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Rošić Despalatović B, Babić M, Bratanić A, Tonkić A, Ardalić Ž, Vilović K. The Impact of Phenotype of Inflammatory Bowel Diseases, Inflammation Activity and Therapy on Mucosal Mature Cd83 + Dendritic Cell. J Clin Med 2024; 13:2070. [PMID: 38610835 PMCID: PMC11012704 DOI: 10.3390/jcm13072070] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/08/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Crohn's disease (CD) and ulcerative colitis (UC) are well-defined phenotypes of chronic inflammatory bowel diseases (IBDs). A mechanism of inflammation in these diseases is partially controlled by the intestinal dendritic cell (DC). In this study, we observed a mature CD83+ DC in colonic bioptic samples, and its correlation with disease phenotype and activity. Methods: The study included 219 subjects: 100 with UC, 44 with CD and 75 healthy subjects. Colonic biopsy specimens were incubated with the primary antibody Anti-CD83. Intraepithelial CD83+ DCs were counted per 100 enterocytes. The presence of CD83+ DC was analysed according to the type of IBD, histopathologic inflammation activity and treatment outcome. Results: The presence of mature CD83+ DCs (0, ≥1) differed according to disease types of IBD (p = 0.001), histologic inflammation activity (p = 0.049) and applied therapy (p = 0.001). The odds for CD83+ DC presence were 5.2 times higher in the CD group than in the control/UC group. The odds for CD83+ DC presence were 2.6 times higher in subjects without inflammation or chronic inflammation than with acute inflammation. They were also 3.7 times higher in subjects without therapy. The cut-off value 0.5 CD83+ DC (Rock analysis area = 0.699; SE 0.046; p < 0.001; 95% CI: 0.609-0.788) had been assessed as a differentiation marker between UC and CD. Conclusion: Presence of CD83+ DC could be used as a possible parameter in distinction between UC and CD, as well as a predictor of inflammation activity and treatment outcome.
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Affiliation(s)
| | - Marija Babić
- Medical School, University of Split, 21000 Split, Croatia;
| | - Andre Bratanić
- Department of Gastroenterology and Hepatology, University Hospital Split, 21000 Split, Croatia; (A.T.); (Ž.A.)
| | - Ante Tonkić
- Department of Gastroenterology and Hepatology, University Hospital Split, 21000 Split, Croatia; (A.T.); (Ž.A.)
| | - Žarko Ardalić
- Department of Gastroenterology and Hepatology, University Hospital Split, 21000 Split, Croatia; (A.T.); (Ž.A.)
| | - Katarina Vilović
- Department of Pathology, University Hospital Split, 21000 Split, Croatia;
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Viculin J, Degoricija M, Vilović K, Gabela I, Franković L, Vrdoljak E, Korac-Prlic J. Elevated Tumor Cell-Intrinsic STING Expression in Advanced Laryngeal Cancer. Cancers (Basel) 2023; 15:3510. [PMID: 37444620 DOI: 10.3390/cancers15133510] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/29/2023] [Revised: 06/29/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
Laryngeal cancer is the second most common malignancy of the head and neck, worldwide. Immunotherapy targeting checkpoint inhibitors has been approved for the treatment of patients with recurrent or metastatic laryngeal cancer but has a relatively low response rate and outcomes that leave many patients underserved. Targeting the cGAS-STING signaling pathway can potentially improve the activation of immune effector cells, although its role in the development and progression of laryngeal cancer has not yet been investigated in depth. Fifty-nine tumor samples from patients with pathologically confirmed squamous cell carcinoma of the larynx, stage I-IV non-metastatic disease, who were treated at the University Hospital of Split, were immunohistochemically stained for the expression of STING, cGAS, CD8, CD68, and CD163. Elevated tumor cell-intrinsic STING expression was positively associated with stage IV (p = 0.0031), pT3, and pT4 laryngeal cancers (p = 0.0336) as well as with higher histological grades (G2 and G3) (p = 0.0204) and lymph node-positive tumors (p = 0.0371). After adjusting for age, sex, location, and cGAS expression, elevated STING expression was significantly associated with stage IV cancer in a multiple logistic regression model (β = 1.849, SE = ±0.8643, p = 0.0324). Elevated STING expression represents a potentially favorable predictive biomarker for new therapeutic approaches involving STING agonists combined with immunotherapy and DNA-damaging agents (radiotherapy, cisplatin, and PARP inhibitors) in laryngeal cancer.
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Affiliation(s)
- Jelena Viculin
- Department of Oncology and Radiotherapy, University Hospital of Split, 21000 Split, Croatia
| | - Marina Degoricija
- Department of Medical Chemistry and Biochemistry, School of Medicine, University of Split, 21000 Split, Croatia
| | - Katarina Vilović
- Department of Pathology, Forensic Medicine and Cytology, University Hospital of Split, 21000 Split, Croatia
- Department of Anatomy, School of Medicine, University of Split, 21000 Split, Croatia
| | - Ivana Gabela
- Laboratory for Cancer Research, Department of Immunology and Medical Genetics, School of Medicine, University of Split, 21000 Split, Croatia
| | - Lucija Franković
- Laboratory for Cancer Research, Department of Immunology and Medical Genetics, School of Medicine, University of Split, 21000 Split, Croatia
| | - Eduard Vrdoljak
- Department of Oncology and Radiotherapy, University Hospital of Split, 21000 Split, Croatia
- Department of Clinical Oncology, School of Medicine, University of Split, 21000 Split, Croatia
| | - Jelena Korac-Prlic
- Laboratory for Cancer Research, Department of Immunology and Medical Genetics, School of Medicine, University of Split, 21000 Split, Croatia
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Kunac N, Degoricija M, Viculin J, Omerović J, Terzić J, Vilović K, Korac-Prlic J. Activation of cGAS-STING Pathway Is Associated with MSI-H Stage IV Colorectal Cancer. Cancers (Basel) 2022; 15:cancers15010221. [PMID: 36612217 PMCID: PMC9818394 DOI: 10.3390/cancers15010221] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/20/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
Colorectal cancer is the second most common cause of cancer-related mortality in adults. Understanding colorectal tumorigenesis at both the cellular and molecular levels is crucial for developing effective treatment options. Forty-one biopsy samples from patients with metastatic CRC (mCRC) were collected at Split University Hospital in Croatia. A total of 41 patients (21 with microsatellite unstable tumours and 20 with microsatellite stable tumours) were randomly included in the study. Immunolabelling of cGAS and STING in metastatic CRC was performed and further complemented by histological classification, tumour grade, and KRAS, NRAS, and BRAF mutational status of mCRC. In bivariate analysis, elevated expression of cGAS and STING was positively associated with MSI-H colon cancer (Fisher's exact test, both p = 0.0203). Combined expression analysis of cGAS and STING showed a significantly higher percentage of patients with mCRC MSI-H with a fully or partially activated cGAS-STING signalling pathway (chi-square test, p = 0.0050). After adjusting for age, sex, and STING expression, increased cGAS expression remained significantly associated with MSI-H colon cancer in a multiple logistic regression model (β = 1.588, SE = ±0.799, p = 0.047). The cGAS-STING signalling axis represents a compelling new target for optimization of immune checkpoint inhibitor therapeutic approaches in patients with MSI-H stage IV CRC.
