Facial nerve near the external auditory meatus in man: Computer reconstruction study—Preliminary report

The anatomy of the facial nerve relative to its intratemporal and extratemporal courses varies over time with developmental changes. Otologic and parotid surgery in infants and children demands detailed knowledge of the precise anatomy of the facial nerve with respect to the tympanic ring and external auditory canal, The authors analyzed this area using our three-dimensional (3-D) computer-aided reconstruction and measurement method studying the spatial relations of the facial nerve to the tympanic ring and stylomastoid foramen. Temporal bones from five normal individuals aged 36 gestational weeks, 3 months, 8 months, 4 years, and 17 years were retrieved from the temporal bone collection stored at the Elizabeth McCullough Knowles Otopathology Laboratory in Pittsburgh. Three-dimensional reconstruction of the facial nerve comparing the developmental anatomy across the various age groups provides the surgeon with the technical information necessary to address problems in this area.     

Psychological distress following first recurrence of disease in patients with breast cancer: prevalence and risk factors

Purpose: To investigate the effect of understanding their own disease by patients with metastatic breast cancer on their survival potential after being informed by their physician. Patientsandmethods: Two hundred and fourteen women with metastatic breast cancer who participated in a multi-institutional, randomized phase III trial (Japan Clinical Oncology Group (JCOG) Study 8808) were asked whether they understood their own disease after being given information about the clinical trial. They were classified into two groups on the basis of whether they understood or not. We estimated their survival after the time of registration and derived relative hazard ratios from Cox's proportional hazards model. Results: There were 190 patients in the better understanding group and 24 in the poor understanding group. Median survival times after registration were 28.3 and 16.1 months, respectively. The better understanding group showed a significant difference from the poor understanding group (p=0.016). In multivariate regression analysis, patients who did not understand still showed poorer survival than those who understood (hazard ratio = 2.09; 95% confidence interval (CI) 1.16–3.78; p=0.014)     

Seven cases of breast cancer recurrence limited to the central nervous system without other visceral metastases

We report 7 rare cases of recurrent breast cancers who presented with central nervous system (CNS) metastases as the initial relapse site without any other organ metastases. The average age of the patients at surgery was 42.6 years old of age (median 45:range 32-60), and 6 of the 7 cases (86%) were premenopausal. The mean disease-free period was 25.7 months (median 22, range 2-60 months). The primary tumors were all invasive ductal carcinomas. The estrogen receptor and progesterone receptor status of the 3 tumors available for study were all negative. The metastatic CNS lesions included the cerebrum (4 cases), cerebellum, cervical spinal cord, and meninges. In 6 out of these 7 cases (86%), the CNS metastasis was the initial recurrent lesion. Multidisciplinary treatments including surgery, radiotherapy and systemic or intrathecal chemotherapy were given. Although the mean survival time from clinical manifestations of the metastases of the 4 deceased patients was 20 months (median 20.5; range 6-33), one patient treated with surgery and radiotherapy is been still alive18 years later. These cases were also notable for the fact that the only metastatic site was in the CNS only during the entire clinical course, except for 2 cases, one with ocular adnexa metastasis, and the other with cervical lymph node metastasis. Premenopausal patients with negative hormone receptor status are more likely to develop this type of recurrence, regardless of the histological type. It is necessary to pay attention to neurological symptoms and signs during follow-up of breast cancer patients.     

Acid phosphatase-producing androgen-independent subline of rat prostatic adenocarcinoma (Dunning R3327 tumor) in cell culture

Establishment of a cell line derived from the androgen-independent subline of rat prostatic adenocarcinoma (Dunning R3327 tumor) is reported. Cells of this line produced acid phosphatase. When the cultured cells were transplanted to Copenhagen rats, solid tumors were formed. Histologically, the tumor consisted of spindle-shaped, large and bizarre polygonal cells; this feature was almost identical to that of the original tumor. Chromosomes were in the triploid range with seven frequently appearing marker chromosomes.     

Morphometrical and Cell Kinetic Studies of Normal Human Colorectal Mucosa

Morphometric and cell kinetic studies were performed on normal mucosa in 30 specimens of surgically resected colorectum. The average crypt length was 372 ± 57μm in the proximal colon and 506 ± 65μm in the distal colon, and the average cell numbers per crypt column in these regions were 76.4 ± 8.9 and 80.3 ± 8.8, respectively. In the proximal and distal colon, goblet cells constituted 23.3 ± 3.4% and 25.2 ± 4.0%, respectively, of the total cells in each crypt, and in both regions entero chromaffin cells constituted about 1%. The labeling indices of the proximal and distal colon were 9.4 ± 3.9% and 8.2 ± 2.2%, respectively. Combined microautoradiography and periodic acid Schiff reaction on selected cases revealed that the labeling indices of columnar cells and goblet cells were 11.0 ± 2.0% and 7.0 ± 3.2%, respectively. It was suggested that the increased number of larger goblet cells in crypts of the sigmoid colon and rectum resulted in an increase of crypt length and a decrease in the labeling index. These results provide information on the morphological and cell kinetic characteristics of normal mucosa of the colon and rectum. Acta Pathol Jpn 39: 725 730, 1989.     

GENERALIZED ASPERGILLOSIS SHOWING A GRANULOMATOUS PATTERN

An autopsy case of a very rare form of generalized aspergillosis with a prominent granulomatous pattern simulating sarcoidosis was presented. The patient was a forty-year-old Japanese female with a four years' clinical course. Kveim's test was positive. Multiple epithelioid cell granulomata as well as necrotizing and suppurative lesions were recognized in generalized lymph nodes, liver, epicardium, gall bladder, adrenals, kidneys and duodenal mucosa. Fungal elements in the epithelioid cell granulomata and necrotizing lesions were identified as Aspergillus by fluorescent antibody technique (indirect method). Predisposing factors for the generalized fungal infection could not be clarified in this case. There was neither underlying disease nor evident immunodeficiency state, so far as examined.     

Complex formations involving both SP-1 and SP-3 at the transcriptional regulatory sequence correlate with the activation of the Keratin 14 gene in human oral squamous cell carcinoma cells

We have previously reported that significantly higher levels of Keratin 14 (Ker-14) was observed in oral squamous cell carcinoma (OSCC) and severely dysplastic tissues, whereas this expression was reversed in hyperplasia and in mild to moderate dysplasia. In this study, the mechanism of Keratin 14 activation in oral squamous cell carcinoma (OSCC) cell lines (HSC-2, HSC-3 and Ca9-22) was investigated. Reporter analysis demonstrated that an upstream region (-1759/-1629) accounted for efficient promoter activity. Furthermore, electromobility sift and supershift assay demonstrated that interactions of the SP-1/SP-3 complex at the elements resided in -1737/-1702 and -1680/-1652 and may be essential for this activation in OSCC cells.