bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of continuous subcutaneous insulin infusion by a portable insulin pump during pregnancy in women with type 1 diabetes mellitus
Authors: Zoric Svetlana , Micic Dragan , Kendereski Aleksandra , Sumarac-Dumanovic Mirjana , Cvijovic Goran , Pejkovic Danica , Cvetkovic Milos , Ljubic Aleksandar , Dukanac-Stamenkovic Jelena
Published: December 2010

Background/aim: Diabetes mellitus is associated with an increased risk for neonatal morbidity and mortality. One of the most important goals in treating pregnancies complicated with diabetes is keeping glucose level within the normal range, especially in the first trimester. A portable insulin pump for continuous subcutaneous insulin infusion (CSII) represents the best form of therapy for patients with type 1 diabetes mellitus during pregnancy. The aim of our study was to evaluate the effects of therapy with a portable insulin pump for continuous subcutaneous insulin infusion during the first trimester of pregnancy on the quality of glycoregulation and pregnancy outcome in women with type 1 diabetes mellitus. Methods. A total of 17 newly diagnosed pregnant women with type 1 diabetes mellitus were treated with CSII therapy for three months. The parameters of glycoregulation (hemoglobin A, glycosylated - HbA1c, mean blood glucose value in daily profiles - MBG, daily requirement for insulin - IJ/kg BM), lipid levels, blood pressure and renal function were estimated before and after the therapy. These parameters were correlated with parameters of pregnancy outcome: fetal weight, APGAR score, duration of pregnancy. Results. There was a significant improvement in HbA1c (8.94?1.62 vs. 6.90?1.22 %, p < 0.05), MBG (9.23?2.22 vs. 6.41?1.72 mmol/l, p < 0.01), and daily requirement for insulin (0.66?0.22 vs. 0.55?0.13 IJ/kg BM, p < 0.05) during the CSII therapy. There were significant correlations between fetal weight and HbA1c (r = -0.60, p < 0.05), triglyceride levels (r = ?0.63, p < 0.01), and the number of pregnancies (r = ?0.62, p < 0.01), as well as between APGAR score and MBG (r = ?0.52, p < 0.05) and cholesterol levels (r = ?0.65, p < 0,01) before a portable insulin pump was applicated. Conclusions. There was a significant improvement in the quality of glycoregulation during CSII therapy in the pregnant women with type 1 diabetes mellitus. The quality of glycoregulation in the moment of conception was the important factor for pregnancy outcome.
Heyde's syndrome
Authors: Perisic Nenad , Doder Radoje , Ilic Radoje , Jovic Jasna , Tukic Ljiljana , Tavciovski Dragan
Published: December 2010

Background: Heyde's syndrome implies an association of calcified aortic stenosis with the high gradient of pressure and angiodysplasic bleeding from the digestive tract. It has been proven that in patients with this syndrome, acquired form of von Willebrand type II A develops. Replacing of aortic valves by artificial ones brings about the spontaneous retreat of coagulation disorder, and the stoppage of the digestive tract bleeding. Case report. We reported two patients with the Heyde's syndrome. In one of the patients the aortic valves were replaced by biologic valves, after which the digestive tract bleeding stopped, while the second patient was treated conservatively due to a high operation risk. Conclusion. Patients with Heyde's syndrome are a complex multidisciplinary problem, thus their adequate treatment requires a team work in order to provide the most rational type of therapy for each patient separately.
Descending necrotizing mediastinitis
Authors: Cvijanovic Vlado , Stanic Vojkan , Ristanovic Aleksandar , Gulic Bojan , Durkovic Savo , Stamenovic Davor , Maric Nebojsa
Published: December 2010

Background: Descending necrotizing mediastinitis (DNM) is an acute, serious, septic disease which results from a complication of oropharyngeal infection. The disease requires a prompt diagnosis and radical surgical treatment to reduce high mortality (40%). The optimal form of mediastinal drainage remains controversial. The reason for publishing this report is both the fact that DNM is very rare and our experience preferring thoracotomy as an optimal approach to treating the disease. Case report. We reported a 34-years-old woman with DNM. The disease began as a peritonsillar abscess. After a bilateral double pleural drainage the disease worsened. In order to achieve radical mediastinal debridement and drainage, we carried out posterolateral right thoracotomy. We also had to perform left thoracotomy because of massive bleeding caused by septic erosion. There were no more reoperations. Conclusion. Aggressive surgical treatment, regardless the localization and the extent of changes is the key to success in the treatment of patients with necrotizing mediastinitis.
Local application of concentrated trombocytes and the level of osseointegration of dental titanium implants: a histomorphometrical analysis
Authors: Lazic Zoran , Bubalo Marija , Matic Smiljana , Stamatovic Novak
Published: December 2010

