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Bascarevic Z.,University of Belgrade | Vukasinovic Z.,University of Belgrade | Slavkovic N.,University of Belgrade | Dulic B.,University of Belgrade | And 3 more authors.
International Orthopaedics | Year: 2010

The aim of the study was to evaluate the reliability and durability of alumina-on-alumina ceramic in comparison to metal-on-highly cross-linked polyethylene (CoCr/HXLPE) bearing couples. This prospective randomised study involved 150 patients (157 hips). All patients (mean age: 54.7 years) obtained an identical fibre metal midcoat femoral stem and fibre metal-coated acetabular shell. In 78 patients (82 hips) we used alumina, while in 72 patients (75 hips) metal-polyethylene bearing couples were used. During a mean 50.4-month follow-up period (51 ± 8 alumina and 50 ± 8.9 metal-polyethylene) no statistically significant changes in clinical and radiographic parameters were noted between the two groups. There was no ceramic breakage and no need for revision surgery due to the ceramic liner. The alumina bearing couples proved to be as reliable as CoCr/HXLPE. © 2009 Springer-Verlag.

Marisavljevic D.,Medical Center Bezanijska kosa | Kraguljac-Kurtovic N.,Institute of Hematology
Journal of B.U.ON. | Year: 2010

Purpose: To evaluate the biological and clinical significance of circulating CD34+ cells in patients with myelodysplastic syndromes (MDS). Methods: The relative count of CD34+ cells in peripheral blood was evaluated by flow cytometry and the results were recorded on the total number of mononuclear cells (MNCs). CD34+ status was correlated with the percentage of circulating and bone marrow blasts, cytogenetic studies, CFU-GM colony growth, overall survival and transformation to acute myeloid leukemia (AML). Results: The number of MNC positive for anti-CD34 monoclonal antibody in the healthy control group ranged from 0.00% to 0.73%. Therefore, the cutoff value for overexpression of CD34 antigen on peripheral blood MNC of MDS patients was ≥1% (CD34+ cases). The mean number of circulating CD34+ MNCs in 30 MDS patients was significantly higher than in the control group (p=0.009). The proportion of circulating CD34+ MNCs did not correlate with the blast count in the peripheral blood (r=0.282, p=0.131), netther with the blast count in the bone marrow. In contrast, the proportion of circulating CD34+ cells in MDS patients was significantly correlated with the proportion of bone marrow CD34+ cells (r=0.461, p=0.035). The proportion of circulating CD34+ cells did not correspond to the percentage of blast count in the bone marrow, neither with the presence of cytogenetic abnormalities or abnormal growth of GM-progenitors. The median actuarial survival of 19 patients with elevated proportion of circulating CD34+ cells was 16 months, as compared to >57 months in 11 patients with CD34+ cells within normal range (p=0.16). Five patients with elevated proportion of circulating CD34+ cells progressed to AML, as compared to only one of CD34-negative (CD34-) cases. Conclusion: The presence of circulating CD34+ cells is a common finding in MDS, but no significant correlations with clinical and/or biological features of the disease have beenfound. © 2010 Zerbinis Medical Publications.

Peric P.,Military Medical Academy | Antic B.,Military Medical Academy | Radosavljevic A.,Medical Center Bezanijska kosa | Tasic-Radic O.,Military Medical Academy | Arsic S.,University of Nis
Spine | Year: 2011

Study Design. A case report of a rare symptomatic, idiopathic, noncommunicating intradural arachnoid cyst (IAC) of the proximal part of the S1 nerve root (NR). Objective. To discuss the possible pathophysiology, clinical and magnetic resonance imaging (MRI) presentation, intraoperativefindings, and follow-up of IAC of the proximal part of the S1 NR. Summary of Background Data. Rare variety of the Nabors's Type 3 spinal IAC. The etiopathogenesis are uncertain. Surgical NR decompression with extirpation of the cyst is the treatment of choice. Methods. A 37-year-old woman clinically presented as monoradiculopathy with a 9-month history of progressive, posturedependent radicular pain, paresthesia and hypoesthesia in the right S1 dermatome, and mild weakness of the ipsilateral plantar flexors. Magnetic resonance imaging (MRI) showed a noncommunicating IAC of the proximal part of the S1 NR on the right side. Surgical exploration through the ipsilateral L5-S1 hemilaminectomy was performed with microsurgical arachnolysis of the compressed and stretched S1 NR fascicles that surrounded the cyst, during which the cyst spontaneously collapsed. The remnant of the cyst wall was extirpated and histopathology confirmed the diagnosis. Results. After surgery an excellent clinical outcome was archived: the leg pain was no longer present and the paraesthesia, hypoesthesia, and motor weakness were resolved within 3 months. At 12 months of follow-up, the patient continues to be completely asymptomatic with no evidence of recurrence on MRI. Conclusion. A rare case of symptomatic, idiopathic, noncommunicating IAC of the proximal part of the S1 NR has been presented. Early recognition and treatment resulted in complete symptom resolution, with preservation of the full working capacity and good quality of life. Isolated monoradiculopathy with progressive, posture-dependent radicular pain seem to be typical clinical findings for such a lesion. Attending physicians should always be mindful of this fact in the total clinical evaluation of such cases. © 2011 Lippincott Williams & Wilkins.

