Surgical treatment of oral cavity carcinoma

Karcinom usne šupljine maligni je tumor epitelnog podrijetla. Najčešće se pojavljuje kod osoba koje puše cigarete i konzumiraju alkoholna pića. Karcinom se može pojaviti na bilo kojem dijelu usne šupljine, ali najčešće je zahvaćeno dno usne šupljine i ventralna površina jezika. Metastazira primarno limfogeno u regionalne limfne čvorove vrata. O postojanju regionalnih metastaza, ali i veličini (T stadij) i sublokalizaciji primarnog tumora unutar usne šupljine ovisi i metoda kirurškog liječenja. Cilj ovog retrospektivnog istraživanja bilo je utvrditi pojavnost, sublokalizaciju tumora, stadij proširenosti bolesti i metodu izbora u liječenju karcinoma usne šupljine. Istraživanje je obuhvatilo 1097 bolesnika sa histološki verificiranim planocelularnim karcinomom usne šupljine koji su liječeni u Klinici za kirurgiju lica, čeljusti i usta Kliničke bolnice Dubrava u razdoblju od 20 godina. Prema rezultatima ovog istraživanja, karcinom usne šupljine se javlja češće u muškaraca nego u žena (5:1), najčešća sublokalizacija tumora je dno usne šupljine. Karcinom se najčešće dijagnosticirao u T2 stadiju, a intraoralna ekscizija je najčešća metoda liječenja.Oral cavity squamous cell carcinoma (OCSCC) is a malignant tumour of epithelial descent. The tumour appears most frequently with people who smoke cigarettes and drink alcoholic beverages. Oral cavity squamous cell carcinoma can appear anywhere in the oral cavity, but the most common sublocalizations are the floor of the mouth and the ventral surface of the tongue. The major metastatic path for squamous cell carcinoma is the one to the cervical nodes. We choose the type of surgical treatment depending on the existence of regional metastases and the size (T stage) and the sublocalization of primary tumour. The aim of our retrospective study was to determine the incidence, sublocalization, TNM classification and the method of treatment of the oral cavity carcinoma. The study included 1097 patients with squamous cell carcinoma of the oral cavity who were treated on the Department of Maxillofacial Surgery, University Hospital Dubrava during the period of 20 years. The results have shown that the OCSCC is more common in males than in females (5:1), with the most common sublocalization being the floor of the mouth. The carcinoma was most evident and therefore most commonly diagnosed in the T2 stage, and the surgical treatment that was generally used was the intraoral excision

Surgical treatment of oral cavity carcinoma

Karcinom usne šupljine maligni je tumor epitelnog podrijetla. Najčešće se pojavljuje kod osoba koje puše cigarete i konzumiraju alkoholna pića. Karcinom se može pojaviti na bilo kojem dijelu usne šupljine, ali najčešće je zahvaćeno dno usne šupljine i ventralna površina jezika. Metastazira primarno limfogeno u regionalne limfne čvorove vrata. O postojanju regionalnih metastaza, ali i veličini (T stadij) i sublokalizaciji primarnog tumora unutar usne šupljine ovisi i metoda kirurškog liječenja. Cilj ovog retrospektivnog istraživanja bilo je utvrditi pojavnost, sublokalizaciju tumora, stadij proširenosti bolesti i metodu izbora u liječenju karcinoma usne šupljine. Istraživanje je obuhvatilo 1097 bolesnika sa histološki verificiranim planocelularnim karcinomom usne šupljine koji su liječeni u Klinici za kirurgiju lica, čeljusti i usta Kliničke bolnice Dubrava u razdoblju od 20 godina. Prema rezultatima ovog istraživanja, karcinom usne šupljine se javlja češće u muškaraca nego u žena (5:1), najčešća sublokalizacija tumora je dno usne šupljine. Karcinom se najčešće dijagnosticirao u T2 stadiju, a intraoralna ekscizija je najčešća metoda liječenja.Oral cavity squamous cell carcinoma (OCSCC) is a malignant tumour of epithelial descent. The tumour appears most frequently with people who smoke cigarettes and drink alcoholic beverages. Oral cavity squamous cell carcinoma can appear anywhere in the oral cavity, but the most common sublocalizations are the floor of the mouth and the ventral surface of the tongue. The major metastatic path for squamous cell carcinoma is the one to the cervical nodes. We choose the type of surgical treatment depending on the existence of regional metastases and the size (T stage) and the sublocalization of primary tumour. The aim of our retrospective study was to determine the incidence, sublocalization, TNM classification and the method of treatment of the oral cavity carcinoma. The study included 1097 patients with squamous cell carcinoma of the oral cavity who were treated on the Department of Maxillofacial Surgery, University Hospital Dubrava during the period of 20 years. The results have shown that the OCSCC is more common in males than in females (5:1), with the most common sublocalization being the floor of the mouth. The carcinoma was most evident and therefore most commonly diagnosed in the T2 stage, and the surgical treatment that was generally used was the intraoral excision

