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Introduction: Carcinoma of the stratified squamous epithelium of the oral cavity - oral squamous cell carcinoma (OSCC) is an invasive pathological lesion of the epithelium with varying degrees of squamous differentiation. It is characterized by early and extensive metastases, infiltration of adjacent anatomical structures, frequent recurrences, and a relatively low five-year survival rate of less than 50%. The aim of the study to determine the correlation between the analysis of the lymphocytic infiltrate of biopsy specimens with pathohistologically proven metastases of oral squamous cellular carcinoma on postoperative neck dissection specimens. Material and methods: The study included 42 patients with pathohistologically verified oral squamous cellular carcinoma who underwent surgery at the Department of Maxillofacial Surgery of the Clinic of Dental medicine in Niš in the period from 2018 to 2022. The histopathological analysis included the depth of tumor invasion, histopathological analysis of the lymph nodes of neck dissections, analysis of lymphocytic infiltration, and presence of lymphovascularand perineural invasion. Results: It was determined that the depth of invasion is statistically significantly different regarding the degree of lymphocytic infiltration (p=0.004). Invasion of over 4mm was present in 20% of patients with high infiltration, 44.4% of patients with medium infiltration, and 85.7% of patients with low infiltration. Conclusion: Given that the results of the study indicate that the analysis of the lymphocytic infiltrate can be a reliable predictive factor of the appearance of metastases in the lymph nodes of the neck, further research should be directed toward as sociating lymphocytic infiltration with certain biochemical and genetic parameters based on which a plan can be created for neck treatment in the N0 stage of oral squamous cellular carcinoma.

Salivary gland tumors are neoplasms characterized by a high level of pleomorphism and histological overlap. One tumor may contain several cell types; therefore, it is necessary to include immunohistochemical staining, as well as morphometric analysis of tumor cells as prerequisites for an appropriate diagnosis. Our research included 120 tumors, such as pleomorphic adenoma, Warthin tumor, basal cell adenoma, myoepithelioma, adenoid cystic carcinoma, mucoepidermoid carcinoma, salivary duct carcinoma, polymorphous low-grade carcinoma and myoepithelial carcinoma. The aim of the study was to differentiate benign and malignant tumors based on the characteristics of nuclei. The expression of Ki67 and the morphometric nuclear parameters – area, perimeter, Feret diameter, integrated optical density, circularity, and roundness, were analyzed. It was observed that the Ki67 proliferative index was statistically significantly higher in malignant tumors (P

Introduction/Objective. Nasolacrimal duct obstruction with consequent epiphora and the development of dacryocystitis (DC) represents a common pathological entity in the clinical practice of ophthalmologists and maxillofacial surgeons. The etiology of DC is multifactorial and still has not been clarified in detail. It is considered that ascending infections from the nasal cavity and paranasal sinuses, injuries and surgical interventions in the middle third of the face, dacryoliths, tumors of the lacrimal sac and surrounding structures may be some of the etiological factors of nasolacrimal duct obstruction. The aim of this study is to present clinical characteristics and surgical treatment of DC. Methods. A retrospective study was carried out. It covered a period of 10 years during which 49 patients with clinically verified DC were treated after surgical examination and complete diagnostics. Out of the total number, 37 patients underwent surgery. Results. The occurrence of predisposing factors was present in 80% of the patients – rhinitis and the inflammation of paranasal sinuses in 27 patients (72%), injuries and surgical interventions in the middle third of the face in nine patients (24%), whereas lacrimal sac and nasolacrimal duct tumors were noted in three patients (8%). Surgical failure, which was manifested in terms of recurrent DC and epiphora, was noted in six cases (16%). Conclusion. Regarding the possible complications of inadequately administered antibiotic therapy and a broad spectrum of pathological entities which comprise the differential diagnosis, dacryocystorhinostomy with an adequate histopathological analysis and appropriate antibiotic therapy in the acute stage represents a right way for the treatment of DC.

