Breast cancer is a serious health problem. It is the most common cancer in women. The aim of this study was to estimate the concordance between ER, PR receptor and HER-2 immunohistochemistry assessment scores in pared CNB (core needle biopsy) and surgical specimens. Histological grade, oestrogen receptor (ER) status, progesterone receptor (PR) status, and human epidermal growth factor receptor-2 (HER2) status were evaluated in a blinded fashion in CNB and in surgical excision specimens. Absolute concordance rate between core needle biopsies and surgical specimens for histological grade was 50% with κ value (0,15) for ER 92% with κ value (0,79), PR 88% with κ value (0,73) and for HER2 96% with κ value (0,91). CNB can provide reliable information in evaluation of ER, PR and HER2 status in an invasive breast carcinoma. Ključne reči: breast cancer, core needle biopsy, oestrogen receptors, progesterone receptors, HER-2. Analiza odstupanja statusa hormonskih receptora i receptora za epidermalni faktor rasta 2 u uzorcima dobijenim iglenom biopsijom i hirurškim uzorkom kod obolelih od invazivnog karcinoma dojke Ljiljana Tadic Latinovic1, Zivka Eri2, Darko Jovic3, Aleksandra Salapura1, Jovan Culum3, Branislava Jakovljevic3, Ilija Baros1, Slavica Maric4 1 Department of Pathology, University Clinical Center of Republic of Srpska, Banja Luka, Republic of Srpska, Bosnia and Herzegovina 2 Canter for Molecular Genetics, Institute for Pulmonary Diseases, Sremska Kamenica, Republic of Serbia 3 Surgical Clinic “S-Tetik”, Banja Luka, Republic of Srpska, Bosnia and Herzegovina 4 International Medical CantersCentar za Radioterapiju Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina

Abstract In this case, we have presented a 55-year old patient with dysuria and bloody urine. He was hospitalized at the Urology Department of County Zenica Hospital due to obstructive uropathy. Diagnostics showed the cause is a large bleeding mass in prostatic part of urethra. After cystectomy, immunohistochemistry revealed urachal adenocarcinoma, rare type of urogenital carcinomas, presented only in 5% of all cancer types. He was treated with dual modality, chemotherapy and radiotherapy

Rustom Bharucha dedicates the first chapter of Terror and Performance to Jean Genet and the last to Mahatma Gandhi. In this way, his rich series of reflections is bookended by a literary criminal and political saint, a (former) small-time crook and a (former) lawyer, a champion of stateless nations and a nation-builder, a traitor and a martyr... It seems that oppositions between them could go on forever. Even when Bharucha finally mentions them in the same sentence towards the end of the book, it is to illustrate their opposition, not similarity: here, one G stands for theatrical irony, and the other for sacrificial Truth (165). What brings Genet and Gandhi together is their queerness in relation to the world of letters and the world of politics, respectively. Their simultaneous position of marginality and excess in relation to their own historical and institutional situations came from their unique capacities for self-renunciation, so rare and precious in the contemporary world of literature, politics, and especially theatre. In Bharucha’s book, the route from Genet to Gandhi winds through the treacherous world of contemporary international politics and performance. This itinerary takes the reader away from the beaten paths of scholarly discourse on the two key terms indicated in the book’s title.

Introduction: The efficacy of ureteric stents in the management of various urological conditions causing the upper urinary tract obstruction has been extensively proven, and their contribution to urology remains enormous. The clinical use of ureteric stents is associated with several complications. “Stent syndrome,” encrustation, migration and urothelial hyperplasia are the most common problems related to long-term ureteral stenting. Case report: This work presents an interesting case from our practice: a complete encrustation of a classical polyurethane double J stent two and a half months after its initial instillation, in a 70 year old man, with a solitary functioning kidney, as well as successful removal of it by using a simultaneous treatment of extracorporeal lithotripsy and ureteroscopy with a contact disintegration of encrustations and with percutaneous nephrostomy, as an auxiliary procedure for providing of additional urine derivation. Conclusion: These problems can be overcome by the introduction of new advanced ureteral stent designs and biomaterials.

