  4. A Triassic aquatic protorosaur with an extremely long neck.

    PubMed

    Li, Chun; Rieppel, Olivier; LaBarbera, Michael C

    2004-09-24

    By Middle Triassic time, a number of reptile lineages had diversified in shallow epicontinental seas and intraplatform basins along the margins of parts of Pangea, including the giraffe-necked protorosaurid reptile Tanystropheus from the Western Tethys (Europe and the Middle East), which grew to approximately 5 to 6 m long. Here we report another long-necked fossil, Dinocephalosaurus, from southwestern China, recently collected in Middle Triassic marine deposits approximately 230 million years old. This taxon represents unambiguous evidence for a fully aquatic protorosaur. Its extremely elongated neck is explained as an adaptation for aquatic life, perhaps for an increase in feeding efficiency. PMID:15448262

  5. Head and neck considerations in the elderly patient.

    PubMed

    Robinson, D S

    1994-04-01

    An evaluation of head and neck surgery in the elderly reveals that old age should not be an issue in determining the course of treatment. The risks, complication rates, mortality rates, and final outcome of older patients are similar to those seen in younger patients with head and neck cancer. Although age itself should not be an issue in setting forth a plan of treatment, underlying co-morbid factors such as cardiovascular and respiratory illness that may occur with advanced age should be taken into careful account. As our population becomes older, surgeons dealing with head and neck cancer will need to give special consideration to this age group. PMID:8165475

  6. Minimally invasive surgery for radial neck fractures using bone paste.

    PubMed

    Yamanaka, Kazuyoshi; Sasaki, Takashi

    2014-01-01

    We treat radial neck fractures by a minimally invasive technique using bone paste. The indication of this technique is radial neck fractures in which the continuity with the radius shaft is retained. We have treated 13 patients using this technique. As a result, the average range of motion of the elbow was 90° for supination and 92° for pronation, +5° for extension, and 141° for flexion. The reduced position at surgery was kept unchanged until bone union. None of the patients complained of pain. The surgical scar was unnoticeable. This technique is recommended surgery for the radial neck fractures when the indication is appropriate. PMID:25288294

  7. Multidetector Computed Tomographic Angiography (MDCTA) for Penetrating Neck Injuries.

    PubMed

    Pasley, Jason; Berg, Regan J; Inaba, Kenji

    2012-07-01

    Evaluation of patients after penetrating neck injury has evolved over time. Previously, location of injury and symptoms were used to determine management. The contemporary management of penetrating neck injuries relies on physical examination. Patients with hard signs of vascular or aerodigestive tract injury require immediate operation, regardless of location of injury. Those with no signs can be observed. For the remainder with soft signs, multidetector computed tomographic angiography (MDCTA) is a highly sensitive and specific screening modality for evaluating the vasculature and aerodigestive structures in the neck. Utilizing MDCTA, the patient can be safely directed towards operative intervention, observation, or further investigation. PMID:23908840

  8. Multidetector Computed Tomographic Angiography (MDCTA) for Penetrating Neck Injuries

    PubMed Central

    Pasley, Jason; Berg, Regan J.; Inaba, Kenji

    2012-01-01

    Evaluation of patients after penetrating neck injury has evolved over time. Previously, location of injury and symptoms were used to determine management. The contemporary management of penetrating neck injuries relies on physical examination. Patients with hard signs of vascular or aerodigestive tract injury require immediate operation, regardless of location of injury. Those with no signs can be observed. For the remainder with soft signs, multidetector computed tomographic angiography (MDCTA) is a highly sensitive and specific screening modality for evaluating the vasculature and aerodigestive structures in the neck. Utilizing MDCTA, the patient can be safely directed towards operative intervention, observation, or further investigation. PMID:23908840

  9. 76 FR 582 - Elizabeth Hartwell Mason Neck National Wildlife Refuge, Fairfax County, VA, and Featherstone...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-05

    ... notice of intent to prepare a CCP in the Federal Register on May 18, 2007 (72 FR 28066). Mason Neck and... Fish and Wildlife Service Elizabeth Hartwell Mason Neck National Wildlife Refuge, Fairfax County, VA... Elizabeth Hartwell Mason Neck (Mason Neck) National Wildlife Refuge (NWR) and Featherstone NWR for a...

  10. The effects of a neck musculoskeletal intervention on neck pain levels and depression in post-traumatic stress disorder patients

    PubMed Central

    Yu, Seong Hun; Park, Seong Doo

    2015-01-01

    [Purpose] To identify the effects of a neck intervention on neck pain and depression in patients with post-traumatic stress disorder (PTSD). [Subjects] Thirty-one patients with neck pain and a diagnosis of PTSD were enrolled. [Methods] Neck exercise training was performed with the experimental group and neck self-exercise (using a modification of the McKenzie exercise) was used with the control group. Both groups performed their exercises for 30 minutes at a time, three times per week. To compare the effects of the interventions, the threshold of neck tenderness and depression levels were measured at each period. [Results] The pain threshold of both sides of the trapezius showed a significant difference between the two groups at the three measurement periods. In the experimental group, the threshold increased by 19.7% on the left and 18.3% on the right after the intervention compared to before. Depression levels significantly differed in the experimental group between the three measurements. [Conclusion] This study has important implications for therapeutic strategies, as it provides strong evidence for a method of improving symptoms of neck pain; furthermore, it is effective for subjects with psychological problems such as PTSD. PMID:26180361

  11. Microsatellite alteration in head and neck squamous cell carcinoma patients from a betel quid-prevalent region.

    PubMed

    Lin, Jin-Ching; Wang, Chen-Chi; Jiang, Rong-San; Wang, Wen-Yi; Liu, Shih-An

    2016-01-01

    We investigated the frequency of microsatellite alteration and their impact on survival in head and neck squamous cell carcinoma patients from an endemic betel quid chewing area. We collected 116 head and neck squamous cell carcinoma specimens along with corresponding surgical margins which were confirmed by pathological examination. Ten oligonucleotide markers were chosen for the assessment of microsatellite alteration. The specimens were amplified by polymerase chain reaction followed by automatic fragment analysis. There were 44 specimens (37.9%) with microsatellite instability (MSI) in at least one marker while more than half of the specimens (n = 68, 58.6%) had loss of heterozygosity (LOH) in at least one marker. Though MSI/LOH was not correlated with the survival of head and neck squamous cell carcinoma patients, presence of MSI in the tumor-free surgical margins was associated with local recurrence (odds ratio: 15.14; 95% confidence interval: 6.451 ~ 35.53; P < 0.001). Genomic assessment of surgical margin can help surgeons to identify head and neck squamous cell carcinoma patients who are at risk of developing local recurrence in a betel quid-prevalent region. PMID:27009367

  12. Microsatellite alteration in head and neck squamous cell carcinoma patients from a betel quid-prevalent region

    PubMed Central

    Lin, Jin-Ching; Wang, Chen-Chi; Jiang, Rong-San; Wang, Wen-Yi; Liu, Shih-An

    2016-01-01

    We investigated the frequency of microsatellite alteration and their impact on survival in head and neck squamous cell carcinoma patients from an endemic betel quid chewing area. We collected 116 head and neck squamous cell carcinoma specimens along with corresponding surgical margins which were confirmed by pathological examination. Ten oligonucleotide markers were chosen for the assessment of microsatellite alteration. The specimens were amplified by polymerase chain reaction followed by automatic fragment analysis. There were 44 specimens (37.9%) with microsatellite instability (MSI) in at least one marker while more than half of the specimens (n = 68, 58.6%) had loss of heterozygosity (LOH) in at least one marker. Though MSI/LOH was not correlated with the survival of head and neck squamous cell carcinoma patients, presence of MSI in the tumor-free surgical margins was associated with local recurrence (odds ratio: 15.14; 95% confidence interval: 6.451 ~ 35.53; P < 0.001). Genomic assessment of surgical margin can help surgeons to identify head and neck squamous cell carcinoma patients who are at risk of developing local recurrence in a betel quid-prevalent region. PMID:27009367

  13. Evaluation of neck circumference as a predictor of central obesity and insulin resistance in Chinese adults

    PubMed Central

    Wang, Xuhong; Zhang, Ning; Yu, Caiguo; Ji, Zhili

    2015-01-01

    Objectives: To evaluate whether neck circumference (NC) could be used as a valid and effective method for identifying obesity and insulin resistance (IR) in Chinese adults. Methods: A total of 3307 adults aged 20-65 years were randomly recruited from two communities of Tongzhou, Beijing. Height, weight, waist circumference (WC), hip circumference (HC), neck circumference (NC), blood pressure, fasting plasma glucose (FPG), fasting serum insulin (FINS), total cholesterol (TC), serum triglyceride (TG), High-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and Urinary albumin (UAlb) were measured. Pearson correlation coefficient was used to explore the relationship between NC and other measurements. Furthermore, the best cutoff values of NC for central obesity identification were determined by applying the receiver operating characteristic (ROC) curve analysis. Results: NC correlated positively with BMI, SBP and WC In both sexes. Both WC and NC correlated significantly positively with IR. A positive correlation between NC and FPG as well as a negative correlation between NC and HDL were found in obese men. NC≥38.5 cm for men and ≥34.5 cm for women were determined to be the best cutoff levels for identifying subjects with central obesity, with 82.9% accuracy for men and 79.9% accuracy for women. Conclusions: NC correlated positively with BMI and WC in both genders, indicating that NC could be used as a valid marker for both overall obesity and central obesity. In addition, measuring NC was shown to be a useful test for IR identification. Large number of NC is suggested to be associated with high risk of developing metabolic disorders, such as diabetes and dyslipidemia. PMID:26770540

  14. Associations among temporomandibular disorders, chronic neck pain and neck pain disability in computer office workers: a pilot study.

    PubMed

    Bragatto, M M; Bevilaqua-Grossi, D; Regalo, S C H; Sousa, J D; Chaves, T C

    2016-05-01

    Neck pain is the most common musculoskeletal complaint among computer office workers. There are several reports about the coexistence of neck pain and temporomandibular disorders (TMD). However, there are no studies investigating this association in the context of work involving computers. The purpose of this study was to verify the association between TMD and neck pain in computer office workers. Fifty-two female computer workers who were divided into two groups: (i) those with self-reported chronic neck pain and disability (WNP) (n = 26) and (ii) those without self-reported neck pain (WONP) (n = 26), and a control group (CG) consisting of 26 women who did not work with computers participated in this study. Clinical assessments were performed to establish a diagnosis of TMD, and craniocervical mechanical pain was assessed using manual palpation and pressure pain threshold (PPT). The results of this study showed that the WNP group had a higher percentage of participants with TMD than the WONP group (42·30% vs. 23·07%, χ(2) = 5·70, P = 0·02). PPTs in all cervical sites were significantly lower in the groups WNP and WONP compared to the CG. Regression analysis revealed TMD, neck pain and work-related factors to be good predictors of disability (R(2) = 0·93, P < 0·001). These results highlighted the importance of considering the work conditions of patients with TMD, as neck disability in computer workers is explained by the association among neck pain, TMD and unfavourable workplace conditions. Consequently, this study attempted to emphasise the importance of considering work activity for minimising neck pain-related disability. PMID:26732204

  15. Human papillomavirus and p53 expression in cancer of unknown primary in the head and neck region in relation to clinical outcome

    PubMed Central

    Sivars, Lars; Näsman, Anders; Tertipis, Nikolaos; Vlastos, Andrea; Ramqvist, Torbjörn; Dalianis, Tina; Munck-Wikland, Eva; Nordemar, Sushma

    2014-01-01

    Patients with cancer of unknown primary (CUP) in the head neck region are generally treated with neck dissection followed by radiotherapy at times combined with chemotherapy, a treatment associated with considerable side effects. Some of these tumors may originate as human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OSCC), with better clinical outcome than head neck squamous cell cancer (HNSCC) in general, and could potentially do well with less treatment. Here, we therefore investigated whether HPV status and p53-expression correlated to clinical outcome in patients with CUP in the head neck region. Fifty metastases were analyzed for presence of HPV DNA, and expression of p16INK4A and p53 and the data were correlated to clinical outcome. Patients with HPV DNA-positive (HPVDNA+) metastases had significantly better 5-year overall survival (OS) compared to those with HPVDNA− metastases (80.0% vs. 36.7%, respectively; P = 0.004), with a similar tendency for disease-free survival (DFS). These survival rates showed excellent concordance with those of HPVDNA+ and HPVDNA− OSCC in Sweden during the same time period, strengthening the hypothesis that HPVDNA+ head and neck CUP may originate from HPVDNA+ OSCC. In addition, having absent/intermediary-low as compared to high expression of p53 correlated to a better prognosis with a 69% as compared to 14% 5-year OS, respectively (P < 0.001), and for DFS the tendency was analogous. In conclusion, both HPV status and p53 expression are valuable prognostic factors in patients with CUP in the head and neck region and should be further explored for clinical use. PMID:24510528

  16. Metastases to the Head and Neck: An Overview

    PubMed Central

    2009-01-01

    This paper provides a review of the more common tumors to metastasize to 12 anatomic subsites of the head and neck, exclusive of cervical lymph nodes. Emphasis is placed on clinical rather than subclinical metastases discovered at autopsy. PMID:20596975

  17. 50 Facts about Oral, Head and Neck Cancer

    MedlinePlus

    ... Head and Neck Cancer most commonly refers to squamous cell carcinoma of the tongue, throat, and voice box. However, ... in the nasal cavity and paranasal sinuses is squamous cell carcinoma. It makes up a little over a half ...

  18. A case report of missed femoral neck stress fracture

    PubMed Central

    Onibere, Oruaro Adebayo; Sugathan, Hari Kovilazhikathu

    2015-01-01

    Femoral neck stress fracture (FNSF) is an uncommon but potentially serious orthopaedic problem. This is a case report on missed femoral neck stress fracture in a 62-year-old female who was initially treated as early-onset coxarthrosis. She later presented to us with a displaced intra-capsular neck of left femur fracture and underwent total hip replacement. This case illustrates that causes other than osteoarthritis should be taken into consideration in patients presenting with anterior hip pain where symptoms are disproportionate to clinical and radiological findings. More advanced investigations such as MRI scan or regular follow up with plain radiographs should be performed. A delay in diagnosis can lead to secondary displacement of the femoral neck stress fracture.

  19. Surgery, Stents Equally Effective for Opening Neck Arteries

    MedlinePlus

    ... nih.gov/medlineplus/news/fullstory_157338.html Surgery, Stents Equally Effective for Opening Neck Arteries: Study Both ... Stenting involves placing a tiny tube, called a stent, in the narrowed area to open the artery ...

  20. Advances in otolaryngology-Head and neck surgery. Volume 1

    SciTech Connect

    Myers, E.N. ); Bluestone, C.D. )

    1987-01-01

    This book consists of 14 sections. The section titles are: The impact of AIDS on otolaryngology--head and neck surgery; The management of sleep apneas and snoring; Antimicrobial agents for infections in the ear, nose, and throat--head and neck; Nasal allergy: Medical and surgical treatment; Uses of computerized tomography and magnetic resonance imaging in temporal bone imaging; Surgical management of otitis media with effusion; middle ear reconstruction: Current status; Cochlear implants: an overview; Diagnosis and management of acute facial paralysis; The use of the laser in head and neck surgery; The management and prevention of subglottic stenosis in infants and children; Management of the mass in the thyroid; Suction-assisted lipectomy of the head and neck area; and Ambulatory surgery.

  1. Head and Neck Cancers May Be Linked to Hepatitis C

    MedlinePlus

    ... Head and Neck Cancers May Be Linked to Hepatitis C Researcher sees need for improved screening, treatment ... 13, 2016 WEDNESDAY, April 13, 2016 (HealthDay News) -- Hepatitis C may increase the risk for certain types ...

  2. Lhermitte's Sign Developing after IMRT for Head and Neck Cancer

    PubMed Central

    Lim, Dong C.; Gagnon, Patrick J.; Meranvil, Sophia; Kaurin, Darryl; Lipp, Linda; Holland, John M.

    2010-01-01

    Background. Lhermitte's sign (LS) is a benign form of myelopathy with neck flexion producing an unpleasant electric-shock sensation radiating down the extremities. Although rare, it can occur after head and neck radiotherapy. Results. We report a case of Lhermitte's developing after curative intensity-modulated radiotherapy (IMRT) for a patient with locoregionally advanced oropharyngeal cancer. IMRT delivers a conformal dose of radiation in head and neck cancer resulting in a gradient of radiation dose throughout the spinal cord. Using IMRT, more dose is delivered to the anterior spinal cord than the posterior cord. Conclusions. Lhermitte's sign can develop after IMRT for head and neck cancer. We propose an anterior spinal cord structure, the spinothalamic tract to be the target of IMRT-caused LS. PMID:20628529

  3. Reconstructive Surgery for Head and Neck Cancer Patients

    PubMed Central

    Hanasono, Matthew M.

    2014-01-01

    The field of head and neck surgery has gone through numerous changes in the past two decades. Microvascular free flap reconstructions largely replaced other techniques. More importantly, there has been a paradigm shift toward seeking not only to achieve reliable wound closure to protect vital structures, but also to reestablish normal function and appearance. The present paper will present an algorithmic approach to head and neck reconstruction of various subsites, using an evidence-based approach wherever possible. PMID:26556426

  4. [Radical neck dissection and the possibility of complications: surgical technique].

    PubMed

    Kurnatowski, P; Latkowski, B; Lukomski, M; Piotrowski, S

    1996-01-01

    Based on 15 pictures the technique of radical neck dissection is presented with particular attention to the topography of the neck. Steps by steps the possibility of complications is considered. During the operation the mandible branches of the facial nerve, vagus nerve, hypoglossal nerve, phrenic nerve, accessory nerve, shoulder plexus, cervical plexus, sympathetic trunk can be injured as well as the jugular vein, carotid artery, occipital artery, thoracic duct. The critical moments for generation of these complications are indicated. PMID:9045181

  5. Surgical Technique Refinements in Head and Neck Oncologic Surgery

    PubMed Central

    Liu, Jeffrey C.; Shah, Jatin P.

    2010-01-01

    The head and neck region poses a challenging arena for oncologic surgery. Diseases and their treatment can affect a myriad of functions, including sight, hearing, taste, smell, breathing, speaking, swallowing, facial expression and appearance. This review discusses several areas where refinements in surgical techniques have led to improved patient outcomes. This includes surgical incisions, neck lymphadenectomy, transoral laser microsurgery, minimally invasive thyroid surgery, and the use of vascularized free flaps for oromandibular reconstruction. PMID:20512941

  6. [Penetrating neck injury of a blacksmith by splitter projectile].

    PubMed

    Fabian, T; Sakka, S G; Trojan, S; Wafaisade, A; Mutschler, M; Tjardes, T; Bouillon, B; Probst, C

    2014-06-01

    Laryngeal injuries are rare but potentially life-threatening injuries. Due to the topography of the neck, accompanying injuries of the greater blood vessels, cervical nerves, thoracic organs and spinal cord are common. Therefore in initial diagnostics, these must be excluded from injuries which determine the prognosis. A patient presented with ventral perforation of the larynx, initial dyspnea, hematemesis and left-sided emphysema of the neck. Cause of the findings, we treated the patient non-operatively in interdisciplinary consensus. PMID:23949194

  7. Correlation methods

    NASA Technical Reports Server (NTRS)

    Rottger, J.

    1983-01-01

    A method for processing complex radar data with a computer using correlation functions is reviewed. Parameters including data storage, data reduction, and real time operation are addressed. Since complex auto- and cross-correlation functions are calculated and stored, almost no information is lost. These also can be analyzed in terms of the full correlation analysis of the spaced-antenna-drifts technique. The proposed approach therefore appears to be very feasible to suit most Mesosphere-Stratosphere-Troposphere (MST) radar applications.

  8. The cervical anatomy of Samotherium, an intermediate-necked giraffid

    PubMed Central

    Danowitz, Melinda; Domalski, Rebecca; Solounias, Nikos

    2015-01-01

    Giraffidae are represented by many extinct species. The only two extant taxa possess diametrically contrasting cervical morphology, as the okapi is short-necked and the giraffe is exceptionally long-necked. Samotherium major, known from the Late Miocene of Samos in Greece and other Eurasian localities, is a key extinct giraffid; it possesses cervical vertebrae that are intermediate in the evolutionary elongation of the neck. We describe detailed anatomical features of the cervicals of S. major, and compare these characteristics with the vertebrae of the two extant giraffid taxa. Based on qualitative morphological characters and a quantitative analysis of cervical dimensions, we find that the S. major neck is intermediate between that of the okapi and the giraffe. Specifically, the more cranial (C2–C3) vertebrae of S. major represent a mosaic of features shared either with the giraffe or with the okapi. The more caudal (C5–C7) S. major vertebrae, however, appear transitional between the two extant taxa, and hence are more unique. Notably, the C6 of S. major exhibits a partially excavated ventral lamina that is strong cranially but completely absent on the caudal half of the ventral vertebral body, features between those seen in the giraffe and the okapi. Comprehensive anatomical descriptions and measurements of the almost-complete cervical column reveal that S. major is a truly intermediate-necked giraffid. Reconstructions of the neck display our findings. PMID:26716010

  9. An integrated approach towards future ballistic neck protection materials selection.

    PubMed

    Breeze, John; Helliker, Mark; Carr, Debra J

    2013-05-01

    Ballistic protection for the neck has historically taken the form of collars attached to the ballistic vest (removable or fixed), but other approaches, including the development of prototypes incorporating ballistic material into the collar of an under body armour shirt, are now being investigated. Current neck collars incorporate the same ballistic protective fabrics as the soft armour of the remaining vest, reflecting how ballistic protective performance alone has historically been perceived as the most important property for neck protection. However, the neck has fundamental differences from the thorax in terms of anatomical vulnerability, flexibility and equipment integration, necessitating a separate solution from the thorax in terms of optimal materials selection. An integrated approach towards the selection of the most appropriate combination of materials to be used for each of the two potential designs of future neck protection has been developed. This approach requires evaluation of the properties of each potential material in addition to ballistic performance alone, including flexibility, mass, wear resistance and thermal burden. The aim of this article is to provide readers with an overview of this integrated approach towards ballistic materials selection and an update of its current progress in the development of future ballistic neck protection. PMID:23637268

  10. Lymphedema Outcomes in Patients with Head and Neck Cancer

    PubMed Central

    Little, Leila G.; Skoracki, Roman J.; Rosenthal, David I.; Lai, Stephen Y.; Lewin, Jan S.

    2015-01-01

    Objective We sought to describe the presentation of external head and neck lymphedema in patients treated for head and neck cancer and examine their initial response to complete decongestive therapy. Study Design Case series with chart review. Setting MD Anderson Cancer Center, Houston, TX. Subjects and Methods Patients evaluated for head and neck cancer at MD Anderson Cancer Center after treatment 01/2007-01/2013 were retrospectively reviewed. Response to complete decongestive therapy was evaluated per changes in lymphedema severity rating or surface tape measures. Predictors of therapy response were examined using regression models. Results 1,202 patients were evaluated. Most patients (62%) had soft, reversible pitting edema (MDACC Stage 1b). Treatment response was evaluated in 733 patients after receiving therapy; 439 (60%) improved after complete decongestive therapy. Treatment adherence independently predicted complete decongestive therapy response (p<0.001). Conclusions These data support the effectiveness of a head and neck cancer-specific regimen of lymphedema therapy for cancer patients with external head and neck lymphedema. Our findings suggest that head and neck lymphedema is distinct from lymphedema that affects other sites, requiring adaptations in traditional methods of management and measurement. PMID:25389318

  11. Neck length and mean arterial pressure in the sauropod dinosaurs.

    PubMed

    Hughes, Stephen; Barry, John; Russell, Jeremy; Bell, Robert; Gurung, Som

    2016-04-15

    How blood was able to reach the heads of the long-necked sauropod dinosaurs has long been a matter of debate and several hypotheses have been presented. For example, it has been proposed that sauropods had exceptionally large hearts, multiple 'normal' sized hearts spaced at regular intervals up the neck or held their necks horizontal, or that the siphon effect was in operation. By means of an experimental model, we demonstrate that the siphon principle is able to explain how blood was able to adequately perfuse the sauropod brain. The return venous circulation may have been protected from complete collapse by a structure akin to the vertebral venous plexus. We derive an equation relating neck height and mean arterial pressure, which indicates that with a mean arterial pressure similar to that of the giraffe, the maximum safe vertical distance between heart and head would have been about 12 m. A hypothesis is presented that the maximum neck length in the fossil record is due to the siphon height limit. The equation indicates that to migrate over high ground, sauropods would have had to either significantly increase their mean arterial pressure or keep their necks below a certain height dependent on altitude. PMID:26944489

  12. Prediction of three dimensional maximum isometric neck strength.

    PubMed

    Fice, Jason B; Siegmund, Gunter P; Blouin, Jean-Sébastien

    2014-09-01

    We measured maximum isometric neck strength under combinations of flexion/extension, lateral bending and axial rotation to determine whether neck strength in three dimensions (3D) can be predicted from principal axes strength. This would allow biomechanical modelers to validate their neck models across many directions using only principal axis strength data. Maximum isometric neck moments were measured in 9 male volunteers (29±9 years) for 17 directions. The 3D moments were normalized by the principal axis moments, and compared to unity for all directions tested. Finally, each subject's maximum principal axis moments were used to predict their resultant moment in the off-axis directions. Maximum moments were 30±6 N m in flexion, 32±9 N m in lateral bending, 51±11 N m in extension, and 13±5 N m in axial rotation. The normalized 3D moments were not significantly different from unity (95% confidence interval contained one), except for three directions that combined ipsilateral axial rotation and lateral bending; in these directions the normalized moments exceeded one. Predicted resultant moments compared well to the actual measured values (r2=0.88). Despite exceeding unity, the normalized moments were consistent across subjects to allow prediction of maximum 3D neck strength using principal axes neck strength. PMID:24893597

  13. Intensity-modulated radiotherapy for head and neck surgeons.

    PubMed

    Gutiontov, Stanley I; Shin, Edward J; Lok, Benjamin; Lee, Nancy Y; Cabanillas, Ruben

    2016-04-01

    The development of intensity-modulated radiotherapy (IMRT) has played a major role in improving outcomes and decreasing morbidity in patients with head and neck cancer. This review addresses this vital modality with a focus on the important role of the head and neck surgeon. The technique as well as its benefits and points of caution are outlined, the definitions of tumor and treatment volumes are discussed, and the dose and fractionation are detailed. Following this are several sections dedicated to the role of the head and neck surgeon in the planning of both definitive and postoperative radiotherapy to the primary site and neck. There is a focus throughout on anatomic and surgical considerations; commonly encountered situations are illustrated. With a deeper understanding of this technique and their own pivotal contribution to target delineation, head and neck surgeons will be poised to expand their role and improve cancer care for their patients. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2368-E2373, 2016. PMID:26705685

  14. The cervical anatomy of Samotherium, an intermediate-necked giraffid.

    PubMed

    Danowitz, Melinda; Domalski, Rebecca; Solounias, Nikos

    2015-11-01

    Giraffidae are represented by many extinct species. The only two extant taxa possess diametrically contrasting cervical morphology, as the okapi is short-necked and the giraffe is exceptionally long-necked. Samotherium major, known from the Late Miocene of Samos in Greece and other Eurasian localities, is a key extinct giraffid; it possesses cervical vertebrae that are intermediate in the evolutionary elongation of the neck. We describe detailed anatomical features of the cervicals of S. major, and compare these characteristics with the vertebrae of the two extant giraffid taxa. Based on qualitative morphological characters and a quantitative analysis of cervical dimensions, we find that the S. major neck is intermediate between that of the okapi and the giraffe. Specifically, the more cranial (C2-C3) vertebrae of S. major represent a mosaic of features shared either with the giraffe or with the okapi. The more caudal (C5-C7) S. major vertebrae, however, appear transitional between the two extant taxa, and hence are more unique. Notably, the C6 of S. major exhibits a partially excavated ventral lamina that is strong cranially but completely absent on the caudal half of the ventral vertebral body, features between those seen in the giraffe and the okapi. Comprehensive anatomical descriptions and measurements of the almost-complete cervical column reveal that S. major is a truly intermediate-necked giraffid. Reconstructions of the neck display our findings. PMID:26716010

  15. Neck afferent involvement in cardiovascular control during movement

    NASA Technical Reports Server (NTRS)

    Bolton, P. S.; Ray, C. A.

    2000-01-01

    It is well established that labyrinth and neck afferent information contributes to the regulation of somatomotor function during movement and changes in posture. There is also convincing evidence that the vestibular system participates in the modulation of sympathetic outflow and cardiovascular function during changes in posture, presumably to prevent orthostatic hypotension. However, the labyrinth organs do not provide any signals concerning body movements with respect to the head. In contrast, the neck receptors, particularly muscle spindles, are well located and suited to provide information about changes in body position with respect to the head and vestibular signals. Studies in the cat suggest that neck afferent information may modulate the vestibulosympathetic reflex responses to head-neck movements. There is some evidence in the cat to suggest involvement of low threshold mechanoreceptors. However, human studies do not indicate that low threshold mechanoreceptors in the neck modulate cardiovascular responses. The human studies are consistent with the studies in the cat in that they demonstrate the importance of otolith activation in mediating cardiovascular and sympathetic responses to changes in posture. This paper briefly reviews the current experimental evidence concerning the involvement of neck afferent information in the modulation of cardiovascular control during movement and changes in posture.

  16. Radial Neck Osteotomy for Malunion of Radial Neck Fracture in Childhood

    PubMed Central

    Vandergugten, Simon; Troussel, Serge; Lefebvre, Bernard

    2015-01-01

    In a case of a neglected radial neck fracture in childhood, the management of initial fracture and its complications are subjected to discussion. In children, open reduction should be avoided but an angulation less than 30° must be obtained. Several techniques exist to manage symptomatic malunion in adults, including resection, prosthesis, and osteotomy. When performing an osteotomy, it is important first to preserve an intact osseous hinge to avoid avascular necrosis and second to align the edge of the radial head articular surface with the lateral edge of the coronoid process, in order to avoid overstuffing elbow joint. PMID:26347364

  17. Osteoid Osteoma of the Femoral Neck in Athletes: Two Case Reports Differentiating From Femoral Neck Stress Injuries.

    PubMed

    Cordova, Christopher B; Dembowski, Scott C; Johnson, Michael R; Combs, John J; Svoboda, Steven J

    2016-03-01

    The diagnosis of an intra-articular osteoid osteoma can be a challenging and lengthy process, with reports of delayed diagnosis of greater than 2 years. In the young, athletic patient with an atraumatic onset of groin pain, an overuse injury or muscle strain is the most likely etiology. However, an overuse injury of femoral neck stress fracture must be identified because of the potentially disastrous outcome of fracture completion. The similar clinical presentation of a femoral neck stress fracture and intra-articular osteoid osteoma of the femoral neck can further delay the diagnosis of the osteoid osteoma. In a patient with these differential diagnoses that do not improve with a period of nonweightbearing activity, a more intensive workup must ensue. The purpose of this case report is to describe the initial presentations, subsequent follow-up, and imaging findings leading to the diagnosis of osteoid osteoma as well as to differentiate an osteoid osteoma from femoral neck stress injuries. PMID:26517936

  18. Hemodynamic Responses to Head and Neck Cooling

    NASA Technical Reports Server (NTRS)

    Ku, Yu-Tsuan E.; Carbo, Jorge E.; Montgomery, Leslie D.; Webbon, Bruce W.

