A Clinical Concept for Interfractional Adaptive Radiation Therapy in the Treatment of Head and Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

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

A Clinical Concept for Interfractional Adaptive Radiation Therapy in the Treatment of Head and Neck Cancer

International Nuclear Information System (INIS)

Jensen, Alexandra D.; Nill, Simeon; Huber, Peter E.; Bendl, Rolf; Debus, Jürgen; Münter, Marc W.

2012-01-01

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

A clinical concept for interfractional adaptive radiation therapy in the treatment of head and neck cancer.

Science.gov (United States)

Jensen, Alexandra D; Nill, Simeon; Huber, Peter E; Bendl, Rolf; Debus, Jürgen; Münter, Marc W

2012-02-01

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. 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. 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. 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

Bio-Adaption between Magnesium Alloy Stent and the Blood Vessel: A Review

Science.gov (United States)

Ma, Jun; Zhao, Nan; Betts, Lexxus; Zhu, Donghui

2016-01-01

Biodegradable magnesium (Mg) alloy stents are the most promising next generation of bio-absorbable stents. In this article, we summarized the progresses on the in vitro studies, animal testing and clinical trials of biodegradable Mg alloy stents in the past decades. These exciting findings led us to propose the importance of the concept “bio-adaption” between the Mg alloy stent and the local tissue microenvironment after implantation. The healing responses of stented blood vessel can be generally described in three overlapping phases: inflammation, granulation and remodeling. The ideal bio-adaption of the Mg alloy stent, once implanted into the blood vessel, needs to be a reasonable function of the time and the space/dimension. First, a very slow degeneration of mechanical support is expected in the initial four months in order to provide sufficient mechanical support to the injured vessels. Although it is still arguable whether full mechanical support in stented lesions is mandatory during the first four months after implantation, it would certainly be a safety design parameter and a benchmark for regulatory evaluations based on the fact that there is insufficient human in vivo data available, especially the vessel wall mechanical properties during the healing/remodeling phase. Second, once the Mg alloy stent being degraded, the void space will be filled by the regenerated blood vessel tissues. The degradation of the Mg alloy stent should be 100% completed with no residues, and the degradation products (e.g., ions and hydrogen) will be helpful for the tissue reconstruction of the blood vessel. Toward this target, some future research perspectives are also discussed. PMID:27698548

Finishing of additively manufactured titanium alloy by shape adaptive grinding (SAG)

Science.gov (United States)

Beaucamp, Anthony T.; Namba, Yoshiharu; Charlton, Phillip; Jain, Samyak; Graziano, Arthur A.

2015-06-01

In recent years, rapid prototyping of titanium alloy components for medical and aeronautics application has become viable thanks to advances in technologies such as electron beam melting (EBM) and selective laser sintering (SLS). However, for many applications the high surface roughness generated by additive manufacturing techniques demands a post-finishing operation to improve the surface quality prior to usage. In this paper, the novel shape adaptive grinding process has been applied to finishing titanium alloy (Ti6Al4V) additively manufactured by EBM and SLS. It is shown that the micro-structured surface layer resulting from the melting process can be removed, and the surface can then be smoothed down to less than 10 nm Ra (starting from 4-5 μm Ra) using only three different diamond grit sizes. This paper also demonstrates application of the technology to freeform shapes, and documents the dimensional accuracy of finished artifacts.

Adverse local tissue reaction arising from corrosion at the femoral neck-body junction in a dual-taper stem with a cobalt-chromium modular neck.

Science.gov (United States)

Cooper, H John; Urban, Robert M; Wixson, Richard L; Meneghini, R Michael; Jacobs, Joshua J

2013-05-15

Femoral stems with dual-taper modularity were introduced to allow additional options for hip-center restoration independent of femoral fixation in total hip arthroplasty. Despite the increasing availability and use of these femoral stems, concerns exist about potential complications arising from the modular neck-body junction. This was a multicenter retrospective case series of twelve hips (eleven patients) with adverse local tissue reactions secondary to corrosion at the modular neck-body junction. The cohort included eight women and three men who together had an average age of 60.1 years (range, forty-three to seventy-seven years); all hips were implanted with a titanium-alloy stem and cobalt-chromium-alloy neck. Patients presented with new-onset and increasing pain at a mean of 7.9 months (range, five to thirteen months) following total hip arthroplasty. After serum metal-ion studies and metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) revealed abnormal results, the patients underwent hip revision at a mean of 15.2 months (range, ten to twenty-three months). Tissue specimens were examined by a single histopathologist, and the retrieved implants were studied with use of light and scanning electron microscopy. Serum metal levels demonstrated greater elevation of cobalt (mean, 6.0 ng/mL) than chromium (mean, 0.6 ng/mL) or titanium (mean, 3.4 ng/mL). MRI with use of MARS demonstrated adverse tissue reactions in eight of nine patients in which it was performed. All hips showed large soft-tissue masses and surrounding tissue damage with visible corrosion at the modular femoral neck-body junction. Available histology demonstrated large areas of tissue necrosis in seven of ten cases, while remaining viable capsular tissue showed a dense lymphocytic infiltrate. Microscopic analysis was consistent with fretting and crevice corrosion at the modular neck-body interface. Corrosion at the modular neck-body junction in dual-tapered stems with a modular

Dosimetric Evaluation of Automatic Segmentation for Adaptive IMRT for Head-and-Neck Cancer

International Nuclear Information System (INIS)

Tsuji, Stuart Y.; Hwang, Andrew; Weinberg, Vivian; Yom, Sue S.; Quivey, Jeanne M.; Xia Ping

2010-01-01

Purpose: Adaptive planning to accommodate anatomic changes during treatment requires repeat segmentation. This study uses dosimetric endpoints to assess automatically deformed contours. Methods and Materials: Sixteen patients with head-and-neck cancer had adaptive plans because of anatomic change during radiotherapy. Contours from the initial planning computed tomography (CT) were deformed to the mid-treatment CT using an intensity-based free-form registration algorithm then compared with the manually drawn contours for the same CT using the Dice similarity coefficient and an overlap index. The automatic contours were used to create new adaptive plans. The original and automatic adaptive plans were compared based on dosimetric outcomes of the manual contours and on plan conformality. Results: Volumes from the manual and automatic segmentation were similar; only the gross tumor volume (GTV) was significantly different. Automatic plans achieved lower mean coverage for the GTV: V95: 98.6 ± 1.9% vs. 89.9 ± 10.1% (p = 0.004) and clinical target volume: V95: 98.4 ± 0.8% vs. 89.8 ± 6.2% (p 3 of the spinal cord 39.9 ± 3.7 Gy vs. 42.8 ± 5.4 Gy (p = 0.034), but no difference for the remaining structures. Conclusions: Automatic segmentation is not robust enough to substitute for physician-drawn volumes, particularly for the GTV. However, it generates normal structure contours of sufficient accuracy when assessed by dosimetric end points.

Finishing of additively manufactured titanium alloy by shape adaptive grinding (SAG)

International Nuclear Information System (INIS)

Beaucamp, Anthony T; Namba, Yoshiharu; Charlton, Phillip; Jain, Samyak; Graziano, Arthur A

2015-01-01

In recent years, rapid prototyping of titanium alloy components for medical and aeronautics application has become viable thanks to advances in technologies such as electron beam melting (EBM) and selective laser sintering (SLS). However, for many applications the high surface roughness generated by additive manufacturing techniques demands a post-finishing operation to improve the surface quality prior to usage. In this paper, the novel shape adaptive grinding process has been applied to finishing titanium alloy (Ti6Al4V) additively manufactured by EBM and SLS. It is shown that the micro-structured surface layer resulting from the melting process can be removed, and the surface can then be smoothed down to less than 10 nm Ra (starting from 4–5 μm Ra) using only three different diamond grit sizes. This paper also demonstrates application of the technology to freeform shapes, and documents the dimensional accuracy of finished artifacts. (paper)

The effect of fear of movement on muscle activation in posttraumatic neck pain disability

NARCIS (Netherlands)

Nederhand, Marcus Johannes; Hermens, Hermanus J.; IJzerman, Maarten Joost; Groothuis-Oudshoorn, Catharina Gerarda Maria; Turk, Dennis C.

Studies using surface electromyography have demonstrated a reorganization of muscle activation patterns of the neck and shoulder muscles in patients with posttraumatic neck pain disability. The neurophysiologically oriented "pain adaptation" model explains this reorganization as a useful adaptation

Dissolution ad uptake of cadmium from dental gold solder alloy implants

International Nuclear Information System (INIS)

Bergman, B.; Bergman, M.; Soeremark, R.

1977-01-01

Pure metallic cadmium was irradiated by means of thermal neutrons. The irradiated cadmium ( 115 Cd) was placed in bags of gold foil and the bags were implanted subcutaneously in the neck region of mice. Two and 3 d respectively after implantation the mice were killed, the bags removed and the animals subjected to whole-body autoradiography. The autoradiograms revealed an uptake of 115 Cd in liver and kidney. In another experiment specimens of a cadmium-containing dental gold solder alloy, a cadmium-free dental casting gold alloy and soldered assemblies made of these two alloys were implanted subcutaneously in the neck region of mice. The animals were killed after 6 months; cadmium analysis showed significant increases in the cadmium concentration in liver and kidney of those mice which had been given implants of gold solder alloy. The study clearly shows that due to electrochemical corrosion cadmium can be released from implants and accumulated in the kidneys and the liver. (author)

Dissolution and uptake of cadmium from dental gold solder alloy implants

Energy Technology Data Exchange (ETDEWEB)

Bergman, B; Bergman, M; Soeremark, R [Umeaa Univ. (Sweden); Karolinska Institutet, Stockholm (Sweden))

1977-01-01

Pure metallic cadmium was irradiated by means of thermal neutrons. The irradiated cadmium (/sup 115/Cd) was placed in bags of gold foil and the bags were implanted subcutaneously in the neck region of mice. Two and 3 d respectively after implantation the mice were killed, the bags removed and the animals subjected to whole-body autoradiography. The autoradiograms revealed an uptake of /sup 115/Cd in liver and kidney. In another experiment specimens of a cadmium-containing dental gold solder alloy, a cadmium-free dental casting gold alloy and soldered assemblies made of these two alloys were implanted subcutaneously in the neck region of mice. The animals were killed after 6 months; cadmium analysis showed significant increases in the cadmium concentration in liver and kidney of those mice which had been given implants of gold solder alloy. The study clearly shows that due to electrochemical corrosion cadmium can be released from implants and accumulated in the kidneys and the liver.

In Vivo Damage of the Head-Neck Junction in Hard-on-Hard Total Hip Replacements: Effect of Femoral Head Size, Metal Combination, and 12/14 Taper Design

Directory of Open Access Journals (Sweden)

Massimiliano Baleani

2017-07-01

Full Text Available Recently, concerns have been raised about the potential effect of head-neck junction damage products at the local and systemic levels. Factors that may affect this damage process have not been fully established yet. This study investigated the possible correlations among head-neck junction damage level, implant design, material combination, and patient characteristics. Head-neck junctions of 148 retrieved implants were analysed, including both ceramic-on-ceramic (N = 61 and metal-on-metal (N = 87 bearings. In all cases, the male taper was made of titanium alloy. Damage was evaluated using a four-point scoring system based on damage morphology and extension. Patient age at implantation, implantation time, damage risk factor, and serum ion concentration were considered as independent potential predicting variables. The damage risk factor summarises head-neck design characteristics and junction loading condition. Junction damage correlated with both implantation time and damage factor risk when the head was made of ceramic. A poor correlation was found when the head was made of cobalt alloy. The fretting-corrosion phenomenon seemed mainly mechanically regulated, at least when cobalt alloy components were not involved. When a component was made of cobalt alloy, the role of chemical phenomena increased, likely becoming, over implantation time, the damage driving phenomena of highly stressed junctions.

Rotor-bearing system integrated with shape memory alloy springs for ensuring adaptable dynamics and damping enhancement-Theory and experiment

DEFF Research Database (Denmark)

Enemark, Søren; Santos, Ilmar F.

2016-01-01

nonlinear coupled dynamics of the rotor-bearing system. The nonlinear forces from the thermomechanical shape memory alloy springs and from the passive magnetic bearings are coupled to the rotor and bearing housing dynamics. The equations of motion describing rotor tilt and bearing housing lateral motion......Helical pseudoelastic shape memory alloy (SMA) springs are integrated into a dynamic system consisting of a rigid rotor supported by passive magnetic bearings. The aim is to determine the utility of SMAs for vibration attenuation via their mechanical hysteresis, and for adaptation of the dynamic...

Cross-Cultural Translation, Adaptation and Reliability of the Danish M. D. Andeson Dysphagia Inventory (MDADI) in Patients with Head and Neck Cancer.

Science.gov (United States)

Hajdú, Sara Fredslund; Plaschke, Christina Caroline; Johansen, Christoffer; Dalton, Susanne Oksbjerg; Wessel, Irene

2017-08-01

The objectives were to translate and culturally adapt the M.D. Anderson Dysphagia Inventory (MDADI) into Danish and subsequently test the reliability of the Danish version. The MDADI was translated into Danish and cross culturally adapted through cognitive interviews. The final version was test-retest evaluated in a group of head and neck cancer (HNC) patients who responded to the questionnaire twice with a mean of eight days apart. Interclass correlation coefficient, Cronbach's alpha, floor and ceiling effects, standard error of measurement and minimal detectable change were investigated. Fourteen patients were interviewed on the comprehensibility of the Danish MDADI, and all found the questionnaire meaningful, easy to understand, non-offensive and to include relevant aspects of dysphagia related to HNC. Sixty-four patients were included in the test-retest study. Especially, one item in the emotional scale (E7) appeared to be often misinterpreted, and ceiling effects were found in all four subdomains (global, emotional, functional and physical). The four subdomains and the composite score showed acceptable test-retest reliability and internal consistency in a Danish population of HNC patients. The Danish MDADI is reliable in terms of internal consistency and test-retest reproducibility and can be used in assessing the health-related quality of life in head and neck cancer patients with dysphagia.

Molecular PET imaging for biology-guided adaptive radiotherapy of head and neck cancer.

Science.gov (United States)

Hoeben, Bianca A W; Bussink, Johan; Troost, Esther G C; Oyen, Wim J G; Kaanders, Johannes H A M

2013-10-01

Integration of molecular imaging PET techniques into therapy selection strategies and radiation treatment planning for head and neck squamous cell carcinoma (HNSCC) can serve several purposes. First, pre-treatment assessments can steer decisions about radiotherapy modifications or combinations with other modalities. Second, biology-based objective functions can be introduced to the radiation treatment planning process by co-registration of molecular imaging with planning computed tomography (CT) scans. Thus, customized heterogeneous dose distributions can be generated with escalated doses to tumor areas where radiotherapy resistance mechanisms are most prevalent. Third, monitoring of temporal and spatial variations in these radiotherapy resistance mechanisms early during the course of treatment can discriminate responders from non-responders. With such information available shortly after the start of treatment, modifications can be implemented or the radiation treatment plan can be adapted tailing the biological response pattern. Currently, these strategies are in various phases of clinical testing, mostly in single-center studies. Further validation in multicenter set-up is needed. Ultimately, this should result in availability for routine clinical practice requiring stable production and accessibility of tracers, reproducibility and standardization of imaging and analysis methods, as well as general availability of knowledge and expertise. Small studies employing adaptive radiotherapy based on functional dynamics and early response mechanisms demonstrate promising results. In this context, we focus this review on the widely used PET tracer (18)F-FDG and PET tracers depicting hypoxia and proliferation; two well-known radiation resistance mechanisms.

Predicting the need for adaptive radiotherapy in head and neck cancer

International Nuclear Information System (INIS)

Brown, Elizabeth; Owen, Rebecca; Harden, Fiona; Mengersen, Kerrie; Oestreich, Kimberley; Houghton, Whitney; Poulsen, Michael; Harris, Selina; Lin, Charles; Porceddu, Sandro

2015-01-01

Background and purpose: Adaptive radiotherapy (ART) can account for the dosimetric impact of anatomical change in head and neck cancer patients; however it can be resource intensive. Consequently, it is imperative that patients likely to require ART are identified. The purpose of this study was to find predictive factors that identify oropharyngeal squamous cell carcinoma (OPC) and nasopharyngeal carcinoma (NPC) patients more likely to need ART. Materials and methods: One hundred and ten patients with OPC or NPC were analysed. Patient demographics and tumour characteristics were compared between patients who were replanned and those that were not. Factors found to be significant were included in logistic regression models. Risk profiles were developed from these models. A dosimetric analysis was performed. Results: Nodal disease stage, pre-treatment largest involved node size, diagnosis and initial weight (categorised in 2 groups) were identified as significant for inclusion in the model. Two models were found to be significant (p = 0.001), correctly classifying 98.2% and 96.1% of patients respectively. Three ART risk profiles were developed. Conclusion: Predictive factors identifying OPC or NPC patients more likely to require ART were reported. A risk profile approach could facilitate the effective implementation of ART into radiotherapy departments through forward planning and appropriate resource allocation

The evaluation of composite dose using deformable image registration in adaptive radiotherapy for head and neck cancer

International Nuclear Information System (INIS)

Hwang, Chul Hwan; Ko, Seong Jin; Kim, Chang Soo; Kim, Jung Hoon; Kim, Dong Hyun; Choi, Seok Yoon; Ye, Soo Young; Kang, Se Sik

2013-01-01

In adaptive radiotherapy(ART), generated composite dose of surrounding normal tissue on overall treatment course which is using deformable image registration from multistage images. Also, compared with doses summed by each treatment plan and clinical significance is considered. From the first of May, 2011 to the last of July, 2012. Patients who were given treatment and had the head and neck cancer with 3-dimension conformal radiotherapy or intensity modulated radiotherapy, those who were carried out adaptive radiotherapy cause of tumor shrinkage and weight loss. Generated composite dose of surrounding normal tissue using deformable image registration was been possible, statistically significant difference was showed to mandible(48.95±3.89 vs 49.10±3.55 Gy), oral cavity(36.93±4.03 vs 38.97±5.08 Gy), parotid gland(35.71±6.22 vs 36.12±6.70 Gy) and temporomandibular joint(18.41±9.60 vs 20.13±10.42 Gy) compared with doses summed by each treatment plan. The results of this study show significant difference between composite dose by deformable image registration and doses summed by each treatment plan, composite dose by deformable image registration may generate more exact evaluation to surrounding normal tissue in adaptive radiotherapy

The evaluation of composite dose using deformable image registration in adaptive radiotherapy for head and neck cancer

Energy Technology Data Exchange (ETDEWEB)

Hwang, Chul Hwan; Ko, Seong Jin; Kim, Chang Soo; Kim, Jung Hoon; Kim, Dong Hyun; Choi, Seok Yoon; Ye, Soo Young; Kang, Se Sik [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Pusan (Korea, Republic of)

2013-09-15

In adaptive radiotherapy(ART), generated composite dose of surrounding normal tissue on overall treatment course which is using deformable image registration from multistage images. Also, compared with doses summed by each treatment plan and clinical significance is considered. From the first of May, 2011 to the last of July, 2012. Patients who were given treatment and had the head and neck cancer with 3-dimension conformal radiotherapy or intensity modulated radiotherapy, those who were carried out adaptive radiotherapy cause of tumor shrinkage and weight loss. Generated composite dose of surrounding normal tissue using deformable image registration was been possible, statistically significant difference was showed to mandible(48.95±3.89 vs 49.10±3.55 Gy), oral cavity(36.93±4.03 vs 38.97±5.08 Gy), parotid gland(35.71±6.22 vs 36.12±6.70 Gy) and temporomandibular joint(18.41±9.60 vs 20.13±10.42 Gy) compared with doses summed by each treatment plan. The results of this study show significant difference between composite dose by deformable image registration and doses summed by each treatment plan, composite dose by deformable image registration may generate more exact evaluation to surrounding normal tissue in adaptive radiotherapy.

Evaluation of Deformable Image Coregistration in Adaptive Dose Painting by Numbers for Head-and-Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

Olteanu, Luiza A.M., E-mail: AnaMariaLuiza.Olteanu@uzgent.be [Department of Radiotherapy, Ghent University Hospital, De Pintelaan, Ghent (Belgium); Madani, Indira; De Neve, Wilfried; Vercauteren, Tom; De Gersem, Werner [Department of Radiotherapy, Ghent University Hospital, De Pintelaan, Ghent (Belgium)

2012-06-01

Purpose: To assess the accuracy of contour deformation and feasibility of dose summation applying deformable image coregistration in adaptive dose painting by numbers (DPBN) for head and neck cancer. Methods and Materials: Data of 12 head-and-neck-cancer patients treated within a Phase I trial on adaptive {sup 18}F-FDG positron emission tomography (PET)-guided DPBN were used. Each patient had two DPBN treatment plans: the initial plan was based on a pretreatment PET/CT scan; the second adapted plan was based on a PET/CT scan acquired after 8 fractions. The median prescription dose to the dose-painted volume was 30 Gy for both DPBN plans. To obtain deformed contours and dose distributions, pretreatment CT was deformed to per-treatment CT using deformable image coregistration. Deformed contours of regions of interest (ROI{sub def}) were visually inspected and, if necessary, adjusted (ROI{sub def{sub ad}}) and both compared with manually redrawn ROIs (ROI{sub m}) using Jaccard (JI) and overlap indices (OI). Dose summation was done on the ROI{sub m}, ROI{sub def{sub ad}}, or their unions with the ROI{sub def}. Results: Almost all deformed ROIs were adjusted. The largest adjustment was made in patients with substantially regressing tumors: ROI{sub def} = 11.8 {+-} 10.9 cm{sup 3} vs. ROI{sub def{sub ad}} = 5.9 {+-} 7.8 cm{sup 3} vs. ROI{sub m} = 7.7 {+-} 7.2 cm{sup 3} (p = 0.57). The swallowing structures were the most frequently adjusted ROIs with the lowest indices for the upper esophageal sphincter: JI = 0.3 (ROI{sub def}) and 0.4 (ROI{sub def{sub ad}}); OI = 0.5 (both ROIs). The mandible needed the least adjustment with the highest indices: JI = 0.8 (both ROIs), OI = 0.9 (ROI{sub def}), and 1.0 (ROI{sub def{sub ad}}). Summed doses differed non-significantly. There was a trend of higher doses in the targets and lower doses in the spinal cord when doses were summed on unions. Conclusion: Visual inspection and adjustment were necessary for most ROIs. Fast automatic ROI

Adaptive proportional–integral–derivative tuning sliding mode control for a shape memory alloy actuator

International Nuclear Information System (INIS)

Tai, Nguyen Trong; Ahn, Kyoung Kwan

2011-01-01

In this paper, a novel adaptive sliding mode control with a proportional–integral–derivative (PID) tuning method is proposed to control a shape memory alloy (SMA) actuator. The goal of the controller is to achieve system robustness against the SMA hysteresis phenomenon, system uncertainties and external disturbances. In the controller, the PID controller is employed to approximate the sliding mode equivalent control along the direction that makes the sliding mode asymptotically stable. Due to the system nonlinearity, the PID control gain parameters are systematically computed online according to the adaptive law. To improve the transient performance, the initial PID gain parameters are optimized by the particle swarm optimization (PSO) method. Simulation and experimental results demonstrate that the controller performs well for the desired trajectory tracking, and the hysteresis phenomenon is compensated for completely. The control results are also compared with the optimized PID controller

Microstructures and superplasticity in near-gamma titanium aluminide alloys

International Nuclear Information System (INIS)

Bampton, C.C.; Martin, P.L.

1993-01-01

Microstructure control by thermomechanical processing in near-gamma titanium aluminide alloys has recently progressed to a point where the authors are able to reliably produce a wide range of microstructures in a single alloy. The authors are now studying the basic superplastic deformation microstructures. Correlations are made between microstructural details and flow stress, strain hardening, strain-rate hardening, necking, cavitation and failure. Special emphasis is given to the cavitation behavior since this phenomenon may constitute a major limitation to the useful application of superplastic forming for gamma TiAl structures

Cross-Cultural Translation, Adaptation and Reliability of the Danish M. D. Andeson Dysphagia Inventory (MDADI) in Patients with Head and Neck Cancer

DEFF Research Database (Denmark)

Hajdú, Sara Fredslund; Plaschke, Christina Caroline; Johansen, Christoffer

2017-01-01

The objectives were to translate and culturally adapt the M.D. Anderson Dysphagia Inventory (MDADI) into Danish and subsequently test the reliability of the Danish version. The MDADI was translated into Danish and cross culturally adapted through cognitive interviews. The final version was test...... patients were interviewed on the comprehensibility of the Danish MDADI, and all found the questionnaire meaningful, easy to understand, non-offensive and to include relevant aspects of dysphagia related to HNC. Sixty-four patients were included in the test-retest study. Especially, one item....... The Danish MDADI is reliable in terms of internal consistency and test-retest reproducibility and can be used in assessing the health-related quality of life in head and neck cancer patients with dysphagia....

The innovation trap: modular neck in total hip arthroplasty

Directory of Open Access Journals (Sweden)

Samo Karel Fokter

2017-04-01

Full Text Available Background: Innovations play the key role in the success of orthopaedic surgery. However, even minor modifications in the established concepts and proven designs may result in disasters. The endemic of modular femoral neck fracture (24 cases of about 4000 implanted in fully modular total hip arthroplasty, popular in our country for the last 20 years, seems to challenge us with such an unfortunate consequences. The aim of this report was to analyze the extent and the causes of the problem on the one hand and to propose possible solutions on the other.Methods: Literature search for problems associated with Profemur Z (or earlier versions with the same taper-cone design fully-modular femoral stem made of titanium alloy (Ti6Al4V was performed, and hip arthroplasty registries were searched to evaluate the failure rates of the mentioned design. Mechanisms of failure were studied to get in-depth understanding of this particular hip reconstruction device.Results: Since 2010 onwards, several case reports on catastrophic modular femoral neck fractures of Profemur Z were published. Te frst Slovenian case was described in 2012. The first two larger series with modular femoral neck fractures were published in 2016. Te Australian Joint Replacement Registry was the first to discover increased revision rates due to fractures of this hip reconstruction system. Public Agency of the Republic of Slovenia for Medicinal Products and Medical Devices (JAZMP received frst two reports regarding Profemur Z modular neck complication from abroad in 2010, the first Slovenian report was received in 2012, and altogether 7 reports from Slovenian hospitals were received until December 2016. Corrosion at the neck-taper interface, where two equal or different materials are subject to constant wear in the presence of body fluids, is assumed to be responsible for the unacceptable high failure rate.Conclusions: Manufacturers are responsible to produce and market only safe devices

An integrated approach to understanding the role of the long neck in plesiosaurs

Directory of Open Access Journals (Sweden)

Leslie F. Noè

2017-03-01

Full Text Available The evolution and function of the long neck in plesiosaurs, and how the problems associated with stiffness or flexibility were overcome during feeding, or rapid swimming during predator avoidance, are explored, and a new interpretation for the function of the plesiosaur neck is presented. Based on the anatomy of the articular faces of contiguous cervical vertebral centra, neural arches, and cervical ribs, the plesiosaur neck was mainly adapted for ventral bending, with dorsal, lateral and rotational movements all relatively restricted. Predominant ventral bending indicates the neck was adapted for use beneath the body, suggesting feeding in the water column, close to the sea floor, or within soft sediments on the sea floor. A new model is proposed for the plesiosaur bauplan, comprising the head as a filter, straining, sieve feeding or sediment raking apparatus, mounted on a neck which acted as a stiff but ventrally flexible feeding tube, attached to the body which acted as a highly mobile feeding platform. Numerous features of plesiosaurs, including cranial and dental form, cervical vertebral morphology, body shape and limb-based propulsion, conform to this model. Comparative data from modern organisms support this novel explanation for the structure and function of the plesiosaur long neck. This integrative analysis offers an explanation for the evolution of the plesiosaur long neck as a key evolutionary novelty, and why this apparently enigmatic feature remained a prominent feature of plesiosaurs throughout their long evolutionary history.

Neck proprioception shapes body orientation and perception of motion.

Science.gov (United States)

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.

Shape Memory Alloy Adaptive Structures, Phase I

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National Aeronautics and Space Administration — This SBIR Phase I effort will demonstrate and scale up an innovative manufacturing process that yields aerospace grade shape memory alloy (SMA) solids and periodic...

Neck proprioception shapes body orientation and perception of motion

Directory of Open Access Journals (Sweden)

Vito Enrico Pettorossi

2014-11-01

Full Text Available This review article deals with some effects of neck muscle proprioception on human balance, gait trajectory, subjective straight-ahead, 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, subjective straight-ahead, 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, subjective straight-ahead and walking trajectory.Neck vibration also induces persistent aftereffects on the subjective straight-ahead 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.

Neck curve polynomials in neck rupture model

International Nuclear Information System (INIS)

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

2012-01-01

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 280 X 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.

Neck Pain Occurrence and Characteristics in Nigerian University Undergraduates

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Olufunke Patience Iroko

2010-06-01

Full Text Available AIM: University students seem to be a high risk group for neck pain which often leads to diminished concentration and academic performance among them. This study examined the occurrence and characteristics of neck pain in undergraduate students from the University of Ibadan, Nigeria. METHOD: One thousand and sixty nine (512 male and 557 female undergraduate students with the mean age of 23.49 ± 2.54 years responded in this cross-sectional survey. An adapted questionnaire that sought information on demographics, occurrence, characteristics and the consequence of neck pain on activities of daily living served as the survey instrument. Data were summarized using descriptive statistics. RESULTS: Lifetime prevalence and current frequency of neck pain among the respondents was 34.9% and 9.8% respectively. Female students had a higher preponderance of lifetime neck pain prevalence than their male counterparts (52.8 vs. 47.2%. There was higher frequency of neck pain after admission into the university than before (68.6 vs. 28.7%. Neck pain increased according to level of study and commoner among clinical students. 20% of the respondents reported chronic neck pain and was commoner in males than females (13% vs. 7% females. Seats without back supports used during lectures (48.0%, long reading hours (31.4%, poor self perpetuating posture (16.6%, and types of pillow used when sleeping (14.2% were the most implicated predisposing factors to neck pain. Reading (49.7% and concentration on school work (27.9% were the most limited activities of daily living. CONCLUSION: Neck pain is common among Nigerian university undergraduate students and affects females than males. The prevalence increased with higher level of study and commoner among clinical students. Neck pain mostly affects reading and concentration on school work among university undergraduate students. [TAF Prev Med Bull 2010; 9(3.000: 167-174

Adaptive radiotherapy for soft tissue changes during helical tomotherapy for head and neck cancer

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Duma, M.N.; Kampfer, S.; Winkler, C.; Geinitz, H. [Universitaetsklinikum rechts der Isar, Muenchen (Germany). Dept. of Radiation Oncology; Schuster, T. [Universitaetsklinikum rechts der Isar, Muenchen (Germany). Inst. of Medical Statistics and Epidemiology

2012-03-15

The goal of the present study was to assess the frequency and impact of replanning triggered solely by soft tissue changes observed on the daily setup mega-voltage CT (MVCT) in head and neck cancer (H and N) helical tomotherapy (HT). A total of 11 patients underwent adaptive radiotherapy (ART) using MVCT. Preconditions were a soft tissue change > 0.5 cm and a tight mask. The dose-volume histograms (DVHs) derived from the initial planning kVCT (inPlan), the recalculated DVHs of the fraction (fx) when replanning was decided (actSit) and the DVHs of the new plan (adaptPlan) were compared. Assessed were the following: maximum dose (D{sub max}), minimum dose (D{sub min}), and mean dose (D{sub mean}) to the planning target volume (PTV) normalized to the prescribed dose; the D{sub mean}/fx to the parotid glands (PG), oral cavity (OC), and larynx (Lx); and the D{sub max}/fx to the spinal cord (SC) in Gy/fx. No patient had palpable soft tissue changes. The median weight loss at the moment of replanning was 2.3 kg. The median PTV D{sub mean} was 100% for inPlan, 103% for actSit, and 100% for adaptPlan. The PTV was always covered by the prescribed dose. A statistically significant increase was noted for all organs at risk (OAR) in the actSit. The D{sub mean} to the Lx, the D{sub mean} to the OC and the D{sub max} to the SC were statistically better in the adaptPlan. No statistically significant improvement was achieved by ART for the PGs. No significant correlations between weight and volume loss or between the volume changes of the organs to each other were observed, except a strong positive correlation of the shrinkage of the PGs ({rho} = + 0.77, p = 0.005). Soft tissue shrinkage without clinical palpable changes will not affect the coverage of the PTV, but translates into a higher delivered dose to the PTV itself and the normal tissue outside the PTV. The gain by ART in individual patients - especially in patients who receive doses close to the tolerance doses of the OAR

Adaptation and micro-structure of Co-Cr alloy maxillary complete denture base plates fabricated by selective laser melting technique.

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Ye, Ye; Jiao, Ting; Zhu, Jiarui; Sun, Jian

2018-01-24

The purpose of the study was to evaluate the adaptation and micro-structure of Co-Cr alloy maxillary complete denture base plates fabricated by the selective laser melting (SLM) technique. Twenty pairs of edentulous casts were randomly and evenly divided into two groups, and manufacturing of the Co-Cr alloy maxillary complete denture base was conducted either by the SLM technique or by the conventional method. The base-cast sets were transversally sectioned into three sections at the distal canines, mesial of the first molars and the posterior palatal zone. The gap between the metal base and cast was measured in these three sections with a stereoscopic microscope, and the data were analysed using t tests. A total of five specimens of 5 mm diameter were fabricated with the Co-Cr alloy by SLM and the traditional casting technology. A scanning electron microscope (SEM) was used to evaluate the differences in microstructure between these specimens. There was no statistical difference between the three sections in all four groups (P > 0.05). At the region of the canines, the clearance value for the SLM Co-Cr alloy group was larger than that of the conventional method group (P  0.05). The SLM Co-Cr alloy has a denser microstructure behaviour and less casting defect than the cast Co-Cr alloy. The SLM technique showed initial feasibility for the manufacture of dental bases of complete dentures, but large sample studies are needed to prove its reliability in clinical applications. The mechanical properties and microstructure of the denture frameworks prepared by selective laser melting indicate that these dentures are appropriate for clinical use.

End-stage head and neck cancer coping mechanisms

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Bogdan Popescu

2017-10-01

Full Text Available Coping mechanisms are patients’ means of adapting to stressful situations and involve psychological and physical changes in behavior. Patients adapt to head and neck cancer in a variety of ways. Head and neck cancers are extremely debilitating, especially in advanced stages of the disease or in end-of-life situations. While an oncology team needs to address the needs of all oncology patients, the advanced terminal patients require special attention. Most of these patients do not cope well with their situation and have a tendency to cease social interactions. Pain is the most frequentlyexperienced medical disability in patients having an end-stage illness experience, and thus an important medical endeavor is to afford dignity to the dying patient facingan incurable disease. In such cases, the medical community should never refuse therapy or to assist a dying patient.In some instances, the patient and family may derive benefit from their religious beliefs.

Porous Nb-Ti based alloy produced from plasma spheroidized powder

Directory of Open Access Journals (Sweden)

Qijun Li

Full Text Available Spherical Nb-Ti based alloy powder was prepared by the combination of plasma spheroidization and mechanical alloying. Phase constituents, microstructure and surface state of the powder, and pore characteristics of the resulting porous alloy were investigated. The results show that the undissolved W and V in the mechanically alloyed powder is fully alloyed after spheroidization, and single β phase is achieved. Particle size of the spheroidized powder is in the range of 20–110 μm. With the decrease of particle size, a transformation from typical dendrite solidification structure to fine cell microstructure occurs. The surface of the spheroidized powder is coated by a layer of oxides consisting mainly of TiO2 and Nb2O5. Probabilities of sinter-neck formation and particle coalescence increases with increasing sintering temperature. Porous skeleton with relatively homogeneous pore distribution and open pore channel is formed after vacuum sintering at 1700 °C, and the porosity is 32%. The sintering kinetic analysis indicates that grain boundary diffusion is the primary mass transport mechanism during sintering process. Keywords: Powder metallurgy, Nb-Ti based alloy, Porous material, Mechanical alloying, Plasma spheroidizing, Solidification microstructure

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

International Nuclear Information System (INIS)

Jang, Na Young; Lee, Keun-Wook; Ahn, Soon-Hyun; Kim, Jae-Sung; Ah Kim, In

2012-01-01

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

Adaptive online inverse control of a shape memory alloy wire actuator using a dynamic neural network

Science.gov (United States)

Mai, Huanhuan; Song, Gangbing; Liao, Xiaofeng

2013-01-01

Shape memory alloy (SMA) actuators exhibit severe hysteresis, a nonlinear behavior, which complicates control strategies and limits their applications. This paper presents a new approach to controlling an SMA actuator through an adaptive inverse model based controller that consists of a dynamic neural network (DNN) identifier, a copy dynamic neural network (CDNN) feedforward term and a proportional (P) feedback action. Unlike fixed hysteresis models used in most inverse controllers, the proposed one uses a DNN to identify online the relationship between the applied voltage to the actuator and the displacement (the inverse model). Even without a priori knowledge of the SMA hysteresis and without pre-training, the proposed controller can precisely control the SMA wire actuator in various tracking tasks by identifying online the inverse model of the SMA actuator. Experiments were conducted, and experimental results demonstrated real-time modeling capabilities of DNN and the performance of the adaptive inverse controller.

Adaptive radiotherapy with an average anatomy model: Evaluation and quantification of residual deformations in head and neck cancer patients

International Nuclear Information System (INIS)

Kranen, Simon van; Mencarelli, Angelo; Beek, Suzanne van; Rasch, Coen; Herk, Marcel van; Sonke, Jan-Jakob

2013-01-01

Background and purpose: To develop and validate an adaptive intervention strategy for radiotherapy of head-and-neck cancer that accounts for systematic deformations by modifying the planning-CT (pCT) to the average misalignments in daily cone beam CT (CBCT) measured with deformable registration (DR). Methods and materials: Daily CBCT scans (808 scans) for 25 patients were retrospectively registered to the pCT with B-spline DR. The average deformation vector field ( ) was used to deform the pCT for adaptive intervention. Two strategies were simulated: single intervention after 10 fractions and weekly intervention with an from the previous week. The model was geometrically validated with the residual misalignment of anatomical landmarks both on bony-anatomy (BA; automatically generated) and soft-tissue (ST; manually identified). Results: Systematic deformations were 2.5/3.4 mm vector length (BA/ST). Single intervention reduced deformations to 1.5/2.7 mm (BA/ST). Weekly intervention resulted in 1.0/2.2 mm (BA/ST) and accounted better for progressive changes. 15 patients had average systematic deformations >2 mm (BA): reductions were 1.1/1.9 mm (single/weekly BA). ST improvements were underestimated due to observer and registration variability. Conclusions: Adaptive intervention with a pCT modified to the average anatomy during treatment successfully reduces systematic deformations. The improved accuracy could possibly be exploited in margin reduction and/or dose escalation

Porous Nb-Ti based alloy produced from plasma spheroidized powder

Science.gov (United States)

Li, Qijun; Zhang, Lin; Wei, Dongbin; Ren, Shubin; Qu, Xuanhui

Spherical Nb-Ti based alloy powder was prepared by the combination of plasma spheroidization and mechanical alloying. Phase constituents, microstructure and surface state of the powder, and pore characteristics of the resulting porous alloy were investigated. The results show that the undissolved W and V in the mechanically alloyed powder is fully alloyed after spheroidization, and single β phase is achieved. Particle size of the spheroidized powder is in the range of 20-110 μm. With the decrease of particle size, a transformation from typical dendrite solidification structure to fine cell microstructure occurs. The surface of the spheroidized powder is coated by a layer of oxides consisting mainly of TiO2 and Nb2O5. Probabilities of sinter-neck formation and particle coalescence increases with increasing sintering temperature. Porous skeleton with relatively homogeneous pore distribution and open pore channel is formed after vacuum sintering at 1700 °C, and the porosity is 32%. The sintering kinetic analysis indicates that grain boundary diffusion is the primary mass transport mechanism during sintering process.

Head and Neck Margin Reduction With Adaptive Radiation Therapy: Robustness of Treatment Plans Against Anatomy Changes

International Nuclear Information System (INIS)

Kranen, Simon van; Hamming-Vrieze, Olga; Wolf, Annelisa; Damen, Eugène; Herk, Marcel van; Sonke, Jan-Jakob

2016-01-01

Purpose: We set out to investigate loss of target coverage from anatomy changes in head and neck cancer patients as a function of applied safety margins and to verify a cone beam computed tomography (CBCT)–based adaptive strategy with an average patient anatomy to overcome possible target underdosage. Methods and Materials: For 19 oropharyngeal cancer patients, volumetric modulated arc therapy treatment plans (2 arcs; simultaneous integrated boost, 70 and 54.25 Gy; 35 fractions) were automatically optimized with uniform clinical target volume (CTV)–to–planning target volume margins of 5, 3, and 0 mm. We applied b-spline CBCT–to–computed tomography (CT) deformable registration to allow recalculation of the dose on modified CT scans (planning CT deformed to daily CBCT following online positioning) and dose accumulation in the planning CT scan. Patients with deviations in primary or elective CTV coverage >2 Gy were identified as candidates for adaptive replanning. For these patients, a single adaptive intervention was simulated with an average anatomy from the first 10 fractions. Results: Margin reduction from 5 mm to 3 mm to 0 mm generally led to an organ-at-risk (OAR) mean dose (D_m_e_a_n) sparing of approximately 1 Gy/mm. CTV shrinkage was mainly seen in the elective volumes (up to 10%), likely related to weight loss. Despite online repositioning, substantial systematic errors were present (>3 mm) in lymph node CTV, the parotid glands, and the larynx. Nevertheless, the average increase in OAR dose was small: maximum of 1.2 Gy (parotid glands, D_m_e_a_n) for all applied margins. Loss of CTV coverage >2 Gy was found in 1, 3, and 7 of 73 CTVs, respectively. Adaptive intervention in 0-mm plans substantially improved coverage: in 5 of 7 CTVs (in 6 patients) to 2 Gy in 0-mm plans may be identified early in treatment using dose accumulation. A single intervention with an average anatomy derived from CBCT effectively mitigates discrepancies.

Adaptive online inverse control of a shape memory alloy wire actuator using a dynamic neural network

International Nuclear Information System (INIS)

Mai, Huanhuan; Liao, Xiaofeng; Song, Gangbing

2013-01-01

Shape memory alloy (SMA) actuators exhibit severe hysteresis, a nonlinear behavior, which complicates control strategies and limits their applications. This paper presents a new approach to controlling an SMA actuator through an adaptive inverse model based controller that consists of a dynamic neural network (DNN) identifier, a copy dynamic neural network (CDNN) feedforward term and a proportional (P) feedback action. Unlike fixed hysteresis models used in most inverse controllers, the proposed one uses a DNN to identify online the relationship between the applied voltage to the actuator and the displacement (the inverse model). Even without a priori knowledge of the SMA hysteresis and without pre-training, the proposed controller can precisely control the SMA wire actuator in various tracking tasks by identifying online the inverse model of the SMA actuator. Experiments were conducted, and experimental results demonstrated real-time modeling capabilities of DNN and the performance of the adaptive inverse controller. (paper)

[Rare tumors of the head and neck; on behalf of the REFCOR, the French Network of rare head and neck tumors].

Science.gov (United States)

Baujat, Bertrand; Thariat, Juliette; Baglin, Anne Catherine; Costes, Valérie; Testelin, Sylvie; Reyt, Emile; Janot, François

2014-05-01

Malignant tumors of the upper aerodigestive tract may be rare by their histology (sarcoma, variants of conventional squamous cell carcinomas) and/or location (sinuses, salivary glands, ear, of various histologies themselves). They represent less than 10% of head and neck neoplasms. The confirmation of their diagnosis often requires a medical expertise and sometimes biomolecular techniques complementary to classical histology and immunohistochemistry. Due to their location, their treatment often requires a specific surgical technique. Radiation therapy is indicated based on histoclinical characteristics common to other head and neck neoplasms but also incorporate grade. Further, the technique must often be adapted to take into account the proximity of organs at risk. For most histologies, chemotherapy is relatively inefficient but current molecular advances may allow to consider pharmaceutical developments in the coming years. The REFCOR, the French Network of head and neck cancers aims to organize and promote the optimal management of these rare and heterogeneous diseases, to promote research and clinical trials.

SU-F-T-449: Dosimetric Comparison of Acuros XB, Adaptive Convolve in Intensity Modulated Radiotherapy for Head and Neck Cancer

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Uehara, R [National Cancer Center Hospital East, Kashiwa, Chiba (Japan); Tachibana, H [National Cancer Center, Kashiwa, Chiba (Japan)

2016-06-15

Purpose: There have been several publications focusing on dose calculation in lung for a new dose calculation algorithm of Acuros XB (AXB). AXB could contribute to dose calculation for high-density media for bone and dental prosthesis rather than in lung. We compared the dosimetric performance of AXB, Adaptive Convolve (AC) in head and neck IMRT plans. Methods: In a phantom study, the difference in depth profile between AXB and AC was evaluated using Kodak EDR2 film sandwiched with tough water phantoms. 6 MV x-ray using the TrueBeam was irradiated. In a patient study, 20 head and neck IMRT plans had been clinically approved in Pinnacle3 and were transferred to Eclipse. Dose distribution was recalculated using AXB in Eclipse while maintaining AC-calculated monitor units and MLC sequence planned in Pinnacle. Subsequently, both the dose-volumetric data obtained using the two different calculation algorithms were compared. Results: The results in the phantom evaluation for the shallow area ahead of the build-up region shows over-dose for AXB and under-dose for AC, respectively. In the patient plans, AXB shows more hot spots especially around the high-density media than AC in terms of PTV (Max difference: 4.0%) and OAR (Max. difference: 1.9%). Compared to AC, there were larger dose deviations in steep dose gradient region and higher skin-dose. Conclusion: In head and neck IMRT plans, AXB and AC show different dosimetric performance for the regions inside the target volume around high-density media, steep dose gradient regions and skin-surface. There are limitations in skin-dose and complex anatomic condition using even inhomogeneous anthropomorphic phantom Thus, there is the potential for an increase of hot-spot in AXB, and an underestimation of dose in substance boundaries and skin regions in AC.

SU-F-T-449: Dosimetric Comparison of Acuros XB, Adaptive Convolve in Intensity Modulated Radiotherapy for Head and Neck Cancer

International Nuclear Information System (INIS)

Uehara, R; Tachibana, H

2016-01-01

Purpose: There have been several publications focusing on dose calculation in lung for a new dose calculation algorithm of Acuros XB (AXB). AXB could contribute to dose calculation for high-density media for bone and dental prosthesis rather than in lung. We compared the dosimetric performance of AXB, Adaptive Convolve (AC) in head and neck IMRT plans. Methods: In a phantom study, the difference in depth profile between AXB and AC was evaluated using Kodak EDR2 film sandwiched with tough water phantoms. 6 MV x-ray using the TrueBeam was irradiated. In a patient study, 20 head and neck IMRT plans had been clinically approved in Pinnacle3 and were transferred to Eclipse. Dose distribution was recalculated using AXB in Eclipse while maintaining AC-calculated monitor units and MLC sequence planned in Pinnacle. Subsequently, both the dose-volumetric data obtained using the two different calculation algorithms were compared. Results: The results in the phantom evaluation for the shallow area ahead of the build-up region shows over-dose for AXB and under-dose for AC, respectively. In the patient plans, AXB shows more hot spots especially around the high-density media than AC in terms of PTV (Max difference: 4.0%) and OAR (Max. difference: 1.9%). Compared to AC, there were larger dose deviations in steep dose gradient region and higher skin-dose. Conclusion: In head and neck IMRT plans, AXB and AC show different dosimetric performance for the regions inside the target volume around high-density media, steep dose gradient regions and skin-surface. There are limitations in skin-dose and complex anatomic condition using even inhomogeneous anthropomorphic phantom Thus, there is the potential for an increase of hot-spot in AXB, and an underestimation of dose in substance boundaries and skin regions in AC.

Trunnion Failure of the Recalled Low Friction Ion Treatment Cobalt Chromium Alloy Femoral Head.

Science.gov (United States)

Urish, Kenneth L; Hamlin, Brian R; Plakseychuk, Anton Y; Levison, Timothy J; Higgs, Genymphas B; Kurtz, Steven M; DiGioia, Anthony M

2017-09-01

Gross trunnion failure (GTF) is a rare complication in total hip arthroplasty (THA) reported across a range of manufacturers. Specific lots of the Stryker low friction ion treatment (LFIT) anatomic cobalt chromium alloy (CoCr) V40 femoral head were recalled in August 2016. In part, the recall was based out of concerns for disassociation of the femoral head from the stem and GTF. We report on 28 patients (30 implants) with either GTF (n = 18) or head-neck taper corrosion (n = 12) of the LFIT CoCr femoral head and the Accolade titanium-molybdenum-zirconium-iron alloy femoral stems. All these cases were associated with adverse local tissue reactions requiring revision of the THA. In our series, a conservative estimate of the incidence of failure was 4.7% (n = 636 total implanted) at 8.0 ± 1.4 years from the index procedure. Failures were associated with a high-offset 127° femoral stem neck angle and increased neck lengths; 43.3% (13 of 30) of the observed failures included implant sizes outside the voluntary recall (27.8% [5 of 18] of the GTF and 75.0% [8 of 12] of the taper corrosion cases). Serum cobalt and chromium levels were elevated (cobalt: 8.4 ± 7.0 μg/mL; chromium: 3.4 ± 3.3 μ/L; cobalt/chromium ratio: 3.7). The metal artifact reduction sequence magnetic resonance imaging demonstrated large cystic fluid collections typical with adverse local tissue reactions. During revision, a pseudotumor was observed in all cases. Pathology suggested a chronic inflammatory response. Impending GTF could be diagnosed based on aspiration of black synovial fluid and an oblique femoral head as compared with the neck taper on radiographs. In our series of the recalled LFIT CoCr femoral head, the risk of impending GTF or head-neck taper corrosion should be considered as a potential diagnosis in a painful LFIT femoral head and Accolade titanium-molybdenum-zirconium-iron alloy THA with unknown etiology. Almost half of the failures we observed included sizes outside of the

Face, neck, and eye protection: adapting body armour to counter the changing patterns of injuries on the battlefield.

Science.gov (United States)

Breeze, J; Horsfall, I; Hepper, A; Clasper, J

2011-12-01

Recent international papers have suggested an urgent need for new methods of protecting the face, neck, and eyes in battle. We made a systematic analysis to identify all papers that reported the incidence and mortality of combat wounds to the face, eyes, or neck in the 21st century, and any papers that described methods of protecting the face, neck, or eyes. Neck wounds were found in 2-11% of injuries in battle, and associated with high mortality, but no new methods of protecting the neck were identified. Facial wounds were found in 6-30% of injuries in battle, but despite the psychological effects of this type of injury only one paper suggested methods for protection. If soldiers wore existing eye protection they potentially reduced the mean incidence of eye injuries in combat from the 4.5% found in this analysis to 0.5%. Given the need to balance protection with the functional requirements of the individual soldier, a multidisciplinary approach is required. Military surgeons are well placed to work with material scientists and biomechanical engineers to suggest modifications to the design of both personal and vehicle-mounted protection. Further research needs is needed to find out how effective current methods of protecting the neck are, and to develop innovative methods of protecting the vulnerable regions of the neck and face. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

Morbidity of the neck after head and neck cancer therapy

NARCIS (Netherlands)

van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

Background. Studies on morbidity of the neck after head and neck cancer therapy are scarcely described. Methods. Patients who underwent surgery, including neck dissection, with and without radiation therapy at least 1 year before the study were asked to participate. We assessed neck pain, loss of

Text neck and neck pain in 18-21-year-old young adults.

Science.gov (United States)

Damasceno, Gerson Moreira; Ferreira, Arthur Sá; Nogueira, Leandro Alberto Calazans; Reis, Felipe José Jandre; Andrade, Igor Caio Santana; Meziat-Filho, Ney

2018-06-01

The aim of this study was to investigate whether there is an association between text neck and neck pain in young adults. Observational cross-sectional study with 150 18-21-year-old young adults from a public high school in the state of Rio de Janeiro was performed. In the self-report questionnaire, the participants answered questions on sociodemographic factors, anthropometric factors, time spent texting or playing on a mobile phone, visual impairments, and concern with the body posture. The neck posture was assessed by participants' self-perception and physiotherapists' judgment during a mobile phone texting message task. The Young Spine Questionnaire was used to evaluate the neck pain. Four multivariate logistic regression models were fitted to investigate the association between neck posture during mobile phone texting and neck pain, considering potential confounding factors. There is no association between neck posture, assessed by self-perception, and neck pain (OR = 1.66, p = 0.29), nor between neck posture, assessed by physiotherapists' judgment, and neck pain (OR = 1.23, p = 0.61). There was also no association between neck posture, assessed by self-perception, and frequency of neck pain (OR = 2.19, p = 0.09), nor between neck posture, assessed by physiotherapists' judgment, and frequency of neck pain (OR = 1.17, p = 0.68). This study did not show an association between text neck and neck pain in 18-21-year-old young adults. The findings challenge the belief that neck posture during mobile phone texting is associated to the growing prevalence of neck pain.

