Abstract Introduction. We monitored the fetal heart rate (FHR) during amniocentesis in fetuses at 16-22 weeks of gestation and investigated whether an abnormal FHR was associated with chromosomal abnormalities. Methods. This prospective study involved 600 women at 16-22 weeks of gestation who underwent genetic amniocentesis. The FHR, expressed as beats for minute, was recorded before (FHR1), immediately after (FHR2) and 60 min after (FHR3) the invasive procedure. Structural malformations detected by ultrasound and multiple pregnancy were excluded from the study. Results. Chromosomal abnormalities have been diagnosed in 27 fetuses. Mean FHR decrease after amniocentesis has been observed in normal and in abnormal fetuses. The mean variation during amniocentesis was significant in both groups (P<0.01). The comparison between the mean FHR of the two groups showed no differences in FHR1 and FHR2 (P>0.05) but a significant difference in FHR3 (P<0.05). Conclusion. The FHR decreased after amniocentesis; the decrease was larger in chromosomally abnormal fetuses than in normal fetuses. This difference in heart rate reaction to amniocentesis might be due to cardiac defects or developmental delay associated with the abnormal karyotype.
{"title":"Evaluation of the Fetal Heart Rate during Amniocentesis in Fetuses with Normal and Abnormal Karyotype","authors":"M. Hadži-Lega, A. Daneva-Markova, Eva Sozovska","doi":"10.2478/mmr-2014-0005","DOIUrl":"https://doi.org/10.2478/mmr-2014-0005","url":null,"abstract":"Abstract Introduction. We monitored the fetal heart rate (FHR) during amniocentesis in fetuses at 16-22 weeks of gestation and investigated whether an abnormal FHR was associated with chromosomal abnormalities. Methods. This prospective study involved 600 women at 16-22 weeks of gestation who underwent genetic amniocentesis. The FHR, expressed as beats for minute, was recorded before (FHR1), immediately after (FHR2) and 60 min after (FHR3) the invasive procedure. Structural malformations detected by ultrasound and multiple pregnancy were excluded from the study. Results. Chromosomal abnormalities have been diagnosed in 27 fetuses. Mean FHR decrease after amniocentesis has been observed in normal and in abnormal fetuses. The mean variation during amniocentesis was significant in both groups (P<0.01). The comparison between the mean FHR of the two groups showed no differences in FHR1 and FHR2 (P>0.05) but a significant difference in FHR3 (P<0.05). Conclusion. The FHR decreased after amniocentesis; the decrease was larger in chromosomally abnormal fetuses than in normal fetuses. This difference in heart rate reaction to amniocentesis might be due to cardiac defects or developmental delay associated with the abnormal karyotype.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"68 1","pages":"25 - 27"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69234008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Kakasheva-Mazhenkovska, V. Janevska, G. Petrushevska, L. Spasevska, N. Basheska
Abstract The stroma of the neoplasm is a highly complex structure built by: specialized mesenchymal cells typical for each tissue surroundings, cancer associated fibroblast/myofibroblast, congenital or acquired immune cells, vascular network with endothelial cells and pericytes, mastocytes, macrophages, leukocytes and adipocytes, all together incorporated in the extracellular matrix. Each neoplasm produces its own unique microenvironment where the tumor grows and modifies. Although most of the cells of the host in the stroma have compulsory tumor suppressor ability, the stroma is changing during the malignant process and it even promotes growth, invasion and metastasis. Genetic changes that occur during the development of the cancer, which are guided by the malignant cells lead to changes in the stroma of the host that will overtake it and adjust it to their own needs. In the early stages of the tumor development and invasion, the basal membrane is degraded and the stroma becomes active and contains an increased number of fibroblasts, inflammatory infiltrate and newly composed capillaries which come into direct contact with the tumor cells. These changes lead to cancer invasion.
