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Mesoporous silica nanoparticles (MSN) are covalently functionalized with Ir(III)-based complex and further characterized by nitrogen sorption, SEM, FTIR, EDS, TGA, DSC, DLS and zeta potential measurements. Controlled, pHresponsive delivery Ir(III)-complexes was noticed and demonstrated for efficient treatment of glioblastoma multiforme (GBM) cells upon exposure to acidification.

Small renal tumor is a radiologically detected renal mass up to four cm in diameter. Surgery is the main therapeutic option in the treatment of these tumors, but in elderly and comorbid patients ablative techniques are the alternative. The aim of this paper is to report our experience in the treatment of small renal tumors with ablative techniques. We retrospectively analyzed patient records of individuals treated with radiofrequency and microwave ablation at the University hospital center Zagreb in the period from January 2017 to August 2019. An appropriate radiological and preoperative work-up was performed for all subjects, and then tumor biopsy and ablation. Patients were followed using the standard follow-up schedule: three, six, and 12 months after the procedure, and then annually, using radiological methods. Ablation of 32 small renal tumors was performed for 31 patients, 27 of which were radiofrequency and seven microwave ablations. One-year overall and cancer specific survival was 100%. In 12.9% of patients a residual mass was diagnosed – three were retreated with ablation and one underwent radical nephrectomy. We had four ClavienDindo grade 2 complications. Ablative techniques are an oncologically effective and safe treatment option for patients that are unfit for surgery.

We present a case series of 12 consecutive robot- assisted adrenalectomies performed from May 2019 to March 2020 by a single surgeon experienced in laparoscopy using the novel Senhance robotic system. Eleven patients had primary aldosteronism due to an adrenal adenoma, diagnosed by means of endocrinological and radiological evaluation, and 1 had a benign adrenal cyst. The robotic adrenalectomy technique is described in detail. The mean procedure time was 165.1 minutes, with robotic docking time of 11.6 minutes and console time of 98.6 minutes. The mean estimated blood loss was 47 mL, and hospital stay duration was 4.5 days. There was 1 Clavien Dindo IIIB complication and 1 patient underwent conversion to laparoscopy. All patients with adenoma had complete biochemical remission after surgery. In conclusion, the Senhance robotic system is a safe and feasible platform for benign adrenal surgery in high-volume centers.

Background: Mesoporous silica nanoparticles (MSN) are being vastly demonstrated in the literature as efficient nanocarriers for cancer therapeutics. Their high surface area (ca. 1000 m2/g), well-structured porosity, versatile possibilities for obtaining nanocarriers of different morphologies, pore diameters and surface characteristics, allow construction of different nanosystems for efficient cancer targeting. Methods: In this study, the potential of mesoporous silica nanoparticles for applications in targeted treatment of cancer is presented. Results: Our team focuses on construction and surface functionalization of MSN with different moieties for active cancer-targeting. The drug release process can be also controlled through different externally applicable stimuli (eg. light irradiation, magnetic field), or upon exposure to intratumoral conditions such as weakly acidic environment, the elevated concentration of glutathione or other cancer biomarkers. In addition, MSN can be decorated with specific moieties to enable imaging of cancer (eg. magnetic resonance imaging (MRI)), which would enable simultaneous cancer therapy and diagnostics (theranostics). Conclusions: Mesoporous silica nanoparticles have substantial potentials for enhancing the efficacy and precision of cancer treatment.

The capabilities in applying mesoporous silica nanoparticles (MSN) for the construction of different types of nanosystems for simultaneous cancer therapy and diagnostics (theranostics) are widely known in the scientific literature. Their specific characteristics, such as high surface area (ca. 1000 m2/g), well-structured porosity, and versatile surface-functionalization possibilities allow devising a plethora of multifunctional nanostructures. In this context, our research team works on the synthesis of MSNs of different structures and their surface modification toward enabling active cancer-targeting. These MSNs are loaded with different cargo molecules which can serve different purposes, such as cancer treatment, imaging, or sensing cancer-specific environment and biomolecules. The process of cargo release can be also governed by employing externally applicable stimuli (e.g. light irradiation, magnetic field), or upon exposure to intratumoral conditions such as weakly acidic environment, the elevated concentration of glutathione, or in the presence of other cancer biomarkers. The control over this process allows the application of MSNs as unique facilitators in cancer therapy, imaging and sensing, with substantial benefits for enhancing the efficacy and precision of cancer treatment or for early cancer diagnosis.

