bluuebunny/crossref_metadata_2025 huggingface dataset:
Revision hip arthroplasty by Waldemar Link custom-made total hip prosthesis
Authors: Medenica Ivica , Lukovic Milan , Radoicic Dragan
Published: December 2010

Background. The number of patients undergoing hip arthroplasty revision is constantly growing. Especially, complex problem is extensive loss of bone stock and pelvic discontinuity that requires reconstruction. Case report. The paper presented a 50-year old patient, who ten years ago underwent a total cement artrhroplasty of the left hip. A year after the primary operation the patient had difficulties in walking without crutches. Problems intensified in the last five years, the patient had severe pain, totally limited movement in the left hip and could not walk at all. Radiographically, we found loose femoral component, massive loss of bone stock of proximal femur, acetabular protrusion and a consequent pelvic discontinuity. Clinically, a completely disfunctional left hip joint was registered (Harris hip score - 7.1). We performed total rearthroplasty by a custom- made Waldemar Link total hip prosthesis with acetabular antiprotrusio cage and compensation of bone defects with a graft from the bone bank. A year after the operation, we found clinically an extreme improvement in Harris hip score - 87.8. Radiographically, we found stability of implanted components, a complete graft integration and bone bridging across the site of pelvic discontinuity. Conclusion. Pelvic discontinuity and massive loss of proximal femoral bone stock is a challenging and complex entity. Conventional prostheses cannot provide an adequate fixation and stability of the hip. Application of custom-made prosthesis (measured specifically for a patient) and additional alografting bone defects is a good method in revision surgery after unsuccessful hip arthroplasty with extensive bone defects.
Primary ovarian malignant melanoma
Authors: Kostov Milos , Vukomanovic-Djurdjevic Biserka , Nenadic Dane , Pavlovic Milos
Published: December 2010

Background. Primary ovarian malignant melanoma is extremely rare. It usually appears in the wall of a dermoid cyst or is associated with another teratomatous component. Metastatic primary malignant melanoma to ovary from a primary melanoma elsewhere is well known and has been often reported especially in autopsy studies. Case report. We presented a case of primary ovarian malignant melanoma in a 45- year old woman, with no evidence of extraovarian primary melanoma nor teratomatous component. The tumor was unilateral, macroscopically on section presented as solid mass, dark brown to black color. Microscopically, tumor cells showed positive immunohistochemical reaction for HMB-45, melan-A and S-100 protein, and negative immunoreactivity for estrogen and progesteron receptors. Conclusion. Differentiate metastatic melanoma from rare primary ovarian malignant melanoma, in some of cases may be a histopathological diagnostic problem. Histopathological diagnosis of primary ovarian malignant melanoma should be confirmed by immunohistochemical analyses and detailed clinical search for an occult primary tumor.
Influence of admission plasma glucose level on short- and long-term prognosis in patients with ST-segment elevation myocardial infarction
Authors: Mladenovic Violeta , Zdravkovic Vladimir , Jovic Marina , Vucic Rada , Iric-Cupic Violeta , Rosic Mirko
Published: December 2010

Background/Aim. Hyperglicemia is common in patients with ST-elevation myocardial infarction (STEMI) and is associated with high risk of mortality and morbidity. Relationship between admission plasma glucose (APG) levels and mortality in diabetic and nondiabetic patients with STEMI needs further investigation. The aim of this study was to analyse the short- and longterm prognostic significance of APG levels in patients with STEMI with and without diabetes. Methods. This study included 115 patients with STEMI, 86 (74,8%) nondiabetic and 29 (25,2%) dibaetic patients, in which we performed a prospective analysis of the relationship between APG levels and shortand long-term mortality. Results. Comparison of APG levels between nondiabetic (8.32 ? 2.4 mmol/L) and diabetic (10.09 ? 2.5 mmol/L) patients showed statistically significantly higher average APG levels in diabetic patients (p = 0.001). In all patients observed who died either after one month or one year after STEMI, average APG values were significantly higher in comparison with those in survived patients. There was no statistical significance in average APG levels in the diabetic patients with STEMI who died after one month and those who survived (10.09 ? 2.68 vs 10.0 ? 2.51 mmol/L, respectively; p = 0.657), as well as those who died after one year and those who survived (10.1 ? 1.92 vs 10.09 ? 2.8 mmol/L, respectively; p = 0.996). There was, however, statistical significance in average APG levels in the nondiabetic patients with STEMI who died after one month and those who survived (9.97 ? 2.97 vs 7.91 ? 2.08 mmol/L, respectively; p = 0.001), as well as those who died after one year and those who survived (9.17 ? 2.49 vs 7.84 ? 2.24 mmol/L, respectively; p = 0.013). Conclusion. Acute hyperglicemia in the settings of STEMI worsenes the prognosis in patients with and without diabetes. Our study showed that nondiabetic patients with high APG levels are at higher risk of mortality than patients with a known history of diabetes.
New nutrition recommendations for healthy aging
Authors: Vasiljevic Nadja , Radakovic Sonja , Radjen Slavica , Marmut Zoran
Published: December 2010

nema
Dynamic magnetic resonance imaging of the cerebrospinal fluid flow within the cerebral aqueduct by different FISIP 2D sequences
Authors: Lucic Milos , Koprivsek Katarina , Till Viktor , Vesic Zoran
Published: December 2010

