Postoperative Morbidity after Dental Treatment under General Anesthesia in Children with and without Disabilities

Background and Objectives: General anesthesia induces reversible unconsciousness, eliminating sensation and enabling painless medical procedures. Vital for dental care, it addresses patients with medical conditions, those needing extensive procedures, and those unable to cooperate due to fear. Dental care for patients with disabilities is a significant unmet need, with studies showing increased oral disease prevalence. This research aims to analyze postoperative morbidity both in healthy and disabled children undergoing dental procedures under general anesthesia. Materials and Methods: This study involved 96 children aged 3 to 15 with dental caries. Two groups were formed: the control group (CTL) (52.94%) included healthy patients requiring general anesthesia due to unsatisfactory cooperation, and the other group included children with physical or intellectual disabilities (CD) (47.96%). Postoperative complications were monitored 1 h after the procedure and 1, 3, 7, and 14 days after the procedure by contacting parents/caregivers by phone. The intensity of postoperative pain was assessed using the Wong-Baker faces pain rating scale. General anesthesia was conducted following a standardized protocol for dental procedures. Results: CTL patients complained more often about postoperative pain 1 h after the procedure (p = 0.03). One day after the procedure, oral bleeding (p = 0.04), fever (p = 0.009), and diarrhea (p = 0.037) occurred more often in CD. In the same period, sore throat appeared more often in CTL (p = 0.036). Three days after the dental treatment, there were statistically significant increases in the occurrence of agitation (p = 0.043) and constipation (p = 0.043) in CD. Seven days later, CD demonstrated a higher occurrence of agitation (p = 0.037). According to the Wong-Baker faces pain rating scale, CTL experienced more frequent and intense pain. Conclusions: CD more frequently reported complications like oral bleeding, fever, and diarrhea. In contrast, the CTL group more often reported pain-related symptoms. The conclusion underscores the need for a pain control protocol for CD and emphasizes the importance of frequent monitoring to prevent unwanted consequences during tooth restoration under general anesthesia.

The Role of Family Factors in the Development of Dental Anxiety in Children

Background and Objectives: In the literature, the influence of parents who suffer from dental anxiety and a previous unpleasant experience at the dentist are cited as the two most common causes of dental anxiety in children. The aim of this study is to investigate the relationship between socioeconomic factors and the development of dental anxiety in children aged 9 to 12 years. Materials and Methods: A total of 131 children and their accompanying parents/guardians participated in the cross-sectional study. The children were divided into an experimental group, which visited a specialised office for paediatric and preventive dentistry for the examination, and a control group, which visited a primary care dental office. During the visit, the children completed questionnaires on dental anxiety (CFSS-DS). Parents completed a socioeconomic questionnaire and a dental anxiety questionnaire for adults (CDAS). Results: The results showed a statistically significant positive predictor: parental dental anxiety as measured by the CDAS. In addition, the t-test showed that children who visited a specialised dental office did not show a statistically significant increase in dental anxiety compared to children who visited a primary care dental office. Conclusions: With this study, we confirm the influence of parental dental anxiety on the development of dental anxiety in children. The socioeconomic status of the family and the type of dental office do not play a statistically significant role in the development of dental anxiety in children.

Bennett Angle, Condylar and Jaw Movements in Asymptomatic Athletes with a History of a Blow to One Side of the Mandibula

Sports activities may induce long-lasting changes in mandibular trajectories. The aim was to compare condylar and mandibular movements in athletes with orofacial injuries with values measured in non-injured athletes. The group of 132 athletes without mandibular injury included asymptomatic athletes with a history of a blow to the right side (N = 43) and the group included asymptomatic athletes with a history of a blow to the left side (N = 41) of the mandible. The injured athletes suffered from stiffness/pain and/or limitation of jaw movements. The symptoms disappeared shortly after the injury. Athletes with a history of injury have smaller mean values of Bennett angle on the side of impact, and Bennett angle on the opposite side is greater than the mean found in non-injured athletes. Significantly smaller Bennett angle values in athletes with a history of a blow to one side of the mandible are due to the adaptability of the orofacial system. The larger Bennett angle on the opposite side of the injury is also due to the adaptive mechanism of the TMJ. Clinical Relevance: An individualized approach to TMJ values is mandatory in restorative procedures in every patient, especially in patients with a history of trauma to the orofacial system.