    1994-01-01

    Personal thermoregulatory systems which provide head and neck cooling are used in the industrial and aerospace environments to alleviate thermal stress. However, little information is available regarding the physiologic and circulatory changes produced by routine operation of these systems. The objective of this study was to measure the scalp temperature and circulatory responses during use of one commercially available thermal control system. The Life Support Systems, Inc. Mark VII portable cooling system and a liquid cooling helmet were used in this study. Two EEG electrodes and one skin temperature transducer were placed on the anterior midline of the scalp to measure the scalp blood and temperature. Blood flow was measured using a bipolar impedance rheograph. Ten subjects, seated in an upright position at normal room temperature, were tested at high, medium, moderate, moderate-low and low coolant temperatures. Scalp blood flow was recorded continuously using a computer data acquisition system with a sampling frequency of 200 Hz. Scalp temperature and cooling helmet Inlet temperature was logged periodically during the test period. This study quantifies the effect of head cooling upon scalp temperature and blood flow. These data may also be used to select operational specifications of the head cooling system for biomedical applications such as the treatment of migraine headaches, scalp cooling during chemotherapy, and cooling of multiple sclerosis patients.

  19. Spinal cord injury incurred by neck massage.

    PubMed

    Cheong, Hyun Suk; Hong, Bo Young; Ko, Yeong-A; Lim, Seong Hoon; Kim, Joon Sung

    2012-10-01

    Massage is generally accepted as a safe and a widely used modality for various conditions, such as pain, lymphedema, and facial palsy. However, several complications, some with devastating results, have been reported. We introduce a case of a 43-year-old man who suffered from tetraplegia after a neck massage. Imaging studies revealed compressive myelopathy at the C6 level, ossification of the posterior longitudinal ligament (OPLL), and a herniated nucleus pulposus (HNP) at the C5-6 level. After 3 years of rehabilitation, his motor power improved, and he is able to walk and drive with adaptation. OPLL is a well-known predisposing factor for myelopathy in minor trauma, and it increases the risk of HNP, when it is associated with the degenerative disc. Our case emphasizes the need for additional caution in applying manipulation, including massage, in patients with OPLL; patients who are relatively young (i.e., in the fifth decade of life) are not immune to minor trauma. PMID:23185737

  20. Raman spectroscopy in head and neck cancer

    PubMed Central

    2010-01-01

    In recent years there has been much interest in the use of optical diagnostics in cancer detection. Early diagnosis of cancer affords early intervention and greatest chance of cure. Raman spectroscopy is based on the interaction of photons with the target material producing a highly detailed biochemical 'fingerprint' of the sample. It can be appreciated that such a sensitive biochemical detection system could confer diagnostic benefit in a clinical setting. Raman has been used successfully in key health areas such as cardiovascular diseases, and dental care but there is a paucity of literature on Raman spectroscopy in Head and Neck cancer. Following the introduction of health care targets for cancer, and with an ever-aging population the need for rapid cancer detection has never been greater. Raman spectroscopy could confer great patient benefit with early, rapid and accurate diagnosis. This technique is almost labour free without the need for sample preparation. It could reduce the need for whole pathological specimen examination, in theatre it could help to determine margin status, and finally peripheral blood diagnosis may be an achievable target. PMID:20923567

  1. Photodynamic Therapy for Head and Neck Cancer

    PubMed Central

    Kato, Harubumi; Okunaka, Tetsuya; Saeki, Tetsuo; Ohashi, Shinya; Okudaira, Tadao; Lee, A. Masaji; Yoshida, Hikari; Maruoka, Hidehiro; Ito, Hiroyuki; Funasaka, Sotaro

    1996-01-01

    Photodynamic therapy (PDT) is a recently developed treatment involving the use of a photosensitizer and low power light, usually from a laser, to selectively destroy tumor cells. At present, we perform PDT for head and neck cancer using argon or excimer dye lasers with hematoporphyrin derivative as a photosensitizer. This study attempted to assess the utility and safety of PDT and to investigate the long-term outcome. All 24 patients had squamous cell carcinoma: 15 with laryngeal, 5 with lingual or oral, and 4 with pharyngeal cancer and were treated by PDT. Data were obtained from records from February 1988 through April 1995. After PDT, 12 of 15 laryngeal cancer patients were classified as having a complete remission (CR), as were 2 of the 5 lingual or oral and one of the 4 pharyngeal cancer patients. The patients were followed for 8 to 153 months. The longest duration of CR in patients treated by PDT alone was 148 months. Photosensitivity was experienced by all patients, but required no treatment. Liver, kidneys, and bone marrow showed no abnormal values. There were no clinically relevant adverse reactions, and patients with severe complications due to other types of treatment and elderly patients were also treated safely with this therapy. PMID:18493416

  2. Bladder neck incompetence at posterior urethroplasty

    PubMed Central

    Koraitim, Mamdouh M.

    2015-01-01

    The finding of an incompetent bladder neck (BN) at the time of posterior urethroplasty will necessarily exacerbate the already difficult situation. In such cases the aim of the treatment is not only to restore urethral continuity by end-to-end urethral anastomosis, but also to restore the function of the BN to maintain urinary continence. Fortunately, the incidence of incompetence of the BN at posterior urethroplasty is uncommon, usually ?4.5%. It seems that pelvic fracture-related BN injuries, in contrast to urethral injuries which result from a shearing force, are due to direct injury by the sharp edge of the fractured and displaced pubic bone. The risk of injuries to the BN is greater in children, in patients with a fracture involving both superior and inferior pubic rami on the same side, and in those managed initially by primary realignment. An incompetent BN is suspected by finding an open rectangular BN on cystography, and a fixedly open BN on suprapubic cystoscopy. An incompetent BN can be treated either subsequent to or concomitant with the urethral repair, according to whether a perineal or a perineo-abdominal urethroplasty is used, respectively. Several options have been reported to treat pelvic fracture-related BN incompetence, including reconstructing the BN, forming a new sphincter by tubularisation of a rectangular flap of the anterior bladder wall, and mechanical occlusion by an artificial sphincter or collagen injection. Reconstruction of the BN by the Young-Dees-Leadbetter?? procedure probably provides the most successful results. PMID:26019982

  3. [Lymphoid lesions of the head and neck].

    PubMed

    Costes, Valérie

    2009-09-01

    Lymphoid lesions of the head and neck mainly affect four regions: Waldeyer's ring, nasal and paranasal sinus, oral cavity and salivary glands. Each site is affected by lymphoid proliferation that reflected the biology of local lymphocytes. Waldeyer's ring, functionally similar to the mucosal associated lymphoid tissue of the gastrointestinal tract is most commonly affected by large B-cell lymphomas. The nasal cavity and paranasal sinuses are the typical site of extranodal NK/T-cell lymphoma, nasal type, a proliferation of cytotoxic, EBV infected cells. This lesion is sometimes difficult to distinguish from inflammatory processes as Wegener disease. Plasmablastic lymphoma have been first described in oral cavity in HIV patients. Endemic Burkitt lymphoma, considered as a polymicrobial disease associated with the t(14;18) translocation presented in the great majority of cases as a jaw tumor with oral extension. Salivary glands, not normally containing lymphoid tissue are the site of lymphoepithelial sialadenitis associated to Sjögren syndrome. It represents a pre lymphomatous state of marginal zone lymphoma. These different lymphoproliferations serve as a model for mechanisms of lymphomagenesis. PMID:19900637

  4. Associations between psychosocial functioning and smiling intensity in patients with head and neck cancer.

    PubMed

    Lee, Juhun; Teo, Irene; Guindani, Michele; Reece, Gregory P; Markey, Mia K; Fingeret, Michelle Cororve

    2015-01-01

    Increasing attention is being given to developing quantitative measures of facial expression. This study used quantitative facial expression analysis to examine associations between smiling intensity and psychosocial functioning in patients with head and neck cancer (HNC). Smiling intensity of 95 HNC patients was measured using 48 quantitative measures calculated from facial photographs with and without a smile. We computed a composite smiling intensity score for each patient representing the degree of similarity to healthy controls. A lower composite score indicates that the person is less expressive, on average, than healthy controls. Patients also completed self-report measures assessing domains of body image and quality of life (QOL). Spearman rank correlations were computed to examine relationships between composite scores and psychosocial functioning. Composite scores were significantly correlated with multiple measures of body image and QOL. Specifically, decreased smiling intensity was associated with feelings of dissatisfaction with one's body, perceived negative social impact of body image, increased use of avoidance as a body image-coping strategy, reduced functional well-being, and greater head and neck cancer-specific issues. To the best of our knowledge, this is the first study to demonstrate associations between an objectively quantified facial expression (i.e. smiling) and psychosocial functioning. Most previous studies have measured facial expression qualitatively. These findings indicate that smiling intensity may serve as an important clinical indicator of psychosocial well-being and warrants further clinical investigation. PMID:25159529

  5. ADAM8 in squamous cell carcinoma of the head and neck: a retrospective study

    PubMed Central

    2012-01-01

    Background A disintegrin and metalloproteinase (ADAMs) have been associated with multiple malignancies. ADAMs are involved in cell fusion, cell migration, membrane protein shedding and proteolysis. ADAM8 has been found to be overexpressed in squamous cell carcinomas of the lung. A new study showed that ADAM8 is significantly overexpressed in metastasis of squamous cell carcinomas of the head and neck (HNSCC). Methods We determined ADAM8 levels in the serum of 79 HNSCC patients at the time of diagnosis, in 35 patients 3 months after treatment and in 10 patients 1 year after therapy and compared the results to the sera of 31 healthy volunteers. We also constructed tissue microarrays to detect ADAM8 immunohistochemically in 100 patients. The results were correlated with the survival data of the patients to determine the diagnostic and prognostic value. Results The data demonstrated that patients with high ADAM8 expression in the tumor have worse survival rates. We found that high ADAM8 serum levels correlated with high ADAM8 expression in tumor samples. Soluble ADAM8 levels did not show any prognostic or diagnostic properties. Conclusion In summary ADAM8 expression is a prognostic factor for survival of patients with head and neck squamous cell carcinoma. PMID:22369429

  6. Washington Correlator

    NASA Technical Reports Server (NTRS)

    Hall, David M.; Boboltz, David

    2013-01-01

    This report summarizes the activities of the Washington Correlator for 2012. The Washington Correlator provides up to 80 hours of attended processing per week plus up to 40 hours of unattended operation, primarily supporting Earth Orientation and astrometric observations. In 2012, the major programs supported include the IVS-R4, IVS-INT, APSG, and CRF observing sessions.

  7. The association between neck pain, the Neck Disability Index and cervical ranges of motion: a narrative review

    PubMed Central

    Howell, Emily R.

    2011-01-01

    Background: The Neck Disability Index (NDI) and Cervical Ranges of Motion (CROM) are measurement tools that are used for neck pain patients. Objective: To review the literature to determine how the NDI is associated with neck pain and CROM outcomes. Methods: Computer based searches of 5 databases were performed and supplemented by internet and hand searching of article references and “related citations.” Results: The search yielded 23 studies that met the inclusion and exclusion criteria and these were summarized into four categories: NDI, NDI and other questionnaires, whiplash and NDI and cervical range of motion and NDI. The NDI was shown to be a well validated and reliable self-reported questionnaire, especially when compared to other questionnaires, in both neck pain and whiplash (WAD) patients. There are very few studies that discuss the NDI and cervical range of motion. Conclusion: This review outlines the strength of the NDI as a self-reported neck disability questionnaire, but also demonstrates a need for further research to explore the association between the NDI, neck pain and cervical ranges of motion. PMID:21886283

  8. Alterations in 18F-FDG accumulation into neck-related muscles after neck dissection for patients with oral cancers

    PubMed Central

    Kito, Shinji; Koga, Hirofumi; Kodama, Masaaki; Habu, Manabu; Kokuryo, Shinya; Oda, Masafumi; Matsuo, Kou; Nishino, Takanobu; Matsumoto-Takeda, Shinobu; Uehara, Masataka; Yoshiga, Daigo; Tanaka, Tatsurou; Nishimura, Shun; Miyamoto, Ikuya; Sasaguri, Masaaki; Tominaga, Kazuhiro; Yoshioka, Izumi; Morimoto, Yasuhiro

    2016-01-01

    Background 18F-fluoro-2-deoxy-D-glucose (18F-FDG) accumulations are commonly seen in the neck-related muscles of the surgical and non-surgical sides after surgery with neck dissection (ND) for oral cancers, which leads to radiologists having difficulty in diagnosing the lesions. To examine the alterations in 18F-FDG accumulation in neck-related muscles of patients after ND for oral cancer. Material and Methods 18F-FDG accumulations on positron emission tomography (PET)-computed tomography (CT) in neck-related muscles were retrospectively analyzed after surgical dissection of cervical lymph nodes in oral cancers. Results According to the extent of ND of cervical lymph nodes, the rate of patients with 18F-FDG-PET-positive areas increased in the trapezius, sternocleidomastoid, and posterior neck muscles of the surgical and/or non-surgical sides. In addition, SUVmax of 18F-FDG-PET-positive areas in the trapezius and sternocleidomastoid muscles were increased according to the extent of the ND. Conclusions In evaluating 18F-FDG accumulations after ND for oral cancers, we should pay attention to the 18F-FDG distributions in neck-related muscles including the non-surgical side as false-positive findings. Key words:18F-FDG, PET-CT, oral cancers, muscles. PMID:27031062

  9. Melanoma Metastases to the Neck Nodes: Role of Adjuvant Irradiation

    SciTech Connect

    Strojan, Primoz; Jancar, Boris; Cemazar, Maja; Perme, Maja Pohar; Hocevar, Marko

    2010-07-15

    Purpose: To review experiences in the treatment of regionally advanced melanoma to the neck and/or parotid with emphasis on the role of adjuvant radiotherapy. Patients and Methods: Clinical and histopathologic data, treatment details, and outcomes in patients treated during the period 2000-2006 at the Institute of Oncology, Ljubljana, Slovenia, were reviewed. Results: A total of 40 patients with 42 dissections underwent surgery, and 43 patients with 45 dissections received irradiation postoperatively to a median equivalent dose (eqTD{sub 2}: 2 Gy/fraction, 1 fraction/day, 5 fractions/week) of 60 Gy (range, 47.8-78.8). Regional control 2 years after surgery was 56% (95% confidence interval [CI] 40-72%) and after postoperative radiotherapy 78% (CI 63-92%) (p = 0.015). On multivariate analysis, postoperative radiotherapy (yes vs. no: hazard ratio [HR] 6.3, CI 2.0-20.6) and sum of the risk factors present (i.e., risk factor score; HR 1.7 per score point, CI 1.2-2.6) were predictive for regional control. On logistic regression testing, the number of involved nodes was associated with the probability of distant metastases (p = 0.021). The incidence of late toxicity did not correlate with the mode of therapy, eqTD{sub 2}, or fractionation pattern. Conclusions: Adjuvant radiotherapy has the potential to compensate effectively for the negative impact of adverse histopatologic features to disease control in a dissected nodal basin. More conventionally fractionated radiotherapy regimens using fraction doses of 2-2.5 Gy, with cumulative eqTD{sub 2{>=}}60 Gy, are recommended. The number of involved lymph nodes is proposed as an additional criterion for limiting the implementation of adjuvant irradiation.

  10. Predicting recurrence after radiotherapy in head and neck cancer.

    PubMed

    Begg, Adrian C

    2012-04-01

    Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide. Radiotherapy is a mainstay of treatment, either alone for early stage tumors or combined with chemotherapy for late stage tumors. An overall 5-year survival rate of around 50% for HNSCC demonstrates that treatment is often unsuccessful. Prediction of outcome is, therefore, aimed at sparing patients from ineffective and toxic treatments on the one hand, and indicating more successful treatment modalities on the other. Both functional and genetic assays have been developed to predict intrinsic radiosensitivity, hypoxia, and repopulation rate. Few, however, have shown consistent correlations with outcome across multiple studies. Messenger RNA and microRNA profiling show promise for predicting hypoxia, whereas epidermal growth factor receptor expression combined with other measures of tumor differentiation grade shows promise for predicting repopulation rate. Intrinsic radiosensitivity assays have not proven useful to date, although development of repair protein foci assays indicates promise from preclinical studies. Assays for cancer stem cell content have shown promise in several clinical studies. In addition, 2 assays showing robustness as predictors for outcome in HNSCC are human papilloma virus status and epidermal growth factor receptor expression. Neither these nor stem cell assays, however, can as yet reliably indicate alternative and better treatments for poor prognosis patients. It would be of great value to have assays that predict the benefit for an individual from combining new molecularly targeted agents with radiotherapy to increase response, in particular those that exploit tumor mutations to provide tumor specificity. Predictive assays are being developed for detecting defects in repair pathways for single- and double-strand DNA breaks, which should allow selection of drugs targeting the appropriate backup pathway, thus exploiting the concept of synthetic lethality. This is one of the most promising areas for prediction, both currently and in the future. PMID:22385918

  11. Glucose uptake, perfusion, and cell proliferation in head and neck tumors: Relation of positron emission tomography to flow cytometry

    SciTech Connect

    Haberkorn, U.; Strauss, L.G.; Reisser, C.; Haag, D.; Dimitrakopoulou, A.; Ziegler, S.; Oberdorfer, F.; Rudat, V.; van Kaick, G. )

    1991-08-01

    The uptake of 18F-Deoxyglucose (FDG) was studied in vivo in relation to the proliferation rate of human head and neck tumors. Forty-two patients with histologically proven squamous-cell carcinoma of the head and neck and four patients with metastases of head and neck tumors were examined with PET and FDG prior to surgery. In 35 of these patients, a flow cytometric analysis of the DNA content and the proliferation rate was done using one-dimensional flow cytometry rate was done using one-dimensional flow cytometry (DAPI staining). In 17 cases, perfusion studies with 15O-labeled water were performed. Twenty-seven specimens were evaluable by flow cytometry. The analysis of the distribution of the FDG uptake revealed two groups, showing a high and a lower uptake pattern. In both groups the FDG uptake and the proliferation rate were correlated with an r-value of 0.64 and 0.8 respectively. However, the slope of the regression function was flat. No correlation was found between the perfusion and the proliferation rate. It is suggested that these differences in uptake in histologically identical tumor populations may correspond to differences at the molecular level, e.g., differences in the amount of the glucose carrier, perhaps caused by oncogenic transformation.

  12. Classification of neck/shoulder pain in epidemiological research: a comparison of personal and occupational characteristics, disability, and prognosis among 12,195 workers from 18 countries.

    PubMed

    Sarquis, Leila M M; Coggon, David; Ntani, Georgia; Walker-Bone, Karen; Palmer, Keith T; Felli, Vanda E; Harari, Raul; Barrero, Lope H; Felknor, Sarah A; Gimeno, David; Cattrell, Anna; Vargas-Prada, Sergio; Bonzini, Matteo; Solidaki, Eleni; Merisalu, Eda; Habib, Rima R; Sadeghian, Farideh; Kadir, M Masood; Warnakulasuriya, Sudath S P; Matsudaira, Ko; Nyantumbu, Busisiwe; Sim, Malcolm R; Harcombe, Helen; Cox, Ken; Marziale, Maria H; Harari, Florencia; Freire, Rocio; Harari, Natalia; Monroy, Magda V; Quintana, Leonardo A; Rojas, Marianela; Harris, E Clare; Serra, Consol; Martinez, J Miguel; Delclos, George; Benavides, Fernando G; Carugno, Michele; Ferrario, Marco M; Pesatori, Angela C; Chatzi, Leda; Bitsios, Panos; Kogevinas, Manolis; Oha, Kristel; Freimann, Tiina; Sadeghian, Ali; Peiris-John, Roshini J; Sathiakumar, Nalini; Wickremasinghe, A Rajitha; Yoshimura, Noriko; Kelsall, Helen L; Hoe, Victor C W; Urquhart, Donna M; Derrett, Sarah; McBride, David; Herbison, Peter; Gray, Andrew; Salazar Vega, Eduardo J

    2016-05-01

    To inform case definition for neck/shoulder pain in epidemiological research, we compared levels of disability, patterns of association, and prognosis for pain that was limited to the neck or shoulders (LNSP) and more generalised musculoskeletal pain that involved the neck or shoulder(s) (GPNS). Baseline data on musculoskeletal pain, disability, and potential correlates were collected by questionnaire from 12,195 workers in 47 occupational groups (mostly office workers, nurses, and manual workers) in 18 countries (response rate = 70%). Continuing pain after a mean interval of 14 months was ascertained through a follow-up questionnaire in 9150 workers from 45 occupational groups. Associations with personal and occupational factors were assessed by Poisson regression and summarised by prevalence rate ratios (PRRs). The 1-month prevalence of GPNS at baseline was much greater than that of LNSP (35.1% vs 5.6%), and it tended to be more troublesome and disabling. Unlike LNSP, the prevalence of GPNS increased with age. Moreover, it showed significantly stronger associations with somatising tendency (PRR 1.6 vs 1.3) and poor mental health (PRR 1.3 vs 1.1); greater variation between the occupational groups studied (prevalence ranging from 0% to 67.6%) that correlated poorly with the variation in LNSP; and was more persistent at follow-up (72.1% vs 61.7%). Our findings highlight important epidemiological distinctions between subcategories of neck/shoulder pain. In future epidemiological research that bases case definitions on symptoms, it would be useful to distinguish pain that is localised to the neck or shoulder from more generalised pain that happens to involve the neck/shoulder region. PMID:26761390

  13. Prevalence of salmonella in neck skin and bone of chickens.

    PubMed

    Wu, Diezhang; Alali, W Q; Harrison, M A; Hofacre, C L

    2014-07-01

    Bone-in and boneless parts, such as drumsticks, are used in ground chicken production. In addition, neck skin is used as a source of fat in ground products. Contaminated chicken neck skin and bones containing internalized Salmonella are potential sources of this pathogen in ground chicken. This study determined the prevalence of Salmonella and serotype distribution in drumstick bones and neck skin of postchill chicken carcasses. One week prior to slaughter, chicken houses (n = 26) at nine farms were tested for the presence of Salmonella, using the boot sock method. Chicken flocks from these houses originated from Salmonella-positive breeders. Eight Salmonella-positive chicken flocks and one flock with undetermined Salmonella status were monitored through processing. Three hundred postchill drumsticks and 299 neck skin samples were analyzed for Salmonella prevalence. Skin samples were rinsed and stomached prior to analysis. Bones were extracted from the drumsticks, external surfaces were sterilized, and bones were crushed for analysis. One Salmonella isolate from each positive sample was serogrouped. Half of the isolates representing different sample types were serotyped. Overall, Salmonella was found in 0.8, 21.4, and 80.1% of bone marrow, neck skin, and farms, respectively. Prevalence of Salmonella on rinsed skin samples (2.3%) and stomached skin samples (20.7%) differed significantly (P ≤ 0.05). Serogroups B, C2, D, and E were found at 23.4, 31.9, 11.7, and 29.8%, respectively. Six Salmonella serotypes were identified: Liverpool (37.9%), Kentucky (27.6%), and Typhimurium (27.6%) were isolated most frequently from neck skin; the two bone isolates were Kentucky; and more than 50% of the farm isolates were Kentucky and Ouakam. Salmonella-contaminated neck skin might be a more significant source of this contamination in ground chicken than Salmonella internalized in bones. PMID:24988028

  14. Effectiveness of a tailored neck training program on neck strength, movement, and fatigue in under-19 male rugby players: a randomized controlled pilot study

    PubMed Central

    Barrett, Matthew D; McLoughlin, Terence F; Gallagher, Kieran R; Gatherer, Don; Parratt, Michael TR; Perera, Jonathan R; Briggs, Tim WR

    2015-01-01

    Purpose To investigate the effect of a tailored neck muscle conditioning program on neck muscle strength, neck muscle fatigue, and range of neck movement in 16–18-year-old male rugby players. Materials and methods Thirty-four male rugby players were divided into forward and back playing positions and randomized within these groups. Seventeen players were randomly assigned to each group. The test group was given a tailored 6-week exercise regime based on their baseline measurements to be performed three times a week in addition to their normal training and playing. The control group trained and played as normal. The outcome measures used were cervical spine range of movement, neck strength, and neck muscle fatigability. Results There were no clinically relevant statistically significant differences between the two groups. Trends identified between the two groups suggest that a tailored neck exercise program increases neck strength, particularly neck extension, and increases resistance to fatigue, as well as influencing right- and left-sided neck muscle balance. A reduction in range of movement was also demonstrated in the test group. There was a great deal of variability in range of movement and strength within this age group. No previously undiagnosed neck conditions were detected, and there were no adverse events reported. Conclusion This study has shown that neck strength, range of movement, and susceptibility of the neck muscles to fatigue can be influenced using a focused neck training regime. It forms an important basis for a larger, multicenter study to ensure the neck is given due attention in rugby training and receives the same focus of conditioning as other parts of the body. PMID:25999771

  15. Noninvasive Assessment of Tumor Microenvironment Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging and {sup 18}F-Fluoromisonidazole Positron Emission Tomography Imaging in Neck Nodal Metastases

    SciTech Connect

    Jansen, Jacobus; Schoeder, Heiko; Lee, Nancy Y.; Wang Ya

    2010-08-01

    Purpose: To assess noninvasively the tumor microenvironment of neck nodal metastases in patients with head-and-neck cancer by investigating the relationship between tumor perfusion measured using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and hypoxia measured by {sup 18}F-fluoromisonidazole ({sup 18}F-FMISO) positron emission tomography (PET). Methods and Materials: Thirteen newly diagnosed head-and-neck cancer patients with metastatic neck nodes underwent DCE-MRI and {sup 18}F-FMISO PET imaging before chemotherapy and radiotherapy. The matched regions of interests from both modalities were analyzed. To examine the correlations between DCE-MRI parameters and standard uptake value (SUV) measurements from {sup 18}F-FMISO PET, the nonparametric Spearman correlation coefficient was calculated. Furthermore, DCE-MRI parameters were compared between nodes with {sup 18}F-FMISO uptake and nodes with no {sup 18}F-FMISO uptake using Mann-Whitney U tests. Results: For the 13 patients, a total of 18 nodes were analyzed. The nodal size strongly correlated with the {sup 18}F-FMISO SUV ({rho} = 0.74, p < 0.001). There was a strong negative correlation between the median k{sub ep} (redistribution rate constant) value ({rho} = -0.58, p = 0.042) and the {sup 18}F-FMISO SUV. Hypoxic nodes (moderate to severe {sup 18}F-FMISO uptake) had significantly lower median K{sup trans} (volume transfer constant) (p = 0.049) and median k{sub ep} (p = 0.027) values than did nonhypoxic nodes (no {sup 18}F-FMISO uptake). Conclusion: This initial evaluation of the preliminary results support the hypothesis that in metastatic neck lymph nodes, hypoxic nodes are poorly perfused (i.e., have significantly lower K{sup trans} and k{sub ep} values) compared with nonhypoxic nodes.

  16. Misconceived Retropharyngeal Calcific Tendinitis during Management of Myofascial Neck Pain Syndrome.

    PubMed

    Oh, Ji Youn; Lim, Jin Hun; Kim, Yong Seok; Kwon, Young Eun; Yu, Jae Yong; Lee, Jun Hak

    2016-01-01

    Differential diagnosis of posterior neck pain is very challenging based on symptoms and physical examination only. Retropharyngeal calcific tendinitis is a rare and frequently misdiagnosed entity in various causes of neck pain. It results from calcium hydroxyapatite deposition in the longus colli muscle which is characterized by severe neck pain, painful restriction of neck movement, dysphagia, and odynophagia. We herein report a case of a patient with acute retropharyngeal calcific tendinitis, who complained of posterior neck pain, initially diagnosed and treated as a myofascial neck pain syndrome. PMID:26839671

  17. Misconceived Retropharyngeal Calcific Tendinitis during Management of Myofascial Neck Pain Syndrome

    PubMed Central

    Oh, Ji Youn; Lim, Jin Hun; Kim, Yong Seok; Kwon, Young Eun; Yu, Jae Yong

    2016-01-01

    Differential diagnosis of posterior neck pain is very challenging based on symptoms and physical examination only. Retropharyngeal calcific tendinitis is a rare and frequently misdiagnosed entity in various causes of neck pain. It results from calcium hydroxyapatite deposition in the longus colli muscle which is characterized by severe neck pain, painful restriction of neck movement, dysphagia, and odynophagia. We herein report a case of a patient with acute retropharyngeal calcific tendinitis, who complained of posterior neck pain, initially diagnosed and treated as a myofascial neck pain syndrome. PMID:26839671

  18. Random Positional Variation Among the Skull, Mandible, and Cervical Spine With Treatment Progression During Head-and-Neck Radiotherapy

    SciTech Connect

    Ahn, Peter H. Ahn, Andrew I.; Lee, C. Joe; Shen Jin; Miller, Ekeni; Lukaj, Alex; Milan, Elissa; Yaparpalvi, Ravindra; Kalnicki, Shalom; Garg, Madhur K.

    2009-02-01

    Purpose: With 54{sup o} of freedom from the skull to mandible to C7, ensuring adequate immobilization for head-and-neck radiotherapy (RT) is complex. We quantify variations in skull, mandible, and cervical spine movement between RT sessions. Methods and Materials: Twenty-three sequential head-and-neck RT patients underwent serial computed tomography. Patients underwent planned rescanning at 11, 22, and 33 fractions for a total of 93 scans. Coordinates of multiple bony elements of the skull, mandible, and cervical spine were used to calculate rotational and translational changes of bony anatomy compared with the original planning scan. Results: Mean translational and rotational variations on rescanning were negligible, but showed a wide range. Changes in scoliosis and lordosis of the cervical spine between fractions showed similar variability. There was no correlation between positional variation and fraction number and no strong correlation with weight loss or skin separation. Semi-independent rotational and translation movement of the skull in relation to the lower cervical spine was shown. Positioning variability measured by means of vector displacement was largest in the mandible and lower cervical spine. Conclusions: Although only small overall variations in position between head-and-neck RT sessions exist on average, there is significant random variation in patient positioning of the skull, mandible, and cervical spine elements. Such variation is accentuated in the mandible and lower cervical spine. These random semirigid variations in positioning of the skull and spine point to a need for improved immobilization and/or confirmation of patient positioning in RT of the head and neck.

  19. Irreversible electroporation of locally advanced pancreatic neck/body adenocarcinoma

    PubMed Central

    2015-01-01

    Objective Irreversible electroporation (IRE) of locally advanced pancreatic adenocarcinoma of the neck has been used to palliate appropriate stage 3 pancreatic cancers without evidence of metastasis and who have undergone appropriate induction therapy. Currently there has not been a standardized reported technique for pancreatic mid-body tumors for patient selection and intra-operative technique. Patients Subjects are patients with locally advanced pancreatic adenocarcinoma of the body/neck who have undergone appropriate induction chemotherapy for a reasonable duration. Main outcome measures Technique of open IRE of locally advanced pancreatic adenocarcinoma of the neck/body is described, with the emphasis on intra-operative ultrasound and intra-operative electroporation management. Results The technique of open IRE of the pancreatic neck/body with bracketing of the celiac axis and superior mesenteric artery with continuous intraoperative ultrasound imaging and consideration of intraoperative navigational system is described. Conclusions IRE of locally advanced pancreatic adenocarcinoma of the body/neck is feasible for appropriate patients with locally advanced unresectable pancreatic cancer. PMID:26029461

  20. Animal models of cancer in the head and neck region.

    PubMed

    Kim, Seungwon

    2009-06-01

    Animal models that resemble the cancers of the head and neck region are of paramount importance in studying the carcinogenesis of these diseases. Although several methods for modeling cancer in the head and neck are available, none are fully satisfactory. Subcutaneous xenograft models of cancer in nude mice are often used in preclinical studies. However, these models are problematic in several aspects as they lack the specific interactions that exist between the tumor cells and their native environment. Establishment of tumors at the orthotopic sites restore these distinct patterns of interactions between the tumor and the host organs that are lost or altered when the tumors are established in ectopic sites. With regard to the transgenic model of cancer in the head and neck region, it should be kept in mind that the transgene used to drive the malignant transformation may not be representative of the carcinogenic process found in human tumors. Low penetrance of tumor formation also translates into high cost and time commitment in performing studies with transgenic models. In this review, we will discuss some of the commonly used methods for modeling cancer in the head and neck region including squamous cell carcinoma of the head and neck as well as thyroid carcinoma. PMID:19565028

  1. Minimizing Liability Risks of Head and Neck Injuries in Football

    PubMed Central

    Heck, Jonathan F.; Weis, Michael P.; Gartland, James M.; Weis, Craig R.

