[Omentomyelosynangiosis--a direct intraoperative observation]. / Omentomijelosinangioza--neposredna intraoperativna opservacija.

The late outcome of implantation of the vascular omental pedicle on the injured spinal cord performed in 7 patients to improve functional recovery through revascularization of the injured cord tissue is reported. All the patients were reoperated at the same spinal level 2-5 years after the omental pedicle implantation for the treatment of chronic neuropathic spinal pain by employing DREZ (Dorsal Root Entry Zone lesion) surgery. From the technical standpoint it was necessary to mobilize the implanted omental pedicle from the cord surface to provide the access to dorsolateral cord sulcus for the DREZ operation. Mobilization of the omental pedicle provided unique opportunity to observe omental-cord contact surface (omentomielosinangiosis) that is believed to stimulate revascularization of the cord tissue. In our report particular attention was paid to the specificity of the omental-cord contact surface and the late tissue changes of the cord as well as omental tissue knowing the fact that the capacity of omental tissue to stimulate neoangiogenesis still represents the actual doubt in neurobiological theory and practice. Detailed analysis of the actual neurological condition of these patients compared to neurological condition assessed before the implantation of the pediculated-vascular omental graft revealed neither sensory nor motoric improvement (in the postimplantation period). The effect of DREZ surgery of the chronic neuropathic spinal pain was not a topic of this report.

[Analysis of a 4-year follow-up of the results of kidney transplantation from living related donors]. / Analiza cetvorogodiznjeg pracenja rezultata transplantacije bubrega od zivog srodnog davaoca.

The aim was to present a four-year experience in living related kidney transplantation. A total of 43 patients (9 females and 34 males) were enrolled in this study. The standard triple immunosuppressive therapy (steroids, azathioprine and cyclosporine) was administered in 19 (44.1%) patients, and in 20 (46.5%) mycophenolate mophetil in daily dose of 2 g instead of azathioprine. In 5 (14.2%) patients with high immunological risk and delayed graft function was administered antithymocite globulin in duration of 7-14 days, prophylactically. In 3 (6.97%) patients graft loss was caused by vascular complications and in 1 (2.32%) by infection as the complication. During the first post-transplantation year acute rejection was noticed in 8 (34.7%) patients and in 3 (37.5%) it was steroid resistant. The graft loss was never caused by acute rejection. Six-months graft survival was noticed in 91.1% patients and one-year graft survival in 88.4% patients. One-year patient survival was 100%. Short term results in living related kidney transplantation are excellent and nowadays, due to improvement in immunosuppressive therapy, the success in this type of kidney transplantation is mainly limited by surgical and infective complications.

High doses of immunoglobulins decrease mortality rate of surgical patients with severe intraabdominal infections and sepsis.

Two groups of 40 surgical Intensive Care Unit patients each, were included in the study. All patients had severe intraabdominal infections and sepsis, and septic score higher than 20. All were treated with individual specified conventional symptomatic therapy, and 40 of them received high doses of intravenous immunoglobulins. Significantly lower mortality rate was noticed in IVIG group (40%) than in control group (63.7%). Immunoglobulin therapy also decreased mortality rate in patients with septic shock, but it was no more effective than conventional therapy in patients with multiple organ failure (MOF).

[Smoking as a risk factor in the onset of bronchial carcinoma]. / Pusenje kao riziko faktor nastanka karcinoma bronha.

With regard to proved fact that smoking plays very important role in appearance of the lung cancer, prevention of the lung cancer goes together with fight against smoking. Since smoking is narcotism, prevention of smoking is the only solution of the problem of smoking, respectively that is the only prevention of bronche-cancer. For those who continue smoking, there is some suggestions, such as: not to smoke the last third of cigarette, do not inhale smoke deeply, to reduce number of consumed cigarette, and to have regularly examinations, i.e. to have X-ray examination of the lung on the six months basis.

[Characteristics of the pneumonia syndrome in adults during the war in Sarajevo 1992-1993]. / Karakteristike pneumonijskog sindroma odraslih u ratnom Sarajevu 1992/1993.

We have compared some vital statistics and symptoms as well as clinical findings of the patients hospitalised due to primary non specific lung inflammation in the previous period of aggression at Bosnia and Herzegovina with those in patients hospitalised before the aggression at Bosnia and Herzegovina. The frequency of hospitalisation due to bronchopneumoniae and pleuropneumoniae has been more frequent during the war about three times, while the frequency of treatment from pneumoniae has been the same as before the war. The war population of hospitalised is distinguished in aged persons and persons suffering from chronic diseases, in particular alcoholism, chronic hepatitis and so on. Generally observing, symptoms and physical signs has been more significantly expressed in the war than in the pre-war hospitalised population. The remarkable fact is that clinical findings of values drop of alpha 1 globulins is expressed as well as erythrocytes and the slow increase of leucocytes value in the war in relation to pre-war population of hospitalised from the non specific lung inflammation. The significantly prolonged is the treatment duration, the time of roentgenologic regression of the findings as well as the period of normalisation of haematologic findings with more frequent finding of acute complications (abscess, empyema) in the war than in the pre-war population.

[Evidence of the harmful effects of eosinophils in bronchial asthma]. / Prilog dokazu stetnosti eozinofila u bronhijalnoj astmi.

Fifteen asthmatic patients were prospectively selected. If they had more than 450 eosinophils in peripheral blood on admission to hospital treatment and if before BAL had been performed they were not treated by corticosteroids. No associated disease was found which could cause the increased number of eosinophils in peripheral blood except bronchial asthma. BAL was performed when the subjects tested had no dyspnea, usually 1-3 days after the hospital admission. In contrast to blood eosinophilia, increase of eosinophils number in BAL was found to correlate to impairment of clinically measured parameters such as: ventilation level of blood gases and duration of hospitalisation. On the contrary there was no correlation between the level of blood eosinophilia and gas disturbance and duration of hospitalisation. Eosinophilic proteins (MBP, ECP, EPX, EPO) are not the only that harmfully effect the lung cells in the asthmatic attack but the fact that their level in lavage fluid correlates to eosinophilia degree in BAL is evident so the correlation between the number of eosinophils in BAL and impairment of clinically measured parameters is clear.