bluuebunny/crossref_metadata_2025 huggingface dataset:
Correction of congenital ptosis of the eyelid by frontal muscle transposition
Authors: Jevtovic Dobrica
Published: December 2010

Congenital ptosis (CP) represents a significant reconstructive problem Numerous studies have not yet provided full and satisfactory results. In this study, we have presented our experience in the surgical treatment of 108 patients by the use of Son Ye Guang's modified method - frontal muscle transposition. A total of 108 patients with CP were surgically treated at the Clinic for Plastic Surgery and Burns of the Military Medical Academy in the period 1991-2000. Unilateral ptosis was operated in 85 patients, and bilateral in 23 patients. CP was more frequently found in males (58.34%) than in females (41.66%). The youngest patient was only 5.5 years old, and the oldest was 42, the average age was 21.3 years. All patients were operated on by the same surgeon, and were monitored monthly during the first six months and then twice a year for the next 3 years. Postoperative results were evaluated after 6 months: the action of raising the eyelids was compared to the full amplitude of movement of the eye on the healthy side. The closure of the eyelids and the symmetry of the palpebral fissure in a steady horizontal view was also assessed. The action of the opening as well as closure of the eyelids in full amplitude was obtained in all operated patients. Asymmetry of the palpebral fissure in a steady horizontal view up to 1 mm did not require additional correction. In 9 cases, asymmetry of the palpebral fissure greater than 1 mm was subsequently corrected. The advantages of this surgical method compared to the other, previously described techniques, were emphasized in the conclusion. The main advantage was the elimination of postoperative lagophthalmos, which represented the problem in all previously used methods.
Could the use of computed tomography and transesophageal echosonography decrease the number of explorative thoracotomy in the lung carcinoma?
Authors: Rankovic Bosko
Published: December 2010

A group of 49 patients (41 males, 8 females) with locally confined non small cell lung carcinoma, of the average age 58.48 ? 9.05 years, was retrospectively analyzed. Bronchoscopy, computed tomography of the thorax and transesophageal echosonography were performed in all the patients to evaluate preoperatively the loco regional dissemination of the disease as well as the tumor resectability. The aim was to establish whether the complementary use of computed tomography and transesophageal echosonography could decrease the number of explorative thoracotomies. Resectability evaluation by computed tomography, burdened by many falsely negative results, could lead to 15 (30.61%) explorative thoracotomies. When transesophageal echosonography was performed, only 3 (6.12%) falsely negative results were obtained. Resectability evaluation by complementary use of computed tomography and transesophageal echosonography would be the best, with only 1 (2.04%) explorative thoracotomies necessary. By such procedure, it was possible to set the optimal indications for surgical treatment with the minimal number of explorative thoracotomies.
War injuries of the blood vessels of the extremities
Authors: Radulovic Svetozar , Despot Branko , Papic Vladimir , Pusac Branislava , Trkulja Nebojsa
Published: December 2010

Treatment results of 200 injured with the lesions of 282 magisterial blood vessels were analyzed. All were combat injuries, and the majority was caused by the fragments of explosive device. The mechanism of such the injuries produced large defects of soft tissues as well as the high level of the wound contamination, which aggravated reconstructive procedures and increased the risk of infection. In the majority of cases anatomic reconstruction of the artery was performed, and the ligature was used only in the case of graft infection and in the injuries of one artery of the lower leg or the forearm. The majority of injuries was solved by lateral suture or patch plastic, since postoperative constriction caused by those methods did not cause greater hemodynamic disorders due to the size of venous lumen. The duration of ischemic interval was of the utmost importance for the favorable final result of the treatment, as well as the adequate debridement of the wound, good soft-tissue cover of the reconstructed blood vessel and precise a traumatic technique. Total percentage of amputations was 14.5%, and all were involving the lower extremities, and were mostly caused by popliteal artery lesion.
Necrotizing fasciitis caused by group A streptococcus
Authors: Mikic Dragan , Bojic Ivanko , Djokic Milomir , Stanic Vojkan , Stepic Vladislav , Micevic Dusko , Rudnjanin Slobodan , Radosavljevic Aleksandar , Micic Jovanka , Tomanovic Branka , Begovic Vesna , Popovic Svetlana
Published: December 2010

The first case of the confirmed necrotizing fasciitis caused by Group A Streptococcus in Yugoslavia was presented. Male patient, aged 28, in good health, suddenly developed symptoms and signs of severe infective syndrome and intensive pain in the axillary region. Parenteral antibiotic, substitution and supportive therapy was conducted along with the radical surgical excision of the necrotizing tissue. The patient did not develop streptococcal toxic shock syndrome thanks to the early established diagnosis and timely applied aggressive treatment. He was released from the hospital as completely cured two months after the admission.
Churg-Strauss syndrome
Authors: Ilic Tatjana , Popovic-Kuzmanovic Dragana , Milicic Anka , Paranos Svetlana
Published: December 2010