    1994-01-01

    Although catastrophic head and neck injuries in football occur infrequently, their occurrence is almost always followed by litigation. The athletic trainer has to be sure he/she has adequate liability insurance to cover the costs of a defense and a possible judgment. General claims filed against athletic staffs usually deal with instruction, equipment, matching of participants, supervision, and/or postinjury care. The defenses to these claims include: statutory immunity, assumption of risk, releases or waivers, and the reckless disregard standard. The athletic trainer plays a key role in head and neck injury prevention and care, and must be aware of litigation possibilities, along with methods of risk management. We present recommendations aimed at minimizing the risk of head and neck injuries and the risk of liability. The areas covered are: preparing for head and neck lawsuits, preventing head and neck injuries, and postcatastrophic injury care. We base these recommendations on principles that the athletic trainer can easily apply to other areas, broadening the risk management concept presented. ImagesFig 1.Fig 5.Fig 6.Fig 7. PMID:16558275

  2. Strategies for prevention and management of musculoskeletal conditions. Neck pain.

    PubMed

    Jensen, Irene; Harms-Ringdahl, Karin

    2007-02-01

    The aim of this article was to summarise the existing evidence concerning interventions for non-specific neck pain. Neck-and-shoulder pain is commonly experienced by both adolescents and adults. Although the prevalence appears to vary among different nations, the situation is essentially the same, at least in the industrialised nations. Explanations for the wide variation in incidence and prevalence include various methodological issues. Back and neck disorders represent one of the most common causes for both short- and long-term sick leave and disability pension. Evidenced risk factors for the onset and maintenance of non-specific neck and back pain include both individual and work-related psychosocial factors. Based on the existing evidence different forms of exercise can be strongly recommended for at-risk populations, as well as for the acute and chronic non-specific neck pain patient. Furthermore, for symptom relief this condition can be treated with transcutaneous electric nerve stimulation, low level laser therapy, pulse electromagnetic treatment or radiofrequency denervation. PMID:17350546

  3. Femoral head-neck junction reconstruction, after iatrogenic bone resection

    PubMed Central

    Guevara-Alvarez, Alberto; Lash, Nicholas; Beck, Martin

    2015-01-01

    Arthroscopic over-resection of the head-neck junction during the treatment of a cam deformity can be a devastating complication and is difficult to treat. Large defects of the femoral head-neck junction (FHNJ) increase the risk of femoral neck fracture and can also affect hip biomechanics. We describe a case of an iatrogenic defect of the FHNJ due to excessive bone resection, and a previously non-described treatment using iliac crest autograft to restore femoral head-neck sphericity and hip joint stability. After protecting the femoral neck with an angled blade plate, the large anterior FHNJ defect was reconstructed using autogenous iliac crest bone graft; sphericity was restored by contouring the graft using spherical templates. Clinical and radiographic follow-up was performed up to 2 years. Results at 2 years showed no residual groin pain and normal range of motion. The Oxford Hip Score was 46/48, rated as excellent. Computed tomography (CT) scanning showed union of bone graft without resorption, and CT arthrogram indicating retained sphericity of the FHNJ without evidence of degenerative changes in the articular surface. This novel surgical technique can be used to restore the structural integrity and contour of the FHNJ that contains a significant anterior defect.

  4. Therapeutic applications of botulinum neurotoxins in head and neck disorders

    PubMed Central

    Alshadwi, Ahmad; Nadershah, Mohammed; Osborn, Timothy

    2014-01-01

    Objective The aim of this article is to review the mechanism of action, physiological effects, and therapeutic applications of botulinum neurotoxins in the head and neck area. Study design An extensive literature search was performed using keywords. The resulting articles were analyzed for relevance in four areas: overview on botulinum neurotoxins, the role of botulinum neurotoxins in the management of salivary secretory disorders, the role of botulinum neurotoxins in the management of facial pain, and the role of botulinum neurotoxins in head and neck movement disorders. Institutional review board approval was not needed due the nature of the study. Results Botulinum neurotoxin therapy was demonstrated to be a valuable alternative to conventional medical therapy for many conditions affecting the head and neck area in terms of morbidly, mortality, and patient satisfaction with treatment outcomes. Conclusion Botulinum neurotoxin therapy provides viable alternatives to traditional treatment modalities for some conditions affecting the head and neck region that have neurological components. This therapy can overcome some of the morbidities associated with conventional therapy. More research is needed to determine the ideal doses of botulinum neurotoxin to treat different diseases affecting the head and neck regions. PMID:25544809

  5. Airway management in patients with burn contractures of the neck.

    PubMed

    Prakash, Smita; Mullick, Parul

    2015-12-01

    Airway management of patients with burn contracture of the neck (PBC neck) is a challenge to the anesthesiologist. Patient evaluation includes history, physical and airway examination. A safe approach in the airway management of a patient with moderate to severe PBC neck is to secure the airway with the patient awake. The anesthesiologist should have a pre-planned strategy for intubation of the difficult airway. The choices advocated for airway management of such patients include awake fiberoptic-guided intubation, use of intubating laryngeal mask airway, intubation without neuromuscular blocking agents, intubation with neuromuscular blocking agents after testing the ability to ventilate by mask, pre-induction neck scar release under local anesthesia and ketamine or sedation followed by direct laryngoscopy and intubation and video-laryngoscope guided intubation, amongst others. Preparation of the patient includes an explanation of the proposed procedure, sedation, administration of antisialogogues and regional anesthesia of the airway. The various options for intubation of patients with PBC neck, intraoperative concerns and safe extubation are described. Back-up plans, airway rescue strategies and a review of literature on this subject are presented. PMID:25868969

  6. Prognostic value of FDG PET/CT in head and neck squamous cell carcinomas

    PubMed Central

    Dequanter, D; Shahla, M; Aubert, C; Deniz, Y; Lothaire, P

    2015-01-01

    Introduction The purpose of this study was to evaluate the use of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to identify the presence of cervical lymph nodes metastases and extracapsular spread with histologic correlations in head and neck squamous cell carcinoma. Methods The medical records of 54 patients who underwent 18F-FDG PET/CT for head and neck squamous cell carcinoma before surgery were reviewed. Receiver operating characteristic (ROC) analysis was performed to differentiate patients with cervical lymph node metastasis from those without lymph node metastasis. The same statistical analysis was done to differentiate cervical lymph nodes with extracapsular spread from those without extracapsular spread. Results Metastatic disease was diagnosed histologically in 49% (26 of 54) of the patients. Extracapsular spread was present in ten of the 54 patients (19%). When ROC curve analysis and maximum standardized uptake (SUVmax) values were used to detect cervical lymph node metastasis, the area under the ROC curve was 0.96 and the optimal cutoff value for SUVmax was 4.05 based on ROC curve analysis. The sensitivity and specificity of SUVmax for the detection of cervical lymph node metastasis using this cutoff point were 92% and 88%, respectively. When ROC curve analysis and SUVmax values were used in order to detect extracapsular spread, the area under the ROC curve was 0.86, and the optimal cutoff value for SUVmax was 4.15 based on ROC curve analysis. Using this cutoff value, the sensitivity and specificity of SUVmax for the detection of extracapsular spread were 83% and 88%, respectively. Conclusion In our study, a median 18F-FDG PET/CT SUVmax cutoff value of 4.15 was found to be related with cervical lymph node metastasis and extracapsular spread in patients with head and neck cancer. PMID:26346890

  7. A liquid biopsy for head and neck cancers.

    PubMed

    Schmidt, Henri; Kulasinghe, Arutha; Perry, Chris; Nelson, Colleen; Punyadeera, Chamindie

    2016-02-01

    Head and neck cancer patients often present with advanced metastatic disease resulting in a poor 5-year survival. Therefore, there is a need for non-invasive diagnostic tools that could complement conventional imaging to inform clinicians of patient outcomes and treatment responses. A liquid biopsy addresses this unmet clinical need; a simple peripheral blood draw could provide information about the disseminated disease in terms of circulating tumor cells and circulating tumor DNA. Moreover, detectable tumor DNA in the saliva of head and neck cancer patients could signify the early signs of the disease and present an opportunity for clinical intervention. This review provides an overview of the current literature with regard to the feasibility of such a test in the head and neck cancer field and highlights the need for such a test. PMID:26631411

  8. Defining value-driven care in head and neck oncology.

    PubMed

    Roman, Benjamin R; Awad, Mahmoud I; Patel, Snehal G

    2015-01-01

    In the USA, increasing attention is being paid to adopting a value-based framework for measuring and ultimately improving health care delivery. Value is defined as the benefit achieved relative to costs. The numerator of the value equation includes quality of care and outcomes achieved. The denominator includes costs, both financial costs and harms of treatment. Herein, we describe these elements of value as they pertain to head and neck cancer. A particular focus is to identify areas of the value equation where physicians have some control. We examine quality in each of three dimensions: structure, process, and outcomes. We also adopt Porter's three-tiered hierarchy of outcomes model, with specific outcomes relevant to patients with head and neck and thyroid cancer. Finally, we review issues related to costs and harms. We believe these findings can serve as a framework for further efforts to drive value-based delivery of head and neck cancer care. PMID:25416318

  9. Cutaneous Squamous Cell Carcinoma of the Head and Neck

    PubMed Central

    Gurudutt, Vivek V.; Genden, Eric M.

    2011-01-01

    Cutaneous squamous cell carcinoma of the head and neck is an epidemic that reaches all parts of the world. Making the diagnosis relies on the acumen of the clinician and pathologist. Various pathologic subtypes exist and differ in histology and prognosis. High-risk tumors need aggressive treatment and vigilant surveillance to monitor for recurrence. Large tumors, deep tissue invasion, perineural involvement, recurrence, location in high-risk areas, and immunosuppression are implicated in worsening prognosis. Surgery is the mainstay of treatment with adjuvant radiation therapy as needed for aggressive tumors; however, other modalities are potentially useful for low-risk lesions. The use of Mohs surgery has become increasingly useful and has shown high success rates. Involvement of parotid and neck lymph nodes significantly affects outcomes and the physician should be comfortable with management of this complex disease. This paper examines the diagnosis, pathology, clinical course, and treatment options for cutaneous squamous cell carcinoma of the head and neck. PMID:21461387

  10. Revision of Recalled Modular Neck Rejuvenate and ABG Femoral Implants.

    PubMed

    Walsh, Christopher P; Hubbard, James C; Nessler, Joseph P; Markel, David C

    2015-05-01

    Modular neck femoral stems have been associated with adverse local tissue reactions (ALTR), leading to a voluntary recall, but these effects have not been well-characterized. A retrospective review of intraoperative findings and cobalt/chromium levels was performed in 103 hips undergoing revision for ALTR. The average preoperative serum cobalt level was 7.6 μg/L (range 1.1-23 μg/L) and chromium level was 1.8 μg/L (range 0.1-6.8 μg/L). Metallic sludge was noted in 100%, synovitis in 98%, pericapsular rind in 82%, and calcar erosion in 85%. An osteotomy was required for removal in 44%. We concluded that revision of modular neck femoral stems is associated with increased preoperative metal ion levels and stem-neck corrosion. Despite advanced stem explantation techniques, osteotomy was frequently required, leading to increased morbidity. PMID:25573180

  11. [Epidemiologic aspects of cancers of the head-neck area].

    PubMed

    Dietz, A; Heller, W D; Maier, H

    1991-10-01

    This review gives an impression of the different epidemiological aspects of squamous cell carcinomas of the oral cavity, the pharynx and the larynx. The main riskfactor associated to development of head/neck-cancer is the chronical consumption of tobacco and alcohol. Tobacco contains different types of well known carcinogens (tobaccospecific nitrosamins, polycyclic aromatic carbonates PAH). Alcohol by itself is not described as carcinogen. The multiplicative effect on the carcinogenic potency of tobacco in head/neck-cancer caused by alcohol consumption is well documented in many epidemiological studies. Enquires were directed at occupational exposure to substances like asbestos, solvents, coal products, welding fumes, wood dust, cement and many other substances. Different authors could show that socioeconomic factors, dietary habits and life style are associated to an elevated head/neck-cancer risk, independent of alcohol and tobacco consumption. PMID:1837600

  12. Current advances in radiotherapy of head and neck malignancies

    PubMed Central

    Roopashri, G; Baig, Muqeet

    2013-01-01

    Necessity is the mother of all inventions. This is also true in case of cancer therapy. With increasing incidence of head and neck malignancies, remarkable developments have been made towards cancer development and treatment which continues to be a major challenge. Approximately fifty percent of all cancer patients receive radiotherapy which contributes towards forty percent of curative treatment for cancer. New developments in radiation oncology have helped to improve outlook for patients and find more effective treatment. With the advent of new technologies, radiotherapy seems to be promising in patients with head and neck malignancies these advancements include Altered fractionation, Three-dimensional conformal radiotherapy, Intensity-modulated radiotherapy, Image Guided Radiotherapy, Stereotactic radiation, Charged-particle radiotherapy, and Intraoperative radiotherapy. How to cite this article: Roopashri G, Baig M. Current advances in radiotherapy of head and neck malignancies. J Int Oral Health 2013; 5(6):119-23 . PMID:24453456

  13. Sleep apnea syndrome after irradiation of the neck

    SciTech Connect

    Herlihy, J.P.; Whitlock, W.L.; Dietrich, R.A.; Shaw, T. )

    1989-12-01

    After irradiation of the neck for a squamous cell carcinoma of the tonsillar pillar and vocal cord, a 71-year-old man presented with a rapidly progressive sleep apnea syndrome. Previous reports describe the condition of patients with obstructive sleep apnea that developed after neck irradiation and secondary to supraglottic edema. Our patient had an obstructive component to his apnea similar to that described in previous cases, but, in addition, he had hypothyroidism. Myxedema is a well-described cause of both obstructive and central apnea. We believe both contributed to his condition. He was successfully treated by placement of a tracheostomy and by thyroid supplementation. In patients who present with sleep apnea after neck irradiation, especially with acute or severe symptoms, the differential diagnosis should include both a central cause from hypothyroidism as well as a peripheral obstructive cause from laryngeal edema.

  14. Neck stoma patients: is vital information displayed at the bedside?

    PubMed

    Darr, Adnan; Siddiq, Somiah; Jolly, Karan; Spinou, Catherine

    2016-03-10

    Tracheostomies are common procedures in head and neck and critical care practice, with 50% of airway-related deaths attributable to complications such as occlusion or displacement. The National Tracheostomy Safety Project (NTSP) published guidance regarding emergency management of neck stoma patients. A prospective multicentre regional audit of all neck stoma inpatients (ward and intensive care unit (ICU) settings) was conducted. Bed spaces were assessed for tracheostomy care bundles and essential stoma information, as recommended by the NTSP guidelines. The results demonstrate inadequate ward compliance across all three trusts, with ICU compliance greater in comparison to a ward environment. Of note, crucial information regarding the nature of stoma and whom to contact in the event of an emergency, was not displayed in the majority of cases. A greater awareness of the NTSP guidance and implementation of vital information is a necessity across all disciplines in order to reduce stoma complication-related morbidity and mortality. PMID:26972996

  15. Current clinical immunotherapeutic approaches for head and neck cancer

    PubMed Central

    Soto Chervin, Carolina; Brockstein, Bruce

    2016-01-01

    It was estimated that 59,340 new cases of head and neck cancer would be diagnosed in the US alone in 2015 and that 12,290 deaths would be attributed to the disease. Local and regional recurrences may be treated with chemotherapy and radiation; however, metastatic head and neck cancer is fatal and is treated with chemotherapy for palliation. Recent successful treatment of a variety of solid and hematological malignancies by immunotherapeutic approaches (i.e. harnessing the body’s own immune system to combat disease) has added a fourth therapeutic option for the treatment of cancer. This commentary will review the status of immunotherapies in clinical development for the specific treatment of head and neck cancer.

  16. Cervical Myelopathy Caused by Injections into the Neck

    PubMed Central

    Ralph, Jeffrey W.; Layzer, Robert B.

    2015-01-01

    Three cases of longitudinally extensive cervical myelopathies temporally associated with neck injections are presented. The spinal cord injury was similar radiographically, despite a number of different needle approaches and substances injected. In recent years, there have been reports of an acute cervical myelopathy immediately following an injection procedure in the neck. Various explanations have been offered for this unfortunate complication, including (1) direct injection into the cord leading to traumatic injury, (2) injection of particulate matter into the arterial supply of the cord causing microvascular embolism and spinal cord infarction, and (3) intraneural injection of the chemical with centripetal spread of the injectant from the nerve trunk to the substance of the cord. The merits of each of these 3 mechanisms in explaining these cases are discussed. Albeit rare, acute cervical myelopathy should be considered a potential complication from any deep injection of chemicals into the neck. PMID:26425248

  17. Acute suppurative thyroiditis with deep neck infection: a case report.

    PubMed

    Tien, Kai-Jen; Chen, Tun-Chieh; Hsieh, Ming-Chia; Hsu, Shih-Chieh; Hsiao, Jeng-Yueh; Shin, Shyi-Jang; Hsin, Shih-Chieh

    2007-05-01

    Thyroid gland suppuration is a rare condition with nonspecific features. For this reason, diagnosis is often delayed, which may lead to a life-threatening situation. Causative agents are often gram-positive bacteria, such as Staphylococcus aureus and Streptococcus pneumoniae. With appropriate antibiotics and drainage of the abscess, the prognosis is usually excellent. Herein, we describe a unique case of acute suppurative thyroiditis in an adult male presenting with nonspecific sore throat after a fish bone injury to the throat. The patient had a history of essential hypertension and gouty arthritis. In the emergency room, fever, chills, and neck swelling were noted. Thyroid echo and computed tomography of the neck revealed the thyroid abscess with deep neck infection. The culture of the abscess showed Streptococcus viridans. He recovered gradually after parenteral antibiotics and surgical intervention. PMID:17542677

  18. Validation and application of the M.D. Anderson Dysphagia Inventory in patients treated for head and neck cancer in Brazil.

    PubMed

    Guedes, Renata Lígia Vieira; Angelis, Elisabete Carrara-de; Chen, Amy Y; Kowalski, Luiz Paulo; Vartanian, José Guilherme

    2013-03-01

    Analysis of quality of life (QOL) has revealed that preservation of swallowing, speech, and breathing functions has a direct impact on QOL and that these functions are important patient-reported outcomes. The purposes of this study were to adapt and culturally validate the M.D. Anderson Dysphagia Inventory (MDADI) to the Brazilian Portuguese language and to evaluate QOL related to dysphagia in patients treated for head and neck cancer. This was a cross-sectional study that included 72 adult patients with a mean age of 63 years who were treated for head and neck cancer. Construct validity and reliability analyses were performed through the comparison of the MDADI with three other health-related QOL questionnaires administered at the time of enrollment and MDADI application 2 weeks thereafter, respectively. Reliability was established by assuring both internal consistency (Cronbach's α) and test-retest reliability (intraclass correlation coefficient, ICC). Test-retest reliability for the total score in the MDADI had an ICC greater than 0.795 (p < 0.001). The MDADI had significant statistical correlations with the other questionnaires. Patients treated for head and neck cancer had a mean total score of 83 on the MDADI, which is indicative of minimal limitation in overall QOL. In conclusion, the present study validates the adaptation of the MDADI to the Brazilian Portuguese language and provides another tool to evaluate the impact of dysphagia on the QOL of head and neck cancer patients. PMID:22684923

  19. Standardization of Head and Neck Contouring Using the Acanthiomeatal Line

    SciTech Connect

    Desai, Snehal; Teh, Bin S. Hinojosa, Jose; Bell, Bent C.; Paulino, Arnold C.; Butler, E. Brian

    2009-10-01

    The purpose of this study was to determine the perceived and actual chin position(s) used for radiotherapy of head-and-neck cancers in a variety of clinical settings. Dosimetrists were asked to describe the external landmarks used to set the chin position. The lateral treatment planning radiographic figures in Ang's textbook, Radiotherapy for Head and Neck Cancers: Indications and Techniques, were analyzed for chin position by drawing a horizontal line from the tip of the chin to the cervical spine. The physicians at 7 departments were asked to rate the chin positions used in their departments for head-and-neck simulations. Choices included: (1) mildly flexed, (2) neutral, (3) mildly extended, and (4) hyperextended. In addition, each center was asked to select 2 representative cases to show routine chin position. The dosimetrists fixed the chin in neutral position by placing a virtual plane defined by 3 points (the base of the nasal septum [acanthus] and the external auditory canals) perpendicular to the table top. The type of head holder was irrelevant. Eighty-two percent (31/38) of the figures in Ang's text showed positioning in the neutral position (tip of the chin intersected the cervical spine between C2-3/C3-4). Most (71.4%) of the radiotherapists thought their patients were treated in the hyperextended neck position but, in fact, 85.7% (12/14) of the simulations showed a neural neck position. Reproducible chin positioning can be obtained by using the acanthiomeatal line. Consistent use of this technique will create a uniformly positioned set of axial co-images that have consistent appearance of avoidance and lymphatic areas. This will simplify contouring on axial computed tomography (CT) images of the neck. Standardizing the chin position is an important step to developing a standardized atlas and developing an information tool for automated contouring.

  20. Cognitive Functioning After Radiotherapy or Chemoradiotherapy for Head-and-Neck Cancer

    SciTech Connect

    Gan, Hui K.; Bernstein, Lori J.; Brown, Jennifer; Ringash, Jolie; Vakilha, Mehrdad; Wang, Lisa; Goldstein, David; Kim, John; Hope, Andrew; O'Sullivan, Brian; Waldron, John; Abdul Razak, Albiruni R.; Chen, Eric X.; Siu, Lillian L.

    2011-09-01

    Purpose: To perform a comprehensive cognitive function (CF) assessment in patients who were relapse free after curative intent radiotherapy (RT) or chemoradiotherapy for squamous cell carcinoma of the head and neck. Methods and Materials: Patients underwent neuropsychological tests to assess their objective CF; completed questionnaires to assess subjective CF, quality of life, and affect; and underwent blood tests to assess hematologic, biochemical, endocrine, and cytokine status. Retrospectively, the dosimetry of incidental radiation to the brain was determined for all patients, and the dose intensity of cisplatin was determined in those who had undergone chemoradiotherapy. Results: A total of 10 patients were enrolled (5 treated with radiotherapy only and 5 with radiotherapy and cisplatin). The mean time from the end of treatment was 20 months (range, 9-41). All patients were able to complete the assessment protocol. Of the 10 patients, 9 had impaired objective CF, with memory the most severely affected. The severity of memory impairment correlated significantly with the radiation dose to the temporal lobes, and impaired dexterity correlated significantly with the radiation dose to the cerebellum, suggesting that these deficits might be treatment related. Patients receiving cisplatin appeared to have poorer objective CF than patients receiving only RT, although this difference did not achieve statistical significance, likely owing to the small sample size. Consistent with the published data, objective CF did not correlate with subjective CF or quality of life. No association was found between objective CF and patients' affect, hematologic, biochemical, endocrine, and cytokine status. Conclusion: Neuropsychological testing is feasible in squamous cell carcinoma of the head-and-neck survivors. The findings were suggestive of treatment-related cognitive dysfunction. These results warrant additional investigation.

  1. [The supraclavicular flap for reconstruction of the head and neck].

    PubMed

    Reiter, M; Betz, C S; Harréus, U; Baumeister, P

    2015-02-01

    The complex anatomy of the head and neck region requires the ability to raise a wide spectrum of pedicled and free flaps, to ensure optimal reconstruction of various defects by the reconstructive surgeon. The supraclavicular (island) flap, which has almost been buried in oblivion, provides excellent potential to reconstruct even bigger defects of the head and neck region, while causing minimal donor site morbidity at the same time. Its benefits lie in the reliable skin island and its wide arc of rotation, resulting in excellent cosmetic and functional outcomes. PMID:25098721

  2. Rehabilitation of Dysphagia Following Head and Neck Cancer

    PubMed Central

    Pauloski, Barbara R.

    2008-01-01

    SYNOPSIS Patients with cancers of the oral cavity, pharynx or larynx may be treated with surgery, radiotherapy, chemotherapy, or a combination of these modalities. Each treatment type may have a negative impact on posttreatment swallowing function; these effects are presented in this chapter. The clinician has a number of rehabilitative procedures available to reduce or eliminate swallowing disorders in patients treated for cancer of the head and neck. The various procedures--including postures, maneuvers, modifications to bolus volume and viscosity, range of motion exercises, and strengthening exercises--and their efficacy in treated head and neck cancer patients are discussed. PMID:18940647

  3. Oral microbiome, periodontitis and risk of head and neck cancer.

    PubMed

    Galvão-Moreira, Leonardo Victor; da Cruz, Maria Carmen Fontoura Nogueira

    2016-02-01

    A wide range of studies has been successfully exploring the association between the human microenvironment, sustained inflammation, and cancer. Growing evidence has then emerged in this field over the past few years. Nevertheless, reliable data addressing the impact of the oral microbiome and periodontitis on the pathogenesis and risk of head and neck malignancies remain scarce. Hence, this communication focuses on briefly discuss the relationship between the oral microbiome, periodontitis and head and neck cancer based on the current understanding of such a disease-associated scenario. PMID:26684542

  4. Submandibular gland mucocele presenting as a lateral neck swelling.

    PubMed

    Felstead, Am; Patel, Pm; Revington, Pj

    2012-01-01

    Mucus extravasation cysts or mucoceles are an extremely rare occurrence in the major salivary glands. We report upon an unusual case of a submandibular gland mucocele presenting as a neck lump. It should therefore be considered in the differential diagnosis of swellings in the lateral neck. Diagnosis and management are complicated by their similarity to the plunging or cervical ranula and differentiation may be potentially difficult. Detailed imaging often reveals the plunging ranula as being characterised by a so -called 'tail' sign. In our case this sign was absent and subsequent excision confirmed origin from the submandibular gland. We discuss potential treatment modalities and propose a rationale for definitive management. PMID:24960677

  5. Magnetic Resonance Imaging of Acute Head and Neck Infections.

    PubMed

    Thayil, Neil; Chapman, Margaret N; Saito, Naoko; Fujita, Akifumi; Sakai, Osamu

    2016-05-01

    This article discusses the use of MR imaging in various acute infectious diseases of the head and neck, with particular emphasis on situations where MR imaging provides additional information that can significantly impact treatment decisions and outcomes. MR imaging findings of various disease processes are discussed, based on the head and neck compartments from which they originate. Specifically, infectious entities of the orbit, paranasal sinuses, pharynx, oral cavity (including periodontal disease), salivary glands, temporal bone, and lymph nodes are described in detail. PMID:27150323

  6. Head and neck cancer in two American presidents: Case reports.

    PubMed

    Weinberg, Mea A; Wang, Beverly

    2011-01-01

    Two former U.S. presidents, Ulysses S. Grant and Grover Cleveland, were diagnosed with head and neck cancer in 1884 and 1893, respectively. A historical review of the risk factors, diagnoses, and treatments is examined and compared with modern-day interpretations. A comparison was made using the original diagnoses with today's equivalent diagnosis. Different treatment outcomes at the time of the original diagnoses relative to today's treatment are reviewed. Clinicians must be familiar with risk factors, signs, symptoms, diagnosis, and treatment of head and neck cancer. PMID:22313921

  7. [A fatal case of necrotizing fasciitis of the neck].

    PubMed

    Osma, Ustün; Eyigör, Hülya; Yılmaz, Mustafa Deniz

    2011-01-01

    Necrotizing fasciitis is a rare but life-threatening soft-tissue infection primarily involving the superficial fascia and subcutaneous tissue. Only early diagnosis and aggressive therapy including broad-spectrum antibiotics and surgical intervention can avoid systemic toxicity associated with a high mortality rate. Necrotizing fasciitis is rarely seen in the head and neck region. In this article, we report a fatal case of necrotizing fasciitis in the neck of 75-years-old female patient and reviewed the microbiology, diagnosis, treatment and prognosis of this rare infection together with literature data. PMID:22014301

  8. Fusion, deep-inelastic collisions, and neck formation

    SciTech Connect

    Aguiar, C.E.; Barbosa, V.C.; Canto, L.F.; Donangelo, R.

    1988-07-01

    We use the liquid drop model to calculate the cross section for neck formation in a heavy-ion collision and show that for the recently measured /sup 58/Ni+/sup 124/Sn case this cross section is strongly related to the sum of the fusion and deep-inelastic cross sections. We note that the observation of deep-inelastic collisions at sub-Coulomb barrier energies may be classically understood by the effective barrier lowering obtained when the neck degree of freedom is considered.

  9. Pancreatic ampullary carcinoma with neck metastases: a case report

    PubMed Central

    2009-01-01

    Background An 18-year-old Turkish woman was referred with a 6-week history of rapidly enlarging cervical mass at the left side. Case report She was diagnosed of ampullary carcinoma for which pancreatoduodenectomy was performed 14 months ago. In our patient with a history of malignancy, a rapidly enlarging neck mass was considered a metastasis to the neck. Tumor resection was performed. Histopathological examination revealed the metastasis of the precedent ampullary adenocarcinoma. Conclusion Surgery does not improve survival for advanced metastatic ampullary cancer however, it can be mandatory in specific conditions as our patient. PMID:19946517

  10. [Two cases of synovial sarcoma in the head and neck].

    PubMed

    Zhang, Chengbin; Wu, Di; Bi, Lirong

    2015-02-01

    Synovial sarcoma is a malignant soft tissue with unknown origin. Although head and neck region is the second common site of involvement, rare cases have been reported in Para nasal sinus and larynx. We presented two cases of synovial sarcoma, one of which arised from maxillary sinus and the other from laryx, and re- view the literature to sum up the diagnosis and treatment strategies. The conclusion is that synovial sarcoma in the head and neck still raises diagnostic and therapeutic issues. Surgical excision with wide margins is essential and necessary, usually associated radiotherapy. The effect of chemotherapy remains to explored. PMID:26121847

  11. Survivorship and Quality of Life in Head and Neck Cancer.

    PubMed

    Ringash, Jolie

    2015-10-10

    Head and neck cancer is becoming more common, and survival rates are improving. Human papillomavirus-associated oropharyngeal cancer, in particular, is increasing in incidence and is associated with an excellent prognosis. However, toxicity from disease and treatment leads to long-term impairment, disability, and handicap. Currently, more than 60% of survivors have unmet needs. As the numbers of survivors increase, current models of care will be increasingly inadequate to meet their needs. Exploration of new strategies and models of care to better address quality-of-life issues and meet the needs of survivors of head and neck cancer is urgently required. PMID:26351336

  12. Complications of Head and Neck Reconstruction and Their Treatment

    PubMed Central

    Tan, Bien-Keem; Por, Yong-Chen; Chen, Hung-Chi

    2010-01-01

    Head and neck reconstruction is an intensive multistep process that requires attention to detail to achieve a successful result. The knowledge and prevention of complications as well as their management is an essential part of the training of the surgeon participating in head and neck reconstruction. This article explores the general complications, including free flap failure, carotid artery blowout, hardware exposure, and ectropion, as well as regional complications relating to operations of the scalp, cranium, base of skull, midface, mandible, and pharyngoesophagus. PMID:22550450

  13. Metal Fatigue Causing Cystoscope Rupture During Bladder Neck Incision

    PubMed Central

    Fernandez, Alfonso

    2011-01-01

    The modern cystoscope is the result of the advancement in technology in numerous areas and is an invaluable tool that allows the urologist to perform a number of diagnostic and therapeutic procedures. Although various degrees of endoscope failure have been widely reported, instrument breakage that leads to a foreign body has not. While performing a bladder neck stricture incision for a 72-year-old male patient with a previous radical prostatectomy for prostate cancer and a resulting bladder neck stricture, we documented a major 17-French cystoscope malfunction and a resulting foreign body that was retrieved from the bladder using a 22-French scope and alligator forceps. PMID:21985739

  14. Head and Neck Cancer: An Evolving Treatment Paradigm

    PubMed Central

    Cognetti, David M.; Weber, Randal S.; Lai, Stephen Y.

