Úvod: Frekvencia pankreatických metastáz sa pohybuje od 2 % do 5 % všetkých malígnych tumorov pankreasu. Pankreas je elektívnym miestom metastáz renálneho karcinómu a všeobecne sa vyskytujú v siedmej dekáde a sú obyčajne asymptomatické. Kazuistika: V kazuistike prezentujeme prípad 58 ročnej ženy s multifokálnym a izolovaným postihnutím pankreasu metastázami renálneho karcinómu, ktorý sme riešili totálnou duodenopankreatektómiou. Záver: V selektovaných prípadoch považujeme resekčný výkon na pankrease pri metastázach renálneho karcinómu za indikovaný a zlepšujúci celkové prežívanie pacientov. Kľúčové slová: renálny karcinóm – izolované pankreatické metastázy – totálna duodenopankreatektómia, Introduction: The frequency of pancreatic metastases ranges from 2% to 5%. Pancreas is an elective site for metastases from renal carcinoma. Pancreatic metastases from renal cell carcinoma are frequently the only metastatic site and they typically occur in the seventh decade of life. Case report: We report 1 female patient (aged 58 years) with multifocal and isolated pancreatic metastases of renal cell carcinoma. Total duodenopancreatectomy was performed. Conclusion: In selected cases, pancreatic resection due to renal cell cancer metastases is deemed indicated, improving overall patient survival. Key words: renal cell carcinoma (RCC) − isolated pancreatic metastases − total duodenopancreatectomy, and R. Donát, M. Sabol, Š. Durdík
Autoři referují o vzácném případu traumatické totální avulze očního bulbu s optickým nervem v úrovni chiazmatu. Kazuistické sdělení retrospektivně popisuje průběh ročního sledování mladé ženy, která byla zraněna při hasičských závodech. Avulze bulbu a optiku, kombinovaná s poraněním chiazmatu, rezultovala v hemianopický defekt druhostranného zorného pole. Při traumatu vzniklo subarachnoidální krvácení do oblasti cisteren chiazmatu, jež spontánně ustoupilo. Nedošlo k rozvoji vaskulárních spazmů mozku. Celková kortikoterapie a neuroprotekce neměla vliv na průběh onemocnění. Během sledovací doby objektivně došlo k descendentní atrofii korespondujících axonů a retinálních gangliových buněk. V současné době neexistuje efektivní terapie poranění v oblasti chiazmatu., The authors report a rare case of complete traumatic avulsion of the eyeball with the optic nerve at the level of chiasm. The case report retrospectively describes a year-long monitoring of a young woman who was injured in fire-fighter races. Avulsion of the globe and optic nerve combined with injured chiasm resulted in contralateral hemianopic visual field defect. The trauma led to subarachnoid hemorrhage in cisterns of chiasm, which spontaneously resolved. There was no development of vascular spasms in the brain. Systemic corticosteroid therapy and neuroprotection did not affect the course of the disease. During the observation period, descending atrophy of the corresponding axons and retinal ganglion cells developed. There is currently no effective therapy of chiasm injuries., and L. Hejsek, V. Kaňa, P. Rozsíval, J. Dusová, A. Stepanov, P. Trávníček, L. Tuček
V devadesátých letech minulého století dochází k rozvoji laparoskopické chirurgie. Cestu ukázali chirurgickým oborům gynekologové. Vývoj metody započal simultáně na třech místech. V USA, Francii a Německu. V roce 1989 provedl Reich v USA první LAVH. Querleu v roce 1991 první laparoskopickou lymfadenektomii a v roce 1992 kombinoval Dargeant Schautovu radikální vaginální hysterektomii s laparoskopickým přístupem. Systematická pánevní a alternativně paraortální lymfadenektomie je součástí radikálních laparoskopických výkonů. Stanovili jsme novou nomenklaturu parametrií, snažíme se šetřit autonomní inervaci. Zpočátku byli operatéři autodidakté, v poslední době jsme svědky standardizace indikací a techniky. Bezpečnost výkonu a komfort operatéra zvyšuje vyspělá technika, 3D zobrazení, vysokofrekvenční bipolární technika, konstrukce trokarů omezujících možnost cévních poranění. Postupně byl téměř na všech specializovaných pracovištích opuštěn vaginální přístup a kompletní operace je prováděna pouze laparoskopicky pod mezinárodně srozumitelným označením TRLH (totální, radikální, laparoskopická hysterektomie). Systematicky se budeme ve svém sdělení věnovat anatomickým aspektům, aplikaci trokarů, základním preparačním krokům a postupům, které omezí možné komplikace, zejména ze strany močového měchýře a ureterů. Zmíníme nutné technické vybavení, základy bezpečné práce s vysokofrekvenční koagulací. Na závěr probereme pooperační péči., In the nineties we experienced a massive development of laparoscopic surgery. Gynecologists were the first who paved the way. The method was simultaneously developed in three countries - the United States, France and Germany. From the United States the vaginal laparoscopically assisted procedures have came to Europe. The French and German schools were based on the historical knowledge of the Schauta radical hysterectomy. In 1989 Reich was the first who operated the LAVH, followed by Querleu in 1992 with lymphadenectomy and Dargeant who combined the Schauta procedure with the laparoscopic lymph node dissection. It was the laparoscopy that taught us the proper functional anatomy. A new nomenclature of the parametries was defined. Careful attention is given to the preservation of the autonomous inervation. In the beginning all laparoscopic surgeons were self-taught. Nowadays a standardized laparoscopic techniques are implemented for a radical laparoscopic operations. The safety of this method is enhanced by using advanced technologies like 3D imaging, high frequence bipolar tools, safety trocars. More often the vaginal approach is being abandoned and the whole operation is performed laparoscopically. A generally accepted term for this operation is TRLH which stands for Total Radical Laparoscopic Hysterectomy. We will systematically describe the anatomical aspects of the dissection technique regarding the save preparation of the ureters and the bladder. The technical equipment will be mentioned as well as the use of monopolar and bip, Radek Chvátal, and Literatura
In this article, we propose an automated construction of knowledge based artificial neural networks (KBANN) for the recognition of restricted sets of handwritten words or characters. The features that better describe the chosen vocabulary are first selected, according to the characteristics of the used script, language and lexicon. Then, ideal samples of lexicon elements (words or characters) are submitted to a feature extraction module to derive their description using the chosen primitives. The analysis of these descriptions generates a symbolic knowledge base reflecting a hierarchical classification of the words (or characters). The rules are then translated into a multilayer neural network by determining precisely its architecture and initializing its connections with specific values. This construction approach reduces the training stage, which enables the network to reach its final topology and to generalize. The proposed method has been tested on the automated construction of neuro-symbolic classifiers for two Arabic word lexicons.
