Sample records for neck clinicoplathologic correlation

  1. Neck muscle stiffness quantified by sonoelastography is correlated with body mass index and chronic neck pain symptoms.

    PubMed

    Kuo, Wen-Hsiu; Jian, Deng-Wei; Wang, Tyng-Guey; Wang, Yi-Chian

    2013-08-01

    This study aimed to quantify neck muscle stiffness in the normal population with ultrasound elastography. We applied the acoustic radiation force impulse technique and measured shear wave velocities (SWVs) as representative values. The mean ± standard deviation values of SWV in 20 healthy volunteers were 2.09 ± 0.45, 1.21 ± 0.30, 1.12 ± 0.17 and 0.97 ± 0.10 m/s for the trapezius, levator scapulae, scalene anterior and sternocleidomastoid muscles, respectively. The SWV values of the four muscles significantly differed (Kruskal-Wallis test, p < 0.001). The SWV values for the trapezius muscle correlated with body mass indexes (Pearson's correlation, p = 0.034). Subjects with chronic neck pain symptoms had significantly stiffer trapezius muscle (Mann-Whitney U test, p = 0.008). This study demonstrated the technique and feasibility of quantifying neck muscle stiffness using acoustic radiation force impulse elastography and shear wave velocity detection. Further study is necessary to evaluate its diagnostic power in assessing various neck muscle diseases. PMID:23683408

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

    PubMed Central

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

    2013-01-01

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

  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. [Univ. of California, Los Angeles, CA (United States)

    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. 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

  5. From multifragmentation to neck fragmentation: Mass, isospin, and velocity correlations

    NASA Astrophysics Data System (ADS)

    Baran, V.; Colonna, M.; Di Toro, M.; Zus, R.

    2012-05-01

    We present new features of fragmentation dynamics at the transition from semicentral to semiperipheral heavy-ion collisions at Fermi energies, as obtained within a microscopic transport model, the stochastic mean field. We show that, along this transition, specific hierarchy phenomena of some kinematic observables associated with the intermediate mass fragments develop. Their correlations with the dynamics of the isospin degree of freedom, predicted by our calculations, open new possibilities to learn about the density dependence of nuclear symmetry energy below saturation, as well as about the relevant fragmentation mechanisms. Detailed results are presented for mass symmetric Sn+Sn reactions with different isospin content at 50 MeV/nucleon.

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

    PubMed Central

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

    2014-01-01

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

  7. Oral side effects of head and neck irradiation: correlation between clinical manifestations and laboratory data.

    PubMed

    Kuten, A; Ben-Aryeh, H; Berdicevsky, I; Ore, L; Szargel, R; Gutman, D; Robinson, E

    1986-03-01

    Salivary flow rate and composition, oral microflora and clinical manifestations of radiation damage were studied in 32 patients treated with external irradiation to head and neck areas. Several parameters were investigated: field arrangement, amount of salivary glands irradiated, clinical manifestations such as dryness of the mouth, taste impairment, dysphagia, salivary secretion and composition, and oral yeast flora. The salivary glands have a greater sensitivity to radiation damage than the gustatory tissues. The decrease in salivary secretion is accompanied by a rise in salivary sodium concentration, and in oral yeast flora. The clinical symptomatology was correlated with the amount of salivary glands irradiated. We found that most of the parotids have to be outside of the treated volume, when the rest of the major salivary glands are irradiated, to prevent severe dryness phenomena. PMID:3957738

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

    SciTech Connect

    Burri, Ryan J. [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States)], E-mail: ryan.burri@mountsinai.org; Rangaswamy, Balasubramanya; Kostakoglu, Lale [Division of Nuclear Medicine, Mount Sinai School of Medicine, New York, NY (United States); Hoch, Benjamin [Department of Pathology, Mount Sinai School of Medicine, New York, NY (United States); Genden, Eric M. [Department of Otolaryngology-Head and Neck Surgery, Mount Sinai School of Medicine, New York, NY (United States); Som, Peter M. [Department of Radiology, Mount Sinai School of Medicine, New York, NY (United States); Kao, Johnny [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States)

    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.

  9. RAR beta2 suppression in head and neck squamous cell carcinoma correlates with site, histology and age.

    PubMed

    Olasz, Judit; Juhász, Alíz; Remenár, Eva; Engi, Helga; Bak, Mihály; Csuka, Orsolya; Kásler, Miklós

    2007-07-01

    Retinoids as important growth and differentiation regulating agents have a potential role in the chemoprevention of head and neck squamous cell carcinoma (HNSCC). Despite the promising preclinical and early clinical findings, limitations of application are raised by intrinsic resistance acquired during carcinogenesis. Retinoic acid receptor beta2 (RAR beta2) is one of the proximate mediators of retinoid signalling and its expression is often diminished in early stages of head and neck carcinogenesis. One form of retinoid resistance has been associated with the methylation-induced silencing of the RAR beta gene. We studied primary HNSCC samples of different anatomical sites in respect of methylation, expression and allelic loss of RAR beta gene. A strong correlation (p<0.01) was found between hyper-methylation and reduced expression of RAR beta2, however the allelic loss at 3p24, the locus of RAR beta, did not considerably influence its mRNA level. Hypopharynx tumors showed significantly lower hypermethylation (p<0.05) and higher mRNA expression levels of RAR beta2 compared to the tumors located at other sites of the head and neck. We could also provide evidence that poorly differentiated grade 3 tumors had significantly higher RAR beta2 expression and lower methylation levels (p<0.05) than better differentiated grade 1 and grade 2 tumors. In addition, we found a good correlation between the methylation degree of the RAR beta2 promoter and the ages of patients. Collectively, our results suggest that evaluation of several factors such as tumor location, age, histology and methylation state of the RAR beta gene might contribute to the selection of patients for retinoid-based chemoprevention. PMID:17549354

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

    PubMed Central

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

    2015-01-01

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

  11. Neck dissection

    MedlinePLUS

    ... dissection; Modified radical neck dissection; Selective neck dissection; Lymph node removal - neck ... dissection is a major surgery done to remove lymph nodes that have cancer. It is done in the ...

  12. Enhanced Expression of ANO1 in Head and Neck Squamous Cell Carcinoma Causes Cell Migration and Correlates with Poor Prognosis

    PubMed Central

    Rudin, Florian; Schneider, Sandra; Dietsche, Tanja; Fischer, Claude A.; Tornillo, Luigi; Terracciano, Luigi M.; Schreiber, Rainer; Bubendorf, Lukas; Kunzelmann, Karl

    2012-01-01

    Head and neck squamous cell carcinoma (HNSCC) has the potential for early metastasis and is associated with poor survival. Ano1 (Dog1) is an established and sensitive marker for the diagnosis of gastrointestinal stromal tumors (GIST) and has recently been identified as a Ca2+ activated Cl? channel. Although the ANO1 gene is located on the 11q13 locus, a region which is known to be amplified in different types of human carcinomas, a detailed analysis of Ano1 amplification and expression in HNSCC has not been performed. It is thus still unclear how Ano1 contributes to malignancy in HNSCC. We analyzed genomic amplification of the 11q13 locus and Ano1 together with Ano1-protein expression in a large collection of HNSCC samples. We detected a highly significant correlation between amplification and expression of Ano1 and showed that HNSCC patients with Ano1 protein expression have a poor overall survival. We further analyzed the expression of the Ano1 protein in more than 4?000 human samples from 80 different tumor types and 76 normal tissue types and detected that besides HNSCC and GISTs, Ano1 was rarely expressed in other tumor samples or healthy human tissues. In HNSCC cell lines, expression of Ano1 caused Ca2+ activated Cl? currents, which induced cell motility and cell migration in wound healing and in real time migration assays, respectively. In contrast, knockdown of Ano1 did not affect intracellular Ca2+ signaling and surprisingly did not reduce cell proliferation in BHY cells. Further, expression and activity of Ano1 strongly correlated with the ability of HNSCC cells to regulate their volume. Thus, poor survival in HNSCC patients is correlated with the presence of Ano1. Our results further suggest that Ano1 facilitates regulation of the cell volume and causes cell migration, which both can contribute to metastatic progression in HNSCC. PMID:22912841

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

    SciTech Connect

    Truong, Minh Tam, E-mail: mitruong@bu.edu [Department of Radiation Oncology, Boston Medical Center and Boston University School of Medicine, Boston, MA (United States); Department of Radiology, Boston Medical Center and Boston University School of Medicine, Boston, MA (United States); Lee, Richard [Department of Radiation Oncology, Boston Medical Center and Boston University School of Medicine, Boston, MA (United States); Saito, Naoko [Department of Radiology, Boston Medical Center and Boston University School of Medicine, Boston, MA (United States); Qureshi, Muhammad M. [Department of Radiation Oncology, Boston Medical Center and Boston University School of Medicine, Boston, MA (United States); Ozonoff, Al [Department of Biostatistics, Boston University School of Public Health, Boston, MA (United States); Romesser, Paul B. [Department of Radiation Oncology, Boston Medical Center and Boston University School of Medicine, Boston, MA (United States); Wang, Jimmy; Sakai, Osamu [Department of Radiology, Boston Medical Center and Boston University School of Medicine, Boston, MA (United States)

    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.

  14. Neck Pain

    MedlinePLUS

    ... Pregnancy and Rheumatic Disease Sex and Arthritis Neck Pain PRINT Download PDF Description Saying, “It’s a pain ... requires expensive or uncomfortable tests. What is neck pain? Acute strain may occur after sleeping in an ...

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

    SciTech Connect

    Prosnitz, Robert G. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)]. E-mail: robert.prosnitz@duke.edu; Yao, Bin M.S. [Amgen, Inc. Thousand Oaks, CA (United States); Farrell, Catherine L. [Amgen, Inc. Thousand Oaks, CA (United States); Clough, Robert [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Brizel, David M. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)

    2005-03-15

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

  16. Neck lump

    MedlinePLUS

    ... et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice . 7th ed. Philadelphia, Pa: Elsevier Mosby; 2009:chap 70. Chen A, Otto KJ. Differential diagnosis of neck masses. In: Cummings CW, Flint PW, ...

  17. 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

  18. Neck pain

    PubMed Central

    2008-01-01

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

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

    SciTech Connect

    Balermpas, Panagiotis [Department of Radiation Therapy and Oncology, J. W. Goethe – University Frankfurt am Main, Frankfurt (Germany)] [Department of Radiation Therapy and Oncology, J. W. Goethe – University Frankfurt am Main, Frankfurt (Germany); Michel, Yvonne [Senckenberg Institute of Pathology, J. W. Goethe – University Frankfurt am Main, Frankfurt (Germany)] [Senckenberg Institute of Pathology, J. W. Goethe – University Frankfurt am Main, Frankfurt (Germany); Wagenblast, Jens [Department of Otorhinolaryngology, J. W. Goethe – University Frankfurt am Main, Frankfurt (Germany)] [Department of Otorhinolaryngology, J. W. Goethe – University Frankfurt am Main, Frankfurt (Germany); Seitz, Oliver [Department of Maxillofacial Surgery, J. W. Goethe – University Frankfurt am Main, Frankfurt (Germany)] [Department of Maxillofacial Surgery, J. W. Goethe – University Frankfurt am Main, Frankfurt (Germany); Sipek, Florian; Rödel, Franz; Rödel, Claus [Department of Radiation Therapy and Oncology, J. W. Goethe – University Frankfurt am Main, Frankfurt (Germany)] [Department of Radiation Therapy and Oncology, J. W. Goethe – University Frankfurt am Main, Frankfurt (Germany); Fokas, Emmanouil, E-mail: emmanouil.fokas@kgu.de [Department of Radiation Therapy and Oncology, J. W. Goethe – University Frankfurt am Main, Frankfurt (Germany)] [Department of Radiation Therapy and Oncology, J. W. Goethe – University Frankfurt am Main, Frankfurt (Germany)

    2013-07-15

    Background: To examine whether nuclear NF-?B 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-?B p65 (RelA) nuclear immunoreactivity. A sample was assigned to be positive with more than 5% positive nuclear expression. The predictive relevance of NF-?B 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-?B/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-?B/p65 and its role as a suitable target for a molecular-based targeted therapy in HNSCC cancer.

  20. 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.

    PubMed

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

    2014-01-01

    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 69.96Gy 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(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 29.2Gy, 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. PMID:24485054

  1. 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, E-mail: mitruong@bu.edu

    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.

  2. 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, E-mail: mhatake@radiol.med.kyushu-u.ac.jp [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City (Japan); Nakamura, Katsumasa; Yabuuchi, Hidetake; Shioyama, Yoshiyuki; Matsuo, Yoshio; Ohnishi, Kayoko; Sunami, Shunya; Kamitani, Takeshi; Setoguchi, Taro; Yoshiura, Takashi [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City (Japan); Nakashima, Torahiko [Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City (Japan); Nishikawa, Kei [Radiology Center, Kyushu University Hospital, Kyushu University, Fukuoka City (Japan); Honda, Hiroshi [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City (Japan)

    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.

  3. 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

  4. Neck Circumference and Cardio- Metabolic Syndrome

    PubMed Central

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

    2014-01-01

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

  5. Is elective neck dissection indicated during salvage surgery for head and neck squamous cell carcinoma?

    PubMed

    Sanabria, Alvaro; Silver, Carl E; Olsen, Kerry D; Medina, Jesus E; Hamoir, Marc; Paleri, Vinidh; Mondin, Vanni; Rinaldo, Alessandra; Rodrigo, Juan P; Suárez, Carlos; Boedeker, Carsten C; Hinni, Michael L; Kowalski, Luiz P; Teymoortash, Afshin; Werner, Jochen A; Takes, Robert P; Ferlito, Alfio

    2014-12-01

    Among patients with head and neck squamous cell carcinoma with a negative neck who are initially treated with (chemo)radiotherapy, a number of cases will recur locally without obvious neck recurrence. There is little information available as to the most efficacious management of the neck in these cases. We have reviewed the literature to see what conclusions can be drawn from previous reports. We conducted a bibliography search on MEDLINE and EMBASE databases. Studies published in the English language and those on squamous cell carcinoma of the oral cavity, nasopharynx, oropharynx, larynx and hypopharynx were included. Data related to neck management were extracted from the articles. Twelve studies satisfied the inclusion criteria. Five studies reported only one treatment plan (either neck dissection or observation), while the others compared neck dissection to observation. The rate of occult metastases ranged from 3.4 to 12 %. The studies included a variable distribution of primary sites and stages of the recurrent primary tumors. The risk of occult neck node metastasis in a clinically rN0 patient correlated with tumor site and T stage. Observation of the neck can be suggested for patients with T1-2 glottic tumors, who recurred with less advanced tumors (rT1-2). For patients with more advanced laryngeal recurrences or recurrence at other high-risk sites, neck dissection could be considered for the rN0 patient, particularly if the neck was not included in the previous radiation fields. PMID:24515917

  6. Neck curve polynomials in neck rupture model

    SciTech Connect

    Kurniadi, Rizal; Perkasa, Yudha S.; Waris, Abdul [Nuclear Physics and Biophysics Research Division, Department of Physics, Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung, Jalan Ganesa 10 Bandung 40132 (Indonesia)

    2012-06-06

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

  7. Head and Neck Cancer

    MedlinePLUS

    Head and Neck Cancer Head and Neck Cancer htmCancerHead Head and neck cancer begins with the abnormal growth of cells. These cells multiply out of ... eventually forming a tumor in part of the head or neck. 284362 InteliHealth 2010-06-16 t ...

  8. 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., E-mail: Stephanie.donaldson@physics.cr.man.ac.uk [School of Cancer and Enabling Sciences, University of Manchester, Manchester (United Kingdom) and North Western Medical Physics, The Christie, Manchester (United Kingdom); Betts, Guy [School of Cancer and Enabling Sciences, University of Manchester, Manchester (United Kingdom); Bonington, Suzanne C. [Department of Radiology, The Christie, Manchester (United Kingdom); Homer, Jarrod J. [School of Cancer and Enabling Sciences, University of Manchester, Manchester (United Kingdom); Department of Otolaryngology-Head-and-Neck Surgery, Manchester Royal Infirmary, Manchester (United Kingdom); Slevin, Nick J. [Department of Clinical Oncology, The Christie, Manchester (United Kingdom); Kershaw, Lucy E.; Valentine, Helen [School of Cancer and Enabling Sciences, University of Manchester, Manchester (United Kingdom); West, Catharine M.L. [School of Cancer and Enabling Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester (United Kingdom); Buckley, David L. [School of Cancer and Enabling Sciences, University of Manchester, Manchester (United Kindgom) and Division of Medical Physics, University of Leeds, Leeds (United Kingdom)

    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.

  9. Questions about Neck Manipulation?

    MedlinePLUS

    ... therapies available for the treatment of back pain, neck pain, joint pain of the arms or legs, headaches, ... are visiting your doctor of chiropractic with upper-neck pain or headache, be very specific about your symptoms, ...

  10. Head and Neck Cancer

    MedlinePLUS

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

  11. [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

  12. Correlation

    NSDL National Science Digital Library

    Edwin P. Christmann

    2008-11-01

    This chapter will discuss the concept of correlation , which is used in later chapters that will explain the concepts of validity and reliability. Here, the authors introduce the Pearson correlation coefficient, a statistic that is used with ratio

  13. [Selective neck dissection in head and neck cancer].

    PubMed

    Teymoortash, A; Werner, J A

    2013-09-01

    While (modified) radical neck dissection was seen formerly as an essential measure for securing local tumor control and improvement of the prognosis for head and neck cancer patients, this procedure is nowadays often replaced by selective neck dissection. Selective neck dissection is associated with a comparably low morbidity and acceptable functional results without having a negative impact on the prognosis of the patients. As staging procedure, neck dissection is currently the gold standard, so that selective neck dissection is an approved part of the therapy of the clinical N0 neck and is recommended as salvage therapy of the neck after radiochemotherapy. There are also aspects supporting the performance of selective neck dis-section in selected patients with N + neck. PMID:23996554

  14. Head and Neck Cancer

    MedlinePLUS

    ... factors of head and neck cancer cannot be changed, such as age, there may be steps you ... the recurrence, including whether the cancer’s stage has changed. After testing is done, you and your doctor ...

  15. 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

  16. Hemangiopericytoma of the neck

    PubMed Central

    2010-01-01

    Hemangiopericytoma (HPC) is an exceedingly rare tumor of uncertain malignant potential. Approximately 300 cases of HPC have been reported since Stout and Murray described HPCs as "vascular tumors arising from Zimmerman's pericytes" in 1942. After further characterization, the WHO reclassified HPC as a fibroblastic/myofibroblastic tumor. Long term follow up is mandatory because the histologic criteria for prediction of biologic behavior are imprecise. There are reports of recurrence and metastasis many years after radical resection. The head and neck incidence is less than 20%, mostly in adults. We report herein a case of HPC resected from the neck of a 74-year-old woman, who presented in our department with a painless right-sided neck mass. The mass was well circumscribed, mobile and soft during the palpation. The skin over the tumor was intact and normal. Clinical diagnosis at this time was lipoma. A neck computer tomography scan showed a large submucosal mass in the neck, which extended in the muscular sites. The tumor was completely removed by wide surgical resection. During surgery we found a highly vascularised tumor. The histopathologic examination revealed a cellular, highly vascularized tumor. The diagnosis was that of solitary fibrous tumor, cellular variant, with haemangiopericytoma-like features. The patient had normal postoperative course of healing and 24 months later she remains asymptomatic, without signs of recurrence or metastases. PMID:20868476

  17. Do patients with obstructive sleep apnea have thick necks?

    PubMed

    Katz, I; Stradling, J; Slutsky, A S; Zamel, N; Hoffstein, V

    1990-05-01

    During physical examination of patients with suspected obstructive sleep apnea (OSA), a comment is frequently made that they appear to have a short and fat neck. To confirm this subjective impression by objective measurements, we studied a group of 123 patients referred to us because of snoring and suspected OSA, all of whom had nocturnal polysomnography and measurements of external and internal neck circumference. The external neck circumference was measured at the level of the superior border of the cricothyroid cartilage. Internal neck circumferences were calculated from the measurements of pharyngeal, glottic, and tracheal areas obtained by the acoustic reflection technique. Internal pharyngeal circumference was further subdivided into the proximal, middle, and distal thirds. The acoustic technique also permitted us to measure the distance between the teeth and the glottic minimum, which reflects the length of the upper airway. Stepwise multiple linear regression analysis revealed that the apnea/hypopnea index (AHI) correlated only with the external neck circumference, the body mass index, and the internal circumference of the distal pharynx; these three variables accounted for 39% of the variability in AHI. We conclude that the external and internal neck circumferences and the degree of obesity are important predictors of sleep apnea; it is possible that obesity produces its effect via fat in the neck. We speculate that the static pharyngeal size modulated by the dynamic loading of the airway due to the weight of fatty tissue of the neck may contribute to the pathogenesis of OSA. PMID:2339843

  18. 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

  19. Head and Neck Melanoma

    PubMed Central

    Shashanka, R.; Smitha, B. R.

    2012-01-01

    The incidence of malignant melanoma appears to be increasing at an alarming rate throughout the world over the past 30–40 years and continues to increase in the United States, Canada, Australia, Asia, and Europe. The behavior of head and neck melanoma is aggressive, and it has an overall poorer prognosis than that of other skin sites. The authors review the published literature and text books, intending to give an overall picture of malignant melanomas of the head and neck and a special emphasis on treatment considerations with controversies in treatment including biopsy, radiation therapy, sentinel node biopsy, and nodal dissection. PMID:22570796

  20. Overview of Neck Pain

    MedlinePLUS

    ... broad and general approaches to the treatment of neck pain. The physiatrist that you choose will develop an individual treatment plan for you. As a public service, the American Academy of Physical Medicine and Rehabilitation (AAPM&R) provides listings of its member physiatrists ...

  1. Understanding selection for long necks in different taxa.

    PubMed

    Wilkinson, David M; Ruxton, Graeme D

    2012-08-01

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

  2. Correlation

    NSDL National Science Digital Library

    Pennilyn Higgins

    Three hypothetical rock sections along an East-West transect are provided. Students correlate the three sections using the biostratigraphy of planktic forams (as a proxy for age), benthic forams (as a proxy of depth), and lithology (as a proxy of environment). Students are asked to provide an interpretation of the history of this depositional basin. An ash bed of known age is added and students are asked to determine if this new information affects their interpretation. Finally, an interesting lithologic feature is added, and students are asked to provide a geological explanation.

  3. Anatomy of neck configuration in fission decay

    E-print Network

    S. K. Patra; R. K. Choudhury; L. Satpathy

    2010-05-10

    The anatomy of neck configuration in the fission decay of Uranium and Thorium isotopes is investigated in a microscopic study using Relativistic mean field theory. The study includes $^{236}U$ and $^{232}Th$ in the valley of stability and exotic neutron rich isotopes $^{250}U$, $^{256}U$, $^{260}U$, $^{240}Th$, $^{250}Th$, $^{256}Th$ likely to play important role in the r-process nucleosynthesis in stellar evolution. Following the static fission path, the neck configurations are generated and their composition in terms of the number of neutrons and protons are obtained showing the progressive rise in the neutron component with the increase of mass number. Strong correlation between the neutron multiplicity in the fission decay and the number of neutrons in the neck is seen. The maximum neutron-proton ratio is about 5 for $^{260}$U and $^{256}$Th suggestive of the break down of liquid-drop picture and inhibition of the fission decay in still heavier isotopes. Neck as precursor of a new mode of fission decay like multi-fragmentation fission may also be inferred from this study.

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

    PubMed Central

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

    2015-01-01

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

  5. Stereotactic Body Radiotherapy for Head and Neck Tumors

    ClinicalTrials.gov

    2014-01-30

    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

  6. 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

  7. Head and neck cancer.

    PubMed

    Crozier, Emily; Sumer, Baran D

    2010-09-01

    Early detection of upper aerodigestive tract cancer improves prognosis. The primary care physician plays an important role in early detection of these cancers. Most upper aerodigestive tract cancers are squamous cell carcinomas that are linked to tobacco, alcohol, or human papillomavirus exposure. These cancers produce nonspecific symptoms; thus, any persistent oral cavity lesion or neck mass or other unexplainable ear, nose, and throat symptoms should prompt an evaluation for malignancy. Although overall survival has not improved, nonsurgical treatment approaches have led to higher rates of organ preservation and rehabilitation after treatment has improved the quality of life of survivors. PMID:20736111

  8. Pretreatment oxygenation predicts radiation response in advanced squamous cell carcinoma of the head and neck

    Microsoft Academic Search

    Marianne Nordsmark; Marie Overgaard; Jens Overgaard

    1996-01-01

    Background and purpose: Hypoxic tumor cells are known to be relatively radioresistant. The aim of the study was to correlate oxygenation status and radiation response in advanced squamous cell carcinomas of head and neck.Methods and patients: Pretreatment oxygenation status was measured in 34 lymph nodes and one primary tumor neck using oxygen electrodes. The primary oxygenation endpoint was the fraction

  9. Noninvasive treatment of the neck.

    PubMed

    Brobst, Robert W; Ferguson, Maria; Perkins, Stephen W

    2014-05-01

    Emerging trends in neck rejuvenation include the incorporation of nonsurgical treatment modalities as an offering to those patients desiring minimal downtime and accepting of mild results. Intense focused ultrasound is a promising technology for treatment of the neck. It is rapidly growing in clinical use and undergoing further investigation to determine optimum treatment parameters and make its outcomes more predictable. PMID:24745382

  10. Head-Neck Biomechanics in Simulated Rear Impact

    PubMed Central

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

    1998-01-01

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

  11. Evolution of neck vertebral shape and neck retraction at the transition to modern turtles: an integrated geometric morphometric approach.

    PubMed

    Werneburg, Ingmar; Wilson, Laura A B; Parr, William C H; Joyce, Walter G

    2015-03-01

    The unique ability of modern turtles to retract their head and neck into the shell through a side-necked (pleurodiran) or hidden-necked (cryptodiran) motion is thought to have evolved independently in crown turtles. The anatomical changes that led to the vertebral shapes of modern turtles, however, are still poorly understood. Here we present comprehensive geometric morphometric analyses that trace turtle vertebral evolution and reconstruct disparity across phylogeny. Disparity of vertebral shape was high at the dawn of turtle evolution and decreased after the modern groups evolved, reflecting a stabilization of morphotypes that correspond to the two retraction modes. Stem turtles, which had a very simple mode of retraction, the lateral head tuck, show increasing flexibility of the neck through evolution towards a pleurodiran-like morphotype. The latter was the precondition for evolving pleurodiran and cryptodiran vertebrae. There is no correlation between the construction of formed articulations in the cervical centra and neck mobility. An increasing mobility between vertebrae, associated with changes in vertebral shape, resulted in a more advanced ability to retract the neck. In this regard, we hypothesize that the lateral tucking retraction of stem turtles was not only the precondition for pleurodiran but also of cryptodiran retraction. For the former, a kink in the middle third of the neck needed to be acquired, whereas for the latter modification was necessary between the eighth cervical vertebra and first thoracic vertebra. Our paper highlights the utility of 3D shape data, analyzed in a phylogenetic framework, to examine the magnitude and mode of evolutionary modifications to vertebral morphology. By reconstructing and visualizing ancestral anatomical shapes, we provide insight into the anatomical features underlying neck retraction mode, which is a salient component of extant turtle classification. PMID:25305281

  12. Neck Pain following Laminoplasty.

    PubMed

    Mesfin, Addisu; Park, Moon-Soo; Piyaskulkaew, Chaiwat; Chuntarapas, Tapanut; Song, Kwang Sup; Kim, Han Jo; Riew, K Daniel

    2015-02-01

    Study Design?Retrospective evaluation of prospectively collected data. Objective?To compare preoperative and postoperative neck pain following laminoplasty using the Neck Disability Index (NDI). Methods?Seventy-two patients undergoing laminoplasty from 2006 to 2009 at a single institution were identified. Thirty-four patients with a minimum 1-year follow-up who completed preoperative, 6-week, and 1-year postoperative NDI questionnaires were enrolled. Demographic data and surgical data including estimated blood loss (EBL), length of surgery, number of laminoplasty levels, complications, and length of hospitalization were collected. Results?Mean age was 62 years (range: 34 to 88), mean follow-up was 17 months (range: 12 to 31), and there were 21 men and 13 women. Diagnoses were cervical spondylotic myelopathy (n?=?26), ossification of the posterior longitudinal ligament (n?=?6), and central cord syndrome (n?=?2). Mean EBL was 120 mL (range: 50 to 200), and mean surgical time was 152 minutes (range: 70 to 240). Average number of laminoplasty levels was 3 (range: 1 to 5). The open door technique was used, and 24/34 (71%) did not have laminoplasty at C3 and C7. No intraoperative complications were noted, and average hospital stay was 1.6 days (range: 1 to 7). Significant improvement in NDI total score was noted at 1?year (p?

  13. Analysis of Head Impacts Causing Neck Compression Injury

    Microsoft Academic Search

    David C. Viano; Chantal S. Parenteau

    2008-01-01

    Objective. Human cadavers have been subjected to inverted drop, linear, and pendulum impacts to the top of the head, causing neck compression injury. The data are not comparable on the basis of impact velocity because of differing impact masses and test conditions. This study analyzed the published biomechanical data and used peak head velocity to merge the datasets. Correlations were

  14. Neck Pain (Cervical Strain) COMMON CAUSES

    E-print Network

    Virginia Tech

    Neck Pain (Cervical Strain) COMMON CAUSES: Neck pain may be triggered by a specific event discomfort. Long term neck problems are more likely when pain develops gradually or discomfort is recurrent over a period of time. Chronic neck pain is often triggered by prior injuries, especially if original

  15. Head and Neck Cancer Treatment

    MedlinePLUS

    ... of cancer in the head and neck is squamous cell carcinoma, which arises from the cells that line the inside of the nose, mouth and throat. Squamous cell cancer is often associated with a history ...

  16. Head and neck vascular lesions.

    PubMed

    Hoff, Stephen R; Rastatter, Jeffrey C; Richter, Gresham T

    2015-02-01

    Vascular lesions of the head and neck are complex and diverse. These include infantile hemangioma, venous malformations, lymphatic malformations, and arteriovenous malformations, among others. Vascular malformations and tumors display different growth patterns and require different approaches to treatment. Therefore, accurate diagnosis is of utmost importance. This article is a guide for the diagnosis and management of vascular lesions of the head and neck. PMID:25439548

  17. Incorporation of Lower Neck Shear Forces to Predict Facet Joint Injury Risk in Low-Speed Automotive Rear Impacts

    Microsoft Academic Search

    Brian D. Stemper; Steven G. Storvik

    2010-01-01

    Lower neck shear force remains a viable candidate for a low-velocity automotive rear-impact injury criterion. Data were previously reported to demonstrate high correlations between the magnitude of lower neck shear force and lower cervical spine facet joint motions. The present study determined the ability of lower neck shear force to predict soft-tissue injury risk in simulated automotive rear impacts. Rear-impact

  18. Chiropractic and Neck Pain: Conservative Care of Cervical Pain, Injury

    MedlinePLUS

    ... this flexibility makes the neck very susceptible to pain and injury. The neck’s susceptibility to injury is ... normal aging, and everyday wear and tear. Neck pain can be very bothersome, and it can have ...

  19. Femoral Neck Version Affects Medial Femorotibial Loading

    PubMed Central

    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

  20. Head and Neck International Group (HNIG)

    Cancer.gov

    The Head and Neck International Group was established in 2014 with the mission to promote and conduct high quality head and neck cancer clinical trials worldwide to improve outcomes in patients diagnosed with these diseases.

  1. Initial conformation of kinesin's neck linker

    NASA Astrophysics Data System (ADS)

    Geng, Yi-Zhao; Ji, Qing; Liu, Shu-Xia; Yan, Shi-Wei

    2014-10-01

    How ATP binding initiates the docking process of kinesin's neck linker is a key question in understanding kinesin mechanisms. By exploiting a molecular dynamics method, we investigate the initial conformation of kinesin's neck linker in its docking process. We find that, in the initial conformation, the neck linker has interactions with ?0 and forms a ‘cover-neck bundle’ structure with ?0. From this initial structure, the formation of extra turns and the docking of the cover-neck bundle structure can be achieved. The motor head provides a forward force on the initial cover-neck bundle structure through ATP-induced rotation. This force, together with the hydrophobic interaction of ILE327 with the hydrophobic pocket on the motor head, drives the formation of the extra turn and initiates the neck linker docking process. Based on these findings, a pathway from ATP binding-induced motor head rotation to neck linker docking is proposed.

  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 ... Emotions Research and Advocacy Survivorship Blog About Us Head and Neck Cancer Guide Cancer.Net Guide Head ...

  3. Pseudopathologic fracture of the femoral neck

    SciTech Connect

    Pope, T.L. Jr.; Keats, T.E.; Goldner, R.; Stelling, C.B.; Logan, M.

    1981-11-01

    We have seen two cases of traumatic subcapital fractures of the femoral neck which resembled pathologic fractures on plain radiography. We have named this entity pseudopathologic fracture of the femoral neck and offer suggestions for why it occurs.

  4. The effects of head movement and walking speed on gait parameters in patients with chronic neck pain.

    PubMed

    Uthaikhup, Sureeporn; Sunkarat, Somporn; Khamsaen, Khanamporn; Meeyan, Kitti; Treleaven, Julia

    2014-04-01

    It has been documented that neck pain can influence sensorimotor function. However, little is known about the effects of head movement and walking speed on gait characteristics in patients with neck pain. The aim of this study was to determine gait characteristics of patients with neck pain during walking with different head movements and gait speeds as compared to a control group without neck pain. Twenty women aged between 18 and 59 years with chronic neck pain (>3 months) and 20 healthy controls of similar age, weight and height were recruited into the study. Participants with neck pain completed the Neck Disability Index and Visual Analogue Pain Scale. The experiment consisted of two walking sessions. The first session included walking with head straight, head up-down, and head turns from side to side. The second session included walking at comfortable and maximum speeds. Each trial was performed twice. Gait parameters measured using GAITRite walkway system were step length, stride length, step time, stride time, step width, cadence and gait speed. Patients with chronic neck pain demonstrated a narrower step width, a shorter step length and a slower gait speed during walking with the head movements and at maximum speed compared to the control group (all p < 0.05). Maximum gait speed was moderately correlated with pain intensity and disability (p < 0.01). The results suggest that patients with chronic neck pain have gait disturbances. This supports the notion that assessment of gait should be addressed in patients with persistent neck pain. PMID:24144513

  5. HEAD AND NECK CANCER 12. HEAD AND NECK CANCER

    E-print Network

    Paxton, Anthony T.

    malignant neoplasms, excluding non-melanoma skin cancer, in women and 4.0% in men (Table 12.1). The average excluding non-melanoma skin cancer 1.6% 4.0% 1.5% 3.9% 1.9% 4.3% average number of new cases per year 170HEAD AND NECK CANCER 105

  6. Diffuse Neck Swelling after Car Accident

    Microsoft Academic Search

    HUAN-WU CHEN; SHENG-CHAU HUANG; HUAN-WEN CHEN; KOU-MOU HUANG

    2005-01-01

    The neck connects the head with the trunk, and is easily injuried due to trauma. Herein we reported a case with diffuse neck swelling after car accident. She suffered from progressive dyspnea and cyanosis 3 hours after the accident and needed airway main- tenance with tracheostomy. A plain lateral radi- ograph and computed tomography scan of the neck showed diffuse

  7. 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-? 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

  8. Radiotherapy and head neck cancer

    Microsoft Academic Search

    V. K. Jenkins; C. M. Griffiths; P. Ray; R. R. Perry; M. H. Olson

    1980-01-01

    The mean number of lymphocytes, response to phytohemagglutinin (PHA), and response to concanavalin A (Con A) in whole-blood cultures for 106 patients with head and neck cancer were 83%, 73%, and 64%, respectively, of values for healthy control individuals. During radiotherapy, lymphocyte counts declined to 44% and PHA and Con A responses declined to about one third of control values.

  9. The neck constriction in plasmodesmata

    Microsoft Academic Search

    Peter Olesen

    1979-01-01

    Simple plasmodesmata between mesophyll and bundle sheath cells in actively expanding leaves of Salsola kali L. and roots of Epilobium hirsutum L. are shown to possess specialized structures, called sphincters, around their neck regions. The sphineters are made visible by the combined effects of tannic acid and heavy metal staining; they are localized just outside that area of the plasmalemma,

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

    ClinicalTrials.gov

    2015-03-25

    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

  11. Monitoring of radiation therapy response of head and neck tumors by non-invasive optical blood flow measurements

    NASA Astrophysics Data System (ADS)

    Sunar, U.; Quon, H.; Zhang, J.; Du, J.; Durduran, T.; Zhou, C.; Yu, G.; Kilger, A.; Lustig, R.; Loevner, L.; Nioka, S.; Yodh, A. G.; Chance, B.

    2005-08-01

    The aim is to evaluate the usefulness of optical blood flow measurements for predicting early tumor response to radiation therapy in patients with head and neck tumors. The results suggest a correlation between tumor blood flow changes with clinical outcome.

  12. Peripheral quantitative computed tomography of the femoral neck in 60 Japanese women.

    PubMed

    Horikoshi, T; Endo, N; Uchiyama, T; Tanizawa, T; Takahashi, H E

    1999-12-01

    Peripheral quantitative computed tomography (pQCT) is able to evaluate trabecular and cortical bone separately, and to determine geometric properties from cross-sectional images for noninvasive assessments of mechanical strength. In order to assess the diagnostic value of pQCT of the femoral neck, 60 healthy women were examined with a new pQCT machine, XCT-3000 (Norland-Stratec, Germany), which is suitable for direct measurement of the hip. The region of interest chosen was the center of the femoral neck. pQCT of the distal radius and dual energy X-ray absorptiometry (DXA) of the lumbar spine and femoral neck were also performed. The study demonstrated that total bone mineral density (BMD) (femoral MD) and trabecular BMD (femoral-TBD) decreased with advancing age. Percent cortical area showed a small but significant decrease with advancing age and % trabecular area increased slightly. Both the endosteal perimeter and the periosteal perimeter were relatively constant with aging. Bone strength index (BSI) and stress-strain index (SSI), which reflect the mechanical strength of bone, declined with advancing age, especially after menopause. Femoral TBD correlated strongly with femoral neck BMD by DXA and L2-L4 BMD by DXA but femoral-CBD did not correlate with femoral neck BMD by DXA. Volumetric BMD of the femoral neck and distal radius were closely correlated. It is concluded that (1) cortical thinning occurs with aging by endocortical resorption and loss of femoral-TBD; (2) loss of femoral-CBD occurred at a slower rate than radial CBD, perhaps due to the weight-bearing effect; (3) biomechanical parameters such as the BSI and SSI may reflect increasing fragility of the femoral neck in pre- and postmenopausal women; (4) pQCT of the femoral neck had diagnostic value at least equivalent to that of DXA or pQCT of the distal radius. PMID:10594163

  13. [Hereditary head and neck tumors].

    PubMed

    Schwarz-Furlan, S; Brase, C; Stockmann, P; Furlan, I; Hartmann, A

    2010-10-01

    Hereditary paraganglioma, Gorlin-Goltz syndrome and Fanconi anemia are among the rare hereditary tumor syndromes of the head and neck. Patients with hereditary paraganglioma often develop multiple tumors of the glomus caroticum and glomus jugulotympanicum. The corresponding genetic defects of the mitochondrial succinate dehydrogenase complex induce autonomous tumor cell growth. In patients with Gorlin-Goltz syndrome basal cell carcinomas and keratocystic odontogenic tumors usually occur much earlier than in patients with sporadic tumors. The associated germline mutations are located in the patched gene which is a modulator of the cell cycle. Fanconi anemia represents a chromosomal instability syndrome which is characterized by early onset of pancytopenia, i.e. bone marrow failure and subsequent development of acute myeloid leukemia and/or squamous cell carcinomas, especially of the head and neck. A total of 13 different gene clusters have been identified in 2 DNA associated complexes which play an important role in DNA repair mechanisms. PMID:20844882

  14. Treatment Option Overview (Metastatic Squamous Neck Cancer with Occult Primary)

    MedlinePLUS

    ... neck, and shoulder movement, speech, and swallowing. The patient may need physical therapy of the throat , neck, shoulder, and/or arm after radical neck dissection. Radical neck dissection may be used when cancer has spread widely in the neck. Modified radical ...

  15. Chronic neck pain: How to approach treatment

    Microsoft Academic Search

    David G. Borenstein

    2007-01-01

    Chronic neck pain is a common patient complaint. Despite its frequency as a clinical problem, there are few evidence-based\\u000a studies that document efficacy of therapies for neck pain. The treatment of this symptom is based primarily on clinical experience.\\u000a Preventing the development of chronic neck pain can be achieved by modification of the work environment with chairs that encourage\\u000a proper

  16. Infections of the deep neck spaces.

    PubMed

    Hedge, Amogh; Mohan, Suyash; Lim, Winston Eng Hoe

    2012-05-01

    Deep neck infections (DNI) have a propensity to spread rapidly along the interconnected deep neck spaces and compromise the airway, cervical vessels and spinal canal. The value of imaging lies in delineating the anatomical extent of the disease process, identifying the source of infection and detecting complications. Its role in the identification and drainage of abscesses is well known. This paper pictorially illustrates infections of important deep neck spaces. The merits and drawbacks of imaging modalities used for assessment of DNI, the relevant anatomy and the possible sources of infection of each deep neck space are discussed. Certain imaging features that alter the management of DNI have been highlighted. PMID:22584969

  17. Objective classification of different head and neck positions and their influence on the radiographic pharyngeal diameter in sport horses

    PubMed Central

    2014-01-01

    Background Various head and neck positions in sport horses are significant as they can interfere with upper airway flow mechanics during exercise. Until now, research has focused on subjectively described head and neck positions. The objective of this study was to develop an objective, reproducible method for quantifying head and neck positions accurately. Results Determining the angle between the ridge of the nose and the horizontal plane (ground angle) together with the angle between the ridge of nose and the line connecting the neck and the withers (withers angle) has provided values that allow precise identification of three preselected head and neck positions for performing sport horses. The pharyngeal diameter, determined on lateral radiographs of 35 horses, differed significantly between the established flexed position and the remaining two head and neck positions (extended and neutral). There was a significant correlation between the pharyngeal diameter and the ground angle (Spearman’s rank correlation coefficient ?0.769, p?correlation coefficient 0.774, p?neck positions in sport horses. The ground angle and the withers angle show significant correlation with the measured pharyngeal diameter in resting horses. Hence, these angles provide an appropriate method for assessing the degree of head and neck flexion. Further research is required to examine the influence of increasing head and neck flexion and the related pharyngeal diameter on upper airway function in exercising horses. PMID:24886564

  18. [Penetrating trauma of the neck: prospective study of 53 cases].

    PubMed

    Lourencao, J L; Nahas, S C; Margarido, N F; Rodrigues Junior, A J; Birolini, D

    1998-01-01

    The treatment of penetrating injuries of the neck is still controversial nowadays, especially when there is doubt concerning the existence of any anatomic structure lesion. The delay to indicate surgical cervical exploration may predispose the patient to have serious sequels when the esophagus or the trachea are injured. The infection which may occur in this eventuality progresses rapidly to the mediastinum, determining the patient's death. The purpose of this work was to identify and to analyze the parameters which suggest the best treatment indicated for patients with penetrating injuries of the neck. This is a non-randomized prospective study which gathered 53 patients, victims of penetrating wounds of the neck, treated at the Emergency Surgical Service of the Hospital das Clínicas, University of São Paulo School of Medicine, during a three-year period, starting in October, 1990. All the patients were evaluated by the surgical team on call who elected the selective exploration approach for the cases that did not present clear evidence of injuries in the cervical structures nor hemodynamic alterations. For the fifteen carriers of evident injuries, immediate surgical exploration was the treatment adopted. All the patients had epidemiologic data, evaluation results, hospitalization period, complications, morbidity and mortality rates, besides trauma indexes, collected. For patients whose clinical observation was allowed, endoscopic studies were also performed and compared. In order to evaluate variable correlations, statistical analysis were performed using Q square test, Student test and Z statistics, which leaded to the following conclusions: 1. Penetrating wounds of the neck were most frequent in white people aged from 20 to 30 years. They were mostly located in the right side of cervical zone II and were caused by gunshot. 2. Trauma indexes correlated with patients' clinical evolution. 3. In cases when there was doubt about the effective presence of injuries, complementary digestive and respiratory evaluations were indicated. These exams contributed for reducing the rate of unnecessary surgical explorations. PMID:10436632

  19. Head and Neck Radiation Treatment and Your Mouth

    MedlinePLUS

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

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

    PubMed Central

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

    2013-01-01

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

  1. Stages of Metastatic Squamous Neck Cancer with Occult Primary

    MedlinePLUS

    ... NCI Publications Español Metastatic Squamous Neck Cancer with Occult Primary Treatment (PDQ®) Stages of Metastatic Squamous Neck Cancer with Occult Primary Key Points for This Section After metastatic ...

  2. Update Head and Neck Steering Committee

    Cancer.gov

    Update Head and Neck Steering Committee NCI Clinical Trials Advisory Committee December 8, 2008 Co-Chairs Arlene Forastiere, M.D. David Schuller, M.D. Andrew Trotti, M.D. Primary Goal Increase productivity of clinical research involving head and neck

  3. Use of Gold in Head and Neck

    E-print Network

    Walter, Peter

    Use of Gold in Head and Neck Cancer Treatments Q & A with Dr. Frank McCormick UCSF Helen Diller in the Department of Otolaryngology-Head and Neck Surgery at UCSF, is working on several techniques to use gold nanoparticles to improve the identification of cancer. "Gold is very interesting because it has extraordinary

  4. Head and Neck Squamous Cell Carcinoma

    Cancer.gov

    Most head and neck cancers begin in the moist, mucus membranes lining the inside of the mouth, nose and throat. These membranes are made up of squamous cells and the head and neck cancers that grow in these cells are called squamous cell carcinomas.

  5. Neck and shoulder complaints among sewing-machine operators: a study concerning frequency, symptomatology and dysfunction.

    PubMed

    Blåder, S; Barck-Holst, U; Danielsson, S; Ferhm, E; Kalpamaa, M; Leijon, M; Lindh, M; Markhede, G

    1991-08-01

    The occupation of sewing-machine operators (SMO) involves monotonous and repetitive tasks, performed in a work position equivalent to a static component of muscular load on the neck and shoulder. The present study concerns the occurrence of neck-shoulder problems in a population of SMO. A total of 224 SMO from four textile factories in the western part of Sweden were subjected to a comprehensive questionnaire about demographic, vocational, medical and psychosocial data. The Nordic Ministry Questionnaire specifically directed towards neck-shoulder complaints showed a prevalence rate during the last 12 months of 75% and during the last seven days a rate of 51%. Daily problems were experienced by 26%. Some 27% had had problems leading to restraints in work time and 37% in leisure time. Those SMO screening positive were clinically examined in an attempt to describe the clinical picture behind the complaints. Diagnoses were made according to specific criteria. The tension neck syndrome (TNS) was most frequent, followed by the cervical syndrome. In half of those examined, symptoms and findings were too unspecific for diagnosis. A positive correlation between the TNS and working hours per week suggests a daily prolonged static load on the neck and shoulder to be of importance for neck-shoulder problems among the SMO. PMID:15676820

  6. Giant epidermoid cyst of the posterior neck.

    PubMed

    Kim, Cheesun; Park, Myong Chul; Seo, Seung Jo; Yoo, Young Moon; Jang, Yu Jin; Lee, Il Jae

    2011-05-01

    A 49-year-old man was presented for evaluation of a painless mass on his right posterior neck. The mass had gradually enlarged for a 25-year period without inflammation or rupture. On physical examination, a round, nontender, soft-tissue mass, 8 cm in diameter, was noted on the right posterior neck. The neck is a common site of epidermoid cysts, but a mass more than 5 cm in diameter is rare. A contrast-enhanced neck computed tomographic (CT) scan revealed a 7.6 × 6.5 × 5.7 cm unilocular hypodense mass adjacent to the posterior neck muscles.The mass was completely excised under general anesthesia. A histopathologic examination of the excised specimen resulted in a diagnosis of an epidermoid cyst. The patient was discharged from the hospital on the third postoperative day. There were no recurrences in a 2-year follow-up period. PMID:21586972

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

    PubMed

    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. Continuous motion analysis of the head-neck complex under impact.

    PubMed

    Yoganandan, N; Pintar, F A; Arnold, P; Reinartz, J; Cusick, J F; Maiman, D J; Sances, A

    1994-10-01

    The objective of the present study was to analyze the localized kinematic biodynamics of the human head-neck complex under impact loading. Unembalmed human cadaveric head-neck complexes were subjected to axial compressive forces delivered using an electrohydraulic testing device. The head-neck complex was aligned along the stiffest-axis; musculature was simulated using preloaded springs and cables; and retroreflective targets were inserted into the vertebral body, the facet joint articulation, and the spinous process at every level of the cervical column. At dynamic loading rates (1.8-5.1 m/min), mid to lower cervical spine injuries consistently occurred in these preparations. Continuous motion analysis of the components (vertebral body, intervertebral disk, facet joint, and the spinous process) at all levels of the cervical spine showed the temporal order of the transfer of the external load. Injuries documented by computed tomography and cryomicrotomy techniques correlated with the kinematics of the structure. The application of dynamic loading to the head-neck complex coupled with high-speed, continuous-motion analysis of the intervertebral components of the entire cervical column makes possible the definition of the temporal kinematic mechanics that are fundamental to the understanding of the biodynamics of cervical spine trauma. Using these procedures, we have correlated the kinematics with the onset and pattern of neck injury secondary to impact forces. PMID:7819642

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

    PubMed

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

    2011-04-01

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

  10. Penetrating Neck Trauma: Review of 192 Cases

    PubMed Central

    Mahmoodie, Mohsen; Sanei, Behnam; Moazeni-Bistgani, Mohammad; Namgar, Mohammad

    2012-01-01

    Background The neck region contains a high density of vital organ structures within a relatively small and unprotected anatomic region, making it one of the most vulnerable areas of the body for all types of injuries. Objectives In this article, we studied penetrating neck trauma cases in Alzahra Hospital over a 10-year period. Patients and Methods In this retrospective, descriptive, analytical study, penetrating neck trauma cases admitted to Alzahra Hospital between April 2000 and April 2010 were analyzed for epidemiology, mechanism of trauma, zone of trauma, therapeutic method, injuries to other organs, complications, and mortality. Results Among 192 penetrating neck injuries, the mean age at the time of injury was 25.08 ± 15.02 years. Of these cases, 96.4% occurred in men. The most common mechanisms of trauma was stab wounds (85.93%). In 56.3% of penetrating neck injuries, zone 2 was involved. Neck exploration was positive in 84.4% of cases, and 52.1% of patients underwent surgery. Vascular exploration was the most common cause of surgery (67.2% of patients). The most common surgical intervention was vein ligation (50.8% of cases). In 11.98% of cases, another organ injury occurred simultaneously, and chest injury was the most common coexisting problem (65.2%). Complications were reported in 9.3% of patients, and the need for intubation was the most common complication (5.2% of patients). Mortality rate was 1.5%. Conclusions According to the findings of this study, the most common cause of penetrating neck injuries was stab wounds, and the majority of patients were young men, therefore, preventive measures should be implemented. Because of fatal complications associated with neck injuries, we recommend early neck exploration in unstable cases or when injuries are deeper than the platysma. PMID:24719835

  11. Pathology Case Study: Anterior Cervical Neck Mass

    NSDL National Science Digital Library

    Schubert, Eric

    This is a head & neck pathology case study presented by the University of Pittsburgh Department of Pathology in which a 55-year-old male has an increasing neck mass with a choking feeling. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose. It is also a helpful site for educators to use to introduce or test student learning in head and neck pathology.