Churg-Strauss syndrome (CSS) is medium blood vessels vasculitis with predilection for lungs in patients with bronchial asthma, chronic eosinophilic pneumonia and positive ANCA in the sera in 55-67%. This is a case report of a 60 years old female patient with bronchial asthma, peripheral pulmonary infiltrations, blood eosinophilia, xerophtalmia, tachycardia, chronic rhino sinusitis, polyneuropathia and negative immunological tests: CIC (PEG), CRYO, ANA (IIF), RF (agglutination) and ANCA (IIF: pANCA and cANCA; ELISA: proteinase 3, lactoferrin, myeloperoxidase, elastase, cathepsin G). Eosinophilic infiltrates in the tissues tested by skin and salivary gland biopsies were not found. The patient had fulfilled five clinical diagnostic criteria and responded well to immunosuppressive therapy, so this case could be classified as the ANCA negative angiitis and granulomatous of CSS type.
Endovascular procedures in the treatment of obstructive lesions of brachiocephalic arteries
Authors: Sagic Dragan , Radak Djordje , Peric Miodrag , Ilijevski Nenad , Sajic Zoran , Petrovic Branko , Miric Milutin
Published: December 2010

Background. To assess the early effects, possible risks, and long term results of percutaneous transluminal angioplasty (PTA) of brachiocephalic trunk (BT) and subclavian arteries (SA). Methods. During the period of 11 years, in 92 patients (57 males - 62%, mean age 53,5 ? 7,8 years) 93 PTA of SA/BT were performed; 70 (75%) lesions were stenosis, while 23 (25%) lesions were occlusions with mean diameter stenosis percent of 83,1 ? 6,2%. Clinical indications were: vertebrobasilar insufficiency (n=57), upper limb ischemia (n=40), coronary steal syndrome (n=4) and scheduled aorto-coronary bypass, using internal thoracic artery (ITA) (n=4 asymptomatic patients). Mean lesion length was 22 ? 8 mm. Results. Eighty one (87%) out of 93 lesions were successfully dilated; all of 12 (13%) failures were due to unsuccessful recanalisation of occluded arteries. In 10 patients 10 stents were implanted (2 in BT and 8 in left SA). There were 6 (6.5%) procedural complications: 1 dissection, 1 thrombosis of the left SA, transient ischemic attack in 2 patients, and 2 cases of dislocation of atheromatous plaque from the right SA into the right common carotid artery. During the follow-up of 48 ? 3 months, 16 (20%) restenoses were treated by PTA (n=7) or operatively (n=9). Primary and secondary patency for all lesions treated during 11 years was 87% and 80%, respectively (stenosis: 97% and 89%; occlusions: 58% and 58%). Conclusion. PTA with or without stenting was relatively simple, efficient and safe procedure. It required short hospitalization with low treatment costs. If any of suboptimal results or chronic occlusions were present, the implantation of endovascular stents should have been considered.
Intrathecal synthesis of complement components C3c and C4 in the central nervous system infections with signs of the acute serous meningitis syndrome
Authors: Tatomirovic Zeljka , Bokun Radojka , Bokonjic Dubravko
Published: December 2010

Two hundred and ten patients with meningismus and the infections of the central nervous system (CNS) with the clinical symptoms and signs of the acute serous meningitis syndrome, were divided into groups according to etiology (enterovirus meningitis-ENTERO, serous meningitis various etiology-SM and tuberculosis meningitis-TBC). Intrathecal synthesis (ITS) of C3c and C4 complement components and IgG were determined by the method of cerebrospinal indexes (I), to examine their role in differential diagnosis of this syndrome. Correlative study between the CSF/serum ratio (Q) for albumin (Alb) and QC3c and QC4 in patients with no proven ITS of this two complement proteins, and the comparative study of the increased value of C3cI and C4I (and IgGI) between the examined groups of the patients was done. Highly significant correlations were found between QAlb and QC3c (r?=?0.89, p<0.001) and QC4 (r?=?0.85, p<0.001). In 22,4% of the examined patients ITS of C3c and C4 were found. There was no difference in frequency of ITS of the two complement proteins between the examined groups, nor inside any particular group. TBC group had significantly lower (p<0.05) intensity of ITS of C3c and C4 than MNG and ENTERO, and significantly higher intensity of ITS of IgG (p<0.05) than the other tested groups. CSF index was confirmed as a valid method to detect intrathecal C3c and C4 production. Determination of ITS C3c and C4 could not be of great help in differential diagnosis in the acute serous meningitis syndrome. The intensity of ITS of C3c and C4, related to the intensity of ITS of IgG, could be of help in the determination of the duration of the disease.
The reliability of serogroup determination in the detection of Escherichia coli as a causative agent of sporadic and epidemic occurrence of enterocolitis
Authors: Stojanovic Valentina , Cobeljic Miloje
Published: December 2010

The purpose of this study was to determine the presence of virulence factors (heat-labile, heat-stable enterotoxin, verotoxin, invasiveness, localized, aggregative and diffuse adherence) among E. coli strains isolated from sporadic cases and outbreaks of enterocolitis, which belonged to serogroups characteristic for enteropathogenic E. coli. Serogroup was determined in 57.2% of 622 strains isolated from sporadic cases, and among them virulence factors were detected in 23.6%. Serogroup was also determined in 73.3% of 90 outbreaks isolates tested and virulence factors were detected in 97% of them. The detection rate of virulence factors rarely exceeded 50% among strains belonging to any of serogroup that was determined. The obtained data suggested that the identification of E. coli as a causative agent of enterocolitis by serogroup determination was a reliable method in outbreaks, but not in sporadic cases of this disease.
Multiorgan tuberculosis
Authors: Djokic Milomir , Bojic Ivanko , Mikic Dragan , Mladenovic Ljubisa , Begovic Vesna , Kupresanin Srdjan , Mirovic Veljko , Dimitrijevic Jovan
Published: December 2010

