The Mediterranean deep-water kelp Laminaria rodriguezii is an endangered species in the Adriatic Sea

Deep-water kelps are little-known large brown algae occurring close to the lower limit of photosynthetic life in the sea. This study compares historical and recent records of the deep-water Mediterranean kelp Laminaria rodriguezii in the Adriatic Sea. Historical records include data from herbarium collections and trawling fishery expeditions in the mid-twentieth century, while recent data comprise records of the last 17 years from MEDITS expeditions, ROV surveys of historical kelp locations, benthic surveys and records by fishermen. Altogether, these findings demonstrate that the Adriatic population of L. rodriguezii has suffered a decline of more than 85 % of its historical range and is now present only around the small offshore island of Palagruža. Bottom trawling activities are presumably responsible for the disappearance elsewhere. We propose to classify L. rodriguezii as "Endangered" in the Adriatic Sea under IUCN criteria B1ab(i,iii,iv), ver 3.1. Oceanographic characteristics of the habitat suggest that besides high water transparency, presence of North Adriatic Dense Water with both strong currents and stable low temperatures of around 14 °C are essential oceanographic factors for the development of L. rodriguezii in the Central Adriatic. The origin of cold water thus differs from that at upwelling sites permitting populations of tropical deep-water kelps. The phylogenetic position of L. rodriguezii is so far unknown. DNA sequences from nuclear and cytoplasmic markers of two thalli from Croatia and the western Mediterranean confirmed that L. rodriguezii is a member of the Laminariaceae and most closely related to L. ochroleuca, L. pallida and the Brazilian deep-water kelp L. abyssalis.

New record and phylogenetic affinities of the oomycete Olpidiopsis feldmanni infecting Asparagopsis sp. (Rhodophyta)

A new geographic record of the oomycete Olpidiopsis feldmanni infecting the tetrasporophytic stage of the red alga Asparagopsis sp. from the Adriatic Sea, confirmed through morphological identification, allowed us to expand previous observations of this organism. Ultrastructural investigations of environmental material showed a large central vacuole and a cell wall thicker than previously reported from other basal oomycete pathogens of algae. Phylogenetic analysis closely associates O. feldmanni to O. bostrychiae concurrent with structural observations. This constitutes the first genetic characterisation of an Olpidiopsis species that was initially described before 1960, adding to the genetic data of 3 other marine Olpidiopsis species established and genetically characterised in the last 2 decades. The paper discusses concurrences of the ultrastructural observations made here and in previous studies of the marine Olpidiopsis species with those made on the freshwater species.

Genetic analysis of Dobrava-Belgrade virus from western Serbia--a newly detected focus in the Balkan Peninsula

Dobrava-Belgrade virus (DOBV) is a hantavirus species that causes the most severe form of haemorrhagic fever with renal syndrome (HFRS) in Europe. DOBV has been detected in three Apodemus rodents: A. flavicollis, A. agrarius and A. ponticus. These emerging viruses appear throughout the Balkan Peninsula including Serbia as its central part. In this study, we examined the seroprevalence, molecular epidemiology and phylogenetics of DOBV from A. flavicollis captured at six Serbian localities. Furthermore, we applied microsatellite typing of host animal genome to analyse the role of host kinship in DOBV animal transmission. The overall IgG seropositivity rate over 3 years (2008-2010) was 11.9% (22/185). All seropositive samples were subjected to RT-PCR and DNA sequencing for S and L genome segments (pos. 291-1079 nt and 2999-3316 nt, respectively). DOBV was genetically detected in three samples from mountain Tara in western Serbia, a newly detected DOBV focus in the Balkans. No sequence data from human cases from Serbia are available for the studied period. However, collected DOBV isolates in this work phylogenetically clustered together with isolates from Serbian human cases dating from 2002, with 1.9% nucleotide divergence. We determined the level of kinship between seropositive and seronegative animal groups and found no significant difference, suggesting that horizontal virus transmission in the studied population was the same within and among the hatches. Our findings are the first genetic detection of DOBV in rodents in Serbia. We confirm wide and continuous hantavirus presence in the examined parts of the Balkans, underlying the necessity of continual monitoring of hantavirus circulation in A. flavicollis.

