bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical characteristics and results of surgical treatment of petroclival meningioma
Authors: Tasic Goran , Jovanovic Vladimir , Radulovic Danilo , Djurovic Branko , Piscevic Ivan , Nikolic Igor , Janicijevic Milos
Published: July 2008

Introduction: The size of meningioma and its relation with neurovascular structures in petroclival region stipulate the degree of surgical radicalism and determine an operation risk. In spite of progress of surgical technology, the rate of surgical morbidity in view of cranial nerves deficit is 30%-50%. Objective: The objective of our study was to present the results of treatment of patients with petroclival meningiomas and to point to correlation of preoperative radiological findings and intraoperative results as well as neurological status of patients before and after surgical treatment. Method: Retrospective analysis of 35 operated petroclival meningiomas at the Institute of Neurosurgery, CCS, in the period from 1995 to 2004 was presented. The following parameters were analyzed: size of tumor, relation with bone and neurovascular structures, preoperative condition, degree of surgical radicalism and postoperative outcome. Results: The size of tumor was classified in four groups. There were 20 tumors at the right, and 15 at the left side. At the time of diagnostic procedures (based on CT and MRI), 20 tumors were in contact with brainstem, 9 compressed the brainstem, and 6 obstructed the IV ventricle. Preoperative patient condition was evaluated by Karnofsky index. Mean value for group I was 90, II - 80, III - 70 and IV - 50. In 9 cases, liquor drainage was performed preoperatively. In 3 cases, external liquor drainage was carried out postoperatively, and in one case it was replaced by permanent liquor drainage. Radical operation was performed in 44%, and significant reduction was done in other cases. In the postoperative period, 11% patients died, 28% had cranial nerves deficit, and pyramid deficit was recorded in 14% of the patients. The tumor size (III-IV) and brainstem compression were found to be statistically significant (p<0.05) as predisposed factors of deficit prolongation. Conclusion: Petroclival meningoma surgery is reljuired upon precise preoperative analysis. Radicalism of operation is reserved for small and medium tumors, younger patients, and patients in good preoperative condition.
Surgical treatment of eye injuries in five-year survey period
Authors: Vukosavljevic Miroslav
Published: July 2008

Introduction: Eye injuries represent one of the biggest problems in eye surgery all around the world, including our country. Treatment of eye injuries demands highly skilled personnel and adequate technical equipment. Objective: To show a total number of eye injuries, including the surgical methods used for their treatment. Methods: In our study, retrospective analysis of all performed surgical methods used in treatment of hospitalized patients in our Clinic during 2000-2004 was carried out. A special attention was paid to pars plana vitrectomy, together with combined anterior-posterior segment procedures. Results: During 2000-2004, a total of 347 pars plana vitrectomy, and 27 traumatic retinal detachments (conventional methods) were performed. In addition, 314 patients with contusion trauma of the eyes were treated. Out of 297 patients with penetrant eye injuries, 196 (66%) had intraocular foreign bodies (IOFB), and 101 (34%) were without IOFB. A total number of endophthalmitis was 34 (8.73%). The number of combined anterior-posterior segment operations during this period was 227. Conclusion: Vitreoretinal operations are the most prevailing in treatment of serious eye injuries. Pars plana vitrectomy is also the most common method of surgical treatment of eye injuries.
Significance of fine-needle aspiration biopsy of peripheral lymph nodes upon the initial presentation of patients with lymphadenopathy of unknown etiology
Authors: Mihaljevic Biljana , Nedeljkov-Jancic Ruzica , Cemerikic-Martinovic Vesna
Published: July 2008

Fine-needle aspiration biopsy is safe, simple, cost-effective and efficient technique providing rapid information and, therefore, directing further approach to a patient. Its findings are especially beneficial for verification of lymphoid origin of the enlarged growth, diagnostics and differentiation of metastatic, infectious, reactive and lymphomatous conditions; determination of the extent of tumor; detection of recurrence; monitoring of the course of disease; obtaining of material for special studies such as microbiological cultures, immunological or genetic studies as well as electron microscopy; in addition, for encouragement of patient in case of benign nature of the disease. At the Institute of Hematology, in three-year period, a total of 193 fine-needle aspiration biopsies were performed in 172 patients with the enlarged peripheral lymph nodes. Technically, aspiration biopsy was successful in 175/193 attempted interventions (91%). Punctates were analyzed by cytomorphology and subsequently compared with histopathological findings. In indistinguishable cases, additional immunocytochemical streptavidin-biotin peroxidase staining was carried out. In our studies, immunocytochemical analysis was performed in 63 out of 81 patients (78%), and diagnostic accuracy was 93.6% what was compatible with the results of other authors. It significantly corrected the earlier cytomorphological-histological congruence that used to be 83%. Immunocytochemistry has contributed to diagnostic value of cytological analysis of punctate, before all, in view of its higher diagnostic accuracy, which, according to majority of authors, is about 90%.
Acute appendicitis in the first three years of life
Authors: Marjanovic Zoran , Spasic Zivojin , Zivanovic Dragoljub , Kostic Ana , Djordjevic Ivona , Zdravkovic Dejan
Published: July 2008

