Numerical Analysis of Standard and Modified Osteosynthesis in Long Bone Fractures Treatment

The fundamental problem in osteoporotic fracture treatment is significant decrease in bone mass and bone tissue density resulting in decreased firmness and elasticity of osteoporotic bone. Application of standard implants and standard surgical techniques in osteoporotic bone fracture treatment makes it almost impossible to achieve stable osteosynthesis sufficient for early mobility, verticalization and load. Taking into account the form and the size of the contact surface as well as distribution of forces between the osteosynthetic materials and the bone tissue numerical analysis showed advantages of modified osteosynthesis with bone cement filling in the screw bed. The applied numerical model consisted of three sub-models: 3D model from solid elements, 3D cross section of the contact between the plate and the bone and the part of 3D cross section of the screw head and body. We have reached the conclusion that modified osteosynthesis with bone cement resulted in weaker strain in the part of the plate above the fracture fissure, more even strain on the screws, plate and bone, more even strain distribution along all the screws’ bodies, significantly greater strain in the part of the screw head opposite to the fracture fissure, firm connection of the screw head and neck and the plate hole with the whole plate and more even bone strain around the screw

Association of IL-1β and IL-10 Polymorphisms with Prostate Cancer Risk and Grade of Disease in Eastern Croatian Population

Single nuclear polymorphisms (SNPs) in the promotor regions of cytokine genes included in angiogenesis may influence prostate cancer (PCa) development via regulation of the pathways of tumor angiogenesis. The aim of the present study was to investigate the association of IL-1β+3954 (rs1143634) and IL-10-1082 (rs1800896) polymorphisms with PCa risk and aggressiveness in eastern Croatian patients. One hundred twenty PCa patients and 120 benign prostatic hyperplasia (BPH) controls were genotyped using real-time PCR (LightCycler Instrument, Roche Diagnostics) and the melting curve analysis method. There was no significant difference in the frequency of genotypes for the two polymorphisms between PCa patients and controls (χ2=0.857, p=0.355 for IL-β1; χ2=0.026, p=0.872 for IL-10). Carriers of the IL-10-1082A>G variant were found to be associated with the Gleason score (GS)>7 (AA versus GA+GG, OR=3.47, 95% CI 1.11-10.88, p=0.033). There was no significant difference in the frequency of genotypes for the two polymorphisms and the presence of metastatic disease in PCa patients. These results suggest that tested SNPs associated with differential production of IL-1β and IL-10 are not risk factors for PCa and do not correlate with the presence of distant metastasis in eastern Croatians. We found that IL-10-1082 GA+/or GG carriers have a higher risk of developing PCa with GS>7 in eastern Croatians

RISK FACTOR EVALUATION USED AS INDICATORS IN EARLY DETECTION OF RECURRENT VULVAR CANCER

Cilj rada. Procijeniti je li analizirani faktori rizika, koji postoje u vrijeme primarnoga liječenja skvamoznog raka vulve, mogu poslužiti kao markeri za otkrivanje onih pacijentica u kojih će se razviti rekurentni rak vulve. Bolesnice i način istraživanja. Retrospektivna analiza podataka o 32 pacijentice s rakom vulve koje su liječene u Odjelu za ginekologiju i porodništvo Kliničke bolnice Osijek od 01. 01. 1993 do 31. 12. 2000 godine. Rezultati. Samo su se debljina tumora 3,4 mm i dubina stromalne invazije 3,0 mm pokazali korisnim za otkrivanje pacijentica u kojih će se razviti rekurentni rak vulve. Postojanje oba faktora registrirano je prilikom primarnoga liječenja skvamoznog raka vulve u 87,5% pacijentica u kojih se za vrijeme praćenja razvio rekurentni rak vulve. Međutim, oba faktora su isto tako bila i u 55,0% pacijentica u kojih se za vrijeme praćenja nije razvio rekurentni rak vulve. Osjetljivost zajedničke primjene oba faktora za otkrivanje pacijentica u kojih će se razviti rekurentni rak vulve iznosila je 87,5%, specifičnost 45,0%, a prediktivna vrijednost 48,8%. Zaključak. Procjena debljine tumora i dubine stromalne invazije pri primarnom liječenju skvamoznog raka vulve mogli bi se koristiti za selekcioniranje pacijentica u kojih će se kroz duže vrijeme provoditi intenzivniji nadzor radi što ranijeg otkrivanja i liječenja rekurentnog raka vulve.Objective. To evaluate risk factors, already present during the primary treatment of squamous cell carcinoma¬ of the vulva, which can be used as indicators in detection of recurrent vulvar cancer cases. Material and Methods. The retrospective data analysis consists of 32 patients with squamous cell carcinoma of the vulva, who were treated at the Department of Gynaecology and Obstetrics of Clinical hospital Osijek in the period from January 1 1993 till December 31 2000. Results. Of the risk factors, only two have been useful in detection of recurrent vulvar cancer cases: the tumor thickness 3.4 mm and the depth of stroma invasion 3.0 mm. Both risk factors have been noticed in the primary treatment of squamous cell carcinoma of the vulva and in 87.5% of the patients who during follow-up period developed recurrent vulvar cancer; both factors were present in 55.0% patients who did not develop recurrent vulvar cancer during follow-up period. Therefore, we can say that the sensitivity of both factors, used in early detection of recurrent vulvar cancer is 87.5%, specificity 45.0% and predictive value 48.8%. Conclusion. The estimation of tumor thickness and the level of stroma invasion during primary treatment of squamous cell carcinoma of the vulva can be used to select patients who would require a closer follow-up for a longer period in order to detect and treat recurrent vulvar cancer on time

