PROF. ZDENKO KRIŽAN (1915 – 2005) - PHYSICIAN, ANATOMIST AND TEACHER

Zdenko Križan (1915. - 2005.), liječnik, anatom i nastavnik, važna je akademska ličnost 20. stoljeća, posebno na južnoslavenskom području. Sudjelovao je u osnivanju tri anatomska zavoda i rukovodio njihovim radom. Tijekom dugogodišnje karijere bavio se nastavnim i znanstveno-istraživačkim radom. Prof. Križan je autor kompendija opće i specijalne anatomije za studente medicine i stomatologije. Rezultate svojih anatomskih istraživanja, uglavnom iz područja skeleta glave i krvnih žila, objavio je u domaćim i inozemnim znanstvenim časopisima. Ovaj rad pregledno daje biografske podatke o prof. Križanu.Zdenko Križan (1915 - 2005), physician, anatomist and teacher, is an important academic figure of the 20th century, especially in the South Slavic area. He participated in the founding of three anatomical institutes and directed their work. During the years of his career he was teaching and he did scientific research. Prof. Križan is author of three compendia of anatomy for Medicine and Dentistry students. The results of his anatomical research, mainly in the area of the head skeleton and blood vessels, were published in national and international scientific journals. This article is a rewiew of prof. Križan’s biography data

ISOLATED TRAUMATIC INJURIES OF THE GALLBLADDER – TWO CASE REPORTS

Izolirane traumatske ozljede žučnog mjehura relativno su rijetka stanja koja mogu ugroziti život. U ovome radu prikazujemo dva bolesnika s izoliranom ozljedom žučnog mjehura i njihovu bolničku obradu, s naglaskom na doprinosu radiološke dijagnostike. Slikovne metode radiološke dijagnostike (ultrazvuk, višeslojna kompjutorizirana tomografija) imaju važno mjesto tijekom svih faza u bolničkom zbrinjavanju bolesnika s traumatskom ozljedom žučnog mjehura.Isolated traumatic injuries of the gallbladder are rare but, if inadequately recognized, potentially life-threatening conditions. In this paper we present two cases of treatment of isolated injuries with a special accent on the great contribution of the imaging diagnostic methods in both diagnosis and choosing the therapeutic approach of these conditions. Radiology imaging methods – ultrasound and computed tomography – have a significant role in all stages of the hospital treatment of patients with traumatic gallbladder injury, as well as in confi rming the uneventful recovery of these patients

The Influence of Clinical and Anthropometric Parameters on the Serum Levels of the Endothelin-1 in Pregnant Women and their Newborns

Pregnancy induced hypertension (PIH) is major contributor to maternal death in developing countries. Endothelin-1 (ET-1) is the most potent vasoconstriction agent known and its serum levels are increased in PIH. Therefore it is important to elucidate maternal and neonatal factors which influence endothelin-1 serum levels. 100 pathological pregnancies and 88 controls were analyzed for blood endothelin-1 and their anthropometric and clinical data were collected. In maternal blood ET-1 levels were strongly predicted by diagnosis, therapy and BMI, while umbilical cord ET-1 levels were strongly predicted by gestational age, therapy and delivery termination. Positive correlation between BMI and ET-1 levels suggest that obese pregnant women have increased risk for cardiovascular diseases. Inverse relationship between Apgar and umbilical ET-1 indicates that ET-1 could be considered as a prognostic marker in cases of neonatal asphyxia

The effect of age, anthropometric parameters, vertebral bone densitometry and ash density on iliac crest bone volume and microstructure

Background and Purpose: The purpose was to compare iliac crest bone static bone histomorphometry and vertebral bone densitometry as two methods frequently used in clinical practice. Patients and Methods: Cylindrical bone samples of the iliac crest bone (N=100) for bone histomorphometry and the whole bodies of the third lumbar vertebra (L3) (N=100) for bone densitometry and atomic absorption spectrometry were collected. Multiple regression analyses were carried out and results were considered significant when p<0.05 and 0.01. Results: Age was inversely proportional to all histomorphometric parameters except for Tb.Sp. Age predicted BV/TV with the largest share of contribution of 68%. Gender showed the highest share of contribution for the Tb.Th (32%), while BMD showed it for the Ct.Th (10%). Conclusions: After age and gender, BMD is the third strongest variable to predict iliac crest bone histomorphometric parameters, and thus we can conclude that iliac crest bone histomorphometry and vertebral bone densitometry are correlated, which is important for monitoring osteoporosis in good clinical practic

