Borislav Spajić - Academia.edu (original) (raw)
Papers by Borislav Spajić
Urology, 2007
The incidence of hyperechoic prostate cancer in transrectal ultrasound-guided biopsy specimens. U... more The incidence of hyperechoic prostate cancer in transrectal ultrasound-guided biopsy specimens. Urology, 70 (4). pp. 734-737.
A case of multilocular, cystic metanephric adenoma in a 34-year-old man is presented to increase ... more A case of multilocular, cystic metanephric adenoma in a 34-year-old man is presented to increase awareness among urologists and radiologists of this rare entity. Metanephric adenoma of the kidney is an uncommon benign epithelial tumor that may present at any age. To our knowledge, only few cases of cystic manifestation have been reported. Metanephric adenoma is extremely rare and its diagnosis should be considered in a patient with well circumscribed multilocular renal tumor and paraneoplastic syndromes. Its appearance on sonography, intravenous pyelography and magnetic resonance is described. Distinct pathologic features are also discussed. Radiologic and clinical features of the tumor are nonspecific, and histopathologic examination is essential to establish definitive diagnosis. Its recognition may facilitate nephronsparing surgery.
Sa`etak. Karcinom prostate naj~e{}i je visceralni zlo}udni tumor mu{karaca koji je i drugi uzrok ... more Sa`etak. Karcinom prostate naj~e{}i je visceralni zlo}udni tumor mu{karaca koji je i drugi uzrok smrti u mu{karaca zbog zlo}udnih tumora. Naj~e{}e se pojavljuje u starijih od 50 godina, a sve se ~e{}e otkriva u asimptomatskoj fazi s pomo}u jednostavnih i lako dostupnih testova odre|ivanja PSA i posljedi~ne biopsije iglom. Ovakav pristup omogu}ava pravodobno lije~enje ~ime se zna~ajno pobolj{ava prognoza odnosno posti`e izlje~enje bolesnika. U ovom tekstu opisujemo postupke i mogu}nosti rane patohistolo{ke dijagnostike s pomo}u biopsije {irokom iglom. Osim toga opisujemo naj~e{}e histolo{ke podtipove karcinoma prostate i razli~ita netumorska stanja koja mogu opona{ati karcinom i na koja treba misliti u diferencijalnoj dijagnostici da se ne bi postavila la`no pozitivna dijagnoza i tako izbjegle nepotrebne prostatektomije.
![Research paper thumbnail of [Adrenal myelolipoma--report of 15 patients]](https://attachments.academia-assets.com/75022120/thumbnails/1.jpg)
](Myelolipoma is a rare, benign, non-functioning tumor most frequently located in the adrenal corte... more Myelolipoma is a rare, benign, non-functioning tumor most frequently located in the adrenal cortex. It consists of mature fatty tissue with components of hematopoietic tissue in different proportions. There are certain ambiguities related to the diagnosis and therapy of myelolipoma, and it is therefore important to keep in view all the aspects of the lesion and the circumstances in which it develops. This paper presents a series of 15 patients with myelolipoma diagnosed at the Ljudevit Jurak Department of Pathology, Sestre milosrdnice University Hospital Center. Out of 15 patients, 10 were men (one of them with bilateral tumor) aged 41 to 73, and 5 were women aged 51 to 54. Macroscopically, the tumors were oval, encapsulated, yellowish, soft masses located in the adrenal glands. The diameter of the tumors ranged between 0.5 and 13.9 cm. Microscopically, they consisted of multiplied mature adipose cells combined with myeloid tissue composed largely of megakaryocytes, erythroid cells ...
Medical Hypotheses, 2010
The main puzzle of the pulmonary circulation is how the alveolar spaces remain dry over a wide ra... more The main puzzle of the pulmonary circulation is how the alveolar spaces remain dry over a wide range of pulmonary vascular pressures and blood flows. Although normal hydrostatic pressure in pulmonary capillaries is probably always below 10 mm Hg, well bellow plasma colloid pressure of 25 mm Hg, most textbooks state that some fluid filtration through capillary walls does occur, while the increased lymph drainage prevents alveolar fluid accumulation. The lack of a measurable pressure drop along pulmonary capillaries makes the classic description of Starling forces unsuitable to the low pressure, low resistance pulmonary circulation. Here presented model of pulmonary fluid traffic describes lungs as a matrix of small vascular units, each consisting of alveoli whose capillaries are anastomotically linked to the bronchiolar capillaries perfused by a single bronchiolar arteriole. It proposes that filtration and absorption in pulmonary and in bronchiolar capillaries happen as alternating periods of low and of increased perfusion pressures. The model is based on three levels of filtration control: short filtration phases due to respiratory cycle of the whole lung are modulated by bidirectional bronchiolo-pulmonar shunting independently in each small vascular unit, while fluid evaporation from alveolar groups further tunes local filtration. These mechanisms are used to describe a self-sustaining regulator that allows optimal fluid traffic in different settings. The proposed concept is used to describe development of pulmonary edema in several clinical entities (exercise in wet or dry climate, left heart failure, people who rapidly move to high altitudes, acute cyanide and carbon monoxide poisoning, large pulmonary embolisms).
