Nosna polipoza : dijagnoza i liječenje

Nosni je polip edematozno zadebljanje sluznice koje formira viseći proces na široj ili užoj peteljci. Najčešće je lokaliziran u gornjem dijelu nosa i oko otvora paranazalnih sinusa uz širenje u nosnu šupljinu. U slučaju većeg broja polipa govorimo o polipozi čije je obilježje poremećena funkcija nosa. Nosna polipoza je dio upalne reakcije koja zahvaća mukoznu membranu nosa, paranzalnih šupljina, a često i donjih dišnih putova. To su najčešći dobroćudni tumori u nosu i nalazimo ih u 1 do 4 % slučajeva u ukupnoj populaciji. Sve je veća učestalost pojave kroničnih upalnih bolesti dišnog puta, prije svega astme s kojom je nosna polipoza često udružena, pa je tako i učestalost pojavljivanja nosne polipoze sve veća. Konzervativno liječenje nosnih polipa usmjereno je na lokalnu ili sustavnu primjenu lijekova iz skupine steroida. Danas se smatra da ovaj način liječenja ima prednost u usporedbi s kirurškim. Funkcionalna endoskopska sinusna kirurgija drugi je oblik liječenja koji je u praksi zamijenio radikalnu kliničku kirurgiju. Kombinirano liječenje podrazumijeva primjenu steroida prije kirurškog zahvata, kao i nakon zahvata, u svrhu smanjenja vraćanja bolesti.A nasal polyp is an oedematous thickening of a mucous membrane that forms a suspension process in the broad or narrow stalk. It is usually localized in the upper part of the nose and around the opening of the paranasal sinuses with the expansion in the nasal cavity. In the case of a larger number of polyps we are talking about polyposis which is characterized by an impaired function of the nose. Nasal polyposis is a part of an inflammatory reaction that affects the mucous membrane of the nose, paranasal sinuses and often the lower respiratory tract. These are the most common benign tumors of the nose and they are found in 1 to 4 % of the total population. There is an increasing incidence of chronic inflammatory diseases of the airway, especially asthma which the nasal polyps are often associated with, and so the incidence of nasal polyposis is increasing, too. The conservative treatment of nasal polyps is focused on the local or systematic use of medication from the group of steroids. Today, it is considered that this kind of treatment has an advantage compared to a surgical treatment. Another form of treatment is a functional endoscopic sinus surgery and in practice it has replaced the radical clinical surgery. A combined treatment involves application of steroids prior to surgery and after surgery in order to reduce the recurrence of the disease

Nosna polipoza : dijagnoza i liječenje

Nosni je polip edematozno zadebljanje sluznice koje formira viseći proces na široj ili užoj peteljci. Najčešće je lokaliziran u gornjem dijelu nosa i oko otvora paranazalnih sinusa uz širenje u nosnu šupljinu. U slučaju većeg broja polipa govorimo o polipozi čije je obilježje poremećena funkcija nosa. Nosna polipoza je dio upalne reakcije koja zahvaća mukoznu membranu nosa, paranzalnih šupljina, a često i donjih dišnih putova. To su najčešći dobroćudni tumori u nosu i nalazimo ih u 1 do 4 % slučajeva u ukupnoj populaciji. Sve je veća učestalost pojave kroničnih upalnih bolesti dišnog puta, prije svega astme s kojom je nosna polipoza često udružena, pa je tako i učestalost pojavljivanja nosne polipoze sve veća. Konzervativno liječenje nosnih polipa usmjereno je na lokalnu ili sustavnu primjenu lijekova iz skupine steroida. Danas se smatra da ovaj način liječenja ima prednost u usporedbi s kirurškim. Funkcionalna endoskopska sinusna kirurgija drugi je oblik liječenja koji je u praksi zamijenio radikalnu kliničku kirurgiju. Kombinirano liječenje podrazumijeva primjenu steroida prije kirurškog zahvata, kao i nakon zahvata, u svrhu smanjenja vraćanja bolesti.A nasal polyp is an oedematous thickening of a mucous membrane that forms a suspension process in the broad or narrow stalk. It is usually localized in the upper part of the nose and around the opening of the paranasal sinuses with the expansion in the nasal cavity. In the case of a larger number of polyps we are talking about polyposis which is characterized by an impaired function of the nose. Nasal polyposis is a part of an inflammatory reaction that affects the mucous membrane of the nose, paranasal sinuses and often the lower respiratory tract. These are the most common benign tumors of the nose and they are found in 1 to 4 % of the total population. There is an increasing incidence of chronic inflammatory diseases of the airway, especially asthma which the nasal polyps are often associated with, and so the incidence of nasal polyposis is increasing, too. The conservative treatment of nasal polyps is focused on the local or systematic use of medication from the group of steroids. Today, it is considered that this kind of treatment has an advantage compared to a surgical treatment. Another form of treatment is a functional endoscopic sinus surgery and in practice it has replaced the radical clinical surgery. A combined treatment involves application of steroids prior to surgery and after surgery in order to reduce the recurrence of the disease

