Neck Area Research Articles

Composite tissue xenopreservation: Preliminary results of staged VCA in rat to mouse model.

The time between procurement and transplantation of composite tissues, especially regarding the limited donor pool, is a challenge effecting the outcomes of the transplantation. Current preservation techniques mainly include either cold preservation with a solution or machine perfusion using blood or certain oxygen-carrying solutions. However, none enables preservation beyond 24 h. Increasing this time to several days will provide better usage of the donor pool, safer transplantation of VCA with significant muscle content, and gives time to stabilize a patient before long surgical procedures. Herein, we described a novel strategy of xenopreservation (preservation via xenotransplantation) to preserve composite tissues for 7 days, followed by staged transplantation. We used two concordant species, female Sprague Dawley rats (n = 10) and female CF-1 mice (n = 10) in this study. Four of pair of animals are used for anatomical study. The groin flap of the rat was used as a xenograft and xenotransplanted to the neck area of the carrier mouse. Cyclosporine (CsA) was administered used as immunosuppressant. After 7 days of preservation on the mouse neck, xenotransplanted groin flap (called xenopreserved flap) was re-harvested, skin and vessels samples were collected for histopathological evaluation, and the xenopreserved flap was transplanted to the donor rat's opposite groin area. Anastomoses were performed between the flap's pedicle and the femoral vessels. Clinical observation regarding inflammation and tissue perfusion of the xenopreserved flap was monitored daily. Fifteen days after the second surgical procedure, the rats were euthanized, and skin and vessel samples were collected. Histologic evaluation, including inflammatory cell numbers, was performed. Wilcoxon test was used to compare the changes in inflammation severity and p < .05 was set for statistical significance. All xenopreserved groin flaps except one survived. Mean lymphocyte count before the second operation (at the end of the xenopreservation procedure) was 20,22 ± 0.44 and reduced to 13,14 ± 0.47 at the end of 15 days, and the difference was statistically significant (p < .05). This proof-of-concept study with preliminary results showed that xenotransplantation might be a novel strategy for preservation of VCA for a certain period of time. However, additional translational studies are needed to modulate the tissue changes following xenopreservation.

Prognostic Factors in Epithelioid Hemangioendothelioma: Analysis of a Nationwide Molecularly/Immunohistochemically Confirmed Cohort of 57 Cases.

Epithelioid hemangioendothelioma (EHE) is an extremely rare vascular sarcoma with variable aggressive clinical behavior. In this retrospective study, we aimed to investigate prognostic factors based on clinicopathologic findings in a molecularly/immunohistochemically confirmed nationwide multicenter cohort of 57 EHE cases. Patients had unifocal disease (n = 29), multifocal disease (n = 5), lymph node metastasis (n = 8) and/or distant metastasis (n = 15) at the time of diagnosis. The overall survival rate was 71.4% at 1 year and 50.7% at 5 years. Survival did not correlate with sex, age or histopathological parameters. No survival differences were observed between multifocal and metastatic disease, suggesting that multifocality represents early metastases and treatment options are limited in comparison to unifocal disease. In unifocal tumors, survival could be predicted using the risk stratification model of Shibayama et al., dividing the cases into low- (n = 4), intermediate- (n = 15) and high- (n = 3) risk groups. No clinical or histopathological parameters were associated with progressive unifocal disease course. Lymph node metastases at the time of diagnosis occurred in 14.0% of the cases and were mainly associated with tumor localization in the head and neck area, proposing lymph node dissection. In conclusion, our results demonstrate the aggressive behavior of EHE, emphasize the prognostic value of a previously described risk stratification model and may provide new insights regarding tumor focality, therapeutic strategies and prognosis.

Differential pericyte marker expression in craniofacial benign and malignant vascular tumors.