Mali tumor bubrega je radiološkim metodama utvrđena tvorba promjera do 4 cm. Kirurško liječenje je terapija izbora ovakvih tumora, ali se kod starijih bolesnika s komorbiditetima preporučuju i ablacijske metode. Cilj je ovoga rada prikazati naša iskustva liječenja malih tumora bubrega ablacijskim metodama. Učinili smo retrospektivnu analizu serije bolesnika liječenih radiofrekventnom i mikrovalnom ablacijom u Kliničkom bolničkom centru Zagreb u razdoblju od siječnja 2017. godine do kolovoza 2019. godine. Svim bolesnicima učinjena je odgovarajuća radiološka i preoperativna obrada, biopsija tumora i ablacija. Praćeni su prema standardnom protokolu radiološkim metodama 3, 6 i 12 mjeseci postoperativno te nakon toga jednom godišnje. Ablacija 32 mala tumora bubrega učinjena je kod 31 pacijenta, od čega 27 radiofrekventnih i 7 mikrovalnih ablacija. Jednogodišnje ukupno i tumor specifično preživljenje bilo je 100%, a kod 12,9% bolesnika utvrđen je rezidualni tumor. Troje ih je liječeno ponovnom ablacijom, a jedan radikalnom nefrektomijom. Imali smo četiri komplikacije iz 2. skupine po Clavien-Dindo klasifikaciji. Ablacijske metode su onkološki dobra i sigurna terapija kod bolesnika koji nisu pogodni za kirurški zahvat., Small renal tumor is a radiologically detected renal mass up to four cm in diameter. Surgery is the main therapeutic option in the treatment of these tumors, but in elderly and comorbid patients ablative techniques are the alternative. The aim of this paper is to report our experience in the treatment of small renal tumors with ablative techniques. We retrospectively analyzed patient records of individuals treated with radiofrequency and microwave ablation at the University hospital center Zagreb in the period from January 2017 to August 2019. An appropriate radiological and preoperative work-up was performed for all subjects, and then tumor biopsy and ablation. Patients were followed using the standard follow-up schedule: three, six, and 12 months after the procedure, and then annually, using radiological methods. Ablation of 32 small renal tumors was performed for 31 patients, 27 of which were radiofrequency and seven microwave ablations. One-year overall and cancer specific survival was 100%. In 12.9% of patients a residual mass was diagnosed – three were retreated with ablation and one underwent radical nephrectomy. We had four ClavienDindo grade 2 complications. Ablative techniques are an oncologically effective and safe treatment option for patients that are unfit for surgery.

We present a young adult male patient with suspicious lesion in urinary bladder found on routine exam using ultrasound. Urethrocystoscopy was performed and revealed urethral fibroepithelial polyp that was causing partial and total obstruction of urine flow. We have documented this case with a series of high-quality endoscopic images., Prikazan je slučaj dvadesetdevetogodišnjeg muškarca kojem je na redovnom sistematskom pregledu, ultrazvukom je pronađena sumnjiva lezija u mokraćnom mjehuru. Uretrocistoskopijom je potvrđen uretralni fibroepitelni polip, mogući uzročnik potpunog ili djelomičnog zastoja mokrenja. Slučaj je dokumentiran serijom visokokvalitetnih endoskopskih fotografija.

Introduction: We present a case of an extensive endometriosis involving left paracolpium and left parametrium, rectovaginal septum, urinary bladder, left interiliac region between artery and vein, left ureter and rectum, presenting as dysmenorrhoea, alternating bouts of diarrhea and constipation and hydronephrosis. Methods: Laparoscopic surgery made by a multidisciplinary team consist of gynecologic, abdominal surgeon and urologist. Results: Successfully managed deep infiltrated endometriosis. Conclusion: The aim of this report is to demonstrate benefit of one-stage, minimally invasive radical surgical procedure performed in a tertiary referral center. To the best of our knowledge, this report presents an extremely complex case because we successfully managed deep infiltrating endometriosis in three different organ systems at the same time, using minimally invasive nerve-sparing technique. A case with the same constellation has not been published yet since reported cases of extrapelvic endometriosis chiefly address one organ system involvement.

