bluuebunny/crossref_metadata_2025 huggingface dataset:
Examination of cardiovascular function variables in tooth extraction under local anesthesia
Authors: Zivotic-Vanovic Mirjana , Marjanovic Marjan
Published: December 2010

Background/Aim. Local anesthesia is the one of the most used procedures in surgical practice. It is used for toot extraction to produce analgesic and anesthetic effects. However, there is a question if it is equally safe to apply a local anesthetic combined with a vasoconstrictor (adrenaline) in healthy persons, and in the patients with a certain cardiovascular system disease. The aim of this study was to determine whether there were differences in cardiovascular variables during tooth extraction in healthy persons, and in cardiovascular patients when an anesthetic was applyted with adrenaline, or without it. Methods. The examinees were divided into the group with cardiovascular diseases (CV, n = 57) of II and III type, according to the American Society of Anesthesiologists (ASA) qualification, and healthy persons (H, n = 55). Both groups were randomly divided into two subgroups: CVa and Ha - where the anesthetic solution had the vasoconstrictor (3% lidocaine, and 1 : 100 000 adrenaline); CVb and Hb - where the anesthetic solution was without the vasoconstrictor (3% lidocaine). During the preparation for tooth extraction, the application of anesthetics, extraction and relaxation puls (fc), systolic (TAs) and diastolic arterial blood pressure (TAd) and ECG were registered. Results. The values of fc did not significantly differ among the groups in any measured term. The values of systolic and diastolic blood pressure in the groups CVa and CVb were significantly higher in all the terms of measuring (p < 0.05) from the values in the groups Ha and Hb. A significant increase of TAs was registered only in the phase of tooth extraction in the CVa and CVb group (< 0.05). The values of TAd did not significantly differ between the groups in all the measured terms. Extrasystolic beats were registered in 11 patients of the CV group and in 7 patients of the H group in the phase of anesthetic application or tooth extraction. Conclusion. This research shoved that tooth extraction under local anesthesia did not cause complications in cardiovascular patients who were in II or III ASA qualification group, regardless the presence of a vasoconstrictor in the local anesthetic solution.
Alternative and complementary medicine
Authors: Malicevic Zivorad
Published: December 2010

 Ovaj kratki pregled KAM disciplina ukazuje na njihovu heterogenost i jasno pokazuje da nema univerzalnog KAM terapeuta. Raznovrsnost i razlicitost KAM postupaka zahteva odredjenu i dobru edukaciju koja, posebno u nasim uslovima, mora biti jasno zakonski regulisana. Nedostatak zakonske regulative izaziva sukobljavanje izmedju medicinskih poslanika i KAM terapeuta koje ide do potpunog negiranja, sto sa aspekta obolelog coveka, koji ima pravo i licnu slobodu da bira kako ce biti lecen, nije humano. Medicina i KAM imaju isti plemeniti cilj da pomognu i izlece obolelog i u ostvarenju ovog uzvisenog cilja moraju da saradjuju. Medicinska nauka, bez obzira na nedostajuce potpune dokaze o valjanosti KAM postupaka, mora pazljivo da ih istrazuje i, posle valorizacije, da ih ugradjuje u svakodnevnu praksu.
Preimplant preparation of the extraction alveolus with the deproteinized bovine bone and calcium-sulphate
Authors: Brkovic Bozidar , Radulovic Milan , Danilovic Vesna
Published: December 2010

Background. Different materials are used to prevent the resorption of alveolar bone. The aim of this report was to show the radiographical and histological results prior to implant insertion, when a deproteinized bovine bone mineral (BioOss) and calcium-sulphate were placed into the extraction socket immediately after the tooth removal. Case report. A 22-year-old woman was scheduled for the removal of the second lower molar when the extraction socket was filled with BioOss covered with calcium-sulphate as a resorbable membrane. Primary closure of the surgical site was performed. Radiography was done 4 and 12 months later. One year after the surgery, when the implant was inserted, a biopsy of the new regenerated bone was obtained for the histological evaluation. The lamellar bone was evident using both materials. The resorption of BioOss was slow and the connective tissue was observed. Conclusion. Both materials had biocompatible and oseoconductive properties. One year after the grafting procedure, we observed the lamellar bone and partial resorption of BioOss, while calciumsulphate showed no significant effect as a resorbable membrane.
Analysis of the use and adverse effects of non-steroidal anti-inflammatory drugs: A pilot study
Authors: Peric Aneta , Toskic-Radojicic Marija
Published: December 2010

