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Introduction. Elevated cardiac troponin gives excellent accuracy in the identification of myocardial damage in children, but it can also be elevated in a series of other diseases. Case report. We presented two children thirteen years of age with a high serum level of troponin-I after an acute episode of supraventricular tachycardia. We analyzed troponin- I levels in correlation with the maximum heart rate, duration of tachycardia and systolic left ventricular function (ejection fraction and fractional shortening). Conclusion. Abnormal troponin level can be seen in children with sustained supraventricular tachycardia and normal heart. Caution is advised in diagnosing cardiac dysfunction in children with supraventricular tachycardia and elevated troponin levels.

Background/Aim. The most frequent form of sternal defects is a single foramen, usually located at the distal half of the sternal body, with prevalence that varies among different ethnic populations. Clinical importance of these defects arises from various diagnostic and therapeutic sternal treatments and close location of heart, lungs and other vital organs of the chest cavity. The aim of this study was to determine the prevalence and morphometric characteristics of the sternal midline foramen in the population of central Serbia. Methods. The multidetector computed tomography (MDCT) chest images of 422 patients of both genders were analyzed. The radiological imaging was performed on 64- slice MDCT scanner (Aquilion 64, Toshiba, Japan). All scans were performed in the axial plane, with subsequent multiplanar reconstruction (MPR). Due to the angulation of the sternal body coronal curved-planar, the images were obtained in order to show the whole length of the sternum and the vertical diameter of the sternal foramen. The measurements were done using the commercially available software (Imaging Software ver. 4.1.14.0, Vital-Images). Results. The solitary foramen, located in the distal segment of the sternal body, was detected in 24 patients, representing 5.9% of the observed population with slightly higher prevalence in males. The average size of foramen was 3.9 × 4.2 mm. The mean distance from the skin was 12.7 ± 3.3 mm, the distance from skin to pericardium was on average 37.3 ± 8.2 mm, while the average distance from skin to pleura was 25 ± 5.9 mm. The average depth of foramen 8.7 ± 2 mm, while the mean distance from the posterior surface of foramen to pericardium was 12.7 ± 9.1 mm. Conclusion. The results presented in this paper confirmed the prevalence of 5.9% regarding the midline sternal foramen in the observed population. Serious complications of the sternal puncture could be prevented by prior MDCT imaging.

Introduction. Percutaneous vertebroplasty (PVP), as a mini-invasive approach in the treatment of patients with osteoporotic vertebral compression fractures (OVCFs), provides stabilization of the spine and relives pain. The most commonly it is applied in the 3–6 weeks before bending of the spine. Complete cessation of pain is easier to achieve if you treat “less mature” fractures. The aim of the report is to show that PVP is effective and safe for old fractures too. Case report. A 77-old patient suffered from a stable compression fracture of 3th lumbar (L3) vertebral body after minor trauma. This fracture was clinically and radiologically diagnosed. The conservative treatment that included lumbo-sacral orthosis (LSO), analgesic drugs and physical therapy, was primarily applied due to permanent pain and type of fracture. After a period of two months, pain persisted, but it was localized in a thoracic spinal segment with radiologically diagnosed fractured bodies of 8th (Th8) and 10th (Th10), thoracic vertebra without neurological deficit. Thoraco-lumbo-sacral orthosis (TLSO) was prescribed and after six months the indication for vertebroplasty of the Th8 and Th10 vertebral body was given. The pain relief had been achieved and the patient was discharged from the Clinic for Orthopedics on the postoperative day 2, and was symptom free during the follow-up period. Conclusion. In patients with stable OVCFs, PVP is an effective therapy for reducing pain and improving mobility of 6 months old fractures.

Introduction. Malignant fibrous histiocytoma is a fast spreading pleomorphic sarcoma with a high malignant potential. Its spreading is characterized with local invasion and distant metastazes with early onset. Most common localisations of development are extremities, trunk and retroperitoneum. Given the line of rare case and specimen, lack of a clear etiology and mechanisms of this disease, as well as adequate histopathologic findings and intraoperative documentation, we presented current status, discuss putative etiology, histopathology with variant morphology, differential diagnosis and treatment modalities. Case report. We presented a 56-years-old female Serbian with tumor in the thigh that clinically resembles incapsulated hematoma. Computed tomography revealed intramuscular tumor with a heterodense structure and compression on surround tissue. Ex tempore biopsy specimen showed malignant potential of the tumor. Wide and radical excision of the nodule has been done, and definitive histopathological verification revealed malignant fibrous histiocytoma. Conclusion. Malignant fibrous histiocytoma is a most common type of soft tissue sarcomas in adults. Frequent localization is on lower extremities, and every rapidly enlarging nodule in this localization that on computed tomography is like incapsulated hematoma with necrotic zone should alert suspicion on presence of this type of sarcoma.

Background/Aim. The values of the Böhler’s angle (BA) are relevant parameters for diagnosis, management and prognosis of the calcaneal fracture and the outcome. Range of normal values of Böhler’s angle (BA) in adults varies depending on the examined population, age, gender or ethnicity. The aim of this study was to determine the range of normal values of the Böhler’s angle in the central part of Serbia. Methods. The lateral foot radiographs of 225 subjects (111 males and 114 females) without calcaneal fractures, divided into 6 age groups were observed to determine the normal values of the Böhler’s angle by using the IMPAX 6.5.2.114 Enterprise software. Obtained values for Böhler’s angle were compared among gender and groups using appropriate statistical tests. Results. The mean of Böhler’s angle in observed population was 34.06°, ranging from 25.1° to 49.5° and was higher in males than in females included in our study. Gender difference was statistically significant. The distribution of the mean BA across the age groups showed tendency of decreasing with age and the highest BA was found in the youngest group. Conclusion. The findings presented in this paper confirmed the existence of wide range of BA values as well as its gender and age differences.