Introduction. Urolithiasis is a multifactorial disease. Changes in social and economic living conditions have generated changes in chemical composition of urolith too. Although calcium is a predominant crystalline constituent of kidney stones in 80% of cases, metabolic disorders are not the main reason for their formation. Hyperparathyroidism may be a cause of occurrence of calcium lithiasis, however, the biggest number of its occurrence is not a consequence of elevated values of parathormone. Acid uric has a pervasive presence in all body fluids. The serum level of acid uric is determined by its rate of synthesis, rate of excretion by kidney and gastrointestinal tract, and metabolism. Goal. The goal of our study is to determine a correlation of calcium lithiasis of the upper part of the urinary tract with the parathormone values and the concomitant values of acidum uricum. Material and methods. The study was prospective and included 120 patients with calcium lithiasis of the upper part of urinary tract, divided in three age categories, 20-40 years, 40-60 years and older than 60 years. The diagnosis of calcium lithiasis of the upper part of the urinary tract was made on the basis of urinary tract ultrasonography, and kidney-ureter-bladder radiography (KUB) /intravenous urography (IVU), urine culture and chemical analysis of stone with patients who had a spontaneous emission of stone or following some of the methods for active removal of stone; with some patients non-contrast (NCCT) was carried out too. All patients were subjected to the laboratory analysis of the serum level of acidum uricum and parathormone. Results. With observed 120 patients suffering from calcium urolithiasis, who belonged to adult population, no patient had an elevated value of parathormone, while three patients (2.5%) had the values of acidum uricum higher than the reference values. The average value (for both parameters) was the lowest with the youngest patients and vice versa, and only in the group of 40 to 60 years of age there were patients whose values of the acidum uricum parameter was outside the interval of reference values; the other age groups did not have such values. Based on the analysis of the variance, as a statistical method, it was determined that the average values of acidum uricum in different age groups were statistically significantly different, which is not the case for the parameter parathormone. (p>0,05). Conclusion. The biggest number of nephrolithiasis is not a consequence of elevated values of parathormone. Hyperuricosemia may be present with calcium urolithiasis, without participation in forming kidney stones, most probably as an indirect sign of the existence of the initial insulin resistance and metabolic disease.

Aneurysm of the visceral arteries is a rare condition and it represents around 1% of all arterial aneurisms. Aneurysm of the inferior pancreaticoduodenal artery represents around 2% of all visceral aneurysms. Aneurysm associated with occlusion of the coeliac trunk is very rare condition and there are only about 40 cases presented in the literature. In our study, we presented 56 year-old female admitted to hospital with obstructive jaundice. CT scan diagnosed tumor of the head of pancreas and CT angiography confirmed aneurysm of the inferior pancreaticoduodenal artery which was successfully operated at our clinic.

