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A. Suljak-Loncarević, Muhamed Ajanović

The position of mandible in centric relation is the initial position in prosthodontic rehabilitation. This fact is especially significant today when, due to development of implantology, the use of osseointegrated prostheses is increasingly discussed. The aim of the study is to define if the peak of the articulating surface of mandible in centric relation position is directed towards the zenith of madibular fossa, or is in the retroposition. The research was conducted on macerated human sculls in anthropometric system, based on objective measuring techniques and methods. The results showed that if the zenith of mandibular fossa is determined according to the vertical line of the Frankfurt horizontal, the peak of the mandibular caput articulating surface is in retroposition. The relation of the lower joint surface to the mandibular fossa zenith is the same on both right and left side. The correlation coefficient demonstrates a high correlation between the sides, highly significant with probability level of p<0,01. If the peak of mandibular fossa is determined according to the vertical line of the Frankfurt horizontal, the peak of the articulating surface of mandibular caput is in retroposition in relation to the peak of the upper jaw surface. This original scientific work will help better understanding of x-ray analysis and understanding of relationship of TMJ surfaces, what is necessary for treatment of TMD and occlusal imbalances.

Z. Perič, O. Sinanović

It was performed electroneurographic (ENG) studies with surface electrodes and examined nervus medianus (NM) in 60 patients (38 females), average age of 50,28 years (X+/-SD=50,28+/-11), with clinical diagnosis of carpal tunnel syndrome (CTS) and at least one border or discrete abnormal value of conventional electrophysiological tests. It was also examined 57 healthy individuals (33 females) as control group, average age of 45,65 years (X+/-SD=45,65+/-9,68). The sensitivity and specificity of sensory-motor index (SMI), terminal latency index (TLI) and residual latency (RL) were calculated and compared. SMI is determinate by using following formula: distal distance (DD) (in cm)/distal motor latency (DML) (in ms) + sensory conduction velocity (SCV) (in m/s)/motor conduction velocity (MCV) (in m/s) of NM. SCV of NM was measured by antidromic technique in segment wrist-index finger and MCV of NM in forearm segment above wrist. SMI mean value of control group was 3,45 (X+/-SD=3,45+/-0,45) with lower limit of normal value 2,82 and in patients with CTS 2,13 (X+/-SD=2,13 +/-0,37). The sensitivity of SMI in patients with CTS was 98,51%. SMI is useful parameter in electroneurographical diagnosis of CTS and it's determination is easy and fast and specially important in cases with border or discrete abnormal values of other NM electrophysiological parameters, when SMI values can indicate incipient phase of CTS evolution. In rare cases (about 1%) of CTS with selective NM motor axons affection, SMI may have normal value (false negative result), but DML is always prolonged in this cases. SMI is not dependent on age and DD values in patients with CTS and control subjects.

E. Nakas-ićindić, Almira Hadzović, E. Kučukalić-Selimović, N. Avdagić, Asija Začiragić

Physical effort is a strong physiological stimulus that provokes an increase in blood growth hormone (GH) concentration. Interactions between GH and body composition are very complex. Seven athletes and seven age-matched controls completed a single 30-min bout of upright cycling exercise (5 % of VO(2max).) in order to estimate the influence of body composition on serum GH concentration during exercise. The serum GH concentration was measured in blood samples by standard immunoradiometric (IRMA) method. Anthropometric measurements were used for the calculation of body composition. There were no significant differences in total body mass or body mass index between the groups. The athletes had significantly less fat and higher bone and muscle mass. Serum GH concentration was 2.39 times higher in the athlets versus the control in the period of rest. During acute exercise, the serum GH concentration increased in both groups. No statistically significant differences between the groups in serum GH concentration were found either during the exercise or in the recovery. No correlation between body composition and serum GH concentration was found. Body composition depends on the level of physical activities but if the total body mass is in physiologycal range it does not influence the serum GH response to acute exercise.

