bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-surgical approach to bleeding gastric ulcer
Authors: Mijalkovic N.S. , Djuranovic S. , Popovic D. , Pavlovic A.R. , Culafic Dj. , Jovanovic I. , Sokic-Milutinovic A. , Krstic M.N.
Published: November 2008

Bleeding gastric ulcers is a common reason for emergency upper endoscopy in Emergency Center of Clinical Center of Serbia. Randomized controlled trials have shown that endoscopic hemostasis is beneficial for patients with a bleeding peptic ulcer. Aim of this study was to analyze the frequency, etiological factors and localization of bleeding gastric ulcer. At the same time we were evaluated a degree of bleeding activity according to Forrest?s classification and modality of performed endoscopic hemostasis. All patients who underwent upper gastrointestinal (UGI) endoscopy for bleeding gastric ulcer in Emergency Center (January 2001.- December 2005.) were identified from an endoscopy database and the clinical records were reviewed retrospectivel. A total of 3954 patients underwent UGI endoscopy for presumed acute UGI hemorrhage. More than thirty % of them(31,1)- 1230 had an endoscopic diagnosis of bleeding gastric ulcer. We observed 1230 bleeding patients (60 % male and 40 % female) with a mean age of 64,3. The commonest localization of bleeding gastric ulcers was antrum (54 - 15%). Percentage of patients who received non-steroidal anti-inflammatory drugs (NSAIDs) and/or salicilates before bleeding was 54, 6%. The main symptom was melaena, which was observed in 82, 44% of patients with bleeding gastric ulcer. According to Forrest?s classification of bleeding activity, the most of patients had F IB and F III degree (23, 41% and 22, 76%). Injection endoscopic hemostasis was performed in 26,34% patients, which had active bleeding (F IA, F IB) Hemostasis was initially obtained in 96% of bleeding patients. Bleeding gastric ulcer is one of the commonest endoscopic diagnosis in Emergency Center of Clinical Center of Serbia. The most frequent etiology factor was no - steroid antinflamatory drugs and/or salicilates. Injection endoscopic hemostasis is a safe procedure with a low cost, and, if successful, substantially reduces the need for emergency surgery.
Surgical treatment of gastroduodenal ulcer bleeding: Our experience
Authors: Krstic S.N. , Alempijevic T. , Krstic M.N. , Lausevic Z.D. , Sijacki A. , Djukic V.R. , Jovanovic D. , Stefanovic B. , Arsenijevic V.
Published: November 2008

Introduction: Acute bleeding from the upper gastrointestinal tract remains the commonest emergency in gastroenterology, and is most often caused by gastroduodenal ulcer disease. Despite introduction of novel endoscopic techniques and pharmacological treatment, 6-15% patients have to be operated. The aim of our investigation is analyze data of patients treated for gastrointestinal ulcer bleeding in our institution, their treatment options and outcome. Patients and methods: We included 2237 patients admitted in the Department for Emergency medicine of Clinical center of Serbia during the period from January 1999 until December 2003. because of gastroduodenal ulcer bleeding. We analyzed age, gender treatment option, hospital stay and mortality. Results: The mean age of our patients was 61.58 years, 1346 male and 891 female. The majority of patients were conservatively treated (84.5%). Operated patients mostly undergo Billroth II resection (57.8%). The mean hospital stay was 7.3 days. Average mortality was 14.4% Conclusions: Despite adequate endoscopic management of bleeding gastroduodenal ulcer, surgeons will continue to treat this patients for emergency surgery.
Therapeutically effect of the physical procedures on the elbow contractures in children with supracondylar humerus fractures
Authors: Jandric S.Dj.
Published: November 2008

Supracondylar humerus fractures are the most common fracture around the elbow in the pediatric population. These fractures in children may lead to functional disturbance with loss or reduction of range of motion in the elbow joint. The aim of this study was to investigate the effect of the physical therapy on the range of the motion of the elbow joint in the post-traumatic elbow contractures in the childhood after supracondylar fractures. We analyzed in this research 34 children (average age 8.57+2.94 years) with elbow contractures that were treated by physical therapy after orthopedic treatment. Functional outcome was presented in degree from 1 to 3 (Flynn). The difference in the grade at the beginning and the end of the therapy is statistically significant (t=16.38, p<0.001). 91.18 %, of the children had excellent result. Complex of various therapeutically physical procedures can significant improve range of motion of the elbow joint. .
Compliance and capacity of the normal human rectum: Physical considerations and measurement Pitfalls
Authors: Zbar A.P.
Published: November 2008

The assessment of parameters which adequately represent rectal and neorectal compliance is complex. Biological properties of the rectum during distension and relaxation show significant departures from in vitro physical compliance measurements; as much dependent upon the viscoelastic characteristics of hollow organ deformation as upon the technique of compliance calculation. This review discusses the pressure/volume characteristics of importance in the rectum during distension from a bioengineering perspective and outlines the disparities of such measurements in living biological systems. Techniques and pitfalls of newer methods to assess rectal wall stiffness (impedance planimetry and barostat measurement) are discussed. .
Endometriosis in cesarean section surgical scar
Authors: Stefanovic D. , Kerkez M. , Djordjevic Z. , Knezevic S. , Markovic Lj. , Knezevic Dj. , Palibrk I. , Novakovic I. , Ignjatovic I. , Dimitrijevic Ivan
Published: November 2008

