Odnosi silvijevog kanala sa okolnim delovima mozga i lobanje mereni anatomski i magnetnom rezonancom

Introducton/Objective: Insufficiency of relevant anatomic data and great neurological and neurosurgical significance were the reasons for this study with scientific and practical implications. The purpose was to determine, at the transverse in situ section of the head, the position and relations of the sylvian aqueduct of the mesencephalon by measuring its distances from particular brain and calvaria structures. Also, the aim was to determine the same distances according to axial sections by using MRI. Methods: The material consisted of twenty autopsy human heads. The section of the head was made at the level of the tentorial hiatus and the midbrain. After that, we measured the distances between the cerebral aqueduct and a) posterior border of the optic chiasm, b) upper border of the dorsum sellae, c) terminal bifurcation of the basilar artery, d) beginning of the straight sinus, e) internal occipital protuberance, f ) tentorial edge (lateral from the aqueduct), and g) internal surface of the calvaria (lateral to the aqueduct). We determined the same distances by the MRI system. The measurements were made in 37 subjects. Results: The numerical data obtained by this study will be of benefit to neurosurgeons in choosing a surgical approach to the contents of the incisural space, and to neurologists for the exact localization of the lesion and interpretation of certain signs and symptoms. Conclusion: The results of a detailed examination of the sylvian aqueduct position and relations have shown that the use of MRI is the morphometric method of choice, because it is more precise for all the parameters monitored than in situ measurements.Uvod/Cilj: Nedostatak odgovarajućih anatomskih podataka i veliki neurološki i neurohirurški značaj su bili razlozi za pokretanje ove studije sa naučnim i praktičnim značajem. Cilj rada je bio da se, na poprečnom preseku glave, odrede položaj i odnosi Silvijevog kanala srednjeg mozga merenjem razdaljina do određenih struktura mozga i lobanje. Takođe, cilj je i da se odrede iste razdaljine korišćenjem poprečnih preseka magnetne rezonance (MR) glave. Metode rada: Materijal su činili preseci 20 glava dobijeni tokom rutinske obdukcije. Preseci glave i mozga su pravljeni u nivou zjapa šatora malog mozga i srednjeg mozga. Merili smo rastojanja između Silvijevog kanala i a) zadnje ivice optičke raskrsnice, b) gornje ivice leđnog dela hipofizne jame, v) završne račve bazilarne arterije, g) početka pravog sinusa, d) unutrašnje potiljačne kvrge, đ) ivice tentorijuma (upolje od kanala srednjeg mozga) i e) unutrašnje površine krova lobanje (upolje od kanala srednjeg mozga). Merili smo iste razdaljine korišćenjem MR. Merenje je obavljeno na 37 osoba. Rezultati: Numerički podaci dobijeni ovom studijom biće od koristi neurohirurzima u pronalaženju hirurškog pristupa sadržaju prostora između slobodnih ivica tentorijuma, kao i neurolozima za preciznu lokalizaciju lezija i interpretaciju nekih znakova i simptoma. Zaključak: Rezultati detaljnog proučavanja položaja i odnosa Silvijevog kanala pokazali su da je korišćenje MR morfometrijska metoda izbora jer je mnogo preciznije za sve posmatrane parametre od merenja tokom obdukcije

Piloting of Blended Learning: Implementation and Benefits

This paper is based on piloting of blended learning as a transformative learning process in order to keep pace with technological innovation. Our redesign of the course was the intention of the use of blended learning as a tool for high-quality, meaningful and longer lasting knowledge, improvements in learning outcomes and greater engagement of students in learning. We chose Moodle platform as a highly sophisticated learning management system with many modules and its possibilities of application in the learning context to develop the online component as a supplement to classroom lessons. After conducting an analysis of the course and a questionnaire, we concluded that students use all the segments of the online component and they become more engaged, their assignments end on time and at the end they would express their satisfaction with the course redesign. Using the T-test for large independent samples there is statistically significantly better performance in the final test (p0.05), which leads us to the view that blended learning helps, above all, average students to upgrade and advance their knowledge. Considering that many of our student are athletes, blended learning is a good choice for them as they are professionally engaged in sports and they can follow the course and complete their assignments in addition to sports commitments. This piloting will serve as a parameter for future use of blended learning to be more adapted to the needs and objectives of students and eliminate any disadvantages

