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Biomedical subjects

J C Cheng

Publications and source records attributed to J C Cheng.

At least 37 records · Page 2Linked to original sources
PubMed2000

Aggressive thoracic actinomycosis complicated by vertebral osteomyelitis and epidural abscess leading to spinal cord compression.

STUDY DESIGN: Report of a successfully diagnosed and treated case of spinal cord compression due to epidural actinomycosis. OBJECTIVE: To illustrate that proper use of imaging strategy can greatly facilitate diagnosis and management of this rare condition. SUMMARY OF BACKGROUND DATA: Spinal actinomycosis causing epidural abscess and significant spinal cord compression is an uncommon condition. Although diagnosis is difficult, favorable results are widely reported when specific therapy is instituted. METHODS: A 32-year-old Chinese man had extensive dorsal thoracic soft tissue swelling and lower limb weakness. Collapse of the T5 vertebral body was found on plain radiographs with mediastinal infiltrates on chest radiograph. It took magnetic resonance imaging (MRI) to fully delineate the epidural abscess and dorsal muscular abscesses, which were not depicted by computed tomographic (CT) scan. Diagnosis was made by examination of CT-guided aspirate and tissue recovered during surgery by a microbiologist. The patient received high-dose intravenous penicillin and prompt spinal decompression once diagnosis of actinomycosis was confirmed. RESULTS: The dorsal muscular abscesses and upper thoracic epidural abscess resolved rapidly after intravenous antibiotics and surgical drainage. This was well documented by follow-up MRI and the full recovery of motor power and lower limb sensation in the patient. CONCLUSIONS: High clinical suspicion and proper use of imaging data led to timely diagnosis of this rare case of mediastinal, epidural, and intramuscular thoracic actinomycosis. Specific antibiotic therapy and timely, well-targeted surgical intervention greatly improve the outcome of this condition.

Actinomycosis↗
PubMed2000

Correlation of ultrasonographic imaging of congenital muscular torticollis with clinical assessment in infants.

Congenital muscular torticollis (CMT) is a common problem affecting infants and children. There is a general lack of standard clinical classification or objective assessment methods. Ultrasonographic imaging of the sternomastoid muscle (SCM) has been carried out in a consecutive series of 436 infants less than 1 y old presenting with CMT over a 5-y period. All patients were classified into three clinical groups: postural torticollis, muscular torticollis and sternomastoid tumor. The severity of the torticollis was also expressed into four subgroups according to the degree of deficits in passive rotation of the neck. The ultrasonographic image of the affected SCM included the echogenicity, texture, motility, softness and the transverse and longitudinal extent of the involvement. The disturbance in the quantitative measurement of the transverse diameter of the lower and upper third of the SCM and the ratio of the measurement to the normal side was recorded. The qualitative and quantitative changes in the SCM image were found to correlate significantly with the clinical typing and severity of rotational deficits of the neck. Ultrasonographic imaging has important potential clinical application in helping the diagnosis, prognostication and monitoring of progress of CMT longitudinally.

Female↗
PubMed2000

Unique features of breast cancer in Taiwan.

Between April 1990 and December 1997, 811 consecutive patients with 830 newly diagnosed breast cancers having their primary treatments in our institution were included in this study. Sixty three percent of breast cancer patients were premenopausal. The early-onset breast cancer (age < or = 40) composed 29.3% of all patients. The five-year survival rate of all patients was 80.4% (95% confidence interval [CI], 76.2-84.6%). The five-year overall survival rate for stage 0 was 95.7% (95% CI, 87.3-100%), stage I, 93.9% (95% CI, 88.9-98.9%), stage II, 88.5% (95% CI, 82.0-95.1%), stage III, 65.0% (95% CI, 54.0-75.9%), and stage IV, 18.5% (95% CI, 3.4-33.7%). Multivariate analysis of primary operable breast cancer revealed that axillary lymph node involvement, high nuclear grade and early-onset breast cancer (age < or = 40) were poor prognostic factors. The early-onset breast cancer had a more aggressive clinical behavior than that of the older age group, their five-year disease-free survival rates for stage I, stage II and stage III diseases being only 64.7%, 66.5%, and 43.3%, respectively. In these patients the only meaningful prognostic factor was extensive axillary lymph node metastasis (> or = 10). In summary, breast cancer patients in Taiwan tend to be younger than their counterpart in western countries. The early-onset breast cancer had poorer prognostic features for all stages comparing to the older age group. Standard pathologic factors are not good predictors of their outcome. For these patients new biologic markers need to be sought to distinguish between high and low risk and the treatment strategy for them should be guided by the aggressive characteristics of the disease.

