Browsing by Author "Simić, Radoje (16744648200)"

Introduction Lipoma arborescens is a rare, tumor-like lesion commonly involving synovial joints and less commonly bursae and synovial tendon sheaths. Case Outline We report a case of a 12-year-old boy with symmetric involvement of the bicipitoradial bursae, synovial sheaths of extensor compartments of both hands and medial ankles. The diagnosis of polyarticular lipoma arborescens was proposed on magnetic resonance (MR) imaging and this diagnosis was histologically proven after biopsy of the bursae and later by open surgery of the synovial sheath of the right ankle tendons. Literature search was performed and twelve cases with polyarticular involvement were analyzed. Lipoma arborescens commonly involves suprapatellar recess of the knee and very rarely other joints or bursae. Histological analysis revealed an accompanying non-necrotizing granulomatous synovial inflammation. Conclusion Polyarticular lipoma arborescens is a rare entity and symmetrical involvement of the joints other than the knees is exceedingly rare. MR imaging plays a significant role in the diagnostic protocol, and the characteristic fatty signal on MR imaging is highly suggestive of lipoma arborescens. ©2016, Serbia Medical Society. All rights reserved.

Background/Aim. Medico-legal aspect of physical disfigurements has been subject of few scientific researches. The aim of this study was to establish a standardized instrument for forensic evaluation of all kinds of physical disfigurements, which has not existed until now. Methods. The research was conducted in 3 phases: the first one – drafting a list of disfigurements; the second phase – evaluation of the draft of the disfigurement list provided by 11 experts (plastic surgery lecturers) by the use of the Delphy method; the third one during which 51 medical doctors, members of Serbian Association of Plastic, Reconstructive and Aesthetic Surgery were evaluating the list of disfigurements. Results. Totally 176 individual physical disfigurements were described in the first phase of research. In the second phase, 217 disfigurements were established which were classified into 5 degrees of severity 0 – none/very small, 1 – small, 2 – medium, 3 – large, 4 – very large disfigurements. In the third phase, 217 disfigurements were evaluated. Conclusion. The first 4-point ordinal scale was established, rating 217 disfigurements, which showed high level of compatibility in practice and which can be used as an instrument for standardization of disfigurements in giving of forensic expertise. © 2018, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim. A great number of syndactyly release techniques have been described over last two centuries. The aim of our study is outcome assessment of congenital syndactyly surgery using temporary tissue expansion of the dorsal hand and local flaps, without skin grafts. Methods. This study included children with congenital hand syndactyly treated in period from 2009–2015 by operative technique with temporary tissue expansion of the dorsal hand skin and local flaps, without skin grafting. In all cases surgery was performed under general anesthesia. According to Weber’s descriptive method, the functional outcome at the end of the follow-up period was categorized as good, fair or bad. All patients were evaluated for associated anomalies. Results. A total of 26 children (20 males, 6 females), aged from 6 months to 6 years (average age of 23 months), were operated by previously described technique. There were 20 patients with complete syndactyly and 6 with incomplete, mostly involving the third web. Associated anomalies were diagnosed in 9 patients. The follow-up period ranged from 1 to 5 years with average duration of 2.6 years. The functional results were good in 20 patients, fair in 5 and bad in 1 patient. Conclusion. Surgical procedure with temporary tissue expansion of the dorsal hand skin and local flaps, without skin grafting is effective method of congenital syndactyly treatment in children with good functional and aesthetic results. The advantages of this technique are the reduction of surgery duration and avoiding certain complications, such as web hair growth, hyperpigmentation and hypertrophic scars. © 2018, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background: Diagnosis of acute appendicitis (AA) and decisions about its treatment remain among the most common dilemmas of pediatric surgical teams. Monitoring of immune response may be of importance for this purpose. Our aim was to measure and analyze serum and peritoneal fluid cytokines, in children who had undergone surgery for suspected AA. Methods: Prospective investigation of serum and peritoneal fluid cytokine values was performed in 127 consecutive patients. According to the pathohistological findings, patients were divided into three groups: normal/early, uncomplicated and complicated AA. Determination of cytokine concentrations for 20 different cytokines was done using a commercial flow cytometry kit: Human Inflammation 20 plex BMS 819. Results: Statistically significant differences in serum cytokine values between pathohistological groups were found for IP-10, MIP-1α and IL-10. Preoperative cut-off values of IP-10, MIP-1α and IL-10 between groups were obtained using ROC curve analysis. Positive correlations between serum and peritoneal concentrations were recorded for most of the analyzed cytokines. Conclusion: IP-10, MIP-1α and IL-10 showed potential in assessment of AA in children. Confirmatory studies with a larger number of patients are required to prove reliability of these biomarkers. © 2019 The Author(s).