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Background This study aims at identifying orthodontic activities with the highest frequency of unfavorable/awkward and static postures held over a period of more than 4 s based on kinematic analysis. Moreover, a separate analysis of static postures for orthodontic and non-orthodontic activities serves to evaluate the duration for which these particular postures are assumed. Methods In total, 21 (13f/8 m) orthodontists (age: 31.5 ± 3.8 years) participated in this study. CUELA, a personal measurement system, was used to collect kinematic data for all orthodontic activities in a working day. Angle values of the head and torso were evaluated in accordance with ergonomic standards. Only those postures that were held statically for 4 s and longer were selected for further analysis. Alongside the kinematic analysis, the activities performed on-site were also subject to a detailed computerized analysis. The synchronization of data collected from both measurements arranges the patterns of posture found chronologically and in conjunction with the orthodontic activities performed ((I) “treatment” (II) “office” and (III) “other activities”). Results For (I) we observed an anterior inclination of the head and torso area as well as a twist of the head and neck area to the right. We found anterior back inclination and lateral back torsion to the right for (II) and (III). If, furthermore, we differentiate the duration of static postures, there are primarily short to medium-term (4–30s) static postures identified for (I). Also, categories (II) and (III) predominantly demonstrate static back postures with a duration of up to 30 s. With regard to (II) we observed that the back is ventrally inclined for 10.1% of the total activity duration. Conclusions During treatment static strains are observed in the entire head and torso area. On the contrary, static postures prevalent in the torso area are essential for activities of the other categories, particularly office work. These findings allow for a careful selection of unfavorable and static postures for each of the activities performed and help to develop specific preventive measures.

KEY POINTS A healthy 50-year-old woman presented with acute onset of the worst headache of her life. She characterized the headache as constant, pulsating and over her entire head. It was associated with photophobia and fever without visual changes and neck stiffness. On examination, the patient was

Headaches often suddenly attack and this causes disruption to the various activities that are being carried out by ours. Headaches are pain in the head that can occur gradually or appear instantly almost unexpectedly. Headaches that appear can be felt light, heavy, and the area can be felt in the entire head or only in certain areas. There are many ways to deal with headaches, such as get some medication or get some massage therapy at certain points area, depending kind of headaches. However, the use of pain medication usually only has a short-term impact, so that at any time this headache reappears. Yoga therapy is an alternative in dealing with this headache. Yoga is indeed known as an alternative healing for certain diseases, one of them is headache. Although there is no exact and in-depth research on this issue, but some yoga movements are said to be able to deal with headaches, especially for those who often experience this headache attack at the wrong time, for example.

As children develop, they differ from adults in a number of important ways, including anatomy, metabolism, immune system, and the extent of myelination of the nervous system. As a consequence, equivalent exposures to radiation from mobile phones result in different doses to specific tissues in children compared with adults. Higher doses are likely to have more severe implications in the young. A young child’s skull is not only smaller and thinner than an adult’s, but also has dielectric characteristics closer to those of soft tissues, probably due to a higher water content. The young skull better matches the electromagnetic characteristics of the skin and brain. As a result, finite-difference time-domain (FDTD) simulations confirm field penetration and higher specific absorption rate (SAR) in deeper structures in the young brain. If the peak spatial SAR (psSAR) is modeled in the entire head, as current testing standards recommend, the results for adults and children are equivalent. Our anatomically based evaluations rely on FDTD simulations of different tissues within the brain and confirm that the psSAR in a child’s brain is higher than in an adult’s brain.

The benefit of hyperthermia as a potent modifier of radiotherapy has been well established and more recently also the combination with chemotherapy was shown beneficial. Also for head and neck cancer, the impact of hyperthermia has been clinically demonstrated by a number of clinical trials. Unfortunately, the technology applied in these studies provided only limited thermal dose control, and the devices used only allowed treatment of target regions close to the skin. Over the last decade, we developed the technology for deep and controlled hyperthermia that allows treatment of the entire head and neck region. Our strategy involves focused microwave heating combined with 3D patient-specific electromagnetic and thermal simulations for conformal, reproducible and adaptive hyperthermia application. Validation of our strategy has been performed by 3D thermal dose assessment based on invasively placed temperature sensors combined with the 3D patient specific simulations. In this paper, we review the phase III clinical evidence for hyperthermia in head and neck tumors, as well as the heating and dosimetry technology applied in these studies. Next, we describe the development, clinical implementation and validation of 3D guided deep hyperthermia with the HYPERcollar, and its second generation, i.e. the HYPERcollar3D. Lastly, we discuss early clinical results and provide an outlook for this technology.

