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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. Correlation among scapular asymmetry, neck pain, and neck disability index (NDI) in young women with slight neck pain

    PubMed Central

    Kim, Su-Rim; Kang, Mi-Hee; Bahng, Sun-Young; An, Jin-Kyoung; Lee, Ji-Young; Park, Sang-Young; Kim, Seong-Gil

    2016-01-01

    [Purpose] This study aimed to investigate the correlations among scapular asymmetry, neck pain, and neck disability index in women in their 20s with slight neck pain. [Subjects and Methods] A total of 60 female students at U university in Gyeongsangbuk-do, South Korea, participated in this study. The lateral scapular slide test, which measures the distance between the thorax and scapula, was used to analyze the scapular asymmetry. The lateral scapular slide test was performed in three positions. The visual analogue scale and neck disability index were used to measure neck pain. [Results] In the lateral scapular slide test in position 3 (shoulder abduction at 90 degrees), the scapular left-right asymmetry and VAS showed a moderate positive linear relationship, with r=0.344. The VAS and NDI showed a moderate positive linear relationship, with r = 0.632. [Conclusion] Scapular asymmetry indicates imbalance of surrounding muscles of the scapula and is related to neck pain based on the results of measuring the distance from the thorax to the scapula. PMID:27313361

  3. 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.

  4. 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

  5. Correlation of corrosion and biomechanics in the retrieval of a single modular neck total hip arthroplasty design: modular neck total hip arthroplasty system.

    PubMed

    Lanting, Brent A; Teeter, Matthew G; Vasarhelyi, Edward M; Ivanov, Todor G; Howard, James L; Naudie, Douglas D R

    2015-01-01

    Increased modularity of total hip arthroplasty components has occurred, with theoretical advantages and disadvantages. Recent literature indicates the potential for elevated revision rates of modular neck systems and the potential for local pseudotumor and metallosis formation at the modular neck/stem site. Retrieval analysis of one modular neck implant design including SEM (SCANNING ELECTRON MICROSCOPY) assessment was done and correlated with FEA (finite element analysis) as well as clinical features of patient demographics, implant and laboratory analysis. Correlation of the consistent corrosion locations to FEA indicates that the material and design features of this system may result in a biomechanical reason for failure. The stem aspect of the modular neck/stem junction may be at particular risk. PMID:25060562

  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. Overexpression of neuromedin U is correlated with regional metastasis of head and neck squamous cell carcinoma.

    PubMed

    Wang, Lei; Chen, Chen; Li, Fen; Hua, Qing-Quan; Chen, Shiming; Xiao, Bokui; Dai, Mengyuan; Li, Man; Zheng, Anyuan; Yu, Di; Hu, Zhang Wei; Tao, Zezhang

    2016-08-01

    Regional metastasis is an important prognostic factor for patients with head and neck squamous cell carcinoma (HNSCC). Neuromedin U (Nmu) is a secreted neuropeptide, named due to its potent uterine contraction‑inducing activity. The aim of the present study was to analyze the significance of Nmu in the regional metastasis of HNSCC. The characteristics of 240 patients recruited from the Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University (Wuhan, China) were summarized retrospectively. The positive rate of neck dissection was analyzed according to the material. The expression levels of Nmu in human tumor samples were analyzed using immunohistochemistry. Subsequently, the expression of Nmu was investigated using a tissue microassay to analyze the association between Nmu protein expression and Tumor Node Metastasis (TNM) status. The positive rate of neck dissection was 51.4% in the study sample. The expression levels of Nmu in primary tumors with regional metastasis were higher, compared with those without metastasis. There was increased protein expression of Nmu in the advanced tumor tissues. The data obtained in the present study demonstrated that the expression of Nmu was correlated with regional metastasis and TNM status. Overexpression of Nmu may be involved in the process of regional metastasis of HNSCC, and may serve as a novel and valuable biomarker for predicting regional metastasis in patients with HNSCC. PMID:27279246

  9. Overexpression of neuromedin U is correlated with regional metastasis of head and neck squamous cell carcinoma

    PubMed Central

    Wang, Lei; Chen, Chen; Li, Fen; Hua, Qing-Quan; Chen, Shiming; Xiao, Bokui; Dai, Mengyuan; Li, Man; Zheng, Anyuan; Yu, Di; Hu, Zhang Wei; Tao, Zezhang

    2016-01-01

    Regional metastasis is an important prognostic factor for patients with head and neck squamous cell carcinoma (HNSCC). Neuromedin U (Nmu) is a secreted neuropeptide, named due to its potent uterine contraction-inducing activity. The aim of the present study was to analyze the significance of Nmu in the regional metastasis of HNSCC. The characteristics of 240 patients recruited from the Department of Otolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University (Wuhan, China) were summarized retrospectively. The positive rate of neck dissection was analyzed according to the material. The expression levels of Nmu in human tumor samples were analyzed using immunohistochemistry. Subsequently, the expression of Nmu was investigated using a tissue microassay to analyze the association between Nmu protein expression and Tumor Node Metastasis (TNM) status. The positive rate of neck dissection was 51.4% in the study sample. The expression levels of Nmu in primary tumors with regional metastasis were higher, compared with those without metastasis. There was increased protein expression of Nmu in the advanced tumor tissues. The data obtained in the present study demonstrated that the expression of Nmu was correlated with regional metastasis and TNM status. Overexpression of Nmu may be involved in the process of regional metastasis of HNSCC, and may serve as a novel and valuable biomarker for predicting regional metastasis in patients with HNSCC. PMID:27279246

  10. Lymphoma of the mediastinum and neck: Evaluation with Ga-67 imaging and CT correlation

    SciTech Connect

    Drossman, S.R.; Schiff, R.G.; Kronfeld, G.D.; McNamara, J.; Leonidas, J.C. )

    1990-01-01

    The role of gallium-67 in the differentiation between active disease and fibrotic changes in patients with childhood lymphoma involving the mediastinum and neck was evaluated prospectively. Ga-67 imaging and computed tomography (CT) were correlated with clinical findings at the time of initial presentation and follow-up in 19 patients. Both modalities enabled detection of active disease on all occasions, but CT results were false-positive for residual disease in 10 patients (53%), whereas Ga-67 imaging results were false-positive in only one patient (5%). Neither modality, however, proved accurate in patients with rebound thymic hyperplasia. Ga-67 imaging is a useful tool for assessing response to therapy in children with lymphoma of the mediastinum and neck.

  11. Differential biomarker expression in head and neck cancer correlates with anatomical localization.

    PubMed

    Tamás, László; Szentkúti, Gabriella; Eros, Mónika; Dános, Kornél; Brauswetter, Diána; Szende, Béla; Zsákovics, Ivett; Krenács, Tibor

    2011-09-01

    We tested the expression of known (p16(ink4), Ki67, p53, EGFR) and a new immunohistochemical (collagen XVII/BP180) biomarker in head and neck squamous cell carcinomas (SCC) of diverse anatomical localization. Tissue microarrays (TMA) of 124 SCC were created, immunostained, and analyzed following whole slide digitalization using the Pannoramic Scan and the TMA Module software (3DHISTECH Kft, Budapest, Hungary). Statistical analysis of scoring results was carried out using Pearson's chi-square test. We observed the significant elevation of p16(ink4) and Ki67 expression in supraglottic, tonsillar and tonsillo-lingual SCCs compared to those affecting the oral cavity, oropharynx without tonsils, larynx without supraglottis and the hypopharynx. This differential antigen expression may reflect the diverse route of embryologic differentiation followed by the affected regions except those of the tonsils and the supraglottis which show similar antigenic pattern but diverse developmental path. All the other biomarkers tested including p53, collagen XVII and EGFR were detected in the majority of cancers including high grade cases, but did not reveal any significant regional difference. Based on our results oropharyngeal squamous cell carcinomas may not be regarded as one entity. Concerning the oral cavity and the oropharynx, cancers affecting the tonsils (palatine and lingual) show significantly elevated p16(ink4) and Ki67 expression; so as the cancers of the supraglottis compared to the rest of larynx. Consequently, tonsillar and supraglottic cancers show similar biomarker profiles. Correlation of differential biomarker expression with diverse biological behavior in head and neck cancers need further investigations. PMID:21487776

  12. XPF expression correlates with clinical outcome in squamous cell carcinoma of the head and neck

    PubMed Central

    Vaezi, Alec; Wang, XiaoZhe; Buch, Shama; Gooding, William; Wang, Lin; Seethala, Raja R.; Weaver, David T.; D’Andrea, Alan D.; Argiris, Athanassios; Romkes, Marjorie; Niedernhofer, Laura J.; Grandis, Jennifer R.

    2011-01-01

    Purpose Tumor-specific biomarkers that predict resistance to DNA damaging agents may improve therapeutic outcomes by guiding the selection of effective therapies and limiting morbidity related to ineffective approaches. XPF (ERCC4) is an essential component of several DNA repair pathways and XPF-deficient cells are exquisitely sensitive to DNA damaging agents. The purpose of this study was to determine whether XPF expression levels predict clinical response to DNA damaging agents in head and neck squamous cell carcinoma (HNSCC). Experimental Design Quantitative immunohistochemistry was used to measure XPF expression in tumors from a cohort of 80 patients with newly diagnosed HNSCC treated with radiation therapy with or without platinum-based chemotherapy; samples were collected prospectively. Genomic DNA isolated from blood samples was analyzed for nine single nucleotide polymorphisms in the XPF gene using a custom array. The primary endpoint was progression-free survival (PFS). Results XPF expression was higher in tumors from the oral cavity than from the other sites (p<0.01). High XPF expression correlated with early time to progression both by univariate (HR =1.87, p=0.03) and multivariate analysis (HR =1.83, p=0.05). The one year PFS for high expressers was 47% (95% CI = 31% – 62%) compared to 72% (95% CI = 55% – 83%) for low expressers. In addition, we identified four XPF single nucleotide polymorphisms (SNPs) that demonstrated marginal association with treatment failure. Conclusions Expression level of XPF in HNSCC tumors correlates with clinical response to DNA damaging agents. XPF has potential to guide next-generation personalized cancer therapy. PMID:21737503

  13. Correlations between prognosis and regional biomarker profiles in head and neck squamous cell carcinomas.

    PubMed

    Szentkúti, Gabriella; Dános, Kornél; Brauswetter, Diána; Kiszner, Gergő; Krenács, Tibor; Csákó, László; Répássy, Gábor; Tamás, László

    2015-07-01

    Head and neck squamous cell carcinomas (HNSCC) show diverse clinicopathological features and are mostly linked with poor outcome. In this study, we tested if the expression of tumor growth, cell cycle and basement membrane anchorage related biomarkers allow prognostic and clinicopathological stratification of HNSCC. Archived HNSCC samples from 226 patients included into tissue microarrays (TMA) were tested using immunohistochemistry. Histopathological evaluation and the analysis of immunostaining for EGFR, Ki67, p53, p16(ink4) and Collagen XVII proteins were carried out in digital whole slides. Statistical evaluation was carried out using Pearson's Chi-square test and Kaplan-Meier survival analysis. In the tested cohort, hypopharyngeal cancers had the least favorable, and glottic cancers had the most favorable prognosis. High Ki67 positive tumor cell fractions were associated with significantly worse prognosis and elevated rate of lymph node metastasis. Both Ki67 and EGFR expression correlated significantly with the tumor localization. Ki67 index was the highest in the hypopharyngeal region and it proved to be the lowest in the glottic region. EGFR expression was the highest in the oral cavity and the lowest in the glottic region. The survival rate of patients with p16(ink4)-negative cancer was significantly lower than of those with p16(ink4)-positive disease. A significant inverse correlation was found between histological grade and the prognosis of HNSCC. Our data support that elevated Ki67 positive proliferating cell fractions contribute to the unfavorable prognosis of hypopharyngeal cancers, while glottic cancers have the most favorable prognosis because of the lowest Ki67 expression rate. PMID:25547827

  14. 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.

  15. 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

  16. Self-Reported Tobacco Use Does Not Correlate With Carcinogen Exposure in Smokers With Head and Neck Cancer

    PubMed Central

    Khariwala, Samir S.; Carmella, Steven G.; Stepanov, Irina; Bandyopadhyay, Dipankar; Nelson, Heather H.; Yueh, Bevan; Hatsukami, Dorothy K.; Hecht, Stephen S.

    2015-01-01

    Objectives/Hypothesis Head and neck squamous cell carcinoma (HNSCC) is strongly associated with tobacco use. We sought to examine the relationship between self-reported tobacco use and the level of urinary tobacco carcinogen metabolites in a cohort of patients with HNSCC. Study Design Cross-sectional analysis. Methods Eighty-four cigarette smokers with head and neck cancer completed tobacco and alcohol use questionnaires, and the following urinary tobacco metabolites were quantified: 1-hydroxypyrene (1-HOP), N′-nitrosonornicotine and its glucuronides (total NNN), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronides (total NNAL), and cotinine. A cross-sectional analysis was performed with assessment of correlation coefficients. Results When analyzed based on self-reported cigarettes per day (CPD), no significant correlation with any of the studied tobacco carcinogen metabolites was found. However, urinary cotinine showed significant correlation with total NNN, total NNAL, and 1-HOP. Total NNN, total NNAL, and 1-HOP showed significant correlation with each other suggesting exposure occurs to each proportionally. Conclusions In smokers with HNSCC, self-reported tobacco use does not predict actual carcinogen exposure. In contrast, urinary cotinine levels significantly correlate with carcinogen levels. Therefore, urinary cotinine is the preferred value for estimating carcinogen dose in these patients. 1-HOP levels were significantly associated with total NNN and total NNAL suggesting that smokers are exposed to these carcinogens proportionally. These data indicate that utilizing conventional methods of estimating tobacco exposure (CPD) may not accurately approximate exposure to tobacco carcinogens in smokers with HNSCC. These data have implications for future studies focused on screening and epidemiology of smokers with HNSCC. Level of Evidence NA PMID:25877866

  17. The Correlation between the Fracture Types and the Complications after Internal Fixation of the Femoral Neck Fractures

    PubMed Central

    Jo, Suenghwan; Lee, Hyeon Jun

    2016-01-01

    Purpose This study aims to determine the correlation between the fracture patterns and the complications in patients with femoral neck fracture treated with internal fixation. Materials and Methods The study comprises 45 patients with femoral neck fracture treated with multiple screws or compression hip screw between May 2008 and April 2012. The mean age was 48 years at the time of the surgery and the mean duration from initial injury to surgery was 20 hours. The fracture patterns were identified according to the anatomical location, the Garden classification and the Pauwels classification. The occurrence of nonunion and avascular necrosis were reviewed with clinical results including Harris hip score and Lunceford hip function test. The correlation between the fracture pattern and occurrence of complications were analyzed. Results Fracture site union was achieved in 40 hips with the average union time of 17 weeks. Five nonunions occurred which showed high likelihood to occur in subcapital type, displaced (Garden stage III or IV) and Pauwels type III fractures (P<0.05). Avascular necrosis was developed in 10 hips which was mostly in subcapital type and Pauwels type III fracture but no statistical significance was found (P>0.05). The mean Harris hip score was 91 points, and Lunceford functional results were excellent in 15 hips, good in 24, fair in 4 and poor in 2. Conclusion There was high risk of nonunion in subcapital type fracture, displaced fracture (Garden stage III and IV) and vertically oriented fracture (Pauwels type III). Careful attention is needed in these fracture types.

  18. 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

  19. p53 oncoprotein overexpression correlates with mutagen-induced chromosome fragility in head and neck cancer patients with multiple malignancies.

    PubMed Central

    Gallo, O.; Bianchi, S.; Giovannucci-Uzzielli, M. L.; Santoro, R.; Lenzi, S.; Salimbeni, C.; Abbruzzese, M.; Alajmo, E.

    1995-01-01

    In this study, we analysed immunocytochemically p53 expression in first primary and second primary cancers from 25 head and neck cancer patients (HNCPs) with multiple malignancies in comparison with oncoprotein expression in tumour tissues from 25 historical HNCP controls with single cancer in a match-paired analysis. Moreover, we investigated bleomycin-induced chromosome fragility in both groups of HNCPs and in 21 additional healthy controls. Thirty-nine out of 75 tumour specimens analysed (52%) showed positive p53 immunostaining. Eleven out of 25 (44%) from single cancer patients and 28 out of 50 (56%) tumours from HNCPs with multiple malignancies were p53 positive. In the group of multiple primary cancers, nine patients (36%) showed positive staining of both first and second primaries, whereas six (24%) had positive labelling of first primary cancer but not of the subsequent second primary, four (16%) patient showed p53 expression only in the second primary cancer and six (24%) patients showed no p53 immunoreactivity in both tumours. Chromosomal analysis demonstrated a higher sensitivity to clastogens of HNCPs with multiple tumours than of HNCPs with a single cancer (P < 0.01), and a significant correlation between chromosome fragility and p53 overexpression (P < 0.01) only in HNCPs with multiple malignancies more than in those with single head and neck cancer (P = 0.11). Moreover, we found that patients with p53-positive staining of both first and second primaries showed a statistically significant higher mutagen sensitivity than those with a single p53 immunoreactive tumour or those in whom both cancers were p53 negative (P < 0.01). Our data suggest that subjects with increased susceptibility to carcingogens after exposure to tobacco or alcohol are at higher risk for multiple cancers in which one of the most common genetic events is aberrant p53 expression. Images Figure 1 PMID:7734291

  20. 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

  1. Papanicolaou stain may not be necessary in majority of head and neck fine-needle aspirations: evidence from a correlation study between Diff-Quik-based onsite diagnosis and final diagnosis in 287 head and neck fine-needle aspirations.

    PubMed

    Wu, Maoxin; Idrees, Muhammad; Zhang, Zhengbin; Genden, Eric; Burstein, David E

    2010-11-01

    Fine-needle aspiration (FNA) is a useful tool for immediate assessment of palpable lesions, especially in the head and neck region. The objective of this study is to evaluate the degree of correlation between Diff-Quik-based onsite diagnosis (OD) and final diagnosis (FD) and further improve the efficiency of FNA practice. Two hundred and eighty-seven cytopathologist-performed FNAs from the head and neck region were evaluated. Number of passes, number and type of slides and correlation (agreement, modified final diagnosis and disagreement) between OD and FD were evaluated. Among 287 FNAs, the average number of passes per FNA case was 2 (range, 1-5&.rpar;). The mean number of slides reviewed per case was 5 including 2 Diff-Quik (D-Q)-stained slides, 2 Papanicolaou (Pap)-stained slides, and 1 cell block (CB)/1 cytospin (Cy). 247 of 287 (86%) cases showed agreement between OD and FD. FD on 36 out of 287 cases (12.5%) was slightly modified or refined after reviewing additional slides. A major diagnostic discrepancy was noted in four cases (1.5%), three of which were classified as squamous cell carcinoma on final diagnosis, and confirmed on surgical follow-up. Accurate diagnosis can be achieved in the majority (86%) of head and neck FNAs based on immediate examination of D-Q stained slides alone. In a small number of cases (12.5%), reviewing additional slides may refine the final diagnosis. In rare cases, especially cystic squamous lesions, Pap-stained slides appeared to be helpful. It is plausible to use D-Q-stained slides alone with most head and neck FNAs in order to provide more cost effective and efficient triaging and patient management. PMID:20301212

  2. The Activation Pattern of Blood Leukocytes in Head and Neck Squamous Cell Carcinoma Is Correlated to Survival

    PubMed Central

    Millrud, Camilla Rydberg; Månsson Kvarnhammar, Anne; Uddman, Rolf; Björnsson, Sven; Riesbeck, Kristian; Cardell, Lars Olaf

    2012-01-01

    Head and neck squamous cell carcinoma (HNSCC) is known to cause substantial immunosuppression. The present study was designed to characterize blood leukocyte activation in HNSCC and to investigate if the individual activation pattern could be related to tumor progress and survival. The leukocyte activation profile of HNSCC patients and healthy controls was assessed with flow cytometry. HNSCC patients displayed increased numbers of monocytes, neutrophils and total leukocytes as well as an enhanced neutrophil/lymphocyte ratio. In addition, patients had a higher percentage of CD69+, CD71+ and CD98+ T cell subsets and NK cells, and a reduced expression of L-selectin in CD14highCD16+ monocytes and neutrophils, when compared to controls. These changes could be correlated to both tumor burden and spread to lymph nodes. Among the cancer patients an increased neutrophil/lymphocyte ratio, a low neutrophil and CD14high CD16+ monocyte activation state and an elevated CD4/CD8 ratio were related to poor survival. In contrast, a high percentage of CD98+ Th cells appeared to be associated with a better outcome. Taken together, the present data indicate that HNSCC causes activation of blood leukocytes and that the individual activation pattern can be linked to prognosis. PMID:23251433

  3. Neck pain

    MedlinePlus

    ... Alternative Names Pain - neck; Neck stiffness; Cervicalgia; Whiplash Images Neck pain Whiplash Location of whiplash pain References ... pubmed/19272509 . Read More Diskectomy Foraminotomy Laminectomy Spinal fusion Patient Instructions Spine surgery - discharge Update Date 3/ ...

