Results of the Surgical Reconstruction of the Anterior Cruciate Ligament

Results of the surgical reconstruction of the anterior cruciate ligament (ACL), using as a graft fourfold hamstring tendons (gracilis and semitendinosus) and middle third of the patellar ligament, were compared. In all patients that were participating in this study clinical examination and magnetic resonance showed ACL rupture, and apart from the choice of the graft, surgical technique was identical.We evaluated 112 patients with implemented patellar ligament graft and fourfold hamstring tendons graft six months after the procedure. Both groups were similar according to age, sex, activity level, knee instability level and rehabilitation program. The results showed that there was no significant difference between groups regarding Lysholm Knee score, IKDC 2000 score, activity level, musculature hypotrophy, and knee joint stability 6 months after the surgery. Anterior knee pain incidence is significantly higher in the group with patellar ligament graft (44% vs. 21%). Both groups had a significant musculature hypotrophy of the upper leg of the knee joint that was surgically treated, six months after the procedure. Both grafts showed good subjective and objective results

From Postpartum Metastatic Cancer to Parathyroid Adenoma: A Case Report

We present a 36 year old female patient with suspected advanced postpartum metastatic cancer and multiple osteolytic lesions due to which she was referred to the Internal medicine clinic for further diagnostic evaluation. After extensive investigation, it was discovered that the underlying condition was a parathyroid gland adenoma and the patient was treated surgically. Clinicians should note that parathyroid adenoma can mimic metastatic malignant disease, and should make appropriate diagnostic tests that will lead to the correct diagnosis

Biomechanical Analysis of the Gracilis and Superficial Third of the Quadriceps Tendons Concerning MPFL Biomechanics

The primary goal of this research is the analysis of the biomechanical performances of most common transplants (distal tendon of m.gracilis and upper third of m.quadriceps femoris) used for the reconstruction of the medial patellofemoral ligament (MPFL). The secondary goal is the comparison of the data obtained from the research with the data available in the literature.The research was conducted on 16 samples of the human tendon, of which there are 8 gracilis tendons and 8 quadriceps tendons. Tensile strength is significantly higher in gracilis tendon (26 MPa - 92 MPa) than in quadriceps tendon (30 MPa - 44 MPa). The extensibility is significantly higher in the quadriceps tendon (10% - 15%) than in the gracilis tendon (13% - 17%). Regarding stiffness (N/mm) there are no significant differences between the groups of gracilis and quadriceps tendons. The module of elasticity is significantly higher in gracilis tendon (235 MPa - 855 MPa) in comparison to quadriceps tendon (239 MPa - 361 MPa).The biomechanical characteristics of the distal surface third of the quadriceps tendon are more favourable than the distal tendon of the gracilis which could prove applicable in operative techniques of reconstruction of the medial patellofemoral ligament when choosing a transplant

Applicability of bovine tibia as a model in research on various osteosynthesis techniques

Background and Purpose: The main problem in experimental research in traumatology and orthopedics is unavailability of a large number of samples of human origin. In this research, standard and modified osteosyntheses were performed on bovine tibia to determine whether bovine tibia can be used as a model in biomechanical research on two or more methods of osteosynthesis. Materials and Methods: Investigations were carried out on six preparations of cadaveric human tibia and on six preparations of bovine tibia with the use of device for static and dynamic research on long bone model. The bones were artificially broken and then osteosynthesis was performed on them in two ways: applying the standard method and the modified method with bone cement. The aim of these investigations was to determine the size of the axial force and torsion moment that can be exerted to apply static and dynamic loading on the macerated cadaveric tibia and bovine tibia without breaking the bone or causing its permanent deformation. Results: Investigations conducted on preparations of bovine tibia and cadaveric human tibia showed that there was not even minimal deformation of the bovine tibia in both standard and modified osteosynthesis. There was no shift in torsion angle at all with all three values of torsion moment applied in these investigations. This result was obtained in both standard and modified osteosynthesis. The results showed that in both bovine and human preparations the loosening occurred sooner when standard osteosynthesis was applied. Conclusion: In conclusion, the bovine bone has good potential for use as material for biomechanical experiments