  12. Imaging evaluation of the suprahyoid neck.

    PubMed

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

    2015-01-01

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

  13. Endovascular Embolization of Head and Neck Tumors

    PubMed Central

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

    2011-01-01

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

  14. Thyroid rupture secondary to blunt neck trauma.

    PubMed

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

    2013-04-01

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

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

    PubMed Central

    Kaya, Kamil Hakan; Koç, Arzu Karaman; Uzut, Mahmut; Altinta?, Ahmet; Ye?in, Yakup; Say?n, ?brahim; Kayhan, Fatma Tülin

    2013-01-01

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

  16. [Homicide by stab to the neck with subsequent attempted suicide by cut to the neck].

    PubMed

    Olze, Heidi; Hosse, Ulrike; Rosenbaum, Frank; Schmeling, Andreas; Schneider, Volkmar

    2005-01-01

    A 37-year-old Turkish woman was fatally injured by her 65-year-old Turkish husband with a stab to the cervical region. After her death he inflicted a deep cut to his own neck, which he survived thanks to immediate medical assistance. To the authors' knowledge this combination of a homicidal stab to the neck and a suicidal cut to the neck has not been described before. Kosher butchering, which is common in the couple's traditional cultural environment, is discussed as possible reason for the choice of the neck as site for applying sharp violence. It may have induced the perpetrator to choose this anatomical region. PMID:15887781

  17. 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

  18. Bladder neck evaluation by perineal ultrasound before and after reconstructive surgery for pelvic organ prolapse

    Microsoft Academic Search

    Manabu Nishibayashi; Koichi Kobayashi; Akinori Miki; Ryugo Okagaki; Ichiro Nagata; Mitsuyoshi Urashima; Osamu Ishihara

    2009-01-01

    Purpose  To study the correlation between stress urinary incontinence (SUI) and the mobility and funneling of the bladder neck (BN)\\u000a by observation of pre- and postoperative course by perineal ultrasound (PUS).\\u000a \\u000a \\u000a \\u000a Methods  We investigated 123 cases that underwent reconstructive surgery for pelvic organ prolapse (POP). We prospectively checked\\u000a bladder neck mobility (BNM) during the Valsalva maneuver and funneling of the BN at

  19. 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.

  20. 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

  1. The electrodiagnostic evaluation of neck pain.

    PubMed

    Plastaras, Christopher T; Joshi, Anand B

    2011-08-01

    Electrodiagnostic studies play an important role in the evaluation of radiculopathy. This article reviews the use of standard nerve conduction studies, late responses, evoked potentials, and needle electrode examination in the electrodiagnostic evaluation of neck pain. PMID:21824584

  2. 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.

  3. Neck-proprioceptive influence on auditory lateralization

    Microsoft Academic Search

    Jörg Lewald; Hans-Otto Karnath; Walter H. Ehrenstein

    1999-01-01

    The effect of transcutaneous vibration of the posterior neck muscles on the lateralization of dichotic sound was investigated\\u000a in human subjects. Two-alternative forced-choice (left\\/right) judgements were made on acoustic stimuli presented with different\\u000a interaural level differences via headphones during neck-muscle vibration. A shift of the subjective auditory median plane\\u000a toward the side contralateral of vibration was found, indicating that the

  4. Modeling neck mobility in fossil turtles.

    PubMed

    Werneburg, Ingmar; Hinz, Juliane K; Gumpenberger, Michaela; Volpato, Virginie; Natchev, Nikolay; Joyce, Walter G

    2015-05-01

    Turtles have the unparalleled ability to retract their heads and necks within their shell but little is known about the evolution of this trait. Extensive analysis of neck mobility in turtles using radiographs, CT scans, and morphometry reveals that basal turtles possessed less mobility in the neck relative to their extant relatives, although the anatomical prerequisites for modern mobility were already established. Many extant turtles are able to achieve hypermobility by dislocating the central articulations, which raises cautions about reconstructing the mobility of fossil vertebrates. A 3D-model of the Late Triassic turtle Proganochelys quenstedti reveals that this early stem turtle was able to retract its head by tucking it sideways below the shell. The simple ventrolateral bend seen in this stem turtle, however, contrasts with the complex double-bend of extant turtles. The initial evolution of neck retraction therefore occurred in a near-synchrony with the origin of the turtle shell as a place to hide the unprotected neck. In this early, simplified retraction mode, the conical osteoderms on the neck provided further protection. J. Exp. Zool. (Mol. Dev. Evol.) 324B: 230-243, 2015. © 2014 Wiley Periodicals, Inc. PMID:24497449

  5. [Necrotizing fasciitis of the neck].

    PubMed

    Kovaci?, Marijan; Kovaci?, 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

  6. 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

  7. 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

  8. 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

  9. Neck Rotation and Neck Mimic Docking in the Noncatalytic Kar3-associated Protein Vik1*

    PubMed Central

    Duan, Da; Jia, Zhimeng; Joshi, Monika; Brunton, Jacqueline; Chan, Michelle; Drew, Doran; Davis, Darlene; Allingham, John S.

    2012-01-01

    It is widely accepted that movement of kinesin motor proteins is accomplished by coupling ATP binding, hydrolysis, and product release to conformational changes in the microtubule-binding and force-generating elements of their motor domain. Therefore, understanding how the Saccharomyces cerevisiae proteins Cik1 and Vik1 are able to function as direct participants in movement of Kar3Cik1 and Kar3Vik1 kinesin complexes presents an interesting challenge given that their motor homology domain (MHD) cannot bind ATP. Our crystal structures of the Vik1 ortholog from Candida glabrata may provide insight into this mechanism by showing that its neck and neck mimic-like element can adopt several different conformations reminiscent of those observed in catalytic kinesins. We found that when the neck is ?-helical and interacting with the MHD core, the C terminus of CgVik1 docks onto the central ?-sheet similarly to the ATP-bound form of Ncd. Alternatively, when neck-core interactions are broken, the C terminus is disordered. Mutations designed to impair neck rotation, or some of the neck-MHD interactions, decreased microtubule gliding velocity and steady state ATPase rate of CgKar3Vik1 complexes significantly. These results strongly suggest that neck rotation and neck mimic docking in Vik1 and Cik1 may be a structural mechanism for communication with Kar3. PMID:23043140

  10. Epidemiology, diagnosis, and treatment of neck pain.

    PubMed

    Cohen, Steven P

    2015-02-01

    Neck pain is the fourth leading cause of disability, with an annual prevalence rate exceeding 30%. Most episodes of acute neck pain will resolve with or without treatment, but nearly 50% of individuals will continue to experience some degree of pain or frequent occurrences. History and physical examination can provide important clues as to whether the pain is neuropathic or mechanical and can also be used to identify "red flags" that may signify serious pathology, such as myelopathy, atlantoaxial subluxation, and metastases. Magnetic resonance imaging is characterized by a high prevalence of abnormal findings in asymptomatic individuals but should be considered for cases involving focal neurologic symptoms, pain refractory to conventional treatment, and when referring a patient for interventional treatment. Few clinical trials have evaluated treatments for neck pain. Exercise treatment appears to be beneficial in patients with neck pain. There is some evidence to support muscle relaxants in acute neck pain associated with muscle spasm, conflicting evidence for epidural corticosteroid injections for radiculopathy, and weak positive evidence for cervical facet joint radiofrequency denervation. In patients with radiculopathy or myelopathy, surgery appears to be more effective than nonsurgical therapy in the short term but not in the long term for most people. PMID:25659245

  11. Neck-shoulder crossover: how often do neck and shoulder pathology masquerade as each other?

    PubMed

    Sembrano, Jonathan N; Yson, Sharon C; Kanu, Okezika C; Braman, Jonathan P; Santos, Edward Rainier G; Harrison, Alicia K; Polly, David W

    2013-09-01

    Cases of consecutive new patients seen at orthopedic spine and shoulder clinics were reviewed. Four percent of spine patients had significant shoulder pathology, and 3.6% of shoulder patients had significant spine pathology. Identification of the correct pain generator is a prerequisite for effective treatment in patients with neck and/or shoulder problems. However, distinguishing between the two can be difficult. Relative frequencies of how often one is mistaken for the other have not been well established. Six hundred ninety-four new patients were seen at the orthopedic shoulder clinic (n = 452) or spine clinic (n = 242) at an academic institution during a 2-year period. One hundred seven patients had previous shoulder surgery, and 39 had previous neck surgery. The 548 patients (shoulder clinic, 345; spine clinic, 203) who had no previous surgery were reviewed with respect to workup performed, final diagnosis, subsequent operative procedures, and incidence of referral from the shoulder clinic to the spine clinic and vice versa. Among the patients seen at the shoulder clinic, 325 (94.2%) had shoulder pathology, 6 (1.7%) had neck but no shoulder pathology, 6 (1.7%) had shoulder and neck pathology, and 8 (2.3%) had an unidentifiable cause of pain. Of the 12 patients with neck pathology, none underwent neck surgery. Among the patients seen at the spine clinic, 182 (89.7%) had neck pathology, 5 (2.5%) had shoulder but no neck pathology, 3 (1.5%) had neck and shoulder pathology, and 13 (6.4%) had an unidentifiable cause of pain. Of the 8 patients with shoulder pathology, 1 (12.5%) underwent shoulder surgery. Our analysis suggests that for patients who present to a shoulder surgeon's clinic for shoulder pain, 3.6% will turn out to have neck pathology. For patients who present to a spine surgeon's clinic for neck pain, 4% may turn out to have shoulder pathology. Thus, approximately 1 in 25 patients seen at a surgeon's clinic for a presumed shoulder or neck problem may exhibit neck-shoulder crossover, in which pathology in one may be mistaken for or coexist with the other. PMID:24078971

  12. Pediatric neck injury scale factors and tolerance.

    PubMed

    Kumaresan, S; Yoganandan, N; Pintar, F A

    2001-01-01

    Although significant research efforts have been made to determine the tolerance for the adult neck, relatively little research has been conducted to derive the pediatric neck injury parameters. The existing approach to determine injury for the one, three and six year old pediatric populations is based on extrapolations from the adult male and calcaneal tendon tensile data. This study addresses the scale factors for pediatric age groups using data obtained from spinal components and neck geometry. The analysis included the determination of scale factors under extension, tension, compression and flexion loading modes as a function of age. The variations in biomechanical properties of each spinal component were determined from human cadaver studies. Active spinal components were identified under each loading mode and relationships were established for each component to obtain material-based scale factors. The scale factors and resulting injury tolerance values based on spine component material properties are more appropriate than values extrapolated from the calcaneal tendon. PMID:11347431

  13. Hip resurfacing femoral neck fracture influenced by valgus placement.

    PubMed

    Anglin, Carolyn; Masri, Bassam A; Tonetti, Jérôme; Hodgson, Antony J; Greidanus, Nelson V

    2007-12-01

    Femoral neck fracture is the most common short-term concern after hip resurfacing arthroplasty. Currently, there is little basis to decide between neutral and valgus placement. We loaded 10 notched cadaveric femur pairs to failure; one side was implanted at 0 degrees relative to the femoral neck and the other at 10 degrees valgus. All 20 were dual-energy X-ray absorptiometry-scanned. Failure load correlated with bone mineral density. Valgus placement increased the fracture load by an average of 28% over neutral for specimens with normal bone mineral density but had no effect on fracture load in specimens with low bone mineral density. For specimens with normal bone mineral density (typical of patients undergoing resurfacing arthroplasty), neutral-valgus placement had a greater effect than bone mineral density, explaining 54% of the fracture load variance. Component placement greater than 10 degrees valgus is likely undesirable because this can lead to an increase in component size and a greater likelihood of notching. To reduce fracture risk, we recommend placing the femoral component in valgus and selecting patients with higher bone mineral density. PMID:17589356

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

    SciTech Connect

    Thariat, Juliette [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Department of Radiation Oncology/IBDC CNRS UMR, Cancer Center Antoine-Lacassagne, University Nice Sophia-Antipolis, Nice, Cedex 2 (France); Ang, K. Kian; Allen, Pamela K. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Ahamad, Anesa [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); University of the West Indies, St. Augustine (Trinidad and Tobago); Williams, Michelle D. [Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Myers, Jeffrey N. [Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Department of Cancer Biology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); El-Naggar, Adel K. [Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Ginsberg, Lawrence E. [Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Rosenthal, David I. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Glisson, Bonnie S. [Department of Thoracic/Head and Neck Medicine, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Morrison, William H. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Weber, Randal S. [Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Garden, Adam S., E-mail: agarden@mdanderson.org [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)

    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.

  16. Cerebrovascular Complications of Neck Manipulation

    Microsoft Academic Search

    Maurizio Paciaroni; Julien Bogousslavsky

    2009-01-01

    The safety of spinal manipulation is an issue that demands regular and rigorous assessment, as manipulation of the upper spine has been associated with serious adverse events such as cerebrovascular accidents due to cervical artery dissection. A correlation between stroke and cervical manipulation has been reported with increasing frequency, and each new report seems to reignite debate between neurologists and

  17. If I Had - A Bruit In My Neck

    MedlinePLUS Videos and Cool Tools

    ... Neck - Dr. Michael Jaff, DO, Harvard Medical School, Massachusetts General Hospital Back to Home Page If I ... Neck - Dr. Michael Jaff, DO, Harvard Medical School, Massachusetts General Hospital (November 25, 2008 - Insidermedicine) On a ...

  18. Genetics Home Reference: Head and neck squamous cell carcinoma

    MedlinePLUS

    ... Genetic disorder catalog Conditions > Head and neck squamous cell carcinoma On this page: Description Genetic changes Inheritance ... January 2015 What is head and neck squamous cell carcinoma? Squamous cell carcinoma is a cancer that ...

  19. General Information about Metastatic Squamous Neck Cancer with Occult Primary

    MedlinePLUS

    ... disease in which squamous cell cancer spreads to lymph nodes in the neck and it is not known ... the body. When squamous cell cancer spreads to lymph nodes in the neck or around the collarbone , it ...

  20. Neck Injuries and Disorders - Multiple Languages: MedlinePlus

    MedlinePLUS

    ... Somali (af Soomaali) Spanish (español) Arabic (???????) Neck Exercises English (Arabic) ?????? ?????? - ??????? Multimedia Patient Education Institute Somali (af Soomaali) Neck and Shoulder Relaxation Exercises Jimicsiyada Jilcinta Luqunta iyo Garbaha - af Soomaali (Somali) ...

  1. 49 CFR 572.163 - Neck assembly and test procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES Hybrid III Six-Year-Old Weighted Child Test Dummy § 572.163 Neck assembly and test procedure. The neck assembly is...

  2. 49 CFR 572.163 - Neck assembly and test procedure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES Hybrid III Six-Year-Old Weighted Child Test Dummy § 572.163 Neck assembly and test procedure. The neck assembly is...

  3. 49 CFR 572.163 - Neck assembly and test procedure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES Hybrid III Six-Year-Old Weighted Child Test Dummy § 572.163 Neck assembly and test procedure. The neck assembly is...

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES Hybrid III Six-Year-Old Weighted Child Test Dummy § 572.163 Neck assembly and test procedure. The neck assembly is...

  5. American Academy of Otolaryngology--Head and Neck Surgery

    MedlinePLUS

    ... ear, nose, throat and related structures of the head and neck. The released list is part of ... Log in © Copyright 2015. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, VA ...

  6. 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

  7. Parturitional injury of the head and neck.

    PubMed

    Huisman, Thierry A G M; Phelps, Timothy; Bosemani, Thangamadhan; Tekes, Aylin; Poretti, Andrea

    2015-03-01

    Parturitional injuries refer to injuries sustained during and secondary to fetal delivery. The skull, brain, and head and neck regions are frequently involved. Accurate differentiation and classification of the various injuries is essential for treatment, prognosis, and parental counseling. In this review, we discuss the various "bumps and lumps" that maybe encountered along the neonatal skull as well as the most frequent calvarial and intracranial parturitional injuries. In addition, a short discussion of the most common head and neck, facial, and spinal lesions is included. Various mimickers and risk factors are also presented. PMID:25040483

  8. Multidisciplinary Treatment of Head and Neck Cancer

    PubMed Central

    Varkey, Prashanth; Liu, Yi-Tien; Tan, Ngian Chye

    2010-01-01

    Head and neck cancer remains a significant cause of morbidity worldwide. Multimodality treatment is often the only way to achieve improved function, quality of life, and survival, calling for a multidisciplinary team approach, particularly in view of the rapid advances being made in various fields. The roles of the head and neck surgeon and reconstructive surgeon are discussed, together with the input afforded by specialists in areas such as diagnostic imaging, radiation therapy, medical oncology, and gene therapy. Telemedicine is of importance in centers where multidisciplinary expertise is not available. PMID:22550455

  9. Lebensbedrohliche und letale Komplikationen der Neck dissection

    Microsoft Academic Search

    H. Eufinger; J. Lehmbrock

    2001-01-01

    Zusammenfassung  \\u000a \\u000a Hintergrund. Von 1990–1999 wurden 395 Neck dissections bei 357 Patienten durchgeführt: 195 links, davon 105 radikal, 200 rechts, davon\\u000a 107 radikal. In 4 Fällen traten lebensbedrohliche Komplikationen auf, woran 2 Patienten verstarben.\\u000a \\u000a \\u000a \\u000a \\u000a Kasuistik. Im 1. Fall kam es nach radikaler Neck dissection links mit Chylusfistel zu einem Chylothorax, der trotz Drainage und Thorakotomie\\u000a nicht beherrschbar war, sodass die 75-jährige

  10. Treatment Response Assessment of Head and Neck Cancers on CT Using Computerized Volume Analysis

    PubMed Central

    Hadjiiski, L.; Mukherji, S.K.; Gujar, S.K.; Sahiner, B.; Ibrahim, M.; Street, E.; Moyer, J.; Worden, F.P.; Chan, H.-P.

    2013-01-01

    Background and Purpose Head and neck cancer can cause substantial morbidity and mortality Our aim was to evaluate the potential usefulness of a computerized system for segmenting lesions in head and neck CT scans and for estimation of volume change of head and neck malignant tumors in response to treatment. Materials and Methods CT scans from a pretreatment examination and a post 1-cycle chemotherapy examination of 34 patients with 34 head and neck primary-site cancers were collected. The computerized system was developed in our laboratory. It performs 3D segmentation on the basis of a level-set model and uses as input an approximate bounding box for the lesion of interest. The 34 tumors included tongue, tonsil, vallecula, supraglottic, epiglottic, and hard palate carcinomas. As a reference standard, 1 radiologist outlined full 3D contours for each of the 34 primary tumors for both the pre- and posttreatment scans and a second radiologist verified the contours. Results The correlation between the automatic and manual estimates for both the pre- to post-treatment volume change and the percentage volume change for the 34 primary-site tumors was 0.95, with an average error of ?2.4 ± 8.5% by automatic segmentation. There was no substantial difference and specific trend in the automatic segmentation accuracy for the different types of primary head and neck tumors, indicating that the computerized segmentation performs relatively robustly for this application. Conclusions The tumor size change in response to treatment can be accurately estimated by the computerized segmentation system relative to radiologists' manual estimations for different types of head and neck tumors. PMID:20595363

  11. 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

  12. A rare differential diagnosis to occupational neck pain: bilateral stylohyoid syndrome

    Microsoft Academic Search

    Gertrud Kirchhoff; Chlodwig Kirchhoff; Sonja Buhmann; Karl-Georg Kanz; Miriam Lenz; Tobias Vogel; Rainer Maria Kichhoff

    2006-01-01

    Chronic neck pain is widely prevalent and a common source of disability in the working-age population. Etiology of chronic neck pain includes neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain as well as pain due to degenerative changes. We report the case of a 42 year old secretary, complaining about a longer history of neck

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

    PubMed

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

    2014-07-01

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

  14. [Quality assurance in head and neck surgical oncology].

    PubMed

    Vergez, Sébastien; Jegoux, Franck; Dolivet, Gilles; Morinière, Sylvain

    2014-05-01

    In patients' management affected by head and neck cancers, surgery takes a major place with radiotherapy and chemotherapy. An updating of the surgical techniques available, and validated indications seems useful to harmonize the head and neck oncological surgery practices and so optimize its safety. A focus on the quality assurance in head and neck surgical oncology is proposed. PMID:24886901

  15. Aneurysm of external jugular vein mimicking hemangioma of neck.

    PubMed

    Aiyappan, Senthil Kumar; Ranga, Upasana; Veeraiyan, Saveetha

    2013-12-01

    Venous aneurysms are one of the rare causes of neck swellings. Among neck veins, external jugular vein aneurysms are uncommon. We present a case of a woman who presented with a nontender compressible swelling in the left lower neck region, which initially thought to be hemangioma, was later found to be external jugular vein aneurysm on Doppler ultrasound and CT angiography. PMID:24465108

  16. http://oto.sagepub.com/ Otolaryngology --Head and Neck Surgery

    E-print Network

    http://oto.sagepub.com/ Otolaryngology -- Head and Neck Surgery http://oto.sagepub.com/content/149 published online 23 October 2013Otolaryngology -- Head and Neck Surgery Randall A. Bly, David Su, Thomas S://www.sagepublications.com On behalf of: American Academy of Otolaryngology- Head and Neck Surgery can be found at:Otolaryngology

  17. http://oto.sagepub.com/ Otolaryngology --Head and Neck Surgery

    E-print Network

    Allen, Jont

    http://oto.sagepub.com/ Otolaryngology -- Head and Neck Surgery http://oto.sagepub.com/content/118Otolaryngology -- Head and Neck Surgery Eugene N. Myers, International Editor, Shingo Murakami, Kiyofumi Gyo://www.sagepublications.com On behalf of: American Academy of Otolaryngology- Head and Neck Surgery can be found at:Otolaryngology

  18. http://oto.sagepub.com/ Otolaryngology --Head and Neck Surgery

    E-print Network

    Rubel, Edwin

    http://oto.sagepub.com/ Otolaryngology -- Head and Neck Surgery http.1177/0194599813498218 published online 24 July 2013Otolaryngology -- Head and Neck Surgery Nicole C. Schmitt and Edwin W Rubel://www.sagepublications.com On behalf of: American Academy of Otolaryngology- Head and Neck Surgery can be found at:Otolaryngology

  19. OPTIMIZING BOTTLE-NECK FEATURES FOR LVCSR Frantisek Grezl

    E-print Network

    OPTIMIZING BOTTLE-NECK FEATURES FOR LVCSR Frantisek Gr´ezl Speech@FIT, Brno University proposed Bottle-Neck features for ASR. A five-layers MLP used in bottle- neck feature extraction allows training targets are replaced by phoneme states and when delta features are added. Index Terms-- Bottle

  20. Reirradiation for Recurrent Neck Metastases of Head-and-Neck Tumors Using CT-Guided Interstitial 192 Ir HDR Brachytherapy

    Microsoft Academic Search

    Christos Kolotas; Nikolaos Tselis; Manon Sommerlad; Sandra Röddiger; Thomas Schnabel; Dimos Baltas; Anna Kalogera-Fountzila; George Fountzilas; Nikolaos Zamboglou

    2007-01-01

    Purpose:  To report the therapeutic results obtained with CT-guided interstitial high-dose-rate brachytherapy (HDR-BRT) as exclusive treatment for recurrent neck metastases of head-and-neck tumors.Patients and Methods:  Between 1995 and 1999, 49 patients with prior radiation therapy (RT) with or without surgery for primary head-and-neck tumors were treated for recurrent neck metastases located within previously irradiated volumes. All patients had fixed lymphadenopathy with a

  1. Hypoxia in head and neck cancer

    Microsoft Academic Search

    A Y Isa; M Phil; T H WARD; C M L WEST; N J SLEVIN; J J HOMER

    2006-01-01

    A high level of hypoxia in solid tumours is an adverse prognostic factor for the poor outcome of cancer patients following treatment. This review describes the status of research into finding a practical method for measuring hypoxia and treating hypoxic tumours. The application of such methodology would enable the selection of head and neck cancer treatment based on an individual's

  2. Giant osteochondroma of the talar neck.

    PubMed

    Al Mutani, Mohammed; Mahmood, Aatif; Chandrasekar, C R

    2013-03-01

    Giant osteochondroma is an uncommon entity and it is rare in the foot and ankle region. It is extremely rare to originate from the talus. In this case report we present a case of giant osteochondroma arising from the talar neck measuring 100 mm × 90 mm × 30 mm. It is unique because of the size, site and the age at presentation. PMID:23415762

  3. 49 CFR 572.183 - Neck assembly.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...TEST DEVICES 2re Side Impact Crash Test Dummy, 50th Percentile...subpart, so that the midsagittal plane of the neck-headform assembly...vertical and perpendicular to the plane of motion of the pendulum...lateral direction of the reference plane of the headform...

  4. 49 CFR 572.193 - Neck assembly.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...TEST DEVICES IIsD Side Impact Crash Test Dummy, Small Adult Female...respectively, so that the midsagittal plane of the neck-headform assembly...angle (90 ± 1 degrees) to the plane of motion of the pendulum longitudinal...translation-rotation of the midsagittal plane of the headform...

  5. Management of neck masses in adults.

    PubMed

    Goffart, Y; Hamoir, M; Deron, P; Claes, J; Remacle, M

    2005-01-01

    Initial management of a neck mass in adults is a frequently encountered problem in ENT practice. The differential diagnosis with regards to clinical presentation, localization, imaging studies and cytology and/or histology is reviewed. An algorithm is provided to help the practioner. PMID:16363275

  6. Head and Neck Cancer: Altered Fractionation Schedules

    Microsoft Academic Search

    M. I. SAUNDERS; Marie Curie

    Local control is paramount in the treatment of local- ized advanced head and neck cancer. Standard radio- therapy cures a high percentage of early tumors—more than 80% of the early laryngeal tumors—but fewer of the advanced tumors. Attempts have therefore been made to improve the therapeutic ratio by: A) hyperfractionation: reducing the dose per fraction to reduce late morbidity; the

  7. Head and Neck Steering Committee Roster

    Cancer.gov

    Head and Neck Steering Committee Roster Co-chairs Ezra Cohen, M.D. University of Chicago  Chicago, IL Brian O'Sullivan, M.B. University of Toronto, Princess Margaret Hospital Toronto, Ontario Robert Ferris, M.D., Ph.D. University of Pittsburgh Pittsburgh,

  8. Outcomes Research in Head and Neck Cancer

    Microsoft Academic Search

    Kevin Fung; Jeffrey E. Terrell

    2004-01-01

    Quality of life (QOL) considerations are uniquely important in head and neck oncology outcomes research due to the multidimensional impact of these tumors and their treatment. Patient variables, tumor variables and treatment variables must be considered comprehensively in order to maximize the validity of QOL outcome measures. There are a multitude of QOL instruments, which can be classified into: (1)

  9. Neck muscle fatigue alters upper limb proprioception.

    PubMed

    Zabihhosseinian, Mahboobeh; Holmes, Michael W R; Murphy, Bernadette

    2015-05-01

    Limb proprioception is an awareness by the central nervous system (CNS) of the location of a limb in three-dimensional space and is essential for movement and postural control. The CNS uses the position of the head and neck when interpreting the position of the upper limb, and altered input from neck muscles may affect the sensory inputs to the CNS and consequently may impair the awareness of upper limb joint position. The purpose of this study was to determine whether fatigue of the cervical extensors muscles (CEM) using a submaximal fatigue protocol alters the ability to recreate a previously presented elbow angle with the head in a neutral position. Twelve healthy individuals participated. CEM activity was examined bilaterally using surface electromyography, and kinematics of the elbow joint was measured. The fatigue protocol included an isometric neck extension task at 70 % of maximum until failure. Joint position error increased following fatigue, demonstrating a significant main effect of time (F 2, 18?=?19.41, p???0.0001) for absolute error. No significant differences were found for variable error (F 2, 18?=?0.27, p?=?0.76) or constant error (F 2, 18?=?1.16 of time, p???0.33). This study confirms that fatigue of the CEM can reduce the accuracy of elbow joint position matching. This suggests that altered afferent input from the neck subsequent to fatigue may impair upper limb proprioception. PMID:25764200

  10. 49 CFR 572.183 - Neck assembly.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...neck-headform assembly to the part 572 subpart E pendulum test fixture as shown in Figure U2-A...perpendicular to the plane of motion of the pendulum longitudinal centerline shown in Figure...or equivalent; (3) Release the pendulum from a height sufficient to allow...

  11. 49 CFR 572.183 - Neck assembly.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...neck-headform assembly to the part 572 subpart E pendulum test fixture as shown in Figure U2-A...perpendicular to the plane of motion of the pendulum longitudinal centerline shown in Figure...or equivalent; (3) Release the pendulum from a height sufficient to allow...

  12. 49 CFR 572.183 - Neck assembly.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...neck-headform assembly to the part 572 subpart E pendulum test fixture as shown in Figure U2-A...perpendicular to the plane of motion of the pendulum longitudinal centerline shown in Figure...or equivalent; (3) Release the pendulum from a height sufficient to allow...

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

    SciTech Connect

    Yao Min [Department of Radiation Oncology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States)]|[Department of Otolaryngology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States)]. E-mail: min-yao@uiowa.edu; Hoffman, Henry T.; Funk, Gerry F. [Department of Radiation Oncology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States)]|[Department of Otolaryngology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States); Chang, Kristi [Department of Otolaryngology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States); Smith, Russell B. [Department of Radiation Oncology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States)]|[Department of Otolaryngology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States); Tan Huaming [Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA (United States); Clamon, Gerald H. [Department of Medical Oncology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States); Dornfeld, Ken [Department of Radiation Oncology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States)]|[Department of Otolaryngology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States); Buatti, John M. [Department of Radiation Oncology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States)]|[Department of Otolaryngology, Holden Comprehensive Cancer Center, University of Iowa Health Care, Iowa City, IA (United States)

    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.

  14. Postoperative shoulder function after different types of neck dissection in head and neck cancer.

    PubMed

    Sheikh, Adil; Shallwani, Hussain; Ghaffar, Shehzad

    2014-01-01

    Reported complications of neck dissection surgery have included decreases in shoulder muscle power and range of motion, drooping shoulder, and shoulder pain. We conducted a cross-sectional study to assess postoperative shoulder function following three different types of neck dissection surgery that were performed at Aga Khan University Hospital and to determine how various treatment factors and patient characteristics affected postoperative shoulder function. Our study population included 70 patients--51 men and 19 women, aged 18 to 70 years (mean: 48.6 ± 11.6)--who had undergone a total of 92 neck dissections (22 patients underwent bilateral procedures). Patients were assessed by physical examination and questionnaire responses. The physical examination included objective assessments of shoulder muscle power against resistance, active range of motion, maximum possible forward flexion, the length of time needed to repeat active shoulder flexion 5 times, and shoulder abduction. The questionnaire covered shoulder mobility during activities of daily living, the results of physiotherapy (and exercise), postoperative radiation status, and shoulder pain. Of the 92 neck dissections, 17 were selective (18.5%), 64 were modified radical (69.6%), and 11 were radical (12.0%). We found that patients who had undergone a nerve-sparing procedure (i.e., selective neck dissection or a modified radical neck dissection) exhibited significantly better shoulder function than did patients who had undergone radical neck dissections (p < 0.01). In addition, increasing age (p < 0.001) and a history of diabetes (p = 0.003) were associated with worse shoulder function, and postoperative physiotherapy was associated with better shoulder function (p = 0.002). Neither sex, weight, the side of the neck operated on (left or right), the administration of postoperative radiation, the length of time between surgery and shoulder function assessment, comorbidities such as hypertension and ischemic heart disease, nor the status of the level V lymph nodes had any statistically significant association with shoulder function. PMID:24817237

  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 selected muscles that have been examined in human electromyographic studies. Neck muscle function and morphology can be studied at a detailed level using exercise-induced shifts in magnetic resonance images.

  16. 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

  17. 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

  18. Current potential and limitations of molecular diagnostic methods in head and neck cancer

    Microsoft Academic Search

    Magdy E. Mahfouz; Juan P. Rodrigo; Robert P. Takes; Mohamed N. Elsheikh; Alessandra Rinaldo; Ruud H. Brakenhoff; Alfio Ferlito

    2010-01-01

    Traditional diagnostic methods such as clinical assessment, histopathological examination and imaging techniques are limited\\u000a in their capacity to provide information on prognosis and treatment choice of head and neck cancer. In recent years, molecular\\u000a techniques have been developed that enabled us to get more insight into the molecular biological cellular pathways underlying\\u000a tumor progression and metastasis. Correlation of these molecular

  19. Intervertebral Neck Injury Criterion for Prediction of Multiplanar Cervical Spine Injury Due to Side Impacts

    Microsoft Academic Search

    Manohar M. Panjabi; Paul C. Ivancic; Yasuhiro Tominaga; Jaw-Lin Wang

    2005-01-01

    Objective. Intervertebral Neck Injury Criterion (IV-NIC) is based on the hypothesis that dynamic three-dimensional intervertebral motion beyond physiological limits may cause multiplanar injury of cervical spine soft tissues. Goals of this study, using a biofidelic whole human cervical spine model with muscle force replication and surrogate head in simulated side impacts, were to correlate IV-NIC with multiplanar injury and determine

  20. Oral and head and neck cancer. Special listing

    SciTech Connect

    Not Available

    1980-07-03

    The Special Listing of Current Cancer Research Projects is a publication of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute. Each Listing contains descriptions of ongoing projects in one selected cancer research area. The research areas include: Diagnostic and prognostic studies of oral and head and neck cancers; Treatment of oral and head and neck cancers; Rehabilitation and other support following treatment of oral and head and neck cancers; Etiology, epidemiology, and follow-up studies of patients with oral and head and neck cancers; Training programs for dental professions; Broad clinical programs for treatment of head and neck cancers; Salivary gland pathology.

  1. Neck dissection with cervical sensory preservation in thyroid cancer.

    PubMed

    Xue, Shuai; Wang, Peisong; Chen, Guang

    2013-11-01

    Thyroid cancer is the most common endocrine malignancy. Recently, controversy has focused on the management of lymph node metastases, which represent approximately 90% of disease recurrences and may require considerable time, effort, and resources to diagnose and treat. Neck dissections play an essential role in the management of head and neck cancer. A modified radical neck dissection (MND) refers to resection of the lymph nodes in levels II through V and often including the central nodes in level VI. When performing modified neck dissection, we recommend to protect more reserved cervical plexus. The purpose is to better protect patient's neck skin feeling. PMID:25083485

  2. Field survey and laboratory feeding study of Asian shore crabs, Hemigrapsus sanguineus, from Wood Neck Beach, Cape Cod, MA

    Microsoft Academic Search

    Jennifer Benoit; Stacy DeRuiter; Joanna Gyory

    We performed 2 days of field studies to investigate the distribution of the Asian shore crab, Hemigrapsus sanguineus, in the rocky intertidal zone at Wood Neck Beach (near Woods Hole, MA). We found that the number of Hemigrapsus found under rocks was positively correlated with the surface area of the rocks. We also noted that a large proportion of sampled

  3. Novel Treatment of Neck Wrinkles with an Intradermal Radiofrequency Device

    PubMed Central

    Hyun, Moo Yeol; Li, Kapsok; Kim, Myeung Nam; Hong, Chang Kwun; Kim, Hyuk; Koh, Hyun-Ju; Park, Won-Seok

    2015-01-01

    Neck wrinkles commonly develop owing to the aging process. However, recently, the number of patients with neck wrinkles has been increasing. Also, an increasing number of young patients have presented with this condition, possibly because of the effect of the head-down posture that they adopt when using their computer or smartphone. We report two cases of young adults with a prominent neck wrinkle. In case 1, a 29-year-old woman with a neck wrinkle was treated with six intradermal radiofrequency (RF) procedures. Her neck wrinkle was significantly improved with the RF treatment. In case 2, a 32-year-old woman with a wrinkle and generalized light brownish tiny papules on the neck was treated with three intradermal RF procedures simultaneously with 30% glycolic acid peeling. Her wrinkle and skin tone were improved dramatically. We conclude that intradermal RF has a considerable efficacy for reducing neck wrinkles. PMID:25673937

  4. Angular Correlation of Photons from Positron Annihilation in Copper-Nickel Alloys

    Microsoft Academic Search

    Masayuki Hasegawa; Toshiharu Suzuki; Makoto Hirabayashi

    1974-01-01

    Angular correlation measurements of radiation from positrons annihilating in copper-nickel alloys have been carried out with crossed-slit geometry using single crystals containing less than 73 at % Ni. The neck radius of the Fermi surface decreases linearly with increasing nickel content, but the neck does not detach from the hexagonal zone face even at the highest nickel content. No marked

  5. [Deep neck infections: etiology, bacteriology and treatment].

    PubMed

    Regueiro Villarín, S; Vázquez Barro, J C; Herranz González-Botas, J

    2006-01-01

    Deep neck infections are dangerous for its potential ease to fascial spread, sepsis, and upper airway obstruction. This article reviews 77 cases of deep cervical infection, focus on etiological, clinical and therapeutic aspects. The most frequent location was the submaxillary area (29%), followed by the parapharyngeal space (28%), floor of the mouth (27%) and retropharyngeal (14%) spaces. Etiology was dental in 32%; pharyngoamigdalar infection in 27%; foreign bodies in 13%. In 22% the cause is unknown. Two or more bacteria were isolated in 72%, with Streptococcus B haemolytic being the most frequent germ. All patients were treated with intravenous broad-spectrum antibiotics. Surgical drainage was needed in 54%, and tracheotomy in 18%. Four patients developed mediastinitis, and one died as a consequence of it. The incidence of deep neck infections has decreased after the itroduction of antibiotics but they still may be lethal especially when life-threatening complications occur. Early recognition and management are necessary. PMID:17036995

  6. Descending necrotizing mediastinitis from deep neck infection.

    PubMed

    Ishinaga, Hajime; Otsu, Kazuya; Sakaida, Hiroshi; Miyamura, Tomotaka; Nakamura, Satoshi; Kitano, Masako; Tenpaku, Hironori; Takao, Motoshi; Kobayashi, Masayoshi; Takeuchi, Kazuhiko

    2013-03-01

    This study aims to identify predisposing characteristics of descending necrotizing mediastinitis (DNM) arising from deep neck infection (DNI) and to determine appropriate therapeutic intervention strategies. We retrospectively reviewed 54 patients (male, n = 34; female, n = 20; mean age, 64.5 years) who had been treated at Mie University Hospital for DNI between April 2001 and October 2011. Eight of nine patients who developed DNM confirmed by computed tomography of the neck and chest, underwent mediastinal drainage (video-assisted thoracic surgical drainage, n = 6; mediastinoscopy-assisted drainage, n = 2). A patient developed uncontrolled acute respiratory distress syndrome after aggressive surgery, resulting in a mortality rate of 12 %. High blood CRP values, and the pharynx and tonsils as origins of infection were factors involved in the development of DNM arising from DNI. In conclusion, DNM remains a destructive and fatal disease that requires aggressive treatment including mediastinal exploration. PMID:22986415

  7. Femoral neck fractures: a changing paradigm.

    PubMed

    Su, E P; Su, S L

    2014-11-01

    Surgical interventions consisting of internal fixation (IF) or total hip replacement (THR) are required to restore patient mobility after hip fractures. Conventionally, this decision was based solely upon the degree of fracture displacement. However, in the last ten years, there has been a move to incorporate patient characteristics into the decision making process. Research demonstrating that joint replacement renders superior functional results when compared with IF, in the treatment of displaced femoral neck fractures, has swayed the pendulum in favour of THR. However, a high risk of dislocation has always been the concern. Fortunately, there are newer technologies and alternative surgical approaches that can help reduce the risk of dislocation. The authors propose an algorithm for the treatment of femoral neck fractures: if minimally displaced, in the absence of hip joint arthritis, IF should be performed; if arthritis is present, or the fracture is displaced, then THR is preferred. PMID:25381407

  8. Validation of the German version of the Neck Disability Index (NDI)

    PubMed Central

    2014-01-01

    Background The Neck Disability Index (NDI) is the most commonly used outcome measure for neck pain. This study aimed to determine the psychometric properties of a German version of the NDI. Cross-cultural translation and psychometric testing of the NDI were performed. Methods The 10-item NDI was translated into German and administered to 558 patients with chronic unspecific neck pain (Mean age 49.9?±?11.4 years, 76% female). The factor structure and reliability of the NDI were assessed using factor analysis, Cronbach’s alpha, split-half reliability (Spearman-Brown coefficient), and intra-class correlation (ICC2,1). To determine convergent validity, pain intensity (visual analog scale; VAS), pain on movement (VAS), and quality of life (Short Form 36 Health Survey Questionnaire; SF-36) were correlated with the NDI. Correlation with range of motion and sensitivity to change were also assessed in a subsample of 49 patients. Results The mean NDI score was 32.75?±?13.09. Factor analysis revealed a single factor that explained 39.8% of the variance. Cronbach’s alpha was 0.81; Spearman-Brown coefficient was 0.80; and intra-class correlation was 0.81 (95% confidence interval?=?0.78, 0.83). Significant correlations were found for pain intensity (r?=?0.22, p?Neck disability is associated with other measures of neck pain. PMID:24642209

  9. Effects of Neck Exercise on High-School Students’ Neck–Shoulder Posture

    PubMed Central

    Lee, Myoung-Hyo; Park, Su-Jin; Kim, Jin-Sang

    2013-01-01

    [Purpose] This study examined the effects of deep flexor muscle-strengthening exercise on the neck–shoulder posture, and the strength and endurance of the deep flexor muscles of high-school students. [Subjects] The subjects were 30 seventeen-year-old female high-school students who complained about bad posture and chronic neck–shoulder pain. They were randomly divided into an experimental group of 15 subjects, who performed a deep flexor muscle-strengthening exercise and a control group of 15 subjects, who performed a basic stretching exercise. [Methods] The experimental group of 15 subjects performed a deep flexor muscle-strengthening exercise consisting of low-load training of the cranio-cervical flexor muscle, and the control group of 15 subjects performed a basic stretching exercise consisting of seven motions. [Results] The experimental group showed statistically significant changes in head tilt angle, neck flexion angle, forward shoulder angle, and the result of the cranio-cervical flexion test after the training. In contrast, the control group showed no statistically significant changes in these measures following the training. When the results of the groups were compared, statistically significant differences were found for all items between the experimental group and the control group. [Conclusion] Strengthening cranio-cervical flexor muscles is important for the adjustment of neck posture, and maintaining their stability is required to improve neck-shoulder posture. PMID:24259804

  10. Chronic neck pain and cervicogenic headaches

    Microsoft Academic Search

    Frank L. Feng; Jerome Schofferman

    2003-01-01

    Opinion statement  Chronic axial neck pain and cervicogenic headache are common problems, and there have been significant advances in the understanding\\u000a of the etiology and treatment of each. The severity and duration of pain drives the process. For patients who have had slight\\u000a to moderate pain that has been present for less than 6 months and have no significant motor loss,

  11. Translational Research in Head and Neck Oncology

    Microsoft Academic Search

    David S. Yoo; David M. Brizel

    \\u000a Translational research in head and neck oncology has evolved dramatically. Ongoing discoveries in basic mechanisms of cancer\\u000a biology and technological advances in both diagnostic imaging and radiation delivery have enhanced the ability to improve\\u000a treatment outcomes. The overarching goal for all translational research should be to enlarge the armamentarium from which\\u000a clinicians can rationally select the most appropriate options for

  12. Marjolin's ulcer presenting in the neck.

    PubMed

    Simmons, M A; Edwards, J M; Nigam, A

    2000-12-01

    'Marjolin's ulcer' is a term that has come to be used for epidermal squamous cell carcinomas that have developed in areas of chronic inflammation. To our knowledge this is the first ever report of a Marjolin's ulcer developing following long-term irritation of the skin of the neck. The history of the eponym is traced and reveals that Marjolin probably never actually described this pathological process. PMID:11177375

  13. Mycobacterial infections of the head and neck

    Microsoft Academic Search

    David C. Perlman; Ron D’Amico; Nadim Salomon

    2001-01-01

    Mycobacteria are important causes of head and neck infections. Mycobacterial lymphadenitis may be caused by both Mycobacterium tuberculosis and a variety of nontuberculous myocbacteria. Changes in the epidemiology of tuberculosis have caused a shift of the peak\\u000a age range of tuberculous lymphadenitis from childhood to ages 20 to 40 years. Short-course chemotherapy is highly effective.\\u000a Mycobacterium avium has become the

  14. Immunity in head and neck cancer.

    PubMed

    Schoenfeld, Jonathan D

    2015-01-01

    Head and neck cancers are a diverse group of malignancies that includes an increasing number of virally mediated cancers in addition to tumors caused by tobacco and alcohol use. In both cases, tumor development is intimately related to the host immune system, and the status of an endogenous antitumor response is likely prognostic. Virally mediated cancers provide unique targets for preventive vaccines that generate immune responses directed against virus-associated antigens. Once head and neck tumors develop, they are commonly treated with surgery, radiotherapy, and/or chemotherapy. These treatments are associated with significant toxicities, and despite this, subgroups of patients respond poorly and are likely to relapse and die of their disease. Tumor immunotherapy may allow for improvements in both treatment-associated toxicity and outcome. In addition to providing specific targets for therapeutic vaccines and adoptive therapy, virally associated cancers may also be particularly dependent on immune checkpoints; therefore, immune checkpoint inhibitors are being actively tested for these diseases. Cancers that are not virally mediated may also respond to immunotherapies, and biomarkers that could predict response to immunotherapy irrespective of viral status are being evaluated. Multiple ongoing studies are testing benefits of immunotherapy in the management of metastatic squamous cell carcinoma of the head and neck. Early promising results pave the way for future studies that will expand testing to nonmetastatic diseases and other types of head and neck cancers. Prospects of combining various immunotherapies and more established treatments such as chemotherapy and radiotherapy are very intriguing and may provide synergistic benefits. PMID:25568068

  15. Management of bladder neck leiomyoma during pregnancy.

    PubMed

    Tupikowski, Krzysztof; Szewczyk, Pawe?; Szyde?ko, Tomasz; Ha?o?, Agnieszka; Polok, Marcin; Dembowski, Janusz; Zdrojowy, Romuald

    2011-01-01

    A 29-year-old primigravida was admitted to the urology ward with acute urinary retention. The patient underwent cystoscopy, MRI (magnetic resonance imaging), and tissue biopsy, which consequently led to the diagnosis of bladder neck leiomyoma that obstructed urine outflow. Subsequent to a cesarean section, a successful transurethral resection was performed. Here the diagnostic complexity in the pregnant patient, clinical course, and outcome are described. One year after successful treatment both mother and daughter are in good condition. PMID:24578908

  16. Management of bladder neck leiomyoma during pregnancy

    PubMed Central

    Szewczyk, Pawe?; Szyde?ko, Tomasz; Ha?o?, Agnieszka; Polok, Marcin; Dembowski, Janusz; Zdrojowy, Romuald

    2011-01-01

    A 29-year-old primigravida was admitted to the urology ward with acute urinary retention. The patient underwent cystoscopy, MRI (magnetic resonance imaging), and tissue biopsy, which consequently led to the diagnosis of bladder neck leiomyoma that obstructed urine outflow. Subsequent to a cesarean section, a successful transurethral resection was performed. Here the diagnostic complexity in the pregnant patient, clinical course, and outcome are described. One year after successful treatment both mother and daughter are in good condition. PMID:24578908

  17. 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

  18. Head and neck cancers in developing countries.

    PubMed

    Joshi, Poonam; Dutta, Sourav; Chaturvedi, Pankaj; Nair, Sudhir

    2014-04-01

    Head and neck cancers are the most common cancers in developing countries, especially in Southeast Asia. Head and neck cancers are more common in males compared to females. This is mainly attributed to tobacco, areca nut, alcohol, etc. Oral cancers are most common amongst all head and neck squamous cell cancers (HNSCC). HNSCC in the developing world differ from those in the Western world in terms of age, site of disease, etiology, and molecular biology. Poverty, illiteracy, advanced stage at presentation, lack of access to health care, and poor treatment infrastructure pose a major challenge in management of these cancers. The annual GDP (gross domestic product) spent on health care is very low in developing countries compared to the developed countries. Cancer treatment leads to a significant financial burden on the cancer patients and their families. Several health programs have been implemented to curb this rising burden of disease. The main aims of these health programs are to increase awareness among people regarding tobacco and to improve access to health care facilities, early diagnosis, treatment, and palliative care. PMID:24808947

  19. Head and Neck Cancers in Developing Countries

    PubMed Central

    Joshi, Poonam; Dutta, Sourav; Chaturvedi, Pankaj; Nair, Sudhir

    2014-01-01

    Head and neck cancers are the most common cancers in developing countries, especially in Southeast Asia. Head and neck cancers are more common in males compared to females. This is mainly attributed to tobacco, areca nut, alcohol, etc. Oral cancers are most common amongst all head and neck squamous cell cancers (HNSCC). HNSCC in the developing world differ from those in the Western world in terms of age, site of disease, etiology, and molecular biology. Poverty, illiteracy, advanced stage at presentation, lack of access to health care, and poor treatment infrastructure pose a major challenge in management of these cancers. The annual GDP (gross domestic product) spent on health care is very low in developing countries compared to the developed countries. Cancer treatment leads to a significant financial burden on the cancer patients and their families. Several health programs have been implemented to curb this rising burden of disease. The main aims of these health programs are to increase awareness among people regarding tobacco and to improve access to health care facilities, early diagnosis, treatment, and palliative care. PMID:24808947

  20. 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).

  1. Evolution and development of the vertebrate neck.

    PubMed

    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

  2. Inverted drop testing and neck injury potential.

    PubMed

    Forrest, Stephen; Herbst, Brian; Meyer, Steve; Sances, Anthony; Kumaresan, Srirangam

    2003-01-01

    Inverted drop testing of vehicles is a methodology that has long been used by the automotive industry and researchers to test roof integrity and is currently being considered by the National Highway Traffic Safety Administration as a roof strength test. In 1990 a study was reported which involved 8 dolly rollover tests and 5 inverted drop tests. These studies were conducted with restrained Hybrid III instrumented Anthropometric Test Devices (ATD) in production and rollcaged vehicles to investigate the relationship between roof strength and occupant injury potential. The 5 inverted drop tests included in the study provided a methodology producing "repeatable roof impacts" exposing the ATDs to the similar impact environment as those seen in the dolly rollover tests. Authors have conducted two inverted drop test sets as part of an investigation of two real world rollover accidents. Hybrid-III ATD's were used in each test with instrumented head and necks. Both test sets confirm that reduction of roof intrusion and increased headroom can significantly enhance occupant protection. In both test pairs, the neck force of the dummy in the vehicle with less crush and more survival space was significantly lower. Reduced roof crush and dynamic preservation of the occupant survival space resulted in only minor occupant contact and minimal occupant loading, establishing a clear causal relationship between roof crush and neck injuries. PMID:12724903

  3. 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. Am J Phys Anthropol 156:531-542, 2015. © 2015 Wiley Periodicals, Inc. PMID:25752265

  4. Retest Reliability of Force-Time Variables of Neck Muscles Under Isometric Conditions

    PubMed Central

    Almosnino, Sivan; Pelland, Lucie; Stevenson, Joan M.

