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Izrađen je elaborat prijave projekta: Postavljanje spomen-ploče nobelovcu Leopoldu (Lavoslavu) Ružički na kuću u Gundulićevoj ulici br. 13 u kojoj je živio u Osijeku, po Pozivu za predlaganje Programa javnih potreba u kulturi Grada Osijeka za 2020., Osijek, 06. 09. 2019.

Patients with urolithiasis, particularly hypercalciuria, may have reduced bone mineral density (BMD). There are numerous risk factors contributing to reduction of BMD such as advanced age, sedentary lifestyle, smoking, low calcium intake, etc. The aim of our study was to investigate the association of lifestyle risk factors and daily intake of milk and dairy products with determinants of BMD in a group of recurrent calcium stone formers (RSF) compared with healthy subjects (HS). The study was carried out at the Department of Mineral Research, Faculty of Medicine in Osijek, Croatia. The study included 144 subjects, i.e. 56 RSF and 78 HS. BMD was assessed by dual- energy x-ray absorptiometry. A standard self- reported questionnaire was used to collect data on lifestyle risk factors. Current dietary intake was assessed by personal interview that included questions about milk and dairy product intake. Low BMD was observed in 44.64% of RSF and 35.90% of HS. RSF consumed significantly less milk and dairy products than HS. Calcium restriction in dietary recommendations might be unnecessary due to the impact on bone mineral loss in RSF and dual-energy x-ray absorptiometry should be included in the routine evaluation of RSF.

Urolitijaza je karakterizirana stvaranjem solidnih depozita unutar renalnog sustava. Postoje brojni uzroci nastanka bubrežnih kamenaca. Većina kamenaca sastavljena je od kalcijevog oksalata, koji stvara slobodne radikale te time uzrokuje oksidativno opterećenje i oštećenje endotelnih stanica bubrega. Oštećenje endotelnih stanica zajedničko je većini pretpostavljenih modela nastanka kamenaca. Cilj ovog istraživanja bio je istražiti utjecaj antioksidansa (vitamina E i L-arginina) na prevenciju okisdativnog opterećenja u endotelnim stanicama sabirnog tubula bubrega. Madin-darby kanine kidney stanice subtip I (MDCK I) korištene su kao in vitro model sabirnog tubula bubrega. Kako bi prevenirali oksidativni stres u stanicama uzrokovan 8 mM natrijevim oksalatom stanice smo predtretirali rastućim koncentracijama vitamina E i L- arginina te smo stanično preživljenje odredili brojanjem stanica. Kako bi dodatno procjenili oksidativno oštećenje stanica odredili smo koncentracije glutationa (GSH) u stanicama. Predtretman antioksidansima uzrokovao je statistički signifikantno povećano preživljenje stanica koje su potom bile tretirane natrijevim oksalatom. Štoviše, izmjerene koncentracije GSH pokazale su smanjenje oksidativnog opterećenja stanica predtretiranih s antioksidansima. Naši rezultati sugeriraju da bi se L-arginin i vitamin E mogli koristiti kao preventivno sredstvo za stvaranje bubrežnih kamenaca. Potrebna su daljnja istraživanja kako bi se ovi in vitro rezultati potvrdili.

Anastrozole is a selective competitive aromatase inhibitor (AI) widely used as adjuvant treatment for early stage breast cancer. Highly efficient estrogen depletion by AI benefits breast cancer (BC) patients by extending recurrence-free survival. However, AIs put patients at high risk of osteoporosis due to the central role of estrogen in maintaining normal bone metabolism. Although awareness of osteoporosis by health care professionals has increased in recent years, it remains underdiagnosed and undertreated. Findings of this study should raise awarness of the importance of BMD screening among BC patients treated with anastrazole and to tailor treatment and prevention strategies for Al users as a high - risk population for bone morbidity. The intensity of adverse effects plays an essential part in maintaining patient complience to anastrazole therapy. Functional genetic polymorphisms of enzymes involved in anastrazole metabolism could be correlated to altered aromatase activity, disease prognosis and severity of aromatase inhibitor adverse effects, however large genotyping studies are obligatory.

Urolithiasis is a result of formation and retention of crystals within the kidneys. Numerous causes may lead to kidney stone formation. However, most kidney stones are predominantly composed of calcium oxalate which predominantly generates free radicals that are toxic to the renal tubular cells. The aim was to study the toxic effect of oxalate to renal cells and possible inhibition of oxalate induced oxidative stress by antioxidant treatment. Pig kidney epithelial cells (LLC-PK1) were used as in vitro model of urolithiasis. Oxidative stress was induced by exposure of LLC-PK1 cells to sodium oxalate (NaOX). In order to prevent oxidative stress LLC-PK1 cells were pretreated with different concentrations of vitamin E, an antioxidant. The cytotoxicity of oxalate against LLC-PK1 cells was determined by cell counting and by light microscopy. The oxidative stress was evaluated by expression of superoxide dismutase (SOD), which was done by RT-PCR and immunohistochemically (using anti-SOD I antibody In the cells treated with NaOX only, necrosis was observed proportionally to the concentration of NaOX. Interestingly, cells treated with vitamin E prior NaOX exposure showed lover levels of necrosis by light microscopy as well as by cell counting. Positive correlation of SOD expression was observed in all groups of cells. An antioxidant pretreatment with vitamin E of the cells later exposed to oxalate toxicity is able to hamper oxalate induced oxidative stress generation in kidney cells. Vitamin E may play role in prevention of urolithiasis. Further evaluation of its potential as a prevention agent of urolithiasis are needed.

Osteoprotegerin gene (OPG) is an important candidate gene of osteoporosis. The aim of this study was to determine if two polymorphisms in the OPG gene influ- ence bone turnover markers and bone mineral density (BMD). A total of 135 patients, aged 41 to 87 years, were included in the study. Lumbar spine, femoral neck, total-hip and distal radius BMD were measured by dual-energy X-ray absorp- tiometry (DXA) and bone turnover markers were measured by standard biochem- ical procedures. OPG gene polymorphisms A163>G and T245>G were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The frequencies of A163>G and T245>G polymorphisms in the OPG gene were determined by screening 131 DNA samples. The prevalence of genotypes of the A163G polymorphism was 59, 4% for GG, 33, 3% for AG and 7, 2% for AA geno- type in group with osteoporosis, whereas in control group the prevalence was 77, 8%, 16, 7% and 5, 6%, respectively. The prevalence of genotypes of the T245G polymorphism was 88, 4% for genotype TT and 11, 6% for genotype TG in group with osteoporosis, whereas in control group the prevalence was 94, 4% and 5, 6%, respectively. Analysis of BMD in the distal radius of postmenopausal women showed a trend to lower levels in the minor allele homozygote group (GG) versus two other groups. Our results suggest that OPG polymorphism influences BMD in postmenopausal women, however further biological and/or functional evidence would be needed to confirm the suggestive influence of OPG polymorphisms on BMD.

