The school environment-related predictors of fights and bullying among School-Age Children in Serbia

Background

The health and development of school-age children is a contemporary topic of various health policies and programs, which has become even more of a focus in critical situations such as the COVID-19 pandemic. The study aims to assess the prevalence of school-age children's participation in fights and bullying in Serbia, and to examine the relevance of students’ socio-demographic characteristics and perceptions of school and relations with other students and professors for participation in fights and bullying.

Methods

A secondary analysis of the original data of the 2017 HBSC study is performed on 3267 students in a nationally representative sample of primary and high schools in Serbia. Predictors of taking part in fights and taking part in bullying were examined by using univariate and multivariate logistic regression.

Results

The main results show that 50.8% of boys and 17.1% of girls have taken part in fights, while 17.7% boys and 10.4% of girls have taken part in bullying. Students who felt a large and very large burden of school obligations were 1.43 times more likely to participate in bullying at least once, while they were 1.38 and 2.12 times more likely to participate in multiple fights and 4.04, 1.24, and 2.78 times more likely to participate multiple times in bullying. Fights among school-age children are significantly positively associated with living with relatives/legal guardians and poor quality of life.

Conclusions

The prevalence of participating in at least one fight/bullying is higher than in multiple fights/bullying. These associations suggest a necessity to enhance the monitoring and control of peer behavior among school-age children. The findings of the study imply key enablers of protection, such as building relationships based on team spirit and work, friendly behavior, empathy, and help, which should be included in the value system of school and family activities in programs to combat fights and bullying in school-age children.

Key messages

• In Serbia, every second boy and every fifth girl participated in fights, while less than every fifth boy and every tenth girl participated in bullying.

• Study results can inform school and healthcare actors’ efforts to improve school-age children’s development and health capacity for life.

Environmental pollution influence to soil-plant-air system in organic vineyard: bioavailability, environmental, and health risk assessment

This study was performed in organic vineyard to assess integrated pollution in soil-plant-air system by potentially toxic elements (PTE). Concentrations of 26 PTE were determined in soil, grapevine, and air biomonitors (moss bags) using ICP-OES and ICP-MS. Environmental implication assessment of soil did not show pollution by PTE, except for B in samples collected in the middle of grapevine season (July). Despite low total Cd concentrations in soil, it has the highest influence on increase of environmental risk. Based on biological accumulation concentration (BAC), grapevine is not hyperaccumulator of PTE from soil. Advanced classification algorithm, Kohonen self-organizing map (SOM), was applied to compare environmental implications in organic with conventional vineyards. PTE concentrations were significantly lower in organic than conventional grapevine. PTE concentrations were higher in the outer (leaf and petiole) than in the inner grapevine parts (skin, pulp, and seed). Some airborne elements have an influence on outer grapevine parts, especially on leaves (ratio factor-RF > 1). Moss bag technique testified about lower enrichment of airborne elements compared with the conventional vineyard and urban microenvironments. Environmental and health risk assessments confirmed that organic production is harmless for field workers and grape consumers.

Trace elements in different tissues in aging rats

BACKGROUND

Trace elements (TE) in the human body provide a connecting link between the environment, lifestyle and biochemical modulation of homeodynamics. On the other hand, many non-essential (toxic) elements are linked to numerous diseases. Our study tried to identify differences in TE levels between healthy old and young Wistar rats in blood and the tissues of kidney, liver, heart, and testicles. Furthermore, we wanted to see if there were age-related differences in correlations between essential and/or non-essential (toxic) TE within and between mentioned tissues.

METHODS

We used 28 healthy male Wistar rats which were divided into two age groups: young, aged 10 weeks (n = 15) and old, aged 36 months (n = 13). The animals were sacrificed under general anesthesia and the blood samples, and samples from the tissues of the heart, kidneys, testicles, and liver were used for the determination of TE content in them. Analysis of the 16 elements was performed by inductively coupled plasma mass spectrometry (ICP-MS).

RESULTS

Toxic elements in old rats (As, Hg, and Cd) were significantly higher in all of the tissues where the difference in levels of these elements was found. Tissues of the kidney and liver had the most correlations between TE in old and young rats, respectively. In both old and young rats, arsenic was the toxic element that had most of the correlations with other essential or non-essential elements. In old rats, most of the TE correlations were detected between the tissues of the kidney and heart (11 correlations), while in young rats most of the correlations were observed between the tissues of kidney and liver, and kidney and testicles (with 9 correlations both).

CONCLUSIONS

Our study has found significant changes in levels of trace elements in all of the mentioned tissues, with kidney and testicles being the tissues with the most TE differences between the two aged groups. This and other similar studies should encourage other investigators to evaluate the mutual connections between TE and physiological, or the "unhealthy" aging. More studies with more tissues included, more biomarkers of the systemic function, and even molecular methods are needed to provide the answers to numerous questions relating to TE and aging.

Colorectal cancer and trace elements alteration

BACKGROUND

Trace elements have important influence on body function primarily because of the vital role they have in many physiological processes. Their alterations have been found in many disorders, including cancer. It has been well known for decades that disturbances in elemental concentration may lead to cell damaging, DNA injuries and imbalance in oxidative burden. Our study tried to determine the difference of trace elements concentrations between colorectal adenocarcinoma and adjacent healthy intestinal tissue.

METHODS

59 subjects participated in this study. Healthy colon mucosa samples and colon tumor tissue samples were obtained from patients previously diagnosed with colon carcinoma by standard diagnostic procedures. Analysis of the elements was performed by inductively coupled plasma mass spectrometry (ICP-MS).

RESULTS

The results showed that Na, K, Mg, Ca, Cu, Zn, Se, Mn, Cd, Cr and Hg significantly differ between malignant tissue of colorectal cancer (CRC) and adjacent healthy bowel tissue. We have, also, found that Cu/Zn tissue ratio was significantly higher in CRC compared to a healthy tissue and that patients with higher CRC stages had also significantly higher ratio.

CONCLUSIONS

Since this is the first such study in Balkan region, we assume that results of our study could be a good indicator of elemental alterations in colorectal cancer of Balkan population, due to similarity in lifestyle, dietary intake, pollution and exposure to toxic elements.

Potential predictors of unmet health needs among the elderly: a population-based study in Serbia

Background

This study assessed the prevalence of unmet health needs of the elderly and the associated factors regarding socioeconomic, health and functional status.

Methods

A secondary analysis of the 2013 National Health Survey data was conducted on a representative sample of 3540 persons aged sixty-five and older (the lowest response rate was 99.7%). Participants characteristics such as socioeconomic status, health self-perception, diagnosed chronic disease, physical functional limitations, performing essential daily activities in the home and daily personal care were explored with logistic regression analysis (Odds Ratio - OR and 95% Confidence Interval) in relation to five aspects of unmet health needs.

Results

15.8% participants had unmet health needs due to the long waiting times, 16.1%, had unmet needs for medical care, 17.7% for dental care, 15.2% for drugs prescription and 96.9% participants for mental health care. Common predictors exist for medical, dental drug prescription and due to long waiting times unmet needs including older age years, middle education, rural residence, lower wealth index, single persons, with average or bad self-perceived health, chronic disease and difficult daily performance of personal care and of home activities. Unmet mental health needs by 61% less likely had participants with average wealth index, while a greater likelihood had participants with average and bad self-perceived health by 3.7 times and 8.4 times (p = 0.035, p = 0.001) respectively, by 6.2 times those with difficulties (p < 0.001) and by 5.9 times unable (p = 0.045) to perform daily activities of personal care and by 1.7 times those with difficulties (p = 0.037) to perform home activities.

Conclusions

Unmet health needs reported less than 20% of the elderly but almost all have unmet mental health needs. Unmet health needs are associated with negative health outcomes, age, low education level, single persons, rural settings, poorer households, and limited daily activities.

