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Ovim istraživanjem nastojalo se odgovoriti na pitanje jesu li cervikalne neoplazije sposobne izazvati neovaskularizaciju - angiogenezu. Kvantiteta (zbroj krvnih žila uz bazalnu membranu epitela i ukupan broj krvnih žila zadanog vidnog polja) te kvaliteta krvnih žila (promjer, opseg i površina) uspoređivani su između 30 uzoraka CIN 1, 30 uzoraka CIN 2, 30 uzoraka CIN 3 te dviju kontrolnih skupina od kojih svaka sadrži po 30 uzoraka tkiva cerviksa bez patohistološke abnormalnosti, a medđusobno se razlikuje po tome što su uzorci skupine K 1 uzeti s cerviksa bolesnica histerektomiranih zbog razloga koji nemaju veze s CINom, a uzorci skupine K 2 od bolesnica s CIN 3, ali s mjesta bez patohistološke abnormalnosti. Uzorci su histokemijski obrađeni po PASu i Malloryu te imunihistokemijski metodama s biljezima anti-F-VIII i anti-CD31. Kvantitativni i kvalitativni parametri obrađeni su kvantitativnom morfometrijskom analizom u programu "ISSA for windows" firme VAMS, Zagreb. Klasični histološki pokazatelji kao stupanj upale, veličina CINe, broj mitoza CINe i prisustvo koilocita obrađeni su polukvantitativnim pristupom i uspoređeni s rezultatima kvantitativne morfometrije. Rezultati su statistički obrađeni testiranjem analize varijance metodom (ANOVA), a kriterij značajnosti bio je Fischerov F-test. Značajke kvantitativne i kvalitativne razlike između krvnih žila kontrolnih skupina K1 i K2 nisu nađene (P>0.05). Nađena je statistički značajna razlika u broju krvnih žila neposredno ispod ili uz bazalnu membranu epitela između CIN 1, CIN 2, CIN 3 i kontrolne skupine K 1 u imnunohistokemijskim metodama F-VIII i CD 31 i metodi Mallory (P, The aim of this research was to answer whether cervical intraepithelial neoplasias are able to provoke neovascularisation - angiogenesis. The quantity (the sum of micro-vessels along with the basement membrane of epithelium and total number of vessels of set microscopic view field) and the quality of vessels (diameter, circumference and area) were compared between 30 specimens of CIN 1, 30 specimens of CIN 2, 30 specimens of CIN 3 and two control groups each of them containing 30 specimens of cervical tissue without any pathohistological abnormality and differing from each other in the fact that specimens of control group K 1 were taken from patients who underwent hysterectomy for reasons unrelated to CIN and group K 2 whose specimens were taken from patients with CIN 3 lesions but taken from parts wich had no pathohistological abnormality. Samples were treated with histochemical methods PAS and Mallory and with immunohistochemical methods with anti-F-VIII and anti-CD 31 markers. Quantitative and qualitative parameters were processed using quantitative morphometric analysis in program "ISSA for windows", produced by VAMS, Zagreb. Classic histological criteria such as degree of inflammation, the CIN cell size, the number of CIN mitoses and the presence of koilocytes were all processed by semiquantitative approach and compared with the results of quantitative morphometrics. The results were statistically analysed by method testing analysis of variance (ANOVA) based on Fischer' s (F-test) test as the criterion of significance. No significant difference between control groups K 1 and K 2 (P>0,05) was found. Statistically significant difference was found in the sum of micro-vessels directly below or along the basement membrane between CIN 1, CIN 2, CIN 3 and the control group K 1 using immunohistochemical methods F-VIII, CD 31 and histochemical method Mallory (P

To determine the compatibility rate between histological grades of endometrial carcinoma in curettage and hysterectomy and to determine how quantity of material, given by the method of fractional hysterectomy, affects the compatibility between histological grades in the two methods.

Background & Objectives: The Hedgehog-GLI (HH- GLI) signalling pathway is primarily associated with embryonic development but its role in carcinogenesis has being intensely studied in the last two decades. Recent research indicates that HH-GLI pathway could be a key player in prostate cancer (PC) development and progression, as well as therapeutic resistance. The main objective of this study was to investigate the HH-GLI pathway activity in PC in comparison with healthy prostate and prostate inflammation. Methods: Around 30 formalin-fixed paraffin-embedded tissue samples per group were collected from PC patients (Grade Groups I-V) and two controls groups (benign prostate tissue and prostate inflammation). Expression profiles of GLI3 and PTCH1 proteins was detemined immunohistochemically. The level of protein staining was expressed by multiplying percentage of positive stained cells and staining intensity (histoscore), separately for prostate epithelium and stroma. Cellular localization of protein staining (nuclear and/or cytoplasmic) was also determined. Results: GLI3 and PTCH1 were overexpressed in epithelium (P

Hedgehog je evolucijski konzerviran put prijenosa signala. Aktivan je u embrionalnom razvoju ljudskog organizma, ali osim fiziološke funkcije u nastanku organa, patološki mehanizmi aktivacije su prisutni i u tumorima. Tumori prostate i jajnika su najistraživaniji tumori kod kojih je aktivan Hedgehog signalni put.

Prostate cancer is the second most frequently diagnosed cancer type in men. It starts as an androgen-dependent disease, therefore, androgen deprivation presents the main treatment option for advanced stages of the disease. This type of therapy is efficient at first, but resistance and androgen independence develop quickly. Since the molecular mechanisms involved in sustaining androgen-independent growth are not fully understood, further research is needed to identify new potential therapeutic targets. Recent research indicates that the Hedgehog-GLI (HH-GLI) signaling pathway could be a key player in prostate cancer development of resistance to therapy. This pathway is primarily associated with embryonic development of many tissues and organs, but in the last two decades its role in cancer has become intensely studied. The aim of this study was to investigate the role of HH-GLI signaling in the development of androgen independence of previously androgen-dependent prostate cancer cells (LNCaP). We examined the activity of this pathway after short-term (5 days) and long- term androgen deprivation (8 months), when these cells develop androgen independence. After short-term androgen deprivation LNCaP cells display a downregulation in HH-GLI signaling and become insensitive the the GLI1/2 inhibitor GANT-61. However, after developing androgen independence GLI2 becomes upregulated and GLI3 processing into its repressor form is inhibited, indicating a role for these proteins in maintaining long-term androgen-independent growth. On the other hand, cyclopamine, an inhibitor that acts upstream of GLI, decreases the proliferation rate of LNCaP cells in the presence of androgen as well as after short- and long-term androgen deprivation, but with different effects on HH-GLI signaling activity. Our results show that canonical HH-GLI signaling is present in androgen-dependent LNCaP cells, but changes in its activity occur after short- and long-term androgen deprivation indicating a role for GLI2 and GLI3 activator forms in sustaining long-term androgen-independent growth.