Background/aim: In order to achieve better, and, thus an increased bone-implant interface, growth factors have been used over the past few years. All growth factors considered have fundamental role in the growth and development of cells and tissues. Concentrated trombocytes from platelet-rich plasma (CT-PRP) are fraction of the blood. Thrombocytes contain a number of growth factors namely PDGF, TGF-?, IGF, VEGF and many others, which contribute to the achievement of the increased bone-implant interface, the increased stability of implants and the faster functional loading of implants. The aim of this study was to establish the effect of CT-PRP on bone implant interface. Methods. This experimental study included six dogs in which 24 BCT implants were inserted (4 implants per dog). On the left side of the lower jaw 2 implants were placed with CT-PRP, while on the right side the implants were placed without CT-PRP. The animals were sacrificed after 42, 70, and 98 days. The specimens were examined histomorphometrically, and analyzed 42, 70 and 98 days after the implant insertion. The contacts bone to implant in 16 zones for each analyzed implant were measured according to the established protocol. Results. Results obtained with histomorphometrical analysis imply the increased bone-to-implant contact by use CTPRP. The difference of the bone-to-implant contacts between these two groups of inserted implants has been particularly pronounced at six weeks after the implant insertion. Conclusion. According to the obtained results in the measurement of the level of osseointegration of the inserted implants, it should be advisable to use the CT-PRP method because it provides the higher level of osseointegration.
Inflammatory pseudotumor of the spleen
Authors: Colovic Natasa , Colovic Radoje , Grubor Nikica , Micev Marijan , Radak Vladimir , Stojkovic Mirjana
Published: December 2010

Background. Inflammatory pseudotumors are benign tumor lesions of an unknown etiology that can appear almost at any organ, sometimes along with infectious agens, like Epstein-Barr virus. They are extremely rare in the spleen, with less than 80 cases described in the world literature. It is a single, very rarely multinodal lesion. Middle aged patients are mostly affected. Symptoms are either absent or uncharacteristic, so that the tumors are discovered by chance or during investigations of other diseases. Case report. We presented a 56-year-old woman in whom a nodal lesion of 2 cm in diameter had been discovered in the spleen during a routine check-up after a mild traffic accident. The lesion had grown up to 6 cm in diameter during a 5-year follow-up causing a mild pain over the upper left abdomen and left shoulder. Fine needle biopsy failed to show the exact nature of the lesion. Splenectomy was performed due to a suspected lymphoproliferative disorder. Histology and immunohistochemistry of the lesion of the upper pole of the spleen showed inflammatory pseudotumor. Epstein-Barr virus was not present. The patient developed postsplenectomy thrombocytosis (up to 850 ? 109/l) which settled down within 10 weeks. Conclusion. Inflammatory pseudotumors of the spleen are extremely rare. The exact diagnosis can be established only by histology and/or immunohistochemistry of the spleen removed for a suspected lymphoproliferative disorder, most frequently lymphoma. The patient was cured with splenectomy.
Growing skull fracture
Authors: Mihajlovic Miljan , Nikolic Igor , Raicevic Mirjana
Published: December 2010

Background. Growing skull fracture or craniocerebral erosion is a rare complication of linear skull fracture in childhood. It is characterized by progressive diastatic enlargement of the fracture line, which leads to a cranial defect, dural cleft, and cerebral herniation. It is presented as a soft pulsabile scalp swelling above the fracture, with a clear cranial defect. Case report. In this paper we presented a patient, an 8-month-old boy with the growing skull fracture revealed four weeks after the injury. After the surgical treatment, the boy was in a good general condition without the presence of neurologic impairment. Conclusion. Early recognition of craniocerebral erosion is very important. Timely detection prevents further progression of the disease and the evolution of neurological impairment. Surgery is the method of choice for treating a growing skull fracture .
Parathyroid carcinoma
Authors: Filipovic Aleksandar , Paunovic Ivan , Savjak Dragutin , Zivkovic Tamara
Published: December 2010

Background. Parathyroid carcinoma is the least frequent malignancy among endocrine tumors. In the most reported series of patients with primary hyperparathyroidism the incidence of carcinoma is less than 1%. Recognition by a surgeon that the parathyroid tumor is malignant, and the performance of an adequate en bloc removal of primary lesion, with histologic diagnosis offer the best treatment of a patient with this unusual malignancy. Case report. We reported a 30-year-old patient with parathyroid carcinoma, primary hyperparathyroidism, and recurrent nephrocalcinosis. Marked hypercalcemia, low serum phosphorus, and substantial elevation of serum parathyroid hormone indicated a diagnosis of primary hiperparathyroidism. General symptoms were anorexia, muscle weakness, back pain and depression. Ultrasonography done before the surgery revealed a 2 cm upper left parathyroid gland with solid and cystic areas. The neck exploration was done with en block resection of the tumor. A histopathological evaluation confirmed the diagnosis of parathyroid carcinoma. Over more than a three-year-follow-up, the patient had no evidence of the disease recurrence and his serum PTH and calcium levels remained within the normal. Conclusion. Parathyroid carcinoma is a rare cause of primary hyperparathyroidism. Preoperative diagnosis remains a challenge. Radical en bloc resection of the tumor is the treatment of choice for this malignancy.
Roentgencraniometric evaluation of the craniofacial dimensions in subjects with symptoms of temporomandibular disorders
Authors: Dodic Slobodan , Vukadinovic Miroslav , Sinobad Vladimir
Published: December 2010

