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Background/Aim. The depth of invasion of oral cavity carcinoma (OCC) and the nodal involvement define the treatment selection, outcome, and prognosis of the disease. In determining the stage of OCC, the most widely applied methods are computerized tomography (CT) and magnetic resonance imaging (MRI), whose limitations can be overcome to some extent by using intraoral ultrasound (IOUS). The aim of the study was to evaluate the imaging presentation of early-stage OCC, determine the depth of invasion (DOI) and the greatest diameter (GD) of the tumor using the IOUS and CT methods, and compare them with histopathological (HP) findings. Methods. The study was designed as a prospective one, with a time limitation of three months. Eleven patients with clinical early-stage OCC underwent a native CT examination of the head and neck as well as a contrast-enhanced phase, and then IOUS of the lesion was performed. Using both methods, DOI and GD values were measured, and the values were correlated with HP findings. The analysis of the obtained data was per-formed using the statistical package SPSS 22 and Pearson correlation coefficient. Results. A significant correlation (p = 0.001) was established between the DOI values measured by IOUS and CT examination with the measurements obtained by HP processing. On the other hand, by comparing the GD measured on IOUS and CT examination, no correlation was established with the HP report. Conclusion. Measurements of DOI obtained by IOUS significantly correlated with those in the HP report, while overcoming the limitations of the CT method in the evaluation of small-sized tumors and tumors that cannot be shown due to artifacts.

Background/Aim: Radiopacity enables radiographic visualization, which is significant in diagnostic procedures and assessment of the quality of endodontic filling. It is important to compare newly developed endodontic sealers with materials that are already in clinical use in order to promote evidence-based dentistry. The aim of our study was to evaluate radiopacity of different calcium silicate-based sealers in comparison with control, epoxy resin-based sealer. The null hypothesis was that there were no statistically significant differences in radiopacity of the tested sealers. Material and Methods: Premixed (TotalFill BC Sealer, EndoSequence BC Sealer, Ceraseal, Bio-C Sealer), two-component (BioRoot RCS, MTA Fillapex, Bioceramic Root Canal Sealer, GuttaFlow Bioseal) calcium silicate-based sealers and AH Plus, as a control, were used. Specimens were radiographed using a Radiovisiography (RVG-4) CCD (charge-coupled devices)-based digital sensor. Results: Ceraseal had the highest, while Bioceramic Root Canal Sealer had the lowest radiopacity. Bioceramic Root Canal Sealer and MTA Fillapex had radiopacity significantly lower than all other sealers. Radiopacity level of AH Plus, was similar to premixed and significantly higher than radiopacities of all two-component endodontic sealers. Conclusions: Calcium silicate-based sealers radiopacity ranged from slightly above minimal required value (3mm), to a value higher than control sealer. Premixed endodontic sealers showed similar radiopacity as AH Plus which suggests that their clinical performance, in terms of visibility on dental radiograms, should be similar

Background/Aim: Mylohyoid boutonnière is a common anatomical variant with extremely rare clinical manifestations. We report two cases of symptomatic unilateral mylohyoid boutonnière with sublingual gland herniation. Case report: The first was a 34-year-old female with a two months history of a left submandibular swelling, intermittent pulsations, and otalgia. The second 67-year-old female presented with a left submandibular pain six months after total thyroidectomy due to papillary carcinoma. After detailed clinical and radiological evaluation by ultrasonography (US) and computed tomography (CT), the mylohyoid gap with sublingual gland herniation was diagnosed in both patients. The dynamic US with a tongue pressed down on the mouth floor revealed blood vessel compression by a herniated sublingual gland in the first patient. Conclusions: This is the first case of a mylohyoid boutonnière related intermittent vascular compression. Dynamic US and CT may help to differentiate intermittent and persistent sublingual gland herniation through the mylohyoid boutonnière from other pathological lesions in the submandibular region.