Uncertainty analysis along the ecological quality status of water bodies: the response of the Posidonia oceanica multivariate index (POMI) in three Mediterranean regions

Uncertainty analyses allow the identification and quantification of the factors that contribute to the potential misclassification of the ecological status of water bodies, helping to improve the sampling design used in monitoring. Here we used a Posidonia oceanica multivariate index (POMI) bio-monitoring dataset covering a total of 81 sites distributed throughout 28 water bodies from the coast of Catalonia, Balearic Islands and Croatia to determine the levels of uncertainty associated with each region and how they change according to the quality status of water bodies. Overall, variability among sites (meadows) within water bodies was the factor that generated the greatest risk of misclassification among the three regions, within which the Balearic Islands had the lowest uncertainty, followed by Croatia and Catalonia. When water bodies classified in good/high quality were separated from those in moderate/poor status classes, we found that the latter displayed higher levels of uncertainty than the former.

[Topographic localisation of insertion of the anterior cruciate ligament]

INTRODUCTION

Determining the center of tibial insertion of the anterior cruciate ligament is important during reconstruction ligament.

AIM

Determining the center of insertion of the anterior cruciate ligament on the anterior intercondylar area relate to anterior and medial edge of the upper end of tibia.

MATERIAL AND METHODS

The messurement has been done on 102 tibia. We measured distance from the center of ACL to anterior and medial edge of the uper part of tibia, and the lenght and the width of the tibial insetion. Also, we showed the procentual ratio these distances with medio-lateral and anteroposterior diametar of upper tibial part.

RESULTS

The distance between the centre of attachment and medial edge is at 39% from entire latero-medial diametar, while the distance from anterior edge is at 31% from entire anterio-posterior diametar. The possitive correlation between the distance of centar of the anterior cruciate ligament from anterior and inner edge (r = 0.366, p) was found.

CONCLUSION

The center of the attachment of the ACL at anterior intercondylarl area is at 1/3 of antero-posterial diametar behind the anterior edge of the upper part of tibia and 2/5 of latero-medial diametar inside from the medial edge.

[Current trends in surgical treatment of radial nerve injuries associated with injuries of the humerus]

Radial nerve is the most common injured peripheral nerve after bone and wrist injuries in human body. Radial nerve can be injured by force causing fracture of the humeral shaft, due to compound fracture of the bone or by direct injury with small fragments of the bone. This happen in of cases and in remaining caseswas caused by manipulation during the treatment of the fracture of the humeral shaft. Because of the possibility of spontaneous recovery, indication and timing of surgical treatment of the radial nerve still remain controversial. There is contradictory approach in the treatment of the injured radial nerve. In a period betwen 1979 and 2005 year we have operated 193 patients with injury of radial nerve. Among them, 97 (50.2%) have had combined injury of the humeral shaft or proximal part of radius. Rest of injuries of the radial nerve were associated with manipulation during treatment. Surgical treatment has been performed in a period between three and four months after neurological deficit. Analysing our result regarding recovery of the motor function we have used combination of gradation including British Medical Council Score and modified Highet Scale to obtain satisfactory analysis of useful functional recovery of motor function after surgical procedure. We have classified results as bad M O-2 for all muscles innervated by the radial nerve; satisfactory M3, for extensors of the wrist and fingers and M O-2 for abductor of the thumb, good M 4-5 extensors of the wrist and fingers and M3 for abductor of the thumb, and excellent M 4-5 for all muscles.

[Influence of morphometric intercondylar notch parameters in ACL ruptures]

The most important anatomic risk factors in ACL lesions are the morphometric parameters of intercondylar notch. In the morphometric studies index of notch width and index of notch shape (NWI and NSI) are commonly used. The certain morphologic parameters of distal femoral part are used in calculation. Beside standard parameters we measured the maximal width of intercondylar notch and distal part of femur, which we used for calculation of maximal index of notch width and maximal index of notch shape (NWI max and NSI max). We compared two different methods of calculation of intercondylar notch indexes to find out which one represent anatomic risk factor and influence the ACL lesions. The indexes were measured in the two groups of patients (33) who have the history of knee injuries, the first group has document of ACL injuries and the second without ACL injuries (control one). The important difference between two groups was founded in NWI (p < 0.01) and NSI (p < 0.05). NWImax and NSImax do not show the difference (p > 0.05). The NWI and NSI importance is higher in males, and smaller in females. There is no difference in NWImax and NSImax (p > 0.05) comparing to the gender.

