bluuebunny/crossref_metadata_2025 huggingface dataset:
Distribution pattern of the human lingual nerve
Authors: Zur Karen B. , Mu Liancai , Sanders Ira
Published: February 2004

The tongue is an intricate organ with many functions. Despite the knowledge of the presence of muscular and neural connections in the tongue, a detailed neuroanatomical depiction of the nerves' topography in the tongue has not been demonstrated. The topography, branching patterns and neuronal interconnections of the lingual nerve were studied in five postmortem human tongues. They were stained with Sihler's stain, a technique that renders most of the tongue tissue translucent while counterstaining nerves. The lingual nerve reaches the tongue posterolaterally. There are two main branches off of the main trunk: the medial branch sends 2–4 small branches to the medial part of the ventrolateral tongue and the lateral branch runs along the lateral tongue border and sends 3–4 large branches to the anterior tip of tongue. Each subdivision gives off 2–5 distal branches. Both medial and lateral branches have interconnections with the proximal part of the hypoglossal nerve. One of the unexpected discoveries in this study was the high density of nervous fibers in the lateral aspect of the tongue as compared to the midline region. The average diameter of the main trunk of the lingual nerve is 3.5 mm. The medial and lateral branches average 1 mm in diameter, the more distal subdivisions measure 0.5–0.75 mm, and the lingual‐hypoglossal interconnections measure 0.125–0.250 mm. In summary, this study provides the first detailed depiction of the topography of the human lingual nerve and its branches in situ, confirmation of lingual‐hypoglossal nerve connection, and the first depiction of the high density of lingual nerve innervation in the lateral tongue. Clin. Anat. 17:88–92, 2004. © 2004 Wiley‐Liss, Inc.
In vivo 3D analysis of the adipose tissue in the orbital apex and the compartments of the parasellar region
Authors: Weninger Wolfgang J. , Prokop Mathias
Published: February 2004

As tissue dissections carried out on formaldehyde‐fixed anatomical specimens demonstrate, the parasellar region (PSR), traditionally referred to as the cavernous sinus, is composed of three distinct compartments: orbital, pterygopalatine, and lateral sellar. The aim of our study was to identify and measure these compartments in the living and to describe the topography of their adipose body tissues. For this purpose data sets of 35 patients, who had undergone thin‐section multislice computed tomography (CT), were examined using 3D‐reconstruction software. The pterygopalatine and orbital compartments of the PSR could be identified in the images by their adipose bodies. We provide more exacting measurements of their size than have been presented in earlier studies. Furthermore, we include data about the uni‐ and bilateral presence of the single compartments and analyze the topography of the adipose tissue bodies in the orbital apex region. Our quantitative data and topographical descriptions confirm the compartmentalization concept of the PSR, allow for correct interpretation of CT scans of the orbital apex and anterior PSR, and provide baseline information for individual planning of surgical and radiological interventions. Clin. Anat. 17:112–117, 2004. © 2004 Wiley‐Liss, Inc.
Fenestration of the superior medullary velum as treatment for a trapped fourth ventricle: A feasibility study
Authors: Tubbs R. Shane , Wellons John C. , Salter George , Oakes W. Jerry
Published: February 2004

We developed a novel approach for fenestration of the trapped fourth ventricle utilizing the superior medullary velum (valve of Vieussens). Trapped fourth ventricles, which are seen often in the pediatric hydrocephalic population, are troublesome entities surgically. A right burr hole was carried out in 10 adult cadavers with no gross intracranial pathology and the superior medullary velum was fenestrated to the quadrigeminal cistern with the aid of an endoscope. This technique was carried out easily in all cadaveric specimens. With endoscopy, no vascular insult was appreciated either before or after fenestration of the superior medullary velum. These preliminary findings demonstrate that fenestration of the superior medullary velum may provide a good alternative to the present therapy of shunting trapped fourth ventricles, a therapy wrought with complications. Clin. Anat. 17:82–87, 2004. © 2004 Wiley‐Liss, Inc.
Anatomy of the pelvic plexus and innervation of the prostate gland
Authors: Ali M. , Johnson I.P. , Hobson J. , Mohammadi B. , Khan F.
Published: February 2004

We have examined the anatomy of the pelvic (inferior hypogastric) plexus in six male cadavers, paying particular attention to gross anatomical landmarks that might aid in locating it and have used immunohistochemistry to study the small branches of the plexus that supply the prostate gland. The pelvic plexus was found two finger breadths lateral to the third anterior sacral foramina, lying deep to a line drawn from third sacral vertebra, the conventional level of the recto‐sigmoid junction, and the palpable posterior superior surface of the pubic symphysis. Immunohistochemical staining showed small nerve branches from the pelvic plexus entering the prostate gland and the presence of ganglia within the prostate gland that contained both tyrosine hydroxylase positive and negative neuronal cell bodies. This information may be useful in nerve‐sparing surgical procedures and in discussions of the functional implications of perturbations of prostate innervation. Clin. Anat. 17:123–129, 2004. © 2004 Wiley‐Liss, Inc.
Fossa navicularis: Anatomic variation at the skull base
Authors: Cankal F. , Ugur H.C. , Tekdemir I. , Elhan A. , Karahan T. , Sevim A.
Published: February 2004