Background/Aim. Contrast-induced acute kidney injury (CI-AKI) is a common complication after the percutaneous coronary intervention, associated with a prolonged hospital stay, increased medical costs, and risk of adverse clinical outcomes. The aim of this study was to compare changes in levels of serum creatinine (sCr) and cystatin C (sCyC) 24 h after coronary angiography as an early indicator of CI-AKI. Methods. The study included 45 patients with chronic renal failure grade I–III scheduled for coronary angiography. Levels of sCr and sCyC were measured a day before and 24 h after coronary angiography. CI-AKI was defined as a 25% and 10% increase of sCr and sCyC levels from baseline within 24 h from contrast media exposure, in the absence of alternative causes. Results. Mean sCr and sCyC concentra-tions were 86.4 ± 22.6 μmol/L and 1.18 ± 0.52 mg/dL, respectively before contrast administration, and 90.6 ± 24.1 μmol/L and 1.24 ± 0.65 mg/dL, respectively 24 h after contrast media exposure. sCr-based CI-AKI occurred in 4 patients (8.89%) and sCyC-based CI-AKI was detected in 19 patients (42.22%) after the contrast procedure (p < 0.001). Conclusion. sCyC level measured 24 h after contrast media exposure is a more sensitive indicator of CI-AKI than sCR level.

Background/Aim. Oxidative stress is an important risk factor for the development of cardiovascular atherosclerotic diseases in the population of patients treated with regular hemodialysis. Bioincompatibility of the dialysis membrane and increased concentration of endotoxin in the hemodialysis solution are two main factors that can trigger oxidative stress. This paper was intended to examine the effect of a vitamin E-coated membrane on oxidative stress during a single session of on-line hemodiafiltration. Methods. Twenty-four patients undergoing hemodiafiltration with vitamin E-coated polysulfone dialysis membrane (Leoceed 21H) were examined, followed by a polysulfone dialysis membrane treatment without vitamin E (FX800). The following parameters of oxidative stress were measured: superoxide anion radical (O2-), hydrogen peroxide (H2O2), thiobarbutyric acid reactive substances (TBARS), nitric oxide (NO2-), catalase (CAT), superoxide dizmutase (SOD), and reduced glutathione (GSH) activity. Statistical analysis included the Kolmogorov-Smirnov test, Student-t test and Wilcoxon test. Results. On-line hemodiafiltration using a high-flux polysulfone vitamin E-coated membrane led to significant reduction of TBARS concentration and SOD activity, while the on-line hemodiafiltration session using a high-flux polysulfone membrane that is not vitamin E-coated induced a significant increase in H2O2 concentration in the serum and a decrease in SOD activity. There was no statistical significance among the other parameters of oxidative stress. Conclusion. A single session of on-line hemodiafiltration using a vitamin E-coated polysulfone membrane significantly affects oxidative stress. After a single session of on-line hemodiafiltration using a vitamin E-coated membrane, the concentration of TBARS has significantly decreased. The decreased activity of superoxide dismutase could be a consequence of an increased loss of microelements during an on-line hemodiafiltration session using a high-flux polysulfone membrane. Patient selection, continuous on-line hemodiafiltration using a vitamin E-coated polysulfone membrane over a 3–6 month period and increased antioxidant protection capacity could possibly reduce the risk of cardiovascular morbidity and mortality in patients treated by hemodialysis.

Background: The mortality of oral squamous cell cancer (OSCC) in Serbia increased in the last decade. Recent studies on the Serbian population focused mainly on the epidemiological aspect of OSCC. This study aimed to investigate the demographic and imaging features of OSCC in the Serbian population at the time of diagnosis. Methods: We retrospectively analyzed computed tomography (CT) images of 276 patients with OSCC diagnosed between 2017 and 2022. Age, gender, tumor site, tumor volume (CT-TV, in cm3), depth of invasion (CT-DOI, in mm), and bone invasion (CT-BI, in %) were evaluated. TNM status and tumor stage were also analyzed. All parameters were analyzed with appropriate statistical tests. Results: The mean age was 62.32 ± 11.39 and 63.25 ± 11.71 for males and females, respectively. Male to female ratio was 1.63:1. The tongue (36.2%), mouth floor (21.0%), and alveolar ridge (19.9%) were the most frequent sites of OSCC. There was a significant gender-related difference in OSCC distribution between oral cavity subsites (Z=-4.225; p < 0.001). Mean values of CT-TV in males (13.8 ± 21.5) and females (5.4 ± 6.8) were significantly different (t = 4.620; p < 0.001). CT-DOI also differed significantly (t = 4.621; p < 0.001) between males (14.4 ± 7.4) and females (10.7 ± 4.4). CT-BI was detected in 30.1%, the most common in the alveolar ridge OSCC. T2 tumor status (31.4%) and stage IVA (28.3%) were the most dominant at the time of diagnosis. Metastatic lymph nodes were detected in 41.1%. Conclusion: Our findings revealed significant gender-related differences in OSCC imaging features. The predominance of moderate and advanced tumor stages indicates a long time interval to the OSCC diagnosis. [ABSTRACT FROM AUTHOR]