Key messages

Unmet mental health needs of the elderly are an extremely important problem for the health system and healthy ageing in Serbia. A strong association of unmet health needs of old, low educated elderly without partners, from rural settings and poor households with health and functional outcomes, requires responsive policies.

Exercise training in overweight and obese children: Recreational football and high-intensity interval training provide similar benefits to physical fitness

This study compared the effects of recreational football and high-intensity interval training (HIIT) on body composition, muscular fitness, and cardiorespiratory fitness in overweight and obese children. Forty-two overweight/obese males aged 11-13 years [body mass index (BMI) >20.5 kg/m² ] were randomly assigned to a recreational football training group (n = 14; 157.9 ± 5.8 cm; 63.7 ± 12.6 kg), HIIT group (n = 14; 163.8 ± 9.4 cm; 71.5 ± 10.5 kg), or nontraining control group (n = 14; 162.7 ± 9.3 cm; 67.4 ± 16.1 kg). Physical fitness components were measured at baseline and after 12 weeks of training at the same time of the day and under similar conditions, including body composition, muscular fitness (lower-body power, change-of-direction speed, and flexibility), and cardiovascular fitness (Yo-Yo Intermittent Endurance test distance, resting heart rate, and blood pressure). Lean body mass (4.3%, ES = 0.40; 95% CI: -0.48, 1.29; P = .382) and muscle mass 4.4% (ES = 0.40; 95% CI: -0.48, 1.29; P = .378) very likely increased in the recreational football group, while possible improvements were observed in the HIIT group (lean body mass: 2.5%, ES = 0.22; 95% CI: -0.62, 1.06; P = .607, muscle mass: 2.8%, ES = 0.23; 95% CI: -0.61, 1.07; P = .594). Only trivial increases were observed in the control group for lean body mass (0.5%, ES = 0.05; 95% CI: -0.70, 0.79; P = .906) and muscle mass (1.1%, ES = 0.09; 95% CI: -0.65, 0.83; P = .814). Significant differences were found between the recreational football and control groups in post-training body mass (P = .034) and body mass index (P = .017). Body fat very likely decreased in the recreational football group (-7.7%, ES = -0.41; 95% CI: -1.29, 0.48; P = .376) and possibly decreased in the HIIT group (-5.2%, ES = -0.22; 95% CI: -1.05, 0.62; P = .607), with a trivial reduction in the control group (-1.1%, ES = -0.04; 95% CI: -0.78, 0.70; P = .914). Very likely increases in lower-body power were evident in the recreational football (17.0%, ES = 0.76; 95% CI: -0.15, 1.66; P = .107) and control groups (16.1%, ES = 0.55; 95% CI: -0.20, 1.31; P = .156), while small improvements were observed in the HIIT group (6.0%, ES = 0.24; 95% CI: -0.60, 1.08; P = .580, possible). Likely to most likely improvements in Yo-Yo Intermittent Endurance test performance and change-of-direction speed were noted in the recreational football group (Yo-Yo: 79.8%, ES = 1.09; 95% CI: 0.16, 2.03; P = .025, change-of-direction speed: -10.6%, ES = -1.05; 95% CI: -1.98, -0.12; P = .031) and the HIIT group (Yo-Yo: 81.2%, ES = 1.03; 95% CI: 0.15, 1.92; P = .025, change-of-direction speed: -5.4%, ES = -0.91; 95% CI: -1.79, -0.04; P = .045). Diastolic blood pressure likely decreased in the recreational football (-8.6%, ES = -0.74; 95% CI: -1.64, 0.17; P = .116) and HIIT groups (-9.8%, ES = -0.57; 95% CI: -1.40, 0.30; P = .195), with a possible increase in the control group (1.2%, ES = 0.21; 95% CI: -0.53, 0.96; P = .068). Recreational football and HIIT elicited improvements in all muscular and cardiorespiratory fitness measures. In contrast, the control group, which performed only physical education classes, increased body mass, BMI, and fat mass. Therefore, additional activities such as recreational football or HIIT might counter the prevalence of overweight and obesity in children.

Development and validation of the short version of the diabetes obstacles questionnaire (DOQ-30) in six European countries

BACKGROUND

Patients with type 2 diabetes reveal different obstacles in living with the disease. The EGPRN initiated a qualitative research EUROBSTACLE to create a broadly conceptualized diabetes-related quality of life (DR-QoL) instrument. It led to the development of the diabetes obstacle questionnaire (DOQ), a five-point Likert-scaled measure, consisting of 78 items in eight scales.

OBJECTIVES

To develop and validate a short, easy-to-use version of the DOQ.

METHODS

A cross-sectional study with the DOQ was carried out. Participants answered the DOQ and GPs added some clinical data from their medical records. Data of 853 patients from Belgium, France, Estonia, Serbia, Slovenia, and Turkey were included in the analysis. The selection of items for the short version of the DOQ was achieved with exploratory factor analysis (EFA). Construct validity was proved with EFA and Pearson correlations between the DOQ and the new DOQ-30. Internal reliability was established with Cronbach's alpha.

RESULTS

DOQ-30 resulted in 30 items in nine subscales. It explained 49.8% of items' variance. It shows a considerable good internal reliability and construct validity.

CONCLUSION

The DOQ-30 is a five-point Likert-scaled broadly conceptualized measure of DR-QoL. It addresses a variety of obstacles, such as social, psychological, cognitive and behavioural. The DOQ-30 is ready for implementation in general practice and research in Europe as a valuable instrument to assess DR-QoL.

First Report of Fusarium Root Rot of Stored Carrot Caused by Fusarium avenaceum in Serbia

Carrot (Daucus carota L. subsp. sativus (Hoffm.) Thell., Apiaceae), a widely consumed antioxidant-rich plant, is among the major vegetable crops grown in Serbia, with average annual production of 65,400 tons on approximately 7,000 ha (4). In May 2013, a severe root rot was observed on approximately 20% of cold-stored carrot roots originating from Gospođinci, South Bačka District, Serbia. Symptoms included dry rot of the collar and crown as well as large, brown to dark brown, circular, sunken lesions on the stored roots. Frequently, abundant whitish mycelium was observed covering the surface of the colonized roots. To determine the causal agent, small pieces of infected tissue were surface-disinfested with 2% NaOCl without rinsing, air-dried, and placed on potato dextrose agar. Five single-spore isolates obtained from collar and crown tissue sections, as well as nine isolates from root sections, all formed abundant, cottony white to pale salmon fungal colonies with reddish orange pigment on the reverse surface of the agar medium when grown at 25°C under 12 h of fluorescent light per day. All recovered isolates formed numerous, three- to six-septate, hyaline, needle-like, straight to slightly curved, fusoid macroconidia (30 to 80 × 4 to 5.5 μm, average 58.3 × 4.9 μm, n = 100 spores) each with a tapering apical cell. Microconidia of all isolates were generally scarce, two- to four-septate, spindle-shaped, and 15 to 35 × 3 to 5 μm (average 21.3 × 4.2 μm). Chlamydospores were not observed. Based on these morphological characteristics, the pathogen was identified as Fusarium avenaceum (Fries) Saccardo (1). The pathogenicity on carrot was tested for isolate 19-14 by inoculating each of five carrot roots surface-disinfected with 2% NaOCl, by placing a mycelial plug into the surface of a wound created with a cork borer. Carrot roots inoculated with sterilized PDA plugs served as a negative control treatment. After 5 days of incubating the roots at 25°C, root rot symptoms identical to those observed on the source carrot plants developed on all inoculated roots, and the pathogen was re-isolated from each of these roots using the same procedure descibed above. There were no symptoms on the control roots. Morphological species identification was confirmed by sequencing the translation elongation factor (EF-1α) gene (2). Total DNA was extracted directly from fungal mycelium of isolate 19-14 with a DNeasy Plant Mini Kit (Qiagen, Hilden, Germany), and PCR amplification was performed with primer pair EF-1/EF-2 (2). Sequence analysis of the EF-1α gene revealed 100% nucleotide identity of isolate 19-14 (GenBank Accession No. KM102536) with the EF-1α sequences of two F. avenaceum isolates from Canada (KC999504 from rye and JX397864 from Triticum durum). To our knowledge, this is the first report of F. avenaceum causing collar, crown, and root rots of stored carrot in Serbia. Since F. avenaceum can produce several mycotoxins, including moniliformin, acuminatopyrone, and chrysogine (3), the presence of this pathogen on stored carrots could represent a significant constraint for carrot production in Serbia, for both direct yield losses and potential mycotoxin contamination. References: (1) J. F. Leslie and B. A. Summerell. The Fusarium Laboratory Manual, Blackwell Publishing, London, UK, 2006. (2) K. O'Donnell et al. Proc. Natl. Acad. Sci. U.S.A. 95:2044, 1998. (3) J. L. Sorenson. J. Agric. Food Chem. 57:1632, 2009. (4) Statistical Office, Republic of Serbia. Retrieved from http://webrzs.stat.gov.rs in May 2014.

