This article reports a systematic research effort aimed at establishing a normative database of thumb circumduction range of motion (ROM) and related kinematic characteristics in vivo while examining the effects of anthropometry, gender, and direction of rotation. Twenty-eight (14 men, 14 women) anthropometrically diverse participants performed maximum voluntary thumb circumductions as the trajectories of the surface markers placed on their thumb landmarks were recorded by an optoelectronic motion capture system. A globographic representation method was employed to model the measured marker trajectories, determining the center of rotation and central reference axes for thumb circumduction. Thumb ROM was quantified using (a) the joint sinuses expressing the thumb orientation change with respect to the reference axes and (b) cone volumes circumscribed by the thumb at the distal phalangeal, interphalangeal, and metacarpophalangeal levels. Data analyses resulted in statistical summaries of the derived kinematic and ROM measures with significant effects identified and regression equations predicting the cone volumes. Potential applications of this research include ergonomic design of hand-operated controls or devices and evaluation of thumb impairments or disorders.
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. ; Abstract Background Treatment of tonsil cancer, a subset of oropahryngeal cancer, varies between surgery and radiotherapy. Well-designed studies in tonsil cancer have been rare and it is still controversial which treatment is optimal. This study aimed to assess the outcome and failure patterns in tonsil cancer patients treated with either approaches. Methods We retrospectively reviewed medical records of 586 patients with tonsil cancer, treated between 1998 and 2010 at 16 hospitals in Korea. Two hundred and one patients received radiotherapy and chemotherapy (CRT), while 385 patients received surgery followed by radiotherapy and/or chemotherapy (SRT). Compared with the SRT group, patients receiving CRT were older, with more advanced T stage and received higher radiotherapy dose given by intensity modulation techniques. Overall survival (OS), disease-free survival (DFS), locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), and clinicopathologic factors were analyzed. Results At follow-up, the 5-year OS, DFS, LRRFS and DMFS rates in the CRT group were 82, 78, 89, and 94%, respectively, and in the SRT group were 81, 73, 87, and 89%, respectively. Old age, current smoking, poor performance status, advanced T stage, nodal involvement, and induction chemotherapy were associated with poor OS. Induction chemotherapy had a negative prognostic impact on OS in both treatment groups (p = 0.001 and p = 0.033 in the CRT and SRT groups, respectively). Conclusions In our multicenter, retrospective study of tonsil cancer patients, the combined use of radiotherapy and chemotherapy resulted in comparable oncologic outcome to surgery followed by postoperative radiotherapy, despite higher-risk patients having been treated with the definitive radiotherapy. Induction chemotherapy approaches combined with either surgery or definitive radiotherapy were associated with unfavorable outcomes. ; This research was supported by a grant from the National Research Foundation of Korea (NRF), which is funded by the Korean government (MEST, grant no.2015M2A2A7055063); a grant of the Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (H14C3459); and the National R&D Program through the Dong-nam Institute of Radiological and Medical Sciences (DIRAMS) funded by the Ministry of Education, Science, and Technology (50595–2016). The funding bodies had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.
