Wound Care by Dragica M Smrke
The loss of a tissue is still one of the most challenging problems in healthcare. Efficient labor... more The loss of a tissue is still one of the most challenging problems in healthcare. Efficient laboratory expansion of skin tissue to reproduce the skins barrier function can make the difference between life and death for patients with extensive full-thickness burns, chronic wounds or genetic disorders such as bullous conditions. This engineering has been initiated based on the acute need in the 1980s and today, tissue-engineered skin is the reality. The human skin equivalents are available not only as models for permeation and toxicity screening, but are frequently applied in vivo as clinical skin substitutes. This review aims to introduce the most important recent development in the extensive field of tissue engineering and to describe already approved, commercially available skin substitutes in clinical use.
Cellulose, 2014
In this paper, the use of ultrathin cellulose supports as platform for the incorporation of analg... more In this paper, the use of ultrathin cellulose supports as platform for the incorporation of analgesic drugs in wound 37 dressings is proposed. As a model drug, diclofenac (DCF) is chosen, which is commonly used in pain easing 38 medical treatments. The DCF containing cellulose films are prepared by mixing solutions of trimethylsilyl 39 cellulose (DSSi:2.5) with diclofenac dissolved in THF. After depositing the material on a solid surface by spin-40 coating, the films are subjected to vapor-phase hydrolysis using 3 M HCl in order to achieve regeneration of 41 cellulose. The release of DCF from these films over time is studied by UV-VIS. Upon deposition of additional 42 layers of cellulose that do not contain DCF, the release from these films can be decelerated significantly. The 43 release kinetics from these films is very similar to those of viscose fibers impregnated with DCF solutions. These 44 studies indicate a potential use of cellulose thin films as model platform for viscose based wound dressings.
Papers by Dragica M Smrke
DOAJ (DOAJ: Directory of Open Access Journals), Sep 1, 2002
Background. In the past decade and with increased life expectancy the incidence of wrist fracture... more Background. In the past decade and with increased life expectancy the incidence of wrist fractures has been rising. To improve a quality of treatment of patients with wrist fractures, a protocol specifying the timing and nature of the patient data to be recorded and an appropriate information solution are needed. Methods. The protocol for acquisition of data on patients with fractures of distal radius was based on internationally accepted standards. Computer-based implementation of the protocol used standard approaches for building databases on handhelds. Results. We have developed a protocol for data acquisition from patients with fractures of distal radius. The protocol consists of four follow-ups and includes an initial examination, two control exams and a final examination. The application that supports the protocol was implemented on a handheld computer, so that its practical value and ease of use could have been assessed. Conclusions. The proposed protocol and its handheld-based implementation were already used to acquire the data from more then 100 patients with Colles’ wrist fracture. Only unstable fractures of distal radius with 20 degrees dislocation, potentially including a dorsal fragment, have been considered.
WIT Transactions on Biomedicine and Health, 1970
Some recent advances in object oriented programming techniques and in programming languages in pa... more Some recent advances in object oriented programming techniques and in programming languages in particular, the object oriented programming language Java™ (Sun Microsystems, Inc.) are used to produce a set of objects that comprise the hip-joint geometry (points, axes, profiles, distances, angles), objects that describe the forces and the stress distribution in the hip-joint articular surface (forces, stress), as well as objects that can be manipulated by using Drag and Drop operations in order to simulate changes in the hip-joint geometry (femoral head, femoral neck, greater trochanter and lower part of the femur). Any change in the objects that can be manipulated influences the remaining objects that are currently displayed. Particularly, any change can influence the hip-joint reaction force, and the corresponding contact stress distribution. The changes are estimated automatically by using methods that are attached to the specific objects. Digitized profiles of standard AP radiographs of the hip-joint are used as input to this computer-aided system. A non-homogeneous scaling method that is based on a reference model of the hip musculature, is used to prepare data for each human subject. These data serve as input to a three-dimensional mathematical model of the hip-joint in one-legged stance, which is used to estimate the values of the hip-joint reaction force (R) and its inclination angle (8%). Afterwards, the stress distribution in the hip-joint articular surface is calculated by using a three-dimensional model of the hip-joint articular surface, which takes into account the previously estimated values of R and SR, the femoral head radius (r) and the center-edge angle of Wiberg (8^). The system was applied to 21 male and 79 female radiographs of healthy subjects. The results show that the contact stress in the hip-joint articular surface is significantly greater for females than for males. Because the increased stress in the hip-joint is unfavorable regarding arthrosis development (Hadley et al. [1]), the presented results could partially explain the fact that females have greater incidence of arthrosis in the hip-joint than males. This is related not only to femoral, but also to pelvic geometry.