First Report of Fusarium Wilt of Strawberry Caused by Fusarium oxysporum in Serbia

Strawberry (Fragaria × ananassa Duch.) is the third most important berry crop in Serbia with average production ranging from 30,000 to 35,000 t on approximately 5,000 ha (2). In June 2013, symptoms of wilt and whole plant collapse were observed on approximately 25% plants growing in commercial strawberry crop of cv. Alba in the locality of Zablaće (Moravica district). Initial symptoms included leaf chlorosis and wilt, followed by withering and necrosis of older leaves and reduced fruit production, eventually leading to plant collapse and desiccations. Internal vascular tissues of the crown showed distinct brown reddish discoloration. Three small pieces of infected roots, petioles, or crown vascular tissues were surface disinfested with 2% NaOCl and placed on five potato dextrose agars (PDA) per sample. After 7 days incubation at 23°C under 12 h of fluorescent light, nine monoconidial isolates were obtained (1) forming colonies with light purple mycelia. Colonies produced numerous hyaline, oval to ellipsoid microconidia (5 to 15 × 2.5 to 4.5 μm, average 8.45 × 2.25 μm), 3 to 5 septate fusoid macroconidia with pedicellate bases (20 to 50 × 2.70 to 6 μm, average 32.35 × 3.25 μm from 100 measured) and chlamydospores. Morphological and growth features were similar to the descriptions of Fusarium oxysporum Schlechtend emend. Snyder & Hansen (1). Pathogenicity of one selected isolate (97-13) was tested by dipping for 15 min the roots of five plants of each cultivar: Alba, Arosa, Clery, and Roxana into a conidial suspension (1 × 10⁶ conidia/ml) harvested from a 7-day-old culture on PDA. Control plants were dipped in sterile distilled water. The inoculated plants were transplanted into pots containing sterilized peat and maintained in the greenhouse at 25°C. Thirty to thirty-five days post-inoculation, all plants developed wilt symptoms and vascular discoloration of crown tissues from which F. oxysporum was successfully re-isolated using the same method as for isolation. No symptoms were observed on any of the control plants. Morphological identification was confirmed by amplification and sequencing of a portion of the translation elongation factor-1 alpha (EF-1α) gene. Total DNA was extracted directly from fungal mycelium with a DNeasy Plant Mini Kit (Qiagen, Hilden, Germany) and PCR amplification performed with primers EF-1/EF-2 (4). Sequence analysis of EF-1α region revealed that Serbian isolate 97-13 (GenBank Accession No. KJ647280) shared 99 to 100% identity with the F. oxysporum sequences in GenBank. To our knowledge, this is the first report of Fusarium wilt on strawberry in Serbia. The presence of a new and potentially harmful disease may represent a serious constraint for strawberry production in Serbia. References: (1) J. F. Leslie and B. A. Summerell. The Fusarium Laboratory Manual, Blackwell Publishing, London, UK, 2006. (2) M. Nikolić et al. Acta Hort. 842:615, 2009. (3) K. O'Donnell et al. Proc. Natl. Acad. Sci. USA 95:2044, 1998.

First Report of Cucumber mosaic virus in Tulipa sp. in Serbia

Tulips (Tulipa sp. L.), popular spring-blooming perennials in the Liliaceae family, are one of the most important ornamental bulbous plants, which have been cultivated for cut flower, potted plant, garden plant, and for landscaping. In May 2013, during a survey to determine the presence of Cucumber mosaic virus (CMV, Cucumovirus, Bromoviridae) on ornamentals in Serbia, virus-like symptoms, including the presence of bright streaks, stripe and distortion of leaves, and reduced growth and flower size, were observed in an open field tulip production in the Krnjaca locality (a district of Belgrade, Serbia). Disease incidence was estimated at 20%. Symptomatic tulip plants were collected and tested for the presence of CMV by double-antibody sandwich (DAS)-ELISA using commercial diagnostic kit (Bioreba, AG, Reinach, Switzerland). Commercial positive and negative controls were included in each ELISA. Of the six tulip plants tested, all were positive for CMV. In bioassay, five plants of each Chenopodium quinoa, Nicotiana tabacum 'Samsun,' and N. glutinosa were mechanically inoculated with sap from selected ELISA-positive sample (79-13) using 0.01 M phosphate buffer (pH 7). Chlorotic local lesions on C. quinoa, and severe mosaic and leaf malformations on N. tabacum 'Samsun' and N. glutinosa, were observed 5 and 14 days post-inoculation, respectively. All mechanically inoculated plants were positive for CMV in DAS-ELISA testing. For further confirmation of CMV presence in tulip, total RNAs from all ELISA-positive symptomatic tulip plants were extracted with the RNeasy Plant Mini Kit (Qiagen, Hilden, Germany). Reverse transcription (RT)-PCR was performed with the One-Step RT-PCR Kit (Qiagen) using specific primer pair CMVCPfwd and CMVCPrev (1), which flank conserved fragment of the RNA3 including the entire coat protein (CP) gene and part of 3'- and 5'-UTRs. Total RNAs obtained from the Serbian watermelon CMV isolate (GenBank Accession No. JX280942) and healthy tulip leaves served as the positive and negative controls, respectively. The RT-PCR products of 871 bp were obtained from all six samples that were serologically positive to CMV, as well as from the positive control. No amplicon was recorded in the healthy control. The amplified product which derived from isolate 79-13 was purified (QIAquick PCR Purification Kit, Qiagen), directly sequenced in both directions using the same primer pair as in RT-PCR, deposited in GenBank (KJ854451), and analyzed by MEGA5 software (4). Sequence comparison of the complete CP gene (657 nt) revealed that the Serbian isolate 79-13 shared the highest nucleotide identity of 99.2% (99% amino acid identity) with CMV isolates from Japan (AB006813) and the United States (S70105). To our knowledge, this is the first report on the occurrence of CMV causing mosaic on Tulipa sp. in Serbia. Taking into account vegetative reproduction of tulips and the large scale of international trade with tulip seeding material, as well as wide host range of CMV including a variety of ornamentals (2,3), this is a very important discovery representing a serious threat for the floriculture industry in Serbia. References: (1) K. Milojević et al. Plant Dis. 96:1706, 2012. (2) M. Samuitienė and M. Navalinskienė. Zemdirbyste-Agriculture 95:135, 2008. (3) D. Sochacki. J. Hortic. Res. 21:5, 2013. (4) K. Tamura et al. Mol. Biol. Evol. 28:2731, 2011.

The effect of a paraffin screen on the neutron dose at the maze door of a 15 MV linear accelerator

PURPOSE

The purpose of this study was to explore the effects of a paraffin screen located at various positions in the maze on the neutron dose equivalent at the maze door.

