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Biomedical subjects

S Ilić

Publications and source records attributed to S Ilić.

At least 19 recordsLinked to original sources

[Biomechanical characteristics of spinal cord tissue--basis for the development of modifications of the DREZ (dorsal root entry zone) operation].

Mechanical properties of the spinal cord tissue--biological basis for the development of the modality of the DREZ surgery lesioning technique Succesful treatment of the chronic neurogenic pain of spinal cord and cauda equina injury origin remains a significant management problem. The mechanism of this pain phenomenon has been shown to be related to neurochemical changes that lead to the state of hypereactivity of the second order dorsal horn neurons. The DREZ surgery (Dorsal Root Entry Zone lesion), designed to destroy anatomy structures involved in pain generating thus interrupting the neurogenic pain mechanism, as a causative procedure in treating this chronic pain, has been performed by using different technical modalities: Radiofrequency (RF) coagulation technic, Laser, Ultrasound and Microsurgical DREZotomy technic. The purpose of the study was to assess the possibility for the establishment of the lesioning technic based on the natural difference in the mechanical properties between the white and gray cord substance. We experimentally deteminated mechanical properties of the human cadaveric cord white versus gray tissue for the purpose of testing possibility of selective suction of the dorsal horn gray substance as a DREZ lesioning procedure. Based on the fact of the difference in tissue elasticity between white and gray cord substance we established a new and simple DREZ surgical lesioning technique that was tested on cadaver cord. For the purpose of testing and comparing the size and shape of the DREZ lesion axchieved the DREZ surgery has been performed on cadaver cord by employing selective dorsal horn suction as a lesioning method. After the procedure cadaver cord underwent histological fixation and analysis of the DREZ lesions achieved. Our result revealed that the white cord substance with longitudinal fiber structure had four time higher dynamical viscosity than gray substance of local neuronal network structure (150 PaS versus 37.5 PaS) that provided possibility for the safe and selective suction of the gray substance of the dorsal horn. Technic includes incision of the dorsolateral sulcus according to Sindous Microsurgical DREZotomy technic than suction under visual control of the dorsal horn gray matter using succer adopted from the lumbar puncture nidle. Operative experimental testing and hystological analysis confirmed expected size and shape of the DREZ lesion performed by dorsal horn suction as DREZ lesioning technique. The utility, selectivity and safety of this technic has been provided by the natural mechanical properties of the cord tissue itself. Application of the Dorsal horn suction as a DREZ lesioning in humans confirmed this technic as a safe and reliable DREZ lesioning method.

Biomechanical Phenomena↗

[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↗

Radionuclide voiding pattern in children with unstable bladder.

BACKGROUND: The purpose of this study was to investigate bladder function parameters by means of quantitative radionuclide cystography (QRC) in anxious, irritable children with unstable bladder. METHODS: Quantitative radionuclide cystography was performed in 18 children aged between 8 and 12 years, without evidence of neurologic and nephrologic disorders. Findings were compared with those obtained in 10 healthy children aged between 7 and 10 years. The dynamics of the bladder emptying were studied after intravenous injection of 37 MBq/10 kg b.w. 99mTc-diethylenetriaminepentaacetic acid (DTPA) in the posterior views. Images of 90 frames every 2 sec. were stored in the 64 x 64 computer matrix during voiding. The patients voided into a container and the volumes were measured. RESULTS: The parameters evaluated were: functional bladder capacity (ml)--FBC, expected bladder capacity (ml)--EBC, percentage of EBC (%), voided urine volume (ml)--VV, residual urine (ml)--RU, voiding time (sec)--VT, average flow rate (ml/sec)--AFR and peak flow rate (ml/sec)--PFR. There was a statistically significant difference between controls and children with unstable bladder in the following parameters: FBC 288 +/- 33 vs. 244 +/- 27 ml (p < 0.001), % of EBC 99 +/- 6 vs. 82 +/- 6% (p < 0.0001), VV 265 +/- 37 vs. 202 +/- 35 ml (p < 0.0001), RU 22 +/- 11 vs. 48 +/- 19 ml (p < 0.007), AFR 13 +/- 5 ml/sec vs. 9 +/- 4 ml/sec. (p < 0.01) and PFR 19 +/- 2 vs. 13 +/- 3 ml/s (p < 0.0001), respectively. The VT obtained from the control group of 23 +/- 9 s did not differ significantly from the value of children with unstable bladder of 28 +/- 14 s. CONCLUSION: The results show that quantitative radionuclide cystography is a simple, noninvasive method, which allows a good separation of patients with unstable bladder from the children with normal voiding pattern.

