Sarginių limfmazgių nustatymo metodai, operuojant krūties vėžį: literatūros apžvalga

Introduction. Detecting metastases is an important part of successful breast cancer treatment. Usually, the tumor tissue first spreads to the sentinel lymph nodes. Removal of the latter during surgery and histological examination allows to assess the patient’s di­sease stage, prognosis and treatment. The literature provides more than one approach or a combination of them, allowing us to accurately identify the breast’s sentinel lymph nodes and avoid removing all axillary lymph nodes. Purpose. To review the methods of intraoperative detection of breast sentinel lymph nodes presented in the literature. Research material and methods. Publications were searched using the specialized information search system Google Scholar. Keywords used in the search: breast sentinel lymph nodes, intraoperative detection. After evaluating the exclusion criteria, the review was based on 25 scientific publications. Results. 4 individual measures and 2 combinations of them can be used to detect sentinel breast lymph nodes during surgery. The materials used can be injected in 6 different ways. Conclusions. The combination of technetium-99m radiocolloid and methylene blue can be evaluated as the best method for intraoperative detection of sentinel lymph nodes in breast cancer patients. On the other hand, due to radiation and operating costs, more attention is being paid to the use of indocyanine green, superparamagnetic iron oxide, methylene blue dye, and the detection of metastases without surgery. Superficial methods of injecting the substance should be combined with deep ones due to the possibility of detecting extra-axillary sentinel lymph nodes of the breast. Ultimately, all decisions must be made on a case-by-case basis.Įvadas. Svarbi krūties vėžio sėkmingo gydymo dalis – nustatyti metastazes. Piktybiniai navikai įprastai pirmiausia išplinta į sritinius limfmazgius. Šių limfmazgių pašalinimas operacijos metu ir histologinis tyrimas leidžia įvertinti paciento ligos stadiją, ligos prognozę ir parinkti tinkamą gydymą. Mokslinėje literatūroje aprašomas ne vienas metodas ar jų derinys, padedantys nustatyti sarginius limfmazgius operuojant krūties vėžį ir leidžiantys išvengti visų pažasties limfmazgių pašalinimo. Tikslas. Apžvelgti mokslinėje literatūroje nurodytus metodus krūties sarginiams limfmazgiams intraoperaciškai nustatyti. Tyrimo medžiaga ir metodai. Publikacijų paieška atlikta naudojant specializuotą informacijos paieškos sistemą Google Scholar. Paieškai naudoti reikšminiai žodžių junginiai: „krūties sarginiai limfmazgiai“ (angl. breast sentinel lymph nodes) ir „intraoperacinis nustatymas“ (angl. intraoperative detection). Įvertinus atmetimo kriterijais, apžvalgoje remtasi 25 mokslinėmis publikacijomis. Rezultatai. Atliekant operaciją, sarginiams krūties limfmazgiams nustatyti gali būti panaudoti keturi individualūs metodai ir du jų deriniai. Naudojamos medžiagos gali būti injekuotos šešiais skirtingais būdais. Išvados. Patikimiausiu metodu sarginiams krūties limfmazgiams intraoperaciškai nustatyti laikytina technecio-99m radioaktyviojo koloido ir metileno mėlio kombinacija. Vis dėlto dėl patiriamos radiacijos ir didelių eksploatavimo kaštų ieškoma naujų, pigesnių ir techniškai paprastesnių sarginių limfmazgių nustatymo būdų. Tai galėtų būti indocianino žaliojo, superparamagnetinio geležies oksido, metileno mėlio naudojimas ir metastazių nustatymas neoperuojant. Paviršiniai medžiagos injekcijos būdai turėtų būti derinami su giliaisiais, siekiant aptikti ne tik pažastyje esančius sarginius krūties limfmazgius. Galutiniai sprendimai turi būti priimami atsižvelgiant į konkretų klinikinį atvejį

Gaming times four: how does customer participation shape consumer brand identification during the new product creation process a conceptual model proposal

Consumer participation in the new product development is an old concept, but one that has only recently started to appear more among companies in the gaming industry. This paper proposes a conceptual model focused on understanding what effect consumer’s participation has on Consumer Brand Identification (CBI) through perceived brand attractiveness - conducting a mediating, and brand innovativeness - a moderating role. A research model is constructed together with the possible hypotheses and research design. Also, possible outcomes, future research opportunities and limitations are provided for those who are interested in researching the effect that the consumer’s participation has on CBI in different cultural setups.info:eu-repo/semantics/publishedVersio

Surgical Treatment of Finger Degloving Injuries Without Usable Skin: a Case Report and Literature Review

The treatment of avulsion injuries of the fingers is complicated by the lack of universally accepted treatment guidelines and the wide variety of reconstruction techniques. The aim of this paper is to present a case and review the scientific literature to provide clear criteria for amputation and reconstruction and to present and discuss the reconstruction techniques with the best results

Mokyklinio fizikos demonstracinio eksperimento veiksmingumo klausimu

When improving the content and methods of the school course used when teaching physics, it is necessary to develop demonstration experiment. It is expedient to abandon a special schematic illustration of devices. Their structure must meet the equipment used in practice to a particular extent. A demonstration experiment must also reflect the newest achievement in technology. The demonstration experiment must be used not only for teaching new material, but also in other stages of a lesson. The involvement of students into preparation for the demonstration experiment and conduction thereof has a positive effect on the quality of their knowledge, as well as the development of practical faculties and skills.Tobulinant mokyklinio kurso turinį ir metodus, naudojamus mokant fizikos, reikia toliau vystyti demonstracinį eksperimentą. Tikslinga atsisakyti ypatingo prietaisų schematiškumo. Jų konstrukcija tam tikru laipsniu privalo atitikti įrenginius, naudojamus praktikoje. Demonstraciniame eksperimente taip pat turi būti atspindėti naujausi technikos pasiekimai. Demonstracinį eksperimentą reikia naudoti ne tik dėstant naują medžiagą, bet ir kituose pamokos etapuose. Mokinių įtraukimas į pasirengimą demonstraciniam eksperimentui ir jo pravedimą teigiamai veikia jų žinių kokybę ir praktinių mokėjimų bei įgūdžių raidą