Background/aim: The aim of this study was to evaluate the possible association between certain morphologic features of the craniofacial skeleton and the presence of symptoms of temporomandibular disorders in young subjects with natural dentitions. Methods. The investigation was carried out on 80 lateral cephalometric radiographs of two groups of male and female subjects between 18 and 25 years of age with natural dentitions. The analysed group consisted of 30 subjects with symptoms of temporomandibular disorders, and the control group of 50 subjects without such symptoms. According to the values of the ANB angle (position of the maxilla with the mandible- Steiner cephalometric analysis) all subjects were classified in the skeletal class 1. The roentgen craniometric analysis of cephalometric radiographs included the evaluation of 25 linear dimensions which values were compared between the examined groups and with the values of the same dimensions in the Bolton standards for 18 years of age. Results. The results of this study confirmed the presence of significant differences between the examined linear dimensions in the Bolton standards and the same dimensions measured in the subjects of the analyzed and the control group. The comparative analysis of these values between the groups confirmed the presence of significant differences in following linear dimensions at the level of p<0,00: S - Cs(Go), Mol - PP, Mol - MP and Ar - Go. Conclusion. Significant differences between the examined linear dimensions measured in the subjects included in this study and the same dimensions in the Bolton standards can be explained by specific morphologic features of the craniofacial skeleton in people of our population. Within the limitation of this study, the minor differences in the values of the examined linear variables between the subjects of the experimental and the control group can not be accepted as indicators of disturbed function of the orofacial system.
Significance of color doppler ultrasonography in the assessment of pancreatic carcinoma vascular invasion
Authors: Alempijevic Tamara , Kovacevic Nada , Tomic Dragan , Djuranovic Srdjan , Krstic Miodrag
Published: December 2010

Background/Aim. It is highly appreciated to provide exact data on vascular invasion of pancreatic carcinoma relying as much as possible on non-invasive diagnostic procedures. Color Doppler ultrasonography has been proven as an efficient method for clinical staging of pancreatic carcinoma essential for therapeutic decisions. The aim of this study was to provide an analysis of the sensitivity and specificity for color Doppler ultrasonography in patients suffering from pancreatic carcinoma. Methods. We performed color Doppler ultrasonography examination in 43 patients with pancreatic carcinoma prior to the surgery. The findings of ultrasonography on neoplasm vascular invasion were correlated to the findings obtained during the subsequent surgical procedures. An estimation of neoplastic invasion of certain blood vessels including portal vein, celiac trunk, and superior mesenteric artery and vein is critical for decision making regarding surgical treatment. The patients with metastases of pancreatic carcinoma were excluded from the study. Results. Comparing color Doppler and the surgical findings we estimated the sensitivity for detection of neoplastic vascular invasion ranging from 79?93%, whereas the specificity range was from 83?93%. Conclusion. Color Doppler ultrasonography is a sufficiently sensitive and specific method for evaluation of vascular invasion in pancreatic carcinoma patients. Since color Doppler ultrasonography is a non-invasive, radiation free, and inexpensive diagnostic tool, considering also the results of this and similar studies we could strongly recommend its use for an initial presurgical evaluation of vascular invasion in pancreatic carcinoma patients.
Mobility of B.C.T. Dental implants inserted by one and two-phase surgical method: An experimental study
Authors: Stamatovic Novak , Matic Smiljana , Lazic Zoran , Tatic Zoran
Published: December 2010

Background/Aim. Achievement of the osseointegration of dental implants is of crucial importance for their long-term survival. One of the factors that influence the osseointegration is a surgical method of implantation. The outcome of osseointegration can be evaluated on the basis of implant mobility in bone. The aim of this study was to investigate and compare the mobility of B.C.T. dental titanium implants inserted to experimental animals using an one and two-phase method. Methods. The investigation was performed using a split-mouth design on nine dogs, male german shephards, average age of 3.5 years and average weight of 32 kg. Extractions of the third and fourth lower premolars were performed under intravenous (i.v.) anaesthesia with 5% ketamine chloride. Eight weeks after the extractions, the implants, diameter of 4.5 mm each, with four threads 13.7 mm long, were inserted. Eighteen implants were inserted one side of the jaw using a one-phase method, and another 18 implants were inserted contralaterally using a two-phase method. Three months after the implantation, the implant mobility was evaluated. Three measurements were performed with a Periotest device, and average values were calculated. The implant mobility was classified according to the Periotest scale in four groups of Periotest values (PTV) and compared. A total of 36 implants were inserted in 9 experimental dogs. The PTV ranged from -7.666 to + 50. Results. According to the Periotest scale, 14 one-phase implants (78%) were classified into the 0 group of PTV, and 4 one-phase implants (22%) in the 3rd group. Thirteen two phase implants (72%) were classified in the 0 group, and 5 implants in the 3rd group of Periotest scale. The difference in the average values of PTV between the two methods was 0.879 which was not statistically significant. Conclusion. This study showed that the method of implant insertion had no influence on the implant mobility, i.e. satisfactory osseointegration could be achieved by both methods. Further clinical parameters, as well as pathohistological and histomorphometric ones, have to be evaluated in order to assess better outcome of a particular method.
Preparation and testing of buffered eye drops containing pilocarpine chloride with timolol maleate
Authors: Rakic Danijela , Antunovic Mirjana
Published: December 2010

Background/Aim. In glaucoma therapy ?-blocator, timololmaleate, is the firsk-line medicine of selection, whereas a miotic, pilocarpine chloride, is one of the oldest medicines used for the treatment of this illness. They are applied as eye drops. In order to achieve a better therapeutic effect and improve life quality of the ill, we produced and tested eye drops formulations based on combining pilocarpinechloride and timolol maleate in buffers of different pH values. Methods. Following the general pharmacopoeial eye drops preparation regulation, we prepared formulations, of solution type, of pilocarpine chloride and timolol maleate combination, of pilocarpine choloride alone and of timolol maleate alone. A modified phosphate buffer according to Sorensen at 7.4, 7.7 and 8.0 pH values was used as a solvent. The quality of the produced formulations was examined using physical and physic-chemical methods and biological tests. Following pharmacopoeial regulations, we examined clarity, pH value and sterility. Pilocarpine chloride level was determined by means of ion-par (High Performance Liguid Chromatography) RP-HPLC method, whereas UV/VIS absorption spectrophotometry was used for determining the level of both timolol maleate, and timolol. Results. Results showed that monocomponent and combined preparations complied with the regulation demands. With the increase in the pH value of the solution pilocarpine chloride level decreased in relation to its initial content, whereas timolol level showed a tendency of moderate increase. Conclusion. Magistrally prepared pilocarpine chloride eye drops with timololmaleate have satisfied all the required conditions for an ophtalmological preparation. A modified phosphate buffer according to Sorensen at 7.4 pH value proved to be the most optimal solvent.
Reconstruction of the anterior cruciate ligament of the knee
Authors: Nikolic Dragan , Draskovic Vlajko , Vulovic Rajko
Published: December 2010

