Correlation between increased maternal body mass index and pregnancy complications

OBJECTIVE

Obesity in pregnancy carries significant maternal and fetal risk. The aim of this study was to investigate the effect of maternal body mass index on pregnancy outcomes.

PATIENTS AND METHODS

The study retrospectively reviewed the clinical outcome of 485 pregnant women who delivered at the Department of Obstetrics and Gynecology, Clinical Centre of Vojvodina, Novi Sad, during the period of three years (2018-2020) and compared them against the body mass index (BMI). Correlation coefficient was calculated for BMI and seven pregnancy complications (hypertensive syndrome, preeclampsia, gestational diabetes mellitus, intrauterine growth restriction, premature rupture of membranes, mode of delivery and postpartum hemorrhage). The collected data were presented in the form of median values and relative numbers (the measure of variability). The implementation of the simulation model and its verification were carried out using a specialized programming language, Python. Statistical models were created where the Chi-square and p-value were as determined for every observed outcome.

RESULTS

The average age of the subjects was 35.79 years and average BMI 29.28 kg/m2. A statistically significant correlation was found between the BMI and arterial hypertension, gestational diabetes mellitus, preeclampsia and cesarean section. The correlations between the body mass index and postpartum hemorrhage, intrauterine growth restriction and premature rupture of membranes were not statistically significant.

CONCLUSIONS

As high BMI correlates with a number of negative outcomes in pregnancy, weight control before and during pregnancy and proper antenatal and intranatal care are necessary to achieve a favorable pregnancy outcome.

The effect of arsenic, cadmium, mercury, and lead on the genotoxic activity of Boletaceae family mushrooms present in Serbia

The aim of this study was to determine accumulation of heavy metals and metalloids which are widely distributed in the environment and in food chain using wild edible mushrooms belonging to the Boletaceae family mushrooms. In addition, methanol extracts of mushrooms were tested for in vitro protective effect by the cytochalasin-B blocked micronucleus (CBMN) assay using chromosome aberrations in human peripheral lymphocytes as a model. The genotoxic activity of methanol extracts prepared at 4 different concentrations (1, 2, 3 or 6 µg/ml) was examined using amifostine and mitomycin C as positive controls. Extracts of species B. regius and B. edulis exhibited the greatest reduction in the frequency of micronuclei (MN). Extract of B. regius at concentrations of 2 µg/ml showed the highest decrease in number of MN. In comparison, extract of mushroom B. edulis at a concentration of 3 µg/ml displayed less reduction. However, as heavy metals and metalloids are found in mushrooms, another aim was to examine whether these agents affected genotoxicity. Principal component analysis (PCA) identified clustering differences between control and heavy metals and metalloids groups and might explain the influence of heavy element content and genotoxic activity in mushrooms.

Selected fungi of the genus Lactarius - screening of antioxidant capacity, antimicrobial activity, and genotoxicity

It is well-known that mushrooms of the genus Lactarius constitute a natural food resource providing health benefits as a nutritient. This genus contains 4 mushrooms identified as L. deliciosus, L. volemus, L. sanguifluus, L. semisanguifluus and L. piperatus which were collected in Serbia. The aim of this study aimed was to identify and characterize the content of phenolic compounds and examine the antioxidant potential of 5 wild edible mushrooms. L. sanguifluus contained the highest content of total phenol compounds (75.25 mg gallic acid equivalents (GAE) per g dry extract weight (GAE/g DE) and exhibited the greatest antioxidant activity through the ability to remove radicals as evidenced by ABTS assay (8.99 mg of trolox equivalents (TE) per g dry extract weight (mg TE/g DE); total reducing power (TRP) assay mg ascorbic acid equivalents per mg of dry extract weight (0.42 mg AAE/g DE) and CUPRAC (14.23 mg TE /g DE). L. deliciosus methanolic extract produced greatest scavenging of the DPPH radical (46%). The methanol mushroom extracts were screened for in vitro antimicrobial activity against a panel of pathogenic bacterial strains using the microdilution method. Of all the extracts tested, L. sanguifluus extract showed the best antibacterial properties. The cytokinesis block micronucleus assay results for the examined mushrooms demonstrated that extracts at a concentration of 3 μg/ml decreased the number of micronuclei (MN) in the range of 19-49% which is significant bearing in mind that radioprotectant amifostine reduced the frequency of MN by only 16.3%. Data thus demonstrate that the 5 wild edible mushrooms of genus Lactarius contain constituents that are beneficial not only as nutrients but also have the potential as antioxidants, antibacterial and antigenotoxic properties.

The effects of Artemisia methanol extracts and ferulic acid, rutin, rosmarinic acid, and quercetin on micronucleus distribution on human lymphocytes

Methanol extracts of A. absinthium, A. annua, A vulgaris, A. scoparia, and A. alba from Serbia at concentrations of 1.00; 2.00 and 4.00 μg/ml, and as pure compounds identified in examined extracts (ferulic acid, rutin, rosmarinic acid, and quercetin) were examined for their effects on micronucleus distribution in human lymphocytes in vitro. All extracts greatly reduced the number of micronuclei in the concentration of 2.00 μg/ml comparing to the control, whereby A. alba extract exhibited the most prominent effect on decreasing frequency of micronucleus (45.2%), followed by extracts of A. vulgaris, A. absinthium, A. scoparia and A. annua. The same declining trend was observed for the extracts at concentrations of 4.00 µg/ml, and 1.00 µg/ml, respectively. Among pure compounds (concentration 2.00 μg/ml), rutin showed the most pronounced effect on decreasing frequency of micronucleus (41.7%), higher than ferulic acid, quercetin, and rosmarinic acid comparing to the control.

