Biomedical subjects

Faruk Dilberović

Publications and source records attributed to Faruk Dilberović.

At least 19 recordsLinked to original sources

PubMed2006

Injection pressure as a marker of intraneural injection in procedures of peripheral nerves blockade.

The blockade of peripheral nerves carries a certain risk of unwanted complications, which can follow after unintentional intraneural injection of a local anesthetic. Up till today, the research of measuring injection pressure has been based on animal models, even though the histological structure of periphery nerve is different for animal and human population, so the application pressure which presages intraneural injection in human population is still unknown. As material in performing this study there have been used 12 Wistar rats and 12 delivered stillborns. After bilateral access to the median nerve, we applied 3 ml of 2% lidocaine with epinephrine, with the help of automatic syringe charger. The needle was at first placed perineural on one side, and then intraneural on the other side of both examination groups. During every application the pressure values were monitored using the manometer, and then they were analyzed by special software program BioBench. All perineural injections resulted with the pressure < or = 27.92 kPa, while the majority of intraneural injections were combined with the injection pressure > or = 69.8 kPa. The difference between intraneural and perineural injection pressures for the two different examination groups (rats and delivered stillborns) was not statistically significant (P>0.05). As prevention from intraneural injections today are in use two methods: the method of causing paresthesia or the method of using the peripheral nerve stimulator. However the nerve injury can still occur, independent from the technique used. If our results are used in clinical practice on human population, than the high injection pressure could be the marker of intraneural lodging of a needle.

Anesthetics, Local↗

PubMed2006

Morphologic findings of the ischemic myocardium.

This study assesses the relation between qualitative and quantitative findings of myocytes and interstitial connective tissue in the ischemic heart disease. Qualitative and quantitative changes of myocytes and interstitial connective tissue were studied on the serial cross myocardial sections from 20 autopsied hearts with ischemic lesions, stained by immunohistochemistry using a monoclonal antibody (von Willebrand factor) and with hematoxylin-eosin method. Myocardial sections included proximal and distal part of occlusion and area of occlusion of coronary vessels. The volume densities (V V) of the cardiac myocytes and interstitial fibrosis in the group with coronary occlusion were examined stereologically and compared with control group. The findings showed a significant reduction in the volume density of myocytes and an increase in the volume density of interstitial fibrosis in patients with coronary occlusion compared with control group. Significant reduction in the volume density of myocytes and an increase in volume density of interstitial fibrosis were greater in the distal part of occlusion and area of occlusion, than in the proximal part of the occlusion. Our stereological results give useful quantitative information's of changes in myocardium parts during coronary occlusion as well as in normal conditions, and represent objective proof of significant changes in ischemic myocardium described by qualitative analyses.

Case-Control Studies↗

PubMed2005

Detection of neurovascular structures using injection pressure in blockade of brachial plexus in rat.

In the last few decades there has been a great development of regional anesthesia; all the postulates are defined and all the techniques of usage are perfected. However, like any other medical procedure, the block of brachial plexus carries a risk of certain unwanted complications, like possible intraneural and intravascular injections. The reason for great discrepancy between the injury of brachial plexus and other periphery nerves while performing the nerve blockade is the frequent usage of this block, but also the specific proximity of neurovascular structures in axilla. The purpose of this work is to determine the values of pressures which appear in para-neural, intraneural and intravascular injection applications of local anesthetic, and to compare those values in order to avoid cases of intraneural and intravascular injections in clinical practice with consequential complications. In experimental study there have been used 12 Wistar rats of both genders. After anesthesia with ether and mid-humoral access to the neurovascular structures in axilla, the injection of 2% lidocaine with epinephrine was performed with the help of automatic syringe charge. The needle was at first placed para-neural, and then also intraneural and intravascular. During every application the pressure values were monitored using the manometer, and then they were analyzed by special software program. All para-neural injections resulted with the pressure between 13,96-27,92 kPa. The majority of intraneural injections were combined with the injection pressure greater than 69,8 kPa, while the intravascular injections were combined with injection pressure less than 6,98 kPa. Based on the available data it can be noticed that so far none of the methods of prevention from unwanted complications of regional anesthesia can insure the avoidance of intraneural and intravascular injection of local anesthetic. Based on our research it is obvious that the measuring of pressure during the nerve blockade is very important in order to decrease the risk of neurological and possible systematic complications. It is also clear that a small, mobile, and financially quite available apparatus for pressure measurement can help in differentiation between para-neural, intraneural and intravascular injection. Avoiding high injection pressure prevents from lodging the needle into intraneural space, while avoiding a very low injection pressure prevents from lodging the needle into intravascular space followed by consequential complications. The usage of this apparatus can find its application in other blockades of periphery nerves, and in other branches of medicine as well.