Vascular anomalies and tumors are common in the head, neck, and craniofacial areas and are associated with abnormalities in the angiomatous architecture. However, the etiology and molecular basis for the pathogenesis of most vascular lesions are still unknown. Pericytes are mural cells that surround endothelial cells. Besides angiogenesis and other physiological functions, pericytes play an important role in vascularized tissue repair and as resident mesenchymal stem/progenitor cells. Perivascular cells demonstrate a distinct immunohistochemical profile, including expression of alpha-smooth muscle actin (α-SMA), CD146, CD105, and PDGFRβ, without endothelial differentiation (absence of CD31 and CD34 immunoreactivity). These pericyte markers have been shown to be expressed in soft tissue hemangiomas. However, they have not been fully examined in intraosseous hemangiomas. In this study, we compared mesenchymal stem cell (MSC)expression of CD146 and α-SMA markers inpericytes from hemangiomas from different tissues and malignant vascular tumors. The results demonstrated an increased expression of pericyte markers in perivascular cells of benign hemangiomas, especially intraosseous hemangiomas and a significantly reduced expression of pericyte markers in malignant angiosarcomas. The evidence provides insight into the function of pericytes in vascular tumors and suggests their role in vascular tumor disease types.

Beyond Limits: A Case of Progressive Leiomyosarcoma of the Mandible

Leiomyosarcoma (LMS) is a rare malignancy which develops from the smooth muscles. It constitutes about 3 to 10% of all sarcomas in the head and neck area. Furthermore, it is extremely rare in the area of the mouth and jaws due to the rarity of smooth muscle in these areas. Spindle cells with visible smooth muscle differentiation, distinct features of atypia and presence of actin and desmin in Immunohistochemical (IHC) stains are characteristic of LMS. The common pattern of spread is similar with other sarcomas, involving the lung and rarely the lymphatics. Surgery, Radiotherapy and Chemotherapy have been described as standard forms of management. The prognosis is usually poor as rate of local, regional and distant metastasis is high. In this paper, we present a case of a 23 year-old female who presented with Leiomyosarcoma of the mandible. She remained to have good performance status and was able to undergo multiple lines of treatment for progressive disease prior to her demise.

Melanotic Neuroectodermal Tumor of Infancy: A Case Report with Review of Literature

AbstractMelanotic neuroectodermal tumors of infancy are rare pigmented neuroectodermal locally aggressive tumors that usually occur within 1 year of life. Head and neck areas are frequently involved with maxilla being the most common site. Expansile growth and high recurrence rate are characteristics of this cancer. Though rare, radiologists and clinicians must be aware and should consider this entity when diagnosing pediatric head and neck masses. Computed tomography can be used for diagnosing and looking at the extent of the disease and predicting the operative outcome. Surgery with wide resection margin is the mainstay of treatment for these masses. Surgery followed by adjuvant chemotherapy and radiation is reserved for aggressive malignant lesions. Since it has a high recurrence rate, follow-up is done with imaging and clinical examination. Early detection and treatment of recurrence have a favorable outcome for the patients.

Prolonged Survival of NUT Midline Carcinoma and Current Approaches to Treatment.

NUT midline carcinoma is a rare malignancy most commonly seen in adolescents and young adults. The disease presents most often in the lung or head and neck area but can be seen occasionally elsewhere. The diagnosis can be difficult and requires a high degree of suspicion with demonstration of the classic fusion rearrangement mutation of the NUTM1 gene with one of a variety of partners by immunohistochemistry, fluorescent in situ hybridization, or genomic analysis. Survival is usually only a number of months with few long-term survivors. Here we report one of the longest-known survivors of this disease treated with surgery and radiation without additional therapy. Systemic treatment approaches including the use of chemotherapy and BET and histone deacetylase inhibitors have yielded modest results. Further studies of these, as well as p300 and CDK9 inhibitors and combinations of BET inhibitors with chemotherapy or CDK 4/6 inhibitors, are being evaluated. Recent reports suggest there may be a role for immune checkpoint inhibitors, even in the absence of high tumor mutation burden or PD-L1 positivity. RNA sequencing of this patient's tumor demonstrated overexpression of multiple potentially targetable genes. Given the altered transcription that results from the causative mutation multi-omic evaluation of these tumors may uncover druggable targets for treatment.

