bluuebunny/crossref_metadata_2025 huggingface dataset:
Poor outcome in patients with diffuse large B-cell lymphoma is associated with high percentage of bcl-2 and Ki 67-positive tumor cells
Authors: Perunicic-Jovanovic Maja , Jakovic Ljubomir , Bogdanovic Andrija , Markovic Olivera , Cemerikic-Martinovic Vesna , Mihaljevic Biljana
Published: December 2010

Background/Aim. Newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL) tretaed with immunochemotherapy have durable remission and improved overall survival. It is important to identify high risk patients who may benefit from even more effective therapies. Methods. In a group of 50 newly diagnosed patients with DLBCL, treated with CHOP/R-CHOP (cyclophosphemide doxorubicine, vincristine, prednisone with or without rituximab) regimen, we analyzed the prognostic value of the expression of Ki67 and bcl-2 at diagnosis as well as other standard clinical parameters: International Prognostic Index (IPI), bulky disease, extranodal distribution and lactat dehydrogenase (LDH). Significance was tested according to response rate and overall survival. Results. Univariate survival analysis showed that high IPI had a statistically significant negative influence on overall and event free survival time (log rank, p < 0.01). The log rank test analysis signified that patients with a high proliferative fraction (Ki-67 > 60%) had a worse overall survival rate (OS5y) of 40% compared to those with low proliferation (Ki-67 < 60%) with OS5y of 80% (p < 0.01). There was a clear difference between bcl-2 positivity (treshold 50%) and the achievement of complete remission (66% vs 86% in patients with bcl-2 high and low levels respectively, p < 0.05). In survival analysis, patients with low bcl-2 expression had significantly higher OS5y - 68% compared to those with high bcl-2+ with OS5y 37% (p < 0.05). Multivariate analysis performed by Cox model revealed that IPI > 3, high Ki-67+, bcl-2 positivity had a significant independent prognostic value concerning overall survival (p < 0.05). Conclusion. An initial high IPI score associated with high Ki-67+ and bcl2+ could represent possible predictive factors of poor prognosis, which would help to identify a high risk subgroup of newly diagnosed DLBCL.
Stenting for symptomatic high-grade basilar artery stenosis
Authors: Culafic Slobodan , Lakicevic Novak , Mihajlovic Miodrag , Stefanovic Dara , Spaic Milan
Published: December 2010

Background. Stenosis of brain vessels in 5-10% of cases causes ischemic disesase of the brain. Atherosclerosis is a cause of stenosis in 95% of cases. Patients with basilar artery stenosis and recurrent ischemic attacks are candidate for stroke in 50% of cases in the first two years. Case report. A 48-year old man presented with a 12-month history of transitory ischemic attacks, periodical loss of vision and balance disorder. Diagnostic cerebral angiography performed by MSCT revealed annular stenosis of basilar artery (85%). Digital subtraction angiography (DSA) confirmed dimensions, grade and localisation of stenosis. Endovascular stenting was performed in general anesthesia. The first step of procedure was preliminary balloon angioplasty and after that self- expandable stent (diameter of 3.0 mm, length of 12 mm) was placed. Check angiogram after stenting confirmed complete dilatation of basilar artery stenosis. Conclusion. Combination of balloon angioplasty and selfexpandable stenting made possible non-surgical treatment of simptomatic basilar artery stenosis.
Bronchial artery embolization being the therapy of choice for massive hemoptyses in bronchiectases
Authors: Djuric Mirna , Povazan Djordje , Puskar Slobodan , Cemerlic-Adjic Nada , Skrbic Dusan
Published: December 2010

Introduction. Hemoptyses may be very often due to bronchiectases. Although these bleedings are usually spontaneously resolved recurrent and massive hemoptyses may vitally endanger a patient. Therefore, an urgent diagnosis and treatment of hemoptyses is required. Case report. A 56- year old patient was admitted to the hospital due to massive hemoptyses, presented with a non-homogenous shadowing, paracardially on the left. The chest Computerized Tomography finding delineated atelectasis of the lower left lobe and bronchiectases. Bronchoscopy sampling of the left lung airways provided the fresh blood. The multislice angiography and embolization of the bronchial arteries was carried out, entirely ceasing hemoptyses so the patient was discharged with no symptoms. On the control examination one month later, he was well, with normal radiological finding and inflammation markers. Conclusion. In our patient, the life-threatening bleeding due to inflamed bronchiectases was successfully resolved by bronchial arterial embolization, thus avoiding surgery.
Acute glyphosate-surfactant poisoning with neurological sequels and fatal outcome
Authors: Potrebic Olivera , Jovic-Stosic Jasmina , Vucinic Slavica , Tadic Jelena , Radulac Misel
Published: December 2010