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

Science.gov (United States)

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

2016-04-01

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

Crystallization characteristics of cast aluminum alloys during a unidirectional solidification process

Energy Technology Data Exchange (ETDEWEB)

Okayasu, Mitsuhiro, E-mail: mitsuhiro.okayasu@utoronto.ca; Takeuchi, Shuhei

2015-05-01

The crystal orientation characteristics of cast Al–Si, Al–Cu and Al–Mg alloys produced by a unidirectional solidification process are examined. Two distinct crystal orientation patterns are observed: uniform and random formation. A uniform crystal orientation is created by columnar growth of α-Al dendrites in the alloys with low proportions of alloying element, e.g., the Al–Si alloy (with Si <12.6%) and the Al–Cu and Al–Mg alloys (with Cu and Mg <2%). A uniformly organized crystal orientation with [100] direction is created by columnar growth of α-Al dendrites. With increasing proportion of alloying element (>2% Cu or Mg), the uniform crystal orientations collapse in the Al–Cu and Al–Mg alloys, owing to interruption of the columnar α-Al dendrite growth as a result of different dynamics of the alloying atoms and the creation of a core for the eutectic phases. For the hypo-eutectic Al–Si alloys, a uniform crystal orientation is obtained. In contrast, a random orientation can be detected in the hyper-eutectic Al–Si alloy (15% Si), which results from interruption of the growth of the α-Al dendrites due to precipitation of primary Si particles. There is no clear effect of crystal formation on ultimate tensile strength (UTS), whereas crystal orientation does influence the material ductility, with the alloys with a uniform crystal orientation being elongated beyond their UTS points and with necking occurring in the test specimens. In contrast, the alloys with a nonuniform crystal orientation are not elongated beyond their UTS points.

Crystallization characteristics of cast aluminum alloys during a unidirectional solidification process

International Nuclear Information System (INIS)

Okayasu, Mitsuhiro; Takeuchi, Shuhei

2015-01-01

The crystal orientation characteristics of cast Al–Si, Al–Cu and Al–Mg alloys produced by a unidirectional solidification process are examined. Two distinct crystal orientation patterns are observed: uniform and random formation. A uniform crystal orientation is created by columnar growth of α-Al dendrites in the alloys with low proportions of alloying element, e.g., the Al–Si alloy (with Si <12.6%) and the Al–Cu and Al–Mg alloys (with Cu and Mg <2%). A uniformly organized crystal orientation with [100] direction is created by columnar growth of α-Al dendrites. With increasing proportion of alloying element (>2% Cu or Mg), the uniform crystal orientations collapse in the Al–Cu and Al–Mg alloys, owing to interruption of the columnar α-Al dendrite growth as a result of different dynamics of the alloying atoms and the creation of a core for the eutectic phases. For the hypo-eutectic Al–Si alloys, a uniform crystal orientation is obtained. In contrast, a random orientation can be detected in the hyper-eutectic Al–Si alloy (15% Si), which results from interruption of the growth of the α-Al dendrites due to precipitation of primary Si particles. There is no clear effect of crystal formation on ultimate tensile strength (UTS), whereas crystal orientation does influence the material ductility, with the alloys with a uniform crystal orientation being elongated beyond their UTS points and with necking occurring in the test specimens. In contrast, the alloys with a nonuniform crystal orientation are not elongated beyond their UTS points

Microstructure of V-4Cr-4Ti alloy after low-temperature irradiation by ions and neutrons

International Nuclear Information System (INIS)

Gazda, J.; Meshii, M.; Chung, H.M.

1998-01-01

Mechanical properties of V-4Cr-4Ti alloy were investigated after low-temperature ( ++ ) and dual ion beams (350-keV He + simultaneously with 4.5-MeV Ni ++ ). TEM observations showed the formation of a high density of point-defect clusters and dislocation loops (<30 nm diameter) distributed uniformly in the specimens. Mechanical-property testing showed embrittlement of the alloy. TEM investigations of deformed microstructures were used to determine the causes of embrittlement and yielded observation of dislocation channels propagating through the undeformed matrix. Channels are the sole slip paths and cause early onset of necking and loss of work-hardening in this alloy. Based on a review of the available literature, suggestions are made for further research of slip localization in V-base alloys

Structural thermodynamics of alloys

CERN Document Server

Manenc, Jack

1973-01-01

Technical progress has for a very long time been directly dependent on progress in metallurgy, which is itself connected with improvements in the technology of alloys. Metals are most frequently used in the form of alloys for several reasons: the quantity of pure metal in its native state in the earth's crust is very limited; pure metals must be extracted from ores which are themselves impure. Finally, the methods of treatment used lead more easily to alloys than to pure metals. The most typical case is that of iron, where a pure ore may be found, but which is the starting point for cast iron or steel, alloys of iron and carbon. In addition, the properties of alloys are in general superior to those of pure metals and modem metallurgy consists of controlling these properties so as to make them conform to the requirements of the design office. Whilst the engineer was formerly compelled to adapt his designs and constructions to the materials available, such as wood, stone, bronze, iron, cast iron and ordinary st...

Translation and cultural adaptation of the Shame and Stigma Scale (SSS) into Portuguese (Brazil) to evaluate patients with head and neck cancer.

Science.gov (United States)

Pirola, William Eduardo; Paiva, Bianca Sakamoto Ribeiro; Barroso, Eliane Marçon; Kissane, David W; Serrano, Claudia Valéria Maseti Pimenta; Paiva, Carlos Eduardo

Head and neck cancer is the sixth leading cause of death from cancer worldwide and its treatment may involve surgery, chemotherapy and/or radiation therapy. The surgical procedure may cause mutilating sequelae, that can alter patient self-image. Thus, head and neck cancer is often connected to the negative stigma with decreased quality of life. Few studies assess the social stigma and shame perceived by patients with head and neck cancer. To perform the translation and cultural adaptation of the Shame and Stigma Scale (SSS) into Portuguese (Brazil). Two independent translations (English into Portuguese) were carried out by two professionals fluent in the English language. After the synthesis of the translations, two independent back-translations (from Portuguese into English) were performed by two translators whose native language is English. All translations were critically assessed by a committee of experts consisting of five members. A sample of 15 patients answered the Brazilian Portuguese version of the SSS to carry out the pretest. At this step, the patients were able to suggest modifications and evaluate the understanding of the items. There was no need to change the scale after this step. Based on the previous steps, we obtained the Portuguese (Brazil) version of the SSS, which was called "Escala de Vergonha e Estigma". The Portuguese (Brazil) version of the SSP was shown to be adequate to be applied to the population with HNC and, therefore, the psychometric properties of the tool will be evaluated during following steps. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Determination of necking time in tensile test specimens, under high-temperature creep conditions, subjected to distribution of stresses over the cross-section

Science.gov (United States)

Lokoshchenko, A.; Teraud, W.

2018-04-01

The work describes an experimental research of creep of cylindrical tensile test specimens made of aluminum alloy D16T at a constant temperature of 400°C. The issue to be examined was the necking at different values of initial tensile stresses. The use of a developed noncontacting measuring system allowed us to see variations in the specimen shape and to estimate the true stress in various times. Based on the obtained experimental data, several criteria were proposed for describing the point of time at which the necking occurs (necking point). Calculations were carried out at various values of the parameters in these criteria. The relative interval of deformation time in which the test specimen is uniformly stretched was also determined.

Radiographic evaluation of marginal bone level around implants with different neck designs after 1 year.

Science.gov (United States)

Shin, Young-Kyu; Han, Chong-Hyun; Heo, Seong-Joo; Kim, Sunjai; Chun, Heoung-Jae

2006-01-01

To evaluate the influence of macro- and microstructure of the implant surface at the marginal bone level after functional loading. Sixty-eight patients were randomly assigned to 1 of 3 groups. The first group received 35 implants with a machined neck (Ankylos); the second group, 34 implants with a rough-surfaced neck (Stage 1); and the third, 38 implants with a rough-surfaced neck with microthreads (Oneplant). Clinical and radiographic examinations were conducted at baseline (implant loading) and 3, 6, and 12 months postloading. Two-way repeated analysis of variance (ANOVA) was used to test the significance of marginal bone change of each tested group at baseline, 3, 6, and 12 month follow-ups and 1-way ANOVA was also used to compare the bone loss of each time interval within the same implant group (P implant neck not only reduce crestal bone loss but also help with early biomechanical adaptation against loading in comparison to the machined neck design. A rough surface with microthreads at the implant neck was the most effective design to maintain the marginal bone level against functional loading.

Asymmetry of neck motion and activation of the cervical paraspinal muscles during prone neck extension in subjects with unilateral posterior neck pain.

Science.gov (United States)

Park, Kyue-Nam; Kwon, Oh-Yun; Kim, Su-Jung; Kim, Si-Hyun

2017-01-01

Although unilateral posterior neck pain (UPNP) is more prevalent than central neck pain, little is known about how UPNP affects neck motion and the muscle activation pattern during prone neck extension. To investigate whether deviation in neck motion and asymmetry of activation of the bilateral cervical paraspinal muscles occur during prone neck extension in subjects with UPNP compared to subjects without UPNP. This study recruited 20 subjects with UPNP and 20 age- and sex-matched control subjects without such pain. Neck motion and muscle onset time during prone neck extension were measured using a three-dimensional motion-analysis system and surface electromyography. The deviation during prone neck extension was greater in the UPNP group than in the controls (p cervical extensor muscle activation in the UPNP group was significantly delayed on the painful side during prone neck extension (p cervical extensors, triggering a need for specific evaluation and exercises in the management of patients with UPNP.

Evaluation of radiotherapy methods for adaptative head and neck treatment with RapidArc®; Avaliacao de uma metodologia de radioterapia adaptativa para tratamentos de cabeca e pescoco com RapidArc®

Energy Technology Data Exchange (ETDEWEB)

Mazaro, Sarah J.; Vasconcellos, Herminiane L.; Silva, Laura E. da; Bastos, Fernanda M.; Silva, Leonardo P. da; Alvaro S; Migoviski, Igor, E-mail: sarahmazaro@yahoo.com.br [Instituto Nacional de Cancer Jose de Alencar Gomes da Silva (INCA), Rio de Janeiro,RJ (Brazil)

2015-08-15

Head and neck cancer is considered a public health problem worldwide. The intensity-modulated techniques have shown benefit in the treatment of these sites, particularly with respect to reduction of deterministic effects of risk, such as parotid. Anatomical variations in cases of head and neck are very frequent and may lead, for example, to an overdose in the parotid. This can be mitigated if making use of adaptive radiation therapy. The work aims to analyze a methodology to redo the planning of treatments, through 02 acquisitions of TC. The results showed that, due to a reduction in the volumes of the parotid, the doses delivered to these organs are underestimated, which is relevant to readapt the treatment, with the addition of only a second scan without the need of the third. (author)

Can adaptive threshold-based metabolic tumor volume (MTV) and lean body mass corrected standard uptake value (SUL) predict prognosis in head and neck cancer patients treated with definitive radiotherapy/chemoradiotherapy?

Science.gov (United States)

Akagunduz, Ozlem Ozkaya; Savas, Recep; Yalman, Deniz; Kocacelebi, Kenan; Esassolak, Mustafa

2015-11-01

To evaluate the predictive value of adaptive threshold-based metabolic tumor volume (MTV), maximum standardized uptake value (SUVmax) and maximum lean body mass corrected SUV (SULmax) measured on pretreatment positron emission tomography and computed tomography (PET/CT) imaging in head and neck cancer patients treated with definitive radiotherapy/chemoradiotherapy. Pretreatment PET/CT of the 62 patients with locally advanced head and neck cancer who were treated consecutively between May 2010 and February 2013 were reviewed retrospectively. The maximum FDG uptake of the primary tumor was defined according to SUVmax and SULmax. Multiple threshold levels between 60% and 10% of the SUVmax and SULmax were tested with intervals of 5% to 10% in order to define the most suitable threshold value for the metabolic activity of each patient's tumor (adaptive threshold). MTV was calculated according to this value. We evaluated the relationship of mean values of MTV, SUVmax and SULmax with treatment response, local recurrence, distant metastasis and disease-related death. Receiver-operating characteristic (ROC) curve analysis was done to obtain optimal predictive cut-off values for MTV and SULmax which were found to have a predictive value. Local recurrence-free (LRFS), disease-free (DFS) and overall survival (OS) were examined according to these cut-offs. Forty six patients had complete response, 15 had partial response, and 1 had stable disease 6 weeks after the completion of treatment. Median follow-up of the entire cohort was 18 months. Of 46 complete responders 10 had local recurrence, and of 16 partial or no responders 10 had local progression. Eighteen patients died. Adaptive threshold-based MTV had significant predictive value for treatment response (p=0.011), local recurrence/progression (p=0.050), and disease-related death (p=0.024). SULmax had a predictive value for local recurrence/progression (p=0.030). ROC curves analysis revealed a cut-off value of 14.00 mL for

Maximum tolerated dose in a phase I trial on adaptive dose painting by numbers for head and neck cancer

International Nuclear Information System (INIS)

Madani, Indira; Duprez, Fréderic; Boterberg, Tom; Van de Wiele, Christophe; Bonte, Katrien; Deron, Philippe; De Gersem, Werner; Coghe, Marc; De Neve, Wilfried

2011-01-01

Purpose: To determine the maximum tolerated dose (MTD) in a phase I trial on adaptive dose-painting-by-numbers (DPBN) for non-metastatic head and neck cancer. Materials and methods: Adaptive intensity-modulated radiotherapy was based on voxel intensity of pre-treatment and per-treatment [ 18 F]fluoro-2-deoxy-D-glucose positron emission tomography ( 18 F-FDG-PET) scans. Dose was escalated to a median total dose of 80.9 Gy in the high-dose clinical target volume (dose level I) and 85.9 Gy in the gross tumor volume (dose level II). The MTD would be reached, if ⩾33% of patients developed any grade ⩾4 toxicity (DLT) up to 3 months follow-up. Results: Between February 2007 and August 2009, seven patients at dose level I and 14 at dose level II were treated. All patients completed treatment without interruption. At a median follow-up for surviving patients of 38 (dose level I) and 22 months (dose level II) there was no grade ⩾4 toxicity during treatment and follow-up but six cases of mucosal ulcers at latency of 4–10 months, of which five (36%) were observed at dose level II. Mucosal ulcers healed spontaneously in four patients. Conclusions: Considering late mucosal ulcers as DLT, the MTD of a median dose of 80.9 Gy has been reached in our trial.

Automatic Segmentation and Online virtualCT in Head-and-Neck Adaptive Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Peroni, Marta, E-mail: marta.peroni@mail.polimi.it [Department of Bioengineering, Politecnico di Milano, Milano (Italy); Ciardo, Delia [Advanced Radiotherapy Center, European Institute of Oncology, Milano (Italy); Spadea, Maria Francesca [Department of Experimental and Clinical Medicine, Universita degli Studi Magna Graecia, Catanzaro (Italy); Riboldi, Marco [Department of Bioengineering, Politecnico di Milano, Milano (Italy); Bioengineering Unit, Centro Nazionale di Adroterapia Oncologica, Pavia (Italy); Comi, Stefania; Alterio, Daniela [Advanced Radiotherapy Center, European Institute of Oncology, Milano (Italy); Baroni, Guido [Department of Bioengineering, Politecnico di Milano, Milano (Italy); Bioengineering Unit, Centro Nazionale di Adroterapia Oncologica, Pavia (Italy); Orecchia, Roberto [Advanced Radiotherapy Center, European Institute of Oncology, Milano (Italy); Universita degli Studi di Milano, Milano (Italy); Medical Department, Centro Nazionale di Adroterapia Oncologica, Pavia (Italy)

2012-11-01

Purpose: The purpose of this work was to develop and validate an efficient and automatic strategy to generate online virtual computed tomography (CT) scans for adaptive radiation therapy (ART) in head-and-neck (HN) cancer treatment. Method: We retrospectively analyzed 20 patients, treated with intensity modulated radiation therapy (IMRT), for an HN malignancy. Different anatomical structures were considered: mandible, parotid glands, and nodal gross tumor volume (nGTV). We generated 28 virtualCT scans by means of nonrigid registration of simulation computed tomography (CTsim) and cone beam CT images (CBCTs), acquired for patient setup. We validated our approach by considering the real replanning CT (CTrepl) as ground truth. We computed the Dice coefficient (DSC), center of mass (COM) distance, and root mean square error (RMSE) between correspondent points located on the automatically segmented structures on CBCT and virtualCT. Results: Residual deformation between CTrepl and CBCT was below one voxel. Median DSC was around 0.8 for mandible and parotid glands, but only 0.55 for nGTV, because of the fairly homogeneous surrounding soft tissues and of its small volume. Median COM distance and RMSE were comparable with image resolution. No significant correlation between RMSE and initial or final deformation was found. Conclusion: The analysis provides evidence that deformable image registration may contribute significantly in reducing the need of full CT-based replanning in HN radiation therapy by supporting swift and objective decision-making in clinical practice. Further work is needed to strengthen algorithm potential in nGTV localization.

Automatic segmentation and online virtualCT in head-and-neck adaptive radiation therapy.

Science.gov (United States)

Peroni, Marta; Ciardo, Delia; Spadea, Maria Francesca; Riboldi, Marco; Comi, Stefania; Alterio, Daniela; Baroni, Guido; Orecchia, Roberto

2012-11-01

The purpose of this work was to develop and validate an efficient and automatic strategy to generate online virtual computed tomography (CT) scans for adaptive radiation therapy (ART) in head-and-neck (HN) cancer treatment. We retrospectively analyzed 20 patients, treated with intensity modulated radiation therapy (IMRT), for an HN malignancy. Different anatomical structures were considered: mandible, parotid glands, and nodal gross tumor volume (nGTV). We generated 28 virtualCT scans by means of nonrigid registration of simulation computed tomography (CTsim) and cone beam CT images (CBCTs), acquired for patient setup. We validated our approach by considering the real replanning CT (CTrepl) as ground truth. We computed the Dice coefficient (DSC), center of mass (COM) distance, and root mean square error (RMSE) between correspondent points located on the automatically segmented structures on CBCT and virtualCT. Residual deformation between CTrepl and CBCT was below one voxel. Median DSC was around 0.8 for mandible and parotid glands, but only 0.55 for nGTV, because of the fairly homogeneous surrounding soft tissues and of its small volume. Median COM distance and RMSE were comparable with image resolution. No significant correlation between RMSE and initial or final deformation was found. The analysis provides evidence that deformable image registration may contribute significantly in reducing the need of full CT-based replanning in HN radiation therapy by supporting swift and objective decision-making in clinical practice. Further work is needed to strengthen algorithm potential in nGTV localization. Copyright © 2012 Elsevier Inc. All rights reserved.

Developing prospects of NiAlMn high temperature shape memory alloy

International Nuclear Information System (INIS)

Zou Min

1999-01-01

The reason and information on high temperature shape memory alloy research are introduced briefly Also, referring to some experimental reports on NiAlMn high temperature shape memory alloy, it is pointed out that ductility and memory property of this alloy can be improved by adapting proper composition and procedure to control its microstructure. Meanwhile, the engineering details must be considered when NiAlMn high temperature shape memory alloy being developed so as to resolve the problems of its practical use

Head and neck cancer

International Nuclear Information System (INIS)

Vogl, S.E.

1988-01-01

This book contains 10 chapters. Some of the titles are: Combined Surgical Resection and Irradiation for Head and Neck Cancers; Analysis of Radiation Therapy Oncology Group Head and Neck Database: Identification of Prognostic Factors and the Re-evaluation of American Joint Committee Stages; Combined Modality Approach to Head and Neck Cancer; Induction Combination Chemotherapy of Regionally Advanced Head and Neck Cancer; and Outcome after Complete Remission to Induction Chemotherapy in Head and Neck Cancer

Explosive device of conduit using Ti Ni alloy

Directory of Open Access Journals (Sweden)

A. Yu. Kolobov

2014-01-01

Full Text Available Presently, materials have been developed which are capable at changing temperate to return significant inelastic deformations, exhibit rubber-like elasticity, convert heat into mechanical work, etc. The aggregate of these effects is usually called the shape memory effect.At present a great number of compounds and alloys with a shape memory effect has been known.These are alloys based on titanium nickelide (TiNi, copper-based alloys (Cu-Al, Cu-Sn, Cu-Al-Ni, Cu-Zn-Si, etc., gold and silver (Ag-Cd, Au-Ag-Cd, Au-Cd-Cu, Au-Zn-Cu, etc., manganese (Mn-Cr, Fe-Cu, Mn-Cu-Ni, Mn-Cu-Zr, Mn-Ni, etc., iron (Fe-Mn, Fe-Ni, Fe-Al, etc., and other compounds.The alloys based on titanium nickelide (nitinol are the most widely used.Alloys with shape memory effect find various applications in engineering and medicine, namely connecting devices, actuators, transformable design, multipurpose medical implants, etc.There is a task of breaking fuel conduit during separating the spacecraft from the rocket in space technology.The paper examines the procedure for design calculation of the separating device of conduit with the use of Ti-Ni alloy. This device can be used instead of the pyro-knives.The device contains two semi-rings from Ti-Ni alloy. In the place of break on the conduit an annular radius groove is made.At a temperature of martensite passage the semi-rings undergo deformation and in the strained state are set in the device. With heating to the temperature of the austenitic passage of bushing macro-deformation the energy stored by the nitinol bushing is great enough to break the conduit on the neck.The procedures of design calculation and response time of device are given.

Neck muscle endurance and head posture: A comparison between adolescents with and without neck pain.

Science.gov (United States)

Oliveira, Ana Carolina; Silva, Anabela G

2016-04-01

The main aims of this study were to compare the neck flexor and extensor endurance and forward head posture between adolescents with and without neck pain. The secondary aims were to explore potential associations between muscles endurance, head posture and neck pain characteristics and to assess intra-rater reliability of the measurements used. Adolescents with neck pain (n = 35) and age-matched asymptomatic adolescents (n = 35) had their forward head posture, neck flexor endurance and neck extensor endurance measured using clinical tests. Intra-rater reliability was also assessed. Forward head posture and neck flexor and extensor endurance tests showed moderate to almost perfect intra-rater reliability (ICC between 0.58 and 0.88). Adolescents with neck pain showed significantly less forward head posture (neck pain = 46.62 ± 4.92; asymptomatic = 44.18°± 3.64°, p > 0.05) and less neck flexor (neck pain = 24.50 ± 23.03s; asymptomatic = 35.89 ± 21.53s, p > 0.05) and extensor endurance (neck pain = 12.6.64 ± 77.94s; asymptomatic = 168.66 ± 74.77s, p > 0.05) than asymptomatic adolescents. Results suggest that changes in posture and neck muscle endurance are a feature of adolescents with neck pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

Three-dimensional measurement of femoral neck anteversion and neck shaft angle.

Science.gov (United States)

Sangeux, Morgan; Pascoe, Jessica; Graham, H Kerr; Ramanauskas, Fiona; Cain, Tim

2015-01-01

We present a three-dimensional measurement technique for femoral neck anteversion and neck shaft angles which do not require alignment of the femoral and scanner axes. Two assessors performed the measurements on 11 patients (22 femurs). Repeatability between assessors was 2.7 degrees for femoral neck anteversion and 4.8 degrees for neck shaft angle. Measurements compared with an alternative single slice method were different by 2 degrees (3 degrees) in average. The method was repeatable and appropriate for clinical practice.

Neck Pain

Science.gov (United States)

... too many hours hunched over your computer or smartphone, often triggers muscle strains. Even minor things, such ... your shoulder. The weight can strain your neck. Sleep in a good position. Your head and neck ...

Neck dissection following chemo radiation for node positive head and neck carcinomas

International Nuclear Information System (INIS)

Thariat, J.; Thariat, J.; Marcy, P.Y.; Bozec, A.; Peyrade, F.; Hofman, P.; Hamoir, M.; Janot, F.; De Mones, E.; Marcy, P.Y.; Carrier, P.; Bozec, I.; Guevara, J.; Santini, J.; Albert, S.; Vedrine, P.O.; Graff, P.; Peyrade, F.; Hofman, P.; Bourhis, J.; Lapeyre, M.

2009-01-01

The optimal timing and extent of neck dissection in the context of chemo radiation for head and neck cancer remains controversial. For some institutions, it is uncertain whether neck dissection should still be performed up front especially for cystic nodes. For others, neck dissection can be performed after chemo radiation and can be omitted for N1 disease as long as a complete response to chemo radiation is obtained. The question is debated for N2 and N3 disease even after a complete response as the correlation between radiological and clinical assessment and pathology may not be reliable. Response rates are greater than or equal to 60% and isolated neck failures are less than or equal to 10% with current chemo radiation protocols. Some therefore consider that systematic up front or planned neck dissection would lead to greater than or equal to 50% unnecessary neck dissections for N2-N3 disease. Positron-emission tomography (PET) scanning to assess treatment response and have shown a very high negative predictive value of greater than or equal to 95% when using a standard uptake value of 3 for patients with a negative PET at four months after the completion of therapy. These data may support the practice of observing PET-negative necks. More evidence-based data are awaited to assess the need for neck dissection on PET. Selective neck dissection based on radiological assessment and preoperative findings and not exclusively on initial nodal stage may help to limit morbidity and to improve the quality of life without increasing the risk of neck failure. Adjuvant regional radiation boosts might be discussed on an individual basis for aggressive residual nodal disease with extra-capsular spread and uncertain margins but evidence is missing. Medical treatments aiming at reducing the metastatic risk especially for N3 disease are to be evaluated

Creep and rupture of an ODS alloy with high stress rupture ductility. [Oxide Dispersion Strengthened

Science.gov (United States)

Mcalarney, M. E.; Arsons, R. M.; Howson, T. E.; Tien, J. K.; Baranow, S.

1982-01-01

The creep and stress rupture properties of an oxide (Y2O3) dispersion strengthened nickel-base alloy, which also is strengthened by gamma-prime precipitates, was studied at 760 and 1093 C. At both temperatures, the alloy YDNiCrAl exhibits unusually high stress rupture ductility as measured by both elongation and reduction in area. Failure was transgranular, and different modes of failure were observed including crystallographic fracture at intermediate temperatures and tearing or necking almost to a chisel point at higher temperatures. While the rupture ductility was high, the creep strength of the alloy was low relative to conventional gamma prime strengthened superalloys in the intermediate temperature range and to ODS alloys in the higher temperature range. These findings are discussed with respect to the alloy composition; the strengthening oxide phases, which are inhomogeneously dispersed; the grain morphology, which is coarse and elongated and exhibits many included grains; and the second phase inclusion particles occurring at grain boundaries and in the matrix. The creep properties, in particular the high stress dependencies and high creep activation energies measured, are discussed with respect to the resisting stress model of creep in particle strengthened alloys.

Inter-vertebral flexibility of the ostrich neck: implications for estimating sauropod neck flexibility.

Science.gov (United States)

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.

Inter-vertebral flexibility of the ostrich neck: implications for estimating sauropod neck flexibility.

Directory of Open Access Journals (Sweden)

Matthew J Cobley

Full Text Available 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.

The Neck Disability Index-Russian Language Version (NDI-RU): A Study of Validity and Reliability.

Science.gov (United States)

Bakhtadze, Maxim A; Vernon, Howard; Zakharova, Olga B; Kuzminov, Kirill O; Bolotov, Dmitry A

2015-07-15

Cross-cultural adaptation and psychometric testing. To perform a validated Russian translation and then to evaluate the validity and reliability of the Russian language version of the Neck Disability Index (NDI-RU). Neck pain is highly prevalent and can greatly affect daily activity. The Neck Disability Index (NDI) is the most frequently used scale for self-rating of disability due to neck pain. Its translated versions are applied in many countries. However, the Russian language version of the NDI has not been developed yet. Cross-cultural adaptation of the NDI-RU was performed according to established guidelines. Then, the NDI-RU was evaluated for content validity, concurrent criterion validity, internal consistency, test-retest reliability, factor structure, and minimum detectable change. Two hundred thirty-two patients took part in the study in total: 109 in validity (39.5 ± 10 yr), 123 in reliability (38.4 ± 11 yr; 80 in the test-retest phase). A culturally valid translation was achieved. NDI-RU total scores were distributed normally. Floor/ceiling effects were absent. Good values of Cronbach α were obtained for each item (from 0.80 to 0.84) and for the total NDI-RU (0.83). A 2-factor solution was found for the NDI-RU. The average interitem correlation coefficient was 0.53. Intraclass correlation coefficients for test-retest reliability coefficients ranged from 0.65 to 0.92 for different items and 0.91 for the total NDI-RU. Moderate correlation (Spearman rs = 0.62; P Russian language version of the Neck Disability Index resulted in a valid, reliable instrument that can be used both in clinical practice and scientific investigations. 1.

HVEM in situ deformation of Al-Li-X alloys

International Nuclear Information System (INIS)

Crooks, R.E.; Kenik, E.A.; Starke, E.A. Jr.

1983-01-01

Lithium additions to aluminum alloys increase both the strength and elastic modulus while decreasing the density, thereby resulting in very attractive combinations of properties. The commercial utilization of these alloys, however, has been hindered by a lack of adequate ductility at peak strength. Recent investigations have attributed the low ductility to intense, localized deformation. This is considered to be due to the promotion of planar slip by coherent, shearable, delta' (Al 3 Li) precipitates and the presence of precipitate free zones (PFZ's) at high angle grain boundaries. An Al-Cu-Li-Mg-Zr alloy, produced by rapidly solidified powder processing, was found to exhibit ductility improvements over comparable, lithium-containing alloys. Thin foils prepared from bulk tensile samples were examined by transmission electron microscopy (TEM), and no evidence of localized deformation was found. These, however, were only successfully produced from the region of uniform elongation below the neck and were thus limited to approximately 4% plastic strain. In order to observe the deformation behavior under severe strain, an in situ deformation study was conducted in a high voltage electron microscope (HVEM). Several investigators have used in situ HVEM techniques to study ductile fracture processes. The advantages of HVEM versus TEM for this purpose include: thicker specimens (due to a lower energy exchange of the electrons), a lower specimen contamination rate and a negligible increase in specimen temperature. Two lithium-containing alloys which had been previously reported to demonstrate localized, planar slip were studied for comparison

Treatment results of the neck by concurrent chemoradiotherapy for advanced head and neck cancer

International Nuclear Information System (INIS)

Tokumaru, Yutaka; Fujii, Masato; Habu, Noboru; Yajima, Yoko; Yorozu, Atsunori

2009-01-01

Concurrent chemoradiotherapy (CCRT) is one of the recent emerging modalities for advanced squamous cell carcinoma of the head and neck (HNSCC). However some of the patients treated by CCRT have residual or recurrent cervical lymph nodes. In these cases, neck dissection is considered to be useful in the point of locolegional control and disease free survival. This study aims to analyze neck control rate by CCRT and usefulness of the neck dissection after CCRT for HNSCC. The medical records of 69 consecutive patients (stage III: 4%, stage IV: 96%) treated with CCRT for SCCHN (hypopharynx: 40, oropharynx: 25, larynx: 4) from 2003 through 2007 were reviewed. Clinical complete response (CR) rates of N1, N2a, N2b, N2c and N3 were 75%, 100%, 71%, 74% and 43% respectively. Among the patients with complete neck response, only 2 patients (5%) had an isolated neck recurrence. Eleven patients underwent surgical neck procedures including 7 planned neck dissections and 4 salvage neck dissections. All the 11 patients with neck dissections had good regional control except 1 case. There were a few minor complications such as wound infection and laryngeal edema. Patients who have a complete clinical regional response to CCRT have a low probability of an isolated recurrence in the neck. Planned and salvage neck dissections can be safely performed and considered to be useful in the point of regional control after intensive CCRT. (author)

Neck movement and muscle activity characteristics in female office workers with neck pain.

Science.gov (United States)

Johnston, V; Jull, G; Souvlis, T; Jimmieson, N L

2008-03-01

Cross-sectional study. To explore aspects of cervical musculoskeletal function in female office workers with neck pain. Evidence of physical characteristics that differentiate computer workers with and without neck pain is sparse. Patients with chronic neck pain demonstrate reduced motion and altered patterns of muscle control in the cervical flexor and upper trapezius (UT) muscles during specific tasks. Understanding cervical musculoskeletal function in office workers will better direct intervention and prevention strategies. Measures included neck range of motion; superficial neck flexor muscle activity during a clinical test, the craniocervical flexion test; and a motor task, a unilateral muscle coordination task, to assess the activity of both the anterior and posterior neck muscles. Office workers with and without neck pain were formed into 3 groups based on their scores on the Neck Disability Index. Nonworking women without neck pain formed the control group. Surface electromyographic activity was recorded bilaterally from the sternocleidomastoid, anterior scalene (AS), cervical extensor (CE) and UT muscles. Workers with neck pain had reduced rotation range and increased activity of the superficial cervical flexors during the craniocervical flexion test. During the coordination task, workers with pain demonstrated greater activity in the CE muscles bilaterally. On completion of the task, the UT and dominant CE and AS muscles demonstrated an inability to relax in workers with pain. In general, there was a linear relationship between the workers' self-reported levels of pain and disability and the movement and muscle changes. These results are consistent with those found in other cervical musculoskeletal disorders and may represent an altered muscle recruitment strategy to stabilize the head and neck. An exercise program including motor reeducation may assist in the management of neck pain in office workers.

Neck Pain

Science.gov (United States)

... Vomiting Nausea and Vomiting in Infants and Children Neck Pain Neck Swelling Shortness of Breath Shortness of Breath ... worse or doesn’t get better. Start OverDiagnosisYour pain may be from DEGENERATIVE CERVICAL ARTHRITIS, a disorder that affects the bones and ...

Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study

NARCIS (Netherlands)

Ariens, G.A.M.; Bongers, P.M.; Douwes, M.; Miedema, M.C.; Hoogendoorn, W.E.; van der Wal, G.; Bouter, L.M.; van Mechelen, W.

2001-01-01

Objective: To study the relation between neck pain and work related neck flexion, neck rotation, and sitting. Methods: A prospective cohort study was performed with a follow up of 3 years among 1334 workers from 34 companies. Work related physical load was assessed by analysing objectively measured

Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? : Results of a prospective cohort study

NARCIS (Netherlands)

Ariëns, G A; Bongers, P M; Douwes, M; Miedema, M C; Hoogendoorn, W E; van der Wal, G; Bouter, L M; van Mechelen, W

OBJECTIVE: To study the relation between neck pain and work related neck flexion, neck rotation, and sitting. METHODS: A prospective cohort study was performed with a follow up of 3 years among 1334 workers from 34 companies. Work related physical load was assessed by analysing objectively measured

Neck and Upper Limb Dysfunction in Patients following Neck Dissection: Looking beyond the Shoulder.

Science.gov (United States)

Gane, Elise M; O'Leary, Shaun P; Hatton, Anna L; Panizza, Benedict J; McPhail, Steven M

2017-10-01

Objective To measure patient-perceived upper limb and neck function following neck dissection and to investigate potential associations between clinical factors, symptoms, and function. Study Design Cross-sectional. Setting Two tertiary hospitals in Brisbane, Australia. Subjects and Methods Inclusion criteria: patients treated with neck dissection (2009-2014). aged <18 years, accessory nerve or sternocleidomastoid sacrifice, previous neck dissection, preexisting shoulder/neck injury, and inability to provide informed consent (cognition, insufficient English). Primary outcomes were self-reported function of the upper limb (Quick Disabilities of the Arm, Shoulder, and Hand) and neck (Neck Disability Index). Secondary outcomes included demographics, oncological management, self-efficacy, and pain. Generalized linear models were prepared to examine relationships between explanatory variables and self-reported function. Results Eighty-nine participants (male n = 63, 71%; median age, 62 years; median 3 years since surgery) reported mild upper limb and neck dysfunction (median [quartile 1, quartile 3] scores of 11 [3, 32] and 12 [4, 28], respectively). Significant associations were found between worse upper limb function and longer time since surgery (coefficient, 1.76; 95% confidence interval [CI], 0.01-3.51), having disease within the thyroid (17.40; 2.37-32.44), postoperative radiation therapy (vs surgery only) (13.90; 6.67-21.14), and shoulder pain (0.65; 0.44-0.85). Worse neck function was associated with metastatic cervical lymph nodes (coefficient, 6.61; 95% CI, 1.14-12.08), shoulder pain (0.19; 0.04-0.34), neck pain (0.34; 0.21-0.47), and symptoms of neuropathic pain (0.61; 0.25-0.98). Conclusion Patients can experience upper limb and neck dysfunction following nerve-preserving neck dissection. The upper quadrant as a whole should be considered when assessing rehabilitation priorities after neck dissection.

Oncologic safety of cervical nerve preservation in neck dissection for head and neck cancer.

Science.gov (United States)

Honda, Keigo; Asato, Ryo; Tsuji, Jun; Miyazaki, Masakazu; Kada, Shinpei; Tsujimura, Takashi; Kataoka, Michiko

2017-09-01

Although the functional merits of preserving cervical nerves in neck dissection for head and neck cancer have been reported, the oncologic safety has not yet been determined. Therefore, the purpose of this study was to evaluate the safety of cervical nerve preservation. A retrospective chart review was performed on patients with head and neck cancer who had been treated by neck dissection between 2009 and 2014 at Kyoto Medical Center. Management of cervical nerves and clinical results were analyzed. A total of 335 sides of neck dissection had been performed in 222 patients. Cervical nerves were preserved in 175 neck sides and resected in 160 sides. The 5-year overall survival (OS) rate calculated by the Kaplan-Meier method was 71%. The 5-year neck control rate was 95% in cervical nerve preserved sides and 89% in cervical nerve resected sides. Preserving cervical nerves in neck dissection is oncologically safe in selected cases. © 2017 Wiley Periodicals, Inc.

Effects of neck strength training on isometric neck strength in rugby union players.

Science.gov (United States)

Geary, Kevin; Green, Brian S; Delahunt, Eamonn

2014-11-01

To investigate the effectiveness of a neck strengthening program on the isometric neck strength profile of male rugby union players. Controlled laboratory study. Professional rugby union club. Fifteen professional and 10 semiprofessional rugby union players. The 15 professional players undertook a 5-week neck strengthening intervention, which was performed twice per week, whereas the 10 semiprofessional players acted as the control group. Isometric strength of the neck musculature was tested using a hand-held dynamometer, for flexion (F), extension (E), left-side flexion (LSF), and right-side flexion (RSF). Preintervention and postintervention evaluations were undertaken. No significant between-group differences in isometric neck strength were noted preintervention. A significant main effect for time was observed (P isometric neck strength in all planes after the 5-week intervention (F preintervention = 334.45 ± 39.31 N vs F postintervention 396.05 ± 75.55 N; E preintervention = 606.19 ± 97.34 vs E postintervention = 733.88 ± 127.16 N; LSF preintervention = 555.56 ± 88.34 N vs LSF postintervention = 657.14 ± 122.99 N; RSF preintervention = 570.00 ± 106.53 N vs RSF postintervention = 668.00 ± 142.18 N). No significant improvement in neck strength was observed for control group participants. The results of the present study indicate that a 5-week neck strengthening program improves isometric neck strength in rugby union players, which may have implications for injury prevention, screening, and rehabilitation. The strengthening program described in the present study may facilitate rehabilitation specialists in the development of neck injury prevention, screening, and rehabilitation protocols.

Head, Neck, and Oral Cancer

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Full Text Available ... Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

Head, Neck, and Oral Cancer

Medline Plus

Full Text Available ... and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed with ... and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed with ...

Neck muscle vibration can improve sensorimotor function in patients with neck pain.

Science.gov (United States)

Beinert, Konstantin; Keller, Martin; Taube, Wolfgang

2015-03-01

People with neck pain display a diminished joint position sense and disturbed postural control, which is thought to be a result of impaired somatosensory afferent activity and/or integration. Afferent processing can be artificially manipulated by vibration and was shown to reduce motor performance in healthy subjects. However, the effect of vibration on sensorimotor function in neck pain patients is scarcely investigated. To assess the effect of neck muscle vibration on joint position sense and postural control in neck pain subjects and healthy controls. Case control study. Thirteen neck pain patients and 10 healthy controls participated in the present study. Cervical joint position sense and dynamic and static postural stability. Short-term, targeted neck muscle vibration with 100 Hz was applied after baseline measurement. Vibration had opposite effects in patients and healthy subjects. Patients showed improved joint position sense (pneck pain. Thus, vibration may be used to counteract sensorimotor impairment of the cervical spine. Potential underlying mechanisms are discussed. Copyright © 2015. Published by Elsevier Inc.

Head and neck cancer: Radiotherapeutic precepts in the management of the neck

International Nuclear Information System (INIS)

Million, R.R.; Cassisi, N.J.; Parsons, J.T.; Mendenhall, W.M.

1986-01-01

The authors provide a series of statements regarding the use of radiotherapy and surgery for metastatic squamous cancer to the neck. Some of these precepts are established facts requiring no additional documentation - for example, the combination of radiation and neck dissection for effective treatment of N2B neck disease or for subclinical disease, depending on extracapsular spread. Other precepts of the authors are not as generally accepted by head and neck surgeons, such as the mandatory staging of neck dissections following curative radiation therapy or the routine use of computerized tomography (CT) to confirm pathologic adenopathy. Most of the authors' precepts are supported by a combination of their personal clinical experience and hard data from the University of Florida, Gainesville

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

OpenAIRE

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 o...

SU-E-J-229: Quantitative Assessment for Timely Adaptive Re-Planning Using Weekly Dose Monitoring for Head and Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

Shang, Q; Liu, H; Greskovich, J; Koyfman, S; Xia, P [Cleveland Clinic, Cleveland, OH (United States); Li, Z [Cleveland Clinic, Cleveland, OH (United States); the 6th people' s hospital of Shanghai Jiaotong University, Shanghai, Shanghai (China)

2014-06-01

Purpose: For patients with head and neck (HN) cancer, mid-course adaptive radiation therapy (ART) is a common practice in our institution to accommodate anatomic changes. The aim of the study is to evaluate whether dose re-calculation on weekly verification images can provide quantitative assessment for timely adaptive re-planning with daily image-guided intensity modulated radiotherapy (IMRT). Methods: We retrospectively selected sixty daily verification images acquired on CT-on-rail/CBCT from ten HN patients. These image sets were typically a week apart. Among these patients, six patients received a mid-course ART. Contours of the tumors and organ-at-risks (OARs) were manually delineated by a physician on each verification CT. After placing the treatment iso-center on the verification CTs according to the recorded clinical shifts, daily dose was re-calculated with the same beam configuration as the original plan. For the purpose of this study, electron densities for both verification CTs and planning CTs were set to 1.0 g/cm3. Results: Two patients had D99 of the CTV < 97% of the planned dose for more than three fractions due to remarkable tumor volume shrinkages. D-max of the spinal cord exceeded a tolerance of 45 Gy for four fractions in additional two patients. D-mean of the parotid increased within 25% of the planned value. D-max of the brainstem and D-mean of the oral cavity did not show significant variation. If the re-planning criteria included D99 of the CTV < 97% of the planned dose and D-max of the spinal cord > 45 Gy, two out ten patients required ART at week 2 and two patients required ART at week 3, respectively. Conclusion: Weekly dose monitoring with re-calculation on verification images can provide quantitative dose guidance for timely adaptive re-planning. Future work will include accumulative dose analysis for the decision of adaptive re-planning. The study is supported in part by Siemens Medical Solutions.

Head, Neck, and Oral Cancer

Science.gov (United States)

... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

Head, Neck, and Oral Cancer

Medline Plus

Full Text Available ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

AN EFFECT OF SHOT PEENING ON GROWTH AND RETARDATION OF PHYSICALLY SHORT FATIGUE CRACKS IN AN AIRCRAFT Al-ALLOY

Directory of Open Access Journals (Sweden)

Ivo Černý

2009-11-01

Full Text Available Results of an investigation of effect of shot peening on development of physically short fatigue crack in an aircraft V-95 Al-alloy, which is of a similar type as 7075 alloy, are described and discussed in the paper. The first part deals with adaptation and verification of direct current potential drop method for detection and measurement of short crack initiation and growth. The specific material and quite large dimensions of flat specimens with side necking of a low stress concentration factor had to be considered when position of electrodes was specified and the measurement method verified. The specimen type and dimensions were proposed taking account of the investigation of shot peening effects. Physically short fatigue cracks of the length from 0.2 mm to more than 3 mm, most of them between 0.8 – 1.5 mm, were prepared under high cycle fatigue loading of a constant nominal stress amplitude plus/minus 160 MPa. Specimens with existing short fatigue cracks were shot peened using two different groups of parameters. Development of crack growth after shot peening was measured and compared with crack growth in specimens without shot peening. Retardation of crack growth was significant particularly with cracks shorter than 2 mm. For the specific stress amplitude, evaluated results enable to estimate threshold length of defects, which after the application of shot peening will be reliably arrested.

Prevalence, incidence, and risk factors for shoulder and neck dysfunction after neck dissection: A systematic review.

Science.gov (United States)

Gane, E M; Michaleff, Z A; Cottrell, M A; McPhail, S M; Hatton, A L; Panizza, B J; O'Leary, S P

2017-07-01

Shoulder pain and dysfunction may occur following neck dissection among people being treated for head and neck cancer. This systematic review aims to examine the prevalence and incidence of shoulder and neck dysfunction after neck dissection and identify risk factors for these post-operative complications. Electronic databases (Pubmed, CINAHL, EMBASE, Cochrane) were searched for articles including adults undergoing neck dissection for head and neck cancer. Studies that reported prevalence, incidence or risk factors for an outcome of the shoulder or neck were eligible and assessed using the Critical Review Form - Quantitative Studies. Seventy-five articles were included in the final review. Prevalence rates for shoulder pain were slightly higher after RND (range, 10-100%) compared with MRND (range, 0-100%) and SND (range, 9-25%). The incidence of reduced shoulder active range of motion depended on surgery type (range, 5-20%). The prevalence of reduced neck active range of motion after neck dissection was 1-13%. Type of neck dissection was a risk factor for shoulder pain, reduced function and health-related quality of life. The prevalence and incidence of shoulder and neck dysfunction after neck dissection varies by type of surgery performed and measure of dysfunction used. Pre-operative education for patients undergoing neck dissection should acknowledge the potential for post-operative shoulder and neck problems to occur and inform patients that accessory nerve preservation lowers, but does not eliminate, the risk of developing musculoskeletal complications. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Multidisciplinary treatment of the neck

NARCIS (Netherlands)

de Bree, Remco; Langendijk, Johannes A.; Leemans, C. R.

2016-01-01

Since lymph node metastases are one of the most important prognostic factors, treatment of the neck is challenging. In clinically N0 neck, (super)selective neck dissection is indicated, whereas a more extensive neck dissection with preservation of important structures is performed in N2-N3 disease.

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

Science.gov (United States)

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.

Psychometric properties of the Neck OutcOme Score, Neck Disability Index, and Short Form-36 were evaluated in patients with neck pain

DEFF Research Database (Denmark)

Juul, Tina; Søgaard, Karen; Davis, Aileen M.

2016-01-01

Objective:To assess reliability, construct validity, responsiveness, and interpretability for Neck OutcOme Score (NOOS), Neck Disability Index (NDI), and Short Form–36 (SF-36) in neck pain patients. Study Design and Setting: Internal consistency was assessed by Cronbach alpha. Test-retest reliabi...

Towards adaptive radiotherapy for head and neck patients: validation of an in-house deformable registration algorithm

Science.gov (United States)

Veiga, C.; McClelland, J.; Moinuddin, S.; Ricketts, K.; Modat, M.; Ourselin, S.; D'Souza, D.; Royle, G.

2014-03-01

The purpose of this work is to validate an in-house deformable image registration (DIR) algorithm for adaptive radiotherapy for head and neck patients. We aim to use the registrations to estimate the "dose of the day" and assess the need to replan. NiftyReg is an open-source implementation of the B-splines deformable registration algorithm, developed in our institution. We registered a planning CT to a CBCT acquired midway through treatment for 5 HN patients that required replanning. We investigated 16 different parameter settings that previously showed promising results. To assess the registrations, structures delineated in the CT were warped and compared with contours manually drawn by the same clinical expert on the CBCT. This structure set contained vertebral bodies and soft tissue. Dice similarity coefficient (DSC), overlap index (OI), centroid position and distance between structures' surfaces were calculated for every registration, and a set of parameters that produces good results for all datasets was found. We achieve a median value of 0.845 in DSC, 0.889 in OI, error smaller than 2 mm in centroid position and over 90% of the warped surface pixels are distanced less than 2 mm of the manually drawn ones. By using appropriate DIR parameters, we are able to register the planning geometry (pCT) to the daily geometry (CBCT).

The neck-tongue syndrome.

Science.gov (United States)

Orrell, R W; Marsden, C D

1994-01-01

The neck-tongue syndrome, consisting of pain in the neck and altered sensation in the ipsilateral half of the tongue aggravated by neck movement, has been attributed to damage to lingual afferent fibres travelling in the hypoglossal nerve to the C2 spinal roots. The lingual afferents in the hypoglossal nerve are thought to be proprioceptive. Two further cases of the neck-tongue syndrome are described, the spectrum of its clinical manifestations is explored, and the phenomenon of lingual pseudoathetosis is illustrated as a result of the presumed lingual deafferentation. Images PMID:8158185

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

Science.gov (United States)

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

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

Directory of Open Access Journals (Sweden)

Michael P. Taylor

2013-02-01

Full Text Available 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.

Dose-response relationship for elective neck irradiation of head and neck cancer - facts and controversies

International Nuclear Information System (INIS)

Suwinski, R.; Maciejewski, B.; Withers, H.R.

1998-01-01

The aim of this study is to assign dose-response relationship for subclinical neck metastases of squamous cell head and neck cancer based on extensive survey of 24 data sets collected from the literature. Neck relapse rates (NRR) without and after elective (ENI) or preoperative irradiation were estimated for each site and stage of primary tumor and the reduction in neck relapse rate was calculated. An average NRR without ENI was 22% (12-35% ) and only 2.5% (0-1 0%) after the ENI with total dose of 46- 50 Gy which gives high reduction rate in the risk of neck recurrences being on the average 89% and 42% (0-46%) after preoperative irradiation using 22-30 Gy. Dose response curve for elective and preoperative irradiation have shown that 50 Gy in 2 Gy fraction reduces the incidence of neck relapses in the NO patients by more than 90% and only by less than 50% after total doses lower than 30 Gy. No correlation between the risk of neck metastases without ENI and the reduction in neck relapses after ENI was found. (authors)

Neck x-ray

Science.gov (United States)

X-ray - neck; Cervical spine x-ray; Lateral neck x-ray ... There is low radiation exposure. X-rays are monitored so that the lowest amount of radiation is used to produce the image. Pregnant women and ...

Assessment of nutritional status and quality of life in patients treated for head and neck cancer.

Science.gov (United States)

Prevost, V; Joubert, C; Heutte, N; Babin, E

2014-04-01

The purpose of this study was to identify tools for the assessment of nutritional status in head and neck cancer patients, to evaluate the impact of malnutrition on therapeutic management and quality of life and to propose a simple screening approach adapted to routine clinical practice. The authors conducted a review of the literature to identify tools for the assessment of nutritional status in head and neck cancer patients published in French and English. Articles were obtained from the PubMed database and from the references of these articles and selected journals, using the keywords: "nutritional assessment", and "head and neck" and "cancer". Anthropometric indices, laboratory parameters, dietary intake assessment, clinical scores and nutritional risk scores used in patients with head and neck cancers are presented. The relevance of these tools in clinical practice and in research is discussed, together with the links between nutritional status and quality of life. This article is designed to help teams involved in the management of patients with head and neck cancer to choose the most appropriate tools for assessment of nutritional status according to their resources and their objectives. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Decision Trees Predicting Tumor Shrinkage for Head and Neck Cancer: Implications for Adaptive Radiotherapy.

Science.gov (United States)

Surucu, Murat; Shah, Karan K; Mescioglu, Ibrahim; Roeske, John C; Small, William; Choi, Mehee; Emami, Bahman

2016-02-01

To develop decision trees predicting for tumor volume reduction in patients with head and neck (H&N) cancer using pretreatment clinical and pathological parameters. Forty-eight patients treated with definitive concurrent chemoradiotherapy for squamous cell carcinoma of the nasopharynx, oropharynx, oral cavity, or hypopharynx were retrospectively analyzed. These patients were rescanned at a median dose of 37.8 Gy and replanned to account for anatomical changes. The percentages of gross tumor volume (GTV) change from initial to rescan computed tomography (CT; %GTVΔ) were calculated. Two decision trees were generated to correlate %GTVΔ in primary and nodal volumes with 14 characteristics including age, gender, Karnofsky performance status (KPS), site, human papilloma virus (HPV) status, tumor grade, primary tumor growth pattern (endophytic/exophytic), tumor/nodal/group stages, chemotherapy regimen, and primary, nodal, and total GTV volumes in the initial CT scan. The C4.5 Decision Tree induction algorithm was implemented. The median %GTVΔ for primary, nodal, and total GTVs was 26.8%, 43.0%, and 31.2%, respectively. Type of chemotherapy, age, primary tumor growth pattern, site, KPS, and HPV status were the most predictive parameters for primary %GTVΔ decision tree, whereas for nodal %GTVΔ, KPS, site, age, primary tumor growth pattern, initial primary GTV, and total GTV volumes were predictive. Both decision trees had an accuracy of 88%. There can be significant changes in primary and nodal tumor volumes during the course of H&N chemoradiotherapy. Considering the proposed decision trees, radiation oncologists can select patients predicted to have high %GTVΔ, who would theoretically gain the most benefit from adaptive radiotherapy, in order to better use limited clinical resources. © The Author(s) 2015.