Railway transportation is the backbone of the economy significantly influences mobility and life quality in many developed and developing countries. Railway infrastructure investment problems are inherently complex and involve multiple and often conflicting criteria in an uncertain socio-economic environment. This study presents an integrated rough group FUll COnsistency Method (FUCOM) and Multi-Atributive Ideal-Real Comparative Analysis (MAIRCA) method for railway infrastructure project evaluation and prioritization. The FUCOM method evaluates the selection criteria through a simple algorithm, and the MAIRCA method prioritizes alternative projects through structured and systematic mathematical computations. Sensitivity analysis measures the impact of the criteria weights on the final results. Spearman's rank correlation coefficient assesses the effect of criteria weight variations on alternative rankings' stability. This study's main contribution is developing and implementing a comprehensive and robust framework for ex-ante evaluation and prioritization of railway infrastructure projects. A case study in Serbian Railways demonstrates the proposed integrated framework's applicability and efficacy in evaluating the railway infrastructure projects for Serbian Railways.

Introduction: Literature reveals several peritoneal dialysis laparoscopic catheter insertion techniques developed to improve long- term results for treatment chronic kidney failure with the technic of peritoneal dialysis. The purpose of the study is evaluation of developed and recommended minimally invasive laparoscopic technic for chronic peritoneal dialysis catheter placement using specially constructed trocar. Materials and Methods: Retrospective study included 804 patients in 10 departments of surgery. Surgical and non surgical complications related to PD catheter placement were analysed: bleeding, dialysate leak, early SSI, peritonitis, catheter tip migration, catheter obstruction, omental wrapping and visceral perforations. Available software (Microsoft® Excel for Windows 10, MedCalc, Mariakerke, Belgium) was used for statistical analysis (presented as percentages, mean ± SD or median). Conclusions: The presented technique with specially constructed trocar is a simple and effective procedure with fewer complications comparing to literature. The advantages of this method include long rectus sheath tunnel with the deep cuff placed pre- peritoneally, the small size of the entrance into the peritoneum and accurate position and control of catheter tip in the pelvis.

Cloud services have turned remote computation into a commodity and enable convenient online collaboration. However, they require that clients fully trust the service provider in terms of confidentiality, integrity, and availability. Toward reducing this dependency, this article introduces VICOS , a protocol for verification of integrity and consistency for cloud object storage that enables a group of mutually trusting clients to detect data integrity and consistency violations for a cloud object storage service. It aims at services where multiple clients cooperate on data stored remotely on a potentially misbehaving service. VICOS enforces the consistency notion of fork-linearizability, supports wait-free client semantics for most operations, and reduces the computation and communication overhead compared to previous protocols. VICOS is based on a generic authenticated data structure. Moreover, its operations cover the hierarchical name space of a cloud object store, supporting a real-world interface and not only a simplistic abstraction. A prototype of VICOS that works with the key-value store interface of commodity cloud storage services has been implemented, and an evaluation demonstrates its advantage compared to existing systems.

Novel cancer-targeting nanotherapeutics are developed based on mesoporous silica nanoparticles (MSN) loaded with metal complexes, for potent activity against cancer. MSN was synthesized by a surfactant-templated method. The nanomaterials are designed, through post-synthetic surface-functionalization with the capability to release Ruthenium- and Iridium-based drugs from MSN nanomaterials by lowering pH value. This effect would lead to preferential cancer-targeting due to the more acidic tumor tissue in comparison to the healthy tissue. Novel Ru(II) and Ir(III) coordination compounds were also synthesized, containing the same ligands which are contained on the surface of MSN, and their anticancer activity was evaluated with and without their covalent attachment to MSN. The constructed series of novel nanomaterials and coordination compounds were characterized by scanning electron microscopy, thermogravimetric analysis, infrared spectroscopy, X-ray crystallography, and elemental analysis. The characteristics of prepared metal complexes and novel nanomaterials demonstrate high potential for their effective application in targeted cancer treatment.

Manuscript describing initial experience with novel robotic platform the Senhance. We describe the technical aspects of surgery and the operative technique.