Introduction. Clinical picture of severe glyphosatesurfactant poisoning is manifested by gastroenteritis, respiratory disturbances, altered mental status, hypotension refractory to the treatment, renal failure, shock. Single case report indicated possible neurotoxic sequels of glyphosatesurfactant exposure with white matter lesions and development of Parkinsonism. We described a patient with massive white matter damage which led to vigil coma and lethal outcome. Case report. A 56-year old woman ingested about 500 mL of herbicide containing glyphosate isopropylamine salt. The most prominent manifestation of poisoning included hypotension, coma, hyperkaliemia, respiratory and renal failure. The patient was treated in intensive care unit by symptomatic and supportive therapy including mechanical ventilation and hemodialysis. The patient survived the acute phase of poisoning, but she developed vigil coma. Nuclear magnetic imagining revealed extensive bilateral lesions of the brain stem white matter and pons. Conclusion. The outcome of reported poisoning may be the consequence of glyphosate-surfactant neurotoxic effect or/and ischemia, especially in the episodes of marked hypotension during hemodialysis. Considering recommendation of early hemodialysis as the treatment of choice, even before renal failure development, we point out the importance of careful planning of dialysis modality in hemodynamically instable patient and recommend continuous dialysis methods.
Association between tobacco smoking and pulmonary tuberculosis
Authors: Skodric-Trifunovic Vesna , Gvozdenovic Branislav , Jovanovic Dragana , Vucinic Violeta , Djuric Dusan , Zunic Miodrag
Published: December 2010

Background/Aim. Numerous studies evaluate the influence of tobacco smoking on the tuberculosis (TB) development, with the results indicating that smoking can be also considered as important risk factor in TB. The aim of this study was to assess the influence of tobacco smoking as the risk factor in the development of TB as well as in its clinical course. Methods. We analyzed data from the medical records of 192 consecutively hospitalized TB patients (124 males and 68 females) in the Institute of Pulmonary Diseases and Tuberculosis, Clinical Center of Serbia, Belgrade in the period from 2005 to 2007. Results. Among the analyzed TB patients there were more smokers (63.5%) than nonsmokers (36.5%). The majority of the smokers (73.8%) belonged to a middle age group (35-54 years) while the majority of nonsmokers (64.3%) were older than 55 years. Sex ratio among the smokers showed the domination of males (80.3%). There were significantly more males in the smoking group and more females in the nonsmoking group (?2 = 34.402, p < 0.0001). Most smokers (68.9%) smoked more than 20 cigarettes daily. The average index of pack/years among all of the examinated patients was 32.75 ? 18.26. Cavitary pulmonary lesions were more frequently verified in the smokers (64.2%) than in the nonsmokers (35.8%). The sputum acid-fast bacillus smear-positive finding was more frequent in the smokers (78%) than in the nonsmokers (22%). The nonsmoking TB patients had more accompanied immunodeficient diseases (34%) than the smoking ones (19%). Body-mass index was lower in the smokers (21.75) than in the nonsmokers (23.80), although this difference did not reach the statistical significance. Conclusion. There are more smokers than nonsmokers in TB patients. Smokers more frequently have cavitary forms of TB with sputum acid-fast bacillus smear - positive finding than nonsmokers.
Preterm delivery in a patient with frontal lobe brain tumor
Authors: Cutura Nedjo , Soldo Vesna
Published: December 2010

Introduction/Aim. Brain tumors are very rare in pregnancy. Diagnosis could be very simple if one consider brain tumor alongside blurred symptoms of headache, repetitive vomiting and/or epileptic attacks during pregnancy. The aim of this paper was to emphasize the importance of such pregnancy expert control and completion. Case report. We presented a 45-year-old pregnant woman at 30 weeks of gestation, and with brain tumor recidive in frontal lobe, hystologicaly confirmed as astrocytoma. The patient was newly diagnosed with tumor in 1995, and monitored until 2003, when she was operated. Due to malignant profile and a partial removal of tumor masses, postoperative gamma-ray therapy was recommended. Because of the continuous need for that kind of therapy, termination of pregnancy was also recommended. It was carried out by the application of PGE2 vaginal tablets. Delivery lasted for 8 hours and 50 minutes, and with auxilium manuale sec. Bracht, due to the breech presentation, newborn was delivered 1 550 grams in weight and 39 cm length. Apgar score was 6/7. Conclusion. Pregnancy in patient with brain tumors can be intensively monitored by neurosurgeons and obstetricians, and with the use of the symptomatical therapy almost up to the delivery term. Surgical intervention is recommended to be performed during the second and/or third trimester if the condition requires. The way of delivery in these patients should be individually determined in the most appropriate way both for the mother and the newborn, under given circumstances.
Orthodontic treatment of nongrowing patient with class II division 2 malocclusion by Herbst appliance
Authors: Nedeljkovic Nenad , Glisic Branislav , Markovic Evgenija , Scepan Ivana , Stamenkovic Zorana
Published: December 2010

Background. Inheritance is most casual etiological factor of Class II division 2 malocclusion. This kind of malocclusion is very difficult for treatment specially in older patients. Case report. In the female patient, 20 years old, at the beginning of the treatment at the School of Dentistry in Belgrade, lateral cephalogram showed skeletal and dentoalveolar Class II division 2 malocclusion. She was in the Herbst treatment for 8 months and 12 months more with a fixed multibracket appliance. The measurements were performed on lateral cephalograms before and after the treatment: ii, is, mi, ms, Pg and ss. The distance from these points to occlusal perpendicular line (Olp) were measured and compared from cephalogram before to cephalogram after the treatment. Temporomandibular joint (TMJ) tomograms were compared from before and after the treatment by superimposition. Correction was found in molar and incisor relation, overjet and overbite. There were found sagital skeletal changes and soft tissue profile improvement. Conclusion. Herbst appliance is effective in the treatment of Class II malocclusions, even in adult patients. Dental and skeletal changes as a result of Herbst treatment could be good choice instead of camouflage orthodontics or surgical decision.
Application of palatal RB obturator in babies with isolated palatal cleft
Authors: Radojicic Julija , Tanic Tatjana , Blazej Zorica
Published: December 2010