Evaluation of Bioactive Glass Treatment for Dentin Hypersensitivity: A Systematic Review

The aim of this systematic review is to compare home and office desensitizers containing bioactive glass with control groups in randomized controlled trials (RCT) conducted between 2018 and 2022. According to PRISMA guidelines, three electronic databases (Scopus, PubMed, and Cochrane Library) were searched for published scientific articles in October 2022. RCT with adult participants with dentin hypersensitivity (DH) diagnosed by evaporative, mechanical, or thermal stimulation, with a follow-up period and quantified pain assessment were included in the study. Studies that reported DH due to tooth restoration, crown preparation, bleaching, or periodontal surgery or used bioactive glass-ceramics were excluded. The quality of the studies was assessed using version 2 of the Cochrane Risk-of-Bias Tool for randomized studies (RoB 2 tool). Articles that were duplicative or unrelated to this study were excluded. Nine articles were selected for full-text evaluation, whereas two articles were rejected. The remaining seven reports were included in this review. The calcium sodium phosphosilicate group (CSPS) was not significantly different from the positive control groups. Compared with the control groups, fluoro calcium phosphosilicate (FCPS) may be the most effective long-term treatment option. In terms of DH symptom reduction, the FCPS group performed better than the CSPS group. CSPS at a concentration of 5-15% and FCPS at a concentration of 5% are effective in treating DH in adult participants.

Treatment fracture of the diaphisis humerus with functional plaster

Treatment of humerus fractures is divided into operative and non-operative treatment Fractures of the diaphysis of the humerus heal well. Surgeons today have many opportunities to treat them. The decision on the type of treatment to be applied depends on the location of the fracture, the existence of associated injuries, the age and the general condition of the patient. Non-operative treatment is most often applied, although there are fractures in which surgical intervention is necessary in order to perform healing and prevent complications. Non-operative treatment of fractures of the diaphysis of the humerus gives good results, with little angulation and minimal or no shortening of the arm. Adequate repositioning, appropriate plaster immobilization and regular X-rays heal the fracture within the allotted time. Disciplined early physical therapy in terms of circular movements prevents shoulder contracture and allows later physical therapy to last significantly shorter. Non-operative treatment lasts from 7-11,5 weeks.

Repair of Bone Tissue Affected by Osteoporosis with Hydroxyapatite-Poly-L-lactide (HAp-PLLA) With and Without Blood Plasma

The aim of this study is to examine the reparatory ability of the synthetic biomaterial hydroxyapatite-poly-L-lactide (HAp-PLLA), the replacement of alveolar ridge, and rehabilitation of bone defects caused by osteoporosis, in an experimental group of animals. The experiments are performed on syngeneic Sprague Dawley rats. Osteoporosis is induced by glucocorticoids in rats during a 12-week period. After this, the experimental group of animals is divided into five subgroups. An artificial defect is made in the alveolar bone on the left side of the mandible. In one group of animals, the defect is left to heal by itself, while in other groups, pure HAp-PLLA or one mixed with plasma is implanted. The best results are achieved by the implantation of the HAp-PLLA composite biomaterial mixed with autologous plasma. Formation of a new mandibular bone is seen, growing intensely, leading to rapid osteogenesis.

[Prosthetic rehabilitation in patient with forced class III malocclusion]

The paper presents clinical case of 63 years old edentulous patient with slight class III malocclusion. For 15 years he was using inadequately fabricated dentures causing forced severe class III malocclusion. Forced progeny was corrected by newly fabricated dentures which restored normal orofacial function and facial harmony.

Penile self-mutilation - two cases in one family

Male genital self-mutilation is an infrequently reported event in the general medical literature. The majority of cases deal with a single episode of self-mutilation. These cases are usually focused on surgical repair. We present an extremely rare situation of two cases of male genital self-mutilation occurring in the same family. Both patients were treated for schizophrenia. Both patients had religious psychotic experiences and guilt feelings associated with sexual conflicts. Both patients had an experience of setting fire. Although they were close relatives, the younger did not imitate the older one when he mutilated his genitals. The possible causes of such behavior have been analyzed in the light of the recent literature.

