Classification of Ventricular Septal Defects for the Eleventh Iteration of the International Classification of Diseases—Striving for Consensus: A Report From the International Society for Nomenclature of Paediatric and Congenital Heart Disease

The definition and classification of ventricular septal defects have been fraught with controversy. The International Society for Nomenclature of Paediatric and Congenital Heart Disease is a group of international specialists in pediatric cardiology, cardiac surgery, cardiac morphology, and cardiac pathology that has met annually for the past 9 years in an effort to unify by consensus the divergent approaches to describe ventricular septal defects. These efforts have culminated in acceptance of the classification system by the World Health Organization into the 11th Iteration of the International Classification of Diseases. The scheme to categorize a ventricular septal defect uses both its location and the structures along its borders, thereby bridging the two most popular and disparate classification approaches and providing a common language for describing each phenotype. Although the first-order terms are based on the geographic categories of central perimembranous, inlet, trabecular muscular, and outlet defects, inlet and outlet defects are further characterized by descriptors that incorporate the borders of the defect, namely the perimembranous, muscular, and juxta-arterial types. The Society recognizes that it is equally valid to classify these defects by geography or borders, so the emphasis in this system is on the second-order terms that incorporate both geography and borders to describe each phenotype. The unified terminology should help the medical community describe with better precision all types of ventricular septal defects

Nomenclature for Pediatric and Congenital Cardiac Care: Unification of Clinical and Administrative Nomenclature – The 2021 International Paediatric and Congenital Cardiac Code (IPCCC) and the Eleventh Revision of the International Classification of Diseases (ICD-11)

Substantial progress has been made in the standardization of nomenclature for paediatric and congenital cardiac care. In 1936, Maude Abbott published her Atlas of Congenital Cardiac Disease, which was the first formal attempt to classify congenital heart disease. The International Paediatric and Congenital Cardiac Code ( IPCCC ) is now utilized worldwide and has most recently become the paediatric and congenital cardiac component of the Eleventh Revision of the International Classification of Diseases ( ICD-11 ). The most recent publication of the IPCCC was in 2017. This manuscript provides an updated 2021 version of the IPCCC . The International Society for Nomenclature of Paediatric and Congenital Heart Disease ( ISNPCHD ), in collaboration with the World Health Organization (WHO), developed the paediatric and congenital cardiac nomenclature that is now within the eleventh version of the International Classification of Diseases (ICD-11). This unification of IPCCC and ICD-11 is the IPCCC ICD-11 Nomenclature and is the first time that the clinical nomenclature for paediatric and congenital cardiac care and the administrative nomenclature for paediatric and congenital cardiac care are harmonized. The resultant congenital cardiac component of ICD-11 was increased from 29 congenital cardiac codes in ICD-9 and 73 congenital cardiac codes in ICD-10 to 318 codes submitted by ISNPCHD through 2018 for incorporation into ICD-11. After these 318 terms were incorporated into ICD-11 in 2018, the WHO ICD-11 team added an additional 49 terms, some of which are acceptable legacy terms from ICD-10, while others provide greater granularity than the ISNPCHD thought was originally acceptable. Thus, the total number of paediatric and congenital cardiac terms in ICD-11 is 367. In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature . This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature. The members of ISNPCHD realize that the nomenclature published in this manuscript will continue to evolve. The version of the IPCCC that was published in 2017 has evolved and changed, and it is now replaced by this 2021 version. In the future, ISNPCHD will again publish updated versions of IPCCC , as IPCCC continues to evolve

Prostaglandin production in mouse mammary tumour cells confers invasive growth potential by inducing hepatocyte growth factor in stromal fibroblasts

Interactions between stromal and mammary tumour cells play a crucial role in determining the malignant behaviour of tumour cells. Although MMT mouse mammary tumour cells do not produce hepatocyte growth factor (HGF), addition of conditioned medium (CM) from MMT cells to cultures of human fibroblasts derived from skin and breast tissues stimulated the production of HGF, thereby indicating that MMT cells secrete an inducing factor for HGF. This HGF-inducing factor, purified from MMT-derived CM, proved to be prostaglandin E2 (PGE2). Consistently, treatment of MMT cells with indomethacin, an inhibitor of cyclooxygenase, abolished this HGF-inducing activity in MMT-derived CM, while treatment of MMT cells with HGF stimulated cell growth and cell motility. Likewise, HGF strongly enhanced urokinase-type plasminogen activator activity and invasion of MMT cells through Matrigel: a 15-fold stimulation in the invasion of MMT cells was seen by HGF. Finally, MMT cells in the upper compartment were co-cultivated with fibroblasts in the lower compartment of the Matrigel chamber, HGF levels in the co-culture system exceeded the level in fibroblasts alone and suppression occurred with exposure to indomethacin. Together with increase in the HGF level, the invasion of MMT cells was enhanced by co-cultivation with fibroblasts, whereas the increased invasion of MMT cells was significantly inhibited by an anti-HGF antibody and by indomethacin. These results indicate mutual interactions between MMT cells and fibroblasts: MMT-derived PGE2 plays a role in up-regulating HGF production in fibroblasts, while fibroblast-derived HGF leads to invasive growth in MMT cells. The mutual interactions mediated by HGF and prostaglandins may possibly be a mechanism regulating malignant behaviour of mammary tumour cells, through tumour–stromal interactions. © 1999 Cancer Research Campaig