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Operacije v področju prsnega koša spadajo med najbolj boleče operacije, kjer prepletanje operacijskega polja in dihalne poti še dodatno prispeva k nastanku in vzdrževanju bolečine po posegu. T. i. pooperativno bolečino je potrebno lajšati, ker povečuje tveganje za zaplete, kot so pljučne atelektaze, pljučnica, daljša hospitalizacija, kasneje pa tudi razvoj kroničnega bolečinskega sindroma. Pristop k lajšanju bolečine po operacijah v prsnem košu je tri stopenjski. Vključuje seznanitev z možnostmi za lajšanje bolečine med in po operaciji v sklopu priprave na poseg, čim pogostejšo uporabo področnih tehnik za lajšanje bolečine med operacijo ter multimodalni pristop za lajšanje bolečine v obdobju po posegu za zmanjšanje celokupne porabe opioidov. V sklopu tega so se tradicionalno uveljavljeni torakalni epiduralni analgeziji v zadnjem desetletju pridružile manj invazivne področne analgetične tehnike, kot so paravertebralni blok, blok pod mišico erector spinae, retrolaminarni blok, blok serratus anterior in interkostalni blok. K razvoju teh tehnik je prispevala predvsem uporaba ultrazvoka, vedno večja uporaba zdravil proti strjevanju krvi ter uvajanje manj invazivnih kirurških tehnik, ki zahtevajo prilagoditev vodenja anestezije v smislu uporabe čim manj invazivnih področnih analgetičnih tehnik. Učinkovito lajšanje bolečine med in po operaciji je ključno za preprečitev kroničnega bolečinskega sindroma, ki bolnikom močno poslabša kakovost življenja, zdravstvenemu sistemu pa naloži dodatne stroške zdravljenja. Pregledni članek bo prikazal trenutne možnosti za lajšanje bolečine med in po operacijah v prsnem košu s poudarkom na vrsti in mehanizmu delovanja novejših področnih analgetičnih tehnik.

Introduction Breast cancer (BC) is the most common cancer in women, with a high disease burden, especially in the advanced disease stages. Our study investigated the metabolomic profile of breast cancer patients’ serum with the aim of identifying novel diagnostic biomarkers that could be used, especially for early disease detection. Materials and Methods Using targeted metabolomic serum profiling based on high-performance liquid chromatography mass spectrometry, women with BC (n = 39) and a control group (n = 21) were examined for 232 endogenous metabolites. Results The top performing biomarkers included acylcarnitines (ACs) and 9,12-linoleic acid. A combined panel of the top 4 biomarkers achieved 83% sensitivity and 81% specificity, with an area under the curve (AUC) of 0.839 (95% confidence interval, 0.811-0.867). Individual markers also provided significant predictive values: AC 12:0, sensitivity of 72%, specificity of 67%, and AUC of 0.71; AC 14:2, sensitivity of 74%, specificity of 71%, and AUC of 0.73; AC 14:0: sensitivity of 67%, specificity of 81%, and AUC of 0.73; and 9,12-linoleic acid, sensitivity of 69%, specificity of 67%, and AUC of 0.71. The individual markers, however, did not reach the high sensitivity and specificity of the 4-biomarker combination. Conclusion Using mass spectrometry-targeted metabolomic profiling, ACs and 9,12-linoleic acid were identified as potential diagnostic biomarkers for breast cancer. Additionally, these identified metabolites could provide additional insight into cancer cell metabolism.