Background/Aim. A vast majority of current radiogical techniques, such as computerized tomography (CT) and magnetic resonance imaging (MRI) have great potential of visualization and delineation of cerebrospinal fluid spaces morphology within cerebral aqueduct. The aim of this study was to determine the possibilities of two differently acquired FISP (Fast Imaging with Steady State Precession) 2D MR sequences in the estimation of the pulsatile cerebrospinal fluid (CSF) flow intensity through the normal cerebral aqueduct. Methods. Sixty eight volunteers underwent brain MRI on 1.5T MR imager with additionally performed ECG retrospectively gated FISP 2D sequences (first one, as the part of the standard software package, with following technical parameters: TR 40, TE 12, FA 17, Matrix: 192 ? 256, Acq 1, and the second one, experimentally developed by our investigation team: TR 30, TE 12, FA 70, Matrix: 192 ? 256, Acq 1) respectively at two fixed slice positions - midsagittal and perpendicular to cerebral aqueduct, displayed and evaluated by multiplegated images in a closed-loop cinematographic (CINE) format. Results. Normal brain morphology with preserved patency of the cerebral aqueduct in all of 68 healthy volunteers was demonstrated on MRI examination. Cerebrospinal fluid flow within the cerebral aqueduct was distinguishable on both CINE MRI studies in midsagittal plane, but the estimation of intraaqueductal CSF flow in perpendicular plane was possible on CINE MRI studies acquired with experimentally improved FISP 2D (TR 30, FA 70) sequence only. Conclusion. Due to the changes of technical parameters CINE MRI study acquired with FISP 2D (TR 30, FA 70) in perpendicular plane demonstrated significantly higher capability in the estimation of the CSF pulsation intensity within the cerebral aqueduct. .
Prognostic factors of mortality in elderly with community acquired pneumonia
Authors: Djordjevic Ivanka , Pejcic Tatjana , Stankovic Ivana , Golubovic Slavica , Ciric Zorica
Published: December 2010

Background/Aim. Community acquired pneumonia in elderly has specific clinical aspect and higher mortality in relation to younger patients. According to specific pneumonia severity assessment on admission and its importance in proper prediction of clinical course and outcome, the aim of this study was defining prognostic factors of mortality. Methods. This study included 240 patients aged ? 65 years with community acquired pneumonia. On admission, demographic characteristics, underlying diseases, physical symptoms and findings, laboratory values, chest radiography and oxygen blood saturation (SaO2) were analyzed. Multivariate analysis was used to identify characteristic prognostic factors which showed a statistical significance in relation to mortality. Results. Altered mental status, respiratory frequency ? 23/min and the presence of bilateral pneumonic infiltrates were defined as the most important prognostic factors of mortality (p < 0.001). These factors displayed 57.89% sensitivity, 100% specificity and 93.33% accuracy. Conclusion. The presence of identified characteristic prognostic factors on admission pointed out an adverse clinical course and outcome of community acquired pneumonia in elderly. Age and sex were not significantly associated with mortality.
Correlation between morphologic carotid plaque findings based on color-Doppler and CT multidetector angiography with intraopertive findings in carotid artery stenosis
Authors: Savic Zivorad , Davidovic Lazar , Sagic Dragan , Brajovic Milan , Popovic Srdjan , Mijailovic Milija
Published: December 2010

Bacground/Aim. Vast majority of patients with corotid artery sclerosis do not have transitory ischemic attacks (TIA) as working to the persistent silent disease, but stroke is the first sign. Precise and early diagnosis of the carotid artery disease and plaques are very important. The aim of this study was to determine how the composition / identity of diagnostic methods, color-Doppler, ultrasonography (US) CT multidetector angio (MDCTA) scan and intraoperative (IO) findings, as well as the morphology of plaques in patients with haemodynamic significant stenosis of the internal carotid artery. Methods. Carotid plaques were observed by two diagnostic methods, US and MDCTA, and these findings were correlated with the IO findings. Results. In 62 patients both carotid artheries were examined and 83 plaques were observed. There were 68 surgical interventions. The structure of plaques was divided into four types: lipid, fibrous, fibrocalcified and calcified plaque. US showed: lipid plaques 10.8%; fibrous 1.2%; fibrocalcified 44.6% and calcified 43.4%, and the MDCTA lipid plaques 8.4%; fibrocalcified 48.2% and calcified 43.4%. Intraoperative findings were: lipid plaques 10.3%; fibrocalcified 41.2% and calcified 48.5%. A statistically highly significant agreement between the US and MDCTA in the diagnosis of plaque morphology was obtained (Cramer's V = 0.919, p < 0.01; Lambda = 0.921, p < 0.01) and also statistically significant agreement between US and IO findings (Cramer' s V = 0.831, p < 0.01; Lambda = 0.859, p < 0.01). A statistically highly significant agreement between MDCTA and IO findings in plaque morphology was found, as well (Cramer's V = 0.815, p < 0.01; Lambda = 0.829, p < 0.01). Conclusion. There is statistically highly significant correlation between US and MDCTA diagnostic methods in the evaluation of plaque morphology in surgically significant stenosis of internal carotid artery as well as their agreement with the intraoperative finding.
Expression of CD34 in cirrhotic liver: Reliance to dedifferentiation
Authors: Gligorijevic Jasmina , Djordjevic Biljana , Petrovic Aleksandar , Radicevic Aleksandra , Stojanovic Simonida
Published: December 2010

