bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of proteinuria on tubular transport of Na+, K+, CL
Authors: Petrovic Dejan , Obrenovic Radmila , Poskurica Mileta , Stojimirovic Biljana
Published: July 2008

Functional and structural damages of tubulointerstitium are caused by proteinuria. The aim of this study was to assess the influence of different proteinuria levels on Na+, K+, Cl tubular transport. We examined 50 patients (24 males, 26 females), mean age 46.50 ? 13.08 years, with mean creati-nine clearence of 87.29 ? 31.17 mL/min. They were separated in three groups depending on proteinuria value. The first group with proteinuria less than 0.3 g/24h included 19 persons (7 males, 12 females), mean age 45.12 ? 13.28 years, with mean creatinine clearance of 94.27 ? 34.70 mL/min. The second group of 18 patients (8 males, 10 females), mean age 45.39 ? 12.64 years had proteinuria of 0.3-3,0 g/24h and mean creatinine clearance of 90.07 ? 31.89 mL/min. The third group had proteinuria level higher than 3.0g/24h and mean creatinine clearance of 73.25 ? 20.44 mL/min. It included 13 patients (9 males, 4 females), mean age 50.08 ? 13.73 years. As a parameter of proteinuria influence on tubular transport of Na+, K+ and Cl-, fractional excretion of these electrolytes, was studied. Student's T test, Mann Whitney U test and c2 test were used for statistical analysis. No statistically significant influence of proteinuria was found on Na+, K+ and Cl tubular transport.
Microcystic adenoma of the pancreas
Authors: Colovic Radoje , Grubor Nikica , Micev Marjan , Colovic Natasa , Milosavljevic Tomica
Published: July 2008

Microcystic adenoma of the pancreas is a rare benign tumour of the pancreas without malignant potential which usually appears in older women. Pain weight loss, palpable mass and jaundice (if the tumor is localized in the head of the pancreas) are the main symptoms. Thanks to the modern imaging techniques (US, CT, FNB) the tumor is discovered and with rising frequency exactly preoperatively diagnosed. Surgical excision is the treatment of choice. In risk patients without symptoms surgery is not necessary but patients have to be regularly followed-up. The authors present a 70-year old woman in whom, because of constant epigastric pain, a multicystic mass of the pancreatic body, 58 x 40 mm in diameter, was discovered and removed by distal pancreatectomy. The spleen could not be saved. Histologic examination showed a microcystic adenoma. Three years after surgery the patient is symptom-free with normal ultra-sonographic findings.
PCNA in assessment of progression rate of chronic renal allograft rejection
Authors: Simic-Ogrizovic Sanja , Starcevic-Bozovic Angelina , Blagojevic Radmila , Radivojevic Dragana , Djukanovic Ljubica
Published: July 2008

Chronic graft failure may occur due to CR, cyclosporine nephrotoxicity repeated acute rejection, recurrent glomerular diseases, surgical and urological complications, but CR was recognized as the most common cause of chronic graft failure and renal graft loss [7]. Progression of renal disease reflects the interactive effects of changes in the structure and function. This notion has been examined many times in the native kidneys by studies correlating glomerular filtration rate with architectural deterioration in the glomerular or interstitial compartment [8-10]. Meanwhile, the similar studies in human renal allograft are scarce. Increased PCNA immunodetection in glomerular cells as well as in interstitial infiltrates was described in acute and chronic renal graft rejection and diagnostic value of this finding was analyzed [12,15]. Similarly, PCNA was often examined immunohistochemically in lymphoma and solid tumors as a marker of cell proliferation, but its reliability as a prognostic factor was also evaluated [18-20]. In the present study the prognostic value of PCNA expression in different tissue compartments of renal grafts experiencing CR was examined for the first time. The present study revealed that two groups examined with the different chronic graft failure progression rate as the main difference had significantly different proliferation of cells in glomerular, TIN and vascular compartments. PCNA immunoreactivity scores in these three compartments were significantly higher in the fast than in slow progression group. The significant positive correlation between the slope of the regression line plotting 1/sCr vs. time and cell proliferation in glomerular, TIN and vascular compartments was also found. Therefore, it was suggested that the measurement of PCNA expression in renal graft tissue might be used as a prognostic index.
Clinical-pathomorphological correlation in patients with symptomatic dystonias
Authors: Ivanovic Natasa , Svetel Marina , Kozic Dusko , Semnic Robert , Kostic Vladimir
Published: July 2008

Symptomatic dystonia can be the result of various metabolic, degenerative diseases, the consumption of certain medications or exposure to toxic agents. However, only symptomatic dystonia with focal structural lesion provides a significant "window" for, at least indirect, perception of aetiopa-thogenesis and pathomorphological substratum of idiopathic dystonia. Our study included 57 patients with symptomatic dystonia, which as a base had focal or multifocal lesions, of whom 7 patients had generalized dystonia, 18 hemidystonia, 6 segmental dystonia, 7 torticollis, 6 blepharospasm, 7 hand dystonia, 3 spasmodic dysphonia, and 3 had oromandibular dystonia. Stroke was highly statistically the most frequent cause of structural lesions (33/57 or 58%). Relevant pathomorphological changes were present in 50/57 (88%) patients, of whom 25 (50%) had lesion in the lenticular nucleus (including individual damage of the putamen and globus pallidus), 12/50 (24%) had damage of the thalamus and 6/50 (12%) had damage of the brainstem. Generalized dystonia was most frequently associated with bilateral lesion of the putamen, hemidystonia with lesion of contralateral putamen, torticollis with damage of the caudate nucleus, hand dystonia with lesion of the thalamus and blepharospasm with lesion of the upper brainstem.
Analysis of donor selection for living related kidney transplantation and their postoperative outcome
Authors: Lezaic Visnja , Djukanovic Ljubica , Radivojevic-Djokic Dragana , Blagojevic-Lazic Radmila , Ristic Stojanka , Dokic Zeljka , Stojkovic Dragisa
Published: July 2008