Incidence of Text Neck Syndrome and Assessment of knowledge on Text Neck Syndrome among young adults in a selected community at Kothamangalam, Ernakulam District, Kerala

Text neck syndrome is charactrised by pain in the neck, pain in the muscles of the neck and shoulder, and may even involve a degeneration of the bones, joints, or spinal discs in the neck. This becomes a problem when injury around the neck area happens over and over again through the use of mobile phone or other electronic devices over a long period of time. A study was conducted with an objective of identifying the incidence of Text neck syndrome among 50 young adults and their knowledge regarding the condition by using a questionnaire. Sample was selected by non probability sampling – purposive sampling technique and data were analyzed using descriptive and inferential statistics. Study results show Majority of the sample (58%) had good knowledge and 32% had average knowledge regarding Text Neck Syndrome. There was subjects who show the clinical manifestations of text neck syndrome such as postural abnormality (8%) and neck pain (8%). It was also noted an association of knowledge on text neck syndrome with selected demographic variables such as gender, educational status and monthly income (p&lt;0.05).

Contactless and continuous blood pressure measurement according to caPTT obtained from millimeter wave radar

Continuous measurement of blood pressure (BP) is very important for assessing the health of the cardiovascular system. In this paper, a new system is first-time established to contactlessly and continuously measure BP according to the central-artery pulse transit time (caPTT) which is acquired from the neck and chest areas simultaneously with single millimeter wave (mmWave) radar. The two signals are separated by beam-component focusing and then BP is estimated by regression fitting. The correlation of the PTT’s variation measured by radar and contact device is verified by data from 16 subjects. The effectiveness of BP estimation is evaluated by data from 27 subjects. It is illustrated that the correlation of PTT’s variation is up to 0.91 and the errors of SBP and DBP are 5.54±7.62 mmHg and 4.68±6.15 mmHg respectively. The developed system in this work suggested that single radar has the potential to continuously measure BP in daily life.

Histopathologic Spectrum and Clinicopathologic Concordance of Pediatric Skin Biopsies: 18-Year Experience in a Tertiary Hospital in Southeast Nigeria

ABSTRACT Background: Many studies have evaluated the spectrum of pediatric skin disorders in outpatient, inpatient, and emergency settings in different regions of Nigeria. However, literature analyzing histopathological data of dermatologic diseases in children undergoing biopsy or excision of skin lesions in Nigeria is lacking. The present study was aimed at determining the spectrum, frequency, and clinicopathologic diagnostic concordance of pediatric dermatopathological lesions at a tertiary care hospital in southeast Nigeria. Materials and Methods: This is a retrospective cross-sectional study undertaken at the department of Histopathology, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi. All pediatric (up to 18 years old) skin biopsies received at the department of Histopathology, NAUTH, Nnewi over an 18-year period from January 2004 to December 2021 were included in the study. Relevant clinical and demographic data had been collected from the request forms. For ease of analysis and comparison with other skin studies, the skin lesions were classified according to the International Classification of Diseases, Tenth revision (ICD-10) (2019), for disorders of the skin and subcutaneous tissue. Results: Pediatric skin biopsies constituted 20.2% of all the skin biopsies received at our laboratory during the study period, with a male to female ratio of 1:1. The initial clinical diagnosis was concordant with histopathologic diagnosis in 88 out of 189 cases (46.6%). Forty-nine percent of biopsies/excisions were performed in the head and neck area. The most common diagnostic categories, in decreasing order of size, were neoplasms, disorders of skin appendages, papulosquamous disorders, and infections. Only about a quarter of neoplasms were malignant. Conclusion: Our study has documented the importance of histopathology as a gold standard in the diagnosis and management of skin lesions. Improved training of primary care physicians and closer cooperation between pediatricians, dermatologists, and pediatric surgeons will increase the chances of accurate diagnosis.

