O przemieniającym życie mroku postaci

On the darkness of the character that transforms lifeThe author analyses the relationship between the actor>s life and the character they create on stage. He points to the interdependencies between the actor and their role. He determines the conditions in which the role should be constructed and also discusses the on- and off-stage circumstances that determine the value of a particular role. This analysis is supported by the authors own experience as a theatre director.On the darkness of the character that transforms lifeThe author analyses the relationship between the actor>s life and the character they create on stage. He points to the interdependencies between the actor and their role. He determines the conditions in which the role should be constructed and also discusses the on- and off-stage circumstances that determine the value of a particular role. This analysis is supported by the authors own experience as a theatre director

An extension to the filtered-x LMS algorithm with logarithmic transformation

© 2015 IEEE. Active control of impulsive noise has been of increasing interest due to high impact of such noise on humans. The algorithm with logarithmic transformation, developed by Wu, et al. has been found particularly interesting. In this paper this idea is continued, and an extension to this algorithm is proposed to improve its convergence properties and allow for successful control if the noise has also another type of noise together with the impulses. A number of simulations are performed to validate the algorithm and compare it with algorithms leading in the literature. Additionally to simulated benchmark impulsive noises, real recordings are considered, which bring another insight into efficiency of the algorithms

Stent fracture after endovascular treatment patient with subclavian vein thrombosis – difficult diagnosis and complication of venous thoracic outlet syndrome

Subclavian vein thrombosis is relatively rare. It constitutes 4 to 10% of all cases of venous thrombosis and is often associated with compression or canniulation of the subclavian vein. We present the case of patient with Paget-Schroetter syndrome treated in our center for right subclavian vein thrombosis as a result of the venous thoracic outlet syndrome (VTOS). In the case described below, VTOS was unrecognized and the stent fracture following endovascular treatment led to a relapse of venous thrombosis. Secondary angioplasty and stenting with subclavian vein decompression was successfully made. The patient was regularly monitored throughout the following year and there was no relapse of clinical symptoms. Conclusions: in case of subclavian vein thrombosis decompression is a very important step in the management of VTOS. It prevents recurrence of thrombosis and potential complications

The outcomes of three-dimensional conformal radiotherapy for early-stage non-small-cell lung cancer patients eligible and ineligible for stereotactic body radiotherapy