Introduction: Endometriosis is the presence of endometrial glands and stroma outside of uterine cavity. It may occur in the abdominal wall scar after the operation in which uterus was opened. In cesarean section scar it occurs in 0.4%. It is in 2/3 patients characterized with triad of: tumor, periodic pain associated with menses and history of cesarean section. The mechanism of endometriosis occurring in the cesarean scar is felt to be secondary to iatrogenic transplantation of endometrium or extrauterine decidual tissue into the incision during the cesarean section. Case outline. Forty years old patient with tumor 4,5x4 cm that appeared in abdominal wall scar one year after second cesarean section, followed by periodic pain and macroscopic changes associated with menses. First diagnosis was granuloma in the surgical scar, but as she had periodic symptoms, diferential diagnosis was endometriosis. Hormonal therapy with contraceptive drugs was ordered. As it was no improvement she was operated. The surgical excision of the tumor including fascia and muscle tissue was done. Sample revealed endometrium after histopathologic examination. Patient was completely recovered and without relapse of symptoms during follow up to date. Conclusion. When there is a tumor in the cesarean section scar or scar after the operation in which uterus or ovarial tube was opened, followed with periodical pain and macroscopic changes associated with menses, endometriosis should be considered. Surgical excision of the tumor is sufficient and patohistological examination confirms diagnosis. .
Treatment of emergency surgical complications of kidney transplantations
Authors: Dzamic Z. , Acimovic M. , Tulic C. , Basic D. , Milutinovic D. , Hadzi-Djokic J.
Published: November 2008

Surgical complications subsequent to the kidney transplantation are not infrequent and they are characterized by the high percentage of graft loss (596-18% in standard surgical procedures and up to 37% in atypically performed transplantations). The study included 311 transplanted patients (206 (66.2%) living donors and 105 (33.8%) cadaver donors). Surgical complications developing during the immediate posttransplantation period as well as during the late period (after a year and a half) were classified as: I urinary complications; II vascular complications; III other complications. In majority of the cases urinary complications (urinary fistulas, ureteral obstructions, vesico-ureteral reflux) as well as other complications (cholecystopancreatitis and lymphocele) did not necessitate urgent treatment, unlike most of the vascular complications. All the vascular complications (29/311) developed during the immediate postoperative period, except for occurrence of arterial stenoses which ensued later on, while the development of symptoms was rapid. Severity of both symptoms and clinical picture necessitated urgent surgical re-intervention in order to preserve the graft and patient?s life. Vascular complications were classified as: true vascular complications, hemorrhages and kidney ruptures in order to distinguish technical and other factors contributing to development of the complications. Onset of the true vascular complications related to the graft and recipient blood vessel changes was evidenced in 20 patients (69%/29 patients) while the incidence of hemorrhages and ruptures was considerably lower (14%/29 patients and 17%/29 patients). As for the true vascular complications, vascular stem thrombosis subsequent to cadaveric transplantations was the most frequent, and transplantectomy was performed in all the cases in absence of any lethal outcomes. Two cases with iliac artery rupture resulted in graft loss subsequent to urgen exploration. In all cases with hemorrhages the applied therapy resulted in positive responses, except in one case in which massive gastrointestinal hemorrhage led to lethal outcome. The response to the urgent surgical treatment of spontaneous kidney graft ruptures was positive in 60% of the cases, while in the remaining 40% transplantectomy was necessitated due to the extensiveness of the lesion in order to preserve patient?s life. .
Primary adrenal hydatid cyst: A case report
Authors: Tsaroucha A.K. , Polychronidis A.C. , Laftsidis P.A. , Pitiakoudis M.S. , Fotakis S.N. , Simopoulos C.E.
Published: November 2008

A rare case of primary adrenal hydatid cyst is reported in a 56-year-old male. The cyst was discovered incidentally. The only symptom was hypertension. Partial excision of the gland and pericystectomy were performed. Surgical treatment was also therapeutic for the hypertension. .
Evaluation and management of traumatic rupture of the corpus cavrnosum
Authors: Milutinovic D. , Dzamic Z. , Acimovic M. , Hadzi-Djokic J.
Published: November 2008

Fracture of the penis, or rupture of the corpus c avernosum is an uncommon injury, but probably under-reported entity. Only approximately 180 cases have been reported in the literature. Penile N fracture with urethral injury is even more uncommon, accounting for approximately 10 to 20% of the cases reported. Early reports on this injury suggest conservative therapy as the choice of treatment. Recent reports emphasize immediate surgical repair to prevent late sequelae of injury, especially those associated with urethral rupture. We review 5 cases with evaluation, treatment and follow-up. Delays in treatment lead to long-term complications. .
Five-years experience with urinary derivation by sygma-rectum pouch at the Department for urology in Smederevo
Authors: Obradovic G. , Stanojevic D. , Jakovljevic V. , Hadzi-Djokic J. , Acimovic M.
Published: November 2008

