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Duvančić T, Vukasović Barišić A, Čizmić A, Plečko M, Bohaček I, Delimar D. Specificities in the Structure of the Cartilage of Patients with Advanced Stages of Developmental Dysplasia of the Hip. Diagnostics (Basel) 2024; 14:779. [PMID: 38611693 PMCID: PMC11011320 DOI: 10.3390/diagnostics14070779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
Developmental dysplasia of the hip (DDH) presents varying degrees of femoral head dislocation, with severe cases leading to the formation of a new articular surface on the external side of the iliac bone-the neoacetabulum. Despite conventional understanding suggesting otherwise, a tissue resembling hyaline cartilage is found in the neoacetabulum and acetabulum of Crowe III and IV patients, indicating a potential for hyaline cartilage development without mechanical pressure. To test this theory, acetabular and femoral head cartilage obtained from patients with DDH was stained with hematoxylin-eosin and toluidine blue. The immunohistochemical analysis for collagen types II and VI and aggrecan was performed, as well as delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) analysis on a 7.0 T micro-MRI machine. The results obtained from DDH patients were compared to those of the control groups. Hyaline cartilage was found in the neoacetabulum and the acetabulum of patients with DDH. The nature of the tissue was confirmed with both the histological and the MRI analyses. The results of this study proved the presence of hyaline cartilage in patients with DDH at anatomical regions genetically predisposed to be bone tissue and at regions that are not subjected to mechanical stress. This is the first time that the neoacetabular cartilage of patients with advanced stages of DDH has been characterized in detail.
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Affiliation(s)
- Tea Duvančić
- Department of Innovative Diagnostics, Srebrnjak Children’s Hospital, 10000 Zagreb, Croatia;
| | | | - Ana Čizmić
- Sestre Milosrdnice University Hospital Centre, Clinic for Traumatology, 10000 Zagreb, Croatia;
| | - Mihovil Plečko
- Department of Orthopaedic Surgery, University Hospital Center Zagreb, 10000 Zagreb, Croatia; (M.P.); (I.B.)
| | - Ivan Bohaček
- Department of Orthopaedic Surgery, University Hospital Center Zagreb, 10000 Zagreb, Croatia; (M.P.); (I.B.)
- Department of Orthopaedic Surgery, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Domagoj Delimar
- Department of Orthopaedic Surgery, University Hospital Center Zagreb, 10000 Zagreb, Croatia; (M.P.); (I.B.)
- Department of Orthopaedic Surgery, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Duvančić T, Škokić S, Erjavec I, Plečko M, Bohaček I, Gajović S, Delimar D. Novel micro-MRI approach for subchondral trabecular bone analysis in patients with hip osteoarthritis is comparable to micro-CT approach. Croat Med J 2022; 63:515-524. [PMID: 36597563 PMCID: PMC9837720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
AIM To test the agreement between a newly developed micro-magnetic resonance imaging (MRI) analysis of the subchondral bone and the micro-computed tomography (CT) approach. METHODS Samples obtained from 10 patients with osteoarthritis undergoing total hip arthroplasty were scanned with a 7.0 T micro-MRI. Proton density-weighted images and proton density-weighted images with fat suppression were obtained. The results were validated with a micro-CT device. Micro-MRI and micro-CT scans of the same sample were aligned, and regions of interest were delineated on equal areas of the sample. Bone volume fraction was calculated by using in-house plugins. The agreement between the methods was tested with Bland-Altman analysis. RESULTS The agreement between the methods was good, with average difference of 2.167%. The differences between the methods were not significant (P=0.272, t test). CONCLUSION The novel micro-MRI approach could be used for subchondral bone analysis. With further optimization for clinical MRI machines, the approach can be also used in the diagnostics of hip osteoarthritis.
