Opial inequality in q-calculus.

In this article we give q-analogs of the Opial inequality for q-decreasing functions. Using a closed form of the restricted q-integral (see Gauchman in Comput. Math. Appl. 47:281-300, 2004), we establish a new integral inequality of the q-Opial type.

Dynamic Opial diamond-α integral inequalities involving the power of a function.

In this paper, we present some new dynamic Opial-type diamond alpha inequalities on time scales. The obtained results are related to the function [Formula: see text].

Application of concentrated growth factors in reconstruction of bone defects after removal of large jaw cysts--the two cases report.

INTRODUCTION: Coagulation and blood clot formation in bone defects is sometimes followed by retraction of a blood clot and serum extrusion, thus producing peripheral serum-filled spaces between bony wall and coagulum. This can result in a higher incidence of postoperative complications. Stabilization of blood coagulum, which enables successful primary healing, may be accomplished by autotransplantation, allotransplantation, xenotransplantation, or application of autologous platelet concentrate and concentrated growth factors (CGF). Case report. Two patients with large cystic lesions in the upper and lower jaw were presented. In both patients postoperative bony defects were filled with autologous fibrin rich blocks containing CGF. Postoperative course passed uneventfully. CONCLUSION: Application of fibrin rich blocks containing CGF is one of the possible methods for reconstruction of bone defects. CGF can be applied alone or mixed with a bone graft. The method is relatively simple, without risk of transmissible and allergic diseases and economically feasible.

Application of modern computer-aided technologies in the production of individual bone graft: A case report.

INTRODUCTION: An autologous bone (bone derived from the patient himself) is considered to be a "golden standard" in the treatment of bone defects and partial atrophic alveolar ridge. However, large defects and bone losses are difficult to restore in this manner, because extraction of large amounts of autologous tissue can cause donor-site problems. Alternatively, data from computed tomographic (CT) scan can be used to shape a precise 3D homologous bone block using a computer-aided design-computer-aided manufacturing (CAD-CAM) system. CASE REPORT: A 63-year old male patient referred to the Clinic of Dentistry of Vojvodina in Novi Sad, because of teeth loss in the right lateral region of the lower jaw. Clinical examination revealed a pronounced resorption of the residual ridge of the lower jaw in the aforementioned region, both horizontal and vertical. After clinical examination, the patient was referred for 3D cone beam (CB)CT scan that enables visualization of bony structures and accurate measurement of dimensions of the residual alveolar ridge. Considering the large extent of bone resorption, the required ridge augmentation was more than 3 mm in height and 2 mm in width along the length of some 2 cm, thus the use of granular material was excluded. After consulting prosthodontists and engineers from the Faculty of Technical Sciences in Novi Sad we decided to fabricate an individual (custom) bovine-derived bone graft designed according to the obtained-3D CBCT scan. CONCLUSION: Application of 3D CBCT images, computer-aided systems and software in manufacturing custom bone grafts represents the most recent method of guided bone regeneration. This method substantially reduces time of recovery and carries minimum risk of postoperative complications, yet the results fully satisfy the requirements of both the patient and the therapist.

Comparative analysis of accuracy of diagnosis of chronic periapical lesions made by clinical and histopatological examination.

INTRODUCTION: The preliminary diagnosis of chronic periapical lesions is made on the basis of clinical symptoms and radiographs, which is a reliable diagnostic tool, but it has only a subsidiary role since histopathological verification is essential for the definitive diagnosis. This study was aimed at diagnosing removed chronic periapical lesions and classifying them by size as well as at comparing the clinical diagnoses with histipathological results. MATERIAL AND METHODS: The study included 34 patients diagnosed with chronic periapical process by applying clinical examination and radiography. The removed chronic periapical lesions were processed according to classical histological technique and analyzed by hematoxylin and eosin staining protocol. RESULTS: According to histopathological analysis 53% of chronic periapical lesions were periapical granulomas and 47% were radicular cysts. The size of the lesions ranged from <9 mm (70% of lesions), 9 to 20 mm (18% of lesions) and >20 mm (12% of lesions).The histopathological examination revealed that clinical diagnosis was wrong in 26% of cases. CONCLUSION: A statistically significant difference between clinical and histopathological diagnosis has been found. The histopathological findings strongly suggest the necessity of complete curettage of lesions sizing >20 mm in order to prevent recurrences.

