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Ljiljana Tadić-Latinović, Ž. Eri, D. Jović, Aleksandra Salapura, J. Ćulum, B. Jakovljević, I. Baroš, S. Marić

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

S. Miličević, Radojka Bijelić, B. Jakovljević

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.

S. Miličević, Radojka Bijelić, B. Jakovljević

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.

S. Miličević, Radojka Bijelić, B. Jakovljević, M. Krivokuća, Vladimir Krivokuća

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.

Ljiljana Tadić-Latinović, Aleksandra Salapura-Dugonjic, Ž. Eri, S. Knežević-Ušaj, Milana Panjković, L. Amidžić, I. Baroš, B. Jakovljević

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