The fossa navicularis is a relatively rare anatomic variation of the skull base. Awareness of its existence will avoid misinterpretations of radiological images and unnecessary investigations. This study describes the appearance of the fossa navicularis, and investigates its incidence and whether it is related to pathology at the basiocciput. We studied 492 dry human skulls and 525 computer tomography (CT) images of patients. Dry skulls showing a fossa navicularis were investigated by CT scan, whereas patients identified as having a fossa navicularis were further examined with magnetic resonance imaging (MRI). To document the position of the fossa more precisely, measurements were made between the fossa navicularis and certain anatomic landmarks such as the foramen ovale, the pharyngeal tubercle, the posterior border of the vomer, the foramen lacerum, the carotid canal, and the occipital condyle. Upon examination, 26 of 492 skulls (5.3%) were found to have a fossa navicularis. Twelve were <2 mm in depth and the other 14 had a depth of ≥2 mm. Of the 525 patients, 16 (3.0%) were identified as having a fossa navicularis in CT images. Evaluation of MRIs showed no soft tissue lesions in any of these patients. Comprehensive anatomic details of the fossa navicularis have not been reported in the literature. The results of this study may be useful to radiologists, anatomists, and surgeons interested in the skull base. Clin. Anat. 17:118–122, 2004. © 2004 Wiley‐Liss, Inc.
Intrabony course of the inferior alveolar nerve in the edentulous mandible
Authors: Kieser J.A. , Paulin M. , Law B.
Published: February 2004

The purpose of this study was to investigate the vertical positioning and intrabony branching patterns of the inferior alveolar nerve (IAN) in 39 edentulous human cadaveric mandibles by buccal microdissection. Dissected mandibles were classified on the basis of the height of the IAN within the body of the mandible and the branching pattern of the IAN. The IAN was located in the superior part of the body of the mandible in 30.7% (12/39) of cases, all of which showed a small posterior molar plexus of branches. In 69.2% (27/39) of cases the IAN was half‐way or closer to the inferior border of the mandible. Of these latter cases, 41% demonstrated a small, posterior molar plexus of branches, 37% showed posterior and anterior plexuses, and 22% showed either no branches or a single trunk with a small number of single branches directed at the superior border of the mandible. These findings were rendered in 3D computer format for instructional purposes. Clin. Anat. 17:107–111, 2004. © 2004 Wiley‐Liss, Inc.
Kinematics of the toe touching test: An investigation using motion analysis
Authors: Rice J. , Kaliszer M. , Walsh M. , Jenkinson A. , O'Brien T.
Published: February 2004

We describe a technique for measuring dynamic motion at the low back along with the major lower limb joints during the toe touching maneuver. This type of motion analysis was carried out on eight normal volunteers. Flexion during the toe touching maneuver involves not only low back and hip movement but also ankle plantar flexion and a varying degree of knee movement. The low back and ankle movements were highly correlated within each subject to an extent that suggests a functional connection between the lower limb and low back movements. The significance of our work is two‐fold. First, we emphasize that the toe touching test represents a combined movement of the low back, the hips, the knees, and the ankles and it is reasonable to suggest that abnormalities of these joints may affect the clinical relevance of the test as an indicator of back movement. Second, we point out that the guidelines of the American Medical Association in using the test to determine hip movement are incorrect as they do not take into account the effect of knee and ankle movements on the estimation of hip movement. Clin. Anat. 17:130–138, 2004. © 2004 Wiley‐Liss, Inc.
Development of the sensory nerves to the dorsum of the tongue in staged human embryos
Authors: Tamatsu Yuichi , Gasser Raymond F.
Published: February 2004

To determine in selected, staged human embryos the time period and manner of formation of the sensory nerves to the mucosa on the dorsum of the tongue, cranial nerves V3 and IX and their lingual branches were traced microscopically. These two cranial nerves along with cranial nerve VII are present in the dorsal part of their respective pharyngeal arch 1, 2, and 3 at Stage 13. All three nerves grow ventrally at Stage 16, and the lingual branches of V3 and IX become closer to the developing tongue region. The lingual fibers begin to enter the tongue substance at Stage 17 when they appear as large short branches that terminate 100–400 μm from the dorsal mucosal basement membrane; of the fibers that are in the tissue deep to the surface mucosa, those in the posterior tongue segment terminate the closest and those in the anterior segment the farthest. Chorda tympani nerve fibers are joined with V3 at Stage 20. At this stage nerve fibers reach the basement membrane in the posterior tongue segment and by Stage 23 they terminate at the basement membrane throughout the tongue, being sparsest in the anterior segment. Primordial papillae appear as small mucosal projections throughout the tongue at Stage 20 and are innervated by Stage 23. The study found that innervation to the dorsum of the tongue develops during the second month of prenatal life. During the 4‐week period, Stages 13–23, an innervation pattern was observed based on the relative time fibers terminate at the basement membrane. The pattern begins caudally in the root, then moves rostrally lateral to the middle tongue segment, proceeding then to the tip of the tongue. The last area to become innervated is the medial part of the middle segment or central portion of the tongue. Clin. Anat. 17:99–106, 2004. © 2004 Wiley‐Liss, Inc.
Variant of the coracobrachialis muscle with a tunnel for the median nerve and brachial artery
Authors: El‐Naggar Mostafa M. , Al‐Saggaf Samar
Published: February 2004