  4. Intravoxel Incoherent Motion MR Imaging in the Head and Neck: Correlation with Dynamic Contrast-Enhanced MR Imaging and Diffusion-Weighted Imaging

    PubMed Central

    Xu, Xiao Quan; Choi, Young Jun; Sung, Yu Sub; Yoon, Ra Gyoung; Jang, Seung Won; Park, Ji Eun; Heo, Young Jin; Baek, Jung Hwan

    2016-01-01

    Objective To investigate the correlation between perfusion- and diffusion-related parameters from intravoxel incoherent motion (IVIM) and those from dynamic contrast-enhanced MR imaging (DCE-MRI) and diffusion-weighted imaging in tumors and normal muscles of the head and neck. Materials and Methods We retrospectively enrolled 20 consecutive patients with head and neck tumors with MR imaging performed using a 3T MR scanner. Tissue diffusivity (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were derived from bi-exponential fitting of IVIM data obtained with 14 different b-values in three orthogonal directions. We investigated the correlation between D, f, and D* and model-free parameters from the DCE-MRI (wash-in, Tmax, Emax, initial AUC60, whole AUC) and the apparent diffusion coefficient (ADC) value in the tumor and normal masseter muscle using a whole volume-of-interest approach. Pearson's correlation test was used for statistical analysis. Results No correlation was found between f or D* and any of the parameters from the DCE-MRI in all patients or in patients with squamous cell carcinoma (p > 0.05). The ADC was significantly correlated with D values in the tumors (p < 0.001, r = 0.980) and muscles (p = 0.013, r = 0.542), despite its significantly higher value than D. The difference between ADC and D showed significant correlation with f values in the tumors (p = 0.017, r = 0.528) and muscles (p = 0.003, r = 0.630), but no correlation with D* (p > 0.05, respectively). Conclusion Intravoxel incoherent motion shows no significant correlation with model-free perfusion parameters derived from the DCE-MRI but is feasible for the analysis of diffusivity in both tumors and normal muscles of the head and neck. PMID:27587952

  5. 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

  6. Correlating Computed Tomography Perfusion Changes In The Pharyngeal Constrictor Muscles During Head-And-Neck Radiotherapy To Dysphagia Outcome

    PubMed Central

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

    2016-01-01

    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. PMID:21669502

  7. 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.

  8. Loss of Y-chromosome does not correlate with age at onset of head and neck carcinoma: a case-control study

    PubMed Central

    Silva Veiga, L.C.; Bérgamo, N.A.; Reis, P.P.; Kowalski, L.P.; Rogatto, S.R.

    2012-01-01

    Loss of Y-chromosome has been correlated with older age in males. Furthermore, current evidence indicates that Y-chromosome loss also occurs in several human tumors, including head and neck carcinomas. However, the association between Y nullisomy and the occurrence of neoplasias in elderly men has not been well established. In the present study, the association between Y-chromosome loss and head and neck carcinomas was evaluated by comparison to cells from peripheral blood lymphocytes and normal mucosa of cancer-free individuals matched for age using dual-color fluorescence in situ hybridization. Twenty-one patients ranging in age from 28 to 68 years were divided into five-year groups for comparison with 16 cancer-free individuals matched for age. The medical records of all patients were examined to obtain clinical and histopathological data. None of the patients had undergone radiotherapy or chemotherapy before surgery. In all groups, the frequency of Y-chromosome loss was higher among patients than among normal reference subjects (P < 0.0001) and was not age-dependent. These data suggest that Y-chromosome loss is a tumor-specific alteration not associated with advanced age in head and neck carcinomas. PMID:22249426

  9. 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

  10. Down-regulation of neutrophil gelatinase-associated lipocalin in head and neck squamous cell carcinoma correlated with tumorigenesis, not with metastasis

    PubMed Central

    Wang, Lei; Chen, Chen; Li, Fen; Hua, Qingquan; Chen, Shiming; Xiao, Bokui; Dai, Mengyuan; Li, Man; Zheng, Anyuan; Yu, Di; Hu, Zhangwei; Tao, Zezhang

    2015-01-01

    To examine the significance of the Neutrophil gelatinase-associated lipocalin (NGAL) in diagnosing head and neck squamous cell carcinoma (HNSCC) and predicting regional metastasis. We first used GEO dataset to analyze the NGAL gene expression in HNSCC. Then, we summarized the characteristics of patients retrospectively selected in clinic. Expression of NGAL protein in human HNSCC tumor, lymph node and normal samples were analyzed using immunohistochemistry. Next, we further investigated the NGAL expression in a tissue microassay to analyze the relationship between NGAL protein expression and TNM stage. Finally, we tested the NGAL protein expression in head and neck cancer cell lines. Analysis of GEO dataset concluded that NGAL gene expression in HNSCC was lower than that in normal tissue (P<0.01). There was no statistically significant difference of NGAL gene expression between T-stage and N-stage (P>0.05). NGAL protein expression in tumor was lower than that in normal tissue (P<0.01). There was no statistically significant difference of NGAL protein expression between metastasis group and non-metastasis group (P>0.05). Expression of NGAL protein was not correlated with TNM stage of HNSCC. Aggressive HNSCC cell lines have lower NGAL protein expression. Our data demonstrated that the expression of NGAL protein was correlated with tumorigenesis of HNSCC, but not with regional metastasis. It may serve as a novel biomarker for prognostic evaluation of patients with HNSCC. PMID:26464627

  11. The Expression Levels of XLF and Mutant P53 Are Inversely Correlated in Head and Neck Cancer Cells

    PubMed Central

    Feng, Sizhe; Rabii, Ramin; Liang, Guobiao; Song, Chenxi; Chen, Wei; Guo, Mian; Wei, Xuezhong; Messadi, Diana; Hu, Shen

    2016-01-01

    XRCC4-like factor (XLF), also known as Cernunnos, is a protein encoded by the human NHEJ1 gene and an important repair factor for DNA double-strand breaks. In this study, we have found that XLF is over-expressed in HPV(+) versus HPV(-) head and neck squamous cell carcinoma (HNSCC) and significantly down-regulated in the HNSCC cell lines expressing high level of mutant p53 protein versus those cell lines harboring wild-type TP53 gene with low p53 protein expression. We have also demonstrated that Werner syndrome protein (WRN), a member of the NHEJ repair pathway, binds to both mutant p53 protein and NHEJ1 gene promoter, and siRNA knockdown of WRN leads to the inhibition of XLF expression in the HNSCC cells. Collectively, these findings suggest that WRN and p53 are involved in the regulation of XLF expression and the activity of WRN might be affected by mutant p53 protein in the HNSCC cells with aberrant TP53 gene mutations, due to the interaction of mutant p53 with WRN. As a result, the expression of XLF in these cancer cells is significantly suppressed. Our study also suggests that XLF is over-expressed in HPV(+) HNSCC with low expression of wild type p53, and might serve as a potential biomarker for HPV(+) HNSCC. Further studies are warranted to investigate the mechanisms underlying the interactive role of WRN and XLF in NHEJ repair pathway. PMID:27471552

  12. The Expression Levels of XLF and Mutant P53 Are Inversely Correlated in Head and Neck Cancer Cells.

    PubMed

    Feng, Sizhe; Rabii, Ramin; Liang, Guobiao; Song, Chenxi; Chen, Wei; Guo, Mian; Wei, Xuezhong; Messadi, Diana; Hu, Shen

    2016-01-01

    XRCC4-like factor (XLF), also known as Cernunnos, is a protein encoded by the human NHEJ1 gene and an important repair factor for DNA double-strand breaks. In this study, we have found that XLF is over-expressed in HPV(+) versus HPV(-) head and neck squamous cell carcinoma (HNSCC) and significantly down-regulated in the HNSCC cell lines expressing high level of mutant p53 protein versus those cell lines harboring wild-type TP53 gene with low p53 protein expression. We have also demonstrated that Werner syndrome protein (WRN), a member of the NHEJ repair pathway, binds to both mutant p53 protein and NHEJ1 gene promoter, and siRNA knockdown of WRN leads to the inhibition of XLF expression in the HNSCC cells. Collectively, these findings suggest that WRN and p53 are involved in the regulation of XLF expression and the activity of WRN might be affected by mutant p53 protein in the HNSCC cells with aberrant TP53 gene mutations, due to the interaction of mutant p53 with WRN. As a result, the expression of XLF in these cancer cells is significantly suppressed. Our study also suggests that XLF is over-expressed in HPV(+) HNSCC with low expression of wild type p53, and might serve as a potential biomarker for HPV(+) HNSCC. Further studies are warranted to investigate the mechanisms underlying the interactive role of WRN and XLF in NHEJ repair pathway. PMID:27471552

  13. 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

  14. Surgical Outcomes and Correlation of the Copenhagen Neck Functional Disability Scale and Modified Japanese Orthopedic Association Assessment Scales in Patients with Cervical Spondylotic Myelopathy

    PubMed Central

    Azhari, Shirzad; Shazadi, Sohrab; Khayat Kashany, Hamid; Nayeb Aghaei, Hossein; Mohammadi, Hassan Reza

    2016-01-01

    Study Design Cross-sectional. Purpose Clinical outcome study comparing the Copenhagen Neck Functional Disability Scale (CNFDS) and modified Japanese orthopedic association (mJOA) assessment scales in patients with cervical spondylotic myelopathy (CSM). Overview of Literature Comparison of instruments that measure patient-reported outcomes is needed. Methods A cross-sectional analysis was conducted. Ninety five patients with CSM were entered into the study and completed the CNFDS and the mJOA preoperatively and postoperatively. Correlation between the CNFDS and the mJOA was evaluated preoperatively and at the end of follow-up. Responsiveness to change of CNFDS and mJOA was also assessed. Clinical outcomes were also measured with the recovery rate of mJOA score at end of follow-up. Results The mean age of patients was 58.2 (standard deviation, SD=8.7) years. Mean follow-up was 2.1 years (range, 1 to 4 years). The mJOA correlated strongly with the CNFDS score preoperatively and postoperatively (r=–0.81 and –0.82, respectively; p<0.001). The CNFDS and the mJOA were able to detect changes after the surgery (p<0.001). The mean mJOA recovery rate was 51.8% (SD=13.1%). Conclusions Surgery for the treatment of patients with CSM is an efficacious procedure. CNFDS and mJOA scores have a strong correlation in measuring disability among CSM patients. PMID:27340528

  15. 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.

  16. [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

  17. 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 ...

  18. Developmental biomechanics of neck musculature

    PubMed Central

    Lavallee, Amy V.; Ching, Randal P.; Nuckley, David J.

    2012-01-01

    Neck mechanics is central to head injury prevention since it is the musculoskeletal neck, which dictates the position and movement of the head. In the US, traumatic injury is the leading cause of death for children; however prevention is hampered by the lack of data concerning the mechanics of the immature head-and-neck. Thus, the objective of this study was to quantify neck muscle strength and endurance across the maturation spectrum and correlate these with head-and-neck anthropometry. A factorial study was performed on 91 human subjects measuring head-and-neck anthropometry and neck strength and endurance in three bending directions (flexion, extension, and lateral) as a function of age (6–23 years). Using a custom device, neck maximum voluntary contraction (MVC) force was measured in triplicate. Next, neck muscle endurance (sustained effort) was measured as the subjects’ ability to maintain 70% of peak force over 30 s. Linear regression of peak force and endurance as a function of age revealed each direction to significantly (p<0.0001) increase with age. The MVC force, averaged across all directions and normalized to the adult values, exhibits the following maturation curve: %MVC Force= −0.0879(age)2+6.018(age)+8.120. Neck muscle strength, similar between young males and females, becomes disparate in adolescence and adulthood with males exhibiting greater strength. Bending direction differences were also found with extension strength being the greatest regardless of age and sex. Furthermore, neck circumference appears predictive of neck strength and endurance in children. Together, these relationships may facilitate improved design of injury prevention interventions. PMID:23127787

  19. PRAME expression in head and neck cancer correlates with markers of poor prognosis and might help in selecting candidates for retinoid chemoprevention in pre-malignant lesions

    PubMed Central

    Szczepanski, Miroslaw J.; DeLeo, Albert B.; Łuczak, Michał; Molinska-Glura, Marta; Misiak, Jan; Szarzynska, Bronislawa; Dworacki, Grzegorz; Zagor, Mariola; Rozwadowska, Natalia; Kurpisz, Maciej; Krzeski, Antoni; Kruk-Zagajewska, Aleksandra; Kopec, Tomasz; Banaszewski, Jacek; Whiteside, Theresa L.

    2012-01-01

    Objectives PRAME (Preferentially Expressed Antigen in Melanoma) is a tumor-associated antigen recognized by immunocytes, and it induces cytotoxic T cell-mediated responses in melanoma. PRAME expression in tumors interferes with retinoic acid receptor (RAR) signaling thus promoting tumor progression. Here, we study PRAME expression in head and neck squamous cell carcinoma (HNSCC) to determine its potential clinical significance. Materials and Methods PRAME expression in HNSCC was evaluated by immunohistochemistry in tissue microarrays of primary tumors (n=53), metastatic lymph nodes (n=8) and normal oral mucosa (n=11). Biopsies of dysplastic oral lesions (n=12) were also examined. PRAME expression levels in tissues were correlated with markers of poor prognosis in HNSCC. PRAME mRNA in HNSCC cell lines and in normal immortalized human keratinocytes (HaCaT cell line) was measured by qRT-PCR, and the protein expression by flow cytometry and western blots. Results PRAME was expressed in HNSCC cell lines and HNSCC lesions. PRAME expression in dysplastic mucosa was variable. No or only weak expression was found in normal cells or tissues. PRAME expression levels significantly correlated with the tumor grade, size, nodal involvement and the clinical status of HNSCC patients. Conclusions Elevated PRAME expression associates with clinicopathologic markers of poor outcome in HNSCC and might identify potential candidates with pre-cancerous lesions for chemoprevention with retinoids. PMID:22944049

  20. 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

  1. Glioblastoma metastasis to parotid gland and neck lymph nodes: fine-needle aspiration cytology with histopathologic correlation.

    PubMed

    Romero-Rojas, Alfredo E; Diaz-Perez, Julio A; Amaro, Deirdre; Lozano-Castillo, Alfonso; Chinchilla-Olaya, Sandra I

    2013-12-01

    Glioblastoma (GBM) is one of the most highly aggressive neoplasms of the central nervous system. Extra-cranial metastases in GBM are rare. Here we present the case of a 26-year-old man with extra-cranial metastasis of a frontal lobe GBM to the parotid gland, cervical lymph nodes, and bones, with initial diagnosis made by fine needle aspiration cytology (FNAC) of the parotid gland. FNAC is a reliable technique in the study of primary and secondary parotid gland neoplasms, allowing a presumptive diagnosis in difficult cases. We correlate the cytologic, histopathologic, and immunohistochemical findings in this case and discuss previous literature reports. PMID:23637061

  2. Anterior gradient protein 2 expression in high grade head and neck squamous cell carcinoma correlated with cancer stem cell and epithelial mesenchymal transition.

    PubMed

    Ma, Si-Rui; Wang, Wei-Ming; Huang, Cong-Fa; Zhang, Wen-Feng; Sun, Zhi-Jun

    2015-04-20

    Anterior gradient protein 2 (AGR2) is a novel biomarker with potential oncogenic role. We sought to investigate the diagnostic and prognostic role of AGR2 on head and neck squamous cell carcinoma (HNSCC) with an emphasis on its correlation of cancer stemloid cells (CSC) and epithelial mesenchymal transition (EMT). We found that AGR2 protein levels were higher in HNSCC than in normal oral mucosa. High levels of AGR2 were associated with the T category, pathological grade and lymph node metastasis of HNSCC. Expression of AGR2 increased in recurring HNSCC after radiotherapy and in post cisplatin-based chemotherapeutic tissues. In HNSCC cell lines, knock-down of AGR2 induced apoptosis, reduced sphere formation, and down-regulated Survivin, Cyclin D1, Bcl2, Bcl2l1, Slug, Snail, Nanog and Oct4. In addition, over-expressed AGR2 in transgenic mice with spontaneous HNSCC was associated with lost function of Tgfbr1 and/ or lost function of Pten. In vitro knockdown TGFBR1 in HNSCC cell lines increased AGR2 expression. These results suggest that AGR2 is involved in EMT and self-renewal of CSC and may present a potential therapeutic target (oncotarget) for HNSCC. PMID:25871396

  3. 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.

  4. Neck Pain

    MedlinePlus

    ... get better. No 7. Did you have a whiplash-type injury in the past, or do you have pain and/or stiffness every day in your neck, hands, knees, hips or other joints? Yes Your pain may be from DEGENERATIVE CERVICAL ARTHRITIS, a disorder that affects the bones and ...

  5. 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

  6. 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.

  7. 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

  8. C4.4A as a biomarker of head and neck squamous cell carcinoma and correlated with epithelial mesenchymal transition

    PubMed Central

    Liu, Jian-Feng; Mao, Liang; Bu, Lin-Lin; Ma, Si-Rui; Huang, Cong-Fa; Zhang, Wen-Feng; Sun, Zhi-Jun

    2015-01-01

    C4.4A, a member of the Ly6/uPAR family of membrane proteins, has been identified as a metastasis-associated molecule, but little is known about its actual expression and possible function in head and neck squamous cell carcinoma (HNSCC). To explore diagnostic and prognostic roles of C4.4A in HNSCC, we investigated the expression of C4.4A in human HNSCC tissue array which contains 43 HNSCC, 6 epithelial dysplasia and 16 normal oral mucosa. Expression of C4.4A was significantly increased in epithelial dysplasia and HNSCC when compared with normal oral mucosa. Moreover, high C4.4A expression indicated a rather poor prognosis of HNSCC patients. To better understand the function of C4.4A in HNSCC progression, we investigated epithelial to mesenchymal transition (EMT) associated proteins including transforming growth factor (TGF-β1), Slug and CD147 in HNSCC. The expression of TGF-β1, Slug, and CD147 was significantly increased in HNSCC when compared with normal oral mucosa. Meanwhile, the expression of C4.4A was significantly correlated with TGF-β1, Slug, and CD147 in HNSCC tissue array. Furthermore, knockdown of C4.4A decreased the cell invasion and migration in CAL27 cell line and suppressed the EMT with increased E-cadherin and decreased N-cadherin and Slug. Our study demonstrated that C4.4A was a potential marker for prognosis of HNSCC, and C4.4A participated in EMT program in HNSCC progression. PMID:26885441

  9. 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.

