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Lipomas are superficial tumors that occur primarily in the subcutaneous region and very rarely occur deeply within or between the muscle layers. No reports to date have described cervical lipomas in patients with head and neck cancer who underwent neck dissection. We herein report a case involving a 72-year-old woman with supraglottic carcinoma complicated by a cervical lipoma who underwent simultaneous neck dissection and lipoma removal. The lipoma was a deep-seated intermuscular lipoma arising in the longus cervicis muscle. We initially considered that the lipoma would be removed en bloc with neck dissection, but the imaging findings clearly indicated that the tumor was located more deeply than the prevertebral layer of the deep cervical fascia and outside the range of neck dissection. The lipoma was removed by incision of the prevertebral fascial layer following neck dissection, and no complications occurred.

PurposeSwallowing dysfunction and the risk of aspiration pneumonia are frequent clinical problems in the treatment of head and neck squamous cell carcinomas (HNSCCs). Breathing-swallowing coordination is an important factor in evaluating the risk of aspiration pneumonia. To investigate breathing-swallowing discoordination after chemoradiotherapy (CRT), we monitored respiration and swallowing activity before and after CRT in patients with HNSCCs.MethodsNon-invasive swallowing monitoring was prospectively performed in 25 patients with HNSCCs treated with CRT and grade 1 or lower radiation-induced dermatitis. Videoendoscopy, videofluoroscopy, Food Intake LEVEL Scale, and patient-reported swallowing difficulties were assessed.ResultsOf the 25 patients selected for this study, four dropped out due to radiation-induced dermatitis. The remaining 21 patients were analyzed using a monitoring system before and after CRT. For each of the 21 patients, 405 swallows were analyzed. Swallowing latency and pause duration after the CRT were significantly extended compared to those before the CRT. In the analysis of each swallowing pattern, swallowing immediately followed by inspiration (SW-I pattern), reflecting breathing-swallowing discoordination, was observed more frequently after CRT (p = 0.0001). In 11 patients, the SW-I pattern was observed more frequently compared to that before the CRT (p = 0.00139). One patient developed aspiration pneumonia at 12 and 23 months after the CRT.ConclusionThe results of this preliminary study indicate that breathing-swallowing discoordination tends to increase after CRT and could be involved in aspiration pneumonia. This non-invasive method may be useful for screening swallowing dysfunction and its potential risks.

Preoperative diagnosis of the presence of anomalies or abnormalities of the cervical vessels is important to safely perform neck dissection in patients with head and neck cancer. We present a case of cervical lymph node metastasis from carcinoma of unknown primary origin in a 72-year-old man. The patient had a huge lymph node metastasis in his right neck that was more than 90° adjacent to the common carotid artery. Imaging studies incidentally revealed right internal carotid artery hypoplasia. Internal carotid artery hypoplasia is a very rare vascular anomaly with an incidence of

Abstract Background Adenoid cystic carcinoma is a rare malignant tumor arising from exocrine glands such as the major and minor salivary glands of the paranasal sinuses or the external auditory canal. Although multiple retrospective clinical studies of ACC have been reported to date, clinical questions, such as 1) long-term prognosis beyond 20 years, 2) usefulness and suitability for treatment of therapeutic interventions, 3) therapeutic goal to aim for, and 4) prognosis by recurrence sites, are still unclear. Methods To improve understanding and management of adenoid cystic carcinoma of the head and neck (ACC), a retrospective study with 58 new ACC cases between 1991 and 2016 was performed. The median observation period was 66.8 months (range 3–316 months). The overall clinical stages were as follows: I, 6.9%; II, 25.9%; III, 19.0%; and IV, 48.2%. Histology was cribriform/tubular type (C-T type) in 62.0% and solid type in 27.5%. The main treatment strategy was definitive surgery, which was performed in 75.2% of cases. Results Overall 10-year, 20-year, and 25-year survivals were 63.7, 27.3, and 20.0%, respectively. Similarly, disease-specific survival (DSSs) was 65.7, 51.2, and 38.4%, respectively, and disease-free survival was 25.2, 9.4, and 9.4%, respectively. Conducting surgery (HR: 0.19, 95% CI: 0.06–0.61, p = 0.005) and C-T type (HR: 0.32, 95% CI: 0.11–0.93, p = 0.036) were independent prognostic predictors of DSS. DSS was significantly prolonged after salvage surgery for both locoregional recurrence (p = 0.004) and lung metastatic recurrence (p = 0.012, vs best supportive care). Conclusions In ACC cases, both initial surgical treatment and repetitive surgical resection of resectable recurrent lesions, including both locoregional and lung metastases, resulted in longer survival. The major goal of treatment for ACC may be long-term survival including cancer-bearing survival, resulting in either natural death or intercurrent-disease death, since judging cure of ACC is almost impossible. Trial registration Retrospectively registered.