This case report documents a variation in the insertion of the coracobrachialis muscle of the right arm of an adult male cadaver of unknown age. In addition to the normal insertion of the coracobrachialis muscle into the middle of the medial border of the humerus, an additional slender tendon passed inferiorly, crossing anterior to the median nerve and brachial artery before attaching to the medial epicondyle of the humerus. Most of the proximal part of the tendon gave rise to an aponeurotic expansion that inserted into the distal medial border of the humerus. The tendinous insertion and aponeurotic expansion may represent a variant of the coracobrachialis longus (Wood's) muscle and the internal brachial ligament, respectively. The median nerve and brachial artery traversed a tunnel bounded by the additional tendon and aponeurotic expansion as well as the usual humeral insertion of the coracobrachialis muscle. The clinical implication of this variation is that it may be a cause of median nerve entrapment and brachial artery compression. Clin. Anat. 17:139–143, 2004. © 2004 Wiley‐Liss, Inc.
Effects of an alternate dissection schedule on gross anatomy laboratory practical performance
Authors: McWhorter David L. , Forester Joseph P.
Published: February 2004

The current medical curricula reform that is taking place in many medical schools throughout the world has resulted in less time for gross anatomy laboratory instruction. In response, anatomists are using a variety of approaches (e.g., peer teaching, prosections, plastinated anatomical models, etc.) to adapt to these changes. To accommodate recent curricular reform at the University of Health Sciences College of Osteopathic Medicine, an alternating dissection schedule was implemented. The purpose of this study is to examine the effects of the alternating schedule on gross anatomy laboratory practical performance. Using a Mann‐Whitney Rank Sum test, back and upper limb (back‐upper limb), and lower extremity laboratory practical performance for students who dissected in every laboratory (EL group; n = 227) is compared to students who dissected in every other laboratory (EOL group; n = 254). For the back‐upper limb part of the anatomy laboratory practical, the mean percentage scores for the EL and EOL groups were 74.5% and 68.1%, respectively (P < 0.001). The mean percentage scores for the EL and EOL groups on the lower limb portion of the anatomy lab practical were 75.9% and 75.6%, respectively (P = 0.994). These data suggest that the use of an alternating dissection schedule had an equivocal effect on the students' gross anatomy laboratory practical performance for these two sections. The reasons for these conflicting results may have been related to regional complexity or volume of information, and the sequence in which the regions were taught. Clin. Anat. 17:144–148, 2004. © 2004 Wiley‐Liss, Inc.
Cloning and characterization of Kin5, a novel Tetrahymena ciliary kinesin II
Authors: Awan Aashir , Bernstein Mitchell , Hamasaki Toshikazu , Satir Peter
Published: February 2004

Two Tetrahymena kinesin‐like proteins (klps) of the kinesin II subfamily, Kin1 and Kin2, were first identified by Brown et al. [1999 : Mol Biol Cell 10 : 3081–3096] and shown to be involved in ciliary morphogenesis probably as molecular motors in intraciliary transport (ICT). Using Tetrahymena genomic DNA as a template, we cloned Kin5, another kinesin II subfamily member. Kin5 is upregulated upon deciliation, suggesting that Kin5 is a ciliary protein. Kin5 is most closely related to Osm3, a Caenorhabditis elegans kinesin II; Osm3 and Kin5 have a 56% identity, which rises to 60.4% in the motor domain and a 45% identity in a 60 amino acid region of the C‐terminal FERM (4.1, Ezrin, Radixin, Moesin) domain, not present in Kin1 or Kin2, which we hypothesize to be a critical domain either for dimerization or for cargo recognition in ICT. An antibody to a peptide sequence from the tail region of Kin5 localizes in a punctate pattern along the ciliary axoneme, colocalizing with an antibody to the raft protein IFT139. These findings suggest that Kin5 is an ICT motor like Osm3. Osm3 orthologs apparently transport membrane proteins and Kin5 may be the homodimeric kinesin II that performs this function in Tetrahymena cilia. Cell Motil. Cytoskeleton 58:1–9, 2004. © 2004 Wiley‐Liss, Inc.
Palladin is a novel binding partner for Ena/VASP family members
Authors: Boukhelifa Malika , Parast Mana M. , Bear James E. , Gertler Frank B. , Otey Carol A.
Published: February 2004

Palladin is an actin‐associated protein that contains proline‐rich motifs within its amino‐terminal sequence that are similar to motifs found in zyxin, vinculin, and the Listeria protein ActA. These motifs are known to be potential binding sites for the Vasodilator‐Stimulated Phosphoprotein (VASP). Here, we demonstrate that palladin is an additional direct binding partner for VASP, by using co‐immunoprecipitation and blot overlay techniques with both endogenous palladin and recombinant myc‐tagged palladin. These results show that VASP binds to full‐length palladin and also to the amino‐terminal half of palladin, where the polyproline motifs are located. Using a synthetic peptide array, two discrete binding sites for VASP were identified within palladin's proline‐rich amino‐terminal domain. Using double‐label immunofluorescence staining of fully‐spread and actively‐spreading fibroblasts, the extent of co‐localization of palladin and VASP was explored. These proteins were found to strongly co‐localize along stress fibers, and partially co‐localize in focal adhesions, lamellipodia, and focal complexes. These results suggest that the recently described actin‐associated protein palladin may play an important role in recruiting VASP to sites of actin filament growth, anchorage, and crosslinking. Cell Motil. Cytoskeleton 58:17–29, 2004. © 2004 Wiley‐Liss, Inc.
Properties of the full‐length heavy chains of Tetrahymena ciliary outer arm dynein separated by urea treatment
Authors: Toba Shiori , Gibson Tracie M. , Shiroguchi Katsuyuki , Toyoshima Yoko Y. , Asai David J.
Published: February 2004