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Affiliation(s)
- Tea Duvančić
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Siniša Škokić
- Laboratory for Regenerative Neuroscience – GlowLab, Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Igor Erjavec
- University of Zagreb School of Medicine, Zagreb, Croatia
| | | | - Ivan Bohaček
- Department of Orthopedic Surgery, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Srećko Gajović
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Domagoj Delimar
- Department of Orthopedic Surgery, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
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Duvančić T, Škokić S, Erjavec I, Plečko M, Bohaček I, Gajović S, Delimar D. Novel micro-MRI approach for subchondral trabecular bone analysis in patients with hip osteoarthritis is comparable to micro-CT approach. Croat Med J 2022. [PMID: 36597563 PMCID: PMC9837720 DOI: 10.3325/cmj.2022.63.515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
AIM To test the agreement between a newly developed micro-magnetic resonance imaging (MRI) analysis of the subchondral bone and the micro-computed tomography (CT) approach. METHODS Samples obtained from 10 patients with osteoarthritis undergoing total hip arthroplasty were scanned with a 7.0 T micro-MRI. Proton density-weighted images and proton density-weighted images with fat suppression were obtained. The results were validated with a micro-CT device. Micro-MRI and micro-CT scans of the same sample were aligned, and regions of interest were delineated on equal areas of the sample. Bone volume fraction was calculated by using in-house plugins. The agreement between the methods was tested with Bland-Altman analysis. RESULTS The agreement between the methods was good, with average difference of 2.167%. The differences between the methods were not significant (P=0.272, t test). CONCLUSION The novel micro-MRI approach could be used for subchondral bone analysis. With further optimization for clinical MRI machines, the approach can be also used in the diagnostics of hip osteoarthritis.
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Affiliation(s)
- Tea Duvančić
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Siniša Škokić
- Laboratory for Regenerative Neuroscience – GlowLab, Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Igor Erjavec
- University of Zagreb School of Medicine, Zagreb, Croatia
| | | | - Ivan Bohaček
- Department of Orthopedic Surgery, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Srećko Gajović
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Domagoj Delimar
- Department of Orthopedic Surgery, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
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Čengić T, Kodvanj J, Smoljanović T, Adamović P, Alerić A, Bohaček I, Milošević M, Sabalić S, Delimar D. IMPACT OF CEMENTLESS ZWEYMÜLLER STEM ANTEVERSION ON RESISTANCE TO PERIPROSTHETIC FRACTURE IN TOTAL HIP ARTHROPLASTY. Acta Clin Croat 2022; 60:429-434. [PMID: 35282477 PMCID: PMC8907947 DOI: 10.20471/acc.2021.60.03.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/01/2021] [Indexed: 11/28/2022] Open
Abstract
Total hip arthroplasty implies proper orientation of both acetabular and femoral components with a range of 25-40° of combined anteversion. The aim of the study was to examine resistance to periprosthetic fracture of the axially loaded cross section rectangular femoral stem (Zweymüller) with respect to different degrees of anteversion, implanted in the artificial bone model, in laboratory conditions. Femoral bone models with implanted femoral stems were divided into 3 groups depending on the degree of stem anteversion (A, control group 13-17°; B, stem retroverted 0°-4°; and C, stem anteverted 26-30°). The amount of axial load leading to periprosthetic fracture (PPFx) of the artificial bone model was determined experimentally for each construct. The results showed that the load at which the PPFx occurred significantly increased with the increase of the endoprosthesis anteversion angle. In our clinical practice, we are often unable to place the acetabular component in an ideal grade of anteversion for intraoperatively determined reasons. The results of this experimental study suggested that increasing rectangular femoral (Zweymüller) stem anteversion lowered the risk of PPFx. This study was limited by experimental design (laboratory conditions, artificial bone) and should be clinically verified.
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Bohaček I, Plečko M, Duvančić T, Smoljanović T, Vukasović Barišić A, Delimar D. Current knowledge on the genetic background of developmental dysplasia of the hip and the histomorphological status of the cartilage. Croat Med J 2020. [PMID: 32643343 PMCID: PMC7358691 DOI: 10.3325/cmj.2020.61.260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Developmental dysplasia of the hip (DDH) represents a morphological abnormality characterized by the incongruity of femoral head and acetabulum. It ranges from mild dysplastic changes to complete dislocation. DDH has been associated with several hereditary and environmental risk factors, which could explain the incidence variability among different countries. Numerous genes may be involved in the disease etiology and progression. However, there are controversies in the literature regarding some of these genes. DDH-induced secondary osteoarthritis (OA) is characterized by changes in the macromolecule content of the cartilage and the expression of cartilage degradation markers. In addition, it exhibits a pattern of specific histological changes, with several reported differences between primary and DDH-induced secondary OA. The articular cartilage of patients with DDH shows specific radiological characteristics, including changes visible already in infancy, but also at pre-arthritic stages, early stages of OA, and in fully developed DDH-induced secondary OA. Although DDH has been extensively researched in different disease stages, the etiology of the disorder still remains uncertain. This review focuses on the current knowledge on the histomorphological status of the cartilage and the genetic background of DDH.
