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At least 325 records · Page 18Linked to original sources
PubMed2001

Human papillomavirus-associated head and neck squamous cell carcinoma: mounting evidence for an etiologic role for human papillomavirus in a subset of head and neck cancers.

There is increasing molecular and epidemiologic evidence that human papillomavirus (HPV) is associated with a distinct subset of head and neck squamous cell carcinomas. The strength and consistency of HPV DNA presence in oropharyngeal cancers bolster the argument that this association is likely causal. HPV-positive tonsillar cancer in particular is emerging as a specific disease entity with distinct molecular, pathologic, and clinical characteristics. Recent data suggest that the incidence of tonsillar carcinoma in the United States is increasing, despite a decline in tobacco use, supporting the existence of other important risk factors such as HPV infection. Individuals with a history of an HPV-associated anogenital cancer and HIV-infected men are at increased risk for tonsillar carcinoma. This review focuses on the recent literature (since 1998) investigating the relationship between HPV and head and neck cancer development, using the current paradigm for causal inference in epidemiologic research attributed to Sir A. Bradford Hill. Data examining the association of HPV with pathogenesis of head and neck squamous cell carcinoma before 1999 were previously reviewed in this journal.

Adult↗
PubMed1983

The structure of the bladder neck in male bladder neck obstruction.

A light microscope and neurohistochemical study is presented of full thickness biopsies from the bladder neck of 10 middle-aged males with urodynamically proven bladder neck obstruction. Apart from varying degrees of collagen deposition in seven cases, no abnormality was present in the detrusor and pre-prostatic components of the bladder neck muscles or in the distribution of cholinergic nerve fibres. The normal noradrenergic innervation to the pre-prostatic sphincter was absent in all specimens; this may be age-related.

Adult↗
PubMed1978

Frequency-response analysis of vestibular-induced neck reflex in cat. I. Characteristics of neural transmission from horizontal semicircular canal to neck motoneurons.

1. Vestibular-induced neck muscle reflexes (vestibulocollic reflexes) were studied with frequency-response methods in unanesthetized, decerebrate cats. The horizontal semicircular canals were stimulated by oscillation of the turntable and EMG activity was recorded from neck extensor muscles. 2. The maximum firing rate of each motor unit was less than 40 spikes/s. The motor units were classified by their maximum firing rates into two groups: HF (high frequency) units which could fire above 20 spikes/s and LF (low frequency) units which could not exceed 20 spikes/s of firing. The HF units had larger gains than the LF units on the average. 3. Compound EMGs, which presumably represent activity of the whole muscle, were examined at different frequencies of stimulation. The gain of compound EMG responses depended on the spontaneous activity. When the spontaneous activity was low or too high, the gain was small. There was an intermediate spontaneous activity level at which the gain became maximal. 4. The phase lag and the gain of the frequency response were represented in a Bode diagram with respect to angular acceleration. The transfer function of the system from the vestibular nuclei to neck EMG activity was estimated by assuming a first-order lag-lead system. A phase lag of 70-80 degrees (0.05 Hz) was found between the averaged activity of vestibular nucleus neurons and cervical motor activity. A positive correlation was observed between the phase lag and the gain of each motor unit. These results cannot be attributed solely to the action of the vestibulospinal tract, but suggest the existence of a neural intergrator in the vestibulocollic reflex arc.

Action Potentials↗
PubMed1992

Elective radiotherapy of the neck in patients with squamous cell carcinoma of the head and neck.

A prospectively recorded 5-year series of 254 patients receiving elective neck irradiation is evaluated. All had clinically negative necks and initial control at the primary site. Forty-seven percent of the patients had T3-4 tumours. Radiotherapy was delivered from a megavolt source at 2 Gy/day 5 days a week to a total dose of 46-50 Gy. All but 3 patients completed the treatment as planned. Neither tumour stage nor site of the primary tumour was related to the incidence of regional recurrences. Of 30 patients receiving 46-49 Gy, 5 died from neck node recurrences. Of 221 patients treated to 50 Gy or more, 16 (7.2%) developed regional recurrences. Two of these recurrences were avoided, giving a regional failure rate of 6.3%. As a whole, 7.8% died from regional, 11.4% from local, and 3.1% from distant recurrences.

Adult↗
PubMed1990

Efficacy of adjuvant chemotherapy for patients with resectable head and neck cancer: a subset analysis of the Head and Neck Contracts Program.

