Abdominal aortic aneurysm volume and relative intraluminal thrombus volume might be auxiliary predictors of rupture-an observational cross-sectional study.

Objectives: The study aimed to identify differences and compare anatomical and biomechanical features between elective and ruptured abdominal aortic aneurysms (AAAs). Methods: Data (clinical, anatomical, and biomechanical) of 98 patients with AAA, 75 (76.53%) asymptomatic (Group aAAA) and 23 (23.46%) ruptured AAA (Group rAAA), were prospectively collected and analyzed. Anatomical, morphological, and biomechanical imaging markers like peak wall stress (PWS) and rupture risk equivalent diameter (RRED), comorbid conditions, and demographics were compared between the groups. Biomechanical features were assessed by analysis of Digital Imaging and Communication in Medicine images by A4clinics (Vascops), and anatomical features were assessed by 3Surgery (Trimensio). Binary and multiple logistic regression analysis were used and adjusted for confounders. Accuracy was assessed using receiving operative characteristic (ROC) curve analysis. Results: In a multivariable model, including gender and age as confounder variables, maximal aneurysm diameter [MAD, odds ratio (OR) = 1.063], relative intraluminal thrombus (rILT, OR = 1.039), and total aneurysm volume (TAV, OR = 1.006) continued to be significant predictors of AAA rupture with PWS (OR = 1.010) and RRED (OR = 1.031). Area under the ROC curve values and correct classification (cc) for the same parameters and the model that combines MAD, TAV, and rILT were measured: MAD (0.790, cc = 75%), PWS (0.713, cc = 73%), RRED (0.717, cc = 55%), TAV (0.756, cc = 79%), rILT (0.656, cc = 60%), and MAD + TAV + rILT (0.797, cc = 82%). Conclusion: Based on our results, in addition to MAD, other important predictors of rupture that might be used during aneurysm surveillance are TAV and rILT. Biomechanical parameters (PWS, RRED) as valuable predictors should be assessed in prospective clinical trials. Similar studies on AAA smaller than 55 mm in diameter, even difficult to organize, would be of even greater clinical value.

Does the presence of an unerupted lower third molar influence the risk of mandibular angle and condylar fractures?

It has been suggested that unerupted lower third molars (M3) increase the fragility of the mandibular angle and simultaneously decrease the risk of condylar fracture. However, it is unknown whether this applies regardless of the direction and point of impact of the traumatic force. The aim of this study was to investigate the impact of an unerupted M3 on the fragility of the angle and condyle in terms of a force acting from different directions and affecting different regions of the mandible. Computed tomography scans of a human mandible and finite element methodology were used to obtain two three-dimensional models: a model with, and the other without an unerupted M3. A force of 2000N was applied to three different regions of the models: the symphysis, ipsilateral body, and contralateral body, respectively. When the force was applied to the mandibular body, the results revealed increased angle fragility in cases with unerupted M3. When the force was applied to the symphysis, the condyle region showed higher fragility, irrespective of the presence of an unerupted M3. In summary, fragility of the angle and condyle regions depends on the presence of an unerupted M3 and on the direction and point of impact of the force.

Effects of Candida on insulin secretion of human adult pancreatic islets and possible onset of diabetes.

This study aims to determine the origin of Candida contamination of pancreatic tissue cultures, as well as its influence on insulin secretory activity of the pancreatic islets. Pancreatic tissue was obtained after pancreatectomy in patients who had chronic pancreatitis or benign tumours. Islets were isolated under aseptic conditions by a manual method. Microbiological analysis was performed by standard procedures and secretory activity was determined on the first, third and seventh day of cultivation. Insulin stimulation index (SI) on the first day of incubation was 0.665 +/- 0.082 and 0.982 +/- 0.167 for sterile and infected cultures, respectively (expressed as means +/- SE). On the third day of cultivation, the SI for sterile cultures was 0.645 +/- 0.071 while these value were higher in contaminated cultures (1.252 +/- 0.413). On the seventh day, SI was 0.853 +/- 0.032 and 1.239 +/- 0.169 for sterile and infected cultures, respectively (P = 0.05). Analysis of results for the first, third and seventh day of incubation and comparison of both groups showed that SI was 0.721 +/- 0.041 for sterile cultures, while for contaminated cultures it was higher by 37.68% (SI = 1.157 +/- 0.154; P = 0.01). The results show that cell culture contamination originates from an original pancreatic tissue infection, and that Candida can provoke an elevated level of insulin secretion in such patients, thus increasing chances for the onset of diabetes.