Comprehensive Analysis of the Herbal Mixture Made of Juniperus oxycedrus L. Berries, Inner Bark of Betula pendula Roth., and Grains of Avena sativa L

This is the first report of the high-performance liquid chromatography and gas chromatography–mass spectrometry profile of a herbal mixture (HM) made of Juniperus oxycedrus L. (redberry juniper) berries, inner bark of Betula pendula Roth. (silver birch), and grains of Avena sativa L. (oat), and its effect on the No. of micronuclei (MN) in human lymphocytes and toxicity toward Artemia salina. Constituents represented by over 1000 µg per g of methanol dry extract were gallic acid, protocatechuic acid, and amentoflavone. The methanol extract of the HM at a concentration of 2.0 μg/mL decreased MN frequency by 38.3%, which was more than 3 times greater than that of the radioprotectant amifostine. The essential oil isolated from the HM was composed mainly of β-myrcene (32%) and showed weaker toxicity toward Artemia salina than the positive control after both incubation periods (24 h and 48 h). These findings suggest that the examined HM, beside its ethnopharmacological relevance on the elimination of renal calculi, also significantly reduces the No. of MN in human lymphocytes.

The Association between Depression and Anxiety with Online Social Networking

It would seem that today, for many individuals the most important thing is to have a good profile picture on online social networks. Accordingly, there is a serious possibility that addiction to social networking sites (SNS) can lead to psychosocial and behavioral disorders, and other negative consequences on health-related issues. So, the aim of this study was to determine the association between the use of social networking sites and its dependence on symptoms of depression and anxiety. This cross-sectional study was carried out at the University of Niš, Faculty of Medicine from February to May, 2019. All of the respondents were assessed by using an appropriate questionnaire. The study included 1405 randomly selected respondents (411 males and 994 females). The strongest predictor of whether one has high levels of depression symptoms was state of conflict, where the odds ratio was 10.28. This indicates that the respondents with higher scores of the conflict component have symptoms of depression 10.28 times more often than others. It has been observed that depression symptoms are also more common in those respondents with expressed withdrawal symptoms (OR = 4.27), and with mood modification (OR = 1.82). Anxiety symptoms, similar to those of depression, are most present in individuals with conflict state (OR = 10.31), in those with withdrawal symptoms (OR = 6.83), and then with mood modification (OR = 2.55). The number of active accounts/profiles and number of devices, as well as state of salience and tolerance played no part in any of the cases. There is no doubt that there is a direct link between SNS and depression and anxiety. While these links may not be causal, it is quite certain that overuse of social networks exacerbates these symptoms.

Key messages

There is no doubt that there is a direct link between SNS and depression and anxiety. Strategies for self-control and limited SNS use should be developed by mental health professionals.

Leaf-surface guaianolides from Amphoricarpos neumaeyri showing protective effect on human lymphocytes DNA

Analysis of composition of CH₂Cl₂ surface extract of leaves of Amphoricarpos neumayeri Vis. revealed 16 sesquiterpene lactones with guaianolide skeleton, so called amphoricarpolides, typical for this genus. Four of them, 13-16, were new derivatives and their structures were elucidated by detailed analyses of IR, NMR and MS data. Amphoricarpolide (9), its 15-O-acetyl derivative (5), and two 9β-hydroxyamphoricarpolides, 3,15-di-O-acetyl- and 3-O-acetyl-15-O-isovaleroyl derivatives (3 and 6, respectively) were tested for in vitro protective effect on chromosome aberrations in peripheral human lymphocytes using cytochalasin-B blocked micronucleus (CBMN) assay. The tested compound exerted a beneficial effect by decreasing DNA damage of human lymphocytes.

Jatrophane Diterpenoids With Protective Effect on Human Lymphocytes DNA

Two sets of structurally different jatrophanes (1-11 and 13-16), jatrophane 12, and latex extract of 2 Euphorbia species (17 and 18) were tested for in vitro protective effect against chromosome aberrations in peripheral human lymphocytes using the cytokinesis-block micronucleus (CBMN) assay. Jatrophanes 1-6 in minimal doses of 1 µg/mL prominently decreased micronuclei (MN) frequency in the range 44.86% to 34.29% and manifested considerable protective effect. From the other set of jatrophanes, 13 in the same minimal dose notably decreased MN frequency by 31.05%, while extracts 17 and 18 at a concentration of 4 µg/mL remarkably decreased the frequency of MN by 37.94% and 36.12%, respectively. Jatrophanes 12, 14, and 16 showed moderate protection, while 7-11 and 15 were less active than positive control. The structure-activity relationship (SAR) studies of the tested jatrophanes (1-16) indicated the favorable position of benzoate at C-8 or C-9 (3, 4, and 13) and a preference of isobutanoyloxy group at C-3 (1-3) rather than propanoyloxy at the same position (4-6) for pronounced protective effect on human lymphocytes DNA. In a previous SAR study on 11 jatrophanes (1, 3-8, and 13-16), the same structural features in 3, 4, and 13 influenced powerful inhibition of P-gp, while growth inhibition of cancer cells was more than doubled in 1 (isobutanoyloxy group at C-3) compared to 6 (propanoyloxy at C-3).

Chemical profile and biological activities of Peltigera horizontalis (Hudson) Baumg. thallus and apothecia extracts

The aim of this study was to determine, for the first time, the chemical composition of Peltigera horizontalis thallus and apothecia extracts (ether, ethyl acetate, dichloromethane and acetone) by HPLC-UV and GC-MS, and evaluate activity of genotoxic, anticholinesterase, antioxidant and antibacterial potential of acetone extracts. Major constituents of thallus extracts were gyrophoric acid, and methyl gyrophorate while dominant component of apothecia extracts was tenuiorin. The predominant volatile compounds in extracts were methyl orsellinate, dodecyl acrylate, orcinol and orcinol monomethyl ether. The thallus acetone extract at concentration of 2.0 µg mL^-1 gave the greatest decrease in the micronuclei frequency (22.4%) of all tested extracts. Apothecia extract showed stronger antioxidant activity as compared to thallus extract. Tested extracts at concentration of 10 mg mL^-1 exhibited inhibitory effect (16.5% for thallus and 12.8% for apothecia) on pooled human serum cholinesterase. P. horizontalis acetone extracts had no activity against the tested five bacteria strains.

