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Background/Aim: Locally advanced pancreatic cancer has been considered for a long period of time as an unresectable lesion and therefore, all patients have been traditionally addressed to the oncological services for palliative purposes. However, due to the wide usage of newer oncological agents in association with improved surgical techniques, radical surgical procedures became feasible. The aim of this study was to present the different surgical procedures that were performed in locally advanced pancreatic cancer patients in order to achieve radical resections. Patients and Methods: Between 2019 and 2020, six cases were submitted to pancreatic and vascular resections in Fundeni Clinical Hospital. Results: In all cases, surgery with curative intent was attempted; portal vein resection was performed in five cases, whereas arterial resection was performed in three cases. Reconstruction was performed by direct re-anastomosis, by placing cadaveric or synthetic grafts. The postoperative outcomes were favourable in all cases. Conclusion: Vascular resections can be safely associated with pancreatic resections in cases presenting locally advanced pancreatic lesions, with acceptable morbidity rates.

Background/Aim: Locally advanced liver tumours with vascular invasion have been considered for a long period of time as unresectable lesions, so the patient was further deferred to oncology services for palliation. However, improvement of the surgical techniques and the results reported so far came to demonstrate that extended hepatic and vascular resections might be safely performed in such cases and might significantly improve the long-term outcomes. Materials and Methods: A 61-year-old patient was diagnosed with a caudate lobe tumour invading the inferior cava vein and the right hepatic pedicle. Results: The patient was successfully submitted to surgery, and an extended right hepatectomy en bloc with cava vein resection was performed; the continuity of the cava vein was re-established by the placement of a synthetic graft. The postoperative outcome was uneventful. Conclusions: Although initially considered as a formal contraindication for resection, vascular invasion of the greater vessels should not preclude surgery if complete resection is achievable.

Retroperitoneal sarcomas often require complex surgical procedures in order to achieve complete resection; in such cases both vascular and visceral resections are needed. When it comes to the need for vascular reconstruction, the type of graft as well as the type of reconstructive process are chosen according to the length and location of the resected segment. Meanwhile, depending on the location of the resected segment, other vascular reconstructions may be needed such as the reimplantation of the renal veins. However, in certain cases, this reimplantation is not mandatory, an adequate renal outflow being reported through the collateral network at this level. We present the case of a 43-year-old patient diagnosed with a large retroperitoneal sarcoma originating from the cava vein invading the right kidney. Resection of the tumor was performed en bloc with caval resection and right nephrectomy, without reimplantation of the left renal vein at the level of the graft. Extended visceral and vascular resections might be needed in order to achieve complete resection of inferior cava vein sarcomas; re-implantation of the left renal vein being not mandatory if rich collateral circulation is present.

Background/aim Pancreatic cancer is still associated with poor survival rates due to the fact that it is most often diagnosed at advanced stages of the disease when local invasion is present. However, improvements of surgical techniques have enabled extended resections with curative intent. We present the case of a 43-year-old patient diagnosed with locally invasive pancreatic adenocarcinoma invading the portal vein and the common hepatic artery. Case report Surgery with curative intent consisting of pancreatoduodenectomy en bloc with hepatic artery resection and portal vein resection was successfully performed. The right hepatic artery was further anastomosed with the remaining common hepatic artery while the left hepatic artery was reconstructed using a reversed splenic artery patch. The continuity of the portal vein was re-established by placing a synthetic prosthesis. Conclusion Combined arterial and venous resections might be useful in order to achieve a good local control of disease in patients with locally advanced pancreatic cancer.

Gastrointestinal stromal tumors (GIST�sare the most common mesenchymal neoplasms of the alimentary tract. Angiogenesis is an essential condition in the growth and development of tumors, especially in the case of GISTs due to their particular behavior. The aggressive behavior depends on the size and site of the tumor in close relationship with the intratumoral vascular development. The purpose of this study is to investigate, using immunohistochemical stainings, the types of intratumoral vessels in GIST�s, knowing the interrelation between the tumor angiogenesis and the response to the targeted antivascular therapy, influencing directly the prognosis. In our research, in all 37 cases the most numerous vessels were the immature and intermediate ones, signaling an increased angiogenic activity. The perivascular cell free vessels are the most sensitive at antivascular therapy with tyrosine kinase receptor inhibitors, providing a good response and prognosis to the treatment. Immature vessels evaluation especially, could be a an important sign in assessment of the effectiveness of antivascular therapy in GIST.