Anesthetics, Local↗

PubMed2005

Collateral circulation in human heart.

The aim of the investigations was to demonstrate different types of collaterals of coronary arteries using the method of coronary angiography and injection-corrosion method. The investigations were carried out on 30 human cadaveric hearts from the Department of Anatomy, and 30 angiograms of patients from the Cardiology Department of Clinics Centre in Sarajevo. Clinical investigations were retrospective and prospective on patients that were treated in hospital, and on patients that just arrived in hospital (based on findings of coronary angiography). The results show the existence of different types of collaterals: intercoronary and intracoronary. We established collaterals in a case with occlusion of the right coronary artery and left coronary artery in which better development of collaterals was established. Our patients were classified in two groups: 1) Patients with good collaterals and good left ventricular function; 2) Patients with good collaterals and impaired left ventricular function. On the anatomical material we found different types of collaterals as well. Our results show that coronary angiography is useful diagnostic method for the demonstration of coronary collaterals.

Aged↗

PubMed2005

Histological changes of the sciatic nerve in dogs after intraneural application of lidocaine--relation to the established application pressure.

Histological changes of sciatic nerve in adult dogs 7 days after single application of 2% lidocaine (4 ml dose, speed of injection 3 ml/min) and measurement of the application pressure was studied, with a goal to investigate structural changes of the nerve in relation to the established pressure values. The application pressure was determined by using Bio Bench software. In intrafascicular puncture an average application pressure of 198.23 +/- 52 kPa was found, and in interfascicular puncture its average value was 53.3 +/- 17.9 kPa, with a note that individual differences are regularly present. Seven days after the injection, a nerve dissection was performed and serial sections covering the region of injection's puncture and bordering proximal and distal zones, in the total length of 3 cm, were prepared. The found changed show the presence of nerves' fibers lesions with a strong reactivity of Schwann's cell, as well as the change of interstitial structure concerning hypercellularity and occurrence of cellular extravasation. The covering system of the nerve in the zone of epineurium manifests changes of inflammatory process and in perineurium a decomposition of lamella layers and the alteration of their tinctorial properties were noticed. A comparison of the found nerve reactivities in intra- and interfascicular application showed their one-way alteration, although the lesions were more noticeable in the conditions of intrafascicular application. The damages were mostly expressed in the zone of local application of anesthetic, than distally from it, while the damage to the structure in the proximal part is of the smallest degree.

Anesthetics, Local↗

PubMed2004

Contribution to the knowledge of position, flow and arterial distribution of cerebral blood vessels in foetuses 4 to 9 months of age.

We studied cerebral blood vessels in 25 fetuses of gestational age 16-36 weeks and in 10 cadavers of still-born babies by injection-corrosive method. In the early fetal life, arteries are thin with the straight flow, which is directly connected with the brain development. Progressive changes are observed in all the three cerebral arteries in 28-week old fetus, which straight flow becomes more and more tortuous. As in the 32nd week the brain develops faster and gyri and sulci are being formed, the arteries assume wavy flow and number of their rami increases. In a still-born baby, arteries are of rather bigger caliber; they branch abundantly; and due to their relatively broad cerebral sulci, it can be said that their flow is partly tortuous. Our results show evidently that position, flow and relation of cerebral arteries change concurrently with the brain development and appearance of cerebral gyri and sulci.

Brain↗

PubMed2004

Study of the changes in the position and the pattern of changes of the brain arteries in fetuses and full-term stillborns.