    2009-01-01

    Since the inception of this journal in 1948, the understanding of etiologic factors that contribute to and the treatment of head and neck cancer has evolved dramatically. Advances in surgery, radiation therapy, and chemotherapy have improved locoregional control, survival, and quality of life. The outcomes of these treatment modalities have shifted the focus of curative efforts from radical ablation to preservation and restoration of function. This evolution has been documented in the pages of Cancer for the past 6 decades. This review focuses on the evolution of treatment approaches for head and neck cancer and future directions while recognizing the historic contributions recorded within this journal. PMID:18798532

  15. Rapidly enlarging neck mass in a neonate causing airway compromise

    PubMed Central

    Schmidt, Kyra; Leal, Andres; McGill, Thomas

    2016-01-01

    Up to 20% of all congenital pediatric head and neck masses are branchial cleft cysts. Second branchial cleft cysts account for 95% of branchial anomalies, and fourth branchial cleft cysts are the rarest type. Their typical presentations include non–life-threatening symptoms, such as drainage, skin irritations, minor swelling, and tenderness. We describe a 5-week-old neonate with increasing stridor secondary to a rapidly growing neck mass. Imaging and surgical excision confirmed the mass to be an infected fourth branchial cleft cyst. PMID:27034563

  16. Tracheoinnominate fistula: a rare acute complication of penetrating neck injury.

    PubMed

    Kulyapina, Alena; Díaz, Dolores Pérez; Rodríguez, Teresa Sanchez; Fuentes, Fernando Turegano

    2015-05-01

    Penetrating injuries in the base of the neck are considered to be the most dangerous due to the potential combination of vascular and intrathoracic lesions. We describe an extremely rare case of combined injury of the trachea and innominate artery, which resulted in formation of a traumatic acute tracheoinnominate fistula. Previously, these fistulas have been described as an iatrogenic complication of tracheostomy, presenting with massive peristomal bleed or hemoptysis. This case demonstrates that a combination of lesions to vital anatomical structures in the neck can change their clinical presentation, making them extremely difficult to diagnose. PMID:24948779

  17. Flow visualization in long neck Helmholtz resonators with grazing flow

    NASA Technical Reports Server (NTRS)

    Baumeister, K. J.; Rice, E. J.

    1976-01-01

    Both oscillating and steady flows were applied to a single plexiglass resonator cavity with colored dyes injected in both the orifice and grazing flow field to record the motion of the fluid. For oscillatory flow, the instantaneous dye streamlines were similar for both the short and long-neck orifices. The orifice flow blockage appears to be independent of orifice length for a fixed amplitude of flow oscillation and magnitude of the grazing flow. The steady flow dye studies showed that the acoustic and steady flow resistances do not necessarily correspond for long neck orifices.

  18. Neck-band retention for Canada geese in the Mississippi (USA) flyway

    USGS Publications Warehouse

    Samuel, M.D.; Weiss, N.T.; Rusch, D.H.; Craven, S.R.; Trost, R.E.; Caswell, F.D.

    1990-01-01

    We used capture, harvest, and observation histories of Canada geese (Branta canadensis) banded in the Mississippi flyway, 1974-88, to examine the problem of neck-band retention. Methods for the analysis of survival data were used to estimate rates of neck-band retention and to evaluate factors associated with neck-band loss. Sex, age of bird at banding, rivet use, and neck-band type significantly influenced neck-band retention. For most of the resulting cohorts (e.g., sex, age, rivet, and neck-band type categories), neck-band retention rates decreased through time. We caution against using small samples or data collected during short-term studies to determine retention rates. We suggest that observation data be used in neck-band retention studies to increase the efficiency of estimating retention time.

  19. A rare differential diagnosis to occupational neck pain: bilateral stylohyoid syndrome.

    PubMed

    Kirchhoff, Gertrud; Kirchhoff, Chlodwig; Buhmann, Sonja; Kanz, Karl-Georg; Lenz, Miriam; Vogel, Tobias; Kichhoff, Rainer Maria

    2006-01-01

    Chronic neck pain is widely prevalent and a common source of disability in the working-age population. Etiology of chronic neck pain includes neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain as well as pain due to degenerative changes. We report the case of a 42 year old secretary, complaining about a longer history of neck pain and limited movement of the cervical spine. Surprisingly, the adequate radiologic examination revealed a bilateral ossification of the stylohyoid ligament complex. Her symptoms remained intractable from conservative treatment consisting of anti-inflammatory medication as well as physical therapy. Hence the patient was admitted to surgical resection of the ossified stylohyoid ligament complex. Afterwards she was free of any complaints and went back to work. Therefore, ossification of the stylohyoid ligament complex causing severe neck pain and movement disorder should be regarded as a rare differential diagnosis of occupational related neck pain. PMID:16800878

  20. Exploring the Dynamic Core Microbiome of Plaque Microbiota during Head-and-Neck Radiotherapy Using Pyrosequencing

    PubMed Central

    Wang, Qian; Jiang, Yun-tao; Ma, Rui; Tang, Zi-sheng; Liu, Zheng; Liang, Jing-ping; Huang, Zheng-wei

    2013-01-01

    Radiotherapy is the primary treatment modality used for patients with head-and-neck cancers, but inevitably causes microorganism-related oral complications. This study aims to explore the dynamic core microbiome of oral microbiota in supragingival plaque during the course of head-and-neck radiotherapy. Eight subjects aged 26 to 70 were recruited. Dental plaque samples were collected (over seven sampling time points for each patient) before and during radiotherapy. The V1–V3 hypervariable regions of bacterial 16S rRNA genes were amplified, and the high-throughput pyrosequencing was performed. A total of 140 genera belonging to 13 phyla were found. Four phyla (Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria) and 11 genera (Streptococcus, Actinomyces, Veillonella, Capnocytophaga, Derxia, Neisseria, Rothia, Prevotella, Granulicatella, Luteococcus, and Gemella) were found in all subjects, supporting the concept of a core microbiome. Temporal variation of these major cores in relative abundance were observed, as well as a negative correlation between the number of OTUs and radiation dose. Moreover, an optimized conceptual framework was proposed for defining a dynamic core microbiome in extreme conditions such as radiotherapy. This study presents a theoretical foundation for exploring a core microbiome of communities from time series data, and may help predict community responses to perturbation as caused by exposure to ionizing radiation. PMID:23437114

  1. Measuring pain intensity in patients with neck pain: does it matter how you do it?

    PubMed

    Kamper, Steven J; Grootjans, Sanneke J M; Michaleff, Zoe A; Maher, Christopher G; McAuley, James H; Sterling, Michele

    2015-02-01

    The aim of this study was to investigate whether variations in the way that pain intensity is measured in patients with neck pain influences the magnitude of pain ratings. The study uses data from 3 longitudinal studies (n = 361 at baseline) on people with neck pain due to whiplash injuries. Pain measures included verbal rating scales, numerical rating scales and a visual analog scale. Different measures asked patient to rate current pain, average pain over 24 hours, over 1 week, or over 4 weeks. Scores were converted to a 0-100 scale and tracked over time, correlations between measures were calculated. Mixed models regression was used to explore the factors which influenced the differences between scores on the measures. Scores on the different measures were significantly different from each other in each dataset (P < 0.02). The effect of recall period was significant in all datasets and the effect of number of response options was significant in 2 of 3 datasets. Pain intensity ratings appear to be sensitive to method of measurement. It is likely the length of recall time (eg, pain today vs. average pain over 4 weeks) has a significant influence on pain ratings. The influence of number of response options is less certain. Systematic reviewers should not uncritically rescale and pool absolute pain scores from instruments with varying scale descriptors or recall periods. PMID:24433369

  2. Gene Expression Profiling to Predict Outcome After Chemoradiation in Head and Neck Cancer

    SciTech Connect

    Pramana, Jimmy; Brekel, Michiel van den; Velthuysen, Marie-Louise F. van; Wessels, Lodewijk F.A.; Nuyten, Dimitry S.; Hofland, Ingrid; Atsma, Douwe; Pimentel, Nuno; Hoebers, Frank J.P.; Rasch, Coen; Begg, Adrian C.

    2007-12-01

    Purpose: The goal of the present study was to improve prediction of outcome after chemoradiation in advanced head and neck cancer using gene expression analysis. Materials and Methods: We collected 92 biopsies from untreated head and neck cancer patients subsequently given cisplatin-based chemoradiation (RADPLAT) for advanced squamous cell carcinomas (HNSCC). After RNA extraction and labeling, we performed dye swap experiments using 35k oligo-microarrays. Supervised analyses were performed to create classifiers to predict locoregional control and disease recurrence. Published gene sets with prognostic value in other studies were also tested. Results: Using supervised classification on the whole series, gene sets separating good and poor outcome could be found for all end points. However, when splitting tumors into training and validation groups, no robust classifiers could be found. Using Gene Set Enrichment analysis, several gene sets were found to be enriched in locoregional recurrences, although with high false-discovery rates. Previously published signatures for radiosensitivity, hypoxia, proliferation, 'wound,' stem cells, and chromosomal instability were not significantly correlated with outcome. However, a recently published signature for HNSCC defining a 'high-risk' group was shown to be predictive for locoregional control in our dataset. Conclusion: Gene sets can be found with predictive potential for locoregional control after combined radiation and chemotherapy in HNSCC. How treatment-specific these gene sets are needs further study.

  3. Systemic lupus erythematosus patients with and without neuropsychiatric manifestations: a neck and transcranial duplex sonography study.

    PubMed

    Zardi, E M; Vernieri, F; Navarini, L; Taccone, A; Sambataro, G; Alemanno, P; Margiotta, D; Afeltra, A

    2012-01-01

    Neuropsychiatric manifestations are not rarely associated with systemic lupus erythematosus (SLE). Magnetic resonance angiography and positron emission tomography can provide excellent images of cerebral perfusion and metabolism whereas information is still lacking on a possible diagnostic role of ultrasound. In this study we aim to assess whether duplex sonography of neck and intracranial vessels may be useful in distinguishing patients with and without neuropsychiatric SLE (NPSLE). Neck and transcranial duplex sonography was performed by a single operator on 33 women affected by SLE (mean age +/- SD: 47.69+/-8.17 years) and on 15 healthy control subjects. Nineteen patients presented NPSLE. Pulsatility and resistivity indices (PI and RI) were automatically calculated by the ultrasound instrument in internal carotid (ICA) and middle cerebral artery (MCA), on both sides, according to standard methods. No significant haemodynamic differences were found in mean and median PI and RI values of ICA and MCA comparing SLE with NPSLE patients and with healthy control subjects. No correlation was found between MCA and ICA parameters in the same group of patients. Duplex sonography of cerebral vessels is unable to distinguish SLE and NPSLE patients. Heterogeneity of causes in the pathogenesis of NPSLE and the different vascular adaptation of cerebral macrocirculation as opposed to cerebral microcirculation may represent possible reasons that explain the inability of ultrasound to differentiate SLE patients from NPSLE patients. PMID:23298507

  4. Correlative Tomography

    PubMed Central

    Burnett, T. L.; McDonald, S. A.; Gholinia, A.; Geurts, R.; Janus, M.; Slater, T.; Haigh, S. J.; Ornek, C.; Almuaili, F.; Engelberg, D. L.; Thompson, G. E.; Withers, P. J.

    2014-01-01

    Increasingly researchers are looking to bring together perspectives across multiple scales, or to combine insights from different techniques, for the same region of interest. To this end, correlative microscopy has already yielded substantial new insights in two dimensions (2D). Here we develop correlative tomography where the correlative task is somewhat more challenging because the volume of interest is typically hidden beneath the sample surface. We have threaded together x-ray computed tomography, serial section FIB-SEM tomography, electron backscatter diffraction and finally TEM elemental analysis all for the same 3D region. This has allowed observation of the competition between pitting corrosion and intergranular corrosion at multiple scales revealing the structural hierarchy, crystallography and chemistry of veiled corrosion pits in stainless steel. With automated correlative workflows and co-visualization of the multi-scale or multi-modal datasets the technique promises to provide insights across biological, geological and materials science that are impossible using either individual or multiple uncorrelated techniques. PMID:24736640

  5. Intraaneurysmal balloon assistance for navigation across a wide-necked aneurysm.

    PubMed

    Wolfe, Stacey Quintero; Farhat, Hamad; Moftakhar, Roham; Elhammady, Mohamed Samy; Aziz-Sultan, Mohammad Ali

    2010-06-01

    Endovascular obliteration of wide-necked aneurysms may be precluded by the inability to navigate across the aneurysm neck. The authors present a technique in which a Hyperform balloon is inflated within the aneurysm and used as a contact surface to "bounce" the remodeling balloon across the aneurysm neck. They have successfully used this technique in 3 patients to efficiently overcome vessel tortuosity, aneurysmal dead space, and balloon prolapse, allowing for obliteration of large, wide-necked aneurysms. PMID:19747046

  6. Using the cervical range of motion (CROM) device to assess head repositioning accuracy in individuals with cervical radiculopathy in comparison to neck- healthy individuals.

    PubMed

    Wibault, Johanna; Vaillant, Jacques; Vuillerme, Nicolas; Dedering, sa; Peolsson, Anneli

    2013-10-01

    This study had two purposes: to compare head repositioning accuracy (HRA) using the cervical range of motion (CROM) device between individuals with cervical radiculopathy caused by disc disease (CDD; n = 71) and neck- healthy individuals (n = 173); and to evaluate the test-retest reliability of the CROM device in individuals with CDD, and criterion validity between the CROM device and a laser in neck-healthy individuals, with quantification of measurement errors. Parameters of reliability and validity were expressed with intra- class- correlation coefficients (ICCs), and measurement errors with standard error of measurement (SEM) and Bland Altman limits of agreement. HRA (Mdn, IQR) differed significantly between individuals with CDD and neck- healthy individuals after rotation right 2.7 (6.0), 1.7 (2.7); and rotation left 2.7 (3.3), 1.3 (2.7) (p < = 0.021); 31% of individuals with CDD were classified as having impairment in HRA. The test-retest reliability of the CROM device in individuals with CDD showed ICCs of 0.79- 0.85, and SEMs of 1.4- 2. The criterion validity between the CROM device and the laser in neck-healthy individuals showed ICCs of 0.43- 0.91 and SEMs of 0.8- 1.3. The results support the use of the CROM device for quantifying HRA impairment in individuals with CDD in clinical practice; however, criterion validity between the CROM device and a laser in neck-healthy individuals was questionable. HRA impairment in individuals with CDD may be important to consider during rehabilitation and evaluated with the criterion established with the CROM device in neck-healthy individuals. PMID:23473752

  7. 33 CFR 80.125 - Marblehead Neck, MA to Nahant, MA.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Marblehead Neck, MA to Nahant, MA... INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Atlantic Coast § 80.125 Marblehead Neck, MA to Nahant... Marblehead Neck to the easternmost tower at Nahant, charted in approximate position latitude 42°25.4′...

  8. 33 CFR 80.120 - Cape Ann, MA to Marblehead Neck, MA.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Cape Ann, MA to Marblehead Neck... Marblehead Neck, MA. (a) Except inside lines specifically described in this section, the 72 COLREGS shall... to Marblehead Neck. (b) A line drawn from Gloucester Harbor Breakwater Light to the twin...

  9. Neutron beam therapy in the treatment of advanced head and neck malignancy

    SciTech Connect

    Jones, J.; Hendrix, R.A.

    1989-01-01

    Patients with advanced head and neck cancer continue to present a difficult management problem for the otolaryngologist-head and neck surgeon. This paper discusses the principles of radiation therapy with emphasis on neutron beam therapy as an effective treatment option for advanced malignancy of the head and neck other than squamous cell carcinoma. 6 references.

  10. Towards the prediction of multiple necking during dynamic extension of round bar : linear stability approach versus finite element calculations

    NASA Astrophysics Data System (ADS)

    El Maï, S.; Mercier, S.; Petit, J.; Molinari, A.

    2014-05-01

    The fragmentation of structures subject to dynamic conditions is a matter of interest for civil industries as well as for Defence institutions. Dynamic expansions of structures, such as cylinders or rings, have been performed to obtain crucial information on fragment distributions. Many authors have proposed to capture by FEA the experimental distribution of fragment size by introducing in the FE model a perturbation. Stability and bifurcation analyses have also been proposed to describe the evolution of the perturbation growth rate. In the proposed contribution, the multiple necking of a round bar in dynamic tensile loading is analysed by the FE method. A perturbation on the initial flow stress is introduced in the numerical model to trigger instabilities. The onset time and the dominant mode of necking have been characterized precisely and showed power law evolutions, with the loading velocities and moderately with the amplitudes and the cell sizes of the perturbations. In the second part of the paper, the development of linear stability analysis and the use of salient criteria in terms of the growth rate of perturbations enabled comparisons with the numerical results. A good correlation in terms of onset time of instabilities and of number of necks is shown.

  11. Antitumor mechanisms of combined gastrin-releasing peptide receptor and epidermal growth factor receptor targeting in head and neck cancer.

    PubMed

    Zhang, Qing; Bhola, Neil E; Lui, Vivian Wai Yan; Siwak, Doris R; Thomas, Sufi M; Gubish, Christopher T; Siegfried, Jill M; Mills, Gordon B; Shin, Dong; Grandis, Jennifer Rubin

    2007-04-01

    Head and neck squamous cell carcinoma (HNSCC) is characterized by epidermal growth factor receptor (EGFR) overexpression, where EGFR levels correlate with survival. To date, EGFR targeting has shown limited antitumor effects in head and neck cancer when administrated as monotherapy. We previously identified a gastrin-releasing peptide/gastrin-releasing peptide receptor (GRP/GRPR) aurocrine regulatory pathway in HNSCC, where GRP stimulates Src-dependent cleavage of EGFR proligands with subsequent EGFR phosphorylation and mitogen-activated protein kinase (MAPK) activation. To determine whether GRPR targeting can enhance the antitumor efficacy of EGFR inhibition, we investigated the effects of a GRPR antagonist (PD176252) in conjunction with an EGFR tyrosine kinase inhibitor (erlotinib). Combined blockade of GRPR and EGFR pathways significantly inhibited HNSCC, but not immortalized mucosal epithelial cell, proliferation, invasion, and colony formation. In addition, the percentage of apoptotic cells increased upon combined inhibition. The enhanced antitumor efficacy was accompanied by increased expression of cleaved poly(ADP-ribose) polymerase (PARP) and decreased phospho-EGFR, phospho-MAPK, and proliferating cell nuclear antigen (PCNA). Using reverse-phase protein microarray (RPPA), we further detected decreased expression of phospho-c-Jun, phospho-p70S6K, and phospho-p38 with combined targeting. Cumulatively, these results suggest that GRPR targeting can enhance the antitumor effects of EGFR inhibitors in head and neck cancer. PMID:17431120

  12. Cancer stem cells in head and neck cancer.

    PubMed

    Allegra, Eugenia; Trapasso, Serena

    2012-01-01

    Cancer stem cells (CSCs), also called "cells that start the tumor," represent in themselves one of the most topical and controversial issues in the field of cancer research. Tumor stem cells are able to self-propagate in vitro (self-renewal), giving rise both to other tumor stem cells and most advanced cells in the line of differentiation (asymmetric division). A final characteristic is tumorigenicity, a fundamental property, which outlines the tumor stem cell as the only cell able to initiate the formation of a tumor when implanted in immune-deficient mice. The hypothesis of a hierarchical organization of tumor cells dates back more than 40 years, but only in 1997, thanks to the work of John Dick and Dominique Bonnet, was there the formal proof of such an organization in acute myeloid leukemia. Following this, many other research groups were able to isolate CSCs, by appropriate selection markers, in various malignancies, such as breast, brain, colon, pancreas, and liver cancers and in melanoma. To date, however, it is not possible to isolate stem cells from all types of neoplasia, particularly in solid tumors. From a therapeutic point of view, the concept of tumor stem cells implies a complete revision of conventional antineoplastic treatment. Conventional cytotoxic agents are designed to target actively proliferating cells. In the majority of cases, this is not sufficient to eliminate the CSCs, which thanks to their reduced proliferative activity and/or the presence of proteins capable of extruding chemotherapeutics from the cell are not targeted. Therefore, the theory of cancer stem cells can pose new paradigms in terms of cancer treatment. Potential approaches, even in the very early experimental stages, relate to the selective inhibition of pathways connected with self-renewal, or more specifically based on the presence of specific surface markers for selective cytotoxic agent vehicles. Finally, some research groups are trying to induce these cells to differentiate, thus making them easier to remove. For all these reasons, we have collected existing literature on head and neck cancer stem cells that correlate the biological characteristics of this subpopulation of cancer cells with the clinical behavior of tumors. PMID:23189032

  13. Peritoneoscopic placement of Swan neck peritoneal dialysis catheters.

    PubMed

    Copley, J B; Lindberg, J S; Back, S N; Tapia, N P

    1996-01-01

    Peritoneoscopic placement of peritoneal dialysis catheters, although accomplished in only about 10% of dialysis centers, is a nonsurgical technique that fulfills requirements for safety and dependability. Over a 40-month period, 136 catheters were placed with the peritoneoscope, 135 of which were double-cuffed, Swan neck curled catheters, with a uniform radiopaque stripe. Patients were followed longitudinally for outcome. Catheters were placed in 44 diabetic patients, 1 human immunodeficiency virus (HIV)-positive patient, and 18 morbidly obese patients. No complications occurred as a direct result of placement. Catheters were used, on average, nine days after placement (many on days 1 to 4) usually with 1.5 to 2 L exchanges. With 1183 patient-months' experience, complications were few: 28 patients experienced catheter-related infections, and there were five leaks that resolved with supine, low-volume dialysis for several days. Leakage did not correlate with time of usage after placement. Of ten outflow/mechanical problems that required catheter removal, nine involved catheter migration, probably due to lack of attention during placement to orientation of the radiopaque stripe. One was due to a preperitoneal placement early in this institution's experience with the peritoneoscope. Five of the migrated catheters were removed and then successfully replaced with the peritoneoscope at the same sitting. Four patients requested surgical removal and replacement. Sixteen catheters were removed because of catheter-related infections: five refractory Staphylococcus aureus, six Pseudomonas aeruginosa, two fungal, two Serratia species, and one Mycobacterium chelonei. Actuarial life-table analysis showed that at the end of the 40-month follow-up, 62% of the catheters were expected to survive. Because more than 50% survived, median catheter survival could not be calculated. The adverse responses were removal because of infection or catheter migration. Peritoneal dialysis catheter implantation with the peritoneoscope represents a safe and dependable method for catheter placement. Literature review and comparison indicate that catheter-related complications are fewer and catheter longevity is better with peritoneoscopic placement than with surgical placement. Our experience with prompt postplacement utilization suggests the need for further evaluation of catheter break-in procedure with the peritoneoscope. PMID:8728218

  14. A Multidisciplinary Approach to Castleman Disease of the Neck.

    PubMed

    Shams, Alexandra A; Ahmed, Mostafa M; Scalzitti, Nicholas J; Howell, Della L; Hall, Jordan M; Ritter, John L; Maturo, Stephen C

    2016-02-01

    Castleman disease (CD) is a rare lymphoproliferative disorder that occurs in adults and rarely in the pediatric population. The disease is characterized by slowly enlarging masses that can form anywhere within the lymphatic system. It is an uncommon cause of a neck mass in both children and adults that presents insidiously and nonspecifically. A 21-year-old woman was referred to the otolaryngology service because of an asymptomatic neck mass found incidentally on computed tomographic imaging 15 months earlier. On repeat imaging, the lesion was characterized as a homogenously enhancing soft tissue mass and appeared stable in size compared with previous studies. Given the nondiagnostic radiologic features, tissue sampling was pursued, first using fine-needle aspiration and ultimately excisional biopsy. The excision revealed histopathology consistent with unicentric, hyaline-vascular CD. Excision is the gold standard for treatment of this variant of CD. The patient was referred to the hematology/oncology service but was subsequently lost to follow-up. This case illustrates a rare cause of a neck mass in a young adult and exemplifies the extremely broad differential in this setting. In addition, it highlights the importance of a systematic and thorough approach to diagnosing neck masses in children and adults. PMID:26840960

  15. Mouthwash use and associated head and neck cancer risk.

    PubMed

    Wilson, Gavin; Conway, David I

    2016-03-01

    Data sourcesAll studies with questionnaire items on mouthwash use in the International Head and Neck Cancer Epidemiology Consortium (INHANCE).Data extraction and synthesisPooled analysis data from case controlled studies using Individual Patient Data (IPD) meta-analysis methods. Logistic regression was used to assess the association of mouthwash use with cancers of the oral cavity, oropharynx, hypopharynx and larynx, adjusting for study, age, sex, pack-years of tobacco smoking, number of alcoholic drinks/day and education.ResultsEight thousand, nine hundred and eighty-one cases of head and neck cancer and 10,090 controls from 12 case-control studies with comparable information on mouthwash use were included in the analysis. Compared with never users of mouthwash, the odds ratio (OR) of all head and neck cancers was 1.01 [95% confidence interval (CI): 0.94-1.08] for ever users, based on 12 studies. The corresponding ORs of cancer of the oral cavity and oropharynx were 1.11 (95% CI: 1.00-1.23) and 1.28 (95% CI: 1.06-1.56), respectively.ConclusionsAlthough limited by the retrospective nature of the study and the limited ability to assess risks of mouthwash use in nonusers of tobacco and alcohol, this large investigation shows potential risks for head and neck cancer subsites and in long-term and frequent users of mouthwash. PMID:27012566

  16. Familiar and unfamiliar pseudoneoplastic lesions of the head and neck.

    PubMed

    Richardson, Mary S

    2016-01-01

    Pseudoneoplastic lesions in the head and neck are numerous. Familiarity with the sites of predilection and demographics of these lesions is particularly useful if the differential diagnosis for a minimal biopsy sample includes benign and malignant entities. This article is a brief overview of some common and unusual pseudo neoplasms specific to this region. PMID:26739631

  17. Intra-arterial chemoradiotherapy for head and neck cancer.

    PubMed

    Homma, Akihiro; Onimaru, Rikiya; Matsuura, Kazuto; Robbins, K Thomas; Fujii, Masato

    2016-01-01

    Intra-arterial chemotherapy has been used to treat localized malignant neoplasms in patients with head and neck cancer for over 50 years as the head and neck region is particularly well suited to regional chemotherapy. Early intra-arterial chemotherapy did not prove its efficacy. In addition, the additional complications associated with establishing and maintaining arterial access have further dampened enthusiasm for this approach. Subsequent significant advances in vascular radiology techniques and the development of new devices, such as fluoroscopy units and angiographic catheters, have made possible safe, accurate and repeated superselective intra-arterial chemotherapy. Intra-arterial infusion of high-dose cisplatin with systemic neutralization by intravenous sodium thiosulfate (RADPLAT) is a theoretically attractive approach to the treatment of advanced head and neck cancer. However, a Dutch trial comparing intra-arterial and intravenous chemoradiotherapy for advanced head and neck cancer showed that RADPLAT was not superior to intravenous chemoradiotherapy. Therefore, further investigation of RADPLAT, including the refinement of the indications for its application, is needed. PMID:26486825

  18. A value framework in head and neck cancer care.

    PubMed

    de Souza, Jonas A; Seiwert, Tanguy Y

    2014-01-01

    The care of head and neck squamous cell carcinoma has greatly evolved over the past 30 years. From single modality to a multidisciplinary care, there has also been a concurrent increase in treatment intensity, resulting, at many times, in more zealous regimens that patients must endure. In this article, we apply Porter's value model as a framework to balance survival, toxicities, cost, and trade-offs from a patient's perspective in head and neck cancer. This model defines value as the health outcome per dollar achieved. Domains and outcomes that are important to patients, including not only survival or short-term quality of life, but also functional outcomes, recovery, sustainability of recovery, and the lasting consequences of therapy are included in this framework. Other outcomes that are seldom measured in head and neck cancer, such as work disability and financial toxicities, are also included and further discussed. Within this value model and based on evidence, we further discuss de-escalation of care, intensity-modulated radiation therapy, newer surgical methods, and enhancements in the process of care as potential approaches to add value for patients. Finally, we argue that knowing the patient's preferences is essential in the value discussion, as the attribute that will ultimately provide the most value to the individual patient with head and neck cancer. PMID:24857117

  19. Manual therapy and exercise for neck pain: a systematic review.

    PubMed

    Miller, Jordan; Gross, Anita; D'Sylva, Jonathan; Burnie, Stephen J; Goldsmith, Charles H; Graham, Nadine; Haines, Ted; Brønfort, Gert; Hoving, Jan L

    2010-08-01

    Manual therapy is often used with exercise to treat neck pain. This cervical overview group systematic review update assesses if manual therapy, including manipulation or mobilisation, combined with exercise improves pain, function/disability, quality of life, global perceived effect, and patient satisfaction for adults with neck pain with or without cervicogenic headache or radiculopathy. Computerized searches were performed to July 2009. Two or more authors independently selected studies, abstracted data, and assessed methodological quality. Pooled relative risk (pRR) and standardized mean differences (pSMD) were calculated. Of 17 randomized controlled trials included, 29% had a low risk of bias. Low quality evidence suggests clinically important long-term improvements in pain (pSMD-0.87(95% CI: -1.69, -0.06)), function/disability, and global perceived effect when manual therapy and exercise are compared to no treatment. High quality evidence suggests greater short-term pain relief [pSMD-0.50(95% CI: -0.76, -0.24)] than exercise alone, but no long-term differences across multiple outcomes for (sub)acute/chronic neck pain with or without cervicogenic headache. Moderate quality evidence supports this treatment combination for pain reduction and improved quality of life over manual therapy alone for chronic neck pain; and suggests greater short-term pain reduction when compared to traditional care for acute whiplash. Evidence regarding radiculopathy was sparse. Specific research recommendations are made. PMID:20593537

  20. Altered Pain Sensitivity in Elderly Women with Chronic Neck Pain

    PubMed Central

    Uthaikhup, Sureeporn; Prasert, Romchat; Paungmali, Aatit; Boontha, Kritsana

    2015-01-01

    Background Age-related changes occur in both the peripheral and central nervous system, yet little is known about the influence of chronic pain on pain sensitivity in older persons. The aim of this study was to investigate pain sensitivity in elders with chronic neck pain compared to healthy elders. Methods Thirty elderly women with chronic neck pain and 30 controls were recruited. Measures of pain sensitivity included pressure pain thresholds, heat/cold pain thresholds and suprathreshold heat pain responses. The pain measures were assessed over the cervical spine and at a remote site, the tibialis anterior muscle. Results Elders with chronic neck pain had lower pressure pain threshold over the articular pillar of C5-C6 and decreased cold pain thresholds over the cervical spine and tibialis anterior muscle when compared with controls (p < 0.05). There were no between group differences in heat pain thresholds and suprathreshold heat pain responses (p > 0.05). Conclusion The presence of pain hypersensitivity in elderly women with chronic neck pain appears to be dependent on types of painful stimuli. This may reflect changes in the peripheral and central nervous system with age. PMID:26039149

  1. 33 CFR 117.800 - Mill Neck Creek.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... DRAWBRIDGE OPERATION REGULATIONS Specific Requirements New York § 117.800 Mill Neck Creek. The draw of the Bayville Bridge, mile 0.1, at Oyster Bay, New York, shall open on signal between 7 a.m. and 11 p.m.,...