Applicability of bovine tibia as a model in research on various osteosynthesis techniques

Background and Purpose: The main problem in experimental research in traumatology and orthopedics is unavailability of a large number of samples of human origin. In this research, standard and modified osteosyntheses were performed on bovine tibia to determine whether bovine tibia can be used as a model in biomechanical research on two or more methods of osteosynthesis. Materials and Methods: Investigations were carried out on six preparations of cadaveric human tibia and on six preparations of bovine tibia with the use of device for static and dynamic research on long bone model. The bones were artificially broken and then osteosynthesis was performed on them in two ways: applying the standard method and the modified method with bone cement. The aim of these investigations was to determine the size of the axial force and torsion moment that can be exerted to apply static and dynamic loading on the macerated cadaveric tibia and bovine tibia without breaking the bone or causing its permanent deformation. Results: Investigations conducted on preparations of bovine tibia and cadaveric human tibia showed that there was not even minimal deformation of the bovine tibia in both standard and modified osteosynthesis. There was no shift in torsion angle at all with all three values of torsion moment applied in these investigations. This result was obtained in both standard and modified osteosynthesis. The results showed that in both bovine and human preparations the loosening occurred sooner when standard osteosynthesis was applied. Conclusion: In conclusion, the bovine bone has good potential for use as material for biomechanical experiments

Metastaze karcinoma želuca u dojci – prikaz slučaja

Gastric cancer is one of the most common causes of cancer death. In 2005, there were 1059 newly diagnosed cases of gastric cancer in Croatia. Stomach cancer spreads very early and usually to regional lymph nodes and surrounding tissues such as the liver, lungs, or ovaries, and less often to the bones and central nervous system, whereas the breast is very rarely the site of its metastases. Among the available data, we have found only 9 publications describing cases of gastric metastases developed in the breast, we decided to publish this case report presenting a patient who underwent total gastrectomy for gastric cancer in May 2000, and then surgery for metastases of gastric cancer to the breast in January 2005.Karcinom želuca je jedan od vodećih uzroka smrti od karcinoma. U Hrvatskoj je u 2005 godini otkriveno 1059 novih slučajeva karcinoma želuca. Karcinom želuca obično metastazira vrlo rano i to u okolne limfne čvorove, jetru, pluća, jajnike, te rje|e u kosti i središnji živčani sustav, dok je dojka vrlo rijetko sijelo metastaza. U dostupnoj literaturi pronašli smo samo 9 radova koji opisuju širenje karcinoma želuca u dojku, te smo odlučili prikazati slučaj naše pacijentice koja je u svibnju 2000. godine operirana radi karcinoma želuca, a u siječnju 2005. operirana radi metastaze u dojci

Razlika histološkog gradusa karcinoma endometrija u kiretaži i histerektomiji – presječna studija