Introduction. Polycystic kidney disease is a hereditary kidney disease characterized by the occurrence of cysts (fluid-filled enlargements) in cortex or medula of the kidney, and is inherited in an autosomal dominant or autosomal recessive manner. In addition to multiple cysts in kidneys, there may be many extra-renal manifestations (cysts of the liver, pancreas, lungs, heart, etc.), among which the most serious one is intracranial aneurysms. Case report. A 57-year-old female patient with polycystic kidney disease and stage IV renal failure was hospitalized at our clinic due to decreased renal function, the development of urinary tract infections, headaches and unregulated blood pressure despite the usual treatment. This patient also had a number of associated diseases: obesity, diabetes mellitus (the insulindependent type), hypothyroidism, and depression syndrome. After better regulation of blood pressure, resolved urinary tract infections and improved renal function, there were still persistent headaches (resulting in the excessive use of analgesics). With adequate preparation, multislice computed tomography (MSCT) angiography of blood vessels of the head was performed. As a result, we diagnosed the saccular intracranial aneurysm (IA) with anterior localization. Regarding the symptoms, age and comorbidity, digital subtraction angiography (DSA) was performed, and showed saccular IA (5.2 mm × 4 mm), with wide neck affecting both middle cerebral artery branches (MCA). During the procedure the stent was placed, which filled the aneurysm with spirals, cutting it off from circulation. After the successful procedure and without further complications, the patient no longer had headaches and blood pressure was maintained within the required limits with stable parameters of chronic renal failure. Conclusion. The case of the patient with polycystic kidney disease, stage IV chronic renal failure, with a number of comorbidities (headache, obesity, hypertension, diabetes mellitus, hypothyroidism) and diagnosed with symptomatic intracranial aneurysm was successfully solved with a multidisciplinary approach, emphasizing the importance of teamwork in daily practice.

Background/Aim. Patients with chronic renal failure (CRF) have increased cardiovascular morbidity and mortality. It is unknown which biomarkers best describe the degree of diastolic dysfunction in patients with CRF. The aim of this study was to determine the correlation between B-type natriuretic peptide (BNP), N-terminal prohormone brain natriuretic peptide (NTproBNP) and left ventricular diastolic dysfunction (DD-LV) with the degree of CRF. Methods. The study included 100 adult patients with CRF without major cardiac and cerebral incidents who did not start actively treating CRF. According to the degree of CRF, the patients were divided into two groups: G1 (moderate degree), glomerular filtration rate (GFR) ≥ 30 mL/min/1.73 m2, and G2 (more severe degree), GFR < 30 mL/min/1.73 m2. Blood concentrations of BNP and NTproBNP were measured and Doppler echocardiographic measurement performed to estimate diastolic dysfunction (DD-LV). According to the degree of DD-LV, all the patients were divided into two groups: DD-LV1 (mild diastolic dysfunction) and DD-LV2 (severe diastolic dysfunction). According to the degree of CRF and DD-LV, the patients were divided into four groups: I (G1, DD-LV1), II (G1, DD-LV2), III (G2, DD-LV1) and IV (G2, DD-LV2). Results. There was a highly significant statistical correlation between BNP and NTproBNP with GFR (p < 0.001), and DD-LV with BNP (p < 0.023) and NTproBNP (p = 0.035). In patients with DD-LV2, a statistically significantly higher BNP concentrations were registered in patients with G2 (p < 0.001). Unlike BNP in the patients with diastolic dysfunction DD-LV1 and those with diastolic dysfunction DD-LV2, significantly higher concentrations of NTproBNP were registered in the patients with G2 (DD- LV1: p = 0.006; DD-LV2: p < 0.001). Conclusion. Biomarkers BNP and NTproBNP are not the best predictors in the assessment of diastolic dysfunction because they are correlated with the degree of renal insufficiency.

