Total head excursion and resting head posture: normal and patient comparisons.

OBJECTIVE: To determine whether significant differences existed between normal and patient groups on three postural measurements: anterior-posterior total head excursion (THE), resting head posture in sitting (RHPsit), and resting head posture in standing (RHPstd). SUBJECTS: Forty-two healthy subjects, 13 men and 29 women between the ages of 20 and 60 years, were matched to 42 patients according to gender and age. DESIGN: Measurements of THE, RHPsit, and RHPstd were taken for each subject. Patients were measured during their initial evaluation and had neck pain as a primary or secondary complaint. RESULTS: A two-way multivariate analysis of variance followed by two-way analyses of variance showed that normal subjects had a significantly (p<.05) greater THE than did the patients and that men (patients and controls) scored significantly higher (p<.05) than women (patients and controls) on both THE and RHPstd. CONCLUSION: Clinical assessment of patients with cervical pain should focus on cervical mobility rather than resting head posture. Head/neck posture is different for males and females and they should not be judged by the same standard.

Assessment of total head excursion and resting head posture.

Clinicians typically evaluate head posture and cervical range of motion in both standing and sitting positions. There are currently few quantitative data available regarding resting head posture (RHP) or total head excursion (THE), a retraction-protraction gliding range of head motion in the sagittal plane, and where the RHP lies within THE. The purposes of this study were to describe quick and simple methods to determine quantitative measurements of THE, RHP while sitting, and RHP while standing, to provide preliminary data on these postural measurements for men and women in four age categories; and to determine the effects of gender and age on these measurements. Subjects included 218 able-bodied adults. Measurements of THE, RHP while sitting, and RHP while standing were taken. A two-way multivariate analysis of variance followed by two-way analyses of variance showed only the main effect of gender to be significant (p less than .05) for each of the dependent measurements. Across the age groups, men had a greater excursion distance from retraction to protraction than women. Within THE, women held their heads more forward than men. Men held their heads farther from the vertical than women while standing. These results indicate that normal head and neck posture is different for men and women and should not be judged by the same standard. The methods used in this study are clinically advantageous in that they produce objective, quantitative measurements of THE and RHP that may be obtained quickly and with minimal equipment.

Immunotherapy of murine transitional cell carcinoma.

A series of 6 controlled experiments in C3H/He mice were performed to evaluate nonspecific immunotherapeutic regimens with a transplantable murine bladder tumor (MBT2). Immunotherapeutic agents studied included live Bacillus Calmette-Guerin (BCG) preparations in varying doses and strains (Tice, Pasteur, and Glaxo), Re mutant glycolipid (ReG) from Salmonella typhimurium, BCG cell wall skeletons (CWS), CWS plus B4 glycolipid fraction of ReG, and Keyhole-Limpet Hemocyanin (KLH). Animals received an intradermal MBT2 inoculation and were then randomized to treatment and control (saline treated) groups. Immunotherapy was administered intralesionally 1 day after tumor transplantation. Tumors were excised by amputation at a volume of 400 mm. and animals were later rechallenged with tumor inocula, again treated, and followed for tumor incidence growth rate and survival. No antitumor affect was observed with ReG, CWS or CWS plus B4. KLH immunotherapy did result in measurable antitumor effect. Consistent and statistically significant (p less than 0.01) antitumor responses as measured by prolonged survival and decreased growth rate were observed with Tice and Pasteur strains of BCG in doses ranging from 5 X 10(5) to 1 X 10(7) colony forming units per animal. Doses in excess of 10(7) units were found to decrease antitumor response. Glaxo strain BCG had no beneficial effect when used in the maximal dose (10(6) colony forming units) that could be administered. In animals immunized with intermediate doses of live Tice or Pasteur strain BCG in the study, effective long term immunity to transitional cell carcinoma was observed. Although many new immunotherapeutic agents have been advocated in other tumor models, to date we have found Tice and Pasteur strains of live BCG to be the most effective agents in the treatment of transitional cell carcinoma.