bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of intensive insulin treatment on the development and consequences of oxidative stress in insulin-dependent diabetes mellitus
Authors: Kocic Radivoj , Pavlovic Dusica , Kocic Gordana
Published: December 2010

Background/Aim. The aim of this study, which included patients with insulin-dependent diabetes mellitus, was to determine the influence of the application of various treatment modalities (intensive or conventional) on the total plasma antioxidative capacity and lipid peroxidation intensity expressed as malondialdehyde (MDA) level, catalase and xanthine oxidase activity, erythrocyte glutatione reduced concentration (GSH RBC), erythrocyte MDA level (MDA RBC), as well as susceptibility of erythrocyte to H2O2-induced oxidative stress. Methods. This study included 42 patients with insulin-dependent diabetes mellitus. In 24 of the patients intensive insulin treatment was applied using the model of short-acting insulin in each meal and medium- acting insulin before going to bed, while in 18 of the patients conventional insulin treatment was applied in two (morning and evening) doses. In the examined patients no presence of diabetes mellitus complications was recorded. The control group included 20 healthy adults out of a blood doner group. The plasma and erythrocytes taken from the blood samples were analyzed immediately. Results. This investigation proved that the application of intensive insulin treatment regime significantly improves total antioxidative plasma capacity as compared to the application of conventional therapy regime. The obtained results showed that the both plasma and lipoproteines apo B MDA increased significantly more in the patients on conventional therapy than in the patients on intensive insulin therapy, most probably due to intensified xanthine oxidase activity. The level of the MDA in fresh erythrocytes did not differ significantly between the groups on intensive and conventional therapy. The level of GSH and catalase activity, however, were significantly reduced in the patients on conventional therapy due to the increased susceptibility to H2O2-induced oxidative stress . Conclusion. The presented study confirmed positive effect of intensive insulin therapy on metabolic control expressed through glycemia level, glycolysed hemoglobine (HbAlc) and fructosamine, as well as through antioxidative/prooxidative homeostasis. This is the confirmation that an adequate treatment choice can prevent numerous diabetes mellitus complications induced by free radicals. .
Ecstasy tablets intoxication with lethal autcome
Authors: Djordjevic Snezana , Tomasevic Gordana
Published: December 2010

Background. Ecstasy, 3,4-methylenedioxymethamphetamine (MDMA), is a synthetic compound increasingly popular as a recreational drug. Tablets known as ecstasy contain MDMA, but may also contain caffeine, ephedrine, paramethoxyamphetamine, 3,4-methylenedioxyamphetamine (MDA), amphetamine, methamphetamine, and ketamine. After absorption MDMA is metabolized to MDA, 4-hydroxy-3- metoxymetamphetamine (HMMA) and 4-hydroxy-3- metoxyamphetamine (HMA). After that HMMA and HMA are conjugated and excreted by urine. The aim of this report was to confirm by toxicological post mortem analyses of poisoned person organs that ecstasy had been the cause of his death. Case report. We reported the death of a 17-year-old boy after the ingestion of ecstasy. MDMA and metabolites were determined by multicolumn high performance liquid chromatography with UV spectral detection (HPLC-UV). Toxicological tests showed the presence of MDMA in all samples. When examining post mortem material (the organs), the highest concentrations were measured in the stomach (835,97 ?g/g) and kidney (801,14 ?g/g). The minimal concentration was in the liver (22,26 ?g/g). Conclusion. The obtained results of MDMA and its metabolites concentrations showed abuse of a high dose of ecstasy. .
Determination of diazepam and its metabolites in serum by the use of liquid chromatography: Mass spectrometry method
Authors: Djordjevic Snezana , Kilibarda Vesna
Published: December 2010

Background/Aim. Diazepam is a benzodiazepine anxyolitic. Metabolism of diazepam takes place in liver which generates pharmacologically active metabolites N-desmethyldiazepam, temazepam and oxazepam. The aim of this study was to develop and validate the method of liquid chromatographymass spectrometry (LC-MS) for separation and determination of diazepam and its active metabolites in the serum of rats samples after i.p. application of diazepam in a dose of 10 mg/kg. Methods. The serum samples taken from Wistar rats, were used in LC-MS analysis after the application of 10 mg/kg of diazepam i.p. Results. After alkaline extraction from the serum samples with diethylether and separation on a C18 reversed-phase column by using mobile phase methanolglacial acetic acid-water (50:1:49 v/v), diazepam and its metabolites were quantified. Determination was performed in a selective ion monitoring (SIM) mode, thereby the other exogenous and endogenous compounds did not interfere with this assay. Diazepam, N-desmethyldiazepam, oxazepam and temazepam were eluted in 14 minutes. The standard curve was linear in the range from 10-2 000 ng/ml. The limits of detection for diazepam, N-desmethyldiazepam, oxazepam and temazepam were 4.37, 3.13, 4.38 and 7.31 ng/ml, respectively. The limits of quantitation for diazepam, Ndesmethyldiazepam, oxazepam and temazepam were 14.58, 10.41, 14.59 and 24.36 ng/ml, respectively. Conclusion. The described LC-MS is a simple, sensitive, specific and accurate method and could be used for routine identification and quantification of small concentrations of diazepam and its metabolites in biological fluids.
Evaluation of the depth of infiltration of urothelial carcinoma in the vesical wall obtained by transurethral intravesical echotomography
Authors: Milosevic Radovan , Milovic Novak , Stijelja Borislav , Djokic Milan , Campara Zoran , Mocovic Dejan
Published: December 2010