Background/Aim. The use and adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) in outpatients with rheumatic diseases has not yet been studied enough. The aim of this study was to evaluate the data about the efficacy and safety of NSAIDs obtained from the questionnaires submitted to the outpatients receiving these drugs. Methods. The patients who had been prescribed any of NSAIDs within the period from June to September, 2004 were included in the study. The answers obtained from the questionnaires were statistically analyzed by means of ?2-test. Results. At the time of the study, 150 patients had been prescribed ibuprofen or some other NSAID. Out of the total number of dispensed questionnaires (n = 150), only 45 (30%) were shown to be correctly filled-in. Their analysis showed that 64.4% of the patients had suffered from rheumatic diseases for more than five years, and had regularly used NSAIDs. The average age of these patients was about 70 years, and the number of females was double as high as that of the males. The most frequently used NSAIDs were diclofenac and ibuprofen (46.14%, and 23.24%, respectively). According to the answers given by the patients, the most often adverse reactions were gastric complaints such as nausea (11.1%), and stomach pain (8.9%). Due to this, the majority of the patients (64.4%) used some of the antiulcer drugs, most often ranitidine (31.1%). Conclusion. The results of this pilot study revealed that among the outpatients suffering from rheumatic diseases, the number of females was double as high as the number of males, that these patients were of the mean age of 70 years, and that their diseases lasted longer than five years. Gastric complains such as nausea and gastric pain of mild intensity were the most often adverse effects of NSAIDs reported by our patients. It could be the consequence of the predominant use of diclofenac and ibuprofen, NSAIDs with mild to moderate ulcerogenic potential, as well as the concomitant use of H2-receptor antagonists.
Prognostic significance of sinus deceleration during dobutamine stress echocardiography test following acute myocardial infarction
Authors: Salinger Sonja , Tomasevic Miloje , Glasnovic Jozef , Apostolovic Svetlana , Pavlovic Milan , Pesic Zoran , Randjelovic Miomir , Stojkovic Aleksandar , Krstic Nebojsa , Milic Dragan
Published: December 2010

Background/Aim. Chronotropic incompetence during exercise stress testing after acute myocardial infarction is an indicator of ischemia or impaired left ventricular function. On the other side, infusion of dobutamine leads to a typical dose-dependent increase in heart rate. The aim of this study was to evaluate of paradoxical sinus deceleration during dobutamine stress echocardiography (DSE), as the sign of ischemia and impaired left ventricular function, or the consequence of infarction localization, and the estimation of prognostic significance after acute myocardial infarction. Methods. Our investigation comprised 81 patients hospitalized because of the acute myocardial infarction, and all of them had uncomplicated infarction. Fifty five patients were treated with thrombolytic therapy (67.9%); 53 patients (65.4%) had anterior myocardial infarction, and 28 patients (34.6%) had inferoposterior localization of myocardial infarction. After 10-12 days all of them underwent dobutamine stress echocardiography examination. During the next 3-6 months, the patients underwent coronary angiography. The average follow-up period was 36?22 months. Results. A decrease in heart rate occurred at the dobutamine doses increasing from 15-40mcg/kg/min in 9 (11.1%) of the patients, in 1 patient with an anterior localization and in 8 patients with an inferoposterior localization. The decrease was sudden in 4 (44.4%), and gradual in 5 (55.6%) of the patients. In 3 patients (33.3%) junction rhythm was developed, and in 2 patients (22.2%) AV block II-III. Only in 2 of them, there was a worsening of regional function during a high dose dobutamine infusion, but 7 of them showed an improvement during a low dose. In 7 (77.8%) of the patients there was a simultaneous decrease in blood pressure. Coronary angiographic examination showed that in 4 (44.4%) of the patients there was a significant coronary artery disease and they underwent the revascularization procedure. During the follow up period, there was not any significant arrhythmic disorder in that group of the patients or repeated hospitalization because of postinfarction angina, re-infarction, or heart failure. Conclusion. We could conclude that paradoxical sinus deceleration is not only an indicator of a significant coronary artery disease and ?bad left ventricle?. It also may occur as a consequence of vasodepressor reflex (Bezold-Jarisch), even after acute myocardial infarction, without influencing a long-term prognosis.
Impact of various luting cements on the fixed dentures bonding strength
Authors: Krunic Nebojsa , Tonic Goran
Published: December 2010

Background/Aim. Various luting cements are used to fix dental crowns to prepared teeth, and should provide an adhesive bond to the tooth structure giving reliable retention. The aim of this study was to establish in vitro which type of the tested luting cement provided the strongest adhesive bond of the prepared teeth to the fixed denture. Methods. Testing was carried out on the sample of 100 intact human premolars extracted for orthodontic reasons. The preparation of the teeth was performed by a heavy-duty machine. The surfaces of the prepared teeth were mathematically calculated. Dental crowns from the Nickel-Chromium- Molybenum (Ni-Cr-Mo) alloy were made in a standard fashion, and fixed to prepared teeth (two samples of each group) with 5 different types of luting cements. The strength of force applyed to separate the cast crowns from the prepared teeth was measured by an electronic dynamometer, after 7 days. Results. The obtained results revealed the connection between the type of luting cement and the values of retention power. The best adhesive bond under the constant convergence angle of the prepared teeth was provided by the resin cement. Conclusion. When choosing a luting cement for fixing dental crowns to prepared teeth, the advantage should be given to the resin cement in case the glassionomers are not available.
Autopsy and postmortem examination case study on genetic risk factors for cardiac death: Polymorphisms of endothelial nitric oxide synthase gene Glu298asp variant and T-786c mutation, human paraoxonas
Authors: Ameno Kiyoshi , Ameno Setsuko , Kinoshita Hiroshi , Jamal Mostofa , Wang Weihuan , Kumihashi Mitsuru , Uekita Ikuo , Ijiri Iwao
Published: December 2010