Vukomanovic I.,Medical Center Bezanijska kosa | Colovic V.,Medical Center Bezanijska kosa | Soldatovic I.,University of Belgrade | Hadzi-Djokic J.,Serbian Academy of Science and Arts
Medical Oncology | Year: 2012

The management of high-grade (HG) nonmuscle-invasive bladder cancer (NMIBC) continues to be a serious clinical problem. The role of many factors related to efficacy of Bacillus Calmette-Guérin (BCG), which is the most useful intravesical agent for these tumors, is still unknown. This study investigated the prognostic value of tumor location in high-grade non-muscle-invasive bladder cancer. Seventy-four patients with HG non-muscle-invasive bladder cancer, without carcinoma in situ (CIS), were treated by transurethral resection of bladder tumor (TURBT). Twenty-eight patients received adjuvant BCG therapy after TURBT. The relation between tumor location and the recurrence capacity was estimated using a Cox regression model. Our results suggest that tumor location is an important prognostic factor for BCG-therapy response in patients with high-grade non-muscle-invasive bladder cancer. Tumors in the bladder neck might have a higher risk of recurrence after intravesical immunotherapy. In addition, tumors in the lateral and posterior bladder walls might be at higher risk of recurrence when treated by TURBT alone. © Springer Science+Business Media, LLC 2011.

Marisavljevic D.,Medical Center Bezanijska kosa | Marisavljevic D.,University of Belgrade | Markovic O.,Medical Center Bezanijska kosa | Cemerikic V.,Institute of Hematology | Babic D.,Medical Center Bezanijska kosa
Journal of B.U.ON. | Year: 2011

Purpose: Angiogenesis is an essential component in the growth and progression of multiple myeloma (MM). We studied the clinical significance of angiogenesis in patients with MM estimated by precise counting of the number of vessels (i.e. microvessel density, MVD) and compared these results with the results obtained using semi-quantitative grading of angiogenesis. Methods: Fifty-nine newly diagnosed cases of MM were analyzed with respect to clinical features, laboratory findings, histological features, angiogenesis parameters, and response to treatment. Bone marrow microvessels were examined using immunohistochemical staining for CD34. Bone marrow angiogenesis was estimated by two different methods. The mean number of vessels per area in each sample was characterized as the MVD. Microvessels were counted manually on light microscopy in 3 hot spots at x400 magnification. Semi-quantitative estimation of angiogenesis was based on visual assessment of slides at x100 magnification. Each slide was assigned as low, intermediate or high intensity of angiogenesis. Results: The median MVD was 15 vessels per 3 hot spots (range 1-89). Intensity of angiogenesis was assigned as low in 24 (40.7%) patients, intermediate in 17 (28.8%) and high in 18 (30.5%). Significant correlation between intensity of angiogenesis (estimated using both methods) and histological grade, extent of bone marrow infiltration, proliferative activity of myeloma cells and poor survival was found. Semi-quantitatively assessed intensity of angiogenesis additionally correlated with clinical stage. There was a statistically highly significant correlation between MVD and semi-quantitatively estimated intensity of angiogenesis (p <0.001). Conclusion: Tumor-associated angiogenesis is an important prognostic feature in MM and should be routinely done on bone marrow biopsies of these patients. Simple semi-quantitative grading of angiogenesis can be recommended for daily practice, as an alternative method for complicated and time-consuming estimation of MVD. © 2011 Zerbinis Medical Publications.

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