METHODS

The neutron dose equivalent was measured at the maze door of a room containing a 15 MV linear accelerator for x-ray therapy. Measurements were performed for several positions of the paraffin screen covering only 27.5% of the cross-sectional area of the maze. The neutron dose equivalent was also measured at all screen positions. Two simple models of the neutron source were considered in which the first assumed that the source was the cross-sectional area at the inner entrance of the maze, radiating neutrons in an isotropic manner. In the second model the reduction in the neutron dose equivalent at the maze door due to the paraffin screen was considered to be a function of the mean values of the neutron fluence and energy at the screen.

RESULTS

The results of this study indicate that the equivalent dose at the maze door was reduced by a factor of 3 through the use of a paraffin screen that was placed inside the maze. It was also determined that the contributions to the dosage from areas that were not covered by the paraffin screen as viewed from the dosimeter, were 2.5 times higher than the contributions from the covered areas. This study also concluded that the contributions of the maze walls, ceiling, and floor to the total neutron dose equivalent were an order of magnitude lower than those from the surface at the far end of the maze.

CONCLUSIONS

This study demonstrated that a paraffin screen could be used to reduce the neutron dose equivalent at the maze door by a factor of 3. This paper also found that the reduction of the neutron dose equivalent was a linear function of the area covered by the maze screen and that the decrease in the dose at the maze door could be modeled as an exponential function of the product φ·E at the screen.

First Report of Tomato spotted wilt virus on Brugmansia sp. in Serbia

Brugmansia (Brugmansia spp.), also known as Angel's trumpet, is a perennial shrub in the Solanaceae that is a popular landscape plant in the tropics and subtropics, and potted plant in temperate regions. In April 2012, virus-like symptoms including chlorotic leaf patterns and curling followed by necrosis and distortion of leaves were observed on five outdoor-grown brugmansia plants in a private garden in Mackovac, Rasina District, Serbia. Symptomatic leaves were tested for the presence of several common ornamental viruses including Tomato spotted wilt virus (TSWV), Impatiens necrotic spot virus (INSV), Cucumber mosaic virus (CMV), and Tobacco mosaic virus (TMV) by commercial double-antibody sandwich (DAS)-ELISA diagnostic kits (Bioreba AG, Reinach, Switzerland). Commercial positive and negative controls and extract from healthy brugmansia leaves were included in each ELISA. TSWV was detected serologically in all five brugmansia samples and all tested samples were negative for INSV, CMV, and TMV. The virus was mechanically transmitted from an ELISA-positive sample (41-12) to five plants of each Petuina × hybrida and Nicotiana glutinosa. Inoculated P. × hybrida plants showed local necrotic lesions and N. glutinosa showed mosaic and systemic necrosis 4 and 12 days post-inoculation, respectively, which were consistent with symptoms caused by TSWV (1). For further confirmation of TSWV infection, reverse transcription (RT)-PCR was performed with the OneStep RT-PCR (Qiagen, Hilden, Germany) using a set of TSWV-specific primers, TSWV CP-f and TSWV CP-r (4), designed to amplify a 738-bp fragment of the nucleocapsid protein (N) gene. Total RNAs from naturally infected brugmansia and symptomatic N. glutinosa plants were extracted using the RNeasy Plant Mini Kit (Qiagen). Total RNAs obtained from the Serbian tobacco isolate of TSWV (GenBank Accession No. GQ373173) and healthy brugmansia plants were used as positive and negative controls, respectively. The expected size of the RT-PCR product was amplified from symptomatic brugmansia and N. glutinosa but not from healthy tissues. The amplified product derived from the isolate 41-12 was sequenced directly after purification with the QIAquick PCR Purification kit (Qiagen), deposited in GenBank (JX468080), and subjected to sequence analysis by MEGA5 software (3). Sequence comparisons revealed that the Serbian isolate 41-12 shared the highest nucleotide identity of 99.9% (99.5% amino acid identity) with an Italian TSWV isolate P105/2006RB (DQ915946) originating from pepper. To our knowledge, this is the first report of TSWV on brugmansia in Serbia. Due to the increasing popularity and economic importance of brugmansia as an ornamental crop, thorough inspections and subsequent testing for TSWV and other viruses are needed. This high-value ornamental plant may act also as reservoir for the virus that can infect other ornamentals and cultivated crops, considering that TSWV has a very broad host range (2). References: (1) Anonymous. OEPP/EPPO Bull. 34:271, 2004. (2) G. Parrella et al. J. Plant Pathol. 85:227, 2003. (3) K. Tamura et al. Mol. Biol. Evol. 28:2731, 2011. (4) A. Vučurović et al. Eur. J. Plant Pathol. 133:935, 2012.

First Report of Tomato spotted wilt virus on Chrysanthemum in Serbia

In July 2011, greenhouse-grown chrysanthemum hybrid plants (Chrysanthemum × morifolium) with symptoms resembling those associated with tospoviruses were observed in the Kupusina locality (West Bačka District, Serbia). Disease incidence was estimated at 40%. Symptomatic plants with chlorotic ring spots and line patterns were sampled and tested by double antibody sandwich (DAS)-ELISA using polyclonal antisera (Bioreba AG, Reinach, Switzerland) against the two of the most devastating tospoviruses in the greenhouse floriculture industry: Tomato spotted wilt virus (TSWV) and Impatiens necrotic spot virus (INSV) (2). Commercial positive and negative controls and extracts from healthy chrysanthemum tissue were included in each ELISA. TSWV was detected serologically in 16 of 20 chrysanthemum samples and all tested samples were negative for INSV. The virus was mechanically transmitted from ELISA-positive chrysanthemum samples to five plants each of both Petunia × hybrida and Nicotiana tabacum 'Samsun' using chilled 0.01 M phosphate buffer (pH 7) containing 0.1% sodium sulfite. Inoculated plants produced local necrotic spots and systemic chlorotic/necrotic concentric rings, consistent with symptoms caused by TSWV (1). The presence of TSWV in ELISA-positive chrysanthemum plants and N. tabacum'Samsun' was further confirmed by conventional reverse transcription (RT)-PCR. Total RNAs were extracted with an RNeasy Plant Mini Kit (Qiagen, Hilden, Germany). RT-PCR was performed with the One-Step RT-PCR Kit (Qiagen) using primers TSWVCP-f/TSWVCP-r specific to the nucleocapsid protein (N) gene (4). A Serbian isolate of TSWV from tobacco (GenBank Accession No. GQ373173) and RNA extracted from a healthy chrysanthemum plant were used as positive and negative controls, respectively. An amplicon of the correct predicted size (738-bp) was obtained from each of the plants assayed, and that derived from chrysanthemum isolate 529-11 was purified (QIAqick PCR Purification Kit, Qiagen) and sequenced (JQ692106). Sequence analysis of the partial N gene, conducted with MEGA5 software, revealed the highest nucleotide identity of 99.6% (99% amino acid identity) with 12 TSWV isolates deposited in GenBank originating from different hosts from Italy (HQ830186-87, DQ431237-38, DQ398945), Montenegro (GU355939-40, GU339506, GU339508), France (FR693055-56), and the Czech Republic (AJ296599). The consensus maximum parsimony tree obtained on a 705-bp partial N gene sequence of TSWV isolates available in GenBank revealed that Serbian TSWV isolate 529-11 from chrysanthemum was clustered in the European subpopulation 2, while the Serbian isolates from tomato (GU369723) and tobacco (GQ373172-73 and GQ355467) were clustered in the European subpopulation 1 denoted previously (3). The distribution of TSWV in commercial chrysanthemum crops is wide (2). To our knowledge, this is the first report of TSWV infecting chrysanthemum in Serbia. Since chrysanthemum popularity and returns have been rising rapidly, the presence of TSWV may significantly reduce quality of crops in Serbia. References: (1) Anonymous. OEPP/EPPO Bull. 34:271, 2004. (2) Daughtrey et al. Plant Dis. 81:1220, 1997. (3) I. Stanković et al. Acta Virol. 55:337, 2011. (4) A. Vučurović et al. Eur. J. Plant Pathol. 133:935, 2012.