Acta Ophthalmologica, 2013
ABSTRACT Purpose: To determine whether glycemic control of patients with diabetic retinopathy (DR... more ABSTRACT Purpose: To determine whether glycemic control of patients with diabetic retinopathy (DR) due to type 2 diabetes was related to VEGF plasma levels. Methods: The prospective study included 30 patients with DR due to type 2 diabetes. Retinopathy was classified according to the international clinical DR disease severity scale. The concentrations of VEGF in the blood plasma were measured by ELISA. Glycosylated hemoglobin (HbA1c) was assessed all patients. Results were reported as DCCT/NGSP-HbA1c (%) values. Results: The median plasma level of VEGF was 34.5 (range 15-217) pg/ml. Median HbA1c was 7.5 (range 5.3-10.6). The highest individual plasma VEGF measurements were found in patients with severe non-proliferative DR. HbA1c levels revealed a significant correlation with plasma VEGF concentrations (r = 0.573, p = 0.001). Age (r = 0.097, p = 0.611), gender (r = -0.315, p = 0.09) and severity of DR (r = 0.256, p = 0.172) were with no significant relationship to the VEGF measurements. Conclusion: Poor glycemic control is positively correlated with increased levels of plasma VEGF in patients with type 2 diabetes. As normalization of HbA1c is one of the most effective ways to prevent progression of DR and VEGF has been to shown to be clearly implicated in the development of DR, it affirms the importance of glycemic control in patients with DR.
Acta clinica Croatica
In the last decade there has been an exponential rise in the number of patients diagnosed with pr... more In the last decade there has been an exponential rise in the number of patients diagnosed with prostate cancer, probably because of an increase in life expectancy and therefore an expanding population of men in the susceptible age range (>50 years). Prosmte cancer is a significant cause of morbidiry and mortaliry. The widespread use of diagnostic tests such as prostate specific antigen has led ro an increase in the number of men diagnosed with and treated for localized prostate cancer. Radical prostatectomy is elfective therapy for the treatment of localized prostate cancer. The management of locally advanced prostate cancer continues to evolve and so is the debate about the appropriate use and timing of neoadjuvant and adjuvant endocrine therapy for surgically rreared localized prostate cancer. A large body of published material is reviewed and major areas of controversy are identified. The presenr approach to adjuvant and neoadjuvant hormonal management of surgically treated localized prostate cancer is summarized.
Acta clinica Croatica, 2014
Foreign bodies inside urinary tract are a relatively rare condition in our practice. There are se... more Foreign bodies inside urinary tract are a relatively rare condition in our practice. There are several reports published and in most cases the reason for self insertion of an object was autoerotic stimulation or psychiatric illness. Self treatment by homemade instruments is a rarely seen scenario. A 62-year-old man presented to our department complaining of lower urinary tract symptoms. On examination, a foreign body was detected inside the urinary bladder. Urethral stricture was also detected for which the patient had been previously treated on several occasions. The patient stated that he had attempted self catheterization using a homemade catheter. He had succeeded in emptying his bladder; however, the catheter entered the bladder completely and was irretrievable to him. Sachse urethrotomy was performed following retrieval of the foreign body. No psychiatric illness was detected in our patient. The patient's postoperative course was uneventful.
Collegium antropologicum, 2014
A specific representative of recurrent urinary tract infections (UTI) called cystitis cystica (CC... more A specific representative of recurrent urinary tract infections (UTI) called cystitis cystica (CC) was assessed by ultrasound. The aim of the study was to delineate, by means of ultrasound measurement (US) of bladder wall thickness (BWT), the children with mere repeated UTI from those prone to frequent UTI due to CC. Two groups were compared, the control group of 30 with recurrent UTI without US CC BWT changes, and the group of 30 children with characteristic CC bladder wall thickening in whom cystoscopy was performed for verification the diagnosis of CC. BWT of > 3 mm (> 2.8 mm and > 3.3 mm) was found as cut-of value for distinction of CC versus simple recurrent UTI. US BWT measurement is useful in diagnosing CC and therefore valuable in decision about need of UTI prophylaxis.
