Differentiation of focal hepatic lesions in MR imaging with the use of combined quantitative and qualitative analysis

Background: To evaluate the efficacy of the protocol of combined quantitative-qualitative analysis for the differentiation of focal hepatic lesions. Material/Methods: The study group included 168 patients with 292 hepatic lesions confirmed by histology (n =138) or follow-up (n =154). Lesions were divided into: benign lesions treated conservatively (group A, 120 lesions), malignant tumors and benign lesions treated surgically (group B, 172 lesions). MR imaging (1.5-T) consisted of sequences: T2 double-echo TSE, T2 STIR, T1 GRE and of dynamic study. During the first part of differentiation process, quantitative analysis, based on lesions T2 relaxation times (derived from T2 double-echo TSE sequence), was performed in order to discriminate non-solid lesions (hemangiomas, cysts, abscesses; n = 88) from solid tumors (n = 204). Subsequently, all tumors defined as solid underwent qualitative evaluation based on visual assessment of lesions signal intensities in all sequences and patterns of their contrast enhancement. The aim of this part of analysis was to discriminate benign lesions (FNH and focal fatty infiltration) from other solid tumors. The remaining tumors were characterized as group B lesions. Results: Statistically significant difference between mean T2 relaxation time of solid tumors (84.1 ms) and non-solid lesions (250.5 ms) was noted, allowing diagnosis of solid tumors with sensitivity of 96% and specificity of 93% (at the threshold of 116 ms). Overall 202 lesions were defined as solid (196 true positive, 8 false negative, 6 false positive results). Qualitative analysis of these lesions was performed allowing correct characterization of all 7 focal fatty infiltrations and 21 of 24 FNH. Six lesions were falsely diagnosed as FNH. Remaining 168 lesions were defined as group B lesions. Both parts of differentiation protocol yielded sensitivity and specificity of 92%, allowing correct characterization of 158 of 172 group B lesions. Fourteen false negative and 10 false positive results (3 FNH, 1 focal inflammation, 6 hemangiomas) were obtained. Conclusions: Combined protocol of quantitative and qualitative analysis enabled discrimination of group B lesions (malignant tumors and benign lesions treated surgically) with high sensitivity and specificity of 92%

Ocena przydatności hepatotropowego środka kontrastowego Teslascan (Mn-DPDP) w wykrywaniu zmian ogniskowych w wątrobie

Background: The purpose of our study was to evaluate the usefulness of the hepatotropic contrast agent Teslascan (Mn-DPDP) in the detection of focal hepatic lesions. Material/Methods: A prospective study was performed in 24 patients (12 men, 12 women) with 82 confirmed focal hepatic lesions, in whom the hepatotropic contrast agent Mn-DPDP (Teslascan) was administered. The examinations were performed on a 1.5T unit (Philips Gyroscan). The sensitivity of hepatic lesions detection were compared in T2W, TSE, T2W STIR, T1W GRE, and T1W GRE sequences, 15-30 minutes after intravenous administration of Mn-DPDP. Results: In T2W TSE sequences 64 focal lesions were detected (sensitivity 78%); in T2W STIR sequences, 70 lesions (sensitivity 85%); in T1W GRE sequences, 65 lesions (sensitivity 79%); in T1W GRE sequences after Mn-DPDP administration, 77 lesions (sensitivity 94%). The combined sensitivity of evaluation using all the sequences obtained before Mn-DPDP administration (T2W TSE, T2W STIR, T1W GRE) was 88%. Conclusions: MR examination with the use of MN-DPDP yielded higher sensitivity in hepatic lesion detection compared to unenhanced T2W TSE, T2W STIR and T1W GRE sequences

Metastatic tumors of pancreas — whether and when surgical intervention is gainful for diseased people. Retrospective analysis of data from three surgery centers