Hypogymnia tubulosa extracts: chemical profile and biological activities

This study reports for the first time in the chemical composition of acetone, ether, ethyl acetate and dichloromethane extracts of Hypogymnia tubulosa determined by HPLC-UV, GC-FID and GC-MS as well as effect of H. tubulosa acetone extract on micronucleus distribution on human lymphocytes and on cholinesterase activity. Additionally, antioxidant (estimated via DPPH, ABTS, TRP, CUPRAC and TPC assays) and antibacterial activity against two Gram-positive and three Gram-negative bacteria were also determined. The HPLC-UV analysis revealed the presence of depsidones, 3-hydroxyphysodic, 4-O-methyl physodic acid, physodic and physodalic acid together with two depsides, atranorin and chloroatranorin. GC-FID and GC-MS analyses enabled the identification of atranol, chloroatranol, atraric acid, olivetol, olivetonide and 3-hydroxyolivetonide as the main components. The results of present study show that H. tubulosa acetone extract is a promising candidate for in vivo experiments considering antioxidant activity.

Mental health provision in schools: approaches and interventions in 10 European countries

BACKGROUND

The role of schools in providing community-based support for children's mental health and well-being is widely accepted and encouraged. Research has mainly focused on designing and evaluating specific interventions and there is little data available regarding what provision is available, the focus and priorities of schools and the professionals involved in providing this support. The current study presents these data from schools in 10 European countries.

METHODS

Online survey of 1466 schools in France, Germany, Ireland, Netherlands, Poland, Serbia, Spain, Sweden, UK and Ukraine. The participating countries were chosen based on their geographical spread, diversity of political and economic systems, and convenience in terms of access to the research group and presence of collaborators.

RESULTS

Schools reported having more universal provision than targeted provision and there was greater reported focus on children who already have difficulties compared with prevention of problems and promotion of student well-being. The most common interventions implemented related to social and emotional skills development and anti-bullying programmes. Learning and educational support professionals were present in many schools with fewer schools reporting involvement of a clinical specialist. Responses varied by country with 7.4-33.5% between-country variation across study outcomes. Secondary schools reported less support for parents and more for staff compared with primary schools, with private schools also indicating more staff support. Schools in rural locations reported less student support and professionals involved than schools in urban locations.

CONCLUSION

The current study provides up-to-date and cross-country insight into the approaches, priorities and provision available for mental health support in schools; highlighting what schools prioritise in providing mental health support and where coverage of provision is lacking.

Prevention of Conduct Disorders at the Community Level

Introduction

Epidemiological data indicate that 30% to 50% of young people contact the child psychiatrist for behavioral disorders problems. Protective factors research that reduce the risk of conduct disorders are just as important as the research of risk factors. The aim of this work is to introduce the preventive factors in the reduction of conduct disorders, including 4 domains: individual, family, school and community. The emphasis is placed on preventive factors at the community level, which are covered by the national, state and local policies that support programs oriented towards children and young people. Good infrastructural community support enable young people to participate in activities where they have opportunities to make choices, make decisions and share responsibility. These experiences help young people to develop new skills, increase their self-confidence and make the difference, while such programs help adults to create a basis for understanding and working together with young and engaged people.

Conclusion

The interest in the behavior of young people and their perspective creates a culture of care for young people instead of a culture of ignoring or even marking behavior among young people as deviant and antagonistic, which has a significant preventive effect on the development of behavior disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Elevated serum dipeptidyl peptidase IV activity in patients with chronic tonsillitis

Background: Palatine tonsils represent the first place of contact for a variety of antigenic substances present in air and food. Upon antigen stimulation, the interactions between T and B lymphocytes in the tonsil are known to depend on the expression of different co-stimulatory molecules, including proteolytic ectoenzymes. Dipeptidyl peptidase IV (DPP IV) and aminopeptidase N (APN), as T lymphocyte co-stimulatory molecules, participate in the regulation of the immune response during inflammation.

Methods: In this study, the serum and lymphocyte enzymatic activity of DPP IV and APN was investigated in 32 patients, 13 with recurrent tonsillitis (RT) and 19 with tonsillar hypertrophy (TH), before and one month after tonsillectomy. The enzymatic activity of DPP IV and APN in tonsillar lymphocytes and serum was determined kinetically at 37°C using Gly-Pro- p-nitroanilide (for DPP IV) and Ala- p-nitroanilide (for APN) as chromogenic substrates.

Results: Significantly higher serum DPP IV and APN activities ( P<0.001) were found in TH patients compared with those with RT before tonsillectomy. DPP IV activity in TH patients was also elevated compared with the control of the same age ( P<0.001), whereas the activity of APN was the same as the control group. The activity of both enzymes was the same as of controls after tonsillectomy. In addition, the results show that DPP IV and APN activities in serum decrease significantly with age. Tonsillar lymphocytes demonstrated a wide range of DPP IV and APN activities without significant differences between the investigated groups.

Conclusion: An increased serum DPP IV activity was observed in TH patients compared with both RT patients and controls before tonsillectomy. After tonsillectomy, all activities were similar. The results suggest that serum DPP IV activity may have potential as a diagnostic marker for patients with TH.

Phenolic Compounds from Atriplex littoralis and Their Radiation-Mitigating Activity

From the aerial parts of Atriplex littoralis, three new flavonoid glycosides named atriplexins I-III (1-3), a known flavonoid glycoside, spinacetin 3-O-β-d-glucopyranoside (4), arbutin (5), and 4-hydroxybenzyl-β-d-glucopyranoside (6) were isolated. Their structures were elucidated on the basis of detailed spectroscopic analysis, including 1D and 2D NMR (COSY, NOESY, TOCSY, HSQC, HMBC) and HRESITOF MS data. The compounds were tested for in vitro protective effects on chromosome aberrations in peripheral human lymphocytes using a cytochalasin-B-blocked micronucleus (MN) assay in a concentration range of 0.8-7.4 μM of final culture solution. Chromosomal damage was induced by 2 Gy of γ-radiation on binucleated human lymphocytes, and the effects of the compounds were tested 2 to 19 h after irradiation. The frequency of micronuclei (MNi) was scored in binucleated cells, and the nuclear proliferation index was calculated. The highest prevention of in vitro biochemical and cytogenetic damage of human lymphocytes induced by γ-radiation was exhibited by 3 (reduction of MN frequency by 31%), followed by 4 and 6.