Journal Article↗

Fungus-like hyphochytrids associated with human disease.

We report two cases, with liver and brain abscess, respectively, where fungus-like organisms belonging to the Hyphochytriomycota were found at the site of inflammation together with Peptococcus in the first and Cysticercus cellulosae in the second case. This is the first time these groups of organisms have been reported in human material. The role of hyphochytrids in human pathology remained uncertain as they were found together with already known human pathogens.

Adult↗

Elevated tumour markers in patients with Balkan endemic nephropathy.

Balkan nephropathy (BEN) is commonly associated with urothelial cancer. Urothelial cancer is manifested in the advanced stage of disease. The aim of this study was to facilitate early detection of urothelial cancer in BEN patients and their family members living in an endemic region by using tumour markers, carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA), and a putative marker, ferritin. Fifteen BEN patients with normal renal function, 17 with renal failure (BEN-RF), 13 healthy members of their families (HFM), 14 patients with glomerulonephritis (GN) and 12 healthy controls (C) were studied. Serum CEA levels in BEN patients were within normal limits, however, in BEN-RF patients they were significantly increased over HFM (p<0.05). Serum TPA levels in BEN and BEN-RF patients were significantly higher than in the C and HFM groups (p<0.05). Urinary CEA was not significantly different between the groups studied. Urinary TPA levels in HFM (median 125 U/l, BEN (236 U/l) and BEN-RF (275 U/l) were significantly increased over C (30 U/l), however, TPA levels were increased also in GN patients (437 U/l). None of the BEN patients studied developed urothelial cancer during the ten years' follow-up. Markedly elevated urinary TPA-like levels in all patients studied (HFM, BEN, BEN-RF, GN) suggest that urinary TPA may not be a reliable tumour marker. However, the clinical relevance of high TPA levels in BEN patients should be evaluated.

Balkan Nephropathy↗

Evaluation of autosomal dominant polycystic kidney disease by DTPA renal scintigraphy.

Sixty patients with previously documented autosomal dominant polycystic kidney disease (ADPKD) were investigated using dynamic kidney scintigraphy with 99mTc-diethylenetriaminepentaacetic acid (DTPA). Patients were subdivided in respect of glomerular filtration rate (GFR) as follows: PKD I group (normal GFR), PKD II group (moderately reduced GFR), and PKD III (severely reduced GFR). Scintigraphic features, time activity curves, excretion parameters, global and individual kidney functions were analyzed. Because of GFR dependent sensitivity, in advanced renal failure being only 0.1, and low reproducibility (11% intraobserver, 22% interobserver), 99mTc-DTPA dynamic kidney scintigraphy cannot be generally recommended for the diagnosis of ADPKD, but has to become a routine method for functional evaluation of both global and individual renal functions, as well as degree of excretion disturbances in ADPKD patients.

Adult↗

Kidney ectopeptidases in gentamicin and mercuric chloride-induced acute renal failure.

The clinical use of gentamicin is associated by nephrotoxicity in over 10% of patients. However, the biochemical events responsible for proximal tubular injury and acute renal failure (ARF) are still unclear. In the present study, effects of gentamicin and, comparatively, of mercuric chloride upon rat kidney cortex ectopeptidases were studied. Gentamicin was given i.p., 100 mg/kg daily for up to 6 days, mercuric chloride i.p. once 2.5 mg/kg to rats studied after 3 days. Kidney cortex aminopeptidase N decreased significantly after 3 and 6 days' treatment (p < 0.01), however, angiotensinase A significantly decreased after 3 (p < 0.01), and much more after 6 days of gentamicin treatment (p < 0.001). Dipeptidylpeptidase IV activity was significantly decreased only after 6 days of treatment with gentamicin. In mercuric chloride-induced ARF all three peptidase activities were markedly decreased (p < 0.001). These results suggest that gentamicin-induced decrease in ectopeptidase activities could compromise vasoactive and other biologically active peptides handling, with important consequences upon renal function and metabolism.

