Simultaneous Bilateral Joint Arthroplasties in Treatment of Osteoarthritis

Osteoarthrosis is the most common chronic joint condition, the aetiology of which is still not completely clear. Initial phases of disease are treated conservatively applying physical rehabilitation procedures and medications. Advanced stages need surgical treatment with numerous procedures, depending on the joint affected. Joint arthroplasties are procedure of choice, especially for big joints of the extremities. As osteoarthrosis occurs bilaterally very frequently, there are a growing number of patients in need for operation of both joints. Those procedures can be performed under single anaesthesia or staged procedure, with delay between two surgeries. There are many advantages and disadvantages of both approaches cited by different authors. There is consensus of authors in available articles regarding benefits of single-stage procedure: lower cost, shorter hospital stay, single rehabilitation period and better functional results. Authors disagree about safety of a single-stage bilateral procedure as well as incidence of complications and criteria for selection of patients for safe performing of simultaneous procedure

Effect of ecological conditions on expression of biopomological characteristics of chestnut (Castanea sativa Mill.) in natural populations of Montenegro

This paper presents the five-year long research results (2007-2011) of phenological observations (beginning, full flowering and the end of flowering), morphometric analysis (fruit weight, length, width and thickness of fruit, as well as length and width of the hilum), the ripening time and the average yield of selected genotypes of sweet chestnut (Castanea sativa Mill.). The results show that in terms of time of flowering chestnut trees examined in the group are very early flowering. The ripening of studied chestnut trees shows that the earliest harvest tree was Ostros II, VII and Kostajnica V (09.11.), and Kostajnica III (14.11.) were the latest. The average fruit weight of the selected sweet chestnut trees was (6.9 g). The highest average fruit weight (10.6 g), had the examined Ostros I tree, and the lowest (4.8 g), Kostajnica VI. The yield of the tested chestnut trees was on average (76.3 kg / tree). The selected trees Kostajnica II (66.0 kg / tree), Kostajnica I (69.0 kg / tree) had the smallest yield and Ostros VI (94.0 kg / tree) and Ostros V (87.0 kg / tree) had the highest. Obviously it can be concluded that population genetic variability is very high and gene expression is highly affected in tested samples on both locations. For further research it should be given attention to investigate genotypes in controlled conditions, the best in vitro in tissue culture. [Projekat Ministarstva nauke Republike Srbije, br. TR-20013 i br. TR-31064