Clastogenic effect of atranorin, evernic acid, and usnic acid on human lymphocytes

Three lichen secondary metabolites atranorin (1), evernic acid (2), and usnic acid (3), were evaluated for their in vitro clastogenic and antiproliferative effects on human lymphocytes using the cytochalasin-B blocked micronucleus (CBMN) assay at concentrations of 2 microg/mL, 4 microg/mL and 6 microg/mL of final culture solution. The frequency of micronucleus (MN) was scored in binucleated cells, and cytokinesis-block proliferation index (CBPI) was calculated. Among the tested compounds, 3 exhibited the most prominent effect decreasing the frequency of MN in the range of 42.5% - 48.9%, that is about double of the positive control amifostin WR-2721 that reduces MN frequency for 22.0%. The effect of evernic acid was approximately equal to action of amifostin (23.2% -32.9%). Atranorin at concentrations of 2 microg/mL and 4 microg/mL decreasing the frequency of MN only for 11.1% and 1.8%, while in concentration of 6 microg/mL increases the frequency of MN for 9.6 %. The comparable CBPI values of the investigated compounds and control suggested that they did not show a statistically significant inhibitory effect on lymphocyte cell proliferation at applied concentrations.

Dynamics of oxidative/nitrosative stress in mice with methionine-choline-deficient diet-induced nonalcoholic fatty liver disease

Insulin resistance, oxidative stress, and proinflammatory cytokines play a key role in pathogenesis of nonalcoholic fatty liver disease (NAFLD). The aim of our study was to investigate the dynamics of oxidative/nitrosative stress in methionine-choline-deficient (MCD) diet -induced NAFLD in mice. Male C57BL/6 mice were divided into following groups: group 1: control group on standard diet; group 2: MCD diet for 2, 4, and 6 weeks (MCD2, MCD4, and MCD6, respectively). After treatment, liver and blood samples were taken for histopathology, alanine- and aspartate aminotransferase, acute phase reactants, and oxidative/nitrosative stress parameters. Liver malondialdehyde level was higher in all MCD-fed groups versus control group (p < 0.01), while nitrites + nitrates level showed a progressive increase. The activity of total superoxide dismutase and its isoenzymes was significantly lower in all MCD-fed groups (p < 0.01). Although catalase activity was significantly lower in MCD-fed animals at all intervals (p < 0.01), the lowest activity of this enzyme was evident in MCD4 group. Liver content of glutathione was lower in MCD4 (p < 0.05) and MCD6 group (p < 0.01) versus control. : Ferritin and C-reactive protein serum concentration were significantly higher only in MCD6 group. Our study suggests that MCD diet induces a progressive rise in nitrosative stress in the liver. Additionally, the most prominent decrease in liver antioxidative capacity is in the fourth week, which implies that application of antioxidants would be most suitable in this period, in order to prevent nonalcoholic steatohepatitis but not the initial NAFLD phase.

Diarylheptanoids from Alnus glutinosa bark and their chemoprotective effect on human lymphocytes DNA

A study of secondary metabolites from the bark of Alnus glutinosa led to the isolation of fourteen diarylheptanoids: oregonin (1), platyphylloside (2), rubranoside A (3), rubranoside B (4), hirsutanonol (5), hirsutenone (6), hirsutanonol-5-O-β-D-glucopyranoside (7), platyphyllonol-5-O-β-D-xylopyranoside (8), aceroside VII (9), alnuside A (10), alnuside B (11), 1,7-bis-(3,4-dihydoxyphenyl)-5-hydroxy-heptane-3-O-β-D-xylopyranoside (12), (5S)-1-(4-hydroxyphenyl)-7-(3,4-dihydroxyphenyl)-5-O-β-D-glucopyranosyl-heptan-3-one (13), and (5S)-1,7-bis-(3,4-dihydroxyphenyl)-5-O-β-D-[6-(3,4-dimethoxycinnamoylglucopyranosyl)]-heptan-3-one (14). All of the diarylheptanoids, except 1 and 5, were found in A. glutinosa for the first time, while 13 and 14 were new compounds. The structures were determined by spectroscopic techniques: 1D and 2D NMR, HR-ESI-MS, FTIR, UV, and CD. All isolated compounds were analyzed for an in vitro protective effect on chromosome aberrations in peripheral human lymphocytes using the cytokinesis-block micronucleus assay. The majority of them, including the new compounds 13 and 14, exerted a pronounced effect in decreasing DNA damage in human lymphocytes. Diarylheptanoids 1, 2, 5, 13, and 14 at a concentration of 1 µg/mL decreased the frequency of micronuclei by 52.8 %, 43.8 %, 63.6 %, 44.4 %, and 56.0 %, respectively, exerting a much stronger effect than the synthetic protector amifostine (17.2 %, c = 1 µg/mL).

Antioxidant evaluation of heterocyclic compounds by cytokinesis-block micronucleus assay

This article summarizes the results of using cytokinesis-block micronucleus (CBMN) assay to evaluate the antioxidant potential of heterocyclic compounds. Most studies were carried out with naturally occurring heterocyclic compounds such as plant polyphenols: flavonoids, xanthones, coumarins, and ellagitannins, or plant derived products (juices, extracts, supplements) rich in bioactive heterocyclic compounds. There are also some studies dealing with synthetic heterocyclic antioxidants. CBMN assay is an in vitro study that has been used to evaluate antioxidant and protective effects of heterocyclic compounds on induced chromosome aberration in human lymphocytes.

Effect of Hypogymnia physodes Extracts and their Depsidones on Micronucleus Distribution in Human Lymphocytes

Three lichen depsidones, physodalic acid (1), physodic acid (2), and 3-hydroxy physodic acid (3), were isolated from Hypogymnia physodes diethyl ether extract using column chromatography, and their structures determined by comparing their UV,1H and 13C NMR spectroscopic and MS data with those given in the literature, as well as with data computed by CHEM draw ultra 11 software. The contents of 1, 2 and 3 were determined in the methanol (ME), acetone (AE), and diethyl ether (EE) extracts using reversed-phase high performance liquid chromatography with photodiode array detection. The extracts, isolated depsidones 1-3 and EE fraction F23 (consisting of 90% 2 and 3, in the ratio 5.5: 1) were evaluated for their in vitro effects on chromosome aberrations in peripheral human lymphocytes using the cytochalasin-B blocked micronucleus (CBMN) assay in doses of 1 μg/mL and 2 μg/mL of final culture solution. The frequency of MN was scored in binucleated cells, and nuclear proliferation index was calculated. It was found that 1, 2, 3, F23, and EE at 1.0 μg/mL exerted a beneficial effect on lymphocyte cells giving a significant decrease of the frequency of MN in comparison with the positive control Amifostin WR-2721. Among the tested depsidones at a concentration of 1 μg/mL, 3 exhibited the most prominent effect decreasing the frequency of MN by 30.3%, followed by 2 (28.2%) and 1 (22.0%). The extracts were less effective than the isolated depsidones.

