Detection of CYP2D6*3 and 2D6*4 allelic variants by PCR-restriction fragment length polymorphism

The mutant of CYP2D6*3 allele with A2637 deletion in exon 5 and the mutant of CYP2D6*4 allele G1934-->A, splice site defect are among the most common polymorphic alleles of CYP2D6 gene, resulting in a decreased or no activity of CYP isoenzyme. In this study, a reliable polymerase chain reaction-restriction fragment length polymorphism method for identification of CYP2D6*3 and CYP2D6*4 alleles was used to investigate the genotype and phenotype prevalence in the groups of normal controls, and of cirrhosis and cancer patients. The results showed none of 36 controls genotyped for 2D6*3 and 2D6*4 allele to have the 2D6*3 allele with frameshift mutation in exon 5, while 33% (n=12) were found to bear the 2D6*4 allele with G to A mutation at the intron 3-exon 4 junction. In breast cancer patients (n=35) genotyped for 2D6*3 and 2D6*4 alleles, none with 2D6*3 allele was found either, but 60% (n=18) were found to bear the 2D6*4 allele. In patients with head and neck squamous cell cancer, there was only one subject with 2D6*3 allele and he was heterozygous. Among them, as many as ten (40%) patients were found to bear 2D6*4 allele. In the cirrhosis group, none of the patients was found to have the 2D6*3 allele, while the CYP2D6*4 allele was found in 23% (n=6) patients. The phenotype predicted according to the genotype was as follows: in the control group, 3% of individuals were identified as poor metabolizers, 70% as extensive metabolizers, and 27% as heterozygote extensive metabolizers. In the group of breast cancer, 7% of the patients were identified as poor metabolizer, 57% as extensive metabolizer and 36% as phenotype. In squamous cell cancer and cirrhosis patients, the incidence of poor metabolizer was zero, and of heterozygotes extensive metabolizer 42% and 31%, respectively.

[Pneumatization of the middle nasal turbinate: a CT study]

Anatomic variations of the middle turbinate may be an important factor in the pathogenesis of inflammatory processes of the paranasal sinuses. A detailed analysis of coronal and axial plane CT scans of the paranasal sinuses obtained from 120 patients was performed. Paradoxical curve of the middle concha was detected in 24.2% of patients. Pneumatized middle turbinate was found in 42.5% and "true" concha bullosa in 8.3% of patients. Bilateral concha bullosa was found in 1.7% of patients.

Influence of pyridine and urea on the rat brain ATPase activity

The neurotoxicity of pyridine and urea was investigated in respect to their ability to alter the activity of synaptosomal membrane Na+/K(+)-ATPase and Mg(2+)-ATPase. In vitro treatment with pyridine and urea stimulated Na+/K(+)-ATPase activity in a dose-dependent manner up to 40% and 60%, respectively. Mg(2+)-ATPase activity increased up to 40% after pyridine treatment, while urea had no effect at all. The neuroactive potencies of pyridine and urea were evaluated by estimating parameters Km and delta Vmax for enzyme stimulation, as well as Hill coefficient to estimate the levels of cooperativity for pyridine and urea binding. The results suggest that pyridine stimulates both enzymes, probably by interacting with some neuronal membrane components, and altering the lipid micro-environment of the ATPases. In contrast, urea stimulates the Na+/K(+)-ATPase only, assumingly by acting on it directly or via some other regulatory mechanism. Stimulation of Na+/K(+)-ATPase and Mg(2+)-ATPase by the substances tested and subsequent alteration of neuronal cell functioning could contribute to the CNS dysfunction upon chronic exposure to pyridine and urea.

[Goals and scientific achievements of the Institute of Oncology]

The Institute of oncology represents an oncological center which renders the measures of prevention, early detection and diagnostic of tumours and multidisciplinary strategy for antitumour treatment, including rehabilitation of patients suffering from tumours. To fulfil the above mentioned aims the Institute is organized in ten completely operative units and several functional centres and committees. The paper presents only few aspects of diagnostic and treatment of tumour, and the implementation of the programmes and targets of individual organizational units within the Institute. This orientation is particularly actual now when epidemiological studies show an increase of disease and mortality incidence in the region of Vojvodina.

Recurrent hemolytic uremic syndrome with hypocomplementemia and intestinal lymphangiectasia

A 23-year old male patient had eight distinct episodes of hemolytic uremic syndrome (HUS) between 8.5 and 15 years of age, five of them accompanied by hypocomplementemia. In the further course, severe hypertension, renal insufficiency as well as protein-losing enteropathy due to intestinal lymphangiectasia developed, whilst hypocomplementemia persisted. The association of recurrent HUS with hypocomplementemia and intestinal lymphangiectasia may represent a new association within a subgroup of the atypical HUS.

