27 research outputs found
Role of matrix metalloproteinases and their inhibitors in the development of cervical metastases in papillary thyroid cancer
No full textPapilarni karcinom najčešći je karcinom štitnjače s porastom incidencije u svijetu. Obilježen je visokim brojem vratnih metastaza. Istraživanja invazije i metastaziranja identificirala su metaloproteinaze matriksa (MMP) kao ključne enzime u procesima tumorske diseminacije, osobito MMP-1, -2 i -9. Aktivnost MMP-a mogu modulirati tkivni inhibitori metaloproteinaza matriksa (TIMP 1-4). Ovo je istraživanje retrospektivno i istražuje ekspresije MMP-1, -2 i -9 te TIMP-1 i -2 u tkivu papilarnog karcinoma štitnjače. Cilj istraživanja bio je imunohistokemijski utvrditi povezanost MMP-a i TIMP-a s obrascem metastaziranja papilarnog karcinoma. Dobiveni rezultati pokazuju da su najviše ekspresije MMP-1 i TIMP-1 bile kod bolesnika s metastazama u lateralnim regijama vrata, dok se ekspresije MMP-2, MMP-9 i TIMP-2 nisu statistički razlikovale ovisno o obrascu metastaziranja. Analizirajući bolesnike u skupinama s metastazama i bez njih uočila se povezanost ekspresije ponovno MMP-1 i TIMP-1 s metastatskom skupinom. Uspoređujući kliničko patološke značajke i ekspresiju, zabilježene su značajne pozitivne korelacije MMP-1 sa stadijem bolesti i brojem zahvaćenih limfnih čvorova, TIMP-1 s brojem limfnih čvorova i stadijem tumora te TIMP-2 s veličinom tumora i brojem limfnih čvorova. Sukladno ovom istraživanju pretpostavljamo da su ekspresije MMP-1 i TIMP-1 povezane s obrascem metastaziranja papilarnog karcinoma štitnjače, dok se razina ostalih analiziranih proteina ne povezuje s obrascem metastaziranja.Papillary carcinoma is the most common thyroid cancer with the incidence increasing worldwide. It is characterized by a high number of cervical metastases. Research of the invasiveness and metastatic processes identified matrix metalloproteinases (MMP) as a key enzyme family in tumor progression, especially MMP-1, -2 and -9. MMP activity can be modulated by tissue inhibitors of matrix metalloproteinase (TIMP 1-4). This research retrospectively investigated the expression of MMP-1, -2 and -9, as well as TIMP-1 and -2 in papillary thyroid carcinoma tissue. The aim of the study was to determine the association of MMP and TIMP with papillary thyroid cancer metastasis pattern by immunohistochemistry. The results obtained showed highest expression of MMP-1 and TIMP-1 in cancer tissue of patients with metastasis in the lateral region, while MMP-2, MMP-9 and TIMP-2 did not differ statistically according to the metastasis pattern. Comparing clinical features with expression data, MMP-1 significantly correlated with the disease stage and number of positive lymph nodes, TIMP-1 with number of positive lymph nodes and tumor stage, and TIMP-2 with tumor size and number of positive lymph nodes. According to this study, MMP-1 and TIMP-1, unlike other proteins analysed, appear to be associated with the papillary thyroid cancer metastasis patter
Role of matrix metalloproteinases and their inhibitors in the development of cervical metastases in papillary thyroid cancer
No full textPapilarni karcinom najčešći je karcinom štitnjače s porastom incidencije u svijetu. Obilježen je visokim brojem vratnih metastaza. Istraživanja invazije i metastaziranja identificirala su metaloproteinaze matriksa (MMP) kao ključne enzime u procesima tumorske diseminacije, osobito MMP-1, -2 i -9. Aktivnost MMP-a mogu modulirati tkivni inhibitori metaloproteinaza matriksa (TIMP 1-4). Ovo je istraživanje retrospektivno i istražuje ekspresije MMP-1, -2 i -9 te TIMP-1 i -2 u tkivu papilarnog karcinoma štitnjače. Cilj istraživanja bio je imunohistokemijski utvrditi povezanost MMP-a i TIMP-a s obrascem metastaziranja papilarnog karcinoma. Dobiveni rezultati pokazuju da su najviše