Background/Aim. Transitional cell carcinoma (TCC) is the most frequent tumor of the bladder and represents 95?98% of blader neoplasams and 2?3% of all carcinomas in the body. In urogenital oncology more frequent is only prostatic cancer. Evaluation of the depth of infiltration of urothelial carcinoma in the vesical wall represents the clinical base in treatment planning and prognosis. Clinical investigation and convential radiological procedures have a low level of accuracy in estimating the local growth of the tumor. The aims of our investigation were to determine the depth of infiltration of urothelial carcinoma in the vesical wall in the investigated group of patients by transurethral intravesical echotomography (TIE) and computerised tomography (CT scan) and to compare results obtained by both methods with pathohistological (PH) results, and, based on the difference of the results determine which method was more accurate in the evaluation of the depth of infiltration of urothelial carcinoma in the vesical wall. Methods. Thirty patients with TCC of the bladder both genders, aged 51?81 years were involved in our investigation. In all of these patients, radical cystectomy (RC) was performed. This was neccessary to provide the defintive PH result. Transurethral intravesical echotomography was performed by ultrasound scanner type 1846 Bruel and Kjaer, sond type 1850, and the CT scan was perfomed by Pace plus, General Electric, U.S.A. The specimen for the definitive PH result obtained by RC includes all standards of the TNM classification. Results. Using CT scan, the most frequent was T1 stage (17 patients or 56.68%). Using TIE, the most frequent was T2 stage (22 patients or 73.33%). After RC the most frequent was T2 stage (21 patients or 70%). The Kolmogorov-Smirnov test, showed a high significant difference between the results obtained using CT and definitive PH results after RC. The same test showed no statistically significant difference between the results obtained using TIE and definitive PH results. The sensitivity and accurance of TIE compared to definitive PH results was 93.3%, but using CT it was only 33.3%. Conclusion. There was a significant difference between the results obtained using CT and TIE. The results obtained by TIE were in closer relation with the definitive PH results than the results obtained by CT scan. TIE provides more precise evaluation of the depth of infiltration of urothelial carcinoma in the vesical wall than CT scan. We conclude that the use of this procedure in local staging in TCC is justified and represents the clinical basis in the treatment planning and disease outcome prognosis.
Influence of mental disorders on working ability assessment
Authors: Novakovic Milan , Milovanovic Aleksandar , Jakovljevic Branko , Milovanovic Srdjan , Babic Dragan , Pejanovic Natasa
Published: December 2010

Background/Aim. There is an increasing need for evaluation of working ability due to lower level of social protection of workers and growing number of patients with mental diseases in Bosnia and Herzegovina (B&H). The aim of this study was to establish the influence of mental diseases on the occurrence of disability of I and III categories in B&H during the period from January 1st 2005 to December 31st 2006. Methods. This study involved 1 792 examinees with the complete loss of working ability (I disability category) (n = 921). Disability category III consisted of persons with limited working ability (n = 871). The instruments of research in this multricentric and retrospective study were the forms P-6 and D-2 for the years of service in B&H, and the form IN for persons with years of service abroad and personal features questionnaire (EPQ). Results. The study included 1 494 men (78.5%) and 298 women (21.5%). Univariant analysis represented very high statistical significance (p = 0.001) concerning: age (?2 = 65.428), years of service (?2=28.438), drinking (?2 = 33.234), smoking (?2=70.880), father?s education (?2 = 58.124), migrations (?2 = 14.874), sick leave (?2 = 29.190), medical treatment (?2 = 95.073) and rehabilitation (?2 = 29.453). Multivariant analysis represented the influence on disability category I by parameters such as: years of service, sick leave, psychoticism and depression (p = 0.001). Hospital treatment and fatigation had influence on disability in both groups. Mental diseases are the leading cause in disability category I in 14.98% and in disability category III in 9.3% persons. Leading diseases in both disability categories were depression and schizophrenia followed by alcoholism, anxiety, brain organ psychosyndrome (BOPS) and other diseases. Conclusion. The following parameters have highest influence on the disability category: the years of service, sick leave, psychoticism, depression, and long-lasting disease, medical treatments and fatigation on the disability category III.
Analytical confirmation of lethal heroin overdose by the use of liquid chromatography methods
Authors: Djordjevic Snezana , Kilibarda Vesna
Published: December 2010

Background/Aim. Heroin is diacetylated morphine. Its ability to induce euphoria has led to its frequent abuse, giving rise to psychological and physical dependence. It has a short half-life, of approximately 2?6 min. In the brain, heroin undergoes deacetylation to 6-monoacetylmorphine (6?MAM) and morphine. Detection of 6-acetylmorphine in the urine is indicative of heroin use. The aim of this study was to compare sensitivity and reliability of two analytical methods, a multicolumn liquid chromatography system with UV scanning detector (HPLCUV) and liquid chromatography-mass spectrometry detection (LC-MS) in opiate determining in post mortem material. Methods. Post mortem samples (blood, urine and vitreous humor) were analyzed by liquid chromatography with UV and MS detection. The samples were prepared by liquid-liquid extraction with mixture chloroform-isopropanol (9:1). Separation was performed on C8 column with mobile phase composed of 55% acetonitrile-glacial acetic acid (99:1) and 45% 20 mM ammonium acetate. Results. The analysis of blood samples, urine, and eye liquid by the use of multicolumn HPLC-UV method confirmed the presence of morphine in the samples of blood and urine, codeine only in urine, and 6-MAM in the samples of urine and eye liquid. Using LC-MS method morphine was confirmed in all of the samples, while codeine was confirmed in urine and in the sample of eye liquid. In the samples of eye liquid and urine 6-MAM was confirmed. Conclusion. For determination of opiates in post mortem material LC-MS technique is more sensitive and reliable as compared to multicolumn liquid chromatography.
Pathogenesis of Alzheimer disease
Authors: Pavlovic Dragan , Pavlovic Aleksandra , Zugic Stana
Published: December 2010

