TGF-ß1 expression in chromophobe renal cell carcinoma and renal oncocytoma.

Distinguishing renal oncocytoma (RO) from the eosinophilic variant of chromophobe renal cell carcinoma (ChRCC) under the light microscope is a common diagnostic problem. Our recent research has shown significant difference between the presence of tumor fibrous capsule in ChRCCs and ROs. Transforming growth factor beta 1 (TGF-ß1) is a potent cytokine involved in regulating a number of cellular processes. Two main purposes of this research were to investigate whether the TGF-ß1 staining could be related to the presence of tumor fibrous capsule and if it could be used in the differential diagnosis between ChRCC and RO. We investigated 34 cases: 16 ChRCCs (8 eosinophilic and 8 classic) and 18 ROs. All available slides of each tumor, routinely stained with hematoxylin and eosin (H&E) were first analyzed to note the presence of tumor fibrous capsule. One paraffin embedded tissue block matching the representative H&E slide was selected for the immunohistochemical analysis. TGF-ß1 expression was analyzed semiquantitatively in the tumor tissue, the tumor fibrous capsule, if present and the peritumoral renal parenchyma. Intensity of TGF-ß1 expression was weaker in ChRCCs than the one observed in ROs (P<0.05). The type of reaction in ChRCCs was predominantly membranous unlike in ROs, which exhibited a predominantly cytoplasmic reaction (P<0.05). Moreover, none of the ROs showed membranous type of reaction for TGF-ß1. In the group of ChRCCs, tumors with capsule had statistically significant higher quantity of TGF-ß1 expression in tumor tissue and in peritumoral renal parenchyma compared to the tumors without capsule (P<0.05). Our results showed different types of TGF-ß1 expression in ChRCCs and ROs: ChRCCs had predominantly membranous type of reaction, and ROs predominantly cytoplasmic. Furthermore, ChRCCs with capsule had statistically significant higher quantity of TGF-ß1 expression in tumor tissue and in peritumoral renal parenchyma compared to the tumors without capsule. Based on these findings we can speculate that it could be possible that TGF-ß1 plays a role in the formation of fibrous capsule in ChRCCs.

[Hemipelvectomy due to blast injuries: possibilities of occupational rehabilitation]. / Hemipelvektomija nakon eksplozivnog ranjavanja: mogucnosti radne rehabilitacije.

A case of traumatic hemipelvectomy due to explosion of an antitank shell in a 21-year-old Croatian Army soldier is described. Explosion was due to inadvertent handling of the shell in the army barracks. Literature data on persons who survived traumatic hemipelvectomy are extremely scarce; the injury is characterized by a very high death rate (60-100%). After prompt surgical treatment the patient developed a postoperative anaerobic clostridial infection. Owing to intensive clinical and physical therapy the patient was enabled for moving around in a special wheel-chair and walking with the help of crutches and a prosthesis. He was also enrolled in a training course in computer use. Continual physical therapy and psychotherapy were essential because of a high degree of disablement. Making the patient self-sufficient, fit for work and finding him an appropriate job is considered to be the responsibility not only of the professional medical team but also of joint efforts on the part of competent state ministries, Ministry of Defence, Ministry of Labour and Social Welfare, State Pension and Insurance Fund and Ministry of Education, Culture and Sports.

[A team approach in unemployed persons with psychosomatic disorders]. / Timski pristup nezaposlenim osobama s psihosomatskim teskocama.

A survey was conducted among persons with the health disorders considered to be aggravating factors in finding employment, who were on the list of the unemployed registered with a regional employment bureau. In 1994/1995 forty persons were selected and examined by a vocational guidance team. The team included a psychologist, a pedagogue, an occupational health specialist, a legal advisor and the employment bureau officer. The criteria were based on the health disorders that are contraindicative for an occupation, on the length of unemployment, time of onset of disease or disability, social status, satisfactory residual work capacity for another occupation, job opportunity and on the person's motivation for work, retraining, earning additional qualifications or for schooling. Results demonstrate that investing in vocational guidance is justified if negative selection as well as a futile loss of time, money and effort spent on schooling are to be avoided. The programme of retraining, additional training and finding an occupation in accordance with one's residual work capacity continues to be applicable only in the case of a newly diagnosed disease, newly inflicted injury or wound as well as a useful and humane method in the work of employment bureaus and vocational guidance teams.

[The ergonomic approach to vocational guidance and selection]. / Ergonomski pristup u profesionalnoj orijentaciji i selekciji.

The paper deals with the results of health examinations of elementary school children--eight graders carried out within the programme of vocational guidance in an area of Croatia (the period 1991-1993). The expert's evaluation showed that out of a total of 1983 pupils examined 855 had health disturbances or functional impairments that required properly oriented further vocational training. Advice concerning the choice of school was based on the anticipated requirements and ergonomic characteristics of the pupils future job and their psychophysical abilities. Proper vocational guidance avoids the need for later selection, which is always a complicated problem. This is illustrated by two documented examples.

[Respiratory function in female workers occupationally exposed to acid air pollution]. / Respiratorna funkcija radnica profesionalno izlozenih kiselim oneciscenjima zraka.

Prevalence of respiratory symptoms and ventilatory capacity were studied in 117 female workers exposed to acid fumes and aerosols in pickling industry. Similar prevalence of respiratory symptoms was recorded in three working groups: a) pickling; b) mustard making; c) packing. Significantly higher prevalences of chronic cough (p < 0.05), chest tightness, nasal catarrh and sinusitis (p < 0.01) were found in pickling workers in relation to controls. In all three exposed groups there was a high prevalence of acute symptoms during work shift. Measured FEV1, FEF50 and FEF25 were significantly decreased in comparison to predicted normal values. Pickling workers exposed for more than one year demonstrated significantly larger acute reductions during work shift than those with shorter exposure. Our data suggest that long term exposure to acid fumes and aerosols in industrial environment may cause the development of acute and/or chronic respiratory symptoms and lung function changes.