Makna Kekerasan Dalam Pacaran Pada Pria

Violence in courtship occurs in a relationship that is not merely done by men against women. It turns out that men can also experience violence committed by women in a dating relationship. This study aims to determine the meaning of violence in dating in men. This study uses a qualitative method with a phenomenological approach. Respondents numbered 3 people aged 24 years and 27 years. Research data collection techniques using unstructured interviews. The results of data analysis show that individuals get acts of violence in courtship, conflict occurs due to misunderstanding and possessive attitudes of the couple, as well as at the time of the incident of the perpetrators and victims did not care about the surrounding environment. The implications of research results prove that men also often get violent behavior by couples. Violence in courtship can cause psychological and physical impacts for individuals. This negative impact makes the victim feel traumatized, shame, hurt, afraid and not good for mental health. The physical impact makes the victim have bruises due to blows from the perpetrators and bleeding on the face and neck area. The individual assesses that the ideal partner does not demand too much to a partner, requires mutual trust and maintaining feelings for each other.

Lipectomy for madelung disease using tumescent technique: a cross-sectional study.

A prospective study and clinical descriptions were conducted on 17 patients undergoing 26 head-and-neck lipectomies. A tumescent solution was injected into the surgical region with a blunt-tip cannula 5-10min before skin incision. The authors recorded systemic manifestations both during and after surgery; tumescent volume; surgical region; clarity of the operative field; weight of fat removed, and early complications. After surgery, the authors followed the patients from periods of 3 months to 4 years. All 17 male patients had a history of alcoholism. In total, 12 lipectomies for the removal of anterior neck fatty masses and 14 lipectomies for the removal of posterior neck fatty masses were performed. The average amount of tumescent injected was 260.1ml (range 140-550ml). Surgery was reported as totally bloodless in 10 (38.5%) operative fields, with minimum bleeding in 12 (46.1%) operative fields, acceptable bleeding in four (15.4%) operative fields. The average surgical time was 175.6min (range 135-250min). The removed fatty masses weighed between 250 and 2150g, with an average of 582.9g. Early complications were seen in four patients, accounting for 15.4% (2 hematoma, 1 skin necrosis, and 1 seroma). Using tumescent solution in lipectomies to treat Madelung disease in the head and neck area is a simple, safe, and useful technique. The technique helps to create a clean operative field, reduces bleeding, and thereby assists surgeons during the operation.

Evaluating a 3D deep learning pipeline for cerebral vessel and intracranial aneurysm segmentation from computed tomography angiography-digital subtraction angiography image pairs.

Computed tomography angiography (CTA) is the most widely used imaging modality for intracranial aneurysm (IA) management, yet it remains inferior to digital subtraction angiography (DSA) for IA detection, particularly of small IAs in the cavernous carotid region. The authors evaluated a deep learning pipeline for segmentation of vessels and IAs from CTA using coregistered, segmented DSA images as ground truth. Using 50 paired CTA-DSA images, the authors trained (n = 27), validated (n = 3), and tested (n = 20) a deep learning model (3D DeepMedic) for cerebrovasculature segmentation from CTA. A landmark-based coregistration algorithm was used for registration and upsampling of CTA images to paired DSA images. Segmented vessels from the DSA were used as the ground truth. Accuracy of the model for vessel segmentation was evaluated using conventional metrics (dice similarity coefficient [DSC]) and vessel segmentation-specific metrics, like connectivity-area-length (CAL). On the test cases (20 IAs), 3 expert raters attempted to detect and segment IAs. For each rater, the authors recorded the rate of IA detection, and for detected IAs, raters segmented and calculated important IA morphology parameters to quantify the differences in IA segmentation by raters to segmentations by DeepMedic. The agreement between raters, DeepMedic, and ground truth was assessed using Krippendorf's alpha. In testing, the DeepMedic model yielded a CAL of 0.971 ± 0.007 and a DSC of 0.868 ± 0.008. The model prediction delineated all IAs and resulted in average error rates of < 10% for all IA morphometrics. Conversely, average IA detection accuracy by the raters was 0.653 (undetected IAs were present to a significantly greater degree on the ICA, likely due to those in the cavernous region, and were significantly smaller). Error rates for IA morphometrics in rater-segmented cases were significantly higher than in DeepMedic-segmented cases, particularly for neck (p = 0.003) and surface area (p = 0.04). For IA morphology, agreement between the raters was acceptable for most metrics, except for the undulation index (α = 0.36) and the nonsphericity index (α = 0.69). Agreement between DeepMedic and ground truth was consistently higher compared with that between expert raters and ground truth. This CTA segmentation network (DeepMedic trained on DSA-segmented vessels) provides a high-fidelity solution for CTA vessel segmentation, particularly for vessels and IAs in the carotid cavernous region.

