The clinicopathologic features and problems in classification and diagnosis of the pancreatic neoplasms with abundant mucus production are presented. In this article, the various reported concepts and terminology of these mucus-producing pancreatic tumors are summarized, and the differences between intraductal papillary-mucinous tumors and mucinous cystic tumors are specifically discussed. Intraductal papillary-mucinous tumors show diffuse or segmental dilatation of the pancreatic ducts with intraductal papillary growth. Mucinous cystic tumors are mucus-producing tumors showing cyst formation, which is often accompanied by intracystic papillary projections and "ovarian-type" stroma. Intraductal papillary-mucinous tumors occur most often in the pancreatic head of elderly men, whereas mucinous cystic tumors typically occur in the pancreatic tail or body of middle-aged women. Histologically, these tumors show a wide cytologic spectrum from benign to borderline to malignant. These tumors pursue an indolent clinical course compared with conventional ductal carcinoma of the pancreas. Mucinous cystadenocarcinomas have a higher malignant potential than intraductal papillary-mucinous adenocarcinomas, yet these tumors recur infrequently if they are excised completely. Because of the differences in clinicopathologic features, these tumors should be clearly separated from conventional ductal carcinoma of the pancreas.

Adenocarcinoma, Papillary↗

PubMed1999

A case of ALK-positive large T-cell lymphoma expressing epithelial membrane antigen with favorable prognosis.

We describe the case of a 59-year-old woman with Ki-1-negative, T cell-type, anaplastic lymphoma kinase (ALK)-positive large cell lymphoma that was positive for epithelial membrane antigen. She was histopathologically diagnosed as having a metastatic undifferentiated carcinoma from a cervical lymph node biopsy. Clinical and radiographic studies revealed no other primary tumor. The patient underwent a left radical neck dissection. Surgically resected lymph nodes revealed an ALK1-positive large cell lymphoma. Thereafter the patient has had an unusually favorable prognosis.

Anaplastic Lymphoma Kinase↗

PubMed1999

Carcinoma of the cystic bile duct: MRCP and CT appearance.

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Aged↗

PubMed1999

[Surgery for mitral regurgitation in children].

In pediatric patients, mitral valve (MV) repair is preferable than MV replacement because of no need for anticoagulation and its feasibility in small children. However, long-term outcome of MV repair is still unclear. In the present study, fifty-two pediatric patients who underwent MV repair (n = 46) and MV replacement (n = 6) against mitral regurgitation (MR) between January 1970 and December 1996 were evaluated. 46 patients had associated diseases. Mitral annuloplasty was applied in 20 patients (by Kay method (n = 14) and Paneth-Burr method (n = 6) before and after 1991, respectively). Freedom from reoperation rate in patients with partial endocardial cushion defect (ECD) was significantly lower than that in other patients after MV repair, which was significantly higher than that in patients with MV replacement. Diameter of mitral annulus grew within normal range after MV repair. In conclusion, MV repair may provide better outcomes with respect to reoperation and growth of MV in pediatric patients except with partial ECD.

Cardiac Surgical Procedures↗

PubMed1999

[First brain dead donor heart transplantation under new legislation in Japan and future aspects of heart transplantation in Japan].

After the brain death and organ transplantation law was settled in 1997, the first case of heart transplantation (HTx) was carried out successfully. The patient was 47 year-old male with hypertrophic cardiomyopathy of dilated phase and on Novacor Implantable LVAS for 4 months. The distance from the donor hospital was about 200 km taking 2 hours for transport, and total ischemic time was 3 hours and 24 minutes. The post-transplant course was smooth. The patient was discharged on 75 postoperative day. We described current status of HTx in Japan and worldwide and discussed current problems and future aspects of HTx in Japan.

Brain Death↗

PubMed1998

[Heart transplantation].

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Cyclosporins↗

PubMed1998

A single receptor encoded by vzg-1/lpA1/edg-2 couples to G proteins and mediates multiple cellular responses to lysophosphatidic acid.

Extracellular lysophosphatidic acid (LPA) produces diverse cellular responses in many cell types. Recent reports of several molecularly distinct G protein-coupled receptors have raised the possibility that the responses to LPA stimulation could be mediated by the combination of several uni-functional receptors. To address this issue, we analyzed one receptor encoded by ventricular zone gene-1 (vzg-1) (also referred to as lpA1/edg-2) by using heterologous expression in a neuronal and nonneuronal cell line. VZG-1 expression was necessary and sufficient in mediating multiple effects of LPA: [3H]-LPA binding, G protein activation, stress fiber formation, neurite retraction, serum response element activation, and increased DNA synthesis. These results demonstrate that a single receptor, encoded by vzg-1, can activate multiple LPA-dependent responses in cells from distinct tissue lineages.

Animals↗

PubMed1998