History and development of the Clinical institute for nuclear medicine and radiation protection of the University hospital centre Osijek and Faculty of medicine Osijek

Kao jedna od respektabilnih ustrojbenih jedinica Kliničkoga bolničkog centra Osijek, Klinički zavod za nuklearnu medicinu i zaštitu od zračenja Medicinskoga fakulteta u Osijeku ove godine navršio je 42 godine svoga utemeljenja i djelatnosti. Nagli razvitak biomedicine i zdravstva u drugoj polovici prošloga stoljeća omogućio je nastanak nuklearne medicine kao novije kliničke medicinske specijalnosti. Četiri godine nakon predavanja o primjeni izotopa u dijagnostici koje je u proljeće 1963. godine održano u podružnici Zbora liječnika u Osijeku, 27. svibnja 1967. godine započeo je rad Radioizotopnoga laboratorija sa stacionarom od pet bolesničkih postelja, koji je 1968. postao samostalnim odjelom tadašnje Opće bolnice Osijek. Danas, Klinički zavod za nuklearnu medicinu i zaštitu od zračenja ima 82 djelatnika, šest kliničkih odjela i polikliniku. Najveće je zdravstveno središte koje primjenjuje otvorene izvore ionizirajućega zračenja u dijagnostici i liječenju u istočnoj Hrvatskoj i godišnje učini oko 220.000 medicinskih usluga (pregleda pacijenata te in vivo i in vitro dijagnostičkih pretraga).Clinical Institute for Nuclear Medicine and Radiation Protection of the Faculty of Medicine Osijek, as one of the prominent constituents ot the University Hospital Centre Osijek, marks 42 years of its foundation and activity. Accelerated development of biomedicine and medical services during the second half of the last century has contributed to establishing of nuclear medicine as recent clinical medical specialty. Radioisotope Laboratory with the stationary equipment of 5 beds started its work in the General Hospital Osijek on 27 May, 1967, four years after the lecture on isotope application in diagnostics, which was given at the Osijek branch office of the Medical Association. Radioisotope Laboratory turned into independent clinical department in 1968. Today, the Clinical Institute tor Nuclear Medicine and Radiation Protection has 82 employees and consists of 6 clinical departments and one polyclinic unit. It is the largest health centre in the Eastern Croatia, which applies open ionizing radiation sources in diagnostics and treatments. Approximately 220.000 medical services (medical checkups, in vivo and in vitro diagnostic assays) per year have been performed there

The relationship between the geochemical and mineralogical characteristics of Calcocambisol, colluvium and recent marine lake sediment of the narrow seashore intertidal zone: a case study from the Veliko Jezero (Mljet Island, Croatia)

is study investigates the mineral composition, particle size distribution and geochemical characteristics of Calcocambisol, colluvium and recent marine lake sediment in a narrow intertidal seashore zone of the Veliko Jezero on the Island of Mljet (Croatia). The obtained results show that the fractions of Calcocambisol/colluvium less than 2 mm and 2 µm display similar particle size distribution (PSD) curves compared to marine lake sediments containing larger particles in these fractions. The smallest fractions of the investigated materials that are less than 1 µm show identical PSD curves. The bulk and clay mineral composition of the marine lake sediment show that the non-carbonate fraction is derived from weathering of the surrounding soils and colluvium containing quartz, feldspars and phyllosilicates (illitic material, kaolinites, chlorite, and a mixed layer clay mineral, MLCM), as well as the authigenic formation of early-diagenetic pyrite, while one part is related to the yield of material by aeolian deposition (amphibole). The observed difference between the phyllosilicate mineral phases in the clay fraction of the Calcocambisol/colluvium and the carbonate-free clay fraction of the marine lake sediment is related to 1) the presence of chlorite in the marine lake sediment and 2) the higher content of MLCM in the Calcocambisol/colluvium. The chlorite in the marine lake sediment was inherited from the Calcocambisol/colluvium as a result of soil erosion prior to its complete destabilization in the soil. High Chemical Index of Alteration (CIA) values in the Calcocambisol and colluvium clearly indicate their intense weathering. Based on the Sm/Nd and Ti/Al ratios, it can be concluded that the aluminosilicates in the Calcocambisol, colluvium and marine lake sediment are of the same provenance. The distribution of each analysed element among the sequential fractions is very similar in both the Calcocambisol and colluvium. The highest concentrations for most of trace elements in the Calcocambisol, colluvium and marine lake sediment was determined in their residual fraction. Mn, Co and Pb show a different partitioning between the Calcocambisol/colluvium and marine lake sediment, respectivel

