Prognostic significance of venous invasion in node-negative head and neck squamous cell carcinoma.

BACKGROUND: Venous invasion (VI) is not frequently evaluated on routine histologic examination of head and neck squamous cell carcinoma (HNSCC), and the prognostic significance is largely unknown. Studies have shown that extramural venous invasion is an adverse prognostic factor in colorectal carcinoma. To our knowledge, this is the first study evaluating the prognostic significance of venous invasion in node-negative (without clinical or pathologic evidence of lymph node involvement) HNSCC, utilizing the elastic stain. METHODS: A total of 105 consecutive lymph node-negative (N0) HNSCC were evaluated for the presence of venous channel invasion by tumor utilizing the elastin stain. Clinical, demographic, and follow-up data were recorded. RESULTS: Of 37 patients with venous invasion, 19% had loco-regional recurrence, as opposed to 12% of those without. Univariate analysis revealed statistically significant decreased recurrence-free survival in the presence of venous invasion (log-rank [Mantel-Cox] test P-value .025). CONCLUSION: Identification of VI is greatly aided by elastic stain. In patients with node-negative HNSCC, presence of VI resulted in decreased recurrence-free survival on univariate analysis. The impact of VI as a prognostic marker should be further evaluated.

The production of bimanual percussion in 12- to 24-month-old children.

Bimanual coordination represents a complex self-organizing system that is subject to both internal and contextual constraints. Although there has been interest in examining bimanual development throughout the lifespan, few data exist relative to the bimanual activity of children between 1 and 4 years of age. The study reported here represents an initial effort to address this gap. Twenty-seven children who were either 12, 18 or 24 months old were videotaped while drumming with sticks on a plastic drum. Two independent observers recorded bout length as well as number and phase relation of movement cycles within bouts. Kinematic analysis provided more detailed information about the timing and form of children's activity. Results indicate that bimanual drumming becomes preferred over unimanual drumming by 2 years of age, that the proportions of different phase relations exhibited by children change between 1 and 2 years of age, and that the behavior appears to go through periods of stability and variability within this age range. These results are discussed in the context of the child's physical development and interactions with the environment during this period.