Introduction. Metastatic tumors in the pancreas constitute a small (2–5%), but steadily growing percentage of all neoplasms of this organ. The aim of the study was to analyze the surgical treatment of metastases in the pancreas, in particular its effectiveness and the risk of surgical complications. Material and methods. The retrospective analysis was performed on 21 patients treated surgically in three surgical centers. This group included 16 women (76%) and 5 men (24%). The median age at the time of diagnosis of the underlying disease was 55.5 years (41–71). We analyzed the location of secondary lesions, their size, number, type and radicality of surgical intervention, histopathological diagnosis of the disease, as well as the occurrence of postoperative complications. Results. The starting point for metastatic lesions in 16 patients (76%) was renal cell carcinoma (RCC), in other cases — skin melanoma, eyeball melanoma, adenocarcinoma of the rectum, non-small-cell bronchi carcinoma. R0 radical surgery was performed in 15 patients (74%) and perioperative mortality was 5% (1 patient died). The median total survival time was 151 months (10–342), with 168 months for RCC (25–344) and 62 months for the remaining cancers (10–241). Conclusions. The main factor that determines the patient’s future fate is the type of primary neoplasm and surgical treatment of metastatic tumors in the pancreas is the best solution for selected RCC cases

RECENT RESEARCH IN VLSI, MEMS AND POWER DEVICES WITH PRACTICAL APPLICATION TO THE ITER AND DREAM PROJECTS

Several MEMS (Micro Electro-Mechanical Systems) devices have been analysed and simulated. The new proposed model of SiC MPS (Merged PIN-Schottky) diodes is in full agreement with the real MPS devices. The real size DLL (Dynamic Lattice Liquid) simulator as well as the research on modelling and simulation of modern VLSI devices with practical applications have been presented. In the basis of experience in the field of ATCA (Advanced Telecommunications Computing Architecture) based systems a proof-of-concept DAQ (data acquisition) system for ITER (International Thermonuclear Experimental Reactor) have been proposed

Guzy przerzutowe trzustki — czy i kiedy leczenie operacyjne jest korzystne dla chorego. Analiza retrospektywna materiału trzech ośrodków chirurgicznych

Wstęp. Guzy przerzutowe trzustki stanowią niewielki (2–5%), ale stale rosnący, odsetek wszystkich nowotworów tego narządu. Celem pracy była analiza leczenia operacyjnego przerzutów nowotworowych do trzustki, w szczególności jego skuteczności i ryzyka powikłań chirurgicznych. Materiał i metody. Analizie retrospektywnej poddano 21 chorych leczonych operacyjnie w trzech ośrodkach chirurgicznych. W tej grupie znajdowało się 16 kobiet (76%) i 5 mężczyzn (24%). Mediana wieku chorych w chwili rozpoznania choroby podstawowej wyniosła 55,5 roku (41–71). Przeanalizowano lokalizację zmian wtórnych, ich wielkość, liczbę, typ oraz radykalność interwencji chirurgicznej, rozpoznanie histopatologiczne choroby, a także wystąpienie powikłań pooperacyjnych. Wyniki. Punktem wyjścia zmian przerzutowych u 16 chorych (76%) był rak nerkowokomórkowy nerki (renal cel carcinoma, RCC), w pozostałych przypadkach — czerniak skóry, czerniak gałki ocznej, rak gruczołowy odbytnicy, rak niedrobnokomórkowy oskrzela. Operację o radykalności R0 udało się wykonać u 15 chorych (74%), a śmiertelność okołooperacyjna wynosiła 5% (zmarł 1 chory). Mediana całkowitego czasu przeżycia wynosiła 151 miesięcy (10–342), przy czym dla RCC było to 168 miesięcy (25–344), a dla pozostałych nowotworów 62 miesiące (10–241). Wnioski. Głównym czynnikiem, który determinuje dalszy los chorego, jest rodzaj nowotworu pierwotnego, a leczenie operacyjne guzów przerzutowych trzustki jest najlepszym rozwiązaniem dla wyselekcjonowanych przypadków RCC

Społeczne i ekologiczne aspekty zarządzania

Praca recenzowana / peer-reviewed pape

CONDITIONS FOR THE DEVELOPMENT OF TECHNICAL THINKING IN THE LEARNING PROCESS

The technique comes in almost all areas of human life, tying a person inextricably, which requires a change in the concept of the practice of thinking and acting. Thus, forcing a man to actively explore new technologies, equipments, machines, tools and use them in everyday life. It is important that this knowledge is structured, grounded and connected not only with practical action, but with technical thinking, which will allow for the proper functioning of the students in their daily lives. Technical thinking has a conceptually-imaginative nature, and its development is possible when we provide innovative thinking and creative teachers, pay attention to the selection of appropriate tasks and practical actions