 Alchajmerova bolest javlja se kod 50-60% svih dementnih osoba i predstavlja znacajan zdravstveni i socijalni problem. Upoznavanje patogeneze AB je neophodno u nalazenju terapija koje bi ublazile i modifikovale bolest. Najvise dokaza ima za hipotezu o amiloidnoj kaskadi. Osnovna patohistoloska promena u mozgu obolelih su nakupine amiloida beta (A beta), senilni ili amiloidni pakovi. Ukupni efekat je gubitak sinapsi i neurona. Amiloid se nakuplja i u zidovima krvnih sudova remeteci mozdanu cirkulaciju. Usled navedenih promena nastaje poremecaj neurotransmisije, narocito acetilholina i glutamata i smetnje pamcenja i drugih neuroloskih funkcija. Patogenetski zasnovana terapija se usmerava na aktivaciju alfa sekretaze, inhibiciji beta i gama sekretaza, pojacano uklanjanje A beta, suzbijanje oksidativnog stresa i inflamacije, imunoterapiju upravljenu protiv Abeta i druge mehanizme. U upotrebi su inhibitori ACh-esteraze i antagonista glutamatnih receptora. U prevenciji su dokazani efekti ogranicenog unosa kalorija, Mediteranske dijete i redovne umerene fizicke aktivnosti.
Pain, functional status, social function and conditions of habitation in elderly unilaterally lower limb amputees
Authors: Djurovic Aleksandar , Ilic Dejan , Brdareski Zorica , Plavsic Aleksandra , Djurdjevic Slavisa
Published: December 2010

Background/Aim. Few authors are involved in home rehabilitation of amputees or their reintegration into the community. It has been remarked that there is a discontinuity between the phases of the amputee rehabilitation in Serbia. The aim of the study was to establish pain characteristics and functional status of amputees two months after the amputation and to determine their social function and the conditions of their habitation. Methods. This prospective observation study involved 38 elderly amputees with unilateral lower limb amputations. The patients were tested at the hospital on discharge and at their homes two months after the amputation. Pain intensity and functional status were measured by a visual analogue scale (VAS) and by Functional Independence Measure (FIM). The patients? social function was assessed using the Social Dysfunction Rating Scale (SDRS) and conditions of their habitation by the self-created Scale of Conditions of Habitation (SCH). In statistic analysis we used the Student t test, ?2 test and Analysis of variance (ANOVA). Results. The majority of patients (63%) underwent below knee amputation caused by diabetes (89%). A significant number of patients (84%, ?2 = 17.78; p < 0.01) was not visited by a physiotherapist nor an occupational therapist during two months at home. In this period, the majority of the amputees (68%) had phantom pain or residual limb pain (21%). Two months after amputation the pain intensity was significantly lower (VAS = 4.07?2.19; 2.34?1.41; p < 0.001), and the functional status significantly better than on discharge (FIM = 75.13?16.52; 87.87?16.48; p < 0.001). The amputees had the average level of social dysfunction (SDRS = 62.00?11.68) and conditions of habitation (SCH = 7.81?1.97). Conclusion. A total 38 elderly amputees with unilateral lower limb amputations achieved significant functional improvement and reduction of pain, in spite of their social dysfunction, the absence of socio-medical support and inadequacy of the conditions of habitation.
Efficacy of guided ovarian hyperstimulation in patients with mild type endometriosis
Authors: Jasovic-Siveska Emilija , Jasovic Vladimir
Published: December 2010

Background/Aim. Endometriosis befalls in one of the most frequent gynecologic diseases. It manifests itself by the presence and growth of focus of endometrium out of the uterus cavum that reacts to hormonal stimulations as the normal uterus endometrium does. Hyperstimulation and induction of ovulation together with intrauterine insemination (IUI) are the most frequently used treatments of unexplained infertility in patients with mild type endometriosis. The aim of this study was to compare the effects of stimulation using human menopausal gonadotrophine (hMG) in the patients with mild type endometriosis to the patients with infertility of unknown ethiology. Methods. The study included 50 patients with unexplained infertility (group N), as well as 50 patients with mild type endometriosis (group E) confirmed by laparoscopy. Within the same therapeutic protocole hMG stimulation and horionic gonadotrophine induction (hCG) were used. Results. In the group E ovulation occurred in 74% of the patients during the first stimulation, in 77.78% during the second cycle, and in 75% of the patients during the third one. Regarding the group N, ovulation appeared in 82% of the patients during the first stimulation. Stimulation was performed two times more in 38 patients with unknown couse of infertility, and ovulation appeared in 84.21% of them. In the group N stimulation was performed three times in 28 women resulting in ovulation in 85.71% of them. Conclusion. Considering the obtained results it can be concluded that hMG stimulation and hCG induction are efficient in the treatment of infertility, particularly in mild type endometriosis.
Renal scintigraphy in infants with antenatally diagnosed renal pelvis dilatation
Authors: Ajdinovic Boris , Jaukovic Ljiljana , Peco-Antic Amira , Dugonjic Sanja
Published: December 2010