  10. 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 ...

  11. 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

  12. 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.

  13. 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.

  14. Instantaneous Helical Axis Methodology to Identify Aberrant Neck Motion

    PubMed Central

    Ellingson, Arin M.; Yelisetti, Vishal; Schulz, Craig A.; Bronfort, Gert; Downing, Joseph; Keefe, Daniel F.; Nuckley, David J.

    2013-01-01

    Background Neck pain afflicts 30-50% of the U.S. population annually; however we currently have poor diagnostic differentiation techniques to inform individualized treatment. Planar neck kinematics has been shown to be correlated with neck pain, but neck motion is much more complex than pure planar activities. Our objective was to define a methodology for determining aberrant neck kinematics and assess it. Methods We examined a complex neck kinematic activity of neck circumduction, computed the pathway of motion using the instantaneous helical axis approach in 81 patients with non-specific neck pain and in 20 non-matched symptom free subjects. Neck circumduction, or rolling of the head, represents a complex neck kinematic activity, investigating the innate coupled motion of the cervical spine at the end ranges of motion in all directions. Instance of discontinuities in the helical axis patterns, or folds, were identified and labeled as occurrences of aberrant motion. Findings The instances of aberrant motion, or folds, which are nearly non-existent in the healthy sample group, are present in both the pre and post treatment neck pain patients. Following a treatment intervention of the symptomatic patients, pain and neck disability index decreased significantly (p<0.001) concomitant with a decrease in the number of folds (p=0.021). Interpretation The present study highlights a new technique using an instantaneous helical axis approach to detect subtle abnormalities in the pathway of motion of the head about the trunk, during a neck circumduction exercise. PMID:23911108

  15. 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.

  16. Head, Neck, and Oral Cancer

    MedlinePlus

    ... Neck and Oral Pathology Head, Neck and Oral Pathology Close to 42,000 Americans will be diagnosed ... Neck and Oral Pathology Head, Neck and Oral Pathology Close to 42,000 Americans will be diagnosed ...

  17. 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 ...

  18. Neck Injuries and Disorders

    MedlinePlus

    ... 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 a cervical collar. You rarely need surgery.

  19. Neck dissection - discharge

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000659.htm Neck dissection - discharge To use the sharing features on this page, please enable JavaScript. Neck dissection is surgery to remove the lymph nodes in ...

  20. Head and Neck Cancer

    MedlinePlus

    Head and neck cancer includes cancers of the mouth, nose, sinuses, salivary glands, throat, and lymph nodes in the ... swallowing A change or hoarseness in the voice Head and neck cancers are twice as common in men. Using ...

  1. [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

  2. A randomized phase II efficacy and correlative studies of cetuximab with or without sorafenib in recurrent and/or metastatic head and neck squamous cell carcinoma

    PubMed Central

    Gilbert, Jill; Schell, Michael J.; Zhao, Xiuhua; Murphy, Barbara; Tanvetyanon, Tawee; Leon, Marino E.; Hayes, D. Neil; Haigentz, Missak; Saba, Nabil; Nieva, Jorge; Bishop, Justin; Sidransky, David; Ravi, Rajani; Bedi, Atul; Chung, Christine H.

    2015-01-01

    Introduction A combination of cetuximab and sorafenib in patients with recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) were assessed for potential benefit. Material and Methods In a randomized phase II study, R/M HNSCC patients were treated with cetuximab 400mg/m2 IV on day 1 followed by 250mg/m2 IV weekly (Arm A), or cetuximab at the same dose/schedule plus sorafenib 400mg PO twice-a-day (Arm B). Each cycle was 21 days. Tumor p16 and HPV status, and plasma immunomodulatory cytokine levels were assessed. Results Of 55 patients enrolled (Arm A-27, Arm B-28), 52 patients received assigned treatments and 43 were evaluable for response. Overall response rate was 8% for both arms. Median overall survival (OS) and progression-free survival (PFS) were 9.0 and 3.0 months in Arm A, and 5.7 and 3.2 months in Arm B, respectively. Forty-four patients had tumors available for p16 staining (35-negative, 9-positive). Three of nine p16-positive tumors were also HPV positive. The p16-negative patients had significantly better PFS compared to the p16-positive patients (3.7 vs. 1.6 months; p-value: 0.03), regardless of study arms. Twenty-four plasma samples were tested for 12 cytokine levels and patients with higher TGFβ1 levels had inferior PFS compared to lower levels (1.9 vs. 4.7 months; adjusted p-value: 0.015), regardless of study arms. Conclusions A subset of R/M patients with p16-negative tumors or lower plasma TGFβ1 levels had longer PFS given the cetuximab-based therapy. However, both arms showed only modest response and sorafenib given with cetuximab did not demonstrate clinical benefit. PMID:25593015

  3. 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

  4. Forgotten triangles of neck

    PubMed Central

    Singh, Manpreet; Vashistha, Arpit; Chaudhary, Manoj; Kaur, Gagandeep

    2016-01-01

    The purpose of this manuscript is to add some more information in the present scientific literature on these nearly forgotten triangles of surgical importance. The neck is an area that lends itself to anatomical geometry, such as triangles. Many triangles of the neck have been described, and some are well-known, yet, some have been nearly forgotten, i.e., Lesser's triangle, Farabeuf triangle, Pirogoff's triangle, and Beclard's triangle. From the anatomic and surgical point of view, the neck is an amazingly interesting place. It is like a connection where crucial functional units meet and pass. Added surgical landmarks are always helpful to the surgeon while dealing with the neck. Described triangles of neck in this article are always reliable and constant landmarks for head and neck surgeons

  5. American Head and Neck Society

    MedlinePlus

    American Head & Neck Society Head and Neck Cancer Research & Education American Head & Neck Society | AHNS Head and Neck Cancer Research & Education About AHNS ... and Announcements Copyright ©2016 · American Head and Neck Society · Privacy and Return Policy Managed by BSC Management, ...

  6. 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

  7. Cortical bone distribution in the femoral neck of strepsirhine primates.

    PubMed

    Demes, B; Jungers, W L; Walker, C

    2000-10-01

    The thickness of the inferior and superior cortices of the femoral neck was measured on X-rays of 181 strepsirhine primate femora representing 24 species. Neck length, neck depth and neck-shaft angle were also measured. The strength of the femoral neck in frontal bending was estimated by modeling the neck as a hollow cylinder, with neck depth as the outer diameter and cortical thickness representing the superior and inferior shell dimensions. Results indicate that the inferior cortex is always thicker than the superior cortex. The ratio of superior to inferior cortical thickness is highly variable but distinguishes two of the three locomotor groups in the sample. Vertical clingers and leapers have higher ratios (i.e., a more even distribution of cortical bone) than quadrupeds. The slow climbers tend to have the lowest ratios, although they do not differ significantly from the leapers and quadrupeds. These results do not confirm prior theoretical expectations and reported data for anthropoid primates that link greater asymmetry of the cortical shell to more stereotypical hip excursions. The ratio of superior to inferior cortical thickness is unrelated to body mass, femoral neck length, and neck-shaft angle, calling into question whether the short neck of strepsirhine primates acts as a cantilever beam in bending. On the other hand, the estimated section moduli are highly correlated with body mass and neck length, a correlation that is driven primarily by body mass. In conclusion, we believe that an alternative interpretation to the cantilever beam model is needed to explain the asymmetry in bone distribution in the femoral neck, at least in strepsirhine primates (e.g., a thicker inferior cortex is required to reinforce the strongly curved inferior surface). As in prior studies of cross-sectional geometry of long bones, we found slightly positive allometry of cortical dimensions with body mass. PMID:11006046

  8. 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.

  9. Head and Neck Cancer

    MedlinePlus

    ... head and neck cancer. Poor oral and dental hygiene . Poor care of the mouth and teeth has ... sore throat Foul mouth odor not explained by hygiene Hoarseness or change in voice Nasal obstruction or ...

  10. 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

  11. Neck-Tongue Syndrome.

    PubMed

    Hu, Nancy; Dougherty, Carrie

    2016-04-01

    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

  12. Torticollis (wry neck) (image)

    MedlinePlus

    Torticollis is a form of dystonia (prolonged muscle contractions) in which the neck muscles, particularly the sternocleidomastoid muscle, contract involuntarily causing the head to turn. Torticollis may occur without known cause (idiopathic), ...

  13. 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).

  14. 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

  15. 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

  16. 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

  17. Gravitational demand on the neck musculature during tablet computer use.

    PubMed

    Vasavada, Anita N; Nevins, Derek D; Monda, Steven M; Hughes, Ellis; Lin, David C

    2015-01-01

    Tablet computer use requires substantial head and neck flexion, which is a risk factor for neck pain. The goal of this study was to evaluate the biomechanics of the head-neck system during seated tablet computer use under a variety of conditions. A physiologically relevant variable, gravitational demand (the ratio of gravitational moment due to the weight of the head to maximal muscle moment capacity), was estimated using a musculoskeletal model incorporating subject-specific size and intervertebral postures from radiographs. Gravitational demand in postures adopted during tablet computer use was 3-5 times that of the neutral posture, with the lowest demand when the tablet was in a high propped position. Moreover, the estimated gravitational demand could be correlated to head and neck postural measures (0.48 < R(2) < 0.64, p < 0.001). These findings provide quantitative data about mechanical requirements on the neck musculature during tablet computer use and are important for developing ergonomics guidelines. Practitioner Summary: Flexed head and neck postures occur during tablet computer use and are implicated in neck pain. The mechanical demand on the neck muscles was estimated to increase 3-5 times during seated tablet computer use versus seated neutral posture, with the lowest demand in a high propped tablet position but few differences in other conditions. PMID:25643042

  18. Treatment of Neck Pain

    PubMed Central

    Hurwitz, Eric L.; Cheng, Ivan; Carroll, Linda J.; Nordin, Margareta; Guzman, Jaime; Peloso, Paul; Holm, Lena W.; Côthé, Pierre; Hogg-Johnson, Sheilah; van der Velde, Gabrielle; Cassidy, J. David; Haldeman, Scott

    2008-01-01

    Study Design Best evidence synthesis. Objective To identify, critically appraise, and synthesize literature from 1980 through 2006 on surgical interventions for neck pain alone or with radicular pain in the absence of serious pathologic disease. Summary of Background Data There have been no comprehensive systematic literature or evidence-based reviews published on this topic. Methods We systematically searched Medline for literature published from 1980 to 2006 on percutaneous and open surgical interventions for neck pain. Publications on the topic were also solicited from experts in the field. Consensus decisions were made about the scientific merit of each article; those judged to have adequate internal validity were included in our Best Evidence Synthesis. Results Of the 31,878 articles screened, 1203 studies were relevant to the Neck Pain Task Force mandate and of these, 31 regarding treatment by surgery or injections were accepted as scientifically admissible. Radiofrequency neurotomy, cervical facet injections, cervical fusion and cervical arthroplasty for neck pain without radiculopathy are not supported by current evidence. We found there is support for short-term symptomatic improvement of radicular symptoms with epidural corticosteroids. It is not clear from the evidence that long-term out comes are improved with the surgical treatment of cervical radiculopathy compared to non operative measures. However, relatively rapid and substantial symptomatic relief after surgical treatment seems to be reliably achieved. It is not evident that one open surgical technique is clearly superior to others for radiculopathy. Cervical foramenal or epidural injections are associated with relatively frequent minor adverse events (5%–20%); however, serious adverse events are very uncommon (<1%). After open surgical procedures on the cervical spine, potentially serious acute complications are seen in approximately 4% of patients. Conclusion Surgical treatment and limited

  19. 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

  20. The Relationship of Forward Head Posture and Rounded Shoulders with Neck Pain in Iranian Office Workers

    PubMed Central

    Nejati, Parisa; Lotfian, Sara; Moezy, Azar; Moezy, Azar; Nejati, Mina

    2014-01-01

    Background Office workers spend a long period of time behind a computer during working hours. The relation between the posture of sitting during work with computer and neck pain is still debatable. Even though some researchers claim a significant difference in head posture between patients with neck pain and pain-free participants, the FHP (forward head posture) has not always been associated with neck pain in literature. So, the purpose of this study was to discover the relationship between neck pain and improper posture in the head, cervicothoracic spine and shoulders. Methods: This was a cross-sectional study to explore the relationships between neck pains, sagittal postures of cervical and thoracic spine and shoulders among office workers in two positions, straight looking forward and working position. 46 subjects without neck pain and 55 subjects with neck pain were evaluated using a photographic method. Thoracic and cervical postures were measured by the HT (High Thoracic), CV (Craniovertebral) angles respectively. Shoulder’s posture was evaluated in the sagittal plane by the acromion protrusion. Results: HT and CV angles were positively correlated with the presence of neck pain only in working position (p< 0.05). In straight looking forward position there was no significant difference between the two groups statistically (p>0.05). The difference of shoulder protrusion between symptomatic and asymptomatic groups was not significant. Conclusion: FHP and thoracic kyphosis were accompanied with neck pain. But shoulder posture was not correlated with neck pain. PMID:25250268

  1. Interventional radiology neck procedures.

    PubMed

    Zabala Landa, R M; Korta Gómez, I; Del Cura Rodríguez, J L

    2016-05-01

    Ultrasonography has become extremely useful in the evaluation of masses in the head and neck. It enables us to determine the anatomic location of the masses as well as the characteristics of the tissues that compose them, thus making it possible to orient the differential diagnosis toward inflammatory, neoplastic, congenital, traumatic, or vascular lesions, although it is necessary to use computed tomography or magnetic resonance imaging to determine the complete extension of certain lesions. The growing range of interventional procedures, mostly guided by ultrasonography, now includes biopsies, drainages, infiltrations, sclerosing treatments, and tumor ablation. PMID:27138033

  2. Head and Neck Cancer: Symptoms and Signs

    MedlinePlus

    ... Symptoms and Signs Request Permissions Print to PDF Head and Neck Cancer - Symptoms and Signs Approved by the Cancer. ... Cancer Research and Advocacy Survivorship Blog About Us Head and Neck Cancer Guide Cancer.Net Guide Head and Neck ...

  3. Drugs Approved for Head and Neck Cancer

    MedlinePlus

    ... Professionals Questions to Ask about Your Treatment Research Drugs Approved for Head and Neck Cancer This page ... and neck cancer that are not listed here. Drugs Approved for Head and Neck Cancer Abitrexate (Methotrexate) ...

  4. 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. PMID:27247738

  5. Bladder neck contracture

    PubMed Central

    Simhan, Jay; Ramirez, Daniel; Morey, Allen F.

    2014-01-01

    Bladder neck contracture (BNC) is a well-described complication of the surgical treatment of benign and malignant prostate conditions. Nevertheless, etiologies of BNC development are highly dependent on the primary treatment modality undertaken with BNC also occurring after pelvic radiation. The treatment options for BNC can range from simple, office-based dilation procedures to more invasive, complex abdomino-perineal reconstructive surgery. Although numerous strategies have been described, a patient-specific approach is usually necessary in the management of these complex patients. In this review, we highlight various therapeutic maneuvers described for the management of BNC and further delineate a tailored approach utilized at our institution in these complicated patients. PMID:26816768

  6. 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

  7. MRI of the cervical spine with neck extension: is it useful?

    PubMed Central

    Bartlett, R J V; Hill, C A Rowland; Rigby, A S; Chandrasekaran, S; Narayanamurthy, H

    2012-01-01

    Objectives Standard MRI of the cervical spine is performed in a different anatomical position to that utilised for traditional contrast myelography. Those well practised in myelography are familiar with the considerable changes in configuration of the bony and soft tissues of the cervical spine that may occur with changes in the degree of neck flexion and extension. We set out to compare the findings in a select group of patients with myeloradiculopathy who had undergone myelography and MRI in both standard and neck-extended positions. These findings were correlated with the clinical status. Methods 29 patients underwent myelography with CT (CTM) and MRI in neutral and neck-extended positions. The imaging was assessed for the degree of cord compression and neural foraminal narrowing, quantified using a simple grading scheme suitable for routine clinical practice. The degree of neck extension was assessed using an angular measurement. Results For both CTM and MRI, scanning with the neck extended significantly increases the severity of cord compression compared with the standard supine position, to a degree similar to that shown during conventional prone myelography. The degree of perceived cord compression is related to the degree of neck extension achieved. Correlation of standard MRI findings and the clinical level of radiculopathy is poor. This correlation improves when the neck is extended. Conclusions The most appropriate position for routine MRI of the cervical spine in degenerative disease remains unknown, but in selected patients imaging with the neck extended may provide important additional information. PMID:22215879

  8. 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.

  9. 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

  10. 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

  11. Comparison of neck tension palpation rating systems with surface electromyographic and acoustic measures in vocal hyperfunction

    PubMed Central

    Stepp, Cara E.; Heaton, James T.; Braden, Maia N.; Jetté, Marie E.; Stadelman-Cohen, Tara K.; Hillman, Robert E.

    2010-01-01

    Objectives/Hypothesis The purpose of this study was to evaluate current neck tension palpation rating systems to determine inter-rater reliability and possible correlation with neck surface electromyography (sEMG, collected from three electrode recording locations) and measures of the third formant for /a/ during various vocal behaviors. Study Design This prospective study examined the neck muscle tension of 16 participants before and after a single session of voice therapy. Methods Inter-rater reliability and relationships between palpation ratings and objective measures of sEMG (anterior neck) and the third formant for /a/ were assessed using Pearson’s correlations (r). Results Inter-rater reliability was relatively low as measured by Pearson’s correlations, although Wilcoxon Signed Rank Test results were similar as those in a previous study. Correlations between palpation ratings and sEMG, and between ratings of laryngeal height and the third formant for /a/ were generally low. Correlations increased between anterior neck sEMG and ratings of suprahyoid muscle tension when examined in a reduced set of individuals with higher inter-rater reliability. Conclusions Palpation rating scales do not reliably capture changes that may occur in neck muscle tension of typical voice therapy patients over one session. Consequently, little can be concluded from correlations between sEMG and palpation ratings. PMID:20347260

  12. Palmitoylethanolamide and stearoylethanolamide levels in the interstitium of the trapezius muscle of women with chronic widespread pain and chronic neck-shoulder pain correlate with pain intensity and sensitivity.

