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Biomedical subjects

S Matić

Publications and source records attributed to S Matić.

At least 19 recordsLinked to original sources
PubMed2001

[Protective colostomy or ileostomy?] ].

A group of patients is presented, where colorectal or coloanal anastomosis after resection was performed together with concomitant covering colostomy (102) or ileostomy (25), during the period 1985-2000. Covering colostomy was most often performed upon hepatic flexure (82.1%) and upon sigmoid colon (8.9%). The incidence of complications during performing or closure of colostomy was 6.8% with one case (0.8%) of death due to unsuccessful protection of primary anastomosis. The incidence of complications in covering ileostomy was 16%, with 3 (12%) deaths. Authors are analysing the data from literature about indications and technique of covering enterostomies, comparing them with their experience and concerning the choice of appropriate protective procedure. They came to conclusion that the reason for covering procedure has been in many instances reasonable, and that in the question of protection both methods are comparable, but covering ileostomy has potentially more dangerous complications. Therefore as a method of anastomotic protection authors are generally recommending covering colostomy except in technically specific cases.

Anastomosis, Surgical↗
PubMed2000

[Metastasis of malignant melanoma in the small intestine--case report].

Small bowel metastases of the malignant melanoma are usually discovered in 2-5% of the patients with malignant melanoma of the skin during the life. They are usually being diagnosed with a complication on the small bowel, such as occlusion, bleeding, anemia and perforation of the intestine. Authors show three patients with metastases of the malignant melanoma in the small bowel, which lead to invagination, subocclusion and anemia due to bleeding. In all the patients, resection of the small bowel was performed with termino-terminal anastomosis. One of them lived 7, the other 4 months after the surgery and is in pretty well condition, while third patient was not controlled at all.

Aged↗
PubMed1995

[Liver injuries].

Liver is, after spleen, the second most frequently injured organ in the blunt abdominal trauma. Liver trauma is often associated with injuries to other viscera and the mortality may be even more dependent on the severity of those injuries then on the liver injury itself. New imaging techniques provide an accurate assessment of the extent of liver injury and so more appropriate surgical technique. They provide that certain number of patients, under precisely defined conditions may be treated nonoperatively. A success in establishing a stable hemostasis and debridement of devitalised tissue is mandatory for a favorable outcome. Different methods of surgery are discussed.

Humans↗
PubMed1994

[Causes of dehiscence in the anastomosis between the stomach and small intestine in our clinical data 1970-1990].

Gastrojejunal anastomotic leakage occurred in our clinical material of 4284 gastric resections Billroth II type with an incidence of 0.93 percent. 62 cases with anastomotic dehiscence were analyzed, with 22 from other clinics. The most critical part of the anastomosis was the upper angle of Billroth II Hoffmeister Finsterer anastomosis. The causes were mostly local; reoperations and resuture with necrotic and devitalized tissue, impaired vascularization of the stomach and small intestine due to rough manipulation, too narrow anastomosis and too tight securing of ligatures, as well as too massive tissue aglomeration in more layers. Stomach obstruction is a significant cause, as it is dista obstruction to anastomosis, duodenal dehiscence, peritonitis or pancreatitis. Some of the local causes are likely to be solved with using of one layer of resorptive suture material or using of a stapling device. General conditions are also important, but only as factors that stress the local conditions of risk. The mortality rate in this serial is high as 70.9%, in spite of the reoperations and complex conservative treatment.

Anastomosis, Surgical↗
PubMed1994

[Surgical treatment of peroperative injuries of the duodenum].

Operative duodenal lesions are rare, but often fatal complications of certain abdominal procedures. This was reported in small series with an incidence of 0.2% of all abdominal operations. The management of these injuries requests the surgeon to be familiar with a number of specific operative approaches, which are to be used according to the operative situation. In the 1985-1992, year period, 21 cases of the operative injury of duodenum were managed without mortality, and with 3 cases of transient postoperative fistula, which healed spontaneously. The most important factors in the management of this complication are the early operative recognition of duodenal injury, or early reoperation, if, in a case of duodenal fistula, distal outflow is considered insufficient. The particularities of the duodenal suture and perioperative treatment are to be well understood. Roux en Y covering of the duodenal defect by open jejunal loop is the best method in management of these injuries.

