Congenital cytomegalic inclusion disease with disseminated Herpes simplex infection.

We report a case of congenital cytomegalovirus and Herpes simplex virus infection suspected via ultrasound indicated by the presence of fetal cerebral abnormalities. The pregnancy was electively terminated at 31 weeks of gestation. The postmortem examination of the foetus showed brain with lissencephaly. The histopathological examination revealed numerous enlarged cells containing cytomegalic inclusions and multinucleated giant cells in multiple fetal organs and placenta. Documented evidence of histopathological detection of cytomegalovirus inclusions in multiple organs are very sparse in literature. This case highlights the causal relationship of viral infections in early pregnancy and abnormalities of the central nervous system.

Vitamin C Depletion in Prenatal Guinea Pigs as a Model of Lissencephaly Type II.

Humans and guinea pigs are unable to produce vitamin C, with deficiency resulting in a well-known disorder of collagen synthesis. Pial basement membrane structure preservation is essential in the proper migration of neurons. In our study, intrauterine deprivation of vitamin C in guinea pig fetuses led to a collagen synthesis disorder, weakness, and finally a breach of pial basement membrane. We found excessive migration of the external germinal layer cells into the subarachnoid space of the cerebellum through defects in the pial basement membrane. The changes ranged from focal rupture of pial basement membranes to their complete disintegration. The loss of proper folia formation resulted in macroscopically visible flattening of the cerebellar surface. Different grades of dysplastic changes in the folia of the cerebellar cortex were observed in 2 experimental groups assigned different limits to mark the time of commencement and duration of vitamin C deprivation. The most severe form of dysplastic changes was characterized by marked irregularity of the cerebellar cortex similar to that in lissencephaly type II. Thus, prenatal vitamin C deficiency represents a novel animal model to study the effects of collagen synthesis on development of breaches in the pial basement membrane, disordered migration of neurons, dysplasia of cerebellar cortex, and the pathogenesis of lissencephaly.

Disorder verbal memory in alcoholics after delirium tremens.

AIMS: Alcohol delirium tremens suggests dysfunction of numerous brain regions. Several Authors suggest that alcohol and withdrawal from alcohol could cause neurotoxic lesions in the frontal lobe and thereby affect cognitive function. However, it is not that well known whether the consequences of the damage following delirium are only quantitative or qualitative. PATIENTS AND METHODS: Thirty alcohol-dependent patients after alcohol delirium (ADT-n1 = 30), and 30 alcohol-dependent patients without alcohol delirium (ALC-n2=30) were compared with neuropsychological test-battery. [(Wechsler Bellevue Intelligence Scale - WB form I, Wechsler memory scale and Rey Auditory Verbal Learning Test (RAVLT)]. Examinees were selected as equivalent pairs, in such a manner that they were of approximately same age, i.e. age difference was 0-5 years, they were of the same education level, and difference in the duration of drinking was not more than 3 years. RESULTS: In the group of ADT patients, IQ was 97.53, while it is 109.53 for ALC patients. Mental deterioration of the examined group is 40, and in the control group 13. Group of ADT patients had significantly lower achievements on subtests: arithmetic, block design and digit symbol. ADT patients' average memory quotient (MQ) is 81.8, which is three standard deviations lower compared to ALC patients (MQ 102.2) and standard values, according to Wechsler. In the first repetition of the series of 15 words RAVLT, is no difference (t-test=1.88; p > 0.05), while the difference in other repetitions is significant. Difference is also statistically significant regarding recollection after 30 minutes (t-test=3.66; p < 0.05). CONCLUSION: There is qualitative difference in cognitive deficiencies in alcoholics with delirium tremens and those with no alcohol delirium, while the predominant pathology of the cognitive-amnestic deficiency is in compliance with the dysfunction of the prefrontal lobe. Following alcohol delirium, verbal memory disorders occur within the intellectual decrease and attention disorder in general.

The impact of heroin on visual memory.

INTRODUCTION AND AIM: Heroin abuse can lead to organic damage of cerebral structures, including sequels in cognitive and affective sphere, which are in positive relation with the duration of substance usage. Memory is one of the cognitive functions which is highly sensitive to opiate toxic effects. The aim of this research was determination of heroin impact on the visual memory of addicts, as well as the existence of specific relation of potential deficiencies in visual memory with the duration of substance use. METHODS: The research included 90 examinees, divided into three groups, depending on the duration of heroin intake. We used questionnaire for basic socio-demographic and addictological traits of examinees; Wechsler's scale for the assessment of the intelligence and Visual Memory Test (TVP), for the assessment of the visual memory. RESULTS: The achievements of heroin addicts with different duration of the substance abuse differ significantly (F = 1.83; df = 12; p < 0.05). Total number of errors examinees make in the first series of TVP (immediate visual memory) grows, almost linearly in the function of the duration of heroin abuse (p < 0.05), but in neither of groups meets criteria for the visual memory impairment. Deficiency of the delayed visual memory occurs in examinees who use heroin for one (total number of errors = 6.46; participation of typical organic errors = 31.7%) and longer than five years (total number of errors = 7.66; participation of typical organic errors = 26.7%). Univariate covariance analysis separates the average daily dosage of heroin as the most significant variable that contributes to the expression of the aforementioned deficiencies (F = 4.21; df = 2; p < 0.05). CONCLUSION: Heroin abuse leads to damage of delayed visual memory, whereby for the observed effect intake of the substance for a period longer than one year is necessary.