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Affiliation(s)
- Nenad Kunac
- Department of Pathology, Forensic Medicine and Cytology, University Hospital Centre Split, 21000 Split, Croatia
| | - Marina Degoricija
- Department of Medical Chemistry and Biochemistry, School of Medicine, University of Split, 21000 Split, Croatia
| | - Jelena Viculin
- Department of Oncology, University Hospital Centre Split, 21000 Split, Croatia
| | - Jasminka Omerović
- Laboratory for Cancer Research, Department of Immunology, School of Medicine, University of Split, 21000 Split, Croatia
| | - Janoš Terzić
- Laboratory for Cancer Research, Department of Immunology, School of Medicine, University of Split, 21000 Split, Croatia
| | - Katarina Vilović
- Department of Pathology, Forensic Medicine and Cytology, University Hospital Centre Split, 21000 Split, Croatia
- School of Medicine, University of Split, 21000 Split, Croatia
| | - Jelena Korac-Prlic
- Laboratory for Cancer Research, Department of Immunology, School of Medicine, University of Split, 21000 Split, Croatia
- Correspondence: ; Tel.: +385-21557877; Fax: +385-21557880
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Lešin A, Galić I, Tadin A, Vilović K, Jerković D. Treatment of Inflammatory Dentigerous Cyst Using a Surgical T Drain in a Child. Eur J Dent 2022. [PMID: 36220112 DOI: 10.1055/s-0042-1756688] [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: 10/17/2022] Open
Abstract
Dentigerous cysts are rarely reported in young children. They are usually asymptomatic and only identified when becoming significantly large. Treatment by enucleation may damage structures like the inferior alveolar nerve, maxillary sinus, or permanent teeth, thus reducing the child's quality of life. Therefore, conservative surgical treatment such as decompression is indicated. This case report describes the treatment and subsequent complete regression of an inflammatory dentigerous cyst based on the decompression method using a customized surgical tube in a 10-year-old girl. The innervation was preserved, and permanent teeth erupted.
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Affiliation(s)
- Antonella Lešin
- Department of Maxillofacial Surgery, University Hospital of Split, Split, Croatia
| | - Ivan Galić
- Department of Maxillofacial Surgery, University Hospital of Split, School of Medicine, University of Split, Split, Croatia
| | - Antonija Tadin
- Department of Restorative Dental Medicine and Endodontics, School of Medicine, University of Split, Split, Croatia
| | - Katarina Vilović
- Department of Anatomy, Department of Pathology, University Hospital of Split, School of Medicine, University of Split, Split, Croatia
| | - Daniel Jerković
- Department of Maxillofacial Surgery, University Hospital of Split, School of Medicine, University of Split, Split, Croatia
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Bošković M, Roje B, Chung FFL, Gelemanović A, Cahais V, Cuenin C, Khoueiry R, Vilović K, Herceg Z, Terzić J. DNA Methylome Changes of Muscle- and Neuronal-Related Processes Precede Bladder Cancer Invasiveness. Cancers (Basel) 2022; 14:487. [PMID: 35158756 PMCID: PMC8833512 DOI: 10.3390/cancers14030487] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 12/24/2022] Open
Abstract
Bladder cancer (BC) is the ninth leading cause of cancer death with one of the highest recurrence rates among all cancers. One of the main risks for BC development is exposure to nitrosamines present in tobacco smoke or in other products. Aberrant epigenetic (DNA methylation) changes accompanied by deregulated gene expression are an important element of cancer pathogenesis. Therefore, we aimed to determine DNA methylation signatures and their impacts on gene expression in mice treated with N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN), a carcinogen similar to compounds found in tobacco smoke. Following BBN administration mice developed non-invasive or invasive bladder cancers. Surprisingly, muscle- and neuronal-related pathways emerged as the most affected in those tumors. Hypo- and hypermethylation changes were present within non-invasive BC, across CpGs mapping to the genes involved in muscle- and neuronal-related pathways, however, methylation differences were not sufficient to affect the expression of the majority of associated genes. Conversely, invasive tumors displayed hypermethylation changes that were linked with alterations in gene expression profiles. Together, these findings indicate that bladder cancer progression could be revealed through methylation profiling at the pre-invasive cancer stage that could assist monitoring of cancer patients and guide novel therapeutic approaches.
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Affiliation(s)
- Maria Bošković
- Laboratory for Cancer Research, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia; (M.B.); (B.R.); (K.V.)
| | - Blanka Roje
- Laboratory for Cancer Research, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia; (M.B.); (B.R.); (K.V.)
| | - Felicia Fei-Lei Chung
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69008 Lyon, France; (F.F.-L.C.); (V.C.); (C.C.); (R.K.)
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Jalan Universiti, Bandar Sunway, Petaling Jaya 47500, Selangor, Malaysia
| | - Andrea Gelemanović
- Biology of Robustness Group, Mediterranean Institute for Life Sciences (MedILS), Šetalište Ivana Meštrovića 45, 21000 Split, Croatia;
| | - Vincent Cahais
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69008 Lyon, France; (F.F.-L.C.); (V.C.); (C.C.); (R.K.)
| | - Cyrille Cuenin
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69008 Lyon, France; (F.F.-L.C.); (V.C.); (C.C.); (R.K.)
| | - Rita Khoueiry
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69008 Lyon, France; (F.F.-L.C.); (V.C.); (C.C.); (R.K.)
| | - Katarina Vilović
- Laboratory for Cancer Research, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia; (M.B.); (B.R.); (K.V.)
| | - Zdenko Herceg
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69008 Lyon, France; (F.F.-L.C.); (V.C.); (C.C.); (R.K.)
| | - Janoš Terzić
- Laboratory for Cancer Research, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia; (M.B.); (B.R.); (K.V.)
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Korac-Prlic J, Degoricija M, Vilović K, Haupt B, Ivanišević T, Franković L, Grivennikov S, Terzić J. Targeting Stat3 signaling impairs the progression of bladder cancer in a mouse model. Cancer Lett 2020; 490:89-99. [PMID: 32659249 DOI: 10.1016/j.canlet.2020.06.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 04/03/2020] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 02/06/2023]
Abstract
Bladder cancer is the fourth most commonly diagnosed malignancy in men worldwide and has one of the highest recurrence rates of all cancers. This cancer type is unique because chronic inflammation caused by Schistosoma haematobium can cause bladder cancer, while inflammation induced by Bacillus Calmette Guerin is the therapeutic cornerstone for this cancer type. Activation of proinflammatory IL-6/Stat3 axis promotes the development of different cancers by acting on cancer cells as well as by modulating cancer microenvironment. Using a genetic and pharmacological approach in a mouse model, we demonstrated the importance of IL-6 and Stat3 signaling in bladder cancer. Our findings show that pharmacological inhibition of Stat3 with WP1066 effectively delays progression and invasiveness of bladder cancer in N-butyl-N-(4-hydroxybutyl) nitrosamine-induced mouse model. Moreover, either IL-6 blockade or Stat3 inhibition sensitized bladder cancer to anti-PD-L1 immune therapy. Taken together, our study demonstrates an important role of IL-6/Stat3 signaling in bladder cancer and creates a rationale for testing the therapeutic potential of Stat3 inhibitors in human MIBC both alone or in combination with anti-PD-L1 and anti-IL-6 therapy.
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Affiliation(s)
- Jelena Korac-Prlic
- Laboratory for Cancer Research, University of Split School of Medicine, Split, Croatia
| | - Marina Degoricija
- Laboratory for Cancer Research, University of Split School of Medicine, Split, Croatia
| | - Katarina Vilović
- Department of Pathology, University Hospital of Split, Split, Croatia; University of Split School of Medicine, Split, Croatia
| | - Benedikt Haupt
- Laboratory for Cancer Research, University of Split School of Medicine, Split, Croatia
| | - Tonči Ivanišević
- Laboratory for Cancer Research, University of Split School of Medicine, Split, Croatia
| | - Lucija Franković
- Laboratory for Cancer Research, University of Split School of Medicine, Split, Croatia
| | - Sergei Grivennikov
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, USA
| | - Janoš Terzić
- Laboratory for Cancer Research, University of Split School of Medicine, Split, Croatia.