Analiza mikrostrukture zavarenog spoja aluminijeve legure EN AW-6060 (AIMgSi)

Kako bi se postigla visoka kvaliteta zavarenog spoja, osim ispravne metode, potrebno je poznavati utjecaje na materijal u spoju i usvojiti adekvatne parametre zavarivanja. Mnogi su čimbenici koji mogu utjecati na pojavu grešaka u izvedenom spoju, unatoč dobro postavljenim parametrima zavarivanja, a shodno tome definirane su i razne norme, odnosno pravila prema kojima se zavareni spojevi kontroliraju kako bi se sa sigurnošću mogli pustiti u primjenu. Ovaj rad bavi se analizom sučeljeno zavarenog spoja s ciljem ocjenjivanja kvalitete zavarenog spoja te utvrđivanja utjecaja parametara zavarivanja na istu. Zavareni spoj izveden je na cijevi debljine stjenke 5 mm, TIG postupkom, gdje je osnovni materijal EN AW-6060/T66 (AlMgSi), a dodatni materijal Al 5183 (AlMg4.5Mn0.7). Priprema uzorka za makroskopsku i mikroskopsku analizu izvršena je u nekoliko koraka, odnosno brušenjem, poliranjem te nagrizanjem radi jasnije analize mikrostrukture. Makroskopska analiza provedena je na optičkom stereomikroskopu, dok je za utvrđivanje mikrostrukture te mikrostrukturnih konstituenata korišten svjetlosni metalografski mikroskop. Za ocjenjivanje, odnosno procjenu kvalitete zavarenog spoja praćena je norma HRN EN ISO 17639 koja pokriva i makroskopsku i mikroskopsku analizu zavarenih spojeva. Analiza je pokazala znatnu količinu nepravilnosti te različitosti u mikrostrukturi spoja

Analiza mikrostrukture zavarenog spoja aluminijeve legure EN AW-6060 (AIMgSi)

Kako bi se postigla visoka kvaliteta zavarenog spoja, osim ispravne metode, potrebno je poznavati utjecaje na materijal u spoju i usvojiti adekvatne parametre zavarivanja. Mnogi su čimbenici koji mogu utjecati na pojavu grešaka u izvedenom spoju, unatoč dobro postavljenim parametrima zavarivanja, a shodno tome definirane su i razne norme, odnosno pravila prema kojima se zavareni spojevi kontroliraju kako bi se sa sigurnošću mogli pustiti u primjenu. Ovaj rad bavi se analizom sučeljeno zavarenog spoja s ciljem ocjenjivanja kvalitete zavarenog spoja te utvrđivanja utjecaja parametara zavarivanja na istu. Zavareni spoj izveden je na cijevi debljine stjenke 5 mm, TIG postupkom, gdje je osnovni materijal EN AW-6060/T66 (AlMgSi), a dodatni materijal Al 5183 (AlMg4.5Mn0.7). Priprema uzorka za makroskopsku i mikroskopsku analizu izvršena je u nekoliko koraka, odnosno brušenjem, poliranjem te nagrizanjem radi jasnije analize mikrostrukture. Makroskopska analiza provedena je na optičkom stereomikroskopu, dok je za utvrđivanje mikrostrukture te mikrostrukturnih konstituenata korišten svjetlosni metalografski mikroskop. Za ocjenjivanje, odnosno procjenu kvalitete zavarenog spoja praćena je norma HRN EN ISO 17639 koja pokriva i makroskopsku i mikroskopsku analizu zavarenih spojeva. Analiza je pokazala znatnu količinu nepravilnosti te različitosti u mikrostrukturi spoja

