Influence of PVB Interlayer Mechanical Properties on Laminated Glass Elements Design in Dependence of Real Time-Temperature Changes.

Most used laminated glass is composed of float glass plies bonded together with a viscoelastic Polyvinyl Butyral (PVB) interlayer. The shear stiffness of the polymeric interlayer is the key factor in the behavior of laminated glass. Structural engineers in the past were designing laminated glass regardless of the shear coupling of the plies. This approach with a high level of reliability led to expensive laminated glass structures due to insufficient knowledge of foil properties. Most of the current standards suggest methods that consider the shear coupling of the plies. This paper presents the experimental data from a static loading test performed on a laminated glass panel exposed to changing temperatures. The deformations were observed for 48 h. The measured results were compared with the known analytical design approaches and in addition with the finite element modeling (FEM) analysis in the available software for laminated glass design. A simplified design approach that simulates foil behavior in dependence on load duration and temperature change was adopted in this study. Design approaches that use effective thickness calculations are used with the Young and shear relaxation modulus provided by the foil producer. The imprecision of the Eurocode standards for glass design, and the propensity to change the approach to the calculation by introducing more precise parameters were expounded. The results when combining the time-temperature superposition (TTS) and the Wölfel-Bennison approach were found to be in very good agreement with the FEM analysis of 3D solid elements in Abaqus and measured data.

Expression of proinflammatory cytokine interleukin-6 in tissue samples of human prostate obtained by needle biopsy.

Interleukin-6 (IL-6) has been associated with the development of prostate cancer. The aim of the study was to clarify whether IL-6 expression in prostate tissue could be a useful marker in differentiation of prostate diseases in small foci by pathologist visual scoring. Archival paraffin-embedded specimens of benign prostate hyperplasia (BPH), high-grade prostatic intraepithelial neoplasia (PIN), prostatitis and prostate adenocarcinoma were studied by immunohistochemistry with a mouse monoclonal antibody IL-6 using the streptavidin-biotin method. Significantly, lower IL-6 immunoreactivity was observed in normal epithelial cells (p=0.000) and basal cells (p=0.000) in the samples of prostate adenocarcinoma in comparison to the samples with BPH, PIN and prostatitis. There was no significant difference in IL-6 expression in malignant and premalignant cells (p=0.814) as well as in stromal cells among the four diagnoses (p=0.22). IL-6 was expressed in normal epithelial cells, premalignant epithelial cells and malignant epithelial cells as well as in stromal cells. However, in our research IL-6 was of limited utility as a single marker for differential diagnosis of the prostate diseases in small foci needle biopsy by pathologist visual scoring. The standardization of immunohistochemical (IHC) staining protocol for IL-6 is required to determine IL-6 expression in order to avoid possible misinterpretation of the IHC results.

Association of IL-1ß and IL-10 Polymorphisms with Prostate Cancer Risk and Grade of Disease in Eastern Croatian Population.

Single nucleotide polymorphisms (SNPs) in the promotor regions of cytokine genes included in angiogenesis may influence prostate cancer (PCa) development via regulation of the pathways of tumor angiogenesis. The aim of the present study was to investigate the association of IL-1 female +3954 (rs1143634) and IL-10-1082 (rs1800896) polymorphisms with PCa risk and aggressiveness in eastern Croatian patients. One hundred twenty PCa patients and 120 benign prostatic hyperplasia (BPH) controls were genotyped using real-time PCR (LightCycler Instrument, Roche Diagnostics) and the melting curve analysis method. There was no significant difference in the frequency of genotypes for the two polymorphisms between PCa patients and controls (Χ2 = 0.857, p = 0.355 for IL-female 1; Χ2 = 0.026, p = 0.872 for IL-10). Carriers of the IL-10-1082A>G variant were found to be associated with the Gleason score (GS) > 7 (AA versus GA+GG, OR = 3.47, 95% CI 1.11-10.88, p = 0.033). There was no significant difference in the frequency of genotypes for the two polymorphisms and the presence of metastatic disease in PCa patients. These results suggest that tested SNPs associated with differential production of IL-1 female and IL-10 are not risk factors for PCa and do not correlate with the presence of distant metastasis in eastern Croatians. We found that IL-10-1082 GA+/or GG carriers have a higher risk of developing PCa with GS > 7 in eastern Croatians.