An important challenge is to understand the functional specialization of dynein heavy chains. The ciliary outer arm dynein from Tetrahymena thermophila is a heterotrimer of three heavy chains, called α, β and γ. In order to dissect the contributions of the individual heavy chains, we used controlled urea treatment to dissociate Tetrahymena outer arm dynein into a 19S β/γ dimer and a 14S α heavy chain. The three heavy chains remained full‐length and retained MgATPase activity. The β/γ dimer bound microtubules in an ATP‐sensitive fashion. The isolated α heavy chain also bound microtubules, but this binding was not reversed by ATP. The 19S β/γ dimer and the 14S α heavy chain could be reconstituted into 22S dynein. The intact 22S dynein, the 19S β/γ dimer, and the reconstituted dynein all produced microtubule gliding motility. In contrast, the separated α heavy chain did not produce movement under a variety of conditions. The intact 22S dynein produced movement that was discontinuous and slower than the movement produced by the 19S dimer. We conclude that the three heavy chains of Tetrahymena outer arm dynein are functionally specialized. The α heavy chain may be responsible for the structural binding of dynein to the outer doublet A‐tubule and/or the positioning of the β/γ motor domains near the surface of the microtubule track. Cell Motil. Cytoskeleton 58:30–38, 2004. © 2004 Wiley‐Liss, Inc.
Interaction of Cep135 with a p50 dynactin subunit in mammalian centrosomes
Authors: Uetake Yumi , Terada Yasuhiko , Matuliene Jurgita , Kuriyama Ryoko
Published: February 2004

Cep135 is a 135‐kDa, coiled‐coil centrosome protein important for microtubule organization in mammalian cells [Ohta et al., 2002: J. Cell Biol. 156:87–99]. To identify Cep135‐interacting molecules, we screened yeast two‐hybrid libraries. One clone encoded dynamitin, a p50 dynactin subunit, which localized at the centrosome and has been shown to be involved in anchoring microtubules to centrosomes. The central domain of p50 binds to the C‐terminal sequence of Cep135; this was further confirmed by immunoprecipitation and immunostaining of CHO cells co‐expressing the binding domains for Cep135 and p50. Exogenous p50 lacking the Cep135‐binding domain failed to locate at the centrosome, suggesting that Cep135 is required for initial targeting of the centrosome. Altered levels of Cep135 and p50 by RNAi and protein overexpression caused the release of endogenous partner molecules from centrosomes. This also resulted in dislocation of other centrosomal molecules, such as γ‐tubulin and pericentrin, ultimately leading to disorganization of microtubule patterns. These results suggest that Cep135 and p50 play an important role in assembly and maintenance of functional microtubule‐organizing centers. Cell Motil. Cytoskeleton 58:53–66, 2004. © 2004 Wiley‐Liss, Inc.
Monastrol, a prototype anti‐cancer drug that inhibits a mitotic kinesin, induces rapid bursts of axonal outgrowth from cultured postmitotic neurons
Authors: Haque Saad A. , Hasaka Thomas P. , Brooks Ari D. , Lobanov Pavel V. , Baas Peter W.
Published: February 2004

Terminally postmitotic neurons continue to express many of the kinesin‐related proteins known to configure microtubules during mitosis. Drugs that inhibit these kinesins are being developed as anti‐cancer agents with the hope that they will inhibit proliferation of tumor cells without having adverse effects on the nervous system. The prototype, termed monastrol, inhibits the kinesin known as Eg5, which is essential for maintaining separation of the half‐spindles. Eg5 is also highly expressed in neurons, particularly during development. Exposure of cultured sympathetic neurons to monastrol for a few hours increased both the number and the growth rate of the axons. With additional time, the overall lengths of the axons were indistinguishable from controls. Sensory neurons showed a similar short‐term increase in axonal growth rate. However, prolonged exposure resulted in shorter axons, suggesting that sensory neurons may be more sensitive to toxic effects of the drug. Nevertheless, the overall health of the cultures was still far more robust than cultures treated with taxol, a drug commonly used for anti‐cancer therapy. On the basis of these results, we conclude that Eg5 normally generates forces that oppose axonal growth, presumably by partially suppressing the forward advance of microtubules. We speculate that local regulation of Eg5 could be a means by which neurons coordinate rapid bursts of axonal growth with appropriate environmental cues. The comparatively modest toxic effects on the neurons over time are a hopeful sign for clinicians interested in using anti‐Eg5 drugs for cancer therapy. Cell Motil. Cytoskeleton 58:10–16, 2004. © 2004 Wiley‐Liss, Inc.
Myofibrillogenesis in skeletal muscle cells in the presence of taxol
Authors: Siebrands Cornelia C. , Sanger Jean M. , Sanger Joseph W.
Published: February 2004

