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I Milović

Publications and source records attributed to I Milović.

At least 19 recordsLinked to original sources
PubMed2003

[The characteristics of mediastinal neuroblastoma and perspectives on surgical excision].

Thoracic (mediastinal) neuroblastomas (NB) have been reported to differ from abdominal (suprarenal and retroperitoneal) NB and to be associated with better prognosis. The comparison between them is rarely published. In this retrospective study, the characteristics of thoracic NB (17 cases) are investigated and compared with abdominal NB (51 cases). Regarding the diagnosis, thoracic NB presented in lower clinical stages I and II in 35.3% of cases, compared to 11.7% of abdominal NB in stages I and II (p<0.001). The disease was initially diagnosed at less than one year of age in 7/17 (41.2%) of thoracic NB and in 12/51 (23.5%) in abdominal cases (p<0.001). The median age at the time of initial diagnosis was 15.3 months for thoracic NB and 27.6 months for abdominal neuroblastoma (p<0.05). The cases with an elevated vanillylmandelic acid (VMA) and homovanyillic acid (HVA) excretion were 9/17 (52.9%) in the mediastinal NB, and 43/51 (84.3%) in the abdominal NB, respectively (p<0.05). The quantitative values of tumour markers were significantly lower in thoracic NB (0.85 vs. 2.14, p<0.001). Regarding surgery, complete tumour resection was achieved in 15/17 thoracic NB (88.2%) compared to 36/51 (70.6%) radicality in abdominal NB. Surgical complications developed in 5/17 thoracic procedures (29.4%) without a lethal outcome. The mean tumour mass of thoracic NB was 56.5 g vs. 106.3 g of abdominal neuroblastoma (p<0.001). The incidence of ganglioneuroblastoma in mediastinal tumours was 3/17 (17.6%) compared to 8/51 (15.7%) in abdominal NB (non significant). A favorable histology based on Shimada classification was found in 37% of the mediastinal neuroblastoma cases and in 22% in the abdominal NB cases (p<0.05). Regarding the biological properties, genetic malformations associated with NB were identified in 2 thoracic cases (1p deletion and polyploidy). Genetic changes were identified in 12 cases of abdominal NB (1p deletion in 4 cases, DNA ploidy in 6 cases, N-myc amplification in 1 case). One additional abdominal NB had 1p deletion, DNA ploidy and N-myc amplification. This study supports results of other investigations that thoracic NB differs significantly in many aspects from abdominal NB. Important differences in favorable histology and biological properties of thoracic NB have changed the concept of surgical treatment, although unnecessary attempts of surgical radicality still lead to serious complications. Complete excision remains the mainstay of therapy of localised thoracic NB, while in most abdominal tumours the aim of an initial operation should be sampling of tumour tissue for histology and molecular biological examination, with complete excision of the mass as the second priority.

Abdominal Neoplasms↗
PubMed1990

[The effect of the age of the child at the time of surgery for pectus excavatum on respiratory function and anthropometric parameters of the thorax].

Respiratory function and anthropometric parameters of the chest were studied in two groups of children aged 15, undergoing pectus excavatum repair before and after the age of 12, respectively. Mean values of static and dynamic functional respiratory parameters were significantly lower in children operated before the age of 12. Sagital diameters of the chest determined at the level of sternal angle and costal arch intersection were significantly shorter in children operated before the age of 12. Restricted respiratory motility of the chest and shorter sagital diameters are very likely caused by the damage of active ossification centers in the sternum of children. The results support the indications for pectus excavatum repair beyond the age of 12.

Adolescent↗
PubMedDate not supplied

[A congenital lung cyst in a child with clinical manifestations after a 7-year latent period].

Congenital cysts of the lung originate from embryological malformation of the lung bud and usually produce clinical signs in the first months of life by expansion, causing respiratory distress, or by infection through its bronchial communication. We report a rare case of solitary congenital lung cyst in the middle lobe which was diagnosed in the 3rd month of life and remained silent until the 7th year when tension pneumothorax developed from rupture of the rapidly expanding cyst. An urgent lobectomy of the involved lobe was performed. This rare case supports the attitude that every congenital cyst of the lung should be excised as soon as the correct diagnosis is established in order to prevent serious complications.

