Biomedical subjects

J Jakić-Razumović

Publications and source records attributed to J Jakić-Razumović.

At least 19 recordsLinked to original sources

PubMed2003

Extranodal sinus histiocytosis (Rosai-Dorfman disease) of the brain parenchyma.

Rosai-Dorfman Disease (RDD) is an idiopathic histiocytic proliferation affecting lymph nodes. Although extranodal involvement has been reported in diverse sites, manifestation in the central nervous system (CNS) is extremely rare, particularly in the brain parenchyma. A 39-year-old male presented with an isolated well-circumscribed brain mass in the right temporal lobe, preoperatively thought to be a meningioma. Histology and immunohistochemistry confirmed that the lesion was RDD. The intraparenchymal brain location of RDD appears to have a benign course. Although the adjuvant therapy is a treatment of choice, surgical resection seems to be the appropriate treatment modality. From the clinical point of view RDD might be an important intracerebral entity because it may mimic other lesions, particularly other histiocytic disorders.

Adult↗

PubMed2003

Expression of cyclooxygenase-2 in fine-needle aspirates from breast carcinoma and benign breast diseases.

Numerous studies have demonstrated that the levels of cyclooxygenase (COX), the enzyme that catalyzes the conversion of arachidonic acid to prostaglandin H(2), and of prostaglandins are higher in various tumors and cells during inflammation than in normal tissues. The aim of the present study was to analyze whether COX-2 isoform expression was noticeably higher in fine-needle aspirates (FNA) from breast carcinoma than in FNA from fibroadenoma and fibrocystic breast tissue. COX-2 expression was detected by immunocytochemical (IC) staining and was analyzed by microscopic scoring and computer gray-scale analysis. Evaluation of COX-2 IC positivity in FNA from three groups of patients (nine with breast carcinoma, nine with fibroadenoma, eight with fibrocystic breasts) revealed high COX-2 IC positivity in the majority of patients with breast carcinoma and low or absent COX-2 IC positivity in patients with fibrocystic breast changes. In addition, low or medium COX-2 IC positivity was found in the majority of patients with fibroadenoma, only three of these patients having high COX-2 IC positivity.

Adult↗

PubMed2002

Long-term results of conventional-dose salvage chemotherapy in patients with refractory and relapsed Hodgkin's disease (Croatian experience).

BACKGROUND: The aim of this study was to analyze outcome of patients with Hodgkin's disease (HD) in whom first-line chemotherapy with mustine/vincristine/procarbazine/prednisone (MOPP) had failed. PATIENTS AND METHODS: From January 1982 to December 1989 among 210 patients treated with MOPP and radiotherapy to initial bulky sites, 65 patients were primary refractory to or relapsed after initial treatment. RESULTS: Twenty-nine of 65 patients (44%) were primary refractory to initial chemotherapy, 20 relapsed within 12 months after complete remission (CR) and 16 relapsed after CR that lasted more than 12 months. Patients with primary refractory HD and early relapse (<12 months after CR) were treated with doxorubicin/bleomycin/vinblastine/darcarbazine. In patients with late relapse (>12 months after CR) MOPP was repeated. The median follow-up for all patients was 115 months. The overall response rate was 63%. Thirty-three patients (51%) achieved a second CR and eight patients (12%) partial response. Remission rate was greatest in patients with late relapse (CR >12 months) (75 versus 55% for early relapse versus 35% for primary refractory HD) (P <0.01). At 10 years, overall and failure-free survival rates were 21 and 16%, respectively. Patients who were in first remission longer than 12 months had a superior overall survival (37 versus 18% for early relapse) and failure-free survival (24 versus 10% for early relapse). No patient with primary refractory HD was alive beyond 52 months after initial treatment failure (P <0.01). Main prognostic factors were duration of the first remission and tumor bulk at relapse. CONCLUSIONS: Our results confirm previous observations that a significant proportion of patients with HD who experience induction treatment failure cannot be cured with conventional treatment and probably need more aggressive therapy.

Adolescent↗

PubMed2001

Atopic dermatitis: immunophenotyping of inflammatory cells in skin lesions.