First Report of Cucumber mosaic virus Infecting Watermelon in Serbia

In June 2012, field-grown watermelon plants (Citrullus lanatus L.) with virus-like symptoms were observed in Silbaš locality, South Backa District of Serbia. Plants infected early in the growing season showed severe symptoms including stunting, mosaic, mottling, blistering, and leaf curling with reduced leaf size, while those infected at later stages exhibited only a mild mosaic. Affected plants were spread across the field and disease incidence was estimated at 40%. Thirteen symptomatic watermelon plants were sampled and analyzed by double-antibody sandwich (DAS)-ELISA using a commercial diagnostic kit (Bioreba AG, Reinach, Switzerland) against the most important watermelon viruses: Cucumber mosaic virus (CMV), Watermelon mosaic virus (WMV), Zucchini yellow mosaic virus (ZYMV), Papaya ringspot virus (PRSV), and Squash mosaic virus (SqMV) (1). Commercial positive and negative controls and an extract from healthy watermelon tissue were included in each ELISA. Serological analyses showed that all plants were positive for CMV and negative for ZYMV, WMV, PRSV, and SqMV. The virus was mechanically transmitted from an ELISA-positive sample (449-12) to five plants of each Citrullus lanatus 'Creamson sweet' and Chenopodium amaranticolor using 0.01 M phosphate buffer (pH 7) with Serbian CMV isolate from Cucurbita pepo 'Olinka' (GenBank Accession No. HM065510) and healthy watermelon plants as positive and negative controls, respectively. Small necrotic lesions on C. amaranticolor and mild mosaic with dark green vein banding on watermelon leaves were observed on all inoculated plants 5 and 14 days post-inoculation, respectively. For further confirmation of CMV infection, reverse transcription (RT)-PCR was performed with the One-Step RT-PCR Kit (Qiagen, Hilden, Germany) using specific primers CMVCPfwd (5'-TGCTTCTCCRCGARWTTGCGT-3') and CMVCPrev (5'-CGTAGCTGGATGGACAACCCG-3'), designed to amplify an 871-bp fragment of the RNA3 including the whole CP gene. Total RNA from 12 naturally infected and five mechanically infected watermelon plants was extracted with the RNease Plant Mini Kit (Qiagen). Total RNA obtained from the Serbian CMV isolate (HM065510) and healthy watermelon plants were used as positive and negative controls, respectively. The expected size of RT-PCR products were amplified from all naturally and mechanically infected watermelon plants but not from healthy tissues. The PCR product derived from isolate 449-12 was purified and directly sequenced using the same primer pair as in RT-PCR (JX280942) and analyzed by MEGA5 software (3). Sequence comparison of the complete CP gene (657 nt) revealed that the Serbian isolate 449-12 shared the highest nucleotide identity of 98.9% (99.1% amino acid identity) with the Spanish melon isolate (AJ829777) and Syrian tomato isolate (AB448696). To our knowledge, this is the first report of CMV on watermelon in Serbia. CMV is widely distributed within the Mediterranean basin where it has a substantial impact on many agricultural crops (2) and is often found to be prevalent during pumpkin and squash surveys in Serbia (4). The presence of CMV on watermelon could therefore represent a serious threat to this valuable crop in Serbia. References: (1) L. M. da Silveira et al. Trop. Plant Pathol. 34:123, 2009. (2) M. Jacquemond. Adv. Virus Res. 84:439, 2012. (3) K. Tamura et al. Mol. Biol. Evol. 28:2731, 2011. (4) A. Vucurovic et al. Eur. J. Plant Pathol. 133:935, 2012.

First Report of Tomato spotted wilt virus Infecting Onion and Garlic in Serbia

In June 2011, extensive bleaching and numerous small whitish spots on leaves were observed in an onion (Allium cepa) seed crop as well as chlorotic spots and streaks in the neighboring garlic (A. sativum) bulb crop in the Aleksandrovo locality (Central Banat District, Serbia). Affected plants occurred throughout the field and disease incidence was estimated at 60% in the onion and 40% in the garlic crop. A high population of Thrips tabaci that was found in both crops, and local necrotic spots on Petunia × hybrida mechanically inoculated with infected onion or garlic sap by a chilled 0.01 M phosphate buffer, pH 7.0, containing 0.1% sodium sulfite (1), suggested the presence of a Tospovirus. For these reasons, sampled symptomatic onion and garlic plants were tested for the presence of Tomato spotted wilt virus (TSWV) and Iris yellow spot virus (IYSV) using commercial double-antibody sandwich-ELISA diagnostic kits (Bioreba AG, Reinach, Switzerland). Commercial positive and negative controls and extracts from healthy onion and garlic tissue were included in each ELISA. Of the 18 onion and 10 garlic plants tested, 16 and 7 samples, respectively, were positive for TSWV, and all were negative for IYSV. The identity of TSWV was further confirmed by conventional reverse transcription (RT)-PCR analysis. Total RNAs were extracted with an RNeasy Plant Mini Kit (Qiagen, Hilden, Germany) and RT-PCR was performed with the One-Step RT-PCR Kit (Qiagen) using TSWV-specific forward (5'-GGTTAAGCTCACTAAGAAARCA-3') and reverse primers (5'-TTTAACYCCRAACATTTCATAGA-3'), designed to amplify a 738-bp fragment of the nucleocapsid protein (N) gene. Total RNAs obtained from plants infected with a Serbian isolate of TSWV (GenBank Accession No. GQ373173) and healthy onion garlic plants were used as positive and negative controls, respectively. An amplicon of the expected size was produced from the 16 onion and 7 garlic ELISA-positive plants, but not from healthy controls. The amplified products derived from the two selected isolates, 114-11 from onion and 115-11 from garlic, were sequenced directly after purification with the QIAquick PCR Purification kit (Qiagen); the sequences obtained were allocated GenBank Accession Nos. JQ619234 and JQ619235, respectively. Sequence analysis of the partial N gene, conducted with MEGA5 software (4), revealed 99.9% nucleotide identity (100% amino acid identity) between the two Serbian Allium isolates. Serbian onion and garlic isolates showed the highest nucleotide identities of 100% and 99.9% with Serbian summer squash isolate (JF303081) and tobacco isolate from Montenegro (GU369729), respectively. Well-established in many European countries, TSWV has been reported as an important constraint to the production of tomato, pepper, tobacco, and ornamentals (2), but the information on TSWV naturally infecting Allium spp. is limited. The presence of TSWV on onion and garlic in Serbia revealed that its known host range has expanded in Europe. To our knowledge, other than Marchoux's unpublished data (3), there are no other reports of garlic as a natural host of TSWV. The TSWV presence on Allium spp. represents a serious threat for these crops in Serbia, considering that it is prevalent in other crops in the area and its vectors are widespread. References: (1) Anonymous. OEPP/EPPO Bull. 34:271, 2004. (2) H. R. Pappu et al. Virus Res. 141:219, 2009. (3) G. Parrella et al. J. Plant Pathol. 85:227, 2003. (4) K. Tamura et al. Mol. Biol. Evol. 28:2731, 2011.

Measurement of 56Fe activity produced in inelastic scattering of neutrons created by cosmic muons in an iron shield

We report on the study of the intensities of several gamma lines emitted after the inelastic scattering of neutrons in (56)Fe. Neutrons were produced via nuclear processes induced by cosmic muons in the 20tons massive iron cube placed at the Earth's surface and used as a passive shield for the HPGe detector. Relative intensities of detected gamma lines are compared with the results collected in the same iron shield by the use of the (252)Cf neutrons. Assessment against the published data from neutron scattering experiments at energies up to 14MeV is also provided. It allowed us to infer the qualitative information about the average energy of muon-created neutrons in the iron shield.

