Browsing by Author "Cvrkota, Irena (8943863400)"

Background/Aim. Nerve transfers in cases of directly irreparable, or high level extensive brachial plexus traction injuries are performed using a variety of donor nerves with various success but an ideal method has not been established. The purpose of this study was to analyze the results of nerve transfers in patients with traction injuries to the brachial plexus using the thoracodorsal and medial pectoral nerves as donors. Methods. This study included 40 patients with 25 procedures using the thoracodorsal nerve and 33 procedures using the medial pectoral nerve as donors for reinnervation of the musculocutaneous or axillary nerve. The results were analyzed according to the donor nerve, the age of the patient and the timing of surgery. Results. The total rate of recovery for elbow flexion was 94.1%, for shoulder abduction 89.3%, and for shoulder external rotation 64.3%. The corresponding rates of recovery using the thoracodorsal nerve were 100%, 93.7% and 68.7%, respectively. The rates of recovery with medial pectoral nerve transfers were 90.5%, 83.3% and 58.3%, respectively. Despite the obvious differences in the rates of recovery, statistical significance was found only between the rates and quality of recovery for the musculocutaneous and axillary nerve using the thoracodorsal nerve as donor. Conclusion. According to our findings, nerve transfers using collateral branches of the brachial plexus in cases with upper palsy offer several advantages and yield high rate and good quality of recovery.

Aim: The study deals with intraoperative rupture of intracranial aneurysms (IOR) during microsurgery, analyzing factors that may be connected with IOR. Material and Methods: During the three-year period (2006-2008), 934 patients were operated for aneurysms at the Institute of Neurosurgery, CCS, Belgrade. In total, 536 patients were observed. Results: IOR occurred in 14.7%. Male gender, seizures and timing of surgery proved to be risk factors for IOR. All other tested features had no significance. Localization [IOR rate 11.93% in ACM, 17.06% in ACA and 17.26% in ACI) and size (small: IOR in 68/439 (15.49%), large: 8/74 (10.8%), and very large: 3/23 (13.04%)] of aneurysm seemed to have an influence, but this could not be proved. The majority of IORs (58.23%) occurred in early surgery. Early operated patients: IOR occurred in 46/167 (27.54%), intermediary: 25/103 (24.27%), and delayed: 8/266 (3%) - with highly significant differences. Conclusion: Age, hypertension, diabetes mellitus, cardiomyopathy, pregnancy, higher Fisher score, previous IOR, or the presence of vomiting and headache did not affect the occurrence of IOR, whereas the timing of surgery, male gender and epileptic seizures increased the risk. Localization and size of aneurysm tend to have an influence but statistical significance was not proved in this study.

Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. Homocysteine (Hcy) has a detrimental influence on human neurons, considering that human GBM cells undergo cell death already at D,L-Hcy concentrations in culture medium of 50 μM. This data demonstrate that Hcy is a potent glio-toxic agent capable of inducing the death of human glial cells already at concentrations reached in brain during hyperhomocys-teinemia. The one retrospective study found that the serum vitamin B12 level can be used to predict survival time in metastatic cancer patients including neurological cancer. Cancer risk in-creases with elevated vitamin B12 level, mostly within the first year of the follow-up period, suggesting that vitamin B12 level could be used as a cancer diagnostic marker. In addition, the relationship between elevated vitamin B12 level and poor cancer survival time has been reported. Previous investigation suggests that the folate supplementation could be used as an adjuvant in antiglioma therapy to limit the low DNA methylation level be-cause this confers a poor prognosis in glioblastoma multiforme patients. Taking into account all presented data, it can be con-cluded that effect of homocystein, folic acid and vitamin B12 on formation, development and outcome of treatment in patients with carcinoma is very intriguing question, whose response requires additional both experimental and clinical research. There lack of data in the literature on the incidence of elevated levels of Hcy in the blood, as well as the disorders of folic acid and vitamin B12, at malignant tumors of the brain. © 2023, University of Kragujevac, Faculty of Science. All rights reserved.

Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. Homocysteine (Hcy) has a detrimental influence on human neurons, considering that human GBM cells undergo cell death already at D,L-Hcy concentrations in culture medium of 50 μM. This data demonstrate that Hcy is a potent glio-toxic agent capable of inducing the death of human glial cells already at concentrations reached in brain during hyperhomocys-teinemia. The one retrospective study found that the serum vitamin B12 level can be used to predict survival time in metastatic cancer patients including neurological cancer. Cancer risk in-creases with elevated vitamin B12 level, mostly within the first year of the follow-up period, suggesting that vitamin B12 level could be used as a cancer diagnostic marker. In addition, the relationship between elevated vitamin B12 level and poor cancer survival time has been reported. Previous investigation suggests that the folate supplementation could be used as an adjuvant in antiglioma therapy to limit the low DNA methylation level be-cause this confers a poor prognosis in glioblastoma multiforme patients. Taking into account all presented data, it can be con-cluded that effect of homocystein, folic acid and vitamin B12 on formation, development and outcome of treatment in patients with carcinoma is very intriguing question, whose response requires additional both experimental and clinical research. There lack of data in the literature on the incidence of elevated levels of Hcy in the blood, as well as the disorders of folic acid and vitamin B12, at malignant tumors of the brain. © 2023, University of Kragujevac, Faculty of Science. All rights reserved.

Introduction The aim of this work was to present a rare case of spontaneous regression of a herniated cervical disc in a patient with myelopathy. Case outline A 31-year-old women presented with two weeks’ history of neck pain associated with numbness in her body and all four extremities. Magnetic resonance imaging (MRI) of the cervical spine showed a large posterior medial disc extrusion at the C5–C6 spinal segment, causing myelopathy. The patient refused discectomy that was recommended. She received symptomatic treatment in the form of analgesics, a muscle relaxant, and a hard cervical collar. A follow-up MRI of the cervical spine, performed after 11 months, revealed almost complete regression of disc herniation. The patient’s symptoms subsided completely after one year. Conclusion In some cases of cervical disc herniation with myelopathy, especially in patients with mild neurological deficit, symptomatic therapy should be considered. © 2018, Serbia Medical Society. All rights reserved.