AIM： To distinguish anastomotic from parenchymal leakage at duct-to-mucosa reconstruction of the pancreatic remnant. METHODS： We reviewed the charts of 68 pancreaticoduodenectomies performed between 5/2000 and 12/20...AIM： To distinguish anastomotic from parenchymal leakage at duct-to-mucosa reconstruction of the pancreatic remnant. METHODS： We reviewed the charts of 68 pancreaticoduodenectomies performed between 5/2000 and 12/2005 with end-to-side duct-to-mucosa pancreatojejunostomy （PJ）. The results of pancreatography, as well as peripancreatic drain volumes, and amylase levels were analyzed. RESULTS： Of 68 pancreatojejunostomies, 48 had no leak by pancreatography and had low-drain amylase （normal）; eight had no pancreatographic leak but had elevated drain amylase （parenchymal leak）; and 12 had pancreatographic leak and elevated drain amylase （anastomotic leak）. Although drain volumes in the parenchymal leak group were significantly elevated at postoperative day （POD） 4, no difference was found at POD 7. Drain amylase level was not significantly different at POD 4. In contrast, at POD 7, the anastomotic-leak group had significantly elevated drain amylase level compared with normal and parenchymalleak groups （14158 ＋ 24083 IU/L vs 89 ＋ 139 IU/L and 1707 ＋ 1515 IU/L, respectively, P = 0.012）. CONCLUSION： For pancreatic remnant reconstruction after pancreaticoduodenectomy, a combination of pancreatogram and peripancreatic drain amylase levels can be used to distinguish between parenchymal and anastomotic leakage at pancreatic remnant reconstruction.展开更多
Nowadays, we face many obstacles connected with the high quality education. This sphere forces us to implement new methods and approaches in everyday learning process. The following academic research done on psycho-pe...Nowadays, we face many obstacles connected with the high quality education. This sphere forces us to implement new methods and approaches in everyday learning process. The following academic research done on psycho-pedagogical sphere in higher education showed that the enhancement in the educational system is developing slowly because of the lack of research. By all means, it is the right time to follow the objectives and try to develop and suggest the current teaching process using technology that of course will be based on the development of quality control and thesaurus-agency approaches. As mentioned in Bolkan and Goodboy, their research showed that teachers who promote intellectual stimulation empower and enrich students both cognitive and affective getting knowledge and experience process in the classroom. The main objective of current experiment is that it suggests intellectual stimulation which is linked to intrinsic motivation, and that intrinsic motivation has all the advantages to influence students＇ use of effective studying behaviors. According to Dunlosky, Marsh, Nathan, Willingham and Rawson, there are specific techniques which can influence on the overall process of higher education.展开更多
Current paper presents the influence of academic chess activity in Armenian schools. Nowadays, people face many obstacles connected with the high quality education. This sphere forces them to implement new methods and...Current paper presents the influence of academic chess activity in Armenian schools. Nowadays, people face many obstacles connected with the high quality education. This sphere forces them to implement new methods and approaches in everyday learning process. The following academic research done on research as a deliberate chess activity software testing platform for professional dynamic development of the education sector showed that the implementation of academic chess with low grade students may have positive effect. The experiment done in this paper is closely related to the inclusive education as well. Mainly this experiment showed that collaborative training or learning can be very positive when children with disabilities are integrated in the learning process.展开更多
文摘AIM： To distinguish anastomotic from parenchymal leakage at duct-to-mucosa reconstruction of the pancreatic remnant. METHODS： We reviewed the charts of 68 pancreaticoduodenectomies performed between 5/2000 and 12/2005 with end-to-side duct-to-mucosa pancreatojejunostomy （PJ）. The results of pancreatography, as well as peripancreatic drain volumes, and amylase levels were analyzed. RESULTS： Of 68 pancreatojejunostomies, 48 had no leak by pancreatography and had low-drain amylase （normal）; eight had no pancreatographic leak but had elevated drain amylase （parenchymal leak）; and 12 had pancreatographic leak and elevated drain amylase （anastomotic leak）. Although drain volumes in the parenchymal leak group were significantly elevated at postoperative day （POD） 4, no difference was found at POD 7. Drain amylase level was not significantly different at POD 4. In contrast, at POD 7, the anastomotic-leak group had significantly elevated drain amylase level compared with normal and parenchymalleak groups （14158 ＋ 24083 IU/L vs 89 ＋ 139 IU/L and 1707 ＋ 1515 IU/L, respectively, P = 0.012）. CONCLUSION： For pancreatic remnant reconstruction after pancreaticoduodenectomy, a combination of pancreatogram and peripancreatic drain amylase levels can be used to distinguish between parenchymal and anastomotic leakage at pancreatic remnant reconstruction.
文摘Nowadays, we face many obstacles connected with the high quality education. This sphere forces us to implement new methods and approaches in everyday learning process. The following academic research done on psycho-pedagogical sphere in higher education showed that the enhancement in the educational system is developing slowly because of the lack of research. By all means, it is the right time to follow the objectives and try to develop and suggest the current teaching process using technology that of course will be based on the development of quality control and thesaurus-agency approaches. As mentioned in Bolkan and Goodboy, their research showed that teachers who promote intellectual stimulation empower and enrich students both cognitive and affective getting knowledge and experience process in the classroom. The main objective of current experiment is that it suggests intellectual stimulation which is linked to intrinsic motivation, and that intrinsic motivation has all the advantages to influence students＇ use of effective studying behaviors. According to Dunlosky, Marsh, Nathan, Willingham and Rawson, there are specific techniques which can influence on the overall process of higher education.
文摘Current paper presents the influence of academic chess activity in Armenian schools. Nowadays, people face many obstacles connected with the high quality education. This sphere forces them to implement new methods and approaches in everyday learning process. The following academic research done on research as a deliberate chess activity software testing platform for professional dynamic development of the education sector showed that the implementation of academic chess with low grade students may have positive effect. The experiment done in this paper is closely related to the inclusive education as well. Mainly this experiment showed that collaborative training or learning can be very positive when children with disabilities are integrated in the learning process.