Background/Aim. Ureteropelvic junction obstruction and vesicoureteral reflux are the most frequent entities identified on the basis of antenatal hydronephrosis. The aim of this study was to determine the incidence and pattern of abnormal renal scintigraphy findings in postnatal investigation of children with antenatal hydronephrosis. Methods. Twenty four infants (19 boys and five girls) presented with antenatal hydronephrosis and mild to moderate hydronephrosis on ultrasound in newborn period were referred for renal scintigraphy. Ten patients with vesicoureteral reflux documented on micturating cystoureterography underwent 99mTc-DMSA renal scintigraphy and 14 patients were subjected to 99mTc-DTPA scintigraphy. Results. Anteroposterior pelvic diameter on ultrasound ranged from 11 to 24 mm. Renal DMSA scans identified congenital scars in two boys with bilateral reflux of grade V and unilateral reflux of grade III. Relative kidney uptake (RKU) less than 40% was found in three, and poor kidney function (RKU less than 10%) in two patients. Significant obstruction was shown on DTPA diuretic renal scintigraphy in 6/14 patients. Some slowing in dranaige (T1/2 greater than 10 minutes) with no reduction in differential renal function was identified in three patients. Differential renal function less than 10% was obtained in one case. Conclusion. A high percent of abnormal renal scintigraphy findings was obtained. Renal scintigraphy was useful in determination of underlying cause of antenatally detected hydronephrosis.
Oxidative stress in association with risk factors for the occurrence and development of age-related macular degeneration
Authors: Zoric Lepsa , Kosanovic-Jakovic Natalija , Colak Emina , Radosavljevic Aleksandra , Jaksic Vesna , Stevic Snezana
Published: December 2010

 Niz rezultata potvrdjuje ulogu oksidativnog stresa u etiopatogenezi AMD i to bilo kao inicijalnog ili izolovanog uzrocnog faktora, ili kao dodatnog cinioca u sklopu drugih faktora rizika. Bolje poznavanje ove oblasti prosiruje mogucnosti prevencije ove, ali i drugih bolesti starijeg zivotnog doba.
Ectopic mammary tissue in vulva
Authors: Djordjevic Momcilo , Jovanovic Bozidar , Mitrovic Slobodanka , Djordjevic Gordana
Published: December 2010

Background. Ectopic mammary gland tissue is a residual tissue that persists during the embryologic development along ectodermal primitive milk streaks. Incomplete involution anywhere along the primitive milk streak can result in accessory or ectopic mammary tissue. Case report. A woman, 27-year old, admitted to Obstetrics and Gynecology Clinic Kragujevac for surgery, of goose-egg size, vulva tumor, of elastic consistency. Menarche started in 12 years of age, with the regular menstrual cycle, without previous gynecological diseases. The woman had one pregnancy terminated by cesarean section because of the multiple (twin) pregnancy. Excision of the tumor was completely done in the total endotracheal anesthesia. Pathohistologic (PH) findings was: Dysplasia fibrosa cystica simplex mammae, with focuses of sclerosing adenosis. Expression of estrogen (ER) and progesterone receptors (PR) were positive. Conclusion. Ectopic mammary tissue in vulva in adult period is very rarely seen, and can be changed pathologically as well as normally positioned breast tissue into benign cystic changes, benign tumors, adenomas and fibroadenomas and tumors. Cells with low ER/PR receptor level grow independently of estrogene stimulation and they could be resistant to hormonal therapy effects.
Frequency and risk factors of the use of psychoactive substances among the young
Authors: Pavlovic Zorana , Jakovljevic Branko
Published: December 2010

Background/Aim. Socio-economic changes that occurred in the wake of dismemberment of former Yugoslavia resulted in the appearance of social pathology, one of which was the increase in the use of psychoactive substances. The over whole epidemiological research in the use of psychoactive substances has not been conducted so far. The aim of this study was to establish the type and form of the use of psychoactive substances considering sex and age, as well as risk factors for the use of psychoactive substances among the children and adolescents. Methods. The research was carried out among 1011 elementary school children (seventh and eighth grades) and secondary school children (all four grades) in the area of Belgrade from October 2003 to January 2004. Out of the total number 457 (45.2%) were elementary school pupils and 554 (54.8%) secondary school pupils. There were 524 (51.8%) boys and 487 (48.2%) girls, aged from 12 to 18 years (the average age being 15.3 years). The method used was the European School Survey Project on Alcohol and Other Drugs Questionnaire. Chisquare test, Mann-Whitney, Student's t test and Logistic Regression test were used in statistical processing of the data. Results. Totally 14.2% examinees tried psychoactive substances. The most frequent drug used at the first contact was marijuana (10.8%) at the age of 15 tried by 12.7% examinees, inhalants (4.4%), amphetamines (4.1%), sedatives (3.7%), alcohol combined with marijuana (3.9%), then cocaine (2.8%), heroine (2.3%), alcohol combined with sedatives (2.2%), and ecstasy (1.6%), followed by anabolic steroids, heroin, diethilamid lisergic acid (LSD) and magic mushrooms. It was determined that going out in the evening, smoking and binge form drinking were directly connected with the use of psychoactive substances. Conclusion. Totally 14.2% of the examiners used psychoactive substances, mostly marijuana, followed by amphetamines and others. New tendencies of use characterized by the increase in the use are of synthetic substances, simultaneous use of more psychoactive substances and younger age. The risk factors are going out in the evening, smoking, binge drinking and use of synthetic substances among peers. Our research indicates the necessity of primary prevention.
Sensibility of vagina reconstructed by McIndoe method in Mayer-Küster-Rokitansky-Hauser syndrome
Authors: Vesanovic Svetlana , Panajotovic Ljubomir , Garalejic Elijana
Published: December 2010