ekspresije MMP-1 i TIMP-1 bile kod bolesnika s metastazama u lateralnim regijama vrata, dok se ekspresije MMP-2, MMP-9 i TIMP-2 nisu statistički razlikovale ovisno o obrascu metastaziranja. Analizirajući bolesnike u skupinama s metastazama i bez njih uočila se povezanost ekspresije ponovno MMP-1 i TIMP-1 s metastatskom skupinom. Uspoređujući kliničko patološke značajke i ekspresiju, zabilježene su značajne pozitivne korelacije MMP-1 sa stadijem bolesti i brojem zahvaćenih limfnih čvorova, TIMP-1 s brojem limfnih čvorova i stadijem tumora te TIMP-2 s veličinom tumora i brojem limfnih čvorova. Sukladno ovom istraživanju pretpostavljamo da su ekspresije MMP-1 i TIMP-1 povezane s obrascem metastaziranja papilarnog karcinoma štitnjače, dok se razina ostalih analiziranih proteina ne povezuje s obrascem metastaziranja.Papillary carcinoma is the most common thyroid cancer with the incidence increasing worldwide. It is characterized by a high number of cervical metastases. Research of the invasiveness and metastatic processes identified matrix metalloproteinases (MMP) as a key enzyme family in tumor progression, especially MMP-1, -2 and -9. MMP activity can be modulated by tissue inhibitors of matrix metalloproteinase (TIMP 1-4). This research retrospectively investigated the expression of MMP-1, -2 and -9, as well as TIMP-1 and -2 in papillary thyroid carcinoma tissue. The aim of the study was to determine the association of MMP and TIMP with papillary thyroid cancer metastasis pattern by immunohistochemistry. The results obtained showed highest expression of MMP-1 and TIMP-1 in cancer tissue of patients with metastasis in the lateral region, while MMP-2, MMP-9 and TIMP-2 did not differ statistically according to the metastasis pattern. Comparing clinical features with expression data, MMP-1 significantly correlated with the disease stage and number of positive lymph nodes, TIMP-1 with number of positive lymph nodes and tumor stage, and TIMP-2 with tumor size and number of positive lymph nodes. According to this study, MMP-1 and TIMP-1, unlike other proteins analysed, appear to be associated with the papillary thyroid cancer metastasis patter
Uloga metaloproteinaza matriksa i njihovih inhibitora u razvoju vratnih metastaza papilarnoga karcinoma štitne žlijezde [Role of matrix metalloproteinases and their inhibitors in the development of cervical metastases in papillary thyroid cancer]
No full textPapillary carcinoma is the most common thyroid cancer with the incidence increasing worldwide. It is characterized by a high number of cervical metastases. Research of the invasiveness and metastatic processes identified matrix metalloproteinases (MMP) as a key enzyme family in tumor progression, especially MMP-1, -2 and -9. MMP activity can be modulated by tissue inhibitors of matrix metalloproteinase (TIMP 1-4). This research retrospectively investigated the expression of MMP-1, -2 and -9, as well as TIMP-1 and -2 in papillary thyroid carcinoma tissue. The aim of the study was to determine the association of MMP and TIMP with papillary thyroid cancer metastasis pattern by immunohistochemistry. The results obtained showed highest expression of MMP-1 and TIMP-1 in cancer tissue of patients with metastasis in the lateral region, while MMP-2, MMP-9 and TIMP-2 did not differ statistically according to the metastasis pattern. Comparing clinical features with expression data, MMP-1 significantly correlated with the disease stage and number of positive lymph nodes, TIMP-1 with number of positive lymph nodes and tumor stage, and TIMP-2 with tumor size and number of positive lymph nodes. According to this study, MMP-1 and TIMP-1, unlike other proteins analysed, appear to be associated with the papillary thyroid cancer metastasis patter
Role of matrix metalloproteinases and their inhibitors in the development of cervical metastases in papillary thyroid cancer