Acute appendicitis is the most frequent disease in children population that requires an urgent surgical intervention. Only 2% of operated children belong to the group younger than 3 years. Yet, 77% are school children. Appendicitis in young children is characterized by: atypical clinical course, late diagnosis, high percentage of perforations, and high level of mortality and morbidity rates. The commonest symptoms are: vomiting, undefined abdominal pain, and high temperature. Abdominal distention and diffuse abdominal tenderness are the most frequent signs during examination. Our analysis (1991-2000) included all patients younger than 3 years who were hospitalized in Clinic for Pediatric Surgery Nis with diagnosis of the acute appendicitis. Out of 2533 patients with disease, 58 (2.3%) were younger than 3 years, 23 were girls (39.7%) and 35 were boys (60.3%). Perforated appendicitis was found in 55 (94.8%) of 58 children. Thirty five (60.5%) patients were previously treated. Complications developed in 36 (62.1%) cases: purulence (58.3%), dehiscence (22.3%), abdominal wall abscess (13.8%), and ileus (5.6%). Acute appendicitis is very specific condition that needs high attention by all doctors engaged in pediatric health care. Our recommendation is "to admit and observe" by using the physical examination in all suspected cases. Sometimes, even sedation may be used for better palpation results.
Reverse Trendelenburg’s position vs. supine-horizontal position for induction of general anesthesia in obese neurosurgical patients
Authors: Stosic Mila , Milakovic Branko , Dostanic Mladen , Baljozovic Branislava
Published: July 2008

Introduction: The induction of general endotracheal anesthesia (GETA) is associated with variable period of apnea. Obese patients have reduced oxygen supply during period of apnea. Hypoxemia and subsequent hypercarbia, during period of apnea, are strong stimuli of cerebral blood flow and intracranial pressure increase. Objective: The objective of our study was to determine the patient position with safe apnea period (SAP), which will minimize the risk of hypoxemia, as an optimal positioning for induction of GETA in obese neurosurgical patients. Method: Obese patients (BMI > 30kg m-2) were randomly placed to one of two positions for induction of GETA: group I (n=20) consisted of patients assuming 30 degree reverse Trendelenburg?s position; group II (n=20) was in supine-horizontal position. After the arterial oxygen saturation of 100% measured by pulse oximetry (SpO2), patients were allowed to remain apneic. The time required for SpO2 to decline from 100% to 94% was recorded as SAP. The lowest SpO2 after restoration of ventilation and recovery time to 98% SpO2 were also recorded. Results: Time needed for SpO2 to decline to 94% was: 196.9 ? 21.53 sec in group I, and 130.65 ? 25.73 sec in group II. There was significant difference between groups (I vs. II; p< 0.05). SpO2 of patients in the reverse Trendelenburg?s position dropped the least and took the shortest time to restore to 98%. The recovery time was much longer in group II, 132.65 ? 33.75 (I vs. II; p < 0.05). Conclusion: 30 degree reverse Trendelenburg?s position provides longer SAP when compared with horizontal-supine positions. This extra time may preclude adverse sequelae resulting from hypoxemia during induction of obese neurosurgical patients.
Expression of Fas and Fas-L in renal cell carcinoma
Authors: Govedarovic Vitomir , Radojevic-Skodric Sanja , Mitrovic Dragan , Müller Claudia , Müller Gerhard , Markovic-Lipkovski Jasmina
Published: July 2008

Introduction: The previous investigations revealed that Fas-L expression on tumor cells can be one of the reasons of tumor growth, or tumor regression, with or without activation of the immune response. Objective: The objective of our study was to investigate the expression of Fas and Fas-L in situ in normal human renal tissue as well as in different types of renal cell carcinoma (RCC) according to tumor grading. Method: Expression of Fas and Fas-L was examined in 25 RCCs classified according to nuclear grades: G1-G3 and to cell type: 17 clear cells, 3 chromophilics (2 eosinophilics, 1 basophilic), 2 chromophobes and 3 spindle cells. Ten normal human kidneys were analyzed, too. Indirect immunoperoxidase technique was applied. Spread and intensity of staining of Fas and Fas-L molecules expression were scored semiquantitatively. Results: Distribution of Fas expression in these RCC was typically diffuse. However, Fas-L was almost completely absent in clear cell RCC. In 3 clear cell RCC, some tumor stromal cells exhibited strong expression of Fas-L. On the contrary, chromophilic, chromophobe and spindle cell RCCs grading from G2- G3, manifested variable combinations of Fas and Fas-L expression. Conclusion: The most of clear cell type low grade RCCs manifested intensive and extensive expression of Fas and completely absence of Fas-L. However, RCCs of high grade malignancy belonging to the clear cell, eosinophilic, chromophobe or spindle cell types can have various combinations of Fas and Fas-L expression. It may probably lead to development of different mechanisms of avoidance of immune response to RCC.
Analysis of the effect of diabetes type 2 duration on beta cell secretory function and insulin resistance
Authors: Popovic Ljiljana , Zamaklar Miroslava , Lalic Katarina , Vasovic Olga
Published: July 2008

