Biomedical subjects
Publications and source records attributed to Lj Marković.
Neurogenic tumors, primary bone tumors, are rather exceptional; about 50 cases have been reported so far. The study reports a case of intraosseous schwannoma, a primary bone tumor, in a 20-year-old male patient, localized in the distal end of the right tibia.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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In Belgrade Military Medical Academy 88 males and 1 female (aged 13-55, average 28.6 years) with war craniocerebral injuries (CCI) were secondarily neurosurgically treated from October 1991 trough December 1992. Primary neurosurgical management of these patients was performed in war hospitals in former Yugoslavia. Out of 89 patients, 78 had penetrating, and 11 closed CCI. Out of 55 patients with penetrating CCI who underwent surgery, intracranial debridement was performed in 34 patients. All patients with severe CCI (GCS = 3-8) were severely by disabled or died, and in the majority of patients with minor CCI (GCS = 13-15) the outcome was good (p < 0.01). Statistical analysis showed no significant correlation between the extent of cerebral lesion and the outcome of penetrating CCI (p > 0.05). Eight (10.3%) patients with penetrating CCI died. The outcome of war CCI mostly depended on the severity of injury.
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Epileptic seizures in the patients with multiple sclerosis (MS) were reported more than 100 years ago. The question of mutual physiopathologic association between MS and epilepsy is even nowadays controversial. The question is if epileptic seizures are the symptoms of MS or are just coincidential, i.e., are those two separate neurological diseases? The development of contemporary immunologic, electrophysiologic and neuroradiological diagnostic procedures enabled the diagnosis of MS to be much more certain, and in that way the differentiation of some symptoms and signs, as well as epileptic seizures in those patients became more reliable. In this report are presented three patients in whom the diagnosis of MS was confirmed by clinical, laboratory, immunological, electrophysiological and neuroradiological diagnostic analyses and procedures, and in whom were simultaneously clinically and/or electrophysiologically (EEG) registered epileptic seizures with specific alterations in EEG that were obviously associated with the development of primary disease--MS.
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During the onset and development of pathologic events, numerous changes occur in the body as the result of an attempt of dynamic equilibrium maintenance. Results of such sequence of events may lead to organic, as well as psychic impairment of the body that is often referred to as the onset of psychosomatic disease. This paper deals with the disorder that could provide better insight in the possible physiopathologic mechanisms of psychosomatic disease or disorders. In a patient, chronic alcoholic subdural hematoma was diagnosed. Peptic ulcer hemorrhage occurred after surgical removal of the hematoma. Possible physiopathologic mechanisms in the origin of this disorder have been described.
The results of transnasal transsphenoidal surgery of pituitary adenomas were retrospectively analyzed in a group of 42 patients, 22 females and 20 males, aged 19-70, of average age 43 years. Histopathological examination showed null-cell adenomas in 4, growth-cell in 11, prolactin-cell in 3, adrenocorticotropin-cell in 6, plurihormonal adenomas in 6, craniopharingeoma in 1, metastasis of pulmonary carcinoma in 1, pituitary abscess in 1, and normal pituitary tissue in 9 cases, respectively. Out of 30 patients with adenomas, 21 had macro (> 1 cm) and 9 had microadenomas (< 1 cm). Cerebrospinal fluid leakage (8.7%) and meningitis (6.5%) were the most frequent postoperative complications. There was no operative mortality. Full adenoma recurrence (clinical, hormonal, and radiological) was found in 3, clinical and hormonal in 3, hormonal and radiological in 1, and radiological in 2 patients, respectively. The repeated transsphenoidal surgery was performed in 4 patients. The transnasal transsphenoidal approach is the procedure of choice for surgical treatment pituitary adenomas.
Syndromes of intracranial hemorrhage, and particularly subarachnoidal, i.e., intracerebral hemorrhage (SAH and IH) present clinical entities that are the most severe conditions in neurology. Timely recognition, diagnosis and adequate therapy are imperative. The most important factor that aggravates an already difficult prognosis of those entities is cerebral vasospasm. Upon the presented facts, the aim of this investigation was to establish the value and role of administration of selective calcium channel blocker--nimodipine in patients with SAH and IH compared to the degree of neurological and functional impairment, as well as the recovery of the function of consciousness compared to the patients with those syndromes from an earlier period, who were not treated with this medicament. Investigation comprised 30 patients who received nimodipine and 20 patients without this agent in therapeutic program. Results of the investigation confirmed significant difference concerning the neurological recovery, improvement of functional capability and recovery or consciousness disturbances, respectively, in patients who received nimodipine compared to the group without this agent. It can be concluded that nimodipine as calcium channel blocker with multitopic pharmacological effects on mechanism of SAH or IH development, respectively, as well as on the development of complications of those syndromes, particularly to the development of vasospasm and reactive ischemia, with the improvement of hemorrheologic disorders deserves to be included as the unavoidable segment of therapeutic program of SAH and IH syndrome immediately after clinical phenomenology is revealed.
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The results of a retrospective study of 21 patients undergoing surgery with pterional approach to pituitary adenomas are reported. There were 7 females, and 14 males, between 20 to 68 (average 43.5) years of age. According to adenoma extension 6 patients were with type III-A (suprasellar-suprachiasmatic), 4 with type III-B (suprasellar-retrosellar), 6 with type III-C (parasellar-cavernous), and 5 with type III-D (paninvasive). According to adenoma size there was 1 patient with small (5 mm-2 cm), 11 with moderate (2-4 cm), 4 with large (4-6 cm), and 5 patients with paninvasive adenomas. Histopathological examination showed null cell in 11, growth-cell in 6, prolactin-cell in 1, and plurihormonal adenomas in 3 cases. Two patients have died. The cause of death was hypothalamic lesion or cerebral infarct.
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The authors have explored the effect of intermittent hypoxia in the cell membrane and histochemical changes in the cardiac muscle cells of the white rat. Every day the animals were exposed to experimental conditions characteristic of 7.000 m of high above sea level (first experimental group) and every odd day (second experimental group). Animals of the experimental groups were sacrificed immediately (first subgroup), 24 hours later (second subgroup) and 7 days after the final exposition (third subgroup). The hypoxical stress elicited the vacuolation of the cardiac muscle fibres of the subendocardiac layer of miocard which persisted, and did not reduce its number, intensity and extensity in the first experimental group, although it reduced its intensity and vacuoles size in the second experimental group, while in fuxinorrhagia which has been presented focally the intensity has been reduced in all the three subgroups of the first experimental group of animals. In preparations of animals from the second group, sacrificed 24 hours after the experiment intensity and extensity fell to the half number of those animals, and completely disappeared in those sacrificed 7 days after the final exposure. Glycogen pools, as well as the activity of sucinat-dehydrogenase were preserved in both experimental groups. It could be concluded that apart from hypoxia model, oxygen deficit, too, elicites ischemical changes in the sense of vacuolation of muscle tissue which does not disappear or its disappearance has been much slower than in positive fuxinorrhagia.(ABSTRACT TRUNCATED AT 250 WORDS)
Prolapse of the mitral valve is a frequent occurrence. It is usually benign. However, because of frequent arrhythmias that can provoce sudden death, its detection and treatment are of great importance. In 20 patients with prolapse of the mitral valve the authors detected arrhythmias on a 24-hour electrocardiogram. The results were as follows: ventricular arrhythmias in 50% of patients; auricular arrhythmias in 50% of cases; atrioventricular and sinoatrial block in 5% of subjects, and block of the left bundle-branch in 2% of patients.