Testicular tumors are the most common solid tumors in men between age 15- 34 years. The worldwide incidence of these tumors has doubled in the past 40 years. Germ cell tumors comprise 95% of malignant tumors arising in the testes and they are classified as seminoma and nonseminoma. Testicular cancer has high cure rates even in disseminated stage of disease. The chemotherapy mostly contributed to these results, but surgery is an unavoidable part of this success. In significant number of these patients treatment algorithms today have intention to offer the same cure rates with minimally aggressive therapy. The following text presents the clinical guidelines in order to standardize procedures and criteria for diagnosis, treatment, and follow-up of patients with testicular cancer in the Republic of Croatia.

Rak testisa najčešći je solidni tumor u muškaraca u dobi od 15. do 34. godine. Incidencija raka testisa u svijetu udvostručena je u posljednjih 40 godina. Tumori zametnih stanica čine 95% svih tumora testisa, a podijeljeni su u dva osnovna histološka tipa: seminomi i neseminomi. Osobito značenje daje im velik postotak izlječivosti i u diseminiranoj fazi bolesti. Tom je uspjehu najviše pridonijela kemoterapija, ali kirurgija je i dalje neizostavan dio uspješnog liječenja. U znatnog dijela bolesnika danas se nastoji odrediti terapijski minimum kojim se izbjegava niz nuspojava, a dovodi do jednakog uspjeha kao i donedavno agresivniji terapijski pristup. U tekstu koji slijedi iznesene su kliničke upute radi standardizacije dijagnostike, liječenja i praćenja bolesnika s tumorima zametnih stanica testisa u Republici Hrvatskoj., Testicular tumors are the most common solid tumors in men between age 15- 34 years. The worldwide incidence of these tumors has doubled in the past 40 years. Germ cell tumors comprise 95% of malignant tumors arising in the testes and they are classified as seminoma and nonseminoma. Testicular cancer has high cure rates even in disseminated stage of disease. The chemotherapy mostly contributed to these results, but surgery is an unavoidable part of this success. In significant number of these patients treatment algorithms today have intention to offer the same cure rates with minimally aggressive therapy. The following text presents the clinical guidelines in order to standardize procedures and criteria for diagnosis, treatment, and follow-up of patients with testicular cancer in the Republic of Croatia.

Twenty to thirty percent of patients with clinical stage I testicular tumor have metastases in the retroperitoneum. The aim of this study was to evaluate the role of OCT4 immunohistochemistry in histopathologic diagnosis of lymph node metastases in patients with nonseminomatous germ cell testicular tumors. All clinical stage I patients with staging laparoscopic retroperitoneal lymphadenectomy from 2001 until 2009 were included. Archived materials of dissected lymph nodes were reassessed and additional immunohistochemical staining with OCT4 antibody was performed in patients diagnosed as free from metastases. Each slide was visually estimated for the percentage of tumor cells showing nuclear immunoreactivity for OCT4. The study included 93 patients, of which 30 (32.3%) had initially positive retroperitoneal lymph nodes. Of the remaining 63 patients, materials were missing for 5 patients, so additional immunohistochemical staining was performed in 58 patients. Of these, two (3.4%) patients were OCT4 positive, suggesting a conclusion that they were initially misdiagnosed as stage I and metastasis free. OCT4 proved its value in detecting retroperitoneal metastases. Staging laparoscopic retroperitoneal lymphadenectomy for nonseminomatous germ cell testicular tumors in clinical stage I is a reasonable option for selected patients., Dvadeset do trideset posto bolesnika s tumorom testisa kliničkog stadija I. ima metastaze u retroperitoneumu. Cilj ovoga istraživanja bio je utvrditi vrijednosti OCT4 u patohistološkoj dijagnostici metastaza u limfnim čvorovima dobivenih laparoskopskom retroperitonealnom limfadenektomijom za utvrđivanje proširenosti bolesti. U istraživanje su uključeni bolesnici kliničkog stadija I. koji su operirani u razdoblju od 2001. do 2009. godine. Učinjena je ponovna procjena arhiviranih patohistoloških materijala pričem su uzorci bolesnika za koje je prvobitno utvrđeno da nemaju metastaza dodatno imunohistokemijski obrađeni protutijelima OCT4. Za svako stakalce vizualno je procijenjen postotak tumorskih stanica jezgre kojih su pokazale imunoreakciju za OCT4. Istraživanjem su uključena 93 bolesnika od kojih je 30 (32,3%) inicijalno imalo metastaze u retroperitonealnim limfnim čvorovima. Od preostala 63 bolesnika pet ih nije imalo dostupne materijale za analizu te je imunohistokemijsko bojenje učinjeno za 58 bolesnika. Među njima dijagnosticirali smo dva (3,4%) bolesnika koji su imali limfne čvorove pozitivne na OCT4. Njima je inicijalno utvrđen krivi stadij bolesti, čime smo zaključili kako je OCT4 potvrdio svoju vrijednost u otkrivanju retroperitonealnih metastaza. Laparoskopska retroperitonealna limfadenektomija u svrhu utvrđivanja stadija bolesti predstavlja razumnu opciju za probrane bolesnike u kliničkom stadiju I. neseminomskih tumora zametnih stanica testisa.