Background/Aim. The vascular supply of dysplastic nodules (DN) is altered compared with surrounding cirrhotic nodules. Dysplastic nodules contain unpaired arteries which are isolated arteries unaccompained by bille ducts. In adition, capillarization or neovascularization is evident on CD34 and CD31 staining. The investigation of angiogenic profile of regenerative, dysplastic and nodules of hepatocellular carcinoma aimed at assessing whether vascular profile is in reliance to the process of dedifferentiation of hepatocytes during the course of cirrhosis. Methods. Thirty four liver nodules from surgical biopsies of 12 patients previously undiagnosed to have cirrhosis, were classified as regenerative, dysplastic and small hepatocellular carcinomas (HCC). The investigation included 8 large regenerative nodules (LRN), 11 low grade dysplastic nodules (LGDN), 12 high grade dysplastic nodules (HGDN) and 3 early HCC. Serial sections of the nodules and surrounding cirrhotic liver tissue were immunostained against CD34. The vascular counting method was performed. The results were analysed using SPSS computer statistical program. Results. The number of capillary unites showed significant differences among nodular types, with the largest number of capillaries in hepatocellular carcinoma as well as strong reliance to dedifferentiation. Conclusion. There is a significant correlation of sinusoidal capillarization to dediferentiation of the liver tissue during the course of cirrhosis. From diagnostic view, capillary counting may be helpfull to distinguish dysplastic from nondysplastic nodules. The appearance of dysplastic nodules in nonselected surgical biopsies is frequent enough to challenge caution during the follow-up of cirrhotic patients.
Endoscopic dacryocystorhinostomy
Authors: Milojevic Milanko , Avramovic Sinisa , Kostic Bratislav , Sotirovic Jelena , Peric Aleksandar
Published: December 2010

Background/Aim. Intensive epiphora (lacrimal apparatus disease) can make difficult daily routine and cause ocular refraction disturbances. In most cases ethiology is unknown, rarely occurs after nose surgical procedures, face fractures, in Wegener granulomatosis, sarcoidosis and malignancies. The aim of this study was to evaluate efficacy of endonasal endoscopic surgical procedure with the conventional surgical instruments in treatment of nasolacrimal obstructions. Methods. This retrospective study included 12 female patients with endonasal endoscopic surgical procedure from Otorhinological and Ophtalmological Departments of Military Medical Academy, Belgrade from September 2007 to April 2009. Preoperative nasal endoscopy was performed in order to reveal concomitant pathological conditions and anatomic anomalies which could make surgical procedure impossible. Computerized tomography was performed only in suspect nose diseases. Surgical endonasal endoscopic procedure was performed by otorhinolaryngologist and ophtalmologist in all patients. The patients had regular controls from 2 to 20 months. Results. A total of 12 female patients, age 34-83 years, were included in our study. Epiphora was a dominant symptom in all patients. In two patients deviation of nasal septum was found, and in other one conha bulosa at the same side as chronic dacryocystitis. All patients were subjected to endonasal dacryocystorhinostomy (DCR) by endoscopic surgical technique using conventional instruments. Concomitantly with DCR septoplastics in two patients and lateral lamictetomy in one patient were performed. There were no complications intraoperatively as well as in the immediate postoperative course. In two patients the need for reoperation occurred. Conclusion. Endoscopic DCR is minimally invasive and efficacious procedure for nasolacrymal obstructions performed by otorhinolaryngologist and ophtalmologist. Postoperative recovery is very fast.
Accessory bones of the feet: Radiological analysis of frequency
Authors: Vasiljevic Vladica , Markovic Ljubo , Vasic-Vilic Jasenka , Mihajlovic Djura , Nikolic Bojan , Milosevic Sasa
Published: December 2010

Background/Aim. Accessory bones are most commonly found on the feet and they represent an anatomic variant. They occur when there is a failure in the formation of a unique bone from separated centre of ossification. The aim of this study was to establish their frequency and medical significance. Methods. Anteroposterior and lateral foot radiography was performed in 270 patients aged of 20-80 years with a history of trauma (180) and rheumatology disease (90). The presence and distribution of accessory bones was analysed in relation to the total number of patients and their gender. The results are expressed in numeric values and in terms of percentage. Results. Accessory bones were identified in 62 (22.96%) patients: 29 (10.74%) of them were found in female patients and 33 (12.22%) in males. The most common accessory bones were as follows: os tibiale externum 50%, os peroneum 29.03%, ostrigonum 11.29%, os vaselianum 9.68%. Conclusion. Accessory bones found in 23% of patients with trauma and some of rheumatological diseases. Their significance is demonstrated in the differential diagnosis among degenerative diseases, avulsion fractures, muscle and tendon trauma and other types of injuries which can cause painful affection of the foot, as well as in forensic practice.
Counterfeit drugs and other products and substances: Review of drugs for influenza prevention and treatment including pandemic influenza A(H1N1) 2009
Authors: Jelenkovic Ankica
Published: December 2010

nema
Differential diagnosis problem of pulmonary changes in ulcerative colitis
Authors: Djuric Mirna , Povazan Djordje , Secen Svetozar , Jovic Jelena
Published: December 2010