Lack of cadaveric organs for transplantation resulted in increased number of living related kidney donors examinations and consequent transplantations in our Department. Donor procedure, selection, drop-outs and final results for living related donors (LRD) were retrospectively analyzed in this paper. Between 1987 and 1994 202 potential LRD were examined. Most of them were females (59%) and about 30% were older than 60 years. The family relation between LRD and recipients were: parents (95%), siblings (3%), grandmother grandfather (1.5%) and uncle (0.5%). Potential LRD were informed on risks advantages and procedure of living donor transplantation. After primary information 26% of potential LRD gave up further examinations. Following immunological and clinical evaluations 48% of LRD actually donated a kidney. The other 26% were excluded during the selection procedure. High immunological risks including ABO incompatibility, HLA mismatches and positive cross match test were the reasons for drop outs of 35 potential LRD (17%). Five more donors were excluded for medical reasons: one because of low creatinine clearance and four because of neoplasms, discovered during examination (kidney, laryngeal, lung). Fourteen transplantation were not realized due to different recipient reasons: 5 of them had clinical contraindications, two died and in 7 cadaveric kidney transplantations were performed. Mild hypertension, coronary disease and diabetes mellitus type 2 were presented in 5 LRD accepted for transplantation. Five more had to be operated before donation (abdominal or urological operation). Early complications after donor nephrectomy were acute renal failure, stress ulcus, pleuropneumonia in three and thromboflebitis in two donors. In conclusion, although kidney transplantation from LRD is highly successful careful examination during selection procedure is indispensable.
Pneumonectomy due to bronchus carcinoma after pleural empyema
Authors: Subotic Dragan , Mandaric Dragan , Atanasijadis Nikola , Andric Ljiljana
Published: July 2008

Pneumonectomy is a lung resection that is associated with significantly higher operative mortality and morbidity than lobectomy. Beside classical causes of operative morbidity, such as respiratory and cardiovascular, the most important cause of postoperative complications is bronchopleural fistula. This complication occurs in 5 to 10 percents of patients with pneumonectomy, in some series up to 15 percents before introducing mechanical bronchial suture. The risk of the occurrence of this complication is increased in patients undergoing pneumonectomy after previous infection in the pleural space. Not so frequently, surgeons are faced with the necessity of performing pneumonectomy after pleural empyema as the first manifestation of the bronchus carcinoma. Over the last 5 years, in the the Institute of Lung Diseases, 4 patients underwent pneumonectomy after pleural empyema. The preoperative assessment, operative procedure and postoperative problems are the subject of this paper. Unlike the last three patients, in the first patient, pleural empyema was not recognized preoperatively. Based on the outcome of the treatment of the presented patients, we can conclude that pleural empyema, as the first manifestation of the bronchus carcinoma does not necessarily exclude surgical treatment. Such a statement is based on the fact that, even in these patients, it is possible to achieve postoperative course without significant morbidity and with a possibility to perform various forms of adjuvant therapy.
Early detection of asymptomatic carotid disease in patients with arteriosclerotic occlusive disease of the lower extremities
Authors: Rancic Zoran , Radak Djordje , Stojanovic Dragan
Published: July 2008

Prevalence of asymptomatic carotid artery stenosis in patients with lower extremities atherosclerosis is relatively high. Limiting screening of specific subgroups for any demographic or medical characteristics is ineffective. Screening for asymptomatic carotid artery stenosis is indicated in all patients with lower extremities atherosclerosis except in whom prophylactic carotid endarterectomy is not recommended because of comorbid disease or extreme age.
Cervicomediastinal tuberculous lymphadenitis
Authors: Ivanovic-Krstic Branislava , Kalimanovska-Ostric Dimitra , Vujisic-Tesic Bosiljka , Jovanovic Dragana , Diklic Aleksandar , Cvetkovic-Matic Danica
Published: July 2008

Tuberculous lymphadenitis is an uncommon form of extrapulmonary tuberculosis We report on a case of isolated Cervicomediastinal tuberculous lymphadenitis without parenhimal involvement. A 49-year old woman was hospitalized with a four week history of night sweats and weight loss. Plain chest radiography disclosed mediastinal mass of the right side. Echocardiographic examination revealed a soft tissue mass below the ascending aorta and aortic arch causing moderate narrowing of the right ventricular outflow tract and the main pulmonary artery. Computed tomographic scanning showed soft tissue mass in the middle mediastinum surrouding the great vessels extending posteriorly with moderate compression of trachea. Histological examination of the cervical mass revealed caseating granuloma containing acidalcohol fast bacillus. Antituberculous chemiotherapy was started.
Inflammatory pseudotumour of the liver
Authors: Colovic Radoje , Grubor Nikica , Micev Marjan , Stojkovic Mirjana
Published: July 2008