Ruptura apscesa jetre s posljedicom plinske embolije u sustavu portalne vene

U ovome radu prikazujemo bolesnicu u kliničkoj slici akutnog abdomena koja se razvila zbog rupture apscesa jetre s posljedicom plinske embolije u sustavu portalne vene te doprinos i mogućnosti radiološke dijagnostike u hitnoj bolničkoj obradi. U etiopatogenetskoj podlozi kolangitisa i razvoja apscesa jetre utvrđena je kronična bilijarna litijaza s intermitentnim opstrukcijama u hepatoduodenalnoj cirkulaciji žuči. Anatomske karakteristike sustava portalne vene i njegovih anastomoza sa sistemskom cirkulacijom predstavljaju supstrat za razvoj ozbiljnih posljedica plinske embolije na drugim organskim sustavima, primjerice, u obliku infarkta bubrega i infarkta slezene, što je radiološkim dijagnostičkim metodama dokazano u ovome slučaju

The remodeling of the skeleton

Koštani sustav kralježnjaka vrši dvije glavne uloge: prva je biomehanička uloga koja uključuje podupiranje tijela i zaštitu unutarnjih organa i struktura te inzerciju mišićima u svrhu izvođenja pokreta, a druga uloga je metabolička koja uključuje održavanje mineralne homeostaze organizma. Zato, iako su smatrane „mrtvim” inertnim strukturama, kao što to studenti tijekom svog studija medicine doživljavaju, kosti su metabolički iznimno aktivni organi podvrgnuti kontinuiranim cjeloživotnim promjenama. Tijekom rasta i razvoja kosti se formiraju procesom oblikovanja (engl. bone modeling), što uključuje izgradnju i odlaganje koštanog matriksa na razvojno određenim i biomehanički induciranim mjestima skeleta. Čak i prije negoli se skelet u potpunosti razvije, kosti se počinju kontinuirano pregrađivati (engl. bone remodeling) u svrhu održavanja tkivnog integriteta i biomehaničke funkcije, prilagodbe koštane arhitekture prema mehaničkim zahtjevima i zbog popravaka mikrooštećenja, te ako je potrebno mobilizirati kalcij i fosfor. Proces pregradnje uključuje niz precizno reguliranih i tijesno spregnutih staničnih i molekularnih procesa koje omogućuje koordinirana aktivnost osteocita, osteoblasta i osteoklasta. Ova tri različita tipa stanica koštanog tkiva organizirana su u specifičnu morfološku i funkcionalnu višestaničnu jedinicu (engl. basic multicellular unit) koja obavlja i koordinira dva temeljna procesa u biologiji kosti: razgradnju i izgradnju kosti tijekom ciklusa nazvanog ciklus koštane pregradnje. Ovaj ciklus počinje fazom aktivacije koja uključuje mehanosenzaciju i mehanotransdukciju osteocita ili staničnim odgovorom na sistemski humoralni faktor kao što je paratireoidni hormon. Ovi startni signali potiču stvaranje specifične strukture nad koštanom površinom koju treba pregraditi i nazivamo je odjeljak koštane pregradnje (engl. bone remodeling compartment). Nadalje ovi startni signali aktiviraju osteoklastne prekursore na proliferaciju, diferencijaciju, pričvršćivanje i razgradnju određene koštane površine u sljedećoj fazi resorpcije. Nakon što se razgradi određena količina koštanog matriksa, počinje faza obrata koja uključuje oslobađanje brojnih, još uvijek nedovoljno poznatih činitelja koji povezuju razgradnju i osteoblastnu izgradnju s mineralizacijom kosti u sljedećoj fazi. Kada se stvori ista količina kosti koja se razgradila, slijedi završna faza ciklusa u kojoj se ciklus koštane pregradnje zaustavlja, a koštana površina ulazi u mirnu fazu.The bones of the vertebrate skeleton serve two main functions: the first is biomechanical function which includes support and protection of internal organs and structures, so as providing a muscle attachment for the locomotion and the second is essential metabolic function which includes mineral homeostasis maintaining. In spite skeleton is being presented as “dead”, inert structure, as often medical students learn in anatomy, it is metabolically, extremely active organ and undergoes continuous lifelong changes. Bones are initially formed by modeling processes, which include the production and deposition of bone tissue at developmental and biomechanical sites of the skeleton. Before being fully formed, bones undergo remodeling process which continues throughout life, in order to preserve the structural integrity and biomechanical function, to adjust bone architecture according to mechanical demands, to repair microdamages, and if it is needed, to mobilize stored calcium and phosphorus. The remodeling process involves a series of highly regulated and tightly coupled cellular and molecular processes, performed by coordinated activity of osteocytes, osteoblasts and osteoclasts. These different bone cells are organized into specific morphological and functional bone multicellular units which perform and coordinate two basic bone biology processes: bone resorption and bone formation, throughout a cycle of events called bone remodeling. The bone remodeling cycle starts with phase of activation, which includes mechanosensation and mechanotransduction of the osteocytes, or with cellular response to systemic humoral factors such as PTH. These are start signals which induce a formation of a specific canopy structure over the bone surfaces which need to be remodeled, called the remodeling compartment. Furthermore, these signals will activate osteoclastic precursor to proliferate, differentiate, attach and to resorb bone surface in the following resorption phase. After the certain quantity of bone was removed, the reversal phase occurres, which involves releasing of numerous, yet unknown factors that couple bone resorption and upcoming bone formation and mineralization, which are done by osteoblasts in the formation phase. After the same quantity of new bone was formed, the termination phase proceeds in which the cycle ends and bone surfaces become quiescent or “at rest”