N. Sarajlic, Zdenko Cihlarž, E. Klonowski, I. Selak, H. Brkić, B. Topić

The purpose of this study was to obtain age estimation formulae using the length of periodontosis, transparency of the root and root height in each tooth group for the current male population in Bosnia and Herzegovina and to compare these formulae with Lamendin's and Prince's formulae. The research was undertaken on 847 single rooted teeth from 200 identified deceased persons, individuals who died between the ages of 23 and 85 years. Periodontosis, transparency and root height were measured according to Lamendin's procedure. All teeth were grouped in two ways: according to the tooth groups and to the age groups. The highest coefficients of correlation are obtained for maxillary canines (R = 0,731) and mandibular canines (R = 0,706) and the maxillary lateral incisors showed the lowest mean error (ME = 6,63 years). In age groups, the lowest mean error was obtained in the 40-49 years age group (ME = 5,15 years). Equations developed in this study give statistically significantly better age estimations in comparison to the original Lamendin and Prince formulae for the whole sample as well as for each tooth group, except for mandibular central incisors. Age estimation with models developed for each tooth group (except for mandibular lateral incisors) was statistically significantly better than models based on the whole sample.

A. Šukalo, H. Islami, R. Shabani, Hilmi Dauti, S. Kutllovci, B. Kastrati

Research was done on pharmacological-physiological development of the bronchial receptor system on the smooth muscles of trachea in the newborn children, alive-born and stillborn children. Monitored was the response on: acetylcholine, dopamine, histamine and serotonin in different molar concentrations 10(-4), 10(-3), 10(-2), 10 mol/dm(-3), micromol/dm(-3)). Research was done on tonus of tracheal smooth muscles of 23 tracheal preparations taken by autopsy after death from different factors. Based on pharmacological-physiological research on the preparations of human isolated trachea it was find out that: acetylcholine stimulation effect is significant (p>0,01) in 38-41 weeks of pregnancy comparing with that in 30-37 weeks of pregnancy (p>0,01), while dopamine stimulation effect is significant (p>0,05) in 30-37 pregnancy weeks comparing with the effect of acetylcholine and dopamine on the still-born infants of the same pregnancy period (p<0,01). Histaminic receptors were developed during intrauterine life after 38 weeks of pregnancy (p>0,025). Serotonin has caused contraction of the bronchial smooth muscles after 30 pregnancy weeks, but response was not significant (p<0,01). This suggests that cholinergic and adrenergic system of the airways in alive newborn infants develops in parallel intrauterine, contrary to other systems which develop in certain extrauterine life phases.

A. Jevrić-Čaušević, M. Malenica, T. Dujic

Diabetes mellitus can be looked upon as an array of diseases, all of which exhibit common symptoms. While pathogenesis of IDDM (insulin dependant diabetes mellitus) is well understood, the same is not true for diabetes mellitus type II. In the latter case, relative contribution of the two factors (insulin resistance or decreased insulin secretion) varies individually, being highly increased in peripheral tissues and strictly dependant on insulin for glucose uptake. Moreover, in patients with diabetes mellitus type II, disbalance at the level of regulation of glucose metabolism as well as lipid metabolism has been noted in skeletal muscles. It is normal to assume that in this type of diabetes, these changes are reflected at the level of total activity of enzyme creatine kinase. This experimental work was performed on a group of 80 regular patients of Sarajevo General Hospital. Forty of those patients were classified as patients with diabetes type I and forty as patients with diabetes type II. Each group of patients was carefully chosen and constituted of equal number of males and females. The same was applied for adequate controls. Concentration of glucose was determined for each patient with GOD method, while activity of creatine kinase was determined with CK-NAC activated kit. Statistical analysis of the results was performed with SPSS software for Windows. Obtained results point out highly expressed differences in enzyme activity between two populations examined. Changes in enzyme activity are more expressed in patients with diabetes type II. Positive correlation between concentration of glucose and serum activity of the enzyme is seen in both categories of diabetic patients which is not the case for the patients in control group. At the same time, correlation between age and type of diabetes does exist . This is not followed at the level of enzyme activity or concentration of glucose.

