Primarni zloćudni melanom sluznice usne šupljine

Primary oral malignant melanoma usually presents as a dark brown or black lesion. It is a rare malignancy, accounting for less than 1% of all melanomas and 1.6% of all head and neck malignancies, thus forming up to 0.5% of all oral malignancies in the world literature. In general, the prognosis of oral melanoma is poor and worse than that of cutaneous melanoma. The preferred treatment is radical surgery alone or in combination with radiotherapy, chemotherapy, immunotherapy and immunomodulatory agents. A case is presented of a large malignant melanoma of oral cavity, noticed six months before initial biopsy and by history described as a rapidly growing mass.Primarni melanom sluznice usne šupljine obično je tamno smeđe ili crno pigmentirana lezija. Vrlo je rijetka zloćudna bolest koja se javlja u manje od 1% svih melanoma i čini 1,6% svih maligniteta glave i vrata tvoreći, kako navodi svjetska literatura, do 0,5% svih maligniteta u usnoj šupljini. Općenito, prognoza je lošija nego kod kožnih melanoma. Kirurška resekcija je jedan od najčešćih oblika liječenja, a pokušava se i radioterapijom, kemoterapijom, imunoterapijom i imunomodulatorima. Opisuje se slučaj velikog melanoma u usnoj šupljini ubrzani rast kojega je primijećen šest mjeseci prije biopsije i potvrđene dijagnoze

Convex Combination Inequalities of the Line and Plane

The paper deals with convex combinations, convex functions, and Jensen’s functionals. The main idea of this work is to present the given convex combination by using two other convex combinations with minimal number of points. For example, as regards the presentation of the planar combination, we use two trinomial combinations. Generalizations to higher dimensions are also considered

Jensen's inequality for operators without operator convexity

AbstractWe give Jensen’s inequality for n-tuples of self-adjoint operators, unital n-tuples of positive linear mappings and real valued continuous convex functions with conditions on the bounds of the operators. We also study operator quasi-arithmetic means under the same conditions

Slučaj karcinoma stanica prstena pečatnjaka žučnog mjehura: Imunohistokemija i diferencijalna dijagnostika

The morphological spectrum of gallbladder carcinoma is broad and variable. Most of these tumors are tubular adenocarcinomas. There are some tumors with unusual morphology that may be difficult to classify due to their rarity. One of such tumors is the signet-ring cell carcinoma, which is a highly aggressive, mucin producing variant of gallbladder adenocarcinoma predominantly or exclusively composed of signet-ring cells. Histologically, these tumors are similar to their counterparts in other organs such as stomach, colon and breast, and should not be misinterpreted as metastatic carcinoma from one of these primary sites. The literature about this variant of carcinoma is sparse and little is known about it. We found only three cases of signet-ring cell carcinoma of the gallbladder previously reported. We present the case of an 86-year-old woman with signet-ring cell carcinoma of the gallbladder and discuss the potential diagnostic dilemmas and pitfalls.Morfološki spektar karcinoma žučnog mjehura širok je i raznolik. Većina tumora su tubularni adenokarcinomi. Postoje neki tumori neobične morfologije koje je teže klasificirati zbog njihove rijetkosti. Jedan od takvih tumora je karcinom stanica prstena pečatnjaka, visoko agresivna varijanta adenokarcinoma žučnjaka koja proizvodi sluz, a pretežito je ili isključivo sastavljena od stanica tipa prstena pečatnjaka. Histološki, ovi su tumori slični svojim pandanima u drugim organima kao što su želudac, debelo crijevo i dojka te ih se ne bi smjelo pogrešno interpretirati kao metastatske karcinome iz spomenutih organa. Literatura na temu ovoga tipa karcinoma je rijetka i o njemu se malo zna. Našli smo samo 3 prethodno objavljena slučaja ovoga karcinoma. U članku se prikazuje slučaj 86-godišnje žene s karcinomom stanica prstena pečatnjaka žučnjaka i raspravlja o potencijalnim dijagnostičkim dvojbama i mogućim pogreškama

THE RESULTS OF INTERNAL FIXATION OF PROXIMAL HUMERAL OSTEOPOROTIC FRACTURES WITH PHILOS LOCKING PLATE

Background: In the last fifty years since plate and screw osteosynthesis has been implemented in fracture treatment, osteosporotic bone fractures were observed as a special problem. Due to special histologic, anatomic, physical and biomehanic properties of osteoporotic changed bone the laws of biomechanics suggest that stable osteosynthesis for osteoporotic bone is necessary to increase the contact surface of metallic implants and bone and the stability of the screw-plate-bone compound. There are numerous surgical techniques and methods for treatment of osteoporotic proximal humeral fractures. Every surgical procedure has to establish anatomical reduction and stable fixation that will enable early mobilisation. Subjects and methods: The aim of this study was to present results of internal fixation of proximal humeral osteoporotic fractures with PHILOS locking plate. Between 2007 and 2012, a total of 67 patients older than 65 years with closed proximal humerus fractures underwent surgical treatment with PHILOS plate system (Synthes, Switzerland). 42 patients were operated with deltopectoral approach and 25 with deltoid split approach. After a mean follow up period of 14.68 (6-28) months functional and radiologic results were assessed. Results: We noted 9 postoperative complications related to surgical technique (1 intraarticular screw placement, 1 displacement in major tuberculum fragment, 1 displacement in major tuberculum fragment along with oblique placement of the plate, 2 cases of inadequate reduction, 1 case of humeral head avascular necrosis, varus humeral head fixation in 3 cases). None of the patients developed superficial or deep surgical infection. There was no nonunions. In the final evaluation, the Constant shoulder score was 91.75 (72-100). Conclusions: In this study PHILOS locking plate showed good applicability, respecting bone biologic properties because of negligible interference with blood supply of the humeral head. There was no requirement to shape the plate enabling stabilization at constant angles as clear benefit of this plate. All that enables early mobilisation, and no implant insufficiency resulting in satisfactory treatment results and high Constant shoulder scores

Sex or Surgery – Erectile Dysfunction after Radical Treatment of Localized Prostate Cancer

The maintenance of satisfactory quality of life is major concern in majority of patients who elect treatment for localized prostate cancer. We conducted a cross-sectional study to determine sexual function after radical prostatectomy (RP) and external beam radiotherapy (EBRT). Study population consisted of series of 57 patients with early-stage adenocarcinoma of the prostate, treated in our institution in the period from January 2003 till December 2003. Thirty three patients underwent radical retropubical prostatectomy and 24 patients were treated by primary radical radiotherapy. Patients have been given the full international index of erectile function (IIEF) questionnaire two to four and six months after the treatment. Post treatment sexual function in patients treated by EBRT is significantly better than in patients treated by RP (48,5% vs. 21.57%, p<0,0001). Subgroup analysis reveals that satisfaction with erectile function, maintaining of sexual intercourse and possibility of ejaculation is better in patients treated by EBRT than in patients treated by RP (44.67% vs. 11.57%, p <0,0001) as well as general satisfaction with quality of sexual life (48.5% in EBRT group vs. 21.57% in RP group, p <0,0001). On the other hand, sexual desire remains the same in both groups of patients (63.75% in EBRT group vs. 60.61% in RP group, p = 0.71). Six months after surgical or radiotherapy treatment erectile function is almost as twice as worse in patients treated by surgery than in patients treated by radiotherapy