Child↗
PubMedDate not supplied

[Surgical and nonsurgical therapy of malleolar fractures].

Subjective and objective parameters after the treatment of malleolar fractures were studied in 116 patients during a five-year-period. Nonoperative treatment was used in 48 patients and 68 patients were operated. Nonoperative treatment was successful in both supination-eversion and supination-adduction types of fractures, whereas in pronation fractures the operative treatment provided better results. The results were significantly influenced by residual lateral shortening, altered talocrural angle, talar subluxation and the size of posterior fragment. In all types of fractures but in supination-adduction type anatomical reduction and clinical findings correlated. Subjective results are sometimes influenced by factors which cannot be visualized on radiographies.

Adolescent↗
PubMedDate not supplied

[Spontaneous evolution of pectus excavatum deformity in children: a five-year prospective study].

UNLABELLED: The pathophysiologic effects of pectus excavatum (PE) are controversial. Impaired respiratory performance during exercise is minimal and several studies evaluating cardiovascular function have shown conflicting results. There is no evidence that impaired cardiopulmonary performance, if any, is improved by surgical correction of the deformity. Spontaneous improvement or even disappearance of the deformity have been observed, but not extensively studied. AIM OF THE STUDY: The aim of the present study was to evaluate the spontaneous evolution of PE during the growth period (age 11 to 15 years), as well as the aesthetic component of the deformity based upon the judgment of the subjects, in connection with the evolution of PE and its depth. METHOD: A prospective study included 52 boys who were followed-up on a yearly basis (the first examination at the age of 11, the last at the age of 15 years). Two sagittal diameters of the chest were measured: the first at the deepest point of PE, the second over the flexible metal ruler in order to determine the hypothetic chest diameter without depresion. Index of the deformity was calculated by dividing the diameters and multiplying the result by 100. All results are expressed as mean +/- SD. Comparison of initial and follow-up studies for the same individual were compared with the paired t-test. RESULTS: Statistically significant improvement of the deformity (p<0.05) was observed in 35 subjects and differences between yearly measurements were not significant. In 17 boys the depression deteriorated significantly after five years (p<0.02). The differences between yearly measurements were not significant, except between years 12 and 13. At the age of fifteen, 38.5 per cent of children were satisfied with the appearance of the chest and 61.5 per cent were unsatisfied. The self-perception was not correlated to either spontaneous improvement or deterioration, or the depth of depression. DISCUSSION: In spite of numerous studies, pathophysiologic effects of PE and postoperative results are still a matter of controversy. The others believe that psychologic problems are the only indication for surgery, but spontaneous evolution of PE and its psychologic effects have not been extensively studied. The present study demonstrated unpredictable evolution of the deformity ant its complex impact on the psychology of children in puberty, the facts to be considered when contemplating surgery.

Adolescent↗
PubMedDate not supplied

[Changes in etiologic factors, anatomic distribution and age in children with bronchiectasis].

Changing aetiology, anatomic distribution and age of 62 children with bronchiectasis undergoing lobectomy between 1979 and 1987, were analysed. Postpneumonic bronchiectases were found in about 50% of cases during several years of observed 9-years' period. There was significant increase of bronchiectasis due to the documented congenital malformations of the lungs according to the exact diagnosis of intrapulmonary congenital lesions (congenital cystic disease of the lungs, bronchial and vascular abnormalities). Bronchiectases have been diagnosed and surgically treated in very young children lately; mean age at the time of surgery decreased from 7.1 years in 1979. to 5.2 years in 1987.

Age Factors↗
PubMedDate not supplied

[Polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes: the POEMS syndrome].

We present a case of an unusual multi-systematic disorder whose cardinal signs were severe progressive sensorimotor polyneuropathy, hepatomegaly, endocrinopathy, plasma cell dyscrasia with osteosclerotic bone lesions and M-protein production as well as skin lesions (termed POEMS Syndrome) whose pathophysiology is still unknown, as well as its relationship with myeloma multiplex. The patient, 67 years old, had a history of progressive weakness and numbness of the lower legs, clinically revealed as sensomotor polyneuropathy, hepatomegaly, IgG lambda monoclonal protein in the serum, endocrine abnormalities and skin lesions. The final and definite diagnosis was established by open, surgical biopsy of the second lumbal vertebra.

Aged↗