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

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

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

PURPOSE: The purpose of this study was to explore the effects of a paraffin screen located at various positions in the maze on the neutron dose equivalent at the maze door. METHODS: The neutron dose equivalent was measured at the maze door of a room containing a 15 MV linear accelerator for x-ray therapy. Measurements were performed for several positions of the paraffin screen covering only 27.5% of the cross-sectional area of the maze. The neutron dose equivalent was also measured at all screen positions. Two simple models of the neutron source were considered in which the first assumed that the source was the cross-sectional area at the inner entrance of the maze, radiating neutrons in an isotropic manner. In the second model the reduction in the neutron dose equivalent at the maze door due to the paraffin screen was considered to be a function of the mean values of the neutron fluence and energy at the screen. RESULTS: The results of this study indicate that the equivalent dose at the maze door was reduced by a factor of 3 through the use of a paraffin screen that was placed inside the maze. It was also determined that the contributions to the dosage from areas that were not covered by the paraffin screen as viewed from the dosimeter, were 2.5 times higher than the contributions from the covered areas. This study also concluded that the contributions of the maze walls, ceiling, and floor to the total neutron dose equivalent were an order of magnitude lower than those from the surface at the far end of the maze. CONCLUSIONS: This study demonstrated that a paraffin screen could be used to reduce the neutron dose equivalent at the maze door by a factor of 3. This paper also found that the reduction of the neutron dose equivalent was a linear function of the area covered by the maze screen and that the decrease in the dose at the maze door could be modeled as an exponential function of the product φ·E at the screen.

First Report of Tomato spotted wilt virus on Chrysanthemum in Serbia.

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

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

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

The predictive value of the presence of different antibodies and thymus pathology to the clinical outcome in patients with generalized myasthenia gravis.

OBJECTIVES: To analyze the predictive value of anti-acetylcholine receptor antibodies (anti-AChR Ab) and anti-muscle specific kinase antibodies (anti-MuSK Ab), as well as the thymus pathology to the clinical outcome in patients with generalized myasthenia gravis (MG). METHODS: We analyzed 138 patients with generalized MG, who were thymectomized and assayed for anti-AChR Ab and anti-MuSK Ab. RESULTS: Anti-AChR Ab were detected in 84% of patients, while anti-MuSK Ab were present in 36% of the AChR Ab negative patients. Severe forms of the disease were more frequent in MuSK Ab positive, compared to the AChR Ab positive and complete seronegative patients. Thymic lymphoid follicular hyperplasia (LFH) was present in 60%, thymoma in 23%, atrophic thymus in 9% and the normal thymus in 8% of patients. LFH was more frequent among women, while thymoma and atrophic thymus were more frequent in men. The younger patients mainly had LFH and normal thymus, while thymoma and atrophic thymus were more frequent in older patients. The mildest clinical presentation was present in patients with normal thymus, while severe forms of the disease were registered in the patients with thymoma. The AChR Ab positive patients had more often LFH and thymoma, while within MuSK Ab positive patients atrophic thymus was most common. CONCLUSION: The best disease outcome was observed in patients with normal thymus or LFH with anti-AChR Ab or without both types of antibodies.

The importance of timing in surgical treatment of unruptured symptomatic aneurysm of abdominal aorta.