The aim of the study was to analyze the 5-year survival after first-ever ischemic stroke and intracerebral hemorrhage. In this study 836 patients were analyzed with a first-ever stroke admitted at the Department of Neurology Tuzla, Bosnia and Herzegovina, from January 1(st) 1997 to December 31(st) 1998. Of these 613 (73,3%) were ischemic strokes and 223 intracerebral hemorrhages (26,7%) Subarachnoid hemorrhages were excluded. After hospitalization surviving patients examined periodically, and a final examination was performed 5 years after the stroke. Overall, case-fatility at the first month was 36% (301/836) and the mortality rate was significantly higher in the patients with intracerebral hemorrhage (58,3% vs. 27,9%, p<0,0001). The first year survived 60% patients with ischemic stroke, and 38% with intracerebral hemorrhage. After 5 years, 188 (31%) patients with ischemic stroke and 53 (24%) with intracerebral hemorrhage were alive (p=0,5), and the cumulative survival rate for the entire study was 29%. Among 30-day survivors (n=535) surviving rate after 5 years was significantly higher in patients with intracerebral hemorrhage (57% vs. 42,5%, p=0,01). The survival rate was the highest for those 50 years and younger (57%), and the lowest for those aged over 70 years (9%). Predictors of 5-year mortality were older age and hypertension for both types of stroke, heart diseases for ischemic stroke and diabetes for intracerebral hemorrhage. Long-term survival after first-ever ischemic stroke and intracerebral hemorrhage is similar. However, among 30-day survivors the 5-year survival is better in patients with intracerebral hemorrhage.

J. Karamehić, M. Lorber, R. Formica, F. Gavrankapetanović, B. Heljić, D. Subasić, Lamija Zečević

In practical terms, regardless of HLA compatibility level, whenever tissues are transplanted from one person to another it is essential to suppress the immune response of the recipient. A variety of methods are available however, the most frequently used ones have the disadvantage of being immunologicaly non specific. The consequence is a difficult balance between immunosuppression sufficient to prevent the tissue rejection and maintenance of immune system at the level of ability to adequately deal with an infection. The goal, not yet achieved, is to find a way of generating donor specific immunosuppression that leaves the immune machinery otherwise completely intact. The major approaches to immunosuppression are described below.

Down Syndrome (DS) or trisomy 21 (T21) is the most frequent and the best known malformation syndrome associated with mental deficiency that appears in human,. Average incidence of this syndrome is about 1:700 newborns. Numerous researchers noted thyroid disorders in people with Down Syndrome but, clinical symptoms of thyroid dysfunction are difficult to separate from DS phenotype. The aim of this study was to examine the thyroid function in the patients with DS. Our results confirmed higher frequency of thyroid dysfunction in DS patients. Higher values of TSH were found in 60,34% of the examined DS patients, which is significantly higher value comparing with the control group (p<0,01). Compensated hypothyroidism was established in 27,92% of the examined DS patients, and most of those (63,23%) were younger than 6 years. The conclusions emphasize the necessity of implementation of thyroid function screening program in persons with DS, and the need for adequate treatment of its dysfunction. Thus, the symptoms of the disease would be alleviated and better physical and mental fitness ensured.

Anaplastic large cell lymphoma (ALCL) is a rare non-Hodgkin, T-cell lymphoma, representing only 2-3% of all lymphoid neoplasm's in adults according to World Health Organization (WHO). CD30 antigen-positive, large neoplastic cells characterize ALCL. We present here a 46-year-old male with pulmonary ALCL previously diagnosed with Hodgkin disease. Microscopically, atypical bi-and multinucleated cells with frequent mitoses were present. The neoplastic cells were large and had clear cytoplasm, large vesicular nuclei, and prominent nucleoli. Immunophenotypic analysis revealed LCA, vimentin and CD30 positivity. ALK immunostaining was negative. Immunohistochemical profile was consistent with ALK negative ALCL. The progression of Hodgkin lymphoma to aggressive non-Hodgkin lymphoma (ALCL in this case) is well known entity. After the diagnosis was established, our patient immediately had been referred to the Department of Hematology in order to get appropriate chemotherapy, necessary in such cases.