Acta clinica Croatica, 2013
The main purpose of this study was to demonstrate positive feedback loop between bladder wall nod... more The main purpose of this study was to demonstrate positive feedback loop between bladder wall nodules (nodules being one of the key diagnostic factors), bladder wall thickness, and recurrent urinary tract infections. Cystitis cystica was diagnosed in 115 prepubertal girls (mean age 7.79 +/- 3.05 years) by optic examination of bladder mucosal nodules and by ultrasonographic measurement of bladder wall thickness. Bladder wall thickness increased with the frequency of recurrent urinary tract infections as well as with the number of nodules on bladder wall mucosa (3.52 +/- 0.522 mm < or = 5 nodules vs. 4.42 +/- 0.429 mm 6-10 nodules vs. 5.20 +/- 0.610 mm > 10 nodules, respectively). Study results suggested that early control of urinary tract infections by chemoprophylaxis could prevent higher grades of bladder wall mucosal changes and consequently shorten the length of chemoprophylaxis.
Collegium antropologicum, 2010
The pathogenesis of recurrent urinary tract infections (UTIs) in preschool children with anatomic... more The pathogenesis of recurrent urinary tract infections (UTIs) in preschool children with anatomically correct urinary tract (UT) is rather obscure. In girls, the bladder wall changes of cystitis cystica (CC) may be per se responsible for UTIs recurrence. During the 20-year period, 127 preschool children (125 girls; median age: 6.1 years) with CC, in whom UT anomalies were excluded, were diagnosed. The mean duration of UTIs symptoms prior to diagnosis was 3.31 +/- 2.51 years. Cystoscopical findings were labelled as mild, moderate and severe in 22.8%, 39.4% and 37.8% of patients, respectively. Following the confirmation of CC, long-term chemoprophylaxis with sulfamethoxazole-trimethoprim/nitrofurantoin was administered. A one year UTI-free period after chemoprophylaxis discontinuation was defined as therapeutic success. With 2.5 years median duration of regular chemoprophylaxis this goal was achieved in 58 children mainly with mild/ moderate CC. Thirty children from "improved/unc...
Acta clinica Croatica, 2008
An extremely rare case of seminal vesicle cyst associated with ipsilateral renal dysplasia and ec... more An extremely rare case of seminal vesicle cyst associated with ipsilateral renal dysplasia and ectopic ureter is presented. A 36-year-old patient underwent nephroureterovesiculectomy. Considering the clinical and imaging profile of the patient, a diagnosis of ureterocele with megaureter was initially suspected, but intraoperative findings and definitive pathological analysis of the specimen revealed right renal dysplasia with ectopic ureter opening into seminal vesicle cyst. The clinical and therapeutic peculiarities of this rare condition are presented and the literature on this topic is reviewed.
Acta clinica Croatica, 2010
A 69-year-old man was admitted for resection of rectal adenocarcinoma diagnosed by colonoscopy. P... more A 69-year-old man was admitted for resection of rectal adenocarcinoma diagnosed by colonoscopy. Preoperative computed tomography scan and abdominal ultrasonography revealed bilateral renal tumors measuring up to 2 and 2.8 cm in largest diameter, respectively. The patient underwent partial colectomy and bilateral partial nephrectomy. Microscopically, rectal adenocarcinoma penetrated the submucosa, without invasion of the muscularis propria. Both renal tumors were clear cell renal carcinomas of Fuhrmann nuclear grade 2. To our knowledge, this is the first case of synchronous adenocarcinoma of the rectum and bilateral clear cell renal cell carcinoma described in the literature to date.
Collegium antropologicum, 2014
Herein we present 82-year-old man with leiomyosarcoma arising from the spermatic cord with scalp ... more Herein we present 82-year-old man with leiomyosarcoma arising from the spermatic cord with scalp metastasis, five years after primary surgical treatment. Complete surgical excision is required in such cases, as well as precise evaluation of further therapy. Paratesticular leiomyosarcoma is a rare entity, malignant mesenchimal tumor of smooth muscle differentiation. Although leiomyosarcomas of different localizations have well-known metastatic potential, cutaneous metastases are extremely rare with only 16 cases described in the literature. To our knowledge there are no reported cases of the paratesticular leiomyosarcoma metastatic to the skin. This article reviews the literature regarding paratesticular leiomyosarcoma presentation, diagnosis and treatment.
A rare case of extensive spontaneous perirenal hematoma from a ruptured angiomyolipoma is describ... more A rare case of extensive spontaneous perirenal hematoma from a ruptured angiomyolipoma is described. A 55-year-old woman was admitted to our department with a complaint of acute left flank pain. The images and clinical data of the case are presented. The imaging diagnostic techniques employed were abdominal ultrasonography, computed tomography scan and magnetic resonance imaging, which indicated the diagnosis of a large left perirenal hematoma and showed its size and extension. No tumor was suspected preoperatively. The operation was completed with nephrectomy and definite diagnosis was made on the basis of pathology findings, which revealed a relatively small angiomyolipoma on the upper pole of the left kidney wherefrom the hemorrhage had occurred. Therapeutic approach, i.e. nephrectomy or conservative therapy, remains controversial, however, concerning the prevalence of renal neoplastic lesions, most recent reports recommend nephrectomy in case of even slight doubt of renal neoplasm. The clinical, diagnostic and therapeutic aspects of this rare disease are discussed.
