CD34 AND C-KIT IMMUNOREACTIVE CELLS IN THE HUMAN EMBRYONAL AND FETAL SMALL BOWEL

Interstitial cells of Cajal (ICC) play important roles in the control of digestive motility: they generate the electrical slow-wave activity (pacemaker component) of the gut musculature and are involved in neurotransmission and stretch sensation. ICC expresses c-kit and depends on signaling via Kit receptors for development and maintenance of phenotype. The aim of the present study was to investigate if the c-kit immunoreactive (IR) cells present in the wall of the small bowel at the beginning of the fetal period are CD34 immunopositive. Human small bowel specimens were obtained from 5 embryos and 7 foetuses, 7–12 weeks of gestational age. The specimens were exposed to anti-c-kit antibodies to investigate ICC differentiation and anti-CD34 antibodies to identify presumed ICC progenitors. The differentiation of smooth muscle cells was studied with anti-desmin antibodies. At 9–10 weeks, c-kit IR cells were present in the wall of small bowel in the form of a narrow band of cells, at the level of the myenteric plexus, but they were absent in the mucosa and submucosa of the gut. At the same time, CD34 IR cells were present at the level of submucosa and mucosa, and they were not present in the outer parts of gut wall. A clear distinction between the localization of c-kit IR cells and CD34 IR cells was evident. We may conclude that c-kit IR cells present in the small bowel wall at the beginning of fetal period of development, at 9–10 weeks, do not exhibit concurrent CD34 immunoreactivity.Key words: Small bowel, c-kit, CD-34, immunohistohemistry, huma

LIJEČENJE JEDNOKOMORNIH KOŠTANIH CISTA KOD DJECE: KOMPARATIVNA STUDIJA

Unicameral bone cysts (UBC) are benign bone tumor-like lesions. Mostly they are located in the metaphyseal-diaphyseal region of long bones in children and adolescents. The etiology of UBC is still unclear. There is no consensus about the protocol of UBC treatment. The aim of this study was to evaluate the effectiveness of three different techniques for the treatment of UBC. This study included 129 pediatric patients with UBC treated at University Children’s Hospital in Belgrade during the 8-year period. The mean follow up was 7.14 years. The following parameters were observed: gender, age, site, length of cyst, cyst index, cortical thickness, presentation of pathologic fracture, healing of cyst, treatment complications and length of hospitalization. These parameters were correlated to three treatment modalities, i.e. intracystic methylprednisolone acetate injection (group 1), curettage with bone grafting (group 2) and osteoinductive procedure using demineralized bone matrix (group 3). We found statistically significant differences in healing of the cysts and length of hospital treatment between groups 1 and 2, and between groups 2 and 3. In conclusion, complete healing of UBC can be achieved only using open surgery procedure. Intracystic methylprednisolone acetate instillation can be considered a good option for initial treatment of UBC.Solitarne koštane ciste (SKC) su dobroćudne koštane lezije slične tumorima. Najčešće su lokalizirane u metafizno-dijafiznoj regiji dugih kostiju djece i adolescenata. Etiologija SKC nije razjašnjena. Ne postoji konsenzus o protokolu liječenja SKC. Cilj studije bio je procijeniti učinkovitost tri različite tehnike liječenja SKC. Studija je obuhvatila 129 bolesnika liječenih u Sveučilišnoj dječjoj bolnici u Beogradu tijekom 8 godina (2007.-2014.). Srednje razdoblje praćenja bilo je 7,14 (2,5-10) godina. Parametri za uključivanje bili su: spol, dob, lokacija ciste, veličina ciste, indeks ciste, debljina korteksa, patološka fraktura, cijeljenje ciste, komplikacije liječenja i trajanje hospitalizacije. Usporedili smo navedene parametre s tri različite tehnike liječenja: apliciranje metilprednisolon acetata (MPA) unutar ciste (skupina 1), kiretaža i umetanje koštanog presatka (skupina 2) i osteoinduktivni postupak upotrebom demineralizirane koštane međustanične tvari (DKM) (skupina 3). Utvrđena je statistički značajna razlika u cijeljenju cista i trajanju hospitalizacije između skupina 1 i 2 te između skupina 2 i 3. U zaključku, potpuno liječenje SKC može se jedino postići otvorenom kirurškom tehnikom i time spriječiti mogući rizik od zaostalih lezija i fraktura. Minimalno invazivna metoda aplikacijom MPA unutar ciste može se smatrati dobrom opcijom za početno liječenje SKC dugih kostiju