Background/Aim: Locally advanced pancreatic body tumors invading the celiac axis and the portal vein have been considered since long as unresectable lesions; however, due to improvement of surgical techniques, in certain cases surgery with curative intent might be taken in consideration. Case Report: We present the case of a 48-year-old female investigated for epigastric pain that was diagnosed with a locally invasive pancreatic body tumor. The patient was submitted to computed tomography which revealed the presence of a locally advanced pancreatic tumor with no demarcation line with the celiac axis and the portal vein. The endoscopic ultrasound raised the suspicion of malignancy and retrieved a biopsy which demonstrated the presence of a pancreatic adenocarcinoma. The patient was submitted to surgery, distal pancreatectomy en bloc with splenectomy, celiac axis and portal vein resection was performed; the hepatic artery was reconstructed by placing a cadaveric graft while the portal vein was sutured per primam by an end to end anastomosis. The postoperative outcome was favorable, and the patient was discharged in the 10(th )postoperative day. Conclusion: Multiple vascular resections followed by reconstructions might be needed in order to achieve resection with negative margins in patients with pancreatic body tumors.

The alarming number of children who spend most of their free time in front of the computer has forced pediatric societies around the world to trigger an alarm about the time children spend in front of their screens as well as the content they interact with. of children's technology can trigger a number of serious health problems. A social issue of great importance is the development of children under the premature use of technology. It analyzes the relationships that are established between children and technology, the potential harmful factors that may occur during primary socialization, as well as the parents' view of this phenomenon.

Right hepatic artery aneurysms are rare events that might remain asymptomatic for a long period of time. However, in cases presenting large lesions, symptoms might develop especially due to the association of compression of the surrounding elements. Most often these symptoms and signs include diffuse abdominal pain, jaundice or portal vein compression signs. In rare cases life-threatening complications might develop due to the aneurysmal erosion of the biliary duct, portal vein or due to the aneurysmal rupture in the peritoneal cavity. In all these cases emergency surgery is imposed. We present the case of a 66-year-old patient diagnosed with a partially thrombosed right hepatic artery aneurysm compressing the common bile duct who was initially submitted to a percutaneous arterial embolization of the aneurysm in association with an external biliary drainage; three weeks later the patient presented a fulminant upper gastrointestinal bleeding exteriorized through the external biliary drainage, hematemesis and hematochezia. The patient was successfully submitted to surgery, intraoperatively a synchronous rupture of the portal vein being revealed. The right hepatic artery aneurysm was resected en bloc with common bile duct resection and segmental portal vein resection. The continuity of the portal vein was re-established through the interposition of a cadaveric allograft, the common bile duct was anastomosed with en Roux en Y limb while the right hepatic artery aneurysm was ligated and resected, the arterial vascularization of the liver being provided by the left hepatic artery.

The occurrence of hepatic artery aneurysms is rare and might be incidentally diagnosed, as the patient remains asymptomatic for a long period of time. However, due to the fact that these lesions are associated with a high risk of developing life threatening complications, such as intraperitoneal rupture, it has been stated that all cases should be submitted to treatment by endovascular or surgical approach. We present the case of a 68-year-old patient, who presented with recurrent upper digestive tract bleedings and was diagnosed with a large aneurysm of the common and the proper hepatic artery, and the gastroduodenal artery. The preoperative angiography revealed an anatomic variation consisting of the common hepatic artery originating from the celiac trunk, and the left hepatic artery originating from the left gastric artery. A percutaneous right portal vein embolization was performed in order to induce hypertrophy of the left lobe and prepare the patient for a right hepatectomy and aneurysmal resection. However, at the time of surgery, after performing the aneurysmal resection and arterial ligation, the vascular supply of the entire liver was efficiently provided by the left hepatic artery and its collaterals. Concluding, hepatic resection was no longer necessary.

This paper presents a mechatronic solution for monitoring the crops vegetation status. A data acquisition system containing different types of sensors (multispectral, temperature, plant height, GPS) is placed on a terrestrial mechatronic platform that is carried by a tractor or on an UAV (Unmanned Aerial Vehicle). The multispectral sensor offers information about the reflectance, for discrete wavelengths, necessary to compute the so called vegetation indices. They are correlated with the degree of development and plant health, thermal and water stress, pests, fertilizer need and so on. Knowing these information, a timely intervention is possible, allowing to supply water, pesticide and fertilizer in the proper quantity, at the proper time and in the precise place, leading to major economic impact and significant environmental protection. Geographical information are used for geo-referencing the acquired data, so that the thematic maps to be generated.

This paper proposes an analysis of spectral monitoring processes of the crop vegetation status. In terms of the extensive implementation of precision agriculture, the performant agricultural management must ensure the monitoring of crop vegetation. In this context, determination and interpretation of vegetation indices, based on spectral data, plays a very important role. The performed research revealed the characteristics of monitoring the status of vegetation in order to obtain the necessary information, ie structure, actions and performances required to achieve an efficient system of monitoring the state of vegetation resources and to obtain the application maps for a precision crop management.precision crop management. This complex system ensures data acquisition and processing, thematic and application maps realization and decision generating on obtaining large productions and quality, on optimizing the economic profits, achieving of an integrated environmental protection and increasing of the sustainability of agricultural systems.