Human echinococcosis remains a significant medical issue in endemic areas. Hydatid cysts can rupture, which is the most severe complication of echinococcosis as it can cause anaphylactic reaction and seeding of secondary cysts. Traditionally, hydatid cysts were evacuated by open surgical procedure in order to remove the entire cyst or by unroofing method, with evacuation of the cyst content. Recently, an increasing number of such operations are performed using laparoscopic approach. This study was prospectively conducted in a 5-year period, from 2004–2008. Altogether, 25 surgically treated patients were included in this study. Clinical examination, specific serological test, abdominal ultrasound and computed tomography were used for establishing diagnosis. Open surgery was initially performed in 17 patients and laparoscopic in 8. Three of those 8 patients required conversion to open surgery. Open pericystectomy was performed in 11 patients and laparoscopic pericystectomy in 3 patients. Open partial pericystectomy according to Papadimitriou was performed in 9 patients with hydatid cyst and laparoscopic partial pericistectomy in 2 patients. Our experience indicates that in the case of liver hydatid cyst disease, laparoscopic exploration, and if possible, laparoscopic pericystectomy or partial pericystectomy, should be performed in selected patients.

Urolithiasis is a disease characterized by formation of solid deposits in the urinary tract. The numerous causes may lead to kidney stone formation. However, most kidney stones are predominantly composed of calcium oxalate which predominantly generates free radicals that are damaging to the renal tubular cells To study the toxic effect of oxalate to renal tubular cells and possible inhibition of oxalate caused oxidative stress by antioxidant treatment. Madine-Darby canine kidney cells (MDCK cells) were used as in vitro model of urolithiasis. Oxidative stress was induced by exposure of MDCK cells to sodium oxalate (NaOX). In order to prevent oxidative stress MDCK cells were pretreated with different concentrations of L-arginin, an antioxidant. The cytotoxicity of oxalate against MDCK cells was determined by MTT Assay and by light microscopy. The oxidative stress was evaluated by expression of superoxide dismutase (SOD) by RT PCR using RNAeasy kit (Qiagen) and standard protocol. In the cells treated with NaOX only, observed necrosis was proportional to the concentration of NaOX. Interestingly, cells treated with L-arginin prior NaOX exposure showed lover levels of necrosis by light microscopy as well as by MTT assay. Positive correlation of SOD expression was observed in all groups of cells by RT-PCR. Our results suggest that L-arginin is able to hamper oxalate induced oxidative stress generation in kidney cells and as such may play role in prevention of urolithiasis. More studies are needed to further evaluate its potential as a prevention agent of urolithiasis.

Background. Ureteral stent occlusion by encrustation is a major problem in long-term artificial urinary drainage. In this paper are demonstrated results of the investigation the physical chemical analysis of extracted encrustates to the stents for some patients with recurrent urolithiasis. Methods. We analyzed the composition of encrustates to 20 removed double J stents in patients with recurrent urolithiasis. Analysis of the encrustates composition were made by thermogravimetric analysis (Mettler TG 50) and FT-IR spectroscopy (Shimadzu 8400). Results. The results obtained were compared with encrustates compositionof the primary composition of kidney stones by patients previously excreted. Encrustates samples were taken from three different places on the stent to determine sample homogeneity, considering the diversity of environment through which the stent is situated. The results indicate composition diversity of the sample encrustated with the same stent. Analysis composition encrustates revealed struvite and carbonate hydroxyapatite as most frequent minerals. Conclusions. Based on results of analysis of the composition encrustates deposited at the stent in patients with recurrent urolithiasis we can concluded that it is not homogeneus and is not identical with the composition of primary kidney stones who is patients previously extracted.

Renal lithiasis is a significant medical and social problem with still a high recurrence rate (3%-5%) worldwide. In Croatia urinary and/or renal stones are composed predominantly of calcium oxalate and phosphate stones (about 75%), uric acid (about 10% - 12%) and sometimes so-called infection stones struvite (about 10% - 15%). Major factors contributing to renal stone formation are urine supersaturation and various metabolic factors. However urine can contain various substances which by different mechanisms can inhibit the precipitation process. The objective of this paper is to evaluate and compare several chemical methods for distinguishing between stone formers and non-stone formers. The examined methods are based on testing the inhibitory capacity of urine with respect to precipitation of calcium salts. The two methods in question are: a) initiation of precipitation from whole urine by addition of calcium oxalate monohydrate seed crystals – this method monitors ionic calcium concentration with seed crystals of calcium oxalate monohydrate (COM) (initiated precipitation) and without (spontaneous precipitation) after 3h and 24h incubation at 37˚C. Results are shown according to the following criteria: Δc (Ca) = c (Ca) spont.prec. – c (Ca) init.prec. b) testing the capacity of urine for calcium complexing by adding calcium solution to whole urine – urine samples (first morning urine) are titrated with calcium chloride solution (c(CaCl2)= 0.1 moldm-3). The discriminating criteria for the results is the slope of the titration curve. Preliminary research shows that these two methods have a great potential for discriminating between the stone formers and non-stone formers. The theoretical background experimental design and parameters for discrimination between urines of stone formers and non-stone formers are explained for both methods. The results for experimental groups (stone formers) and control group (non-stone formers) are compared and the advantages and disadvantages of each method are discussed. Disclosure: No significant financial interest or other affiliations with a funding organization or with a commercial supporter of the session and/or provider of commercial services exists.

Točna i pouzdana analiza kemijskog sastava bubrežnih kamenaca s definiranjem kristalnih komponenti koje se nalaze u sastavu kamenaca preduvjet je za djelotvorno medicinsko praćenje osoba koje stvaraju bubrežne kamence. Ona može značajno olakšati procjenu i tretman u takvim slučajevima. Za utvrđivanje sastava kamenaca koriste se brojne fizikalno kemijske tehnike. FTIR spektroskopija fizikalna je metoda za analizu kamenaca koja koristi sofisticiranu instrumentaciju, a zahtijeva usporedbu uzorka s poznatim standardima. U radu je prikazano dvadesetogodišnje iskustvo kliničkoga laboratorija u IR analizi sastava bubrežnih kamenaca. Glavne kristalne supstance koje se mogu naći u kamencima podijeljene su u šest glavnih grupa: kalcij oksalat, kalcij fosfat, infektivni kamenci, uratni kamenci, cistin i ostali.

Dvostruka J proteza mokraćovoda ili kolokvijalno "JJ" stent tanki je gumeni, plastični ili silikonski kateter koji se postavlja između bubrežne nakapnice i mokraćnog mjehura s ciljem omogućavanja protoka mokraće mimi organskih ili anorganskih prepreka od pijeloureteralnog pripoja uzduž mokraćovoda do vezikoureteralnog ušća. Razjašnjenje uloge biofilma unutar urotrakta objašnjava rekurirajuću struvitnu i apatitnu urolitijazu. Produkcija ureaze i bakterijski polisaharidi dokazani su ključni faktori virulencije bakterija uključeni u stvaranje kamenaca. U ovom radu pokazani su rezultati započetih istraživanja fizičko-kemijske analize istaloženih enkrustata na urološkim stentovima za nekoliko ispitanika. Dobiveni rezultati analize sastava enkrustata nisu bili jednoznačni.