Inflammatory pseudotumors are very rare with hardly over hundred cases reported in literature. The disease is rare in children. The tumor is usually solitary, rarely multifocal. We report on two women old 48 and 49 years. One had a solitary tumor, and the other had four multifocal inflammatory pseudotumors which were surgically removed. Preoperatively both patients had pain, loss in weight, the one had attacks of low grade temperature and the other nausea and general malaise. One patient had leucocytosis. After surgery both patients stayed symptom free with normal laboratory and ultrasonographic findings 6 and 50 months respectively.
Concussive convulsions as differential diagnosis of posttraumatic epilepsy
Authors: Vojvodic Nikola , Sokic Dragoslav , Jankovic Slavko , Rasulic Lukas
Published: July 2008

Concussive convulsions are motor manifestations in acute head injury. This clinical phenomenon should be distin- guished from epileptic seizures. We present two young men with motor and convulsive manifestations in acute head injury. Patient 1. A18-year old basketball player felt on the parquet during a game. Initially he was struck on the right shoulder which caused brief and vigorous twitch of the head towards the ground and additional temporal impact. At the moment of impact he lost consciousness and developed tonic leg and arm posturing with both clenched fists. His legs were extended during next 20 seconds. Thereafter he was still and his loss of consciousness lasted 3 minutes. Patient 2. A 26-year old man felt on the wooden ground from a 4 m high ferry. He got head impact and lost consciousness. In a few seconds he had tonic/clonic convulsions for the next 10-15 seconds. Ten minutes later he awaked. Results of subsequent neurological examination, electroencephalography and cerebral magnetic resonance imaging studies were normal in both patients. They returned to their occupations after four weeks without problems for a further one year. Conclusion. Described motor manifestations present concussive convulsions. These clinical features are due to transient functional decerebration and corticomedullary dissociation during cerebral concussion. Concussive convulsions are a non-epileptic phenomenon, they are not associated with structural brain injury and have good prognosis. Antiepileptic treatment is not indicated.
Matematics model in the prediction of hyperlipidemia's influence on the thickness of intima-media complex of A. Carotis communis as the index of atherosclerosis
Authors: Nedeljkovic Marija , Petrovic Branko , Djuric Dragan
Published: July 2008

This is statistically important connection between IMT and hyperlipidemia The importance of hypercholesterolemia is the highest at the persons younger than 55. Hypercholesterolemia is considered to be the only reversible risk factor for them. Therefore, dietetic and medical treatment are of basic importance in the primary and secondary prevention of atherosclerosis. For that reason we are of the opinion that our mathematics model can be noteworthy if estimate the effects of primary and secondary prevention.
Multiple arterial disease in clinical practice
Authors: Despotovic Nebojsa , Zdravkovic Mihajlo
Published: July 2008

There is a significant correlation among obliterate lesions of coronary carotid and peripheral arteries of the lower arteries at the same time. This pointed out that whenever clinical manifestations of obliterate disease of peripheral arteries are present. There is also need for routine examination of existent coronary artery disease. In the case of concomitant significant coronary and carotid vascular disease there is a question what should be operated first. The most vascular centres prefer carotid endarterectomy before aortocoronary bypass, and if there is nonstable coronary disease simultaneous carotid endarterectomy and aortocoronary bypass should be carried out.
Abdominal pregnancy with placenta inserted in the spleen left in situ causing subphrenic abscess
Authors: Colovic Radoje , Grubor Nikica , Colovic Natasa , Ivic Ljiljana
Published: July 2008

Abdominal pregnancy appears once in 3000 pregnancies. It usually terminates with abortion and urgent surgery. Thanks to ultrasonography and computed tomography the diagnosis is possible before surgery. Most frequently the diagnosis has been established during emergency laparotomy. Gynaecologists are not in agreement wheather removal of placenta is mandatory or not, as it may include removal of parts or entire organs or may be followed with serious bleeding difficult to control. We present a 21-year old woman in whom during an urgent laparotomy performed for abdominal pregnancy placenta inserted in the spleen was left in situ. Postoperatively the patient developed subphrenic abscess which could not be solved without reoperation during which both the placenta and the spleen were removed. Ten years after surgery she is symptom-free.
Duodenal obstruction due to chronic pancreatitis
Authors: Colovic Radoje , Grubor Nikica , Zogovic Sergej , Markovic Velimir
Published: July 2008

nema
Hernija kao sportska povreda
Authors: Pejic Miljko , Milic Dragan
Published: July 2008

nema
Adhesion molecules in Wilms tumor (part II) : beta-catenin expression and significance
Authors: Basta-Jovanovic Gordana , Radojevic Sanja , Djuricic Slavisa , Savin Marina , Skodric Stevo , Bunjevacki Gordana , Hadzi-Djokic Jovan , Nesic Vidosava
Published: July 2008

