18 research outputs found
Long-Term Outcomes after Surgery for Appendiceal Mucinous Tumours
No full text<b><i>Background:</i></b> Appendiceal mucinous tumour (AMT) is a very uncommon disease. We aimed to evaluate preoperative and postoperative characteristics as well as long-term outcomes of patients with appendiceal mucinous adenomas and peritoneal pseudomyxoma (PMP). <b><i>Methods:</i></b> A consecutive cohort of patients diagnosed with AMT were included in the study. Tumour recurrence and the development of PMP was diagnosed based on the patients' complaints, physical examination, imaging studies, and biopsy results. The calculation of survival rates was performed using the Kaplan-Meier method. <b><i>Results:</i></b> Between January 2003 and February 2013, 25 patients had AMT. 15 patients underwent appendectomy only (60%), 5 patients (20%) right hemicolectomy, 4 patients (16%) cytoreductive surgery (CRS) ± hyperthermic intraperitoneal chemotherapy (HIPEC), and 1 patient (4%) appendectomy with caecal resection. Another 2 patients underwent CRS and HIPEC 4 days and 3 years, respectively, following initial appendectomy. In the histopathologic examination, adenoma was diagnosed in 12 patients (48%); among these, low-grade PMP was found in 1 patient (4%). Low-grade appendiceal mucinous adenocarcinoma (AMCa) was diagnosed in 11 patients (44%); among these, low-grade PMP was found in seven cases (28%) and high-grade AMCa was diagnosed in 2 patients (8%). 2 of 8 PMP patients did not undergo CRS ± HIPEC because of comorbidities. The 5-year overall survival was 100% for the adenomas and 62% for PMP patients. <b><i>Conclusion:</i></b> AMT is a very rare entity with a considerably good outcome even in disseminated disease. CRS and HIPEC is a gold standard treatment for PMP with excellent prognosis. However, our results could still be improved in the future.</jats:p
Enterogenous cyst of the small bowel mesentery: a case report and review of the literature
No full text
Is acute appendicitis still misdiagnosed?
No full textThe optimal diagnostics and treatment of acute appendicitis continues to be a challenge. A false positive diagnosis of appendicitis may lead to an unnecessary operation, which has been appropriately termed negative appendectomy. The aim of our study was to identify the effectiveness of preoperative investigations in preventing negative appendectomy
Su kokia kavalerija Lietuva pasitiko kryžiuočius XIII amžiuje?
No full textThis article is dedicated to investigating the problems regarding the existence of Lithuanian cavalry in the 13th century as well as the identification of its type and its ability to counter the heavy cavalry of the West. Firstly, we analyze the validity of different opinions about the date when Lithuanians began to fight on horseback that are revealed in our historiography – that this had happened on the junction of the 13th and 14th centuries, on the second half of the 13th century, or long before the beginning of the Baltic crusade. We come to a conclusion that there is enough evidence to support the third opinion, oriented at pre-crusader times. Furthermore, we agree with the idea, soundly based in the description of the source, that these forces were light cavalry. In the second part of our article, we address attention to the peculiarity of the tactics employed by the previously mention cavalry forces: even being able to fight on horseback, these units would get out of their saddles and because of that were often mistaken for infantry. Even more, they would intentionally seek out areas unfavorable for cavalry forces (forests, for example), fighting on foot in these environments, because in those places the enemy was not capable of using anything to their advantage: big war horses, better