Ultrasonography revealed a renal tumour (4 x 4 cm) in a 67-year-old man with right-sided lumbar pain and macrohematuria. In addition he had marked nocturnal dyspnoea with dry cough. He had lost about 10 kg in weight. On admission he had atrial fibrillation with an irregular ventricular rate (140 beats/min) and engorgement of the neck veins. Two-dimensional echocardiography, undertaken because of signs of increasing heart failure and a fall of systolic blood pressure to below 100 mm Hg, demonstrated a space-occupying lesion in the right ventricle, 4 x 2 x 1 cm, indicating an intracardiac thrombus or solid tumour. The heart failure continued to worsen, despite treatment with cardiac glycosides, verapamil and diuretics. Hence an exploratory thoracotomy was performed. This revealed an intracardiac tumour which had markedly displaced the right ventricular inflow tract and infiltrated the entire myocardium, but not the tricuspid valve. As much of the tumour as possible was resected, but the patient died postoperatively of heart failure. The intracardiac tumour proved to be a metastasis from the papillary carcinoma of the kidney. This had infiltrated the renal capsule and pelvis and invaded the branches of the right renal vein.

Coping with uncertainties or ignorance in decision problems may lead to the idea that several scenarios can occur or that several sets of data can constitute a good representation of the reality. In consequence, numerous authors have focused on the robust aspect of these problems. In such a context, one can consider that a scenario (or a particular instance of the data) permits to partially qualify the solutions, just as a criterion does. In other words, the evaluation of a specific solution for a given scenario could be perceived as the evaluation of this solution according to one particular criterion. With this in mind, the applicability of classic multicriteria concepts to the robustness framework, in the context of optimization problems, is explored. We achieve this by studying their similarities and differences. The distinguishing characteristics bring us to introduce a new problematic: the multicriteria evaluation of robustness.

The performance of a rapid spiral chest CT scan during primary diagnosis and intensive care leads, in a high percentage of cases, to clinically relevant diagnoses. In particular, occult ventral (tension-) pneumothoraces and lung contusions have been found in one third of polytraumatized patients both initially and during the sequential course. Additional insertion of chest tubes has been observed to be the major consequence.

The performance of a rapid spiral chest CT scan during primary diagnosis and intensive care leads, in a high percentage of cases, to clinically relevant diagnoses. In particular, occult ventral (tension-) pneumothoraces and lung contusions have been found in one third of polytraumatized patients both initially and during the sequential course. Additional insertion of chest tubes has been observed to be the major consequence.

The performance of a rapid spiral chest CT scan during primary diagnosis and intensive care leads, in a high percentage of cases, to clinically relevant diagnoses. In particular, occult ventral (tension-) pneumothoraces and lung contusions have been found in one third of polytraumatized patients both initially and during the sequential course. Additional insertion of chest tubes has been observed to be the major consequence.

Wiercinski, A.; Marzi, I.; Risse, N.; Buurman, W; Rose, S.; Ziegenfu, Th.; Frank, J; Mutschler, W. Author Information

Ultrasonography revealed a renal tumour (4 x 4 cm) in a 67-year-old man with right-sided lumbar pain and macrohaematuria. In addition he had marked nocturnal dyspnoea with dry cough. He had lost about 10 kg in weight. On admission he had atrial fibrillation with an irregular ventricular rate (140 beats/min) and engorgement of the neck veins. Two-dimensional echocardiography, undertaken because of signs of increasing heart failure and a fall of systolic blood pressure to below 100 mm Hg, demonstrated a space-occupying lesion in the right ventricle, 4 x 2 x 1 cm, indicating an intracardiac thrombus or solid tumour. The heart failure continued to worsen, despite treatment with cardiac glycosides, verapamil and diuretics. Hence an exploratory thoracotomy was performed. This revealed an intracardiac tumour which had markedly displaced the right ventricular inflow tract and infiltrated the entire myocardium, but not the tricuspid valve. As much of the tumour as possible was resected, but the patient died postoperatively of heart failure. The intracardiac tumour proved to be a metastasis from the papillary carcinoma of the kidney. This had infiltrated the renal capsule and pelvis and invaded the branches of the right renal vein.

Ultrasonography revealed a renal tumour (4 x 4 cm) in a 67-year-old man with right-sided lumbar pain and macrohematuria. In addition he had marked nocturnal dyspnoea with dry cough. He had lost about 10 kg in weight. On admission he had atrial fibrillation with an irregular ventricular rate (140 beats/min) and engorgement of the neck veins. Two-dimensional echocardiography, undertaken because of signs of increasing heart failure and a fall of systolic blood pressure to below 100 mm Hg, demonstrated a space-occupying lesion in the right ventricle, 4 x 2 x 1 cm, indicating an intracardiac thrombus or solid tumour. The heart failure continued to worsen, despite treatment with cardiac glycosides, verapamil and diuretics. Hence an exploratory thoracotomy was performed. This revealed an intracardiac tumour which had markedly displaced the right ventricular inflow tract and infiltrated the entire myocardium, but not the tricuspid valve. As much of the tumour as possible was resected, but the patient died postoperatively of heart failure. The intracardiac tumour proved to be a metastasis from the papillary carcinoma of the kidney. This had infiltrated the renal capsule and pelvis and invaded the branches of the right renal vein.