Tuberculosis is an unusual infectious disease because of the latent period between the infection and the appearance of the disease may be prolonged for many weeks, months, or years as it is in case of the secondary tuberculosis. Tuberculosis in organs other than the lung has been observed for many years but has not always been recognized as tuberculosis, and it has been given many names. Extrapulmonary tuberculosis gained new importance, because it represented a progressively greater proportion of new cases. Multiple extrapulmonary sites were reported rarely except for one anatomical site, which was reported frequently. Extrapulmonary rates increase with age, so there are marked differences in age in specific rate patterns among the sites. Extrapulmonary tuberculosis occurred in respiratory organs other than lung, such as lymphatic, urogenital, and central nervous system, abdominal, osteoarticular, as well as tuberculosis of other organs such as skin, pericardium and endocrine glands. This case was reported to analyse clinical, morphologic and laboratory characteristics, method of diagnosis and the outcome in patients with multiorgan tuberculosis in order to explore the factors which might contribute to the decision making, concerning these forms of tuberculosis. Recent knowledge of pathogenesis was summarized as well as clinical presentation and the effects of cytokines produced by T lymphocytes and cellular population on antimycobacterial immune defences, and also susceptibility to tuberculosis. Mortality remains high and the treatment should start as soon as tuberculosis is suspected.
Diagnostic importance of zinc in the clarification of pleural effusions etiology
Authors: Rankovic Bosko , Djordjevic Ruzica
Published: December 2010

Concentration of zinc in blood serum and effusion was determined in 104 patients with the pleural effusion of different etiology. The importance of zinc concentration in serum and effusion was analyzed, as well as their relation regarding the differential diagnosis of pleural effusion. It was established that the isolated zinc concentrations in serum and pleural effusion could not be used separately either in differing transudates from exudates or in the diagnosis of the pleural diseases. The average value of zinc in the pleural effusion in relation to the serum value in patients with tuberculosis effusion was 1.37, higher than 1 in all patients and was significantly different from the average value of the ratio 0,74 in patients with nonspecific and malignant pleural effusions. The relation of zinc concentration in the effusion and serum higher than 1.0 reliably indicated the presence of tuberculous pleurisy.
Estimation of sensitivity of island fasciocutaneous neurovascular medial plantar flap in the reconstruction of soft tissue defects in calcaneal region
Authors: Jevtovic Dobrica
Published: December 2010

The soft tissue cover in the calcaneal region represents one of the great problems in the reconstructive surgery. The distant skin, muscle and musculocutaneous flaps are subjected to ulcers even with the orthopedic shoes. The island fasciocutaneus mid sole neurocutaneous flap can be a good substitute for the soft tissue cover due to its anatomic structure. The flap has the required dimensions, sticks well to the bone and the movements and mobility of the patient is unrestricted. This paper analyses the sensitivity of the transposed flap and the sole distal to the secondary defect observed in 30 patients. The evaluation was made after tactile tests, two-point discrimination test, the warm-cold test, the electrostatus of medial plantar nerve (MPN), and the ninhydrin test. All the tests, including the electrostatus MPN, done after 3 weeks and 3 months after the surgery, showed successful recovery of sensitivity in the transposed medial plantar flap. The results monitored after three months showed that the speed of the neural conduction recovery was 70% of normal neural reaction speed of the MPN. The modified operative techniques provide safe dissection of the plantar nerve with minimal neuropraxia. The postoperative recovery of sensitivity was more rapid, and without loss of sensitivity on the sole.
Izlozenost stanovnistva vestackom ultravioletnom zracenju i zastita
Authors: Hrnjak Miroslav , Zivkovic Dejan
Published: December 2010

 Uglavnom se samo vestacki izvori UV zracenja namenjeni kozmetickom tamnjenju mogu smatrati znacajnim sa aspekta mogucnosti ozracivanja pojedinaca iz stanovnistva. Komercijalni izvori UV zracenja za vestacko tamnjenje i oni za kucnu upotrebu su ozbiljan zdravstveni problem jer njihova upotreba moze da poveca rizik od pojave malignih oboljenja koze, a i da dovede do drugog ostecenja zdravlja. Upozorenja strucnjaka o mogucim stetnim efektima vestackog tamnjenja nisu do sada znacajno smanjili broj korisnika izvora za kozmeticko tamnjenje, a najveci broj lica koja se podvrgavaju zracenju su mlade osobe. Dalje preventivne mere treba da budu usmerene ka boljem informisanju javnosti o opasnosti izlaganja i ka ukidanju navike izlaganja vestackim izvorima UV zracenja radi dobijanja tamnog tena.
The value of cytologic diagnostics in fast intraoperative diagnosis of mediastinal lymphadenopathy and pulmonary and mediastinal tumors
Authors: Tatomirovic Zeljka , Bokun Radojka , Stoiljkovic Bratislav , Stepic Vlado
Published: December 2010