Diabetes type 2 is a chronic metabolic disorder. Pathogenesis of diabetes type 2 results from the impaired insulin secretion, impaired insulin action and increased endogenous glucose production. Diabetes evolves through several phases characterized by qualitative and quantitative changes of beta cell secretory function. The aim of our study was to analyze the impact of diabetes duration on beta cell secretory function and insulin resistance. The results indicated significant negative correlation of diabetes duration and fasting insulinemia, as well as beta cell secretory function assessed by HOMA ? index. Our study also found significant negative correlation of diabetes duration and insulin resistance assessed by HOMA IR index. Significant positive correlation was established between beta cell secretory capacity (fasting insulinemia and HOMA ?) and insulin resistance assessed by HOMA IR index, independently of diabetes duration. These results indicate that: beta cell secretory capacity, assessed by HOMA ? index, significantly decreases with diabetes duration. In parallel with decrease of fasting insulinemia, reduction of insulin resistance assessed by HOMA IR index was found as well.
Total ozone column above the territory of Serbia and Montenegro
Authors: Letic Milorad
Published: July 2008

Introduction: Atmospheric ozone attenuates ultraviolet radiation reaching the Earth?s surface. Since UV-B radiation is considered the principal factor of causing the skin cancers, cataracts and some immunological disorders, determination of total ozone column has become everyday practice. In Serbia and Montenegro, such determinations are not being done. Satellite data for the entire globe are accessible. Objective: The objective of our work was to collect and analyze data for the territory of Serbia and Montenegro, because ozone is an important parameter for the study of effects and protection from UV radiation. METHODS Data collected during TOMS (Total Ozone Measuring Spectrometer) experiment are presented for grid whose elements are 1? latitude by 1.25? longitude. Grid elements in which the territory of Serbia and Montenegro comprises more than 50% of the element area were taken to represent the territory of Serbia and Montenegro. Eleven grid elements were selected and average monthly values for 272 months in the period from 1978 until 2004 were collected. Data for the period between 1993 and 1996 were unavailable. Results: Mean values of total ozone column and mean monthly values of eleven grid elements differed very little. Differences were smaller than magnitudes of random error. Average annual values of total ozone column above the territory of Serbia and Montenegro were in the range from 316 Dobson units (DU) in 2002 to 347 DU in 1981. Annual cyclic changes of total ozone column showed spring maxima and autumn minima. Maximal recorded monthly value was 421 DU in March 1987 and minimal monthly value was 271 DU in October 2001. There was a trend of decreasing total ozone column values in the period between 1979 and 1992 at the rate of approximately 4.5% per decade. Conclusion: Mean total ozone column value above the territory of Serbia and Montenegro can represent total ozone column for the whole territory. Annual cycles with spring maxima and autumn minima are in accordance with oscillations observed for middle northern latitudes. The trend showing 4.5% decrease per decade in the period between 1979 and 1992 corresponds well to trends calculated for comparable locations.
Executive functions in young patients with unipolar depression
Authors: Totic-Poznanovic Sanja , Marinkovic Dragan , Pavlovic Dragan , Tomic Gordana , Paunovic Vladimir
Published: July 2008

Neuropsychological deficits associated with unipolar depression are seen in a broad range of cognitive domains. Executive deficits may be prominent in depression. Investigation of executive functions in younger adult patients with unipolar depression has been the focus of our study. Twenty-two consecutively depressive inpatients (24-36 years) and 21 healthy control subjects, matched on age, gender, education and verbal IQ were included in the study. Neuropsychological tests for executive functions were applied to all subjects. Unipolar young depressives showed significantly reduced number of completed categories and more trials for completion of the first category on Wisconsin Card Sorting Test (WCST). No difference of tasks assessing the short-term memory, total errors on WCST, perseverative and non-perseverative errors, and of both phonemic and semantic conditions of verbal fluency was found between groups. The results suggested that unipolar depressives had specific cognitive style characterized by "negative cognitive set" (stronger negative reaction to negative feedback) and by failure to use negative feedback to improve their performance.
Most severe consequences of eye contusion injuries: Surgical treatment
Authors: Vukosavljevic Miroslav
Published: July 2008

Introduction. One third of all eye injuries are contusion injuries. The most common causes of contusion eye injuries are squash ball, fist fights, sports, and work with blunt objects. Objective. The objective of our study was to analyze the surgical treatment methods and materials for managing the most severe consequences of eye contusion injuries. Method. A large number of complications of contusion eye injuries were treated at Department for Vitreoretinal Surgery of the Eye Clinic, Military Medical Academy, Belgrade. This paper analyzed two periods, from 1991-1999, and 2000-2004. During these periods, 461 patients with contusion eye injuries were surgically treated. Pars plana vitrectomy and phacoemulsification with PCL implantation were the most commonly performed operations. Results. During the analyzed period, a total of 334 pars plana vitrectomies, 253 combined operations (PHACO+ VPP) and 214 operations with PCL implantation (PHACO+VPP+PCL) were performed. Scleral fixation was carried out in 14 patients. After pars plana vitrectomy, some form of extended tamponade of vitreal space, in relation to degree of injury and complications, was performed in 194 cases. CONCLUSION Eye traumatism is still one of the leading causes of vision loss (from the earliest ages) in our region. Preventive measures that could lead to decrease of eye injuries should be fully supported, not only through expert meetings and publications, but via media as well.
Splanchnic artery aneurysms
Authors: Davidovic Lazar , Markovic Miroslav , Bjelovic Milos , Cvetkovic Slobodan
Published: July 2008