Razina leptina u serumu kod raka dojke

Leptin is a polypeptide which is mostly produced in white fat tissue and is an important proinflammatory, proangiogenic, proinvasive and mitotic factor. There is ever more evidence suggesting the key role of leptin in the occurrence of breast cancer. The aim of the study was to investigate serum leptin levels in patients with benign breast tumors, as well as in various breast cancer phenotypes, taking into account leptin levels connected to menopausal status and body mass index (BMI). The study included 97 patients having their breast tumor surgically removed. Serum leptin level was determined by ELISA method in all study patients. Study results showed that significantly more women, regardless of having malignant or benign tumors, were postmenopausal and had a significantly higher level of leptin compared to the premenopausal group. The highest level of leptin was recorded in the group of postmenopausal obese women compared to other postmenopausal women but also compared to premenopausal women. According to BMI alone, obese women had a significantly higher level of leptin regardless of the type of tumor. The most significant differences in leptin levels observed through BMI were found in the Luminal B1 group. In conclusion, serum leptin level was shown to be a good diagnostic parameter suggesting a higher possibility of breast cancer development.Leptin je polipeptid koji se uglavnom proizvodi u bijelom masnom tkivu te predstavlja važan proupalni, proangiogeni, proinvazivni i mitotički čimbenik. Sve je više dokaza koji ukazuju na ključnu ulogu leptina u nastanku tumora dojke. Istraživali smo serumsku razinu leptina u bolesnica s benignim tumorima dojke, kao i kod različitih fenotipova malignih tumora dojke te ovisnost razine leptina o reproduktivnom statusu i indeksu tjelesne mase (ITM). Istraživanje je obuhvatilo 97 bolesnica kojima je tumor uklonjen kirurškim zahvatom. Serumska koncentracija leptina utvrđena je metodom ELISA u svih bolesnica uključenih u istraživanje. Znatno više žena, bez obzira na to jesu li imale zloćudni ili dobroćudni tumor, bilo je u postmenopauzi te su imale značajno više razine leptina u usporedbi s premenopauzalnim skupinama. Najviša razina leptina utvrđena je kod pretilih žena u postmenopauzi u usporedbi s drugim ženama u postmenopauzi, ali i u usporedbi sa ženama u premenopauzi. Prema ITM, pretile ispitanice su imale značajno više razine leptina bez obzira na vrstu tumora. Najznačajnije razlike u razinama leptina, promatrane kroz ITM, utvrđene se u skupini Luminal B1. Razina leptina u serumu je dobar dijagnostički parametar koji govori u prilog većoj predispoziciji za nastanak karcinoma dojke

Morphometric Characteristics of Thyroid Cartilage in People of Eastern Croatia

The aim of this research was to describe thyroid cartilage morphometry in the population of Eastern Slavonia in detail. The research was carried out on 68 samples of adult thyroid cartilages. There was statistically significant difference between all analysed parameters in male and female samples, except for the distance between the superior horns tips. All parameters had greater values in men, except for the thyroid angle, which was greater in women. There was significant correlation between most of the measured parameters. The strongest correlation was noticed in the distance between the horns at all measured levels and between the pairs of parameters measured for the left and right side respectively. The difference of our results in comparison to the results obtained by other researchers is probably caused by the fact that the measurements were taken on the samples obtained from different populations

Vertebroplasty - treatment method in compressive vertebral fractures

Cilj rada je prikaz vertebroplastike kao stabilizacijskog operacijskog zahvata u kojem se aplicira koštani cement iglom u slomljeni trup kralješka uz pomoć rentgenskog pojačivača, radi smanjenja bola. Operacijski zahvat - vertebroplastika je indicirana od visine petog prsnog do petog slabinskog kralješka. Ovom metodom stabilizacija se postiže 10-ak minuta nakon aplikacije cementa u trup, a analgetski učinak je rezultat sprječavanja mikropokreta te uništavanja živčanih završetaka toplinskom reakcijom za vrijeme polimerizacije cementa. Viskoznost cementa, položaj punkcijske igle i kontinuirano korištenje rentgenskog pojačivača tijekom cijele procedure, a naročito za vrijeme aplikacije cementa ključne su za zahvat jer značajno reduciraju mogućnost nastanka komplikacije. Vertebroplastika predstavlja agresivan tretman u liječenju prijeloma, sama operacijska trauma je minimalna, omogućena je trenutna stabilnost i brza mobilizacija bolesnika, što vertebroplastiku čini metodom izbora u liječenju kompresivnih prijeloma trupa kralješka