No full textPapilarni karcinom najčešći je karcinom štitnjače s porastom incidencije u svijetu. Obilježen je visokim brojem vratnih metastaza. Istraživanja invazije i metastaziranja identificirala su metaloproteinaze matriksa (MMP) kao ključne enzime u procesima tumorske diseminacije, osobito MMP-1, -2 i -9. Aktivnost MMP-a mogu modulirati tkivni inhibitori metaloproteinaza matriksa (TIMP 1-4). Ovo je istraživanje retrospektivno i istražuje ekspresije MMP-1, -2 i -9 te TIMP-1 i -2 u tkivu papilarnog karcinoma štitnjače. Cilj istraživanja bio je imunohistokemijski utvrditi povezanost MMP-a i TIMP-a s obrascem metastaziranja papilarnog karcinoma. Dobiveni rezultati pokazuju da su najviše ekspresije MMP-1 i TIMP-1 bile kod bolesnika s metastazama u lateralnim regijama vrata, dok se ekspresije MMP-2, MMP-9 i TIMP-2 nisu statistički razlikovale ovisno o obrascu metastaziranja. Analizirajući bolesnike u skupinama s metastazama i bez njih uočila se povezanost ekspresije ponovno MMP-1 i TIMP-1 s metastatskom skupinom. Uspoređujući kliničko patološke značajke i ekspresiju, zabilježene su značajne pozitivne korelacije MMP-1 sa stadijem bolesti i brojem zahvaćenih limfnih čvorova, TIMP-1 s brojem limfnih čvorova i stadijem tumora te TIMP-2 s veličinom tumora i brojem limfnih čvorova. Sukladno ovom istraživanju pretpostavljamo da su ekspresije MMP-1 i TIMP-1 povezane s obrascem metastaziranja papilarnog karcinoma štitnjače, dok se razina ostalih analiziranih proteina ne povezuje s obrascem metastaziranja.Papillary carcinoma is the most common thyroid cancer with the incidence increasing worldwide. It is characterized by a high number of cervical metastases. Research of the invasiveness and metastatic processes identified matrix metalloproteinases (MMP) as a key enzyme family in tumor progression, especially MMP-1, -2 and -9. MMP activity can be modulated by tissue inhibitors of matrix metalloproteinase (TIMP 1-4). This research retrospectively investigated the expression of MMP-1, -2 and -9, as well as TIMP-1 and -2 in papillary thyroid carcinoma tissue. The aim of the study was to determine the association of MMP and TIMP with papillary thyroid cancer metastasis pattern by immunohistochemistry. The results obtained showed highest expression of MMP-1 and TIMP-1 in cancer tissue of patients with metastasis in the lateral region, while MMP-2, MMP-9 and TIMP-2 did not differ statistically according to the metastasis pattern. Comparing clinical features with expression data, MMP-1 significantly correlated with the disease stage and number of positive lymph nodes, TIMP-1 with number of positive lymph nodes and tumor stage, and TIMP-2 with tumor size and number of positive lymph nodes. According to this study, MMP-1 and TIMP-1, unlike other proteins analysed, appear to be associated with the papillary thyroid cancer metastasis patter
Robotic surgery in otorhinolaryngology – our experience
No full textRobotic surgery is an advanced technique that has significantly improved minimally invasive surgical
procedures in the head and neck area. The development of robotic surgical systems began in the 1980s as part
of a military research with the aim of developing a system for performing surgical procedures remotely. The
first significant step in the application of robotics in head and neck surgery was made in 2005, when McLeod
and Melder successfully used the Da Vinci robotic system for the resection of a vallecular cyst. The transoral
robotic approach (TORS) was officially approved by the FDA in 2009 for the treatment of early-stage
oropharyngeal carcinoma. Since then, indications have expanded rapidly, including tumors of the
hypopharynx, parapharyngeal space, and supraglottis, as well as surgery of the thyroid and parathyroid glands.
