Search PubMed⌕ Search

Biomedical subjects

I Jelić

Publications and source records attributed to I Jelić.

At least 19 recordsLinked to original sources
PubMed1998

Indirect demonstration of the lifetime function of human thymus.

The aim of this study was to test the hypothesis that human thymus maintains its function as the site of early T cell development throughout life, but to a progressively diminishing extent. Mononuclear cell suspensions prepared from the samples of 39 human thymuses were analysed for the total number of cells per gram of thymus tissue, percentage of single marker-positive CD2, CD4 and CD8 cells, percentages of double-positive CD4CD8 and CD2CD8 cells, double-negative CD4CD8 cells, absolute numbers of these cells per gram of tissue, and extent of the in vitro proliferation upon stimulation with concanavalin A (Con A), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) mitogens. The main outcome measures were flow cytometric data on thymus lymphoid cell composition (according to CD classification), expressed as percentages and numbers of cells per gram of thymus tissue. The total number of mononuclear cells expressed per gram of thymus tissue exponentially decreased with age. The slope of none of the analysed cell subpopulations differed from the slope of the line constructed for age-related decline of the total number of mononuclear cells (-0.024 on a semilogarithmic scale). The thymuses of all ages contained all analysed cell subpopulations in approximately the same proportions: percentages of these cell subpopulations did not change with age, except for all CD4+ (P=0.017) and double-positive CD4+CD8+ (P=0.016) cells, which tended to decrease with age. The extent of proliferation of thymus cells upon stimulation with T and B cell mitogens was unrelated to age. We conclude that the thymus retains its function as the site of differentiation of T lymphocytes throughout life. With respect to the number of involved lymphoid cells, the function exponentially decreases with age.

Adolescent↗
PubMed1997

Penetrating cardiothoracic war wounds.

OBJECTIVE: Penetrating cardiothoracic war wounds are very common among war casualties. Those injuries require prompt and specific treatment in an aim to decrease mortality and late morbidity. There are a few controversies about the best modality of treatment for such injuries, and there are not many large series of such patients in recent literature. METHODS: We analysed a group of 259 patients with penetrating cardiothoracic war wounds admitted to our institutions between May 1991 and October 1992. RESULTS: There were 235 (90.7%) patients with thoracic wounds, 14 (5.4%) patients with cardiac, wounds and in 10 (3.7%) patients both heart and lungs were injured. The cause of injury was shrapnel in 174 patients (67%), bullets in 25 patients (9.7%), cluster bomb particles in 45 patients (17.3%) and other (blast etc.) in 15 patients (6%). Patients, 69, had concomitant injuries of various organs. The initial treatment in 164 operated patients was chest drainage in 76 (46.3%) patients, thoracotomy and suture of the lung in 71 (43.2%) patients, lobectomy in 12 (7.3%) patients and pneumonectomy in 5 (3%) patients. Complications include pleural empyema and/or lung abscess in 20 patients (8.4%), incomplete reexpansion of the lung in 10 patients (4.2%), osteomyelitis of the rib in 5 patients (2.1%) and bronchopleural fistula in 1 patient (0.4%). Secondary procedures were decortication in 12 patients, rib resection in 5 patients, lobectomy in 2 patients, pneumonectomy in 4 patients, reconstruction of the chest wall in 2 patients and closure of the bronchopleural fistula in 1 patient. The cardiac chamber involved was right ventricle in 12 patients, left ventricular in 6 patients, right atrium in 7 patients, left atrium in 3 patients, ascending aorta in 2 patients and 1 patient which involved descending aorta, right ventricle and coronary artery (left anterior descending) and inferior vena cava, respectively. The primary procedure was suture in 17 patients (in 10 patients with the additional suture of the lung), suture + extraction of the foreign body in 4 patients, 2 of them with cardiopulmonary bypass. Complications were pericardial effusion in 6 patients, arrhythmia in 2 patients, myocardial infraction in 1 patient and migration of the foreign body in 1 patient. Patients, 7, died, five of the group with concomitant injuries, two of thoracic and one of cardiac injuries (5, 1.2 and 4.2%, respectively). CONCLUSIONS: Penetrating cardiothoracic wounds are among the most serious injuries in war, either in combat or among civilians. In spite of their nature, they can be treated successfully with relatively low mortality and morbidity.