Wiener klinische Wochenschrift, 2012
Your article is protected by copyright and all rights are held exclusively by Springer-Verlag Wie... more Your article is protected by copyright and all rights are held exclusively by Springer-Verlag Wien. This e-offprint is for personal use only and shall not be self-archived in electronic repositories. If you wish to selfarchive your work, please use the accepted author's version for posting to your own website or your institution's repository. You may further deposit the accepted author's version on a funder's repository at a funder's request, provided it is not made publicly available until 12 months after publication. case report Chromophobe renal cell carcinoma with rhabdoid differentiation in an adult 419 1 3 Chromophobes renales Zellkarzinom mit rhabdoider Differenzierung bei einem Erwachsenen Zusammenfassung In der Literatur wurde bisher über Fälle von Nierenkrebs mit rhabdoider Differenzierung normalerweise im Zusammenhang mit Klarzellkarzinomen und Pappilarkarzinomen berichtet. In der zugänglichen Literatur findet man nur einen Bericht von chromophobem Karzinom mit rhabdoider Differenzierung. Wir berichten über den Fall eines 47 Jahre alten männlichen Patienten, der einen routinemäßigen Checkup durchführte. Eine Computer-Tomographie ergab eine große heterogene Masse in der linken Niere, multiple noduläre Veränderungen in beiden Lungenflügeln und multiple vergrößerte Lymphknoten. Mikroskopische Untersuchungen der linken Niere zeigten, dass 65 % des Nierentumors aus rhabdoiden Bereichen bestanden und der Rest des Tumors eosinophile Bereiche aufwies, die mit einem chromophoben renalen Zellkarzinom konsistent waren. Die endgültige Diagnose ergab Chromophobes renales Zellkarzinom mit rhabdoider Differenzierung. Bei Erwachsenen zeigt diese Art von Tumoren eine erhöhte Aggressivität, erfordert aggressivere Behandlung und weist schlechte Erfolgsaussichten auf. Daher sollte rhabdoide Differenzierung im Zusam-menhang mit dieser Art von Karzinomen erkannt und im pathohistologischen Bericht festgestellt werden.
Scandinavian Journal of Urology and Nephrology, 2010
The reactive stroma of prostate cancer contains a mixture of myofibroblasts and fibroblasts, whil... more The reactive stroma of prostate cancer contains a mixture of myofibroblasts and fibroblasts, while fully differentiated smooth-muscle cells are very rare or absent. In experimental prostate cancer models, prostatic stromal cells promote angiogenesis and stimulate prostate tumorigenesis. The aim of this study is to analyse whether the intensity of stromal changes can predict survival in patients with prostatic carcinoma. Stromal reaction was quantified histochemically and imunohistochemically in 50 patients treated with radical prostatectomy for clinically localized prostate carcinoma and its relationship with established prognostic factors was assessed. Kaplan-Meier analysis showed a significant association between the pattern of vimentin and desmin expression and the length of disease-free period; patients with a higher vimentin or lower desmin expression had a shorter disease-free period. On multivariate analysis only vimentin expression (odds ratio 4.06, 95% confidence interval 1.01-16.26, p = 0.049) was a significant predictor of biochemical recurrence. In patients with identical Gleason pattern and Gleason score the level of vimentin expression could identify patients with a higher risk of disease recurrence. Intensity of stromal changes could serve as an independent prognostic factor in the assessment of biochemical recurrence-free survival. Among prostate cancer patients with an identical Gleason score, it could identify patients with a higher risk of biochemical recurrence. Thus, stromal changes and their intensity could serve as a novel marker for the recognition of patients with an increased risk of disease recurrence.
Prostate Cancer and Prostatic Diseases, 2010
Syndecans are a four-member family of transmembrane heparan sulphate proteoglycans that have diff... more Syndecans are a four-member family of transmembrane heparan sulphate proteoglycans that have different functions in cell signalling, adhesion, cytoskeleton organization, migration, proliferation, and angiogenesis. Several studies investigated the role of syndecan-2 (SDC2) in different carcinomas; however, only one being focused on SDC2 in prostate cancer. SDC2 expression and relationship with established prognostic features were assessed in a cohort of 86
Acta clinica Croatica, 2009
A rare case of posttraumatic high-flow priapism is presented. A 20-year-old man underwent diagnos... more A rare case of posttraumatic high-flow priapism is presented. A 20-year-old man underwent diagnostic procedure with color Doppler sonography and angiography. On color Doppler sonography and selective and supraselective angiographic images, arteriocavernosal fistula and pseudoaneurysm were detected in the proximal part of the right cavernous body. Complete detumescence of the penis was achieved by selective embolization with microcoil. No recurrence was observed and postoperative erectile function was incompletely restored. The clinical, diagnostic and therapeutic peculiarities of this rare condition are presented, along with review of the literature on the topic.