Effect of Hypogymnia physodes extracts and their depsidones on micronucleus distribution in human lymphocytes

Three lichen depsidones, physodalic acid (1), physodic acid (2), and 3-hydroxy physodic acid (3), were isolated from Hypogymnia physodes diethyl ether extract using column chromatography, and their structures determined by comparing their UV, 1H and 13C NMR spectroscopic and MS data with those given in the literature, as well as with data computed by CHEM draw ultra 11 software. The contents of 1, 2 and 3 were determined in the methanol (ME), acetone (AE), and diethyl ether (EE) extracts using reversed-phase high performance liquid chromatography with photodiode array detection. The extracts, isolated depsidones 1-3 and EE fraction F23 (consisting of 90% 2 and 3, in the ratio 5.5: 1) were evaluated for their in vitro effects on chromosome aberrations in peripheral human lymphocytes using the cytochalasin-B blocked micronucleus (CBMN) assay in doses of 1 microg/mL and 2 microg/mL of final culture solution. The frequency of MN was scored in binucleated cells, and nuclear proliferation index was calculated. It was found that 1, 2, 3, F23, and EE at 1.0 microg/mL exerted a beneficial effect on lymphocyte cells giving a significant decrease of the frequency of MN in comparison with the positive control Amifostin WR-2721.Among the tested depsidones at a concentration of 1 microg/mL, 3 exhibited the most prominent effect decreasing the frequency of MN by 30.3%, followed by 2 (28.2%) and 1 (22.0%). The extracts were less effective than the isolated depsidones.

Chemical and sensorial characteristics of fruit spirits produced from different black currant (Ribes nigrum l.) and red currant (Ribes rubrum l.) cultivars

Chemical characteristics of fruit spirits produced from three black currant cultivars (Malling Juel, Ometa, Ben Sarek) and two red currant cultivars (Rondom and Versailles) grown in Serbia were examined using gas chromatography. In addition, sensory evaluation of the spirit samples was performed using the Buxbaum model of positive rating. Fruit spirits produced from black currant cultivars displayed the highest contents of methanol (267.2 - 595.0 g/hl A. A) and amyl alcohols (74.2 - 204.8 g/hl A. A). Total sensory scores of currant brandies ranged between 17.60 and 18.40, while currant brandy produced from Ben Sarek black currant cultivar received the highest score (18.40). All tested samples of currant brandies fulfilled EU requirements as regards their content of methanol and other components such as acetaldehyde, ethyl acetate and high alcohols. The currant distillates were compared with other commercial spirits, including plum and grape brandies.

Chemical composition of currant seed extracts and their protective effect on human lymphocytes DNA

On the basis of LC/UV/MS analysis, 35 compounds from the extracts of seeds of black, red, and white currants (2 cultivars of each) were identified. Black currants cultivars contained protocatechuic acid and p-hydroxybenzoic acid, and traces of nitril containing phenolic acids. The presence of synapoyl glucoside was characteristic for cv. Malling Jewel. Sesquiterpenoid glycosides and carboxymethylindol glycosides were present mainly in white and red currant cultivars. Blackcurrant seeds contained higher amounts of flavonoids, especially rutin, isoquercetin, and taxifolin. The currant seed extracts were tested for in vitro protective effect on chromosome aberrations in peripheral human lymphocytes using cytochalasin-B blocked micronucleus (CBMN) assay. The frequency of MN was scored in binucleated cells, and the cultivars of black currants showed the best antioxidant potential. At a concentration of only 0.17 mg/mL, extract of the seed cv. Malling Jewel effected a decrease in the frequency of MN of 60% compared with control cell cultures.

PRACTICAL APPLICATION

Our results provide evidence of protective effects of currant seed extracts and isolated pure compounds on cytogenetic damages in human lymphocytes. Thus, currant seed extracts could exert beneficial effects in quite a few diseases, for many of the biological actions have been attributed to their antioxidant properties.

Protective effect on human lymphocytes of some flavonoids isolated from two Achillea species

This study was conducted to elucidate the in vitro protective effect of five flavonoids [apigenin (1), apigenin-7-O-glucoside (2), centaureidin (3), jaceidin (4) and quercetin (5)] against chromosomal damage in mitogen-induced human lymphocytes. Using the Cytochalasin-B blocked micronucleus (CBMN) assay, in which the biomarker of chromosome breakage and/or chromosome loss is the elevated frequency of micronucleus (MN) in binucleated (BN) cells, the presence of flavonoid 2 in minimal concentration (3 microg/mL) gave a 35.5% decrease in the frequency of MN when compared with control human lymphocytes. The same concentration of flavonoids 1, 3 and 4, reduced the MN frequency by 24.4%, 28.0% and 28.0%, respectively. Higher concentrations (6 microg/mL and 10 microg/mL) seemed less effective. Flavonoid 5 (3 microg/mL) induced a slight decrease in MN frequency (5%), while higher doses (6 microg/mL and 10 microg/mL) provoked an increase of DNA damage. The comparable values for the cytokinesis-block proliferation index (CBPI) of the tested flavonoids and positive control suggested an inhibitory effect on lymphocyte proliferation. In the DPPH scavenging assay, flavonoids 1-4 demonstrated modest activity, in a dose-dependent manner, compared with the synthetic antioxidants BHT and Trolox, while 5 exhibited comparably high antioxidative activity.