Introduction. Splanchnic artery aneurysms are uncommon but important vascular entity because nearly 25% of all cases present as surgical emergency. Objective. The purpose of our study was to present nine patients operated on at the Institute of cardiovascular diseases, as well as literature review of clinical presentation of the disease. Method. There were three splenic artery aneurysms, two celiac trunk aneurysms, and one aneurysm of the hepatic, superior mesenteric, inferior mesenteric and gastroduodenal artery. All patients were males, mean aged 67.5 years (60-73). In four patients, splanchnic artery aneurysm was discovered accidentally during routine ultrasonographic and angiographic examinations of the abdominal aorta. At that time, arteriovenous fistula was diagnosed in a patient No 1; it was formed after rupture of the splenic artery aneurysm into the splenic vein. Three aneurysms were manifested by abdominal pain and palpable pulsating abdominal mass. Two patients were admitted as urgent cases in the state of hemorrhagic shock and signs of intraabdominal bleeding due to rupture of the splenic and hepatic arteries. In 7 cases, diagnosis was made preoperatively by means of ultrasonography and angiography; in two patients, accurate diagnosis was confirmed during surgery. Results. Proximal and distal ligation of the artery was performed in a patient with rupture of the splenic aneurysm into the splenic vein that caused arteriovenous fistula. Gastroduodenal artery aneurysm was treated by trans-aneurysmatic ligation of its "entering" and "exiting" branches. Aneurysms of distal part of the superior mesenteric and splenic artery were resected without further reconstruction. Partial resection of the aneurysm and endoaneurysmorrhaphy was carried out in one case of celiac trunk aneurysm, and in another, after aneurysm resection, the restoration of blood flow through the hepatic and lienal artery was achieved by Dacron grafts. In a patient with the inferior mesenteric artery aneurysm, the resection of aneurysm was followed by reimplantation of medial part of the artery into bifurcated Dacron graft which replaced abdominal aorta. In 5 patients, some of additional surgical procedures were performed. There were 4 reconstructive procedures of abdominal aorta and one splenectomy. The patient with ruptured hepatic artery aneurysm died during surgery due to uncontrolled hemorrhage. In other patients, there was neither morbidity nor mortality in the early postoperative period (first 30 days after surgery). Mean follow up was 1 to 5 years (mean 3.4 years). One patient died after 5 years due to myocardial infarction. CONCLUSION Although the introduction of precise diagnostic procedures (computerized tomography, magnetic resonance imaging, spiral scan) make diagnosis easier, the splanchnic artery aneurysms are still difficult to detect due to their uncommon clinical presentations.
Ewing sarcoma: Analysis of epidemiological parameters and their relation to clinical characteristics
Authors: Stevanovic Vladan , Vukasinovic Zoran , Spasovski Dusko
Published: July 2008

The purpose of this investigation was to evaluate epidemiologic features of Ewing sarcoma in children treated in the Institute for Orthopedic Surgery "Banjica", as well as to establish relation of these features to clinical findings. Study involved 78 patients treated over 20-year period (1980-2000). Analysis included standard epidemiologic data (age, sex, tumor localization) and diagnostic clinical features on presentation (major symptoms, time elapsed between presentation and diagnosis, presence of metastases). Most of the patients were in the age group of 15-18 years (50.0%), predominantly males. In general, the results of our study were consistent with data reported in literature. Nevertheless, this investigation revealed slightly higher incidence in patients younger than four years of age (5.1%); localization on the upper extremity was found to be more frequent (upper to lower extremity ratio was nearly 3:1 in our study), and the time lost between presentation and diagnosis was markedly reduced (average time elapsed between presentation and diagnosis was 2.5 months). The results of our study may improve efficiency and success of treatment, thus providing the basis of better prognosis in management of such a serious illness.
Review of the extratransference intervention practice in the psychoanalytic psychotherapy
Authors: Jojic Boris
Published: July 2008

The transference analysis takes the central position of the work in psychoanalytic psychotherapy. The work in extratransference sphere and experience in practical work with extratransference interventions are not often reported in expert literature. Extratransference sphere includes less transferring relation to the psychotherapist, transference on the other objects, or may refer to the external reality rather than the psychic reality or fantasy. In our illustration, we gave emphasis to extratransference interventions. Application of genetic interpretation and reconstruction were demonstrated as well, which can restore and establish connections between past and present, in order to understand influences of the past and current reality, and helping us to resolve infantile conflicts. Interpretation of extratransference situations is an important part of the analytical work and it is the essential category of interpretation. Analytic understanding should include transference and extratransference spheres, fantasy and reality, past and present. Working with neurotic patterns and character resistance needs an optimal choice of intervention in a given moment of analytic process. Extratransference interventions are the essential category of intervention, irreplaceable for their effectiveness in analytic process.
Management of penetrating ocular injuries and endophthalmitis in thirteen-year follow-up period
Authors: Vukosavljevic Miroslav
Published: July 2008

