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Volume 53, Issue 4, 2025

Online ISSN: 2560-3310

ISSN: 0350-8773

Volume 53 , Issue 4, (2025)

Published: 30.06.2025.

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30.06.2025.

Professional paper

FUNKCIONALNO PRIMARNI PUTEVI NERVNOG SISTEMA: ANATOMIJA I KLINIČKE KORELACIJE

Funkcionalno primarni nervni putevi predstavljaju osnovne provodne strukture centralnog nervnog sistema, odgovorne za integraciju i prenos
motornih, senzitivnih i senzorijalnih informacija. U ovom radu analiziraju se njihova morfološka organizacija, sistematizacija u projekcione,
asocijacione i komisuralne puteve, kao i njihove uloge u regulaciji voljnih i automatskih funkcija organizma.
Poseban akcenat stavljen je na kliničke korelacije, prikazane su najčešće patologije povezane sa oštećenjem pojedinih puteva (moždani udar,
Parkinsonova bolest, siringomijelija, multiple skleroza), njihove manifestacije i relevantne dijagnostičke metode. Kroz tabelarniprikaz omogućeno je
jasno razumevanje anatomsko-kliničkih odnosa.
Rad ukazuje na značaj nervnih puteva ne samo u teorijskom okviru neuroanatomije, već i u savremenoj dijagnostičkoj i terapijskoj praksi. Integracija
morfoloških znanja sa funkcionalnim i kliničkim principima predstavlja ključ za efikasnu procenu neurološkog statusa i planiranje terapijskih
strategija.
Ključne reči: neuroanatomija, funkcionalni putevi, kliničke korelacije, terapijske implikacije

Zdravko Vitošević, Nenad Milošević

01.12.2021.

Professional paper

Coronary sinus, microanatomical study

INTRODUCTION: Complete appreciation of the cardiac venous system requires an understanding of its embryological basis, its usual patterns of distribution, and its common variations. AIM: The aim of our study was to improve our understanding of the coronary sinus morphometrical and topographical anatomy. METHODS: The investigations were carried out on 25 human hearts (from 11 male and 14 female persons of mean age 59.5; range: 40 to 75 years). The classic anatomical technique of microdissection (using neurosurgical microinstruments) was performed under the stereoscopic microscope on 10 specimens injected with a 10% formaldehyde solution. The arteries and veins of an additional 15 hearts were injected with methylmethacrylate and immersed in a 40% solution of NaOH for corrosion. Following washing out and drying, the obtained vascular casts were examined and measured. RESULTS: Coronary sinus (CS) extends from the opening of the oblique vein of the left atrium into the great cardiac vein, to its empty orifice into the right atrium. The length of CS varied between 22.4 and 41.4 mm (mean 33.0 ± 6.1 mm). The diameter of CS at its beginning was 5.0 - 9.6 mm (mean 6.6 ± 1.3 mm), and its diameter at its atrial mouth varied from 6.6 - 12.0 mm (mean 8.4 ± 1.6 mm). The CS had varied relationships to the branches of the left or right coronary arteries. It extended superficial and above the artery in 16 (64%) hearts, and close superficial to the artery in 9 (36%) cases. Duplication of the superior vena cava associated with an aberrant left hepatic vein was found in one case. The persistent left superior vena cava, which drained into the right atrium via the enlarged coronary sinus, was formed by the persistence of the left anterior cardinal vein. CONCLUSION: Our study shows that the coronary sinus, created in an early stage of embryological development, is an important collecting vessel receiving the main veins of the heart.

Ema Bexheti, Emilija Novaković, Zdravko Vitošević, Milan Milisavljević

01.12.2019.

Professional paper

Thyroid storm after chest trauma

Thyroid storm is an acute and severe complication of thyrotoxicosis. It is characterized by high fever, sweating, tachycardia, and often heart failure too. The objectives of the paper is to present the case of a patient with thyroid storm developed after the trauma of the chest at previously apparently healthy individuals, diagnosed on the basis of clinical preview and based on the diagnostic criteria according to Burch and Wartofsky. The most common complication is Mb. Graves - Basedow, but often associated with multi-nodose goiter. Thyroid storm is the most severe form of thyrotoxicosis with a mortality rate of 8 to 25 %. Case report. We present an interesting case from our practice: thyroid storm caused after chest trauma in apparently healthy people, but with unrecognized hyperthyroidism and thyroid gland nodule. Conclusion. The objectives of this presentation were to raise awareness of the association between signs and symptoms of thyroid storm that dominate the clinical picture and complicate the initial presentation and the evolution of the situation caused by trauma. The treatment of hyperthyroidism resulted in conversion in sinus rhythm, withdrawal of symptoms and signs heart failure, and normalization of artery pressure.