Association study of cytochrome P450 1A1*2A polymorphism with prostate cancer risk and aggressiveness in Croatians.

Cytochrome P450 1A1 (CYP1A1) is an enzyme participating in the bioactivation of various endogenous and environmental reactive compounds that can bind to DNA and thus induce cancerogenesis. Gene encoding the enzyme is expressed in the prostate tissue and is polymorphic. CYP1A1*2A gene polymorphism is associated with elevated enzyme activity and/or inducibility which can lead to accumulation of genotoxic compounds and consequently to cancerogenesis. We examined the association of this polymorphism with prostate cancer (PCa) risk and aggressiveness. The case-control study consisted of 120 PCa patients and 120 benign prostatic hyperplasia (BPH) controls, in Croatian population. Regarding aggressiveness, PCa patients were grouped according to the Gleason score (GS), tumor stage (T) and existence of distant metastasis (M). The polymorphism was analyzed using real-time polymerase chain reaction (PCR). We did not observe association of mutated allele with PCa risk, neither with PCa aggressiveness. Furthermore, frequency of polymorphic genotype was slightly higher in BPH group (16.6% vs. 14.2%, respectively) and also in less aggressive form of PCa (20.4% vs. 9.6% for GS < 7; 15.6% vs. 9.1% for T < 3; 16.7% vs. 10.0% for no distant metastasis). Comparing our findings with other published results, we can assume that the ethnicity influence the genotype distribution and thus may affect the etiology of PCa, even possibly in the way to cause an opposite effect among different ethnic groups. Given the small number of participants, results should be validated on the larger sample size.

Comparison between clinical significance of serum proinflammatory protein interleukin-6 and classic tumor markers total PSA, free PSA and free/total PSA prior to prostate biopsy.

The aim of the study was to clarify whether serum levels of proinflammatory cytokine interleukin-6 (IL-6) could be a useful marker in prostate diseases. Serum IL-6 was determined prior to prostate biopsy procedure in 82 patients with prostate adenocarcinoma (PCa), 25 patients with benign prostatic hyperplasia (BPH), 24 patients with high-grade prostatic intraepithelial neoplasia (PIN) and 17 patients with chronic prostatitis. Serum IL-6 levels were compared with total PSA (tPSA), free PSA (fPSA) and the free/total ratio (f/tPSA) serum levels. Statistically significant difference was not found in serum IL-6 levels among the four groups (p = 0.088). However, the patients with poorly differentiated PCa with Gleason score (GS) 4 + 3 = 7 and > 7 had significantly higher serum IL-6 levels than the patients with moderately differentiated PCa with GS 3 + 4 = 7 and < 7 (p = 0.007). The findings suggest that serum IL-6 level might be a potentially useful marker for poorly differentiated PCa.

Interleukin-6 polymorphism and prostate cancer risk in population of Eastern Croatia.

Recent studies suggest that chronic inflammation is crucial in the development and progression of prostate cancer (CaP). Interleukin-6 (IL-6) is a proinflammatory cytokine that plays an important role in intraprostatic inflammation and thus carcinogenesis. The -174G > C polymorphism of IL-6 gene has been associated with high IL-6 producer phenotype and an increased risk for CaP. The aim of this study was to evaluate the association between the mentioned IL-6 polymorphism and CaP risk, as well as to compare the genotype frequency between the different tumour grades of CaP, in population of Eastern Croatia. We analyzed the IL-6 polymorphism in 120 CaP patients and 120 controls with benign prostatic hyperplasia (BPH). CaP patients and BPH controls did not statistically differ in studied IL-6 polymorphism. Furthermore, high IL-6 producer genotypes (GG or GC) were more frequent in controls than in CaP group (86.7% vs 80.8%, respectively, p = 0.147). Also, no statistically significant difference in IL-6 high and low producer genotype frequency was noticed between well, moderately and poorly differentiated tumours. Our results, taken together with other studies on the subject, suggest that IL-6 - 174 single nucleotide polymorphism (SNP) distribution may differ between various ethnic groups and that a single cytokine gene polymorphism has probably just a minor effect on CaP susceptibility. Further studies should be performed to clarify the link between SNPs of different cytokines and the risk for CaP.