Adult↗
PubMed1992

The expression of liver acute-phase protein genes during rat development and in response to inflammation of the dam.

The hepatic expression of albumin (Al) and plasma acute phase protein genes (APP) was examined during the development of rat liver and in response to inflammation of the dam. Throughout the 10- to 20-day gestation period the level of alpha 2-macroglobulin (alpha 2M) mRNA in fetal liver exceeded twice that of the adult liver. The concentrations of the other APP and Al mRNAs were 10-30% of those of the adult liver between days 10 and 13 of gestation, then increased to values which ranged from 40% for haptoglobin (Hp) to 80% for Al and alpha 1-acid glycoprotein (AGP) mRNAs on day 19 of gestation. The transition of fetuses to an extrauterine environment was followed by a temporary overexpression of the Hp gene and an increase of the fibrinogen (Fb), AGP and thiostatin (TST) mRNAs to adult levels. Fetal liver responded to inflammation of the mother by a transcriptional induction of all of the investigated APP genes, except for the Fb gene whose level of expression remained unchanged. The pattern of individual APP genes expression in maternal and fetal livers was similar and characteristic for the acute phase reaction.

Acute-Phase Proteins↗
PubMed1989

Soman intoxication-induced changes in serum acute phase protein levels, corticosterone concentration and immunosuppressive potency of the serum.

We have studied the effect of soman intoxication on serum acute phase reactants (APR) levels, and the relationship of the APR and corticosterone concentrations and the immunosuppressive activity of the serum. One day after the injection of 1.8 LD50 soman the concentrations of alpha 2-macroglobulin (alpha 2-MG) and alpha 1-acid glycoprotein (AGP) in the serum of antidote protected rats increased 4- and 7-fold, respectively, whereas those of hemopexin (Hx), haptoglobin (Hp) and cysteine protease inhibitor (CPI) were two to three times higher than in the controls. A similar magnitude of increase of serum acute phase reactants levels was observed when 0.3 LD50 soman was administered at 24-h intervals over the 5-day period. The relationship of changes in the APR concentration, corticosterone level and immunosuppressive activity of the serum was also comparable to that observed in the acute phase response to tissue injury.

Acute-Phase Proteins↗
PubMed1988

Thermal injury-induced expression of acute-phase proteins in rat liver.

Relative changes in acute-phase protein and albumin mRNAs from the liver of rats exposed to sublethal and lethal scaldings were examined by hybridization and cell-free translation. Infliction of a sublethal scalding comprising 20 per cent of the total skin area resulted in a seven-fold increase of alpha 1-acid glycoprotein (AGP), alpha 1-cysteine protease inhibitor (CPI) and the alpha- and gamma-fibrinogens' (Fb) mRNAs, whereas the level of haptoglobin (Hp) mRNA increased three times. The simultaneous infliction of two such sublethal scaldings were lethal and accompanied by a significant decrease in the concentration of AGP while the levels of CPI. Hp and Fb mRNAs remained similar to those observed after a single 20 per cent injury. A 4 h time delay between the two scaldings was also fatal and followed by an additional increase in Hp mRNA concentration whereas the levels of the other mRNAs were close to those observed after a single 20 per cent scalding. These results demonstrated that the fatal effect of the second scalding was not related to any inhibition of acute-phase reactants mRNA synthesis in the liver.

Acute-Phase Proteins↗
PubMedDate not supplied

[Splenectomy in the treatment of hematologic diseases].