The Hedgehog-GLI (HH-GLI) signaling pathway is primarily associated with embryonic development but in the last two decades its role in cancer development has become intensely studied. The HH- GLI pathway is associated with one third of cancer related deaths, which makes it an interesting new therapeutic target. Recent research indicates that the HH-GLI pathway could be a key player in prostate cancer development and progression, as well as in the development of resistance to therapeutics. The aim of this study is to investigate the activity of the HH-GLI pathway in prostate cancer tissue samples in comparison with healthy prostate tissue samples and samples of prostate inflammation. Around 30 formalin-fixed paraffin-embedded prostate tissue samples per group were collected from prostate cancer patients (Grade Groups I-V) and two controls groups (benign prostate tissue and prostate inflammation). Expression of GLI3 and PTCH1 proteins was determined immunohistochemically. The level of protein staining was expressed by multiplying percentage of positive stained cells and staining intensity (histoscore), separately for prostate epithelium and stroma. Localization of protein staining (nuclear and/or cytoplasmic) was also determined. Both GLI3 and PTCH1 histoscores were significantly higher in epithelial prostate cancer cells (P

Objective: ESS is a rare neoplasm usually arising in the endometrium composed of uniform, oval to fusiform cells with scant cytoplasm that resemble proliferative endometrial stroma. Method: A 61-year old woman underwent routine abdominal hysterectomy with bilateral salpingo- oophorectomy due to abdominal mass and vaginal bleeding. Macroscopic and histological examining revealed an enlarged uterus with numerous fibroids except one that contained „nodes within node“. There were also enlarged ovaries, endometrial polyp of usual type, and hyperplastic endometrium. „Nodes within node“ consists of solid cords and clusters of hypercellular tissue that is reminiscent of proliferating endometrial stroma and sex-cord- stromal-like areas. Foci are surrounded by bundles of smooth muscle cells which do not differ from those in other fibroids of the same uterus. There was no connection of these foci with endometrium. Foci of adenomyosis in the myometrium were not found. There was lympho- vascular invasion. Immunohistochemical examination was made. Foci showed immunohistochemical positivity for vimentin, S- 100, CD99, calretinin, α inhibin, CK7, CKMNF116, EMA, CD10, WT1, MelanA, CD117 and Cyclin D1 while negative for SMA and desmin. Conclusion: Although it is known from the literature that ESS may exhibit differentiation towards the ovarian sex-cord-stromal-like elements and smooth muscle differentiation, in this case it is obvious that ESS grows within the smooth muscle tumour without connection to the endometrium or adenomyosis. It seems that in the occurrence of tumours such as this stem cells have a crucial role as thay have the potential of differentiation in various directions when they are appropriately stimulated. Bilateral stromal hyperplasia of the ovaries with persistent ovarian hormone secretion should be considered as a possible factor of influence on the stem cells differentiation. In this case there are morphological changes that suggest ovarian hormonal activity as endometrial hyperplasia, glandular polyp of the endometrium and numerous leiomyoma.

Single nucleotide polymorphisms (SNPs) in the promotor regions of cytokine genes included in angiogenesis may infl uence prostate cancer (PCa) development via regulation of the pathways of tumor angiogenesis. The aim of the present study was to investigate the association of IL- 1b+3954 (rs1143634) and IL-10-1082 (rs1800896) polymorphisms with PCa risk and aggressiveness in eastern Croatian patients. One hundred twenty PCa patients and 120 benign prostatic hyperplasia (BPH) controls were genotyped using real-time PCR (LightCycler Instrument, Roche Diagnostics) and the melting curve analysis method. There was no signifi cant difference in the frequency of genotypes for the two polymorphisms between PCa patients and controls (χ2=0.857, p=0.355 for IL-b1 ; χ2=0.026, p=0.872 for IL-10). Carriers of the IL-10-1082A>G variant were found to be associated with the Gleason score (GS)>7 (AA versus GA+GG, OR=3.47, 95% CI 1.11–10.88, p=0.033). There was no signifi cant difference in the frequency of genotypes for the two polymorphisms and the presence of metastatic disease in PCa patients. These results suggest that tested SNPs associated with differential production of IL-1b and IL-10 are not risk factors for PCa and do not correlate with the presence of distant metastasis in eastern Croatians. We found that IL-10-1082 GA+/or GG carriers have a higher risk of developing PCa with GS>7 in eastern Croatians.

Objective. PEComas have been reported in a wide variety of intraabdominal, bone, soft tissue, and visceral sites, including uterus, heart and gastrointestinal tract. The primary site of the PEComa in the ovary we hold extremely rare and therefore of valuable for showing. Methods. Thirty years old patients underwent surgery due to ultrasound established solid tumor of the left ovary. The tumor was 8 cm in diameter and contains small foci of hemorrhage. Fresh frozen section was suspected of ovarian granulosa cell tumor. On paraffin sections, tumor is composed of solid cell aggregates distributed perivasculary. The cytoplasms were clear or lightly eosinophilic and nuclei were larger with coarse chromatin. It was observed 3 to 9 mitosis/50 HPF. Results. Tumor was CK7, CK MNF116, EMA, actin SMA, calretinin, CD31, CK20, LCA, chromogranin A, WT1 negative.S-100, vimentin, melan A, melanosma HMB45 were positive.CD99, synaptophisin and c-Kit showed weak punctate cytoplasmic positivity. Conclusion(s). Like the other rare tumors, PEComas can cause difficulties in the interpretation of fresh frozen section as well as to assess the clinical behavior of the neoplasm.

The aim of the study was to clarify whether serum levels of proinflammatory cytokine interleukin-6 (IL-6) could be a useful marker in prostate diseases. Serum IL-6 was determined prior to prostate biopsy procedure in 82 patients with prostate adenocarcinoma (PCa), 25 patients with benign prostatic hyperplasia (BPH), 24 patients with high-grade prostatic intraepithelial neoplasia (PIN) and 17 patients with chronic prostatitis. Serum IL-6 levels were compared with total PSA (tPSA), free PSA (fPSA) and the free/total ratio (f/tPSA) serum levels. Statistically significant difference was not found in serum IL-6 levels among the four groups (p = 0.088). However, the patients with poorly differentiated PCa with Gleason score (GS) 4 + 3 = 7 and7 had significantly higher serum IL-6 levels than the patients with moderately differentiated PCa with GS 3 + 4 = 7 and7 (p = 0.007). The findings suggest that serum IL-6 level might be a potentially useful marker for poorly differentiated PCa.

Rak jajovoda je najrjeđi među svim ginekološkim tumorima s najvećom incidencijom u dobnoj skupini od 54 do 63 godine. Rad prikazuje primarni adenokarcinom jajovoda kod 67-godišnje bolesnice, gravida 1, para 1, otkriven i prijeoperacijski dijagnosticiran u kliničkom stadiju III c. Bolesnica je bila asimptomatska, a jedini simptom je bio blagi vaginalni iscjedak jantarne boje, uz uredne izmjerene vrijednosti CA 125. Dijagnoza se temeljila na kliničkom pregledu i ultrazvučnoj dijagnostici, nakon čega je potvrđena perioperacijski, kroz kirurško-patološko određivanje stupnja proširenosti. Nakon operacijskog zahvata bolesnica je podvrgnuta kemoterapiji zasnovanoj na paklitakselu i platini. Bolesnica se devet godina nalazi u remisiji.

