PubMed Health⌕ Search

Biomedical subjects

M Ignjatović

Publications and source records attributed to M Ignjatović.

At least 19 recordsLinked to original sources
PubMed2003

[Overview of the history of thyroid surgery].

Thyroid gland surgery passed through history from the suggestions for prohibition, during middle of XIX century due to unacceptable mortality even for medieval condition, to highest vel of surgical laser, as W. Halsted sad. First thyroidectomy was done by Albucasis (El Zahrawi) in 925 a.d. and after him by Roger from Salerno. While Pierre-Joseph Dusalt in 1791 has done first operation on thyroid gland than can fulfill todays criteria, Teodor Billroth gave scientific grounds of thyroid surgery. Genius attitude and surgical talent of Theodor Kocher raised thyroid surgery o scientific level, brought surgical skills on the top of surgical art pyramid, and brought him personally to the Nobel Prize in 1909. Every important contribution to development of thyroid surgery gave its giants: Johann von Mikulic, William Halsted, Charles Mayo, George W. Crile and Rank Lahey. Thomas P. Dunhill, F.A. Coller, A.M. Boydena and many others did important contribution, too. Development of thyroid srugery was constant to nowadays, with tendention for multidisciplinary approach in specialized centres. Thyroid surgery in Serbia followed this world trends, in spite of treat problems in the area during history.

General Surgery↗
PubMed2003

[Papillary carcinoma of the thyroid in intrathoracic goiter].

Intrathoracic goiter (more than 80% of tissue in the thoracic cavity) represents very rare clinical entity (less than 1% of total number of thyroid gland surgical procedures). Cancer incidence in these goiter is 0-5%. The aim of this article is to present a case report of intrathoracic thyroid papillary carcinoma with multiple compressive syndrome and review of compressive intrathoracic syndrome of thyroid etiology. In our patient we have found: tracheal and oesophageal deviation and compression, superior vena cava syndrome, downhill varices, chylothorax, pericardial effusion, compress of the left a. subclavia, unilateral lesion of recurrent and phrenic nerve, and brachial plexopathy. This was a unique case with multiple compressive syndrome between 3000 patients surgically treated for all kinds of thyroid diseases. Intrathoracic goiter can cause all the known symptoms and syndromes of intrathoracic compression with possibility of rapid deterioration and fatal end.

Carcinoma, Papillary↗
PubMed2003

[Papillary microcarcinoma of the thyroid and secondary hyperparathyroidism in a patient on hemodialysis].

Association between non-medullary thyroid carcinoma and secondary hyperparathyroidism have been rarely reported in patients with renal failure. A few cases of micropapillary thyroid carcinoma have been reported in patients before and after renal transplantation. We present a case of incidental detection of thyroid carcinoma at the time of parathyroidectomy in patient on dialysis after cadaver renal transplantation.

Carcinoma, Papillary↗
PubMed2003

[Early complications in surgical treatment of thyroid diseases: analysis of 2100 patients].

Thyroid gland surgery today is not saddled with high incidence of main complications. Miscellaneous surgical institutions with different surgical approach, operative technique and radicality have published reports with great discrepancy in incidence of complications, analyzing them with different methods of diagnosis and result evaluation. In the same way it is well known that higher latitude of operative procedure gave better control of thyroid diseases, but it can be accompanied with more complications. All of that motivate us to analyze complications of operative treatment in our patients under well known criteria, with hypothesis that higher radicality of operative procedure do not increase incidence of complications, and that this incidence is in correlations with results published in world literature. Aim of this nonrandomized study was to analyze results of operative treatment for huge number of consecutively operated patients in our teaching hospital, to analyze and compare results according to group of diseases and operative procedures, and to compare final results with results published in the world literature. Complications of operative treatment were analyzed retrospectively for period 1988-1997 (Group I) and prospectively in period 1998-2002 (Group II). Operations were performed by 20 surgeons and 20 young surgeons during their education. We have analyzed only complications during first 30 days after operation. In Group I there was 1425 patients with 1451 operations (192 thyroid malignancies, 247 hyperthyreosis, 98 reoperations, 13% thyroidectomies and 14.8% lobectomies), with complication rate of 14.3%. Most common complication was recurrent laryngeal nerve injury in 9.3% patients or 6.3% according to number of exposed nerves (nerve at risk), then postoperative hypocalcemia with rate of 4.7% (persistent in 1.3%). In Group II in 675 patients there was 687 operations (96 thyroid malignancies, 111 hyperthyreosis, 35 reoperations, 36.6% thyreoidectomies and 25% lobectomies), with complication rate of 10.7%. Most common postoperative complication was hypocalcemia with 5% rate (persistent in 0.7%), then recurrent laryngeal nerve injury in 4.4% patients or 2.9% according to number of exposed nerves. Incidence of recurrent laryngeal nerve injury in Group II is less frequent than in Group I, highly statistically significant (p < 0.01), while for other complications there is no statistically significant difference. Totally for both groups there was 0.7% tracheotomies, postoperative bleeding in 1.1% of patients, wound hemathoma in 0.5%. wound infections in 0.9%, pneumonia in 0.5%, mortality 0.5% and most common cause of death (8/11) was problem with respiration, Airway obstruction. In Group II complications were less frequent in total thyroidectomies in relation to lobectomy with contra lateral subtotal lobectomy. In both groups and totally incidence of complications was higher in reoperations, in patients with more extensive operative procedure, in malignant diseases and hyperthyreosis. In thyroid gland surgery more extensive operative treatment with improved operative technique (micro dissection, recurrent laryngeal nerve visualization and parathyroid gland preservation), in our teaching hospital, do not have influence on incidence of postoperative complications, even recurrent laryngeal nerve injury was significantly less frequent. This results are in correlation with published results of similar hospitals around the world.