First Report of Zucchini yellow mosaic virus in Watermelon in Serbia

During a survey of cucurbit viruses in the Gornji Tavankut locality (North Backa District), Serbia in June 2011, field-grown (a surface of 1.8 ha) watermelon plants (Citrullus lanatus [Thunb.] Matsum and Nakai) with mild mosaic symptoms were observed. Large numbers of Aphis gossypii were colonizing the crop. A total of 26 samples, six from plants exhibiting mosaic and 20 from asymptomatic plants, were analyzed by double-antibody sandwich-ELISA using polyclonal antisera virus (Bioreba AG, Reinach, Switzerland) against three cucurbit-infecting viruses known to infect Cucurbita pepo in Serbia: Zucchini yellow mosaic virus (ZYMV), Cucumber mosaic virus, and Watermelon mosaic virus (3). Commercial positive and negative controls were included in ELISA analysis. Only six symptomatic samples tested positive for ZYMV, but no other tested viruses were found. The virus was mechanically transmitted from a representative ELISA-positive watermelon sample (550-11) to five plants of C. pepo 'Ezra F1' and severe mosaic was noticed 10 days after inoculation. For further confirmation of ZYMV infection, total RNA from a naturally infected watermelon plant and symptomatic C. pepo 'Ezra F1' plants were extracted with the RNeasy Plant Mini Kit (Qiagen, Hilden, Germany). Reverse transcription (RT)-PCR was performed with the One-Step RT-PCR Kit (Qiagen) using primer pair ZY-2 and ZY-3 (2). Total RNA obtained from a Serbian isolate of ZYMV from pumpkin (GenBank Accession No. HM072432) and healthy watermelon plants were used as positive and negative controls, respectively. The expected sizes of the RT-PCR products (1,186 bp) were amplified from naturally and mechanically infected symptomatic samples, but not from healthy tissues. The amplified product that derived from isolate 550-11 was purified (QIAquick PCR Purification Kit, Qiagen), sequenced in both directions, deposited in GenBank (Accession No. JN561294), and subjected to sequence analysis using MEGA4 software. Sequence comparisons revealed a high nucleotide identity of 99.9 to 99.8% and 100 to 99.6% amino acid identity for the CP gene with Serbian ZYMV isolates from C. pepo (Accession Nos. JF308188, HM072431, and HM072432). The nucleotide and deduced amino acid sequences of the entire CP gene (837 nt) of the Serbian ZYMV isolate from watermelon shared 99.9 to 93.7% and 100 to 96.8% identity, respectively, with innumerous isolates of ZYMV deposited in the GenBank (e.g., Accession Nos. AJ420012-17 and FJ705262). To our knowledge, this is the first report of ZYMV spreading its host range to watermelon in Serbia. ZYMV infection has been responsible for severe epidemics on cucurbits throughout the world (1). The presence of ZYMV on watermelon could therefore represent a serious threat for this valuable crop in Serbia, especially considering that it is prevalent in other cucurbit crops in the country and the vectors are widespread. References: (1) H. Lecoq et al. Virus Res. 141:190, 2009. (2) K. G. Thomson et al. J. Virol. Methods 55:83, 1995. (3) A. Vučurović et al. Pestic. Phytomed. (Belgrade) 24:85, 2009.

[Developmental dysplasia of the hip - epidemiological determinants and age assessment regarding time of surgical correction]

PURPOSE OF THE STUDY

Aim of the study was to analyze age structure of the patients with developmental dysplasia of the hip (DDH) at the time of the operation and epidemiological determinants: gender distribution, proportion of left or right hip affection, type of delivery and mode of labor presentation.

MATERIAL AND METHODS

The population of 78 children with DDH was evaluated. Three age groups were analyzed: first group younger than 24 months of life, second group between 24 and 48 months and third group older than 48 months of life. Male and female gender was separately evaluated as well as type of delivery and mode of labor presentation. Separately, 2 groups regarding affected hip were analyzed: group with affected left hip and group with affected right hip. Radiographic findings (Collodiaphyseal angle, Hilgenreiner angle and Wibergs center-edge angle) and clinical findings (positive Trendelenburgs sign, reduced flexion angle (<114°), pain in the hip and incomplete crouch) were evaluated regarding: age of the patients, gender, mode of presentation and type of delivery.

RESULTS

There was 33.3% of patients in the first age group, 46.2% of patients in second group and 20.5% of patients in third age group, and regarding gender, 17.9% of males and 82.1% of females. Vaginal delivery was predominant mode with distribution of 87.2% as well as head presentation with distribution of 71.8%. Distribution of children with affected left hip was 46.2% and right hip 53.9%.

DISCUSSION

Majority of patients in the study were in the age group between 24 and 48 months of life, suggesting delay in on-time diagnostics of DDH. Female gender was more frequently affected by DDH and vaginal delivery as well as head presentation of newborn was significantly frequent in patients with DDH. It is shown that Collodiaphyseal, Hilgenreiner and Wibergs center-edge angles values are in correlation with the age structure of the patients with DDH at the time of diagnosis. Male gender tends more frequently to present with clinical findings. Reduced flexion angle of the hip is the frequent clinical finding for children with DDH that were born by breech presentation or delivered by Caesarean section.

CONCLUSION

Female gender can be taken as one of possible risk factors during clinical examination of newborn regarding diagnostics of DDH, while breech presentation has been shown not to be one of possible risk factors. Early diagnostics and prompt treatment are beneficial in overall outcome for children with DDH. Therefore, there is great need for countinous education of orthopedic surgeons and pediatricians.

Measurements of Hbeta Stark central asymmetry and its analysis through standard theory and computer simulations

Experimental measurements of the center of the H_{beta} Stark profile on three different installations have been done to study its asymmetry in wide ranges of electron density, temperature, and plasma conditions. Theoretical calculations for the analysis of experimental results have been performed using the standard theory and computer simulations and included separately quadrupolar and quadratic Stark effects. Earlier experimental results and theoretical calculations of other authors have been reviewed as well. The experimental results are well reproduced by the calculations at high and moderate densities.

Detection and assessment of near-zero delays in neuronal spiking activity

Cross-correlation histograms (CCHs) have been widely used to study the temporal relationship between pairwise recordings of neuronal signals. One interesting parameter of a CCH is the time position of the central peak which indicates delays between signals. In order to study the potential relevance of these delays which can be as small as 1 ms, it is necessary to measure them with high precision. We present a method for the estimation of the central peak's position that is based on fitting a cosine function to the CCH and show that the precision of this estimate can be tracked analytically. We validate the resulting formula by simulations and by the analysis of a sample dataset obtained from cat visual cortex. The results indicate that the time position of the center peak can be estimated with submillisecond precision. The formula allows one also to develop a test of statistical significance for differences between two sets of measurements.

Surgical methods for the treatment of breast phylodes tumors - a report of 319 cases

Breast phyllodes tumors (FT) belong the fibroapitelial group of breast tumors arising in terminal ductulo-lobular unit (TDLU). Their incidence do not exceed 1% of all breast tumors. Biologicaly they can be divided into benign, borderline and malignant group. Incomplete tumor excision can be the reason for local reccurence. Malignant form of FT metastazise hematogenous most often in the lung. There is no uniform surgical opinion about the treatment FT. Methods: We analyzed histopathology features of 319 FT of the breast surgically removed on Department of surgery Institut of oncology and radiology of Serbia between 1.1.1985.- 31.12.1994 . Retrospective study of surgical treatment 84 patients with FT of the breast (69 benign ,4 borderline and 11 malignant ) and 5 year follow up after surgery we analyzed. Results: local recurrence after surgery was found in 17 (20,2 %) patients(14 benign , 2 borderline and 1 malignant FT ), pulmonary metastases in 6 (7,1%) patients with malignant FT. DFI was 21,3 months for local recurrences and 25,1 months for pulmonary metastases . DFS for al forms of FT was 71 % ( p =0,7104 ) in 5- year follow up . Conclusion: According to biological behavior we propose wide excision for benign and borderline forms and simple mastectomy for malignant FT, and voluminous benign and borderline forms. Axillary disection is not necessary because lymphatic spread of malignant FT is unfrequent.