Background/Aim. Numerous papers on reconstruction of the anterior cruciate ligament of the knee (ACL) contribute to the significance of this method. The aim of this study was to analyze the outcome of the use of this surgical treatment method regardless the type of surgical intervention, graft, and the choice of the material for fixing. Methods. The study included 324 patients treated within the period from April 1997 to April 2004. Arthroscopically assisted ACL reconstruction was typically performed using the central one-third of the patellar ligament, as a graft, with bone blocks. Fixing was performed using screws (spongy or interferential, Mitek type). In the cases who required revision of the surgery, we used a graft m. semitendinosus and m. gracilise (STG) or a graft of the patellar ligament (B-Pt-B). Fixation in these cases was performed using absorptive wedges according to the Rigidfix technique or metallic implants. Results. The analysis included the results of the reconstruction of the anterior cruciate ligament of the knee (B-Pt-B or STG graft) in 139 of the knees. Chronic injuries were revealed in 132 (94.9%) of the knees. According to the anamnesis and clinical findings, the feeling of instability prevailed in 132 (94.9%) of the knees, pain in 72 (51.7%), effluents in 24 (17.2%), and blockages in 13 (9.3%). Early and late postoperative complications were noticeable in 3.5% each. Hypotrophy of the upper knee musculature up to 2 cm was present in 53.9% of the operated knees, while minor contractions in 13.6% of them. The final result of the reconstruction graded begusing the Lysholm Scale was 85.2, simultaneous reconstructions of other ligaments 75.3, and revision surgery 68.0. First-grade degenerative postoperative changes according to the K/L Scale were found in 55.0% of the surgically treated knees, while the worst, four-grade one in 2.5%. Conclusion. On the basis of these findings, we can conclude that this method is the method of choice in preventing further "worsening" of the chronically instable knee. The surgical technique of choice is arthroscopically assisted reconstruction using a B-Pt-B or STG graft.
Review of potential doppler ultrasonographic findings in patients with confirmed gestational trophoblastic neoplasms
Authors: Nikolic Branka , Lazic Jelena
Published: December 2010

 Transvaginalna dopler ultrazvucna dijagnostika, kao neinvazivna i neskodljiva dijagnosticka metoda, ima respektabilno mesto u ranoj dijagnostici gestacijskih trofoblastnih neoplazmi. Uz odredjivanje serumske vrednosti humanog horionskog gonadotropina i pracenje dinamike njegovih promena, histoloski nalaz i promene u ultrazvucnoj slici, moguce je rano dijagnostikovati GTN, pa cak i maligne oblike, sto se pokazalo vaznim u donosenju pravovremene odluke o nacinu lecenja bolesnica i ocuvanja reproduktivnog zdravlja.
Rhodococcus equi infection
Authors: Mikic Dragan
Published: December 2010

 Humana R. equi infekcija jos uvek je retko oboljenje koje se javlja uglavnom kod osoba sa teskim stepenom imunodeficijencije. Najcesce se ispoljava u vidu subakutne bakterijske pneumonije sa kavitacijama, a karakterise se cestim recidivima, bakterijemijama i visokom stopom mortaliteta. Terapija R. equi infekcije bazira se na kombinaciji baktericidnih i antibiotika sa dobrom intracelijskom penetracijom koji se primenjuju u duzem periodu, dok su drenaza apscesnih kolekcija i/ili operativni zahvati indikovani samo u slucajevima izostanka adekvatnog odgovora na antibiotsku terapiju. Uzimajuci u obzir cinjenicu da je R. equi infekciju veoma tesko eradikovati, a u cilju sto ranijeg postavljanja prave dijagnoze i blagovremenog pocetka adekvatne terapije, od velikog znacaja je poznanje najvaznijih karakteristika ove bolesti.
Treatment of community-acquired pneumonia using the modern therapeutical guides
Authors: Skodric-Trifunovic Vesna , Pilipovic Natasa , Stefanovic Branislava
Published: December 2010

 Racionalizacija lecenja pneumonija primenom savremenih terapijskih vodica omogucava skracivanje hospitalizacije, lecenje se nastavlja ambulantno, sto doprinosi komforu bolesnika, znatno smanjuje troskove lecenja, smanjuje opterecenje medicinskih radnika, a istovremeno se izbegavaju nezeljene komplikacije dugotrajne hospitalizacije, kao sto su nozokomijalne infekcije, tromboflebitisi i druge komplikacije.
Extramedular plasmacytoma in the urinary bladder: Unusual localization
Authors: Rabrenovic Violeta , Kovacevic Zoran , Jovanovic Dragan , Rabrenovic Milorad , Milovic Novak , Cerovic Snezana
Published: December 2010