Wstęp: Radioterapia stereotaktyczna (SBRT) daje obiecujące, porównywalne z leczeniem chirurgicznym, wyniki u chorych na niedrobnokomórkowego raka płuca (NDRP) we wczesnych stopniach zaawansowania. Jednak nie wszyscy chorzy z tej grupy kwalifikują się do tej metody leczenia. Dokonano retrospektywnej oceny wyników radioterapii konformalnej (3D-CRT) u chorych na NDRP w I i II stopniu zaawansowania, ze szczególnym uwzględnieniem wyników chorych, którzy byliby kandydatami do SBRT, lecz u których z braku dostępu do tej techniki zastosowano 3D-CRT. Materiał i metody: Oceniono kolejnych 132 chorych na NDRP (I&#8211;II stopień) napromienianych radykalnie techniką 3D-CRT w latach 1998&#8211;2009. Stosowano różne schematy napromieniania. W związku z tym dokonano przeliczenia dawek na dawki biologicznie równoważne (BED). W grupie tej 68 chorych spełniało kryteria napromieniania techniką SBRT (obwodowy guz T1&#8211;3N0, średnica &#163; 5 cm). Przeżycie całkowite i wolne od progresji miejscowej oszacowano metodą Kaplana-Meiera dla całej grupy oraz grupy spełniającej kryteria i niespełniającej kryteriów SBRT. Dokonano oceny czynników rokowniczych w analizie jedno- i wielowariantowej. Wyniki: Mediana BED w całej grupie wyniosła 74 Gy (58&#8211;82 Gy). Chorzy spełniający kryteria SBRT mieli mniejszą objętość guza niż pozostali (p < 0,00001). Trzyletnie przeżycie całkowite i przeżycie wolne od progresji miejscowej wyniosły odpowiednio 37% i 50%. Porównując grupy potencjalnie kwalifikujące się i niekwalifikujące się do SBRT, uzyskano znamienną statystycznie różnicę jedynie w 3-letnim przeżyciu bez progresji miejscowej (odpowiednio 58% i 35%, p = 0,04). W analizie wielowariantowej tylko objętość guza, stan ogólny i stopień zaawansowania miały statystycznie znamienny związek z miejscową wyleczalnością. Wnioski: Wykazano poprawę wyleczalności miejscowej po zastosowaniu techniki 3D-CRT w przypadku guzów spełniających kryteria kwalifikacji do SBRT w stosunku do pozostałych. Jednak również w tych przypadkach miejscowa wyleczalność była gorsza od podawanych w piśmiennictwie wyników SBRT. Pneumonol. Alergol. Pol. 2011; 79, 5: 326&#8211;336Introduction: Stereotactic body radiotherapy (SBRT) in early-stage non-small-cell lung cancer (NSCLC) results in promising outcomes, comparable with the outcomes of surgery. However, not all such patients are good candidates for this treatment. We conducted a retrospective evaluation of the outcomes of three-dimensional conformal radiotherapy (3D-CRT) in patients with stage I/II NSCLC with a special focus on the outcomes of patients who were eligible for SBRT but received 3D-CRT due to the unavailability of the former. Material and methods: We evaluated 132 consecutive patients with stage I/II NSCLC who had received radical 3D-CRT between 1998 and 2009. As various radiotherapy schedules had been used, biologically equivalent doses (BEDs) were calculated for all the patients. A total of 68 patients were eligible for SBRT (peripheral T1-3 N0 tumours < 5 cm in diameter). Overall survival (OS) and local progression free survival (LPFS) were estimated using Kaplan-Meier methodology for the entire study population and for the groups eligible and ineligible for SBRT. Univariate and multivariate analyses were performed for the prognostic factors. Results: Median BED in the study population was 74 Gy (58&#8211;82 Gy). Patients eligible for SBRT had a significantly lower gross tumour volume (GTV) than the other patients (p < 0.00001). Three-year OS and LPFS were 37% and 50%, respectively. When we compared patients eligible for SBRT and those ineligible for SBRT the only significant difference was for three-year LPFS (58% v. 35%, p = 0.04). Multivariate analysis showed that only GTV, performance status and tumour stage were significantly correlated with local curability. Conclusions: We showed an improved local control following 3D-CRT in patients eligible for SBRT compared to the other patients. However, also in these cases, local control was inferior compared to the outcomes of SBRT reported in the literature. Pneumonol. Alergol. Pol. 2011; 79, 5: 326&#8211;33

Peary caribou distribution within the Bathurst Island Complex relative to the boundary proposed for Qausuittuq National Park, Nunavut

How caribou (Rangifer tarandus), including Peary caribou (R. t. pearyi), use their annual ranges varies with changes in abundance. While fidelity to some seasonal ranges is persistent, use of other areas changes. Consequently, understanding changes in seasonal distribution is useful for designing boundaries of protected areas for caribou conservation. A case in point is the proposed Qausuittuq (Northern Bathurst Island) National Park for Bathurst Island and its satellite islands in the High Arctic of Canada. Since 1961, Peary caribou have been through three periods of high and low abundance. We examined caribou distribution and composition mapped during nine systematic aerial surveys (1961–2013), unsystematic helicopter surveys (1989–98), and limited radio-collaring from 1994–97 and 2003–06. While migration patterns changed and use of southern Bathurst Island decreased during lows in abundance, use of satellite islands, especially Cameron Island for winter range, persisted during both highs and lows in abundance. The northeast coast of Bathurst Island was used to a greater extent during the rut and during summer at low abundance. We suggest that Park boundaries which include Cameron Island and the northeast coast of Bathurst Island will be more effective in contributing to the persistence of Peary caribou on the Bathurst Island Complex