We address the controversy of whether mature myofibrils can form in the presence of taxol, a microtubule‐stabilizing compound. Previous electron microscopic studies reported the absence of actin filaments and Z‐bands in taxol‐treated myocytes [Antin et al., 1981: J Cell Biol 90:300–308; Toyoma et al., 1982: Proc Natl Acad Sci USA 79:6556–6560]. Quail skeletal myoblasts were isolated from 10‐day‐old embryos and grown in the presence or absence of taxol. Taxol inhibited the formation of multinucleated elongated myotubes. Myocytes cultured in the continual presence of taxol progressed from rounded to stellate shapes. Groups of myocytes that were clustered together after the isolation procedure fused in the presence of taxol but did not form elongated myotubes. Actin filaments and actin‐binding proteins were detected with several different fluorescent probes in all myofibrils that formed in the presence of taxol. The Z‐bands contained both alpha‐actinin and titin, and the typical arrays of A‐Bands were always associated with actin filaments in the myofibrils. Myofibril formation was followed by fixing cells each day in culture and staining with probes for actin, muscle‐specific alpha‐actinin, myosin II, nebulin, troponin, tropomyosin, and non‐muscle myosin II. Small linear aggregates of alpha‐actinin or Z‐bodies, premyofibrils, were detected at the edges of the myocytes and in the arms of the taxol‐treated cells and were always associated with actin filaments. Non‐muscle myosin II was detected at the edges of the taxol‐treated cells. Removal of the taxol drug led to the cells assuming a normal compact elongated shape. During the recovery process, additional myofibrils formed at the spreading edges of these elongated and thicker myotubes. Staining of these taxol‐recovering cells with specific fluorescent reagents reveals three different classes of actin fibers. These results are consistent with a model of myofibrillogenesis that involves the transition of premyofibrils to mature myofibrils. Cell Motil. Cytoskeleton 58:39–52, 2004. © 2004 Wiley‐Liss, Inc.
Recruiting Black/African American men for research on prostate cancer prevention
Authors: Woods V. Diane , Montgomery Susanne B. , Herring R. Patti
Published: February 2004

BACKGROUND

Black/African American men die of prostate cancer at a greater rate relative to other males. During the period from 1992 to 1998, prostate cancer incidence rates in the United States were 234.2 per 100,000 persons among non‐Hispanic black males and 144.6 per 100,000 persons among white males. The reasons for these increased rates of prostate cancer among black males are largely unknown, but increased mortality is associated with late detection. The authors conducted a longitudinal study of black men that investigated prostate cancer prevention behaviors within this population. The purpose of the current article is to identify successful recruitment strategies that were reported by participants in this study of prevention behaviors.

METHODS

Qualitative research methods were used to elucidate men's thoughts, attitudes, beliefs, and practices regarding prostate cancer prevention behaviors and to identify strategies for attracting black men to research programs and retaining them in these programs.

RESULTS

Ethnocentric recruitment strategies that were identified included the development of tailored printed materials; the use of targeted locations; and a personalized, participatory approach for engaging potential participants. We contacted 498 black men and enrolled a cohort of 277 non‐Hispanic black males (75% of whom were recruited within a 9‐week period) in the current study.

CONCLUSIONS

Unlike other studies that reported difficulty in recruiting African American men, the current study did not encounter such difficulties. The authors attribute their success to culturally attractive Afrocentric materials; cultural sensitivity; a caring, professional, personalized ethnic approach; respect; and participatory involvement of the target population. Nonetheless, the authors did encounter barriers, such as lack of physician interest and lack of trust in quality medical care. These barriers must be overcome before black males can be engaged and retained in research studies on prostate cancer prevention. Cancer 2004;100:1017–25. © 2004 American Cancer Society.
Immunohistochemically detected tumor cells in the sentinel lymph nodes of patients with breast carcinoma
Authors: Moore Katrina H. , Thaler Howard T. , Tan Lee K. , Borgen Patrick I. , Cody Hiram S.
Published: February 2004

BACKGROUND

Sentinel lymph node (SLN) biopsy is a new standard of care for patients with breast carcinoma, and allows enhanced pathologic analysis with serial sections and immunohistochemical (IHC) staining for cytokeratins to be performed on a routine basis. However, the significance of SLN micrometastases detected only by IHC is uncertain. Are these tumor cells truly markers of metastatic potential, or simply evidence of passive displacement by preoperative instrumentation of the tumor site? Here we evaluate whether the pattern of SLN metastasis in breast carcinoma is related to the degree of manipulation at biopsy before surgery, independently of other known predictors.

METHODS

Among 4016 consecutive eligible patients with breast carcinoma registered in a prospective SLN database at Memorial Sloan Kettering Cancer Center, we noted patient/tumor characteristics, pathologic status of the SLN (negative, positive by hematoxylin and eosin [H&E], or positive only on IHC), and method of previous biopsy (none, fine‐needle aspiration biopsy [FNAB], core needle biopsy, or surgical biopsy).

RESULTS

Multivariate analysis showed that the likelihood of an H&E‐positive SLN was significantly associated with lymphovascular invasion, tumor size, tumor type, and tumor location, but not with the method of biopsy. In contrast, the likelihood of finding an SLN positive only on IHC was unassociated with any of the four variables above, but was significantly associated with the method of biopsy. After no previous biopsy, FNAB, core needle biopsy, or surgical biopsy, IHC‐positive SLN were present in 1.2%, 3.0%, 3.8%, and 4.6% of patients, respectively (P = 0.002).