This paper represents the application of A'WOT method for the selection of postal services development scenario in the Republic of Serbia. A'WOT method is a relatively new tool for decision making. This method is made by combination of the Analytic hierarchy process (AHP approach) and SWOT analysis. In this new hybrid method, SWOT analysis gives the basis for decision making by defining the elements, which are under consideration in the process of strategy selection. On the other hand, the AHP approach makes the rank of alternatives based on selected elements.

Nekada smo benignu hiperplaziju prostate smatrali glavnim uzrokom problema s mokrenjem kod muškaraca. Danas koristimo naziv simptomi donjeg urinarnog trakta jer se pokazalo kako je benigna hiperplazija prostate samo jedan od etioloških čimbenika. Kvalitetna dijagnostička obrada simptoma uputit će nas u pravom smjeru kako bismo mogli individualizirati terapiju. Za pacijente koji imaju indikaciju za kirurško liječenje danas postoji nekoliko operativnih tehnika. Otvorena jednostavna prostatektomija najstariji je i dokazano učinkoviti zahvat. Transuretralna resekcija prostate je zlatni standard liječenja. Laserska tehnologija danas stoji uz bok zlatnom standardu, a pojavile su se i tehnike minimalno invazivne kirurgije koje pružaju prednosti niskog morbiditeta i kratkotrajne hospitalizacije., Benign prostatic hyperplasia was once considered the main reason for urinary symptoms in male patients. Today we are aware that many etiological factors cause these symptoms so a new term was coined: lower urinary tract symptoms. An adequate diagnostic work up will lead us onto the right path of individualized treatment for each patient. Those in need of surgery have various surgical procedures at their disposal. Open simple prostatectomy is the oldest procedure that has proven its efficacy. Transurethral resection of prostate is the current gold standard. Laser techniques are challenging the gold standard while minimally invasive surgical procedures offer all the benefits of low morbidity and short hospital stay.

Cloud services have turned remote computation into a commodity and enable convenient online collaboration. However, they require that clients fully trust the service provider in terms of confidentiality, integrity, and availability. Towards reducing this dependency, this paper introduces a protocol for verification of integrity and consistency for cloud object storage (VICOS), which enables a group of mutually trusting clients to detect data-integrity and consistency violations for a cloud object-storage service. It aims at services where multiple clients cooperate on data stored remotely on a potentially misbehaving service. VICOS enforces the consistency notion of fork-linearizability, supports wait-free client semantics for most operations, and reduces the computation and communication overhead compared to previous protocols. VICOS is based in a generic way on any authenticated data structure. Moreover, its operations cover the hierarchical name space of a cloud object store, supporting a real-world interface and not only a simplistic abstraction. A prototype of VICOS that works with the key-value store interface of commodity cloud storage services has been implemented, and an evaluation demonstrates its advantage compared to existing systems.

