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Lichen simplex chronicus (LSC) of the vulva is an acquired, persistent, severely itchy dermatosis usually located in easily reachable areas of the body like the extremities, nape of the neck, and genitalia. It also has a strong association with atopy and is said to be initiated and perpetuated by the itch-scratch-itch cycle. Two cases of rugose labia as the sole presentation of LSC of vulva are being presented.

BACKGROUND Receptor interacting protein kinase 1 (RIPK1)-mediated cell death, including apoptosis and necroptosis, belongs to programmed cell death. It has been reported that RIPK1-mediated necroptosis exists in lesions of cerebral hemorrhage (CH). Electroacupuncture, a treatment derived from traditional Chinese medicine, could improve neurological impairment in patients with brain injury. AIM To investigate the protective role of cross electro-nape acupuncture (CENA) in CH, and clarify the potential mechanism. METHODS CH rat models were established, and CENA was applied to the experimental rats. Neurological functions and encephaledema were then measured. Necrotic cells in the brain of rats with CH were evaluated by propidium iodide staining. Necroptosis was assessed by immunofluorescence. Activation of the necroptosis-related pathway was detected by western blot. Extraction of brain tissue, cerebrospinal fluid and serum samples was conducted to measure the expression and secretion of inflammatory cytokines by quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay. RESULTS The necroptotic marker p-MLKL was detectable in the brains of rats with CH. Next, we found that CENA could ameliorate neurological functions in rat models of CH. Moreover, the upregulation of RIPK1-mediated necroptosis-related molecules in the brains of rats with CH were inhibited by CENA. Further investigation revealed that CENA partially blocked the interaction between RIPK1 and RIPK3. Finally, in vivo assays showed that CENA decreased the expression of the inflammatory cytokines tumor necrosis factor-α, interleukin-6 and interleukin-8 in CH rat models. CONCLUSION These findings revealed that CENA exerts a protective role in CH models by inhibiting RIPK1-mediated necroptosis.

Acne keloidalis nuchae (AKN) is a chronic inflammatory condition that almost exclusively affects the occipital and nape areas. Although not completely understood, its etiopathogenesis seems to be multifactorial, including association with metabolic syndrome (MetS). Despite being commonly seen in patients with MetS, obesity per se as a possible related factor for AKN has yet to be studied. The aim of this study was to evaluate the relationship between obesity and AKN in a series of patients. Eight male patients, with a median age of 38 years (range 15–48), were included. Overweight/obesity was found in 8/8 (100%), with median BMI of 32.2 (range 27.7–43.85 kg/m2), including 2 patients with class 3 obesity. We hypothesize adipose tissue accumulation in the nape, the only moving part of the scalp, leads to redundant skin folds, more friction, and inflammation, triggering AKN. This paper highlights the possible relationship between AKN and overweight/obesity, hypothesizing a mechanism for their contribution to the etiopathogenesis of this scalp disorder. To the best of our knowledge, this is the first study focused specifically in this association. While general physicians should pay attention to the appearing of AKN in overweight/obese patients, dermatologists must be aware that AKN patients should be assessed beyond the skin.

Dermatomyofibroma is a rare cutaneous mesenchymal tumor of benign fibroblastic and myofibroblastic derivations. It predominantly affects young women, and it usually presents as a reddish-brown plaque or nodule, which is commonly located over the upper trunk. We report the case of a 41-year-old female patient who presented with progressive linear dermatomyofibroma over the nape of her neck. This case report expands the knowledge about the clinical and histopathological features of this rare, benign and cutaneous tumor.

Adverse alterations in the composition of the gut microbiota have been implicated in the development of obesity and a variety of chronic diseases. Re-engineering the gut microbiota to produce beneficial metabolites is a potential strategy for treating these chronic diseases. N-acyl-phosphatidylethanolamines (NAPEs) are a family of bioactive lipids with known anti-obesity properties, Previous studies showed that administration of Escherichia coli Nissle 1917 (EcN) engineered with Arabidopsis thaliana NAPE synthase to produce NAPEs imparted resistance to obesity induced by a high fat diet that persisted after ending their administration. In prior studies, mice were pre-treated with ampicillin prior to administering engineered EcN for 8 weeks in drinking water. If use of antibiotics and long-term administration are required for beneficial effects, implementation of this strategy in humans might be problematic. Studies were therefore undertaken to determine if less onerous protocols could still impart persistent resistance and sustained NAPE biosynthesis. Administration of engineered EcN for only two weeks without pre-treatment with antibiotics sufficed to establish persistent resistance. Sustained NAPE biosynthesis by EcN was required as antibiotic treatment after administration of the engineered EcN markedly attenuated its effects. Finally, heterologous expression of human Phospholipase A/acyl-transferase-2 (PLAAT2) in EcN provided similar resistance to obesity as heterologous expression of A. thaliana NAPE synthase, confirming that NAPEs are the bioactive mediator of this resistance.

