Reg3G gene expression in regenerating skeletal muscle and corresponding nerve.

INTRODUCTION: The Reg genes play a major role in the regeneration of various tissues; however, no reports have been published regarding expression of the Reg3G gene in skeletal muscle. In this study we investigated the expression of the Reg3G gene in regeneration of rat skeletal muscle and injured nerves. METHODS: We used 3 experimental models of muscle and nerve injury. RT-PCR and Western blot analysis were performed for detection of Reg3G in regenerating muscle and nerve. RESULTS: We found transcriptional activation of the Reg3G gene in the soleus and extensor digitorum longus muscles and in their corresponding nerves after both muscle and nerve injury in different time periods, respectively. CONCLUSIONS: The results suggest that the Reg3G gene plays a major role in communication between injured axons and muscle and may play a significant role in skeletal muscle and peripheral nerve regeneration.

The Flexion Relaxation Phenomenon in Patients with Radiculopathy and Low Back Pain: A Cross-Sectional Study.

Although the measurements of the lumbar spine and pelvic flexion have shown that subjects with radiculopathy exhibited greater decreases of motion when compared with subjects with low back pain, there is still a lack of evidence regarding the changes in flexion relaxation ratio in patients with radiculopathy. The aims of this study were to investigate the flexion relaxation ratio and flexion of the lumbar spine and pelvis in subjects with low back pain (LBP) and LBP with radiculopathy (LBPR) in comparison with healthy subjects (CG-control group). A total of 146 participants were divided in three groups: LBP patients (54 males; 21 females); LBPR patients (26 males; 11 females); and CG subjects (16 males; 18 females). The lumbar spine and pelvis flexion was recorded using optoelectronic motion capture system. The electrical activity of the erector spinae muscles was assessed by surface electromyography during flexion-extension movements. Comparisons between groups were made using one-way ANOVA tests and Mann-Whithney U test with the level of statistical significance at 0.05. The lumbar and pelvic flexion and electromyography of the erector spinae muscle showed significant differences between LBP and LBPR patients compared to CG. Patients LBPR showed significantly smaller angles of lumbar and pelvic flexion compared to LBP patients and CG. An increase in the erector spinae muscle activity during flexion was also observed in patients with radiculopathy. The increased muscular activity of the erector spinae is related to the reduced flexion of the lumbar spine in order to protect the lumbar spine structure. Measurements of trunk, lumbar spine and pelvic flexion, and the flexion relaxation ratio may allow us to predict better outcomes or responsiveness to treatment of LBPR patients in the future.

The prevalence of depression and anxiety in seafarers type 2 diabetic patients.

Depression and anxiety are co-morbid condition in diabetes as disease-related psychological reactions on this chronic metabolic illness. This study was aimed to determine the occurrence of depression and anxiety in seafarer's type 2 diabetic patients. A random sample of 52 diabetic seafarers treated with diet and oral glucose lowering agents, and 56 healthy seafarers were screened for depression with The Beck Depression Inventory (BDI) and for anxiety with State-Trait Anxiety Inventory (STAI 1, STAI 2). Depression (BDI > 18.5) and anxiety (STAI < 28.5) was significantly higher in the group of diabetic seafarers than in control group (more than 30%). Significant correlation was noted between depression and duration of diabetes mellitus, degree of obesity and poor glycaemic control (HbA1C > 8%) and longer duration of shipping routes (over 6 months). The proportion of depression and anxiety was found higher in seafarer's type 2 diabetic patients than in the healthy seafarers.

Efficancy of decompressive craniectomy in treatment of severe brain injury at the Rijeka University Hospital Centre.