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Despalatović BR, Babić M, Bratanić A, Tonkić A, Vilović K. Difference in Presence and Number of CD83 + Dendritic Cells in Patients with Ulcerative Colitis and Crohn's Disease. Sci Rep 2020; 10:10055. [PMID: 32572123 PMCID: PMC7308349 DOI: 10.1038/s41598-020-67149-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 05/29/2020] [Indexed: 12/16/2022] Open
Abstract
Different pathophysiological models provide insight into the important role of CD83+ dendritic cells (DCs) in the pathogenesis of Crohn's disease (CD) and ulcerative colitis (UC). There were 154 subjects included in this study: 60 with UC, 19 with CD and 75 in the control group. Colonic biopsy was performed in all subjects. Specimens were incubated with a primary anti-CD83 antibody. Intraepithelial DCs per 100 enterocytes were counted. The results were analysed according to demographic data, type of IBD and histological inflammation pattern. The odds ratio for CD83+ DCs=0 in the UC group was 3.4 times higher than that in the control group (OR = 3.4; 95% CI: 1.63-7.14; p = 0.001), and the odds ratio for CD83+ DCs ≥1 in the CD group was 5.3 times higher than that in the UC group (OR = 5.3; 95% CI: 1.4-20.2; p = 0.014). The odds ratio for CD83+ DCs=0 in the acute inflammation group was 2.7 times higher than that in the group without inflammation (OR = 2.7; 95% CI: 1.2-5.9; p = 0.011). In the group of patients with CD and acute inflammation (n = 11), there was only one subject without CD83+ DCs (p = 0,024). These results suggest an association of CD83+ DCs with the type of IBD and the histological inflammation pattern.
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Affiliation(s)
| | - Marija Babić
- Medical School, University of Split, Split, Croatia
| | - Andre Bratanić
- Department of Gastroenterology and Hepatology, University Hospital Split, Split, Croatia.
| | - Ante Tonkić
- Department of Gastroenterology and Hepatology, University Hospital Split, Split, Croatia
| | - Katarina Vilović
- Department of Pathology, University Hospital Split, Split, Croatia
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Kunac N, Šundov Ž, Vilović K. Apoptosis as a Prognostic Factor in Colorectal Carcinoma: Comparison of TUNEL Method and Immunohistochemical Expression of Caspase-3. Appl Immunohistochem Mol Morphol 2020; 27:e22-e27. [PMID: 29489504 DOI: 10.1097/pai.0000000000000623] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The development of colorectal cancer is known to be characterized by a sequence of events during which normal colonic epithelium gradually transforms to carcinoma, the adenoma-carcinoma sequence. Apoptosis plays an important role in the development and maintenance of tissue homeostasis. Currently, there is no agreement in the literature about the prognosis of apoptosis in colorectal cancer. The number of studies examining the expression of caspases in colorectal cancer is very limited, and they have not examined any correlation between expression and patient survival. This study included histologic samples from 179 patients diagnosed with colon cancer. We used the TdT-mediated X-dUTP nick end labeling method and caspase-3 labeling to identify the degree of apoptosis. Our results show that lower apoptotic index measured by TdT-mediated X-dUTP nick end labeling method and lower immnuhistochemical expression of caspase-3 is associated with shorter disease-free survival and overall survival. However, only apoptotic index is proven to be an independent survival indicator. The results of our study are consistent with the proposed models of carcinogenesis of colorectal cancer that emphasize resistance to apoptosis as a decisive factor in the progression of the disease and resistance to treatment.
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Affiliation(s)
- Nenad Kunac
- Departments of Pathology, Forensic Medicine and Cytology
| | - Željko Šundov
- Gastroenterology, Clinical Hospital Center Split, Split, Croatia
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Jakus IA, Jakus D, Aračić N, Stipić I, Vilović K. Immunohistochemical expression of hypoxia-inducible factor-1α in stromal cells of vaginal tissue in post-menopausal women with pelvic organ prolapse. Indian J Med Res 2018; 146:S63-S67. [PMID: 29578197 PMCID: PMC5890598 DOI: 10.4103/ijmr.ijmr_388_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background & objectives: Pelvic organ prolapse (POP) is a common medical condition that affects adult women of different ages. The support of a normal pelvic floor is the result of complex interactions between ligaments, muscles, connective tissue and vaginal walls. Hypoxia and oxidative stress can reduce protein synthesis in the pelvic muscles that may contribute to muscular atrophy. Hypoxia-inducible factor-1α (HIF-1α) is a transcriptional activator which, expressed in response to hypoxia, activates a number of genes involved in cellular response to hypoxia. However, a potential role of hypoxia and oxidative stress in pathogenesis of POP is not known. This study was aimed to compare the level of HIF-1α immunohistochemical expression in the vaginal stromal cells of postmenopausal women with and without POP. Methods: Samples of the vaginal tissue from 120 menopausal women were obtained during surgery, and immunohistochemical expression of HIF-1α was assessed. There were 60 women with POP while 60 women in the control group were without prolapse but with benign gynaecological diseases. Results: In post-menopausal women with prolapse, significant differences were observed in the number of HIF-1α-positive stromal cells in the vaginal tissue compared to the control group. There was a significant increase in the number of HIF-1α in the stromal cells of the vaginal tissue in women with prolapse. Interpretation & conclusions: Difference in expression of HIF-1α in stromal cells of the vaginal tissue in the post-menopausal women with and without POP suggests that prolonged hypoxia probably has an important role in the aetiopathogenesis of POP.
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Affiliation(s)
- Ivana Alujević Jakus
- Clinical Department of Gynecology & Obstetrics, Split University Hospital Center, Split, Croatia
| | - Dora Jakus
- School of Medicine, University of Split, Split, Croatia
| | - Nađa Aračić
- Clinical Department of Gynecology & Obstetrics, Split University Hospital Center, Split, Croatia
| | - Ivica Stipić
- Clinical Department of Gynecology & Obstetrics, Split University Hospital Center, Split, Croatia
| | - Katarina Vilović
- Clinical Department of Pathology, Split University Hospital Center, Split, Croatia
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Kljajić Z, Roje Ž, Bečić K, Čapkun V, Vilović K, Ivanišević P, Marušić E. Formula for the prediction of apnea / hypopnea index in children with obstructive sleep apnea without polysomnography according to the clinical parameters: Is it reliable? Int J Pediatr Otorhinolaryngol 2017; 100:168-173. [PMID: 28802366 DOI: 10.1016/j.ijporl.2017.06.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/19/2017] [Accepted: 06/29/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE OF THE STUDY The aim of the study was to propose "the risk formula" for obstructive sleep apnea in children according to the general and local clinical parameters and findings relevant for obstructive sleep apnea (OSA) severity. The unmet need for this formula arises from the economic burden of polysomnography (device, staff, training, special sleep centers, etc) as the golden standard for the diagnostics. MATERIALS AND METHODS USED The study was performed from January 2013 until January 2016 in the Sleep Center, Department for Neuroscience, School of Medicine of the University of Split, Department of Pediatrics, University Hospital Split, Croatia and ENT Dept. University Hospital in Split, Croatia. Inclusion criteria were: age > two years, AHI >1 diagnosed by polysomnography. Exclusion criteria were: chronic lung disease, active tonsillitis/pharyngitis at the time of the physical exam and syndromes that affect breathing. All polysomnograms were scored by a qualified sleep technologist and interpreted by two board certified sleep physicians independently. Age, sex, BMI, Mallampati score, tonsillar size and adenoids size were recorded. All statistical calculations were performed using SPSS 20. RESULTS In total 60 children were included in the study. The median of age was 5 years (range 2-9). There were 19 (32%) girls and 41 (68%) boys. Of all evaluated predictors, there were statistically significant differences in the values of AHI among children with different modified Mallampati score (χ2 = 28.2; p < 0.001), different size of tonsils (χ2 = 25.3; p < 0.001) and different size of adenoids (z = 2.7; p = 0,006) in univariate regression analysis. Strong positive association of AHI with modified Mallampati score (standardized B = 0.51; partial correlation = 0.542, r = 0.631) was found, as well as positive correlation of AHI with tonsillar size (standardized B = 0.246; partial correlation = 0.295,R = 0.489) in the multivariate forward stepwise regression analysis. CONCLUSION Even though we are aware that PSG is the gold standard for diagnostics of SDB there is a significant financial burden for this diagnostic procedure. That is why there is a necessity for establishing good clinical standards and possible formula for OSA severity evaluation. We propose formula which includes Mallampati score and tonsillar size for OSA -risk calculation in order to perform early therapeutic intervention thereby reducing the risk of long-term negative consequences. We recommend this formula as the screening formula in circumstances where PSG is not available, in cases when the "waiting list" is too long or when a child can not cooperate to perform it. In developing countries like Croatia on time intervention with reduced procedure-associated costs is of the utmost importance.