Suradnja kemičara, liječnika i urologa s Instituta Ruđer Bošković Zagreb, Instituta za medicinska istraživanja i medicinu rada Zagreb te Kliničke bolnice Osijek (danas Kliničkoga bolničkoga centra Osijek) započela je od prije više od tridesetak godina na projektima povezanim s nastankom urolitijaze. Sama istraživanja pridonijela su novim spoznajama o različitim faktorima važnim za nastajanje kamenaca, dijagnosticiranje i liječenje urolitijaze. Više radova objavljeno je u znanstveno-stručnom časopisu Medicinki vjesnik (1984. i 1985.) te u knjizi Urolitijaza (1989.). U radu V. Babić-Ivančić i sur., objavljenom u Medicinskom vjesniku 2004. godine, dan je detaljan pregled bazičnih, primijenjenih i kliničkih istraživanja do 2004. godine na zajedničkim projektima financiranim iz Hrvatske (MZOŠ) i na međunarodnim projektima (EZ, USA, TEMPUS) provedenim u trima suradnim ustanovama čiji su rezultati objavljeni u znanstvenim časopisima i/ili prezentirani na znanstvenim skupovima u zemlji i inozemstvu. u ovome radu dat će se osvrt na rezultate istraživanja, te suradnu u vremenskom razdoblju od 2004. godine do danas (2010.) Iz ranijih istraživanja te istraživanja u zadnjih šest godina dat će se viđenje i istraživanjima te problematike u budućnosti.

Nekoliko kliničkih i epidemioloških istraživanja otkrila su povećanu koštanu pregradnju i nižu koštanu masu u bolesnika s urolitijazom. Gubitak koštane mase je posebno uočen kod idiopatske kalcijske urolitijaze. Međutim, patogenetski mehanizmi i čimbenici povezani s gubitkom koštane mase u ovih bolesnika su još uvijek nepoznati. Ograničenje kalcija u prehrani, povećani unos soli i životinjskih proteina, polimorfizam receptora za vitamin D su vjerojatni rizični čimbenici. Uloge proupalnih citokina, osteopontina i prostaglandin posredovane resorpcije kostiju još treba istražiti. Dokazno je da pozitivan utjecaj u prevenciji i liječenju osteoporoze i urolitijaze imaju nadomjesci kalcija i prehrana s povećanim unosom kalcija s kalijevim alkalijama. Tiazidski diuretici smanjuju hiperkalcuriju u bubrežnim tubulima, te dodatno promoviraju diferencijaciju osteoblasta. Konačno, bisfosfonati, uobičajena terapija osteoporoze, imaju potencijal za inhibiciju stvaranja kalcijskih kamenaca, dok se pozitivan učinak antioksidansa treba još detaljno istražiti.

Osnutak Sbora liečnika kr. Hrvatske i Slavonije sa sjedištem u Zagrebu i Družtva slavonskih liečnika sa sjedištem u Osijeku 1874. godine, rezultat je složenih društveno političkih procesa, ali i zamaha na razini hrvatske kulturne integracije. Oblikovanje strukovnog identiteta podrazumijevalo je sazrijevanje liječnika u kontekstu društvene uloge bez obzira na njihovu regionalnu raspoređenost. Osijek u to vrijeme jača, ne samo kao kao civilno i vojno središte, već i kao zdravstveni centar Slavonije. Borba za oživotvorenje samostalnog strukovnog udruženja pozicionirala ga je stoga kao ravnopravnog partnera Zagrebu već i kao sredinu sa snažnim potencijalom borbe za reformu zdravstva uvjetovanu angažiranom ulogom liječničke profesije.

Karcinom prostate je u većini zemalja zapadne hemisfere najčešći oblik karcinoma u muškaraca i drugi vodeći uzrok smrti od karcinoma. U otkrivanju i praćenju karcinoma prostate važno mjesto ima određivanje koncentracije tumorskoga markera prostata specifičnoga antigena (PSA) u serumu. Glavni je nedostatak PSA niža specifičnost jer njegova koncentracija u serumu raste i kod benigne hiperplazije prostate i prostatitisa. Kako bi se smanjio broj nepotrebnih biopsija, nastoji se poboljšati specifičnost PSA uvođenjem različitih varijanti njegovoga određivanja u serumu i kombinacijom određivanja s drugim specifičnim humanim kalikreinima prostate. U dijagnostici karcinoma prostate istražuju se novi molekularni markeri, čimbenici rasta i inhibicije rasta karcinoma prostate. Dok se ne dokažu, većina njih u svakodnevnoj praksi ostaje nedostupna. I nadalje se koristi etablirani PSA s kontroverzama oko određivanja granice njegove pouzdanosti.

U realizaciji utemljenja visokoškolske medicinske izobrazbe na području Hrvatske presudnu ulogu odigralo je jačanje liječničkog staleža. Osnutak Sbora liečnika kr. Hrvatske i Slavonije u Zagrebu i Družtva slavonskih liečnika u Osijeku početkom 1874. godine početak je sustavne i intenzivne kampanje za Medicinski fakultet, istovremeno nedjeljiv od borbe za održanje samobitnosti hrvatskoga naroda. Ovaj proces je usko povezan s razvojem zdravstva te njegovom institucionalizacijom, procesima koji se intenziviraju tijekom 19. i početkom 20. stoljeća. U ovom radu smo na, temelju postojećih dokumenata, novinskih članaka i objavljene literature, rekonstruirali ključne faze društveno političkog i zdravstvenog razvoja te njihov upliv na realizaciju nastojanja osnutka Medicinskog fakulteta Sveučilišta J.J. Strossmayer u Osijeku. U okviru tog cilja analizirane su pojedine odrednice institucionalizacije i profesionalizacije zdravstva presudne u razvoju visokoškolskog medicinskog obrazovanja slavonske regije.

Introduction & Objectives: Several clinical studies revealed increased bone turnover and lower bone mass in patients with urolithiasis. Bone mass loss is particularly evident in idiopathic calcium stone formers. However, pathogenetic mechanisms and factors implicated in bone loss in these patients are still unknown. Osteopontin (OPN) is a phosphorylated protein of wide tissue distribution, that is found in association with organic matrix of kidney stones. It is a strong inhibitor of crystal formation and growth in vitro, but there is still debate regarding its effects upon crystal adhesion to tubular epithelial cells. OPN influences bone turnover, both by promoting differentiation of osteoclasts and by enhancing osteoclasts activity. Recent studies discovered important role of osteoprotegerin (OPG) and RANKL (receptor activator of NF-kappaB ligand) in bone turnover process, in addition to known effect of some cytokines (such as IL-1, IL-6, TNF) on bone resorption. The objective of this study is to assess changes of cytokines involved in bone turnover and increased bone resorption, as that might play role in bone loss in recurrent calcium stone formers. Material & Methods: Recurrent calcium stone formers were involved in the study and anthropometrical measurements were performed. Ca2+, Mg2+, P, creatinine, Na+, K+, Cl-, proteins, uric acid, alkaline phosphatase, osteocalcin, calcitonin, PTH, 25-OH D vitamin and 1, 25-OH D vitamin were assesed by standard biochemical analysis. IL-1, IL-6, TNF-α , OPG, RANKL and osteopontin serum levels were determined by quantitive enzyme-linked immunosorbent assay (ELISA) according to manufacture’ s protocol (Quantikine, R&D Systems, Inc., Minneapolis, USA). Bone mineral density (BMD ; g/cm2) was measured using dual-energy x-ray absorptiometry (« Lunar Prodigy» ). BMD measurements were performed at the lumbar spine, femoral neck, forearm and total body. Results are presented as bone mineral content (BMC ; g) and bone area (BA ; cm2) Results: Osteopenia was discovered in 27, 8% of recurrent calcium stone formers and 5, 7% had osteoporosis assessed by BMD described above. Kalcitonin and osteokalcin levels were normal in all participants. Vitamin D25 levels were increased in 16, 7% patients with a peak of 213 pmol/ml. PTH ranged from 31, 4 to 131 pg/ml and was increased in 26, 3% of patients. Pyrilinks D was increased in 30, 77% of male participants, whereas in females was increased in 57, 10%. However, crosslaps was increased in 46, 2% of male participants with no significant change in pre- and postmenopausal women. Conclusions: Increased production of cytokines enhances bone resorption and therefore lowers bone mass in patients with idiopathic calcium urolithiasis. Here we have determined factors that could have influenced the changes in bone density in recurrent calcium stone formers, but pathogenetic mechanisms still remain to be evaluated.