Background Treatment of early-stage non-small cell lung cancer (NSCLC) is rapidly evolving. When introducing novelties, real-life data on effectiveness of currently used treatment strategies are needed. The present study evaluated outcomes of stage I–IIIA NSCLC patients treated with upfront radical surgery in everyday clinical practice, between 2010–2017. Patients and methods Data of 539 consecutive patients were retrieved from a prospective hospital-based registry. All diagnostic, treatment and follow-up procedures were performed at the same thoracic oncology centre according to the valid guidelines. The primary outcome was overall survival (OS) analysed by clinical(c) and pathological(p) TNM (tumour, node, metastases) stage. The impact of clinicopathological characteristics on OS was evaluated using univariable (UVA) and multivariable regression analysis (MVA). Results With a median follow-up of 53.9 months, median OS and 5-year OS rate in the overall population were 90.4 months and 64.4%. Five-year OS rates by pTNM stage I, II and IIIA were 70.2%, 60.21%, and 49.9%, respectively. Both cTNM and pTNM stages were associated with OS; but only pTNM retained its independent prognostic value (p = 0.003) in MVA. Agreement between cTNM and pTNM was 69.0%. Next to pTNM, age (p = 0.001) and gender (p = 0.004) retained their independent prognostic value for OS. Conclusions The study showed favourable outcomes of resectable stage I–IIIA NSCLC treated with upfront surgery in real-life. Relatively low agreement between cTNM and pTNM stages and independent prognostic value of only pTNM, observed in real-life data, suggest that surgery remains the most accurate provider of the anatomical stage of disease and important upfront therapy.

Pandemija virusa SARS-CoV-2 je popolnoma presenetila celotni svet. V zelo kratkem času je bilo potrebno reorganizirati zdravstveni sistem v celoti. Bolnišnice, ki sprejemajo bolnike s covidom-19, je bilo treba čez noč prestrukturirati v del bolnišnice za bolnike s covidom-19 in v del bolnišnice z ostalimi bolniki, ki nimajo covida-19. Pri delu s kirurškim bolnikom s covidom-19 je potrebna predvsem popolna in dosledna uporaba zaščitnih sredstev, da ne pride do okužbe zdravstvenega osebja. Prav tako je potrebna posebna klinična pot znotraj bolnišnic, da ne pride do kontaminacije v delu bolnišnice, ki je brez bolnikov s covidom-19. Začasno so bile odpovedane vse elektivne kirurške obravnave. Zdaj se pod posebnimi pogoji za zaščito zdravstvenih delavcev in bolnikov ponovno sproščajo. Pred elektivnimi kirurškimi posegi se priporoča jemanje brisov na covid-19, vendar to ni nujno. Brisi so namreč v 30 % negativni oz. nezanesljivi in se nanje ne moremo popolnoma zanesti. Predvsem je pomembno, da bolnik v zadnjih 14 dneh ni imel znakov prehladne bolezni in prav tako ne člani njegove družine. Znotraj ustanove se moramo vesti do vsakega sprejetega bolnika, kot da je lahko okužen z virusom SARS-CoV-2. Enako velja za osebje. Ravnati se je potrebno glede zaščitnih ukrepov tako, kot da je vsak od zaposlenih okužen z virusom SARS-CoV-2.

Transfuzija krvi po kirurškem posegu poveča tveganje za pooperativne zaplete, podaljša bolnišnično zdravljenje in poslabša izhod kirurškega zdravljenja. Neopredeljena in nezdravljena slabokrvnost pred operacijo predstavlja neodvisni napovedni dejavnik za perioperativne zaplete in transfuzijo v perioperativnem obdobju. Pred operacijo moramo odkriti bolnike, pri katerih je tveganje za slabokrvnost večje, ter jim prilagoditi predoperativno pripravo, kirurško tehniko in pooperativno zdravljenje. Program »Skrb za bolnikovo kri« (angl. Patient Blood Management PBM), ki je že uveljavljen v mnogih evropskih državah in podprt s strani direktorata Evropske komisije, je usmerjen v zdravljenje anemije, optimiziranje hemostaze in zmanjšanje potrebe po transfuziji krvi. Trije osnovni stebri so (1) optimalna hematopoeza, (2) zmanjšana iatrogena izguba krvi in (3) izboljšana bolnikova toleranca za anemijo. Analizirali smo potrebe po transfuziji krvi pri bolnikih, operiranih zaradi pljučnega ali urološkega obolenja v kirurškem centru Bitenc, d.o.o, med oktobrom 2016 in oktobrom 2018. Od bolnikov, ki so transfuzijo eritrocitov prejeli med operacijo, so bili predoperativno anemični 4 (57%) bolniki. Od bolnikov, ki so transfuzijo dobili pooperativno na oddelku, je bilo predoperativno anemičnih 12 (50%) bolnikov. V članku opišemo elemente programa PBM ter načrt za uvedbo programa v vsakodnevno klinično prakso.