CONCLUSIONS

These data suggest that the frequency of IHC‐positive SLN in patients with breast carcinoma 1) is unrelated to conventional predictors of lymph node positivity, 2) is increased after instrumentation of the tumor site, and 3) is increased approximately proportionate to the degree of manipulation. A proportion of IHC‐positive SLN were present before biopsy and therefore less likely to be artifactual. Cancer 2004;100:929–34. © 2004 American Cancer Society.
Dental X‐rays and the risk of intracranial meningioma
Authors: Longstreth W. T. , Phillips Leslie E. , Drangsholt Mark , Koepsell Thomas D. , Custer Brian S. , Gehrels Jo‐Ann , van Belle Gerald
Published: February 2004

BACKGROUND

Ionizing radiation is a likely cause of intracranial meningioma. The authors determined whether the risk of intracranial meningioma was associated with past dental X‐rays—specifically, posterior bitewings, full‐mouth series, and lateral cephalometric and panoramic radiographs.

METHODS

The authors conducted a population‐based case–control study of residents of King, Pierce, and Snohomish counties in western Washington State. Case patients (n = 200) had an incident intracranial meningioma that was confirmed histologically during life between January 1995 and June 1998. The authors used random‐digit dialing and Medicare eligibility lists to identify two control subjects to be matched to each case patient based on age and gender. Exposures were determined during an in‐person interview. The authors compared self‐report and dental records in a subset of study participants.

RESULTS

Of the 4 dental X‐ray procedures evaluated, only the full‐mouth series (specifically, ≥ 6 over a lifetime) was associated with a significantly increased risk of meningioma (odds ratio, 2.06; 95% confidence limits, 1.03–4.17). However, evidence for a dose‐response relation was lacking (P for trend = 0.33). The risk was elevated with the aggregate number of full‐mouth series in 10‐year periods from approximately 15–40 years before diagnosis, with significant elevations in the 10‐year periods beginning 22–30 years before diagnosis. The risks in these analyses were even greater when only women were considered.

CONCLUSIONS

Dental X‐rays involving full‐mouth series performed 15–40 years ago, when radiation exposure from full‐mouth series was much greater than it is now, were associated with an increased risk of meningioma. The authors did not observe an increased risk with bitewings, lateral cephalometric, and panoramic radiographs. Cancer 2004;100:1026–34. © 2004 American Cancer Society.
Can the Gail model be useful in American Indian and Alaska Native populations?
Authors: Kaur Judith Salmon , Roubidoux Marilyn A. , Sloan Jeff , Novotny Paul
Published: February 2004

BACKGROUND

Very little is known about breast carcinoma risk factors for American Indian/Alaska Native (AI/AN) women undergoing screening. The Gail model has been a useful tool for predicting the risk of breast carcinoma in several populations. It has not been applied systematically to AI/AN women.

METHODS

The current study was a retrospective review of 1458 screening mammograms performed for AI/AN women. The authors applied the Gail model to estimate both absolute risk and relative risk for breast carcinoma for AI/AN women screened in South Dakota, Arizona, and Alaska.

RESULTS

The mean age of the women was 52.4 years. The onset of menses was not significantly different than expected. The average age at first birth was 20 years, very few women were nulliparous, and few women were age > 30 years at first live birth. The proportion of women reporting a first‐ or second‐degree relative with breast carcinoma was similar to the proportion in the general population. The results of the model indicated an overall average relative risk that ranged from 1.42 to 2.69 compared with white American women, depending on the model assumptions used. Using a modified Gail model and calculating an imputed absolute risk, the expected incidence of breast carcinoma in this population increased to rates of 170–180 per 100,000 in the next 10 years, a significant increase over the Surveillance, Epidemiology and End Results–derived incidence rates from 1988 to 1992 of 31.6 per 100,000 for AI women in New Mexico and 78.9 per 100,000 for AN women.

CONCLUSIONS

The model indicated a likelihood of increasing rates of breast carcinoma in the study population. The data obtained were useful in generating preliminary estimates of breast carcinoma risk in the study population, for which no prospective population survey has been completed. The inherent weaknesses in the current retrospective study indicated the need for a large‐scale prospective data collection to confirm these exploratory findings. Cancer 2004;100:906–12. © 2004 American Cancer Society.
Potentially advanced malignancies detected by screening for prostate carcinoma after an interval of 4 years
Authors: Postma Renske , Roobol Monique , Schröder Fritz H. , van der Kwast Theodorus H.
Published: February 2004

BACKGROUND

At the Rotterdam branch of the European Randomized Study of Screening for Prostate Cancer, a cohort of 19,970 men ages 55–75 years is screened at an interval of 4 years. Screening includes systematic sextant needle biopsy for men with elevated prostate‐specific antigen (PSA) levels and/or positive findings on digital rectal examination or transrectal ultrasound. Detection during the second screening round of a large number of high‐grade (Gleason Grade 4 or 5) malignancies and/or a large number of malignancies in general could be considered the result of a failure to identify these malignancies at an early stage, during prevalence screening.

METHODS

Men diagnosed during the second screening round with potentially advanced carcinoma (PAC), characterized by a biopsy Gleason score of 7 (4 + 3, or 3 + 4 with > 30% malignant involvement) or a biopsy Gleason score of 8–10, were identified. Clinical data, including PSA values on prevalence screening, biopsy history, clinical stage, and follow‐up data, were retrieved for these patients. Tumor features were further analyzed in radical prostatectomy specimens.