This article sets out a theoretical framework for the political economy of the private rental sector, with a particular focus on the question of inequality. It brings together three existing bodies of research. First, macro-accounts of social stratification and wealth inequality. Second, Marxian critiques of the antagonism between accumulation and social reproduction. Third, qualitative accounts of tenants’ experiences of housing inequality. The article synthesises these three literatures to put forward a political economy approach which can capture the multi-dimensional and multi-scale nature of both ‘housing’ and ‘home’ in the private rental sector. In so doing, it contributes to recent research on ‘generation rent’, in particular the related class and generational inequalities, as well as wider debates on the political economy of housing.
In the domain of \emph{Computing with words} (CW), fuzzy linguistic approaches are known to be relevant in many decision-making problems. Indeed, they allow us to model the human reasoning in replacing words, assessments, preferences, choices, wishes… by \emph{ad hoc} variables, such as fuzzy sets or more sophisticated variables. This paper focuses on a particular model: Herrera and Martínez' 2-tuple linguistic model and their approach to deal with unbalanced linguistic term sets. It is interesting since the computations are accomplished without loss of information while the results of the decision-making processes always refer to the initial linguistic term set. They propose a fuzzy partition which distributes data on the axis by using linguistic hierarchies to manage the non-uniformity. However, the required input (especially the density around the terms) taken by their fuzzy partition algorithm may be considered as too much demanding in a real-world application, since density is not always easy to determine. Moreover, in some limit cases (especially when two terms are very closed semantically to each other), the partition doesn't comply with the data themselves, it isn't close to the reality. Therefore we propose to modify the required input, in order to offer a simpler and more faithful partition. We have added an extension to the package jFuzzyLogic and to the corresponding script language FCL. This extension supports both 2-tuple models: Herrera and Martínez' and ours. In addition to the partition algorithm, we present two aggregation algorithms: the arithmetic means and the addition. We also discuss these kinds of 2-tuple models.
This tutorial summarizes the new approach to complex system theory that comes basically from physical information analogies. The information components and gates are defined in a similar way as components in electrical or mechanical engineering. Such approach enables the creation of complex networks through their serial, parallel or feedback ordering. Taking into account wave probabilistic functions in analogy with quantum physics, we can enrich the system theory with features such as entanglement. It is shown that such approach can explain emergencies and self-organization properties of complex systems.
A trial of analogies utilization among electrical, mechanical and information circuits is presented. The concepts of Information Power and significant proximity of the measure of information and knowledge could enable upgrading these analogies for solving important tasks from the area of Systems Engineering. This attempt seems to be attractive, as it could help in using the well-established and proved methodologies from the classical areas of electricity or mechanics.
In this paper, by using a new representation of fuzzy numbers, namely the ecart-representation, we investigate the possibility to consider such multiplication between fuzzy numbers that is fully distributive. The algebraic and topological properties of the obtained semiring are studied making a comparison with the properties of the existing fuzzy multiplication operations. The properties of the generated fuzzy power are investigated.
Ectrichodiinae (Hemiptera: Reduviidae), the millipede assassin bugs, are a speciose group (>660 species) of assassin bugs that appear to be specialist predators on Diplopoda, or millipedes. Apparently capable of coping with the noxious defensive compounds produced by many millipedes, Ectrichodiinae are engaged in a predator-prey relationship with millipedes realized only by few other arthropods. Unfortunately, feeding behaviors of Ectrichodiinae are inadequately documented, rendering this exciting phenomenon largely inaccessible. We here present a literature review on ectrichodiine prey selection and feeding behaviors, with supplemental original observations on Rhiginia cinctiventris (Stål, 1872) in Costa Rica. Thirteen species in 12 genera have been observed to feed on millipedes. The majority of diplopod prey species were reported from the orders Spirostreptida and Spirobolida, whereas Polydesmida are rarely attacked. Ectrichodiinae insert their stylets at the millipede’s intersegmental membranes on the ventral and ventro-lateral trunk area or between the head and collum. Communal predation was observed among conspecific nymphs, among groups of nymphs with a conspecific adult, and more rarely among adults. Immature ectrichodiines were rarely observed to engage in solitary predation. Observations on R. cinctiventris indicate that this species preys on spirobolid and polydesmid millipedes and are in agreement with behaviors described for other Ectrichodiinae., Michael Forthman, Christiane Weirauch., and Obsahuje seznam literatury