Introduction. Inflammatory intestinal diseases are often accompanied with extraintestinal and even pulmonary manifestations. The treatment of these intestinal diseases includes sulphasalazine and mesalazine, which may have undesirable allergic and other side effects, including hypersensitive pneumonitis. Case report. Having performed colonoscopy due to abdominal pains and mushy stools, the diagnosis of ulcerous colitis was established in a 20-year old female patient and the treatment with mesalazine initiated. However, the patient developed slimy and bloody stools, slightly increased body temperature, dry cough and bilateral lung lesions. The bronchological exploration established interstitial and organizing pneumonia. Despite the treatment with antibiotics, corticosteroids and mesalazine, dry cough, fever and bloody stools persisted, accompanied with bilateral inhomogeneous lesions of the pulmonary parenchyma. Upon discontinuation of the treatment with mesalazine, clinical symptoms and pulmonary lesions disappeared. Conclusion. The differential diagnosis of pulmonary lesions in patients with ulcerous colitis may be a problem. In the reported case, pulmonary lesions were interpreted as interstitial pneumonitis accompanying ulcerous colitis. However, they are most probably a consequence of allergic response to mesalazine.
Exogenous luteinizing hormone for assisted reproduction techniques in poor response patients
Authors: Spremovic-Radjenovic Svetlana , Gudovic Aleksandra , Lazovic Gordana
Published: December 2010

Background/Aim. Two gonadotrophins, two cell theory refers to necessity of both gonadotrophin activities for theca and granulose cells steroidogenesis of dominant follicle. The aim of this study was to determine the influence of recombinant LH in women qualified as poor responders in the first assisted reproduction procedure (IVF), on fertility results, expressed as percentage of clinical pregnancies. Method. The study included 12 women, 35 years and older who were their own controls. The next trial of IVF was with the same dose of recombinant FSH and GnRH agonist, and with the same, long protocol. Recombinant LH was added in the dose of 75 IU from the 2nd to 7th day of the cycle, and 150 IU from the 8th day of the cycle to the aspiration of oocytes. Results. Within the two different protocols: there was no significant difference between LH concentration in 8th and 12th day of cycle; there was no significant difference between E2 concentration on day 2nd and day 8th; there was a significant difference between E2 concentrations on day 12th; endometrial thickness was not significantly different on the day of aspiration, neither was the number of follicles and embryos. In the two patients, clinical pregnancy was detected (pregnancy rate 17%), and they delivered in term. So, a statistically significant difference between the two protocols was in the rate of clinical pregnancies. Conclusion. The patients with low response to a long protocol in IVF procedures had significantly better results according to the clinical pregnancy rate when the recombinant LH was added to recombinant FSH in the stimulation protocol.
Reconstruction of the penile skin loss due to 'radical' circumcision with a full thickness skin graft
Authors: Ignjatovic Ivan , Kovacevic Predrag , Medojevic Nina , Potic Milan , Milic Vladimir
Published: December 2010

Background. Excessive resection of penile skin is a rare but important complication of circumcision. Penis 'trapping' under the skin and consequent sexual dysfunction occur as a result. Case report. Excessive circumcision with complete resection of the penile skin is shown. Penis, trapped under the skin, was deliberated and skin defect was substituted with the full thickness skin graft. One year after the surgery penis has a good cosmetic appearance, adequate size and sexual function. Conclusion. Full thickness skin graft is a good option for augmentation of the penile skin loss in cases with intact hypodermal tissue and extensive skin loss, for the reconstruction in a single act.
A young soldier with syncope, shortness of breath and palpitations
Authors: Mladenovic Zorica , Mijailovic Zdravko , Tavciovski Dragan , Ilic Radoje , Rusovic Sinisa , Trifunovic Zoran , Matunovic Radomir
Published: December 2010

Introduction. Coronary artery disease in people under 30 years is relatively uncommon, but once a disease occurs it brings a significant morbidity and psychological effects. Case report. We reported a 28-year-old patient presenting atypical symptoms after sincopa and non-specific changes on electrocardiogram at admission. After noninvasive and invasive cardiology diagnostic procedures were made, we concluded that he had a subtotal tubular stenosis in proximal segment of the left anterior descending coronary artery. Myocardial revascularization was successfully performed 24-hour after coronarography with the left internal mammary thoracic artery graft on the left anterior descending coronary artery and the patient had a prompt and satisfactory postoperative recovery. Conclusion. This case indicates the importance of a careful evaluation of young adults even if they do not experience typical anginal symptoms or do not have multiple risk factors for cardiovascular diseases.
Burnout and the quality of life of workers in food industry: A pilot study in Serbia
Authors: Arandjelovic Mirjana , Ilic Ivana , Jovic Sladjana
Published: December 2010

