A Noninvasive Assistant System in Diagnosis of Lumbar Disc Herniation

The purpose of this study is the application of pressure sensors in diagnostics and evaluation of the accuracy diagnostics of lumbar disc herniation at levels L4/L5 and L5/S1 using the aforementioned platform. The motivation behind the idea to apply the pressure measurement platform is the fact that the motor weakness of plantar and dorsal flexia of the feet is one of the absolute indications for the operative treatment of patients with lumbar disc herniation at the indicated levels. In patients, MRI diagnosis of the lumbosacral spine served as the ground truth in the diagnosis of herniation at L4/L5 and L5/S1 levels. The inclusive criteria for the study were the proven muscle weakness based on manual muscle tests performed prior to surgery, after seven days of surgery and after physical therapy. The results obtained with the manual muscular test were compared with the results obtained using our platform. The study included 33 patients who met the inclusion criteria. The results of the measurements indicate that the application of our platform with pressure sensors has the same sensitivity diagnostics as a manual muscle test, when done preoperatively and postoperatively. After physical therapy, pressure sensors show statistically significantly better sensitivity compared to the clinical manual muscle test. The obtained results are encouraging in the sense that the pressure platform can be an additional diagnostic method for lumbar disc herniation detection and can indicate the effectiveness of operative treatment and physical therapy after operation. The main advantage of the system is the cost; the whole system with platform and sensors is not expensive

Association between oxidative stress biomarkers and concentrations of some metal ions in the blood of patients with brain tumors and hydrocephalus

Introduction Any substance that induces production of free radicals can be a potential cause of brain damage. The aim of our study was to investigate the relationship between some metal ions and oxidative stress biomarkers in the blood of patients with brain tumor and hydrocephalus. Material and methods Our study included 27 control subjects, 24 patients with brain tumor and 21 patients with hydrocephalus. The activities of superoxide dismutase (CuZn SOD), catalase (CAT), glutathione peroxidase (GSH-Px), glutathione reductase (GR), glutathione S-transferase (GST) and acetyl cholinesterase (AChE), as well as concentrations of reduced glutathione (GSH), lipid peroxides (TBARS) and sulfhydryl groups (SH) were analyzed in the plasma and red blood cells (RBCs) of patients. We also determined the concentrations of Mn, Ni, Co, Cu, Zn, As, Se, Cd, Hg and Fe. Results The higher activity of SOD and concentration of GSH in both investigated groups could indicate higher oxidative stress. We also observed decreased levels of SH groups in both groups of patients. In both groups of patients we detected decreased concentrations of Ni, Co, Zn and Fe (and Mn in brain tumor patients) and increased concentrations of As, Se and Cd in the blood. Interestingly, we observed a higher concentration of Cd in both plasma and RBCs of hydrocephalus patients compared to the patients with brain tumor. Conclusions There are strong correlations between some metal ion concentrations and certain oxidative stress biomarkers in the blood of patients, which supports our hypothesis, but the observed trend needs to be further investigated

Primary spinal glioblastoma multiforme. Single center experience and literature review

Abstract Objectives Spinal glioblastomas represent a rare entity accounting for ca 1–3% of all intramedullary tumors; data about survival, prognostic factors and therapeutic protocols are quite poor. Even with an aggressive multimodal management the spinal glioblastoma patients' survival remains poor, with rapid progression of the disease. This study reports our experience with the management of the primary intramedullary glioblastomas, also in regard to the current literature data. Patients and Methods We retrospectively analyzed the medical records of 5 patients treated at the Department for Neuro-oncology and Spine Surgery of the Clinical Center of Belgrade, Serbia, between January 2007 and December 2016 for a primary intramedullary glioblastoma. Demographic characteristics, pre-operative data and post-operative results were then compared with previous literature regarding spinal GBMs and attempt to identify potential prognostic factors. Results Gross total resection was achieved in two patients, while a subtotal resection was performed in the latter 3 cases; as per protocol, all patients underwent to surgery, followed by radio and chemotherapy. There were no intraoperative complications and no patients developed a new postoperative neurological defect; the median overall survival was 6 months. Progression or recurrence of disease was noted in all patients at the 3-months follow-up, despite the adjuvant treatments. Conclusions To the date, there is a lack of consensus on specific management of spinal glioblastomas: the extent of resection can play an important role, but it appears to be not preeminent. A shorter interval between symptoms onset and treatment and a smaller extension of the tumor seem to be correlated with better outcomes and a longer overall survival. However, there is not an adjunctive viable standardized postoperative therapy yet, which results in concrete and persistent improvement of overall survival and progression free survival

Locating and categorizing causes of discomfort during transport of patients to medical facilities