armor, a close battle order, or lances. The article suggests that this battle method lets us determine, with more precision, the type of Lithuanian light cavalry, equating it to the better-known Irish hobelars who had served in England’s army. In the Teutonic Order’s state in Prussia, the equivalent of hobelars were the native “free” Prussians. Both these types of units rode small horses, fought equally well on horseback as well as on foot, and used javelins. In the last part, we argue on the possibilities of such light cavalry overcoming its heavier counterparts. According to the author of this paper, such possibilities would arise only occasionally – when knights were trapped in swamps in the forests or did some sort of tactical mistake. Eliminating this backwardness, the Lithuanian state had begun using heavy cavalry forces by the early 15th century.Straipsnis skirtas lietuvių kavalerijos egzistavimo XIII a., jos tipo identifikavimo ir gebėjimo pasipriešinti sunkiajai Vakarų kavalerijai klausimams. Pirmiausia analizuojamas lietuviškoje istoriografijoje išryškėjusių skirtingų nuomonių, nuo kada lietuviai pradėjo kautis raiti – tik XIII–XIV a. sandūroje, XIII a. antroje pusėje ar gerokai iki kovų su kryžiuočiais pradžios – patikimumas. Prieinama prie išvados, jog yra pakankamai įrodymų, liudijančių trečiojo, į ankstyviausią datą orientuoto varianto naudai. Taip pat pritariama minčiai, grįstai detaliu lietuvių raitelių veikimo aprašymu šaltinyje, kad tai buvo lengvoji kavalerija. Antroje straipsnio dalyje atkreipiamas dėmesys į minėtosios kavalerijos taktikos savotiškumą, dėl kurio ji dažnai buvo painiojama su pėstininkais – nors ir turėdami galimybę kautis ant žirgų, lietuvių kariai mūšiui dažnai nulipdavo nuo jų. Maža to – kautynių pėsčiomis raiteliams veikti nepalankioje vietovėje, pavyzdžiui, miške, buvo specialiai siekiama norint įveikti kryžiuočių sunkiąją kavaleriją, kuri tokiu atveju negalėdavo pasinaudoti nė vienu iš savo pranašumų – nei dideliais karo žirgais, nei geresne šarvuote, nei glausta rikiuote, nei lancomis. Straipsnyje teigiama, kad šitoks kovos būdas leidžia tiksliau nustatyti lietuviškos lengvosios kavalerijos tipą, prilyginant ją gerai žinomiems Airijos hobelarams, tarnavusiems Anglijos kariuomenėje. Vokiečių ordino valdomoje Prūsijoje hobelarų atitikmuo buvo prūsų „laisvieji“. Ir vieni, ir kiti jodinėjo mažais vietinės kilmės žirgais, kaudavosi raiti arba pėsti ir naudojo svaidomąsias ietis. Baigiamojoje dalyje aptariamos tokio tipo lengvosios kavalerijos galimybės įveikti sunkiąją. Jų, straipsnio autoriaus nuomone, atsirasdavo tik pasitaikius progai – užklupus riterius pelkėje arba miške, sugebėjus pasislėpti už užtvaros arba dėl taktinės priešo klaidos. Likviduodama atsilikimą Lietuvos valstybė iki XV a. pradžios sukūrė sunkiąją kavaleriją
Geneviêve. Sources and variants
No full textKiekviena literatūra, ypač dramaturgija, turi siužetų, prie kurių vis grįžtama ir grįžtama. Tokius likiminius siužetus kiekviena karta bando interpretuoti naujai – iš savo regos ir patyrimo taško. Kartais tolimų tautų didvyriai, kankiniai ir šventieji gana netikėtai aktualizuojami kitų tautų literatūrose, o juos vaizduojantys kūriniai lemtingai veikia jų literatūrą. Viena tokių asmenybių – šventoji Genovaitė iš Brabanto. Dramų apie ją galima rasti prancūzų, vokiečių, lenkų, latvių ir lietuvių, o gal ir dar kitų tautų literatūrose. Vienas veikalų, turėjusių bene daugiausia įtakos lietuvių teatro ir dramaturgijos formavimuisi, taip ir vadinamas – „Genovaitė“. Taip ji dažniausiai ir pristatoma – be autoriaus, kartais pažymint, kad tai vokiečių autoriaus Christofo von Schmidto (1768–1854) to paties pavadinimo didaktinės apysakos inscenizacija. Teatro istorikas Vytautas Maknys nurodo net šešias lietuvių autorių dramas