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Abstract

Background

Bladder cancer is the 7th most common cancer in men. About 75% of all bladder cancer are non-muscle invasive (NMIBC). The golden standard for definite diagnosis and first-line treatment of NMIBC is transurethral resection of bladder tumour (TURB). Historically, the monopolar current was used first, today bipolar current is preferred by most urologists. Following TURB, depending on the tumour grade, additional intravesical chemo- or/and immunotherapy is indicated, in order to prevent recurrence and need for surgical resection. Development of new technologies, molecular and cell biology, enabled scientists to develop organoids – systems of human cells that are cultivated in the laboratory and have characteristics of the tissue from which they were harvested. In the field of urologic cancers, the organoids are used mainly for studying the course of different diseases, however, in the field of bladder cancer the data are scarce.

Conclusions

Different currents - monopolar and bipolar, have different effect on urothelium, that is important for oncological results and pathohistological interpretation. Specimens of bladder cancer can be used for preparation of organoids that are further used for studying carcinogenesis. Bladder organoids are step towards personalised medicine, especially for testing effectiveness of chemo-/immunotherapeutics.

Abstract

Background

Anaplastic thyroid cancer (ATC) is one of the most aggressive tumors. The aim of the study was to determine the correlation between a higher dietary intake of iodine, frequency of ATC and the characteristics of ATC, and to find out how often patients with ATC had a history of radioiodine (RAI) therapy.

Patients and methods

This retrospective study included 220 patients (152 females, 68 males; mean age 68 years) with ATC who were treated in our country from 1972 to 2017. The salt was iodinated with 10 mg of potassium iodide/ kg before 1999, and with 25 mg of potassium iodide/kg thereafter. The patients were assorted into 15-year periods: 1972–1986, 1987–2001, and 2002–2017.

Results

The incidence of ATC decreased after a higher iodination of salt (p = 0.04). Patients are nowadays older (p = 0.013) and have less frequent lymph node metastases (p = 0.012). The frequency of distant metastases did not change over time. The median survival of patients in the first, second, and third periods was 3, 4, and 3 months, respectively (p < 0.05). The history of RAI therapy was present in 7.7% of patients.

Conclusions

The number of patients with a history of RAI therapy did not change statistically over time. The incidence of ATC in Slovenia decreased probably because of higher salt iodination.

Abstract

Background

High energy electron linear accelerators (LINACs) producing photon beams with energies higher than 10 MeV are widely used in radiation therapy. In these beams, fast neutrons are generated, which results in undesired contamination of the therapeutic beam. In this study, measurements and Monte Carlo (MC) simulations were used to obtain neutron spectra and dose equivalents in vicinity of linear accelerator.

Materials and methods

LINAC Siemens Oncor Expression in Osijek University Hospital is placed in vault that was previously used for 60Co machine. Then, the shielding of the vault was enhanced using lead and steel plates. Measurements of neutron dose equivalent around LINAC and the vault were done using CR-39 solid state nuclear track detectors. To compensate energy dependence of detectors, neutron energy spectra was calculated in measuring positions using MC simulations.

Results

The vault is a source of photoneutrons, but a vast majority of neutrons originates from accelerator head. Neutron spectra obtained from MC simulations show significant changes between the measuring positions. Annual neutron dose equivalent per year was estimated to be less than 324 μSv in the measuring points outside of the vault.

Conclusions

Since detectors used in this paper are very dependent on neutron energy, it is extremely important to know the neutron spectra in measuring points. Though, patient dosimetry should include neutrons, estimated annual neutron doses outside the vault were far below exposure limit of ionizing radiation for workers.

Abstract

The esophageal diverticula are divided into pharyngoesophageal, parabronchial and epiphrenic. They could also be divided into congenital and acquired, true and false, pulsion and traction. Pulsion diverticula are usually formed in motor disorders of the esophagus, above the place of hypertension and uncoordinated peristalsis. They are pseudo-diverticula caused by increased intramural pressure, leading to herniation of the mucosa and submucosa through the focal areas of the esophageal wall. We present a 65-year-old woman who underwent left-sided transthoracic diverticulectomy, modified Heller esophagocardiomyotomy, and modified Belsey-Mark IV fundoplication due to a huge epiphrenic esophageal diverticulum.

Abstract

The aim of the work was to study the agglutination and hemolysis of erythrocytes under diff erent conditions in vitro in a patient with unknown cause of anemia and concomitant secondary instability of endoprosthesis.

Material and methods. One percent (1%) suspension of erythrocytes of a woman, 61 years old, A (II) Rh- (negative) presented with anemia was incubated with her serum and plasma at pH 7.3, pH 5.8 and 9.0, as well as with IgM α and β antibodies. Unithiol was used to destroy IgM antibodies. The samples were incubated for 12 hours at 37° C, and the presence of the agglutination and hemolysis was evaluated.

Results. The incubation of the plasma with unwashed erythrocytes of the patient led to the agglutination of the erythrocytes and the usage of the complement led to the hemolysis. After inactivation of IgM in the plasma the agglutination was absent and the hemolysis was present under usual conditions and at pH 5.8, whereas at pH 8.0 the hemolysis was attenuated, however a slight degree agglutination appeared. The usage of the complement led to the agglutination and the hemolysis, absent at pH 8.0. The plasma incubated with washed red blood cells and the complement led to the hemolysis. The incubation of the serum with washed erythrocytes led to the hemolysis at pH 5.8, attenuated after the usage of the complement. The contact of terbinophine with plasma and unwashed red blood cells led to the absence of both the hemolysis and the agglutination. Candida lusitaniae growth was detected in the plasma.