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Affiliation(s)
- Zlatko Kljajić
- University Department of ENT, University Hospital Center Split, Spinčićeva 1, Split, Croatia
| | - Željka Roje
- Private ENT Practice dr. Željka Roje, Kranjčevićeva 45, Split, Croatia
| | - Kristijan Bečić
- School of Medicine, University of Split, Šoltanska 2, Split, Croatia.
| | - Vesna Čapkun
- Department of Nuclear Medicine, University Hospital Center Split, Spinčićeva 1, Split, Croatia
| | - K Vilović
- Department of Pathology, University Hospital Center Split, Spinčićeva 1, Split, Croatia
| | - Petar Ivanišević
- University Department of ENT, University Hospital Center Split, Spinčićeva 1, Split, Croatia
| | - Eugenija Marušić
- Department of Pediatrics, University Hospital Center Split, Spinčićeva 1, Split, Croatia
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Alujević Jakus I, Jakus D, Marinović J, Ćavar M, Banić I, Vilović K. Expression of Mitochondrial Respiratory Chain Complexes in the Vaginal Wall in Postmenopausal Women with Pelvic Organ Prolapse. Gynecol Obstet Invest 2017; 83:487-492. [DOI: 10.1159/000480236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 08/10/2017] [Indexed: 11/19/2022]
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Pogorelić Z, Katić J, Mrklić I, Jerončić A, Šušnjar T, Jukić M, Vilović K, Perko Z. Lateral thermal damage of mesoappendix and appendiceal base during laparoscopic appendectomy in children: comparison of the harmonic scalpel (Ultracision), bipolar coagulation (LigaSure), and thermal fusion technology (MiSeal). J Surg Res 2017; 212:101-107. [PMID: 28550895 DOI: 10.1016/j.jss.2017.01.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [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: 11/05/2016] [Revised: 12/23/2016] [Accepted: 01/18/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND The aim of this study was to compare lateral thermal damage of mesoappendix and appendiceal base using three different instruments for sealing and cutting of mesoappendix. MATERIALS AND METHODS A total number of 99 patients (54 males and 45 females) who underwent laparoscopic appendectomy because of suspected appendicitis between December 2013 and May 2015 were enrolled in the study. The patients were divided in three groups based on instrument used for sealing of mesoappendix: group 1 (Ultracision; n = 36), group 2 (LigaSure; n = 32), and group 3 (MiSeal; n = 31). Lateral thermal damage, intraoperative and postoperative complications, duration of surgery, hospital stay, and economic value were compared within groups. RESULTS The median age of patients was 14 y (range 3-17). A histopathologic analysis revealed a positive diagnosis of appendicitis in 84 patients (85%). The median lateral thermal damage on appendiceal base using Ultracision, LigaSure, and MiSeal was 0.10 mm, 0.16 mm, and 0.10 mm respectively, and on mesoappendix, 0.08 mm, 0.13 mm, and 0.08 mm, respectively. Significantly higher thermal damage was found on mesoappendix (P = 0.015) and appendiceal base (P = 0.012) in patients treated with LigaSure than in patients from other groups. There were no statistical differences among the groups regarding intraoperative and postoperative complications (P = 0.098). No significant difference in thermal damage between appendicitis and nonappendicitis group was found (P = 0.266). CONCLUSIONS Using of Ultracision, LigaSure, and MiSeal for sealing of mesoappendix in laparoscopic appendectomy in children is safe and useful. LigaSure produces significantly greater lateral thermal damage compared with other instruments.
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Affiliation(s)
- Zenon Pogorelić
- Department of Pediatric Surgery, University Hospital of Split, Split, Croatia; School of Medicine, University of Split, Split, Croatia.
| | - Josip Katić
- School of Medicine, University of Split, Split, Croatia
| | - Ivana Mrklić
- School of Medicine, University of Split, Split, Croatia; Department of Pathology, Forensic Medicine and Cytology, University Hospital of Split, Split, Croatia
| | - Ana Jerončić
- Department for Research in Biomedicine and Health, School of Medicine, University of Split, Split, Croatia
| | - Tomislav Šušnjar
- Department of Pediatric Surgery, University Hospital of Split, Split, Croatia
| | - Miro Jukić
- Department of Pediatric Surgery, University Hospital of Split, Split, Croatia
| | - Katarina Vilović
- School of Medicine, University of Split, Split, Croatia; Department of Pathology, Forensic Medicine and Cytology, University Hospital of Split, Split, Croatia
| | - Zdravko Perko
- School of Medicine, University of Split, Split, Croatia; Department of Surgery, University Hospital of Split, Split, Croatia
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Meštrović J, Pogorelić Z, Drmić-Hofman I, Vilović K, Todorić D, Popović M. Protective effect of urapidil on testicular torsion–detorsion injury in rats. Surg Today 2016; 47:393-398. [DOI: 10.1007/s00595-016-1388-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 06/23/2016] [Indexed: 11/24/2022]
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Pogorelić Z, Katić J, Gudelj K, Mrklić I, Vilović K, Perko Z. Unusual cause of acute abdomen in a child – torsion of greater omentum: report of two cases. Scott Med J 2015; 60:e1-e4. [PMID: 25838282 DOI: 10.1177/0036933015581129] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Introduction Torsion of the omentum is twisting along its long axis and a rare cause of acute abdomen. Depending on associated conditions, it is classified as primary and secondary. It may mimic different pathologies presenting as acute abdomen, most common of them being acute appendicitis. Current choice for management of omental torsion is laparoscopic surgery. Case presentation We present two cases of omental torsion of two boys who presented with abdominal pain, nausea and vomiting and underwent emergency laparoscopy. Conclusion Omental torsion is very rare, and its diagnosis is usually made only after surgery. At laparoscopy, omental torsion is suspected when the appendix is normal and the symptoms and findings of torsion are present. Laparoscopy is a safe and effective approach for the diagnosis and management of omental torsion, with the advantages of reduced postoperative pain and hospital stay.
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Affiliation(s)
- Zenon Pogorelić
- Attending Physician, Department of Pediatric Surgery, Split University Hospital Centre and Split University School of Medicine, Croatia
| | - Josip Katić
- Student, School of Medicine, University of Split, Croatia
| | - Karla Gudelj
- Student, School of Medicine, University of Split, Croatia
| | - Ivana Mrklić
- Attending Physician, Department of Pathology, Split University Hospital Centre and Split University School of Medicine, Croatia
| | - Katarina Vilović
- Attending Physician, Department of Pathology, Split University Hospital Centre and Split University School of Medicine, Croatia
| | - Zdravko Perko
- Chief Surgeon, Department of Surgery, Split University Hospital Centre and Split University School of Medicine, Croatia
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Meštrović J, Drmić-Hofman I, Pogorelić Z, Vilović K, Šupe-Domić D, Šešelja-Perišin A, Čapkun V. Beneficial Effect of Nifedipine on Testicular Torsion-detorsion Injury in Rats. Urology 2014; 84:1194-8. [DOI: 10.1016/j.urology.2014.07.022] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/30/2014] [Accepted: 07/07/2014] [Indexed: 10/24/2022]
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Solarić M, Grgić M, Omrcen T, Petković M, Fröbe A, Belaj N, Zorica R, Kruslin B, Dordević G, Kastelan Z, Ruzić B, Gilja I, Krolo I, Vilović K, Librenjak D, Vrdoljak E, Situm M, Padovan RS, Vojnović Z. [Clinical guidelines for diagnosing, treatment and monitoring patients with prostate cancer--Croatian Oncology Society and Croatian Urology Society, Croatian Medical Association]. Lijec Vjesn 2013; 135:298-305. [PMID: 24490329] [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: 06/03/2023]
Abstract
Prostate adenocarcinoma is the second most common solid neoplasm in male population in Croatia. It rarely causes symptoms unless it is advanced. The finding of PSA rise is the most common reason for diagnostic workout. Treatment plan is based on TNM classification, Gleason score and PSA. Clinically localized disease is successfully treated by radical prostatectomy or radiotherapy with or without hormonal therapy. Locally advanced disease is treated with radiotherapy and hormonal therapy. Metastatic disease can be controlled for many years by androgen deprivation. For castration resistant disease appropriate treatment is chemotherapy or secondary hormonal therapy. The following paper presents the clinical guidelines in order to standardize procedures and criteria for the diagnosis, management, management, treatment and monitoring of patients with prostate cancer in the Republic of Croatia.