Introduction. Situs inversus totalis (SIT) represents a total vertical transposition of the thoracic and abdominal organs which are arranged in a mirror image reversal of the normal positioning 1. We presented a successful pre-dialysis kidney transplantation from a living sibling donor with SIT and the longest donor follow-up period, along with analysis of the reviewed literature. Case report. The pair for pre-dialysis kidney transplantation included a 68-year-old mother and 34-year-old daughter at low immunological risk. Comorbidities evidenced in kidney donors with previously diagnosed SIT, included moderate arterial hypertension and borderline blood glucose level. Explantation of the left donor kidney and its placement into the right iliac fossa of the recipient were performed in the course of the surgical procedure. A month after nephrectomy, second degree renal failure was noticed in the donor. A 20-month follow-up of the donor’s kidney and graft in the recipient proved that their functions were excellent. Conclusion. In donors with previously diagnosed SIT the multidisciplinary approach, preoperative evaluation of the patient and detection of possible vascular anomalies are required to provide maximum safety for the donor.

Introduction. Immunoglobulin D (IgD) myeloma is a rare disease, about 2% of all myelomas, even rarer when accompanied with another multiple myeloma in biclonal gammopathy. We presented a case of biclonal gammopathy - associated manifestation of IgD myeloma and light chain disease in a patient who initially had renal failure. Case report. 37-year-old male approximately one month before hospitalization began to feel malaise and fatigue along with decreased urination. Laboratory analysis revealed azotemia. A dialysis catheter was placed and hemodialysis started. The patient was then admitted to our hospital for further tests and during admission, objective examination revealed pronounced paleness with hepatosplenomegaly and hypertension (170/95 mmHg). Laboratory analysis showed erythrocyte sedimentation rate 122 mm/h, expressed anemic syndrome (Hb 71 g/L) and renal failure dialysis rank: creatinine 1,408 μmol/L, urea31.7 mmol/L. There was two M components in serum protein electrophoresis: IgD lambda and free light chain lambda. Proteinuria was nephrotic rank (5.4 g/24 h), whose electrophoresis revealed 2 M components - massive in α 2 fraction of 71%; 7% in the discrete β fraction, beta 2M /serum 110 mg/L, in urine 1.8 mg/L - extremely high; IgL kappa / lambda index 1 : 13 (reference value ratio 2 : 1). The findings pointed to double myeloma disease: IgD myeloma and Bence Jones lambda myeloma. Bone biopsy confirmed IgD myeloma lambda 100% infiltration medulla predominantly plasmablasts. The treatment continued with hemodialysis 3 times per week with chemotherapy protocol bortezomib, doxorubicin, dexamethasone. After 4 cycles of chemotherapy, there was a decrease of IgD, λ - light chains, reduction in proteinuria (1.03 g/24 h), so hemodialysis was reduced to once per week. Six months after treatment initiation the patient underwent autologous bone marrow transplantation. In a 2-year follow-up period double myeloma disease showed complete remission. Conclusion. The presented rare form of double myeloma disease with initial renal insufficiency underscores the importance of careful observation and team-work that can alter the course of this serious disease.

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The researches were performed on brown forest soil used within stationary experiment with a certain fertilizing system for more than 40 years. Researches were made on experiment variants where the increasing dosage of nitrogen fertilizer was applied. The aim of the research was to establish which plant and soil parameters (pots and/or field) might be considered reliable to evaluate values of applied chemical methods (hot water method and easily hydrolyzing nitrogen), being methods used to evaluate potentially mineralized nitrogen in soil. We also wanted to establish the most favorable time to evaluate the values of applied methods (March, July and October). On the basis of established correlation dependences, the plant and soil parameters, either from pots or fields should be used to evaluate the reliability of the hot water method and the reliability of mentioned methods can be estimated in March, July and October. As for the evaluation of easily hydrolyzing nitrogen, we can use both plant and soil parameters in controlled conditions and in the field and the most suitable time is in spring (March) and in fall (October).

Introduction. Newborns adaptation on postnatal conditions includes significant morphological and functional renal changes. Every kidney contains a constant number of nephrons, at the end of the nephrogenesis period, which extends from week 8 to 34 of gestation. Mature juxtamedullary nephrons possess higher filtration capacity than primitive superficial nephrons, which have insufficient vascularization. Objective. The objective of the study was to calculate an average glomerular diameter in cortical zones of the kidney during development, to define periods of their most intensive growth, and to record differences of glomerular size between different cortical zones. METHOD A total of 30 human fetal kidneys aged from IV to X lunar months were analyzed. Stereological methods were used for calculating the average glomerular diameter in superficial, intermediate and juxtamedullary zone of the kidney cortex. Results. Glomeruli in the superficial cortical zone had the lowest average diameter. The average glomerular diameter continually increased from IV lunar month (0.057±0.004 mm) to X lunar month (0.082±0.004 mm), with highly significant correlation with gestational age (r=0.755; p