Background/Aim. Congenital absence of vagina is a failure present in Mayer-K?ster-Rokitansky-Hauser syndrome. Treatment of this anomaly includes nonoperative and operative procedures. McIndoe procedure uses split skin graft by Thiersch. The aim of this study was to determine sensitivity (touch, warmness, coldness) of a vagina reconstructed by McIndoe method in Mayer-K?ster-Rokitansky-Hauser syndrome and compare it with the normal vagina. Methods. A total of 21 female persons with reconstructed vagina by McIndoe method and 21 female persons with normal vagina were observed. All female persons were divided into groups and subgroups (according to age). Sensibility to touch, warmness and coldness were examined, applying VonFrey's esthesiometer and termoesthesiometer for warmness and coldness in three regions of vagina (enter, middle wall, bothom). The number of positive answers was registrated by touching the mucosa regions for five seconds, five times. Results. The obtained results showed that female patients with a reconstructed vagina by McIndoe method, felt touch at the middle part of wall and in the bottom of vagina better than patients with normal one. Also, the first ones felt warmness at the middle part of wall and coldness in the bottom of vagina, better than the patients with normal vagina. Other results showed no difference in sensibility between reconstructed and normal vagina. Conclusion. Various types of sensibility (touch, warmness, coldness) are better or the same in vaginas reconstructed by McIndoe method, in comparison with normal ones. This could be explained by the fact that skin grafts are capable of recovering sensibility.
Treatment of degenerative chronic low back pain with fluoroscopically guided epidural procaine-corticosteroid injection
Authors: Culafic Slobodan , Stefanovic Dara , Dulovic Dragan , Minic Ljubodrag , Culafic Andrijana
Published: December 2010

Background/Aim. Low back pain is one of the most common painful conditions in the modern age. Therefore, it is very important to establish the most effective protocol for the treatment of this condition. The aim of this study was to find out if fluoroscopically, guided epidural procainecorticosteroid injection is effective in the treatment of degenerative chronic low back pain. Methods. This prospective cohort study was performed in the Military Medical Academy from September 2005 to June 2006 and included 60 patients of both sexes, 34-85 years of age. Degenerative changes of lumbosacral spine were determined by magnetic resonance imaging. The intensity of low back pain was evaluated by subjective (Roland's scale) and objective parameter (Lazarevic sign). Epidural procaine-corticosteroid injection was applied in the patients with low back pain not responding to conservative therapy. After the application of injection, effects of the therapy were followed up. Results. In 92% of the patients there was a reduction of pain intensity for three months, in 4.8% a reduction for a month, but after another injection they felt pain reduction for the next three months. One patient (2.3%) had pain reduction for one month. Conclusion. In the treatment of degenerative chronic low back pain, not responding to conservative therapy with nonsteroidal anti-inflammatory drugs, epidural procaine-corticosteroid injection have a satisfactory short-term as well as a long-term analgesic effect.
Radiographic cephalometry analysis of dimensions of condylar processus in persons with mandibular prognathism
Authors: Cutovic Tatjana , Pavlovic Jasna , Kozomara Ruzica
Published: December 2010

Introduction/Aim. There are numerous factors that influence the formation of condylar processus: the growth and development of cranial base, growth and development of the jaws and alveolar extensions, teething, the way of intercuspidation, the overlap of incisors, functions of masticatory muscles, etc. Considering the fact that the above-mentioned factors significantly differ in persons with different morphological set of the face, we set a hypothesis that dimensions of condylar processus and the mandibular ramus considerably differ in persons with mandibular prognathism compared to eugnatic persons. The aim of this study was to establish the differences in dimensions of condylar processus between the above-mentioned groups. Methods. Six parameters representing the dimensions of the condylar processus were measured on profile teleradiographs of 30 eugnatic persons and 30 paersons with mandibular prognathism: the height of condylar processus, the height of head of the mandible, width of the head, width of the neck, height of the ramus without the condylar processus and the overall height of the ramus. Results. A considerable difference in the values of the parameters was found, as well as the distribution toward the values of reference. It was found that the height of the condylar processus was significantly greater in persons with mandibular prognathism, whereas the width of the head of the mandible, the width of the neck and the height of the ramus without the condylar processus was considerably decreased within the same group. The height of the head of the mandible and the overall height of the ramus was not significantly changed. Conclusion. In persons with mandibular prognathism, morphological features of the condylar processus are changed. The condylar processus lengthens on account of shortening of the lower part of the ramus, and the mentioned lengthening is the most prominent in its condylar neck area which is also the centre of its most intense growth.
Granulomatous rosacea: Like leukemid in a patient with acute myeloid leukemia
Authors: Skiljevic Dusan , Colovic Milica , Bogatic Dragana , Popadic Svetlana , Medenica Ljiljana
Published: December 2010

