Introduction. The present article considers the problem of readiness of young teachers to teach children with special educational needs in countries where the introduction of inclusive education began only in the last decade. The authors describe the key concepts of the theory of formation of professional skills and competences of teachers for working in inclusive education, based on which the results of research conducted in theCzechRepublic,Poland andRussia. The aim of this article is to compare the experience of young teachers in teaching children with special educational needs in relation to their skills and competences needed to perform this task. Methodology and research methods. Questionnaires and interviews were used to collect quantitative and qualitative data, which were eventually processed using basic statistics (quantitative survey) and the open-coding method (qualitative content). Results. The results of the study indicate both strong and weak aspects of the skills of young teachers in teaching students with special educational needs. In particular, a qualitative analysis of teachers’ responses revealed some interesting ideas that can be used in the search for improvements in teacher training, as well as in the support provided to teachers working with children with special educational needs directly in the school environment at the beginning of their professional careers. In general, it can be stated that young teachers in all three countries do not feel sufficiently qualified in terms of training to work with these children and are in need of expert support. Scientific novelty . The results of the current research allow for the determination of some priorities in teacher training for the modern development of inclusive education in the countries examined. Practical significance. The presented materials of the research can become the basis for developing a system of expert support for young teachers in the implementation of inclusive education, as well as new programs for preparing future teachers to work with pupils with special educational needs.
A total of 1511 patients were operated on at the 1st Department of Surgery Charles University in Prague during 1996 through 2000. Of this number, 81.3% underwent surgery for primary and 18.7% for recurrent inguinal hernia. Among the patients with recurrences, 81% had the first, 15% patients the second, and 4% at least the third episode of recurrent hernia. A total of 604 patients were operated on during 1999-2000, when a plug system (Bard Mesh Perfix Plug) was introduced into surgery protocols. Of this number, 113 patients had a recurrent hernia with an identical ratio of recurrences. The following plastic surgery interventions were carried out during the latter period: McVay-Lotheissen (54.2%), TAPP (26.5%), PHS (13.2%), Plug (3.3%), and Lichtenstein (2.6%). The following interventions were used when operating recurrences: McVay-Lotheissen (20.3%), TAPP (31%), PHS (21.2%), Plug (16.8%), and Lichtenstein (9.7%). During the 1-24-month follow-up period, recurrences occurred 1x after the TAPP procedure, 1x after McVay-Lotheissen, and 1x after the Lichtenstein procedure (95% and 88% patients who underwent plug and Lichtenstein procedures, respectively, were included in the follow-up). Comparison of plug vs. TAPP in patients with recurrent hernia (Plug/TAPP): mean age of patients: 62/45 years, length of operation: 66/48 minutes, overall post-operative morbidity: 9.4%/3.6%, hospitalization: 4.3/1.8 days, return to the working process 28 days (range 9-38 days) vs. 7.2 days (range 2-15 days). Both procedures can be considered safe and reliable interventions for treatment of recurrent inguinal hernia. They meet the requirements for elastic strength (more the plug procedure), closure, and bridging of defects even in several layers. The plug system can be implanted under local anaesthesia, it is capable of bridging large defects in a firm and elastic manner, and appears to be a very suitable solution for large defects in patients with advanced biological age. In these indications, the plug system brings many benefits but also the risk of more open access and greater "quantity" of materials. TAPP appears to be more suitable in younger patients with recurrences and large defects. We evaluate favourably in particular, all aspects of the postoperative period. An experienced team of surgeons is needed to achieve good results in both procedures.
Previous half of the century has influenced surgery not only by enormous progress of the knowledge in medicine, but namely in the last decade, by the introduction of mini-invasive operation techniques. Because of the highly effective conservation treatment, the spectrum of operations has been changed as well as the tactics and techniques of individual surgical procedures. Perspectives of surgery are in further specialization, introduction of one-day operations, and in the continuous development of mini-invasive operation techniques. The share of robots in the clinical praxis and in the training of surgeons is still difficult to forecast.
The authors describe the problematic of postsplenectomy complications. The main group of complications came in the group of haematological indication to splenectomy. The high risk of complications present the haematological malignancy. The most serious illness complications came only in this group.
Recently, a patient with an unusual pancreatic tumor of smooth muscle origin, presented at the First Surgical Clinic, Charles University Hospital, Prague. Leiomyosarcoma, a malignant smooth muscle tumor, may arise almost anywhere in the body. Pancreatic localization is very unusual. A number of authors have surveyed the literature on pancreatic tumors of mesenchymal origin. As many as fifty cases have been reported in autopsy studies since 1882. Only six operated cases of pancreatic sarcomas were found in surgical series.
In 1981-2000 at the IIIrd Medical Clinic 60 patients were treated with confirmed organic hyperinsulinism. A surgical operation was indicated in 51 patients. In 42 a localized tumour was removed, in one diffuse adenomatosis was involved. In three of the operated patients a malignant, enddocrinologically active insulinoma was confirmed. Two patients were re-operated on account of a relapse. The remaining 9 patients were treated conservatively from the onset. For localization of the tumour before operation US, CT and angiographic examinations were used. US and angiography were an asset in 25 patients (49%). In some instances we encountered however on angiography falsely positive findings. US was positive before surgery in 12 patients (23%), angiography in 21 (41%) and CT only in 2 (4%). The insulinoma was detected only on surgery in 14 patients (33%) of the operated insulinomas. The tumour was found in the head of the pancreas in 13 patients (31%), in the body of the pancreas in 14 (33%) and in the tail of the pancreas in 15 (36%). Surgery was successful in 82%, while the topographic preoperative examination aroused suspicion of a focus (i.e. insulinoma) only in 49% of the operated patients. A total of 17 patients (8 after surgery and 9 without surgery) were successfully treated with diazoxide, in 9 patients this treatment is still administered. According to the response to diazoxide insulinomas can be divided into "responsive" and "non-responsive" ones. Pharmacological treatment is therefore justified only in the first group of patients. Operated and pharmacologically treated patients have no signs of hyperinsulinism. Our experience indicates that a surgical approach is suitable when the diagnosis is unequivocal, even when there is a negative topographic finding of imaging methods as in 33% of the operated patients the insulinoma was detected only on operation.
The authors demonstrate analgetic effect on a group of 32 patients operated for pancreatic cancer pain after videothoracoscopic splanchnikectomy. The authors define adequate criteria for selection of splanchnikectomy.