Coexistence of papillary thyroid cancer with Hashimoto thyroiditis

AIMS: Conflicting data have been reported with regard to Hashimoto thyroiditis (HT) and risk of malignancy. The aim of this study was to evaluate coexistence of papillary thyroid cancer (PTC) with HT. PATIENTS AND METHODS: This is a retrospective cohort study in which HT was diagnosed in 452 (F/M ratio = 405:47, median age 53.5 ± 12.1 years) of 7,545 patients qualified for thyroidectomy throughout the years 2002 to 2010. Pathological reports were reviewed to identify prevalence of PTC in HT vs. non-HT patients. RESULTS: PTC was diagnosed in 106 of 452 (23.5 %) HT patients vs. 530 of 7,093 (7.5 %) non-HT patients (p < 0.001). Metastases to level VI lymph nodes were observed in 81 of 106 (76.4 %) patients with PTC in HT vs. 121 of 530 (22.8 %) patients with PTC in non-HT disease (p < 0.001). CONCLUSIONS: HT was associated with a threefold increase of PTC prevalence as compared to other non-HT thyroid diseases, and the spread of PTC to level VI lymph nodes was four times more frequent in HT than in non-HT patients

Mięśniak komórkowy w więzadle szerokim macicy – opis sytuacji klinicznej i przegląd piśmiennictwa

Myomas are most often benign tumours of the female genital tract. Uterine fibroids are the most common myomas, while uterine cervix and intraligamentary ones are statistically less frequent. The most common histopathological form is the leiomyoma and the least common is the cellular leiomyoma (Mięśniaki są najczęstszymi łagodnymi guzami żeńskich narządów rozrodczych. Mięśniaki macicy rozpoznawalne są najczęściej podczas gdy mięśniaki szyjkowe i międzywięzadłowe występują statystycznie rzadziej. Najczęstszą formą histologiczną mięśniaków jest mięśniak gładkokomórkowy a najrzadziej rozpoznawalną

The use of cilostazol in intermittent claudication in patients with peripheral arterial disease

Chromanie przestankowe jest najczęstszym objawem choroby tętnic obwodowych (PAD). Wydłużenie dystansu wolnego od bólu uzyskuje się poprzez leczenie chirurgiczne, endowaskularne oraz odpowiednią farmakoterapię. Inhibitory fosfodiesterazy III (PDE) są grupą leków, które wykazują bardzo silny efekt antyagregacyjny. Oprócz tego mają działanie wazodylatacyjne, hipolipemizujące i antyproliferacyjne, co sprawia, że są przedmiotem licznych publikacji naukowych. Cilostazol jest najlepiej zbadanym inhibitorem PDE. Choć niepozbawiony działań niepożądanych, lek ma udowodniony wpływ na wydłużenie dystansu chromania przestankowego. W porównaniu z placebo i pentoksyfiliną istotnie wpływa na maksymalny dystans chromania (MWD) i dystans wolny od bólu (PWD). Ponadto skutecznie zapobiega restenozie po leczeniu endowaskularnym naczyń wieńcowych i obwodowych. Cilostazol może być także alternatywą w przypadku zjawiska oporności na tradycyjne leki przeciwpłytkowe. W wytycznych TASC II rekomenduje się stosowanie 3–6-miesięcznej terapii cilostazolem w celu złagodzenia objawów chromania przestankowego. Leczenie wymaga monitorowania i weryfikacji specjalisty.Intermittent claudication is the most frequent one symptom of peripheral arterial disease (PAD). Extending the distance free from pain is achieved by surgical treatment, endovascular and appropriate pharmaco­therapy. Phosphodiesterase III (PDE) are a group of drugs that have a very strong anti-aggregation effect. In addition, they have vasodilator activity, lipid-lowering and anti-proliferative what makes them the subject of numerous scientific publications. Cilostazol is the best studied PDE inhibitor. Though not devoid of side effects the drug has been shown to influence the extension of claudication distance. Compared to the placebo and pentoxifylline significantly affect the maximum claudication distance (MWD) and pain-free distance (PWD). In addition, effectively prevents restenosis after endovascular treatment of coronary and peripheral vessels. Cilostazol may also be an alternative in the case of the development of resistance to conventional anti-platelet agents. TASC II guidelines recommend the use of 3–6 months treatment with cilostazol in alleviating the symptoms of intermittent claudication. Treatment for monitoring and verification requires specialist