Impact of varicocele on quality of spermatogenesis in persons 12-18 years old

Cilj: Varikocela je jedan od najčešćih uzroka infertiliteta, a njena prevalencija značajno raste s razvojem puberteta. Zato je vrlo važno identificirati one adolescente koji imaju najveći rizik za infertilitet, kako bi rana kirurška intervencija bila učinkovita. Cilj rada bio je utvrđivanje učestalosti i stupnja varikocele kod adolescenata (12 – 18 godina), te procjena poboljšanja u morfologiji testisa i parametrima spermograma nakon operativnog liječenja. Metoda: Ispitivana je skupina od 362 muška adolescenta starosti od 12 do 18 godina, od kojih je 23 bilo podvrgnuto kirurškoj intervenciji uklanjanja varikocele (lig. vene spermaticae sec. Palomo). Pregled je obuhvatio: andrološku anamnezu, opći klinički pregled i uroandrološki pregled, kao i određivanje osnovnih parametara spermograma (ukupan broj spermatozoida, postotak pokretljivih i abnormalnih spermatozoida). Rezultati: Varikocela je dijagnosticirana kod 47 (12,98 %) adolescenata starosti od 12 do 18 godina. Nije bilo značajne razlike u zastupljenosti varikocele gr. I i gr. II među različitim starosnim skupinama adolescenata, dok je varikocela gr. III , kao i obostrano smanjenje testisa različitog stupnja, bila češće zastupljena u skupini starijih adolescenata (od 16 do 18 godina). Operativni tretman kod 23 bolesnika rezultirao je povećanjem volumena testisa nakon 3 – 9 mjeseci, kao i povećanjem ukupnog broja i postotka pokretnih spermatozoida. Zaključak: Zbog značajnog utjecaja varikocele na spermatogenezu kod adolescenata potrebno je učiniti detaljna ispitivanja kao osnovu za donošenje odluke o kirurškoj intervenciji. Smanjenje testisa na strani varikocele predstavlja indikaciju za operativni tretman varikocele u ovoj populaciji.Aim: Varicocele is one of the most common causes of infertility, and its prevalence increases significantly in puberty. It is, therefore, important to identify those adolescents who have high risk for infertility, so that early surgical intervention has benefits.The aim of this study was to determine the frequency and degree of varicocele in adolescents (12-18 years), and the assessment of improvement in the morphology of testes and semen parameters after surgical treatment. Methods: A total of 362 male adolescents aged 12-18 years were examined, 23 of them were subjected to surgical removal of varicocele (lig. vene spermaticae sec. Palomo). The examination included: andrological history, general clinical examination and uroandrological review and determination of basic semen parameters (total sperm count, percentage of motile and abnormal sperm). Results: Varicocele was diagnosed in 47 (12.98%) adolescents aged 12-18 years. There were no significant differences in the prevalence of varicocele gr.I and gr.II among different age groups of adolescents, while gr.III varicocele and both testicles reduction in various degree were more frequent in the group of older adolescents (16-18 years). Surgical treatment in 23 patients resulted in an increase in testicular volume after 3-9 months, and in an increase in the total number and percentage of motile spermatozoa. Conclusions: Due to the significant influence of varicocele on spermatogenesis in adolescents it is necesery to do more precise examinations as a basis for deciding about surgery intervention. Shrinking of the testicles on the side where varicocela is present is an indication for surgical treatment of varicocele in this population

Wine polyphenol resveratrol inhibits contractions of isolated rat uterus by activation of smooth muscle inwardly rectifying potassium channels

Resveratrol is a phytoalexin produced in a number of plant species including grapes. The benefit of resveratrol to health is widely reported. Resveratrol has been found to promote relaxation of non-pregnant and pregnant uterus, but its mechanism of action is unclear. The aims of our study were to investigate the involvement of inwardly rectifying potassium channels (Kir) in inhibitory effects of resveratrol on three models of contractions of non-pregnant rat uterus: the spontaneous rhythmic contractions (SRC), oxytocin-elicited phasic contractions and tonic oxytocin-elicited contractions. Uterine strips were obtained from virgin female Wistar rats in oestrus. Strips were mounted into organ bath for recording isometric tension in Krebs-Ringer solution. Experiments followed a multiple curve design. In order to test the involvement of Kirchannels in a mechanism of action of resveratrol (1-100 μM),BaCl2 (1 mM),a antagonist of inwardly rectifying potassium channels was used. Resveratrol induced a concentration-dependent relaxation of all models of contractions. BaCl2 antagonized the response to resveratrolon SRC and oxytocin-elicited phasic contractions. Relaxation achieved by resveratrolon tonic oxytocin-elicited concentrations was insensitive to BaCl2.The antagonism of resveratrol effects by inwardly rectifying potassium channels antagonist suggests that Kir channels are involved in resveratrol action on phasic contractions of rat uterus. Inhibitory effect of resveratrol on tonic contractions did not include Kir channels

Multislice computerized tomography coronary angiography can be a comparable tool to intravascular ultrasound in evaluating “true” coronary artery bifurcations

