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    Miljenko Bura

    In the last 3 years tumour antigens (TA) and immune complexes (IC) were examined in 33 respectively 83 patients with cancer of the larynx. These tests were repeated several times during treatment and during the checking period. Tumour... more
    In the last 3 years tumour antigens (TA) and immune complexes (IC) were examined in 33 respectively 83 patients with cancer of the larynx. These tests were repeated several times during treatment and during the checking period. Tumour antigens were prepared from squamous cell carcinoma of the larynx using a modification of the methods by Bloom et al. and Halliday. Immune complexes in the serum were determined by the polyethylene glycol (PEG) test. In some cases the sensitivity to antigen was changed during the observation period. Constantly elevated immune complexes speaks in favour of recurrence in most of our cases.
    Rad predstavlja marketinsku strategiju i akcijski plan razvoja zdravstvenog turizma na podrucju grada Buzeta.
    P53 je tumor supresorski gen koji ima znacajnu ulogu u patogenezi mnogih vrsta karcinoma u ljudi ukljucujuci glavu i vrat. Mutirani p53 protein može se otkriti rutinskim imunohistokemijskim tehnikama. Invertni papilom nosa i sinusa... more
    P53 je tumor supresorski gen koji ima znacajnu ulogu u patogenezi mnogih vrsta karcinoma u ljudi ukljucujuci glavu i vrat. Mutirani p53 protein može se otkriti rutinskim imunohistokemijskim tehnikama. Invertni papilom nosa i sinusa rijedak je benigni tumor koji cini 0, 5-4% svih primarnih tumora nosa. Uoceno je da ima izrazitu sklonost recidiviranju koja se u literaturi krece između 13-70%, te znacajnu povezanost s karcinomom. Ucestalost karcinoma udruženog s invertnim papilomom je 10-20% i može se ocitovati kao sinhroni karcinom koji je prisutan u trenutku inicijalne dijagnoze invertnog papiloma ili se karcinom razvija naknadno na mjestu gdje je prethodno odstranjen invertni papilom (metakroni karcinom). Cilj ovoga rada bio je analizirati prisutnost p53 mutacije u invertnom papilomu i udruženost s malignitetom. Analizirali smo 39 uzoraka invertnog papiloma od 31 bolesnika s inverinim papilornom. Klinicki podaci pokazuju da je invertni papilom bio cesci u muskaraca i to najcesce u 6...
    Cancer of unknown primary (CUP) site comprises very heterogeneous group of various malignant tumors presented in metastatic phase of the disease. Diagnosis is set when primary site remains unidentified after a thorough diagnostic... more
    Cancer of unknown primary (CUP) site comprises very heterogeneous group of various malignant tumors presented in metastatic phase of the disease. Diagnosis is set when primary site remains unidentified after a thorough diagnostic evaluation in patients with histologically proven malignant metastatic disease. Despite poor prognosis in most patients, favorable prognostic clinical entities have been recognized constituting the most important group of patients for oncological treatment. The following text presents the clinical guidelines in order to standardize the diagnosis, treatment and follow-up of patients with cancer of unknown primary site in the Republic of Croatia.
    Invertni papilom, rijedak je benigni, lokalno agresivni epitelni tumor nosa i paranazalnih sinusa sa znacajnom sklonoscu recidiviranju i malignoj transformaciji. U radu je prikazan 31 slucaj invertnog papiloma lijecenih od 1982. do 1999.... more
    Invertni papilom, rijedak je benigni, lokalno agresivni epitelni tumor nosa i paranazalnih sinusa sa znacajnom sklonoscu recidiviranju i malignoj transformaciji. U radu je prikazan 31 slucaj invertnog papiloma lijecenih od 1982. do 1999. godine. Komparirali smo nase rezultate s rezultatima drugih autora i to obzirom na kirursko lijecenje (konzervativna kirurgija u vecini slucajeva kao inicijalni tretman i funkcionalna endoskopska kirurgija sinusa kao novija metoda lijecenja). U pregledu literature narocita je pozornost posvecena analizi recidiva s obzirom na kirursko lijecenje, zatim malignoj transformaciji, p53 ekspresiji, HPV i Epstein-Barr virus infekcijama, te apoptozi povezanoj s invertnim papilomom.
    The harmonic scalpel cuts and coagulates simultaneously using a mechanical vibration. The present article reports our experience in the use of this instrument. Over a period of 5 months, we performed 123 thyroidectomies, 13... more
    The harmonic scalpel cuts and coagulates simultaneously using a mechanical vibration. The present article reports our experience in the use of this instrument. Over a period of 5 months, we performed 123 thyroidectomies, 13 parotidectomies and 25 tonsillectomies using the harmonic scalpel. 106 thyroidectomies, 9 parotidectomies and 30 tonsillectomies were performed with the use of conventional hemostatic techniques (electrocautery and knot tying). The use of harmonic scalpel shortened the duration of thyroid and parotid surgery by 20-30% as compared with the conventional techniques. The average incision length for those undergoing thyroidectomy with the harmonic scalpel was 1.5 cm shorter compared with the conventional thyroidectomy group. The use of harmonic scalpel shortened the average duration of tonsillectomy by 5.5 minutes. Postoperative pain and complication rate were comparable for both groups. The use of the harmonic scalpel reduces surgical time and intraoperative blood lo...