M. Kacila, K. Schäfer, Esad Subasić, Nermir Granov, Edin Omerbašić, Faida Kučukalić, Ermina Selimović-Mujcić

The aim of this study is to compare the effects of colloidal cardioplegia and blood cardioplegia in patients who underwent cardiac surgical procedures with cardiopulmonary bypass, and to evaluate their influence on hemodilution, bleeding and consumption of donor blood products in a retrospective clinical study. 100 male patients who underwent cardiac surgical procedure were divided into two groups: 50 patients were administered intermittent normotherm or mild hypotherm (34 degrees C) Calafiore blood cardioplegia with potassium chloride 14,9%; 50 patients were administered one initial doses of cold Kirsch - solution followed from intermittent cold colloidal cardioplegia using hydroxyethyl starch (HES 450/0,7). Hemoglobin values after the first dose of cardioplegia were significantly lower in the HES-group than in the Calafiore- group). After the first dose of cardioplegia platelets count was lower in the HES-group than in the Calafiore-group. Hemoglobin and hematocrit values 24h postoperative were lower in the HES-group than in the Calafiore-group. There was no difference in chest-drainage bleeding 12h and 24h postoperative between the groups. The consumption of donor erythrocyte concentrate and fresh frozen plasma was significantly higher in the HES-than in the Calafiore- group. The choice of either colloidal or blood cardioplegia does not influence the postoperative chest-drainage bleeding. The results suggest that high molecular colloidal cardioplegia with HES-solution is associated with higher hemodilution during and after cardiopulmonary bypass and significantly increases the consumption of donor blood products.

The aim of the study was to ascertain presence of Helicobacter pylori in gastric carcinoma as a responsible promoter of inflammatory-regenerative changes, which lead to pathological differentiation and transformation of normal epithelial cells into intestinal type and, in progression, cause epithelial dysplasia that develops into early gastric carcinoma. The paper presents prospective study that includes clinical, pathohistological and microbiological aspects of carcinogenesis initiation in gastric mucosa. The subjects are patients treated at Gastroenterohepatology Clinic divided into two groups. One group included 50 patients with gastric carcinoma while the control group included 50 patients with chronic atrophic H. pylori positive gastritis. All the patients were subjected to endoscopy as well as biopsy targeted at antrum, lesser curvature and corpus and at the region 1-2 cm removed from tumor lesion. We used HUT test to verify H. pylori presence in biopsy samples. We analyzed the samples for presence, frequency and severity of inflammatory-regenerative, metaplastic and dysplastic changes in gastric mucosa and evaluated their meaning for the prognosis. Our study confirmed Helicobaster pylori responsibility for inflammatory events in gastric mucosa in patients with gastric carcinoma. Slight and mild epithelial dysplasia with chronic atrophic gastritis grade I and II coupled with intestinal metaplasia may be considered an indicator for early detection of carcinoma. Such patients represent risk group for gastric carcinoma development.

Xenobiotic solutions of different concentrations were analyzed by TLC method before and after passing trough the column with adsorbent M and compared with adsorption on the active charcoal. The efficiency of adsorption on adsorbent M was higher, compared to active charcoal. The best adsorption, in the value 90 - 100%, have shown certain organochlorine and organophosphorus pesticides, that were dissolved in non-aqueous solvents. Efficiency of adsorbent M was also proven in vivo, when solutions of tested xenobiotics before adsorption have caused death of experimental animals, and after the adsorption on adsorbent M, all treated animals have survived and had just mild symptoms of poisoning.

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