Bladder cancer has poor prognosis. Outcome of the treated patients is dependent on correct staging, histologic grade of the tumor, and correctly realized surgical intervention, i.e. radicality of the operation. During the period from 2002. to 2004., on the Department for Urology in Smederevo, 120 patients were surgically treated because of bladder tumors. Of that number, in 34 patients radical cystectomy and derivation by Sygma-Rectum pouch was done. Of these 34 patients, 22 (64.7%) were being followed during the five-years period.
Chemotherapy by M-VAC protocol in progressive bladder carcinoma treatment
Authors: Janicic A. , Tulic C. , Radosevic-Jelic Lj. , Dzamic Z. , Acimovic M. , Hadzi-Djokic J.
Published: November 2008

Treatment of invasive bladder carcinoma is complex therapy procedure which means surgical and non-surgical treatment appliance. In spite of radical surgical treatment conduction, the gold standard in invasive bladder tumor therapy, about 30- 40% patients spread metastasis in further disease course. The system chemotherapy in invasive bladder tumors treatments is marked with accent. Its fundamental aim is to correct results of surgical treatment. This therapy option very often means the only modality in bladder carcinoma treatment, for instance, in the diseminal disease faze. The adjuvant chemotherapy imposes a task to correct surgical treatments results in case where the high risk of recidive breaking out exists. As risks for recidive breaking out cite are: a) lymphatic and vascular invasion into the primary tumor; b) extravezical tumor extension-T3b; c) tumor invasion neighboring structures-T4; d) positive lgl findings- N+. After radical cystectomy caused by high level malignancy tumors - T3b,T4, is founded frequency of positive lgl of about 40-60%. Patients with positive lgl have badly prognosis. Only 17% they survive longer than two years, and 7% have surviving of five years.
Morphologic characteristics of the urothelial bladder tumors
Authors: Radosavljevic R. , Hadzi-Djokic J. , Acimovic M. , Pejcic T. , Tulic C. , Dzamic Z.
Published: November 2008

Cancer of the urinary bladder is the fourth most common cancer in men and the ninth in women. Approximately 67.000 people (50.000 males and 17. 000 females) develop bladder cancer each year in the United States, and 13.750 individuals (9.630 males and 4.120 females) are expected to die from it. In the showing of the morphologic characteristics of the tumors, authors underlining the increasing of the incidence, pathogenesis, premalignant lesions and the risk factors of disease.
Indikacije i rezultati resekcionih hirurskih postupaka u lokalizovanom obliku bronhiektazija
Authors: Subotic D.R.
Published: November 2008

Although the prevalence of bronchiectasis decreased significantly in developed countries, in less developed and in developing countries, it still represents a significant cause of morbidity and mortality. The localized form of bronchiectasis is the indication for surgical treatment if recurrent respiratory infections make normal life and professional activity impossible. Less frequently, the operation is necessary independently on the symptoms duration, if massive hemoptysis are life threatening for the patient. Compared with the period 10-15 years ago, the diagnostics of bronchiectasis changed in terms that bronchography has been replaced by high resolution CT scan. Owing to angiographic studies performed on sufficient number of patients, the patophysiology of bronchiectasis is fatherly highlighted, but without significant changes in the process of patient selection. In the text, particular accent was given to situations that usually represent practical problems: billateral bronchiectasis, hemoptysis, bronchiectasis after pleural empyema, abscending bronchiectasis and bronchiectasis in children. The outcome of the surgical treatment is good in 90% patients, with operative mortality thatis comparable to that after lung resections for other indications.
Anatomical and functional outcome in nonoperative management of patients with fractures of the distal radial bone
Authors: Cvetkovic V. , Lesic A.
Published: November 2008

Tracking of anatomical and functional results obtained after non-surgical treatment of the distal radius included 115 patients in total, of whom 51cases were available to be analyzed and processed within this work. Tracking of the results was based upon Anatomical Score System and Gartland-Werley Score System. The final numerical results obtained through Anatomical Score were the following:excellent in 12 cases (23.52%), good in 30 cases (58.82%), satisfactory in 8 cases (15.68%), dissatisfactory in 1 case (1.96%). According to the Gartland- Werley Score System, the final results included: excellent in 19 cases (37.25%), good in 24 cases (47.00%), satisfactory in 7 cases (13.72%), dissatisfactory in 1 case (1.96%). This work also presents correlation between Residual Deformity score, Subjective Hardship score and Objective dysfunction, with the results obtained by Anatomical score and Gartland-Werley total score. The possibility of dissatisfactory results obtained by radiological screening followed by dissatisfactory outcome is described in literature; however, dissatisfactory screening results could be found in up to 31.7% of cases with satisfactory clinical findings. Our work records 15.7% of the latter cases. We might say that non-surgical treatment is not to be accepted as the only and exclusive approach to distal radius fracture. Thus, proper evaluation is mandatory.
Disease of lower cranial nerves caused by vascular compression
Authors: Antic B.D. , Peric P. , Stefanovic S.Lj.
Published: November 2008