Conclusions. The agglutination of unwashed erythrocytes by own plasma, attenuated in the alkaline medium and enhanced in the acid medium, as well as the absence of the agglutination after the usage of terbinophine and the hemolysis in the presence of the complement might be the signs of mycogenic and autoimmune origin of anemia with the activation of autoimmune complement – binding antibodies.

Abstract

Granulomatosis with polyangiitis (GPA, Wegener’s granulomatosis) is one of the antineutrophil cytoplasmic antibody (ANCA) - associated small vessel vasculitis, involving various organs such as nasal septum, sinuses, upper respiratory tract, lungs, and kidneys. GPA is pathologically characterized by necrotizing granulomatous inflammation. ANCA-associated small vessel vasculitis represent a major challenge in hospital admissions; therefore, early and accurate diagnosis with aggressive treatment is essential to improve the disease outcome.

Renal involvement of granulomatosis with polyangiitis is characterized morphologically by extensive crescent formation (extracapillary proliferation in Bowman’s space), and clinically by crescentic or rapidly progressive glomerulonephritis that causes hematuria, erythrocyte casts, and proteinuria with progressive loss of renal function. The diagnosis of granulomatosis with polyangiitis is established most securely by biopsy specimens showing the triad of vasculitis, granulomata, and large areas of necrosis (known as geographic necrosis) admitted with acute and chronic inflammatory cells. Usually, renal involvement is severe and is the leading cause of mortality. The combination of high-dose corticosteroids and cyclophosphamide is the mainstay of treatment for vasculitis and disease resistance to this combination is rare.

Abstract

The clinical manifestations in sleep disorders vary according to the type of hypnopathies, a heterogeneous group of conditions, characterized by the presence of any sleep-related symptoms capable of generating discomfort.

We aimed to present the diagnostic criteria and the classification of the subtypes of sleep disorders in the most recent classification published in the medical literature. I have searched in the PubMed, Medline, Google Scholar Search databases, using keywords to select the right items. We selected the articles published in English and French language, in the period of 2000-2018.

The sleep disturbances may be of quantitative order (hyper- or hyposomnia) or of qualitative order (parasomnia), respectively hypnopathies related to breathing or movement, due to the circadian rhythm and other categories, according to ICSD-3.

Conclusions. The correct classification in the subtypes of sleep disorders is the key to their optimal treatment, but this process is complex, staged and multidisciplinary.

Abstract

The purpose of the study is to create computer program for the achievement of precise digital data processing of records performed with the “Facebow Mini-Maxi” and the facilitation of information transfer to the articulator.

Material and method: A conceptual project was developed in order to create a new software product and requirements were defined towards its capacities, which are to provide guidance for its creation. With the assistance of computer programmer, the project was implemented.

Results: The computer program “Facebow Mini-Maxi Analyzer” for digital data processing of registrants performed with the auricular type facebow was created. The program provides automatic recognition, reading, calibration and measurement of data obtained by “Facebow Mini-Maxi”. The main module gives us opportunities for measuring the values of: the sagittal condylar pathway; the arrow point angle and the length of the hinge axis. After finalizing the calculations, the software automatically generates a scheme with visualization of the parameters that significantly supports the dental technician when it comes to defining the accurate position of the models in dental articulator with individual parameters.

Conclusion: The computer program provides accurate analysis of facebow records and assists in determining individual patient movement parameters of the lower jaw. The obtained results from the analysis improve the precision of casts mounting in articulator. The program cuts down the risk of subjective error when analysing the data via manual measurement of the recorded parameters on paper carrier.

Abstract

Cutaneous xanthogranuloma is a rare benign tumor and both adults and children could be affected. Head and neck area of the human body is the most commonly affected one which often poses a serious reconstructive challenge for the plastic surgeon who is in charge of removing the lesion. We report on a clinical case of an adult female patient who presented with cutaneous xanthogranuloma of the upper lip, involving the subnasal area. Both diagnosis and surgical treatment were difficult, considering the clinical behavior and location of the tumor. An innovative surgical approach going out of the dogmas of plastic surgery was applied and an excellent result was achieved.

Abstract

Introduction: Determination of the curvature of root canals at present is accomplished by complicated or expensive methods. Therefore, there is a need to develop a new digital method by which this curvature can be determined quickly, easily and accurately.

The aim of this in-vitro study is to determine the angles of curvature of the root canals of extracted teeth by comparing a new digital method of measurement with an established digital method.

Material and Methods: Forty-eight (48) root canals of extracted teeth were studied to achieve the goal. In all roots, curvature is measured by three methods: Method 1 – new digital photographic method and special Software (Screen Protractor); Method 2 – a new digital radiography method and special software (Screen Protractor); Method 3 – approved method, digital by X-ray and special Software (Durr dental).

Results: The mean degrees of the measured curvature of the root canals in all three groups are similar and are about 22°. There are no statistically significant differences between them (p > 0.05).

Conclusion: This shows that the new digital photographic and x-ray methods for measuring root curvature can accurately determine the curve angle for extracted teeth.