Autopsy material analysis at the Cardiology Clinic in 1999.

Clinico-pathological studies serve as a valuable source of information in everyday practice of most medical institutions. The aim of this study was to correlate the clinical and pathological diagnoses of principal disease and cause of death after autopsy in patients who died during 1999 at the Cardiology Clinic, Institute of Cardiovascular Diseases, Sremska Kamenica, Yugoslavia. Medical histories and autopsy reports of dead patients were analyzed: 255 (8.46%) patients died, but only 72 (28%) underwent autopsy. In 53 patients (73%) clinical cause of death was cardiac. Among these patients, consequences of coronary (atherosclerotic) artery disease prevailed in 41 patients (77%). Noncardiac cause of death was established in 19 patients (27%) and vascular causes prevailed with 17 (23%). The comparison of clinical and principal disease established by autopsy revealed a complete concordance in 62 cases, partial concordance in 1 and no concordance in 9 cases. Thus, concordance was found in 86-87.5%. The correlation coefficient was 0.48. Comparison of clinical and autopsy diagnoses of causes of death revealed concordance in 53 patients, with correlation coefficient 0.26.

[Acute anterior myocardial wall infarct caused by aortic dissection]. / Akutni infarkt miokarda prednjeg zida izazvan disekcijom aorte.

Acute myocardial infarction and aortal dissection are two different entities mostly occurring separately. According to the fact that both are severe diseases their simultaneous occurrence and interdependence present high risk for patients and a differential diagnostic dilemma for physicians. The case of S.J., a 52-year old female patient is a combination of aortic dissection and acute myocardial infarction caused by dissection of aorta and retrograde dissection of the left coronary artery main branch.

[Morphologic characteristics of the gyrus cinguli vascular network]. / Morfoloske karakteristike vaskularne mreze girusa cinguli.

Vascular network of gyrus cinguli has been examined in adult brains. This vascular network is extended in the form of a cone from lower to upper lip of Sulcus corporis calosi. The blood vessels in the area of lower lip and bottom of the Sulcus corporis calosi are oriented obliquely, almost parallel to cerebral cortex surface, while in the area of upper lip of sulcus are oriented perpendicularly to the cerebral cortex surface. Arteries in this area have few recurrent branches, while fountain shaped arteries are found infrequently. Shorter spiral arteries are found, too. Longer veins predominates in this area (V4 and V5). Drainage territories of certain veins are larger than irrigation territories of the appropriate arteries.

[Morphologic characteristics of the vascular network in the striate area in humans]. / Morfoloske karakteristike krvne mreze areje strijate u coveka.

The vascular network of the area striata consists of four vascular layers. The capillary network of the first vascular layer is completely filled only in some parts of the area striata. The capillary networks of second, third and fourth vascular layer have high density, although the capillary networks in border zones of each two adjacent cortical arteries have lower density. In the area striata the fountain-like arteries have been found, with some collateral branches dividing in fountain-like branches, too. In the brain of a 70 year old male we have found collateral branches initially twisted around its main trunk. The tangential sections of the area striata show the existence of vertically-oriented vascular units with centrally located venous vessel surrounded with one or two arterial rings.

[Vascular characteristics of the human subfornical organ]. / Vaskularne karakteristike humanog subfornikalnog organa.

The aim of the study regarding adult brains is to determine the sources of vascularization, vascular area, the size and density of the capillary network of the human subfornical organ. The examined brain blood vessels under filled with a mixture of Indian ink and gelatin. The serial paraffin sections of 50 and 200 microns were cleared after Spalteholz. In the vascularization of this neuroendocrine structure of the diencephalon, two arterial stems take part with their branches: a. cerebri anterior and a. choroidea posterior. In order to quantify the density of the capillary network, the authors used the standard stereologic parameters volume density, surface density and mean radius of blood vessels. By the comparative test of obtained mean values of males and females no statistically significant differences pertaining to sex and in respect to the size and density of capillary network in subfornical organ were confirmed. While the precise functions of the human subfornical organ have yet to be fully elucidated, the similarity in organization of this region to the vascular organ of the lamina terminalis, has led several authors to suggest that the subfornical organ is a site of receptors which are stimulated by circulating angiotensin II to induce water drinking and vasopressin secretion.

[Morphologic characteristics of the superior temporal gyrus vascular network]. / Morfoloske karakteristike krvne mreze gornje slepoocne vijuge.

The investigation of the morphological features of vascular network of superior temporal gyrus was carried out on eight hemispheres of brains of adults from 36 to 48 years old died in accidents without visible signs of central nervous system diseases. Vascular network of auditory areas is characterised by very dense capillary network of the third vascular layer which is the densest one in these areas. The vascular network of the anterior part of the superior temporal gyrus is distinguished by equal density of the third and fourth vascular layer. Fountain-like arteries are mostly of type A3 and A4 and have been found in all parts of the superior temporal gyrus. Vertical functional units of the cortex are supplied by a number of precapillary arterioles being arranged in the shape of a ring. In the center of each unit there is postcapillary venule through which it is drained.

[Dissecting aortic aneurysms]. / Disekantne aneurizme aorte.

33 autopsy cases of dissecting aneurysms of aorta were analyzed to find out the frequency, localization, macroscopic appearance, histological changes and causes of death. On the basis of disturbed appearance and orientation of elastic muscular elements of tunica media aortae, existing cystic spaces, areas of fibrosis and increase of mucoid basic substance in media as well as the severity of atherosclerotic changes, we classified our cases into familiar morentities which are connected with the origin of dissecting aneurysms of aorta (cystic medionecrosis, "noninflammatory aortopathy", atherosclerosis hypoplasia). In the third part of all cases media aortae contains areas similar to those of infarct, which could, considering the absence of cellular reaction, be corresponding with ischemic phenomena which directly preceded the genesis of dissection of aorta.

[The morphologic characteristics of the vascular network of the middle and inferior temporal gyri and middle temporal visual area]. / Morfoloske karakteristike krvne mreze srednje i donje slepoocne vijuge i srednjeg slepoocnog vidnog polja.

The vascular network of the anterior part of the middle and inferior temporal gyri consists of four vascular layers of which the third and fourth have the densest capillary network of the same density. There are all types of arteries in this cortex form A1 to A6 as well as all types of veins from V1 to V5. Fountain-like arteries usually branch into five to six terminal recurrent branches; we have found that there are about two of them in each serial section. The middle temporal visual area has the same features of the vascular network as the above mentioned gyri with one difference only: there are at least six fountain-like arteries in each serial section. The increased number of these arteries might point to a greater sensitivity of this area to hypoxic conditions. The tangential sections of these areas reveal the existence of vertically-oriented vascular units with a centrally located venous vessel surrounded by arterial rings.

[Vascular characteristics of the lamina terminalis of the human hypothalamus]. / Vaskularne karakteristike lamine terminalis hipotalamusa coveka.

The aim of the study is to discover the sources of vascularization, vascular area, the size and density of the capillary network of the vascular organ of the laminae terminalis of the hypothalamus. The brain blood vessels under examination were filled with a mixture of India ink and gelatin. The serial paraffin sections of 30 and 200 um were cleared after Spalteholz. In the vascularization of this neuroendocrine structure of the hypothalamus, two arterial stems take part with their branches: a cerebri anterior and a. communicans anterior. In order to quantify the density of the capillary network, the authors used standard stereologic parameters - volumene density, surface density and mean radius of blood vessels. While the precise functions of the vascular organ have yet to be fully elucidated, the similarity in organization of this region to the median eminence has led several authors to suggest a neurosecretory role for the vascular organ of the lamina terminalis.