Background/Aim. Burnout syndrome as a consequence of a long stress at workplace can seriously disturb health and quality of life in exposed workers. It is necessary to have adequate burnout prevention and its detection. Worldwide much attention is paid to protect burnout and methods for its determination constantly improve. In Serbia there has not been a study of that kind yet. The aim of the study was to investigate burnout syndrome impact on the quality of life of workers in food industry in Nis, and to call attention of researchers in Serbia on this phenomenon, as well as to test probability of applying the original, standardized questionnaires (CBI, ComQolA5) to working population in Serbia. Methods. This study was performed in Nis within a period from 2008 to 2009 in the Institute for Workers Health Protection. A total of 489 workers were included in this study by the use of the standard questionnaire for burnout (CBI) and quality of life (Com- QoL-A5). Scale confidence for measuring burnout and quality of life was determined by Cronbach ? coefficient. ANOVA analysis was used for rating influence of burnout on the quality of life. Results. The values of Cronbach ? coefficient showed a high confidence of the scale for measurement personal burnout (0.87), work-related burnout (0.86) and subjective quality of life (0.83). We detected increased scores as a result of personal burnout (60.0), as well as of work-related burnout (67.9). The workers suggested relationship with the family and friends as a very important part for their quality of life (10.8), health (9.8) and safety (8.0). Productivity (6.8), emotional well-being (6.6) and material property (4.5) had smaller influence on their quality of life. An increase in score of work-related burnout by 1 was statistically significantly related to decreasing inter scores for subjective quality of life in health (B = -0.097), relationship with family and friends (B = - 0.048), safety (B = -0.061) and place in community (B = - 0.105). A statistically significant relation between workrelated burnout and subjective quality of life in productivity, material and emotional well-being was not determined. Conclusion. There is a high score of both personal and work related burnout among manufacturing workers in food industry. A negative correlation between burnout and subjective quality of life was also proved impacting health and well-being of workers, but also their productivity. The questionnaires we used (CBI, ComQolA5) could be considered as reliable and valid instruments for testing burnout and quality of life in Serbia.
Ethics and deontology in forensic medicine
Authors: Matejic Suzana , Otasevic Vujadin
Published: December 2010

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Diagnosis and the treatment of primary amyloidosis
Authors: Djunic Irena , Tomin Dragica , Perunicic Maja , Vidovic Ana , Cemerikic Vesna , Djurasinovic Vladislava , Jakovic Ljubomir , Jankovic Gradimir
Published: December 2010

Backgraund. Primary amyloidosis belongs to a group of monoclonal plasma cell disorders, characterized by extracellular deposition of immunoglobulin light chain fibrils in various tissues and subsequent multiorgan dysfunction. Case report. We present a 51-year-old female with 2-years history of fatigue on exertion, oedema of face, abdomen and legs, bone pain and obstipation. After diagnostic procedures such as electrophoresis and immunoelectrophoresis of serum and urine proteins, immunohistohemical staining of bone marrow biopsy specimens and Congo red staining of rectal biopsy specimens, the patient received misdiagnosis of multiple myeloma and was referred to our hospital for further treatment. We reevaluated and complemented diagnostic procedures (ehocardiosonography and biopsy of subcutaneaus tissue with Congo red staining), and established diagnosis of primary amyloidosis. The therapy had started with intravenous (iv) melphalan and dexamethasone (totally eight cycles) and continued with peroral melphalan and iv dexamethasone. Stabilization of the disease was achieved after 35 months of the treatment. Conclusion. The case of this rare and often fatal disease emphasizes significance of early diagnosis and, consequently, initiation of specific therapies which are indispensable to improve the disease prognosis.
Ophthalmological profile of patients living with HIV/AIDS
Authors: Jankovic-Terzic Katarina , Begic Vera , Dacic-Krnjaja Bojana
Published: December 2010

Introduction. Serbia has 2.287 registered HIV positive persons. A certain number has ocular complications which are mainly the result of opportunistic infections accompanying this illness. Due to a highly stigmatizing environment for people living with HIV/AIDS in Serbia, they do not always seek doctors assistance despite the fear of losing their sight. Case report. We presented ophthalmologic status of nine HIV positive persons, all at the different phases of the illness. The decrease in the visual acuity was the first symptom which led to the diagnosis of HIV infection in two of our patients. Conclusion. Ophthalmologist has an important role in the multidisciplinary approach to patients with HIV/AIDS from introducing the diagnosis to the follow-up and the treatment of ocular complications which may accompany this chronic illness. With the active involvement of eye professionals serious consequences can be prevented, which have not only medical but also social and economic implications on the individual and the society as a whole.
The Mounier-Kuhn syndrome
Authors: Milic Rade , Plavec Goran , Stojisavljevic Marko , Tomic Ilija , Sarac Sanja
Published: December 2010

Background. The Mounier-Kuhn syndrome (MKS) or tracheobronchomegaly (TBM) is a rare condition of unknown frequency, up to now about 100 cases have been reported. It presents by marked dilatation of the trachea and major bronchi, recurrent respiratory infections and consecutive bronchiectasis and scars in lung parenchyme. Sometimes enlargement of transversal colon may be present. Diagnosis is usually made radiologically. Cases report. We reviewed two patients 77 and 72 years old with typical clinical presentation and enlarged upper airways, in whom diagnosis of MKS was established by chest multislice computed tomography (MSCT). Transversal diameter of trachea was 30 mm in the first patient and 33 mm in the other one. Complications of syndrome (tracheal diverticulosis in the first patient, and pulmonary fibrosis, bulous emphysema and bronchiectasis in both patients) also were seen. Lung function tests showed mixed ventilation disorder, and disturbance of respiratory gases values in arterial blood samples. Conclusion. The Mounier-Kuhn syndrome is rare disorder, although diagnosis is often missed. Clinical presentation is similar to chronic obstructive pulmonary disease or bronchiectasis. Computed tomography is gold standard for diagnosis. Therapy is presumely supportive.
The role of insulin-like growth factor in prediction and prevention of preterm delivery
Authors: Bogavac Mirjana , Simin Natasa , Ranisavljevic Milan , Budisic Ljiljana
Published: December 2010