Background/Aim. The Glu298Asp variant in exon 7 and T-786C mutation in the 5'-flanking region of the endothelial nitric oxide synthase (eNOS) gene, paraoxonase I gene (PON1), and ?2?- adrenergic receptor gene (?2?-AR) have been reported to be genetic risk factors for coronary heart disease (CHD). The aim of this study was to investigate the effects of these four genetic polymorphisms on the probability of death due to CHD, using data obtained from medico-legal autopsies. Methods. Blood samples from three groups: healthy controls, dead cases with CHD and without CHD (the latter as a control for dead cases) were used. After DNA extraction, genotyping was performed by polymerase chain reaction ? restriction fragment length polymorphism (PCR-RFLP) test. Results. The frequency of the T allele in Glu298Asp variant in the dead cases with CHD was significantly higher than that in the healthy control (p < 0.001, OR = 4.47) and that in the dead cases without CHD (p < 0.001, OR = 7.62). The gene frequency of PON1 was significantly different (p = 0.007) between dead cases with and without CHD, and was also significantly different (p = 0.025) between the healthy control and dead cases without CHD. The gene frequency of PON1 was not significantly different (p = 0.401) between the healthy controls and dead cases with CHD. Hence this gene was not associated with death due to CHD. The other polymorphisms (T- 786C mutation, ?2?-AR) also showed no effect on death due to CHD. Conclusion. The polymorphism of Glu298Asp eNOS gene in dead cases may be useful for determining the cause of death in CHD cases in the Japanese population.
Pattern of utilization of benzodiazepines in patients with hypertension: A pilot study
Authors: Divac Nevena , Veljkovic Slavomir , Nesic Zorica , Stojanovic Radan , Bajcetic Milica , Vasiljevic Zorana , Prostran Milica , Samardzic Ranka
Published: December 2010

Background/Aim. The analysis of drug prescribing in general practice in Serbia showed that the use of benzodiazepines is most frequently associated with hypertension. The aim of this study was to establish the correlation of the characteristics of patients with hypertension to antihypertensive drug therapy, and the intake of benzodiazepines. Methods. A special questionnaire was used for interviewing the patients (n = 171) chronically treated for hypertenson. Statistical tests used were ?2-test and Student's t-test. Results. No differences were noted in terms of age, gender, education, body weight, smoking habits and blood pressure (155?4.9/100?2.7 mmHg vs. 160?2.2/105?3.7 mmHg), between the group I (antihypertensive drugs+benzodiazepines: n = 79), and the group II (antihypertensives only: n = 92). The patients taking benzodiazepines received a lower number of different antihypertensive drugs (2.3?0.09 vs. 2.7?0.10; p < 0.01), but the total antihypertensive drug load was significantly greater than in the group II (2.6?0.10 vs. 1.9?0.15 defined daily doses (DDD)/patient/day; p < 0.01). Benzodiazepines were taken for anxiety (62%) and hypertension (21%), rarely for insomnia, mostly once a day, at bedtime. About half the patients took benzodiazepines regularly for months or years aware of the risk for addiction. Diazepam was used by 82% of the patients. The average daily exposure to benzodiazepines was 0.45?0.05 DDD/patient/day. The drug was bought without prescription in 25% of the patients, and without consulting a physician in 12% of them. Conclusion. The study confirmed a close association of hypertension with the use of benzodiazepines. The frequent use of benzodiazepines in the patients with hypertension might be caused by an inadequate response to antihypertensive drug therapy, besides anxiety and insomnia. The therapeutic efficacy of a long-term use of low doses of benzodiazepines in hypertension requires further investigation.
Pregnancy outcome during the bombing of Yugoslavia from Mart 24 to June 9, 1999
Authors: Krstic Dragan , Marinkovic Darko , Mirkovic Ljiljana , Krstic Jelena
Published: December 2010

Background/Aim. The aim of this study was to evaluate pregnancy outcome during the bombing of Yugoslavia in the period from March 24 to June 9, 1999. Methods. A retrospective study included a total of 81spontaneous abortion following XII gestation week, and 1448 deliveries, hospitalized in the regional hospital. The analyzed were: the incidence of spontaneous abortion, Cesarean section, post-term delivery, vaginal delivery following the previous Cesarean section within the period from March 24 to June 9, 1999, and compared to the same periods in 1998 and 2000 by the use of ?? and Kolgomorov-Smirnov tests. Results. Under the conditions of a three-month stress imposed by the bombing, significantly increased were the incidence of spontaneous abortion and vaginal delivery following the previous Cesarean section, while the incidence of Cesarean section and post-term delivery were decreased, but the incidence of perinatal outcome was paradoxically improved. The analysis of findings on admittance revealed that iterative Cesarean section was performed electively, close to the expected term of delivery, and vaginal delivery following the previous Cesarean section mainly two weeks before that term with the admittance finding confirming a high active stage pregnancy. Conclusions. Within the bombing, statistically significantly was increased the percentage of abortions after XII gestation week, and the biological duration of pregnancy was reduced. The reduced duration of pregnancy complete with the accelerated fetal mutation (also caused by the stress) resulted in better perinatal outcome, and statistically significantly lower percentage of Cesarean section.
Tanatophobia in the patients on dialysis
Authors: Novakovic Milan , Tiosavljevic-Maric Danijela , Gajic Milan
Published: December 2010

