No abstract

Distal pancreatectomy with resection of the celiac axis can increase resectability of carcinoma of the body and tail of the pancreas. We performed reconstruction of the hepatic artery to avoid complications caused by a decrease in hepatic arterial flow. We carried out distal pancreatectomy with resection of the celiac axis for carcinoma of the body and tail of the pancreas in four patients. When pulsation in the proper hepatic artery was weak after occlusion of the celiac axis, we performed reconstruction of the hepatic artery, using the splenic artery, which had been taken beforehand from the resected specimen. In two patients, we performed reconstruction of the hepatic artery. These two patients underwent reconstruction of the portal vein combined with prolonged clamping of the portal vein. Levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were elevated just after the operation, but recovered to normal levels within 10 days. No complications related to hepatic ischemia were observed. These results suggested that reconstruction of the hepatic artery allowed us to safely perform distal pancreatectomy with resection of the celiac axis for carcinoma of the body and tail of the pancreas.

We have sometimes encountered invasive ductal carcinomas (IDCs) of the pancreas containing intraductal carcinoma components in the intra-and/or extra-tumor area. The purpose of this study was to investigate whether intraductal carcinoma components would be useful for predicting the outcome of IDC patients. Forty-seven surgically treated IDCs were examined, and all histological tumor sections were stained with Elastica to accurately confirm intraductal carcinoma components. Well-known clinicopathological parameters that exhibited a significant correlation in the univariate analyses for predicting disease-free survival (DFS) and overall survival (OS) were entered into the Cox proportional hazard multivariate analysis. Since the lowest P-value predicting DFS or OS periods was observed in IDCs with more than 10% intraductal carcinoma components and those with 10% or less intraductal carcinoma components (P = = = =0.028 and P = = = =0.019), we established the cutoff value of intraductal carcinoma components at 10%. In the multivariate analyses for DFS and OS, the presence of more than 10% intraductal carcinoma components showed a marginally significant increase in the hazard rate (HR) of tumor recurrence (P = = = =0.067) and significantly increased the HR of mortality (P = = = =0.040). The present study demonstrated that IDCs with more than 10% intraductal carcinoma components were associated with a significantly better patient outcome than those with 10% or less intraductal carcinoma components.Key words: Ductal carcinoma -Pancreas -Intraductal component -Prognosis -HistologyThe major histological type of pancreatic tumors is invasive ductal carcinoma (IDC), and the outcome of patients with IDCs is very poor. 1) However, we have sometimes encountered IDCs containing intraductal carcinoma components and exhibiting papillary or low-papillary features resembling the noninvasive components of invasive papillary-mucinous carcinoma of the pancreas.2, 3) Invasive papillary-mucinous carcinomas have ample intraductal carcinoma components, and the clinical course of patients with invasive papillary-mucinous carcinoma is better than that of patients with IDC. In breast cancer, a tendency was observed for decreased nodal metastases and a more favorable prognosis when the intraductal component in the tumor was relatively more abundant.4) This suggested to us that the rate of intraductal carcinoma components in IDCs plays an important role in the outcome for patients with IDC of the pancreas.The purpose of this study was to investigate whether there is a cutoff value for the area of intraductal carcinoma components that would be useful for predicting the outcome in IDC patients. In addition, a comparative study was performed between patients with IDCs with intraductal carcinoma components at or above the cutoff value and patients with invasive papillary-mucinous carcinoma, which is associated with a better clinical course than IDC, 5,6) to clarify whether the clinical course of the former is similar to that of the latter. The res...

In recent years, the disease concept of intraductal papillary neoplasm of the bile duct (IPNB) has been attracting attention as a biliary lesion that is morphologically similar to intraductal papillary mucinous neoplasm (IPMN), which is considered to be a counterpart of IPMN. However, there are few reports on IPNB, and a consensus regarding the features of this disease is thus lacking. We experienced an extremely rare case of IPNB occurring in the bile duct at the duodenal papilla, which is a tumor presentation that has not previously been reported. Herein, we report this interesting case and discuss the possible association between IPMN and IPNB.

There are three main approaches creating stereoscopic S3D content: stereo filming using two cameras, stereo rendering of 3D computer graphics, and 2D to S3D conversion by adding binocular information to 2D material images. Although manual "off-line" conversion can control the amount of parallax flexibly, 2D material images are converted according to monocular information in most cases, and the flexibility of 2D to S3D conversion has not been exploited. If the depth is expressed flexibly, comprehensions and interests from converted S3D contents are anticipated to be differed from those from 2D. Therefore, in this study we created new S3D content for education by applying 2D to S3D conversion. For surgical education, we created S3D surgical operation content under a surgeon using a partial 2D to S3D conversion technique which was expected to concentrate viewers' attention on significant areas. And for art education, we converted Ukiyoe prints; traditional Japanese artworks made from a woodcut. The conversion of this content, which has little depth information, into S3D, is expected to produce different cognitive processes from those evoked by 2D content, e.g., the excitation of interest, and the understanding of spatial information. In addition, the effects of the representation of these contents were investigated.