    2010-01-01

    Abstract Context: Proper conditioning of the neck muscles may play a role in reducing the risk of neck injury and, possibly, concussions in contact sports. However, the ability to reliably measure the force-time–based variables that might be relevant for this purpose has not been addressed. Objective: To assess the between-days reliability of discrete force-time–based variables of neck muscles during maximal voluntary isometric contractions in 5 directions. Design: Cohort study. Setting: University research center. Patients or Other Participants: Twenty-six highly physically active men (age ?=? 21.6 ± 2.1 years, height ?=? 1.85 ± 0.09 m, mass ?=? 81.6 ± 9.9 kg, head circumference ?=? 0.58 ± 0.01 m, neck circumference ?=? 0.39 ± 0.02 m). Intervention(s): We used a custom-built testing apparatus to measure maximal voluntary isometric contractions of the neck muscles in 5 directions (extension, flexion, protraction, left lateral bending, and right lateral bending) on 2 separate occasions separated by 7 to 8 days. Main Outcome Measure(s): Variables measured were peak force (PF), rate of force development (RFD), and time to 50% of PF (T50PF). Reliability indices calculated for each variable comprised the difference in scores between the testing sessions, with corresponding 95% confidence intervals, the coefficient of variation of the typical error of measurement (CVTE), and intraclass correlation coefficients (ICC [3,3]). Results: No evidence of systematic bias was detected for the dependent measures across any movement direction; retest differences in measurements were between 1.8% and 2.7%, with corresponding 95% confidence interval ranges of less than 10% and overlapping zero. The CVTE was lowest for PF (range, 2.4%–6.3%) across all testing directions, followed by RFD (range, 4.8%–9.0%) and T50PF (range, 7.1%–9.3%). The ICC score range for all dependent measures was 0.90 to 0.99. Conclusions: Discrete variables representative of the force-generating capacity of neck muscles under isometric conditions can be measured with an acceptable degree of reliability. This finding has possible applications for investigating the role of neck muscle strength-training programs in reducing the risk of injuries in sport settings. PMID:20831389

  5. X-pinch dynamics: Neck formation and implosion

    SciTech Connect

    Oreshkin, V. I. [Institute of High Current Electronics, SB, RAS, 2/3 Akademichesky Ave., Tomsk 634055 (Russian Federation); National Research Tomsk Polytechnic University, 30 Lenin Ave., Tomsk 634050 (Russian Federation); Chaikovsky, S. A. [Institute of High Current Electronics, SB, RAS, 2/3 Akademichesky Ave., Tomsk 634055 (Russian Federation); Lebedev Physical Institute, RAS, 53 Leninsky Ave., Moscow 119991 (Russian Federation); Artyomov, A. P.; Labetskaya, N. A.; Fedunin, A. V.; Rousskikh, A. G.; Zhigalin, A. S. [Institute of High Current Electronics, SB, RAS, 2/3 Akademichesky Ave., Tomsk 634055 (Russian Federation)

    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.

  6. Neck and shoulder disorders in medical secretaries. Part II. Ergonomical work environment and symptom profile.

    PubMed

    Kamwendo, K; Linton, S J; Moritz, U

    1991-01-01

    Seventy-nine medical secretaries with neck and shoulder pain were included in a study aimed at an in-depth description of the ergonomical work environment and the participant's symptom profile, as well as analysing relationships between ergonomical factors and symptoms. Data were collected by daily ratings, questionnaires, and direct observation. The symptom profile showed low mean daily ratings of perceived fatigue and pain, a low medicine consumption, and few stress symptoms. A mean number of 2.1 undesirable work postures was observed. The correlations between perceived fatigue, pain, and well-being with number of shifts from sitting to standing and time spent typing, were generally small. This study suggests that risk factors for neck and shoulder pain are individual and multifactorial. PMID:1962156

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

    PubMed

    Anderson, J Y; Trinkaus, E

    1998-02-01

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

  8. Analysis of neck fractures from frontal collisions at low speeds

    Microsoft Academic Search

    S.-J. Park; S.-W. Chae; E.-S. Kim

    2010-01-01

    Neck fracture is a major cause of death in traffic accidents. This pattern of injury normally occurs in a frontal collision\\u000a or overturn of a vehicle. This study investigates the case of a neck fracture from a low-speed collision. In the examined\\u000a case, the passenger in the front seat of the car fractured his neck and died. He did not

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

    PubMed Central

    2013-01-01

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

  10. Imaging of cystic or cyst-like neck masses.

    PubMed

    Wong, K T; Lee, Y Y P; King, A D; Ahuja, A T

    2008-06-01

    Cystic or cyst-like neck masses form a unique category within head and neck radiology with unique differential diagnoses. The precise anatomical location and imaging appearances are important for accurate diagnosis and formulating the differential diagnoses of cystic lesions in the neck. In vast majority of cases ultrasound, sometimes supplemented by fine-needle aspiration cytology (FNAC), is adequate for pre-treatment assessment. For large, deep-seated lesions assessment using magnetic resonance imaging (MRI) or computed tomography (CT) often provides useful supplementary information. Radiologists should be aware of imaging findings of common cystic neck masses to help in their appropriate management. PMID:18455551

  11. Predictive factors for postoperative wound complications after neck dissection.

    PubMed

    Pellini, R; Mercante, G; Marchese, C; Terenzi, V; Sperduti, I; Manciocco, V; Ruscito, P; Cristalli, G; Marchesi, P; Pichi, B; Spriano, G

    2013-02-01

    The objective of this retrospective study was to evaluate risk factors for wound complications after neck dissection. One hundred and nineteen patients were treated with neck dissection for squamous-cell carcinoma of the upper aerodigestive tract at the National Cancer Institute in Rome between 2006 and 2009. Postoperative wound complications were divided into major or minor and were related to different variables to identify risk factors. Postoperative wound complications were found in 20.2% of patients with an individual patient probability for different risk factors ranging from 2% to 34.1%. Preoperative chemoradiation therapy (CRT) and the type of neck dissection were associated with a higher risk of major complications (p ? 0.05). Previous CRT and radical neck dissection/modified radical neck dissection are risk factors for major wound complications in patients with head and neck squamous cell carcinoma undergoing neck dissection. Patients requiring neck dissection after CRT should be informed about the increased risk of the procedure, and selective neck dissection, if oncologically appropriate, should be considered to reduce complications. PMID:23620635

  12. Congenital huge submandibular and neck teratoid cyst in newborn.

    PubMed

    He, Jie; He, Yue; Zhu, Hanguang; Wang, Yanan; Qiu, Weiliu

    2015-03-01

    Head and neck teratoid cysts are the least common congenital cysts in the head and neck region, accounting for approximately 1.8% of all dermoid cysts. Teratoid cysts exhibiting mesodermal elements may be lined by gastric, intestinal, respiratory, squamous, or cilitated epithelium. We present a case of huge submandibular and neck teratoid cyst in newborn with airway obstruction and feeding difficulty. Surgical extirpation is the treatment of choice. However, before operation, some other cystic diseases in the head and neck region needs to be excluded. Fine-needle aspiration biopsy was necessary in differential diagnosis of lesions before treatment, especially that the principle of treatment of those diseases is different. PMID:25723656

  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. p16(INK4a) /Ki-67 co-expression specifically identifies transformed cells in the head and neck region.

    PubMed

    Prigge, Elena-Sophie; Toth, Csaba; Dyckhoff, Gerhard; Wagner, Steffen; Müller, Franziska; Wittekindt, Claus; Freier, Kolja; Plinkert, Peter; Hoffmann, Jürgen; Vinokurova, Svetlana; Klussmann, Jens Peter; von Knebel Doeberitz, Magnus; Reuschenbach, Miriam

    2015-04-01

    p16(INK4a) immunohistochemical overexpression is an overall reliable surrogate marker of human papillomavirus (HPV)-associated head and neck squamous cell carcinomas (HNSCC). However, cases of ambiguous p16(INK4a) overexpression are regularly detected in the head and neck: p16(INK4a) expression can be observed in non-malignant tissue, such as tonsillar crypt epithelium and a proportion of branchial cleft cysts. Additionally, diverse patterns of p16(INK4) expression can complicate interpretation of "p16(INK4a) -positivity". These aspects impede the unrestricted application of p16(INK4a) as a diagnostic marker in the head and neck. We hypothesized that combined detection of p16(INK4a) and the proliferation marker Ki-67 could support clarification of ambiguous p16(INK4a) expression in the head and neck by specifically indicating p16(INK4a) -expressing cells with proliferative activity. p16(INK4a) /Ki-67 co-expression in a combined staining procedure was correlated to distinct p16(INK4a) expression patterns and HPV status (HPV DNA followed by E6*I oncogene mRNA detection) in 147 HNSCC and 50 non-malignant head and neck samples. p16(INK4a) /Ki-67 co-expression only occurred in transformed cells of the head and neck. Co-expression was never detected in non-transformed cells. Combined p16(INK4a) /Ki-67 expression was stringently associated with a diffuse p16(INK4a) expression pattern. All HPV oncogene-expressing HNSCC showed p16(INK4a) /Ki-67 co-expression. We demonstrate that p16(INK4a) /Ki-67 co-expression occurs exclusively in transformed cells of the head and neck. Our findings indicate a substantial impact of combined p16(INK4a) /Ki-67 expression in the assessment of ambiguous p16(INK4a) expression in the head and neck by specifically identifying p16(INK4a) -expressing cells with proliferative activity. This property will be of considerable significance for head and neck histo- and cytopathology. PMID:25104331

  15. 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

  16. Pathology Case Study: Right Neck Mass

    NSDL National Science Digital Library

    Bastacky, Sheldon

    This is a case study presented by the University of Pittsburgh Department of Pathology in which an elderly woman developed a right parotid gland tumor, and experienced regrowth after its removal. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in head and neck pathology.

  17. Pathology Case Study: Left Neck Mass

    NSDL National Science Digital Library

    Cohen, Lance

    This is a case study presented by the University of Pittsburgh Department of Pathology in which six-year-old girl has neck mass five years after a liver transplant for biliary atresia. Visitors are given both the microscopic and gross descriptions, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in pediatric pathology.

  18. Targeting angiogenesis in head and neck cancer.

    PubMed

    Vassilakopoulou, Maria; Psyrri, Amanda; Argiris, Athanassios

    2015-05-01

    Angiogenesis is a crucial step in tumor growth and metastasis. Head and neck squamous cell carcinomas (HNSCC) highly express angiogenesis factors, such as vascular endothelial growth factor (VEGF), which are associated with patient prognosis. Antiangiogenesis agents can potentially modulate tumor microenvironment and induce radiosensitivity and chemosensitivity. In this review, we discuss the molecular mechanisms underlying angiogenesis involved in HNSCC, preclinical data with antiangiogenesis agents as well as potential predictive biomarkers. We also review novel therapies under investigation and summarize the results of clinical trials using antiangiogenesis agents alone or in combination with conventional therapies in HNSCC. PMID:25680863

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

    SciTech Connect

    Jereczek-Fossa, Barbara Alicja [Division of Radiotherapy, European Institute of Oncology, Milan (Italy) and University of Milan, Milan (Italy)]. E-mail: barbara.fossa@ieo.it; Santoro, Luigi [Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan (Italy); Alterio, Daniela [Division of Radiotherapy, European Institute of Oncology, Milan (Italy); Franchi, Benedetta [Division of Radiotherapy, European Institute of Oncology, Milan (Italy); Fiore, Maria Rosaria [Division of Radiotherapy, European Institute of Oncology, Milan (Italy); Fossati, Piero [Division of Radiotherapy, European Institute of Oncology, Milan (Italy); Kowalczyk, Anna [Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk (Poland); Canino, Paola [Division of Radiotherapy, European Institute of Oncology, Milan (Italy); Ansarin, Mohssen [Division of Head and Neck Surgery, European Institute of Oncology, Milan (Italy); Orecchia, Roberto [Division of Radiotherapy, European Institute of Oncology, Milan (Italy); University of Milan, Milan (Italy)

    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.

  20. 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

  1. Is pressure pain sensitivity over the cervical musculature associated with neck disability in individuals with migraine?

    PubMed

    Gonçalves, Maria Claudia; Chaves, Thaís Cristina; Florencio, Lidiane Lima; Carvalho, Gabriela Ferreira; Dach, Fabíola; Fernández-De-Las-Penãs, Cesar; Bevilaqua-Grossi, Débora

    2015-01-01

    The objective was to determine if disability due to neck pain is correlated with pressure pain sensitivity in the cervical muscles in patients with migraine. Thirty-two volunteers with migraine completed the Neck Disability Index (NDI). Pressure pain thresholds (PPT) over the sternocleidomastoid, upper trapezius and suboccipital muscles were also assessed. Data were analyzed using the Spearman correlation coefficient (rs) and linear regression models (? < 0.05). Moderate negative correlations between NDI and PPT were obtained for the sternocleidomastoid (rs = -0.42; p = 0.001), upper trapezius (rs = -0.33; p = 0.001) and suboccipital muscles (rs = -0.41; p = 0.001). The linear regression revealed no association between NDI and PPT of sternocleidomastoid (? = 0.01; R(2) = 0.17), upper trapezius (? = 0.01; R(2) = 0.11) and suboccipital muscles (? = 0.02; R(2) = 0.17). NDI scores and PPT of the cervical muscles correlated moderately and was inversely proportional in patients with migraine, but the association was not linear, so both outcomes should be considered in the assessment of this population. PMID:25603745

  2. Incidence of shoulder and neck pain in a working population: effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malmö shoulder and neck study cohort

    PubMed Central

    Ostergren, P.; Hanson, B.; Balogh, I.; Ektor-Andersen, J.; Isacsson, A.; Orbaek, P.; Winkel, J.; Isacsson, S.; t for

    2005-01-01

    Study objective: To assess the impact of mechanical exposure and work related psychosocial factors on shoulder and neck pain. Design: A prospective cohort study. Participants: 4919 randomly chosen, vocationally active men and women ages 45–65 residing in a Swedish city. Neck and shoulder pain were determined by the standardised Nordic questionnaire. Mechanical exposure was assessed by an index based on 11 items designed and evaluated for shoulder and neck disorders. Work related psychosocial factors were measured by the Karasek and Theorell demand-control instrument. Main results: High mechanical exposure was associated with heightened risk for shoulder and neck pain among men and women during follow up. Age adjusted odds ratios (OR) were 2.17 (95% confidence intervals (CI): 1.65, 2.85) and 1.59 (95% CI: 1.22, 2.06), respectively. In women, job strain (high psychological job demands and low job decision latitude) correlated with heightened risk (OR = 1.73, 95% CI: 1.29, 2.31). These risk estimates remained statistically significant when controlled for high mechanical exposure regarding job strain (and vice versa), and for sociodemographic factors. Testing for effect modification between high mechanical exposure and job strain showed them acting synergistically only in women. Conclusion: Job related mechanical exposure in both sexes, and psychosocial factors in women, seem independently of each other to play a part for development of shoulder and neck pain in vocationally active people. The effect of psychosocial factors was more prominent in women, which could be the result of biological factors as well as gender issues. These results suggest that interventions aiming at reducing the occurrence of shoulder and neck pain should include both mechanical and psychosocial factors. PMID:16100307

  3. Head and neck teratomas in children: a case series.

    PubMed

    Chakravarti, Arunabh; Shashidhar, T B; Naglot, Shakuntala; Sahni, J K

    2011-04-01

    Teratomas of the head and neck due to their obscure origin, bizarre microscopic appearance, unpredictable behaviour and often dramatic clinical presentation are a clinical surprise. This article focuses on pediatric head and neck teratomas and on their diversity and rarity and also reviews the recent terminology of this group of tumours. PMID:22468260

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

    ERIC Educational Resources Information Center

    Jeffers, Carol S.

    2000-01-01

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

  5. 49 CFR 572.123 - Neck assembly and test procedure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...2013-10-01 2013-10-01 false Neck assembly and test procedure. 572.123 Section 572.123 Transportation...OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES Six-year-old Child Test Dummy, Beta Version § 572.123 Neck...

  6. 49 CFR 572.123 - Neck assembly and test procedure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...2014-10-01 2014-10-01 false Neck assembly and test procedure. 572.123 Section 572.123 Transportation...OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES Six-year-old Child Test Dummy, Beta Version § 572.123 Neck...

  7. Chiropractic spinal manipulation for neck pain: a systematic review

    Microsoft Academic Search

    Edzard Ernst

    2003-01-01

    Chiropractic spinal manipulation (CSM) is often used as a treatment for neck pain. However, its effectiveness is unclear. The aim of this article was to evaluate systematically and critically the effectiveness of CSM for neck pain. Six electronic databases were searched for all relevant randomized clinical trials. Strict inclusion\\/exclusion criteria had been predefined. Key data were validated and extracted. Methodologic

  8. Human head-neck biomechanics under axial tension

    Microsoft Academic Search

    N. Yoganandan; F. A. Pintar; D. J. Maiman; J. F. Cusick; A. Sances; P. R. Walsh

    1996-01-01

    A significant majority of cervical spine biomechanics studies has applied the external loading in the form of compressive force vectors. In contrast, there is a paucity of data on the tensile loading of the neck structure. These data are important as the human neck not only resists compression but also has to withstand distraction due to factors such as the

  9. Neck Forces and Moments and Head Accelerations in Side Impact

    Microsoft Academic Search

    Narayan Yoganandan; Frank A. Pintar; Dennis J. Maiman; Mat Philippens; Jac Wismans

    2009-01-01

    Objectives: Although side-impact sled studies have investigated chest, abdomen, and pelvic injury mechanics, determination of head accelerations and the associated neck forces and moments is very limited. The purpose of the present study was therefore to determine the temporal forces and moments at the upper neck region and head angular accelerations and angular velocities using postmortem human subjects (PMHS).Methods: Anthropometric

  10. A Rare Presentation of Pellet Injury in the Neck

    PubMed Central

    Gupta, Bulbul; Gulati, Achal; Gupta, Divya

    2011-01-01

    Penetrating neck injuries are dangerous and deserve emergency treatment by virtue of the vital structures present underneath. There is a potential risk of unrecognized vascular injury and retained foreign bodies with their associated complications in these wounds. Therefore, an early diagnostic workup to localize the site of injury and an immediate neck exploration are important. PMID:22084752

  11. Kinematics of a Head-Neck Model Simulating Whiplash

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  12. Simulation of necking using a damage coupled finite element method

    Microsoft Academic Search

    C. Y. Tang; J. P. Fan; T. C. Lee

    2003-01-01

    Necking is a strain localization phenomenon that can cause catastrophic fracture in metal forming. Therefore, the prediction of necking is important. In the present work, an elasto-plastic constitutive equation accounting for isotropic hardening coupled with damage is implemented in the finite element code ABAQUS. A damage variable, that provides a mesoscopic description of material degradation, is used to quantify the

  13. Delayed onset muscle soreness in neck\\/shoulder muscles

    Microsoft Academic Search

    Hongling Nie; Adam Kawczynski; Pascal Madeleine; Lars Arendt-Nielsen

    2005-01-01

    The aim of the present study is to: (1) induce delayed onset muscle soreness (DOMS) in the neck and shoulder muscles; (2) compare the pressure pain sensitivity of muscle belly with that of musculotendinous tissue after DOMS; (3) examine the gender differences in the development of DOMS. An eccentric shoulder exercise was developed to induce DOMS on neck\\/shoulder muscles using

  14. The skull and neck of the basal theropod Herrerasaurus ischigualastensis

    Microsoft Academic Search

    Paul C. Sereno; Fernando E. Novas

    1994-01-01

    We describe the skull and neck of Herrerasaurus ischigualastensis from specimens discovered recently in the Upper Triassic Ischigualasto Formation of northwestern Argentina. The skull has a rectangular profile and a transversely narrow snout. Marked supratemporal depressions for jaw adductor musculature on the skull roof and a well-developed, sliding intra-mandibular joint suggest that Herrerasaurus ischigualastensis was an active predator. The neck

  15. 49 CFR 572.173 - Neck assembly and test procedure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...Newtons, and 0.01778 is the distance in meters from the load center of the neck transducer to the occipital condyle. ...Newtons, and 0.01778 is the distance in meters from the load center of the neck transducer to the occipital condyle....

  16. 49 CFR 572.173 - Neck assembly and test procedure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...Newtons, and 0.01778 is the distance in meters from the load center of the neck transducer to the occipital condyle. ...Newtons, and 0.01778 is the distance in meters from the load center of the neck transducer to the occipital condyle....

  17. 49 CFR 572.173 - Neck assembly and test procedure.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...Newtons, and 0.01778 is the distance in meters from the load center of the neck transducer to the occipital condyle. ...Newtons, and 0.01778 is the distance in meters from the load center of the neck transducer to the occipital condyle....

  18. Case Report: Nodular Fasciitis of Neck in Childhood.

    E-print Network

    Carr, Leslie

    Case Report: Nodular Fasciitis of Neck in Childhood. Authors Saurabh Varshney, Professor & Head. Nodular Fasciitis of Neck in Childhood. Online J Health Allied Scs.2012;11(4):13. Available at URL: http of rapid growth, and is commonly found in the upper extremities and on the chest and trunk. The importance

  19. Neck Proprioception Shapes Body Orientation and Perception of Motion

    PubMed Central

    Pettorossi, Vito Enrico; Schieppati, Marco

    2014-01-01

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

  20. Types and complications of femoral neck fractures in children

    Microsoft Academic Search

    E. M. Azouz; C. Karamitsos; M. H. Reed; L. Baker; K. Kozlowski; J.-C. Hoeffel

    1993-01-01

    This multicenter collaborative study was undertaken to review the types and complications of femoral neck fractures in children. It is a retrospective clinical and radiological review of 108 femoral neck fractures. Cases originated from four different pediatric hospitals. All the patients had plain radiographs. Fractures occurred at all ages (one day to 18 years), and 63% of the patients were

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

    PubMed

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

    2015-04-01

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

  2. NECK LOCALIZATION AND GEOMETRY QUANTIFICATION OF INTRACRANIAL ANEURYSMS

    E-print Network

    Kakadiaris, Ioannis

    NECK LOCALIZATION AND GEOMETRY QUANTIFICATION OF INTRACRANIAL ANEURYSMS E. Sgouritsaa , A. Mohamedb ABSTRACT We present an approach for accurate localization of the neck of intracranial aneurysms the surface of the segmented vessel. We then separate the aneurysm from the parent vessels and localize its

  3. Transcutaneous electrical stimulation and vibration of neck muscles in neglect

    Microsoft Academic Search

    Hans-Otto Karnath

    1995-01-01

    Four neglect patients without visual field defects, one with a lesion of the right basal ganglia and three with a right, predominantly parietal lesion, were examined with a cancellation and a copying task before, during and after neck muscle vibration, during transcutaneous electrical stimulation of neck muscles and during vibration of hand muscles on the left side. In all patients,

  4. Femoral neck stress fracture in a sanitary worker.

    PubMed

    Aslam, Nadim; Gwilym, Steve; Natarajan, Rajan

    2004-08-01

    Stress fractures of the femoral neck are uncommon, it is important to have a high index of suspicion in young active people who perform repetitive vigorous activity or have recently had an increase in frequency of such activity. We report a case of femoral neck stress fracture in a sanitary worker which was treated successfully with a dynamic hip screw. PMID:15249810

  5. Head and Neck Cases - MP/H Rules

    Cancer.gov

    Head and Neck Case 1 PATIENT HISTORY Patient History May 7, 2007 Otolaryngology Head & Neck Subjective: Patient was recently seen by a dentist, who noted a roughness in his lower alveolus, and wanted to have this evaluated prior to denture fitting.

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

    SciTech Connect

    Holsinger, F. Christopher [Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)], E-mail: holsinger@mdanderson.org; Weber, Randal S. [Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

    2007-10-01

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

  7. [Neck pain. Functional and radiological findings compared with topical pain descriptions].

    PubMed

    Krasny, C; Tilscher, H; Hanna, M

    2005-01-01

    Topical pain descriptions of the neck are summarized under the unspecific diagnosis "cervical syndrome" (CS). Neck pain localized in the cranial half of the cervical spine attended with occipital extension is defined as "cervicocephalic syndrome" (OCS). Pain concerning the caudal half with extention in both upper limbs or into the interscapular region is called "cervicobrachial syndrom" (UCS). The combination of both syndromes is described as "cervicocephalic and -brachial syndrom" (OUCS).The retrospective analyzed cohort of 75 patients showed a distribution of incidence of 1:20:17 of OCS : UCS : OUCS. Symptoms like headache, vertigo or tinnitus were reported in 34.7% of all cases, only 4% had MRI documented radicular lesions. Functional disturbances showed a maximum in the segments C2-3 (81.4%) and C3-4 (66.7%). Segmental blockades occurred 6 times more frequently than segmental hyper-mobility. Most of the radiological findings were localized in the vertebral segments C4-5 and C5-6, degenerative disc and joint diseases were predominant. The distribution of functional disturbances and radiological findings of the vertebral segments showed no significant coincidence. Therefore this study proved that there are no correlations between manual-medical findings and radiological results related to the subtypes of chronic neck pain. PMID:15375652

  8. Neutron radiation enhances cisplatin cytotoxicity independently of apoptosis in human head and neck carcinoma cells.

    PubMed

    Kim, H E; Krug, M A; Han, I; Ensley, J; Yoo, G H; Forman, J D; Kim, H R

    2000-10-01

    Recent advances in combined modality treatment of locally advanced head and neck cancer have improved local and regional disease control and survival with better functional outcome. However, the local and regional failure rate after radiation therapy is still high for tumors that respond poorly to cisplatin-based neoadjuvant chemotherapy. This clinical observation suggests a common biological mechanism for resistance to cisplatin and photon irradiation. In this report, we investigated the molecular basis underlying cisplatin resistance in head and neck squamous carcinoma (HNSCC) cells and asked if fast neutron radiation enhances cisplatin cytotoxicity in cisplatin-resistant cells. We found that cisplatin sensitivity correlates with caspase induction, a cysteine proteinase family known to initiate the apoptotic cell death pathway, suggesting that apoptosis may be a critical determinant for cisplatin cytotoxicity. Neutron radiation effectively enhanced cisplatin cytotoxicity in HNSCCs including cisplatin-resistant cells, whereas photon radiation had little effect on cisplatin cytotoxicity. Interestingly, neutron-enhanced cisplatin cytotoxicity was associated neither with apoptosis nor with cell cycle regulation, as determined by caspase activity assay, annexin V staining, and flow cytometric analysis. Taken together, the present study provides a molecular insight into cisplatin resistance and may also provide a basis for more effective multimodality protocols involving neutron radiation for patients with locally advanced head and neck cancer. PMID:11051268

  9. Anatomical study of phrenic nerve course in relation to neck dissection.

    PubMed

    Hamada, Tomohiro; Usami, Akinobu; Kishi, Asuka; Kon, Hideki; Takada, Satoshi

    2015-04-01

    The present study sought to clarify the course of the phrenic nerve and its correlation with anatomical landmarks in the neck region. We examined 17 cadavers (30 sides). In each, the phrenic nerves was dissected from the lateral side of the neck, and its position within the triangle formed by the mastoid process and sternal and acromial ends of the clavicle was determined. The point where the phrenic nerve arises in the posterior triangle was found to be similar to the point where the cutaneous blanches of the cervical plexus emerge at the middle of the posterior border of the sternocleidomastoid muscle. In the supraclavian triangle, the phrenic nerve crosses the anterior border of the anterior scalene muscle near Erb's point where the superficial point is 2-3 cm superior from the clavicle and posterior border of the sternocleidomastoid muscle. The phrenic nerve arises in the posterior triangle near the nerve point, then descends to the anterior surface of the anterior scalene muscle in the supraclavian triangle. It is necessary to be aware of the supraclavian triangle below Erb's point during neck dissection procedures. PMID:25026999

  10. Centrosomal abnormalities, multipolar mitoses, and chromosomal instability in head and neck tumours with dysfunctional telomeres

    PubMed Central

    Gisselsson, D; Jonson, T; Yu, C; Martins, C; Mandahl, N; Wiegant, J; Jin, Y; Mertens, F; Jin, C

    2002-01-01

    Carcinomas of the head and neck typically exhibit complex chromosome aberrations but the underlying mutational mechanisms remain obscure. Evaluation of cell division dynamics in low-passage cell lines from three benign and five malignant head and neck tumours revealed a strong positive correlation between multipolarity of the mitotic spindle and the formation of bridges at anaphase in both benign and malignant tumours. Cells exhibiting a high rate of mitotic abnormalities also showed several chromosome termini lacking TTAGGG repeats and a high frequency of dicentric chromosomes. Multicolour karyotyping demonstrated a preferential involvement in structural rearrangements of chromosomes with deficient telomeres. The majority of malignant, mitotically unstable tumours expressed the reverse transcriptase subunit of telomerase. These data indicate that some of the genomic instability in head and neck tumours is initiated by telomere dysfunction, leading to the formation of dicentric chromosomes. These form chromosome bridges at mitosis that could prevent the normal anaphase-telophase transition. In turn, this may cause an accumulation of centrosomes and mitotic multipolarity. Telomerase expression does not confer total stability to the tumour genome but could be crucial for moderating the rate of chromosomal evolution. British Journal of Cancer (2002) 37, 202–207. doi:10.1038/sj.bjc.6600438 www.bjcancer.com © 2002 Cancer Research UK PMID:12107843

  11. Visuomotor control of neck surface electromyography in Parkinson’s disease

    PubMed Central

    Malloy, Jessica R.; Valentin, Juliana C.; Hands, Gabrielle L.; Stevens, Christina A.; Langmore, Susan E.; Noordzij, J. Pieter; Stepp, Cara E.

    2015-01-01

    OBJECTIVE To compare performance of individuals with Parkinson’s disease (PD) and age-matched controls on a visuomotor tracking task controlled via surface electromyography (sEMG). METHODS Twenty-seven adults with PD and twenty-four older controls produced dry swallows and completed a visuomotor tracking task utilizing both static and dynamic targets. sEMG was recorded at the anterior neck and submental surface during both tasks. RESULTS There was no significant difference in visuomotor tracking ability between cohorts. Post hoc analyses indicated that there was no significant difference between participant groups in the strength or duration of swallows as measured by sEMG but that participants with PD showed a trend for decreased swallow durations at the anterior neck (padj=0.067) whereas controls showed a trend for increased durations at the anterior neck (padj=0.112), compared to the submental surface. However, there were no significant correlations between swallowing behavior and visuomotor tracking ability. CONCLUSION There were no significant differences in visuomotor tracking performance between individuals with PD and controls. Furthermore, there was no relationship between tracking ability and swallowing behavior. We conclude that sEMG-mediated biofeedback may have limited promise as a tool for treating PD-related dysphagia. PMID:25318778

  12. BUTIER CLAMS OR UTILE NECK CLAMS Butter clanlS (Saxidornus nuttali) and little-neck clams (Tapes

    E-print Network

    SHELLFISH CLAMS BUTIER CLAMS OR UTILE NECK CLAMS Butter clanlS (Saxidornus nuttali) and little-neck clams (Tapes starninea) are found in Oregon, Washington, British Columbia and Alaska, where they are canned in varying quantities, princi- pally in the Puget Sound area. The clams are found in gravel

  13. Role of Anterior Neck Soft Tissue Quantifications by Ultrasound in Predicting Difficult Laryngoscopy

    PubMed Central

    Wu, Jinhong; Dong, Jing; Ding, Yingchun; Zheng, Jijian

    2014-01-01

    Background The aim of this study was to determine if ultrasound (US) measurements of anterior neck soft tissue thickness at hyoid bone (DSHB), thyrohyoid membrane (DSEM), and anterior commissure (DSAC) levels can be used to predict difficult laryngoscopy. Material/Methods We included 203 patients age 20–65 years scheduled to undergo general anesthesia in this prospective observational study. Correlation analysis and receiver operating characteristic curve (ROC) analysis were used to determine the roles of screening tests [interincisor gap (IIG), thyromental distance (TMD), modified Mallampati score (MMS)] and US measurements (DSHB, DSEM, DSAC) in predicting difficult laryngoscopy. Results There were 28 out of 203 patients categorized as difficult laryngoscopy. DSHB, DSEM, DSAC, and MMS were greater in the difficult laryngoscopy group (P<0.0001). There was a strong positive correlation between DSEM and DSHB (r=0.74); moderate positive correlations between DSEM and DSAC (r=0.60), DSHB and DSAC (r=0.69); small positive correlations between MMS and DSHB (r=0.32), MMS and DSEM (r=0.27), MMS and DSAC (r=0.32), all P values ?0.0001; very small positive correlation between TMD and IIG (r=0.18, P=0.0089); small negative correlation between IIG and MMS (r=?0.27, P=0.0001); and very small negative correlations between MMS and TMD (r=?0.20, P=0.004), IIG and DSAC (r=?0.18, P=0.011), IIG and DSHB (r=?0.15, P=0.034). The areas under the ROC curve (AUCs) of MMS, DSHB, DSEM, and DSAC were significantly larger compared with the reference line (P<0.0001). Conclusions Anterior neck soft tissue thicknesses measured by US at hyoid bone, thyrohyoid membrane, and anterior commissure levels are independent predictors of difficult laryngoscopy. Combinations of those screening tests or risk factors with US measurements might increase the ability to predict difficult laryngoscopy. PMID:25403231

  14. Modelling of Local Necking and Fracture in Aluminium Alloys

    SciTech Connect

    Achani, D. [Structural Design, Offshore Construction Engineering, SUBSEA7, NO-4056 Tananger (Norway); Eriksson, M. [SINTEF Materials and chemistry, Applied mechanics and corrosion, NO-7465 Trondheim (Norway); Hopperstad, O. S. [SIMLab, Department of Structural Engineering, Norwegian University of Science and Technology, NO-7491 Trondheim (Norway); Lademo, O.-G. [SINTEF Materials and chemistry, Applied mechanics and corrosion, NO-7465 Trondheim (Norway); SIMLab, Department of Structural Engineering, Norwegian University of Science and Technology, NO-7491 Trondheim (Norway)

    2007-05-17

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

  15. Modelling of Local Necking and Fracture in Aluminium Alloys

    NASA Astrophysics Data System (ADS)

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

    2007-05-01

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

  16. Cosmetic outcomes following head and neck melanoma reconstruction: The patient’s perspective

    PubMed Central

    Buck, Donald; Rawlani, Vinay; Wayne, Jeffrey; Dumanian, Gregory A; Mustoe, Thomas A; Fine, Neil A; Galiano, Robert; Kim, John YS

    2012-01-01

    BACKGROUND: While studies have compared aesthetic outcomes following wide local excision of head and neck melanoma, none have evaluated this important outcome from the patient’s perspective. Indeed, one could argue that the psychosocial impact of head and neck melanoma excision and reconstruction is more accurately assessed by deriving patient-based as opposed to surgeon-based outcome measures. OBJECTIVE: To evaluate aesthetic outcomes following wide local excision of head and neck melanoma from the patient’s perspective. METHODS: Fifty-one patients who underwent excision of 57 head and neck melanomas followed by immediate closure by primary repair, skin grafting, local flap coverage or free tissue transfer were asked to complete a written survey at least six months after their surgery. A visual analogue scale (VAS) was used to assess the patient’s perception of appearance alteration, satisfaction with his or her appearance, and emotional impairment. An ordinal scale was used to evaluate several criteria of the reconstructive outcome (pain, itching, colour, scarring, stiffness, thickness and irregularity). RESULTS: Forty-two patients (82.4%) completed the survey. There were significant correlations between VAS scores reported for appearance alteration, satisfaction with outcome and emotional impairment (P=0.001). Patients who received skin grafts reported significantly unfavourable VAS scores compared with other methods of reconstruction (P=0.046). Moreover, skin grafts received significantly worse ordinal scale ratings for itching (P=0.043), colour (P=0.047), scarring (P=0.003) and stiffness (P=0.041) compared with other methods of reconstruction. Both skin grafts and free flaps were reported to have significantly less favourable thickness (P=0.012) and irregularity (P=0.036) than primary closure or local tissue transfer. There was no significant difference between patients undergoing primary closure with local tissue transfer (P>0.413). Other factors related to the patient’s VAS scores included location of the melanoma (P=0.033), size of defect (P=0.037) and recurrence of melanoma (P=0.042). CONCLUSION: The degree of emotional impairment following reconstruction of head and neck melanoma excision defects was correlated with the patient’s perception of appearance alteration. From the patient’s perspective, primary closure and local tissue transfer appeared to result in the highest aesthetic satisfaction. PMID:23598768

  17. Lack of Association of Tumor Necrosis Factor-? G-308A and Transforming Growth Factor-?1 C-509T Polymorphisms in Patients with Deep Neck Space Infections.

    PubMed

    Jevtovi?-Stoimenov, T; Despotovi?, M; Peši?, Z; Cosi?, A

    2013-12-01

    Deep neck space infections are defined as infections that spread along the fascial planes and spaces of the head and neck. Even in the era of antibiotics, these infections can and have been potentially life-threatening conditions. The role of single nucleotide polymorphisms (SNPs) of tumor necrosis factor-? (TNF-?) and transforming growth factor-?1 (TGF-?1) genes in deep neck infections has not been studied. Thus, the aim of this study was to investigate the distribution of the TNF-? G-308A and TGF-?1 C-509T polymorphisms in patients suffering from infections of deep neck spaces and to determine the correlation of these polymorphisms with the values of inflammation markers [C-reactive protein (CRP) and white blood cell (WBC) count]. A total of 41 patients with infections of deep neck spaces and 44 healthy controls were screened for TNF-? G-308A and TGF-?1 C-509T polymorphisms using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The distribution of the TNF-? G-308A genotype in patients did not reveal statistically significant correlation compared to con-trols (p = 0.483, ?(2) = 0.491) as well as the distribution of the TGF-?1 C-509T genotypes (p = 0.644, ?(2) = 0.725). The distribution of TNF-? -308 and TGF-?1 -509 alleles was not significantly different in patients compared to controls. Moreover, CRP levels and WBC counts were not associated with TNF-? G-308A and TGF-?1 C-509T promoter polymorphisms in patients with deep neck infections. In conclusion, our study suggests that the TNF-? G-308A and TGF-?1 C-509T polymorphisms are not associated with infections of deep neck spaces. PMID:24778565

  18. Hypnosis for postradiation xerostomia in head and neck cancer patients: a pilot study.

    PubMed

    Schiff, Elad; Mogilner, Jorge G; Sella, Eyal; Doweck, Ilana; Hershko, Oded; Ben-Arye, Eran; Yarom, Noam

    2009-06-01

    Xerostomia, the sensation of dry mouth, affects almost all patients who undergo radiotherapy for cancer in the head and neck area. Current therapies for xerostomia are inadequate, and the condition negatively impacts the quality of life. This prospective observational pilot study aimed to evaluate whether hypnosis could improve salivation and decrease xerostomia. Twelve patients with xerostomia after radiotherapy for head and neck cancer were assessed for severity of xerostomia symptoms and sialometry. They then received a single hypnosis session with specific suggestions to increase salivation. The session was recorded on a compact disk (CD), and the participants were instructed to listen to it twice a day for one month. Sialometry was repeated immediately after hypnosis. Validated xerostomia questionnaires were completed at one, four, and 12 weeks after hypnosis. A substantial overall improvement was reported by eight patients at 12 weeks (66%). The saliva flow rate increased on sialometry in nine patients following hypnosis (75%). There was no correlation between the magnitude of changes in the measured saliva flow rate and changes in subjective measures (Spearman's correlation coefficient r=0.134). Symptomatic improvement significantly correlated with the number of times the patients listened to the hypnosis CD (r=0.714, P=0.009). No adverse events were reported. The data from this small observational trial suggest that hypnosis may be an effective treatment for xerostomia. Confirmation in a larger randomized and controlled investigation is warranted. PMID:19186028

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

    SciTech Connect

    Igidbashian, Levon, E-mail: levonig@hotmail.co [Department of Radiation Oncology, Centre Hospitalier de l'Universite de Montreal-Hopital Notre-Dame, Montreal, QC (Canada); Fortin, Bernard [Department of Radiation Oncology, Centre Hospitalier de l'Universite de Montreal-Hopital Notre-Dame, Montreal, QC (Canada); Guertin, Louis [Department of Otolaryngology, Head and Neck Surgery, Centre Hospitalier de l'Universite de Montreal-Hopital Notre-Dame, Montreal, QC (Canada); Soulieres, Denis [Department of Medical Oncology, Centre Hospitalier de l'Universite de Montreal-Hopital Notre-Dame, Montreal, QC (Canada); Coulombe, Genevieve [Department of Radiation Oncology, Centre Hospitalier de l'Universite de Montreal-Hopital Notre-Dame, Montreal, QC (Canada); Belair, Manon [Department of Radiology, Centre Hospitalier de l'Universite de Montreal-Hopital Notre-Dame, Montreal, QC (Canada); Charpentier, Danielle [Department of Medical Oncology, Centre Hospitalier de l'Universite de Montreal-Hopital Notre-Dame, Montreal, QC (Canada); Tabet, Jean-Claude [Department of Otolaryngology, Head and Neck Surgery, Centre Hospitalier de l'Universite de Montreal-Hopital Notre-Dame, Montreal, QC (Canada); Nguyen-Tan, Phuc Felix [Department of Radiation Oncology, Centre Hospitalier de l'Universite de Montreal-Hopital Notre-Dame, Montreal, QC (Canada)

    2010-06-01

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

  20. Rhabdomyosarcoma of the head and neck

    SciTech Connect

    Feldman, B.A.

    1982-04-01

    Rhabdomyosarcoma is an uncommon neoplasm that is seen in the head and neck area. Since the symptoms of rhabdomyosarcoma, such as aural discharge and nasal obstruction, mimic common disease states, the clinical diagnosis is often delayed. Case reports and a literature review are presented to emphasize the clinical and roentgenological findings in rhabdomyosarcoma. Misinterpretation of microscopic findings can delay the histological diagnosis. Cross-striations, the hallmark of rhabdomyosarcoma, are not always found, while racquet and spindle cells may be seen. Special stains and electron microscopy can assist the pathologist. The pathological findings of the different variants of rhabdomyosarcoma and a review of cases accessioned by the A.F.I.P. Otolaryngic Registry are presented. Early diagnosis of rhabdomyosarcoma is important because the disease, once inevitably fatal, can now be controlled and apparently cured in most cases by a combination of surgery, radiation, and multidrug chemotherapy. This therapeutic approach, its results, complications, and support measures are considered.

  1. Spontaneous stress fractures of the femoral neck

    SciTech Connect

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

    1985-02-01

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

  2. Myxedema megacolon after external neck irradiation

    SciTech Connect

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

    1983-04-01

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

  3. Pathology Case Study: Neck and Back Pain

    NSDL National Science Digital Library

    Benjamin, Vallo

    This is a case study presented by the University of Pittsburgh Department of Pathology, which describes a 28-year-old female who, after a car accident, complained of a sharp pain of the anterior and posterior base of the neck on expiration and with exertion. Visitors are given patient history, radiology results, along with gross and microscopic descriptions, including images, and are given the opportunity to diagnose the patient. A "Final Diagnosis" section provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in pathology.

  4. Head & Neck Squamous Cell Carcinoma of Unknown Primary: Neck Dissection and Radiotherapy or Definitive Radiotherapy

    PubMed Central

    Koukourakis, Georgios V.; Gutfeld, Orit; Prince, Mark E.; Bradford, Carol R.; Wolf, Gregory T.; McLean, Scott; Worden, Francis P.; Chepeha, Douglas B.; Schipper, Matthew J.; McHugh, Jonathan B.

    2014-01-01

    Background Management of head and neck carcinoma from unknown primary (HNCUP) remains controversial, with neck dissection and radiotherapy (ND+RT) or definitive RT both commonly used. We aimed to characterize HNCUP and retrospectively compare outcomes for patients treated with ND+RT versus definitive RT. Methods From 1994-2009, 41 HNCUP patients underwent either ND+RT (n=22) or definitive RT+ concurrent chemotherapy (n=19) at our institution. Treatment outcomes were compared using Kaplan-Meier methods and log-rank test. Results There were no differences between patients treated with ND+RT and definitive RT in overall survival (OS), progression-free survival (PFS), or locoregional-relapse-free survival, freedom-from-locoregional failure, or freedom-from-distant failure. Among 17 ND+RT patients for whom human papillomavirus (HPV) status could be determined, HPV(+) patients trended towards improved OS (p=0.06)and PFS (p=0.15). Conclusions Neck dissection and post-op RT resulted in similar outcome as definitive RT. The prognostic implications of HPV(+) nodes in HNCUP are similar to those in oropharyngeal primary cancers. PMID:23996575

  5. [Stereotactic irradiation in head and neck cancers].

    PubMed

    Benhaïm, C; Lapeyre, M; Thariat, J

    2014-01-01

    Stereotactic radiotherapy is increasingly used in head and neck tumours, either as a boost for dose escalation/early salvage, or in the reirradiation setting. We aimed to assess the level of evidence for each clinical setting and to discuss the different dose and frationation regimens. A search of the French and English literature was performed on PubMed until December 2013. Stereotactic reirradiation of locally recurrent squamous cell carcinomas can be performed with overall survival rates of about 12 months with good quality of life, and acceptable toxicity, based on several phase 2 trials and retrospective studies. Nasopharyngeal carcinomas may be irradiated with even better control rates. Late severe toxicities yield up to 20-30%. Patient and tumour selection criteria (limited volume) and dose constraints to the carotids (cumulative dose 110 Gy or less, to avoid the risk of potentially lethal carotid blowout) must be carefully chosen. Fractionated regimens (at least five fractions) should be preferred (30 Gy in five fractions to 36 Gy in six fractions). Methods derived from stereotactic, intensity-modulated radiotherapy (IMRT) may be used with conventional fractionation for larger tumours. Stereotactic irradiation may be associated with cetuximab; data with chemotherapy or other targeted therapies are still lacking. Stereotactic irradiation is also used as a boost after 46 Gy IMRT in several institutions or for early salvage (8 to 10 weeks following full dose irradiation with evidence of residual tumour) in squamous or nasopharyngeal carcinomas. Such indications should be evaluated prospectively in clinical trials. Data in salivary gland and sinonasal neoplasms are still scarce. In conclusion, stereotactic body radiation therapy has the potential as a boost or in the reirradiation setting to improve local control in head and neck tumours. Careful hypofractionation with planning caring for the dose to the main vessels is highly recommended. Prospective studies with prolonged follow-up (at least 2 years) should be encouraged. PMID:25059767

  6. Demographics and Efficacy of Head and Neck Cancer Screening

    PubMed Central

    Shuman, Andrew G.; Entezami, Payam; Chernin, Anna S.; Wallace, Nancy E.; Taylor, Jeremy M. G.; Hogikyan, Norman D.

    2013-01-01

    Objectives This study was designed to (1) describe the demographics and (2) determine the efficacy of a head and neck cancer screening program in order to optimize future programs. Methods After IRB approval, we conducted a retrospective cohort study to review a single institution’s 14-year experience (1996–2009) conducting a free annual head and neck cancer screening clinic. Available demographic and clinical data, as well as clinical outcomes were analyzed for all participants (n=761). The primary outcome was the presence of a finding suspicious for head and neck cancer on screening evaluation. Results Five percent of participants had findings suspicious for head and neck cancer on screening evaluation, and malignant or pre-malignant lesions were confirmed in one percent of participants. Lack of insurance (p=.05), tobacco use (p<.001), male gender (p=.03), separated marital status (p=.03), and younger age (p=.04) were the significant demographic predictors of a lesion suspicious for malignancy. Patients complaining of a neck mass (p<.001) or oral pain (p<.001) were significantly more likely to have findings suspicious of malignancy. A high percentage (40%) was diagnosed with benign otolaryngologic pathologies on screening evaluation. Conclusions A minority of patients presenting to a head and neck cancer screening clinic will have a suspicious lesion identified. Given these findings, in order to achieve maximal potential benefit, future head and neck cancer screening clinics should target patients with identifiable risk factors and take full advantage of opportunities for education and prevention. PMID:20723771

  7. The Articulation of Sauropod Necks: Methodology and Mythology

    PubMed Central

    Stevens, Kent A.

    2013-01-01

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

  8. Intratumoral Lymphatics Are Essential for the Metastatic Spread and Prognosis in Squamous Cell Carcinomas of the Head and Neck Region1

    Microsoft Academic Search

    Sanna-Mari Maula; Marjaana Luukkaa; Reidar Grenman; David Jackson; Sirpa Jalkanen; Raija Ristamaki

    2003-01-01

    Head and neck squamous cell carcinomas (HNSCCs) frequently dis- seminate to regional lymph nodes. To investigate the possible mechanisms involved, we studied the expression of cancer cell adhesion molecules together with lymphatic vascular and blood vascular markers in a panel of 97 primary HNSCC tumors and correlated expression levels with conventional clinicopathological parameters and with long-term progno- sis. In particular,

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

    PubMed Central

    Henderson, Donald M.

    2013-01-01

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

  10. Human papillomavirus infection in head and neck cancer: The role of the secretory leukocyte protease inhibitor

    PubMed Central

    HOFFMANN, MARKUS; QUABIUS, ELGAR S.; TRIBIUS, SILKE; HEBEBRAND, LENA; GÖRÖGH, TIBOR; HALEC, GORDANA; KAHN, TOMAS; HEDDERICH, JÜRGEN; RÖCKEN, CHRISTOPH; HAAG, JOCHEN; WATERBOER, TIM; SCHMITT, MARKUS; GIULIANO, ANNA R.; KAST, W. MARTIN

    2013-01-01

    We previously showed that secretory leukocyte protease inhibitor (SLPI) gene and protein expression is significantly lower in metastatic versus non-metastatic head and neck squamous cell carcinoma (HNSCC). However, we did not assess the human papillomavirus (HPV) status of these cases. Since SLPI plays a role in HIV and herpes simplex virus (HSV) infections, we hypothesized that SLPI may be involved in HPV-infected HNSCC. In HNSCC tissue (n=54), HPV DNA was determined and correlated with SLPI expression. Additionally, to investigate a possible role of smoking on SLPI expression in clinically normal mucosa, 19 patients treated for non-malignant diseases (non-HNSCC) were analyzed for SLPI expression and correlated with smoking habits. In HNSCC patients, SLPI expression showed a significant inverse correlation with HPV status. In patients with moderate/strong SLPI expression (n=19), 10.5% were HPV-positive. By contrast, patients with absent/weak SLPI expression (n=35), 45.7% were HPV-positive. Low SLPI expression was correlated with metastasis (P=0.003) independent of HPV status. HPV-positivity was clearly associated with lymph node status (81.3% N1-3 cases). In smoking non-HNSCC patients (n=7), 42.9% showed absent/weak and 57.1% moderate/strong SLPI staining. In non-smoking non-HNSCC patients (n=10) 83.3% showed absent/weak and 16.7% moderate/strong SLPI expression. For the first time, a correlation between SLPI downregulation and HPV infection was demonstrated, suggesting that high levels of SLPI, possibly induced by environmental factors such as tobacco smoking, correlate with protective effects against HPV infection. SLPI may be a potential biomarker identifying head and neck cancer patients not at risk of developing metastases (SLPI-positive), and those at risk to be infected by HPV (SLPI-negative) and likely to develop metastases. PMID:23467841

  11. Physical activity and head and neck cancer risk

    Microsoft Academic Search

    Michael F. Leitzmann; Corinna Koebnick; Neal D. Freedman; Rachel Ballard-Barbash; Albert R. Hollenbeck; Arthur Schatzkin; Christian C. Abnet

    2008-01-01

    Objective  To investigate the relation of physical activity to head and neck cancer.\\u000a \\u000a \\u000a \\u000a Methods  We prospectively examined the association between physical activity and head and neck cancer in 487,732 men and women, who,\\u000a at baseline in 1995–1996, were 50–71 years old and free of cancer and emphysema. Follow-up occurred through 31 December 2003.\\u000a \\u000a \\u000a \\u000a Results  During follow-up, 1,249 participants developed head and neck cancer, of

  12. Desmoid tumor (fibromatosis) of the head and neck

    PubMed Central

    Alherabi, Ameen Z.; Marglani, Osama A.; Bukhari, Deemah H.; Al-Khatib, Talal A.