Vertebroplasty - treatment method in compressive vertebral fractures

Cilj rada je prikaz vertebroplastike kao stabilizacijskog operacijskog zahvata u kojem se aplicira koštani cement iglom u slomljeni trup kralješka uz pomoć rentgenskog pojačivača, radi smanjenja bola. Operacijski zahvat - vertebroplastika je indicirana od visine petog prsnog do petog slabinskog kralješka. Ovom metodom stabilizacija se postiže 10-ak minuta nakon aplikacije cementa u trup, a analgetski učinak je rezultat sprječavanja mikropokreta te uništavanja živčanih završetaka toplinskom reakcijom za vrijeme polimerizacije cementa. Viskoznost cementa, položaj punkcijske igle i kontinuirano korištenje rentgenskog pojačivača tijekom cijele procedure, a naročito za vrijeme aplikacije cementa ključne su za zahvat jer značajno reduciraju mogućnost nastanka komplikacije. Vertebroplastika predstavlja agresivan tretman u liječenju prijeloma, sama operacijska trauma je minimalna, omogućena je trenutna stabilnost i brza mobilizacija bolesnika, što vertebroplastiku čini metodom izbora u liječenju kompresivnih prijeloma trupa kralješka

3D Printed Clamps for In Vitro Tensile Tests of Human Gracilis and the Superficial Third of Quadriceps Tendons

Recent soft tissue studies have reported issues that occur during experimentation, such as the tissue slipping and rupturing during tensile loads, the lack of standard testing procedure and equipment, the necessity for existing laboratory equipment adaptation, etc. To overcome such issues and fulfil the need for the determination of the biomechanical properties of the human gracilis and the superficial third of the quadriceps tendons, 3D printed clamps with metric thread profile-based geometry were developed. The clamps’ geometry consists of a truncated pyramid pattern, which prevents the tendons from slipping and rupturing. The use of the thread application in the design of the clamp could be used in standard clamping development procedures, unlike in previously custom-made clamps. Fused deposition modeling (FDM) was used as a 3D printing technique, together with polylactic acid (PLA), which was used as a material for clamp printing. The design was confirmed and the experiments were conducted by using porcine and human tendons. The findings justify the usage of 3D printing technology for parts manufacturing in the case of tissue testing and establish independence from the existing machine clamp system, since it was possible to print clamps for each prepared specimen and thus reduce the time for experiment setup

Od postporođajnog metastatskog tumora do adenoma paratireoidne žlijezde

We present a 36 year old female patient with suspected advanced postpartum metastatic cancer and multiple osteolytic lesions due to which she was referred to the Internal medicine clinic for further diagnostic evaluation. After extensive investigation, it was discovered that the underlying condition was a parathyroid gland adenoma and the patient was treated surgically. Clinicians should note that parathyroid adenoma can mimic metastatic malignant disease, and should make appropriate diagnostic tests that will lead to the correct diagnosis.Prikazuje se 36-godišnja bolesnica sa sumnjom na poslijeporođajni uznapredovali metastatski karcinom i s višestrukim osteolitičkim lezijama zbog čega je upućena na Internu kliniku radi daljnje dijagnostičke obrade. Nakon opsežne obrade, otkriveno je da se radi o adenomu paratireoidne žlijezde te je bolesnica operativno liječena. Kliničari trebaju imati na umu da adenom paratireoidne žlijezde može oponašati metastatsku malignu bolest te trebaju učiniti odgovarajuće dijagnostičke pretrage koje će uputiti na dijagnozu