Background/Aim. Thanatophobia is an exaggerated, specific, structured fear of death. It appears in childhood and continues to grow over the years, and in the old age it is accompanied with nosophobia and other mental disorders. The aim of this study was to analyze thanatophobia in dialysed patients which was in the direct connection with a basic disorder, and the influence of this disorder on functioning and the quality of life of the patients on dialysis. Methods. In the study we examined 753 patients from the chronic program of haemodialysis in a period from 1999 to 2004. The patients were classified in two groups: 348 randomized patients with Balkan Endemic Nephropathy (BEN), and the control group (N18) of patients with terminal renal insufficiency, and other diagnoses (n = 405). Since the study was a comparative, cross-sectional one, the patients were tested by the appropriate questionnaires for anxiety, depression and general mental functioning. Statistical analysis was done by the standard descriptive and analytic statistic methods. Results. Based on socio-demographics data we revealed a highly significant difference regarding the place of living between the groups BEN and N18 (?2 = 23.970; p < 0.01), the frequency of occurrence of renal comorbidity (?2 = 23.970; p < 0.01), the frequency of family renal comorbidity in siblings (?2 = 23.970; p < 0.01), and the frequency of migrationes (?2 = 4.874; p < 0.01). According to psychiatry scales, the patients from the BEN group were significantly more anxious and depressive than those from the control group. Conclusion. The signs of thanatophobia were revealed in both examined groups, but significantly more in the patients with BEN than in those with other nephrologic diseases. Thanatophobia starts before dialysis, and dialysis structures it into fear of death which is in a direct connection with the basic disorder. This intensive fear may be connected with dementia and depression, but also with other mental disorders.
Positional changes of the lower and upper anterior teeth after surgical correction of mandibular prognathism
Authors: Vukadinovic Miroslav , Jezdic Zoran , Anicic Boban , Sinobad Vladimir , Mikovic Nikola
Published: December 2010

Background/Aim. To establish the influence of surgical corrections of mandibular prognathism upon the position of the lower and upper anterior teeth (incisors). Methods. The changes in position of the lower and upper anterior teeth (incisors) after the surgical correction of mandibular prognathism were analyzed by means of x-ray craniometry in 183 patients (female: n = 110, male: n = 73) in which the correction had been made in accordance with the principles of sagital osteotomy of the mandibular ramus. There were 4 angular and 2 linear parameters determined in the pre- and postoperative tele-xray-pictures. The changes of these parameters were tested by means of the parametric statistic tests. Results. The performed surgical procedures did not cause statistically significant changes in the angular parameters. The changes of both linear parameters were thought highly statistically significant. Conclusion. Under the influence of the performed surgical procedures no changes were found in the position of anterior teeth (incisors) in relation to SN and the mandibular plane. They were actually moved along with the medium fragment of the lower jaw and that fragment was moved linearly backwards along the occlusal plane with a practically insignificant rotation in the cranial direction.
Abnormal ultrasonographic findings of the kidneys obtained with a portable echosonographic device in the patients with infectious diseases - a five-year study
Authors: Dokic Ljubisa , Bojic Ivanko , Dragojlovic Julijana , Djordjevic Marija , Bojic Biljana , Damjanovic Olja
Published: December 2010

Background/Aim. Ultrasonographic kidney changes might be a part of the clinical picture, or consequence of the various infections diseases. The aim of this study was to establish ultrasonographic findings obtained by portable devices, the frequency of abnormal findings of the kidneys in the non-selected group of the patients with infections diseases. Methods. Over a five-year period (January 1, 2000-December 31, 2004), the kidneys were examined by ultrasonography in 2718 patients, 1452 males and 1266 females, mean age 47.52?17 years, (16-92 years). The examination included the measurement of the size of the kidneys, evaluation of the condition of parenchyma and pyelo-calix, detection of simple cysts, calculi and tumor. The conventional portable ultrasonographic devices ALOKA SSD-500 and SSD-1000 (B-mode) with a convex 3.5 and 5 MHz sonde were used. Results. The size of kidneys was normal in 95% of the patients, while they were enlarged in 1.3% and reduced in 1.5% of the patients. A normal ultrasonographic recording was noted in 68.9% of the patients, double pelvis in 0.1%, while hydronephrosis was revealed in 0.9% of the patients. A reduced renal parenchyma was observed in 16.1% of the patients. Nephrolithiasis was found in 10.9% of the patients, and simple cysts of kidneys in 8.9% of the patients. The finding of polycystic kidneys was seen in 0.5% of the patients. An ultrasonographic recording of angiomyolipoma was noted in 0.4% of the patients, and the finding of other tumors in 0.1% of the patients. Adrenal tumors were found in 0.1% of the patients. Conclusion. Portable ultrasonographic units may be highly useful for the standard morphological diagnostics of renal changes during infections, as well as in clinical-epidemiological studies and screening of hereditary and the acquired diseases of this organ.
Stenosis of the right major bronchus from blunt trauma
Authors: Stanic Vojkan , Vulovic Tatjana , Durkovic Savo , Cvijanovic Vlado , Ristanovic Aleksandar , Gulic Bojan , Stamenovic Davor
Published: December 2010

Background. A severe blunt injury to the chest might cause rupture of the tracheobronchial tree. A certain time following the management of the injury, stenosis of the bronchi may develop at the site of the rupture. Case report. We reported a patient injured in a traffic accident. The injury was followed by the signs of pneumothorax, bleeding, and respiratory insufficiency. After the management of the injury using thoracal drainage, the condition of the injured was stabilized. Two weeks later, however, difficulties in breathing and fatigue occurred. Circular stenosis of the right major bronchus was clinically, radiographically and bronchoscopically confirmed. Right thoracotomy and circular resection of the major bronchus with termino-terminal anastomosis were performed. Conclusion. In severe blunt injuries to the chest, it is very important to suspect the injury of the tracheobronchial tree in order to correctly understand the clinical signs of an injury and to interprete a radiographic image of it, so as to decide upon the optimal treatment on time.
Medicamentous abortion with mifepristone and misoprostol in Serbia and Montenegro
Authors: Stojnic Jelena , Ljubic Aleksandar , Jeremic Katarina , Radunovic Nebojsa , Tulic Ivan , Boskovic Vladimir , Dukanac Jelena
Published: December 2010