    2015-01-01

    Desmoid tumors (fibromatosis) are rare benign tumors, they arise from musculoaponeurotic structures throughout the body. They are locally infiltrative, resulting in a high rate of local recurrence following surgical resection. Due to the rarity of these tumors in the head and neck region, we report a case of a patient with a desmoid tumor in the upper neck that was diagnosed and treated in our institution, to increase the awareness of the Otolaryngology-Head and Neck surgeons, and report available treatment options of this condition. PMID:25630012

  13. Pocket atlas of head and neck MRI anatomy

    SciTech Connect

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

    1989-01-01

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

  14. Cross-cultural adaptation of the Neck Disability Index and Copenhagen Neck Functional Disability Scale for patients with neck pain due to degenerative and discopathic disorders. Psychometric properties of the Polish versions

    PubMed Central

    2011-01-01

    Background Even though there are several region-specific functional outcome questionnaires measuring neck disorders that have been developed in English-speaking countries, no Polish version has ever been validated. The purpose of our study was to translate, culturally adapt and validate the Neck Disability Index (NDI) and Copenhagen Neck Functional Disability Scale (CDS) for Polish-speaking patients with neck pain. Methods The translation was carried out according to the International Quality of Life Association (IQOLA) Project. Sixty patients were treated due to degenerative and discopathic disorders in the cervical spine filled out the NDI-PL and the CDS-PL. The pain level was evaluated using the Visual Analog Scale. The mean age of the assessed group was 47.1 years (SD 8.9). We used Cronbach's alpha to assess internal consistency. We assessed the test-retest reliability using the Intraclass Correlation Coefficients (ICCs). The Spearman's rank correlation coefficient (rS) was used to determine dependency between quantitative characteristics. The Mann-Whitney test was applied to determine dependency between quantitative and qualitative characteristics. Results The Cronbach's alpha values were excellent for the NDI-PL in the test and in the retest (0.84, 0.85, respectively), and for the CDS-PL (0.90 in the test and in the retest). Intraclass Correlation Coefficients were excellent for the CDS-PL and NDI-PL and equalled 0.93 (95% CI from 0.89 to 0.95) and 0.87 (95% CI from 0.80 to 0.92), respectively The concurrent validity was good in the test and in the retest (rs = 0.42 p < 0.001; rs = 0.40 p = 0.002, respectively) for NDI-PL and for CDS-PL (rs = 0.42 p < 0.001; rs = 0.40 p = 0.001, respectively). The adapted questionnaires showed a strong inter-correlation both in the test (0.87 p < 0.001) and in the retest (0.79 p < 0.001). Conclusions The present versions of the NDI-PL and CDS-PL, the first to be published in Polish, have proven to be reliable and valid for patients with degenerative changes in the cervical spine. The NDI-PL and CDS-PL have excellent internal consistency and test-retest reliability, and good concurrent validity. The adapted questionnaires showed a strong inter-correlation both in the test and in the retest. No ceiling or floor effects were detected in the NDI-PL and CDS-PL. The NDI-PL and CDS-PL are comparable with other versions and can be recommended and used in international comparative studies. PMID:21529360

  15. Genome Study Yields Clues to Head and Neck Cancers

    Cancer.gov

    Researchers have surveyed the genetic changes in nearly 300 head and neck cancers, revealing some previously unknown alterations that may play a role in the disease, including in patients whose cancer is associated with the human papillomavirus (HPV).

  16. Bilateral Simultaneous Femoral Neck and Shafts Fractures - A Case Report

    PubMed Central

    Sadeghifar, Amirreza; Saied, Alireza

    2014-01-01

    Simultaneous fractures of the femoral neck and shaft are not common injuries, though they cannot be considered rare. Herein, we report our experience with a patient with bilateral occurance of this injury. Up to the best of our knowkedge this is the first case reported in literature in which correct diagnosis was made initially. Both femurs were fixed using broad 4.5 mm dynamic compression plate and both necks were fixed using 6.5 mm cannulated screws. Femur fixation on one side was converted to retrograde nailing because of plate failure. Both neck fractures healed uneventfully. In spite of rarity of concomitant fractures of femoral neck and shaft, this injury must be approached carefully demanding especial attention and careful device selection. PMID:25692158

  17. Oral Complications of Chemotherapy and Head/Neck Radiation (PDQ®)

    Cancer.gov

    Expert-reviewed information summary about oral complications, such as mucositis and salivary gland dysfunction, that occur in cancer patients treated with chemotherapy or radiation therapy to the head and neck.

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

    SciTech Connect

    Myers, E.N. (Univ. of Pittsburgh School of Medicine, Pittsburgh, PA (US)); Bluestone, C.D. (Univ. of Pittsburgh, Pittsburgh, PA (US))

    1987-01-01

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

  19. Carotid artery disease after head and neck radiotherapy.

    PubMed

    Thalhammer, Christoph; Husmann, Marc; Glanzmann, Christoph; Studer, Gabriela; Amann-Vesti, Beatrice R

    2015-01-01

    Radiation induced atherosclerosis of the carotid artery is a clinically relevant late complication after head and neck radiotherapy. Improved long-term survival after multimodality therapy in neck malignancies result in an increased risk of carotid artery disease in patients after radiotherapy (RT). This review focuses on the current knowledge of occlusive carotid disease after head and neck radiotherapy and highlights the exceeding morphologic post-radiation vessel wall pathologies. More severe and extensive carotid artery atherosclerosis with plaque in all segments including the common carotid artery is a frequent finding after RT. Therefore, colour coded duplex ultrasound surveillance in patients after head and neck RT is recommended. Some histopathological studies indicate differences to ?classical? atherosclerosis, and pathogenesis of chronic radiation vasculopathy is still under discussion. PMID:25537055

  20. 34. Detail of neck and shoulder connection showing toga clasp ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    34. Detail of neck and shoulder connection showing toga clasp and shoulder lights that improved nighttime illumination of head. May 1984. - Statue of Liberty, Liberty Island, Manhattan, New York, New York County, NY

  1. 50 Facts about Oral, Head and Neck Cancer

    MedlinePLUS

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

  2. Abductor pollicis longus tendon division with swan neck thumb deformity.

    PubMed

    Zacharia, Balaji; Puthezhath, Kishore

    2012-08-01

    Swan neck thumb deformity can be caused by osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, tendon transfers and paralytic diseases. Abductor pollicis longus is one of the major stabilizing tendon of the carpometacarpal joint of thumb. To the best of our knowledge, swan neck thumb deformity owing to division of abductor pollicis longus tendon is rare. In this article, we describe a case of isolated division of abductor pollicis longus tendon presenting with swan-neck deformity of thumb and discuss the mechanism, management and outcome. The patient was treated by repair of the divided tendon using palmaris longus tendon graft. At approximately 107 weeks following treatment, the patient was having full range of thumb movement and the deformity completely disappeared. We also describe the unusual mechanism whereby an isolated division of abductor pollicis longus tendon results in swan neck thumb deformity. Level of clinical evidence IV. PMID:22825877

  3. Eurosid-2 dummy head-neck responses to lateral acceleration.

    PubMed

    Humm, John; Yoganandan, Narayan; Stemper, Brian; Shender, Barry; Paskoff, Glen

    2012-01-01

    The objective of this study was to characterize the ES-2 head and neck response to lateral impacts at varying low magnitudes of impact velocities. A pendulum and mini sled were used to deliver inertial acceleration pulses to an isolated ES-2 head and neck. The base of the neck was attached to a cart which slid along the direction of impact from left to right on two precision ground rails. The shape of the cart acceleration was controlled by altering the momentum transfer of the pendulum. Eighteen tests were conducted at velocities ranging from 1.0 to 4.3 m/s. The head was instrumented with an internal nine accelerometer package to measure the linear and angular head accelerations. Upper and lower neck load cells measured the forces and moments. Cart and pendulum acceleration were measured from uniaxial accelerometers. All data was sampled at 20 kHz and filtered according to SAEJ211. A six-camera 1 kHz Vicon system measured the 3-d kinematics of retroreflective targets affixed to the head and neck. All forces and moments increased with velocity. Peak axial and shear forces at the upper and lower neck were similar, however moments at the lower neck were up to three times higher. The Head to T1 (Head-T1) and Head to Upper Spine (Head-US) angles were calculated from the marker position data. The Head-US angle plateaued at about 10 degrees at the high velocity due to the physical constraints of the upper neck joint. Peak Head-T1 angle increased up to about 50 degrees at the end velocity; however the overall percentage contribution of the Head-US angle to the Head-T1 angle decreased. The ES-2 head displayed a characteristic head lag that was demonstrated in Head-US angle and upper neck moment plots in velocities above 1.0 m/s which have also been reported in the human head neck complex studies. Matched paired tests with isolated Post Mortem Human Subjects are necessary to fully compare the ES-2 head and neck biofidelity. PMID:22846282

  4. Bilateral femoral neck stress fractures in an amenorrheic athlete.

    PubMed

    Voss, L; DaSilva, M; Trafton, P G

    1997-11-01

    Stress fractures in athletes rarely involve the femoral neck. This report described the diagnosis and treatment of bilateral femoral neck stress fractures in a 30-year-old amenorrheic triathlete who is lactose intolerant and has a low caloric intake. The possibility of fatigue fracture should be considered in patients who have pain in the lower extremities that is exacerbated by activity, especially if they have hormonal or nutritional disorders. PMID:9402215

  5. The deep-plane approach to neck rejuvenation.

    PubMed

    Gordon, Neil A; Adam, Stewart I

    2014-05-01

    This article provides the facial plastic surgeon with anatomic and embryologic evidence to support the use of the deep-plane rhytidectomy for optimal treatment of the aging neck. An anatomic basis is established that demonstrates this technique's ability to maximize neck rejuvenation through its direct relationship to midface soft-tissue mobilization. A detailed description of the procedure, aimed at providing safe and consistent results, is presented with insights into anatomic landmarks, technical nuances, and alternative approaches to facial variations. PMID:24745388

  6. Metastasis of genitourinary tumors to the head and neck region

    Microsoft Academic Search

    Ore Ogunyemi; A. Rojas; K. Hematpour; D. Rogers; C. Head; C. Bennett

    2010-01-01

    The objective of the present study is to characterize genitourinary tumors (GU) metastatic to the head and neck and to determine\\u000a long-term prognoses. Using a retrospective chart review of 734 patients treated between January 1995 and May 2005 with an\\u000a ICD-9 code pertaining to a metastatic head and neck cancer, we found 37 patients with primary GU tumors. There were

  7. Extraperitoneal laparoscopic bladder neck suspension using hernia mesh and tacker

    Microsoft Academic Search

    Tarkan Soygür; Mut ?afak; Orhan Gö?ü?

    2000-01-01

    Objectives. To report our initial experience with extraperitoneal bladder neck suspension for female stress incontinence due to urethral hypermobility.Methods. Between September 1996 and September 1999, 35 patients (mean age 49.5 years) underwent extraperitoneal bladder neck suspension at our institution. An extraperitoneal space was created by a trocar-mounted balloon device, and suspension was created using a 5-mm endoscopic hernia stapler and

  8. 1112 Consecutive Bilateral Neck Explorations for Primary Hyperparathyroidism

    Microsoft Academic Search

    John Allendorf; Mary DiGorgi; Kathryn Spanknebel; William Inabnet; John Chabot; Paul LoGerfo

    2007-01-01

    Background  Bilateral neck exploration has been the standard approach for patients with primary hyperparathyroidism. Improved localization\\u000a studies and the availability of intraoperative parathyroid hormone monitoring have challenged the necessity of four-gland\\u000a exploration. In this series we report a single surgeon’s experience with bilateral neck exploration for primary hyperparathyroidism\\u000a in an effort to establish benchmark outcomes from which to evaluate minimally invasive

  9. Micronucleated lymphocyte rates from head-and-neck cancer patients

    Microsoft Academic Search

    F Duffaud; T Orsière; L Digue; P Villani; F Volot; R Favre; A Botta

    1999-01-01

    We investigated whether head-and-neck cancers are associated with an increased micronucleated cell rates (MN cell rates) and whether risk factors for these cancers are associated with alterations in micronucleated lymphocytes. MN cell rates were assessed in cytokinesis-blocked lymphocytes of 57 head-and-neck cancer patients (CP) before any anticancer treatment and of 198 male and female healthy subjects (HS). In the HS

  10. Deep-neck space infections - a diagnostic dilemma!

    PubMed

    Jain, Shraddha; Kumar, Sunil; Kumar, Nishant; Puttewar, M P; Nagpure, P S

    2008-12-01

    Deep Neck Space Infections (DNI) are a potentially life threatening condition. This paper highlights the importance of their early diagnosis and early intervention. The deep-neck space infections may be odontogenic in origin. The severe airway compromise caused by them may make diagnosis difficult. Suspicion of simultaneous occurrence of tetanus and retropharyngeal space infection in a child can further increase the dilemma. PMID:23120579

  11. Evaluation and management of neck masses in children.

    PubMed

    Meier, Jeremy D; Grimmer, Johannes Fredrik

    2014-03-01

    Neck masses in children usually fall into one of three categories: developmental, inflammatory/reactive, or neoplastic. Common congenital developmental masses in the neck include thyroglossal duct cysts, branchial cleft cysts, dermoid cysts, vascular malformations, and hemangiomas. Inflammatory neck masses can be the result of reactive lymphadenopathy, infectious lymphadenitis (viral, staphylococcal, and mycobacterial infections; cat-scratch disease), or Kawasaki disease. Common benign neoplastic lesions include pilomatrixomas, lipomas, fibromas, neurofibromas, and salivary gland tumors. Although rare in children, malignant lesions occurring in the neck include lymphoma, rhabdomyosarcoma, thyroid carcinoma, and metastatic nasopharyngeal carcinoma. Workup for a neck mass may include a complete blood count; purified protein derivative test for tuberculosis; and measurement of titers for Epstein-Barr virus, cat-scratch disease, cytomegalovirus, human immunodeficiency virus, and toxoplasmosis if the history raises suspicion for any of these conditions. Ultrasonography is the preferred imaging study for a developmental or palpable mass. Computed tomography with intravenous contrast media is recommended for evaluating a malignancy or a suspected retropharyngeal or deep neck abscess. Congenital neck masses are excised to prevent potential growth and secondary infection of the lesion. Antibiotic therapy for suspected bacterial lymphadenitis should target Staphylococcus aureus and group A streptococcus. Lack of response to initial antibiotics should prompt consideration of intravenous antibiotic therapy, referral for possible incision and drainage, or further workup. If malignancy is suspected (accompanying type B symptoms; hard, firm, or rubbery consistency; fixed mass; supraclavicular mass; lymph node larger than 2 cm in diameter; persistent enlargement for more than two weeks; no decrease in size after four to six weeks; absence of inflammation; ulceration; failure to respond to antibiotic therapy; or a thyroid mass), the patient should be referred to a head and neck surgeon for urgent evaluation and possible biopsy. PMID:24695506

  12. Bladder neck preservation following radical prostatectomy: continence and margins.

    PubMed

    Braslis, K G; Petsch, M; Lim, A; Civantos, F; Soloway, M S

    1995-01-01

    Between December 1991 and January 1994, 134 patients underwent radical retropubic prostatectomy with bladder neck preservation. Forty-nine patients had a positive margin. Number and location of positive margins were analyzed. A tumor was identified at the bladder neck in 10 cases (7.5%). In all 10 patients with bladder neck involvement, a tumor was also identified at multiple other sites. These data suggest that preservation of the bladder neck during radical prostatectomy does not appear to compromise the efficacy of the procedure. Using a self-administered patient questionnaire, we evaluated the effect of bladder neck preservation upon continence in 36 patients. At the initial 3-month follow-up, 24 (67%) patients did not wear any pads. Another 7 (19%) wore pads occasionally, while 5 (14%) patients wore pads daily. To date only 1 of the 134 patients has developed an anastomotic stricture. Bladder neck preservation may aid in an earlier return of continence following radical prostatectomy and reduces anastomotic strictures. It does not appear to compromise the removal of the cancer. PMID:8536773

  13. Neck afferent involvement in cardiovascular control during movement

    NASA Technical Reports Server (NTRS)

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

    2000-01-01

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

  14. Lymphedema Outcomes in Patients with Head and Neck Cancer

    PubMed Central

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

    2015-01-01

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

  15. A Septin-Dependent Diffusion Barrier at Dendritic Spine Necks

    PubMed Central

    Petersen, Jennifer D.; Racz, Bence; Sheng, Morgan; Choquet, Daniel

    2014-01-01

    Excitatory glutamatergic synapses at dendritic spines exchange and modulate their receptor content via lateral membrane diffusion. Several studies have shown that the thin spine neck impedes the access of membrane and solute molecules to the spine head. However, it is unclear whether the spine neck geometry alone restricts access to dendritic spines or if a physical barrier to the diffusion of molecules exists. Here, we investigated whether a complex of septin cytoskeletal GTPases localized at the base of the spine neck regulates diffusion across the spine neck. We found that, during development, a marker of the septin complex, Septin7 (Sept7), becomes localized to the spine neck where it forms a stable structure underneath the plasma membrane. We show that diffusion of receptors and bulk membrane, but not cytoplasmic proteins, is slower in spines bearing Sept7 at their neck. Finally, when Sept7 expression was suppressed by RNA interference, membrane molecules explored larger membrane areas. Our findings indicate that Sept7 regulates membrane protein access to spines. PMID:25494357

  16. Surgical errors and risks – the head and neck cancer patient

    PubMed Central

    Harréus, Ulrich

    2013-01-01

    Head and neck surgery is one of the basic principles of head and neck cancer therapy. Surgical errors and malpractice can have fatal consequences for the treated patients. It can lead to functional impairment and has impact in future chances for disease related survival. There are many risks for head and neck surgeons that can cause errors and malpractice. To avoid surgical mistakes, thorough preoperative management of patients is mandatory. As there are ensuring operability, cautious evaluation of preoperative diagnostics and operative planning. Moreover knowledge of anatomical structures of the head and neck, of the medical studies and data as well as qualification in modern surgical techniques and the surgeons ability for critical self assessment are basic and important prerequisites for head and neck surgeons in order to make out risks and to prevent from mistakes. Additionally it is important to have profound knowledge in nutrition management of cancer patients, wound healing and to realize and to be able to deal with complications, when they occur. Despite all precaution and surgical care, errors and mistakes cannot always be avoided. For that it is important to be able to deal with mistakes and to establish an appropriate and clear communication and management for such events. The manuscript comments on recognition and prevention of risks and mistakes in the preoperative, operative and postoperative phase of head and neck cancer surgery. PMID:24403972

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

    PubMed

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

    2015-06-01

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

  18. Dynamic Hip Screw for the Treatment of Femoral Neck Fractures: A Prospective Study with 96 Patients

    PubMed Central

    Schwartsmann, Carlos Roberto; Jacobus, Lucas Senger; Spinelli, Leandro de Freitas; Boschin, Leonardo Carbonera; Gonçalves, Ramiro Zilles; Yépez, Anthony Kerbes; Barreto, Rodrigo Py Gonçalves; Silva, Marcelo Faria

    2014-01-01

    Objectives. To study the correlation between avascular necrosis and the demographics, time elapsed from fracture to surgery, quality of reduction, Garden classification, and the position of the screw following use of the dynamic hip screw (DHS) in the treatment of subcapital neck fractures. Methods. A prospective study of 96 patients with subcapital neck fractures was carried out in a faculty hospital. Patients underwent surgery with closed reduction and internal fixation with DHS. Results. There were 58% male and 42% female patients, with a mean age of 53 years (+/?14). In terms of Garden classification, 60% were Garden IV, 26% were Garden III, and 14% were Garden II. Nonunion was observed in three cases (3%) and was treated with valgus intertrochanteric osteotomy, in all cases leading to successful healing. Avascular necrosis was observed in 16% of patients. The positioning of the screw into the femoral head showed a significant correlation with necrosis. Conclusions. The incidence of necrosis in patients under the age of 50 years is twice as high as that in older patients. Displacement is a predictive factor regarding osteonecrosis and is associated with a high and anterior position of the screw in the femoral head. Level II of evidence. Study Type: therapeutic study. PMID:24967124

  19. Analysis of time taken to discuss new patients with head and neck cancer in multidisciplinary team meetings.

    PubMed

    Mullan, B J; Brown, J S; Lowe, D; Rogers, S N; Shaw, R J

    2014-02-01

    Multidisciplinary team (MDT) meetings have an important role in the management of head and neck cancer. Increasing incidence of the disease and a drive towards centralised meetings on large numbers of patients mean that effective discussions are pertinent. We aimed to evaluate new cases within a single high volume head and neck cancer MDT and to explore the relation between the time taken to discuss each case, the number of discussants, and type of case. A total of 105 patients with a new diagnosis of head and neck malignancy or complex benign tumour were discussed at 10 head and neck cancer MDT meetings. A single observer timed each discussion using a stopwatch, and recorded the number of discussants and the diagnosis and characteristics of each patient. Timings ranged from 15 to 480 s (8 min) with a mean of 119 s (2 min), and the duration of discussion correlated closely with the number of discussants (rs=0.63, p<0.001). The longest discussions concerned patients with advanced T stage (p=0.006) and advanced N stage (p=0.009) disease, the elderly (p=0.02) and male patients (p=0.05). Tumour site and histological findings were not significant factors in the duration of discussion. Most discussions on patients with early stage tumours were short (T1: 58% less than 60s, mean 90) and fewer people contributed. Many patients, particularly those with early stage disease, require little discussion, and their treatment might reasonably be planned according to an agreed protocol, which would leave more time and resources for those that require greater multidisciplinary input. Further studies may highlight extended discussions on patients with head and neck cancer, which may prompt a review of protocols and current evidence. PMID:24280116

  20. Tensile ductility and necking of metallic glass

    NASA Astrophysics Data System (ADS)

    Guo, H.; Yan, P. F.; Wang, Y. B.; Tan, J.; Zhang, Z. F.; Sui, M. L.; Ma, E.

    2007-10-01

    Metallic glasses have a very high strength, hardness and elastic limit. However, they rarely show tensile ductility at room temperature and are considered quasi-brittle materials. Although these amorphous metals are capable of shear flow, severe plastic instability sets in at the onset of plastic deformation, which seems to be exclusively localized in extremely narrow shear bands ~10nm in thickness. Using in situ tensile tests in a transmission electron microscope, we demonstrate radically different deformation behaviour for monolithic metallic-glass samples with dimensions of the order of 100nm. Large tensile ductility in the range of 23-45% was observed, including significant uniform elongation and extensive necking or stable growth of the shear offset. This large plasticity in small-volume metallic-glass samples did not result from the branching/deflection of shear bands or nanocrystallization. These observations suggest that metallic glasses can plastically deform in a manner similar to their crystalline counterparts, via homogeneous and inhomogeneous flow without catastrophic failure. The sample-size effect discovered has implications for the application of metallic glasses in thin films and micro-devices, as well as for understanding the fundamental mechanical response of amorphous metals.

  1. Tensile ductility and necking of metallic glass.

    PubMed

    Guo, H; Yan, P F; Wang, Y B; Tan, J; Zhang, Z F; Sui, M L; Ma, E

    2007-10-01

    Metallic glasses have a very high strength, hardness and elastic limit. However, they rarely show tensile ductility at room temperature and are considered quasi-brittle materials. Although these amorphous metals are capable of shear flow, severe plastic instability sets in at the onset of plastic deformation, which seems to be exclusively localized in extremely narrow shear bands approximately 10 nm in thickness. Using in situ tensile tests in a transmission electron microscope, we demonstrate radically different deformation behaviour for monolithic metallic-glass samples with dimensions of the order of 100 nm. Large tensile ductility in the range of 23-45% was observed, including significant uniform elongation and extensive necking or stable growth of the shear offset. This large plasticity in small-volume metallic-glass samples did not result from the branching/deflection of shear bands or nanocrystallization. These observations suggest that metallic glasses can plastically deform in a manner similar to their crystalline counterparts, via homogeneous and inhomogeneous flow without catastrophic failure. The sample-size effect discovered has implications for the application of metallic glasses in thin films and micro-devices, as well as for understanding the fundamental mechanical response of amorphous metals. PMID:17704779

  2. Head and neck MRI of Kimura disease

    PubMed Central

    Horikoshi, T; Motoori, K; Ueda, T; Shimofusa, R; Hanazawa, T; Okamoto, Y; Ito, H

    2011-01-01

    Objectives The purpose of our study was to describe the MR appearance of Kimura disease and to interpret the differences in appearance from malignant parotid gland tumours. Methods MR studies of seven patients with Kimura disease were reviewed. The MR studies included T1 weighted, T2 weighted, short tau inversion-recovery, diffusion-weighted (DW) and dynamic contrast-enhanced imaging. Results Typical Kimura disease featured subcutaneous lesions, continuously infiltrated parotid lesions from the subcutaneous lesions with or without intraparotid lymphadenopathies, and reactive cervical lymphadenopathies. The subcutaneous lesions showed gradual upward enhancement on dynamic contrast-enhanced MR images. Reactive lymph nodes showed early enhancement on contrast-enhanced MR images and marked high intensity and low apparent diffusion coefficient values on DW images. Conclusion An indication for making the diagnosis of Kimura disease should be the subcutaneous tissue of the head and neck showing gradual upward enhancement on dynamic contrast-enhanced MRI and a lack of high intensity on DW images, associated with reactive lymph nodes. PMID:21849365

  3. Hemodynamic Responses to Head and Neck Cooling

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

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

  4. Mycobacterial Infections of the Head and Neck.

    PubMed

    Perlman, David C.; D'Amico, Ron; Salomon, Nadim

    2001-06-01

    Mycobacteria are important causes of head and neck infections. Mycobacterial lymphadenitis may be caused by both Mycobacterium tuberculosis and a variety of nontuberculous myocbacteria. Changes in the epidemiology of tuberculosis have caused a shift of the peak age range of tuberculous lymphadenitis from childhood to ages 20 to 40 years. Short-course chemotherapy is highly effective. Mycobacterium avium has become the most common cause of nontuberculous lymphadenitis, but new mycobacterial species are increasingly recognized. Treatment consists primarily of complete surgical excision, although roles for antimycobacterial chemotherapy are being identified. Transient flares of mycobacterial lymphadenitis, which occur during initiation of antituberculous therapy and in HIV-infected patients after initiation of antiretroviral therapy, may respond to short courses of corticosteroids. Tuberculous otitis media has become uncommon. Otitis media due to nontuberculous mycobacterial infection is increasingly seen in patients with pre-existing ear disease and after surgical and otic interventions. Tuberculosis of the eye has also become uncommon but may occur via hematogenous dissemination or direct innoculation. Nontuberculous mycobacteria, most commonly Mycobacterium chelonae and Mycobacterium fortuitum, may cause keratitis, usually after some form of corneal trauma. PMID:11384553

  5. Two rare schwannomas of head and neck

    PubMed Central

    2014-01-01

    Twenty-five to 45 percent of all schwannomas occur in the head and neck. Most of them arise along the vestibular portion of the eighth cranial nerve (acoustic neurinoma). They rarely originate from the peripheral facial nerve or other nerves within the parotid gland. Less than 4% of schwannomas involve the nasal cavity and paranasal sinuses. They arise from the branches of the trigeminal nerve and autonomic nervous system. We report two cases of schwannomas arisng from intraparotid facial nerve and nasal cavity. The first case diagnosed in a 62-year-old-man presented with 2-year-history of painless mass of the parotid gland. The lesion was found to be cystic through the pre operative examinations and investigations. The histology of the specimen retained an intraparotid cystic schwannoma. The second case concerned a 75-year-old-man presented with episodes of nasal obstruction, rhinorrhea, anosmia and headache. Histological study of the specimen showed fusiform cells with strongly and diffusely immunostaining for S100 protein suggesting a schwannoma. Virtual Slides http://www.diagnosticpathology.diagnomx.eu/vs/1098335216112242. PMID:24499455

  6. [Suicidal knife injuries of the neck].

    PubMed

    Jovi?, R

    1996-01-01

    During a 10-year period at the Otorhinolaryngology Clinic in Novi Sad (1984-1994), there were 19 patients with suicidal knife injuries of the neck. There were two mechanisms of injuries: cuts in 15 (78.9%) patients and stabs in 4 (21.10%). 9 injured patients had cut structures and open pharynx, 6 patients injured larynx and trachea, 2 injured only trachea and 2 patients injured pharynx and larynx. 3 (15.8%) patients had knife self-injuries on other parts of the body too, that is injuries of abdomen, top of the right lung lobe and wrist. The diagnosis was based on anamnestic data, clinical check-up, pharyngeal, laryngeal and esophageal directoscopy. Surgery was performed in less than 24 hours after injury. Injuries were successfully taken care of and swallowing, breathing and phonation were reestablished in 16 (84.2%) patients. Total laryngectomy with pharyngoplasty was performed in one patient with serious hypopharyngeal and esophageal injuries. Two patients (10.5%) died: one in the state of delirium tremens and one in serious hemorrhagic and traumatic shock. PMID:8926950

  7. Enhanced Recovery for Fractured Neck of Femur

    PubMed Central

    Rees, David; Kendrick, Emily; Bradshaw, Charlotte; Flavell, Esther; Deglurkar, Mukund

    2014-01-01

    Enhanced recovery is now a standard model of care in most UK elective surgical units. For hip and knee arthroplasty this approach typically includes opioid-sparing anesthesia (OSA), local infiltration analgesia (LIA), and day of surgery mobilization. There is evidence that these interventions shorten hospital stay and improve outcomes, without increasing complications or readmissions. These interventions may also benefit patients undergoing surgery for femoral neck (hip) fractures. This group of patients are frail and elderly, and are at high risk from surgery, anesthesia, and opioid and bed rest-related complications. Hip fractures are also a major public health concern. They are common, expensive to treat, and associated with poor outcomes. Despite this there are no published descriptions of the use of OSA and LIA to enable day of surgery mobilization in patients with hip fractures. We present 3 patients who underwent hip fracture surgery according to an enhanced recovery protocol that incorporated all 3 interventions. In each case day of surgery mobilization was achieved safely and comfortably, without requirement for strong opioids postoperatively. The cases demonstrate that these interventions can be well tolerated by patients with hip fracture, including those with impaired mobility or cognitive function. The protocol is compatible with all common operations for hip fracture, and with spinal or general anesthesia. It is inexpensive and requires minimal expertise. It may have the potential to improve care and shorten hospital stay, while reducing cost. Further investigation is required. PMID:25360329

  8. Spinal Cord Injury Incurred by Neck Massage

    PubMed Central

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

    2012-01-01

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

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

    SciTech Connect

    Strojan, Primoz, E-mail: pstrojan@onko-i.s [Department of Radiation Oncology, Institute of Oncology, Ljubljana (Slovenia); Jancar, Boris [Department of Radiation Oncology, Institute of Oncology, Ljubljana (Slovenia); Cemazar, Maja [Department of Tumor Biology, Institute of Oncology, Ljubljana (Slovenia); Perme, Maja Pohar [Institute of Biomedical Informatics, Medical Faculty, University of Ljubljana, Ljubljana (Slovenia); Hocevar, Marko [Department of Surgical Oncology, Institute of Oncology, Ljubljana (Slovenia)

    2010-07-15

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

  10. A controlled study of the effect of neck school in medical secretaries.

    PubMed

    Kamwendo, K; Linton, S J

    1991-01-01

    The effect of "neck school" on neck and shoulder disorders was studied in medical secretaries. A neck school reinforced with compliance enhancing measures (group B) was compared with a traditional neck school (group A) and a control group (group C). The results show that ergonomical knowledge was good even before the secretaries attended the neck schools and that compliance was significantly higher for group B. When comparisons were made within groups some improvements on neck and shoulder fatigue and pain were noted, particularly for group B. When workload was controlled no significant group differences were found. No differences were noted for range of neck motion, or sick leave in any group. Our conclusion is that neck schools, despite good compliance, appear to be of limited clinical value for prevention of neck and shoulder disorders. PMID:1962157

  11. Deep neck infection in Northern Thailand.

    PubMed

    Srivanitchapoom, Chonticha; Sittitrai, Pichit; Pattarasakulchai, Thienchai; Tananuvat, Rak

    2012-01-01

    The aim of this retrospective study, conducted by the Department of Otolaryngology, Chiang Mai University, Thailand, is to understand the clinical characteristics of patients with deep neck infection (DNI), especially in immunocompromised hosts, as well as to analyze the factors that influence multiple spaces' involvement and complications. The data collected (January 2004-July 2009) from 177 patients with DNI, excluding peritonsillar abscess, were reviewed, including demography, clinical presentation, etiology, involved fascial spaces, bacteriology, treatment, and complications. SPSS (15.0) was used to analyze the data. A p value of <0.05 was considered statistically significant. Among 177 DNI patients, there were 30 diabetic and 4 HIV infected patients, who were considered immunocompromised. Furthermore, two characteristics (complications and the Hb level) were statistically significant (p value <0.05) in the immunocompromised and immunocompetent groups. The 87 patients who presented with multiple space involvement were predicted by the level of white blood cell count (<5,000 or >12,000/?l) (OR 2.62; 95% CI 1.38-4.96) in univariate analysis. Complications were affected by both host immunity and abnormal Hb level (<10 or >15 g/dl), in univariate analysis, but Hb level was the only risk factor (OR 4.46; 95% CI 1.81-10.99) in multivariate analysis. Comorbidities such as diabetes mellitus and HIV infection required certain clinical assessment because of potential complications. In addition, blood tests (WBC and Hb levels) are the most important investigations necessary in patients suspected of having multiple space involvement and complications. PMID:21431951

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

    SciTech Connect

    Ahn, Peter H. [Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (United States)], E-mail: phahn@mdanderson.org; Ahn, Andrew I. [Albert Einstein College of Medicine of Yeshiva University, Bronx, NY (United States); Lee, C. Joe; Shen Jin; Miller, Ekeni; Lukaj, Alex; Milan, Elissa; Yaparpalvi, Ravindra; Kalnicki, Shalom; Garg, Madhur K. [Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY (United States)

    2009-02-01

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

  13. Biopsy diagnoses of clinically atypical pigmented lesions of the head and neck in adults.

    PubMed

    Udovenko, Olga; Griffin, John R; Elston, Dirk M

    2014-10-01

    A subset of facial melanoma in situ has histological features that overlap with those of "dysplastic" nevi. The authors evaluated this important diagnostic pitfall by assessing the frequency of melanoma as the final diagnosis in skin biopsies submitted over a 1-year period with a clinical impression of "atypical" or dysplastic nevus from the head or neck of adults. A total of 1998 biopsies met inclusion criteria. Final diagnoses included both melanocytic and nonmelanocytic processes. Clear trends were noted based on the age of the patient with benign nevi encompassing nearly 70% of specimens in patients aged 21-29 years and <10% in patients aged 70 years and above. The incidence of atypical nevi decreased with age (16% in 21-29 years, 3% in age 70+ years). Nineteen of the 180 (10%) atypical nevi in our series were located on the face (7, cheek; 6, forehead; 3, jawline; and 3, temple), a location not traditionally associated with atypical nevi. Facial atypical nevi were found in all age groups. Malignant melanoma accounted for 1.8% of all specimens increasing from 0% in the patients aged 21-29 years to 5% in patients aged 70 years and above. Caution is warranted when evaluating skin biopsies from sun-damaged skin of the head or neck of an older adult submitted with a clinical diagnosis of atypical nevus. However, the authors' findings suggest that atypical nevi with histological features of dysplastic nevi occur on the head and neck of adults, including elderly adults. The incidence of such lesions decreases with age as the incidence of melanoma increases, and careful clinicopathologic correlation is vital. PMID:25247672

  14. Strength and motion analysis of the human head-neck complex.

    PubMed

    Yoganandan, N; Pintar, F A; Sances, A; Maiman, D J

    1991-03-01

    This study was conducted to correlate the pathology of the experimentally tested human cervical spine with biomechanical strength information and localized temporal movements of the various spinal components. Eight fresh human cadaveric head-neck complexes were subjected to compressive forces at a quasistatic rate of 2.5 mm/s until failure. Biomechanical force and deflection data were collected. Localized kinematic data as a function of time were obtained from retroreflective targets placed in the anterior and posterior regions of the vertebral body, facet column, and spinous process at every level of the cervical spine. The specimens were radiographed prior to, during, and following failure; they were then deep frozen at the level of failure to preserve the localized tissue deformations. Specimens underwent computed tomography scanning and sequential sectioning using a cryomicrotome. The failure forces and compressions ranged from 1.3 to 3.6 kN and 0.9 to 3.7 cm. Stiffness and energy-absorbing characteristics ranged from 96.1 to 220.5 kN/m and 12.2 to 53.6 J, respectively. Varying localized temporal motions among spinal components were found to exist at all levels of the head-neck complex. With increasing compressive loads, the specimen components reorient as demonstrated by kinematic changes in the spinal elements; failure was imminent when the structure no longer resisted any further increase in external load. The study demonstrated that an evaluation of the human head-neck complex in a relaxed state, as in clinical observations on posttraumatic radiographs, is often different from that documented immediately following the traumatic insult; this underscores the importance of conducting controlled in vitro investigations to determine the injury biomechanics of the human cervical spine. PMID:1807532

  15. Molecular Targeting of Ultrasonographic Contrast Agent for Detection of Head and Neck Squamous Cell Carcinoma

    PubMed Central

    Knowles, Joseph A.; Heath, Cara H.; Saini, Reshu; Umphrey, Heidi; Warram, Jason; Hoyt, Kenneth; Rosenthal, Eben L.

    2012-01-01

    Objective To investigate the feasibility of ultrasonographic (US) imaging of head and neck cancer with targeted contrast agents both in vitro and in vivo. We hypothesize that conjugation of microbubble contrast agent to tumor-specific antibodies may improve US detection of head and neck squamous cell carcinoma (HNSCC). Design Preclinical blinded assessment of anti-EGFR and anti-CD147 microbubble contrast agents for US imaging of HNSCC. Setting Animal study. Subjects Immunodeficient mice. Intervention Injection of targeted microbubbles. Main Outcome Measure Microbubble uptake in tumors as detected by US. Results In vitro assessment of anti–epidermal growth factor receptor (EGFR) and anti-CD147–targeted micro-bubbles in 6 head and neck cancer cell lines yielded a 6-fold improvement over normal dermal fibroblasts (P<.001). Binding of targeted agents had a positive correlation to both epidermal growth factor receptor (EGFR) (R2=0.81) and CD147 (R2=0.72) expression among all cell lines. In vivo imaging of flank tumors in nude mice (N=8) yielded enhanced resolution of anti-EGFR– and anti-CD147–targeted microbubble agents over IgG control (P<.001), while dual-targeted contrast agents offered enhanced imaging over single-targeted contrast agents (P=.02 and P=.05, respectively). In a blinded in vivo assessment, targeted contrast agents increased intratumoral enhancement of flank tumors over controls. Targeted US contrast agents to both EGFR and CD147 were 100% sensitive and 87% specific in the detection of flank tumors. Conclusion This preclinical study demonstrates feasibility of using molecular US to target HNSCC for contrast-enhanced imaging of HNSCC tumor in vivo. PMID:22801891

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

    PubMed Central

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

    1994-01-01

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

  17. Neck muscle vibration in full cues affects pointing.

    PubMed

    McIntyre, Sarah; Seizova-Cajic, Tatjana

    2007-01-01

    Vibration of the dorsolateral neck stimulates proprioceptors that are normally active during head movement; this induces a visual illusion of contralateral motion and displacement of a stationary target seen against a homogenous background. The spatial constancy explanation of the illusion argues that it occurs because information about head movement is necessary for accurate egocentric localization of visual objects. Accurate egocentric localization, in turn, is necessary for the success of object-directed motor action, but previous studies failed to find evidence that vibration affects pointing toward visual targets in a normally illuminated, structured field. Our goal was to provide this evidence. Vibration lasting 12 s was applied to either side of the neck while observers (N = 11) pointed at the visual target with an unseen hand. Vibration of the right side of dorsal neck in the illuminated visual field induced a 26-mm lateral bias in pointing responses in comparison to the vibration of the left side. We conclude that the mechanism that takes into account neck proprioceptive signals also operates in full cues. The pointing bias in full cues generally co-occurred with reported stationariness of the visual target, suggesting a conflict between cues used in perception of body-centric position used to guide action, which include neck proprioception, and those used in perception of motion, for which object-relative retinal information is sufficient. PMID:18217849

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

    PubMed Central

    Alshadwi, Ahmad; Nadershah, Mohammed; Osborn, Timothy

    2014-01-01

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

  19. Bilateral femoral neck stress fractures in a fire academy student.

    PubMed

    Wright, Russell C; Salzman, Garrett A; Yacoubian, Stephan V; Yacoubian, Shahan V

    2010-10-01

    Unilateral femoral neck stress fractures are well documented in active patients; however, the risk of a subsequent contralateral stress fracture remains unknown in patients who continue to be active. This article describes a 24-year-old male fire academy student who sustained a left femoral neck stress fracture, followed approximately 11 months later by a right femoral neck stress fracture, both of which went on to completely displace. A review of the index radiographs of each hip from outside institutions revealed femoral neck stress fractures that went undiagnosed until they displaced. The patient was referred to our institution and underwent closed reduction and internal fixation using cannulated screws in both cases. A full endocrine evaluation was performed in the following weeks and proved unremarkable. Although it is difficult to extrapolate the results from 1 patient beyond the case studied, there is cause for concern in patients who remain active following femoral neck stress fractures. Our case highlights the significance of obtaining a complete and thorough medical history on physical examination and appropriately counseling patients regarding activity level. Until further research explores this possible relationship, physicians evaluating patients with a history of a stress fracture are encouraged to be vigilant of subsequent contralateral fractures and educate patients of this potentially avoidable injury. PMID:20954652

  20. Relationships between neck muscle electromyography and three-dimensional head kinematics during centrally induced torsional head perturbations

    E-print Network

    Corneil, Brian D.

    Relationships between neck muscle electromyography and three-dimensional head kinematics during. Relationships between neck muscle electromyography and three- dimensional head kinematics during centrally, 2012; doi:10.1152/jn.00312.2012.--The relationship between neck muscle electromyography (EMG

  1. Contribution of biopsychosocial risk factors to nonspecific neck pain in office workers: A path analysis model.

    PubMed

    Paksaichol, Arpalak; Lawsirirat, Chaipat; Janwantanakul, Prawit

    2014-12-01

    Objective: The etiology of nonspecific neck pain is widely accepted to be multifactorial. Each risk factor has not only direct effects on neck pain but may also exert effects indirectly through other risk factors. This study aimed to test this hypothesized model in office workers. Methods: A one-year prospective cohort study of 559 healthy office workers was conducted. At baseline, a self-administered questionnaire and standardized physical examination were employed to gather biopsychosocial data. Follow-up data were collected every month for the incidence of neck pain. A regression model was built to analyze factors predicting the onset of neck pain. Path analysis was performed to examine direct and indirect associations between identified risk factors and neck pain. Results: The onset of neck pain was predicted by female gender, having a history of neck pain, monitor position not being level with the eyes, and frequently perceived muscular tension, of which perceived muscular tension was the strongest effector on the onset of neck pain. Gender, history of neck pain, and monitor height had indirect effects on neck pain that were mediated through perceived muscular tension. History of neck pain was the most influential effector on perceived muscular tension. Conclusions: The results of this study support the hypothesis that each risk factors may contribute to the development of neck pain both directly and indirectly. The combination of risk factors necessary to cause neck pain is likely occupation specific. Perceived muscular tension is hypothesized to be an early sign of musculoskeletal symptoms. PMID:25476863

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

    SciTech Connect

    Gan, Hui K. [Department of Medical Oncology, Princess Margaret Hospital, Toronto, ON (Canada); Bernstein, Lori J. [Department of Psychosocial Oncology, Princess Margaret Hospital, Toronto, ON (Canada); Brown, Jennifer [Department of Medical Oncology, Princess Margaret Hospital, Toronto, ON (Canada); Ringash, Jolie; Vakilha, Mehrdad [Department of Radiation Oncology, Princess Margaret Hospital, Toronto, ON (Canada); Wang, Lisa [Department of Biostatistics, Princess Margaret Hospital, Toronto, ON (Canada); Goldstein, David [Department of Otolaryngology, Princess Margaret Hospital, Toronto, ON (Canada); Kim, John; Hope, Andrew; O'Sullivan, Brian; Waldron, John [Department of Radiation Oncology, Princess Margaret Hospital, Toronto, ON (Canada); Abdul Razak, Albiruni R.; Chen, Eric X. [Department of Medical Oncology, Princess Margaret Hospital, Toronto, ON (Canada); Siu, Lillian L., E-mail: lillian.siu@uhn.on.ca [Department of Medical Oncology, Princess Margaret Hospital, Toronto, ON (Canada)

    2011-09-01

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

  3. Carotidynia: a cause of neck and face pain.

    PubMed Central

    Murray, T. J.

    1979-01-01

    Carotidynia is a form of vascular neck are face pain in which the vascular change occurs in the carotid artery in the neck. The disorder is not uncommon, and most patients have a prior history of migraine. They present with pain in the neck and face, and are often thought to have a disorder such as chronic sinusitis or trigeminal neuralgia. Diagnosis can be made from the type and location of the pain and the finding of a tender and swollen carotid artery on the same side. Carotidynia responds to the prophylactic medications used for migraine, often disappearing in weeks or months. In some patients the syndrome may become recurrent or chronic, with a variable response to medication. PMID:445285

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

    PubMed

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

    2015-01-01

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

  5. Brachial plexus paresis associated with fetal neck compression from forceps.

    PubMed

    Gei, Alfredo F; Smith, Russell A; Hankins, Gary D V

    2003-08-01

    Instrumental vaginal deliveries have been associated with higher risks of brachial plexus injuries. The proposed mechanisms involve the indirect association of instrumental deliveries with shoulder dystocia and nerve stretch injuries secondary to rotations of 90 degrees or more. We present a brachial plexus paresis resulting from direct compression of the forceps blade in the fetal neck. A term infant was delivered by a low Kielland forceps rotation. No shoulder dystocia was noted. The immediate neonatal exam revealed an Erb's palsy and an ipsilateral bruise in the lateral aspect of the neck. The paresis resolved during the first day of life. Direct cervical compression of the fetal neck by forceps in procedures involving rotations of the presentation may result in brachial plexus injuries. PMID:14528397

  6. MR evaluation of femoral neck version and tibial torsion.

    PubMed

    Koenig, James Karl; Pring, Maya E; Dwek, Jerry R

    2012-01-01

    Abnormalities of femoral neck version have been associated with a number of hip abnormalities in children, including slipped capital femoral epiphysis, proximal femoral focal deficiency, coxa vara, a deep acetabulum and, rarely, developmental dysplasia of the hip. Orthopedic surgeons also are interested in quantifying the femoral neck anteversion or retroversion in children especially to plan derotational osteotomies. Historically, the angle of femoral version and tibial torsion has been measured with the use of radiography and later by CT. Both methods carry with them the risks associated with ionizing radiation. Techniques that utilize MR are used less often because of the associated lengthy imaging times. This article describes a technique using MRI to determine femoral neck version and tibial torsion with total scan times of approximately 10 min. PMID:21842328

  7. Lymphoepithelial-like carcinomas of the head and neck.

    PubMed

    Wenig, Bruce M

    2015-01-01

    Lymphoepithelial-like carcinomas (LELC) of the head and neck represent malignant neoplasms that are histologically similar to nasopharyngeal carcinoma (NPC), nonkeratinizing undifferentiated type but arise in locations other than the nasopharynx. The most common location for LELC in the head and neck is the salivary glands, in particular the parotid gland. However, LELC may arise in other sites including the oropharynx (tonsils, base of tongue), sinonasal tract, larynx, and middle ear/temporal bone. Unlike the nonkeratinizing undifferentiated type of NPC which is etiologically linked to Epstein-Barr virus (EBV), LELCs are not uniformly associated with EBV. The differential diagnosis for LELC varies per site and depending on the site of occurrence may include lymphoepithelial sialadenitis, sinonasal undifferentiated carcinoma (SNUC), and large cell neuroendocrine carcinoma. Treatment general includes combined (multimodality) therapy including surgical resection, neck dissection, radiation therapy and/or chemotherapy. The prognosis may vary per site overall favorable owing to a good response to therapy. PMID:25804344

  8. Sleep apnea syndrome after irradiation of the neck

    SciTech Connect

    Herlihy, J.P.; Whitlock, W.L.; Dietrich, R.A.; Shaw, T. (Pulmonary Disease Service, Presidio of San Francisco, CA (USA))

    1989-12-01

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

  9. Complex reconstructions in head and neck cancer surgery: decision making

    PubMed Central

    2011-01-01

    Defects in head and neck after tumor resection often provide significant functional and cosmetic deformity. The challenge for reconstruction is not only the aesthetic result, but the functional repair. Cancer may involve composite elements and the in sano resection may lead to an extensive tissue defect. No prospective randomized controlled studies for comparison of different free flaps are available. There are many options to cover defects and restore function in the head and neck area, however we conclude from experience that nearly all defects in head and neck can be closed by 5 different free flaps: radial forearm flap, free fibula flap, anterior lateral thigh flap, lateral arm flap and parascapular flap. PMID:21385421

  10. Extramedullary Plasmacytoma of Gingiva and Soft Tissue in Neck

    PubMed Central

    Faizuddin, Mohamed; D., Jayanthi; Malleshi, Suchetha .N; Venkatesh, Rashmi

    2014-01-01

    Plasmacytoma is a malignant disease that present either in bone marrow (medullary plasmacytoma), within the bone (solitary plasmacytoma of bone), or outside of bone, as the extramedullary plasmacytoma. Extramedullary plasmacytoma accounts for 3% of all plasma cell tumours and approximately 90% of extramedullary plasmacytomas affect the head and neck region commonly affecting the nasal cavity, paranasal sinuses, tonsillar fossa and oral cavity. Multiple extramedullary plasmacytoma is defined when there is more than one extramedullary tumour of clonal plasma cells and such presentations are extremely rare. We report such a rare case of multiple extramedullary plasmacytoma involving gingiva and neck. Here is a case report of a 65-year-old female patient presenting with extramedullary plasmacytoma of the gingiva and soft tissue in neck. PMID:25584334

  11. Microsatellite analysis of serum DNA in patients with head and neck cancer.

    PubMed

    Nawroz-Danish, Homaira; Eisenberger, Claus F; Yoo, George H; Wu, Li; Koch, Wayne; Black, Carri; Ensley, John F; Wei, Wei-Zen; Sidransky, David

    2004-08-10

    We have shown previously that microsatellite alterations in serum DNA was predictive of distant metastasis in a study with 21 primary head and neck squamous cell carcinoma patients. To further investigate serum microsatellite alterations as a prognostic tool, we carried out microsatellite analysis of serum DNA with 10 markers on 152 patients with head and neck cancer. Forty-five percent (68/152) of patients had microsatellite alterations of serum DNA identical to corresponding tumor DNA. In 16 patients that had distant metastasis, 11 patients had a positive serum test (microsatellite alterations detectable in their serum DNA with one or more markers). The difference in distant metastasis rates between the negative and positive serum tests (6.0% [5/84] vs. 16.2% [11/68], RR = 2.7) was clinically significant and almost reached statistical significance (p = 0.06). When the analysis was restricted to patients with recurrent disease, a positive serum test correlated with those who developed distant metastasis (p = 0.04). Other parameters, such as development of recurrence, stage of the cancer, disease-free survival and overall survival, were not associated with a positive serum test. Detecting tumor DNA in serum by microsatellite analysis may help identify patients at risk for distant metastasis. Therefore, circulating tumor cells may contribute to the presence of tumor DNA in the serum. In the future if a serum test is positive, therapeutic approaches may by intensified, such as platinum-based chemoradiation, to reduce distant failures. PMID:15185349

  12. Development of extension kinematic corridors to validate a head/neck finite element model.

    PubMed

    Stemper, B D; Yoganandan, N; Pintar, F A; Sun, Z

    2001-01-01

    The objective of the current study was the development of experimental response corridors for the purpose of validating a finite element head-neck model in simulated vehicular rear impact. Six intact human head-neck cadaver complexes were used to understand and quantify the kinematics of the cervical spine secondary to low-speed rear impact. The first and second thoracic vertebrae were mounted in a fixative and attached to a minisled/pendulum apparatus. The specimens experienced live different input velocities applied to the first thoracic vertebral, created t),y the pendulum. The response of the specimen was digitally imaged at 1000 Hz from the right lateral side. Relative angles between vertebrae were analyzed in the sagittal plane at 100 ms after impact of the pendulum. Results correlated well with published physiologic range of motion data and dynamic full-body cadaver real impact experiments. Data obtained from this study will be used to validate the macroscopic motions of a finite element model, which will be used to understand the injury mechanisms involved in low-speed vehicular rear impacts. PMID:11347395

  13. Exploring the dynamic core microbiome of plaque microbiota during head-and-neck radiotherapy using pyrosequencing.

    PubMed

    Hu, Yue-jian; Shao, Zi-yang; Wang, Qian; Jiang, Yun-tao; Ma, Rui; Tang, Zi-sheng; Liu, Zheng; Liang, Jing-ping; Huang, Zheng-wei

    2013-01-01

    Radiotherapy is the primary treatment modality used for patients with head-and-neck cancers, but inevitably causes microorganism-related oral complications. This study aims to explore the dynamic core microbiome of oral microbiota in supragingival plaque during the course of head-and-neck radiotherapy. Eight subjects aged 26 to 70 were recruited. Dental plaque samples were collected (over seven sampling time points for each patient) before and during radiotherapy. The V1-V3 hypervariable regions of bacterial 16S rRNA genes were amplified, and the high-throughput pyrosequencing was performed. A total of 140 genera belonging to 13 phyla were found. Four phyla (Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria) and 11 genera (Streptococcus, Actinomyces, Veillonella, Capnocytophaga, Derxia, Neisseria, Rothia, Prevotella, Granulicatella, Luteococcus, and Gemella) were found in all subjects, supporting the concept of a core microbiome. Temporal variation of these major cores in relative abundance were observed, as well as a negative correlation between the number of OTUs and radiation dose. Moreover, an optimized conceptual framework was proposed for defining a dynamic core microbiome in extreme conditions such as radiotherapy. This study presents a theoretical foundation for exploring a core microbiome of communities from time series data, and may help predict community responses to perturbation as caused by exposure to ionizing radiation. PMID:23437114

  14. Gene Expression Profiling to Predict Outcome After Chemoradiation in Head and Neck Cancer

    SciTech Connect

    Pramana, Jimmy [Division of Experimental Therapy, Netherlands Cancer Institute, Amsterdam (Netherlands); Department of Head and Neck Surgery, Netherlands Cancer Institute, Amsterdam (Netherlands); Academic Medical Center, Netherlands Cancer Institute, Amsterdam (Netherlands); Brekel, Michiel van den [Department of Head and Neck Surgery, Netherlands Cancer Institute, Amsterdam (Netherlands); Academic Medical Center, Netherlands Cancer Institute, Amsterdam (Netherlands); Velthuysen, Marie-Louise F. van [Department of Pathology, Netherlands Cancer Institute, Amsterdam (Netherlands); Wessels, Lodewijk F.A. [Department of Molecular Biology, Netherlands Cancer Institute, Amsterdam (Netherlands); Nuyten, Dimitry S. [Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam (Netherlands); Hofland, Ingrid [Division of Experimental Therapy, Netherlands Cancer Institute, Amsterdam (Netherlands); Atsma, Douwe [Department of Pathology, Netherlands Cancer Institute, Amsterdam (Netherlands); Pimentel, Nuno [Department of Radiotherapy, University Hospital Santa Maria, Lisbon (Portugal); Hoebers, Frank J.P.; Rasch, Coen [Department of Radiotherapy, Netherlands Cancer Institute, Amsterdam (Netherlands); Begg, Adrian C. [Division of Experimental Therapy, Netherlands Cancer Institute, Amsterdam (Netherlands)], E-mail: a.begg@nki.nl

    2007-12-01

    Purpose: The goal of the present study was to improve prediction of outcome after chemoradiation in advanced head and neck cancer using gene expression analysis. Materials and Methods: We collected 92 biopsies from untreated head and neck cancer patients subsequently given cisplatin-based chemoradiation (RADPLAT) for advanced squamous cell carcinomas (HNSCC). After RNA extraction and labeling, we performed dye swap experiments using 35k oligo-microarrays. Supervised analyses were performed to create classifiers to predict locoregional control and disease recurrence. Published gene sets with prognostic value in other studies were also tested. Results: Using supervised classification on the whole series, gene sets separating good and poor outcome could be found for all end points. However, when splitting tumors into training and validation groups, no robust classifiers could be found. Using Gene Set Enrichment analysis, several gene sets were found to be enriched in locoregional recurrences, although with high false-discovery rates. Previously published signatures for radiosensitivity, hypoxia, proliferation, 'wound,' stem cells, and chromosomal instability were not significantly correlated with outcome. However, a recently published signature for HNSCC defining a 'high-risk' group was shown to be predictive for locoregional control in our dataset. Conclusion: Gene sets can be found with predictive potential for locoregional control after combined radiation and chemotherapy in HNSCC. How treatment-specific these gene sets are needs further study.