To evaluate the efficacy of adjuvant chemotherapy for patients with advanced head and neck squamous cancer, the Head and Neck Contracts Program conducted a three-arm study comparing standard surgery and radiation, induction chemotherapy (cisplatin and bleomycin) plus standard therapy, and induction chemotherapy plus standard therapy followed by maintenance cisplatin for 6 months. As previously reported, this trial of 462 patients demonstrated no significant difference in disease-free survival or survival, but a significantly lower metastatic rate in the maintenance arm. To determine whether particular subgroups may have benefited from adjuvant therapy, we evaluated results based on primary site, and tumor (T) and node (N) stage. Of the 192 patients with oral cavity cancer, those on the maintenance arm had a significantly improved 3-year disease-free survival (67%) compared with the standard arm (49%) or induction arm (44%) (overall P = .05). For hypopharyngeal and laryngeal cancers there was no marked overall benefit. For the 106 patients with T1 plus T2 disease, there was marginal improvement in disease-free survival for the maintenance group (72%) compared with the standard group (47%) or induction group (43%) (overall P = .09). There was no advantage for patients with T3 and T4 disease. There was superior disease-free survival for patients with N1 disease on the maintenance arm (70%) compared with the standard arm (42%) (P = .024). The same was true for disease-free survival in 109 patients with N2 disease: standard (52%), induction (30%), maintenance (84%) (overall P less than .001). There was no benefit for N3 disease. A significant survival advantage with maintenance chemotherapy was only seen for N2 disease (overall P = .04). Since head and neck cancer patients are a heterogeneous group, there may be particular sites and stages for which adjuvant chemotherapy would be advantageous, and subset analysis can help indicate directions for new trials.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2006

Current and future directions in the treatment of squamous cell carcinoma of the head and neck: multidisciplinary symposium on head and neck cancer.

The treatment of head and neck cancer continues to represent a major challenge. Patients are typically treated with chemotherapy, radiation and surgery. Multiple resources are needed to allow patients to go through the treatment, and recovery can take months and often years. Those resources include, nutritionists, speech and swallow therapists, social workers, psychiatrists and dentists. It is of paramount importance that these patients have access to a multi-disciplinary clinic that can best manage the problems that will invariably arise when treatment is started. These include mucositis, pain, xerostomia, swallowing dysfunction, depression, loss of work and severe deconditioning. Recent advances in the treatment of head and neck cancer have resulted in an improvement in survival. These advances have included the use of newer chemotherapeutic agents, better radiation planning and delivery and better surgical techniques. This report highlights some of the data presented in the first multidisciplinary symposium on head and neck cancer. Special attention is given to the use of newer 'targeted agents' and their incorporation in the definitive therapy with chemotherapy and radiation. Major focus is placed on epidermal growth factor inhibitors and their potential role both in the curative and recurrent settings.

Animals↗
PubMed2001

Do "whiplash" victims with neck pain differ from those with neck pain and other symptoms?

Studying 432 patients with "whiplash" neck pain after a low speed rear-end crash, we determined whether those who reported associated symptoms (arm or low back pain) differed from those with neck pain only. Exposure variables were: age, gender, height, weight, surprised by impact, rotated position of the head, and pre-existing cervical or lumbar spinal degeneration. Immediate symptoms were considered. Odds ratios (OR) were derived from logistic regression. Only pre-existing lumbar spinal degeneration was associated with having arm symptoms (OR = 9.6, CI = 1.1, 83.6) or low back pain (OR = 23.3, CI = 2.6, 206.7) along with neck pain.

Accidents, Traffic↗
PubMed1992

The neck collar--a treatment of hypertrophic burn scars of the neck region. A clinical study.

Hypertrophic burn scars of the neck region are disfiguring and cause functional disturbances such as itchiness, tenderness, blistering or even contractures. Since 1970 the Burns Unit in Copenhagen has treated hypertrophic scars of the neck with a special soft neck collar as a routine. This pressure treatment is controlled in the Jobst day-clinic by a team consisting of a surgeon, physiotherapist, occupational therapist and a nurse. The clinical results of 17 cases are reported and commented on.

Adolescent↗
PubMedDate not supplied

HPV16 DNA in histologically confirmed tumour-free neck lymph nodes of head and neck cancers.