Biochemical Bone Turnover Markers: Significance in Patients with Osteoporosis

Osteoporosis is a systemic disease, which is characterized by reduced bone mass and microarchitectural deterioration of the bone tissue, resulting in an increased risk of fracture. Since osteoporosis is today a disease with high incidence rate, the aim of this study was to determine a correlation between bone mass density (BMD) and concentration of biochemical bone turnover markers – deoxypyridinoline (DPD) as a marker of bone resorption, and osteocalcin (OC) as a marker of bone formation. The study included 70 women between 33 and 76 years of age. In all women BMD was measured by Dual X-ray Absorptiometry (DXA) as a T-score. T-score was defined as the number of standard deviations of the bone mass density from the maximum bone mass density in young adults. According to T-score, patients were divided into three groups: patients with osteoporosis, patients with osteopenia and control group consisting of patients with normal T-score. DPD in urine and OC in serum were measured by a routine procedure. Results: a negative correlation between BMD and concentration of bone turnover marker was discovered. One-way analysis of variance and Pearson correlation were used for statistical analysis, with a P value <0.05 being considered significant. Although a negative correlation was discovered, we concluded that both procedures have a significant role in diagnosis and follow-up of patients with osteoporosis

Neopstruktivna koronarna bolest - klinička važnost, dijagnostika, liječenje i prijedlog nove patofiziološke klasifikacije

New data gathered from large clinical trials indicate that nonobstructive coronary artery disease (non-CAD) is a clinical entity that should not be ignored. It is estimated that 50% of female population undergoing coronarography are diagnosed with non-CAD. There is also an increase in the prevalence of non-CAD in both genders, which is probably due to gradual expanding of clinical indications for angiography in patients with angina. Furthermore, considering the increased mortality risk established recently, a prognosis of non-CAD is not benign as previously thought. However, the concept and definition of non-CAD remains elusive causing difficulties in diagnosis and treatment. One of the major shortcomings is the exclusion-based diagnosis of non-CAD. Furthermore, treatment of non-CAD still presents a great challenge and optimal therapy is yet to be determined. There are two major hypotheses explaining the pathophysiological mechanisms of non-CAD, i.e. ischemic hypothesis based on abnormal microvascular dysfunction and non-ischemic one based on altered pain perception. This review encompasses a broader spectrum of pathophysiological mechanisms of non-CAD, and proposes a new way of classification based on the major disorder involved: type I (ischemic mechanisms) and type II (non-ischemic mechanisms), depending on which mechanism predominates. Hopefully, this would provide new insights in the understanding of this disorder, thus leading to accurate and early diagnosis and successful treatment, especially considering the increased mortality risk in these patients.Novi podaci prikupljeni iz velikih kliničkih ispitivanja pokazuju da je neopstruktivna koronarna bolest (ne-OKB) klinički entitet koji se ne smije zanemariti. Procjenjuje se da se u 50% ženske populacije koja se podvrgava koronarografiji dijagnosticira ne-OKB. Također postoji povećanje učestalosti ne-OKB u oba spola, što je vjerojatno posljedica postupnog širenja kliničkih indikacija za koronarografiju u bolesnika s anginom pektoris. Nadalje, s obzirom na povećani rizik od smrtnosti koji je nedavno ustanovljen, prognoza ne-OKB nije dobroćudna kao što se ranije mislilo. Međutim, koncept i definicija ne-OKB ostaju nedovoljno definirani, što uzrokuje poteškoće kako u dijagnozi tako i u liječenju. Jedan od glavnih nedostataka je dijagnostika ne-OKB koja se temelji na dijagnozi isključivanja. Nadalje, liječenje ne-OKB i dalje predstavlja velik izazov, a optimalnu terapiju tek treba odrediti. Postoje dvije glavne hipoteze koje objašnjavaju patofiziološke mehanizme ne-OKB. Ishemijska hipoteza temelji se na mikrovaskularnoj disfunkciji, a neishemijska hipoteza na promijenjenoj percepciji boli. Ovaj pregledni članak obuhvaća širok spektar patofizioloških mehanizama ne-OKB i predlaže novi način klasifikacije temeljen na glavnom poremećaju koji je uključen u patofiziologiju: tip I. (ishemijski mehanizam) i tip II. (ne-ishemijski mehanizam), ovisno o tome koji mehanizam prevladava. Nadamo se da će to omogućiti nove spoznaje u razumijevanju ovoga poremećaja, što dovodi do točne i rane dijagnoze i uspješnog liječenja, osobito s obzirom na povećani rizik smrtnosti kod ovih bolesnika