An investigation into hot deformation of aluminum alloy 5083

Energy Technology Data Exchange (ETDEWEB)

Hosseinipour, S.J. [Manufacturing Engineering Department, School of Mechanical Engineering, Nushirvani Institute of Technology, University of Mazandaran, P.O. Box 484, Shariati Avenue, Babol (Iran, Islamic Republic of)], E-mail: j.hosseini@nit.ac.ir

2009-02-15

In this paper the hot deformation behavior of Al-5083 commercial alloy is studied. For this purpose, hot tensile tests have been carried out at various temperatures and strain rates. Velocity jump tests have been performed to determine stress-strain rate curves at various temperatures and strains. The microstructures have been studied by optical and electron microscopy (SEM). It is found that continuous recrystallization occurs during hot deformation of the AA5083. Maximum elongation about 250% is obtained at 450 deg. C and strain rate of 0.005 s{sup -1}. The failure surface is narrow and failure occurs by necking.

An investigation into hot deformation of aluminum alloy 5083

International Nuclear Information System (INIS)

Hosseinipour, S.J.

2009-01-01

In this paper the hot deformation behavior of Al-5083 commercial alloy is studied. For this purpose, hot tensile tests have been carried out at various temperatures and strain rates. Velocity jump tests have been performed to determine stress-strain rate curves at various temperatures and strains. The microstructures have been studied by optical and electron microscopy (SEM). It is found that continuous recrystallization occurs during hot deformation of the AA5083. Maximum elongation about 250% is obtained at 450 deg. C and strain rate of 0.005 s -1 . The failure surface is narrow and failure occurs by necking

Prevalance of neck pain in computer users

International Nuclear Information System (INIS)

Sabeen, F.; Bashir, M.S.; Hussain, S.I.

2013-01-01

Prolonged use of computers during daily work activities and recreation is often cited as a cause of neck pain. Neck pain and computer users are clearly connected due to extended periods of sitting in a certain position with no breaks to stretch the neck muscles. Pro-longed computer use with neck bent forward, will cause the anterior neck muscles to gradually get shorter and tighter, while the muscles in the back of neck will grow longer and weaker. These changes will lead to development of neck pain. Objectives: To find incidence of neck pain in computer users, association between neck pain and prolong sitting in wrong posture, association between effects of break during prolong work, association between types of chair in use in prolong sitting and occurrence of neck pain. Methodology: For this observational study data was collected through Questionnaires from office workers (computer users), and students. Results: Out of 50 persons 72% of computer users had neck pain. Strong association was found between neck pain and prolonged computer use (p = 0.001). Those who took break during their work had less neck pain. No significant association was found between type of chair in use and neck pain. Neck pain and type of system in use also had no significant association. Conclusion: So duration of computer use and frequency of breaks are associated with neck pain at work. Severe Neck pain was found in people who use computer for more than 5 hours a day. (author)

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

Energy Technology Data Exchange (ETDEWEB)

Kim, Jinu; Shin, Eun Seow; Kim, Jeong Eon; Yoon, Sang Pil [Jeju National University School of Medicine, Jeju (Korea, Republic of); Kim, Young Suk [Dept. of Radiation Oncology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of)

2015-12-15

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

Neck motion, motor control, pain and disability: A longitudinal study of associations in neck pain patients in physiotherapy treatment.

Science.gov (United States)

Meisingset, Ingebrigt; Stensdotter, Ann-Katrin; Woodhouse, Astrid; Vasseljen, Ottar

2016-04-01

Neck pain is associated with several alterations in neck motion and motor control, but most of the findings are based on cross-sectional studies. The aim of this study was to investigate associations between changes in neck motion and motor control, and changes in neck pain and disability in physiotherapy patients during a course of treatment. Prospective cohort study. Subjects with non-specific neck pain (n = 71) participated in this study. Neck flexibility, joint position error (JPE), head steadiness, trajectory movement control and postural sway were recorded before commencement of physiotherapy (baseline), at 2 weeks, and at 2 months. Numerical Rating Scale and Neck Disability Index were used to measure neck pain and disability at the day of testing. To analyze within subjects effects in neck motion and motor control, neck pain, and disability over time we used fixed effects linear regression analysis. Changes in neck motion and motor control occurred primarily within 2 weeks. Reduction in neck pain was associated with increased cervical range of motion in flexion-/extension and increased postural sway when standing with eyes open. Decreased neck disability was associated with some variables for neck flexibility and trajectory movement control. Cervical range of motion in flexion-/extension was the only variable associated with changes in both neck pain and neck disability. This study shows that few of the variables for neck motion and motor control were associated with changes neck pain and disability over a course of 2 months with physiotherapy treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

"A" shape plate for open rigid internal fixation of mandible condyle neck fracture.

Science.gov (United States)

Kozakiewicz, Marcin; Swiniarski, Jacek

2014-09-01

Reduction of the fracture is crucial for proper outcome of the treatment. The stability of reduction is closed connected to the method of its fixation. The topic of condylar fracture osteosynthesis still remains highly controversial and challenging. That is why authors decided to propose novel design of the fixating plate and the example of its application. The aim of this study was to present A-shape plate dedicated to rigid fixation of mandible condyle neck fracture. A-shape condylar plate (ACP) design is prepared of 1.0 mm thick titanium alloy (grade 5) sheet: posterior and anterior bars are reinforced by widening to 2.5 mm and anatomically curved along the compression and traction lines in ramus and condylar neck. Superior three-hole-group has triangular organization and located on the level of condylar head. The inferior extensions of the bars are equipped in three holes located at each of lower tails. Connecting bar (2.0 mm wide) connects the first hole of each lower tails closing upper part of ACP in triangular shape. The connecting bar runs along compression line of condylar neck. Holes in ACP has 2.0 mm diameter for locking or normal screws. Height of ACP is 31 mm. The proposed new type of plate was compared by finite element analysis (FEA) to nowadays manufactured 9-hole trapezoid plate as the most similar device. ACP design was evaluated by finite element analysis (FEA) and later applied in patient affected with high condylar neck fracture complicated by fracture of coronoid process. FEA revealed high strength of ACP and more stabile fixation than trapezoid plate. The result was caused by multipoint fixation at three regions of the plate and reinforced bars supported by semi-horizontal connecting bar. Clinical application of ACP was as versatile as makes possible to simultaneous fixation of high condylar neck and coronoid process fracture. Application of proposed A-shape condylar plate would be possible in all levels of neck fractures and can be use

Head and Neck Cancer Treatment

Science.gov (United States)

... Professions Site Index A-Z Head and Neck Cancer Treatment Head and neck cancer overview What are my ... and neck cancer. For updated information on new cancer treatments that are available, you should discuss these issues ...

The Use of Neck Support Pillows and Postural Exercises in the Management of Chronic Neck Pain.

Science.gov (United States)

Jamal, Alisha N; Feldman, Brian M; Pullenayegum, Eleanor

2016-10-01

Chronic neck pain is a common problem with a profound effect on quality of life. Identifying evidence-based management strategies is fundamental in improving patient outcomes. This study is a reanalysis of the data from Helewa, et al to further characterize the effects of postural exercises and neck support pillows on neck pain. A full factorial model was used. All interactions were analyzed adjusting for the Northwick Park Neck Pain Questionnaire (NPQ) at baseline. Postural exercises significantly decreased NPQ scores at ≥ 3 weeks, and the use of a neck support pillow significantly decreased NPQ scores at ≥ 12 weeks. These interventions could be beneficial in reducing neck pain symptoms.

Expansion of the neck reconstituted the shoulder-diaphragm in amniote evolution.

Science.gov (United States)

Hirasawa, Tatsuya; Fujimoto, Satoko; Kuratani, Shigeru

2016-01-01

The neck acquired flexibility through modifications of the head-trunk interface in vertebrate evolution. Although developmental programs for the neck musculoskeletal system have attracted the attention of evolutionary developmental biologists, how the heart, shoulder and surrounding tissues are modified during development has remained unclear. Here we show, through observation of the lateral plate mesoderm at cranial somite levels in chicken-quail chimeras, that the deep part of the lateral body wall is moved concomitant with the caudal transposition of the heart, resulting in the infolding of the expanded cervical lateral body wall into the thorax. Judging from the brachial plexus pattern, an equivalent infolding also appears to take place in mammalian and turtle embryos. In mammals, this infolding process is particularly important because it separates the diaphragm from the shoulder muscle mass. In turtles, the expansion of the cervical lateral body wall affects morphogenesis of the shoulder. Our findings highlight the cellular expansion in developing amniote necks that incidentally brought about the novel adaptive traits. © 2015 The Authors Development, Growth & Differentiation published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Developmental Biologists.

Impact of head and neck cancer adaptive radiotherapy to spare the parotid glands and decrease the risk of xerostomia

International Nuclear Information System (INIS)

Castelli, Joel; Simon, Antoine; Louvel, Guillaume; Henry, Olivier; Chajon, Enrique; Nassef, Mohamed; Haigron, Pascal; Cazoulat, Guillaume; Ospina, Juan David; Jegoux, Franck; Benezery, Karen; Crevoisier, Renaud de

2015-01-01

Large anatomical variations occur during the course of intensity-modulated radiation therapy (IMRT) for locally advanced head and neck cancer (LAHNC). The risks are therefore a parotid glands (PG) overdose and a xerostomia increase. The purposes of the study were to estimate: - the PG overdose and the xerostomia risk increase during a “standard” IMRT (IMRT std ); - the benefits of an adaptive IMRT (ART) with weekly replanning to spare the PGs and limit the risk of xerostomia. Fifteen patients received radical IMRT (70 Gy) for LAHNC. Weekly CTs were used to estimate the dose distributions delivered during the treatment, corresponding either to the initial planning (IMRT std ) or to weekly replanning (ART). PGs dose were recalculated at the fraction, from the weekly CTs. PG cumulated doses were then estimated using deformable image registration. The following PG doses were compared: pre-treatment planned dose, per-treatment IMRT std and ART. The corresponding estimated risks of xerostomia were also compared. Correlations between anatomical markers and dose differences were searched. Compared to the initial planning, a PG overdose was observed during IMRT std for 59% of the PGs, with an average increase of 3.7 Gy (10.0 Gy maximum) for the mean dose, and of 8.2% (23.9% maximum) for the risk of xerostomia. Compared to the initial planning, weekly replanning reduced the PG mean dose for all the patients (p < 0.05). In the overirradiated PG group, weekly replanning reduced the mean dose by 5.1 Gy (12.2 Gy maximum) and the absolute risk of xerostomia by 11% (p < 0.01) (30% maximum). The PG overdose and the dosimetric benefit of replanning increased with the tumor shrinkage and the neck thickness reduction (p < 0.001). During the course of LAHNC IMRT, around 60% of the PGs are overdosed of 4 Gy. Weekly replanning decreased the PG mean dose by 5 Gy, and therefore by 11% the xerostomia risk

Electrical Resistance Alloys and Low-Expansion Alloys

DEFF Research Database (Denmark)

Kjer, Torben

1996-01-01

The article gives an overview of electrical resistance alloys and alloys with low thermal expansion. The electrical resistance alloys comprise resistance alloys, heating alloys and thermostat alloys. The low expansion alloys comprise alloys with very low expansion coefficients, alloys with very low...... thermoelastic coefficients and age hardenable low expansion alloys....

Neck pain and disability due to neck pain: what is the relation?

DEFF Research Database (Denmark)

Fejer, René; Hartvigsen, Jan

2008-01-01

Pain and disability are interrelated, but the relationship between pain and disability is not straightforward. The objective of this study was to investigate the relationship between neck pain (NP) intensity, NP duration, and disability based on the population-based 'Funen Neck and Chest Pain......' study. Pain intensity was measured using 11-box numerical rating scales, pain duration was measured using the Standardized Nordic Questionnaire, and disability was measured by the Copenhagen Neck Functional Disability Scale. Spearman rank correlation coefficients and logistic regression analyses were...... used to measure correlations and strength of associations between pain intensity, pain duration, and disability given domain specific characteristics (socioeconomic, health and physical, comorbidity, and variables related to consequences of NP). Neck pain was very common, but mainly mild and did...

Periodic Cellular Structure Technology for Shape Memory Alloys

Science.gov (United States)

Chen, Edward Y.

2015-01-01

Shape memory alloys are being considered for a wide variety of adaptive components for engine and airframe applications because they can undergo large amounts of strain and then revert to their original shape upon heating or unloading. Transition45 Technologies, Inc., has developed an innovative periodic cellular structure (PCS) technology for shape memory alloys that enables fabrication of complex bulk configurations, such as lattice block structures. These innovative structures are manufactured using an advanced reactive metal casting technology that offers a relatively low cost and established approach for constructing near-net shape aerospace components. Transition45 is continuing to characterize these structures to determine how best to design a PCS to better exploit the use of shape memory alloys in aerospace applications.

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

Science.gov (United States)

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.

Biogeometry of femoral neck for implant placement

Directory of Open Access Journals (Sweden)

Patwa J

2006-01-01

Full Text Available Background : Treatment of fracture neck femur with three cannulated cancellous screws in an apex proximal configuration is practised in many parts of the world. Methods : Dimensions of femoral neck at the middle of transcervical neck using CT scan (live neck and vernier caliper (dry cadeveric neck in 20 subjects respectively were measured. Results : Inferior half of the neck is narrower than superior half. Conclusion : Biogeometry of the neck of femur does not accomodate two inferior screws and thus fixation of fracture neck femur with three canulated cancellous screws in an apex distal configuration is recommended.

Charge transfers in complex transition metal alloys (Ti2Fe)

International Nuclear Information System (INIS)

Abramovici, G.

1998-01-01

We introduce a new non-orthogonal tight-binding model, for complex alloys, in which electronic structure is characterized by charge transfers. We give the analytic calculation of a charge transfer, in which overlapping two-center terms are rigorously taken into account. Then, we apply numerically this result to an approximant phase of a quasicrystal of Ti 2 Fe alloy. This model is more particularly adapted to transition metals, and gives realistic densities of states. (orig.)

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

Science.gov (United States)

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

2011-01-01

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

Combined neck dissection and postoperative radiation therapy in the management of the high-risk neck: a matched-pair analysis

International Nuclear Information System (INIS)

Lundahl, Robert E.; Foote, Robert L.; Bonner, James A.; Suman, Vera J.; Lewis, Jean E.; Kasperbauer, Jan L.; McCaffrey, Thomas V.; Olsen, Kerry D.

1998-01-01

Purpose: The purpose of this study was to determine the efficacy of postoperative adjuvant radiation therapy with regard to reducing the rate of recurrence in the neck, cancer-related death, and death from any cause in patients with squamous cell carcinoma of the head and neck region metastatic to neck nodes. Methods: This was a retrospective review of patients with pathologically confirmed nodal metastases who underwent neck dissection and postoperative adjuvant radiation therapy for squamous cell carcinoma of the head and neck region. Time to recurrence in the dissected area of the neck, any recurrence in the neck, cancer-related death, and death from any cause were estimated with the Kaplan-Meier method. A matched-pair analysis was performed utilizing a cohort of patients who underwent neck dissection without postoperative radiation therapy. The patients from the two cohorts were matched according to previously reported high-risk features for cancer recurrence and death. Cox hazards models for the matched pairs were used to evaluate the relative risk of subsequent recurrence in the dissected side of the neck, any neck recurrence, cancer-related death, and overall survival. Materials: The medical records and pathologic slides of 95 consecutive patients with pathologically confirmed nodal metastases from squamous cell carcinoma of the head and neck region who underwent neck dissection and postoperative adjuvant radiation therapy between January 1974 and December 1990 were reviewed. Previously published data from 284 patients with squamous cell carcinoma of the head and neck region treated with neck dissection alone between January 1970 and December 1980 were used for a matched-pair analysis. Results: The relative risks for recurrence in the dissected side of the neck, any neck recurrence (dissected neck or delayed undissected neck metastasis), cancer-related death, and death from any cause for patients treated with operation alone relative to those treated with

Treatment of Wide-Neck Bifurcation Aneurysm Using "WEB Device Waffle Cone Technique".

Science.gov (United States)

Mihalea, Cristian; Caroff, Jildaz; Rouchaud, Aymeric; Pescariu, Sorin; Moret, Jacques; Spelle, Laurent

2018-05-01

The endovascular treatment of wide-neck bifurcation aneurysms can be challenging and often requires the use of adjunctive techniques and devices. We report our first experience of using a waffle-cone technique adapted to the Woven Endoluminal Bridge (WEB) device in a large-neck basilar tip aneurysm, suitable in cases where the use of Y stenting or other techniques is limited due to anatomic restrictions. The procedure was complete, and angiographic occlusion of the aneurysm was achieved 24 hours post treatment, as confirmed by digital subtraction angiography. No complications occurred. The case reported here was not suitable for Y stenting or deployment of the WEB device alone, due to the small caliber of both posterior cerebral arteries and their origin at the neck level. The main advantage of this technique is that both devices have a controlled detachment system and are fully independent. To our knowledge, this technique has not been reported previously and this modality of treatment has never been described in the literature. Copyright © 2018 Elsevier Inc. All rights reserved.

A pain in the neck-Imaging in neck sepsis

International Nuclear Information System (INIS)

Lyle, N.J.; Rutherford, E.E.; Batty, V.B.

2011-01-01

Deep neck infection has a high morbidity and mortality and the extent of infection is often difficult to estimate clinically. The complex anatomy and the communication between neck spaces means that infection can spread along fascial planes leading to life-threatening complications such as airway compromise, vascular erosion/thrombosis, neural dysfunction, and ultimately descending necrotizing mediastinitis. Imaging has an important role to play in identifying the extent of infection and the presence of complications.

A pain in the neck-Imaging in neck sepsis

Energy Technology Data Exchange (ETDEWEB)

Lyle, N.J., E-mail: nickylyle@doctors.org.uk [Department of Diagnostic Imaging, Southampton General Hospital, Southampton (United Kingdom); Rutherford, E.E.; Batty, V.B. [Department of Diagnostic Imaging, Southampton General Hospital, Southampton (United Kingdom)

2011-09-15

Deep neck infection has a high morbidity and mortality and the extent of infection is often difficult to estimate clinically. The complex anatomy and the communication between neck spaces means that infection can spread along fascial planes leading to life-threatening complications such as airway compromise, vascular erosion/thrombosis, neural dysfunction, and ultimately descending necrotizing mediastinitis. Imaging has an important role to play in identifying the extent of infection and the presence of complications.

Stereotactic Body Radiotherapy for Head and Neck Tumors

Science.gov (United States)

2016-04-18

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

Progressive shoulder-neck exercise on cervical muscle functions in middle-aged and senior patients with chronic neck pain.

Science.gov (United States)

Lin, I-Hsien; Chang, Kwang-Hwa; Liou, Tsan-Hon; Tsou, Chih-Min; Huang, Yi-Ching

2018-02-01

Although neck pain is a common musculoskeletal disorder, there is no consensus on suitable exercise methods for middle-aged and senior patients with chronic neck pain. Therefore, this study investigated the effectiveness of a 6-week shoulder-neck exercise intervention program on cervical muscle function improvement in patients aged 45 years or older with chronic neck pain. The aim of the present study was to evaluate the effects of progressive shoulder-neck exercise on cervical muscle functions of middle-aged and senior patients with chronic neck pain. A randomized controlled single-blind trial. Rehabilitation department of a hospital. A total of 72 subjects aged ≥45 years with chronic neck pain were randomly allocated to either an experimental group (N.=36; age 57.3±8.74 years) or a control group (N.=36; age 58.15±8.17 years). The control group received only traditional physiotherapy, whereas the experimental group participated in a 6-week shoulder-neck exercise program consisting of cranio-cervical flexion and progressive resistance exercises in addition to receiving traditional physiotherapy. The muscle functions of subjects in both groups were tested before the experiment and also after the intervention program. The pretest and posttest measured the cranio-cervical flexion test (CCFT) and the superficial cervical muscle strength. After the intervention, the experimental group had a 56.48 point improvement in the performance index of the CCFT (Pcervical muscle functions. This study confirmed that the 6-week progressive shoulder-neck exercise program can effectively improve cervical muscle function in middle-aged and senior patients with chronic neck pain. Progressive shoulder-neck exercise might provide positive effect on deep and superficial neck muscle strength in patients with chronic neck pain. Therefore, this study may serve as a reference for the clinical rehabilitation of patients with chronic neck pain.

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

International Nuclear Information System (INIS)

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.

2012-01-01

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'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.

Neck muscle fatigue alters the cervical flexion relaxation ratio in sub-clinical neck pain patients.

Science.gov (United States)

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

2015-06-01

The cervical flexion relaxation ratio is lower in neck pain patients compared to healthy controls. Fatigue modulates the onset and offset angles of the silent period in both the lumbar and cervical spine in healthy individuals; however, this response has not been studied with neck pain patients. The purpose of this study was to determine if cervical extensor fatigue would alter the parameters of the cervical flexion relaxation more in a neck pain group than a healthy control group. Thirteen healthy and twelve neck pain patients participated. Cervical extensor activity was examined bilaterally and kinematics of the neck and head were collected. An isometric, repetitive neck extension task at 70% of maximum elicited fatigue. Participants performed 3 trials of maximal cervical flexion both pre and post fatigue. The healthy controls and neck pain groups fatigued after 56 (41) and 39 (31) repetitions, respectively. There was a significant interaction effect for the flexion relaxation ratio between the control and neck pain groups from pre to post fatigue trials (F1,96=22.67, P=0.0001), but not for onset and offset angles (F1, 96=0.017, P=0.897), although the onset and offset angles did decrease significantly for both groups following fatigue (F1,96=9.26, P=0.002). Individuals with mild to moderate neck pain have significant differences in their neuromuscular control relative to controls, experienced myoelectric fatigue with fewer repetitions in a shorter time, had a lower cervical flexion relaxation ratio at baseline and had an inability to decrease this ratio further in response to fatigue. Copyright © 2015 Elsevier Ltd. All rights reserved.

The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping.

Science.gov (United States)

van Randeraad-van der Zee, Carlijn H; Beurskens, Anna J H M; Swinkels, Raymond A H M; Pool, Jan J M; Batterham, Roy W; Osborne, Richard H; de Vet, Henrica C W

2016-05-01

To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and multidimensional scaling), was applied to groups of persons with neck pain (n = 3) and professionals treating persons with neck pain (n = 2). Group members generated statements, which were organized into concept maps. Group members achieved consensus about the number and description of domains and the researchers then generated an overall mind map covering the full breadth of the burden of neck pain. Concept mapping revealed 12 domains of burden of neck pain: impaired mobility neck, neck pain, fatigue/concentration, physical complaints, psychological aspects/consequences, activities of daily living, social participation, financial consequences, difficult to treat/difficult to diagnose, difference of opinion with care providers, incomprehension by social environment, and how person with neck pain deal with complaints. All ten items of the NDI could be linked to the mind map, but the NDI measures only part of the burden of neck pain. This study revealed the relevant domains for the burden of neck pain from the viewpoints of persons with neck pain and their care providers. These results can guide the identification of existing measurements instruments for each domain or the development of new ones to measure the burden of neck pain.

Effects of neck exercise on high-school students' neck-shoulder posture.

Science.gov (United States)

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

2013-05-01

[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.

Silicon Alloying On Aluminium Based Alloy Surface

International Nuclear Information System (INIS)

Suryanto

2002-01-01

Silicon alloying on surface of aluminium based alloy was carried out using electron beam. This is performed in order to enhance tribological properties of the alloy. Silicon is considered most important alloying element in aluminium alloy, particularly for tribological components. Prior to silicon alloying. aluminium substrate were painted with binder and silicon powder and dried in a furnace. Silicon alloying were carried out in a vacuum chamber. The Silicon alloyed materials were assessed using some techniques. The results show that silicon alloying formed a composite metal-non metal system in which silicon particles are dispersed in the alloyed layer. Silicon content in the alloyed layer is about 40% while in other place is only 10.5 %. The hardness of layer changes significantly. The wear properties of the alloying alloys increase. Silicon surface alloying also reduced the coefficient of friction for sliding against a hardened steel counter face, which could otherwise be higher because of the strong adhesion of aluminium to steel. The hardness of the silicon surface alloyed material dropped when it underwent a heating cycle similar to the ion coating process. Hence, silicon alloying is not a suitable choice for use as an intermediate layer for duplex treatment

Dosimetric measurement of scattered radiation from dental implants in simulated head and neck radiotherapy.

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Wang, R; Pillai, K; Jones, P K

1998-01-01

The purpose of this study was to examine the dose enhancement at bone-implant interfaces from scattered radiation during simulated head and neck radiotherapy. Three cylindric implant systems with different compositions (pure titanium, titanium-aluminum-vanadium alloy, titanium coated with hydroxyapatite) and a high gold content transmandibular implant system (gold-copper-silver alloy) were studied. Extruded lithium fluoride single crystal chips were used as thermoluminescent material to measure radiation dose enhancement at 0, 1, and 2 mm from the bone-implant interface. The relative doses in buccal, lingual, mesial, and distal directions were also recorded and compared. The results indicated that the highest dose enhancement occurred at a distance of 0 mm from the bone-implant interface for all the implant systems studied. The transmandibular implants had higher scattered radiation than other groups at 0 mm and at 1 mm from the bone-implant interface. There was no significant difference of dose enhancement between buccal, lingual, mesial, and distal directions. Titanium implants coated with hydroxyapatite demonstrated the best results under the simulated irradiation.

Development and characterization of Al-Li alloys

International Nuclear Information System (INIS)

Gupta, R.K.; Nayan, Niraj; Nagasireesha, G.; Sharma, S.C.

2006-01-01

Increased strength to weight ratio of aluminium-lithium alloys has attracted material scientists to develop these for aerospace applications. But commercial scale production of these alloys has always been slow in view of difficulties encountered during addition of lithium and in ensuring homogeneous billet composition. A new technique of Li addition has been adapted, which gives maximum recovery of Li in the billet. Using this technique, aluminium-lithium alloys of two different grades for aerospace application were cast. Billets were hot forged and rolled to the thickness range of 3-4 mm and heat-treated for different temper conditions. Mechanical properties were evaluated in T6 (solution treated and artificial aged), T8 (solution treated, cold worked and artificial aged) and T4 (solution treated and natural aged) temper conditions. Both alloys exhibit a strong natural aging response. Reversion for short periods at 180 deg. C results in decrease of strength. With artificial reaging strength reaches above the T4 temper condition level. Characterization was carried out using optical microscope (OM) and scanning electron microscope (SEM). Experimental investigation shows that addition of lithium at high melt temperature gives lower recovery of Li, and use of impure aluminium adversely affects the mechanical properties of the alloy in all temper conditions

Neck pain or spasms - self care

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Pain - neck - self-care; Neck stiffness - self-care; Cervicalgia - self-care; Whiplash - self-care ... some pharmacies or retail stores. Ask your health care provider about using a soft neck collar to ...

Analysis of scapular muscle EMG activity in patients with idiopathic neck pain: a systematic review.

Science.gov (United States)

Castelein, Birgit; Cools, Ann; Bostyn, Emma; Delemarre, Jolien; Lemahieu, Trees; Cagnie, Barbara

2015-04-01

It is proposed that altered scapular muscle function can contribute to abnormal loading of the cervical spine. However, it is not clear if patients with idiopathic neck pain show altered activity of the scapular muscles. The aim of this paper was to systematically review the literature regarding the differences or similarities in scapular muscle activity, measured by electromyography ( = EMG), between patients with chronic idiopathic neck pain compared to pain-free controls. Case-control (neck pain/healthy) studies investigating scapular muscle EMG activity (amplitude, timing and fatigue parameters) were searched in Pubmed and Web of Science. 25 articles were included in the systematic review. During rest and activities below shoulder height, no clear differences in mean Upper Trapezius ( = UT) EMG activity exist between patients with idiopathic neck pain and a healthy control group. During overhead activities, no conclusion for scapular EMG amplitude can be drawn as a large variation of results were reported. Adaptation strategies during overhead tasks are not the same between studies. Only one study investigated timing of the scapular muscles and found a delayed onset and shorter duration of the SA during elevation in patients with idiopathic neck pain. For scapular muscle fatigue, no definite conclusions can be made as a wide variation and conflicting results are reported. Further high quality EMG research on scapular muscles (broader than the UT) is necessary to understand/draw conclusions on how scapular muscles react in the presence of idiopathic neck pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

Electronic structure of disordered Cu-Ag alloys

International Nuclear Information System (INIS)

Razee, S.S.A.

1994-08-01

We present a self-consistent-field Korringa-Kohn-Rostoker coherent potential approximation study of the electronic structure of disordered Cu x Ag 1-x alloys for x=0.0, 0.25, 0.50, 0.75 and 1.0. In particular, we focus on the Fermi surface, density of states, and Bloch spectral density, and study how they evolve as a function of x. We find that, Fermi surface dimensions have a non-linear composition dependence. The disorder-induced smearing of the Fermi surface, as expected, is very high along the direction; both the Cu and Ag Fermi surfaces have a neck in this direction. Whenever possible we have compared our results with the available experimental data. (author). 34 refs, 4 figs

''Watch-and-see'' policy for the clinically positive neck in head and neck cancer treated with chemoradiotherapy

International Nuclear Information System (INIS)

Homma, Akihiro; Furuta, Yasushi; Oridate, Nobuhiko

2006-01-01

Chemoradiotherapy (CRT) is becoming more widely used for head and neck cancer. However, there are conflicting theories regarding the best management options for patients with advanced nodal disease. From 1990 to 1999, we treated 96 patients with N1-N2 neck disease by concomitant CRT for organ preservation, using weekly carboplatin or a low daily dose of cisplatin, followed by a ''watch-and-see'' policy for the neck. In the present study, we retrospectively analyzed the treatment outcome in 63 of these patients who received definitive CRT for primary and neck diseases and were monitored for neck disease for more than 2 years. In 12 of the 22 (55%) N1 patients, CRT successfully controlled the neck disease. CRT was successful in 18 of the 41(44%) patients with N2 disease. In 6 (60%) of 10 patients with residual or recurrent N1 disease, salvage surgery was successful. Of the 23 patients with residual or recurrent N2 disease, salvage surgery was successful in 8 patients (35%). The group of patients who showed a clinical complete response (CCR) to CRT had an overall survival rate of 62.4% (33 patients), whereas for those with a less than complete response (< CCR), the figure was 13.3% (30 patients; P<0.001). Among the < CCR-neck group, patients who underwent neck dissection (ND) as well (n=20) did not have a significantly better overall survival than those who did not undergo ND (n=10; P=0.069). We propose a treatment plan for neck disease that involves observing the neck closely following CRT. ND should be planned only when there is evidence that neck disease exists. (author)

Treatment of neglected femoral neck fracture

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Anil K Jain

2015-01-01

Full Text Available Intra-capsular femoral neck fractures are seen commonly in elderly people following a low energy trauma. Femoral neck fracture has a devastating effect on the blood supply of the femoral head, which is directly proportional to the severity of trauma and displacement of the fracture. Various authors have described a wide array of options for treatment of neglected/nonunion (NU femoral neck fracture. There is lack of consensus in general, regarding the best option. This Instructional course article is an analysis of available treatment options used for neglected femoral neck fracture in the literature and attempt to suggest treatment guides for neglected femoral neck fracture. We conducted the "Pubmed" search with the keywords "NU femoral neck fracture and/or neglected femoral neck fracture, muscle-pedicle bone graft in femoral neck fracture, fibular graft in femoral neck fracture and valgus osteotomy in femoral neck fracture." A total of 203 print articles were obtained as the search result. Thirty three articles were included in the analysis and were categorized into four subgroups based on treatment options. (a treated by muscle-pedicle bone grafting (MPBG, (b closed/open reduction internal fixation and fibular grafting (c open reduction and internal fixation with valgus osteotomy, (d miscellaneous procedures. The data was pooled from all groups for mean neglect, the type of study (prospective or retrospective, classification used, procedure performed, mean followup available, outcome, complications, and reoperation if any. The outcome of neglected femoral neck fracture depends on the duration of neglect, as the changes occurring in the fracture area and fracture fragments decides the need and type of biological stimulus required for fracture union. In stage I and stage II (Sandhu′s staging neglected femoral neck fracture osteosynthesis with open reduction and bone grafting with MPBG or Valgus Osteotomy achieves fracture union in almost 90

Self-designed femoral neck guide pin locator for femoral neck fractures.

Science.gov (United States)

Xia, Shengli; Wang, Ziping; Wang, Minghui; Wu, Zuming; Wang, Xiuhui

2014-01-01

Closed reduction and fixation with 3 cannulated screws is a widely accepted surgery for the treatment of femoral neck fractures. However, how to obtain optimal screw placement remains unclear. In the current study, the authors designed a guide pin positioning system for femoral neck fracture cannulated screw fixation and examined its application value by comparing it with freehand guide needle positioning and with general guide pin locator positioning provided by equipment manufacturers. The screw reset rate, screw parallelism, triangle area formed by the link line of the entry point of 3 guide pins, and maximum vertical load bearing of the femoral neck after internal fixation were recorded. As expected, the triangle area was largest in the self-designed positioning group, followed by the general positioning group and the freehand positioning group. The difference among the 3 groups was statistically significant (P.05). The authors’ self-designed guide pin positioning system has the potential to accurately insert cannulated screws in femoral neck fractures and may reduce bone loss and unnecessary radiation.

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

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Yang, Xiaofeng [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Yoshida, Emi [Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California (United States); Cassidy, Richard J.; Beitler, Jonathan J.; Yu, David S.; Curran, Walter J. [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Liu, Tian, E-mail: tliu34@emory.edu [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

2015-06-01

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

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

International Nuclear Information System (INIS)

Yao Min; Hoffman, Henry T.; Chang, Kristi; Funk, Gerry F.; Smith, Russell B.; Tan Huaming; Clamon, Gerald H.; Dornfeld, Ken; Buatti, John M.

2007-01-01

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 [ 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 [ 18 F] fluorodeoxyglucose positron emission tomography is a useful tool in selecting patients appropriate for neck dissection

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

International Nuclear Information System (INIS)

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

2015-01-01

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

Automated tube voltage adaptation in head and neck computed tomography between 120 and 100 kV: effects on image quality and radiation dose

Energy Technology Data Exchange (ETDEWEB)

May, Matthias S.; Uder, Michael; Lell, Michael M. [University Hospital Erlangen, Department of Radiology, Erlangen (Germany); University Erlangen, Imaging Science Institute, Erlangen (Germany); Kramer, Manuel R.; Eller, Achim; Wuest, Wolfgang; Scharf, Michael; Brand, Michael; Saake, Marc [University Hospital Erlangen, Department of Radiology, Erlangen (Germany); Schmidt, Bernhard [Siemens Healthcare, Erlangen (Germany)

2014-09-15

Low tube voltage allows for computed tomography (CT) imaging with increased iodine contrast at reduced radiation dose. We sought to evaluate the image quality and potential dose reduction using a combination of attenuation based tube current modulation (TCM) and automated tube voltage adaptation (TVA) between 100 and 120 kV in CT of the head and neck. One hundred thirty consecutive patients with indication for head and neck CT were examined with a 128-slice system capable of TCM and TVA. Reference protocol was set at 120 kV. Tube voltage was reduced to 100 kV whenever proposed by automated analysis of the localizer. An additional small scan aligned to the jaw was performed at a fixed 120 kV setting. Image quality was assessed by two radiologists on a standardized Likert-scale and measurements of signal- (SNR) and contrast-to-noise ratio (CNR). Radiation dose was assessed as CTDI{sub vol}. Diagnostic image quality was excellent in both groups and did not differ significantly (p = 0.34). Image noise in the 100 kV data was increased and SNR decreased (17.8/9.6) in the jugular veins and the sternocleidomastoid muscle when compared to 120 kV (SNR 24.4/10.3), but not in fatty tissue and air. However, CNR did not differ statistically significant between 100 (23.5/14.4/9.4) and 120 kV data (24.2/15.3/8.6) while radiation dose was decreased by 7-8 %. TVA between 100 and 120 kV in combination with TCM led to a radiation dose reduction compared to TCM alone, while keeping CNR constant though maintaining diagnostic image quality. (orig.)

Transoral robotic surgery in head and neck cancer.

Science.gov (United States)

Hans, S; Delas, B; Gorphe, P; Ménard, M; Brasnu, D

2012-02-01

Robots have invaded industry and, more recently, the field of medicine. Following the development of various prototypes, Intuitive Surgical® has developed the Da Vinci surgical robot. This robot, designed for abdominal surgery, has been widely used in urology since 2000. The many advantages of this transoral robotic surgery (TORS) are described in this article. Its disadvantages are essentially its high cost and the absence of tactile feedback. The first feasibility studies in head and neck cancer, conducted in animals, dummies and cadavers, were performed in 2005, followed by the first publications in patients in 2006. The first series including more than 20 patients treated by TORS demonstrated the feasibility for the following sites: oropharynx, supraglottic larynx and hypopharynx. However, these studies did not validate the oncological results of the TORS technique. TORS decreases the number of tracheotomies, and allows more rapid swallowing rehabilitation and a shorter length of hospital stay. Technical improvements are expected. Smaller, more ergonomic, new generation robots, therefore more adapted to the head and neck, will probably be available in the future. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Confirmatory factory analysis of the Neck Disability Index in a general problematic neck population indicates a one-factor model.

Science.gov (United States)

Gabel, Charles Philip; Cuesta-Vargas, Antonio I; Osborne, Jason W; Burkett, Brendan; Melloh, Markus

2014-08-01

The Neck Disability Index frequently is used to measure outcomes of the neck. The statistical rigor of the Neck Disability Index has been assessed with conflicting outcomes. To date, Confirmatory Factor Analysis of the Neck Disability Index has not been reported for a suitably large population study. Because the Neck Disability Index is not a condition-specific measure of neck function, initial Confirmatory Factor Analysis should consider problematic neck patients as a homogenous group. We sought to analyze the factor structure of the Neck Disability Index through Confirmatory Factor Analysis in a symptomatic, homogeneous, neck population, with respect to pooled populations and gender subgroups. This was a secondary analysis of pooled data. A total of 1,278 symptomatic neck patients (67.5% female, median age 41 years), 803 nonspecific and 475 with whiplash-associated disorder. The Neck Disability Index was used to measure outcomes. We analyzed pooled baseline data from six independent studies of patients with neck problems who completed Neck Disability Index questionnaires at baseline. The Confirmatory Factor Analysis was considered in three scenarios: the full sample and separate sexes. Models were compared empirically for best fit. Two-factor models have good psychometric properties across both the pooled and sex subgroups. However, according to these analyses, the one-factor solution is preferable from both a statistical perspective and parsimony. The two-factor model was close to significant for the male subgroup (pfactor structure when analyzed by Confirmatory Factor Analysis in a pooled, homogenous sample of neck problem patients. However, a two-factor model did approach significance for male subjects where questions separated into constructs of mental and physical function. Further investigations in different conditions, subgroup and sex-specific populations are warranted. Copyright © 2014 Elsevier Inc. All rights reserved.

Merkel cell carcinoma of the head and neck: poorer prognosis than non-head and neck sites.

Science.gov (United States)

Morand, G B; Madana, J; Da Silva, S D; Hier, M P; Mlynarek, A M; Black, M J

2016-04-01

Merkel cell carcinoma is a rare, aggressive neurocutaneous malignancy. This study investigated whether patients with Merkel cell carcinoma in the head and neck had poorer outcomes than patients with Merkel cell carcinoma located elsewhere. A retrospective study was performed of patients with Merkel cell carcinoma treated at the Jewish General Hospital in Montréal, Canada, from 1993 to 2013. Associations between clinicopathological characteristics and disease-free and disease-specific survival rates were examined according to the Kaplan-Meier method. Twenty-seven patients were identified. Although basic clinicopathological characteristics and treatments were similar between head and neck and non-head and neck Merkel cell carcinoma groups, disease-free and disease-specific survival rates were significantly lower in the head and neck Merkel cell carcinoma group (log-rank test; p = 0.043 and p = 0.001, respectively). Mortality was mainly due to distant metastasis. Patients with head and neck Merkel cell carcinoma had poorer survival rates than patients with non-head and neck Merkel cell carcinoma in our study. The tendency to obtain close margins, a less predictable metastatic pattern, and/or intrinsic tumour factors related to the head and neck may explain this discrepancy.

Congenital neck masses.

Science.gov (United States)

Rosa, Peter A; Hirsch, David L; Dierks, Eric J

2008-08-01

Congenital neck lesions reflect abnormal embryogenesis in head and neck development. A thorough knowledge of embryology and anatomy is critical in the diagnosis and treatment of these lesions. The appropriate diagnosis of these lesions is necessary to provide appropriate treatment and long-term follow up, because some of these lesions may undergo malignant transformation or be harbingers of malignant disease.

Clinical analysis of neck dissection patients

International Nuclear Information System (INIS)

Sato, Katsuro; Takahashi, Sugata

2008-01-01

Neck dissection is a highly important surgical procedure in the treatment of squamous cell carcinoma (SCC) of the head and neck since the control of the nodal disease is highly important in these patients. In this paper, 131 patients (210 necks) treated in our department were analyzed. The most frequent primary lesion site was the oral cavity, followed by larynx, hypopharynx and mesopharynx, and treatment of metastatic nodes was considered important especially in patients with SCC in those regions. As the surgical procedure for neck dissection, (modified) radical neck dissection was chosen for higher N stage cases, although it was also applied to lower N stage cases. Postoperative irradiation was performed for 70% of the patients, and control of the neck was considered good as recurrent neck disease occurred in 8% of the patients, and only 20% of those died of recurrent neck disease. The most common primary site showing cervical recurrence was the oral cavity, and control of neck disease is considered important, especially in patients with SCC of the oral cavity. Patients with ≤number of pN 1 receiving postoperative irradiation, and patients with pN (-) and ≤number of pN 1 without postoperative irradiation showed significantly higher survival rates. Postoperative irradiation should be done for patients with ≥number of pN 2, and follow-up without postoperative treatment should be considered for the cases of ≤number of pN 1. Further consideration of patient selection with regard to the area of dissection and the indication for postoperative irradiation without decreasing the survival rate is needed to further improve the treatment of head and neck SCCs. (author)

Subcutaneous fibrosis after whole neck irradiation

International Nuclear Information System (INIS)

Hirota, Saeko; Tsujino, Kayoko; Oshitani, Takashi; Hishikawa, Yoshio; Takada, Yoshiki; Kono, Michio; Abe, Mitsuyuki

2002-01-01

Purpose: To identify the risk factors for moderate to severe subcutaneous fibrosis after whole neck irradiation. Methods and Materials: We analyzed 233 cases of patients who had undergone whole neck irradiation with 4-MV X-ray or 8-10-MeV electrons, or both, and had been followed with regard to their skin condition for at least 1 year. The prescribed dose to the whole neck ranged from 19.2 to 72.4 Gy (median 50). The skin-absorbed dose was specified as that at a depth of 4.1 mm (d4.1-mm depth ), and a biologically equivalent dose (BED) of d4.1-mm depth was also estimated (BED 1.8 4.1-mm depth ). Results: Univariate analysis revealed that previous neck dissection, concurrent chemotherapy, corticosteroid administration as a part of chemotherapy, fractionation, and BED 1.8 4.1-mm depth were significant prognostic variables. Multivariate analysis showed that BED 1.8 4.1-mm depth and previous neck dissection were the only prognostic variables for moderate to severe subcutaneous fibrosis. Conclusion: A high dose to a 4.1-mm depth of the skin and a history of neck dissection were identified as the predominant risk factors for moderate to severe subcutaneous fibrosis after whole neck irradiation. A subcutaneous dose should be considered in radiotherapy treatment planning involving the whole neck, especially in cases in which patients have undergone previous neck dissection

Shape memory alloys applied to improve rotor-bearing system dynamics - an experimental investigation

DEFF Research Database (Denmark)

Enemark, Søren; Santos, Ilmar; Savi, Marcelo A.

2015-01-01

passing through critical speeds. In this work, the feasibility of applying shape memory alloys to a rotating system is experimentally investigated. Shape memory alloys can change their stiffness with temperature variations and thus they may change system dynamics. Shape memory alloys also exhibit...... perturbations and mass imbalance responses of the rotor-bearing system at different temperatures and excitation frequencies are carried out to determine the dynamic behaviour of the system. The behaviour and the performance in terms of vibration reduction and system adaptability are compared against a benchmark...... configuration comprised by the same system having steel springs instead of shape memory alloy springs. The experimental results clearly show that the stiffness changes and hysteretic behaviour of the shape memory alloys springs alter system dynamics both in terms of critical speeds and mode shapes. Vibration...

Neck pain in different cephalalgias

Directory of Open Access Journals (Sweden)

E. A. Chechet

2014-01-01

Full Text Available The paper reviews the literature related to the investigations of neck pain (cervicalgia in patients with headache (cephalalgia. Neck pain is second to lower back pain as a reason for considerable socioeconomic damage to society. The prevalence of cervicalgia in the population ranges from 5.9 to 38%; the annual incidence is 10.4–21.3%; 14.2 to 71% of people report to have neck pain at some time in their lifetime. Neck pain is concurrent with cephalalgia in 70% of cases. In patients with cervicalgia, the prevalence of headache is 20–40% higher than in those with musculoskeletal pain at another site. Neck pain is as a major risk factor for migraine and tension headache (TH. Neck pain in TH progresses with the increased intensity, frequency, and strength of headache. There is a direct relationship of the quality of life worsening associated withcervicalgia to the frequency of migraine attacks and the risk of its chronization. Neck pain is noted in cervicogenic headache belonging to secondary headaches. The identification of mixed headache in a patient with cervicalgia allows the prescription of a treatment option that may be effective in relieving both headache and neck pain. The paper discusses the causes and pathogenesis of cervicalgia in patients with headache, examination methods, and main approaches to drug and nondrug therapies in relation to the leading pathophysiological mechanism, as well as new possibilities for the effective and safe relief of pain syndrome in this category of patients. Nonsteroidal anti-inflammatory drugs, myorelaxants,and their combination are observed to be effective in treating patients with cervicalgia and cephalalgia.

3D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparing

Directory of Open Access Journals (Sweden)

Koscielny Sven

2006-06-01

Full Text Available Abstract Background To investigate the potential of parotic gland sparing of intensity modulated radiotherapy (3D-c-IMRT performed with metallic compensators for head and neck cancer in a clinical series by analysis of dose distributions and clinical measures. Materials and methods 39 patients with squamous cell cancer of the head and neck irradiated using 3D-c-IMRT were evaluable for dose distribution within PTVs and at one parotid gland and 38 patients for toxicity analysis. 10 patients were treated primarily, 29 postoperatively, 19 received concomittant cis-platin based chemotherapy, 20 3D-c-IMRT alone. Initially the dose distribution was calculated with Helax ® and photon fluence was modulated using metallic compensators made of tin-granulate (n = 22. Later the dose distribution was calculated with KonRad ® and fluence was modified by MCP 96 alloy compensators (n = 17. Gross tumor/tumor bed (PTV 1 was irradiated up to 60–70 Gy, [5 fractions/week, single fraction dose: 2.0–2.2 (simultaneously integrated boost], adjuvantly irradiated bilateral cervical lymph nodes (PTV 2 with 48–54 Gy [single dose: 1.5–1.8]. Toxicity was scored according the RTOG scale and patient-reported xerostomia questionnaire (XQ. Results Mean of the median doses at the parotid glands to be spared was 25.9 (16.3–46.8 Gy, for tin graulate 26 Gy, for MCP alloy 24.2 Gy. Tin-granulate compensators resulted in a median parotid dose above 26 Gy in 10/22, MCP 96 alloy in 0/17 patients. Following acute toxicities were seen (°0–2/3: xerostomia: 87%/13%, dysphagia: 84%/16%, mucositis: 89%/11%, dermatitis: 100%/0%. No grade 4 reaction was encountered. During therapy the XQ forms showed °0–2/3: 88%/12%. 6 months postRT chronic xerostomia °0–2/3 was observed in 85%/15% of patients, none with °4 xerostomia. Conclusion 3D-c-IMRT using metallic compensators along with inverse calculation algorithm achieves sufficient parotid gland sparing in virtually all advanced

Thyroid Emphysema Following Penetrating Neck Trauma

Directory of Open Access Journals (Sweden)

Demet Karadağ

2011-03-01

Full Text Available Although traumatic thyroid gland rupture or hemorrhage is usually seen in goitrous glands, injuries of the normal thyroid gland after neck trauma have rarely been described in the literature. We describe a 44-year-old man who presented with thyroid emphysema and subcutaneous emphysema (SCE that occurred after penetrating neck trauma. CT images showed complete resolution of thyroid emphysema and subcutaneous emphysema at follow-up examination. Neck injuries can be life threatening. After penetrating neck traumas, physicians should consider subtle esophageal or tracheal laceration. Thyroid emphysema can occur as the result of penetrating neck trauma. The mechanism of emphysema of the thyroid parenchyma can be explained by the thyroid gland’s presence in a single visceral compartment that encompasses the larynx, trachea and thyroid gland. We describe an unusual case of thyroid emphysema of a normal thyroid gland following a penetrating neck injury.

The variation of the strength of neck extensor muscles and semispinalis capitis muscle size with head and neck position.

Science.gov (United States)

Rezasoltani, A; Nasiri, R; Faizei, A M; Zaafari, G; Mirshahvelayati, A S; Bakhshidarabad, L

2013-04-01

Semispinalis capitis muscle (SECM) is a massive and long cervico-thoracic muscle which functions as a main head and neck extensor muscle. The aim of this study was to detect the effect of head and neck positions on the strength of neck extensor muscles and size of SECM in healthy subjects. Thirty healthy women students voluntarily participated in this study. An ultrasonography apparatus (Hitachi EUB 525) and a system of tension-meter were used to scan the right SECM at the level of third cervical spine and to measure the strength of neck extensor muscles at three head and neck positions. Neck extensor muscles were stronger in neutral than flexion or than extension positions while the size of SECM was larger in extension than neutral or than flexion position. The force generation capacity of the main neck extensor muscle was lower at two head and neck flexion and extension positions than neutral position. Copyright © 2012 Elsevier Ltd. All rights reserved.

Development of adaptive helicopter seat systems for aircrew vibration mitigation

Science.gov (United States)

Chen, Yong; Wickramasinghe, Viresh; Zimcik, David G.

2008-03-01

Helicopter aircrews are exposed to high levels of whole body vibration during flight. This paper presents the results of an investigation of adaptive seat mount approaches to reduce helicopter aircrew whole body vibration levels. A flight test was conducted on a four-blade helicopter and showed that the currently used passive seat systems were not able to provide satisfactory protection to the helicopter aircrew in both front-back and vertical directions. Long-term exposure to the measured whole body vibration environment may cause occupational health issues such as spine and neck strain injuries for aircrew. In order to address this issue, a novel adaptive seat mount concept was developed to mitigate the vibration levels transmitted to the aircrew body. For proof-of-concept demonstration, a miniature modal shaker was properly aligned between the cabin floor and the seat frame to provide adaptive actuation authority. Adaptive control laws were developed to reduce the vibration transmitted to the aircrew body, especially the helmet location in order to minimize neck and spine injuries. Closed-loop control test have been conducted on a full-scale helicopter seat with a mannequin configuration and a large mechanical shaker was used to provide representative helicopter vibration profiles to the seat frame. Significant vibration reductions to the vertical and front-back vibration modes have been achieved simultaneously, which verified the technical readiness of the adaptive mount approach for full-scale flight test on the vehicle.

Pitfalls in neck imaging

International Nuclear Information System (INIS)

Gay, S.B.; Phillips, C.D.; Cornett, J.B.

