Sociologija Dinka Tomašića

Društvena istraživanja 2(8), 1993: 887-1001

Diffuse sclerosing variant of thyroid carcinoma presenting as Hashimoto thyroiditis: a case report [Difuzno sklerozirajući oblik papilarnog karcinoma štitnjače nalik Hashimoto tireoiditisu: prikaz slučaja]

The aim of report is to present a case of a rare diffuse sclerosing variant of a papillary thyroid carcinoma. A 15-year old girl referred for ultrasound examination because of painless thyroid swelling lasting 10 days before. An ultrasound of the neck showed diffusely changed thyroid parenchyma, without nodes, looking as lymphocytic thyroiditis Hashimoto at first, but with snow-storm appearance, predominantly in the right lobe. Positive thyroid peroxidase antibodies (TPO-AT) also suggested Hashimoto thyroiditis. Repeated US-FNAB (fine needle-aspiration biopsy) of the right lobe revealed diffuse sclerosing variant of papillary thyroid carcinoma and patient underwent total thyreoidectomy. Patohistologic finding confirmed diffuse sclerosing variant of a papillary thyroid carcinoma in the both thyroid lobes and several metastatic lymph nodes. Two months later patient recived radioablative therapy with 3700 MBq (100 mCi) of 1-131 followed by levothyroxine replacement. At the moment, patient is without evidence of local or distant metastases and next regular control is scheduled in 6 months. In conclusion, a diffuse sclerosing variant is rare form of papillary thyroid carcinoma that echographically looks similar to Hashimoto thyroiditis and sometimes could be easily overlooked

Overview of 100 patients with voice prosthesis after total laryngectomy--experience of single institution [Pregled 100 bolesnika sa govornom protezom nakon totalne laringektomije]

Surgical procedures, especially total laryngectomy, used for treatment of advanced laryngeal carcinoma, have a profound adverse effect on the patient's physical, functional, and emotional health, and almost always decrease quality of life. There are three main types of voice rehabilitation after surgery. They are: esophageal speech techniques, the use of artificial larynx devices and tracheoesophageal puncture with the insertion of various types of voice prostheses. Voice prosthesis was inserted in 100 patients in the ENT Department, University Hospital Center Zagreb, from January 2004 until February 2011, and 91 of these patients were included in our study. The prosthesis was inserted secondary at 71 patients, while in other 20 it was inserted primary, i.e. immediately after laryngectomy as a part of the same procedure. Voice rehabilitation was initiated 10th day after primary insertion and 1st-3rd day after secondary insertion. The postoperative voice quality was compared with a five degree scale, which was taken from Hilger's retrospective study (2000). The rehabilitation was successful in 75.8% of our patients. Early complication rate was 4.4%, and 10.9% of patients had late complications. Statistical analysis didn't show significant differences regarding the complications rate and success rate of rehabilitation between groups of patients, formed according to age, irradiation status and timing of prosthesis insertion

Complications of endoscopic CO2 laser surgery for laryngeal cancer and concepts of their management [Komplikacije endoskopske CO2 laserske kirurgije karcinoma grkljana i koncept njihovog zbrinjavanja]

Endoscopic CO2 laser surgery (ELS) is a widely accepted treatment modality for early laryngeal cancer. Commonly reported advantages of ELS are good oncologic results with low incidence of complications. Although less common if compared with open procedures, complications following ELS can be very serious, even with lethal outcome. They can range from intraoperative endotracheal tube fire accidents to early and late postoperative sequels that require intensive medical treatment, blood transfusion, or revision surgery. We present our institutional experience, discuss the possible complications of ELS for laryngeal cancer, and outline the concepts of their treatment, with comprehensive literature review. Complications are more frequent following the treatment of supraglottic as compared to glottic cancer. If compared with open surgery, ELS for laryngeal cancer is associated with a lower incidence of complications. Every surgeon performing ELS should comply with particular strategies to avoid complications in the first place, and have a clear concept of their management if they occur

