116 research outputs found
Determining the Lifespan of Traffic Signs Using the Survival Analysis Method
Prometni znakovi, kao dio sustava prometne signalizacije, predstavljaju sredstva komunikacije izmeÄu nadležnih za ceste i sudionika u prometu. Da bi prometni znakovi kvalitetno izvrÅ”avali svoje zadatke oni moraju biti vidljivi u svim prometnim i vremenskim uvjetima te moraju prenositi jasnu i na vrijeme razumljivu poruku. S vremenom retroreflektirajuÄa svojstva prometnih znakova degradiraju te znakovi gube na kvaliteti, Äime se smanjuje i vozaÄeva udaljenost percepcije znakova Å”to može utjecati na njegovo ponaÅ”anje te opÄu sigurnost cestovnog prometa. Primjenom metode preživljavanja moguÄe je, na temelju baze podatak o prometnim znakovima, modelirati, odnosno predvidjeti funkcionalni životni vijek prometnih znakova, Å”to je od iznimne važnosti za uspostavljanje kvalitetnog sustava održavanja i zamjene prometne signalizacije, osiguranje zadovoljavajuÄe razine sigurnosti, te dugoroÄno smanjenje troÅ”kova.Traffic signs, as part of a traffic signaling system, represent the means of communication between the road transport operators and traffic participants. In order for the traffic signs to perform their duties well, they must be visible in all traffic and weather conditions and must convey a clear and timely understandable message. Over time, the retroreflective properties of traffic signs degrade and signs loose their quality thus reducing the drivers distance to perceived signs, which can affect their behavior and overall road traffic safety. Using the survival method, it is possible to model or predict the functional lifespan of traffic signs based on the traffic information base, which is of utmost importance for the establishment of a high quality maintenance and replacement of the signaling system, ensuring a satisfactory level of safety and a long-term reduction in costs
Richterov tip inkarcerirane obturatorne hernije: otežana dijagnostika
Obturator hernia is a rare type of abdominal hernia where herniation occurs through the obturator canal. It develops predominantly in elderly underweight women. It has unspecific early symptoms, which is the reason these hernias are usually discovered only after they have become incarcerated. Incarcerated obturator hernias are usually discovered on abdominal computed tomography (CT) scan or emergency surgery due to bowel obstruction. We present a case of an 85-year-old female patient who was admitted because of intermittent abdominal pain and vomiting. Consecutive upright abdominal x-rays failed to show bowel obstruction. Abdominal CT scan revealed a right-sided incarcerated femoral hernia that was not found during emergency surgery. After laparotomy had been performed, a Richter type of right-sided incarcerated obturator hernia was discovered with a small necrotic area on the small bowel. Bowel resection was performed and obturator hernia was closed with interrupted sutures. The patient recovered without complications. Obturator hernia, due to its rarity and unspecific early symptoms, can still be misleading even to the most experienced surgeons. Delayed diagnosis of obturator hernia can lead to bowel necrosis and perforation with significant postoperative morbidity and mortality.Obturatorna hernija je rijedak oblik abdominalne hernije gdje do hernijacije dolazi kroz obturatorni kanal. NajÄeÅ”Äe se javlja kod starijih pothranjenih žena. Rani simptomi obturatorne hernije su nespecifiÄni, Å”to je razlog da se ovakve hernije prepoznaju obiÄno nakon Å”to se razvije inkarceracija. Inkarcerirane obturatorne hernije se najÄeÅ”Äe prepoznaju tijekom CT trbuha ili hitnog kirurÅ”kog zahvata zbog simptoma mehaniÄkog ileusa. Ovdje prikazujemo sluÄaj 85-godiÅ”nje bolesnice koja je primljena u bolnicu zbog povremenih bolova u trbuhu praÄenih povraÄanjem. Uzastopne nativne RTG snimke abdomena nisu pokazale opstrukciju crijeva. UÄinjen je CT trbuha gdje se prikazala desnostrana inkarcerirana femoralna kila koja, meÄutim, tijekom hitnog kirurÅ”kog zahvata nije naÄena. Nakon Å”to je uÄinjena laparotomija, pronaÅ”li smo desnostranu inkarceriranu obturatornu kilu Richterova tipa s malim podruÄjem nekrotiÄnog tankog crijeva. UÄinili smo segmentnu resekciju tankog crijeva. Kilni otvor je zatvoren pojedinaÄnim Å”avima. Postoperacijski oporavak bolesnice je bio uredan. Obturatorna kila, zahvaljujuÄi niskoj incidenciji i nespecifiÄnim ranim simptomima, može biti zbunjujuÄa Äak i za najiskusnijeg kirurga. OdgoÄena dijagnoza obturatorne kile može dovesti do nekroze i perforacije crijeva, Å”to sa sobom nosi znaÄajan pobol i smrtnost