Decompressive Craniectomy (DC) is a treatment option for severe brain injury (SBI). This method is applied when the growth of intracranial pressure (ICP) can no longer be controlled with conservative methods. DC belongs to class III "Guidelines"--"option" which has not clear clinical certainty. They do not correspond to "Standards" (class I) in treatment protocol for SBI, which is common in most neurotraumatological centers. We have analyzed retrospectively 95 patients with SBI who were admitted to the Clinical Hospital Centre Rijeka. All patients were managed based on a protocol of current Brain Trauma Foundations (BTF) Guidelines. 39 patients underwent DC while 34 patients underwent standard craniotomy. 22 patients did not undergo any surgical procedures. In each patient we analyzed ICP changes within the first 11 days and in that way we correlated them statistically with the initial Glasgow Coma Scale (GCS) and then with Glasgow Outcome Scale (GOS), after the end of the treatment. We particularly analyzed the outcome with reference to the time of the operation and the size of DC. The standard measurement of ICP shows statistical significance in recovery in the group without DC after 5 days of intensive treatment, when the pressure is stabilized between 20-25 mm Hg. The stabilization of ICP in the DC group is observed already after 3 days of intensive treatment. Furthermore, better functional recovery according to GOS, which is statistically significant, was observed in patients who underwent DC where the area of craniectomy was larger than 25 cm2, within the first 24 hours from the time of injury. The use of DC considerably reduces the need for CT check-ups. Increase in the number of encephalocele was noted, which is to be expected considering that dural decompression is used in DC procedure. The results of our study indicate that the utilization of DC is characterized with lower mortality and better functional recovery if it is applied at an early stage of treatment and if the size of DC is satisfactory.

Fibre type composition of the human psoas major muscle with regard to the level of its origin.

The aim of our study was to explore the fibre type composition of the human psoas major muscle at different levels of its origin, from the first lumbar to the fourth lumbar vertebra, and to compare the muscle fibre size and distribution of different fibre types between levels with respect to its complex postural and dynamic function. Muscle samples were collected from 15 young males (younger than 35 years). Serial transverse sections (5 microm) of the samples were cut by cryomicrotome. Type I, IIA and IIX muscle fibres were typed using myosin heavy chain identification. The serial sections were analysed using a light microscope with a magnitude of 100x. The differences between measurements were evaluated using a repeated-measures anova and Scheffé test for post-hoc analysis. Our study showed that the human psoas major muscle was composed of type I, IIA and IIX muscle fibres. It had a predominance of type IIA muscle fibres, whereas type I muscle fibres had the largest cross-sectional area. Type IIX muscle fibres were present as a far smaller percentage and had the smallest cross-sectional area. Moreover, the fibre type composition of the psoas major muscle was different between levels of its origin starting from the first lumbar to the fourth lumbar vertebra. We conclude that the fibre type composition of the psoas major muscle indicated its dynamic and postural functions, which supports the fact that it is the main flexor of the hip joint (dynamic function) and stabilizer of the lumbar spine, sacroiliac and hip joints (postural function). The cranial part of the psoas major muscle has a primarily postural role, whereas the caudal part of the muscle has a dynamic role.

The effects of long-term experimental diabetes mellitus type I on skeletal muscle regeneration capacity.

Muscle fibers are dynamic structures capable of altering their phenotype under various pathological conditions. The aim of the present study was to investigate the influence of long-lasting diabetes mellitus on the process of muscle regeneration in the skeletal muscle. Wistar rats were made diabetic by a single intraperitoneal injection of streptozotocin (STZ). The regeneration process in the skeletal muscle was induced in slow (m. soleus, SOL) and fast (m. extensor digitorum longus, EDL) muscles by injection of local anesthetic (bupivacaine). Skeletal muscles were analyzed 10 days, 4 and 8 weeks after bupivacaine treatment. Diabetes mellitus has changed morphological properties of both slow and fast skeletal muscles during the process of regeneration. These changes are evident in redistribution of muscle fibers and significant level of atrophy. All fiber types of diabetic fast muscles showed stronger atrophy than muscle fibers in slow muscles which have more oxidative metabolism. The changes of redistribution of muscle fibers depend on duration of diabetes and affect all types of muscle fibers.

Pedestrian traffic fatalities in Southwestern Croatia.