{"title":"Morphological Characteristics of the Stroma in Malignat Epithelial Neoplasms with Short Review of Skin Squamous Cell Carcinoma","authors":"L. Kakasheva-Mazhenkovska, V. Janevska, G. Petrushevska, L. Spasevska, N. Basheska","doi":"10.2478/mmr-2014-0002","DOIUrl":"https://doi.org/10.2478/mmr-2014-0002","url":null,"abstract":"Abstract The stroma of the neoplasm is a highly complex structure built by: specialized mesenchymal cells typical for each tissue surroundings, cancer associated fibroblast/myofibroblast, congenital or acquired immune cells, vascular network with endothelial cells and pericytes, mastocytes, macrophages, leukocytes and adipocytes, all together incorporated in the extracellular matrix. Each neoplasm produces its own unique microenvironment where the tumor grows and modifies. Although most of the cells of the host in the stroma have compulsory tumor suppressor ability, the stroma is changing during the malignant process and it even promotes growth, invasion and metastasis. Genetic changes that occur during the development of the cancer, which are guided by the malignant cells lead to changes in the stroma of the host that will overtake it and adjust it to their own needs. In the early stages of the tumor development and invasion, the basal membrane is degraded and the stroma becomes active and contains an increased number of fibroblasts, inflammatory infiltrate and newly composed capillaries which come into direct contact with the tumor cells. These changes lead to cancer invasion.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"68 1","pages":"15 - 8"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69233944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction. One of the most frequently used methods for correction of planovalgus deformity of the foot is the method by Grice Green. Correction of the deformity can be achieved using a corticocancelous graft from proximal tibia, fibular graft as well as by using various types of screws. Aim. The aim of the study was to analyze the correction of the planovalgus deformity of the foot by using fibular graft. Methods. In our series of 29 patients we used fibular graft from the same side where the operation was performed. The American College of Foot and Ankle Surgeons score system was used for analyzing the results. Results. In 16 patients good results were attained, in 8 satisfactory and in 5 patients poor results. Mean postoperative follow-up period was 6.5 years (min. 2.2 years; max. 10.4 years). From the third postoperative week all patients were weight bearing. The plaster was removed after 5 weeks, and the patients were referred to physical rehabilitation. Conclusions. We consider that Grice Green procedure with fibular graft enables correction of planovalgus deformity of the foot, early patient mobilization and shortening the time in plaster cast immobilization.
{"title":"Results of the Treatment of Planovalgus Deformity of the Foot with Fibular Graft","authors":"Z. Bozinovski, N. Popovski","doi":"10.2478/mmr-2014-0009","DOIUrl":"https://doi.org/10.2478/mmr-2014-0009","url":null,"abstract":"Abstract Introduction. One of the most frequently used methods for correction of planovalgus deformity of the foot is the method by Grice Green. Correction of the deformity can be achieved using a corticocancelous graft from proximal tibia, fibular graft as well as by using various types of screws. Aim. The aim of the study was to analyze the correction of the planovalgus deformity of the foot by using fibular graft. Methods. In our series of 29 patients we used fibular graft from the same side where the operation was performed. The American College of Foot and Ankle Surgeons score system was used for analyzing the results. Results. In 16 patients good results were attained, in 8 satisfactory and in 5 patients poor results. Mean postoperative follow-up period was 6.5 years (min. 2.2 years; max. 10.4 years). From the third postoperative week all patients were weight bearing. The plaster was removed after 5 weeks, and the patients were referred to physical rehabilitation. Conclusions. We consider that Grice Green procedure with fibular graft enables correction of planovalgus deformity of the foot, early patient mobilization and shortening the time in plaster cast immobilization.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"68 1","pages":"40 - 43"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69234077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction. Pachymetry and ocular coherence tomography is a relatively new method for an accurate diagnosis of glaucoma. Since the newer diagnostic procedures are painless and easily available, they give a great opportunity for establishing a correct diagnosis. Pachymetry is one of the newer methods for measuring the central corneal thickness (CCT). Transparent normal cornea is normally 545 micrometers thick. As one of the newer diagnostic machines OCT is a non-contact, non-invasive imaging technology for optic nerve and macular region. It works on the principle of low coherent interferometry measuring the time delay of the light rays and intensity of light rejected from the tissue structures. Because of the ability to see a detailed view of all layers of the retina recording, it is called “in vivo histology” or “optical biopsy”. Methods. In the period of 6 months, at the Department for ocular coherence tomography we made 430 trials with different referral diagnoses; 45 were with referral diagnosis of glaucoma. The measured intraocular pressure was over 24 mmHg, these patients were referred for further treatment in the Department for glaucoma and ocular coherence tomography. Results. In 28 (58%) of the referred patients glaucomatous changes were found. In the group of patients with confirmed diagnosis, visual field defect was confirmed in 12 and it was not confirmed in 16 patients. In 4 patients positive relationship with central corneal thickness was found (528 nm, with a standard deviation of 29.93) and in 19 patients the diagnosis was confirmed by a positive finding in the thinning of the retinal nerve layer fiber. Regarding the difference between the two groups, those with ocular hypertension and those with glaucoma, the average thickness was 91.6 in the group with glaucoma, 106.5 in the upper segment and 112 in the lower segment. Conclusions. The results showed that it was necessary to start treatment of glaucoma in 58% of the patients, Therefore, the usefulness of these diagnostic procedures in the early detection and treatment of glaucoma is obvious.