Adult↗
PubMed2000

The clinical presentation and outcome of treatment of congenital muscular torticollis in infants--a study of 1,086 cases.

BACKGROUND/PURPOSE: The main objectives of this study were to define the clinical patterns and characteristics of congenital muscular torticollis (CMT) presented in the first year of life and to study the outcome of different treatment methods. METHODS: This is a prospective study of all CMT patients seen in 1 center over a 12-year period with uniform recording system, assessment methods, and treatment protocol. RESULTS: From a total of 1,086 CMT infants, 3 clinical subgroups of sternomastoid tumor (SMT; 42.7%), muscular torticollis (MT; 30.6%), and postural torticollis (POST; 22.1%) were identified. The SMT group was found to present earlier within the first 3 months and was associated with higher incidence of breech presentation (19.5%), difficult labor (56%), and hip dysplasia (6.81%). Severity of limitation of passive neck rotation range (ROTGp) was found to correlate significantly with the presence of SMT, bigger tumor size, hip dysplasia, degree of head tilt, and craniofacial asymmetry. CONCLUSIONS: A total of 24.5% of the patients with initial deficits of passive rotation of less than 10 degrees showed excellent and good outcome with active home positioning and stimulation program. The remaining cases with rotation deficits of over 10 degrees and treated with manual stretching program showed an overall excellent to good results in 91.1% with 5.1% requiring subsequent surgical treatment. The most important prognostic factors for the necessity of surgical treatment were the clinical subgroup, the ROTGp, and the age at presentation (P < .001).

Age Factors↗
PubMed2000

The role of the Arabidopsis ELD1 gene in cell development and photomorphogenesis in darkness.

Because cell growth and differentiation are regulated by complex interactions among different signaling pathways, a growth defect affects subsequent differentiation. We report on a growth-defective mutant of Arabidopsis, called eld1 (elongation defective 1). Cell elongation was impaired in every organ examined. Later characteristics of the eld1 phenotype include defective vascular tissue differentiation, the inability to grow in soil, ectopic deposition of suberin around twisted vascular bundles, the de-etiolation phenotype, and continuation of shoot development and flowering in the dark. The dwarf phenotype of eld1 could not be rescued by treatment with exogenous growth regulators. Because defective cell elongation is the earliest and most universal feature detected in eld1 mutants, control of or activity in cell elongation may be the primary function of the ELD1 gene. The impaired cell growth results in pleiotropic effects on cell proliferation and differentiation, and the retardation in hypocotyl elongation enables growth and development in darkness.

Arabidopsis↗
PubMed2000

Roles of the AX(4)GKS and arginine-rich motifs of hepatitis C virus RNA helicase in ATP- and viral RNA-binding activity.

The nonstructural protein 3 (NS3) of hepatitis C virus (HCV) possesses protease, nucleoside triphosphatase, and helicase activities. Although the enzymatic activities have been extensively studied, the ATP- and RNA-binding domains of the NS3 helicase are not well-characterized. In this study, NS3 proteins with point mutations in the conserved helicase motifs were expressed in Escherichia coli, purified, and analyzed for their effects on ATP binding, RNA binding, ATP hydrolysis, and RNA unwinding. UV cross-linking experiments indicate that the lysine residue in the AX(4)GKS motif is directly involved in ATP binding, whereas the NS3(GR1490DT) mutant in which the arginine-rich motif (1486-QRRGRTGR-1493) was changed to QRRDTTGR bound ATP as well as the wild type. The binding activity of HCV NS3 helicase to the viral RNA was drastically reduced with the mutation at Arg1488 (R1488A) and was also affected by the K1236E substitution in the AX(4)GKS motif and the R1490A and GR1490DT mutations in the arginine-rich motif. Previously, Arg1490 was suggested, based on the crystal structure of an NS3-deoxyuridine octamer complex, to directly interact with the gamma-phosphate group of ATP. Nevertheless, our functional analysis demonstrated the critical roles of Arg1490 in binding to the viral RNA, ATP hydrolysis, and RNA unwinding, but not in ATP binding.

Adenosine Triphosphatases↗
PubMed2000

An international comparison of childhood injuries in Hong Kong.