Background/Aim. Preservation of an adequate posterior tibial slope (PTS) during total knee arthroplasty is crucial for the biomechanical stability and function of the knee joint. Studies that investigated anatomical features of the tibial plateau found significant gender and inter-population differences in all components of the PTS. The aim of this study was to establish reference values of PTS in Serbian population and to explore if there is any difference in the tibial plateau inclination between genders. Methods. We retrospectively reviewed 161 magnetic resonance images (MRIs) of the knee of adult patients examined in Medical Military Academy in Belgrade, Serbia, in a period from November 2011 to September 2014. Measurements of PTS components: medial tibial slope (MTS), lateral tibial slope (LTS), and coronal tibial slope (CTS) were performed through several steps, according to the suggestions in the recent literature. Obtained values for each tibial slope were compared between gender subgroups using appropriate statistical tests. Results. Mean values of each component of the posterior tibial slope for male vs. female subgroups were as follows: MTS 3.7° ± 2.8° vs. 5.1° ± 2.9°, LTS 4.2° ± 2.8° vs. 4.3° ± 2.7°, and CTS 3.9° ± 2.4° vs. 3.3° ± 1.9° respectively. The medial tibial slope was significantly higher in females than in males (p = 0.005). The mean value of the coronal tibial slope was greater in males without statistically significant difference (p = 0.105). Conclusion. This study demonstrated significant difference in MTS of the tibial plateau between males and females, being higher in the female subgroup.

Background/Aim. Damage of any element of pelvic floor leads to its functional damages, reflected in the occurrence of urinary incontinence, prolapse of pelvic organs, fecal incontinence and sexual dysfunction. Basic aim of our paper was to investigate the influence of various risk factors on pelvic floor muscle strength in women. Methods. The study included 90 female patients and examined how age, job, body weight and height, number of deliveries, sports activities, incontinence occurrence, previous prolapse-caused gynecological surgeries, other gynecological surgeries and other conservatively treated gynecological diseases influence the value of pelvic floor muscle strength. Pelvic floor muscle strength was measured using vaginal dynamometer. Results. Univariate regression analysis showed that parameters such as age, demanding job, body height, number of deliveries, sports activities, prolapse-caused gynecological surgeries, other gynecological surgeries and other gynecological diseases were in positive correlation with the values of pelvic floor muscle strength. In multivariate regression model, incontinence and gynecological operation of prolapse were singled out as independent risk factors. Conclusion. If risk factors that cause damage to pelvic floor muscle are known, it is possible to prevent the damages and improve the quality of women's life.

Background/Aim. Nucleus accumbens is a part of the ventral striatum also known as a drug active brain region, especially related with drug addiction. The aim of the study was to investigate the Golgi morphology of the nucleus accumbens neurons. Methods. The study was performed on the frontal and sagittal sections of 15 human brains by the Golgi Kopsch method. We classified neurons in the human nucleus accumbens according to their morphology and size into four types: type I - fusiform neurons; type II - fusiform neurons with lateral dendrite, arising from a part of the cell body; type III - pyramidal-like neuron; type IV - multipolar neuron. The medium spiny neurons, which are mostly noted regarding to the drug addictive conditions of the brain, correspond to the type IV - multipolar neurons. Results. Two regions of human nucleus accumbens could be clearly recognized on Nissl and Golgi preparations each containing different predominant neuronal types. Central part of nucleus accumbens, core region, has a low density of impregnated neurons with predominant type III, pyramidal-like neurons, with spines on secondary branches and rare type IV, multipolar neurons. Contrary to the core, peripheral region, shell of nucleus, has a high density of impregnated neurons predominantly contained of type I and type IV - multipolar neurons, which all are rich in spines on secondary and tertiary dendritic branches. Conclusion. Our results indicate great morphological variability of human nucleus accumbens neurons. This requires further investigations and clarifying clinical significance of this important brain region.

Background/Aim. Anatomical parameters of the bony components of the hip joint are essential for better understanding of etiopathogenesis of diseases like primary osteoarthrosis of the hip joint. The aim of this reserch was to examine the normal acetabular morphometry in Serbian population and to determine whether there are sex differences in anatomical parameters of the acetabulum among asymptomatic subjects. Methods. Pelvic radiographics of 320 adult asymptomatic patients (640 hips) were analyzed in 170 men and 150 women to determine the morphology of the acetabulum in Serbian population. For each hip the center edge angle of Wiberg (CEA), the acetabular angle of Sharp (AA), acetabular depth (AD), acetabular roof obliquity (ARO) and roof angle (RA) were measured. Results. The following average measurements for acetabulum geometry were obtained (X ± SD): CEA - 33.5 ± 6.5° (33.6 ± 5.8° in male, 33.3 ± 6.9° in female), AA - 38.0 ± 3.8° (37.5 ± 3.6° in male, 38.5 ± 3.9° in female), AD - 11.9 ± 2.8 mm (12.5 ± 2.7 mm in male, 11.2 ± 2.7 mm in female), ARO - 7.6 ± 5.7° (6.2 ± 4.9° in male, 9.0 ± 6.0° in female) and RA - 18.4 ± 10.0° (19.6 ± 8.5° in male, 17.1 ± 9.5° in female). There were significant differences in the CEA, AA, AD, ARO and RA related to gender (p < 0.01, t-test). Conclusion. There are significant gender differences in Serbian population for all the examined anatomical parameters of acetabulum. We found sex-related differences in acetabular morphology, female acetabulum being marginally more dysplastic than male acetabulum. There is also a clear tendency of female hips to be more dysplastic than male ones.