RESULTS

During the second screening round, 503 malignancies, including 30 (6.0%) with features of PAC on diagnostic biopsy, were detected in 11,210 patients. Curative treatment was offered to 26 patients. Prostatectomy demonstrated the presence of organ‐confined disease in 11 of 12 specimens, and tumor volume ranged from 0.11–7.93 cm3 (median, 1.05 cm3). PSA failure was noted in 6 of 22 patients who were offered curative therapy.

CONCLUSIONS

PAC is a rare finding in the second round of screening after a 4‐year interval, and a substantial proportion of PAC cases detected in the second screening round represent organ‐confined disease. The findings of the current study suggest that the screening protocol used is sufficiently effective for detecting > 95% of malignancies before they develop features that would make them incurable. Cancer 2004;100:968–75. © 2004 American Cancer Society.
Effects of media information on cancer patients' opinions, feelings, decision‐making process and physician‐patient communication
Authors: Passalacqua Rodolfo , Caminiti Caterina , Salvagni Stefania , Barni Sandro , Beretta Giordano D. , Carlini Paolo , Contu Antonio , Di Costanzo Francesco , Toscano Lucia , Campione Francesco
Published: February 2004

BACKGROUND

The objective of the current study was to determine the influence of media information on the opinions and feelings of patients with cancer and to measure the factors that affected the decision‐making process and physician‐patient communication.

METHODS

The study consisted of a sequence of 2 nationwide surveys across the same dynamic target population of 2600 unselected patients with cancer who attended 1 of 13 centers throughout Italy. The authors measured the changes in patients' opinions and attitudes at the peak of a media campaign promoting the Di Bella therapy, an unproven cancer treatment method, and after the publicized demonstration of its ineffectiveness. An identical 10‐item questionnaire was used.

RESULTS

Opinions and feelings changed in the two surveys according to the way the media described the efficacy of the treatment, but physician‐patient communication and the decision‐making process remained unchanged. Multivariate analysis confirmed the enormous influence of the media on patient opinions (odds ratio [OR], 4.67; P < 0.0001), feelings of hope (OR, 3.63; P < 0.0001), and confusion (OR, 0.51; P < 0.0001), but not on physician‐patient communication or the decision‐making process. Educational level influenced almost all of the studied factors, and communication and decision‐making also were influenced by the patients' gender and place of residence. There was no significant correlation with patient age.

CONCLUSIONS

The media play a powerful role in affecting patients' opinions and feelings; the physician‐patient communication and the decision‐making process are not subject to media influence but are related primarily to level of education. The power of the media should be directed toward improving the spread of scientific knowledge to encourage behavioral changes, particularly among individuals with lower levels of education. Cancer 2004;100:1077–84. © 2004 American Cancer Society.
Validation of axillary sentinel lymph node detection in the staging of early lobular invasive breast carcinoma
Authors: Classe Jean‐Marc , Loussouarn Delphine , Campion Loïc , Fiche Maryse , Curtet Chantal , Dravet François , Pioud Raphaëlle , Rousseau Caroline , Resche Isabelle , Sagan Christine
Published: February 2004

BACKGROUND

Previous reports have shown that regional lymph node involvement in patients with early‐stage breast carcinoma can be evaluated by resection of axillary sentinel lymph nodes (ASLN). Axillary lymphadenectomy may be unnecessary in the absence of ASLN involvement. In the current study, the authors compared the results of ASLN resection in patients with lobular invasive carcinoma (LIC) with the results from patients with ductal invasive carcinoma (DIC) in terms of detection rates and false‐negative rates.

METHODS

For ASLN detection, technetium 99m sulfur‐colloid and patent blue were injected around the tumor. Each patient underwent both ASLN resection and complete axillary lymphadenectomy. Detection rates and false‐negative rates were evaluated in patients with LIC and in patients with DIC.

RESULTS

Two hundred forty‐three patients with invasive, early‐stage breast carcinoma were enrolled in the study (208 patients with DIC and 35 patients with LIC). The median patient age, pathologic tumor size, hormone receptor status, and rates of involved lymph nodes were equivalent for both groups. ASLN detection and false‐negative rates did not differ for patients with LIC and patients with DIC.

CONCLUSIONS

The ASLN detection rate was not dependent on the pathologic type of invasive carcinoma. Pathologic examination of ASLN in patients with LIC and in patients with DIC predicted axillary lymph node status with the same predictive value in terms of lymph node metastasis. For patients with LIC, ASLN examination overestimated the rate of micrometastasis as diagnosed by immunohistochemical techniques. These results will require confirmation in larger studies. Cancer 2004;100:935–41. © 2004 American Cancer Society.
Osteoporosis in men with prostate carcinoma receiving androgen‐deprivation therapy
Authors: Diamond Terrence H. , Higano Celestia S. , Smith Matthew R. , Guise Theresa A. , Singer Frederick R.
Published: February 2004

BACKGROUND

Androgen‐deprivation therapy (ADT) is prescribed with increasing frequency for men with prostate carcinoma. There is growing concern about the effects of such therapy on the skeleton. In the current review, the authors addressed the current research, diagnostic methods, and treatment recommendations for bone loss and osteoporosis in men with prostate carcinoma who received ADT.