Izvođenje dijagnostičkih i terapijskih zahvata u urologiji s pomoću minimalno invazivnih tehnika postalo je uobičajeno. Ovim se pristupom postiže jednaka učinkovitost kao i otvorenim kirurškim zahvatima, no uz znatno smanjenje boli i trajanja oporavka. Cilj ovoga preglednog rada jest prikazati trenutačnu uobičajenu praksu u uporabi minimalno invazivnih tehnika u urologiji. Prikaz je podijeljen prema tehničkom pristupu: postupci kroz prirodne otvore, tj. transuretralni postupci, perkutani zahvati i laparoskopska kirurgija. Iako se minimalno invazivna kirurgija razvija od 19. stoljeća, u posljednjim je desetljećima postignut najveći napredak. Danas je moguće putem minimalno invazivnih tehnika izvesti gotovo svaki kirurški zahvat u urologiji. Daljnji razvoj i napredak dovest će do novih, još manje invazivnih pristupa., Minimally invasive diagnostic and therapeutic procedures are common in urology. This minimally invasive approach is as effective as open approach, but involves significantly less postoperative pain and provides faster recovery for patients. The aim of this paper is to review the usual utilisation of minimally invasive procedures in urology. Procedures are divided into: natural orifice procedures / transurethral procedures, percutaneous procedures and laparoscopic surgery. Although minimally invasive surgery has been present since the 19th century, most advancements have been made in the last few decades. Today it is possible to perform almost any operative procedure in urology with minimally invasive techniques. Further technical development should bring about novel and even less invasive techniques.

Renal arteriovenous fistula (AVF) presents a rare but important condition that can be acquired, congenital, or idiopathic. Embolization techniques have recently been considered the first-line therapy in the treatment of these lesions, but they carry a possible high risk of distal migration of embolic agents into the venous and pulmonary circulation. This risk is especially important with large, high-flow fistulas. In this report, we present a case in which a 31-year-old man with a symptomatic idiopathic AVF was treated with embolization using the Amplatzer vascular plug II after unsuccessful superselective embolization using coils. This method allowed for complete occlusion of the high-flow fistula with good preservation of arterial supply to the renal parenchyma.

Komplicirane infekcije mokraćnog sustava (IMS) uz prisutnost strukturnih ili funkcionalnih abnormalnosti mokraćnog sustava od primarnog su urološkog interesa. Najčešće je potrebno aktivno urološko liječenje poremećaja urotrakta kako bi se postigla eradikacija infekcije te prevenirao nastanak recidiva. Brojne prirođene i stečene abnormalnosti mokraćnog sustava, koje dovode do opstrukcije odnosno usporavanja ili zastoja normalnog toka mokraće, mogu dovesti do razvoja kompliciranih IMS-a. U sklopu kompliciranih infekcija bubrega mogu nastati komplikacije i posebni klinički entiteti (pionefros, renalni apscesi, emfizematozni pijelonferitis, ksantogranulomatozni pijelonefritis) koji zahtijevaju hitno urološko liječenje pa i nefrektomiju zahvaćenog bubrega., Complicated urinary tract infections (UTI) associated with structural or functional abnormality of the urinary tract are of the primary urological interest. Management of the urological abnormality is often necessary to cure UTI and to prevent recurrent infection. A wide variety of both congenital and acquired urinary abnormalities, which cause obstruction and stasis of urine flow, may lead to complicated UTI. Complicated urinary infections of the kidney may be associated with complications (pyonephrosis, renal abscesses, emphysematous pyelonephritis, xanthogranulomatous pyelonephritis) which require urgent urological treatment, including nephrectomy.

The human testis is composed of seminiferous tubules and interstitium. Within the interstitium, residing Leydig cells can occasionally bear Reinke´s crystals. The aim of the current study was to investigate Reinke´s crystals in perivascular and peritubular Leydig cells in control and infertile (cryptorchid) testes. For that purpose, bright field, confocal and transmission electron microscopy were applied. The crystal lattice was investigated by Fast Fourier Transformation and the number of crystals determined by stereology. Results of the study indicated a higher number of crystals in perivascular cells (in the both control and cryptorchid group). Moreover, when control and cryptorchid specimens were compared for the presence of the crystal, a higher number of Reinke´s crystals was recorded in cryptorchid testes. Thick sections of the crystal were extremely helpful in yielding crystallographic data which confirmed a trigonal crystal structure of the lattice. The exact molecular composition of crystal’s microfilaments still remains unknown. (doi: 10.5562/cca1814)