BACKGROUND: Human papillomavirus (HPV) has been demonstrated in lymph node neck metastases (NM) of HPV-positive squamous cell carcinomas of the head and neck (HNSCC), underscoring the possible role of HPV for HNSCC progression. Reports on HPV infections in histopathologically tumour-free lymph-nodes of the SCC of the uterine cervix developing higher rates of lymph-node metastases and recurrences later in the survey of the patients was the starting point of the present study. MATERIALS AND METHODS: The presence of HPV-DNA in primary tumours (PT, n=45), NM (n=45) and histologically confirmed tumour-free neck lymph-nodes (LN, n=102) of HNSCC from 60 patients was analysed by PCR and Southern blot hybridisation. RESULTS: A highly positive correlation of simultaneous HPV-DNA detection in PT and NM was demonstrated. In the case of HPV-positivity of PT and/or NM [24/60 cases (40%)], 11/24 (45.8%) LN contained HPV-DNA, as well. Accepting HPV demonstration as a marker for the presence of micro-metastasis, HPV analysis would result in an upstaging of the N category in 4 out of these 11 patients. CONCLUSION: Considering the high agreement of HPV-DNA detection in PT and simultaneous HPV-DNA demonstration in the draining NM corroborating the monoclonal character of the tumour cells, the HPV-DNA presence in LN seems to be indicative of micro-metastasis in these lymph nodes. Thus, HPV analysis might be another powerful tool for the definition of the N-status of HPV-positive HNSCC.

Adult↗
PubMed1989

Cheek and neck sculpturing: simultaneous buccal fat pad removal and subcutaneous cheek and neck lipoplasty.

A combined procedure removing the buccal fat pad by excision and the subcutaneous fat of the cheek and neck by lipoplasty is described; this results in an improved contour in both the cheeks and neck. The technique has been applied in 28 patients of various ages without complications and with satisfactory results. Both the immediate results of the operation and the results noted 1 year or more after the operation are very satisfactory. Excellent results have been noted for nine young patients, and good results were obtained in 19 older patients. A review is given of the findings previously reported in the literature. At present, we are inclined to believe that removal of the buccal fat pad and lipoplasty of the subcutaneous fat of the cheeks and neck offers more improvement than either procedure alone. It is hoped that this combined procedure will give a solution to the troublesome problem of chubby cheeks and lead to a method of safely recontouring the cheek to a more youthful and beautiful appearance.

Adipose Tissue↗
PubMed1995

Head and neck cancer in Norway. A study of the quality of the Cancer Registry of Norway's data on head and neck cancer for the period 1953-1991.

Data from population-based cancer registries provide information on the causes and outcome of cancer and form a basis for important decision making in connection with the prevention of cancer and the planning of health services. This makes it of the utmost importance to assess the data at all stages of collection to ensure the highest possible quality. The present study focuses on the quality of the Cancer Registry of Norway's data on head and neck cancer for the period 1953-1991. When the study was started, 16,104 cases of head and neck malignancies had been registered. All histological codes were reviewed. The pathologists' reports were reevaluated for 369 cases selected according to set criteria: 133 cases received a new histological code without being excluded from the data material: 112 cases were excluded. The distribution of histological diagnoses for each location is presented. A reevaluation of 300 cases selected at random from the corrected series indicates discrepancies between the pathologist's classification and the Registry's coding in less than 2% (1.4%) of all cases. The percentage that lacked histological verification fell from 5.7% in the first decade to 2.1% during the last 9-year period. Completeness of the Cancer Registry's data base was checked against hospital-based registries and this investigation showed that virtually all new cases are reported. We conclude that the data on head and neck cancer for the studied time period meet standards that justify their use as a basis for epidemiological as well as clinical studies.

Carcinoma↗
PubMed1986

Electron immunocytochemical localization of pepsinogen I (PgI) in chief cells, mucous-neck cells and transitional mucous-neck/chief cells of the human fundic mucosa.

Specific PgI antibodies devoid of PgII cross reactivity have been applied to aldehyde-osmium fixed human, fundic-type, gastric mucosa investigated with the protein A-immunogold technique. PgI immunoreactivity has been detected in the homogeneous secretory granules of glandular chief cells, in bipartite granules of mucous-neck cells, in the granules of cells showing intermediate patterns and topography in between chief and mucous-neck cells (transitional cells), as well as in the granules of a few cells in the foveolar/mucous-neck boundary zone showing mixed foveolar/mucous-neck granule populations. The findings support progressive transformation of mucous-neck cells into chief cells.

Gastric Fundus↗
PubMed1998

A comparison between the University of Washington Head and Neck Disease-Specific measure and the Medical Short Form 36, EORTC QOQ-C33 and EORTC Head and Neck 35.