Correlation of Bone Textural Parameters with Age in the Context of Orthopedic X-ray Studies

The aim of this study was to establish a relationship between the textural parameters observed in X-ray images of bones and the age of the individual. The study utilized a meticulous visual analysis of the images to identify significant correlations between textural features and age. Five distinct regions of interest, namely the Wing of the Ilium, Neck of the Femur, Greater Trochanter, Ischium, and Shaft of the Femur, were identified on both sides of the body. Textural parameters were then measured for each of these regions. The left femoral neck showed the most noteworthy associations, with the textures generated from the histogram of oriented gradients and gray-level co-occurrence matrix exhibiting the strongest correlations (ρ −0.52, p-value 4.95 × 10−14). The main finding of the current study is that correlation of age-dependent bone structure differences in the femoral neck area is higher than in other structures of the femur. This proposed methodology has the potential to aid in the early detection of osteoporosis, which is crucial for devising treatment plans and identifying potential risks associated with bone fragility.

Functional Outcome in C2/C3 Fracture Dislocation Managed with Combined Surgical Decompression and Posterior Stabilization

Spinal cord injury is one of the main reasons for permanent paralysis and immobility till now. Spine injury is usually fatal because it involves more than one component, such as discoligamentous misconfiguration, vascular and spinal cord damage. Spine dislocation fracture at the level of C2-3 is rare and usually affects one or two vertebras. Good functional outcome in spine injury is uncommon in which death almost always happens suddenly or is caused by secondary trauma. Emergency room with a cervical spine injury. The patient was pushed by his friends from the side during playtime, causing the neck to hit the corner of a table. The dislocation fracture at the level of C2-3 and spinal cord compression directly caused tetraplegia. The condition was handled with a decompression procedure, spine fusion at the level of C1-4, and posterior stabilization with pedicle screws. A day after the operation, minimal movements were seen in both arms and legs, with motoric strength of 2/2/2/2. The score improved to 4/4/4/4 after two weeks of meds and physiotherapy. The patient started to write again in week 3. The dislocation fracture in this patient caused spinal cord compression. A retropulsion fracture fragment can be displaced to the spinal canal and potentially cause further spinal cord damage. Displacement towards the anterior horn leads to motoric dysfunction. Dislocation fracture at the level of C2-3 hinders neurotransmitter impulse, causing total paralysis on all extremities with intact sensory function. The patient had temporary external stabilization around the neck area while waiting for the procedure. The management concept in cases like this includes affected spinal cord decompression and internal fixation using pedicle screws to ensure fracture stabilization.

Primitive Myxoid Mesenchymal Tumor of Infancy: A Case Report

Primitive myxoid mesenchymal tumor of infancy (PMMTI) is a rare malignant tumor that occurs in the soft tissue in early childhood. This malignant tumor can occur in various parts of the body, such as the trunk, extremity, and head &amp; neck area, and is characterized by aggressive local infiltration. There is no standardized treatment so far because this tumor is very rare worldwide. Still now, the principle of treatment so far is complete surgical resection. We performed a surgical treatment for a 3-year-old PMMTI patient who visited the hospital with an incidentally discovered mass in the posterior neck. If surgical treatment is selected as the treatment for PMMTI, it is thought that resection with sufficient margins during surgery will help reduce recurrence. In addition, since local recurrence is frequent and the average recurrence- free duration is short, careful short-term follow-up is necessary.