Determination of Correlation between Occurrence of Traffic Accidents and Quality of Traffic Signs on State Road DC8
Prometne nesreÄe su neizostavni dio cestovnog prometa. DosadaÅ”nja znanstvena istraživanja dokazala su da prometna signalizacija utjeÄe na vjerojatnost nastanka prometnih nesreÄa. U cilju ostvarivanja sigurnog i nesmetanog odvijanja prometnog toka posebnu pozornost potrebno je posvetiti prijenosu informacija. U cestovnom prometu se prijenos informacija izmeÄu nadležnih za ceste i sudionika u prometu realizira pomoÄu prometne signalizacije. Cilj ovog rada je dokazati povezanost kvalitete prometnih znakova sa prometnim nesreÄama. StatistiÄkom analizom obuhvaÄeni su podaci o kvaliteti prometne signalizacije na državnoj cesti DC8 i podaci o prometnim nesreÄama koje su se dogodile na državnoj cesti DC8. Rezultatima korelacijske analize podataka utvrÄeno je da postoji srednja pozitivna veza izmeÄu prometnih nesreÄa koje su se dogodile u uvjetima smanjene vidljivosti na državnoj cesti DC8 i prometnih znakova koji ne zadovoljavaju minimalne uvjete retrorefleksije.Traffic accidents are an indispensable part of road traffic. Previous scientific research has shown that traffic signaling affects the likelihood of traffic accidents. In order to achieve a safe and undisturbed flow of traffic, special attention should be paid to the transfer of information. In road traffic, transport of information between road and road transport operators is realized through traffic signaling. The aim of this paper is to demonstrate the correlation of traffic signs with traffic accidents. Statistical analysis includes data on quality of traffic signaling on DC8 state road and traffic accident data for the DC8 state road. The results of the correlation analysis showed that there was a medium positive link between traffic accidents that occurred under low visibility conditions on the DC8 state road and traffic signs that did not meet the minimum retroreflective conditions
Determination of Correlation between Occurrence of Traffic Accidents and Quality of Traffic Signs on State Road DC8
Prometne nesreÄe su neizostavni dio cestovnog prometa. DosadaÅ”nja znanstvena istraživanja dokazala su da prometna signalizacija utjeÄe na vjerojatnost nastanka prometnih nesreÄa. U cilju ostvarivanja sigurnog i nesmetanog odvijanja prometnog toka posebnu pozornost potrebno je posvetiti prijenosu informacija. U cestovnom prometu se prijenos informacija izmeÄu nadležnih za ceste i sudionika u prometu realizira pomoÄu prometne signalizacije. Cilj ovog rada je dokazati povezanost kvalitete prometnih znakova sa prometnim nesreÄama. StatistiÄkom analizom obuhvaÄeni su podaci o kvaliteti prometne signalizacije na državnoj cesti DC8 i podaci o prometnim nesreÄama koje su se dogodile na državnoj cesti DC8. Rezultatima korelacijske analize podataka utvrÄeno je da postoji srednja pozitivna veza izmeÄu prometnih nesreÄa koje su se dogodile u uvjetima smanjene vidljivosti na državnoj cesti DC8 i prometnih znakova koji ne zadovoljavaju minimalne uvjete retrorefleksije.Traffic accidents are an indispensable part of road traffic. Previous scientific research has shown that traffic signaling affects the likelihood of traffic accidents. In order to achieve a safe and undisturbed flow of traffic, special attention should be paid to the transfer of information. In road traffic, transport of information between road and road transport operators is realized through traffic signaling. The aim of this paper is to demonstrate the correlation of traffic signs with traffic accidents. Statistical analysis includes data on quality of traffic signaling on DC8 state road and traffic accident data for the DC8 state road. The results of the correlation analysis showed that there was a medium positive link between traffic accidents that occurred under low visibility conditions on the DC8 state road and traffic signs that did not meet the minimum retroreflective conditions
