BURA NA PLAVNIKU (u govoru otoka Krka)

Der Autor verwendet in der Beschreibung die Bora (des Sturmes) Wörter, die ausschilisslich auf den Inseln Krk, Cres, Lošinj und Rab gesprochen werden, und von diesen überwiegend Wörter und grammatikalische Foremen, die aus der »Čakavski« Mundart um das Gebiet Punta auf der Insel Krk stammen. Alle diese Inseln befinden sich geographisch am Rande des Slawentums unt Kroatentums. Die Insulaner sind sehr konservativ in ihrer Kulturpflege und hüten eifersüchting die überlieferten Lieder und gesprochenen Worte. In diesel Beschreibung gibt es viele Wörten aus der »Čakavski« Mundart, die mit grosser Wahrscheinlichkeit genau so bereits im altkroatischen glagolischen Wortschatz in Verwendung waren. Die Meinung des Autors ist, dass diese Wörter auf jeden Fall zur Bereicherung der kroatischen Sprache dienen und es deshalb wert sei, sie zu voröffentlichen und dadurch einem breiteren Leserkreis zugänglich zu machen. In der Beilage befindet sich auch ein umfangreiches Wörterbuch, ohne das es fast unmöglich wäre, dem text zu folgen

WHAT IS THE RELIABILITY OF DERMOSCOPIC INDICATION FOR EXCISIONAL BIOPSY?

Ekscizijska biopsija kožnih promjena sumnjivih na zloćudnost je zlatni standard u dijagnostici takvih promjena. Dermatološki klinički pregled je unaprijeđen dermatoskopijom kako bi se reducirao broj lezija klinički sumnjivih na zloćudnost za koje je potrebno kirurško liječenje i patohistološka verifi kacija. U kirurškoj praksi se uočava velik broj zahvata kod kojih se dermatoskopska indikacija razlikuje od defi nitivnog patohistološkog nalaza. U ovoj studiji od 125 dermatoskopski suspektnih zloćudnih kožnih promjena (u 66 bolesnika) patohistološki su potvrđena tri bazocelularna karcinoma, dva planocelularna karcinoma i dva maligna melanoma. Rezultati pokazuju pozitivnu prognostičku vrijednost dermatoskopskog nalaza za sve malignitete od 5,6 %.Excisional biopsy of skin lesions suspected of malignancy has been the gold standard as a diagnostic method. Dermatologic clinical examination has been updated by dermoscopic examination with the idea to reduce the number of clinically equivocal skin lesions needed to treat surgically with further histopathologic verifi cation. In clinical practice, there is a considerable rate of false-positive indications made only by clinical examination or with dermoscopic examination in comparison with later histopathologic examination, putting the reliability of dermatologic examination in question. Consecutive patients (n=66) presenting with doubtful lesions (n=125) were considered for enrolment. The lesions were assessed by histopathology, which is considered as the reference standard. Dermatologic indication for skin lesions suspected of malignancy yielded a positive predictive value of 5.6%. There was a discrepancy between our results and the values reported from other studies

Phalangeal fractures in children

Prijelomi članaka prstiju šake kod djece patologija su s kojom se vrlo često susreću liječnici hitnog prijma. U najvećem broju slučajeva riječ je o ozljedama koje zahtijevaju kratko razdoblje imobilizacije, a tek je u rijetkim slučajevima potrebno kirurško liječenje. Stoga, da se kod svakog djeteta osigura optimalan ishod, potrebno je poznavati rijetke prijelome članaka prstiju kod djece kod koje bi operativno liječenje bilo indicirano. Seymourov prijelom zahtijeva liječenje po načelima otvorenog prijeloma. Koštani mallet finger s prisutnom subluksacijom zgloba valjalo bi operativno stabilizirati. Subkapitalni i kondilarni prijelomi, kao i skijaški palac sa značajnom dislokacijom, indikacija su za kirurško liječenje. Kod kompleksnih dislokacija metakarpofalangealnog zgloba u najvećem je broju nužna otvorena repozicija i fiksacija. Avulzije volarne ploče su prijelomi koji mogu rezultirati ukočenošću proksimalnog interfalangealnog (PIP) zgloba u slučaju preduge imobilizacije, a u slučaju avulzijskih ozljeda u području dorzuma srednjeg članka treba uvijek isključiti pridruženu rupturu sagitalnog kraka ekstenzorne tetive.Phalangeal fractures are a pathology that is often encountered in the emergency room setting. In the majority of cases, only a brief period of immobilisation is required while only few require operative treatment. In order to achieve an optimal outcome, it is necessary to be able to recognise the few types of fractures that require operative treatment. Seymour fracture should be treated according to the principles of open fracture management. Bony mallet finger with joint subluxation should be operatively stabilised. Subcapital fracture, condylar fracture as well as skier’s thumb with significant dislocation are indications for operative treatment. In the majority of complex metacarpophalangeal dislocations, open reduction and fixation is required. Avulsions of the volar plate may result in proximal interphalangeal joint stiffness when immobilised longer than one week, and in cases of avulsion from the dorsum of the middle phalanx, one should always exclude central slip rupture