Extemporary (EXT) analysis is unavoidable in establishing the tumor diagnosis, operability and the extent of the operation. Alternative approach is cytologic analysis which, because of its simple methodology, provides results even faster. In this paper, the results of cytologic imprints (CI) and EXT finding were compared with definite histopathologic diagnosis (HDP) to determine the value of both methods. A total of 109 samples obtained during 55 thoracotomies were analyzed. Eighty eight specimens were analyzed simultaneously by CI Method and in frozen sections. Twenty one sample was analyzed only by cytologic methods and the results of standard CI were compared with definite HDP. After being processed for EXT diagnosis, intraoperative specimens were imprinted on glass slides, air-dried and stained by May-Gr?nwald-Giemsa Method. In cytologic analysis there were no false negative results, but there were 7 false positives. The overall diagnostic accuracy was 93.6%, sensitivity and negative predictive value was 100%, specificity was 91.1% and positive predictive value was 81.8%. Diagnostic accuracy of frozen sections was 98.8% also without false negatives and with one false positive finding with sensitivity and negative predictive value of 100%, specificity of 98.4% and positive predictive value of 95%. These results corresponded to the results of other studies and confirmed the efficacy of CI method, which could be used either simultaneously with EXT diagnosis as a complementary or as an alternative method in the hospitals where EXT analysis is not used. However, imprint cytology demands an experienced cytologist and could be used only in hospitals with well organized cytologic service.
Non-Hodgkin lymphomas of oral cavity
Authors: Vicente-Barrero Mario , García-Castro Ines , Knezevic Milan , Castellano-Reyes Jose , García-Jimenez Francisco , Camacho-García María , Baez-Acosta Beatriz , Loncarevic Slobodan
Published: December 2010

Non-Hodgkin lymphomas (NHL) often show up in an extranodal pattern, especially in the head and neck. Intraoral locations are much less frequent, particularly when they are single. This, in turn, can lead to a prolonged diagnosis and even to inadequate treatment. Different patients with initial extranodal location of NHL which were not previously diagnosed and in which it was manifested only intraoraly are presented in this paper. These cases are presented together with the additional examinations used for the early diagnosis and with the corresponding clinical pictures, as well as with the overview of other cases from the available literature.
The use of combination of fibrinolytic therapy and abciximab in the treatment of the acute myocardial infarction with ST elevation
Authors: Gligic Branko , Dincic Dragan , Obradovic Slobodan , Markovic Milic , Orozovic Vjekoslav
Published: December 2010

Background. According to current knowledge, the best way to treat the acute myocardial infarction with ST elevation is primary transluminal coronary angioplasty, which can be performed only in the best equipped tertiary cardiology centers. As it was known that atherothrombosis was the essence of the acute coronary syndrome we wanted to examine the efficacy and safety of combined therapy of tissue plasminogen activator and glycoprotein IIbIIIa platelet receptor antagonist abciximab. Methods. The case is reported of combined abciximab and accelerate schedule of t-PA reperfusion therapy in a young patient with the extensive anterior acute myocardial infarction. Activated partial thromboplastin time and platelet count were regularly measured during therapy. Results. The combination of these two drugs did not cause any complication in our patient. According to early noninvasive parameters, successful reperfusion was achieved. Postinfarction period was without complications. Coronary angiography was performed 15 days after and was without pathological findings. Eighteen months later the event patient had neither chest pain, nor other complaints with slightly reduced R waves in middle precordial leads and hypokinesis of anterior apical segment of the left ventricle showing the signs of important systolic function impairment. Conclusion. Controlled studies are needed to prove the safety and the benefit of such combined reperfusion therapy and to show which kind of treatment is appropriate in every case considering the patient conditions and the facilities of coronary care unit.
The value of urine cytologic examination findings in the diagnosis of the acute renal allograft rejection
Authors: Tatomirovic Zeljka , Bokun Radojka , Dimitrijevic Jovan , Ignjatovic Ljiljana , Aleksic Anastasija , Hrvacevic Rajko
Published: December 2010

Background. Acute rejection of allograft is one of the most serious complications of renal transplantation that requires fast and precise diagnostic approach. In this paper our experience in cytologic urinalysis as a diagnostic method of the acute renal allograft rejection was reviewed. Methods. The study group included 20 of 56 patients with transplanted kidneys who were assumed for the acute allograft rejection according to allograft dysfunction and/or urine cytology findings. Histological findings confirmed allograft rejection in 4 patients. Urine sediment obtained in cytocentrifuge was air-dried and stained with May-Grunwald-Giemsa. Acute allograft rejection was suspected if in 10 fields under high magnification 15 or more lymphocytes with renal tubular cells were found. Results. Acute transplant rejection occured in 32.1% patients. In 15 patients clinical findings of the acute renal allograft rejection corresponded with cytological and histological findings (in the cases in which it was performed). Three patients with clinical signs of the acute allograft rejection were without cytological confirmation, and in 2 patients cytological findings pointed to the acute rejection, but allograft dysfunction was of different etiology (acute tubular necrosis, cyclosporine nephrotoxicity). In patients with clinical, cytological and histological findings of the acute allograft rejection urine finding consisted of 58% lymphocytes, 34% neutrophilic leucocytes and 8% monocytes/macrophages on the average. The accuracy of cytologic urinalysis related to clinical and histological finding was 75%. Conclusion. Urine cytology as the reliable noninvasive, fast and simple method is appropriate as the a first diagnostic line of renal allograft dysfunction, as well as for monitoring of the graft function.
Primary percutaneous transluminal coronary angioplasty in the acute infarction of the right ventricle
Authors: Gligic Branko , Orozovic Vjekoslav , Obradovic Slobodan , Rusovic Sinisa , Kostic Jelena , Baskot Branislav , Dincic Dragan , Ristic-Andjelkov Andjelka
Published: December 2010