Sigurnost i učinkovitost robotom potpomognute stereotaksijske biopsije gliomskih tumora mozga: rana institucijska iskustva i vrednovanje literature

Robot-assisted brain tumor biopsy is becoming one of the most important innovative technologies in neurosurgical practice. The idea behind its engagement is to advance the safety and efficacy of the biopsy procedure, which is much in demand when planning the management of endocranial tumor pathology. Herein, we provide our earliest institutional experiences in utilizing this mesmerizing technology. Cranial robotic device was employed for stereotactic robot-assisted brain glioma biopsy in three consecutive patients from our series: an anaplastic isocitrate dehydrogenase (IDH) negative astrocytoma (WHO grade III) located in the right trigone region of the periventricular white matter; a low grade diffuse astrocytoma (WHO grade II) of bilateral thalamic region spreading into the right mesencephalic area; and an IDH-wildtype glioblastoma (WHO grade IV) of the right frontal lobe producing a contralateral midline shifting. Robot-assisted tumor biopsy was successfully performed to get tissue samples for histopathologic and immunohistochemical analysis. The adjacent tissue iatrogenic damage of the eloquent cortical areas was minimal, while the immediate postoperative recovery was satisfactory in all patients. In conclusion, considering the preliminary results of our early experiences, robot-assisted tumor biopsy was proven to be a feasible and accurate procedure when surgery for brain glioma was not an option. It may increase safety and precision, without expanding surgical time, being similarly effective when compared to standard stereotactic and manual biopsy. Using this method to provide accurate sampling for histopathologic and immunohistochemical analysis is a safe and easy way to determine management strategies and outcome of different types of brain glioma.Robotom potpomognuta tumorska biopsija postaje jednom od najvažnijih inovativnih tehnologija u neurokirurškom radu. Razlog njezine uporabe nalazi se u daljnjem poboljšanju sigurnosti, učinkovitosti i preciznosti biopsijske metode koja je osobito značajna u planiranju opskrbe endokranijske tumorske patologije. Ovim radom donosimo prva institucijska iskustva u primjeni ove začudne tehnologije pri biopsiji gliomskih tumora mozga. Kranijski robotički uređaj korišten je pri stereotaksijskoj robotom potpomognutoj tumorskoj biopsiji u tri susljedna slučaja iz naše serije, koja je uspješno učinjena radi uzimanja uzorka tumorskoga tkiva za patohistološku i imunohistokemijsku dijagnostiku u bolesnice s anaplastičkim izocitrat dehidrogenaza (IDH) negativnim astrocitomom (SZO st. III.) smještenim u periventrukulskoj bijeloj tvari desnoga trigonuma, u bolesnika s difuznim astrocitomom niskoga stupnja malignosti (SZO st. II.) smještenim obostrano u talamičkom području sa širenjem u desni mezencefalon, kao i u bolesnika s IDH-wildtype glioblastomom (SZO st. IV.) desnog čeonog režnja s pomakom središnjih tvorba. Jatrogena lezija pripadajućeg elokventnog moždanog korteksa bila je minimalna, dok je neposredni poslijeoperacijski oporavak bio uspješan u svih bolesnika. Uzimajući u obzir preliminarne rezultate našega početnog iskustva, zaključujemo kako je robotom potpomognuta tumorska biopsija dokazano izvodljiva i primjerena metoda u kirurgiji gliomskih tumora mozga kojom se može poboljšati sigurnost i preciznost bez produljenja vremena operacije, a koja je podjednako učinkovita u usporedbi sa standardnom stereotaksijskom i manualnom biopsijom. Uporaba navedene metode omogućuje precizno uzorkovanje tumorskoga tkiva za patohistološku i imunohistokemijsku analizu na siguran i lak način, što doprinosi odabiru strategije liječenja i predviđanju ishoda različitih tipova gliomskih tumora mozga

