Oncogenesis of anaplastic carcinoma of the pancreas is a subject of controversy, because it shows sarcomatous nature with extremely poor prognosis. We herein report an unusual case of anaplastic carcinoma occurring with a recurrent mucinous cystic neoplasm in a 38-year-old female. A 10-cm retroperitoneal cystic mass was pointed out in the first pregnancy and a probable diagnosis of mucinous cystic neoplasm was made in October 2000. She refused surgery first and delivered her baby uneventfully. During her second pregnancy in 2002, however, she presented hematemesis and underwent urgent distal pancreatectomy, splenectomy and partial resection of the gastric wall where the tumor perforated. A diagnosis of borderline-type mucinous cystic neoplasm with ovarian-like stroma was made. Nine months later, CT visualized a recurrent cystic tumor near the pancreatic stump, which was subsequently resected. Pathology revealed that the tumor was composed of two different components of borderline-type mucinous cystic neoplasm and anaplastic carcinoma. The latter was intensely positive for vimentin, CD68, p53 and focally for cytokeratin, suggesting both sarcomatous and carcinomatous differentiation. She survived four years after the second surgery without tumor recurrence. Although the origin of anaplastic carcinoma has not been determined yet, it should be remembered that anaplastic carcinoma can occur in association with mucinous cystic neoplasm of more benign histology.

These results suggested that this HS molecule, which contained about ten disaccharide units during proliferation, may be an initiator of hepatocyte proliferation.

Purpose This study aimed to examine the effects of 4 main types of gastrectomy for proximal gastric cancer on postoperative symptoms, living status, and quality of life (QOL) using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45). Materials and Methods We surveyed 1,685 patients with upper one-third gastric cancer who underwent total gastrectomy (TG; n=1,020), proximal gastrectomy (PG; n=518), TG with jejunal pouch reconstruction (TGJP; n=93), or small remnant distal gastrectomy (SRDG; n=54). The 19 main outcome measures (MOMs) of the PGSAS-45 were compared using the analysis of means (ANOM), and the general QOL score was calculated for each gastrectomy type. Results Patients who underwent TG experienced the lowest postoperative QOL. ANOM showed that 10 MOMs were worse in patients with TG. Four MOMs improved in patients with PG, while 1 worsened. One MOM was improved in patients with TGJP versus 8 MOMs in patients with SRDG. The general QOL scores were as follows: SRDG (+39 points), TGJP (+6 points), PG (+3 points), and TG (−1 point). Conclusions The TG group experienced the greatest decline in postoperative QOL. SRDG and PG, which preserve part of the stomach without compromising curability, and TGJP, which is used when TG is required, enhance the postoperative QOL of patients with proximal gastric cancer. When selecting the optimal gastrectomy method, it is essential to understand the characteristics of each and actively incorporate guidance to improve postoperative QOL.

No abstract

z h a~g~e e c s .~m a m o t o -~. a c~pIn our studies, EUV radiation from xenon-filled fast capillary Z-pinch discharge has been made. The urgent need for modeling and optimizing such xenon plasma sources requires theoretical efforts in atomic and plasma physics. However, the physics of the plasma-produced processes, which lead to E W emission, are intrinsically complicated. Many simplifying assumption is inevitable with numerical simulation, resulting in suspicious outcomes. ANN can learn complex plasma data both adaptively and nonlinearly without any formation on the causal relationship between the input and output patterns. With the learning and generalization abilities, ANN is utilized to model and optimize Z-pinch piasma source, which is Characterized with a experimental design at vaned operationaJ parameters including electric power input, applied voltageicurrent, pulse repetition, MPC parameters, electrode geometry, Xe flow rate as well as convention efficiency, EUV source size, radiation power etc.A schematic of the 2-Pinch EUV sources is shown in Figure 1. The EUV radiation from the Z-Pinch plasma was characterized with measurement for the temporal behavior of E W intensity and the pinhole images. It is worthy to be noticed the maximum EUV radiation is the most sensitive to the Xe flow rate and the discharge current. ANN is wed to construct evaluation model for EUV plasma process, the back-propagation (BP) neural network, shown in Figure 2., is employed due to its h g h prediction capability in modeling complex EUV plasma data. The ANN input patterns are represented by the four adjustable process factors, i.e., gas flow rate, charge voltage, discharge current and input energy; the output layer is set to unity neuron, representing EUV power [W/5W2%BW/2pisr]; the hidden layer with five neurons do not interact with the outside world, but assist in performing nonlinear feature extraction on the data provided by the input and output layers. The ANN is trained with BP algorithm, a total of 12 experiments were conducted to produce training patterns, and additional five experimental pattems were used as test data for EW evaluation. Figure 3. Shows the EUV evaluation by use of ANN. For comparison, the actual measurement values are also shown in the Figure 3. As seen, the evaluation vahes of EUV power via ANN are highly consistent with the corresponding actual measurements.NevertheIess, there exist some differences between experimental and actual measurements, so that the model is to be fiuther optimized such as ANN structure including the numbers of ANN layers, of each hidden layers as well as the improvement of training algorithm. In addition, the training pattems are to be collected again. For comparison, the dependences of EUV power on the gas flow rates and discharge currents, respectively, are shown in Figures 4 and 5. Whereat, the generalization capabilities of ANN are exploited to intelpolate between training data, thus to overcome system parametric uncertainties. Therefore, the behaviors of EUV power as a...