AIM OF STUDY: Aim of this study is to define an entity of unruptured symptomatic AAA, to examine the influence of timing of the surgical treatment and to analyze the results of the treatment of unruptured symptomatic AAA in acute expansion. MATERIALS AND METHOD: The study is designed as retrospective analysis of 390 operatively treated patients in the last five years at the Clinics of Vascular Surgery in Novi Sad. All patients were grouped into four categories: elective operative surgical treatment, surgical treatment 24 hours after the admission through the Department of Urgent Surgery with an urgent CT diagnosis (in first 2 hours), surgical treatment within 24 hours since the admission through the Department of Urgent Surgery with an urgent CT diagnosis (in first 2 hours) and immediate surgical treatment of ruptured AAA. RESULTS: In the period from Jan 1, 2005 to Dec 31, 2009, 390 patients with AAA were operatively treated. 89 patients had ruptured AAA, 52 were operated 24 hours after the urgent admission, 18 patients were operated in the first 24 hours after the urgent admission and 231 patients were planned for elective surgery. Mortality rates between the groups were as follows: elective surgery-5.1 %, patients operated 24 hours after the urgent admission 7.2 %, patients operated in the first 24 hours after the urgent admission 23 %, and patients who had ruptured AAA 34 %. CONCLUSION: Considering the obtained data, it can be concluded that the treatment of unruptured symptomatic AAA is related to a higher risk of postoperative mortality in relation to an elective surgery. Moreover, surgical treatment in the first 24 hours after the urgent admission of unruptured symptomatic AAA has higher rate of mortality and morbidity compared to surgical treatment 24 hours after the urgent admission of the patients, so we can conclude that the early (semi) elective surgery is a method of choice for the treatment of unruptured symptomatic AAA in acute expansion (Tab. 2, Fig. 2, Ref. 21).

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

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

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

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

[Developmental dysplasia of the hip - epidemiological determinants and age assessment regarding time of surgical correction]. / Vývojová dysplázie kycelního kloubu - epidemiologické urcující faktory a zhodnocení veku vzhledem k dobe chirurgické lécby.

PURPOSE OF THE STUDY: Aim of the study was to analyze age structure of the patients with developmental dysplasia of the hip (DDH) at the time of the operation and epidemiological determinants: gender distribution, proportion of left or right hip affection, type of delivery and mode of labor presentation. MATERIAL AND METHODS: The population of 78 children with DDH was evaluated. Three age groups were analyzed: first group younger than 24 months of life, second group between 24 and 48 months and third group older than 48 months of life. Male and female gender was separately evaluated as well as type of delivery and mode of labor presentation. Separately, 2 groups regarding affected hip were analyzed: group with affected left hip and group with affected right hip. Radiographic findings (Collodiaphyseal angle, Hilgenreiner angle and Wibergs center-edge angle) and clinical findings (positive Trendelenburgs sign, reduced flexion angle (<114°), pain in the hip and incomplete crouch) were evaluated regarding: age of the patients, gender, mode of presentation and type of delivery. RESULTS: There was 33.3% of patients in the first age group, 46.2% of patients in second group and 20.5% of patients in third age group, and regarding gender, 17.9% of males and 82.1% of females. Vaginal delivery was predominant mode with distribution of 87.2% as well as head presentation with distribution of 71.8%. Distribution of children with affected left hip was 46.2% and right hip 53.9%. DISCUSSION: Majority of patients in the study were in the age group between 24 and 48 months of life, suggesting delay in on-time diagnostics of DDH. Female gender was more frequently affected by DDH and vaginal delivery as well as head presentation of newborn was significantly frequent in patients with DDH. It is shown that Collodiaphyseal, Hilgenreiner and Wibergs center-edge angles values are in correlation with the age structure of the patients with DDH at the time of diagnosis. Male gender tends more frequently to present with clinical findings. Reduced flexion angle of the hip is the frequent clinical finding for children with DDH that were born by breech presentation or delivered by Caesarean section. CONCLUSION: Female gender can be taken as one of possible risk factors during clinical examination of newborn regarding diagnostics of DDH, while breech presentation has been shown not to be one of possible risk factors. Early diagnostics and prompt treatment are beneficial in overall outcome for children with DDH. Therefore, there is great need for countinous education of orthopedic surgeons and pediatricians.