Strategije u prevenciji komplikacija kirurškog liječenja gliomskih tumora mozga: analiza skupine slučajeva

Introduction: Brain glioma is the most common and lethal primary malignant intracranial tumor. Nonetheless, gross tumor resection remains the most successful treatment modality, which may prolong progression free survival of these patients. However, excessive surgery brings a danger of neurological, regional and systemic complications, which may be diminished/ avoided by better pre- and intra-operative care and by modern neurosurgical techniques. Aim: To analyze the incidence and type of peri- and post-operative complications in surgical brain glioma patients. Computing the results, advice on complication prevention was made. Methods: A single institution series of brain glioma patients operated on during a two-year period was analyzed. The incidence, type and time of complications were observed, as well as the patients’ gender and age, and the extent of tumor resection complications, dichotomized as peri- and post-operative variables, were correlated with investigated parameters to find out their possible association. Results: Transitory neurological deficit was the most common peri-operative complication. Seizures, meningitis, and permanent neurological deficit were commonly recorded among post operative complications. Conclusion: Patients’ gender and age, and the extent of tumor resection were not influential to the development of brain glioma complications. Aggressive surgery requires the avoidance of complications by cautious patient selection, multidisciplinary preoperative planning, and scrupulous neurosurgical technique augmented by up-to-date armamentarium.Uvod: Gliomi mozga najučestaliji su smrtonosni primarni intrakranijski tumori. Unatoč tomu, njihovo radikalno kirurško uklanjanje i nadalje ostaje najuspješnija metoda liječenja kojom se može usporiti napredovanje bolesti i donekle produljiti život ovakvih bolesnika. Međutim, agresivno kirurško liječenje može povećati opasnost nastanka neuroloških, regionalnih i sustavnih komplikacija, koje se može pokušati izbjeći boljom pripremom prije i tijekom operacije, kao i uporabom suvremenih neurokirurških tehnika. Cilj: Analizirati učestalost i vrstu perioperacijskih i poslijeoperacijskih komplikacija u kirurški liječenih bolesnika s gliomom mozga. Na temelju obrade rezultata, uspostaviti preporuke za sprječavanje nastanka komplikacija. Metode: Analizirana je skupina bolesnika operiranih zbog glioma mozga tijekom dvogodišnjeg razdoblja. Promatrana je učestalost i vrsta komplikacija, kao i vrijeme njihova nastanka. Također su zabilježeni podaci o dobi i spolu bolesnika te stupnju tumorske resekcije. Komplikacije su dihotomizirane kao perioperacijske i poslijeoperacijske varijable čija je moguća povezanost uspoređivana s istraživanim pokazateljima. Rezultati: Tranzitorni neurološki deficit bio je najučestalija perioperacijska komplikacija. Epileptički napadaj, meningitis i trajni neurološki ispad zabilježeni su kao najčešća poslijeoperacijska komplikacija. Zaključak: Spol i dob bolesnika, kao i stupanj tumorske resekcije nisu utjecali na nastanak komplikacija kirurškog liječenja glioma mozga, koje je moguće izbjeći pažljivim odabirom bolesnika, multidisciplinarnim predoperacijskim planiranjem i primjenom obzirne neurokirurške tehnike poduprte uporabom najsuvremenije operacijske opreme

NUMERICAL MULTIGROUP TRANSIENT ANALYSIS OF SLAB NUCLEAR REACTOR WITH THERMAL FEEDBACK

The paper describes a new numerical code for multigroup transient analyses with thermal feedback. The code is developed at Institute of Nuclear and Physical Engineering. It is necessary to carefully investigate transient states of fast neutron reactors, due to recriticality issues after accident scenarios. The code solves numerical diffusion equation for 1D problem with possible neutron source incorporation. Crank-Nicholson numerical method is used for the transient states. The investigated cases are describing behavior of PWR fuel assembly inside of spent fuel pool and with the incorporated neutron source for better illustration of thermal feedback

Transvenozni pristup za indirektnu karotidno kavernoznu fistulu koristeći odvojive zavojnice: prikaz slučaja i pregled metoda liječenja