[Massive hemorrhage and mechanisms of coagulopathy in trauma]

Trauma is disease of the young, mainly affecting people between 15-40 years of age. Uncontrolled massive bleeding is the leading cause of early in-hospital mortality, within 48h of admission, and the second leading cause of prehospital death in victims of both military and civilian trauma, accounting for 40-45% of the total fatalities. Coagulopathy develops early after injury and is present in 25-36% of trauma victims upon admission to the emergency department. Coagulopathy correlates to the severity of trauma and is associated with an increased risk of mortality. The aim of this paper is to explain pathophysiology of developing coagulopathy in trauma. The coagulopathy in the trauma patient is complex and multifactorial. It includes: dilutional coagulopathy, hypothermia, acidosis, hyperfibrinolysis, anemia and consumption coagulopathy. When the patient develops the so called "lethal triad" of hypothermia, acidosis and coagulopathy, surgical restoration of vascular integrity may be insufficient to achieve a deffinitive control of blood loss and non-mechanical bleeding from small vessels, usually terminated by spontaneous coagulation, becomes a life-threatening condition.

Ucestalost ortopedskih povreda kod politraume

Trauma is one of the leading causes of mortality in the world. Traumatic injury has a significant impact on the patient, socially, functionally and financially. Orthopedic injuries are generally not life-threatening unless they result in significant hemodynamic instability. The outcome of the orthopedic injuries might lead to mild or severe disability and lost quality of life. Therefore, the orthopedic surgeon has significant role in treatment of trauma patient. In order to control and prevent traumatic injuries, to improve quality of trauma treatment and outcome, including the costs the National trauma registry is essential. The aim of the study was to collect the dates about the frequency of orthopedic injuries in polytraumatised patients who were treated in intensive care unit of Emergency Center of Serbia in last two years. There were significant number of orthopedic injuries (53,2%) in polytraumatised patients. The major cause of the injuries is traffic (78,6%) and most patients were between 30-50 years (30%).

The relaxant effect of vasoactive intestinal polypeptide in the isolated canine uterine artery: the role of endothelium

The purpose of this study was to examine the effect of vasoactive intestinal polypeptide (VIP) on the uterine artery obtained from non-pregnant dogs. VIP (3 x 10(-9)-3 x 10(-7) M) induced concentration-dependent relaxation in canine uterine arteries with intact endothelium, pre-contracted with 10(-5) M phenylephrine (pEC(50) = 7.52 +/- 0.02, maximal response was 82.19 +/- 2.15%, n = 36). The administration of the cyclooxygenase inhibitor indomethacin (10(-5) M) or 4-aminopyridine (4-AP), a blocker of potassium channels (10(-5) M), did not modify the relaxation induced by VIP. Contrary to this, N(G)-nitro-L-arginine (L-NOARG) (10(-5) M) inhibited relaxation is evoked by VIP. Indomethacin applied with L-NOARG did not provoke further inhibition of VIP-induced relaxation. In the presence of both L-NOARG and L-NOARG + indomethacin, 4-AP led to the further inhibition of VIP-induced relaxation of canine uterine artery. It is concluded that VIP induces endothelium-dependent relaxation of uterine arteries of non-pregnant dogs, which can be entirely explained by the production of nitric oxide (NO) from the endothelial cells. We proposed that when NO synthesis is inhibited, VIP induces further relaxation, independent of the edothelium-derived relaxing factors, probably through activation of K(+) channels.

[Protective ventilation strategy in the acute respiratory distress syndrome]

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) contribute to progressive hypoxemia in critically ill patients. It has been proved that conventional mechanical ventilation with physiological respiratory volume contributes to further lung damage. In this respect, application of protective ventilatory strategy--pulmonary ventilation with limited volume and pressure can avoid mentioned consequences. The aim of this paper is to discuss mechanims by which elements contained in protective mechanical ventilation of patients with ALI/ARDS prevent further progrssive lung injury, to argue the effects of positive end--expiratory pressure and present insturctions for its application.