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Affiliation(s)
- Mladen Solarić
- Medicinski fakultet Sveucilista u Zagrebu, KBC Zagreb, Zagreb
| | - Mislav Grgić
- Medicinski fakultet Sveucilista u Zagrebu, KBC Zagreb, Zagreb
| | | | - Marija Petković
- Medicinski fakultet Sveucilista u Rijeci, KBC Rijeka, Rijeka
| | | | - Nenad Belaj
- Medicinski fakultet Sveucilista u Osijeku, KBC Osijek, Osijek
| | | | | | | | - Zeljko Kastelan
- Medicinski fakultet Sveucilista u Zagrebu, KBC Zagreb, Zagreb
| | | | | | | | | | | | | | - Marijan Situm
- Medicinski fakultet Sveucilista u Splitu, KBC Split, Split
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Gamulin M, Ruzić IP, Grgić M, Jazvić M, Solarić M, Zahirović D, Zorica R, Omrcen T, Petković M, Matić M, Fuckar Z, Ruzić B, Pasini J, Situm M, Dordević G, Miletić D, Tadić T, Kastelan Z, Librenjak D, Gilja I, Vilović K, Kruslin B, Kuvezdić H. [Clinical guidelines for diagnosing, treatment and monitoring patients with bladder cancer--Croatian Oncology Society and Croatian Urology Society, Croatian Medical Association]. Lijec Vjesn 2013; 135:292-7. [PMID: 24490328] [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: 06/03/2023]
Abstract
Urothelial cancer is the most common bladder cancer. Hematuria is the most common presenting symptom in patients with bladder cancer. The most common diagnostics of bladder cancer is performed by transurethral resection of bladder after which pathohistological diagnosis is set. It is necessary to determine whether the cancer penetrated in muscle layer (muscle-invasive cancer) or not (muscle-noninvasive cancer). Decision on therapeutic modality depends on the clinical stage of disease and on prognostic and risk factors. For muscle non-invasive bladder cancer transurethral resection is preferred with or without intravesical instillation of Bacillus Calmette-Guérin (BCG). For invasive cancer the method of choice is radical cystectomy. Radiotherapy is used in radical and palliative purposes. Metastatic disease is most frequently treated by chemotherapy metotrexate/vinblastine/doxorubicine/cisplatin (MVAC) or gemcitabine/cisplatin (GC). The purpose of this article is to present clinical recommendations to set standards of procedures and criteria in diagnostics, treatment and follow up of patients with bladder cancer in the Republic of Croatia.
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Affiliation(s)
- Marija Gamulin
- Medicinski fakultet Sveucilista u Zagrebu, KBC Zagreb, Zagreb
| | | | - Mislav Grgić
- Medicinski fakultet Sveucilista u Zagrebu, KBC Zagreb, Zagreb
| | | | - Mladen Solarić
- Medicinski fakultet Sveucilista u Zagrebu, KBC Zagreb, Zagreb
| | - Dag Zahirović
- Medicinski fakultet Sveucilista u Rijeci, KBC Rijeka, Rijeka
| | | | | | - Marija Petković
- Medicinski fakultet Sveucilista u Rijeci, KBC Rijeka, Rijeka
| | - Mate Matić
- Medicinski fakultet Sveucilista u Osijeku, KBC Osijek, Osijek
| | - Zeljko Fuckar
- Medicinski fakultet Sveucilista u Rijeci, KBC Rijeka, Rijeka
| | | | - Josip Pasini
- Medicinski fakultet Sveucilista u Zagrebu, KBC Zagreb, Zagreb
| | - Marijan Situm
- Medicinski fakultet Sveucilista u Splitu, KBC Split, Split
| | | | - Damir Miletić
- Medicinski fakultet Sveucilista u Rijeci, KBC Rijeka, Rijeka
| | - Tade Tadić
- Medicinski fakultet Sveucilista u Splitu, KBC Split, Split
| | - Zeljko Kastelan
- Medicinski fakultet Sveucilista u Zagrebu, KBC Zagreb, Zagreb
| | | | | | | | | | - Hrvoje Kuvezdić
- Medicinski fakultet Sveucilista u Osijeku, KBC Osijek, Osijek
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Bašić Ž, Anterić I, Vilović K, Petaros A, Bosnar A, Madžar T, Polašek O, Anđelinović Š. Sex determination in skeletal remains from the medieval Eastern Adriatic coast - discriminant function analysis of humeri. Croat Med J 2013; 54:272-8. [PMID: 23771758 PMCID: PMC3692335 DOI: 10.3325/cmj.2013.54.272] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Aim To investigate the usefulness of humerus measurement for sex determination in a sample of medieval skeletons from the Eastern Adriatic Coast. Additional aim was to compare the results with contemporary female population. Methods Five humerus measurements (maximum length, epicondylar width, maximum vertical diameter of the head, maximum and minimum diameter of the humerus at midshaft) for 80 male and 35 female medieval and 19 female contemporary humeri were recorded. Only sufficiently preserved skeletons and those with no obvious pathological or traumatic changes that could affect the measurements were included. For ten samples, analysis of DNA was performed in order to determine sex using amelogenin. Results The initial comparison of men and women indicated significant differences in all five measures (P < 0.001). Discriminant function for sex determination indicated that as much as 85% of cases could be properly categorized, with better results in men (86%) than women (80%). Furthermore, the comparison of the medieval and contemporary women did not show significant difference in any of the measured features. Sex results obtained by anthropological and DNA analysis matched in all 10 cases. Conclusion The results indicate that humerus measurement in Croatian medieval population may be sufficient to determine the sex of the skeleton. Furthermore, it seems that secular changes have not substantially affected contemporary population, suggesting that the results of this study are transferable to contemporary population as well.
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Affiliation(s)
- Željana Bašić
- University Department for Forensic Sciences, University of Split, Rudjera Boskovica 31/IV, 21000 Split, Croatia.
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Pogorelić Z, Stipić R, Druzijanić N, Perko Z, Grandić L, Vilović K, Mrklić I, Jurić I, Boschi V, Bekavac J. Torsion of epiploic appendage mimic acute appendicitis. Coll Antropol 2011; 35:1299-1302. [PMID: 22397276] [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: 05/31/2023]
Abstract
Epiploic appendagitis is a rare cause of focal abdominal pain which, depending on its localisation, can mimic a variety of abdominal diseases. We report a case of 36-year-old woman who presented with a classic signs of acute appendicitis. On examination, the obese, afebrile, and had very strong right iliac fossa tenderness and guarding. The white cell count was 12.82 x 10(9)/L, and C reactive protein count was 15.13MG/DL. She underwent emergency laparoscopic procedure after the acute appendicitis diagnosis has been established. Laparoscopic exploration of the abdominal cavity showed vermiform, no inflamed, appendix and necrotic appendix epiploica of the caecum. The treatment consisted of typical laparoscopic appendectomy and laparoscopic resection of the necrotic appendix epiploica. The patient made rapid recovery and was discharged from the hospital on second day after the operation. Histological investigation of the appendix epiploica revealed gangrenous epiploic appendage.