Acute Kidney Injury↗

[Epizootiologic situation of rabies in 1997. Urbanization of sylvatic rabies in Yugoslavia].

The Federal Republic of Yugoslavia is situated on the border of a great sylvatic rabies epizootics occurring in central and eastern Europe. That is the reason why a relatively small number of rabid animals have been registered. In 1997, 124 rabid animals, mainly red foxes, were identified. In recent years red fox rabies epizootics in Yugoslavia has annually spread 15-20 km to the south. Rabies in domestic animals, especially dogs, was characterized with furious clinical forms and dog-to-dog transmission typical of urban rabies. Sylvatic rabies has been almost completely eradicated in some countries of western Europe in the last years, mostly due to the method of oral vaccination of foxes-the main vector of rabies.

Animals↗

[Zoo-anthroponoses in Vojvodina. IV. Epidemiologic characteristics of trichinosis in Vojvodina].

Epidemiological characteristics of trichinellosis in Vojvodina have been analyzed on the basis of registered cases of the disease, registration of epidemics and also epidemiological investigation of exposed persons. In the period 1984-1993, 1802 diseased persons were registered, 958 male and 844 female. Death was registered in one case. Average morbidity was 8.9/10(5). Trichinellosis affects all age groups. At younger age the disease affects both sexes, but in the group over 20 years of age the disease is statistically more frequent in males. During the observed period 70 epidemics of trichinellosis were registered. The main source was the domestic swine. Epidemiologically the greatest risk were domestically produced sausages causing 80% of epidemics. Consequently the season for pork meat preparation is the most significant for trichinellosis. Analyzing the origin of affected meat it has been established that regions of Srem and South-West Backa are considered to be hyperendemic foci. 94.3% of epidemics were caused by affected meat from these regions.

Female↗

Thyroid hormone profiles in experimental acute renal failure.

Thyroid hormone profiles were determined in two groups of dogs made uremic, either by i.v. uranyl nitrate 10 mg/kg BW injection or by bilateral ureteral ligation, and in one group of sham-operated animals. Each group consisted of 6 dogs and served as its own control. From blood samples taken in 12-h intervals up to 144 h for uranyl nitrate-injected dogs and 96 h for operated dogs, serum levels of T4, T3, fT4, fT3, rT3, and cortisol were measured by radioimmunoassays. The results obtained in both groups of uremic dogs showed an initial sharp fall of T4, T3, fT4, and fT3 followed by a plateau or retarded decrease. In sham-operated dogs the fall of these hormones was slight and of short duration. Reverse T3 had a tendency to increase in all groups examined, but a significant elevation was recorded only after bilateral ureteral ligation. In this group cortisol serum levels were found the highest, being also significantly increased in the other two groups. The temporal coincidence of the most marked alterations in T3, rT3, and cortisol serum concentrations indicates a significant role of stress in thyroid dysfunction. Although serum creatinine rise and weight loss were not parallel with thyroid hormone alterations, the involvement of uremic compounds and malnutrition in this process is also quite clear. Thus, the data presented suggest simultaneous influences of uremic toxins, stress, and malnutrition on the induction of thyroid dysfunction in dogs made uremic by uranyl nitrate injection or bilateral ureteral ligation.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗

Respiratory gases and acid base parameter of the fetus during the second and third trimester.

Respiratory gases and acid base parameters were determined in the samples of fetal blood collected by cordocentesis from 70 patients with normal course of pregnancy, between 18th and 38th gestational week. The mean pH value was 7.386 +/- 0.05; partial pCO2 pressure -4.819 +/- 1.464 kPa; O2-5.712 +/- 1.24 kPa; bicarbonate 21.528 +/- 0.494 mMol/l; base excess -2.284 +/- 0.647 mMol/l and saturation 74.86 +/- 13%. Statistically significant negative correlation between gestational age and pH (r = 0.841, p less than 0.01) and partial O2 pressure (r = -0.961, p less than 0.01) was revealed. Partial CO2 pressure correlated significantly with gestational age (r = 0.923, p less than 0.01). The values of bicarbonate and base excess do not change significantly during gestation. Our own standards of examined parameters were formed.