The Da Vinci system stands out as the most versatile system with advanced visualization and exceptional
precision. The Da Vinci robotic system provides key advantages: three-dimensional visualization with highresolution 3D display, precise bimanual instrumentation with the wrist, tremor filtration with the automatic
removal of unwanted movements, movement scaling for microsurgical interventions, and individual camera
control. These innovations allow the surgeon to overcome the limitations of conventional endoscopic surgery,
including wrist-free instrumentation and two-dimensional visualization. The robotic system is most often used
for a transoral robotic approach (TORS) in the treatment of oropharyngeal tumors, tongue base tumor resection
and surgical treatment of obstructive apneas. In thyroid surgery, a transaxillary approach (RATS) and transoral
approach (TORT) are used. KBC Zagreb introduced robotic surgery in otorhinolaryngology as a pioneering
institution in the region. During the lecture, we will present a series of cases representing the first robotic
procedures performed through a transoral approach at KBC Zagreb, demonstrating the technical aspects,
indications, perioperative course and results. Robotic surgery in otolaryngology represents a significant
advance in the treatment of patients with head and neck diseases, enabling precise, safe, and minimally invasive
treatment of complex conditions with better functional and aesthetic results
Intraoperative Detection of Hyperplastic Parathyroid Gland With Positron Emitter 18F-Fluorocholine and Handheld Probe
No full textWe present the first intraoperative detection of a hyperplastic parathyroid gland with a positron emitter F-fluorocholine and handheld probe, with the estimation of the absorbed dose to the surgeon and surgical staff. Intraoperative positron emitter detection enabled the resection of a small parathyroid gland, resulting in normal postoperative values of PTH and serum calcium in a 69-year-old woman. Calculated whole-body dose to the surgical staff and surgeons' fingers is well below the annual limits for exposed workers and the general public. Intraoperative F-FCH detection with handheld probe is a safe and feasible method for localizing small parathyroid glands
Vladimir Nabokov's art of portraiture
No full textLa passion académique pour Vladimir Nabokov et son œuvre fictionnelle ne faiblit pas et pourtant son art du portrait demeure un sujet inexploré par la critique contemporaine dédiée à ce romancier de renom mondial. Bien que Gavriel Shapiro et Gerard de Vries ont fourni une remarquable recherche ces dernières décennies sur le rôle des arts visuels dans ses romans, il paraît que ce manque de recherche soit le fait d'un désintérêt pour le portrait en littérature en tant que sujet en soi. Défini selon Gérard Genette tout au plus comme une description ou du moins, sa partie la plus attachante, le portrait semble devenir désuet alors qu'au cours du même siècle Nabokov s'affirme en tant que romancier de renom mondial qui brosse à contre-courant, page après page, sa vaste galerie de portraits. Les fait que les courants artistiques ont une si grande influence sur le portrait littéraire depuis l'Antiquité peut être l'une des raisons de ce décalage. Nous savons que Nabokov n'était pas amateur des mouvements et des idéologies, et selon notre hypothèse, la raison pour cela peut être le fait qu'il a été témoin de l'émergence de l'art abstrait russe qui allait de pair avec la Révolution de 1917. Comme nous le savons, le portrait dans l'art abstractionniste et révolutionnaire disparaît du premier plan et du paysage artistique russe à l'aune de la Révolution Russe, qui coïncide avec l'exil de Nabokov. Plus précisément, c'est la figure qui n'est plus représentée en peinture et celle-ci inclut la figure du portrait, son sujet et son objet, l'individu. Par conséquent, les personnes qui étaient d'ordinaire les modèles des portraits, à savoir les riches aristocrates, comme c'était le cas de la famille Nabokov, se sont retrouvées exclues de leur patrie et de leurs traditions artistiques au début de 1917. À cause de l'art abstrait et du nouveau régime, les représentations des personnes comme Nabokov se sont retrouvées