Diagnostic and Treatment Errors in Biliary Cystadenomas and Cystadenocarcinomas: Clinical Cases

Background. Biliary cystadenomas and cystadenocarcinomas are rare cystic tumors of the liver. Complicated differential diagnostics for simple cysts often leads to errors in surveillance of patients with these tumors. Cystadenoma and cystadenocarcinoma should be suspected upon detection of single or multilocular cystic neoplasms of the liver with septa and blood flow loci  in the cyst wall, especially in middle-aged women. The localization of the tumor is critical. The most common localization is segment IV of the liver. Urgent intraoperative biopsy is required to determine the extent of surgery.Case description. Clinical observations with analysis of the examination and treatment data of two female patients aged 38 and 56 were presented. Both clinical observations illustrate the underestimation of the preoperative examination data that served as a ground for diagnosis of liver cysts with inadequate extent of surgery. In the first case, the resection was incomplete, and, as such, the biliary cystadenoma recurred in the resection area, the capsule of the neoplasm was ruptured and an encysted fluid collection was formed. In the second case, lack of histological examination of the excised neoplasm, due to confidence in its morphological verification as a cyst, resulted in cystadenoma recurrence in the resection zone with metastasis to the contralateral lobe of the liver.Conclusion. Hepatic cystadenomas and cystadenocarcinomas are often misdiagnosed as simple cysts. These tumors should be suspected in central localization of the tumor in the liver, especially in young women. The clinical and instrumental symptomatology and radiological semiotics of the disease require careful evaluation. The recurrence of a cystic lesion in the resection zone in a patient previously operated for a hepatic cyst serves as an additional signal for detecting biliary cystadenoma. Rational strategy for surgical management of cystic liver lesions should include hepatectomy within healthy tissues (both anatomical and atypical) with mandatory intraoperative ultrasound and urgent histological examinations

Реалізація сценарного підходу в управлінні проектами на основі типових задач

The problems of communication between the functional units of the tasks and objectives of the project schedule are discussed. For businesses with a functional organizational structure there is proposed using the scenarios of projects on the basis of typical tasks that are defined by functional responsibilities units. Creation a repository of scripts and a repository of typical tasks has been proposed. The research presents the data processing scheme for the analysis of project implementation. The structure of the software project management scenarios using typical problems has been suggested. Fig.: 3. Refs: 10 titles.Рассмотрены вопросы связи между функциональными задачами подразделений и задачами план-графиков проектов. Предложено использование сценариев выполнения проектов на основе типовых задач, которые определяются функциональными обязанностями подразделений для предприятий с функциональной организационной структурой. Предложено создание репозитория сценариев и репозитория типовых задач. Представлена схема обработки данных для анализа состояния выполнения проектов. Предложена структура программного обеспечения управления проектами по сценариям с использованием типовых задач. Ил. 3. Библиогр.: 10 найм.Розглянуто питання зв’язку між функціональними задачами підрозділів і задачами план-графіків проектів. Запропоновано використання сценаріїв виконання проектів на основі типових задач, що визначаються функціональними обов’язками підрозділів для підприємств з функціональною організаційною структурою. Запропоновано створення репозиторію сценаріїв і репозиторію типових задач. Представлено схему обробки даних для аналізу стану виконання проектів. Запропоновано структуру програмного забезпечення управління проектами за сценаріями з використанням типових задач