Between April 1989 and September 2007, 181 patients with disease of lower cranial nerves (DLCN) underwent posterior fossa exploration. As a cause of DLCN, vascular compression (VC) was present in 89 patients with trigeminal neuralgia (TN), in 6 with hemifacial spasm (HFS), in 1 with glossopharyngeal neuralgia, in 1 with Meniere?s disease, and in 5 with multiple DLCN. Depending on intraoperative findings, different surgical options were used: microvascular decompression (MVD), MVD with partial sensory rhizotomy (PSR) or total sensory rhizotomy (TSR). Statistic analysis was made using the Fisher?s exact 2-side test. In patients with TN, excellent outcome was archived in 83 patients and good in 6. Postoperative outcome was better (p = 0.007) in cases with severe VC, but without significant correlation between used surgical option and outcome (p = 0.402). Frequency rate of relapses did not depend on severity of VC (p = 0.502) and used surgical option (p = 0.175). In 6 patients with HFS, excellent outcome was archived in 5 with arterial compression and poor in 1 with venous contact. In patients with Meniere?s disease and glossopharyngeal neuralgia, MVD result with excellent outcome. In 5 patients with multiple DLCN, excellent outcome was archived in 3 and good in 2. MVD is method of choice in surgical treatment of DLCN caused by VC. Overall outcome is better with severity of VC.
Screening of risk groups for discovering intracranial aneurysms before rupture
Authors: Vujotic Lj.B. , Rakic M.Lj. , Radulovic D.V. , Slavik E.E. , Danilovic L.R. , Nestorovic B.D. , Rasulic L.G. , Jovanovic V.T.
Published: November 2008

In development of intracranial aneurysms contribute genetic factors together with smoking, hypertension, diabetes mellitus. Epidemiology studies suggest that as many as 5% of people harbour a cerebral aneurysm by age 75. Rupture of cerebral aneurysm is the most frequent cause of spontaneous subarachnoid haemorrhage (up to 80%.) Annual incidence of SAH is 10-14/100 000, but only 15-20% of aneurysms will rupture, and that will happen probably between 40-60 years. The morbidity and mortality of aneurismal subarachnoid (SAH) continues to be high. It is not possible to predict who has aneurysm and is it going to bleed or not, but it is possible to reveal high risk groups (polycystic kidney disease, Ehlers-Danlos sy, Marphan sy, family history of cerebral aneurysms, suspect de novo aneurysm formation in patients with prior history of cerebral aneurysm). Reviewing data from literature and reporting cases from each group with high risk, that have been screened and aneurysms discovered, authors wish to focus interest on this matter and propose screening program for these groups of patients. The mortality and morbidity in cases treated before rupture is significantly lower than after SAH, so screening programs could save many lives. According to our preliminary data, mostly based on control angiographies after 8-10 years in patients previously operated for intracranial aneurysmas, from 15 angipgraphies 4 revealed new aneurysms (26% in 10 years period) with total number of 6 de novo formed aneurysms, which is not valid due to small number of patients but strongly suggests the importance of screening program for risk groups.
Neurosurgic treatment of spontaneous and traumatic intracerebral hematomas
Authors: Djurovic B.M. , Tasic G.M. , Jovanovic V.T. , Nikolic I.M. , Krunic-Protic R.V. , Radulovic D.V. , Jokovic M.B. , Ilic R.V.
Published: November 2008

In the period from 01.01.2000 until 31.12.2002 34 patients with spontaneous intracerebral hematoma (ICH) and with deeply disturbed state of consciousness were operated in the Department of neurosurgery of the Urgent Center, Clinical Center of Serbia. In all operated patients the indication for surgery was given on the basis of CT scan of the brain, state of consciousness, defined Glasgow coma score (GCS) and neurological status, but due to existing or threatening incarceration not even one patient was submitted to angiography of the blood vessels at the cerebral base, thus preoperatively we did not know the cause of the hemorrhage. Of 34 operated patients 22 or 64.7% died, and 12 or 35.3% survived. 14 patients were in the deepest phase of coma, where the preoperative GCS is from 3 to 5 points, and in the postoperative course only one survived, aged 25. The other survivors had somewhat less disturbed state of consciousness, they also were younger, CT scan of the brain was without blood in the chamber system. In the same period, in the Department of Neurosurgery of the Urgent Center, Clinical Center of Serbia 43 patients with traumatic intracerebral hematoma (TIH) were operated; 9 patients survived, 34 died. Only 4 patients had acute TIH. All of them were in the terminal stage of incarceration, and despite being immediately submitted to surgery all of them died. The remaining 39 patients had, the so called delayed TIH where the secondary CT scan of the brain showed development of the traumatic intracerebral haematoma that was not verified on the incipient scanner. Indication for a repeated CT scan was given in 19 patients due to focal or general neurological deterioration. However in 20 patients subsequent neurological disturbances were not registered. Those that survived were younger patients, and they were not in the deepest stage of coma, most often they had a temporal localization of hematoma.
Difference between values of gas analysis of arteries and internal jugular vein in patients with cerebral infarction
Authors: Danilovic L.R. , Milakovic B.D. , Dostanic M.M. , Stoic M.M. , Baljozovic B.V. , Kojic Z. , Marinkovic D.M. , Markovic D.J.
Published: November 2008