Adolescent↗
PubMed2002

Intrathoracic goiter: analysis of 21 cases.

UNLABELLED: Goiters are classified into: the cervical, retrosternal, substernal and intrathoracic. The aim of research is to analysis of intrathoracic goiters (ITG) which include goiters with more than 80% of tissue in the thoracic cavity and intrathoracic thyroid choristomas. METHODS: In prospective non-randomized study were analyzed 21 consecutive patients operated on for intrathoracic non-toxic benign goiters from 1987-98. Fourteen patients with intrathoracic goiters (more than 80% of tissue in the thoracic cavity) and seven patients with intratoracic choristomas were operated. Two groups of ITG were observed according to the expressed symptomatology and surgical approach and complications of operative treatment were compared to the complications of operative treatment of 986 non-ITG non-toxic benign goiters. RESULTS: ITG represented 1.1% of the whole number of operatively treated thyroid diseases. One third of patients were asymptomatic. Commonly observed symptoms were dispnea, stridor and dysphagia and there was no significant difference in appearance of these symptoms between the two groups of ITG. In 19% of patients correct preoperative diagnosis wasn't assessed. Cervical approach with sternothomy was used in 11 patients, cervical approach with right thoracotomy in seven, right thoracotomy only in two, and cervical approach only in one patient. Thoracic approach was used in 95% of cases and there was no significant difference between the two groups of ITG. Concerning the operative complications, in two patients transient vocal cord paresis and in one patient postoperative bleeding were verified. There was no statistically significant deference in frequency of operative complications between ITG and non-ITG. CONCLUSIONS: ITG are rare, but might present a difficult diagnostic and complex surgical problem. Common clinical presentation and identical surgical approach in operative treatment justify the common review of the two groups of intrathoracic goiters. With adequate and timely performed surgical approach, in specialized institutions, frequency of complications in operative treatment of ITG is not higher if compared to operative treatment of non-ITG.

Aged↗
PubMed2001

[Total intravenous anesthesia using remifentanil and propofol with midazolam co-induction in laparoscopic surgery of the gallbladder].

We investigated effects of total intravenous anesthesia (TIVA) with propofol and remifentanil (in two parallel continuous infusions), on 28 ASA I-II patients undergoing laparoscopic cholecystectomy. All patients received midazolame (0.05 mg/kg b.w.), and 90 sec thereafter, remifentanil (0.5 g/kg b.w.). Computer controlled intravenous infusion of propofol started at dose of 6 mg/kg/h (by Graseby 3400 Syringe Pump). Muscle relaxation was achieved by rocuronium (0.6 mg/kg b.w.). After endotracheal intubation, rate of propofol was decreased on 3 mg/kg/h and started with another infusion of remifentanil (0.5 ug/kg/min). Before (T0) and after induction (T1), after start of surgery (T2), and at the end of surgery (T3), we evaluated: systolic, diastolic, and medial arterial blood pressure (SAP, DAP, MAP), heart rate (HR), peripheral saturation of O2 (O2Sat), and capnometry (ETCO2), by Datex-Engstrome AS/3 Monitore. It was followed side effects of anaesthesia, early and complete recovery rate, and frequency of nausea and vomiting in postoperative period. Results showed haemodynamic stability of patients after induction in anaesthesia (defined as decreasing of MAP 20%, compared with preinduction values). During investigation (T0-T3), results of 0.2Sat and ETCO2 were excellent (0.60 +/- 2 and 5.1 +/- 2.4 min). There wasonly one case of postoperative nausea and vomiting, and no significant side effects of anaesthesia. TIVA remifentanil-propofol and co-induction with midazolame makes possible haemodynamic stability of patients after induction in anaesthesia, good oxygenation during surgery, fast early and complete recovery, and avoiding of side effects of anaesthesia and postoperative nausea and vomiting. We concluded that it is a good choice of anaesthesia for laparoscopic cholecystectomy.

Adult↗
PubMed2001

[Mesothelial cyst and cystic mesothelioma of the greater omentum:case report and literature review].

Mesothelial cysts and cystic mesotheliomas of the greater omentum are very rare clinical entities. About 30 cases of mesothelial cysts and only 4 cases of cystic mesotheliomas were described in the world literature so far. Over 13 years period (1987-2000), between 15,000 laparotomised adult patients, we have diagnosed one case of mesothelial cyst and one of cystic mesothelioma only. Mesothelial cyst, 7 cm in diameter, covered by regular mesothelial cells, was found accidently during gaster cancer surgery. In a 78 years old man, 30 cm in diameter cystic mesothelioma was diagnosed with immunohistochemical studies, necessarily for differentiation between cystic mesothelioma and other peritoneal cysts. Due to possible aggressive course at the diseases and tendency to recurrency, a complete surgical excision and log term follow-up are necessary.