Protective Effect on Human Lymphocytes of Some Flavonoids Isolated from Two Achillea Species

This study was conducted to elucidate the in vitro protective effect of five flavonoids [apigenin (1), apigenin-7- O-glucoside (2), centaureidin (3), jaceidin (4) and quercetin (5)] against chromosomal damage in mitogen-induced human lymphocytes. Using the Cytochalasin-B blocked micronucleus (CBMN) assay, in which the biomarker of chromosome breakage and/or chromosome loss is the elevated frequency of micronucleus (MN) in binucleated (BN) cells, the presence of flavonoid 2 in minimal concentration (3 μg/mL) gave a 35.5% decrease in the frequency of MN when compared with control human lymphocytes. The same concentration of flavonoids 1, 3 and 4, reduced the MN frequency by 24.4%, 28.0% and 28.0%, respectively. Higher concentrations (6 μg/mL and 10 μg/mL) seemed less effective. Flavonoid 5 (3 μg/mL) induced a slight decrease in MN frequency (5%), while higher doses (6 μg/mL and 10 μg/mL) provoked an increase of DNA damage. The comparable values for the cytokinesis-block proliferation index (CBPI) of the tested flavonoids and positive control suggested an inhibitory effect on lymphocyte proliferation. In the DPPH. scavenging assay, flavonoids 1-4 demonstrated modest activity, in a dose-dependent manner, compared with the synthetic antioxidants BHT and Trolox, while 5 exhibited comparably high antioxidative activity.

Antioxidant properties of grape seed extract on human lymphocyte oxidative defence

The distribution of polyphenolic compounds in a grape (Vitis vinifera) seed extract (GSE) was determined using LC/ESI-TOF MS, HPLC/DAD, and (13)C-NMR. The 17 identified compounds comprised gallic and protocatechuic acid, catechin and epicatechin monomers, procyanidin oligomers, and procyanidin gallates. This study addresses the in vitro effects of grape seed extract (GSE) on the frequency of micronuclei with reference to the antioxidant status in human lymphocytes. To establish the most effective protective support, we used four different concentrations of GSE, in the range 1-6 microg/mL. Treatment of lymphocytes with GSE at a concentration of 2.5 microg/mL induced a significant decrease in the frequency of micronuclei by 40%, reduction of malonyldialdehyde production by 30%, while a concentration of 5 microg/mL increased catalase and glutathione S-transferase activity by 10% and 15%, respectively. These results demonstrate that GSE may be effective in the prevention of oxidative lymphocyte damage by ROS.

Antioxidant, antimicrobial and genotoxicity screening of hydro-alcoholic extracts of five serbian Equisetum species

The hydro-alcoholic extracts of five Equisetum species, E. arvense L., E. sylvaticum L., E. fluviatile L., E. palustre L. and E. telmateia Ehrh., growing-wild in Serbia were evaluated for their genotoxicity, antimicrobial activity, antioxidant capacity and the results related to the total phenol content and HPLC flavonoid profiles. The total phenol content was 92-349 micromol expressed as equivalents of chlorogenic acid per g of dried plant material. Main identified compounds were kaempferol-, quercetin- glycosides and caffeic acid derivatives. E. telmateia extract showed the greatest antioxidant capacity. Almost all tested microorganisms demonstrated some degree of sensitivity to the examined extracts. All tested extracts at 62.5 microg/ml showed higher incidence of micronucleus formation than in the control sample. The obtained data allowed mutual comparison of examined species and their assessment as possible sources of antioxidants, antimicrobials and/or genotoxic substances.

HER-2 expression in uterine cervix carcinogenesis

PURPOSE

To assess the expression and clinical significance of HER-2 protooncogene in the uterine cervix carcinogenesis.

PATIENTS AND METHODS

We examined 69 tissue samples of low grade cervical squamous intraepithelial lesions (SIL) (n=16), high grade SIL (n=11) portio vaginalis uteri (PVU) carcinoma in situ (n=11) and PVU invasive carcinoma, stage IA-IIA (n=13; study group) and 18 samples without SIL or malignancy (control group). The expression of HER-2 was detected immunohistochemically using a monoclonal antibody. Fisher's exact test was used to assess statistical significance. By establishing sensitivity and specificity of the test, the level of reliability of these analyses was determined as a possible screening method for early detection of changes in the uterine cervix.

RESULTS

Overexpression of HER-2 was found to increase in direct relation to the grade of the cervical lesions. Statistically significant difference was found in the frequency of overexpression in patients with high grade SIL, PVU carcinoma in situ and PVU invasive carcinoma compared with the control group. High sensitivity was of great diagnostic significance for the detection of these types of changes in the uterine cervix. On the basis of high predictive values it can be concluded that in patients with HER-2 overexpression there is a great possibility that they have premalignant or malignant changes in the uterine cervix.

CONCLUSION

Our results indicate that overexpression of HER-2 oncogene may play an important role in cervical carcinogenesis. However, more extensive series of samples is required to establish the prognostic significance of HER- 2 in cervical carcinogenesis.

[Comparison of clinical results of anterior cruciate ligament reconstruction using two different procedures]

During the last two decades the "golden standard" in reconstruction of anterior cruciate ligament knee was the middle third of patellar tendon, but now are more used hamstrings tendon autograft. The aim of this work was to compare our results of the artroscopic reconstruction ACL (anterior cruciate ligament) of the knee using two different technics. We were controling 60 patients within the period of two years after operation. Group A was composed of 39 patients which had reconstructed ACL done with bone-patella tendon- bone autografts, in the group B were 21 patients and at them as autographts have been used hamstring tendon. Difference between healthe and the ill knee by the Lachman's test after operation, in the group A was 2,4 mm, but in the group B was 2,2mm (p> 0,05 ). Postoperative middle value of the Lysholm and Gillquist score in the group A was 97,74, in the group B it was 96,67 (p>0,05). IKDC score results are following: Group A- mark A 32 patients (84,6%); mark B 5 (12,8%); mark C 1 (2,6%) and in the group B: mark A 17 patients (81%); mark B 3 (14,28%): mark C 1 (4,72%) (p> 0,05). Postoperative value for the Tegner and Lyscholm score activity in the A group was 8,23, in B group it was 8,81. The reconstruction of ACL with bone- patella tendon-bone grafts gave better results then the reconstruction with the hamstring tendon only according to Tegner score values. In other parameters between those two groups there was no statisticaly significant difference.

