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Biomedical subjects

D Kovac

Publications and source records attributed to D Kovac.

47 records · Page 3Linked to original sources
PubMedDate not supplied

[Familial adenomatous colonic polyposis].

We described two patients (brother and sister) with familial adenomatous polyposis of the colon. It is an inherited disease with autosomal dominant pattern of inheritance. The incidence is 1:8.000, with usual onset of polyps development late in the first decade of life or during adolescence, and malignant alteration up to the fourth decade of life. APC gene located on long arm of chromosome 5 is responsible for occurrence of the disease that presents with onset of multiple adenomatous polyps in the colon (from some of them to 1000). The treatment includes chemoprevention by sulindac or aspirin that prevents or reverse process of carcinogenesis. Surgical approach is preventive colectomy up to 20 (25) years of life. APC gene mutation (deletion at codon 1309-1311) was proven by DNA analysis from blood and polyp in both patients. There was no evidence of mutations of genes p53 and K-ras. Preventive colectomy is planned as soon as possible.

Adenomatous Polyposis Coli↗
PubMedDate not supplied

Gastric epithelium proliferation in early Hp+ and Hp- gastritis: a flow cytometry study.

BACKGROUND: Helicobacter pylori increases cellular turn-over causing hyperproliferation and possible assumption of neoplastic characteristics by the gastric epithelial cells. To verify whether patients at risk of cancer can be identified at the very first stages of gastric disease, we studied a sample of patients affected by early Hp+ and Hp- gastritis by flow cytometry and assessed the methods commonly adopted to study gastric cell proliferation. METHODS: 48 fresh biopsies taken from the gastric antrum and body of 24 patients who had undergone endoscopy for dyspepsia, and 48 paraffin-embedded antrum and body biopsies taken from the files of our Department were studied by flow-cytometry. The following markers and parameters were considered: S-phase, proliferation index, PCNA and ploidy. RESULTS: No correlation was found between Hp+ or Hp- gastritis and gastric cell proliferation and no cases of aneuploidy were observed. Gastric proliferation was found to vary depending on the methods, markers and type of biopsy employed. Furthermore, proliferation expressed by PCNA was significantly different in antrum and body. CONCLUSIONS: The commonly studied proliferation markers do not allow the early detection of patients at risk of gastric cancer by flow cytometry. Proliferation differences between body and antrum must be taken into account in the investigation of gastric diseases.

Adult↗
PubMedDate not supplied

[Emergency cardiac defibrillation in a prehospital setting].

It has been show four successful defibrillations performed on a level of the emergency aid under different conditions (ambulance, apartment of a patient, open space) with the definite survival of defibrillated patients who suffered cardiac arrest according to the type of ventricular fibrillation because of various causes. It has been stressed the importance of good equipment and proper education of the Emergency Aid Service for performing complete measures of cardiopulmonary resuscitation including electrotherapy, both in ambulance as well as under difficult out of ambulance conditions. It has been pointed out advantages that Emergency Aid Services have in performing and resulting of cardiopulmonary resuscitation in small urban environments where because of their specific urban characteristic there is a possibility their specific urban characteristics there is a possibility of setting up a connection with clinically dead patients.

Adolescent↗
PubMedDate not supplied

[Automated endoscopic percutaneous diskectomy in the treatment of lumbar disk hernia].

Results of the conventional lumbar disc herniation surgery are not always satisfactory, in spite of the progress made in microsurgical technique. For that reason neurosurgeons started looking for an alternative method of treatment. A combination of the percutaneous posterolateral approach, which was used in chemonucleolysis, accompanied by the development of diagnostics, surgical techniques and technology of medical instruments, are important stages in the development of automatic endoscopic percutaneous diskectomy. The aim of percutaneous diskectomy is derived from pathophysiological principles, i.e. it is based on the reduction of nucleus pulposus volume, namely on the lowering of intradiscal pressure, under the condition that the anulus fibrosus continuity has been preserved. In the past three years 132 patients have been treated with this method with the success rate of 81%. We consider this method to be the best way to the final goal which can be called the protective lumbar disc surgery.