Ovarian cancer together with fallopian tube represents the fifth most common female cancer in the Republic of Croatia. Epithelial ovarian cancer, serous subtype, encompasses most of malignant ovarian neoplasms. Less common are various non-epithelial ovarian malignancies. A special group consists of epithelial carcinomas of low malignant potential with clinically indolent flow, good prognosis and no invasion, and primary cancer of the peritoneum and fallopian tube cancer. Clinically, these malignant tumors are generally asymptomatic in early stages, and usually diagnosed in advanced stages. The diagnosis is confirmed by pathological examination, and occasionally, cytological findings after completing diagnostic procedures. Multidisciplinary team makes treatment decisions, taking into account age, general condition and comorbidities of the patient and characteristics of the tumor itself, including disease stage, histological type and grade of the tumor. The principles of treatment of primary peritoneal and fallopian tube cancer are based on the principles of treatment of epithelial ovarian cancer involving surgery, chemotherapy, immune and hormone therapy, and symptomatic-supportive care throughout the treatment. Less common histological types have a different treatment approach being more frequently diagnosed in the early stages of the disease, have more indolent flow, so in these patients conservative surgeries with the goal of preserving fertility are more often employed. The following text presents the clinical guidelines in order to standardize the procedures and criteria for the diagnosis, management, treatment and monitoring of patients with ovarian carcinoma, fallopian tube and primary peritoneal cancer in the Republic of Croatia.

Rak jajnika i jajovoda po učestalosti je peta zloćudna bolest žena u Hrvatskoj. Histološki je rak jajnika najčešće epitelnog podrijetla, i to seroznog podtipa. Rjeđi su različiti neepitelni malignomi jajnika, a posebnu skupinu čine epitelni karcinomi niskoga zloćudnog potencijala karakterizirani neinvazivnošću, klinički indolentnim tijekom i dobrom prognozom te primarni rak potrbušnice i rak jajovoda. Klinički su ovi zloćudni tumori u ranim stadijima razvoja uglavnom asimptomatski, zbog čega se najčešće dijagnosticiraju u kasnijim stadijima bolesti. Dijagnoza se potvrđuje patohistološkim nalazom, a iznimno citološkim nalazom nakon provedene dijagnostičke obrade. O liječenju odlučuje multidisciplinarni tim uzimajući u obzir dob, opće stanje i komorbiditete bolesnice, kao i obilježja samog tumora uključujući stadij bolesti, histološki tip i gradus tumora. Principi liječenja primarnog raka potrbušnice i jajovoda temelje se na principima liječenja epitelnog raka jajnika koji obuhvaćaju primjenu kirurških zahvata, kemoterapije, imunoterapije i hormonske terapije, kao i suportivno-simptomatskih mjera tijekom cijelog liječenja. Razlikuje se terapijski pristup rjeđim, neepitelnim histološkim tipovima tumora koji se češće dijagnosticiraju u ranim stadijima bolesti, imaju indolentniji tijek pa se kod ovih bolesnica češće primjenjuju poštedni kirurški zahvati s ciljem očuvanja plodnosti. U tekstu koji slijedi predstavljene su kliničke upute s ciljem standardizacije postupaka i kriterija postavljanja dijagnoze, liječenja te praćenja bolesnica s rakom jajnika, jajovoda i potrbušnice u Republici Hrvatskoj.

Objective: Testicular feminization syndrome is a form of male pseudohermaphroditism clinically characterized with female phenotype. We evaluate morphologic features of male gonad in 47 years old patient with an accent on its immunohistochemical properties. Method: Our patient have had a primary amenorrhea. External genitals were female, without pubic and axillary hair. Patient complained of light low abdominal discomfort, and pelvic mass. US confirmed cystic formation of the left gonad and lack of uterus. Tumor markers, including Ca 125, Ca 19, 9, Ca 1.53, CEA, AFP, LDH i HCG were normal but testosterone was high. Cystic formation of the left gonad was surgically removed, initially specified as a left ovary, and sent to quick frozen diagnostic. After that, the other gonad was removed. Pathohistological examination and karyotyping was done. Results: The inner layer of the cystic formation of the left gonad consisted of a single layer of serous cells. The wall of the cyst contained tissue which histological looks like immature testis with small lumen less only Sertoli cells seminiferous tubules, and hyperplastic clusters of Leydig cells between them. Quick frozen section histology, without clinical data, was suggestive for well differentiated Sertoli-Leydig cell tumor of the ovary. The other gonad macroscopically and microscopically was testis that had the same appearance of the seminiferous tubules and had hyperplastic Leydig cell areas. Immunohistochemical analyzes of the gonad sample reveal that Sertoli cells showed positivity for Inhibin α, Vimentin, CD99, CKAE1/AE3 and Calretinin and Leydig cells showed positivity for Inhibin α, Vimentin, CD99, CKAE1/AE3 and Calretinin, and weak positivity for S-100, Synaptophysin i NSE. Immunoreactivity for CD99 in hyperplastic areas of Leydig cells showed the most intensive positivity. PLAP and chromogranin were negative. Ki-67 nuclear positivity was found in less than 1% of Sertoli cells and in about 1% of Leydig cells in hyperplastic areas. Karyotype was 46xy. Conclusion: Although, surgical pathologists encounter TFS rare in a clinical practice, they should be aware of this condition, especially in lack of relevant clinical data, when it could be interpreted as tumor.

Background Granulocytic sarcoma (GS) of the uterine cervix is an unusual manifestation of acute myeloid leukemia (AML). Also known as chloroma, myeloid sarcoma and extramedullary myeloid sarcoma represents a solid tumor composed of immature white blood cells. Localized granulocytic sarcoma of the uterine cervix as a primary manifestation, preceding peripheral blood and bone marrow evidences of acute myeloic leukemia is very rare. Diagnosis of localized GS is difficult and is often confused with other neoplastic conditions. Methods We report a case of GS of the uterine cervix in a 46-years-old woman. Involvement of the cervix was the first manifestation of AML. The patient underwent colposcopy which was suspicious for malignancy. Colposcopically directed biopsy and cervical smear were taken. Results Cervical cytology smear stained with Papanicolaou stain contained numerous clusters of malignant cells that had monotonous appearance, with ovoid nuclei and coarse chromatin pattern. Nucleoli were present, not prominent, placed excentrically. The cytoplasm was scanty. Smear contained some squamous epithelial cells and plenty of erytrocytes. Cervical biopsy demonstrated diffuse infiltration of cervical tissue with uniform undifferentiated blastic tumor cells that were immunohistochemically stained positive for leukocyte common antigen (LCA), CD68, CD43, antimyeloperoxidase (MPO), lysozyme and partly for CD117 but were negative for CD20, CD3, CD4, CD7, CD8, CD45RO, CD 56, CD34, that was consistant with granulocytic sarcoma. Soon after the diagnosis, the disease progressed to AML and despite of aggresive chemotherapy the patient died six months later.