Lack of association between TNF-alpha promoter polymorphism and prostate carcinoma susceptibility in eastern Croatian population.

A single nuclear polymorphisms (SNPs) in the promoter region of the tumor necrosis factor-alpha (TNF-alpha) gene are involved in regulation of expression levels of TNF-alpha and therefore are associated with oncogenesis of several cancers. Aim of our study was to investigate the effect of G--->A polymorphism at -308 position in the promoter region of the TNF-alpha gene on prostate cancer (CalphaP) susceptibility in a subset of patients from Eastern Croatia. Study population consisted of 240 patients (120 with CalphaP, 120 controls). They were genotyped for TNF-alpha G-308A polymorphism using real-time PCR (LightCycler Instrument, Roche Diagnostics) and melting curve analysis method. X(2) test was used to compare distribution of TNF-alpha polymorphism genotypes between patients and control group. Relative risk was estimated by the odds ratio (OR). There was no significant statistical difference (X(2)=0.000, DF=1, p=1, OR=1, 95%CI=0.5537-1.8059) between patients and control group. Besides, data of CalphaP patients were stratified according to pathohistological diagnosis (PHD) by Gleason score and groups were compared according to TNF-alpha genotypes. Also, all patients and CalphaP patients were grouped according to prostate volume (V) into three groups: V<50 mL, V50-100 mL, V>100 mL. These groups were also compared according to TNF-alpha genotypes. There were no significant statistical differences between any of groups. Our findings suggest that TNF-alpha -308 SNP is not associated with CalphaP in Eastern Croatia population.

[Clinical guidelines for diagnosing, treatment and monitoring patients with testicular cancer--Croatian Oncology Society and Croatian Urology Society, Croatian Medical Association]. / Klinicke upute za dijagnostiku, lijecenje i pracenje bolesnika oboljelih od raka testisa Hrvatskoga Onkoloskog Drustva i Hrvatskoga Uroloskog Drustva Hrvatskoga Lijecnickog Zbora.

Testicular tumors are the most common solid tumors in men between 15 and 34 years of age. The worldwide incidence of these tumors has doubled in the past 40 years. Germ cell tumors comprise 95% of malignant tumors arising in the testes and they are classified either as seminoma or nonseminoma. Testicular cancers have a high cure rates even in disseminated stage of the disease. The chemotherapy mostly contributed to these results but surgery is an inevitable part of successful treatment. In a significant number of these patients treatment algorithms with minimum side effects are designed with the intention to maintain same cure rates as previously used, more aggressive therapy. The following text presents the clinical guidelines in order to standardize the procedures and criteria for diagnosis, management, treatment and follow-up of patients with testicular cancer in Republic of Croatia.

Extracorporeal shockwave lithotripsy in elderly: impact of age and comorbidity on stone-free rate and complications.

INTRODUCTION: The aim of this study was to investigate and compare the success and complication rates of extracorporeal shockwave lithotripsy (SWL) in three cohorts of patients older than 60 years. PATIENTS AND METHODS: Our study included 444 patients older than 60 years who were treated with SWL between May 2001 and May 2008 at the Croatian Referential Center for Urolythiasis in Osijek. Three groups were formed: group I (60-65 years old), group II (66-70), and group III (> 70). There were 175, 151, and 118 patients in groups I, II, and III, respectively, with a mean age of 67.7 ± 5.4 years for all patients. Demographic data, comorbidities, kidney function, stone characteristics, treatment details, complications, and stone-free rate (SFR) were analyzed. RESULTS: We performed 1.7 ± 1.12 sessions per patient, with 3166 ± 571.3 impulses per session and a mean energy of 18.78 ± 0.64 kV. Three groups did not differ in number of SWL sessions (p = 0.78), number of impulses (p = 0.34), energy level (p = 0.5), stone size (p = 0.3), and pretreatment creatinine level (p = 0.88). Comorbidities were found in 55% of patients, with almost every third patient having two or more ones present. Complications were noted in 6% of patients, with no significant difference when comparing complication rates between the groups. An overall SFR of 67.98% was found. There was no statistically significant difference when comparing SFRs between the studied groups, even after dividing patients into those with renal and ureteral stones. CONCLUSION: Our study shows that good SFR and low rate of complications can be achieved with proper patient selection for SWL, regardless of patients' age and comorbidities.

