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H. Osmić, E. Đedović, G. Marošević

Based on the computed tomography (CT) images it is not possible to see all the lymph nodes that belong to the stomach. In radiotherapy, for a clinical target volume (CTV) delineation based on CT images, it is necessary to determine the appropriate margin around the corresponding blood vessels to make sure that all the required lymph nodes will be irradiated. The larger margin will certainly cover all the lymph nodes but it can also produce an increase of the received dose in the normal tissues. While a smaller margin can eventually spare the normal structures as a consequence it brings a higher risk of missing the suspected lymph nodes. The aim of this study was to analyse the radiation doses received by some organs at risk (OARs) in the case of the three-dimensional conformal radiotherapy (3DCRT) treatment of the gastric cancer, for lymph node CTV margin sizes 5 mm, 7 mm and 10 mm. The study included 40 patients undergo the external beam radiotherapy (EBRT) treatment of gastric cancer. The one-way analysis of variance (ANOVA) with repeated measures test and Friedman’s nonparametric test have been used for testing the statistical significance of differences among the examined groups. The difference between the examined groups has been considered significant if p < 0.05. The statistically significant differences in the dose contributions to the observed OARs (spinal cord, heart, small bowel and colon), among the examined CTVs, were found.

D. Habibović, A. Gazibegović-Busuladžić, M. Busuladžić, A. Čerkić, D. Milošević

Using our theory which is based on the strong-field approximation we analyze high-order above-threshold ionization and high-order harmonic generation processes for the case of the homonuclear diatomic molecules exposed to an orthogonally polarized two-color (OTC) laser field. The OTC field represents a superposition of two linearly polarized fields with mutually orthogonal polarizations and different frequencies. We analyze the photoelectron energy spectra and the harmonic ellipticity as a function of the ratio of the intensities of the OTC laser-field components and the relative phase. Some combinations of the values of these parameters lead to the high-energy electrons, while the harmonic ellipticity depends strongly on the ratio of the intensities of the laser-field components. It is possible to find the value of this ratio for which the ellipticity of the emitted harmonics is large. The signes of ellipticity are opposite for the molecular orientations which are connected through the reflection with respect to the axis along the first OTC field component. This symmetry is explained using the expression which relates the T-matrix element and the harmonic ellipticity.

Aim To investigate interleukin 6 (IL-6) values depending on duration of diabetes mellitus (DM) and evaluate possible correlation with diabetic polyneuropathy. Methods The research study included 90 patients with DM divided into three groups (30 patients each) according to the duration of DM: group A - patients who had DM for less than 10 years, group B - duration of DM was 10 to 20 years, and group C - patients with DM over 20 years. Control group (K) included 30 healthy participants. Results IL-6 was significantly higher in the healthy control group, 180.318 pg/mL±94.18, than in group A, 47.23pg/ml±34.8, group B, 43.31pg/ml±33.17, and group C, 70.39 pg/ml±59.26 (p=0.0001). All groups had significantly different values of IL-6 between each other (p=0.0001). Level of IL-6 was in correlation with diabetic polyneuropathy in the group A (the youngest participants) (p=0.0001). In other groups there was no significant correlation between IL-6 and diabetic polyneuropathy. Conclusion The level of IL-6 was in correlation with neuropathy among younger patients. A higher level of IL-6 in the control group than in diabetic groups is a sign of stronger inflammatory response among younger and healthy people than in patients with DM.

Nerma Čustović, Lejla Džananović, I. Rašić, Nadža Zubčević, Lejla Šaranović-Čečo, Aida Drljević, Jasmina Redžepagić

Aim To evaluate the pattern of indications and a spectrum of colonic pathology, and to determine appropriateness of indications for colonoscopy in order to improve patient selection for colonoscopy. Methods This retrospective study includes 294 patients who were referred to the Gastroenterology Department from a primary care physician in order to approach endoscopic examination. Study data included patients' anamnestic data (comorbidities, positive family history, performed radiological examinations) an indication for the procedure, and colonoscopy findings. Results Haematochezia was confirmed in 186 (63.26%), positive radiologic finding in183 (62.24%) and anaemia in 157 (53.40%) patients. Adenoma and colorectal carcinoma were detected in 40 (13.6%) and 53 (18%) patients, respectively. A significant association between haematochezia and colorectal neoplasm was confirmed (p=0.019), haematochezia and inflammatory bowel disease (p=0.027), and between radiological finding and colorectal neoplasm (p=0.018). There was no significant association between anaemia and any of the colonoscopic findings. According to EPAGE II criteria indications were appropriate in 187 (63.6%), uncertain in 67 (22.8%) and inappropriate in 40 (13.6%) patients. Conclusion This study confirmed a slightly larger number of uncertain and inappropriate indications for colonoscopy compared to other studies that examined indications for colonoscopy, which can be attributed to a high number of patients with functional bowel disorders.

Jared Vicory, David Allemang, Dženan Zukić, Jack Prothero, M. McCormick, B. Paniagua

Shape analysis is an important and powerful tool in a wide variety of medical applications. Many shape analysis techniques require shape representations which are in correspondence. Unfortunately, popular techniques for generating shape representations do not handle objects with complex geometry or topology well, and those that do are not typically readily available for non-expert users. We describe a method for generating correspondences across a population of objects using a given template. We also describe its implementation and distribution via SlicerSALT, an open-source platform for making powerful shape analysis techniques more widely available and usable. Finally, we show results of this implementation on mouse femur data.