Comparison of multidetector-row computed tomography and duplex Doppler ultrasonography in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage [Usporedba viŔeslojne kompjuterizirane tomografije i duplex Doppler ultrazvuka u otkrivanju aterosklerotskih karotidnih plakova kompliciranih krvarenjem u plak ]
This study compared sensitivity and specificity of multidetector-row computed tomography and duplex Doppler ultrasonography in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage. Carotid plaques from 50 patients operated for carotid artery stenosis were analyzed. Carotid endarterectomy was performed within one week of diagnostic evaluation. Results of multidetector-row computed tomography and duplex Doppler ultrasonography diagnostic evaluation were compared with results of histological analysis of the same plaque areas. American Heart Association classification of atherosclerotic plaques was applied for histological classification. Median tissue density of carotid plaques complicated with intraplaque hemorrhage was 14.7 Hounsfield units. Median tissue density of noncalcified segments of uncomplicated plaques was 54.3 Hounsfield units (p = 0.00003). The highest tissue density observed for complicated plaques was 31.8 Hounsfield units. Multidetector-row computed tomography detected plaques complicated with hemorrhage with sensitivity of 100% and specificity of 70.4%, with tissue density of 33.8 Hounsfield units as a threshold value. Duplex Doppler ultrasonography plaque analysis based on visual in-line classification showed sensitivity of 21.7% and specificity of 89.6% in detecting plaques complicated with intraplaque hemorrhage. Multidetector-row computed tomography showed a very high level of sensitivity and a moderate level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage. Duplex Doppler ultrasonography plaque analysis based on visual in-line classification showed a low level of sensitivity and a moderate-high level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage
Mucinozna komponenta u kolorektalnom karcinomu ā utjecaj na preživljenje
AIM. Clinical significance of mucin component in colorectal cancer is still unclear. We compared clinical and pathological features of mucinous and non-mucinous colorectal cancers and assessed the impact of mucinous differentiation and other specific features of colorectal cancer on survival. PATIENTS AND METHODS. We analyzed clinical and pathological data of 271 patients who underwent surgical resection of colorectal adenocarcinoma at our Department between 1994 and 2002. RESULTS. Patients with mucinous colorectal cancer had worse overall survival, but not statistically significant (P=0.296). In a multivariate model, only tumor size, the presence of hepatic metastases, and the presence of metastases in lymph nodes, but not mucinous differentiation, were found to be significant and independent predictors of survival. CONCLUSION. The results of this study confirm the frequent observation that mucinous colorectal cancer is associated with worse prognosis compared to non-mucinous type. However, these results do not provide evidence that mucinous differentiation is independently associated with more aggressive tumor behavior. Current findings justify surgical resection of all gross tumor deposits, together with the employment of perioperative intraperitoneal chemotherapy in the treatment of patients with mucinous colorectal cancer.CILJ. KliniÄka važnost mucinozne komponente u kolorektalnom karcinomu joÅ” nije jasan. Usporedili smo kliniÄke i patoloÅ”ke osobine kolorektalnog karcinoma mucinoznog i nemucinoznog tipa te mjerili utjecaj diferencijacije mucina i drugih specifiÄnih znaÄajka kolorektalnog karcinoma na preživljenje. BOLESNICI I METODE. Analizirali smo kliniÄke i patoloÅ”ke podatke 271 bolesnika u kojih je na naÅ”em odjelu od 1994. do 2002. kirurÅ”kim putem uklonjen