{"title":"The Importance of Perimetry, Pachimetry and Ocular Coherent Tomography in The Early Treatment of Glaucoma","authors":"K. Buzarovska","doi":"10.2478/mmr-2014-0016","DOIUrl":"https://doi.org/10.2478/mmr-2014-0016","url":null,"abstract":"Abstract Introduction. Pachymetry and ocular coherence tomography is a relatively new method for an accurate diagnosis of glaucoma. Since the newer diagnostic procedures are painless and easily available, they give a great opportunity for establishing a correct diagnosis. Pachymetry is one of the newer methods for measuring the central corneal thickness (CCT). Transparent normal cornea is normally 545 micrometers thick. As one of the newer diagnostic machines OCT is a non-contact, non-invasive imaging technology for optic nerve and macular region. It works on the principle of low coherent interferometry measuring the time delay of the light rays and intensity of light rejected from the tissue structures. Because of the ability to see a detailed view of all layers of the retina recording, it is called “in vivo histology” or “optical biopsy”. Methods. In the period of 6 months, at the Department for ocular coherence tomography we made 430 trials with different referral diagnoses; 45 were with referral diagnosis of glaucoma. The measured intraocular pressure was over 24 mmHg, these patients were referred for further treatment in the Department for glaucoma and ocular coherence tomography. Results. In 28 (58%) of the referred patients glaucomatous changes were found. In the group of patients with confirmed diagnosis, visual field defect was confirmed in 12 and it was not confirmed in 16 patients. In 4 patients positive relationship with central corneal thickness was found (528 nm, with a standard deviation of 29.93) and in 19 patients the diagnosis was confirmed by a positive finding in the thinning of the retinal nerve layer fiber. Regarding the difference between the two groups, those with ocular hypertension and those with glaucoma, the average thickness was 91.6 in the group with glaucoma, 106.5 in the upper segment and 112 in the lower segment. Conclusions. The results showed that it was necessary to start treatment of glaucoma in 58% of the patients, Therefore, the usefulness of these diagnostic procedures in the early detection and treatment of glaucoma is obvious.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"68 1","pages":"82 - 84"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69233694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Stankov, L. Cakar, Natasa Bitoljanu, Viktorija Belakaposka-Srpanova, M. Bujaroska, Zdravko Čakar
Abstract Introduction. Contusions are injuries of the brain dominantly incurred by blunt-force trauma in the head (blow, impact, fall). Proper analysis of the cerebral contusions within all head injuries and data case gives us complete view of the event and enables us to choose the right direction in the investigation. The aim of this investigation was to perform a forensic medical analysis of cases with brain injury (cerebral contusions) incurred by blunt-force trauma, and to compare results with a prior extensive research done at the Institute of Forensic Medicine, Skopje. Methods. A total of 76 cases with cerebral contusions incurred by blunt-force trauma were included. The following data were analyzed: gender, age, event, skull fractures, type of fracture, localisation of contusions and toxicological analysis. The basic descriptive processing included the above information-variables taken from the written reports of the performed autopsies. The data are displayed graphically with the use of Microsoft Excel 2007. Results. Male was the dominant gender in the analyzed cases (86%), with mean age of 51 years. Traffic accidents were the main factor for these injuries (76%). Skull fractures were found in 67% of cases. The dominant cerebral lobes were the temporal and the frontal lobe, and the contrecoup contusions were found in 55% of cases. Conclusions. The experience gained during the processing and analysis of these brain injuries answers the most complicated questions, and contributes to the healthcare especially in dealing with the diagnosis and treatment of cerebral contusions.
