Biomedical subjects

Marko Bumbasirevic

Publications and source records attributed to Marko Bumbasirevic.

5 recordsLinked to original sources

PubMed2006

Iliopsoas haematoma in Gaucher disease.

Extrapelvis or retroperitoneal haemorrhage has long been appreciated as having many causes and considerable variability in subsequent morbidity; however, to date only two cases have been reported in patients with Gaucher disease, the most common lysosomal storage disorder. It had been our assumption that these cases were unique and a consequence of severe disease in patients who had not been treated with enzyme (or other disease-specific) therapy. Herein we present three more cases (as well as our first patient), which allow one to make some generalizations. Ultrasound was used in one centre and computed tomography in the second centre to make the definitive diagnosis. The trigger for the bleeding in all cases was muscle strain after activity. All patients were young with massive hepatosplenomegaly, anaemia, thrombocytopenia, and bone pain with skeletal involvement; the last was the most obvious commonality among these patients. Differential diagnosis is complicated by exquisite groin pain that is common to both Gaucher disease and extrapelvis haemorrhage, but not necessarily.

Adolescent↗

PubMed2006

Analysis of vasoreactivity of isolated human radial artery.

Radial artery (RA) is increasingly used as graft for coronary artery bypass grafting due to its good long-term patency. However, the mechanism of peri- and post-operative spasm is still unclear. Because of that, the aim of our study is to analyze the contractility of RA and to determine whether the presence of functional endothelium alters its contractile properties. Contractions of isolated RA rings were provoked by exogenously applied vasoconstrictors or by electrical field stimulation (EFS, 20 Hz). The order of vasoconstrictors potency based on their EC50 values was as follows: angiotensin II > phenylephrine > 5-hydroxytriptamine. Presence of endothelium increased both EC50 and maximal contraction to phenylephrine and angiotensin II, but inhibited reactivity of RA to 5-hydroxytriptamine. Spontaneous rhythmic contractions (SRC, <4 mHz) and EFS-induced contractions of RA are endothelium-independent and weaker than contractions induced by exogenously applied vasoconstrictors. Our study concludes that RA shows marked sensitivity and reactivity to angiotensin II, phenylephrine, and 5-hydroxytriptamine. Further investigations are necessary to answer why angiotensin II and phenylepehrine induce stronger contractions in the presence of endothelium. In addition, SRC as well as contractions of neurogenic origin may take part in developing vascular spasm of RA.

Angiotensin II↗

PubMed2006

External fixation of open subtalar dislocation.

Subtalar dislocation is a rare and severe injury, caused by high-energy trauma such as fall from a height or traffic accident. Infection and avascular necrosis are not rare sequelae of open subtalar dislocation, and the outcome may be poor. External fixation allows complete wound care, and moderate distraction of the ankle joint should unload the talus, which may reduce the risk of avascular necrosis. We treated 11 open subtalar dislocations by distractional external fixation. The series involved nine males and two females, of average age 30.39 years. In nine cases the injury was caused by falling from a height, and in two by a traffic accident. The follow-up period ranged from 18 to 28 months. The final functional results were good, with no infection and one case of avascular necrosis of the talus. Pain after a longer period of walking or standing was experienced by eight patients, and movement of the subtalar joint was limited in nine patients. Immediate distractional external fixation of open subtalar dislocation may prevent infection and avascular necrosis of the talus.

Adult↗

PubMed2006

Free fibula and corticocancellous bone grafting for salvage of a war-injured forearm.

The treatment of a complex forearm injury inflicted by a wartime mine explosion is presented in this study. Apart from the soft tissue damage, a 4-part fracture of the radius and loss of 19 cm of the ulnar diaphysis were present along with lesions of the median and ulnar nerves. The radial pulse was intact. The first formal treatment of the wounding consisted of extensive soft tissue and bone debridement and external fixation of radius with an additional intramedullary K-wire. After wound closure was obtained, a free vascular fibula grafting of the ulna and corticocancellous bone grafting of the radius were performed. Bone union of both the radius and ulna was subsequently achieved and 9 years after the injury, the patient has full flexion and extension of the elbow, full pronation and 70% of supination. Motion of the wrist is limited because of an ulnar plus variant of the distal radioulnar joint. Hand function is still limited by chronic low-moderate median nerve palsy, but the ulnar nerve has recovered completely. The patient is able to pinch, has full finger extension and can make a fist. He is satisfied that he made the correct decision in not having an initial amputation for his injury.

Adult↗

PubMed2006

Modification of the Ilizarov external fixator for aseptic hypertrophic nonunion of the clavicle: an option for treatment.

OBJECTIVE: To assess the results of treatment of aseptic hypertrophic nonunion of the clavicle by external fixation using a modified Ilizarov apparatus. DESIGN: Prospective study. SETTING: A consecutive series of 12 patients from 2 specialized orthopaedic institutions, treated by the 3 senior authors. PATIENTS: Twelve patients (5 females) with a mean age of 38.7 +/- 12.4 (range, 18-50) years with an aseptic hypertrophic nonunion of the clavicle were treated operatively during the period 1994 to 1998. Ten patients had previously been treated nonoperatively, whereas 2 had been treated surgically; the treatment in all had failed. All patients had pain with shoulder stiffness. INTERVENTION: Patients were treated using the Ilizarov external fixation technique. The operation was performed under general anesthesia and an Ilizarov external fixator was applied percutaneously under fluoroscopic control, without a skin incision or bone grafting. The patients were then monitored clinically and radiologically for 24 to 96 (mean, 45.4) months. MAIN OUTCOME MEASUREMENTS: Radiologic evaluation and clinical assessment by the Constant numerical score. RESULTS: The mean Constant preoperative score was 30.4 +/- 9 (range, 18-44). Healing of the nonunion occurred in all patients treated by the Ilizarov technique. Nine patients had pain relief and gained unlimited range of motion, whereas 3 patients had mild pain during elevation of the arm. A mean period of 75.4 (range, 50-95) days was needed for gradual bone reduction and union. The mean Constant outcome score was 68.8 +/- 14.7 (range, 46-85). COMPLICATIONS: 2 patients had superficial pin infections that cleared with local therapy and antibiotics, and 1 patient had a reoperation for a nonunion after a fall onto the floor. CONCLUSIONS: Ilizarov fixation seems to be an effective method in the treatment of aseptic hypertrophic clavicle nonunions, even in patients where previous surgery has failed.

Adolescent↗