The aim of this research was to determine the VEGF A expression in tumor cells and the intratumoral microvessel density and their prognostic significance in the survival of the subjects. 87 subjects were monitored retrospectively for a period of 60 to 132 months. The subjects were treated at the Department of Obstetrics and Gynecology of Osijek University Hospital Center, Croatia. We analysed standard clinical, pathohistological and therapeutical prognostic factors, intratumoral microvessel density and expression of VEGF A. Five-year survival was calculated by the life chart method and presented graphically by Kaplan-Meier curves. Reaching conclusions on statistical hypotheses in this paper was done with a reliability level p < 0.05. Of the analyzed clinical prognostic factors, those which proved to be statistically significant and independent prognostic factors were age and clinical stage of the disease, and of pathohistologic ones it was the depth of myometrial invasion and VEGF expression. An elevated VEGF expression is associated with deep myometrial invasion, poorly differentiated tumors, histologic type and intratumoral microvessel density to a statistically significant degree. Elevated VEGF expression, age, FIGO stage and depth of myometrial invasion play a significant prognostic role in patients with endometrial cancer. VEGF receptors could be a target for adjuvant therapy in VEGF positive endometrial cancer.

Bladder osteosarcoma is extremely rare tumor. There are about 30 cases described in the literature. Poor prognosis with lethal outcome within one year could be expected, although successful treatments were reported. We present a case of primary bladder osteosarcoma successfully treated with cystectomy, free of the disease for two years. A 63 years old man was admitted with history of blood in urine during the last month. CT showed 5 cm bladder mass and suspected infiltration of rectum. Transurethral resection was performed and after histology revealed osteosarcomma a cystectomy was done. Histology found a mesenhimal malignant tumor made from spindle like cells, areas of osteoid surrounded with malignant osteoblast type cells showing trabeculae resembling structures, cartilage with atypical forms of hondrocytes and osteoclasts. Areas of urothelium were of normal structure and without atypical or malignant cells. Immunochemistry staining was positive for vimentin, S-100, CD31, CD99, CD68 and Ki67, but negative for cytokeratin, epithelial membrane antigen (EMA) and desmin. Bone forming bladder tumors can be divided into the three groups: carcinosarcoma, transitiocellular carcinoma with osseous metaplasia and osteosarcoma. Historically four origin theories were proposed: mesenchymal remains of Wolfian body, blood transfer of cells, metaplasia and theory of alkaline-phosphatase rich mucosa triggering osteogenic differentiation into neoplastic mesenchymal cells has been held for true. Our case showed that with good coordination of pathologist and urologist combined with prompt and aggressive therapy even a locally advanced disease can be treated.

Introduction. Sarcomatoid carcinoma or sarcomatoid variant of urothelial carcinoma is the term that should be used for all biphasic malignant neoplasm's exhibiting morphologic and/or immunochistochemical evidence of epithelial and mesenchymal differentiation with or without heterologous elements. Case report. In this paper we described a case of biphasic malignant neoplasm of the ureter. The patient was 68-years-old woman admitted to the clinic because of painless hematuria, cystoscopically visible tumor protruding from right ureteral orifice, CT documented hydronephrosis and affunction of the right kidney. She underwent right nephroureteroctomy. The tumor consisted of four polypoid intraluminal masses that fulfill distal part of the ureter, and infiltrate ureteral wall. Microscopically, the majority of the tumor was composed of epithelial elements that show squamous or glandular differentiation, and only focal urothelial differentiation. Stroma was abundant fibro-mixoid or highly cellular composed of atypical mesenchymal spindle cells with high mitotic rate evidence. By immunohistochemistry, epithelial elements react with cytokeratin 10/13 and focally with cytokeratins 7, 8, 18 and 20. The epithelial elements were strongly NSE positive while Synaptophyisn and Chromogranin A showed only focal positivity. Atypical mesenchymal spindle cells showed immunoreactivity for Vimentin while Desmin and Actin were negative. The tumor infiltrated ureter wall and spread into periureteral fat tissue as well as into vascular spaces. Conclusion. Sarcomatoid carcinoma of the ureter is a rare aggressive neoplasm with unknown biology. Even terminology for biphasic urothelial neoplasm's is confused. Molecular studies suggest a monoclonal origin for both tumor components. In our case, epithelial component consisted of various epithelial cell types while stroma consisted of undifferentiated mesenchyma.

Cilj Klinički i epidemiološki podaci potvrđuju da je kronična upala bitan čimbenik razvoja karcinoma prostate. Oksidativni stres, izazvan aktivnošću upalnih stanica, djeluje na DNA proliferirajućeg epitela te dovodi do trajnih genomskih promjena. Regulacija imunološkog odgovora je stoga uključena u razvoj i progresiju karcinoma prostate. Parakrina sekrecija citokina, koja može biti pojačana («high producer»), srednje izražena («intermediate producer») ili snižena («low producer»), rezultat je različite ekspresije citokinskih gena. Svrha istraživanja je odrediti izražaj polimorfizama gena za citokine IL-10 i TGF-β kod oboljelih od karcinoma prostate, s ciljem konstrukcije mape polimorfizama gena za citokine u različitim stadijima bolesti. Metode U ovo je prospektivno istraživanje trajanja 3 godine uključeno 120 ispitanika s karcinomom prostate i 120 kontrola (BHP). DNA analiza polimorfizama gena za IL-10 i TGF-β učinjena je iz tkiva prostate ili krvi ispitanika. Rezultati Prikazati ćemo preliminarne rezultate analize polimorfizama citokinskih gena IL-10 i TGF-β na uzorku od 20 bolesnika. Dobiveni rezultati poslužiti će kao osnova za predikciju očekivane raspodjele navedenih polimorfizama u daljnjem istraživanju, zajedno s ostalim proučavanim citokinima. Zaključak TGF-β regulira rast stanice potičući diferencijaciju i apoptozu stanice. TGF-β pokazuje dvojako djelovanje, zaustavljajući rani razvoj karcinoma, ali potičući progresiju kasnijih stadija te razvoj metastaza. IL-10 je protuupalni medijator koji smanjuje prezentaciju MHC antigena na površini makrofaga i na taj način antigen specifični odgovor T limfocita. Djelovanje IL-10 je također dokazano dvojako: visoke razine IL-10 djeluju promotorski na rast tumora zbog imunosupresivnog djelovanja na T limfocite, omogućujući tumorskim stanicama «bijeg» od imunološkog odgovora ; u drugim studijama niske razine IL-10 djeluju pozitivno na rast karcinomskih stanica