Introduction. Cerebral infarction is more and more frequently present by massive participation and high percentage of mortality even in young population. It is notified as very hard, vitally endangered disease. Objective. To prove whether there is a difference in the gas analyses of the arterial and cerebral venous blood between the patients with the cerebral infarction of the left and right hemisphere and why it is significant for the treatment of those patients. Material and methods. Sixty-five (65) patients of both sexes who were diagnosed by CT as: cerebral infarction, cerebral multiinfarctions and cerebral haemorrhagic infarctions were investigated. Under the same conditions their radial artery and left and right internal jugular vein were tapped - on the fourth, eighth and tenth day of their disease. Gas analysis, calculation of oxygen content and statistical comparison of testing results were performed from the samples of arterial and venous blood. Results. By continuous monitoring of gas analysis parameters of arterial and cerebral venous blood from internal jugular vein, we can follow up the phases of disease, the velocity of changes of gas analysis parameters and adequacy of brain circulation and to correct therapy adequately for the purpose of preventing basic disease complications and to estimate the results of treatment. Conclusion. There is a significant difference between the results of gas analysis of arteries and the internal jugular vein, in patients with infarctions of the left and right hemisphere of the brain.
Autonomic nerve preservation in rectal cancer surgery - the forgotten part of the TME message a practical "workshop" description for surgeons
Authors: Heald B.
Published: November 2008

Conceptually TME has its basis in embryology. The original hypothesis was that cancer spread will tend, initially at least, to remain within the embryologic lymphovascular hindgut "envelope" the mesorectum and mesocolon. The corollary to the perfect specimen and cure is the perfect preservation of the layers surrounding the mesorectum which, are formed by the autonomic nerves and plexuses. The first obstacle is that few realistic photographs, sketches or diagrams have been published and visualisation and lighting low down in the pelvis is always problematic. Even when they are understood and visualised the difficulties inherent in preserving these nerves are due to the fact that they are actually adherent to the mesorectum at certain points where the dissection becomes particularly challenging. The most important and most adherent areas are the so-called "lateral ligaments" - low down laterally and anterolaterally where the inferior hypogastric plexuses (virtually the pelvic sex-brain) tether the whole mesorectal package. When the specimen has been carefully released it lifts up in a somewhat spectacular fashion - hence the old idea that there are ligaments at these points. A lesser degree of adherence may be found at various other points and particular care is required anteriorly where the nerves are converging towards the bulb of the penis with a trapezoidal septum between them - Denonvillier?s "fascia"- which is in turn adherent to the anterior mesorectum and lower down in the prostate.
Closure of loop ileostomy after low anterior rectal resection and restorative proctocolectomy
Authors: Krivokapic Z. , Bilali S.
Published: November 2008

Objective: Low pelvic anastomoses are associated with a high leak rate. Loop ileostomies are commonly performed during ileoanal and coloanal anastomoses. This study was undertaken to review our experience with loop ileostomy closure after low anterior rectal resection and restorative proctocolectomy. Patients and methods: One hundred sixty five patients undergoing loop ileostomy closure at a single institution after coloanal and ileoanal anastomoses for rectal carcinoma (n=148) ulcerative colitis (n=9) and FAP (n=8) from January 2003 to December 2006. Fecal diversion was maintained for a mean 13,5 weeks. Results: Of the 165 patients, 100 were male and 65 female with mean age 59 (range 23-83 years). Overall, complication rate was 10,9 per cent. The common complication were sub occlusion six patients, occlusion three patients, wound infection eight patients and abdominal sepsis one patient. Complications required operative management in four cases. There was no mortality related to ileostomy. Conclusion: The study shown that ileostomy closure is a safe and effective with generally minor complications and should be considered as a safe alterative for fecal diversion.
The management of desmoids in patients with familial adenomatous polyposis (FAP)
Authors: Seow-Choen F.
Published: November 2008

Desmoids are rare in the general population but occurs in between 10 to 20% of patients with familial adenomatous polyposis (FAP). This risk is about 852 times the risk for the population at large. Desmoids are benign neoplasms that are capable of infiltrating locally with a high risk of recurrence (25-65%) even after extirpating surgery. Desmoids in FAP may occur extra-abdominally, or within the abdominal wall or most commonly intra-abdominally within the mesentery or retroperitoneal Desmoids are a major problem in patients with FAP. Mortality from desmoids is high in such patients and ranges from 18 to 31%, compared to peri-ampullary carcinomas at about 22% and cancer in the retained rectum at only about 8%. Simple drug treatment with tamoxifen or NSAIDS like sulindac should be used as first line treatment as it carries a response in 30-50% of patients. Surgery should be reserved for extra-abdominal tumours alone and only when needed. Surgery for intra-abdominal desmoids should really only be attempted for intestinal obstruction or ureteric obstruction. Dacarbazine-Doxorubicin chemotherapy may have dramatic response in some cases. Genetic transfer may unlock this disease in future and may give patients with FAP and severe desmoids hope for the future.
Ischaemic colitis - review
Authors: Dimitrijevic I. , Micev M. , Saranovic Dj. , Markovic V. , Petrovic J. , Antic S. , Sekulic A. , Krivokapic Z.
Published: November 2008