    PubMed

    Ghafouri, Nazdar; Ghafouri, Bijar; Larsson, Britt; Stensson, Niclas; Fowler, Christopher J; Gerdle, Björn

    2013-09-01

    Chronic widespread pain (CWP) is a complex condition characterized by central hyperexcitability and altered descending control of nociception. However, nociceptive input from deep tissues is suggested to be an important drive. N-Acylethanolamines (NAEs) are endogenous lipid mediators involved in regulation of inflammation and pain. Previously we have reported elevated levels of the 2 NAEs, the peroxisome proliferator-activated receptor type-α ligand N-palmitoylethanolamine (PEA) and N-stearoylethanolamine (SEA) in chronic neck/shoulder pain (CNSP). In the present study, the levels of PEA and SEA in women with CWP (n=18), CNSP (n=34) and healthy controls (CON, n=24) were investigated. All subjects went through clinical examination, pressure pain threshold measurements and induction of experimental pain in the tibialis anterior muscle. Microdialysis dialysate of the trapezius was collected before and after subjects performed a repetitive low-force exercise and analyzed by mass spectrometry. The levels of PEA and SEA in CNSP were significantly higher post exercise compared with CWP, and both pre and post exercise compared with CON. Levels of both NAEs decreased significantly pre to post exercise in CWP. Intercorrelations existed between aspects of pain intensity and sensitivity and the level of the 2 NAEs in CWP and CNSP. This is the first study demonstrating that CNSP and CWP differ in levels of NAEs in response to a low-force exercise which induces pain. Increases in pain intensity as a consequence of low-force exercise were associated with low levels of PEA and SEA in CNSP and CWP. These results indicate that PEA and SEA have antinociceptive roles in humans. PMID:23707281

  13. 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

  14. 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

  15. 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

  16. Predicting SF-6D utility scores from the Neck Disability Index and Numeric Rating Scales for Neck and Arm Pain

    PubMed Central

    Carreon, Leah Y.; Anderson, Paul A.; McDonough, Christine M.; Djurasovic, Mladen; Glassman, Steven D.

    2010-01-01

    Study Design Cross-sectional cohort Objective This study aims to provide an algorithm estimate SF-6D utilities using data from the NDI, neck pain and arm pain scores. Summary of Background Data Although cost-utility analysis is increasingly used to provide information about the relative value of alternative interventions, health state values or utilities are rarely available from clinical trial data. The Neck Disability Index (NDI) and numeric rating scales for neck and arm pain, are widely used disease-specific measures of symptoms, function and disability in patients with cervical degenerative disorders. The purpose of this study is to provide an algorithm to allow estimation of SF-6D utilities using data from the NDI, and numeric rating scales for neck and arm pain. Methods SF-36, NDI, neck and arm pain rating scale scores were prospectively collected pre-operatively, at 12 and 24 months post-operatively in 2080 patients undergoing cervical fusion for degenerative disorders. SF-6D utilities were computed and Spearman correlation coefficients were calculated for paired observations from multiple time points between NDI, neck and arm pain scores and SF-6D utility scores. SF-6D scores were estimated from the NDI, neck and arm pain scores using a linear regression model. Using a separate, independent dataset of 396 patients in which and NDI scores were available SF-6D was estimated for each subject and compared to their actual SF-6D. Results The mean age for those in the development sample, was 50.4 ± 11.0 years and 33% were male. In the validation sample the mean age was 53.1 ± 9.9 years and 35% were male. Correlations between the SF-6D and the NDI, neck and arm pain scores were statistically significant (p<0.0001) with correlation coefficients of 0.82, 0.62, and 0.50 respectively. The regression equation using NDI alone to predict SF-6D had an R2 of 0.66 and a root mean square error (RMSE) of 0.056. In the validation analysis, there was no statistically

  17. Pain and Disability in the Jaw and Neck Region following Whiplash Trauma.

    PubMed

    Häggman-Henrikson, B; Lampa, E; Marklund, S; Wänman, A

    2016-09-01

    The relationship between whiplash trauma and chronic orofacial pain is unclear, especially with regard to the time elapsed from trauma to development of orofacial pain. The aim was to analyze prevalence of jaw pain and disability, as well as the relationship between pain and disability in the jaw and neck regions in the early nonchronic stage after whiplash trauma. In this case-control study, 70 individuals (40 women, 30 men, mean age 35.5 y) who visited an emergency department with neck pain following a car accident were examined within 3 wk of trauma (group 1) and compared with 70 individuals (42 women, 28 men, mean age 33.8 y), who declined to attend a clinical examination but agreed to fill in questionnaires (group 2). The 2 case groups were compared with a matched control group of 70 individuals (42 women, 28 men, mean age 37.6 y) without a history of neck trauma. All participants completed questionnaires regarding jaw pain and dysfunction, rating pain intensity in jaw and neck regions on the Numerical Rating Scale, the Neck Disability Index, and Jaw Disability Checklist. Compared with controls, individuals with a recent whiplash trauma reported more jaw pain and dysfunction. Furthermore, there was a moderate positive correlation between jaw and neck pain ratings for group 1 (r = 0.61, P < 0.0001) and group 2 (r = 0.59, P < 0.0001). In the logistic regression analysis, cases showed higher odds ratios (range, 6.1 to 40.8) for jaw and neck pain and disability compared with controls. Taken together, the results show that individuals with a recent whiplash trauma report more jaw pain and disability compared with controls without a history of neck trauma. Furthermore, the correlation between jaw and neck pain intensity implies that intensity of neck pain in the acute stage after whiplash trauma might be a possible risk factor also for development of chronic orofacial pain. PMID:27307051

  18. Femoral neck version affects medial femorotibial loading.

    PubMed

    Papaioannou, T A; Digas, Georgios; Bikos, Ch; Karamoulas, V; Magnissalis, E A

    2013-01-01

    The aim of this study was to provide a preliminary evaluation of the possible effect that femoral version may have on the bearing equilibrium conditions developed on the medial tibiofemoral compartment. A digital 3D solid model of the left physiological adult femur was used to create morphological variations of different neck-shaft angles (varus 115, normal 125, and valgus 135 degrees) and version angles (-10, 0, and +10 degrees). By means of finite element modeling and analysis techniques (FEM-FEA), a virtual experiment was executed with the femoral models aligned in a neutral upright position, distally supported on a fully congruent tibial tray and proximally loaded with a vertical only hip joint load of 2800 N. Equivalent stresses and their distribution on the medial compartment were computed and comparatively evaluated. Within our context, the neck-shaft angle proved to be of rather indifferent influence. Reduction of femoral version, however, appeared as the most influencing parameter regarding the tendency of the medial compartment to establish its bearing equilibrium towards posteromedial directions, as a consequence of the corresponding anteroposterior changes of the hip centre over the horizontal tibiofemoral plane. We found a correlation between femoral anteversion and medial tibiofemoral compartment contact pressure. Our findings will be further elucidated by more sophisticated FEM-FEA and by clinical studies that are currently planned. PMID:24959355

  19. Trial of Postoperative Radiation, Cisplatin, and Panitumumab in Locally Advanced Head and Neck Cancer

    ClinicalTrials.gov

    2016-06-28

    Cancer of Head; Cancer of Head and Neck; Cancer of Neck; Cancer of the Head; Cancer of the Head and Neck; Cancer of the Neck; Head and Neck Cancer; Head Cancer; Head Neoplasms; Head, Neck Neoplasms; Neck Cancer; Neck Neoplasms; Neoplasms, Head; Neoplasms, Head and Neck; Neoplasms, Neck; Neoplasms, Upper Aerodigestive Tract; UADT Neoplasms; Upper Aerodigestive Tract Neoplasms

  20. 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

  1. Neck control after definitive radiochemotherapy without planned neck dissection in node-positive head and neck cancers

    PubMed Central

    2012-01-01

    Background The purpose of this study was to evaluate neck control outcomes after definitive radiochemotherapy without planned neck dissection in node-positive head and neck cancer. Methods We retrospectively reviewed medical records of fifty patients with node-positive head and neck cancer who received definitive radiochemotherapy. Twelve patients subsequently underwent neck dissection for suspicious recurrent or persistent disease. A median dose of 70 Gy (range 60-70.6) was delivered to involved nodes. Response evaluation was performed at a median of 5 weeks after completion of radiotherapy. Results Neck failure was observed in 11 patients and the 3-year regional control (RC) rate was 77.1%. Neck dissection was performed in 10 of the 11 patients; seven of these cases were successfully salvaged, and the ultimate rate of neck control was 92%. The remaining two patients who received neck dissection had negative pathologic results. On univariate analysis, initial nodal size > 2 cm, a less-than-complete response at the primary site, post-radiotherapy nodal size > 1.5 cm, and post-radiotherapy nodal necrosis were associated with RC. On multivariate analysis, less-than-complete primary site response and post-radiotherapy nodal necrosis were identified as independent prognostic factors for RC. Conclusions The neck failure rate after definitive radiochemotherapy without planned neck dissection was 22%. Two-thirds of these were successfully salvaged with neck dissection and the ultimate neck control rate was 92%. Our results suggest that planned neck dissection might not be necessary in patients with complete response of primary site, no evidence of residual lesion > 1.5 cm, or no necrotic lymph nodes at the 1-2 months follow-up evaluation after radiotherapy. PMID:22313843

  2. 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

  3. 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

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

    ClinicalTrials.gov

    2016-07-11

    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

  5. 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.

  6. The impact of gross anatomy on the future head and neck surgeon.

    PubMed

    Archibald, David J; Carlson, Matthew L

    2009-01-01

    Gross anatomy is not only a rite of passage for medical students as they enter the world of practicing medicine but may also be an unrecognized fork in the road in their pursuit of choosing a medical specialty. Otolaryngology: head and neck surgery tends to be poorly represented in medical school curriculum, often only offered as an elective rotation. However, head and neck anatomy remains a constant in most medical schools, granting some exposure to otolaryngology whether students realize it or not. A common thread among most head and neck surgeons in their decision to pursue this surgical specialty is a love for head and neck anatomy, spawned in that first year gross anatomy course. This first and potentially only exposure to otolaryngology should be optimized, as it can have a profound effect in the selection of otolaryngology as a specialty. This introduction can be facilitated by (1) inviting otolaryngology residents to assist during the dissection of the head and neck, (2) soliciting otolaryngology attending physicians to provide clinical correlation lectures, and (3) anatomy professors should identify students who excel in the head and neck portion of the curriculum and direct them towards otolaryngology mentors. There may be a great missed opportunity if a career in otolaryngology is not discussed with students during the dissection of the head and neck. PMID:19347950

  7. Prevalence, Practice Patterns and Evidence for Chronic Neck Pain

    PubMed Central

    Goode, Adam P.; Freburger, Janet; Carey, Timothy

    2010-01-01

    Objective The primary objectives of this study were to estimate the prevalence of chronic neck pain in North Carolina, to describe health care use (providers, treatments and diagnostic testing) for chronic neck pain and to correlate health care use with current best evidence. Methods A cross-sectional, telephone survey of a representative sample of North Carolina households in 2006. Five thousand three hundred fifty seven households were contacted in 2006 to identify 141 non-institutionalized adults 21 years and older with chronic neck pain and no chronic low back pain. Subjects were interviewed about their health and health care use (i.e., provider, tests, and treatments). Patterns of health care use were compared to current systematic reviews. Results The estimated prevalence of chronic neck pain in 2006 among non-institutionalized individuals for the state of North Carolina was 2.2% (95% CI 1.7 – 2.6). Individuals with chronic neck pain were middle- aged (mean age 48.9 years and a majority were female (56%) and non-Hispanic White (81%). Subjects saw a mean of 5.21 (95% CI 4.8 – 5.6) provider types and had a mean of 21 visits. The types of treatments subjects reported varied with treatments such as electrotherapy stimulation (30.3%), corsets or braces (20.9%), massage (28.1%), ultrasound (27.3%), heat (57.0%) and cold (47.4%) having unclear or little benefit based on current best available reviews. Conclusion Based on current evidence for best practice, our findings indicate over utilization of diagnostic testing, narcotics and modalities, and the under utilization of effective treatments such as therapeutic exercise. PMID:20521306

  8. Metrology and detonics: analysis of necking

    NASA Astrophysics Data System (ADS)

    Besnard, G.; Etchessahar, B.; Lagrange, J.-M.; Voltz, C.; Hild, F.; Roux, S.

    2008-11-01

    The purpose of the experiment discussed in the present paper is to study the deformation of a structure (here a copper cylinder) induced by explosives. During its expansion, the (initially 3-mm thick) cylinder keeps on thinning until fracture appears. Some tens of microseconds before failure, strain localization occurs, which induces mechanical necking. In order to characterize the time for the onset of localization and the necking development, two diagnostic techniques are designed to provide images: one based on X ray observations (for total thickness variations) and a second consisting in 25 stereoscopic acquisitions at about 400,000 frames per second. The latter enables us to estimate the three dimensional shape changes of the cylinder with time. The 3D reconstructions from the single X radiograph and stereoscopic films are described. Both techniques require calibration as a first stage. For the X view, a self calibration is performed in order to convert X measurements (a radiographic stack with 12 detection levels) to total dose in rad using a flashlight on a steel mock-up with calibrated defects. For stereovision, a controlled calibration object is used. The second stage is the reconstruction. For X radiographs, the results of a 2D hydrodynamic computation of the expansion at radiographic time coupled with an X photon transport code provide us an estimate of the scatter field and allow us to perform attenuation evaluations of copper alone, and to estimate its thickness. In stereovision, the reconstruction is achieved by an image correlation software which exploits the random patterns marking on the object outer surface.

  9. 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

  10. Fusobacterial head and neck infections in children.

    PubMed

    Brook, Itzhak

    2015-07-01

    Fusobacterium species are increasingly recognized as a cause of head and neck infections in children. These infections include acute and chronic otitis, sinusitis, mastoiditis, and tonsillitis; peritonsillar and retropharyngeal abscesses; Lemierre syndrome; post-anginal cervical lymphadenitis; and periodontitis. They can also be involved in brain abscess and bacteremia associated with head and neck infections. This review describes the clinical spectrum of head and neck fusobacterial infection in children and their management. PMID:25980688

  11. Paragangliomas of the Head and Neck.

    PubMed

    Woolen, Sean; Gemmete, Joseph J

    2016-05-01

    Paragangliomas of the head and neck are rare vascular skull-base tumors derived from the paraganglionic system with an estimated incidence of 1:30,000 accounting for 3% of all paragangliomas. The most common paraganglioma locations of the head and neck in descending order are the carotid body, jugular, tympanic, and vagal paragangliomas. This article discusses the clinical characterics, normal anatamy, imaging findings and protocols, pathology, staging, and differential diagnosis for paragangliomas of the head and neck. PMID:27154608

  12. Patients with non-specific neck disorders commonly report upper limb disability.

    PubMed

    Osborn, William; Jull, Gwendolen

    2013-12-01

    Patients with neck disorders can report difficulties with functional use of their upper limb because of their neck pain. Yet, there is little information on the frequency and specifically, the nature of these upper limb activities. This study surveyed patients with neck pain disorders (n = 103) presenting for management at private physiotherapy clinics in a large metropolitan area to investigate the frequency and nature of reduced upper limb function. Participants were asked to complete four questionnaires, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Neck Disability Index (NDI), Pictorial Fear of Activity Scale-Cervical (PFActS-C) and Patient Specific Functional Scale (PSFS). Approximately 80% of patients spontaneously reported that upper limb activities aggravated their neck pain (PSFS). Most frequently, these activities involved loading of the upper limb such as lifting. Eight activity items on the DASH were scored positive by ≥50% of participants. Participants had mild to moderately severe neck pain (NDI: range 2-68%). The DASH and NDI were moderately-highly correlated (ρ = 0.669; p < 0.001), indicating the higher the neck pain severity the greater the upper limb functional restrictions. There was a low correlation between the NDI and PFActS-C (ρ = 0.319; p = 0.001). These findings provide evidence that upper limb function is often impaired in association with neck pain disorders and suggest clinicians should routinely question patients regarding upper limb function. The DASH could be used as a suitable outcome measure in its current or possibly a modified form. PMID:23726285

  13. Effect of clinical symptoms on the indication for selective neck dissection for N0 carcinomas of the parotid gland.

    PubMed

    Maruo, Takashi; Fujimoto, Yasushi; Yoshida, Kenji; Hiramatsu, Mariko; Suzuki, Atsushi; Nishio, Naoki; Shimono, Mariko; Nakashima, Tsutomu

    2014-07-01

    Lymph node metastasis is a major prognostic factor in parotid carcinoma, however, the pre-operative diagnosis of occult nodal metastasis is difficult in clinical N0 (cN0) parotid cancer patients. In addition, the indication of neck dissection in T1-3 cN0 patients is controversial. The current study investigated 17 patients with clinical T1-3 cN0 parotid cancer, and analyzed the correlation between patient symptoms/findings and pathological N status/tumor histological grade. In the statistical analysis, pain was found to significantly correlate with neck metastasis. Furthermore, cN0-staged patients without pain exhibited no neck metastasis. However, no significant correlation was identified between patient symptoms or findings and histological grade. These results indicate the possibility that selective neck dissection can be omitted for T1-3 cN0-staged patients without pain. PMID:24959272

  14. Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma

    PubMed Central

    Coskun, H. Hakan; Medina, Jesus E.; Robbins, K. Thomas; Silver, Carl E.; Strojan, Primož; Teymoortash, Afshin; Pellitteri, Phillip K.; Rodrigo, Juan P.; Stoeckli, Sandro J.; Shaha, Ashok R.; Suçrez, Carlos; Hartl, Dana M.; de Bree, Remco; Takes, Robert P.; Hamoir, Marc; Pitman, Karen T.; Rinaldo, Alessandra; Ferlito, Alfio

    2016-01-01

    Neck dissection is an important treatment for metastases from upper aerodigestive carcinoma; an event that markedly reduces survival. Since its inception, the philosophy of the procedure has undergone significant change from one of radicalism to the current conservative approach. Furthermore, nonsurgical modalities have been introduced, and, in many situations, have supplanted neck surgery. The refinements of imaging the neck based on the concept of neck level involvement has encouraged new philosophies to evolve that seem to benefit patient outcomes particularly as this relates to diminished morbidity. The purpose of this review was to highlight the new paradigms for surgical removal of neck metastases using an evidence-based approach. PMID:24623715

  15. 49 CFR 572.33 - Neck.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Neck. 572.33 Section 572.33 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES Hybrid III Test Dummy § 572.33 Neck....

  16. Radiation therapy for head and neck neoplasms

    SciTech Connect

    Wang, C.C.

    1990-01-01

    This book presents the clinical manifestations of disease, applied anatomy pertaining to the management of head and neck tumors, and results of conventional radiation therapy for uncommon tumors have been explored. It also contains an additional chapter on altered fractionation radiation therapy pertaining to irradiation of major head and neck tumors.

  17. 49 CFR 572.33 - Neck.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... sensor of the six axis neck transducer and Fx is the force measured in lbs by the “X” axis force sensor... Fx is the force measured in lbs by the “X” axis force sensor (Channel Class 600) of the six axis neck... is vertical and coincides with the plane of motion of the pendulum's longitudinal axis....