{"title":"Forensic Aspect of Cerebral Contusions","authors":"A. Stankov, L. Cakar, Natasa Bitoljanu, Viktorija Belakaposka-Srpanova, M. Bujaroska, Zdravko Čakar","doi":"10.2478/mmr-2014-0020","DOIUrl":"https://doi.org/10.2478/mmr-2014-0020","url":null,"abstract":"Abstract Introduction. Contusions are injuries of the brain dominantly incurred by blunt-force trauma in the head (blow, impact, fall). Proper analysis of the cerebral contusions within all head injuries and data case gives us complete view of the event and enables us to choose the right direction in the investigation. The aim of this investigation was to perform a forensic medical analysis of cases with brain injury (cerebral contusions) incurred by blunt-force trauma, and to compare results with a prior extensive research done at the Institute of Forensic Medicine, Skopje. Methods. A total of 76 cases with cerebral contusions incurred by blunt-force trauma were included. The following data were analyzed: gender, age, event, skull fractures, type of fracture, localisation of contusions and toxicological analysis. The basic descriptive processing included the above information-variables taken from the written reports of the performed autopsies. The data are displayed graphically with the use of Microsoft Excel 2007. Results. Male was the dominant gender in the analyzed cases (86%), with mean age of 51 years. Traffic accidents were the main factor for these injuries (76%). Skull fractures were found in 67% of cases. The dominant cerebral lobes were the temporal and the frontal lobe, and the contrecoup contusions were found in 55% of cases. Conclusions. The experience gained during the processing and analysis of these brain injuries answers the most complicated questions, and contributes to the healthcare especially in dealing with the diagnosis and treatment of cerebral contusions.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"68 1","pages":"101 - 103"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69233740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction. Rheumatoid arthritis (RA) causes persistent synovitis which could lead to bone erosion, loss of joint cartilage and loose of ligament. In cervical spine this could cause instability, atlanto-axial joint subluxation and medulla spinalis compression. The aim of this paper was to establish the differences in clinical manifestations between patients with RA and atlanto-axial instability and patients with RA but without atlanto-axial instability. Methods. A total of 60 patients with a diagnosis of classical and definite rheumatoid arthritis according to the ACR criteria, divided into two groups, participated in this study since 1988. Thirty patients with RA and detected atlanto-axial instability, with expressed cervico-occipital symptomatology participated in the first group. The second group comprised 30 patients with RA but without detected atlanto-axial instability. All patients underwent native and functional x-ray of cervical spine in neutral and lateral position, in flexion and extension as well as CT images. MRI was realized in majority of patients. For assessment of rheumatoid arthritis activity, all patients underwent DAS 28 score test as well as laboratory immunologic tests: RF, CRP and anti-CCR. Statistical analysis was made with appropriate statistical methods. Results. The mean patients’ age in the RA group and atlanto-axial instability was 56.9±12.2 years, which was insignificantly smaller than the mean participants’ age from the group with RA. Females dominated in both groups. The mean time duration of the disorder in the RA group and atlanto-axial instability was 17.9±7.8 years, while in the group with RA only it was 6.9±4.2 years. The high SE, RF, anti-CCR as well as DAS28 values were significantly more frequently present in patients with atlanto-axial subluxation (AAS). The results from the investigation showed that the joint deformities as well as the neurologic symptoms were registered significantly more frequently in the patient group with RA and AAS. Conclusion. In patients with long-lasting active RA due to persistent synovitis at the level of the atlanto-axial joint comes to subluxation of the same joint which could cause significant neurologic symptoms.
{"title":"Atlanto-Axial Instability in Rheumatoid Arthritis","authors":"Kuchi Avni, Perchinkova Mishevska Snezhana","doi":"10.2478/mmr-2014-0015","DOIUrl":"https://doi.org/10.2478/mmr-2014-0015","url":null,"abstract":"Abstract Introduction. Rheumatoid arthritis (RA) causes persistent synovitis which could lead to bone erosion, loss of joint cartilage and loose of ligament. In cervical spine this could cause instability, atlanto-axial joint subluxation and medulla spinalis compression. The aim of this paper was to establish the differences in clinical manifestations between patients with RA and atlanto-axial instability and patients with RA but without atlanto-axial instability. Methods. A total of 60 patients with a diagnosis of classical and definite rheumatoid arthritis according to the ACR criteria, divided into two groups, participated in this study since 1988. Thirty patients with RA and detected atlanto-axial instability, with expressed cervico-occipital symptomatology participated in the first group. The second group comprised 30 patients with RA but without detected atlanto-axial instability. All patients underwent native and functional x-ray of cervical spine in neutral and lateral position, in flexion and extension as well as CT images. MRI was realized in majority of patients. For assessment of rheumatoid arthritis activity, all patients underwent DAS 28 score test as well as laboratory immunologic tests: RF, CRP and anti-CCR. Statistical analysis was made with appropriate statistical methods. Results. The mean patients’ age in the RA group and atlanto-axial instability was 56.9±12.2 years, which was insignificantly smaller than the mean participants’ age from the group with RA. Females dominated in both groups. The mean time duration of the disorder in the RA group and atlanto-axial instability was 17.9±7.8 years, while in the group with RA only it was 6.9±4.2 years. The high SE, RF, anti-CCR as well as DAS28 values were significantly more frequently present in patients with atlanto-axial subluxation (AAS). The results from the investigation showed that the joint deformities as well as the neurologic symptoms were registered significantly more frequently in the patient group with RA and AAS. Conclusion. In patients with long-lasting active RA due to persistent synovitis at the level of the atlanto-axial joint comes to subluxation of the same joint which could cause significant neurologic symptoms.","PeriodicalId":86800,"journal":{"name":"Makedonski medicinski pregled. Revue medicale macedonienne","volume":"68 1","pages":"76 - 81"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69234153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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