  15. Relationship between Neck Length, Sleep, and Cardiovascular Risk Factors

    PubMed Central

    Han, Tae Seung; Kim, Su Min; Yang, Hyun Ju; Lee, Bum Soon; Park, Soon Yeob; Lee, Won Joon

    2015-01-01

    Background Neck circumference, as a predicator of obesity, is a well-known risk factor for obstructive sleep apnea and cardiovascular diseases. However, little research exists on neck length associated with these factors. This study explored the association of neck length with sleep and cardiovascular risk factors by measuring midline neck length (MNL) and lateral neck length (LNL). Methods We examined 240 patients aged 30 to 75 years who visited a health check-up center between January 2012 and July 2012. Patients with depressive disorder or sleep disturbance were excluded from this study. MNL from the upper margin of the hyoid bone to the jugular notch and LNL from the mandibular angle to the mid-portion of the ipsilateral clavicle were measured twice and were adjusted by height to determine their relationship with sleep and cardiovascular disease risk factors. Results Habitual snorers had shorter LNL height ratios (P = 0.011), MNL height ratios in men (P = 0.062), and MNL height ratios in women (P = 0.052). Those snoring bad enough to annoy others had shorter MNL height ratios in men (P = 0.083) and women (P = 0.035). Men with objective sleep apnea had longer distances from the mandible to the hyoid bone to the mandible (P = 0.057). Men with metabolic syndrome had significantly shorter LNL height ratios (P = 0.021), and women with diabetes, hyperlipidemia, and metabolic syndrome had shorter MNL height ratios (P < 0.05). Conclusion This study shows that a short neck by measuring the MNL is probably associated with snoring. In addition, MNL is related to cardiovascular disease risk factors in women. PMID:25780512

  16. Cortical bone histomorphometry in male femoral neck: the investigation of age-association and regional differences.

    PubMed

    Tong, Xiaoyu; Burton, Inari S; Isaksson, Hanna; Jurvelin, Jukka S; Kröger, Heikki

    2015-04-01

    Low bone volume and changes in bone quality or microarchitecture may predispose individuals to fragility fractures. As the dominant component of the human skeleton, cortical bone plays a key role in protecting bones from fracture. However, histological investigations of the underlying structural changes, which might predispose to fracture, have been largely limited to the cancellous bone. The aim of this study was to investigate the age-association and regional differences of histomorphometric properties in the femoral neck cortical bone. Undecalcified histological sections of the femoral neck (n = 20, aged 18-82 years, males) were cut (15 ?m) and stained using modified Masson-Goldner stain. Complete femoral neck images were scanned, and cortical bone boundaries were defined using our previously established method. Cortical bone histomorphometry was performed with low (×50) and high magnification (×100). Most parameters related to cortical width (Mean Ct.Wi, Inferior Ct.Wi, Superior Ct.Wi) were negatively associated with age both before and after adjustment for height. The inferior cortex was the thickest (P < 0.001) and the superior cortex was the thinnest (P < 0.008) of all cortical regions. Both osteonal size and pores area were negatively associated with age. Osteonal area and number were higher in the antero-inferior area (P < 0.002) and infero-posterior area (P = 0.002) compared to the postero-superior area. The Haversian canal area was higher in the infero-posterior area compared to the postero-superior area (P = 0.002). Moreover, porosity was higher in the antero-superior area (P < 0.002), supero-anterior area (P < 0.002) and supero-posterior area (P < 0.002) compared to the infero-anterior area. Eroded endocortical perimeter (E.Pm/Ec.Pm) correlated positively with superior cortical width. This study describes the changes in cortical bone during ageing in healthy males. Further studies are needed to investigate whether these changes explain the increased susceptibility to femoral neck fractures. PMID:25646589

  17. Lameness detection based on multivariate continuous sensing of milk yield, rumination, and neck activity.

    PubMed

    Van Hertem, T; Maltz, E; Antler, A; Romanini, C E B; Viazzi, S; Bahr, C; Schlageter-Tello, A; Lokhorst, C; Berckmans, D; Halachmi, I

    2013-07-01

    The objective of this study was to develop and validate a mathematical model to detect clinical lameness based on existing sensor data that relate to the behavior and performance of cows in a commercial dairy farm. Identification of lame (44) and not lame (74) cows in the database was done based on the farm's daily herd health reports. All cows were equipped with a behavior sensor that measured neck activity and ruminating time. The cow's performance was measured with a milk yield meter in the milking parlor. In total, 38 model input variables were constructed from the sensor data comprising absolute values, relative values, daily standard deviations, slope coefficients, daytime and nighttime periods, variables related to individual temperament, and milk session-related variables. A lame group, cows recognized and treated for lameness, to not lame group comparison of daily data was done. Correlations between the dichotomous output variable (lame or not lame) and the model input variables were made. The highest correlation coefficient was obtained for the milk yield variable (rMY=0.45). In addition, a logistic regression model was developed based on the 7 highest correlated model input variables (the daily milk yield 4d before diagnosis; the slope coefficient of the daily milk yield 4d before diagnosis; the nighttime to daytime neck activity ratio 6d before diagnosis; the milk yield week difference ratio 4d before diagnosis; the milk yield week difference 4d before diagnosis; the neck activity level during the daytime 7d before diagnosis; the ruminating time during nighttime 6d before diagnosis). After a 10-fold cross-validation, the model obtained a sensitivity of 0.89 and a specificity of 0.85, with a correct classification rate of 0.86 when based on the averaged 10-fold model coefficients. This study demonstrates that existing farm data initially used for other purposes, such as heat detection, can be exploited for the automated detection of clinically lame animals on a daily basis as well. PMID:23684042

  18. Virus Analysis in Head and Neck and Bladder Cancers - Michael Parfenov, TCGA Scientific Symposium 2012

    Cancer.gov

    Home News and Events Multimedia Library Videos Virus Analysis in Head and Neck and Bladder Cancers - Michael Parfenov Virus Analysis in Head and Neck and Bladder Cancers - Michael Parfenov, TCGA Scientific Symposium 2012 You will need Adobe Flash

  19. Neck-band retention for Canada geese in the Mississippi (USA) flyway

    USGS Publications Warehouse

    Samuel, M.D.; Weiss, N.T.; Rusch, D.H.; Craven, S.R.; Trost, R.E.; Caswell, F.D.

    1990-01-01

    We used capture, harvest, and observation histories of Canada geese (Branta canadensis) banded in the Mississippi flyway, 1974-88, to examine the problem of neck-band retention. Methods for the analysis of survival data were used to estimate rates of neck-band retention and to evaluate factors associated with neck-band loss. Sex, age of bird at banding, rivet use, and neck-band type significantly influenced neck-band retention. For most of the resulting cohorts (e.g., sex, age, rivet, and neck-band type categories), neck-band retention rates decreased through time. We caution against using small samples or data collected during short-term studies to determine retention rates. We suggest that observation data be used in neck-band retention studies to increase the efficiency of estimating retention time.

  20. If I Had - An Enlarged Painless Lymph Node in My Neck

    MedlinePLUS

    ... Infants VIDEO: If I Had - An Enlarged Painless Lymph Node and In My Neck - Dr. Jonathan W. Friedberg, ... Page VIDEO: If I Had - An Enlarged Painless Lymph Node and In My Neck - Dr. Jonathan W. Friedberg, ...

  1. 78 FR 36306 - Proposed Information Collection (Neck (Cervical Spine) Conditions Disability Benefits...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ...Information Collection (Neck (Cervical Spine) Conditions Disability Benefits Questionnaire...a claimant's diagnosis of a cervical spine condition. DATES: Written comments and...Control No. 2900--NEW (Neck (Cervical Spine) Conditions Disability Benefits...

  2. Neck surface electromyography as a measure of vocal hyperfunction before and after injection laryngoplasty

    E-print Network

    Stepp, Cara E.

    Neck surface electromyography as a measure of vocal hyperfunction before and after injection Objectives--The goal of this preliminary study was to determine if neck surface electromyography (s vocal hyperfunction; injection laryngoplasty; speech acoustics; electromyography Introduction Vocal

  3. Genetic diversity predicts outcomes in head and neck cancer

    Cancer.gov

    A new measure of the heterogeneity – the variety of genetic mutations – of cells within a tumor appears to predict treatment outcomes of patients with the most common type of head and neck cancer. In the May 20 issue of the journal Cancer, investigators at Massachusetts General Hospital (a component of the Dana-Farber Cancer Institute) and Massachusetts Eye and Ear Infirmary describe how their measure was a better predictor of survival than most traditional risk factors in a small group of patients with squamous cell carcinoma of the head and neck.

  4. Computed tomography of the infrahyoid neck. Part II: pathology

    SciTech Connect

    Reede, D.L.; Whelan, M.A.; Bergeron, R.T.

    1982-11-01

    The computed tomographic (CT) scans of 44 patients who presented with nonthyroid/parathyroid lesions involving the soft tissues of the neck were analyzed. Among these patients, there were 26 with nodal masses, 6 with vascular lesions, 5 with neural lesions, and 8 with disease involving the connective tissues. One patient had both connective-tissue and vascular disease.CT allowed accurate determination of the extent of disease, while certain CT features added specificity to the diagnosis. It is concluded that CT is the procedure of choice in examining patients with neck lesions.

  5. Deep fascial space infection of the neck: a continuing challenge.

    PubMed

    Hamza, Nashaat S; Farrel, John; Strauss, Melvin; Bonomo, Robert A

    2003-09-01

    We present our clinical experience with two complex cases of deep fascial space infections of the neck. The first was a case of cervical necrotizing fasciitis involving the submental space. The second was an infection beginning at the soft palate and extending to the anterior mediastinum. Both infections emanated from an oral source in patients with diabetes mellitus, and both patients required multiple surgical debridements and endotracheal intubation for airway protection. Despite the declining incidence of deep space neck infections, our cases illustrate the challenging diagnostic and treatment dilemmas for the clinician managing patients with diabetes. PMID:14513995

  6. Neck myoclonia with absence seizures in an Indian girl.

    PubMed

    Jain, Puneet; Sharma, Suvasini; Aneja, Satinder

    2014-11-01

    Absence seizures associated with myoclonic phenomena have been associated with 4 seizure types. Recently, a new seizure type of neck myoclonia with absences was described. We present a case of 9-year-old girl who presented with abnormal head shaking and vacant stare for the past 5 months with an ictal electroencephalograph (EEG) record showing 3-Hz spike-and-wave discharges. The seizures were easily controlled with valproate and clobazam. Neck myoclonia with absences might be a new idiopathic generalized epilepsy syndrome in development. PMID:24556548

  7. Common pediatric head and neck congenital/developmental anomalies.

    PubMed

    LaPlante, Justin K; Pierson, Nicholas S; Hedlund, Gary L

    2015-01-01

    Pediatric head and neck neuroradiology is a broad and complex topic. This article focuses on several of the common and sometimes challenging pediatric head and neck congenital/developmental anomalies physicians may encounter in clinical practice. Although some diagnoses may be evident on physical examination, others may present a diagnostic dilemma. Patients may initially present with a variety of secondary findings. Imaging serves an important role in making a diagnosis, guiding referral, and in some cases even providing treatment options through interventional radiology. Key diagnostic criteria and critical points of interest for each diagnosis are presented. PMID:25476180

  8. Head and neck skin cancer: dentists' responsibility in early detection.

    PubMed

    Corcoran, Paul; Depaola, Louis; Nern, Karen; Urquhart, Jean

    2013-03-01

    While there are 35,000 diagnosed oral cancers per year and 7,500 deaths, there are 30 times this amount when it comes to cases of skin cancer, the majority of which are found on the head and neck. Because many patients see their dentist more frequently than their medical doctor, dentistry is in an advantageous position to reduce the mortality/morbidity of this most common malignancy. This article discusses various types of head and neck skin cancer and how dental practitioners can perform clinical examinations to provide early detection for patients. PMID:23931264

  9. Mutation takes ‘brakes’ off neck and head cancers

    Cancer.gov

    The increased activation of a key oncogene in head and neck cancers could be the result of mutation and dysfunction of regulatory proteins that are supposed to keep the gene, which has the potential to cause cancer, in check, according to a new study led by researchers at the University of Pittsburgh School of Medicine (home of the University of Pittsburgh Cancer Institute). The findings, published in the early online version of the Proceedings of the National Academy of Sciences, suggest a new target for drugs to treat head and neck tumors, as well as other cancers.

  10. Transurethral Incision of the Bladder Neck in a Woman with Primary Bladder Neck Obstruction after Kidney Transplantation

    PubMed Central

    Marki?, Dean; Valen?i?, Maksim; Mari?i?, Anton; Krpina, Kristian; Raheli?, Dražen; Ahel, Juraj; Rubini?, Nino; Orli?, Lidija; Ra?ki, Sanjin

    2015-01-01

    Voiding dysfunction is frequently seen in the early posttransplant period. Among other causes, this condition can arise due to bladder outlet obstruction. Primary bladder neck obstruction (PBNO) is a possible but very rare cause of bladder outlet obstruction. We present the case of a 52-year-old woman who, after kidney transplantation, presented with PBNO. The diagnosis was established based on symptoms, uroflowmetry, and multichannel urodynamics with electromyography. The transurethral incision of the bladder neck was made at the 5- and 7-o'clock position. After the operation, the maximal flow rate was significantly increased, and postvoid residual urine was decreased compared to the preoperative findings. The patient was followed for 5 years, and her voiding improvement is persistent. This is the first reported case of PBNO treated with a transurethral incision of the bladder neck in a posttransplantation female patient.

  11. Atraumatic neck pain and rigidity: a case of calcific retropharyngeal tendonitis.

    PubMed

    Martindale, J L; Senecal, E L

    2012-05-01

    Neck pain with associated rigidity is a concerning clinical presentation that emergency physicians encounter regularly.We present the case of a 58-year-old man with acute neck pain, worsened by movement and swallowing, that was found to be secondary to acute calcific retropharyngeal tendonitis. Patients with severe neck pain, neck stiffness, and odynophagia may have this condition. The diagnosis can be confirmed with imaging, and response to conservative treatment is often dramatic. PMID:21514765

  12. Towards the prediction of multiple necking during dynamic extension of round bar : linear stability approach versus finite element calculations

    NASA Astrophysics Data System (ADS)

    El Maï, S.; Mercier, S.; Petit, J.; Molinari, A.

    2014-05-01

    The fragmentation of structures subject to dynamic conditions is a matter of interest for civil industries as well as for Defence institutions. Dynamic expansions of structures, such as cylinders or rings, have been performed to obtain crucial information on fragment distributions. Many authors have proposed to capture by FEA the experimental distribution of fragment size by introducing in the FE model a perturbation. Stability and bifurcation analyses have also been proposed to describe the evolution of the perturbation growth rate. In the proposed contribution, the multiple necking of a round bar in dynamic tensile loading is analysed by the FE method. A perturbation on the initial flow stress is introduced in the numerical model to trigger instabilities. The onset time and the dominant mode of necking have been characterized precisely and showed power law evolutions, with the loading velocities and moderately with the amplitudes and the cell sizes of the perturbations. In the second part of the paper, the development of linear stability analysis and the use of salient criteria in terms of the growth rate of perturbations enabled comparisons with the numerical results. A good correlation in terms of onset time of instabilities and of number of necks is shown.

  13. Changes of tumor and normal structures of the neck during radiation therapy for head and neck cancer requires adaptive strategy.

    PubMed

    Bando, Ryota; Ikushima, Hitoshi; Kawanaka, Takashi; Kudo, Takaharu; Sasaki, Motoharu; Tominaga, Masahide; Kishi, Taro; Furutani, Shunsuke; Kubo, Akiko; Tamura, Koichi

    2013-01-01

    The treatment period over which radiation therapy is administered extends over several weeks. Since tumor shrinkage in response to radiation therapy and weight loss due to radiation-induced mucositis may impact on the dose distribution in both target and organ at risk in patients with head and neck cancer, the anatomical changes of tumor and neck volumes during this period should be taken into consideration. We investigated the anatomical changes that occurred in the target and normal structure of the neck during radiation therapy for pharyngeal cancer, and evaluated the necessity of an adaptive strategy. Ten patients with pharyngeal cancer who underwent radical chemoradiation therapy using 3-dimensional conformal radiation therapy RT (66-70 Gy in 33-35 fractions) between April 2009 and September 2010 were enrolled in the study. Patients underwent CT scans every week during their course of treatment. We analyzed the CT data in the radiation treatment planning system and measured changes of tumor, organ at risk, and neck volume. Gross tumor volume (GTV) was rapidly reduced by 28% of the original volume on average in the first 3 weeks. The right and left submandibular glands volume decreased to 70% and 63% of their initial volumes on average, respectively. The volume of the neck in the radiation fields decreased to 89% of its initial volume on average by the sixth week mainly caused by body weight loss due to acute radiation morbidity. Considerable anatomical change in the radiation filed that will affect dose distribution of the target and organ at risk was observed during radiation therapy for head and neck cancer. PMID:23614911

  14. Cross-cultural adaptation of the Neck Disability Index and Copenhagen Neck Functional Disability Scale for patients with neck pain due to degenerative and discopathic disorders. Psychometric properties of the Polish versions

    Microsoft Academic Search

    Ewa Misterska; Roman Jankowski; Maciej Glowacki

    2011-01-01

    Background  Even though there are several region-specific functional outcome questionnaires measuring neck disorders that have been developed\\u000a in English-speaking countries, no Polish version has ever been validated. The purpose of our study was to translate, culturally\\u000a adapt and validate the Neck Disability Index (NDI) and Copenhagen Neck Functional Disability Scale (CDS) for Polish-speaking\\u000a patients with neck pain.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The translation was carried

  15. Research Study on Neck Injury Lessening with Active Head Restraint Using Human Body FE Model

    Microsoft Academic Search

    Yuichi Kitagawa; Tsuyoshi Yasuki; Junji Hasegawa

    2008-01-01

    Objectives: The objective of this study is to examine the effectiveness of the active head restraint system in reducing neck injury risk of car occupants in low-speed rear impacts.Methods: A human body FE model “THUMS” was used to simulate head and neck kinematics of the occupant and to evaluate loading to the neck. Joint capsule strain was calculated to predict

  16. Neutron beam therapy in the treatment of advanced head and neck malignancy.

    PubMed

    Jones, J; Hendrix, R A

    1989-01-01

    Patients with advanced head and neck cancer continue to present a difficult management problem for the otolaryngologist-head and neck surgeon. This paper discusses the principles of radiation therapy with emphasis on neutron beam therapy as an effective treatment option for advanced malignancy of the head and neck other than squamous cell carcinoma. PMID:2698523

  17. Widespread Presaccadic Recruitment of Neck Muscles by Stimulation of the Primate Frontal Eye Fields

    E-print Network

    Corneil, Brian D.

    -head gaze shifts by recording EMG activity from multiple dorsal neck muscles after electrical stimulationWidespread Presaccadic Recruitment of Neck Muscles by Stimulation of the Primate Frontal Eye Fields Elsley JK, Nagy B, Cushing SL, Corneil BD. Widespread presac- cadic recruitment of neck muscles

  18. Genodermatosis with Reticulate, Patchy and Mottled Pigmentation of the Neck – A Clue to Rare Dermatologic Disorders

    Microsoft Academic Search

    P. H. Itin; S. Lautenschlager

    1998-01-01

    Reticulate pigmentation of the neck is a common finding in numerous genodermatoses and acquired diseases. As the neck is readily accessible to medical inspection, it may serve as a diagnostic window for various dermatoses. Several entities out of the spectrum of ectodermal dysplasia present with reticulate or mottled pigmentation on the upper trunk and neck. The most impressive genodermatoses with

  19. Prevalence and Risk Factor of Neck Pain in Elderly Korean Community Residents

    PubMed Central

    Son, Kyeong Min; Cho, Nam H.; Lim, Seung Hun

    2013-01-01

    Neck pain is a common musculoskeletal condition, which causes substantial medical cost. In Korea, prevalence of neck pain in community based population, especially in elderly subjects, has scarcely been reported. We evaluated the prevalence, the severity and the risk factors of neck pain in elderly Korean community residents. Data for neck pain were collected for 1,655 subjects from a rural farming community. The point, 6-months and cumulative lifetime prevalence of neck pain was obtained in addition to the measurement of the severity of neck pain. The mean age of the study subjects was 61 yr and 57% were females. The lifetime prevalence of neck pain was 20.8% with women having a higher prevalence. The prevalence did not increase with age, and the majority of individuals had low-intensity/low-disability pain. Subjects with neck pain had a significantly worse SF-12 score in all domains except for mental health. The prevalence of neck pain was significantly associated with female gender, obesity and smoking. This is the first large-scale Korean study estimating the prevalence of neck pain in elderly population. Although the majority of individuals had low-intensity/low-disability pain, subjects with neck pain had a significantly worse SF-12 score indicating that neck pain has significant health impact. PMID:23678258

  20. Survivin expression correlates with nodal metastasis in T1-T2 squamous cell carcinoma of the tongue.

    PubMed

    Do?an, Murat; Ça?l?, Sedat; Yüce, ?mdat; Bayram, Ali; Somda?, Mehmet Akif; Karata?, Duran; Cihan, Mehmet Celalettin; Yüksel, Fatih; Güney, Ercihan

    2015-03-01

    In this study, the correlation between neck metastasis and recurrence was investigated by studying specimens of tongue squamous cell carcinoma patients immunohistochemical with survivin antibodies in the primary biopsy. A retrospective review was conducted at the Academic University Hospital. 46 patients who had squamous cell carcinoma of the tongue, who underwent various types of glossectomy and neck dissections between 1991 and 2008, were evaluated. The patient's sex, TNM staging, differentiation and recurrence rates were analyzed. There were 20 T1 patients and 26 T2 patients; 27 of the patients were N0 and 19 had metastatic lymph nodes in the neck. Survivin antibodies were applied with streptavidin-biotin method to the sections that were prepared from the primary tumor biopsy specimens of the patients. The correlation between neck metastasis and recurrence and survivins' immunohistochemical staining was analyzed with statistical methods. There were no significant differences between the patient's age, sex, tumor's T stage, tumor differentiation and survivin staining density. Survivin staining was positive in 15 (79 %) of 19 patients with neck metastasis, while it was positive in 16 (59 %) of 27 patients without neck metastasis. Eleven (79 %) of the 14 patients who had recurrence and all 6 patients who had neck recurrence only were stained by survivin. Expression of nuclear and cytoplasmic survivin can be a useful marker for predicting cervical lymph node metastasis in T1-T2 tumors in tongue SCC. PMID:24676727

  1. Quality of information available via the internet for patients with head and neck cancer: are we improving?

    PubMed

    Best, James; Muzaffar, Jameel; Mitchell-Innes, Alistair

    2014-11-01

    This study aimed to evaluate the type, content, accessibility and quality of information available via the internet for patients with head and neck cancer. The Google search engine was used to generate lists of the first 100 websites for general head and neck cancer and the first ten for head and neck cancers by anatomical location (160 total). Websites were evaluated with the validated DISCERN and LIDA instruments, the SMOG (Simple measure of gobbledygook) readability score and against the JAMA (Journal of the American Medical Association) criteria. 40 of the 160 websites ranked by Google were suitable for analysis. Seven websites (17.5 %) partially or fully achieved all four JAMA benchmarks and only one (2.5 %) site achieved none. 28 (70 %) included reference to quality of life factors. Correlations were identified between Google site rank and all four of our appraisal tools; LIDA (-0.966, p = 0.006), JAMA (-5.93, p = 0.028), DISCERN (-0.568, p = 0.037) and SMOG (4.678, p = 0.04). Google site rank and both government run sites (-35.38, p = 0.034) and sites run by universities or hospitals (-27.32, p = 0.016) also showed an association. Comparing our observations with those of Riordain in 2008, there has been little improvement in the quality of head and neck cancer information available online over this time. Given the variability in quality of information online, patients would benefit from being directed to reliable websites by clinicians. PMID:25370600

  2. Factors Associated With Long-Term Dysphagia After Definitive Radiotherapy for Locally Advanced Head-and-Neck Cancer

    SciTech Connect

    Caudell, Jimmy J.; Schaner, Philip E.; Meredith, Ruby F. [Department of Radiation Oncology, University of Alabama-Birmingham, Birmingham, AL (United States); Locher, Julie L. [Department of Medicine, University of Alabama-Birmingham, Birmingham, AL (United States); Nabell, Lisle M. [Department of Medical Oncology, University of Alabama-Birmingham, Birmingham, AL (United States); Carroll, William R.; Magnuson, J. Scott [Department of Head and Neck Surgery, University of Alabama-Birmingham, Birmingham, AL (United States); Spencer, Sharon A. [Department of Radiation Oncology, University of Alabama-Birmingham, Birmingham, AL (United States); Bonner, James A. [Department of Radiation Oncology, University of Alabama-Birmingham, Birmingham, AL (United States)], E-mail: jabonner@uabmc.edu

    2009-02-01

    Purpose: The use of altered fractionation radiotherapy (RT) regimens, as well as concomitant chemotherapy and RT, to intensify therapy for locally advanced head-and-neck cancer can lead to increased rates of long-term dysphagia. Methods and Materials: We identified 122 patients who had undergone definitive RT for locally advanced head-and-neck cancer, after excluding those who had been treated for a second or recurrent head-and-neck primary, had Stage I-II disease, developed locoregional recurrence, had <12 months of follow-up, or had undergone postoperative RT. The patient, tumor, and treatment factors were correlated with a composite of 3 objective endpoints as a surrogate for severe long-term dysphagia: percutaneous endoscopic gastrostomy tube dependence at the last follow-up visit; aspiration on a modified barium swallow study or a clinical diagnosis of aspiration pneumonia; or the presence of a pharyngoesophageal stricture. Results: A composite dysphagia outcome occurred in 38.5% of patients. On univariate analysis, the primary site (p = 0.01), use of concurrent chemotherapy (p = 0.01), RT schedule (p = 0.02), and increasing age (p = 0.04) were significantly associated with development of composite long-term dysphagia. The use of concurrent chemotherapy (p = 0.01), primary site (p = 0.02), and increasing age (p = 0.02) remained significant on multivariate analysis. Conclusion: The addition of concurrent chemotherapy to RT for locally advanced head-and-neck cancer resulted in increased long-term dysphagia. Early intervention using swallowing exercises, avoidance of nothing-by-mouth periods, and the use of intensity-modulated RT to reduce the dose to the uninvolved swallowing structures should be explored further in populations at greater risk of long-term dysphagia.

  3. Low-density lipoprotein cholesterol and radiotherapy-induced carotid atherosclerosis in subjects with head and neck cancer

    PubMed Central

    2014-01-01

    Background Radiotherapy (RT) is a risk factor for accelerated carotid artery atherosclerotic disease in subjects with head and neck cancer. However, the risk factors of RT-induced carotid artery remodeling are not established. This study aimed to investigate the effects of RT on carotid and popliteal arteries in subjects with head and neck cancer and to evaluate the relationship between baseline clinical and laboratory features and the progression of RT-induced atherosclerosis. Findings Eleven men (age?=?57.9?±?6.2years) with head and neck cancer who underwent cervical bilateral irradiation were prospectively examined by clinical and laboratory analysis and by carotid and popliteal ultrasound before and after treatment (mean interval between the end of RT and the post-RT assessment?=?181?±?47 days). No studied subject used hypocholesterolemic medications. Significant increases in carotid intima-media thickness (IMT) (0.95?±?0.08 vs. 0.87?±?0.05 mm; p?correlation with RT-induced carotid IMT change (r?=?0.66; p?=?0.027), while no other studied variable exhibited a significant relationship with carotid IMT change. Conclusions These results indicate that RT-induced atherosclerosis is limited to the irradiated area and also suggest that it may be predicted by low-density lipoprotein cholesterol levels in subjects with head and neck cancer. PMID:24919963

  4. Adaptive Planning in Intensity-Modulated Radiation Therapy for Head and Neck Cancers: Single-Institution Experience and Clinical Implications

    SciTech Connect

    Ahn, Peter H.; Chen, Chin-Cheng [Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine of Yeshiva University, Bronx, New York (United States); Ahn, Andrew I. [Albert Einstein College of Medicine of Yeshiva University, Bronx, New York (United States); Hong, Linda; Scripes, Paola G.; Shen Jin; Lee, Chen-Chiao; Miller, Ekeni; Kalnicki, Shalom [Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine of Yeshiva University, Bronx, New York (United States); Garg, Madhur K., E-mail: mgarg@montefiore.org [Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine of Yeshiva University, Bronx, New York (United States)

    2011-07-01

    Purpose: Anatomic changes and positional variability during intensity-modulated radiation therapy (IMRT) for head and neck cancer can lead to clinically significant dosimetric changes. We report our single-institution experience using an adaptive protocol and correlate these changes with anatomic and positional changes during treatment. Methods and Materials: Twenty-three sequential head and neck IMRT patients underwent serial computed tomography (CT) scans during their radiation course. After undergoing the planning CT scan, patients underwent planned rescans at 11, 22, and 33 fractions; a total of 89 scans with 129 unique CT plan combinations were thus analyzed. Positional variability and anatomic changes during treatment were correlated with changes in dosimetric parameters to target and avoidance structures between planning CT and subsequent scans. Results: A total of 15/23 patients (65%) benefited from adaptive planning, either due to inadequate dose to gross disease or to increased dose to organs at risk. Significant differences in primary and nodal targets (planning target volume, gross tumor volume, and clinical tumor volume), parotid, and spinal cord dosimetric parameters were noted throughout the treatment. Correlations were established between these dosimetric changes and weight loss, fraction number, multiple skin separations, and change in position of the skull, mandible, and cervical spine. Conclusions: Variations in patient positioning and anatomy changes during IMRT for head and neck cancer can affect dosimetric parameters and have wide-ranging clinical implications. The interplay between random positional variability and gradual anatomic changes requires careful clinical monitoring and frequent use of CT- based image-guided radiation therapy, which should determine variations necessitating new plans.

  5. Prescribed dose versus calculated dose of spinal cord in standard head and neck irradiation assessed by 3-D plan

    PubMed Central

    Majumder, Dipanjan; Patra, Niladri Bihari; Chatterjee, Debashis; Mallick, Swapan Kumar; Kabasi, Apurba Kumar; Majumder, Anjali

    2014-01-01

    Background and Purpose: Spinal cord toxicity can be dreaded complication while treating head and neck cancer by conventional radiotherapy. Cord sparing approach is applied by two phase planning in conventional head neck radiotherapy. In spite of cord sparing approach spinal cord still receives considerable scatter dose. Our study aims to do the volumetric analysis of spinal cord dosimetry and to correlate with the clinical findings. Materials and Methods: Treatment planning was done in two phases. First phase treatment fields include gross disease- both tumor and involved nodes. in the second phase, treatment field shrinkage was done to cover the gross disease sparing the spinal cord. These fields are termed as off-cord fields. 42 patients with histological proven squamous cell carcinoma of the head and neck region were analysed with two groups. In Group A, 46 Gy was given in 23 fractions, and then tumor-boost with off-cord field received 24 Gy in 12 fractions. In Group B 50 Gy was prescribed in 25 fractions initially, then off-cord field given 20 Gy in 10 fractions to analyze theoutcome. Planning Computed tomography (CT) scan was done Philips Brilliance 16 slice CT scan machine, and contouring and dose calculation were done at ASHA treatment planning software. Results: Maximum dose and dose at 1 cm3, 2 cm3, and 5 cm3 were calculated. Maximum dose to cord was 52.6 Gy (range 48.1-49.7 Gy) in Group A and 54.3 Gy (range 51.48-52.33 Gy) in Group B initially. Off-cord fields received mean dose 8.07 Gy (85.85% of maximum) in Group A and 5.47 Gy (86.84% of maximum) in Group B. At the end of 6 months from the last date of radiotherapy, grade 1 spinal cord toxicity found in two patients in Group A and one patient in Group B respectively (P = 0.55). Both groups received additional dose, which are higher than the prescribed dose, but no patients show significant spinal cord toxicity after 6 month of follow-up. Conclusion: Spinal cord received scatter dose which much higher than the predicted dose in conventional radiotherapy of head neck cancer. Short term follow up failed to establish clinical correlation with volumetric dose of spinal cord. Two phase cord sparing head neck radiation planning if practiced should be used with caution. PMID:24665442

  6. Head and neck space infections in infants and children

    Microsoft Academic Search

    KITIRAT UNGKANONT; ROBERT F. YELLON; JANE L. WEISSMAN; MARGARETHA L. CASSELBRANT; HUGO GONZÁLEZ-VALDEPEÑA; CHARLES D. BLUESTONE

    1995-01-01

    A retrospective study was performed in 117 children with head and neck space infections treated at the Children's Hospital of Pittsburgh from January 1986 through June 1992. Peritonsillar space infections were the most common (49%), followed by retropharyngeal (22%), submandibular (14%), buccal (11%), parapharyngeal (2%), and canine (2%) space infections. The most common pathogens isolated (N = 78) were the

  7. The molecular biology of head and neck cancer

    Microsoft Academic Search

    Boudewijn J. M. Braakhuis; Ruud H. Brakenhoff; C. René Leemans

    2010-01-01

    Head and neck squamous cell carcinomas (HNSCCs) are caused by tobacco and alcohol consumption and by infection with high-risk types of human papillomavirus (HPV). Tumours often develop within preneoplastic fields of genetically altered cells. The persistence of these fields after treatment presents a major challenge, because it might lead to local recurrences and second primary tumours that are responsible for

  8. Chemopreventive Potential of Natural Compounds in Head and Neck Cancer

    Microsoft Academic Search

    Mohammad Aminur Rahman; A. R. M. Ruhul Amin; Dong M. Shin

    2010-01-01

    Head and neck squamous cell carcinoma (HNSCC) is one of the most fatal cancers worldwide. Despite advances in the management of HNSCC, the overall survival for patients has not improved significantly due to advanced stages at diagnosis, high recurrence rate after surgical removal, and second primary tumor development, which underscore the importance of novel strategies for cancer prevention. Cancer chemoprevention,

  9. The black thyroid: an unusual finding during neck exploration.

    PubMed Central

    Noble, J. G.; Christmas, T. J.; Chapple, C.; Katz, D.; Milroy, E. J.

    1989-01-01

    Black thyroid discolouration has been reported in post-mortem examinations on patients who have previously taken minocycline. The discovery of this phenomenon during neck exploration and a review of the possible mechanism of black thyroid discolouration are discussed in this paper. Images Figure 1 Figure 2 PMID:2780449

  10. Access to dental services for head and neck cancer patients.

    PubMed

    Lawrence, Mark; Aleid, Wesam; McKechnie, Alasdair

    2013-07-01

    Dental assessment is important for patients with cancer of the head and neck who are to have radiotherapy, as many of these patients have poor dental health before they start treatment. This, compounded by the fact that radiotherapy to the head and neck has a detrimental effect on oral health, has led the National Institute for Clinical Excellence (NICE) to issue guidance that the dental health of these patients should be assessed before treatment. Unfortunately some multidisciplinary teams, such as the one at United Lincolnshire Hospitals, do not have access to a restorative dentist or a dental hygienist. In a retrospective survey we investigated access to general dental services by patients with head and neck cancer who were to have radiotherapy at our hospital and found that 37/71 (52%) had not been reviewed by a dentist within the past 12 months. A secondary national survey that investigated the availability of restorative dental and dental hygienic services showed that of the 56 multidisciplinary teams that deal with head and neck cancer in England, 19 (34%) do not have access to a restorative dentist and 23 (41%) do not have access to a dental hygienist, suggesting that this problem may be countrywide. PMID:23127589

  11. Co morbidities of Myofascial Neck Pain among Information Technology Professionals

    PubMed Central

    2014-01-01

    Objectives The objective of this study was to identify the musculoskeletal co-morbidities of neck pain of myofascial origin among IT professionals. Methods A retrospective report analysis of 5357 IT professionals from various IT companies in India was conducted. Demographic details, type and intensity of the musculoskeletal problems, employee feedbacks on status of musculoskeletal health and physician’s diagnosis were analysed. Descriptive statistics were used to describe the age, gender, body area affected and nature of work. Chi square test was used to find the association between musculoskeletal co-morbidities and myofascial neck pain (MNP). Results The study participants were predominantly males (71%). 41% of the population used laptops, 35% desktops and 24% both. Neck pain was the commonest reported symptom, followed by low back, shoulder and arm pain respectively. Statistical analysis also revealed that low back pain and shoulder pain, had a significant association with neck pain. Further analysis revealed that there was a significant association between the presence of MNP and thoracic outlet syndrome (p?

  12. [Quality assurance in head and neck medical oncology].

    PubMed

    Digue, Laurence; Pedeboscq, Stéphane

    2014-05-01

    In medical oncology, how can we be sure that the right drug is being administered to the right patient at the right time? The implementation of quality assurance criteria is important in medical oncology, in order to ensure that the patient receives the best treatment safely. There is very little literature about quality assurance in medical oncology, as opposed to radiotherapy or cancer surgery. Quality assurance must cover the entire patient care process, from the diagnosis, to the therapeutic decision and drug distribution, including its selection, its preparation and its delivery to the patient (administration and dosage), and finally the potential side effects and their management. The dose-intensity respect is crucial, and its reduction can negatively affect overall survival rates, as shown in breast and testis cancers for example. In head and neck medical oncology, it is essential to respect the few well-standardized recommendations and the dose-intensity, in a population with numerous comorbidities. We will first review quality assurance criteria for the general medical oncology organization and then focus on head and neck medical oncology. We will then describe administration specificities of head and neck treatments (chemoradiation, radiation plus cetuximab, postoperative chemoradiation, induction and palliative chemotherapy) as well as their follow-up. Lastly, we will offer some recommendations to improve quality assurance in head and neck medical oncology. PMID:24886900

  13. Back and neck pain in seniors—prevalence and impact

    Microsoft Academic Search

    Jan Hartvigsen; Henrik Frederiksen; Kaare Christensen

    2006-01-01

    Neck pain (NP) and back pain (BP) are common complaints in seniors yet specific information on these complaints is lacking in the scientific literature. We present cross-sectional interview data from the 2003 data collection within the population based Longitudinal Study of Aging Danish Twins dealing with the 1-month prevalence of NP and BP and the intensity of possible pain. Further,

  14. OTOLARYNGOLOGY DEPARTMENT Head and Neck Surgery, Strong Audiology & Speech Pathology

    E-print Network

    Goldman, Steven A.

    OTOLARYNGOLOGY DEPARTMENT Head and Neck Surgery, Strong Audiology & Speech Pathology Visit our Otolaryngology Wilmot Cancer Center, Clinton Woods Li-Xing Man, M.D., M.P.A. Rhinology Nasal and Sinus Surgery Clinton Woods Margo M. Benoit, M.D. Pediatric Otolaryngology Clinton Woods Chase H. Miller, M.D. Rhinology

  15. High definition video teaching module for learning neck dissection

    PubMed Central

    2014-01-01

    Introduction Video teaching modules are proven effective tools for enhancing student competencies and technical skills in the operating room. Integration into post-graduate surgical curricula, however, continues to pose a challenge in modern surgical education. To date, video teaching modules for neck dissection have yet to be described in the literature. Purpose To develop and validate an HD video-based teaching module (HDVM) to help instruct post-graduate otolaryngology trainees in performing neck dissection. Methods This prospective study included 6 intermediate to senior otolaryngology residents. All consented subjects first performed a control selective neck dissection. Subjects were then exposed to the video teaching module. Following a washout period, a repeat procedure was performed. Recordings of the both sets of neck dissections were de-identified and reviewed by an independent evaluator and scored using the Observational Clinical Human Reliability Assessment (OCHRA) system. Results In total 91 surgical errors were made prior to the HDVM and 41 after exposure, representing a 55% decrease in error occurrence. The two groups were found to be significantly different. Similarly, 66 and 24 staff takeover events occurred pre and post HDVM exposure, respectively, representing a statistically significant 64% decrease. Conclusion HDVM is a useful adjunct to classical surgical training. Residents performed significantly less errors following exposure to the HD-video module. Similarly, significantly less staff takeover events occurred following exposure to the HDVM. PMID:24666440

  16. Dairy products, leanness, and head and neck squamous cell carcinoma

    Microsoft Academic Search

    Edward S. Peters; Brian G. Luckett; Katie M. Applebaum; Carmen J. Marsit; Michael D. McClean; Karl T. Kelsey

    2008-01-01

    Background. As part of a population-based case- control study, we investigated the association of food groups and micronutrients estimated from a validated food frequency questionnaire (FFQ) with the risk of development of head and neck squamous cell carcinoma (HNSCC). Methods. Incident cases were accrued through Boston area hospitals from 1999 to 2003, and neighborhood controls were selected and matched by

  17. Severe and Catastrophic Neck Injuries Resulting from Tackle Football

    ERIC Educational Resources Information Center

    Torg, Joseph S.; And Others

    1977-01-01

    Use of the spring-loaded blocking and tackling devices should be discontinued due to severe neck injuries resulting from their use; employment of the head and helmet as the primary assault weapon in blocking, tackling, and head butting should be condemned for the same reason. (MJB)

  18. Video-assisted neck surgery for thyroid and parathyroid diseases

    Microsoft Academic Search

    Shigeto Maeda; Kazuo Shimizu; Shigeki Minami; Naomi Hayashida; Tamotsu Kuroki; Akira Furuichi; Nozomu Sugiyama; Katsu Ishigaki; Ryuichiro Suto; Junichiro Furui; Takashi Kanematsu

    Background: Endoscopic surgery has now become a well-established modality for the treatment of various organ diseases. In the present study, we analyzed the surgical results achieved by video-assisted neck surgery (VANS) in thyroid and parathyroid diseases. Methods: From January 2000 to April 2002, 87 patients (eight males and 79 females) with a mean age of 49 years underwent VANS. The

  19. AN IMPROVED METHOD OF SEXING RING-NECKED PHEASANT CHICKS

    E-print Network

    AN IMPROVED METHOD OF SEXING RING-NECKED PHEASANT CHICKS By EUGENE E. WOEHLER AND JOHN M. GATES at the Wisconsin State Game Fann since 1962 bas enabled sexing of 900-1,000 day-old chicks per man) described a practicable method of sexing day-old pheasants. Among chicks classed as male or female, accuracy

  20. Femoral neck fracture prediction by anisotropic yield criteria

    E-print Network

    Paris-Sud XI, Université de

    of fracture load, finite element models were developed in mechanical study of proximal femur. The finiteFemoral neck fracture prediction by anisotropic yield criteria M. Tellache a , b , M. Pithioux and increases its porosity. Hip fractures are the more recurrent consequences of osteoporosis, and are the cause

  1. Progression of head and neck squamous cell cancer

    Microsoft Academic Search

    József Tímár; Orsolya Csuka; Éva Remenár; Gábor Répássy; Miklós Kásler

    2005-01-01

    Squamous cell cancer in the head and neck region (HNSC) is unique concerning its progression since it remains locoregional for long time and visceral metastases develop only in a later stage of the disease. Accordingly, molecular markers of the local invasion and the lymphatic dissemination both have critical importance. HNSC progression is associated with deregulated control of cell proliferation and

  2. [A case of idiopathic neck bleeding from a parathyroid cyst].

    PubMed

    Shibata, Hirofumi; Kuze, Bunya; Hayashi, Hisamitsu; Nishihori, Takesumi; Aoki, Mitsuhiro; Mizuta, Keisuke; Kato, Shimon; Ando, Kenichi; Ito, Yatsuji

    2014-09-01

    Bleeding from parathyroid cysts is rare. The retropharyngeal space has a very soft structure and if bleeding spreads to this space, airway obstruction can easily occur. We report on a 50-year-old female case with idiopathic neck bleeding from a left parathyroid cyst without any episode of injury. The patient complained of neck swelling after exercise and went to a nearby hospital. At the hospital, the doctor thought this swelling was caused by retropharyngeal bleeding from a tumor behind the left thyroid gland. Embolization of the left thyroid artery was performed. However, the next day, airway obstruction.was occurred and she was brought to our hospital. An emergency operation was performed to open the left neck swelling region. The operation findings and pathological examination showed that the bleeding was caused by a parathyroid cyst and airway obstruction had occurred because of retropharyngeal edema. In this case, the bleeding may have been caused by torsion of the neck when the patient exercised. The retropharyngeal edema probably resulted from the delay of delivery of the lymphatic and venous return and the arterial embolization. 1 year after the operation, the patient is very well and there has been no recurrence. PMID:25726661

  3. Kinematics of a Head-Neck Model Simulating Whiplash

    NASA Astrophysics Data System (ADS)

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

    2008-02-01

    A whiplash event is a relative motion between the head and torso that occurs in rear-end automobile collisions. In particular, the large inertia of the head results in a horizontal translation relative to the thorax. This paper describes a simulation of the motion of the head and neck during a rear-end (whiplash) collision. A head-neck model that qualitatively undergoes the same forces acting in whiplash and shows the same behavior is used to analyze the kinematics of both the head and the cervical spine and the resulting neck loads. The rapid acceleration during a whiplash event causes the extension and flexion of the cervical spine, which in turn can cause dislocated vertebrae, torn ligaments, intervertebral disc herniation, and other trauma that appear to be the likely causes of subsequent painful headache or neck pain symptoms. Thus, whiplash provides a connection between the dynamics of the human body and physics. Its treatment can enliven the usual teaching in kinematics, and both theoretical and experimental approaches provide an interesting biological context to teach introductory principles of mechanics.

  4. FHIT Gene Alterations in Head and Neck Squamous Cell Carcinomas

    Microsoft Academic Search

    Laura Virgilio; Michele Shuster; Susanne M. Gollin; Maria Luisa Veronese; Masataka Ohta; Kay Huebner; Carlo M. Croce

    1996-01-01

    To determine whether the FHIT gene at 3p14.2 is altered in head and neck squamous cell carcinomas (HNSCC), we examined 26 HNSCC cell lines for deletions within the FHIT locus by Southern analysis, for allelic losses of specific exons FHIT by fluorescence in situ hybridization (FISH) and for integrity of FHIT transcripts. Three cell lines exhibited homozygous deletions within the

  5. Results of fast neutron therapy in advanced head and neck cancer.

    PubMed

    Sko?yszewski, J; Korzeniowski, S; Huczkowski, J

    1988-04-01

    Eighty-nine patients with advanced head and neck cancer were treated with a fast neutron beam of mean energy 5.6 MeV. The standard tumour dose was 1320 cGyn, gamma in 20 fractions over 4 weeks, but 13 patients with laryngeal cancer received 1200 cGyn, gamma. Complete remission was achieved in 50 patients (56%). Fifteen patients (17%) survived 2 years, 14 of them being symptom-free. Survival correlated with the stage of disease. Encouraging results were obtained for cervical node metastases, oropharynx and salivary gland cancer. In laryngeal and hypopharyngeal cancer, neutron therapy seems to be disadvantageous. The main reason for treatment failure was local recurrence. Two patients died of complications. PMID:3370414

  6. Effect of Occupant and Impact Factors on Forces within Neck: I. Overview of Large Population

    NASA Astrophysics Data System (ADS)

    Shaibani, Saami J.

