Zdravkovski, Panche

Preferred name

Zdravkovski, Panche

Official Name

Zdravkovski, Panche

Main Affiliation

panche.zdravkovski@medf.ukim.edu.mk

Now showing 1 - 10 of 54

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Focal Segmental Glomerulosclerosis and Collapsing Glomerulopathy after Covid 19 Infection
(Macedonian Society of Nephrology, Dialysis, Transplantation and Artifical Organs, Department of Nephrology, 2021)
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Focal segmental glomerulosclerosis (FSGS) is defined as an increase in the mesangial matrix in some glomeruli with obliteration of capillary lumens, sclerosis, hyalinosis, foam cells, and adhesions to the Bowman’s capsule. Collapsing glomerulopathy is a morphologic variant of focal segmental glomerulosclerosis (FSGS) characterized by segmental and global collapse of the glomerular capillaries, marked hypertrophy and hyperplasia of podocytes, and severe tubulointerstitial disease. Actually secondary collapsing glomerulopathy is a heterogeneous group including numerous causes: viruses, toxins and drugs such as heroin and pamidronate
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Role of the radiological variables, clinical picture and values of C-reactive protein (CRP) and leukocytes in the brain edema development and eary intrahospital mortality in patients with hemorrhagic cerebrovascular insult
(Macedonian Association of Physiologists and Antropologists, 2020)
Mihajlovska Rendevska, A
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Aleksovski, B
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Aleksovski, V
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Stojanov, D
Introduction: The development of brain edema is one of the key factors that cause early neurological deterioration in patients with hemorrhagic cerebrovascular insult (H-CVI). In this study we analyzed the impact of: radiological variables (initial volume and volume of the 5th day of the intracerebral hematoma (IH), clinical state at admission (scored on appropriate scale), as well as nonspecific inflammatory markers (leukocyte count and C-reactive protein - CRP). on the development of brain edema and early in-hospital mortality, in patients with H-CVI. Material and methods: 26 conservatively treated patients with acute spontaneous intracerebral haemorrhage treated at the University Clinics of Neurosurgery and Neurology in Skopje. Computed tomography (CT) was used to evaluate radiological variables, the Canadian Stroke Scale (CSS) for neurological status scoring, as well as biochemical analysis of blood taken in the first 24 hours, to measure leukocyte counts and CRP level. Results: 8 of 26 patients (30.8%) were with lethal outcome. Initial volume of IH had the strongest effect on the development of perifocal edema, with less impact but statistically significant were: clinical status on admission and age of the patients. The strongest effect on early in-hospital mortality had all radiological variables (hematoma volume at admission and after 5 days, as well as volume of perifocal edema measured after 5 days).
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Comparative biodistribution studies of technetium-99 m radiolabeled amphiphilic nanoparticles using three different reducing agents during the labeling procedure
(Wiley, 2013-12)
Geskovski, Nikola
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Simonoska Crcarevska, Maja
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Calis, Sema
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Dimchevska, Simona
Considering the confusing biodistribution data through the literature and few reported alerts as well as our preliminary biodistribution results, we decided to evaluate the interaction and interference of the commonly present (99m) Tc (technetium-99m)-stannic oxide colloid during the direct stannous chloride (99m) Tc-labeling procedure and to assess its influence on the biodistribution pattern of amphiphilic poly(lactic-co-glycolic acid) nanoparticles. In order to confirm our thesis, beside stannous chloride, we employed two different reducing agents that don't form colloidal particles. The use of sodium borohydride was previously reported in the literature, whereas sodium dithionite was adapted for the first time in the (99m) Tc direct labeling procedure for nanoparticles. The results in our paper clearly differentiate among samples with and without colloidal impurities originating from the labeling procedure with a logical follow up of the radiochemical, physicochemical evaluation, and biodistribution studies clarifying previously reported data on stannic oxide colloidal interference. (99m) Tc-nanoparticle complex labeled with sodium dithionite as reducing agent illustrated appropriate labeling efficacy, stability, and potential for further use in biodistribution studies thus providing solution for the problem of low-complex stability when sodium borohydride is used and colloidal stannic oxide interference for stannous chloride procedure.