BACKGROUND: The ever increasing incidence of atopic dermatitis (AD) has stimulated many researchers to use various diagnostic procedures to obtain new data to help elucidate the pathogenesis of the disease. AIMS: To perform cell immunophenotyping and to analyze the presence of inflammatory cell-surface markers in the biopsies of skin lesions from 15 AD patients and five healthy subjects. METHODS: Immunohistochemical analysis was performed in a group of AD patients and compared with that in a control group of healthy subjects. Avidin-biotin immunoperoxidase staining of paraffin-embedded, 4 microm skin sections, with semiquantitative counting of cells labeled with anti-CD3, anti-CD8, anti-CD20, anti-HLA-DR (HLA, human leukocyte antigen), and anti-immunoglobulin E (anti-IgE) primary antibodies, was used. RESULTS: The results of AD skin analysis showed a greater infiltration of CD3+ lymphocytes, especially of CD4+ subtype, compared with CD8+ lymphocytes. AD skin biopsy specimens also showed a higher intraepidermal HLA-DR+ Langerhans' cell count, the presence of HLA-DR on lymphocytes in the dermis, and higher intraepidermal expression of IgE+ cells compared with healthy controls. CONCLUSIONS: A statistically significant difference (P < 0.05) was found between the two groups for intradermal and intraepidermal CD3, CD4, and HLA-DR, intradermal CD8, and intraepidermal IgE+ cells. Immunophenotyping was found to be a useful diagnostic method in AD patients.

Adolescent↗

PubMed2001

Inflammatory pseudotumor of the trachea.

Primary tracheal tumors are extremely rare, and the majority of them are malignant. Inflammatory pseudotumor is a benign, tumorlike lesion, most likely of a reactive nature. Its basic morphologic characteristic is spindle cell (myoblasts and fibroblasts) proliferation with a variable number and type of inflammatory cells. A case of intratracheal inflammatory pseudotumor in a 14-year-old boy is presented together with a review of all similar lesions in the available literature. The discussion includes the presentation of tracheal tumors, their basic morphologic and immunohistochemical characteristics, and treatment modalities that are available. The surgeon must exercise caution not to perform radical surgery based on the initial pathologic diagnosis from the intraoperative frozen section, because the prognosis of these benign lesions generally is excellent. This is the second reported case of intratracheal inflammatory pseudotumor successfully endoscopically vaporized using a CO(2) laser, which is an excellent alternative in cases in which surgical treatment is feasible. J Pediatr Surg 36:631-634.

Adolescent↗

PubMed2001

Trastuzumab in the treatment of advanced breast cancer: single-center experience.

A significant number of women with advanced breast cancer fail to respond to standard-dose chemotherapy. From the beginning of 1999, 17 women with HER2 positive advanced breast cancer received Herceptin as monotherapy or in combination with paclitaxel or other non-anthracyclines. Eight (47%) women previously received high-dose chemotherapy followed by haematopoiesis stem cell rescue. Three women received Herceptin alone, eleven Herceptin plus paclitaxel and three Herceptin and some of the other non-anthracyclines (CCNU, cisplatin and gemcitabine). In the group of patients who received Herceptin monotherapy, one has partial response (PR), one stable disease (SD) and in the third patient the disease progressed. Out of three patients who received Herceptin in combination with other non-anthracyclines, two have SD and one progressed. In the group of 11 women who received Herceptin + Taxol, 7 (64%) patients achieved PR, 2 (18%) SD, and 2 (18%) had disease progression. Grade 3-4 neutropenia has been observed in four (23%) women. Febrile neutropenia was observed in two cases and resolved completely when antibiotics were introduced. Other grade 3 toxicity that has been noted is peripheral neuropathy in three (18%) patients, diarrhoea in four (23%) and onycholysis in one (6%). Serial heart ultrasound showed no significant decline in left ventricular ejection fraction. According to our preliminary experience, Herceptin therapy showed promising results in women with metastatic breast cancer.

Adult↗

PubMed2001

Comparison of histopathologists' workloads in two pathology departments in Croatia.

AIM: To calculate workloads of Departments of Pathology and staff histopathologists at two Croatian University Hospitals by means of the Suvarna and Kay's Kim Unit (KU) activity index. METHOD: The total number of specimens and KU activity/year were calculated to compare staff pathologists' workload in two Pathology Departments, one at Split and the other at Zagreb University Hospital. The individual specimen types were assigned a difficulty score on a scale of 1-5 units (KUs), depending on the time needed for specimen dissection and macroscopic description, number of sections and stains required, and time spent on microscopy of an "average case". KU activity was calculated for all pathologists individually in terms of histology (1-5 KUs), autopsy (10 KUs), supervision of residents, and outside consultations (2 KUs). RESULTS: According to calculated Kim Unit activity index, pathologists' workload in two investigated pathology departments was not equally spread. In the Split Department of Pathology the distribution of workload was more uniform than in the Zagreb Department of Pathology. The average workload of both institutions was 4,562 KUs. CONCLUSION: KU activity index is a very useful method for assessing average pathologists' workload. It may be also used in hospital administration for predicting changes in service and number of working pathologists.