éliminées de l'art. Étant donné que le portrait a endossé de nombreuses fonctions depuis l'Antiquité, connues d'une personne cultivée comme Nabokov, notre but était de montrer que les réflexions de Nabokov au sujet du portrait, ainsi que l'exploration de celui-ci, sont tissées dans son approche artistique globale et étroitement liées à sa vision du vingtième siècle. Ainsi, le portrait ne saurait être réduit à un simple ornement de sa prose ou à un outil littéraire dont l'unique but serait de s'adonner au plaisir de décrire de belles jeunes filles. Par conséquent, notre travail continue sur les traces de Gavriel Shapiro et de Gerard de Vries qui ont donné un aperçu de l'éducation précoce de Nabokov en matière de l'art. Afin d'étayer nos arguments, notre corpus est composé de l'intégralité de ses dix-neuf romans publiés à ce jour. L'originalité de notre approche se trouve dans notre emploi des outils rhétoriques empruntés à la fois à la littérature et aux arts visuels qui vont nous permettre de conceptualiser son art du portrait à l'intersection de plusieurs formes artistiques en nous appuyant notamment sur les travaux de Georges Didi-Huberman, Jean-Luc Nancy, Gérard Genette, et Aristote, entre autres. En plus, les portraits nabokoviens qui détonnent au vingtième siècle pourront nous fournir une meilleure vision et une possible solution quant à la classification de son œuvre qui est toujours fréquemment discutée.The academic passion triggered by Vladimir Nabokov and his fictional oeuvre is not receding although his art of portraiture remains vastly unexplored in contemporary critical studies devoted to such a popular global novelist. Even though Gavriel Shapiro and Gerard De Vries have accomplished some tremendous research over the past decades on the role of the visual arts in his novels, it seems that the lack of research in Nabokov's art of portraiture is mostly due to some reluctance to explore portraits as an academic literary subject. Defined merely as a description, the most endearing type of narrative according to Gérard Genette, the portrait seems to fall out of use in the course of the same century when Nabokov asserts himself as a worldwide renowned author constituting his vast gallery of portraits against the tide, page after page.The fact that artistic movements have such a big influence on the art of portraiture - furthermore acknowledged since the Antiquity - may be one of the reasons for that discrepancy. We know that Nabokov was not fond of movements and ideologies and according to our hypothesis it might be because he witnessed the emergence of Russian abstractionist art movement that went hand in hand with the Russian Revolution. As we know, the portrait in Russian abstractionist and revolutionary art disappears from the forefront of Russian landscape in the wake of the Russian Revolution that coincides with Nabokov's exile. More precisely, it is the figure that is no longer represented in painting and that includes the figure of a portrait, its subject and object, the individual. Therefore, the people who previously used to sit to have their portraits drawn like wealthy aristocrats, as was the case with Nabokov's relatives found themselves both alienated from their home country and its artistic traditions in early 1917. As the result of both the abstractionist painting and the new regime, the representations of people like Nabokov were cleansed from art. Considering that the portrait has assumed so many functions ever since the Antiquity which a well-educated person like Nabokov must have known, our aim is to show that Nabokov's reflections on portraits and his explorations of them are woven in his global artistic approach, tightly related to his insights on the 20th century, and cannot be regarded as a mere ornament to his prose or some erotic literary device to give way to the pleasure of depicting beautiful young girls. Therefore, our work continues in the footsteps of Gavriel Shapiro and Gerard De Vries who both gave us the overview of Nabokov's early education in art and his interest for it.In order to buttress our arguments, our corpus is composed of all of his nineteen novels published to this day. The originality of our approach is that it combines the rhetorical devices borrowed from literature and the visual arts at the same time, which will allow us to conceptualize the art of portraiture at the crossroads of various art forms with the help of Georges Didi-Huberman, Jean-Luc Nancy, Gérard Genette, and Aristotle among others. In addition, Nabokov's incongruous twenty-century portraits may provide a further insight and a possible solution for the generic classification of his work, which is still frequently discussed
