Cervical lymph node metastasis in adenoid cystic carcinoma of the larynx: a collective international review

Adenoid cystic carcinoma (AdCC) of the head and neck is a well-recognized pathologic entity that rarely occurs in the larynx. Although the 5-year locoregional control rates are high, distant metastasis has a tendency to appear more than 5 years post treatment. Because AdCC of the larynx is uncommon, it is difficult to standardize a treatment protocol. One of the controversial points is the decision whether or not to perform an elective neck dissection on these patients. Because there is contradictory information about this issue, we have critically reviewed the literature from 1912 to 2015 on all reported cases of AdCC of the larynx in order to clarify this issue. During the most recent period of our review (1991-2015) with a more exact diagnosis of the tumor histology, 142 cases were observed of AdCC of the larynx, of which 91 patients had data pertaining to lymph node status. Eleven of the 91 patients (12.1%) had nodal metastasis and, based on this low proportion of patients, routine elective neck dissection is therefore not recommended

In the unloaded lower leg, vibration extrudes venous blood out of the calf muscles probably by direct acceleration and without arterial vasodilation

Purpose During vibration of the whole unloaded lower leg, effects on capillary blood content and blood oxygenation were measured in the calf muscle. The hypotheses predicted extrusion of venous blood by a tonic reflex contraction and that reactive hyperaemia could be observed after vibration. Methods T welve male subjects sat in front of a vibration platform with their right foot affixed to the platform. In four intervals of 3-min duration vibration was applied with a peak-to-peak displacement of 5 mm at frequencies 15 or 25 Hz, and two foot positions, respectively. Near infrared spectroscopy was used for measuring haemoglobin oxygen saturation (SmO2) and the concentration of total haemoglobin (tHb) in the medial gastrocnemius muscle. Results Within 30 s of vibration SmO2 increased from 55 ± 1 to 66 ± 1 % (mean ± SE). Within 1.5 min afterwards SmO2 decreased to a steady state (62 ± 1 %). During the following 3 min of recovery SmO2 slowly decreased back to base line. THb decreased within the first 30 s of vibration, remained almost constant until the end of vibration, and slowly recovered to baseline afterwards. No significant differences were found for the two vibration frequencies and the two foot positions. Conclusions T he relaxed and unloaded calf muscles did not respond to vibration with a remarkable reflex contraction. The acceleration by vibration apparently ejected capillary venous blood from the muscle. Subsequent recovery did not match with a reactive hyperaemia indicating that the mere mechanical stress did not cause vasodilation

Biomechanics of Vibration Exercise

This biomechanistic approach of vibration exercise discusses the human body as a group of segments (foot, shank, thigh, trunk, head) balanced on top of each other. These segments are interlinked by joints, the stiffness of which is generated by the surrounding muscles. Reflexes and pre-tension of the muscles are important factors that modulate the apparent joint stiffness and leg stiffness. In addition, leg stiffness is also affected by posture, with greater leg stiffness occurring in erect posture than in a crouched posture. To ensure comfort and to reduce the possible risk, vibration transmission to the head should be attenuated. This can be achieved by adjusting the pre-tension and posture. In addition, raising the heel from the vibration platform reduces vibration transmissibility. For similar reasons, side-alternating platforms have lower transmissibility to trunk and head than side-synchronous platforms, as they allow an additional degree of freedom in the lumbo-sacral joint. Finally, vibration elicits stretch-shortening cycles within the tendon and skeletal muscle, at a minimum of 6 Hz. These mechanical stretch-shortening cycles provide a solid rationale for the activation of mono-synaptic stretch reflexes

Experimental Evidence of the Tonic Vibration Reflex during Whole-Body Vibration of the Loaded and Unloaded Leg