Beta-catenin is a glicoprotein which has an important role in cell-cell adhesion, as well as in cell signal transmition, in u regulation of gen expression and in interaction with axin and APC (adenomatous poliposis coli). Its oncogenic role in several types of carcinomas in human population is well known. It is very likely that b-catenin as an protooncogen plays an importante role in genesis of Wilms tumor. It is well known that in 15% Wilms tumors there are b-catenin mutations, which indicates that there is a disorder in Wnt signal paththat plays an important role in Wilms tumor genesis. The aim of our study was to investigate b-catenin expression in Wilms tumor, to compaire it with the expression in normal renal tissue as well as to see if there is a positive correlation between b-catenin expression in Wilms tumor with tumor stage, histologic type and/ or prognostic group.
Promena horizontalnog ugla razrokosti posle operacija na vertikalnim misicima oka
Authors: Risovic Dusica
Published: July 2008

We have operated 79 children with vertical strabismus. We have treated 52 children with primary overaction of the inferior oblique muscles and 27 of them with DVD and primary overaction of the inferior oblique muscles. In all of them, we have done recession of the inferior oblique muscles (for 4, 6, 8 or 10 mm). In only seven of them, from the second group, we did recession of the superior recti (for 7, 8 or 9 mm) simultaneously. This surgery very significantly and adequately ameliorate vertical strabismus (p=0.004). Mentioned surgery on vertical extraocular muscles theoretically may product more esodeviation. In our practice with 79 operated children we didn?t prove that (p=0.148).
Some parameters of the oxidative stress in lens, humour aqueous and serum of patients with diabetes and age-related cataract
Authors: Zoric Lepsa
Published: July 2008

Contemporary hypothesis considers the oxidative stress as a crucial event in age-related processes in the body, as well as in the age-related cataract formation. The secondary aging factors accelerate ageing processes. One of them is diabetes. With the aim of investigation of the noninsulin-dependent diabetes (Type II) influence on cataract genesis here were analyzed contents of the lipid oxidation products (lipid peroxides - LP) and total sulfhydryle groups (TSH) in the lens? corticonuclear blocks and antioxidative capacity in their humour aqueous expressed as percent of induced malondyaldehyde (% iMDA) in 14 samples obtained from patients with cataract and diabetes mellitus type II (without diabetic complications) and compared to 66 samples of patients with cataract without diabetes, as well as some parameters of the oxidative stress in serums (content of vitamin C, acrobat - A dehydroascorbate - DA and their relation, vitamin E, glutathione - GSH peroxidase - P and catalase - Cat activity, content of malondyaldehyde - MDA and % iMDA) of 27 patients with age-related cataract and diabetes mellitus type II (without complications), and compared to the other 135 age-related cataract patients. Also were analyzed frequencies of the secondary senium diseases in a clinical group of 162 patients with cataract and sex and age matched 55 examined people without cataract, as a control group. Patients with diabetes and cataract have lower values of almost all investigated parameters of antioxidative defense in their serum and higher level of the lipid peroxidation products. Level of glutathione in their serums is significantly lower (p<0.05). Intensity of lipid peroxidation in corticonuclear lens blocks is higher in patients with diabetes, whereas their total sulfhydryle groups and % iMDA in humour aqueous shows lower antioxidant capacity in the same group, probably because of higher intensity of oxidative stress. Also, by investigation of frequencies of the secondary ageing diseases in patients with age-related cataract and age and sex matched control subjects, by a logistic regression was found high odds ratio (2.506) for diabetes. Results confirm hypothesis of the oxidative stress role in the age-related cataract genesis, and especially of patients with diabetes mellitus.
Advantageous usage combined spinal, epidural and general anesthesia versus general anesthesia in abdominal surgery
Authors: Malenkovic Vesna , Zoric Sava , Randjelovic Tomislav
Published: July 2008

Type and technique of anesthesia have an important effect on per operative surgical course. The aim of the study was prospective analyses of advantages of combined spinal, epidural and general anesthesia (CSEGA) versus general anesthesia (GA) in abdominal surgery according to: 1. operative course (haemodynamic stability of patients, quality of analgesia, undesirables effects), 2. postoperative course (quality of analgesia, unfavorable effects, temporary abode of patients in intensive care). Using prospective randomized double blind controlled study, we evaluated two groups of patients whom the same type of abdominal surgical intervention was planed and the only difference was the type of technique of anesthesia. First group of patients (n=34), was treated with CSEGA and second group of patients (n=33), was treated only with standard (GA). Both groups had intraoperative and 24-hour-long postoperative continued monitoring of blood pressure central venous pressure, and dieresis. In the 24 hours postoperative period the following parameters were analyzed: vigilance conditions, motor block level, pain intensity in rest and movement, necessity for a complementary analgesia, side effects and final subjective effect of analgesia. There was important difference in waking up the patients after a general anesthesia in the first group this period was shorter. In the first 24 hours, patients from the first group didn't get any systemic analgesic, while the patients from the second group needed fractionary application of parenteral analgesics in the period of 4-6 hours. Patients from the first group were also physically faster and easier recovered and they had less respiratory complications and there was not any example of thromboembolysm and the intestine motility was faster re-established. First group of patients spent less time in intensive care (three days) than second group (six days). Final subjective effect of analgesia, according to verbal descriptive scale (VDS) of pain was satisfying with 75% of patients of the first group and 15% of patients of the second group. According to results investigation advantages of CSEDGA versus GA in abdominal surgery manifold: better hemodynamic stability and perfusion of operative region, decrease of single doses of opioid analgesics, local and general anesthetics followed by the decrease of their side effects, better intensity and longer duration of analgesia, improved total functional capability of patients.
Ultrasound evaluation of intima media thickness of carotid arteries in dialysis patients and correlation with proposed risk factors
Authors: Damjanovic Tatjana , Dimkovic Nada
Published: July 2008