Asymmetry of Hbeta Stark profiles in T-tube hydrogen plasma

The whole Balmer H(beta) line profiles are studied in detail experimentally in the T-tube discharge for the wide range of plasma parameters. Besides the common one, two additional parameters are introduced to characterize the asymmetry behavior of the experimental Stark profiles with the reference point chosen in the center of the line. The experimental data are analyzed and benchmarked versus the simple theoretical model based on the effects of microfield nonuniformity and electron impact shifts.

Comment on "Atomic spectral line-free parameter deconvolution procedure"

Recently Milosavljević and Poparić [Phys. Rev. E 63, 036404 (2001)] proposed a method for the deconvolution of isolated asymmetric plasma broadened atomic (neutral) spectral lines. The authors claim that their method enables a complete plasma diagnostics by applying this deconvolution on a single experimental line profile. In the present Comment the proposed deconvolution procedure and its application are reexamined.

[Initial diagnosis of intra-abdominal hemorrhage caused by isolated splenic injury in blunt abdominal trauma]

Diagnosis of intraabdominal bleeding caused by spleen injury must be performed in the shortest possible period of time, with little risk for the patient, and with high preciseness. By its simple performance, high preciseness and little risk for the patient, DPL imposes as the predominant method in initial diagnostic of intraabdominal bleeding. Control and monitoring of lavage may duly signalize degree of bleeding. Preciseness of this diagnostic in our series ranges up to 93.3%. DPL method is especially important in a combined neurotrauma. Ultrasonography is a sovereign method in diagnostic of bleeding source as well as in monitoring of bleeding that from the very beginning does not require urgent surgical intervention. Its importance is in monitoring both intrasplenic and subcapsulary hematomas. It is not appliable in disturbed and haemodynamically unstable patients. It is in particular important in children where a maximum conservative attitude with respect to operative treatment has been assumed. CT takes the leading place with respect to preciseness of bleeding area, and the combined thoracoabdominal trauma. Preciseness of CT in our series comes up to 96.6%, but can be applied only in haemodynamically stable patients. Same as US of abdomen so the CT of abdomen represents a prominent method in monitoring of both intrasplenic and subcapsular hematomas, which do not require urgent surgical intervention.

A simple method for bremsstrahlung spectra reconstruction from transmission measurements

A new method for evaluation of bremsstrahlung spectra from transmission measurements has been developed. In this method some very well known facts relating to thick target bremsstrahlung spectra are a priori included in the calculation procedure. Some characteristics of the method are preliminarily illustrated on a 6 MV therapy linear accelerator.

[Dislocation of the knee joint]

Dislocations are the rarest but the most severe injuries of the knee joint. Six patients with traumatic knee joint dislocation were treated at the Clinic for Traumatology and Orthopedics of the Military Medical Academy in the period January 1989-November 1998. Popliteal artery was injured in 3 patients. The injuries required reconstruction and the treatment in 1 patient ended with upper leg amputation. In one case the diagnosis was irreducible lateral dislocation. Surgical reparation--reconstruction of ligamentary apparatus was performed in 4 patients. Concerning the knee joint stability satisfactory results were achieved. Knee joint dislocations are very severe injuries requiring thorough diagnosis of the possible injury of neurovascular bundle and surgical treatment.

[Development of highly specialized clinical drug trial units within health care institutions]

The purpose of the most of clinical trials conducted under the auspices of pharmaceutical industries is to evaluate the safety and efficacy of drugs, and they are conducted at university health care institutions or appropriate clinical centres. Close collaboration among the investigators, potential investigators and other academic citizens is essential for an effective and efficient conduct of these studies. Clinical studies usually test a drug which is to be instituted for the first time; therefore more attention is being dedicated to its administration, with monitoring of a greater number of valid parameters in accordance with the Good Clinical Practices (GCP) and Good Laboratory Practices (GLP) standards. These are very strict standards, which have been internationally adopted and are valid worldwide. They define the documentation required, the setting method, the necessary equipment and the facilities within which the clinical trials are to be conducted, as well as human resources indispensable for carrying out the clinical trials. The objective of this paper was to determine whether our medical instructions fulfil the necessary conditions for establishing the clinical trials units. Creation of a symbiosis of this kind (between the pharmaceutical industry and the appropriate health care institutions), reflected in the clinical trials unit, should enable the drug research and development to remain within our country.

Missile injuries of the knee joint

The results of the treatment of missile injuries of 170 knees in 162 patients are analyzed. The injuries were caused by infantry weapon missiles in 52(32.1%) and by fragments of mine or explosive devices in 110(67.9%) patients. The most frequent were penetrating injuries of the joint with multifragment fractures which in 15.8% cases were associated with injuries of the neurovascular bundle. Stabilization of bone fragments was required in 111(65.3%) knees. Stabilization was done by external fixation in 42(37.8%) and by plaster of Paris in 69(62.2%) knees. Additional mini osteosynthesis was required in 13(30.9%) knees stabilized by external fixation and in 3(4.3%) knees stabilized by plaster of Paris. Amputations were performed in 13(7. 6%) injured knees. During the postoperative period local and general complications occurred in 27(16.6%) patients. The most frequent local complications were suppurative articular infections requiring repeated surgery. Soft tissue defect covering was necessary in 53(33. 1%) patients. The poor late results were present in missile fractures of the knee. The most frequent were degenerative changes with bone defects. The possible surgical solutions in such cases are arthrodesis or total endoprosthesis implantation.

[Myositis ossificans in recurrent synovial hemangioma of the knee]

A case of myositis ossificans in 15-year old boy that occurred as a complication of the recurrent synovia hemangioma of the left knee was presented. The alteration was diagnosed as: osteosarcoma, chondrosarcoma and chondromyxoid fibroma by the pathologists from other institutions. The diagnosis of myositis ossificans was established using numerous histochemical and immunochemical methods (PAS, PAS diastasis, Alcian blue, Masson trichrom, von Kossa, Azur A, Toluidin blue, Goldner, method by Peris, Citokeratin, S-100, NSE and Vimentin). The presence of zonal phenomenon, as the one observed in the presented case, is one of the most significant criteria for differentiation of myositis ossificans from osteosarcoma.

Primary surgical treatment of war injuries of major joints of the limbs

We present the results of primary surgical treatment of war injuries of major joints in 339 patients, wounded in the territory of the former Yugoslavia in the period June 1991-October 1995. The total number of surgically treated joints was 358. The injuries were inflicted by the fragments of explosive devices in 176 (51.9%) patients and by bullets in 125 (36.9%) patients. A single wound was present in 160 (47.2%) and several wounds in 176 (51.9%) patients; 276 (77.1%) patients had injuries of articular bone. The most frequently injured joints were knee joint 167 (46.6%) and elbow joint 72 (20.1%). Associated neurovascular injuries were present in 68 (18.9%) patients. Postoperative bone fragment stabilization was required in 254 (70.9%) joints. Stabilization was by plaster of Paris in 148 (58.2%) and external fixation in 85 (33.4%) patients. Postoperative course was uneventful in 262 (77.3%) while postoperative complications occurred in 77 (22.7%) patients. Amputations were performed in 15 (4.4%) patients. After the primary surgical treatment 254 (74.9%) patients were discharged and directed to rehabilitation or home care and 81 (23.9%) patients required additional reconstructive surgery for bone and soft tissue defects.