[Characteristics of skulls of ancient skeletons from the province of Xinjiang in China]

INTRODUCTION

On available anthropological material of seven skulls that dates back to the 3800 B.P. to the 2000 B.P., taken from various archaeological sites of Xinjiang area in China, the racial characteristics were studied. The investigated skulls are part of the collection of the prehistoric skeletons housed at the Institute of Archaeology in Beijing.

METHOD

Anthropological examination comprised measuring of 32 cranial diameters and calculation of 18 cranial indices, and morphological analyses of 26 traits of the skull and 36 epigenetic characteristics.

RESULTS

Three skulls were excavated in Hejing cemetery dated in 1800 years B.P. The skulls are mesocranic, acrocranic and metriocranic (Tab. 1) with outstanding occipital tori and flattening in the lambdoid region (Tab. 2). The orbits are quadrangular, glabella is small with sharp supraorbital margin, the palate is narrow, the mandible is gracile. The fourth skull was excavated in Alagou cemetery from about 2700-2000 years B.P. The skull also possesses western racial characteristics similar to the East Mediterranean type. The fifth skull is from Zhaosu cemetery dated in about 2400-1800 years B.P. The skull is mesocranic with the high cranial vault, broad forehead and quadrangular orbits. The sixth and seventh skulls belonged to the Pfoto-European type. They are excavated in the Gumogou cemetery (about 3800 years B.P.) and in Quinghai region. Among the studied skulls there was no case showing Mongoloid characteristics. Data concerning the epigenetic characteristics (Tab. 3) suggest differences in frequency of certain traits (Os Japonicum, torus palatinus, processus paracondylaris, foramen spinosum bridging) found in investigated material in comparison with findings in other European populations.

DISCUSSION

On the basis of the obtained results and investigations of Chinese scientists, it can be concluded that Western racial elements with primitive morphological characteristics had entered from Central Asia into Xinjiang area at least by the early Bronze Age. Other racial elements close to that of the East Mediterranean entered into the western part of Xinjiang several centuries B.C.E. Mongoloid racial elements have not been found in our material. Only about 10 percent among 274 crania investigated by Chinese anthropologists were described as Mongoloid in morphology. The late emergence of the East Mongoloid population, about 300 years B.P. that appeared in small groups, contributes to the conclusion that eastward movement of the Western race to Xinjiang was more rapid than the westward movement of Mongoloid people in that period.

[Shunt nephritis. 2 case reports and a review of the literature]

Two cases of glomerulonephritis associated with colonization of cerebrospinal fluid shunts inserted for the treatment of hydrocephalus (shunt nephritis) are described and additional 113 cases reported in world literature, are reviewed. Both of our patients were affected by two episodes of shunt nephritis. Complete clinical remission of renal disease followed antibiotic treatment in one patient, and shunt replacement combined with antibiotic therapy in the other. In the 115 cases of shunt nephritis reported to date, the causative organisms, clinical features, pathogenesis, renal histology, treatment, and outcome are discussed in detail. The importance of regular observation for early recognition of this reversible form of glomerulonephritis, is emphasized.

[Belgrade and Hantaan hantaviruses--the causative agents of haemorrhagic fever with renal syndrome in children in Serbia]

During an outbreak of haemorrhagic fever with renal syndrome (HFRS) in 1989, five children (3 girls, 2 boys, aged 6.8-16 years) with severe clinical form of the disease, were treated at the Institute of Mother and Child Health of Serbia; four of them were followed-up 22-28 months thereafter. The main clinical features were: fever, headache, myalgia, abdominal and back pains, and vomiting in all, and haemorrhagic syndrome in three; renal syndrome with severe acute renal failure in all five patients. All the patients recovered. Serological confirmation by an indirect immunofluorescence assay, enzyme immunoassay for IgM antibodies, and by plaque reduction neutralization test revealed that the infection was caused by Belgrade virus in three, and by Hantaan virus in two patients. It was not possible to differentiate these two serogroups on the basis of clinical features. This finding gave further evidence of circulation of different hantaviruses causing severe HFRS in Serbia.