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Plečko M, Bohaček I, Duvančić T, Delimar D. The neoacetabulum in developmental dysplasia of the hip is covered with hyaline cartilage. Med Hypotheses 2020; 142:109820. [PMID: 32442678 DOI: 10.1016/j.mehy.2020.109820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/20/2020] [Accepted: 05/05/2020] [Indexed: 11/18/2022]
Abstract
The lack of adequate mechanical stimulation and appropriate contact between acetabulum and femoral head results with developmental dysplasia of the hip (DDH). In DDH, hip joint forms normally during the organogenesis, but deforms during the fetal development. Acetabulum remains comparable in width with normal acetabulum, but has increased length and decreased depth, resulting in a poor coverage of the femoral head. In cases of severe hip subluxation and luxation due to DDH, the femoral head articulates with the external side of the iliac bone, forming a neoacetabulum in the position that was genetically predetermined to become bony tissue. A neoacetabulum is therefore formed under intermittent mechanical pressure, but never has the depth of a physiological acetabulum due to different forces at this new location. Over time, the depth of the neoacetabulum increases, and a crest is formed that obstructs reposition of the femoral head into the anatomic acetabulum. We hypothesize that the neoacetabulum on the iliac bone in DDH patients is formed of hyaline cartilage, despite the lack of genetic predisposition for hyaline cartilage formation in this area. We assume that as the femoral head migrates during development in such patients, joint capsular tissue interposes between the external side of the iliac bone and the femoral head, and a cartilaginous metaplasia of the capsule follows. This results in elongation of the acetabular cartilage in the same direction as the femoral head migrated. This assumption is based on the finding that in patients with hip luxation such interposed joint capsule showed signs of cartilaginous transformation. Furthermore, in the inner part of such joint capsules, proteoglycan production was notably higher than that of other non-cartilaginous tissue. Also, high expression of cartilaginous genes, which are usually not expressed in this tissue, was observed. Confirmation of this hypothesis would put a new perspective on the pathogenesis of DDH and could lead to better management or even prevention of this condition.
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Affiliation(s)
- Mihovil Plečko
- Department of Orthopaedic Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ivan Bohaček
- Department of Orthopaedic Surgery, University Hospital Centre Zagreb, Zagreb, Croatia; Department of Orthopaedic Surgery, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Tea Duvančić
- Department of Orthopaedic Surgery, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Domagoj Delimar
- Department of Orthopaedic Surgery, University Hospital Centre Zagreb, Zagreb, Croatia; Department of Orthopaedic Surgery, School of Medicine, University of Zagreb, Zagreb, Croatia.
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Plečko M, Bohaček I, Tripković B, Čimić M, Jelić M, Delimar D. Applications and critical evaluation of fascia iliaca compartment block and quadratus lumborum block for orthopedic procedures. Acta Clin Croat 2019; 58:108-113. [PMID: 31741568 PMCID: PMC6813479 DOI: 10.20471/acc.2019.58.s1.16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Anterior section of the hip joint capsule is innervated by femoral nerve and obturator nerve, and posterior section is innervated by the nerve to quadratus femoris muscle and occasionally by the superior gluteal (posterolateral region) and sciatic nerve (posterosuperior region). One of the regional anesthesia options for hip surgery is the fascia iliaca compartment block (FICB) that affects nerves important for hip innervation and sensory innervation of the thigh - femoral, obturator and lateral femoral cutaneous nerve. FICB can be easily performed and is often a good solution for management of hip fractures in emergency departments. Its use reduces morphine pre-operative requirement for patients with femoral neck fractures and can also be indicated for hip arthroplasty, hip arthroscopy and burn management of the region. Quadratus lumborum block (QLB) is a block of the posterior abdominal wall performed exclusively under ultrasound guidance, with still unclarified mechanism of action. When considering hip surgery and postoperative management, the anterior QLB has shown to reduce lengthy hospital stay and opioid use, it improves perioperative analgesia in patients undergoing hip and proximal femoral surgery compared to standard intravenous analgesia regimen, provides early and rapid pain relief and allows early ambulation, thus preventing deep vein thrombosis and thromboembolic complications etc. However, some nerve branches responsible for innervation of the hip joint are not affected by QLB, which has to be taken into consideration. QLB has shown potential for use in hip surgery and perioperative pain management, but still needs to be validated as a reliable treatment approach.