Subtrochanteric missile fractures of the femur

The treatment results of subtrochanteric missile fractures of the femur in 41 casualties are analyzed. The wounds were inflicted by infantry weapon missiles in 29 (70.7%) and by fragments of mine or explosive devices in 12 (29.3%) casualties. The associated neurovascular bundle injuries were present in 11 (26.8%) patients. Fracture stabilization was done by external fixation in 25 (62.5%): group A; and by plaster of Paris in 15 (37.5%) patients: group B. The postoperative period was uneventful in 14 (35.0%) and early or late complications occurred in 26 (65.0%) patients. Bone infection developed in six (15.0%) and fractures did not heal in four (10.0%) patients. Complications were present in 13 (52.0%) patients from group A and in 13 (86.7%) patients from group B. Delayed fracture healing and fracture nonunion were present in group A and contractures of large joints in group B. Subtrochanteric missile fractures of the femur present very severe injuries where the treatment is followed by a very high percentage of complications. External fracture fixation in this region facilitates the care, stability, early covering of soft tissue defects and early physical therapy.

[Rigid osteosynthesis with the AO plate and Phemister's spongioplasty in secondary treatment of diaphyseal gunshot fractures]

In prospective study, in 160 injured with diaphyseal gunshot fractures (DGF), in secondary treatment phase, there were applied rigid osteosynthesis by AO plate and spongioplasty with iliac graft by Phemister assuming that this method would provide good functional results. The average age of injured was 32.25 years, and average postsurgical follow-up period was 32.5 months. The fracture healing was achieved in 93.7% injured while pseudoarthrosis developed in 6.25%. Osteomyelitis, as the second significant complication, appeared in 8.12% cases. Good functional results were achieved in 55.62%, satisfying in 36.25% while the poor result was noticed only in 8.12% cases. The applied method in DGF treatment proved to be very successful, it led to faster fracture healing, shortening of hospitalization time of the injured with better functional results and less complications compared to the other treatment methods in the secondary phase.

[Pigmented villonodular synovitis--analysis of 50 patients]

Fifty patients with pigmented villonodular synovitis (PVNS) were examined and treated in the Military Medical Academy in twenty-year period (1977-1996). Among them, 32 were male and 18 female (2:1), of average age from 6 to 72 years. Articular disease localization was 2.5 times more frequent compared to the non-articular. The rate of circumscribed in relation to diffuse form was 1.5:1. The ankle joint was most frequently involved (94%). In one patient, PVNS was proved in both ankle joints. The disease was clinically expressed as chronic, and 4 times more frequently as chronic recurrent synovitis. The data of previous injury were known in 14 patients. Associated rheumatic disease or injury was found in more than a half patients (53%). For the disease diagnosis there were used: physical examination, standard laboratory tests, radiography, ultrasonographic and magnet resonance examination and histopathologic examination of synovia obtained by open or arthroscopic biopsy. Surgical methods, such as total or partial synovectomy were applied in the therapy. Chemical synovectomy was performed in one patient, 6 months after the diagnostic arthroscopy due to disease recurrence. Therapeutic effect was estimated in 22 patients, from 3 months to 11 years after the surgery on the basis of disease recurrence. Except for the cited one patient, none other had the disease recurrence. It was concluded that timely diagnosis of PVNS offered more adequate treatment and conditions for complete recovery. In the disease limited just in the ankle joint, arthroscopic synovectomy would be the therapy of choice. In advanced diffuse form, total synovectomy should be performed for all the disease localizations.

Arthroscopy of the knee in war injuries

The results of arthroscopic removal of bullets and explosive ordnance fragments from the knee joint are presented. The operations were performed on 18 patients injured in battle operations in the former Yugoslavian territory in the period September 1991-October 1994. The indications for arthroscopic operations were positive radiographic findings, a locked knee, pain, effusion, instability and painful movement. In 13 patients, bullets and explosive ordnance fragments were removed arthroscopically, while in five patients, the clinic findings were found to be misleading. There were no complications from the arthroscopic surgery.

[Chronic knee instability--arthroscopic analysis]

Knees in 150 patients with the old disruption of the anterior cruciate ligament (ACL) and a certain degree of anterolateral rotational instability have been arthroscopically analyzed. The complete old disruption of ACL has been found in 130 (86.6%) patients, and a partial one in 20 (13.4%) patients. The degenerative changes of the inner femoral condylus have been present in 79 (52.6%) and of lateral femoral condylus in 14 (9.3%) patients. In 35 (23.3%) patients there has been the simultaneous disruption of both menisci. The isolated disruption of medial meniscus has been found in 44 (29.3%), and of the lateral one in 43 (28%) patients. The knee with disruption of meniscus has been found in 122 (81.3%) patients.

Effects of cis-diamminedichloroplatinum II (cisplatin) on the splenic tissue of rats: a histoquantitative study

Histoquantitative methods were applied to study the changes of splenic structure and proportions of splenic tissue compartments in cisplatin-treated (6 mg/kg body wt) male Wistar rats. Six days after treatment the significant reduction of volume density of white pulp was observed, which was due to the very prominent decrease of volume density of follicles. The volume density of periarteriolar lymphatic sheaths did not change substantially. Volume density of the marginal zone was also significantly reduced. A significant increase of volume density of connective tissue was observed. Morphometrical parameters of the follicles were also markedly altered: the number of follicles per mm2 of spleen section area, the numerical density of the follicles in the spleen, and the total number of the follicles were significantly reduced.

[Influence of steroid receptors content in primary breast cancer on early relapse pattern]

The early relapse pattern was followed in 165 operable breast cancer pts: 81 pts in stage I of the disease being without any adjuvant treatment, and 84 pts in stage II receiving systemic adjuvant chemo-, hormono-, or chemohormonal treatment, according to nodal status, histological grade of tumours and positivity of progesterone receptors (PR > 20 fmol/mg), as the functional parameter of primary tumour hormonodependency. The analyses of early relapses, occurring within the first 24 months, were based on quantitative oestrogen and progesterone receptor values, known as the prognostic and predictive factors for the early relapse pattern, and for the responce to adjuvant treatment. In stage I pts ER distribution showed lower values in pts with relapse, as compared to the group without relapse (0-115 vs. 0-464), and a tendency for relapse occurrence below the ER levels of 33 fmol/mg. Such a trend was not found for PR. In stage II pts a remarkable trend towards lower values of both receptors was observed in relapsed pts. A trend towards lower receptor values existed in both stages in pts with visceral metastases (ER = 0-50 fmol/mg, PR = 0-64 fmol/mg), while in those with bone metastases the receptor levels tended to be higher (ER = 0-1 15 fmol/mg, PR = 0-278 fmol/mg). Our results indicate the importance of steroid receptor status as a prognostic factor as well as its role in prediction of the localization of early relaps in operable breast cancer.

[Diagnostic arthroscopy of the knee and its use in meniscus surgery]

The results of 1000 diagnostic knee arthroscopies are presented. The clinical diagnosis of meniscus tear was established in 740 (74%) patients. This diagnosis was arthroscopically confirmed in 431 (58.2%) patients only. Other pathologic states of the knee were clinically diagnosed in 260 (26%) patients. In this group of patients the meniscus tear was found by arthroscopy in 41 (15.7%) patients. Complications developed in 11 (1.1T%) of all operated patients.

[Early results of arthroscopic meniscectomy of the knee]

The results of 218 arthroscopic meniscectomies of the knee in 200 patients are reported. There were 188 men and 12 women. There have been performed 141 medial, 41 lateral and 18 bilateral meniscectomies. The tear in the form of "bucket handle" was dominated and it was found in 140 cases of which 76 were incarcerated. The postoperative hospitalization lasted 1 to 3 days. No infections of arthroscopic operative wounds were found. Three synovitis with effusions were found.

[Clinico-arthroscopic analysis of the synovial plica of the knee]

In order to evaluate frequency of synovial plica and diagnosis of synovial plica syndrome 200 knees were analysed clinically and arthroscopically. In 79 (39%) knees synovial plica was the only finding or together with damages of other structures of the knee. As the isolated finding and the cause of plica syndrome, the mediopatellar plica was diagnosed in 16 (8%) patients. The crossed mediopatellar plica was found in 6 patients and in 1 patient it was the cause of plica syndrome. In four patients the infrapatellar plica was in the form of the complete septum.