Association of nephrolithiasis and gene for glucose transporter type 9 (SLC2A9): study of 145 patients.

AIM: To investigate the association of nephrolithiasis and solute carrier family 2, facilitated glucose transporter, member 9 (SLC2A9), also known as glucose transporter type 9, Glut9. METHODS: A total of 145 participants were recruited in the period April-October 2008 from the Department of Mineral Research of the Medical School Osijek, Osijek, Croatia; 58 (40%) had confirmed nephrolithiasis and 87 (60%) were asymptomatic. Four single nucleotide polymorphisms (SNP) from the SLC2A9 gene were genotyped in both groups (rs733175, rs6449213, rs1014290, and rs737267). RESULTS: There was a weak but significant association of all 4 SNPs and nephrolithiasis (P=0.029 for rs733175; P=0.006 for rs6449213; P=0.020 for rs1014290, and P=0.011 for rs737267). Logistic regression in an age- and sex-adjusted model suggested that genotype C/T for rs6449213 had odds ratio for nephrolithiasis of 2.89 (95% confidence interval 1.13-7.40). This SNP explained a total of 4.4% of nephrolithiasis variance. CONCLUSION: Development of nephrolithiasis may be associated with SLC2A9 gene. Further studies are needed to clarify the role of SLC2A9 gene as a link between uric acid and nephrolithiasis.

Oral acanthosis nigricans: case report and comparison with literature reports.

Acanthosis nigricans (AN) is a rare condition which may affect oral cavity. There are two forms of AN: benign and malignant. Benign AN may be hereditary, or may be related to systemic diseases or drugs. Malignant AN is most often associated with gastric adenocarcinoma but cancers of other sites and types may also occur. This case report is based on a case of a 78-year-old woman suffering from invasive bladder papillary transitional cell carcinoma accompanied by extensive papillomatous areas of normal mucosal color and soft consistency involving the lips, buccal mucosa and hard palate. Verrucous changes with tiny pigmented macules were also found on the skin of the right ear auricle. Oral lesions occurred after the tumor had been diagnosed, i.e. after third operation for tumor recurrence. The fifth operation for tumor recurrence resulted in slight improvement of oral changes. It is concluded that the severity of oral changes is in correlation with tumor progression. The occurrence of oral lesions may be an indicator of tumor progression.

Prostate disease prevalence with epidemiological and hormonal analysis in randomly selected male population in Croatia.

The objective of our study was to investigate the prevalence of prostate disease in general male population. Also, an extended analysis of medical history, behavior and hormonal analysis was performed. 1000 candidates were randomly selected out of voluntary male population. 977 of those were included in the study, and 23 were rejected because of incomplete data, unwillingness to be subjected to examination and other reasons. Blood samples were taken from all participants, and a questionnaire and physical examination (with rectal exam) were performed. Based on the results, answers and the examination all participants were divided in four groups. The prevalence of benign prostate hyperplasia was 23.1%, of prostatitis 5.1% and of prostate cancer 3.7%, which is within expected reported values. Family history data provided little specific data. Significant lower urinary tract symptoms were found in both subjects with benign prostate hyperplasia and prostatitis, showing a strong overlap of symptoms. The results indicate that alcohol abuse is strongly related to subjects with prostate cancer, although this relation is not confirmed by all authors. On the hormonal scale we found higher levels of binned testosterone in our subjects with prostate cancer, what is disproved by some authors. Estrogen is found in higher levels and recent reports are showing higher levels of estrogen metabolites in prostate cancer subjects. Also we found lower levels of vitamin D in subjects with benign prostate hyperplasia and prostate cancer. Since vitamin D is known to inhibit cellular proliferation, lower levels are confirmatory, with its loss of protective role against prostate cancer. Our results suggest that male population in Croatia (at least in Slavonia) with prostate diseases is, with all findings taken into account, within limits as compared to populations in developed European countries, but on a lower border. Since the prevalence of investigated diseases is rising throughout Europe we could expect the same trends in our country.