METHODS

Data were obtained from electronic literature searches (for the years 1986 through 2002) and from abstracts and meeting proceedings. All randomized and nonrandomized clinical trials, retrospective studies, and cross‐sectional studies of osteoporosis in men with prostate carcinoma who received ADT with or without other therapies were reviewed.

RESULTS

The findings confirmed that ADT resulted in significant bone loss in men with prostate carcinoma. Bone mineral density (BMD) of the hip, as measured by dual‐energy X‐ray absorptiometry (DXA), is considered the preferred site of assessment in older men. Spinal BMD is equally important, although careful interpretation of spinal DXA values is required, because of coexisting facet joint disease and extravertebral calcification. Osteoporosis is diagnosed when BMD is > 2.5 standard deviations below a reference mean. Men with prostate carcinoma who were treated with ADT had average BMD measurements below those of eugonadal men. Rates of bone loss ranged from 2% to 8% in the lumbar spine and from 1.8% to 6.5% in the femoral neck during the initial 12 months of continuous ADT. Retrospective data indicated an increased risk of fracture in men with prostate carcinoma who were treated with ADT.

CONCLUSIONS

For men with prostate carcinoma who are at high risk for osteoporosis and fractures, clinical management should be dictated by the results of radiographic and DXA skeletal assessment. Cancer 2004;100:892–9. © 2004 American Cancer Society.
Craniotomy for the resection of metastatic brain tumors in the U.S., 1988–2000
Authors: Barker Fred G.
Published: February 2004

BACKGROUND

To assist in selecting treatment for patients with brain metastases, the current study assessed the risk of adverse outcomes after contemporary resection of metastatic brain tumors in relation to patient, surgeon, and hospital characteristics, with particular attention to the volume of care and trends in outcomes.

METHODS

A retrospective cohort study of 13,685 admissions from the Nationwide Inpatient Sample between 1988–2000 was performed. Multivariate logistic, ordinal, and loglinear regression were used with endpoints of mortality, discharge disposition, length of stay, and total hospital charges.

RESULTS

The overall in‐hospital mortality rate was 3.1% and an additional 16.7% of patients were not discharged directly home. In multivariate analyses, larger‐volume centers were found to have lower mortality rates for intracranial metastasis resection (odds ratio [OR], 0.79; 95% confidence interval [95% CI], 0.59–1.03 [P= 0.09]). An adverse discharge disposition also was less likely at higher‐volume hospitals (OR, 0.75; 95% CI, 0.65–0.86 [P< 0.001]). For surgeon caseload, mortality was lower with higher‐caseload providers (OR, 0.49; 95% CI, 0.30–0.80 [P= 0.004]) and an adverse discharge disposition occurred significantly less frequently (OR, 0.51; 95% CI, 0.40–0.64 [P< 0.001]). The annual number of resections increased by 79% during the study period, from 3900 (1988) to 7000 (2000). In‐hospital mortality rates decreased from 4.6% (1988–1990) to 2.3% (1997–2000), a 49% relative decrease. Length of stay was reported to be significantly shorter with higher‐volume providers. Hospital charges were not found to be associated significantly with hospital caseload and were found to be significantly lower after surgery that was performed by higher‐caseload surgeons.

CONCLUSIONS

The results of the current study found that higher‐volume hospitals and surgeons provided superior short‐term outcomes after resection of intracranial metastasis was performed, with shorter lengths of stay and a trend toward lower charges. Cancer 2004;100:999–1007. © 2004 American Cancer Society.
The predictive potential of molecular detection in the nonmetastatic Ewing family of tumors
Authors: Avigad Smadar , Cohen Ian J. , Zilberstein Julia , Liberzon Ella , Goshen Yacov , Ash Shifra , Meller Isaac , Kollender Yehuda , Issakov Josephine , Zaizov Rina , Yaniv Isaac
Published: February 2004

BACKGROUND

Tumors in the Ewing family (EFTs) are the second most common bone tumors in children and adolescents. Despite aggressive chemotherapy, one‐third of patients with localized tumor still may develop recurrences. This implies that not all tumor cells are eradicated and that the patients may have a level of residual disease. EFTs are characterized by specific chromosomal translocations that result in chimeric transcripts that can be detected with reverse transcriptase‐polymerase chain reaction (RT‐PCR) analysis.

METHODS

The authors report the prognostic potential of the positive chimeric transcript (EWS/FLI1) in bone marrow (BM) and/or peripheral blood (PBL) in 26 patients with EFT during a long follow‐up period (median, 61 months).

RESULTS

At diagnosis, 43% of patients had positive RT‐PCR BM results, with no correlation to tumor progression (P = 0.3). During follow‐up, 58% of patients had positive RT‐PCR results in their last sample analyzed (BM and/or PBL). A highly significant correlation between the presence of the chimeric transcript and disease progression was detected (P = 0.0028). In a multivariate analysis, the percentage of tumor necrosis (P = 0.007) and RT‐PCR results during follow‐up (P = 0.02) remained significant prognostic markers. In 10 of 11 patients who developed disease progression, BM and/or PBL samples were positive for the chimeric transcript before evidence of overt clinical recurrence.

CONCLUSIONS

Occult tumor cells in BM and/or PBL samples during long follow‐up are strong predictors of recurrent disease in patients with nonmetastatic EFTs. Cancer 2004;100:1053–8. © 2004 American Cancer Society.