  18. Preventable Sternocleidomastoid Muscular Atrophy after Neck Dissection

    PubMed Central

    Yamamoto, Nao; Sawai, Natsuko Yoshimura; Ishimoto, Shunsuke; Ogura, Hide; Aikawa, Tomonao; Kogo, Mikihiko

    2015-01-01

    Background: Modified radical neck dissection (mRND) [preserving the sternocleidomastoid muscle (SCM) and the spinal accessory nerve] and supraomohyoid neck dissection have become common surgical procedures for treating head and neck cancer. Postoperative severe asymmetry of the neck and severe atrophy of the SCM, however, have been demonstrated. Methods: Using computed tomographic images, cross-sectional areas of the SCMs were measured in 99 patients with carcinoma of the oral cavity who underwent unilateral mRND or supraomohyoid neck dissection. An asymmetry index was used. Results: Innervation to the SCM was preserved in 91 patients. The spinal accessory nerve and the innervation were sacrificed in 3 patients; the innervation was repaired in 5 patients. Sacrifice of innervation to the SCM resulted in extremely severe asymmetry. Repair of the innervation prevented severe asymmetry in 40%. Preservation of the innervation prevented severe asymmetry in 75% at the middle portion of the neck and in 56% at the lower portion after mRND. Conclusion: Preserving innervation to the SCM and gentle handling of the nerve during neck dissection could prevent severe asymmetry after neck dissection. PMID:26495217

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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

  4. HPV Associated Head and Neck Cancer.

    PubMed

    Spence, Tara; Bruce, Jeff; Yip, Kenneth W; Liu, Fei-Fei

    2016-01-01

    Head and neck cancers (HNCs) are a highly heterogeneous group of tumours that are associated with diverse clinical outcomes. Recent evidence has demonstrated that human papillomavirus (HPV) is involved in up to 25% of HNCs; particularly in the oropharyngeal carcinoma (OPC) subtype where it can account for up to 60% of such cases. HPVs are double-stranded DNA viruses that infect epithelial cells; numerous HPV subtypes, including 16, 18, 31, 33, and 35, drive epithelial cell transformation and tumourigenesis. HPV positive (HPV+) HNC represents a distinct molecular and clinical entity from HPV negative (HPV-) disease; the biological basis for which remains to be fully elucidated. HPV positivity is strongly correlated with a significantly superior outcome; indicating that such tumours should have a distinct management approach. This review focuses on the recent scientific and clinical investigation of HPV+ HNC. In particular, we discuss the importance of molecular and clinical evidence for defining the role of HPV in HNC, and the clinical impact of HPV status as a biomarker for HNC. PMID:27527216

  5. HPV Associated Head and Neck Cancer

    PubMed Central

    Spence, Tara; Bruce, Jeff; Yip, Kenneth W.; Liu, Fei-Fei

    2016-01-01

    Head and neck cancers (HNCs) are a highly heterogeneous group of tumours that are associated with diverse clinical outcomes. Recent evidence has demonstrated that human papillomavirus (HPV) is involved in up to 25% of HNCs; particularly in the oropharyngeal carcinoma (OPC) subtype where it can account for up to 60% of such cases. HPVs are double-stranded DNA viruses that infect epithelial cells; numerous HPV subtypes, including 16, 18, 31, 33, and 35, drive epithelial cell transformation and tumourigenesis. HPV positive (HPV+) HNC represents a distinct molecular and clinical entity from HPV negative (HPV−) disease; the biological basis for which remains to be fully elucidated. HPV positivity is strongly correlated with a significantly superior outcome; indicating that such tumours should have a distinct management approach. This review focuses on the recent scientific and clinical investigation of HPV+ HNC. In particular, we discuss the importance of molecular and clinical evidence for defining the role of HPV in HNC, and the clinical impact of HPV status as a biomarker for HNC. PMID:27527216

  6. 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

  7. Determine the effect of neck muscle fatigue on dynamic visual acuity in healthy young adults

    PubMed Central

    Al Saif, Amer A.; Al Senany, Samira

    2015-01-01

    [Purpose] The aim of this study was to determine whether neck muscle fatigue affects dynamic visual acuity in healthy young participants. [Subjects and Methods] This study was a double-blinded, prospective, randomized, controlled trial. Thirty healthy young subjects (ages 21 to 30 years) participated in the study. Participants were randomly divided into an experimental group (n=15) and a control group (n=15). The experimental group performed an exercise designed to induce neck muscle fatigue and the control group preformed non-fatiguing sham exercises. [Results] There were significant differences in mean dynamic visual acuity between the two groups (0.26±0.11 LogMar versus 0.003±0.02 LogMar). Subjects in the experimental group showed a significant decline in their dynamic visual acuity compared with the control group. Dynamic visual acuity strongly correlated with neck muscle fatigue (r = 0.79). No significant differences in joint position error were observed between the two groups and no significant correlations between joint position error and neck muscle fatigue were observed (r = 0.23). [Conclusion] The results of this study suggest that neck muscle fatigue negatively impacts dynamic visual acuity. Although not statistically significant, cervical spine proprioception as measured by the joint position error in the experimental group was diminished after fatigue. PMID:25642087

  8. 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

  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. 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

  11. Head and neck mucosal melanoma: a review.

    PubMed

    Lourenço, Silvia V; Fernandes, Juliana D; Hsieh, Ricardo; Coutinho-Camillo, Claudia M; Bologna, Sheyla; Sangueza, Martin; Nico, Marcello M S

    2014-07-01

    Head and neck mucosal melanoma (MM) is an aggressive and rare neoplasm of melanocytic origin. To date, few retrospective series and case reports have been reported on MM. This article reviews the current evidence on head and neck MM and the molecular pathways that mediate the pathogenesis of this disease. Head and neck MM accounts for 0.7%-3.8% of all melanomas and involve (in decreasing order of frequency) the sinonasal cavity, oral cavity, pharynx, larynx, and upper esophagus. Although many studies have examined MM of the head and neck and the underlying molecular pathways, individual genetic and molecular alterations were less investigated. Further studies are needed to complement existing data and to increase our understanding of melanocytes tumorigenesis. PMID:24423929

  12. 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

  13. 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.

  14. Neck pain or spasms - self care

    MedlinePlus

    ... exercise: This may involve walking, riding a stationary bicycle, or swimming. These activities can help improve blood ... Alexander EP. History, physical examination, and differential diagnosis of neck pain. Phys Med Rehabil Clin N Am . Aug 2011;22(3): ...

  15. 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.

  16. 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.

  17. Measuring anteversion and femoral neck-shaft angle in cerebral palsy.

    PubMed

    Miller, F; Liang, Y; Merlo, M; Harcke, H T

    1997-02-01

    Femoral anteversion was measured by computed tomography (CT) in 40 children with cerebral palsy, however an accurate measurement was possible in only 59 of the 80 hips. Flat-surface measurement of anteversion was possible in 72 of 80 hips by CT, and in 36 of 40 hips by ultrasound. A high neck-shaft angle correlated with an inability to measure anteversion by CT. Measuring by ultrasound allowed subjects to be positioned in internal rotation and in this way accurate measurements of neck-shaft angles were obtained. PMID:9062426

  18. Sharp neck injuries in suicidal intention.

    PubMed

    Biétry, Damien; Exadaktylos, Aristomenis; Müller, Thomas; Zbären, Peter; Caversaccio, Marco; Arnold, Andreas

    2015-12-01

    Sharp neck injuries in suicidal intention often present as serious emergency situations with the need for an immediate diagnosis and treatment. We report our study of the clinical evolution of this emergency condition. This study investigates the cases of sharp neck injuries in suicidal intention treated at our institution between 2000 and 2010. Patient records were collected in a retrospectively reviewed and analyzed database. The current literature was compared to our findings. We found 36 cases (10 female and 26 male). The neck injuries were superficial and profound in 16 and 20 patients, respectively. Twenty-two patients were seen by the Head and Neck surgeon. A surgical neck exploration was necessary in 19 cases. Tracheal, laryngeal, pharyngeal and vascular injuries were found in one, five, three and three cases, respectively. The hospital stay ranged from 1 to 47 days. All the patients underwent emergency psychiatric assessment and were subsequently referred for psychiatric treatment. One patient died in the emergency room from an additional arterial injury to the wrist. Sharp neck injuries in suicidal intention treated with an interdisciplinary medical, surgical and psychiatric emergency assessment and treatment have low mortality and morbidity. PMID:25543307

  19. Chronic neck pain and masticatory dysfunction.

    PubMed

    Catanzariti, Jean-François; Debuse, Thierry; Duquesnoy, Bernard

    2005-12-01

    Chronic nonspecific neck pain is a common problem in rheumatology and may resist conventional treatment. Pathophysiological links exist between the cervical spine and masticatory system. Occlusal disorders may cause neck pain and may respond to dental treatment. The estimated prevalence of occlusal disorders is about 45%, with half the cases being due to functional factors. Minor repeated masticatory dysfunction (MD) with craniocervical asymmetry is the most common clinical picture. The pain is usually located in the suboccipital region and refractory to conventional treatment. The time pattern may be suggestive, with nocturnal arousals or triggering by temporomandibular movements. MD should be strongly suspected in patients with at least two of the following: history of treated or untreated MD, unilateral temporomandibular joint pain and clicking, lateral deviation during mouth opening, and limitation of mouth opening (less than three fingerbreadths). Rheumatologists should consider MD among causes of neck pain, most notably in patients with abnormal craniocervical posture, signs linking the neck pain to mastication, and clinical manifestations of MD. Evidence suggesting that MD may cause neck pain has been published. However, studies are needed to determine whether treatment of MD can relieve neck pain. PMID:16226475

  20. 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

  1. [Necrotizing fasciitis of the neck].

    PubMed

    Kovacić, Marijan; Kovacić, Ivan; Delalija, Boris

    2013-03-01

    Necrotizing fasciitis is a rare and rapidly progressive infection characterized by necrosis of the superficial fascia and spread on the surrounding skin or muscles, which can be fatal. It usually occurs in the limbs, abdominal wall and perineum. In this retrospective review, the authors present 15 patients with cervical necrotizing fasciitis. The patient mean age was 54.7 years and they had one or more comorbid health problems. Five of them had descending necrotizing mediastinitis and three had progressive sepsis with toxic shock syndrome. Broad-spectrum intravenous antibiotic therapy was administered to all patients immediately, and in three of them we used five-day intravenous immunoglobulin therapy for the signs of toxic shock syndrome. After positive computed tomography imaging for necrotizing fasciitis, we used surgical exploration and debridement of necrotic tissue. In five patients, the initial surgery also included mediastinal transcervical drainage. Preoperative tracheotomy was performed in six patients and delayed tracheotomy in one patient. Histopathologically, all cases showed extensive necrosis of debrided fascia and vascular thrombosis of the neck soft tissue. The mortality rate was 6.7% (1/15). The authors point to the importance of early diagnosis and timely surgical management, broad-spectrum antibiotics and intravenous immunoglobulin therapy when patients are too unstable to undergo surgery. PMID:24279256

  2. Comparison of DXA and MRI methods for interpreting femoral neck bone mineral density.

    PubMed

    Arokoski, Merja H; Arokoski, Jari P A; Vainio, Pauli; Niemitukia, Lea H; Kröger, Heikki; Jurvelin, Jukka S

    2002-01-01

    The aim of the study was to improve the practical implementation of the dual X-ray absorptiometry (DXA) by converting the areal bone mineral density BMD (BMD(areal)) to volumetric BMD using magnetic resonance (MR) imaging (MRI) because a failure to control for the femoral neck size can lead to erroneous interpretation of BMD values. We also evaluated the feasibility of MR T2* relaxation time in assessing bone mineral status of the femoral neck. Twenty-eight randomly selected 47- to 64-yr-old healthy men were studied. The men had neither unilateral nor bilateral hip osteoarthritis according to radiographs. Bone width, mineral content (BMC), BMD(areal), and apparent volumetric BMD (BMD(vol)) of the right femoral neck were measured with DXA. The BMD(vol) was calculated by approximating the femoral neck to be cylindrical with a circular cross-section (Vol(dxa)). Volumetric measurements from MR (Vol(mri)) images of the femoral neck were also used to create a BMD measure that was corrected for the femoral neck volume (BMD(mri)). T2* measurements were performed with a 1.5-T scanner (Siemens Magnetom 63SP, Erlangen, Germany). A single 10-mm-thick coronal slice was generated on the femur with a repetition time of 60 ms, and nine echo times (4-20 ms) were used to derive T2* values. Vol(mri) correlated positively (r = 0.828, p < 0.001) with Vol(dxa). However, the Vol(mri) of the femoral neck was 18% lower than the Vol(dxa). Similarly, the BMD(mri) was related to the BMD(vol) (r = 0.737, p < 0.001). Because of the difference in the volumetric measures, the BMD(mri) of the femoral neck was 21% higher than the BMD(vol) (p < 0.001). T2* relaxation time showed a significant negative correlation with BMC, BMD(areal), BMD(vol), and BMD(mri) (r = -0.423 to -0.757, p < 0.05-0.001). In conclusion, these results are evidence that DXA-derived volume approximations by the cylinder with circular cross-section geometry may lead to lower DXA-derived BMD(vol) values, as compared to true MRI

  3. Comparison of electromyographic activity and range of neck motion in violin students with and without neck pain during playing.

    PubMed

    Park, Kyue-nam; Kwon, Oh-yun; Ha, Sung-min; Kim, Su-jung; Choi, Hyun-jung; Weon, Jong-hyuck

    2012-12-01

    Neck pain is common in violin students during a musical performance. The purpose of this study was to compare electromyographic (EMG) activity in superficial neck muscles with neck motion when playing the violin as well as neck range of motion (ROM) at rest, between violin students with and without neck pain. Nine violin students with neck pain and nine age- and gender-matched subjects without neck pain were recruited. Muscle activity of the bilateral upper trapezius, sternocleidomastoid, and superficial cervical extensor muscles was measured using surface EMG. Kinematic data on neck motion while playing and active neck ROM were also measured using a three-dimensional motion analysis system. Independent t-tests were used to compare EMG activity with kinematic data between groups. These analyses revealed that while playing, both the angle of left lateral bending and leftward rotation of the cervical spine were significantly greater in the neck pain group than among those without neck pain. Similarly, EMG activity of the left upper trapezius, both cervical extensors, and both sternocleidomastoid muscles were significantly greater in the neck pain group. The active ROM of left axial rotation was significantly lower in the neck pain group. These results suggest that an asymmetric playing posture and the associated increased muscle activity as well as decreased neck axial rotation may contribute to neck pain in violin students. PMID:23247874

  4. 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

  5. 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

  6. 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

  7. Motor vehicle occupants, neck injuries, and seat belt utilization: a 5-year study of fatalities in New York City.

    PubMed

    Sgarlato, Anthony; Deroux, Stephen J

    2010-03-01

    Despite the implementation of numerous safety devices in automobiles, vehicular occupant fatalities following collisions remain common. We reviewed all fatalities of vehicular occupants in New York City over a 5-year period on whom autopsies were performed (437) to determine the incidence of neck injuries and correlate them with seat belt utilization; 26.5% had neck injuries (mild to severe) and only 10.3% of these occupants were confirmed to be wearing seatbelts. Of those that had documentation of seat belt utilization there were twice as many neck injuries in the unbelted group. We highlight two cases of submarining with severe neck injuries that were related to automatic 2-point shoulder harness restraints without engagement of the lap belt. PMID:20070463

  8. Endocrine, morphometric, and ultrasonographic characterization of neck adiposity in Andalusian horses.

    PubMed

    Martin-Gimenez, T; de Blas, I; Aguilera-Tejero, E; Diez de Castro, E; Aguirre-Pascasio, C N

    2016-07-01

    Equine metabolic syndrome (EMS) can be diagnosed by hormonal measurements; however, it would be important to find simpler measurements that allow easy identification of affected or at risk individuals. In horses, the dorsal neck region is one of the most frequent anatomical sites for fat deposition and neck obesity has been linked to EMS. The aim of this study was to evaluate the association of hormonal markers of obesity (leptin) and insulin resistance (insulin) with morphometric and ultrasonographic neck measurements in Andalusian horses. Plasma leptin and insulin concentrations were measured by RIA in 127 Andalusian horses. Neck circumferences (NC) were measured at 3 equidistant locations at 25%, 50%, and 75% of neck length (NC-25%, NC-50%, and NC-75%). At the same 3 locations, subcutaneous fat thickness (SFT-25%, SFT-50%, and SFT-75%) was measured ultrasonographically. In the population under study, a tendency to adiposity was confirmed by the elevated plasma leptin levels (7.47 ± 5.03 ng/mL). However, plasma insulin concentrations (4.05 ± 3.74 μIU/mL) were within normal range in most horses. Our results indicate that NC showed significant sexual dimorphism and did not correlate well with hormonal measurements. Ultrasonographic assessment of fat thickness at the base of the neck (SFT-75%) was significantly correlated with both plasma leptin and insulin and did not show differences between males and females. Thus, in the search for a single objective parameter which can be used in large populations, SFT-75% is a potential candidate and may be a meaningful parameter to predict EMS. PMID:27088603

  9. 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

  10. Optimizing Stability in Femoral Neck Fracture Fixation.

    PubMed

    Ye, Ye; Hao, Jiandong; Mauffrey, Cyril; Hammerberg, E Mark; Stahel, Philip F; Hak, David J

    2015-10-01

    Optimizing stability of femoral neck fracture fixation is important in obtaining a successful outcome. The mechanical problems and strategies for achieving optimal stability differ depending on patients' age and degree of osteoporosis. Femoral neck fractures in younger adults usually result from high-energy trauma and have a vertical fracture pattern. Strategies for optimizing fixation stability in this group include placing additional screws at right angles to the fracture plane and medial buttress plate augmentation. In elderly patients, screw position relative to the intact cortical femoral neck bone is of critical importance. Additional strategies for optimizing fixation stability in this group include the concept of length stable fixation, use of adjunctive calcium phosphate cement, and use of novel fixed angle fixation implants. PMID:26488776

  11. Work-related chronic neck impairment. Neck motion analysis in female traverse crane operators.

    PubMed

    Alund, M; Larsson, S E; Lewin, T

    1992-09-01

    Twenty-one female steel industry traverse crane operators with long-term sick-leave (3 (1-8) years) due to chronic neck disability underwent careful analysis of case history, physical status and electrogoniometric three-dimensional recordings of active neck motion. Results were compared with those from working female crane operators having identical work posture and tasks and, further, with a group of working female clerks. The sick-listed crane operators had previous frequent contacts with the primary health care because of complaints from the neck and back. In comparison with the reference groups, the sick-listed crane operators showed tenderness of the trapezius and levator scapulae muscles and a short neck stature in combination with impaired active neck motion range with reduced motion speed. The motion pattern was however unchanged. The findings are consistent with the clinical picture of chronic neck myalgia that persisted despite long-term absence from the previous exposure to high static work load upon the neck-shoulders. PMID:1411359

  12. 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

  13. 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.

  14. 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

  15. Heparanase 2 Attenuates Head and Neck Tumor Vascularity and Growth.

    PubMed

    Gross-Cohen, Miriam; Feld, Sari; Doweck, Ilana; Neufeld, Gera; Hasson, Peleg; Arvatz, Gil; Barash, Uri; Naroditsky, Inna; Ilan, Neta; Vlodavsky, Israel

    2016-05-01

    The endoglycosidase heparanase specifically cleaves the heparan sulfate (HS) side chains on proteoglycans, an activity that has been implicated strongly in tumor metastasis and angiogenesis. Heparanase-2 (Hpa2) is a close homolog of heparanase that lacks intrinsic HS-degrading activity but retains the capacity to bind HS with high affinity. In head and neck cancer patients, Hpa2 expression was markedly elevated, correlating with prolonged time to disease recurrence and inversely correlating with tumor cell dissemination to regional lymph nodes, suggesting that Hpa2 functions as a tumor suppressor. The molecular mechanism associated with favorable prognosis following Hpa2 induction is unclear. Here we provide evidence that Hpa2 overexpression in head and neck cancer cells markedly reduces tumor growth. Restrained tumor growth was associated with a prominent decrease in tumor vascularity (blood and lymph vessels), likely due to reduced Id1 expression, a transcription factor highly implicated in VEGF-A and VEGF-C gene regulation. We also noted that tumors produced by Hpa2-overexpressing cells are abundantly decorated with stromal cells and collagen deposition, correlating with a marked increase in lysyl oxidase expression. Notably, heparanase enzymatic activity was unimpaired in cells overexpressing Hpa2, suggesting that reduced tumor growth is not caused by heparanase regulation. Moreover, growth of tumor xenografts by Hpa2-overexpressing cells was unaffected by administration of a mAb that targets the heparin-binding domain of Hpa2, implying that Hpa2 function does not rely on heparanase or heparan sulfate. Cancer Res; 76(9); 2791-801. ©2016 AACR. PMID:27013193

  16. [Congenital neck mass. Diagnosis and treatment].