[Orthodontic-surgical therapy of retained upper canine].

INTRODUCTION: Therapy of impacted teeth is undoubtedly one of the most intriguing issues for the experts in the field of dentistry. General dental practitioners, as well as specialists in the field of pediatric dentistry, periodontology, orthodontics and particularly oral and maxillofacial surgery have been facing this challenge throughout past several years. Each of these experts can contribute to solving this problem; however, each of them alone can solve only a limited number of cases. DISCUSSION AND CONCLUSION: Since recently, the fate of impacted tooth has been determined mainly by the competence, experience and skill of the orthodontist to apply light traction in an appropriate direction once the tooth has been made surgically exposed. Oral surgeon and orthodontist should share the responsibility for a patient with impaction as they together have the necessary skill and competence required for an effective therapy. In addition, dental age of the child is to be taken into consideration, as well as his/her overall health status and potential interference with other anomalies of dental arch.

[Influence of different types of surgical suture materials on mechanical damage of oral mucosa].

INTRODUCTION: Throughout history many kinds of different suture materials have been used for closing and suturing surgical wounds. Medical literature describes four basic characteristics of suture material: knot safety, tensile strength, tissue reaction and wound safety. The tissue reaction is reflected in an inflammatory response, which, though minimal, occurs during first two to seven days after implanting suture into the tissue. The aim of this research was to investigate whether different suture materials affect the development of decubital damage of oral mucosa, which to a great extent can compromise the process of wound healing. MATERIAL AND METHODS The investigation was designed as a prospective clinical study including 150 patients of both genders, aged between 25 and 60. The patients were distributed into three groups of 50 persons. The suture Black Silk was used in the first group, designated as a control group. Nylon and Vicril were used in the second and third group, i.e. experimental groups, respectively. Decubital damage of the surrounding soft tissues was the main parameter for monitoring the effects of selected suture materials on the oral mucosa. CONCLUSION: The comparison of results obtained for the investigated suture materials after suturing oral mucosa revealed that certain advantage could be given to synthetic monofilament suture materials.

[Complications after placement of peritoneal catheter].

INTRODUCTION: Peritoneal dialysis is one of the modalities used for treatment of end-stage chronic kidney failure. Nowadays, this method is complementary to haemodialysis and renal transplantation. Owing to the rich vascularization of the peritoneum, it is used in the processes of osmosis and diffusion, enabling the removal of uremic material from the body. The procedure includes introduction of peritoneal fluid via the peritoneal catheter. COMPLICATIONS: The catheter is placed through the anterior abdominal wall with its tip positioned in the small pelvis. There are several techniques for catheter placement considered minimally invasive, which, however, may be associated with various complications. These complications can be divided into mechanical (catheter dysfunction, cuff protrusion, hernia, dialysate leaks, visceral perforation) and infectious (early peritonitis, exit site or tunnel infection, surgical wounds). In most cases, such complications are rare and can be successfully managed using conservative therapy; however, in some situations severe complications can endanger the life of the patient. On-time recognition of complications, particularly in patients at risk, is of paramount importance for an effective treatment. The development of complications can increase the morbidity and the chance of treatment failure, and therefore transfer to haemodialysis. CONCLUSION: The preoperative evaluation and determination of the risk factors as well as the early recognition and adequate management of complications are essential in their prevention.

Peritoneal dialysis--experiences.

Peritoneal dialysis is the method of treatment of terminal-stage chronic kidney failure. Nowadays, this method is complementary to haemodialysis. It is based on the principles of the diffusion of solutes and ultrafiltration of fluids across the peritoneal membrane, which acts as a filter. The dialysate is introduced into the peritoneum via the previously positioned peritoneal catheter. The peritoneal dialysis is carried out on daily basis, at home by the patient, and the "exchange" is repeated 4-5 times during the 24 hours. The first steps in peritoneal dialysis at the Department for Haemodialysis of the Clinical Centre of Vojvodina date back to 1973. Until 1992, the patients were subjected to this program only sporadically. Since 1998 the peritoneal dialysis method has been performed at the Clinic for Nephrology and Clinical Immunology. In the period 1998-2008 ninety nine peritoneal catheters were placed. Chronic glomerulonephritis, nephroangiosclerosis and diabetes were identified as the most common causes of chronic renal failure. Two methods of catheter placement were applied: the standard open surgery method (majority of patients) and laparoscopy. Most of the patients were subjected to continuous ambulatory peritoneal dialysis, whereas four patients received automatic dialysis. Transplantation was performed in 10 patients, i.e. cadaveric transplantation and living-related donor transplantation, each in 5 patients. Peritoneal dialysis was available as a service outside our institution as well. A ten-year experience in peritoneal dialysis gained at our Centre has proved the advantages and qualities of this method, strongly supporting its wider application in the treatment of terminal-stage chronic kidney failure.