The importance of intraoperative touch smears cytology in the nipple sparing mastectomy

Karcinom dojke je jedan od najraširenijih malignih tumora u žena, češće je duktalnog nego lobularnog podrijetla. Nalazi se na prvom mjestu i po pojavnosti i po mortalitetu. Vrlo je važno što ranije otkriti bolest jer dijagnosticiranje karcinoma u početnom stadiju jamči bolje izlječenje. Postoji mnogo dijagnostičkih metoda. Citološka punkcija pod nadzorom ultrazvuka i core biopsija imaju veliku ulogu u ranom otkrivanju bolesti i boljem preživljenju. Velik broj pacijentica operiran je poštednom operacijom zahvaljujući ranom otkrivanju karcinoma. Mastektomija se obično radi u pacijentica s multicentričnim, velikim ili ponovljenim tumorom nakon konzervativne terapije. Ponekad se mastektomija s poštedom kože i bradavice radi kod pacijentica s pozitivnim genom BRCA-1 i BRCA-2. U 5 do 10% pacijentica s karcinomom dojke tumorske se stanice mogu otkriti u bradavici. Intraoperacijska citološka analiza otiska baze mamile vrlo je važna i točnost ovisi o pravilno označenom dijelu bradavice (najvažnije je dobro označavanje vanjske i unutarnje površine bradavice) i znanju citologa. Tijekom jedne godine od 9. studenoga 2010. do 10. studenoga 2011. napravljena je mastektomija s poštedom bradavice u 47 pacijentica. Usporedbom hitne citološke i konačne patohistološke dijagnoze, citološka je dijagnoza pokazala specifičnost 97%, osjetljivost 85% i dijagnostičku točnost 91%. Moramo biti oprezni u interpretaciji rezultata zbog pukotina u smrznutim hitnim patohistološkim rezovima i sklonosti malignih stanica grupiranju, kao i kod nekrotičnih citoloških otisaka u kojima mogu biti skrivene i razorene maligne stanice. Intraoperacijska analiza omogućuje rekonstrukciju dojke tijekom iste operacije.Breast cancer is one of the most widespread malignant tumours in women, more commonly of ductal than lobular origin. It also has the highest incidence and mortality rates. Early detection is very important since breast cancer diagnosis in the initial stages guarantees better outcomes. There are many diagnostic methods. Ultrasound-guided cytological puncture and core biopsy have a major role in early detection of this disease and better chances of survival. A large number of patients had breast-conserving surgery thanks to the early detection of cancer. Mastectomy is usually performed on patients with multicentric, large or recurrent tumours after conservative treatment. Sometimes skin-sparing and nipple-sparing mastectomy is performed on patients with positive BRCA-1 and BRCA-2 genes. Tumour cells can be detected in the nipple in 5-10% of patients with breast cancer. Intraoperative cytologic analysis of the nipple-areola complex imprint is very important and the accuracy depends on the properly marked part of the nipple (the most important step is to properly label the inner and outer surface of the nipple) and the skill of the cytologist. Over the course of one year, from 9 November 2010 to 10 November 2011, 47 patients had nipple-sparing mastectomy. The comparison of the cytologic and final histopathological diagnosis showed that cytological diagnosis had 97% specificity, 85% sensitivity and 91% diagnostic accuracy. We need to exercise caution in the interpretation of results due to cracks in frozen urgent histopathological cuts and the grouping tendency of malignant cells, as well as necrotic cytologic imprints which can contain hidden and destroyed malignant cells. Intraoperative analysis allows for breast reconstruction during the same surgical procedure