    PubMed

    Muñoz-Proto, F; Sarría-Echegaray, P; Epprecht-González, M P; Alba-Mesquida, J

    2016-01-01

    Congenital neck masses are a challenge for general practitioners and specialists. Although some of them are diagnosed in utero, most of them remain silent until complications appear in the adult age. The anatomical location, consistency and age are determinants in guiding the possible diagnosis. A midline infrahyoid mass may be a thyroglossal cyst, however a lateral neck mass is more possible to result in a brachial cyst. Complementary imaging studies are essential such as pathological tests like needle aspiration fine needle aspiration (FNA). PMID:26558520

  17. 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.

  18. 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

  19. Not just another pain in the neck.

    PubMed

    Campo, Theresa M; Bradbury-Golas, Kathleen; Lucasti, Christopher; Schumacher, William

    2012-01-01

    A 56-year-old man presents to the emergency department with complaints of neck pain with numbness to the right upper extremity. The complaints and symptoms initially appear to be cervical radiculopathy but further diagnostic testing during an inpatient hospitalization revealed an unusual diagnosis. The purpose of this article is to bring awareness to practitioners of the alternative and sometimes rare diagnosis of neck pain. A detailed history and physical examination accompanied with diagnostic testing and collaboration can ensure a definitive diagnosis and positive outcome. PMID:22561223

  20. Chemoprophylaxis for surgery of the head and neck.

    PubMed

    Becker, G D

    1981-01-01

    A prospective study of patients undergoing major head and neck cancer surgery was undertaken to 1) define the value of cefazolin prophylaxis in reducing the incidence of wound infection, 2) define the value of preoperative and intraoperative (perioperative) cultures in identifying the patient at high risk of wound infection and in predicting the bacteriology of subsequent wound infection, and 3) demonstrate the most common aerobic and anaerobic flora of infected wounds. Preoperatively, the neck skin, oropharynx and anterior nares were swabbed for aerobic cultures. An intraoperative wound culture was obtained after the mucosal defect was sutured and the wound irrigated with water and sent for aerobic culture. All infected wounds were cultured for aerobic and anaerobic flora. Cefazolin, 1 g, was given intramuscularly (IM) about two hours before the skin incision, and continued in 0.5 g doses IM or intravenously (IV) every six hours for four doses. Cefazolin prophylaxis significantly reduced the incidence of postoperative wound infection. Isolation of aerobic pathogens perioperatively was not correlated with a greater risk of wound infection and did not accurately predict the flora of subsequent wound infection. The most common pathogenic aerobes isolated from infected wounds were Staphylococcus aureus and beta-Streptococcus not group A, as well as a variety of Gram-negative organisms. The most common anaerobic isolate was Bacteroides melaninogenicus. PMID:6791570

  1. 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

  2. Functional morphology of the primate head and neck.

    PubMed

    Nalley, Thierra K; Grider-Potter, Neysa

    2015-04-01

    The vertebral column plays a key role in maintaining posture, locomotion, and transmitting loads between body components. Cervical vertebrae act as a bridge between the torso and head and play a crucial role in the maintenance of head position and the visual field. Despite its importance in positional behaviors, the functional morphology of the cervical region remains poorly understood, particularly in comparison to the thoracic and lumbar sections of the spinal column. This study tests whether morphological variation in the primate cervical vertebrae correlates with differences in postural behavior. Phylogenetic generalized least-squares analyses were performed on a taxonomically broad sample of 26 extant primate taxa to test the link between vertebral morphology and posture. Kinematic data on primate head and neck postures were used instead of behavioral categories in an effort to provide a more direct analysis of our functional hypothesis. Results provide evidence for a function-form link between cervical vertebral shape and postural behaviors. Specifically, taxa with more pronograde heads and necks and less kyphotic orbits exhibit cervical vertebrae with longer spinous processes, indicating increased mechanical advantage for deep nuchal musculature, and craniocaudally longer vertebral bodies and more coronally oriented zygapophyseal articular facets, suggesting an emphasis on curve formation and maintenance within the cervical lordosis, coupled with a greater resistance to translation and ventral displacement. These results not only document support for functional relationships in cervical vertebrae features across a wide range of primate taxa, but highlight the utility of quantitative behavioral data in functional investigations. PMID:25752265

  3. Comfort effects of a new car headrest with neck support.

    PubMed

    Franz, M; Durt, A; Zenk, R; Desmet, P M A

    2012-03-01

    This paper describes the design of a neck-/headrest to increase car comfort. Two studies were undertaken to create a new comfortable headrest with neck support. In experiment one, neck- and headrest data were gathered using 35 test subjects. The pressure distribution, stiffness of the foam material and position of the head and neck support were determined. In experiment two a full adjustable final headrest with adjustable neck support was constructed and tested with 12 subjects using a new adjustable headrest under virtual reality driving conditions. Experiment two showed that the headrest with the new/adjustable neck support was favoured by the majority of the subjects. 83% were satisfied with the stiffness of the material. 92% were satisfied with the size of the neck- and headrest. All subjects mentioned that the neck support is a comfort benefit in calm traffic conditions or on the motorway. PMID:21944482

  4. 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.

  5. 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.

  6. Transoral Endoscopic Head and Neck Surgery: The Contemporary Treatment of Head and Neck Cancer.

    PubMed

    Lim, Gil Chai; Holsinger, Floyd Christopher; Li, Ryan J

    2015-12-01

    Traditional open surgical approaches are indicated for treatment of select tumor subsites of head and neck cancer, but can also result in major cosmetic and functional morbidity. Transoral surgical approaches have been used for head and neck cancer since the 1960s, with their application continuing to evolve with the changing landscape of this disease and recent innovations in surgical instrumentation. The potential to further reduce treatment morbidity with transoral surgery, while optimizing oncologic outcomes, continues to be investigated. This review examines current literature evaluating oncologic and quality-of-life outcomes achieved through transoral head and neck surgery. PMID:26568549

  7. The evolution of surgery in the management of neck metastases

    PubMed Central

    Subramanian, S; Chiesa, F; Lyubaev, V; Aidarbekova, A; Brzhezovskiy, V

    2006-01-01

    Summary In spite of advancement in science, molecular medicine and target therapies, surgical treatment of metastases using different techniques, from selective neck dissection to extended radical neck dissections, form a major part in the management of neck metastases. This is due to the fact that, so far, there is no treatment more effective for resectable neck metastases, than surgery. Since most head and neck cancer patients die due to loco-regional progression of disease, and a very large majority of them do not live long enough to develop distant metastases, the status of neck lymph nodes remains the single most important prognostic factor, in these cases. In the 100 years since George Washington Crile described Radical Neck Dissection, we now have a much better understanding of the biological and clinical behaviour of neck metastases. This has ultimately led to the conservative approaches of selective neck dissections depending on the primary site of the tumour, type of tumour and the characteristic features of the metastases themselves. A search of the literature on neck lymph nodes and neck dissections, on the internet and in old publications, not available in the electronic media, has been carried out. Using this as the basis, we arranged, in sequence, the dates of various landmarks in the treatment of head and neck cancer related to neck dissections to emphasize the overall process of evolution of neck dissection thereby showing how the field of head and neck surgery has travelled a long way from radical neck dissection to its modifications and further to selective neck dissections and sentinel node biopsies. The present understanding of the patterns of neck metastases enables us not only to adequately treat the neck metastases, but also to diagnose metastases from unknown primaries. Therefore, depending on the site of the primary tumour, it is now easy to predict the most probable route of metastatic spread and vice versa. This has enabled us to adopt

  8. 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

  9. [A smoker with hoarseness and a swelling of his neck].

    PubMed

    van der Poel, N A; Vleming, M; Bok, J W

    2016-01-01

    A 68-year-old man was referred to the Department of Otolaryngology because of a swelling of his neck and hoarseness. CT imaging of his neck revealed a cystic mass in the larynx as well as in the neck, with an air-fluid level. The diagnosis 'laryngopyocele' was made. PMID:27096477

  10. 27 CFR 9.109 - Northern Neck George Washington Birthplace.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 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. The appropriate maps for determining the boundaries of the Northern Neck George Washington Birthplace...

  11. 27 CFR 9.109 - Northern Neck George Washington Birthplace.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 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. The appropriate maps for determining the boundaries of the Northern Neck George Washington Birthplace...

  12. 27 CFR 9.109 - Northern Neck George Washington Birthplace.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 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. The appropriate maps for determining the boundaries of the Northern Neck George Washington Birthplace...

  13. 27 CFR 9.109 - Northern Neck George Washington Birthplace.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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. The appropriate maps for determining the boundaries of the Northern Neck George Washington Birthplace...

  14. 27 CFR 9.109 - Northern Neck George Washington Birthplace.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 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. The appropriate maps for determining the boundaries of the Northern Neck George Washington Birthplace...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 50 Facts about Oral, Head and Neck Cancer

    MedlinePlus

    ... ENT Doctor Near You 50 Facts about Oral, Head and Neck Cancer 50 Facts about Oral, Head and Neck Cancer Patient Health Information News media ... public relations staff at newsroom@entnet.org . Oral, Head and Neck Cancer most commonly refers to squamous ...

  2. 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

  3. 49 CFR 572.113 - Neck assembly.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Neck assembly. 572.113 Section 572.113 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES Side Impact Hybrid...

  4. Anatomy of lithosphere necking during orthogonal rifting

    NASA Astrophysics Data System (ADS)

    Nestola, Yago; Cavozzi, Cristian; Storti, Fabrizio

    2013-04-01

    The evolution of lithosphere necking is a fundamental parameter controlling the structural architecture and thermal-state of rifted margin. The necking shape depends on several parameters, including the extensional strain-rate and thermal layering of the lithosphere. Despite a large number of analogue and numerical modelling studies on lithosphere extension, a quantitative description of the evolution of necking through time is still lacking. We used analogue modelling to simulate in three-dimension the progression of lithosphere thinning and necking during orthogonal rifting. In our models we simulated a typical "cold and young" 4-layer lithosphere stratigraphy: brittle upper crust (loose quartz sand), ductile lower crust (silicon-barite mixture), brittle upper mantle (loose quartz sand), and ductile lower mantle (silicon-barite mixture). The experimental lithosphere rested on a glucose syrup asthenosphere. We monitored model evolution by periodic and coeval laser scanning of both the surface topography and the lithosphere base. After model completion, each of the four layers was removed and the top of the underlying layer was scanned. This technical approach allowed us to quantify the evolution in space and time of the thinning factors for both the whole lithosphere (βz) and the crust (γ). The area of incremental effective stretching (βy) parallel to the extensional direction was obtained from the βz maps.

  5. 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

  6. Head and neck cancer stem cells.

    PubMed

    Krishnamurthy, S; Nör, J E

    2012-04-01

    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

  7. 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 572.33) in either the left or right lateral impact orientations, respectively, so that...

  8. Bronchogenic cysts of the neck in adults.

    PubMed

    Newkirk, Kenneth A; Tassler, Andrew B; Krowiak, Edward J; Deeb, Ziad E

    2004-09-01

    Bronchogenic cysts are congenital sacs that result from maldevelopment of the primitive foregut. Although they occur predominantly in the chest, there are reports of lesions in extrathoracic locations. The majority of reported bronchogenic cysts located in the neck are found in the pediatric population; a review of the literature reveals few reports of bronchogenic cysts of the neck among adults. The diagnosis of a bronchogenic cyst relies on the histology and location of the lesion. Here, we review our experience in the diagnosis and management of 2 adult patients with pathologically proven bronchogenic cysts. Both patients presented with solitary neck masses that proved to be bronchogenic cysts on histologic examination. Our purpose is to define the histopathologic and clinical characteristics of bronchogenic cysts and discuss the features that distinguish them from other cervical cysts. In conclusion, congenital bronchogenic cysts can occur in the neck of adults and should be considered in the differential diagnosis of cystic cervical masses in adults, as well as children. PMID:15453524

  9. 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... shown in 49 CFR Part 572 Figure 15, at the instant the pendulum makes contact with the...

  10. 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;...

  11. 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;...

  12. 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... shown in 49 CFR Part 572 Figure 15, at the instant the pendulum makes contact with the...

  13. 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.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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.

  20. 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

  1. Anthropometric Assessment of Neck Adipose Tissue and Airway Volume Using Multidetector Computed Tomography

    PubMed Central

    Maresky, Hillel S.; Sharfman, Zachary; Ziv-Baran, Tomer; Gomori, J.M.; Copel, Laurian; Tal, Sigal

    2015-01-01

    Abstract 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 mm2, respectively. NATV when compared to the upper and lower levels of NCSA showed correlations of 0.64 and 0.79, respectively (P < 0.001). Interobserver analysis showed mean deviations of 0.46% and 0.32% for NATV and AWV, respectively. A strong correlation between NATV and body mass index (BMI) was found (r = 0.658, P < 0.001), and the top quartile of NATV:AWV patients (out of 519 patients) displayed a statistically significant mortality rate during 670 days of follow-up (d = 7.5%, P = 0.032). After adjustment for age and gender, the association between NATV:AWV and mortality was close to significant (P = 0.072). Volumetric quantification of NATV and AWV is a reproducible and prognostic anthropometric tool, as a high NATV:AWV demonstrated a significant risk factor for mortality; future research may further advance our understanding of this phenomenon. PMID:26559286

  2. [Rare giant salivary gland pleomorphic adenoma on the neck].

    PubMed

    Shi, Dongling; Li, Qinghuai

    2013-12-01

    The patient has found his neck mass for more than 30 years, and the neck mass has slowly growed into giant tumor. Five days ago, the neck giant mass suddenly burst, hemorrhage and overflow liquid. The giant mass with irregular in shape, surface uneven, skin highly tension and superficial venous engorgement, was seen in left lateral neck. CT scan demonstrates a mixture of solid, cystic and lobulated mass shadow within subcutaneous fat spaces of left lateral neck. Postoperative pathological examination proved that it is salivary gland pleomorphic adenoma. PMID:24620671

  3. 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

  4. Comparison of visual and ultrasound based techniques to measure head repositioning in healthy and neck-pain subjects.

    PubMed

    Roren, Alexandra; Mayoux-Benhamou, Marie-Anne; Fayad, Fouad; Poiraudeau, Serge; Lantz, Didier; Revel, Michel

    2009-06-01

    Three-dimensional (3D) ultrasound based (US) and usual Revel visual techniques were compared to measure head repositioning ability in 41 healthy subjects and 41 subjects with neck pain. Head repositioning absolute value of the global error (AE) was calculated by both techniques after active head rotations. The AE was 3.6 degrees and 3.7 degrees for healthy subjects and 6.3 degrees and 6.1 degrees for neck-pain subjects for the visual and US techniques, respectively. The AE was higher in neck-pain subjects (p<0.001), and a value of 4.5 degrees was identified as a threshold of abnormal repositioning for both techniques. The test-retest reliability, calculated in the neck-pain subjects, was moderate (intraclass correlation coefficient [ICC]=0.68) for both techniques. The correlation between the two techniques for AE was poor for both groups with successive measurement of visual and US techniques (r=0.32 and 0.46, respectively) but excellent with simultaneous measurement (r=0.95 for both groups). Moreover, we showed substantial agreement between the techniques in discriminating healthy and neck-pain subjects (kappa=0.65). The Revel visual technique is more appropriate for clinical practice, but with improved software, the 3D US method could provide additional quantitative and qualitative data invaluable for research. PMID:18514016

  5. 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

  6. 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

  7. Head and neck solitary infantile myofibroma: Clinicopathological and immunohistochemical features of a case series.

    PubMed

    Lopes, Rodrigo Nascimento; Alves, Fábio de Abreu; Rocha, André Caroli; Suassuna, Thales M; Kowalski, Luiz Paulo; de Castro, Jurema Freire Lisboa; Perez, Danyel Elias da Cruz

    2015-01-01

    Infantile myofibroma is a rare mesenchymal benign tumor mostly found in the head and neck region. The aim of this study was to describe a small case series of head and neck solitary infantile myofibroma, emphasizing the importance of the histopathological and immunohistochemical features, and the potential diagnostic challenges. For the study, clinical and imaging data were obtained from the medical records. All cases were histologically reviewed, and immunohistochemical analyses were performed to confirm the diagnosis. Four cases of head and neck solitary infantile myofibroma were identified. All patients were females and presented a mean age of 3 years old (ranging from 2 to 6 years). The site of the tumors were the mandible, right cheek, subcutaneous tissue adjacent to basal cortical of the mandible and upper anterior gingiva. No symptoms, such as pain or paresthesia, were reported. Computerized tomography revealed well-delimited tumors. All tumors were positive for vimentin and alpha-smooth muscle actin. All patients underwent surgical excision and no signs of recurrence were observed after long-term follow-up. In summary, head and neck solitary infantile myofibromas are rare and present excellent prognosis. The correlation between clinical, histopathological and immunohistochemical features are essential for a correct diagnosis. PMID:25744090

  8. Effects of changing in the neck circumference during sleep on snoring sound characteristics.

    PubMed

    Saha, Shumit; Taheri, Mahsa; Mossuavi, Zahra; Yadollahi, Azadeh

    2015-01-01

    Rostral fluid shift during sleep from the lower body part into the neck can increase neck circumference (NC) and narrow the upper airway. Such narrowing in the upper airway may increase turbulence of airflow passing through the upper airway; thus, induce snoring. The objective of this study was to investigate the effects of changes in NC during sleep on snoring sound characteristics. Fifteen non-obese men slept supine, and their sleep was monitored by a regular polysomnography. Snoring sounds were recorded with a microphone attached to the neck. NC was measured before and after sleep with a measuring tape. Snoring sounds' average power was calculated in different frequency ranges of 100 - 4000 Hz, 100 - 150 Hz, 150 - 450 Hz, 450 - 600 Hz, 600 - 1200 Hz, 1200 - 1800 Hz, 1800 - 2500 Hz and 2500 - 4000 Hz. Statistical analysis showed that increases in NC after sleep were strongly correlated with higher average power of the snoring sounds in the frequency ranges of 100-4000 Hz (r=0.74, P=0.004), 100-150 Hz (r=0.70, P=0.008), 150-450 Hz (r=0.73, P=0.005), and 450 - 600 Hz (r= 0.65, P=0.025). These results encourage the use of snoring sound analysis for monitoring the effects of fluid accumulation in the neck in relation to sleep apnea. PMID:26736736

  9. Multiple regions-of-interest analysis of setup uncertainties for head-and-neck cancer radiotherapy

    SciTech Connect

    Zhang Lifei; Garden, Adam S.; Lo, Justin; Ang, K. Kian; Ahamad, Anesa; Morrison, William H.; Rosenthal, David I.; Chambers, Mark S.; Zhu, X. Ronald; Mohan, Radhe; Dong Lei . E-mail: ldong@mdanderson.org

    2006-04-01

    Purpose: To analyze three-dimensional setup uncertainties for multiple regions of interest (ROIs) in head-and-neck region. Methods and Materials: In-room computed tomography (CT) scans were acquired using a CT-on-rails system for 14 patients. Three separate bony ROIs were defined: C2 and C6 vertebral bodies and the palatine process of the maxilla. Translational shifts of 3 ROIs were calculated relative to the marked isocenter on the immobilization mask. Results: The shifts for all 3 ROIs were highly correlated. However, noticeable differences on the order of 2-6 mm existed between any 2 ROIs, indicating the flexibility and/or rotational effect in the head-and-neck region. The palatine process of the maxilla had the smallest right-left shifts because of the tight lateral fit in the face mask, but the largest superior-inferior movement because of in-plane rotation and variations in jaw positions. The neck region (C6) had the largest right-left shifts. The positioning mouthpiece was found effective in reducing variations in the superior-inferior direction. There was no statistically significant improvement for using the S-board (8 out of 14 patients) vs. the short face mask. Conclusions: We found variability in setup corrections for different regions of head-and-neck anatomy. These relative positional variations should be considered when making setup corrections or designing treatment margins.