We studied cerebral blood vessels in 20 fetuses of the gestation age between 16-36 weeks, and in 5 full-term stillborn cadavers by the method of dissection. One portion of the brain samples were processed by filling the blood vessels with 10% solution of formalin, whereas in the other group we used Mixobar and injected it through carotid artery to demonstrate brain arteries. In early fetal life the arteries are thin and have a straightforward pattern, which is in a direct correlation with the development of the brain. In brain arteries of a 28-week old fetus we observed progressive changes at all three brain arteries that began to assume more curved pattern. Since a significant increase in the brain growth and formation of the gyruses and sulcuses of the brain occurs in the 32nd week, the arteries also assume a wavier pattern, and the number of its branches increases. In full-term stillborns, the arteries are much larger in caliber, they branch abundantly, and due to relatively wide brain sulcuses we may also conclude that their pattern is partially tortuous. From our results it is evident that there are changes in the position, pattern and relationship of brain arteries that are parallel with the brain development and formation gyruses and sulcuses of the brain.

Brain↗

PubMed2004

Clinical and anatomy study of the human mental foramen.

The great diffusion of the surgical techniques in jaws surgery and the progress of the radiological imagining procedures expressed many interest in clinical anatomy of the mental foramen (MF). The study goal was to determine the precise location of the MF and the surrounding anatomical landmarks. Measurements of the MF position relative to the surgical landmarks and related posterior teeth were made on 20 dry mandibles with complete dentition and intact alveolar bridge obtained from the Institute of Anatomy, School of Medicine, University in Sarajevo. The measurements were made by anthropometric methods on the booth sides of the mandible, and compared with measurement made on the orthopantomogram radiographs of the same mandibles. The most common position of the MF was in line with the longitudinal axis of the second premolar. In the vertical plane on the skulls the MF lays in the midpoint of the distance between the lower border of the mandible and the alveolar margin, however on the orthopantomogram MF appeared slightly bellow the midpoint. In the horizontal plane it lays approximately one third of the distance between the mandibular symphysis and the posterior border of the ramus of the mandible measurement from A-P projection and one quarter of that distance measurement from the profile projection. There were no significant differences between distances MF from posterior border of the ramus of the mandible measurement from A-P and profile projection and the one obtained on orthopantomogram and their ratio is constant value determine das 1,065. The MF was on average 25 mm lateral to the mandibular skeletal midline and symmetrical, and symmetry was preserved on the orthopantomogram. The measurement showed significant differences in distances of M from superior border mandible measurement on dry mandible and orthopantomogram radiographs while distance bellow the MF was not significantly different. The constant values of MF distance to the posterior border of the ramus of the mandible measured as 1,065 and the distance to the medial skeletal line of 2,11 made it possible to also determine average angle of 43 degrees stream of the cor-pus of the mandible behind MF. These values in combination with ratios of MF to the different anatomic landmarks designated as relative horizontal and relative vertical position, would be of importance not only from anatomical but also from practical point of view for estimation of alveolar bridge resorption and preoperative analysis in orthognat postresection or implant surgery in the mandible.

Chin↗

PubMed2004

Study on skull asymmetry.

The aim of this study is to determine the type of skull as well as to examine its internal appearance and configuration of skull base. Special attention is given to the direction and position of the pyramid of the temporal bone, the volume and appearance of all the three cranial fossas, and the direction and appearance of crista alaris--all of those compared to the skull type. Considering the obtained results (specially for crista alaris and middle fossa) we can ascertain outstanding independence of sphenoid bone and its parts in the formation of cranial base. Located in the middle of the skull, in front of strong pyramids transversal axis and two vertical axis, frontal crest and internal occipital crest, it by itself with her lesser wing presents an important transversal axis of cranial base. Cases in which crista alaris with its position does not follow the type of skull (in 20 % cases crista alaris does not follow skull protuberances), may probably be explained by strong and independent development of this bone, which is placed among other bones of cranial base like a peg. It also, by itself dictates form and configuration of the middle part of skull. That is also confirmed by middle fossa which, according to its position in the middle of cranial base and relation with sphenoid bone, shows significant deviation with respect to posterior fossa (follows the type of skull in 47 % cases).

Cephalometry↗

PubMed2004

Changes in blood vessels in fetuses 4 to 9 months intrauterine life old by postmortem angiography method.