The remodeling of the skeleton

Koštani sustav kralježnjaka vrši dvije glavne uloge: prva je biomehanička uloga koja uključuje podupiranje tijela i zaštitu unutarnjih organa i struktura te inzerciju mišićima u svrhu izvođenja pokreta, a druga uloga je metabolička koja uključuje održavanje mineralne homeostaze organizma. Zato, iako su smatrane „mrtvim” inertnim strukturama, kao što to studenti tijekom svog studija medicine doživljavaju, kosti su metabolički iznimno aktivni organi podvrgnuti kontinuiranim cjeloživotnim promjenama. Tijekom rasta i razvoja kosti se formiraju procesom oblikovanja (engl. bone modeling), što uključuje izgradnju i odlaganje koštanog matriksa na razvojno određenim i biomehanički induciranim mjestima skeleta. Čak i prije negoli se skelet u potpunosti razvije, kosti se počinju kontinuirano pregrađivati (engl. bone remodeling) u svrhu održavanja tkivnog integriteta i biomehaničke funkcije, prilagodbe koštane arhitekture prema mehaničkim zahtjevima i zbog popravaka mikrooštećenja, te ako je potrebno mobilizirati kalcij i fosfor. Proces pregradnje uključuje niz precizno reguliranih i tijesno spregnutih staničnih i molekularnih procesa koje omogućuje koordinirana aktivnost osteocita, osteoblasta i osteoklasta. Ova tri različita tipa stanica koštanog tkiva organizirana su u specifičnu morfološku i funkcionalnu višestaničnu jedinicu (engl. basic multicellular unit) koja obavlja i koordinira dva temeljna procesa u biologiji kosti: razgradnju i izgradnju kosti tijekom ciklusa nazvanog ciklus koštane pregradnje. Ovaj ciklus počinje fazom aktivacije koja uključuje mehanosenzaciju i mehanotransdukciju osteocita ili staničnim odgovorom na sistemski humoralni faktor kao što je paratireoidni hormon. Ovi startni signali potiču stvaranje specifične strukture nad koštanom površinom koju treba pregraditi i nazivamo je odjeljak koštane pregradnje (engl. bone remodeling compartment). Nadalje ovi startni signali aktiviraju osteoklastne prekursore na proliferaciju, diferencijaciju, pričvršćivanje i razgradnju određene koštane površine u sljedećoj fazi resorpcije. Nakon što se razgradi određena količina koštanog matriksa, počinje faza obrata koja uključuje oslobađanje brojnih, još uvijek nedovoljno poznatih činitelja koji povezuju razgradnju i osteoblastnu izgradnju s mineralizacijom kosti u sljedećoj fazi. Kada se stvori ista količina kosti koja se razgradila, slijedi završna faza ciklusa u kojoj se ciklus koštane pregradnje zaustavlja, a koštana površina ulazi u mirnu fazu.The bones of the vertebrate skeleton serve two main functions: the first is biomechanical function which includes support and protection of internal organs and structures, so as providing a muscle attachment for the locomotion and the second is essential metabolic function which includes mineral homeostasis maintaining. In spite skeleton is being presented as “dead”, inert structure, as often medical students learn in anatomy, it is metabolically, extremely active organ and undergoes continuous lifelong changes. Bones are initially formed by modeling processes, which include the production and deposition of bone tissue at developmental and biomechanical sites of the skeleton. Before being fully formed, bones undergo remodeling process which continues throughout life, in order to preserve the structural integrity and biomechanical function, to adjust bone architecture according to mechanical demands, to repair microdamages, and if it is needed, to mobilize stored calcium and phosphorus. The remodeling process involves a series of highly regulated and tightly coupled cellular and molecular processes, performed by coordinated activity of osteocytes, osteoblasts and osteoclasts. These different bone cells are organized into specific morphological and functional bone multicellular units which perform and coordinate two basic bone biology processes: bone resorption and bone formation, throughout a cycle of events called bone remodeling. The bone remodeling cycle starts with phase of activation, which includes mechanosensation and mechanotransduction of the osteocytes, or with cellular response to systemic humoral factors such as PTH. These are start signals which induce a formation of a specific canopy structure over the bone surfaces which need to be remodeled, called the remodeling compartment. Furthermore, these signals will activate osteoclastic precursor to proliferate, differentiate, attach and to resorb bone surface in the following resorption phase. After the certain quantity of bone was removed, the reversal phase occurres, which involves releasing of numerous, yet unknown factors that couple bone resorption and upcoming bone formation and mineralization, which are done by osteoblasts in the formation phase. After the same quantity of new bone was formed, the termination phase proceeds in which the cycle ends and bone surfaces become quiescent or “at rest”