Background. Multiple myeloma is a plasmaproliferative disease characterized by the uncontrolled proliferation of a pathogenic plasma cell clone engaged in the production of monoclonal immunoglobulin. This condition affects the bone marrow, but it can be manifested in any other organ or tissue. The urinary bladder involvement is extremely rare. Case report. We reported a 70-year-old male with the history of multiple myeloma, receiving chemotherapy containing melphalan and prednisone (MP). Two years after the treatment, there was a renal failure associated with oligoanuria, hematuria and bilateral hydronephrosis. The urine cytology tests revealed the atypical cells, so was suspected obstructive uropathy to be caused by urothelium cancer. However, only upon the cystoscopy and biopsy performed on the urinary bladder mass, plasmacytoid infiltration diagnosis was confirmed. This extremely rare variant was presented throughout the illness period and proved to be resistant to the administered chemotherapy. Conclusion. When renal failure associated with hematuria and bilateral hydronephrosis is presented in a patient with multiple myeloma, this unusual and rare extramedular localization should be also considered.
Incidence of pelvic lymph node metastasis in radical prostatectomy
Authors: Jeremic Nebojsa , Cerovic Snezana , Brajuskovic Goran , Tomovic Sasa , Maletic-Vukovic Vinka
Published: December 2010

Background/Aim. Radical prostatectomy (RP) provides the best cancer control in patients with clinically prostate gland confined cancer. Multiple models and nomograms combining preoperative prostate-specific antigen (PSA) serum level, clinical stage and Gleason score have been developed to predict the probability of metastatic disease. In prostate cancer (PC) the presence of metastases to the pelvic lymph nodes (PLNs) is recognized widely as an unfavorable prognostic factor. Currently, PLNs dissection is not done in a low-risk group of prostate cancer patients. The aim of this study was to analyze PLN metastases in PC patients, in clinically localized stages of PC. Methods. Radical prostatectomy specimens with pelvic lymphadenectomy specimens from 82 PC patients were reviewed. In this group of patients, serum preoperative PSA values ranged from 2 to 23 ng/ml. Results. We diagnosed 11/82 (13.4%) patients with PLN metastases. There were 8 (72%) patients with pT3c pathological stage, and 3 (28%) patients with pT4a stage. PSA below 4 ng/ml was detected in 2/5 (40%) patients with PLN metastases. There was no statistically significant difference between preoperative PSA values and postoperative T stage, and PLN metastases. A statistically significant correlation between PLN metastases and the stage was found in the patients with pT4 and the patients with pT3c PC stages (p < 0.05). Conclusion. Recent RP series indicate PLN metastases to be less than 10%. We demonstrated higher detection of PLN metastases (13.4%) in our RP series. Our results suggest that PLNs dissection should be performed even in patients with low-risk PC.
Angiogenesis in squamous precancerous cervical lesions
Authors: Panjkovic Milan , Ivkovic-Kapicl Tatjana
Published: December 2010

Background/Aim. Vascularisation is one of basic tumor's characteristics. Neoangiogenesis starts at the stage of the dysplastic epithelial changes, thus before the progression into invasive lesion. This study was designed to determine the relation between stromal angiogenesis and the grade of cervical intraepithelial changes (CIN). Methods. The tissue sections of 50 cone biopsies were immunohistochemically stained for CD31 antigen, a marker for endothelial cells. All microvessels along the basement membrane subtending dysplastic epithelium were counted. The mean microvessel count was calculated from the three separate fields for each specimen. All the cases were devided into four groups: normal cervical epithelium (n = 5), CIN1 (n = 7), CIN2 (n = 13), and CIN3 (n = 25). Results. The mean microvessel count (MVC) under the dysplastic epithelium was 18.1. For the patients with CIN1 changes the mean MVC was 12.9, while this number was 18.72 and 19.24 for the patients with CIN2 and CIN3 grade of epithelial changes, respectively. In a subset of the high grade lesions vascular structures were also noted in the upper layer of the epithelium. The mean MVC in the cases with the presence of these structures was 22, while this number was 12.91 in the cases without intraepithelial vessels. Although we found an increase of the mean MVC with the increase of the CIN grade, statistically significant differences were found out between CIN1 and CIN3 lesions. The mean MVC of the patients with the presence of intraepithelial vessels was statistically higher than the mean MVC of the patients without these structures. Conclusion. On the basis of the obtained results, we can conclude that the mean MVC and CIN grade positively correlated, while the number of cases with intraepithelial vessels increased with the CIN grade.
Prognostic and therapeutic implication of residual timorous tissue in cervix conizate
Authors: Zivadinovic Radomir , Lilic Vekoslav , Petric Aleksandra , Tubic Aleksandra
Published: December 2010