Antibacterial medicinal plants Equiseti herba and Ononidis radix modulate micronucleus formation in human lymphocytes in vitro

We assessed the in vitro cytogenetic effects of extracts of the commonly used medicinal plants Equiseti herba, Ononidis radix, and Uvae ursi on irradiated human blood lymphocytes. We examined the acquired micronucleus formation in unirradiated and irradiated samples of cultured blood lymphocytes using the cytochalasin block micronucleus test (CBMN). Centromere-positive micronuclei were identified by fluorescence in situ hybridization using a DNA probe labeled with alpha-satellite digogsigenin. Equiseti herba had weak clastogenic properties, increasing the yield of micronuclei in unirradiated samples and reducing the level of radiation-induced micronuclei in a concentration-dependent manner. In the control, unirradiated samples, 36.8% of micronuclei were centromere-positive (MNC+), while in the irradiated ones the percentage of MNC+ ranged from 10.8-15.3%, indicating a clastogenic mechanism for the micronuclei formation. Ononidis radix was a strong clastogen and radiosensitizer, rapidly increasing the yield of micronuclei in unirradiated samples up to 5-fold and potentiating the yield of radiation-induced micronuclei up to 1.7-fold. In cultures treated with Ononidis radix, the percentage of MNC+ micronuclei ranged from 18.8 to 23.8%, indicating that micronuclei originated by a clastogenic mechanism. Uvae ursi did not affect the yield of micronuclei either in unirradiated or in irradiated samples. The micronucleus formation assay is a reliable screen for plant extracts and purified compounds, for the identification of compounds that might either inhibit clastogenesis or potentiate radiotherapy for malignancy.

[Soft tissue injuries of the neck]

Thirty five patients were examined. All had soft tissue spinal cord injury and were not treated in a hospital. Complete diagnostic and therapeutical protocol was carried out only for 13 patients. The goal was to compare their initial condition with condition after the control examination after the therapy. Results showed that 8 patients (23%) suffered from pain in the neck, 25 (72%) had limited neck mobility, and 17 (49%) manifested neurological symptoms. Signs of osteochondrosis at isolated spinal levels and dyscoligamental instability were noted in one fifth of the observed patients. In 24 patients (69%) the condition was defined as "serious". Although soft tissue spinal cord injuries are considered as "light" injuries, they can cause serious consequences that reduce the quality of patient's life due to inadequate treatment. From that point of view, a serious approach to diagnosis and treatment is necessary.

[Comparative radiographic analysis of surgical and conservative treatment of unstable injuries of the thoracic and lumbar spine]

INTRODUCTION

Treatment of fractures and dislocations of the thoracolumbar spine is aimed at achieving a stable and painless spine. Concerning mode of treatment therapists are divided into two groups--those for conservative approach and those who advocate operative stabilization of spinal column. The objective of this paper was to compare radiological findings of both modes of treatment on the basis of our clinical material.

MATERIALS AND METHODS

The examination included radiographs of 96 patients with radiolographic signs of unstable spine, treated at Clinic of Orthopaedic Surgery and Traumatology of the Institute of Surgery of the Clinical Center in Novi Sad from 1984 to 1998. Among 48 operated patients (average age of 40.7), there were more females--25, and among nonoperated, there were more males--33. The average age of conservatively treated patients was 52. Dynamic radiographs evaluated the angle of local kyphosis on the spot of injury (Cobb's angle), reduction of dimensions of the body of injured vertebra and sagittal movement of the body on affected level. Measured values were corrected by values of sagittal index.

RESULTS

Initially the average angle of local kyphosis among operated was 26.9, among conservatively treated it was 19.7. Control values for operated were 14.7 and for conservatively treated 25.6. Initially, a wedge-shaped deformity larger than half of the front part of the injured vertebra body had 42 nonoperated and 32 operated patients. Initially, the average sagittal movement of the injured vertebra body among operated patients was 6.97 mm, and at control 1.34 mm. Among nonoperated, the average movement of the body was 1.71 mm initially and 3.23 mm at control.

DISCUSSION

Similar results of angular deformity were found by other examiners. Their results are also in favor of operative treatment of unstable injuries of Th-L spine. The number of those proclaiming good results of conservative treatment of injures of thoracolumbar spine in patients with initially high values of angular deformity is much less. Willen, Mumford, Andreycik and others using wedge-shaped deformity and sagittal movement of the body as parameters in their studies had similar results as those in this study, and they conclude that the stability of segment is much higher among operated patients and that operative treatment finally ends in better radiological results.

CONCLUSION

Radiological results of operative treatment of unstable injuries of thoracolumbar and lumbar spine are better than those of conservative treatment. In order to obtain a stable spine, which is the aim of treatment of unstable spine injuries, operative stabilization is necessary.

Influence of ribavirin on the micronucleus formation and in vitro proliferation of human lymphocytes

Cytotoxic effects of the antiviremic drug ribavirin (1-beta-D-ribofuranosyl-1,2,4-triazole-3-carboxamide) were evaluated in vitro measuring micronucleus formation and cell proliferation kinetics in whole blood cultures employing cytokinesis block (CB) micronucleus test. The cells were exposed to ribavirin doses ranging from 0.05 0.65 micromol/ml at three different incubation times. The frequency of micronuclei in treated samples demonstrated relatively low ability of ribavirin to induce micronuclei. However, the lowest concentration ofribavirin markedly changed the frequency of mononucleated and multinucleated cells, particularly binucleated ones, which declined significantly. The decline in the frequency ofbinucleate cells was followed with accumulation of greater number of mononucleate cells. Decreased proliferation potential of lymphocytes treated with ribavirin indicates that cells are arrested prior to metaphase. The present investigation showed that ribavirin is capable to induce a delay in cellular proliferation at all the doses assayed. The study demonstrated that CB micronucleus assay is simple and rapid method that can be used to assess toxic effect of drugs in vitro.

[Arthroscopy of the knee--"surgery without complications"]

INTRODUCTION

Beside other advantages that arthroscopic surgery has, comparing to the open surgery, there is one more--the risk of complications is present but a very little. The aim of this work is to present complications that we have had and to point at possibilities how to prevent and treat them.