Background. Isolated cleft of secondary palate has a specific clinical picture due to a wide communication between the mouth and nose cavity. As a consequence of that, babies born with this malformation are often subject to infections of the upper bronchial tubes, middle ear, speech disorders, and certainly the most difficult existential problem they face at the very beginning of their lives, the impossibility of suckling (breast feeding). Such babies have to be fed with gastric probe. The difficulties in their nutrition have often been described in literature, yet a singular attitude toward early orthodontic therapy has not been adopted still. The aim of the paper was to describe a design and application of obturator immediately after the birth of a baby with isolated palatal cleft, and the role in feeding. Case report. We presented a female neonate, born on 27th December 2007, with a wide fissure in the shape of the letter U over the entire secondary palate. The baby was referred to the Stomatology Clinic due to nutrition impossibility. To avoid feeding with gastric probe, the formation of RB obturator was performed (artificial palate). Hereby, the procedure of obturator making with an explanation of its function is presented. Conclusion. The application of RB obturator and the necessary education of parents have a major role in shortening the time of breast feeding and increasing the amount of food intake and, thus, for the normal growth and development of newborn infants with isolated palate cleft.
Large saphenous venous graft aneurysm mimicking atypical mediastinal mass
Authors: Krotin Mirjana , Ristic Miljko , Zdravkovic Marija , Popovic-Lisulov Danica , Saponjski Jovica , Putnik Svetomir
Published: December 2010

Background. Saphenous venous graft (SVG) aneurysm is a very rare but potentially fatal complication of the coronary artery bypass surgery. Case report. We reported a case of 72-year-old man admitted to hospital because of atypical chest pain related to body motions in horizontal position, especially to the left side. Pain was followed by dispnea, palpitations, fatigue, cough, yellow sputum expectorations, as well as elevated temperature. He had had coronary artery bypass grafting (CABG) surgery with saphenous vein grafts (SVGs) to the left anterior descending artery (LAD) and right coronary artery (RCA) 27 years earlier. Chest X-ray revealed a poor-defined shadow in the region of the right atrium. A transthoracic echocardiogram revealed an atypical tumorous mediastinal mass near the right atrium and right ventricle that seemed partially calcified on transesophaeal echocardiography (TEE). CT scan confirmed an atypical mediastinal mass in contact with the right ventricle that might be a right ventricle aneurysm, pericardial cyst or SVG aneurysm. Coronary angiography was performed subsequently and it revealed a big saphenous venous graft aneurysm originating from the previous venous graft to the RCA. The aneurysm was resected and a new bypass graft was placed. Histopathology confirmed a true aneurysm of the venous graft. Conclusion. Although SVG aneurysm is a very rare complication of CABG surgery, patients presenting with atypical hilar or mediastinal mass following CABG should always be evaluated firstly for existence of this cardiosurgical complication.
Tuberculous synovitis of the knee in a 65-year-old man
Authors: Ciobanu Laura , Pesut Dragica
Published: December 2010

Introduction. Tuberculous (TB) synovitis is a rare, treatable, potentially lethal form of extrapulmonary TB resulting from massive lymphohematogenous dissemination of Mycobacterium tuberculosis (M. tuberculosis). We presented a case of TB synovitis of the knee in a Caucasian HIV negative man from Romania, a high TB incidence country. Case report. A 65-year old man presented with cough, high fever, mild wheezing, and swelling of the left knee. Chest radiography was normal. Sputum smears were Acid Fast Bacilli negative and L?wenstein-Jensen (L-J) culture negative for M. tuberculosis. Tuberculin skin test was negative. Respiratory symptoms disappeared in a week under antibiotics. Positive L-J cultures of knee punctation and favourable treatment outcome following standardized antituberculous treatment regimen confirmed the diagnosis of specific synovitis, which was also demonstrated by Magnetic Resonance Imaging (MRI). Conclusion. Tuberculous synovitis is important differencial diagnosis in patients with arthropathies and risk factors for TB in all the countries and all patients' ages even when tuberculin skin test is negative.
Validity of dual tracer 99mTc-tetrofosmin and 99mTc-pertechnetate subtraction parathyroid scintigraphy in patients with primary and secondary hyperparathyroidism
Authors: Dugonjic Sanja , Ajdinovic Boris , Cerovic Snezana , Jankovic Zoran
Published: December 2010