This article presents geographic information system usage in transportation management for comfort calculations, analysing vehicle vibration data measured during patient transportation. The main goal of this article is to develop a methodology for automatic discomfort cause recognition (DCR) that may be tested under real life conditions. We analysed differences between uncomfortable locations detected by passengers during patient transportation (according to their subjective opinions) and uncomfortable locations detected by the measurement system. The measuring system is based on the three-axis accelerometer which is used to determine road comfort values for specific locations gathered by a GPS module. The results obtained were compared with data collected by passengers. During driving, when they experienced discomfort, passengers marked locations in near real time using the GIS. The data thus obtained were analysed with the data obtained by DCR. For the first time, the application of GIS provides analytical tools to create spatial data and define spatial data relations that determine comfort. Testing under real conditions, involving three separate cases, shows a high degree of correlation between the results. The proposed system allows dynamic comfort threshold criteria management and provides a visual representation of summarized tabular data

Mutation rates of 22 autosomal STR LOCI in a European population from central Balkan, Republic of Serbia

Analysis of short tandem repeats (STRs) is a tool for human DNA identification, including paternity and criminal investigations. Locus-specific STR mutation rates are critical for interpretation of DNA identification in practice. Accumulating evidence suggests that STR mutation rates are populationspecific. However, STR mutation rates based on trios have not been analyzed in European population yet. In this study, mutation rates of 20 CODIS and two additional autosomal STR loci (Penta E and Penta D) were determined from 1279 cases of paternity testing in the Serbian population, and the relationships between STR mutation rates and sex, allele length, and heterozygosity were investigated. A total of 63 mutations were observed at 18 loci in a total of 28278 allele transmissions, including 62 (98.4%) single-step and 1 (1.6%) two-step mutations. The average mutation rate was 1.7×10-3 (95% CI: 1.3-2.3×10-3), whereas locus-specific mutation rates ranged from 5.6×10-3 (D12S391) to 0.6×10-3 (D2S1338, D5S818, and D21S11). No mutation was observed at the TPOX, TH01, D16S539, and D22S1045 loci. The mutation rate of paternal origin (2.4×10-3) was eight times higher than that of maternal origin (0.3×10-3), and long alleles mutated more frequently than short and medium alleles (χ2=4.436 and χ2=4.646, respectively, p<0.05). No differences were found when analyzing overall expansion versus contraction (χ2=0.999, p=0.317). Among short alleles two expansions and no contraction were detected, while among long ones three expansions and nine contractions were observed. Furthermore, we found no correlation between locus-specific mutation rates and corresponding heterozygosity (rs=-0.188, p=0.559). Comparisons between populations revealed statistically significant differences in locus-specific mutation rates of 13 CODIS STRs between Serbian population and Chinese or Brazilian. Our results show that STR mutation rates depend on sex, allele size and population, and provide useful data on STR mutation rate based on trios for human DNA identification in European populations.Book of abstracts: International Conference of Biochemists and Molecular Biologists in Bosnia and Herzegovina - ABMBBIH May, 202

Phosphorylated neurofilament heavy chain in cerebrospinal fluid and plasma as a Nusinersen treatment response marker in childhood-onset SMA individuals from Serbia

IntroductionBiomarkers capable of reflecting disease onset and short- and long-term therapeutic effects in individuals with spinal muscular atrophy (SMA) are still an unmet need and phosphorylated neurofilament heavy chain (pNF-H) holds significant promise.MethodsWe conducted a longitudinal prospective study to evaluate pNF-H levels in the cerebrospinal fluid (CSF) and plasma of 29 individuals with childhood-onset SMA treated with Nuinersen (SMA type 1: n = 6, 2: n = 17, 3: n = 6). pNF-H levels before and during treatment were compared with the levels of controls (n = 22), patients with Duchenne muscular dystrophy (n = 17), myotonic dystrophy type 1 (n = 11), untreated SMA individuals with chronic type 3 disease (n = 8), and children with presymptomatic SMA (n = 3).ResultsSMA type 1 showed the highest mean CSF pNF-H levels before treatment initiation. All Nusinersen-treated individuals (types 1, 2, and 3) showed significantly elevated mean baseline CSF pNF-H compared to controls, which inversely correlated with age at disease onset, age at first dose, disease duration and the initial CHOP INTEND result (SMA type 1 and 2). During 22 months of treatment, CSF pNF-H levels declined during loading doses, stabilizing at reduced levels from the initial maintenance dose in all individuals. Baseline plasma pNF-H levels in type 1 and 2 SMA were significantly increased compared to other cohorts and decreased notably in type 1 after 2 months of treatment and type 2 after 14 months. Conversely, SMA type 3, characterized by lower baseline pNF-H levels, did not show significant fluctuations in plasma pNF-H levels after 14 months of treatment.ConclusionOur findings suggest that CSF pNF-H levels in untreated SMA individuals are significantly higher than in controls and that monitoring of CSF pNF-H levels may serve as an indicator of rapid short-term treatment response in childhood-onset SMA individuals, irrespective of the subtype of the disease, while also suggesting its potential for assessing long-term suppression of neurodegeneration. Plasma pNF-H may serve as an appropriate outcome measure for disease progression and/or response to treatment in types 1 and 2 but not in type 3. Presymptomatic infants with SMA may show elevated pNF-H levels, confirming early neuronal degeneration