1991-01-01

CT and MR imaging have become effective imaging modalities in the evaluation of primary head and neck neoplasms. As radiologists have gained experience in head and neck imaging, certain pitfalls have become evident. Identification of pathologic lymph nodes is the critical element in staging neoplasms of the head and neck. The diagnosis of cervical lymphadenopathy may be complicated by confusion with normal structures, inadequate contrast opacification of vascular structures, and poor scanning technique. This paper illustrates these potential problem areas on both CT and MR images and offers the authors' approach to further evaluation in problem cases

Morbidity after neck dissection in head and neck cancer patients : a study describing shoulder and neck complaints, and quality of life

NARCIS (Netherlands)

Wilgen, Cornelis Paul van

2004-01-01

In this thesis we are aiming at more insight in morbidity after head and neck cancer treatment (resection of the primary tumour, neck dissection and pre-or post-operative radiation therapy). We will study shoulder complaints and the role of the spinal accessory nerve, pain and the underlying pain

Adaptation of fuel code for light water reactor with austenitic steel rod cladding

International Nuclear Information System (INIS)

Gomes, Daniel de Souza; Silva, Antonio Teixeira; Giovedi, Claudia

2015-01-01

Light water reactors were used with steel as nuclear fuel cladding from 1960 to 1980. The high performance proved that the use of low-carbon alloys could substitute the current zirconium alloys. Stainless steel is an alternative that can be used as cladding. The zirconium alloys replaced the steel. However, significant experiences in-pile occurred, in commercial units such as Haddam Neck, Indian Point, and Yankee experiences. Stainless Steel Types 347 and 348 can be used as cladding. An advantage of using Stainless Steel was evident in Fukushima when a large number of hydrogens was produced at high temperatures. The steel cladding does not eliminate the problem of accumulating free hydrogen, which can lead to a risk of explosion. In a boiling water reactor, environments easily exist for the attack of intergranular corrosion. The Stainless Steel alloys, Types 321, 347, and 348, are stabilized against attack by the addition of titanium, niobium, or tantalum. The steel Type 348 is composed of niobium, tantalum, and cobalt. Titanium preserves type 321, and niobium additions stabilize type 347. In recent years, research has increased on studying the effects of irradiation by fast neutrons. The impact of radiation includes changes in flow rate limits, deformation, and ductility. The irradiation can convert crystalline lattices into an amorphous structure. New proposals are emerging that suggest using a silicon carbide-based fuel rod cladding or iron-chromium-aluminum alloys. These materials can substitute the classic zirconium alloys. Once the steel Type 348 was chosen, the thermal and mechanical properties were coded in a library of functions. The fuel performance codes contain all features. A comparative analysis of the steel and zirconium alloys was made. The results demonstrate that the austenitic steel alloys are the viable candidates for substituting the zirconium alloys. (author)

Adaptation of fuel code for light water reactor with austenitic steel rod cladding

Energy Technology Data Exchange (ETDEWEB)

Gomes, Daniel de Souza; Silva, Antonio Teixeira, E-mail: dsgomes@ipen.br, E-mail: teixeira@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Giovedi, Claudia, E-mail: claudia.giovedi@labrisco.usp.br [Universidade de Sao Paulo (POLI/USP), Sao Paulo, SP (Brazil). Lab. de Analise, Avaliacao e Gerenciamento de Risco

2015-07-01

Light water reactors were used with steel as nuclear fuel cladding from 1960 to 1980. The high performance proved that the use of low-carbon alloys could substitute the current zirconium alloys. Stainless steel is an alternative that can be used as cladding. The zirconium alloys replaced the steel. However, significant experiences in-pile occurred, in commercial units such as Haddam Neck, Indian Point, and Yankee experiences. Stainless Steel Types 347 and 348 can be used as cladding. An advantage of using Stainless Steel was evident in Fukushima when a large number of hydrogens was produced at high temperatures. The steel cladding does not eliminate the problem of accumulating free hydrogen, which can lead to a risk of explosion. In a boiling water reactor, environments easily exist for the attack of intergranular corrosion. The Stainless Steel alloys, Types 321, 347, and 348, are stabilized against attack by the addition of titanium, niobium, or tantalum. The steel Type 348 is composed of niobium, tantalum, and cobalt. Titanium preserves type 321, and niobium additions stabilize type 347. In recent years, research has increased on studying the effects of irradiation by fast neutrons. The impact of radiation includes changes in flow rate limits, deformation, and ductility. The irradiation can convert crystalline lattices into an amorphous structure. New proposals are emerging that suggest using a silicon carbide-based fuel rod cladding or iron-chromium-aluminum alloys. These materials can substitute the classic zirconium alloys. Once the steel Type 348 was chosen, the thermal and mechanical properties were coded in a library of functions. The fuel performance codes contain all features. A comparative analysis of the steel and zirconium alloys was made. The results demonstrate that the austenitic steel alloys are the viable candidates for substituting the zirconium alloys. (author)

Clinical analysis of deep neck space infections

International Nuclear Information System (INIS)

Hatano, Atsushi; Ui, Naoya; Shigeta, Yasushi; Iimura, Jiro; Rikitake, Masahiro; Endo, Tomonori; Kimura, Akihiro

2009-01-01

Deep neck space infections, which affect soft tissues and fascial compartments of the head and neck, can lead to lethal complications unless treated carefully and quickly, even with the advanced antibiotics available. We reviewed our seventeen patients with deep neck abscesses, analyzed their location by reviewing CT images, and discussed the treatment. Deep neck space infections were classified according to the degree of diffusion of infection diagnosed by CT images. Neck space infection in two cases was localized to the upper neck space above the hyoid bone (Stage I). Neck space infection in 12 cases extended to the lower neck space (Stage II), and further extended to the mediastinum in one case (Stage III). The two cases of Stage I and the four cases of Stage II were managed with incision and drainage through a submental approach. The seven cases of Stage II were managed with incision and drainage parallel to the anterior border of the sternocleidomastoid muscle, the ''Dean'' approach. The one case of Stage III received treatment through transcervicotomy and anterior mediastinal drainage through a subxiphodal incision. The parapharyngeal space played an important role in that the inflammatory change can spread to the neck space inferiorly. The anterior cervical space in the infrahyoid neck was important for mediastinal extension of parapharyngeal abscesses. It is important to diagnose deep neck space infections promptly and treat them adequately, and contrast-enhanced CT is useful and indispensable for diagnosis. The point is which kind of drainage has to be performed. If the surgical method of drainage is chosen according to the level of involvement in the neck space and mediastinum, excellent results may be obtained in terms of survival and morbidity. (author)

Measurement properties of disease-specific questionnaires in patients with neck pain: a systematic review.

Science.gov (United States)

Schellingerhout, Jasper M; Verhagen, Arianne P; Heymans, Martijn W; Koes, Bart W; de Vet, Henrica C; Terwee, Caroline B

2012-05-01

To critically appraise and compare the measurement properties of the original versions of neck-specific questionnaires. Bibliographic databases were searched for articles concerning the development or evaluation of the measurement properties of an original version of a self-reported questionnaire, evaluating pain and/or disability, which was specifically developed or adapted for patients with neck pain. The methodological quality of the selected studies and the results of the measurement properties were critically appraised and rated using a checklist, specifically designed for evaluating studies on measurement properties. The search strategy resulted in a total of 3,641 unique hits, of which 25 articles, evaluating 8 different questionnaires, were included in our study. The Neck Disability Index is the most frequently evaluated questionnaire and shows positive results for internal consistency, content validity, structural validity, hypothesis testing, and responsiveness, but a negative result for reliability. The other questionnaires show positive results, but the evidence for each measurement property is mostly limited, and at least 50% of the information on measurement properties per questionnaire is lacking. Our findings imply that studies of high methodological quality are needed to properly assess the measurement properties of the currently available questionnaires. Until high quality studies are available, we recommend using these questionnaires with caution. There is no need for the development of new neck-specific questionnaires until the current questionnaires have been adequately assessed.

Point defects and diffusion in alloys: correlation effects

International Nuclear Information System (INIS)

Barbe, Vincent

2006-01-01

Kinetic models in alloys aim at predicting the transport properties of a system starting from the microscopic jump frequencies of defects. Such properties are of prior importance in systems which stay out of equilibrium for a long time, as for example irradiated alloys in nuclear reactors. We hereby propose several developments of the recent self-consistent mean field (SCMF) kinetic theory, which deals particularly with the correlation effects due to the coupling of atomic and defect fluxes. They are taken into account through a non-equilibrium distribution function of the system, which is derived from the time evolution of small clusters (of two or more atoms or defects). We therefore introduce a set of 'dynamic' interactions called effective Hamiltonian. The SCMF theory is extended to treat high jump frequency ratios for the vacancy mechanism, as well as the transport through interstitial defects. We use in both cases an atomic model which accounts for the thermodynamic properties of the alloy, as e.g. the short-range order. Those models are eventually applied to predict the diffusion properties in two model alloys of nuclear interest: the concentrated Fe-Ni-Cr solid solution and the dilute Fe(P) alloy. We present adapted atomic models and compare our predictions to experimental data. (author)

Thermodynamic aspects of grain refinement of Al-Si alloys using Ti and B

Energy Technology Data Exchange (ETDEWEB)

Groebner, Joachim [Technical University of Clausthal, Institute of Metallurgy, Robert-Koch-Str. 42, D-38678 Clausthal-Zellerfeld (Germany); Mirkovic, Djordje [Technical University of Clausthal, Institute of Metallurgy, Robert-Koch-Str. 42, D-38678 Clausthal-Zellerfeld (Germany); Schmid-Fetzer, Rainer [Technical University of Clausthal, Institute of Metallurgy, Robert-Koch-Str. 42, D-38678 Clausthal-Zellerfeld (Germany)]. E-mail: schmid-fetzer@tu-clausthal.de

2005-03-25

A thermodynamic assessment of ternary Al-Si-Ti phases was performed. Published datasets for the other subsystems were checked and adapted. Based on that, a consistent thermodynamic description of quaternary Al-Si-Ti-B alloys was generated. This was applied in a calculation of Al-Si-Ti-B phase diagram sections for practically relevant temperatures and compositions of Al-Si alloys from Al-rich to typical Al-Si foundry alloys. These stable and metastable phase diagrams could be correlated to many detailed aspects of possible reactions observed or suggested in experimental studies of grain refining. Understanding the mechanisms of grain refining of Al wrought alloys and Al-Si foundry alloys using titanium and boron requires a fundamental knowledge of both thermodynamic and kinetic aspects of this complex process. This work focuses exclusively on the thermodynamic aspects and the phase diagrams, which were not available for the quaternary alloys and partly incomplete and inconsistent for the ternary subsystems.

Automated tube voltage adaptation in head and neck computed tomography between 120 and 100 kV: effects on image quality and radiation dose.

Science.gov (United States)

May, Matthias S; Kramer, Manuel R; Eller, Achim; Wuest, Wolfgang; Scharf, Michael; Brand, Michael; Saake, Marc; Schmidt, Bernhard; Uder, Michael; Lell, Michael M

2014-09-01

Low tube voltage allows for computed tomography (CT) imaging with increased iodine contrast at reduced radiation dose. We sought to evaluate the image quality and potential dose reduction using a combination of attenuation based tube current modulation (TCM) and automated tube voltage adaptation (TVA) between 100 and 120 kV in CT of the head and neck. One hundred thirty consecutive patients with indication for head and neck CT were examined with a 128-slice system capable of TCM and TVA. Reference protocol was set at 120 kV. Tube voltage was reduced to 100 kV whenever proposed by automated analysis of the localizer. An additional small scan aligned to the jaw was performed at a fixed 120 kV setting. Image quality was assessed by two radiologists on a standardized Likert-scale and measurements of signal- (SNR) and contrast-to-noise ratio (CNR). Radiation dose was assessed as CTDIvol. Diagnostic image quality was excellent in both groups and did not differ significantly (p = 0.34). Image noise in the 100 kV data was increased and SNR decreased (17.8/9.6) in the jugular veins and the sternocleidomastoid muscle when compared to 120 kV (SNR 24.4/10.3), but not in fatty tissue and air. However, CNR did not differ statistically significant between 100 (23.5/14.4/9.4) and 120 kV data (24.2/15.3/8.6) while radiation dose was decreased by 7-8%. TVA between 100 and 120 kV in combination with TCM led to a radiation dose reduction compared to TCM alone, while keeping CNR constant though maintaining diagnostic image quality.

The role of FDG PET in management of neck metastasis from head-and-neck cancer after definitive radiation treatment

International Nuclear Information System (INIS)

Yao Min; Smith, Russell B.; Graham, Michael M.; Hoffman, Henry T.; Tan Huaming; Funk, Gerry F.; Graham, Scott M.; Chang, Kristi; Dornfeld, Kenneth J.; Menda, Yusuf; Buatti, John M.

2005-01-01

Purpose: The role of neck dissection after definitive radiation for head-and-neck cancer is controversial. We select patients for neck dissection based on postradiation therapy (post-RT), computed tomography (CT), and [ 18 F] fluorodeoxyglucose positron emission tomography (FDG PET). We summarize the clinical outcomes of patients treated with this policy to further elucidate the role of FDG PET in decision making for neck dissection after primary radiotherapy. Methods and Materials: Between December 1999 and February 2004, 53 eligible patients were identified. These patients had stage N2A or higher head-and-neck squamous cell carcinoma and had complete response of the primary tumor after definitive radiation with or without chemotherapy. PET or computed tomography (CT) scans were performed within 6 months after treatment. Neck dissection was performed in patients with residual lymphadenopathy (identified by clinical examination or CT) and a positive PET scan. Those without residual lymph nodes and a negative PET were observed without neck dissection. For patients with residual lymphadenopathy, but a negative PET scan, neck dissection was performed at the discretion of the attending surgeon and decision of the patient. There was a total of 70 heminecks available for analysis (17 patients had bilateral neck disease). Results: There were 21 heminecks with residual lymphadenopathy identified on CT imaging or clinical examination and negative PET. Of these, 4 had neck dissection and were pathologically negative. The remaining 17 were observed without neck dissection. There was a total of 42 heminecks without residual lymph nodes on post-RT CT imaging or clinical examination with a negative PET. They were also observed without neck dissection. Seven heminecks had a positive PET scan and residual lymphadenopathy. Six of them had neck dissection and 1 had fine-needle aspiration of a residual node; 3 contained residual viable cancer and 4 were pathologically negative. At

Are People With Whiplash-Associated Neck Pain Different from People With Nonspecific Neck Pain?

DEFF Research Database (Denmark)

Anstey, Ricci; Kongsted, Alice; Kamper, Steven

2016-01-01

Study Design Secondary analysis of a prospective cohort study with cross sectional and longitudinal analyses. Background The clinical importance of a history of whiplash associated disorder (WAD) in people with neck pain remains uncertain. Objective To compare people with WAD to people with non......-specific neck pain, in terms of their baseline characteristics, and pain and disability outcomes over 1 year. Methods Consecutive patients with neck pain presenting to a secondary care spine centre answered a comprehensive self-report questionnaire and underwent a physical examination. Patients were classified...

Quality of life and neck pain in nurses

Directory of Open Access Journals (Sweden)

Lucy Joslin

2014-04-01

Full Text Available Objectives: To investigate the association between neck pain and psychological stress in nurses. Material and Methods: Nurses from the Avon Orthopaedic Centre completed 2 questionnaires: the Short Form-36 (SF-36 and 1 exploring neck pain and associated psychological stress. Results: Thirty four nurses entered the study (68% response. Twelve (35.3% had current neck pain, 13 (38.2% reported neck pain within the past year and 9 (26.5% had no neck pain. Subjects with current neck pain had significantly lower mental health (47.1 vs. 70.4; p = 0.002, physical health (60.8 vs. 76.8; p = 0.010 and overall SF-36 scores (56.8 vs. 74.9; p = 0.003. Five (41.7% subjects with current neck pain and 5 (38.5% subjects with neck pain in the previous year attributed it to psychological stress. Conclusions: Over 1/3 of nurses have symptomatic neck pain and significantly lower mental and physical health scores. Managing psychological stress may reduce neck pain, leading to improved quality of life for nurses, financial benefits for the NHS, and improved patient care.

Laser surface alloying of aluminium-transition metal alloys

International Nuclear Information System (INIS)

Almeida, A.; Vilar, R.

1998-01-01

Laser surface alloying has been used as a tool to produce hard and corrosion resistant Al-transition metal (TM) alloys. Cr and Mo are particularly interesting alloying elements to produce stable high-strength alloys because they present low diffusion coefficients and solid solubility in Al. To produce Al-TM surface alloys a two-step laser process was developed: firstly, the material is alloyed using low scanning speed and secondly, the microstructure is modified by a refinement step. This process was used in the production of Al-Cr, Al-Mo and Al-Mo and Al-Nb surface alloys by alloying Cr, Mo or Nb powder into an Al and 7175 Al alloy substrate using a CO 2 laser . This paper presents a review of the work that has been developed at Instituto Superior Tecnico on laser alloying of Al-TM alloy, over the last years. (Author) 16 refs

Modeling neck mobility in fossil turtles.

Science.gov (United States)

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. © 2014 Wiley Periodicals, Inc.

Specific Adaptation of Gas Atomization Processing for Al-Based Alloy Powder for Additive Manufacturing

Energy Technology Data Exchange (ETDEWEB)

Anderson, Iver [Ames Lab., Ames, IA (United States); Siemon, John [Alcoa, Inc, Pittsburgh, PA (United States)

2017-06-30

The initial three atomization attempts resulted in “freeze-outs” within the pour tubes in the pilot-scale system and yielded no powder. Re-evaluation of the alloy liquidus temperatures and melting characteristics, in collaboration with Alcoa, showed further superheat to be necessary to allow the liquid metal to flow through the pour tube to the atomization nozzle. A subsequent smaller run on the experimental atomization system verified these parameters and was successful, as were all successive runs on the larger pilot scale system. One alloy composition froze-out part way through the atomization on both pilot scale runs. SEM images showed needle formation and phase segregations within the microstructure. Analysis of the pour tube freeze-out microstructures showed that large needles formed within the pour tube during the atomization experiment, which eventually blocked the melt stream. Alcoa verified the needle formation in this alloy using theoretical modeling of phase solidification. Sufficient powder of this composition was still generated to allow powder characterization and additive manufacturing trials at Alcoa.

Experimental and FE simulation validation of sheet thickness optimization in superplastic forming of Al alloy

Energy Technology Data Exchange (ETDEWEB)

Kumaresan, G.; Jothilingam, A. [Anna University, Chennai (India)

2016-07-15

Superplasticity is the ability of a polycrystalline materials to exhibit very large elongations without necking prior to failure. In this paper, the superplastic forming potential of fine grained 7075 aluminium alloy was studied. The process parameters like pressure, forming time and initial sheet thickness were selected, using the design of experiments technique. The same condition of formation process was attempted in the finite element simulation using ABAQUS software. The deviation of the thickness distribution between the simulation and experiment was made and the variation lies within 8%.

Third-generation dual-source CT of the neck using automated tube voltage adaptation in combination with advanced modeled iterative reconstruction: evaluation of image quality and radiation dose

International Nuclear Information System (INIS)

Scholtz, Jan-Erik; Wichmann, Julian L.; Huesers, Kristina; Albrecht, Moritz H.; Beeres, Martin; Bauer, Ralf W.; Vogl, Thomas J.; Bodelle, Boris

2016-01-01

To evaluate image quality and radiation dose in third-generation dual-source computed tomography (DSCT) of the neck using automated tube voltage adaptation (TVA) with advanced modelled iterative reconstruction (ADMIRE) algorithm. One hundred and sixteen patients were retrospectively evaluated. Group A (n = 59) was examined on second-generation DSCT with automated TVA and filtered back projection. Group B (n = 57) was examined on a third-generation DSCT with automated TVA and ADMIRE. Age, body diameter, attenuation of several anatomic structures, noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), radiation dose (CTDI vol ) and size-specific dose estimates (SSDE) were assessed. Diagnostic acceptability was rated by three readers. Age (p = 0.87) and body diameter (p = 0.075) did not differ significantly. Tube voltage in Group A was set automatically to 100 kV for all patients (n = 59), and to 70 kV (n = 2), 80 kV (n = 5), and 90 kV (n = 50) in Group B. Noise was reduced and CNR was increased significantly (p < 0.001). Diagnostic acceptability was rated high in both groups, with better ratings in Group B (p < 0.001). SSDE was reduced by 34 % in Group B (20.38 ± 1.63 mGy vs. 13.04 ± 1.50 mGy, p < 0.001). Combination of automated TVA and ADMIRE in neck CT using third-generation DSCT results in a substantial radiation dose reduction with low noise and increased CNR. (orig.)

An immediate effect of axial neck rotation training with real time visual feedback using a smartphone inclinometer on improvement in axial neck rotation function.

Science.gov (United States)

Park, Kyue-Nam; Kwon, Oh-Yun; Kim, Si-Hyun; Jeon, In-Cheol

2017-03-01

The purpose of this study was to compare the immediate effects of axial neck rotation training (Axi-NRT) with and without real-time visual feedback (VF) using a smartphone inclinometer on the range of motion (ROM) for axial neck rotation and the onset of compensatory neck lateral bending and extension during active neck rotation. Twenty participants with restricted ROM for neck rotation but no neck pain (21.1 ± 1.6 years and 8 males, 12 females) were recruited for Axi-NRT with VF, and twenty age- and gender-matched participants with restricted ROM for neck rotation were recruited for Axi-NRT without VF. Changes in ROM for neck rotation and the onset time of compensatory neck movement during active neck rotation were measured using an electromagnetic tracking system. Axi-NRT with VF was more effective in increasing ROM for neck rotation and decreasing and delaying the onset of compensatory neck movements during active neck rotation compared with Axi-NRT without VF. Repeated Axi-NRT using VF is useful to educate participants in maintaining the axis of the cervical spine and to increase ROM for axial neck rotation with less compensatory neck motion in participants with a restricted range of neck rotations.

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

International Nuclear Information System (INIS)

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

2016-01-01

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

Adapting the Revised Self-Leadership Questionnaire to the Portuguese Context

Science.gov (United States)

Marques-Quinteiro, Pedro; Curral, Luis Alberto; Passos, Ana Margarida

2012-01-01

This study aimed to adapt the Revised Self-Leadership Questionnaire (RSLQ) (Houghton and Neck in J Manag Psychol 17(8):672-691, 2002) for the Portuguese population. 720 professionals, and university and post-graduate students participated in this study. The RSLQ factorial structure was accessed through exploratory and multi group confirmatory…

Psychometric properties of the Neck OutcOme Score, Neck Disability Index, and Short Form-36 were evaluated in patients with neck pain.

Science.gov (United States)

Juul, Tina; Søgaard, Karen; Davis, Aileen M; Roos, Ewa M

2016-11-01

To assess reliability, construct validity, responsiveness, and interpretability for Neck OutcOme Score (NOOS), Neck Disability Index (NDI), and Short Form-36 (SF-36) in neck pain patients. Internal consistency was assessed by Cronbach alpha. Test-retest reliability was evaluated by intraclass correlation coefficient (ICC), and measurement error was estimated from the standard error of measurement. Responsiveness was assessed as standardized response mean (SRM) and interpretability from the minimal important difference (MID). Construct validity was tested correlating subscale scores from NOOS and SF-36 and NDI items. At baseline, 196 neck pain patients were included. Cronbach α was adequate for most NOOS subscales, NDI, and SF-36 with few exceptions. Good to excellent reliability was found for NOOS subscales (ICC 0.88-0.95), for NDI, and for SF-36 with few exceptions. For NOOS, minimal detectable changes varied between 1.1 and 1.9, and construct validity was supported. SRMs were higher for NOOS subscales (0.19-0.42), compared to SF-36 and NDI. MID values varied between 15.0 and 24.1 for NOOS subscales. In conclusion, the NOOS is a reliable, valid, and responsive measure of self-reported disability in neck pain patients, performing at least as well or better than the commonly used SF-36 and NDI. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of head and neck cancer adaptive radiotherapy to spare the parotid glands and decrease the risk of xerostomia.

Science.gov (United States)

Castelli, Joel; Simon, Antoine; Louvel, Guillaume; Henry, Olivier; Chajon, Enrique; Nassef, Mohamed; Haigron, Pascal; Cazoulat, Guillaume; Ospina, Juan David; Jegoux, Franck; Benezery, Karen; de Crevoisier, Renaud

2015-01-09

Large anatomical variations occur during the course of intensity-modulated radiation therapy (IMRT) for locally advanced head and neck cancer (LAHNC). The risks are therefore a parotid glands (PG) overdose and a xerostomia increase. The purposes of the study were to estimate: - the PG overdose and the xerostomia risk increase during a "standard" IMRT (IMRTstd); - the benefits of an adaptive IMRT (ART) with weekly replanning to spare the PGs and limit the risk of xerostomia. Fifteen patients received radical IMRT (70 Gy) for LAHNC. Weekly CTs were used to estimate the dose distributions delivered during the treatment, corresponding either to the initial planning (IMRTstd) or to weekly replanning (ART). PGs dose were recalculated at the fraction, from the weekly CTs. PG cumulated doses were then estimated using deformable image registration. The following PG doses were compared: pre-treatment planned dose, per-treatment IMRTstd and ART. The corresponding estimated risks of xerostomia were also compared. Correlations between anatomical markers and dose differences were searched. Compared to the initial planning, a PG overdose was observed during IMRTstd for 59% of the PGs, with an average increase of 3.7 Gy (10.0 Gy maximum) for the mean dose, and of 8.2% (23.9% maximum) for the risk of xerostomia. Compared to the initial planning, weekly replanning reduced the PG mean dose for all the patients (pxerostomia by 11% (pxerostomia risk.

A modified face mask device for radiotherapy of head and neck tumor

International Nuclear Information System (INIS)

Adamietz, I.A.; Kremmin, B.; Emminger, A.

1991-01-01

The reproducibility during radiotherapy of head and neck tumors has been significantly improved by special devices like individual masks. However, the temporary fixation of head and neck region to the irradiation berth induces in many patients anxiety state and reduces this way the compliance. By means of modification of the device used till now a new model in which the set up mask is only coupled to the berth, could be developed. The clinical evaluation showed that this form of fixation device is much better tolerated by the patients and can be adapted without any problems to all equipment pieces in a radiotherapy department. The estimated reproducibility was comparable to that obtained with mounted device. The average translation of the central beam during 21 days observation period was 2.6±1.4 mm (0 to 9 mm) in the sagittal plane and 3.4±1.0 mm (1 to 8 mm) in the frontal plane. (orig.) [de

Replacement of steel parts with extruded aluminum alloys in an automobile

Science.gov (United States)

Daggula, Manikantha Reddy

Over the past years, vehicle emissions have shown a negative impact on environment and human health. A new strategy has been used by automakers to reduce a vehicle's weight which significantly reduce fuel consumption and C02 emissions. A very light car consumes very less fuel as it needs to overcome less inertia, decreasing the required power to movie the vehicle. Reducing weight is the easiest way to increase fuel economy and making it by just 10% can increase its efficiency 6 to 8 percent. For a normal scale 80% of vehicles weight is shared among chassis, power train and other exterior components. Almost 60% of the vehicles weight is comprised of steel and the remaining is with cast and extruded aluminum and magnesium alloys. Our main aim is to look for the parts like Fuel tank holder, Fuel filler neck, Turbo inlet assembly, and Brake lines, Dash board frame which are made from steel and replace them with extruded aluminum alloys, to analyze a conventional rear wheel aluminum drive shaft and replace it with a new design and with a new aluminum alloy. The current project involves dismantling an automobile and looking for feasible steel parts and making samples, analyzing the hardness of the samples. These parts are optimally analyzed using Ansys Finite element analysis tool, these parts are subjected to the constraints such as three-point bending, tensile testing, hydrostatic pressure and also torsional stress action on the drive shaft, the deformation and stress are observed in these parts. The results show the current steel parts can be replaced with 3000 series aluminum alloy and the drive shaft can be replaced with new design with 6061-T6 Al-alloy which decreases 25% of the shaft weight.

Occupational Therapy for the Head and Neck Cancer Patient.

Science.gov (United States)

Park, Priscilla; Hashmi, Mahjabeen

2018-01-01

Occupational therapy is a health profession concerned with promoting health and well-being through occupation. A diagnosis of head and neck cancer (HNC) often invokes fear and anxiety because of the potential negative impact of the diagnosis and/or treatment on lifestyle and well-being. Occupational therapists perform a unique and important role in addressing quality of life concerns for HNC patients through applied expertise in lifestyle management, facilitating the use of positive coping strategies and daily routine management. Occupational therapy concurrently assists HNC patients to effectively manage the debilitating stress and anxiety associated with HNC diagnosis, treatment, and recovery while facilitating a return to prior or adapted daily routines.

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

OpenAIRE

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-bas...

SU-E-J-109: Evaluation of Deformable Accumulated Parotid Doses Using Different Registration Algorithms in Adaptive Head and Neck Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Xu, S [Key Laboratory of Particle & Radiation Imaging (Tsinghua University), Ministry of Education, Beijing, 100084 China (China); Chinese PLA General Hospital, Beijing, 100853 China (China); Liu, B [Image processing center, Beihang University, Beijing, 100191 China (China)

2015-06-15

Purpose: Three deformable image registration (DIR) algorithms are utilized to perform deformable dose accumulation for head and neck tomotherapy treatment, and the differences of the accumulated doses are evaluated. Methods: Daily MVCT data for 10 patients with pathologically proven nasopharyngeal cancers were analyzed. The data were acquired using tomotherapy (TomoTherapy, Accuray) at the PLA General Hospital. The prescription dose to the primary target was 70Gy in 33 fractions.Three DIR methods (B-spline, Diffeomorphic Demons and MIMvista) were used to propagate parotid structures from planning CTs to the daily CTs and accumulate fractionated dose on the planning CTs. The mean accumulated doses of parotids were quantitatively compared and the uncertainties of the propagated parotid contours were evaluated using Dice similarity index (DSI). Results: The planned mean dose of the ipsilateral parotids (32.42±3.13Gy) was slightly higher than those of the contralateral parotids (31.38±3.19Gy)in 10 patients. The difference between the accumulated mean doses of the ipsilateral parotids in the B-spline, Demons and MIMvista deformation algorithms (36.40±5.78Gy, 34.08±6.72Gy and 33.72±2.63Gy ) were statistically significant (B-spline vs Demons, P<0.0001, B-spline vs MIMvista, p =0.002). And The difference between those of the contralateral parotids in the B-spline, Demons and MIMvista deformation algorithms (34.08±4.82Gy, 32.42±4.80Gy and 33.92±4.65Gy ) were also significant (B-spline vs Demons, p =0.009, B-spline vs MIMvista, p =0.074). For the DSI analysis, the scores of B-spline, Demons and MIMvista DIRs were 0.90, 0.89 and 0.76. Conclusion: Shrinkage of parotid volumes results in the dose increase to the parotid glands in adaptive head and neck radiotherapy. The accumulated doses of parotids show significant difference using the different DIR algorithms between kVCT and MVCT. Therefore, the volume-based criterion (i.e. DSI) as a quantitative evaluation of

[Oral maxillofacial-head and neck tumor and holistic integrative medicine].

Science.gov (United States)

Zhang, C P

2017-08-09

The advance of clinical diagnosis and treatment in oral and maxillofacial-head and neck tumors has been through the process of specialization and multidisciplinary cooperation. In most cases, a single discipline cannot meet the requirements of diagnosis and treatment, which needs the cooperation of oral and maxillofacial surgery, otolaryngology and oncology approach and therapeutic method such as surgery, radiotherapy and chemotherapy. Holistic integrative medicine aims at integrating the most effective clinical practice experience and patients' individual situation and prognosis, establishing new medical mode conforming to the modern concept and fulfilling the medical system adapting to the specific characteristics of the diseases.

Head, Neck, and Oral Cancer

Medline Plus

Full Text Available ... and Neck Pathology Close to 49,750 Americans will be diagnosed with oral or pharyngeal cancer this ... and Neck Pathology Close to 49,750 Americans will be diagnosed with oral or pharyngeal cancer this ...

Dosimetric evaluation of scattered and attenuated radiation due to dental restorations in head and neck radiotherapy

Directory of Open Access Journals (Sweden)

Mona Azizi

2018-01-01

Full Text Available In radiotherapy of head and neck cancer, the presence of high density materials modifies photon dose distribution near these high density materials during treatment. The aim of this study is to calculate the backscatter and attenuation effects of a healthy tooth, Amalgam, Ni-Cr alloy and Ceramco on the normal tissues before and after these materials irradiated by 6 and 15 MV photon beams, respectively. All measurements were carried out in a water phantom with dimension of 50 × 50 × 50 cm3with an ionization chamber detector. Two points before and four points after the dental sample were considered to score the photon dose. The depth dose on the central beam axis was explored in a water phantom for source to surface distance (SSD of 100 cm in a 10 × 10 cm2 field size. The percentage dose change was obtained relative to the dose in water versus depth of water, tooth, Amalgam, Ni-Cr alloy and Ceramco for the photon beams. The absolute dose (cGy was measured by prescription of 100 cGy dose in the water phantom at depth of 2.0 and 3.1 cm for 6 and 15 MV photons, respectively. At depth of 0.6 cm, the maximum percentage dose increase was observed with values of 6.99% and 9.43%for Ni-Cr and lowest percentage dose increase of 1.49% and 2.63% are related to the healthy tooth in 6 and 15 MV photon beams, respectively. The maximum absolute dose of 95.58 cGy and 93.64 cGy were observed at depth of 0.6 cm in presence of Ni-Cr alloy for 6 and 15 MV photon beams, respectively. The presence of dental restorations can cause backscattering dose during head and neck radiation therapy. Introduction of compositions and electron density of high density materials can improve the accuracy of dosimetric calculations in treatment planning systems to deliver the relevant dose to target organ and reduce the backscattering dose in healthy tissues in the surrounding of tooth.

Evaluation of Corrosion Resistance of Titanium Alloys Used for Medical Implants

Directory of Open Access Journals (Sweden)

Szewczenko J.

2016-06-01

Full Text Available The study presents the results of investigations of modeling the usable properties of implant surfaces made of Ti6Al7Nb alloy, using the example of a dynamic hip screw (DHS applied in surgical treatment of intertrochanteric femoral neck fractures. Numerical simulation has been performed for the model load of femoral fixation with DHS screw. The load simulation results provided the basis to select mechanical properties of the fixator elements and to define those fixation areas which are mostly susceptible to development of corrosion. The surfaces of Ti6Al7Nb alloy were ground, vibro-abrasive machined, mechanically polished, sandblasted, anode oxidized at different voltage values and steam sterilized. Results of surface topography evaluation, resistance to pitting and crevice corrosion as well as degradation kinetics of the outer layer were presented. Usability of the formed passive layer in clinical applications was evaluated through wear and corrosion tests of the femoral fixation model. The test results proved usefulness of the proposed surface modification methods for clinical application of different size and shape implants

Head and neck cancer in South Asia: Macroeconomic consequences and the role of the head and neck surgeon.

Science.gov (United States)

Alkire, Blake C; Bergmark, Regan W; Chambers, Kyle; Lin, Derrick T; Deschler, Daniel G; Cheney, Mack L; Meara, John G

2016-08-01

Head and neck cancer constitutes a substantial portion of the burden of disease in South Asia, and there is an undersupply of surgical capacity in this region. The purpose of this study was to estimate the economic welfare losses due to head and neck cancer in India, Pakistan, and Bangladesh in 2010. We used publicly available estimates of head and neck cancer morbidity and mortality along with a concept termed the value of a statistical life to estimate economic welfare losses in the aforementioned countries in 2010. Economic losses because of head and neck cancer in India, Pakistan, and Bangladesh totaled $16.9 billion (2010 US dollars [USD]), equivalent to 0.26% of the region's economic output. Bangladesh, the poorest country, experienced the greatest proportional losses. The economic consequences of head and neck cancer in South Asia are significant, and building surgical capacity is essential to begin to address this burden. © 2016 Wiley Periodicals, Inc. Head Neck 38:1242-1247, 2016. © 2016 Wiley Periodicals, Inc.

Head and Neck Cancer—Health Professional Version

Science.gov (United States)

Head and neck cancers include hypopharyngeal, laryngeal, lip and oral cavity, metastatic squamous neck, nasopharyngeal, oropharyngeal, paranasal sinus, and salivary gland cancers. Find evidence-based information on head and neck cancer treatment, causes and prevention, research, screening, and statistics.

The relationship between physical impairments, quality of life and disability of the neck and upper limb in patients following neck dissection.

Science.gov (United States)

Gane, Elise M; McPhail, Steven M; Hatton, Anna L; Panizza, Benedict J; O'Leary, Shaun P

2018-05-16

The purpose of this study was to examine the relationship between physical impairments, quality of life and disability in patients following neck dissection, with consideration of patient and clinical characteristics. Cross-sectional study of patients < 5 years after neck dissection for head and neck cancer. Quality of life and self-reported disability were measured with the Neck Dissection Impairment Index, Quick Disabilities of the Arm, Shoulder and Hand, and Neck Disability Index. Active neck and shoulder range of motion and isometric muscle strength were also assessed. Generalised linear modelling was used to explore relationships between variables. Eighty-four participants (68% male, median age 61 years) demonstrated reduced quality of life (median (interquartile range) score = 76 (49, 93) from 0 (worst) to 100 (best)), and mild levels of upper limb (14 (2, 32)) and neck disability (14 (6, 28)) (from 0 (best) to 100 (worst)). Bilateral neck dissection was associated with reduced quality of life (coeff (95% CI) = - 12.49 (- 24.69, - 0.29)). Post-operative chemoradiation therapy was associated with reduced quality of life (- 21.46 (- 37.57, - 5.35)) and neck disability (0.71 (0.10, 1.32)). Measures of shoulder flexibility or strength were associated with quality of life and self-reported disability. Quality of life and musculoskeletal disability after neck dissection are associated with factors from multiple domains including physical motor function and treatment modality. Having reduced shoulder flexibility or strength is related to functional deficits and quality of life after neck dissection for head and neck cancer.

Initial conformation of kinesin's neck linker

International Nuclear Information System (INIS)

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

2014-01-01

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 β0 and forms a ‘cover-neck bundle’ structure with β0. 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. (interdisciplinary physics and related areas of science and technology)

Increased neck muscle activity and impaired balance among females with whiplash-related chronic neck pain

DEFF Research Database (Denmark)

Juul-Kristensen, Birgit; Clausen, Brian; Ris Hansen, Inge

2013-01-01

To investigate neck muscle activity and postural control in patients with whiplash-associated disorder compared with healthy controls.......To investigate neck muscle activity and postural control in patients with whiplash-associated disorder compared with healthy controls....

Chronic neck pain and masticatory dysfunction.

Science.gov (United States)

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

2005-12-01

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

CrossNeck 1.0 XSLT-SVG cross-section analysis tool for analyzing necking state of a sphere bed

CERN Document Server

Pouchon, M A

2002-01-01

A tool for analyzing ceramographic cuts of sphere beds was programmed. The parameter of interest was the neck ratio being formed during sintering. A neck investigation based on such a cross section was programmed in a way, that the cross section discs could be entered graphically, and that the necking data was extracted from this information. In a resulting graphic the neck information on the surface was overlaid and could be crosschecked with the actual visible necking data. This allowed a quality control of the extracted data but was also necessary to exclude some false solution being introduced by the principle how the data was extracted. Some test on cross sections of a Cer-Med Sphere-Bed showed good results.

Femoral neck buttressing: a radiographic and histologic analysis

International Nuclear Information System (INIS)

Dixon, T.; Benjamin, J.; Lund, P.; Graham, A.; Krupinski, E.

2000-01-01

Objective. To examine the incidence, radiographic and histologic findings of medial femoral neck buttressing in a consecutive group of patients undergoing total hip arthroplasty.Design. Biomechanical parameters were evaluated on standard anteroposterior pelvic radiographs of 113 patients prior to hip replacement surgery. Demographic information on all patients was reviewed and histologic evaluation was performed on specimens obtained at the time of surgery.Results. The incidence of medial femoral neck buttressing was found to be 50% in a consecutive series of patients undergoing total hip arthroplasty. The incidence was slightly higher in women (56% vs 41%). Patients with buttressing had increased neck-shaft angles and smaller femoral neck diameters than were seen in patients without buttressing. Histologic evaluation demonstrated that the buttress resulted from deposition bone by the periosteum on the femoral neck in the absence of any evidence of femoral neck fracture.Conclusion. It would appear that femoral neck buttressing occurs in response to increased joint reactive forces seen at the hip being transmitted through the femoral neck. The increased joint reactive force can be related to the increased neck shaft angle seen in patients with buttressing. (orig.)

Neck injury tolerance under inertial loads in side impacts.

Science.gov (United States)

McIntosh, Andrew S; Kallieris, Dimitrios; Frechede, Bertrand

2007-03-01

Neck injury remains a major issue in road safety. Current side impact dummies and side impact crashworthiness assessments do not assess the risk of neck injury. These assessments are limited by biofidelity and knowledge regarding neck injury criteria and tolerance levels in side impacts. Side impact tests with PMHS were performed at the Heidelberg University in the 1980s and 1990s to improve primarily the understanding of trunk dynamics, injury mechanisms and criteria. In order to contribute to the definition of human tolerances at neck level, this study presents an analysis of the head/neck biomechanical parameters that were measured in these tests and their relationship to neck injury severity. Data from 15 impact tests were analysed. Head accelerations, and neck forces and moments were calculated from 9-accelerometer array head data, X-rays and anthropometric data. Statistically significant relationships were observed between resultant head acceleration and neck force and neck injury severity. The average resultant head acceleration for AIS 2 neck injuries was 112 g, while resultant neck force was 4925 N and moment 241 Nm. The data compared well to other test data on cadavers and volunteers. It is hoped that the paper will assist in the understanding of neck injuries and the development of tolerance criteria.

Exercises for mechanical neck disorders

NARCIS (Netherlands)

Kay, Theresa M.; Gross, Anita; Goldsmith, Charles H.; Rutherford, Sherrill; Voth, Sandra; Hoving, Jan L.; Brønfort, Gert; Santaguida, Pasqualina L.

2012-01-01

Background Neck disorders are common, disabling and costly. The effectiveness of exercise as a physiotherapy intervention remains unclear. Objectives To improve pain, disability, function, patient satisfaction, quality of life and global perceived effect in adults with neck pain. Search methods

Stress corrosion cracking growth rate of TT alloy 690 and its weld joint in simulated PWR primary water

International Nuclear Information System (INIS)

Yonezawa, T.

2015-01-01

Recently, some researchers reported that the SCC growth rate (SCCGR) of cold worked thermally treated (TT) Alloy 690 was significantly different in heat by heat. But, author has hypothesized that these high SCCGRs in cold worked TT Alloy 690 could be due to the metallurgical characteristics of these heats. In order to confirm this hypothesis, this study has been started in the author's laboratory, and the following 4 new evidences were obtained. First, microcracks of carbides and voids were observed in eutectic M 23 C 6 GB carbides (primary carbides) for cold rolled laboratory heat after as cast or lightly forged condition or for chemical composition simulated Bettis'TT Alloy 690 heat, after cold rolling, before SCC test. However, microcracks in primary carbides along grain boundaries and voids were rarely detected in the cold rolled commercial heat of TT Alloy 690 used for CRDM penetrations. Secondly, the SCCGR observed in TT Alloy 690 was different in each hot working process and each heat. Comparing the SCCGRs for all heats of cold worked TT Alloy 690, the SCCGR decreased with increasing of Vickers hardness. However, in same heats of cold worked TT Alloy 690, the SCCGR increased with increasing of Vickers hardness. Thirdly, the SCCGR in cold rolled TT Alloy 690 should be integrated by the effect of hardness or cold working ratio and by the effect of existing ratio of primary M23C6 carbides with cracks and Voids due to chemical composition and the fabrication process of TT Alloy 690. Fourthly, it is argued that the high SCCGRs in highly cold rolled TT Alloy 690 are not representative of the practical situation with TT Alloy 690 in service for CRDM adapter nozzles etc. The high SCCGR of highly cold rolled TT Alloy 690 is not thought to be an accurate tool in predicting the possibility of cracking of TT Alloy 690 for CRDM adapter nozzles. (author)

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

International Nuclear Information System (INIS)

Soltys, Scott G.; Choi, Clara Y.H.; Fee, Willard E.; Pinto, Harlan A.; Le, Quynh-Thu

2012-01-01

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→pCR, and cPR→pPR were 90%, 93%, and 78%, respectively (p = 0.36). The 5-year disease-free survival rates for the cCR, cPR→pCR, and cPR→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.

Neck lift my way: an update.

Science.gov (United States)

Feldman, Joel J

2014-12-01

The author updates prior descriptions of an approach to the surgical neck lift that aims for a maximum degree of control over the size, shape, and position of every anatomical feature of the neck that is negatively affecting its appearance. A 38-year clinical experience guided the development of the operative tactics that define the strategy. Data collected from a records review of 522 consecutive neck lifts performed during the 10-year period 2004 through 2013 further inform the report. The approach has eight features: (1) nearly routine use of open submental access to all tissue layers of the central neck, including a regimen that curbed the problems that may attend an extensive tissue dissection; (2) management of lax neck skin by lateral excision using a specific postauricular incision, or by using the nonexcisional method of redistribution; (3) open lipectomy for precise removal of excess subcutaneous neck and jawline fat; (4) individualized modifications to subplatysmal fat, perihyoid fascia, and anterior digastric muscles; (5) treatment of large, ptotic, or malpositioned submandibular salivary glands by partial excision using a transcutaneous traction suture; (6) the current version of the corset platysmaplasty, which is used to treat static paramedian platysma muscle bands, and to avoid contour imperfections following subplatysmal maneuvers; (7) an approach that facilitates an isolated neck lift; and (8) durable results. Case examples demonstrate outcomes. Although the updated approach remains relatively complex and invasive, the author believes that the ends justify the means.

A cellular automaton - finite volume method for the simulation of dendritic and eutectic growth in binary alloys using an adaptive mesh refinement

Science.gov (United States)

Dobravec, Tadej; Mavrič, Boštjan; Šarler, Božidar

2017-11-01

A two-dimensional model to simulate the dendritic and eutectic growth in binary alloys is developed. A cellular automaton method is adopted to track the movement of the solid-liquid interface. The diffusion equation is solved in the solid and liquid phases by using an explicit finite volume method. The computational domain is divided into square cells that can be hierarchically refined or coarsened using an adaptive mesh based on the quadtree algorithm. Such a mesh refines the regions of the domain near the solid-liquid interface, where the highest concentration gradients are observed. In the regions where the lowest concentration gradients are observed the cells are coarsened. The originality of the work is in the novel, adaptive approach to the efficient and accurate solution of the posed multiscale problem. The model is verified and assessed by comparison with the analytical results of the Lipton-Glicksman-Kurz model for the steady growth of a dendrite tip and the Jackson-Hunt model for regular eutectic growth. Several examples of typical microstructures are simulated and the features of the method as well as further developments are discussed.

Systematic evaluation of three different commercial software solutions for automatic segmentation for adaptive therapy in head-and-neck, prostate and pleural cancer

International Nuclear Information System (INIS)

La Macchia, Mariangela; Fellin, Francesco; Amichetti, Maurizio; Cianchetti, Marco; Gianolini, Stefano; Paola, Vitali; Lomax, Antony J; Widesott, Lamberto

2012-01-01

To validate, in the context of adaptive radiotherapy, three commercial software solutions for atlas-based segmentation. Fifteen patients, five for each group, with cancer of the Head&Neck, pleura, and prostate were enrolled in the study. In addition to the treatment planning CT (pCT) images, one replanning CT (rCT) image set was acquired for each patient during the RT course. Three experienced physicians outlined on the pCT and rCT all the volumes of interest (VOIs). We used three software solutions (VelocityAI 2.6.2 (V), MIM 5.1.1 (M) by MIMVista and ABAS 2.0 (A) by CMS-Elekta) to generate the automatic contouring on the repeated CT. All the VOIs obtained with automatic contouring (AC) were successively corrected manually. We recorded the time needed for: 1) ex novo ROIs definition on rCT; 2) generation of AC by the three software solutions; 3) manual correction of AC. To compare the quality of the volumes obtained automatically by the software and manually corrected with those drawn from scratch on rCT, we used the following indexes: overlap coefficient (DICE), sensitivity, inclusiveness index, difference in volume, and displacement differences on three axes (x, y, z) from the isocenter. The time saved by the three software solutions for all the sites, compared to the manual contouring from scratch, is statistically significant and similar for all the three software solutions. The time saved for each site are as follows: about an hour for Head&Neck, about 40 minutes for prostate, and about 20 minutes for mesothelioma. The best DICE similarity coefficient index was obtained with the manual correction for: A (contours for prostate), A and M (contours for H&N), and M (contours for mesothelioma). From a clinical point of view, the automated contouring workflow was shown to be significantly shorter than the manual contouring process, even though manual correction of the VOIs is always needed

Systematic evaluation of three different commercial software solutions for automatic segmentation for adaptive therapy in head-and-neck, prostate and pleural cancer.

Science.gov (United States)

La Macchia, Mariangela; Fellin, Francesco; Amichetti, Maurizio; Cianchetti, Marco; Gianolini, Stefano; Paola, Vitali; Lomax, Antony J; Widesott, Lamberto

2012-09-18

To validate, in the context of adaptive radiotherapy, three commercial software solutions for atlas-based segmentation. Fifteen patients, five for each group, with cancer of the Head&Neck, pleura, and prostate were enrolled in the study. In addition to the treatment planning CT (pCT) images, one replanning CT (rCT) image set was acquired for each patient during the RT course. Three experienced physicians outlined on the pCT and rCT all the volumes of interest (VOIs). We used three software solutions (VelocityAI 2.6.2 (V), MIM 5.1.1 (M) by MIMVista and ABAS 2.0 (A) by CMS-Elekta) to generate the automatic contouring on the repeated CT. All the VOIs obtained with automatic contouring (AC) were successively corrected manually. We recorded the time needed for: 1) ex novo ROIs definition on rCT; 2) generation of AC by the three software solutions; 3) manual correction of AC.To compare the quality of the volumes obtained automatically by the software and manually corrected with those drawn from scratch on rCT, we used the following indexes: overlap coefficient (DICE), sensitivity, inclusiveness index, difference in volume, and displacement differences on three axes (x, y, z) from the isocenter. The time saved by the three software solutions for all the sites, compared to the manual contouring from scratch, is statistically significant and similar for all the three software solutions. The time saved for each site are as follows: about an hour for Head&Neck, about 40 minutes for prostate, and about 20 minutes for mesothelioma. The best DICE similarity coefficient index was obtained with the manual correction for: A (contours for prostate), A and M (contours for H&N), and M (contours for mesothelioma). From a clinical point of view, the automated contouring workflow was shown to be significantly shorter than the manual contouring process, even though manual correction of the VOIs is always needed.

Systematic evaluation of three different commercial software solutions for automatic segmentation for adaptive therapy in head-and-neck, prostate and pleural cancer

Directory of Open Access Journals (Sweden)

La Macchia Mariangela

2012-09-01

Full Text Available Abstract Purpose To validate, in the context of adaptive radiotherapy, three commercial software solutions for atlas-based segmentation. Methods and materials Fifteen patients, five for each group, with cancer of the Head&Neck, pleura, and prostate were enrolled in the study. In addition to the treatment planning CT (pCT images, one replanning CT (rCT image set was acquired for each patient during the RT course. Three experienced physicians outlined on the pCT and rCT all the volumes of interest (VOIs. We used three software solutions (VelocityAI 2.6.2 (V, MIM 5.1.1 (M by MIMVista and ABAS 2.0 (A by CMS-Elekta to generate the automatic contouring on the repeated CT. All the VOIs obtained with automatic contouring (AC were successively corrected manually. We recorded the time needed for: 1 ex novo ROIs definition on rCT; 2 generation of AC by the three software solutions; 3 manual correction of AC. To compare the quality of the volumes obtained automatically by the software and manually corrected with those drawn from scratch on rCT, we used the following indexes: overlap coefficient (DICE, sensitivity, inclusiveness index, difference in volume, and displacement differences on three axes (x, y, z from the isocenter. Results The time saved by the three software solutions for all the sites, compared to the manual contouring from scratch, is statistically significant and similar for all the three software solutions. The time saved for each site are as follows: about an hour for Head&Neck, about 40 minutes for prostate, and about 20 minutes for mesothelioma. The best DICE similarity coefficient index was obtained with the manual correction for: A (contours for prostate, A and M (contours for H&N, and M (contours for mesothelioma. Conclusions From a clinical point of view, the automated contouring workflow was shown to be significantly shorter than the manual contouring process, even though manual correction of the VOIs is always needed.

Poster — Thur Eve — 17: In-phantom and Fluence-based Measurements for Quality Assurance of Volumetric-driven Adaptation of Arc Therapy

International Nuclear Information System (INIS)

Schaly, B; Hoover, D; Mitchell, S; Wong, E

2014-01-01

During volumetric modulated arc therapy (VMAT) of head and neck cancer, some patients lose weight which may result in anatomical deviations from the initial plan. If these deviations are substantial a new treatment plan can be designed for the remainder of treatment (i.e., adaptive planning). Since the adaptive treatment process is resource intensive, one possible approach to streamlining the quality assurance (QA) process is to use the electronic portal imaging device (EPID) to measure the integrated fluence for the adapted plans instead of the currently-used ArcCHECK device (Sun Nuclear). Although ArcCHECK is recognized as the clinical standard for patient-specific VMAT plan QA, it has limited length (20 cm) for most head and neck field apertures and has coarser detector spacing than the EPID (10 mm vs. 0.39 mm). In this work we compared measurement of the integrated fluence using the EPID with corresponding measurements from the ArcCHECK device. In the past year nine patients required an adapted plan. Each of the plans (the original and adapted) is composed of two arcs. Routine clinical QA was performed using the ArcCHECK device, and the same plans were delivered to the EPID (individual arcs) in integrated mode. The dose difference between the initial plan and adapted plan was compared for ArcCHECK and EPID. In most cases, it was found that the EPID is more sensitive in detecting plan differences. Therefore, we conclude that EPID provides a viable alternative for QA of the adapted head and neck plans and should be further explored

Measurement properties of translated versions of neck-specific questionnaires: a systematic review.

