α-Tocopherol Reduces Morphological Changes and Oxidative Stress during Gentamicin-Induced Acute Renal Failure.

We studied the effect of α-tocopherol on gentamicin-induced morphological and functional changes in the kidneys of Wistar rats. Special attention was paid to the ability of α-tocopherol administered in combination with gentamicin to correct ultrastructural changes in the glomerular basal membrane and tubules. Combined treatment with α-tocopherol (100 mg/kg) and gentamicin (100 mg/kg) led to correction of histopathological and biochemical changes and oxidative injury to the kidneys induced by this antibiotic.

[Computerized tomography in postoperative monitoring of patients with the Whipple operation--characteristics of CT findings].

We presented the postoperative CT findings of patients after the Whipple's operation (cephalic pancreaticoduodenectomy), performed for the pancreatic head cancer, or ampullary carcinoma. Technique of the Whipple's operation is described, and normal and pathological postoperative CT findings, which are characteristic for the immediate (early) and delayed (late) follow-up period, are presented. In addition, difficulties in differentiation of afferent jejunal loop from the recurrent tumor by CT are discussed, and references from the literature about the possibilities of successful visualization of the afferent jejunal loop are cited. Possible locations and CT appearances of the tumor recurrences are presented. An overview of the literature is provided.

A theoretical investigation of the vibrational states of HCO2- and its isotopomers.

Making use of the coupled cluster variant CCSD(T) and the aug-cc-pVQZ basis set a six-dimensional (6D) potential energy surface has been calculated for HCO2-, a fundamental organic anion. Therefrom, a variety of vibrational term energies and wavefunctions has been obtained by means of the discrete variable representation in an approach termed DVR(6). Calculated wavenumbers of the fundamentals of HCO2- and DCO2- agree with recent experimental values from neon matrix isolation IR spectroscopy within 15 cm(-1). The out-of-plane bending vibrations v4 are predicted at 1030 and 894 cm(-1). Moderately strong Fermi resonance interaction is calculated between vibrational states v1 and 2v4 of DCO2-. Excellent agreement with experiment (differences less than 0.7 cm(-1) is observed for the 13C and 18O isotopic shifts. Accurate ground-state rotational constants are predicted for eight different isotopomers of the formate ion and the dissociation process HCO2- --> H- + CO2 is investigated in some detail, with the dissociation energy D0 predicted to be 216 kJ mol(-1).

Supracondylar missile fractures of the femur.

We present the results of the surgical treatment of 50 supracondylar missile fractures of the femur in 48 patients wounded in the territory of the former Yugoslavia in the period June 1991-October 1995. The injuries were caused by bullets in 28 (58.3%) patients and by fragments of mines or other explosive devices in 20 (41.7%) patients. In nine (18.0%) missile supracondylar fractures there were associated fractures of articular surfaces in the knee-joint. Neurovascular bundle injuries were present in 19 (38.0%) and vascular injuries alone in 17 (34.0%) limbs. Bone fragments were stabilized by external fixation in 43 (86.0%) and by plaster of Paris in five (10.0%) limbs. Primary reconstruction of large blood vessel was necessary in 16 (32.0%) limbs. In total eight (16.0%) above knee amputations were done. Coverage of soft tissue defects was required in 19 (38.0%) limbs. Early and late postoperative complications occurred in 26 (52.0%) limbs. Additional surgical procedures were necessary in 15 patients. Definitive results showed a large number of limb shortenings, nerve paralyses and contractures of the knee-joint.

Theoretical investigations of proton-bound cluster ions.

Several proton-bound cluster ions have been studied by means of coupled cluster calculations with large basis sets. Among these are complexes of a krypton or xenon atom with the cations HCO+, HN2+ and HNCH+. Various spectroscopic properties have been calculated in all cases. Effects of vibrational anharmonicity are particularly pronounced for the intramolecular stretching vibrations of Kr...HN2+ and Xe...HN2+. The proton stretching vibration of (N2)H+(N2) is predicted around 800 cm-1, with a large transition dipole moment of 1.15 D. Both (N2)H+(N2) and (HCN)H+(NCH) have linear centrosymmetric equilibrium structures. Those of (OC)H+(CO) and (HCC-)H+(CCH-) are asymmetric with barrier heights to the centrosymmetric saddle points of 382 and 2323 cm-1, respectively. The dissociation energy of the anionic complex Cl-...HCCH is calculated to be Do = 3665 cm-1, 650 cm-1 larger than the corresponding value for Br-...HCCH. The complex between a fluoride ion and acetylene is more strongly bound and shows strongly anharmonic behaviour, similar to the bihalides FHF- or ClHCl-. Strong Fermi resonance interaction is predicted between nu 3 (approximately proton stretch) and 2 nu 4 (first overtone of intermolecular stretch).

Missile injuries of the knee joint.