PRESENTATION A 62-year-old woman’s dermatologic difficulties were compounded when light treatment for psoriasis spurred pemphigus foliaceus; an occurrence very rarely noted in the medical literature. She presented with an erythematous, crusted eruption involving her entire head and neck and most of her trunk. The lesions developed several months after consecutive exposures to narrowband ultraviolet B (UVB) phototherapy for chronic plaque psoriasis (Figure 1).

To study brain mechanisms of memory scan, we have measured event-related potentials (ERPs) during the execution of a Sternberg task concerned with movement directions of random dot patterns (RDPs). Five healthy male subjects participated in the experiment. Event-related potentials were recorded at 20 electrode positions over the entire head. A prominent positive ERP component peaking at 380–390 ms known as P300 was observed in the parietal region after the presentation of the probe moving random dot pattern, whereas the P300 was not observed after the presentation of a control stationary RDP. On the other hand, a positive ERP component peaking at 127 ms was commonly observed in the occipital region after the presentation of both moving and control stationary RDPs. These findings suggest that P300 may reflect cortical activities related to the memory scan of movement directions of RDP.

There are various recommendations about keeping operating gowns sterile, but the validity of these recommendations has not been definitively established. The purpose of this study was to use bacterial cultures to identify which areas of operating gowns are vulnerable to infection and which are safe against infection, as well as to find ways to improve bacterial identification and to prevent contamination. There were statistically significant differences according to year, as follows: F1, F4, B1, and B3. Based on 2009's results, when assisting with putting on OR gowns, we wore sterile gloves, sterile vests, and helmet-shaped hats which cover the entire head area to prevent rear area infections. Also, we performed bacterial identification immediately after finishing operations in 2010. The results showed that in this study, the areas of F1, F4, B1, B3, and B4 exhibited significant differences in bacterial identification.

A pituitary adenoma was diagnosed via histopathologic examination in an aged female Dumeril's ground boa, Acrantophis dumerili. The snake exhibited postural abnormalities, dull mentation, and poor muscle tone prior to death. Pituitary neoplasms appear to occur very rarely in reptiles, but may be underreported if the pituitary gland is not routinely examined. This report illustrates the importance of submitting the brain or entire head for microscopic evaluation.

The myth of rachipagus twins is hereby exploded-the myth, not the rachipagus! In a review of over 1,200 cases of conjoined twins, one classic example of rachipagus was found-two complete infants with dorsal union of the entire head and trunk, with roentgenograms showing clearly visible bony union of the vertebral arches from T6 to L3. After the typical case was discovered, 20 dorsal parasitic twins were reevaluated and reclassified as rachipagus. Two had extensive vertebral fusion and 18 were united in the dorsal midline, all with a meningocele, vertebral anomaly, and/or bony or neural connection. A theory of the embryologic origin of these twins is proposed: two embryonic discs located on diametrically opposing aspects of a single amniotic cavity becoming united in the area of the closing neural folds. This again raises the controversy concerning "fission or fusion" in conjoined twins.