Prophylactic Central Neck Dissection in Well-differentiated Thyroid Cancer
No full textPapilarni i folikularni karcinomi čine 90% svih zloćudnih tumora štitnjače. Dobro diferencirani karcinomi štitnjače imaju
indolentan tijek bolesti, s dvadeset godišnjim za bolest specifičnim preživljenjem preko 90%. Totalna tireoidektomija je
terapija izbora za većinu bolesnika. Kod bolesnika s karcinomima niskog rizika moguće je učiniti samo lobektomiju zahvaćenog
režnja, a da se pritom ne ugrozi ukupno preživljenje bolesnika. Profilaktička disekcija središnjeg dijela vrata predmet
je brojnih istraživanja zbog nejasnih kliničkih posljedica njezina izvođenja. Kod folikularnih karcinoma štitnjače koji primarno
metastaziraju hematogeno, nema indikacije za profilaktičku disekciju središnjeg vrata. Kod malih solitarnih papilarnih
karcinoma štitnjače (T1 i T2) profilaktička disekcija središnjeg vrata nije indicirana, jer ne donosi koristi u smislu poboljšanog
preživljavanja pacijenata, a istodobno značajno povećava rizik od privremenih i trajnih postoperativnih komplikacija,
poput pareza i paralize povratnog laringealnog živca i hipoparatireoidizma. Ipsilateralna profilaktička disekcija središnjeg
vrata indicirana je kod uznapredovalih papilarnih karcinoma štitnjače (T3 i T4) te kod svih ostalih koje karakterizira visok
rizik za povrat bolesti ili regionalnu diseminaciju. Metastatski limfni čvorovi na lateralnom vratu, s urednim predoperativnim
statusom limfnih čvorova središnje regije vrata, također su indikacija za profilaktičku disekciju središnjeg vrata.Well-differentiated cancers, both papillary and follicular, account for 90% of all
diagnosed thyroid cancers. They have an indolent disease course with a 20-year disease-specific survival
over 90%. According to current guidelines, the therapy of choice for well-differentiated thyroid
carcinoma is total thyroidectomy or lobectomy. The indication for prophylactic central neck dissection
is still a controversial issue and the subject of unfinished and ongoing debate. There is no indication
for prophylactic central neck dissection in follicular thyroid carcinomas, which primarily metastasize
hematogenously. In small solitary papillary thyroid carcinomas (T1 and T2), prophylactic central neck
dissection is not indicated as it does not bring benefits in terms of improved patient survival and at the
same time significantly increases the risk of temporary and permanent postoperative complications.
Prophylactic central neck dissection is indicated in advanced papillary thyroid cancers (T3 and T4)
and all other high-risk well-differentiated thyroid cancer, as well as in the presence of metastatic
lymph nodes in the lateral neck
Hypocalcemia After Completion Thyroidectomy for Papillary Thyroid Carcinoma
No full textKirurška terapija papilarnog karcinoma štitnjače obuhvaća totalnu tireoidektomiju i lobektomiju. Katkad je nakon lobektomije
potrebno napraviti reoperaciju koja se naziva „completion“ tireoidektomija. Postoperativna hipokalcijemija najčešća je
komplikacija povezana s kirurgijom štitnjače. Cilj našeg rada bio je utvrditi postoji li značajna razlika u učestalosti postoperativne
hipokalcijemije kod pacijenata koji su bili podvrgnuti totalnoj tireoidektomiji zbog papilarnog karcinoma štitnjače i
pacijenata kod kojih je rađena „completion“ tireoidektomija zbog papilarnog karcinoma štitnjače. Osim toga analizirali smo
sljedeće potencijalne prediktivne faktore za pojavu hipokalcijemije: spol, dob, veličina tumora, strana tumora, maksimalni
promjer pojedinačnog režnja, okultne metastaze i kirurg. U istraživanje je bilo uključeno 340 pacijenata operiranih zbog
papilarnog karcinoma štitnjače na Klinici za bolesti uha, grla i nosa i kirurgiju glave i vrata, KBC Zagreb, u razdoblju od 25.