Atherosclerosis is significant risk factor for cardiovascular morbidity and mortality in dialysis patients. Aim of the study was ultrasound evaluation of intima media thickness on carotid arteries (as a marker of atherosclerosis), in dialysis patients and its correlation with proposed risk factors. Intima media thickness was measured in 45 dialysis patients with no signs of cardiovascular diseases (15 on peritoneal dialysis, group I,30 on hemodialysis, group II) and 20 healthy controls. The mean carotid artery intima media thickness was significantly higher in dialysis patients than in control group. According to intima media thickness, dialysis patients were divided in group A (patient with intima media thickness less or equal 0,720 mm) and group B (intima media thickness higher then 0,720mm). Intima media thickness in bout group was correlated with proposed risk factors. In group A there was not significant correlation of intima media thickness with risk factors. In group B significant correlation have been found between intima media thickness and LDL, VLDL cholesterol, body mass index and systolic, diastolic and mean blood pressure. Although atherosclerosis was not the only cause for cardiovascular morbidity and mortality, it has a dominant role in dialysis patients. Augmented intima media thickness could be early marker of atherosclerosis. The risk factors of great influence on intima media thickness are lipid disturbances, obesity and hypertension.
Laparoscopic ovary biopsy and infertility
Authors: Popovic Jasmina , Sulovic Vojin , Vucetic Dragomir , Pop-Trajkovic Zoran , Veljkovic Milena
Published: July 2008

In the most developed countries, laparoscopic diagnostics and surgical procedures in the chosen cases still play a very important role and represent the acceptable alternative to the extrauterine fertilization. On the basis of histopathological verification of ovary biopsy cuts taken during the laparoscopy, the optimum conditions are fulfilled for determination of the ovary potentiality enabling the selection of patients for the further proper treatment. 113 patients that, due to the marriage infertility, were examined and treated at the Department of Sterility and Infertility of the Obstetrics and Gynecology Clinic, Clinical Center of Nis with the average age of 31.39 ? 6.10 and with the average marriage infertility period lasting from 4.11?2.99 had undergone the surgical laparoscopy. The most frequently used interventions that were performed disregarding the adnexial findings, were salipongovariolyses in 73 cases (64.60%), then fimbrioplastic in 60 cases (53.10%). Ovary biopsy and histopathological analysis of the cuts taken were performed in 110 patients (89.39%). We got 105 histopathological findings. The most common histopathological findings showed the existence of the primordial folicules in 39.60% of women, with the prevalence in younger ones. (In patients younger than 20 - 66.67%, while in patients over 40 - 25%). We found out that the prevailing number of women had the histological findings that spoke on behalf of the potential ovaries in case the infertility lasted shorter. The ovary tissue cuts taken by biopsy that were histopathologically analyzed showed the significantly higher pregnancy and delivery rate in findings with the primordial folicules present (67.5% of the pregnancy rate 57.5% of the intrauterine pregnancy rate and 47.5% of the delivery rate).
Proteinuria: The diagnostic strategy based on urine proteins differentiation
Authors: Stojimirovic Biljana , Petrovic Dejan
Published: July 2008

Basal glomerular membrane represents mechanical and electrical barrier for passing of the plasma proteins. Mechanical barrier is composed of cylindrical pores and filtration fissure, and negative layer charge in exterior and interior side of basal glomerular membrane, made of heparan sulphate and sialoglicoproteine, provides certain electrical barrier. Diagnostic strategy based on different serum and urine proteins enables the differentiation of various types of proteinuria. Depending on etiology of proteinuria it can be prerenal, renal and postrenal. By analyzing albumin, armicroglobulin, immunoglobulin G and armacroglobulin, together with total protein in urine, it is possible to detect and differentiate causes of prerenal, renal (glomerular, tubular, glomerulo-tubular) and postrenal proteinuria. The adequate and early differentiation of proteinuria type is of an immense diagnostic and therapeutic importance.
Systemic inflammatory response syndrome in surgical patients with sepsis
Authors: Milic Dragan , Pejic Miljko , Zivic Sasa , Karanikolic Aleksandar , Jovanovic Slobodan , Radojkovic Milan
Published: July 2008

Systemic inflammatory response syndrome and sepsis are common in surgically treated patients. Systemic inflammatory response syndrome represents a major factor of morbidity and mortality in these patients. The pathogenesis of these syndromes has been increasingly clarified. The objective of this review is to present an overview of our current understanding of the physiology underlying these conditions.

