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Biomedical subjects

D Savic

Publications and source records attributed to D Savic.

At least 19 recordsLinked to original sources

Granulocyte and plasma cytokine activity in acute cadmium intoxication in rats.

Changes in the number and ex vivo function of peripheral blood neutrophils were investigated following intraperitoneal administration of cadmium-chloride in rats. Besides a dose-dependent increase in the number of peripheral blood neutrophils, changes were found in the functional state of isolated polymorphonuclear leukocytes (PMNs). Increased spontaneous adhesion and activation, and TNF activity in a conditioned medium were observed in cultures of granulocytes in comparison to granulocytes from control (saline-treated) animals. Increased levels of plasma activity of inflammatory cytokines, tumor necrosis factor (TNF) and interleukin-6 (IL-6) were noted following cadmium administration. Cytological signs of pulmonary inflammation were revealed histologically and the majority of neutrophils recovered from the lungs by enzyme digestion exhibited a capacity of nitroblue tetrazolium (NBT) reduction. Our data demonstrate that acute cadmium intoxication leads to a systemic inflammatory response characterized by numerical and functional changes in the granulocyte compartment and to increased levels of inflammation-related cytokine activity in the circulation. Correlations between the increased number of peripheral blood neutrophils and IL-6 plasma activity (r=0.776, p<0.00001) and the number of neutrophils recovered from the lung tissue (r=0.893, p<0.00001) suggested that systemic cadmium-induced inflammation might be involved in the pulmonary toxicity of cadmium.

Acute Disease

[Labyrinth fistula in chronic otitis with cholesteatoma].

The authors studied 116 surgically treated patients with labyrinthine fistulae due to cholesteatoma. The fistulae were most commonly localized on the lateral semicircular canal (75%) and much less frequently involved only the oval window area (7%) and the promontory (4%). The multiple fistulae were found in 14% patients. The closed technique was used, while the open technique was adopted only when the ear was deaf preoperatively, in cases of multiple fistulae and associated intracranial complications. The cholesteatoma matrix was not removed from the fistula of the oval window area or the promontory or in the cases of multiple fistulae and large fistulae of the lateral semicircular canal if the cholesteatoma matrix had penetrated into the labyrinth. The fistulae on the lateral semicircular canal were covered by a piece of fascia. Postoperatively deafness occurred only very exceptionally.

Adolescent

Association between stimulated QT interval and ventricular rhythm disturbances: influence of autonomic nervous system.

To examine the association between ventricular rhythm disturbances and changes in the pacemaker-induced stimulated T interval (STIM-T interval), we compared findings from monitoring of two patient groups. The first group consisted of 15 patients with QTX microprocessor pacemakers and the second group consisted of 198 patients with documented ventricular rhythm disturbances and coronary artery disease (CAD). In the first group, which was free of ventricular rhythm disturbances and manifest coronary artery disease, the STIM-T interval was measured every 4 hours over a 36-hour period at four pacemaker frequency settings (70, 80, 90, and 100) in order to observe the circadian variation of the STIM-T interval as a function of changes in autonomic nervous system (ANS) tone. The second group was comprised of patients with CAD and over 30 VES/hrs (Lown grade classification 1-5), and taking no antiarrhythmic medication. These patients were followed using 24-hour Holter monitoring over a minimum of 23 hours and with less than 5% artifact/recording. Information regarding mean hourly heart rate, total number of VES, VES pairs, VT runs, and ischemic episodes in this group was compared with changes in the STIM-T interval in the first group. The STIM-T interval was found to be shorter during the day and longer at night at all heart rate settings. The total frequency of VES, of VES pairs, VT runs, and ischemic episodes in the second group varies in a similar circadian fashion. The greatest total number of VES, of VES pairs, VT runs, and ischemic episodes was recorded in the waking hours, at the same time when the STIM-T interval is the shortest, while this number was significantly lower during sleep, when the STIM-T interval of the first group is the longest. This coincidence of circadian variation pattern between STIM-T interval in group I, and ventricular arrhythmias and ischemic episodes in group II, suggests that alterations in ANS tone reflected in the STIM-T interval may be an important factor in the occurrence of these untoward events.

Adult

Anatomical variations and relations of the medical and lateral portions of the attic and their surgical significance.