Background/Aim. Medicamentous abortion was first introduced in Serbia and Montenegro in September 2001. The aim of this study was to assess the efficiency, side effects, and acceptability of medicamentous abortion using mifeprostone orally (600 mg), and 48 hours later, misoprostol both orally and vaginally in different regiments in our population (400 mcg, 600 mcg, 800 mcg). Methods. A total of 235 consecutive women with pregnancies up to 49 days of gestational age were assigned to 4 groups according to the different misoprostol regiment (group I 400 mcg, group II 600 mcg, group III 800 mcg orally, and group IV 800 mcg both orally and vaginally). The principal outcome measure was a successful abortion defined as a complete expulsion of intrauterine contents without a need for surgical intervention 14 days after the procedure. Other outcome measures were the following: drug related effects, and adverse effects related to the abortion process. Results. In general, the success rate was 50%, 89.48%, 75% and 92.11% in the groups I, II, III, and IV, respectively, as judged by the complete expulsion of the intrauterine contents without surgical intervention (t1:4 = 7.005; t2:4 = 0.3872, t3:4 = 2.9784, p < 0.01). The incidence of adverse effects (vomiting, abdominal pain, bleeding, and fever) was low in general, but among our groups it occurred mostly with the higher doses of orally applied misoprostol (800 and 600 mcg). Only one case required urgent curettage for heavy vaginal bleeding, and two blood transfusions, as well. No cases of intact pregnancies were recorded in the study. Conclusion. Our study showed that a mifepristone dose of 600 mg orally, and misoprostol 400 mcg orally and 400 mcg vaginally were most effective. Thus, a combination of mifepristone and misoprostol for medicamentous abortion should take a higher proportion in the termination of early pregnancy in our population.
Therapeutic approach to progressive Takayasu's arteritis
Authors: Petrovic-Rackov Ljiljana
Published: December 2010

Background. Takayasu's arteritis (TA) is a nonspecific autoimmune inflammation manifested with systemic large vessel vasculitis which affects predominantly the aorta and its main branches. Case report. We presented a 40-year-old woman with a two-year history of the symptoms of compromised circulation in the head, the neck, the upper extremities and the right leg, followed by claudications in the left leg, numbness in the left hand and stenocardia. Aortic arch angyography revealed occlusion of the right subclavian artery stenosis of the right vertebral artery (20?30%) and the right iliac artery. Anti-inflammatory agents had no satisfactory effect and due to the discase progression first aorto-bifemoral bypass grafting, and 10 months later left carotid-axillary bypass grafting were performed which led to the restoration of circulation in the lower extremities and the left arm. Conclusion. This case suggested that a surgical therapy should be applied in the cases with progressive Takayasu's arteritis, particularly in the absence of a response to the conventional immunosupressive therapy to prevent eventual fatal complications.
Disseminated crusted papules in a newborn
Authors: Pavlovic Milos , Minic Aleksandra , Zolotarevski Lidija , Vesic Sonja
Published: December 2010

Background. Congenital self-healing Langerhans cell histiocytosis (Hashimoto-Pritzker disease) is the rarest form of Langerhans cell histiocytosis, usually confined to the skin and/or mucous membranes. Cutaneous eruption is mostly generalized, papular, nodular or vesicular. Despite impressive clinical presentation in a newborn it infrequently spreads to internal organs (which then portends a grave prognosis, indistinguishable from Letterer-Siwe disease). Case report. We presented a full-term newborn, female, 3.3 kg who had a multitude of erythematous and crusted papules, nodules and pseudovesicles distributed all over the body, except for the mucous membranes. A biopsy and haematoxylin ? eosin stain revealed dermal infiltration of pleomorphic histiocytes with eosinophilic ground-glass cytoplasm and round to bean-shaped nuclei. Over the next six weeks the eruption gradually subsided leaving no residues, or a few atrophic scars. Conclusion. There is no need for specific treatment of congenital self-healing Langerhans cell-histiocytosis in the absence of multiorgan involvement. However, a close and regular follow-up is necessary to evaluate the children for systemic symptoms and signs.
High-density cervical ureaplasma urealyticum colonization in pregnant women
Authors: Randjelovic Gordana , Kocic Branislava , Miljkovic-Selimovic Biljana , Mladenovic-Antic Snezana , Stojanovic Predrag , Stefanovic Milan
Published: December 2010