Availability of abundant thiamine determines efficiency of thermogenic activation in human neck area derived adipocytes

Brown/beige adipocytes express uncoupling protein-1 (UCP1) that enables them to dissipate energy as heat. Systematic activation of this process can alleviate obesity. Human brown adipose tissues are interspersed in distinct anatomical regions including deep neck. We found that UCP1 enriched adipocytes differentiated from precursors of this depot highly expressed ThTr2 transporter of thiamine and consumed thiamine during thermogenic activation of these adipocytes by cAMP which mimics adrenergic stimulation. Inhibition of ThTr2 led to lower thiamine consumption with decreased proton leak respiration reflecting reduced uncoupling. In the absence of thiamine, cAMP-induced uncoupling was diminished but restored by thiamine addition reaching the highest levels at thiamine concentrations larger than present in human blood plasma. Thiamine is converted to thiamine pyrophosphate (TPP) in cells; the addition of TPP to permeabilized adipocytes increased uncoupling fueled by TPP-dependent pyruvate dehydrogenase. ThTr2 inhibition also hampered cAMP-dependent induction of UCP1, PGC1a, and other browning marker genes, and thermogenic induction of these genes was potentiated by thiamine in a concentration-dependent manner. Our study reveals the importance of amply supplied thiamine during thermogenic activation in human adipocytes which provides TPP for TPP-dependent enzymes not fully saturated with this cofactor and by potentiating the induction of thermogenic genes.

RADIATION NECROSIS AFTER CAVERNOMA RADIOSURGERY SIMULATING BRAIN HIGH-GRADE GLIOMA – A CASE REPORT AND REVIEW OF THE LITERATURE

We report a 62-year-old female patient who came to our institution due to pain and limited movements in the neck area, nausea, and headache. The magnetic resonance imaging (MRI) revealed a single larger and two smaller lesions with the appearance of cavernomas in the left parietal brain region. The patient was consulted with a neurosurgeon and was judged to be inoperable. Radiosurgery was performed in ​​the cavernoma with a total focal dose of 15Gy. 11 months after the radiotherapy, during a routine follow-up MRI scan, a tumor-like lesion with extensive perifocal edema and midline dislocation, with heterogenous structure and ring-like enhancement was reported in the left parietal brain region. After follow-up for 15 months, the last MRI showed almost complete reverse development of the described lesion, with marked reduction of volume, edema, and contrast enhancement. Along with MRI features of the lesion, some of which overlap with high-grade glioma characteristics, the evolution of the lesion is in favor of a radiation necrosis zone.

The Indigenous Australian Human Papillomavirus (HPV) Cohort Study 2, Continuation for 5 to 10 Years: Protocol for a Longitudinal Study.

Human papillomavirus (HPV) infection, a common sexually transmitted disease, is associated with cancers of the cervix, vulva, vagina, penis, anus, and head and neck. Oropharyngeal squamous cell carcinoma (OPSCC; throat cancer) is a type of cancer involving the head and neck area that is rapidly increasing across the globe. There are higher rates of OPSCC among Indigenous populations relative to non-Indigenous Australian populations, although the HPV-attributable fraction remains unknown. For the first time at a global level, we plan to extend an Indigenous Australian adult cohort to monitor, screen, and ultimately prevent HPV-associated OPSCC and to undertake extensive cost-effectiveness modelling around HPV vaccination. This study aims to (1) extend follow-up to a minimum of 7 years post recruitment to describe the prevalence, incidence, clearance, and persistence of oral HPV infection; and (2) conduct clinical examinations of the head and neck, oral cavity, and oropharynx and collect saliva samples for early-stage OPSCC testing. We will continue to implement a longitudinal design for the next study phase, where we will ascertain the prevalence, incidence, clearance, and persistence of oral HPV infection at 48, 60, and 72 months; undertake clinical examinations/saliva assessments to detect early-stage OPSCC; and refer for treatment. The primary outcome measures are changes in oral HPV infection status, biomarker measures of early HPV-related cancer, and clinical evidence of early-stage OPSCC. Participant 48-month follow-up will commence in January 2023. The first results are expected to be submitted for publication 1 year after 48-month follow-up begins. Our findings have potential to change the way in which OPSCC among Australian Indigenous adults is managed, with desired impacts including cost-savings on expensive cancer treatments; improved nutritional, social, and emotional outcomes; and improved quality of life for both Indigenous adults and the Indigenous community more broadly. Continuing a large, representative Indigenous adult cohort to track oral HPV infection and monitor early OPSCC is essential to yield critical information to include in the management armamentarium of health and well-being recommendations for Australia's First Nations. PRR1-10.2196/44593.