M. Perović, M. Bošković, V. Kusigerski, Z. Jagličić, J. Blanuša, V. Spasojević, N. Pizúrová, O. Schneeweiss

E. Nieuwenhuis, B. Kolenaar, J. Hof, Xander Bemmel, J. Baarlen, B. Haken, R. Bree, L. Alic

Davor Čarić, S. Zekić Tomaš, N. Filipović, V. Šoljić, Benjamin Benzon, Sandro Glumac, I. Rakovac, K. Vukojević

Hip osteoarthritis (HOA) is characterized by degradation of the cartilage and synovitis. However, the pathohistological effects of synovial tissue inflammation on HOA are not clear. The aim of this study was to evaluate the expression of iNOS, BCL-2 and MMP-9 markers in different synovial cell populations. A total of 32 patients were evaluated retrospectively. Age, sex, height, weight, body mass index were recorded and lymphocyte, fibrocytes and macrophages were analysed in tissue sections. Osteoarthritis cartilage histopathology assessment system (OARSI), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Krenn score, Harris Hip Score (HHS) and Kellgren–Lawrence (K-L) grading of the hip joints were performed. Total hip arthroplasty was performed on 32 patients and controls. Patients were divided into two groups according to their disease severity. The tissues were immunohistochemically analysed. K-L grade and Krenn score differ between all three groups, but also between moderate and severe OA. Synovial lining cell layer, resident cells in stroma and especially inflammatory infiltration were increasing with severity of OA. iNOS expression in both intima and subintima was positively correlated with Krenn score in moderate and severe osteoarthritis (OA) groups. Expression of BCL-2 in intima of severe OA patients was positively correlated with Krenn score. In conclusion, iNOS, BCL-2 and MMP-9 are involved in the regulation of HOA. Our study indicates a relationship between the pathohistological features, the synovial inflammation and the cartilage condition at the time of hip replacement due to OA or femoral neck fracture.

M. Topčagić, E. Đedović, H. Osmić, M. Smajlovic

The presence of a high-density material object such as the vascular access port made of titanium, can affect the homogeneity of dose distribution in underlying tissues. This influence depends on numerous factors but in the first place on the composition material of such an object and its geometry. In this work an influence of the various titanium-made vascular ports, placed in the 6 MV photon field, have been analyzed. The vascular ports of various sizes were placed on the top of thepolymethyl-methacrylate (PMMA) phantom which is then scanned on a computed tomography (CT) simulator to generate the digitized 3-dimensional images for the purpose of treatment planning. The treatment plans were prepared in matRad treatment planning toolkit. The beam profiles and the percentage depth doses have been analyzed. The observed maximum dose values, for ports A, B, C and D, relatively to the maximum dose value in PMMA phantom alone, were 102.25%, 100.62%, 101.78% and 102.48%, respectively. The titanium edges of the ports reduce the dose below them in amount of 8.52%, 8.64%, 10.01% and 10.04% observed for ports A, B, C and D, respectively, in comparison to the central axis dose value obtained in PMMA phantom for the port-free case. The established changes in PDD curves and beam profiles depend on the vascular access port dimensions, reservoir volumes as well as of the amount of titanium content.

Objectives: To avoid hospital spread of Coronavirus-2019 (COVID-19) and to analyze out of hospital outcomes after amputation. Methods: Prospective analysis of data obtained from 60 diabetic patients in 2020 was performed at Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina. Personal protection equipment included double surgical mask, glasses, disposable surgical coats, and surgical masks for patients. Swabs were used to take samples from wounds. We randomly divided patients in 2 groups of 30 patients each. In pre-operative treatment, we used local anesthesia lidocaine hydrochloride 2% (Belupo, Koprivnica, Croatia) in group A and systemic analgesia intravenous tramadol chloride 100 mg intravenous (Krka, Novo Mesto, Slovenia) in group B. Wounds were surgically treated each day and heal spontaneously. Periodical control exams were performed. Results: Wound healing did not present any statistically significant differences between groups (group A: 69±21.97 and B: 61±22.13 days, t=−1.22; p=0.11). No statistically significant differences (p<0.05) between groups A and B in wound healing regarding to gender or cigarette use was noted. Conclusion: No significant differences in amputation treatment between the 2 comparative groups were noted. No confirmed COVID-19 infections in medical staff who performed surgical interventions or in treated patients were detected.

The study of atomic spectra is one of the key subjects in teaching physics. It represents a combination of topics such as wave physics, atomic physics, particle physics, etc. Because of its complexity, it takes a well-prepared student and a very creative and resourceful teacher for this subject to be adequately understood and comprehended. This article presents theoretical background with key points in physics that help teachers to better organize their preparation for students and different experimental sets for this specific experiment, such as Nikola Tesla’s transformer or some other high-voltage transformers. Another point of view for this experiment is a variety of subexperiment possibilities to choose from in the execution of this practical exercise. This article also brings some difficulties that both teachers and students experience while preparing or doing this experiment, such as lack of more profound quantum physics knowledge since the conventional approach in teaching this specific topic in high schools and universities focuses on an introductory course in the history of this topic-oriented towards early years of the 20th century.

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