Assessing the Improvements GAIA-DR1 Will Bring to Dynamical Astronomy

The first part of this thesis deals with the dynamical estimation of the Oort constants using proper motions and parallaxes provided from the Gaia-DR1 TGAS catalogue. The photometric information was provided by the 2MASS catalogue. The Oort constants calculated from the TGAS catalogue are compared to those obtained from the original Hipparcos catalogue in order to attempt to estimate how well Gaia-DR1 performs. A least squares approach was implemented to calculate the Oort constants. This routine contained seven parameters where the stellar LSR velocity components were included as well. The overall trend seems to be such that the TGAS catalogue can provide meaningful and potentially better results compared to that of the Hipparcos catalogue if the study is not sensitive to a catalogue that is colour incomplete. TGAS worked fairly well in the determination of the Oort constants mainly due to its large sample size, giving it a statistical edge over the Hipparcos catalogue. In the second part of the thesis the local mass density, ρ₀, was determined using tracer star populations for two catalogues. The first one was the original Hipparcos catalogue where the data was propagated to the year 2015. The second catalogue was a combination of Hipparcos stars obtained from both the TGAS and the propagated HIP catalogues. This was done in order to avoid the incompleteness issue that resulted after the creation of the TGAS catalogue. The estimated local mass density from the propagated Hipparcos catalogue was ρ₀ = 0.112 ± 0.009 solar masses per pc³ while the combined TGAS sample got ρ₀ = 0.113 ± 0.006 solar masses per pc³. This result implies that the TGAS catalogue is slightly better compared to the HIP catalogue in performance since it provides with lower formal errors. Based on the results of the two dynamical estimations performed, the TGAS catalogue can be seen as marginally better when compared to the HIP catalogue. In addition, the formal errors resulting from the calculations using the TGAS catalogue are better compared to those obtained using the HIP catalogue. The formal errors are especially good when dynamically estimating the Oort constants since so many stars are included in the calculations. It is, however, difficult to estimate the performance of the complete Gaia catalogue by simply considering the first data release. The release of Gaia-DR2 will hopefully resolve the questions surrounding the performance of the Gaia catalogue.Genom att observera och intervjua invånarna i Lund, kan man erhålla mycket information om historien och infrastrukturen för staden. Detta tyder på en särskilt självklar princip; om man studerar de mindre beståndsdelarna av ett system, så kan man erhålla egenskaper som är gällande för systemet i helhet. Detta är precis vad dagens astronomer utnyttjar för att lära sig mera om vårt universum. De minsta beståndsdelarna i en galax är stjärnorna, och genom att samla information för alla dessa så kan man erhålla detaljer kring galaxens utveckling och struktur. Gaia uppdraget har precis detta i åtanke. I detta väldigt ambitiösa projekt så hoppas man kunna kartlägga Vintergatan genom att ta mätningar för ungefär en miljard stjärnor. Med denna moderna kartläggningen av galaxen så hoppas man kunna upptäcka mer om vad Vintergatan består av, dess historia och dess evolution. Gaia lanserades 2014 och förmodas vara helt avslutad omkring 2022 och kommer då kunna erbjuda den största astrometriska stjärnkatalogen någonsin. Eftersom man inte förväntas få en komplett stjärnkatalog från Gaia förräns om ungefär 5 år, så kommer det lanseras mellanliggande, mindre kataloger som innehåller den information man lyckats samla in under tiden. Den första av dessa mindre katalogerna kallas för Gaia-DR1 (Gaia Data Release 1) och innehåller information för de första 14 månaderna som projektet varit aktivt. Det är denna mindre katalog som vi har använt i detta examensarbete i ett försök att uppskatta den totala prestandan som den kompletta Gaia katalogen kommer att erbjuda. Genom att redan nu undersöka möjligheterna och begränsningarna med Gaia, kan vi planera i förtid på hur de kommande projekten som använder sig av Gaia kommer kunna ge oss en större inblick i hur vårt universum fungerar. Astronomerna hoppas kunna erhålla den mest kompletta beskrivningen av vår galax någonsin genom implementationen av den information som Gaia kommer att erbjuda

New Modalities to Treat Laryngeal Cancer

Early laryngeal cancer comprises T1 and T2 stages of the disease. Open functional operations achieve local control of the disease in 90–95% of T1 patients and in 70–90% of T2 patients. Primary RT achieves local control in 85–94% of T1 tumors and in 70–80% of patients with T2 tumors. Introduction of endoscopic laser surgery resulted in further popularization of preservation laryngeal surgery, whereby equally successful treatment results are achieved with minimal invasiveness. Quality of voice is also better after RT and laser resection. In the last century a golden standard of treatment of advanced laryngeal cancer (T3/T4 stage) was total laryngectomy (TL) with neck dissection followed by adjuvant RT. Overall 5 year survival was around 50%. Due to impact of TL on quality of life, »Larynx preservation strategy« (LPS) was developed in the early \u2790 for advanced stages of the disease. Novel approach is an introduction of targeted therapy, such as anti-EGFR monoclonal antibody, cetuximab. Concomitant cetuximab with RT achieves higher survival, and better locoregional disease control in comparison to administration of single RT modality. Therefore non-surgical methods of treatment of advanced laryngeal carcinoma are constantly changing and improving as new chemotherapeutics are being introduced into protocols. Uncritical enthusiasm with non-surgical methods of treatment resulted in higher incidence of treatment toxicities, higher rates of »salvage surgery« with more frequent adverse effects. That resulted in a consensus attempt around »LPS« project with reevaluation of clinical studies and uniform recommendations for future studies. When choosing appropriate therapy for oncological patient, quality of life (QOL) is a special category to be taken into account besides complications, pain, duration of treatment and overall benefit for the patient