Colonic ischaemia, commonly referred to as ischaemic colitis, is the most common type of intestinal ischaemia. The term "ischaemic colitis" was used by Marston (1966) with three typical patterns of injury described: transient reversible ischaemia, ischaemic ulcers with stricturing, and gangrenous ischaemic colitis. Dominant presenting symptoms were colicky abdominal pain, vomiting, bloody diarrhea, and hematochezia. Patients often have minimal signs on clinical examination. Most patients were diagnosed at colonoscopy. Two regions that are believed to be anatomically vulnerable to ischemic disease are "Griffith?s point", at the splenic flexure and "Sudeck?s critical point", of the Drummond marginal artery. Clinically, ischaemic colitis is classified as non-gangrenous or gangrenous. Non-gangrenous ischaemic colitis involves the mucosa and submucosa and accounts for 80-85 percent of all cases of ischaemic colitis. Non-gangrenous ischaemic colitis is further subclassified into transient, reversible ischaemic colitis with a less severe form of injury and chronic, non-reversible ischaemic colitis, which includes chronic colitis and stricture and has a more severe form of injury. Gangrenous ischaemic colitis accounts for the remaining 15-20 percent of cases and manifests as the most severe form of injury. It includes acute fulminant ischaemia with transmural infarction that may progress to necrosis and death. Specific indications for operation include peritonitis, perforation, recurrent fever or sepsis, clinical deterioration in patients refractory to medical management. Relative indications include fulminant colitis, massive hemorrhage, chronic protein losing colopathy, and symptomatic ischemic structure.
Diverticulitis
Authors: Pfeifer J.
Published: November 2008

Diverticular disease produces a wide range of clinical presentations varying from minimal clinical discomfort to life-threatening complications. Often there is a considerable discrepancy between clinical, radiologic, endoscopic and pathologic findings. Diverticulosis is a quite common disease affecting about 2/3 of people in the Western world over the age 80. The exact incidence of acute diverticulitis is unclear. We distinguish between uncomplicated and complicated diverticular disease forms. The latter includes abscess formation, stricture, obstruction, and free perforation causing life-threatening peritonitis. Several classifications for perforated diverticulitis have been proposed. From the practical point of view the Hansen-Stock classification seems to be the most appropriate one as it includes all forms of diverticular disease; it can also be used preoperatively. Prophylactic resection to avoid complications is not justified in minimally symptomatic individuals. Timing of the operation depends on the clinical course and the grade of peritonitis and on concomitant treatment modalities. Emergency operations should be avoided if possible, to reduce morbidity and mortality. Elective operations should be performed best 6-8 weeks after a second diverticulitis attack. Resection plus primary anastomosis is preferred to a Hartmann?s procedure, if possible. Elective surgery should be done laparoscopically. In acute diverticulitis the goal is to treat uncomplicated forms conservatively, while complicated forms should undergo elective, laparoscopic colon resection.
Open and closed haemorrhoidectomy for fourth degree haemorrhoids - comparative one center study
Authors: Mik M. , Rzetecki T. , Sygut A. , Trzcinski R. , Dziki A.
Published: November 2008

AIM: We compared results of two techniques of haemorrhoidectomy: open Milligan-Morgan (MM) and closed Ferguson (CF) techniques. Length of hospitalization, pain complaints, return to full activity, wound healing time were considered. METHODS: We included the group of 63 patients: 29 patients (16 women) were randomly allocated to MM operation and 34 patients (15 women) to CF operation. Follow-up study was performed after 2, 4, 24 weeks and six and eighteen months postoperatively. RESULTS: We did not note any statistically significant differences in relation to hospitalization time 30.9 days (MM) and 30.8 days (CF). Postoperative urine retention was similar: 5 (17,2 %) patients (MM) and 7 (20,6 %) patients (CF). No differences in the intensity of postoperative pain was observed. Patients returned to work after 293 days (MM) and 342 days (CF) (p=0,059). We observed no infection of the wound in MM group but in four patients from CF group (11,8%); (p=0,053). However overall wound healing time was shorter after CF method than after MM method: 233 vs. 274 days, respectively (p=0,053). CONCLUSIONS: Our study confirms that the results after MM and CF haemorrhoidectomy are similar. We found a trend towards faster wound healing after CF procedure, however there was a trend towards higher wound infection in that group. There was also a trend towards shorter recovery time in patients after MM operation.
Humanoid standing control: learning from human demonstration
Authors: Hofmann Andreas , Popovic Marko , Herr Hugh
Published: November 2008

A three-dimensional numerical model of human standing is presented that reproduces the dynamics of simple swaying motions while in double-support. The human model is structurally realistic, having both trunk and two legs with segment lengths and mass distributions defined using human morphological data from the literature. In this investigation, model stability in standing is achieved through the application of a high-level reduced-order control system where stabilizing forces are applied to the model's trunk by virtual spring- damper elements. To achieve biologically realistic model dynamics, torso position and ground reaction force data measured on human subjects are used as demonstration data in a supervised learning strategy. Using Powell's method, the error between simulation data and measured human data is minimized by varying the virtual high-level force field. Once optimized, the model is shown to track torso position and ground reaction force data from human demonstrations. With only these limited demonstration data, the humanoid model sways in a biologically realistic manner. The model also reproduces the center-of-pressure trajectory beneath the foot, even though no error term for this is included in the optimization algorithm. This indicates that the error terms used (the ones for torso position and ground reaction force) are sufficient to compute the correct joint torques such that independent metrics, like center-of-pressure trajectory, are correct.
Open-chain analysis of single stance
Authors: Mizrahi Joseph , Brion Orly , Adam Dan
Published: November 2008