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Ultrastructural abnormalities essential for diagnosis of Tufting Enteropathy
(Springer, 2015-09)
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Domazetovski, I
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Objective: Tufting enteropathy (intestinal epithelial dysplasia) is a rare congenital enteropathy related to severe intractable diarrhea with early onset due to specific abnormalities of the intestinal epithelium. We report a case with distinguished ultrastructural characteristics. Method: Four-month old male infant was admitted in Pediatric Clinic because of protracted watery diarrhea in a period of 3 weeks and failure to thrive. After thorough clinical and laboratory examination, duodenoscopy was done. Biopsy specimens were fixated in glutaraldehyde and embedded in Durcupan resin. Semi-thin sections dyed with Toluidine Blue and ultra-thin sections treated with Uranyl Acetate and Lead Citrate were made. Results: Light-microscopic analysis shows small intestinal mucosa with variable abnormalities of villous projections, which were flattened in parts. Focally, there was evident crowding of surface enterocytes, disorganization and focal forming of tear-shaped tufts. There was low mononuclear cell infiltration in lamina propria. Electron-microscopic analysis shows reduced number of microvilli of surface enterocytes, with structural disorganization, represented by desmosomes increased in number and length. There was evident tufts formation with disruption of brush border in their vicinity, whereas basement membrane was stratified and laminated. Conclusion: Tufting enteropathy is a rare genetic disease for which transmission electron microscopy is a superior diagnostic tool.
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Colorectal adenocarcinoma with heterotopic bone.
(Springer, 2015-09)
Gjorgjievska, A
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Objective: Heterotopic bone is rarely found in colorectal carcinoma with low incidence of 0,4 %. We report a case of a 75-years old male presenting with constipation, vomiting and abdominal, i.e. acute abdomen, due to large bowel obstruction. He underwent urgent surgical operation. Method: The received material was a total colectomy with egsophytic tumour in the sigmoid colon, measuring 4 cm in length, with proximal dilatation of 16 cm in diameter. Standard tissue samples were embedded in paraffin blocks and Hematoxylin-Eosin and imunohistochemical stainings were made. Results: Histological analysis showed poorly differentiated adenocarcinoma Stage IVA. We found abundant desmoplastic stroma, partly hyalinised, with deposition of osteoid and focal formation of well-defined osseous islands of various shapes and sizes, with evident osteoblasts arranged as osteoplasts, with focally formed Haversian canals. Immunohistochemical staining showed CK18(+), Vimentin(-) signal for tumour cells, and Vimentin(+) signal for the osteoid, Osteopontin(+) signal for osteoblasts and osteoid. Conclusion: Pathogenesis is unclear, but there are theories describing fibroblast metaplasia into osteoblasts or production of BMP-2 and FGF-2 by tumour cells, inducing bone formation. The finding of osseous metaplasia in colorectal carcinoma does not change the prognosis, although is very important to differentiate this entity from carcinosarcoma, that have poor prognosis.
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Effect of bladder cancer variant histology on survival outcome in patients treated with radical cystectomy: A single-centre experience
(Wolters Kluwer - Medknow, 2021-07)
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Context: Bladder cancer (BC) is the sixth most common malignant neoplasm in men. Recently, great effort has been devoted to the study of BC variant histology (VH). Yet, the results from these studies have shown conflicting data and remain unclear whether their presence alters recurrence and survival rates after radical cystectomy (RC). Aims: We undertook this study aiming to test the effect on VH on recurrence-free survival (RFS) and overall survival (OS) in single-center RC patients. Settings and Design: We have retrospectively analyzed medical records and pathology reports from 331 patients who underwent RC with or without pelvic lymphadenectomy at University Urology Clinic-Skopje, North Macedonia, in the period between 2010 and 2018. Subjects and Methods: Microscopic analysis of the specimens involved