[Acute tubulointerstitial nephritis with uveitis]

Clinical features and natural course of acute tubulointerstial nephritis and uveitis (TINU syndrome) in five adolescent patients (3 girls and 2 boys), are presented. Initial nonspecific symptoms preceding nephropathy were anorexia, weight loss, fever and malaise. Inflammatory syndrome consisted of increased ESR, high plasma proteins and gamma globulins. Analysis of urine showed proteinuria and sterile leukocyturia. Laboratory features of tubular dysfunction and decreased GFR were found in all patients. Renal biopsy, which was performed in 2 pts, revealed acute interstitial nephritis. Anterior uveitis which appeared later, was successfully treated with topical steroids. Renal function completely recovered within a few month in four pts and markedly improved in one. Despite the fact that renal biopsy was not performed in all children, the combination of an acute nonoliguric renal failure without hypertension and signs of tubular dysfunction together with particular benign course, suggested acute idiopathic TINU syndrome.

Asymmetrical modulation of immune reactivity in left- and right-biased rats after ipsilateral ablation of the prefrontal, parietal and occipital brain neocortex

We report here on the lateralized brain immunomodulation in male Wistar rats, a phenomenon related to the rotational bias of animal and the site of cortical lesion. Rats assigned to left- and right-rotators in a cylindrical Plexiglass rotometer were subjected to the ablation of the ipsilateral prefrontal cortex (PFC), parietal cortex (PC) and occipital cortex (OC) and sensitized with bovine serum albumin (BSA) in complete Freund's adjuvant. Intact and sham-lesioned left-biased animals demonstrated increased Arthus and delayed hypersensitivity skin reactions and antibody production to BSA in comparison with corresponding right-biased animals. PFC ablation decreased humoral and cellular immune responses to BSA in left- but increased in right-biased rats. Lesioning of PC decreased humoral immune reactions in left- but increased in right-rotating animals. OC ablation failed to produce immunological abnormalities. These results suggest that immunopotentiation is associated with the left neocortex, and immunosuppression with the right neocortex. The prefrontal cortex appears to be particularly associated with immune reactions.

Belgrade and Hantaan hantaviruses--the causative agents of severe haemorrhagic fever with renal syndrome in children in Serbia

During an outbreak of haemorrhagic fever with renal syndrome (HFRS) in 1989, five children (3 girls, 2 boys, aged 6.8-16 years) with a severe form of the disease were treated; four of these were followed for 22-28 months. The main clinical features in all five patients were: fever, headache, myalgia, abdominal and back pain and vomiting; haemorrhagic syndrome was present in four children. Renal syndrome presented with severe acute renal failure in all five patients. All patients recovered. Serological confirmation by an indirect immunofluorescence assay, by enzyme immunoassay for IgM antibodies and by plaque reduction neutralization test showed infection by Belgrade virus in three and by Hantaan virus in two patients. It was not possible to differentiate these two serogroups on the basis of clinical features. This study provides further information on the circulation of different hantaviruses causing severe HFRS in Serbia.

[Lupus nephritis in children and adolescents (Part II: Prognosis)]

In 27 children and adolescents (24 females, 3 males suffering from lupus nephritis the important role of renal pathohistologic changes in the evolution and outcome of the disease was analysed, and a five-year survival rate was calculated. The mean age at the onset of the disease was 12.1 +/- 1.9 (range: 0.7-0) years, the mean interval from onset to renal biopsy was 2.1 +/- 1.9 (0.1 - 7.0) years, ant the mean follow-up was 4.1 +/- 2.1 (1-8) years. The pathohistologic changes were classified according to the World Health Organisation criteria. At the end of the follow-up patients classified in Ib and II classes were without urinary abnormalities, i.e. without preoteinuria and/or haematuria. However, patients in class IV manifests nephrotic syndrome (2 pts), renal failure (3 pts) or proteinuria and heamaturia (6 pts), and two patients died. More severe clinical features and course of lupus nephiritis associated with infavourable outcome significantly correlated with WHO classes III and IV. A five-year survival rate (life-table method) of 88.5% is among the best results reported to date in children and adolescents with lupus nephritis.

[Lupus nephritis in children and adolescents (clinical-morphologic correlation)]

Clinical and laboratory features in 27 children and adolescents (24 females, 3 males) with lupus nephritis were analysed and correlated with pathohistologic findings obtained by renal biopsy. The mean age at the onset of the disease was 12.1 +/- 1.9 (range 0.1-7.0) years. In the 30% of patients nephritis was one of the presenting features of the disease. The most frequent signs of the lupus nephritis at the time of biopsy were proteinuria (9 pts), proteinuria and haematuria (9 pts), and nephrotic syndrome (8 pts), while 7 patients showed decreased glomerular filtration rate (GFR), and hypertension was present in five. Distribution of patients according to the WHO morphologic classification of Lupus nephritis was as follows: 6 pts showed class Ib, 6 class II, 2 class III and 13 class IV. More severe renal dysfunction, manifested by nephrotic syndrome, proteinuria with haematuria, decreased GFR and hypertension was significantly associated with proliferative lupus nephritis (combined WHO classes III and IV). Nephrotic syndrome, haematuria and decreased serum C3 with significant probability predicted proliferative lupus nephritis, while decreased GFR was of borderline predictive value.