Background/Aim. Conization is an excisive technique used for both diagnostic and therapeutic purposes. If conizate margins do not show any pathologic changes (negative findings) it is also the only therapeutic measure which should be applied. In case of conizate margins affected by the disease (positive findings), it is necessary not only to assess various parameters but also to decide on a further therapeutic approach. The aim of this study was to determine the incidence of positive findings and its impact on a further optimal therapeutic approach choice. Methods. The data for analyses were retrospectively acquired through an insight into the medical records of the female patients who had undergone conization in the Institute for Gynecology and Obstetrics, Clinical Center of Serbia, within a period from 1995 to 2000. Histopathologic analyses of the bioptic and cervical conizate and reconizate samples were performed in the same institute. The acquired data were analyzed and statistically processed. Results. Within the above mentioned period, a total of 823 conizations were done. In 76 patients, positive findings were determined. The acquired data analysis revealed positive findings decrease during this period, yet with no statistical significance. Higher statistically significant incidence of positive findings, however, was revealed in the patients over 40 years of age. Also, a statistically significantly higher incidence of positive findings was revealed in the apex as compared with other localizations. During the period observed, there was the raise of the number of patients only followed up after the conization without reconization. Also evident was decreasing in the number of histerectomies followed by increasing in the number of reconizations, as the method for reintervention. The most common cause of histerectomy was the apex positive findings with no statistical significance, while of reconization it was positive finding on lateral conizate margins with statistical significance. The association of the apical conizate positive finding with that in the curettements in all the cases was in correlation with positive findings at reintervention. Conclusion. According to the results obtained by analyzing and statistical processing of the acquired data, it could be concluded that reconization does represent a more suitable reintervention in patients with positive conizate findings as compared to histerectomy.
Damage of tubule cells in diabetic nephropathy type 2: Urinary N-acetyl-β-D-glucosaminidasis and γ-glutamil-transferasis
Authors: Vlatkovic Vlastimir , Stojimirovic Biljana , Obrenovic Radmila
Published: December 2010

Background/Aim. A damage of tubular epithelial cells is followed by the release of cell enzymes and production of proinflammatory compounds, which lead to the tubulointerstitial damage. The aim of this study was to examine the function of renal tubules in the patients with diabetes mellitus type 2 (DM type 2) and the various proteinuria degrees, to establish the damage of the proximal tubule cells caused by DM type 2 by determining urinary N-acetyl-?-D-glucosaminidasis (?-NAG) and ?- glutamil-transferasis (?-GT) activity in urine, as well as to compare the obtained results in the examined groups of patients with the values in the healthy examinees. Methods. A complete examination of renal function and selective enzymuria was performed in 37 patients with DM type 2, and 14 healthy examinees as the controls. The patients were divided in three groups according to the degree of proteinuria. The first group consisted of the patients with diabetes without microalbuminuria; the second one consisted of the patients with proteinuria of < 300 mg/24 h, and microalbuminuria of >20 mg/24 h, while the third one included the patients with proteinuria of >300 mg/24 h. Results. In the patients with DM type 2 and the preserved global renal function, fractional excretion of sodium, potassium and phosphates, as well as renal threshold of phosphates concentration, were not sensitive parameters for discovering the damage of the renal tubule function. The determination of ?-NAG activity proved to be the most sensitive parameter for early discovering of tubule cells damages. The difference among the examined groups was statistically highly significant. Conclusion. The increased presence of ?-NAG in the urine of DM type 2 patients, pointed out an early tubular disorder and damage of cells, while ?-GT was a less sensitive indicator of this damage.
Prevention of osteoporosis
Authors: Vujasinovic-Stupar Nada , Radojcic Ljiljana , Nenadic Dane
Published: December 2010

 Osteoporoza je generalizovan, progresivan i ireverzibilan proces gubljenja kostane mase sa ostecenjem mikroarhitekture kostanih gredica, pre svega trabekularne kosti, zbog cega kosti postaju lako lomljive. Ispitivanja ukazuju na pretecu epidemiju bolesti u nastupajucim decenijama usled demografskih prome- na, tj., povecanom broju osoba starijih od 65 godina. Prevencijom osteoporoze potrebno je obuhvatiti sve uzraste, osobe oba pola bez procene individualnih faktora rizika. Cilj je da se u svakom zivotnom periodu, na osnovu danasnjih dobro dokumentovanih medicinskih saznanja i cinjenica maksimalno ucini za postizanje i ocuvanje zdrave i cvrste kostane strukture. Kod prevencije osteoporoze bitna su sva tri stupnja: primarni, sekundarni i tercijarni. Oni se po nacinu lecenja preplicu. Terapija mora da bude individualizovana. Socioekonomski faktori igraju bitnu ulogu, kao i nacin ishrane, fizicka aktivnost i genetsko nasledje. Dokazan je pozitivan uticaj estrogena na promene u strukturi kostiju kod zena. Hormonska supstituciona terapija je efektna u prevenciji osteoporoze i dodatno doprinosi kvalitetu zivota, poboljsava kogniciju i odlaze pocetak demencije, smanjuje opseg kolorektalnog karcinoma 51. Veci broj studija pokazao je da se zivotni vek kod zena koje primaju HRT produzava 52, 53. Bitno je da postoji individualizovan pristup prevenciji i terapiji oteoporoze koji se zasniva na zasebnom rizicnom profilu svake zene. Veci broj pitanja koja su vezana za primenu HRT zahtevaju dodatna ispitivanja, kao sto su efekti na centralni nervni sistem, delovanje na kardiovaskularni sistem i na rizik od raka dojke.
Left ventricular noncompaction: A rarity or something else
Authors: Nikolic Aleksandra , Jovovic Ljiljana
Published: December 2010