Cilj Etiologija karcinoma prostate je djelomično poznata, a kronična upala je uzročno povezana sa razvojem karcinoma. Upala dovodi do pojave prostatične intraepitelne atrofije, sa posljedičnom hiperplazijom stanica prostate koja se događa u okolini bogatoj radikalima kisika. Takav okoliš je izuzetno pogodan za razvoj mutacija i defekata na genskom materijalu stanice koji mogu dovesti do pojave karcinomskih stanica. Citokini su regulatori i posrednici u upalnom procesu. Polimorfizmi gena za citokine su razlogom različite fenotipske ekspresije citokina: povećana produkcija („high producer“) ili smanjena produkcija („low producer“), koja dovodi do razlika u upalnom procesu među pojedincima. Cilj našeg istraživanja je utvrditi postoje li razlike u polimorfizmima gena za citokine u bolesnika sa karcinomom prostate u odnosu na bolesnike sa benignom hiperplazijom prostate. Metode Istraživanje je prospektivnog tipa sa 240 bolesnika uključenih (120 sa BPH i 120 sa karcinomom prostate), ukupnog trajanja istraživanja 3 godine. Anamneza, urološki pregled i uzorci krvi za DNA analizu su prikupljeni od svakog bolesnika. Analizirali smo polimorfizme za IL-6, TNF-α i INF-γ. Rezultati Prve rezultate polimorfizama gena za citokine smo učinili na uzorku od 20 bolesnika sa krcinomom prostate: IL-6 povećana produkcija u 87, 5%, smanjena produkcija u 12, 5%, a za TNFalpha povećana produkcija u 31%, a smanjena produkcija u 69%. Zaključak TNF-α, IL-6 i INF-γ su upalni citokini sa antivirusnim i antikarcinomskim djelovanjem koje ostvaruju kroz poticanje upale i mobilizaciju T limfocita, a u do sada objavljenim istraživanjim je dokazano da manja produkcija, tj. prisutnost polimorfizama koji određuju fenotip manje produkcije, može ubrzati razvoj ili čak djelovati povoljno za pojavu više oblika karcinoma.

Gastric cancer is one of the most common causes of cancer death. In 2005, there were 1059 newly diagnosed cases of gastric cancer in Croatia. Stomach cancer spreads very early and usually to regional lymph nodes and surrounding tissues such as the liver, lungs, or ovaries, and less often to the bones and central nervous system, whereas the breast is very rarely the site of its metastases. Among the available data, we have found only 9 publications describing cases of gastric metastases developed in the breast, we decided to publish this case report presenting a patient who underwent total gastrectomy for gastric cancer in May 2000, and then surgery for metastases of gastric cancer to the breast in January 2005., Karcinom želuca je jedan od vodećih uzroka smrti od karcinoma. U Hrvatskoj je u 2005 godini otkriveno 1059 novih slučajeva karcinoma želuca. Karcinom želuca obično metastazira vrlo rano i to u okolne limfne čvorove, jetru, pluća, jajnike, te rje|e u kosti i središnji živčani sustav, dok je dojka vrlo rijetko sijelo metastaza. U dostupnoj literaturi pronašli smo samo 9 radova koji opisuju širenje karcinoma želuca u dojku, te smo odlučili prikazati slučaj naše pacijentice koja je u svibnju 2000. godine operirana radi karcinoma želuca, a u siječnju 2005. operirana radi metastaze u dojci.

Introduction The mixed germ cell – sex cord stromal tumor of the testis is defined as neoplasm having neoplastic germ cells elements and neoplastic sex-cord stromal elements arranged in a diffuse pattern. Case report The case of a 45-year-old man with painless right sided testicular tumor is reported. Radiologic and laboratory investigations including serum alpha- fetoprotein (AFP) and human chorionic gonadotropin (HCG) showed no abnormalities. A right radical orchidectomy was performed. A histologic examination showed biphasic tumor which was composed of two different types of cells. The majority of the tumor consisted of quite unifom predominantly spindle cells, which were immunohistochemically positive for vimentin and S-100 protein and focally for α- inhibin. The second cell type were large cells with abundant clear cytoplasm arranged in a small clusters at the periphery of the tumor. These cells showed no reactivity for immunostains mentioned above neither for cytokeratines MNF 116 and 7, AFP, HCG and PLAP. Conclusion As any rare neoplasm the mixed germ cell – sex cord stromal tumor of the testis makes a huge diagnostic problem. Clinical and biological behavior of this type of testicular neoplasm is not jet completely discovered.

Neonatal giant cell hepatitis is a very rare condition in a clinical praxis. It is characterized by syncytial cell hepatocytes. Both children with neonatal giant cell hepatitis were born in the same family in a two year interval and both died in the first 24 hour period. In the first case the female child's autopsy finding showed haemorrhagic diathesis: intraalveolar, kidney and ventricular mucosae bleeding. In the second case the male new-born child's autopsy finding showed petechial cutaneous bleeding of the head, trunck and extremities, fetal hydrops and ascites. Both cases share the same histological findings in the liver. Severe disorder of the liver parenchima with syncytial giant cell hepatocytes contained yellow pigment which react with Berlin blue. As hemosiderin deposites were found in the multinucleated transformed hepatocytes, we concluded that the metabolic disorder in transportation and storage of iron is in the background of both cases so that hepatocellular damage caused fatal haemorrhagic disorder.

This paper describes a case of asymptomatic multifocal actinomycosis of the greater omentum which was detected accidentally in a patient who was suspected of uterus myoma. The patient was a 40 year old woman who had a copper intrauterine contraceptive device (IUCD) for three years. After the gynecological examination and pelvic ultrasound she was diagnosed with sub serous myoma of uterus. Since she did not give a birth it was suggested to have myoma enucleating. However during the surgery a dermoid teratoma of the right ovary was detected so it was removed together with tumor and there were two thickenings on the greater omentum, suspicious of inflammation, whereas one grew together with the front abdominal wall. Due to these conditions, she had partial omentectomy done and omentum was sent for path histological examination. The path histological examination confirmed it to be actinomycosis. The patient had an intensive antibiotic therapy prescribed (Penicillin) in order to prevent a disease relapse because we could not be sure whether the remaining part of omentum was affected by microscopic actinomycosis.