OBJECTIVES: This study describes 7813 childhood injuries in Shatin, Hong Kong. Supplementary analyses include developmental specificity of external causes and comparison with international childhood injury data. METHODS: Children aged 0-15 attending the accident and emergency (A&E) department of the Prince of Wales Hospital in Hong Kong were recruited for the study. Attendance records of participants from the A&E department were analyzed. Details concerning the injury, including the International Classification of Diseases, ninth revision, external cause of injury (E code), nature of injury (N code), abbreviated injury scale, and injury severity scale constitute core measurements, along with participants' age, gender, and respective A&E procedural data. RESULTS: Males (65.7%) and fall related injuries (44.2%) predominate, while contusion (34.6%) is the prevailing nature of injury. Two age external cause dimensions are derived from a correspondence analysis. Children 0-1 years old are associated with falls, poisoning, scalds, and machinery related injury. Adolescents aged 12-15 are associated with motor related injury, animal related injury, and cuts/piercings. In comparison with international data, unintentional child injuries in Hong Kong comprised more falls but fewer poisonings and burns. CONCLUSION: A large proportion of falls, along with low proportion of poisonings and burns, are characteristics of childhood injury profile in Hong Kong. From the results of age external cause correspondence analysis, prevention strategies for different external cause should be developmentally specific.

Adolescent↗
PubMed2000

Concomitant radiotherapy and chemotherapy for early-stage nasopharyngeal carcinoma.

PURPOSE: Early-stage nasopharyngeal carcinoma (NPC) continues to carry a failure rate of 15% to 30% when treated with radiotherapy alone; the benefit of concomitant radiotherapy and chemotherapy (CCRT) in early-stage NPC is unclear. The purpose of this report is to describe our efforts to improve treatment outcome in early-stage NPC after CCRT. PATIENTS AND METHODS: Of 189 newly diagnosed NPC patients without evidence of distant metastases who were treated in our institution between 1990 and 1997, 44 presented with early-stage (stage I and II) disease according to the American Joint Committee on Cancer (AJCC) 1997 NPC staging system. Twelve of these patients were treated with radiotherapy alone and 32 with CCRT. Each patient's head and neck area was evaluated by magnetic resonance imaging or computed tomography. Radiotherapy was administered at 2 Gy per fraction per day, Monday through Friday, for 35 fractions for a total dose of 70 Gy. Chemotherapy consisting of cis-diamine-dichloroplatinum and fluorouracil was delivered simultaneously with radiotherapy in weeks 1 and 6 and sequentially for two monthly cycles after radiotherapy. RESULTS: Patients who were treated with radiotherapy alone primarily had stage I disease, whereas none of those who were treated with CCRT had stage I disease (11 of 12 patients v none of 32 patients; P =.001). The locoregional control rate at 3 years for the radiotherapy group was 91.7% (median follow-up period, 34 months) and was 100% for the CCRT group (median follow-up period, 44 months) (P =.10). The 3-year disease-free survival rate in the radiotherapy group was 91.7% and was 96.9% in the CCRT group (P =.66). CONCLUSION: Our results reveal excellent prognosis of AJCC 1997 stage II NPC treated with CCRT. Stage II patients with a greater tumor burden treated with CCRT showed an equal disease-free survival, compared with stage I patients treated with radiotherapy alone. A prospective randomized trial is underway to confirm the role of CCRT in stage II NPC.

Adult↗
PubMed2000

Generalized low areal and volumetric bone mineral density in adolescent idiopathic scoliosis.

Adolescent idiopathic scoliosis (AIS) may be associated with generalized low bone mineral status. The bone mineral density (BMD) of 75 girls of 12-14 years of age and diagnosed as having AIS were compared with 94 age-matched female control subjects. Areal BMD (aBMD) of the lumbar spine (L2-L4) and the bilateral proximal femur were measured using-energy X-ray absorptiometry (DEXA), and volumetric BMD (vBMD) of the nondominant distal radius and bilateral distal tibias was measured with peripheral quantitative computer tomography (pQCT). Relevant anthropometric parameters and the severity of the spinal deformity (Cobb's angle) also were evaluated and correlated with the BMD measurements. Results revealed the presence of a generalized lower bone mineral status in AIS patients. Detailed analysis showed that the aBMD and vBMD measured at the bilateral lower extremities were significantly lower in AIS patients when compared with the same in the normal controls. The most significant effect was seen in the trabecular BMD (tBMD) of the distal tibias. Of all the AIS girls, 38% of the aBMD and 36% of the vBMD were below -1 SD of the normal. BMD was found to correlate better with "years since menarche" (YSM) than with chronological age. When the BMD was evaluated for the 3 YSM groups, aBMD of the proximal femur and tBMD of distal tibias were found to be significantly lower in the AIS patients. Neither the aBMD nor the vBMD of AIS patients was found to be associated with the severity of spinal deformity. In addition, anthropometric measurements showed significantly longer arm span and lower extremities in the AIS girls. We concluded that the AIS girls had generalized lower aBMDs and vBMDs.