 This article has been retracted. Link to the retraction 10.2298/SARH1206269U
The impact of mitoxantrone on neurological disability in active multiple sclerosis patients
Authors: Mesaros Sarlota , Stojsavljevic Nebojsa , Dujmovic Irena , Mandic Edita , Drulovic Jelena
Published: July 2008

Several in vivo and in vitro studies showed that mitoxantrone (MTX), a novel anthracendione antineoplastic agent, had an immunomodulatory effect that suppressed humoral immunity, reduced T-cell numbers, lessened helper activity, enhanced suppressor function and had some positive effect on acute and chronic experimental allergic encephalomyelitis in rats. Up to now, several trials of therapy with MTX have been performed in patients with multiple sclerosis (MS). MTX has been recently shown to reduce disease activity, as expressed by reducing relapse rate and decreasing new, active MRI lesions, in a selected group of patients with active relapsing-remitting (RR) MS. Furthermore, more recently, it has been demonstrated that MTX reduce neurological disability in secondary progressive MS. We designed the open-label clinical trial involving 35 MS patients with active disease in order to evaluate the long-term clinical effects of 6-months MTX treatment during a follow-up period of 20-46 months (mean, 30 months). The study comprised 35 patients, who met the Poser criteria for clinically definite MS. All patients were clinically treated at the Institute of Neurology, Clinical Centre of Serbia, Belgrade, during the period from March 1996 to August 2000. The neurological disability state was evaluated at the entry, every month until completion of the therapy and every six months until August 2000, by means of Kurtzke Expanded Disability Status Scale (EDSS) score. All patients had active MS. The criteria for disease activity were: 1) at least 2 relapses within the previous 2 years, or 2) progression of at least 1.0 point on EDSS scale during the same period. The included patients did not receive immunosuppressive therapy six months prior to the entry. The patients were assigned to receive MTX 20 mg intravenously (iv) per month and methylprednisolone 1g iv per month, over six months. The clinical characteristics and demographic data of patients included in the study were shown in table 1. The parameters monitored during the trial were shown in table 2. Clinical assessment showed a significant improvement of the final mean EDSS score after 6 months of the therapy as compared to the value at entry in the total MS group (p=0.00001). Although EDSS value showed an increasing tendency during the follow-up period (20-46 months), the mean EDSS value was still significantly lower at the end of the follow-up comparing to the value at entry (p=0.013) (Figure 1). Overall, MTX was well tolerated and only minor side effects occurred. Cardiotoxicity was not registered. Our findings further support the notion that mitoxantrone reduces neurological disability in active relapsing and secondary progressive multiple sclerosis patients. However, follow-up suggests that this effect slowly subsides after discontinuation of therapy, implying the need for prolongation of such treatment (up to 120 mg/m2) for a period as long as possible.
Prevalence of craniomandibular dysfunction sings and symptoms in students of the School of Stomatology in Belgrade
Authors: Dodic Slobodan
Published: July 2008

Numerous epidemiological studies suggest that CMD problem is rather present in most countries all over the world, particularly in the Scandinavian and East European countries. There have not still been epidemiological studies on incidence of CMD in our surroundings, either organized or academic treatment programs of these diseases. The results of this study showed that most common CMD signs and symptoms were: impaired mandibular movements, deviation (deflection) in opening and closing the jaws, and TMJ sounds during mandible movements. Pain as a primary symptom was seen only in 5.2% of the analyzed subjects. Such fact indicates that this analyzed population group manifested the initial stage signs and symptoms of CMD. Recording of signs and symptoms mentioned above in young subjects should lead the therapist to perform more detailed analysis and apply adequate therapy modalities.
Mechanisms of protective effects of moderate alcohol consumption on the cardiovascular system
Authors: Jakovljevic Branko , Paunovic Katarina , Belojevic Goran , Stojanov Vesna
Published: July 2008

Consumption of alcoholic beverages has been known in many cultures since the ancient civilizations, so harmful consequences of excessive alcohol intake have been well explained. Many epidemiological studies confirmed lower morbidity and mortality rates of cardiovascular diseases in persons who drink alcohol "moderately" (1-2 drinks a day), independently of the kind of alcoholic beverage. This paper presents the review of molecular mechanisms that are believed to explain cardioprotective effect of moderate drinking-alcohol effects on lipoproteins, endothelial cells, blood clot formation and dissolution, as well as genetic and gender variances modifying the relation. A simple recommendation regarding the increase of alcohol consumption cannot be made on population level. The professionals must therefore concentrate on other preventive methods in order to reduce other significant risk factors of cardiovascular diseases.
Pathogenesis of helicobacter pylori infection: Bacterium and host relationship
Authors: Sokic-Milutinovic Aleksandra , Todorovic Vera , Milosavljevic Tomica
Published: July 2008

Helicobacter pylori (H. pylori) colonizes the gastric mucosa of a half of the mankind. Duodenal ulcer is found in 15-25%, t gastric ulcer in 13%, while gastric adenocarcinoma develops in 1% of all infected individuals. Pathogenesis of H. pylori infection is related to the virulence factors of the bacterium, environmental (dietary habits, hygiene, stress) and host factors (age, sex, blood type). Colonization of the gastric mucosa is related to the motility of the bacterium, presence of lipopolysacharide (LPS) and various bacterial enzymes. Gastric mucosal injury is the result of H. pylori LPS, vacuolization cytotoxin (vacA), cytotoxin associated protein (cagA), heat shock proteins and factors responsible for neutrophil chemotaxis and activity. H. pylori colonizes the gastric mucosa and zones of ectopic gastric epithelium. H. pylori infection is transmitted via oral-oral, fecal-oral and iatrogenic way (during endoscopy). Higher prevalence of the infection is associated with lower socioeconomic level, lack of drinking water, and living in a community. Acute H. pylori gastritis is superficial pangastritis progressing into the chronic phase after 7-10 days. Gastric mucosal atrophy and intestinal metaplasia can develop during the course of H. pylori infection. Clearly defined factors that influence the outcome of H. pylori infection include bacterial strain, distribution of gastritis, acid secretion and gastric mucosal atrophy.
Management of idiopathic nephrotic syndrome in childhood
Authors: Peco-Antic Amira
Published: July 2008