An industrial-scale stereo-selective enzymatic oxidation process for the conversion of pyrmetazole to esomeprazole was developed and optimized. Slurry-to-slurry stages are highly demanding synthetic operations due to several deteriorating factors: competing equilibria, mass transfer limitations and long-term bio-catalytic activity. Challenging characteristics of this bio-oxidation included foaming, thickening, continuous dynamic changes in viscosity, mass transport, and bio-catalyst inactivation. By screening pH, optimization of reactant loading ratios, and modification of control, crucial production attributes of materials, such as substrate particle size, were controlled and better batch-to-batch stability and scale-up was achieved.

3606 Background: Colorectal cancer (CRC) screening programs suffer from poor uptake and biomarkers have limited diagnostic accuracy. The measurement of the methylation status of tumor-derived cell-free DNA in plasma may address these challenges. We used a targeted methylation panel, tumor-derived signal deduction and machine learning algorithm to refine a blood test for the detection of early-stage CRC. Methods: This was a prospective, international multicenter observational cohort study. Plasma samples were collected either prior to a scheduled colonoscopy as part of standard colorectal cancer screening or prior to colonic surgery for primary CRC. Differentially methylated regions (DMRs) were initially selected by analyzing CRC and control tissue samples with whole genome bisulfite sequencing. A targeted sequencing assay was designed to capture these DMRs in plasma ctDNA. Individual sequencing reads were evaluated for cancer-specific methylation signal and scores calculated for each DMR in a sample. A panel of methylation scores originating from 203 DMRs was used in a prediction model building and validated in a test cohort of patients. Results: Calculated scores were used to train a machine learning model on 68 ctDNA samples from 18 early stage (I-II) and 16 late-stage (III-IV) CRC patients and 34 age, BMI, gender and country of origin matched neoplasia-free controls (median age 63 [50-74], mean BMI 27 [19.5-37], female 50%, Spanish and Ukrainian population, distal cancers 50%). This model was then applied to an independent set of subjects from Spanish, Ukraine and Germany, including 36 stage I-IV cancer patients (median age 61.5 [55-82], BMI 28 [16-39], female 47%, 42% of the tumors were distal) and 159 age and sex matched controls. 87 of the control patients had a negative colonoscopy finding (cNEG), 19 had hyperplastic polyps (HP), 37 had small non-advanced adenomas (NAA) and 16 were diagnosed with other benign gastrointestinal diseases (GID). The model correctly classified 92% (33/36) of CRC patients. Sensitivity per cancer stage ranged from 83% (5/6) for stage I, 92% (11/12) for stage II, 92% (12/13) for stage III to 100% (5/5) for stage IV. Specificity of the model was 97% (154/159), with 100% (37/37) NAA, 94% (15/16) GID, 95% (18/19) HP and 97% cNEG patients correctly identified. Lesion location, gender, BMI, age and country of origin were not significantly correlated to prediction outcome. Conclusions: Methylation sequencing data analyzed using read-wise scoring approach combined with a machine-learning algorithm is highly diagnostic for early-stage (I-II) CRCs (89% sensitivity at 97% specificity). This method could serve as the basis for a highly accurate and minimally invasive blood-based CRC screening test with significant implications for the clinical utility of ctDNA in early-stage cancer detection.

Purpose Endometrial cancer (EC) is the most common gynecological malignancy with high disease burden especially in advanced stages of the disease. Our study investigated the metabolomic profile of EC patient’s serum with the aim of identifying novel diagnostic biomarkers that could be used especially in early disease detection. Material and methods Using targeted metabolomic serum profiling based on HPLC-TQ/MS, women with EC (n ​= ​15) and controls (n ​= ​21) were examined for 232 endogenous metabolites. Results Top performing biomarkers included ceramides, acylcarnitines and 1-methyl adenosine. Top 4 biomarkers combined achieved 94% sensitivity with 75% specificity with AUC 92.5% (CI 90.5–94.5%). Individual markers also provided significant predictive values: C16-ceramide achieved sensitivity 73%, specificity 81%, AUC 0.83, C22-ceramide sensitivity 67%, specificity 81%, AUC 0.77, hydroxyhexadecenoylcarnitine sensitivity 60%, specificity 96%, AUC 0.76 and 1-methyladenosine sensitivity 67%, specificity 81%, AUC 0.75. The individual markers, however, did not reach the high sensitivity and specificity of the 4-biomarker combination. Conclusions Using mass spectrometry targeted metabolomic profiling, ceramides, acylcarnitines and 1-methyladenosine were identified as potential diagnostic biomarkers for EC. Additionally, these identified metabolites may provide additional insight into cancer cell metabolism.