MATERIAL, METHODS AND RESULTS

In the period from September 1990 to December 1998, 1071 arthroscopic surgeries were performed in our hospital. 817 patients (76%) were male and 254 (24%) female, average age 30.63 (12-69). Left knee was involved in 560, while the right in 511 cases. Among all arthroscopic interventions 463 (43.23%) were diagnosed when damages of LCA or cartilage were seen, and 608 (56.76%) were patients with therapeutic arthroscopic interventions. Among different arthroscopic interventions medial meniscectomy was performed in 417 (38.93%) patients, lateral in 124 (11.57%), removal of joint loose bodies in 39 (3.64%), reconstruction of LCA in 29 (2.70%), operation on patellar and condylar cartilage in 26 (2.42%) etc. There were 39 (3.64%) complications. 10 (25.64%) of them were intraoperative (breakage of arthroscopic instruments, loss of meniscal parts, extravasation of the fluid in extremity and 29 (74.35%) of them were postoperative (infection, synovial sinus, thrombophlebitis, haemarthrosis, synovial effusion, painful scar). 8 (1.72%) of those complications appeared after diagnostic arthroscopy and 31 (5.09%) after different therapeutic arthroscopic procedures.

DISCUSSION

Advantages of arthroscopic surgery are exhibited in different ways (shortening hospital stay, lower cost of treatment, shortening the time necessary for complete recovery and return to everyday life and sport activities), while the risk of complications, although possible, is significantly diminished. Insufficient education, improvisation, rude manipulation, unprecise++ surgical approaches to the knee joint lead to aforementioned complications. Our results are discussed and compared to those found in the literature giving suggestions in the same time how to avoid and prevent them.

CONCLUSION

Orthopedic surgeons who perform arthroscopic surgery must be well trained and familiar with the arthroscopic procedures and able to prevent and overcome possible complications. Continual education and training is necessary for arthroscopic surgeons in order to be able to follow innovations in surgical techniques and instrumentation.

Radiosensitivity of human lymphocytes in vitro correlates more with proliferative ability of cells than with the incidence of radiation-induced damages of the genome

The purpose of this study was the estimate the extent of individual variability in radioresponse of human lymphocytes in vitro and to establish the reasons of variability. Individual variability in radiation-response was evaluated using the cytochalasin B micronucleus test among 82 healthy individuals (36 men and 46 women), of mean age 38 (range 30-48). Blood samples were irradiated with gamma (60Co) rays at a dose of 2 Gy in vitro. The yield of radiation-induced micronuclei (MN), cytochalasin blocked proliferation index (CBPI), fraction of micronucleated binucleate (BN) cells and mean incidence of MN per micronucleated BN cells at a sampling time of 72 hours were scored. Our results brought out a significant effect of gender on the level of spontaneously occurring micronuclei, the lack of statistical differences between gender in the yield of radiation-induced micronuclei and marked variability in radiation response among individuals. Likelihood of expressing hypersensitivity was correlated with ability of cells to proliferate in vitro (beta = 0.41, p < 0.000) more than with the incidence of radiation-induced micronuclei per micronucleated cell (beta = 0.20, p < 0.000).

Localisation of ecto-5'-nucleotidase and divalent cation-activated ecto-ATPase in chronic tonsillitis

The histochemical localisation of two ecto-enzymes, 5'-nucleotidase (5'-NT) and Mg(2+)-ATPase, was investigated in hyperplastic and recurrent tonsillitis. Detection of enzymes was performed on frozen sections using the classical lead nitrate method. Activity of 5'-NT was demonstrated particularly in the cells of lymphoid follicles and in the basal layer of the surface tonsillar epithelium. There was no difference in localisation of 5'-NT between hyperplastic and recurrent tonsillitis, whereas a stronger reaction in follicular mantle zones was observed in recurrent tonsillitis compared to hyperplastic tonsillitis. Mg(2+)-ATPase activity was mainly associated with the cells lining the tonsillar crypt, with the interfollicular areas and blood vessels. In recurrent tonsillitis only half of the studied follicular germinal centres expressed Mg(2+)-ATPase activity, compared to hyperplastic tonsillitis. The similar localisation of 5'-NT and ecto-ATPase in both types of chronic tonsillitis suggests that in inflamed tonsils expression of investigated enzymes probably does not depend on the type of chronic tonsillitis.

Divalent cation-activated-ATPase and ecto 5'-nucleotidase activities in chronic tonsillitis

The activities of two ectoenzymes,Mg(2+)-ATPase (ATPase) and 5'-nucleotidase (5'-NT) from tonsillar mononuclear cells (TMC) and peripheral blood mononuclear cells (PBMC) were investigated in idiopathic tonsillar hyperplasia and recurrent tonsillitis. The ATPase activity of TMC was significantly higher in recurrent tonsillitis than in idiopathic tonsillar hyperplasia, whereas no difference was demonstrated in ATPase activity of PBMC. The activity of 5'-NT was similar in both investigated groups. However, ATPase and 5'-NT activities were significantly higher in TMC compared to PBMC. Such results suggest a possible role of ATPase in the activation of TMC during the course of chronic tonsillitis and indicate a difference in the function of TMC and PBMC.

[Arthroplasty in the treatment of congenital anomalies of the hip in adults]

At the Clinic for Orthopedic Surgery and Traumatology in Novi Sad, 79 adult patients with osteoarthritic hip dysplasia underwent total joint replacement surgery in the period 1984-1993. 45 patients were followed-up for an average time of 4.2 years. The results obtained have been evaluated following the criteria of Postel-Merle-d'Aubigne's hip rating system. After surgery 37 (82.2%) patients had minimal or no pain at all, while the hip flexion was over 75 degrees in 35 (75.5%) patients. 9% of patients could not walk longer than 20 minutes with a flexion under 50 degrees. Firm footfall and slight limp in exhaustion occurred in 35 (75.5%) patients, while 7 (15.5%) patients were extremely unstable and were able to get about on crutches. The gathered results confirm that total hip replacement in patients with osteoarthritic dysplastic hip improves stability and hip joint movement as well as pain reduction.

[Evaluation of long-term prognosis in patients with whiplash syndrome]

We reviewed 50 patients who sustained whiplash injuries of the neck. The mean time of the follow-up was 3 years. Only 16% of observed cases recovered completely. Residual symptoms were severe in 38%. Pain in the neck, headache and paraesthesia were the commonest complaints. Older patients and patients with significantly restricted movements of the neck, sharp local kyphotic deformity, chronic instability and neurologic involvement had a worse prognosis.