Background. Predilection site for the acute myocardial infarction of the right ventricle, (AMI-RV) is the upper third of the right coronary artery and for this reason such an infarction is followed by numerous complications, primarily by conduction disorders and very often by sudden and rapid cardiogenic shock development. Methods. Primary percutaneous transluminal coronary angioplasty (PPTCA) was performed on three patients in whom the acute infarction of the right ventricular was diagnosed and who had been hospitalized six hours after the beginning of chest pain. In all three patients intracoronary stent was implanted. On the admission patients had been in the threatening cardiogenic shock, with the prominent chest pain and with the elevation of ST-segment in V4R>2 mV. In the course of intervention patients were administered low-molecular intracoronary heparin with direct platelet glycoprotein IIb/IIIa inhibitors (abciximab), according to the established procedure applied in such cases. Results. The complete dilatation of the infarcted artery was established with the signs of reperfusion and the further clinical course was completely normal, there was no heart failure and patients had no subjective difficulties. Conclusion. Invasive approach in the treatment of AMI-RV is justifiable, and possibly the therapy of choice of these patients, providing well trained and equipped team is available.
Cytologic picture of ameloblastoma
Authors: Bokun Radojka , Tatomirovic Zeljka , Skuletic Vesna , Tatic Vujadin , Milosavljevic Ivica
Published: December 2010

Ameloblastoma is a rare tumor of the jaw arising from odontogenic epithelium. There are sparse reports in the literature concerning cytologic features of this tumor. This paper presents two cases of ameloblastoma diagnosed by imprint cytology and confirmed histopathologically. The imprints were hypercellular, with single cells and the groups of basaloid and polygonal squamous cells with huge vacuoles in cytoplasm. Stellate and fusiform cells were found in the background of the preparation. These morphologic parameters were sufficient for the cytologic diagnosis of ameloblastoma.
Malignant brain astrocytomas: The outcome of surgical treatment
Authors: Pavlicevic Goran , Roganovic Zoran
Published: December 2010

Background. The aim of this study was to analyze the outcome after the surgical treatment of patients with malignant brain astrocytomas, as well as the factors influencing the outcome. Retrospective study was performed on 145 operated patients (102 with glioblastoma multiforme, and 43 with anaplastic astrocytomas). Methods. Clinical state was graded according to the Yasargil scale (grades I-IV) and the Karnofski score, and the outcome was defined either as good (better or unchanged clinical state) or as poor (deteriorated state or death). The outcome was correlated with patients? age and preoperative clinical condition, as well as with the localization extensiveness and the extent of resection of the tumor. Results. Preoperative clinical state of patients most frequently corresponded to grades II-III (75.9%). Radical resection was done in 48.3%, subtotal in 15.2%, partial in 30.3%, and biopsy was performed in 6.2% of patients, with the total operative mortality of 16.5%, morbidity of 9.7%, and good postoperative outcome in 73.8% of the patients. The incidence of good postoperative outcome did not significantly depend on the tumor location (42.6-78.3%), cortical presentation, the extent of resection (68.2-75.7%) and preoperative clinical state (67.8-81.5%). Good outcome was seen in 82.7% of patients with one, and in 53.8% of patients with three or more infiltrated lobes (p<0.01). Patients with poor outcome were significantly older in average than the patients with good outcome (58.9?12.1 and 50.9?13.4 years of age, respectively; p<0.05). Operative mortality was 7.4% and 27.3% for clinical grades II and IV (p<0.05), namely 11% and 23.8% for the patients with the Karnofski score above and under 50 (p<0.05) respectively. Conclusion. The outcome after the operative treatment of malignant cerebral astrocytomas significantly depended on patient?s age and the extensity of the tumor. For such patients operative mortality was also significantly influenced by clinical preoperative state.
Formant structure of the voice during the intensive acute hypoxia
Authors: Obrenovic Jovisa , Nesic Milkica , Nesic Vladimir , Cekic Snezana
Published: December 2010

The influence of intensive acute hypoxia on the frequency-amplitude formant vocal O characteristics was investigated in this study. Examinees were exposed to the simulated altitudes of 5 500 m and 6 700 m in climabaro chamber and resolved Lotig?s test in the conditions of normoxia, i.e. pronounced the three-digit numbers beginning from 900, but in reversed order. Frequency and intensity values of vocal O (F1, F2, F3 and F4) extracted from the context of the pronunciation of the word eight (osam in Serbian), were measured by spectral speech signal analysis. Changes in frequency values and the intensity of the formants were examined. The obtained results showed that there were no significant changes of the formant frequencies in hypoxia condition compared to normoxia. Though significant changes of formant?s intensities were found compared to normoxia on the cited altitudes. The rise of formants intensities was found at the altitude of 5 500 m. Hypoxia at the altitude of 6 700 m caused the significant fall of the intensities in the initial period, compared to normoxia. The prolonged hypoxia exposure caused the rise of the formant intensities compared to the altitude of 5 500 m. In may be concluded that due to different altitudes, hypoxia causes different effects on the formants structure changes, compared to normoxia.
Fluoroscence bronhoscopy
Authors: Tomic Ilija , Mrdja Vladimir , Karlicic Vukojica , Bokun Radojka , Tatomirovic Zeljka
Published: December 2010

