Head and Neck Cancer Trends in Semarang: An analysis of ASR and ASCR

Background: The sustainable incidence data of Head and Neck Cancer is poorly described in Indonesia. There was no large-scale epidemiological study of head and neck cancer in Indonesia, especially in Semarang and surrounding areas. Whereas, by knowing the distribution of sex and age in the incidence data could indicate changes in patterns of cancer that occur every year. Aim: This research aim to determine the distribution of head and neck cancer based on anatomic site, age and sex by counting the Age Standardization Rates (ASR) and Age Standardization Cancer Ratio (ASCAR) score Methods : This research was a retrospective observational descriptive study using the medical records of Head and Neck Cancer Patients from Anatomical Pathology Laboratory of Kariadi Central Hospital / Medical Faculty Diponegoro University and Waspada Laboratory in 2010- 2014. Collected data were tabulated manually using Microsoft Excel and analyzed and presented descriptively in table or graphic form Result: The incidences of head and neck cancer were varies every year. The nasopharyngeal cancer seems to be the most common head and neck cancer diagnosed during 2010- 2014. ASCR and ASR in male and female were different in certain head and neck cancer cases. Generally, ASR in male was higher than in females. Conclusion: The trends of head and neck cancer mostly in men. Based on age it distributed mostly in age group 40- 44.Nasopharyngeal cancer is the most cases diagnosed in this period in both male and female and followed with the neoplasm of nasal cavity and middle ear. Age Standardization used in this research allows this research’s result to be compared with the result in another population which used the same method. Keywords Head and Neck Cancer, ASR, ASC

A practical approach to the patient presenting with dropped head

Head drop, or having a dropped head, is an uncommon condition in which patients present with a disabling inability to lift their head. It may arise in many neurological conditions that can be divided into those with neuromuscular weakness of neck extensors and those with increased tone of neck flexors. The most common neuromuscular causes include myasthenia gravis, motor neurone disease and myositis, while neck dystonia secondary to movement disorders can cause an increased tone. Investigations should include blood tests, imaging, muscle biopsy and neurophysiological studies. Here, we present a man with dropped head and discuss the investigation and management of this condition.peer-reviewe

Evaluation of a pig femoral head osteonecrosis model

Background A major cause of osteonecrosis of the femoral head is interruption of a blood supply to the proximal femur. In order to evaluate blood circulation and pathogenetic alterations, a pig femoral head osteonecrosis model was examined to address whether ligature of the femoral neck (vasculature deprivation) induces a reduction of blood circulation in the femoral head, and whether transphyseal vessels exist for communications between the epiphysis and the metaphysis. We also tested the hypothesis that the vessels surrounding the femoral neck and the ligamentum teres represent the primary source of blood flow to the femoral head. Methods Avascular osteonecrosis of the femoral head was induced in Yorkshire pigs by transecting the ligamentum teres and placing two ligatures around the femoral neck. After heparinized saline infusion and microfil perfusion via the abdominal aorta, blood circulation in the femoral head was evaluated by optical and CT imaging. Results An angiogram of the microfil casted sample allowed identification of the major blood vessels to the proximal femur including the iliac, common femoral, superficial femoral, deep femoral and circumflex arteries. Optical imaging in the femoral neck showed that a microfil stained vessel network was visible in control sections but less noticeable in necrotic sections. CT images showed a lack of microfil staining in the epiphysis. Furthermore, no transphyseal vessels were observed to link the epiphysis to the metaphysis. Conclusion Optical and CT imaging analyses revealed that in this present pig model the ligatures around the femoral neck were the primary cause of induction of avascular osteonecrosis. Since the vessels surrounding the femoral neck are comprised of the branches of the medial and the lateral femoral circumflex vessels, together with the extracapsular arterial ring and the lateral epiphyseal arteries, augmentation of blood circulation in those arteries will improve pathogenetic alterations in the necrotic femoral head. Our pig model can be used for further femoral head osteonecrosis studies