Urology, 2007
The incidence of hyperechoic prostate cancer in transrectal ultrasound-guided biopsy specimens. U... more The incidence of hyperechoic prostate cancer in transrectal ultrasound-guided biopsy specimens. Urology, 70 (4). pp. 734-737.
A case of multilocular, cystic metanephric adenoma in a 34-year-old man is presented to increase ... more A case of multilocular, cystic metanephric adenoma in a 34-year-old man is presented to increase awareness among urologists and radiologists of this rare entity. Metanephric adenoma of the kidney is an uncommon benign epithelial tumor that may present at any age. To our knowledge, only few cases of cystic manifestation have been reported. Metanephric adenoma is extremely rare and its diagnosis should be considered in a patient with well circumscribed multilocular renal tumor and paraneoplastic syndromes. Its appearance on sonography, intravenous pyelography and magnetic resonance is described. Distinct pathologic features are also discussed. Radiologic and clinical features of the tumor are nonspecific, and histopathologic examination is essential to establish definitive diagnosis. Its recognition may facilitate nephronsparing surgery.
Sa`etak. Karcinom prostate naj~e{}i je visceralni zlo}udni tumor mu{karaca koji je i drugi uzrok ... more Sa`etak. Karcinom prostate naj~e{}i je visceralni zlo}udni tumor mu{karaca koji je i drugi uzrok smrti u mu{karaca zbog zlo}udnih tumora. Naj~e{}e se pojavljuje u starijih od 50 godina, a sve se ~e{}e otkriva u asimptomatskoj fazi s pomo}u jednostavnih i lako dostupnih testova odre|ivanja PSA i posljedi~ne biopsije iglom. Ovakav pristup omogu}ava pravodobno lije~enje ~ime se zna~ajno pobolj{ava prognoza odnosno posti`e izlje~enje bolesnika. U ovom tekstu opisujemo postupke i mogu}nosti rane patohistolo{ke dijagnostike s pomo}u biopsije {irokom iglom. Osim toga opisujemo naj~e{}e histolo{ke podtipove karcinoma prostate i razli~ita netumorska stanja koja mogu opona{ati karcinom i na koja treba misliti u diferencijalnoj dijagnostici da se ne bi postavila la`no pozitivna dijagnoza i tako izbjegle nepotrebne prostatektomije.
Myelolipoma is a rare, benign, non-functioning tumor most frequently located in the adrenal corte... more Myelolipoma is a rare, benign, non-functioning tumor most frequently located in the adrenal cortex. It consists of mature fatty tissue with components of hematopoietic tissue in different proportions. There are certain ambiguities related to the diagnosis and therapy of myelolipoma, and it is therefore important to keep in view all the aspects of the lesion and the circumstances in which it develops. This paper presents a series of 15 patients with myelolipoma diagnosed at the Ljudevit Jurak Department of Pathology, Sestre milosrdnice University Hospital Center. Out of 15 patients, 10 were men (one of them with bilateral tumor) aged 41 to 73, and 5 were women aged 51 to 54. Macroscopically, the tumors were oval, encapsulated, yellowish, soft masses located in the adrenal glands. The diameter of the tumors ranged between 0.5 and 13.9 cm. Microscopically, they consisted of multiplied mature adipose cells combined with myeloid tissue composed largely of megakaryocytes, erythroid cells ...
Medical Hypotheses, 2010
The main puzzle of the pulmonary circulation is how the alveolar spaces remain dry over a wide ra... more The main puzzle of the pulmonary circulation is how the alveolar spaces remain dry over a wide range of pulmonary vascular pressures and blood flows. Although normal hydrostatic pressure in pulmonary capillaries is probably always below 10 mm Hg, well bellow plasma colloid pressure of 25 mm Hg, most textbooks state that some fluid filtration through capillary walls does occur, while the increased lymph drainage prevents alveolar fluid accumulation. The lack of a measurable pressure drop along pulmonary capillaries makes the classic description of Starling forces unsuitable to the low pressure, low resistance pulmonary circulation. Here presented model of pulmonary fluid traffic describes lungs as a matrix of small vascular units, each consisting of alveoli whose capillaries are anastomotically linked to the bronchiolar capillaries perfused by a single bronchiolar arteriole. It proposes that filtration and absorption in pulmonary and in bronchiolar capillaries happen as alternating periods of low and of increased perfusion pressures. The model is based on three levels of filtration control: short filtration phases due to respiratory cycle of the whole lung are modulated by bidirectional bronchiolo-pulmonar shunting independently in each small vascular unit, while fluid evaporation from alveolar groups further tunes local filtration. These mechanisms are used to describe a self-sustaining regulator that allows optimal fluid traffic in different settings. The proposed concept is used to describe development of pulmonary edema in several clinical entities (exercise in wet or dry climate, left heart failure, people who rapidly move to high altitudes, acute cyanide and carbon monoxide poisoning, large pulmonary embolisms).