[Surgical aspects of liver resection based on 5 years' data]

From 1988 to 1993 thirty liver resections were performed in thirty patients. Eight were operated for suffering from hepatocellular carcinoma, four from metastasis of colon's adenocarcinoma, five for great hemangiomas and the rest for focal liver changes. Right lobectomy was performed in six cases, as well as two trisegmentectomies and two left lobectomies while segmentectomies in the rest. Periopretive mortality occurred in two cases as two patients died because of postoperative thrombosis of vena portae and massive gastrointestinal bleeding. Recidive of malignant tumors was established in five patients after year and in other five till the second year. Benign tumors are without recidives. Later resection is a safe procedure with a considerable selection of patients, with use of latest technical conveniences, application of grafts on branches of vena portae and with routine application of intraoperative ultrasonography. The paper contains diagnostical postulates, surgical techniques and anatomic and morphologic types of resection.

Focal glomerular sclerosis and nephrotic syndrome in spondyloepiphyseal dysplasia

The association of a spondyloepiphyseal dysplasia and disproportionate short stature with focal glomerular sclerosis is reported in two girls. Renal disease manifested by proteinuria at the age of 2.5 and 11 years, leading to treatment-resistant nephrotic syndrome over 15 and 45 months, respectively. One patient went into end-stage renal failure shortly after nephrotic syndrome developed, the other died from sepsis. The association of spondyloepiphyseal dysplasia and focal glomerular sclerosis with nephrotic syndrome may represent a distinct disease entity.

[Coronary arteries in the Macaca fascicularis monkey]

The coronary arterial epicardial network in the monkey Macaca fascicularis was studied. The study concerned 11 hearts of healthy and fertile animals of both sexes. The morphological and morphometric results of the studies performed by microdissection revealed that: In all examined cases of the Macaca fascicularis the heart was supplied by blood through the left and right coronary arteries. The left coronary artery had a larger external diameter (1.2 mm-2.5 mm, average 1.8 mm) than the right one (0.7 mm-1.2 mm, average 0.9 mm). The left coronary artery, with the average length of 4.3 mm (1.8 mm-6.5 mm), usually (82%) ended by bifurcation in to the anterior interventricular and the circumflex branch, and less frequently (18%) by trifurcation forming, in this way, another branch: the left marginal branch. The anterior interventricular branch had the larger external diameter (0.9 mm-1.7 mm, average 1.3 mm) than the circumflex one (0.7 mm-1.7 mm, average 1.1 mm). Most frequently (73%) it could be traced along the diaphragmatic cardiac surface. The circumflex branch usually (73%) terminated as the posterior interventricular branch, and less frequently (9%) as one of the right posterior ventricular branches. The long type of the right coronary artery was observed in 45% of the cases. The presence of the myocardial bridges over the branches of the left coronary artery was found in 54% of the examined hearts. The great resemblance between the Macaca fascicularis subepicardial network with the corresponding one in humans suggest that Macacus fascicularis is a suitable experimental animal for functional studies of the cardiovascular system.

Brain-applied magnetic fields and immune response: role of the pineal gland

In an attempt to clarify the mechanisms underlying immunopotentiation induced by prolonged exposure of the rat brain to static magnetic fields, and to evaluate the role of the pineal gland in that phenomenon, experiments were carried out on the following groups of adult rats (maintained under a 12 hr light/12 hr dark photoperiod): pinealectomized rats (Px); rats with micromagnets implanted to the occipito-parietal region of the skull (M); rats pinealectomized and implanted with micromagnets to the skull (PxM); sham-pinealectomized rats with non-magnetic beads implanted to the occipito-parietal area of the skull (ShPxMx); and intact controls (IC). Twenty-one days after surgery, animals of all groups were immunized with sheep red blood cells and tested for plaque forming cell (PFC) response and serum hemagglutinin level. Humoral immune reactions decreased significantly in Px rats, while increased markedly in M rats in comparison to the ShPxMx and IC controls. Compromised immune function induced by pinealectomy was restored by prolonged exposure of the brain to magnetic fields (PxM rats). Thus reconstituted immune responsiveness in PxM rats reached the level observed in controls, but was lower than that in M rats. The results imply that magnetic fields applied to the rat brain may exert their immunoenhancing activity in the absence of the pineal gland. However, this activity of magnetic fields is more pronounced in the presence of the pineal organ. The latter finding suggests the involvement of the pineal in the immunopotentiation induced by magnetic fields, but does not imply that magnetic fields operate solely via the pineal gland.(ABSTRACT TRUNCATED AT 250 WORDS)