Apoptosis of cardiomyocytes in myocarditis

Apoptosis of cardiomyocytes has been reported to be involved in the pathogenesis of heart failure of different aetiologies. The purpose of this study is to assess the role and extent of apoptosis of cardiomyocytes in active myocarditis. Endomyocardial samples from the right ventricle of 22 patients with active myocarditis were compared with 25 traffic accident victims without a history of cardiovascular disease. Twenty-two patients fulfilled the histopathologic Dallas criteria for myocarditis. The TUNEL method and immunostaining for active caspase 3 were used for the detection of apoptosis. Immunohistochemical methods were used for the evaluation of regulators of apoptosis (p53, Bcl-2) and evaluation of interstitial cells (macrophages, T and B lymphocytes). Apoptosis of cardiomyocytes (TUNEL-positive and anti-caspase 3-positive cardiomyocytes), which was not p53-dependent, was present in 0.3 to 0.4% (0.3% by TUNEL method and 0.4% by immunostaining for active caspase 3) of cardiomyocytes in active myocarditis, whereas only few apoptotic cardiomyocytes (0.0006 +/- 0.002% TUNEL-positive cardiomyocytes and 0.001 +/- 0.002% active caspase 3-positive cardiomyocytes) were found in the control group (P = 0.001). Apoptotic (TUNEL-positive and active caspase 3-positive) cardiomyocytes were found in small clusters. An increased expression of Bcl-2 was found in active myocarditis compared to the controls (P < 0.01), yet Bcl-2 failed to protect myocytes from apoptosis. We provide evidence of apoptosis of cardiomyocytes in active myocarditis, which may be involved in the development of heart failure.

[Results of IVF treatment methods in Germany in 1998--the German IVF Registry]

We used data in Germany IVF registar 1998 from 86 (94.6%) centers which take upon IVF procedures. The total documentary were treated 46730. The cultivated data were 45459. The visible is increase number of group which use IVF procedures and growth IVF/ICSI centers with options KRYO preservations. In Germany 1998, IVF ICSI, KRYO and GIFT procedures were treated 30,009 women, on an average 1,515 cycles per year. The endurance leaning of children was amoung 2 and 8 years for both procedures. In stimulated cycles on an average were taken 9.04 eggs (follicule punction). During IVF procedures it was 22.64% clinical pregnancy and ICSI procedures 23.53% clinical pregnancy. In most of the cases cycles were stimulated with long gonadotropine protocol, with GnRH-agonists, after suppression adenohypophysis. Considering pregnancies and abortions in addiction to chosen gonadothropine it was not possible to confirm significant difference neither for IVF of ICSI procedures. Results of therapy showed clear addiction to age of women and become worse after 39 the year of life and distintcly less after 49th year for both procedures. During transvaginal ultrasonography follicule punction reported is 253 (0.67%) complications. Severe cases such as ovarial hyperstimulation syndroms (OHSS III) were reported in 1.12% cases.

[Radical vulvectomy with inguino-femoral lymphadenectomy in the surgical treatment of vulvar carcinoma]

INTRODUCTION

Vulvar carcinomas comprise almost 5% of all malignant tumors of the female genital tract. The final diagnosis is made after histologic examination of biopsy specimens obtained from different sites in the vulva. Primary therapeutic approach in all cases is surgery, whereas the operative procedure depends on the size and location of the lesion, stage of the disease, general condition and age of the patient, as well as on the condition of the surrounding tissue and possible continuance of sexual life.

METHODS

In the period from 1985-1999, there were 39 patients with invasive forms of vulvar carcinomas operated at the Department of Gynaecology in Novi Sad. Radical vulvectomy associated with inguinal-femoral lymphadenectomy was performed in 26 (66.6%) patients. During 1994, a wide "butterfly-shaped "block" dissection of the vulva, pubis and inguinal area was done, whereas during the following period, the operative area was reduced by application of separate inguinal incisions after Hacker, leaving the tissue bridge in between.

RESULTS

The mean age of operated patients was 62.1 years (34-85). There were 53.8% stage I, 17.9% stage II, 20.7% stage III and 7.6% stage IV patients. In patients undergoing radical surgery the average number of extirpated lymph nodes was 16.3 out of which in 7 (26.9%) cases the nodes were positive. Lethal outcome was recorded in 4 (15.3%) patients. Two (7.6%) died of pulmonary thromboembolism and 2 (7.6%) during the following 5 years for diffuse dissemination of metastases. During 1994, complications were recorded in 69.2% operated patients versus 7.6% recorded during the following period.

CONCLUSIONS

Radical vulvectomy associated with bilateral inguinal-femoral lymphadenectomy is a standard procedure in surgical treatment of invasive stages of vulvar carcinoma protruding more than 1 mm. The application of two separate inguinal incisions after Hacker resulted in shortening the intrahospital postoperative period from 34.2 to 14 days and reduction of the rate of wound dehiscence and postoperative complications in the period following 1994.