PubMed, Sep 1, 2007
The distortion of human pelvis X ray scans, due to different scanning positions, can cause huge m... more The distortion of human pelvis X ray scans, due to different scanning positions, can cause huge mistakes in estimation of pelvic diameters. The aim of the study was to quantify distortion of pelvic diameters in relation to scanning inclination angles. Twenty anatomically defined spots on the pelvis of a young male cadaver, freed of soft tissues, were marked with 3 mm metal balls. The digitalized X-ray scans were made with seven different but similar inclination angles, and marked spots were recognized by computer software. Obstetrical-gynecological (Ob-Gyn), horizontal and vertical diameters were measured between marked spots, and percentages of distortion were calculated for each new scanning position. Twenty seven distances on human pelvis from seven X-ray scans varied from -35.9% to 28.3%, on average 0.47%. This study has pointed to a high variation of vertical pelvic dimensions (4.94 +/- 5.73%), consequently making them unreliable in the estimation of general pelvic shape, and low variation of horizontal dimensions (0.92 +/- 0.61%). Generally, the percentage of variation of pelvic dimensions highly increases with inclination angle, in frontal and sagittal plane. Alteration of scanning distance by 4 cm has a weak influence on pelvic diameters. The most reliable Ob-Gyn pelvic diameter was conjugata diagonalis, then diameters obliqua prima and secunda, with an average length deviations of 3.4, 4.0, and 6.0% respectively. The conjugata anatomica was the most unreliable with an average variation of 11.5%.
Radiology and Oncology, Jan 3, 2001
Background. In this work, we describe the computer systems Viprecox and Active Contours that are ... more Background. In this work, we describe the computer systems Viprecox and Active Contours that are used in the process of realistic estimation of some biomechanical parameters of the hip joint, including the maximal value of the stress in the hip joint p max. The computer system Active Contours uses standard anteroposterior radiographs of the whole pelvis and both hips for its calculations and Viprecox in its kernel uses a relatively simple three-dimensional mathematical model of stress distribution in the hip-joint articular surface which has been extensively described elsewhere (e.g. Iglič 1996). Material and methods. Both state-of-the-art computer systems were tested by analysing the calculated values of p max for 81 patients (37 males and 44 females). Conclusions. In this way we prove that the described computer systems can be used for the determination of the contact stress distribution from standard AP radiographs.
PubMed, Dec 1, 2005
The aim of this study is to mathematically approximate the shape of the femoral articulating line... more The aim of this study is to mathematically approximate the shape of the femoral articulating line and compare radiuses of condylar curves within and between males and females. Ten male and ten female participants were included in the study. Radiuses of medial and lateral condylar curves were calculated from the side view knee X-ray by original mathematical equation. Average radiuses of condylar curves were between 4.5 and 1.7 cm medially, and between 3.2 and 1.8 cm laterally, for 0 degrees and 90 degrees flexion contact point respectively. Males had longer curve radiuses of both condyles (p < 0.05). Differences turned out to be statistically insignificant after adjusting to body height. Even small changes in the joint geometry during lifetime could make a joint susceptible to osteoarthritis or injuries. Approximation of the radiuses of femoral condyle curves is a useful method in anthropometric, radiological and virtual calculations of the knee geometry, and other ellipsoidal structures in human body, like wrist, scull segments, dental arches, etc.
Archives of Orthopaedic and Trauma Surgery, Apr 25, 2000
Some functional parameters of the hip-joint 3.3 years on average (range 2-8.6 years) after hip ar... more Some functional parameters of the hip-joint 3.3 years on average (range 2-8.6 years) after hip arthroplasty are compared with regard to two types of hip endoprostheses: the total (TEP) and the bipolar (BPEP). Flexion, extension, abduction, adduction, and internal and external rotation were measured for 75 patients with BPEP type Self-Locking, for 11 patients with BPEP type Vario-Cup, and for 43 with TEP type Lubinus. One-way analysis of variance with respect to co-variances was used for statistical testing of the measured data. It was found that flexion, abduction and adduction were significantly higher in the BPEP endoprosthesis (P &lt; 0.05). The results obtained are favourable for the bipolar hip endoprosthesis, and they can be related to the biomechanical differences between both types of hip endoprosthesis.