Background/Aim. Primary hyperparathyroidism (pHPT) is an endocrine disease with the third highest incidence of all endocrine disorders after diabetes mellitus and hyperthyroidism. pHPT is typically caused by a solitary parathyroid adenoma, less frequently by multiple parathyroid gland disease (MGD) and rarely by parathyroid carcinoma. Secondary hyperparatyroidism (sHPT) is a common complication in patients with chronic renal failure. The aim of this study was to estimate sensitivity of dual tracer 99mTctetrofosmin and 99mTc-pertechnetate subtraction scintigraphy in detection of abnormal parathyroid glands in patients with pHPT and sHPT confirmed by histopathology. Methods. In 46 patients, (77 abnormal parathyroid glands), 30 with pHPT and 16 with sHPT parathyroid scintigraphy was done preoperatively. All the patients had histopathological confirmation of diagnosis. Abnormal parathyroid glands weighted from 0.1 to 7 g. After iv injection dynamic scintigraphy during 25 minutes (one frame-one minute) using 555 MBq of 99mTc-tetrofosmin, and three hours latter using 111 MBq of 99mTc /pertechnetate was performed. 99mTc-tetrofosmin dynamic study was followed by static scintigraphy of the neck and chest 30 minutes, 1, 2 and 3 hours after iv injection. Results. An abnormal scintigraphic finding was found in 44 of 46 patients with sensitivity of 96%. In pHPT sensitivity was 93% (28 of 30 patients, and 28 of 30 glands). In sHPT scintigraphy was abnormal in all the patients (sensitivity 100%). In the patients with sHPT scintigraphy detected 30 of 47 abnormal parathyroid glands (sensitivity 64%). An overall sensitivity of scintigraphy per gland, for pHPT and sHPT in detecting 58 of 77 abnormal parathyroid glands was 75%. Conclusion. An abnormal scintigrafic result per patient was found in 44 patients (sensitivity 96%) and 58 of 77 abnormal parathyroid glands were detected (sensitivity 75%). A high sensitivity of dual tracer subtraction 99mTc-tetrofosmin/99mTc-pertechnetate parathyroid scintigraphy in detecting abnormal parathyroid glands in primary and secondary hyperparathyroidism was achieved.
Influence of intracoronary injections of bone-marrow-derived mononuclear cells on large myocardial infarction outcome: Quantum of initial necrosis is the key
Authors: Obradovic Slobodan , Balint Bela , Romanovic Radoslav , Trifunovic Zoran , Rusovic Sinisa , Baskot Branislav , Dopudja Marija , Trifunovic Gordana , Rafajlovski Saso , Jung Robert , Gligic Branko
Published: December 2010

Background/Aim. Autologous bone-marrow-derived intracoronary injection of mononuclear cells (MNC) modestly improved left ventricular ejection fraction (LVEF) in the selected patients after acute ST elevation myocardial infarction (STEMI). Major determinants of stem cell therapy outcome in the subacute phase of STEMI still remain unknown. Therefore, the aim of this study was to determine modifying factors for the outcome of stem cell therapy after STEMI. Methods. Eighteen patients in the stem cell therapy group and 24 patients in the control group with the successfully reperfused first large STEMI (LVEF ? 40%) were enrolled in the study. The stem cell group was submitted to autologous bone-marrow-derived MNC injection between 7-12 days after MI. Left ventricular ejection fraction and infarction size at baseline and after 4 months were determined by echocardiography and scintigraphy examination. Age, pain onset to reperfusion time, admission glycemia, maximum lactate dehydrogenase (LDH) activity and C-reactive protein level, baseline LVEF and infarction size, and the number of MNC injected were compared between patients with and without significant improvement of LVEF and decrease of myocardial infarct size after 4 months. Results. In the stem cell group, patients with the improvement of LVEF for more than 5.1% had significantly lower levels of LDH than patients without such improvement (1689 ? 139 vs 2133 ? 215 IU/L, p < 0.001) and lower baseline infarction size on scintigraphy (26.7 ? 5.2 vs 34.9 ? 3.7%, p < 0.001). Such dependence was not found in the control group. Conclusion. In the patients with first large STEMI intracoronary injection of autologous bone-marrow-derived MNC leads to the significant decrease of myocardial infarction size but not the significant improvement of LVEF after four months. Higher serum LDH levels after STEMI and very large baseline infarction size are predictors of failure of stem cell therapy in our group of STEMI patients.
Ultrasonographic findings validity in the identification of metastatic regional lymph nodes in patients with cutaneous melanoma
Authors: Sijan Goran , Kozarski Jefta , Stefanovic Dara , Lalkovic Mikica , Milicevic Sasa , Stankovic Goran
Published: December 2010

Background/Aim. Early identification of lymph node (LN) metastases has both therapeutic and prognostic significance in patients with cutaneous melanoma. Ultrasonographic (US) examination of LN morphological characteristics and US of LN morphological and vascular characteristics are diagnostic methods used in identification of regional LN metastases, thus rendering a base for lymphonododisection indication. The aim of this study was to determine validity of these two US diagnostic methods and eventual statistically significant difference between them. Methods. The study included the two groups of the patients with clinical stage III melanoma. The group I included 31 patients followed up by the use of US of LN morphological characteristics due to the fact that US findings described them only. The group II included 30 patients in whom morphological and vascular LN characteristics were followed up. The patients of both groups were examined in the Institute for Radiology, Military Medical Academy using an ultrasonographic unit type Akuson Sequoia Model 2000. After that, therapeutic and elective radical disections were performed. Sensitivity, specificity and accuracy of US examination of LN were checked by histopathological examination. Results. The presence of LN metastases in the group I was suggested by LN enlargement and its extent, while in the group II it was suggested by the ratio of LN length and width in 83.3% of the patients, echogenicity of LN center in 76.7% of the patients, LN resistance index in 73.3% of the patients, pathologic LN vascularization in 86.7%, and pathologic intranodal arborization in 83.3% of the patients. In 67.7% of the patients in the group I and in 93.3% of the patients in the group II matastatic changes of LN were diagnosed by pathohistology. A difference between validities of the two groups was statistically significant (p < 0.05). Conclusion. LN size without other US morphological and vascular characteristics of LN does not provide enough valid US finding for a reliable preoperative identification of LN with metastatic changes in patients with cutaneous melanoma.
Influence of retrobulbar neuritis and papillitis on echographically measured optic nerve diameter
Authors: Stefanovic Ivan , Jovanovic Milos , Dacic-Krnjaja Bojana , Veselinovic Dragan , Jovanovic Predrag
Published: December 2010