Background/Aim. Prediction and prevention of preterm delivery remain great challenge. It is important to include in everyday medical practice determination of certain markers that could help identifying pregnant women with preterm delivery. Insulin like growth factor (IGF) is involved in the control mechanism of fetal and placental growth and development. The aim of this study was to examine the presence of insulin-like growth factor binding protein 1 (IGFBP-1) in cervicovaginal secretion of pregnant women with symptoms of preterm labor, but with apparently intact fetal membranes and to point out a possible application of the strip test for detection of phIGFBP-1 in diagnosis of preterm premature rupture of total membranes (PPROM) in everyday medical practice. Methods. The study was performed at the Department for Obstetrics and Gynecology, Clinical Center of Vojvodina between October 2008 and May 2009. The study included 54 pregnant women between 20-35 weeks of gestation (WG), divided into two groups: the study group (16 pregnant women with symptoms of preterm delivery that gave birth before 37 WG) and the control group (38 pregnant women with the normal course of pregnancy that gave birth on term). In cervicovaginal secretion of the examined pregnant women the level of IGFBP-1 was determined by the immunochromatographic assay with monoclonal antibodies 6303 as a detecting antibody (Actim PROM test, Medix Biochemica, Kauniainen, Finland). Results. Gestational age (GA) at delivery in the study group was 32.6 WG and in the control group it was 38.4 WG. Weight of newborns in the study group was 2,021 g and in the control group 3,430 g. IGFBP test was positive in 15 women (93.75%) of the study group, while in the control group it was positive only in 1 woman (2.63%). Conclusion. Test on phIGFBP-1 in cervicovaginal mucus was positive in 93.75% women with preterm delivery, suggesting that this test could be used in diagnosis of silent rupture of fetal membranes and in prediction of preterm delivery.
Frequency of foot deformity in preschool girls
Authors: Mihajlovic Ilona , Smajic Miroslav , Sente Jelena
Published: December 2010

Background/Aim. In order to determine the moment of creation of postural disorders, regardless of the causes of this problem, it is necessary to examine the moment of entry of children into a new environment, ie. in kindergarten or school. There is a weak evidence about the age period when foot deformity occurs, and the type of these deformities. The aim of this study was to establish the relationship between the occurrence of foot deformities and age characteristics of girls. Methods. The research was conducted in preschools 'Radosno detinjstvo' in the region of Novi Sad, using the method of random selection, on the sample of 272 girls, 4-7 years of age, classified into four strata according to the year of birth. To determine the foot deformities measurement technique using computerized digitized pedografy (CDP) was applied. Results. In preschool population girls pes transversoplanus and calcanei valga deformities occurred in a very high percentage (over 90%). Disturbed longitudinal instep ie flat feet also appeared in a high percentage, but we noted the improvement of this deformity according to increasing age. Namely, there was a statistically significant correlation between the age and this deformity. As a child grows older, the deformity is lower. Conclusion. This study confirmed that the formation of foot arches probably does not end at the age of 3-4 years but lasts until school age.
Accounting Scholarship that Advances Professional Knowledge and Practice
Authors: Kaplan Robert S.
Published: December 2010

ABSTRACT: Recent accounting scholarship has used statistical analyses on asset prices, financial reports and disclosures, laboratory experiments, and surveys of practice. The research has studied the interface among accounting information, capital markets, standard-setters, and financial analysts and how managers make accounting choices. But as accounting scholars have focused on understanding how markets and users process accounting data, they have distanced themselves from the accounting process itself. Accounting scholarship has failed to address important measurement and valuation issues that have arisen in the past 40 years of practice. This gap is illustrated with missed opportunities in risk measurement and management and the estimation of the fair value of complex financial securities. This commentary encourages accounting scholars to devote more resources to obtaining a fundamental understanding of contemporary and future practice and how analytic tools and contemporary advances in accounting and related disciplines can be deployed to improve the professional practice of accounting.
Effects of SFAS 133 on the Risk Relevance of Accounting Measures of Banks’ Derivative Exposures
Authors: Ahmed Anwer S. , Kilic Emre , Lobo Gerald J.
Published: December 2010

ABSTRACT: We provide evidence on the effects of SFAS 133 on the risk relevance of accounting measures of bank derivative exposures to bond markets. First, we find that interest rate derivatives classified as hedging are more negatively associated with fixed-rate bond spreads after SFAS 133. We also find that hedging derivatives offset non-trading positions to a greater extent after SFAS 133. Second, for the largest 25 banks, we find that interest and foreign exchange rate trading derivatives are more negatively associated with fixed-rate bond spreads after SFAS 133, consistent with more economic hedges being classified as trading after SFAS 133. For these banks, trading derivative exposures offset non-derivative trading exposures to a greater extent after SFAS 133. Our results suggest that, contrary to critics’ claims, SFAS 133 has increased the risk relevance of accounting measures of derivative exposures to bond investors and benefited banks in terms of reducing their cost of capital.
Dividends, Share Repurchases, and Tax Clienteles: Evidence from the 2003 Reductions in Shareholder Taxes
Authors: Blouin Jennifer L. , Raedy Jana S. , Shackelford Douglas A.
Published: December 2010