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Affiliation(s)
- Zenon Pogorelić
- University of Split, Split University Hospital Center, Department of Pediatric Surgery, Split, Croatia.
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Perko Z, Pogorelić Z, Druzijanić N, Bilan K, Vilović K. Formation of adhesions at surgical meshes in a rat experimental model. Coll Antropol 2011; 35:911-914. [PMID: 22053576] [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: 05/31/2023]
Abstract
Abdominal wall hernias are surgical problem that are easily solved with laparoscopic surgery. The determining factor for the success of the operation is the right choice and use of surgical mesh as the support material. The most common complication of surgical mesh placement is the formation of adhesions. Aim of this paper is to determine whether there is a statistic difference in formation of adhesions between different surgical meshes in lab environment. Wistar rats were used as the experimental model. After the anaesthesia a 1x1 cm defect of the abdominal wall was made, but the skin was left intact. The mesh was placed directly on the internal organs. The experiment considered four different mesh types. After set time periods of one, two or four weeks the animals were sacrificed and the amount of formed adhesions were evaluated based on the modified Diamond scale. Immediately after the first week we found a statistically significant difference in the adhesion occurrence rate between compared materials. The smallest amount of adhesions was caused by polypropylen + polydoksanon mesh, and the most by polypropilen mesh. Polypropylen + polyglactin mesh showed significant reduction of adhesion formation between the tested weeks. We can conclude that polypropylen + polydoxanon meshes are superior for ventral hernia operation, because those defects are in close contact with the internal organs and it is very important to have the smallest amount of adhesions.
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Affiliation(s)
- Zdravko Perko
- University of Split, Split University Hospital Center, Department of Surgery, Split, Croatia
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Poljicanin A, Carić A, Vilović K, Kosta V, Marinović Guić M, Aljinović J, Grković I. Daily mini quizzes as means for improving student performance in anatomy course. Croat Med J 2009; 50:55-60. [PMID: 19260145 DOI: 10.3325/cmj.2009.50.55] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM To evaluate daily-written 10-question quizzes in a medical anatomy course as a way to integrate assessment into the course and to evaluate their effect on the course success. METHODS Students answering correctly 8/10 or more questions were awarded 0.5 points per quiz. There were 34 quizzes with a maximum point score 17. Measurable outcomes of academic progress in anatomy course (pass rates on 4 examination terms, total pass rate, and average marks) were calculated, and 2007/08 academic year was compared with the previous academic year in which daily written quizzes were not a part of the course. The relationship between cumulative points on daily quizzes and 3 components of the final examination (written, practical, and oral) for 2007/08 academic year was assessed by non-parametric correlation testing. RESULTS Individual scores on quizzes ranged from 1.5 to 13.5 points. There was a positive correlation between scores on quizzes and grades on 3 components of the final examination: written (Spearman rho=0.784, P<0.001, n=79), practical (Spearman rho=0.342, P<0.002, n=79), and oral (Spearman rho=0.683, P<0.001, n=79) part. Compared with students in the previous academic year, students attending the course with daily quizzes significantly improved their academic achievement, expressed as the pass rate at the first examination term (39% vs 62%, respectively, chi(2) test, P=0.006, ) and the average course grade (2.71+/-1.08 vs 3.38+/-1.26, respectively; t test, P<0.001). CONCLUSION Despite their frequency and possible associated stress, daily quizzes were associated with better academic success in the anatomy course.
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Affiliation(s)
- Ana Poljicanin
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia.
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Grković I, Marinović Guić M, Kosta V, Poljicanin A, Carić A, Vilović K. Designing anatomy program in modern medical curriculum: matter of balance. Croat Med J 2009; 50:49-54. [PMID: 19260144 DOI: 10.3325/cmj.2009.50.49] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM To evaluate the structure of the anatomy program in the first year medical curriculum of University of Split School of Medicine by comparing it with the recommendations by the Educational Affairs Committee of the American Association of Clinical Anatomists (AACA) and the Terminologia Anatomica (TA); we also quantitatively evaluated the organization of teaching material in contemporary topographical anatomy textbooks and matched them with the AACA recommendations, TA, and the curriculum of the anatomy course taught at Medical School in Split, Croatia. METHODS TA, official recommendations of the AACA, 6 contemporary anatomy textbooks, and the structure of the anatomy course were analyzed for the proportion of the terms or text devoted to standard topographical regions of the body. The findings were correlated using Spearman rho test. RESULTS The curriculum outline correlated both with the AACA recommendations (Spearman rho=0.83, P=0.015) and TA (Spearman rho=0.73, P=0.046). Textbooks contained 8 distinct sections, 7 allocated to topographic anatomy regions and 1 to general anatomy concepts and principles. The structure of all textbooks correlated significantly with the course curriculum. However, 4 out of 6 textbooks did not correlate with TA and only a single textbook showed significant correlation with the AACA recommendations. CONCLUSION Anatomy textbooks vary in the amount of text dedicated to different parts of topographical anatomy and are not quite concordant with curriculum recommendations and standard anatomical terminology. Planning the structure of an anatomy course should not be based on a single book or recommendation but on evidence.
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Affiliation(s)
- Ivica Grković
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Soltanska 2, 21000 Split, Croatia.
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Sundov Z, Tomić S, Vilović K, Kunac N, Kalebić M, Bezić J. Immunohistochemically detected high expression of matrix metalloproteinase-2 as predictor of poor prognosis in Duke's B colon cancer. Croat Med J 2009; 49:636-42. [PMID: 18925697 DOI: 10.3325/cmj.2008.5.636] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
AIM To demonstrate immunohistochemical expression of matrix metalloproteinase-2 (MMP-2) protein in Duke's B colon cancer and determine its correlation with age, sex, grade, presence of vascular invasion, and patients' overall survival. METHOD The study took place from January 1995 to December 1997. We determined the expression of MMP-2 in 152 formalin-fixed, paraffin embedded specimens of Duke's B colon carcinomas by immunohistochemical analysis using MMP-2 monoclonal antibody. Immunohistochemical expression was scored semiquantitatively. Carcinomas were graded as low or high grade. Survival time was analyzed with Kaplan-Meier method, and the log-rank test was used to assess the differences between groups. Cox proportional hazard regression model was used for multivariate survival analysis. RESULT Univariate analysis showed that positive staining for MMP-2, high histological grade, vascular invasion, male sex, and age>60 years were associated with shorter survival in patients with Duke's B colon cancer (P range from 0.023 to <0.001). Multivariate analysis showed that only MMP-2 overexpression (P<0.001; hazard ratio [HR]=3.64) and vascular invasion (P<0.001; HR=4.27) were associated with shorter overall survival. CONCLUSION Expression of MMP-2 is an important independent indicator of shorter survival in patients with Duke's B colon cancer and should be taken into consideration in decision-making on the use of adjuvant systemic therapy in patients with Duke's B colon cancer.
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Affiliation(s)
- Zeljko Sundov
- Department of Internal Medicine, Split University School of Medicine, Split, Croatia
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Perko Z, Bilan K, Vilović K, Druzijanić N, Kraljević D, Juriicić J, Krnić D, Srsen D, Pogorelić Z, Tomić S. Partial cecal necrosis treated by laparoscopic partial cecal resection. Coll Antropol 2006; 30:937-9. [PMID: 17243575] [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: 05/13/2023]
Abstract
Acute colonic ischemia is the common cause of colitis in elderly population. However, isolated ischemic necrosis of cecum is rare entity, often associated with variety of conditions. Here we present a case of a 73-year old woman with a past history of hypertension presented with clinical symptoms of right lower quadrant abdominal pain and tenderness localized to the right lower quadrant, guarding and rebound tenderness. With diagnosis of acute appendicitis, the patient underwent laparoscopy where the cecal partial necrosis was discovered. Necrotic area of cecum was excised using two endoscopic cutters and laparoscopic appendectomy was performed. Pathologist report showed thrombosis of vessels and necrosis of entire cecal wall. The patient completely recovered without any surgical complications. This is the first case of partial cecum necrosis laparoscopicaly managed and with a partial cecal resection only.