Descending necrotizing mediastinitis

Background: Descending necrotizing mediastinitis (DNM) is an acute, serious, septic disease which results from a complication of oropharyngeal infection. The disease requires a prompt diagnosis and radical surgical treatment to reduce high mortality (40%). The optimal form of mediastinal drainage remains controversial. The reason for publishing this report is both the fact that DNM is very rare and our experience preferring thoracotomy as an optimal approach to treating the disease. Case report. We reported a 34-years-old woman with DNM. The disease began as a peritonsillar abscess. After a bilateral double pleural drainage the disease worsened. In order to achieve radical mediastinal debridement and drainage, we carried out posterolateral right thoracotomy. We also had to perform left thoracotomy because of massive bleeding caused by septic erosion. There were no more reoperations. Conclusion. Aggressive surgical treatment, regardless the localization and the extent of changes is the key to success in the treatment of patients with necrotizing mediastinitis

Thoracic surgery in solving enormous elevation of the left hemidiaphragm

Background. Acquired elevation of the diaphragm is mostly the result of phrenic nerve paralysis, some of thoracic and abdominal patological states, and also some of neuromuscular diseases. Surgical treatment is rarely performed and is indicated when lung compression produces disabilitating dyspnea, and includes plication of diaphragm. The goal of this case report has been to show completely documented diagnostic procedures and surgical treatment one of rare pathological condition. Case report. A 62-year-old patient was admitted to our clinic because of surgical treatment of the enormous elevation of the left hemidiaphragm. After thoracotomy and plication of the bulging diaphragm, lung compression did not exist any more and mediastinum went back in the normal position. Conclusion. Elevation of the diaphragm rarely demands surgical correction. When it is complicated with lung compression and disabilitating dyspnea, surgical treatment has extremely useful functional effect

C-myc Expression in the Microvessels of Medulloblastoma

The increased expression of c-myc is related to neoplastic transformation and angiogenesis. Therefore, the assessment of expression of c-myc in endothelial cells and neovascularization could help to determine the biological behavior of the tumor. We analyzed neovascularization and c-myc expression in 36 medulloblastoma specimens. The results were shown by determining immunohistochemical staining index (ISI), the sum of staining intensity (SI) and the percentage of positive cells (PPC) in the blood vessels endothelium of the tumor. We also performed the microvessel count (MVC) in 10 high-power fields (400X) with the most prominent vascularization and expressed it as microvessel density per mm2 (MVD). C-myc immunostaining intensity index in blood vessel endothelium is grouped into four groups, 0 – no reaction, I – weak reaction (ISI = 1 or 2), II – moderate reaction (ISI = 3 or 4), III – strong reaction (ISI = 5 or 6). Statistically significant differences (p=0.0214) have been found between groups 0 and 1 compared to groups 2 and 3. A higher percentage of positive cells has been found in male patients than in female ones (p=0.0483). C-myc PPC 0 or 1 has on the average smaller density of blood vessels per mm2 than c-myc PPC 2 or 3, but the difference is not statistically significant. C-myc ISI 0 or 1 has, on the average, smaller density of blood vessels per mm2 than c-myc ISI 2 or 3, but the difference is not statistically significant.We concluded that c-myc staining intensity was associated with higher microvessels density

Mesoporous TiO2 nanostructures: A route to minimize Pt loading on titania photocatalysts for hydrogen production