Incidence of cerebral dysfunction as a parameter for decision making in the management of preterm labor

The study presents a retrospective analysis of the data on pregnancy, delivery and cerebral dysfunction in 296 premature infants of singleton pregnancies, body weight > 1000 g, delivered at the Department of Obstetrics and Gynaecology in Novi Sad during 1997. Preterm newborns are exposed to a high risk of perinatal pathology, with 66.55% newborns from pathological course of pregnancy. Vaginal delivery--vertex presentation was registered in 69.93%, breech presentation in 6.41% and cesarean section in 23.65%. The preterm children have lower Apgar Scores and umbilical artery Ph values than term children. Cerebral dysfunction was diagnosed in 32.09%, whereas the incidence is inversely proportionate to gestational age and body weight at birth. The mode of delivery does not significantly affect cerebral dysfunction (p < 0.05) which means that intrapartal trauma is not a frequent cause of cerebral distress of preterm newborns. The labor occurring before the 34th gestational week can be performed vaginally if the fetus is either in vertex or complete breech presentation, if the course of labor is regular and cardiotocography findings within physiologic values.

[Postpartum anemia--incidence and etiology]

INTRODUCTION

Anemia is the most common puerperal complication which increases the risk of maternal morbidity in postpartal period with incidence of up to 56% of women. In 90% cases the etiology of postpartal anemia is decreased serum iron level. Postpartal hemorrhage (loss of blood more than 0.5 L during labor) is the cause of anemia in 5-10% of women.

MATERIAL AND METHODS

This prospective study included 4009 postpartal women with normal pregnancy and delivery who gave birth during the year 1997 at our Department. There were 3305 women with vaginal delivery and 704 women who had cesarean section. Anemia was diagnosed when the hemoglobin serum concentrations were less than 100 g/L (6.21 mmol/L) and hematocrit less than 0.31.

RESULTS AND DISCUSSION

Although about three quarters of pregnant women had 8 and more obstetrical controls and 3 and more ultrasound examinations during pregnancy, only half of them had blood count control 3 or more times. Blood count was checked 3 or more times during pregnancy in 54.98% women and 32.9% of all women took iron medication during pregnancy but no longer than 12 weeks. Before pregnancy 0.6% of women had anemia, and after the delivery that number increased to 25.41% with no significant differences between those who had vaginal delivery and those with cesarean section. The incidence of newborns with anemia was 5.11% in both groups. These results show that anemia of mother has no influence on anemia of the newborn who has its own mechanisms of compensation. The etiology of puerperal anemia was in 79.18% women caused by low serum iron levels with no differences between both groups, but infection caused anemia was more frequent in women with cesarean section (11.8%) than in women with vaginal delivery (0.36%).

CONCLUSION

Although one third of pregnant women take iron medication during pregnancy, every third woman has anemia after delivery, both vaginal delivery and cesarean section. Women who had cesarean section had anemia more frequently caused by infection. Anemia is 5 times more frequent in the mother than in her newborn. Prophylactic iron medications during pregnancy are not recommended, but more frequent control of blood count during pregnancy is required, as well as adequate therapy of anemia.

[Transvaginal sonography of the postmenopausal endometrium]

INTRODUCTION

The most frequent symptom suggesting endometrial pathology is uterine bleeding. Each postmenopausal uterine bleeding requires fraction explorative curettage and histopathologic examination of the material obtained from the cervical canal and uterine cavity. The aim of this study was to estimate the efficacy of ultrasonography as a non-invasive method in detection of endometrial pathology in postmenopausal women, and to find out whether its more frequent use could safely decrease the number of curettages in detection of these conditions.

MATERIAL AND METHODS

A prospective investigation has been performed in postmenopausal women not menstruating for more than a year, and who reported to the Department of Obstetrics and Gynaecology in Novi Sad for uterine bleeding during 1996 and 1997. Each woman underwent ultrasonographic examination by vaginal probe of 5 MHz and fraction curettage, whereas the samples from cervical canal (if obtained) and from uterine cavity were sent to histopathologic examination to the Institute of Pathology in Novi Sad. Standard statistical methods have been used for the analysis of the results. Validity of the applied ultrasonographic method in detecting endometrial pathology has been estimated by calculation of its sensitivity and specificity.

RESULTS

A satisfactory visualisation of the endometrium has been obtained in all 35 examined cases. The thinnest endometrium was 1 mm wide and the thickest one was--25 mm. The fraction curettage has been used to obtain material from the cervix in 2 cases and from the uterine cavity in 35 cases. In our patients with uterine bleeding, who were in the postmenopause for 13 years on average, endometrial atrophy was recorded in 17.14%, endometrial polyp in 11.43%, endometrial hyperplasia in 22.86%, endometrial adenocarcinoma in 42.86% and uterine sarcoma in 5.71%. There were 2 false negative ultrasonographic findings (2 cases of endometrial hyperplasia) and sonographic thickness less than standard versus 2 false positive cases (endometrium thicker than the limit value, 7 and 14 mm, with no real pathology) which showed that the sensitivity of the investigated method was 93.10% and the specificity was 66.66%, if the limit value for the thickness of endometrium was 3 mm.

