Correlation between clinical and histopathologic diagnoses of potentially malignant oral lesions

BACKGROUND: The serious nature of potentially malignant oral lesions (PMOL) demands that the final diagnosis be made on both clinical and histopathologic grounds. The aim of the present study was to determine the correlation between clinical and histopathologic diagnoses of PMOL using a discrepancy index (DI). METHODS: Fifty-one patients with PMOL were examined clinically, and a biopsy was taken from each one. The results of histopathologic diagnosis were compared with the clinical diagnosis. We established that the histopathologic diagnosis was incompatible when the clinical diagnosis was not confirmed. On the basis of the incompatible diagnosis, we calculated a discrepancy index between the clinical and histopathologic diagnosis. RESULTS: Clinically, the homogeneous leukoplakia was the most frequent lesion followed by erosive lichen planus and reticular lichen planus. No cases of erythroplakia were observed. Lesions were most frequently seen at the buccal mucosa, followed by the gingiva (alveolar mucosa) and tongue. The histopathologic diagnosis showed that the majority of the lesions were benign keratoses followed by lichen planus. Three cases of epithelial dysplasia were mild. The DI between clinical and histopathologic diagnosis was 17.6 %. The higher DI was found in erosive lichen planus. CONCLUSION: The obtained findings show that in 90% of leukoplakias, clinical diagnosis was confirmed by histopathologic examination. The discrepancy between clinical and histopathologic diagnoses in 17.6 % of cases suggests that all PMOLs should be submitted to histological analysis

DEMOGRAPHICS OF COMMUNICATION SKILLS OF PRESCHOOL CHILDREN (4-5 YEAR OLD)

The research was carried out with the aim of identifying the impact of demographic factors on the expression of communication skills of 4-5-year-old children in Montenegro. The influence of several factors that can affect the speech development (gender, educational level of mother and father, birth order, length of stay in kindergarten and the age subgroup within the same year) has been examined. This is a transverse study. From the overall, four-part model of the Gunzberg II test, we highlighted items related to communication in the order of age 4 and 5. Items were observed in relation to development standards and in relation to the Curriculum in preschool institutions. The sample is consisted of 639 children from 17 kindergartens. The results of the research suggest that the participants of this research do not have enough developed communication skills in accordance with the standards for appropriate ages. The variables we tested as independent did not show a constant impact on the appearance of differences in some tasks. In order to improve childrenʼs communication development, it would be necessary to: a. redesign the curriculum, b. develop programs of systematic parent training; and c. reduce the number of children in one educational group