We monitored changes in caliber, position and branching of blood vessels in fetuses of 4 - 9 months of intrauterine life. By precise dissection we prepared starting parts of common carotid artery and internal jugular vein in 40 cadaver fetuses. The vessels were injected with Telebrix and subjected to postmortem angiography at the Institute of Radiology Clinics Center in Sarajevo. Thereafter, arteries obtained were compared and analyzed. In preparations of few months old fetal material we observed arteries of fairly straight course, low caliber and with no observable ramification. When preparations of more mature stillborn infants were examined, we detected arteries of undulating course, more expressed ramification and higher caliber. In stillborn babies, all three arteries are of high caliber with rich branching. Considering that in this phase of brain development sulcuses are relatively wide, we can say that course of arteries is partially tortuous. Analysis of venous vessels shows good distinction of venous sinuses and subarachnoidal cisterns. We can conclude with great certainty that the changes occur in position, caliber and relationship among vessels in fetus during the period of brain sulci and gyri formation.

Anterior Cerebral Artery↗

PubMed2004

Significance of establishing collateral circulation by leptomeningeal anastomoses in the occlusion of arteriae cerebri mediae.

We have investigated establishment of collateral circulation in patients with cerebral circulation disorder. Thirty angiograms of patients treated at Neurological Department of Hospital Centre in Sarajevo suffering from arteriae cerebri mediae occlusion were used for this study. Cerebral anastomoses that included connections between arteriae cerebri anterior and arteriae cerebri mediae over leptomeningeal anastomoses occurred in some patients suffering from occlusion of this arteriae. It was concluded that the majority of anastomoses existed between big leptomeningeal branches of postcommunicant segment of a. cerebri anterior and branches of cerebri mediae. These collaterals are of great significance as their functional ability is sometimes of a high degree in cases of occlusion of one or the other artery. It can be concluded that anastomosing of the blood vessels increases their volume in the whole and therefore more blood can be provided, although physiological factors should not be neglected, as functional effectiveness of collateral circulation in postocclusive states depends also on the state of the whole cerebrovascular system, then on the speed of creation of occlusion (thrombosis or embolism), systemic arterial pressure, volume and viscosity of the blood.

Arterial Occlusive Diseases↗

PubMed2004

The significance of the extracranial-intracranial anastomoses of carotid system in occlusion of internal carotid artery.

The existence of collateral circulation in patients with impaired intracranial circulation was studied. We analysed angiograms of 35 patients of the Neurology Clinic of Clinical Centre in Sarajevo with occlusion of internal carotid artery. In majority cases collateral circulation was not established. In patients with occlusion of internal carotid artery, extracranial-intracranial anastomoses were established in some cases, with results of surviving and patients recovery. Collateral circulation based on blood vessels which are formed in the early stages of fetal life. Some embryonal arteries undergo an involution process, while the other part of blood vessels stay unfunctional during life, until cerebrovascular disease appearence, when it comes to their activation. Establishing of the collateral circulation in post-occlusiv status depend on great number of factors: number of anastomoses, their calibre,velocity of occlusion and complete vascular status of patients.

Arterial Occlusive Diseases↗

PubMed2003

Anatomical-clinical investigations of variations of the human coronary arteries.

Variations of the human coronary arteries have always attracted the attention of many researchers. A review of the literature shows that variations can cause ischemic heart disease or sudden cardiac death. The aim of the investigations was to examine the existence and clinical significance of variations of the human coronary arteries. Special attention has been focused on myocardial bridging of the coronary arteries and coronary arteriovenous fistula. Our investigations were carried out on the human hearts at the Department of Anatomy and on patients at the Cardiology Department of University Clinical Centre in Sarajevo. Using the method of dissection and coronary angiography we established the existence of variations of the coronary arteries (variations of origin, distribution) on the human hearts without macroscopic visible changes as well as on patients with ischemic changes (angina pectoris, myocardial infarction, congenital cardiovascular malformation etc.). We established the higher incidence of ischemic changes on patients with variations of coronary arteries.

Journal Article↗

PubMed2003

The principles of telemedicine in practice.

