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Objective: To describe 2 patients with traumatic neuromas of the intratemporal facial nerve in the absence of trauma., Study Design: Retrospective case review., Setting: Tertiary care referral center., Patients: Patients included underwent resection of an intratemporal facial nerve mass. Upon pathologic evaluation, the patients were found to have traumatic neuromas of the facial nerve., Intervention(s): Patients underwent resection of an intratemporal facial traumatic neuroma. Histopathologic evaluation was performed including an immunohistochemistry evaluation., Results: Two patients were identified with intratemporal facial nerve traumatic neuromas. The patients had no significant history of trauma or chronic inflammatory process. Pathologic evaluations, including immunohistochemistry, of the excised masses were consistent with traumatic neuromas. All tumors were noted to have a disorganized collection of axons and were not consistent with the expected diagnosis of schwannoma. Tumors involved the tympanic and vertical segments of the facial nerve. A cavernous angioma was found within one mass and is thought to be the etiology of neuroma formation., Conclusion: Traumatic neuromas are possible in the intratemporal facial nerve in the absence of trauma. A cavernous angioma of the facial nerve is a newly described possible cause of traumatic neuroma formation.

Melioidosis, an infection caused by the gram-negative bacillus Burkholderia pseudomallei, is endemic to Southeast Asia and Northern Australia. Human infection is acquired through contact with contaminated water via percutaneous inoculation. Clinical manifestations range from skin and soft tissue infection to pneumonia with sepsis. We report a case of a man who was taken as a prisoner of war by the Japanese during World War II who presented with a nonhealing ulcer on his right hand 62 years after the initial exposure.

Presented is a comprehensive program designed to isolate human cytokine genes and investigate their relative induction, and to analyze cytokine activities in cell culture, animal tumor models, and human clinical trials. Human cytokine cDNAs have been isolated from a cDNA library made from normal human peripheral blood leukocytes (PBLs) treated with Sendai virus and the relative induction of tumor necrosis factor (TNF), alpha and gamma interferons (IFN-alpha, IFN-gamma), and interleukin-1 beta IL-1 beta) genes has been analyzed. In the Sendai virus-induced PBL system, IL-1 beta mRNA was shown to be approximately twofold higher than TNF or IFN-alpha mRNA whereas IFN-gamma mRNA was 50-100-fold lower than TNF or IFN-alpha mRNA. The cytotoxic activity of TNF was analyzed on several cell lines and IFN-alpha and IFN-gamma were shown to potentiate TNF cytotoxicity about 2-200-fold depending on cell lines. The LD50 for recombinant TNF in BALB/c mice was determined to be 6 X 10(7) U/kg and the therapeutic dose of recombinant TNF in sarcoma 180 bearing BALB/c mice was 3 X 10(5) U/kg, indicating a wide therapetic index. Phase I clinical trials of recombinant TNF given I.V. indicated a tolerated dose of 150,000 U/kg with biphasic half-life (T-1/2) of 2 and 31 min following TNF injection. Phase II trials of TNF and trials of TNF combined with IFN-alpha are in progress. These studies indicate that cytokines such as TNF and IFN-alpha are subject to similar induction systems, potentiate each other's activities, and can be tolerated at specific doses for potential therapeutic use.