Biopsy, Needle↗

PubMed2001

Event-related potentials in medical workers with long-term exposure to xylene.

The effects of chronic exposure to xylene on cognitive ability were studied in a group of 35 medical workers occupationally exposed to low-level concentrations of xylene for at least five years by using event-related potentials (ERPs), and compared with a control group of 21 subjects. The exposure to xylene was confirmed through determination of m-methylhippuric acid, a reliable biological indicator of xylene exposure, in pre- and post-shift urine. A dose-effect relationship between log m-methylhippuric acid and ERP log latency (p = 0.032), and the ERP amplitude (p = 0.047) was statistically significant. The group of medical workers showed significantly longer ERP log latency (p < 0.001) than did the control group with respect to factors of exposure to smoking, education and age as covariates. For the ERP amplitude the difference was found not to be significant (p = 0.263), probably due to high between subject variability. The cognitive impairment may occur in workers chronically exposed to xylene.

Adult↗

PubMed2000

Histopathological features of gastritis before and after treatment for Helicobacter pylori.

AIM: To assess five main histological features of gastritis in gastric mucosa colonized with Helicobacter pylori before and after the treatment. METHODS: Histologic assessment of H. pylori-associated gastritis was performed according to the Sydney classification before and after the treatment in 97 patients. Two additional parameters - the presence of lymphocytic aggregates and coccoid forms of bacteria - were also analyzed. Helical and coccoid forms of H. pylori were detected by immunohistochemistry in biopsies after the treatment. RESULTS: Whereas acute epithelial damage was quickly repaired, some of the local responses to bacteria, e.g., lymphoid aggregates and intestinal metaplasia, persisted after treatment. Higher H. pylori and cocci density was found before and after treatment in patients with intestinal metaplasia (p=0.020). Correlation between H. pylori and mucosal atrophy was found only after treatment (p=0.009). Immunohistochemical staining was more sensitive in detecting of H. pylori than Giemsa staining (p=0.007) in cases where, using only Giemsa staining, it was not possible to distinguish coccoid forms of H. pylori from other cocci. CONCLUSION: After treatment, H. pylori-associated gastritis showed reduction of acute and chronic inflammation, but lymphoid aggregates and intestinal metaplasia persisted. Immunohistochemistry of different forms of H. pylori may be a valuable technique in monitoring the success of the treatment.

Amoxicillin↗

PubMed1999

Autopsy findings and clinical diagnoses: retrospective study of 3,117 autopsies.

AIM: To determine the extent of agreement between clinical and autopsy findings. METHODS: A 14-year retrospective study (1982-1995) of autopsies from the Departments of Internal Medicine and Surgery was performed at the Zagreb University Hospital Center, Croatia. The autopsy findings were compared with the clinical diagnoses. RESULTS: The autopsy rate among hospital deaths ranged between 23% and 33%. The overall rate of major discrepancies was 11.6% for all autopsy reports. The most common cause of death were cardiovascular diseases (40.9%), followed by malignancies (25.2%) and infections (12.9%). Among all cardiovascular diseases, myocardial infarction was the most frequently diagnosed (17.9%) and was misdiagnosed by clinicians in 16.5% of the cases. Incorrectly diagnosed malignancies were found in only 5.7% of the cases; hematological and lymphoid malignancies (48.8%) were the most common neoplasms and were usually confirmed before death. Infections were found in 46.9% of all autopsies. Bacterial pneumonias and peritonitis were overlooked in 67.5% and 23. 5% of the cases, respectively, in which they existed together with another serious condition. CONCLUSIONS: Modern technology has not improved the overall accuracy of clinical diagnoses. When an autopsy should be performed is still a matter of discussion.

Adolescent↗

PubMed1998

Prognostic significance of cell cycle parameters in infiltrative ductal breast carcinoma.