Background/Aim. Retrobulbar (optic) neuritis is inflammation of the optic nerve that may cause a complete or partial loss of vision. This inflammation can affect a part of the nerve within the eyeball (neuropapillitis) or a part of the nerve behind the eyeball (retrobulbar neuritis). The aim of this study was to establish whether there is a correlation between the diameter of a retrobulbar part of the optic nerve and either visual acuity, prominence of the optic disk (papillitis), or nature of the neuritis (papillitis or retrobulbar). Methods. We tested 23 patients with retrobulbar neuritis and papillitis. In addition to a complete ophthalmologic examination, the diameter of retrobulbar region of the optic nerve was measured by the B-scan method. Following this, the 30-degree test was carried out. Results. We found an increased thickness of the retrobulbar region in 22 patients and different responses to the 30-degree test, as well as a statistically significant negative correlation between the thickness of retrobulbar part of the optic nerve and visual acuity. Conclusion. The retrobulbar part of the optic nerve is thicker in 94% of the patients with retrobulbar neuritis and in all the patients with papillitis. There is a correlation between the reduction of visual acuity and thickening of a retrobulbar part.
Exercise tolerance and dyspnea in patients with chronic obstructive pulmonary disease
Authors: Cekerevac Ivan , Lazic Zorica , Novkovic Ljiljana , Petrovic Marina , Cupurdija Vojislav , Kitanovic Gordana , Todorovic Zoran , Gajovic Olgica
Published: December 2010

Background/Aim. Peripheral muscle weakness and nutritional disorders, firstly loss of body weight, are common findings in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to analyse the impact of pulmonary function parameters, nutritional status and state of peripheral skeletal muscles on exercise tolerance and development of dyspnea in COPD patients. Methods. Thirty COPD patients in stable state of disease were analyzed. Standard pulmonary function tests, including spirometry, body pletysmography, and measurements of diffusion capacity were performed. The 6-minute walking distance test (6MWD) was done in order to assess exercise tolerance. Level of dyspnea was measured with Borg scale. In all patients midthigh muscle cross-sectional area (MTCSA) was measured by computerized tomography scan. Nutritional status of patients was estimated according to body mass index (BMI). Results. Statistically significant correlations were found between parameters of pulmonary function and exercise tolerance. Level of airflow limitation and lung hyperinflation had significant impact on development of dyspnea at rest and especially after exercise. Significant positive correlation was found between MTCSA and exercise tolerance. Patients with more severe airflow limitation, lung hyperinflation and reduced diffusion capacity had significantly lower MTCSA. Conclusion. Exercise tolerance in COPD patients depends on severity of bronchoobstruction, lung hyperinflation and MTCSA. Severity of bronchoobstruction and lung hyperinflation have significant impact on dyspnea level.
Conditions causing copious bleeding important for dental medicine practice
Authors: Mihailovic Branko , Duka Milos , Miladinovic Milan , Vujicic Biljana , Macukanovic-Golubovic Lana
Published: December 2010

 Dobro poznavanje mogucih uzoraka prekomernog krvarenja, kao i stomatoloskih postupaka u toku oralnohirurskih intervencija kod obolelih od trombocitopenije, hemofilije, u slucaju snizene koncentracije faktora zavisnih od vitamina K i predozirane antitrombotske terapije, omogucava adekvatnu i blagovremenu oralnohirursku hemostazu u skladu sa predvidjenim protokolom lecenja. Ukoliko je, medjutim, oralnohirurska intervencija propracena produzenim krvarenjem u trajanju od nekoliko sati ili dana, bez pouzdanih anamnestickih podataka i pismene medicinske dokumentacije, problem postaje veliki. U takvim situacijama, podsecanje na stanja koja izazivaju prekomerno krvarenje, kao i na stomatoloske postupke u toku oralnohirurskih intervencija kod takvih bolesnika, moze biti dragocen doprinos dobroj stomatoloskoj praksi.
Early pathohistological changes in dysfunction of arteriovenous fistula for hemodialysis
Authors: Stolic Radojica , Mitrovic Slobodanka , Stolic Dragica , Mitic Nebojsa
Published: December 2010

Background. In hemodialysis patients the most common cause of vascular access failure is neointimal hyperplasia of vascular smooth muscle cells at the venous anastomosis of arteriovenous fistulas. Case report. We presented a 76-year old patient who had developed fistula thrombosis without the presence of known risk factors the eighth day after the initial function. A histopathological finding pointed to a significant rate of neointimal proliferation, as an initial reasons for the fistula stenosis and trombosis. Conclusion. Early pathohistological changes observed in ateriovenous fistula dysfunction are response to hemodynamic changed conditions.
Influence of the purification of human adult pancreatic islets on insulin secretion
Authors: Nikolic Dragan , Djordjevic Predrag , Dimitrijevic-Sreckovic Vesna , Dzingalasevic Marina , Belij Sandra , Kalezic Nevena
Published: December 2010