Introduction: Ocular trauma is one of the most common causes of unilateral morbidity and blindness in the world today. Objective: Frequency of penetrating ocular injuries and endophthalmitis after injuries caused by explosive weapons during the war in former Yugoslavia in the period 1991-1999 as well as eye injuries in the period 2000-2004 was examined. Method: During 1991-1999, 647 patients with eye injuries were hospitalized at Eye Clinic, MMA, out of whom 500 cases with penetrating eye injuries. In 2000-2004 period, 601 patients with eye injuries were treated, out of whom 297 had penetrating eye injuries (including patients from Montenegro and Republica Srpska). All patients underwent thorough ophthalmological examination, antibiotic treatment and VPP or other required surgical interventions. Results: All 500 patients from the first period had severe penetrating eye injuries. Intrabulbar foreign bodies (IFB) were detected in 286 cases, while 214 cases with penetrating eye injuries had no intrabulbar foreign bodies. Almost all patients had multiple head and body injuries as well. Endophthalmitis was observed in 29 eyes (5.2%) upon admission to hospital. In the second observed period (2000-2004), 196 (66%) out of 297 penetrating eye injuries had IOFB, and 101 (34%) was without IOFB. Endophthalmitis was observed in 34 eyes (8.4%). Conclusion: War eye injuries are a special group of injuries. Relatively low percent of posttraumatic endophthalmitis is definitely worth attention, especially in comparison with peacetime eye penetrating injuries.
Estrogen and ischemic heart disease in females
Authors: Stevic-Gajic Vesna , Borzanovic Milorad , Obrenovic Radmila , Nikolic Jelenka , Lepopojic Olgica , Djindjic Ljubica
Published: July 2008

Introduction: Although ischemic heart disease (IHD) develops in both genders under the influence of the same risk factors, it is much less frequent among female population, which is mostly assigned to favorable effects of estrogen. Objective: Since latest investigations have pointed to higher incidence of disease in female population, the objective of our study was to examine the relation between estrogen and other clinical and biochemical parameters significant for its manifestation. Method: The relation between estrogen levels and frequency of obesity, diabetes, hypertension as well as the levels of total, HDL, LDL i VLDL cholesterol, triglycerides, Lp(a), apoprotein A i B i PAI-1 was analyzed in 50 (25 pre- and postmenopausal) patients, treated due to IHD in the Health Center, Krusevac, in 2002 year. Results: Low concentration of estrogen was found in 22 (44%) patients. In addition, frequency of diabetes, obesity and risky levels of high atherogenic lipid fractions (total and LDL cholesterol, Lp(a), apoprotein B) was insignificantly higher, whereas the concentrations of PAI 1, triglycerides and HDL cholesterol were lower, with significant correlation between estrogen level and PAI-1 (T=0.32, p<0.05). Conclusion: Despite all past investigations, numerous questions related to high incidence of IHD among premenopausal women, have remained open - whether it occurs as a consequence of reduced estrogen synthesis, lower expression of estrogen receptors, their modified function or maybe concomitant influence of other risk factors, not necessarily connected with sex, that eliminate protective effects of this hormone.
Prevalence of asthma in college student population
Authors: Stojanovic-Ristic Snezana , Mitic-Milikic Marija , Ilic Dragan , Vukcevic Miodrag
Published: July 2008

Introduction: Bronchial asthma is common chronic disease among young people and prevalence of this condition has been constantly growing over past two decades throughout the world. Objective: To establish the prevalence of asthma in student population of Belgrade University and to determine the frequency distribution in regard to their permanent residence. Method: Data obtained from annual physical examinations of 118 342 students (age 19-23 years) treated at the Student?s Health Care Institute between 1996-2001 were analyzed. Affirmative answer to the question: "Are you currently treated", or "Have you ever been treated for asthma" indicated diagnosis of asthma. Data on student?s age, gender, permanent residence, and smoking habits were collected. Results: The prevalence of asthma was 3680/100.000 and mildly growing trend was noted over the last several years (from 2.96% to 4.05%) (F=42.427; df=4; p<0.01). Asthma was more prevalent in females (57%) than among males (43%) (?2=91.189; df=1; p<0.01). Several regions with increased asthma incidence were identified and the causes of such findings still need to be clarified. Cigarette smoking was common in students (?2=236.781; df=1; p<0.01), but also among asthmatics [one out of three students was a smoker (?2=8.141; df=1; p<0.01)]. Conclusion: The prevalence of asthma in student population is 3.68% with mildly growing trend over the last years. The disease is more prevalent in females. Cigarette smoking is common in students as well as among asthmatics. To our knowledge, this is the first study on prevalence of asthma in young adult population in our country.
Aberrations of chromosome 8 in myelodysplastic syndromes: Clinical and biological significance
Authors: Marisavljevic Dragomir , Pantic-Ludoski Milena , Novak Angelina , Djordjevic Vesna
Published: July 2008