ABSTRACT: This study jointly evaluates firm-level changes in investor composition and shareholder distributions following a 2003 reduction in the dividend and capital gains tax rates for individuals. We find that directors and officers, but not other individual investors, rebalanced their portfolios to maximize after-tax returns in light of the new tax rules. We also find that firms adjusted their distribution policy (specifically, dividends versus share repurchases) in a manner consistent with the altered tax incentives for individual investors. To our knowledge, this is the first study to employ simultaneous equations to estimate both shareholder and managerial responses to the 2003 rate reductions. We find that the generalized method of moments (GMM) estimates are substantially stronger than OLS estimates, consistent with our expectation that investor and manager responses are simultaneously determined. Failure to estimate systems of equations may account for some of the weak and conflicting results from prior studies of the 2003 rate reductions.
How a Systems Perspective Improves Knowledge Acquisition and Performance in Analytical Procedures
Authors: Brewster Billy E.
Published: December 2010

ABSTRACT: Auditors are required to understand dynamic business environments as part of the performance of analytical procedures. Prior evidence, though, suggests that auditors have difficulty understanding such environments. This study reports an experimental investigation of techniques that help auditors to identify incorrect management representations by developing expectations that are both accurate and adaptive to changing business conditions. My predictions suggest that analyzing a dynamic client environment through a systems perspective enhances information-processing ability, which then improves both evidence discrimination and the assimilation of new audit evidence. Results reveal that participants taking a holistic systems-based view of a client environment develop more coherently organized mental models that increase their likelihood of identifying management representations that are inconsistent with industry evidence. Furthermore, these participants more efficiently use their information-processing ability, thereby improving assimilation of newly learned evidence to understand how changing business conditions affect their initial expectations.
Principles-Based versus Rules-Based Accounting Standards: The Influence of Standard Precision and Audit Committee Strength on Financial Reporting Decisions
Authors: Agoglia Christopher P. , Doupnik Timothy S. , Tsakumis George T.
Published: December 2010

ABSTRACT: Recent accounting scandals have resulted in regulatory initiatives designed to strengthen audit committee oversight of corporate financial reporting and have led to a concern that U.S. GAAP has become too rules-based. We examine issues related to these initiatives using two experiments. CFOs in our experiments exhibit more agreement and are less likely to report aggressively under a less precise (more principles-based) standard than under a more precise (more rules-based) standard. Our results also indicate that CFOs applying a more precise standard are less likely to report aggressively in the presence of a strong audit committee than a weak audit committee. We find no effect of audit committee strength when the standard is less precise. Finally, we find support for a three-path mediating model examining mechanisms driving the effect of standard precision on aggressive reporting decisions. These results should be of interest to U.S. policymakers as they continue to contemplate a shift to more principles-based accounting standards (e.g., IFRS).
Mathematical Model of the Effective Properties of a Fiber Reinforced Composite with a Linearly Graded Transition Zone
Authors: Childers Carey F.
Published: December 2010

Tires are fabricated using single ply fiber reinforced composite materials, which consist of a set of aligned stiff fibers of steel material embedded in a softer matrix of rubber material. The main goal is to develop a mathematical model to determine the local stress and strain fields for this isotropic fiber and matrix separated by a linearly graded transition zone. This model will then yield expressions for the internal stress and strain fields surrounding a single fiber. The fields will be obtained when radial, axial, and shear loads are applied. The composite is then homogenized to determine its effective mechanical properties—elastic moduli, Poisson ratios, and shear moduli. The model allows for analysis of how composites interact in order to design composites which gain full advantage of their properties.
Use of Orthogonal Arrays for Efficient Evaluation of Geometric Designs for Reducing Vibration of a Non-Pneumatic Wheel during High-Speed Rolling
Authors: Rutherford William , Bezgam Shashank , Proddaturi Amarnath , Thompson Lonny , Ziegert John C. , Rhyne Timothy B. , Cron Steven M.
Published: December 2010

During high speed rolling of a nonpneumatic wheel, vibration may be produced by the interaction of collapsible spokes with a shear deformable ring as they enter the contact region, buckle, and then snap back into a state of tension. In the present work, a systematic study of the effects of six key geometric design parameters is presented using Orthogonal Arrays. Orthogonal Arrays are part of a design process method developed by Taguchi which provides an efficient way to determine optimal combinations of design variables. In the present work, a two-dimensional planar finite element model with geometric nonlinearity and explicit time-stepping is used to simulate rolling of the nonpneumatic wheel. Vibration characteristics are measured from the FFT frequency spectrum of the time signals of perpendicular distance of marker nodes from the virtual plane of the spoke, and ground reaction forces. Both maximum peak amplitudes and RMS measures are considered. Two complementary Orthogonal Arrays are evaluated. The first is the L8 orthogonal array which considers the six geometric design variables evaluated at lower and higher limiting values for a total of eight experiments defined by statistically efficient variable combinations. Based on the results from the L8 orthogonal array, a second L9 orthogonal array experiment evaluates the nonlinear effects in the four parameters of greatest interest, (a) spoke length, (b) spoke curvature, (c) spoke thickness, and (d) shear beam thickness. The L9 array consists of nine experiments with efficient combinations of low, intermediate, and high value levels. Results from use of the Orthogonal Array experiments were used to find combinations of parameters which significantly reduce peak and RMS amplitudes, and suggest that spoke length has the greatest effect on vibration amplitudes.
Avascular Villi, Increased Syncytial Knots, and Hypervascular Villi Are Associated with Pregnancies Complicated by Factor V Leiden Mutation
Authors: Rogers Beverly Barton , Momirova Valerija , Dizon-Townson Donna , Wenstrom Katharine , Samuels Philip , Sibai Baha , Spong Catherine , Caritis Steve N. , Sorokin Yoram , Miodovnik Menachem , O'Sullivan Mary J. , Conway Deborah , Wapner Ronald J. ,   Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network
Published: December 2010