Carotid-cavernous fistula (CCF) is a relatively rare pathology with a low incidence compared with other vascular pathologies. They can be classified based on hemodynamics as low- or high-flow fistulas, and anatomically as direct or indirect fistulas. Anatomy of the shunt somewhat dictates the selection of endovascular treatment, meaning the venous or arterial approach and selection of embolizing materials. Although there is general agreement as to when to access CCF transvenously or transarterialy, which depends on the shunt being direct or indirect, there is no uniform agreement on which occlusion method should be used. Herein, we report a case of an 80-year-old woman treated for indirect CCF using detachable coils. We also provide a brief review of the literature, including recent advances in treatment of said entities. In conclusion, selection of both the approach and material used depends on the operator’s experience and preference.Karotidno kavernozna fistula je relativno rijetka patologija s niskom incidnecijom u odnosu na ostale vaskularne abnormalnosti. Hemodinamski se dijele na niskoporotočne i visokoprotočne, a anatomski na direktne i indirektne. Anatomija fistule određuje vrstu endovaskularnog tretmana, dakle arterijki ili venski pristup, kaoo I vrstu materijala kojom se vrši embolizacija. Iako postoji opći konsenzus oko primjene arterijskog ili venskog pristupa, ovisno o tome je li fistula direktna ili indirektna, ne postoji uniformni dogovor koja bi se metoda trebala koristiti u pojedinačnim slučajevima. Ovim radom smo prikazali slučaj osamdesetogodišnje bolesnice koja je liječena radi indirektne karotidno kavernozne fistule koristeći zavojnice. Također, prikazan je pregled literature i recentnog napretka u liječenju spomenutih entiteta. Zaključno, kako izbor pristup tako i izbor materijala ovise o iskustvu te preference operatera

Velika aneurizma vrška bazilarne arterije predstavljena kao mezencefalični tumor i uzrok jednostranog opstrukcijskog hidrocefalusa: prikaz slučaja i tehnička napomena

Cerebral ventricular system is a sporadic location of intracranial aneurysms including those of basilar artery tip. Treatment of such aneurysms remains challenging regardless of endovascular or microsurgical techniques applied. Basilar tip aneurysm presenting as third ventricular mass is rarely associated with obstructive hydrocephalus, mimicking midbrain expansive process and urging precise diagnostics and prompt treatment. Hence, the management of such patients may be delicate, having an uncertain outcome. We report on a case of a patient with unilateral hydrocephalus caused by large basilar tip aneurysm mimicking a midbrain tumor. We also discuss different operative strategies influencing the outcome, including our own endovascular treatment technical modification. A 62-year-old female patient presented with slightly decreased cognition, minor gait disturbances and urinary incontinence. Computed brain tomography revealed a third ventricle mass with unilateral ventricular dilatation, indicating hypertensive obstructive hydrocephalus. Magnetic resonance and digital subtraction angiography identified the third ventricular mass as a large saccular basilar tip aneurysm. The patient was selected for endovascular treatment followed by cerebrospinal fluid derivation. After aneurysm endovascular occlusion and temporary external ventricular drainage, the symptoms diminished and ventricular dilatation decreased. On post-procedure day 10, the hydrocephalus was relieved and external drainage removed. The patient recovered fully and was discharged without neurological deficit. In conclusion, large basilar tip aneurysms associated with obstructive hydrocephalus are rare and best treated by a combination of endovascular obliteration and cerebrospinal fluid ventricular diversion. The possibility of such an aneurysm should always be considered on the differential diagnosis of cerebral ventricular growths.Intrakranijske su aneurizme smještene unutar ventrikulskog sustava rijetke, uključujući one vrška bazilarne arterije. Njihovo je liječenje izrazito zahtjevno, neovisno o primijenjenoj endovaskularnoj ili mikrokirurškoj tehnici. Aneurizme bazilarnoga vrška koje se očituju kao ventrikulska ekspanzivna tvorba u području mezencefalona rijetko su povezane s razvitkom opstrukcijskoga hidrocefalusa, što zahtijeva preciznu dijagnostiku i žurno aktivno liječenje. Postupak je liječenja u ovakvih bolesnika iznimno složen, a ishod neizvjestan. U ovom radu opisujemo slučaj bolesnice s jednostranim hidrocefalusom uzrokovanim velikom aneurizmom bazilarnoga vrška, koja se diferencijalno dijagnostički očitovala kao mezencefalični tumor. Također raspravljamo o različitim mogućnostima operacijskog liječenja od utjecaja na ishod, uključujući i vlastitu tehničku modifikaciju endovaskularnog zahvata. Bolesnica u dobi od 62 godine zaprimljena je zbog blago sniženih kognitivnih sposobnosti, manjeg poremećaja u hodu i urinarne inkontinencije. Kompjutorska tomografija mozga upućivala je na ekspanzivnu tvorbu područja treće klijetke s jednostranim proširenjem postranične klijetke i posljedičnim hipertenzivnim hidrocefalusom. Magnetna rezonancija i digitalna suptrakcijska angiografija razotkrile su ekspanzivnu tvorbu kao veliku sakularnu aneurizmu bazilarnoga vrška. Bolesnica je podvrgnuta endovaskularnom liječenju sa susljednom derivacijom cerebrospinalnoga likvora. Simptomi i proširenje postranične klijetke su se umanjili nakon učinjene endovaskularne okluzije i privremene izvanjske ventrikulske drenaže. Desetog dana od operacije hidrocefalus se u cijelosti povukao pa je izvanjska drenaža uklonjena. Bolesnica se je u potpunosti oporavila te je otpuštena bez neurološkog ispada. Zaključujemo kako su aneurizme bazilarnoga vrška udružene s opstrukcijskim hidrocefalusom rijetke i kako ih je najpovoljnije liječiti kombinacijom endovaskularnog postupka i likvorske ventrikulske derivacije. Na mogućnost nastanka ovakve aneurizme treba uvijek pomisliti u diferencijalnoj dijagnostici cerebralnih ventrikulskih tvorba