veljače 2013. do 3. siječnja 2016. Učestalost hipokalcijemije nakon totalne tirodektomije bila je veća, 37, 8% u usporedbi s
29% nakon „completion“ tireoidektomije. Unatoč tome, ta razlika nije bila statistički značajna. Nijedan od analiziranih faktora
nije doveden u korelaciju s postoperativnom hipokalcijemijom. Naše je istraživanje pokazalo da ne postoji značajna
razlika
u učestalosti postoperativne hipokalcijemije između pacijenata podvrgnutih „completion“ tireoidektomiji i pacijenata
podvrgnutih totalnoj tireoidektomiji zbog papilarnog karcinoma štitnjače.Surgical management of papillary thyroid carcinoma (PTC) includes total thyroidectomy
and lobectomy. After lobectomy, a reoperation called completion thyroidectomy is occasionally
required. Postoperative hypocalcemia is the most common complication associated with thyroid
surgery. Our main goal was to determine if there is a significant difference between the incidence
rate of postoperative hypocalcemia in patients who underwent total thyroidectomy for PTC compared
with patients who underwent completion thyroidectomy for PTC. Apart from that, we analyzed
the following potential predictive factors for the occurrence of hypocalcemia: sex, age, size of
tumor, side of tumor, maximum diameter of individual lobe, occult metastasis, and operating surgeon.
The study involved 340 patients who underwent surgery for PTC at the Department of ENT and
Head and Neck Surgery, Zagreb University Hospital Centre, between February 25, 2013 and January
3, 2016. Postoperative hypocalcemia incidence rates were higher in the total thyroidectomy group
than in the completion thyroidectomy group (37.8% and 29.0%, respectively). However, these differences
were not statistically significant. Every analyzed potential predictive factor was proven not to
have any correlation with postoperative hypocalcemia. This study demonstrated that there was no
significant difference between postoperative hypocalcemia rates in patients who underwent completion
thyroidectomy compared with patients who underwent total thyroidectomy for PTC
Descendentni nekrotizirajući medijastinitis
No full textDescending necrotizing mediastinitis is a severe septic infection of the mediastinum, mostly resulting from an infectious process originating from the neck or oral cavity. The mortality rate associated with descending necrotizing mediastinitis remains high (>40%) in spite of the current medical and surgical treatment options. The disease may occur at any age and in either sex. Early diagnosis is of utmost importance to immediately initiate intensive antibiotic therapy or surgical intervention in case of the infectious process descent to the thoracic cavity. A patient with descending necrotizing mediastinitis, initially treated with antibiotic therapy followed by surgical intervention due to the disease propagation, is presented. Intraoperatively, a life threatening complication of the left venous angle erosion developed.Descendentni nekrotizirajući medijastinitis je ozbiljna gnojna infekcija medijastinuma koja najčešće nastaje spuštanjem infekta iz područja usne šupljine ili vrata. Smrtnost je i dalje vrlo visoka (preko 40%) usprkos današnjim mogućnostima liječenja konzervativnim ili kirurškim putem. Bolest se može pojaviti kod svih dobnih skupina, kako kod muškaraca tako i kod žena. U liječenju bolesti najvažnije je rano postavljanje dijagnoze kako bi se odmah započela intenzivna antibiotska terapija, a u slučaju spuštanja gnojnog procesa u prsni koš kirurška intervencija. Prikazuje se bolesnik s descendentnim nekrotizirajućim medijastinitisom koji je u početku liječen antibioticima, a zbog propagacije bolesti i kirurškim zahvatom. Tijekom kirurškog zahvata razvila se za život opasna komplikacija, erozija lijevostranog venskog spoja
