Browsing by Author "Stimec, Bojan (7003411337)"

Background: Clinical expression of pancreas divisum is often explained as a consequence of relative or true stenosis of the minor papilla with dorsal duct obstruction. This anatomo-functional study of the minor papilla in pancreas divisum has included its topographical, functional and structural features. Materials and methods: The study was carried out on 37 human autopsy specimens of duodenopancreas, which underwent pancreatography, manometrically controlled perfusion and light microscopy. Results: One pancreas divisum was detected in the study group. In this case, the distances between the minor and the major papilla was 24.0 mm, and between the minor papilla and the superior duodenal flexure 27.4 mm. The minor papilla was patent when perfused under pressure of 10 mmHg, and its light microscopy revealed regular global histological organization with only light fibrosis and no cellular atypia. Conclusions: The structure and position of the minor papilla in pancreas divisum did not significantly differ from the ones in fused pancreases. © Springer-Verlag 2006.

Background: The use of the gastrocolic trunk of Henle (GTH) as a landmark has been advocated in laparoscopic right colectomy. The aim of this study was to evaluate the GTH as a possible landmark in laparoscopic right colectomy in the context of the adjacent arteries. Methods: Corrosion casting (30 specimens) and anatomic dissection were performed on formol-fixed cadavers (12 specimens). Results: The GTH was found in 34 specimens (81.0%). Among its closely related neighboring arterial vessels, the right colic artery was the most frequent (19 cases [55.9%]). It passed by the GTH at a mean distance of 3.6 mm. The course of the arteries in relation to the GTH was caudal and parallel in most cases (29 [85.3%]), but there was also a significant portion of crossing schemes (11.7%). Conclusions: Although the GTH is a constant and conspicuous anatomic entity, it is not easily accessible, because of its tight relations to the right colon arteries. Instead, the authors advocate the use the superior right colic vein as an anatomic landmark leading to the GTH during laparoscopic right colectomy. © 2010 Elsevier Inc. All rights reserved.

The aim of this study was to evaluate postmortem pancreatograms by means of computerized planimetry of the ductal drainage area. This method was applied to a total of 136 pancreatograms from autopsy specimens of the human duodenopancreas, with and without pathological changes. The mean value of the total ductal drainage surface area was 5 054 mm2 for normal specimens and 3 938 mm2 in cases with chronic pancreatitis; this difference was statistically highly significant. The analyses also included measuring the accessory duct drainage area (if an accessory duct was present), and the percentage of its share in the total gland area. This share was significantly larger in cases with chronic pancreatitis (24.4%) in comparison to the normal specimens (16.8%). In conclusion, computerized planimetry of pancreatograms supplies valuable data not only on the pathogenesis of chronic inflammation of the gland, but also on some of the possible predisposing factors for this condition.

The aim of this study was to evaluate postmortem pancreatograms by means of computerized planimetry of the ductal drainage area. This method was applied to a total of 136 pancreatograms from autopsy specimens of the human duodenopancreas, with and without pathological changes. The mean value of the total ductal drainage surface area was 5 054 mm2 for normal specimens and 3 938 mm2 in cases with chronic pancreatitis; this difference was statistically highly significant. The analyses also included measuring the accessory duct drainage area (if an accessory duct was present), and the percentage of its share in the total gland area. This share was significantly larger in cases with chronic pancreatitis (24.4%) in comparison to the normal specimens (16.8%). In conclusion, computerized planimetry of pancreatograms supplies valuable data not only on the pathogenesis of chronic inflammation of the gland, but also on some of the possible predisposing factors for this condition.

[No abstract available]

Villous adenomas are benign epithelial lesions with malignant potential that can occur in any part of the gastrointestinal tract. We present a case of a middle age woman with acromegaly who was investigated for nonspecific gastrointestinal complaints. Ultrasonography and subsequent endosonography diagnosed a large (4.5 cm), hyperechoic, sessile polyp with numerous pedicles. An open cholecystectomy was performed and revealed a villous adenoma with several foci of carcinoma in situ. Detailed investigations showed no other tumors of the gastrointestinal tract. After five years of follow-up, the patient reports no complaints, and the results of laboratory testing and imaging studies are within the normal range. © 2007 The WJG Press. All rights reserved.