DISCUSSION

Ultrasonographic thickness of endometrium means maximum double thickness in longitudinal plane, i.e. the distance of the opposite bordering surfaces of endometrium and myometrium. The procedure of measurements of endometrial thickness is simple in most cases. Most authors agree that there is a positive correlation between the thickness of endometrium and its pathological conditions. The most often used limit values are 3 and 4 mm. Higher limit values of endometrial thickness increase the sensitivity of the method even to 100%, but negatively affect its specificity making this method inadequate as a screening method for endometrial carcinoma. Many authors insist on introducing other criteria for evaluation of the endometrium i.e. for taking its thickness as the only criterion. Ultrasonography does not provide a completely safe differentiation between benign hyperplasia and endometrial carcinoma.

CONCLUSION

The transvaginal sonography is an efficient and acceptable, noninvasive method for early detection of endometrial pathology in postmenopausal women. The thickened endometrium during menopause is the most significant ultrasonographic criterion implicating its pathology. The vaginosonographically measured thickness of 3 mm and less, gives a relatively safe prediction of endometrial atrophy, whereas the thickness above 3 mm requires explorative curettage and histopathologic examination of the endometrium, no matter if the woman has or has not uterine bleeding. (ABSTRACT TRUNCATED)

[Effect of prolactin on the regulation of osmotic processes across the fetoplacental membranes in vitro]

INTRODUCTION

The aim of this investigation was to point to the influence of minerals and total osmolality on regulation and secretion of prolactin in decidual tissue of the placenta and the role of prolactin in regulation of osmotic processes across the fetoplacental membrane.

MATERIAL AND METHODS

Explants for the tissue culture have been obtained from pregnant women with normal pregnancy and delivery, between the 277 and 282 days of gestation. The investigation consisted of 4 repeated experiments. The parietal decidua and the corresponding chorion were separated from the amnion, rinsed in salt solution and cut into explants 0.2 g of weight. After a 2-hour period of preincubation in the control medium, 12 explants were incubated in the media of altered mineral and osmotic properties, whereas the 13-th in the control medium. Concentrations of prolactin following the 3-hour incubation in the medium was estimated by immunoenzymologic procedures.

RESULTS

During the 3-hour incubation, the control explants secreted on average 75.4 +/- 5.23 micrograms/l of prolactin in the experiment repeated 4 times. The changes of Na+, Cl-, K+, Mg++, P- and HCO3- concentrations and of the total osmolality have not significantly influenced the synthesis of prolactin. In the medium with no Ca++, the value of secreted prolactin was 26.7 +/- 3.34 micrograms/l (p < 0.001); increase of the Ca++ concentration has not influenced the synthesis of prolactin. In the medium with increased concentration of H+ (pH = 7.00), the prolactin concentration was 50.9 +/- 2.9 micrograms/l (p < 0.001).

CONCLUSION

The minerals--Na+, Cl-, K+, Mg++, P-, HCO3- and the total osmolality do not significantly influence the synthesis of prolactin in decidual-chorionic tissue. Certain quantities of Ca++ and optimal concentration of H+ are necessary for the synthesis of prolactin (PRL).

[Premature rupture of the fetal membranes--an active or expectant approach in management of this obstetrical problem]

INTRODUCTION

A prospective investigation and comparative analysis of clinical and microbiological results have been performed as to point to some facts of possible significance in solving the dilemmas concerning the problem of pregnant women with premature rupture of the membranes.

MATERIAL AND METHODS

Intensive clinical monitoring of the course, methods and complications of the labor was undertaken in 75 pregnant women with premature rupture of the membranes and term delivery. Smears from the vagina, cervix, amnion and amniotic fluid were obtained from each pregnant woman, as well as nasal and throat smears from newborn infants in order to microbiological analysis. According to the method of labor treatment, the investigated patients (n = 75) were distributed into 2 groups. Early induction of labor was applied in 39 pregnant women (labor induction 6 h following rupture of the membranes) and expectatively treated 37 pregnant women (the control of pregnant women until initiation of the spontaneous contractions associated with antibiotic prophylaxis).