After first splenectomy performed 1888 for spherocytosis until now, a number of hematological indications for therapeutical splenectomy were described, with established preoperative treatment and more favorable postoperative results in recent studies. In the period between 1985 and 1997, 130 splenectomies for hematological disorders were performed on Department of surgical gastroenterology, 1st Surgical Clinic. The indications were as follows: 72 patients with autoimmune hematological diseases (55.38%), 28 patients with lymphoproliferative diseases (21.54%), Hodgkin-s disease in 11 patients (8.46%), myeloproliferative diseases in 6 (4.62%), splenectomy as a part of staging laparotomy in patients (7.69%), and for other hematological disorders in 3 patients (2.31%). Most of the removed spleens (95) weighted from 500 to 1500 g (73.08%). In 19 patients spleens weighted less then 500 g (14.62%), and in 16 patients more then 1500 g (12.31%). There was no significant correlation between the weight of the removed spleen and the incidence of postoperative complications. In 8 patients with preoperative thrombocytopenia (6.16%), intraoperative infusions of fresh thrombocytes were used. In 12 patients (9.23%) postoperative complications occurred, mainly in the patients who received immunosuppressive therapy preoperatively in excessive amounts, and were disease-dependent. Overall mortality was 4 (3.12%), and in 2 patients there was "exitus in tabular". Delayed results depended of basic hematological disorder and supportive treatment. The surgical particularities of the operative procedure are discussed, as well as the perioperative treatment and certain aspects of teamwork of hematologist and surgeon.

Adolescent↗
PubMedDate not supplied

[Treatment of chronic resistant tuberculosis].

Two groups of patients with chronic pulmonary tuberculosis are presented. The first group of 92 patients were unsuccessfully treated according to current principles of treatment of chronic, resistant pulmonary tuberculosis. In the second group of 11 patients, unsuccessfully treated according to current methods, a new combination of drugs was applied so that a drug of the aminoglycoside group or chinolon group (Amikacin 1000 mg every second day or Ciprofloxacin 750 mg daily) was added to conventional therapy. Applying such therapy during 4 months encouraging results have been obtained.

Adult↗
PubMedDate not supplied

Prosthetic reconstruction of facial defects.

A seven-year experience in prosthetic reconstruction of facial defects is presented. Surgical-prosthetic treatment was performed in 25 patients. Facial defect associated with organ loss of the midface was found in 4 (16%) patients. Isolated facial or midfacial organ defects were found in 21 (84%) patients, and dominant eye loss in 11 (44%) patients. All patients were managed by facial prostheses made of rigid acrylate and soft silicon. To obtain retention and stability of facial prostheses, eye glasses were most frequently used in 32% patients, and modern methods of retention with implants in 26%. The use of implants improved prosthetic reconstruction in terms of stability and retention.

Face↗
PubMedDate not supplied

Implants in management of gunshot injuries of teeth, facial bones and jaws.

The use of implants in management of gunshot injuries of teeth, face and jaws presents novelty that is manifested in primary surgical treatment, reduction and fixation of bone fragments and teeth, replacement of lost parts of bone tissues as well as preparation for definitive prosthetic management. At the Clinic for Maxillofacial Surgery of the MMA 173 implants of different types and purposes have been placed in the period 1991-1997, in rehabilitation of the patients injured during the civil war. Although this number of placed implants is significant, the conclusive estimate about benefit of using implants may be obtained only after a longer period of time. Early results are satisfactory.

Adolescent↗
PubMedDate not supplied

Two-component transdental implants.

Transdental implantation is a procedure of tooth stabilization in maxillary and/or mandibular bone. Indications for use of these implants are root fractures, chronic periapical inflammations and periodontal disease. Transdental implants have been used in the Clinic for Maxillofacial Surgery since 1977. In the period of 20 years of treatment 490 two-component transdental implants have been inserted and failure rate was 9% (43). Considering our experience and that of other authors we can conclude that with proper indications and sophisticated surgical technique the use of this type of implants has favorable survival rate.

Dental Implantation↗