6BACKGROUND. The etiology of tumors arising in the biliary tract remains unclear. Several previous studies have detected Helicobacter pylori organisms in bile from patients with gallstones or cholecystitis. The objective of this study was to determine whether there is an association between H. pylori in bile and biliary tract carcinoma. METHODS. The authors used polymerase chain reaction (PCR) assays to detect the presence of H. pylori in the stomach and bile from 89 patients: Sixty-three disease free patients had biliary calculi, 15 patients had carcinoma of the biliary tract, and 11 patients had neither gallstones nor carcinoma. Bile was considered to contain H. pylori only if the results of PCR determinations were positive in two or more samples assayed independently in two separate laboratories. RESULTS. There was a strong association between the presence of H. pylori in the stomach and in the bile (P≤0.01). Biliary H. pylori was associated with age but not with gender, and it was associated strongly with the clinical diagnosis. Patients with gallstones were 3.5 times as likely to have H. pylori in the bile compared with patients in a control group (95% confidence interval [95%Cl], 0.8-15.8; P = 0.100), and H. pylori was 9.9 times more frequent in patients with biliary tract carcinoma compared with patients in the control group (95%Cl, 1.4-70.5; P = 0.022). CONCLUSIONS. There is a strong association between biliary tract carcinoma and H. pylori in bile. If these results are confirmed by prospective studies, H. pylori may be responsible for a significant proportion of malignant biliary tract disease. © 2002 American Cancer Society.

6BACKGROUND. The etiology of tumors arising in the biliary tract remains unclear. Several previous studies have detected Helicobacter pylori organisms in bile from patients with gallstones or cholecystitis. The objective of this study was to determine whether there is an association between H. pylori in bile and biliary tract carcinoma. METHODS. The authors used polymerase chain reaction (PCR) assays to detect the presence of H. pylori in the stomach and bile from 89 patients: Sixty-three disease free patients had biliary calculi, 15 patients had carcinoma of the biliary tract, and 11 patients had neither gallstones nor carcinoma. Bile was considered to contain H. pylori only if the results of PCR determinations were positive in two or more samples assayed independently in two separate laboratories. RESULTS. There was a strong association between the presence of H. pylori in the stomach and in the bile (P≤0.01). Biliary H. pylori was associated with age but not with gender, and it was associated strongly with the clinical diagnosis. Patients with gallstones were 3.5 times as likely to have H. pylori in the bile compared with patients in a control group (95% confidence interval [95%Cl], 0.8-15.8; P = 0.100), and H. pylori was 9.9 times more frequent in patients with biliary tract carcinoma compared with patients in the control group (95%Cl, 1.4-70.5; P = 0.022). CONCLUSIONS. There is a strong association between biliary tract carcinoma and H. pylori in bile. If these results are confirmed by prospective studies, H. pylori may be responsible for a significant proportion of malignant biliary tract disease. © 2002 American Cancer Society.

[No abstract available]

[No abstract available]

[No abstract available]

Recognition of Helicobacter pylori as an important factor in genesis of gastric adenocarcinoma lead to a large number of studies concerning potential role of Helicobacter spp. in the development of extragastric digestive malignancies. The serological studies indicated possible localizations in the digestive system being from interest in enlightening Helicobacter spp. carcinogenic potential. The PCR obtruded itself as a gold standard in proving existence of actual correlation. In this review, the authors have examined studies conducted in the last 10 years examining Helicobacter spp. correlation with extragastric digestive carcinogenesis. Studies have been observed in four groups referring to hepatic carcinoma, bile duct cancer, pancreatic cancer, and colon cancer. The results of these researches have shown that there is a strong correlation between Helicobacter spp. colonization and primary liver tumors as well as bile duct tumors, whereas conclusions made by authors examining pancreatic cancer are contradictory and demands further investigation. No correlation between Helicobacter spp. and colon cancer have been proven. The PCR subtype most widely used in studies included in this review was nested PCR, whereas genes targeted most frequently for amplification are 16S rDNA of Helicobacter spp. and UreA gene or cagA gene of H. pylori. During the last 10 years PCR has proven itself as a sovereign method for Helicobacter spp. diagnostic in extragastric organs in the digestive system. Knowledge and experiences obtained in this domain could be encouraging for researchers in analogous fields of interest. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Background: The analysis of morphometric right-left symmetry of the salivary glands is important for assessing unilateral changes discovered in these organs during diagnostic imaging. Study design: A study was carried out on 18 adult human autopsy neck and maxillofacial specimens from both sexes (14 males, 4 females), with age range of 17 to 73 years (mean age 49.9 years). The submandibular duct was injected with contrast medium and images were made in two projection planes. Results: Morphometry performed using the obtained radiographs included: (a) caliber (mean proximal, middle, and distal = 1.73 mm, 1.82 mm, and 1.77 mm), (b) length (mean = 37.2 mm); (c) genu of the submandibular duct (mean = 114°); and (d) longitudinal and transverse diameters of the gland (mean = 44.1 mm and 25.9 mm). Comparison of these morphometric parameters between the right and the left glands revealed no statistically significant differences. Conclusion: There is a high level of right-left symmetry in linear morphometric parameters of the submandibular gland. © 2006 Mosby, Inc. All rights reserved.