 Nedovoljno formiran miokard je atipicna forma kardiomiopatije koju treba poznavati i na koju treba misliti pri rutinskim ehokardiografskim pregledima. Novija istrazivanja ukazuju da LVNC ima vecu prevalenciju zahvaljujuci poboljsanju imaging tehnika. Kako su kriterijumi za dijagnozu LVNC prvenstveno ehokardiografski, potrebno je upoznati lekare koji se bave ultrazvucnim pregledima srca sa osnovnim karkteristikama ovog oboljenja, kako bi ga u buducnosti lakse prepoznali. Nedovoljno formiran miokard je udruzen sa drugim nesrcanim oboljenjima, kao sto su neuromuskularna oboljenja. Predlaze se skrining bolesnika, narocito u porodicama sa neuromuskularnim oboljenjima da bi se pronasli bolesnici sa LVNC, kao i skrining bolesnika sa LVNC kako bi se otkrila neuromuskularna oboljenja. Kod familijarnog javljanja bolesti utvrdjena je genetska osnova nasledjivanja. Zbog pretpostavke da postoji dug preklinicki period, potrebno je da se otkriju bolesnici u asimptomatskoj ili oligosimptomatskoj fazi, kako bi se pratili i pravilno tretirali. Iako postoje kontroverze koje se odnose na etiologiju, patogenezu, dijagnosticke kriterijume i prognozu, vecina istrazivaca izrazava stav da i ovu kardiomiopatiju SZO treba da svrsta u poseban entitet.
Somatostatinoma of the Vater's papilla in a patient with von Recklinghausen's disease
Authors: Colovic Radoje , Micev Marjan , Grubor Nikica , Radak Vladimir
Published: December 2010

Background. Somatostatinomas of the gastrointestinal tract secret hormone somatostatin which can cause "inhibitory syndrome" comprising diabetes mellitus, cholelithiasis and steatorrheic diarrhea. It is also secreted by the D cells of Langerhans's islands of the pancreas as well as endocrine cells of the stomack, small bowel, salivary glands and parafollicular cells of the thiroid gland. Somatostatinomas of the digestive tract appear within the pancreas and duodenum. Patients suffering from von Recklinghausens's disease are paticularly prone to the somatostatinomas of the duodenum. Case report. In this paper we presented a 51-year old female patient with von Recklinghausen's disease in whom, during the investigation for obstructive jaundice, tumor of the Vater's papilla was found. The patient was submitted to Whipple's duodenopancreatectomy. Histology and immunohistochemistry discovered type B glandular carcinoid tumor with strong antisomatostatin and mild antigastrin immunoreactivity. The patient stayed symptom-free more than four years now. Conclusion. Patients with von Recklinghausen's disease should be examined for other tumors, particularly carcinoids of the duodenum and papilla, especially if the signs of cholestasis are present.
Comorbidity of eating disorder and alcohol dependency
Authors: Vukovic Olivera , Britvic Dubravka , Zebic Mirjana , Maric Nadja , Cvetic Tijana , Injac Lidija
Published: December 2010

Introduction. Epidemiological studies suggest that a high prevalence of alcohol addiction exists in female patients diagnosed with eating disorder in comparison to general population. For the purpose of explanation of the relationship of these disorders many conceptual models have been proposed. Case report. We presented a female patient displaying a comorbidity of eating disorder and alcohol dependency. We analyzed phenomenological similarities, personal characteristics and bio-psychological predisposition in order to ensure better understanding of the nature of the correlation of the two mentioned disorders. Conclusion. Even though, these days we find the synonym for eating disorders in the phrase "food addiction", it is impossible to categorize such a complex group of disorders to an addictive process. Moreover, we could assume that there exists a common psychobiological vulnerability which predisposes the development of one and/or the other disorder. To date knowledge has a significant implication for the development of new strategy in treating this comorbidity.
Mechanical properties of metal-ceramic systems from nickel-chromium and cobalt-chromium alloys
Authors: Mirkovic Nemanja
Published: December 2010

Background/Aim. Metal-ceramic bond strength and alloys' elastic modulus clearly determine the potential of alloy application, because the ceramic integrity during mastication depends on these two characteristics. The aim of this study was to evaluate metal-ceramic bond strength and elastic modulus of cobalt-chromium alloys in making porcelainfused- to-metal restorations, regarding the application of the most frequent nickel-chromium alloy. Methods. The research was performed as an experimental study. Six metalceramic samples were made from nickel-chromium alloy (Wiron 99) and cobalt-chromium alloy (Wirobond C), according to the manufactures manuals and instructions from ISO 9693: 1996. Three-point bending test was performed up to the ceramic fracture. The fracture load was measured on an universal testing machine (Zwick, type 1464), with cross-head speed of 0,05mm/min. Results. The results of this study confirmed the significant differences between the metal-ceramic bond strength (p < 0.01) and elastic modulus (p < 0.001) of nickel-chromium and cobalt-chromium alloys, where cobalt-chromium alloys showed higher values for both tested parameters. Conclusion. Cobalt-chromium metal-ceramic alloys can successfully replace nickel-chromium alloys, especially for fabrication of long-span metal-ceramic bridges due to the great flexural strength.
Pharmacovigilance in clinical trials
Authors: Ilic Katarina , Ugresic Nenad
Published: December 2010

 Spontano saopstavanje o nezeljenim efektima lekova u postregistracionoj fazi je od znacaja za registrovanje retkih nezeljenih efekata. Medjutim, klinicke studije omogucavaju da se pouzdano utvrdi ucestalost nezeljenih efekata, kao i da se proceni da li je toksicni potencijal leka takav da moze omoguciti njegovu bezbednu primenu. Neophodno je da se farmakovigilanca detaljno planira, sistematski sprovodi i da ima podjednako vaznu ulogu u klinickim istrazivanjima, kao utvrdjivanje efikasnosti leka. Objavljivanju rezultata klinickih istrazivanja koji se odnose na nezeljena dejstva lekova treba posvetiti vecu paznju. Regulatorne agencije moraju usloviti sponzore i istrazivace da putem naucnih publikacija sto pre ucine dostupnim siroj naucnoj javnosti podatke koji se odnose na toksicnost leka. Ovo je najbolji nacin da se na vreme, tj. pre registracije leka, proceni da li je korist veca od eventualne stete koju moze imati njegova primena.
Thoracic surgery in solving enormous elevation of the left hemidiaphragm
Authors: Cvijanovic Vlado , Stanic Vojkan , Ristanovic Aleksandar , Gulic Bojan , Durkovic Savo , Stamenovic Davor , Maric Nebojsa , Kovacevic Snezana
Published: December 2010