[Choice of surgical suture material used in oral cavity-clinical study].

INTRODUCTION: Historical data on closing and suturing of surgical wound describe a wide range of various suture materials. The choice of the surgical catgut, i.e. type and diameter, depends on the localization, characteristics and condition of the tissue to be treated. From the standpoint of oral-surgical practice the following clinical parameters are of the outstanding importance regarding the choice of suture material: accumulation of soft deposits on the sutures, decubitus of the adjacent soft tissues and dehiscence of the operative wound. AIM: The aim of this research was to determine the correlation between different types of suture materials and accumulation of soft deposits on the sutures, decubitus of the adjacent soft tissues and dehiscence of the operative wound. MATERIAL AND METHODS: Our prospective clinical study included 150 patients distributed into three groups of 50 subjects. The surgical procedure performed on each patient involved resection (aplicoectomy) of the tooth root end in the intercanine sector of the upper jaw. The following suture materials were applied: BLACK SILK 5-0, NYLON 5-0 and VICRYL 5-0. The effects of the selected sutures were evaluated by using several parameters: accumulation of soft deposits, wound dehiscence and decubitus of the adjacent soft tissues. The effects of the applied sutures were recorded on days 2, 5 and 7 after the surgery. CONCLUSION: The comparison of cited parameters of the investigated materials of ter suture of oral cavity mucosa revealed that none of the used material was ideal; however a certain preference might be given to the synthetic monofilament suture materials.

[Therapy of lupus nephritis with mycophenolate mofetil].

INTRODUCTION: Mycophenolate mofetil is an immunosuppressive agent used in transplantation and subsequently in a variety of autoimmune conditions. It inhibits both B and T lymphocyte proliferation, and also has nonimmune effects on the kidney. The major experience in systemic lupus erythematosus has focused on proliferative lupus nephritis. MATERIALS AND METHODS: In our study we treated 8 female patients having proliferative lupus nephritis with combination therapy of prednisone (1 mg/kg body weight) and mycophenolate mofetil (2 g per day). Complete remission was defined as a value for urinary protein excretion that was less than 0.5 g per 24 hours, with normal urinary sediment, a normal serum albumin concentration and improved or stable serum creatinine. Partial remission was defined as a daily proteinuria below 2g in the previously nephrotic patient or minimum 30% from starting values, with normal urinary sediment, serum albumin of minimum 30 g/L and stable serum creatinine. RESULTS: Two patients had a complete remission after 7 and 2 months respectively. Five patients had a partial remission after 5.2 +/- 4.3 months of therapy. One patient did not react to therapy. There were no side effects during the course of therapy. DISCUSSION: Considering the fact that 7/8 patients have had nephrotic range proteinuria and that 50% of patients were refractory on standard induction therapy, the results of this study are a good indicator of value of mycophenolate mofetil in the therapy of proliferative forms of lupus nephritis. CONCLUSION: Mycophenolate mofetil has satisfactory results in the treatment of proliferative forms of lupus nephritis with minimal side effects.

[Therapy of lupus nephritis with mycophenolate mofetil].

INTRODUCTION: Mycophenolate mofetil is an immunosupressive agent used in transplantation and subsequently in a variety of autoimmune conditions. It inhibits both B and T lymphocyte proliferation, and also has nonimmune effects on the kidney. The major experience in systemic lupus erythematosus has focused on proliferative lupus nephritis. MATERIALS AND METHODS: In our study we treated 8 female patients with proliferative lupus nefritis with combination therapy of prednisone (1 mg/kg body weight) and mycophenolate mofetil (2 g per day). Complete remission was defined as a value for urinary protein excretion that was less than 0.5 g per 24 hours, with normal urinary sediment, a normal serum albumin concentration and improved or stable serum creatinine. Partial remission was defined as a daily proteinuria below 2 g in a previously nephrotic patient or minimum 30% from starting values, with normal urinary sediment, serum albumin of minimum 30 g/L and stable serum creatinine. RESULTS: Two patients had a complete remission after 7 and 2 months respectively. Five patients had a partial remission after 5.2+/-4.3 months of therapy. One patient did not react on therapy. There were no side effects during the course of therapy. DISCUSSION: Considering the fact that 7/8 patients have had nephrotic range proteinuria and that 50% of patients were refractory on standard induction therapy, results of this study are good indicator of value of mycophenolate mofetil in the terapy of proliferative forms of lupus nephritis. CONCLUSION: Mycophenolate mofetil gives satisfactory results in the treatment of proliferative forms of lupus nephritis with minimal side effects.

