Determining the Lifespan of Traffic Signs Using the Survival Analysis Method

Prometni znakovi, kao dio sustava prometne signalizacije, predstavljaju sredstva komunikacije između nadležnih za ceste i sudionika u prometu. Da bi prometni znakovi kvalitetno izvršavali svoje zadatke oni moraju biti vidljivi u svim prometnim i vremenskim uvjetima te moraju prenositi jasnu i na vrijeme razumljivu poruku. S vremenom retroreflektirajuća svojstva prometnih znakova degradiraju te znakovi gube na kvaliteti, čime se smanjuje i vozačeva udaljenost percepcije znakova što može utjecati na njegovo ponašanje te opću sigurnost cestovnog prometa. Primjenom metode preživljavanja moguće je, na temelju baze podatak o prometnim znakovima, modelirati, odnosno predvidjeti funkcionalni životni vijek prometnih znakova, što je od iznimne važnosti za uspostavljanje kvalitetnog sustava održavanja i zamjene prometne signalizacije, osiguranje zadovoljavajuće razine sigurnosti, te dugoročno smanjenje troškova.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. Najčešće se javlja kod starijih pothranjenih žena. Rani simptomi obturatorne hernije su nespecifični, što je razlog da se ovakve hernije prepoznaju obično nakon što se razvije inkarceracija. Inkarcerirane obturatorne hernije se najčešće prepoznaju tijekom CT trbuha ili hitnog kirurškog zahvata zbog simptoma mehaničkog ileusa. Ovdje prikazujemo slučaj 85-godišnje bolesnice koja je primljena u bolnicu zbog povremenih bolova u trbuhu praćenih povraćanjem. Uzastopne nativne RTG snimke abdomena nisu pokazale opstrukciju crijeva. Učinjen je CT trbuha gdje se prikazala desnostrana inkarcerirana femoralna kila koja, međutim, tijekom hitnog kirurškog zahvata nije nađena. Nakon što je učinjena laparotomija, pronašli smo desnostranu inkarceriranu obturatornu kilu Richterova tipa s malim područjem nekrotičnog tankog crijeva. Učinili smo segmentnu resekciju tankog crijeva. Kilni otvor je zatvoren pojedinačnim šavima. Postoperacijski oporavak bolesnice je bio uredan. Obturatorna kila, zahvaljujući niskoj incidenciji i nespecifičnim ranim simptomima, može biti zbunjujuća čak i za najiskusnijeg kirurga. Odgođena dijagnoza obturatorne kile može dovesti do nekroze i perforacije crijeva, što sa sobom nosi značajan pobol i smrtnost

Determination of Correlation between Occurrence of Traffic Accidents and Quality of Traffic Signs on State Road DC8