[Determination of beta-endorphin plasma concentrations in surgical patients with acute abdominal pain]

Abdominal pain and surgery, frequently associated with this kind of pain, modify plasma levels of stress-hormones and iniciates the response of endogenous analgetic system. The aim of this study was to determine serum concentration of beta-endorphine in patients with acute abdominal pain (n=12), which were surgically treated. Serum concentration of beta-endorphin was measured on five data points: before, during and after surgery. During abdominal surgery serum concentration of beta-endorphin was increased by 7% compared to preoperative period; in postoperative period the concentration continued to rise and remained increased within next hours. The maximal levels of beta-endorphine were not observed during, and immediately after surgery. Postoperatively, between 6 and 8 p.m. on the day of surgery, maximal level of beta-endorphin was noted, which was even ten times higher than to preoperative value. Plasma level of beta-endorphin fell to the baseline values 24 hours after surgery. In conclusion, abdominal surgery induces a postponed (delayed) increase in serum beta-endorphine levels, which are associated with modulation of preoperative, intraoperative and postoperative pain perception.

Ultrasound measurement in defining the regional distribution of subcutaneous fat tissue

The aim of this research is to determine the significance of ultrasound diagnostics in measuring the thickness of subcutaneous fat tissue as well as to point out sex and age differences in regional distribution of subcutaneous fat tissue. The research included 37 men and 33 women with different body mass indexes. Ultrasound measuring of subcutaneous fat tissue was conducted on 16 measuring points. The thickness of subcutaneous fat tissue measured by ultrasound and estimated proportion of fat tissue obtained by comparative methods coincided mostly on the back side of the upper arm, lower abdominal region in interspinal line and the front side of the forearm. Analysis of the subcutaneous fat tissue distribution indicates that there is more equal accumulation of fat tissue in women than in men. BMI limit value for obesity is not the same for men and women because the point at which abdominal region becomes the main storage of subcutaneous fat in body depends on sex. That BMI value represents the physiological beginning of obesity since it marks the change in distribution pattern of subcutaneous fat tissue in different body regions.

Glomerular involvement in myelodysplastic syndromes

Several reports have documented various forms of glomerular diseases in adults with myelodysplastic syndromes (MDS), but similar reports in children are lacking. We describe two children with MDS-associated steroid-responsive nephrotic syndrome (NS). Patient 1, who had MDS with myelofibrosis, presented with hepatosplenomegaly, pancytopenia, chronic hepatitis, moderate proteinuria, hypocomplementemia and elevated ANA titer. During initial prednisone treatment proteinuria markedly diminished and partial but transient hematological improvement occurred. Relapse subsequently occurred that manifested by overt NS and pancytopenia. High doses of prednisolone led to remission of the renal disease, but hematological remission did not occur. Persisting pancytopenia and repeated infections terminated in sepsis, 2 years after the onset of the MDS. Patient 2, who had refractory anemia with clonal monosomy 19, presented with bowel disease, hepatosplenomegaly, anemia and non-organ-specific autoantibodies. Prednisone led to both clinical and hematological remission. The hematologic disease relapsed 12 months later, when nephrotic-range proteinuria, hematuria and mild azotemia were also found. Corticosteroid treatment led to long-lasting renal and hematologic remission, maintained by a small dosage of prednisone. In both patients, renal biopsy findings were consistent with those seen in idiopathic NS. A Medline search disclosed 16 cases of glomerulopathy in the course of MDS in adult patients. Clinical features included NS, usually accompanied by renal insufficiency with acute, chronic, or rapidly progressive glomerulonephritis. On biopsy, membranous nephropathy, crescentic or mesangial proliferative glomerulonephritis, and AL amyloidosis were found. We conclude: (1) that glomerular disease may be present and should be searched for in patients with MDS and (2) that MDS can be added to the list of rare conditions associated with corticosteroid-responsive NS in children.