[Correlation between sera levels of sICAM-1 and sVCAM-1 and severity of kidney lesions in patients with lupus nephritis].

INTRODUCTION: Adhesion molecules are essential for cellular interactions and are important in the activation and adhesion of cells. Studies have shown that elevated levels of solubile ICAM and VCAM are related to disease activity in patients with various acute and chronic inflammatory diseases. Our aim was to investigate the correlation between the levels of sICAM-1 anti sVCAM-1 and the degree of disease activity and severity of lupus nephritis. MATERIAL AND METHODS: Using the ELISA procedure, we determined the sera levels of sVCAM-1 and sICAM-1 in 80 patients with SLE and in group of 27 healthy volunteers. RESULTS: Patients with SLE had significantly higher sera levels of adhesion molecules comparing to the controls (p<0.001). There was a high positive correlation between the sera levels of sVCAM-1 and concentration of anti-ds DNA antibodies in patients with SLE (p<0.001), and there was also a negative correlation between the sera levels of sVCAM-1 and concentration of C3 and C4 component of complement (r=-0.64, r=-0.58). In the group of patients with lupus nephritis, significantly higher sera concentrations of sVCAM-1 were detected compared patients without nephritis. Patients with class III and IV kidney changes had significantly higher levels of sVCAM-1 compared to the patients with class II kidney changes. In the group of patients with activity index of kidney changes (AI) over 4 sVCAM-1 the sera levels were significantly higher compared to the group with AI <4. CONCLUSION: The sera level of sVCAM-1 is a reliable parameter to evaluate the autoreactivity degree in SLE. In the same time, sVCAM-1 sera level can be used as a reliable marker to evaluate the renal lesion extensivity in SLE.

[Quality of life in patients with chronic renal failure].

INTRODUCTION: Hemodialysis and transplantation are performed not only to replace renal function, but also to improve patients' quality of life. The aim of our investigation was to compare the quality of life in patients with chronic renal failure (CRF) before and after the introduction of active therapy. MATERIAL AND METHODS: We tested 76 patients (pts): 20 pts on conservative therapy (CT), 21 pts on chronic hemodialysis and 35 pts with renal transplantation. A questionnaire (combining two questionnaires) was used to investigate the physical, emotional and social aspects of health. RESULTS: In regard to physical health of transplantation patients (TP) it was established that work capacity and activities were less damaged, whereas physical activity was highest in pts on CT. Social activity was limited in a higher percentage in TP (40%) than in hemodialysis patients (HD) (19%), while family relationships were most damaged in pts on HD (28.57%). Discomforts were most common in pts on HD. The highest percentage of pts estimated their health status as good or average, but their health status improved after transplantation in 82.86% that is in 57.14% after HD. It was similar with the quality of life: 28.57% of kidney transplant patients rated their quality of life as very good, and 54.28% rated it as good: 38.09% of HD patients rated their quality of life as very good, whereas only 5% of CT patients rated it as very good, and 20% as good.

Urinary obstruction secondary to an ossifying fibroma of the os penis in a dog.

A 13-year-old, 25-kg, castrated male border collie was referred for evaluation of pollakiuria, stranguria, and a decreased urine stream. A calcified periurethral mass near the caudal aspect of the os penis was identified on survey abdominal radiographs. A retrograde contrast urethrocystogram demonstrated that the mass was compressing the penile urethra. The mass was surgically resected. A histopathological diagnosis of an ossifying fibroma of the os penis was made. This report describes an atypical presentation of a rare tumor, an ossifying fibroma, that caused a urinary obstruction in a male dog. A review of the incidence, histopathological features, and behavior of ossifying fibromas is included.