Povezanost koštane mineralne gustoće i sastavnica metaboličkog sindroma u postmenopauzalnih žena sa šećernom bolešću tipa 2

Diabetes mellitus type 2 is associated with greater bone mineral density (BMD) due to obesity, although rapid bone loss observed over time could be explained by elevated chronic inflammation. The objective of this study was to investigate the relationship between central adiposity and hyperinsulinemia, as well as inflammation markers with vertebral and femoral BMD and bone turnover markers in postmenopausal women with type 2 diabetes. Femoral and vertebral BMD, osteocalcin, pyrilinks D, beta-CrossLaps (B-CTx), insulin, C-reactive protein (CRP), fibrinogen and plasminogen activator inhibitor-1 (PAI-1) were measured in 114 postmenopausal female patients with diabetes type 2. The patients of similar age, HbA1c levels and diabetes duration were divided into 2 groups based on their body mass index (BMI) values: lower or equal to 27 kg/m2(31 patients) and higher than 27 kg/m2(83 patients). Lower levels of osteocalcin (p=0.001), B-CTx (p=0.000007) and pyrilinks D (p=0.0365), and higher femoral BMD (p=0.00006), insulin level (p=0.0002), PAI-1 (p=0.00000) and CRP (p=0.002) were found in the overweight group. There were no significant differences in vertebral BMD and fibrinogen. Osteocalcin and B-CTx showed inverse correlation, and femoral BMD positive correlation with waist circumference, insulin level and PAI-1. This suggests that abdominal obesity and hyperinsulinemia as components of the metabolic syndrome could increase femoral BMD by lowering bone rate. In addition, the only inflammation marker linked with femoral BMD was PAI-1, which is associated with increased mineralization of cortical bone in mouse models.Šećerna bolest tipa 2 povezana je s većom koštanom mineralnom gustoćom (bone mineral density, BMD) zbog debljine, iako se zamijećeni ubrzani gubitak koštane mase tijekom vremena može objasniti prisustvom kronične upale. Cilj ovoga istraživanja bio je utvrditi povezanost biljega koštane pregradnje i koštane gustoće s centralnom debljinom, hiperinzulinemijom kao i upalnim biljezima u postmenopauzalnih žena sa šećernom bolešću tipa 2. U 114 ispitanica izmjerena je koštana gustoća kralježnice i kuka, određeni su osteokalcin, pirilinks D, beta-CrossLaps (B-CTx), inzulin, C-reaktivni protein (CRP), fibrinogen i inhibitor aktivatora plazminogena-1 (PAI-1). Ispitanice slične dobi, podjednakog trajanja dijabetesa te HbA1c bile su podijeljene u dvije skupine prema indeksu tjelesne mase (ITM): niži ili jednaki 27 kg/m2(31 ispitanica) te veći od 27 kg/m2 (83 ispitanice). Niže vrijednosti osteokalcina (p=0,001), B-CTx (p=0,000007) i pirilinksa D (p=0,0365) te više vrijednosti košane gustoće kuka (p=0,00006), inzulina (p=0,0002), PAI-1 (p=0,0000) i CRP (p=0,002) utvrđene su u skupini s prekomjernom tjelesnom težinom. Nije bilo statistički značajne razlike u koštanoj gustoći kralježnice i vrijednosti fibrinogena. Osteokalcin i B-CTx su negativno korelirali, dok je BMD kuka bio u pozitivnoj korealciji s opsegom struka, inzulinom i PAI-1. Ovi rezultati upućuju na to da sastavnice metaboličkog sindroma, centralna debljina i hiperinzulinemija utječu na povećanje koštane gustoće kuka inhibirajući koštanu pregradnju. Jedini upalni biljeg povezan s BMD kuka bio je PAI-1 koji povećava mineralizaciju kortikalne kosti na mišjem modelu