Objectives: To determine the compatibility rate between histological grades of endometrial carcinoma in curettage and hysterectomy and to determine how quantity of material, given by the method of fractional hysterectomy, affects the compatibility between histological grades in the two methods. Material and methods: The study included 102 patients with endometrioid endometrial cancer who underwent methods of fractional curettage and hysterectomy. Data regardingthepathohistological status of uterine tissue was obtained from the available medical records. Information on age andclinical diagnoses were obtained from referrals for pathohistologicaltissue examination. The age of the subjects was determined at the time when the tissue samples were taken for analysis. Data on the amount of material was obtained from the description of macroscopic evaluation of the given material. Results: Most subjects had grade II endometrioid endometrial cancer (47.1 % and 50 %). Most of the respondents had a medium deficient material obtained by fractional curettage (40.2 %). There was no statistically significant difference between the histological grade determined after the fractional curettage and hysterectomy. There were no statistically significant differences in histological grade in the sample obtained by fractional curettage and hysterectomy depending on the amount of material in fractional curettage. Conclusions: There was no statistically significant differences in the grade of endometrial cancer in samples obtained by the fractional curettage and hysterectomy. The correspondence is higher in higher tumor grade (III), and lower in lower tumor grades (I, II). The amount of material did not affect the grade deviation in the sample obtained by fractional curettage and hysterectomy.Cilj: Ispitati podudarnost histološkog gradusa endometrioidnog karcinoma endometrija u uzorcima dobivenim frakcioniranom kiretažom i histerektomijom te ispitati utječe li količina materijala dobivenog frakcioniranom kiretažom na podudarnost histoloških gradusa. Materijal i metode: U istraživanje su bile uključene 102 pacijentice oboljele od endometrioidnog karcinoma endometrija. Iz dostupne medicinske dokumentacije prikupljeni su arhivski podatci o patohistološkom nalazu tkiva maternice dobivenog metodom frakcionirane kiretaže i histerektomijom. Iz uputnice za patohistološki pregled tkiva dobiveni su podatci o dobi i uputnim kliničkim dijagnozama. Podatci o količini materijala dobiveni su iz opisa makroskopske procjene prikupljenog materijala. Rezultati: Najveći broj ispitanica imao je gradus II endometrioidnog karcinoma endometrija (47,1 % i 50 %). Najveći dio ispitanica imao je srednje obilan materijal dobiven frakcioniranom kiretažom (40,2 %). Nije uočena statistički značajna razlika između histološkog gradusa utvrđenog nakon frakcionirane kiretaže i nakon histerektomije, kao ni u histološkom gradusu između uzoraka dobivenih frakcioniranom kiretažom i histerektomijom s obzirom na količinu kiretiranog materijala. Zaključci: Nije bilo statistički značajne razlike u određenim gradusima karcinoma endometrija u uzorcima dobivenima metodom frakcionirane kiretaže i histerektomije. Podudarnost je veća u višem gradusu tumora (III), a manja u nižem gradusu tumora (I, II). Količina materijala nije utjecala na odstupanje gradusa u uzorku dobivenom frakcioniranom kiretažom i histerektomijom

Primarni serozni papilarni adenokarcinom jajovoda

Fallopian tube cancer is least common of all gynecologic tumors, with the mean age at onset between 54 and 63 years. This case report presents a 67-year-old female, gravida 1, para 1, with primary adenocarcinoma of the fallopian tube, detected and diagnosed preoperatively in clinical stage III c. The patient was asymptomatic, with only mild vaginal discharge of amber color and normal measured value of CA 125. The diagnosis was based on routine clinical and ultrasound examination, followed by surgery, surgical-pathological staging of the disease, and finally paclitaxel and platinum based chemotherapy. The patient has been in remission for nine years now.Rak jajovoda je najrjeđi među svim ginekološkim tumorima s najvećom incidencijom u dobnoj skupini od 54 do 63 godine. Rad prikazuje primarni adenokarcinom jajovoda kod 67-godišnje bolesnice, gravida 1, para 1, otkriven i prijeoperacijski dijagnosticiran u kliničkom stadiju III c. Bolesnica je bila asimptomatska, a jedini simptom je bio blagi vaginalni iscjedak jantarne boje, uz uredne izmjerene vrijednosti CA 125. Dijagnoza se temeljila na kliničkom pregledu i ultrazvučnoj dijagnostici, nakon čega je potvrđena perioperacijski, kroz kirurško-patološko određivanje stupnja proširenosti. Nakon operacijskog zahvata bolesnica je podvrgnuta kemoterapiji zasnovanoj na paklitakselu i platini. Bolesnica se devet godina nalazi u remisiji

Prognostički utjecaj niskog pozitiviteta estrogenih i progesteronskih receptora u luminalnim B (HER2 negativnim) karcinonima dojke

