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Biomedical subjects

M Djordjevic

Publications and source records attributed to M Djordjevic.

At least 19 recordsLinked to original sources
PubMed1997

Natural erection induced by prostaglandin-E1 in the diagnosis and treatment of congenital penile anomalies.

OBJECTIVE: To report the use of a natural erection induced by prostaglandin EI (PGE1) in the diagnosis and therapy of congenital penile anomalies as an alternative to artificial erection. PATIENTS AND METHODS: From February 1991 to December 1995 a natural erection was induced in 672 patients (mean age 5.7 years, range 12 months-47 years) to diagnose and treat congenital anomalies, e.g. simple penile curvature, chordee with and without hypospadias, epispadias, micropenis, cripple penis, etc. The dose injected intracavernosally was dependent on the patient's age, penile size and response, and ranged from 0.5 to 15 micrograms. RESULTS: A natural dilatation of erectile tissue was achieved in all forms of penile anomalies except in seven patients who did not respond. The mean duration of erection was 80 min, but a prolonged erection, for up to 6 h, occurred in two patients. CONCLUSION: The natural erection achieved by injecting PGE1 into the corpora cavernosa is a useful alternative to artificial erection in the diagnosis and treatment of congenital penile anomalies.

Adolescent↗
PubMed1996

Peritoneo-vulvar catheter extrusion after shunt operation.

We report an unusual case of catheter extrusion through the external genitalia. between the labium majus and the labium minus, in a 6-month-old hydrocephalic baby. The event occurred 5 months after placement of a ventriculoperitoneal shunt.

Cerebrospinal Fluid Shunts↗
PubMed1993

[Coronary occlusive disease and carotid stenosis].

In around 2.5% of patients with coronary artery diseases (CAOD), considerably occlusive changes in carotid arteries were also registered at the same time. In the period from March 1982 to February 15, 1993, at the University Clinic of Cardiovascular surgery in Novi Sad, a total of 5,701 patients underwent aortocoronary by-pass (ACBG). In 137 (2.4%) patients an additionally endarterectomy of carotid arteries (EAC) were also performed. Bad left ventricle function (EF < 30%) was registered in 30 pts (22%). Endarterectomy on one or more arteries had to be performed in 45% patients because diffuse and distal occlusive changes. Two stage operations were performed in 62 cases. Three stages operations (bilat. EAC) in 24 and simultaneous in 51. Operative mortality (30 days) was registered in 5 (3%) pts. Neurologic deficit (ND) happened in two (1.4%) pts, TIA in 3 pt (2.2%). Comparing our results in simultaneous and stage procedure, operative risk is higher in simultaneous operations, and only in case of unstable angina we prefer simultaneous operations.

Arterial Occlusive Diseases↗
PubMed1991

Epidural lead fracture caused by material processing fault.

Fracture of the epidural lead (Pisces Quad 3487) is documented in four out of eight patients with an implanted Itrel pacing system for treatment of peripheral vascular disease. In two patients, lead fracture was established during x-ray fluoroscopy. In the remaining two patients, x-ray examination did not reveal any fracture, due to proximity of the fragments. Microscopic examination of the extracted lead, however, confirmed lead fracture, as well as the presence of tissue fluid and thrombus between the two ends of the spiral shaped lead, but no insulation defect was observed. A cross-sectional area on the fracture line of the broken lead was examined using scanning electron microscopy. It was found, by tracing the radial marks to their point of convergence, that the initial microcrack started from a large inclusion of the calcium-silicon type at the lead surface. The initial microcrack was propagated by the fatigue mechanism. The presence of a large inclusion at the surface suggests that the main cause of the failure of the investigated epidural leads could be improper fabrication of the material. The high incidence of epidural lead fracture in our group suggests that this complication should be considered as a possible cause of epidural spinal electrical stimulation pacing system dysfunction.

Adult↗
PubMed1991

The etiology of syncope in pacemaker patients.