    2000-03-01

    Scientific and medical data have been gathered for nearly 500 motor-vehicle occupants, whose dynamic response[1-2] was calculated to determine the forces generated at all potential injury sites. Particular attention was paid to the load within the cervical spine to examine the influence of certain variables relating to the occupant (height, weight, sex), the impact (magnitude, direction), and the neck itself (local vector, anatomical level). Exhaustive efforts were made to match the force with each variable using linear and logarithmic fits, but correlation coefficients were generally not high. These results might be influenced by the emphasis in this research to obtain the best statistics with large groupings of patients. Hence, a separate study with more detail is proposed as a significant continuation of this effort. 1. Proper Treatment of Complex Human Structures, Announcer 27 (4), 100 (1997); 2. Physics as a Key Element in the Complete Description of Dichotomies in Injury Distribution, Bull. Am. Phys. Soc. 44, 274 (1999).

  7. Recurrence patterns of locally advanced head and neck squamous cell carcinoma after 3D conformal (chemo)-radiotherapy

    Microsoft Academic Search

    Didem C Oksuz; Robin J Prestwich; Brendan Carey; Stuart Wilson; Mustafa S Senocak; Ananya Choudhury; Karen Dyker; Catherine Coyle; Mehmet Sen

    2011-01-01

    Background  To establish recurrence patterns among locally advanced head and neck non-nasopharyngeal squamous cell carcinoma (HNSCC) patients\\u000a treated with radical (chemo-) radiotherapy and to correlate the sites of loco-regional recurrence with radiotherapy doses\\u000a and target volumes\\u000a \\u000a \\u000a \\u000a \\u000a Method  151 locally advanced HNSCC patients were treated between 2004-2005 using radical three-dimensional conformal radiotherapy.\\u000a Patients with prior surgery to the primary tumour site were excluded.

  8. Optical Correlation

    NASA Technical Reports Server (NTRS)

    Cotariu, Steven S.

    1991-01-01

    Pattern recognition may supplement or replace certain navigational aids on spacecraft in docking or landing activities. The need to correctly identify terrain features remains critical in preparation of autonomous planetary landing. One technique that may solve this problem is optical correlation. Correlation has been successfully demonstrated under ideal conditions; however, noise significantly affects the ability of the correlator to accurately identify input signals. Optical correlation in the presence of noise must be successfully demonstrated before this technology can be incorporated into system design. An optical correlator is designed and constructed using a modified 2f configuration. Liquid crystal televisions (LCTV) are used as the spatial light modulators (SLM) for both the input and filter devices. The filter LCTV is characterized and an operating curve is developed. Determination of this operating curve is critical for reduction of input noise. Correlation of live input with a programmable filter is demonstrated.

  9. Prospective Imaging Assessment of Mortality Risk After Head-and-Neck Radiotherapy

    SciTech Connect

    Moeller, Benjamin J.; Rana, Vishal; Cannon, Blake A. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Williams, Michelle D. [Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Sturgis, Erich M. [Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Ginsberg, Lawrence E. [Department of Diagnostic Imaging, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Macapinlac, Homer A. [Department of Nuclear Medicine, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Lee, J. Jack [Department of Biostatistics, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Ang, K. Kian; Chao, K.S. Clifford; Chronowski, Gregory M.; Frank, Steven J.; Morrison, William H.; Rosenthal, David I. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Weber, Randal S. [Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Garden, Adam S. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Lippman, Scott M. [Department of Thoracic/Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Schwartz, David L., E-mail: docdls@mdanderson.or [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Department of Experimental Diagnostic Imaging, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)

    2010-11-01

    Purpose: The optimal roles for imaging-based biomarkers in the management of head-and-neck cancer remain undefined. Unresolved questions include whether functional or anatomic imaging might improve mortality risk assessment for this disease. We addressed these issues in a prospective institutional trial. Methods and Materials: Ninety-eight patients with locally advanced pharyngolaryngeal squamous cell cancer were enrolled. Each underwent pre- and post-chemoradiotherapy contrast-enhanced computed tomography (CT) and {sup 18}F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT imaging. Imaging parameters were correlated with survival outcomes. Results: Low post-radiation primary tumor FDG avidity correlated with improved survival on multivariate analysis; so too did complete primary tumor response by CT alone. Although both imaging modalities lacked sensitivity, each had high specificity and negative predictive value for disease-specific mortality risk assessment. Kaplan-Meier estimates confirmed that both CT and FDG-PET/CT stratify patients into distinct high- and low-probability survivorship groups on the basis of primary tumor response to radiotherapy. Subset analyses demonstrated that the prognostic value for each imaging modality was primarily derived from patients at high risk for local treatment failure (human papillomavirus [HPV]-negative disease, nonoropharyngeal primary disease, or tobacco use). Conclusions: CT alone and FDG-PET/CT are potentially useful tools in head-and-neck cancer-specific mortality risk assessment after radiotherapy, particularly for selective use in cases of high-risk HPV-unrelated disease. Focus should be placed on corroboration and refinement of patient selection for imaging-based biomarkers in future studies.

  10. Postradiation Metabolic Tumor Volume Predicts Outcome in Head-and-Neck Cancer

    SciTech Connect

    Murphy, James D.; La, Trang H.; Chu, Karen [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States); Quon, Andrew [Department of Nuclear Medicine, Stanford University School of Medicine, Stanford, CA (United States); Fischbein, Nancy J. [Department of Radiology, Stanford University School of Medicine, Stanford, CA (United States); Maxim, Peter G.; Graves, Edward E.; Loo, Billy W. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States); Le, Quynh-Thu, E-mail: qle@stanford.ed [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States)

    2011-06-01

    Purpose: To explore the prognostic value of metabolic tumor volume measured on postradiation {sup 18}F-fluorodeoxyglucose positron emission tomography (PET) imaging in patients with head-and-neck cancer. Methods and Materials: Forty-seven patients with head-and-neck cancer who received pretreatment and posttreatment PET/computed tomography (CT) imaging along with definitive chemoradiotherapy were included in this study. The PET/CT parameters evaluated include the maximum standardized uptake value, metabolic tumor volume (MTV{sub 2.0}-MTV{sub 4.0}; where MTV{sub 2.0} refers to the volume above a standardized uptake value threshold of 2.0), and integrated tumor volume. Kaplan-Meier and Cox regression models were used to test for association between PET endpoints and disease-free survival and overall survival. Results: Multiple postradiation PET endpoints correlated significantly with outcome; however, the most robust predictor of disease progression and death was MTV{sub 2.0}. An increase in MTV{sub 2.0} of 21cm{sup 3} (difference between 75th and 25th percentiles) was associated with an increased risk of disease progression (hazard ratio [HR]= 2.5, p = 0.0001) and death (HR = 2.0, p = 0.003). In patients with nonnasopharyngeal carcinoma histology (n = 34), MTV{sub 2.0} <18 cm{sup 3} and MTV{sub 2.0} {>=}18 cm{sup 3} yielded 2-year disease-free survival rates of 100% and 63%, respectively (p = 0.006) and 2-year overall survival rates of 100% and 81%, respectively (p = 0.009). There was no correlation between MTV{sub 2.0} and disease-free survival or overall survival with nasopharyngeal carcinoma histology (n = 13). On multivariate analysis, only postradiation MTV{sub 2.0} was predictive of disease-free survival (HR = 2.47, p = 0.0001) and overall survival (HR = 1.98, p = 0.003). Conclusions: Postradiation metabolic tumor volume is an adverse prognostic factor in head-and-neck cancer. Biomarkers such as MTV are important for risk stratification and will be valuable in the future with risk-adapted therapies.

  11. Post Burn Contracture Neck: Clinical Profile and Management

    PubMed Central

    Bankar, Sanket S.; Patil, Avinash

    2014-01-01

    Background: Morbidity related to hypertrophic scars and contractures which are well known sequel after burns remains high and in fact has increased as more severely burned patients are surviving. This study was undertaken in order to assess the varied clinical presentation, precipitating factors, preventive measures, treatment modalities of neck contractures and evaluate the results after surgical procedures. Materials and Methods: This hospital based study was conducted on patients admitted in our institution with proven cases of Post burn neck contracture from 1st August 2009 to 31st July 2011. Twenty two patients of post burn neck contracture who underwent operative treatment were included. Observation: 10 of 22 cases were in the middle age group i.e. between 21-30 years. There were 5 males and 17 females. Accidental flame burn was the commonest aetiology. Fourteen patients were treated within 1 year of burns for functional disability. Excisional release was performed in 13 and incisional release in 9 of our patients. Resurfacing with STSG (split thickness skin graft) was carried out in 19 cases and a local or regional flap with or without a graft in 3 patients. Hypertrophy and recontracture were the commonest late complications and occurred in 3 cases. Good to fair results were obtained in 19 patients Conclusion: Local flaps have many advantages and are to be used whenever possible. It is preferable to place the grafts if used in the area surrounding the neck (donor site of flap) or at least in the non-visible area of the neck (submental area). When a combination of flap & graft is used, it’s preferable to place the flap in a horizontal intersecting fashion in between the two patches of the graft. A follow up program for reasonable period is highly desired. PMID:25478392

  12. Morphological MRI criteria improve the detection of lymph node metastases in head and neck squamous cell carcinoma: multivariate logistic regression analysis of MRI features of cervical lymph nodes

    Microsoft Academic Search

    R. B. J. de Bondt; P. J. Nelemans; F. Bakers; J. W. Casselman; C. Peutz-Kootstra; B. Kremer; P. A. M. Hofman; R. G. H. Beets-Tan

    2009-01-01

    The aim was to evaluate whether morphological criteria in addition to the size criterion results in better diagnostic performance\\u000a of MRI for the detection of cervical lymph node metastases in patients with head and neck squamous cell carcinoma (HNSCC).\\u000a Two radiologists evaluated 44 consecutive patients in which lymph node characteristics were assessed with histopathological\\u000a correlation as gold standard. Assessed criteria

  13. Neglected simultaneous bilateral femoral neck fractures secondary to narcotic drug abuse treated by bilateral one-staged hemiarthroplasty: a case report

    Microsoft Academic Search

    Alireza Hootkani; Ali Moradi; Ehsan Vahedi

    2010-01-01

    Simultaneous bilateral femoral neck fractures are extremely rare and associated with various conditions. Up to now Most cases had correlations with major trauma, repetitive minor trauma, seizure, parathyroid or renal dysfunction, anti-epileptic medications, seizure, etc. A 28-year-old addict man referred to us with a 10-year history of narcotic drug abuse and history of 8 months bilateral groin pain. He admitted

  14. Deep neck abscess in neonatal period: case report and review of literature.

    PubMed

    Mutlu, Mehmet; Dereci, Selim; Aslan, Yakup

    2014-04-01

    Deep neck abscess is very rare in neonatal period. We reported a deep neck abscess caused by methicillin-sensitive Staphylococcus aureus infection (MSSA) in a neonate. A 10-day male infant was admitted to our neonatal unit with the complaints of fever, irritability, and refused to food intake. Ultrasonography and magnetic resonance imaging revealed as an abscess in the neck. Needle aspiration from abscess revealed pus. Antibiotics and drainage were applied. We also reviewed the neonatal deep neck abscess reported in English literature and clinical presentation, risk factors, causing microorganisms, treatment, complication and outcome of deep neck abscesses were discussed. PMID:24512784

  15. Significant differences in demographic, clinical, and pathological features in relation to smoking and alcohol consumption among 1,633 head and neck cancer patients

    PubMed Central

    Moyses, Raquel Ajub; López, Rossana Verónica Mendoza; Cury, Patrícia Maluf; Siqueira, Sheila Aparecida Coelho; Curioni, Otávio Alberto; de Gois Filho, José Francisco; Figueiredo, David Livingstone Alves; Head; GENCAPO, Neck Genome Project; Tajara, Eloiza Helena; Michaluart, Pedro

    2013-01-01

    OBJECTIVE: As a lifestyle-related disease, social and cultural disparities may influence the features of squamous cell carcinoma of the head and neck in different geographic regions. We describe demographic, clinical, and pathological aspects of squamous cell carcinoma of the head and neck according to the smoking and alcohol consumption habits of patients in a Brazilian cohort. METHODS: We prospectively analyzed the smoking and alcohol consumption habits of 1,633 patients enrolled in five São Paulo hospitals that participated in the Brazilian Head and Neck Genome Project – Gencapo. RESULTS: The patients who smoked and drank were younger, and those who smoked were leaner than the other patients, regardless of alcohol consumption. The non-smokers/non-drinkers were typically elderly white females who had more differentiated oral cavity cancers and fewer first-degree relatives who smoked. The patients who drank presented significantly more frequent nodal metastasis, and those who smoked presented less-differentiated tumors. CONCLUSIONS: The patients with squamous cell carcinoma of the head and neck demonstrated demographic, clinical, and pathological features that were markedly different according to their smoking and drinking habits. A subset of elderly females who had oral cavity cancer and had never smoked or consumed alcohol was notable. Alcohol consumption seemed to be related to nodal metastasis, whereas smoking correlated with the degree of differentiation. PMID:23778492

  16. Complications of neck dissection at a tertiary level hospital: study of 30 cases.

    PubMed

    Masud, M K; Ahmad, S M; Karim, M A; Ferdouse, F; Fakir, A Y; Hanif, M A; Abdullah, M; Roy, A S

    2014-10-01

    Metastatic dissemination into lymph nodes of neck occurs frequently in head neck cancers which down grade the patient's curability and survival. Neck dissection is a curable option for its management. To evaluate the complications following different types of neck dissection. This cross sectional study was conducted among patients undergone different types of neck dissection due to cervical nodal metastasis and attended follow up during July 2010 to June 2011 in Department of ENTs and Head-Neck surgery Dhaka Medical College Hospital, Dhaka, Bangladesh. Among 30 selected patient, 23 were male (76.67%) and 7 were female (23.33%), age ranged from 31-72 years (Mean=59.1±5.44). In different modalities of neck dissection 11 were modified neck dissection (36.67%) and 10(33.33%) were radical neck dissection. Common indication was carcinoma of unknown origin (66.67%). Involved neck nodes were commonly level II-IV (69.99%). Nodal stage was N2(50%) and N3 (40%).Common immediate complications were bleeding 03(10%), facial oedema 02 (6.67%) and thoracic duct injury 02(6.67%). Intermediate complications were seroma 05(16.67%), wound infection 04(13.33%) and chylous fistula 02(6.67%), Late Complications were hypertrophic scar 07(23.33%) and shoulder syndrome 06(20%). Proper indications, skilled surgery along with early recognize and treatment in both early and late manifestations of neck dissection preventing its grave sequence. PMID:25481582

  17. Washington Correlator

    NASA Technical Reports Server (NTRS)

    Hall, David M.; Boboltz, David

    2013-01-01

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

  18. Altered motor control patterns in whiplash and chronic neck pain

    PubMed Central

    Woodhouse, Astrid; Vasseljen, Ottar

    2008-01-01

    Background Persistent whiplash associated disorders (WAD) have been associated with alterations in kinesthetic sense and motor control. The evidence is however inconclusive, particularly for differences between WAD patients and patients with chronic non-traumatic neck pain. The aim of this study was to investigate motor control deficits in WAD compared to chronic non-traumatic neck pain and healthy controls in relation to cervical range of motion (ROM), conjunct motion, joint position error and ROM-variability. Methods Participants (n = 173) were recruited to three groups: 59 patients with persistent WAD, 57 patients with chronic non-traumatic neck pain and 57 asymptomatic volunteers. A 3D motion tracking system (Fastrak) was used to record maximal range of motion in the three cardinal planes of the cervical spine (sagittal, frontal and horizontal), and concurrent motion in the two associated cardinal planes relative to each primary plane were used to express conjunct motion. Joint position error was registered as the difference in head positions before and after cervical rotations. Results Reduced conjunct motion was found for WAD and chronic neck pain patients compared to asymptomatic subjects. This was most evident during cervical rotation. Reduced conjunct motion was not explained by current pain or by range of motion in the primary plane. Total conjunct motion during primary rotation was 13.9° (95% CI; 12.2–15.6) for the WAD group, 17.9° (95% CI; 16.1–19.6) for the chronic neck pain group and 25.9° (95% CI; 23.7–28.1) for the asymptomatic group. As expected, maximal cervical range of motion was significantly reduced among the WAD patients compared to both control groups. No group differences were found in maximal ROM-variability or joint position error. Conclusion Altered movement patterns in the cervical spine were found for both pain groups, indicating changes in motor control strategies. The changes were not related to a history of neck trauma, nor to current pain, but more likely due to long-lasting pain. No group differences were found for kinaesthetic sense. PMID:18570647

  19. A Planned Neck Dissection Is Not Necessary in All Patients With N2-3 Head-and-Neck Cancer After Sequential Chemoradiotherapy

    SciTech Connect

    Soltys, Scott G., E-mail: sgsoltys@stanford.edu [Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA (United States); Choi, Clara Y.H. [Department of Neurosugery, Stanford University Medical Center, Stanford, CA (United States); Fee, Willard E. [Department of Otolaryngology, Stanford University Medical Center, Stanford, CA (United States); Pinto, Harlan A. [Department of Medical Oncology, Stanford University Medical Center, Stanford, CA (United States); Veterans Affairs, Palo Alto Health Care System, Palo Alto, CA (United States); Le, Quynh-Thu [Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA (United States)

    2012-07-01

    Purpose: To assess the role of a planned neck dissection (PND) after sequential chemoradiotherapy for patients with head-and-neck cancer with N2-N3 nodal disease. Methods and Materials: We reviewed 90 patients with N2-N3 head-and-neck squamous cell carcinoma treated between 1991 and 2001 on two sequential chemoradiotherapy protocols. All patients received induction and concurrent chemotherapy with cisplatin and 5-fluorocuracil, with or without tirapazamine. Patients with less than a clinical complete response (cCR) in the neck proceeded to a PND after chemoradiation. The primary endpoint was nodal response. Clinical outcomes and patterns of failure were analyzed. Results: The median follow-up durations for living and all patients were 8.3 years (range, 1.5-16.3 year) and 5.4 years (range, 0.6-16.3 years), respectively. Of the 48 patients with nodal cCR whose necks were observed, 5 patients had neck failures as a component of their recurrence [neck and primary (n = 2); neck, primary, and distant (n = 1); neck only (n = 1); neck and distant (n = 1)]. Therefore, PND may have benefited only 2 patients (4%) [neck only failure (n = 1); neck and distant failure (n = 1)]. The pathologic complete response (pCR) rate for those with a clinical partial response (cPR) undergoing PND (n = 30) was 53%. The 5-year neck control rates after cCR, cPR{yields}pCR, and cPR{yields}pPR were 90%, 93%, and 78%, respectively (p = 0.36). The 5-year disease-free survival rates for the cCR, cPR{yields}pCR, and cPR{yields}pPR groups were 53%, 75%, and 42%, respectively (p = 0.04). Conclusion: In our series, patients with N2-N3 neck disease achieving a cCR in the neck, PND would have benefited only 4% and, therefore, is not recommended. Patients with a cPR should be treated with PND. Residual tumor in the PND specimens was associated with poor outcomes; therefore, aggressive therapy is recommended. Studies using novel imaging modalities are needed to better assess treatment response.

  20. Non-invasive label-free investigation and typing of head and neck cancers by multimodal nonlinear microscopy

    NASA Astrophysics Data System (ADS)

    Meyer, Tobias; Vogler, Nadine; Dietzek, Benjamin; Akimov, Denis; Inhestern, Johanna; Guntinas-Lichius, Orlando; Popp, Jürgen

    2012-06-01

    Early detection and typing of tumors is pressing matter in clinical research with important impacts for prognosis and successful treatment. Currently, staining is the golden standard in histopathology but requires surgical removal of tissue. In order to avoid resection of non-diseased tissue a non-invasive real-time imaging method is required which can be applied ideally intrasurgically. In this proceeding a combination of second harmonic generation (SHG), two photon excited fluorescence (TPEF) and coherent anti-Stokes Raman (CARS) imaging has been employed to investigate tissue sections of head and neck carcinomas focussing on laryngeal carcinoma. Primary laryngeal and other head and neck carcinomas consist to 99% of squamous cell carcinoma. By fusing the various imaging methods it is possible to measure the thickness of the epithelial cell layer as a marker for dysplastic or cancerous tissue degradation and to differentiate keratinizing and nonkeratininzing squamous cell carcinomas (SCC). As nonkeratinizing SCCs of the oropharynx correlate with a human papillomavirus (HPV) infection as a subentity of head and neck cancer, and HPV related tumors are associated with a better clinical prognosis, the differentiation between keratinizing and non-keratinizing forms of SCCs is of high diagnostic value. TPEF is capable of displaying cell nuclei, therefore, morphologic information as cell density, cell to cytoplasm ratio, size and shape of cell nuclei can be obtained. SHG - on the other hand - selectively reveals the collagen matrix of the connective tissue, which is useful for determination of tumor-islets boundaries within epithelial tissue - a prerequisite for precise resection. Finally CARS in the CH-stretching region visualizes the lipid content of the tissue, which can be correlated with the dysplastic grade of the tissue.

  1. Diffusion-Weighted MRI for Nodal Staging of Head and Neck Squamous Cell Carcinoma: Impact on Radiotherapy Planning

    SciTech Connect

    Dirix, Piet, E-mail: piet.dirix@uzleuven.b [Department of Radiation Oncology, Leuvens Kankerinstituut (LKI), University Hospitals Leuven, Campus Gasthuisberg, Leuven (Belgium); Vandecaveye, Vincent; De Keyzer, Frederik; Op de beeck, Katya [Department of Radiology, Leuvens Kankerinstituut (LKI), University Hospitals Leuven, Campus Gasthuisberg, Leuven (Belgium); Poorten, Vincent Vander; Delaere, Pierre [Department of Otorhinolaryngology-Head and Neck Surgery, Leuvens Kankerinstituut (LKI), University Hospitals Leuven, Campus Gasthuisberg, Leuven (Belgium); Verbeken, Eric [Department of Pathology, Leuvens Kankerinstituut (LKI), University Hospitals Leuven, Campus Gasthuisberg, Leuven (Belgium); Hermans, Robert [Department of Radiology, Leuvens Kankerinstituut (LKI), University Hospitals Leuven, Campus Gasthuisberg, Leuven (Belgium); Nuyts, Sandra [Department of Radiation Oncology, Leuvens Kankerinstituut (LKI), University Hospitals Leuven, Campus Gasthuisberg, Leuven (Belgium)

    2010-03-01

    Purpose: To evaluate the use of diffusion-weighted magnetic resonance imaging (DW-MRI) for nodal staging and its impact on radiotherapy (RT) planning. Methods and Materials: Twenty-two patients with locally advanced head and neck squamous cell carcinoma underwent contrast-enhanced computed tomography (CT), as well as MRI (with routine and DW sequences) prior to neck dissection. After topographic correlation, lymph nodes were evaluated microscopically with prekeratin immunostaining. Pathology results were correlated with imaging findings and an RT planning study was performed for these surgically treated patients. One set of target volumes was based on conventional imaging only, and another set was based on the corresponding DW-MRI images. A third reference set was contoured based solely on pathology results. Results: A sensitivity of 89% and a specificity of 97% per lymph node were found for DW-MRI. Nodal staging agreement between imaging and pathology was significantly stronger for DW-MRI (kappa = 0.97; 95% confidence interval [CI], 0.84-1.00) than for conventional imaging (kappa = 0.56; 95% CI, 0.16-0.96; p = 0.019, by McNemar's test). For both imaging modalities, the absolute differences between RT volumes and those obtained by pathology were calculated. Using an exact paired Wilcoxon test, the observed difference was significantly larger for conventional imaging than for DW-MRI for nodal gross tumor volume (p = 0.0013), as well as for nodal clinical target volume (p = 0.0415) delineation. Conclusions: These results suggest that DW-MRI is superior to conventional imaging for preradiotherapy nodal staging of head and neck squamous cell carcinoma, and provides a potential impact on organsparing and tumor control.

  2. Long-term functional donor site morbidity of the free radial forearm flap in head and neck cancer survivors

    PubMed Central

    2014-01-01

    Background To assess the functional donor site morbidity of the forearm free flap in patients surviving at least 2 years after ablative head and neck cancer surgery in a tertiary care centre. Methods This study involved nine long-term survivors (2 year post-operative) who had forearm free flaps to reconstruct head and neck defects. All flaps were raised from the non-dominant arm. The non-donor side acted as a control for all patients. Objective measurements were as follows: grip, tip pinch and key pinch strength measured with dynamometers; flexion, extension, radial and ulnar deviation and pronation and supination range of motion at the wrist measured with goniometry; A timed manual dexterity task was performed with a grooved pegboard test, and sensation of the radial nerve was tested with Semmes Weinstein monofilaments. Subjective measurements included a validated patient questionnaire of hand function and opinions of scar appearance as well as a validated scar assessment from two different observers. Results Pronation at the wrist, manual dexterity and sensation were found to be significantly reduced in the donor side compared to the non-donor side. Inter-rater agreement between the two observers was found to be poor, except for an acceptable correlation between overall scar opinions. No correlations were found between any subjective or objective items or between the patient’s and the observers’ subjective evaluations. Conclusions Donor site morbidity can be demonstrated with objective testing however this is accepted and well tolerated by head and neck cancer patients. PMID:24418459

  3. Response Assessment in Locally Advanced Head and Neck Cancer Based on RECIST and Volume Measurements Using Cone Beam CT Images.

    PubMed

    Hou, Jidong; Guerrero, Mariana; Suntharalingam, Mohan; D'Souza, Warren D

    2015-02-01

    The purpose of this work was to find potential trends in RECIST measurements and volume regressions obtained from weekly cone-beam computed tomography images and to evaluate their relationship to clinical outcomes in locally advanced head and neck cancer. We examined thirty head and neck cancer patients who underwent a pre-treatment planning CT and weekly cone-beam computed tomography (CBCT) during the 5-7 week treatment period. The gross tumor volume (GTV) and lymph nodes were manually contoured on the treatment planning CT. The regions of interest enclosed by delineated contours were converted to binary masks and warped to weekly CBCT images using the 3D deformation field obtained by deformable image registration. The RECIST diameters and volumes were measured from these warped masks. Different predictor variables based on these measurements were calculated and correlated with clinical outcomes, based on a clinical exam and a PET imaging study. We found that there was substantial regression of the gross tumor volume over the treatment course (average gross tumor volume regression of 25%). Among the gross tumor volume predicators, it was found that the early regression of gross tumor volume showed a marginal statistical significance (p = 0.045) with complete response and non-complete response treatment outcomes. RECIST diameter measurements during treatment varied very little and did not correlate with clinical outcomes. We concluded that regression of the gross tumor volume obtained from weekly CBCT images is a promising predictor of clinical outcomes for head and neck patients. A larger sample is needed to confirm its statistical significance. PMID:25403431

  4. Elevated expression of MMP-13 and TIMP-1 in head and neck squamous cell carcinomas may reflect increased tumor invasiveness

    PubMed Central

    Culhaci, Nil; Metin, Kubilay; Copcu, Eray; Dikicioglu, Emel

    2004-01-01

    Background Matrix metalloproteinases [MMPs], which degrade the extracellular matrix, play an important role in the invasion and metastasis of squamous cell carcinomas. One MMP, MMP-13, is thought to play a central role in MMP activation. The purpose of this study was to investigate MMP-13 and TIMP-1 expression in squamous cell carcinomas of the head and neck and to relate these levels of expression to histologic patterns of invasion. Methods This study included T1 lesions obtained via biopsy from the larynx, tongue, and skin/mucosa of 78 patients with head and neck squamous cell carcinomas. The relationship between expression of MMP-13 and TIMP-1 and the mode of tumor invasion [MI] was evaluated immunohistochemically, using breast carcinoma tissue as a positive control. Results Increased expression was observed in highly invasive tumors, as reflected by the significant correlation between the degree of staining for MMP-13 or TIMP-1 and MI grade [p < 0.05]. There was no significant relationship between the degree of staining for MMP-13 or TIMP-1 and patient age, sex, tumor site, or tumor histologic grade. In addition, levels of staining for MMP-13 did not correlate with levels of staining for TIMP-1. Conclusion The expression of MMP-13 and TIMP-1 appears to play an important role in determining the invasive capacity of squamous cell carcinomas of the head and neck. Whereas additional studies are needed to confirm these findings, evaluating expression of these MMPs in small biopsy samples may be useful in determining the invasive capacity of these tumors at an earlier stage. PMID:15291964

  5. Effect of preservation of the C-6 spinous process and its paraspinal muscular attachment on the prevention of postoperative axial neck pain in C3-6 laminoplasty.

    PubMed

    Mori, Eiji; Ueta, Takayoshi; Maeda, Takeshi; Yugué, Itaru; Kawano, Osamu; Shiba, Keiichiro

    2015-03-01

    OBJECT Axial neck pain after C3-6 laminoplasty has been reported to be significantly lesser than that after C3-7 laminoplasty because of the preservation of the C-7 spinous process and the attachment of nuchal muscles such as the trapezius and rhomboideus minor, which are connected to the scapula. The C-6 spinous process is the second longest spinous process after that of C-7, and it serves as an attachment point for these muscles. The effect of preserving the C-6 spinous process and its muscular attachment, in addition to preservation of the C-7 spinous process, on the prevention of axial neck pain is not well understood. The purpose of the current study was to clarify whether preservation of the paraspinal muscles of the C-6 spinous process reduces postoperative axial neck pain compared to that after using nonpreservation techniques. METHODS The authors studied 60 patients who underwent C3-6 double-door laminoplasty for the treatment of cervical spondylotic myelopathy or cervical ossification of the posterior longitudinal ligament; the minimum follow-up period was 1 year. Twenty-five patients underwent a C-6 paraspinal muscle preservation technique, and 35 underwent a C-6 nonpreservation technique. A visual analog scale (VAS) and VAS grading (Grades I-IV) were used to assess axial neck pain 1-3 months after surgery and at the final follow-up examination. Axial neck pain was classified as being 1 of 5 types, and its location was divided into 5 areas. The potential correlation between the C-6/C-7 spinous process length ratio and axial neck pain was examined. RESULTS The mean VAS scores (± SD) for axial neck pain were comparable between the C6-preservation group and the C6-nonpreservation group in both the early and late postoperative stages (4.1 ± 3.1 vs 4.0 ± 3.2 and 3.8 ± 2.9 vs 3.6 ± 3.0, respectively). The distribution of VAS grades was comparable in the 2 groups in both postoperative stages. Stiffness was the most prevalent complaint in both groups (64.0% and 54.5%, respectively), and the suprascapular region was the most common site in both groups (60.0% and 57.1%, respectively). The types and locations of axial neck pain were also similar between the groups. The C-6/C-7 spinous process length ratios were similar in the groups, and they did not correlate with axial neck pain. The reductions of range of motion and changes in sagittal alignment after surgery were also similar. CONCLUSIONS The C-6 paraspinal muscle preservation technique was not superior to the C6-nonpreservation technique for preventing postoperative axial neck pain. PMID:25525962

  6. Migration of a swallowed blunt foreign body to the neck.

    PubMed

    Ozturk, Kerem; Turhal, Goksel; Gode, Sercan; Yavuzer, Atilla

    2014-01-01

    Ingestion of foreign bodies is a common problem in the otolaryngology practice. Reports of extraluminal migration of the foreign bodies from the upper aerodigestive tract are rare. Penetration and extraluminal migration of ingested foreign bodies may cause severe vascular and suppurative complications, even death. We report a 4-year-old girl who presented with a mass and partial extrusion of a foreign body in the neck. She had a history of ingesting the plastic top piece of a knitting needle approximately 1 year ago. She had been asymptomatic until the present time. The examination revealed a red, blunt, rectangular plastic foreign body half embedded in the skin of the right neck. Esophagography with barium swallow, cervical X-rays, and computed tomography scans were obtained. The foreign body was easily removed under general anesthesia. Primary closure and direct laryngoscopy was also performed. The patient recovered very well without any complications. PMID:24592347

  7. Migration of a Swallowed Blunt Foreign Body to the Neck

    PubMed Central

    Ozturk, Kerem; Turhal, Goksel; Gode, Sercan; Yavuzer, Atilla

    2014-01-01

    Ingestion of foreign bodies is a common problem in the otolaryngology practice. Reports of extraluminal migration of the foreign bodies from the upper aerodigestive tract are rare. Penetration and extraluminal migration of ingested foreign bodies may cause severe vascular and suppurative complications, even death. We report a 4-year-old girl who presented with a mass and partial extrusion of a foreign body in the neck. She had a history of ingesting the plastic top piece of a knitting needle approximately 1 year ago. She had been asymptomatic until the present time. The examination revealed a red, blunt, rectangular plastic foreign body half embedded in the skin of the right neck. Esophagography with barium swallow, cervical X-rays, and computed tomography scans were obtained. The foreign body was easily removed under general anesthesia. Primary closure and direct laryngoscopy was also performed. The patient recovered very well without any complications. PMID:24592347

  8. Presentation of intramuscular myxoma as an unusual neck lump.

    PubMed

    Kalsi, Jagdip Singh; Pring, Miranda; Hughes, Ceri; Fasanmade, Adekunmi

    2013-05-01

    Intramuscular myxoma (IM) has a distinct diagnostic identity among soft tissue myxomas. IMs have an approximate incidence of 1 per million of the population per year, with a female-to-male ratio of 14:3. The age range for presentation is 40 to 70 years, and the thigh is affected most frequently. IMs most commonly affect larger muscle groups, making the head and neck a rare site. To the authors' knowledge, there is 1 previous report of an IM presenting in the sternocleidomastoid muscle. In addition, IMs usually present as slow-growing asymptomatic swellings. Although abnormal gag reflexes have been reported in cases of glossopharyngeal schwannoma and neurofibroma in patients with neurofibromatosis-1, a gag reflex has not been reported previously as a complication of IM in the head and neck. A case of IM in the left sternocleidomastoid muscle, presenting with an intense gag reflex on palpation, in a 70-year-old woman is presented. PMID:23351479

  9. Moving Toward Bioadjuvant Approaches to Head and Neck Cancer Prevention

    SciTech Connect

    Saba, Nabil F.; Hammond, Anthea; Shin, Dong M. [Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA (United States); Khuri, Fadlo R. [Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA (United States)], E-mail: fkhuri@emory.edu

    2007-10-01

    Head and neck squamous cell carcinoma affects >45,000 Americans annually. Patients who are successfully treated for their primary tumor are at high risk of developing a second primary tumor, making effective preventive strategies highly desirable for this disease. Although a landmark study in 1990 suggested some benefit of high-dose retinoids in head and neck cancer prevention, subsequent trials using more tolerable doses have shown limited clinical success. Newer preventive strategies have included bioadjuvant therapy combining retinoids with interferon and {alpha}-tocopherol, combinations of molecularly targeted agents, and oncolytic viruses. Furthermore, considerable evidence has supported a cancer protective role for several nutrients, including green tea and curcumin analogs. Natural compounds such as these with favorable long-term safety profiles might be particularly suited to the cancer prevention setting, in which patients will usually tolerate only moderate risk and toxicity.

  10. Neck-motor interactions trigger rotation of the kinesin stalk

    PubMed Central

    Liu, Hong-Lei; Pemble IV, Charles W.; Endow, Sharyn A.

    2012-01-01

    Rotation of the coiled-coil stalk of the kinesin-14 motors is thought to drive displacements or steps by the motor along microtubules, but the structural changes that trigger stalk rotation and the nucleotide state in which it occurs are not certain. Here we report a kinesin-14 neck mutant that releases ADP more slowly than wild type and shows weaker microtubule affinity, consistent with defective stalk rotation. Unexpectedly, crystal structures show the stalk fully rotated – neck-motor interactions destabilize the stalk, causing it to rotate and ADP to be released, and alter motor affinity for microtubules. A new structural pathway accounts for the coupling of stalk rotation – the force-producing stroke – to changes in motor affinity for nucleotide and microtubules. Sequential disruption of salt bridges that stabilize the unrotated stalk could cause the stalk to initiate and complete rotation in different nucleotide states. PMID:22355749

  11. Photodynamic therapy of head and neck cancer with different sensitizers

    NASA Astrophysics Data System (ADS)

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

    1997-12-01

    This paper deals with the results of clinical trials for sulfated aluminum phthalocyanine (PHS) (Photosens, Russia; Photogeme (PG) in Russia. The results of photodynamic therapy (PDT) of head and neck tumors (HNT), side effects and ways of their correction and prevention, as well as possibility to work out less toxic regimes of PDT with photosense, choice of laser and type of irradiation are discussed. PDT have been provided in 79 patients with different head and neck tumors. Efficacy of PDT depended on tumor size and its histological type. Undesirable changes in plasma content of antioxidants by means of high pressure liquid chromatography (HLPC) have been found in patients after PHS injection. Influence of short-term and long-term supplementation with beta-carotene and vitamin E on this parameters are discussed.

  12. Fibromatosis Colli - A Rare Cytological Diagnosis In Infantile Neck Swellings

    PubMed Central

    Jetley, Sujata; Jairajpuri, Zeeba; Husain, Musharraf

    2014-01-01

    Fibromatosis colli or sternocleidomastoid tumour is a rare cause of benign neck mass in infants. It is a self limiting fibroblastic lesion usually presenting with torticollis and a history of birth trauma.It is one of the few causes in which Fine Needle Aspiration Cytology (FNAC) is indicated in a neonate to confirm the diagnosis and to differentiate it from other congenital, inflammatory and neoplastic causes. FNAC provides a rapid, cost-effective, reliable, non invasive method of diagnosis resulting in conservative management of these lesions. We present two interesting cases of neck swelling in infants where FNAC performed as the first diagnostic procedure was instrumental in establishing the diagnosis of fibromatosis colli thus avoiding unnecessary surgical intervention. PMID:25584233

  13. Mechanisms of neck and shoulder injuries in tennis players.

    PubMed

    Lee, H W

    1995-01-01

    Shoulder injuries are common among athletes involved in repetitive overhead arm movements, particularly baseball pitchers and tennis players. Due to the similarities between pitching and serving, both athletes often present with similar types of shoulder injuries. However, subtle differences in neck and shoulder movements between the pitcher and tennis player may be responsible for additional mechanisms of injuries specific to tennis players. This paper outlines the similarities and differences between the pitch and serve and discusses how these differences may relate to additional neck and/or shoulder injuries specific to tennis players. In the analyses of mechanisms of injuries sustained by tennis players, such detailed analyses of movement patterns occurring during the serve may optimize a clinician's sports-specific rehabilitation protocol. PMID:7889030

  14. Diffusion-weighted imaging in head and neck cancers

    PubMed Central

    Chawla, Sanjeev; Kim, Sungheon; Wang, Sumei; Poptani, Harish

    2009-01-01

    This article reviews the utility of diffusion-weighted imaging (DWI) in the diagnosis, prognosis and monitoring of treatment response in tumors arising in the head and neck region. The apparent diffusion coefficient (ADC) value, determined from DWI, can help in cancer staging and detection of subcentimeter nodal metastasis. The ADC value also discriminates carcinomas from lymphomas, benign lesions from malignant tumors and tumor necrosis from abscesses. Low pretreatment ADC values typically predict a favorable response to chemoradiation therapy. These promising reports indicate the potential of DWI as a potential biomarker for diagnosis and monitoring of treatment response in head and neck cancers. In view of the overlapping ADC values between different salivary gland tumors, care should be taken when interpreting these results and other imaging parameters should be considered for a better diagnosis. Susceptibility and motion-induced artifacts may sometimes degrade DWI image quality; however, novel techniques are being developed to overcome these drawbacks. PMID:19792966

  15. Vertebral artery dissection after a chiropractor neck manipulation.

    PubMed

    Jones, Jeremy; Jones, Catherine; Nugent, Kenneth

    2015-01-01

    The differential diagnosis for ischemic central nervous system infarcts in young patients includes paradoxic emboli through cardiac shunts, vasculitis, and vascular trauma. We report a young woman who developed headache, vomiting, diplopia, dizziness, and ataxia following neck manipulation by her chiropractor. A computed tomography scan of the head revealed an infarct in the inferior half of the left cerebellar hemisphere and compression of the fourth ventricle causing moderate acute obstructive hydrocephalus. Magnetic resonance angiography revealed severe narrowing and low flow in the intracranial segment of the left distal vertebral artery. The patient was treated with mannitol and a ventriculostomy and had an excellent functional recovery. This report illustrates the potential hazards associated with neck trauma, including chiropractic manipulation. The vertebral arteries are at risk for aneurysm formation and/or dissection, which can cause acute stroke. PMID:25552813

  16. Recent advances in radiation therapy for head and neck cancer.

    PubMed

    Bangalore, Madan; Matthews, Shirnett; Suntharalingam, Mohan

    2007-01-01

    The treatment of locally advanced or recurrent head and neck cancers has improved from single modality interventions of surgery and radiation therapy alone to include combined modality therapy with surgery, chemotherapy and radiation. Combined therapy has led to improved local control and disease-free survival. New developments in radiation oncology such as altered fractionation, three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, stereotactic radiosurgery, fractionated stereotactic radiotherapy, charged-particle radiotherapy, neutron-beam radiotherapy, and brachytherapy have helped to improve this outlook even further. These recent advances allow for a higher dose to be delivered to the tumor while minimizing the dose delivered to the surrounding normal tissue. This article provides an update of the new developments in radiotherapy in the management of head and neck cancers. PMID:17085946

  17. Recent advances in radiotherapy for head and neck cancers.

    PubMed

    Chou, R H; Wilder, R B; Wong, M S; Forster, K M

    2001-10-01

    Advancements in surgery have made it possible to resect cancers that had previously been regarded as incurable. Similarly, new developments in radiation oncology have helped improve the outlook for patients with locally advanced or recurrent head and neck cancers. Among these advancements are refinements in altered fractionation, three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, stereotactic radiosurgery and fractionated stereotactic radiotherapy, neutron-beam radiotherapy, charged-particle radiotherapy, and intraoperative radiotherapy. These recent developments have allowed radiation oncologists to escalate the dose of radiation delivered to tumors while minimizing the dose delivered to surrounding normal tissue. Additionally, more continues to be learned about the optimum delivery of chemotherapy. This article provides an update on the status of these new developments in the treatment of head and neck cancers. PMID:11605568

  18. Tissue engineering for otorhinolaryngology-head and neck surgery.

    PubMed

    Lott, David G; Janus, Jeffrey R

    2014-12-01

    Tissue regeneration in otorhinolaryngology-head and neck surgery is a diverse area filled with specialized tissues and functions. Head and neck structures govern many of the 5 senses, swallowing, breathing, communication, facial animation, and aesthetics. Loss of these functions can have a severe negative effect on patient quality of life. Regenerative medicine techniques have the potential to restore these functions while minimizing the risks associated with traditional reconstruction techniques. This article serves as a review and update on some of the regenerative medicine research in this field. A description of the predominant clinical problems is presented, followed by a discussion of some of the most promising research working toward a solution. There are many noteworthy findings appropriate for inclusion, but limitations preclude mention of them all. This article focuses on laryngeal surgery, craniofacial reconstruction and plastic surgery, and otology and hearing. PMID:25468518

  19. Huge Facial Desmoid Tumors with Neck Extension: A Case Report

    PubMed Central

    Ghazipour, Ali; Ghavami Lahiji, Shervin; Bradd, Bassel; Saleheh, Fariborz

    2014-01-01

    Introduction: Desmoid tumors are very rare, benign fibrous neoplasms arise from the musculoaponeurotic structures throughout the body. Case Report: The patient was a seven-year old boy with a large mandibular mass growing over a period of six months. His CT-scan showed a large mass, 13 cm in diameter in the cheek area extending to the neck and trachea. Biopsy was compatible with desmoid fibromatosis. He was given neoadjovant treatment with vinblastin and methotrexate. The patient underwent a tracheostomy. Then a complete hemimandibulectomy and submandibular gland excision was performed. Finally reconstruction with latisimus dorsi free flap was performed. Conclusion: Despite rarity desmoid tumors should be kept in mind of an otorhinolaryngologist as a differential diagnosis in children with head and neck mass. PMID:25009811

  20. BNCT for advanced or recurrent head and neck cancer.

    PubMed

    Aihara, Teruhito; Morita, Norimasa; Kamitani, Nobuhiko; Kumada, Hiroaki; Ono, Koji; Hiratsuka, Junichi; Harada, Tamotsu

    2014-06-01

    The therapeutic effect of surgery and/or combination of conventional chemoradiotherapy is limited in the patients with recurrent squamous cell carcinoma (SCC) and locally advanced non-squamous cell carcinoma without malignant melanoma (non-SCC) of the head and neck. Currently, clinical trials of BNCT for head and neck cancers are being conducted in some institutes to verify its the effectiveness. BNCT was performed in 10 patients with recurrent SCC, 7 patients with recurrent non-SCC and 3 patients with newly diagnosed non-SCC in our university between October 2003 and September 2007. Eleven patients showed complete remission and 7 patients showed partial remission of irradiated site. The effective rate [(CR+PR)/total cases] was 90%. No severe acute or chronic normal-tissue reactions were observed in any patients. BNCT is effective and safe in the patients with recurrent SCC and locally advanced non-SCC. PMID:24799334

  1. Quality of life assessment in head and neck cancer patients.

    PubMed

    Terrell, J E

    1999-08-01

    Patient-oriented QOL evaluation has become a useful adjunct to the more traditional measures used to assess the effectiveness of new therapies. In the future, it will be especially important to assess QOL outcomes of newer multimodality therapies and of conventional therapies in head and neck oncology, particularly those that are expensive or labor-intensive. Promising areas for QOL research include assessments of therapies for which survival rates are similar, but patient-oriented QOL outcomes or cost may differ greatly, such as treatment of oropharyngeal cancer or early glottic cancer, organ preservation strategies, and free flap reconstruction of surgical defects. Finally, valid QOL information will help oncologists understand their patients' physical and emotional impairments better and therefore better assess, treat, and rehabilitate patients with head and neck cancer. PMID:10494518

  2. Basal Cell Carcinoma of the Head and Neck

    PubMed Central

    Nakayama, Masahiro; Tabuchi, Keiji; Nakamura, Yasuhiro; Hara, Akira

    2011-01-01

    Basal cell carcinoma (BCC) is a malignant neoplasm derived from nonkeratinizing cells that originate from the basal layer of the epidermis and is the most frequent type of skin cancer in humans, with cumulative exposure to ultraviolet radiation as an important risk factor. BCC occurs most frequently at sun-exposed sites, with the head and neck being common areas. Tumors can be classified as nodular, superficial, morpheaform, infiltrating, metatypic, and fibroepithelioma of Pinkus. Several treatment options such as surgical excision and nonsurgical procedures are available. The choice of treatment should be determined based on the histological subtype of a lesion, cost, its size and location, patient age, medical condition of the patient, treatment availability, and the patient's wishes. The aim of any therapy selected for BCC treatment involving the head and neck is to ensure complete removal, the preservation of function, and a good cosmetic outcome. PMID:21209728

  3. Recurrences near base of skull after IMRT for head-and-neck cancer: implications for target delineation in high neck and for parotid gland sparing

    Microsoft Academic Search

    Avraham Eisbruch; Lon H Marsh; Laura A Dawson; Carol R Bradford; Theodoros N Teknos; Douglas B Chepeha; Francis P Worden; Susan Urba; Alexander Lin; Matthew J Schipper; Gregory T Wolf

    2004-01-01

    PurposeLocoregional (LR) failures near the base of the skull, and their relationships to the targets in the high neck, were examined in a series of patients who underwent intensity-modulated radiotherapy (IMRT) for head-and-neck cancer.

  4. [Research, design and application of model NSE-1 neck muscle training machine for pilots].

    PubMed

    Cheng, Haiping; Wang, Zhijie; Liu, Songyang; Yang, Yi; Zhao, Guang; Cong, Hong; Han, Xueping; Liu, Min; Yu, Mengsun

    2011-04-01

    Pain in the cervical region of air force pilots, who are exposed to high G-forces, is a specifically occupational health problem. To minimize neck problems, the cervical muscles need specific strength exercise. It is important that the training for the neck must be carried out with optimal resistance in exercises. The model NSE-1 neck training machine for pilots was designed for neck strengthening exercises under safe and effective conditions. In order to realize the functions of changeable velocity and resistant (CVR) training and neck isometric contractive exercises, the techniques of adaptive hydraulics, sensor, optic and auditory biological feedback, and signal processing were applied to this machine. The training system mainly consists of mechanical parts (including the chair of flexion and extension, the chair of right and left lateral flexion, the components of hydraulics and torque transformer, etc.), and the software of signal processing and biological feedback. Eleven volunteers were selected for the experiments of neck isometric contractive exercises, three times a week for 6 weeks, where CVR training (flexion, extension, right, left lateral flexion) one time a week. The increase in relative strength of the neck (flexion, extension, left and right lateral flexion) was 70.8%, 83.7%, 78.6% and 75.2%, respectively after training. Results show that the strength of the neck can be increased safely, effectively and rapidly with NSE-1 neck training machine to perform neck training. PMID:21604507

  5. Neck linker length determines the degree of processivity in kinesin-1 and kinesin-2 motors.

    PubMed

    Shastry, Shankar; Hancock, William O

    2010-05-25

    Defining the mechanical and biochemical determinates of kinesin processivity is important for understanding how diverse kinesins are tuned for specific cellular functions. Because transmission of mechanical forces through the 14-18 amino acid neck linker domain underlies coordinated stepping, we investigated the role of neck linker length, charge, and structure in kinesin-1 and kinesin-2 motor behavior. For optimum comparison with kinesin-1, the KIF3A head and neck linker of kinesin-2 were fused to the kinesin-1 neck coil and rod. Extending the 14-residue kinesin-1 neck linker reduced processivity, and shortening the 17-residue kinesin-2 neck linker enhanced processivity. When a proline in the kinesin-2 neck linker was replaced, kinesin-1 and kinesin-2 run lengths scaled identically with neck linker length, despite moving at different speeds. In low-ionic-strength buffer, charge had a dominant effect on motor processivity, which resolves ongoing controversy regarding the effect of neck linker length on kinesin processivity. From stochastic simulations, the results are best explained by neck linker extension slowing strain-dependent detachment of the rear head along with diminishing strain-dependent inhibition of ATP binding. These results help delineate how interhead strain maximizes stepping and suggest that less processive kinesins are tuned to coordinate with other motors differently than the maximally processive kinesin-1. PMID:20471270

  6. Emerging applications for OCT in the head and neck

    NASA Astrophysics Data System (ADS)

    Rubinstein, Marc; Kim, Jason H.; Armstrong, William B.; Djalilian, Hamid R.; Chen, Zhongping; Wong, Brian J. F.

    2010-02-01

    Objectives: To describe the current and promising new applications of Optical Coherence Tomography (OCT) as a helpful tool when imaging the different sites in the head and neck. We used the OCT Niris system, which is the first commercially available OCT device for applications outside the field of ophthalmology. Methods: OCT images were obtained of normal, benign, premalignant and malignant lesions in different areas of the head and neck. The OCT imaging system has a tissue penetration depth of approximately 1-2mm, a scanning range of 2mm and a spatial depth resolution of approximately 10-20?m. Imaging was performed using a flexible probe in two different settings, the outpatient clinic and the operating room. Results: High-resolution cross-sectional images from the larynx were obtained with the patient awake, without the need for general anesthesia, under direct visualization with a flexible fiberoptic endoscope. The OCT probe was inserted through the nasal cavity and placed in slight contact with the laryngeal tissue. In the ears, cholesteatoma was differentiated from inflamed middle ear mucosa by the different hyperintensity. In the neck, normal as well as different pathologies of the thyroid were identified. Conclusions: This system is non invasive and easy to incorporate into the operating room setting as well as the outpatient clinic. It requires minimal set-up and only one person is required to operate the system. OCT has the distinctive capability to obtain highresolution images, and the microanatomy of different sites can be observed. OCT technology has the potential to offer a quick, efficient and reliable imaging method to help the surgeon not only in the operating room but also in the clinical setting to guide surgical biopsies and aid in clinical decision making of different head and neck pathologies, especially those arising form the larynx.