Flow-cytometric DNA analysis was performed retrospectively from paraffin-embedded blocks in 158 consecutive ductal infiltrative breast carcinoma patients grades I-III. Normal breast tissue was used as control. Tumor proliferative activity, cell ploidy, and DNA index (DI) were related to age of patients, histological grade of tumor, tumor size, axillary lymph node status, estrogen and progesterone receptor status, menopausal status,TNM clinical classification, and survival. There was a significant association between DNA aneuploidy and a high cellular proliferative activity, increased DI, poor differentiation of tumor, primary tumor size, number of positive lymph nodes, and postmenopausal state. Increased proportion of cells in S-phase was associated with positive lymph node status and higher number of positive lymph nodes. The cell cycle parameters had no prognostic value either for overall survival of disease-free survival of the patients.

Adult↗

PubMed1998

Organotypic skin cultures: a human model for basic studies.

AIM: To produce organotypic skin cultures using human skin samples as a source of keratinocytes and fibroblasts. METHODS: Keratinocytes and fibroblasts from human skin samples were separated by warm trypsine and collagenase, respectively. Keratinocytes were plated in tissue culture dishes in keratinocyte serum free medium supplemented with epidermal growth factor and bovine pituitary extract, and were grown until confluence. Fibroblasts were cultured in Dulbecco's medium (DMEM) supplemented with fetal bovine serum and hydrocortisone. A mixture of fibroblasts, rat dermal collagen type I, E tissue culture medium, and reconstitution buffer were used as a dermal equivalent. Keratinocytes were plated on the top of the dermal equivalent and cultured for 10 days in organotypic culture dishes on stainless steel grids in the supplemented DMEM medium. The cultures were fixed in formaline, embedded in paraffin, stained with hematoxylin and eosin, and immunohistochemically stained with a nti-cytokeratin and anti-HLA-DR antibody. RESULTS: Cultured keratinocytes in organotypic skin cultures expressed the majority of the cytokeratins seen in the normal stratified epithelium. Consistent with previous studies, organotypic skin cultures did not show antigen-presenting Langerhans cells. CONCLUSION: Human skin from patients who underwent thoracic surgery can be used to produce organotypic skin cultures. This artificial skin can serve as a basis for future basic science studies and as a skin transplantation model.

Animals↗

PubMed1997

[Copper levels in the tissues of patients with Wilson's disease].

The evaluation of tissue copper concentration is essential for the diagnosis of Wilson's disease. It is characterized by symptoms of the damages to parenchymatous organs, primarily liver and brain, due to chronic copper intoxication. The paper presents the autopsy tissue analysis of a 39-year-old patient diagnosed to suffer from the Wilson's disease while still alive. The patient died from sepsis due to burns caused by direct flame exposure. The standard histochemical staining of tissue samples failed to demonstrate the presence of copper but it was qualitatively proved by line spectrum-based mass spectrography. The copper concentrations in the liver, brain, and kidney (240, 73.8, and 30 micrograms/g wet tissue weight, respectively), measured by flame-atomic absorption spectrometry, were significantly elevated. In this study, the Wilson's disease was verified by a postmortem determination of increased copper concentration in the tissues. The results obtained contribute to the understanding of this rare disease.

Adult↗

PubMed1996

Anxiety as a possible predictor of acute GVHD.

In order to determine the influence of anxiety on the development of BMT complications and survival, we analysed data on 35 consecutive patients undergoing BMT in our Centre between June 1992 and December 1994. All patients received bone marrow from HLA-identical MLC non-responsive siblings. For GVHD prophylaxis, all patients received cyclosporin (CsA) and short methotrexate (MTX). The diagnosis and severity of acute GVHD were defined according to the Seattle Transplant Team criteria. The patients were tested with the Spielberger STAI test as a measure of anxiety as a state (STAI-S) and as a trait (STAI-T). The STAI-S/1 and STAI-T/1 were performed during the first week of isolation (day -5 to day -3 prior BMT) and STAI-S/2 and STAI-T/2 at the end of the discharge from laminar air flow units (day +35 to day +40 post-transplant). During isolation all patients had daily psychiatric support. Out of 35 patients, 31 (89%) fulfilled the STAI-S and STAI-T during the first week and at discharge from laminar air flow isolation. The level of anxiety at the beginning of isolation as measured by STAI-S/1 and STAI-T/1 tests had been significantly higher in patients who subsequently developed acute grade II-IV GVHD as compared to patients with GVHD grade 0-I (P < 0.001), irrespective of age, sex or stage of the disease prior to BMT. In those patients who died, the STAI-S/1, STAI-T/1 and STAI-T/2 tests had been almost identical to those of surviving patients, while STAI-S/2 had been significantly higher (P = 0.034). These data clearly indicate an association between the level of anxiety and the risk for BMT complications, but this should be confirmed in further controlled clinical trials.