Adolescent↗
PubMed1997

The cardiac migration of a Kirschner wire. A case report.

In June of 1995, a 48-year-old woman was admitted to an outlying hospital with a history of stomach pain several weeks in duration. A few years before, she had undergone orthopedic surgery because of bilateral coxarthrosis. Total endoprosthesis had been implanted at both hips. Chest radiography showed a metal foreign body (apparently a Kirschner wire) in the heart, whereas right-hip radiography showed no Kirschner wire. Echocardiography indicated that the wire was in the right ventricle. The patient underwent open-heart surgery, and the 5-cm-long Kirschner wire was removed from the right ventricle through a right atriotomy. To the best of our knowledge, this is the only reported instance of intracardiac embolization of a Kirschner wire.

Bone Wires↗
PubMed1996

Wound infection after median sternotomy during the war in Croatia.

From 1990 to 1994 at Clinical Hospital Center, Zagreb, 1904 median sternotomies were performed for cardiac operations. Patients shared the same intensive care unit (ICU) with the wounded persons, admitted to the hospital from battlefield. Infection developed in 124 patients, an incidence of 6.51%. Methicillin resistant Staphylococcus aureus (MRSA) was isolated from 90, methicillin resistant Staphylococcus epidermidis (MRSE) from 19, and gram negative bacilli (GNB) from 56 patients, Pseudomonas aeruginosa in 2, and Clostridium pneumoniae in 1 case. Ninety-six patients (5.04%) developed superficial localized infection of subcutaneous tissues and they were treated with frequent dressing changes with antibiotic-soaked gauze in combination with systemic antibiotics. Twenty-eight patients (1.47%) developed mediastinitis and sternal dehiscence. They were treated by operative debridement followed by reclosure of the sternum with continuous antibiotic irrigation. We obtained satisfactory results with our method of closure of sternum which is a modification of Robicsek's technique. Nine of them required further operation. In seven cases we performed muscle flaps and in two omentoplasty. One hundred and twenty patients were discharged in satisfactory condition. The uncontrolled mediastinal sepsis caused death in 4 patients. Higher infection rate after median sternotomy during 1991 and 1992 could be possibly explained with the war circumstances in Croatia, and especially with MRSA strain becoming endemic in surgical ICU.

Anti-Bacterial Agents↗
PubMed1995

[Causes of complications in the early postoperative period after heart surgery].

In this study we have evaluated 32 patients who underwent open heart surgery with extracorporeal circulation. The aim of the study was to determine the influence of duration of surgical procedure, amount of bleeding after surgery, duration of assisted ventilation, need for mechanical and pharmacological assistance on the occurrence of complications in the early postoperative period. Sixteen patients who developed signs of systemic infection were evaluated. Other 16 patients had similar clinical characteristics and they were operated on the same day or within the same week as patients in the first group and they served as the controls. There was a statistically significant difference between those two groups in the duration of surgical procedure, amount of blood loss after surgery, amount of transfusions and duration of mechanical ventilation. The group of patients with systemic infection and other complications required in the majority cases left ventricular support and developed multiorgan system failure that resulted in a higher rate of mortality. In conclusion, this study shows that the causes of complications and systemic infection in the early postoperative period could be due to a greater blood loss following surgery, demand for blood transfusions and duration of mechanical ventilation.

Adult↗
PubMed1993

Mitochondrial cardiomyopathy and scapuloperoneal spinal muscular atrophy in a child.

A 14-year old boy was admitted for signs of heart failure and scapuloperoneal muscle weakness. He fulfilled the clinical, functional and diagnostic criteria for dilated cardiomyopathy. There was also a moderate increase in pulmonary vascular resistance. The immunohistochemical examination of the heart muscle revealed a slightly positive phytohemagglutinin reaction and minimal IgM deposits without complement. The electron microscopy examination disclosed increased numbers of abnormal mitochondria disrupting the usual cell structure; the mitochondria were of various sizes with irregular and abnormal structure of the cristae. The scapuloperoneal spinal muscular atrophy was mild and diagnosed according to clinical and electromyographic findings. Light microscope examination of the skeletal muscle revealed hypotrophic fibers. This patient is presumed to have postinflammatory mitochondriopathy and is currently being managed on low-dose digitalis, diuretics and captopril.

