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Traian Dumitrascu,Andra Scarlat,Mihnea Ionescu,Irinel Popescu 한국간담췌외과학회 2017 Annals of hepato-biliary-pancreatic surgery Vol.21 No.2
Backgrounds/Aims: Standard pancreatic resections are the current approach for patients with resectable, isolated pancreatic metastases of other neoplasms. However, the role of parenchyma-sparing pancreatectomies for such pathology is poorly investigated. The aim of the present study is to assess the oncological safety of central pancreatectomies for pancreatic metastases of other neoplasms. Methods: A literature search was performed in order to identify patients with central pancreatectomies for pancreatic metastases of other neoplasms. The available data of the patients were extracted and analyzed. Results: A total number of 16 patients were identified. Renal carcinoma was the primary origin for the largest number of these patients (11 patients - 69%). The mean overall survival time was 109 months, with 1-, 5- and 10-year survival rates of 100%, 84%, and 60%, respectively. Conclusions: Although not often performed, a central pancreatectomy appears to be an oncologically safe surgical procedure in select patients with pancreatic metastases of other neoplasms of the pancreatic body and isthmus. However, no definitive conclusions should be drawn, based on the data provided in the present study, due to the limited number and heterogeneity of the patients.
Martiniuc, Alexandru,Dumitrascu, Traian,Ionescu, Mihnea,Tudor, Stefan,Lacatus, Monica,Herlea, Vlad,Vasilescu, Catalin The Korean Gastric Cancer Association 2021 Journal of gastric cancer Vol.21 No.1
Purpose: Incidence, risk factors, and clinical consequences of pancreatic fistula (POPF) after D1+/D2 radical gastrectomy have not been well investigated in Western patients, particularly those from Eastern Europe. Materials and Methods: A total of 358 D1+/D2 radical gastrectomies were performed by surgeons with high caseloads in a single surgical center from 2002 to 2017. A retrospective analysis of data that were prospectively gathered in an electronic database was performed. POPF was defined and graded according to the International Study Group for Pancreatic Surgery (ISGPS) criteria. Uni- and multivariate analyses were performed to identify potential predictors of POPF. Additionally, the impact of POPF on early complications and long-term outcomes were investigated. Results: POPF was observed in 20 patients (5.6%), according to the updated ISGPS grading system. Cardiovascular comorbidities emerged as the single independent predictor of POPF formation (risk ratio, 3.051; 95% confidence interval, 1.161-8.019; P=0.024). POPF occurrence was associated with statistically significant increased rates of postoperative hemorrhage requiring re-laparotomy (P=0.029), anastomotic leak (P=0.002), 90-day mortality (P=0.036), and prolonged hospital stay (P<0.001). The long-term survival of patients with gastric adenocarcinoma was not affected by POPF (P=0.661). Conclusions: In this large series of Eastern European patients, the clinically relevant rate of POPF after D1+/D2 radical gastrectomy was low. The presence of co-existing cardiovascular disease favored the occurrence of POPF and was associated with an increased risk of postoperative bleeding, anastomotic leak, 90-day mortality, and prolonged hospital stay. POPF was not found to affect the long-term survival of patients with gastric adenocarcinoma.
( Ji-eun Lee ),( Gabriela Dumitrascu ) 한국수학교육학회 2017 初等 數學敎育 Vol.20 No.2
본 연구는 수학교수에서 중요도가 높은 관행들(High-leverage Teaching Practices [HLPs])에 대해 예비교사들이 스스로 자각하고 있는 준비도를 조사하였다. 미국 중서부에 위치한 대학에서 수학교육방법론을 수강하고 있는 81명의 예비초등교사들이 HLPs에 대한 자신감 및 능력에 대한 자가응답을 요하는 설문조사에 참여하였다. 특히 이 연구는 예비교사들이 자각하고 있는 HLPs에 대한 준비도와 수학교사교육자들이 예측하고 있는 교사교육 진행과정에 대한 비교 연구를 하였다. 연구 결과는 예비교사들과 수학교사교육자들이 HLPs의 복잡성에 대해 상당히 다른 견해를 보이고 있음을 제시하고 있다. 본 연구는 교사교육 프로그램들이 각각의 수학교수관행을 세분화하여 고찰할 수 있는 구체적인 기회를 예비교사들에게 제공할 것을 제안한다.
Pseudoaneurysm of the splenic artery
Radu Dumitru,Ana Carbunaru,Mugur Grasu,Mihai Toma,Mihnea Ionescu,Traian Dumitrascu 한국간담췌외과학회 2016 Annals of hepato-biliary-pancreatic surgery Vol.20 No.4
Delayed post-pancreatectomy hemorrhage (PPH) is a relatively uncommon, but feared, complication after pancreaticoduodenectomy (PD). A splenic artery pseudoaneurysm is a rare cause of delayed PPH after a PD. This paper describes the case of a patient with PD used to treat a distal bile duct cholangiocarcinoma complicated with a clinically significant pancreatic fistula and secondary intraabdominal abscess. Computed tomography-guided drainage of the abscess was performed with an apparently favourable outcome; the patient was discharged on postoperative day (POD) 35 and the abdominal drains were removed on POD 50. On POD 80, the patient was readmitted for a severe digestive hemorrhage. Computed tomography revealed a pseudoaneurysm of the splenic artery with a subsequent hematoma formation. Immediately, an angiography was performed and coils were successfully mounted. This case illustrates the rare possibility of the development of a splenic artery pseudoaneurysm with severe delayed PPH after PD complicated with a clinically significant pancreatic fistula, even after the patient was discharged from the hospital. An interventional radiology approach represents the first treatment option in hemodynamically stable patients with high success rates.