Osteoprotegerin and Vascular Calcification: Clinical and Prognostic Relevance

Osteoprotegerin ( OPG ) is a key regulator in bone metabolism, that also has effect in vascular system. Studies suggest that osteoprotegerin is a critical arterial calcification inhibitor, and is released by endothelial cells as a protective mechanism for their survival in certain pathological conditions, such as diabetes mellitus, chronic kidney disease, and other metabolic disorders. That has been shown in studies in vitro and in animal models. The discovery that OPG deficient mice (OPG-/- mice) develop severe osteoporosis and arterial calcification, has led to conclusion that osteoprotegerin might be mulecule linking vascular and bone system. Paradoxically however, clinical trials have shown recently that OPG serum levels is increased in coronary artery disease and correlates with its severity, ischemic cardial decompensation, and future cardiovascular events. Therefore it is possible that osteoprotegerin could have a new function as a potential biomarker in early identification and monitoring patients with cardiovascular disease. Amongst that osteoprotegerin is in association with well known atherosclerosis risc factors: undoubtedly it is proven its relationship with age, smoking and diabetes mellitus. There is evidence regarding presence of hyperlipoproteinemia and increased serum levels of osteoprotegerin. Also the researches have been directed in genetic level, linking certain single nucleotid genetic polymorphisms of osteoprotegerin and vascular calcification appearance. This review emphasises multifactorial role of OPG, presenting numerous clinical and experimental stydies regarding its role in vascular pathology, suggesting a novel biomarker in cardiovascular diseases, showing latest conclusions about this interesting topic that needs to be further explored

Viticulture and enology in the Republic of Croatia within the framework of the world

Unatoč globalnoj gospodarskoj krizi kojoj svjedočimo, smanjenju svjetskih vinogradarskih površina, opstojnost vinogradarstva i vinarstva u Republici Hrvatskoj neupitna je, prvenstveno zahvaljujući bogatstvu prirodnih, ekoloških čimbenika u kojima je naš čovjek već ispisao snažnu povijesnu baštinu, prožetu demografskim i kulturnim utjecajima. Danas je i vinograd u mnogim djelovima države dio turističkog pejzažnog sadržaja, a dobro vino, bez ikakve sumnje, visoko pozicionirani razlog dolaska novih i vraćanja starih gostiju. Brojnost starih sorata kojih je nazivlje izvan naših granica nepoznato danas predstavlja pravo nacionalno bogatstvo, a specifi čnosti u proizvodnji i sve češći povratak na povijesnu izvornost, govori u prilog činjenici da je tržište zasićeno vrhunski proizvedenim i dorađenim, ali vinima jednakog lica, te da je naša budućnost u spoju drugačijeg i kvalitetnog. U prilog tome govori i činjenica da unatoč krizi, potrošnja vina u svijetu raste, a posebnosti su uvijek s „korakom ispred“. U tom smislu općepoznati i prihvaćeni pojam „terroir“ dobiva novu dimenziju, u koju se uključuje i potrošač i njegov doživljaj kvalitete vina u defi niranom okruženju prirode i čovjeka.Despite the current global economic crisis and the decrease in the number of the world’s wine-growing areas, viability of viticulture and enology in Croatia is unquestionable, mostly owing to the opulence of natural and ecological factors in which our men have already written a strong historical heritage permeated with demographic and cultural influences. Even vineyards are nowadays in many parts of the country a part of the touristic landscape offer and a good wine, undoubtedly, is a highly-positioned reason of the arrival of new guests and the return of the regular ones. The abundance of old varieties which are unknown outside our country represents a true national treasure and specificity in the production and the more frequent return to historical authenticity speaks for the fact that the market is saturated with perfected wines produced in high-quality, but they are all similar so our future lies in the compound of the difference and the quality. This claim is supported by the fact that, despite the crisis, the consumption of wine in the world grows and specific qualities are always one step ahead. In this sense, a generally-known and accepted term “terroir” gets a new dimension which includes both the consumer and his experience of wine quality in a defined environment of nature and man