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Affiliation(s)
| | - Ivan Bohaček
- Department of Orthopaedic Surgery, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Branko Tripković
- Department of Orthopaedic Surgery, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Mislav Čimić
- Department of Orthopaedic Surgery, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Mislav Jelić
- Department of Orthopaedic Surgery, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Domagoj Delimar
- Department of Orthopaedic Surgery, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
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Abstract
Methods A cross-sectional study was conducted among 743 masters rowers who participated in the 34th International Federation of Rowing Associations (Fédération Internationale des Sociétés d’Aviron, FISA) World Rowing Masters Regatta held in Zagreb, September 2-9, 2007. A rowing-specific questionnaire was used, followed by an interview about the injuries sustained during the 12-month period before the competition. Results The mean injury rate per year was 0.48 injuries/masters rower (2.25 injuries/1000 training sessions/rower). The majority of injuries were chronic injuries (the ratio of acute to chronic injuries was 1:1.7), and did not lead to the loss of training/competition time. Of all acute injuries, 49.6% were acquired during rowing-specific training, 43.7% during cross-training, and 6.7% in the gym. The most commonly affected region was the low back (32.6%), followed by the knee (14.2%), shoulder/upper arm, and elbow (10.6% each). Conclusion International masters rowers sustained predominantly chronic injuries of low severity, and the most commonly injured region was the low back. The mean injury rate per rower per year was lower than the rates previously reported for juniors and seniors.
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Affiliation(s)
- Tomislav Smoljanović
- Tomislav Smoljanović, Department of Orthopedic Surgery, University Hospital Center Zagreb, University of Zagreb School of Medicine, Šalata 6, 10000 Zagreb, Croatia,
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Delimar D, Bohaček I, Dimnjaković D, Viderščak D, Schauperl Z. Femoral head wear and metallosis caused by damaged titanium porous coating after primary metal-on-polyethylene total hip arthroplasty: a case report. Croat Med J 2018. [PMID: 30394017 PMCID: PMC6240820 DOI: 10.3325/cmj.2018.59.253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Excessive metal femoral head wear has been described only as revision surgery complication after primary ceramic-on-ceramic total hip arthroplasty (THA). Here, we present the first case of metal femoral head wear after primary metal-on-polyethylene THA. A 56-year-old woman was referred to our outpatient clinic 17 years after primary right-sided THA, experiencing pain and decreased right hip range of motion. Radiographic examination revealed acetabular cup dislocation, eccentric femoral head wear, damaged titanium porous coating of femoral stem, metallosis, and pseudotumor formation. Endoprosthetic components were extracted, but further reconstruction was impossible due to presence of large acetabular bone defect. Macro- and micro-structure of extracted components were analyzed. Acetabular liner surface was damaged, with scratches, indentations, and embedded metal debris particles present on the entire inner surface. Analysis of metal debris by energy-dispersive spectroscopy showed that it consisted of titanium and stainless-steel particles. Femoral head was gravely worn and elliptically shaped, with abrasive wear visible under scanning electron microscope. No signs of trunnionosis at head/neck junction were observed. Microstructure of femoral head material was homogeneous austenitic, with microhardness of 145 HV 0.2, which is lower than previously described titanium hardness. In conclusion, detached titanium porous coating of femoral stem can cause stainless-steel femoral head wear in primary metal-on-polyethylene THA. As soon as such detachment becomes evident, revision surgery should be considered to prevent devastating complications.
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Delimar D, Bohaček I, Paštar Z, Lipozenčić J. Orthopedic and Cutaneous Reactions to Nickel after Total Hip Replacement. Acta Dermatovenerol Croat 2018; 26:39-43. [PMID: 29782298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Implant degradation products have shown signs of a cutaneous allergic response after implantation of a metal orthopedic replacement, loosening and failure of the joints as well as skin rashes, general fatigue, pain, and impaired wounds and bone healing. The prevalence of contact skin sensitivity in patients with a joint replacement device is higher than that in the general population. This delayed hypersensitivity to metallic orthopedic implants is more clearly defined and is a contributing factor to implant failure. Nickel was associated with hypersensitivity responses as the first cause in metallic orthopedic implants as early as 1966 by Foussereau and Laugieru and is a commonly used metal in alloys because it grants necessary strength and durability to the implant. Herein we report on delayed hypersensitivity to nickel sulfate in a patient with pain, fatigue, and contact allergic dermatitis in both inguinal regions, with instability of the left acetabular part and with five hip replacements from 1987 to 2013. The findings of this report support that primary sensitization to a metal due to an implant itself might develop. Proper investigation in patients with history or prior hypersensitivity reactions to metals and test evaluation before orthopedic device implantation is needed. before orthopedic device implantation is needed.