Adolescent↗
PubMed2000

Deferoxamine-induced bone dysplasia in the distal femur and patella of pediatric patients and young adults: MR imaging appearance.

OBJECTIVE: We investigated the MR imaging appearance of deferoxamine-induced bone dysplasia in the distal femur and patella in patients with thalassemia major. MATERIALS AND METHODS: Thirty-five patients with homozygous ss-thalassemia major who were undergoing regular transfusions and chelation therapy underwent coronal T1-weighted MR imaging of the femur, including the femoral head and the distal femoral epiphysis. Additional coronal fat-saturated dual-echo and sagittal T1-weighted images of the distal femur and patella were obtained in 11 patients who were suspected of having distal femoral lesions on the basis of the coronal T1-weighted images of the entire femur. RESULTS: No dysplastic change was detected in the proximal femur on coronal T1-weighted images. In 22 distal femurs of 11 patients, the following abnormalities were detected on MR imaging: blurred physeal-metaphyseal junction (n = 22), distal metaphyseal areas of hyperintensity (n = 21), physeal widening (n = 18), metadiaphyseal lesions (n = 11), epiphyseal lesions (n = 10), and patellar lesions (n = 2). Physeal widening and distal metaphyseal hyperintense areas were all more pronounced peripherally. Of the 21 distal metaphyseal hyperintensities, lateral abnormalities were larger than medial abnormalities in 16. Of the 18 distal femurs in which physeal widening was detected, the lateral widening was more marked than the medial widening in 12. Patients with MR imaging evidence of bone dysplasia have a significantly (p = 0.003) greater height reduction than patients without such evidence of bone dysplasia. CONCLUSION: Deferoxamine-induced bone dysplasia in the distal femur and patella is represented by a spectrum of morphologic changes in the epiphysis, physis, metaphysis, and metadiaphysis on MR imaging.

Adolescent↗
PubMed2000

Locoregional recurrence in patients with one to three positive axillary nodes after mastectomy without adjuvant radiotherapy.

PURPOSE: To retrospectively assess the risk of locoregional recurrence (LRR) and analyze the prognostic factors of this pattern of failure in patients with breast cancer and one to three positive axillary lymph nodes treated with modified radical mastectomy (MRM) without adjuvant radiotherapy. METHODS: From April 1991 through December 1997, 649 patients received a diagnosis of invasive breast cancer, and 545 were treated with MRM. Eighty-one of these patients who were found to have one to three positive axillary nodes and had a minimum follow-up of 2 years were included in this study. None of the 81 patients received adjuvant radiation therapy after mastectomy; 43 patients received adjuvant chemotherapy; and 60 patients received adjuvant hormone therapy. The median duration of follow-up was 39 months. RESULTS: Thirteen patients had LRR during follow-up, all within 2 years after mastectomy. The 3-year LRR rate was 14%. The 3-year rates of distant metastasis for patients with and without LRR were 48% and 14% (p = 0.03), respectively. The 3-year survival rates for patients with and without LRR were 73% and 87% (p = 0.01), respectively. In univariate analysis, age (p = 0.01), estrogen receptor (ER) status (p = 0.02), and the addition of hormone therapy (p < 0.001) were significant risk factors for LRR; in multivariate analysis, negative ER status (p = 0.02) was the only statistically significant risk factor. The 3-year LRR rates for ER-negative patients and those with positive or unknown ER status were 31% and 11%, respectively. CONCLUSIONS: LRR after mastectomy is a substantial clinical problem, despite the use of adjuvant chemotherapy and/or hormone therapy. Further randomized trials of postmastectomy radiotherapy for patients with one to three positive axillary nodes and specific risk factors are urgently needed to determine its potential benefit in locoregional control and survival, especially for young and ER-negative patients.