In this study we present a model by which the kinematics of single stance standing can be formulated and solved from forceplate measurements. A three-segment model with four rotation coordinates, two at the ankle and two at the hip, was developed as an open chain of linkages, with the trunk treated as the end-effector. Using the Denavit-Hartenberg notation, the trajectory of the center of mass (CoM) was evaluated by an iteration procedure, combining angular momentum principles with direct integration of the equations of motion. Kinematics and torques in the joints were thereafter solved. Single stance standing experiments were made on six healthy subjects and forceplate measurements served as input data for the model. The results show that the typical CoM excursion is within 2-3 cm roughly one order of magnitude higher than in double stance standing. Average oscillations of the joint angles ranged from 0.79 to 4.57 deg, with the higher values taking place in the hip sagittal rotation. The highest torques were coronal, at the hip, amounting to an average of 141 Nm. It was also found that when moving from ankle to hip the sequence of torque and angular displacement is inverted, indicating that the power delivered to the muscles at the distal/proximal joint is taken back by the muscles acting about the upper/lower joint. This provides evidence for the central strategy of the body to keep the CoM in a stable position.
The role of the hering-breuer deflationary reflex in the control of spontaneous human respiration
Authors: Fuhr Thomas , Jaeger Robert
Published: November 2008

The application of engineering control theory to biological systems is a challenge. Often, in initial engineering models or designs of systems to exert control over a certain aspect or part of a biological system, other control loops may be in operation within the biological system that are not accounted for. When the operation of such unconsidered hidden loops reveals themselves, this presents an opportunity to expand knowledge of biological control systems. A complimentary pair of reflexes involved in respiration was described by Hering and Breuer in 1868. Since that time, the manifestation of these reflexes has been controversial. In a recent group of studies seeking to apply an open-loop control system to assist or restore ventilation by electrically stimulating abdominal muscles, unexpected experimental results led to a more thorough study of the potential presence of the Hering-Breuer deflationary reflex in adult human subjects. This paper describes experiments in which abdominal compression (both manual and by electrical stimulation of abdominal muscles) provide evidence supporting the presence of the deflationary reflex control loop in adult human subjects. The results can be utilized to develop a comprehensive model of the human respiratory system considering both chemical and mechanical feedback.
Towards a compact and computer-adapted formulation of the dynamics and stability of multi rigid body systems
Authors: Hemami Hooshang
Published: November 2008

The dynamics of rigid bodies coupled by homonymic and non-homonymic constraints are formulated by the Newton - Euler method - employing a compact notation. The compact notation involves the use of two three by three matrices A and ? and the totality of constraint vector C. The Lagrangian and Newton - Euler methods are related for a one - link rigid body in order to introduce the methodology of the paper in full detail. Stability and control of the resulting nonlinear systems are investigated by the use of Lyapunov methods. Digital computer simulations of typical movements are carried out in order to demonstrate feasibility of the formulation and the approach.
A nonlinear neural fir filter with an adaptive activation function
Authors: Lee Su , Bozic Milorad , Mandic Danilo
Published: November 2008

An adaptive amplitude normalized nonlinear gradient descent (AANNGD) algorithm for the class of nonlinear finite impulse response (FIR) adaptive filters (dynamical perception) is introduced. This is achieved by making the amplitude of the nonlinear activation function gradient adaptive. The proposed learning algorithm is suitable for processing of nonlinear and nonstationary signals with a large dynamical range, and removes the unwanted effect of saturation nonlinearities. For rigor, sensitivity analysis is performed and the improved performance of the AANNGD algorithm over the standard LMS, NGD, NNGD, the fully adaptive NNGD (FANNGD) and the sign algorithm is verified by simulations on nonlinear and nonstationary inputs with large dynamics.
A taxonomy fuzzy filtering approach
Authors: Vrettos S. , Stafylopatis A.
Published: November 2008

Our work proposes the use of topic taxonomies as part of a filtering language. Given a taxonomy, a classifier is trained for each one of its topics. The user is able to formulate logical rules combining the available topics, e.g. (Topic1 AND Topic2) OR Topic3, in order to filter related documents in a stream. Using the trained classifiers, every document in the stream is assigned a belief value of belonging to the topics of the filter. These belief values are then aggregated using logical operators to yield the belief to the filter. In our study, Support Vector Machines and Na?ve Bayes classifiers were used to provide topic probabilities. Aggregation of topic probabilities based on fuzzy logic operators was found to improve filtering performance on the Renters text corpus, as compared to the use of their Boolean counterparts. Finally, we deployed a filtering system on the web using a sample taxonomy of the Open Directory Project.
Elementary linear filtering tasks using CNNs with minimum-size templates
Authors: Matei Radu , Goraç Liviu
Published: November 2008