Tatjana Novaković, Bogdan Dejanović, Zdravko Vitošević, Nenad Milošević, Jovana Milošević, Ljiljana Jovićević, Emilija Novaković, Miloš Mirković, Zlatica Mirković

01.12.2017.

Professional paper

Microanatomical characteristics of arterial vascularization of the intracranial segment of optic nerve

Introduction: The intracranial part of the optic nerve is perfused by the upper hypophyseal and ophthalmic arteries. Standard anatomical textbooks have not dealt with the vasculature of this clinicaly important part of the central nervous system. Objective: To study morphological characteristics of perioptical arterial vascularization of the intracranial part of optic nerve. Material and methods: The study was conducted on 18 whole brains of both sexes (11 male and 7 female), from the age of 51-78 years, with no signs of changes in the structures of the central nervous system. The vasculature of the optic nerves was microdissected and examined under the stereoscopic microscope after injecting their arteries with a 10% mixture of India ink and gelatin, and fixation in a 5% solution of formalin. Results: Intracranial segment of the optic nerve was richly supplied, from both, the ventral and the dorsal side, strictly with penetrating branches which come from the pial arterial network originating from the internal carotid artery and the superior hypophyseal artery for the ventral nervous surface, and from the anterior cerebral artery for the dorsal nervous surface. Conclusion: In accordance with the objective, and based on the obtained results, we confirmed that intracranial segment of the optic nerve has a rich and very delicate vascular network.

Samra Hajrović, Radmila Balaban-Đurević, Suzana Matejić, Zdravko Vitošević, Milan Milisavljević

01.01.2016.

Professional paper

Morphological analysis of a structures of prenatal pancreas in human

As a mixed exocrine and endocrine gland pancreas has a very important role in the digestive tract. The juice of his exocrine part, which is released into the duodenum, carries more than 20 pancreatic enzymes, important for a normal process of digestion. Endocrine part of the gland, which consists of the islets-insula, actively participate in the metabolism of human organism, secreting two important hormones - insulin and glucagon. Because of its location, the pancreas is an extremely inaccessible organ for a physical examination. Despite of a large number of modern clinical methods for monitoring changes in the body, the detail knowledge of morphological characteristics of this gland is still very important. The material was taken from the cadaver of the fetus and newborn at the Institute of Pathology of the Faculty of Medicine. We classified samples of pancreas into three groups, with respect to age (from 3 months to neonates) and CS length. After dehydration and the molding compositions are cut at a thickness of between 6 and 10 microns. In addition to standard staining methods, some preparations are for identification of insula, painted by Grimelijus. In this study, we determined the morphological changes of the prenatal pancreas, from the third month of intrauterine fetal development, until the end of the fetal time and determine the dynamics of changes in the parenchyma and stroma. We could distinguish functional parts of the pancreas, in 10-11th week of development. In the first trimester of pregnancy, we have noticed an increase in parenchymal elements and the reduction of the stroma, which is slightly more pronounced in interlobular area, that clearly differentiating lobules. At the beginning of the second trimester of pregnancy, in the pancreas that are developing, we observed significant changes.The lobular structure of pancreas was clearly visible. Pancreatic acini are clearly differentiated and are in very close contact, since the stroma between them very reduced. Within almost all lobulus there are clearly expressed the islets of Langerhans, which are multiplied, different sizes, separated from the exocrine part by poorly expressed connective tissue. In the group of prematurely born children, we found that the morphology of the pancreas is very similar to the pancreas at the end of the fetal period.

Tatjana Filipovic, Milan Filipovic, Predrag Mandic, Suzana Matejic, Natasa Djukic, Zdravko Vitosevic

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