Adult↗
PubMed1999

Correlation between curve severity, somatosensory evoked potentials, and magnetic resonance imaging in adolescent idiopathic scoliosis.

STUDY DESIGN: A prospective study in patients with adolescent idiopathic scoliosis of different clinical severity using whole-spine magnetic resonance imaging and somatosensory evoked potentials. OBJECTIVES: To correlate the presence of magnetic resonance imaging structural abnormalities with somatosensory evoked potential-detected functional disorders in the hind brain and spinal cord and the Cobb's angle in patients with adolescent idiopathic scoliosis and to compare the result with those in healthy matched control subjects. SUMMARY OF BACKGROUND DATA: Many different types of neurologic dysfunction have been reported in scoliosis. With the advent of magnetic resonance imaging, there are increased reports on the association of idiopathic scoliosis and syringomyelia, Chiari I malformation, or tonsillar ectopia. The actual link between structural and functional disorder in idiopathic scoliosis is, however, unclear. METHODS: Posterior tibial nerve evoked potentials and whole-spine magnetic resonance imaging were performed in 36 healthy control subjects, 135 patients with adolescent idiopathic scoliosis with Cobb's angle less than 45 degrees, and 29 patients with Cobb's angle more than 45 degrees. RESULTS: Tonsillar ectopia or syringomyelia, detected by magnetic resonance imaging, or functional disturbance in the somatosensory pathway, detected by somatosensory evoked potentials, was found to be significantly more frequent in the group of patients with severe scoliosis curvature, with an incidence of 31% and 27.6%, respectively. Incidence of tonsillar ectopia was 33.3% in patients with abnormal somatosensory evoked potentials in contrast to the much lower incidence of 2.9% in patients with normal somatosensory evoked potentials. There was a significant structural and functional link. The incidence of syringomyelia in patients with and without tonsillar ectopia was 33.3% and 0.7%, respectively. CONCLUSIONS: In patients with adolescent idiopathic scoliosis with severe curve, the significant association with tonsillar ectopia and abnormal somatosensory function points to a neural origin. Disorders in the somatosensory function may be one of the mechanisms linking tonsillar ectopia to scoliosis. Somatosensory evoked potentials and magnetic resonance imaging may have important diagnostic and predictive value and may help in the management of adolescent idiopathic scoliosis.

Adolescent↗
PubMed1999

Persistent osteopenia in adolescent idiopathic scoliosis. A longitudinal follow up study.

STUDY DESIGN: A follow-up study assessing the bone mineral dynamics in adolescent patients with idiopathic scoliosis and associated osteopenia. OBJECTIVES: To investigate whether osteopenia in patients with adolescent idiopathic scoliosis is a transient phenomenon or a persistent problem. SUMMARY OF BACKGROUND DATA: Investigators have suggested a significant correlation of osteopenia with adolescent idiopathic scoliosis. Because one half of the skeletal mass is acquired during the adolescent years, it is of importance to know whether the osteopenia is transient or persistent. METHODS: Using dual-energy x-ray absorptiometry, bone mineral density of bilateral proximal femurs was studied longitudinally in 70 healthy control subjects and 14 patients with adolescent idiopathic scoliosis with significant osteopenia more than 2 standard deviations below the mean normal value. RESULTS: The 14 girls with osteopenic adolescent idiopathic scoliosis who were followed up longitudinally for up to 3 years showed persistent and significantly lower bone mineral density when compared with normal age-, sex- and maturity-matched control subjects. CONCLUSIONS: Patients with adolescent idiopathic scoliosis are at increased risk of osteoporosis than are healthy adolescents. The lower rate of increase of bone mineral density in patients with adolescent idiopathic scoliosis who have low bone mineral density could predict a significantly lower peak bone mass in adulthood, with all the associated problems of osteoporosis. Further investigation is needed to define whether osteopenia-associated scoliosis has the same cause, pathogenetic mechanism, and risk of progression when compared with adolescent scoliosis without osteopenia.

Absorptiometry, Photon↗
PubMed1999

MRI evaluation of multifidus muscles in adolescent idiopathic scoliosis.