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Affiliation(s)
| | | | - Zrinjka Paštar
- Assist. Prof. Zrinjka Paštar, MD, PhD, Department of Health Studies , University of Zadar , Splitska 1 , 23000 Zadar, Croatia;
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Abstract
Aim To compare the overall and disease-specific mortality of Croatian male athletes who won one or more Olympic medals representing Yugoslavia from 1948 to 1988 or Croatia from 1992 to 2016, and the general Croatian male population standardized by age and time period. Methods All 233 Croatian male Olympic medalists were included in the study. Information on life duration and cause of death for the Olympic medalists who died before January 1, 2017, was acquired from their families and acquaintances. We asked the families and acquaintances to present medical documentation for the deceased. Data about the overall and disease-specific mortality of the Croatian male population standardized by age and time period were obtained from the Croatian Bureau of Statistics (CBS). Overall and disease-specific standard mortality ratios (SMR) with 95% confidence intervals (CI) were calculated to compare the mortality rates of athletes and general population. Results Among 233 Olympic medalists, 57 died before the study endpoint. The main causes of death were cardiovascular diseases (33.3%), neoplasms (26.3%), and external causes (17.6%). The overall mortality of the Olympic medalists was significantly lower than that of general population (SMR 0.73, 95% CI 0.56-0.94, P = 0.013). Regarding specific causes of death, athletes’ mortality from cardiovascular diseases was significantly reduced (SMR 0.61, 95% CI 0.38-0.93, P = 0.021). Conclusions Croatian male Olympic medalists benefit from lower overall and cardiovascular mortality rates in comparison to the general Croatian male population.
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Affiliation(s)
- Vedran Radonić
- Vedran Radonić, Institute for Emergency Medicine Sisak and Moslavina County, Ulica 1. svibnja 20, 44000 Sisak, Croatia,
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Božić D, Josipović M, Bohaček I, Smoljanović T, Bojanić I. OSTEOID OSTEOMA OF THE CORACOID PROCESS: CASE REPORT WITH LITERATURE REVIEW. Acta Clin Croat 2016; 55:505-509. [PMID: 29046018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
Osteoid osteoma (OO) is the most common benign osteogenic bone tumor that predominantly affects young adults. OO is commonly localized in long bones, and therefore, it is rarely considered in differential diagnosis of chronic shoulder pain. We report a case of a 22-year-old male athlete, without history of previous trauma, who presented to our Department with chronic shoulder pain, which escalated during the night and responded to nonsteroidal anti-inflammatory drug treatment. Considering these typical symptoms, diagnostic pathway was immediately directed towards OO, with magnetic resonance and computed tomography confirming the diagnosis of OO of the coracoid process (CP). Since neurovascular structures are in the proximity of CP, and this very delicate area does not support radiofrequency ablation, we decided to perform an open procedure with drilling of the lesion and excochleation. The pain withdrew immediately after the procedure, and on six-month follow up the patient remained pain free. In the treatment of OO of the CP, we recommend open surgical procedure with tumor ablation by drilling instead of CP resection, presenting a safe, simple and low-cost method that simultaneously completely destroys the lesion and preserves the anatomical and functional role of CP
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Abstract
This study presents a series of 13 patients who underwent peroneal tendoscopy as a solitary or accessory procedure at our department in 2013. Patients were clinically diagnosed with peroneal tendons disorders and underwent an additional radiological assessment. Peroneal tendoscopy was carried out in a standard manner before any other arthroscopic or open procedure. Postoperative management depended on the type of pathology. We found 3 peroneus brevis tendon partial tears, 4 cases of a low-lying peroneus brevis muscle belly, 5 cases of tenosynovitis, and 1 case of an intrasheath peroneal tendon subluxation. In 5 patients peroneal tendoscopy was performed as a solitary procedure and in 8 patients as an accessory procedure – together with anterior or posterior ankle arthroscopy, combined posterior and anterior ankle arthroscopy, or open surgery. Both as a solitary and accessory procedure, peroneal tendoscopy was safe and successful, ie, all patients were without any symptoms at one-year follow-up. Our series of patients showed that peroneal tendoscopy can be used both as an independent procedure as well as a valuable accessory procedure.