Differential postural effects of plantar-flexor muscles fatigue under normal, altered and improved vestibular and neck somatosensory conditions

The aim of the present study was to assess the effects of plantar-flexor muscles fatigue on postural control during quiet standing under normal, altered and improved vestibular and neck somatosensory conditions. To address this objective, young male university students were asked to stand upright as still as possible with their eyes closed in two conditions of No Fatigue and Fatigue of the plantar-flexor muscles. In Experiment 1 (n=15), the postural task was executed in two Neutral head and Head tilted backward postures, recognized to degrade vestibular and neck somatosensory information. In Experiment 2 (n=15), the postural task was executed in two conditions of No tactile and Tactile stimulation of the neck provided by the application of strips of adhesive bandage to the skin over and around the neck. Centre of foot pressure displacements were recorded using a force platform. Results showed that (1) the Fatigue condition yielded increased CoP displacements relative to the No Fatigue condition (Experiment 1 and Experiment 2), (2) this destabilizing effect was more accentuated in the Head tilted backward posture than Neutral head posture (Experiment 1) and (3) this destabilizing effect was less accentuated in the condition of Tactile stimulation than that of No tactile stimulation of the neck (Experiment 2). In the context of the multisensory control of balance, these results suggest an increased reliance on vestibular and neck somatosensory information for controlling posture during quiet standing in condition of altered ankle neuromuscular function

Metastasis to parotid gland from non Head and Neck tumors

Most primary tumors spreading metastasis to the parotid gland are usually located in the head and neck region, nonetheless, rarely, parotid gland can also be the target of metastatic localization site of distant primary tumors. The purpose of this study was to describe a clinical series of metastasis to the parotid gland from distant primary tumors (non Head & Neck)

Are the demographics for squamous cell cancer in the head and neck changing in the United Kingdom?

Head and neck squamous cell carcinoma is well known to be more common in men than women. Smoking and alcohol are the key risk factors causing such malignancies and there are several publications which have suggested that the prevalence of these diseases is increasing more in women than in men in western countries due to increased smoking and alcohol use.We collected our data at the Institute of Laryngology and Otology from the last 45 years and analysed the disease ratios in male to female patients in different sites within the head and neck. Our results revealed a decreasing male to female ratio, though this was not statistically significant. However, it draws attention to the increasing number of women with head and neck cancer, which may reflect their increasing use of cigarettes and alcohol

Head and neck cancer: metronomic chemotherapy

In the era of personalized medicine, head and neck squamous cell carcinoma (HNSCC) represents a critical oncologic topic. Conventional chemotherapy regimens consist of drugs administration in cycles near or at the maximum tolerated dose (MDT), followed by a long drug-free period to permit the patient to recover from acute toxicities. Despite this strategy is successful in controlling the cancer process at the beginning, a significant number of HNSCC patients tend to recurred or progress, especially those patients with locally advanced or metastatic disease. The repertoire of drugs directed against tumor cells has greatly increased and metronomic chemotherapy (MC) could be an effective treatment option.It is the purpose of this article to review the concept of MC and describe its potential use in HNSCC. We provide an update of ongoing progress and current challenges related to this issue

Supraclavicular node metastasis presenting with internal jugular vein thrombosis

A case of internal jugular vein thrombosis secondary to compression by a metastasis in Virchow’s node and the investigations leading to the diagnosis is described. Internal jugular vein thrombosis was not an uncommon complication of fulminant sepsis in the head and neck in the pre-antibiotic era. The commonest causes are now iatrogenic usually secondary to central venous catheterisation or related to intravenous drug abuse. Thrombosis commonly complicates superior vena caval obstruction secondary to malignancy in the chest but isolated internal jugular vein thrombosis is rare and usually secondary to obvious tumour in the neck. Infection related to head and neck malignant disease may also cause venous thrombosis.peer-reviewe