  7. The Mutational Landscape of Head and Neck Squamous Cell Carcinoma

    Microsoft Academic Search

    Nicolas Stransky; Ann Marie Egloff; Aaron D. Tward; Aleksandar D. Kostic; Kristian Cibulskis; Andrey Sivachenko; Gregory V. Kryukov; Michael S. Lawrence; Carrie Sougnez; Aaron McKenna; Erica Shefler; Alex H. Ramos; Petar Stojanov; Scott L. Carter; Douglas Voet; Maria L. Cortés; Daniel Auclair; Michael F. Berger; Gordon Saksena; Candace Guiducci; Robert C. Onofrio; Melissa Parkin; Marjorie Romkes; Joel L. Weissfeld; Raja R. Seethala; Lin Wang; Claudia Rangel-Escareño; Juan Carlos Fernandez-Lopez; Alfredo Hidalgo-Miranda; Jorge Melendez-Zajgla; Wendy Winckler; Kristin Ardlie; Stacey B. Gabriel; Matthew Meyerson; Eric S. Lander; Gad Getz; Todd R. Golub; Levi A. Garraway; Jennifer R. Grandis

    2011-01-01

    Head and neck squamous cell carcinoma (HNSCC) is a common, morbid, and frequently lethal malignancy. To uncover its mutational spectrum, we analyzed whole-exome sequencing data from 74 tumor-normal pairs. The majority exhibited a mutational profile consistent with tobacco exposure; human papillomavirus was detectable by sequencing DNA from infected tumors. In addition to identifying previously known HNSCC genes (TP53, CDKN2A, PTEN,

  8. Femoral neck erosions: sign of hip joint synovial disease

    SciTech Connect

    Goldberg, R.P.; Weissman, B.N.; Naimark, A.

    1983-07-01

    Pathologic synovial processes in the hip joint can cause characteristic extrinsic erosions of the femoral neck, which in extreme cases produce an ''apple core'' appearance. Nine such cases of synovial diseases, including synovial osteochondromatosis, pigmented villonodular synovitis, rheumatoid arthritis, and amyloidosis, that demonstrate this radiographic finding are presented. The anatomic relations of the hip joint that result in theis appearance, differential diagnosis, and radiographic techniques useful in diagnosis are discussed.

  9. PROBABILISTIC AND BOTTLE-NECK FEATURES FOR LVCSR OF MEETINGS

    Microsoft Academic Search

    Martin Kara; Jan Cernock

    2006-01-01

    In recent years, probabilistic features became an integral part of state-of-the-are LVCSR systems. In this work, we are exploring the possibility of obtaining the features directly from neural net with- out the necessity of converting output probabilities to features suit- able for subsequent GMM-HMM system. We experimented with 5-layer MLP with bottle-neck in the middle layer. After training such a

  10. Comprehensive management of head and neck tumors, volume 1

    SciTech Connect

    Thawley, S.E.; Panje, W.R.

    1987-01-01

    This book consists of 14 parts, each containing several papers. The parts are: General Considerations in the Management of Patients with Head and Neck Tumors, Tumors of the Ear, Tumors of the Nasal Cavity and Paranasal Sinuses, Tumors of the Oral Cavity, Tumors of the Pharynx, Tumors of the Larynx, Tumors of the Skin, Dental and Jaw Tumors, Tumors of the Thyroid and Parathyroid Glands, Tumors of the Trachea, Tumors of the Eye, Orbit, and Lacrimal Apparatus, and Special Topics.

  11. Three Years Old Child Neck Finite Element Modelisation

    Microsoft Academic Search

    Raphaël Dupuis; Frank Meyer; Rémy Willinger

    Despite of recent progresses in occupant safety, the protection of children is still not optimal. To offer a better comprehension\\u000a of child injury mechanisms, we developed a human-like finite element of a three years old child's neck. The subject was scanned\\u000a with a medical scanner. The images were first semiautomatically segmented in order to extract the soft tissues and the

  12. Pediatric infectious disease: unusual head and neck infections.

    PubMed

    Moffett, Kathryn S

    2012-08-01

    Infections in children in the head and neck regions are common, leading to frequent use and overuse of antibiotics. This review includes common as well as diverse and unusual infectious diseases, such as PFAPA (Periodic Fever Aphthous stomatitis, Pharyngitis, Adenitis) syndrome, Lemierre Syndrome, Arcanobacterium infection, and tuberculous and nontuberculous adenitis, which occur in infants, children, and adolescents. In addition, the first pediatric vaccines available with the potential to prevent oropharyngeal cancers are reviewed. PMID:22739434

  13. Cortical and trabecular load sharing in the human femoral neck.

    PubMed

    Nawathe, Shashank; Nguyen, Bich Phuong; Barzanian, Nasim; Akhlaghpour, Hosna; Bouxsein, Mary L; Keaveny, Tony M

    2015-03-18

    The relative role of the cortical vs trabecular bone in the load-carrying capacity of the proximal femur-a fundamental issue in both basic-science and clinical biomechanics-remains unclear. To gain insight into this issue, we performed micro-CT-based, linear elastic finite element analysis (61.5-micron-sized elements; ~280 million elements per model) on 18 proximal femurs (5M, 13F, ages 61-93 years) to quantify the fraction of frontal-plane bending moment shared by the cortical vs trabecular bone in the femoral neck, as well as the associated spatial distributions of stress. Analyses were performed separately for a sideways fall and stance loading. For both loading modes and across all 18 bones, we found consistent patterns of load-sharing in the neck: most proximally, the trabecular bone took most of the load; moving distally, the cortical bone took increasingly more of the load; and more distally, there was a region of uniform load-sharing, the cortical bone taking the majority of the load. This distal region of uniform load-sharing extended more for fall than stance loading (77±8% vs 51±6% of the neck length for fall vs. stance; mean±SD) but the fraction of total load taken by the cortical bone in that region was greater for stance loading (88±5% vs. 64±9% for stance vs. fall). Locally, maximum stress levels occurred in the cortical bone distally, but in the trabecular bone proximally. Although the distal cortex showed qualitative stress distributions consistent with the behavior of an Euler-type beam, quantitatively beam theory did not apply. We conclude that consistent and well-delineated regions of uniform load-sharing and load-transfer between the cortical and trabecular bone exist within the femoral neck, the details of which depend on the external loading conditions. PMID:25582355

  14. Electrognathographic and electromyographic observations on jaw depression during neck extension.

    PubMed

    McKay, D C; Christensen, L V

    1999-11-01

    Albeit never substantiated through experimental and clinical evidence, the theoretical linchpin of the mechanics of a so-called whiplash injury of the temporomandibular joint (TMJ) is the postulate that a pre-existing depressor force (continual anchoring force), generated by the anterior suprahyoid (SH) muscles, will always act on the mandible and cause traumatic mouth opening (anterior acceleration of the TMJ condyles) when the neck is extended (posterior acceleration of the head). To test aspects of this postulate, six subjects assumed the positions of neutral (0 degrees ), medium (32 degrees ) and maximum (58 degrees ) neck extension while the mandible was in its postural positions of rest and light centric occlusion. By means of surface electromyography, it was shown that the relative contractile activities of the anterior SH muscles never exceeded 7.3% of the contractile activity required to anchor the mandible in a position of maximum depression. By means of electrognathography, it was shown that the maxillary and mandibular incisors were never separated by more than 2.6 mm during neutral, medium, and maximum extension of the neck. In other words, during neck extensions there was no evidence of a continual or induced voluntary or involuntary depressor force that would and could anchor the mandible in a position of traumatic mouth opening. Accordingly, and in agreement with other biophysical and biomedical evidence, it was concluded that there is no foundation for the pseudoscientific speculations and unsubstantiated opinions offered in support of a concept and diagnosis of a so-called TMJ whiplash injury. Additionally, this study found co-activation of cervical flexor muscles and mandibular elevator as well as depressor muscles. PMID:10583737

  15. Esthesioneuroblastoma: Is There a Need for Elective Neck Treatment?

    SciTech Connect

    Demiroz, Candan [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Gutfeld, Orit, E-mail: ogutfeld@gmail.com [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Aboziada, Mohamed; Brown, Doris [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Marentette, Lawrence J. [Department of Otolaryngology, University of Michigan, Ann Arbor, MI (United States); Eisbruch, Avraham [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)

    2011-11-15

    Purpose: To assess the risk of cervical lymph node metastases after definitive treatment for esthesioneuroblastoma (ENB) that did not include elective neck therapy. Methods and Materials: This was a retrospective analysis of 26 ENB patients treated at University of Michigan between 1995 and 2007. Tumor stage was Kadish A in 1 patient, B in 19, C in 5, and unknown in 1. Craniofacial or subcranial resection was performed in 24 patients (92%), with negative margins in 22 (92%). Postoperative radiotherapy (RT) to the primary site was given in 12 patients (46%), and 14 patients (54%) had surgery alone. All patients had clinically N0 disease, and no patient underwent elective neck dissection or radiation. Median follow-up was 72 months. Results: Local relapse-free survival was significantly better for patients who received postoperative RT compared with those who had surgery alone: 100% vs. 29% at 5 years, respectively (p = 0.005). Five-year disease-free survival was 87.5% in the RT group vs. 31% in the surgery-alone group (p = 0.05). Regional failure was observed in 7 patients (27%), 6 with Kadish Stage B and 1 with Stage C disease. The most common site of nodal failure was Level II, and 3 patients failed in the contralateral neck. Only 3 patients with regional failure were successfully salvaged. Conclusion: The high rate of regional failures when the neck is not electively treated justifies elective nodal RT in patients with both Kadish Stages B and C. In addition, our experience confirms the beneficial effect on local control of adjuvant RT to the tumor bed.

  16. Recent Advances in Radiation Therapy for Head and Neck Cancer

    Microsoft Academic Search

    Madan Bangalore; Shirnett Matthews; Mohan Suntharalingam

    2007-01-01

    The treatment of locally advanced or recurrent head and neck cancers has improved from single modality interventions of surgery and radiation therapy alone to include combined modality therapy with surgery, chemotherapy and radiation. Combined therapy has led to improved local control and disease-free survival. New developments in radiation oncology such as altered fractionation, three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, stereotactic radiosurgery,

  17. Dysphagia in Head and Neck Cancer Patients Treated with Chemoradiotherapy

    Microsoft Academic Search

    Nele Platteaux; Piet Dirix; Eddy Dejaeger; Sandra Nuyts

    2010-01-01

    Dysphagia is a very common complaint of head and neck cancer patients and can exist before, during, and after chemoradiotherapy.\\u000a It leads to nutritional deficiency, weight loss, and prolonged unnatural feeding and also has a major potential risk for aspiration.\\u000a This has a significant negative impact on the patient’s entire quality of life. Because treatment of dysphagia in this setting

  18. Modified Pauwels’ Intertrochanteric Osteotomy in Neglected Femoral Neck Fracture

    Microsoft Academic Search

    Narender Kumar Magu; Rajesh Rohilla; Roop Singh; Rochak Tater

    2009-01-01

    Many reported treatment methods for neglected femoral neck fractures do not always satisfactorily address nonunion, coxa vara,\\u000a and limb shortening. We retrospectively reviewed the functional outcome of the modified Pauwels’ intertrochanteric osteotomy\\u000a in 48 adults (mean age, 48.1 years) to determine whether this approach would correct those problems. The average preoperative\\u000a limb shortening was 2.7 cm (range, 1.5–5 cm) in 38 patients and

  19. Six-year experience with swan neck catheters.

    PubMed

    Twardowski, Z J; Prowant, B F; Nichols, W K; Nolph, K D; Khanna, R

    1992-01-01

    From the beginning of our continuous ambulatory peritoneal dialysis (CAPD) program in January 1977 until June 1985, we used Tenckhoff and Toronto Western Hospital catheters. Throughout these years catheter survival probabilities of about 30% at three years persisted unchanged and were similar to survival probabilities reported by the National CAPD Registry special survey for these catheters. The first improvement in catheter results regarding leaks was noted after the adoption of lateral catheter insertion. Malfunction was less using swan neck prototypes from August 1985 to April 1986. The latter catheters were made of 80 degrees arc angle tubing between 8.5 cm spaced cuffs and were inserted in a reversed U-shape tunnel with the incision at the top of the tunnel. The use of these catheters was abandoned because of high cuff extrusion and exit infection rates. The next generation of swan neck catheters, the swan neck Missouri 2 and 3 catheters with straight intraperitoneal segments, improved the results dramatically. These catheters were made of 180 degrees arc angle tubing between 5 or 3 cm spaced cuffs. The estimated survival probability of 61% at three years more than doubled compared to previously used catheters. Recently we modified the intraperitoneal segment of the catheters, replacing the straight segment with a coiled one. These modified catheters, the swan neck Missouri coiled catheters, have been used exclusively since February 1990. In addition to an acceptable survival probability of 88% at one year, there are two major advantages of these catheters, the same as for other coiled catheters: elimination of infusion pain due to a jet effect and pain related to straight catheter tip pressure on the peritoneum experienced by some patients. PMID:1420498

  20. Neck emergency due to parathyroid adenoma bleeding: a case report

    Microsoft Academic Search

    Isabella Merante-Boschin; Matteo Fassan; Maria Rosa Pelizzo; Eric Casal Ide; Massimo Rugge

    2009-01-01

    INTRODUCTION: The spontaneous rupture of a parathyroid adenoma accompanied by extracapsular hemorrhage is a rare, potentially fatal, condition and is a cervicomediastinal surgical emergency. CASE PRESENTATION: This report describes an atypical two-step spontaneous rupture of an asymptomatic parathyroid adenoma in a 56-year-old Caucasian woman who presented with a painful mass in the right side of her neck. CONCLUSION: Based on

  1. [An enlarged neck fold: a sonographic marker of Down's syndrome].

    PubMed

    Weisner, D; Fiestas-Hummler, A; Grote, W

    1988-01-01

    We report about one case of twin pregnancy where one fetus is healthy and the other has Trisomie 21. The one large skin fold on the neck is observe in the ultrasound. This ultrasound finds is noticed in the Ullrich-Turner-Syndrome as well as in the Down Syndrome. The Trisomie 21 was ascertained after the birth. The clinical meaning of this sonographic criterium will be discussed in this paper. PMID:2975089

  2. Laser safety in head and neck cancer surgery

    Microsoft Academic Search

    Ferhan Ahmed; Andrew J. Kinshuck; Michael Harrison; Dan O’Brien; Jeffrey Lancaster; Nicholas J. Roland; Shaun R. Jackson; Terrence M. Jones

    2010-01-01

    The use of trans-oral laser techniques for the resection of head and neck carcinomas has increased exponentially over the\\u000a last four decades. Inadvertent laser damage to the patient or operating theatre staff is an acknowledged risk. However, no\\u000a data exist to verify the safety margin of commonly employed precautions. The aims of this study was to assess the safety margins

  3. Selective electromyography of dorsal neck muscles in humans

    Microsoft Academic Search

    M. A. Mayoux-Benhamou; M. Revel; C. Vallee

    1997-01-01

    The patterns of activation of splenius capitis, semispinalis capitis, transversospinalis, and levator scapulae muscles were\\u000a studied during various head-neck positions, movements, and isometric tests in 19 healthy human subjects. Myoelectric activities\\u000a were recorded with intramuscular bipolar wire electrodes. Cervical computerized tomography of each subject was performed before\\u000a the electromyography session in order to guide electrode insertion. Head motion was recorded

  4. Demons deformable registration for CBCT-guided procedures in the head and neck: Convergence and accuracy

    SciTech Connect

    Nithiananthan, S.; Brock, K. K.; Daly, M. J.; Chan, H.; Irish, J. C.; Siewerdsen, J. H. [Department of Medical Biophysics, University of Toronto, Ontario, M5G 2M9 (Canada) and Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21205-2109 (United States); Department of Medical Biophysics, University of Toronto, Ontario, M5G 2M9 (Canada); Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Ontario, M5G 2M9 (Canada) and Department of Radiation Oncology, University of Toronto, Toronto, Ontario, M5G 2M9 (Canada); Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Ontario, M5G 2M9 (Canada); Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario M5G 2M9 (Canada) and Surgical Oncology Program, University Health Network, Toronto, Ontario M5G 2M9 (Canada); Department of Medical Biophysics, University of Toronto, Ontario M5G 2M9 (Canada); Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Ontario M5G 2M9 (Canada) and Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21205-2109 (United States)

    2009-10-15

    Purpose: The accuracy and convergence behavior of a variant of the Demons deformable registration algorithm were investigated for use in cone-beam CT (CBCT)-guided procedures of the head and neck. Online use of deformable registration for guidance of therapeutic procedures such as image-guided surgery or radiation therapy places trade-offs on accuracy and computational expense. This work describes a convergence criterion for Demons registration developed to balance these demands; the accuracy of a multiscale Demons implementation using this convergence criterion is quantified in CBCT images of the head and neck. Methods: Using an open-source ''symmetric'' Demons registration algorithm, a convergence criterion based on the change in the deformation field between iterations was developed to advance among multiple levels of a multiscale image pyramid in a manner that optimized accuracy and computation time. The convergence criterion was optimized in cadaver studies involving CBCT images acquired using a surgical C-arm prototype modified for 3D intraoperative imaging. CBCT-to-CBCT registration was performed and accuracy was quantified in terms of the normalized cross-correlation (NCC) and target registration error (TRE). The accuracy and robustness of the algorithm were then tested in clinical CBCT images of ten patients undergoing radiation therapy of the head and neck. Results: The cadaver model allowed optimization of the convergence factor and initial measurements of registration accuracy: Demons registration exhibited TRE=(0.8{+-}0.3) mm and NCC=0.99 in the cadaveric head compared to TRE=(2.6{+-}1.0) mm and NCC=0.93 with rigid registration. Similarly for the patient data, Demons registration gave mean TRE=(1.6{+-}0.9) mm compared to rigid registration TRE=(3.6{+-}1.9) mm, suggesting registration accuracy at or near the voxel size of the patient images (1x1x2 mm{sup 3}). The multiscale implementation based on optimal convergence criteria completed registration in 52 s for the cadaveric head and in an average time of 270 s for the larger FOV patient images. Conclusions: Appropriate selection of convergence and multiscale parameters in Demons registration was shown to reduce computational expense without sacrificing registration performance. For intraoperative CBCT imaging with deformable registration, the ability to perform accurate registration within the stringent time requirements of the operating environment could offer a useful clinical tool allowing integration of preoperative information while accurately reflecting changes in the patient anatomy. Similarly for CBCT-guided radiation therapy, fast accurate deformable registration could further augment high-precision treatment strategies.

  5. Image-guided adaptive radiotherapy for prostate and head-and-neck cancers

    NASA Astrophysics Data System (ADS)

    O'Daniel, Jennifer C.

    In the current practice of radiation therapy, daily patient alignments have been based on external skin marks or on bone. However, internal organ variation (both motion and volumetric changes) between treatment fractions can displace the treatment target, causing target underdosage and normal tissue overdosage. In order to deliver the radiation treatment as planned, more accurate knowledge of the daily internal anatomy was needed. Additionally, treatments needed to adapt to these variations by either shifting the patient to account for the daily target position or by altering the treatment plan. In this dissertation, the question of whether inter-fractional variations in internal patient anatomy combined with external set-up uncertainties produced measurable differences between planned and delivered doses for prostate and head-and-neck cancer patients was investigated. Image-guided adaptive treatment strategies to improve tumor coverage and/or reduce normal tissue dose were examined. Treatment deliveries utilizing various alignment procedures for ten prostate cancer patients and eleven head-and-neck cancer patients, each of whom received multiple CT scans over the course of treatment, were simulated. The largest prostate dose losses between planning and delivery were correlated with anterior/posterior and superior/inferior prostate displacement. Daily bone alignment sufficiently maintained target coverage for 70% of patients, ultrasound for 90%, and CT for 100%. A no-action-level correction protocol, which corrected the daily bone alignment for the systematic internal displacement of the prostate based on a pre-determined number of CT image sets, successfully improved the prostate and seminal vesicle dosimetric coverage. Three CT image sets were sufficient to accurately correct the bone alignment scheme for the prostate internal systematic shifts. For head-and-neck cancer patient treatment, setup uncertainties and internal organ variations did not greatly affect the target dose coverage, but did increase the parotid gland dose. Bone alignment provided a lower delivered parotid gland dose, but daily adaptive treatment replanning provided the best normal tissue sparing. External set-up uncertainty and inter-fractional anatomic variation negatively affected the delivered dose distribution for both prostate cancer and H&N cancer patients. This dissertation has shown that adapting for inter-fractional internal anatomic variations improved tumor coverage for prostate cancer and educed normal tissue dose for H&N cancer.

  6. Anchor fixation and other modifications of endoscopic bladder neck suspension.

    PubMed

    Benderev, T V

    1992-11-01

    The long-term efficacy of surgical treatment of stress urinary incontinence can be improved by modifications that reduce the possibility of suspending suture detachment. Fifty-three women with stress urinary incontinence underwent consecutive endoscopic bladder neck suspensions with new modifications developed in an effort to decrease suspending suture detachment. Those modifications included: (1) technique of needle passage to capture a maximum volume of urethropelvic fascia lateral to the bladder neck and urethra while avoiding injury to the bladder, (2) pubic bone fixation of the suspending suture using a small anchor developed for orthopedic use, and (3) a simple technique to limit tension of the suspending sutures. Procedures were outpatient in 60 percent of patients (93% of the last 27 patients). Seventy percent of patients did not require intermittent catheterization beyond the day when their indwelling catheter was removed. The postoperative success rate (absence of stress urinary incontinence) at one month was 100 percent. There were 4 failures on follow-up up to fifteen months. Urgency incontinence decreased from 59 percent preoperatively to 15 percent postoperatively. The complication of osteitis pubis was not noted. Patient rating of satisfaction postoperatively was high. These modifications constitute a safe alternative to procedures that effectively suspend the bladder neck. An assessment of any change in long-term efficacy as a result of these modifications will require continued follow-up. PMID:1441037

  7. Pancreaticogastrostomy: A Salvage Procedure for Pancreatic Body and Neck Resection

    PubMed Central

    Li, Ang; Prasoon, Pankaj; Hong, Wu; Lu, Hui Min; Zhang, Zhao Da; Zhaoda, Zhang

    2012-01-01

    Abstract The purpose of this analysis was to evaluate the technological viability, basic safety and consequence of central pancreatectomy (CP) with pancreaticogastrostomy in properly chosen sufferers with noncancerous central pancreatic pathology. This research is centered on the infirmary charts of West China hospital. We recruited 20 individuals from 2007 to 2009 diagnosed with benign cancerous growth of pancreatic body and neck. They underwent pancreatic body and neck resection adhering to pancreaticogastrostomy. We carried out central pancreatectomy following pancreaticogastrostomy in 20 patients: 8 with serous cyst adenomas, 11 with mucinous cystadenomas, and 1 with neuroendocrine tumor. The position of all tumors was restricted to body and neck of the pancreas, measuring a mean ± standard deviation of 2.6±1.3cm. The mean post-operative hospital stay was 7 days (ranging from 6 to 16 days).There was no intraoperative additional complications. From a technical perspective, CP is a safe and sound, pancreas-preserving pancreatectomy for non-enucleable non-cancerous pancreatic pathology restricted to the pancreatic body. PMID:23396710

  8. Imaging findings of vascular lesions in the head and neck.

    PubMed

    Güneyli, Serkan; Ceylan, Naim; Bayraktaro?lu, Selen; Acar, Türker; Sava?, Recep

    2014-01-01

    Vascular lesions of the head and neck include vascular neoplasms, vascular malformations, and hypervascular lesions, derived from nonvascular soft-tissue elements. We retrospectively evaluated magnetic resonance imaging and computed tomography images of vascular lesions located in the head and neck. Twelve patients (seven males, five females) aged 1-68 years (mean age, 35.25 years) were included in this study. Most of the vascular lesions in our study were histologically diagnosed. The lesions were as follows: a hemangioma located in the parotid space (n=1); a hemangioendothelioma located in the parotid space (n=1); a hemangiopericytoma located in the larynx (n=1); a juvenile angiofibroma located in the nasopharynx (n=1); a glomus tumor located in the carotid bifurcation (n=1); venous malformations located in the parapharyngeal space, the pterygoid area, the orbital space, and the larynx (n=4); lymphatic malformations located in the parotid space and the supraclavicular area (n=2); and an arteriovenous malformation located in the infratemporal fossa (n=1). We present rare vascular lesions of the head and neck, which have typical radiological findings. PMID:25010372

  9. [Human papillomavirus (HPV) and head and neck cancer].

    PubMed

    Wagner, S; Mayer, C; Wittekindt, C; Klussmann, J P

    2012-01-01

    Squamous cell carcinomas of the head and neck belong to the most common cancers worldwide. Although they are in general on the decline, rising incidence rates have been reported for certain specific sites. In developed countries the impact of classical risk factors like tobacco and alcohol seems to decline, while the association with oncogenic papillomavirus infections, in particular in cancers of the oropharynx, is increasing markedly. The accumulation of genetic and epigenetic changes due to toxin exposure leads to inactivation of tumor suppressors or activation of proto-oncogenes, resulting in genetic instability and malignant transformation in non-papillomavirus-related cancer. Papillomavirus-related cancers infrequently contain genetic alterations and are caused by deregulation of the cell cycle, senescence and apoptosis induced by viral oncoproteins. Detection of oncogenic papillomavirus infections may be basis for further classification of head and neck squamous cell carcinoma and could be a key in differential treatment modalities for subsets of head and neck cancer in the near future. PMID:22179127

  10. Multivariate approach to investigating prognostic factors in deep neck infections.

    PubMed

    Staffieri, Claudia; Fasanaro, Elena; Favaretto, Niccolo'; La Torre, Fabio Biagio; Sanguin, Saverio; Giacomelli, Luciano; Marino, Filippo; Ottaviano, Giancarlo; Staffieri, Alberto; Marioni, Gino

    2014-07-01

    Deep neck infections (DNI) spread along fascial planes and involve neck spaces. Very few studies have investigated potentially prognostic factors using multivariate statistical models. Our aim was to analyze 282 consecutive cases of DNI using multivariate (logistic) statistical models to identify independent significant factors influencing prognosis in terms of complications and long-term hospitalization (>6 days). In our series, only involvement of more than one neck space was independently significant in prognosticating complications of DNI (odds ratio [OR] 2.46). The presence of comorbidities (OR 2.13), non-odontogenic sites of origin (OR 1.88), leukocyte counts above 11.0 cells × 10(9)/L at presentation (OR 3.57), and the need for both medical and surgical treatments (OR 4.66) was significantly and independently prognostic of long hospital stays. Multivariate analysis can distinguish between risk factors and their relative contribution to outcome. The few published studies using multivariate models to analyze DNI prognosis considered quite large cohorts, but no clinical variables persistently revealed an independent significant prognostic role. This evidence seems to underscore the complex interdependence of several clinical variables in contributing to DNI prognosis, and the heterogeneity of the diagnostic/therapeutic approaches adopted. PMID:24522964

  11. Bioimpedance vector pattern in head and neck squamous cell carcinoma.

    PubMed

    Malecka-Massalska, T; Smolen, A; Zubrzycki, J; Lupa-Zatwarnicka, K; Morshed, K

    2012-02-01

    Direct bioimpedance measures (resistance, reactance, phase angle (PA)) determined by bioelectrical impedance analysis (BIA) detect changes in tissue electrical properties. The study was conducted to evaluate soft tissue hydration and mass through pattern analysis of vector plots as height, normalized resistance, and reactance measurements by bioelectric impedance vector analysis in patients with head and neck cancer. Whole-body measurements were made with ImpediMed bioimpedance analysis in 56 adult, white, male subjects 42 to 79 years old: 28 patients with head and neck squamous cell carcinoma (H&NC) and 28 healthy volunteers matched by sex, age and BMI as a control group. All patients were previously untreated and without active nutritional interventions. Mean vectors of H&NC group vs. the control group were characterized by an increased normalized resistance component with a reduced reactance component (separate 95% confidence limits, P<0.05), indicating a decreased ionic conduction (dehydration) with loss of dielectric mass (cell membranes and tissue interfaces) of soft tissue. Monitoring vector displacement trajectory toward the reference target vector position may represent useful feedback in support therapy planning of individual patients before surgery in patients with head and neck cancer in order to reduce post-operational complications. PMID:22460467

  12. Evaluation of Driver-vehicle Matching using Neck Muscle Activity and Vehicle Dynamics

    NASA Astrophysics Data System (ADS)

    Iwamoto, Yoshiki; Umetsu, Daisuke; Ozaki, Shigeru

    Objective measurement of a car driver's feeling has been a subject of automobile researches. In the present study, we aimed at quantifying the matching between the physiological response of a driver and the vehicle motion. Assuming that the performance of a head stabilization mechanism, the vestibulo-collic reflex, affects driving feeling, we recorded the activity of neck muscles that help maintain the head position. Electromyograms (EMGs) were recorded from the sternocleidomastoid muscles (SCM) using active electrodes and a compact amplifier. Vehicle acceleration and gas pedal movement were recorded with small accelerometers. Subjects were required to perform straight-line acceleration. Four road cars with different characteristics were used. EMG signals were filtered, full-wave rectified and averaged across trials. Main results are summarized as follows. First, the EMG response of a driver's neck muscle depended not only on vehicle acceleration but on its time derivative, jerk. A quantitative analysis showed that, for the data obtained with the four cars, the EMG profile can be reproduced by a linear sum of acceleration and jerk. The correlation coefficient, an index of goodness of matching, ranged from ~0.8 to ~0.95. Second, our analysis indicated that the relationship between the muscle response and the vehicle motion can be characterized by two parameters: the optimal weight for the jerk term and the optimal time lag. The current study proposes a method for characterizing a physiological response of a driver to dynamic vehicle motion. It remains to be investigated whether these parameters are related to the driving feeling.

  13. Nuclear S100A7 Is Associated with Poor Prognosis in Head and Neck Cancer

    PubMed Central

    Tripathi, Satyendra Chandra; Matta, Ajay; Kaur, Jatinder; Grigull, Jorg; Chauhan, Shyam Singh; Thakar, Alok; Shukla, Nootan Kumar; Duggal, Ritu; DattaGupta, Siddhartha

    2010-01-01

    Background Tissue proteomic analysis of head and neck squamous cell carcinoma (HNSCC) and normal oral mucosa using iTRAQ (isobaric tag for relative and absolute quantitation) labeling and liquid chromatography-mass spectrometry, led to the identification of a panel of biomarkers including S100A7. In the multi-step process of head and neck tumorigenesis, the presence of dysplastic areas in the epithelium is proposed to be associated with a likely progression to cancer; however there are no established biomarkers to predict their potential of malignant transformation. This study aimed to determine the clinical significance of S100A7 overexpression in HNSCC. Methodology Immunohistochemical analysis of S100A7 expression in HNSCC (100 cases), oral lesions (166 cases) and 100 histologically normal tissues was carried out and correlated with clinicopathological parameters and disease prognosis over 7 years for HNSCC patients. Overexpression of S100A7 protein was significant in oral lesions (squamous cell hyperplasia/dysplasia) and sustained in HNSCC in comparison with oral normal mucosa (ptrend<0.001). Significant increase in nuclear S100A7 was observed in HNSCC as compared to dysplastic lesions (p?=?0.005) and associated with well differentiated squamous cell carcinoma (p?=?0.031). Notably, nuclear accumulation of S100A7 also emerged as an independent predictor of reduced disease free survival (p?=?0.006, Hazard ratio (HR?=?7.6), 95% CI?=?1.3?5.1) in multivariate analysis underscoring its relevance as a poor prognosticator of HNSCC patients. Conclusions Our study demonstrated nuclear accumulation of S100A7 may serve as predictor of poor prognosis in HNSCC patients. Further, increased nuclear accumulation of S100A7 in HNSCC as compared to dysplastic lesions warrants a large-scale longitudinal study of patients with dysplasia to evaluate its potential as a determinant of increased risk of transformation of oral premalignant lesions. PMID:20689826

  14. Evaluation of Thyroid Disorders During Head-and-Neck Radiotherapy by Using Functional Analysis and Ultrasonography

    SciTech Connect

    Bakhshandeh, Mohsen [Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran (Iran, Islamic Republic of); Hashemi, Bijan, E-mail: bhashemi@modares.ac.ir [Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran (Iran, Islamic Republic of); Mahdavi, Seyed Rabie [Department of Medical Physics, Faculty of Medical Sciences, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of); Nikoofar, Alireza [Department of Radiation Oncology, Hafte-Tir Hospital, Tehran University of Medical Sciences, Tehran (Iran, Islamic Republic of); Edraki, Hamid Reza [Department of Radiology, Panzdahe-Khordad Hospital, Shahid Beheshti University of Medical Sciences, Tehran (Iran, Islamic Republic of); Kazemnejad, Anoshirvan [Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran (Iran, Islamic Republic of)

    2012-05-01

    Purpose: To evaluate thyroid function and vascular changes during radiotherapy for patients with head and neck cancer. Methods and Materials: Fifty patients treated with primary or postoperative radiotherapy for various cancers in the head and neck region were prospectively evaluated. The serum samples (triiodothyronine [T3], thyroxine [T4], thyroid-stimulating hormone [TSH], free triiodothyronine [FT3], and free thyroxine [FT4]), the echo level of the thyroid gland, and color Doppler ultrasonography (CDU) parameters of the right inferior thyroid artery (RITA) of the patients were measured before and at regular intervals during radiotherapy. The thyroid gland dose-volume histograms of the patients were derived from their computed tomography-based treatment plans. Results: There was a significant fall in TSH level (p < 0.0001) but an increase in FT4 (p < 0.0001) and T4 (p < 0.022) levels during the radiotherapy course. The threshold dose required to produce significant changes was 12 Gy (Biologically Effective Dose in 2-Gy fractions, BED{sub 2}). There were significant rises in the patients' pulsatility index, resistive index, peak systolic velocity, blood volume flow levels, and RITA diameter (p < 0.0001), as detected by CDU during radiotherapy, compared to those parameters measured before the treatment. Hypoechogenicity and irregular echo patterns (p < 0.0001) were seen during radiotherapy compared to those before treatment. There was significant Pearson's correlation between the CDU parameters and T4, FT4, and TSH levels. Conclusions: Radiation-induced thyroiditis is regarded as primary damage to the thyroid gland. Thyroiditis can subsequently result in hypothyroidism or hyperthyroidism. Our results demonstrated that changes in thyroid vessels occur during radiotherapy delivered to patients. Vessel changes also can be attributed to the late effect of radiation on the thyroid gland. The hypoechogenicity and irregular echo patterns observed in patients may result from the increase in intrathyroidal flow.

  15. A Clinical Concept for Interfractional Adaptive Radiation Therapy in the Treatment of Head and Neck Cancer

    SciTech Connect

    Jensen, Alexandra D., E-mail: Alexandra.Jensen@med.uni-heidelberg.de [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany); Nill, Simeon [Department of Medical Physics, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Huber, Peter E. [Clinical Co-Operation Unit Radiation Oncology, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Bendl, Rolf [Department of Medical Physics, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Debus, Juergen; Muenter, Marc W. [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany)

    2012-02-01

    Purpose: To present an approach to fast, interfractional adaptive RT in intensity-modulated radiation therapy (IMRT) of head and neck tumors in clinical routine. Ensuring adequate patient position throughout treatment proves challenging in high-precision RT despite elaborate immobilization. Because of weight loss, treatment plans must be adapted to account for requiring supportive therapy incl. feeding tube or parenteral nutrition without treatment breaks. Methods and Materials: In-room CT position checks are used to create adapted IMRT treatment plans by stereotactic correlation to the initial setup, and volumes are adapted to the new geometry. New IMRT treatment plans are prospectively created on the basis of position control scans using the initial optimization parameters in KonRad without requiring complete reoptimization and thus facilitating quick replanning in daily routine. Patients treated for squamous cell head and neck cancer (SCCHN) in 2006-2007 were evaluated as to necessity/number of replannings, weight loss, dose, and plan parameters. Results: Seventy-two patients with SCCHN received IMRT to the primary site and lymph nodes (median dose 70.4 Gy). All patients received concomitant chemotherapy requiring supportive therapy by feeding tube or parenteral nutrition. Median weight loss was 7.8 kg, median volume loss was approximately 7%. Fifteen of 72 patients required adaptation of their treatment plans at least once. Target coverage was improved by up to 10.7% (median dose). The increase of dose to spared parotid without replanning was 11.7%. Replanning including outlining and optimization was feasible within 2 hours for each patient, and treatment could be continued without any interruptions. Conclusion: To preserve high-quality dose application, treatment plans must be adapted to anatomical changes. Replanning based on position control scans therefore presents a practical approach in clinical routine. In the absence of clinically usable online correction methods, this approach allows significant improvement of target volume coverage and continuous parotid sparing without treatment delays.

  16. Chronic neck pain alters muscle activation patterns to sudden movements.

    PubMed

    Boudreau, Shellie A; Falla, Deborah

    2014-06-01

    The aim of this study was to assess the activation of the sternocleidomastoid (SCM) and splenius capitis (SC) muscles in response to unanticipated, full body perturbations in individuals with chronic neck pain (NP) and age-matched healthy controls (HC). Individuals with NP had a history of NP for 8.9 ± 7.8 years, rated the intensity of NP as 4.2 ± 2.0 (score out of 10), and scored 15.3 ± 6.5 on the Neck Disability Index. Participants stood on a moveable platform during which 32 randomized postural perturbations (eight repetitions of four perturbation types: 8 cm forward slide (FS), 8 cm backward slides, 10° forward tilt, and 10° backward tilt) with varying inter-perturbation time intervals were performed over a period of 5 min. Bilateral surface electromyography (EMG) from the SCM and SC was recorded, and the onset time and the average rectified value of the EMG signal was determined for epochs of 100 ms; starting 100 ms prior to and 500 ms after the perturbation onset. Individuals with NP, as compared to HC, demonstrated delayed onset times and reduced EMG amplitude of the SCM and SC muscles in response to all postural perturbations. Such findings were most pronounced following the FS postural perturbation (healthy vs. NP for SCM 83.3 ± 8.0 vs. 86.3 ± 4.4 and SC 75.6 ± 3.5 vs. 89.3 ± 4.2), which was also associated with the greatest change (expressed in % relative to baseline) in EMG amplitude (healthy vs. NP for SCM 206.6 ± 50.4 vs. 115.9 ± 15.7 and SC 83.4 ± 19.2 vs. 69.2 ± 10.9) across all postural perturbations types. Individuals with NP display altered neural control of the neck musculature in response to rapid, unanticipated full body postural perturbations. Although the relative timing of neck musculature activity in individuals with NP appears to be intact, simultaneous co-activation of the neck musculature emerges for unanticipated anterior-posterior postural perturbations. PMID:24632836

  17. Matched asymptotic analysis to solve the narrow escape problem in a domain with a long neck

    NASA Astrophysics Data System (ADS)

    Li, Xiaofei

    2014-12-01

    In this study, we mainly consider the narrow escape problem (NEP) in a two-dimensional domain ? with a long neck, which is the two-dimensional analogue of a dendritic spine geometry. The NEP requires the computation of the mean escape time of a Brownian particle starting from the head until it exits from the end of the neck, where the particle is absorbed. We divide the domain into the neck part ?n and the head part ?h, with the common boundary {{? }\\varepsilon }. The escape time in ?h can be considered to be the time from the head to the end of the neck, while the escape time in ?n can be considered to be the time from the neck to the end of the neck. We compute the two exit times separately and match them by considering some boundary value problem with an impedance boundary condition on {{? }\\varepsilon }, which we refer to as the Neumann–Robin boundary model.

  18. Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients

    Microsoft Academic Search

    G Jull; E Kristjansson; P Dall’Alba

    2004-01-01

    There has been little investigation into whether or not differences exist in the nature of physical impairment associated with neck pain of whiplash and insidious origin. This study examined the neck flexor synergy during performance of the cranio-cervical flexion test, a test targeting the action of the deep neck flexors.Seventy-five volunteer subjects participated in this study and were equally divided

  19. Effect of gaze direction on neck muscle activity during cervical rotation

    Microsoft Academic Search

    Catharina S. M. Bexander; Rebecca Mellor; Paul W. Hodges

    2005-01-01

    Control of the neck muscles is coordinated with the sensory organs of vision, hearing and balance. For instance, activity\\u000a of splenius capitis (SC) is modified with gaze shift. This interaction between eye movement and neck muscle activity is likely\\u000a to influence the control of neck movement. The aim of this study was to investigate the effect of eye position on

  20. Long-term regional control after radiation therapy and neck dissection for base of tongue carcinoma

    Microsoft Academic Search

    Henry J. Lee; Michael J. Zelefsky; Dennis H. Kraus; David G. Pfister; Elliot W. Strong; Adam Raben; Jatin P. Shah; Louis B. Harrison

    1997-01-01

    Purpose: Minimal literature exists with 10-year data on neck control in advanced head and neck cancer. The purpose of this study is to determine long-term regional control for base of tongue carcinoma patients treated with primary radiation therapy plus neck dissection.Methods and Materials: Between 1981–1996, primary radiation therapy was used to treat 68 patients with squamous cell carcinoma of the

  1. The association between physical activity and neck and low back pain: a systematic review

    Microsoft Academic Search

    Ekalak Sitthipornvorakul; Prawit Janwantanakul; Nithima Purepong; Praneet Pensri; Allard J. van der Beek

    2011-01-01

    The effect of physical activity on neck and low back pain is still controversial. No systematic review has been conducted\\u000a on the association between daily physical activity and neck and low back pain. The objective of this study was to evaluate\\u000a the association between physical activity and the incidence\\/prevalence of neck and low back pain. Publications were systematically\\u000a searched from

  2. Outcomes of Endovascular Abdominal Aortic Aneurysm Repair in Patients with Hostile Neck Anatomy

    SciTech Connect

    Choke, Edward; Munneke, Graham; Morgan, Robert; Belli, Anna-Maria; Loftus, Ian; McFarland, Robert; Loosemore, Thomas; Thompson, Matthew M. [St. George's Hospital, Vascular Institute (United Kingdom)], E-mail: Matt.Thompson@stgeorges.nhs.uk

    2006-12-15

    Purpose. The principal anatomic contraindication to endovascular aneurysm repair (EVR) is an unfavorable proximal aortic neck. With increasing experience, a greater proportion of patients with unfavorable neck anatomy are being offered EVR. This study aimed to evaluate outcomes in patients with challenging proximal aortic neck anatomy. Methods. Prospectively collected data from 147 consecutive patients who underwent EVR between December 1997 and April 2005 were supplemented with a retrospective review of medical records and radiological images. Unfavorable anatomic features were defined as neck diameter >28 mm, angulation >60 deg., circumferential thrombus >50%, and length <10 mm. Eighty-seven patients with 0 adverse features (good necks) were compared with 60 patients with one or more adverse features (hostile necks). Results. Comparing the good neck with the hostile neck group, there were no significant differences in the incidence of primary technical success (p = 0.15), intraoperative adjunctive procedures (p = 0.22), early proximal type I endoleak (<30 days) (p = 1.0), late proximal type I endoleak (>30 days) (p = 0.57), distal type I endoleak (p = 0.40), type III endoleak (p 0.51), secondary interventions (p = 1.0), aneurysm sac expansion (p = 0.44), or 30 day mortality (p = 0.70). The good neck group had a significantly increased incidence of type II endoleak (p = 0.023). By multivariate analysis, the incidence of intraoperative adjunctive procedures was significantly increased in the presence of severe angulation (p = 0.041, OR 3.08, 95% CI 1.05-9.04). Conclusion. Patients with severely hostile proximal aortic neck anatomy may be treated with EVR, although severely angulated necks require additional intraoperative procedures. Early outcomes are encouraging and suggest that indications for EVR may be expanded to include patients with hostile neck anatomy.

  3. Endoscopic surgery for a parathyroid functioning adenoma resection with the neck region-lifting method

    Microsoft Academic Search

    Hiroya Kitano; Masaki Fujimura; Masamitu Hirano; Hideyuki Kataoka; Takashi Kinoshita; Satoshi Seno; Kazutomo Kitajima

    2000-01-01

    Recently, endoscopic surgery has been applied to cervical exploration. We have developed new techniques for endoscopic neck surgery. We reported on a 53-year-old Japanese man with functioning parathyroid adenoma resected by endoscopic surgery with a neck region-lifting method. A 10-mm midline trocar for the endoscope and two 5-mm lateral trocars were inserted from the anterior chest wall to avoid neck

  4. Cardiovascular functional disorder and stress among patients having neck-shoulder symptoms

    Microsoft Academic Search

    M Gockel; H Lindholm; H Alaranta; A Viljanen; A Lindquist; T Lindholm

    1995-01-01

    OBJECTIVES--To investigate if autonomic nervous system function, reflected in cardiovascular variables, among patients with neck-shoulder symptoms (tension neck group (T)) differed from that in a symptom free control group (C), and to establish its relation with pain and psychological stress. METHODS--Twelve women with tension neck and nine controls in secretarial jobs were studied. They underwent an orthostatic test, deep breathing

  5. Clinical and Molecular Implications of MED15 in Head and Neck Squamous Cell Carcinoma.

    PubMed

    Shaikhibrahim, Zaki; Offermann, Anne; Halbach, Rebecca; Vogel, Wenzel; Braun, Martin; Kristiansen, Glen; Bootz, Friedrich; Wenzel, Jörg; Mikut, Ralf; Lengerke, Claudia; Reischl, Markus; Schröck, Andreas; Perner, Sven

    2015-04-01

    Head and neck squamous cell carcinoma (HNSCC) progression depends on various dysregulated pathways. Regulation of diverse pathways is mediated by the mediator complex. The mediator subunit MED15 is essential for transforming growth factor (TGF)-? signaling and involved in breast and prostate cancers. We investigated the implication of MED15 in HNSCC. IHC for MED15 was performed on 324 tissue samples, and TGF-? assessed the use of Ki-67 and pSMAD3 as markers. MED15 knockdown followed by proliferation and migration assays, as well as TGF-?1 treatment followed by MED15 analysis, was also performed. MED15 was overexpressed in 35% of primary tumors, 30% of lymph node metastases, and 70% of recurrences in contrast to no or low expression in benign tumors. MED15 overexpression in primary tumors from patients who developed recurrences was associated with higher mortality rates and occurred at highest frequency in oral cavity or oropharyngeal tumors. Furthermore, MED15 expression correlated between primary tumors and corresponding lymph node metastases. MED15 correlated with proliferation in tissues, and MED15 knockdown reduced proliferation and migration. We observed an association between MED15 and TGF-? activity in tissues because TGF-? activation led to increased MED15 expression and reduced pSMAD3 on MED15 knockdown. Taken together, our results implicate MED15 in HNSCC and hint that MED15 overexpression is a clonal event during HNSCC progression. MED15 may serve as a prognostic marker for recurrence and as a therapeutic target. PMID:25791637

  6. Tumor cells with low proteasome subunit expression predict overall survival in head and neck cancer patients

    PubMed Central

    2014-01-01

    Background Experimental and clinical data suggest that solid cancers contain treatment-resistant cancer stem cells that will impair treatment efficacy. The objective of this study was to investigate if head and neck squamous cell carcinoma (HNSCC) also contain cancer stem cells that can be identified by low 26S proteasome activity and if their presence correlates to clinical outcome. Methods Human HNSCC cells, engineered to report lack of proteasome activity based on accumulation of a fluorescent fusion protein, were separated based on high (ZsGreen-cODCneg) or low (ZsGreen-cODCpos) proteasome activity. Self-renewal capacity, tumorigenicity and radioresistance were assessed. Proteasome subunit expression was analyzed in tissue microarrays and correlated to survival and locoregional cancer control of 174 patients with HNSCC. Results HNSCC cells with low proteasome activity showed a significantly higher self-renewal capacity and increased tumorigenicity. Irradiation enriched for ZsGreen-cODCpos cells. The survival probability of 82 patients treated with definitive radio- or chemo-radiotherapy exhibiting weak, intermediate, or strong proteasome subunit expression were 21.2, 28.8 and 43.8 months (p?=?0.05), respectively. Locoregional cancer control was comparably affected. Conclusions Subpopulations of HNSCC display stem cell features that affect patients’ tumor control and survival. Evaluating cancer tissue for expression of the proteasome subunit PSMD1 may help identify patients at risk for relapse. PMID:24593279

  7. Fascin upregulation in primary head and neck squamous cell carcinoma is associated with lymphatic metastasis.

    PubMed

    Papaspyrou, Konstantinos; Brochhausen, Christoph; Schmidtmann, Irene; Fruth, Kai; Gouveris, Haralampos; Kirckpatrick, James; Mann, Wolf; Brieger, Juergen

    2014-06-01

    Fascin is an actin-bundling protein that is associated with cellular motility and cancer-cell invasion. The present study aimed to examine the expression of fascin in head and neck squamous cell carcinoma (HNSCC) and its potential use as a biomarker. In a prospective study with a median follow-up time of 48.8 months, tumor tissues, adjacent healthy tissues and cervical lymph node metastases were collected from 25 patients and analyzed by immunohistochemistry. The specimens were scored according to the intensity of fascin staining and the percentage of tumor cells stained using a semi-quantitative scoring approach; the data were analyzed and correlated with clinical follow-up observations. All of the investigators were blinded to the origin of the specimens. The expression levels of fascin were significantly increased in the tumor tissues (P=0.03) and lymph node metastases (P=0.03) compared with that of the normal tissues. The high expression level of fascin in the tumor tissues was correlated with the N-status, however, not with overall survival. Therefore, fascin may be a suitable marker for the prediction of regional lymphatic metastasis in HNSCC. PMID:24932286

  8. Communicative Participation and Quality of Life in Head and Neck Cancer

    PubMed Central

    Eadie, Tanya L.; Lamvik, Kristin; Baylor, Carolyn R.; Yorkston, Kathryn M.; Kim, Jiseon; Amtmann, Dagmar

    2015-01-01

    Objectives The purpose of this study was to determine how a new self-report outcome measure of communicative participation, the Communicative Participation Item Bank (CPIB), related to disease- and discipline-specific quality of life outcomes in a head and neck cancer (HNC) population. Methods One hundred ninety-five individuals treated for HNC completed the Communicative Participation Item Bank (CPIB), the University of Washington Quality of Life (UW-QOL) questionnaire, and the Voice Handicap Index-10 (VHI-10). Results Results revealed moderate QOL scores across the UW-QOL (mean scores: global QOL = 66; physical subscale = 70; social-emotional subscale =73) and VHI-10 questionnaire (mean = 16). Correlations between the CPIB and the UW-QOL scores were statistically significant (p <.001), but relatively weak (r = .37 – .38). As hypothesized, a stronger correlation was found between the CPIB with the VHI-10 (r = ?0.79; p <.001). Conclusions Clinicians may consider adopting the CPIB to complement existing tools in assessing communication outcomes after HNC. PMID:24671481

  9. Blood flow dynamics during local photoreaction in a head and neck tumor model

    NASA Astrophysics Data System (ADS)

    Rohrbach, Daniel; Tracy, Erin; Walker, Jessica; Baumann, Heinz; Sunar, Ulas

    2015-03-01

    We have applied continuous blood flow dynamics, quantified with diffuse correlation spectroscopy (DCS), in investigating photodynamic therapy (PDT) induced local photoreaction in a head and neck tumor model. Photoclor (0.47 µmol/kg) was intravenously administered 24 hour before PDT. Two types of fluence rates were implemented: Low fluence rate (14 mW/cm2) and high fluence rate (75 mW/cm2). The total delivered fluence was 100 J for both types. We observed that PDT induced substantial vascular shut down in both types. While the shutdown was persistent in tumors exposed to low fluence rate PDT, the shutdown was transient in tumors exposed to high fluence PDT. Loss of microvascular structures was confirmed by the microscopic analyses of tumor section following immunostaining for CD31. Blood flow dynamics related metrics were also strongly correlated with crosslinking of STAT3, a molecular marker of photoreaction. STAT3 analysis indicated that low fluence rate yields a substantially higher photoreaction, and, thus, a more effective PDT. Our results indicate that noninvasive blood flow measurements can monitor the efficacy of PDT in real-time and potentially provide a feedback for its optimization.