To observe the clinical efficacy of Gao’s nape acupuncture plus swallowing training in treating pharyngeal deglutition disorder after stroke. One hundred patients with post-stroke pharyngeal deglutition disorder were randomized into a treatment group and a control group, with 50 cases in each group. The two groups both received routine neurological intervention. In addition, the treatment group was given Gao’s nape acupuncture plus swallowing training, while the control group was intervened by swallowing training alone. After eight-week treatment, the two groups were observed in terms of the changes in repetitive saliva swallowing test (RSST), modified water swallowing test (MWST), standardized swallowing assessment (SSA) and swallowing-related quality of life (SWAL-QOL). The clinical efficacies of the two groups were also compared. After treatment, the RSST grading, and scores of MWST, SSA and SWAL-QOL changed significantly in both groups (P

Some patients with hidradenitis suppurativa (HS) develop severe inflammatory lesions of the nape. Through a single-center, cross-sectional study with a total of 377 patients, we sought to compare patients with and without nape involvement, to determine whether disease severity is greater in these patients and to describe their clinical characteristics. Thirty patients (90% male) were identified as having nape involvement. Patients with versus without nape involvement had greater disease severity, earlier disease onset, a family history of HS, lower body mass, and higher Dermatological Life Quality Index and pain scores. Amongst them, involvement of the trunk and gluteal regions predominated. A significant univariate relationship existed between patients with nape involvement and male sex, early disease onset, family history, scalp and gluteal involvement, Canoui-Poitrine phenotypes II and III, and Dowling-Degos disease. A significant multivariate relationship existed with early disease onset, Dowling-Degos disease, and phenotypes II and III.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disorder affecting the hair follicle which typically affects the axilla, inguinal, sub-mammary and perianal areas. Atypical HS, such as facial HS, dissecting cellulitis of the scalp (DCS), nape HS and HS lymphedema has also been described. There is scarce evidence about the treatment of atypical HS. AIMS: To describe the efficacy of biologic drugs and adjuvant therapeutic interventions used in patients with atypical HS who had an inadequate response to systemic antibiotics. METHODS: Prospective case series study of patients with atypical HS (facial HS, DCS, nape HS and HS lymphedema) treated with biologic drugs in a HS Clinic setting. Disease activity indexes, socio-demographic, clinical and safety variables were collected. RESULTS: Two patients met criteria for Facial HS, three met criteria for DCS / nape HS and three patients met criteria for HS lymphedema. Patients with facial HS achieved rapid improvement without requiring other therapies. Patients with DCS, nape HS and HS lymphedema showed variable response, with decrease of activity indexes, and requiring adjuvant treatments. CONCLUSIONS: Biologic drugs are useful in the management of special HS locations. In the case of facial HS, biologic therapy seems to be quite effective as monotherapy. In the cases of DCS, HS lymphedema and nape HS, treatment combination or intensification may be needed. This article is protected by copyright. All rights reserved.

Houhai acupoint (HA) is a site for acupuncture stimulation, located in the fossa between the anus and tail base in animals. To evaluate HA as a potential immunization site, the immune responses were compared when HA and the conventional site nape were vaccinated in rats. The results showed that injection of a porcine epidemic diarrhea virus (PEDV) vaccine in HA induced significantly higher IgG, IgG1, IgG2, splenocyte proliferation and mRNA expression of IL-2, IL-4 and IFN-γ than in the nape. To search for the underlying mechanisms, the draining lymph nodes for HA and the nape were investigated. When rats were injected in HA with Indian ink, 11 lymph nodes including caudal mesenteric lymph node and bilateral gluteal lymph nodes, posterior inguinal lymph nodes, lumbar lymph nodes, internal iliac lymph nodes and popliteal lymph nodes were visibly stained with the ink and injection of a model antigen ovalbumin (OVA) in HA resulted in detection of OVA by western blotting while in the same lymph nodes only a pair of lymph nodes (central brachial lymph nodes) were observed when Indian ink or OVA was injected in the nape. IL-2 mRNA expression was detected in all the lymph nodes when PEDV vaccine was injected. Therefore, the enhanced immune response elicited by vaccination in HA may be attributed to more lymphocytes activated.