Ovim istraživanjem nastojalo se odgovoriti na pitanje jesu li cervikalne neoplazije sposobne izazvati neovaskularizaciju - angiogenezu. Kvantiteta (zbroj krvnih žila uz bazalnu membranu epitela i ukupan broj krvnih žila zadanog vidnog polja) te kvaliteta krvnih žila (promjer, opseg i površina) uspoređivani su između 30 uzoraka CIN 1, 30 uzoraka CIN 2, 30 uzoraka CIN 3 te dviju kontrolnih skupina od kojih svaka sadrži po 30 uzoraka tkiva cerviksa bez patohistološke abnormalnosti, a medđusobno se razlikuje po tome što su uzorci skupine K 1 uzeti s cerviksa bolesnica histerektomiranih zbog razloga koji nemaju veze s CINom, a uzorci skupine K 2 od bolesnica s CIN 3, ali s mjesta bez patohistološke abnormalnosti. Uzorci su histokemijski obrađeni po PASu i Malloryu te imunihistokemijski metodama s biljezima anti-F-VIII i anti-CD31. Kvantitativni i kvalitativni parametri obrađeni su kvantitativnom morfometrijskom analizom u programu "ISSA for windows" firme VAMS, Zagreb. Klasični histološki pokazatelji kao stupanj upale, veličina CINe, broj mitoza CINe i prisustvo koilocita obrađeni su polukvantitativnim pristupom i uspoređeni s rezultatima kvantitativne morfometrije. Rezultati su statistički obrađeni testiranjem analize varijance metodom (ANOVA), a kriterij značajnosti bio je Fischerov F-test. Značajke kvantitativne i kvalitativne razlike između krvnih žila kontrolnih skupina K1 i K2 nisu nađene (P>0.05). Nađena je statistički značajna razlika u broju krvnih žila neposredno ispod ili uz bazalnu membranu epitela između CIN 1, CIN 2, CIN 3 i kontrolne skupine K 1 u imnunohistokemijskim metodama F-VIII i CD 31 i metodi Mallory (P

Budući da postoji značajna razlika u broju krvnih žila uzduž bazalne membrane epitela između normalnog i displastičnog epitela, a taj se broj povećava s porastom CIN gradusa, zaključeno je da su CIN promjene angiogenične.

Angiogeneza je osnovni proces kojim nastaju krvne žile. Stvaranje novih krvnih žila potrebno je za odvijanje rasta, razvoja kao i procesa u organizmu kojim nastaje cijeljenje rane, rast i metastaziranje solidnih tumora, ali je ovaj proces uključen i u mnoge druge patološke procese. cilj disertacije bio je utvrditi stanje mikrocirkulacije s obziroma na kvalitetu i kvantitetu vaskularizacije između uzoraka normalnog vrata maternice i uzoraka s CIN promjenama. Radom je dokazano postojanje neoangiogeneze u CIN promjenama.

Sažetak Objective. Procijeniti dali analizirani faktori rizika, prisutni u vrijeme primarnoga liječenja skvamoznog raka vulve, mogu poslužiti kao markeri za otkrivanje onih pacijentica u kojih će se razviti rekurentni rak vulve. Design. Prospektivna analiza podataka o 32 pacijentice s rakom vulve koje su liječene u Odjelu za ginekologiju i porodiljstvo Kliničke bolnice Osijek između 01.01.1993 i 31.12.2000 godine. Rezultati. Samo su se debljina tumora = ili >3.4mm i dubina stromalne invazije = ili >3.0mm pokazali korisnim za otkrivanje pacijentica u kojih će se razviti rekurentni rak vulve. Prisutnost oba faktora registrirana je prilikom primarnoga liječenja skvamoznog raka vulve u 87.5% pacijentica u kojih se za vrijeme praćenja razvio rekurentni rak vulve. Međutim, oba faktora su isto tako bila prisutna i u 55.0% pacijentica u kojih se za vrijeme praćenja nije razvio rekurentni rak vulve. Prema tome, osjetljivost zajedničke primjene oba faktora za otkrivanje pacijentica u kojih će se razviti rekurentni rak vulve iznosila je 87.5%, specifičnost 45.0%, a prediktivna vrijednost 48.8%. Zaključak. Procjena debljine tumora i dubine stromalne invazije prilikom primarnoga liječenja skvamoznog raka vulve mogli bi se koristiti za selekcioniranje pacijentica u kojih će se kroz duže vrijeme provoditi intenzivniji nadzor radi što ranijeg otkrivanja i liječenja rekurentnog raka vulve. Ključne riječi: Rak vulve, povrat bolesti, faktori rizika, predviđanje.

Primary mediastinal teratomas, whether mature or immature, are very rare. They could cause serious life threatening respiratory obstruction at newborn age. This report presents clinical course, imaging, autopsy and pathohistological findings in a newborn with mature mediastinal teratoma, which led to severe respiratory failure and death. Despite the fact that postnatal respiratory distress was rarely caused by mediastinal tumor, that type of tumor should be taken into consideration in case of severe perinatal asphyxia. The case is therefore worth of presentation., Primarni teratomi medijastina, bez obzira jesu li zreli ili nezreli, rijetkost su i u novorođenačkoj dobi mogu biti uzrokom teške, za život opasne opstrukcije dišnih puteva. U ovom radu prikazan je klinički tijek, pretrage, obdukcijski i patohistološki nalazi u novorođenčeta sa zrelim teratomom medijastina koji je prouzročio težak oblik respiratornog zastoja i smrt. Unatoč činjenici da su postnatalne respiratorne smetnje rijetko prouzročene tumorom medijastina, tu vrstu tumora treba uzeti u obzir u slučaju teške perinatalne asfiksije. Stoga ovaj slučaj vrijedi prikazati.

Dijagnoza karcinoma prostate počiva na kombinaciji strukture i citoloških obilježja. Većina adenokarcinoma prostate građena je od acinusa raspoređenih u jedan ili više histoloških oblika koji su osnova za određivanje histološkoga gradusa. U radu su obrađeni osnovni histološki i citološki kriteriji za dijagnozu karcinoma prostate. Osobitosti iz svjetlosno-mikroskopskog nalaza obično su dovoljne za točnu dijagnozu karcinoma prostate. Međutim, uzorci s malim sumnjivim žarištima zahtijevaju imunohistokemijsku obradu. Osnovni kriteriji za točnu dijagnozu jesu strukturna i citološka obilježja, dok su obilježja kao luminalni kristaloidi, luminalni mucini, promjene strome i kolageni mikronoduli pomoćni kriteriji. Najznačajniji imunohistokemijski biljezi u patologiji prostate jesu PSA, PAP, citokeratin velike molekularne mase 34 E12, ali razvijaju se i novi imunohistokemijski biljezi korisni za dijagnostiku karcinoma prostate.