Urolitijaza, unatoč dugogodišnjim opsežnim fizikalno-kemijskim i metaboličkim istraživanjima, kao i različitim pristupima, ostaje i dalje do kraja nerazjašnjen proces u organizmu čovjeka. Razlog je kompleksna priroda tog višesloženog procesa, a istraživanja koja se provode trebala bi pridonijeti rasvijetljavanju tog problema s naglaskom na efikasnijoj preventivi stvaranja kamenaca koji najčešće nastaje u uvjetima abnormalnog izlučivanja metaboličkih čimbenika rizika pojave urolitijaze. U ovom radu u okviru metaboličke obrade mokraće određen je pH urina, kristalurija, te niz biokemijskih parametara u prvom jutarnjem urinu. Tako su određene koncentracije kalcija, magnezija, natrija, kalija, klorida, fosfata, urata, oksalata, citrata, kreatinina te glikozaminoglikana. Iz rezultata dobivenih za biokemijske parametre u urinu računati su stupanj prezasićenja urina kod kojeg se stvara kamenac, odnos između promovirajućih i inhibirajućih čimbenika stvaranja kamenaca kao i indeksi rizika za nastanak urolitijaze.

Ispitivana je uloga glikozaminoglikana na proces nastajanja bubrežnih kamenaca u kalcijskoj urolitijazi zbog kontradiktornih literaturnih podataka o njihovoj ulozi u ovom procesu (promotori ili inhibitori). Postavljeni su i čimbenici rizika za razvoj urolitijaze koji bi mogli diskriminirati stvaratelje kamenaca od zdravih osoba. Ispitivanu skupinu činile su osobe oba spola s kalcijskim kamencima. U prvom jutarnjem urinu određivana je koncentracija ukupnih glikozaminglikana koja je izražena na gram izlučenog kreatinima u urinu. Dobiveni rezultati pokazali su statistički značajno niže vrijednosti ukupnih glikozaminglikana u odnosu na kontrolnu skupinu, što ukazuje na njihovu moguću inhibitornu ulogu. Bolja diskriminacija među skupinama postignuta je ako je koncentracija glikozaminoglikana prikazana u obliku (Baggio) indeksa.

Učinili smo analizu operiranih bolesnika na našoj Klinici u 10 godišnjem periodu zbog karcinoma bubrega i prostate. Zbog karcinoma prostate je liječeno ukupno 421 bolesnik, a radikalno je operirano njih 45. Zbog karcinoma bubrega je operirano 285 bolesnika, radikalnim zahvatom njih 71. Zajedničko za obje dijagnoze je veći udio bolesnika sa uznapredovalom bolešću što je i osnovni razlog nešto manjeg broja radikalnih zahvata. Druga epidemiološka obilježlja naših bolesnika, izuzev nešto manjeg omjera muškaraca sa karcinomom bubrega su u skladu sa literaturom.

Hrvatska se kao i druge države svijeta suočava sa visokim porastom incidencije karcinoma, a od njih se karcinom mokraćnog mjehura ističe porastom više od 2 puta u zadnjih 10 godina. U ovoj retrospektivnoj studiji analizirali smo sve bolesnike operirane na našoj klinici od 1994 do 2003 zbog tumora mokraćnog mjehura, kanalnog sustava bubrega i uretera. Ukupno je zbog tumora kanalnog sustava i uretera operirano 84 bolesnika, prosječno stara 70, 2 godine, od kojih je nešto više žena. Zbog tumora mokraćnog mjehura je operirano 1079 bolesnika, od toga kod 41 bolesnika je rađena cistektomija. Prosječna starost je bila 66, 3 godine, muškarci su 3, 4 puta češće oboljeli. Ukupno smo imali dvije perforacije mokraćnog mjehura i dva smrtna slučaja nakon cistektomije. Općenito su sve osobine naših bolesnika u skladu sa očekivanim podacima.

Metabolic parameters were determined in fasting blood serum, fasting first morning urines, 2-hour urines, and 24-hour urines of male patients with calcium oxalate stones (n=26, age 39.1 +/- 6.2 years) and male healthy controls (n=18, age 35.0 +/- 7.1 years), which were recruited from eastern part of Croatia. The urinary calcium excretion in 24 hours was higher (p

Iako se osteoporoza u muškaraca javlja rjeđe u odnosu na žene, sekundarni oblici te bolesti imaju veću učestalost u muškaraca. Cilj - utvrditi da li su i u kojoj mjeri hiperkalciurija i snižen unos kalcija hranom značajni čimbenici gubitka koštane mase u bolesnika s urolitijazom. Ispitanici: 34 bolesnika s recidivirajućom urolitijazom, u dobi od 41, 2+-7, 9 godina i kontrolna skupina od 30 zdravih muškaraca, srednje dobi 39, 2+-6, 3 godina. Metode - svim ispitanicima izmjerena je visina i težina i izračunat indeks tjelesne mase (BMI). Mineralna gustoća kosti (BMD ; g/cm2) je određena na početku istraživanja te nakon godinu dana, metodom dvoenergetske apsorpciometrije X zraka. Na temelju dvodnevne evidencije prehrane, izračunat je prosječni dnevni unos kalcija hranom. Iz 24h urina analiziran je kalcij, magnezij, fosfor, kreatinin, natrij, kalij, klor, proteini i mokraćna kiselina. Rezultati - koštana masa (BMD) u bolesnika s urolitijazom bila je značajno niža u području kralježnice u odnosu na kontrolnu skupinu (p