[Major characteristics of immunoglobulin A nephropathy]. / Glavne karakteristike imunoglobulin A nefropatije.

INTRODUCTION: Immunoglobulin A nephropathy (IgAN) is one of the most common forms of primary glomerulonephritis in many countries. Most clinical features of IgAN point to a renal problem, such as recurrent macroscopic hematuria or asymptomatic microscopic hematuria and proteinuria. Pathologic features of IgAN present with different types and different degrees of glomerular, tubulointerstitial and vascular lesions. The aim of this study was detailed analysis of clinical and laboratory findings, as well as findings of immunofluorescence and light microscopy. We also investigated associations between these factors. MATERIAL AND METHODS: We investigated 60 patients who underwent renal biopsy. The study was partly retrospective and partly prospective. RESULTS: The average age of patients was 34.19 years. Male female ratio was 2.33:1. IgAN was most frequently asymptomatic (83.33%) as microhematuria and proteinuria, while gross hematuria was found in 16.667%. Renal biopsy material was analyzed by light microscopy revealing changes in all glomerular structures. Immunofluorescence microscopy demonstrated dominant IgA deposits. This study established association of glomerulosclerosis with clinical features of disease. DISCUSSION AND CONCLUSIONS: IgAN frequently develops in the 4th decade of life, mostly in males and presents as asymptomatic (83.33%). Pathohistological changes include all glomerular structures. There is no specific serological test for IgAN, but pathological changes affect clinical features of the disease, as proteinuria and increase of creatinine concentration.

Tubulointerstitial dysfunction in early post-transplant period.

Dysfunction of a transplanted kidney may develop at any time in the post-transplant period. The aim of this study was to differentiate levels of early dysfunction of a transplanted kidney. The study included 45 examinees undergoing kidney transplantation. They were divided into four groups, in regard to length of hospitalization and post-transplant complications: group I (up to 15 days, complication-free); group II (up to 15 days, with complications); group III (up to 30 days); group IV (up to 60 days). The control group included patients undergoing abdominal surgery, without uropoetic system disorders. The following parameters were examined on a daily basis a month after transplantation on average: creatinine clearance, creatinine and urea. Statistical analysis of these parameters revealed the following levels of renal dysfunction: control group--circulatory tubular dysfunction without azotemia; group I--polyuric acute tubular necrosis; group II and group III--severe or moderately severe polyuric acute tubular necrosis and group IV--polyuric acute tubular necrosis.

[Radioconstrast nephropathy]. / Radiokontrastna nefropatija.

INTRODUCTION: Hospital-acquired acute renal failure increased in the last years from about 5 to 6.4%, while mortality remained high and according to newest investigations it is about 60% on average. Radiocontrast-induced nephropathy is the third cause of death in hospital-acquired acute renal failure. RISK FACTORS FOR RADIOCONTRAST-INDUCED NEPHROPATHY: Risk factors for radiocontrast-induced nephropathy include: the existing kidney disease, diabetes, dehydratation, multiple myeloma, older age and earlier kidney damage by contrast substances. COURSE OF RADIOCONTRAST-INDUCED NEPHROPATHY: The clinical course of radiocontrast-induced nephropathy may manifest from asymptomatic picture to development of oliguric form of acute renal failure. PREVENTION AND TREATMENT MODALITIES OF RADIOCONTRAST-INDUCED NEPHROPATHY: Modalities of prevention and treatment of radiocontrast-induced nephropathy are as follows: adequate hydration of patients, appropriate application of diuretics, calcium channel blockers nonionizing radiocontrast and preventive haemodialysis. EXPERIMENTAL STUDIES IN PREVENTION AND TREATMENT OF RADIOCONTRAST-INDUCED NEPHROPATHY: Experimental studies indicate application of atrial natriuretic peptide, endothelin, prostaglandin. CASE REVIEW: Two patients treated at the Clinic for Nephrology and Clinical Immunology in Novi Sad, presented with radiocontrast-induced nephropathy. In one patient it appeared after panaortography and in the second after computerized tomography of the abdomen. In both cases aggravation occurred due to already existing renal failure caused by radiocontrast substances. CONCLUSION: The problem is particularly important because there is a large number of patients in whom there is a risk of radiocontrast-induced nephropathy and it is necessary to carry out adequate prophylaxis and accurate assessment of kidney function before application of radiocontrast substances.