In this paper we investigate the linear filtering capabilities of the standard cellular neural network in the general case of non-symmetric templates. We approached here systematically the CNNs with minimum-size templates (1x3), analyzing in detail their filtering capabilities in the one-dimensional case. Starting from a general form of the spatial transfer function, we emphasize some useful filtering functions that can be obtained. For each filter type, we derive the relations which give the template parameter values, in order to design a given CNN filter with specified characteristics-like central frequency, bandwidth, selectivity etc. Filters with symmetric templates are treated as a particular case. For each type of filtering the characteristics are shown and simulation results are presented as well. Some of these results are then extended to 2-D CNNs and several simulations of useful filtering tasks are presented on real images.
Clustering and mapping spatial-temporal datasets using SOM neural networks
Authors: Reljin Irini , Reljin Branimir , Jovanovic Gordana
Published: November 2008

Large datasets can be analyzed through different linear and nonlinear methods. Most frequently used linear method Is Principal Component Analysis (PCA) known also as EOF (Empirical Orthogonal Function) analysis, permitting both clustering and visualizing high-dimensional data Items. However, many problems are nonlinear In nature, so, for analyzing such a problems some nonlinear methods will be more appropriate. The SOM (Self-Organizing Map) neural network is very promising tool for clustering and mapping spatial-temporal datasets describing nonlinear phenomena. The SOM network is applied on the precipitation and temperature data observed in the region of Serbia and Montenegro during 48 years period (1951-1998) and the zonal maps of homogeneous geographical units are derived. These maps are compared with those recently derived via EOF analysis. Significant similarity of results derived from the two methods confirms high efficiency of the SOM network in analyzing spatial-temporal fields. Moreover, the SOM neural network is more appropriate in analyzing climate data since both climate data and the SOM analyzing method are nonlinear in nature.
Control of leg movements driven by electrically stimulated muscles
Authors: Radulovic Milovan , Popovic Dejan , Jaukovic Novak
Published: November 2008

A planar biomechanical model of a human leg has been developed to investigate automatic control strategies for artificially stimulated muscle using electrical stimulation (ES). The model comprises the nonlinear multiplicative model of the muscles, tendons and two body segments (thigh and shank-foot complex), that is, the hip and the knee. Flexor and extensor muscles are included for each joint. The parameters determining the model used for the analysis can all be assessed; hence, the model can be customized to a particular subject. Simulation software is organized within the SIMULINK environment, and the user can easily change parameters of the model by using Dialogue Boxes. The simulation allows determining constraints imposed by parameters, which are essential for designing control system for rehabilitation of humans with disabilities.
3D visualisation of MRI images using MATLAB
Authors: Kleut Duska , Jovanovic Milorad , Reljin Branimir
Published: November 2008

This paper describes the use of MATLAB in three-dimensional reconstruction of human brain MRI images. The programme that was designed enables observing disections of the gained 3D structure along three axes.
A measuring system for supervision of the rail welding machine PRSM-4 no. 083
Authors: Antic Boris , Pejic Dragan
Published: November 2008

The paper describes a measuring system implemented on the rail welding machine PRSM-4 No. 083. The measuring system monitors and controls all parameters of rail welding procedure in real time. The paper gives an overview of the measurement of all relevant variables, control of the duration of individual welding phases and of the basic options of the command software. The paper describes the most important parts of the measuring block and presents the results of the system exploitation on over 10,000 completed welds on territories of Serbia, Montenegro and Bosnia and Herzegovina during a period of about two years.
Automatic classification of leukocytes
Authors: Mircic Stanislav , Jorgovanovic Nikola
Published: November 2008

This paper presents a novel algorithm for the automatic compilation of differential blood count (DBC), which is based on the direct analysis of a blood smear image and artificial neural networks. The results of the algorithm testing show high sensitivity of the algorithm in leukocyte detection and classification accuracy of 86%. Also, the algorithm enables the detection of potentially falsely classified leukocytes and in that way, with the help of a hematological expert, enables additional increase in the DBC compilation quality.
Low-frequency noise of a Dual-Gate MOSFET in linear region
Authors: Videnovic-Misic Mirjana , Jevtic Milan , Nadj Laslo
Published: November 2008

This paper presents results of low frequency noise measurements for a Dual-Gate MOSFET (DGMOSFET) in linear region. DGMOSFET working conditions are chosen in order to set both inner transistors in linear regime. Results are discussed with the use of the unified 1/f noise model.
Cursive word raw segmentation based on scanning Skew slots
Authors: Babic Ranko
Published: November 2008

In this paper we present an outline of a method for low-level structural analysis of cursive words by scanning skew slots which produce histograms or word profiles. Having different angles slots can detect corresponding structural details - writing strokes and their directions. The word baseline which serves as a reference for slot angles, can be easily revealed Also from word profiles taken by different slots we can get candidate spots for preliminary word segmentation. Although very simple this segmentation approach does not request any preprocessing of input bitmap image, including deskew, deslant or smoothing, but it is not resistant on patch noise. In the same manner it is possible to structurally examine isolated word segments without interference with neighboring ones, in order to combine prominent details from various histograms and get lexicon-like segment description. Finally, we announce further improvement of analytic abilities of this method through partial histograms which more successfully cope with specific structural cases.