  2. 33 CFR 117.800 - Mill Neck Creek.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... DRAWBRIDGE OPERATION REGULATIONS Specific Requirements New York § 117.800 Mill Neck Creek. The draw of the Bayville Bridge, mile 0.1, at Oyster Bay, New York, shall open on signal between 7 a.m. and 11 p.m.,...

  3. Epidemiology and Trend of Head and Neck Cancers in Iran

    PubMed Central

    Mirzaei, Maryam; Hosseini, Seyedeh-Akram; Ghoncheh, Mahshid; Soheilipour, Fahimeh; Soltani, Shahin; Soheilipour, Fatemeh; Salehiniya, Hamid

    2016-01-01

    Introduction: Head and neck cancers are the sixth common cancer worldwide. It is necessary to inform the trend of incidence for health planning. This study aimed to investigate the trend of head and neck cancers in Iran. Methods: This study was carried out based on national report on cancer registry in Iran. The crude incidence rate was calculated as per 100,000 people, and Age Standardized incidence Rate (ASR) was estimated using direct standardization and the standard population of World Health Organization (W.H.O). Data was analyzed using the Cochran - Armitage test for linear trend and software of WinPepi 2.1. Results: A total of 25,952 cases of cancers of the head and neck have been registered between 2003 and 2009. The age-standardized incidence rate reached from 4.8 cases per 100,000 in 2003 to 8.5 and 7.4 in 2008 and 2009, respectively, which revealed significantly increasing trends. Conclusions: According to increasing trend age-standardized rate of head and neck cancer in Iran, it is recommended to identify risk factors and vulnerable groups in order to reduce the burden of this type of cancers. PMID:26234980

  4. Kinematics of a Head-Neck Model Simulating Whiplash

    NASA Astrophysics Data System (ADS)

    Colicchia, Giuseppe; Zollman, Dean; Wiesner, Hartmut; Sen, Ahmet Ilhan

    2008-02-01

    A whiplash event is a relative motion between the head and torso that occurs in rear-end automobile collisions. In particular, the large inertia of the head results in a horizontal translation relative to the thorax. This paper describes a simulation of the motion of the head and neck during a rear-end (whiplash) collision. A head-neck model that qualitatively undergoes the same forces acting in whiplash and shows the same behavior is used to analyze the kinematics of both the head and the cervical spine and the resulting neck loads. The rapid acceleration during a whiplash event causes the extension and flexion of the cervical spine, which in turn can cause dislocated vertebrae, torn ligaments, intervertebral disc herniation, and other trauma that appear to be the likely causes of subsequent painful headache or neck pain symptoms. Thus, whiplash provides a connection between the dynamics of the human body and physics. Its treatment can enliven the usual teaching in kinematics, and both theoretical and experimental approaches provide an interesting biological context to teach introductory principles of mechanics.

  5. Why does necking ignore notches in dynamic tension?

    NASA Astrophysics Data System (ADS)

    Rotbaum, Y.; Osovski, S.; Rittel, D.

    2015-09-01

    Recent experimental work has revealed that necking of tensile specimens, subjected to dynamic loading, is a deterministic phenomenon, governed by the applied boundary conditions. Furthermore it was shown that the potential sited, dictated by the boundary conditions, may prevail even in the presence of a notch, thus necking may occur away of the notched region. The present paper combines experimental and numerical work to address this issue. Specifically, it is shown that the dynamic tensile failure locus is dictated by both the applied velocity boundary condition and the material mechanical properties, specifically strain-rate sensitivity and strain-rate hardening. It is shown that at sufficiently high impact velocities, the flows stress in the notch vicinity becomes quite higher than in the rest of the specimen, so that while the former resists deformation, it transfers the load to the latter, resulting in the formation of a local neck and failure away from the notch. Small local perturbations in the material properties are shown to be sufficient to stabilize the structure under local failure until a neck forms elsewhere. While the physical observations are quite counterintuitive with respect to the engineering views of stress concentrator's effect, the present work rationalizes those observations and also provides information for the designers of dynamically tensioned structures that may contain notches or similar flaws.

  6. [Psychological care of patients with head and neck cancer].

    PubMed

    Moya, Mélanie

    2015-09-01

    Treatments for head and neck cancers are generally complex and debilitating. Surgery, often mutilating, profoundly affects the relationship between oneself and others and causes verbal communication, breathing and swallowing difficulties. The functional and aesthetic sequelae are a constant reminder to the patient of the disease and make them conscious of their appearance. PMID:26369747

  7. Synovial Sarcoma in Head and Neck: A Case Report

    PubMed Central

    Fonseca, Adriano Santana; Azevedo, Amanda Canário Andrade; Magalhães, Fabíola Moreira; Andrade, Nilvano Alves de

    2013-01-01

    Introduction Synovial sarcoma is a malignant tumor of mesenchymal pluripotent cells. Objectives We present a case of synovial sarcoma in the posterolateral wall of the oropharynx. Resumed report The patient, a 23-year-old woman, was admitted with a history of dysphagia and difficulty in breathing for 8 months, resulting in progressive deterioration and onset of snoring, muffled voice, and local pain. An oropharyngeal tumor in the left posterolateral wall touched the base of the ipsilateral tongue. The patient underwent endoscopic pharyngectomy to remove the lesion. Pathologic examination revealed synovial sarcoma with positive margins, and Mohs technique was proposed for margin control. The margins were disease-free, without the need for total laryngectomy. The pharynx was reconstructed with a microvascular forearm flap. The patient developed postoperative stability. Conclusion Despite its name, synovial sarcoma is rarely sourced directly from synovial membranes. It is most commonly found in the vicinity of large joints. The location at the head and neck, a location poor in synovial tissue, is unusual. Synovial sarcoma in the head and neck has an aggressive nature and poor prognosis. Resection with negative margins remains the foundation of therapy, which is not so easily achieved in the head and neck. It is important for the otorhinolaryngologist and head and neck surgeon to be familiar with this aggressive tumor, which carries high mortality and morbidity. The appropriate diagnosis and treatment can improve prognosis and patient survival. PMID:25992071

  8. 33 CFR 117.800 - Mill Neck Creek.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... DRAWBRIDGE OPERATION REGULATIONS Specific Requirements New York § 117.800 Mill Neck Creek. The draw of the Bayville Bridge, mile 0.1, at Oyster Bay, New York, shall open on signal between 7 a.m. and 11 p.m.,...

  9. 33 CFR 117.800 - Mill Neck Creek.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... DRAWBRIDGE OPERATION REGULATIONS Specific Requirements New York § 117.800 Mill Neck Creek. The draw of the Bayville Bridge, mile 0.1, at Oyster Bay, New York, shall open on signal between 7 a.m. and 11 p.m.,...

  10. 33 CFR 117.800 - Mill Neck Creek.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... DRAWBRIDGE OPERATION REGULATIONS Specific Requirements New York § 117.800 Mill Neck Creek. The draw of the Bayville Bridge, mile 0.1, at Oyster Bay, New York, shall open on signal between 7 a.m. and 11 p.m.,...

  11. Fibular strut grafting for fibrous dysplasia of the femoral neck.

    PubMed Central

    Bryant, D. D.; Grant, R. E.; Tang, D.

    1992-01-01

    When fibrous dysplasia affects the femoral neck, normal bone is replaced by fibro-osseous dysplastic bone that is both mechanically weakened and biomechanically abnormal. Surgical management is recommended for persistent pain, progressive deformity, or impending fracture. Surgical options include curettage and cancellous bone grafting, osteotomy and nail-plate fixation, intramedullary rodding, and cortical bone grafting. We present the case of a patient with a painful, dysplastic lesion of the femoral neck who underwent cortical bone grafting using dual fibular strut grafts. To ensure long-term graft incorporation, the fibular cortical grafts bridged the lesion in the femoral neck and were securely anchored to the normal bone of the lateral femoral cortex and a head of the femur. No supplemental internal fixation was required. The biological basis for success of the fibular strut grafting procedure is that creeping substitution of the cortical graft necrotic bone does not replace the interstitial lamellae, which persist to lend structural support. Fibular strut grafting is an excellent procedure for fibrous dysplasia of the femoral neck. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:1404469

  12. Severe and Catastrophic Neck Injuries Resulting from Tackle Football

    ERIC Educational Resources Information Center

    Torg, Joseph S.; And Others

    1977-01-01

    Use of the spring-loaded blocking and tackling devices should be discontinued due to severe neck injuries resulting from their use; employment of the head and helmet as the primary assault weapon in blocking, tackling, and head butting should be condemned for the same reason. (MJB)

  13. [Quality assurance in head and neck medical oncology].

    PubMed

    Digue, Laurence; Pedeboscq, Stéphane

    2014-05-01

    In medical oncology, how can we be sure that the right drug is being administered to the right patient at the right time? The implementation of quality assurance criteria is important in medical oncology, in order to ensure that the patient receives the best treatment safely. There is very little literature about quality assurance in medical oncology, as opposed to radiotherapy or cancer surgery. Quality assurance must cover the entire patient care process, from the diagnosis, to the therapeutic decision and drug distribution, including its selection, its preparation and its delivery to the patient (administration and dosage), and finally the potential side effects and their management. The dose-intensity respect is crucial, and its reduction can negatively affect overall survival rates, as shown in breast and testis cancers for example. In head and neck medical oncology, it is essential to respect the few well-standardized recommendations and the dose-intensity, in a population with numerous comorbidities. We will first review quality assurance criteria for the general medical oncology organization and then focus on head and neck medical oncology. We will then describe administration specificities of head and neck treatments (chemoradiation, radiation plus cetuximab, postoperative chemoradiation, induction and palliative chemotherapy) as well as their follow-up. Lastly, we will offer some recommendations to improve quality assurance in head and neck medical oncology. PMID:24886900

  14. Associations Between Dietary Patterns and Head and Neck Cancer

    PubMed Central

    Bradshaw, Patrick T.; Siega-Riz, Anna Maria; Campbell, Marci; Weissler, Mark C.; Funkhouser, William K.; Olshan, Andrew F.

    2012-01-01

    Few studies have examined the associations between dietary patterns and head and neck squamous cell carcinoma (SCC) or whether they differ by race. This was evaluated using data from a population-based case-control study (2002–2006) including 1,176 cases of head and neck SCC and 1,317 age-, race-, and gender-matched controls from central and eastern North Carolina whose diets had been assessed by food frequency questionnaire. Factor analysis identified 2 patterns of intake: 1) high consumption of fruits, vegetables, and lean protein and 2) high consumption of fried foods, high-fat and processed meats, and sweets. Associations were estimated using logistic regression, adjusting for matching factors and confounders. Heterogeneity by tumor site (oral/pharyngeal vs. laryngeal) and effect-measure modification were also evaluated. Reduced odds of head and neck SCC were found for the fruit, vegetable, and lean protein pattern (for highest quartile vs. lowest, odds ratio = 0.53, 95% confidence interval: 0.39, 0.71). The fried foods, high-fat and processed meats, and sweets pattern was positively associated only with laryngeal cancer (odds ratio = 2.12, 95% confidence interval: 1.21, 3.72). These findings underline the importance of a dietary pattern rich in fruits and vegetables and low in high-fat and processed meats and sweets for prevention of head and neck cancer. PMID:22575416

  15. The effects of laparoscopic sleeve gastrectomy on head, neck, shoulder, low back and knee pain of female patients

    PubMed Central

    Çakır, Tuğrul; Oruç, Mehmet Tahir; Aslaner, Arif; Duygun, Fatih; Yardımcı, Erdem Can; Mayir, Burhan; Bülbüller, Nurullah

    2015-01-01

    As the rise on the prevalence of obesity, it is related with physical impairment of joints, especially in the lumbar spine and knee joints. Losing body weight can reduce or eliminate pain of head, neck, shoulder, lumbar spine and knees. By performing a laparoscopic bariatric surgery we demonstrated a significant improvement on the pain by body weight reduction. In this study we aimed to explore the efficacy and safety of Laparoscopic Sleeve Gastrectomy (LSG) on the relief of pain on head and neck, shoulder, low back and knee among the severely morbid obese female patients. A total of 39 morbidly obese female patients who underwent LSG for morbid obesity were included in this study. Body weight, height, body mass index (BMI), head and neck, shoulder, low back and knee pain intensity were measured with Visual Analog Scale (VAS) before and after LSG at the 6th month. 39 morbidly obese female patients were enrolled to this study. The mean age of the patients was 37.69 ± 11.33 years. Preoperative and postoperative body weights were 127.3 kg and 91.21 kg, respectively. Mean height was 165.23 ± 5.78 cm. Preoperative and postoperative BMIs were 46.49 kg/m2 and 32.33 kg/m2, respectively. A significant correlation between preoperative and postoperative parameters was found according to BMI. Our data showed that LSG is an efficient and safe procedure on severely obese patients and showed a predictive remission of head and neck, shoulder, low back and knee pain intensity of female patients by analyzing with VAS during the first 6 months. PMID:25932217

  16. The effects of laparoscopic sleeve gastrectomy on head, neck, shoulder, low back and knee pain of female patients.

    PubMed

    Çakır, Tuğrul; Oruç, Mehmet Tahir; Aslaner, Arif; Duygun, Fatih; Yardımcı, Erdem Can; Mayir, Burhan; Bülbüller, Nurullah

    2015-01-01

    As the rise on the prevalence of obesity, it is related with physical impairment of joints, especially in the lumbar spine and knee joints. Losing body weight can reduce or eliminate pain of head, neck, shoulder, lumbar spine and knees. By performing a laparoscopic bariatric surgery we demonstrated a significant improvement on the pain by body weight reduction. In this study we aimed to explore the efficacy and safety of Laparoscopic Sleeve Gastrectomy (LSG) on the relief of pain on head and neck, shoulder, low back and knee among the severely morbid obese female patients. A total of 39 morbidly obese female patients who underwent LSG for morbid obesity were included in this study. Body weight, height, body mass index (BMI), head and neck, shoulder, low back and knee pain intensity were measured with Visual Analog Scale (VAS) before and after LSG at the 6(th) month. 39 morbidly obese female patients were enrolled to this study. The mean age of the patients was 37.69 ± 11.33 years. Preoperative and postoperative body weights were 127.3 kg and 91.21 kg, respectively. Mean height was 165.23 ± 5.78 cm. Preoperative and postoperative BMIs were 46.49 kg/m(2) and 32.33 kg/m(2), respectively. A significant correlation between preoperative and postoperative parameters was found according to BMI. Our data showed that LSG is an efficient and safe procedure on severely obese patients and showed a predictive remission of head and neck, shoulder, low back and knee pain intensity of female patients by analyzing with VAS during the first 6 months. PMID:25932217

  17. Quality of information available via the internet for patients with head and neck cancer: are we improving?

    PubMed

    Best, James; Muzaffar, Jameel; Mitchell-Innes, Alistair

    2015-11-01

    This study aimed to evaluate the type, content, accessibility and quality of information available via the internet for patients with head and neck cancer. The Google search engine was used to generate lists of the first 100 websites for general head and neck cancer and the first ten for head and neck cancers by anatomical location (160 total). Websites were evaluated with the validated DISCERN and LIDA instruments, the SMOG (Simple measure of gobbledygook) readability score and against the JAMA (Journal of the American Medical Association) criteria. 40 of the 160 websites ranked by Google were suitable for analysis. Seven websites (17.5%) partially or fully achieved all four JAMA benchmarks and only one (2.5%) site achieved none. 28 (70%) included reference to quality of life factors. Correlations were identified between Google site rank and all four of our appraisal tools; LIDA (-0.966, p = 0.006), JAMA (-5.93, p = 0.028), DISCERN (-0.568, p = 0.037) and SMOG (4.678, p = 0.04). Google site rank and both government run sites (-35.38, p = 0.034) and sites run by universities or hospitals (-27.32, p = 0.016) also showed an association. Comparing our observations with those of Riordain in 2008, there has been little improvement in the quality of head and neck cancer information available online over this time. Given the variability in quality of information online, patients would benefit from being directed to reliable websites by clinicians. PMID:25370600

  18. Factors Associated With Long-Term Dysphagia After Definitive Radiotherapy for Locally Advanced Head-and-Neck Cancer

    SciTech Connect

    Caudell, Jimmy J.; Schaner, Philip E.; Meredith, Ruby F.; Locher, Julie L.; Nabell, Lisle M.; Carroll, William R.; Magnuson, J. Scott; Spencer, Sharon A.; Bonner, James A.

    2009-02-01

    Purpose: The use of altered fractionation radiotherapy (RT) regimens, as well as concomitant chemotherapy and RT, to intensify therapy for locally advanced head-and-neck cancer can lead to increased rates of long-term dysphagia. Methods and Materials: We identified 122 patients who had undergone definitive RT for locally advanced head-and-neck cancer, after excluding those who had been treated for a second or recurrent head-and-neck primary, had Stage I-II disease, developed locoregional recurrence, had <12 months of follow-up, or had undergone postoperative RT. The patient, tumor, and treatment factors were correlated with a composite of 3 objective endpoints as a surrogate for severe long-term dysphagia: percutaneous endoscopic gastrostomy tube dependence at the last follow-up visit; aspiration on a modified barium swallow study or a clinical diagnosis of aspiration pneumonia; or the presence of a pharyngoesophageal stricture. Results: A composite dysphagia outcome occurred in 38.5% of patients. On univariate analysis, the primary site (p = 0.01), use of concurrent chemotherapy (p = 0.01), RT schedule (p = 0.02), and increasing age (p = 0.04) were significantly associated with development of composite long-term dysphagia. The use of concurrent chemotherapy (p = 0.01), primary site (p = 0.02), and increasing age (p = 0.02) remained significant on multivariate analysis. Conclusion: The addition of concurrent chemotherapy to RT for locally advanced head-and-neck cancer resulted in increased long-term dysphagia. Early intervention using swallowing exercises, avoidance of nothing-by-mouth periods, and the use of intensity-modulated RT to reduce the dose to the uninvolved swallowing structures should be explored further in populations at greater risk of long-term dysphagia.

  19. Adaptive Planning in Intensity-Modulated Radiation Therapy for Head and Neck Cancers: Single-Institution Experience and Clinical Implications

    SciTech Connect

    Ahn, Peter H.; Chen, Chin-Cheng; Ahn, Andrew I.; Hong, Linda; Scripes, Paola G.; Shen Jin; Lee, Chen-Chiao; Miller, Ekeni; Kalnicki, Shalom; Garg, Madhur K.

    2011-07-01

    Purpose: Anatomic changes and positional variability during intensity-modulated radiation therapy (IMRT) for head and neck cancer can lead to clinically significant dosimetric changes. We report our single-institution experience using an adaptive protocol and correlate these changes with anatomic and positional changes during treatment. Methods and Materials: Twenty-three sequential head and neck IMRT patients underwent serial computed tomography (CT) scans during their radiation course. After undergoing the planning CT scan, patients underwent planned rescans at 11, 22, and 33 fractions; a total of 89 scans with 129 unique CT plan combinations were thus analyzed. Positional variability and anatomic changes during treatment were correlated with changes in dosimetric parameters to target and avoidance structures between planning CT and subsequent scans. Results: A total of 15/23 patients (65%) benefited from adaptive planning, either due to inadequate dose to gross disease or to increased dose to organs at risk. Significant differences in primary and nodal targets (planning target volume, gross tumor volume, and clinical tumor volume), parotid, and spinal cord dosimetric parameters were noted throughout the treatment. Correlations were established between these dosimetric changes and weight loss, fraction number, multiple skin separations, and change in position of the skull, mandible, and cervical spine. Conclusions: Variations in patient positioning and anatomy changes during IMRT for head and neck cancer can affect dosimetric parameters and have wide-ranging clinical implications. The interplay between random positional variability and gradual anatomic changes requires careful clinical monitoring and frequent use of CT- based image-guided radiation therapy, which should determine variations necessitating new plans.

  20. Effect of Occupant and Impact Factors on Forces within Neck: I. Overview of Large Population

    NASA Astrophysics Data System (ADS)

    Shaibani, Saami J.

    2000-03-01

    Scientific and medical data have been gathered for nearly 500 motor-vehicle occupants, whose dynamic response[1-2] was calculated to determine the forces generated at all potential injury sites. Particular attention was paid to the load within the cervical spine to examine the influence of certain variables relating to the occupant (height, weight, sex), the impact (magnitude, direction), and the neck itself (local vector, anatomical level). Exhaustive efforts were made to match the force with each variable using linear and logarithmic fits, but correlation coefficients were generally not high. These results might be influenced by the emphasis in this research to obtain the best statistics with large groupings of patients. Hence, a separate study with more detail is proposed as a significant continuation of this effort. 1. Proper Treatment of Complex Human Structures, Announcer 27 (4), 100 (1997); 2. Physics as a Key Element in the Complete Description of Dichotomies in Injury Distribution, Bull. Am. Phys. Soc. 44, 274 (1999).

  1. Nutritional status and general immune competence in patients with head and neck cancer1

    PubMed Central

    Brookes, Gerald B; Clifford, Peter

    1981-01-01

    Anergy to 2,4-dinitrochlorobenzene (DNCB) has been reported as a highly significant adverse prognostic immunological factor in several studies of patients with squamous cell carcinomas involving the head and neck. Patients with these tumours often present with concurrent nutritional deficiencies. This paper reports the findings of a prospective study into both the nutritional status and general immune competence of 53 such patients. Analysis of the results has demonstrated a statistically highly significant positive correlation between nutritional status and both the delayed hypersensitivity response to DNCB, and the pretreatment total lymphocyte count levels. It is suggested that nutritional deficit may be a primary adverse prognostic factor in this disease group, with immunoincompetence a secondary phenomenon, and supporting evidence is presented. The consequent probable importance of nutritional status with regard to clinical trials, and the necessity for controlled studies to determine the possible beneficial effect of nutritional support on `cure' rates, are discussed. PMID:7205848

  2. Neck-cooling improves repeated sprint performance in the heat

    PubMed Central

    Sunderland, Caroline; Stevens, Ryan; Everson, Bethan; Tyler, Christopher J.

    2015-01-01

    The present study evaluated the effect of neck-cooling during exercise on repeated sprint ability in a hot environment. Seven team-sport playing males completed two experimental trials involving repeated sprint exercise (5 × 6 s) before and after two 45 min bouts of a football specific intermittent treadmill protocol in the heat (33.0 ± 0.2°C; 53 ± 2% relative humidity). Participants wore a neck-cooling collar in one of the trials (CC). Mean power output and peak power output declined over time in both trials but were higher in CC (540 ± 99 v 507 ± 122 W, d = 0.32; 719 ± 158 v 680 ± 182 W, d = 0.24 respectively). The improved power output was particularly pronounced (d = 0.51–0.88) after the 2nd 45 min bout but the CC had no effect on % fatigue. The collar lowered neck temperature and the thermal sensation of the neck (P < 0.001) but had no effect on heart rate, fluid loss, fluid consumption, lactate, glucose, plasma volume change, cortisol, or thermal sensation (P > 0.05). There were no trial differences but interaction effects were demonstrated for prolactin concentration and rating of perceived exertion (RPE). Prolactin concentration was initially higher in the collar cold trial and then was lower from 45 min onwards (interaction trial × time P = 0.04). RPE was lower during the football intermittent treadmill protocol in the collar cold trial (interaction trial × time P = 0.01). Neck-cooling during exercise improves repeated sprint performance in a hot environment without altering physiological or neuroendocrinological responses. RPE is reduced and may partially explain the performance improvement. PMID:26594177

  3. Neck muscle fatigue affects postural control in man.

    PubMed

    Schieppati, M; Nardone, A; Schmid, M

    2003-01-01

    We hypothesised that, since anomalous neck proprioceptive input can produce perturbing effects on posture, neck muscle fatigue could alter body balance control through a mechanism connected to fatigue-induced afferent inflow. Eighteen normal subjects underwent fatiguing contractions of head extensor muscles. Sway during quiet stance was recorded by a dynamometric platform, both prior to and after fatigue and recovery, with eyes open and eyes closed. After each trial, subjects were asked to rate their postural control. Fatigue was induced by having subjects stand upright and exert a force corresponding to about 35% of maximal voluntary effort against a device exerting a head-flexor torque. The first fatiguing period lasted 5 min (F1). After a 5-min recovery period (R1), a second period of fatiguing contraction (F2) and a second period of recovery (R2) followed. Surface EMG activity from dorsal neck muscles was recorded during the contractions and quiet stance trials. EMG median frequency progressively decreased and EMG amplitude progressively increased during fatiguing contractions, demonstrating that muscle fatigue occurred. After F1, subjects swayed to a larger extent compared with control conditions, recovering after R1. Similar findings were obtained after F2 and after R2. Although such behaviour was detectable under both visual conditions, the effects of fatigue reached significance only without vision. Subjective scores of postural control diminished when sway increased, but diminished more, for equal body sway, after fatigue and recovery. Contractions of the same duration, but not inducing EMG signs of fatigue, had much less influence on body sway or subjective scoring. We argue that neck muscle fatigue affects mechanisms of postural control by producing abnormal sensory input to the CNS and a lasting sense of instability. Vision is able to overcome the disturbing effects connected with neck muscle fatigue. PMID:14521987

  4. Neck-cooling improves repeated sprint performance in the heat.

    PubMed

    Sunderland, Caroline; Stevens, Ryan; Everson, Bethan; Tyler, Christopher J

    2015-01-01

    The present study evaluated the effect of neck-cooling during exercise on repeated sprint ability in a hot environment. Seven team-sport playing males completed two experimental trials involving repeated sprint exercise (5 × 6 s) before and after two 45 min bouts of a football specific intermittent treadmill protocol in the heat (33.0 ± 0.2°C; 53 ± 2% relative humidity). Participants wore a neck-cooling collar in one of the trials (CC). Mean power output and peak power output declined over time in both trials but were higher in CC (540 ± 99 v 507 ± 122 W, d = 0.32; 719 ± 158 v 680 ± 182 W, d = 0.24 respectively). The improved power output was particularly pronounced (d = 0.51-0.88) after the 2nd 45 min bout but the CC had no effect on % fatigue. The collar lowered neck temperature and the thermal sensation of the neck (P < 0.001) but had no effect on heart rate, fluid loss, fluid consumption, lactate, glucose, plasma volume change, cortisol, or thermal sensation (P > 0.05). There were no trial differences but interaction effects were demonstrated for prolactin concentration and rating of perceived exertion (RPE). Prolactin concentration was initially higher in the collar cold trial and then was lower from 45 min onwards (interaction trial × time P = 0.04). RPE was lower during the football intermittent treadmill protocol in the collar cold trial (interaction trial × time P = 0.01). Neck-cooling during exercise improves repeated sprint performance in a hot environment without altering physiological or neuroendocrinological responses. RPE is reduced and may partially explain the performance improvement. PMID:26594177

  5. Post Burn Contracture Neck: Clinical Profile and Management

    PubMed Central

    Bankar, Sanket S.; Patil, Avinash

    2014-01-01

    Background: Morbidity related to hypertrophic scars and contractures which are well known sequel after burns remains high and in fact has increased as more severely burned patients are surviving. This study was undertaken in order to assess the varied clinical presentation, precipitating factors, preventive measures, treatment modalities of neck contractures and evaluate the results after surgical procedures. Materials and Methods: This hospital based study was conducted on patients admitted in our institution with proven cases of Post burn neck contracture from 1st August 2009 to 31st July 2011. Twenty two patients of post burn neck contracture who underwent operative treatment were included. Observation: 10 of 22 cases were in the middle age group i.e. between 21-30 years. There were 5 males and 17 females. Accidental flame burn was the commonest aetiology. Fourteen patients were treated within 1 year of burns for functional disability. Excisional release was performed in 13 and incisional release in 9 of our patients. Resurfacing with STSG (split thickness skin graft) was carried out in 19 cases and a local or regional flap with or without a graft in 3 patients. Hypertrophy and recontracture were the commonest late complications and occurred in 3 cases. Good to fair results were obtained in 19 patients Conclusion: Local flaps have many advantages and are to be used whenever possible. It is preferable to place the grafts if used in the area surrounding the neck (donor site of flap) or at least in the non-visible area of the neck (submental area). When a combination of flap & graft is used, it’s preferable to place the flap in a horizontal intersecting fashion in between the two patches of the graft. A follow up program for reasonable period is highly desired. PMID:25478392

  6. Anthropometric Assessment of Neck Adipose Tissue and Airway Volume Using Multidetector Computed Tomography: An Imaging Approach and Association With Overall Mortality.

    PubMed

    Maresky, Hillel S; Sharfman, Zachary; Ziv-Baran, Tomer; Gomori, J M; Copel, Laurian; Tal, Sigal

    2015-11-01

    Neck adiposity tissue volume (NATV) accumulation is an indicator for metabolic syndrome and cardiovascular disease (CVD). Neck circumference is a poor measure of NATV, and a quantifier for this entity has not yet been established. To evaluate volumetric quantification by multidetector computed tomography (MDCT) as a reproducible anthropometric tool to measure NATV and airway volume (AWV). A total of 519 patients, including a subset of 70 random patients who underwent head and neck CT scanning in our hospital within 1 year (2013), were studied. Included patients were all those undergoing nonenhanced CT (NECT) or CT angiography (CTA). Neck cross-sectional areas (NCSA) were measured at 2 separate levels of the neck, and 3D postprocessing tissue reconstruction was performed, and NATV and AWVs were quantified volumetrically for all patients within the year. The average NCSA at the level of the soft palate and thyroid cartilage was 22,579 and 14,500?mm, respectively. NATV when compared to the upper and lower levels of NCSA showed correlations of 0.64 and 0.79, respectively (P?correlation between NATV and body mass index (BMI) was found (r?=?0.658, P?

  7. Effects of scapular stabilization exercise on neck posture and muscle activation in individuals with neck pain and forward head posture

    PubMed Central

    Im, Boyoung; Kim, Young; Chung, Yijung; Hwang, Sujin

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effects of scapular stabilization exercise on neck posture, muscle activity, pain, and quality of life in individuals with neck pain and forward head posture. [Subjects and Methods] Fifteen participants were recruited according to the selection criteria and were randomly allocated to the scapular stabilization group (n=8) and the control group (n=7). The scapular stabilization group underwent training for 30 minutes a day, 3 times a week for 4 weeks; the control group performed relaxation exercises for 4 weeks. [Results] After training the scapular stabilization group showed significant improvement on the craniovertebral angle, upper trapezius muscle activity, serratus anterior muscle activity, Neck Disability Index scores, Visual Analog Scale scores, and World Health Organization Quality of Life Assessment-BREF scores compared to those in the control group. [Conclusion] Scapular stabilization exercise can help improve the head posture and pain in the patients with neck pain and forward head posture. Controlling the muscular activities through scapular stabilization exercise also improves the patients’ quality of life. PMID:27134391

  8. Prospective Imaging Assessment of Mortality Risk After Head-and-Neck Radiotherapy

    SciTech Connect

    Moeller, Benjamin J.; Rana, Vishal; Cannon, Blake A.; Williams, Michelle D.; Sturgis, Erich M.; Ginsberg, Lawrence E.; Macapinlac, Homer A.; Lee, J. Jack; Ang, K. Kian; Chao, K.S. Clifford; Chronowski, Gregory M.; Frank, Steven J.; Morrison, William H.; Rosenthal, David I.; Weber, Randal S.; Garden, Adam S.; Lippman, Scott M.

