Searching for New Targets and Treatments in the Battle Against Squamous Cell Carcinoma of the Head and Neck, with Specific Focus on Tumours of the Tongue.

Squamous cell carcinoma of the head and neck, SCCHN, is a heterogeneous group of tumours not only concerning the site of origin but also regarding aetiology. The 5-year survival for the whole group of SCCHN tumours has not significantly improved over the last 20-25 years. Apart from tumour spread to lymph nodes, N status, gains and losses of specific chromosomes are the only factors shown to be independent prognostic markers for these tumours. Worldwide, an increasing number of people ≤ 40 years are seen being affected by tongue SCC, the most common tumour within the SCCHN group. Even without any clinical signs of metastasis, up to 30% of all tongue SCC have histologically detectable spread to lymph nodes. In this mini review, field cancerization, tumour microenvironment, the so called EMT (epithelial mesenchymal transition) process and the role of viruses in development of SCCHN are discussed as well as potential new therapeutic targets. For the group of tongue SCC, with the increasing incidence seen in young patients and particularly women, new data with impact on prognosis and treatment are urgently needed. But as long as data from the analyses of several sub sites are presented as valid for the whole group of tumours, this vital point is missed.

Vestibular Stimulus and Perceived Roll Tilt During Coordinated Turns in Aircraft and Gondola Centrifuge.

BACKGROUND: One disorienting movement pattern, common during flight, is the entering of a coordinated turn. While the otoliths persistently sense upright head position, the change in roll attitude constitutes a semicircular canal stimulus. This sensory conflict also arises during acceleration in a swing-out gondola centrifuge. From a vestibular viewpoint there are, however, certain differences between the two stimulus situations; the aim of the present study was to elucidate whether these differences are reflected in the perceived roll attitude. METHODS: Eight nonpilots were tested in a centrifuge (four runs) and during flight (two turns). The subjective visual horizontal (SVH) was measured using an adjustable luminous line in darkness. The centrifuge was accelerated from stationary to 1.56 G (roll 50°) within 7 s; the duration of the G plateau was 5 min. With the aircraft, turns with approximately 1.4 G (45°) were entered within 15 s and lasted for 5 min. Tilt perception (TP) was defined as the ratio of SVH/real roll tilt; initial and final values were calculated for each centrifugation/turn. RESULTS: In both systems there was a sensation of tilt that declined with time. The initial TP was (mean ± SD): 0.40 ± 0.27 (centrifuge) and 0.37 ± 0.30 (flight). The final TP was 0.20 ± 0.26 and 0.17 ± 0.19, respectively. Both initial and final TP correlated between the two conditions. CONCLUSION: The physical roll tilt is under-estimated to a similar degree in the centrifuge and aircraft. Also the correspondence at the individual level suggests that the vestibular dilemma of coordinated flight can be recreated in a lifelike manner using a gondola centrifuge.