Serum concentration of nine hormones in aging male population and association with potency and libido problems.

Aim was to determine if a serum levels of free testosterone and selected eight hormones are in correlation with potency and libido problems in aging male. Male population older then 45 years of two Slavonian villages was called for voluntary examination. Every patient filled a questionnaire concerning medical history, operations and potency and libido problems. Based on answers we formed six groups of patients, but only three were analyzed further. Population with potency and libido problems is on average older. In group of patients with normal potency and libido (PNLN group) average levels of free testosterone are 46.01 pmol/L, LH 4.62 IU/L and FSH 6.20 IU/L. In group of patients with mild-damaged potency and normal libido (PMLN group) average levels of free testosterone are 44.61 pmol/L, LH 6.19 IU/L and FSH 8.18 IU/L. In PALA group of patients with absent potency and libido (PALA group) average levels of free testosterone are 41,89 pmol/L, LH 8.07 IU/L and FSH 11.27 IU/L. Significant higher levels of FSH and LH were found compared with the control group (for FSH p<0.001 and p < 0.003, and for LH p <0.003 and p < 0.021). No significant difference in serum levels of free or binned testosterone were found between three groups. Even if average serum levels of free testosterone is found lower in patients with libido and potency problems, this difference is not significant and testosterone deficiency itself can not explain potency and libido problems in aging male.

The results after transrectal prostate biopsy with 12 biopsy cores taken.

This report describes the clinical value of transrectal prostate biopsy during which 12 biopsy cores are taken in comparison to the classical sextant method. There were 106 patients included in the study, who had transrectal prostate biopsy (TRB) due to abnormal finding after digitorectal examination (DRE) and/or values of PSA > 4 ng/ml in the period from 4 October 2001 till 14 August 2002. There were 117 biopsies with 12 biopsy cores taken, 6 cores from each lobe. Prostate cancer was confirmed in 49 patients (46%). Out of total number of confirmed cancer cases, initial biopsy detected 94%. There were three patients who had suspicious DRE finding, with PSA value of < 4 ng/ml, but cancer was not detected in any of them. In the patient group with PSA value between 4-10 ng/ml, cancer was detected in 26% of them and in the group with PSA value > 10 ng/ml cancer was detected in 58%. The most common Gleason score in the case of cancer was 7 (43%). During the biopsy procedure, 3 patients experienced strong vasovagal reactions, meaning that out of 117 biopsies incidence of complications was 2.6%. Few days after the biopsy, two patients developed urogenital tract infections (1.7%) and right after the procedure, there was one case of strong hematuria (0.8%) and strong rectal bleeding (0,8%) that needed hospitalization. Our results regarding the incidence of complications do not differ much from the results in the literature. According to data in the literature regarding sextant biopsy, 15-34% of cancer cases remain undiagnosed at initial biopsy. The method of 12 biopsy cores fails to diagnose only 6% of all cancers, but it is important to note that in the mentioned period, re-biopsy was indicated only in 11 from 60 patients with negative biopsies.

Acute abdomen as first symptom of acute leukemia.

CASE REPORT: The authors presented a rare case of acute abdomen syndrome caused by the rupture of the corpus rubrum as the first symptom in a 35-years-old woman with the acute lymphatic leukemia. During the laparotomy is notice diffuse bleeding from under skin blood vessels and muscles. The blood was electrocoagulated and was sewn with catgut sutures. The right ruptured corpus rubrum was found from which fresh blood was leaking. The right ovary was carefully resected and sutured, and each ligature was bleeding. At the beginning of the surgery laboratory analysis results arrived which showed a high leukocytosis (28.0 x 10(9)/l) with sever thrombocytopenia (10 x 10(9)/l) and afibrinogenemia (0.1 g/l) with anemia (1.9 x 10(12)/l erythrocyte, haematocrit 0.24), which indicated leukemia with disseminated intravascular coagulopathy (antithrombin III levels 0.9 g/l, D-dimers 1989 micro g/l). RESULT. A year later she died with the picture of severe disseminated intravascular coagulopathy, agranulocytosis and septic condition with multiorganic failure.

Role of screening in detection of clinically localized prostate cancer.