Background/Aim. The most effective method for human adult pancreatic islets purification is density-gradient centrifugation. The aim of this study was to analyze the effects of non-automated purification on preservation of functional capacity of human adult pancreatic islet cells. Methods. Human pancreata were obtained after pancreatectomy in the patients with chronic pancreatitis or benign tumors. Pancreatic islets were purified by non-automated method in discontinuous Ficoll density gradient. The samples were divided in 2 fractions: purified (P) and non-purified (NP) cultures. Islets were stained with diphenyl-thiocarbazone. The efficiency of separation was determined by comparing percentage of stained cells in P and NP cultures on day 1, 3 and 7 of shortterm cultivation. Glucose-stimulated insulin secretion was expressed as stimulation index (SI). Results. The results obtained showed a statistically significant difference (p < 0.01) between P and NP cultures. P cultures had higher percentages of stained cells (70.43 ? 3.97%, 73.77 ? 4.22% and 71.34 ? 4.69% on the first, third and seventh day of cultivation, respectively) than NP cultures (53.68 ? 1.71%, 57.14 ? 3.94% and 43.97 ? 4.56%, respectively). P cultures had higher values of SI for the first, third and seventh day of cultivation than NP cultures (0.45 ? 0.08, 0.80 ? 0.21, 1.28 ? 0.15 and 0.46 ? 0.10, 0.752 ? .0.16, 0.76 ? 0.11 for P and NP cultures respectively). The difference was statistically significant on day seven (p = 0.01). Conclusion. Although during purification process islets were exposed to a number of insults that might result in cellular damage and functional impairment, our assessments showed that islets in P cultures preserved their functional capacity better than islets in NP cultures, since they had greater insulin secretion.
Dentaoalveolar changes in young adult patients with Class II/1 malocclusion treated with the Herbst appliance and an activator
Authors: Nedeljkovic Nenad , Scepan Ivana , Glisic Branislav , Markovic Evgenija
Published: December 2010

Background/Aim. Functional appliances can be used effectively in the treatment of skeletal Class II/1 malocclusions. The best treatment results are obtained during active period of facial growth when skeletal, as well as dentoalveolar, changes occur. In comparison with removable functional appliances, such as activator, that are effective only during adolescent period of growth, the Herbst fixed appliance is also successful at the end of the growth period. It also offers a shorter treatment time and a patient compliance is not necessary. The aim of this study was to analyze and compare dentoalveolar changes in the group of young adult patients with Class II/1 malocclusion treated with the Herbst appliance and an activator. Methods. The sample for this study consisted of 50 patients of both sexes, 14-21 years of age with Class II/1 malocclusion. For estimating the effect of functional appliances used, the following cephalometrics parameters were determined: inclination of the upper and lower incisors, interincisal angle, antero-posterior molars relationships, overjet and overbite. The results obtained were statistically tested. Results. The cephalometric findings after the treatment indicated retroinclination of upper incisors (average value of 9?) and proclination of lower incisors (average value of 7?), mostly expressed in the patients treated by Herbst appliance (p < 0.001). Increased overjet and distocclusion were completely corrected in the group of patients treated with the Herbst appliance, while the correction of malocclusion in the activator group was only partially accomplished. No changes in the overbite were noticed at the end of the treatment in both groups. Conclusion. The results of this study revealed that the Herbst appliance is more effective in the treatment of Class II/1 malocclusion in young adults in comparison with the activator.
Forensic aspects of operative bile ducts injuries
Authors: Colovic Radoje
Published: December 2010

 Operativna povreda zucnih vodova moze nastati kod svakog bolesnika i svakom hirurgu u toku holecistektomije i/ili nekih drugih operacija u toj regiji. Ukoliko se povreda blagovremeno prepozna i na odgovarajuci nacin tretira, ona se moze sa uspehom drzati u okviru clana 251 stava 3. Krivicnog zakonika Republike Srbije, kao ostecenje ucinjeno iz nehata. Blagovremene i ispravno preduzete mere za saniranje posledica nisu samo od velike vaznosti za bolesnika, nego i za hirurga. Propust da se povreda blagovremeno dijagnostikuje i ispravno tretira rezultira teskim posledicama po zdravlje ili dovodi do smrtnog ishoda, kada delo potpada pod clan 259 Krivicnog zakonika koji predvidja iskljucivo visegodisnje zatvorske kazne. To je jos jedan od razloga da se hirurg blagovremeno suoci sa ucinjenom greskom i da maksimalno saradjuje u lecenju posledica i da se ne uzdrzava da trazi pomoc za ostvarenje tih ciljeva. Lekarska, pa, prema tome, i hirurska udruzenja morala bi preduzeti inicijativu da se osiguranje od lekarske greske (tzv. 'rdjave lekarske prakse - malparctice') sto pre regulise i u nasoj zemlji na nacin na koji je to reseno u zemljama Zapadne Evrope.
Impact of rhinosinusal polyposis on CT score in patients with chronic rhinosinustis
Authors: Dudvarski Zoran , Janosevic Ljiljana , Pendjer Ivica , Djukic Vojko , Jesic Snezana , Dimitrijevic Milovan , Arsovic Nenad
Published: December 2010