Aged↗
PubMed2001

Early angiogenic capabilities of the transposed omental flap after omentomyelopexy.

Abundant in blood and lymph vessels, capable to adhere to the surface of every lesion, with capillary overgrowing in 4-6 hours, omentum represents almost very suitable organ for revascularization of the ishaemic nervous tissue. Angiographic study of the omentum, especially of the surgically developed omental flap have been rarely performed in clinical practice. The aim of this study was evaluate the angiographic features of the omental flaps after omentomyelopexy. Omentomyelopexy based on the left gastroepiploic vessels was performed in 100 patients of different levels spinal cord injuries. In order to study the omental flap's vascularization, selective angiography of the splenic artery was performed in three patients at the 10th postoperative day. In one patient, angiographic finding showed the establishment of anastomosis between omental flap's arteries and vertebral and spinal artery and in that way, almost incredible angiogenic capabilities of omentum have been proved. Besides confirmation of vitality and good vascularization of the extraperitonealy transposed omental flap, an extraordinary angiogenic capabilities of the omentum have been proved as early as at the 10th postoperative day. To our best knowledge the angiographic findings of this kind have not been published so far.

Angiography↗
PubMed2000

[Surgical treatment of rare anatomic variations and anomalies of the thyroid gland].

Choristoma and thyroid gland malpositions are embryonal disorders. The aim of this article is ten years analysis of their diagnostic and operative treatment. In 1425 thyroidectomies we have found: one lingual, intratracheal, intracardial thyroid and ovarial struma; six separated intrathoracic goitre and 10 mostly intrathoracaly (80%) situated goitre; 1.4% out of all. Correct preoperative diagnosis we have in lingual thyroid, two intrathoracal thyroid and in all mostly intrathoracal thyroids, and in others after histopathological examination. Operative approach was: collar incision with medial sternotomy in nine, collar incision with lateral thoracotomy in three, right thoracotomy in two, and only collar incision in one. There were two operative complications, one recurrent nerve lesion and one mediastinal haematoma. There was no hypocalcaemia and mortality. Thyroid gland anomalies are very rare and associated with lot of problems in diagnostic and treatment. In specialised institutions frequency of operative complications is the same like in routine thyroid gland surgery.

Choristoma↗
PubMed1999

[Necrosis of the omental flap].

The aim of this research is to review the frequency of the omental flap necrosis comparing the vascularized omental flaps based on the left or right gastroepiploic vessels. The first 100 patients, with injuries of spinal cord on different levels, are included in this prospective clinical study with follow-up from 12 to 24 months. The special surgical technique was used for preparation of omental pedicled graft, for its lengthening and transposition to the level of the spinal cord injury and direct and indirect signs of the omental flap necrosis were studied. In our patients there was no necrosis of the omental grafts based on the left gastroepiploic artery. The insufficiency of the left gastroepiploic artery was not present in any patient and so it was not the reason of the omental flap necrosis. Devascularisation of the great gastric curvature until to the root of the left gastroepiploic artery, administration of the prophylactic doses of the Heparin and to put gently pressure on the omental flap do not contribute to the appearance of the omental flap necrosis. Based on our experiences and on results of this research we conclude that this way of forming the omental graft can be used for the other omentopexies.

Adolescent↗
PubMed1991

Urinary tract tumors and Balkan nephropathy in the South Morava River basin.

The aim of this investigation was to study the frequency of urinary tract tumors (UTT) in settlements around the South Morava River and its tributaries where Balkan nephropathy is endemic. For this purpose 659 surgery and autopsy records of patients with UTT were reviewed. The records came from 25 counties and 1279 settlements classified as endemic, hypoendemic and nonendemic. Upper tract urothelial, urinary bladder and kidney tumors were included in the evaluation. A highly significant geographic correlation between Balkan nephropathy and UTT localized in renal pelvis and ureter was noted in the South Morava River valley. These tumors were 57 and 61.8 times more frequent in endemic settlements than in control rural and city populations free of Balkan nephropathy. The frequency of urinary bladder tumors in endemic settlements was also increased compared with the nonendemic villages and large cities, up to 11.9 and 8.5 times, respectively. In endemic settlements, upper urinary tract tumors were five times and tumors of urinary bladder were seven times more frequent in families with Balkan nephropathy than in those without, and up to 224 times more frequent than in the city families. Familial clustering of UTT was also noted. The geographic correlation between Balkan nephropathy and UTT supports the speculation that these disorders share a common etiology.

Aged↗
PubMed1988

A case of monosomy 21.

A new case of monosomy 21 was observed in a newborn male. Characteristic clinical features include: an antimongoloid eye slants, large and low set ears, flat nose bridge, hypoplastic nipples, cardiac anomalies, muscular hypotonia, retarded psychomotor development. The karyotypes of the parents were normal.

Chromosome Banding↗