Introduction: A large group of benign bone tumors of the jaw are fibroosseous tumors. The basis of the pathophysiological processes of this type of tumor is the replacement of normal bone tissue by fibrous tissue. The cemento-ossifying fibroma (COF) belongs to this group of tumors. Case report: A rare case of COF in the maxilla end maxillary sinus in a 40-year old patient is presented. In the initial stage, COF developed asymptomatically, as most benign tumors. In later stage other symptoms appeared, first of all facial deformities of the jaw and head, ophthalmic disorders, paresthesia due to compression of the nerves, and the like. We performed subtotal maxillectomy using the Weber-Fergusson approach. Conclusion: In this case report we presented a patient with rare localisation of COF. To set a definitive diagnosis of COF, a detailed clinical examination with MSCT and angiography are required. Surgical therapy is only method of treatment. Postoperative monitoring of the patient is necessary, including control MSCT radiography.

Introduction: Salivary gland tumors are extremely rare neoplasms. Given their pathohistological image, these tumors represent a great diagnostic challenge. The aim of our study was to differentiate these three tumor types by applying the immunohistochemical and morphometric analysis. Material and Methods: The entire study was conducted at the Center for Pathology and Pathological Anatomy in Niš. The study included 44 tumors, 20 pleomorphic adenomas, 12 basal cells adenomas and 12 polymorphous low-grade adenocarcinomas. The expression of Ki67, p53 and HER-2 antigens, as proliferation markers, was analyzed. The differential diagnostics also included the analysis of the expression of CEA, EMA, GFAP, p63, vimentin, CK14, α-SMA, S-100 protein and WT1 antigen. The morphometric analysis was done in the program pack 'ImageJ' version 1.43u. The statistical analysis of data was done in the program pack SPSS 15.0. Results: Neoplastic cells in pleomorphic adenoma showed a strong expression of GFAP (20/20), p63 (20/20), WT1 (20/20), vimentin (18/20) and S100 (16/20). Diffuse expression of CK14 (12/12) was present in the group of 12 polymorphous low-grade adenocarcinomas. S-100, vimentin and EMA were absolutely expressed, whereas α-SMA was negative. Basal cell adenoma showed negativity to S-100, CEA, p63 and vimentin. The analysis of the proliferative Ki67 index values pointed to a statistically significant difference in the pleomorphic adenoma group, which was associated with a frequent recurrence of this benign tumor. The analysis of morphometric characteristics showed higher values in the polymorphous low-grade adenocarcinoma group, but statistically significant differences were found only for the Feret diameter and the integrated optical density (p < 0.05). As for the basal cell adenoma group, tumor cells showed statistically higher values for the integrated optical density (p < 0.001). Conclusion: Apart from the basic micromorphological analysis, the differential analysis of salivary gland tumors also requires the immunohistochemical analysis as well as the monitoring of morphometric characteristics of these tumors' nuclei.

Introduction/Objective. A mucocele is a benign cystic but extremely expansive change in paranasal cavities, first described in literature by Langenbeck in 1820. The etiology of mucoceles is still a subject of debate. It is assumed that the obstruction of the frontal sinus duct and drainage impairment into the middle nasal meatus, as a consequence of a chronic infection, trauma, or tumor, represent one of the main causes of their occurrence. The aim of this study was to describe ophthalmological and clinical properties of frontal sinus mucoceles. Methods. Our retrospective study covered a period of 10 years during which seven patients with mucocele in the frontal sinus were operated on. Results. Predisposing factors for the appearance of frontal sinus mucoceles were observed in six out of seven patients – the existence of a previous surgical intervention in two patients, the existence of a previous injury in four, and one patient did not exhibit the existence of predisposing factors. Four out of seven mucoceles were located in the rear segments of the frontal sinus. The destruction of the anterior sinus wall was observed in one patient, while the process propagation toward the endocranium and the orbit was present in three out of the seven patients. Postoperative epistaxis was noted in two out of three patients treated with transfacial approaches. Conclusion. Transcranial and transfacial approaches are treatment methods for advanced mucoceles with a present intraorbital, intracranial, and endonasal process propagation.