Iskustva s vakuumskim pakovanjem polutvrdih sireva u "Sireli", Bjelovar

Polutvrdi sir je prehrambeni artikl, koji nakon tehnološke zrelosti prolazi put transporta, skladištenja, prodaje i čuvanja kod potrošača do konzumacije

Displaced supracondylar humeral fractures in children: Comparison of three treatment approaches

Introduction. Closed reduction and percutaneous pinning are the most widely used treatment options for displaced supracondylar humerus fractures in children, but there is still no consensus concerning the most preferred technique in injuries of the extension type. Objective. The aim of this study was to compare three common orthopaedic procedures in the treatment of displaced extension type supracondylar humerus fractures in children. Methods. Total of 93 consecutive patients (66 boys and 27 girls) referred to our hospital with Gartland type II or III extension supracondylar humeral fractures were prospectively included in the study over a six-year period. At initial presentation 48 patients were classified as Gartland type II and 45 as Gartland type III fractures. The patients were subdivided into three groups based on the following treatment modality: closed reduction with percutaneous pinning, open reduction with Kirschner wires (K-wires) fixation, and closed reduction with cast immobilisation. The treatment outcome and clinical characteristics were compared among groups, as well as evaluated using Flynn’s criteria. Results. Excellent clinical outcome was reported in 70.3% of patients treated with closed reduction with percutaneous pinning and in 64.7% of patients treated with open reduction with K-wire fixation. The outcome was significantly worse in children treated with closed reduction and cast immobilisation alone, as excellent outcome is achieved in just 36.4% of cases (p=0.011). Conclusion. Closed reduction with percutaneous pinning is the method of choice in the treatment of displaced pediatric supracondylar humeral fracture, while open reduction with K-wire fixation is as a good alternative in cases with clear indications. [Projekat Ministarstva nauke Republike Srbije, br. 175095

A prospective randomised non-blinded comparison of conventional and Dorgan's crossed pins for paediatric supracondylar humeral fractures

Closed reduction and percutaneous pinning are the preferred treatment of displaced supracondylar humeral fractures in children. The purpose of this study is to evaluate the non-standard Dorgan's method and compare its results with those of the standard percutaneous cross pinning method in treatment of unstable or irreducible Gartland type II and III supracondylar humeral fractures in children. This was a prospective evaluation of 138 consecutive patients with Gartland type II or III extension supracondylar humeral fractures referred to University Children's Hospital during a four-year period. The patients were randomized into two groups: the first group, comprised of 71 patients, was treated with standard pin configuration and the second group, comprised of 67 patients, underwent Dorgan's method. The study included 88 boys and 50 girls aged 1.5-11.4 years (mean 6.5±2). At initial presentation 8.7% (n-12) fractures were classified as Gartland type IIa, 25.4% (n-35) as Gartland type IIb and 65.9% (n-91) as Gartland type III. Flynn's criteria were used to evaluate the results. An excellent clinical outcome was reported in about 90% of patients (n-90) treated with standard pin configuration and 89.5% (n-60) of patients treated with Dorgan's method. There were no statistically significant differences in outcomes between the groups in terms of their gender, age, fracture types, function and cosmetics. Neurological lesions were observed in 9.9% of patients (n=7) who were treated using the standard configuration Kirschner pins, while in those treated by Dorgan's method neurological complications were not observed. However, the procedure time was longer (mean 36.54±5.65min) and radiation exposure significantly higher (mean 10.19±2.70 exposures) in the group that was treated using Dorgan's method, compared to the conventional method (mean 28.66±3.76min and 7.54±1.63 exposures). Two laterally inserted crossed pins provide adequate stability with good functional and cosmetic outcome for most unstable paediatric supracondylar humeral fractures with no risk of iatrogenic ulnar nerve injury