Adolescent↗
PubMed1982

[Use of the free venous auto-transplant of the "patch" type in the prevention and treatment of ureteral stenoses. Experimental study with emphasis on the functional value of the operation].

The author analyze the problems of transplantation of the free venous auto-transplant which they implant in the milieu of the urinary system at the location of a previously intentionally performed defect on the side of the ureter. Distinctively, they examine the functional value of such an operation. The experimental model was chosen as the ureter of a dog. A free venous auto-transplant, elliptical in shape (patch) with standard dimensions 2cm-6mm is built in a defect of the ureter side. Fifteen days after the operation an intravenous urography is done, while is repeated after four months. The findings of the urography show consistent values. Four months after the operation in order to check the functional value of the operation a dynamic scintigraphy of the kidneys together with computer data processing is done. An intravenous injection is given to the dogs of 25 micro Curie Hipurin (ortho-iod-hippuric acid labeled with J131). Following this, the dogs are put under a Gamma camera (LFOV - Searle), while registers a accumulation of activity. The results are expressed by a dynamic graph; from which it is easily seen that part of the graph, which relates to the disappearance of activity is almost identical with the graph of the non-operated half of the urinary system. This shows the functional equivalence of the operated and non-operated sides. Such good functional results are obtained in all trials. All together 6 dogs are operated and a total of 8 operations are performed. The results of this work, as well as the clinical experience of other author allow us to propose the application of the free venous auto-transplant (patch), in the cure and prevention of the stenosis of the ureter of the shorter segment at specific indications.

Animals↗
PubMed1977

[Various causes of breakage of osteosynthetic material].

The authors in their work present some of the most common causes in breakage of osteosynthetic material. They emphasise the quality of the material is mainly satisfactory but the material should be from the same factory. Exhaustion of the material and corrosion are two of the common causes of the osteosynthetic material breakage. However uncorrect application and errors during the operation are the most common causes of breakage. The mechanical differences of the intramedullar nail and plate as two of the most used materials and their influences are explained. The most common errors which appear during the performance of opperation are explained to.

Biomechanical Phenomena↗
PubMed1977

[Asepsis and hospitalization in surgery].

The authors renews the interest in care of "hospital infection". Recent advances in clinical and epidemiologic research give us important informations and caution than we shall not be able in futher avoid them. Special care is needed and the frequency of post operative wound infections can be lowered due to respect asepsis and antisepsis principles. Of great importance are the hygienic, technical, surgical and education measures taken for preventing infections.

Antisepsis↗
PubMedDate not supplied

[Residual postoperative murmurs in children with congenital heart defects].

Fifty-four children without postoperative complications were admitted to the Department of Pediatrics, University Hospital Rebro, following a complete surgical correction of ventricular septal defect (VSD), atrial septal defect - secundum type (ASD II) and patent ductus arteriosus (PDA) in the period from June, 1989, to February, 1991. Twenty-two patients were treated surgically for VSD, 17 for ASD II and 15 for PDA. There were 23 male and 31 female children. In the early postoperative period, 57% of all the examinees had a murmur with the innocent or functional characteristics. The murmur was significantly more frequent among children with VSD than among children of other groups (ASD II, PDA). Sex, age and hematocrit did not influence this difference. There were 8 anemic children (3 with operated VSD, 4 with ASD II, and 1 with PDA). From this, it may be concluded that anemia also did not cause this difference. However, anemic children represented 50% of the examinees with a murmur among the operated for ASD II and 33% among those treated surgically for PDA. When these anemic children were eliminated, the others operated on for ASD II and PDA probably had the innocent murmurs, since the proportion of examinees with a murmur fits into the incidence of innocent murmurs in the population. The children operated for VSD have had a greater proportion of examinees with a murmur, and most likely, some of these murmurs do not belong to a group of innocent or functional murmurs. Their cause is unknown, as yet (probably, small organic lesion).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[War injuries of the thorax].

Chest injuries are very common in war circumstances. Chest injury is commonly associated with other injuries of intrathoracic organs and development of shock, which has to be treated immediately. Our patients with war chest injuries are presented, along with our approach to the treatment of these injuries. "The conservative treatment" is stressed, with particularly importance of proper chest drainage, as a corner stone of proper and successful therapy. Shock treatment and prevention of atelectasis does present an unavoidable procedure of this type of therapy.

Adult↗