Introduction. Skin findings in leukemias may be divided into specific lesions (leukemia cutis) and non-specific lesions (leukemids) which may be found in up to 80% of all patients with leukemias. The leukemids vary clinically and they are usually a manifestation of bone marrow or immunologic impairment, but also Sweet syndrome, pyoderma gangrenosum, erythroderma, maculopapular exanthema, prurigo-like papules, generalized pigmentation, follicular mucinosis, generalized pruritus may be found during the course of leukemia. Case report. We report a 70-year-old male with a 3-month history of erythema, papules and pustules on the face, ears and neck and over a month history of refractory anemia, anorexia, weight loss, malaise, and fever. Physical examination revealed symmetric erythematous, violaceous papules, papulo-nodules and plaques with slate scale and sparse, small pustules on the face, earlobes and neck. Histopathologic findings of involved skin showed diffuse mixed inflammatory cell infiltrate with perifollicular accentuation and focal granulomatous inflammation in the papillary and upper reticular dermis. Extensive checkup revealed the presence of acute myeloid leukemia French- American-British (FAB) classification subtype M2, with signs of three-lineage dysplasia. The patient was treated by L6 protocol which led to complete remission, both in bone marrow and skin, but after seven months he had relapse of leukemia with the fatal outcome. Conclusion. This case indicates the importance of skin eruptions in the context of hematological malignancies.
Size of lower jaw as an early indicator of skeletal class III development
Authors: Stojanovic Zdenka , Nikodijevic Angelina , Udovicic Bozidar , Milic Jasmina , Nikolic Predrag
Published: December 2010

Background/Aim. Malocclusion of skeletal class III is a complex abnormality, with a characteristic sagital position of the lower jaw in front of the upper one. A higher level of prognatism of the lower jaw in relation to the upper one can be the consequence of its excessive length. The aim of this study was to find the differences in the length of the lower jaw in the children with skeletal class III and the children with normal sagital interjaw relation (skeletal class I) in the period of mixed dentition. Methods. After clinical and x-ray diagnostics, profile tele-x-rays of the head were analyzed in 60 examinees with mixed dentition, aged from 6 to 12 years. The examinees were divided into two groups: group 1 - the children with skeletal class III and group 2 - the children with skeletal class I. The length of the lower jaw, upper jaw and cranial base were measured. The proportional relations between the lengths measured within each group were established and the level of difference in the lengths measured and their proportions between the groups were estimated. Results. No significant difference between the groups was found in the body length, ramus and the total length of the lower jaw. Proportional relation between the body length and the length of the lower jaw ramus and proportional relation between the forward cranial base and the lower jaw body were not significantly different. A significant difference was found in proportional relations of the total length of the lower jaw with the total lengths of cranial base and the upper jaw and proportional relation of the length of the lower and upper jaw body. Conclusion. Of all the analyzed parameters, the following were selected as the early indicators of the development of skeletal class III on the lower jaw: greater total length of the lower jaw, proportional to the total lengths of cranial base and the upper jaw, as well as greater length of the lower jaw body, proportional to the length of the upper jaw body. .
Total antioxidant blood capacity in patients with type 2 diabetes mellitus and distal symmetrical polyneuropathy
Authors: Djordjevic Gordana , Djuric Stojanka , Apostolski Slobodan , Djordjevic Vidosava , Zivkovic Miroslava
Published: December 2010

Background/Aim. Reduced systemic antioxidant defense is considered to play an important mediating role in pathogenesis of diabetic neuropathy. The aim of this study was to evaluate if the total antioxidant blood capacity (TAC) is reduced in patients with type 2 diabetes mellitus (DM) and diabetic distal symmetrical polyneuropathy (DDSP) and to correlate this antioxidant capacity with the degree of peripheral nerve dysfunction. Methods. This study involved 100 patients with type 2 DM and signs of DDSP, as well as the control group of 50 healthy subjects. The evaluation of DDSP was based on physical examination and nerve conduction studies. The degree of peripheral nerve dysfunction was estimated by scoring and analysing sensory and motor nerve conduction parameters (distal latency and amplitude of evoked potential, conduction velocity). Laboratory analyses involved blood glucose and HbA1C levels, as well as plasma TAC. Results. Blood glucose and HbA1C level was significantly higher in the patients than in the control group (p < 0.0001). The TAC was depleted in the diabetic group and the depletion was statistically significant (p < 0.0001). There was no significant correlation between the TAC and the serum glucose level, TAC and HbA1C level as well as between TAC and the duration of DM. There was no significant correlation between TAC and peripheral nerve conduction parameters. Conclusion. Total antioxidant blood capacity is reduced in patients with DDSP, but it does not correlate with blood sugar level, with the duration of DM or with the degree of functional nerve damage. These results show a reduced systemic antioxidant defence in patients with type 2 DM and DDSP. However, it is still unclear to what extent the oxidative stress is a contributing factor or leading cause of diabetic neuropathy, suggesting that further studies are necessary.
Disseminated subcutaneous fat necrosis and elbow joint arthritis as a complication of pancreatitis
Authors: Colovic Radoje , Grubor Nikica , Radak Vladimir , Colovic Natasa , Rankovic Vitomir , Latincic Stojan , Matic Slavko
Published: December 2010