AimCoronary bifurcation atherosclerosis depends on its angles, flow, and extensive branching. We investigate the ability of CT coronary angiography (CTCA) to determine atherosclerotic plaque characteristics of “true” bifurcation compared with intravascular ultrasound (IVUS) and the influence on side branch (SB) fate after percutaneous coronary intervention (PCI).Methods and resultsThe study included 70 patients with 72 “true” bifurcations. Most of the bifurcations were in the left anterior descending—diagonal (Dg) territory [50 out of 72 (69.4%)]. Longitudinal plaque evaluation at the polygon of confluence [carina and 5 mm proximal and distal in the main branch (MB)] showed that carina side MB and SB plaque had occurred with the lowest incidence with fibro-lipid structure (115 ± 63 HU and 89 ± 73 HU, p < 0.001 for all). Bland–Altman analysis showed a discrepancy in measuring mainly the lumen area between CTCA and IVUS in proximal MB [lumen 5.10, 95% CI (95% confidence interval, 4.53–5.68) mm2, p < 0.001; vessel −1.42, 95% CI (−2.63 to −0.21) mm2, p = 0.023], carina MB [lumen 3.74, 95% CI (3.37–4.10) mm2, p < 0.001; vessel −0.48, 95% CI (−1.45 to 0.48) mm2, p = 0.322], and distal MB [lumen 4.72, 95% CI (4.27–5.18) mm2, p < 0.001; vessel 0.62, 95% CI (−0.53 to 1.77) mm2, p = 0.283]. A significant correlation existed between average plaque density on CTCA with a percentage of calcified plaque on IVUS tissue characterization (proximal r = 0.307/p = 0.024, carina 0.469/0.008, distal 0.339/0.024, minimal lumen diameter 0.318/0.020). Circumferential plaque in the proximal MB segment remained an independent predictor of SB compromise [OR 3.962 (95% CI 1.170–13.418)].ConclusionDetection and characterization of atherosclerotic plaque by CTCA in non-left main “true” coronary bifurcations can provide useful information about bifurcation anatomy and plaque distribution that can predict outcomes after provisional stenting, thus guiding the interventional strategy to bifurcation PCI

Clinical significance of radioimmunoassay (RIA) and immunoradiometric assay (IRMA) in endocrinology

Radiopharmaceuticals are compounds used in human medicine for the diagnosis of 95% and therapy of 5%. Radiopharmaceuticals are used by in-vivo and in-vitro in medicine. In-vitro application includes RIA methods (radioimmunoassay) in clinical laboratories. RIA methods are methods with bookmarks, i.e. the indicator molecule is marked with a radioactive isotope 125J with a half-life of 60 days. RIA methods are the most sensitive quantitative and qualitative techniques. A radioimmunoassay (RIA) is an immunoassay that uses radiolabeled molecules in a stepwise formation of immune complexes. Immunoradiometric assay (IRMA) is an assay that uses radiolabeled antibodies. It differs from conventional RIA n that the compound to be measured combines immediately with the radiolabeled antibodies, rather than displacing another antigen by degrees over some period. RIA and IRMA are the most commonly used techniques which allow the measurement of a wide range of materials of clinical and biological importance, especially in endocrinology for estimation of hormones. These techniques have a significant impact on medical diagnosis due to the ease with which the tests can be carried out, while assuring precision, specificity and sensitivity. These techniques achieve sensitivity through the use of radionuclides and specificity that is uniquely associated with immunochemical reactions. They are largely used for measuring biologically active compounds present in low concentrations, such as hormones, proteins, drugs, microorganisms, etc. The radioimmunoassay (RIA) method is employed to determine numerous hormones, enzymes, antigens, and drugs in very low quantities (10-12–10-9 M) in human plasma in order to assess various diseases. In RIA, the immunologic reaction between the antigen and the antibody is highly specific, and hence the method has high specificity. The accuracy of the method depends on various experimental factors and the specificity of the antigen–antibody reaction. The precision of RIA is affected by experimental errors in pipetting of reagents, chemical separation of the complex, and counting. IRMA is much more sensitive to RIA, which in some cases (e.g. in TSH) is very significant. Because of the use of monoclonal antibodies in the first phase of the reaction, this system has a much better specificity, which significantly reduces errors due to cross-reactions with other hormones.VII International Conference on Radiation in Various Fields of Research : RAD 2019 : book of abstracts; June 10-14, 2019; Herceg Novi, Montenegr