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Affiliation(s)
- Zdravko Perko
- Department of Surgery, University Hospital Split, Split, Croatia.
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Perko Z, Pogorelić Z, Bilan K, Tomić S, Vilović K, Krnić D, Druzijanić N, Kraljević D, Juricić J. Lateral thermal damage to rat abdominal wall after harmonic scalpel application. Surg Endosc 2005; 20:322-4. [PMID: 16333532 DOI: 10.1007/s00464-005-0089-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2005] [Accepted: 05/21/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Use of the Harmonic Scalpel transduces a lower amount of energy to tissues, thereby limiting the potential for lateral thermal damage and deep penetration because only low temperatures are reached. The working principle of the Harmonic Scalpel is the transformation of electric power into the longitudinal mechanical movement of the instrument tip. This study aimed to determine the effects from varying durations of Harmonic Scalpel application on the experimental model of rat abdominal wall without skin. METHODS After the rats had been anesthetized, and a laparotomy was performed. The Harmonic Scalpel shears were used on the muscular part of the abdominal wall without skin. Different durations of output power 3 were applied: a single 5-s application, a single 10-s application, and a regimen of two sequential 5-s applications. Each animal in each group of 10 received five individual activations, after which the animals were killed. Tissue samples were fixed and embedded in paraffin before sections were taken and stained. Using light microscopy and morphometric imaging analysis, the width of tissue lateral thermal damage was measured from the point of Harmonic Scalpel incision. RESULTS The rat abdominal wall showed lateral thermal damage over a mean width of 0.0522 +/- 0.0097 mm after a 5-s Harmonic Scalpel application, a damage width of 0.1544 +/- 0.0419 mm after a 10-s application, and a damage width of 0.1020 +/- 0.0430 mm after a 5-s application followed by 5 s of inactivity and another 5 s of activity. These differences in thermal damage width between all the groups are statistically significant. CONCLUSIONS The findings lead to the conclusion that tissue lateral thermal damage after Harmonic Scalpel application at standard output power is greater when a longer sustained period of application is used. Lateral thermal damage also is greater if the Harmonic Scalpel application time is continuous rather than of the same total duration with a brief midpoint interruption.
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Affiliation(s)
- Z Perko
- University Department of Surgery, Clinical Hospital and Medical School Split, Spinciceva 1, Split, 21000, Croatia
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Vilović K, Ilijić E, Glamoclija V, Kolić K, Bocina I, Sapunar D, Saraga-Babić M. Cell death in developing human spinal cord. ACTA ACUST UNITED AC 2005; 211:1-9. [PMID: 16315061 DOI: 10.1007/s00429-005-0044-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2005] [Indexed: 10/25/2022]
Abstract
Cell death in the developing human spinal cord was investigated in 5-12 week human conceptuses using immunohistochemical and TUNEL methods. Expression of pro-apoptotic (Fas-receptor, caspase-3) and anti-apoptotic (bcl-2) markers and marker for internucleosomal fragmentation (TUNEL) were analysed in the cranial and caudal parts of the human spinal cord. In early developmental stages (5-6 weeks) of the cranial spinal cord, bcl-2 positive cells were seen in the ventricular zone and in the roof plate, while in the caudal part they were seen surrounding the central lumen. Subsequently, bcl-2 expression appeared in the basal plates of the grey matter and in the spinal ganglia, and from the seventh week on they also appeared in the intermediate horn of the grey matter. In the fetal period, bcl-2 expression appeared in the dorsal horns of the grey matter (9 weeks) but ceased in the ventricular zone (12 weeks) . In the trunk region, TUNEL-positive cells were found in ventricular and mantle zones along the whole length of the spinal cord. Caspase-3 positive cells and Fas-receptor positive cells appeared only in the grey matter of the cranial segments (head and trunk) of the spinal cord, but they were missing in the caudal parts. Caspase-3 dependant pathway, probably activated by Fas-receptor, seems to operate only in the cranial part of the human spinal cord. In the caudal (sacrococcygeal and tail) parts, cells seem to die by caspase-3 independent pathway. The interplay of pro-apoptotic and anti-apoptotic factors may be associated with cranial spinal cord morphogenesis, adjustment of cells number and selective survival of neurons, while in the caudal regions these factors cause massive cell death associated with regression of the caudal spinal cord.
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Affiliation(s)
- Katarina Vilović
- Department of Anatomy, Histology and Embryology, School of Medicine, University of Split, PAK, KB Split, Spincićeva 1, 21000 Split, Croatia.
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Glamoclija V, Vilović K, Saraga-Babić M, Baranović A, Sapunar D. Apoptosis and active caspase-3 expression in human granulosa cells. Fertil Steril 2005; 83:426-31. [PMID: 15705385 DOI: 10.1016/j.fertnstert.2004.06.075] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2004] [Revised: 06/22/2004] [Accepted: 06/22/2004] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To document the expression of activated forms of caspase-3 in human granulosa cells. DESIGN Laboratory study. SETTING In vitro fertilization (IVF) laboratory of the Split University Hospital and laboratory of the Department of Anatomy, Histology, and Embryology. PATIENT(S) Ovarian tissues were obtained from women undergoing hysterectomy/ovariectomy for benign conditions and human granulosa cells were obtained from women undergoing oocyte retrieval for IVF. INTERVENTION(S) Immunostaining of tissue sections and cell smears using antibody to active caspase-3 and terminal deoxynucleotidyl transferase (TdT) assay (TUNEL) for detection of internucleosomal DNA fragmentation. MAIN OUTCOME MEASURE(S) Microscopic evaluation to assess the presence and cellular co-localization of active caspase-3 and TUNEL-positive cells. RESULT(S) In human ovarian tissue, no apoptosis was observed in primordial and primary follicles. Apoptosis in granulosa cells was detected only in atretic antral follicles. Granulosa cells classified as apoptotic on the basis of their morphologic features contained a single condensed nucleus, multiple nuclear fragments, or apoptotic bodies. All apoptotic granulosa cells expressed active caspase-3, but only few contained fragmented DNA detected with the TUNEL method. The expression of active caspase-3 was also demonstrated in human granulosa cells of preovulatory follicles obtained from patients undergoing IVF. CONCLUSION(S) Caspase-3 dependent apoptosis occurs in human granulosa cells and activates when follicles begin to leave the resting pool. After initial formation of the antrum, activation of caspase-3 is a normal physiologic process of the follicle during atresia and luteinization. Higher numbers of granulosa cells positive with caspase-3 than cells positive with TUNEL suggest an earlier activation of caspase-3 compared with the DNA fragmentation detected by TUNEL assay and also a longer detection period of caspase-3 than DNA fragmentation in apoptotic granulosa cells.
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Affiliation(s)
- Violeta Glamoclija
- Department of Anatomy, Histology, and Embryology, School of Medicine, University of Split, Split, Croatia.