    2010-11-01

    Purpose: The optimal roles for imaging-based biomarkers in the management of head-and-neck cancer remain undefined. Unresolved questions include whether functional or anatomic imaging might improve mortality risk assessment for this disease. We addressed these issues in a prospective institutional trial. Methods and Materials: Ninety-eight patients with locally advanced pharyngolaryngeal squamous cell cancer were enrolled. Each underwent pre- and post-chemoradiotherapy contrast-enhanced computed tomography (CT) and {sup 18}F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT imaging. Imaging parameters were correlated with survival outcomes. Results: Low post-radiation primary tumor FDG avidity correlated with improved survival on multivariate analysis; so too did complete primary tumor response by CT alone. Although both imaging modalities lacked sensitivity, each had high specificity and negative predictive value for disease-specific mortality risk assessment. Kaplan-Meier estimates confirmed that both CT and FDG-PET/CT stratify patients into distinct high- and low-probability survivorship groups on the basis of primary tumor response to radiotherapy. Subset analyses demonstrated that the prognostic value for each imaging modality was primarily derived from patients at high risk for local treatment failure (human papillomavirus [HPV]-negative disease, nonoropharyngeal primary disease, or tobacco use). Conclusions: CT alone and FDG-PET/CT are potentially useful tools in head-and-neck cancer-specific mortality risk assessment after radiotherapy, particularly for selective use in cases of high-risk HPV-unrelated disease. Focus should be placed on corroboration and refinement of patient selection for imaging-based biomarkers in future studies.

  9. DXA femoral neck strength analysis in Chinese overweight and normal weight adolescents.

    PubMed

    Gong, Jian; Xu, Yi; Guo, Bin; Xu, Hao

    2012-01-01

    The aim of this study was to compare femoral neck (FN) strength in Chinese overweight adolescents with gender-matched normal weight controls and investigate the relationship of total body soft tissue composition (lean and fat masses) to indices of FN strength. Dual-energy X-ray absorptiometry (DXA) measurements of the proximal femur and total body were made in 65 Chinese overweight adolescents and 89 gender-matched normal weight controls using Lunar Prodigy DXA bone densitometer (GE Healthcare, Madison, WI). FN bone mineral density (BMD), total body lean mass, fat mass, and bone mineral content (BMC) were measured. Using FN BMD values derived from DXA measurements, hip structural analysis (HSA) was performed using Lunar enCORE (GE Healthcare), version 10.5 software. Structural parameters derived by HSA were bone cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), and the section modulus (Z). Data were analyzed by Student's t-test, Pearson correlation coefficients (r), and one-way analysis of covariance (ANCOVA). Overweight boys and girls had higher body weight, lean mass, fat mass, and body mass index (p<0.001) than normal controls. CSA, CSMI, and Z were higher in overweight groups compared with controls (p<0.05). Lean mass correlated well with all HSA parameters (range of r: 0.501--0.714) for both genders. ANCOVA test showed no significant differences between overweight and normal weight groups regarding HSA variables in both genders after adjustment for lean mass. However, the differences remain significant after adjustment for fat mass in boys but not in girls. This study supports the conclusion that overweight individuals have greater hip neck strength in comparison with normal weight controls in Chinese adolescents. Lean mass is a major determinant for FN strength. PMID:22402117

  10. Noninvasive diffuse optical monitoring of head and neck tumor blood flow and oxygenation during radiation delivery

    PubMed Central

    Dong, Lixin; Kudrimoti, Mahesh; Cheng, Ran; Shang, Yu; Johnson, Ellis L.; Stevens, Scott D.; Shelton, Brent J.; Yu, Guoqiang

    2012-01-01

    This study explored using a novel diffuse correlation spectroscopy (DCS) flow-oximeter to noninvasively monitor blood flow and oxygenation changes in head and neck tumors during radiation delivery. A fiber-optic probe connected to the DCS flow-oximeter was placed on the surface of the radiologically/clinically involved cervical lymph node. The DCS flow-oximeter in the treatment room was remotely operated by a computer in the control room. From the early measurements, abnormal signals were observed when the optical device was placed in close proximity to the radiation beams. Through phantom tests, the artifacts were shown to be caused by scattered x rays and consequentially avoided by moving the optical device away from the x-ray beams. Eleven patients with head and neck tumors were continually measured once a week over a treatment period of seven weeks, although there were some missing data due to the patient related events. Large inter-patient variations in tumor hemodynamic responses were observed during radiation delivery. A significant increase in tumor blood flow was observed at the first week of treatment, which may be a physiologic response to hypoxia created by radiation oxygen consumption. Only small and insignificant changes were found in tumor blood oxygenation, suggesting that oxygen utilizations in tumors during the short period of fractional radiation deliveries were either minimal or balanced by other effects such as blood flow regulation. Further investigations in a large patient population are needed to correlate the individual hemodynamic responses with the clinical outcomes for determining the prognostic value of optical measurements. PMID:22312579

  11. Refining Measurement of Social Cognitive Theory Factors Associated with Exercise Adherence in Head and Neck Cancer Patients.

    PubMed

    Rogers, Laura Q; Fogleman, Amanda; Verhulst, Steven; Bhugra, Mudita; Rao, Krishna; Malone, James; Robbs, Randall; Robbins, K Thomas

    2015-01-01

    Social cognitive theory (SCT) measures related to exercise adherence in head and neck cancer (HNCa) patients were developed. Enrolling 101 HNCa patients, psychometric properties and associations with exercise behavior were examined for barriers self-efficacy, perceived barriers interference, outcome expectations, enjoyment, and goal setting. Cronbach's alpha ranged from.84 to.95; only enjoyment demonstrated limited test-retest reliability. Subscales for barriers self-efficacy (motivational, physical health) and barriers interference (motivational, physical health, time, environment) were identified. Multiple SCT constructs were cross-sectional correlates and prospective predictors of exercise behavior. These measures can improve the application of the SCT to exercise adherence in HNCa patients. PMID:26177345

  12. Postradiation Metabolic Tumor Volume Predicts Outcome in Head-and-Neck Cancer

    SciTech Connect

    Murphy, James D.; La, Trang H.; Chu, Karen; Quon, Andrew; Fischbein, Nancy J.; Maxim, Peter G.; Graves, Edward E.; Loo, Billy W.; Le, Quynh-Thu

    2011-06-01

    Purpose: To explore the prognostic value of metabolic tumor volume measured on postradiation {sup 18}F-fluorodeoxyglucose positron emission tomography (PET) imaging in patients with head-and-neck cancer. Methods and Materials: Forty-seven patients with head-and-neck cancer who received pretreatment and posttreatment PET/computed tomography (CT) imaging along with definitive chemoradiotherapy were included in this study. The PET/CT parameters evaluated include the maximum standardized uptake value, metabolic tumor volume (MTV{sub 2.0}-MTV{sub 4.0}; where MTV{sub 2.0} refers to the volume above a standardized uptake value threshold of 2.0), and integrated tumor volume. Kaplan-Meier and Cox regression models were used to test for association between PET endpoints and disease-free survival and overall survival. Results: Multiple postradiation PET endpoints correlated significantly with outcome; however, the most robust predictor of disease progression and death was MTV{sub 2.0}. An increase in MTV{sub 2.0} of 21cm{sup 3} (difference between 75th and 25th percentiles) was associated with an increased risk of disease progression (hazard ratio [HR]= 2.5, p = 0.0001) and death (HR = 2.0, p = 0.003). In patients with nonnasopharyngeal carcinoma histology (n = 34), MTV{sub 2.0} <18 cm{sup 3} and MTV{sub 2.0} {>=}18 cm{sup 3} yielded 2-year disease-free survival rates of 100% and 63%, respectively (p = 0.006) and 2-year overall survival rates of 100% and 81%, respectively (p = 0.009). There was no correlation between MTV{sub 2.0} and disease-free survival or overall survival with nasopharyngeal carcinoma histology (n = 13). On multivariate analysis, only postradiation MTV{sub 2.0} was predictive of disease-free survival (HR = 2.47, p = 0.0001) and overall survival (HR = 1.98, p = 0.003). Conclusions: Postradiation metabolic tumor volume is an adverse prognostic factor in head-and-neck cancer. Biomarkers such as MTV are important for risk stratification and will be valuable in the future with risk-adapted therapies.

  13. Inorganic Contaminants, Nutrient Reserves and Molt Intensity in Autumn Migrant Red-Necked Grebes (Podiceps grisegena) at Georgian Bay.

    PubMed

    Holman, Katie L; Schummer, Michael L; Petrie, Scott A; Chen, Yu-Wei; Belzile, Nelson

    2015-11-01

    Red-necked grebes (Podiceps grisegena) are piscivorous waterbirds that breed on freshwater lakes in northwestern Canada and stop-over at the Great Lakes during autumn migration to molt feathers and replenish lipid and protein reserves. The objectives of this study were to (1) describe concentrations of, and correlations among, inorganic contaminants in a sample of autumn migrant red-necked grebes from the Great Lakes, (2) compare concentrations of inorganic contaminants to those in autumn migrant common loons from Schummer et al. (Arch Environ Contam Toxicol 62:704, 2011a), (3) evaluate if the inorganic elements are negatively associated with lipid and protein reserves, and (4) determine if nutrient reserves and molt intensity were correlated. None of the 14 contaminants analyzed were above threshold levels known to cause acute health problems in piscivorous birds. Body masses of plucked birds were within the normal reported range. Lipid reserves varied positively with hepatic concentrations of arsenic, copper, iron, nickel, lead, and selenium and negatively with mercury and magnesium. Protein reserves variety negatively with hepatic concentrations of arsenic, calcium, nickel, lead, and zinc and positively with aluminum, cadmium, and iron. A negative correlation was observed between chest molt and lipid reserves but not between nutrient reserves and other feather tracts. The relationships between lipid reserves and both mercury and selenium were consistent with current research on other piscivorous waterbirds at the Great Lakes and justify continued work to determine interactions of these contaminants in waterbirds that breed, stage, and winter in the region. PMID:26250452

  14. Correlative microscopy.

    PubMed

    Loussert Fonta, Céline; Humbel, Bruno M

    2015-09-01

    In recent years correlative microscopy, combining the power and advantages of different imaging system, e.g., light, electrons, X-ray, NMR, etc., has become an important tool for biomedical research. Among all the possible combinations of techniques, light and electron microscopy, have made an especially big step forward and are being implemented in more and more research labs. Electron microscopy profits from the high spatial resolution, the direct recognition of the cellular ultrastructure and identification of the organelles. It, however, has two severe limitations: the restricted field of view and the fact that no live imaging can be done. On the other hand light microscopy has the advantage of live imaging, following a fluorescently tagged molecule in real time and at lower magnifications the large field of view facilitates the identification and location of sparse individual cells in a large context, e.g., tissue. The combination of these two imaging techniques appears to be a valuable approach to dissect biological events at a submicrometer level. Light microscopy can be used to follow a labelled protein of interest, or a visible organelle such as mitochondria, in time, then the sample is fixed and the exactly same region is investigated by electron microscopy. The time resolution is dependent on the speed of penetration and fixation when chemical fixatives are used and on the reaction time of the operator for cryo-fixation. Light microscopy can also be used to identify cells of interest, e.g., a special cell type in tissue or cells that have been modified by either transfections or RNAi, in a large population of non-modified cells. A further application is to find fluorescence labels in cells on a large section to reduce searching time in the electron microscope. Multiple fluorescence labelling of a series of sections can be correlated with the ultrastructure of the individual sections to get 3D information of the distribution of the marked proteins: array tomography. More and more efforts are put in either converting a fluorescence label into an electron dense product or preserving the fluorescence throughout preparation for the electron microscopy. Here, we will review successful protocols and where possible try to extract common features to better understand the importance of the individual steps in the preparation. Further the new instruments and software, intended to ease correlative light and electron microscopy, are discussed. Last but not least we will detail the approach we have chosen for correlative microscopy. PMID:26072116

  15. Correlation spectrometer

    SciTech Connect

    Sinclair, Michael B.; Pfeifer, Kent B.; Flemming, Jeb H.; Jones, Gary D.; Tigges, Chris P.

    2010-04-13

    A correlation spectrometer can detect a large number of gaseous compounds, or chemical species, with a species-specific mask wheel. In this mode, the spectrometer is optimized for the direct measurement of individual target compounds. Additionally, the spectrometer can measure the transmission spectrum from a given sample of gas. In this mode, infrared light is passed through a gas sample and the infrared transmission signature of the gasses present is recorded and measured using Hadamard encoding techniques. The spectrometer can detect the transmission or emission spectra in any system where multiple species are present in a generally known volume.

  16. Prevalence of Neck Pain and Associated Factors with Personal Characteristics, Physical Workloads and Psychosocial among Male Rubber Workers in FELDA Settlement Malaysia

    PubMed Central

    Shan, Chow Li; Adon, Mohd Yusoff Bin; Rahman, Anita Binti Abd; Hassan, Syed Tajuddin Syed; Ismail, Kamal Bin

    2012-01-01

    Rubber tapping processes posed potential risk of various health problems among rubber workers. It ranges from simple musculoskeletal aches to more serious and complicated structural damage to bone, muscles, tendons and nerves of musculoskeletal system. These health problems might be linked directly to the arduous demands of farm labor. Objectives: A cross-sectional study was conducted to determine the prevalence of neck pain (NP) and musculoskeletal symptoms (MSS) and its association with personal characteristics, physical workloads and psychosocial factors among rubber workers. Methods: Stratified random sampling method was adopted and a total of 419 rubber workers in FELDA’s scheme Malaysia participated in this study. Data was collected through face to face interview using modified Standardized Nordic Questionnaire (SNQ) and Job Content Questionnaire (JCQ). Results: The results revealed the prevalence of NP was 59.9% and weak correlation with age (ρ= -0.184, p= 0.001) and a positive weak correlation with working hours per day (ρ= 0.099, p= 0.043) significantly. All physical workloads (neck flexion or rotation, awkward postures, repetitive motion and static postures) had significant weak to moderate positive correlation with NP (p<0.05). Job insecurity was found to have weak and positive correlation with NP (p<0.05). Binary logistic regression analysis showed risk factors for NP were decreased with age (OR= 3.92, 95% CI 1.61 – 9.58, p=0.003), increase in neck flexion or rotation (OR= 9.52, 95% CI 5.55 – 16.32, p= 0.001), awkward postures (OR=2.23, 95% CI 1.29 – 3.86, p= 0.004) and static postures (OR= 1.86, 95% CI 1.10 – 3.14, p= 0.021). Conclusion: This study showed that high prevalence of NP was associated with neck flexion or rotation, awkward and static postures. PMID:22980103

  17. Matching Intensity-Modulated Radiation Therapy to an Anterior Low Neck Field

    SciTech Connect

    Amdur, Robert J. Liu, Chihray; Li, Jonathan; Mendenhall, William; Hinerman, Russell

    2007-10-01

    When using intensity-modulated radiation therapy (IMRT) to treat head and neck cancer with the primary site above the level of the larynx, there are two basic options for the low neck lymphatics: to treat the entire neck with IMRT, or to match the IMRT plan to a conventional anterior 'low neck' field. In view of the potential advantages of using a conventional low neck field, it is important to look for ways to minimize or manage the problems of matching IMRT to a conventional radiotherapy field. Treating the low neck with a single anterior field and the standard larynx block decreases the dose to the larynx and often results in a superior IMRT plan at the primary site. The purpose of this article is to review the most applicable studies and to discuss our experience with implementing a technique that involves moving the position of the superior border of the low neck field several times during a single treatment fraction.

  18. Radiographic anatomy of the proximal femur: correlation with the occurrence of fractures

    PubMed Central

    Pires, Robinson Esteves Santos; Prata, Eric Fontes; Gibram, Athos Vilela; Santos, Leandro Emilio Nascimento; Lourenço, Paulo Roberto Barbosa de Toledo; Belloti, João Carlos

    2012-01-01

    Objective To evaluate the correlation between radiographic parameters of the proximal femur anatomy and fractures. Methods Three hundred and five digital x-rays of the pelvis were analyzed in the anteroposterior view. Of these x-rays, twenty-seven showed femoral neck or transtrochanteric fractures. The anatomical parameters analyzed were: femoral neck width (FNW), femoral neck length (FNL), femoral axis length (FAL), cervicodiaphyseal angle (CDA), acetabular tear-drop distance (ATD) and great trochanter-pubic symphysis distance (GTPSD). The analysis was performed by comparing the results of the x-rays with and without proximal femoral fracture, to establish a correlation between them. Results No differences were found between the anatomical parameters of the groups with and without proximal femoral fracture. Conclusion There was no association between anatomical changes in the proximal femur and greater susceptibility to fractures. Level of evidence IV, Cross-sectional Study. PMID:24453585

  19. Neck pain and postural balance among workers with high postural demands - a cross-sectional study

    PubMed Central

    2011-01-01

    Background Neck pain is related to impaired postural balance among patients and is highly prevalent among workers with high postural demands, for example, cleaners. We therefore hypothesised, that cleaners with neck pain suffer from postural dysfunction. This cross-sectional study tested if cleaners with neck pain have an impaired postural balance compared with cleaners without neck pain. Methods Postural balance of 194 cleaners with (n = 85) and without (N = 109) neck pain was studied using three different tests. Success or failure to maintain the standing position for 30 s in unilateral stance was recorded. Participants were asked to stand on a force platform for 30 s in the Romberg position with eyes open and closed. The centre of pressure of the sway was calculated, and separated into a slow (rambling) and fast (trembling) component. Subsequently, the 95% confidence ellipse area (CEA) was calculated. Furthermore a perturbation test was performed. Results More cleaners with neck pain (81%) failed the unilateral stance compared with cleaners without neck pain (61%) (p < 0.01). However, the risk of failure in unilateral stance was statistically elevated in cleaners with concurrent neck/low back pain compared to cleaners without neck/low back pain (p < 0.01), whereas pain at only neck or only low back did not increase the risk. Impaired postural balance, measured as CEA (p < 0.01), rambling (p < 0.05) and trembling (p < 0.05) was observed among cleaners with neck pain in comparison with cleaners without neck pain in the Romberg position with eyes closed, but not with eyes open. Conclusions Postural balance is impaired among cleaners with neck pain and the current study suggests a particular role of the slow component of postural sway. Furthermore, the unilateral stance test is a simple test to illustrate functional impairment among cleaners with concurrent neck and low back pain. Trial registration ISRCTN96241850 PMID:21806796

  20. Recurrent neck lesions secondary to pyriform sinus fistula.

    PubMed

    Zhang, Peijun; Tian, Xiufen

    2016-03-01

    Recurrent neck lesions associated with third or fourth branchial arch fistula are much less common than those of second arch and usually present with acute suppurative thyroiditis or neck abscess. Our aim is to describe clinical features, management and treatment outcomes of 64 cases of congenital pyriform sinus fistula (PSF). Medical record of these 64 patients (33 males, 31 females) treated at the First Affiliated Hospital of Zhengzhou University from 2011 to 2014 were reviewed. The patients comprised 33 males and 31 females, and their ages ranged from 18 months to 47 years (median 10 years, mean 12.7 years). Neck abscess and recurrent infection was the mode of presentation in 37 cases (57.8 %), 4 patients (6.3 %) presented with acute suppurative thyroiditis, neck mass was the mode of presentation in 17 cases (26.6 %), 2 patients (3.1 %) presented with neck mass with respiratory distress, and cutaneous discharging fistula was the mode of presentation in 1 cases (1.6 %). The remaining 3 patients (4.7 %) presented with cutaneous discharging fistula with neck infection. Investigations performed include barium swallow, CT scan, and ultrasound which were useful in delineating PSF tract preoperatively. Barium swallow was taken as the gold standard for diagnosis. Our patients were treated by fistulectomy with hemithyroidectomy, fistulectomy, fistulectomy with endoscopic electric cauterization, endoscopic electric cauterization or endoscopic coblation cauterization, respectively. Histopathologic examination of the surgical specimens revealed that they were lined with ciliated epithelium, stratified cuboid epithelium with chronic inflammatory cell infiltration and fibrosis. Voice hoarseness occurred after operation in seven patients, but disappeared 1 week later. PSF recurred in 6 patients, 4 of them were cured by a successful re-excision. One patient was cured by successful endoscopic electric cauterization. The other 1 has remained asymptomatic for 5 months. In our series, mean follow-up period was 13.3 months and median follow-up period was 12.5 months (range 2-40 months). Presence of congenital PSF should be suspected when intra-thyroidal abscess formation occurs as the gland is resistant to infection. Strong clinical suspicion, barium swallow study, CT scan and ultrasound are the key to diagnosis. Both fistulectomy with hemithyroidectomy and endoscopic treatment have comparable success rate. Endoscopic coblation cauterization may prove a useful and equally effective method of treatment for PSF in future. PMID:25708412

  1. A Planned Neck Dissection Is Not Necessary in All Patients With N2-3 Head-and-Neck Cancer After Sequential Chemoradiotherapy

    SciTech Connect

    Soltys, Scott G.; Choi, Clara Y.H.; Fee, Willard E.; Pinto, Harlan A.; Le, Quynh-Thu

    2012-07-01

    Purpose: To assess the role of a planned neck dissection (PND) after sequential chemoradiotherapy for patients with head-and-neck cancer with N2-N3 nodal disease. Methods and Materials: We reviewed 90 patients with N2-N3 head-and-neck squamous cell carcinoma treated between 1991 and 2001 on two sequential chemoradiotherapy protocols. All patients received induction and concurrent chemotherapy with cisplatin and 5-fluorocuracil, with or without tirapazamine. Patients with less than a clinical complete response (cCR) in the neck proceeded to a PND after chemoradiation. The primary endpoint was nodal response. Clinical outcomes and patterns of failure were analyzed. Results: The median follow-up durations for living and all patients were 8.3 years (range, 1.5-16.3 year) and 5.4 years (range, 0.6-16.3 years), respectively. Of the 48 patients with nodal cCR whose necks were observed, 5 patients had neck failures as a component of their recurrence [neck and primary (n = 2); neck, primary, and distant (n = 1); neck only (n = 1); neck and distant (n = 1)]. Therefore, PND may have benefited only 2 patients (4%) [neck only failure (n = 1); neck and distant failure (n = 1)]. The pathologic complete response (pCR) rate for those with a clinical partial response (cPR) undergoing PND (n = 30) was 53%. The 5-year neck control rates after cCR, cPR{yields}pCR, and cPR{yields}pPR were 90%, 93%, and 78%, respectively (p = 0.36). The 5-year disease-free survival rates for the cCR, cPR{yields}pCR, and cPR{yields}pPR groups were 53%, 75%, and 42%, respectively (p = 0.04). Conclusion: In our series, patients with N2-N3 neck disease achieving a cCR in the neck, PND would have benefited only 4% and, therefore, is not recommended. Patients with a cPR should be treated with PND. Residual tumor in the PND specimens was associated with poor outcomes; therefore, aggressive therapy is recommended. Studies using novel imaging modalities are needed to better assess treatment response.

  2. Diffusion-Weighted MRI for Nodal Staging of Head and Neck Squamous Cell Carcinoma: Impact on Radiotherapy Planning

    SciTech Connect

    Dirix, Piet; Vandecaveye, Vincent; De Keyzer, Frederik; Op de beeck, Katya; Poorten, Vincent Vander; Delaere, Pierre; Verbeken, Eric; Hermans, Robert; Nuyts, Sandra

    2010-03-01

    Purpose: To evaluate the use of diffusion-weighted magnetic resonance imaging (DW-MRI) for nodal staging and its impact on radiotherapy (RT) planning. Methods and Materials: Twenty-two patients with locally advanced head and neck squamous cell carcinoma underwent contrast-enhanced computed tomography (CT), as well as MRI (with routine and DW sequences) prior to neck dissection. After topographic correlation, lymph nodes were evaluated microscopically with prekeratin immunostaining. Pathology results were correlated with imaging findings and an RT planning study was performed for these surgically treated patients. One set of target volumes was based on conventional imaging only, and another set was based on the corresponding DW-MRI images. A third reference set was contoured based solely on pathology results. Results: A sensitivity of 89% and a specificity of 97% per lymph node were found for DW-MRI. Nodal staging agreement between imaging and pathology was significantly stronger for DW-MRI (kappa = 0.97; 95% confidence interval [CI], 0.84-1.00) than for conventional imaging (kappa = 0.56; 95% CI, 0.16-0.96; p = 0.019, by McNemar's test). For both imaging modalities, the absolute differences between RT volumes and those obtained by pathology were calculated. Using an exact paired Wilcoxon test, the observed difference was significantly larger for conventional imaging than for DW-MRI for nodal gross tumor volume (p = 0.0013), as well as for nodal clinical target volume (p = 0.0415) delineation. Conclusions: These results suggest that DW-MRI is superior to conventional imaging for preradiotherapy nodal staging of head and neck squamous cell carcinoma, and provides a potential impact on organsparing and tumor control.

  3. Non-invasive label-free investigation and typing of head and neck cancers by multimodal nonlinear microscopy

    NASA Astrophysics Data System (ADS)

    Meyer, Tobias; Vogler, Nadine; Dietzek, Benjamin; Akimov, Denis; Inhestern, Johanna; Guntinas-Lichius, Orlando; Popp, Jürgen

    2012-06-01

    Early detection and typing of tumors is pressing matter in clinical research with important impacts for prognosis and successful treatment. Currently, staining is the golden standard in histopathology but requires surgical removal of tissue. In order to avoid resection of non-diseased tissue a non-invasive real-time imaging method is required which can be applied ideally intrasurgically. In this proceeding a combination of second harmonic generation (SHG), two photon excited fluorescence (TPEF) and coherent anti-Stokes Raman (CARS) imaging has been employed to investigate tissue sections of head and neck carcinomas focussing on laryngeal carcinoma. Primary laryngeal and other head and neck carcinomas consist to 99% of squamous cell carcinoma. By fusing the various imaging methods it is possible to measure the thickness of the epithelial cell layer as a marker for dysplastic or cancerous tissue degradation and to differentiate keratinizing and nonkeratininzing squamous cell carcinomas (SCC). As nonkeratinizing SCCs of the oropharynx correlate with a human papillomavirus (HPV) infection as a subentity of head and neck cancer, and HPV related tumors are associated with a better clinical prognosis, the differentiation between keratinizing and non-keratinizing forms of SCCs is of high diagnostic value. TPEF is capable of displaying cell nuclei, therefore, morphologic information as cell density, cell to cytoplasm ratio, size and shape of cell nuclei can be obtained. SHG - on the other hand - selectively reveals the collagen matrix of the connective tissue, which is useful for determination of tumor-islets boundaries within epithelial tissue - a prerequisite for precise resection. Finally CARS in the CH-stretching region visualizes the lipid content of the tissue, which can be correlated with the dysplastic grade of the tissue.

  4. Tri-modal microscope for head and neck tissue identification

    PubMed Central

    De Montigny, Etienne; Goulamhoussen, Nadir; Madore, Wendy-Julie; Strupler, Mathias; Gologan, Olguta Ecaterina; Ayad, Tareck; Boudoux, Caroline

    2016-01-01

    A novel tri-modal microscope combining optical coherence tomography (OCT), spectrally encoded confocal microscopy (SECM) and fluorescence imaging is presented. This system aims at providing a tool for rapid identification of head and neck tissues during thyroid surgery. The development of a dual-wavelength polygon-based swept laser allows for synchronized, co-registered and simultaneous imaging with all three modalities. Further ameliorations towards miniaturization include a custom lens for optimal compromise between orthogonal imaging geometries as well as a double-clad fiber coupler for increased throughput. Image quality and co-registration is demonstrated on freshly excised swine head and neck tissue samples to illustrate the complementarity of the techniques for identifying signature cellular and structural features. PMID:27231585

  5. Dementia Risk in Irradiated Patients With Head and Neck Cancer.

    PubMed

    Chen, Jin-Hua; Yen, Yu-Chun; Liu, Shing-Hwa; Lee, Fei-Peng; Lin, Kuan-Chou; Lai, Ming-Tang; Wu, Chia-Che; Chen, Tsung-Ming; Yuan, Sheng-Po; Chang, Chia-Lun; Wu, Szu-Yuan

    2015-11-01

    Patients with head and neck cancer are treated through surgery, radiotherapy (RT), and chemotherapy (CT). Carotid artery damage and neurotoxicity were previously observed in these patients. This study estimated the dementia risk associated with different treatment modalities in a head and neck cancer population with long-term follow-up. Taiwan's National Health Insurance claims database and a cancer registry database from the Collaboration Center of Health Information Application were linked for the present analysis. Patients with head and neck cancer, treated from January 1, 2002 to December 31, 2010, were included in the study. The follow-up duration was the period from the index date to December 31, 2012. Inclusion criteria were head and neck cancer; an age >20 years; and having undergone surgery, CT, concurrent CT, or surgery with adjuvant treatment. Exclusion criteria were another cancer diagnosed before the head and neck cancer, death or being diagnosed with dementia within 2 years after the treatment of the head and neck cancer, stroke before the index date, distant metastasis, in situ carcinoma, sarcoma, head and neck cancer recurrence, an unknown sex, and an age <20 years. In total, 20,135 patients were included. In patient groups that underwent surgery alone, surgery and adjuvant chemoradiotherapy, and chemoradiotherapy alone, the dementia incidence per 1000 person-years was 1.44, 1.04, and 1.98, respectively. The crude hazard ratio (HR) of dementia was 1.84 (95% confidence interval [CI] 1.21-2.81) in the RT with or without CT group. After adjustment for age, sex, clinical stage, and comorbidity, the HR was 1.92 (95% CI 1.14-3.24). Examining the dementia risk in patients who received different treatment modalities according to the Cox proportional-hazard model revealed that an age >65 years and having undergone RT with or without CT were risk factors (P < 0.001 and P = 0.015; and HRs of 16.5 and 1.92, respectively). The dementia risk in patients at different clinical stages was not significantly different among the various treatment groups, regardless of whether the patients received RT. However, younger (<65 y) patients who received RT with or without CT had a 2.96-fold (95% CI 1.24-7.08) higher risk of dementia and a 3.54-fold (95% CI 1.32-9.51) higher adjusted HR compared with the surgery-alone group. Patients who received a total radiation dose >6660 cGy exhibited a 1.69-fold (95% CI 0.97-2.95, P = 0.063) higher dementia risk compared with those who received a total radiation dose <6660 cGy. Receiving a higher radiation dose increased the dementia risk and persistently escalated the dementia incidence even 9 years after RT. Younger (<65 y) patients have a high risk of dementia after RT. The selection of young patients for dose de-escalation requires improvement for reducing irradiation to the neck and areas near brain tissues, particularly in Taiwan, where the median patient age is 53 years. PMID:26559280

  6. Benign anlage tumour: a very unusual neck mass.

    PubMed

    Parihar, Shivani; Gohil, Rohit; Oparka, Richie; Kennedy, Ceilidh

    2016-01-01

    A 44-year-old woman presented with a slow-growing asymptomatic neck swelling at the left medial clavicle. Haematological and biochemical work up was normal and an ultrasound confirmed the swelling, but needle aspiration was non-diagnostic. As lymphoma was the main differential diagnosis, the swelling was completely excised. Immunohistochemistry yielded a rare lesion, suspected to represent a myoepithelial/mixed cellularity tumour of soft tissue. The extreme rarity of these tumours required a confirmatory secondary opinion, which ultimately led to it being identified as a benign anlage tumour (previously known as an ectopic hamartomatous thymoma) This case highlights the fact that thorough assessment of patients with neck swellings should be undertaken to rule out sinister causes-keeping in mind more rare differentials-helping to guide final management. PMID:27194678

  7. Gunshot wound to the mandible with secondary neck injuries.

    PubMed

    Stanley, R B; Canalis, R F; Colman, M F

    1981-09-01

    Four consecutive patients were initially seen with witnessed, low-velocity gunshot wounds to the mandible with deflection of the bullet into the neck, causing a life-threatening situation. The mechanics of injury were similar in all four patients who were shot at close range with a moderately heavy caliber handgun and sustained comminuted fractures from the parasymphyseal area to the ascending ramus of the jaw. Severe vascular injuries were seen in three cases and lacerations of the pharynx and cervical esophagus in one. Aggressive management of these injuries is recommended, with neck exploration after endoscopy playing a major role. Management of the mandibular fracture at the time of the initial surgery is favored. However, if roentgenograms are unavailable, reduction and fixation may need to be deferred. PMID:7271557

  8. Moving Toward Bioadjuvant Approaches to Head and Neck Cancer Prevention

    SciTech Connect

    Saba, Nabil F.; Hammond, Anthea; Shin, Dong M.; Khuri, Fadlo R.