kolorektalni adenokarcinom. REZULTATI. Bolesnici s mucinoznim kolorektalnim karcinomom imaju loÅ”ije sveukupno preživljenje, ali to nije statistiÄki znaÄajno (P=0,296). Na multivarijatnom modelu uoÄeno je da su samo veliÄina tumora, prisutnost jetrenih metastaza i prisutnost metastaza u limfnim Ävorovima, a ne i mucinozna diferencijacija, znaÄajni i nezavisni prognostiÄki faktori preživljenja. ZAKLJUÄAK. Rezultati ovog ispitivanja potvrÄuju ono Å”to se Äesto uoÄava, a to je da je prognoza za mucinozni kolorektalni karcinom loÅ”ija od prognoze za nemucinozni tip raka toga sijela. MeÄutim, tj. rezultati ne dokazuju da je mucinozna diferencijacija nezavisno povezana s agresivnijim ponaÅ”anjem tumora. SadaÅ”nji nalazi opravdavaju kirurÅ”ku resekciju svih okom vidljivih tumorskih depozita uz primjenu perioperativne intraperitonejske kemoterapije u lijeÄenju bolesnika s mucinoznim kolorektalnim karcinomom
Isolated Splenic Metastasis from Colon Cancer ā Case Report and Literature Review
Solitary splenic metastases are very rare and sporadic. There are several explanations for this low incidence of splenic metastasis including anatomical, histological and immunological features of the spleen. In this paper we present a case of 70-year-old man with no history of previous diseases who was first operated under the diagnosis of acute abdomen revealing perforated colon tumor of splenic flexure with no metastases at that time. Left hemicolectomy was performed followed by postoperative complications demanding a subtotal colectomy and ileostomy. Primary tumor was classified as Dukes (Astler-Coller)-C2, T4N1M0. Patient was referred to oncologist and received chemotherapy (5FU, Leucovorin). 5 months later continuity of the gut was performed by ileosygmoanastomosis. 2 years after first surgical procedure, a CT scan and abdominal ultrasound, followed by needle biopsy, showed isolated metastasis in spleen, so splenectomy was performed. Pathological findings revealed sharply bordered, partially necrotic tumor inside of spleen tissue, spreading to, but not reaching splenic hilum. Histology showed low to medium differentiated adenocarcinoma tissue with desmoplastic stromal reaction. There were no protrusions of tumor cells through spleen surface. In splenic hilum 4 tumor free lymph nodes were harvested. No additional chemotherapy was conducted. The latest follow up, a year after diagnosis of metastasis showed no signs of cancer disease. Review of the literature showed that long term survival and prognosis of isolated splenic colorectal metastasis after splenectomy are rather optimistic, although these are the cases of distant metastasis. Due to small number of cases reported in literature, definitive conclusions and/or guidelines for the treatment of isolated splenic metastasis cannot be given, but splenectomy and chemotherapy are preferable in the treatment, promising long term survival at least for metachronous metastasis
Mucinozna komponenta u kolorektalnom karcinomu ā utjecaj na preživljenje
AIM. Clinical significance of mucin component in colorectal cancer is still unclear. We compared clinical and pathological features of mucinous and non-mucinous colorectal cancers and assessed the impact of mucinous differentiation and other specific features of colorectal cancer on survival. PATIENTS AND METHODS. We analyzed clinical and pathological data of 271 patients who underwent surgical resection of colorectal adenocarcinoma at our Department between 1994 and 2002. RESULTS. Patients with mucinous colorectal cancer had worse overall survival, but not statistically significant (P=0.296). In a multivariate model, only tumor size, the presence of hepatic metastases, and the presence of metastases in lymph nodes, but not mucinous differentiation, were found to be significant and independent predictors of survival. CONCLUSION. The results of this study confirm the frequent observation that mucinous colorectal cancer is associated with worse prognosis compared to non-mucinous type. However, these results do not provide evidence that mucinous differentiation is independently associated with more aggressive tumor behavior. Current