Locus ceruleus and immunity. III. Compromised immune function (antibody production, hypersensitivity skin reactions and experimental allergic encephalomyelitis) in rats with lesioned locus ceruleus is restored by magnetic fields applied to the brain

This study deals with the relationship between the immunosuppression induced by electrolytic lesions placed into the nucleus locus cerules and the immunopotentiation produced by micromagnets implanted to the parietal area of the skull. The following groups of rats were set up: LC, rats with lesioned locus ceruleus; ShL, sham-lesioned animals bearing non-magnetic beads in the brain parietal region; M, rats with micromagnets of 60 mT influx density in the parietal part of the skull; LCM, animals with impaired locus ceruleus and magnetic beads placed in the parietal area of the skull; and IC, intact control rats. Animals of all groups were tested for plaque-forming cell response, circulating antibodies to sheep red blood cells and bovine serum albumin, Arthus and delayed hypersensitivity skin reactions to bovine serum albumin and old tuberculin, and experimental allergic encephalomyelitis. In LC-rats, humoral and cell-mediated immune reactions were compromised. On the other hand, immune responses in M-rats were significantly potentiated. In LCM-rats, however, the immunosuppression induced by destruction of the locus ceruleus was abrogated by prolonged exposure of the brain parietal region to the magnetic fields, i.e. immune reactivity of LCM-rats was quite similar to that of control IC- and ShL-animals. Several mechanisms may account for the immunomodulating effects produced by lesioning of the locus ceruleus and exposure of the brain to magnetic fields. Noradrenergic, serotoninergic, dopaminergic and peptidergic neurotransmitters, as well as growth hormones and immunopeptides, produced within the central nervous system or elsewhere, may be implicated as necessary for the interactions among the brain, immune apparatus and magnetic fields.

Locus ceruleus and immunity. I. Suppression of plaque-forming cell response and antibody production in rats with lesioned locus ceruleus

Earlier research had demonstrated that lesions placed in different brain structures may alter the immune responsiveness. Norepinephrine is one of neurotransmitters which plays a role in immune reactions, and the locus ceruleus represents the largest group of norepinephrine-containing neurons in the brain. The present study concerns, therefore, the relationship between the locus ceruleus and humoral immune reactions. For this purpose, rats with electrolytically induced lesions in locus ceruleus were used in the study. Locus ceruleus-lesioned animals showed a decreased ability to produce hemolysin-releasing cells, hemagglutinins, and antibodies to bovine serum albumin. In brain-lesioned rats, thymus tended to the smaller in size, and there was a depletion of CD4+ helper/inducer lymphocyte population in the peripheral blood.

Locus ceruleus and immunity. II. Suppression of experimental allergic encephalomyelitis and hypersensitivity skin reactions in rats with lesioned locus ceruleus

Rats with lesions restricted to the locus ceruleus were tested for immune inflammatory reactions. In these rats, Arthus and delayed skin hypersensitivity reactions to bovine serum albumin and old tuberculin were suppressed. The ablation of locus ceruleus completely inhibited the development of clinical signs of experimental allergic encephalomyelitis, markedly diminished the occurrence and intensity of lesions in the central nervous system, and significantly reduced the production of antibody against the rat brain myelin basic protein. These results establish a link between the locus ceruleus and immune inflammatory reactions in the rat.

[Epidemiologic characteristics of Lyme borreliosis in Vojvodina]

In the period 1988-1992 in the region of Vojvodina diseases caused by Borrelia burgdorferi were investigated for the first time. This investigation encompassed 398 persons with tick bites. There were 340 clinically healthy and 58 affected by Lyme borreliosis. Lyme borreliosis was registered in all age groups. The youngest patient was 5 and the oldest 75. Erythema migrans, clinical disease marker, was found in 94.8% of affected persons. Rheumatic disorders--arthralgiae were found in 3.5% and Sclerodermia circumscripta in 1.7%. Antibodies to Borrelia burgdorferi antigen were found in 46.9% of 32 patients tested by IFA test. In 55 (94.8%) patients the infestion took place in region of Vojvodina.

[HIV infection in Vojvodina]

The study of HIV infection in the population of Vojvodina was carried out in the period 1985-1991. The results obtained by the seroepidemiologic examination of some epidemiologically important groups of populations and recorded cases of AIDS are compared. It has been found that the seroepidemiologic examinations, in spite of some shortcomings, provide a more reliable insight into the epidemiologic situation of HIV infection.