Science.gov (United States)

Schellingerhout, Jasper M; Heymans, Martijn W; Verhagen, Arianne P; de Vet, Henrica C; Koes, Bart W; Terwee, Caroline B

2011-06-06

Several disease-specific questionnaires to measure pain and disability in patients with neck pain have been translated. However, a simple translation of the original version doesn't guarantee similar measurement properties. The objective of this study is to critically appraise the quality of the translation process, cross-cultural validation and the measurement properties of translated versions of neck-specific questionnaires. Bibliographic databases were searched for articles concerning the translation or evaluation of the measurement properties of a translated version of a neck-specific questionnaire. The methodological quality of the selected studies and the results of the measurement properties were critically appraised and rated using the COSMIN checklist and criteria for measurement properties. The search strategy resulted in a total of 3641 unique hits, of which 27 articles, evaluating 6 different questionnaires in 15 different languages, were included in this study. Generally the methodological quality of the translation process is poor and none of the included studies performed a cross-cultural adaptation. A substantial amount of information regarding the measurement properties of translated versions of the different neck-specific questionnaires is lacking. Moreover, the evidence for the quality of measurement properties of the translated versions is mostly limited or assessed in studies of poor methodological quality. Until results from high quality studies are available, we advise to use the Catalan, Dutch, English, Iranian, Korean, Spanish and Turkish version of the NDI, the Chinese version of the NPQ, and the Finnish, German and Italian version of the NPDS. The Greek NDI needs cross-cultural validation and there is no methodologically sound information for the Swedish NDI. For all other languages we advise to translate the original version of the NDI.

Rupture of the neck in nuclear fission

International Nuclear Information System (INIS)

Davies, K.T.R.; Managan, R.A.; Nix, J.R.; Sierk, A.J.

1977-01-01

We introduce a degree of freedom to describe the rupture of the neck in nuclear fission and calculate the point at which the neck ruptures as the nucleus descends dynamically from its fission saddle point. This is done by mentally slicing the system into two portions at its minimum neck radius and calculating the force required to separate the two portions while keeping their shapes fixed. This force is obtained by differentiating with respect to separation the sum of the Coulomb and nuclear interaction energies between the two portions. For nuclei throughout the Periodic Table we calculate this force along dynamical paths leading from the fission saddle point. The force is initially attractive but becomes repulsive when the neck reaches a critical size. For actinide nuclei the neck radius at which rupture occurs is about 2 fm. This increases the calculated translational kinetic energy of the fission fragments at infinity relative to that calculated for scission occurring at zero neck radius. With the effect of neck rupture taken into account, we calculate and compare with experimental results fission-fragment kinetic energies for two types of nuclear dissipation: ordinary two-body viscosity and one-body dissipation

Assessment of Neck Pain and Its Associated Disorders

Science.gov (United States)

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

2008-01-01

Study Design Best evidence synthesis. Objective To critically appraise and synthesize the literature on assessment of neck pain. Summary of Background Data The published literature on assessment of neck pain is large and of variable quality. There have been no prior systematic reviews of this literature. Methods The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders conducted a critical review of the literature (published 1980– 2006) on assessment tools and screening protocols for traumatic and nontraumatic neck pain. Results We found 359 articles on assessment of neck pain. After critical review, 95 (35%) were judged scientifically admissible. Screening protocols have high predictive values to detect cervical spine fracture in alert, low-risk patients seeking emergency care after blunt neck trauma. Computerized tomography (CT) scans had better validity (in adults and elderly) than radiographs in assessing high-risk and/or multi-injured blunt trauma neck patients. In the absence of serious pathology, clinical physical examinations are more predictive at excluding than confirming structural lesions causing neurologic compression. One exception is the manual provocation test for cervical radiculopathy, which has high positive predictive value. There was no evidence that specific MRI findings are associated with neck pain, cervicogenic headache, or whiplash exposure. No evidence supports using cervical provocative discography, anesthetic facet, or medial branch blocks in evaluating neck pain. Reliable and valid self-report questionnaires are useful in assessing pain, function, disability, and psychosocial status in individuals with neck pain. Conclusion The scientific evidence supports screening protocols in emergency care for low-risk patients; and CT-scans for high-risk patients with blunt trauma to the neck. In nonemergency neck pain without radiculopathy, the validity of most commonly used objective tests is lacking. There is

Primary Hydatid Cyst of the Neck

International Nuclear Information System (INIS)

Mujtaba, S. S.; Faridi, N.; Haroon, S.

2013-01-01

Hydatid cysts in the neck are relatively exceptional, even in areas where Echinococcus granulosis is endemic, such as Asia. Although liver and lung are frequent sites of involvement, it can involve all tissues, with neck remaining one of the most rare sites. It should come in the differential diagnosis of cystic lesion of neck, as the treatment options differ widely from common neck cysts. The role of radiological investigation is important and, in these cases, the involvement of other organs should be investigated. Serological tests may be helpful. The major treatment modality is surgical and the cyst should be excised as a whole, without being ruptured, to prevent any treatment complications, as the cyst fluid can initiate an anaphylactic reaction. Postoperative albendazole therapy is recommended particularly when there is intra-operative spillover. We report a case of an isolated hydatid cyst localized in the anterior triangle of the neck without any pulmonary or hepatic involvement. (author)

Selection and delineation of lymph node target volumes in head and neck conformal radiotherapy. proposal for standardizing terminology and procedure based on the surgical experience

International Nuclear Information System (INIS)

Gregoire, V.; Coche, E.; Cosnard, G.; Hamoir, M.; Reychler, H.

2000-01-01

The increasing use of 3D treatment planning in head and neck radiation oncology has created an urgent need for new guidelines for the selection and the delineation of the neck node areas to be included in the clinical target volume. Surgical literature has provided us with valuable information on the extent of pathological nodal involvement in the neck as a function of the primary tumor site. In addition, few clinical series have also reported information on radiological nodal involvement in those areas not commonly included in radical neck dissection. Taking all these data together, guidelines for the selection of the node levels to be irradiated for the major head and neck sites could be proposed. To fill the missing link between these Guidelines and the 3D treatment planning, recommendations for the delineation of these node levels (levels I-VI and retropharyngeal) on CT (or MRI) slices have been proposed using the guidelines outlined by the Committee for Head and Neck Surgery and Oncology of the American Academy for Otolarynology-Head and Neck Surgery. These guidelines were adapted to take into account specific radiological landmarks more easily identified on CT or MRI slices than in the operating field. (author)

Planned neck dissection for oropharyngeal and hypopharyngeal cancers

International Nuclear Information System (INIS)

Hanai, Nobuhiro; Hasegawa, Yasuhisa; Terada, Akihiro; Ozawa, Taijiro; Hirakawa, Hitoshi; Kawakita, Daisuke; Maruo, Takashi; Mikami, Shinnji

2010-01-01

Recently, the use of chemoradiotherapy for preserving organs in the treatment of head and neck cancer is increasing. However, there is controversy about advanced neck node management in post-chemoradiation cases. We retrospectively analyzed our 119 cases of chemoradiotherapy for oropharyngeal and hypopharyngeal cancer to examine the effectiveness and indications of planned neck dissection. Regional control rate and survival rate were superior in the neck dissection group. If the cases did not achieve complete response (CR) in imaging, planned neck dissection improved the regional control rate significantly. We should perform planned neck dissection immediately rather than 'wait and see' for this persistent disease. However, in the cases achieving radiological CR, it is possible to omit planned neck dissection because of the high salvage rate of neck disease. However, in these cases, careful observation is essential. We clarified that the presence of pathologically positive lymph node is a prognostic factor. For evaluating persistent disease of cervical lymph nodes, positron emission tomography (PET)-CT was the most accurate method of imaging. (author)

Torsion and bending in the neck and tail of sauropod dinosaurs and the function of cervical ribs: insights from functional morphology and biomechanics.

Directory of Open Access Journals (Sweden)

Holger Preuschoft

Full Text Available The long necks of sauropods have been subject to many studies regarding their posture and flexibility. Length of the neck varies among groups. Here, we investigate neck posture and morphology in several clades from a mechanical viewpoint. Emphasis is put on comparing sauropod necks and tails with structures in living archosaurs and mammals. Differences in the use made of necks and tails lead to clear-cut differences in the mechanical loads occurring in the same models. Ways of sustaining loads are identified by theoretical considerations. If the observed skeletal structures are suited to resist the estimated loading in a particular posture, this concordance is taken as an argument that this posture or movement was of importance during the life of the individual. Apart from the often-discussed bending in side view, we analyze the often overlooked torsion. Because torsional stresses in a homogenous element concentrate near the periphery, a cylindrical cross section gives greatest strength, and the direction of forces is oblique. In a vertebrate neck, during e.g. shaking the head and twisting the neck, oblique muscles, like the mm. scaleni, if activated unilaterally initiate movement, counterbalance the torsional moments and keep the joints between neck vertebrae in equilibrium. If activated bilaterally, these muscles keep the neck balanced in an energy-saving upright posture. The tendons of the mm. scaleni may have ossified as cervical ribs The long cervical ribs in brachiosaurids and mamenchisaurids seem to have limited flexibility, whereas the shorter cervical ribs in Diplodocidae allowed free movement. The tails of sauropods do not show pronounced adaptation to torsion, and seem to have been carried more or less in a horizontal, extended posture. In this respect, sauropod tails resemble the necks of herbivorous cursorial mammals. These analyses provide an improved understanding of neck use that will be extended to other sauropods in subsequent

Neck massage induced dural sinus thrombosis

Directory of Open Access Journals (Sweden)

Verma Ashish

2007-01-01

Full Text Available Thrombosis of the intracranial dural sinuses and internal jugular veins may occur as a complication of head and neck infections, surgery, central venous access, local malignancy, polycythemia, hyperhomocysteinemia, neck massage and intravenous drug abuse. A high degree of clinical suspicion followed by adequate imaging is prerequisite to early diagnosis and management. We report a young man who had dural sinus thrombosis with jugular venous thrombosis following neck massage.

Review of patients with dysphasia after a neck dissection

International Nuclear Information System (INIS)

Yokoyama, Junkichi

2007-01-01

The most useful modality for treating neck metastasis is a neck dissection. A neck dissection was previously performed as a radical neck dissection. However, disabilities in shoulder movement and swallowing function often occur after this procedure. Recently, a functional neck dissection has therefore been performed in order to avoid such postoperative complications. The current study for dysphasia after a neck dissection investigates patients with primary unknown neck metastasis and neck recurrence after chemoradiation. Eleven cases of dysphasia occurred after a neck dissection between 2003 and 2006. These cases resected the lower cranial nerves (IX, X, XII), or paralysis of these nerves occurred despite their preservation after surgery. Patients with dysphasia underwent rehabilitation to regain their swallowing function. However, rehabilitation was unsuccessful and the patients were thus required to undergo further surgery. A neck dissection with resection of the lower cranial nerves (IX, X, XII) may sometimes result in dysphasia. Consequently, surgery to prevent dysphasia should be performed simultaneously so that timely postoperative therapy can be carried out. (author)

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

Directory of Open Access Journals (Sweden)

Soklic Marina

2012-01-01

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

Development of Semi-Stochastic Algorithm for Optimizing Alloy Composition of High-Temperature Austenitic Stainless Steels (H-Series) for Desired Mechanical and Corrosion Properties.

Energy Technology Data Exchange (ETDEWEB)

Dulikravich, George S.; Sikka, Vinod K.; Muralidharan, G.

2006-06-01

The goal of this project was to adapt and use an advanced semi-stochastic algorithm for constrained multiobjective optimization and combine it with experimental testing and verification to determine optimum concentrations of alloying elements in heat-resistant and corrosion-resistant H-series stainless steel alloys that will simultaneously maximize a number of alloy's mechanical and corrosion properties.

Metastasis to neck from unknown primary tumor

International Nuclear Information System (INIS)

Jose, B.; Bosch, A.; Caldwell, W.L.; Frias, Z.

1979-01-01

The records of 54 consecutive patients who were irradiated for metastatic disease in the neck from an unknown primary tumor were reviewed. The overall survival results are comparable to those of other reported series. Patients with high or posterior cervical lymph node involvement were irradiated with fields including the nasopharynx and oropharynx. Patients with high neck nodes had a better survival rate than those with low neck nodes. The size of the neck tumors and the local control after treatment also have prognostic significance. (Auth.)

Thyroid Emphysema Following Penetrating Neck Trauma

OpenAIRE

Karadağ, Demet; Doner, Egemen; Adapınar, Baki

2014-01-01

Although traumatic thyroid gland rupture or hemorrhage is usually seen in goitrous glands, injuries of the normal thyroid gland after neck trauma have rarely been described in the literature. We describe a 44-year-old man who presented with thyroid emphysema and subcutaneous emphysema (SCE) that occurred after penetrating neck trauma. CT images showed complete resolution of thyroid emphysema and subcutaneous emphysema at follow-up examination. Neck injuries can be life threatening. After pene...

Modeling neck mobility in fossil turtles

OpenAIRE

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

2014-01-01

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 cent...

Quality of life after neck dissection. Multicenter study

International Nuclear Information System (INIS)

Nibu, Ken-ichi; Onitsuka, Tetsuo; Kawabata, Kazuyoshi

2010-01-01

To assess the impact of modifications to radical neck dissection and radiotherapy on the postoperative quality of life, the study group 'Study on Standardization of Treatment for Lymph Node Metastasis of Head and Neck Cancer' performed a multicenter cross-sectional study using our self-administered neck dissection questionnaire and arm abduction test. While sparing levels IV and V improved most postoperative symptoms, such as stiffness and constriction of the neck were avoided as long as the sternocleidmastoid muscle (SCM) and the spinal accessory nerve were preserved. Resection of the SCM and spinal accessory nerve resulted in a drop shoulder and neck pain, respectively. Irradiation with a total dose of 50 Gy or more worsened stiffness of neck and shoulder. (author)

Magnesium secondary alloys: Alloy design for magnesium alloys with improved tolerance limits against impurities

Energy Technology Data Exchange (ETDEWEB)

Blawert, C., E-mail: carsten.blawert@gkss.d [GKSS Forschungszentrum Geesthacht GmbH, Max-Planck-Str. 1, 21502 Geesthacht (Germany); Fechner, D.; Hoeche, D.; Heitmann, V.; Dietzel, W.; Kainer, K.U. [GKSS Forschungszentrum Geesthacht GmbH, Max-Planck-Str. 1, 21502 Geesthacht (Germany); Zivanovic, P.; Scharf, C.; Ditze, A.; Groebner, J.; Schmid-Fetzer, R. [TU Clausthal, Institut fuer Metallurgie, Robert-Koch-Str. 42, 38678 Clausthal-Zellerfeld (Germany)

2010-07-15

The development of secondary magnesium alloys requires a completely different concept compared with standard alloys which obtain their corrosion resistance by reducing the levels of impurities below certain alloy and process depending limits. The present approach suitable for Mg-Al based cast and wrought alloys uses a new concept replacing the {beta}-phase by {tau}-phase, which is able to incorporate more impurities while being electro-chemically less detrimental to the matrix. The overall experimental effort correlating composition, microstructure and corrosion resistance was reduced by using thermodynamic calculations to optimise the alloy composition. The outcome is a new, more impurity tolerant alloy class with a composition between the standard AZ and ZC systems having sufficient ductility and corrosion properties comparable to the high purity standard alloys.

Are People With Whiplash-Associated Neck Pain Different From People With Nonspecific Neck Pain?

Science.gov (United States)

Anstey, Ricci; Kongsted, Alice; Kamper, Steven; Hancock, Mark J

2016-10-01

Study Design Secondary analysis of a prospective cohort study with cross-sectional and longitudinal analyses. Background The clinical importance of a history of whiplash-associated disorder (WAD) in people with neck pain remains uncertain. Objective To compare people with WAD to people with nonspecific neck pain, in terms of their baseline characteristics and pain and disability outcomes over 1 year. Methods Consecutive patients with neck pain who presented to a secondary-care spine center answered a comprehensive self-report questionnaire and underwent a physical examination. Patients were classified into a group of either those with WAD or those with nonspecific neck pain. We compared the outcomes of baseline characteristics of the 2 groups, as well as pain intensity and activity limitation at follow-ups of 6 and 12 months. Results A total of 2578 participants were included in the study. Of these, 488 (19%) were classified as having WAD. At presentation, patients with WAD were statistically different from patients without WAD for almost all characteristics investigated. While most differences were small (1.1 points on an 11-point pain-rating scale and 11 percentage points on the Neck Disability Index), others, including the presence of dizziness and memory difficulties, were substantial. The between-group differences in pain and disability increased significantly (Pneck pain. Conclusion People referred to secondary care with WAD typically had more self-reported pain and disability and experienced worse outcomes than those with nonspecific neck pain. Caution is required when interpreting the longitudinal outcomes due to lower-than-optimal follow-up rates. Level of Evidence Prognosis, level 2. J Orthop Sports Phys Ther 2016;46(10):894-901. Epub 3 Sep 2016. doi:10.2519/jospt.2016.6588.

A deformable head and neck phantom with in-vivo dosimetry for adaptive radiotherapy quality assurance

Energy Technology Data Exchange (ETDEWEB)

Graves, Yan Jiang [Center for Advanced Radiotherapy Technologies and Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California 92037-0843 and Department of Physics, University of California San Diego, La Jolla, California 92093 (United States); Smith, Arthur-Allen; Mcilvena, David; Manilay, Zherrina; Lai, Yuet Kong [Department of Mechanical and Aerospace Engineering, University of California San Diego, La Jolla, California 92093 (United States); Rice, Roger; Mell, Loren; Cerviño, Laura, E-mail: lcervino@ucsd.edu, E-mail: steve.jiang@utsouthwestern.edu [Center for Advanced Radiotherapy Technologies and Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California 92037-0843 (United States); Jia, Xun; Jiang, Steve B., E-mail: lcervino@ucsd.edu, E-mail: steve.jiang@utsouthwestern.edu [Center for Advanced Radiotherapy Technologies and Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California 92037-0843 and Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas 75235 (United States)

2015-04-15

Purpose: Patients’ interfractional anatomic changes can compromise the initial treatment plan quality. To overcome this issue, adaptive radiotherapy (ART) has been introduced. Deformable image registration (DIR) is an important tool for ART and several deformable phantoms have been built to evaluate the algorithms’ accuracy. However, there is a lack of deformable phantoms that can also provide dosimetric information to verify the accuracy of the whole ART process. The goal of this work is to design and construct a deformable head and neck (HN) ART quality assurance (QA) phantom with in vivo dosimetry. Methods: An axial slice of a HN patient is taken as a model for the phantom construction. Six anatomic materials are considered, with HU numbers similar to a real patient. A filled balloon inside the phantom tissue is inserted to simulate tumor. Deflation of the balloon simulates tumor shrinkage. Nonradiopaque surface markers, which do not influence DIR algorithms, provide the deformation ground truth. Fixed and movable holders are built in the phantom to hold a diode for dosimetric measurements. Results: The measured deformations at the surface marker positions can be compared with deformations calculated by a DIR algorithm to evaluate its accuracy. In this study, the authors selected a Demons algorithm as a DIR algorithm example for demonstration purposes. The average error magnitude is 2.1 mm. The point dose measurements from the in vivo diode dosimeters show a good agreement with the calculated doses from the treatment planning system with a maximum difference of 3.1% of prescription dose, when the treatment plans are delivered to the phantom with original or deformed geometry. Conclusions: In this study, the authors have presented the functionality of this deformable HN phantom for testing the accuracy of DIR algorithms and verifying the ART dosimetric accuracy. The authors’ experiments demonstrate the feasibility of this phantom serving as an end

Alloying principles for magnesium base heat resisting alloys

International Nuclear Information System (INIS)

Drits, M.E.; Rokhlin, L.L.; Oreshkina, A.A.; Nikitina, N.I.

1982-01-01

Some binary systems of magnesium-base alloys in which solid solutions are formed, are considered for prospecting heat resistant alloys. It is shown that elements having essential solubility in solid magnesium strongly decreasing with temperature should be used for alloying maqnesium base alloys with high strength properties at increased temperatures. The strengthening phases in these alloys should comprise essential quantity of magnesium and be rather refractory

The future of personalised radiotherapy for head and neck cancer.

Science.gov (United States)

Caudell, Jimmy J; Torres-Roca, Javier F; Gillies, Robert J; Enderling, Heiko; Kim, Sungjune; Rishi, Anupam; Moros, Eduardo G; Harrison, Louis B

2017-05-01

Radiotherapy has long been the mainstay of treatment for patients with head and neck cancer and has traditionally involved a stage-dependent strategy whereby all patients with the same TNM stage receive the same therapy. We believe there is a substantial opportunity to improve radiotherapy delivery beyond just technological and anatomical precision. In this Series paper, we explore several new ideas that could improve understanding of the phenotypic and genotypic differences that exist between patients and their tumours. We discuss how exploiting these differences and taking advantage of precision medicine tools-such as genomics, radiomics, and mathematical modelling-could open new doors to personalised radiotherapy adaptation and treatment. We propose a new treatment shift that moves away from an era of empirical dosing and fractionation to an era focused on the development of evidence to guide personalisation and biological adaptation of radiotherapy. We believe these approaches offer the potential to improve outcomes and reduce toxicity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Public knowledge of head and neck cancer.

LENUS (Irish Health Repository)

O'Connor, T E

2010-04-01

Studies show 60% of patients with newly diagnosed Head & Neck Squamous Cell Cancer in Ireland, present with advanced disease. A poor level of knowledge and awareness among the public of Head & Neck Cancer, is an important consideration in the often delayed presentation for medical attention in many of these cases. Our study surveyed 200 members of the public to assess their knowledge and awareness of Head & Neck Cancer. One hundred and forty (70%) of respondents had never encountered the term "Head & Neck Cancer". One hundred and forty six (73%) failed to identify excessive alcohol consumption as a risk factor. Less than 100 (50%) would have concern about persisting hoarseness or a prolonged oral ulcer. An urgent need exists to raise awareness of Head & Neck Cancer among the public in Ireland.

Selective neck dissection: a review of the evidence.

Science.gov (United States)

Pagedar, Nitin A; Gilbert, Ralph W

2009-01-01

The management of regional metastatic disease in patients with oral cancer is a topic of controversy. Comprehensive neck dissection has been the mainstay of treatment historically, but clinicians have sought alternatives to limit the morbidity of the classic radical neck dissection. This article will review evidence on the applicability of selective neck dissection in two settings: as primary treatment of the clinically positive neck and as salvage treatment of recurrent neck disease after radiotherapy. In the text, for each article cited we supply the level of evidence thereof according to the Oxford Centre for Evidence-based medicine.

Alloy materials

Energy Technology Data Exchange (ETDEWEB)

Hans Thieme, Cornelis Leo (Westborough, MA); Thompson, Elliott D. (Coventry, RI); Fritzemeier, Leslie G. (Acton, MA); Cameron, Robert D. (Franklin, MA); Siegal, Edward J. (Malden, MA)

2002-01-01

An alloy that contains at least two metals and can be used as a substrate for a superconductor is disclosed. The alloy can contain an oxide former. The alloy can have a biaxial or cube texture. The substrate can be used in a multilayer superconductor, which can further include one or more buffer layers disposed between the substrate and the superconductor material. The alloys can be made a by process that involves first rolling the alloy then annealing the alloy. A relatively large volume percentage of the alloy can be formed of grains having a biaxial or cube texture.

Identification of mechanical properties of weld joints of AlMgSi07.F25 aluminium alloy

Directory of Open Access Journals (Sweden)

P. Kopas

2017-01-01

Full Text Available The aim of this paper is to present the analysis of selected mechanical properties of weld joints of AlMgSi07.F25 aluminium alloy. We will focus on the influence of the test bar neck shape on the tensile strength characteristics and the course of hardness in the weld joint cross-section. For the welding process using TIG (Tungsten Inert Gas technology we considered AlSi5 as the additive material. This paper also includes a short study of numerical modelling of the test bar welding.

The role of USG in neck monitoring after surgery of malignant neoplasms of head and neck

International Nuclear Information System (INIS)

Szmeja, Z.; Kordylewska, M.; Dziamska, K.; Szyfter, W.; Kruk-Zagajewska, A.

1994-01-01

Metastases to regional lymph nodes of the neck in patients with larynx cancer are a more frequent cause of death in comparison to local recurrence. Thus it is necessary to thoroughly examine the treatment and after the treatment. The ultrasound examination introduced significant diagnostic value in the diagnosis of malignant cancers. Ultrasound monitoring of the lymphatic system after surgical treatment or radiation allows to diagnose early metastases which are not visible in palpation examination. In over 200 patients after surgical treatment of larynx cancer several ultrasound examinations of the neck were carried out. The time following the end of the treatment was 4 months to l 8 years. In the ultrasound examination of the neck changes in the lymphatic system were observed, which were not clinically manifested in 10 patients. Metastases to regional lymph nodes of the neck were most frequently observed in the first year after the operation. Patients who were diagnosed with metastases before operation and patients with supraglottic cancers were at more risk of having metastases. The ultrasound examination of the neck should be a routine, systematically repeated examination in the observation of patients after larynx cancer operation. (author)

Prognostic Factor Analysis for Management of Chronic Neck Pain: Can We Predict the Severity of Neck Pain with Lateral Cervical Curvature?

Science.gov (United States)

Seong, Han Yu; Lee, Moon Kyu; Jeon, Sang Ryong; Roh, Sung Woo; Rhim, Seung Chul; Park, Jin Hoon

2017-07-01

Although little is known about its origins, neck pain may be related to several associated anatomical pathologies. We aimed to characterize the incidence and features of chronic neck pain and analyze the relationship between neck pain severity and its affecting factors. Between March 2012 and July 2013, we studied 216 patients with chronic neck pain. Initially, combined tramadol (37.5 mg) plus acetaminophen (325 mg) was administered orally twice daily (b.i.d.) to all patients over a 2-week period. After two weeks, patients were evaluated for neck pain during an outpatient clinic visit. If the numeric rating scale of the patient had not decreased to 5 or lower, a cervical medial branch block (MBB) was recommended after double-dosed previous medication trial. We classified all patients into two groups (mild vs. severe neck pain group), based on medication efficacy. Logistic regression tests were used to evaluate the factors associated with neck pain severity. A total of 198 patients were included in the analyses, due to follow-up loss in 18 patients. While medication was successful in reducing pain in 68.2% patients with chronic neck pain, the remaining patients required cervical MBB. Lateral cervical curvature, such as a straight or sigmoid type curve, was found to be significantly associated with the severity of neck pain. We managed chronic neck pain with a simple pharmacological management protocol followed by MBB. We should keep in mind that it may be difficult to manage the patient with straight or sigmoid lateral curvature only with oral medication.

Correction of the post -- necking true stress -- strain data using instrumented nanoindentation

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Romero Fonseca, Ivan Dario

The study of large plastic deformations has been the focus of numerous studies particularly in the metal forming processes and fracture mechanics fields. A good understanding of the plastic flow properties of metallic alloys and the true stresses and true strains induced during plastic deformation is crucial to optimize the aforementioned processes, and to predict ductile failure in fracture mechanics analyzes. Knowledge of stresses and strains is extracted from the true stress-strain curve of the material from the uniaxial tensile test. In addition, stress triaxiality is manifested by the neck developed during the last stage of a tensile test performed on a ductile material. This necking phenomenon is the factor responsible for deviating from uniaxial state into a triaxial one, then, providing an inaccurate description of the material's behavior after the onset of necking. The research of this dissertation is aimed at the development of a correction method for the nonuniform plastic deformation (post-necking) portion of the true stress-strain curve. The correction proposed is based on the well-known relationship between hardness and flow (yield) stress, except that instrumented nanoindentation hardness is utilized rather than conventional macro or micro hardness. Three metals with different combinations of strain hardening behavior and crystal structure were subjected to quasi-static tensile tests: power-law strain hardening low carbon G10180 steel (BCC) and electrolytic tough pitch copper C11000 (FCC), and linear strain hardening austenitic stainless steel S30400 (FCC). Nanoindentation hardness values, measured on the broken tensile specimen, were converted into flow stress values by means of the constraint factor C from Tabor's, the representative plastic strainepsilonr and the post-test true plastic strains measured. Micro Vickers hardness testing was carried out on the sample as well. The constraint factors were 5.5, 4.5 and 4.5 and the representative plastic

Purse-string platysmaplasty: the third dimension for neck contouring.

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Gentile, Richard D

2005-11-01

Techniques and concepts for treatment of the aging neck have been evolving since the late 1960s and rely on two-dimensional anterior approximation with lateral imbrication of the platysma with or without submental fat reduction, However, the medial approximation can sometimes give a "boxy" appearance to the anterior neck, especially if anterior shifting of the platysma recurs after platysmaplasty with laxity redeveloping in this midline location. The "purse-string" platysmaplasty (PSP) is a new concept in neck contouring that facilitates an enhanced definition for the cervicomandibular transition to better simulate the well-defined contour of this transition that is present in youth. It aids in the contouring of difficult poorly defined necks and in male patients. The PSP adds a "third dimension" to neck recontouring by invaginating the platysma with a plication suture and pexing the platysma, without incising it, to deeper neck fascia with a technique that adds support and definition to the neck contour. The PSP can be performed in patients undergoing a full rhytidectomy as well as in individuals having isolated neck rejuvenation. The PSP is especially helpful in rejuvenating the male lower face and neck because of the relatively heavier deeper structures of the male neck and the need to enhance definition along the jawline.

The association between a lifetime history of a neck injury in a motor vehicle collision and future neck pain: a population-based cohort study

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Côté, Pierre; Cassidy, J. David; Carroll, Linda J.

2010-01-01

The objective of this population-based cohort study was to investigate the association between a lifetime history of neck injury from a motor vehicle collision and the development of troublesome neck pain. The current evidence suggests that individuals with a history of neck injury in a traffic collision are more likely to experience future neck pain. However, these results may suffer from residual confounding. Therefore, there is a need to test this association in a large population-based cohort with adequate control of known confounders. We formed a cohort of 919 randomly sampled Saskatchewan adults with no or mild neck pain in September 1995. At baseline, participants were asked if they ever injured their neck in a motor vehicle collision. Six and twelve months later, we asked about the presence of troublesome neck pain (grade II–IV) on the chronic pain grade questionnaire. Multivariable Cox regression was used to estimate the association between a lifetime history of neck injury in a motor vehicle collision and the onset of troublesome neck pain while controlling for known confounders. The follow-up rate was 73.5% (676/919) at 6 months and 63.1% (580/919) at 1 year. We found a positive association between a history of neck injury in a motor vehicle collision and the onset of troublesome neck pain after controlling for bodily pain and body mass index (adjusted HRR = 2.14; 95% CI 1.12–4.10). Our analysis suggests that a history of neck injury in a motor vehicle collision is a risk factor for developing future troublesome neck pain. The consequences of a neck injury in a motor vehicle collision can have long lasting effects and predispose individuals to experience recurrent episodes of neck pain. PMID:20213298

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

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

2012-05-01

Brain and heart activities were measured in 31 veal calves during restraining and rotating followed by neck cutting with or without stunning to evaluate welfare. After neck cutting correlation dimension analyses and %power of EEG beta wave fraction decreased gradually to lower values resulting in an induction of unconsciousness lasting on average 80s. Corneal reflex response ceased 135±57s after neck cutting. The CD scores and the %power of beta waves fell immediately after post-cut captive bolt and pre-cut electrical stunning to levels indicating unconsciousness. Heart rate in lairage increased upon entrance to the restrainer and again after rotation, heart rate variability decreased. Rotating the restrainer 90°, 120° or 180° compromised veal calf welfare and should be avoided. It is recommended to use post-cut captive bolt stunning or pre-cut electrical stunning inducing immediate unconsciousness. Copyright © 2011 Elsevier Ltd. All rights reserved.

Neck pain

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... cause of neck pain is muscle strain or tension. Most often, everyday activities are to blame. Such ... of a heart attack , such as shortness of breath, sweating, nausea, vomiting, or arm or jaw pain. ...

Shoulder and neck morbidity in quality of life after surgery for head and neck cancer

NARCIS (Netherlands)

van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

2004-01-01

Background. Quality of life has become a major issue in determining the outcome of treatment in head and neck surgery with curative intent. The aim of our study was to determine which factors in the postoperative care, especially shoulder and neck morbidity, are related to quality of life and how

Measurement properties of translated versions of neck-specific questionnaires: a systematic review

Directory of Open Access Journals (Sweden)

de Vet Henrica C

2011-06-01

Full Text Available Abstract Background Several disease-specific questionnaires to measure pain and disability in patients with neck pain have been translated. However, a simple translation of the original version doesn't guarantee similar measurement properties. The objective of this study is to critically appraise the quality of the translation process, cross-cultural validation and the measurement properties of translated versions of neck-specific questionnaires. Methods Bibliographic databases were searched for articles concerning the translation or evaluation of the measurement properties of a translated version of a neck-specific questionnaire. The methodological quality of the selected studies and the results of the measurement properties were critically appraised and rated using the COSMIN checklist and criteria for measurement properties. Results The search strategy resulted in a total of 3641 unique hits, of which 27 articles, evaluating 6 different questionnaires in 15 different languages, were included in this study. Generally the methodological quality of the translation process is poor and none of the included studies performed a cross-cultural adaptation. A substantial amount of information regarding the measurement properties of translated versions of the different neck-specific questionnaires is lacking. Moreover, the evidence for the quality of measurement properties of the translated versions is mostly limited or assessed in studies of poor methodological quality. Conclusions Until results from high quality studies are available, we advise to use the Catalan, Dutch, English, Iranian, Korean, Spanish and Turkish version of the NDI, the Chinese version of the NPQ, and the Finnish, German and Italian version of the NPDS. The Greek NDI needs cross-cultural validation and there is no methodologically sound information for the Swedish NDI. For all other languages we advise to translate the original version of the NDI.

Measurement properties of translated versions of neck-specific questionnaires: a systematic review

Science.gov (United States)

2011-01-01

Background Several disease-specific questionnaires to measure pain and disability in patients with neck pain have been translated. However, a simple translation of the original version doesn't guarantee similar measurement properties. The objective of this study is to critically appraise the quality of the translation process, cross-cultural validation and the measurement properties of translated versions of neck-specific questionnaires. Methods Bibliographic databases were searched for articles concerning the translation or evaluation of the measurement properties of a translated version of a neck-specific questionnaire. The methodological quality of the selected studies and the results of the measurement properties were critically appraised and rated using the COSMIN checklist and criteria for measurement properties. Results The search strategy resulted in a total of 3641 unique hits, of which 27 articles, evaluating 6 different questionnaires in 15 different languages, were included in this study. Generally the methodological quality of the translation process is poor and none of the included studies performed a cross-cultural adaptation. A substantial amount of information regarding the measurement properties of translated versions of the different neck-specific questionnaires is lacking. Moreover, the evidence for the quality of measurement properties of the translated versions is mostly limited or assessed in studies of poor methodological quality. Conclusions Until results from high quality studies are available, we advise to use the Catalan, Dutch, English, Iranian, Korean, Spanish and Turkish version of the NDI, the Chinese version of the NPQ, and the Finnish, German and Italian version of the NPDS. The Greek NDI needs cross-cultural validation and there is no methodologically sound information for the Swedish NDI. For all other languages we advise to translate the original version of the NDI. PMID:21645355

[Volume changes to the neck lymph node metastases in head-neck tumors. The evaluation of radiotherapeutic treatment success].

Science.gov (United States)

Liszka, G; Thalacker, U; Somogyi, A; Németh, G

1997-08-01

This work is engaged with the volume change of neck lymph node metastasis of malignant tumors in the head-neck region during radiotherapy. In 54 patients with head and neck tumors, the volume of neck lymph nodes before and after radiation was measured. The volumetry was done with CT planimetry. The total dose was 66 Gy (2 Gy/d) telecobalt from 2 lateral opponated fields. The time of volume change could be defined with measuring of the half-time and the doubling-time by the help of Schwartz formula. After 10 Gy the volume diminution was about 20% and half-time 24 to 26 days. Afterwards the time of volume diminution picked up speed and finally achieved 60 to 72%. Meanwhile the half-time decreased to the half value. The result was independent of the site of primary tumor, the patient's sex and age. In our opinion the effectivity of radiotherapy can best be judged with defining of the volume change of lymph nodes of the neck.

An accelerated electrochemical MIC test for stainless alloys

International Nuclear Information System (INIS)

Gendron, T.S.; Cleland, R.D.

1994-11-01

Previous work in our laboratory and elsewhere has suggested that microbially influenced corrosion (MIC) of stainless steels and nickel-base alloys occurs in locally anaerobic regions that support the growth of sulfate-reducing bacteria (SRB). The cathodic reaction is provided by oxygen reduction at remote sites. Such a coupling between anode and cathode is difficult to reproduce in the laboratory, but can be simulated indirectly using a double electrochemical cell, as in previous work. A more realistic simulation using a single aerated electrochemical cell has now been developed, in which a second organism (P. aeruginosa) is used to provide an anoxic habitat for SRB growth and possible a source of organic carbon, within a layer of silt. A bare alloy electrode is used as the oxygen cathode. Tests of this kind using rigorous microbiological procedures have generated pitting corrosion of several alloys in low chloride media simulating freshwater heat exchanger conditions. This report discusses the adaption of these procedures to study corrosion of nuclear waste containers. (author). 20 refs., 2 tabs., 7 figs

Neck circumference as a measure of neck fat and abdominal visceral fat in Chinese adults.

Science.gov (United States)

Li, Hong-Xing; Zhang, Fen; Zhao, Dong; Xin, Zhong; Guo, Shu-Qin; Wang, Shu-Mei; Zhang, Jian-Jun; Wang, Jun; Li, Yan; Yang, Guang-Ran; Yang, Jin-Kui

2014-04-04

Visceral adipose tissue (VAT) is a unique pathogenic fatty deposit, in that it is closely correlated with risk of cardiovascular diseases. The present study is to investigate the usefulness of neck circumference (NC) to indicate VAT. Participants aged 35 to 75 years who had taken abdomen and neck computer tomography (CT) examination were included in this study. Neck adipose tissue, abdominal VAT and subcutaneous adipose tissue (SAT) areas, as well as sagittal abdominal diameter (SAD) were measured by CT. Body anthropometrics and metabolic parameters including blood glucose, lipid profiles and blood pressure were also measured. A lower abdomen CT examination was carried out on a total of 177 patients (87 male and 90 female) with a mean age of 59 years. Of the 177 participants, 15 men and 15 women also took a neck CT examination. With a comparable age and BMI, neck adipose area was correlated with abdominal VAT area significantly in men (r = 0.57, p = 0.028) and women (r = 0.53, p = 0.041). NC is positively correlated with VAT both in men (r = 0.49, p fat both in men (r = 0.83, p fat area is significantly correlated with abdominal VAT. Meanwhile, SAD is the best predictor for visceral fat in the Chinese population.

Intra-tumor heterogeneity in head and neck cancer and its clinical implications

Directory of Open Access Journals (Sweden)

Edmund A. Mroz

2016-06-01

Full Text Available The presence of heritable differences among cancer cells within a tumor, called intra-tumor genetic heterogeneity, has long been suspected of playing a role in poor responses to therapy. Research over the past decade has documented the existence of such heterogeneity within tumors of individual patients and documented its potential clinical significance. The research methods for identifying this heterogeneity were not, however, readily adaptable to widespread clinical application. After a brief review of this background, we describe the development of a measure of intra-tumor genetic heterogeneity, based on whole-exome sequencing of individual tumor samples, that could be applied to biopsy specimens in a clinical setting. This measure has now been used in head and neck squamous cell carcinoma (HNSCC to document, for the first time, a relation of high intra-tumor genetic heterogeneity to shorter overall survival in a large, multi-institutional study. The implications of heterogeneity for research and clinical care thus now need to be addressed. Keywords: Head and neck squamous cell carcinoma, Intra-tumor genetic heterogeneity, Next-generation sequencing, Targeted therapy

Regional control of melanoma neck node metastasis after selective neck dissection with or without adjuvant radiotherapy

NARCIS (Netherlands)

Hamming-Vrieze, Olga; Balm, Alfons J. M.; Heemsbergen, Wilma D.; Hooft van Huysduynen, Thijs; Rasch, Coen R. N.

2009-01-01

OBJECTIVE: To examine the effect of adjuvant radiotherapy on regional control of melanoma neck node metastasis. DESIGN: A single-institution retrospective study. SETTING: Tertiary care cancer center. PATIENTS: The study included 64 patients with melanoma neck node metastasis who were treated with

Image-guided and adaptive radiotherapy

International Nuclear Information System (INIS)

Louvel, G.; Chajon, E.; Henry, O.; Cazoulat, G.; Le Maitre, A.; Simon, A.; Bensadoun, R.J.; Crevoisier, R. de

2012-01-01

Image-guided radiotherapy (IGRT) aims to take into account anatomical variations occurring during irradiation by visualization of anatomical structures. It may consist of a rigid registration of the tumour by moving the patient, in case of prostatic irradiation for example. IGRT associated with intensity-modulated radiotherapy (IMRT) is strongly recommended when high-dose is delivered in the prostate, where it seems to reduce rectal and bladder toxicity. In case of significant anatomical deformations, as in head and neck tumours (tumour shrinking and decrease in volume of the salivary glands), re-planning appears to be necessary, corresponding to the adaptive radiotherapy. This should ideally be 'monitored' and possibly triggered based on a calculation of cumulative dose, session after session, compared to the initial planning dose, corresponding to the concept of dose-guided adaptive radiotherapy. The creation of 'planning libraries' based on predictable organ positions (as in cervical cancer) is another way of adaptive radiotherapy. All of these strategies still appear very complex and expensive and therefore require stringent validation before being routinely applied. (authors)

Management of the clinically negative neck in early-stage head and neck cancers after transoral resection

NARCIS (Netherlands)

Rodrigo, J.P.; Shah, J.P.; Silver, C.E.; Medina, J.E.; Takes, R.P.; Robbins, K.T.; Rinaldo, A.; Werner, J.A.; Ferlito, A.

2011-01-01

The decision regarding treatment of the clinically negative neck has been debated extensively. This is particularly true with early-stage tumors for which surgery is the treatment of choice, and the tumor has been resected transorally without a cervical incision. Elective neck dissection in this

Treatment of Neck Pain: Noninvasive Interventions

Science.gov (United States)

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

2008-01-01

Study Design. Best evidence synthesis. Objective. To identify, critically appraise, and synthesize literature from 1980 through 2006 on noninvasive interventions for neck pain and its associated disorders. Summary of Background Data. No comprehensive systematic literature reviews have been published on interventions for neck pain and its associated disorders in the past decade. Methods. We systematically searched Medline and screened for relevance literature published from 1980 through 2006 on the use, effectiveness, and safety of noninvasive interventions for neck pain and associated disorders. Consensus decisions were made about the scientific merit of each article; those judged to have adequate internal validity were included in our best evidence synthesis. Results. Of the 359 invasive and noninvasive intervention articles deemed relevant, 170 (47%) were accepted as scientifically admissible, and 139 of these related to noninvasive interventions (including health care utilization, costs, and safety). For whiplash-associated disorders, there is evidence that educational videos, mobilization, and exercises appear more beneficial than usual care or physical modalities. For other neck pain, the evidence suggests that manual and supervised exercise interventions, low-level laser therapy, and perhaps acupuncture are more effective than no treatment, sham, or alternative interventions; however, none of the active treatments was clearly superior to any other in either the short-or long-term. For both whiplash-associated disorders and other neck pain without radicular symptoms, interventions that focused on regaining function as soon as possible are relatively more effective than interventions that do not have such a focus. Conclusion. Our best evidence synthesis suggests that therapies involving manual therapy and exercise are more effective than alternative strategies for patients with neck pain; this was also true of therapies which include educational interventions

Pathology-based validation of FDG PET segmentation tools for volume assessment of lymph node metastases from head and neck cancer

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Schinagl, Dominic A.X. [Radboud University Nijmegen Medical Centre, Department of Radiation Oncology, Nijmegen (Netherlands); Radboud University Nijmegen Medical Centre, Department of Radiation Oncology (874), P.O. Box 9101, Nijmegen (Netherlands); Span, Paul N.; Kaanders, Johannes H.A.M. [Radboud University Nijmegen Medical Centre, Department of Radiation Oncology, Nijmegen (Netherlands); Hoogen, Frank J.A. van den [Radboud University Nijmegen Medical Centre, Department of Otorhinolaryngology, Head and Neck Surgery, Nijmegen (Netherlands); Merkx, Matthias A.W. [Radboud University Nijmegen Medical Centre, Department of Oral and Maxillofacial Surgery, Nijmegen (Netherlands); Slootweg, Piet J. [Radboud University Nijmegen Medical Centre, Department of Pathology, Nijmegen (Netherlands); Oyen, Wim J.G. [Radboud University Nijmegen Medical Centre, Department of Nuclear Medicine, Nijmegen (Netherlands)

2013-12-15

FDG PET is increasingly incorporated into radiation treatment planning of head and neck cancer. However, there are only limited data on the accuracy of radiotherapy target volume delineation by FDG PET. The purpose of this study was to validate FDG PET segmentation tools for volume assessment of lymph node metastases from head and neck cancer against the pathological method as the standard. Twelve patients with head and neck cancer and 28 metastatic lymph nodes eligible for therapeutic neck dissection underwent preoperative FDG PET/CT. The metastatic lymph nodes were delineated on CT (Node{sub CT}) and ten PET segmentation tools were used to assess FDG PET-based nodal volumes: interpreting FDG PET visually (PET{sub VIS}), applying an isocontour at a standardized uptake value (SUV) of 2.5 (PET{sub SUV}), two segmentation tools with a fixed threshold of 40 % and 50 %, and two adaptive threshold based methods. The latter four tools were applied with the primary tumour as reference and also with the lymph node itself as reference. Nodal volumes were compared with the true volume as determined by pathological examination. Both Node{sub CT} and PET{sub VIS} showed good correlations with the pathological volume. PET segmentation tools using the metastatic node as reference all performed well but not better than PET{sub VIS}. The tools using the primary tumour as reference correlated poorly with pathology. PET{sub SUV} was unsatisfactory in 35 % of the patients due to merging of the contours of adjacent nodes. FDG PET accurately estimates metastatic lymph node volume, but beyond the detection of lymph node metastases (staging), it has no added value over CT alone for the delineation of routine radiotherapy target volumes. If FDG PET is used in radiotherapy planning, treatment adaptation or response assessment, we recommend an automated segmentation method for purposes of reproducibility and interinstitutional comparison. (orig.)

The premature necking of twinning-induced plasticity steels

International Nuclear Information System (INIS)

Yang, C.L.; Zhang, Z.J.; Zhang, P.; Zhang, Z.F.

2017-01-01

An unusual necking behavior was found in twinning-induced plasticity (TWIP) steels during tensile tests, which is quite different from that observed on most ductile metals. A sharp drop of the strain-hardening rate (Θ) arises before necking initiation, rather than after it, leading to the premature necking of TWIP steels. Through carefully examining the evolution of macroscopic defects at various tensile strains using three-dimensional X-ray tomography (3D-XRT), this premature necking behavior was attributed to the multiplication of macroscopic voids during plastic deformation. Combining with the previous theories and present characterizations on the evolution of macroscopic voids, the mechanism of the unusual necking behavior in TWIP steels was quantificationally revealed.

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

Directory of Open Access Journals (Sweden)

Barrett MD

2015-05-01

Full Text Available Matthew D Barrett,1 Terence F McLoughlin,2 Kieran R Gallagher,1 Don Gatherer,3 Michael TR Parratt,1 Jonathan R Perera,1 Tim WR Briggs1 1Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom; 2Royal Liverpool University Hospital, Liverpool, Mersey Deanery, United Kingdom; 3The Gatherer Partnership, Aylesbury, United Kingdom Purpose: To investigate the effect of a tailored neck muscle conditioning program on neck muscle strength, neck muscle fatigue, and range of neck movement in 16–18-year-old male rugby players. Materials and methods: Thirty-four male rugby players were divided into forward and back playing positions and randomized within these groups. Seventeen players were randomly assigned to each group. The test group was given a tailored 6-week exercise regime based on their baseline measurements to be performed three times a week in addition to their normal training and playing. The control group trained and played as normal. The outcome measures used were cervical spine range of movement, neck strength, and neck muscle fatigability. Results: There were no clinically relevant statistically significant differences between the two groups. Trends identified between the two groups suggest that a tailored neck exercise program increases neck strength, particularly neck extension, and increases resistance to fatigue, as well as influencing right- and left-sided neck muscle balance. A reduction in range of movement was also demonstrated in the test group. There was a great deal of variability in range of movement and strength within this age group. No previously undiagnosed neck conditions were detected, and there were no adverse events reported. Conclusion: This study has shown that neck strength, range of movement, and susceptibility of the neck muscles to fatigue can be influenced using a focused neck training regime. It forms an important basis for a larger, multicenter study to ensure the neck is given due attention in

[Disappearance of essential neck tremor after pontine base infarction].

Science.gov (United States)

Urushitani, M; Inoue, H; Kawamura, K; Kageyama, T; Fujisawa, M; Nishinaka, K; Udaka, F; Kameyama, M

1996-08-01

Mechanism of essential tremor remains unknown. Central oscillators, postulated in thalamus, inferior olive, and spinal cord are thought to be important to form rhythmicity, and finally to stimulate spinal or medullary motor cells, leading trembling muscle contraction, tremor. Among several subtypes of essential familial tremor, including hand tremor, neck tremor, and voice tremor, essential neck tremor is a common disorder, and its pathophysiology seems different from that of typical essential hand tremor, since patients with essential hand tremor are responsive to beta blocker, whereas those with neck tremor are usually not. We experienced a 41-year-old left handed woman with essential neck tremor in whom neck titubation disappeared shortly after pontine base infarct. She was our patient in the outpatient clinic with the diagnosis of essential neck tremor. The tremor developed when she was teenage, and has been localized in the neck muscles. Alcohol intake had apparently diminished it transiently. Her mother also had the tremor in her neck. She was admitted to our hospital with sudden onset of right-sided limb weakness and speech disturbance. Neurological examination showed right hemiparesis including the ipsilateral face, scanning speech, and cerebellar limb ataxia on the same side. In addition, there was no tremor in her neck. Brain MR imaging revealed a pontine base infarct at the level of middle pons, which was consistent with paramedian artery territory. The hemiparesis and speech disturbance improved almost completely after treatment, and her neck tremor has never occurred in one year follow-up. In our patient, efficacy of alcohol imply that essential neck tremor and hand tremor had same central nervous pathway including central oscillator in common, and descending cortical fibers is seemingly associated with diminishing patient's tremor. Pathophysiology of essential neck tremor was discussed with reviewing previous literature.

Necked-in superdeformed nuclei

International Nuclear Information System (INIS)

Joensson, L.O.

1997-03-01

In this dissertation the possibility of forming superdeformed states related to two connected spheres, having a more or less pronounced neck, is investigated. Detailed Nilsson-Strutinsky calculations with the cranked Woods-Saxon potential and a finite-range liquid drop model are carried out in the 180 Hg region, where superdeformed states related to two overlapping 90 Zr are predicted. Detailed spectroscopic properties are calculated. The effect of the necking degree of freedom on the giant dipole resonance, GDR, is investigated. The calculations are carried out with the Woods-saxon potential for the single-particle states, and the random phase approximation formalism for the phonon states. The residual interaction and coupling constants are determined by requirements of transitional invariance. The lower energy component of the GDR spectrum for superdeformed shapes, corresponding to vibrations along the symmetry axis, is diminished with increasing necking, and the mean energy of the GDR is increased. The folded Yukawa-plus-exponential liquid drop models take into account the finite range of the nuclear force, which is important when elongated and necked-in nuclear shapes are considered. However, it is shown that they are unstable towards higher multipole deformations, and that unphysical shapes are obtained in free minimizations when too high multipole deformations are included. Limits on multipolarity are given as functions of mass number. 9 refs., 4 figs

Isolated neck-lifting procedure: isolated stork lift.

Science.gov (United States)

Barbarino, Sheila C; Wu, Allan Y; Morrow, David M

2013-04-01

Many patients desire cosmetic improvement of neck laxity when consulting with a plastic surgeon about their face. Neck laxity and loss of the cervicomental angle can be due to multiple components of aging such as skin quality/elasticity, loss of platysma muscle tone, and submental fat accumulation. Traditionally, the procedure of choice for patients with an aging lower face and neck is a cervicofacial rhytidectomy. However, occasionally, a patient wishes to have no other facial surgery than an improvement of their excessive skin of the anterior, lateral, and/or posterior neck. In other instances, a patient may present with having had a face/neck-lifting procedure that left objectionable vertical/diagonal lines at the lateral neck. In both these instances, a surgeon should consider an isolated stork lift (ISL) procedure. An ISL procedure avoids and/or corrects problematic vertical/diagonal lateral neck folds by "walking" the excess skin flaps around the posterior inferior occipital hairline bilaterally, bringing the flaps together at the lateral and posterior neck, which sometimes involves a midline posterior dart excision of the dog ear. A patient presenting with excessive skin of the neck (anterior, lateral, and/or posterior) and/or residual vertical/diagonal skin folds is an excellent candidate for the ISL. The ISL procedure was performed on 273 patients over a 2-year period at The Morrow Institute. Patients were included if they had excessive skin of the anterior, lateral, and/or posterior neck and/or diagonal/vertical lateral bands and did not desire a full face-lifting procedure. Patients were excluded from this study if they would not accept having longer hair in order to cover the scar along the posterior inferior occipital hairline or a midline T-flap skin closure scar at the base of the posterior midline neck. Under a combination of local anesthesia and IV sedation, a postauricular face-lift incision was made that was extended in a circumoccipital fashion

Predictors of Persistent Axial Neck Pain After Cervical Laminoplasty.