Iatrogenic comminution of the phalangeal head during management of phalangeal neck fractures has not been previously investigated.To investigate the causes and outcomes of this particular iatrogenic complication.A database of phalangeal neck fractures over a six-year period (2006 to 2011) was reviewed for this iatrogenic complication. Special attention was devoted to documenting the cause and pattern of comminution of the phalangeal head, as well as the outcome in range of motion.Of 152 cases treated during the study period, there were five (two children and three adults) with comminution. Two patterns of comminution were encountered: splitting and fragmentation of the phalangeal head. The complication occurred during open reduction and K-wire fixation, or during closed reduction in the emergency room. The outcome was generally poor and worse in patients with fragmentation of the entire head. Two of the five cases ultimately resulted in medicolegal claims.Comminution of the phalangeal head is a serious iatrogenic complication that may occur during the management of phalangeal neck fractures. Awareness of this complication is important and attempts should be made to avoid it.La comminution iatrogène de la tête de la phalange pendant la prise en charge de fractures de la phalange distale n’a jamais été examinée auparavant.Explorer les causes et les issues de cette complication iatrogène.Les chercheurs ont analysé une base de données sur les fractures de la phalange distale sur une période de six ans (2006 à 2011) pour dépister cette complication iatrogène. Ils se sont attardés à étayer la cause et le profil de la comminution de la tête de la phalange, ainsi que l’issue de l’amplitude de mouvement.Sur les 152 cas traités pendant la période de l’étude, cinq (deux enfants et trois adultes) ont présenté une comminution. Il y avait deux profils de comminution : une fente et une fragmentation de la tête de la phalange. La complication s’est produite pendant la réduction ouverte et la fixation par broche de Kirschner, ou pendant la réduction fermée à l’urgence. L’issue était généralement médiocre, et pire encore chez les patients présentant une fragmentation de toute la tête de la phalange. Deux des cinq cas ont donné lieu à des réclamations médicolégales.La comminution de la tête de la phalange est une complication iatrogène qui peut se produire pendant la prise en charge des fractures de la phalange distale. Il est important de connaître cette complication et de tenter de l’éviter.

✓ Although hair removal prior to neurosurgery may increase the risk of infection, the practice of shaving the patient's entire head is still common, particularly in implant surgery. The authors describe a technique for implanting a deep brain stimulation electrode without shaving the patient's hair and present a retrospective analysis of 261 implantations in 221 cases.

A new high-resolution MR protocol for the combined assessment of neurovascular arterial anatomy and subsequent evaluation of inflammatory disease in cranial vessels walls has been investigated. First-pass contrast-enhanced MR angiography (CE-MRA) in combination with parallel imaging at high field permits the depiction of the neurovascular geometry with large coverage, including the aortic arch, supraaortic vessels, and almost the entire head, with high, submillimeter detail. Utilizing the remaining contrast agent, postcontrast T1-weighted turbo spin-echo (TSE) imaging was used to generate late enhancement images of the vessel walls to assess the morphology and potential inflammatory changes in cranial arteries with high in-plane (195 × 260 μm2) spatial resolution. As a result, a combined analysis of neurovascular arterial anatomy as well as cranial vessel wall inflammations could be achieved in less than 45 minutes in all studies. The feasibility and clinical value for the diagnosis of rheumatologic diseases and simultaneous arteriosclerotic involvement was demonstrated in seven patients with suspected giant cell arteritis (GCA). Excellent CE-MRA image quality could be achieved and even vascular geometry of small superficial cranial arteries could be successfully visualized using single dose (0.1 mmol/kg) contrast agent administration and a dedicated phased-array head and neck coil at 3T. J. Magn. Reson. Imaging 2006. © 2006 Wiley-Liss, Inc.

Although hair removal prior to neurosurgery may increase the risk of infection, the practice of shaving the patient's entire head is still common, particularly in implant surgery. The authors describe a technique for implanting a deep brain stimulation electrode without shaving the patient's hair and present a retrospective analysis of 261 implantations in 221 cases.