BIOTECHNOLOGY OF RECOMBINANT HORMONES IN DOPING

Recombinant DNA technology has allowed rapid progress in creating biosynthetic gene products for the treatment of many diseases. In this way it can produce large amounts of hormone, which is intended for the treatment of many pathological conditions. Recombinant hormones that are commonly used are insulin, growth hormone and erythropoietin. Precisely because of the availability of these recombinant hormones, it started their abuse by athletes. Experiments in animal models confirmed the potential effects of some of these hormones in increasing physical abilities, which attracted the attention of athletes who push the limits of their competitive capability by such manipulation. The risks of the use of recombinant hormones in doping include serious consequences for the health of athletes. Methods of detection of endogenous hormones from recombined based on the use of a monoclonal antibodies, capillary zone electrophoresis and protein biomarker

The importance of compression elastography in the evaluation of thyroid nodule malignancy

Introduction/Objective. Compression, also called strain elastography imaging techniques, represent new echotomographic modality, which is a promising method for the differentiation of benign from malignant lesions, not only in the thyroid gland but also in other organs. The objective of this study is to evaluate the importance of compression elastography in the differentiation of benign and malignant thyroid nodules. Methods. We performed echotomographic examinations in B mode, and examinations using compression elastography in a total of 186 persons (152 females and 34 males, with the average age of 45.3 ± 13.5 years), with 264 nodules in the thyroid gland. Elastography was done in two steps: the first one through scoring elastographic figures, and the second one through the determination of the resistance index (strain ratio – SR). Results. Using elastography scores by Fukunari, 44 of 60 malignant nodules had a score of 3–4, while 152 of the 204 benign nodules had a score of 1–2. Using the receiver operating characteristic (ROC) analysis, the best cut-off point obtained using elastography scores was 2, with a sensitivity of 73.3% and specificity of 74.5%. Using the software-calculated SR we found that out of 89 nodules with SR ≥ 2.5, 52 were malignant nodules, while out of 175 nodules with SR 2.5, with a sensitivity of 86.7%, and specificity of 81.9%. Conclusion. As a follow-up of standard echotomographic examination in B mode, compression elastography is a newly developed and promising technique in the differentiation of benign from malignant lesions. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175030

Anatomical and MRI relations of the cerebral aqueduct to the adjacent parts of the brain and calvaria

Introducton/Objective. Insufficiency of relevant anatomic data and great neurological and neurosurgical significance were the reasons for this study with scientific and practical implications. The purpose was to determine, at the transverse in situ section of the head, the position and relations of the sylvian aqueduct of the mesencephalon by measuring its distances from particular brain and calvaria structures. Also, the aim was to determine the same distances according to axial sections by using MRI. Methods. The material consisted of twenty autopsy human heads. The section of the head was made at the level of the tentorial hiatus and the midbrain. After that, we measured the distances between the cerebral aqueduct and a) posterior border of the optic chiasm, b) upper border of the dorsum sellae, c) terminal bifurcation of the basilar artery, d) beginning of the straight sinus, e) internal occipital protuberance, f) tentorial edge (lateral from the aqueduct), and g) internal surface of the calvaria (lateral to the aqueduct). We determined the same distances by the MRI system. The measurements were made in 37 subjects. Results. The numerical data obtained by this study will be of benefit to neurosurgeons in choosing a surgical approach to the contents of the incisural space, and to neurologists for the exact localization of the lesion and interpretation of certain signs and symptoms. Conclusion. The results of a detailed examination of the sylvian aqueduct position and relations have shown that the use of MRI is the morphometric method of choice, because it is more precise for all the parameters monitored than in situ measurements. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175030