tokiu pavadinimu: Jono Griniaus, Aleksandro Vitkausko, Gabrieliaus Landsbergio-Žemkalnio, Jono Marcinkaus-Tauronio, Motiejaus Gustaičio ir Antano Šmulkščio-Paparonio (rankraštis). Straipsnyje mėginama atsekti, iš kur kilo „Genovaitės“ siužetas ir koks buvo jo kelias į lietuvių literatūrąEvery literature, especially play writing, has recurrent plots, which resurface again and again. Such destiny plots are interpreted anew by each generation – looking at them from its own viewpoint and experience. Sometimes, heroes, martyrs, and saints from distant lands, quiet unexpectedly, gain relevance in literature of other nations, while works depicting them exert a critical influence on local literature. One of such figures is saint Genovaitė from Brabant. One can find plays about her written in French, German, Polish, Latvian, and Lithuanian, and maybe also in literary works of other nations. One of the works that decisively influenced the evolution of Lithuanian theatre and play writing went by eponymous name “Genovaitė”. This is how it is introduced most of the time: with no reference to the author, sometimes it is remarked that it is a staging of German author Christof von Schmidt’s (1768–1854) didactic short story. Theatre historian Vytautas Maknys points out six plays by Lithuanian authors with the same name: by Jonas Grinius, Aleksandras Vitkauskas, Gabrielius Landsbergis-Žemkalnis, Jonas Marcinkus-Tauronis, Motiejus Gustaitis, and Antanas Šmulkštys-Paparonis (a manuscript). The article seeks to retrace where did the plot of “Genovaitė” descend from and what path it covered before entering Lithuanian literature
One-Stage Operation for Cancer of the Left Colon with Bowel Obstruction: Do We Need On-Table Wash-Out of the Colon?
No full textLithuanian open air museum
No full textStraipsnyje apžvelgiama Liaudies buities muziejaus įkūrimo genezė. Muziejaus po atviru dangumi kūrimo idėja kilo dar XIX amžiuje. Muziejus turėjo aprėpti platų istorinį kontekstą – valstybingumo praradimą, spaudos draudimą, Rusijos imperijos vykdomą priverstinę Lietuvos gyventojų asimiliaciją ir pasipriešinimą jai. Puiki proga atkreipti pasaulio visuomenės dėmesį į Lietuvos problemas buvo dalyvavimas Pasaulinėje parodoje Paryžiuje 1900 metais. Paryžiaus parodos organizatoriai, siekdami išvengti tarptautinių prieštarų, neleido parodoje tiesmukos politinės veiklos. Lietuviška etnografine ekspozicija buvo siekta parodyti buvusią didžią valstybę su turtinga praeitimi, kuri dabar svetimųjų engiama, negali net melstis iš gimtąja kalba išleistų maldaknygių. Dėmesį turėjo atkreipti ne kuklūs, neišvaizdūs „kišeninio formato“ leidiniai, o valstietiškas interjeras su gausiais eksponatais. Dalyvavimas parodoje ne tik padarė įspūdį prancūzams, bet turėjo didelę reikšmę patiems lietuviams – parodos organizavimas ir žinia Lietuvoje apie parodą skatino lietuvių vienybę, tautinį sąmoningumą, suvokimą, kad tik vieningu darbu ir pasiaukojimu galima išsaugoti savo tautinę kultūrą. Ši ekspozija davė pradžią Mažosios Lietuvos muziejui Tilžėje (1905 m.) ir Rytų Prūsijoje (Kaliningradas, 1912 m.), taip pat sumanymui tokį muziejų įkurti Vilniuje. Karas sutrukdė įgyvendinį šį sumanymą. Apie muziejaus sukūrimą buvo daug kalbama, rašoma, ginčijamasi dėl vietos. Buvo renkama medžiaga. Lietuvos liaudies buities muziejus įkurtas tik 1966 metais. Ilgainiui jis tapo viena stambiausių paveldosaugos objektų saugykla ir edukacijos centru Lietuvoje. Reikšminiai žodžiai: Kultūros paveldas; Lietuvos istorija; Lietuvos kultūros istorija; Lietuvos liaudies buities muziejus; Cultural heritage; History of Lithuania; Lithuania; Lithuanian Culture history; Lithuanian Open Air Musieum; Open Air Folk Museum of LithuaniaThe article describes the origin of the Lithuanian open air museum creation