A total of 46 patients with syncopal episodes after VVI pacemaker implantation were studied. Of these, 92% had one to three syncopal episodes and 8% more than three. All underwent a thorough clinical examination, which included chest X ray, echocardiogram, neurological exam, and the following protocol: 24-hour Holter monitoring, EEG, blood pressure (BP) measurement in three positions, Doppler exam of the carotid vessels, fasting blood glucose, and head-up tilt table test (60 minutes, 60 degrees). Holter monitoring showed exit block in two patients (4.3%) and failed sensing in one (2.1%). In two patients there was unilateral slowing on EEG. Orthostatic hypotension was found in four patients (8.6%), and hypoglycemia in three insulin-dependent diabetics. An occlusive atherosclerotic plaque in the carotid artery was found in three patients (6.5%). Syncope was induced in 17 patients (36.9%) by the tilt table test, after a mean standing time of 47 +/- 11 minutes. The mean resting systolic BP of these patients was 140 +/- 24 mmHg, and fell to a mean level of 56 +/- 8 mmHg (mean systolic BP drop was 79 +/- 8 mmHg). Sixteen of these 17 patients with positive tilt table were being paced at the time of syncope and one had a spontaneous heart rate of 73 beats/min. In 14 cases (30.4%) the cause of syncopal episodes after this extensive workup remained unexplained. These results indicate that pacemaker dysfunction is not a major cause of syncopal episodes in pacemaker patients and that these are most often due to vasovagal syncope. Long-term follow-up is warranted to determine the prognostic significance of various types of syncope in pacemaker patients.

Blood Pressure↗
PubMed1989

Circadian variations of heart rate and STIM-T interval: adaptation for nighttime pacing.

In order to determine the optimal pacing rate for pacemaker patients at night, 150 normal subjects with regular sinus rhythm and free of manifest heart disease, were studied using 24-hour Holter monitoring. Minimum and average heart rates were analyzed on an hourly basis. The study group was divided into six age groups, 25 subjects each, ranging from 20-29 years to 60-69 years. The minimum heart rate during the night was found to be lower than 65 ppm for all groups. The youngest subjects showed the largest variation in the minimum heart rate. The results suggest that an automatic lowering of the pacing rate during the night would allow for longer periods of sinus rhythm, thereby improving hemodynamic performance and reducing pacemaker power consumption. Suitable sensors for automatic lowering of the pacing rate include inbuilt 24-hour clock systems and the QT interval that lengthens during sleep.

Adult↗
PubMed1988

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↗
PubMed1986

Target lead--low threshold electrode.

Acute and chronic threshold measurements were compared for three different electrodes: the Medtronic Target Tip model 4011, the Medtronic Ring Tip Model 6971 and the Siemens-Elema Carbon Tip Model 412S. The results of this study show that acute thresholds are lower with the Target Tip lead as compared to the other two. This finding applies to chronic thresholds as well. The results of this study favor programming to lower output energies while maintaining adequate safety margins with this lead system.

Electrodes, Implanted↗
PubMed1976

Hemodynamic effects of venous valves in aorto-coronary bypass grafts.

Use of the saphenous vein in aorto-coronary bypass surgery for treatment of occlusive coronary artery disease is a well-established technique. Use of the mammary artery for the same purpose has also been favorably reported. This study was undertaken to determine whether a vein graft containing a valve would have an added advantage. A comparison of the effect of competent and incompetent valves in vein grafts on the hemodynamics of coronary circulation was made. In a group of 18 dogs, a 5 cm. portion of each dog's cephalic vein containing a valve was used in a single aorto-coronary bypass graft. Flow measurements were made between the valve and the anastomosis of the graft to the left anterior descending coronary artery (LAD). The valve was made temporarily incompetent by the insertion of a spring wire basket, 3.5 mm. in diameter, through the valve via a side branch. The flow of blood through the venous graft with the competent valve was 11.0 +/- 2.6 per cent higher than with the incompetent valve. An analysis of flow patterns showed that this increased flow could be attributed to a reduction of backflow during systole and an increase in forward diastolic flow. Results suggest that postoperative myocardial perfusion is enhanced by the presence of valves in aorto-coronary bypass vein grafts.

Animals↗
PubMedDate not supplied

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↗
PubMedDate not supplied

Cardiac arrest.

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Anesthesia, General↗