Background. Fluorescence bronchoscopy is one of the methods of the early detection of lung cancer that involves the large airways. The method is based on the detection of the altered autofluorescence of malignantly transformed tissue, and confirmed by biopsy and histopathologic examination. Method. Fluorescence bronchoscopy was performed in 18 patients, mean age of 51.2 years (male n=12, female n=6) due to the suspected lung cancer. Fluorescence bronchoscopy was performed using the Xillix LIFE-Lung System Vancouver, Canada. After conventional white-light bronchoscopy, the tracheobronchial tree was illuminated by blue light (442 nm) using helium-cadmium laser, and the results of autofluorescence were classified into three classes. Normal mucosa was of green fluorescence (Class I) abnormal mucosa was red or dark brown fluorescence (Class II and II), which was the indication for performing biopsy. Results. Normal endoscopy findings were established in 15 patients by conventional bronchoscopy. In the same group, by fluorescence bronchoscopy, Class I of fluorescence (normal finding) was found in 9 patients, while Class II changes occured in 6 patients. Histopathologic analysis of bronchial mucosa with Class II changes was performed detecting planocellular carcinoma in situ in one patient. Tumor-like changes were detected in 3 patients by conventional bronchoscopy and were determined as Class III changes by fluorescence bronchoscopy. By the biopsy of these chages carcinoma was documented in 2 patients while in one patient metaplasia of epithelium and granulation tissue around aspirated foreign body was detected. Conclusion. Fluorescence bronchoscopy is one of the methods for detecting metaplasia, carcinoma in situ and cancerous changes of bronchial epithelium in the large airways. However, the high rate of falsely positive findings represents a limitation of this method.
Agenesis of corpus callosum
Authors: Maksic Jasmina , Raicevic Ranko , Obradovic Dragana , Rajsic Nenad , Popovic Smiljana , Vladejic Sibin
Published: December 2010

This paper presents a case of a sixteen-year-old female patient with agenesis of corpus callosum which was accidentally discovered during etiological investigation of the consciousness disorder. Agenesis of corpus callosum, a rare congenital defect, might be associated with macrocephalia and various degrees of mental impairment, optic defects, and seizures. Apart from patients with these pathologic states, there are individuals with agenesis of corpus callosum, but without any clinical disturbances.
The influence of vertical muscles surgery on refraction and visual acuity
Authors: Risovic Dusica
Published: December 2010

Background. The aim of this paper was to determine whether the surgery on vertical muscles of the eye influenced the change in refraction and visual acuity. Methods. This prospective study included testing of 79 children with infantile esotropia who suffered from the vertical strabismus after the surgery on horizontal muscles. Patients were divided into two groups: the first group of 52 children (the test group) had only vertical component (overaction of m. obliqui inferior) and the second group (the control group) had two vertical components (dissociated vertical deviation - DVD and overaction of m. obliqui inferior). Refraction and visual acuity were tested before the surgery on the vertical muscles and one month and six months after the surgery. There was no significant difference between the results of the objective refraction in those three different periods of time. Results. In both groups mild hypermetria (according to Costenbander) occurred in 40-48% of the examinees of both groups, while moderately-expressed hypermetropia occurred in 40-50% of the examinees. There was neither statistically significant difference between the results of the three observed measurings among every group, nor between the observed groups of patients (p>0,05). By the analysis of the results of visual acuity it could be concluded that it was significantly improved 6 months after the surgery on cyclovertical muscles. This change was more significant in the sample group of patients (p<0,01) than in the children from the control group (p<0,05), who were much older. Conclusion. Objective refraction in patients was in the range of low values of hypermetropia (+2.00 Dsph - t 3.00 Dsph). Significant improvement of visual acuity occurred 6 months after the surgery performed on vertical muscles of the eye. These results were achieved by the repeated measuring of objective refraction and the precise correction of every new accommodative element.
Bigeminy: A result of digoxin and St John’s wort interaction
Authors: Andjelic Sladjana
Published: December 2010

A case of an by digoxin under unusual circumstances is reported. An 80-year-old man, previously on long-term digoxin treatment, started consuming St John?s wort herbal tea (2 000 ml/daily) because of frequent episodes of depression. After the cessation of consuming herbal tea containing Hypericum perforatum, digoxin poisoning developed in our patient. Electrocardiography revealed nodal bradicardia 36/min and bigeminy. Manifested symptoms were the consequence of interaction between digoxin and Hypericum perforatum which were consumed simultaneously, and the cessation of consuming St John?s wort herbal tea afterwards. Therapy was the same as in the standard digitalis poisoning. Consumers of St John?s wort combined with medical products are advised not to discontinue tea consumption on their own, without consulting their physician.
Surgical-prosthetic treatment of large mandibular cysts
Authors: Dzambas Ljubisa , Dzolev Asen
Published: December 2010

This paper presents a combined surgical-prosthetic procedure of reconstructing mandibular bone defect in a 53 year old patient, following enucleation of a mandibular cyst (Cystectomy Partsch II). After a thorough diagnostic evaluation, a surgical procedure was planned with the particular attention to the nature of the disease, patient?s condition, size and extension of the cyst, tissue loss, and the possibilities of prosthetic management of a mandibular bone defect with partial postresection dental prosthesis. It is of great importance to point to the significance of teamwork of a maxillofacial surgeon and a specialist in prosthodontics. This kind of cooperation provided very effective and less risky soft tissue, as well as bone tissue regeneration (osteogenesis). The patient?s recovery was fast, and he could return to his daily activities and work without significant changes regarding quality of life after surgery and prosthetic treatment.
The relation of serum PSA and Gleason's grade in patients with prostacic carcinoma
Authors: Zivkovic Sladjana , Velickovic Ljubinka , Kostov Milos , Stojanovic Nebojsa
Published: December 2010