Klinička sigurnost bilateralne bescementne artroplastike kuka u jednom aktu

Uvod: Koksartroza je hronično degenerativno oboljenje zgloba kuka koje se javlja u oko 4% populacije a obostrano javljanje je procenjeno u oko 42% pacijenata. Pacijenti sa bilateralnim oboljenjem mogu operisati oba kuka u jednoj proceduri, što značajno smanjuje troškove lečenja. Cilj ove studije je analiza podataka o bilateralnim artroplastikama kukova izvedenim u jednom ili dva akta, procena da li je izvođenje bilateralne artroplastike kukova u jednom aktu povezano sa povišenim rizikom u odnosu na proceduru u dva akta kao i davanje preporuka za izvođenje procedure u jednom aktu kod selektovanih pacijenata. Metode: Obradili smo podatke za 113 pacijenata oba pola, operisanih u periodu od 2005 do 2015 godine, kod kojih je učinjena bilateralna artroplastika kukova u jednom aktu kao i 157 pacijenata kod kojih je bilateralna artroplastika izvedena u dva akta. Kod svih pacijenata je primenjena identična operativna tehnika kao i standardna antibiotska i tromboprofilaktička terapija. Pacijenti su praćeni u periodu od 30 dana postoperativno. Rezultati: Nije bilo statistički značajne razlike između grupa pacijenata u pogledu godina starosti, pola, komorbiditeta klasifikovanog po ASA skoring sistemu, broju i vrsti komplikacija, revizionim hirurgijama i učestalosti primene transfuzija. Primetili smo povećane zahteve za transfuzijom krvi u obe grupe pacijena u poređenju sa podacima objavljivanim u modernoj literaturi. Zaključak: Bilateralna artroplastika kukova u jednom aktu se može izvoditi rutinski i sigurno u ustanovama koje omogućavaju interdisciplinarni pristup pacijentu i uz adekvatnu selekciju pacijenata. Prednosti izvođenja obostrane procedure u jednom aktu su ekonomski i oni vezani za pacijenta. Podaci iz naše studije koji pokazuju povećane potrebe za primenom transfuzijakrvi navode na zaključak o neophodnosti uvođenja savremenih protokola za perioperativno upravljanje krvnim produktima.Introduction: Coxarthrosis is a chronic degenerative joint disorder which occurs in approximately 4% of population, and bilateral occurrence is estimated at 42%. Patients with bilateral disease can undergo bilateral hip replacement in one procedure, which decreases treatment costs significantly. Aim of this study is to analize our data for bilateral hip arthroplasties performed in one or two stages and to estimate if there is increased risk while performing simultaneous procedure compared to staged one as well as giving recommendations for performing one stage procedure in selected patients. Methods: We processed data for 113 patients of both genders, operated from 2005 until 2015 where single stage bilateral hip arthroplasty was performed and 157 patients where bilateral hip artrhoplasty was performed in two operations. Identical operative technique was applied in all patients as well as standard antibiotic and thromboprophylactic treatment. Follow-up period was 30 days postoperatively. Results: There was no statistically significant difference between two groups of patients regarding age, gender, comorbidity classified by ASA scoring system, number of complications, revision surgeries and frequency of transfusion. We noticed increased transfusion demands in both group of patients comparing to data reported in contemporary literature. Conclusion: One stage bilateral hip arthroplasty can be performed routinely and safely in facilities with possibility for interdisciplinary approach and adequate selection of patients. Benefits from performing simultaneous procedure are economic and patient related. Data from our study which indicate significantly increased need for blood substitution, emphasize the need to introduce contemporary perioperative blood loss management principles