Background/aim: Ureaplasma urealyticum, a common commensal of the female lower genital tract, has been observed as an important opportunistic pathogen during pregnancy. The aims of this study were to determine the degree of cervical colonization with U. urealyticum in pregnant women with risk pregnancy and in pregnant women with normal term delivery and to evaluate the correlation between high-density cervical U. urealyticum colonization and premature rupture of membranes (PROM) as well. Methods. This research was conducted on the samples comprising 130 hospitalized pregnant women with threatening preterm delivery and premature rupture of membranes. The control group consisted of 39 pregnant women with term delivery without PROM. In addition to standard bacteriological examination and performing direct immunofluorescence test to detect Chlamydia trachomatis, cervical swabs were also examined for the presence of U. urealyticum and Mycoplasma hominis by commercially available Mycofast Evolution 2 test (International Microbio, France). Results. The number of findings with isolated high-density U. urealyticum in the target group was 69 (53.08%), while in the control group was 14 (35.90%). Premature rupture of membranes (PROM) occurred in 43 (33.08%) examinees: 29 were pPROM, and 14 were PROM. The finding of U.urealyticum ?104 was determined in 25 (58.14%) pregnant women with rupture, 17 were pPROM, and 8 were PROM. There was statistically significant difference in the finding of high-density U. urealyticum between the pregnant women with PROM and the control group (?? = 4.06, p < 0.05). U. urealyticum was predominant bacterial species found in 62.79% of isolates in the PROM cases, while in 32.56% it was isolated alone. Among the 49 pregnant women with preterm delivery, pPROM occurred in 29 (59.18%) examinees, and in 70.83% of pregnant women with findings of high-density U. urealyticum pPROM was observed. Conclusion. Cervical colonization with U. urealyticum ? 104 is more frequent in pregnant women with risk pregnancy than in pregnant women with normal term delivery. High-density cervical U. urealyticum colonization should be observed as a possible etiological factor for PROM.
Use of the modified fries technique in the reconstruction of the lower lip after the removal of a malignant tumor
Authors: Vukadinovic Miroslav , Petrovic Milan , Jezdic Zoran
Published: December 2010

Background/aim: Lip carcinoma makes about 1/4 of all oral carcinomas. Primary treatment of the lower lip carcinoma means radical excision of the full thickness of the lower lip tissue together with the tumor. The reconstruction of the defect accomplished after the removal of the lower lip tumor is a challenge for the surgeon and requires a detailed preoperative planning, the right choice of the method for reconstruction and the knowledge of the adequate surgical techniques needed. The aim of this study was to present a ten-year clinical results and experience concerning the reconstruction of lower lip defects longer than 4 cm by means of the modified Fries method in patients treated for the lower lip carcinoma. Methods. The reconstruction of the lower lip by means of the modified Fries method was performed in 37 patients. The following parameters were analyzed: sex, age, the time elapsed from the occurrence of the first symptoms until the first consultation with the doctor, the size of tumors, the size of the postexcision defect, TNM classification, the application of side diagnostic procedures, pathohistological diagnosis of postoperative complications. The sensibility of the lower lip region was monitored, as well as the obtained esthetic effects. Results. The results classified according to the mentioned parameters were processed, analyzed and displayed in detail. Clinical experience concerning the application of this reconstruction technique was presented and analyzed. Conclusion. The modified Fries technique can successfully be applied in the reconstruction of the lower lip defects longer than 4 cm because its application leads to satisfactory functional and acceptable esthetic results.
Methods of the physical medicine therapy in prevention of heterotopic ossification after total hip arthroplasty
Authors: Kocic Mirjana , Lazovic Milica , Kojovic Zoran , Mitkovic Milorad , Milenkovic Sasa , Ciric Tamara
Published: December 2010

Background/aim: In the prevention of periarticular heterotopic ossification (HO), a common complication after total hip arthroplasty (THA), nonsteroidal antiinflammatory drugs (NSAID) and irradiation are used. Some theories presume that local hypoxia of the soft tissue causes HO. The aim of this study was to investigate if the early use of pulsed electromagnetic fields (PEMF) could prevent this ossification since it accelerates the circulation and oxigenation of soft tissue. Methods. The study included three groups of the patients with primary THA. The group C consisted of 66 patients/79 hips who had only kinesitherapy in postoperative rehabilitation. The group B consisted of 117 patients/ 131 hips who had PEMF and interferential current (IC) which, on average, started on the 14th day after the surgery combined with the standard kinesitherapy. The group A consisted of 117 patients/131 hips who had PEMF from the third postoperative day and IC from, on average, the 14th postoperative day with the standard kinesitherapy. The classification of HO was done on a standard AP roentgenograms of the hips, taken at least one year after the surgery. Results. The overall HO was seen in 50.63% of the group C patients, in 43.51% of the B group and in 16.67% of the group A. Severe HO (III and IV class according to Brooker) was seen in 26.58% of the group C patients and in 6.10% of the group B, but none in the group A. Conclusion. According to the obtained results an early treatment with PEMF could prevent severe HO and reduce the overall HO.
Long-term outcome of strabismus and ptosis surgery in a mother and daughter with congenital fibrosis of extraocular muscles
Authors: Stankovic Branislav , Stojkovic Milenko , Vlajkovic Gordana , Zdravkovic Ivana , Risovic Dusica
Published: December 2010

Background. Congenital fibrosis of extraocular muscles (CFEOM) is a very rare congenital condition, characterized by variable amounts of restriction of the extraocular muscles, with or without ptosis. The aim of this report was to deseribe a severe, atypical, exposure-induced corneal stromal lysis in two patients. Case report. A mother and a daughter with a severe CFEOM were presented. The surgery of both extraocular muscles and ptosis led to a fair outcome in mother even 30 years after, and a very good outcome in daughter 4 years after the treatment. Conclusion. Though frequently challenging and disappointing the outcome of surgery of both extraocular muscles and ptosis in CFEOM can be favorable even in rather severe cases. To the best of our knowledge, the atypical keratolysis we described has not been highlighted in the literature on CFEOM so far.
Aggressive intraabdominal fibromatosis
Authors: Colovic Radoje , Grubor Nikica , Radak Vladimir , Micev Marijan , Stojkovic Mirjana , Colovic Natasa
Published: December 2010