Introduction: Both bladder cancer or cancer of kidney collecting system and urether have always been a specific issue at our department. An incidence of bladder cancer is on high rise in last few years in Croatia showing a 2-3 fold rise in number of new cases. Relatively known toxic agents that can cause bladder cancer, together with better understanding of gene aberrations have given us a needed perspective of this problem. Symptoms are relatively specific, and what is more important are very obvious. A wide spectrum of treatment options can assure us that every patient will get best and specific care for its disease, modeled by every patient life style and of course a disease itself. An endemic nephropathy is a disease specific for our region and it’ s shown that a greater risk for urothelial carcinoma is common with this condition. All above is a warning for better control and understanding of our patients treated for bladder or collecting system urothelial cancer. Materials and methods: Operating protocols, patient’ s charts, ambulance charts and other associated material of each operated patient at our clinic has been used. We included in our analysis selected tumors: 1.Urothelial cancers of the kidney in last 10 years. 2. Cancer of the bladder in last 10 years for those treated with TUR and in last 20 years for those treated with cystectomy. Results: A total of 84 patients have been operated for urothelial tumor of kidney collecting system and urether with average age of 70, 2 years for all patients, average age is same for male and female patients, and slight predominance of female patients (52 F: 31 M). In all patients a transitiocellulare carcinoma was found. Transurethral resection, electro coagulation or cystectomy due to bladder cancer was reason for operation in 1079 cases. In 41 patients a cystectomy was performed with high predominance of male population (34 vs. 7 female) with average age 58, 6 years. Formation of ileum conduit was done in 34 patients ; one neo bladder was made, while other types of urine derivation were done (Coffey, ureterocutaneostomy) in 6 patients. A transitocellulare carcinoma was found in 81, 5 % and in 18, 5% a planocellulare carcinoma. Total of 1038 operations was made by means of transurethral resection or electro-coagulation (EC). Of those TUR was made in 802 cases and EC in 236 cases, EC is in more then 85% done when a small recidive tumor is found. We had high predominance of male population in sample: 619 male patients and 183 female. Average age of those treated by TUR or EC was same: 66, 3 years. Grading and TNM staging for patients treated with different types of operations is shown on table 1. and table 2. In 10, 5% of patients treated with cystectomy a positive regional lymph nodes were found. We had two postoperative deaths in patients with cystectomy performed. Recurrence rate is over 60%. Discussion: Incidence of bladder cancer is not high, but it is on constant rise. We have a small but constant number of 2-3 cystectomies per year. More than one fact is account for that: long preclinical period of disease, following co morbidity, patients’ refusal to a radical procedure… In those in whom we perform a radical operation, often a local invasion is found thus making ileum conduit ideal choice for urine derivation. All data for bladder cancer are as expected, but recurrence rate of 60% is somewhat higher then cited (1, 2, 3). Explanation for a high recurrence rate can be found in different postoperative therapy protocols within hospitals, since a significant number of outside patients are treated within our clinic, but discharged for later care in primary hospital. A large number of urothelial carcinomas of kidney collecting system and urether could be explained by presence of endemic uropathy in our region (1, 2).

Introduction As the population is getting older we are facing an increasing number of oncological patients. At the same time population is more and more fit to face advancing age with reduced co morbidity and better control of associated diseases found in older population. All this factors are responsible for facing urologist of today with increased number of oncological patients and radical procedures with its risks. Among those oncological illness a prostate cancer is enigma being in focus for decades and every time that we think that we now everything a new approach rises. Renal parenchyma tumors are in some ways a constant in everyday urological practice, but as such are reason for complete understanding of this malignant disease. Materials and methods Patients history, operating protocols, ambulance charts and other associated material of each operated patient at our clinic has been used. Basic revision of some record has been done such a TNM classification for some type of tumor due to new recommendations. We included in our analysis selected tumors: carcinoma of the prostate and parenchymal tumors of the kidney in last 10 years. Results 421 patient received treatment for prostate cancer with average age of 69 years. Of those orchydectomy was performed in 376 patients who are slightly older (69 years) then those in whom we did radical prostatectomy (45 patients with average age of 63, 5 years, 11% of all patients). T stage for selected patients in whom we did radical prostatectomy are T2 in 62%, T3 in 35% and T4 in 3%. Regional lymph node metastases were found in 7% of all patients. Gleason score for patients underwent orchydectomy and radical procedure is shown in table 1. Parenchyma renal tumor was found in 285 patients and of those clear cell carcinoma in 266 cases, followed by oncocitoma and some rare cases of lymphoma, sarcoma and even with rare case of mixed epithelial-stromal tumor of the kidney. There were 164 male patients and 121 female patients. We had 144 left sided tumors contra 141 rights sided. Radical nephrectomy was performed in 71 patients with average age of 56 years and simplex nephrectomy in 210 patients with average age of 62, 4 years. In only small number of cases a partial nephrectomy was performed. Average size of tumor was same for patients underwent simplex nephrectomy or radical nephrectomy: 7, 1 cm. TNM classification for all cases is shown in table 2. Only limited number of major complications is seen: no mortal outcome is seen in prostate cancer patients, and 2 deaths postoperatively for patients with radical nephrectomy. Discussion When we look patients with prostate cancer a high rate of orchidectomy is seen. Reason for that can be found in fact that most of our patients are presented with metastasis disease (verified on bone scan) or with locally advanced prostate cancer with high PSA levels (1, 3). Some attempts have been made to start prostate cancer screening in our country. This efforts are having as result a increased number of radical procedures , for example in year 2000 we had 5 radical operations, in 2004 13, and so far in 2005 we have 15 operations. Also it can be seen from table 1. that indication for radical procedure are well set. Other variables are not different with those reported in literature (1, 3, 4). Same can be told for renal cancers in whom a late diagnosis or high co-morbidity is by our opinion a main reason for limited number of radical nephrectomy (1, 2). Most of our patients are presented with locally advanced disease or with distant metastasis. Co- morbidity is second reason for limited number of radical operations, since a vast number of our patients are found unfit for radical procedures by our anesthesist.

U radu je prikazana IR spektroskopija u analizi sastava kamenaca kao i rezultati analize kemijskog sastava bubrežnih kamenaca napravljenih spomenutom tehnikom u razdoblju od 1989-2001 godine. Rezultati su uspoređeni s objavljenim podacima sastava bubrežnih kamenaca iz zemalja zapadnog svijeta. Analizirano je 2005 bubrežnih kamenaca od 1586 osoba. Najveći dio uzoraka dobiven je nakon litotripsije kamenaca metodom ESWL-a. Analiza sastava kamenaca učinjena je metodom infracrvene spektroskopije. Analiza sastava 2005 bubrežnih kamenaca na Odjelu za medicinsku biokemiju Kliničke bolnice Osijek potvrđuju visoki udio kalcij-oksalatnih kamenaca (73, 3%). Ne postoji značajnija razlika u sastavu bubrežnih kamenaca u odnosu na podatke iz literature, ali je u odnosu na iste podatke omjer muških i ženskih bolesnika s urolitijazom u našoj skupini bio niži (1, 36). Metoda IR spektroskopije dobar je izbor za svakodnu analizu bubrežnih kamenaca jer za kratko vrijeme daje vrijedne podatke nužne za razrješenje etiopatogeneze urolitijaze. Nema značajnijih razlika u sastavu kamenaca u odnosu na podatke iz literature ali je omjer između muških i ženskih bolesnika koji stvaraju kamence niži vjerojatno zato što je analizirano razdoblje (1989-2001 godine) zahvaćalo i vrijeme rata u Hrvatskoj.

Biomedical application of nanotechnology, such as early, in vivo disease detection and malignant cell destruction, were documentated using a small sized supermagnetic particles coated with specific antibodies. Antibody coated nanoparticles can be used as a contrast markers in magnetic resonance imaging of targeted cells and at the same time in temeprature induced specific destruction of these cells in situ, using external aletrnative magnetic field. Our experimetal results corroborate this hypothesis. Combined diagnosis with treatment, many considerable applications of nanotechnology in biomedicine could be performe, depending on availability of appropiate antibodies. This paper describes strategy for future developments and multidisciplinary approach involved in the preparation and handling of nanoparticles and experimental design.