    2007-10-01

    Head and neck squamous cell carcinoma affects >45,000 Americans annually. Patients who are successfully treated for their primary tumor are at high risk of developing a second primary tumor, making effective preventive strategies highly desirable for this disease. Although a landmark study in 1990 suggested some benefit of high-dose retinoids in head and neck cancer prevention, subsequent trials using more tolerable doses have shown limited clinical success. Newer preventive strategies have included bioadjuvant therapy combining retinoids with interferon and {alpha}-tocopherol, combinations of molecularly targeted agents, and oncolytic viruses. Furthermore, considerable evidence has supported a cancer protective role for several nutrients, including green tea and curcumin analogs. Natural compounds such as these with favorable long-term safety profiles might be particularly suited to the cancer prevention setting, in which patients will usually tolerate only moderate risk and toxicity.

  9. Modified neck muscular system of the giraffe (Giraffa camelopardalis).

    PubMed

    Endo, H; Yamagiwa, D; Fujisawa, M; Kimura, J; Kurohmaru, M; Hayashi, Y

    1997-10-01

    The muscular and skeletal systems of the long neck were morphologically examined in order to clarify their modification and their functional significance in the giraffe (Giraffa camelopardalis). The longissimus, the thoracic and cervical, spinalis and semispinalis, the cranial and caudal head oblique, and the multifidus muscles, and the nuchal ligament were observed at their origin and insertion. The atlas, axis, and the third cervical vertebra were measured and examined. The modified spinous processes provided the large attachment surface for the strong nuchal ligament and for the muscles of the axis and other cervical vertebrae, while the muscle tendons had their origin in the ventrocaudally-enlarged transverse process. It is concluded that the modified muscles with their expanded belly and tendon have the functions of occupying the interspace among long vertebrae, and also of supporting the head and neck by means of their wide attachment to the altered vertebral processes. PMID:9341956

  10. Photodynamic therapy of head and neck cancer with different sensitizers

    NASA Astrophysics Data System (ADS)

    Vakoulovskaya, Elena G.; Shental, Victor V.; Abdoullin, N. A.; Kuvshinov, Yury P.; Tabolinovskaia, T. D.; Edinak, N. J.; Poddubny, Boris K.; Kondratjeva, T. T.; Meerovich, Gennadii A.; Stratonnikov, Alexander A.; Linkov, Kirill G.; Agafonov, Valery V.

    1997-12-01

    This paper deals with the results of clinical trials for sulfated aluminum phthalocyanine (PHS) (Photosens, Russia; Photogeme (PG) in Russia. The results of photodynamic therapy (PDT) of head and neck tumors (HNT), side effects and ways of their correction and prevention, as well as possibility to work out less toxic regimes of PDT with photosense, choice of laser and type of irradiation are discussed. PDT have been provided in 79 patients with different head and neck tumors. Efficacy of PDT depended on tumor size and its histological type. Undesirable changes in plasma content of antioxidants by means of high pressure liquid chromatography (HLPC) have been found in patients after PHS injection. Influence of short-term and long-term supplementation with beta-carotene and vitamin E on this parameters are discussed.

  11. Magnetic resonance imaging of the neck. Part II. Pathologic findings

    SciTech Connect

    Stark, D.D.; Moss, A.A.; Gamsu, G.; Clark, O.H.; Gooding, G.A.W.; Webb, W.R.

    1984-02-01

    Magnetic resonance (MR) images of the neck were obtained in 14 patients with thyroid, parathyroid, lymph node, or laryngeal lesions. Tumors and lymph nodes were more easily differentiated from muscle and blood vessels with MR than with CT because of the superior soft tissue contrast of MR. Tissue characterization allowed MR differentiation of thyroid nodules, thyroid cysts, and parathyroid tumors from normal thyroid tissue; however, nonspecifically increased T1 and T2 relaxation times overlapped for a variety of neoplastic and inflammatory conditions. Thyroid cyst fluid had the greatest water content and longest T1 and T2 times of all tissues studied. Parathyroid hyperplasia could not be differentiated from parathyroid adenoma; however, parathyroid tumors had slightly longer T1 and T2 times than thyroid nodules or lymph nodes. With further experience, MR tissue characterization may become a useful technique for evaluating neck masses.

  12. Hypoxia in Head and Neck Squamous Cell Carcinoma

    PubMed Central

    Li, John Zenghong; Gao, Wei; Chan, Jimmy Yu-Wai; Ho, Wai-Kuen; Wong, Thian-Sze

    2012-01-01

    Hypoxia is a common feature in most of the solid tumors including head and neck squamous cell carcinoma (HNSCC). Hypoxia reflects the imbalance between oxygen consumption by the rapidly proliferating cancer cells and the insufficient oxygen delivery due to poor vascularization and blood supply. The hypoxic microenvironment in the HNSCC contributes to the development of aggressive carcinoma phenotype with high metastatic rate, resistance to therapeutic agents, and higher tumor recurrence rates, leading to low therapeutic efficiency and poor outcome. To overcome the therapeutic resistance due to hypoxia and improving the prognosis of the HNSCC patients, many approaches have been examined in laboratory studies and clinical trials. In this short paper, we discuss the mechanisms involved in the resistance of radiotherapy and chemotherapy in hypoxic condition. We also exploit the molecular mechanisms employed by the HNSCC cells to adapt the hypoxic condition and their tumorigenic role in head and neck, as well as the strategies to overcome hypoxia-induced therapeutic resistance. PMID:23762617

  13. Cutaneous manifestations associated with malignancy of the head and neck.

    PubMed

    Lorimer, Patrick; Milas, Zvonimir

    2016-06-01

    Most cutaneous malignancies of the head and neck (HN) are non-melanoma skin cancers, predominantly basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs). Less common entities include Merkel cell carcinoma (MCC), sebaceous carcinoma (SC), and angiosarcoma. Treatment is based on histology subtype, stage, and extent of involvement. Surgery is the primary means of treatment and includes wide local excision, Mohs micrographic surgery, sentinel lymph node biopsy, and cervical lymphadenectomy. Multidisciplinary management including radiation and targeted chemotherapy are critical adjuncts to surgery. Surgical planning must balance oncologic, functional, and cosmetic considerations. This review addresses cutaneous manifestations of primary malignancies of the HN and dermatologic complications of small molecule inhibitors used for targeted therapy. A working knowledge of both the cutaneous malignancies (CM) in the head and neck as well as the secondary dermatologic manifestations is relevant to multiple disciplines including dermatology, medical oncology, radiation oncology, and surgical oncology. PMID:27178688

  14. The Current State of Head and Neck Cancer Gene Therapy

    PubMed Central

    Thomas, Sufi Mary

    2009-01-01

    Abstract The incidence of head and neck cancer continues to increase worldwide, with tobacco exposure and human papillomavirus type 16 infections being the major etiological factors. Current therapeutic options are ineffective in approximately half of the individuals afflicted with this malignancy. Developments in the identification of molecules that sustain head and neck squamous cell carcinoma (HNSCC) growth and survival have made molecular targeting by gene therapy approaches a feasible therapeutic strategy. Although gene therapy was originally designed to correct single gene defects, it has now evolved to encompass all forms of therapeutic interventions involving engineered cells and nucleic acids that modify the overall pattern of gene expression within target tissues. Several preclinical studies and clinical trials have tested the efficacy of targeting specific molecules in patients with HNSCC, using genetic therapy approaches. This review discusses promising preclinical and clinical approaches and new directions for HNSCC gene therapy. PMID:19747066

  15. Calcified Amyloid Tumor of Neck with Exuberant Giant Cell Reaction

    PubMed Central

    Bandyopadhyay, Arghya; Bhattacharya, Shubham; Maiti, Barnali; Bose, Koushik

    2015-01-01

    Amyloidosis is a group of disorders characterized by an extracellular deposition of an abnormal amount of proteins in a variety of organs resulting from abnormal folding of protein. It typically presents as disseminated deposits. Tumor like localized presentation of amyloidosis in the absence of systemic amyloidosis is referred to as amyloidoma or amyloid tumor. Amyloidoma is the least common presentation of tissue amyloid deposition. Amyloidoma of soft tissue is again a very rare entity, especially in the neck region. Calcification and minimum giant cell reaction can occur in amyloidoma. However, extensive calcification and exuberant giant cell reaction in amyloidoma of soft tissue neck make it difficult to diagnose. In this report, we discuss such a rare case with its differential diagnoses. PMID:25949063

  16. Head-Neck Taper Corrosion in Hip Arthroplasty

    PubMed Central

    Hussenbocus, S.; Kosuge, D.; Solomon, L. B.; Howie, D. W.; Oskouei, R. H.

    2015-01-01

    Modularity at the head-neck junction of the femoral component in THA became popular as a design feature with advantages of decreasing implant inventory and allowing adjustment of leg length, offset, and soft tissue balancing through different head options. The introduction of a new modular interface to femoral stems that were previously monoblock, or nonmodular, comes with the potential for corrosion at the taper junction through mechanically assisted crevice corrosion. The incidence of revision hip arthroplasty is on the rise and along with improved wear properties of polyethylene and ceramic, use of larger femoral head sizes is becoming increasingly popular. Taper corrosion appears to be related to all of its geometric parameters, material combinations, and femoral head size. This review article discusses the pathogenesis, risk factors, clinical assessment, and management of taper corrosion at the head-neck junction. PMID:25954757

  17. Iridescence in the neck feathers of domestic pigeons

    NASA Astrophysics Data System (ADS)

    Yin, Haiwei; Shi, Lei; Sha, Jing; Li, Yizhou; Qin, Youhua; Dong, Biqin; Meyer, Serge; Liu, Xiaohan; Zhao, Li; Zi, Jian

    2006-11-01

    We conducted structural characterizations, reflection measurements, and theoretical simulations on the iridescent green and purple neck feathers of domestic pigeons (Columba livia domestica). We found that both green and purple barbules are composed of an outer keratin cortex layer surrounding a medullary layer. The thickness of the keratin cortex layer shows a distinct difference between green and purple barbules. Green barbules vary colors from green to purple with the observing angle changed from normal to oblique, while purple barbules from purple to green in an opposite way. Both the experimental and theoretical results suggest that structural colors in green and purple neck feathers should originate from the interference in the top keratin cortex layer, while the structure beyond acts as a poor mirror.

  18. Tissue engineering for otorhinolaryngology-head and neck surgery.

    PubMed

    Lott, David G; Janus, Jeffrey R

    2014-12-01

    Tissue regeneration in otorhinolaryngology-head and neck surgery is a diverse area filled with specialized tissues and functions. Head and neck structures govern many of the 5 senses, swallowing, breathing, communication, facial animation, and aesthetics. Loss of these functions can have a severe negative effect on patient quality of life. Regenerative medicine techniques have the potential to restore these functions while minimizing the risks associated with traditional reconstruction techniques. This article serves as a review and update on some of the regenerative medicine research in this field. A description of the predominant clinical problems is presented, followed by a discussion of some of the most promising research working toward a solution. There are many noteworthy findings appropriate for inclusion, but limitations preclude mention of them all. This article focuses on laryngeal surgery, craniofacial reconstruction and plastic surgery, and otology and hearing. PMID:25468518

  19. Perivascular stem cell niche in head and neck cancer

    PubMed Central

    Ritchie, Kathryn E.; Nör, Jacques E.

    2012-01-01

    Cancers may contain a small sub-population of uniquely tumorigenic cells that exhibit self-renewal and multipotency, i.e. cancer stem cells (CSC). These cells reside in invasive fronts in close proximity to blood vessels in many tumors, including head and neck squamous cell carcinomas (HNSCC). Recent evidence suggests that CSC resist chemotherapy and “drive” local recurrence and metastatic spread. Notably, endothelial cell-initiated signaling is critical for the survival and self-renewal of CSC and may play a role in resistance to therapy. Therefore, patients with head and neck cancer might benefit from therapies that target the CSC directly or their supportive perivascular niche. PMID:22842095

  20. PET Scan in Head and Neck Tumours in a Developing Country Like India: Is It a Must?

    PubMed

    Kapre, Neeti Madan; Dabholkar, Jyoti Pralhad

    2014-01-01

    To study the impact of Positron emission tomography (PET) and its incremental value in diagnosing an unknown primary tumour with secondaries in the head and neck; recurrent head and neck cancers (confirmation of suspected recurrences and re-staging); and staging of head and neck tumours. This was a prospective observational study where 60 patients of head and neck tumours under the clinical settings as described above were evaluated. Thorough clinical examination and necessary radiological and histopathological investigations were done. All patients underwent a PET scan, the results of which were correlated with histopathological examination. Sensitivities, specificities, positive and negative predictive values, false positives and false negatives of PET scan in the different indications were calculated. The study included 11 patients of unknown primary, 28 patients with suspected recurrent tumours and 21 patients where PET scan was done for initial staging. PETCT scan was able to detect the primary in 3 out of 11 patients (27.27 %) who presented with cervical metastases with an unknown primary. In 2 of the 8 patients where a primary tumour was not found, PETCT detected distant metastases. For recurrent tumours, PETCT scan showed sensitivity, specificity, positive predictive value and negative predictive value as 100, 72.72, 85 and 100 % respectively. In restaging of recurrent disease, 4 out of 28 patients were detected to have distant metastases. In 7 cases of locoregionally advanced tumors, where PETCT scan was used for pre-treatment staging, it detected distant metastases in 4 of 7 patients. In the patients with N0 neck status PETCT scan showed a sensitivity, specificity, positive predictive value and negative predictive value of 100, 66.67, 50 and 100 % respectively. PETCT scan was able to alter the plan of management in 15 out of 60 patients. Thus, in carefully selected patients PETCT scan can provide incremental information that proves invaluable in these circumstances even in a developing country like India. In all the settings, PETCT scan demonstrated a very high negative predictive value. Hence, negative PETCT scan could be interpreted as absence of disease with reasonable assurance. PMID:24605310

  1. Neck abscess secondary to cat-scratch disease.

    PubMed

    Dean, Robert L; Eisenbeis, John F

    2004-11-01

    A 7-year-old boy was referred to us for evaluation of an enlarging neck mass. The results of his primary care physician's initial clinical examination suggested lymphadenopathy secondary to lymphadenitis, and the patient was treated over a 4-week period with two rounds of antibiotics. However, the mass did not resolve, and it subsequently became fluctuant. The patient was referred to our institution, where we diagnosed cat-scratch disease. PMID:15628637

  2. Emerging applications for OCT in the head and neck

    NASA Astrophysics Data System (ADS)

    Rubinstein, Marc; Kim, Jason H.; Armstrong, William B.; Djalilian, Hamid R.; Chen, Zhongping; Wong, Brian J. F.

    2010-02-01

    Objectives: To describe the current and promising new applications of Optical Coherence Tomography (OCT) as a helpful tool when imaging the different sites in the head and neck. We used the OCT Niris system, which is the first commercially available OCT device for applications outside the field of ophthalmology. Methods: OCT images were obtained of normal, benign, premalignant and malignant lesions in different areas of the head and neck. The OCT imaging system has a tissue penetration depth of approximately 1-2mm, a scanning range of 2mm and a spatial depth resolution of approximately 10-20μm. Imaging was performed using a flexible probe in two different settings, the outpatient clinic and the operating room. Results: High-resolution cross-sectional images from the larynx were obtained with the patient awake, without the need for general anesthesia, under direct visualization with a flexible fiberoptic endoscope. The OCT probe was inserted through the nasal cavity and placed in slight contact with the laryngeal tissue. In the ears, cholesteatoma was differentiated from inflamed middle ear mucosa by the different hyperintensity. In the neck, normal as well as different pathologies of the thyroid were identified. Conclusions: This system is non invasive and easy to incorporate into the operating room setting as well as the outpatient clinic. It requires minimal set-up and only one person is required to operate the system. OCT has the distinctive capability to obtain highresolution images, and the microanatomy of different sites can be observed. OCT technology has the potential to offer a quick, efficient and reliable imaging method to help the surgeon not only in the operating room but also in the clinical setting to guide surgical biopsies and aid in clinical decision making of different head and neck pathologies, especially those arising form the larynx.

  3. Comprehensive management of head and neck tumors, volume 1

    SciTech Connect

    Thawley, S.E.; Panje, W.R.

    1987-01-01

    This book consists of 14 parts, each containing several papers. The parts are: General Considerations in the Management of Patients with Head and Neck Tumors, Tumors of the Ear, Tumors of the Nasal Cavity and Paranasal Sinuses, Tumors of the Oral Cavity, Tumors of the Pharynx, Tumors of the Larynx, Tumors of the Skin, Dental and Jaw Tumors, Tumors of the Thyroid and Parathyroid Glands, Tumors of the Trachea, Tumors of the Eye, Orbit, and Lacrimal Apparatus, and Special Topics.

  4. Femoral neck erosions: sign of hip joint synovial disease

    SciTech Connect

    Goldberg, R.P.; Weissman, B.N.; Naimark, A.

    1983-07-01

    Pathologic synovial processes in the hip joint can cause characteristic extrinsic erosions of the femoral neck, which in extreme cases produce an ''apple core'' appearance. Nine such cases of synovial diseases, including synovial osteochondromatosis, pigmented villonodular synovitis, rheumatoid arthritis, and amyloidosis, that demonstrate this radiographic finding are presented. The anatomic relations of the hip joint that result in theis appearance, differential diagnosis, and radiographic techniques useful in diagnosis are discussed.

  5. Optical diagnostic systems for assessing head and neck lesions.

    PubMed

    Green, B; Tsiroyannis, C; Brennan, P A

    2016-04-01

    Novel optical-based diagnostic systems are promising technologies that can be used in the clinic providing the clinician with an adjunct to histopathological assessment and facilitating rapid diagnosis for patients. Aided by the use of differing wavelengths of light, these systems are capable of detecting changes within tissues and provide immediate results. We reviewed the most common optical biopsy systems to detect oral and head and neck lesions and discussed their clinical applications. PMID:26581174

  6. Lepromatous leprosy presenting as a swelling in the neck.

    PubMed

    Dogra, D; Verma, K K; Sood, A; Handa, R

    1999-01-01

    A 25-year-old electrician presented with gradually, asymptomatic swelling on left of the neck since 2 years. The swelling which was initially diagnosed as cervical lymphadenitis by the internist represented the enlarged left great auricular nerve. Cutaneous examination revealed an ill-defined, hypoaesthetic macule with minimal atrophy on the pinna of the left ear. The histopathology of the nerve showed a lepromatous neuritis with bacteriological index (BI) of 5+. PMID:20921641

  7. Esthesioneuroblastoma: Is There a Need for Elective Neck Treatment?

    SciTech Connect

    Demiroz, Candan; Gutfeld, Orit; Aboziada, Mohamed; Brown, Doris; Marentette, Lawrence J.; Eisbruch, Avraham

    2011-11-15

    Purpose: To assess the risk of cervical lymph node metastases after definitive treatment for esthesioneuroblastoma (ENB) that did not include elective neck therapy. Methods and Materials: This was a retrospective analysis of 26 ENB patients treated at University of Michigan between 1995 and 2007. Tumor stage was Kadish A in 1 patient, B in 19, C in 5, and unknown in 1. Craniofacial or subcranial resection was performed in 24 patients (92%), with negative margins in 22 (92%). Postoperative radiotherapy (RT) to the primary site was given in 12 patients (46%), and 14 patients (54%) had surgery alone. All patients had clinically N0 disease, and no patient underwent elective neck dissection or radiation. Median follow-up was 72 months. Results: Local relapse-free survival was significantly better for patients who received postoperative RT compared with those who had surgery alone: 100% vs. 29% at 5 years, respectively (p = 0.005). Five-year disease-free survival was 87.5% in the RT group vs. 31% in the surgery-alone group (p = 0.05). Regional failure was observed in 7 patients (27%), 6 with Kadish Stage B and 1 with Stage C disease. The most common site of nodal failure was Level II, and 3 patients failed in the contralateral neck. Only 3 patients with regional failure were successfully salvaged. Conclusion: The high rate of regional failures when the neck is not electively treated justifies elective nodal RT in patients with both Kadish Stages B and C. In addition, our experience confirms the beneficial effect on local control of adjuvant RT to the tumor bed.

  8. Dynamic modeling of the neck muscles during horizontal head movement.

    PubMed

    Haapala, Stephenie A; Enderle, John D

    2002-01-01

    This paper presents modeling and simulation of superficial neck muscle movement in the horizontal plane (yaw). The parametric muscle model was constructed using Pro/Engineer 2000i Student Edition, Parametric Technologies Corp, and simulated using Pro/Mechanica. Pennation angles, force-tension, force-generation and rate of muscle activation data were obtained from anatomic and physiological studies. Saccadic eye movement models developed by G. Alexander Korentis and John Enderle also provided the basis for this model. PMID:12085608

  9. Proximal median neuropathy secondary to humeral neck fracture.

    PubMed

    Veilleux, M; Richardson, P

    2000-03-01

    Median neuropathies proximal to the wrist are uncommon and usually result from penetrating injuries, fracture dislocation of the distal humerus, or compression by fibrous bands. A 66-year-old man suffered a comminuted fracture of the proximal humerus after a fall. Electrodiagnostic studies revealed a severe proximal median neuropathy and a mild distal radial mononeuropathy. Proximal median neuropathy rarely occurs in humeral neck fracture, mostly because the median nerve is not in close contact with the humerus proximally. PMID:10679720

  10. Femoral neck non-union treatment by valgus intertrochanteric osteotomy

    PubMed Central

    Schwartsmann, Carlos Roberto; Spinelli, Leandro de Freitas; Yépez, Anthony Kerbes; Boschin, Leonardo Carbonera; Silva, Marcelo Faria

    2015-01-01

    ABSTRACT OBJECTIVE : The purpose of this study was to evaluate the performance of valgus intertrochanteric osteotomy in femoral neck non-union. METHODS : Forty-two patients with femoral neck fractures with non-union treated using Pauwels' intertrochanteric osteotomy were reviewed. Demographics, time elapsed between fracture and surgery, follow--up, osteosynthesis used, Garden's classification, limb shortening, and x-rays were evaluated. RESULTS : Twenty-two men and 20 women were reviewed. The youngest patient was 18 years old and the oldest 65 years old, with a mean age of 42.4 years (±11.2). The minimum follow-up was 2 years, with a mean of 10.2 years. The average time elapsed between initial fracture and osteotomy was 6.5 months. Twel-ve cases were neglected femoral neck fractures. Nineteen patients were classified as Garden III, and 23 patients as Garden IV. After valgus osteotomy, non-union healing was observed in 38 patients (38/42; 90.4%). Healing of thirty-seven cases of pseudoarthrosis were obtained after the first-attempt osteotomy, and one case required two operations for healing. The osteotomy failed in four cases. Conside-ring the healed osteotomies, good to excellent functional results were achieved in 80.9% (34/42) of the patients. Total hip replacement was subsequently performed in 14.2% (6/42) of the patients for unfavoura-ble outcomes (two for cutting out, two for osteonecrosis, and two for osteoarthritis). CONCLUSIONS : Valgus intertrochanteric osteotomy has a high success rate in archiving healing in femoral neck non-union with good functional results. It is a biological and effective method. Level of Evidence IV, Therapeutic Study. PMID:27057146

  11. [Lymphatic malformations in the head and neck area].

    PubMed

    Wiegand, S; Werner, J A

    2016-02-01

    Lymphatic malformations are congenital malformations of the lymphatic system. They are mainly located in the head and neck area, and grow proportional to the patients' body growth. Depending on the morphology, it can be distinguished between macrocystic, microcystic and mixed lymphatic malformations. Due to their infiltrative growth, microcystic lymphatic malformations are particularly difficult to treat. Therapeutic approaches include conventional surgical resection, laser therapy, sclerotherapy and systemic drug therapies. PMID:26820157

  12. Pediatric infectious disease: unusual head and neck infections.

    PubMed

    Moffett, Kathryn S

    2012-08-01

    Infections in children in the head and neck regions are common, leading to frequent use and overuse of antibiotics. This review includes common as well as diverse and unusual infectious diseases, such as PFAPA (Periodic Fever Aphthous stomatitis, Pharyngitis, Adenitis) syndrome, Lemierre Syndrome, Arcanobacterium infection, and tuberculous and nontuberculous adenitis, which occur in infants, children, and adolescents. In addition, the first pediatric vaccines available with the potential to prevent oropharyngeal cancers are reviewed. PMID:22739434

  13. Adjuvant Intraoperative Photodynamic Therapy in Head and Neck Cancer

    PubMed Central

    Rigual, Nestor R.; Shafirstein, Gal; Frustino, Jennifer; Seshadri, Mukund; Cooper, Michele; Wilding, Gregory; Sullivan, Maureen A.; Henderson, Barbara

    2015-01-01

    IMPORTANCE There is an immediate need to develop local intraoperative adjuvant treatment strategies to improve outcomes in patients with cancer who undergo head and neck surgery. OBJECTIVES To determine the safety of photodynamic therapy with 2-(1-hexyloxyethyl)-2-devinyl pyropheophorbide-a (HPPH) in combination with surgery in patients with head and neck squamous cell carcinoma. DESIGN, SETTING, AND PARTICIPANTS Nonrandomized, single-arm, single-site, phase 1 study at a comprehensive cancer center among 16 adult patients (median age, 65 years) with biopsy-proved primary or recurrent resectable head and neck squamous cell carcinoma. INTERVENTIONS Intravenous injection of HPPH (4.0 mg/m2), followed by activation with 665-nm laser light in the surgical bed immediately after tumor resection. MAIN OUTCOMES AND MEASURES Adverse events and highest laser light dose. RESULTS Fifteen patients received the full course of treatment, and 1 patient received HPPH without intraoperative laser light because of an unrelated myocardial infarction. Disease sites included larynx (7 patients), oral cavity (6 patients), skin (1 patient), ear canal (1 patient), and oropharynx (1 patient, who received HPPH only). The most frequent adverse events related to photodynamic therapy were mild to moderate edema (9 patients) and pain (3 patients). One patient developed a grade 3 fistula after salvage laryngectomy, and another patient developed a grade 3 wound infection and mandibular fracture. Phototoxicity reactions included 1 moderate photophobia and 2 mild to moderate skin burns (2 due to operating room spotlights and 1 due to the pulse oximeter). The highest laser light dose was 75 J/cm2. CONCLUSIONS AND RELEVANCE The adjuvant use of HPPH-photodynamic therapy and surgery for head and neck squamous cell carcinoma seems safe and deserves further study. PMID:23868427

  14. [Research, design and application of model NSE-1 neck muscle training machine for pilots].

    PubMed

    Cheng, Haiping; Wang, Zhijie; Liu, Songyang; Yang, Yi; Zhao, Guang; Cong, Hong; Han, Xueping; Liu, Min; Yu, Mengsun

    2011-04-01

    Pain in the cervical region of air force pilots, who are exposed to high G-forces, is a specifically occupational health problem. To minimize neck problems, the cervical muscles need specific strength exercise. It is important that the training for the neck must be carried out with optimal resistance in exercises. The model NSE-1 neck training machine for pilots was designed for neck strengthening exercises under safe and effective conditions. In order to realize the functions of changeable velocity and resistant (CVR) training and neck isometric contractive exercises, the techniques of adaptive hydraulics, sensor, optic and auditory biological feedback, and signal processing were applied to this machine. The training system mainly consists of mechanical parts (including the chair of flexion and extension, the chair of right and left lateral flexion, the components of hydraulics and torque transformer, etc.), and the software of signal processing and biological feedback. Eleven volunteers were selected for the experiments of neck isometric contractive exercises, three times a week for 6 weeks, where CVR training (flexion, extension, right, left lateral flexion) one time a week. The increase in relative strength of the neck (flexion, extension, left and right lateral flexion) was 70.8%, 83.7%, 78.6% and 75.2%, respectively after training. Results show that the strength of the neck can be increased safely, effectively and rapidly with NSE-1 neck training machine to perform neck training. PMID:21604507

  15. Pancreaticogastrostomy: a salvage procedure for pancreatic body and neck resection.

    PubMed

    Li, Ang; Prasoon, Pankaj; Hong, Wu; Lu, Hui Min; Zhang, Zhao Da; Zhaoda, Zhang

    2012-11-01

    The purpose of this analysis was to evaluate the technological viability, basic safety and consequence of central pancreatectomy (CP) with pancreaticogastrostomy in properly chosen sufferers with noncancerous central pancreatic pathology. This research is centered on the infirmary charts of West China hospital. We recruited 20 individuals from 2007 to 2009 diagnosed with benign cancerous growth of pancreatic body and neck. They underwent pancreatic body and neck resection adhering to pancreaticogastrostomy. We carried out central pancreatectomy following pancreaticogastrostomy in 20 patients: 8 with serous cyst adenomas, 11 with mucinous cystadenomas, and 1 with neuroendocrine tumor. The position of all tumors was restricted to body and neck of the pancreas, measuring a mean ± standard deviation of 2.6±1.3cm. The mean post-operative hospital stay was 7 days (ranging from 6 to 16 days).There was no intraoperative additional complications. From a technical perspective, CP is a safe and sound, pancreas-preserving pancreatectomy for non-enucleable non-cancerous pancreatic pathology restricted to the pancreatic body. PMID:23396710

  16. Update on primary head and neck mucosal melanoma.

    PubMed

    López, Fernando; Rodrigo, Juan P; Cardesa, Antonio; Triantafyllou, Asterios; Devaney, Kenneth O; Mendenhall, William M; Haigentz, Missak; Strojan, Primož; Pellitteri, Phillip K; Bradford, Carol R; Shaha, Ashok R; Hunt, Jennifer L; de Bree, Remco; Takes, Robert P; Rinaldo, Alessandra; Ferlito, Alfio

    2016-01-01

    Primary mucosal melanomas (PMMs) of the head and neck are uncommon malignancies that arise mainly in the nasal cavity and paranasal sinuses, followed by the oral cavity. The mainstay of treatment is radical surgical resection followed by adjuvant radiotherapy in selected patients with high-risk features. Multimodality therapy has not been well studied and is not standardized. Adjuvant radiotherapy seems to improve locoregional control but does not improve overall survival (OS). Elective neck dissection is advocated in patients with oral PMM. Systemic therapy should be considered only for patients with metastatic or unresectable locoregional disease. Despite improvements in the field of surgery, radiotherapy, and systemic therapy, patients with PMM still face a very unfavorable prognosis (5-year disease-free survival [DFS] <20%) with high rates of locoregional recurrence and distant metastasis. The present review aims to summarize the current state of knowledge on the molecular biology, pathological diagnosis, and management of this disease. © 2015 Wiley Periodicals, Inc. Head Neck 38: 147-155, 2016. PMID:25242350

  17. Bioimpedance vector pattern in head and neck squamous cell carcinoma.

    PubMed

    Malecka-Massalska, T; Smolen, A; Zubrzycki, J; Lupa-Zatwarnicka, K; Morshed, K

    2012-02-01

    Direct bioimpedance measures (resistance, reactance, phase angle (PA)) determined by bioelectrical impedance analysis (BIA) detect changes in tissue electrical properties. The study was conducted to evaluate soft tissue hydration and mass through pattern analysis of vector plots as height, normalized resistance, and reactance measurements by bioelectric impedance vector analysis in patients with head and neck cancer. Whole-body measurements were made with ImpediMed bioimpedance analysis in 56 adult, white, male subjects 42 to 79 years old: 28 patients with head and neck squamous cell carcinoma (H&NC) and 28 healthy volunteers matched by sex, age and BMI as a control group. All patients were previously untreated and without active nutritional interventions. Mean vectors of H&NC group vs. the control group were characterized by an increased normalized resistance component with a reduced reactance component (separate 95% confidence limits, P<0.05), indicating a decreased ionic conduction (dehydration) with loss of dielectric mass (cell membranes and tissue interfaces) of soft tissue. Monitoring vector displacement trajectory toward the reference target vector position may represent useful feedback in support therapy planning of individual patients before surgery in patients with head and neck cancer in order to reduce post-operational complications. PMID:22460467

  18. Nonsurgical treatment of aggressive fibromatosis in the head and neck

    SciTech Connect

    West, C.B. Jr.; Shagets, F.W.; Mansfield, M.J. )

    1989-09-01

    Aggressive fibromatosis is a poorly defined, locally aggressive, yet histologically benign fibroblastic proliferative lesion that may occur in the head and neck. The lesion is highly cellular and locally infiltrative and has a propensity to invade and erode bone, compromising vital structures within the head and neck. However, it is not a true malignancy because it does not have malignant cytologic characteristics nor does it metastasize. We present two cases of aggressive fibromatosis occurring in young adult men. The first case involved a rapidly enlarging mass of the anterior maxilla that involved the upper lip, nasal alae, nasal septum, inferior turbinates, and hard palate. The patient underwent incisional biopsy to confirm the diagnosis. Because of difficulty in determining the actual margins of this extensive lesion and the significant morbidity that would have resulted from surgical resection, we elected to treat this patient with chemotherapy and radiation therapy. The second case was an extensive lesion involving the right temporal bone, pterygomaxillary space, and infratemporal, temporal, and middle cranial fossae. Incisional biopsy confirmed the diagnosis. Because of the lack of functional and cosmetic deficits and the unavoidable morbidity of a surgical resection, this patient was treated with radiation therapy. Although wide field resection is the most satisfactory form of treatment, in situations in which this modality would result in unacceptable morbidity or if surgical margins are positive, then radiation therapy and chemotherapy should be considered. Support for these therapeutic modalities is found in larger series of cases outside the head and neck.