The relationship between coronavirus disease 2019 (COVID-19) and myocardial injury was established at the onset of the COVID-19 pandemic. An increase in the incidence of out-of-hospital cardiac arrest was also observed. This case report aims to point to the prothrombotic and proinflammatory nature of coronavirus infection, leading to simultaneous coronary vessel thrombosis and subsequently to out-of-hospital cardiac arrest. During the COVID-19 pandemic, a 46-year-old male patient with no comorbidities suffered out-of-hospital cardiac arrest (OHCA) with ventricular fibrillation as the first recorded rhythm. The applied cardiopulmonary resuscitation (CPR) measures initiated by bystanders and continued by emergency medical service (EMS) resulted in the return of spontaneous circulation. The stabilized patient was transferred to the tertiary university center. Electrocardiogram (ECG) revealed "lambda-like" ST-segment elevation in DI and aVL leads, necessitating an immediate coronary angiography, which demonstrated simultaneous occlusion of the left anterior descending (LAD) and right coronary artery (RCA). Primary percutaneous coronary intervention (PCI) with the implantation of one drug-eluting stent (DES) in LAD and two DES in RCA was done. Due to the presence of cardiogenic shock (SCAI C), an intra-aortic balloon pump (IABP) was implanted during the procedure, and due to the comatose state and shockable cardiac arrest, targeted temperature management was initiated. The baseline chest X-ray revealed bilateral interstitial infiltrates, followed by increased proinflammatory markers and a positive polymerase chain reaction (PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) demasking underlying COVID-19-related pneumonia. Within the following 48 h, the patient was hemodynamically stable, which enabled weaning from IABP and vasopressor discontinuation. However, due to the worsening of COVID-19 pneumonia, prolonged mechanical ventilation, together with antibiotics and other supportive measures, was needed. The applied therapy resulted in clinical improvement, and the patient was extubated and finally discharged on Day 26, with no neurological sequelae and with mildly reduced left ventricle ejection fraction. [ABSTRACT FROM AUTHOR]

Introduction. Mucoepidermoid carcinoma, compared to other tumors of salivary glands, occurs in 5-10% of cases. Histopathologically, it is divided into a well differentiated tumor that is of low-grade of malignancy, and a medium and poorly differentiated tumor of high grade of malignancy. Central mucoepidermoid carcinoma (CMEC) of the mandible was firstly described by Lepp in 1936, on a 66-year-old female patient. CMEC is characterized by atypical clinical image and radiological manifestation. Case Outline. A 55-year-old female patient was examined at the Clinic of Dentistry in Niš, Serbia, with anamnestic data regarding the presence of painless swelling in the right side of the mandible. Considering the histopathological results and presence of enlarged lymph nodes, right hemimandibulectomy and tumour excision from pterygomandibular space followed by supraomohyoid neck dissection was done. In due course, postoperative radiotherapy was applied (60 Gy). Conclusion. CMEC represents a rare tumor, characterized by local tissue destruction and ability to metastasize. Initial biopsy represented the key in preoperative planing. Radical excision with neck lymph node dissection followed by postoperative radiotherapy in our case represent a successful method of treating CMEC of the mandible.