There is controversy about whether pathologic abnormalities are associated with pregnancies complicated by factor V Leiden (FVL) mutation. The purpose of this study was to evaluate 105 placentas delivered to mothers heterozygous for FVL mutation to determine if there are pathologic changes suggestive of hypoxia or thrombosis, which correlate with mutation status. We examined placentas obtained as part of a prospective study of 5188 pregnancies analyzed for the presence of FVL mutation in either the mother or the infant. One hundred five placentas from mothers heterozygous for the mutation were compared with 225 controls matched for maternal age, race, and geographic site. Of the 330 pregnancies, 50 infants were FVL mutation heterozygotes. Maternal FVL heterozygote status was associated with more frequent increased numbers of syncytial knots (13% vs 4%); the difference remained significant after controlling for hypertension, preeclampsia, small-for-gestational-age infants, and delivery prior to 35 weeks of gestation (odds ratio 3.6, 95% confidence interval 1.5−8.7, P = 0.004). Maternal FVL heterozygotes had more hypervascular villi (10% vs 3%), with significance retained controlling for delivery route (odds ratio 3.4, 95% confidence ratio 1.2–9.4, P = 0.018). Placentas from infants heterozygous for FVL mutation had more avascular villi than controls (odds ratio 2.9, 95% confidence interval 1.5–5.6, P = 0.001). Fetal or maternal FVL heterozygosity was not associated with infarcts, small-for-gestational-age placentas, or fetal thrombotic vasculopathy. This analysis demonstrates that pathologic findings associated with placental hypoxia, specifically focal avascular villi, increased numbers of syncytial knots, and hypervascular villi, also correlate with FVL heterozygosity in infants or mothers.
Laboratory and Clinical Predictors of Thrombosis and Hemorrhage in 29 Pediatric Extracorporeal Membrane Oxygenation Nonsurvivors
Authors: Reed Robyn C. , Rutledge Joe C.
Published: December 2010

Extracorporeal membrane oxygenation (ECMO) is a lifesaving therapy for infants and children with cardiac and respiratory failure. However, thrombosis and hemorrhage are common complications. To determine clinical and laboratory predictors of thrombosis and hemorrhage resulting from ECMO, records and slides were reviewed from 29 consecutive autopsies from 2004 through 2008 of pediatric patients who received ECMO at our institution. Laboratory results, including prothrombin time, activated partial thromboplastin time, platelet count, fibrinogen level, and activated clotting time, were analyzed, as was heparin dosing. Thrombosis and hemorrhage were very common, with 1 or both seen in 86% of patients. Sixty-nine percent had thrombosis, and 52% had hemorrhage after ECMO initiation, including intracranial hemorrhage in 33% of the patients in whom brain examination was permitted. Hemorrhage and thrombosis coexisted in 31% of patients. Thrombosis was significantly more common in patients with congenital cardiac disease. Duration of ECMO therapy, being on ECMO at death, sepsis, and patient age and sex did not predict hemorrhage or thrombosis at autopsy. Laboratory tests were poor predictors of thrombosis and hemorrhage, with no correlation between these complications and prothrombin time, partial thromboplastin time, platelet count, fibrinogen level, activated clotting time, or heparin dose. In conclusion, thrombosis and hemorrhage continue to be frequent complications among patients who die during or after ECMO therapy. Patients with congenital cardiac disease appear especially susceptible to thrombosis on ECMO. Prothrombin time, partial thromboplastin time, platelet count, fibrinogen level, activated clotting time, and heparin dose are poor predictors of thrombosis or hemorrhage for pediatric patients who die after ECMO.
Supernumerary Intestinal Muscle Coat in a Patient with Hirschsprung Disease/Mowat-Wilson Syndrome
Authors: Leong May , Verey Frances , Newbury-Ecob Ruth , Ramani Pramila
Published: December 2010

We present the 1st case report of an additional enteric smooth muscle layer in a patient with Mowat-Wilson syndrome and Hirschsprung disease. After resection of the aganglionic colon at the age of 5 months, our patient initially suffered from intermittent constipation, and subsequently by the age of 5 years, he developed ongoing diarrhea requiring medical treatment for more than a decade. Although the exact mechanism of abnormal gut motility in this case is unknown, we postulate that the supernumerary muscle and its associated neural plexus may be responsible for the patient's unusual late complication in treated Hirschsprung disease.