The results of the treatment of missile injuries of 170 knees in 162 patients are analyzed. The injuries were caused by infantry weapon missiles in 52(32.1%) and by fragments of mine or explosive devices in 110(67.9%) patients. The most frequent were penetrating injuries of the joint with multifragment fractures which in 15.8% cases were associated with injuries of the neurovascular bundle. Stabilization of bone fragments was required in 111(65.3%) knees. Stabilization was done by external fixation in 42(37.8%) and by plaster of Paris in 69(62.2%) knees. Additional mini osteosynthesis was required in 13(30.9%) knees stabilized by external fixation and in 3(4.3%) knees stabilized by plaster of Paris. Amputations were performed in 13(7. 6%) injured knees. During the postoperative period local and general complications occurred in 27(16.6%) patients. The most frequent local complications were suppurative articular infections requiring repeated surgery. Soft tissue defect covering was necessary in 53(33. 1%) patients. The poor late results were present in missile fractures of the knee. The most frequent were degenerative changes with bone defects. The possible surgical solutions in such cases are arthrodesis or total endoprosthesis implantation.

Primary surgical treatment of war injuries of the foot.

Presented are the results of primary surgical treatment of war injuries of the foot in 250 patients wounded in the territory of former Yugoslavia in the period June 1991-October 1995. Total number of feet treated was 275. Aetiologically, the most frequent injuries were those inflicted by the effect of mine blasts (65.2%) and by bullets from firearms (30.8%). Injuries to a single foot were present in 140 (56.0%), combined injuries in 107 (42.8%) and associated with burn injuries in three (1.2%) patients. Soft tissue injuries were present in 25 (9.1%) and injuries to bone structures and joints in 250 (90.9%) feet. Injuries resulting from solid blasts were found in nine (3.2%) feet. Postoperative bone fragment stabilization was required in 115 (41.8%) feet. Stabilization was by plaster of Paris in 87 (75.6%) and by external fixation in 23 (20. 0%) feet. Amputations were performed in 73 (26.5%) feet. Covering of soft tissue and bone defects was required in 84 (33.6%) patients.

[Amputation of the lower extremities in angiopathies and reamputation as a sequelae of postoperative complications]. / Amputacije donjih ekstremiteta kod angiopatija i reamputacije kao posledice komplikacija u postoperativnom toku.

In the period from January 1985 till January 1995 in the Clinic of Traumatology and Orthopedics of Military Medical Academy were treated 305 patients with 317 primary amputations of the lower extremities that were performed as the sequelae of ischemia and necrosis on the basis of occlusive changes, arteriosclerosis and diabetes. Out of the total number of operated patients, 210 were with diabetes mellitus. The amputations were performed at the level of: foot in 102 (32.17%), lower leg in 145 (45.74%) and upper leg in 70 patients (22.09%). Reamputations were performed in 52 patients (16.4%): at the level of foot in 22 (6.94%), lower leg in 17 (5.36%) and upper leg in 13 patients (4.10%). Tourniquet was used during the surgery of primary amputation in 56 patients.

Primary surgical treatment of war injuries of major joints of the limbs.

We present the results of primary surgical treatment of war injuries of major joints in 339 patients, wounded in the territory of the former Yugoslavia in the period June 1991-October 1995. The total number of surgically treated joints was 358. The injuries were inflicted by the fragments of explosive devices in 176 (51.9%) patients and by bullets in 125 (36.9%) patients. A single wound was present in 160 (47.2%) and several wounds in 176 (51.9%) patients; 276 (77.1%) patients had injuries of articular bone. The most frequently injured joints were knee joint 167 (46.6%) and elbow joint 72 (20.1%). Associated neurovascular injuries were present in 68 (18.9%) patients. Postoperative bone fragment stabilization was required in 254 (70.9%) joints. Stabilization was by plaster of Paris in 148 (58.2%) and external fixation in 85 (33.4%) patients. Postoperative course was uneventful in 262 (77.3%) while postoperative complications occurred in 77 (22.7%) patients. Amputations were performed in 15 (4.4%) patients. After the primary surgical treatment 254 (74.9%) patients were discharged and directed to rehabilitation or home care and 81 (23.9%) patients required additional reconstructive surgery for bone and soft tissue defects.

Subtrochanteric missile fractures of the femur.

The treatment results of subtrochanteric missile fractures of the femur in 41 casualties are analyzed. The wounds were inflicted by infantry weapon missiles in 29 (70.7%) and by fragments of mine or explosive devices in 12 (29.3%) casualties. The associated neurovascular bundle injuries were present in 11 (26.8%) patients. Fracture stabilization was done by external fixation in 25 (62.5%): group A; and by plaster of Paris in 15 (37.5%) patients: group B. The postoperative period was uneventful in 14 (35.0%) and early or late complications occurred in 26 (65.0%) patients. Bone infection developed in six (15.0%) and fractures did not heal in four (10.0%) patients. Complications were present in 13 (52.0%) patients from group A and in 13 (86.7%) patients from group B. Delayed fracture healing and fracture nonunion were present in group A and contractures of large joints in group B. Subtrochanteric missile fractures of the femur present very severe injuries where the treatment is followed by a very high percentage of complications. External fracture fixation in this region facilitates the care, stability, early covering of soft tissue defects and early physical therapy.