Luminal B (HER2 negative) subtype is the most diversiform type of breast cancers, with a high Ki-67 proliferation index (>20%) or/and low progesterone (PR; <20%) with various intensity and distribution of hormone receptors. Considerable difference has also been noticed in disease outcome, wherefore there is the need for a more detailed classification of this tumor subtype. The clinical and pathologic parameters of 147 luminal B (HER2 negative) breast cancers were examined. The expression of hormone receptors in correlation with other prognostic factors and disease outcome was analyzed by Kaplan-Meier curves and multivariate Cox regression analysis. The Kaplan-Mayer analysis showed that low positivity of estrogen (ER) and PR receptors in tumors was associated with a significantly worse disease outcome (overall survival (ER), p=0.020; disease free survival (ER), p=0.019; overall survival (PR), p=0.026; disease free survival (PR), p=0.038)), unlike Ki-67, which did not show a statistically significant connection (overall survival, p=0.343; disease free survival, p=0.322). The intensity of receptor staining and Ki-67 relative to other histopathologic prognostic factors showed a statistically significant correlation solely with histologic grade of tumor. By using the Cox regression model, PR proved to be an independent prognostic factor for overall survival (p=0.004) and disease free survival (p=0.029). The luminal B (HER2 negative) breast cancer with low expression of hormone receptors, independent of the Ki-67 proliferation index, and in correlation with a higher histologic grade, could be a unique subtype of cancer.Luminalni B (HER 2 negativni) karcinomi dojke najheterogenija su podskupina s velikim rasponom proliferacijskog indeksa Ki-67 kao i intenziteta te raspodjele hormonskih receptora unuatar tumorskih stanica. Također je zamjetna različitost u kliničkom ishodu bolesti, zbog čega se ukazuje potreba za detaljnijom subtipizacijom ove skupine tumora. Izdvojeno je 147 luminalnih B HER2 negativih karcinoma, a ispitani su kliničko-patološki parametri u korelaciji s intenzitetom hormonskih receptora (estrogen (ER) i progesteron (PR)) kao i Ki-67 u odnosu na sveukupno preživljenje te preživljenje bez povrata bolesti. Unutar ispitivanih kliničko patoloških parametara slabiji intenzitet hormonskih receptora kao i viši Ki-67 bili su statistički značajno povezani samo s gradusom tumora. Kaplan-Meierovom analizom ustanovljena je statistički značajna povezanost slabog intenziteta ER i PR s preživljenjem (sveukupno preživljenje (ER), p=0,020; preživljenje bez povrata bolesti (ER), p=0,019; sveukupno preživljenje (PR), p=0,026; preživljenje bez povrata bolesti (PR), p=0,038)), za razliku od Ki-67 vrijednosti kojega nisu bile statistički značajno povezane s preživljenjem (sveukupno preživljenje, p=0,343; preživljenje bez povrata bolesti, p=0,322). Coxovom regresijskom analizom PR se pokazao kao statistički značajan neovisni parametar povezan sa sveukupnim preživljenjem (p=0,004) i preživljenjem bez povrata bolesti (p=0,029). Ovi rezultati pokazuju da bi podskupina luminalnih B HER2 negativnih karcinoma dojke s niskim intenzitetom hormonskih receptora, neovisno o proliferacijskom indeksu Ki-67, a u korelaciji s histološkim gradusom tumora mogla biti zaseban podtip karcinoma dojke

Zreli primarni teratom medijastina u novorođenčeta: prikaz slučaja

Primary mediastinal teratomas, whether mature or immature, are very rare. They could cause serious life threatening respiratory obstruction at newborn age. This report presents clinical course, imaging, autopsy and pathohistological findings in a newborn with mature mediastinal teratoma, which led to severe respiratory failure and death. Despite the fact that postnatal respiratory distress was rarely caused by mediastinal tumor, that type of tumor should be taken into consideration in case of severe perinatal asphyxia. The case is therefore worth of presentation.Primarni teratomi medijastina, bez obzira jesu li zreli ili nezreli, rijetkost su i u novorođenačkoj dobi mogu biti uzrokom teške, za život opasne opstrukcije dišnih puteva. U ovom radu prikazan je klinički tijek, pretrage, obdukcijski i patohistološki nalazi u novorođenčeta sa zrelim teratomom medijastina koji je prouzročio težak oblik respiratornog zastoja i smrt. Unatoč činjenici da su postnatalne respiratorne smetnje rijetko prouzročene tumorom medijastina, tu vrstu tumora treba uzeti u obzir u slučaju teške perinatalne asfiksije. Stoga ovaj slučaj vrijedi prikazati

Metastaze karcinoma želuca u dojci – prikaz slučaja

Gastric cancer is one of the most common causes of cancer death. In 2005, there were 1059 newly diagnosed cases of gastric cancer in Croatia. Stomach cancer spreads very early and usually to regional lymph nodes and surrounding tissues such as the liver, lungs, or ovaries, and less often to the bones and central nervous system, whereas the breast is very rarely the site of its metastases. Among the available data, we have found only 9 publications describing cases of gastric metastases developed in the breast, we decided to publish this case report presenting a patient who underwent total gastrectomy for gastric cancer in May 2000, and then surgery for metastases of gastric cancer to the breast in January 2005.Karcinom želuca je jedan od vodećih uzroka smrti od karcinoma. U Hrvatskoj je u 2005 godini otkriveno 1059 novih slučajeva karcinoma želuca. Karcinom želuca obično metastazira vrlo rano i to u okolne limfne čvorove, jetru, pluća, jajnike, te rje|e u kosti i središnji živčani sustav, dok je dojka vrlo rijetko sijelo metastaza. U dostupnoj literaturi pronašli smo samo 9 radova koji opisuju širenje karcinoma želuca u dojku, te smo odlučili prikazati slučaj naše pacijentice koja je u svibnju 2000. godine operirana radi karcinoma želuca, a u siječnju 2005. operirana radi metastaze u dojci