To evaluate the therapeutic effects of nape acupuncture combined with rehabilitative swallowing training for dysphagia caused by pseudobulbar palsy, and to compare it with rehabilitative swallowing training alone, and to observe the improvement in quality of life after the therapy.One hundred patients were randomly divided into two groups: the rehabilitative swallowing training group (control group, n=50) and the nape acupuncture combined with rehabilitative swallowing training group (experimental group, n=50). Each group had 8 weeks' therapy, 5 times a week. Patients in the control group received rehabilitative swallowing training, while those in the experimental group received nape acupuncture therapy based on swallowing rehabilitation. The outcomes were assessed by the repetitive saliva-swallowing test (RSST), water swallow test (WST), standardized swallowing assessment (SSA), and a swallow quality-of-life questionnaire (SWAL-QOL). Correlations of onset age, onset frequency and lesion location with the efficacy of the acupuncture treatment were also observed.The scores for RSST, WST, and SSA in both groups were lower than before the therapy (P0.001), although the changes were more marked in the experimental group than in the control group (RSST and WST, P0.005; SSA, P0.001). Both groups recorded changes in SWAL-QOL index after the therapy (P0.001); and the experimental group scored higher than the control group (P0.001). The efficacy of acupuncture was not correlated with location (P0.05), but was related to onset age (P0.05) and onset frequency (P0.01).Nape acupuncture combined with rehabilitative swallowing training has an effect on dysphagia caused by pseudobulbar palsy and improves quality of life.

Craniofacial hyperhidrosis occurs in the forehead, temples, upper lips, nose, nape, and scalp. It is less common in these areas than in the armpits, palmar region, or plantar region. It is possible to notice isolated sweating, or it can be associated with other areas.

Our objective was to explore the physiological role of the intestinal endocannabinoids in the regulation of appetite upon short-term exposure to high-fat-diet (HFD) and understand the mechanisms responsible for aberrant gut-brain signaling leading to hyperphagia in mice lacking Napepld in the intestinal epithelial cells (IECs). We generated a murine model harboring an inducible NAPE-PLD deletion in IECs ( NapepldΔIEC). After an overnight fast, we exposed wild-type (WT) and NapepldΔIEC mice to different forms of lipid challenge (HFD or gavage), and we compared the modification occurring in the hypothalamus, in the vagus nerve, and at endocrine level 30 and 60 min after the stimulation. NapepldΔIEC mice displayed lower hypothalamic levels of N-oleoylethanolamine (OEA) in response to HFD. Lower mRNA expression of anorexigenic Pomc occurred in the hypothalamus of NapepldΔIEC mice after lipid challenge. This early hypothalamic alteration was not the consequence of impaired vagal signaling in NapepldΔIEC mice. Following lipid administration, WT and NapepldΔIEC mice had similar portal levels of glucagon-like peptide-1 (GLP-1) and similar rates of GLP-1 inactivation. Administration of exendin-4, a full agonist of GLP-1 receptor (GLP-1R), prevented the hyperphagia of NapepldΔIEC mice upon HFD. We conclude that in response to lipid, NapepldΔIEC mice displayed reduced OEA in brain and intestine, suggesting an impairment of the gut-brain axis in this model. We speculated that decreased levels of OEA likely contributes to reduce GLP-1R activation, explaining the observed hyperphagia in this model. Altogether, we elucidated novel physiological mechanisms regarding the gut-brain axis by which intestinal NAPE-PLD regulates appetite rapidly after lipid exposure.

A 58-year-old Caucasian male presents to the physician due to generalized fatigue, arthralgias of the metacarpophalangeal joints, and abdominal discomfort for 2 months. He has hypertension, hyperlipidemia, and type 2 diabetes mellitus. His grandfather died of liver cancer at the age of 62 years. He is 5 ft 7 in. tall and weighs 205 lb. BMI is 32.11 kg/m2. His temperature is 98 °F, pulse is 106/min, and blood pressure is 130/80 mmHg. Physical examination reveals bronze hyperpigmented skin over the nape of the neck and extremities (Figs. 3.1 and 3.2). The liver is palpated 5 cm below the right costal margin. Wood’s light reveal lime green fluorescence of the patient’s urine.

Iniencephaly (Greek: “inoin” meaning nape of neck) is an extremely rare and uniformly lethal form of neural tube defect. We report a case diagnosed in the first trimester using two-dimensional and three-dimensional ultrasound. The diagnosis was confirmed on postnatal autopsy. This case highlights the importance of diagnosing structural abnormalities in the first trimester itself.