Mesostructured TiO2 nanocrystals have been prepared using Pluronic F127 as the structure-directing agent. Platinum nanoparticles at different contents (0.1-1.0 wt%) have been photochemically deposited onto the mesoporous TiO2. TEM investigation of 0.2 wt% Pt/TiO2 calcined at 450 °C reveals that the TiO2 particles are quite uniform in size and shape with the particle sizes of TiO2 and Pt being 10 and 3 nm, respectively. The photocatalytic activities of the Pt loaded TiO2 have been assessed and compared with those of nonporous commercial Pt/TiO2-P25 by determining the rates and the photonic efficiencies of molecular hydrogen production from aqueous methanol solutions. The results show that the amount of hydrogen evolved on Pt/TiO2-450 at low Pt loading (0.2 wt%) is three times higher than that evolved on Pt/TiO2-P25 and twelve times higher than that evolved on Pt/TiO 2-350. Despite the BET surface area of the TiO2-450 photocatalyst being 3.5 times higher than that of TiO2-P25, a 60% smaller amount of the Pt co-catalyst is required to obtain the optimum photocatalytic hydrogen production activity. The reduced Pt loading on the mesoporous TiO2 will be important both from a commercial and an ecological point of view. © 2011 the Owner Societies

Treatment of nonalcoholic fatty liver disease

Nealkoholna masna bolest jetre (engl. nonalcoholic fatty liver disease; NAFLD) najčešća je kronična bolest jetre danas. Jedna je od manifestacija metaboličkog sindroma, uz dijabetes, inzulinsku rezistenciju, debljinu, hiperlipidemiju i hipertenziju. NAFLD je klinički sindrom koji obuhvaća jednostavnu steatozu, nealkoholni steatohepatitis, fibrozu i cirozu jetre te hepatocelularni karcinom. Za sada ne postoji optimalna terapija nealkoholne masne bolesti jetre, liječenje se temelji na promjeni načina života, dijeti i tjelesnoj aktivnosti. Lijekovi za smanjenje inzulinske rezistencije, vitamini E i D te blokatori renin-angiotenzinaldosteron sustava pokazuju obećavajuće rezultate u pristupu pacijentu s NAFLD-om, ali njihova dugoročna učinkovitost i sigurnost primjene još uvijek nije znanstveno utemeljena.Nonalcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease worldwide. NAFLD is a liver manifestation of metabolic syndrome, along with hypertension, diabetes, dyslipidemia and insulin resistance. Nonalcoholic steatohepatitis (NASH) is a progressive form of NAFLD, which often develops into liver cirrhosis and increases the risk of hepatocellular carcinoma. There is no optimal treatment for NAFLD and most treatment options are based on lifestyle changes, diet and physical activity. Medications that are reducing insulin resistance, vitamin E and D and renin-angiotensin-aldosterone system blockers have shown promising results, but their long-term effectiveness and safety remains to be established

Lost in Transition – The Island of Susak (1951–2001)

The isolated population of the Island of Susak was thoroughly studied by a multidisciplinary team of the Croatian Academy of Sciences and Arts in early 1950’s. Recently, a team of scientists revisited the island. This paper describes the main characteristics of the transition process during which a massive exodus occurred with 90% of the island’s population migrating to New Jersey, USA. We summarise the differences in lifestyle, economy, social structure and sense of identity between the historic (1950’s) and contemporary (2001) Susak population. We applied contemporary methods (analysis of microsatellite DNA polymorphisms) to investigate local myths about extreme levels of inbreeding and genetic homogeneity among the Susak islanders. Analysis of short-tandemrepeat (STR) loci showed that Susak displayed characteristics of a small homogeneous breeding isolate. The average heterozygosity was found to be low compared to outbred populations. The signature of a recent severe bottleneck could be detected. Analysis of 8 markers located on Xq13–21 in 71 individuals suggested extensive level of linkage disequilibrium (LD). A migrant study was designed to investigate the effects of large environmental changes (Susak vs. USA) and inbreeding (Susak vs. Croatian general population) on some biologically important quantitative traits, such as blood pressure and serum lipids. The results confirmed the positive correlation between inbreeding level and blood pressure that has been reported in the literature on several occasions. The last remnants of this traditional island community will soon be lost forever