Introduction: Pathogenesis of kidney stones includes many factors, whereas uroliths, as a generic term for kidney stones, are of a different composition. In pathogenesis of calcium urolithiasis hypercalcemia/hypercalciuria takes a significant place. Hypercalcemia exists when the serum calcium is of increased values, along with measurement and calculation of physiologically active calcium, when there are differences in the Ph of the blood or albumin. Goal: the goal of this research is to determine the correlation of values of the serum (CaS) and ionized calcium (Ca++) in patients with the calcium nephrolithiasis, whom have been established not to have hyperparathyroidism and malign diseases. Material and methods: the research was prospective and implemented at the Clinical Center in Banja Luka, at the Urology Clinic, in the period between 1st April 2012 – 1st January 2013 and it included 120 patients with the calcium lithiasis of the upper part of the urinary tract, divided into three age categories. Diagnosis of the calcium lithiasis of the upper part of the urinary tract was established on the basis of the ultrasonography of the urinary tract as well as native urinary tract/intravenous urography and chemical analysis of the stone in patients with spontaneous stone emission or after some of the methods for active removal of the stone. Chemical laboratory analysis of the serum and ionized calcium was done for all the patients, with 3ml of blood being taken for establishing the aforementioned parameters (1-2 ml of the serum) in vacuumed test tubes or glass tubes of capillary blood. Increased parathormone values (PHT) and history of malignity were excluding factors. Results: out of the 120 patients observed, Cs(S) had the value in the reference interval with most of them, that is, in 110 patients (91.7%). Those, whose value was out of the interval, are of an older age (all above 40). Average value of this parameter amounted to 2.3017, with an average difference (the standard deviation) of 0.11391. Observing the value of Ca++, the value within the reference interval was found in 106 patients (88.3%). Out of the remaining 14 patients, only two simultaneously had the value of Ca(S) out of the permitted interval. The majority of this group consisted of older patients (a half of those whose values were outside the interval was over 60). Average value of Ca++ amounted to 1.22 mmol/L with an average difference of 0.06454. In the 2 aforementioned patients, who simultaneously had increased values of CaS and Ca++, the blood Ph was within the referential value limits, which suggests that, in line with the hyporcalcemia definition, only 2 patients with nephrolithiasis, in the total sample of 120 patients of our research sample, could have had a true hypercalcemia. Conclusion: the biggest number of patients with the calcium urolithiasis, who do not have hyperparathyroidism and history of malign diseases, do not have a real hypercalcemia.

Colonel Sandurz: Now! You're looking at now, sir.Everything that happens now is happening now.Lord Dark Helmet: What happened to then?Colonel Sandurz: We passed then.Lord Dark Helmet: When?Colonel ...

Objective. The differences in immunohistochemical expression of estrogen receptors (ER) and p53 in endometrial carcinoma and correlated with of histological type, grade and stage are crucial in the planning of further monitoring and treatment of patients. Materials and methods. This paper deals with data of the patients treated for endometrial carcinoma in Public Hospitals in Travnik, gynecological department in the period from 01.01.2007. to 01.01.2013 th the sample consisted of 97 women with endometrial carcinoma, with ages ranging from 42 to 90 years (mean of 64 years). 72 cases (74.2%) were of endometrioid and 25 (25.8%) nonendometrioid carcinoma. Results. The 72 endometrioid carcinoma cases were final disease stage as follows: stage I = 29/72 (40%) and stages II, III et IV = 43/72 (60%). Markers and histological types: p53 expression was found in 10 patients (13.8%) of the endometrioid and 17 patients (68%) of the nonendometrioid endometrial carcinoma. The estrogen receptors were more frequent in the endometrioid type 44 patients (61%) with regard to 7 patients of the nonendometrioid type endometrial carcinoma. Markers and histological grade: In the 72 cases of endometrioid carcinoma, those with grade I expressed estrogen (22 out of 36 cases = 61.1%) more frequently than those with grades II and III. p53 was expressed in only 3.8% of endometrioid carcinomas. Conclusion. The different immunohistochemical profiles of endometrioid and nonendometrioid carcinomas confirm different molecular pathways in their development. The correlation of immunohistochemical findings with histological grade and clinical stage could help in predicting biologic behavior and planning treatment in patients who are diagnosed as having these tumors. 2 Sinisa Maksimovic et al.: Expression of Estrogen Receptors (ER) and P53 in Endometrial Carcinoma and Correlated with of Histological Type, Grade and Stage