We wish to thank Dr. Wierzbicka for the interesting comments to the paper ‘‘Open partial horizontal laryngectomies: a proposal for classification by the working committee on nomenclature of the European Laryngological Society’’ by Succo et al. [1]. Its declared aim, as well as that of the other ELS classifications on oncologic subjects published in the past years [2–4] is to create a common platform for sharing surgical data among the greatest number of institutions worldwide. In this sense, the specific intent of our working committee was to keep the classification as easy as possible, including only well-known, standardized, and widely accepted procedures, reproducible among the entire head and neck surgical community. Clearly, this is required to make choices among the dozens of types of open partial laryngectomies described in the literature, focusing on those that, in our opinion, still play a pivotal role between the two extremes of transoral microsurgery on one hand, and total laryngectomy on the other. Among the many less common types of open partial laryngectomies, horizontal glottectomy, described in 1978 by Calearo and Teatini [5] (who were both, by the way, strictly linked to our laryngological school), definitely represents a procedure that is nowadays quite limited in its application since it has been overshadowed, for the reported indications, by transoral laser microsurgery and radiotherapy. Nevertheless, we are perfectly aware of the fact that any classification of surgical procedures should be regarded as a temporary tool that is being continuously reshaped and modified whenever consistent limits in its application should become evident in the future among the head and neck cancer community.

Dissection of temportal bone is essential for training in otology. Human temporal bones, if for different reasons are not available, an animal model like Ram Head may be used for surgical dissection training of the temporal bones. In Ram model the entire head is used as head of removing the temporal bone. Ram Head is advantageous for its easy access and anatomical similarity with human temporal bones.

P300 recordings were made from males at high risk (HR) for alcoholism and low-risk (LR) controls, participating in a visual go/no go reaction time paradigm. The go (button press) and no go (inhibit response) stimuli were large and small forms of the same letters. The LR group had significantly larger go than no go P300 amplitudes in the central, parietal, and temporal regions; the HR group manifested no response differences in any region. In the LR group compared to the HR group, both go and no go response amplitudes were larger over the entire head; no group differences in latencies were observed in any region. Surface energy magnitudes paralleled P300 amplitudes and were also larger in the LR group during both go and no go trials. Our findings indicate that HR individuals manifest widespread P300 amplitude deficits while performing a simple information-processing paradigm. These deficits, which may reflect genetic influences, preceded the onset of alcoholism and may function as a phenotypic marker for its development.

This interactive feature presents the case of a 54-year-old woman with a history of mild, intermittent headaches who awoke from sleep with a squeezing, stabbing pain around her entire head. Test your diagnostic and therapeutic skills at NEJM.org.

In 20 healthy subjects, auditory evoked magnetic fields were measured over the entire head, using a helmet-shaped 66-channel MEG system linked to MRI. When the left or right ear was stimulated by 60 msec 2 kHz tones, the prominent 100 msec response (N100m) appeared significantly earlier in the contralateral hemisphere than in the ipsilateral one. In 16 cases, the N100m dipolar field patterns were clear in both hemispheres, overlapping each other across the midline. The N100m sources were estimated using a 2-dipole model in a spherical conducting medium with the size and location of the sphere determined individually according to the MRI images. No differences were found between the contralateral and ipsilateral N100m dipole positions in one hemisphere. When superimposed on MRI, the N100m dipoles were located precisely on the upper surface of bilateral temporal lobes with a standard deviation of 2.2 mm in the superior-inferior direction. In 16 right handed males, the right hemispheric N100m dipoles were 6 mm anterior to the left hemispheric dipoles. The whole head MEG is suitable to see small but significant differences of bilateral cerebral function, with exceptionally high spatial resolution, confirmed by the MRI-linked system.

• A totally implantable infusion pump (Infusaid) has been developed to achieve continuous drug delivery for long periods of time. The recent availability of a dualcatheter totally implantable infusion pump permits the infusion of both external carotid arteries simultaneously. This has obvious advantages for the treatment of extensive tumors of the head and neck that extend across the midline. Likewise, for the first time, unilateral local-regional disease that extends inferiorly beyond the nutrient field of the external carotid artery may be treated with intra-arterial infusion chemotherapy without the need to infuse the common carotid or innominate arteries. Unilateral infusion of the entire head and neck is accomplished by using the dual-catheter pump to infuse both the thyrocervical trunk and the external carotid artery. ( Arch Otolaryngol 1982;108:703-708)