the evaluation of histological tumor type, tumor grade, pathological tumor node metastasis stage, presence of lymphovascular invasion, and resection margin status. Statistical Analysis Used: Univariable and multivariable Cox regression models were applied to test the effect of VH on RFS and OS. Results: We found 185 patients who matched our inclusion criteria. At multivariable analyses, lymphovascular invasion and positive resection margins were associated with shorter RFS. Similarly, patients diagnosed with lymphovascular invasion, positive resection margins, and a pelvic lymph node metastasis had poorer OS. VH was not found to be an independent predictor of both RFS and OS (P > 0.05). Conclusions: The present study did not reveal prognostic effect of VH on RFS and OS. In our series, histomorphologic parameters including lymphovascular invasion, resection margins, and pelvic lymph node metastasis were the most relevant predictors on survival outcome after RC.
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Measurement-oriented deep-learning workflow for improved segmentation of myelin and axons in high-resolution images of human cerebral white matter
(Elsevier BV, 2019-10)
Janjic, Predrag
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Petrovski, Kristijan
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Dolgoski, Blagoja
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Smiley, John
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Background: Standard segmentation of high-contrast electron micrographs (EM) identifies myelin accurately but does not translate easily into measurements of individual axons and their myelin, even in cross-sections of parallel fibers. We describe automated segmentation and measurement of each myelinated axon and its sheath in EMs of arbitrarily oriented human white matter from autopsies. New methods: Preliminary segmentation of myelin, axons and background by machine learning, using selected filters, precedes automated correction of systematic errors. Final segmentation is done by a deep neural network (DNN). Automated measurement of each putative fiber rejects measures encountering pre-defined artifacts and excludes fibers failing to satisfy pre-defined conditions. Results: Improved segmentation of three sets of 30 annotated images each (two sets from human prefrontal white matter and one from human optic nerve) is achieved with a DNN trained only with a subset of the first set from prefrontal white matter. Total number of myelinated axons identified by the DNN differed from expert segmentation by 0.2%, 2.9%, and -5.1%, respectively. G-ratios differed by 2.96%, 0.74% and 2.83%. Intraclass correlation coefficients between DNN and annotated segmentation were mostly>0.9, indicating nearly interchangeable performance. Comparison with existing method(s): Measurement-oriented studies of arbitrarily oriented fibers from central white matter are rare. Published methods are typically applied to cross-sections of fascicles and measure aggregated areas of myelin sheaths and axons, allowing estimation only of average g-ratio. Conclusions: Automated segmentation and measurement of axons and myelin is complex. We report a feasible approach that has so far proven comparable to manual segmentation.
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Serous adenocarcinoma of the fallopian tube: a case report
(Macedonian Association of Pathology, 2016-09)
Trajkovska, Elizabeta
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Objective: Primary serous adenocarcinoma of the fallopian tube (PSAFT) is a rare tumor which histologically and clinically resembles epithelial ovarian cancers. Although it has been postulated that both ovarian and tubal high-grade serous carcinomas actually share common histogenesis, PSAFT has a worse prognosis than ovarian cancer. We report a case of PSAFT that presented clinically as hydrosalpinx. Material and Methods: A 62-year-old patient with complaints of a low abdominal pain and vaginal discharge was admitted at the gynecological department. During the diagnostic procedure, the ultrasound examination revealed uterine fibroid and a right-sided hydrosalpinx. The patient underwent hysterectomy with bilateral adnexectomy. Due to the clinical assessment of benign disease, no tumor markers were required preoperatively, nor biopsy from the omentum and parietal peritoneum, as well as peritoneal washing, were obtained intraoperatively. The operative material was routinely dissected and a standard procedure for histology and immunohistochemistry was performed. Results: The right tube was tortuous, 17 cm in length, having 5 cm long dilatation in the proximal third. In the dilated part, few exophytic, neoplastic, white-grayish soft lesions were found. The histopathologic examination revealed areas of in situ as well as high-grade PSAFT with lamina propria involvement. The malignant cells were positive for CK7 and WT1. The tumor did not infiltrate the muscle layer, so it was defined as FIGO stage IA. The leiomyoma previously diagnosed by ultrasound was histologically confirmed, while the left adnexa and right ovary revealed regular morphology and were free of tumor. Two months after the operation the patient is in good health and diseasefree. Conclusions: PSAFT should be distinguished as a different clinical entity from primary ovarian epithelial neoplasms so that the patient could receive adequate therapy and follow-up.