Pedestrians are often considered the most vulnerable group of road users. The aim of our study was to analyze the forensic aspects of pedestrian traffic fatalities in Rijeka region. We analyzed pedestrian fatalities in a 5-year period (2002-2006), which included 44 fatally injured pedestrians examined at the Rijeka Institute of Forensic Medicine. The male:female ratio was 1:1. The median age was 57 (ranging from 2-95), with 66% aging over 60 and 89% aging over 40. The least of the accidents happened in July and during weekend. Almost 65% of the fatally injured pedestrians were sober (0.00 g/kg) and 24% had blood alcohol level of more than 1.50 g/kg. Our study showed that pedestrian fatalities in Rijeka region have specific forensic characteristics. These findings suggest the necessity of the specific approach and caution in planning of prevention measures for specific traffic fatalities, in this case pedestrian ones.

Traffic accidents with fatally injured drivers in Southwestern Croatia.

Traffic accidents represent a significant cause of death in Croatia, therefore being an important social and public-health problem. The aim of our study was to analyze the forensic characteristics of traffic accidents with fatally injured drivers in Southwestern Croatia. Study population included 277 fatally injured drivers, in a 10 year period (between 1994 and 2004). As for the gender, 92% were male and only 8% were female. The median age was 35 (13-86), with 53% of them aging 20-39, therefore being a part of the working population. Most of the accidents happened during the summertime (44%) and weekend (57%). Half of the fatally injured drivers (139) were sober (0.00 g/kg) and only 10% (28) had blood alcohol level of 0.00-0.5g/kg. Our results suggest that, as opposed to the current public opinion in Croatia, alcohol might not be the only crucial factor contributing to the drivers' mortality in Croatia. As for the prevention measures, other factors (drug intoxication, fatigue...) should also be taken into consideration and further studied.

The methods of committing and alcohol intoxication of suicides in Southwestern Croatia from 1996 to 2005.

Alcohol is the psychoactive substance most frequently associated with suicidal behavior. We hypothesized that the level of alcohol intoxication and the choice of specific methods of committing suicide are related. Suicides in the Southwestern Croatia in a 10-year period, especially regarding the method of committing and alcohol intoxication, were analyzed. Ten various methods of committing suicide were recorded. The average blood alcohol concentration at the moment of suicide was 0.68 g/kg with male, and 0.29 g/kg with female victims. The highest blood alcohol levels at the moment of suicide were recorded with suicides by explosive device (with the average blood alcohol concentration of 1.71 g/kg). This especially drastic method of suicide was rare in Croatia in a period prior to the Croatian Independence War (1991-1995), but its incidence significantly increased during the war and in a post-war period. These victims were not chronic alcoholics, but the excessive alcohol consumption occurred as a result of psychiatric disorders as a consequence of war stress they suffered.

Reg IV protein is expressed in normal rat tissue.

The Reg IV gene has been documented in the colon, small intestine, stomach and pancreas of the human. Expression of the Reg IV in different cell types has been associated with regeneration, cell growth and cell survival, cell adhesion and resistance to apoptosis. It is unknown whether the Reg IV protein is present in the normal rat tissue. The aim of this study was to reveal the expression of the Reg IV protein in the rat spleen and colon. Western blot analysis using antibody specific for Reg IV protein were performed on rat spleen and colon extracts. Low level of Reg IV expression was found in all examined colon samples. The expression of Reg IV protein in spleen tissue was significantly higher than in the colon. Reg IV protein was immunohistochemically stained in a few epithelial cells in the basal portion of colon crypts and in a large spleen cells which were scattered in the red pulp. Our results demonstrate for the first time the presence of the Reg IV protein expression in the healthy spleen and colon tissue of the rat. Other members of the Reg family, Reg I and Reg III proteins have been shown to act as a growth factors in gastrointestinal tract, but without further experiments we can only assume the potential role of the Reg IV protein in spleen and colon cell growth.

Aspergilloma in a pulmonary abscess--the first manifestation of malignant bronchial obstruction.

We report a case of aspergilloma in a pulmonary abscess being the first manifestation of malignant bronchial obstruction. In our case, only the autopsy revealed that planocellular carcinoma was the real cause of aspergilloma. Malignant bronchial obstruction finally resulted in pulmonary abscess with secondary fungal colonization. The co-existence of these pathologies is uncommon, and the situation we report is extremely rare. Even in cases when there are no radiological, bronchoscopical or cytological signs of malignancy, as in our case, careful observation of these patients is necessary. Surgical approach should be considered whenever possible.