The medial and lateral attics were examined in 150 specimens of temporal bones of adults using anatomical and histological methods. The medial attic varies in shape and size, depending upon the position of the auditory ossicles, the degree of prominence of the lateral semicircular canal and the direction in which the tympanic segment of the facial canal extends. The latero-medical diameter of this attic at the level of the body of the incus averages 1.7 mm., but is somewhat smaller at the level of the head of the malleus. The medial attic always communicates with the mesotympanum through an opening between the prominence of the tympanic part of the facial canal and the superstructures of the auditory ossicles. The lateral attic is always of smaller dimensions than the medial attic and its latero-medial diameter averages less than 1 mm. This attic very seldom communicates with the mesotympanum.

Adult

Surgical anatomy of the hypotympanum.

Anatomical characteristics of the hypotympanum were tested on 50 temporal bones. The hypotympanum has the shape of an irregular bony groove which is surrounded by five walls. The outer wall is formed by the tympanic part of the temporal bone. In 65 per cent of the cases the inner wall is formed by part of the petrous bone which extends under the promontory; in 25 per cent it is formed only by the lower part of the promontory; and in 10 per cent it corresponds to the juncture of the promontory and the petrous bone. The lower wall is clearly defined in 48.2 per cent of cases and corresponds to the juncture of its inner and outer walls. In 65 per cent of cases a recess of the inferior hypotympanic sinus is found on the floor of the hypotympanum. In 25.3 per cent of cases the jugular bulb protrudes into the tympanic cavity. In 73.4 per cent of cases the front wall is formed by part of the petrous bone which extends from its floor towards the tympanic opening of the protympanum, and in 26 per cent of the cases it is formed by the wall of the internal carotid artery. On the front wall, in 22.4 per cent of cases, a recess of the anterior hypotympanic sinus is found. The back wall is formed by elements of the styloid complex and in five per cent of the cases a recess or posterior hypotympanic sinus is found on it.

Ear, Middle

[Anomalies of the mastoid portion of the facial canal and their surgical importance].

Examination of 150 sagittal sections of temporal bone showed that anomalies of mastoid part of facial canal could be divided into 3 groups: abnormal deviations of the vertical portion, the curves or the nerve bifurcation. Deviations of the vertical pathway of facial nerve can be of three types in relation to the frontal plane: the nerve, after its second bend travels towards the tympanic cavity (9 of 150 cases); it curves forward passing through the hypotympanum (1 of 150 cases); it turns backwards in the direction of the sigmoid sinus (15 of 150 cases). Abnormal or supplementary bends were noted in 10% of cases (15 of 150), in more than half of the cases the latter developing 2-3 mm from the second bend, and more rarely in the inferior wall of the tympanic cavity. A bifurcation of the nerve after its second bend was observed in only one case.

Adult

Potential yield of pulmonary tuberculosis cases by direct microscopy of sputum in a district of South India.

In the District Tuberculosis Programme in India, which is part of a national programme, case-finding and treatment of pulmonary tuberculosis are integrated into the general health services. With such an integration, it is desirable, in order to forecast possible achievements, to understand the additional work-load that the programme will impose upon the existing health institutions and to assess the potential of these institutions for case-finding and treatment.The operational study described in this paper was made under programme conditions in a district in South India and is an examination of the case-finding potential of rural health institutions, using direct microscopy of sputum for diagnosis, and of the additional work-load involved by such case-finding. Under the conditions found in the course of the study, it is clear that a substantial proportion (at least 65%) of pulmonary tuberculosis cases prevalent in the district can be detected by the existing staffs with an easily manageable work-load.

Adolescent

Results of 132 PTFE (Gore-Tex) bifurcated graft implantations.

One hundred and thirty-two PTFE bifurcated prosthetic grafts were implanted during the course of a bicentre study conducted at the abovenamed institutions from 1982 to 1986. The study included 118 males and 14 females with an average age of 62 years. One hundred and eighteen patients suffered from aorto-iliac occlusive disease and 14 from abdominal aortic aneurysms (AAA). Five patients had already undergone previous surgery (redo operations), with extirpation of thrombosed Dacron prostheses. Proximal end to end anastomoses were fashioned in 94 cases (71.2%), while end to side anastomoses were performed in 38 cases (28.8%). The distal anastomoses were to the iliac arteries in 11 cases, the common femoral artery in 89 cases and the deep femoral artery in 32 cases.

Aorta, Abdominal