Acta Ophthalmologica, 2013
ABSTRACT Purpose: To determine whether glycemic control of patients with diabetic retinopathy (DR... more ABSTRACT Purpose: To determine whether glycemic control of patients with diabetic retinopathy (DR) due to type 2 diabetes was related to VEGF plasma levels. Methods: The prospective study included 30 patients with DR due to type 2 diabetes. Retinopathy was classified according to the international clinical DR disease severity scale. The concentrations of VEGF in the blood plasma were measured by ELISA. Glycosylated hemoglobin (HbA1c) was assessed all patients. Results were reported as DCCT/NGSP-HbA1c (%) values. Results: The median plasma level of VEGF was 34.5 (range 15-217) pg/ml. Median HbA1c was 7.5 (range 5.3-10.6). The highest individual plasma VEGF measurements were found in patients with severe non-proliferative DR. HbA1c levels revealed a significant correlation with plasma VEGF concentrations (r = 0.573, p = 0.001). Age (r = 0.097, p = 0.611), gender (r = -0.315, p = 0.09) and severity of DR (r = 0.256, p = 0.172) were with no significant relationship to the VEGF measurements. Conclusion: Poor glycemic control is positively correlated with increased levels of plasma VEGF in patients with type 2 diabetes. As normalization of HbA1c is one of the most effective ways to prevent progression of DR and VEGF has been to shown to be clearly implicated in the development of DR, it affirms the importance of glycemic control in patients with DR.
Acta clinica Croatica
In the last decade there has been an exponential rise in the number of patients diagnosed with pr... more In the last decade there has been an exponential rise in the number of patients diagnosed with prostate cancer, probably because of an increase in life expectancy and therefore an expanding population of men in the susceptible age range (>50 years). Prosmte cancer is a significant cause of morbidiry and mortaliry. The widespread use of diagnostic tests such as prostate specific antigen has led ro an increase in the number of men diagnosed with and treated for localized prostate cancer. Radical prostatectomy is elfective therapy for the treatment of localized prostate cancer. The management of locally advanced prostate cancer continues to evolve and so is the debate about the appropriate use and timing of neoadjuvant and adjuvant endocrine therapy for surgically rreared localized prostate cancer. A large body of published material is reviewed and major areas of controversy are identified. The presenr approach to adjuvant and neoadjuvant hormonal management of surgically treated localized prostate cancer is summarized.
Acta clinica Croatica, 2014
Foreign bodies inside urinary tract are a relatively rare condition in our practice. There are se... more Foreign bodies inside urinary tract are a relatively rare condition in our practice. There are several reports published and in most cases the reason for self insertion of an object was autoerotic stimulation or psychiatric illness. Self treatment by homemade instruments is a rarely seen scenario. A 62-year-old man presented to our department complaining of lower urinary tract symptoms. On examination, a foreign body was detected inside the urinary bladder. Urethral stricture was also detected for which the patient had been previously treated on several occasions. The patient stated that he had attempted self catheterization using a homemade catheter. He had succeeded in emptying his bladder; however, the catheter entered the bladder completely and was irretrievable to him. Sachse urethrotomy was performed following retrieval of the foreign body. No psychiatric illness was detected in our patient. The patient's postoperative course was uneventful.
Collegium antropologicum, 2014
A specific representative of recurrent urinary tract infections (UTI) called cystitis cystica (CC... more A specific representative of recurrent urinary tract infections (UTI) called cystitis cystica (CC) was assessed by ultrasound. The aim of the study was to delineate, by means of ultrasound measurement (US) of bladder wall thickness (BWT), the children with mere repeated UTI from those prone to frequent UTI due to CC. Two groups were compared, the control group of 30 with recurrent UTI without US CC BWT changes, and the group of 30 children with characteristic CC bladder wall thickening in whom cystoscopy was performed for verification the diagnosis of CC. BWT of > 3 mm (> 2.8 mm and > 3.3 mm) was found as cut-of value for distinction of CC versus simple recurrent UTI. US BWT measurement is useful in diagnosing CC and therefore valuable in decision about need of UTI prophylaxis.
Acta clinica Croatica, 2013
The main purpose of this study was to demonstrate positive feedback loop between bladder wall nod... more The main purpose of this study was to demonstrate positive feedback loop between bladder wall nodules (nodules being one of the key diagnostic factors), bladder wall thickness, and recurrent urinary tract infections. Cystitis cystica was diagnosed in 115 prepubertal girls (mean age 7.79 +/- 3.05 years) by optic examination of bladder mucosal nodules and by ultrasonographic measurement of bladder wall thickness. Bladder wall thickness increased with the frequency of recurrent urinary tract infections as well as with the number of nodules on bladder wall mucosa (3.52 +/- 0.522 mm < or = 5 nodules vs. 4.42 +/- 0.429 mm 6-10 nodules vs. 5.20 +/- 0.610 mm > 10 nodules, respectively). Study results suggested that early control of urinary tract infections by chemoprophylaxis could prevent higher grades of bladder wall mucosal changes and consequently shorten the length of chemoprophylaxis.