RESULTS AND DISCUSSION

Duration of labor (period from rupture of the membranes to the delivery and from the initiation of regular contractions to the delivery) was significantly shorter (p < 0.01) in the induced labor group. Cesarean section was performed in 18.4% od labors in the first and in 13.5% of labors in the second group. Chorioamnionitis occurred in 7.9% in the first and in 21.6% in the second group during the labor (p < 0.05). The incidence of puerperal and neonatal infection was lower in the first investigated group (7.9% and 5.2%) than in the second group (18.9% and 16.2%). Positive microbiological finding was recorded in 13.2% of pregnant women from the first group and in 27.0% from the second group (p < 0.05).

CONCLUSION

From the medical point of view it is reasonable to apply early induction of labor in pregnant women at more than 34 weeks' gestation. In pregnant women of less than 34 weeks' gestation, the expectant management of labor is recommended only in the next 48-72 hours.

[Cesarean hysterectomy im modern obstetrical practice from 1968 to 1993]

A retrospective study of cesarean hysterectomies at the Department of Obstetrics and Gynecology in Novi Sad was conducted for the period 1968-1993. There were 129,127 deliveries, whereas cesarean section was performed in 10,485 (8.12%) cases. There were 55 cesarean hysterectomies (0.042%), while in 0.52% they were performed during cesarean section. Elective hysterectomy was performed in 7 (12.73%) cases because of neoplastic process and uterine myoma, while in 48 (87.27%) cases it was performed for heavy bleeding. Most often bleeding occurred due to complications of placenta previa, uteroplacental apoplexy, premature placental ablation, uterine rupture and atony. Total hysterectomy was performed in 30 (54.54%) cases and subtotal hysterectomy in 25 (45.45%) cases. Bilateral adnexectomy was performed in 3 (5.45%) cases. Urinary bladder injury occurred in 4 (7.27%) patients, wound infection in 11 (20.00%) patients, urinary infection in 3 (5.45%) and pelvic peritonitis in 1 (1.82%) patient. One maternal death (1.82%) occurred due to DIC (disseminated intravascular coagulation). Out of 57 delivered newborns 20 (35.10%) died in the perinatal period. There were 13 stillbirths (22.80%), whereas 7 newborns (12.30%) died in the early neonatal period due to prematurity and RDS (respiratory distress syndrome).

[Prolactin levels in pregnant women with glucose intolerance at full-term delivery]

A prospective study was carried out to establish the influence of deteriorated metabolism of glucose in mothers to the synthesis and secretion of prolactin during the pregnancy. The examination included a 101 pregnant women with delivery term between 259 and 287 day of gestation; 36 pregnant women manifested glucose intolerance or diabetes during the pregnancy and 12 of them also had marked signs of gestation. Control group consisted of 65 pregnant women. The level of prolactin in the sera of mothers with glucose intolerance (205.7 +/- 66.4 micrograms/l) was significantly increased (p < 0.05) than in case of mothers with normal pregnancy (172.2 +/- 60.7 micrograms/l), probably due to the development of gestosis in a large number of pregnant women. The difference of prolactin level in pregnant women with glucose intolerance but without the elements of gestosis (167.3 +/- 35.7 micrograms/l) and in women with normal pregnancy was not important. The difference of prolactin level in the serum of umbilical artery (245.5 +/- 101.2 micrograms/l and 261.0 +/- 78.8 micrograms/l) and in amniotic fluid (428.6 +/- 161.1 micrograms/l and 422.9 +/- 112.9 micrograms/l) was not of statistical significance. Pregnant women with glucose intolerance and elements of gestosis had significantly higher concentration (p < 0.05) in the serum of the mother, in the serum of umbilical artery and in the serum of amniotic fluid (282.4 +/- 41.6 micrograms/l, 315.6 +/- 103.3 micrograms/l and 460.4 +/- 130.2 micrograms/l) than the pregnant women with glucose intolerance but without elements of developing gestosis (167.3 +/- 35.7 micrograms/l, 210.5 +/- 81.5 micrograms/l, and 402.6 +/- 118.8 micrograms/l). There was no evidence of the functional connection between prolactin and glucose metabolism.

[The volume and present methods of legal abortion in children and adolescents at the Gynecology Clinic in Novi Sad 1985-1995]

Legal pregnancy interruptions in juvenile and adolescent age performed at the Department of Obstetrics and Gynaecology in Novi Sad, during the period from 1985 to 1995, have been analyzed and presented. The authors point out the following methods of choice for pregnancy interruptions: interception to 7 weeks of pregnancy, electric vacuum aspiration from 8 to 13 weeks of pregnancy, a combination of parenteral and local application of prostaglandins from 14 to 20 weeks of pregnancy.