Non-visual responsiveness to photic stimulation was investigated in pigeon embryos (days 11½–17½ of incubation) and neonates (6–24 hours posthatch). At all ages observed, these animals exhibited a marked overt response to light onset, a response which occurred even when the entire head was occluded from light, but which could be blocked (in hatchlings) by covering all of the body except the head. It was therefore concluded that retinal or direct brain mediation did not underlie the response, but rather, some form of dermal sensitivity would best account for it. Chicken embryos (day 19 of incubation) and Ring dove hatchlings (12–24 hours posthatch) were similarly investigated. Although there was evidence in both of these species for light-contingent motility, their responsiveness was seemingly mediated by either visual or direct brain stimulation, since occlusion of the head eliminated the effect. Thus, of the three species tested, only the pigeon appeared to possess the non-visual dermal light sensitivity. Possible significance of this responsiveness for this species was discussed.

Synopsis A multi-technique evaluation of the hair regreasing process is described. Preliminary experimentation in vitro was followed by a long-term in vivo study conducted on a single subject having greasy hair. First, a shampoo for very greasy hair and one for dry hair were applied to the left and right sides of the head respectively (split-head test) for 7 weeks; then a shampoo for greasy hair was applied to the entire head (whole-head test) for 5 weeks. Three parameters were studied: (1) hair spacing, determined by means of a special device; (2) regreasing of individual hairs, measured using the contact-reprint technique; (3) the amount of sebum extracted from individual hairs, performed by g.l.c. determination of squalene. Results obtained during the split-head period showed that the shampoo for very greasy hair showed higher average hair spacing, slower progression of regreasing, and better sebum-removal efficiency when compared to the shampoo for dry hair. During the whole-head test period with one shampoo, results showed that there was consistent asymmetry as regards hair spacing and progression of regreasing. These results support our hypothesis concerning the role of interfacial forces in the hair regreasing process. Differents aspects du regraissage des cheveux Resume L'evaluation du regraissage des cheveux par differrentes techniques est decrite dans le texte. Apres avoir effectue une serie d'experiences in vitro, une etude a long terme a ete conduite sur un seul sujet ayant des cheveux gras. Apres avoir applique un shampooing pour cheveux tres gras et un shampooing pour cheveux sees respectivement sur les cotes gauche et droit de la tete du sujet pendant 7 semaines consecutives (test mi-tete), nous avons applique un shampooing pour cheveux gras sur les cheveux du meme sujet pendant 5 semaines consecutives (test monotete). Nous avons ainsi pu examiner trois parametres: (1) l'espacement entre les cheveux au sein meme de la chevelure, mesure au moyen d'un appareil specialement concu a cet effet; (2) le regraissage des cheveux par une technique d'impression sur papier absorbant; (3) la quantite de sebum extraite des cheveux individuels mesuree par g.l.c. Les resultats obtenus pendant le test mi-tete montrent.

F. N., a white man aged 66, was admitted to the Graduate Hospital of the University of Pennsylvania on July 11, 1950, because of swelling of the entire head, face, and neck. The patient stated that two months prior to admission he first noted that his lower eyelids were swollen in the morning. The swelling became progressively worse, so that his eyes were swollen shut in the morning, his neck veins became prominent, like cords, and his arms were swollen. He also began to notice distended veins on his chest and a sensation of being choked when he "stooped" over. All these symptoms were less severe after he was up and about. Physical examination revealed distended neck veins and numerous varices on the anterior chest wall, but no dependent edema. The rest of the examination revealed nothing significant. Laboratory studies showed a venous pressure of 310 mm. of water, a

I. ASEPTIC PROTECTIVE SHEET FOR MASTOID SURGERY. One of the important problems confronting the aural surgeon is the maintenance of strict asepsis of the mastoid wound without unduly disfiguring the patient, even temporarily, by extensive removal of hair. The practice of different operators, as regards the preparation of the field for a mastoid operation, varies from removal of only a small amount of hair immediately surrounding the area to be opened, to a close shaving of the entire head. I have never felt justified in exposing an extensive area of the scalp, except in a premeditated brain investigation, and yet, in my efforts to save the patient from unnecessary loss of hair, I have frequently been sorely troubled by hairs encroaching on the wound at a critical stage of the operation. In preparing for a simple mastoidectomy it has been my custom to have the scalp shaved for a distance