Čimbenici povezani s depresijom u bolesnika sa shizofrenijom

The aim of this study was to analyze risk factors present in schizophrenic patients with depressive symptomatology. The sample comprised of 76 respondents diagnosed with schizophrenia. In the study, we used the Positive and Negative Syndrome Scale (PANSS) and Calgary Depression Scale for Schizophrenia. The prevalence of depression was estimated to be 30%. The mean scores on the negative subscale of the PANSS were significantly higher in patients with schizophrenia and depression compared to control group (U=3.64, p=0.00), and so were those on the General Psychopathology Scale (U=4.91, p=0.00). Socio-demographic factors were identified as important factors (p<0.05). Personal and environmental factors such as loneliness, immediate social environment, social support and isolation were statistically significantly different between the groups (p<0.05). There was a correlation of poor compliance with psycho-pharmacotherapy, increased number of hospitalizations and shorter remission period with the severity of clinical presentation (p<0.05). Since the presence of these factors is associated with depression in schizophrenia, their early detection in clinical practice is vital to ensure timely prevention of the development of depressive symptomatology.Cilj ovoga rada bio je analizirati čimbenike rizika prisutne u shizofrenih bolesnika s depresivnom simptomatologijom. Uzorak se sastojao od 76 ispitanika s dijagnozom shizofrenije. U studiji smo koristili Ljestvicu za procjenu pozitivnog i negativnog sindroma kod shizofrenije (PANSS) i Kalgarijsku ljestvicu depresije. Procjenjuje se da je učestalost depresije 30%. Prosječni rezultati na negativnoj podljestvici PANSS-a bili su značajno veći u bolesnika sa shizofrenijom i depresijom u usporedbi s kontrolnom skupinom (U=3,64, p=0,00), kao i na općoj psihopatološkoj ljestvici (U=4,91, p=0,00). Socio-demografski čimbenici identificirani su kao važni čimbenici (p<0,05). Osobni i okolišni čimbenici, kao što su usamljenost, neposredna društvena okolina, socijalna potpora i izolacija statistički se značajno razlikuju među skupinama (p<0,05). Postoji korelacija između slabe usklađenosti s psihofarmakoterapijom, povećanog broja hospitalizacija, kao i kraćeg razdoblja remisije s težinom kliničke slike (p<0,05). Budući da je prisutnost ovih čimbenika povezana s depresijom u shizofreniji, njihovo rano otkrivanje u kliničkoj praksi je od vitalnog značenja za pravodobno sprječavanje razvoja depresivne simptomatologije

Povezanost meteoroloških varijabla sa subarahnoidnim krvarenjem: iskustvo jednog centra