Uvod i cilj. U ovome radu autori žele prikazati vlastite rezultate dobivene nakon transperinealne (TPB) i transrektalne (TRB) metode biopsije prostate, te utvrditi postoji li značajna razlika između jedne i druge metode detekcije karcinoma prostate i postoji li značajna razlika po učestalosti komplikacija. Materijali i metode. Obradili su podatke za 203 bolesnika kod kojih je od 24. kolovoza 2000. do 14. kolovoza 2002. godine učinjena biopsija prostate zbog abnormalnoga nalaza digitorektalnoga pregleda (DRE) i/ili vrijednosti PSA>4 ng/ml. Do 10. mjeseca 2001. godine biopsije prostate na Klinici za urologiju Kliničke Bolnice Osijek provodile su se transperinealnim pristupom. Nakon toga se započelo s transrektalnim biopsijama, koje su gotovo u potpunosti zamijenile transperinealni pristup. U navedenom razdoblju, koje je obuhvatilo vremenski interval od 2 godine, učinjeno je 238 biopsija, 121 transperinealna i 117 transrektalnih. Prilikom provođenja obiju metoda, uzimano je 12 bioptičkih uzoraka, po 6 uzoraka iz svakoga režnja. Rezultati. Karcinom prostate dokazan je kod 87 od ukupno 203 bolesnika koja su pristupila biopsiji (43%). TPB provedena je kod 97 bolesnika i karcinom je dokazan kod njih 38 (39%), a TRB provedena je kod 106 bolesnika i kod 49 dokazan je karcinom (46%). Inicijalnom TPB, odnosno TRB dokazalo se 33, odnosno 46 karcinoma, a preostalih 5 karcinoma, odnosno 3 dokazalo se rebiopsijom, što znači da postotak karcinoma koji se nije uspio detektirati prvom biopsijom iznosi 13% za TPB, a 6% za TRB. Najzastupljeniji "Gleason score" karcinoma dobivenih objema metodama bio je 7. Prostatična intraepitelijalna neoplazija niskoga stupnja (low grade prostatic intraepithelial neoplasia-LGPIN) dijagnosticirana je ukupno kod 5 bolesnika. Kod svih je učinjena rebiopsija i karcinom je pronađen u jednom slučaju (20%). Prostatična intraepitelijalna neoplazija visokoga stupnja (high grade prostatic intraepithelial neoplasia-HGPIN) dijagnosticirana je kod 22 bolesnika. Rebiopsija je učinjena kod njih 13 (kod ostalih se također planira učiniti) i kod 2 bolesnika dokazan je karcinom (15%). Od komplikacija nakon TPB pojavio se jedan slučaj jake hematurije, a nakon TRB jedan orhiepididimitis, jedan prostatitis, tri vazovagalne epizode, po jedan slučaj izraženoga rektalnog krvarenja (hematohezije) i jake hematurije koji su zahtijevali hospitalizaciju, te jednu registriranu hematospermiju. Zaključak: Zabilježen je nešto veći je postotak detekcije karcinoma nakon TRB nego nakon TPB, ali se ova razlika nije pokazala statistički značajnom. Također je postotak detekcije karcinoma inicijalnom biopsijom, od ukupno dijagnosticiranih karcinoma, veći kod TRB nego kod TPB, ali niti ova razlika nije statistički značajna. Više komplikacija pojavilo se nakon TRB nego nakon TPB, ali s obzirom na malen ukupan broj komplikacija i na to da se pojedine komplikacije nisu javile niti u jednom slučaju nakon TPB, nije imalo smisla računati postojanje eventualne statistički značajne razlike.

A case report of pleomorphic leiomyoma in Bartholin gland's area in 26-year-old woman. After diagnostic treatment, primarly excision was done. A big solid tumor, 10x7, 5 cm was extirpated. Tumor showed local invasive behavior, which, because of localisation and outlook of tumor, sugested, that it is a malign tumor of Bartholin gland Based in pathohistological examine and immunohistochemical reactions, conclusion is, that it is mesenchymal tumor, smooth muscle origin, with marked polymorphism, without mitosis, with myxoid stroma and with biological aggressivity, and posibility of appearance of local recidiv.Because of this, second surgicaly procedure, more radical, was brought. In excised tissue, residual tumor was not found, and all lymphonodi ware negative.

Undifferentiated nasopharingeal carcinoma (lymphoepithelioma) is very rare. About 50% to 80% of patients are initially seen with cervical lymph node metastases froman occult primary. Such lesions may be difficult or impossible to distinguish from lymphoma on haematoxylin and eosin stained sections, particularly when the lesion appears as a lymph node metastasis from occult primary. Ancillary methods like immunohistochemistry and molecular technicqes or detection of serum antibodies against viral proteins may be necessary.

Primarni melanom vagine je rijedak s manje od 250 do sada opisanih slučajeva. Tumor čini manje od 3% svih malignih tumora vagine i manje od 1% svih melanoma u žena. Većina pacijenata u literaturi su izolirani prikazi slučaja. Tumori vagine izgleda nastaju iz melanocita koji se nalaze u sluznici vagine u oko 3% žena. U radu je prikazan slučaj primarnog melanoma vagine sa naglaskom na citološkom nalazu. Znanstveni doprinos je u opisu citomorfoloških osobina izuzetno rijetkog primarnog melanoma vagine u razmazu obojenom po Papanicolaou, na temelju kojih se može citološki postaviti sumnja i/ili dijagnoza tog tumora.

We analysed the causes of intrauterind foetal death after the 26th week of pregnancy during the years 1991-2002 at the Departments of obstetrics and gynaecology of the Clinical Hospital Osijek and General Hospital Karlovac.

The workabout cervical metaplasia and atypical gladnular cells in cervicovaginal smears

Introduction: In our region eosinophilic gastroenteritis is a very rare disease. Etiology is unknown. Case report: A 39-year-old female patient was admitted to the clinic due to slight cough, right side pleural outflow and ascites, without other symptoms. Gyanecological ultrasound, ultrasound of the upper abdomen, CT refer to ascites besides normal findings of abdominal and pelvic organs. Laboratory examinations were normal except peripheral eosinophilia and increased values of Ca 125. cytological findings of pleural outflow and ascites revealed a great number of eosinophilic granulocytes but without malignant cells. Patohistological findings: During explorative laparotomy resected parts of both ovaries, a lymph node, a hyperplastic part of pylorus, a knot from a small bowel designated as a tumor, and an appendix were taken out for a patohistological examination. Both ovaries reveal normal ovarial parenhima. A regional lymph node showed reactive changes with hyperplastic follicles and prominent germinative centres. The main histological finding reveal Pyloric stromal edema and a dense infiltrate of eosinophilic granulocytes throughout the muscle layer as well as eosinophils situated in perivascular spaces which is accompanied with swelling of endotelium of capillary blood vessels. Eosinophilic granulocytes were found in the smooth muscle layer of intestine as well as in the subserosal tissue. Lumen of the appendix was obliterated and the muscle layer and the subserosal tissue contzained eosinophils. Conclusion: From uor review it is visible that eosinophilic gastroenteritis can represent a great diagnostic problem especially when it is accompanied with pleural outflow and ascites and increasing values of tumor markers. That can possibly mislead a diagnostic procedure to the neoplastic rather than the immunological or allergic disease. Three years after surgery the patient is well.

A case of pleomorphic leiomyoma in Bartholin gland's area in a 26-year-old woman is reported. After diagnostic treatment, primary excision was done. A large, solid tumor 10 x 7.5 cm was extirpated. The tumor showed locally invasive behavior, which suggested a malignant tumor of Bartholin gland, because of it's localization and outlook. Pathohistological examination and immunohistochemical reactions proved that it was a mesenchymal tumor of smooth muscle origin with marked polymorphism, without mitosis, with a myxoid stroma and with biological aggressivity, and the possibility of local recurrence. Thus, a second more radical surgical procedure, was performed. In the excised tissue, no residual tumor was found and all lymphnodes were negative.