Collegium antropologicum, 2010
The pathogenesis of recurrent urinary tract infections (UTIs) in preschool children with anatomic... more The pathogenesis of recurrent urinary tract infections (UTIs) in preschool children with anatomically correct urinary tract (UT) is rather obscure. In girls, the bladder wall changes of cystitis cystica (CC) may be per se responsible for UTIs recurrence. During the 20-year period, 127 preschool children (125 girls; median age: 6.1 years) with CC, in whom UT anomalies were excluded, were diagnosed. The mean duration of UTIs symptoms prior to diagnosis was 3.31 +/- 2.51 years. Cystoscopical findings were labelled as mild, moderate and severe in 22.8%, 39.4% and 37.8% of patients, respectively. Following the confirmation of CC, long-term chemoprophylaxis with sulfamethoxazole-trimethoprim/nitrofurantoin was administered. A one year UTI-free period after chemoprophylaxis discontinuation was defined as therapeutic success. With 2.5 years median duration of regular chemoprophylaxis this goal was achieved in 58 children mainly with mild/ moderate CC. Thirty children from "improved/unc...
Acta clinica Croatica, 2008
An extremely rare case of seminal vesicle cyst associated with ipsilateral renal dysplasia and ec... more An extremely rare case of seminal vesicle cyst associated with ipsilateral renal dysplasia and ectopic ureter is presented. A 36-year-old patient underwent nephroureterovesiculectomy. Considering the clinical and imaging profile of the patient, a diagnosis of ureterocele with megaureter was initially suspected, but intraoperative findings and definitive pathological analysis of the specimen revealed right renal dysplasia with ectopic ureter opening into seminal vesicle cyst. The clinical and therapeutic peculiarities of this rare condition are presented and the literature on this topic is reviewed.
Acta clinica Croatica, 2010
A 69-year-old man was admitted for resection of rectal adenocarcinoma diagnosed by colonoscopy. P... more A 69-year-old man was admitted for resection of rectal adenocarcinoma diagnosed by colonoscopy. Preoperative computed tomography scan and abdominal ultrasonography revealed bilateral renal tumors measuring up to 2 and 2.8 cm in largest diameter, respectively. The patient underwent partial colectomy and bilateral partial nephrectomy. Microscopically, rectal adenocarcinoma penetrated the submucosa, without invasion of the muscularis propria. Both renal tumors were clear cell renal carcinomas of Fuhrmann nuclear grade 2. To our knowledge, this is the first case of synchronous adenocarcinoma of the rectum and bilateral clear cell renal cell carcinoma described in the literature to date.
Collegium antropologicum, 2014
Herein we present 82-year-old man with leiomyosarcoma arising from the spermatic cord with scalp ... more Herein we present 82-year-old man with leiomyosarcoma arising from the spermatic cord with scalp metastasis, five years after primary surgical treatment. Complete surgical excision is required in such cases, as well as precise evaluation of further therapy. Paratesticular leiomyosarcoma is a rare entity, malignant mesenchimal tumor of smooth muscle differentiation. Although leiomyosarcomas of different localizations have well-known metastatic potential, cutaneous metastases are extremely rare with only 16 cases described in the literature. To our knowledge there are no reported cases of the paratesticular leiomyosarcoma metastatic to the skin. This article reviews the literature regarding paratesticular leiomyosarcoma presentation, diagnosis and treatment.
A rare case of extensive spontaneous perirenal hematoma from a ruptured angiomyolipoma is describ... more A rare case of extensive spontaneous perirenal hematoma from a ruptured angiomyolipoma is described. A 55-year-old woman was admitted to our department with a complaint of acute left flank pain. The images and clinical data of the case are presented. The imaging diagnostic techniques employed were abdominal ultrasonography, computed tomography scan and magnetic resonance imaging, which indicated the diagnosis of a large left perirenal hematoma and showed its size and extension. No tumor was suspected preoperatively. The operation was completed with nephrectomy and definite diagnosis was made on the basis of pathology findings, which revealed a relatively small angiomyolipoma on the upper pole of the left kidney wherefrom the hemorrhage had occurred. Therapeutic approach, i.e. nephrectomy or conservative therapy, remains controversial, however, concerning the prevalence of renal neoplastic lesions, most recent reports recommend nephrectomy in case of even slight doubt of renal neoplasm. The clinical, diagnostic and therapeutic aspects of this rare disease are discussed.