Posterior sternoclavicular dislocation in a 15-year old boy: case report

Posteriorne dislokacije sternoklavikularnog zgloba su rijetke ozljede koje čine manje od 5% ozljeda ramenog obruča. Dok se anteri- orne dislokacije mogu liječiti neoperativno, posteriorne dislokacije treba ili zatvoreno reponirati ili provesti otvorenu repoziciju i fiksa- ciju. U slučajevima pridruženih ozljeda medijastinalnih struktura, otvorena repozicija je obavezna. Mi prikazujemo slučaj 15-godiš- njeg dječaka koji se prezentirao sa posteriornom dislokacijom sternoklavikularnog zgloba bez pridruženih ozljeda kod kojega smo napravili RTG toraksa ali je za definitivnu dijagnozu bila potrebna kompjuterizirana tomografija. Otvorena repozicija i serklaža sa 3 ne-resorptivna šava je omogućila stabilnu fiksaciju te je pacijent bio bez simptoma tijekom perioda praćenja.Posterior sternoclavicular joint dislocation is a very rare injury, representing less than 5% of all shoulder girdle injuries. While anterior dislocations may be treated non-operatively, posterior dislocations should either be reduced closed or open and fixed. In cases of concomitant injuries to the mediastinal structures, an open reduction is mandatory. We present a case of a 15-year old boy who presented with a posterior sternoclavicular joint dislocation without concomitant injuries in whom we have performed a chest X-ray but a computerised tomography was needed for a definitive diagnosis. An open reduction and cerclage with 3 non-absorbable sutures provided a stable fixation and the patient remained free of symptoms during the follow-up period

Sonoelastografske karakteristike lezija dojke visokog rizika i duktalnog karcinoma in situ - probno istraživanje

The aim of this study was to evaluate the quantitative sonoelastographic values recorded on shear-wave sonoelastography (SWE) of high-risk breast lesions and ductal carcinoma in situ (DCIS). We retrospectively analyzed histopathologic and SWE data (quantitative maximum, minimum and mean stiffness, lesion-to-fat ratio (E-ratio), lesion size) of 228 women referred to our Department for core needle breast biopsy during a four-year period. Among 230 lesions, histopathologic findings showed 34 high-risk breast lesions and 29 DCIS, which were compared with 167 ductal invasive carcinomas. High-risk lesions had lower values of all sonoelastographic features than ductal in situ and invasive carcinoma, however, only E-ratio showed a statistically significant difference in comparison to DCIS (3.7 vs. 6, p<0.001). All sonoelastographic features showed significant difference between in situ and invasive carcinoma. There was a significant correlation between lesion size and stiffness (r=0.36; p<0.001). Stiffness measured by SWE is an effective predictor of the histopathologic severity of sonographically detectable breast lesions. Elasticity values of high-risk lesions are significantly lower than those of malignant lesions. Furthermore, we showed that along with the sonographic appearance, which in most cases shows typical microcalcifications, DCIS had significantly different elasticity parameters than invasive carcinoma.Cilj ove studije bio je izmjeriti kvantitativne vrijednosti tvrdoće lezija dojke visokog rizika i duktalnog karcinoma in situ (DKIS) pomoću shear-wave sonoelastografije. Retrospektivno smo analizirali patohistološke, ultrazvučne i elastografske podatke (maksimalna, srednja i minimalna tvrdoća, omjer tvrdoće lezije i masnog tkiva (E-omjer), veličina lezije) 228 bolesnica upućenih tijekom četvorogodišnjeg razdoblja na naš odjel radi biopsije dojke širokom iglom. Patohistološki su među 230 lezija dojke dijagnosticirane 34 lezije dojke visokog rizika, 29 duktalnih karcinoma in situ te 167 invazivnih duktalnih karcinoma dojke. Lezije visokog rizika pokazale su niže vrijednosti svih elastografskih parametara u usporedbi s duktalnim in situ i invazivnim karcinomima, no u usporedbi s DKIS jedino je E-omjer pokazao značajnu razliku tvrdoće (3,7 prema 6; p<0,001). Sve su se sonoelastografske vrijednosti značajno razlikovale pri usporedbi duktalnih in situ i invazivnih karcinoma. Nađena je značajna povezanost veličine i tvrdoće lezije (r=0,36; p<0,001). Tvrdoća mjerena shear-wave sonoelastografijom dobro korelira s patohistološkim nalazom lezija dojke koje se mogu otkriti ultrazvukom. Vrijednosti tvrdoće lezija visokog rizika su značajno niže od onih kod malignih lezija. Također smo pokazali da DKIS, uz ultrazvučni nalaz tipičnih mikrokalcifikata u najvećem broju slučajeva, ima i značajno manje vrijednosti tvrdoće od invazivnih karcinoma