Adolescent↗

PubMed1995

An autopsy study of systemic fungal infections in patients with hematologic malignancies.

The aim of this study was to determine the incidence of fungal infections detected on autopsy in a group of 40 patients with hematologic malignancies treated with intensive chemotherapy or bone marrow transplantation, and to evaluate the risk factors for fungal infections. A control group included 38 patients with nonhematologic diseases and without granulocytopenia but with at least one of the known risk factors for fungal infections. Standard histopathological and microbiological methods were used. A higher incidence of invasive fungal infections was found in patients with hematologic malignancies as compared to the control group (p < 0.01). The predominant causes of fungal infections were Candida albicans and Aspergillus spp. The incidence of fungal infections caused by Aspergillus was higher (p < 0.05) in patients with hematologic malignancies than in the control group. The independent risk factors for fungal infections were fungal colonization, number of antibiotics and duration of antibiotic therapy, duration of fever and skin rash. A higher proportion of fungal infections was diagnosed on autopsy than during the patients' life (p < 0.01).

Adolescent↗

PubMed1995

Analysis of renal allograft frozen-sections.

Frozen-section analysis of renal allograft biopsy specimens is performed to permit modification of therapy during acute events in transplanted patients. Over a two-year period, out of 110 renal allograft biopsies 66 were analyzed on a frozen-section. The authors compared diagnoses obtained on a fresh-material frozen-section with those following profound specimen analysis. The accurate diagnosis was achieved in 61 (92.4%) cases, acute rejection being predominant (53 cases). Missdiagnoses referred to oxalosis (1 case), acute rejection (2 cases), acute pyelonephritis (1 case) and cortical infarction (1 case). The authors conclude that a frozen-section analysis is a useful tool in cases requiring fast decision.

Biopsy↗

PubMed1995

AgNORs predictive value of prognosis in non-Hodgkin's lymphoma according to the Kiel classification.

Application of the colloidal silver method for demonstration of argyrophilic proteins of nucleolar organizer regions (AgNORs) in histological sections of non-Hodgkin's lymphomas (NHLs) has been shown to be a helpful method for the discrimination of high- and low-grade NHL. In this study correlation between the mean number of AgNORs and other morphological and clinical parameters with survival in 58 patients with NHL, classified according to the Kiel classification, was investigated. It was shown that the mean number of AgNORs differed between the low- and high-grade group of NHLs (P < 0.001), as did survival (P < 0.0001). The mean number of AgNORs was also highly significant when describing actuarial survival. The value of 2.9 NORs per nuclei was the cut-point for separating the whole group into two subgroups, which differed the most when related to survival of patients with NHL.

Adolescent↗

PubMed1993

Nucleolar organiser regions and survival in patients with non-Hodgkin's lymphomas classified by the working formulation.

AIMS: To correlate the numbers of silver staining nuclear organiser regions (AgNORs) in non-Hodgkin's lymphoma classified by the working formulation with survival, the first complete remission, and the length of remission. METHODS: Sixty one patients were included in the study. Paraffin wax sections were stained using silver solution to visualise nucleolar organiser regions. The AgNORs were counted in 150 nuclei of each specimen. Data were examined using the Kruskal-Wallis test, multivariate discriminant analysis, and Cox's regression test. Curves were calculated by the method of Kaplan and Meier. RESULTS: Most patients who were alive had low grade lymphoma (p < 0.01). The first complete remission was obtained more frequently in the low and intermediate grade groups (p < 0.05). The longest survival was found in the low grade group (p < 0.001). The mean number of AgNORs differed significantly in all three groups (p < 0.001). This was also true for area of nuclei (p < 0.001) and length of remission (p < 0.05). In a multivariate analysis the numbers of AgNORs were highly predictive for survival, remission, and the length of remission. CONCLUSIONS: The numbers of AgNORs correlated with survival, remission, and the length of remission in patients with non-Hodgkin's lymphoma.

Adolescent↗