Journal of Tissue Science and Engineering, Nov 30, 2017
ISBS - Conference Proceedings Archive, 1998
Slovenian Medical Journal, Oct 6, 2015
Unfallchirurg, Mar 1, 2000
Zusammenfassung Die Autoren untersuchten 500 Femurschaftfrakturen, die vom 01.01.1992 bis zum 3... more Zusammenfassung Die Autoren untersuchten 500 Femurschaftfrakturen, die vom 01.01.1992 bis zum 31.12.1996 an der Traumatologischen Klinik in Ljubljana unter Verwendung von Osteosyntheseplatten und Schrauben behandelt wurden. Die behandelten Patienten waren überwiegend männlichen Geschlechts (70,6%) mit einem Durchschnittsalter von 36,6 Jahren und wurden größtenteils bei Verkehrsunfällen verletzt. Bei 50% der Patienten wurde eine Einzelfraktur festgestellt, die verbleibenden Patienten hatten entweder Begleitverletzungen
Journal of clinical & experimental dermatology research, 2016
Clinical research on foot & ankle, 2016
Background: Bladder carcinoma with distal bone metastasis is rare. Treatment should be multidisci... more Background: Bladder carcinoma with distal bone metastasis is rare. Treatment should be multidisciplinary, including pain relief, treatment of threatening (or) pathological fractures, and oncologic therapy for bladder cancer. Case report: A 52-year-old male patient with bladder cancer reported having pain in the right foot and ankle. Xray and CT revealed multiple bone metastases of bladder cancer to the right foot and ankle, causing pathological fractures. The patient refused proposed below-knee amputation, therefore, preservative surgery with metastasectomy of larger metastases in the foot and ankle, and distal fibulaectomy were performed. To fulfill the defects in the foot, bone guided regeneration with equine xenograft bone block and collagen membrane was performed and additionally stabilized with osteosynthetic material. Two months after surgery, the bone graft was incorporated into the bone and the patient was capable of weight bearing, pain-free, and able to continue with chemotherapy and radiation therapy. Despite the therapy, the patient died of embolism due to metastasis 6 months following the foot operation. Discussion: The aim of our case report is to show that amputation is not the only method of treatment for patients with multiple metastases of the foot and ankle. Alternatively, bone-guided regeneration with xenograft can be successfully performed also in such patients. Rehabilitation following bone-guided regeneration is shorter compared to amputation, and also enables a better quality of life.
PubMed, 2006
Osteosinthesis of femoral neck fractures achieves higher stability of fragments but additionally ... more Osteosinthesis of femoral neck fractures achieves higher stability of fragments but additionally destroys weak vascular elements of femoral neck. Aim of this study is to analyze relation between different treatment options of impacted femoral neck fracture and avascular necrosis of femoral head. In retrospective analysis we have retrieved data from 1632 patients who were treated at the Department for traumatology, Clinical center Ljubljana in period Jan/87 - Dec/01. Impacted femoral neck fracture was found in 365 patients (22.4%). We have selected only patients with follow up period longer then half year and finally there were only 94 patients included in study. Analyzing incidence of avascular necrosis, dislocation of fragments, and pseudoarthrosis in non-operatively and surgically treated groups of patients by lambda2 (0.305), we have concluded that there is no relation between avascular necrosis and way of treatment of impacted femoral neck fracture.