Abstract Background Induction chemotherapy (IC) in locally advanced squamous cell carcinoma of the head and neck (LA‐SCCHN) often compromises compliance with subsequent chemoradiotherapy (CRT), which negatively affects outcomes. Here, we assessed the combination of paclitaxel (PTX), carboplatin (CBDCA), and cetuximab (Cmab) as IC for unresectable LA‐SCCHN. Methods Induction chemotherapy consisted of weekly CBDCA area under the plasma concentration‐time curve = 1.5, PTX 80 mg/m2 and Cmab with an initial dose of 400 mg/m2 followed by 250 mg/m2 for 8 weeks. Following IC, CDDP (20 mg/m2, 4 days × 3 cycles) and concurrent radiotherapy (70 Gy/35 fr) were started. Primary endpoint was the proportion of CRT completion (%CRT completion). PCE was planned to be deemed effective if the Bayesian posterior probability (PP), defined as the probability that %CRT completion was larger than the threshold value of 65%, exceeded 84%. Results Thirty‐five patients were enrolled. Cases were hypopharynx/oropharynx/larynx in 17/17/1 patients, all at Stage IV. Of 35 patients, 34 (97%) completed IC and 32 received CRT and met the criteria of full analysis set (FAS). In FAS, the %CRT completion was 96.9%, and PP was 99.9%, exceeding the prespecified boundary of 84%. Mean cumulative dose and relative to dose intensity of CDDP in CRT was 232.5 mg/m2 and 100%, respectively. Response rate was 88.6% by IC and 93.8% in the CRT phase. Three year overall survival was 83.5%. Main grade 3 toxicities included neutropenia (11.4%) and skin rash (5.7%) during IC; and oral mucositis (31.3%) and neutropenia (12.5%) during CRT. No grade 4 toxicity or treatment‐related death was seen. Conclusions PCE as IC was feasible, with promising efficacy and no effect on compliance with subsequent CRT in unresectable LA‐SCCHN.

Purpose: Swallowing dysfunction and the risk of aspiration pneumonia are frequent clinical problems in the treatment of head and neck squamous cell carcinomas (HNSCCs). Breathing–swallowing coordination is an important factor in evaluating the risk of aspiration pneumonia. To investigate breathing–swallowing discoordination after chemoradiotherapy (CRT), we monitored respiration and swallowing activity before and after CRT in patients with HNSCCs. Methods: Non-invasive swallowing monitoring was prospectively performed in 25 patients with HNSCCs treated with CRT and grade 1 or lower radiation-induced dermatitis. Videoendoscopy, videofluoroscopy, Food Intake LEVEL Scale, and patient-reported swallowing difficulties were assessed. Results: Of the 25 patients selected for this study, four dropped out due to radiation-induced dermatitis. The remaining 21 patients were analyzed using a monitoring system before and after CRT. For each of the 21 patients, 405 swallows were analyzed. Swallowing latency and pause duration after the CRT were significantly extended compared to those before the CRT. In the analysis of each swallowing pattern, swallowing immediately followed by inspiration (SW-I pattern), reflecting breathing–swallowing discoordination, was observed more frequently after CRT (p = 0.0001). In 11 patients, the SW-I pattern was observed more frequently compared to that before the CRT (p = 0.00139). One patient developed aspiration pneumonia at 12 and 23 months after the CRT. Conclusion: The results of this preliminary study indicate that breathing–swallowing discoordination tends to increase after CRT and could be involved in aspiration pneumonia. This non-invasive method may be useful for screening swallowing dysfunction and its potential risks. [ABSTRACT FROM AUTHOR]