Background. Intraabdominal or mesenteric fibromatosis is a rare benign nonmetastatic neoplasm that appears as a sporadic lesion or in patients with familiar polyposis. Its evolution is unpredictable. About 10% of the cases show a very aggressive growth. Case report. We presented a 22-year-old woman in whom an aggressive intraabdominal fibromatosis had appeared during the first pregnancy as a well circumscribed ovoid tumor, involving the terminal ileum, the caecum, the ascending colon, the right kidney, the ureter, and the right common iliac artery. The tumor was excised with right colectomy, nephroureterectomy and resection of the involved artery using arterial reconstruction with graft interposition. Two years after the surgery the patient developed an inoperable tumor recurrence with a fatal outcome. Conclusion. In spite of a successful surgical excision during the original surgery intraabdominal or mesenteric fibromatosis might have an aggressive evolution leading to an inoperable tumor recurrency and a fatal outcome.
The influence of aging on pathologic and immunobiologic parameters of invasive ductal breast carcinoma
Authors: Ivkovic-Kapicl Tatjana , Knezevic-Usaj Slavica , Panjkovic Milana , Nincic Dejan , Mastilovic Katarina
Published: December 2010

Background/Aim. Most human cancers, including breast one, increase in frequency with aging. The aim of this study was to explore the hypothesis that aging also alters breast cancer biology. Methods. The study included 120 women with primary invasive ductal carcinoma of the breast. We correlated the patients age and diagnosis with the commonly used clinical, pathological factors and newer tumor biomarkers. Immunohistochemical staining was conducted for p53, c-erbB-2, Ki-67, estrogen (ER), progesterone (PR) receptors, and angiogenesis. Results. In our study, the patients with axillary lymph node metastases and negative steroid hormone receptors (ER and PR) were significantly younger than the patients with nodal involvement and positive hormone receptors. There was also a significant association between the patients age, diagnosis and angiogenesis. No association was found between the patients age and tumor size, histological grade, p53, c-erbB-2, and Ki-67. Conclusion. The results of our study supported only partially the hypothesis that the breast cancer biology is significantly affected by a patient's age.
Sexual dimorphism of the human corpus callosum: Digital morphometric study
Authors: Spasojevic Goran , Stojanovic Zlatan , Suscevic Dusan , Malobabic Slobodan
Published: December 2010

Background/Aim. Changes in the morphology and the size of the corpus callosum, are related to various pathological conditions. An analysis of these changes requires data about sexual dimorphism of the corpus callosum, which we tried to obtain in our study. We also investigated the method of digital morphometry and compared the obtained results with the results of other authors obtained by magnetic resonance imaging or by planimetry. Methods. A morphological research included 34 human brains (cadavers of both sexes ? 19 female and 15 male aged 26?72 years). By digital morphometry using an AutoCAD software we performed measurements in the corpus callosum: the length (L), width in the half of its length (WW?), length of its cortical margin (LCM), area and perimeter of the anterior and posterior callosal segments, as well as the area and perimeter of the corpus callosum section area. The investigated parameters were analyzed and compared between the females and males. Results. There was not a statistically significant difference between the males and females in the investigated parameters of the corpus callosum (t test; p > 0.05), including the mean values of the two most important parameters, the surface of its midsagittal section area (males 654.11 mm2; females 677.40 mm2) and of its perimeter (males 19.61 cm; females 19.72 cm). The results obtained by digital morphometry were in the range of the results of other authors obtained by magnetic resonance and by planimetry. However, the value of Pearson coefficient of linear correlation between the section surface area and perimeter of the corpus callosum in the males was highly significant (rxy = 0.6943, p < 0.01), while in the females this value was statistically insignificant. Conclusion. Digital morphometry is accurate method in encephalometric investigations. Our results suggest that the problem of sexual dimorphism of the corpus callosum is very complex, because the identical variables (section surface area or its perimeter) do not exhibit the same behavior in males and in females, implicating that these variables even cannot be simply compared between the sexes.
Induratio penis plastica: Localized or diffusive fibromatosis of tunica albuginea penis
Authors: Nale Djordje , Micic Sava , Vukovic Ivan , Radosavljevic Radoslav
Published: December 2010