  10. Fascin upregulation in primary head and neck squamous cell carcinoma is associated with lymphatic metastasis

    PubMed Central

    PAPASPYROU, KONSTANTINOS; BROCHHAUSEN, CHRISTOPH; SCHMIDTMANN, IRENE; FRUTH, KAI; GOUVERIS, HARALAMPOS; KIRCKPATRICK, JAMES; MANN, WOLF; BRIEGER, JUERGEN

    2014-01-01

    Fascin is an actin-bundling protein that is associated with cellular motility and cancer-cell invasion. The present study aimed to examine the expression of fascin in head and neck squamous cell carcinoma (HNSCC) and its potential use as a biomarker. In a prospective study with a median follow-up time of 48.8 months, tumor tissues, adjacent healthy tissues and cervical lymph node metastases were collected from 25 patients and analyzed by immunohistochemistry. The specimens were scored according to the intensity of fascin staining and the percentage of tumor cells stained using a semi-quantitative scoring approach; the data were analyzed and correlated with clinical follow-up observations. All of the investigators were blinded to the origin of the specimens. The expression levels of fascin were significantly increased in the tumor tissues (P=0.03) and lymph node metastases (P=0.03) compared with that of the normal tissues. The high expression level of fascin in the tumor tissues was correlated with the N-status, however, not with overall survival. Therefore, fascin may be a suitable marker for the prediction of regional lymphatic metastasis in HNSCC. PMID:24932286

  11. Nicotine dependence and smoking habits in patients with head and neck cancer*

    PubMed Central

    de Almeida, Adriana Ávila; Bandeira, Celso Muller; Gonçalves, Antonio José; Araújo, Alberto José

    2014-01-01

    Objective: To assess smoking habits and nicotine dependence (ND) in patients with head and neck cancer Methods: This study involved 71 smokers or former smokers with squamous cell carcinoma in the oral cavity, pharynx, or larynx who were treated at a university hospital in the city of São Paulo between January and May of 2010. We used the Fagerström Test for Nicotine Dependence to evaluate smoking habits and ND in the sample. Data regarding cancer treatment were collected from medical records. Depending on the variables studied, we used the chi-square test, Fisher's exact test, Student's t-test, or Spearman's correlation test. Results: Of the 71 patients, 47 (66.2%) presented with high or very high ND, 40 (56.3%) smoked more than 20 cigarettes/day, and 32 (45.1%) smoked their first cigarette within 5 min of awakening. Advanced disease stage correlated significantly with the number of cigarettes smoked per day (p = 0.011) and with smoking history (p = 0.047). We found that ND did not correlate significantly with gender, disease stage, smoking cessation, or number of smoking cessation attempts, nor did the number of cigarettes smoked per day correlate with smoking cessation or gender. Treatment for smoking cessation was not routinely offered. Conclusions: In most of the patients studied, the level of ND was high or very high. The prevalence of heavy smoking for long periods was high in our sample. A diagnosis of cancer is a motivating factor for smoking cessation. However, intensive smoking cessation treatment is not routinely offered to smoking patients diagnosed with cancer. PMID:25029652

  12. The New Neck Design for the Rear-End Impact Dummy, BioRID I

    PubMed Central

    Linder, Astrid; Svensson, Mats Y; Davidsson, Johan; Flogård, Anders; Håland, Yngve; Jakobsson, Lotta; Lövsund, Per; Wiklund, Kristina

    1998-01-01

    A new mechanical neck was developed for a new dummy possessing a complete articulated spine, for low speed rear-end collisions. The new neck consists of seven cervical elements connected by hinge joints. The neck stiffness properties were created by rubber blocks between each pair of vertebrae in combination with simulated muscle elements between the head and T1. The neck was validated against volunteer tests (?v of 7 km/h) results. Both displacement and acceleration of the head relative to the upper torso for both duration and peak values, were in agreement with the volunteer data.

  13. Knowledge and Screening of Head and Neck Cancer Among American Indians in South Dakota.

    PubMed

    Dwojak, Sunshine; Deschler, Daniel; Sargent, Michele; Emerick, Kevin; Guadagnolo, B Ashleigh; Petereit, Daniel

    2014-10-16

    Objectives. We established the level of awareness of risk factors and early symptoms of head and neck cancer among American Indians in South Dakota and determined whether head and neck cancer screening detected clinical findings in this population. Methods. We used the European About Face survey. We added questions about human papillomavirus, a risk factor for head and neck cancer, and demographics. Surveys were administered at 2 public events in 2011. Participants could partake in a head and neck cancer screening at the time of survey administration. Results. Of the 205 American Indians who completed the survey, 114 participated in the screening. Mean head and neck cancer knowledge scores were 26 out of 44. Level of education was the only factor that predicted higher head and neck cancer knowledge (b?=?0.90; P?=?.01). Nine (8%) people had positive head and neck cancer screening examination results. All abnormal clinical findings were in current or past smokers (P?=?.06). Conclusions. There are gaps in American Indian knowledge of head and neck cancer risk factors and symptoms. Community-based head and neck cancer screening in this population is feasible and may be a way to identify early abnormal clinical findings in smokers. (Am J Public Health. Published online ahead of print October 16, 2014: e1-e6. doi:10.2105/AJPH.2014.302177). PMID:25320895

  14. [The indication of panendoscopy in the search for synchronous and metachronous head and neck cancer].

    PubMed

    Dulguerov, N; Dulguerov, P

    2013-10-01

    Head and neck cancer result from excessive tobacco and alcohol consumption. The survival has not improved in the last decades despite better loco-regional control, mainly because of secondary cancers. Head and neck cancer is associated to a high rate of synchronous esophageal and lung tumors and an annual 4% rate of new metachronous malignancies. The role of panendoscopy is evolving: a flexible esophagoscopy with Lugol's iodine staining should be performed and a chest CT-scan should replace bronchoscopy. During follow-up, metachronous malignancy should be searched for in the head and neck region; investigation beyond the head and neck is questionable since prognosis is poor. PMID:24187750

  15. Stanford University School of Medicine Department of Otolaryngology/Head & Neck

    E-print Network

    Bogyo, Matthew

    Stanford University School of Medicine Department of Otolaryngology/Head & Neck Surgery Resident ............................................................................................................................................ 4 2. STANFORD UNIVERSITY OTOLARYNGOLOGY FACULTY ROSTER ................................................ 5 3. OTOLARYNGOLOGY RESIDENCY APPLICATION REQUIREMENTS

  16. Neck pain in military helicopter aircrew and the role of exercise therapy.

    PubMed

    Salmon, Danielle M; Harrison, Michael F; Neary, J Patrick

    2011-10-01

    Neck pain is a growing aeromedical concern for military forces on an international scale. Neck pain prevalence in the global military helicopter community has been reported in the range of 56.6-84.5%. Despite this high prevalence, historically, research examining helicopter aircrews has focused predominantly on low back pain. A number of recent studies have emerged examining flight-related factors that are hypothesized to contribute to the development of flight-related neck pain. Loading factors such as the posture adopted during flight, use of night vision goggles, and vibration have all been found to contribute to neck pain and muscular fatigue. Prolonged or repeated exposureto these loading factors has been hypothesized to perpetuate or contribute to the development of neck pain. Despite the high number of helicopter aircrew personnel that suffer from neck pain, very few individuals seek treatment for the disorder. The focus of medical personnel should, therefore, be directed toward a solution that addresses not only the issue of muscular fatigue, but the hesitancy to seek treatment. Previous research in military and civilian populations have used exercise therapy as a treatment modality for neck pain and have found improved endurance capacity in the neck musculature and reduced self-reported neck pain. PMID:21961403

  17. Effects of spiral taping applied to the neck and ankle on the body balance index

    PubMed Central

    Lee, Byung Hoon; Lee, Hye Rim; Kim, Kyeong Mi; Lee, Jeong Hun; Kim, Kyung Yoon

    2015-01-01

    [Purpose] This study was performed to investigate the changes in the body balance index when spiral taping is applied to the neck and ankle. The findings are expected to serve as evidence of the usefulness of taping the neck instead of the ankle when ankle taping is not feasible in clinical practice. [Subjects and Methods] Twenty healthy male students at A university were enrolled in this study. Balance measurements were made under three conditions: no intervention, ankle intervention and neck intervention. Static balance was measured with subjects’ eyes open and closed, and dynamic balance was measured with subjects’ eyes closed. [Results] There were significant differences in dynamic balance assessed by the Overall Balance Index (OBI), and the Anteroposterior Balance Index (ABI) with subjects’ eyes open when ankle or neck taping was applied compared to no intervention. The static balance (OBI) of subjects with eyes open showed significant differences from the no intervention condition in both the ankle and neck intervention. The static balance (OBI) with subjects’ eyes closed also showed significant differences in both the ankle and neck interventions compared to the no intervention condition. [Conclusion] Our results indicate that neck taping stimulates the somatic senses around the neck and increase proprioception, resulting in balance improvement similar to that elicited by ankle taping. Further studies with larger sample sizes various experimental conditions should be performed to more systematically and objectively elucidate the effects of neck taping. PMID:25642043

  18. Correlative Tomography

    PubMed Central

    Burnett, T. L.; McDonald, S. A.; Gholinia, A.; Geurts, R.; Janus, M.; Slater, T.; Haigh, S. J.; Ornek, C.; Almuaili, F.; Engelberg, D. L.; Thompson, G. E.; Withers, P. J.

    2014-01-01

    Increasingly researchers are looking to bring together perspectives across multiple scales, or to combine insights from different techniques, for the same region of interest. To this end, correlative microscopy has already yielded substantial new insights in two dimensions (2D). Here we develop correlative tomography where the correlative task is somewhat more challenging because the volume of interest is typically hidden beneath the sample surface. We have threaded together x-ray computed tomography, serial section FIB-SEM tomography, electron backscatter diffraction and finally TEM elemental analysis all for the same 3D region. This has allowed observation of the competition between pitting corrosion and intergranular corrosion at multiple scales revealing the structural hierarchy, crystallography and chemistry of veiled corrosion pits in stainless steel. With automated correlative workflows and co-visualization of the multi-scale or multi-modal datasets the technique promises to provide insights across biological, geological and materials science that are impossible using either individual or multiple uncorrelated techniques. PMID:24736640

  19. Correlation Correlogram

    E-print Network

    Wrigley, Stuart

    Network Correlation Neural Oscillator Correlogram CrossHair cell Cochlear Filtering Signal oscillator is combination of raw input (Ir - based on segments), global inhibition and network activity oscillators is active, all others are suppressed; i.e. only one group can be active at any one time. Io Ir Wz

  20. Acupuncture at Houxi (SI 3) acupoint for acute neck pain caused by stiff neck: study protocol for a pilot randomised controlled trial

    PubMed Central

    Sun, Zhong-ren; Yue, Jin-huan; Tian, Hong-zhao; Zhang, Qin-hong

    2014-01-01

    Introduction The use of acupuncture has been suggested for the treatment of acute neck pain caused by stiff neck in China. However, current evidence is insufficient to draw any conclusions about its efficacy. Therefore this pilot study was designed to evaluate the feasibility and efficacy of acupuncture at the Houxi (SI3) acupoint for treatment of acute neck pain. Methods/analysis This pilot study will be a two-parallel-group, assessor-blinded, randomised controlled trial. Thirty-six stiff neck participants with acute neck pain will be recruited and randomly divided into two groups in a 1:1 ratio. Participants in the control group will receive massage on the local neck region (5?min each session, three times a day for 3?days). In addition to massage, patients in the treatment group will receive acupuncture (one session a day for 3?days). Measures will be taken at 0, 3 and 15?days. The primary outcome is the Northwick Park Neck Pain Questionnaire (NPQ). The secondary outcome is the Short Form of the McGill Pain Questionnaire (SF-MPQ). Ethics/dissemination The protocol for this pilot randomised clinical trial has undergone ethics scrutiny and been approved by the ethics review boards of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine (Permission number: HZYLL201303502). The findings of this study will provide important clinical evidence on the feasibility and efficacy of acupuncture treatment for stiff neck patients with acute neck pain. In addition, it will explore the feasibility of further acupuncture research. Trial registration number ChiCTR-TRC-13003911. PMID:25537784

  1. Dosimetric Comparison of Split Field and Fixed Jaw Techniques for Large IMRT Target Volumes in the Head and Neck

    SciTech Connect

    Srivastava, Shiv P. [Department of Radiation Oncology, Reid Hospital and Health Care Services Richmond, IN (United States); Das, Indra J., E-mail: Idas@IUpui.ed [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States); Kumar, Arvind [Department of Radiation Oncology, Reid Hospital and Health Care Services Richmond, IN (United States); Johnstone, Peter A.S. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States)

    2011-04-01

    Some treatment planning systems (TPSs), when used for large-field (>14 cm) intensity-modulated radiation therapy (IMRT), create split fields that produce excessive multiple-leaf collimator segments, match-line dose inhomogeneity, and higher treatment times than nonsplit fields. A new method using a fixed-jaw technique (FJT) forces the jaw to stay at a fixed position during optimization and is proposed to reduce problems associated with split fields. Dosimetric comparisons between split-field technique (SFT) and FJT used for IMRT treatment is presented. Five patients with head and neck malignancies and regional target volumes were studied and compared with both techniques. Treatment planning was performed on an Eclipse TPS using beam data generated for Varian 2100C linear accelerator. A standard beam arrangement consisting of nine coplanar fields, equally spaced, was used in both techniques. Institutional dose-volume constraints used in head and neck cancer were kept the same for both techniques. The dosimetric coverage for the target volumes between SFT and FJT for head and neck IMRT plan is identical within {+-}1% up to 90% dose. Similarly, the organs at risk (OARs) have dose-volume coverage nearly identical for all patients. When the total monitor unit (MU) and segments were analyzed, SFT produces statistically significant higher segments (17.3 {+-} 6.3%) and higher MU (13.7 {+-} 4.4%) than the FJT. There is no match line in FJT and hence dose uniformity in the target volume is superior to the SFT. Dosimetrically, SFT and FJT are similar for dose-volume coverage; however, the FJT method provides better logistics, lower MU, shorter treatment time, and better dose uniformity. The number of segments and MU also has been correlated with the whole body radiation dose with long-term complications. Thus, FJT should be the preferred option over SFT for large target volumes.

  2. Psychometric characteristics of the Spanish version of instruments to measure neck pain disability

    PubMed Central

    Kovacs, Francisco M; Bagó, Joan; Royuela, Ana; Seco, Jesús; Giménez, Sergio; Muriel, Alfonso; Abraira, Víctor; Martín, José Luis; Peña, José Luis; Gestoso, Mario; Mufraggi, Nicole; Núñez, Montserrat; Corcoll, Josep; Gómez-Ochoa, Ignacio; Ramírez, Ma José; Calvo, Eva; Castillo, Ma Dolores; Martí, David; Fuster, Salvador; Fernández, Carmen; Gimeno, Nuria; Carballo, Alejandro; Milán, Álvaro; Vázquez, Dolores; Cañellas, Montserrat; Blanco, Ricardo; Brieva, Pilar; Rueda, Ma Trinidad; Álvarez, Luis; del Real, María Teresa Gil; Ayerbe, Joaquín; González, Luis; Ginel, Leovigildo; Ortega, Mariano; Bernal, Miryam; Bolado, Gonzalo; Vidal, Anna; Ausín, Ana; Ramón, Domingo; Mir, María Antonia; Tomás, Miquel; Zamora, Javier; Cano, Alejandra

    2008-01-01

    Background The NDI, COM and NPQ are evaluation instruments for disability due to NP. There was no Spanish version of NDI or COM for which psychometric characteristics were known. The objectives of this study were to translate and culturally adapt the Spanish version of the Neck Disability Index Questionnaire (NDI), and the Core Outcome Measure (COM), to validate its use in Spanish speaking patients with non-specific neck pain (NP), and to compare their psychometric characteristics with those of the Spanish version of the Northwick Pain Questionnaire (NPQ). Methods Translation/re-translation of the English versions of the NDI and the COM was done blindly and independently by a multidisciplinary team. The study was done in 9 primary care Centers and 12 specialty services from 9 regions in Spain, with 221 acute, subacute and chronic patients who visited their physician for NP: 54 in the pilot phase and 167 in the validation phase. Neck pain (VAS), referred pain (VAS), disability (NDI, COM and NPQ), catastrophizing (CSQ) and quality of life (SF-12) were measured on their first visit and 14 days later. Patients' self-assessment was used as the external criterion for pain and disability. In the pilot phase, patients' understanding of each item in the NDI and COM was assessed, and on day 1 test-retest reliability was estimated by giving a second NDI and COM in which the name of the questionnaires and the order of the items had been changed. Results Comprehensibility of NDI and COM were good. Minutes needed to fill out the questionnaires [median, (P25, P75)]: NDI. 4 (2.2, 10.0), COM: 2.1 (1.0, 4.9). Reliability: [ICC, (95%CI)]: NDI: 0.88 (0.80, 0.93). COM: 0.85 (0.75,0.91). Sensitivity to change: Effect size for patients having worsened, not changed and improved between days 1 and 15, according to the external criterion for disability: NDI: -0.24, 0.15, 0.66; NPQ: -0.14, 0.06, 0.67; COM: 0.05, 0.19, 0.92. Validity: Results of NDI, NPQ and COM were consistent with the external criterion for disability, whereas only those from NDI were consistent with the one for pain. Correlations with VAS, CSQ and SF-12 were similar for NDI and NPQ (absolute values between 0.36 and 0.50 on day 1, between 0.38 and 0.70 on day 15), and slightly lower for COM (between 0.36 and 0.48 on day 1, and between 0.33 and 0.61 on day 15). Correlation between NDI and NPQ: r = 0.84 on day 1, r = 0.91 on day 15. Correlation between COM and NPQ: r = 0.63 on day 1, r = 0.71 on day 15. Conclusion Although most psychometric characteristics of NDI, NPQ and COM are similar, those from the latter one are worse and its use may lead to patients' evolution seeming more positive than it actually is. NDI seems to be the best instrument for measuring NP-related disability, since its results are the most consistent with patient's assessment of their own clinical status and evolution. It takes two more minutes to answer the NDI than to answer the COM, but it can be reliably filled out by the patient without assistance. Trial Registration Clinical Trials Register NCT00349544. PMID:18400084

  3. Alternative Agents to Prevent Fogging in Head and Neck Endoscopy

    PubMed Central

    Piromchai, Patorn; Kasemsiri, Pornthep; Thanaviratananich, Sanguansak

    2011-01-01

    Background: The essential factor for diagnosis and treatment of diseases in head and neck endoscopy is the visibility of the image. An anti-fogging agent can reduce this problem by minimizing surface tension to prevent the condensation of water in the form of small droplets on a surface. There is no report on the use of hibiscrub® or baby shampoo to reduce fogging in the literature. The objective of this study was to compare the efficacy between commercial anti-fogging agent, hibiscrub® and baby shampoo to reduce fogging for the use in head and neck endoscopy. Methods: The study was conducted at the Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University in August 2010. Commercial anti-fogging agent, baby shampoo and hibiscrub® were applied on rigid endoscope lens before putting them into a mist generator. The images were taken at baseline, 15 seconds, 30 seconds and 1 minute. The images’ identifiers were removed before they were sent to two evaluators. A visual analogue scale (VAS) was used to rate the image quality from 0 to 10. Results: The difference in mean VAS score between anti-fogging agent, baby shampoo and hibiscrub® versus no agent were 5.46, 4.45 and 2.1 respectively. The commercial anti-fogging agent and baby shampoo had most protective benefit and performed significantly better than no agent (P = 0.05). Conclusions: Baby shampoo is an effective agent to prevent fogging during head and neck endoscopy and compares favourably with commercial anti-fogging agent. PMID:24179399

  4. High-risk HPV types and head and neck cancer.

    PubMed

    Michaud, Dominique S; Langevin, Scott M; Eliot, Melissa; Nelson, Heather H; Pawlita, Michael; McClean, Michael D; Kelsey, Karl T

    2014-10-01

    Although HPV16 has been strongly implicated in oropharyngeal carcinogenesis, the role of other high-risk HPV types in the etiology of head and neck cancer remains unclear. To date, few data exist addressing the nature of the association between antibodies to oncogenic proteins of non-HPV16 HPVs in relation to head and neck cancer. We examined the relationship between multiple HPV types (HPV6, 11, 16, 18, 31, 33, 45, 52, 58) and head and neck squamous cell carcinoma (HNSCC) in a large population-based case-control study (1069 cases and 1107 controls). Serological measures for HPV types included antibodies to L1, E6 and/or E7. In a secondary analysis, we excluded HPV16 seropositive subjects to examine independent associations with other high-risk HPVs. All analyses were adjusted for age, race, sex, education, smoking and alcohol consumption. Statistically significant associations were observed for HPV16, 18, 33 and 52 and risk of HNSCC after mutually adjusting for HPV types. Among HPV16 seronegative subjects, elevated risks of HNSCC were observed for HPV18 E6 (OR = 4.19, 95% CI = 1.26-14.0), HPV33 E6 (OR = 7.96, 95% CI = 1.56-40.5) and HPV52 E7 (OR = 3.40, 95% CI = 1.16-9.99). When examined by tumor type, associations with HPV18 and HPV33 remained statistically significant for oropharyngeal cancer, and HPV52 was associated with oral cancer. In addition, magnitude of associations for HNSCC increased markedly with increasing number of seropositive high-risk HPV infections. High-risk HPV types, other than HPV16, are likely to be involved in the etiology of HNSCC. PMID:24615247

  5. Emergency imaging assessment of deep neck space infections.

    PubMed

    Maroldi, Roberto; Farina, Davide; Ravanelli, Marco; Lombardi, Davide; Nicolai, Piero

    2012-10-01

    Deep neck space infection may lead to severe and potentially life-threatening complications, such as airway obstruction, mediastinitis, septic embolization, dural sinus thrombosis, and intracranial abscess. The clinical presentation is widely variable, and often early symptoms do not reflect the disease severity. The complication risk depends on the extent and anatomical site: diseases that transgress fascial boundaries and spread along vertically oriented spaces (parapharyngeal, retropharyngeal, and paravertebral space) have a higher risk of complications and require a more aggressive treatment compared with those confined within a nonvertically oriented space (peritonsillar, sublingual, submandibular, parotid, and masticator space). Imaging has 5 crucial roles: (1) confirm the suspected clinical diagnosis, (2) define the precise extent of the disease, (3) identify complications, (4) distinguish between drainable abscesses and cellulitis, and (5) monitor deep neck space infection progression. Ultrasonography is the gold standard to differentiate abscesses from cellulitis, for the diagnosis of lymphadenitis. and to identify internal jugular thrombophlebitis in the infrahyoid neck. However, field-of-view limitation and poor anatomical information confine the use of ultrasonography to the evaluation of superficial lesions and to image-guided aspiration or drainage. Computed tomography (CT) combines fast image acquisition and precise anatomical information without field-of-view limitations. For these reasons, it is the most reliable technique for the evaluation of deep and multicompartment lesions and for the identification of mediastinal and intracranial complications. Contrast agent administration enhances the capability to differentiate fluid collections from cellulitis and allows the detection of vascular complications. Magnetic resonance imaging is more time-consuming than CT, limiting its use to selected indications. It is the technique of choice for assessing the epidural space involvement in pre- and paravertebral space infections and complements CT in the evaluation of the infections reaching the skull base. PMID:22964409

  6. Neck muscle afferents influence oromotor and cardiorespiratory brainstem neural circuits.

    PubMed

    Edwards, I J; Lall, V K; Paton, J F; Yanagawa, Y; Szabo, G; Deuchars, S A; Deuchars, J

    2014-03-01

    Sensory information arising from the upper neck is important in the reflex control of posture and eye position. It has also been linked to the autonomic control of the cardiovascular and respiratory systems. Whiplash associated disorders (WAD) and cervical dystonia, which involve disturbance to the neck region, can often present with abnormalities to the oromotor, respiratory and cardiovascular systems. We investigated the potential neural pathways underlying such symptoms. Simulating neck afferent activity by electrical stimulation of the second cervical nerve in a working heart brainstem preparation (WHBP) altered the pattern of central respiratory drive and increased perfusion pressure. Tracing central targets of these sensory afferents revealed projections to the intermedius nucleus of the medulla (InM). These anterogradely labelled afferents co-localised with parvalbumin and vesicular glutamate transporter 1 indicating that they are proprioceptive. Anterograde tracing from the InM identified projections to brain regions involved in respiratory, cardiovascular, postural and oro-facial behaviours-the neighbouring hypoglossal nucleus, facial and motor trigeminal nuclei, parabrachial nuclei, rostral and caudal ventrolateral medulla and nucleus ambiguus. In brain slices, electrical stimulation of afferent fibre tracts lateral to the cuneate nucleus monosynaptically excited InM neurones. Direct stimulation of the InM in the WHBP mimicked the response of second cervical nerve stimulation. These results provide evidence of pathways linking upper cervical sensory afferents with CNS areas involved in autonomic and oromotor control, via the InM. Disruption of these neuronal pathways could, therefore, explain the dysphagic and cardiorespiratory abnormalities which may accompany cervical dystonia and WAD. PMID:24595534

  7. Human head-neck biomechanics under axial tension.

    PubMed

    Yoganandan, N; Pintar, F A; Maiman, D J; Cusick, J F; Sances, A; Walsh, P R

    1996-06-01

    A significant majority of cervical spine biomechanics studies has applied the external loading in the form of compressive force vectors. In contrast, there is a paucity of data on the tensile loading of the neck structure. These data are important as the human neck not only resists compression but also has to withstand distraction due to factors such as the anatomical characteristics and loading asymmetry. Furthermore, evidence exists implicating tensile stresses to be a mechanism of cervical spinal cord injury. Recent advancements in vehicular restraint systems such as air bags may induce tension to the neck in adverse circumstances. Consequently, this study was designed to develop experimental methodologies to determine the biomechanics of the human cervical spinal structures under distractive forces. A part-to-whole approach was used in the study. Four experimental models from 15 unembalmed human cadavers were used to demonstrate the feasibility of the methodology. Structures included isolated cervical spinal cords, intervertebral disc units, skull to T3 preparations, and intact unembalmed human cadavers. Axial tensile forces were applied, and the failure load and distraction were recorded. Stiffness and energy absorbing characteristics were computed. Maximum forces for the spinal cord specimens were the lowest (278 N +/- 90). The forces increased for the intervertebral disc (569 N +/- 54). skull to T3 (1555 N +/- 459), and intact human cadaver (3373 N +/- 464) preparations, indicating the load-carrying capacities when additional components are included to the experimental model. The experimental methodologies outlined in the present study provide a basis for further investigation into the mechanism of injury and the clinical applicability of biomechanical parameters. PMID:8782187

  8. Neck pain patients’ preference scores for their current health

    Microsoft Academic Search

    Gabrielle van der Velde; Sheilah Hogg-Johnson; Ahmed M. Bayoumi; Pierre Côté; Hilary Llewellyn-Thomas; Eric L. Hurwitz; Murray Krahn

    2010-01-01

    Purpose  To elicit neck pain (NP) patients’ preference scores for their current health, and investigate the association between their\\u000a scores and NP disability.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Rating scale scores (RSs) and standard gamble scores (SGs) for current health were elicited from chronic NP patients (n = 104) and patients with NP following a motor vehicle accident (n = 116). Patients were stratified into Von Korff Pain Grades: Grade

  9. Deep space neck infection: principles of surgical management.

    PubMed

    Osborn, Timothy M; Assael, Leon A; Bell, R Bryan

    2008-08-01

    Knowledge of the management of infections of the deep spaces of the neck is essential to the daily practice of oral and maxillofacial surgery. Timely decisions must be made through the acute course of the disease. Interventions must be performed with the appropriate surgical skill. The surgeon must decide on medical and surgical management, including antibiotic selection, how to employ supportive resuscitative care, when to operate, what procedures to perform, and how to secure the airway. To make these decisions the surgeon must understand the anatomy of the region and the etiology of infection, appropriate diagnostic workup, and medical and surgical management. This article provides a review of these pertinent topics. PMID:18603196

  10. Immunochemistry and electron microscopy of head and neck rhabdomyoma.

    PubMed Central

    Helliwell, T R; Sissons, M C; Stoney, P J; Ashworth, M T

    1988-01-01

    Rhabdomyomas are rare benign tumours originating in skeletal or cardiac muscle. Extracardiac tumours are usually situated in the head and neck. Four cases are presented, three arising in the larynx and the other in the cervical region. All four cases were studied by light and electron microscopy, and in three immunohistochemical staining for myoglobin, desmin, and vimentin was carried out to study the diagnostic features of the lesions and their histogenesis. Images Fig 1 Fig 2 Fig 3 Fig 4 Fig 5 Fig 6 Fig 7 Fig 8 Fig 9 Fig 10 PMID:3056977

  11. Advanced techniques in radiation therapy for head and neck cancers.

    PubMed

    Mittal, B B

    1991-12-01

    This article focuses on a number of innovative radiotherapeutic methods to improve local and regional control with increased chances of preservation of normal function compared with the use of standard external beam irradiation alone in the management of selected head and neck cancers. Some of these radiotherapeutic techniques are well established (brachytherapy and neutron therapy in advanced salivary gland tumors); some have a large body of experience accumulated and are currently being investigated in phase III trials (thermoradiotherapy and altered fractionation); whereas the other techniques (intraoperative therapy, charged-particle therapy, and sterotactic radiosurgery) are highly experimental. PMID:1792085

  12. Intravascular small cell neuroendocrine tumor in the neck.

    PubMed

    Chang, Chian A; Jong, Ian; Nowicki, Anna; Ramdave, Shakher

    2014-11-01

    A 40-year-old man presented with a painless enlarging right neck mass over several weeks without a history of trauma or infection. Ultrasound, contrast-enhanced CT, and MRI showed a mass in an expanded vein extending into the parotid gland. Blood-stained fine-needle aspiration biopsy demonstrated atypical lymphoid cells, but there was insufficient material for a diagnosis. The mass was intensely avid on 18F-FDG PET/CT and was suggestive of a neoplasm. Excision confirmed a mass within the external jugular vein with areas of invasion through the vessel wall. A diagnosis of small cell neuroendocrine carcinoma was made on histology. PMID:24978335

  13. Cancer Stem Cells in Head and Neck Cancer

    PubMed Central

    Mitra, Doyel; Malkoski, Stephen P.; Wang, Xiao-Jing

    2011-01-01

    Head and neck cancer (HNC) is the sixth most common malignancy world-wide, however the survival rate has not improved for the past 20 years. In recent years, the cancer stem cell (CSC) hypothesis has gained ground in several malignancies and there is mounting evidence suggesting CSCs mediate tumor resistance to chemotherapy and radiation therapy. However, the CSC theory is also challenged at least in certain types of cancer. Here we review the progress of CSC studies in HNC, which suggest that HNC conforms to the CSC model. The identified CSC markers and their tumor initiation properties provide a framework for the development of novel therapeutic strategies for HNC. PMID:24212622

  14. Chemotherapy advances in locally advanced head and neck cancer

    PubMed Central

    Georges, Peter; Rajagopalan, Kumar; Leon, Chady; Singh, Priya; Ahmad, Nadir; Nader, Kamyar; Kubicek, Gregory J

    2014-01-01

    The management of locally advanced unresectable head and neck squamous cell cancer (HNSCC) continues to improve. One of the major advances in the treatment of HNSCC was the addition of chemotherapy to radiation in the treatment of non-surgical patients. The majority of the data regarding chemotherapy in HNSCC involve cisplatin chemotherapy with concurrent radiation. However, several new approaches have included targeted therapy against epidermal growth factor receptor and several recent studies have explored the role of induction chemotherapy in the treatment of HNSCC. The purpose of this article is to provide an overview of the role of chemotherapy in the treatment of locally advanced HNSCC. PMID:25493232

  15. Recurrent chylous pericardial effusion and left neck mass.

    PubMed

    Gilmore, Denis; Colson, Yolonda L

    2012-12-01

    We present a case of a woman initially presenting with a neck mass and subsequently found to have generalized lymphatic anomaly with diffuse lymphatic dilation and proliferation involving the mediastinum and pericardium. Intrathoracic involvement of generalized lymphatic anomalies can lead to recurrent pleural effusions, pericardial effusions, and severe respiratory infections. These anomalies cannot be cured and significantly impact quality of life. Multidisciplinary involvement is crucial to maximize symptom relief as surgery to remove lymphatics can be morbid and the disease is usually recurrent. PMID:23165758

  16. Dynamic necking in materials with strain induced martensitic transformation

    NASA Astrophysics Data System (ADS)

    Zaera, R.; Rodríguez-Martínez, J. A.; Vadillo, G.; Fernández-Sáez, J.

    2014-03-01

    This work investigates the interplay between inertia and strain induced martensitic transformation (SIMT) on necking inception and energy absorption in dynamically stretched cylindrical rods. For that task a linear stability technique, derived within a quasi-1D framework and specifically accounting for SIMT, has been developed. Likewise, finite element simulations have been performed, using a specific constitutive equation to consider SIMT. Stability analysis and numerical simulations demonstrate that, at high strain rates, inertia may take the dominant role in stabilizing the material, on top of the transformation hardening effects. Furthermore, under certain loading conditions the martensitic transformation may penalize either ductility or energy absorption capacity.

  17. [Head and neck squamous cell carcinoma: What's new in 2009].

    PubMed

    Badoual, Cécile; Péré, Hélène; Cros, Jérôme; Roussel, Hélène

    2009-09-01

    Classical epidermoid carcinoma is the most frequent head and neck malignant neoplasm. Some particular variants are nevertheless of interest as they harbor a different prognosis, require specific care management and may arise from an alternate oncogenesis path. Best examples are verrucous carcinoma, basal-like or spindle cell carcinoma. Recent studies pointed out the critical role of infection with oncogenic HPV strains in the development of these carcinomas, especially in the oropharynx. In addition, HPV infection is changing the epidemiological profile of these cancers seems to have a prognostic value. New targeted therapies and prognostic markers will be discussed as they may dramatically improve the outcome of these tumors. PMID:19900632

  18. Characterization of squamous cell carcinomas of the head and neck using methods of spatial statistics.

    PubMed

    Mattfeldt, T; Fleischer, F

    2014-10-01

    In the present study, 53 cases of squamous cell carcinomas of the head and neck were characterized by a quantitative histological texture analysis based on principles of spatial statistics. A planar tessellation of the epithelial tumour component was generated by a skeletonization algorithm. The size distribution of the virtual cells of this planar tessellation, and the size distribution of the profiles of the tumour cell nuclei were estimated in terms of area and boundary length. The intensity, the reduced second moment function (K-function) and the pair correlation function of the point process of the centroids of the profiles of the tumour cell nuclei were also estimated. For both purposes, it is necessary to correct for edge effects, which we consider in this paper in some detail. Specifically, the point patterns of the tumour cell nuclei were considered as realizations of a point process, where the points exist only in the epithelial tumour component (the permitted phase) and not in the stroma (the forbidden phase). The methods allow to characterize each individual tumour by a series of summary statistics. The total set of cases was then partitioned into two groups: 19 cases without lymph node metastases (pN0), and 34 nodal positive cases (pN1 or pN2). Statistical analysis showed no significant differences between the intensities, the mean K-functions and the mean pair correlation functions of the tumour cell nucleus profiles of the two groups. However, there were some significant differences between the sizes of the virtual cells and of the nucleus profiles of the nodal negative cases as compared to the nodal positive cases. In a logistic regression analysis, one of the quantitative nuclear size variables (mean nuclear area) was found to be a significant predictor of lymph node metastasis, in addition to tumour stage. The study shows the potential of methods of spatial statistics for objective quantitative grading of squamous cell carcinomas of the head and neck, and provides an example for modelling histological point patterns as realizations of planar point processes occupying a reference phase which is only a partial component of the total tissue. PMID:25142175

  19. In July 2011, Raj Manek '94 visited a giraffe sanctuary in nairobi, Kenya, and was neck-and-neck with a Rothschild giraffe, an endangered species. Boundless curiosity takes Manek around the

    E-print Network

    de Lijser, Peter

    In July 2011, Raj Manek '94 visited a giraffe sanctuary in nairobi, Kenya, and was neck-and-neck with a Rothschild giraffe, an endangered species. Boundless curiosity takes Manek around the world, both with his

  20. The Relationship Between Human Papillomavirus Status and Other Molecular Prognostic Markers in Head and Neck Squamous Cell Carcinomas

    SciTech Connect

    Kong, Christina S. [Department of Pathology, Stanford University, Santa Cruz, CA (United States); Narasimhan, Balasubramanian [Department of Statistics, Stanford University, Santa Cruz, CA (United States); Cao Hongbin [Department of Radiation Oncology, Stanford University, Santa Cruz, CA (United States); Kwok, Shirley [Department of Pathology, Stanford University, Santa Cruz, CA (United States); Erickson, Julianna P. [Biochemistry-Genome Center, Stanford University, Santa Cruz, CA (United States); Koong, Albert [Department of Radiation Oncology, Stanford University, Santa Cruz, CA (United States); Pourmand, Nader [Biochemistry-Genome Center, Stanford University, Santa Cruz, CA (United States); Department of Biomolecular Engineering, University of California, Santa Cruz, CA (United States); Le, Quynh-Thu [Department of Radiation Oncology, Stanford University, Santa Cruz, CA (United States)], E-mail: qle@stanford.edu

    2009-06-01

    Purpose: To evaluate the relationship between human papillomavirus (HPV) status and known prognostic makers for head and neck cancers including tumor hypoxia, epidermal growth factor receptor (EGFR) expression and intratumoral T-cell levels and to determine the prognostic impact of these markers by HPV status. Methods and Materials: HPV status in 82 evaluable head and neck squamous cell carcinomas patients was determined by pyrosequencing and related to p16{sup INK4a} staining and treatment outcomes. It was correlated with tumor hypoxia (tumor pO{sub 2} and carbonic anhydrase [CAIX] staining), EGFR status, and intratumoral lymphocyte expression (CD3 staining). Results: Forty-four percent of evaluable tumors had strong HPV signal by pyrosequencing. There was a significant relationship between strong HPV signal and p16{sup INK4a} staining as well as oropharynx location. The strong HPV signal group fared significantly better than others, both in time to progression (TTP, p = 0.008) and overall survival (OS, p = 0.004) for all patients and for the oropharyngeal subset. Positive p16{sup INK4a} staining was associated with better TTP (p = 0.014) and OS (p = 0.00002). There was no relationship between HPV status and tumor pO{sub 2} or CAIX staining. However, HPV status correlated inversely with EGFR reactivity (p = 0.0006) and directly with CD3(+) T-lymphocyte level (p = 0.03). Whereas CAIX and EGFR overexpression were negative prognostic factors regardless of HPV status, CD3(+) T-cell levels was prognostic only in HPV(-) tumors. Conclusion: HPV status was a prognostic factor for progression and survival. It correlated inversely with EGFR expression and directly with T-cell infiltration. The prognostic effect of CAIX and EGFR expression was not influenced by HPV status, whereas intratumoral T-cell levels was significant only for HPV(-) tumors.

  1. Radiation related morbidities and their impact on quality of life in head and neck cancer patients receiving radical radiotherapy.

    PubMed

    Bansal, M; Mohanti, B K; Shah, N; Chaudhry, R; Bahadur, S; Shukla, N K

    2004-03-01

    Although 50-70% of head and neck cancer patients in India receive radiotherapy (RT), radiation-related acute and late morbidities and their impact on quality of life (QOL) are infrequently reported. Acute and late radiation morbidities and QOL were assessed in a prospective longitudinal study of 45 patients with head and neck cancers receiving radical RT to a dose of 7000 cGy in conventional fractionation. Grade II acute morbidities experienced by the largest percent of the sample during the course of RT pertained to the mucosa (66.4%), salivary gland (84%), and oesophagus (53%). These morbidities led to an increase in the symptom scores of appetite loss (76.46), fatigue (65.75) and pain (44.77). This increase in the symptom scores consequently led to a significant decline in physical, social and emotional functioning as well as global health status score during the course of RT (p < 0.001). Scores improved after 1 month of RT but did not reach the pre-RT value. Future studies may consider correlating QOL assessment to significant patient and disease related parameters such as performance status, weight loss, stage and site of disease. PMID:15085920

  2. Successful management of simple fractures of the femoral neck with femoral head and neck excision arthroplasty in two free-living avian species.

    PubMed

    Burgdorf-Moisuk, Anne; Whittington, Julia K; Bennett, R Avery; McFadden, Mike; Mitchell, Mark; O'Brien, Robert

    2011-09-01

    A red-tailed hawk (Buteo jamaicensis) and a Canada goose (Branta canadensis) were evaluated for unilateral pelvic limb lameness. Physical examination findings and results of diagnostic imaging revealed femoral neck fractures in both birds. Both birds were treated with a femoral head and neck excision arthroplasty. The affected legs were not immobilized, and the birds were encouraged to use the legs immediately after surgery to encourage formation of a pseudoarthrosis. Within 2 weeks, both birds were using the affected limb well enough to be either successfully released or transferred to a wildlife rehabilitation facility. Femoral head and neck excision arthroplasty without immobilization of the limb is recommended for managing avian femoral neck fractures, especially in free-ranging species in which a rapid and complete or near complete return to function is vital for survival in the wild. PMID:22216722

  3. Comprehensive Genomic Characterization of Squamous Cell Carcinoma of the Head and Neck - David Neil Hayes, TCGA Scientific Symposium 2012

    Cancer.gov

    Home News and Events Multimedia Library Videos Characterization of Squamous Cell Carcinoma of the Head and Neck - David Neil Hayes Comprehensive Genomic Characterization of Squamous Cell Carcinoma of the Head and Neck - David Neil Hayes, TCGA Scientific

  4. Functional capabilities of devices for unidimensional echography in the diagnosis of head and neck tumors

    Microsoft Academic Search

    A. A. Fazylov; A. M. Dusmuratov

    1983-01-01

    Of great practical interest is the use of unidimensional echographic instruments to diagnose head and neck tumors because the complexity of the topographic anatomy in this region creates special difficulties when using two-dimensional echographic instruments. However, the lack of articles investigating the functional capabilities of instruments for unidimensional echography and diagnosis of head and neck tumors hampers their application in

  5. Neck Muscle Paths and Moment Arms are Significantly Affected by Wrapping Surface Parameters

    E-print Network

    Krishnamoorthy, Bala

    Neck Muscle Paths and Moment Arms are Significantly Affected by Wrapping Surface Parameters.S.A. *Corresponding author. Email: vasavada@wsu.edu We have studied the effects of wrapping surfaces on muscle paths and moment arms of the semispinalis capitis muscle, one of the major extensors of the neck. Sensitivities

  6. Predictors for the immediate responders to cervical manipulation in patients with neck pain

    Microsoft Academic Search

    Yuh-Liang Tseng; Wendy T. J. Wang; Wen-Yin Chen; Tsun-Jen Hou; Tzu-Ching Chen; Fu-Kong Lieu

    2006-01-01

    Cervical manipulation has been considered an effective treatment for managing neck pain. However, clinical observation showed that cervical manipulation was not effective for every patient. Development of clinical prediction rules for identifying patients with neck pain who are likely to respond to cervical manipulation may improve clinical decision-making and the treatment success rate. The purpose of the study was to

  7. A systematic review of randomized controlled trials of acupuncture for neck pain

    Microsoft Academic Search

    A. R. White; E. Ernst

    1999-01-01

    Objective. To establish whether there is evidence for or against the eYcacy of acupuncture in the treatment of neck pain. Methods. A systematic literature review was undertaken of studies that compared needle or laser acupuncture with a control procedure for the treatment of neck pain. Two reviewers independently extracted data concerning study methods, quality and outcome. Results. Overall, the outcomes

  8. Effect of prolonged neck muscle vibration on lateral head tilt in severe spasmodic torticollis

    Microsoft Academic Search

    H-O Karnath; J Konczak; J Dichgans

    2000-01-01

    Short term vibration of the dorsal neck muscles (10–35 s) is known to induce involuntary movements of the head in patients with spasmodic torticollis. To investigate whether neck muscle vibration might serve as a therapeutic tool when applyed for a longer time interval, we compared a vibration interval of 5 seconds with a 15 minute interval in a patient with

  9. Lasting amelioration of spatial neglect by treatment with neck muscle vibration even without concurrent training

    Microsoft Academic Search

    Leif Johannsen; Hermann Ackermann; Hans-Otto Karnath

    2003-01-01

    Objective: It has been shown recently that neck muscle vibration in combination with an exploration training leads to lasting amelioration of spatial neglect. The present study evaluated whether vibration of the left posterior neck muscles alone has the potential to induce lasting reduction in spatial neglect. Design: A multiple baseline design was used to control for spontaneous recovery or uncontrolled

  10. The Incidence of p53 Mutations Increases with Progression of Head and Neck Cancer

    Microsoft Academic Search

    Jay O. Boyle; John Hakim; Wayne Koch; Peter van der Riet; Ralph H. Hruban; R. Arturo Roa; Yolanda J. Eby; J. Michael Ruppert; David Sidransky

    1993-01-01

    To establish a genetic model of the progression of head and neck squa- mous carcinoma we have defined the incidence and timing of p53 muta- tions in this type of cancer. We sequenced the conserved regions of the p53 gene in 102 head and neck squamous carcinoma lesions. These included 65 primary invasive carcinomas and 37 noninvasive archival specimens con-

  11. Clonal analysis reveals a common origin between nonsomite-derived neck muscles and heart myocardium.

    PubMed

    Lescroart, Fabienne; Hamou, Wissam; Francou, Alexandre; Théveniau-Ruissy, Magali; Kelly, Robert G; Buckingham, Margaret

    2015-02-01

    Neck muscles constitute a transition zone between somite-derived skeletal muscles of the trunk and limbs, and muscles of the head, which derive from cranial mesoderm. The trapezius and sternocleidomastoid neck muscles are formed from progenitor cells that have expressed markers of cranial pharyngeal mesoderm, whereas other muscles in the neck arise from Pax3-expressing cells in the somites. Mef2c-AHF-Cre genetic tracing experiments and Tbx1 mutant analysis show that nonsomitic neck muscles share a gene regulatory network with cardiac progenitor cells in pharyngeal mesoderm of the second heart field (SHF) and branchial arch-derived head muscles. Retrospective clonal analysis shows that this group of neck muscles includes laryngeal muscles and a component of the splenius muscle, of mixed somitic and nonsomitic origin. We demonstrate that the trapezius muscle group is clonally related to myocardium at the venous pole of the heart, which derives from the posterior SHF. The left clonal sublineage includes myocardium of the pulmonary trunk at the arterial pole of the heart. Although muscles derived from the first and second branchial arches also share a clonal relationship with different SHF-derived parts of the heart, neck muscles are clonally distinct from these muscles and define a third clonal population of common skeletal and cardiac muscle progenitor cells within cardiopharyngeal mesoderm. By linking neck muscle and heart development, our findings highlight the importance of cardiopharyngeal mesoderm in the evolution of the vertebrate heart and neck and in the pathophysiology of human congenital disease. PMID:25605943

  12. Electromyographic Control of a Hands-Free Electrolarynx Using Neck Strap Muscles

    ERIC Educational Resources Information Center

    Kubert, Heather L.; Stepp, Cara E.; Zeitels, Steven M.; Gooey, John E.; Walsh, Michael J.; Prakash, S. R.; Hillman, Robert E.; Heaton, James T.

    2009-01-01

    Three individuals with total laryngectomy were studied for their ability to control a hands-free electrolarynx (EL) using neck surface electromyography (EMG) for on/off and pitch modulation. The laryngectomy surgery of participants was modified to preserve neck strap musculature for EMG-based EL control (EMG-EL), with muscles on one side…

  13. Kinesin's Neck-Linker Determines its Ability to Navigate Obstacles on the Microtubule Surface

    E-print Network

    Hancock, William O.

    -linker, is more processive than kinesin-2. Although small differences in processivity are likely obscured in vivo neck-linker, kinesin-2 can more easily navigate obstacles (e.g., MAPs) on the microtubule surface than from different kinesin-1 and kinesin-2 neck-linker chimeras stepping along microtubules in the absence

  14. Osteoma with cholesteatoma of the external auditory canal: neck manifestation of this rare association†

    PubMed Central

    Khoyratty, Fadil; Sweed, Ahmed; Douglas, Susan; Magdy, Tawfik

    2013-01-01

    Osteoma and cholesteatoma of the external auditory canal is a rare clinical finding, presenting specific challenges in patients suffering from this dual pathology of the ear. We report on a unique complication of this association in a patient suffering with recurrent neck abscesses. Neck disease secondary to cholesteatoma has become nearly extinct with better clinical imaging and sensible antibiotic usage. PMID:24964451

  15. Salmonella recovery following air chilling for matched neck-skin and whole carcass sampling methodologies

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The prevalence and serogroups of Salmonella recovered following air chilling were determined for both enriched neck skin and matching enriched whole carcass samples. Commercially processed and eviscerated carcasses were air chilled to 4C before removing the neck skin (8.3 g) and stomaching in 83 mL...

  16. Discovery of a short-necked sauropod dinosaur from the Late Jurassic period of Patagonia

    Microsoft Academic Search

    Oliver W. M. Rauhut; Kristian Remes; Regina Fechner; Gerardo Cladera; Pablo Puerta

    2005-01-01

    Sauropod dinosaurs are one of the most conspicuous groups of Mesozoic terrestrial vertebrates. They show general trends towards an overall increase in size and elongation of the neck, by means of considerable elongation of the length of individual vertebrae and a cervical vertebra count that, in some cases, increases to 19 (ref. 1). The long neck is a particular hallmark

  17. Complications of hyperbaric oxygen in the treatment of head and neck disease

    Microsoft Academic Search

    J. W. Giebfried; W. Lawson; H. F. Biller

    1986-01-01

    Hyperbaric oxygen has been advocated in the treatment of many head and neck diseases. Reports of such treatments have described eustachian tube dysfunction as the only complication. A review of patients receiving hyperbaric oxygen for head and neck diseases at The Mount Sinai Medical Center revealed serious complications, which included seizure, stroke, and myocardial infarction. In addition, follow-up study of

  18. The role of the neck and trunk in facilitating head stability during walking

    Microsoft Academic Search

    Justin Kavanagh; Rod Barrett; Steven Morrison

    2006-01-01

    An apparent goal of the human postural system is to maintain head stability during walking. Although much is known about sensory-motor stabilising mechanisms associated with the head and neck, less is known about how the postural system attenuates motion between the trunk and neck segments in order to regulate head motion. Therefore the purpose of this study was to determine

  19. Head and Neck Nerve Sheath Tumors: A 10Year Evaluation in Iran

    Microsoft Academic Search

    Hedieh Moradi Tabriz; Ebrahim Razmpa; Alireza Abdollahi

    2009-01-01

    Background and Objective: Approximately 45% of benign peripheral nerve sheath tumors (PNST) occur in head and neck regions. Malignant peripheral nerve sheath tumors (MPNST) are less common and only 815%- of these tumors occur in head and neck region. In this study, we aimed at evaluating the demographic characteristics, pathologic findings, locations, main clinical presentations and family history of these

  20. Case-control study of risk factors for disease in the neck and shoulder area

    Microsoft Academic Search

    K Ekberg; B Björkqvist; P Malm; B Bjerre-Kiely; M Karlsson; O Axelson

    1994-01-01

    A case-control study was performed to elucidate the strength of the relation between musculoskeletal disorders in the neck and shoulders and physical, organisational, and psychosocial aspects of the work environment. Cases were identified as those persons who consulted a physician in a community in southern Sweden for new musculoskeletal disorders in the neck and shoulders during a study period from