Design, implementation and testing of the controller for the terabit packet switch

The sequential greedy scheduling (SGS) is a scalable algorithm that provides non-blocking in high-capacity packet switches. We implemented the SGS scheduler in the FPGA device, and examined its scalability and speed. Then, we developed the software for design testing. Our testing software confirms the correct functioning of the scheduler. Both, the scheduler implementation, and the testing software are presented in this paper

Epidural hematomas of posterior fossa

Background. Posterior fossa epidural hematomas represent 7-14% of all traumatic intracranial epidural hematomas. They are most frequently encountered posttraumatic mass lesions in the posterior fossa. The aim of this study was to identify clinical features that could lead to the early diagnosis of posterior fossa epidural hematoma. Methods. Between 1980 and 2002, 28 patients with epidural hematoma of the posterior fossa were operated on at the Institute for Neurosurgery, Belgrade. Clinical course neuroradiological investigations, and the results of surgical treatment of the patients with posterior fossa epidural hematomas were analyzed retrospectively. Results. Almost two thirds of patients were younger than 16 years of age. In 20 cases injury was caused by a fall, in 6 cases by a traffic accident, and in 2 by the assault. Clinical course was subacute or chronic in two thirds of the patients. On the admission Glasgow Coma Scale was 7 or less in 9 injured, 8-14 in 14 injured, and 15 in 5 injured patients. Linear fracture of the occipital bone was radiographically evident in 19 patients, but was intraoperatively encountered in all the patients except for a 4-year old child. In 25 patients the diagnosis was established by computer assisted tomography (CAT) and in 3 by vertebral angiography. All the patients were operated on via suboccipital craniotomy. Four injured patients who were preoperatively comatose were with lethal outcome. Postoperatively, 24 patients were with sufficient neurologic recovery. Conclusion. Posterior fossa epidural hematoma should be suspected in cases of occipital injury, consciousness disturbances, and occipital bone fracture. In such cases urgent CAT-scan is recommended. Early recognition early diagnosis, and prompt treatment are crucial for good neurological recovery after surgery

Intracranial myopericitoma: A case report of a rare tumour in a rare location in an AIDS patient

Myopericytoma is a benign, soft tissue tumor probably derived from perivascular myoid cells. They are usually found in subcutaneous tissues in the extremities. Intracranial localization of myopericitoma is exceedingly uncommon. We report a 43 years old male patient with incidentally found myopericitoma of the posterior fossa. Patient was operated and tumor was completely removed. Patient was subsequently diagnosed with acquired immunodeficiency syndrome due to human immunodeficiency virus infection. One year after operation tumor showed no signs of recurrence, but patient developed progressive symptoms of AIDS and started highly active antiretroviral therapy (HAART). Connection of intracranial myopericitoma appearance and HIV/AIDS has been reported before, but clear connection is yet to be elucidated

Comparative analysis of the animal model and results of the clinical research of the aneurysm inclination angle as the predisposing factor for the occurrence of rupture

Introduction. Natural course of aneurysms that occur on blood vessels of the brain singles out the need for understanding the mechanism of the occurrence of aneurysm wall rupture and identification of anatomic characteristics as predictive factors for hemorrhage to occur. Objective. In this study we comparatively present results of our researches and experimental models on animals. Methods. We made a comparative analysis of anatomical characteristics of blood vessels of the brain and aneurysms obtained on the basis of digital subtraction angiography and intraoperative finding. In this article we review recent research in the anatomic characteristics of intracranial aneurysms and parent blood vessels. We present a series of 185 aneurysms (ruptured and unruptured) dissected at the Neurosurgical Clinic of Clinical Center of Serbia in Belgrade. Results. Inclination angle may be considered as the vital predesposing factor for intracranial aneurysm rupture. In aneurysms that ruptured it was 139.748±27.242°, while in unruptured aneurysms it was considerably smaller and amounted to 100.882±22.001° (p<0.01). Conclusion. Inclination angle may be regarded as the vital predisposing factor since it differs considerably in unruptured and ruptured aneurysms. Aneurysms with blood stream angle smaller than 115° have very small probability of rupture, while blood stream angle bigger than 150° presents a high risk of rupture