Increased muscle activation during whole-body vibration (WBV) is mainly ascribed to a complex spinal and supraspinal neurophysiological mechanism termed the tonic vibration reflex (TVR). However, TVR has not been experimentally demonstrated during low-frequency WBV, therefore this investigation aimed to determine the expression of TVR during WBV.  Whilst seated, eight healthy males were exposed to either vertical WBV applied to the leg via the plantar-surface of the foot, or Achilles tendon vibration (ATV) at 25Hz and 50Hzfor 70s. Ankle plantar-flexion force, tri-axial accelerations at the shank and vibration source, and surface EMG activity of m. soleus (SOL) and m. tibialis anterior (TA) were recorded from the unloaded and passively loaded leg to simulate body mass supported during standing.  Plantar flexion force was similarly augmented by WBV and ATV and increased over time in a load- and frequency dependent fashion. SOL and TA EMG amplitudes increased over time in all conditions independently of vibration mode. 50Hz WBV and ATV resulted in greater muscle activation than 25Hz in SOL when the shank was loaded and in TA when the shank was unloaded despite the greater transmission of vertical acceleration from source to shank with 25Hz and WBV, especially during loading. Low-amplitude WBV of the unloaded and passively loaded leg produced slow tonic muscle contraction and plantar-flexion force increase of similar magnitudes to those induced by Achilles tendon vibration at the same frequencies. This study provides the first experimental evidence supporting the TVR as a plausible mechanism underlying the neuromuscular response to whole-body vibration

Neuromuscular fatigue induced by whole-body vibration exercise

The aim of this study was to examine the magnitude and the origin of neuromuscular fatigue induced by half-squat static whole-body vibration (WBV) exercise, and to compare it to a non-WBV condition. Nine healthy volunteers completed two fatiguing protocols (WBV and non-WBV, randomly presented) consisting of five 1-min bouts of static half-squat exercise with a load corresponding to 50 % of their individual body mass. Neuromuscular fatigue of knee and ankle muscles was investigated before and immediately after each fatiguing protocol. The main outcomes were maximal voluntary contraction (MVC) torque, voluntary activation, and doublet peak torque. Knee extensor MVC torque decreased significantly (P < 0.01) and to the same extent after WBV (-23 %) and non-WBV (-25 %), while knee flexor, plantar flexor, and dorsiflexor MVC torque was not affected by the treatments. Voluntary activation of knee extensor and plantar flexor muscles was unaffected by the two fatiguing protocols. Doublet peak torque decreased significantly and to a similar extent following WBV and non-WBV exercise, for both knee extensors (-25 %; P < 0.01) and plantar flexors (-7 %; P < 0.05). WBV exercise with additional load did not accentuate fatigue and did not change its causative factors compared to non-WBV half-squat resistive exercise in recreationally active subjects

A historical overview of the Pavilion Lake Research Project-Analog science and exploration in an underwater environment

As humans venture back to the Moon, or onward to near-Earth objects and Mars, it is expected that the rigors of this exploration will far exceed those of Apollo. Terrestrial analogs can play a key role in our preparations for these complex voyages, since in addition to their scientifi c value, analogs afford the exploration community a means to safely prepare and test exploration strategies for future robotic and human planetary missions. Many relevant analog studies exist, and each is focused on a particular aspect of strategic development. Some analog programs such as the Pavilion Lake Research Project (PLRP) present the opportunity to investigate both real scientifi c and real exploration scenarios in tandem. The activities of this research program demand the use of techniques, tools, and strategies for underwater scientifi c exploration, and the challenges associated with the scientifi c exploration of Pavilion Lake are analogous to those human explorers will encounter on other planetary and small solar system bodies. The goal of this paper is to provide a historical synopsis of the PLRP's objectives, milestones, and contributions to both the scientifi c and exploration community. Here, we focus on detailing the development and deployment of an integrated science and exploration program with analog application to our understanding of early Earth systems and the preparation for future human space exploration. Over a decade of exploration and discovery is chronicled herein. © 2011 The Geological Society of America.link_to_subscribed_fulltex