Background. Acquired elevation of the diaphragm is mostly the result of phrenic nerve paralysis, some of thoracic and abdominal patological states, and also some of neuromuscular diseases. Surgical treatment is rarely performed and is indicated when lung compression produces disabilitating dyspnea, and includes plication of diaphragm. The goal of this case report has been to show completely documented diagnostic procedures and surgical treatment one of rare pathological condition. Case report. A 62-year-old patient was admitted to our clinic because of surgical treatment of the enormous elevation of the left hemidiaphragm. After thoracotomy and plication of the bulging diaphragm, lung compression did not exist any more and mediastinum went back in the normal position. Conclusion. Elevation of the diaphragm rarely demands surgical correction. When it is complicated with lung compression and disabilitating dyspnea, surgical treatment has extremely useful functional effect.
External fixation combined with limited internal fixation in the treatment of pilon tibia fractures
Authors: Golubovic Zoran , Macukanovic-Golubovic Lana , Stojiljkovic Predrag , Jovanovic Jovica , Micic Ivan , Stojiljkovic Danilo , Milic Dragan , Mitkovic Milorad
Published: December 2010

Background/Aim. Intraarticular fractures of the tibial plafond (pilon fractures) belong to the group of most severe fractures. They are usually caused by high-energy trauma and frequently associated with a marked soft-tissue damage. Surgical treatment has replaced the traditional nonoperative treatment. The aim of this study was to present the results of the treatment of distal tibial intraarticular fracture by the use of internal fixation, as well as the combination of minimal internal fixation and external fixation. Methods. The study included 47 patients with pilon tibia fractures who went through at the Clinic for Orthopedics and Traumatology, School of Medicine, Nis (1995-2004). Within the analyzed group there were 33 (70.2%) males and 14 (29.8%) females. The patients mean age was 45.8 years. In the first group, which consisted of 22 patients, open reduction and internal fixation of both the tibia and the fibula was performed in the two separate incisions. The second group consisted of 25 patients managed with external fixation by external fixator "Mitkovic" with limited internal fixation. Besides external fixation, a minimal internal fixation was performed by the use of Kirschner wires and screws. The patients were followed-up inside a 24-months-period. Results. The obtained was a substantially high number of complications after open reduction and internal fixation in the group of patients. There was no difference in a long-term clinical outcome. Postoperative osteitis, as the most severe complication in the management of closed pilon tibia fractures, was not registered in the second group. Conclusion. Considering the results obtained in this study, it can be concluded that external fixation by the "Mitkovic" external fixator with the minimal internal fixation is a satisfactory method for the treatment of fractures of the tibial plafond causing less complications than internal fixation. .
Risk for infection by Lyme disease cause in green surfaces maintenance workers in Belgrade
Authors: Krstic Milena , Stajkovic Novica
Published: December 2010

Background/Aim. Lyme disease (LD) is a cosmopolitan disease from the group of zoonoses that in humans can affect skins, joints, heart and/or nervous system. Research conducted in endemic areas, shows not only that the population, which lives or works in tick habitats, is in a high risk for getting infected by LD cause, but also that every enviroment itself is specific in regard to both vectors and B. burgdorferi species. In our enviroment, research of seropositivity to B. burgdorferi in persons exposed to vectors of LD have not been conducted. The aim of this study was to determine whether there was a higher risk for getting B. burgdorferi infection in the fieldworks of JKP "Zelenilo Beograd" than in other persons. Methods. Risk for getting LD in the fieldworkers of JKP "Zelenilo Beograd" (park-maintanance company) was determined according to seropositivity, the number and infection rate of LD vectors, and entomological risk index (ERI) value. Serum samples of 34 fieldworkers of JKP "Zelenilo Beograd", and 35 persons of the control group, were tested for the presence of specific IgM and IgG anti-B. burgdorferi antibodies by using ELISA test. In the research localities, the number of ticks was estimated by using the flag hours method, and tick infection rate was determined by dark field microscopy, with magnification rate of 400?. The data were analyzed statistically using ?2 test, and Pearson's correlation analysis. Results. Out of 34 fieldworkes serum samples, 8 (23.5%) were positive on anti-B. burgdorferi antibody presence, while in the control group only one (2.9%) sample was positive (p < 0,05). Seropositivity rate varied from 0-66.6% among localities. Flag hours value among the localities ranged from 8.2-29.9, and tick infection rate ranged from 10.8- 22.3%. ERI value was 0.03-0.15. Correlation between flag hour rate and seropositivity, tick infection rate and seropositivity, and also ERI and seropositivity was established. Conclusion. Frequency of B. burgdorferi seropositivity was significantly higher in green-surface maintenance workers, than in the control group not exposed to these habitats. A significant correlation was found between anti-B. burgdorferi antibodies findings and the number of ticks, tick infection rate, and ERI. The results obtained in our study indicate that there was a significantly higher risk for getting LD cause in the fieldworkers than in the control group. .