Introduction: Rearrangements of any single chromosome in human karyotype have been reported in patients with pMDS. Objective: To examine the role of aberrations of chromosome 8 in pathogenesis, clinical presentation and progression of myelodysplastic syndromes. Method: Cytogenetic analysis of bone marrow cells was carried out by direct method and by means of 24- and/or 48-hour unstimulated cell culture. Chromosomes were obtained by modified method of HG-bands. Results: On presentation, 109 out of 271 successfully karyotyped patients (40,2%) had abnormal karyotypes. Among them, 22 patients (10.9%) had aberrations of chromosome 8. Ten patients had trisomy 8 as "simple" aberration whilst additional three cases had trisomy 8 included in "complex" karyotypes (?3 chromosomes). Cases with constitutional trisomy 8 mosaicism (CT8M) were excluded using the chromosome analyses of PHA-stimulated blood cultures. On the contrary, monosomy (seven patients) or deletion of chromosome 8 (two patients) were exclusively found in "complex" karyotypes. During prolonged cytogenetic follow-up, trisomy 8 was not recorded in evolving karyotypes. In contrast, trisomy 8 disappeared in two cases during subsequent cytogenetic studies, i.e. 23 and 72 months from diagnosis, accompanied in one patient with complete hematological remission. No difference regarding age, sex, cytopenia, blood and marrow blast count or response to treatment was found between patients with trisomy 8 as the sole aberration compared to those with normal cytogenetics. Median survival of patients with trisomy 8 as the sole aberration was 27 months, as compared to 32 months in patients with normal cytogenetics (p=0.468), whilst median survival of patients with aberrations of chromosome 8 included in "complex" karyotypes was only 4 months. Conclusion: Aberrations of chromosome 8 are common in patients with pMDS. The presence of a clone with trisomy 8 is not always the sign of disease progression or poor prognosis in MDS patients, in contrast to clones with aberrations of chromosome 8 manifesting the loss of genetic material.
Ewing’s sarcoma in children: Prognosis in relation to the method of treatment
Authors: Stevanovic Vladan , Vukasinovic Zoran , Spasovski Dusko
Published: July 2008

Ewing?s tumor of bone is the second primary malignant bone tumor. Localized lesion is found in nearly 80% of cases and metastatic lesions are present in 20% at the time of diagnosis. Treatment protocols were analyzed, prognostic parameters were evaluated, and overall survival as well as survival until relapse of disease was studied. Prognostic features included age and sex, localization of tumor, type of applied surgical resection and treatment protocol, and presence of necrosis after neoadjuvant therapy as well as morphological characteristics of the tumor. Wide surgical resection (?2=7.855; p<0.05), and tumor necrosis (?2=7.855; p<0.05) were verified to be significant parameters for the outcome. Multimodal chemotherapy with local radiation and/or surgical resection is the best mode of modern treatment. Follow-up included the period from the completion of therapy to final control, with remission period defined by development of recurrence or metastatic lesions. Localization on distal parts of the extremities and axial skeleton is good prognostic feature, while localization on proximal parts of the extremities and pelvic girdle, presence of metastatic disease and low index of postchemotherapeutic necrosis, are associated with poor outcome. In Ewing?s sarcoma, prognosis of good outcome is definitely very delicate process.
Solitary fibrous tumor of the visceral pleura of the right lung base
Authors: Radak Vladimir , Radovanovic Dragan , Grubor Nikica , Micev Marijan , Colovic Radoje
Published: July 2008

Solitary fibrous tumors are relatively frequent. They may occur throughout the body. About 20% of tumors develop in the thorax, out of which vast majority is localized on its wall. Within thorax, they usually originate from pleura, most frequently the visceral one. Authors present a 67- year old male in whom the tumor was diagnosed during the investigation for dyspnea. During operation, solitary, well circumscribed, firm, rubber-like tumour, 11x10x9 cm in diameter, covered with serosa, arising from the visceral pleura of the base of the right lung was easily excised. The classical histological and immunohistochemical examinations confirmed the diagnosis of benign fibrous tumor. Postoperative recovery was uneventful. Preoperative symptoms disappeared.
The relation between the thickness of retrobulbar part of the optic nerve, measured by ultrasound, and the degree of prominence of the optic disc in stasis of the optic nerve
Authors: Stefanovic Ivan , Stanojevic-Paovic Anka , Antunovic Vaso
Published: July 2008

Introduction: The etiology of the noninflamed edema of the optic disc, or the stasis of the same, is related to a large number of various illnesses which result in the increased intracranial pressure. When examining fundus, an edema of the optic disc is found which can be quantitatively expressed in diopters, while retrobulbar part of the optic nerve can be measured by ultrasonography. Objective: The Objective of our investigation is to explore the relation of the optic disc prominence and the degree of thickness of retrobulbar part of the optic nerve. Method: Study included 21 patients with the increased intracranial pressure, treated at the Institute of Neurosurgery, Clinical Center of Serbia, that is, 41 eyes that manifested stasis of the optic nerve. Echographically, by means of Schraeder?s Method, the thickness of retrobulbar part of the optic nerve was measured and the degree of the optic disc prominence was clinically determined in diopters. Results: The thickened optic nerve was confirmed in all patients. Using Pearson?s correlation, the relation between the degree of the optic nerve thickness and the prominence of the same was analyzed, and it was found that there was no significant correlation between these two parameters. Conclusion: Instead of Conclusion, we shall ask a question: How relevant is dogma that the prominence of the optic disc more than 3D should be considered the optic disc stasis? The authors think that rating of the optic disc prominence in diopters is not justified.
Residual renal function and blood count in patients on continuous ambulatory peritoneal dialysis
Authors: Jovanovic Natasa , Lausevic Mirjana , Stojimirovic Biljana
Published: July 2008

