Tomáš Skalický

Optimization of the Model of Abdominal Aortic Aneurysm – Experiment in an Animal Model

Background: Many studies have been performed in order to model abdominal aortic aneurysm (AAA) in an experimental animal, most commonly in small laboratory animals. In our study, we tried to find the best AAA model in a pig by using various mechanical and enzymatic mechanisms. Methods: Twenty-two pigs were operated on. We combined 3 mechanisms of creating an AAA, using an intraluminal infusion of porcine pancreatic elastase into the abdominal aortic segment, application of plastic cuff below the renal arteries causing turbulent blood flow, and inserting a patch into the longitudinal aortotomy. Results: We found different results in different groups according to the mechanisms used. In group A, with a combination of the intraluminal elastase infusion and application of a stenosing cuff, AAA developed in all 7 animals (100%). In this group, we also found the largest histological changes in the abdominal aorta samples. Conclusion: The use of intraluminal pancreatic elastase infusion, together with increased turbulent flow caused by the stenosing cuff, seems to be the best model of AAA in pigs. This model is suitable for further research in the etiopathology of AAA. In fact, it is the first successful approach to a large-caliber native aneurysm model.Background: Many studies have been performed in order to model abdominal aortic aneurysm (AAA) in an experimental animal, most commonly in small laboratory animals. In our study, we

FlowOpt: bridging the gap between optimization technology and manufacturing planners

FlowOpt is an integrated collection of tools for workflow optimization in production environments. It was developed as a demonstration of advancements in the areas of modeling and optimization with the focus on simplifying the usage of the technology for end customers. The system consists of several interconnected modules. First, the user visually models a workflow describing the production of some item. Then the user specifies which items and how many of them should be produced (order management) and the system automatically generates a production schedule. This schedule is then visualized in the form of a Gantt chart where the user can arbitrarily modify the schedule. Finally, the system can analyze the schedule and suggest some improvements such as buying a new machine. Constraint satisfaction technology is the solving engine behind these modules.

Solid Pseudopapillary Tumor of the Pancreas – Rare Neoplastic Disease in 20-Year-Old Woman

INTRODUCTION Benign cystic tumors represent only 2% of all pancreatic tumors (pancreatic cancer - PC). In contrast to malignant cystic tumors, these tumors occur typically in young women. A solid pseudopapillary tumor is a relatively rare affliction representing less than 4% of cystic PC. Although the tumor is considered benign, metastasis, especially to the spleen, has been reported in approximately 0.5-4% patients. Despite R0 resection, vascular and perineural invasion is monitored in 20% of cases. Invasion is the cause of tumor relapse in up to one third of affected patients. Characteristic features of the disease are latent clinical indicators such as signs of pain and malfunction of intestinal passage. The diagnostics is based on MR, sometimes in combination with positron emission tomography. Medical treatment is specifically surgical. CASE HISTORY Authors present a case of a 20-year-old female patient who was examined due to pain in the epigastrium, further exasperated by a voluminous expansion of the abdominal cavity. An initial ultra-sonographic examination was conducted to examine for possible nodular focal nodular hyperplasia of the liver; however, an MRI scan revealed the likelihood of a malignant tumor in the subhepatic region. During laparotomy, a tumor protruding from the head of the pancreas was discovered and removed. Histological examination showed it was a solid pseudopapillary pancreatic tumor. After a month of good post-operative progress, the patient was re-operated because of the presence of pancreatic fistula. Complete healing of the fistula was achieved after total parenteral nutrition and administration of sandostatin. At her last examination, the patient was without any problems. CONCLUSION Solid pseudopapillary pancreatic tumors are rare, mainly benign lesions. It is essential to consider them in the differential diagnostics of afflictions of the subhepatic region, especially in young women. The only generally accepted cure nowadays is surgical resection. It is necessary to monitor patients consistently considering the rather high frequency of relapse of disease despite R0 resections. In the case of surgical removal, the 5-year survival rate is near 97%. Key words: solid pseudopapillary tumor of pancreas - diagnostics - therapy The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 17. 4. 2018 Accepted: 13. 8. 2018.

The Influence of Palliative Chemotherapy on the Quality of Life of Patients with Gastric Cancer

BACKGROUND Gastric cancer is a malignant disease with a poor prognosis. The incidence of gastric cancer in the Czech Republic in 2013 was 14.34 cases per 100,000 citizens. Unfortunately, most patients are dia-gnosed with advanced stage disease and therefore undergo palliative treatment. Some patients undergo surgery and a very small percentage undergo palliative chemotherapy. The five year survival rate for those with advanced gastric cancer ranges from 5-15%. METHODS This is a prospective study of patients undergoing chemotherapy for advanced gastric cancer. The aim was to assess the quality of life of those undergoing chemotherapy. RESULTS The results showed that chemotherapy reduced the quality of life for these patients. DISCUSSION Although palliative chemotherapy prolonged time to progression, it had little impact on overall survival. Conversely, chemotherapy reduced quality of life. Thus, clinicians and patients must decide whether to begin palliative chemotherapy. The final decision should be made by the patient after discussion with the treating clinician. CONCLUSION Treatment of patients with gastric cancer must be undertaken on an individual basis. Those undergoing palliative treatment must play an active role in the decision process regarding chemotherapy and assess the potential benefits and drawbacks. Because chemotherapy treatment has a detrimental effect on quality of life, the decision should be based on factors that predict the likely therapeutic effect of chemotherapy. A definitive decision can then be made as to whether chemotherapy is indicated. KEY WORDS gastric cancer - palliative chemotherapy - chemotherapy - quality of life - WHOQOL-BREFThis study was supported by grant of Internal Grant Agency of the Czech Ministry of Health No. NS14227-3.The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 10. 1. 2016Accepted: 8. 6. 2016.