The management of idiopathic nephrotic syndrome (INS) in children includes immunosuppressive and symptomatic treatment. The response to corticosteroid therapy is the best prognostic marker of the disease. The majority of children with INS (about 85%) are steroid-sensitive as they normalize proteinuria within 4 weeks of daily, oral prednisone administration. The most of steroid-sensitive patients (94%) has minimal change of nephrotic syndrome, while the majority (80.5%-94.4%) of those who are steroid-resistant has focal segmental glomerulosderosis or mesangioproliferative glomerulonephritis. Initial therapy of INS consists of 60 mg/m2/day prednisone daily for 4 weeks followed by 40 mg/m2 on alternate days for 4 weeks, thereafter decreasing alternate day therapy every month by 25% over the next 4 months. Thus, the overall duration of the initial cortico-steroids course is 6 months that may be significantly protective against the future development of frequent relapses. Approximately 30% of patients experience only one attack and are cured after the first course of therapy; 10-20% have only 3 or 4 steroid-responsive episodes before permanent cure; the remaining 40-50% of patients are frequent relapsers, or steroid-dependent. Standard relapse therapy consists of 60 mg/m2/ day prednisone until urine is protein free for at least 3 days, followed by 40 mg/m2 on alternate days for 4 weeks. The treatment of frequent-relapses and steroid-dependent INS includes several different regimens: maintenance (6 months) alternate steroid therapy just above steroid threshold (0.1-0.5 mg/kg/ 48h), levamisole, alkylating agents (cyclophosphamide or chlorambucil) or cyclosporine. The worse prognosis is expected in steroid-resistant patients who are the most difficult to treat. Renal biopsy should be performed in them. At present, there is no consensus on therapeutic regimen for steroid-resistant patients. The following immunosuppressive drugs have been used with varying success: cyclosporine, intravenous methyl prednisone pulses alone or combined with or followed by alkylating agents, plasma-exchange, and angiotensin-converting enzyme (ACE) inhibitors. Symptomatic treatment includes: 1) dietary regimen with normal protein intake and salt restriction, 2) calcium and vitamin D are prescribed with steroids, 3) diuretics should be used in case of severe edema, 4) infusion of albumin in case of severe hypovolemia, 5) treatment of hypertension, 6) anticoagulant therapy, and 7) prophylactic antibiotics in high-risk patients.
Transverse testicular ectopia - case report
Authors: Zivanovic Dragoljub , Slavkovic Andjelka , Madic Jelica , Novakovic Dejan
Published: July 2008

Transverse testicular ectopia is an extremely rare anomaly, characterized by migration of one testis towards the opposite inguinal canal, usually associated with inguinal hernia. Spermatic cord of the ectopic testis originates from the appropriate side. In most reported cases, the accurate diagnosis has not been made before surgery. This is a case report of transverse testicular ectopia in eleven-year-old boy who had undergone an operation for the left inguinal hernia in age often months. At the time of herniorrhaphy, the right testis was absent. Ten years later, during re-operation of the left inguinal hernia, both testis were found in left inguinal canal and easily brought down sequentially through the left groin into the scrotum. The right testis was fixed in the left hemiscrotum, due to shorter funicular elements, and the left was trans-septally moved to the right hemiscrotum (a modified Ombr?danne operation). Ultrasonography and voiding cystoureterography showed no associated genitourinary anomalies and no M?lerian duct remnants. The rupture of gubernaculum and dysfunction of the genito-femoral nerve could explain the etiology of crossed testis ectopia. Although ectopic testis could be localized preoperatively by ultrasonography, CT, MRI, arteriography and venography, correct diagnosis was made intraoperatively in the majority of cases. Treatment modalities include laparoscopic and surgical procedures. Atrophie testis should be removed. If testes are fused, they have to be brought into one hemiscrotum. In cases where testes are completely separated with individual funicular elements and vas deferens, an ipsilateral or contralateral orchiopexy should be performed depending on the length of funicular elements.
Blood supply of the internal capsule and basal nuclei
Authors: Vitosevic Zdravko , Cetkovic Mila , Vitosevic Biljana , Jovic Darko , Rajkovic Natasa , Milisavljevic Milan
Published: July 2008