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Affiliation(s)
- Ivan Bojanić
- Ivan Bojanic, Department of Orthopaedic Surgery, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Salata 7, 10000 Zagreb, Croatia,
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Gorup D, Bohaček I, Miličević T, Pochet R, Mitrečić D, Križ J, Gajović S. Increased expression and colocalization of GAP43 and CASP3 after brain ischemic lesion in mouse. Neurosci Lett 2015; 597:176-82. [PMID: 25929184 DOI: 10.1016/j.neulet.2015.04.042] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 04/15/2015] [Accepted: 04/16/2015] [Indexed: 11/30/2022]
Abstract
GAP43 is a protein involved in neurite outgrowth during development and axon regeneration reflecting its presynaptic localization in developing neurons. Recently, it has been demonstrated that GAP43 is a ligand of CASP3 involved in receptor endocytosis and is also localized post-synaptically. In this study, by using a transgenic mouse strain carrying a bioluminescent reporter for GAP43 combined with an in vivo bioluminescence assay for CASP3, we demonstrated that one day after brain ischemic lesion and, even more pronounced, four days after stroke, expression of both CASP3 and Gap43 in neurons increased more than 40 times. The in vivo approach of CASP3 and GAP43 colocalization imaging was further validated and quantified by immunofluorescence. Importantly, in 82% of GAP43 positive cells, colocalization with CASP3 was present. These findings suggested that one and four days after stroke CASP3 expression, not necessarily associated with neuronal death, increased and suggested that CASP3 and GAP43 might be part of a common molecular pathway involved in early response to ischemic events occurring after onset of stroke.
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Affiliation(s)
- Dunja Gorup
- Laboratory for Neurogenetics and Developmental Genetics, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Šalata 12, Zagreb HR-10000, Croatia.
| | - Ivan Bohaček
- Laboratory for Neurogenetics and Developmental Genetics, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Šalata 12, Zagreb HR-10000, Croatia.
| | - Tena Miličević
- Laboratory for Neurogenetics and Developmental Genetics, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Šalata 12, Zagreb HR-10000, Croatia.
| | - Roland Pochet
- Laboratory for Neurogenetics and Developmental Genetics, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Šalata 12, Zagreb HR-10000, Croatia; Laboratory of Histology, Neuroanatomy and Neuropathology, Faculty of Medicine, Université Libre de Bruxelles, 808 Route de Lennik, Brussels B-1070, Belgium.
| | - Dinko Mitrečić
- Laboratory for Stem Cells, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Šalata 12, Zagreb HR-10000, Croatia.
| | - Jasna Križ
- Research Centre of Institute universitaire en santé mentale and Department of Psychiatry and Neuroscience, Laval University, Quebec City G1J2G3a, Canada.
| | - Srećko Gajović
- Laboratory for Neurogenetics and Developmental Genetics, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Šalata 12, Zagreb HR-10000, Croatia.
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Dobrivojević M, Bohaček I, Erjavec I, Gorup D, Gajović S. Computed microtomography visualization and quantification of mouse ischemic brain lesion by nonionic radio contrast agents. Croat Med J 2013; 54:3-11. [PMID: 23444240 PMCID: PMC3584505 DOI: 10.3325/cmj.2013.54.3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim To explore the possibility of brain imaging by microcomputed tomography (microCT) using x-ray contrasting methods to visualize mouse brain ischemic lesions after middle cerebral artery occlusion (MCAO). Methods Isolated brains were immersed in ionic or nonionic radio contrast agent (RCA) for 5 days and subsequently scanned using microCT scanner. To verify whether ex-vivo microCT brain images can be used to characterize ischemic lesions, they were compared to Nissl stained serial histological sections of the same brains. To verify if brains immersed in RCA may be used afterwards for other methods, subsequent immunofluorescent labeling with anti-NeuN was performed. Results Nonionic RCA showed better gray to white matter contrast in the brain, and therefore was selected for further studies. MicroCT measurement of ischemic lesion size and cerebral edema significantly correlated with the values determined by Nissl staining (ischemic lesion size: P=0.0005; cerebral edema: P=0.0002). Brain immersion in nonionic RCA did not affect subsequent immunofluorescent analysis and NeuN immunoreactivity. Conclusion MicroCT method was proven to be suitable for delineation of the ischemic lesion from the non-infarcted tissue, and quantification of lesion volume and cerebral edema.
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Affiliation(s)
- Marina Dobrivojević
- Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia
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