Wiener klinische Wochenschrift, 2012
Your article is protected by copyright and all rights are held exclusively by Springer-Verlag Wie... more Your article is protected by copyright and all rights are held exclusively by Springer-Verlag Wien. This e-offprint is for personal use only and shall not be self-archived in electronic repositories. If you wish to selfarchive your work, please use the accepted author's version for posting to your own website or your institution's repository. You may further deposit the accepted author's version on a funder's repository at a funder's request, provided it is not made publicly available until 12 months after publication. case report Chromophobe renal cell carcinoma with rhabdoid differentiation in an adult 419 1 3 Chromophobes renales Zellkarzinom mit rhabdoider Differenzierung bei einem Erwachsenen Zusammenfassung In der Literatur wurde bisher über Fälle von Nierenkrebs mit rhabdoider Differenzierung normalerweise im Zusammenhang mit Klarzellkarzinomen und Pappilarkarzinomen berichtet. In der zugänglichen Literatur findet man nur einen Bericht von chromophobem Karzinom mit rhabdoider Differenzierung. Wir berichten über den Fall eines 47 Jahre alten männlichen Patienten, der einen routinemäßigen Checkup durchführte. Eine Computer-Tomographie ergab eine große heterogene Masse in der linken Niere, multiple noduläre Veränderungen in beiden Lungenflügeln und multiple vergrößerte Lymphknoten. Mikroskopische Untersuchungen der linken Niere zeigten, dass 65 % des Nierentumors aus rhabdoiden Bereichen bestanden und der Rest des Tumors eosinophile Bereiche aufwies, die mit einem chromophoben renalen Zellkarzinom konsistent waren. Die endgültige Diagnose ergab Chromophobes renales Zellkarzinom mit rhabdoider Differenzierung. Bei Erwachsenen zeigt diese Art von Tumoren eine erhöhte Aggressivität, erfordert aggressivere Behandlung und weist schlechte Erfolgsaussichten auf. Daher sollte rhabdoide Differenzierung im Zusam-menhang mit dieser Art von Karzinomen erkannt und im pathohistologischen Bericht festgestellt werden.
Scandinavian Journal of Urology and Nephrology, 2010
The reactive stroma of prostate cancer contains a mixture of myofibroblasts and fibroblasts, whil... more The reactive stroma of prostate cancer contains a mixture of myofibroblasts and fibroblasts, while fully differentiated smooth-muscle cells are very rare or absent. In experimental prostate cancer models, prostatic stromal cells promote angiogenesis and stimulate prostate tumorigenesis. The aim of this study is to analyse whether the intensity of stromal changes can predict survival in patients with prostatic carcinoma. Stromal reaction was quantified histochemically and imunohistochemically in 50 patients treated with radical prostatectomy for clinically localized prostate carcinoma and its relationship with established prognostic factors was assessed. Kaplan-Meier analysis showed a significant association between the pattern of vimentin and desmin expression and the length of disease-free period; patients with a higher vimentin or lower desmin expression had a shorter disease-free period. On multivariate analysis only vimentin expression (odds ratio 4.06, 95% confidence interval 1.01-16.26, p = 0.049) was a significant predictor of biochemical recurrence. In patients with identical Gleason pattern and Gleason score the level of vimentin expression could identify patients with a higher risk of disease recurrence. Intensity of stromal changes could serve as an independent prognostic factor in the assessment of biochemical recurrence-free survival. Among prostate cancer patients with an identical Gleason score, it could identify patients with a higher risk of biochemical recurrence. Thus, stromal changes and their intensity could serve as a novel marker for the recognition of patients with an increased risk of disease recurrence.
Prostate Cancer and Prostatic Diseases, 2010
Syndecans are a four-member family of transmembrane heparan sulphate proteoglycans that have diff... more Syndecans are a four-member family of transmembrane heparan sulphate proteoglycans that have different functions in cell signalling, adhesion, cytoskeleton organization, migration, proliferation, and angiogenesis. Several studies investigated the role of syndecan-2 (SDC2) in different carcinomas; however, only one being focused on SDC2 in prostate cancer. SDC2 expression and relationship with established prognostic features were assessed in a cohort of 86
Acta clinica Croatica, 2009
A rare case of posttraumatic high-flow priapism is presented. A 20-year-old man underwent diagnos... more A rare case of posttraumatic high-flow priapism is presented. A 20-year-old man underwent diagnostic procedure with color Doppler sonography and angiography. On color Doppler sonography and selective and supraselective angiographic images, arteriocavernosal fistula and pseudoaneurysm were detected in the proximal part of the right cavernous body. Complete detumescence of the penis was achieved by selective embolization with microcoil. No recurrence was observed and postoperative erectile function was incompletely restored. The clinical, diagnostic and therapeutic peculiarities of this rare condition are presented, along with review of the literature on the topic.