Background: The analysis of morphometric right-left symmetry of the salivary glands is important for assessing unilateral changes discovered in these organs during diagnostic imaging. Study design: A study was carried out on 18 adult human autopsy neck and maxillofacial specimens from both sexes (14 males, 4 females), with age range of 17 to 73 years (mean age 49.9 years). The submandibular duct was injected with contrast medium and images were made in two projection planes. Results: Morphometry performed using the obtained radiographs included: (a) caliber (mean proximal, middle, and distal = 1.73 mm, 1.82 mm, and 1.77 mm), (b) length (mean = 37.2 mm); (c) genu of the submandibular duct (mean = 114°); and (d) longitudinal and transverse diameters of the gland (mean = 44.1 mm and 25.9 mm). Comparison of these morphometric parameters between the right and the left glands revealed no statistically significant differences. Conclusion: There is a high level of right-left symmetry in linear morphometric parameters of the submandibular gland. © 2006 Mosby, Inc. All rights reserved.

TWENTY-EIGHT ABDUCENT NERVES were examined after injecting india ink and gelatin into the vertebrobasilar arterial system. All the abducent nerves were found to be crossed and/or penetrated by the surrounding vessels. The ventral surface of the nerves was crossed by the anterior inferior cerebellar artery (AICA) (75.0%), the posterior inferior cerebellar artery (17.85%), the common trunk of the AICA and posterior inferior cerebellar artery (7.14%), the internal auditory artery (14.28%), the anterolateral artery (46.43%), the pontomedullary artery (92.86%), and the corresponding veins (46.43%). The dorsal surface of the cisternal segment was crossed by the AICA (35.71%), the inferolateral pontine artery (10.71%), the anterolateral artery (82.14%), and the certain veins (46.43%). Sixty-four percent of the cisternal segments were penetrated by one or more of the following vessels: the AICA (25.0%), the anterolateral artery (17.86%), the pontomedullary artery (3.57%), and/or by the corresponding veins (42.86%). The majority of the cisternal segments of the abducent nerves were supplied by the anterolateral arteries (85.71%), and only some of them by the AICA (14.29%) or the pontomedullary artery (7.14%). The authors discuss the possible clinical significance of the anatomical data. © by the Congress of Neurological Surgeons.

Objective - Ultrasound examination for each and every pregnancy is being accepted as a standard practice worldwide, and prenatal ultrasound diagnosis of congenital heart disease (CHD) is improving due to both staff education and ultrasound equipment modernization. The objective of this study was to estimate the value and accuracy of fetal echocardiography for diagnosis of fetal CHD in a large tertiary referral center for obstetrics and gynecology. Methods - This study was based on a prospective follow-up of 27,051 consecutive patients at the Institute of Ob/Gyn, Belgrade, during 1999-2003. Out of this population a total of 517 (1.9%) patients were selected for fetal echocardiography. The final diagnosis of congenital heart disease was confirmed or rejected on the basis of autopsy and histopathological findings, for the dead fetuses and newborns, or on the basis of neonatal echocardiography (followed by surgery/invasive diagnostic procedure), for the living neonates. Results - From the total population analyzed, there was 71 gravida (0.26%) with congenital fetal heart disease. In that study group, the most frequent cardiac anomalies were complex congenital heart diseases. Analyzing the outcome, there were 67.6% cases with fetal CHD who delivered live neonates. Out of the 73 fetuses/neonates with CHD, abnormal karyotype was detected in only 9 cases. The parameters of the diagnostic value of fetal echocardiography were as follows: sensitivity 94.4%, specificity 99.8%, positive predictive value 98.5%, negative predictive value 99.1%, and overall diagnostic accuracy 99.0%. Conclusion - Fetal echocardiography has a very high diagnostic accuracy, commending referral of suspected patients to large tertiary referral centers. © 2007 Controversies in Obstetrics and Gynecology, Polish Society of Perinatal Medicine, the International Society of Reproductive Medicine, the World Foundation for Medical Studies in Female Health and the Center for the Study of Cryopreservation of Oocytes and Spermatozoa.