The data presented here are related to the research paper entitled “Metabolomic profiling suggests long chain ceramides and sphingomyelins as a possible diagnostic biomarker of epithelial ovarian cancer.” (Kozar et al., 2018) [1] . Metabolomic profiling was performed on 15 patients with ovarian cancer, 21 healthy controls and 21 patients with benign gynecological conditions. HPLC-TQ/MS was performed on all samples. PLS-DA was used for the first line classification of epithelial ovarian cancer and healthy control group based on metabolomic profiles. Random forest algorithm was used for building a prediction model based over most significant markers. Univariate analysis was performed on individual markers to determine their distinctive roles. Furthermore, markers were also evaluated for their biological significance in cancer progression.

Background: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide, and its incidence is increasing in younger persons. Established CRC screening methods include fecal immunochemical testing, which requires handling of stool, and colonoscopy, which is invasive. Many persons who remain unscreened might accept a blood-based screening test, which could have profound public health impact. DNA methylation is a stable, early, and tissue-specific event in cancer development and progression. Measuring the methylation status of tumor-derived cell-free DNA in plasma could enable identification of early-stage CRC. We first developed a plasma-based methylated DNA panel for all stages of CRC (Study 1). We then validated this panel in a subsequent study with independent samples (Study 2). Methods: Differentially methylated regions (DMRs) were initially selected by analyzing tissue data from The Cancer Genome Atlas (TCGA) database. In Study 1, candidate regions were evaluated in plasma samples of 215 patients (93 CRC, 122 controls including 31 with non-advanced adenoma) using methylation-sensitive restriction enzyme qPCR (MSRE-qPCR). This training set was used for marker evaluation and construction of a prediction model. The most promising methylation markers were selected by a support vector machine (SVM)-based machine learning classifier using a random forest algorithm. In Study 2, the selected markers were validated in an independent validation set of 724 samples collected in Spain, Ukraine, the UK, and the US (152 CRC, 622 controls including 148 with non-advanced adenoma and 52 with non-CRC cancer). Results: Tissue data analysis yielded 180 potential DMRs. In Study 1, a panel consisting of the top 12 methylation markers was selected. In Study 2, the prediction model based on this panel correctly classified 117/152 CRC (77%) patients. Sensitivity improved with CRC stage, ranging from 71% (25/35) for stage I, 76% (37/49) for stage II, 77% (37/48) for stage III, to 100% (14/14) for stage IV. Specificity of the model was 88% (544/622). Among non-CRC cancer cases, specificity was 83% overall (73% [19/26] for lung cancer and 92% [24/26] for breast cancer). Conclusions: We developed a prediction model based on a novel plasma 12-marker methylation panel that demonstrated highly promising test performance characteristics for early-stage CRC detection in a validation study using independent samples. This method could serve as the basis for a highly accurate and minimally invasive blood-based CRC screening test. Citation Format: Kristi Kruusmaa, Marko Bitenc, Walter Pulverer, Andreas Weinhaeusel, José Luis Rodrigo Agudo, Andrés Barrientos Delgado, Andrés Sánchez Yagüe, José Manuel Rodríguez Laiz, Marko Chersicola, Primož Knap, Silvia Schönthaler, Uri Ladabaum. Development and clinical performance of an accurate cell-free DNA (cfDNA) methylation assay for early detection of colorectal cancer [abstract]. In: Proceedings of the AACR Special Conference on Advances in Liquid Biopsies; Jan 13-16, 2020; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(11_Suppl):Abstract nr A05.