Stiffness of the neck is often found in clinical practice accompanying meningeal irritation. Yet, paradoxically enough, patients have been erroneously diagnosed as having had meningitis because of its presence. We had to note the conditions where stiff neck was found, for it soon became obvious that not all stiff necks were due to meningeal irritation. In order to establish a diagnosis when this condition is present, one has to collect the evidence based on inspection, percussion, palpation and rarely auscultation. The factors causing stiffness of the neck originate in nerves, muscles, bones, fascia, ligaments, glands and other structures. The neck is inspected from front, side and back. One notes how the head is held. Is it braced and splinted to avoid pain? Is there pain in certain positions only? Is pain absent? Is the entire head and neck moved in a marionette manner or is the neck stiffened so that

In the practice of surgery, the successful bandaging and dressing of head wounds has always seemed to me a difficult feat. Patients with large wounds, requiring large dressings, usually need hospitalization, and every one knows the difficulty of keeping a head dressing on a restless or uncontrollable patient. Small operative and accidental wounds about the head are covered generally with a collodion dressing (which is difficult and painful of removal), or the entire head is swathed in bandages, much to the discomfort and dismay of the patient desirous of going about his usual duties. In the handling of quite a number of patients suffering with head wounds, the dressing presented in the accompanying illustration has been evolved, and, with it, the mode of closure, thus making the closure and dressing all part of the same technic. Since it was first used it has been tried many times and has proved

With our limited access to the literature we have been unable to find any satisfactory description for an arthroplasty of the shoulder-joint. Having a case for operation, we began the work on the cadaver and developed the following technic, which we believe is nearest anatomically correct of anything we have been able to find. In this operation we have utilized a portion of the short head of the biceps for a flap to interpose, because it is covered bymore dense tendinous sheath than any other structure in the neighborhood of the shoulder-joint, is correctly located anatomically and we believe in the majority of cases will furnish sufficient fascia and muscle to make a flap of necessary dimensions. The flap obtained is quite sufficient to line the glenoid fossa and cover the entire head of the humerus. In our clinical case there was considerable enlargement of the head of the humerus

This case is reported because of the unusual rapidity with which the symptoms developed and their extraordinary severity, leading to a fatal termination. REPORT OF CASE Onset. —E. S., a white woman, aged 63, first complained of symptoms on March 12, 1927, consisting chiefly of nausea and terrific pain over the entire head. The patient was perfectly well in every way on March 11. At 5 a. m. on the 12th, she awakened with a terrific pain in the temporal part of the head, extending over the eyes. It was extremely severe and different from any other previous headaches, associated with nausea and followed within two hours by vomiting. She found it impossible to retain any food that day. The extreme retching increased the pain in the head markedly. There was noticeable drowsiness the entire day. Codeine sulphate, one-half grain (32 mg.), slightly relieved the headache and somewhat controlled the

Weanling rats whose bodies were lead-shielded, were X-irradiated to defined areas of the head. Body growth, incisal tooth development, and histopathology of the tongue and glossopharyngeal area (throat) were studied for a period of 7 weeks following irradiation. An X-ray dose of 2000 rads to the head and throat caused injury to the tongue and palate which resulted in a reduction in food intake and a marked loss in weight of the exposed rats. The more extensive the head area irradiated the higher the mortality, attaining 100 per cent deaths at 9-10 days when the entire head was irradiated. Irradiation of the throat only with 2000 rads elicited 50 per cent deaths. There was a persistent reduction in the growth rate of the survivors compared to that of non-irradiated controls. These effects were not seen if the base of the tongue only was irradiated. The maxillary incisors, which received 120 rads through the lead shielding, after 5-7 weeks were either lost or grew abnormally in all throat-irradiated rats. The same dose of X-radiation to the incisors of rats in which the base of the tongue only was irradiated, had no deleterious effect on their development. The possibility of a relationship between metabolic disturbances caused by throat irradiation, and growth of the incisors receiving low doses of X-radiation, is postulated and discussed. (Author)