BACKGROUND Vesicovaginal fistulas (VVF) are rare. In developed countries, the majority of vesicovaginal fistulas occur after gynecological procedures such as total hysterectomies. OBJECTIVE The evaluation of successfulness of VVF surgical repairs with transvesical, transvaginal and transabdominal approach with omental flap in 30 patients. METHODS This is a retrospective study of patients suffering from VVF who were treated with transvesical, transvaginal and transabdominal approach with omental flap from July 2004 until December 2012. During that period, 30 patients with VVF underwent a surgical treatment at the Clinic of Urology, University Clinical Center of Banjaluka. Ten patients had previously taken radiotherapy due to cervical cancer and as a consequence of that VVF developed. In 19 patients, fistula occurred after total hysterectomy, and in one patient it occurred after the cesarean section. In six patients, primary surgical repair was performed by supravesical urinary diversion. The average size of fistula was 14 mm. RESULTS The primary repair of VVF was successful in 75.00% of patients (18/24). In six patients (25.00%), it was not successful, and they remained incontinent. The successfulness of primary repairs with transvaginal and transabdominal approach with the use of omental flap was 100%, and with transvesical approach, it was 68.42%. The secondary surgical repair was performed in the remaining five patients, and it was successful in two patients (40.00%), but cumulatively speaking, the successfulness was 83.33% (20/24). In the secondary repair, the successfulness of transvaginal approach was 50.00%, and of transvesical one, it was 33.33%. Three patients underwent the tertiary surgical repair and its successfulness was 0%, and the approaches were transvaginal in one patient, transvesical in another one, and combination of transvesical with additional stitches with transvaginal approach in the third patient. When the surgical repair was undertaken for the fourth time, the successfulness was 100%. In two patients, the approach was transabdominal with interposition of omental flap, and in one patient, the approach was transvaginal. When everything is taken into consideration, 23 out of 24 patients had a successful closure of fistula, and we lost track of one patient whose primary repair was unsuccessful. CONCLUSION The selective approach to the repair of VVF mostly depends on the surgeons skill and experience. The successfulness of the repair depends on the excision of the pathological tissue, the closure of fistula in a well vascularized tissue and on urine drainage.

www.onk.ns.ac.rs/Archive Vol 21, No. 3-4, December 2013 INTRODUCTION Lung cancer is one of the leading causes of death throughout the world. Approximately one million people, 850,000 men and 330,000 women, die of lung cancer per year (1). Despite some advances in the diagnosis and treatment of lung cancer in the last several decades, the prognosis of lung cancer remains poor. The overall 5-year survival rate of lung cancer is approximately 12.4% of all newly detected cases in the world, and <9% in developing countries (2, 3). The MMP family comprises 23 human enzymes that traditionally have long been associated with cancer invasion and metastasis because of their ability to degrade the extracellular matrix. However, recent studies have showed that the roles of MMPs in tumour development and metastasis are much more complex than was originally envisioned. In vitro and animal studies have demonstrated that MMPs are also the key mediators of growth factor activation, bioavailability and receptor signalling, cell adhesion and motility, apoptosis and survival mechanisms, angiogenesis, and inflammatory responses and immune surveillance (4). Matrix metalloproteinases (MMP) are the group of enzymes responsible for degradation of certain extracellular matrix proteins such as collagen, proteoglycan, elastin, laminin and fibronectin. Malignant diseases are accompanied with higher expression of matrix metalloproteinases and lower concentrations of the tissue inhibitors of matrix metalloproteinases (TIMP), also resulting in an increased proteolytic activity. The presence of matrix metalloproteinases was discovered on the surface of invasive tumor cells (5). Degradation of the basal membrane and extracellular matrix presents the key step in the process of intravasation and extravasation of tumor cells (6). MMP-9 belongs to the gelatinases group, synthesized by keratinocytes, monocytes, alveolar macrophages, polymorphonuclear neutrophil granulocytes, and in many cancer cells. Tumor invasion is a multi-phase process in which the cell motility is associated with controlled proteolysis and includes interaction between tumor cells and extracellular matrix. During the invasion process, malignant tumor cells are detached from the primary tumor, migrate through structural barriers such as the basal membrane and surrounding extracellular matrix rich in collagen. Degradation of the stromal extracellular matrix is also considered one of the key steps in the process of tumor angiogenesis (7). It has been proved that the activity of matrix metalloproteinases is necessary for increased motility of epithelial cells, as well as for the growth of metastatic deposits. Research has confirmed that MMP-2 and MMP-9 have an exceptionally significant role in metastasizing, due to their ability to degrade type IV The prognostic value of mmp-9 expression in lung adenocarcinoma