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Recent advances in lanthanide spectroscopy in Brazil

This review discusses recent advances in lanthanide spectroscopy involving luminescence applications Q2 carried out in Brazil. The revised topics include glasses, sol–gel, light-emitting diodes, nanoparticles, metal–organic frameworks, coordination polymers, thin films, energy transfer processes, upconversion and development of new theoretical tools. The important role played by Prof. Oscar L. Malta on this subject is evidenced by his many contributions to the broad range of investigations reported here and this review is dedicated to him, on the occasion of his 60th birthday

Possibilities of economic regulations modelling using computers

This article presents possibilities of using computers for economic regulations modelling. The introduction gives a computer history and shows possibilities to use computers in many different ways. Research on the combination of economic regulations is carried out. Human and computer functions using economic regulations are presented. Research shows modelling possibilities of economic regulations with computer, text editors, text editing options. The article also presents economic regulations modelling algorithms and programs

From the History of Modern Interlinguistics

Reikšminiai žodžiai: Dirbtinė kalba; Ekonomikos kategorijos; Esperanto kalba; Interlingvistika; Natūrali kalba; Tarptautiniai terminai; Tarptautinė kalba; Tarptautinė kalbotyra; A natural language; An artificial language; Artificial language; Categories of economics; Esperanto; Interlinguistics; International language; International terms; International terms, categories of economics; Natural languag

Potential customer value determination in uncertain environment

Vykstant globaliems pokyčiams, organizacijos veikia išaugusio aplinkos neapibrėžtumo sąlygomis, jas supa daug išorinės aplinkos veiksnių, kurie dažnai keičiasi ir kurių pokyčius sunku prognozuoti. Esant tokio pobūdžio išorinei aplinkai, tradiciniais metodais prognozuojama klientų teikiama vertė yra pervertinama arba per menkai įvertinama. Atsiranda poreikis sukurti naują modelį, kuriuo būtų galima nustatyti potencialių klientų vertę, atsižvelgiant į įmonę supančios aplinkos neapibrėžtumą. Disertacijoje analizuojamas klientų vertės nustatymas vadybinių sprendimų kontekste, atliekama verslas verslui (angl. B2B) aplinkos analizė. Nagrinėjamos neapibrėžtos aplinkos sampratos, sudedamosios dalys, savybės, aplinkos galimas poveikis klientų teikiamai vertei. Disertaciniame darbe tiriami klientų vertės teoriniai aspektai, nurodomas klientų vertės nustatymo ryšys su klientų vertės valdymu. Moksliniame darbe atliekamas tradicinių klientų vertės nustatymo metodų sisteminimas, analizė bei palyginimas, išskiriami jų ribotumai bei tuo pagrindu suformuojami naujai kuriamo potencialių klientų teikiamos vertės nustatymo modelio reikalavimai. Atliekamas modelio kūrimo metodologinis pagrindimas, išskiriant mokslininkų pateikiamus kuriamų modelių reikalavimus, etapus. Modelis sujungia finansų srityje naudojamą binominį opciono kainos nustatymo bei disertanto sukurtą, empiriniu tyrimu grindžiamą, „subjektyviųjų“ veiksnių, įtakojančių klientų pirkimų elgseną, profilio priimtinumo tikimybės nustatymo metodus. Siekiant patvirtinti sudaromo modelio tinkamumą naudoti praktinėje situacijoje, atliekama modelio patikra. Potencialaus kliento vertė nustatoma dviejų parduodančiųjų įmonių atžvilgiu.With the global changes taking place, companies work under the conditions of increased uncertainty. They are surrounded by a number of factors of external environment which frequently change, the prognosis of their change is complex. Under such conditions of uncertainty, traditional customer given value determination methods are insufficient. Thus, there is a need for research in order to develop a new model for customer given value determination, which would allow taking into consideration the uncertainty of a company surrounding environment. After evaluation and generalization of scientific literature, customer value determination in the context of managerial decisions is presented. Further, the theoretical analysis of business-to-business environment is carried out. Special attention is paid to the environmental uncertainty and its potential effect on customer value. Analysis of theoretical aspects of customer value distinguishing the relationship between determination and management of customer value is performed. Different traditional methods determining customer value are evaluated and systematized, their limitations are distinguished, requirements for the proposed model are formulated. Having established the methodological basis, the model determining customer value in uncertain environment is structured. The model joins binomial option pricing model used in sphere of finances with the method for the determination of the acceptability likelihood of the profile of soft factors influencing customer buying behavior. The empirical studies enable the determination of acceptability likelihood of the profile of soft factors. The created model is tested empirically, by determining value of potential customer from two sales companies’ points of view.Vytauto Didžiojo universiteta

Practical Application of Simulation of Economic Corroborated Rules

The possibilities of practical application of modelling of economic corroborated rules will be described in detail below. The application of methods for modelling economic corroborated rules for compiling an economic dictionary, an economic text, for reviewing and modifying a text will be shown. The application of the method of modelling in the studying : the preparation of homework, course work, graduate work and the modelling of the studying process as well as the modelling of a non-economic text will be considered