Highlights • Lipoblastoma is rare benign tumour of extremities. • It occurs in infants and early childhood. • It usually involves subcutaneous tissue. • In our case lipoblastoma occurred in adolescent girl and presented as a mass in name of neck involving muscles., Introduction Lipoblastoma usually develops in extremities and trunk during infancy or childhood. Its occurrence in head and neck is rare. Case presentation Here we present a case of lipoblastoma in 14 years old female who developed swelling in the nape of her neck. Initially the diagnosis of lymphangioma was made on the basis MRI findings but histopathology after excisional biopsy confirmed it to be lipoblastoma. Conclusion Lipoblastoma can rarely present as swelling in the nape of neck in adolescents.

Background: Hair loss at the nape of the neck causes embarrassment and psychological stress in a number of patients due to a variety of causes including acne keloidalis nuchae and traction alopecia. Objectives: To report a case of hair transplantation into the nape of the neck as a treatment option for scarring resulting from acne keloidalis nuchae. Methods: 700 grafts where transplanted from the occipital donor area and transplanted by follicular unit extraction (FUE) into the nape area of a male patient with recurrent scarring folliculitis in that area. Results: Hair Restoration was successful with natural looking results. More tumescence than usual and skin traction was necessary to stabilize the skin during graft insertion due to soft skin in the nape area. Conclusions: Hair Restoration Surgery into the nape of the neck is an option for patients with hair loss in that area. FUE is the best method of hair transplantation allowing the selection of 1 and 2 hair FUE grafts in order to achieve a natural looking result in the nape area.

Background: Cannabis use remains a major public health concern, and its use typically begins in adolescence. Chronic administration of ∆9-tetrahydrocannabinol (THC), the main psychoactive compound in cannabis, during adolescence can produce deficits in adult learning and memory, stress reactivity and anxiety. One possible mechanism behind the disruptions in adulthood from adolescent exposure to THC includes changes in social behaviours, such as social play, which has been shown to be critical to socio-cognitive development. Methods: Here, using an established animal model of adolescent THC exposure in male and female Long–Evans rats, we explored the effects of THC on play behaviour during the chronic administration period. Following puberty onset, as indicated by external changes to the genitalia, THC (5mg/kg) was administered for 14 days. Play behaviour was assessed seven days following the onset of the injection period at approximately 1 hour post treatment. The frequency of nape attacks, the likelihood and tactics of defensive behaviour, and pins were scored and analyzed. Results: THC exposure decreased playfulness in adolescent rats including the number of attacks, likelihood of defense and pins compared to control and vehicle treated rats. Conclusion: This suggests that THC suppresses both the attack and defense components of social play. This is an important finding because there is evidence that attack and defense may be mediated by different mechanisms. Furthermore, the effect of THC exposure decreasing playfulness occurred similarly in males and females.

Background: The molecular mechanisms underlying itch are constantly being studied to create new opportunities to prevent or alleviate itch. The aim of our study was to determine the spinal gene expression changes induced by compound 48/80 in a mouse itch model.Methods: Mice were divided into saline group (control group, n=12) and compound 48/80 group (48/80 group, n=12). 100 µl saline or compound 48/80 was microinjected intradermally in the nape of the neck. After injection, pruritic behavior was immediately measured every 5 minutes. 30 minutes after injection, tissue was prepared to carry out mRNA profiling microarray and reverse transcription polymerase chain reaction (RT-qPCR) analyses.Results: The total numbers of scratching bout after compound 48/80 injection (100 µg/100 µl) were significantly increased in 48/80 group (190±11.33) as compared with control group (6.83±1.17). We screened the dorsal part of the cervical spinal cord of the mouse itch model for differentially expressed genes. Out of 45037 studied transcripts, the abundance levels of 15 transcripts were altered following compound 48/80 injection. 9 and 6 genes were up- and down-regulated in 48/80 group, respectively. We validated the reliability of the microarray results by RT-qPCR, and found 6 up-regulated mRNA, including Sgk1, Bag4, Fos, Ehd2, Edn3 and Wdfy, were significantly increased, whereas 3 down-regulated mRNA, including Corin, 4921511E18Rik and 4930423020Rik, were significantly decreased.Conclusions: These findings indicate that the alterations of spinal gene expression are involved in acute itch, and provide a translational bridge for spinal drugs targeting their signaling pathway to prevent or alleviate itch. Citation: Zhi-Gang He, Bao-Wen Liu, Zhi-Xiao Li, Cheng Liu, Hong-Bing Xiang. Altered expression profiling of spinal genes modulated by compound 48/80 in a mouse itch model. J Anesth Perioper Med 2017; 4: 220-4. doi:10.24015/JAPM.2017.0020This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

The dropped head syndrome (DHS) is a rare clinical syndrome with a broad differential diagnosis. The basic manifestation is inappropriate kyphosis of the cervico-thoracic link, usually caused by weakness of the extensor muscles of the nape. DHS is a source of significant discomfort and reduces quality of life (visual impairment, dysphagia, secondary pain, etc.).