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Bacić J, Vilović K, Baronica KB. The gynaecological-obstetrical practice of the renaissance physician Amatus Lusitanus (Dubrovnik, 1555-1557). Eur J Obstet Gynecol Reprod Biol 2002; 104:180-5. [PMID: 12206935 DOI: 10.1016/s0301-2115(02)00066-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE A gynaecological-obstetrical causation review in Dubrovnik from 1555 to 1557. Extract from the book "Curationum Medicinalium Centuriae V et VI" Amatus Lusitanus. METHOD A thorough life and work archive study of Amatus Lusitanus has been made and, for this review, extracted his gynaecological-obstetrical causation observations and annotations. RESULTS Amatus Lusitanus was an undisputed, reputable and respected medical figure during the mid 16th century. He decisively focused on intern medicine, incorporating the gynaecological-obstetrical field. His work and skill, most assuredly, contributed to the better comprehension, acknowledgement and reputation of the gynaecological-obstetrical practice, thus leaving repute and respect in medical history latitude. CONCLUSION All these cases occurred in Dubrovnik during 1555-1557 and Amatus is assuredly an excellent observer and exactist, extracting the "relevant from the non-relevant" even in Dubrovnik's gynaecological-obstetrical daily happenings. He thoughtfully concludes his inability to remedy a malignant, advanced illness of the uterus, presumes an utero-vesico-intestinal fistula and openly speaks of medical ineptness of this causation. Proud of his invention in treating "contracted nipples"; correct in his advice and recommendations of "long and difficult births". Impartial in his perception of puerperal sepsis and its unfavourable pathology outcome. His description of "hormone insufficiency" is concise and precise; the preferred procedure in an "abortus in tractu" is purposeful and meaningful. He closely works with other physicians living and working in Dubrovnik; conscientiously directing surgeons in procedures of stillborn child births. He explains and treats pyschosexual disturbances "without fault" and in concurrence with, not only, the contemporary knowledge of such sexual disturbances, but also in concurrence with contemporary psychiatric procedures that, even today, are applied in such pathology treatment.
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Affiliation(s)
- Jurica Bacić
- General Hospital Dubrovnik, Roko Misetića bb, 20000 Dubrovnik, Croatia.
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Vilović K, Sapunar D, Ilijić E, Mimica MD, England MA, Saraga-Babić M. Morphological characteristics of dying cells in axial structures of developing human embryos. Cells Tissues Organs 2002; 169:347-54. [PMID: 11490113 DOI: 10.1159/000047901] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Programmed cell death (PCD) is a widespread phenomenon in the development of vertebrates. In most cases, dying cells during development exhibit generalized morphological features typical of apoptosis. We analyzed the morphological features of dying cells in the developing axial structures of 5 human embryos between 5 and 8 weeks of postovulatory age. Cell death in the axial structures, i.e. spinal cord, notochord and surrounding mesenchyme and somites, was analyzed using light and electron microscopy. Tissue samples were taken from the cervicothoracic region of normal human conceptuses. Two morphological types of cell death were found: apoptosis which was characterized by round or semilunar nuclear chromatin condensations, condensation and shrinkage of the cytoplasm and formation of apoptotic bodies, and cell death without the morphological features of apoptosis which was characterized by pyknotic nuclear chromatin condensations, vacuolated cytoplasm and the formation of numerous intercellular spaces. Apoptotic death occurred during the 5th week of normal development in all the axial structures. Later, apoptotic death appeared in all the axial structures, with the exception of the notochord, where some dying cells displayed features of secondary necrosis. According to our findings, apoptosis seems to be the most frequently observed type of PCD, but it is not the exclusive type of morphological cell death during the development of axial structures in human embryos.
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Affiliation(s)
- K Vilović
- Department of Anatomy, Histology and Embryology, School of Medicine, University of Split, PAK, KB Split, Spincićeva 1, CRO-21000 Split, Croatia.
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Abstract
During normal human development a number of transient structures form and subsequently regress completely. One of the most prominent structures that regress during development is the human tail. We report here a histological and ultrastructural study of cell death in the cranial and caudal (tail) parts of the neural tube in 4 to 6-week-old human embryos. Initially, the human tail is composed of tail bud mesenchyme which differentiates into caudal somites, secondary neural tube, notochord and tail gut. Later on, these structures gradually regress by cell death. During the investigated period, we observed two morphologically distinct types of dying cells. The well-described apoptotic type of cell death was observed only in the cranial neural tube that forms during primary neurulation. The other type of cell death characterized by necrotic morphology was observed in the tail mesenchyme and in the caudal neural tube that forms during secondary neurulation. This morphological diversity suggests that besides differences in origin and fate there are different mechanisms of developmental cell death between two parts of the human neural tube. We can speculate that the apoptotic type of cell death is associated with the precise control of cell numbers and that the other morphologically distinct type of cell death is responsible for the massive removal of transitory structures.
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Affiliation(s)
- D Sapunar
- Department of Anatomy, Histology and Embryology, School of Medicine, University of Split, Croatia.
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Krolo M, Vilović K, Sapunar D, Vrdoljak E, Saraga-Babic M. Fibronectin expression in the developing human spinal cord, nerves, and ganglia. Croat Med J 1998; 39:386-91. [PMID: 9841937] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
AIM Analysis of developmental role of fibronectin during differentiation of the human spinal cord, nerves, and ganglia. METHODS Seven normal human embryos and fetuses between the 7th and 9th developmental week and a 9-week fetus with cervical spina bifida were histologically examined on hematoxylin and eosin stained serial paraffin sections of thoracic axial segments. Monoclonal antibody to the human cell fibronectin fragment was used for immunohistochemical detection of fibronectin. RESULTS In the 7th and 8th week of development, fibronectin was weakly expressed in the ventricular and intermediate zones of the spinal cord. Intense fibrillar expression was found in the marginal zone of the spinal cord - first over the ventral gray horns and later over the lateral and dorsal gray horns, and along the pathways of ventral and dorsal roots of the spinal nerves and in the spinal ganglia. At 9th week, fibronectin expression disappeared in the ventricular and intermediate zones a nd became weak and granular in the marginal zone of the spinal cord. In the spinal cord of a 9-week malformed fetus with cervical spina bifida, fibronectin expression was completely absent. Fibronectin was expressed in the nerves and ganglia throughout the investigated period, both in normal and malformed human conceptuses. CONCLUSION Transient expression of fibronectin in the human spinal cord coincided with the most intense neuronal differentiation. Temporal and spatial expression of fibronectin during normal development, and its absence in a malformed human fetus suggests developmental role of fibronectin for the normal formation of the spinal cord.
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Affiliation(s)
- M Krolo
- Department of Histology and Embryology, Split University School of Medicine, Spinciceva 1, HR-21000 Split, Croatia
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Radonić V, Budimir D, Bradarić N, Luksić B, Sapunar D, Vilović K. Envenomation by the horned viper (Vipera ammodytes L.). Mil Med 1997; 162:179-82. [PMID: 9121663] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Snake venom poisoning is a medical emergency that requires urgent therapeutic procedures. The treatment of venomous snakebites is still controversial because of unclear therapeutic modalities. Choice of treatment is dictated in part by regional characteristics with regard to patient population and types of venomous snakes. The purpose of the study presented here was to report regional experience with venomous snakebites and to describe first-aid, pre-hospital, and hospital therapeutic procedures for horned viper bite. During a 16-year period, from 1980 to 1996, at the Clinical Hospital Split (Croatia) we collected data on 389 victims of horned viper bite. Incidence of the local and general complications is presented. We also reviewed therapeutic modalities and outcome with special attention to compartment syndromes and the indications for fasciotomy.
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Affiliation(s)
- V Radonić
- Department of Surgery, University Hospital, Split, Croatia
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Affiliation(s)
- Vedran Radonić
- Department of Surgery, University Hospital, 21000 Split, Croatia
| | - Dražen Budimir
- Department of Pediatric Surgery, University Hospital, 21000 Split, Croatia
| | - Nikola Bradarić
- Department of Infectious Diseases, University Hospital, 21000 Split, Croatia
| | - Boris Luksić
- Department of Infectious Diseases, University Hospital, 21000 Split, Croatia
| | - Damir Sapunar
- Department of Histology and Embryology, Medical School Split, 21000 Split, Croatia
| | - Katarina Vilović
- Department of Histology and Embryology, Medical School Split, 21000 Split, Croatia
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