Spontaneous subarachnoid hemorrhage (SAH) can occur unexpectedly and independently of the classic risk factors. Several different factors could affect intracranial aneurysm (IA) rupture, such as morphological and hemodynamic factors. The aim of this study was to establish the potential association of meteorological data such as temperature, atmospheric pressure, and humidity, and the onset of clinical symptoms preceding hospital admission of patients with acute SAH due to IA rupture. This retrospective study included 130 consecutive patients admitted for non-traumatic SAH with a determinable onset of SAH symptoms. The effects of meteorological parameters of atmospheric pressure, ambient temperature, and relative air humidity on the day of acute SAH onset and 24 hours prior to the onset of symptoms were recorded and analyzed in each patient. Spearman rank correlation analysis was used to assess the risks of incident SAH on the basis of daily meteorological data. Seasonal incidence of acute SAH showed the peak incidence in winter and a trough in summer, with monthly incidence peak in January and December. The circadian rhythm analysis showed the peak incidence of SAH in the forenoon, followed by the evening. Acute SAH incidence showed moderate positive association with daily atmospheric pressure (p<0.05), while no association was found with ambient temperature and relative air humidity. Our results suggested no significant association of changes in ambient temperature and relative humidity with the risk of SAH. Increases in atmospheric pressure were weakly associated with a higher SAH risk. Additional studies are needed to establish in detail both meteorological and morphological factors important to predict IA rupture and SAH.Spontano subarahnoidno krvarenje (SAH) može nastati neočekivano i neovisno o klasičnim čimbenicima rizika. Nekoliko različitih čimbenika može utjecati na rupturu intrakranijske aneurizme (IA), poput morfoloških i hemodinamskih čimbenika. Cilj ovoga istraživanja bio je utvrditi potencijalnu povezanost meteoroloških podataka kao što su temperatura, atmosferski tlak i vlažnost te pojave kliničkih simptoma prije prijma u bolnicu bolesnika s akutnim SAH-om zbog rupture IA. Ova retrospektivna studija uključila je 130 uzastopnih bolesnika primljenih zbog netraumatskog SAH-a s vidljivim početkom simptoma SAH-a. Za svakog bolesnika zabilježeni su i analizirani učinci meteoroloških parametara atmosferskog tlaka, temperature okoline i relativne vlažnosti zraka na dan nastanka akutnog SAH-a i 24 sata prije pojave simptoma. Korelacijska Spearmanova analiza primijenjena je za procjenu rizika od incidentnog SAH-a na temelju dnevnih meteoroloških podataka. Sezonska incidencija akutnog SAH-a pokazala je vrhunac incidencije zimi i pad ljeti, s mjesečnim vrhom incidencije u siječnju i prosincu. Analiza cirkadijanog ritma pokazala je vrhunac incidencije SAH-a u prijepodnevnim satima, a zatim navečer. Učestalost akutnog SAH-a pokazala je umjereno pozitivnu povezanost s dnevnim atmosferskim tlakom (p<0,05), dok nije nađena povezanost s temperaturom okoline i relativnom vlagom zraka. Naši rezultati ukazuju na to da nema značajne povezanosti promjena u temperaturi okoline i relativnoj vlažnosti s rizikom od SAH-a. Povećanje atmosferskog tlaka slabo je povezano s većim rizikom od SAH-a. Potrebne su dodatne studije kako bi se detaljno utvrdili meteorološki i morfološki čimbenici važni za predviđanje rupture IA i SAH-a

The Mini Labyrinth - a Simple Benchmark for Radiation Protection and Shielding Analysis

The Mini Labyrinth experiment is a simple neutron and gamma shielding experiment developed at STU, inspired by the ALARM-CF-AIR-LAB-001 ICSBEP benchmark experiment. The STU Mini Labyrinth is approximately ten times smaller and consists of NEUTRONSTOP shielding blocks. This paper describes the second version of the Mini Labyrinth experiment and presents the results of the neutron and gamma fields simulation and measurement. The PuBe neutron source with the emission rate of 1.0E7 n/s was utilized in the experiment. The measurement of gamma ambient dose equivalent H*(10) and neutron count rates is performed by the Thermo Scientific RadEye portable survey meter. The simulation part was carried out using the state-of-the-art MCNP6 and SCALE6 MONACO stochastic calculation tools taking into account the detailed geometry of the labyrinth and combined neutron and gamma source of particles. The comparisons were performed between codes and experiment, based on the dose rate in the unique detection positions and using a 2D map of neutron and photon fluxes. The propagation of cross-section uncertainties was investigated through shielding analysis. Partial agreement between codes and measurement was achieved, however serious discrepancies near the PuBe source were identified