Kinematic measurement of the lumbar spine and pelvis in the normal population.

Spinal and pelvis motion has been studied by a variety of different methods, the majority of which have a number of limitations. The present study investigated motion characteristics of the lumbar spine and pelvis using a three-dimensional optoelectronic system. The aim of our study was to determine kinematic parameters of spine and pelvis during trunk flexion, extension and lateral bending in normal, healthy subjects. Kinematic motion analysis was performed on 63 asymptomatic volunteers for four different trunk motions. This study has shown that the pelvis range of motion is affected by the gender Contribution of pelvic movement to trunk flexion was 50%, while pelvic angle was significantly higher in women. During lateral bending female subjects had statistically significant higher values of vertebral arc with respect to male subjects. During extension the contribution of pelvic movement was 45%. There was no significant difference found in total angle, pelvic angle and vertebral arc.

Assessing glycemia in type 1 diabetic patients using a microdialysis system for continuous glucose monitoring.

BACKGROUND: Continuous glucose monitoring systems can monitor moment-to-moment changes in blood glucose concentration, which cannot be detected by intermittent self-monitoring. Continuing monitoring systems may lead to improved glycemic control. We evaluated a microdialysis technique for improving glycemic control in type 1 diabetes patients treated by different means of basal insulin substitution. PATIENTS AND METHODS: Fifty-two type 1 diabetic patients on twice daily NPH and pre-meal aspart insulin were randomized in two groups: the continuation of NPH (n=26) (group 1) or once daily glargine (n=26) (group 2). 48-hour GlucoDay registrations were started at the beginning and after 4 months. RESULTS: At baseline, time spent in the euglycemic range (glucose between 3.9 and 8.0 mmol/L) was 37.96+/-6.81% for the NPH group and 35.83+/-6.24% for the glargine group. At endpoint, time in the euglycemic range increased in both groups (51.02+/-7.22% and 57.29+/-10.27%, P<0.001 vs. before treatment for both groups). Time spent in the hypoglycemic range (glucose <3.9 mmol/L) was 9.+/-2.57% for the first group and 10.24+/-3.55% for the second group at baseline. At endpoint, time in the hypoglycemic range decreased in both groups (8.00+/-2.13% and 6.59+/-2.04%, P<0.001 vs. before treatment for both groups). CONCLUSION: The analysis of the GlucoDay data gave us information about glycemia other than HbA1c and self-monitoring of blood glucose, such us a peakless activity profile and the lower percentage of time spent in the hypoglycemic range in the glargine-treated group.

Aging of human skeletal muscles.

Normal aging in humans is associated with progressive decrease in skeletal muscle mass and strength (sarcopenia) which contributes to frailty and falls. The age associated changes in body composition result from lower levels of anabolic hormones, oxidative damage, neuromuscular alterations and a general decrease in muscle protein turnover. In this review we discuss the potential mechanisms and physical activity as prevention and treatment of sarcopenia.

Reg IV protein and mRNA expression in different rat organs.

The Reg IV gene has been documented in the human colon, small intestine, stomach and pancreas. Expression of the Reg IV in different cell types has been associated with regeneration, cell growth and cell survival, cell adhesion and resistance to apoptosis. Since the distribution of the Reg IV protein in normal rat tissues is unknown, the aim of this study was to reveal the expression of the Reg IV protein in structurally and functionally different rat organs. The expression of Reg IV gene was analyzed by Western blot and reverse transcription-polymerase chain reaction. Immunohistochemistry was used to localize Reg IV protein. Reg IV protein was expressed in pancreas, stomach, small intestine, colon, brain, spleen, kidney and urinary bladder in two-month-old male Wistar rats. In addition, the expression of Reg IV mRNA by reverse transcription-polymerase chain reaction was confirmed. Our study provides detailed information about the expression and localization of Reg IV protein in different rat organs. These findings provide an evidence of Reg IV expression in different rat organs, which may help elucidate a potential role in growth and proliferation of different cells like other members of the Reg family genes which act as growth factors in the different organs.