Prometne nesreće su neizostavni dio cestovnog prometa. Dosadašnja znanstvena istraživanja dokazala su da prometna signalizacija utječe na vjerojatnost nastanka prometnih nesreća. U cilju ostvarivanja sigurnog i nesmetanog odvijanja prometnog toka posebnu pozornost potrebno je posvetiti prijenosu informacija. U cestovnom prometu se prijenos informacija između nadležnih za ceste i sudionika u prometu realizira pomoću prometne signalizacije. Cilj ovog rada je dokazati povezanost kvalitete prometnih znakova sa prometnim nesrećama. Statističkom analizom obuhvaćeni su podaci o kvaliteti prometne signalizacije na državnoj cesti DC8 i podaci o prometnim nesrećama koje su se dogodile na državnoj cesti DC8. Rezultatima korelacijske analize podataka utvrđeno je da postoji srednja pozitivna veza između prometnih nesreća 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 nesreće su neizostavni dio cestovnog prometa. Dosadašnja znanstvena istraživanja dokazala su da prometna signalizacija utječe na vjerojatnost nastanka prometnih nesreća. U cilju ostvarivanja sigurnog i nesmetanog odvijanja prometnog toka posebnu pozornost potrebno je posvetiti prijenosu informacija. U cestovnom prometu se prijenos informacija između nadležnih za ceste i sudionika u prometu realizira pomoću prometne signalizacije. Cilj ovog rada je dokazati povezanost kvalitete prometnih znakova sa prometnim nesrećama. Statističkom analizom obuhvaćeni su podaci o kvaliteti prometne signalizacije na državnoj cesti DC8 i podaci o prometnim nesrećama koje su se dogodile na državnoj cesti DC8. Rezultatima korelacijske analize podataka utvrđeno je da postoji srednja pozitivna veza između prometnih nesreća 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 višeslojne 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 – 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. Klinička važnost mucinozne komponente u kolorektalnom karcinomu još nije jasan. Usporedili smo kliničke i patološke osobine kolorektalnog karcinoma mucinoznog i nemucinoznog tipa te mjerili utjecaj diferencijacije mucina i drugih specifičnih značajka kolorektalnog karcinoma na preživljenje. BOLESNICI I METODE. Analizirali smo kliničke i patološke podatke 271 bolesnika u kojih je na našem odjelu od 1994. do 2002. kirurškim putem uklonjen kolorektalni adenokarcinom. REZULTATI. Bolesnici s mucinoznim kolorektalnim karcinomom imaju lošije sveukupno preživljenje, ali to nije statistički značajno (P=0,296). Na multivarijatnom modelu uočeno je da su samo veličina tumora, prisutnost jetrenih metastaza i prisutnost metastaza u limfnim čvorovima, a ne i mucinozna diferencijacija, značajni i nezavisni prognostički faktori preživljenja. ZAKLJUČAK. Rezultati ovog ispitivanja potvrđuju ono što se često uočava, a to je da je prognoza za mucinozni kolorektalni karcinom lošija od prognoze za nemucinozni tip raka toga sijela. Međutim, tj. rezultati ne dokazuju da je mucinozna diferencijacija nezavisno povezana s agresivnijim ponašanjem tumora. Sadašnji nalazi opravdavaju kiruršku resekciju svih okom vidljivih tumorskih depozita uz primjenu perioperativne intraperitonejske kemoterapije u liječenju bolesnika s mucinoznim kolorektalnim karcinomom

Isolated Splenic Metastasis from Colon Cancer – 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 – 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. Klinička važnost mucinozne komponente u kolorektalnom karcinomu još nije jasan. Usporedili smo kliničke i patološke osobine kolorektalnog karcinoma mucinoznog i nemucinoznog tipa te mjerili utjecaj diferencijacije mucina i drugih specifičnih značajka kolorektalnog karcinoma na preživljenje. BOLESNICI I METODE. Analizirali smo kliničke i patološke podatke 271 bolesnika u kojih je na našem odjelu od 1994. do 2002. kirurškim putem uklonjen kolorektalni adenokarcinom. REZULTATI. Bolesnici s mucinoznim kolorektalnim karcinomom imaju lošije sveukupno preživljenje, ali to nije statistički značajno (P=0,296). Na multivarijatnom modelu uočeno je da su samo veličina tumora, prisutnost jetrenih metastaza i prisutnost metastaza u limfnim čvorovima, a ne i mucinozna diferencijacija, značajni i nezavisni prognostički faktori preživljenja. ZAKLJUČAK. Rezultati ovog ispitivanja potvrđuju ono što se često uočava, a to je da je prognoza za mucinozni kolorektalni karcinom lošija od prognoze za nemucinozni tip raka toga sijela. Međutim, tj. rezultati ne dokazuju da je mucinozna diferencijacija nezavisno povezana s agresivnijim ponašanjem tumora. Sadašnji nalazi opravdavaju kiruršku resekciju svih okom vidljivih tumorskih depozita uz primjenu perioperativne intraperitonejske kemoterapije u liječenju bolesnika s mucinoznim kolorektalnim karcinomom

Laparoscopic Operation of Hepatic Hydatid Cyst with Intraabdominal Dissemination – A Case Report and Literature Review

Hepatic hydatid cysts are a serious medical problem in some regions like Mediterranean region. In Croatia 25–30 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