V prispevku predstavljamo primer 67-letnega bolnika z napredovalim karcinomom srednje tretjine požiralnika, s širjenjem v zgornjo in spodnjo tretjino, v stadiju T3 N2–3M0. Kljub obsežnosti bolezni je prejel optimalno zdravljenje s predoperativno radiokemoterapijo in operacijo. Uspešen potek zdravljenja je omogočil individualen pristop, tesno sodelovanje vseh strok onkologije in uporaba novih obsevalnih tehnik. In this article, we present a case of a 67-year-old patient with advanced stage T3 N2–3M0 carcinoma of the middle third of the oesophagus which is spreading to the upper and lower thirds. Despite the extensiveness of the disease, the patient received optimal treatment with pre-operative radiochemotherapy and surgery. Successful treatment was a result of an individual approach, close collaboration of all branches of oncology and use of new radiation techniques.

Introduction Epithelial ovarian cancer (EOC) is a disease with a poor survival rate mostly due to its discovery in late stages. The aim of this study was to investigate the metabolomic profile of ovarian cancer with the intention of identifying and describing novel biomarkers with diagnostic potential. Material and methods Targeted serum metabolomic profiling was performed on 15 patients with ovarian cancer, 21 healthy controls and 21 patients with benign ovarian conditions, using HPLC–TQ/MS. Results Panel of 49 top performing biomarkers shows separation between EOC and controls with 87% specificity and 87% sensitivity with AUC of 93% (CI 90%–95%). Using only 5 top biomarkers, specificity of 80% and sensitivity of 83% was achieved on extended sample set. Most significant biomarkers belong to sphingolipid classes, especially long chain ceramides and sphingomyelins. Different concentrations of various fatty acid chain lengths ceramides and sphingomyelins are also implying their respective roles in cell proliferation and growth inhibition. Conclusion Long chain ceramides and sphingomyelins may serve as a novel biomarker for epithelial ovarian cancer detection and may also offer insight into the role of sphingolipid metabolism in cell proliferation.

The preparation of ZnO nanoparticles with a multi-step process is reported. The preparation path included zinc hydroxide nitrate (ZnHN) or zinc hydroxide carbonate (ZnHC) precipitation, their thermal treatment and nano-milling. ZnO preparation was followed in detail by STEM, FT-IR, XRD and TG-MS analyses. In order to demonstrate the efficiency of the nano-milling process, the obtained ZnO nanoparticles were characterized with regard to their photo-catalytic activity of caffeine degradation. The smallest ZnO nanoparticles (∼20 nm) with the highest BET surface (∼80 m2 g−1) were prepared from ZnHC at 300 °C.

Zinc oxide (ZnO) powders with diverse morphologies were synthesized with various solvothermal techniques. Water, 1-butanole and ethylene glycol were used as the solvents, while the temperature of the solvothermal synthesis was varied from 90 °C to 120 °C. Resazurin and caffeine were used for the evaluation of the photocatalytic activity of all the prepared samples, and in particular to compare ZnO with commercial titanium dioxide photocatalytic material (P25 Evonik Degussa) using UV–vis spectroscopy. The composition, crystallinity, and morphology of the prepared materials were investigated with FTIR, XRD, TEM and FEG-SEM techniques. The band gaps of the obtained semiconductors were measured because the band gap of hydrozincite, determined in this study to be 4.1 eV, has not been reported previously. The specific surface area (BET) and the porosity of the prepared particles were estimated. The crystal size in one dimension was estimated and was found to play an important role in the photocatalytic activity, which increased with a smaller size. A higher degree of aggregation caused the opposite effect. Thus, a more aggregated material with a larger surface area than a less aggregated one exhibited a lower photocatalytic activity. The particle morphology strongly influenced the photocatalytic process, while the degree of crystallinity was not comparably significant. The external mass-transfer (diffusion to the catalytic surface) resistance was negligible, and consequently the first-order, second-order, and Langmuir–Hinshelwood mechanism kinetics of the photocatalysis were examined.