  10. Carbonic anhydrase-9 expression in head and neck cancer: a meta-analysis.

    PubMed

    Peridis, Stamatios; Pilgrim, Gemma; Athanasopoulos, Ioannis; Parpounas, Konstantinos

    2011-05-01

    The purpose of the study was to compare CA-9 positivity versus CA-9 negativity in head and neck malignancies and to correlate levels of CA-9 with tumor grade, size, and nodal status. Overall and disease-free survival were also compared for CA-9 positive and negative tumors. A literature search was performed using Medline, Embase, Ovid and Cochrane databases for studies between 1990 and 2009. Carbonic anhydrase IX, CA IX, CA-9, head and neck, and survival were used as search terms. Random-effect meta-analytical techniques were conducted for outcome measures of overall survival and disease-free survival. Sixteen studies matched the selection criteria, reporting on 1,470 patients. Eight hundred and forty two specimens were reported as being CA-9 positive or negative: 512 (60.81%) were CA-9 positive and 330 (39.19%) were CA-9 negative. Nine hundred and eighty specimens had levels of CA-9 expression recorded: 547 (55.82%) had high levels of CA-9 and 433 (44.18%) had low CA-9 levels. Survival was significantly reduced if the tumor was positive for CA-9 (P < 0.0001). Disease-free survival is significantly reduced in patients with CA-9 positive (P = 0.0008) head and neck malignant tumors. The presence of CA-9 in head and neck malignant tumors is associated with reduced overall survival and disease-free survival. PMID:21246209

  11. 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

  12. 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

  13. Test Characteristics of Neck Fullness and Witnessed Neck Pulsations in the Diagnosis of Typical AV Nodal Reentrant Tachycardia

    PubMed Central

    Sakhuja, Rahul; Smith, Lisa M; Tseng, Zian H; Badhwar, Nitish; Lee, Byron K; Lee, Randall J; Scheinman, Melvin M; Olgin, Jeffrey E; Marcus, Gregory M

    2011-01-01

    Summary Background Claims in the medical literature suggest that neck fullness and witnessed neck pulsations are useful in the diagnosis of typical AV nodal reentrant tachycardia (AVNRT). Hypothesis Neck fullness and witnessed neck pulsations have a high positive predictive value in the diagnosis of typical AVNRT. Methods We performed a cross sectional study of consecutive patients with palpitations presenting to a single electrophysiology (EP) laboratory over a 1 year period. Each patient underwent a standard questionnaire regarding neck fullness and/or witnessed neck pulsations during their palpitations. The reference standard for diagnosis was determined by electrocardiogram and invasive EP studies. Results Comparing typical AVNRT to atrial fibrillation (AF) or atrial flutter (AFL) patients, the proportions with neck fullness and witnessed neck pulsations did not significantly differ: in the best case scenario (using the upper end of the 95% confidence interval [CI]), none of the positive or negative predictive values exceeded 79%. After restricting the population to those with supraventricular tachycardia other than AF or AFL (SVT), neck fullness again exhibited poor test characteristics; however, witnessed neck pulsations exhibited a specificity of 97% (95% CI 90–100%) and a positive predictive value of 83% (95% CI 52–98%). After adjustment for potential confounders, SVT patients with witnessed neck pulsations had a 7 fold greater odds of having typical AVNRT, p=0.029. Conclusions Although neither neck fullness nor witnessed neck pulsations are useful in distinguishing typical AVNRT from AF or AFL, witnessed neck pulsations are specific for the presence of typical AVNRT among those with SVT. PMID:19479968

  14. 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

  15. Neck masses in children: diagnosis and treatment.

    PubMed

    May, M

    1976-08-01

    Neck masses in children most often represent benign lymphadenitis due to infection. The involved lymph nodes are usually small, shotty, diffusely distributed, and superficial. They may be tender and associated with an acute upper respiratory infection or with chronic infection of the tonsils and adenoids. Enlargement of the jugulodigastric node is most often associated with tonsillitis, and the spinal accessory group of nodes with adenoiditis. Acute viral diseases may be associated with lymphadenopathy; mononucleosis is the most striking example. The differential diagnosis must include deep neck-space abscesses, congenital cysts, and benign as well as malignant neoplasms. A diagnosis can be derived from a consideration of the history and physical findings, the age of the patient, and the location, size, and consistency of the mass. A careful otolaryngologic exam--including the nasopharynx, a chest radiograph, and appropriate blood studies--should be routine. When malignancy is suspected, a biopsy of the mass is indicated. PMID:958741

  16. Translation and validation of the German version of the Bournemouth Questionnaire for Neck Pain

    PubMed Central

    2012-01-01

    Background Clinical outcome measures are important tools to monitor patient improvement during treatment as well as to document changes for research purposes. The short-form Bournemouth questionnaire for neck pain patients (BQN) was developed from the biopsychosocial model and measures pain, disability, cognitive and affective domains. It has been shown to be a valid and reliable outcome measure in English, French and Dutch and more sensitive to change compared to other questionnaires. The purpose of this study was to translate and validate a German version of the Bournemouth questionnaire for neck pain patients. Methods German translation and back translation into English of the BQN was done independently by four persons and overseen by an expert committee. Face validity of the German BQN was tested on 30 neck pain patients in a single chiropractic practice. Test-retest reliability was evaluated on 31 medical students and chiropractors before and after a lecture. The German BQN was then assessed on 102 first time neck pain patients at two chiropractic practices for internal consistency, external construct validity, external longitudinal construct validity and sensitivity to change compared to the German versions of the Neck Disability Index (NDI) and the Neck Pain and Disability Scale (NPAD). Results Face validity testing lead to minor changes to the German BQN. The Intraclass Correlation Coefficient for the test-retest reliability was 0.99. The internal consistency was strong for all 7 items of the BQN with Cronbach α's of .79 and .80 for the pre and post-treatment total scores. External construct validity and external longitudinal construct validity using Pearson's correlation coefficient showed statistically significant correlations for all 7 scales of the BQN with the other questionnaires. The German BQN showed greater responsiveness compared to the other questionnaires for all scales. Conclusions The German BQN is a valid and reliable outcome measure that

  17. [Grading of head and neck neoplasms].

    PubMed

    Agaimy, A; Weichert, W

    2016-07-01

    Tumors of the head and neck form a heterogeneous group of benign and malignant neoplasms with significant differences in biological behavior and therapeutic strategies. Squamous cell carcinomas (SCC) of the larynx, pharynx and oral cavity represent the most frequent and, thus, clinically most important malignant neoplasms in this anatomical region. Similar to other neoplasms, grading of head and neck malignancies is based on evaluation of the tumor histology usually including both architectural and cytological features; however, the current consensus grading for head and neck SCC is of limited prognostic and therapeutic value and the reproducibility is low. Therefore, novel grading criteria have been proposed that are based on additional parameters, such as the type of tumor growth pattern at the invasive front (so-called tumor budding). These novel algorithms, however, have not yet been officially endorsed into guidelines. Salivary gland (SG) neoplasms, although less frequent, constitute a second important pathologically and clinically complex group of tumors at this location. In contrast to SCC, grading of these tumors is of high clinical importance. Based on the large variety of carcinoma entities of the SG, both entity-specific (e. g. mucoepidermoid carcinoma) algorithms but also algorithms, which are solely based on the recognition of a specific carcinoma variant with subsequent automatic assignment of the tumor grade (e. g. acinic cell carcinoma and salivary duct carcinoma) are in use. In the sinonasal tract, grading is important for non-intestinal type adenocarcinoma and esthesioneuroblastoma. In this article the most important grading schemes and criteria for head and neck malignancies are presented and their prognostic and therapeutic implications are discussed. PMID:27342593

  18. Neck injury response to direct head impact.

    PubMed

    Ivancic, Paul C

    2013-01-01

    Previous in vivo studies have observed flexion of the upper or upper/middle cervical spine and extension at inferior spinal levels due to direct head impacts. These studies hypothesized that hyperflexion may contribute to injury of the upper or middle cervical spine during real-life head impact. Our objectives were to determine the cervical spine injury response to direct head impact, document injuries, and compare our results with previously reported in vivo data. Our model consisted of a human cadaver neck (n=6) mounted to the torso of a rear impact dummy and carrying a surrogate head. Rearward force was applied to the model's forehead using a cable and pulley system and free-falling mass of 3.6kg followed by 16.7kg. High-speed digital cameras tracked head, vertebral, and pelvic motions. Average peak spinal rotations observed during impact were statistically compared (P<0.05) to physiological ranges obtained from intact flexibility tests. Peak head impact force was 249 and 504N for the 3.6 and 16.7kg free-falling masses, respectively. Occipital condyle loads reached 205.3N posterior shear, 331.4N compression, and 7.4Nm extension moment. We observed significant increases in intervertebral extension peaks above physiologic at C6/7 (26.3° vs. 5.7°) and C7/T1 (29.7° vs. 4.6°) and macroscopic ligamentous and osseous injuries at C6 through T1 due to the 504N impacts. Our results indicate that a rearward head shear force causes complex neck loads of posterior shear, compression, and extension moment sufficient to injure the lower cervical spine. Real-life neck injuries due to motor vehicle crashes, sports impacts, or falls are likely due to combined loads transferred to the neck by direct head impact and torso inertial loads. PMID:22613632

  19. [Deep neck infections: a retrospective study].

    PubMed

    Bagnati, Tania; Olina, Massimo; Guglielmetti, Chiara; Borello, Giovanni; Valletti, Paolo Aluffi; Pia, Francesco; Garavelli, Pietro Luigi

    2007-09-01

    A retrospective study was carried out on 79 patients with deep neck infections (DNI) admitted to our Department between 1990 and 2005 in order to review our experience with DNI and verify if diabetic and immunocompromised patients have more aggressive infections and poorer prognosis. Demographics, clinical presentation, etiology, site of infection, associated systemic diseases (26.6%-21/79), microbiology, treatment and complications were considered. PMID:17902568

  20. Course and Prognostic Factors for Neck Pain in Workers

    PubMed Central

    Hogg-Johnson, Sheilah; Côté, Pierre; van der Velde, Gabrielle; Holm, Lena W.; Carragee, Eugene J.; Hurwitz, Eric L.; Peloso, Paul M.; Cassidy, J. David; Guzman, Jaime; Nordin, Margareta; Haldeman, Scott

    2008-01-01

    Study Design Best-evidence synthesis. Objective To perform a best evidence synthesis on the course and prognostic factors for neck pain and its associated disorders in workers. Summary of Background Data Knowledge of the course of neck pain in workers guides expectations for recovery. Identifying prognostic factors assists in planning effective workplace policies, formulating interventions and promoting lifestyle changes to decrease the frequency and burden of neck pain in the workplace. Methods The Bone and Joint Decade 2000−2010 Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) conducted a critical review of the literature published between 1980 and 2006 to assemble the best evidence on neck pain and its associated disorders. Studies meeting criteria for scientific validity were included in a best evidence synthesis. Results We found 226 articles related to course and prognostic factors in neck pain and its associated disorders. After a critical review, 70 (31%) were accepted on scientific merit; 14 of these studies related to course and prognostic factors in working populations. Between 60% and 80% of workers with neck pain reported neck pain1 year later. Few workplace or physical job demands were identified as being linked to recovery from neck pain. However, workers with little influence on their own work situation had a slightly poorer prognosis, and white-collar workers had a better prognosis than blue-collar workers. General exercise was associated with better prognosis; prior neck pain and prior sick leave were associated with poorer prognosis. Conclusion The Neck Pain Task Force presents a report of current best evidence on course and prognosis for neck pain. Few modifiable prognostic factors were identified; however, having some influence over one's own job and being physically active seem to hold promise as prognostic factors.

  1. 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

  2. Bladder neck sparing in radical prostatectomy

    PubMed Central

    Smolski, Michal; Esler, Rachel C.; Turo, Rafal; Collins, Gerald N.; Oakley, Neil; Brough, Richard

    2013-01-01

    The role of a bladder neck sparing (BNS) technique in radical prostatectomy (RP) remains controversial. The potential advantages of improved functional recovery must be weighed against oncological outcomes. We performed a literature review to evaluate the current knowledge regarding oncological and functional outcomes of BNS and bladder neck reconstruction (BNr) in RP. A systematic literature review using on-line medical databases was performed. A total of 33 papers were identified evaluating the use of BNS in open, laparoscopic and robotic-assisted RP. The majority were retrospective case series, with only one prospective, randomised, blinded study identified. The majority of papers reported no significant difference in oncological outcomes using a BNS or BNr technique, regardless of the surgical technique employed. Quoted positive surgical margin rates ranged from 6% to 32%. Early urinary continence (UC) rates were ranged from 36% to 100% at 1 month, with long-term UC rate reported at 84-100% at 12 months if the bladder neck (BN) was spared. BNS has been shown to improve early return of UC and long-term UC without compromising oncological outcomes. Anastomotic stricture rate is also lower when using a BNS technique. PMID:24235797

  3. Talar Neck Fracture after United Tibiotalar Fusion.

    PubMed

    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

  4. 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).

  5. Evolution and development of the vertebrate neck

    PubMed Central

    Ericsson, Rolf; Knight, Robert; Johanson, Zerina

    2013-01-01

    Muscles of the vertebrate neck include the cucullaris and hypobranchials. Although a functional neck first evolved in the lobe-finned fishes (Sarcopterygii) with the separation of the pectoral/shoulder girdle from the skull, the neck muscles themselves have a much earlier origin among the vertebrates. For example, lampreys possess hypobranchial muscles, and may also possess the cucullaris. Recent research in chick has established that these two muscles groups have different origins, the hypobranchial muscles having a somitic origin but the cucullaris muscle deriving from anterior lateral plate mesoderm associated with somites 1–3. Additionally, the cucullaris utilizes genetic pathways more similar to the head than the trunk musculature. Although the latter results are from experiments in the chick, cucullaris homologues occur in a variety of more basal vertebrates such as the sharks and zebrafish. Data are urgently needed from these taxa to determine whether the cucullaris in these groups also derives from lateral plate mesoderm or from the anterior somites, and whether the former or the latter represent the basal vertebrate condition. Other lateral plate mesoderm derivatives include the appendicular skeleton (fins, limbs and supporting girdles). If the cucullaris is a definitive lateral plate-derived structure it may have evolved in conjunction with the shoulder/limb skeleton in vertebrates and thereby provided a greater degree of flexibility to the heads of predatory vertebrates. PMID:22697305

  6. Perforator Flaps in Head and Neck Reconstruction

    PubMed Central

    Chana, Jagdeep S.; Odili, Joy

    2010-01-01

    Free tissue transfer has revolutionized the management of complex head and neck defects. Perforator flaps represent the most recent advance in the development of free flap surgery. These flaps are based on perforating vessels and can be harvested without significant damage to associated muscles, thereby reducing the postoperative morbidity associated with muscle-based flaps. Elevation of perforator flaps requires meticulous technique and can be more challenging than raising muscle-based flaps. Use of a Doppler device enables reliable identification of the perforating vessels and aids in the design of free-style free flaps, where the flaps are designed purely according to the perforator located. The major advantage of free-style free flaps is that an unlimited number of flaps can potentially be designed on much shorter pedicles. The anterolateral thigh flap is the most commonly used perforator flap in head and neck reconstruction. Its use is described in detail, as is use of other less common perforator flaps. This article also describes head and neck reconstruction in a region-specific manner and gives a short-list of suitable flaps based on the location of the defect. PMID:22550446

  7. The femoral head–neck contour varies as a function of physeal development

    PubMed Central

    Vo, A.; Beaule, P. E.; Sampaio, M. L.; Rotaru, C.; Rakhra, K. S.

    2015-01-01

    Objectives The purpose of this study was to investigate whether the femoral head–neck contour, characterised by the alpha angle, varies with the stage of physeal maturation using MRI evaluation of an asymptomatic paediatric population. Methods Paediatric volunteers with asymptomatic hips were recruited to undergo MRI of both hips. Femoral head physes were graded from 1 (completely open) to 6 (completely fused). The femoral head–neck contour was evaluated using the alpha angle, measured at the 3:00 (anterior) and 1:30 (anterosuperior) positions and correlated with physeal grade, with gender sub-analysis performed. Results A total of 43 asymptomatic paediatric volunteers (26 male, 17 female) with mean age 13.0 years (eight to 18) were included with review of bilateral hip MRIs. Correlation between the physeal grade and alpha angle was moderate in males at both the 3:00 (r = 0.477, p < 0.001) and 1:30 (r = 0.509, p < 0.001) positions, whereas there was no significant correlation in females. A significant difference was found between the alpha angles of all the physeal grades (3:00, p = 0.030, 1:30, p = 0.005), but only in males, with the angle increasing with higher grades. For physeal grading, the inter-reader reliability was substantial (intraclass correlation coefficient (ICC) = 0.694), and the intra-reader reliability was also substantial (ICC = 0.788). Conclusion The femoral head–neck contour varies and correlates with the stage of physeal development, but only in males, with the alpha angle increasing with progressive physeal maturation. This suggests that gender differences exist in the natural physiological growth, development or remodelling of femoral head–neck junction. In males, pre-physeal fusion may be a critical period of vulnerability for development of morphologic abnormalities of the femoral head–neck junction. Cite this article: Bone Joint Res 2015;4:17–22 PMID:25673625

  8. 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.

  9. Overcoming barriers to effective immunotherapy: MDSCs, TAMs, and Tregs as mediators of the immunosuppressive microenvironment in head and neck cancer.

    PubMed

    Davis, Ruth J; Van Waes, Carter; Allen, Clint T

    2016-07-01

    A significant subset of head and neck cancers display a T-cell inflamed phenotype, suggesting that patients with these tumors should respond to therapeutic approaches aimed at strengthening anti-tumor immune responses. A major barrier to the development of an effective anti-tumor immune response, at baseline or in response to immunotherapy, is the development of an immunosuppressive tumor microenvironment. Several well described mechanisms of effector immune cell suppression in the head and neck cancer microenvironment are discussed here, along with updates on current trials designed to translate what we have learned from pre-clinical and correlative clinical studies into improved responses in patients with head and neck cancer following immune activating therapies. PMID:27215705

  10. X-pinch dynamics: Neck formation and implosion

    SciTech Connect

    Oreshkin, V. I.; Chaikovsky, S. A.; Artyomov, A. P.; Labetskaya, N. A.; Fedunin, A. V.; Rousskikh, A. G.; Zhigalin, A. S.