Total bilateral hip arthroplasty in one surgical procedure

Background/Aim. Primary coxarthrosis occurs often in older population. There is possibility of implanting both endoprothesis simultaneously in bilateral coxarthrosis which decreases hospitalization and reduces the expenses and possibility of complication that can occur during general anesthesia. The most serious indications for bilateral total hip arthroplasty in one procedure are younger patients with serious bilateral osteoarthrosis of the hips, without added diseases. Absolute contraindication is found in patients with persistent ductus arteriosus and septal defect. The aim of this study was to point out the possibility and advantages of a single-staged bilateral hip arthroplasty and introducing it in our orthopedic practice. Methods. The procedure was accomplished in 19 patients. The standard total hip arthroplasty surgical technique was performed, followed by the usual antibiotic and anticoagulant therapy. Results. Only one complication - acetabular part instability we recorded, followed by luxation that was surgically managed. Conclusion. This procedure can be performed routinely in selected population and should be reserved for major medical centers capable to provide adequate postoperative care

Arthroscopic findings after shoulder dislocation

Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii). Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical treatment. Methods. Arthroscopy of the shoulder joint was performed in 158 patients with at least one documented shoulder joint dislocation. These patients were divided into two groups. The group I included the patients with one to three dislocations, while the group II those with more than three dislocations. Preoperative diagnosis was based on anamnestic data and clinical examination using specific tests, and on the diagnosis of shoulder joint using radiography or computed tomography. Results. Out of the total number of the patients 138 (87.34%) had injury of the anterior patellar brim, 119 (75.32%) had failure of the anterior capsule, 126 (79.75%) had compressive cartilage injury of the posterior part of the head of the upper arm bone (Hill-Sachs lesion), 102 (64.56%) had insufficiency of glenohumeral tendon, 11 (6.96) had complete cut of the rotator cuff, 23 (14.56%) had injury of the posterior patellar brim, 12 (7.59%) had injury of the upper anterior-posterior patellar brim (SLAP). Conclusion. According to the obtained results it could be concluded that there is no a unique injury that leads to shoulder joint instability. It is necessary to point out to the significance of anamnesis and clinical examination in making diagnosis. Arthroscopic diagnostics is indicated in clinically unreliable findings as an additional method for determining operative treatment

Mammaglobin expression in tissue as a predictor of breast carcinoma aggressiveness

Background/Aim. Human mammaglobin is considered to be one of the most significant markers of hematogenous dissemi-nation of breast carcinoma. This paper aimed to indicate the important role of peritumoral tissue as an active participant in the tumorigenesis process and the concentration/expression of mammaglobins in the peritumoral tissue as a significant prog-nostic factor. Methods. This research included 64 female pa-tients with primary breast carcinoma during the five-year fol-low-up period. To determine the concentration of mammaglo-bin A in samples of carcinoma tissue and peritumoral tissue, Enzyme-linked immunosorbent assay (ELISA) test was used, and for the determination of relative gene expression of mammaglobin A, quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used. Results. The concentra-tion of mammaglobin A was increased in both the carcinoma tissue and peritumoral tissue with an increase in tumor size, number of affected lymph nodes, number of metastases, while relative expression of mammaglobin A was statistically signifi-cantly higher in carcinoma tissue than in peritumoral tissue, re-gardless of the tumor size, number of affected lymph nodes, number of metastases and tumor type. The concentration of mammaglobin A was higher in peritumoral tissue than in tissue of ductal carcinoma, while in the case of lobular carcinoma the concentration of mammaglobin A was higher in carcinoma tis-sue than in peritumoral tissue. Conclusion. Mammaglobin A concentration in peritumoral tissue higher than 0.6704221 ng/mL, and in carcinoma tissue higher than 0.5784426 ng/mL, as well as mammaglobin A relative gene expression in carcino-ma tissue higher than 1.003, were determined as cut-off values. These values may identify patients who are at higher risk of metastatic disease, which would be treated with early radical ad-juvant treatment