Biomedical applications of nanotechology, such as early, in vivo disease detection and malignant cell destruction, were documented, using a small-sized superparamagnetic particles coated with specific antibodies. Antibody coated nanoparticles can be used as contrast markers in magnetic resonance imaging of targeted cells and at the same time in temperature induced specific destruction of these cells in situ, using external alternative magnetic field . Our experimental results corroborate this hypothesis. Combined diagnoses with treatments, many considerable applications of nanotechnology in biomedicine could be performed, depending on availability of appropriate antibodies. This paper describes strategy for future developments and multidisciplinary approach involved in the preparation and handling of nanoparticles and experimental design.

Najzanimljiviji oblik hidronefroze jest idiopatska hidronefroza, budući se kod nje ne može makroskopski dokazati mehanička zapreka otjecanja urina. Mehanizam nastanka ovog oblika hidronefroze je tek djelomice poznat. U ovom retrospektivnom radu prikazana su naša iskustva vezana za liječenje bolesnika s hidronefrozom, patohistološke promjene u PU segmentu kod bolesnika s idiopatskom hidronefrozom. Patohistološka je analiza učinjena pomoću svjetlosnog, a kod dijela bolesnika i pomoću elektronskog mikroskopa. Materijal je odabran iz slučajeva hidronefroza liječenih u našoj ustanovi od 1969. godine. Od ukupno liječenih 520 bolesnika, slučajevi su idiopatske hidronefroze nađeni u 120 bolesnika. Bolesnici su najčešće operirani metodom resekcije PU segmenta po Hynes-Andersonu. U histološkom materijalu dobivenom nakon operacijskog zahvata utvrđene su promjene zadebljanja submukoznog sloja, zatim smanjenje debljine mišićnog sloja uz atrofične i degenerativne promjene mišićnih stanica s njihovom karakterističnom longitudinalizacijom i gubitkom staničnih kontakta. Rezultati prikazani u ovom radu ukazuju kako u slučajevima idiopatske hidronefroze glavnu ulogu ima kompleks promjena koje se mogu zajedničkim imenom nazvati fibro-muskularni kompleks, a koje su karakterizirane nakupljanjem vezivnog tkiva. Prikazana se istraživanja mogu povezati molekularnim spoznajama na životinjskim modelima hidronefroze, a isto tako i kod ljudi i ukazuju na ulogu čimbenika rasta vezivnog tkiva u nastanku ovog oblika hidronefroze (TGF- ).

Aims: To analyze performed nephrectomy in our clinic due to renal cancer diagnosed in our patients, retrospectively and to begin forming Cancer Registry to support future studies and patients follow up. Materials & methods: Data was obtained from patient's history, laboratory findings, imaging procedures, pathologist remarks and ambulance charts to asses survival rates. All patients underwent surgery in our clinic and all procedures were performed by different departments of our hospital. Results: Total of 269 patients were operated for parenchymal renal cancer in given period of time. Of those 114 patients were females and 155 male, with female to male ratio of 1:1, 36. Average age at the time of operation was 61 years, male population slightly older (61, 5 years) than females (60, 5 years).Also we measured size of tumor but classified by type of procedure (simplex or radical nephrectomy), measuring 6, 9 cm (in largest dimension) for radical nephrectomy and 7, 7 cm for simplex nephrectomy. Predominant stage in our patients wasT1, with T3 as second and of those 17% patients presented with distant metastases (M1) at the time of operation. In 91% of our patients clear cell renal cancer was pathological finding with only sporadic finding of other type of tumors such as oncocytoma, sarcoma and some benign forms. In 269 operated patients, clinically significant complications showed in only 10 patients, prolonging hospital treatment or needing intensive treatment, of those with lethal outcomes. Survival rates are also presented classified by type of procedure (simplex/radical). Conclusion: This retrospective study stands as baseline in our attempt to create a Cancer Registry by our department, helping us to choose best and needed treatment for each patient. Also, as said before this is a first review with more to come in future.

Bimedical applications of nanotechnology, such as early in vivo metastatic disease detection and specific cell destruction, were documneted, using small sized supermagnetic coated particles with specific antibodies. Antibody coated nanoparticles can be used as contrast markers in magnetic resonance imaging (MRI) of targeted cells and at the same time in temeprature induced specific, in situ destruction of these cells, using external alternative magnetic field application. Oure experimental results corroborate this hypothesis. Combined diagnosis with treatments many considerable applications of nanotechnology in biomedicine could be performed depending on availability of appropiate antibodies.

This report describes the clinical value of transrectal prostate biopsy during which 12 biopsy cores are taken in comparison to the classical sextant method. There were 106 patients included in the study, who had transrectal prostate biopsy (TRB) due to abnormal finding after digitorectal examination (DRE) and/or values of PSA > 4 ng/ml in the period from 4 October 2001 till 14 August 2002. There were 117 biopsies with 12 biopsy cores taken, 6 cores from each lobe. Prostate cancer was confirmed in 49 patients (46%). Out of total number of confirmed cancer cases, initial biopsy detected 94%. There were three patients who had suspicious DRE finding, with PSA value of < 4 ng/ml, but cancer was not detected in any of them. In the patient group with PSA value between 4-10 ng/ml, cancer was detected in 26% of them and in the group with PSA value > 10 ng/ml cancer was detected in 58%. The most common Gleason score in the case of cancer was 7 (43%). During the biopsy procedure, 3 patients experienced strong vasovagal reactions, meaning that out of 117 biopsies incidence of complications was 2.6%. Few days after the biopsy, two patients developed urogenital tract infections (1.7%) and right after the procedure, there was one case of strong hematuria (0.8%) and strong rectal bleeding (0, 8%) that needed hospitalization. Our results regarding the incidence of complications do not differ much from the results in the literature. According to data in the literature regarding sextant biopsy, 15-34% of cancer cases remain undiagnosed at initial biopsy. The method of 12 biopsy cores fails to diagnose only 6% of all cancers, but it is important to note that in the mentioned period, re-biopsy was indicated only in 11 from 60 patients with negative biopsies.

Istraživanja kemičara, liječnika i urologa iz tri suradne ustanove (Institut "Ruđer Bošković", Zagreb, Institut za medicinska istraživanja, Zagreb i Klinička bolnica Osijek) na projektima urolitijaze rezultirala su novim spoznajama o različitim faktorima važnim u kalkulogenezi, te napretkom u dijagnostici i liječenju urolitijaze. U ovom radu dan je pregled bazičnih, primijenjenih i kliničkih ispitivanja provedenih u trima suradnim ustanovama, koja su objavljena u znanstvenim časopisima i/ili prezentirana na znanstvenim skupovima. Detaljnije su opisani uvjeti u kojima kristaliziraju soli značajne u urolitijazi s naglaskom na različite faktore koji utječu na sastav i morfologiju kristala.

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.