The internal capsule and basal nuclei are supplied by perforating branches of the anterior cerebral artery (ACA), Heubner's artery, middle cerebral artery (MCA), internal carotid artery (ICA) and anterior choroidal artery (AChA). Some of the mentioned perforators vascularize both the internal capsule and basal nuclei, while some of them also perfuse the adjacent brain structures. Dorsal part of the anterior limb, knee and posterior limb of the internal capsule are commonly supplied by lateral MCA perforators. The intermediate part of the anterior limb is perfused by medial MCA perforators, while its ventral part is nourished by ACA perforators and Heubner's artery. The intermediate part of the knee is supplied by medial MCA perforators, while its ventral partis mostly vascularized by ICA and proximal AChA perforators. The intermediate part of the posterior limb is perfused by medial MCA perforators anteriorly and the proximal AChA perforators posteriorly. The ventral part is supplied by AChA perforators. The retrolenticular and sublenticular portions of the internal capsule are mainly nourished by distal AChA perforators. The caudate nucleus is supplied by perforators of the ACA, MCA and AChA, as well as by branches of the lateral posterior choroidal artery. Most of the putamen is vascularized by MCA perforators, and smaller parts by ACA and AChA perforators. The lateral segment of the globus pallidus is perfused by MCA perforators and partially by Heubner's artery and ACA, while its medial segment is supplied by ICA and AChA perforators. The ACA perforators, that most often originate from the initial 5.9 mm of the Al segment, range in number from 1 to 5 (mean, 2.2) and in diameter between 80 urn and 710 urn (average, 295 urn). Heubner's artery, which most often arises close to the anterior communicating artery, can be singular (72.5%), double (23%) or triple (4.5%). It varies in diameter from 190 urn to 1,600 um (average, 750 urn) and in length between 11 mmand36mm (mean, 22.4 mm). The MCA perforators, that most frequently originate from M1 segment (90.7%) and leptomeningeal branches (62.6%), range in number between 2 and 13 (mean, 8.1) and in diameter from 80 um to 1,300 um (mean, 520 um). Many perforators arise as individual vessels, and some of them with common trunks (70.8%). Medial and lateral group of these perforators can be distinguished. The ICA perforators, which more often arise close to the AChA originating site (35.4%) than from the ICA bifurcation point (10.4%), vary in number from 1 to 5 (average, 3) and in diameter between 70 ?m and 500 um (mean, 236 ?m). The AChA perforators that originate from its cisternal segment, range in number from 2 to 9 (mean, 4.5) and in diameter from 90 ?m to 600 ?m (mean, 325 ?m).
Treatment of the infected wound with exposed Silver-ring Dacron graft and delayed skin transplant covering
Authors: Nenezic Dragoslav , Pandjaitan Simon , Ilijevski Nenad , Matic Predrag , Gajin Predrag , Radak Djordje
Published: July 2008

Although the incidence of prosthetic infection is low (1%-6%), the consequences (limb loss or death) are dramatic for a patient, with high mortality rate (25%-75%) and limb loss in 40%-75% of cases. In case of Szilagyi's grade III infection, standard procedure consists of the excision of prosthesis and wound debridement. Alternative method is medical treatment. This is a case report of a patient with prosthetic infection of Silver-ring graft, used for femoropopliteal reconstruction, in whom an extreme skin necrosis developed in early postoperative period. This complication was successfully treated medically. After repeated debridement and wound-packing, the wound was covered using Thiersch skin graft.
The first pediatricians in Serbia
Authors: Pesic Vladimir , Pavlovic Budimir , Jovanovic-Simic Jelena
Published: July 2008

Dr. Platon Papakostopulos (1864-1915), Dr. Milenko Materni (1875-1929), Dr. Milan Petrovic (1886-1963), Dr. Nadezda Stanojevic (1887-1979) and Dr. Djura Jovanovic (1892-1977) were founders of modern pediatrics in Serbia. They established and managed the first pediatric institutions: Hospital pediatric departments, Mother and Child Health Care Consultations and Child welfare clinics in Belgrade and Novi Sad. They also established Pediatric Section of the Serbian Medical Association and published numerous scientific and popular articles in pediatrics.
Arterial hypertension frequency in urban and rural population of children
Authors: Pavicevic Mirjana , Pavicevic Dragana , Milosevic Bojan , Stojanovic Dragoljub
Published: July 2008

The principle objective of this investigation was to establish the frequency and form of the arterial hypertension in children between 7 and 16 years in urban and rural population. Specific goals were to determine by screening method, i.e., by elimination, the arterial hypertension prevalence in relation to permanent residence (town-village), age and sex of children; to determine, by the same method, the prevalence of the essential and borderline arterial hypertension; to test the risk factors in patients with essential and borderline arterial hypertension: obesity, hereditary predisposition (relatives of the first and second line), lipids, and ten-year follow-up of children with essential arterial hypertension. The examination included 3000 children (age 7-16 years) during regular school days. Essential arterial hypertension in this study was defined as blood pressure continuously higher than 95th percentile for age and sex in at least three different measurements; secondary causes of hypertension were excluded by available clinical, laboratory and functional investigations. Borderline hypertension was defined as blood pressure continually higher than 90th percentile, and from time to time higher than 95th percentile for age and sex in at least three measurements, when the secondary causes of hypertension were excluded. The obtained results were the basis for the following conclusions: Prevalence of arterial hypertension for all children was 0.93% and was the lowest in children aged 7-8 years (0.83%), and the highest in children aged 15-16 years (2.96%). Prevalence of the essential arterial hypertension was 0.37% and of borderline arterial hypertension 0.56%. Prevalence of the arterial hypertension was higher in urban than in rural population of children (1.09:0.55%), but without statistically significant difference (p>0.05). Hypertension was verified in 60.7% of family members of children with increased blood pressure. 21.4% of hypertensive children were overweight. Hyperlipidemia was noted in 4 children with essential hypertension. All children with arterial hypertension underwent 24-hours Holter monitoring. Patients with essential arterial hypertension had sinus tachycardia in 95% and patients with borderline hypertension in 60% (in stress and pressure).