A rapidly enlarging neck mass

We presented an unusual case of cutaneous and bilateral ovarian metastases of malignant melanoma. There was no previously identifiable cutaneous or mucous lesion or teratoid element. Past history revealed that the patient had undergone removal of a blackish, elevated, irregular shaped tumor from the right arm eleven years previously. This lesion was considered to be the primary melanoma; therefore, it was thought to be very unusual as metastasis occurred in both the skin and ovaries after an eleven year disease-free interval.     

Differential diagnosis of a mass in the upper lateral neck

The differential diagnosis and the duration of symptoms are presented for a group of 288 patients encountered over a ten-year period with a mass in the region of the neck behind and below the angle of the mandible. While infections constituted the largest aetiological group (48.3 per cent), 109 cases (37.9 per cent) had some form of neoplasia, with malignancy being found in 48 (16.6 per cent). The duration of symptoms varied widely, only the acute infections having an acceptably short delay prior to hospital admission. The mean symptom duration for all the neoplastic cases was in excess of five months.     

Dental hygiene screening reveals childhood neck mass

A benign neck mass was discovered in a young child which, based on presentation, was diagnosed as a thyroglossal duct cyst. Thyroglossal duct cysts normally appear in childhood and are usually asymptomatic. They are a congenital neoplasm resulting from incomplete resorption of the thyroglossal duct following the embryonic descent of the thyroid gland and are often found attached to the hyoid bone. They may or may not have exterior fistulae and are slow growing. Other types of neck masses should be included in a complete differential diagnosis, as this case verified. Masses such as the dermoid cyst may be misdiagnosed as TGDC. While also slow growing, and presenting similarly to the TGDC, dermoid cysts may enlarge and compromise airways and interfere with eating and swallowing. Treatment of choice for these neck masses is excision including ductal remnants. Care must be taken not to remove ectopic thyroid tissue if that is the entire extent of the patient's thyroid gland. This case presentation exemplifies the role of the dental hygienist in identifying lesions of the head and neck and seeking appropriate referral when indicated. The dental hygienist if ideally suited to perform complete extraoral and intraoral examinations by virtue of education and training. Routine examinations must extend beyond the intraoral structures to include the head and neck regions. One must not assume that pathology exists only in the older population.     

Evaluation of the uncertainty of molecular mass measurement by electrospray ionization mass spectrometry

Electrospray ionization (ES) is a novel method used in mass spectrometry (MS) for producing gas-phase ions from substances in solutions. Common practices for molecular mass estimation from ES spectra summarize the spectrum as a single peak giving no estimate of uncertainty or treat each peak as an independent molecular mass measurement. ES-MS data analysis showed that each peak in an ES spectrum does not always provide an independent measure of molecular mass. Underestimation of measurement uncertainty is a possible result. An elementary time series method, the Yule-Walker equations, was applied to molecular mass estimation from ES data.     

Evaluation and treatment of head and neck venous vascular malformations

Congenital venous vascular malformations of the head and neck are low-flow, nonproliferative lesions that should be distinguished from hemangiomas. The characteristic history and clinical findings can establish the diagnosis. Direct percutaneous puncture and contrast injection at the time of treatment delineate the lesion and its drainage pattern. Treatment must be individualized according to lesion extent, patient tolerance and physician experience. Sclerotherapy with ethanol has proved to be a successful treatment modality for these lesions, as demonstrated in this study of 57 patients. Surgery is used for treatment of clinically significant residual disease. A multidisciplinary approach to evaluation and treatment is key to successful management.     

Evaluation of bone mass density after extensive resections within the alimentary tract

The authors have examined a group of 30 patients at 24-36 months after extensive resections within the alimentary tract. The bone density assessment has been done. The results were compared to those obtained from another group of 30 patients awaiting sinister operations. Bone loss was found in all postoperative patients. However, it was statistically significant only in patients after pancreatoduodenectomy.     

Synovial sarcoma of the neck

Although the zygomatic arch can be employed as a key landmark to the accurate alignment of a displaced malar fracture, it has been traditionally avoided because of the need for a bicoronal incision. Exposure of the zygomatic arch by means of the conventional bicoronal incision has several possible disadvantages, including an increased risk of blood loss, alopecia, loss of sensation posterior to the incision, and traction palsy of the facial nerve. Endoscopic-assisted exposure of a zygomatic arch can largely obviate the disadvantages of a bicoronal incision and yield this site accessible to reduction and fixation in the routine treatment of displaced malar fractures. A case of endoscopic-assisted open reduction and internal fixation of a moderately displaced malar fracture is presented. In particular, exposure and fracture fixation of the zygomatic arch were performed without the need for a bicoronal incision.     

Neurinoma of the neck area

Test-retest reliability of the WAIS-R Satz-Mogel short form was tested on a sample of 122 normal elderly volunteer subjects with mean age of 70.4. Subjects' performance was assessed over 3 annual probes. Reliability coefficients for sums of scaled scores on Verbal subscale and Full Scale ranged between 0.79 and 0.83. Corresponding coefficients for Performance subscale ranged between 0.70 and 0.72. The percentage of subjects who showed change between two probes of more than 1 SD was the highest for the Performance subscale. Implications for clinical use, particularly for the purpose of estimation of premorbid intellectual functioning are discussed.     

重量法测定电镀锌钢板锌层重量的不确定度评定

通过重量法测定电镀锌钢板锌层重量测量结果的不确定度评定实践,分析了该方法测定过程的不确定度来源,建立了数学模型并计算了各标准不确定度分量、合成标准不确定度、扩展不确定度等。     

Treatment of the neck in melanoma

Three and five times weekly narrow-band TL-01 (311-313 nm) ultraviolet (UV) B phototherapy regimens for chronic plaque psoriasis were compared in a randomized, observer-blinded, half-body, within-patient paired study. Twenty-one patients [13 men, eight women, age range 21-68 years, skin phototypes I (two patients), II (14) and III (five)] entered the study. Sixteen reached clearance or minimal residual activity (MRA) on both sides. Of the other five, three withdrew because they did not reach clearance or MRA on the 5x weekly side by a maximum of 30 treatments, one when he was satisfied with moderate improvement and one because of repeated failure to attend. Those who completed treatment reached clearance or MRA after a median of 35 days with 5x weekly treatment compared with 40 days with 3x weekly treatment (P = 0.007), but required a median of 23.5 compared with 17 UVB exposures (P = 0.001) and 94 minimal erythema dose multiples (MEDs) compared with 64 MEDs (P = 0.01). Fifteen (of 16) developed at least one episode of well-demarcated erythema during 5x weekly treatment compared with just three of 16 treated 3x weekly (P < 0.001). There was no significant difference between regimens in duration of remission. For this skin phototype I-III population, the more rapid clearance of psoriasis with 5x weekly phototherapy is not, for the majority of patients, sufficient to justify the extra exposures and higher UVB dose. We no longer use 5x weekly phototherapy for psoriasis.     

Surgical treatment of the rheumatic neck

This paper reviews rheumatoid cervical spine disease with emphasis on surgical management. The rheumatoid process in the cervical spine is outlined, and the different clinical syndromes are explained according to the underlying pathology. Guidelines for the management of patients with this disease are suggested, and the indications for surgery are discussed. The different surgical approaches and techniques are briefly summarised.