Immunohistochemical study of the BMPs and their extracellular antagonists in osteoarthritic human knee joint

The osteophytes are bone spurs overgrowing the edge of the articular cartilage during the course of osteoarthritis (OA). The cellular mechanism of their development and growth resembles the intramembranous and endochondral bone development during embrional and postnatal normal bone development, growth, modeling, remodeling and repair. The role of BMPs in bone development and metabolism is well documented and the members of the BMPs molecular network were recognized as important factors which could modulate new bone development and growth of osteophytes. The purpose of this study is to analyze the cooexpression of the most potent osteoinductive members of the BMP family (BMP-2, -4 and -7) and their extracellular antagonists gremlin, noggin, chordin, follistatin in order to establish their role during degenerative process of the synovial joints and growth of osteophyte. In this study, the BMP-2, BMP-4, BMP-7, gremlin, noggin, chordin, follistatin expressions were analyzed in joint tissues from OA patients and from healthy individuals by immunohistochemistry and Western blot. The immunohistochemistry showed different localization pattern of BMPs and BMP extracellular antagonists expressions in OA vs. normal joint tissues. In osteophyte, BMP-2 was not detected, while BMP-4 and BMP-7 were positive in hypertrophyc chondrocytes and osteocytes at the sites of endochondral bone development. BMP-7 was strongly positive, while BMP-4 was negative in synovial membrane of OA joints. Gremlin, chordin and noggin were found in chondrocytes, osteoblasts of the osteophytic bone and synovial epithelium, while follistatin was found in chondrocytes, blood vessels and synovial epithelium. Our result demonstrate the significant differences in BMPs and their antagonists expression in normal tissues compare to joint tissue affected by OA and revealed how molecular balance of the local growth factors such as BMPs and their antagonists could be disturbed during degenerative processes. Also, these findings suggest the potent role of these molecular factors in pathogenesis of the OA and/or during growth and development of the human knee joint osteophytes