Background. Intraabdominal fat necrosis of the retroperitoneum, mesenthery and omentum is a frequent complication of acute pancreatitis. Very rarely, during the disease multiple aseptic subcutaneous fat necrosis, polyarthritis, polyserositis, vasculitis, subcutaneous nodi and eosinophylia, isolated or in combination, may appear. They are known as "pancreatic disease syndrome". Case report. We presented a female patient, 43-year-old, in whom in the course of acute interstitial billiary pancreatitis had occur red multiple localized aseptic necrosis of subcutaneous fat tissue of extremities appeared mostly around the talocrural and wrist joints requiring multiple incision, as well as aseptic elbow joints arthritis requiring puncture of one elbow joint. The symptoms were followed by a prolonged febrility that settled within several weeks. Conclusion. Localized disseminated fat necrosis around joints, arthritis of major joints, alone or with some of other symptoms of the "pancreatic disease syndrome" have to be considered as a probable sign of pancreatitis, even in the abscence of major abdominal symptoms.
Fournier's gangrene
Authors: Milovic Novak , Bancevic Vladimir , Campara Zoran , Kosevic Branko , Zoranovic Uros
Published: December 2010

Background. Fournier's gangrene (FG) represents a necrotizing infection of the skin and subcutaneous soft tissue of the external genitalia and perineum. It arises as a result of propagation of anorectal, urogenital and skin infections. The principles of treatment include improving general condition of a patient, debridement of wound, excision of necrotic tissue, combined antibiotic therapy, hyperbaric oxygen therapy and reconstructive procedures. It is a rare but very serious condition which regardless to aggressive treatment can lead to a lethal outcome in up to 20-30% of patients. Case report. Since the year 2000 we have treated six patients with FG. We presented the course and positive treatment outcome in a 65- year-old male patient with numerous comorbid conditions, nonregulated insulin-dependent diabetes, hypertension, previous myocardial infarction, chronic viral hepatitis and thrombocytopenia, rehabilitation was complicated with heart failure, atrial fibrillation and pulmonary thromboembolism. The treatment consisted of two extensive debridement of the wound with removing necrotic tissue, drainage, consolidation of state of health, correction of his blood sugar levels and thrombocytopenia, antimycotic and combination of three antibiotics and hyperbaric oxygen therapy. In two delayed surgical procedures reconstruction of a large defect of the urethra was performed. Conclusion. A patient with numerous and serious comorbid conditions with FG could recover as a result of teamwork of urologists, infective medicine specialists, cardiologists, endocrinologist, vascular and plastic surgeons.
Myocardial hipertrophy in hypertensive patients with and without metabolic syndrome
Authors: Ivanovic Branislava , Cvijanovic Dane , Tadic Marija , Simic Dragan
Published: December 2010

Background/Aim. Beside arterial hypertension as the most important factor of a myocardial hypertension development, very important risk factors are obesity, hypercholesterolemia, insulin resistance, etc. The aim of the study was to examine the influence of metabolic syndrome (MetS) on left ventricular hypertrophy in patients with arterial hypertension. Methods. We checked medical records for 138 patients with arterial hypertension, and compared them with the control group of 44 normotensive subjects. The patients with arterial hypertension were divided into two groups considering the presence of MetS: with MetS (59 patients), and without MetS (79 patients). We defined MetS as presence of three (or more) within five criteria: central obesity (> 102 cm male, > 88 cm female), raised triglycerides (> 1.7 mmol/L, or drug treatment for elevated triglycerides), reduced high density lipoprotein (HDL) cholesterol (< 1.03 mmol/L male, < 1.3 mmol/L female), raised blood pressure (> 130 mmHg systolic, > 90 mmHg diastolic), raised fasting glucose (> 6.11 mmol/L, or drug treatment for elevated glucose level). In each group routine laboratory, echocardiography and 24-hour ambulatory blood pressure monitoring were performed. Results. We found statisticaly significant higher left ventricular mass in both subgroups hypertensive patients in comparison with the control group (p < 0.05). We did not find statistically significant difference (227.31?63.44 vs 219?59.5, p > 0.05) in left ventricular mass between these two groups of patients. In the patients with arterial hypertension and MetS we found hypertrophy more frequently than in the subgroup without MetS (43/57 vs 34/69, p < 0.001). Conclusion. Our results suggest that associated cardiometabolic risks increase the prevalence of myocardial hypertrophy, but do not influence left ventricular mass.
The effects of polarized light therapy in pressure ulcer healing
Authors: Djurovic Aleksandar , Maric Dragan , Brdareski Zorica , Jevtic Miodrag , Djurdjevic Slavisa
Published: December 2010

Background/Aim. Neglecting polarized light as an adjuvant therapy for pressure ulcers and methodology distinctions in the trials engaging polarized light are the reasons for many dilemmas and contradictions. The aim of this study was to establish the effects of polarized light therapy in pressure ulcer healing. Methods. This prospective randomized single-blind study involved 40 patients with stage I-III of pressure ulcer. The patients in the experimental group (E) were subjected, besides polarized light therapy, to standard wound cleaning and dressing. Standard wound cleaning and dressing were the only treatment used in the control group (C). A polarized light source was a Bioptron lamp. Polarized light therapy was applied for six min daily, five times a week, four weeks. The Pressure Ulcer Scale for Healing (PUSH) was used in the assessment of outcome. Statistic analysis included Mann Whitney Test, Fisher Exact Test, Wilcoxon Signed Rank test. Results. There were significant differences between the groups at the end of the treatment regarding the surface of pressure ulcer (E: 10.80?19.18; C: 22,97?25,47; p = 0.0005), rank of pressure ulcer (E: 5.90?2.48; C: 8.6?1.05; p = 0.0005) and total PUSH score (E: 7.35?3.17; C: 11.85?2.35; p = 0,0003). The patients in the experimental group had significantly better values of the parameters monitored than the patients in the control group. Conclusion. After a four-week polarized light therapy 20 patients with stage I-III ulcer had significant improvement in pressure ulcer healing, so it could be useful to apply polarized light in the treatment of pressure ulcers.
Atypical proliferating mucinous tumors of gigantic dimensions
Authors: Likic-Ladjevic Ivana , Ladjevic Nebojsa , Stefanovic Aleksandar , Kadija Sasa , Jeremic Katarina , Durutovic Otas , Petkovic Spasoje , Atanackovic Jasmina
Published: December 2010