[131-I-lipiodol in therapy of liver carcinoma--methods and case report]

INTRODUCTION

Primary malignant liver tumors are successfully treated only by means of surgery, but no more than 10% of patients are candidates for surgical intervention. The rest receive only palliative treatment which is, as a rule, unsuccessful. 131I-Lipiodol therapy (commercial label LIPIOCISTM) applied to the hepatic artery through a catheter has been used since 1984, primarily for treatment of hepatocellular carcinoma (HCC). The aim of this paper is to review the methodology of 131J-Lipiodol treatment of primary liver carcinomas. This treatment was applied for the first time in Yugoslavia.

CASE REPORT

A female patient, 46 years of age had an inoperable primary liver carcinoma. Since progression of the disease couldn't be controlled by chemotherapy, treatment with 131I-Lipiodol was indicated. After blocking the thyroid with Lugol, Sol. 2.22 GBq of 131I-Lipiodol was injected into hepatic artery via catheter, and the patient was isolated in a designated facility until discharged. Around 5 months later, second therapeutic dose of 1.11 GBq was administered. Early post-therapy complications were severe, but transient. After 131I-Lipiodol therapy, the tumor growth was stopped, but the patient's general condition slowly deteriorated. The patient died 7 months after receiving the first therapeutic dose.

CONCLUSION

In the reported patient, 131I-Lipiodol therapy stopped the tumor growth within the liver and significantly prolonged survival compared to the expected, but no improvement in quality of life was achieved. This treatment methodology is very complex. Medical staff providing care for these patients is exposed to substantial irradiation.

[Acute tubulointerstitial nephritis in children]

Acute tubulointerstitial nephritis (ATIN) is a rare renal disorder in children. Patients usually present non-specific symptoms and signs so that the diagnosis of ATIN is often delayed. The disease may be infection- or drug-induced or it may occur without a known cause. Early recognition and appropriated therapy usually lead to an excellent prognosis. The aim of the study was to describe clinical and laboratory findings and the course of ATIN in 21 patients, that are typical enough to enable early recognition of the disease as it is potentially reversible.

METHODS

Between 1986 and 1997 we observed 21 patients, aged 7-16 years (mean, 12.8), with acute tubulointerstitial nephritis, including eight with tubulointerstitial nephritis and uveitis (TINU syndrome). Laboratory studies included urinalysis, complete blood count, erytrocyte sedimentation rate (ESR), plasma creatinine, glomerular filtration rate (GFR), electrolytes, proteins, IgG, C3, C4 antinuclear-antibodies (ANA), antistreptolysin-O and antibodies to hantaviruses. Renal ultrasound was done in all patients. Renal biopsy was performed in 5 children.

RESULTS

All children had previously been healthy. The symptoms of ATIN developed within a few days (Table 1). The most common initial symptoms were fatigue, fever, gastrointestinal disturbances, anorexia and weight loss. Less common complaints included headache, arthralgias and maculopapular rash. On addmition no patient had hypertension, oedema or evidence of acute infection. ESR, plasma urea and creatinine concentrations were increased in all, plasma proteins and IgG levels in the majority of patients. ANA were negative in 15 pts in whom this analysis was performed; C3 and C4 levels were normal. In two children recent strepococcal and in the other 6 hantavirus infection was serologicaly proved. All patients had non-oliguric acute renal failure (ARF): GFR was 21.7 +/- 8 9 in 14 pts and 67 +/- 9.7 in 7 pts. Low urine specific gravity (1003-1014), mild proteinuria (0.3-0.4 g/24 h), leukocyturia and/or haematuria were found in all patients; glycosuria, aminoaciduria and decreased tubular reaposrption of phosphate (TRP) were found in 12/21, 9/21 and 9/14 patients, respectively. Urine cultures were negative in all children. Renal US demonstrated enlarged hyperechoic kidneys in 11 pts, in remaining 10 pts no abnormalities were found. Renal biopsy, performed in 5 children, confirmed the diagnosis of ATIN. Eight patients subsequently developed anterior uveitis as part of TINU syndrome. Treatment included supportive therapy in all and six patients received prednisolone for 4-8 weeks (40-60 mg/m2/24 h for 10-14 days with subsequent reduction of dose over several weeks). Anterior uveitis was successfully treated with topical steroids. Renal function completely recovered in all patients: GFR (109 +/- 22.6 ml/min) within a mean interval of 47 +/- 33 days, concentration ability within 2-12 (mean 4.5) months.