Layered ZnO microspheric particles were prepared by the thermal decomposition of layered hydrozincite (LZnHC), which was synthesized from zinc nitrate and urea in a water/PEG400 mixture. The influence of the starting reagents, their concentrations, and the amount of PEG in the water/PEG400 mixture on the particle growth was observed. The chemical aspect of the particle growth was proposed in the frame of the partial charge model (PCM), and the formation of [Zn(OH)(2)(OH(2))(4)](0) and [Zn(OH)(HCO(3))(OH(2))(3)](0) was predicted for the solid phase. The assumed growth mechanism, which follows the "nonclassical crystallization" concept of a self-assembling mechanism, was observed in situ by small-angle X-ray scattering (SAXS) and predicts the rapid formation of approximately 6 nm sized building units. The size of these nano building units, stable only in the reaction medium, remains nearly constant during the synthesis, as the concentration of the nano building units increases throughout the reaction. The nano building units connect into leaves of LZnHC with a thickness of 20 nm. These leaves of LZnHC are further agglomerated into porous, microsphere-like particles with sizes up to 4 μm.

We present a solution-phase preparation method for the synthesis of ZnO in an open reactor (with constant stirring) or in a closed reactor (autoclave). The method is based on a combination of the polyol method and the homogeneous precipitation of zinc nitrate with urea. ZnO particles with a rod-like shape and with a regular bipod structure were prepared in an open reactor, while needle-like shapes were prepared in the autoclave. A detailed characterization of the planar base-plane and prismatic defects obtained in the hexagonal ZnO bipod particles with electron microscopy revealed that in the middle of the bipod the planar defects contain a small amount of silicon. A rough estimation indicated that there was a single atomic layer of silicon at the defect. From convergent-beam electron-diffraction experiments, we found that these planar defects were inversion domain boundaries (IDBs) with a head-to-head orientation of the polar axis. In the needle-like particles, besides IDBs on the basal planes, prismatic...

A simple urea aqueous solution process at low temperature (85 °C) was employed for the preparation of zinc hydroxide carbonate from zinc nitrate. The influence of different additives on the final particle morphology was studied. Porous spherical particles in the shape of chrysanthemums with an average size of 4 μm and a surface area of 16 m 2 /g were obtained in the presence of poly-vinyl pyrrolidone (PVP-K30). After heat treatment ZnO particles were formed that preserved the size and shape of the hydrozincite precursor. The morphology and crystallinity of the solids obtained before and after the heat treatment were characterized by FE-SEM, XRD, FTIR, BET and TG methods.

The growth mechanism of ZnO is investigated by a combination of electron microscopy and in situ small-angle X-ray scattering (SAXS). The particles are prepared by the precipitation of zinc nitrate with urea. Depending on the reaction conditions, ZnO, hydrozincite, or a mixture of both phases is detected in our system. The molecular precursors and complexation reactions of the formation process are numerically predicted by the partial-charge model. The condensation and complexation reactions lead to the formation of nanoparticle building units up to a size of 10 nm. Afterwards, the nanoparticles immediately self-assemble into micro-sized particles.

We have investigated nanosized thin films ofα-Fe2O3(hematite) andα-Fe2O3with addition of Li, by the impedance spectroscopy (IS), the Raman spectroscopy, scanning electron microscopy (SEM), and X-ray diffraction (XRD). Combining all of these methods, and earlier obtained thermally stimulated currents (TSC) on the same samples, the dependence of structural and electrical properties upon percentage of Li added into the matrix of these metal-oxide films was found. The comparison of IS, Raman, SEM, XRD, and TSC results reveals the increase of the size of nanoparticles upon inducing 1% of Li inFe2O3matrix followed by the decrease of the size of nanoparticles in the case of samples with 10% Li, as well as the decrease (increase) of conductivity, respectively. These changes are explained by the structural and morphological changes caused by the impact ofLi+ions in the charge transfers. This material is suitable for application in the galvanic cell of second generation that could be used as solar-cells backup.

