UV stabilnost termokromne boje

Cilj ispitivanja je utvrditi utjecaj prirodnog zeolita klinoptilolita kao punila u papiru na UV stabilnost termokromne boje. Laboratorijski listovi pripremljeni su uz dodatak 20% punila (kalcijev karbonat i zeolit). Prirodni zeolit dodavan je kalcijevom karbonatu u različitim masenim udjelima (20 i 60%). Laboratorijski listovi pripremljeni su u skladu s ISO 5269-1. Za izradu otisaka korišten je laboratorijski uređaj IGT A2. Uzorci su bili izloženi procesu umjetnog starenja u komori za starenje Solarbox 1500e (CO.FO.ME.GRA) u različitim vremenskim intervalima tijekom 40 sati. (E,a*,b*,c*,L*) promjene ovisno o vremenu ubrzanog starenja vrlo su velike već nakon 1 sata. Najmanje (E,a*,b*,c*,L*) promjene dobivene su u uzorku s 20% klinoptilolita, a najveće u uzorku sa 60% klinoptilolita. Klinoptilolit kao punilo povoljno utječe na UV stabilnost termokromne boje u manjim koncentracijama, a u većim koncentracijama najvjerojatnije dolaze do izražaja fotokatalitička oksidacijska svojstva prisutnih Fe-oksida u uzorku prirodnog zeolita

Endocrinological outcomes of pure endoscopic transsphenoidal surgery: a Croatian Referral Pituitary Center experience

AIM: To analyze early remission, complications, and pituitary function recovery after pure endoscopic endonasal transsphenoidal surgery (PEETS), a novel method in pituitary adenoma treatment. ----- METHODS: Testing of all basal hormone values and magnetic resonance imaging (MRI) were performed preoperatively and postoperatively (postoperative MRI only in nonfunctioning adenomas) in 117 consecutive patients who underwent PEETS in the period between 2007 and 2010. The series consisted of 21 somatotroph adenomas, 61 prolactinomas, and 4 corticotroph and 31 nonfunctioning adenomas. Sixty-three were macroadenomas and 54 were microadenomas. Remission was defined as hormonal excess normalization on the seventh postoperative day in functioning adenomas and as normal MRI findings approximately four months postoperatively in nonfunctioning adenomas. The presence of hypogonadism, growth hormone deficiency, and hypothyroidism was assessed on the seventh postoperative day. Hypocortisolism was assessed through necessity for replacement therapy within 18 months postoperatively. ----- RESULTS: Remission was achieved in 84% of patients: in 100% of microadenoma and 70% of macroadenoma patients (P<0.001, odds ratio [OR], 28.16, 95% confidence interval [CI], 1.61-491.36), respectively. Endocrinological complications occurred in 17.1% of patients: in 9% of microadenoma and 24% of macroadenoma patients (P=0.049, OR, 3.06; 95% CI, 1.03-9.08). Duration of empirical hydrocortisone replacement therapy was significantly shorter in microadenoma patients (P<0.001). Thirty-five percent of preoperatively present hormonal deficiencies improved after the surgery. Between tumor types there were no significant differences in remission, complications, and normal pituitary function recovery. ----- CONCLUSION: Patients with microadenomas had higher remission and lower complication rates following PEETS, emphasizing the necessity for early detection and treatment of pituitary adenomas. PEETS is a discussion-worthy method for microprolactinoma treatment

Ksantogranulom selarnog područja u bolesnika sa sarkoidozom

Xanthogranuloma of the sellar region is a very rare brain tumor with favorable prognosis and without reported relapses of purely xanthogranulomatous lesion after complete resection. A case is presented of a 40-year-old male diagnosed with and treated for sarcoidosis,complaining of headache, photophobia and loss of libido. Physical examination revealed generally scarce hairiness, while laboratory investigations showed panhypopituitarism. Expansive sellar and suprasellar mass compressing the floor of the third ventricle and optical chiasm was confirmed by cranial multi-slice computerized tomography (MSCT). Complete resection of the tumor mass using trans-sphenoidal approach was performed. Histopathologic analysis revealed cholesterol clefts, sparse lymphoplasmacellular infiltrates, macrophages, siderophages and foreign body giant cells around cholesterol clefts confirming the diagnosis of xanthogranuloma of the sellar region. Since preoperative diagnosis of xanthogranuloma is very difficult, therapeutic algorithm does not differ from other expansive lesions of the sellar region, but pituitary involvement should always be considered inpatient with sarcoidosis since therapeutic management is non-surgical. Follow up MSCT imaging after 6 months revealed a solid, contrast-enhanced mass at the posterior base of the sella.Ksantogranulom selarnog područja je vrlo rijedak tumor mozga s povoljnom prognozom i bez opisanih recidiva čisto ksantogranulomatozne lezije nakon potpunog odstranjenja. Prikazuje se slučaj 40-godišnjeg bolesnika s dijagnosticiranom i liječenom sarkoidozom koji se tužio na glavobolju, fotofobiju i gubitak libida. Fizikalni pregled je pokazao oskudnu dlakavost, dok su laboratorijske pretrage otkrile panhipopituitarizam. Ekspanzivnu selarnu i supraselarnu tvorbu koja je pritiskala dno trećeg ventrikla i optičkog hijazma potvrdila je višeslojna kompjutorizirana tomografija (MSCT). Tumorska tvorba je odstranjena u potpunosti transsfenoidnim pristupom. Histopatološka analiza je pokazala nakupine kolesterola,rijetke infiltrate limfoplazmatskih stanica, makrofage, siderofage i divovske stanice stranog tijela oko nakupina kolesterola, potvrđujući dijagnozu ksantogranuloma selarnog područja. Kako je prijeoperacijsku dijagnozu ksantogranuloma vrlo teško postaviti, terapijski algoritam se ne razlikuje od onoga za druge ekspanzivne lezije selarnog područja, no zahvaćenost hipofize treba uvijek imati na umu u bolesnika sa sarkoidozom, jer je liječenje neoperacijsko. Kontrolni MSCT nakon 6 mjeseci pokazao je čvrstu, kontrastom pojačanu tvorbu na stražnjoj bazi sele