Background. The development of human kidney is a complex process. The number, shape, size, and distribution of nephrons as functional units in a kidney, provide some important information about the organization of the kidney. The aim of this study was to extend the knowledge of the developing human kidney by studying nephrons in the kidney's cortex during gestation. Methods. Kidney tissue specimens of 32 human fetuses, the gestational age from IV lunar month (LM IV) to LM X, were analyzed. Specimens were divided in ten groups based on gestational age. Stereological methods were used at the light microscopic level to estimate the volume densities of the corpuscular and tubular components of the nephron in the cortex of the developing human kidney. Results. Nephron polymorphism was the main characteristic of the human fetal kidney during development. In younger fetuses, just below the renal capsule, there was a wide nephrogenic zone. It contained the condensed mesenchyme and terminal ends of the ureteric bud. Nephrons, in the different stages of development, were located around the ureteric bud which branched in the cortical nephrogenic zone and induced nephrogenesis. More mature nephrons were located in the deeper part of the cortex, close to the juxta-medullary junction. During gestation, nephrogenesis continually advanced, and the number of nephrons increased. Glomeruli changed their size and shape, while the tubules changed their length and convolution. Renal cortex became wider and contained the more mature glomeruli and the more convoluted tubules. The volume density of the tubular component of the nephron increased continually from 10.53% (LM IVa) to 27.7% (LM X). Renal corpuscles changed their volume density irregularly during gestation, increasing from 13% (LM IVa) to 15.5% (LM IVb). During the increase of gestational age, the volume density of corpuscular component of the nephron decreased to 11.7% (LM VIII), then went on increasing until the end of the intrauterine development (LM X) when corpuscles occupied 16.73% of the cortical volume. The volume density of the developing nephrons (corpuscular and tubular portion) showed the significant positive correlation (r = 0.85; p

Background. The sciatic nerve, as the terminal branch of the sacral plexus, leaves the pelvis through the greater sciatic foramen beneath the piriform muscle. Afterwards, it separates into the tibial and the common peroneal nerve, most frequently at the level of the upper angle of the popliteal fossa. Higher level of the sciatic nerve division is a relatively frequent phenomenom and it may be the cause of an incomplete block of the sciatic nerve during the popliteal block anesthesia. There is a possibility of different anatomic relations between the sciatic nerve or its terminal branches and the piriform muscle (piriformis syndrome). The aim of this research was to investigate the level of the sciatic nerve division and its relations to the piriform muscle. It was performed on 100 human fetuses (200 lower extremities) which were in various gestational periods and of various sex, using microdissection method. Characteristic cases were photographed. Results. Sciatic nerve separated into the tibial and common peroneal nerve in popliteal fossa in 72.5% of the cases (bilaterally in the 66% of the cases). In the remainder of the cases the sciatic nerve division was high (27.5% of the cases) in the posteror femoral or in the gluteal region. Sciatic nerve left the pelvis through the infrapiriform foramen in 192 lower extremities (96% of the cases), while in 8 lower extremities (4% of the cases) the variable relations between sciatic nerve and piriform muscle were detected. The common peroneal nerve penetrated the piriform muscle and left the pelvis in 5 lower extremities (2.5% of the cases) and the tibial nerve in those cases left the pelvis through the infrapiriform foramen. In 3 lower extremities (1.5% of the cases) common peroneal nerve left the pelvis through suprapiriform, and the tibial nerve through the infrapiriform foramen. The high terminal division of sciatic nerve (detected in 1/3 of the cases), must be kept in mind during the performing of popliteal block anesthesia. Conclusion. Although very rare, anatomical abnormalities of common peroneal nerve in regard to piriform muscle are still possible.

Psammoma bodies are one of many choroid plexus aging changes which origin is still enigma for the scientists. During our investigation psammoma bodies were studied on 30 postmortem brains by light microscopy. They stained red with HE, and were PAS and AB PAS positive. The largest number of lamellas were stained blue with Mallory's connective tissue stain, except peripheral and next to the center lamella which stained red. During the aging, psammoma bodies became larger and more irregular, which was followed with group area and perimeter, single psammoma body average area and average perimeter, average diameter and contour index increase. Psammoma bodies mearged in the second and the third age group and mearging process led to larger and more irregular structures formation. The results of this investigation suggest that psammoma bodies are more frequent in choroid plexus of healthy older people and during the aging they obtain larger dimensions, more irregular contours, which is the result of their mutual mearging.