Double innominate osteotomy and the Smith-Petersen technique in the treatment of developmental hip disorder.

PURPOSE: The purpose of our study was to present results of different surgical orthopaedic approaches in the treatment of children with developmental hip disorder. MATERIAL AND METHODS: At the University Childrens Hospital in Belgrade, 21 young adults diagnosed with developmental hip disorder were treated with double osteotomy and with a modified Smith-Peterson approach during a period of 10 years, from 1997 to 2007. All patients were clinically and radiographically evaluated. RESULTS: We were successful with 23 hips in 20 patients, since some patients underwent surgery of both hips. The evaluation of improvement was done according to the Merle d'Aubigne and Postel system which indicated very satisfied outcome in five patients, satisfied in 8, fair in 7 and poor in one patient. CONCLUSIONS: In this paper we discuss the advantages and disadvantages of double osteotomy procedures compared with others that are used in the correction of developmental hip disorder. The best solution is adequate and timely diagnosis with proper correction of the deformity.

Effects of bacterial infection on insulin secretory capacity of human adult pancreatic islets.

This study aims to determine the origin of bacterial contamination of pancreatic tissue cultures, as well as its influence on insulin secretory activity (expressed as stimulation index [SI]) of the pancreatic islets. Pancreatic tissue was obtained after pancreatectomy in patients who had chronic pancreatitis or benign tumours. Islets were isolated under aseptic conditions by a manual method. Microbiological analyses were performed by standard procedures and the SI was determined on the first and seventh day of cultivation. In cultures contamminated by Pseudomonas, SI was 1.58 +/- 1.16 on day 1 and 0.22 +/- 0.14 on day 7 (P<0.01). Cultures contaminated by Enterobacter showed an SI of 0.21 +/- 0.1 on day 1, which increased to 1.19 +/- 0.66 on day 7 (P<0.01). In cases of Staphylococcus contamination, SI was 0.07 +/- 0.05 on day 1 and 0.33 +/- 0.21 on day 7 (P<0.01). The study shows that cell culture contamination originates from an original pancreatic tissue infection. The presence of bacteria may reduce or increase insulin secretion in cell culture, depending on the type of microorganism, and this can provoke reduced or elevated levels of insulin secretion in recipients, thus increasing the chances for the onset of diabetes.

Orthopaedic patterns of retroperitoneal tumors in pediatric population.

The paper presents three children of various ages with tumors of different histology localized in the retroperitoneum. The children underwent investigation as orthopedic cases at the Orthopedic Department of the Belgrade University Childrens' Hospital. All children had orthopedic symptoms and several similar clinical findings: high or increased red blood cell (RBC) sedimentation, increased lactate dehydrogenase (LDH) and hypochromic anemia. Retroperitoneal tumors were diagnosed by echosonography. Further investigations were targeted towards histological verification and treatment protocol for retroperitoneal tumor. Since the children were presented chronologically to the deparmtent, diagnosis was reached more rapidly. It is our aim to draw attention to the possibility that various retroperitoneal tumors can be presented as orthopedic diseases. If symptomatology of retroperitoneal tumors is suspected and particularly in insufficiently clear cases, one should always perform echsonography of the retroperitoneum as a non-agressive, simple, readily available and reliable diagnostic method. This reduces examination time, direction of patients to further treatment according to pathology and also in reduction of risk both for patient and orthopedic surgeon who normally are presented with such diseases (Fig. 2, Ref. 10). Full Text (Free, PDF) www.bmj.sk.

Rehabilitation protocols in children with corrected congenital heart defects due to the presence of pulmonary complications.