Nekroza potkožnog masnog tkiva kod dojenčeta

Subcutaneous fat necrosis of the newborn and infant is a rare disease, with still unknown incidence, which usually occurs in term or post-term newborns that have experienced perinatal stress. It usually occurs within the fi rst six weeks of newborn’s life; however, onset of the disease may be delayed for several months. A 6-week-old female infant was admitted to our department due to failure to thrive, irritability and vomiting. Physical examination in the area of the inner thighs, hips, back and shoulders, revealed the presence of subcutaneous infi ltrations, which were fi rm, slightly livid, and did not seem painful to touch. Laboratory analysis showed hypercalcemia, ultrasonographic review of body fat revealed hyperechogenicity, while abdominal ultrasound revealed nephrocalcinosis. Computerized tomography detected the presence of calcifi cations in the brain. Deep skin biopsy confi rmed the diagnosis of subcutaneous fat necrosis. Treatment included fl uid loading, termination of vitamin D substitution, and low calcium diet. Single doses of calcitonin and pamidronate were administered. After this therapy, calcium levels returned to normal range. Subcutaneous infi ltrates gradually decreased and became softer. In most reported cases, regression of skin lesions is expected after a few months, often without any residue on the skin. Elevated serum calcium may persist long after the withdrawal of cutaneous lesions, which is the reason for continuous monitoring of serum calcium and appropriate treatment in case of hypercalcemia in order to prevent metastatic calcifi cation.Nekroza potkožnog masnog tkiva kod novorođenčeta i dojenčeta je rijetka bolest još uvijek nepoznate incidencije, koja se obično javlja kod novorođenčadi rođene u terminu ili poslije termina izložene perinatalnom stresu. Najčešće nastaje u prvih šest tjedana djetetova života, no moguć je i odgođeni nastup bolesti za nekoliko mjeseci. Žensko dojenče staro 6 tjedana primljeno je na naš odjel zbog slabog napredovanja, razdražljivosti i povraćanja. Fizikalni pregled otkrio je na unutarnjem dijelu bedara, bokovima, leđima i ramenima potkožne infi ltrate koji su bili tvrdi, blago modrosivi i nisu se činili bolnima na dodir. Laboratorijske pretrage pokazale su hiperkalcemiju, dok je ultrazvučni pregled tjelesne masti otkrio hiperehogeničnost, dok je ultrazvuk abdomena pokazao nefrokalcinozu. Kompjutorizirana tomografi ja otkrila je prisutnost kalcifi kacija u mozgu. Duboka kožna biopsija potvrdila je dijagnozu nekroze potkožnog masnog tkiva. Liječenje je provedeno opterećenjem tekućinom, uz prestanak nadomještanja vitamina D i prehranu s niskim sadržajem kalcija. Dijete je dobilo po jednu dozu kalcitonina i pamidronata. Nakon ove terapije razine kalcija vratile su se na normalu. Potkožni infi ltrati postupno su se smanjili i omekšali. U većini opisanih slučajeva regresija kožnih promjena očekuje se kroz nekoliko mjeseci, često bez ikakvih zaostalih tragova na koži. Povišena razina kalcija u serumu može potrajati još dugo nakon što se kožne promjene povuku pa je potrebno stalno praćenje serumskog kalcija i odgovarajuće liječenje u slučaju hiperkalcemije kako bi se spriječila metastatska kalcifi kacija

The crude protein content in red clover grown on different soil types

Crude protein content is one indicator of red clover quality, which, among other things, is affected by the variability of soil properties. The aim of this study was to determine the effect of different soil types on the content of crude protein in red clover. The examination was conducted on six types of soil: chernozem, vertisol, eutric cambisol, humofluvisol, fluvisol and humogley (according to domestic soil classification). Sampling of plant material was carried out during May 2011, in the second year of red clover production. On the basis of these results it can be concluded that there are statistically significant differences in the content of crude protein between red clover plants, grown on different soil types. The highest protein content has red clover grown on chernozem (21.33%) and lowest on the fluvisol (14.33%). Soils, on which the protein content in red clover was higher, are characterized by good physical and chemical properties, a higher content of total nitrogen, primarily nitrogen fixation increased, as have the favorable conditions for microbial activity. This is primarily related to the pH value, because the greatest number of Rhizobium is in neutral and slightly alkaline soils. The expected results should be a guideline for the production practice, because the modeling of feed production, in different production conditions, raises the possibility of more intensive crop and livestock production

Lobular panniculitis: A manifestation of pancreatic tumor with fatal outcome

Lobular panniculitis is a skin condition that may be the first sign of underlying pancreatic disease. Though rare, the condition has been sufficiently well defined and pathognomonic, thus making differentiation from idiopathic lobular panniculitis quite possible. A 77-year-old woman was in apparently good general health condition when developed skin lesions in a form of erythematous painful fluctuant nodules localized predominantly on the breast, but also present on the arms, thighs, and trunk. Her serum and urinary amylase levels were respectively 3 and 8 fold higher than normal. On histology, skin biopsy showed acute lobular panniculitis with large foci of adipocyte necrosis. Examination of the breast excluded any specific process other than nodular subcutaneous inflammation, but revealed a tumor of the pancreatic head. The nodules spontaneously ulcerated exuding an oily thick brownish material. Her condition deteriorated, and she became progressively debilitated. The patient died before operation, within the next 3 weeks. Subcutaneous fat necrosis was the first manifestation of an otherwise occult pancreatic disease with fatal outcome

Nezrele ganglijske stanice kolona kao uzrok megakolona u dojenačkoj dobi: prikaz bolesnika

