Hand injuries

Autori iz Medicinskog centra u Vinkovcima analizirali su 722 bolesnika s otvorenim ozljedama šake. Bolesnici su razvrstani po dobnim skupinama i po spolu, a vrste ozljeda prikazane su brojčano i tabelarno. Zaključili su da je u cca 200 bolesnika ostao veći ili manji invaliditet. Predlažu mjere kojima bi se utjecalo na poboljšanje rezultata i skraćenje vremena liječenja.Seven hundred and twenty two open hand traumatized patients have been analyzed. Patients have been grouped with respect to age and sex. A variety of lesions are presented numerically, as well as in tabular form. The authors concluded that about two hundred of such patients are handicaped forever, in major or minor ways. Measures are suggested to achieve better results and shorten the time of treatment

Fractures of the upper part of the femur

Autori analiziraju 226 bolesnika sa prijelomom vrata i pertrohantemog masiva femura, operiranih nekom od metoda unutarnje fiksacije: kutnom pločom ili Kirschnerovim žicama. Rezultati operiranih pertrohantemih prijeloma su o osnovi dobri, ali prijelomi vrata femura zahtijevaju mnogo kompleksniji pristup. Mortalitet je u ovoj grupi bolesnika bio vrlo mali. Nije bilo nijednog slučaja osteomyelitisa. Na tablicama su prikazani svi važniji faktori i podaci za ovu grupu bolesnika. Diskutira se također i o raznim terapeutskim mogućnostima.Two hundred and twenty-six neck and pertrochanteric fractures of the femur have been analyzed, treated by some kind of internal fixation devices — angle plate or Kirschner’s wires. Operative treatment of pertrochanteric fractures shows basically good results, whereas neck fractures need a much more complex approach. Mortality is very low in this group of patients. No osteomyelitis occured. The tables show all relevant data for this group of patients. Various therapeutic possibilities are also discussed

Wounds of extremities: experience with 480 wounded extremitie

Prikazani su rezultati liječenja 1186 stradalih u domovinskom ratu na području općine Vinkovci, i to od 01. srpnja 1991. do 30. lipnja 1992. god. Od svih ozlijeđenih muškarci su činili 85,49% (1014), žene 10,3 (122) i djeca 4,2% (50). Najveći je broj ozlijeđen krhotinama eksplozivnih naprava (granate, rakete) 85,48%, minama 8,48%, metkom 4,18%, a 1,92% je zadobilo opekotine, obično III stupnja. Učinjeno je 178 (28,52%) zahvata na gornjim i 302 (48,39%) kirurška zahvata na donjim udovima. Moderna oružja s projektilima velikih početnih brzina dovode do izuzetno ozbiljnih rana s masivnom destrukcijom tkiva. Krhotine bombi, granata ili mina postižu brzinu i od 1800 m/sec. Razarajući učinci prijenosa velike kinetičke energije na tkiva su dobro poznati i proučeni. Iako i nije izravno pogođena projektilom, kost će frakturirati ako se nađe unutar prostora zvanog "privremena šupljina", koja može biti i 30-40 puta veća od promjera projektila, a koštani ulomci postaju sekundarni projektili i dodatno proširuju područje tkivnog oštećenja. Najteže ozljede udova posljedica su eksplozivnog djelovanja mina ili granata. Načela primarnog zbrinjavanja otvorenih prijeloma u ratnih rana su jasno određena: • ekscizija kože • ekscizija svih devitaliziranih dijelova tkiva • odstranjenje stranih tijela • odstranjenje fragmenata kortikalisa koji su bez kontakta s tkivom • fragmenti spongioze se mogu očistiti i koristiti kao koštani graft • ispiranje rane • stabilizacija kosti (metoda izbora je vanjska fiksacija) • rekonstrukcija magistralnih krvnih žila • izbjegavati primarnu rekonstrukciju živaca ili tetivaThere are 1186 casualites, victims of the 1991-1992 war in Vinkovci, Eastern Slavonija, Croatia, represented in this text. Out of them, 480 were operated on for a war wound of an extremity. Types of wounds and their distribution, methods of surgical treatment and the results have been analyzed

Pilot study of the association between the HLA region and testicular carcinoma among Croatian patients

OBJECTIVES: To analyze the distribution of HLA alleles and HLA microsatellite alleles in Croatian patients with testicular carcinoma, compare it with that of healthy controls and investigate whether the polymorphism within the HLA region could be associated with the development of testicular cancer. ----- METHODS: Genomic DNA was isolated from the peripheral blood of 24 patients with testicular germ cell tumors (TGCT). Patients and controls were typed for HLA class I and class II polymorphism by the PCR-SSO method. Nine HLA microsatellites were analyzed by PCR and electrophoresis in an automated sequencer. ----- RESULTS: No significant deviation in the distribution of frequencies at HLA class I alleles was observed between patients and controls. Among HLA class II alleles, a statistically significant increase in the frequency of the HLA-DPB1*1701 allele was found among patients. The frequency of the HLA-DRB1*07-DQA1*0201-DQB1*0202 haplotype was increased in patients in comparison to the controls. Analysis of HLA microsatellites showed an increased frequency of D6S291-3 allele (p(corr) = 0.0455, OR = 3.05) among patients. ----- CONCLUSIONS: The observed association of the disease and the DPB1*1701 allele as well as with the D6S291-3 allele suggests that this part of the HLA region might be involved in the pathogenesis of TGCT. Our data provide a basis for further studies about the correlation between the HLA region and testicular cancer

Immunohistochemical Expression of Wnt-4 Protein in Clear Cell Renal Carcinoma

Wingless binding integration site proteins (Wnt) have an important role in normal kidney development and in various kidney diseases. They are required for complete epithelial differentiation and normal nephron formation. Changes in these proteins could also have important role in carcinogenesis. This study included 185 patients with clear cell renal carcinoma (ccRCC) in whom immunohistochemical expression of Wnt-4 protein in healthy and tumorous tissue after surgery was investigated. There was higher expression of Wnt-4 in healthy than in tumor tissue. No difference between Fuhrman’s grade and Wnt-4 expression was found. A poor negative correlation between tumor size and Wnt-4 expression was found. Patients with suspected metastatic diseases had higher Wnt-4 expression. There was no difference in survival rates between Wnt-4 negative and positive groups. In our study we have shown that high Wnt-4 expression in healthy tissue decreases in low-grade tumors but then increases in high-grade tumors, suggesting that tumor progression requires Wnt-4 activation or reactivation