BACKGROUND: The role of the multifidus muscles in the initiation and progression of curve in adolescent idiopathic scoliosis is not fully understood and controversy exists as to the side of the abnormality. OBJECTIVE: To evaluate on MRI the multifidus muscles at the apex of the major curve in adolescent idiopathic scoliosis to ascertain if the multifidus muscles on the convex or concave side are abnormal and the relationship to curve severity. MATERIALS AND METHODS: Forty-six patients with adolescent idiopathic scoliosis, separated into two groups, were studied using a 1.5-T MR scanner with the synergy spine coil, employing a modified STIR (short tau inversion recovery) axial sequence obtained at the apex of the major scoliotic curve. RESULTS: No hyperintense signal change was demonstrated in the convex side multifidus muscles in any patient. In group I, 16 of 18 patients with severe or rapidly progressive curve showed increase in signal intensity in the multifidus muscle on the concave side of the apex of the curve. In group II, of the 15 patients with mild curve (Cobb angle 10-30 degrees), 4 had increased signal intensity in the multifidus muscle on the concave side; of the 13 with more severe curve (Cobb angle greater than 30 degrees), 10 had increase in multifidus signal intensity on the concave side. CONCLUSIONS: The concave-side multifidus muscle at the apex of a scoliotic curve was morphologically abnormal. A significant association between abnormal signal change and curve severity was also established.

Adolescent↗
PubMed1999

Axial and peripheral bone mineral acquisition: a 3-year longitudinal study in Chinese adolescents.

UNLABELLED: We performed a 3-year longitudinal study of a group of 179 healthy Chinese adolescents (92 boys and 87 girls) aged from 12 to 16 years to determine the effects of puberty, physical activity, physical fitness, and calcium intake on the acquisition of bone mass. At yearly intervals for 3 consecutive years we recorded nutrition, calcium intake and anthropometric measurements, and assessed pubertal status according to Tanner. Bone mass of the lumbar spine was determined by dual-energy X-ray absorptiometry and radial bone mass by single-photon absorptiometry. Physical fitness and level of physical activity were assessed and muscle strength and power determined by isokinetic testing. Peripheral bone mass correlated with axial skeleton bone mass. Age, pubertal staging, physical fitness and muscle strength were significantly associated with bone mass increments on cross-sectional univariate and regression analysis. Longitudinal regression analysis showed that the most important factor affecting bone mass accretion in adolescents in both sexes was their pubertal stage. In boys, bone mass increment throughout the study was greater in children who were already in the advanced pubertal stages on entering the study than in those who started puberty in year 2 or 3 of the study. The percentage change in bone mineral content of the forearm and in bone mineral density of the lumbar spine was greater than 25% in the advanced pubertal group as compared to around 20% in the less mature group. For girls, the reverse was true. The increment of bone mass during the study period was significantly greater in those who presented in the earlier pubertal stages than in those who were at the more advanced stage of puberty on entry into the study. There was no significant effect of calcium intake and physical activities on the bone mass accretion. CONCLUSION: In Chinese adolescents, bone mineral accretion at adolescence is not influenced by exercise, level of physical fitness and calcium intake. In both sexes, and especially in girls, to optimally increase bone mass, regular physical exercise programmes should be instituted well before the onset of puberty rather than at or after it. Once puberty starts, these interventions may have no or only limited effect.

Adolescent↗
PubMed1999

Sternocleidomastoid pseudotumor and congenital muscular torticollis in infants: a prospective study of 510 cases.

OBJECTIVES: Congenital muscular torticollis is a common and controversial condition in infancy. We studied prospectively a group of infants with clearly defined sternomastoid tumor treated with a well-defined protocol. STUDY DESIGN: A total of 510 cases of sternomastoid tumor in infants over a 10-year period were studied prospectively with a mean follow-up of 3.5 years and a range from 1. 5 years to 13 years. The clinical presentations, associated abnormalities, treatments, and outcomes of the overall group and subgroups were evaluated to determine the most important prognostic factors. RESULTS: The mean age of presentation was day 24, with most (92.7%) presenting before the age of 3 months. There was a high correlation with breech presentation and assisted delivery. Clinical subgroups according to the deficit in passive rotation of the neck correlated with the incidence of hip dysplasia (up to 11.6%), mode of delivery, time of presentation, degree of craniofacial asymmetry, head tilt, and the size and extent of the pseudotumor (P <.05). With an early and prolonged manual stretching program, 90.7% had excellent and good overall results. The 6.7% of patients in the poor outcome group requiring surgical treatment all belonged to the more severe rotation limitation groups. CONCLUSIONS: Subgrouping patients with sternomastoid tumor according to the passive limitation of rotation of the neck has prognostic significance, with good overall results of conservative treatment with manual stretching.

Diagnosis, Differential↗