[Prostaglandins in the induction of labor at term with premature rupture of fetal membranes]

A prospective, randomized study included 389 pregnant women with normal pregnancy, gestational age of 37 weeks (259 days) in whom the delivery started by premature rupture of fetal membranes and without labor pains 6 or more hours after rupture of fetal membranes. The Bishop score was < or = 6 and there were no clinical or laboratory signs of infection before induction. The first group (n = 219) included pregnant women at term with premature rupture of fetal membranes and unfavourable pelvic score in whom labor was induced by intracervical dinoprostone. The second-control group (n = 170) included pregnant women at term with premature rupture of fetal membranes and unfavorable pelvic score in whom delivery was induced by oxytocin infusion. In a 6 hour interval from the beginning of induction 61.64% women from the I group and 40.00% from the control group had a pelvic score > or = 7, (p < 0.05). After 12 hours the Bishop score was > or = 7 in 89.94% of women from the I group and 61.18% from the II-control group (p < 0.03). 63.34% of women, in whom labor was induced by intracervical application of dinoprostone, had an additional oxytocin induction. 82.18% of women from the first group and 62.25% from the second group (p < 0.05) had vaginal delivery with reduced activity of the uterus (p < 0.05) and significantly decreased number of irregular labor pains (p < 0.05) with hypertonia, hypercontraction and frequent contractions. In the first group the mean time of induction was 8.12 +/- 5.51 hours, while in the second-control group it was 10.83 +/- 7.34 hours (p < 0.01). In the group of deliveries induced by dinoprostone incidence of puerperal induction was 1.01% and 5.93% in the control group. Neonatal infection occurred in 3.19% of newborns in the first group and in 11.18% in the second group. 5.05% of newborns from the first group and 9.41% from the control group suffered from perinatal trauma and anoxia. In the first group the total perinatal morbidity was 10.43% and 31.18% in the second group (p < 0.05).

Prostatic polyp in the prostatic urethra

The authors report on a case of prostatic polyp in the urethral bulb of a 35-year-old man. The presence of this lesion in the urethral bulb is quite unusual and may be overlooked on cystocopic evaluation.

Cystosarcoma phyllodes of the prostate

We report a case of a 40-year-old man with cystosarcoma phyllodes of the prostate. This tumour is very rare in the prostate. The stroma of the tumour was cellular and composed of elongated cells with spindle shaped nuclei, scanty, pale and eosinophilic cytoplasm. Some cells showed nuclear atypia but the cells did not display mitotic activity. We categorised this tumour as benign. The suprapubic prostatectomy was done. The patient is alive and well after three years.

[Serum selenium in patients with epidermoid carcinoma of the oral cavity and pleomorphic adenoma of the salivary glands]

In 23 patients with epidermoid carcinoma of the oral cavity and in 13 patients with pleomorphic adenoma of the salivary gland blood selenium level was studied with hydride atomic absorptive spectrophotometry. Serum selenium was significantly lower in patients with epidermoid carcinoma of the oral cavity (79.37% lower than control values). In patients with pleomorphic adenoma of the salivary gland values were lower by 32.20% than control values. The results suggest the need of further epidemiological studies in order to determine the selenium concentration in the ground and the food. In this way the optimal dose of selenium for prevention of benignant and malignant diseases in the maxillofacial region, can be established.

[Determination of acetylsalicylic and salicylic acid in tablets using high-performance liquid chromatography and a diode array detector]

A fast and sensitive method of high-performance liquid chromatography (HPLC) for determination of acetylsalicylic acid (ASA) and products of salicylic acid (SA) hydrolysis in tablets has been elaborated. Extraction was done with the mixture of methanol: formic acid (98:2 v/v) and separation of the components was achieved by using the colon of Ultropac Lichrosorb RP-18, 10 um, 4 cm x 250 mm and diode array detector. The mobile phase of methanol:water: :mol/1 H3PO4 (60:35:5) v/v, pP = 2.6 and safe flow of 1 ml/min were used. Follow up of chromatographic separation of ASA, SA and internal standard beta-naphtole (ITS) was performed at the wave length of 290 microns. The threshold of ASA was 0.5 mg/ml and of SA 0.0025 mg/ml.

[Biological standardization of the allergenic extract of Ambrosia elatior]

Allergenic activity of allergen extract Ambrosia elatior (AE) was tested in fifteen volunteers extremely sensitive to the allergen. The research was performed by using the quantitative prick (P) and the intradermal (ID) test. The results were analyzed by the parallel line assay method. Allergenic activity of the specimen was estimated: by the number of the allergen units (AU) in 1 ml of the undiluted specimen according to the results of the P (prick) test; by the number of the allergen units (AU) in 1 ml of the undiluted specimen according to the results of the I. D. test, and by the in vitro standardized method of the RAST inhibition. These preliminary results show that allergen extract Ambrosio elatior has 100,000-130,000 Bu/ml and ca 1000 AU/ml while allergenic activity of the extract measured by the RAST inhibition method has ca 57,000 IU/ml.