beginning with a wide historical survey after losing the statehood and drawing the attention to the forcible assimilation of the Lithuanians by the Russian empire and resistance to it. The struggle for the restoration of the statehood lead to the World exhibition in Paris in 1900 where the attention was directed to the press ban, and Europe reacted to it. In order to soften that political moment in the Lithuanian stand there was used an Ethnographic exposition that gave rise to the Lithuanian Museum in Lithuania Minor (in Tilsit in 1905) and Eastern Prussia (in Köningsberg in 1912) and also to the intention to establish such a museum in Vilnius. However, the war stopped the establishment of the museum in Lithuania Magnus and it was resumed after the war (that ended in the territory of Lithuania in 1923). In 1930 the museum was opened in Kaunas, and the establishment of the museum of nations of the Great Duchy of Lithuania in the occupied by Poland Vilnius ended in talk. In 1966 the Lithuanian Open Air Museum was established. The author describes its development, creators and principles of exposition creation that became worthy of imitation to many museums in the former Soviet Union. In the museum everybody "could find his or her native land". Much attention is paid to the creation of a small town-museum and the sector of exile and resistance movement. The Museum represents the Lithuanian cultur
Aberrant pancreas adenocarcinoma in the stomach: A case report and literature review
No full textRationale: Aberrant pancreatic tissue in the gastrointestinal tract is a relatively common finding. However, malignant transformation is extremely rare. Herein, we report a case of ectopic pancreatic ductal adenocarcinoma in the stomach wall. Patient concerns: A 38 year old male presented with nausea, bloating, abdominal distention and weight loss for 4 months. Diagnoses: Endoscopy of upper gastrointestinal tract was performed twice with 2 months interval and a stenotic pyloric part was observed with a suspected submucosal lesion. It was sampled both times, however the pathology findings of the mucosal biopsies were unremarkable with no identifiable neoplastic structures. CT scan and MRI was performed and showed a thickened pyloric wall with a submucosal lesion 15 × 15 mm in diameter. Blood levels of tumor markers carcinoembrionic antigen and carbohydrate antigen 19-9 were within a normal range. Interventions: Pyloric stenosis progressed and the patient underwent a Billroth type I distal gastric resection with D2 lymphadenectomy. Pathologic examination revealed a well differentiated ductal adenocarcinoma arising in the heterotopic pancreatic tissue (Heinrich type III). The resection margins and lymph nodes were free of tumor. The patient received adjuvant chemotherapy with 6 courses of XELOX. Outcomes: No disease recurrence is reported in 12 months follow-up. Lessons: Aberrant pancreatic ductal adenocarcinoma in the stomach is a rare finding, however this pathology should be included in the differential diagnosis of gastric submucosal lesion causing pyloric stenosis. Abbreviations: AP = aberrant pancreas, CT = computed tomography, DEAP = the CT attenuation value of arterial phase minus that of unenhanced phase, EUS = endoscopic ultrasound, EUS-FNA = endoscopic ultrasound-guided fine-needle aspiration, FOLFOX = folinic acid, fluorouracil and oxaliplatin, GST = gastric stromal tumor, R0 = resection margin free of tumor, S-1 = tegafur, gimeracil and oteracil, T3N0M0 = the gastric tumor reaches subserosa, but does not penetrate the serosa, there is no spread to lymph nodes or distant metastasis, XELOX = capecitabine and oxaliplatin
Improved perioperative care is associated with improved long-term survival in colorectal cancer
No full text