Introduction:Most of patients with chronic renal failure are affected by normochromic, normocytic anemia caused by different etiological factors. Anemia causes a series of symptoms in chronic renal failure, which can hardly be recognized from the uremic signs. Anemia adds to morbidity and mortality rates in patients affected by advanced chronic renal failure. Blood count partially improves during the first months after starting the chronic renal replacement therapy, in correlation with the quality of depuration program, with extension of erythrocyte lifetime and with hemoconcentration due to reduction of plasma volume. Recent trials found that higher residual renal function (RRF) significantly reduced co-morbidity, the rate and duration of hospitalization and risk of treatment failure. Objective: The aim of the study was to follow blood count parameters in 32 patients on chronic continuous ambulatory peritoneal dialysis (CAPD) during the first six months of treatment, to evaluate the influence of demographic and clinical factors on blood count and RRF, and to examine the correlation between RRF and blood count parameters. Method: A total of 32 patients affected by end-stage renal disease of different major cause during the first six months of CADP treatment were studied. RRF and blood count were evaluated as well as their relationship during the follow-up. Results: Blood count significantly improved in our patients during the first six months of CAPD treatment even if Hb and HTC failed to reach normal values. Iron serum level slightly decreased because of more abundant erythropoiesis and iron utilization during the first six months of treatment. RRF slightly decreased. After six months of CAPD treatment, the patients with higher RRF had significantly higher Hb, HTC and erythrocyte number and a lot of positive correlations between RRF and anemia markers were observed. Conclusion: After 6-month follow-up period, the patients with higher RRF had significantly higher blood count parameters, and several positive correlations between RRF and blood count markers were confirmed.
Role of hydrosonography in prevention and screening of premalignant and malignant endometrial disease
Authors: Zamurovic Milena , Srbinovic Pavle , Petrovic Jovana
Published: July 2008

Introduction: The study emphasizes the significance of hydrosonography in prevention and early diagnostics of endometrial pathology. Objective: To express the significance of hydrosonography in relation to timely detection and treatment of premalignant and malignant endometrial disease. Method: Our study included 104 patients referred to transvaginal sonography, after which hydrosonography was recommended in order to obtain precise visualization of the endometrium because of suspected endometrial pathology. After hydrosonography, dilatation and curettage with endometrial biopsy were performed in all patients. Biopsy specimens were histologically analyzed. Results: The application of contrast sonography described in our research helped diagnose and timely treat as many as 30.8% of patients suffering from premalignant and malignant endometrial disease (23.2% of premalignant and 7.6% of malignant). Discomforts (bleeding and pelvic pain) occurred in 72.1% of patients, out of whom 43.3% had already undergone curettage once or more than once because of the same or similar symptoms, while 27.9% of cases presented for regular control, i.e. they were symptom free. The obtained Results clearly emphasized the significance of application of contrast sonohysterography as a Method for timely detection of endometrial pathology and its adequate treatment. Conclusion: The study shows that application of contrast sonohysterography before exploratory curettage significantly facilitates the use of invasive diagnostics and improves accuracy and validity of the obtained Results, especially in cases of endometrial focal changes; consequently, it is also possible to achieve positive cost - benefit effect.
The results of surgical and nonsurgical treatment of mallet finger
Authors: Starcevic Branislav , Bumbasirevic Marko , Lesic Aleksandar , Radonjic Vidosava , Miric Dragan
Published: July 2008

Introduction: The injury of the hand tendon classified as mallet finger presents the loss of continuity of the united lateral band of the extensor apparatus above distal interphalangeal joint, which consequently leads to specific deformity of distal interphalangeal joint which is called mallet (hammer) finger. Objective Our paper had several research Objectives: presentation of the existing Results of surgical and nonsurgical treatment of mallet finger deformities and comparison of our findings and other authors? Results. Method: The study was retro-prospective, and analyzed 62 patients treated in the Clinical Center of Serbia in Belgrade (at the Institute of Orthopedic Surgery and Traumatology, and the Emergency Center) in the period 1998 to 2003. The follow up of these patients lasted at least 8 months (from 8.3 months to 71.7 months). An average follow up was 28.7 months. The Objective parameters used in the study were as follows: sex, age, dominating hand, hand injury, finger injury, mode of treatment, complications, distal interphalangeal joint flexion and total movement of the distal interphalangeal joint. Collected data were analyzed by ?2-test and Student?s t-test. The confidence interval was p=0.05. Results: A total range of motion was 51.9?6.6 for nonsurgically treated patients, and 48.2?4.2 degrees for operated patients. Mean extension deficit of the distal interphalangeal joint was 6.5?3.3 for nonsurgical and 10.0?3.2 for operated patients. Conclusion: The Results confirmed that nonsurgical mode of treatment of mallet finger deformity was much more successful than surgical Method of treating the same deformity.
Diagnosis and treatment of chondroblastoma: Our experience
Authors: Slavkovic Slobodan , Vukasinovic Zoran , Slavkovic Nemanja , Spasovski Dusko
Published: July 2008