Telemedicine (distance medicine) represents a field of medicine that has been in a tremendous expansion over the last couple of years thanks to the fast development of telecommunications and reduction of their costs. It enables a direct communication (visual) between the peripheral hospitals and referral facilities in the interior of the country as well as a connection of centres with referral centres abroad in the fields of diagnostics, consultations or education. The main objective is to encourage interest in telemedicine among physicians and other health care experts, initiate an exchange of opinions, and experience about the application of telecommunication technology in medicine, so to reach a common perception of its role in the context of future development of the health care system in Bosnia and Herzegovina. As a standard, current equipment consists of computers, which are equipped with frame grabbers and communication modem for communication through a public telecommunication system. Input data can all be visual data (X-Ray, CT, MRI, ultrasound, ECG, histological finding, cariogram, and of course photos of the patients, of operational/surgical field. The Institute of Pathology of the Sarajevo Medical Faculty has actively participated in the experimental project "SHARED" (1996-2000) together with the Radiology and Ophthalmology Clinic of the Sarajevo Clinical Centre. The past experience in using telemedicine has shown that the introduction of such a telemedicine system in B&H would be of great significance in the future in the context of providing better and more efficient health services to the patients. In practice, that means a more simple approach to some services and data for patients, a better and faster circulation of information and experience of medical experts and health care workers with cost control at the same time.

Journal Article↗

PubMed2003

Computed tomography review of the osseous structures of the orbital apex.

In this paper, we described osseous anatomy of the orbital apex using CT in axial and coronal projections. The main osseous landmarks facilitate the evaluation of orbital apex in radiology, especially on the axial and coronal CT scans. These landmarks include so called optic strut, small segment of the greater wing of the sphenoid bone and upper part of the pterygopalatine fossa. We also concentrate attention upon visualisation and review of the optic canal, superior and inferior orbital fissure, pterygopalatine fossa and foramen rotundum.

Journal Article↗

PubMed2003

Experimental design--basic considerations.

Experimental design is a critically important tool for improving the performance of a manufacturing process. It has also extensive application in the development of new processes. It is important to investigate all factors that may be of importance and to not be overly influenced by past experience, particularly when we are in the early stages of experimentation or when the process is not very mature.

Journal Article↗

PubMed2003

Observing of the asymmetry of hippocampal formation on patients with complex partial attacks.

Lobus limbicus is anatomical basis for explaining the temporal epilepsy because it not only includes the focus of infection of temporal lobe but also the frontal lobe, and with it we can explain many of the phenomenon's of the epilepsy (hallucinations, the change of the effects, and so on.). The goal of this assignment was to explore the asymmetry of hippocampal formation on the patients with complex partial attacks. The results show that the least number of patients with epilepsy have a symmetric (same) size of the hippocampal formation both from the left and the right side. The number is statistically significantly lower than the number of patients with epilepsy who has asymmetric (different size) hippocampal formation both from the left and the right side. By the direction of asymmetry the difference in the number of patients with epilepsy isn't statistically significant. Coefficient. of asymmetry shows that the asymmetry on the left side is more common to men, while it is distributed evenly on sides, left and right in women. Testing of significance in age differences depends on the sim./asim. of the hippocampal formation of both the right and the left side of coronal slice is a statistical significance. While with axial and sagittal slices, we have a statistical significance between a women and a man on the level of the course of asymmetry. So, the use of MRI technique in examining asymmetry of the hippocampal formation, that we used on this asymmetry, we suggest it as an template of future examinations in a sense of shedding light of the anatomical functions that is located on the basis of neuropsychiatrics dysfunctions.

Journal Article↗

PubMed2003

[Variation in the flow and branching of the anterior and middle cerebral arteries].

We used injection and corrosion method to study path, caliber and branching of anterior and middle cerebral artery, which supplies anterior two thirds of medial and external surface of cerebral hemispheres and associated subcortical structures. When we studied our specimens, we observed that internal carotid artery always bifurcates and gives anterior and middle cerebral artery. Precommunicant segment of anterior cerebral artery has variable appearance. In 65 percent this path of anterior cerebral artery is arch shaped with convexity laterally and forward, but in 44 percent it is straight and oblique in direction. We observer that in 1 percent of cases precommunicant segment of anterior cerebral artery has wavey path. In one percent of the cases anterior third of pericallosal artery is branching from anterior communicating artery. This third pericallosal artery is smaller than the other pair of pericallosal arteries branching from anterior cerebral artery. Initial segment of middle cerebral artery(pars sphenoidalis) is 2.5 cm long. In 70 percent of cases terminal part of sphenidal segment of middle cerebral artery bifurcates, in 30 percent of cases we studied this segment trifucates. Insular segment of the middle cerebral artery branches into several segments which are narrower. When we studied our specimens we found one rare variation branching from middle cerebral artery where it bifurcated into anterior smaller and posterior larger branch, than they divide into multiple smaller branches in periinsular segment.

Anterior Cerebral Artery↗