A novel algorithm to efficiently calculate the impingement-free range of motion of irregularly-shaped total hip arthroplasty components.

There is great difficulty in quickly calculating the impingement-free range of motion (IFROM) of hip components with complex shapes after total hip arthroplasty. We have established a new algorithm to investigate the effect of different shapes of hip components on the IFROM and impingement-free safe zone (IFSZ). Then find the best combination of hip prosthesis and the optimal mounting position of the elevated-rim liner under different radiographic anteversion (RA) and radiographic inclination (RI) of the cup. We found the larger the opening angle of the beveled-rim liner and the smaller the cross-sectional area of the stem neck with an inverted teardrop cross-sectional shape, the greater the IFROM of the hip component. The beveled-rim liner in combination with the stem neck with an inverted teardrop-shaped cross-section could provide the greatest IFSZ (excluding the flat-rim liner). The optimal orientation of the elevated-rim liner was the posterior-inferior side (RI ≤ 37°), posterior-superior side (RI ≥ 45°), and posterior side (37° ≤ RI ≤ 45°). Our novel algorithm provides a solution to analyze the IFROM of any hip prosthesis with any complex shape. The shape and size of the cross-section of the stem neck, the orientation of the elevated rim, and the shape and opening angle of the liner are all critical factors for the quantitative calculation of the IFROM and mounting safe zone of the prosthesis. Stem necks with inverted teardrop cross-section and beveled-rim liner improved the IFSZ. The optimal direction of the elevated rim is not constant but varies with RI and RA.

POSTURAL CORRECTION PADA INTERVENSI INIT DAN ULTRASOUND THERAPY DALAM MENURUNKAN DISABILITAS PADA NYERI LEHER NON SPESIFIK

Pendahuluan: Nyeri leher non spesifik jika tidak ditindaklanjuti dengan tepat akan berdampak pada aktivitas, produktivitas dan pendapatan serta kualitas hidup seseorang. Penatalaksanaan klinis kasus ini dapat berupa terapi Integrated Neuromuscular Inhibition Technique (INIT) dan Ultrasound Therapy yang dikombinasikan dengan postural correction. Tujuan dari penelitian ini adalah untuk mengetahui efektivitas kombinasi postural correction, INIT dan Ultrasound Therapy dalam mengurangi disabilitas leher pada pasien nyeri leher non spesifik.&#x0D; Metode: Penelitian ini merupakan quasi eksperimental dengan jenis rancangan one group pre-test and post-test group design. Penelitian dilakukan di praktek mandiri fisioterapi di Denpasar dan Badung, Bali terhitung mulai bulan Agustus-September 2022. Terdapat 12 orang sampel yang diberikan intervensi sebanyak tiga kali tiap minggu selama empat minggu. Pengukuran disabilitas dilakukan dengan Neck Disability Index (NDI).&#x0D; Hasil: Hasil uji hipotesis berpasangan pada kelompok didapatkan nilai p&lt;0,001 yang menyatakan bahwa terdapat perubahan yang signifikan sebelum dan sesudah intervensi.&#x0D; Simpulan: Intervensi Postural Control, Integrated Neuromuscular Inhibition Technique dengan Ultrasound Therapy dapat mengurangi disabilitas leher pada penderita nyeri leher non spesifik di Indonesia. Data yang didapat bermanfaat bagi peneliti dan praktisi di ranah klinis untuk mengimplementasikan hasil penelitian pada populasi nyeri leher non-spesifik.&#x0D; &#x0D; Kata kunci: postural correction, init, ultrasound therapy, nyeri leher non spesifik