findings justify surgical resection of all gross tumor deposits, together with the employment of perioperative intraperitoneal chemotherapy in the treatment of patients with mucinous colorectal cancer.CILJ. KliniÄka važnost mucinozne komponente u kolorektalnom karcinomu joÅ” nije jasan. Usporedili smo kliniÄke i patoloÅ”ke osobine kolorektalnog karcinoma mucinoznog i nemucinoznog tipa te mjerili utjecaj diferencijacije mucina i drugih specifiÄnih znaÄajka kolorektalnog karcinoma na preživljenje. BOLESNICI I METODE. Analizirali smo kliniÄke i patoloÅ”ke podatke 271 bolesnika u kojih je na naÅ”em odjelu od 1994. do 2002. kirurÅ”kim putem uklonjen kolorektalni adenokarcinom. REZULTATI. Bolesnici s mucinoznim kolorektalnim karcinomom imaju loÅ”ije sveukupno preživljenje, ali to nije statistiÄki znaÄajno (P=0,296). Na multivarijatnom modelu uoÄeno je da su samo veliÄina tumora, prisutnost jetrenih metastaza i prisutnost metastaza u limfnim Ävorovima, a ne i mucinozna diferencijacija, znaÄajni i nezavisni prognostiÄki faktori preživljenja. ZAKLJUÄAK. Rezultati ovog ispitivanja potvrÄuju ono Å”to se Äesto uoÄava, a to je da je prognoza za mucinozni kolorektalni karcinom loÅ”ija od prognoze za nemucinozni tip raka toga sijela. MeÄutim, tj. rezultati ne dokazuju da je mucinozna diferencijacija nezavisno povezana s agresivnijim ponaÅ”anjem tumora. SadaÅ”nji nalazi opravdavaju kirurÅ”ku resekciju svih okom vidljivih tumorskih depozita uz primjenu perioperativne intraperitonejske kemoterapije u lijeÄenju bolesnika s mucinoznim kolorektalnim karcinomom
Laparoscopic Operation of Hepatic Hydatid Cyst with Intraabdominal Dissemination ā A Case Report and Literature Review
Hepatic hydatid cysts are a serious medical problem in some regions like Mediterranean region. In Croatia 25ā30 new cases of hepatic hydatid cysts are recorded each year. In University Hospital Dubrava 7 patients with hepatic hydatid cysts were operated in 2008. Surgical approach recognizes open laparotomy and laparoscopy. The case and technique of laparoscopic operation of hepatic hydatid cyst in seventh segment and three disseminated intraabdominal cysts is described. Laparoscopy should be attempted even in complex cases with dissemination
Comparison of Multidetector-Row Computed Tomography and Duplex Doppler Ultrasonography in Detecting Atherosclerotic Carotid Plaques Complicated with Intraplaque Hemorrhage
This study compared sensitivity and specificity of multidetector-row computed tomography and duplex Doppler ultrasonography in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage. Carotid plaques from 50 patients operated for carotid artery stenosis were analyzed. Carotid endarterectomy was performed within one week of diagnostic evaluation. Results of multidetector-row computed tomography and duplex Doppler ultrasonography diagnostic evaluation were compared with results of histological analysis of the same plaque areas. American Heart Association classification of atherosclerotic plaques was applied for histological classification. Median tissue density of carotid plaques complicated with intraplaque hemorrhage was 14.7 Hounsfield units. Median tissue density of noncalcified segments of uncomplicated plaques was 54.3 Hounsfield units (p=0.00003). The highest tissue density observed for complicated plaques was 31.8 Hounsfield units. Multidetector-row computed tomography detected plaques complicated with hemorrhage with sensitivity of 100% and specificity of 70.4%, with tissue density of 33.8 Hounsfield units as a threshold value. Duplex Doppler ultrasonography plaque analysis based on visual in-line classification showed sensitivity
of 21.7% and specificity of 89.6% in detecting plaques complicated with intraplaque hemorrhage. Multidetector-row computed tomography showed a very high level of sensitivity and a moderate level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage. Duplex Doppler ultrasonography plaque analysis based on visual in-line classification showed a low level of sensitivity and a moderate-high level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage
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