The preparation of nano- and submicrometre-sized one-dimensional (1D) zinc oxides (ZnOs) from zinc nitrate was performed by precipitation with urea in two types of solvents (water and water/polyol mixtures). The influence of different polyols (ethylene glycol, diethylene glycol and tetraethylene glycol) on the size of the final particles (length and diameter) is presented for the first time. As well as the influence of the solvents used, the ratio of water/polyol, temperature, pH and time of synthesis was correlated with the size and morphology of the final particles. In all cases crystalline ZnO was synthesized in the form of hexagonal bipods. The morphological and crystalline properties of the samples obtained were characterized by SEM, IR, and XRD. (C) 2008 Elsevier Ltd. All rights reserved.

ZnO nanorods were prepared at relatively low temperatures by homogeneous precipitation from zinc nitrate and urea in a water/ethylene glycol mixture. Crystal size and morphology are controlled by growth time and solvent composition. We observed a strong correlation between nanocrystals’ size/morphology and their optoelectronic defect-related properties. Smaller crystallites exhibited intense deep-defect luminescence and enhanced emission related to near-surface excitonic recombination. Longer growth times lead to formation of well-defined nanorods with hexagonal symmetry exhibiting reduced defect emission.

Background. The aim of the study was to establish eventual progress in routine management of lung cancer patients over a ten-year period at University Clinic for Respiratory and Allergic Diseases Golnik, Slovenia, comparing the results of analysis of 345 patients, diagnosed in 1996 (with analysis performed in 2002), and 405 patients, diagnosed in 2006 (with analysis performed in 2008). Patients and methods. The patients of both analysed groups were of comparable age and number of patients in stage I and II, but there were relatively more females, patients with better performance status, more precise clinical staging and tumour histology in the 2006 group. The parameters used for assessing the progress of management were as follows: time period from admittance to diagnosis and to surgery; precision of staging; accordance of clinical and pathological staging in resected patients; percentage of exploratory thoracotomy; and use of new treatment modalities. The proportion of patients in selected/actual primary treatment modality and survival rate could also be used for assessing the progress. Results. Although unessential longer time from admittance to microscopic confirmed diagnosis increased from a mean 7.4 to 8.6 days in 2006 progress was established by the following: more precise clinical staging (stage I and II also A and B stage, TNM staging also in small-cell lung cancer patients); improved accordance with clinical and pathological staging in resected patients (46% against 58%); decreased percentage of exploratory thoracotomy (13% against 4%); increased use of multimodality therapy as primary treatment modality (radiotherapy/chemotherapy, neoadjuvant chemotherapy); newly performed radio frequency tumour ablation. The proportion in selected/actual surgery increased from 76% to 93% and median survival rate of all patients from 6.2 to 10.6 months. One-year survival increased from 33.6% to 45.8% and two-year survival from 17.4% to 23%. Conclusions. Progress in routine lung cancer management was proved by better staging, lower percentage of exploratory thoracotomy, use of new treatment modalities, minor discordance between selected and actual therapy, and improved short-term survival rate.

In the period 1988-1992, 74 consecutive radically resected patients with NSCLC were randomised to postoperative radiotherapy or surgery alone in order to evaluate the influence of postoperative radiotherapy on survival. There were 61 males and 13 females, aged 35-80 years, median 59 years. Their distribution by stage was as follows: pT1N2 = 19, pT2N2 = 54, pT3N2 = one patient; histology: 32 squamous, 32 adeno and 10 large cell carcinomas; surgery: atypical resection in six, lobectomy in 27, bilobectomy in ten, and pneumonectomy in 31 patients. In 27 patients, only one lymph node in a single mediastinal lymph node site was affected; in 31 patients more than one lymph node in one site; in 16 patients more sites were affected. In 35/74 patients radiotherapy of hilar and mediastinal sites with 3000 cGy in 2 weeks was performed. On December 31, 1994, 19 patients (26%) were still alive; 39/55 patients died of the following causes: locoregional failure-10(26%), distant metastases- 25 (64%), other tumor-unrelated causes-four patients (10%). Five-year survival rates did not show statistically significant differences between the irradiated and surgically treated patients only with respect to sex, pTNM stage, histology and frequency of locoregional failure. The number of metastatic mediastinal lymph nodes was the only significant prognostic factor (P < 0.005) in both randomised groups.