Background/Aim. Chronic sinusitis is a disease characterized with mucosal inflammatoion of nasal and paranasal sinuses for at least 12 weeks. In order to assess the extent and severity of inflammatory changes in paranasal sinuses CT score according to Lund-Mackay is the most commonly used. Recent studies show the possibility of existing different subtipes of chronic rhinosinusitis, pointing out the presence of nasal polyps and their influence on the severity of chronic rhinosinusitis. The aim of this research was to examine the influence of sinonasal polyposis on the extensity of inflammatory changes on computerized tomography (CT), evaluated by the Lund-Mackay CT score. Methods. A prospective study compared the Lund-Mackay CT score values between the patients with chronic rhinosinusitis associated with nasal polyps and those without them. We determined mean values of the total CT score in both groups of the patients, as well as mean values of CT score for each group of sinuses and ostiomeatal complexes. Results. The study included 90 patients, 47 males and 43 females, 45-year old on average, diagnosed with chronic rhinosinusitis on the basis of diagnostic algorithm. The group with uncomplicated chronic rhinosinusitis (without nasal polyps) consisted of 30 patients and the group with complicated chronic rhinosinusitis (with nasal polyps) of 60 patients. Observing these two groups of patients revealed statistically highly important intergroup difference in CT score for each group of sinuses and ostiomeatal complexes. The mean value of total CT score in the group with uncomplicated chronic rhinosinusitis was 4.37 while in the group with complicated chronic rhinosinusitis it was 16.05 (p < 0.01). Conclusion. Chronic rhinosinusitis complicated by sinonasal polyposis is characterized with more extensive inflammatory changes on CT and, consequently, with higher CT score for each group of sinuses and ostiomeatal complexes, as well as higher total CT score.
Impact of dental implant insertion method on the periimplant epithelial seal: Experimental study on dogs
Authors: Matic Smiljana , Stamatovic Novak , Lazic Zoran , Petkovic-Curcin Aleksandra , Bubalo Marija , Vojvodic Danilo , Djurdjevic Dragan
Published: December 2010

Background/Aim. There is a controversial opinion among implantologists on the method of dental implantation that provides more favourable response of soft and bone tissues. The aim of this study was to pathohistologicaly compare the influences of one- and two-phase implant surgical methods on the periimplant epithelial tissues. Methods. The experiment was performed on 10 dogs. Eight weeks following tooth extractions implants were inserted using one phase method on the right side of the mandible, and two-phase method on the left one. Three months after implantation the animals were sacrificed. Contact regions of epithelial and subepithelial tissues and implants were pathohistologicaly examined, the elements of analysis were scored and compared. Results. Epithelial tissue was not found in the two samples of one-phase implants, while in the remainder of samples the structure of basal membrane was preserved, massive inflammatory infiltrate was found in one, and partial necrosis was found in three samples. Epithelial tissue was not found in the three samples of two-phase implants, in three samples the structure of basal mambrane was intact, while in three remained samples the membrane could not be detected; moderate inflammatory infiltrate was found in four samples and massive inflammatory infiltrate in both two remained samples; tissue necrosis, which was observed in the half of the samples, was complete. In subepithelial gingival tissues around one-phase implants the number of blood vessels was increased in three samples, accompanied by the thickening and dilatation of vascular walls, proliferation of blood elements, altered vascular walls and inflammatory cell infiltrate was found in four samples. Conclusion. On the base of the analized characteristics of epithelial and subepithelial tissues in contact with dental implants, one-phase method of implantation showed a more favorable tissue response.
Angiotensin II type 1 receptor gene polymorphism could influence renoprotective response to losartan treatment in type 1 diabetic patients with high urinary albumin excretion rate
Authors: Dragovic Tamara , Ajdinovic Boris , Hrvacevic Rajko , Ilic Vesna , Magic Zvonko , Andjelkovic Zoran , Kocev Nikola
Published: December 2010

Background/Aim. Diabetic nephropathy (DN) is a clinical syndrome characterized by persistent albuminuria, increasing arterial blood pressure and progressive decline in glomerular filtration rate (GFR). When persistent albuminuria is established, antihypertensive treatment becomes most important factor in slowing the progression of diabetic glomerulopathy. The aim of this study was to examine if renoprotective response to a short-term losartan therapy depends on 1166 A/C gene polymorphism for its target receptor. Method. The study included 35 patients with diabetes mellitus type 1 and persistently high urinary albumin excretion rate (UAE: > 30 mg/24 h), genotyped for the 1166 A/C gene polymorphism for the angiotensin II type 1 receptor (AT1R). The participants were segregated into 3 genotype groups according to combinations of A or C allele: AA(16%), AC(15%) and CC(11%). The patients received losartan 50 mg daily for 4 weeks, following 100 mg daily for another 8 weeks. At baseline and after 12 weeks of the treatment period UAE, blood pressure, GFR and filtration fraction (FF) were determined. Results. After 12 weeks of the treatment with losartan, albuminuria was reduced from baseline by 9% [95% confidence interval (CI): 1-17, p = 0.039] in the AA genotype, and by 11% (95% CI: 6-17, p = 0.0001) in the AC genotype. Losartan treatment reduced albuminuria in the CC group by 5% (95%CI: -13-22, p = 0.47). Glomerular filtration rate remained unchanged in all genotype groups. Filtration fraction was significantly reduced from baseline by 0.018 ? 0.024 (p = 0.012) only in the AC genotype. In the AA genotype, FF was reduced from baseline by 0.017 ? 0.03 (p = 0.052), and in the CC genotype by 0.01 ? 0.008 (p = 0.092). In the AA group, systolic blood pressure declined from 136 ? 24 mmHg at baseline, to an average of 121 ? 18 mmHg at the end of the study (p = 0.001). The AC group achived reduction from 131 ? 10 mmHg at baseline to 115 ? 7 mmHg (p = 0.001) during the investigation period. In the AA genotype group losartan reduced diastolic blood pressure from 86 ? 13 mmHg at baseline to 78 ? 8 mmHg (p = 0.004), and in the AC genotype from 88 ? 5 mmHg at baseline to 11.7 ? 5.6 mmHg during the investigation period (p = 0.001). In the CC genotype diastolic blood pressure reduction remained nonsignificant (p = 0.066). Conclusion. The results of our small sample size study provide the evidence that 1166 A/C AT1R polymorphism could be associated with the renoprotective response to losartan therapy.
Histamine index and clinical expression of rheumatoid arthritis activity
Authors: Tomic-Lucic Aleksandra , Pantovic Suzana , Rosic Gvozden , Obradovic Zdravko , Rosic Mirko
Published: December 2010