Recidivirajuća urolitijaza je često povezana s poremećajima u metabolizmu kalcija. Cilj je ovog istraživanja bio utvrditi promjenu mineralne gustoće kosti u razdoblju od godinu dana u bolesnika s urolitijazom i odrediti čimbenike koji utječu na tu promjenu. Sudjelovala su 34 muškarca s urolitijazom, u dobi 41.2 + 7.9 godina i 30 zdravih muškaraca iste dobi. Mineralna gustoća kosti (BMD ; g/cm2), mineralni sadržaj kosti (BMC ; g) i površina kosti (BA ; cm2) izmjereni su u dva navrata u razdoblju od godinu dana, na lumbalnoj kralježnici i vratu femura. BMC i BA bili su niži u bolesnika nego u kontrolnoj skupini, ali ne značajno. Najveći pad BMD-a u godini dana je nađen u području Wardovog trokuta (-5.7% u bolesnika i -2.36% u kontrola), zatim na vratu femura (-4.06% u bolesnika i -2.03% u kontrola) i trohanteru (-3.06% u bolesnika i 1.39% u kontrola). Nije nađen značajan pad BMD-a na kralježnici. Analizirajući utjecaj dobi, indeksa tjelesne mase (BMI), metaboličkih pokazatelja i unosa kalcija hranom na pad mineralne koštane gustoće unutar godinu dana, utvrđeno je da su dob i unos kalcija hranom značajno povezani s gubitkom koštane mase u tom razdoblju.

Analiza 14-godišnjeg iskustva u primjeni izvantjelesno-valne litotripsije u liječenju kamenaca mokraćnog sustava uz komparaciju s drugim metodama (perkutana nefrolitotomija, transuretralna litolapaksija, otvoreni operacijski zahvati).

Raspravljamo li o kronološkoj pojavnosti medicinskih časopisa kao službenih glasila liječničkih društava u ovom dijelu svijeta i Europe, tada je Glasnik družtva slavonskih liečnika (Glasnik DSL), prvi i najstariji medicinski časopis te vrste u Hrvatskoj, kojeg prvi broj nosi nadnevak 1.siječnja 1877.a posljednji 1.prosinca 1878. Riječ je o glasilu Družtva slavonskih liečnika u Osieku (DSL u Osieku), strukovnog liječničkog društva osnovanog g. 1874. koje danas bilježi svoje djelovanje kao Hrvatski liječnički zbor - Podružnica Osijek (HLZ). Cilj nam je bio istražiti ključne odrednice njegove pojavnosti u kontekstu uloge i doprinosa slavonskih liječnika u promicanju i razvoju hrvatske medicinske književnosti, posebice medicinske periodike u 19.stoljeću. Zaključci do kojih smo došli temeljeni su na spoznajama stjecanim tijekom prethodnih studija o povijesti liječničkih društava i razvoju stručne medicinske periodike u Hrvatskoj i Slavoniji u 19.stoljeću, te na povijesnoj građi i sačuvanoj dokumentaciji DSL u Osieku, HLZ u Zagrebu i Glasnika DSL od početka 1874. do konca 1878. godine. Rezultati: Osvijetljene su temeljne odrednice postanka i relativno kratkotrajnog opstanka mjesečnika Glasnik DSL, s naglaskom na: 1. zbivanja koja su prethodila njegovu izlaženju, uključujući inicijative liječnika iz Slavonije za razvijanje hrvatske medicinske terminologije, stručne medicinske publicistike, posebice medicinskih časopisa od sredine 19.st do konca 1876.godine ; 2. okolnosti koje su pratile izdavanje časopisa Glasnik DSL u razdoblju od 1. siječnja 1877. do konca 1878.godine ; 3. zbivanja koja su pridonijela donošenju odluke o prekidu njegova izlaženja. Rezultati su predočeni u nekoliko zasebnih poglavlja koja pružaju nove znanstvene spoznaje kako o povijesti medicinskog časopisa Glasnik DSL tako o ulozi slavonskih liječnika i DSL u Osieku u promicanju hrvatske medicinske terminologije i razvoju stručne medicinske književnosti od sredine 19. st. do konca 1878.godine. Zaključci: Danas u Glasniku DSL prepoznajemo prvijenac naše medicinske periodike kao najstarije znanstveno, stručno i strukovno glasilo liječničkog društva ; jedinstveni izvor i građu za proučavanje povijesti hrvatskih medicinskih časopisa ; povijesti liječničkih društava ; zdravstvenih prilika, uvjeta rada i stremljenja liječnika ; te stručnih i znanstvenih dometa u Hrvatskoj 19.st. Svaki broj sam po sebi predstavlja vrednotu i bibliografsku rijetkost, svi brojevi zajedno čine jedinstveni spomenik hrvatske medicinske baštine, čija je dostupnost za nove naraštaje olakšana objavljivanja reprint izdanja g. 1999.

The aim of this study was to confirm the role of screening by determining the percent age of clinically localized cancer (stage A and B) in patients with prostatae cancer detected on screening and in those presenting to urologic clinic for the symptoms of urination impairment or ostalgia. During the study, 1, 000 men aged>50 from the community of Čepin and village of Josipovac near Osijek were examined. The subjects with elevated concentration of total prostate specific antigen and/or digital rectal examination suspect of carcinoma underwent transperineal biopsy of the prostate. Clinical staging was performed in patients with prostate cancer detected on screening, and data on clinical staging for prostate cancer patients treated during the 1996-1997 period were retrieved from patient files of the Department of Urology, University Hospital Osijek. On screening, 28(80%) patients with localized prostate cancer and seven (20%) patients with metastases were detected. In the group of patients examined on an outpatinet basis for the signs and symptoms of prostatism, there were 30 (83.4%) patients with metastases and only six (16.6%) patients with localized prostate cancer. Study results indicated that an early diagnosis of prostate cancer could be made by use of noninvasive and inexpensive methods that cause no major discomfort to the patient. Accordingly, these results appear to strongly support such screening in men, if not in all those aged over 50, then at least in the otherwise healthy, 50-70 age group.

The purpose of this investigation was to assess the bone mineral content (BMC) and bone mineral density (BMD) over a period of one year in patients with urolithiasis and to determine the factors that could have influenced the changes in bone density during that period. The patient group comprised 34 men, aged 41.2&plusmn ; ; 7.9 years with recurrent urolithiasis. A wide spectrum of biochemical measurements was performed. Bone mineral density (g/cm^2), bone mineral content (BMC) and bone area (BA) were measured twice over a period of one year, at the lumbar spine (L2-L4), femoral neck, Ward's triangle and trochanter, using dual energy absorptiometry. Patients' results were compared to those obtained from 30 healthy male controls of a comparable age group. Nine patients were hypercalciuric, while most of other metabolic parameters were within the reference values. Bone mineral content and bone areas at all regions were lower in patients comparing to controls, but not significantly. The biggest annual reduction of BMD was noticed at the Ward's triangle (-5.70% in patients and -2.36% in controls), following with femoral neck (-4.06% patients, -2.03% controls) and trochanter (-3.06% patients, -1.39% controls). There was no significant decrease of the BMD of the spine. Analysing the influence of age, body mass index, metabolic parameters and dietary calcium intake on the annual reduction of bone density, we found that age, hyperuricosuria and calcium intake were significantly associated with the bone loss in that time period. Bone mass reduction in patients with urolithiasis over a one year period did not differ significantly from that in controls and was mostly related to age, hyperuricosuria and calcium dietary restriction, but not to increased calcium excretion.