The paper presented the results of diagnostics and treatment of patients with diagnosis of chondroblastoma, treated at the Institute of Orthopedic Surgery "Banjica", Belgrade. A total of 30 patients were analyzed, involving the period from 1975-2004. All important data were obtained using the complete medical documentation, physical examination, radiographic findings and available additional diagnostic procedures. The proximal part of tibia, the proximal part of humerus and the distal part of femur were the most common sites of tumor, accounting for 63% of cases. Higher incidence of chondroblastoma was found in male patients, especially in the second decade of life. Pathohistological tumor verification was done in all patients. The patients were then treated by different surgical procedures, both on account of primary lesion and recurrence. Curettage and osteoplasty using the auto- and homograft were carried out in 21 patients, wide resection in nine cases, and amputation was performed in three cases. One patient had radiotherapy due to recurrence of lesion, nevertheless malignant transformation of chondroblastoma occurred in time. Seven patients manifested local recurrence, and one of them even had relapse on two occasions and malignant transformation of chondroblastoma. Malignant lesions were found in three cases (10% of patients); one lesion was diagnosed as primary while other two malignancies were detected only after recurrence, and the treatment was completed by lower leg amputation.
Evaluation of the intensive rehabilitation protocol after arthroscopically assisted anterior cruciate ligament reconstruction
Authors: Dubljanin-Raspopovic Emilija , Kadija Marko , Matanovic Dragana
Published: July 2008

Introduction: Optimal treatment of ACL (anterior cruciate injury) injuries is one of the most dynamic topics of contemporary orthopedics. Despite huge amount of publications on this subject, golden rehabilitation standard has not been established yet. Objective: The aim of our study was to compare two different rehabilitation groups in respect to dynamics and safety of recovery, and accordingly to recommend contemporary rehabilitation approach. Method: A prospective study included 45 patients with unilateral ACL rupture who were randomized into conservative (THC) and intensive rehabilitation (TH-I) group. The arthroscopic reconstruction of ACL was performed using the BTBP or STG graft. After the operation, in the TH-C group, ROM was limited to 0-0-90? and weight bearing was not allowed in the first 4 postoperative weeks. In the TH-I group, progression depended only on the knee edema and pain. The groups were compared in relation to demographic, anamnestic, and clinical characteristics (knee circumference, thigh circumference, stability tests, Lysholm, Tegner and one-leg hop test, and single stance test). Data were recorded preoperatively and postoperatively after 6 weeks, 4, 6, 9 and 12 months, and compared with parametric and non-parametric statistical tests. Results: The investigated groups clearly differed already after 6 weeks by range of motion (p<0.05), thigh circumference (p<0.01) and Lysholm test score (p<0.01), after 4 months in relation to one leg hop test (p<0.05), and after 6 months according to Tegner test (p<0.01). In the TH-I group, graft integrity was not compromised in any of these patients, nor did postoperative arthrofibrosis develop. Conclusion: Our investigation has undoubtedly revealed that early intensive rehabilitation approach leads to faster functional recovery without complications compared to conventional rehabilitation treatment.
Undiagnosed tuberculosis as clinical, epidemiological and medicolegal problem: Report of two cases
Authors: Savic Slobodan , Savic Branislava , Skodric Vesna
Published: July 2008

The authors present two cases of undiagnosed tuberculosis in order to point out clinical, epidemiological and medicolegal importance of such cases. The first patient was a 29- year old woman, who died after 10-day hospital treatment, but true nature of her disease remained undiscovered. Due to her known marital problems, as well as numerous bruises developed as a consequence of hemorrhagic syndrome, violent death caused by injuries inflicted by her husband was suspected. Medicolegal autopsy and microscopic examination revealed fatal tuberculosis of the lungs, and small and large intestines. In another case, a 35-year old male died suddenly and unexpectedly, being found dead in his flat where numerous blood traces were noticed during the scene investigation. Therefore, possible homicide was suspected. Medicolegal investigation proved pulmonary tuberculosis as a cause of natural death. Presented cases point out the fact that even nowadays both pulmonary and extrapulmonary tuberculosis may remain clinically undiscovered, even when this disease is a cause of death. Hence, physicians should always keep in mind possible tuberculosis, especially in patients with long-lasting typical symptoms and signs. In both reported cases, the individuals suffered from cavernous pulmonary tuberculosis being thus a permanent source of infection. From medicolegal point of view, described cases represent examples of so called suspicious natural death. On the other hand, the fact that fatal tuberculosis remained clinically undiagnosed may make physicians be accused of medical negligence and malpractice.