The University of Washington Head and Neck Disease-Specific questionnaire (UW-QOL) is potentially a suitable routine measure of outcome in head and neck cancer because it is quick and simple for patients to complete and is easy to process. The aim of this study was to compare the UW-QOL with three validated instruments in a group of patients having primary surgery for oral cancer. Between May and December 1995, 34 consecutive patients with previously untreated oral and oropharyngeal squamous cell carcinoma underwent primary surgery. Patients self-completed the following questionnaires: UW-QOL, Medical Outcomes Short Form 36 (SF-36), the European Organisation for Research and Treatment of Cancer (EORTC) QOQ-C33 and the EORTC Head and Neck (H&N35). Questionnaires were distributed at four time intervals: pre-operatively, and at 3, 6 and 12 months. Patients were withdrawn if they developed recurrent disease. 29 patients agreed to participate in this prospective study and cross-sectional comparisons were made on baseline data and trends over time for longitudinal comparisons. This study emphasises the difficulties of one questionnaire to adequately evaluate quality of life. However, it would appear that the UW-QOL is a broad measure suitable for routine "low cost" assessment of disease-specific functional status.

Activities of Daily Living↗
PubMed1993

[Ultrasound diagnosis of regional lymph node metastasis of the neck in patients with head-neck neoplasms: sono-morphologic criteria and diagnostic accuracy].

High resolution sonography is generally considered a diagnostic tool with high sensitivity but low specificity in the assessment of cervical lymph node metastases. This study shows, that excellent sonographic results regarding sensitivity and specificity can be achieved, if sonomorphologic parameters, such as size, shape, delineation and type of echo pattern are included in the evaluation. We compared sonomorphology and histology of 82 patients operated for head and neck malignancies. The sonomorphological and histological findings in the largest lymph nodes in all neck areas were compared, and if a definite identification was possible, also in the second largest ones. Virtually, all longitudinal nodes of any size and practically all oval nodes of an axial diameter of up to 20 mm were found to be free of metastases, whereas 80% of round nodes with an axial diameter of up to 20 mm and practically all round and oval nodes exceeding 20 mm in axial diameter as well as irregularly shaped, poorly delineated and structurally inhomogeneous nodes demonstrated metastatic disease. On the basis of these results we have established the following criteria for the assessment of cervical lymph node metastases: All findings demonstrating longitudinal nodes of any size and oval nodes less than 20 mm in axial diameter are to be considered sonographically negative, whereas findings in which oval nodes exceeding 20 mm in axial diameter, as well as round, irregularly shaped, poorly delineated or inhomogeneous lymph nodes are found to be classified malignant. Of 58 sonographically positive neck areas, 54 were found to be malignant on histological examination, while 23 of 24 sonographically negative areas corresponded with histologically benign findings.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Adenoid Cystic↗
PubMed1997

Surgical morbidity of neck dissection after chemoradiotherapy in advanced head and neck cancer.

The use of chemotherapy and irradiation for organ preservation attempts to eliminate the need for extensive surgery in patients with advanced squamous cell carcinoma of the head and neck (SCCHN). We sought to characterize the morbidity of surgery in patients who needed surgery after treatment with induction chemotherapy followed by simultaneous chemotherapy and radiotherapy (chemoradiotherapy). The surgical morbidity within the first 30 postoperative days of 17 patients treated in an organ preservation approach between July 1991 and December 1994 was compared with a control group of patients undergoing similar surgical procedures during the same period. The organ preservation study patients underwent surgical procedures consisting of 18 neck dissections and 5 resections of the primary site. Six patients in the organ preservation study group experienced 8 surgical complications within the first 30 postoperative days, and most complications were minor. There was no significant difference in the duration of surgery or length of hospitalization between study patients and matched controls. Our surgical complication rate (35.3%) was higher but not statistically different from that of the control group, and compared favorably to reports of surgical morbidity (44% to 61%) in the literature on patients treated with chemoradiotherapy. The lower complication rate seen in this study may be a reflection of early surgical intervention as part of our organ preservation study scheme, the preponderance of neck dissections performed, and the limited number of pharyngeal procedures performed.

Adult↗
PubMedDate not supplied

Analysis of disability resulting from treatment including radical neck dissection or modified neck dissection.

A multiinstitutional study to define the impact of total treatment programs involving radical neck dissection (RND) and modified neck dissection (MND) on patients' permanent disability was undertaken. A total of 243 patient responses were included in the study. Comparative analyses between the treatment groups show no advantage of one surgical operation over the other in returning patients to their pretreatment employment status. Radiation therapy was identified as adding significantly to the patient's permanent disability.

Adaptation, Psychological↗
PubMed1987

An improved technique of radical neck dissection with an analysis of long-term results of 1,000 operated cases of head and neck cancer.

An improved technique of radical neck dissection is presented with a report of all 1,000 operated cases of the head and neck region from 1964 to 1980 at the Affiliated Tumor Hospital of Zhongshan Medical College, in Guangzhou, China. The practice has proved that our operative procedures are time-saving, with less blood loss during operation, fewer operative mortalities, fewer complications, better end results, better cosmetic effects, and that the techniques are easier to master.

Adolescent↗