Background. Ovarian tumors of low malignant potential (LMP) are also known as atypically proliferating tumors. Ovarian tumors of LPM account for approximately 15% of all epithelial ovarian cancers. Mean age of occurrence is 40 years and they are 15-20 cm in diameter. Case report. A 32-year-old female patient was hospitalized as an urgent case with a large tumor mass that filled the entire abdomen. Cyst was 100 ? 70 cm dimensions belonging to the right ovary and filled with 18 liters of content. Right adnexectomy, resection of the second ovary, as well as biopsy of the omentum were performed. Lymphadenectomy of the right iliac and obturator area was also performed. After receiving definitive histopathological results it was decided to perform a radical reoperation. On the 10th postoperative day relaparotomy, total hysterectomy and left adnexectomy were performed. The patient was released on the 6th postoperative day. She used to come to regular examinations up to date. Conclusion. This case is a proof that LMP tumors have low malignant potential, they grow slowly and can reach great proportions.
Does acute sensorineural deafness befall to urgent conditions?
Authors: Cvorovic Ljiljana , Djeric Dragoslava , Pavicevic Ljubomir , Probst Rudolf , Hegemann Stefan
Published: December 2010

Background/Aim. Idiopathic sudden sensorineural hearing loss (ISSHL) is one of the most controversial issues in otology. The aim of this study was to determine whether a delay in treatment has any influence on hearing recovery in ISSHL. Method. This study was designed as a retrospective evaluation of an electronic patient data base of the University Hospital Z?rich from January 1995 to August 2006. Five hundred and forty one patients with a sudden hearing loss were identified. The standard treatment was carbogen inhalation (95% O2 and 5% CO2 eight times per day in the duration of 30 minutes) and prednisone orally (100 mg in one morning dose) for 7 days. Factor that was analyzed included the interval between the onset of symptoms and the beginning of the treatment. The initial hearing loss was described using the pure tone average (PTA in dB) hearing level at 4 frequencies (0.5, 1, 2 and 4 kHz). Hearing gain was expressed either as absolute hearing gain (dB values from initial PTA minus dB values from final PTA) or as relative hearing gain (absolute hearing gain divided by initial PTA minus baseline PTA) ? 100. Significant recovery of hearing was defined as the final PTA ? 30 dB (or same as PTA of the opposite ear). Results. An absolute hearing gain between the initial audiogram and the final audiogram was 15.1 dB. The mean relative hearing gain was 47%. Three hundred one (57%) patients had a significant recovery of hearing, and 228 (43%) had not. If the patients received treatment in the first 24 hours after onset of symptoms, then the rate of significant recovery was 56%, and no significant difference existed between this group and the patients who received the therapy after 24 hours, but within seven days (?2 = 0.007, DF = 1, p > 0.01). Conclusion. These results suggest that it is not critical to begin the treatment of ISSHL immediately as an emergency, but within seven days.
Effects of physical exercise on inflammatory parameters and risk for repeated acute coronary syndrome in patients with ischemic heart disease
Authors: Rankovic Goran , Milicic Branislava , Savic Todorka , Djindjic Boris , Mancev Zorica , Pesic Gordana
Published: December 2010

Background/Aim. Inflammation is an important factor in the pathogenesis of atherosclerosis, and several markers of inflammation have been associated with an increased risk of cardiovascular events. Physical activity may lower the risk for coronary heart disease (CHD) by mitigating inflammation. The aim of this study was to investigate the effects of aerobic physical exercise on systemic inflammatory response in patients with stable coronary disease participating in a cardiovascular rehabilitation exercise program. Methods. Male (n = 29) and female (n = 23) patients with stable coronary heart disease were enrolled in this study. All the patients were divided into two groups: the group with regular aerobic physical training during cardiovascular rehabilitation program phase II for 3 weeks in our rehabilitation center and 3 weeks after that in their home setting, and sedentary lifestyle group. There were no significant differences in gender distribution among the analyzed groups. Student's t-test showed no significant differences in average age, waist circumference (OS) and waist/hip ratio (WHR). Results. The degree of obesity was measured by BMI and there was a significant improvement in BMI in the patients who undertook 6-week physical training compared to the controls (p < 0.05). Physical training during 6-week appeared not to have any effects on leukocite count and ICAM-1 levels compared to controls. Exercise induced reduction in plasma CRP levels by 23.72% (p < 0.001) and reduction in plasma VCAM-1 levels by 10.23%, (p < 0.05). Conclusion. Moderate aerobic exercise resulted in a significant reduction of inflammatory state by decreasing CRP and VCAM-1 levels with significant obesity reduction but without visceral obesity reduction. The obtained results indicate that regular physical activity is clinically desirable in primary and secondary prevention of coronary heart diseases.