Contemporary trends in the surgical management of aortic valve disease

Introduction: Aortic valve pathology carries a high mortality burden. Its incidence is growing in proportion to the continuous ageing of the population. Surgery remains the gold standard in the treat- ment of severe aortic valve disease. Methods: We performed a retrospective analysis of the University Hospital Center Zagreb’s cardiac sur- gical database from 2009 to 2020, focusing on surgical aortic valve replacement (SAVR). We dichoto- mized patients with respect to the date of their surgical procedures into two eras. Group 1 included patients operated from 2009-2014, whereas Group 2 included patients operated on from 2015-2020. Results: A total of 1012 SAVRs were identified during the study period. The procedural volume over the two identical 6-year time periods increased in the latter era from 413 to 598. When comparing groups 1 and 2, we have observed in increase in the number of patients with diabetes (19% vs. 26%, P=0.015) and coronary artery disease (14% vs. 18%, P=0.099). The composite risk assessment score increased significantly from 3.0±2.4 to 3.2±2.7, P=0.023. Despite an increase in the comorbidity burden of the targeted patient population, the periprocedural mortality remained the same (2.1% vs 2.5%, P=0.835). The per-patient averaged volume of transfused packed red blood cells decreased from 839±954 to 614±821 ml, P<0.001. An increase in the proportion of tissue valve implantations in com- parison to mechanical prostheses was also noted in the present era (58% vs 68%, P=0.001) Conclusion: Despite an increasingly more complex patient population referred for SAVR in the con- temporary era, the results have remained excellent. The introduction of transcatheter methods should measure up to the surgical standard

Contemporary trends in the surgical management of aortic valve disease

Introduction: Aortic valve pathology carries a high mortality burden. Its incidence is growing in proportion to the continuous ageing of the population. Surgery remains the gold standard in the treat- ment of severe aortic valve disease. Methods: We performed a retrospective analysis of the University Hospital Center Zagreb’s cardiac sur- gical database from 2009 to 2020, focusing on surgical aortic valve replacement (SAVR). We dichoto- mized patients with respect to the date of their surgical procedures into two eras. Group 1 included patients operated from 2009-2014, whereas Group 2 included patients operated on from 2015-2020. Results: A total of 1012 SAVRs were identified during the study period. The procedural volume over the two identical 6-year time periods increased in the latter era from 413 to 598. When comparing groups 1 and 2, we have observed in increase in the number of patients with diabetes (19% vs. 26%, P=0.015) and coronary artery disease (14% vs. 18%, P=0.099). The composite risk assessment score increased significantly from 3.0±2.4 to 3.2±2.7, P=0.023. Despite an increase in the comorbidity burden of the targeted patient population, the periprocedural mortality remained the same (2.1% vs 2.5%, P=0.835). The per-patient averaged volume of transfused packed red blood cells decreased from 839±954 to 614±821 ml, P<0.001. An increase in the proportion of tissue valve implantations in com- parison to mechanical prostheses was also noted in the present era (58% vs 68%, P=0.001) Conclusion: Despite an increasingly more complex patient population referred for SAVR in the con- temporary era, the results have remained excellent. The introduction of transcatheter methods should measure up to the surgical standard

Hipopituitarizam uzrokovan metastazom supraglotičnog karcinoma larinksa u hipofizu: prikaz slučaja