Four types of oxides, ATiM2O8 (A: Mg, Zn; M: Nb, Ta) were prepared by high-temperature solid-state reaction. MgTiNb2O8, ZnTiNb2O8 and ATiTa2O8 had rutile-type, α-PbO2-type and trirutile-type structures, respectively. The crystal structures of these compounds were refined based on the synchrotron X-ray powder diffraction data with the following R-factors: Rwp = 4.34% and Rp = 2.21% for MgTiNb2O8; Rwp = 2.19% and Rp = 1.52% for ZnTiNb2O8; Rwp = 9.03% and Rp = 6.31% for MgTiTa2O8; and Rwp = 5.70% and Rp = 4.16% for ZnTiTa2O8. Their lattice parameters were a = 4.69585(8) and c = 3.04260(6) Å for MgTiNb2O8; a = 4.67138(6), b = 5.65916(7) and c = 5.00745(6) Å for ZnTiNb2O8; a = 4.6876(2) and c = 9.1385(3) Å for MgTiNb2O8; and a = 4.6987(7) and c = 9.1296(1) Å for ZnTiTa2O8. The optical band gap for these compounds ranged from 2.98 to 3.15 eV and every compound exhibited a small amount of photocatalytic activity for phenol decomposition under UV light irradiation. However, no photocatalytic activity was observed under visible light irradiation. The dielectric constants for these compounds were between 25 and 125 at a temperature range of room temperature to 400°C.

This assessment of the status of computer assisted school automation (CASA) in Japan begins by describing the structure of the Japanese educational system and the roles of CASA in that system. Statistics on various aspects of computers in Japanese schools and the findings of several surveys are cited to report on the present state of educational computing, educational computing in the curriculum, computer assisted automation (CASA) in the schools, and educational information networks. Areas that can be supported by CASA in teaching, instructional management, and school administration are then listed: (1) curriculum development, lesson planning, time scheduling; (2) instructional design and evaluation; (3) information retrieval of educational materials and devices and production of educational materials; (4) diagnosis and evaluation of teaching processes concerning information on individual children; (5) data processing on achievement scores; (6) information on school counselling; (7) information on school and vocational guidance; (8) health and physical ability records; (9) information about the library; and (10) data processing on other school affairs. The status of these applications is briefly reviewed, and developmental strategies for CASA are described. Future tasks in the areas of teaching personnel and the infrastructure for supporting CASA are briefly discussed, and a need for financial support by both the central and local governments is indicated. (BBM)

Background: Primary progressive aphasia is a clinical dementia syndrome secondary to neurodegenerative disease characterized by language-related difficulties. Currently, there is no effective treatment for language impairment in primary progressive aphasia. In the present study, we investigated the feasibility of Internet video-based speech-language activities for this condition. Methods: Twenty-three people with primary progressive aphasia (pwPPA) participated in the study and were provided with twelve speech-language activity videos on a dedicated website, with three sessions per week. The group that chose to continue with participation after three months of intervention received Internet activities for one year. Cognitive domains associated with persistence, treatment motivation, and video difficulty settings were statistically analyzed. Results: After three months, 17 out of 23 participants opted to continue with the activities. The ability to follow oral commands which was measured pre intervention was higher in the group that continued compared with those participants who discontinued activity. The scores of two Standard Language Test of Aphasia subtests, sentence repetition and narrative writing–associated with the ability to comprehend and produce sentence structure–were highly correlated with motivation, interest and concentration in activity. Participants with different levels of primary progressive aphasia progression could participate in the same video-based activities when high-frequency words were used in the video. Conclusions: Internet video-based speech-language activity at home has potential as a useful tool for future primary progressive aphasia treatment because it provides a cost-effective approach to intensive intervention and overcomes barriers associated with traditional therapy approaches. [ABSTRACT FROM AUTHOR]