U ovom radu prikazani su uzroci smrti u petogodišnjem razdoblju u Kliničkoj bolnici Osijek.

Domovinski rat u Hrvatskoj imao je sve osobitosti modernih ratova: veliki udio civilnih žrtava, znatnu uporabu artiljerijskih oruđa s posljedičnim višestrukim ranjavanjem i gubitak klasične linije bojišnice. Tijekom istraživanja pregledani su obdukcijski zapisnici Kliničkog zavoda za patologiju i sudsku medicinu Kliničke bolnice Osijek od 1. svibnja 1991. do 30. travnja 1992. U tom je razdoblju provedena 751 obdukcija žrtava nasilne smrti. 414 žrtava (55, 1%) podleglo je ozljedama od eksplozivnih sredstava, dok je u 274 slučaja smrt bila posljedica strijelnih rana. Većina je žrtava bila muškog spola (673 - 89, 6%). Mlađe dobne skupine bile su izloženije ranjavanju - većina žrtava bila je u trećem i četvrtom desetljeću života (399 - 53, 1%). Udio poginulih među vojnicima i civilima bio je gotovo jednak. Broj žrtava u naseljenim područjima nadvisio je gubitke ljudstva na fronti. Najveći broj žrtava zabilježen je u rujnu (128 - 17, 4%) i studenom (150 - 19, 9%) 1991. godine. Većina umrlih nasilnom smrću bili su žrtve ubojstva (94%), dok su samoubojstva (2, 9%) i nesretni slučajevi (3, 1%) bili rijetki. Ozljede nastale djelovanjem eksplozivnih sredstava bile su većinom višestruke, prekrivajući sve dijelove tijela (50%). Pojedinačne strijelne ozljede najčešće su se nalazile na glavi (48%), dok su se višestruke strijelne ozljede najčešće nalazile na trupu i udovima (26, 3%). Razaranje civilnih ciljeva, veliki udio ozljeda nastalih djelovanjem eksplozivnih sredstava i višestruke strijelne ozljede čine se sve tipičnijim osobitostima modernih ratova.

Istraživanjem je obuhvaćeno 2104 bolesnika obduciranih na Kliničkom zavodu za patologiju i sudsku medicinu Kliničke bolnice Osijek, u razdoblju od 1989. do 1995. godine, sa izuzetkom 1991. i 1992. godine zbog ratnih zbivanja. U navedenom je razdoblju učestalost obdukcije iznosila 51, 62% i ne bilježi pad kao u većini razvijenih zemalja. Najviše obduciranih osoba umrlo je u šestom desetljeću života i prethodno je bilo zbrinuto na Internom odjelu. Najčešći pojedinačni neposredni uzroci smrti bili su redom: ishemijska bolest srca, pneumonija, plućna tromboembolija, spontano krvarenje u mozak, respiratorni distres sindrom i iskrvarenje, a sveukupno su kardiovaskularne bolesti prouzročile 40, 30% svih smrti. Podudarnost kliničke i obdukcijske dijagnoze postojala je u 70, 30% slučajeva, a najmanja je bila u osoba čiji je boravak u bolnici iznosio manje od 24 sata. U osoba koje su boravile u bolnici dulje od 24 sata duljina boravka nije imala bitnijeg utjecaja na točnost dijagnoze. Unatoč postojanju suvremenih dijagnostičkih metoda, obdukcija ima vrlo istaknuto mjesto u otkrivanju uzroka smrti i provjeri kliničke dijagnoze.

U radu se iznosi problematika patohistološke problematike interpretacije punkcijske biopsije prostate, s osvrtom na diferencijalno dijagnostičke probleme u dijagnostici raka prostate. Punkcijska biopsija prostate u našoj ustanovi koristi se kao rutinska dijagnostička metoda od 1996. godine. U radu su obrađene punkcijske biopsije prostate 162 bolesnika. Rak prostate nađen je u 41 (25,3%) slučajeva. U 23 (14,1%) nađena je atipična žljezdana hiperplazija. bazalna epitelna hiperplazija našena je u 25 (15,4%) slučajeva, a atipična bazalna epitelna hiperplazija u 12 (7,4%) slučajeva. U 48 (29,6%) slučajeva nađene su postatrofične proliferacijske promjene. PIN niskog stupnja nađen je u 21 (13%) slučajeva, a PIN visokog stupnja u 36 (22,2%) slučajeva. Statističkim f-testom analizirana je razlika u razini serumskog PSA kod bolesnika s PIN-om visokog stupnja. PIN-om niskog stupnja i atipične žljezdane hiperplazije, te utvrđeno kako ne postoji statistički značajna razlika u razini serumskog PSA u ovim skupinama bolesnika.

Prikaz bioptičkog materijala vezanog za karcinom dojke u razdoblju od 1991-1995 godine.

U jednostruko slijepo, randomnizirano, prospektivno istraživanje je uključeno 60 ambulantnih bolesnika s recidivantnim duodenalnim ulkusima i Helicobacter pylori infekcijom. Bolesnici su metodom slučajnog izbora podijeljeni u dvije skupine. Prva skupina bolesnika (n=30) liječena je famotidinom 40 mg, navečer prije spavanja, šest tjedana uz amoksicilin 2×1000 mg/dan tijekom 14 dana i metronidazol 2×800 mg/dan tijekom sedam dana. Druga skupina bolesnika (n=30) liječena je famotidinom 40 mg, navečer prije spavanja, tijekom 6 tjedana uz oksitetraciklin 4×500 mg/dan tijekom 14 dana i metronidazol 2×800 mg/dan tijekom 7 dana. Nakon šest tjedana ulkusi su zacijelili u 93, 3% (28/30) bolesnika prve i 96, 6% (29/30) bolesnika druge skupine. Razlika nije statistički značajna. Bolesnici s nezacijeljenim ulkusima dobivali su famotidin 40 mg navečer prije spavanja još dva tjedna. Nakon zacijeljenja ulkusa bolesnici nisu uzimali antiulkusnu terapiju održavanja. Mjesec dana po završetku liječenja eradikacija Helicobacter pylori postignuta je u 73, 3% (22/30) bolesnika prve i u 80% (24/30) bolesnika druge skupine. Razlika nije statistički značajna. Nazočnost H. pylori dokazivana je brzim utreaza testom i histološkim ispitivanjem bioptičkih uzoraka iz antruma i korpusa želuca. Tijekom 12 mjeseci od završetka liječenja, do ponovnog javljanja ulkusa došlo je u 35, 7% (5/14) bolesnika kod kojih nije eradiciran H. pylori i u 2, 2% (1/46) bolesnika s eradiciranim H. pylori. Razlika je statistički značajna (p