A total of 142 war injuries to the urogenital organs in 115 of 4425 wounded patients were treated at our clinical hospital during 18 months of warfare in Osijek, Croatia. Kidney injury was the most common (64 cases) and urethral injury (4) the least common, with a relatively large number of urethral injuries (11). Twothirds of the injuries were associated with other trauma, most frequently abdominal injuries. The mortality rate was high (15,6%), explained by the proximity of the battlefield and resulting rapid patient transport (average 52,2 minutes), which excluded the possibility of separating out the moribund cases, as well as the exceptional destructive power of modern explosives and firearms, and associated wounds of the vital organs. Of the wounded, 60 % were members of the Croatian armed forces, 1 was a member of the United Nations Professional Force and 39,1% were civilians. Surgical intervention was characterized a tendency towards conservation and the avoidance of organ sacrifice. Thus, nephrectomy was performed in only one quarter of the cases of renal injury. Nevertheless, orchiectomy was performed in two-thirds of the cases of testicular injury. In 5 of 8 cases of corpus spongiosum, injury to the tunica albuginea was primarily reconstructed with free transplantation of the fascia lata. For urethral injury,resection with primary suture yielded good results in contrast to stents without resection in cases of urethral wall contusion, which resulted in urethral stenosis in our patients.

Introduction and objectives: Peacetime ureleral injuries caused by the effects of external force are exceptionally rare as a result of the anatomy and anatomic relation of the ureter. In our study we present our experience with this type of war injury. Material and methodes: During the 18 months of war in Croatia, from 1991 until 1992, 4, 425 wounded patients werw treated at University Hospital Osijek. Urogenital injuries werw present in 155 treated patients (2, 6%) and among them ureteral injuries were present in 11 patients ( 9, 5%). Results: The ureteral injuries were discovered by chance during exploratoy abdominal surgery performet for other accompanying injuries. Ureteroureteral anastomosis was done in the three casees. In three cases ureterocystoneostomywas performed. Exploration was performed in three cases and nephroctomy was performed in two cases. It is important to emphasise that in three cases with conturions of the ureter wall that where not surgically reconstructed, the final result was ureteral stenosis. Moreover, in one sace the final result was complete obliteration of the ureteral lumen. Conclusions: In contemporary wartime with explosive weapons the injuries of ureter are more frequent. In our material ureteral injuries constituted 9, 5% of the total urogenital injuries. Resection of the ureter with primary ureteroureteral reconstruction yields good results, moreover this procedure is recommended in the case of ureteral consusion. Conservative approach in such cases resulted in ureteral stenosis.

Die Behandlung der Urolithiasis bei Kinder unterliegt den gleichen Prinziprn wie bei alteren Patientengruppen. Die ESWL stellt die Therapie der Wahl in der konservativen Behandlung von Harnsteinen bei Kindern dar. In diser Untersuchung berichten wir uber unsere Erfahrung mit der ESWL bei Kindern uber einen Zeitraum von 10 Jahren zwischen 1986 und 1996. Wahrend dieser Zeit wurden in unserer Klinik 5000 Patienten mit ESWL behandelt. Darunter waren 38 Kinder (0,76%). Unter den so behandelten Kindern waren 23 mannlich (61%) und 15 weiblich (39%). 27 Kinder oder 72% waren zwischen 10 und 15 Jahren alt. Mehrere Konkremente wurden bei 5 Kindern gefunden und in 4 Fallen lagen Ausgušsteine vor. Die Verteilung der Konkremente war folgendermasen: Kelchsteine n=17 (44,7%), pyeloureteraler Ubergang n=2 (5,3%), Nierenbecken n=11 (28,9%) und Ureter n=9 (23,7%). Kalziumsteine wurden bei 84,3% der Falle gefunden, 10,5% der Patienten litten an Zystinsteinen und bei 5,2% lagen Harnsaurekonkremente vor. Insgesamt fuhrten wir bei den Kindern 48 ESWL durch. Allgemeinanasthesie wurde bei 12 Kindern oder 31,6% benotigt, bei 6 Kindern waren Sedativa und Analgesie notwendig, 20 Kinder oder 52,6% benotigten lediglich Analgesie. Bei 9 Kindern (23,7%) wurden zusatzlich Eingriffe benotigt. Bei 6 Kindern war vor ESWL die Anlage eines Doppel-J-Stents notwendig, in einem Fall wurde das Konkrement aus dem Harnleiter ins Nierenbecken luxiert, bei 2 Kindern wurden eine retrograde Ureterographie durchgefuhrt. Komplikationen nach ESWL-Behandlung im Sinne einer Steinstrase fanden sich bei 5 Patienten (13,1%). 3 Patienten wurden konservativ behandelt, bei einem Kind wurden eine Doppel-J-Anlage notwendig, in einem Fall wurde eine chirurgische Intervention notwendig. Nach 6-monatiger Beobachtungszeit waren 89% Patienten, die mit ESWL behandelt wurden, konkrementfrei. Unsere Erfahrung zeigen, das die ESWL die Therapie der Wahl bei Urolithiasis von Kindern ist.

Introduction: ESWL treatment of urinary stones in children is based on same principles as in adults. The ESWL je treatment of choice when conservative approach failed. MATRERIALS& METHODS: Since 1986 until 1998 at our department 6000 patients were treated with the ESWL. Among them 48 patients (0, 8%) were children, most of them or 33 were between 10 and 15 years old. RESULTS:In our children group we treated 26 calceal, 16 pyelon, 5 pyeloertheral segment and 11 uretheral stones. In 48 patients we perfomed 68 ESWL sesions. Treatmens were performed in general anaesthesia in 15 cases (31, 25%), in 24 only analgesia and in 9 sedation and analgesia.Supporting procedures were used in 11 patients (22, 9%) in 7 (14, 5%) cases "JJ" stent, "push and bang" in 2 (4, 2%) and retrograde catheter plus contrast in 2 (4, 2%) cases. Complication like "steinstrasse" were found in 7 patients (14, 58%). In 4 patients this complication were treated by conservative approach and in 3 patients by placing "JJ" stent.Febrile reaction was present in 5 patients. CONCLUSION: The average unmber of ESWL sessions for stone treatment were 1, 42. After 6 months of follow-up 89, 7% of patients were stone free. In our group of patients ESWL was successful method of urinary stone removal with very low incidence of complications.

Elevated erythrocyte sedimentation rate (ESR)is a common finfing in patients with chronic renal failure (CRF), both in those treated conservatively and in those od dialysis therapy. Teherefore, the value of ESR determination is questionable. Elevated ESR is generally considered to be the sequel of the chronic renal failure itself rather of the mode of the treatment used. ESR and a number of laboratory parameters were determined in a group of 42 hemodialyzed patients on there occasions in two-month intervales. Patients with malignant disseases, history of acute infection of whatever localization in the month preceding the study, elevated body temperature, postoperative state and increased transaminases were excluded. ESR is significantly elevated in most but not in all patients on hemodialysis. In absence of some additional reasons, ESR undergoes no substantial changes with time. ESR values are predominantly influenced by plasma factors. ESR determination in the stable phase is of low diagnostic value.

Honey as food and honey as medicina are for a long time in peoples use. The nutritious and healing substances are different, also of the honey-herbs which the bees vizit. The anasised kind of honey (Acacia, Flower hony, linden -hony) show a real richnes healing and nutritious structure. The organoleptic and chemical features of the analised honey-types fit into the standards of Republic Croatia and the Europian Unit. The said exhibitors justificate the hitherto way of bee-keeping and technology of honey production.