Acid-Base Equilibrium↗

The influence of anemia on respiratory gases and acid base parameters of the fetus.

Fetal blood samples were collected by cordocentesis from 82 pregnant women; 12 of whom had severe forms of Rh isoimmunization, while 70 comprised the control group. The mean hematocrit value in the group under investigation was 15.72 +/- 3.62% and indication of severe anemia. The pH value in this group was 7.31 +/- 0.06; pCO2 partial pressure 6.36 +/- 0.64; O2-2.65 +/- 0.89 kPa; bicarbonate 23.84 +/- 3.02 mMol/l: base excess was -2.72 +/- 2.66 mMol/l and saturation 28.66 +/- 15.56%. In the control group the following values were established: pH -7.386 +/- 0.05; partial pressure pCO2-4.980 +/- 0.31 kPa; O2--4.960 +/- 0.90 kPa; bicarbonate 21.560 +/- 0.27 mMol/l; base excess -2.30 +/- 0.90 mMol/l and saturation 67.23 +/- 11.60%. The pH, partial pressure O2 and saturation values were significantly lower, while partial pressure CO2 was significantly higher in the investigated group than in the control group. Bicarbonates and base excess do not change significantly in the presence of anemia. Fetal blood sampling carried out by means of cordocentesis is the most reliable method for assessment of the degree of fetal anemia. The values of acid base parameters and of blood gases are an indication of either respiratory, respiratory-metabolic or metabolic acidosis. The possibilities of prenatal diagnostics, undoubtedly, contribute to a significant reduction of perinatal mortality.

Acid-Base Imbalance↗

[The effect of thyroxine on renal function in experimental acute renal insufficiency].

The aim of the study was to investigate the influence of exogenous thyroxine upon the kidney function in the experimental renal failure induced by the uranyl acetate application. Acute renal failure was induced by uranyl acetate in 32 rats, divided into 4 groups, each consisted of 8 rats. The group of untreated animals and the group of animals treated with thyroxine only were used as controls. Then glomerular filtration rate was determined in all the rats taken in the experiment. The comparison was made between the control or the group with acute renal failure without the thyroxine treatment and the groups treated with a single application of thyroxine before, simultaneously and after the uranyl acetate injection. An improvement of the glomerural filtration rate and a decrease of the blood nitrogen retention were obtained in rats with acute renal failure pretreated with thyroxine. Necrotic alterations of the kidney cortex were less marked in this group than in the group without thyroxine treatment. The improvements of the kidney function and morphology in acute renal failure suggest the possibility of the protective effect of thyroxine.

Acute Kidney Injury↗

Heart rate, magnitude and duration of ST-segment depression in symptomatic and asymptomatic episodes of myocardial ischemia in patients with coronary artery disease recorded by Holter.

In the group of 85 patients with coronary artery disease the exercise and 24-hour ambulatory electrocardiograms were recorded in order to analyse the frequency of asymptomatic episodes of myocardial ischemia and to determine differences between symptomatic and asymptomatic episodes of myocardial ischemia. All patients had ischemic ST-segment depression (greater than or equal to 1 mm) on the exercise electrocardiogram. During exercise testing, 23 (27%) patients had ST-segment depression without anginal pain or dyspnea. On the 24-hour ambulatory electrocardiogram transient episodes of myocardial ischemia were found in 50 (58.8%) patients. In 16 patients all episodes were asymptomatic, in 9 all episodes were symptomatic, and in 25 patients some episodes were symptomatic and some asymptomatic. During a 24-hour electrocardiogram in 25 patients with both types of ischemia, 175 transient episodes of myocardial ischemia were recorded. Most of them (125, i.e. 71.4%) were asymptomatic. The heart rate in symptomatic and asymptomatic episodes was similar. The magnitude of ST-segment depression in symptomatic episodes was higher than in asymptomatic episodes (P less than 0.01). There was not significant difference in the duration of the two types of myocardial ischemia. This study suggests: 1. During daily activities, in patients with the positive exercise test, asymptomatic episodes of myocardial ischemia are more frequent than symptomatic episodes. 2. The magnitude of ST-segment depression is the main factor in the determination of the presence of anginal pain.

Angina Pectoris↗