Motility-related protein-1 (MRP-1/CD9) expression can predict disease-free survival in patients with squamous cell carcinoma of the head and neck.

CD9 is a transmembrane protein that has been implicated in cell adhesion, motility and proliferation, and numerous studies have demonstrated the prognostic value of its expression in different solid tumours. The purpose of this study is to determine the predictive value of CD9 in squamous cell carcinoma (SCC) of the head and neck. A total of 153 cases were examined for CD9 expression using immunohistochemistry applied on formalin-fixed, paraffin-embedded tissue. Cases were stratified in two categories depending on CD9 expression, as positive (>/=50% positive cells) or reduced (<50%). In all, 108 cases were positive for CD9 (85 cases with membranous, and 23 with both membranous and cytoplasmic staining) and 45 reduced expression. Reduced CD9 expression was significantly associated with high grade (P=0.0007) and lower disease-free survival (DFS) (P=0.017). The latter retained its significance in the multivariate analysis. When the 23 cases with both membranous and cytoplasmic patterns were studied as a separate subgroup, there were significant associations between CD9 expression and tumour grade (P=0.025) (95% CI 11-68), tumour stage (P=0.08) (95% CI 3.5-86) and the occurrence of any failure (P=0.083) (95% CI -1.7-57). Immunohistochemical CD9 expression proved to be an independent prognostic factor in SCC of the head and neck, and it may detect patients at a high risk of recurrence. In addition, the cytoplasmic pattern seems to have an even more significant value. However, this finding is limited to the small number of cases with this pattern.

Fibronectin distribution in the chick embryo during formation of the blastula.

The distribution of the fibronectin-rich extracellular matrix (ECM) in the chick embryo during formation of the blastula has been evaluated semiquantitatively using an electron microscopical immunogold staining technique. During the first 10 h of postlaying development, fibronectin was found in both embryonic area pellucida and extra-embryonic area opaca of the blastoderm. In the area pellucida, the fibronectin was (1) associated with the basal lamina of the epiblast, (2) present between epiblastic and hypoblastic cells and (3) occasionally internalized in hypoblastic cells. Along the embryonic axis, a transient and high density of ECM was associated with the front of the anteriorly and rapidly expanding hypoblast. Very high density of fibronectin was observed in the marginal zone of the area pellucida, where the epiblastic and deeper cell layers show contacts and intense re-arrangements. In the area opaca, fibronectin was at first found only sporadically between contacting cells, but its density increased steadily and markedly during the first day of development. These rapid and significant changes in the regional distribution of fibronectin-rich ECM are discussed with respect to the early morphogenesis of the chick embryo.

Fibronectin in the area opaca of the young chick embryo. Immunofluorescence and immuno-electron-microscopic study.

Distribution of fibronectin-like immunoreactivity was studied in the area opaca of the young chick embryo (stages 4-6 HH) by use of the immunofluorescence and protein A-coupled to colloidal gold techniques. Fibronectin, associated to the basement membrane, formed a fibrillar network, the pattern of which changed from the centre to the periphery of the area opaca. At the ultrastructural level, differences in fibronectin distribution were found between non-moving and moving cells. The epithelial-like cells presented fibronectin staining exclusively on their basal side. Actively migrating cells (edge and mesodermal cells) showed immunoreactive material localized around their entire surface and within the cytoplasm. The fibronectin distribution is discussed in relation to three important phenomena taking place during the early growth of the area opaca: anchorage and migration of the edge cells, modification of cell shape in relation to mechanical tension, and expansion of the area vasculosa.

Pollicization of the index finger for reconstruction of the congenitally hypoplastic or absent thumb.

Between 1962 and 1980, 30 pollicizations of the index finger for congenital absence of the thumb were performed. None of the 30 index fingers were lost during the intraoperative or postoperative period. Of the 14 cases followed up on a long-term basis, six required secondary procedures, three for scar revisions; one, bone shortening; one, tenolysis of flexor tendons; and one, tenolysis of extensor tendons. All new thumbs showed normal sensibility. In four cases opposition was possible with all three residual fingers; in five cases, with the long and the ring finger; and in five cases, with the long finger only. Active motion averaged 42 degrees at the metacarpophalangeal (MP) joint of the new thumb and 35 degrees at the interphalangeal (IP) joint. The technique of pollicization has been modified over the years. Important steps are: correct skin incisions, complete destruction of the growth cartilage of the metacarpal head, fixation of the MP joint in maximum hyperextension, a rotation of 150 degrees, and the reconstruction of a musculotendinous shroud of the new thumb with the extrinsic and intrinsic tendons.

Report of the Committee on Tendon Injuries (International Federation of Societies for Surgery of the Hand).

Most of the committee members agreed on the material presented. Universal adoption of a single system for measuring and recording tendon function will require additional meetings. It is suggested that TAM and the Dieter Buck-Gramcko systems be more widely publicized and adopted by various hand surgeons before further discussion.

Krukenberg's operation. Indications and limitations.

The Krukenberg operation--creating a sensory forceps--is indicated principally in bilateral below elbow amputation with blindness. Other indications are proposed, in particular in children. The limitations to this procedure are essentially aesthetic problems and should not be minimized. The operative technique is described in details.

[The prefiguration of a museum of the Hand of Man]. / Préfiguration d'un musée de la Main de l'Homme.

The author has created a foundation, acknowledged as being of public benefit, whose purpose is to set up a "Museum of the Hand of Man", conceived as a coordination and research center on the hand. An attempt at systematizing a prefiguration of this institution is proposed, with five subsectors: the original of this institution is proposed, with five subsectors: the original hand, the experienced hand, the hand and culture, the hand and society, and the hand as a symbol. In addition, a collection of publications on these various aspects of the hand is projected.

The thumb in syndactyly.

Syndactyly of the thumb is a rare but very serious malformation. It produces a loss of the grasping function of the thumb, which is the main function of the human hand. The author presents different methods for the reconstruction of the first web space and a functional thumb. The surgical methods of reconstruction depend upon the extend and type of the malformation. The opening of the deep intermuscular fascia of the first web is a most important step of the procedure.