Intracranial metastases from laryngeal carcinoma are rarely clinically diagnosed. To our knowledge, this is the first report of hypopituitarism due to pituitary metastasis from laryngeal carcinoma. We report on a 70-year-old man who had a supraglottic squamous cell carcinoma, which was resected surgically followed by local full dose radiation therapy. Four months later, he presented with a sudden onset of diplopia, syncope, headache, general malaise and loss of appetite. Magnetic resonance imaging of the brain revealed a tumorous process of the sellar region. Endocrinological tests disclosed the presence of hypopituitarism. The tumor was subtotally resected endoscopically via endonasal transsphenoidal approach. Histopathology of tumor specimens indicated squamous cell carcinoma. Tumors of the sellar and parasellar region as in the case presented may easily be confused with pituitary adenoma. Pituitary metastases should be considered on differential diagnosis of unusual pituitary tumors, especially in patients with as well as in those without a history of malignant disease.Intrakranijske metastaze karcinoma larinksa se rijetko dijagnosticiraju. Prema našim spoznajama, ovo je prvi zabilježeni slučaj hipopituitarizma uzrokovanog metastazom karcinoma larinksa u hipofizu. Prikazujemo slučaj muškarca u dobi od 70 godina kojemu je dijagnosticiran supraglotički planocelularni karcinom larinksa koji je kirurški uklonjen te je provedena lokalna radioterapija u punoj dozi. Četiri mjeseca kasnije javljaju se naglo nastale dvoslike, glavobolja, sinkopa, opća slabost i gubitak apetita. Učinjena je MR mozga te je otkriven tumorski proces selarne i paraselarne regije. Endokrinološkim testovima otkriveno je postojanje hipopituitarizma. Tumor je djelomice odstranjen endonazalnim transsfenoidnim pristupom. Patohistološki nalaz pokazao je planocelularni karcinom. Tumori selarne i paraselarne regije, kao u ovom slučaju, lako se zamijene za adenom hipofize. Metastaze u hipofizu bi trebalo razmotriti u diferencijalnoj dijagnozi neobičnih tumora hipofize, pogotovo u bolesnika s poviješću maligne bolesti, ali također i u onih bez nje

TECHNICAL-TECHNOLOGICAL CHARACTERISTICS AND APPLICATION OF CRANE IN TRANSHIPMENT PROCESS

Rad ne sadrži sažetak

TECHNICAL-TECHNOLOGICAL CHARACTERISTICS AND APPLICATION OF CRANE IN TRANSHIPMENT PROCESS

Rad ne sadrži sažetak

Surgical management of endoscopic colon perforation

Kolonoskopija služi kao zlatni standard za probir, dijagnostiku i kontroliranje bolesti debelog crijeva, npr. za karcinom debelog crijeva. Kolonoskopija, kao i svaki drugi pregled ili liječnička intervencija, ima svoje komplikacije, od kojih je najozbiljnija i najopasnija perforacija debelog crijeva koja može rezultirati značajnim morbiditetom i mortalitetom. Perforaciju debelog crijeva kolonoskopom treba što ranije otkriti i odmah početi liječiti. Postoje tri načina liječenja perforacije – endoskopsko, konzervativno i kirurško liječenje. Ako je perforacija kolona dijagnosticirana za vrijeme kolonoskopije može se liječiti endoskopski. U slučaju da je perforacija dijagnosticirana nakon kolonoskopije može se liječiti konzervativno ili kirurški. Kirurško liječenje podrazumijeva laparotomiju i laparoskopiju, koje mogu biti eksplorativne i terapijske. Neki smatraju da je eksplorativno kirurško liječenje bolje od konzervativnog jer odgađanje reparacije perforacije dovodi do većeg rizika za nastanak komplikacija perforacije. Postoje mnoge rasprave o tome koji način liječenja je najbolji jer je perforacija kolona kolonoskopom rijetka komplikacija (<1%), te zasebne institucije/bolnice nisu mogle prikupiti dovoljno podataka o liječenju perforacije debelog crijeva kolonoskopom da bi mogli donijeti strateški terapijski plan. World Society of Emergancy Surgery (WSES) je 2017. godine objavila rad u kojem su prikupljeni i obrađeni svi podaci iz radova koji su obrađivali perforacije debelog crijeva i njihovo liječenje, te su objavili smjernice o tome kako pristupiti pacijentima s perforacijom kolona uzrokovanom kolonoskopom.Colonoscopy is considered the gold standard in screening, diagnostics and follow-up of colon pathology, for example of colorectal cancer. Colonoscopy, as any other examination or medical procedure, has a risk of complications, of which colonic perforation is the most serious and the most dangerous and it can result in significant mobidity and mortality. Colonic perforation needs to be diagnosed early and treatment should be started immediately. There are three ways to manage colonic perforation – endoscopic, conservative and surgical treatment. If perforation is diagnosed during colonoscopy it can be managed endoscopically. In case perforation is diagnosed after colonoscopy conservative or surgical treatment is used. Surgical treatment includes laparotomy and laparoscopy, and it can be used for diagnostics or treatment. Some people believe that exploratory surgical treatment is better than conservative treatment because delaying the repair of perforation can lead to increased risk of developing complications of perforation. There are many discussions about which treatment is the best one because colonic perforation is a rare complication of colonoscopy (<1%) and because of that single institutions/hospitals were not able to collect enough information/data about the treatment of colonic perforation to develop a strategic therapeutic plan. The World Society of Emergancy Surgery (WSES) published a paper in 2017 in which they collected and processed all information and data about colonic perforation from other papers and thereafter published guidelines for the management of colonoscopy perforation