[Working environment conditions and occupational disorders in artillery unit personnel]

Occupational environment risk factors and health status of 172 soldiers and 89 officers were examined aiming to discover early signs of occupational diseases and disorders in artillery personnel. Among all physical and chemical risk factors noise caused by artillery and infantry firing (140 to over 170 dB) were the most frequent and among occupational diseases/disorders only perceptive hearing disorders being very frequent in artillery officers (65.22%) were found out. Preventive measures against occupational environment risk factors were suggested.

[Application of phosphatic ceramics synthesized in our laboratories for compensation of post-cystical bone defects]

The problem of how to compensate bone defects after Cystectomy is not new. However, phosphatic ceramics (hydroxyapatite and three-calcium phospate) called attention to this problem recently. On the basis of previous experience in minor bone tissue defects the results of application of phosphatic ceramics presented in this article. The patients were clinically and roentgenologically examined. The results showed the usage of phosphatic ceramics in the preservation of the shape and function of the bone tissue. The surgical technique and some details about the application of phosphatic ceramics are also emphasized.

Modification of potentially lethal damage repair by some intrinsic intra- and extracellular agents: I. Proteinases and proteinase inhibitors

The effects of nine intra- and extracellular proteinases and six proteinase inhibitors on the repair of potentially lethal damage (PLDR) induced by gamma-rays in plateau-phase V79 cells were examined. It was demonstrated that these agents, which are intrinsic factors produced within mammalian cells, can modify PLDR activity. A stimulatory effect on PLDR was seen with calf liver neutral proteinase, and to a lesser extent, with inhibitor pepstatin A. Other proteinases which belong to serine, cysteine and aspartic superfamilies, as well as proteinase inhibitors, inhibited PLDR to different degrees. The effects of some of these agents, present during the PLDR period, on the rate of tritiated thymidine incorporation into the acid-insoluble cell fraction was also examined. They can modify the DNA synthesis of cells when subcultured from plateau phase for the assessment of colony-forming ability. There is no clear evidence that the effects observed are entirely attributed to the alteration of cellular proliferative processes. It seems more likely that many serine and cysteine proteinases and their inhibitors can adversely affect the PLDR process by modulating the activity of proteinase(s) and other enzymes involved more directly in PLDR because of interrelationships of the entire intracellular proteinase system.

Absence of AET protection against fast neutrons: cellular effects

A series of experiments has been undertaken in order to test the biological properties of neutrons produced in the cyclotron of the Institute "Ruder Bosković" (IRB) in Zagreb. Protective effect of AET (2-amino ethylisothiuronium bromide hydrobromide) on survival of L cells irradiated by fast neutrons generated in the IRB cyclotron were studied by employing the single cell clonal growth method. For comparison the protective effect of AET after gamma irradiation has also been studied. The most important findings that have emerged from these experiments can be summarized as follows: (1) Protective effect of AET was present after gamma irradiation only. (2) The degree of protection was dependent on AET concentration in the growth medium. (3) No protective effect was found after neutron irradiation. These findings are in agreement with the generally less efficient protection of this compounds after high-LET irradiation.

Dependence of the nucleoside effect on linear energy transfer

L929 cells were irradiated by cyclotron-produced neutrons and by 14.8 MeV monoenergetic neutrons. For comparison cells were also irradiated by 60Co gamma rays. Following irradiation cells were treated by an equimolar solution of deoxyribonucleosides, and the effect on cell survival measured. Results show that nucleoside treatment was efficient after low-LET irradiation: gamma ray survival curves were altered by deoxyribonucleosides in terms of significantly increased extrapolation numbers only, but without Do change. Cells irradiated by neutrons from either of the two sources did not respond to nucleoside treatment, and consequently their survival curves remained unaltered. These results show that the nucleoside effect does occur after low-LET irradiation, but apparently not following high-LET irradiation. Since deoxyribonucleosides as well as other cell breakdown products are released in irradiated and necrotic tumours due to massive cell destruction, such a nucleoside effect could possibly enhance the cell survival and thus effect the result of radiotherapy. Absence of the nucleoside effect in case of high-LET irradiation may therefore be an additional potential gain from neutrons in radiotherapy.