IImmaturity of ganglion cells is a rare form of dysganglionosis that belongs to the group of dysmorphic types, characterized by a normal or mildly decreased number of ganglion cells, with the cells and their nuclei being considerably smaller in size. The disorder usually manifests clinically early after birth with abdominal distension, vomiting, feeding intolerance, and delayed passing of meconium. Diagnostic evaluation may include radiological studies; however, biopsy of colonic mucosa with histochemical analysis is considered the most reliable method. Manometry is a reliable noninvasive diagnostic study to confi rm motility disorder. Treatment may be medical in mild cases and more commonly surgical due to complications of the disorder. We present a case of immature colonic ganglion cells as a cause of megacolon in infancy. In our case, medicamentous treatment was eff ective and led to normalization of bowel emptying and stool consistency. Considering that follow up rectosigmoidoscopy was refused by the patient’s parents, we were not able to compare the histopathologic fi ndings before and after the medicamentous treatment; however, the favorable clinical course made us assume that the ganglion cells had probably fully matured.Nezrelost ganglijskih stanica je rijedak oblik disganglionoze koji spada u skupinu dismorfi čnih tipova, a obilježen je normalnim ili blago povišenim brojem ganglijskih stanica, pri čemu su stanice i njihove jezgre znatno manje veličine. Klinički se bolest obično očituje rano poslije rođenja uz nadutost trbuha, povraćanje, nepodnošenje hranjenja i odgođen prolazak mekonija. Dijagnostička procjena može obuhvatiti radiološka ispitivanja, međutim, biopsija sluznice kolona uz histokemijsku analizu smatra se najpouzdanijom metodom. Manometrija je pouzdana neinvazivna dijagnostička pretraga za potvrdu poremećaja pokretljivosti. Liječenje može biti medikamentno u blažim slučajevima, ali je češće kirurško zbog komplikacija bolesti. Prikazuje se slučaj gdje su nezrele ganglijske stanice kolona uzrokovale megakolon kod dojenčeta. U našem slučaju se medikamentno liječenje pokazalo učinkovitim i dovelo je do normalizacije pražnjenja crijeva i konzistencije stolice. Kako su bolesnikovi roditelji odbili kontrolnu rektosigmoidoskopiju, nismo mogli usporediti histopatološke nalaze prije i poslije medikamentnog liječenja, ali povoljan klinički tijek ukazuje na to da su ganglijske stanice vjerojatno sazrele

Anatomske karakteristike furkacija i korenova višekorenih zuba - epidemiološka studija

Background/Aim. Knowledge of numerous variations in anatomical features of furcation area is a prerequisite for the achievement of more predictable results in the therapy of multi-rooted teeth with furcation involvement (FI). The aim of the study was to evaluate the morphological characteristics of extracted molars of adult population in Belgrade, Serbia. Methods. In total, 468 extracted first and second molars, both mandibular and maxillary, were measured. The values of root trunk lengths and root lengths, diameter of furcation entrances (FE), distance between the roots and depth of root concavity were analysed. Results. The maxillary first molars had significantly higher root trunk lengths values than the second molars. As for the mandibular molars, FE was smaller than 1 mm. The distance between the roots was more than 2 mm at the third level of measurement. Conclusion. The buccal FE of maxillary molars was the lowest. The root concavity of the second mandibular molars was higher from the lingual aspect.Uvod/Cilj. Poznavanje mnogobrojnih varijacija anatomskih karakteristika furkacija (furkacionih regija) je preduslov za postizanje predvidivih rezultata terapije furkacionih defekata višekorenih zuba. Cilj ovog istraživanja je bio procena morfološke karakteristike izvađenih zuba adultne populacije u Beogradu. Metode. Merenja su vršena na ukupno 468 izvađenih prvih i drugih molara i gornje i donje vilice. Analizirane su izmerene vrednosti dužine korenskog stabla i dužine korenova, prečnik ulaza u furkaciju, odstojanje između korenova i dubina korenskog konkaviteta. Rezultati. Prvi gornji molari su imali signifikantno veće vrednosti dužine korenskog stabla od drugih gornjih molara. Kod donjih molara, prečnik ulaska u furkaciju bio je manji od 1 mm. Na trećem nivou merenja, odstojanje između korenova imalo je vrednost veću od 2 mm. Zaključak. Prečnik ulaska u furkaciju sa bukalne strane gornjih molara bio je najmanji. Dubina korenskog konkaviteta drugih donjih molara bila je veća sa lingvalne strane