Background Cortical neuronal dysfunction has been proposed to underlie the psychopathology and cognitive dysfunction of schizophrenia. Previously we have reported altered sphingolipid and N-acylphosphatidylserine (NAPS) metabolism in the frontal cortex in schizophrenia. We continue to expand these investigations to define the biochemical basis for these critical neuropathologies. Methods We undertook a targeted high resolution mass spectrometric analysis to validate our previous reports of elevated sphingolipids and NAPS in the frontal cortex of a new cohort of schizophrenia subjects. Furthermore we expanded these analyses to include ceramides, N-acylphosphatidylethanolamines (NAPE), and N-acylethanolamines (NAE). In the same tissue samples we examined N-acetylaspartylglutamate (NAAG), a modulator of excitatory amino acid transmission, hypothesized to be involved in the pathology of schizophrenia. Results We repeated our observations of elevated sulfatides in the frontal cortex in schizophrenia. An in-depth analysis of other sphingolipids revealed decrements in ceramide levels and increased levels of lactosylceramides. NAPS also were found to be augmented in schizophrenia as we previously reported. In addition, levels of NAPES, established biomarkers of neuronal stress, were elevated while their metabolites, NAEs were decreased. With regard to excitatory amino acid neurotransmission, NAAG levels were decreased by 50% while the metabolic precursor, N-acetylaspartate was unaltered. Conclusions Our data support the concept of cortical neuronal dysfunction in schizophrenia as indicated by altered metabolism of structural sphingolipids and NAAG, a modulator of excitatory amino acid neurotransmission.

Introduction Current markers of Parkinson’s disease (PD) fail to detect the early progression of disease state. Conversely, current omics techniques allow the investigation of hundreds of molecules potentially altered by disease conditions. Based on evidence previously collected by our group in a mouse model of PD, we speculated that a particular set of circulating lipids might be significantly altered by the pathology. Objectives The aim of current study was to evaluate the potential of a particular set of N-acyl-phosphatidylethanolamines (NAPEs) as potential non-invasive plasma markers of ongoing neurodegeneration from Parkinson’s disease in human subjects. Methods A panel of seven NAPEs were quantified by LC–MS/MS in the plasma of 587 individuals (healthy controls, n = 319; Parkinson’s disease, n = 268); Random Forest classification and statistical modeling was applied to compare Parkinson’s disease versus controls. All p-values obtained in different tests were corrected for multiplicity by controlling the false discovery rate (FDR). Results The results indicate that this panel of NAPEs is able to distinguish female PD patients from the corresponding healthy controls. Further to this, the observed downregulation of these NAPEs is in line with the results in plasma of a mouse model of Parkinson’s (6-OHDA). Conclusions In the current study we have shown the downregulation of NAPEs in plasma of PD patients and we thus speculate that these lipids might serve as candidate biomarkers for PD. We also suggest a molecular mechanism, explaining our findings, which involves gut microbiota. Electronic supplementary material The online version of this article (10.1007/s11306-019-1536-z) contains supplementary material, which is available to authorized users.

In patients with melanomas on the upper back or nape, axillary sentinel lymph node (SLN) biopsy (SLNB), when performed in the traditional supine position, is often disturbed by scattered radiation emitted from the primary tumor site. The results from the present study suggestthat axillary SLNB performed in the prone position can solve this problem. We compared two consecutive groups of patients with melanomas of the dorsal trunk or nape who received axillary SLNB performed either in the supine (

International audience; Selective serotonin reuptake inhibitor medications (SSRIs) are prescribed to up to 10% of pregnant women to treat maternal mood disorders. Exposure to these medications in-utero has raised concerns about altered neurobehavioral outcomes; most recently those related to peer-to-peer social interactions and play. While clinical data show that both perinatal SSRIs (pSSRI) and maternal stress can contribute to social behavioral changes in children, minimal animal work has investigated the effects of pSSRIs in relevant models of maternal stress or the long-term implications of these effects. Therefore the aim of this work was to investigate the long-term effects of pSSRI exposure to fluoxetine on social behaviors, the hypothalamic pituitary adrenal system (HPA) and hippocampal plasticity in adult male and female rat offspring using a model of pre-gestational maternal stress. Adult Sprague-Dawley female and male rat offspring from the following four groups were utilized 1. Control + Vehicle, 2. Control + Fluoxetine, 3. Pre-gestational Stress + Vehicle, 4. Pre-gestational Stress + Fluoxetine (n = 8-16/female/age groups, n = 8-14/male/age groups). Main findings show pSSRIs increased social investigation in adult females and increased social play (pouncing, nape attacks) in adult males. Perinatal SSRIs also had sexually differentiated effects on hippocampal neurogenesis and GR density. Pre-gestational stress had enduring effects by decreasing social investigation and hippocampal neurogenesis in adult males. Thus pSSRIs, as well as pre-gestational maternal stress, have significant long-term effects on social neurobehavioral outcomes which differ in males and females. This suggests that it would be valuable to consider fetal-sex specific treatments for maternal mental illness.