Copyright of Acta Medica Medianae is the property of Acta Medica Medianae and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Stomatologica Naissi is the property of Clinic of Stomatology Nis and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Facultatis Medicae Naissensis is the property of Nis University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Stomatologica Naissi is the property of Clinic of Stomatology Nis and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Stomatologica Naissi is the property of Clinic of Stomatology Nis and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Stomatologica Naissi is the property of Clinic of Stomatology Nis and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fungal unspecific peroxygenases (UPOs, EC 1.11.2.1) are known for their unique biocatalytic properties and have been extensively studied since their discovery more than two decades ago. UPOs have found a wide range of applications in various fields, such as bioremediation, drug metabolism, and synthetic organic chemistry. Nonetheless, the production of UPOs seems limited to fungal expression systems which makes enzyme engineering challenging. It would be attractive to have a peroxygenase available that is easily expressed in a bacterial host. Here, we report on the expression and engineering of a bacterial peroxygenase, tyrosine hydroxylase (TyrH, EC 1.11.2.6). With only two rounds of computer‐aided engineering, we have identified distal and active‐site mutations that improve enzymatic activities and substrate scope, respectively. The combination of these mutations in a single variant led to an effective peroxygenase, capable of indigo production and enantioselective sulfoxidation and which can be overexpressed in Escherichia coli. [ABSTRACT FROM AUTHOR]

Introduction. Some patients with clinical symptoms and signs of acute myocardial and coronary artery occlusion have atypical electrocardiographic presentations - ST elevation myocardial infarction equivalents. Rapid recognition of these patterns is imperative, because the condition requires prompt reperfusion therapy following actual guidelines. De Winter pattern. Diagnostic criteria are: tall, prominent, symmetrical T-waves in the precordial leads, upsloping ST segment depression > 1 mm at the J-point in the precordial leads, absence of ST elevation in the precordial leads, ST segment elevation (0.5 mm - 1 mm) in aVR. ST Elevation in aVR. Electrocardiographic criteria include ST segment elevation in aVR ≥ 1 mm, ST segment elevation in aVR ≥ V1, and diffuse ST segment depression in lateral leads. Wellens syndrome. Wellens syndrome describes deeply inverted or biphasic T-waves in leads V2 - V3, highly specific for significant stenosis of the left anterior descending artery. Posterior infarction. Posterior infarction is confirmed with ST segment depression ≥ 0,5 mm in leads V1 - 3 and ST segment elevation ≥ 0.5 mm in posterior leads (V7 - V9). Conclusion. There are many electrocardiographic patterns that physicians should promptly recognize as clinical myocardial infarction with ST segment elevation equivalents in order to perform urgent reperfusion therapy for better prognosis and survival in these patients. [ABSTRACT FROM AUTHOR]

Introduction. Rapid diagnosis of acute myocardial infarction is essential for proper treatment and reduction of patient mortality. Electrocardiography plays an important role in its diagnosis. Acute myocardial infarction with ST segment elevation requires urgent reperfusion therapy, that is, primary percutaneous coronary revascularization. A small number of patients with acute myocardial infarction have ST segment depression in one or more leads, whereas ST segment elevation in augmented vector right the electrocardiogram is characteristic for a myocardial infarction without ST elevation, but the clinical course and the severity of disease correspond to the anterior myocardial infarction with ST segment elevation. De Winter T-wave electrocardiography. One of these forms is known as de Winter T-wave pattern, characterized by ST segment depression at the J-point (> 1 mm) in the precordial leads, the absence of ST segment elevation in the precordial leads, high peaked and symmetrical T-waves in the precordial leads and, in most cases, mild ST segment elevation (0.5 mm to 1 mm) in the augmented vector right. These patients have occlusion of the left main coronary artery, occlusion of the proximal segment of the anterior descending artery, or a severe multivessel coronary disease. Patients with this electrocardiographic pattern, which is equivalent to acute myocardial infarction with ST segment elevation, require consideration of emergency reperfusion therapy due to high mortality, compared to other patients with acute myocardial infarction without ST elevation. Primary percutaneous intervention is recommended, or if there is no catheterization laboratory nearby, fibrinolytic therapy may be considered. Because of the lack of clear recommendations, treatment decisions are made individually, from case to case. Conclusion. We need large prospective studies with this specific electrocardiographic pattern to provide quick recognition and proper treatment of the anterior myocardial infarction with ST elevation. [ABSTRACT FROM AUTHOR]