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Metastatic ductal breast carcinoma in meningioma: A case report
(Springer, 2017-09)
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Noveska Petrovska, B
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Kocmanovska Petreska, S
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Stojkovski, V
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Objective: Meningiomas and breast cancers statistically are very common tumours among women. However, metastasis from breast carcinoma into an intracranial meningioma is extremely rare. We present a case of 66-years-old female patient diagnosed with breast tumour on physical exam 2 years prior, but refusing further treatment at that time. Method: After incidental fall from height the patient was admitted with vertigo and headaches. CT and MRI was performed which revealed temporoparietal extra-axial brain tumour measuring 7,4x6,3x4,8 cm and small diffuse post-contrast lesions suspicious for sarcoidosis. Surgery with fragmented excision and brain biopsy was performed. Gross examination showed hard white tumour parts with uniform cut surface. Standard procedure for histology and immunohistochemistry was made. Results: Microscopically the tumour was composed of spindle-shaped fibroblastoid cells with small areas of edema. On one sample from totally fifteen taken and on the samples from the brain biopsy, micro-metastatic foci resembling ductal breast carcinoma were detected. Immunohistochemical positivity for CK7, E-cadherin, ER, PR and strong HER with high Ki-67, confirmed the diagnosis. Conclusion: Tissue sampling plays great role in macroscopically undetectable lesions and patients without desire for cooperation. It is important to avoid overlooking the diagnosis of metastatic disease, taking into consideration the requirements for specific treatment strategy.
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Craniopharyngiomas: A 20-Year-Period Evaluative Single Center Study
(Scholars.Direct, 2021-06-21)
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Cvetkovski, Petar
Introduction: Craniopharyngioma is a rare histologically benign brain tumor with potential malignant clinical course because of the high propensity of recurrence, deriving from the remnants of Ratkhe’s pouch, presenting as solid mass and partly as fluid-filled cyst. There are two main histological subtypes: adamantinomatous and papillary. The aim of this study is to evaluate statistical features of this tumor in the Republic of North Macedonia. Materials and Methods: This is a 20-year-period retrospective, single center evaluative study (1998-2018) of 40 craniopharyngioma cases operated in the University Clinic of Neurosurgery, diagnosed at the Institute of Pathology, Medical Faculty, University ‘’Ss. Cyril and Methodius’’ in Skopje, Republic of North Macedonia on paraffin section slides routinely stained with H&E. Statistica for Windows 7 was used. Results: From total 4929 cases of benign and malignant brain tumors, craniopharyngioma comprise 40 cases (0.81%); 25 (62.5%) males (37.9 ± 17.8 years), 15 (37.5%) females (34.0 ± 25.4 years), age 3 to 68 years; Most prevalent localization: Sellar region - 11 (27.5%), cerebrum - 8 (20%). Adamantinomatous - 27 (67.5%) cases, papillary 13 (32.5%) cases. Age group distribution: the most cases - 7 (17.5%) in 0-9, 40-49, 60-69 years groups; least cases - 3 (7.5%) in 20-29 years group. Nine (22.5%) of 40 patients have had recurrent tumor (first 1-3 years). Adamantinomatous was diagnosed in 14 (51.85%) males and 13 (48.15%) females; Papillary in 11 (84.62%) males and 2 (15.38%) females. There is significant statistical difference between age groups and craniopharyngioma subtypes (Kruskal-Wallis ANOVA: H = 14.86; p = 0.0274). Conclusion: We found association/correlation between gender, age and histological subtype. Papillary craniopharyngioma appears more frequently in males and adamantinomatous was most prevalent in younger patients.

Zdravkovski, Panche

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