    2014-10-15

    We propose a model that describes the neck formation and implosion in an X-pinch. The process is simulated to go in two stages. The first stage is neck formation. This stage begins with an electrical explosion of the wires forming the X-pinch, and at the end of the stage, a micropinch (neck) is formed in the region where the wires are crossed. The second stage is neck implosion. The implosion is accompanied by outflow of matter from the neck region, resulting in the formation of a “hot spot”. Analytical estimates obtained in the study under consideration indicate that these stages are approximately equal in duration. Having analyzed the neck implosion dynamics, we have verified a scaling which makes it possible to explain the observed dependences of the time of occurrence of an x-ray pulse on the X-pinch current and mass.

  11. Association of Neck Circumference with Obesity in Female College Students

    PubMed Central

    Papandreou, Dimitrios; Noor, Zujaja Tul; Rashed, Maitha; Jaberi, Hadeel Al

    2015-01-01

    BACKGROUND: Obesity levels have been dramatically increased in the United Arab Emirates over the last few years. High levels of body Mass Index, waist circumference, and percent of total body fat as a measure of obesity have found to be related to cardiovascular risk factors and other diseases. Neck circumference is a new tool that has been linked to obesity. However, no studies in UAE have been conducted yet. AIM: The purpose of this study was to measure the obesity levels in a college population and to correlate them with NC and other anthropometrical indexes. METHODS AND SUBJECTS: Two hundred forty three (243) female students aged 18-25 were conveniently selected to participate in the study. Anthropometrical indexes were obtained from all subjects e after fasting. RESULTS: The prevalence of overweight and obesity together was found to be 28.4 % (n = 69). Pearson correlation showed that WC, NC and BF (%) were significantly positively related to obesity, (r = 0.790; r = 0.758; r = 0.767, p < 0.001), respectively. In multiple regression analysis, only NC (Beta: 1.627, 95 %CI: 0.370, 2.846, p < 0.001) and WC (Beta: 0.464, 95 %CI: 0.135, 0.664, p < 0.001) were found to be independently associated with obesity. CONCLUSION: NC was found to be independently associated with obesity levels in Emirati college students.

  12. 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

  13. Corrosion behavior of tantalum-coated cobalt-chromium modular necks compared to titanium modular necks in a simulator test.

    PubMed

    Dorn, Ulrich; Neumann, Daniel; Frank, Mario

    2014-04-01

    This study compared the corrosion behavior of tantalum-coated cobalt-chromium modular necks with that of titanium alloy modular necks at their junction to titanium-alloy femoral stem. Tests were performed in a dry assembly and two wet assemblies, one contaminated with calf serum and the other contaminated with calf serum and bone particles. Whereas the titanium modular neck tested in the dry assembly showed no signs of corrosion, the titanium modular necks tested in both wet assemblies showed marked depositions and corrosive attacks. By contrast, the tantalum-coated cobalt-chromium modular necks showed no traces of corrosion or chemical attack in any of the three assemblies. This study confirms the protective effect of tantalum coating the taper region of cobalt-chromium modular neck components, suggesting that the use of tantalum may reduce the risk of implant failure due to corrosion. PMID:24099841

  14. 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

  15. The association between malnutrition and psychological distress in patients with advanced head-and-neck cancer

    PubMed Central

    Ma, L.; Poulin, P.; Feldstain, A.; Chasen, M.R.

    2013-01-01

    Objective Malnutrition and psychological distress are often seen in patients with head-and-neck cancer, but little is known about the interrelationships between those two symptoms. The present study examined the relationship between malnutrition and psychological distress in patients with advanced head-and-neck cancer. Methods Using the Patient-Generated Subjective Global Assessment, 99 patients with advanced-stage head-and-neck cancer were screened for nutrition status. The patients were also screened for psychosocial distress (using the Distress Thermometer) and for psychosocial issues (using the Problem Checklist). Any relationship between malnutrition and psychosocial distress was determined by regression and correlation analysis. We also used t-tests to compare distress levels for patients with and without specific nutrition-related symptoms. Results The study group included 80 men and 19 women [mean age: 58.4 ± 10.9 years (range: 23–85 years)]. The correlation between poorer nutrition status and level of psychological distress was significant r = 0.37 (p < 0.001). Specifically, reduced food intake and symptoms were both positively associated with distress: r = 0.27 and r = 0.29 respectively, both significant at p < 0.01. After controlling for the effects of psychosocial problems and pain, nutrition status remained a significant predictor of distress, explaining 3.8% of the variance in the distress scores of the patients (p < 0.05). Conclusions Malnutrition and symptoms were strongly related to distress in patients with advanced head-and-neck cancer. Our results suggest the need for further research into the complex relationship between nutrition status and distress and into the management of both nutrition and distress in cancer care. PMID:24311956

  16. Leiomyosarcoma of the Head and Neck

    PubMed Central

    Eppsteiner, Robert W.; DeYoung, Barry R.; Milhem, Mohammed M.; Pagedar, Nitin A.

    2012-01-01

    Objectives To describe the characteristics of head and neck leiomyosarcoma and to identify factors associated with survival. Design Retrospective population-based study. Patients The 17-registry Surveillance, Epidemiology, and End Results database was used to identify 578 patients with leiomyosarcoma of the head and neck. Interventions Surgery and primary and adjuvant radiotherapy. Main Outcome Measures Patient demographics and tumor characteristics were examined. Treatment modalities were compared, and survival was assessed using the log-rank test. Results The mean age at diagnosis was 64 years. Most tumors were smaller than 5 cm in greatest dimension (87%) and high grade (44% were moderately differentiated and 39% were poorly differentiated). The primary tumor demonstrated deep extension in 39% of cases, and 2% had lymph node metastases. The most common primary site was the skin and soft tissue of the head and neck (83%). Surgical treatment was provided to 89% of patients, 14% received adjuvant radiotherapy, and 4% received radiotherapy alone. The median observed survival was 84.7 months. The 5-year disease-specific survival rate was 87.6% in patients with well-differentiated tumors, 85.7% in patients with moderately differentiated tumors, and 52.7% in patients with poorly differentiated tumors (P<.001). Survival was better for patients who received surgery alone (median survival, 100.1 months [n=413]) than for those who received radiotherapy alone (median survival, 16 months [n=16]) or adjuvant radiotherapy (median survival, 64.2 months [n=80]) (P<.001). The latter group was more likely to have poorly differentiated, large, locally invasive tumors. Conclusions Leiomyosarcoma typically presents in older patients; it is often poorly differentiated; and improved survival is associated with surgical treatment. PMID:21930982

  17. [Head and neck cancer--history].

    PubMed

    Woźniak, Anna; Szyfter, Krzysztof; Szyfter, Witold; Florek, Ewa

    2012-01-01

    According to epidemiological data head and neck cancers constitute for 12% of all malignancies in the world. It is estimated that a total of 400 000 cases of the mouth and throat and of 160 000 cases of laryngeal cancer, 300 000 people die each year. History of head and neck cancers developed and underwent many changes at the turn of the century. Treatment, pathogenesis and possessed state of knowledge on the subject has changed. Starting from the ancient times there were texts on how to treat and examine patients. The Edwin Smith and Ebers Papyrus are two of the oldest medical documents describing the treatment of cancer patients. Hippocrates was the first person who used the word "cancer" and probably he was the first who divided the tumors into benign and malignant. In a document known as the Doctrine of Hippocrates he described skin cancer and cancer treatments. Over the next centuries, medical science did not develop because of religious concerns about autopsy and surgical procedures. The 17th century is a period in which there were a lot of new information about how to treat such oral cancer. Cancer of the tongue was removed by cauterization, which in the 18th century was replaced by the use of surgical instruments. In the same age glossectomy has been accepted as the treatment of choice performed in the treatment of cancer. The 19th century brought a major breakthrough in the treatment of surgical, diagnostic, anesthetic techniques and understanding of the pathological mechanisms. Histological evaluation of tumors has become mandatory and standard practice in the assessment of cancer. Laryngectomy and neck lymph nodes removal has become commonplace. Modified Radical Neck Dissection (MRND), became popularized as another cancer treatment technique. Describing ways to treat cancer, radiotherapy can not be ignored - there are several new techniques such as Intensity Modulated Radiotherapy (IMRT) and hypofractionation currently used. Chemotherapy and the

  18. The extended SMAS approach to neck rejuvenation.

    PubMed

    Perkins, Stephen W; Waters, Heather H

    2014-05-01

    Jowling, submental lipoptosis, and platysmal banding can affect self-image and reduce quality of life, leading one to seek facial and neck rejuvenation. With realistic expectations, a facelift can provide the desired improvement in appearance and sense of well-being. Before any intervention, a detailed history, focused examination, communication of expected outcomes with the assistance of preoperative digital imaging, and discussion of perioperative instructions are of utmost importance. Although many techniques exist, the modified deep plane extended superficial muscular aponeurotic system rhytidectomy with submentoplasty reliably delivers a significant improvement with lasting results. PMID:24745387

  19. Cystic masses of neck: A pictorial review

    PubMed Central

    Mittal, Mahesh Kumar; Malik, Amita; Sureka, Binit; Thukral, Brij Bhushan

    2012-01-01

    Cystic masses of neck consist of a variety of pathologic entities. The age of presentation and clinical examination narrow down the differential diagnosis; however, imaging is essential for accurate diagnosis and pretreatment planning. Ultrasound is often used for initial evaluation. Computed tomography (CT) provides additional information with regard to the extent and internal composition of the mass. Fine-needle aspiration cytology (FNAC) has a supplementary role for confirmation of diagnosis. Magnetic resonance imaging may be needed in some cases for preoperative assessment. PMID:23833426

  20. An Unusual Observation During Neck Dissection.

    PubMed

    Anehosur, Venkatesh; Rajendiran, Saravanan; Jayade, Gautam R; Kumar, Niranjan

    2016-07-01

    External jugular vein (EJV) is a major superficial vein in the neck which drains deeper parts of face and posterior scalp region. Although it follows a predicted pattern in formation, course and termination in general unusually it also exhibits variations which are clinically important. Gross variations in the incidence of these variations in EJV are noted. We report an anomalous course of EJV which drains into internal jugular vein in our case report. Knowledge about EJV and its origin, course and termination is important for surgeons, interventional radiologist, anaesthesiologist, clinicians in general to avoid inadvertent complication. PMID:27408458

  1. Imaging of head and neck emergencies.

    PubMed

    Brucker, Justin L; Gentry, Lindell R

    2015-01-01

    The anatomy of the head and neck contains very few structures that could be considered expendable and, consequently, is exceptionally intolerant to infection, inflammation, and injury. Acute pathologic processes in this body region, therefore, tend to result in significant suffering, functional impairment, or life endangerment if the diagnosis is missed or treatment is delayed. Many emergent processes within the cervical region also need to be considered for their possible impact on structures within the head and chest, into which there are many routes for potential communication. PMID:25476182

  2. Sex-specific prediction of neck muscle volumes

    PubMed Central

    Zheng, Liying; Siegmund, Gunter; Ozyigit, Gulsum; Vasavada, Anita

    2013-01-01

    Biomechanical analyses of the head and neck system require knowledge of neck muscle forces, which are often estimated from neck muscle volumes. Here we use magnetic resonance images (MRIs) of 17 subjects (6 females, 11 males) to develop a method to predict the volumes of 16 neck muscles by first predicting the total neck muscle volume (TMV) from subject sex and anthropometry, and then predicting individual neck muscle volumes using fixed volume proportions for each neck muscle. We hypothesized that the regression equations for total muscle volume as well as individual muscle volume proportions would be sex specific. We found that females have 59% lower TMV compared to males (females: 510±43 cm3, males: 814±64 cm3; p<0.0001) and that TMV (in cm3) was best predicted by a regression equation that included sex (male=0, female=1) and neck circumference (NC, in cm): TMV=269+13.7NC−233 Sex (adjusted R2=0.868; p<0.01). Individual muscle volume proportions were not sex specific for most neck muscles, although small sex differences existed for three neck muscles (obliqus capitis inferior, longus capitis, and sternocleidomastoid). When predicting individual muscle volumes in subjects not used to develop the model, coefficients of concordance ranged from 0.91 to 0.99. This method of predicting individual neck muscle volumes has the advantage of using only one sex-specific regression equation and one set of sex-specific volume proportions. These data can be used in biomechanical models to estimate muscle forces and tissue loads in the cervical spine. PMID:23351366

  3. Development and Reproducibility of a Computed Tomography–Based Measurement for Upper Body Subcutaneous Neck Fat

    PubMed Central

    Rosenquist, Klara J.; Therkelsen, Kate E.; Massaro, Joseph M.; Hoffmann, Udo; Fox, Caroline S.

    2014-01-01

    Background Upper body subcutaneous neck fat (UBSF) is a unique fat depot anatomically separate from visceral abdominal fat that appears to be associated with cardiometabolic risk above and beyond generalized adiposity. We sought to develop a protocol to quantify UBSF using multidetector computed tomography measurements. Methods and Results Protocol development was performed in participants from the Framingham Heart Study who had participated in the multidetector computed tomography scanning substudy, consisting of chest scans. Volumetric assessment of UBSF was defined by 40 contiguous 0.625‐mm slices superior to the body of the sternum. The reader manually traced the chest to identify total neck fat. Breast tissue exterior to the chest wall was excluded. Subcutaneous and visceral fat volumes were obtained using standard protocols. Age‐ and sex‐adjusted Pearson correlation coefficients were used to assess the association among UBSF, traditional adiposity measures, and cardiometabolic risk factors. Inter‐ and intrareader reproducibility was assessed using intraclass correlation coefficients. Volumetric assessments were obtained in 92 participants because 8 scans were not readable (51% women; mean age: 59 years [women], 58 years [men]). The mean volume of UBSF was 310 cm3 for women and 345 cm3 for men. Intra‐ and interreader class correlation coefficients were 0.99 and 0.99, respectively. UBSF was correlated with waist circumference (r=0.90), neck circumference (r=0.75), body mass index (r=0.89), subcutaneous adipose tissue (r=0.87), and visceral adipose tissue (r=0.86). Conclusions UBSF can be quantified reproducibly using computed tomography in a community‐dwelling sample from the Framingham Heart Study. PMID:25523152

  4. 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.

  5. Reconstruction following head and neck burns.

    PubMed

    Neale, H W; Billmire, D A; Carey, J P

    1986-01-01

    Burn reconstruction of the head and neck must first start with special care to this anatomic area in the early acute phase, with appropriate early débridement and coverage with sheet grafts of medium thickness into unit facial orientation. Postoperative garment and mask splinting, will help lessen the hypertrophic scar formation that frequently follows facial burns and skin coverage. Carefully planned reconstruction of these areas is indicated, with priority given first to the neck, then to the periorbital area, and then to perioral areas. Principles of scalp, ear, nasal, and cheek reconstruction following burns of the face are carefully outlined. The unit concept of burn scar resurfacing of the face has been the mainstay of our treatment. We have emphasized skin coverage of the face from similar donor site areas. The emotional and psychological effects of facial scarring secondary to severe burns are crippling to patients. Although numerous reconstructive surgical procedures may lessen the deformity, ultimately burn patients realize that their burn scars are permanent and no surgeon can give them back their original facial appearance. These patients need strong and continued support and reassurance from their physicians and nursing professional staff to maintain their self-identity and confidence. PMID:3514059

  6. Photodynamic therapy in head and neck cancer.

    PubMed

    Nelke, Kamil H; Pawlak, Wojciech; Leszczyszyn, Jarosław; Gerber, Hanna

    2014-01-01

    Photodynamic therapy (PDT) is a special type of treatment involving the use of a photosensitizer or a photosensitizing agent along with a special type of light, which, combined together, induces production of a form of oxygen that is used to kill surrounding cells in different areas of the human body. Specification of the head and neck region requires different approaches due to the surrounding of vital structures. PDT can also be used to treat cells invaded with infections such as fungi, bacteria and viruses. The light beam placed in tumor sites activates locally applied drugs and kills the cancer cells. Many studies are taking place in order to invent better photosensitizers, working on a larger scale and to treat deeply placed and larger tumors. It seems that PDT could be used as an alternative surgical treatment in some tumor types; however, all clinicians should be aware that the surgical approach is still the treatment of choice. PDT is a very accurate and effective therapy, especially in early stages of head and neck squamous cell carcinomas (HNSCC), and can greatly affect surgical outcomes in cancerous patients. We present a detailed review about photosensitizers, their use, and therapeutic advantages and disadvantages. PMID:24491903

  7. Extracranial Head and Neck Schwannomas: Our Experience.

    PubMed

    Shrikrishna, B H; Jyothi, A C; Kulkarni, N H; Mazhar, Md Shafiuddin

    2016-06-01

    Schwannomas are benign neoplasms of the peripheral nerves originating in the Schwann cells. They are rare and usually solitary, with clearly delimited capsules. They occur in the head and neck region in only 25 % of the cases, and may be associated with Von Recklinghausen's disease. Schwannomas are always a diagnostic dilemma as they are asymptomatic for long time and histopathology is the gold standard for diagnosis. The present study retrospectively analysed data of 4 patients with schwannomas and reviewed the literature on the subject. Retrospective study at ENT & Head and Neck Surgery Department of Navodaya Medical College, Raichur. Data of 4 patients between 2008 and 2014 were reviewed. The sites of cervical schwannomas and the intraoperative, histopathological and postoperative clinical status of these cases were studied. Diagnostic methods, type of surgery and associated nerve of origin (NOO) were evaluated. The patients' age ranged from 18 to 50 years. None of them had type I neurofibromatosis or Von Recklinghausen's disease. The nerves affected included the brachial plexus, vagus nerve, sympathetic chain and lingual nerve. The nerve of origin was identified based on intra-operative findings and post-operative neurological deficits. Tumour was removed by debulk operation with the preservation of NOO method. Schwannomas are generally benign, and rarely recur. An accurate preoperative workup with the identification of NOO is very important not only for a correct diagnosis, but also for surgical planning and informing the patient about the possible complications. PMID:27340644

  8. Exploring biomarkers in head and neck cancer.

    PubMed

    Langer, Corey J

    2012-08-15

    Personalized medicine based on predictive markers linked to drug response, it is hoped, will lead to improvements in outcomes and avoidance of unnecessary treatment in squamous cell carcinoma of the head and neck (SCCHN). Recent research has shown that expression of ERCC1 may predict resistance to treatment with platinum agents. Future testing for this marker may help select the optimal type of chemotherapy. Infection with human papillomavirus (HPV) is associated with less aggressive disease and better prognosis in locally advanced SCCHN treated with chemoradiation or radiation alone; HPV-positive patients may ultimately benefit from less intensive, less toxic therapy. K-RAS mutations, occurring in about 40% of colorectal cancers and associated with lack of benefit from epidermal growth factor receptor (EGFR) antibodies in this disease, are found in <5% of SCCHN patients, making routine testing for K-RAS mutations unwarranted at this time. Virtually all head and neck tumors overexpress EGFR, which limits the usefulness of EGFR expression as a marker for treatment selection. Although the incidence of EGFR tyrosine kinase domain mutations is very rare, a better understanding of the role of EGFR mutations, expression, amplification, and downstream effects in SCCHN may help define the role of EGFR in this setting. These observations caution against extrapolating results obtained with biomarkers in other types of cancer to SCCHN. Validation of each biomarker in the context of SCCHN clinical trials will be required before a specific marker can be incorporated into daily practice. PMID:22281752

  9. [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

  10. [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