Science.gov (United States)

Kimura, Atsushi; Shiraishi, Yasuyuki; Inoue, Hirokazu; Endo, Teruaki; Takeshita, Katsushi

2018-01-01

Retrospective analysis of prospective data. The aim of this study was to reveal baseline predictors of persistent postlaminoplasty neck pain. Axial neck pain is one of the most common complications after cervical laminoplasty; however, baseline predictors of persistent postlaminoplasty neck pain are unclear. We analyzed data from 156 patients who completed a 2-year follow-up after double-door laminoplasty for degenerative cervical myelopathy. Patients rated the average intensity of axial neck pain in the last month using an 11-point numerical rating scale preoperatively and at the 2-year follow-up. The dependent variable was the presence of moderate-to-severe neck pain (numerical rating scale ≥4) at the 2-year follow-up. The independent variables included patient characteristics, baseline radiological parameters, surgical variables, baseline axial neck pain intensity, and baseline functions, which were measured by the Japanese Orthopaedic Association score and the Short Form-36 survey (SF-36). Logistic regression analysis was performed to identify independent predictors of moderate-to-severe neck pain after laminoplasty. At the 2-year follow-up, 51 patients (32%) had moderate-to-severe neck pain, and 106 patients (68%) had no or mild pain. Univariate analysis revealed that the ratio of cervical anterolisthesis, ratio of current smoking, baseline neck pain intensity, and baseline SF-36 Mental Component Summary differed significantly between the groups. Multivariate logistic regression analysis showed that independent predictors of moderate-to-severe neck pain at the 2-year follow-up include the presence of anterolisthesis, current smoking, moderate-to-severe baseline neck pain, and lower SF-36 Mental Component Summary. The presence of anterolisthesis and moderate-to-severe baseline neck pain were also associated with significantly poorer physical function after surgery. The presence of anterolisthesis was associated not only with the highest odds ratio of

Scapulothoracic muscle strength in individuals with neck pain.

Science.gov (United States)

Petersen, Shannon M; Domino, Nathan A; Cook, Chad E

2016-08-10

People with neck pain often present with weakness in the scapulothoracic muscles. Few studies have examined lower trapezius (LT), middle trapezius (MT) and serratus anterior (SA) muscle strength in individuals with neck pain, nor compared strength to asymptomatic individuals. The aim of this study was to examine LT, MT and SA muscle strength in individuals with chronic neck pain. Descriptive cross sectional design. Twenty two individuals with chronic neck pain and 17 asymptomatic individuals were included. Participants were asked to complete a screening questionnaire, Neck Disability Index, and underwent manual muscle testing for the LT, MT, and SA muscles bilaterally. Data analyses included paired and comparative independent t-tests. For individuals with neck pain, significant within subject differences in strength between sides for the LT (Pneck pain were significantly weaker than asymptomatic individuals for the LT (p= 0.02), MT (p= 0.03), and SA (p= 0.01) on their side of neck pain, but not on their non-painful side. Significant within subject differences were found between sides for the LT and MT while significant between group differences were identified for all three muscles tested.

Psychometric properties of the neck disability index amongst patients with chronic neck pain using item response theory.

Science.gov (United States)

Saltychev, Mikhail; Mattie, Ryan; McCormick, Zachary; Laimi, Katri

2017-05-13

The Neck Disability Index (NDI) is commonly used for clinical and research assessment for chronic neck pain, yet the original version of this tool has not undergone significant validity testing, and in particular, there has been minimal assessment using Item Response Theory. The goal of the present study was to investigate the psychometric properties of the original version of the NDI in a large sample of individuals with chronic neck pain by defining its internal consistency, construct structure and validity, and its ability to discriminate between different degrees of functional limitation. This is a cross-sectional cohort study of 585 consecutive patients with chronic neck pain seen in a university hospital rehabilitation clinic. Internal consistency was evaluated using Cronbach's alpha, construct structure was evaluated by exploratory factor analysis, and discrimination ability was determined by Item Response Theory. The NDI demonstrated good internal consistency assessed by Cronbach's alpha (0.87). The exploratory factor analysis identified only one factor with eigenvalue considered significant (cutoff 1.0). When analyzed by Item Response Theory, eight out of 10 items demonstrated almost ideal difficulty parameter estimates. In addition, eight out of 10 items showed high to perfect estimates of discrimination ability (overall range 0.8 to 2.9). Amongst patients with chronic neck pain, the NDI was found to have good internal consistency, have unidimensional properties, and an excellent ability to distinguish patients with different levels of perceived disability. Implications for Rehabilitation The Neck Disability Index has good internal consistency, unidimensional properties, and an excellent ability to distinguish patients with different levels of perceived disability. The Neck Disability Index is recommended for use when selecting patients for rehabilitation, setting rehabilitation goals, and measuring the outcome of intervention.

X-Ray Exam: Neck (For Parents)

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... Staying Safe Videos for Educators Search English Español X-Ray Exam: Neck KidsHealth / For Parents / X-Ray Exam: ... Neck Enlarged Adenoids Croup Sinusitis Getting an X-ray (Video) X-Ray (Video) View more Partner Message About Us ...

Head and Neck Cancer—Patient Version

Science.gov (United States)

Head and neck cancers include cancers in the larynx (voice box), throat, lips, mouth, nose, and salivary glands. Start here to find information on head and neck cancer treatment in adults and children, causes and prevention, screening, research, and statistics.

Fractionated BNCT for locally recurrent head and neck cancer: Experience from a phase I/II clinical trial at Tsing Hua Open-Pool Reactor

International Nuclear Information System (INIS)

Wang, Ling-Wei; Chen, Yi-Wei; Ho, Ching-Yin; Hsueh Liu, Yen-Wan; Chou, Fong-In; Liu, Yuan-Hao; Liu, Hong-Ming; Peir, Jinn-Jer; Jiang, Shiang-Huei; Chang, Chi-Wei; Liu, Ching-Sheng; Wang, Shyh-Jen; Chu, Pen-Yuan; Yen, Sang-Hue

2014-01-01

To introduce our experience of treating locally and regionally recurrent head and neck cancer patients with BNCT at Tsing Hua Open-Pool Reactor in Taiwan, 12 patients (M/F=10/2, median age 55.5 Y/O) were enrolled and 11 received two fractions of treatment. Fractionated BNCT at 30-day interval with adaptive planning according to changed T/N ratios was feasible, effective and safe for selected recurrent head and neck cancer in this trial. - Highlights: • We treated 12 patients with recurrent Head and Neck (H and N) cancer after radical surgery and radiotherapy since 2010. • Four complete response (CR) and 3 partial response (PR) were found. Total response rate was 58%. • Two patients had local control longer than one year. • No grade 4 or higher toxicity was noted for both acute and chronic effects

Radiation-induced neck fibrosis in patients with nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Li Jian; Wang Rensheng; Gan Langge; Liu Wenqi; Zhang Yong

2005-01-01

Objective: To investigate the post-irradiation neck fibrosis in patients with nasopharyngeal carcinoma and its related factors. Methods: A total of 267 patients received conventional fractionated radiotherapy with D T 50-72 Gy on the neck a half year to 10 years ago were observed for the changes of cervical shape and functions. Results: Different degrees of post-irradiation neck fibrosis were seen in all patients. The rate of heavy degree of neck radiation fibrosis was 24.34 %, and it was 2.74% when received preventive dose on the neck. There was a very significant difference between patients who received late course of tangential irradiation on the neck and those who didn't receive (P=0.0001). The incidence of post-irradiation neck fibrosis didn't increase when patients received radiotherapy combined with chemotherapy (P=0.2678). The function of cervical muscles turned weak in patients received radiotherapy delivered by 6 MV accelerator in late course of tangential irradiation, whereas skin damage was severer in patients treated with 60 Co γ-rays. Conclusions: The incidence of heavy degree of post-irradiation neck fibrosis is high ,and is related closely to late course of tangential irradiation. The authors should avoid adopting this sort of irradiation on the neck. (authors)

Investigation on mechanical alloying process for v-cr-ti alloys

International Nuclear Information System (INIS)

Stanciulescu, M.; Carlan, P.; Mihalache, M.; Bucsa, G.; Abrudeanu, M.; Galateanu, A.

2015-01-01

Mechanical alloying (MA) is an efficient approach for fabricating oxide-dispersion alloys and structural materials including vanadium alloys for fusion and fission application. Dissolution behaviour of the alloying elements is a key issue for optimizing the mechanical alloying process in fabricating vanadium alloys. This paper studies the MA process of V-4wt.%Cr-4wt.%Ti alloy. The outcomes of the MA powders in a planetary ball mill are reported in terms of powder particle size and morphology evolution and elemental composition. The impact of spark-plasma sintering process on the mechanically alloyed powder is analysed. An optimal set of sintering parameters, including the maximum temperature, the dwell time and the heating rate are determined. (authors)

Basilar artery aneurysm case presented with neck pain

Directory of Open Access Journals (Sweden)

Uygar Utku

2013-04-01

Full Text Available Neck pain related with disorders of the brain and neck vascular structures is not rare but importance was attached to a condition that is often overlooked. Tension as a sudden onset, radiating to the nape, the neck pain becomes unbearable and within seconds the raging 51-year-old female patient with aneurysm at the distal end of basilar artery was found. Case, the only sign of neck pain with unruptured basilar artery aneurysm is presented in terms of raising awareness on the subject.

Quality of life after planned neck dissection

International Nuclear Information System (INIS)

Iwae, Shigemichi; Hirayama, Yuji; Komatsu, Hirokazu

2009-01-01

We evaluated the effect of planned neck dissection (PND) after concurrent chemoradiotherapy (CCRT) on quality of life (QOL) by using a self-administered neck dissection questionnaire and an arm abduction test. Subjects are fourteen patients who had undergone CCRT followed by planned selective neck dissection for the treatment of mesopharyngeal and hypopharyngeal cancer. The findings of the survey were compared with thirty-two patients who had undergone CCRT alone. Patients without PND had better scores on measures of pain, constriction, numbness and appearance of the neck, but had no advantage about arm abduction. After PND, the patients who had dissected dominant hand side had lower satisfaction compared with those who had dissected non-dominant hand side. (author)

Laser surface alloying of aluminium-transition metal alloys

Directory of Open Access Journals (Sweden)

Almeida, A.

1998-04-01

Full Text Available Laser surface alloying has been used as a tool to produce hard and corrosion resistant Al-transition metal (TM alloys. Cr and Mo are particularly interesting alloying elements to produce stable highstrength alloys because they present low diffusion coefficients and solid solubility in Al. To produce Al-TM surface alloys a two-step laser process was developed: firstly, the material is alloyed using low scanning speed and secondly, the microstructure is modified by a refinement step. This process was used in the production of Al-Cr, Al-Mo and Al-Nb surface alloys by alloying Cr, Mo or Nb powder into an Al and 7175 Al alloy substrate using a CO₂ laser. This paper presents a review of the work that has been developed at Instituto Superior Tecnico on laser alloying of Al-TM alloys, over the last years.

En el presente trabajo se estudia la aleación superficial mediante láser de aluminio con metales de transición. El cromo y el molibdeno son particularmente interesantes porque producen aleaciones de alta resistencia y por el bajo coeficiente de difusión y solución sólida en aluminio. Para producir estas aleaciones se ha seguido un procedimiento desarrollado en dos partes. En primer lugar, el material se alea usando una baja velocidad de procesado y en segundo lugar la estructura se modifica mediante un refinamiento posterior. Este procedimiento se ha empleado en la producción de aleaciones Al-Cr, Al-Mo y Al-Nb mediante aleación con láser de CO₂ de polvos de Cr, Mo o Nb en aluminio y la aleación 7175. Este trabajo es una revisión del desarrollado en el Instituto Superior Técnico de Lisboa en los últimos años.

Arm and neck pain in ultrasonographers.

Science.gov (United States)

Claes, Frank; Berger, Jan; Stassijns, Gaëtane

2015-03-01

The aim of this study was to evaluate the prevalence of upper-body-quadrant pain among ultrasonographers and to evaluate the association between individual ergonomics, musculoskeletal disorders, and occurrence of neck pain. A hundred and ten (N = 110) Belgian and Dutch male and female hospital ultrasonographers were consecutively enrolled in the study. Data on work-related ergonomic and musculoskeletal disorders were collected with an electronic inquiry, including questions regarding ergonomics (position of the screen, high-low table, and ergonomic chair), symptoms (neck pain, upper-limb pain), and work-related factors (consecutive working hours a day, average working hours a week). Subjects with the screen on their left had significantly more neck pain (odds ratio [OR] = 3.6, p = .0286). Depending on the workspace, high-low tables increased the chance of developing neck pain (OR = 12.9, p = .0246). A screen at eye level caused less neck pain (OR = .22, p = .0610). Employees with a fixed working space were less susceptible to arm pain (OR = 0.13, p = .0058). The prevalence of arm pain was significantly higher for the vascular department compared to radiology, urology, and gynecology departments (OR = 9.2, p = .0278). Regarding prevention of upper-limb pain in ultrasonograph, more attention should be paid to the work environment and more specialty to the ultrasound workstation layout. Primary ergonomic prevention could provide a painless work situation for the ultrasonographer. Further research on the ergonomic conditions of ultrasonography is necessary to develop ergonomic solutions in the work environment that will help to alleviate neck and arm pain. © 2014, Human Factors and Ergonomics Society.

Evaluation of deformable image registration for contour propagation between CT and cone-beam CT images in adaptive head and neck radiotherapy.

Science.gov (United States)

Li, X; Zhang, Y Y; Shi, Y H; Zhou, L H; Zhen, X

2016-04-29

Deformable image registration (DIR) is a critical technic in adaptive radiotherapy (ART) to propagate contours between planning computerized tomography (CT) images and treatment CT/Cone-beam CT (CBCT) image to account for organ deformation for treatment re-planning. To validate the ability and accuracy of DIR algorithms in organ at risk (OAR) contours mapping, seven intensity-based DIR strategies are tested on the planning CT and weekly CBCT images from six Head & Neck cancer patients who underwent a 6 ∼ 7 weeks intensity-modulated radiation therapy (IMRT). Three similarity metrics, i.e. the Dice similarity coefficient (DSC), the percentage error (PE) and the Hausdorff distance (HD), are employed to measure the agreement between the propagated contours and the physician delineated ground truths. It is found that the performance of all the evaluated DIR algorithms declines as the treatment proceeds. No statistically significant performance difference is observed between different DIR algorithms (p> 0.05), except for the double force demons (DFD) which yields the worst result in terms of DSC and PE. For the metric HD, all the DIR algorithms behaved unsatisfactorily with no statistically significant performance difference (p= 0.273). These findings suggested that special care should be taken when utilizing the intensity-based DIR algorithms involved in this study to deform OAR contours between CT and CBCT, especially for those organs with low contrast.

The management of vacuum neck drains in head and neck surgery and the comparison of two different practice protocols for drain removal.

Science.gov (United States)

Kasbekar, A V; Davies, F; Upile, N; Ho, M W; Roland, N J

2016-01-01

Introduction The management of vacuum neck drains in head and neck surgery is varied. We aimed to improve early drain removal and therefore patient discharge in a safe and effective manner. Methods The postoperative management of head and neck surgical patients with vacuum neck drains was reviewed retrospectively. A new policy was then implemented to measure drainage three times daily (midnight, 6am, midday). The decision for drain removal was based on the most recent drainage period (at Measuring drainage volumes three times daily allows for more accurate assessment of wound drainage, and this can lead to earlier removal of neck drains and safe discharge.

Analysis of alloys and salt solutions by 'beta'-ray back-scattering

Energy Technology Data Exchange (ETDEWEB)

Bahadur, A; Maji, K D; Kumar, R [National Metallurgical Lab., Jamshedpur (India)

1975-07-01

This investigation reports the results of a study undertaken to assess the suitability of using the GM counter for measuring the intensity of ..beta..-backscattered radiation to determine the chemical composition of binary solid alloys, and aqueous salt solutions containing a metallic radical. The results indicate that the technique is not suitable for the determination of the composition of binary alloys since the error is in the range of 1.2 to 2.3 wt-% metal. The technique can be conveniently adapted for aqueous salt solutions where the maximum error is approximately 0.2 wt-% metal for metallic elements with atomic number greater than 20.

MR of head and neck hemangiomas

International Nuclear Information System (INIS)

Bilaniuk, L.T.; Zimmerman, R.A.; Gusnard, D.A.

1990-01-01

This paper defines the MR characteristics of head and neck hemangiomas and to evaluate the role of MR in their diagnosis and management. Eighteen pediatric and young adult patients with head and neck hemangiomas (six neck, six face, three eyelid, two scalp, and one parotid) underwent high-field-strength 1.5-T MR imaging. Conventional spin-echo sequences with T1 and T2 weighting were performed. In addition, one-third of patients underwent MR angiography and gadolinium enhancement. The hemangiomas were isointense to muscle on T1-weighted images and hyperintense on proton-density and T2-weighted images

Musculoskeletal networks reveal topological disparity in mammalian neck evolution.

Science.gov (United States)

Arnold, Patrick; Esteve-Altava, Borja; Fischer, Martin S

2017-12-13

The increase in locomotor and metabolic performance during mammalian evolution was accompanied by the limitation of the number of cervical vertebrae to only seven. In turn, nuchal muscles underwent a reorganization while forelimb muscles expanded into the neck region. As variation in the cervical spine is low, the variation in the arrangement of the neck muscles and their attachment sites (i.e., the variability of the neck's musculoskeletal organization) is thus proposed to be an important source of neck disparity across mammals. Anatomical network analysis provides a novel framework to study the organization of the anatomical arrangement, or connectivity pattern, of the bones and muscles that constitute the mammalian neck in an evolutionary context. Neck organization in mammals is characterized by a combination of conserved and highly variable network properties. We uncovered a conserved regionalization of the musculoskeletal organization of the neck into upper, mid and lower cervical modules. In contrast, there is a varying degree of complexity or specialization and of the integration of the pectoral elements. The musculoskeletal organization of the monotreme neck is distinctively different from that of therian mammals. Our findings reveal that the limited number of vertebrae in the mammalian neck does not result in a low musculoskeletal disparity when examined in an evolutionary context. However, this disparity evolved late in mammalian history in parallel with the radiation of certain lineages (e.g., cetartiodactyls, xenarthrans). Disparity is further facilitated by the enhanced incorporation of forelimb muscles into the neck and their variability in attachment sites.

Long-lasting effects of neck muscle vibration and contraction on self-motion perception of vestibular origin.

Science.gov (United States)

Pettorossi, Vito Enrico; Panichi, Roberto; Botti, Fabio Massimo; Biscarini, Andrea; Filippi, Guido Maria; Schieppati, Marco

2015-10-01

previously experienced position of head with respect to trunk. Tonic proprioceptive inflow, as might occur as a consequence of enduring or permanent head postures, can induce adaptive plastic changes in vestibular-dependent motion sensitiveness. These changes might be counteracted by vibration of selected neck muscles. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Evaluation of dried salted pork ham and neck quality

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Simona Kunová

2015-12-01

Full Text Available The aim of the present study was analysed chemical and physical parameters of dried salted pork ham and neck. Dry-cured meat is a traditional dry-cured product obtained after 12 - 24 months of ripening under controlled environmental conditions.  Ham and neck was salted by nitrite salt mixture during 1 week. Salted meat products were dried at 4 °C and relative humidity 85% 1 week after salting. The quality of dry-cured meat is influenced by the processing technology, for example length of drying and ripening period. The average moisture of dried salted pork ham was 63.77% and dried salted pork neck was 59.26%. The protein content was 24.87% in dried salted pork ham and significantly lower (20.51% in dried salted pork neck. The value of intramuscular fat in dried salted pork ham was 4.97% and 14.40% in dried salted pork neck. The salt content was 5.39% in dried salted pork ham and 4.83% in dried salted pork neck. The cholesterol content was 1.36 g.kg-1 in dried salted pork ham and significant lower in dried salted pork neck (0.60 g.kg-1. The value of lightness was 44.36 CIE L* in dried salted pork ham and significantly lower in dried salted pork neck (40.74 CIE L*. The pH value was 5.84 in dried salted pork ham and 5.80 in dried salted pork neck. The shear work was 9.99 kg.s-1 in dried salted pork ham and 6.34 in dried salted pork neck. The value of water activity (aw was 0.929 in dried salted pork ham and similar 0.921 in dried salted pork neck. 

Characteristics of mechanical alloying of Zn-Al-based alloys

International Nuclear Information System (INIS)

Zhu, Y.H.; Hong Kong Polytechnic; Perez Hernandez, A.; Lee, W.B.

2001-01-01

Three pure elemental powder mixtures of Zn-22%Al-18%Cu, Zn-5%Al-11%Cu, and Zn-27%Al-3%Cu (in wt.%) were mechanically alloyed by steel-ball milling processing. The mechanical alloying characteristics were investigated using X-ray diffraction, scanning electron microscopy, and transmission electron microscopy techniques. It was explored that mechanical alloying started with the formation of phases from pure elemental powders, and this was followed by mechanical milling-induced phase transformation. During mechanical alloying, phases stable at the higher temperatures formed at the near room temperature of milling. Nano-structure Zn-Al-based alloys were produced by mechanical alloying. (orig.)

Physical risk factors for neck pain

NARCIS (Netherlands)

Ariëns, Geertje A M; Van Mechelen, Willem; Bongers, Paulien M.; Bouter, Lex M.; Van Der Wal, Gerrit

2000-01-01

To identify physical risk factors for neck pain, a systematic review of the literature was carried out. Based on methodological quality and study design, 4 levels of evidence were defined to establish the strength of evidence for the relationship between risk factors and neck pain. Altogether, 22

Neck and scleral hemorrhage in drowning.

Science.gov (United States)

Alexander, Russell T; Jentzen, Jeffrey M

2011-03-01

The determination of the cause and manner of death for a body recovered from the water can be difficult because of a lack of autopsy findings specific for drowning. This case report describes a 30-year-old man found submerged at the bottom of a hotel pool. An autopsy revealed scleral hemorrhages and fascial hemorrhages of multiple muscles of the anterior and posterior neck bilaterally. No evidence of traumatic injury was on the surface of the body. An investigation by law enforcement found no evidence of foul play. The occurrence of petechial and neck hemorrhage in a body recovered from the water is controversial, and a review of this literature will be given. We suggest that fascial hemorrhages of the muscles of the neck, as well as cephalic hemorrhages, can be explained by drowning-related elevated central venous pressure that is communicated to the head through the valveless veins of the neck. © 2010 American Academy of Forensic Sciences.

Sauropod necks: are they really for heat loss?

Directory of Open Access Journals (Sweden)

Donald M Henderson

Full Text Available 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.

An Unusual Neck Mass: Ingested Chicken Bone

OpenAIRE

Demirhan, Erhan; İber, Metin; Yağız, Özlem; Kandoğan, Tolga; Çukurova, İbrahim

2016-01-01

Background: Foreign bodies in the upper aerodigestive tract are frequently seen in otolaryngological practice, but migration of an ingested foreign body to the neck is a very rare condition. Case Report: We present a 66-year-old woman admitted to our outpatient department with a painful neck mass. She had a history of emergency department admission 4 months prior with odynophagia after eating chicken meal. A physical examination revealed a painful and hyperemic mass on the left neck. Ant...

Heritability of neck pain

DEFF Research Database (Denmark)

Fejer, R; Hartvigsen, J; Kyvik, K O

2006-01-01

73%) answered the questions regarding neck pain. Probandwise concordance rates, zygosity-specific odds ratios and tetrachoric correlations showed a significant genetic effect on neck pain. An overall additive genetic component of 44% was found. The genetic effect decreased with age, accounting...... for only 10% in the oldest male group and 0% in the oldest female group. There was a statistically significant difference in heritability between males and females (34 vs 52%, P... gradually less important with increasing age, and environmental factors dominate almost completely in the older age groups....

The relationship between neck pain and physical activity.

Science.gov (United States)

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.

Pain education combined with neck- and aerobic training is more effective at relieving chronic neck pain than pain education alone--A preliminary randomized controlled trial.

Science.gov (United States)

Brage, K; Ris, I; Falla, D; Søgaard, K; Juul-Kristensen, B

2015-10-01

To evaluate the effect of training and pain education vs pain education alone, on neck pain, neck muscle activity and postural sway in patients with chronic neck pain. Twenty women with chronic neck pain were randomized to receive pain education and specific training (neck-shoulder exercises, balance and aerobic training) (INV), or pain education alone (CTRL). Effect on neck pain, function and Global Perceived Effect (GPE) were measured. Surface electromyography (EMG) was recorded from neck flexor and extensor muscles during performance of the Cranio-Cervical Flexion Test (CCFT) and three postural control tests (two-legged: eyes open and closed, one-legged: eyes open). Sway parameters were calculated. Fifteen participants (CTRL: eight; INV: seven) completed the study. Per protocol analyses showed a larger pain reduction (p = 0.002) for the INV group with tendencies for increased GPE (p = 0.06), reduced sternocleidomastoid activity during the CCFT (p = 0.09), reduced sway length (p = 0.09), and increased neck extensor activity (p = 0.02) during sway compared to the CTRL group. Pain education and specific training reduce neck pain more than pain education alone in patients with chronic neck pain. These results provide encouragement for a larger clinical trial to corroborate these observations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Intraoperative monitoring of marginal mandibular nerve during neck dissection.

Science.gov (United States)

Tirelli, Giancarlo; Bergamini, Pier Riccardo; Scardoni, Alessandro; Gatto, Annalisa; Boscolo Nata, Francesca; Marcuzzo, Alberto Vito

2018-05-01

The purpose of this study was to assess the efficacy of intraoperative nerve integrity monitoring (NIM) to prevent marginal mandibular nerve injuries during neck dissection. This prospective study compared 36 patients undergoing NIM-assisted neck dissection from July 2014 to March 2015 to a cohort of 35 patients subjected to neck dissection over an identical period of time before the technique was introduced. We also assessed possible correlations between marginal mandibular nerve injuries and other factors, such as anthropometric measurements, presence of clinical neck metastases, type of neck dissection, and site of primary tumor. The incidence of marginal mandibular nerve paralyses was significantly lower among the group of patients undergoing NIM-assisted neck dissection (P = .021). There was no significant difference in the duration of the procedure, and the technique resulted in a limited increase of cost. No other factor seemed to influence the onset of marginal mandibular nerve palsy. In our opinion, NIM is a valuable aid for preventing marginal mandibular nerve injuries during neck dissection. © 2018 Wiley Periodicals, Inc.

Bilateral femoral neck fractures following pelvic irradiation

International Nuclear Information System (INIS)

Mitsuda, Kenji; Nishi, Hosei; Oba, Hiroshi

1977-01-01

Over 300 cases of femoral neck fractures following radiotherapy for intrapelvic malignant tumor have been reported in various countries since Baensch reported this disease in 1927. In Japan, 40 cases or so have been reported, and cases of bilateral femoral neck fractures have not reached to ten cases. The authors experienced a case of 75 year-old female who received radiotherapy for cancer of the uterus, and suffered from right femoral neck fracture 3 months after and left femoral neck fracture one year and half after. As clinical symptoms, she had not previous history of trauma in bilateral femurs, but she complained of a pain in a hip joint and of gait disturbance. The pain in left femoral neck continued for about one month before fracture was recognized with roentgenogram. As histopathological findings, increase of fat marrow, decrease of bone trabeculae, and its marked degeneration were recognized. Proliferation of some blood vessels was found out, but thickness of the internal membrane and thrombogenesis were not recognized. Treatment should be performed according to degree of displacement of fractures. In this case, artificial joint replacement surgery was performed to the side of fracture of this time, because this case was bilateral femoral neck fractures and the patient had received artificial head replacement surgery in the other side of fracture formerly. (Tsunoda, M.)

Digital subtraction angiography in head and neck radiology

Energy Technology Data Exchange (ETDEWEB)

Carmody, R F; Seeger, J F; Smith, R L; Horsley, W W; Miller, R W

1984-07-01

Intravenous digital subtraction angiography (IVDSA) was used to evaluate 44 patients with suspected otolaryngologic abnormalities. Sixteen had IVDSA for pulsatile tinnitus or suspected glomus tumor of the petrous bone. Nine patients were evaluated because of pulsatile neck masses, and 12 others had suspected tumors of the neck, face, and paranasal sinuses. Seven had IVDSA following head and neck trauma. The technique of examination is described. The current indications of IVDSA in head and neck radiology are discussed. It is concluded that IVDSA is a suitable substitute for conventional angiography for many otolaryngologic conditions and, because of its safety, can be used more liberally.

Information architecture for a patient-specific dashboard in head and neck tumor boards.

Science.gov (United States)

Oeser, Alexander; Gaebel, Jan; Dietz, Andreas; Wiegand, Susanne; Oeltze-Jafra, Steffen

2018-03-28

Overcoming the flaws of current data management conditions in head and neck oncology could enable integrated information systems specifically tailored to the needs of medical experts in a tumor board meeting. Clinical dashboards are a promising method to assist various aspects of the decision-making process in such cognitively demanding scenarios. However, in order to provide extensive and intuitive assistance to the participating physicians, the design and development of such a system have to be user-centric. To accomplish this task, conceptual methods need to be performed prior to the technical development and integration stages. We have conducted a qualitative survey including eight clinical experts with different levels of expertise in the field of head and neck oncology. According to the principles of information architecture, the survey focused on the identification and causal interconnection of necessary metrics for information assessment in the tumor board. Based on the feedback by the clinical experts, we have constructed a detailed map of the required information items for a tumor board dashboard in head and neck oncology. Furthermore, we have identified three distinct groups of metrics (patient, disease and therapy metrics) as well as specific recommendations for their structural and graphical implementation. By using the information architecture, we were able to gather valuable feedback about the requirements and cognitive processes of the tumor board members. Those insights have helped us to develop a dashboard application that closely adapts to the specified needs and characteristics, and thus is primarily user-centric.

Genetics Home Reference: head and neck squamous cell carcinoma

Science.gov (United States)

... and neck squamous cell carcinoma Head and neck squamous cell carcinoma Printable PDF Open All Close All Enable Javascript ... Consumer Version: Overview of Mouth, Nose, and Throat Cancers Orphanet: Squamous cell carcinoma of head and neck University of Michigan ...

Pocket Proteins Suppress Head and Neck Cancer

Science.gov (United States)

Shin, Myeong-Kyun; Pitot, Henry C.; Lambert, Paul F.

2012-01-01

Head and neck squamous cell carcinomas (HNSCC) is a common cancer in humans long known to be caused by tobacco and alcohol use, but now an increasing percentage of HNSCC is recognized to be caused by the same human papillomaviruses (HPVs) that cause cervical and other anogenital cancers. HPV-positive HNSCCs differ remarkably from HPV-negative HNSCCs in their clinical response and molecular properties. From studies in mice, we know that E7 is the dominant HPV oncoprotein in head and neck cancer. E7 is best known for its ability to inactivate pRb, the product of the retinoblastoma tumor susceptibility gene. However loss of pRb function does not fully account for E7’s potency in causing head and neck cancer. In this study, we characterized the cancer susceptibility of mice deficient in the expression of pRb and either of two related “pocket” proteins, p107 and p130, that are also inactivated by E7. pRb/p107 deficient mice developed head and neck cancer as frequently as do HPV16 E7 transgenic mice. The head and neck epithelia of the pRb/p107 deficient mice also displayed the same acute phenotypes and biomarker readouts as observed in the epithelia of E7 transgenic mice. Mice deficient for pRb and p130 in their head and neck epithelia showed intermediate acute and tumor phenotypes. We conclude that pRb and p107 act together to efficiently suppress head and neck cancer, and are therefore highly relevant targets of HPV16 E7 in its contribution to HPV-positive HNSCC. PMID:22237625

High Temperature Deformation of Twin-Roll Cast Al-Mn-Based Alloys after Equal Channel Angular Pressing.

Science.gov (United States)

Málek, Přemysl; Šlapáková Poková, Michaela; Cieslar, Miroslav

2015-11-12

Twin roll cast Al-Mn- and Al-Mn-Zr-based alloys were subjected to four passes of equal channel angular pressing. The resulting grain size of 400 nm contributes to a significant strengthening at room temperature. This microstructure is not fully stable at elevated temperatures and recrystallization and vast grain growth occur at temperatures between 350 and 450 °C. The onset of these microstructure changes depends on chemical and phase composition. Better stability is observed in the Al-Mn-Zr-based alloy. High temperature tensile tests reveal that equal channel angular pressing results in a softening of all studied materials at high temperatures. This can be explained by an active role of grain boundaries in the deformation process. The maximum values of ductility and strain rate sensitivity parameter m found in the Al-Mn-Zr-based alloy are below the bottom limit of superplasticity (155%, m = 0.25). However, some features typical for superplastic behavior were observed-the strain rate dependence of the parameter m , the strengthening with increasing grain size, and the fracture by diffuse necking. Grain boundary sliding is believed to contribute partially to the overall strain in specimens where the grain size remained in the microcrystalline range.

Neck Muscle Fatigue with Helmet-Mounted Systems

National Research Council Canada - National Science Library

Eveland, Edward S; Pellettiere, Joseph A

2006-01-01

.... Changes in neck muscle strength were identified along with EMG evidence of fatigue. When flights occurred on an almost daily basis over 4 days, the force imparted to the neck was reduced each day...

A self-driven temperature and flow rate co-adjustment mechanism based on Shape-Memory-Alloy (SMA) assembly for an adaptive thermal control coldplate module with on-orbit service characteristics

International Nuclear Information System (INIS)

Guo, Wei; Li, Yunhua; Li, Yun-Ze; Zhong, Ming-Liang; Wang, Sheng-Nan; Wang, Ji-Xiang; Zhang, Jia-Xun

2017-01-01

Highlights: • A self-driven temperature and flow rate co-adjustment mechanism based on SMA assembly is proposed. • An adaptive thermal control coldplate module (TCCM) is introduced. • A testbed is set up to investigate the TCCM adaptive thermal management performances. • The TCCM has the potential for spacecrafts on-orbit services. - Abstract: An adaptive thermal control coldplate module (TCCM) was proposed in this paper to fulfill the requirements of modular thermal control systems for spacecrafts on-orbit services. The TCCM could provide flow rate and temperature co-adjustment by using Shape-Memory-Alloy (SMA) assembly which possesses self-driven abilities. In this paper, the adaptive thermal management mechanism of the TCCM integrated with a single phase mechanically pumped fluid loop (SPMPFL) is described in detail, a verification testbed was established to examine the TCCM dynamic characteristics. Various working conditions such as inlet temperature, flow rate and thermal load disturbances were imposed on the TCCM to inspect its startup and transient performance. It was observed that the TCCM may present robust temperature control results with low overshoot (maximum 16.8%) and small temperature control error (minimum 0.18%), fast time response (minimum 600 s) was also revealed. The results demonstrated that the well-designed TCCM provided effective autonomous flow-rate and temperature co-adjustment operations, which may be a promising candidate for realizing modular level adaptive thermal management for spacecrafts on-orbit services.

Microstructures and mechanical properties evolution of an Al–Fe–Cu alloy processed by repetitive continuous extrusion forming

Energy Technology Data Exchange (ETDEWEB)

Kong, Xiangxin [College of Materials Science and Engineering, Hunan University, Changsha 410082 (China); Zhang, Hui, E-mail: zhanghui63hunu@163.com [College of Materials Science and Engineering, Hunan University, Changsha 410082 (China); Hunan Province Key Laboratory for Spray Deposition Technology and Application, Hunan University, Changsha 410082 (China); Ji, Xiankun [College of Materials Science and Engineering, Hunan University, Changsha 410082 (China)

2014-08-26

Repetitive continuous extrusion forming process (R-Conform process), as a continuous severe plastic deformation method, was performed on a horizontal continuous casting Al–0.74Fe–0.23Cu alloy. The microstructural evolution and mechanical properties were studied by optical microscope, X-ray diffraction, scanning electron microscope, transmission electron microscope, and tensile testing. The results show that tensile ductility of the Al–0.74Fe–0.23Cu alloy is greatly improved but tensile strength is gradually decreased after repetitive Conform processing. The necking is more intense and the size of dimples becomes bigger with increasing Conform passes. The first pass Conform process induces obviously grains refining, dissolution of AlFe, AlFeSi and AlSi primary phases, strain-induced precipitation and transformation of crystal orientation distributions, but further Conform deformation only changes the redistribution of precipitates. The changes of mechanical properties may be attributed to a complex progress of recovery, recrystallization and redistribution of precipitates during repetitive Conform process.

[Cervical adaptation of complete cast crowns of various metal alloys, with and without die spacers].

Science.gov (United States)

Stephano, C B; Roselino, R F; Roselino, R B; Campos, G M

1989-01-01

A metallic replica from a dental preparation for crown was used to make 8 class-IV stone dies. The wax patterns for the casting of the crowns were obtained in two conditions: a) from the stone die with no spacer; and b) from the stone die with an acrylic spacer. Thus, 64 metallic crowns were casted, using 4 different alloys: DURACAST (Cu-Al), NICROCAST (Ni-Cr) and DURABOND (Ni-Cr), and gold. The casted crowns were fitted in the metallic replica and measured as to the cervical discrepance of fitting. The results showed that the use of die spacers decreases the clinical discrepancies of fitting of the casted crowns (in a statistically significant level), no matter the metallic alloy employed.

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

Science.gov (United States)

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. © The Author(s) 2014. Published by Oxford University Press

Pain education combined with neck- and aerobic training is more effective at relieving chronic neck pain than pain education alone - A preliminary randomized controlled trial

DEFF Research Database (Denmark)

Brage, K; Ris Hansen, Inge; Falla, D

2015-01-01

-shoulder exercises, balance and aerobic training) (INV), or pain education alone (CTRL). Effect on neck pain, function and Global Perceived Effect (GPE) were measured. Surface electromyography (EMG) was recorded from neck flexor and extensor muscles during performance of the Cranio-Cervical Flexion Test (CCFT......OBJECTIVE: To evaluate the effect of training and pain education vs pain education alone, on neck pain, neck muscle activity and postural sway in patients with chronic neck pain. METHODS: Twenty women with chronic neck pain were randomized to receive pain education and specific training (neck......) and three postural control tests (two-legged: eyes open and closed, one-legged: eyes open). Sway parameters were calculated. RESULTS: Fifteen participants (CTRL: eight; INV: seven) completed the study. Per protocol analyses showed a larger pain reduction (p = 0.002) for the INV group with tendencies...

Shape Morphing Adaptive Radiator Technology (SMART) for Variable Heat Rejection

Science.gov (United States)

Erickson, Lisa

2016-01-01

The proposed technology leverages the temperature dependent phase change of shape memory alloys (SMAs) to drive the shape of a flexible radiator panel. The opening/closing of the radiator panel, as a function of temperature, passively adapts the radiator's rate of heat rejection in response to a vehicle's needs.

Digital subtraction angiography in head and neck radiology

International Nuclear Information System (INIS)

Carmody, R.F.; Seeger, J.F.; Smith, R.L.; Horsley, W.W.; Miller, R.W.

1984-01-01

Intravenous digital subtraction angiography (IVDSA) was used to evaluate 44 patients with suspected otolaryngologic abnormalities. Sixteen had IVDSA for pulsatile tinnitus or suspected glomus tumor of the petrous bone. Nine patients were evaluated because of pulsatile neck masses, and 12 others had suspected tumors of the neck, face, and paranasal sinuses. Seven had IVDSA following head and neck trauma. The technique of examination is described. The current indications of IVDSA in head and neck radiology are discussed. It is concluded that IVDSA is a suitable substitute for conventional angiography for many otolaryngologic conditions and, because of its safety, can be used more liberally. (orig.)

Validity of the neck disability index, Northwick Park neck pain questionnaire, and problem elicitation technique for measuring disability associated with whiplash-associated disorders

NARCIS (Netherlands)

Hoving, Jan Lucas; O'Leary, Elizabeth F.; Niere, Ken R.; Green, Sally; Buchbinder, Rachelle

2003-01-01

The Neck Disability Index (NDI) and Northwick Park Neck Pain Questionnaire (NPQ) were developed to measure self-perceived disability from neck pain, including that which may arise from whiplash injury. However, there is little data specifically concerning their validity for whiplash-associated

Viable tumor in salvage neck dissections in head and neck cancer : Relation with initial treatment, change of lymph node size and human papillomavirus

NARCIS (Netherlands)

van den Bovenkamp, Karlijn; Dorgelo, Bart; Noordhuis, Maartje G; van der Laan, Bernard F A M; van der Vegt, Bert; Bijl, Hendrik P; Roodenburg, Jan L; van Dijk, Boukje A C; Oosting, Sjoukje F; Schuuring, Ed M D; Langendijk, Johannes A; Halmos, Gyorgy B; Plaat, Boudewijn E C

Objectives: To identify predictive factors for the presence of viable tumor and outcome in head and neck cancer patients who undergo therapeutic salvage neck dissections. Materials and Methods: Retrospective analysis of 76 salvage neck dissections after radiotherapy alone (n = 22), radiotherapy in

Preliminary Analysis of the General Performance and Mechanical Behavior of Irradiated FeCrAl Base Alloys and Weldments

Energy Technology Data Exchange (ETDEWEB)

Gussev, Maxim N. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Field, Kevin G. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Briggs, Samuel A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Yamamoto, Yukinori [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2016-09-30

The iron-based, iron-chromium-aluminum (FeCrAl) alloys are promising, robust materials for deployment in current and future nuclear power plants. This class of alloys demonstrates excellent performance in a range of environments and conditions, including high-temperature steam (>1000°C). Furthermore, these alloys have the potential to have prolonged survival under loss-of-coolant accident (LOCA) conditions compared to the more traditional cladding materials that are either Zr-based alloys or austenitic steels. However, one of the issues associated with FeCrAl alloys is cracking during welding. The present project investigates the possibility of mitigating welding-induced cracking via alloying and precise structure control of the weldments; in the frame work of the project, several advanced alloys were developed and are being investigated prior to and after neutron irradiation to provide insight into the radiation tolerance and mechanical performance of the weldments. The present report provides preliminary results on the post-irradiation characterization and mechanical tests performed during United States Fiscal Year (FY) 2016. Chapter 1 provides a general introduction, and Chapter 2 describes the alloy compositions, welding procedure, specimen geometry and manufacturing parameters. Also, a brief discussion of the irradiation at the High Flux Isotope Reactor (HFIR) is provided. Chapter 3 is devoted to the analysis of mechanical tests performed at the hot cell facility; tensile curves and mechanical properties are discussed in detail focusing on the irradiation temperature. Limited fractography results are also presented and analyzed. The discussion highlights the limitations of the testing within a hot cell. Chapter 4 underlines the advantages of in-situ testing and discusses the preliminary results obtained with newly developed miniature specimens. Specimens were moved to the Low Activation Materials Development and Analysis (LAMDA) laboratory and prepared for

Application of mechanical alloying to synthesis of intermetallic phases based alloys

International Nuclear Information System (INIS)

Dymek, S.

2001-01-01

Mechanical alloying is the process of synthesis of powder materials during milling in high energetic mills, usually ball mills. The central event in mechanical alloying is the ball-powder-ball collision. Powder particles are trapped between the colliding balls during milling and undergo deformation and/or fracture. Fractured parts are cold welded. The continued fracture and cold welding results in a uniform size and chemical composition of powder particles. The main applications of mechanical alloying are: processing of ODS alloys, syntheses of intermetallic phases, synthesis of nonequilibrium structures (amorphous alloys, extended solid solutions, nanocrystalline, quasi crystals) and magnetic materials. The present paper deals with application of mechanical alloying to synthesis Ni A l base intermetallic phases as well as phases from the Nb-Al binary system. The alloy were processed from elemental powders. The course of milling was monitored by scanning electron microscopy and X-ray diffraction. After milling, the collected powders were sieved by 45 μm grid and hot pressed (Nb alloys and NiAl) or hot extruded (NiAl). The resulting material was fully dense and exhibited fine grain (< 1 μm) and uniform distribution of oxide dispersoid. The consolidated material was compression and creep tested. The mechanical properties of mechanically alloys were superior to properties of their cast counterparts both in the room and elevated temperatures. Higher strength of mechanically alloyed materials results from their fine grains and from the presence of dispersoid. At elevated temperatures, the Nb-Al alloys have higher compression strength than NiAl-based alloys processed at the same conditions. The minimum creep rates of mechanically alloyed Nb alloys are an order of magnitude lower than analogously processed NiAl-base alloys. (author)

Ultrasonographic changes in malignant neck nodes during radiotherapy in head and neck squamous carcinoma

International Nuclear Information System (INIS)

Correa, P.D.; Laskar, S.G.; Shrivastava, S.K.; Dinshaw, K.A.; Gupta, T.; Agarwal, J.P.; Arya, S.

2005-01-01

Limited information is available about the sonomorphological changes in metastatic neck nodes during radiotherapy. The aim of this study was to evaluate the pattern of sonomorphological changes in metastatic neck nodes with radiotherapy. The study population consisted of 16 consecutive patients planned for radical radiotherapy to the head and neck. All patients were subjected to four ultrasound examinations: before therapy, at 46 Gy, at the conclusion of radiation and at first follow up. A total of 59 ultrasound examinations were performed on 16 patients. The difference between the mean number of nodes detected per patient before (10.6) and after (7.8) radiation was significant (P = 0.05). Sixteen nodes were categorized as malignant at first sonography, half of which reverted back to normal by the end of radiation. Changes in the sonomorphology of malignant cervical lymph nodes occur with radiotherapy with more that half demonstrating reversion to normal pattern. Future studies correlating this with histopathology should be considered Copyright (2005) Blackwell Publishing Asia Pty Ltd

Outcome-based anatomic criteria for defining the hostile aortic neck.

Science.gov (United States)

Jordan, William D; Ouriel, Kenneth; Mehta, Manish; Varnagy, David; Moore, William M; Arko, Frank R; Joye, James; de Vries, Jean-Paul P M

2015-06-01

There is abundant evidence linking hostile proximal aortic neck anatomy to poor outcome after endovascular aortic aneurysm repair (EVAR), yet the definition of hostile anatomy varies from study to study. This current analysis was undertaken to identify anatomic criteria that are most predictive of success or failure at the aortic neck after EVAR. The study group comprised 221 patients in the Aneurysm Treatment using the Heli-FX Aortic Securement System Global Registry (ANCHOR) clinical trial, a population enriched with patients with challenging aortic neck anatomy and failure of sealing. Imaging protocols were not protocol specified but were performed according to the institution's standard of care. Core laboratory analysis assessed the three-dimensional centerline-reformatted computed tomography scans. Failure at the aortic neck was defined by type Ia endoleak occurring at the time of the initial endograft implantation or during follow-up. Receiver operating characteristic curve analysis was used to assess the value of each anatomic measure in the classification of aortic neck success and failure and to identify optimal thresholds of discrimination. Binary logistic regression was performed after excluding highly intercorrelated variables, creating a final model with significant predictors of outcome after EVAR. Among the 221 patients, 121 (54.8%) remained free of type Ia endoleak and 100 (45.2%) did not. Type Ia endoleaks presented immediately after endograft deployment in 58 (58.0%) or during follow-up in 42 (42.0%). Receiver operating characteristic curve analysis identified 12 variables where the classification of patients with type Ia endoleak was significantly more accurate than chance alone. Increased aortic neck diameter at the lowest renal artery (P = .013) and at 5 mm (P = .008), 10 mm (P = .008), and 15 mm (P = .010) distally; aneurysm sac diameter (P = .001), common iliac artery diameters (right, P = .012; left, P = .032), and a conical (P = .049) neck

Effect of neck warming and cooling on thermal comfort

Science.gov (United States)

Williams, B. A.; Chambers, A. B.

1972-01-01

The potential use of local neck cooling in an area superficial to the cerebral arteries was evaluated by circulating cold or hot water through two copper disks held firmly against the neck. Subjective responses indicated that neck cooling improves the thermal comfort in a hot environment.

Prevention of flight-related neck pain in military aircrew

NARCIS (Netherlands)

van den Oord, M.H.A.H.

2012-01-01

Military pilots and rear aircrew members are occupations with several occupational exposures that might cause neck pain. In addition to the negative impact of neck pain on health, safety is one of the main concerns for the military aviation, because neck pain may interfere with flying performance.

Shoulder morbidity after non-surgical treatment of the neck.

NARCIS (Netherlands)

van Wouwe, V.; de Bree, R.; Kuik, D.J.; de Goede, C.J.T.; de Leeuw, I.M.; Leemans, C.R.

2009-01-01

Background and purpose: Reports on shoulder function after non-surgical treatment are not available. In the present study shoulder morbidity after surgical and non-surgical treatment of the neck is determined and compared. Materials and methods: In 100 head and neck cancer patients 174 neck sides

Conservative Management of Mechanical Neck Pain in a Helicopter Pilot.

Science.gov (United States)

Alagha, Babak

2015-10-01

Acute and chronic spinal symptoms such as neck pain may limit flying performance significantly and disqualify the pilot from flight duty. Mechanical neck pain is very common among pilots because of their exposure to vibration, +GZ forces, helmet weight, poor neck posture during air combat maneuvers, previous neck injuries, and poor treatment plans for such injuries. Successful treatment of such injuries requires appropriate therapeutic procedures as well as an aeromedical assessment. The aim of this case study was to demonstrate the benefits of conservative procedures such as spinal manipulation and mobilization therapy (SMMT) and exercise therapy (ET) in treating chronic mechanical neck pain in an Iranian commercial helicopter pilot. A 36-yr-old male patient presented to the clinic with moderate, intermittent nonradicular chronic neck pain and limited range of motion over a 2-yr period. The patient was treated with cervical and upper thoracic SMMT followed by home ET for 5 wk. After this period, the patient reported significant recovery and improvement in range of motion in his neck. Mechanical neck pain is very common among helicopter pilots. Although Air Force and Navy waiver guides recommend nonsteroidal anti-inflammatory medications as well as SMMT and ET, there are currently very few published studies that examine the benefits of manual and exercise therapy for treating mechanical neck pain in commercial and military pilots. Based on the results of this study, it seems that SMMT and ET may be a safe and effective in treatment of uncomplicated mechanical neck pain in helicopter pilots. Alagha B. Conservative management of mechanical neck pain in a helicopter pilot.

The articulation of sauropod necks: methodology and mythology.

Science.gov (United States)

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.

The Articulation of Sauropod Necks: Methodology and Mythology

Science.gov (United States)

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

The incidence of late neck recurrence in N0 maxillary sinus squamous cell carcinomas after superselective intra-arterial chemoradiotherapy without prophylactic neck irradiation.

Science.gov (United States)

Sakashita, Tomohiro; Homma, Akihiro; Hatakeyama, Hiromitsu; Kano, Satoshi; Mizumachi, Takatsugu; Furusawa, Jun; Yoshida, Daisuke; Fujima, Noriyuki; Onimaru, Rikiya; Tsuchiya, Kazuhiko; Yasuda, Koichi; Shirato, Hiroki; Fukuda, Satoshi

2014-10-01

The efficacy of elective neck irradiation (ENI) for patients with N0 carcinoma of the maxillary sinus has been controversial. The purpose of our study was to investigate the incidence of late neck recurrence and the mortality rate from regional disease in patients with N0 maxillary sinus cancer after superselective cisplatin infusion and concomitant radiotherapy (RADPLAT) without ENI. We retrospectively analyzed 48 patients with N0 maxillary sinus cancer who underwent RADPLAT. Chemotherapy consisted of 100-120 mg/m(2) superselective intra-arterial cisplatin administered at a median rate of four times weekly. Concurrent radiation therapy was administered at a median dose of 65 Gy without ENI. Late neck recurrence was observed in 8.3% (4/48). Three patients underwent salvage neck dissection and survived without any evidence of disease. The remaining patient did not undergo neck dissection due to coexistence with distant metastasis, and he died of regional disease. The mortality rate from regional disease was calculated to be 2% (1/48). The incidence of late neck recurrence was not frequent, and the mortality rate from regional disease was low. Salvage neck dissection was considered to be feasible for patients with late neck recurrence. When definitive radiotherapy and concomitant chemotherapy are applied, it is considered that ENI is not required for cases of N0 maxillary sinus cancer.

Acupuncture at Houxi (SI 3) acupoint for acute neck pain caused by stiff neck: study protocol for a pilot randomised controlled trial.

Science.gov (United States)

Sun, Zhong-ren; Yue, Jin-huan; Tian, Hong-zhao; Zhang, Qin-hong

2014-12-23

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. 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). 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. ChiCTR-TRC-13003911. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

TCGA head Neck

Science.gov (United States)

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

Clinical Practice Guideline: Evaluation of the Neck Mass in Adults.