BACKGROUND: The Aim of our study was to present early rehabilitation protocols for children with and without pulmonary complications after the correction of congenital heart defects and to estimate the optimal time for the initiation of early rehabilitation in both groups of children. METHODS: In our study, 176 children treated at the University Children's Hospital in Belgrade were evaluated during the period 2003-2007. All patients were children with the corrected congenital heart defects from birth to 12 months of life. RESULTS: In the group of patients without pulmonary complications we administered 3.64 +/- 1.02 exercises and in the group with present pulmonary complications we implemented 2.71 +/- 0.79 exercises. The optimal time for the initiation of early rehabilitation is 1.54 +/- 1.37 days for the group of children that did not have pulmonary complications, but for the other group the period was longer: 2.27 +/- 1.68 days. DISCUSSIONS: The optimal number of exercises in children younger than one year of life is from 2 to 4 and the early rehabilitation should start as soon as possible. A desirable time for beginning of such program is within 24 to 48 hours post surgery but it cannot be limited to this interval due to possible complications stating that every child should have an individual approach (Tab. 3, Ref. 14).

[Surgical methods for the treatment of breast phyllodes tumors--a report of 319 cases].

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

In vitro assessment of intestinal permeability and hepatic metabolism of 4'-bromoflavone, a promising cancer chemopreventive agent.

1. The intestinal permeability and hepatic metabolism of the investigational cancer chemoprevention agent 4'-bromoflavone were investigated in vitro using human intestinal Caco-2 cell monolayers, human liver microsomes and human hepatocytes. Liquid chromatography-mass spectrometry and tandem mass spectrometry were used for quantitative analysis in support of the Caco-2 cell studies and for the characterization of metabolites of 4'-bromoflavone. 2. The Caco-2 cell model indicated that 4'-bromoflavone would be absorbed by the intestine at a moderate rate by means of direction-independent, passive diffusion. There was no indication of active transport or efflux. 3. Three monohydroxylated metabolites and one monohydroxylated, hydrated metabolite of 4'-bromoflavone were detected at relatively low levels in the human liver microsomal and hepatocyte incubations. The structures of these metabolites were confirmed by comparison with synthetic standards. Hydroxylation occurred on the A-ring of 4'-bromoflavone but not on the B-ring, probably due to deactivation of the B-ring by bromine. No phase II metabolites were detected following incubation of 4'-bromoflavone in these in vitro systems. 4. In conclusion, these studies predict that 4'-bromoflavone should show moderate oral bioavailability, and that it would probably be excreted as unchanged compound and monohydroxylated metabolites. The results might be helpful in the design of clinical trials and in the interpretation of pharmacokinetic studies of 4'-bromoflavone.

Isolation of linoleic acid as an estrogenic compound from the fruits of Vitex agnus-castus L. (chaste-berry).

A methanol extract of chaste-tree berry (Vitex agnus-castus L.) was tested for its ability to displace radiolabeled estradiol from the binding site of estrogen receptors alpha (ERalpha) and beta (ERbeta). The extract at 46 +/- 3 microg/ml displaced 50% of estradiol from ERalpha and 64 +/- 4 microg/ml from ERbeta. Treatment of the ER+ hormone-dependent T47D:A18 breast cancer cell line with the extract induced up-regulation of ERbeta mRNA. Progesterone receptor (PR) mRNA was upregulated in the Ishikawa endometrial cancer cell line. However, chaste-tree berry extract did not induce estrogen-dependent alkaline phosphatase (AP) activity in Ishikawa cells. Bioassay-guided isolation, utilizing ER binding as a monitor, resulted in the isolation of linoleic acid as one possible estrogenic component of the extract. The use of pulsed ultrafiltration liquid chromatography-mass spectrometry, which is an affinity-based screening technique, also identified linoleic acid as an ER ligand based on its selective affinity, molecular weight, and retention time. Linoleic acid also stimulated mRNA ERbeta expression in T47D:A18 cells, PR expression in Ishikawa cells, but not AP activity in Ishikawa cells. These data suggest that linoleic acid from the fruits of Vitex agnus-castus can bind to estrogen receptors and induce certain estrogen inducible genes.

A simple method for bremsstrahlung spectra reconstruction from transmission measurements.

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