DISCUSSION

Common clinical features of ATIN are non-oliguric acute renal failure of various degrees, signs of tubular dysfunction, proteinuria, haematuria, leukocyturia and absence of hypertension. All our patients had normal blood pressure, non-oliguric renal failure, proteinuria, hypostenuria and abnormal urinary sediment; about half of them had glycosuria and/or other signs of proximal tubular dysfunction. The most important causes of ATIN in children reported in literature are systemic infections and drugs. However, the cause of ATIN in our patients was assessed as being related to infection only in 8 patients and to diclofenac in one. No infection, drug, toxin or other cause could be identified in 4, as well as in 8 pts with TINU syndrome. The prognosis of ATIN in children is considered to be favourable, but some patients may develop chronic renal failure. Renal function completely recovered in all our patients; that is consistent with outcome data from the most reports.

CONCLUSION

Acute tubulointerstitial nephritis is an important cause of ARF in children, its aetiology may be different and it carries an excellent prognosis. ATIN should be suspected in a child who presents typical, although non-specific symptoms and signs, associated with lukocyturia and/or microhaematuria, signs of tubular dysfunction and unexplained renal failure. The diagnosis can be verified at renal biopsy. Early recognition of the disease is important to remove possible aetiologic agents and to treat them before chronic lesions are present to avoid long-term renal damage.

Interferometry in the assessment of biomechanical features of the masticatory system hard segments

Biomechanical studies have found wide application and solved many problems in dental medicine. An interdisciplinary approach has allowed an ever-faster progress in the field. The aim of this study was to point out the advantages of holographic interferometry. With the use of this method, the study object is observed as a whole rather than as a substrate, thus providing a three-dimensional holographic image visualizing the load transmission from one jaw to another, tooth pressure against the alveolus, and strain of Sharpey's fibers, and yielding precise data on deformities, dislocations and force distribution.

Osteogenic effect of a gastric pentadecapeptide, BPC-157, on the healing of segmental bone defect in rabbits: a comparison with bone marrow and autologous cortical bone implantation

Gastrectomy often results in increased likelihood of osteoporosis, metabolic aberration, and risk of fracture, and there is a need for a gastric peptide with osteogenic activity. A novel stomach pentadecapeptide, BPC-157, improves wound and fracture healing in rats in addition to having an angiogenic effect. Therefore, in the present study, using a segmental osteoperiosteal bone defect (0.8 cm, in the middle of the left radius) that remained incompletely healed in all control rabbits for 6 weeks (assessed in 2 week intervals), pentadecapeptide BPC-157 was further studied (either percutaneously given locally [10 microg/kg body weight] into the bone defect, or applied intramuscularly [intermittently, at postoperative days 7, 9, 14, and 16 at 10 microg/kg body weight] or continuously [once per day, postoperative days 7-21 at 10 microg or 10 ng/kg body weight]). For comparison, rabbits percutaneously received locally autologous bone marrow (2 mL, postoperative day 7). As standard treatment, immediately after its formation, the bone defect was filled with an autologous cortical graft. Saline-treated (2 mL intramuscularly [i.m.] and 2 mL locally into the bone defect), injured animals were used as controls. Pentadecapeptide BPC-157 significantly improved the healing of segmental bone defects. For instance, upon radiographic assessment, the callus surface, microphotodensitometry, quantitative histomorphometry (10 microg/kg body weight i.m. for 14 days), or quantitative histomorphometry (10 ng/kg body weight i.m. for 14 days) the effect of pentadecapeptide BPC-157 was shown to correspond to improvement after local application of bone marrow or autologous cortical graft. Moreover, a comparison of the number of animals with unhealed defects (all controls) or healed defects (complete bony continuity across the defect site) showed that besides pentadecapeptide intramuscular application for 14 days (i.e., local application of bone marrow or autologous cortical graft), also following other pentadecapeptide BPC-157 regimens (local application, or intermittent intramuscular administration), the number of animals with healed defect was increased. Hopefully, in the light of the suggested stomach significance for bone homeostasis, the possible relevance of this pentadecapeptide BPC-157 effect (local or intramuscular effectiveness, lack of unwanted effects) could be a basis for methods of choice in the future management of healing impairment in humans, and requires further investigation.

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.