Acta medica Croatica : c̆asopis Hravatske akademije medicinskih znanosti, Jul 1, 2008
The percentage of elderly people increases in societies today and so does the number of specific ... more The percentage of elderly people increases in societies today and so does the number of specific conditions, illnesses and injuries, with hip fracture as the most important one. The aim of the study was to point to hip fracture as a medical and social problem by objectively quantifying functional abilities of geriatric patients after hip fracture. The study included 414 (63 male and 351 female) with femoral neck fracture and hip endoprosthesis implanted at University Department of Traumatology in Ljubljana during the 1988-2004 period. Data on sex distribution, concomitant diseases, complications, estimation of functionality before injury, and dynamic and final level of functional recovery were collected. The patient mean age was 77 +/- 7.3 (range 28-96) years. Excellent mobility before injury, according to personal report, was recorded in 322 (77.78%), good mobility in 78 (18.84%) and poor mobility in only 14 (3.38%) patients. The mean dynamics of functional recovery was as follows: independent sitting at 2 days, standing at 3.6 days, and walking at 7 days of the surgery. At the end of rehabilitation, an average patient felt periodic pain that did not affect his/her activities, could walk without problems at least one kilometer, limped to a certain degree, used a cane, could climb stairs holding a handrail, sat in the chair for a long time, put on shoes and socks with minor difficulties, used public transportation and had no significant deformity of the hip. With that level of functionality, our patients were independent in daily activities, able to stay socially integrated, and other people&amp;amp;amp;amp;amp;amp;#39;s help was reduced to the minimum. The patient&amp;amp;amp;amp;amp;amp;#39;s functionality before injury, the duration and quality of rehabilitation after surgery, and the patient&amp;amp;amp;amp;amp;amp;#39;s motivation and cooperation during rehabilitation are the key factors of patient recovery to the pre-injury state. In spite of numerous concomitant diseases, reduced psychophysical abilities of the elderly and medical difficulties in the management of these injuries, such treatment of hip fractures is necessary and human for patients and time-consuming for medical staff, yet being the most profitable option for the society. Hip fracture and consequential disablement cause a double problem. On the one hand, it entails dependence on other person, family or social institution, or society in general, and on the other hand there is mental frustration, especially if he/she is psychically instable. Quite frequently, disabled persons have psychical traumas that have unfavorable impact on their families. It is additionally complicated in societies that tend to stigmatization of disabled persons. Therefore, it is very important how the society will behave toward disabled elderly who are generally more vulnerable.
Zeitschrift Fur Orthopadie Und Unfallchirurgie, Mar 4, 2009
The aim of this study was to estimate the influence of concomitant diseases and the cooperation o... more The aim of this study was to estimate the influence of concomitant diseases and the cooperation of patients on the duration of rehabilitation after femoral neck fractures. This study reviewed 493 patients with dislocated femoral neck fracture treated with hip endoprostheses. The duration of hospitalisation and rehabilitation periods were significantly shorter (p = 0.0001) for patients with high cooperation and motivation. Pulmonary diseases led to a significantly prolonged rehabilitation process (p &lt; or = 0.05). Other comorbidities like diabetes mellitus, cardiovascular diseases or concomitant neurological diseases did not have a significant influence on the duration of the rehabilitation process (p &gt; or = 0.05). Our results suggest that less cooperative patients and patients with pulmonary diseases have to be supported psychologically to improve the cooperation and to avoid long-lasting rehabilitation. Perioperatively, we recommend an optimizing treatment of chronic obstructive pulmonary diseases by a specialist.
InTech eBooks, Nov 21, 2011
Slovenian Medical Journal, Jan 20, 2019
Amnijska membrana (AM) je notranja stran posteljice, ki obdaja in ščiti plod. AM je sestavljena i... more Amnijska membrana (AM) je notranja stran posteljice, ki obdaja in ščiti plod. AM je sestavljena iz večplastne strukture, ki jo gradijo amnijske epitelne celice, amnijske mezenhimske stromalne celice, bazalna lamina in vezivno tkivo. Iz njene zgradbe izhajajo tudi lastnosti AM, zaradi katerih se že vrsto let uporablja v terapevtske namene, predvsem v oftalmologiji, saj pospešuje epitelizacijo, deluje kot substrat za celice, zmanjšuje fibrozo in neovaskularizacijo tkiva ter deluje protimikrobno. Zaradi mehanskih lastnosti AM, ki so posledica predvsem molekul zunajceličnega matriksa bazalne lamine in vezivnega tkiva ter različnih rastnih dejavnikov, ki jih vsebuje, se AM v zadnjih letih vedno pogosteje uporablja tudi kot biološki nosilec v regenerativni medicini. Regenerativna medicina je interdisciplinarno področje raziskovanja in kliničnih aplikacij, ki uporablja načela bioloških in inženirskih znanosti za razvoj nadomestkov živih tkiv ali organov. V regenerativni medicini ločimo tri pristope: 1. vsaditev funkcionalnih celic, med drugim tudi matičnih celic, v poškodovano ali okvarjeno tkivo; 2. preoblikovanje poškodovanega ali okvarjenega tkiva z uporabo različnih sintetičnih ali naravnih materialov; 3. tkivno inženirstvo, tj. uporabo ustreznih nosilcev, ki spodbujajo rast tkivno specifičnih celic in oblikovanje novega tkiva. V prispevku predstavljamo uporabo AM kot biološkega nosilca v regenerativni medicini v Sloveniji.
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Wound Care by Dragica M Smrke
Papers by Dragica M Smrke