The aim of this study was to confirm the role of screening by determining the percentage of clinically localized prostate cancer (stage A and B) in patients with prostate cancer detected on screening and in those presenting to urologic clinic for the symptoms of urination impairment or ostalgia. During the study, 1,000 men aged > or = 50 from the community of Cepin and village of Josipovac near Osijek were examined. The subjects with elevated concentration of total prostate specific antigen and/or digital rectal examination suspect of carcinoma underwent transperineal biopsy of the prostate. Clinical staging was performed in patients with prostate cancer detected on screening, and data on clinical staging for prostate cancer patients treated during the 1996-1997 period were retrieved from patient files of the Department of Urology, University Hospital "Osijek". On screening, 28 (80%) patients with localized prostate cancer and seven (20%) patients with metastases were detected. In the group of patients examined on an outpatient basis for the signs and symptoms of prostatism, there were 30 (83.4%) patients with metastases and only six (16.6%) patients with localized prostate cancer. Study results indicated that an early diagnosis of prostate cancer could be made by use of noninvasive and inexpensive methods that cause no major discomfort to the patient. Accordingly, these results appear to strongly support such screening in men, if not in all those aged over 50, then at least in the otherwise healthy, 50-70 age group.

Comparison of digital rectal examination and prostate specific antigen in early detection of prostate cancer.

This study compares the value of digital rectal examination (DRE) and prostate specific antigen (PSA) determination in the detection of prostate cancer. 1,000 men aged > or = 50 from the Osijek surroundings were examined. The subjects with prostatitis were excluded from the study. The subjects with elevated concentration of total prostate specific antigen and/or digital rectal examination suspect of carcinoma underwent prostate biopsy. The rate of prostate cancer detection showed to be 3.3% for PSA > 4 ng/ml, 2% for abnormal finding of DRE, and 3.7% for combination of the two methods. Out of 35 patients with prostate cancer detected, 19 had suspect DRE finding and 32 had PSA exceeding 4 ng/ml. Thus, PSA pointed to the diagnosis of prostate cancer in 91.4%, and abnormal finding of DRE in 54.2% of cases, the difference being statistically significant. The positive predictive value was 48.7% for abnormal finding of DRE, 47% for PSA > 4 ng/ml, and 80.0% for the combination of both. Although PSA determination detected a considerable proportion of tumors missed on DRE, the former alone was found to be insufficient as a screening method because of its inadequate sensitivity. When combined with digital rectal examination, the probability of prostate cancer detection increased considerably.

Bone mineral density loss in patients with urolithiasis: a follow-up study.

BACKGROUND: Recurrent calcium urolithiasis is often associated with disorders of calcium metabolism. The purpose of this investigation was to assess bone mineral content (BMC) and bone mineral density (BMD) over a period of 1 year in patients with urolithiasis and to determine the factors that could have influenced the changes in bone density during that period. METHODS: The patient group comprised 34 men aged 41.2 plus minus 7.9 years with recurrent urolithiasis. A wide spectrum of biochemical measurements was performed. Bone mineral density (g/cm(2)), bone mineral content (BMC), and bone area (BA) were measured twice during a period of 1 year at the lumbar spine (L2-L4), femoral neck, Ward triangle, and trochanter, using dual energy absorptiometry. Patient results were compared to those obtained from 30 healthy male controls of a comparable age group. RESULTS: Nine patients were hypercalciuric, while the majority of the remaining metabolic parameters were within the reference values. Bone mineral content and bone areas at all regions were lower in patients comparing to controls, but not significantly. The greatest annual reduction of BMD was noticed at Ward triangle (-5.70% in patients and -2.36% in controls), followed by femoral neck (-4.06% patients, -2.03% controls) and trochanter (-3.06% patients, -1.39% controls). There was no significant decrease of the BMD of the spine. Analyzing the influence of age, body mass index (BMI), metabolic parameters, and dietary calcium intake on the annual reduction of bone density, we found that age, hyperuricosuria, and calcium intake were significantly associated with bone loss in that time period. CONCLUSIONS: Bone mass reduction in patients with urolithiasis over a 1-year period did not differ significantly from that in controls and was principally related to age, hyperuricosuria, and calcium dietary restriction but not to increased calcium excretion.