We report two cases of granular cell tumors (GCTs) arising on rare sites, namely, the nape and umbilicus. While GCTs have a very characteristic histology, their clinical signs and symptoms are non-specific. Therefore, it is extremely difficult to make a diagnosis of GCT on the basis of clinical findings only. The two cases reported here were clinically similar to hypertrophic scars and keloids, respectively. Skin surgeons should remember that GCTs are an important differential diagnosis from hypertrophic scars and keloids.

Introduction At Homagama Base Hospital there are approximately 100 patients looked after by the ENT clinic. Among the clinic attendees, paranasal sinusitis with vertigo and nape pain is a common observed phenomenon. In Sri Lanka data on these aspects are rare. Method Cross sectional descriptive study at the ENT Clinic of Base Hospital Homagama. Patients diagnosed as Paranasal Sinusitis amongst the patients attending the ENT clinic, age above 12 years. Patients diagnosed as Paranasal Sinusitis further evaluated for Vertigo and Nape pain. Total 425 patients taken for study. Result Patients diagnosed as Sinusitis, 425, 100% Patients diagnosed as Vertigo, 396 – 93.176% Patients diagnosed as Nape Pain, 322 – 75.76% There were Clinical improvement of Sinusitis – 423, 99.523%, among the research group. Patients with Vertigo – 396, all the symptomatic patients improved. Nape Pain – 322, all the symptomatic patients improved. Conclusion Rhino Sinusitis can cause symptoms like vertigo and nape pain. Whilst treating nape pain and vertigo, sinusitis should be considered in the differential diagnosis.

WHO in 2016 still shows the average rate of exclusive breastfeeding (ASI) in the new world is around 38%. In Indonesia, although a large number of women (96%) breastfeed their children in their lifetime, only 42% of babies under 6 months of age are exclusively breastfed. By the time children approach their second birthday, only 55% are still being breastfed. When compared with the WHO target of 50%, this figure is still far from the target. Maximum achievement can be applied by applying nape and marmot massage techniques for postpartum mothers so that breast milk can be released more quickly. This study aims to help and explain the combination of nape and marmet massage techniques to speed up the use of breast milk in postpartum mothers in the working area of Ngaglik II Sleman Health Center. This research is Quasi-Experimental research using quantitative and post-test designs, with a sample of 30 respondents divided into groups given intervention and control groups taken by purposive sampling. Univariate and bivariate data analysis. The results showed that the effect of nape massage combination and guinea pig technique on the acceleration of ASI use based on the Mann Whitney Test statistical test showed results (p-value 0,002)

Pthirus pubis usually infests the pubis, inguinal folds, buttocks and perianal region. In hairy males or when the infestation is longstanding, this louse can also occur on the thighs, abdomen, chest, axillae and beard. Eyelashes may be involved in children. The involvement of the scalp is very rare. We describe four girls with P. pubis infestation located exclusively on the scalp which was characterized by a rash on the nape that can suggest a head and neck form of atopic dermatitis.

Introduction: Ankylosing Spondylitis (AS) is a sero negative chronic inflammatory arthritis of unknown cause that primarily affects the axial skeleton which usually begins in the second or third decade of life with a male to female ratio of 3:1. The prevalence rate of AS in India is 0.03%. It is clinically correlated to Danda Apatanaka in Ayurveda. It is caused due to the vitiated Vata and Kapha Dosha which enters the Dhamani and causes stiffness of the body. Due to its known complications and its tendency to hamper the quality of life, there is a need for an effective Ayurvedic intervention. This report is based on a case of Ankylosing Spondylitis which presented with pricking pain over nape of the neck and low back associated with stiffness and restricted movements, swelling over nape of neck right shoulder and right side of face, associated with restricted movements of right upper limb. Methods: This case was diagnosed as Danda Apatanaka and was treated with Basti Karma, Abhyanga along with oral medications. Assessment was done before and after treatment using relevant scales. Result: After 2 weeks of treatment pain and swelling over the nape of neck, right shoulder and face resolved completely, pain and stiffness of low back reduced, pain in right upper limb reduced and patient was able to perform normal movements. Stiffness of neck still persisted. Conclusion: Ankylosing spondylitis can be effectively managed by Ayurvedic treatment modalities after proper assessment of the involved Dosha and Dhatus.