Science.gov (United States)

Pynnonen, Melissa A; Gillespie, M Boyd; Roman, Benjamin; Rosenfeld, Richard M; Tunkel, David E; Bontempo, Laura; Brook, Itzhak; Chick, Davoren Ann; Colandrea, Maria; Finestone, Sandra A; Fowler, Jason C; Griffith, Christopher C; Henson, Zeb; Levine, Corinna; Mehta, Vikas; Salama, Andrew; Scharpf, Joseph; Shatzkes, Deborah R; Stern, Wendy B; Youngerman, Jay S; Corrigan, Maureen D

2017-09-01

Objective Neck masses are common in adults, but often the underlying etiology is not easily identifiable. While infections cause most of the neck masses in children, most persistent neck masses in adults are neoplasms. Malignant neoplasms far exceed any other etiology of adult neck mass. Importantly, an asymptomatic neck mass may be the initial or only clinically apparent manifestation of head and neck cancer, such as squamous cell carcinoma (HNSCC), lymphoma, thyroid, or salivary gland cancer. Evidence suggests that a neck mass in the adult patient should be considered malignant until proven otherwise. Timely diagnosis of a neck mass due to metastatic HNSCC is paramount because delayed diagnosis directly affects tumor stage and worsens prognosis. Unfortunately, despite substantial advances in testing modalities over the last few decades, diagnostic delays are common. Currently, there is only 1 evidence-based clinical practice guideline to assist clinicians in evaluating an adult with a neck mass. Additionally, much of the available information is fragmented, disorganized, or focused on specific etiologies. In addition, although there is literature related to the diagnostic accuracy of individual tests, there is little guidance about rational sequencing of tests in the course of clinical care. This guideline strives to bring a coherent, evidence-based, multidisciplinary perspective to the evaluation of the neck mass with the intention to facilitate prompt diagnosis and enhance patient outcomes. Purpose The primary purpose of this guideline is to promote the efficient, effective, and accurate diagnostic workup of neck masses to ensure that adults with potentially malignant disease receive prompt diagnosis and intervention to optimize outcomes. Specific goals include reducing delays in diagnosis of HNSCC; promoting appropriate testing, including imaging, pathologic evaluation, and empiric medical therapies; reducing inappropriate testing; and promoting appropriate

Neck Flexor and Extensor Muscle Endurance in Subclinical Neck Pain: Intrarater Reliability, Standard Error of Measurement, Minimal Detectable Change, and Comparison With Asymptomatic Participants in a University Student Population.

Science.gov (United States)

Lourenço, Ana S; Lameiras, Carina; Silva, Anabela G

2016-01-01

The aims of this study were to assess intrarater reliability and to calculate the standard error of measurement (SEM) and minimal detectable change (MDC) for deep neck flexor and neck extensor muscle endurance tests, and compare the results between individuals with and without subclinical neck pain. Participants were students of the University of Aveiro reporting subclinical neck pain and asymptomatic participants matched for sex and age to the neck pain group. Data on endurance capacity of the deep neck flexors and neck extensors were collected by a blinded assessor using the deep neck flexor endurance test and the extensor endurance test, respectively. Intraclass correlation coefficients (ICCs), SEM, and MDC were calculated for measurements taken within a session by the same assessor. Differences between groups for endurance capacity were investigated using a Mann-Whitney U test. The deep neck flexor endurance test (ICC = 0.71; SEM = 6.91 seconds; MDC = 19.15 seconds) and neck extensor endurance test (ICC = 0.73; SEM = 9.84 minutes; MDC = 2.34 minutes) are reliable. No significant differences were found between participants with and without neck pain for both tests of muscle endurance (P > .05). The endurance capacity of the deep neck flexors and neck extensors can be reliably measured in participants with subclinical neck pain. However, the wide SEM and MDC might limit the sensitivity of these tests. Copyright © 2016. Published by Elsevier Inc.

Fragmentation of neck-like structures

International Nuclear Information System (INIS)

Montoya, C.; Bowman, D.R.; Peaslee, G.F.; Michigan State Univ., East Lansing, MI

1994-01-01

Evidence for intermediate mass fragment emission from neck-like structures joining projectile- and target-like residues has been observed for peripheral 129 Xe+ nat Cu collisions at E/A=50 MeV. These framents are emitted primarily at velocities intermediate between those of the projectile and the target. Relative to the charge distribution for fragments evaporated from the projectile-like residue, the distribution for ''neck'' emission shows an enhanced emission for fragments with 4 f < 8. (orig.)

Unusual head and neck injury in elevator: autopsy study.

Science.gov (United States)

Eren, B; Türkmen, N; Dokgöz, H

2012-10-01

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

Recurrence of ICA-PCoA aneurysms after neck clipping.

Science.gov (United States)

Sakaki, T; Takeshima, T; Tominaga, M; Hashimoto, H; Kawaguchi, S

1994-01-01

Between 1975 and 1992, 2211 patients underwent aneurysmal neck clipping at the Nara Medical University clinic and associated hospitals. The aneurysm in 931 of these patients was situated at the junction of the internal carotid artery (ICA) and posterior communicating artery (PCoA). Seven patients were readmitted 4 to 17 years after the first surgery because of regrowth and rupture of an ICA-PCoA aneurysmal sac that had arisen from the residual neck. On angiograms obtained following aneurysmal neck clipping, a large primitive type of PCoA was demonstrated in six patients and a small PCoA in one. A small residual aneurysm was confirmed in only two patients and angiographically complete neck clipping in five. Recurrent ICA-PCoA aneurysms were separated into two types based on the position of the old clip in relation to the new growth. Type 1 aneurysms regrow from the entire neck and balloon eccentrically. In this type, it is possible to apply the clip at the neck as in conventional clipping for a ruptured aneurysm. Type 2 includes aneurysms in which the proximal portion of a previous clip is situated at the corner of the ICA and aneurysmal neck and the distal portion on the enlarged dome of the aneurysm, because the sac is regrowing from a portion of the residual neck. In this type of aneurysm, a Sugita fenestrated clip can occlude the residual neck, overriding the old clip. Classifying these aneurysms into two groups is very useful from a surgical point of view because it is possible to apply a new clip without removing the old clip, which was found to be adherent to surrounding tissue.

Chronic Neck Pain and Whiplash: A Case-Control Study of the Relationship between Acute Whiplash Injuries and Chronic Neck Pain

OpenAIRE

Freeman, Michael D; Croft, Arthur C; Rossignol, Annette M; Centeno, Christopher J; Elkins, Whitney L

2006-01-01

The authors undertook a case-control study of chronic neck pain and whiplash injuries in nine states in the United States to determine whether whiplash injuries contributed significantly to the population of individuals with chronic neck and other spine pain.Four hundred nineteen patients and 246 controls were randomly enrolled. Patients were defined as individuals with chronic neck pain, and controls as those with chronic back pain. The two groups were surveyed for cause of chronic pain as w...

Automated Image-Based Procedures for Adaptive Radiotherapy

DEFF Research Database (Denmark)

Bjerre, Troels

be employed for contour propagation in adaptive radiotherapy. - MRI-radiotherapy devices have the potential to offer near real-time intrafraction imaging without any additional ionising radiation. It is detailed how the use of multiple, orthogonal slices can form the basis for reliable 3D soft tissue tracking.......-based treatment replanning and real-time intrafraction guidance techniques. The selected contributions detail a number of findings and techniques, in particular: - For ten head & neck cancer patients, changes in tumour density were well described by linear functions with patient-specific slope and intercept...

Femoral neck radiography: effect of flexion on visualization

International Nuclear Information System (INIS)

Garry, S.C.; Jhangri, G.S.; Lambert, R.G.W.

2005-01-01

To determine whether flexion improves radiographic visualization of the femoral neck when the femur is externally rotated. Five human femora, with varying neck-shaft and anteversion angles, were measured and immobilized. Degree of flexion required to bring the femoral neck horizontal was measured, varying the rotation. Next, one bone was radiographed in 16 positions, varying rotation in 15 o and flexion in 10 o increments. Radiographs were presented in randomized blinded fashion to 15 staff radiologists for scoring of femoral neck visualization. Following this, all 5 bones were radiographed in 4 positions of rotation and at 0 o and 20 o flexion, and blinded randomized review of radiographs was repeated. Comparisons between angles and rotations were made using the Mann-Whitney test. The flexion angle required to bring the long axis of the femoral neck horizontal correlated directly with the degree of external rotation (ρ o internal rotation to 30 o external rotation (ρ o flexion was applied to bones in external rotation, visualization significantly improved at 15 o (ρ o (ρ o ) of flexion can significantly improve radiographic visualization. This manoeuvre could be useful for radiography of the femoral neck when initial radiographs are inadequate because of external rotation of the leg. (author)

Neck pain in children: a retrospective case series.

Science.gov (United States)

Cox, Jocelyn; Davidian, Christine; Mior, Silvano

2016-09-01

Spinal pain in the paediatric population is a significant health issue, with an increasing prevalence as they age. Paediatric patients attend for chiropractor care for spinal pain, yet, there is a paucity of quality evidence to guide the practitioner with respect to appropriate care planning. A retrospective chart review was used to describe chiropractic management of paediatric neck pain. Two researchers abstracted data from 50 clinical files that met inclusion criteria from a general practice chiropractic office in the Greater Toronto Area, Canada. Data were entered into SPSS 15 and descriptively analyzed. Fifty paediatric neck pain patient files were analysed. Patients' age ranged between 6 and 18 years (mean 13 years). Most (98%) were diagnosed with Grade I-II mechanical neck pain. Treatment frequency averaged 5 visits over 19 days; with spinal manipulative therapy used in 96% of patients. Significant improvement was recorded in 96% of the files. No adverse events were documented. Paediatric mechanical neck pain appears to be successfully managed by chiropractic care. Spinal manipulative therapy appears to benefit paediatric mechanical neck pain resulting from day-today activities with no reported serious adverse events. Results can be used to inform clinical trials assessing effectiveness of manual therapy in managing paediatric mechanical neck pain.

Assessment of the Sheffield Support Snood, an innovative cervical orthosis designed for people affected by neck muscle weakness

OpenAIRE

Pancani, Silvia; Rowson, Jennifer; Tindale, Wendy; Heron, Nicola; Langley, Joe; McCarthy, Avril D.; Quinn, Ann; Reed, Heath; Stanton, Andrew; Shaw, Pamela J.; McDermott, Christopher J.; Mazzà, Claudia

2016-01-01

The aim of this study was to quantify the biomechanical features of the Sheffield Support Snood (SSS), a cervical orthosis specifically designed for patients with neck weakness. The orthosis is designed to be adaptable to a patient’s level of functional limitation using adjustable removable supports, which contribute support and restrict movement only in desired anatomical planes. \\ud Methods: The SSS was evaluated along with two commercially available orthoses, the Vista and Headmaster. The ...

Surface modification of 5083 Al alloy by electrical discharge alloying processing with a 75 mass% Si-Fe alloy electrode

Energy Technology Data Exchange (ETDEWEB)

Stambekova, Kuralay [Department of Materials Science and Engineering, National Chung Hsing University, 250 Kuo-Kuang Rd., Taichung 40227, Taiwan (China); Lin, Hung-Mao [Department of Mechanical Engineering, Far East University, No. 49, Zhonghua Rd., Xinshi Dist., Tainan City 74448, Taiwan (China); Uan, Jun-Yen, E-mail: jyuan@dragon.nchu.edu.tw [Department of Materials Science and Engineering, National Chung Hsing University, 250 Kuo-Kuang Rd., Taichung 40227, Taiwan (China)

2012-03-01

This study experimentally investigates the surface modification of 5083 Al alloy by the electrical discharge alloying (EDA) process with a Si-Fe alloy as an electrode. Samples were analyzed by transmission electron microscopy (TEM), scanning electron microscopy (SEM), micro-hardness and corrosion resistance tests. The micro-hardness of EDA alloyed layer was evidently higher than that of the base metal (5083 Al alloy). The TEM results show that the matrix of the alloyed layer has an amorphous-like structure; the matrix contains fine needle-like Si particles, block-like Si particles and nano-size Al{sub 4.5}FeSi and Al{sub 13}Fe{sub 4} particles. The TEM results support experimental results for the high hardness of the alloyed layer. Moreover, the EDA alloyed layer with composite microstructures has good corrosion resistance in NaCl aqueous solution.

Synthesis Of NiCrAlC alloys by mechanical alloying

International Nuclear Information System (INIS)

Silva, A.K.; Pereira, J.I.; Vurobi Junior, S.; Cintho, O.M.

2010-01-01

The purpose of the present paper is the synthesis of nickel alloys (NiCrAlC), which has been proposed like a economic alternative to the Stellite family Co alloys using mechanical alloying, followed by sintering heat treatment of milled material. The NiCrAlC alloys consist of a chromium carbides dispersion in a Ni 3 Al intermetallic matrix, that is easily synthesized by mechanical alloying. The use of mechanical alloying enables higher carbides sizes and distribution control in the matrix during sintering. We are also investigated the compaction of the processed materials by compressibility curves. The milling products were characterized by X-ray diffraction, and the end product was featured by conventional metallography and scanning electronic microscopy (SEM), that enabled the identification of desired phases, beyond microhardness test, which has been shown comparable to alloys manufactured by fusion after heat treating. (author)

Shoulder morbidity after non-surgical treatment of the neck

International Nuclear Information System (INIS)

Wouwe, Merian van; Bree, Remco de; Kuik, Dirk J.; Goede, Cees J.T. de; Verdonck-de Leeuw, Irma M.; Doornaert, Patricia; Rene Leemans, C.

2009-01-01

Background and purpose: Reports on shoulder function after non-surgical treatment are not available. In the present study shoulder morbidity after surgical and non-surgical treatment of the neck is determined and compared. Materials and methods: In 100 head and neck cancer patients 174 neck sides were treated by surgery (n = 51) or (chemo)radiation (n = 123). Abduction, anteflexion, endorotation and exorotation were assessed. Subjective measurements were performed using the Visual Analogue Scale for pain, the Shoulder Disability Questionnaire (SDQ) and stiffness reporting. Results: Predictive factors for SDQ-score > 0 (n = 54) were VAS pain score, stiffness, abduction, anteflexion, physiotherapy, low shoulder position and surgical treatment. The SDQ, stiffness and pain scores were significantly higher in the surgically treated group than in the non-surgical group (p < 0.01). Anteflexion, abduction and exorotation were less impaired in the non-surgically treated group than in the surgically treated group (p < 0.01). No differences between neck dissection and neck dissection with post-operative radiotherapy, and radiotherapy and chemoradiation were found for these movements. Conclusions: Shoulder morbidity is often present after non-surgical treatment of the neck, but to a lesser extent compared to surgical treatment. Radiotherapy adds no morbidity to neck dissection and chemotherapy does not add extra morbidity to primary radiation

Gender differences in head-neck segment dynamic stabilization during head acceleration.

Science.gov (United States)

Tierney, Ryan T; Sitler, Michael R; Swanik, C Buz; Swanik, Kathleen A; Higgins, Michael; Torg, Joseph

2005-02-01

Recent epidemiological research has revealed that gender differences exist in concussion incidence but no study has investigated why females may be at greater risk of concussion. Our purpose was to determine whether gender differences existed in head-neck segment kinematic and neuromuscular control variables responses to an external force application with and without neck muscle preactivation. Forty (20 females and 20 males) physically active volunteers participated in the study. The independent variables were gender, force application (known vs unknown), and force direction (forced flexion vs forced extension). The dependent variables were kinematic and EMG variables, head-neck segment stiffness, and head-neck segment flexor and extensor isometric strength. Statistical analyses consisted of multiple multivariate and univariate analyses of variance, follow-up univariate analyses of variance, and t-tests (P Gender differences existed in head-neck segment dynamic stabilization during head angular acceleration. Females exhibited significantly greater head-neck segment peak angular acceleration (50%) and displacement (39%) than males despite initiating muscle activity significantly earlier (SCM only) and using a greater percentage of their maximum head-neck segment muscle activity (79% peak activity and 117% muscle activity area). The head-neck segment angular acceleration differences may be because females exhibited significantly less isometric strength (49%), neck girth (30%), and head mass (43%), resulting in lower levels of head-neck segment stiffness (29%). For our subject demographic, the results revealed gender differences in head-neck segment dynamic stabilization during head acceleration in response to an external force application. Females exhibited significantly greater head-neck segment peak angular acceleration and displacement than males despite initiating muscle activity earlier (SCM only) and using a greater percentage of their maximum head-neck segment

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

Science.gov (United States)

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

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

Directory of Open Access Journals (Sweden)

Vogel Tobias

2006-06-01

Full Text Available Abstract Chronic neck pain is widely prevalent and a common source of disability in the working-age population. Etiology of chronic neck pain includes neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain as well as pain due to degenerative changes. We report the case of a 42 year old secretary, complaining about a longer history of neck pain and limited movement of the cervical spine. Surprisingly, the adequate radiologic examination revealed a bilateral ossification of the stylohyoid ligament complex. Her symptoms remained intractable from conservative treatment consisting of anti-inflammatory medication as well as physical therapy. Hence the patient was admitted to surgical resection of the ossified stylohyoid ligament complex. Afterwards she was free of any complaints and went back to work. Therefore, ossification of the stylohyoid ligament complex causing severe neck pain and movement disorder should be regarded as a rare differential diagnosis of occupational related neck pain.

Topographic Pattern Distribution of Head And Neck Squamous Cell ...

African Journals Online (AJOL)

FINEPRINT

value of 71% of SCC in Turkey. Nevertheless a similar report documented a relatively lower value especially in. Yemen where head and neck SCC constituted only 8% of all head and neck cancers. Reports from Yemen revealed that oral cavity SCC was the most common topographic site of all head and. 3 neck cancers.

A Septin-Dependent Diffusion Barrier at Dendritic Spine Necks.

Directory of Open Access Journals (Sweden)

Helge Ewers

Full Text Available 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.

Cervical biomechanics and neck pain of "head-spinning" breakdancers.

Science.gov (United States)

Kauther, M D; Piotrowski, M; Hussmann, B; Lendemans, S; Wedemeyer, C; Jaeger, M

2014-05-01

The cervical spine of breakdancers is at great risk due to reversed body loading during headspin manoeuvers. This study focused on the cervical biomechanics of breakdancers and a correlation with neck pain. A standardized interview and biomechanical testing of the cervical spine of 25 participants with "headspin" ability ages 16-34 years and an age-matched cohort of 25 participants without any cervical spine problems was conducted. Neck pain history, Neck Disability Index (NDI), cervical range of motion (CROM) and cervical torque were recorded. The "headspin" group reported significantly better subjective fitness, more cervical complaints, higher pain intensity, a longer history of neck pain and a worse NDI compared to the "normal" collective. The "headspin" group showed a 2-2.5 times higher rate of neck pain than the normal population, with increased cervical flexion (pcervical torque in all planes (ppain intensity and history of neck pain. Sports medicine practitioners should be aware of headspin maneuver accidents that pose the risk of fractures, dislocations and spinal cord injuries of breakdancers. © Georg Thieme Verlag KG Stuttgart · New York.

An exponential material model for prediction of the flow curves of several AZ series magnesium alloys in tension and compression

International Nuclear Information System (INIS)

Fereshteh-Saniee, F.; Barati, F.; Badnava, H.; Fallah Nejad, Kh.

2012-01-01

Highlights: ► The exponential model can represent flow behaviors of AZ series Mg alloys very well. ► Strain rate sensitivities of AZ series Mg alloys in compression are nearly the same. ► Effect of zinc element on tensile activation energy is higher than on compressive one. ► Activation energies of AZ80 and AZ81 in tension were greater than in compression. ► Tensile and compressive rate sensitivities of AZ80 are not close to each other. -- Abstract: This paper is concerned with flow behaviors of several magnesium alloys, such as AZ31, AZ80 and AZ81, in tension and compression. The experiments were performed at elevated temperatures and for various strain rates. In order to eliminate the effect of inhomogeneous deformation in tensile and compression tests, the Bridgeman’s and numerical correction factors were respectively employed. A two-section exponential mathematical model was also utilized for prediction of flow stresses of different magnesium alloys in tension and compression. Moreover, based on the compressive flow model proposed, the peak stress and the relevant true strain could be estimated. The true stress and strain of the necking point can also be predicted using the corresponding relations. It was found that the flow behaviors estimated by the exponential flow model were encouragingly in very good agreement with experimental findings.

Impact of Zr + 2.5% Nb alloy corrosion upon operability of RBMK-1000 fuel channels

International Nuclear Information System (INIS)

Kovyrshin, V.; Zaritsky, N.

1999-01-01

The basic components of RBMK-1000 core (fuel channels, bimetal adapters, claddings of fuel elements, etc.) are of zirconium alloys. Their corrosion is one of factors influencing upon fuel channels operability. Dynamics of channel tubes nodular corrosion development is presented by the results of in-reactor investigation at ChNPP. Radiation-induced mechanism of corrosion damage of tubes surface in contact with coolant was formulated and substantiated by data of post-reactor studies. Within the certain time period of operation corrosion of zirconium alloy of lower bimetal adapter along with removal from there of corrosion products are predominant within the whole process of reactor elements corrosion. The experimental and calculating method was proposed and substantiated to predict time duration up to loss of fuel channels leak tightness. The approaches were generalized to control state of fuel channels material to assess their operability under operation of RBMK-1000 reactors. (author)

SU-E-J-68: Adaptive Radiotherapy of Head and Neck Cancer: Re-Planning Based On Prior Dose

Energy Technology Data Exchange (ETDEWEB)

Dogan, N; Padgett, K [University of Miami Miller School of Medicine, Miami, FL (United States); Evans, J; Sleeman, W; Song, S [Virginia Commonwealth University, Richmond, VA (United States); Fatyga, M [Mayo Clinic Arizona, Phoenix, AZ (United States)

2015-06-15

Purpose: Adaptive Radiotherapy (ART) with frequent CT imaging has been used to improve dosimetric accuracy by accounting for anatomical variations, such as primary tumor shrinkage and/or body weight loss, in Head and Neck (H&N) patients. In most ART strategies, the difference between the planned and the delivered dose is estimated by generating new plans on repeated CT scans using dose-volume constraints used with the initial planning CT without considering already delivered dose. The aim of this study was to assess the dosimetric gains achieved by re-planning based on prior dose by comparing them to re-planning not based-on prior dose for H&N patients. Methods: Ten locally-advanced H&N cancer patients were selected for this study. For each patient, six weekly CT imaging were acquired during the course of radiotherapy. PTVs, parotids, cord, brainstem, and esophagus were contoured on both planning and six weekly CT images. ART with weekly re-plans were done by two strategies: 1) Generating a new optimized IMRT plan without including prior dose from previous fractions (NoPriorDose) and 2) Generating a new optimized IMRT plan based on the prior dose given from previous fractions (PriorDose). Deformable image registration was used to accumulate the dose distributions between planning and six weekly CT scans. The differences in accumulated doses for both strategies were evaluated using the DVH constraints for all structures. Results: On average, the differences in accumulated doses for PTV1, PTV2 and PTV3 for NoPriorDose and PriorDose strategies were <2%. The differences in Dmean to the cord and brainstem were within 3%. The esophagus Dmean was reduced by 2% using PriorDose. PriorDose strategy, however, reduced the left parotid D50 and Dmean by 15% and 14% respectively. Conclusion: This study demonstrated significant parotid sparing, potentially reducing xerostomia, by using ART with IMRT optimization based on prior dose for weekly re-planning of H&N cancer patients.

Effectiveness of the Pilates Method in the Treatment of Chronic Mechanical Neck Pain: A Randomized Controlled Trial.

Science.gov (United States)

de Araujo Cazotti, Luciana; Jones, Anamaria; Roger-Silva, Diego; Ribeiro, Luiza Helena Coutinho; Natour, Jamil

2018-05-09

To assess the effectiveness of the Pilates method on pain, function, quality of life, and consumption of pain medication in patients with mechanical neck pain. The design was a randomized controlled trial, with a blinded assessor and intention-to-treat analysis. The study took place in the outpatient clinic of the rheumatology department, referral center. Sixty-four patients with chronic mechanical neck pain were randomly allocated into 2 groups: the Pilates group (PG) and control group (CG). The PG attended 2 sessions of Pilates per week, for 12 weeks. The protocol included Pilates exercises performed on a mat and on equipment and was adapted depending on the physical fitness of each participant; the repetitions varied from 6 to 12, respecting patient reports of fatigue and pain, using a single series for each exercise. The CG received only the standard pharmacological treatment. Both groups were instructed to use acetaminophen 750 mg if necessary. Patients were evaluated at baseline after 45, 90, and 180 days. We used the numerical pain scale (NPS) for pain; the neck disability index (NDI) for function, and the SF-36 questionnaire for quality of life. The groups were homogeneous at baseline, the only exception being body mass index (BMI), with the PG showing higher BMI. Regarding the assessment between groups over time (ANOVA), statistical differences were identified for pain (p Pilates method for the treatment of chronic mechanical neck pain, resulting in improvement of pain, function, quality of life, and reduction of the use of analgesics. Copyright © 2018. Published by Elsevier Inc.

Hypothyroidism after Radiotherapy of Locally Advanced Head and Neck Cancer

International Nuclear Information System (INIS)

Lee, Jeong Eun; Eun; Kim, Jae Chul; Park, In Kyu; Yea, Ji Woon

2010-01-01

The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. The 1- and 3- year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patients especially with the risk factor of neck node dissection.

Hypothyroidism after Radiotherapy of Locally Advanced Head and Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

Lee, Jeong Eun; Eun; Kim, Jae Chul; Park, In Kyu [Kyungpook National Yonsei University School of Medicine, Daegu (Korea, Republic of); Yea, Ji Woon [Dongguk University Gyeongju Hospital, Gyeongju (Korea, Republic of)

2010-11-15

The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. The 1- and 3- year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patients especially with the risk factor of neck node dissection.

Skate blade neck lacerations: a survey and case follow-up.

Science.gov (United States)

Stuart, Michael J; Link, Andrew A; Smith, Aynsley M; Krause, David A; Sorenson, Matthew C; Larson, Dirk R

2009-11-01

To learn about neck lacerations caused by skate blades in hockey. A retrospective Web-based survey and follow-up of registered USA Hockey players. Three hundred twenty-eight thousand eight hundred twenty-one of 457 038 registered USA Hockey players with a current e-mail address were contacted and invited to participate in the survey. Of 26 589 players (5.8% of all USA registered players) who responded to the survey, 247 were excluded due to incomplete data. Of 26 342 surveys analyzed, 23 199 respondents were men (88%), 3015 women (11.4%), and 128 (0.5%) did not designate gender. An original survey instrument was developed, formatted, and linked to a Mayo Clinic Web site. Neck lacerations from a skate blade, including mechanism, severity, treatment required, and the type of neck protector worn. Of the 26 342 respondents, 11 935 (45.4%) currently wear neck protection and 485 (1.8%) have sustained a neck laceration. When the laceration occurred, 132 of the players (27%) were wearing neck protection. Interviews with 33 injured players established that lacerations were superficial: 20 (61%) required bandaging only, 11 were sutured, and 2 were glued. Based on this survey, the currently available neck laceration protectors do not eliminate the risk of a neck laceration from a skate blade.

The Relationship Between Neck Pain and Physical Activity

OpenAIRE

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...

Correlation between diffusion barriers and alloying energy in binary alloys

DEFF Research Database (Denmark)

Vej-Hansen, Ulrik Grønbjerg; Rossmeisl, Jan; Stephens, Ifan

2016-01-01

In this paper, we explore the notion that a negative alloying energy may act as a descriptor for long term stability of Pt-alloys as cathode catalysts in low temperature fuel cells.......In this paper, we explore the notion that a negative alloying energy may act as a descriptor for long term stability of Pt-alloys as cathode catalysts in low temperature fuel cells....

Changes of postural control and muscle activation pattern in response to external perturbations after neck flexor fatigue in young subjects with and without chronic neck pain.

Science.gov (United States)

Cheng, Chih-Hsiu; Chien, Andy; Hsu, Wei-Li; Yen, Ling-Wei; Lin, Yang-Hua; Cheng, Hsin-Yi Kathy

2015-03-01

Previous studies have identified sensorimotor disturbances and greater fatigability of neck muscles in patients with neck pain. The purpose of this study was to investigate the effect of neck pain and neck flexor fatigue on standing balance following postural perturbations. Twenty patients with chronic neck pain (CNP) (24.7±3.6 year-old) and 20 age-matched asymptomatic subjects (22.1±2.2 year-old) were recruited. Subjects stood barefoot on a force plate and experienced backward perturbations before and after neck flexor fatigue. Center of pressure, electromyography of cervical and lumbar muscles, and head/trunk accelerations were recorded. Two-way ANOVA (pain×fatigue) was used for statistical analysis. CNP group showed larger body sway during quiet standing but not during perturbed standing compared with asymptomatic adults. In both groups, neck flexor fatigue resulted in greater body sway during the quiet standing but smaller body sway during perturbed standing, increased neck muscle activations and decreased lumbar muscle activations, as well as increased time to maximal head acceleration. Disturbed balance control was observed in CNP patients during the quiet standing. However, a rigid strategy was used to minimize the postural sway and to protect the head against backward perturbations in both CNP and asymptomatic young adults after neck flexor fatigue. The results facilitate the understanding of how the subjects with chronic neck pain and with neck muscle fatigue deal with the challenging condition. Further studies are needed to verify if such phenomenon could be changed after the intervention of specific flexor muscle retraining and balance control exercises. Copyright © 2015 Elsevier B.V. All rights reserved.

Bilateral experimental neck pain reorganize axioscapular muscle coordination and pain sensitivity.

Science.gov (United States)

Christensen, S W; Hirata, R P; Graven-Nielsen, T

2017-04-01

Neck pain is a large clinical problem where reorganized trunk and axioscapular muscle activities have been hypothesised contributing to pain persistence and pain hypersensitivity. This study investigated the effects of bilateral experimental neck pain on trunk and axioscapular muscle function and pain sensitivity. In 25 healthy volunteers, bilateral experimental neck pain was induced in the splenius capitis muscles by hypertonic saline injections. Isotonic saline was used as control. In sitting, subjects performed slow, fast and slow-resisted unilateral arm movements before, during and after injections. Electromyography (EMG) was recorded from eight shoulder and trunk muscles bilaterally. Pressure pain thresholds (PPTs) were assessed bilaterally at the neck, head and arm. Data were normalized to the before-measures. Compared with control and post measurements, experimental neck pain caused (1) decreased EMG activity of the ipsilateral upper trapezius muscles during all but slow-resisted down movements (p neck pain reorganized axioscapular and trunk muscle activity together with local hyperalgesia and widespread hypoalgesia indicating that acute neck pain immediately affects trunk and axioscapular function which may affect both assessment and treatment. Bilateral clinical neck pain alters axioscapular muscle coordination but only effects of unilateral experimental neck pain has been investigated. Bilateral experimental neck pain causes task-dependent reorganized axioscapular and trunk muscle activity in addition to widespread decrease in pressure pain sensitivity. © 2016 European Pain Federation - EFIC®.

A customized head and neck support system

International Nuclear Information System (INIS)

Bentel, Gunilla C.; Marks, Lawrence B.; Sherouse, George W.; Spencer, David P.

1995-01-01

Purpose: To describe a customized head and neck immobilization system for patients receiving radiotherapy including a head support that conforms to the posterior contour of the head and neck. Methods: The system includes a customized headrest to support the posterior head and neck. This is fixed to a thermoplastic face mask that molds to the anterior head/face contours. The shape of these customized head and neck supports were compared to 'standard' supports. Results: This system is comfortable for the patients and appears to be effective in reproducing the setup of the treatment. Conclusions: The variability in the size and shape of the customized posterior supports exceeded that of 'standard' headrests. It is our clinical impression that the customized supports improve reproducibility and are now a standard part of our immobilization system. The quantitative analysis of the customized headrests and some commonly used 'standard' headrests suggests that the customized supports are better able to address variabilities in patient shape

Neck dissection - discharge

Science.gov (United States)

... drain in your neck when you leave the hospital. The provider will tell you how to care for it. Healing time will depend on how much tissue was removed. Diet and Nutrition You can eat your regular foods ...

Titanium alloys. Advances in alloys, processes, products and applications

International Nuclear Information System (INIS)

Blenkinsop, P.A.

1993-01-01

The last few years have been a period of consolidation of existing alloys and processes. While the aerospace industry remains the principal driving force for alloy development, the paper illustrates examples of new markets being established in 'older' alloys, by a combination of product/process development and a re-examination of engineering design parameters. Considerable attention is still being directed towards the titanium aluminide systems, but other more conventional alloy developments are underway aimed at specific engineering and process requirements, both in the aerospace and non-aerospace sectors. Both the advanced high temperature and conventional alloy developments are considered, before the paper goes on to assess the potential of new processes and products, like spray-forming, metal matrix composites and shaped-plate rolling. (orig.)

High-temperature deformation of a mechanically alloyed niobium-yttria alloy

International Nuclear Information System (INIS)

Chou, I.; Koss, D.A.; Howell, P.R.; Ramani, A.S.

1997-01-01

Mechanical alloying (MA) and hot isostatic pressing have been used to process two Nb alloys containing yttria particles, Nb-2 vol.%Y 2 O 3 and Nb-10 vol.%Y 2 O 3 . Similar to some thermomechanically processed nickel-based alloys, both alloys exhibit partially recrystallized microstructures, consisting of a 'necklace' of small recrystallized grains surrounding much larger but isolated, unrecrystallized, cold-worked grains. Hot compression tests from 1049 to 1347 C (0.5-0.6T MP ) of the 10% Y 2 O 3 alloy show that MA material possesses a much higher yield and creep strength than its powder-blended, fully recrystallized counterpart. In fact, the density-compensated specific yield strength of the MA Nb-10Y 2 O 3 exceeds that of currently available commercial Nb alloys. (orig.)

33 CFR 117.800 - Mill Neck Creek.

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Mill Neck Creek. 117.800 Section 117.800 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements New York § 117.800 Mill Neck Creek. The draw of the...

Studies on Al-Cu-Li-Mg-Ag-Zr alloy processed through vacuum induction melting (VIM) technique

International Nuclear Information System (INIS)

Nayan, Niraj; Govind; Nair, K. Suseelan; Mittal, M.C.; Sudhakaran, K.N.

2007-01-01

A new technique of lithium addition has been adapted for the processing of Al-Cu-Li-Ag-Mg-Zr alloy, which gives more than 90% recovery of lithium throughout the billet. Processing studies on this alloy include casting, three step homogenization, to avoid incipient melting, and mechanical working particularly forging and rolling. The products in the form of sheets were subjected to various T6 (solution treatment + water quenching + aging) tempers. Mechanical properties were evaluated at room temperature and correlated with microstructure. Characterizations using optical microscope and post-fracture analysis have been carried out using Scanning electron microscope (SEM). Experimental investigation shows highest mechanical properties for the Al-1.3%Li alloy in T6 (500 deg. C/1 h + WQ + 190 deg. C/24 h) condition

Iron-based amorphous alloys and methods of synthesizing iron-based amorphous alloys

Science.gov (United States)

Saw, Cheng Kiong; Bauer, William A.; Choi, Jor-Shan; Day, Dan; Farmer, Joseph C.

2016-05-03

A method according to one embodiment includes combining an amorphous iron-based alloy and at least one metal selected from a group consisting of molybdenum, chromium, tungsten, boron, gadolinium, nickel phosphorous, yttrium, and alloys thereof to form a mixture, wherein the at least one metal is present in the mixture from about 5 atomic percent (at %) to about 55 at %; and ball milling the mixture at least until an amorphous alloy of the iron-based alloy and the at least one metal is formed. Several amorphous iron-based metal alloys are also presented, including corrosion-resistant amorphous iron-based metal alloys and radiation-shielding amorphous iron-based metal alloys.

SU-C-BRC-05: Monte Carlo Calculations to Establish a Simple Relation of Backscatter Dose Enhancement Around High-Z Dental Alloy to Its Atomic Number

Energy Technology Data Exchange (ETDEWEB)

Utsunomiya, S; Kushima, N; Katsura, K; Tanabe, S; Hayakawa, T; Sakai, H; Yamada, T; Takahashi, H; Abe, E; Wada, S; Aoyama, H [Niigata University, Niigata (Japan)

2016-06-15

Purpose: To establish a simple relation of backscatter dose enhancement around a high-Z dental alloy in head and neck radiation therapy to its average atomic number based on Monte Carlo calculations. Methods: The PHITS Monte Carlo code was used to calculate dose enhancement, which is quantified by the backscatter dose factor (BSDF). The accuracy of the beam modeling with PHITS was verified by comparing with basic measured data namely PDDs and dose profiles. In the simulation, a high-Z alloy of 1 cm cube was embedded into a tough water phantom irradiated by a 6-MV (nominal) X-ray beam of 10 cm × 10 cm field size of Novalis TX (Brainlab). The ten different materials of high-Z alloys (Al, Ti, Cu, Ag, Au-Pd-Ag, I, Ba, W, Au, Pb) were considered. The accuracy of calculated BSDF was verified by comparing with measured data by Gafchromic EBT3 films placed at from 0 to 10 mm away from a high-Z alloy (Au-Pd-Ag). We derived an approximate equation to determine the relation of BSDF and range of backscatter to average atomic number of high-Z alloy. Results: The calculated BSDF showed excellent agreement with measured one by Gafchromic EBT3 films at from 0 to 10 mm away from the high-Z alloy. We found the simple linear relation of BSDF and range of backscatter to average atomic number of dental alloys. The latter relation was proven by the fact that energy spectrum of backscatter electrons strongly depend on average atomic number. Conclusion: We found a simple relation of backscatter dose enhancement around high-Z alloys to its average atomic number based on Monte Carlo calculations. This work provides a simple and useful method to estimate backscatter dose enhancement from dental alloys and corresponding optimal thickness of dental spacer to prevent mucositis effectively.

Prevalence of neck pain among cabin crew of Saudi Airlines.

Science.gov (United States)

Ezzat, Hesham M; Al-Sultan, Alanood; Al-Shammari, Anwar; Alyousef, Dana; Al-Hamidi, Hager; Al-Dossary, Nafla; Al-Zahrani, Nuha; Al-Abdulqader, Wala

2015-01-01

Neck pain is considered to be a major health problem in modern societies. Many previous studies found that certain occupations are related to this problem or are associated with the risk of developing it in future. Although the pain is caused by mechanical factors, it may progress to a serious problem and give rise to other abnormal symptoms such as vertigo, headache, or migraine. To investigate the prevalence of neck pain among the cabin crew of Saudi Airlines. A cross-sectional study was carried out on the available Saudi Airlines cabin crews in King Fahad Airport during our visits, using questionnaires and measurements of several parameters. Neck Pain Questionnaires were distributed to the cabin crews on Saudi Airlines and assessment sheets were completed by all participants of the study to evaluate the prevalence and distribution of neck pain. Physical therapy examination of neck motions in different directions and specific tests were performed by all the participants to identify any symptoms. Using these data the prevalence of neck pain among the cabin crews was calculated. Collected data were analyzed statistically using SPSS software calculating the mean, median, and score of the questionnaire. According to the scoring system of the study, 31 (30.09%) of 105 cabin crew staff of Saudi Airlines had neck pain. Our study confirmed a positive correlation between this occupation and neck pain, and in fact found that according to the results of logistic regression analysis, this occupation is the only significant factor that affects the positive compression test. The prevalence of neck pain among the cabin crews of Saudi Airlines was emphasized. The results show a high prevalence of neck pain in the participants of the study, with most cases appearing to run a chronic - episodic course. Further research is needed to help us understand more about the long-term course of neck pain and its broader outcomes and impacts.

The retrograde transverse cervical artery as a recipient vessel for free tissue transfer in complex head and neck reconstruction with a vessel-depleted neck.

Science.gov (United States)

Ciudad, Pedro; Agko, Mouchammed; Manrique, Oscar J; Date, Shivprasad; Kiranantawat, Kidakorn; Chang, Wei Ling; Nicoli, Fabio; Lo Torto, Federico; Maruccia, Michele; Orfaniotis, Georgios; Chen, Hung-Chi

2017-11-01

Reconstruction in a vessel-depleted neck is challenging. The success rates can be markedly decreased because of unavailability of suitable recipient vessels. In order to obtain a reliable flow, recipient vessels away from the zone of fibrosis, radiation, or infection need to be explored. The aim of this report is to present our experience and clinical outcomes using the retrograde flow coming from the distal transverse cervical artery (TCA) as a source for arterial inflow for complex head and neck reconstruction in patients with a vessel-depleted neck. Between July 2010 and June 2016, nine patients with a vessel-depleted neck underwent secondary head and neck reconstruction using the retrograde TCA as recipient vessel for microanastomosis. The mean age was 49.6 years (range, 36 to 68 years). All patients had previous bilateral neck dissections and all, except one, had also received radiotherapy. Indications included neck contracture release (n = 3), oral (n = 1), mandibular (n = 3) and pharyngoesophageal (n = 2) reconstruction necessitating free anterolateral thigh (n = 3) and medial sural artery (n = 1) perforator flaps, fibula (n = 3) and ileocolon (n = 2) flaps respectively. There was 100% flap survival rate with no re-exploration or any partial flap loss. One case of intra-operative arterial vasospasm at the anastomotic suture line was managed intra-operatively with vein graft interposition. There were no other complications or donor site morbidity during the follow-up period. In a vessel-depleted neck, the reverse flow of the TCA may be a reliable option for complex secondary head and neck reconstruction in selected patients. © 2017 Wiley Periodicals, Inc.

Interfacial Reaction of Sn-Ag-Cu Lead-Free Solder Alloy on Cu: A Review

Directory of Open Access Journals (Sweden)

Liu Mei Lee

2013-01-01

Full Text Available This paper reviews the function and importance of Sn-Ag-Cu solder alloys in electronics industry and the interfacial reaction of Sn-Ag-Cu/Cu solder joint at various solder forms and solder reflow conditions. The Sn-Ag-Cu solder alloys are examined in bulk and in thin film. It then examines the effect of soldering conditions to the formation of intermetallic compounds such as Cu substrate selection, structural phases, morphology evolution, the growth kinetics, temperature and time is also discussed. Sn-Ag-Cu lead-free solder alloys are the most promising candidate for the replacement of Sn-Pb solders in modern microelectronic technology. Sn-Ag-Cu solders could possibly be considered and adapted in miniaturization technologies. Therefore, this paper should be of great interest to a large selection of electronics interconnect materials, reliability, processes, and assembly community.

[Clinical efficacy of warm needling therapy on cervical spondylosis of neck type based on the theory of "treatment both for the neck and lumbus"].

Science.gov (United States)

Yang, Yu; Pan, Luping; Lin, Xianming

2016-11-12

To compare the difference in the short-term and long-term efficacy on cervical spondylosis of neck type between warm needling therapy in the regions of both neck and lumbus and that only in the region of neck. Eighty-one patients of cervical spondylosis of neck type were randomized into group A (41 cases) and group B (40 cases), in which 2 cases dropped out. Finally, 40 cases in the group A and 39 cases in the group B accomplished the trial. In the group A, the warm needling therapy was applied to the acupoints in the region of neck and the lumbus. Fengchi (GB 20), Tianzhu (BL 10), Neck-Bailao (EX-HN 15), Wangu (GB 12), Tianyou (TE 16) and ashi (including the tender points and code-like masses on palpation) were selected in the region of neck. Dachangshu (BL 25), Qihaishu (BL 24) and Jiaji (EX-B 2) of L5 were selected in the region of lumbus. The warm needling was applied to Fengchi (GB 20), Tianzhu (BL 10), Dachangshu (BL 25). In the group B, the warm needling therapy was applied only to the acupoints in the neck, which were same as the group A. The treatment was given once every two days, three times a week in the two groups. Separately, before treatment, 1 week after treatment, at the end of 2-week treatment and at the end of 1 month follow-up, the score of neck pain questionnaire (NPQ), the score of range of motion (ROM) in the cervical region and the score of the cervical symptoms were recorded. The efficacy at the end of treatment and in the follow-up was evaluated. Compared with those before treatment, the scores at all the observation time points were significantly improved in the two groups after treatment (all P 0.05). In the follow-up, the total effective rate was 87.5% (35/40) in the group A, better than 64.1% (25/39) in the group B ( P lumbar regions with warm needling therapy and the treatment in the local area all achieve the short-term efficacy on cervical spondylosis of neck type. For the long-term efficacy, the treatment for both neck and lumbar

Adaptive neck support for wellbeing adaptive neck support for wellbeing

NARCIS (Netherlands)

Tan, C.F.; Chen, W.; Rauterberg, G.W.M.; Augusto, J.C.; Huch, M.; Kameas, A.; Maitland, J.; McCullagh, P.; Roberts, J.; Sixsmith, A.; Wichert, R.

2012-01-01

Air travel is becoming increasingly more accessible to people both through the availability of low cost flights. Health problems may arise due to anxiety and unfamiliarity with airport departure procedures prior to flying, whilst during the air travel, problems may arise as a result of the food

The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.

Science.gov (United States)

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

2009-02-01

Systematic review and best evidence synthesis. To describe the prevalence and incidence of neck pain and disability in workers; to identify risk factors for neck pain in workers; to propose an etiological diagram; and to make recommendations for future research. Previous reviews of the etiology of neck pain in workers relied on cross-sectional evidence. Recently published cohorts and randomized trials warrant a re-analysis of this body of research. We systematically searched Medline for literature published from 1980-2006. Retrieved articles were reviewed for relevance. Relevant articles were critically appraised. Articles judged to have adequate internal validity were included in our best evidence synthesis. One hundred and nine papers on the burden and determinants of neck pain in workers were scientifically admissible. The annual prevalence of neck pain varied from 27.1% in Norway to 47.8% in Québec, Canada. Each year, between 11% and 14.1% of workers were limited in their activities because of neck pain. Risk factors associated with neck pain in workers include age, previous musculoskeletal pain, high quantitative job demands, low social support at work, job insecurity, low physical capacity, poor computer workstation design and work posture, sedentary work position, repetitive work and precision work. We found preliminary evidence that gender, occupation, headaches, emotional problems, smoking, poor job satisfaction, awkward work postures, poor physical work environment, and workers' ethnicity may be associated with neck pain. There is evidence that interventions aimed at modifying workstations and worker posture are not effective in reducing the incidence of neck pain in workers. Neck disorders are a significant source of pain and activity limitations in workers. Most neck pain results from complex relationships between individual and workplace risk factors. No prevention strategies have been shown to reduce the incidence of neck pain in workers.

The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping

NARCIS (Netherlands)

Carlijn H. van Randeraad-van der Zee; Anna Beurskens; Raymond Swinkels; Jan Pool; Roy Batterham; Richard Osborne; Henrica de Vet

2015-01-01

Purpose To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the

The burden of neck pain : its meaning for persons with neck pain and healthcare providers, explored by concept mapping

NARCIS (Netherlands)

Carlijn H. van Randeraad-van der Zee; Anna J.H.M. Beurskens; Reymond A.H.M. Swinkels; Jan J.M. Pool; Richard H. Osborne; Roy W. Batterham; Henrica C.W. de Vet

2015-01-01

Purpose To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the

ROLE OF MULTIDETECTOR CT IN EVALUATION OF NECK LESIONS

Directory of Open Access Journals (Sweden)

Reena Mathur

2016-06-01

Full Text Available AIMS AND OBJECTIVES To find out the role of multidetector computed tomography in the evaluation of neck lesions with respect to evaluation of the size, location and extent of tumour. Extension of tumour infiltrating into surrounding vascular and visceral structures. To correlate the findings of MD-CT with final diagnosis by biopsy. MATERIAL AND METHODS Data for the study was collected from patients with suspected neck lesions attending Department of Radio-diagnosis, J.L.N. Medical College and Associated Group of Hospitals, Ajmer, Rajasthan. A prospective study was conducted over a period (From 1st March 2014 to 31 Aug. 2015 on patients with clinically suspected neck lesions or patients who were diagnosed to have neck lesion on ultrasound and were referred to CT for further characterisation. The patients presented with symptoms of palpable neck mass and neck pain. Patients were evaluated using multidetector CT. A provisional diagnosis was made after CT scan and these findings were correlated with histopathology/surgical findings as applicable. RESULT In the present study, 97 out of 100 cases were correctly characterised by computed tomography giving an accuracy of 97%. One case of buccal carcinoma was wrongly diagnosed as benign lesion and another case of malignant lymph node was inaccurately diagnosed as benign lymph node, also another case of benign lymph node was inaccurately diagnosed as malignant lymph node. CONCLUSION Multidetector Computed Tomography of the neck has improved the localisation and characterisation of neck lesions. Accurate delineation of disease by CT scan provides a reliable preoperative diagnosis, plan for radiotherapy ports and posttreatment followup. However, histopathology still remains the gold standard as CT is not 100% accurate.

Ipsilateral femoral neck and trochanter fracture

Directory of Open Access Journals (Sweden)

Devdatta S Neogi

2011-01-01

Full Text Available Ipsilateral fractures in the neck and trochanteric region of the femur are very rare and seen in elderly osteoporotic patients. We present a case of a young man who presented with ipsilateral fracture of the femoral neck and a reverse oblique fracture in the trochanteric region following a motor vehicle accident. A possible mechanism, diagnostic challenge, and awareness required for identifying this injury are discussed.

Schwannomas of the head and neck

Directory of Open Access Journals (Sweden)

Anastasios Kanatas

2011-12-01

Full Text Available Schwannomas are benign encapsulated nerve sheath tumors composed of Schwann cells. Malignant change in head and neck schwannomas is rare, with the incidence varying between 8 and 13.9%. In this review, we discuss the presentation and the management of head and neck schwannomas. The issues and difficulties based on our own experience as well as the experience of published reports from the literature are presented.

Head-neck-radiology; Kopf-Hals-Radiologie

Energy Technology Data Exchange (ETDEWEB)

Cohnen, Mathias (ed.) [Staedtische Kliniken Neuss Lukaskrankenhaus GmbH (Germany). Institut fuer klinische Radiologie

2012-11-01

The book on head-neck-radiology covers the following issues: (1) Methodic fundamentals: conventional radiography, angiography, sonography, computerized tomography, digital volume tomography, NMR imaging, nuclear medicine. (2) Base of the skull. (3) Petrous bone. (4) Pharynx. (5) Paranasal sinuses. (6) Eye socket. (7) Temporomandibular joint. (8) Salivary gland. (9) Oral cavity. (19) Parynx. (11) Neck soft tissue and lymph nodes. (12) Thyroid and parathyroid. (13) Teeth and jaw. (14) Interventions.

High strength alloys

Science.gov (United States)

Maziasz, Phillip James [Oak Ridge, TN; Shingledecker, John Paul [Knoxville, TN; Santella, Michael Leonard [Knoxville, TN; Schneibel, Joachim Hugo [Knoxville, TN; Sikka, Vinod Kumar [Oak Ridge, TN; Vinegar, Harold J [Bellaire, TX; John, Randy Carl [Houston, TX; Kim, Dong Sub [Sugar Land, TX

2010-08-31

High strength metal alloys are described herein. At least one composition of a metal alloy includes chromium, nickel, copper, manganese, silicon, niobium, tungsten and iron. System, methods, and heaters that include the high strength metal alloys are described herein. At least one heater system may include a canister at least partially made from material containing at least one of the metal alloys. At least one system for heating a subterranean formation may include a tubular that is at least partially made from a material containing at least one of the metal alloys.

Aluminum fin-stock alloys

International Nuclear Information System (INIS)

Gul, R.M.; Mutasher, F.

2007-01-01

Aluminum alloys have long been used in the production of heat exchanger fins. The comparative properties of the different alloys used for this purpose has not been an issue in the past, because of the significant thickness of the finstock material. However, in order to make fins lighter in weight, there is a growing demand for thinner finstock materials, which has emphasized the need for improved mechanical properties, thermal conductivity and corrosion resistance. The objective of this project is to determine the effect of iron, silicon and manganese percentage increment on the required mechanical properties for this application by analyzing four different aluminum alloys. The four selected aluminum alloys are 1100, 8011, 8079 and 8150, which are wrought non-heat treatable alloys with different amount of the above elements. Aluminum alloy 1100 serve as a control specimen, as it is commercially pure aluminum. The study also reports the effect of different annealing cycles on the mechanical properties of the selected alloys. Metallographic examination was also preformed to study the effect of annealing on the precipitate phases and the distribution of these phases for each alloy. The microstructure analysis of the aluminum alloys studied indicates that the precipitated phase in the case of aluminum alloys 1100 and 8079 is beta-FeAI3, while in 8011 it is a-alfa AIFeSi, and the aluminum alloy 8150 contains AI6(Mn,Fe) phase. The comparison of aluminum alloys 8011 and 8079 with aluminum alloy 1100 show that the addition of iron and silicon improves the percent elongation and reduces strength. The manganese addition increases the stability of mechanical properties along the annealing range as shown by the comparison of aluminum alloy 8150 with aluminum alloy 1100. Alloy 8150 show superior properties over the other alloys due to the reaction of iron and manganese, resulting in a preferable response to thermal treatment and improved mechanical properties. (author)

The industrial applications of shape memory alloys in North America

International Nuclear Information System (INIS)

Mc Schetky D, L.

