To assess the ability of simultaneous cisplatin, 5-Fluorouracil, and radiation to substitute for surgery and radiation in advanced head and neck cancer, we have retrospectively selected from our phase II study a subgroup of 29 patients having primary disease requiring either more than a hemiglossectomy or a laryngectomy for control. Patients included 22 with stage IV and 7 with stage III disease, 12 tongue, 10 hypopharynx, and 7 larynx primaries. The treatment consisted of concurrent cisplatin, 5-Fluorouracil, and split-course radiation every other week for a total of 7 cycles within 13 weeks. With a median follow-up of 5 years, 86% of patients had preservation of speech and/or swallowing function. Median survival was 45 months, with 14 (48%) patients currently alive and disease free, 11 (38%) dead from their cancer, and 4 (14%) dead of other causes. The overall failure rate was 38%. Advanced-stage presence of N3 nodal disease and fewer than 7 cycles of chemotherapy received were significantly associated with increasing failure rates. This program of concomitant cisplatin, 5-Fluorouracil, and radiation produced control rates quite competitive with surgery and radiation and is appropriate for definitive testing in a randomized trial.

The case histories of 36 laryngectomees with vocal restorative surgery from the Department of Otolaryngology were reviewed to determine the patient's current mode of speech and number and type of complications to recovery and rehabilitation. The patients comprised two groups: 21 with tracheoesophageal fistula (tef) at the time of laryngectomy (primary) and 15 with tef subsequent to laryngectomy (secondary). Results of the review indicated that while approximately 10% fewer patients in the primary group were using a surgically restored voice, none of the surviving primary group remained aphonic. In contrast, 27% of the surviving secondary group failed to develop some form of verbal communication. When the complication rate is identified, vocal restorative surgery at the time of laryngectomy appeared to be very successful in initiating the rehabilitation process without

Nucleolar organizer regions are collections of nucleolar proteins associated with ribosomal genes that can be visualized in histologic sections using a silver colloid stain, thus the term silver-staining nucleolar organizer region (AgNOR). In some tissues, the number of AgNORs per nucleus correlates with cellular proliferation and, independently, with malignant change. AgNORs were studied in 66 paraffin-embedded head and neck squamous cell carcinomas and in 12 samples of normal tonsillar squamous epithelium. Carcinomas had a significantly higher mean AgNOR count than the benign epithelium (P less than .0001). Among carcinomas, mean AgNOR count increased with stage of the disease (P less than .001), but there was no significant correlation with histologic grade or DNA ploidy as determined by flow cytometry. These data suggest that AgNOR count should be evaluated as a possible aid in differentiating benign from malignant squamous epithelial proliferations in the head and neck, and also possibly as a prognostic marker in these carcinomas.

The Draw A Person test has continued to be one of the most frequently utilized psychological tests with children and adolescents. This is especially true for the child/adolescent populations in state hospitals. Because of the frequent criticism leveled against the DAP's validity, this study was undertaken in order to provide normative data for the DAP with this particular clinical population. Previous research has focused on the drawings of the same sex as the subjects; this study deals with the characteristics of the drawings of the opposite sex. The subjects were 84 male and 66 female psychiatric patients from the Adolescent Unit (AU) at Rusk State Hospital. As each patient was admitted to the AU, he was scheduled for psychological testing, with the DAP, the Revised Beta, and the MMPI being a part of this testing. The results of this study indicate that IQ ranking is the most significant factor affecting DAP test performance by male subjects. IQ ranking was not found to significantly influence the drawings by females. Neither MMPI test performance nor social background factors were shown to significantly affect DAP test performance. It is suggested that in order for the DAP to become a more objectively utilized personality technique, a scoring method should be developed that takes into account the overall quality of the drawing in conjunction with the individual details of each area of the figure drawn. More focus should also be given to the characteristics of the opposite-sex figure drawn by the subjects and its potential interpretation.

Hirsch, SM and Frost, DM. Considerations for velocity-based training: the instruction to move “as fast as possible” is less effective than a target velocity. J Strength Cond Res 35(2S): S89–S94, 2021—In addition to the potential benefits with monitoring training intensity with velocity-measuring tools during exercise, these devices also provide an opportunity for researchers and practitioners to provide feedback and instruction to performers in a new way. The purpose of this study was to assess the influence of instructing athletes with a target velocity vs. instructing them to move “as fast as possible” during a free-weight bench press. In addition, the effects of each instruction on future repetition maximum (RM) test performance was compared. Thirteen male powerlifters were recruited and performed 4 sets of 5 repetitions with 45% 1RM while being instructed to attain a target velocity of 1.0 m·s−1 or to move as fast as possible. The maximum mean velocity attained in each set was compared with a repeated measures analysis of variance and Tukey's post-hoc test. After these 4 sets of 5 repetitions, the number of repetitions performed during an RM test with 75% 1RM was compared with a Wilcoxon Signed-Rank test. Participants moved faster when they received the target velocity instruction (0.84 ± 0.10 m·s−1) than when they received the “move as fast as possible” instruction (0.82 ± 0.09 m·s−1) (p < 0.001) with no differences in the number of repetitions performed in the following RM test between the 2 testing sessions (p = 0.43). An instruction to attain a challenging velocity target may be a more effective strategy to use when attempting to elicit maximum barbell velocities during training relative to the traditional instruction to move as fast as possible.

No abstract

Hirsch, SM, Chapman, CJ, Frost, DM, and Beach, TAC. Mechanical energy expenditure at lumbar spine and lower extremity joints during the single-leg squat is affected by the nonstance foot position. J Strength Cond Res 36(9): 2417-2426, 2022-Previous research has shown that discrete kinematic and kinetic quantities during bodyweight single-leg squat (SLS) movements are affected by elevated foot positioning and sex of the performer, but generalizations are limited by the high-dimensional data structure reported. Using a 3D inverse dynamical linked-segment model, we quantified mechanical energy expenditure (MEE) at each joint in the kinetic chain, the total MEE (sum of MEE across aforesaid joints), and the relative contribution of each joint to total MEE during SLSs performed with elevated foot positioned beside stance leg (SLS-Side), and in-front of (SLS-Front) and behind (SLS-Back) the body. Total MEE differed between SLS variations (p 5 0.002), with the least amount observed in the SLS-Back (effect size [ES] 5 0.066-0.069). Approximately 50% of total MEE was contributed by the knee joint in each SLS variation, whereas MEE at the ankle, hip, and lumbar spine (in absolute and relative terms) varied complexly as a function of the elevated foot position. Total MEE (p 5 0.0192, ES 5 0.852) and the absolute MEE at the knee and spine was greater in men across the SLS variations performed (p 5 0.025-0.036, ES 5 0.715-0.766), but only the lumbar spine contribution to total MEE was larger in men across all SLS variations (p 5 0.045, ES 5 0.607). Otherwise, there were no other sex-specific responses observed. Biomechanically, SLS movements are generally "knee-dominant," but changing elevated foot position effectively redistributes MEE among other joints in the linkage. Consistent with the previous conclusions reached based on discrete kinematic and kinetic data, not all SLSs are equal.

No abstract