Adolescent↗
PubMedDate not supplied

Proliferating cell nuclear antigen (PCNA) as a prognostic factor for colorectal cancer.

PCNA (proliferating cell nuclear antigen) is a cell cycle related protein that is maximally elevated in late G1 and S-phase of proliferating cells. 114 biopsy specimens of colorectal cancer were immunolabeled with PC 10 which specifically recognizes PCNA; Dukes' staging and histological grading were estimated for each case. All patients were followed-up for at least 60 months or to death. All data were analysed by the computer program NCSS (Number Cruncher Statistical System). According to the results, PCNA-index may be considered an independent prognostic factor for colorectal cancer; it may also be helpful in supporting the therapeutic strategies based only on Dukes' stage.

Colorectal Neoplasms↗
PubMedDate not supplied

Duodenal obstruction from chronic pancreatitis.

The fibrosclerosing process of the pancreas in the chronic pancreatitis may constrict not only the pancreatic duct but also the bile duct, splenoportal venous system and duodenum. In our retrospective study we analysed 24 patients with duodenal obstruction associated with chronic pancreatitis. Duodenal obstruction was suspected whenever repeated vomiting occurred or large volumes of nasogastric aspirate were obtained. The diagnosis was confirmed by barium meal and endoscopic examination. Duodenal obstruction was relieved by gastrojejunostomy in eight patients, gastrojejunostomy and vagotomy in eight patients, gastroduodenostomy and vagotomy in two patients, vagotomy with Finney pyloroplasty in one patient, duodenoplasty with vagotomy in one patient and Whipple procedure in four patients. We concluded that vagotomy and gastroenterostomy are the procedures of choice. Bypass surgery is helpful to relieve the obstruction of the common bile duct and pancreatic duct. Whipple procedure should be reserved for the small duct form of chronic pancreatitis and for the cases in which there is high suspicion of malignancy.

Adult↗
PubMedDate not supplied

[Nodular lymphoid hyperplasia of the colon and terminal ileum. Case report].

A patient admitted to our hospital because of diarrhea and hematochesia is presented. These complaints appeared eight months before, and were not accompanied by other disturbances. All hematological, biochemical and microbiological findings were normal, but endoscopic, x-ray and histologic examination of the gastrointestinal tract showed nodular lymphoid hyperplasia of the colon and terminal ileum. Since an immunological derangement was not verified, this seems to be a rare benign disorder as a response to repeated antigenic stimuli. In our patient these were recurrent parasitoses. The treatment is not needed, but due to the possibility of late onset hypogammaglobulinemia. Long-term patient follow up is required.

Castleman Disease↗
PubMedDate not supplied

[Shock].

UNLABELLED: Shock is a consequence of disturbed circulation and decreased blood perfusion of tissues which, on the whole, cause functional and morphological impairments of organic systems. Occurrence of shock is not high, but it is significant due to bad prognosis and high mortality rate. CLASSIFICATION: This is one of the classifications of shock: cardiogenic, extracardiogenic-obstructive, oligentic and distributive shock. PATHOPHYSIOLOGIC MECHANISMS OF SHOCK: Regardless of the cause of shock, the clinical picture is dominated by hypotension mostly caused by decrease of minute volume (septic shock may be an exception--minute volume might be high). Due to hypotension a lot of compensatory mechanisms are activated and in the beginning showing the compensatory phase of disease and if nothing is done decompensatory and in the end irreversible phase of shock occurs with fatal outcome. The clinical picture depends on the etiology of shock, type of shock, but it also has certain specificities. PROGNOSIS: The prognosis depends on the clinical picture dominated by the following symptoms: hypotension, decreased diuresis, acidosis, consciousness disorders, tachypnea, peripheral cyanosis, cold and damp skin. MANAGEMENT: These patients are managed in intensive care units, where the following parameters are followed-up: arterial pressure, central venous pressure, minute heart volume, systemic vascular resistance, diuresis, continual follow-up of heart rate, breathing and consciousness. In treatment of shock it is necessary to: normalize the circulatory volume, establish electrolyte balance, regulate glycemia and acid-base status, compensate the volume, calm the patient and alleviate pain.

Humans↗