2000-01-01

Literature in the recent past on shape memory effect alloys dwelt principally on the physical metallurgy, crystallography and kinetics of the shape memory phenomenon. By contrast, we now have books and conference proceedings devoted to the engineering aspects of SMAs, their technology and application. The dominant role SMAs now play in the field of medical and orthodontic devices is well documented and will be reviewed by others in this conference. In this paper we will discuss the commercial applications for shape memory alloy devices in the North American market; applications which are in many cases also produced in European countries and Japan. The early success of shape memory alloy couplings for joining tubing and pipe in the late 1960's was not followed by other large volume applications until the advent of shape memory eyeglass frames, brassiere underwires and cellular phone antennas. Many other applications have now evolved into mature markets and these will be reviewed. In addition to the many commercial applications cited, there are a number of other fields in which shape memory alloys are destined to play a major role; these include smart materials and adaptive structures, MEMS devices, infrastructure systems and electrical power generation and distribution. These applications are being developed with private and government funding and will also be briefly discussed. (orig.)

The industrial applications of shape memory alloys in North America

Energy Technology Data Exchange (ETDEWEB)

Mc Schetky D, L. [Memry Corp., Brookfield, CT (United States)

2000-07-01

Literature in the recent past on shape memory effect alloys dwelt principally on the physical metallurgy, crystallography and kinetics of the shape memory phenomenon. By contrast, we now have books and conference proceedings devoted to the engineering aspects of SMAs, their technology and application. The dominant role SMAs now play in the field of medical and orthodontic devices is well documented and will be reviewed by others in this conference. In this paper we will discuss the commercial applications for shape memory alloy devices in the North American market; applications which are in many cases also produced in European countries and Japan. The early success of shape memory alloy couplings for joining tubing and pipe in the late 1960's was not followed by other large volume applications until the advent of shape memory eyeglass frames, brassiere underwires and cellular phone antennas. Many other applications have now evolved into mature markets and these will be reviewed. In addition to the many commercial applications cited, there are a number of other fields in which shape memory alloys are destined to play a major role; these include smart materials and adaptive structures, MEMS devices, infrastructure systems and electrical power generation and distribution. These applications are being developed with private and government funding and will also be briefly discussed. (orig.)

Neck osteotomy for malunion of neglected radial neck fractures in children: a report of 2 cases.

Science.gov (United States)

Ceroni, Dimitri; Campos, José; Dahl-Farhoumand, Agnes; Holveck, Jérôme; Kaelin, André

2010-01-01

Radial neck fractures are a common injury in children as a result of a fall on an extended and supinated outstretched hand. We present 2 cases of osteotomy of the neck of the radius performed in 2 children with neglected radial neck fractures. Preoperatively, both patients complained of pain and severely reduced mobility of the elbow. Surgery was performed at 6 weeks and 3 months, respectively, after the initial injury and the 2 children were reviewed at 6 and 16 months follow-up. Osteotomies healed within the usual time and no avascular necrosis of the radial head, proximal radioulnar synostosis, or myositis ossificans were observed. The Mayo Elbow Performance Index Score improved significantly after the operation with the 2 patients rated as excellent. In this small series, we present a novel technique of proximal osteotomy of the radius to correct this deformity in children. Case series, level IV evidence.

Neck Pain in Military Helicopter Pilots: Prevalence and Associated Factors

NARCIS (Netherlands)

van den Oord, Marieke H. A. H.; de Loose, Veerle; Meeuwsen, Ted; Sluiter, Judith K.; Frings-Dresen, Monique H. W.

2010-01-01

Our aim is to estimate the self-reported one-year prevalence of neck pain in military helicopter pilots and to compare work-related, individual, and health-related factors in the pilots with (neck pain group) and without (reference group) regular or continuous neck pain. A questionnaire was

Nickel alloys and high-alloyed special stainless steels. Properties, manufacturing, applications. 4. compl. rev. ed.

International Nuclear Information System (INIS)

Heubner, Ulrich; Kloewer, Jutta; Alves, Helena; Behrens, Rainer; Schindler, Claudius; Wahl, Volker; Wolf, Martin

2012-01-01

This book contains the following eight topics: 1. Nickel alloys and high-alloy special stainless steels - Material overview and metallurgical principles (U. Heubner); 2. Corrosion resistance of nickel alloys and high-alloy special stainless steels (U. Heubner); 3. Welding of nickel alloys and high-alloy special stainless steels (T. Hoffmann, M. Wolf); 4. High-temperature materials for industrial plant construction (J. Kloewer); 5. Nickel alloys and high-alloy special stainless steels as hot roll clad composites-a cost-effective alternative (C. Schindler); 6. Selected examples of the use of nickel alloys and high-alloy special stainless steels in chemical plants (H. Alves); 7. The use of nickel alloys and stainless steels in environmental engineering (V. Wahl); 8: Nickel alloys and high-alloy special stainless steels for the oil and gas industry (R. Behrens).

Biocompatibility of dental alloys

Energy Technology Data Exchange (ETDEWEB)

Braemer, W. [Heraeus Kulzer GmbH and Co. KG, Hanau (Germany)

2001-10-01

Modern dental alloys have been used for 50 years to produce prosthetic dental restorations. Generally, the crowns and frames of a prosthesis are prepared in dental alloys, and then veneered by feldspar ceramics or composites. In use, the alloys are exposed to the corrosive influence of saliva and bacteria. Metallic dental materials can be classified as precious and non-precious alloys. Precious alloys consist of gold, platinum, and small amounts of non-precious components such as copper, tin, or zinc. The non-precious alloys are based on either nickel or cobalt, alloyed with chrome, molybdenum, manganese, etc. Titanium is used as Grade 2 quality for dental purposes. As well as the dental casting alloys, high purity electroplated gold (99.8 wt.-%) is used in dental technology. This review discusses the corrosion behavior of metallic dental materials with saliva in ''in vitro'' tests and the influence of alloy components on bacteria (Lactobacillus casei and Streptococcus mutans). The test results show that alloys with high gold content, cobalt-based alloys, titanium, and electroplated gold are suitable for use as dental materials. (orig.)

Chronic Neck Pain and Whiplash: A Case-Control Study of the Relationship between Acute Whiplash Injuries and Chronic Neck Pain

Directory of Open Access Journals (Sweden)

Michael D Freeman

2006-01-01

Full Text Available The authors undertook a case-control study of chronic neck pain and whiplash injuries in nine states in the United States to determine whether whiplash injuries contributed significantly to the population of individuals with chronic neck and other spine pain.

Matching Intensity-Modulated Radiation Therapy to an Anterior Low Neck Field

International Nuclear Information System (INIS)

Amdur, Robert J.; Liu, Chihray; Li, Jonathan; Mendenhall, William; Hinerman, Russell

2007-01-01

When using intensity-modulated radiation therapy (IMRT) to treat head and neck cancer with the primary site above the level of the larynx, there are two basic options for the low neck lymphatics: to treat the entire neck with IMRT, or to match the IMRT plan to a conventional anterior 'low neck' field. In view of the potential advantages of using a conventional low neck field, it is important to look for ways to minimize or manage the problems of matching IMRT to a conventional radiotherapy field. Treating the low neck with a single anterior field and the standard larynx block decreases the dose to the larynx and often results in a superior IMRT plan at the primary site. The purpose of this article is to review the most applicable studies and to discuss our experience with implementing a technique that involves moving the position of the superior border of the low neck field several times during a single treatment fraction

Interphase thermodynamic bond in heterogeneous alloys: effects on alloy properties

International Nuclear Information System (INIS)

Savchenko, A.M.; Konovalov, Yu.V.; Yuferov, O.I.

2005-01-01

Inconsistency between a conventional thermodynamic description of alloys as a mechanical mixture of phases and a real alloys state as a common thermodynamic system in which there is a complicated physical-chemical phases interaction has been considered. It is supposed that in heterogeneous alloys (eutectic ones, for instance), so called interphase thermodynamic bond can become apparent due to a partial electron levels splitting under phase interaction. Thermodynamic description of phase equilibrium in alloys is proposed taking into account a thermodynamic bond for the system with phase diagram of eutectic type, and methods of the value of this bond estimation are presented. Experimental evidence (Al-Cu-Si, Al-Si-Mg-Cu, U-Mo + Al) of the effect of interphase thermodynamic bond on temperature and enthalpy of melting of alloys are produced as well as possibility of its effects on alloys electrical conduction, strength, heat and corrosion resistance is substantiated theoretically [ru

Postoperative radiation for advanced head and neck cancers

International Nuclear Information System (INIS)

Ang, K. Kian; Garden, Adam S.

1995-01-01

Purpose: To discuss both general and specific indications for radiation following surgery for patients with cancers of the head and neck. Patients with advanced cancers of the head and neck are often not suitable candidates for treatment with definitive radiation, and are treated with surgery. Frequently these patients fail by recurring in either the primary sites or in the necks. Adjuvant radiation is therefore often a critical component in the management of these patients. While radiation can be done either prior to or after surgery, most centers prefer the postoperative setting. This refresher course will review general concepts of postoperative irradiation for the patient with head and neck cancer and apply these concepts to specific situations. The course will begin with a broad review of the indications for postoperative irradiation as not all patients undergoing surgery for cancers of the head and neck require additional treatment. We will also review the concept of using postoperative radiation to allow for more conservative surgery with preservation of function. The second portion of the course will focus on general techniques of postoperative irradiation. We will review concepts of patient setup and treatment portal design and describe how specific techniques are practiced at MDACC. Controversial topics, including field matching, total dose and fractionation, and the timing of postoperative radiation will be discussed. The final section of the course will review the results of postoperative irradiation as applied to the head and neck in general as well as to specific subsites. In addition to results for the common scenarios of squamous cell carcinomas of the oral cavity, pharynx and larynx, we will review results of postoperative irradiation for skin cancers of the head and neck, paranasal sinuses, and salivary glands

Plain Language Summary: Evaluation of the Neck Mass in Adults.

Science.gov (United States)

Pynnonen, Melissa A; Colandrea, Maria; Finestone, Sandra A; O'Connor, Sarah S

2017-09-01

This plain language summary serves as an overview in explaining the evaluation of the neck mass in adults. The summary applies to patients aged ≥18 years and is based on the 2017 "Clinical Practice Guideline: Evaluation of the Neck Mass in Adults." The evidence-based guideline includes research to support more effective evaluation and diagnosis of the neck mass in adults. The guideline was developed as a quality improvement opportunity for evaluation of the neck mass by creating clear recommendations to use in medical practice.

Neck ultrasound in staging squamous oesophageal carcinoma - a high yield technique

International Nuclear Information System (INIS)

Griffith, J.F.; Chan, A.C.W.; Ahuja, A.T.; Leung, S.F.; Chow, L.T.C.; Chung, S.C.S.; Metreweli, C.

2000-01-01

AIM: This study evaluates the use of neck ultrasound in staging squamous oesophageal carcinoma. MATERIALS AND METHODS: A prospective analysis of the clinical, neck ultrasound (US) and thoraco-abdominal computed tomography (CT) findings in 121 patients with squamous oesophageal carcinoma at presentation was performed. The relationship between malignant neck nodes, mediastinal and abdominal adenopathy, location and size of the primary tumour was analysed. RESULTS: Ten of 121 patients (8%) had clinically palpable neck nodes which were deemed malignant in six (5%) following US and fine-needle aspiration for cytology. Of those 111 patients with no palpable neck nodes, 31 (28%) had malignant nodes shown on US. The more cephalad the location of the primary tumour, the higher the frequency of malignant neck nodes which were found in 80%, 52%, 29% and 9% of cervical, upper thoracic, mid-thoracic and lower thoracic oesophageal tumours, respectively. Eleven (29%) of the 38 patients with malignant neck nodes shown on US had no CT evidence of additional adenopathy in the mediastinum or upper abdomen. Neck US altered TNM staging in 22/121 (18%) patients at presentation. CONCLUSION: Neck US frequently detects clinically impalpable metastatic nodes leading to altered TNM staging in patients with squamous oesophageal carcinoma. We advocate its routine use when staging squamous oesophageal carcinoma. Griffith, J.F. 2000

Factors associated with cervical kinematic impairments in patients with neck pain.

Science.gov (United States)

Treleaven, Julia; Chen, Xiaoqi; Sarig Bahat, Hilla

2016-04-01

Cervical kinematics have functional relevance and are important for assessment and management in patients with neck disorders. A better understanding of factors that might influence cervical kinematics is required. The aim of this study was to determine any relationships between altered kinematics to the symptoms and signs of sensorimotor impairments, neck pain and disability and fear of neck motion in people with neck pain. Kinematics were measured in 39 subjects with chronic neck pain using a customized virtual reality system. Range of cervical motion, mean and peak velocity, time to peak velocity percentage, number of velocity peaks and accuracy were derived. Correlations between these measures to self-reported (neck pain intensity, disability, fear of motion, dizziness, visual disturbances) and sensorimotor measures and regression analyses were conducted. Range and velocity of motion of cervical rotation appeared to be most related to visual disturbances and pain or dynamic balance. Nevertheless these relationships only explained about 30% of the variance of each measure. Signs and symptoms of sensorimotor dysfunction should be considered and monitored in the management of altered cervical rotation kinematics in patients with chronic neck disorders. Future research should consider the effects of addressing these factors on neck kinematics and vice versa to aid functional recovery in those with neck pain. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Brachytherapy in the treatment of head and neck cancer

International Nuclear Information System (INIS)

Yoo, Seong Yul

1999-01-01

Brachytherapy has been proved to be an effective method for the purpose of increasing radiation dose to the tumor and reducing the dose to the surrounding normal tissue. In head and neck cancer, the rationale of brachytherapy is as follows; Firstly, early small lesion is radiocurative and the major cause of failure is local recurrence. Secondly, it can diminish evidently the dose to the normal tissue especially masseteric muscle and salivary gland. Thirdly, the anatomy of head and neck is suitable to various technique of brachytherapy. On background of accumulated experience of LDR iridium brachytherapy of head and neck cancer for the last 15 years, the author reviewed the history of radioisotope therapy, the characteristics of radionuclides, and some important things in the method, clinical technique and treatment planning. The author analyzed the clinical result of 185 cases of head and neck cancer treated in the Korea Cancer Center Hospital. Finally the future prospect of brachytherapy of head and neck cancer is discussed

frequency of ipsilateral femoral neck fractures in patients

African Journals Online (AJOL)

Background: Ipsilateral associated femoral neck and shaft fractures are reported to occur in 2.5-6% of all femoral shaft ... nailing of the shaft fracture, which makes treatment of the neck ... chest, spine), while the other had maxillofacial injuries.

[Effectiveness of an individualised physiotherapy program versus group therapy on neck pain and disability in patients with acute and subacute mechanical neck pain].

Science.gov (United States)

Antúnez Sánchez, Leonardo Gregorio; de la Casa Almeida, María; Rebollo Roldán, Jesús; Ramírez Manzano, Antonio; Martín Valero, Rocío; Suárez Serrano, Carmen

To compare the efficacy in reducing neck pain and disability in an individualised physiotherapy treatment with group treatment in acute and subacute mechanical neck pain. Randomised clinical trial. Health Area of University Hospital Virgen del Rocío, Seville, Spain. A total of 90 patients diagnosed with mechanical neck pain of up to one month onset, distributed randomly into two groups: (i)individualised treatment; (ii)group treatment. The treatment consisted of 15 sessions of about 60minutes for both groups. Individual treatment consisted of 15minutes of infrared heat therapy, 17minutes of massage, and analytical passive stretching of the trapezius muscles and angle of the scapula. The group treatment consisted of a program of active mobilisation, isometric contractions, self-stretching, and postural recommendations. Pain was measured at the beginning and end of treatment pain using a Visual Analogue Scale (VAS) and an algometer applied on the trapezius muscles and angle of the scapula, and neck disability using the Neck Disability Index. Both treatments were statistically significant (P<.001) in improving all variables. Statistically significant differences (P<.001) were found for all of them in favour of individualised treatment compared to group treatment. Patients with acute or subacute mechanical neck pain experienced an improvement in pain and neck disability after receiving either of the physiotherapy treatments used in our study, with the individual treatment being more effective than collective. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Parotid Glands Dose–Effect Relationships Based on Their Actually Delivered Doses: Implications for Adaptive Replanning in Radiation Therapy of Head-and-Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

Hunter, Klaudia U. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Fernandes, Laura L. [Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States); Vineberg, Karen A.; McShan, Daniel; Antonuk, Alan E. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Cornwall, Craig [Department of Hospital Dentistry, University of Michigan, Ann Arbor, Michigan (United States); Feng, Mary [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Schipper, Mathew J. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States); Balter, James M. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Eisbruch, Avraham, E-mail: eisbruch@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

2013-11-15

Purpose: Doses actually delivered to the parotid glands during radiation therapy often exceed planned doses. We hypothesized that the delivered doses correlate better with parotid salivary output than the planned doses, used in all previous studies, and that determining these correlations will help make decisions regarding adaptive radiation therapy (ART) aimed at reducing the delivered doses. Methods and Materials: In this prospective study, oropharyngeal cancer patients treated definitively with chemoirradiation underwent daily cone-beam computed tomography (CBCT) with clinical setup alignment based on the C2 posterior edge. Parotid glands in the CBCTs were aligned by deformable registration to calculate cumulative delivered doses. Stimulated salivary flow rates were measured separately from each parotid gland pretherapy and periodically posttherapy. Results: Thirty-six parotid glands of 18 patients were analyzed. Average mean planned doses was 32 Gy, and differences from planned to delivered mean gland doses were −4.9 to +8.4 Gy, median difference +2.2 Gy in glands in which delivered doses increased relative to planned. Both planned and delivered mean doses were significantly correlated with posttreatment salivary outputs at almost all posttherapy time points, without statistically significant differences in the correlations. Large dispersions (on average, SD 3.6 Gy) characterized the dose–effect relationships for both. The differences between the cumulative delivered doses and planned doses were evident at first fraction (r=.92, P<.0001) because of complex setup deviations (eg, rotations and neck articulations), uncorrected by the translational clinical alignments. Conclusions: After daily translational setup corrections, differences between planned and delivered doses in most glands were small relative to the SDs of the dose–saliva data, suggesting that ART is not likely to gain measurable salivary output improvement in most cases. These differences were

Cross-sectional imaging in pediatric neck masses

International Nuclear Information System (INIS)

Koenigsberg, R.A.; Patel, M.; Horowitz, C.

1990-01-01

This paper reports on US, CT, and MR imaging that demonstrates unique roles in the evaluation of pediatric neck masses. The causes of these masses range from infections/abscesses to primary and secondary tumors. The purpose of this paper is to review pediatric neck masses and the current role of cross-sectional imaging. Seventy-one examinations of the neck by means of CT, US, and MR imaging on 62 patients aged 1-21 y were retrospectively reviewed. Diseases were categorized according to benign versus malignant causes. Benign: 9 abscesses/cellulitis, 5 thyroglossal duct cysts, 3 branchial cleft cysts, 2 parotid cysts, 2 benign enlarged lumphadenopathies, 2 cystic hydromas, 1 ranula, and 1 hematoma

TC pathological Neck

International Nuclear Information System (INIS)

Garcia Fontes, M.

2012-01-01

This presentation is about different imaging techniques such as ultrasound, CT, RNM, PET-CT. These techniques permit to detect head and neck tumors, breast and digestive pathologies as well as congenital diseases and glandular tumor in the thyroid, parathyroid, muscles, lymphatic, nerves and vessels

Irradiation-assisted stress corrosion cracking in HTH Alloy X-750 and Alloy 625

International Nuclear Information System (INIS)

Bajaj, R.; Mills, W.J.; Lebo, M.R.; Hyatt, B.Z.; Burke, M.G.

1995-01-01

In-reactor testing of bolt-loaded compact tension specimens was performed in 360 C water to determine the irradiation-assisted stress corrosion cracking (IASCC) behavior of HTH Alloy X-750 and direct-aged Alloy 625. New data confirm previous results showing that high irradiation levels reduce SCC resistance in Alloy X-750. Heat-to-heat variability correlates with boron content, with low boron heats showing improved IASCC properties. Alloy 625 is resistant to IASCC, as no cracking was observed in any Alloy 625 specimens. Microstructural, microchemical and deformation studies were performed to characterize the mechanisms responsible for IASCC in Alloy X-750 and the lack of an effect in Alloy 625. The mechanisms under investigation are: boron transmutation effects, radiation-induced changes in microstructure and deformation characteristics, and radiation-induced segregation. Irradiation of Alloy X-750 caused significant strengthening and ductility loss that was associated with the formation of cavities and dislocation loops. High irradiation levels did not cause significant segregation of alloying or trace elements in Alloy X-750. Irradiation of Alloy 625 resulted in the formation of small dislocation loops and a fine body-centered-orthorhombic phase. The strengthening due to the loops and precipitates was apparently offset by a partial dissolution of γ double-prime precipitates, as Alloy 625 showed no irradiation-induced strengthening or ductility loss. In the nonirradiated condition, an IASCC susceptible HTH heat containing 28 ppm B showed grain boundary segregation of boron, whereas a nonsusceptible HTH heat containing 2 ppm B and Alloy 625 with 20 ppm B did not show significant boron segregation. Transmutation of boron to helium at grain boundaries, coupled with matrix strengthening, is believed to be responsible for IASCC in Alloy X-750, and the absence of these two effects results in the superior IASCC resistance displayed by Alloy 625

Practical measurement of silicon in low alloy steels by differential pulse stripping voltammetry

International Nuclear Information System (INIS)

Rahier, A.; Lunardi, S.; Triki, C.

2005-01-01

A sensitive differential pulse anodic stripping voltammetry has been adapted to allow the determination of Si in low-alloy steels using a hanging mercury drop electrode. The method has been qualified using certified ASTM standards and is now running in routine. The present report describes the experimental details, thereby allowing the reader to carry out the measurements precisely. (author)

Evaluation of the dynamic and kinematic performance of the THOR dummy : neck performance

NARCIS (Netherlands)

Hoofman, M.; van Ratingen, M.R.; Wismans, J.S.H.M.; Cesari, D.

1998-01-01

The objective of this study is to evaluate the frontal head-neck performance of the THOR neck with respect to the human frontal head-neck performance and the Hybrid-III frontal head-neck performance. For this purpose, tests were carried out with an isolated THOR and Hybrid-III head-neck system on a

Outcomes after primary chemoradiotherapy for N3 (>6 cm) head and neck squamous cell carcinoma after an FDG-PET--guided neck management policy.

Science.gov (United States)

Adams, Gerard; Porceddu, Sandro V; Pryor, David I; Panizza, Benedict; Foote, Matthew; Rowan, Ann; Burmeister, Bryan

2014-08-01

The purpose of this study was to assess whether a positron emission tomography (PET)-directed policy remains appropriate for managing neck nodes (N3; >6 cm) in head and neck squamous cell carcinoma (HNSCC). All patients with N3 (>6 cm) HNSCC treated with definitive chemoradiotherapy (CRT) at our institution between 2005 and 2012 were included in the analysis. Patients underwent PET assessment before and 12 weeks after CRT. Neck dissections were performed for PET-avid residual nodal abnormalities after complete response at the primary site. Rate of isolated nodal failure (INF) was the primary outcome. Median follow-up from diagnosis for 33 patients was 30 months (range, 6-76 months). INF occurred in 2 patients (6%) with neck dissections performed in 4 cases (12%). First failure was predominantly distant metastatic (10; 30%). The rate of INF remains low when following a PET-directed neck management policy after definitive CRT for N3 (>6 cm) HNSCC. Copyright © 2013 Wiley Periodicals, Inc.

Turnover in intracranial aneurysm phantoms: its relation to neck size

International Nuclear Information System (INIS)

Chung, Tae Sub; Lee, Young Jun; Rhim, Yoon Chul

2003-01-01

To evaluate the physiologic background of aneurysms poorly visualized during 3D-TOF MRA, contrast-enhanced MRA (CEMRA) and DSA due to hemodynamic isolation. Using handmade elastic silicon phantoms to represent terminal basilar tip aneurysms, 3D-TOF MRA, CEMRA and DSA were used to determine blood turnover. Aneurysmal neck size was 2 mm and 10 mm, and the use of a pulsatile pump also helped recreate human physiologic parameters. We compared the results with those of computational fluid dynamics. DSA images of the narrow-necked aneurysm showed that a small volume of contrast medium washed into it during the systolic phase. As the width of its neck increased, the turnover volume of fragments of contrast bolus also increased. At CEMRA, the broad-necked aneurysm was visualized as the main bolus of Gd-DTPA passed through it, and at delayed CEMRA, the narrow-necked aneurysm was visualized faintly after the passage of bolus Gd-DTPA. The results correlated closely with those of 3D-TOF MRA and computational fluid dynamics. The visualization of intracranial aneurysms at 3D-TOF MRA, CEMRA and DSA was greatly dependent upon blood turnover, which varied according to aneurysmal neck size. A narrow-necked aneurysm might be missed at 3D-TOF MRA, CEMRA and DSA due to hemodynamic isolation

Chronic neck pain and whiplash: a case-control study of the relationship between acute whiplash injuries and chronic neck pain.

Science.gov (United States)

Freeman, M D; Croft, Arthur C; Rossignol, Annette M; Centeno, Christopher J; Elkins, Whitney L

2006-01-01

The authors undertook a case-control study of chronic neck pain and whiplash injuries in nine states in the United States to determine whether whiplash injuries contributed significantly to the population of individuals with chronic neck and other spine pain. Four hundred nineteen patients and 246 controls were randomly enrolled. Patients were defined as individuals with chronic neck pain, and controls as those with chronic back pain. The two groups were surveyed for cause of chronic pain as well as demographic information. The two groups were compared using an exposure-odds ratio. Forty-five per cent of the patients attributed their pain to a motor vehicle accident. An OR of 4.0 and 2.1 was calculated for men and women, respectively. Based on the results of the present study, it reasonable to infer that a significant proportion of individuals with chronic neck pain in the general population were originally injured in a motor vehicle accident.

Chronic neck pain and whiplash: A case-control study of the relationship between acute whiplash injuries and chronic neck pain

Science.gov (United States)

Freeman, Michael D; Croft, Arthur C; Rossignol, Annette M; Centeno, Christopher J; Elkins, Whitney L

2006-01-01

The authors undertook a case-control study of chronic neck pain and whiplash injuries in nine states in the United States to determine whether whiplash injuries contributed significantly to the population of individuals with chronic neck and other spine pain. Four hundred nineteen patients and 246 controls were randomly enrolled. Patients were defined as individuals with chronic neck pain, and controls as those with chronic back pain. The two groups were surveyed for cause of chronic pain as well as demographic information. The two groups were compared using an exposure-odds ratio. Forty-five per cent of the patients attributed their pain to a motor vehicle accident. An OR of 4.0 and 2.1 was calculated for men and women, respectively. Based on the results of the present study, it reasonable to infer that a significant proportion of individuals with chronic neck pain in the general population were originally injured in a motor vehicle accident. PMID:16770448

Neck sprain after motor vehicle accidents in drivers and passengers

NARCIS (Netherlands)

Versteegen, GJ; Kingma, J; Meijler, WJ; ten Duis, HJ

2000-01-01

Neck sprain is a general term denoting a soft tissue injury of the neck, which seldom causes major disability but is considered a modem epidemic. The purpose of the present study was to determine the prevalence of sprain of the neck injury due to motor vehicle accidents (MVAs) in both drivers and

Neck and arm pain syndromes

DEFF Research Database (Denmark)

de las Peñas, César Fernández; Cleland, Joshua; Huijbregts, Peter

approaches.It uniquely addresses the expanding role of the various health care professions which require increased knowledge and skills in screening for contra-indications and recognizing the need for medical-surgical referral. Neck and Arm Pain Syndromes also stresses the integration of experiential......The first of its kind, Neck and Arm Pain Syndromes is a comprehensive evidence- and clinical-based book, covering research-based diagnosis, prognosis and management of neuromusculoskeletal pathologies and dysfunctions of the upper quadrant, including joint, muscle, myofascial and neural tissue...... of the most commonly seen pain syndromes in clinical practice over 800 illustrations demonstrating examination procedures and techniques....

Evaluation of the dynamic and kinematic performance of the THOR dummy: neck performance

NARCIS (Netherlands)

Hoofman, M.; Ratingen, M.R. van; Wismans, J.S.H.M.

1998-01-01

The objective of this study is to evaluate the frontal head-neck performance of the THOR neck with respect to the human frontal head-neck performance and the Hybrid-III frontal head-neck performance. For this purpose, tests were carried out with an isolated THOR and Hybrid-III-neck system on a HyGe

Filler metal alloy for welding cast nickel aluminide alloys

Science.gov (United States)

Santella, M.L.; Sikka, V.K.

1998-03-10

A filler metal alloy used as a filler for welding cast nickel aluminide alloys contains from about 15 to about 17 wt. % chromium, from about 4 to about 5 wt. % aluminum, equal to or less than about 1.5 wt. % molybdenum, from about 1 to about 4.5 wt. % zirconium, equal to or less than about 0.01 wt. % yttrium, equal to or less than about 0.01 wt. % boron and the balance nickel. The filler metal alloy is made by melting and casting techniques such as are melting the components of the filler metal alloy and cast in copper chill molds. 3 figs.

The Evaluation of the Corrosion Resistance of the Al-Si Alloys Antimony Alloyed

Directory of Open Access Journals (Sweden)

Svobodova J.

2014-06-01

Full Text Available This paper deals with the evaluation of the corrosion resistance of the Al-Si alloys alloyed with the different amount of antimony. Specifically it goes about the alloy AlSi7Mg0,3 which is antimony alloyed in the concentrations 0; 0,001; 0,005; 0,01 a 0,05 wt. % of antimony. The introduction of the paper is dedicated to the theory of the aluminium alloys corrosion resistance, testing and evaluation of the corrosion resistance. The influence of the antimony to the Al-Si alloys properties is described further in the introduction. The experimental part describes the experimental samples which were prepared for the experiment and further they were exposed to the loading in the atmospheric conditions for a period of the 3 months. The experimental samples were evaluated macroscopically and microscopically. The results of the experiment were documented and the conclusions in terms of the antimony impact to the corrosion resistance of the Al-Si alloy were concluded. There was compared the corrosion resistance of the Al-Si alloy antimony alloyed (with the different antimony content with the results of the Al-Si alloy without the alloying after the corrosion load in the atmospheric conditions in the experiment.

VANADIUM ALLOYS

Science.gov (United States)

Smith, K.F.; Van Thyne, R.J.

1959-05-12

This patent deals with vanadium based ternary alloys useful as fuel element jackets. According to the invention the ternary vanadium alloys, prepared in an arc furnace, contain from 2.5 to 15% by weight titanium and from 0.5 to 10% by weight niobium. Characteristics of these alloys are good thermal conductivity, low neutron capture cross section, good corrosion resistance, good welding and fabricating properties, low expansion coefficient, and high strength.

[Planned neck dissection in the treatment of locally advanced head and neck squamous cell carcinoma].

Science.gov (United States)

Jiang, L; Lou, J L; Wang, K J; Fang, M Y; Fu, Z F

2018-02-07

Objective: To investigate the value of planned neck dissection combined with induction chemotherapy and concurrent chemoradiotherapy in regional control and the outcome of locally advanced head and neck squamous cell carcinoma. Methods: A prospective randomized controlled study totally enrolled sixty-four patients of head and neck squamous cell carcinomas(include oropharynx, hypopharynx, and larynx) in stages Ⅳa-Ⅳb with lymph node metastase was were N2-N3. All patients firstly received 2-3 cycles of induction chemotherapy(ICT), then divided into two groups randomly, according to the efficacy of ICT. Group A(the study group) received planned neck dissection(PND) and concurrent chemoradiotherapy(CCRT). Group B(the control group) received concurrent chemoradiotherapy(CCRT). The differences in clinicopathologic features, local recurrence(LR), regional recurrence(RR), disease-free survival(DFS), and overall survival(OS) between the two groups were estimated. SPSS 19.0 software was used to analyze the data. Results: Group A enrolled twenty-one patients, and group B enrolled forty-three patients.The follow-up of all patients were 4-55 months, median follow-up time was 22 months. In study group, two-year OS and DFS were 80.9% and 68.3%, respectively. In control group, two-year OS and DFS were 90.7% and 67.1%, respectively. There was no significant difference in gender( P =0.215), age( P =0.828), primary tumor site( P =0.927), LR( P =0.126), DFS( P =0.710), and OS( P =0.402) between the two groups, while the RR(χ(2)=5.640, P squamous cell carcinoma.

An informatics approach to transformation temperatures of NiTi-based shape memory alloys

International Nuclear Information System (INIS)

Xue, Dezhen; Xue, Deqing; Yuan, Ruihao; Zhou, Yumei; Balachandran, Prasanna V.; Ding, Xiangdong; Sun, Jun; Lookman, Turab

2017-01-01

The martensitic transformation serves as the basis for applications of shape memory alloys (SMAs). The ability to make rapid and accurate predictions of the transformation temperature of SMAs is therefore of much practical importance. In this study, we demonstrate that a statistical learning approach using three features or material descriptors related to the chemical bonding and atomic radii of the elements in the alloys, provides a means to predict transformation temperatures. Together with an adaptive design framework, we show that iteratively learning and improving the statistical model can accelerate the search for SMAs with targeted transformation temperatures. The possible mechanisms underlying the dependence of the transformation temperature on these features is discussed based on a Landau-type phenomenological model.

Ipsilateral humeral neck and shaft fractures

Directory of Open Access Journals (Sweden)

Zhu Bin

2017-01-01

Full Text Available Background/Aim. Fractures of the proximal humerus or shaft are common, however, ipsilateral neck and shaft humerus fracture is a rare phenomenon. This combination injury is challenging for orthopaedic surgeons because of its complex treatment options at present. The purpose of this study was to review a series of ipsilateral humeral neck and shaft fractures to study the fracture pattern, complications and treatment outcomes of each treatment options used. Methods. A total of six patients (four female and two male with the average age of 42.8 years (range: 36–49 years was collected and reviewed retrospectively. Two of them were treated with double plates and four with antegrade intramedullary nail. According to the Neer’s classification, all proximal fractures were two-part surgical neck fractures. All humeral shaft fractures were located at the middle of one third. Five fractures were simple transverse (A3, one fragmented wedge fracture (B3. One patient had associated radial nerve palsy. Results. All surgical neck fractures except one united uneventfully in the average time span of 8.7 weeks. Four humeral shaft fractures healed in near anatomic alignment. The remaining two patients had the nonunion with no radiological signs of fracture healing. The average University of California, Los Angeles End-Results (UCLA score was 23.1. On the contrary, the average American Shoulder and Elbow Surgeon's (ASES score was 73.3. The patients treated with antegrade intramedullary nails presented 70.5 points. The ASES scores were 79 in the double plates group. Conclusions. Ipsilateral humeral shaft and neck fracture is extremely rare. Both antegrade intramedullar nailing and double plates result in healing of fractures. However the risk of complication is lower in the double plating group.

A comparison of bladder neck preservation and bladder neck reconstruction for urinary incontinence after radical retro pubic prostatectomy

Directory of Open Access Journals (Sweden)

Mohammad Hossein Izadpanahi

2014-01-01

Full Text Available Background: Prostate cancer is the sixth most common cancer worldwide and will include about 30% of all malignancies in men. Since the initial report of the anatomic radical prostatectomy, refinements in the surgical technique have been made. Several studies show that bladder neck preservation (BNP during radical prostatectomy makes improve early return of urinary continence, erectile function or both. However, some clinical trials have suggested little difference between the return of continence while using modifications. In this study, we compared outcomes of BNP and bladder neck reconstruction (BNR during radical retropubic prostatectomy (RRP. Materials and Methods: This prospective study was performed on 60 patients at a referral university hospital from March 2010 to March 2012. Study population was all patients candidate for RRP (RRP in this period. All patients divided into two groups, A and B (30 patients in each group. Group A (n = 30 who preserved bladder neck (BNP and Group B (n = 30 who had BNR. Prostate specific antigen (PSA before and at 2, 6, 9, 12 and18 months after surgery, anastomotic stricture symptoms, positive bladder neck margin, Gleason score and urine incontinence were compared between two groups. Also, we compared bladder neck contracture, urinary continence and positive surgical margin rates after BNP and BNR while retropubic prostatectomy in 24 months period follow-up. Results: The mean age of the patients was 61.81 ± 7.15 years (range, 50-74 years. After a follow-up period of 24 months, the PSA rising was not different between the two groups. After 2 months, 19 (63.33% of patients in A group and the same number in B group were continent (P = 0.78. Stricture of the bladder neck at the anastomosis site requiring transurethral dilation occurred in 7 (23.33% and 3 (10.0% patients in groups A and B, respectively (P = 0.04. Conclusion: Although there was no difference in prevalence and duration of return of urinary

Biomechanics of Concussion: The Importance of Neck Tension

Science.gov (United States)

Jadischke, Ronald

Linear and angular velocity and acceleration of the head are typically correlated to concussion. Despite improvements in helmet performance to reduce accelerations, a corresponding reduction in the incidence of concussion has not occurred (National Football League [NFL] 1996-present). There is compelling research that forces on and deformation to the brain stem are related to concussion. The brain stem is the center of control for respiration, blood pressure and heart rate and is the root of most cranial nerves. Injury to the brain stem is consistent with most symptoms of concussion reported in the National Football League and the National Hockey League, such as headaches, neck pain, dizziness, and blurred vision. In the Hybrid III anthropomorphic test device (ATD), the upper neck load cell is in close proximity to the human brain stem. This study found that the additional mass of a football helmet onto the Hybrid III headform increases the upper neck forces and moments in response to helmet-to-helmet impact and helmet-to-chest impacts. A new laboratory impactor device was constructed to simulate collisions using two moving Hybrid III ATDs. The impactor was used to recreate on-field collisions (n = 20) in American football while measuring head, neck and upper torso kinematics. A strong correlation between upper neck forces, upper neck power and the estimated strains and strain rates along the axis of the upper cervical spinal cord and brain stem and concussion was found. These biomechanical responses should be added to head kinematic responses for a more comprehensive evaluation of concussion.

Psychological Care, Patient Education, Orthotics, Ergonomics and Prevention Strategies for Neck Pain

DEFF Research Database (Denmark)

Gross, Anita R; Kaplan, Faith; Huang, Stacey

2013-01-01

To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain.......To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain....

Validity and QOL of neck dissection preceding radiation therapy for hypopharyngeal cancer

International Nuclear Information System (INIS)

Uemura, Hirokazu; Yoshino, Kunitoshi; Fujii, Takashi; Suzuki, Motoyuki

2009-01-01

Thirty-one cases of hypopharyngeal cancer with neck dissection preceding radiation and 16 cases of hypopharyngeal cancer with neck dissection for locoregional recurrences after radiation were reviewed in order to make comparative evaluations of difficulty in surgical operation, postoperative complications, laryngeal preservation rate, and cause specific 5-year survival rate retrospectively. And quality of life (QOL) after neck dissection was additionally evaluated through the questionnaire. Since neck dissection preceding radiation for hypopharyngeal cancer may be superior to neck dissection for radiation failure, with easy surgical approach an non-lymphoid tissue preservation, that modality can be a reasonable choice of treatment for patients with nodal lesions, which are probably difficult to treat with radiation alone. Even though further investigation on QOL questionnaire is necessary, this modality can make a contribution to the neck and shoulder condition after neck dissection. (author)

Five-step neck lift: integrating anatomy with clinical practice to optimize results.

Science.gov (United States)

Narasimhan, Kailash; Stuzin, James M; Rohrich, Rod J

2013-08-01

A harmonious and youthful appearing neckline is arguably the most vital aspect of a successful facial rejuveation. Without sound principles, the neck appears skeletonized, tethered, and hollow. The anatomical studies that the authors have performed regarding the neck, jowl, and subplatysmal elements have influenced the techniques that they now use. The authors' approach modifies the classic techniques of the past, and seeks a nuanced approach to each patient by resuspension and reshaping of deeper neck elements. In this article, the authors apply their anatomical research and cadaveric studies to demonstrate and support their neck-lift techniques. The authors integrate their knowledge to describe how the technique of one of the senior authors (R.J.R.) has evolved over time. The main tenets of the authors' approach have evolved into a sequence that involves skin undermining over the neck and cheek, submental access to the neck, with possible excision of fat and midline plication of the platysma with release of the muscle inferiorly, platysmal window suspension laterally, precise release of the mandibular septum and ligament if needed, and finally redraping of the superficial musculoaponeurotic system (SMAS) by plication or SMASecomy. These five steps ensure correction of jowling, a smooth jawline, and a well-shaped neck. The five-step neck lift helps to optimize results in creating the ideal neck contour. The authors provide four points that should be considered in any neck-lift procedure. The end result is a well-defined, well-contoured neck, with an approach grounded in sound anatomical principles.

Crevice corrosion propagation on alloy 625 and alloy C276 in natural seawater

International Nuclear Information System (INIS)

McCafferty, E.; Bogar, F.D.; Thomas, E.D. II; Creegan, C.A.; Lucas, K.E.; Kaznoff, A.I.

1997-01-01

Chemical composition of the aqueous solution within crevices on two different Ni-Cr-Mo-Fe alloys immersed in natural seawater was determined using a semiquantitative thin-layer chromatographic method. Active crevices were found to contain concentrated amounts of dissolved Ni 2+ , Cr 3+ , Mo 3+ , and Fe 2+ ions. Propagation of crevice corrosion for the two alloys was determined from anodic polarization curves in model crevice solutions based upon stoichiometric dissolution or selective dissolution of alloy components. Both alloys 625 (UNS N06625) and C276 (UNS N10276) underwent crevice corrosion in the model crevice electrolytes. For the model crevice solution based upon selective dissolution of alloy constituents, the anodic dissolution rate for alloy 625 was higher than that for alloy C276. This trend was reversed for the model crevice solution based upon uniform dissolution of alloy constituents

Corrosion of aluminum alloys as a function of alloy composition

International Nuclear Information System (INIS)

Johnson, A.B. Jr.

1969-10-01

A study was initiated which included nineteen aluminum alloys. Tests were conducted in high purity water at 360 0 C and flow tests (approx. 20 ft/sec) in reactor process water at 130 0 C (TF-18 loop tests). High-silicon alloys and AlSi failed completely in the 360 0 C tests. However, coupling of AlSi to 8001 aluminum suppressed the failure. The alloy compositions containing iron and nickel survived tht 360 0 C autoclave exposures. Corrosion rates varied widely as a function of alloy composition, but in directions which were predictable from previous high-temperature autoclave experience. In the TF-18 loop flow tests, corrosion penetrations were similar on all of the alloys and on high-purity aluminum after 105 days. However, certain alloys established relatively low linear corrosion rates: Al-0.9 Ni-0.5 Fe-0.1 Zr, Al-1.0 Ni-0.15 Fe-11.5 Si-0.8 Mg, Al-1.2 Ni-1.8 Fe, and Al-7.0 Ni-4.8 Fe. Electrical polarity measurements between AlSi and 8001 alloys in reactor process water at temperatures up to 150 0 C indicated that AlSi was anodic to 8001 in the static autoclave system above approx. 50 0 C

Surface treatment of new type aluminum lithium alloy and fatigue crack behaviors of this alloy plate bonded with Ti–6Al–4V alloy strap

International Nuclear Information System (INIS)

Sun, Zhen-Qi; Huang, Ming-Hui; Hu, Guo-Huai

2012-01-01

Highlights: ► A new generation aluminum lithium alloy which special made for Chinese commercial plane was investigated. ► Pattern of aluminum lithium alloy and Ti alloy were shown after anodization. ► Crack propagation of samples bonded with different wide Ti straps were studied in this paper. -- Abstract: Samples consisting of new aluminum lithium alloy (Al–Li alloy) plate developed by the Aluminum Company of America and Ti–6Al–4V alloy (Ti alloy) plate were investigated. Plate of 400 mm × 140 mm × 2 mm with single edge notch was anodized in phosphoric solution and Ti alloy plate of 200 mm × 20 (40) mm × 2 mm was anodized in alkali solution. Patterns of two alloys were studied at original/anodized condition. And then, aluminum alloy and Ti alloy plates were assembled into a sample with FM 94 film adhesive. Fatigue crack behaviors of the sample were investigated under condition of nominal stress σ = 36 MPa and 54 MPa, stress ratio of 0.1. Testing results show that anodization treatment modifies alloys surface topography. Ti alloy bonding to Al–Li alloy plate effectively retards crack growth than that of Al–Li alloy plate. Fatigue life of sample bonded with Ti alloy strap improves about 62.5% than that of non-strap plate.

Delineation of the neck node levels for head and neck tumors: A 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines

DEFF Research Database (Denmark)

Grégoire, Vincent; Ang, Kian; Budach, Wilfried

2014-01-01

In 2003, a panel of experts published a set of consensus guidelines for the delineation of the neck node levels in node negative patients (Radiother Oncol, 69: 227-36, 2003). In 2006, these guidelines were extended to include the characteristics of the node positive and the post-operative neck...... (Radiother Oncol, 79: 15-20, 2006). These guidelines did not fully address all nodal regions and some of the anatomic descriptions were ambiguous, thereby limiting consistent use of the recommendations. In this framework, a task force comprising opinion leaders in the field of head and neck radiation...... of Otolaryngology-Head and Neck Surgery, and in alignment with the TNM atlas for lymph nodes in the neck, 10 node groups (some being divided into several levels) were defined with a concise description of their main anatomic boundaries, the normal structures juxtaposed to these nodes, and the main tumor sites...

The Properties of 7xxx Series Alloys Formed by Alloying Additions

Directory of Open Access Journals (Sweden)

Kwak Z.

2015-06-01

Full Text Available Currently there is a constant development in the field of aluminium alloys engineering. This results from, i.a., better understanding of the mechanisms that direct strengthening of these alloys and the role of microalloying. Now it is microalloying in aluminum alloys that is receiving a lot of attention. It affects substantially the macro- and microstructure and kinetics of phase transformation influencing the properties during production and its exploitation. 7xxx series aluminum alloys, based on the Al-Zn-Mg-Cu system, are high-strength alloys, moreover, the presence of Zr and Sr further increases their strength and improves resistance to cracking.

Advances in otolaryngology-Head and neck surgery. Volume 1

International Nuclear Information System (INIS)

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

1987-01-01

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

Advances in otolaryngology-Head and neck surgery. Volume 1

Energy Technology Data Exchange (ETDEWEB)

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.

Acoustic levitation with self-adaptive flexible reflectors.

Science.gov (United States)

Hong, Z Y; Xie, W J; Wei, B

2011-07-01

Two kinds of flexible reflectors are proposed and examined in this paper to improve the stability of single-axis acoustic levitator, especially in the case of levitating high-density and high-temperature samples. One kind is those with a deformable reflecting surface, and the other kind is those with an elastic support, both of which are self-adaptive to the change of acoustic radiation pressure. High-density materials such as iridium (density 22.6 gcm(-3)) are stably levitated at room temperature with a soft reflector made of colloid as well as a rigid reflector supported by a spring. In addition, the containerless melting and solidification of binary In-Bi eutectic alloy (melting point 345.8 K) and ternary Ag-Cu-Ge eutectic alloy (melting point 812 K) are successfully achieved by applying the elastically supported reflector with the assistance of a laser beam.

Effect of casting atmosphere on the marginal deficiency and misfit of Ni-Cr alloys with and without beryllium.

Science.gov (United States)

da Silva, Leandro J; Leal, Monica B; Valente, Mariana L C; de Castro, Denise T; Pagnano, Valéria O; Dos Reis, Andréa C; Bezzon, Osvaldo L

2017-07-01

The marginal adaptation of prosthetic crowns is still a significant clinical problem. The purpose of this in vitro study was to evaluate the marginal deficiency and misfit of Ni-Cr alloys with and without beryllium under different casting conditions. Four casting conditions were selected: flame-torch, induction/argon, induction/vacuum, and induction/air; and 2 alloys were used, Ni-Cr-Be and Ni-Cr. For each group, 10 metal specimens were prepared. Silicone indirect impressions and analysis of the degree of rounding were used to evaluate the marginal deficiencies of metal copings, and a standardized device for the setting pressure associated with optical microscopy was used to analyze the marginal misfit. Results were evaluated with 2-way ANOVA (α=.05), followed by the Tukey honest significant difference post hoc test, and the Pearson correlation test (α=.05). Alloy (Pcasting technique (Pcast using the torch technique showed the highest marginal deficiency, and the Ni-Cr-Be cast in a controlled argon atmosphere showed the lowest (Pcasting techniques (P=.206) did not affect the marginal misfit, but significant differences were found in the interaction (P=.001); the lowest misfit was achieved using the Ni-Cr-Be, and the highest misfit occurred with the molten Ni-Cr, using the cast torch technique. No correlation was found between deficiency and marginal misfit (r=.04, P=.69). The interactions demonstrated that the alloy containing beryllium that was cast in an argon atmosphere led to reduced marginal deficiency. Improved marginal adaptation can be achieved for the same alloy by using the torch technique. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Changes in disability, physical/mental health states and quality of life during an 8-week multimodal physiotherapy programme in patients with chronic non-specific neck pain: a prospective cohort study.

Directory of Open Access Journals (Sweden)

Antonio Ignacio Cuesta-Vargas

Full Text Available The aim of this study was to analyse the effect of an 8-week multimodal physiotherapy programme (MPP, integrating physical land-based therapeutic exercise (TE, adapted swimming and health education, as a treatment for patients with chronic non-specific neck pain (CNSNP, on disability, general health/mental states and quality of life.175 CNSNP patients from a community-based centre were recruited to participate in this prospective study.60-minute session (30 minutes of land-based exercise dedicated to improving mobility, motor control, resistance and strengthening of the neck muscles, and 30 minutes of adapted swimming with aerobic exercise keeping a neutral neck position using a snorkel. Health education was provided using a decalogue on CNSNP and constant repetition of brief advice by the physiotherapist during the supervision of the exercises in each session.primary: disability (Neck Disability Index; secondary: physical and mental health states and quality of life of patients (SF-12 and EuroQoL-5D respectively. Differences between baseline data and that at the 8-week follow-up were calculated for all outcome variables.Disability showed a significant improvement of 24.6% from a mean (SD of 28.2 (13.08 at baseline to 16.88 (11.62 at the end of the 8-week intervention. All secondary outcome variables were observed to show significant, clinically relevant improvements with increase ranges between 13.0% and 16.3% from a mean of 0.70 (0.2 at baseline to 0.83 (0.2, for EuroQoL-5D, and from a mean of 40.6 (12.7 at baseline to 56.9 (9.5, for mental health state, at the end of the 8-week intervention.After 8 weeks of a MPP that integrated land-based physical TE, health education and adapted swimming, clinically-relevant and statistically-significant improvements were observed for disability, physical and mental health states and quality of life in patients who suffer CNSNP. The clinical efficacy requires verification using a randomised controlled study

Reducing thermal conductivity of binary alloys below the alloy limit via chemical ordering

International Nuclear Information System (INIS)

Duda, John C; English, Timothy S; Jordan, Donald A; Norris, Pamela M; Soffa, William A

2011-01-01

Substitutional solid solutions that exist in both ordered and disordered states will exhibit markedly different physical properties depending on their exact crystallographic configuration. Many random substitutional solid solutions (alloys) will display a tendency to order given the appropriate kinetic and thermodynamic conditions. Such order-disorder transitions will result in major crystallographic reconfigurations, where the atomic basis, symmetry, and periodicity of the alloy change dramatically. Consequently, the dominant scattering mechanism in ordered alloys will be different than that in disordered alloys. In this study, we present a hypothesis that ordered alloys can exhibit lower thermal conductivities than their disordered counterparts at elevated temperatures. To validate this hypothesis, we investigate the phononic transport properties of disordered and ordered AB Lennard-Jones alloys via non-equilibrium molecular dynamics and harmonic lattice dynamics calculations. It is shown that the thermal conductivity of an ordered alloy is the same as the thermal conductivity of the disordered alloy at ∼0.6T melt and lower than that of the disordered alloy above 0.8T melt .

Change in neck circumference after shoulder arthroscopy: An observational study

Directory of Open Access Journals (Sweden)

Shrividya Chellam

2015-01-01

Full Text Available Background and Aims: Shoulder arthroscopy requires fluid irrigation, which causes soft-tissue oedema around chest, neck, and arm intraoperatively, leading to postoperative airway complications. We decided to study the incidence of increase in the neck circumference in shoulder arthroscopy and its effects on the airway. Methods: We studied 32 cases of shoulder arthroscopies over a period of 1-year, performed under general anaesthesia with interscalene block. The neck circumference of patients before and after the procedure was measured along with other parameters. The endotracheal tube cuff was deflated at the end of surgery to determine air leak around the tube. The negative leak test suggested airway oedema. Results: Thirty out of 32 patients showed positive air leak test. The average change in neck circumference was 1.17 ± 1.16 cm and all could be extubated uneventfully. Two showed negative leak test with an increase in neck circumference by 4.5 and 6.4 cm and were not extubated. Multiple regression analysis for risk factors showed intraoperative hypertension as a single predictor for an increase in neck circumference. Conclusion: Change in the neck circumference beyond 4 cm may suggest airway compromise and below 4 cm, airway compromise is unlikely even in the presence of extensive soft-tissue oedema around the shoulder, upper arm and chest.

Training preferences and motivation for rehabilitation in patients with neck pain