Morphological analysis of a structures of prenatal pancreas in human

As a mixed exocrine and endocrine gland pancreas has a very important role in the digestive tract. The juice of his exocrine part, which is released into the duodenum, carries more than 20 pancreatic enzymes, important for a normal process of digestion. Endocrine part of the gland, which consists of the islets-insula, actively participate in the metabolism of human organism, secreting two important hormones - insulin and glucagon. Because of its location, the pancreas is an extremely inaccessible organ for a physical examination. Despite of a large number of modern clinical methods for monitoring changes in the body, the detail knowledge of morphological characteristics of this gland is still very important. The material was taken from the cadaver of the fetus and newborn at the Institute of Pathology of the Faculty of Medicine. We classified samples of pancreas into three groups, with respect to age (from 3 months to neonates) and CS length. After dehydration and the molding compositions are cut at a thickness of between 6 and 10 microns. In addition to standard staining methods, some preparations are for identification of insula, painted by Grimelijus. In this study, we determined the morphological changes of the prenatal pancreas, from the third month of intrauterine fetal development, until the end of the fetal time and determine the dynamics of changes in the parenchyma and stroma. We could distinguish functional parts of the pancreas, in 10-11th week of development. In the first trimester of pregnancy, we have noticed an increase in parenchymal elements and the reduction of the stroma, which is slightly more pronounced in interlobular area, that clearly differentiating lobules. At the beginning of the second trimester of pregnancy, in the pancreas that are developing, we observed significant changes. The lobular structure of pancreas was clearly visible. Pancreatic acini are clearly differentiated and are in very close contact, since the stroma between them very reduced. Within almost all lobulus there are clearly expressed the islets of Langerhans, which are multiplied, different sizes, separated from the exocrine part by poorly expressed connective tissue. In the group of prematurely born children, we found that the morphology of the pancreas is very similar to the pancreas at the end of the fetal period

Vasculature of the distal part of optic nerve

Background/Aim. Vascularisation of the distal, namely intracranial and intracanalicular parts of the optic nerve have not been explained in conventional textbooks of anatomy, while there have been explanations of proximal, that is intraorbital segment. The aim of this research was to study the pattern of arterial supply of the intracranial and intracanalicular part (the distal part) of human optic nerve. Methods. The optic nerve and the ophthalmic artery (OA), predominately in their intracranial and intracanalicular parts, were investigated in 25 human specimens by three different methods: macroscopic, stereomicroscopic, and histological observations. Mixture with 10% of India ink and gelatin was injected through the intracranial part of the internal carotid artery, and the most proximal part of the OA. Each optic canal specimen was fixed in formaldehyde and finally paraffin embedded, sectioned, and stained with Masson trichrome, Azan, Toluidin blue, and Van Gieson methods. Results. OA passed through the optic canal within the dural sheath of the optic nerve. In 44% of our specimens the OA was on the inferomedial side of the optic nerve at the entrance point to the optic canal. OA left the optic canal at its lateral border in the apex of the orbit in 72% of our specimens. The intracanalicular portion of the optic nerve receives arterial blood principally from the intracanalicular part of OA. OA gives one (72% of the specimens) to two branches that supply the intracanalicular part of the optic nerve. Each branch pierces the dura mater from below and then supplies the nerve through the pia mater. These arteries then terminate in a pial vascular network of continuous transverse centripetal arterioles and capillaries that surround each optic nerve. The rich anastomoses with branches of superior hypophyseal artery, from the cranial cavity, which take part in the optic nerve vascularization in its hole length, was observed. There were no intraaxial vessels in the intracranial and intracanalicular parts of the nerve in our specimens. Conclusion. These anatomical data offer important informations for understanding the variety of the pathology in the region of optic canal and orbitocranial junction, and is also useful for designing operative strategies. This report indicates the delicacy and vulnerability of the intracranial and intracanalicular capillary network to traumatic disruption

Morphometric analysis of the fascicular organisation of the optic nerve

Background/Aim. The optic nerve is anatomically observed in four segments: intrabulbar, orbital, canalicular, and cranial. According to the literature, the surface of the transversal cut of the nerve is different through it. The aim of this study was to evaluate the fascicular organisation of the optic nerve, throughout its three segments from the eye. Methods. Five pairs of optic nerves, obtained from the autopsies were examined. Using Heidenhain's (azan) staining, the cuts were prepared for microscopy. Morphometric analysis was performed using the stereological methods for morphometric cytology - the Weible’s testing system M42. The following measures were established: the surface of the transverse cut of the nerve, the entire surface of fasciculi, the entire surface of connective tissue and blood vessels, the number of fasciculi, the surface of a single fasciculus. Results. The surface of the transverse cut of the nerve was found to grow from the orbital to the cranial segment, as well as the entire surface of fasciculi. While their number is significantly lower in the cranial segment, the number of fasciculi varied slightly between the orbital and the canalicular segment. The surface of a single fasciculus grows from the bulb to the chiasma. There is probable a cause to believe that this may be due to fusion of the “small” fasciculi in the orbitocranial direction. Conclusion. There are significant differences among the examined parameters of the different parts of the optic nerve