Supplementary data for article: Stanković, N.; Šenerović, L.; Bojic-Trbojevic, Z.; Vuckovic, I.; Vicovac, L.; Vasiljevic, B.; Nikodinović-Runić, J. Didehydroroflamycoin Pentaene Macrolide Family from Streptomyces Durmitorensis MS405(T): Production Optimization and Antimicrobial Activity. Journal of Applied Microbiology 2013, 115 (6), 1297–1306. https://doi.org/10.1111/jam.12326

Supporting information for: [https://doi.org/10.1111/jam.12326]Related to published version: [http://cherry.chem.bg.ac.rs/handle/123456789/1438]Related to accepted version: [http://cherry.chem.bg.ac.rs/handle/123456789/3486

Drug-related pityriasis rubra pilaris with acantholysis

Introduction. Acantholysis is rarely reported histological feature of Pityriasis rubra pilaris (PRP), recently recognized as having diagnostic specificity for differentiating PRP from psoriasis. Case report. Adult male patient one week after the introduction of simvastatin had experienced pruritic erythemo-squamous eruption on head and upper trunk that in a month progressed to erythrodermia, with islands of sparing. Histological picture combined pemphigus-like acantholysis with alternating hyper- and parakeratosis, follicular plugs and dermal inflammation, and confirmed the clinical diagnosis of classic adult type 1 PRP. Acitretin therapy resulted in a resolution of skin disease. Patch test with simvastatin was negative, scratch test was positive, and it was estimated that potential risk of oral challenge with simvastatin outweighed actual need for it. Drug triggering PRP episode is the most likely explanation for temporal relation between the start of simvastatin treatment and skin eruption. Conclusion. In management of rare inflammatory skin disease, such as PRP, we have to carefully observe and evaluate not only diagnostic features but possible external influences on its course also

Nokardijalni apsces mozga koji je oponašao metastazu karcinoma pluća kod imunokompetentnog bolesnika s plućnom nokardijazom: prikaz slučaja

Nocardia is a ubiquitous microorganism which can be the cause of local and disseminated infection in humans. Immunocompetent and immunocompromised patients both can be affected and Nocardia cyriacigeorgica was reported as a pathogen isolated in patients worldwide. In most cases, nocardiosis is present as pulmonary infection because inhalation is the primary way of bacterial exposure. Nocardial brain abscess occurs usually secondary to a septic focus elsewhere in the body. Considering the facts that the elderly population is growing, such as the number of immunocompromised patients together with high mortality rate in patients with nocardial infection of the central nervous system, we have to raise aware-ness of the possibility for this rare but potentially fatal condition. We present a case where nocardial ab-scesses of lung and brain were initially suspected as lung cancer with brain metastases. The patient was treated with a combination of surgical resection and antimicrobial therapy with good outcome.Nocardia je ubikvitaran mikroorganizam koji može biti uzročnik lokalnih i sistemskih infekcija kod čovjeka. No-cardia cyriacigeorgica je patogen koji je izoliran i prijavljen u svim dijelovima svijeta. I imunokompetentne i imu-nokompromitirane osobe mogu biti zahvaćene ovom infekcijom. U većini slučajeva prisutna je infekcija pluća bu-dući da je inhalacija primarni put unošenja uzročnika. Nokardijalni apscesi mozga se obično javljaju uslijed posto-janja žarišta infekcije u drugim dijelovima organizma. Imajući u vidu činjenicu da raste broj osoba starije životne dobi i broj imunokompromitiranih osoba u ukupnoj populaciji, uz visoku smrtnost bolesnika s nokardijalnom infek-cijom središnjega živčanog sustava, moramo biti svjesni mogućnosti za razvoj ovog rijetkog, ali potencijalno fatal-nog stanja. Prikazujemo slučaj bolesnika kod kojega su plućna nokardijalna infekcija i nokardijalni apsces mozga inicijalno shvaćeni kao karcinom pluća i metastatski tumor mozga. Bolesnik je liječen kombinacijom kirurškog liječenja i antimikrobne terapije s dobrim ishodom