The prostatic adenocarcinoma is one of the most frequent malignant tumors of men over 50 years of age. It is distinguished by agressive clinical course and heterogeneous multifocal hystomorphologic changes. PSA is the most reliable serum marker in diagnostics and observation of prostatic carcinoma and gleason's system of tumor-diferentiation grading is generally accepted way of determining the hystologic grade. Gleason's system is correlated with serum levels of PSA and with biological behaviour of the tumor. We presented 40 patients with verified ACP in whom the level of serum PSA, gleason's grade and score were compared. Highly significant correlation was found between serum level of PSA and the differentation grade of the tumor - Gleason's grade and score. Combination of PSA parameters and Gleason's score enables correct estimation of tumor's behaviour and correct therapeutic protocole.
The first documented case of enterocolitis in Yugoslavia caused by enterohemorrhagic Escherichia coli 0517
Authors: Cobeljic Miloje , Bojic Ivanko , Opacic Dolores , Lepsanovic Zorica , Lazic Srdjan
Published: December 2010

A ?new? group of pathogenic agents, enterohemorrhagic Escherichia coli (EHEC) (particularly the strains of O157 serogroup), emerged in the last 20 years causing an increased number of sporadic and epidemic diarrhoeal diseases with hemorrhagic enterocolitis as a most common clinical manifestation of the infection. As a consequence of the absorption and cytotoxic effect of the main virulence factor of these bacteria - verotoxin (shiga-toxin), in about 10% of the affected persons extraintestinal complications, most frequently hemolytic-uremic syndrome (HUS), occurred 7-14 days after an episode of diarrhoeal disease. The first case of hemorrhagic enterocolitis with the documented EHEC O157 infection in Yugoslavia is presented in this paper. Considering the existing expansion trend of these carriers, practitioners should be aware of them in case of the occurrence of diarrhoeal disease (particularly hemorrhagic enterocolitis), and keep these patients under control during the reconvalescence period because of potential development of extraintestinal complications, such as HUS.
Solid papillary breast carcinoma with mucinous differentiation
Authors: Kostov Milos , Tasic-Dimov Desanka , Milenkovic Sreten , Dimic Milorad , Petrovic Ljubisa , Mijovic Zaklina
Published: December 2010

A case is reported of a solid variant of infiltrating papillary carcinoma of the breast with mucinous differentiation in a 74-year-old woman. Macroscopically, the tumor was solid and lobular, 4.5 cm in diameter. Light microscopy showed solid papillary invasive carcinoma mixed with infiltrating ductal carcinoma, not otherwise specified. Abundant intracellular and extracellular acid mucin produced by the solid papillary tumor cells was proven histochemically by: PAS, PAS-D, mucicarmine and alcian blue. Immunohistochemically, the papillary carcinoma cells were strongly reactive to estrogen receptors, and weakly to moderately reactive to smooth muscle actin. We suggest that papillary carcinoma of the breast could have potentially high degree of aggressiveness, and that differential diagnosis of these rare tumors might be a histopathological problem.
Nerve transfer in brachial plexus traction injuries
Authors: Samardzic Miroslav , Grujicic Danica , Rasulic Lukas , Bacetic Dragoljub , Milicic Biljana
Published: December 2010

Background. The aim of this study was to analyze the results of nerve transfer to the musculocutaneous and axillary nerves, using some technical modalities such as intercostal, spinal accessory or intraplexal transfer, and on the basis of the results to try to clarify the most common controversies concerning these operations. Methods. The study included 82 patients with brachial plexus traction injuries, who were operated on using various techniques of nerve transfer. The follow-up period was at least two years. The analysis of biceps and deltoid muscles recovery was performed according to the type of the donor nerve. Results. The corresponding rates of recovery for the musculocutaneous and axillary nerves were 46.7% and 68.1% in intercostal nerve transfer, 71.4% and 75% in accessory nerve transfer, 93.1% and 88.8% in nerve transfer of the brachial plexus collateral branches, and 55.5% and 60% in classical intraplexal nerve transfer, respectively. Comparative statistical analysis demonstrated significantly better final outcome and quality of recovery in regional nerve transfers in comparison to the other methods. Conclusion. Our findings suggest that nerve transfer of collateral branches, where possible, (such as in cases with upper or extended upper brachial plexus palsy) might be a method of choice, offering better results and quality of recovery.
Efficacy of valsartan in the therapy of persistent microalbuminuria in normotensive patients with type 1 diabetes mellitus
Authors: Dragovic Tamara , Hrvacevic Rajko , Ajdinovic Boris , Vujanic Svetlana
Published: December 2010