Background/Aim. The part of the tunica albuginea that is not affected by localized pathological fibrosis is excised by the Nesbit contralateral excisional corporalplasty in patients with induratio penis plastica (IPP). The aim of this study was to find out if there were any histological changes of the macroscopically normal tunica albuginea excised during the Nesbit corporalplasty. Methods. A total of 31 patients, mean age 45 ? 7.65 years, were surgical treated for extensive penile curvature (impossible or difficult penile imission in the vagina), using the Nesbit surgical technique. The tunica albuginea tissue was manipulated by Allis?s clamps and excised in the shape of a diamond and placed in the 4% formaldehyde solution for histological analysis. The excised tunica albuginea was not wider than 1 cm, while the histological preparations were 3 to 5 ?m thick, and they were stained with hematoxylin-eosin. The excised tunica albuginea tissue appeared macroscopically (anatomically) normal in all of the operated patients. In 28 (90.3%) patients operated for dorsal curvature of the penis, the tissue of the tunica albuginea was excised from the urethral ridge, while in 3 (9.7%) patients operated for lateral curvature, the tissue was excised from the lateral corpus cavernosum. Results. The histological results were normal in 12 (38.7%) patients, while in 19 (61.3%) cases the findings indicated fibrosis of tunica albuginea. No significant difference in the patients age was found between these two groups (p = 0.09). The analysis of a total number of histological results of the patients with tunica albuginea fibrosis in relation to the patients with normal results showed that there was no significant difference (?? = 1,2; df = 1; p > 0.05), suggesting that the macroscopically normal tunica albuginea is not always expected to yield normal histological result. Conclusion. Significantly more reported histological results of tunica albuginea fibrosis in the location that appeared normal macroscopically (?2 = 27.5; df = 1; p < 0.01) indicated that, in the majority of IPP patients (61.3%), pathological lesion was diffusive with localized phenotypic expression plaque in the tunica albuginea, showing that, in the majority of cases noxa acted diffusely.
Modern approach to carpal tunnel syndrome treatment
Authors: Martic Vesna , Stepic Nenad
Published: December 2010

 U lecenju SKT primenjuje se konzervativno i hirursko lecenje. Konzervativno lecenje obuhvata imobilizaciju rucnog zgloba, lokalnu transkutanu aplikaciju kortikosteroida i analgetsku terapiju antireumaticima i antikonvulzivima. U hirurskom lecenju primenjuje se veliki broj tehnika u cilju dekompresije nerva. U izboru nacina lecenja SKT pored klinickog nalaza rukovodimo se i neurofizioloskom dijagnostikom komprimovanog nerva. Konzervativno lecenje se primenjuje kod blazih oblika i intermitentnih smetnji. Kada, i pored konzervativnog lecenja perzistira bol, a neurofizioloska ispitivanja pokazuju pogorsanje, neophodno je razmisljati o hirurskom lecenju. Atrofija tenara uz prisustvo denervacionih potencijala pri neurofizioloskom ispitivanju, uz postojanje neuroloskog deficita, upucuje na potrebu hirurskog lecenja.
Incidence and imaging characteristics of skeletal metastases detected by bone scintigraphy in lung cancer patients
Authors: Jaukovic Ljiljana , Ajdinovic Boris , Jankovic Zoran , Dugonjic Sanja
Published: December 2010

Background/Aim. Detection of metastatic bone disease by skeletal scintigraphy is a classical application of nuclear medicine in cancer patients. Detection of bone metastases in patients with lung cancer is necessary for an appropriate treatment modality. The aim of this study was to report the frequency and imaging characteristics of bone metastases detected by bone scintigraphy (BS) using technetium-99m phosphonates in patients with lung cancer. Methods. We retrospectively analyzed a total of one hundred patients (78 males and 22 females), mean age of 63.3 years, with the diagnosis of lung cancer, who underwent BS during a three-year period (2003?2005). Scintiscans were classified as positive, negative and suspicious with regard to the presence of bone metastases. Results. The incidence of positive, negative and suspicious findings were 57%. 32% and 11%, respectively. Out of 57 patients with bone metastases, 51 had multiple asymmetric foci of increased tracer activity localized in the ribs, spine, extremities, pelvis, sternum, scapula and skull in 72%, 54%, 49%, 37%, 12%, 9% and 5% of scans, respectively. BS revealed solitary metastases in 6 of the patients. The lesions were located in the lower limbs in three patients and in the upper limbs, pelvis and sternum in the remaining three patients. Conclusion. Bone scintigraphy plays a significant role in staging and selecting of patients for curative lung surgery. Due to the fact that metastatic involvment of the extremities was frequently shown, our study suggests that systematic inclusion of the limbs in BS acquisition should be obligatory.
Villous duodenal adenoma with II and III grade dysplasia and carcinoma in situ treated with cephalic duodenopancreatectomy
Authors: Colovic Radoje , Grubor Nikica , Micev Marijan , Ugljesic Milenko , Latincic Stojan
Published: December 2010

Background. Villous duodenal adenomas are rare, tend to malignant alteration and recurrence if surgical procedures are not sufficiently radical. They are mostly localized in the second portion of the duodenum and close to a papilla and are prone to malignant alteration. Case report. In this paper we presented a 79-year-old female patient already operated on twice elsewhere due to obstructive jaundice caused by villous duodenal adenoma, using, firstly, cholecystectomy and T-tube drainage of the choledoclus, and, then, an unsuccessful attempt of radical surgery ? duodenopancreatectomy. The patient was some time wearing a T-tube drainage, and, then, submitted to endoscopic papillotomy, endoscopic stenting, and, finally to the insertion of a self-expandable metallic stent which got clogged three months later causing chalangitis. Three years following the first surgery, the patient presented to our institution and submitted to cephalic duodenopancreatectomy. Histology confirmed villous duodenal adenomas with II and III grade dysplasia and carcinoma in situ. The lymph nodes were tumour-free. The postoperative recovery was somewhat prolonged due to cardiologic difficulties and a mild infection of the wound. Conclusion. Villous duodenal adenoma is curable if treated correctly and in a proper time. Radical treatment delay increases the risk for malignant alteration which was the case with our patient who was submitted to it three years after the histologic confirmation of the diagnosis.