Play is an important part of normal childhood development and seen in many mammals, including rats. To better understand the interplay between genotype and postnatal experiences, the effects of neonatal handling on play were assessed in Lewis (LEW) and Fischer 344 (F344) rats. Handled litters experienced brief periods of separation during the first two postnatal weeks. F344 rats were less likely to direct nape contacts toward an untreated Sprague-Dawley (SD) partner and less likely to rotate to a supine position in response to a nape contact. When compared to rats from control litters, handled LEW, and F344 rats were more likely to respond to nape contacts with complete rotations, suggesting that handling increased playful responsiveness to a comparable extent in both strains. SD rats paired with handled inbred rats had more nape contacts than those paired with non-handled rats. While handled LEW rats also tended to direct more nape contacts to the SD partner than non-handled LEW rats there was no difference between handled and non-handled F344 rats. These results could not be readily explained by handling-induced changes in either maternal care or anxiety. These data suggest that the behavioral consequences of neonatal handling may not depend to a great extent on the genetic platform that these manipulations are acting on. These data also suggest that the ability to maintain the ebb and flow between playful solicitation and playful responsiveness may be compromised in F344 rats and may contribute to the lower levels of play in this strain.

Acupuncture has been used in traditional Chinese medicine for over 2500 years. Clinical evidence supports the efficacy of acupuncture in the treatment of itch. In particular, acupuncture can relieve histamine-induced itch, refractory uremic pruritus and neurogenic pruritus. However, very little clinical evidence is available as to how acupuncture can assist in itch. Preclinical investigations into itch typically use rodents, in which scratching behavior reliably serves as a behavioral readout of itch. Typically, researchers count the numbers of hindlimb scratch bouts at the site of an injected pruritogen in the nape of the neck. Using murine models of itch, we have demonstrated that EA at Hegu (LI4) and Quchi (LI11) or cold stimulation at LI11 significantly attenuates pruritogen-induced scratching behavior. This chapter discusses evidence suggesting that this effect is mediated by the inhibition of microglial activation in the spinal cord.

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Objective To observe the clinical efficacy of nape cluster acupuncture in treating migraine.

The authors have adopted acupuncture at Jľngjiājľ ( ) combined with nape cluster needling in treatment of 100 patients with cervicogenic headache. Nape cluster needling was: Xianaohu ( ) (located in the median depression under occipital bone), Fēngfŭ ( GV 16) and Yamen ( GV 15) were selected longitudinally; horizontally, the part from GV 16 to Wangŭ ( GB 12) was divided into six equal sections, one section was an acupoint, and there were 12 acupoints in total at the left and right sides. Bilateral Jľngjiājľ ( ) points on the second vertebra to the seventh vertebra were selected. The acupuncture was conducted once a day, five days were considered as one course of treatment, and two days were free from treatment between two courses. Four courses of treatment were needed. All the patients were cured clinically. It can be seen that acupuncture at Jľngjiājľ combined with nape cluster needling in treatment of cervicogenic headache has sound effect.

Background Obesity and emaciation in horses have major detrimental effects on health and morbidity, reproductive failure, work performance or carcass quality. Scoring is a current management tool used to assess and monitor equine body condition due to its simplicity and low cost. However, accurate assessment of obesity remains a challenge, even though a number of approaches have been tested, particularly for research purposes on adiposity. Their merit is usually validated by comparison with standard scoring methods. The overall aim of this study was to establish the correlation between post-mortem nape fat measurements obtained after photographic image analysis and cresty neck score (CNS) in horses. Data were collected from seventeen horses with a hot carcass weight of 165 ± 51 kg. Pre-slaughter CNS measurements were obtained using a six-point scale (from 0 to 5). Image capture was performed post-mortem, in the slaughter line; for each carcass, images of the dorsal and medial views were collected and afterwards transferred to a computer for analysis. After outlining the cresty neck fat, its area, major axis and thickness were determined. Correlation coefficients between nape fat measurements, CNS and carcass fatness were determined. Results The horses in the study show similar variation for CNS and hot carcass weight [Coefficient of variation (CV) = 32 and 31 %, respectively], but a high variation for carcass fattening (CV = 41 %). The nape fat area measurement was the parameter exhibiting the greatest variation (CV = 50 %). Correlations established between CNS and the variables tested revealed the existence of moderate to strong correlations among CNS, nape fat measurements, and carcass fatness. The highest correlation coefficients were found between CNS and nape fat thickness (r = 0.882; P

Proliferating trichilemmal tumours are benign but locally aggressive tumours arising from the hair follicle. They are biologically benign lesions, but may be locally aggressive. They are generally solitary lesion and commonly occurring in the scalp of elderly women. Malignant transformation has been known to occur but very rarely. Here we report a rare case of a recurrent malignant trichilemmal tumour of the scalp in a middle aged male which was surgically excised.