Aim. To determine the efficacy of AT1 receptor antagonist (valsartan) in decreasing of urinary excretion of albumin in normotensive patients with type 1 diabetes and incipient diabetic nephropathy (DN). Methods. This was a prospective, randomised, placebo-controlled study, which included 20 patients with insulin-dependent diabetes mellitus, mean age 25.15, and the duration of diabetes of 13.95 years. All the patients were normotensive, with persistent microalbuminuria (incipient phase of DN). Patients were randomly divided into two groups (10 patients each): valsartan group treated with 80 mg valsartan daily during 6 months, and the group treated with placebo during the same period. Both groups were similar and comparable concerning the observed parameters at the beginning of the study. Results. After 6 months therapy, valsartan caused significant decrease of urinary albumin excretion rate (UEAR) by 69.1% from 64.8 to 21.1 mg/24 h, while in placebo group there was an insignificant increase of UEAR by 29.8%. During the follow-up of UEA in the observed groups, at the beginning and the end of the mentioned period highly significant decrease of albumine secretion (p<0.001) was observed. Valsartan significantly lowered mean systolic blood pressure (from 122.0 ? 10.1 to 110.0 ? 11.8 mmHg). After 6 months therapy, the reduced values of total cholesterol and LDL-cholesterol fraction were registered in the valsartan group, while the difference in serum trigliceride values reached statistical significance (1.42 ? 0.79 vs. 1.21 ? 0.89 mmol/L; p<0.05). Neither significant difference in glycoregulation quality between the two groups, nor the occurence of hyperkalemia was detected throughout the study period. Conclusion. Valsartan's efficacy in the decrease of microalbuminuria after 6 months of therapy could justify the use of this group of renin/angiotensin blockers in delaying the clinically manifested DN. Valsartan was well tolerated and did not influence the quality of glycoregulation. It did not increase the level of serum lipids and could be recomended in the treatment of diabetic patients.
Dedicated composite fillings − inlays
Authors: Saulic Slobodan , Tihacek-Sojic Ljiljana
Published: December 2010

Background. The aim of the study was to evaluate the quality and persistance of esthetics of dedicated inlay by clinical methods. Methods. The paper reviews the clinical significance and technique of preparing particular composite inlays before and after the construction of the metallic framework partial denture. On the basis of indications the total of 30 inlays were placed into cavities under relatively dry working conditions. Six, twelve eighteen and twenty-four months after the placement of filling, control check-up was carried out by Ryge criteria. Results. After two years marginal discoloration as well as the change of the colour occured in 3.3% of inlays. There was neither detectable secondary caries, nor the symtoms of pulpal damage. The requirements to be fulfilled concerning the composite materials in order that they can be implemented for this purpose, were also discussed. Conclusion. From the clinical point of view, purpouse inlays from Herculite XRV lab C8B in combination with Opti Bond System and composite cement Porcelite Dual Cure showed high functional and esthetic values in the observational period of two years.
Extrahepatic manifestations of hepatitis C virus infection
Authors: Nozic Darko
Published: December 2010

 Hepatitis C virusna infekcija je zaista povezana sa sirokim spektrom ekstrahepatickih sindroma. Neke bolesti su sigurno povezane sa HCV infekcijom (krioglobulinemija, kasna kozna porfirija, membranoproliferativni glomerulo-nefritis), za neke postoji velika verovatnoca (autoimunske bolesti stitaste zlezde, autoimunska trombocitopenija, limfomi, secerna bolest neuropatije, artritis, lihen planus, nodozni poliarteritis, sijaloedenitis sindrom fibromialgije) dok se za neke bolesti ostavlja mogucnost da se radi o slucajnoj udruzenosti za sto su potrebna nova istrazivanja.
Epidermodysplasia verruciformis: A model of virus-caused oncogenesis in the skin
Authors: Jovanovic Marina , Karadaglic Djordjije
Published: December 2010

 U osnovi HPV izazvane onkogeneze u kozi nalaze se visoko specificni mehanizmi HPV adaptacije. Koji su to, pokazace buduca istrazivanja.
Kikuchi-fujimoto disease
Authors: Djokic Milomir , Begovic Vesna , Bojic Ivanko , Tasic Olga , Stamatovic Dragana
Published: December 2010

Kikuchi-Fujimoto disease (KFD), also know as histiocytic necrotizing lymphadenitis, is a benign disorder characterized histologically by necrotic foci surrounded by histiocytic aggregates, and with the absence of neutrophils. KFD was recognized in Japan, where it was first described in 1972. The disease is most commonly affecting young women. The cause of the disease is unknown, and its exact pathogenesis has not yet been clarified. Many investigators have postulated viral etiology of KFD, connecting it with Epstein Barr virus, human herpes simplex virus 6 parvo B 19, but also with toxoplasmic infection. Kikuchi-Fujimoto disease is usually manifested with lymphadenopathy and high fever, and is associated with lymphopenia splenomegaly, and hepatomegaly with abnormal liver function tests arthralgia, and weight loss. The disease has the tendency of spontaneous remission, with mean duration of three months. Single recurrent episodes of KFD have been reported with many years? pauses between the episodes. Kikuchi-Fujimoto disease may reflect systemic lupus erythematosus (SLE), and self-limited SLE-like conditions. Final diagnosis could only be established on the basis of typical morphological changes in the lymph node, and lymph node biopsy is needed for establishing the diagnosis. Lymphadenopathy in a patient with fever of the unknown origin could provide a clue to the diagnosis of lymphoma, tuberculosis, metastatic carcinoma, toxoplasmosis and infectious mononucleosis. As KFD does not have any classical clinical features and laboratory characteristics, it may lead to diagnostic confusion and erroneous treatment. We described a case of KFD, and suggested that this disease should be considered as a possible cause of fever of the unknown origin with lymphadenopathy.