TECHNOLOGY OF OZONE APPLICATIONS IN VITAL MEDICAL FIELDS

Veliki broj bolesti nastaje prvenstveno zbog nedostatka kisika u tkivima zbog akumulacije toksina u tijelu. Bezbolan i prirodan tretman ozonom pomaže kod operativnog oporavka i liječenja brojnih ozljeda i bolesti, pa čak i tumora, a za sada se najčešće koristi u stomatologiji. Ozon ima pozitivan utjecaj na zacjeljivanje rana, stimulaciju imunološkog sustava, oksigenaciju i protok krvi u tkivu, te smanjuje oticanje i bol.A large number of disease is primarily due to the lack of oxygen in the tissue due to the accumulation of toxins in the body. Painless and natural treatment with ozone helps with after-operating recovery and cure numerous injuries and illnesses, even tumors, and for now the most commonly used in dentistry. Ozone has a positive effect on wound healing, stimulation of the immune system, oxygenation and blood flow to tissues and to reduce swelling and pain

Fine-Needle Aspiration Cytology of Apocrine Hidradenoma

An apocrine hidradenoma is a benign adnexal neoplasm, usually covered by intact skin, but may show superficial ulceration and serous discharge. This feature is raising the possibility of malignancy as it was in our case of macroscopically suspicious tumour. We described cytomorphologic features of cutaneous nodule that might be a lead to the cytologic diagnosis of hidradenoma, but primary or secondary malignant tumour has been ruled out first

SUSTITUTE AND ALTERNATIVE FORMS OF TREATMENT OF SKIN DEFECTS

Gubitak kožnog pokrova ima različite uzroke te zahtijeva pokrivanje defekta da bi se smanjile posljedice i komplikacije, te produljenje hospitalizacije uz povećanje troškova liječenja. Standarne plastično rekonstrukcijske metode često nisu moguće ili su prekompleksne, tako da alternativni oblici liječenja koji uključuju zamjene za kožu imaju važnu ulogu.Damage to skin barrier has different causes, and in case of prolonged exposure without expeditious coverage it entails consequences such as prolonged hospitalization and higher treatment costs. Standard plastic reconstructive techniques of coverage are not always possible, so alternative skin coverage techniques have an important role in treatment

SUSTITUTE AND ALTERNATIVE FORMS OF TREATMENT OF SKIN DEFECTS

Gubitak kožnog pokrova ima različite uzroke te zahtijeva pokrivanje defekta da bi se smanjile posljedice i komplikacije, te produljenje hospitalizacije uz povećanje troškova liječenja. Standarne plastično rekonstrukcijske metode često nisu moguće ili su prekompleksne, tako da alternativni oblici liječenja koji uključuju zamjene za kožu imaju važnu ulogu.Damage to skin barrier has different causes, and in case of prolonged exposure without expeditious coverage it entails consequences such as prolonged hospitalization and higher treatment costs. Standard plastic reconstructive techniques of coverage are not always possible, so alternative skin coverage techniques have an important role in treatment