Basidiobolomycosis is a rare chronic subcutaneous infection caused by Basidiobolus ranarum. The disease usually occurs in children, less often in adolescent and rarely in adults. Males are more frequently affected than females. We report a case of subcutaneous zygomycosis of head and neck region caused by B. ranaram, in an immunocompetent adult female presenting with nontender firm swelling over the nape of neck and temporo-parietal region. The diagnosis was confirmed by histopathology, microbiology (culture) and DNA sequencing of molecular technique (sequencing). The patient was successfully treated with amphotericin B and potassium iodide.

In psychophysical experiments, humans use different verbal responses to pruritic and algesic chemical stimuli to indicate the different qualities of sensation they feel. A major challenge for behavioural models in the mouse of chemical itch and pain in humans is to devise experimental protocols that provide the opportunity for the animal to exhibit a multiplicity of responses as well. One basic criterion is that chemicals that evoke primarily itch or pain in humans should elicit different types of responses when applied in the same way to the mouse. Meeting this criterion is complicated by the fact that the type of behavioural responses exhibited by the mouse depends in part on the site of chemical application such as the nape of the neck that evokes only scratching with the hind paw versus the hind limb that elicits licking and biting. Here, we review to what extent mice behaviourally differentiate chemicals that elicit itch versus pain in humans.

Objective To observe the clinical efficacy of needling nape acupoints in the treatment of pseudobulbar palsy.

We report a case of dermatitis papillaris capilliti (DPC) that was successfully treated with Kampo (Japanese traditional herbal medicine) formulations (Keigai-rengyo-to and Keishi-bukuryo-gan). A 38-year-old man presented with longstanding-therapy resistant papillomatous lesions on the occipital area and nape for 15 years. Diagnosis was made as DPC. He had also cystic acne. Histopathological findings revealed follicular hyperkeratosis in the infundibulum and fibrosis in the dermis. After Kampo formulations (Keigai-rengyo-to and Keishi-bukuryo-gan) were administered, inflamed and granulomatous lesions subsided remarkably. The successful treatment with these herbal formulations shows Kampo therapy can acts as an alternative treatment for DPC.

Geoscientists and engineers appreciate the answers that technology can provide, but when making application decisions there are always the questions: Where does the technology work? What is the risk? What return on investment (ROI) is reasonable to expect? Answers to these questions apply to the prospect market as well as to the properties a company operates. Those who are selling prospects want to make their prospect look as attractive as possible, so it behooves them to apply sound technologies. Those buying prospects need to sense where the opportunities/upsides are should they buy a prospect.

Objective: To investigate the mechanism of nape cluster acupuncture in the treatment of acute cerebral infarction.Methods: Eighty patients with acute cerebral infarction were selected and randomly allocated to group A and B. Group B was given routine treatment for acute phase and Group A was added with the nape cluster acupuncture based upon the treatment for Group B. The treatment was given twice daily, with 15 d as a course of the treatments, to observe the decreasing situation in the score of the nerve function defects and changes in plasma ET content.Results: There were significant differences in the score of the nerve function defects and plasma ET content before and after treatments in two groups (P

Numerous clinical observations have provided evidence for a tight connection between impairments in the functions of the hypothalamo-hypophyseal-thyroid system and nervous and mental disorders. The aim of the present work was to compare the effects of experimental decreases and increases in blood thyroxine levels on the extents of two types of pathological freezing reaction in male Wistar rats — spontaneous catalepsy and catalepsy evoked by pinches at the nape of the neck (pinch-induced catalepsy). Chronic administration of the thyroxine synthesis inhibitor propylthiouracil (5 mg/kg/day for 28 days) significantly decreased the blood hormone level and sharply increased the proportion of animals showing spontaneous catalepsy and the immobility time, but had no effect on the extent of pinch-induced catalepsy. At the same time, chronic administration of thyroxine (0.1 mg/kg/day for 28 days), which produced significant increases in blood hormone levels, had no effect on the extent of spontaneous catalepsy but significantly increased the proportion of animals showing pinch-induced catalepsy and the duration of this type of catalepsy. It is concluded that both insufficiency and excess of thyroid hormones have cataleptogenic actions, but enhance different types of catalepsy.