  19. Advances in Radiotherapy for Head and Neck Cancer.

    PubMed

    Grégoire, Vincent; Langendijk, Johannes A; Nuyts, Sandra

    2015-10-10

    Over the last few decades, significant improvements have been made in the radiotherapy (RT) treatment of head and neck malignancies. The progressive introduction of intensity-modulated RT and the use of multimodality imaging for target volume and organs at risk delineation, together with the use of altered fractionation regimens and concomitant administration of chemotherapy or targeted agents, have accompanied efficacy improvements in RT. Altogether, such improvements have translated into improvement in locoregional control and overall survival probability, with a decrease in the long-term adverse effects of RT and an improvement in quality of life. Further progress in the treatment of head and neck malignancies may come from a better integration of molecular imaging to identify tumor subvolumes that may require additional radiation doses (ie, dose painting) and from treatment adaptation tracing changes in patient anatomy during treatment. Proton therapy generates even more exquisite dose distribution in some patients, thus potentially further improving patient outcomes. However, the clinical benefit of these approaches, although promising, for patients with head and neck cancer need to be demonstrated in prospective randomized studies. In this context, our article will review some of these advances, with special emphasis on target volume and organ-at-risk delineation, use of molecular imaging for tumor delineation, dose painting for dose escalation, dose adaptation throughout treatment, and potential benefit of proton therapy. PMID:26351354

  20. Head and Neck Sarcomas: A Comprehensive Cancer Center Experience

    PubMed Central

    Tejani, Mohamedtaki A.; Galloway, Thomas J.; Lango, Miriam; Ridge, John A.; von Mehren, Margaret

    2013-01-01

    Head/neck sarcomas are rare, accounting for about 1% of head/neck malignancies and 5% of sarcomas. Outcomes have historically been worse in this group, due to anatomic constraints leading to difficulty in completely excising tumors, with high rates of local recurrence. We retrospectively analyzed cases of head/neck soft tissue sarcomas (STS) and osteogenic sarcomas managed in a multi-disciplinary setting at Fox Chase Cancer Center from 1999–2009 to describe clinicopathologic characteristics, treatment, outcomes, and prognostic factors for disease control and survival. Thirty patients with STS and seven patients with osteogenic sarcoma were identified. Most STS were high grade (23) and almost all were localized at presentation (28). Common histologies were synovial cell (6), rhabdomyosarcoma (5), angiosarcoma (4), liposarcoma (4) and leiomyosarcoma (3). The type of primary therapy and disease outcomes were analyzed. Cox proportional hazards regression analysis was performed to identify predictors of disease-free survival (DFS) and overall survival (OS). The HR and 95% CI for Cox model and median DFS/OS analyzed by Kaplan-Meier curves were calculated. PMID:24202325

  1. The Role of Lymphedema Management in Head and Neck Cancer

    PubMed Central

    Smith, Brad G.; Lewin, Jan S.

    2014-01-01

    Purpose of review Head and neck lymphedema (HNL) is a common and often debilitating cancer treatment effect that is under-researched and ill defined. We examined current literature and reviewed historical treatment approaches. We propose a model for evaluation and treatment of HNL used at The University of Texas M. D. Anderson Cancer Center (MDACC) for patients with head and neck cancer (HNC). Recent findings Despite the morbidity associated with HNL in patients with HNC, to our knowledge, no article has been published within the past 18 months whose primary focus is HNL. Eight publications included HNL but only as a secondary focus related to treatment effect, risk of dysphagia, prognostic indicator of underlying disease, and quality of life. A potential benefit of Selenium treatment to reduce HNL was reported. Summary This article highlights the recent literature regarding HNL in patients treated for HNC. Although HNL is reported as a potential complication of HNC treatment, no clear definition of the disease or its management are published. Our early experience using an objective evaluation and treatment protocol holds promise for a better understanding of HNL in patients treated for head and neck malignancy. PMID:20463478

  2. Extracranial non-vestibular head and neck schwannomas

    PubMed Central

    Wang, Baoxin; Yuan, Junjie; Chen, Xinwei; Xu, Hongming; Zhou, Yuan; Dong, Pin

    2015-01-01

    Objectives: To retrospectively describe our 10-year experience with extracranial non-vestibular head and neck schwannomas by presenting their clinical features, diagnostic methods, surgical decisions, and treatment outcomes. Methods: This is a retrospective study conducted at the Department of Otolaryngology, Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Shanghai First People’s Hospital, Shanghai, China. The medical records of 46 patients diagnosed with schwannoma in the extracranial head and neck region as confirmed on paraffin-embedded sections from January 2003 to December 2012 were reviewed. Results: All tumors were benign, and 52% presented as asymptomatic palpable solitary masses. Compressive symptoms, which can represent meaningful indicators of the nerve of origin were commonly noted. The most common nerve of origin was the brachial plexus (n=13, 28.3%). Conclusion: While postoperative histopathologic examination is still the gold standard, fine needle aspiration cytology, CT scan, and magnetic resonance imaging may be useful in the diagnosis of schwannomas. As schwannomas are radioresistant, and as, despite their benign nature, can cause severe secondary symptoms, the best treatment of choice is complete excision with preservation of functions. PMID:26593174

  3. Bone impregnated hip screw in femoral neck fracture: Clinicoradiological results

    PubMed Central

    Sundar Raj, PK; Nuuman, Jiju A; Pattathil, Amish Sunder

    2015-01-01

    Background: Femoral neck fractures are treated either by internal fixation or arthroplasty. Usually, cannulated cancellous screws are used for osteosynthesis of fracture neck of femur. The bone impregnated hip screw (BIHS) is an alternative implant, where osteosyntehsis is required in femoral neck fracture. Materials and Methods: The BIHS is a hollow screw with thread diameter 8.3 mm, shank diameter 6.5 mm and wall thickness 2.2 mm and holes in the shaft of the screw with diameter 2 mm, placed in a staggered fashion. Biomechanical and animal experimental studies were done. Clinical study was done in two phases: Phase 1 in a group of volunteers, only with BIHS was used in a pilot study and phase 2 comparative study was done in a group with AO cannulated screws and the other group treated with BIHS. Results: In the phase 1 study, out of 15 patients, only one patient had delayed union. In phase 2, there were 78 patients, 44 patients in BIHS showed early union, compared to the rest 34 cases of AO cannulated screws Out of 44 patients with BIHS, 41 patients had an excellent outcome, 2 had nonunions and one implant breakage was noted. Conclusions: Bone impregnated hip screw has shown to provide early solid union since it incorporates the biomechanical principles and also increases the osteogenic potential and hence, found superior to conventional cannulated cancellous screw. PMID:26015608

  4. Radiotherapy in nonlentiginous melanoma of the head and neck

    SciTech Connect

    Harwood, A.R.; Dancuart, I.; Fitzpatrick, P.J.; Brown, T.

    1981-12-15

    Thirty-seven patients with superficial spreading or nodular melanoma of the head and neck treated with irradiation are reviewed. Twenty-one patients were referred within three months of surgery. Six had an incisional biopsy followed by postoperative irradiation, 4 were locally controlled (1 dying of metastatic melanoma, 2 dying of intercurrent disease and 1 is alive and well), and 2 were not (both dead of melanoma). Fifteen patients had a local excisional biopsy (11 having tumor to the limits of the excision) followed by postoperative irradiation. Fourteen of the 15 had local control (3 had lymph node metastases and died, 3 died of distant metastases from melanoma, 7 are alive and well from 1-14 years following treatment, and one is dead of intercurrent disease), and 1 had a local recurrence and subsequently died of metastatic melanoma. Sixteen patients were irradiated for local and/or regionally recurrent disease following unsuccessful surgery, and only two were successfully controlled by irradiation and are alive and well at four and five years, respectively. Local control was 70% when a dose per fraction of greater than 400 rads was used, compared with 25% when a dose per fraction of less than 400 rads was used. It is concluded that nonlentiginous melanoma of the head and neck is not a radioresistant tumor and that local excision followed by high dose per fraction radiotherapy deserves further study in the management of melanomas of the head and neck.

  5. American Cancer Society Head and Neck Cancer Survivorship Care Guideline.

    PubMed

    Cohen, Ezra E W; LaMonte, Samuel J; Erb, Nicole L; Beckman, Kerry L; Sadeghi, Nader; Hutcheson, Katherine A; Stubblefield, Michael D; Abbott, Dennis M; Fisher, Penelope S; Stein, Kevin D; Lyman, Gary H; Pratt-Chapman, Mandi L

    2016-05-01

    Answer questions and earn CME/CNE The American Cancer Society Head and Neck Cancer Survivorship Care Guideline was developed to assist primary care clinicians and other health practitioners with the care of head and neck cancer survivors, including monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. A systematic review of the literature was conducted using PubMed through April 2015, and a multidisciplinary expert workgroup with expertise in primary care, dentistry, surgical oncology, medical oncology, radiation oncology, clinical psychology, speech-language pathology, physical medicine and rehabilitation, the patient perspective, and nursing was assembled. While the guideline is based on a systematic review of the current literature, most evidence is not sufficient to warrant a strong recommendation. Therefore, recommendations should be viewed as consensus-based management strategies for assisting patients with physical and psychosocial effects of head and neck cancer and its treatment. CA Cancer J Clin 2016;66:203-239. © 2016 American Cancer Society. PMID:27002678

  6. Identifying the Best Treatment Among Common Nonsurgical Neck Pain Treatments

    PubMed Central

    Hogg-Johnson, Sheilah; Bayoumi, Ahmed M.; Cassidy, J. David; Côté, Pierre; Boyle, Eleanor; Llewellyn-Thomas, Hilary; Chan, Stella; Subrata, Peter; Hoving, Jan Lucas; Hurwitz, Eric; Bombardier, Claire; Krahn, Murray

    2008-01-01

    Study Design Decision analysis. Objective To identify the best treatment for nonspecific neck pain. Summary of Background Data In Canada and the United States, the most commonly prescribed neck pain treatments are nonsteroidal anti-inflammatory drugs (NSAIDs), exercise, and manual therapy. Deciding which treatment is best is difficult because of the trade-offs between beneficial and harmful effects, and because of the uncertainty of these effects. Methods (Quality-adjusted) life expectancy associated with standard NSAIDs, Cox-2 NSAIDs, exercise, mobilization, and manipulation were compared in a decision-analytic model. Estimates of the course of neck pain, background risk of adverse events in the general population, treatment effectiveness and risk, and patient-preferences were input into the model. Assuming equal effectiveness, we conducted a baseline analysis using risk of harm only. We assessed the stability of the baseline results by conducting a second analysis that incorporated effectiveness data from a high-quality randomized trial. Results There were no important differences across treatments. The difference between the highest and lowest ranked treatments predicted by the baseline model was 4.5 days of life expectancy and 3.4 quality-adjusted life-days. The difference between the highest and lowest ranked treatments predicted by the second model was 7.3 quality-adjusted life-days. Conclusion When the objective is to maximize life expectancy and quality-adjusted life expectancy, none of the treatments in our analysis were clearly superior.

  7. Nonunion of fractures of the femoral neck in children.

    PubMed

    Neto, Pedro F Tucci; Dos Reis, Fernando Baldy; Filho, José Laredo; Fernandes, Helio J A; Fujiki, Edison Noboru; Bensahel, Henri; Milani, Carlo

    2008-03-01

    The authors present the prospective clinical outcome of nine pseudoarthroses resulting from surgical treatment carried out in nine children, whose ages varied from 6 years and 2 months to 14 years and 2 months (mean 10 years and 2 months), who had fractures of the femoral neck. Five were classified as type II, according to the Delbet classification modified by Colonna, and four were type III. The initial fractures were caused by high-energy traumas, such as trampling, bicycle falls, and car accidents. Treatment of choice was valgus osteotomy of the femoral neck associated or not with insertion of bony graft. The mean time of follow-up was 38 months, ranging from 23 to 71 months, and the mean time of pseudoarthrosis consolidation after osteotomy was 76.6 days, varying from 45 to 240 days. In this study, all the pseudoarthroses consolidated. For final analysis of clinical and radiographic results, the Ratliff's classification was used. We obtained three cases as good results, five as fair and one as poor. The authors concluded that valgus osteotomy is a good option for treatment of pseudoarthrosis in the femoral neck fractures in children. PMID:19308588

  8. Why does necking ignore notches in dynamic tension?

    NASA Astrophysics Data System (ADS)

    Rotbaum, Y.; Osovski, S.; Rittel, D.

    2015-05-01

    Recent experimental work has revealed that notched tensile specimens, subjected to dynamic loading, may fail by growing a neck outside of the notched region. This apparent lack of sensitivity to a classical stress concentration case was reported but not explained or modeled. The present paper combines experimental and numerical work to address this issue. Specifically, it is shown that the dynamic tensile failure locus is dictated by both the applied velocity boundary condition and the material mechanical properties, specifically strain-rate sensitivity and strain-rate hardening. It is shown that at sufficiently high impact velocities, the flows stress in the notch vicinity becomes quite higher than in the rest of the specimen, so that while the former resists deformation, it transfers the load to the latter. The result will be the formation of a local neck and failure away from the notch. This effect is shown to be active when the material properties are perturbed only at the local level, as in the case of machining of the notch, which in itself may again be sufficient to stabilize the structure under local failure until a neck forms elsewhere. While the physical observations are quite counterintuitive with respect to the engineering views of stress concentrator's effect, the present work rationalizes those observations and also provides information for the designers of dynamically tensioned structures that may contain notches or similar flaws.

  9. Updated overview of current biomarkers in head and neck carcinoma.

    PubMed

    Dahiya, Kiran; Dhankhar, Rakesh

    2016-03-26

    Squamous cell cancer is the most common type of malignancy arising from the epithelial cells of the head and neck region. Head and neck squamous cell carcinoma (HNSCC) is one of the predominant causes of cancer related casualties worldwide. Overall prognosis in this disease has improved to some extent with the advancements in therapeutic modalities but detection of primary tumor at its initial stage and prevention of relapse are the major targets to be achieved for further improvement in terms of survival rate of patients. Latest achievements in basic research regarding molecular characterization of the disease has helped in better perception of the molecular mechanisms involved in HNSCC progression and also in recognizing and targeting various molecular biomarkers associated with HNSCC. In the present article, we review the information regarding latest and potential biomarkers for the early detection of HNSCC. A detailed molecular characterization, ultimately, is likely to improve the development of new therapeutic strategies, potentially relevant to diagnosis and prognosis of head and neck cancers. The need for more accurate and timely disease prediction has generated enormous research interests in this field. PMID:27018324

  10. Ruxolitinib Associated Tuberculosis Presenting as a Neck Lump

    PubMed Central

    Shamil, Eamon; Cunningham, David; Wong, Billy L. K.; Jani, Piyush

    2015-01-01

    Tuberculosis is an opportunistic infection with protean clinical manifestations. We describe a case of Ruxolitinib induced miliary tuberculosis presenting as a neck lump. A 78-year-old female presented with a two-month history of right-sided neck lump associated with fever, night sweats, and significant weight loss. She had a past medical history that included myelofibrosis, being treated with Ruxolitinib. Examination demonstrated 4 × 4 cm right-sided cervical lymphadenopathy. A chest radiograph showed extensive shadowing in both lungs. CT scan demonstrated perilymphatic nodes in addition to the cervical mass. An ultrasound-guided biopsy of a cervical lymph node demonstrated confirmed Mycobacterium tuberculosis infection. It was hypothesized that use of Ruxolitinib through its selective inhibition of Janus-activated kinases 1 and 2 resulted in immunosuppression and miliary tuberculosis in this patient. The medication was stopped and a 12-month regime of antituberculosis therapy commenced. She remained well at one-year follow-up with resolution of lung involvement. Clinicians should consider tuberculosis as a differential diagnosis for patients presenting with a neck lump, particularly in those taking immunosuppressant medication such as Ruxolitinib. A multidisciplinary approach is needed to promptly treat the tuberculosis and consider discontinuation of Ruxolitinib. PMID:26788384

  11. Status quo and directions in deep head and neck hyperthermia.

    PubMed

    Paulides, Margarethus M; Verduijn, Gerda M; Van Holthe, Netteke

    2016-01-01

    The benefit of hyperthermia as a potent modifier of radiotherapy has been well established and more recently also the combination with chemotherapy was shown beneficial. Also for head and neck cancer, the impact of hyperthermia has been clinically demonstrated by a number of clinical trials. Unfortunately, the technology applied in these studies provided only limited thermal dose control, and the devices used only allowed treatment of target regions close to the skin. Over the last decade, we developed the technology for deep and controlled hyperthermia that allows treatment of the entire head and neck region. Our strategy involves focused microwave heating combined with 3D patient-specific electromagnetic and thermal simulations for conformal, reproducible and adaptive hyperthermia application. Validation of our strategy has been performed by 3D thermal dose assessment based on invasively placed temperature sensors combined with the 3D patient specific simulations. In this paper, we review the phase III clinical evidence for hyperthermia in head and neck tumors, as well as the heating and dosimetry technology applied in these studies. Next, we describe the development, clinical implementation and validation of 3D guided deep hyperthermia with the HYPERcollar, and its second generation, i.e. the HYPERcollar3D. Lastly, we discuss early clinical results and provide an outlook for this technology. PMID:26868027

  12. Management of femoral neck fractures in young adults

    PubMed Central

    Ly, Thuan V; Swiontkowski, Marc F

    2008-01-01

    Femoral neck fractures in young adults are uncommon and often the result of high-energy trauma. They are associated with higher incidences of femoral head osteonecrosis and nonunion. Multiple factors can play a significant role in preventing these devastating complications and contribute to a good outcome. While achieving an anatomic reduction and stable internal fixation are imperative, other treatment variables, such as time to surgery, the role of capsulotomy and the fixation methods remain debatable. Open reduction and internal fixation through a Watson-Jones exposure is the recommended approach. Definitive fixation can be accomplished with three cannulated or noncannulated cancellous screws. Capsulotomy in femoral neck fractures remains a controversial issue and the practice varies by trauma program, region and country. Until there is conclusive data (i.e. prospective and controlled) we recommend performing a capsulotomy. The data available is inconclusive on whether this fracture should be operated emergently, urgently or can wait until the next day. Until there is conclusive data available, we recommend that surgery should be done on an urgent basis. The key factors in treating femoral neck fractures should include early diagnosis, early surgery, anatomic reduction, capsular decompression and stable internal fixation. PMID:19823648

  13. Observations of benefit finding in head and neck cancer patients.

    PubMed

    Cavell, Sandra; Broadbent, Elizabeth; Donkin, Liesje; Gear, Kim; Morton, Randall P

    2016-02-01

    The management of head and neck cancer (HNC) can lead to potentially severe physical, functional and psychological disturbances. As a result, many HNC patients develop symptoms of depression following diagnosis and treatment. Finding benefit in a disease and its treatment can reduce the symptoms of depression and enhance quality of life (QOL). 92 patients from the Head and Neck Cancer Clinic at Auckland Hospital completed measures of unmet needs and quality of life at diagnosis, and completed measures of benefit finding, coping, fear of recurrence and depression 12-18 months later. Patients reported at least moderate benefit finding in the majority of areas. More benefit finding was predicted by the presence of more advanced disease, Maori/Pacific Island ethnicity, lower baseline QOL, and the use of active coping strategies. These findings support the view that screening for QOL at diagnosis and facilitating the development of coping skills may lead to improved benefit finding and psychological adjustment in people with head and neck cancer. Identification of the factors that facilitate benefit finding may assist management of patients after treatment for HNC. PMID:25634065

  14. Complications of sclerotherapy for 75 head and neck venous malformations.

    PubMed

    Castrén, Eeva; Aronniemi, Johanna; Klockars, Tuomas; Pekkola, Johanna; Lappalainen, Kimmo; Vuola, Pia; Salminen, Päivi; Pitkäranta, Anne

    2016-04-01

    Sclerotherapy is one treatment option for head and neck venous malformations (VMs). Evaluation of complication risks is, however, essential to improve its safety. We aimed to systematically report sclerotherapy complications by means of the Clavien-Dindo classification and to distinguish factors predisposing to complications. We identified our institution's head and neck VM patients who received sclerotherapy between 1 January 2007 and 31 August 2013, analyzed patient reports retrospectively, and applied to them the Clavien-Dindo classification. Our 75 VM patients underwent a total of 150 sclerotherapy sessions. The most common sclerosants were 3 % sodium tetradecyl sulfate and polidocanol. Complications occurred in 13 patients (17.3 %) and in 15 sessions (10.0 %); 3 complications required extensive postprocedural treatment and caused permanent morbidity, whereas 12 received conservative treatment. Patients with sclerotherapy complications underwent more treatments (p = 0.009) and more often needed further surgery (p = 0.007). We thus consider sclerotherapy a relatively safe treatment modality for head and neck VMs. To avoid complications, evaluation of VM characteristics and optimal treatment technique in a multidisciplinary team is vital. PMID:25731642

  15. Pancreaticogastrostomy: A Salvage Procedure for Pancreatic Body and Neck Resection

    PubMed Central

    Li, Ang; Prasoon, Pankaj; Hong, Wu; Lu, Hui Min; Zhang, Zhao Da; Zhaoda, Zhang

    2012-01-01

    Abstract The purpose of this analysis was to evaluate the technological viability, basic safety and consequence of central pancreatectomy (CP) with pancreaticogastrostomy in properly chosen sufferers with noncancerous central pancreatic pathology. This research is centered on the infirmary charts of West China hospital. We recruited 20 individuals from 2007 to 2009 diagnosed with benign cancerous growth of pancreatic body and neck. They underwent pancreatic body and neck resection adhering to pancreaticogastrostomy. We carried out central pancreatectomy following pancreaticogastrostomy in 20 patients: 8 with serous cyst adenomas, 11 with mucinous cystadenomas, and 1 with neuroendocrine tumor. The position of all tumors was restricted to body and neck of the pancreas, measuring a mean standard deviation of 2.61.3cm. The mean post-operative hospital stay was 7 days (ranging from 6 to 16 days).There was no intraoperative additional complications. From a technical perspective, CP is a safe and sound, pancreas-preserving pancreatectomy for non-enucleable non-cancerous pancreatic pathology restricted to the pancreatic body. PMID:23396710

  16. Peripheral glutamate signaling in head and neck areas.

    PubMed

    Haas, Helga Susanne; Linecker, Alexander; Pfragner, Roswitha; Sadjak, Anton

    2010-11-01

    The major excitatory neurotransmitter glutamate is also found in the periphery in an increasing number of nonexcitable cells. In line with this it became apparent that glutamate can regulate a broad array of peripheral biological responses, as well. Of particular interest is the discovery that glutamate receptor reactive reagents can influence tumor biology. However, the knowledge of glutamate signaling in peripheral tissues is still incomplete and, in the case of head and neck areas, is almost lacking. The roles of glutamate signaling pathways in these regions are manifold and include orofacial pain, periodontal bone production, skin and airway inflammation, as well as salivation. Furthermore, the interrelations between glutamate and cancers in the oral cavity, thyroid gland, and other regions are discussed. In summary, this review shall strengthen the view that glutamate receptor reagents may also be promising targets for novel therapeutic concepts suitable for a number of diseases in peripheral tissues. The contents of this review cover the following sections: Introduction; The "Glutamate System"; The Taste of Glutamate; Glutamate Signaling in Dental Regions; Glutamate Signaling in Head and Neck Areas; Glutamate Signaling in Head and Neck Cancer; A Brief Overview of Glutamate Signaling in Other Cancers; and Conclusion. PMID:20848447

  17. Updated overview of current biomarkers in head and neck carcinoma

    PubMed Central

    Dahiya, Kiran; Dhankhar, Rakesh

    2016-01-01

    Squamous cell cancer is the most common type of malignancy arising from the epithelial cells of the head and neck region. Head and neck squamous cell carcinoma (HNSCC) is one of the predominant causes of cancer related casualties worldwide. Overall prognosis in this disease has improved to some extent with the advancements in therapeutic modalities but detection of primary tumor at its initial stage and prevention of relapse are the major targets to be achieved for further improvement in terms of survival rate of patients. Latest achievements in basic research regarding molecular characterization of the disease has helped in better perception of the molecular mechanisms involved in HNSCC progression and also in recognizing and targeting various molecular biomarkers associated with HNSCC. In the present article, we review the information regarding latest and potential biomarkers for the early detection of HNSCC. A detailed molecular characterization, ultimately, is likely to improve the development of new therapeutic strategies, potentially relevant to diagnosis and prognosis of head and neck cancers. The need for more accurate and timely disease prediction has generated enormous research interests in this field. PMID:27018324

  18. Cervicogenic headache: evidence that the neck is a pain generator.

    PubMed

    Becker, Werner J

    2010-04-01

    This review was developed as part of a debate, and takes the "pro" stance that abnormalities of structures in the neck can be a significant source of headache. The argument for this is developed from a review of the medical literature, and is made in 5 steps. It is clear that the cervical region contains many pain-sensitive structures, and that these are prone to injury. The anatomical and physiological mechanisms are in place to allow referral of pain to the head including frontal head regions and even the orbit in patients with pain originating from many of these neck structures. Clinical studies have shown that pain from cervical spine structures can in fact be referred to the head. Finally, clinical treatment trials involving patients with proven painful disorders of upper cervical zygapophysial joints have shown significant headache relief with treatment directed at cervical pain generators. In conclusion, painful disorders of the neck can give rise to headache, and the challenge is to identify these patients and treat them successfully. PMID:20456156

  19. WE-E-BRE-09: Investigation of the Association Between Radiation-Induced Pain and Radiation Dose in Head and Neck Cancer Patients

    SciTech Connect

    Gay, H; Dyk, P; Mullen, D; Eschen, L; Fergus, S; Chin, R; Thorstad, W; Oh, J; Apte, A; Deasy, J

    2014-06-15

    Purpose: Patients with head and neck cancer who undergo radiotherapy often experience several undesirable side-effects, including xerostomia, trismus, and pain in the head and neck area, but little is know about the dose-volume predictors of such pain. We investigated the association between radiation dose and both throat and esophagus pain during radiotherapy. Methods: We analyzed 124 head and neck patients who received radiotherapy at the Washington University School of Medicine in Saint Louis. For these patients, weekly PROs were recorded, including 16 pain and anatomical location questions. In addition, 17 observational symptoms were recorded. Patients were asked to describe their pain at each site according to a four-level scale: none (0), mild (1), moderate (2), and severe (3). We explored the association between throat pain and the mean dose received in oral cavity and between esophageal pain and the mean dose received in the esophagus. The severity of pain was determined by the difference between the baseline (week 1) pain score and the maximum pain score during treatment. The baseline pain score was defined as the first available pain score before receiving 10 Gy because radiotherapy pain originates later during treatment. Dose-volume metrics were extracted from treatment plans using CERR. To evaluate the correlation between pain and radiation dose, Spearman's correlation coefficient (Rs) was used. Results: The associations between throat pain and the mean dose to the oral cavity, and between esophagus pain and the mean dose to the esophagus, were both statistically significant, with Rs=0.320 (p=0.003) and Rs=0.424 (p<0.0001), respectively. Mean dose, for each structure, was a better predictor of pain than total integral dose. Conclusion: We demonstrated that pain during radiotherapy in head and neck patients highly correlates with the dose delivered. We will further investigate the association between other pain locations and relevant normal tissue dose characteristics.

  20. Heterogeneity of the proliferative fraction and cyclin D1/CCND1 gene amplification in head and neck squamous cell carcinoma

    SciTech Connect

    El-Naggar, A.K.; Steck, K.; Batsakis, J.G.

    1995-09-01

    High proliferative fraction and cyclin D1/CCND1 gene amplification have been associated with certain aggressive features of head and neck squamous carcinoma in some studies, but not in others. The differences may be related to the intratumoral heterogeneity of these factors. Moreover, the interrelationship between these seemingly related factors has not been determined. In order to determine the correlation between tumor proliferative fractions and CCND1 gene amplification, 3 spatially different samples from each of 32 primary head and neck squamous cell carcinomas (RNSCC) were separately analyzed by flow cytometry. A mixture of these specimens was also minced and snap frozen for molecular studies. DNA was extracted from patient lymphocytes, normal appearing squamous epithelium, and tumors. A genomic DNA probe containing the first exon of CCND1 was used for hybridization by Southern technique. A 5.6 kb genomic DNA probe of immunoglobulin heavy chain was used as an internal standard for quantification of CCND1 gene amplification. Our results showed that 30% of the tumor cases manifested intratumoral heterogeneity (>50% differences) of their proliferative activity. The highest value was used for correlation with gene amplification. Eleven (34.4%) of the 32 tumors showed CCND1 amplification (2-10-fold). When the proliferative fraction was dichotomized into high and low groups based on the mean value ({ge}13%), a highly statistical correlation between CCND1 amplification and tumor proliferation was obtained (P < 0.001). No significant correlation between gene amplification and other clinicopathologic parameters was noted. Our study indicates that (1) intratumoral heterogeneity of the proliferative fraction is a feature of HNSCC and (2) CCND1 gene amplification correlates significantly with high proliferation and may be associated with the tumorigenesis of a subset of these neoplasms. 32 refs., 2 figs., 2 tabs.