Background/Aim. Many arguments prove the pathophysiologic role of histamine in the process of remodeling and joint destruction in rheumatoid arthritis. The aim of our study was to find out if there was a relation between histamine concentration in synovial fluid and blood with clinical expression of disease activity. Methods. Histamine concentration in synovial fluid and blood was determinated in 19 patients with rheumatoid arthritis. Histamine concentration measurement was based on the Shore's fluorometric method. Histamine index (HI) was evaluated as a ratio between histamine concentration in synovial fluid and blood. Disease activity score, DAS 28 (3), with three variables (erythrocyte sedimentation rate, the number of swelled joints and the number of tender joints) was also evaluated. Results. Our results showed that there was no significant difference in concentration of histamine in synovial fluid and blood related to disease activity. However, there was a significant difference in the histamine index which was increased proportionally with disease activity. Conclusion. Our study indicates that histamine index could be useful in estimation of rheumatoid arthritis activity.
Portosystemic shunt in the treatment of portal hypertension
Authors: Mirkovic Darko , Mitrovic Miroslav , Jovanovic Milan
Published: December 2010

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Analysis of sagittal condyl inclination in subjects with temporomandibular disorders
Authors: Dodic Slobodan , Sinobad Vladimir , Vukadinovic Miroslav
Published: December 2010

Bacground/Aim. Disturbances of mandibular border movements is considered to be one of the major signs of temporomandibular disorders (TMD). The purpose of this study was to evaluate the possible association between disturbances of mandibular border movements and the presence of symptoms of TMD in the young. Methods. This study included two groups of volunteers between 18 and 26 years of age. The study group included 30 examineers with signs (symptoms) of TMD, and the control group also included 30 persons without any signs (symptoms) of TMD. The presence of TMD was confirmed according to the craniomandibular index (Helkimo). The functional analysis of mandibular movements was performed in each subject using the computer pantograph. Results. The results of this study did not confirm any significant differences between the values of the condylar variables/sagittal condylar inclination, length of the sagital condylar guidance, in the control and in the study group. Conclusion. The study did not confirm significant differences in the length and inclination of the protrusive condylar guidance, as well as in the values of the sagittal condylar inclination between the subjects with the signs and symptoms of TMD and the normal asymptomatic subjects.
Gender differences in victims of war torture: Types of torture and psychological consequences
Authors: Spiric Zeljko , Opacic Goran , Jovic Vladimir , Samardzic Radomir , Knezevic Goran , Mandic-Gajic Gordana , Todorovic Milorad
Published: December 2010

Background/Aim. Torture for political reasons is an extreme violence in interpersonal relations resulting in not only acute psychiatric disorders but also very often in very severe and far reaching negative consequences for the overall psychosocial functioning of a victim. The aim of this study was to investigate gender differences in types of torture and psychological consequences in subjects who experienced war torture. Methods. A sample (410 men and 76 women) included clients of 'Centre for rehabilitation of torture victims - IAN, Belgrade' who experienced torture in prisons and concentration camps during civil wars in ex-Yugoslavia 1991-1995 and 1999. Types of Torture Questionnaire with 81 items was used for collecting data about forms of torture. Symptom Checklist 90-Revised (SCL-90- R) was used for assessing type and intensity of psychological symptoms, and Impact of Event Scale (IES) was used to estimate posttraumatic complaints. Results. A gender difference was found for 33 types of torture: 28 more frequent in men, and 5 in women. Factor analysis of torture types revealed three factors explaining 29% of variance: 'common torture', 'sadistic torture', and 'sexual torture'. Discriminant analysis revealed significant gender difference concerning the factors. 'Common torture' and 'sadistic torture' were more prominent in men, and 'sexual torture' was more present in women. Higher scores on depression, anxiety, somatization, interpersonal sensitivity and obsessive-compulsive dimensions on SCL-90-R were found in women. General score and scores of subscales (intrusion and avoidance) on IES were significantly higher in women. Conclusion. Women exposed to war torture experienced less torture techniques and shorter imprisonment than men, but had more frequent and severe symptoms of posttraumatic stress disorder and other psychological symptoms. Gender differences in posttraumatic symptomatology can not be explained exclusively by gender differences in types of torture found in this study.
Pharmacotherapy of dementia
Authors: Pavlovic Dragan , Pavlovic Aleksandra , Totic Sanja
Published: December 2010

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