The occurrence of hepatic artery aneurysms is rare and might be incidentally diagnosed, as the patient remains asymptomatic for a long period of time. However, due to the fact that these lesions are associated with a high risk of developing life threatening complications, such as intraperitoneal rupture, it has been stated that all cases should be submitted to treatment by endovascular or surgical approach. We present the case of a 68-year-old patient, who presented with recurrent upper digestive tract bleedings and was diagnosed with a large aneurysm of the common and the proper hepatic artery, and the gastroduodenal artery. The preoperative angiography revealed an anatomic variation consisting of the common hepatic artery originating from the celiac trunk, and the left hepatic artery originating from the left gastric artery. A percutaneous right portal vein embolization was performed in order to induce hypertrophy of the left lobe and prepare the patient for a right hepatectomy and aneurysmal resection. However, at the time of surgery, after performing the aneurysmal resection and arterial ligation, the vascular supply of the entire liver was efficiently provided by the left hepatic artery and its collaterals. Concluding, hepatic resection was no longer necessary.

Ex-situ liver surgery refers to complex liver resections involving hepatic vascular exclusion and a warm ischemia time (WIT) of more than 90 minutes that allows liver resection and vascular reconstruction in patients with giant liver tumours with a difficult approach . Ante-situm liver resections, otherwise called "œex-situ in-vivo" resections is achieved through externalization of the liver outside of the abdominal cavity by clamping and sectioning of the efferent pedicles (suprahepatic veins) ("ex situ") without cutting the afferent vascular pedicle ("in vivo"), thus leaving the hepatic pedicle intact. We present a case report of a 36 yo male patient diagnosed by MRI scan with giant liver tumor in the left hemiliver. A left "ex-situ in-vivo" hepatectomy was performed by dissecting and ligating the left and middle hepatic veins, clamping and sectioning the right hepatic vein, Pringle maneuver, externalization of the liver followed by the tumor resection and right hepatic vein reimplantation. The short warm ischemia time (hepatic resection + liver reimplantation - 30 minutes) allowed us to perform the procedure without installing a veno-venous or porto-caval shunt otherwise used in all of ex-situ procedures described in the literature reviewed in this presentation. Ex-situ liver resection is a viable procedure for giant liver tumours in highly selected cases. It facilitates resection of large liver tumours that would be otherwise unresectable, extending the indications of surgical treatment.

This paper deals with the dynamic optimization of the dual-axis tracking mechanism, which is used for increasing the energetic efficiency of a photovoltaic module, by maximizing the rate of incident solar radiation. The study is based on the optimal design algorithm included in the commercial MBS (Multi-Body Systems) software solution ADAMS, through the parameterization of the virtual model, which offers the possibility to perform a series of studies aiming at identifying the design parameters that decisively influence the dynamic behavior of the tracking systems. The global coordinates of the design points (i.e. the mounting points of the actuating sources) are defined as design variables for the optimization process, while the design objectives refer to the power consumptions of the actuating sources.

The paper deals with the modeling and simulation in virtual prototyping environment of a mechatronic solar tracker used for photovoltaic systems, with the aim to increase the energetic efficiency, by maximizing the rate of incoming incident solar radiation. The solar tracker in study is an equatorial dual-axis mechanism, which allows the adjustment of the diurnal and seasonal angles of the PV module in accordance with a predefined tracking program, the actuating sources being linear actuators. The modeling and simulation of the tracking system is carried out by using the MBS (Multi-Body System) commercial software solution ADAMS (Automatic Dynamic Analysis of the Mechanical Systems).

Pancreatic cancer is one of the most lethal malignancies and is associated with a very poor overall survival. However, it seems that the only curative option remains an aggressive surgical approach capable of obtaining a radical resection. Unfortunately, this desiderate is even harder to be obtained when it comes to pancreatic tumors with vascular invasion.We present the case of a 65-year-old patient who was diagnosed with a cephalopancreatic tumor invading both the portal vein and the superior mesenteric artery.Whipple procedure was performed with portal and superior mesenteric artery resection; the continuity of the portal vein was established by an end-to-end anastomosis, while the superior mesenteric artery was re-implanted in the infra-renal aorta.Due to improvements of surgical techniques and postoperative management, the postoperative morbidity and early mortality significantly decreased and enabled the surgeon to perform ultra-radical surgery with better outcome.