    Presentation is made of 2 boys and a girl with fibrous dysplasia involving the frontal and ethmoidal sinuses and the maxilla. This tumor-like growth of the bone was not restricted to the sinus alone but expanded to the orbit, adjacent... more
    Presentation is made of 2 boys and a girl with fibrous dysplasia involving the frontal and ethmoidal sinuses and the maxilla. This tumor-like growth of the bone was not restricted to the sinus alone but expanded to the orbit, adjacent sinus, skull base and infratemporal or pterygoid fossa. In such cases, surgical therapy is the treatment of choice, with maximal preservation of healthy tissue and avoidance of major devastations that may result in undesired cosmetic defects. The etiology of the disease is still unknown. However, it should be emphasized that all 3 patients had suffered an injury to the adjacent bony structures at various time points preceding the disease manifestation. That is why we are inclined to believe that trauma might be a factor responsible for the onset of fibrous dysplasia.
    In the last 3 years tumour antigens (TA) and immune complexes (IC) were examined in 33 respectively 83 patients with cancer of the larynx. These tests were repeated several times during treatment and during the checking period. Tumour... more
    In the last 3 years tumour antigens (TA) and immune complexes (IC) were examined in 33 respectively 83 patients with cancer of the larynx. These tests were repeated several times during treatment and during the checking period. Tumour antigens were prepared from squamous cell carcinoma of the larynx using a modification of the methods by Bloom et al. and Halliday. Immune complexes in the serum were determined by the polyethylene glycol (PEG) test. In some cases the sensitivity to antigen was changed during the observation period. Constantly elevated immune complexes speaks in favour of recurrence in most of our cases.
    The aim of this study is to test the possible prognostic significance of p53 and Ki67 expression in inverted papilloma of the lateral nasal wall and adjacent sinuses regarding their malignant potential and recurrence. 49 biopsies of the... more
    The aim of this study is to test the possible prognostic significance of p53 and Ki67 expression in inverted papilloma of the lateral nasal wall and adjacent sinuses regarding their malignant potential and recurrence. 49 biopsies of the lateral nasal wall and adjacent sinuses obtained from 41 patients from three hospitals were investigated. Immunohistochemically demonstrated p53 and Ki67 expression was measured and statistically evaluated. p53 immunoreactivity was demonstrated in most of papillomas with carcinomas but only in two benign papillomas, while Ki67 demonstrated stronger immunoreactivity in carcinomas and surrounding epithelium. Immunohistochemical staining of inverted sinonasal papillomas for p53 and Ki67 can give useful information concerning the existence of synchronous carcinoma and, in case of high Ki67, a hint toward possible recurrence.
    The possibility that the stomach, affected by general stress, might initiate a counter-response has not until recently been considered in theories of stress. We suggest that the stomach, as the most sensitive part of the gastrointestinal... more
    The possibility that the stomach, affected by general stress, might initiate a counter-response has not until recently been considered in theories of stress. We suggest that the stomach, as the most sensitive part of the gastrointestinal tract and the largest neuroendocrine organ in the body, is crucial for the initiation of a full stress response against all noxious stress pathology. The end result would be a strong protection of all organs invaded by 'stress'. Consistent with this assumption, this coping response is best explained in terms of 'organoprotection'. Endogenous organoprotectors (eg prostaglandins, somatostatin, dopamine) are proposed as mediators. Such an endogenous counteraction could even be afforded by their suitable application. A new gastric juice peptide, M(r) 40,000, named BPC, was recently isolated. Herein, a 15 amino acid fragment (BPC 157), thought to be essential for its activity, has been fully characterized and investigated. As has been demonstrated for many organoprotective agents using different models of various tissue lesions, despite the poorly understood final mechanism, practically all organ systems appear to benefit from BPC activity. These effects have been achieved in many species using very low dosages (mostly microgram and ng/kg range) after ip, ig, and intramucosal (local) application. The effect was apparent already after one application. Long lasting activity was also demonstrated. BPC was highly effective when applied simultaneously with noxious agents or in already pathological, as well as chronical, conditions. Therefore, it seems that BPC treatment does not share any of the so far known limitations for 'conventional organoprotectors'. No influence on different basal parameters and no toxicity were observed. These findings provide a breakthrough in stress theory. BPC, as a possible endogenous free radical scavenger and organoprotection mediator, could be a useful prototype of a new class of drugs, organoprotective agents.
    Cathepsin D, a protease with the capability of degrading matrix proteins, is implicated in the process of breast and colorectal cancer invasion and metastasis. Biochemical studies in laryngeal cancer have shown a potential prognostic... more
    Cathepsin D, a protease with the capability of degrading matrix proteins, is implicated in the process of breast and colorectal cancer invasion and metastasis. Biochemical studies in laryngeal cancer have shown a potential prognostic significance of cathepsin D content determination. We studied immunohistochemical positivity of cathepsin D in tumor epithelium and stroma of 61 surgical specimens of squamous cell laryngeal cancer. Immunohistochemical reaction was quantitatively assessed using a PC-based image analysis system SFORM-VAMS. The results were correlated to clinical and morphological parameters and survival. Immunohistochemical positivity was noted in neoplastic cells and tumor stroma. Significant prognostic value for cathepsin D was established separately for epithelial tumor component and tumor stroma using log-rank test, the Cox proportional hazards regression model, and C4.5 machine learning system. In all groups, patients above the median cathepsin D staining showed significantly shorter survival time. C4.5 machine learning system extracted cutoff values for the decision tree that defines the probabilities of patients survival and death with high sensitivity (92.8% alive, 73.6% dead), 100% specificity, and 86.9% accuracy. This makes immunohistochemical cathepsin D estimation an independent prognostic parameter in laryngeal carcinomas within a 5-year period from the time of tumor surgery.