Forty-eight patients with ductal cell carcinoma of the pancreas underwent total pancreatectomy. During 1970-1976, there were four deaths (a mortality of 18%). During the last twenty-eight operations (1977-1986), there were no hospital deaths. Seventeen per cent of the patients suffered intraoperative complications involving the mesenteric vessels. Twenty-seven per cent suffered postoperative complications. Twenty-five per cent of the patients left the hospital within 2 weeks, 50% left within 4 weeks, and another 25% remained in the hospital for longer than 4 weeks. Thirty-five per cent of the patients have returned to their preoperative job or similar life activity. Another 35% were able to lead an active life but did not return to regular work, and 30% were to some degree incapacitated by their operative procedure and disease. Twenty-one per cent of the patients lived for 4 years, and 14% survived for 5 years.

Two patients developed nodular, well-circumscribed tumors of the breast, discovered by mammography. They were fibroadenoma-like by gross examination and biphasic by light microscopy, containing both tubular glands and spindled myoid cells. Immunocytochemical studies revealed cytokeratin and S-100 immunoreactivity in both the spindled myoid cells and in the tubuloglandular cells (S-100 was focal in the latter). In addition, the spindled myoid cells were immunoreactive for vimentin but negative for desmin. Ultrastructural studies showed the tubular glands to be composed of luminal epithelial cells focally surrounded by myoepithelial cells, but the stroma contained spindled myoepithelial cells admixed with occasional fibroblasts. The diagnostic term, "adenomyoepithelioma," is appropriate for biphasic tumors having both glandular and myoepitheliomatous differentiation. Although additional experience is necessary to be conclusive regarding the biologic behavior of these unusual lesions, the authors believe the adenomyoepitheliomas described here are benign. They were well circumscribed without invasion of adjacent breast, contained neither mitotic figures nor cytologic atypia, and have not recurred or metastasized (6 and 10 months after removal).

Near the approaches of interstate and other major highways, posted directional signs warn drivers about the proper lanes for entering these high-speed limited-access roadways. These signs are intended to guide drivers with clear, concise directions, but they may instead expose drivers to ambiguous information. This ambiguity has the potential for causing accidents when the wrong lane is chosen and the driver must cross several lanes of traffic in these frequently busy interchanges. The present study exantined the effectiveness of currently used interstate entrance-ramp directional signs) as well as a set of systematically manipulated alternative signs. Participants examined 94 sets of signs having various forms of simple vs. complex arrows and text (both alone and together) and for each, they were to indicatethe appropriate lanes and direction to enter the interstate highway. Participants also rated the same signs according to clarity. Results indicated that text alone and text plus arrow signs consistently produced better performance and higher clarity ratings compared to signs containing arrows alone. No differences were found in the set of text statements investigated. However, differences were found for the arrow alternatives. Simple arrows (both alone and with text) produced better performance and higher clarity ratings compared to complex arrows. The data show that the current highway signs are ambiguous, and that there are alternative designs that are clearer. In real-world applications, improved signs may reduceaccidentrates by decreasing decision errors.

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