The basic morphological characteristics of astrocytomas in Vojvodina in the period 2001-2006.

PURPOSE: Astrocytomas are the most common primary intracranial neoplasms. The aim of this investigation was to register the age, sex, tumor localization, frequency and histological types of patients with astrocytomas. METHODS: The investigation was carried out from January 2001 to June 2006 and included 490 consecutive patients of both sexes with diagnosed intracranial tumors, who had undergone surgical treatment at the Neurosurgery Clinic of the Clinical Centre of Vojvodina. Tumor histological studies were carried out in the Laboratory of the Centre for Pathology and Histology of the Clinical Centre of Vojvodina. Out of 490 patients with diagnosed intracranial tumors, 139 (28.4%) had astrocytomas. RESULTS: Astrocytomas were more frequent in males (63.3%) and were most common in the 50-59-year age group (39.5%). The most common localization was the frontal region (30.2%), more commonly on the right side (51.8%). In regard to other histological types of intracranial tumors, astrocytomas were more frequent in males (34.8%). Grade III astrocytomas were most common (55.4%). The frequency of hemorrhage and thrombosis showed a positive correlation with the histological grade of astrocytomas. CONCLUSION: The typical patient with astrocytoma is a male of 50-59 years. The tumor is grade III located in the right frontal region.

A qualitative study of participants' experiences with dietary assessment.

OBJECTIVE: This article reports on the use of focus groups and an experimental participatory activity to investigate factors influencing participants' decisions about what to eat and what to report on food records and food frequency questionnaires. DESIGN: Four focus groups examined participants' experience with diet records and 3 focus groups explored the topic of food portions using a group consensus activity. Twenty-two women participated in the diet record focus groups, and 15 participated in portion estimation groups. SUBJECTS: Focus group participants were equally distributed by age and body mass index values. Each woman completed a 10-day doubly labeled water protocol to measure total energy expenditure, 7 days of diet records (before and during total energy expenditure), and a food frequency questionnaire after the total energy expenditure. ANALYSIS: Transcripts of the focus groups were coded to index categories of responses and to identify themes within and across those responses. Themes discussed in this article are those that were discussed most often and at greatest length by all groups. RESULTS: The diet record focus groups revealed that 2 major factors influenced reporting on diet records: honesty vs social acceptability, and simplifying food intake. The portion estimation focus groups revealed 5 factors that influenced perceptions of portion size: the role of food in the meal, the type of food, personal preferences, product serving sizes, and comparison of personal servings with those of others. APPLICATIONS: The validity and reliability of self-reported food consumption is greatly influenced by the ways people interpret and respond to dietary assessment instruments. These findings indicate that dietetics professionals need to take extra steps to address issues of accurately recording "bad" foods when training patients to complete diet records. Extra probing is needed when dietary records do not include snacks and include simple meals and a large amount of prepared and packaged food because this may indicate that changes in normal dietary patterns were made in order to more easily complete a dietary record.

Changing patterns of pharmaceutical practice in the United States.

In the United States, contradictions related to medicine use abound in a social environment in which the pursuit of health has become a cultural project. In a marketplace where over half a million health products are available, choices at once seem to foster agency and encourage dependency on medical fixes. The aggressive marketing of medicines as indispensable commodities co-exits with rising concerns among the lay population about what is safe in the short- and long-term. In this paper we broadly consider medication-related practice in the United States as it is affected by social, cultural, and political-economic factors. We direct attention to changes in medicine use related to product proliferation, lowered thresholds of discomfort, the economics of health care, and a revival of the self-help ethic. We also consider the manner in which the demand for and use of medications reflect deeply embedded cultural ideals and emergent perceptions of need. We juxtapose two trends in American thinking about medicines: (1) the perception that "more is better," associated with cultural impatience with illness; and (2) a growing doubt about medicine necessity, safety, and efficacy.

Agenda for an anthropology of pharmaceutical practice.

Over the last two decades, patterns of pharmaceutical-related behavior and the cultural interpretation of medicines have been examined by anthropologists in several cultural settings. In this paper the authors identify additional issues warranting study so as to broaden the scope of pharmaceutical anthropology, utilizing as a unifying focus the examination of pharmaceutical use in the context of social transformation. Ten interactive themes are presented which bridge micro-level and macro-level investigations of pharmaceutical use. The discussion moves from the discourse on 'rational drug use' to the rationales which underscore drug prescription, manufacture, and demand.

Dieting and "watching" behaviors among adolescent females: report of a multimethod study.

PURPOSE: This study posits a distinction between "watching what you eat" and dieting behaviors in a sample of adolescent females. Findings suggest that the dichotomy of dieter/nondieter fails to capture a range of healthful behaviors practiced by many adolescent girls. METHODS: Anthropologic and nutritional research methods were used in this study. Data were drawn from 1 year of a longitudinal study of food intake and dieting behaviors in a sample of 231 adolescent females. Multiple methods including one ethnographic interview, a survey questionnaire, a telephone interview, and food records were collected from each informant. RESULTS: Although 44% of the girls in this sample reported trying to lose weight on the day of the survey, only 8.6% of the food records reflected dieting days. In interviews, many identified "watching what they eat" as a health-promoting strategy that allowed them to maintain their weight. Analysis of food record data confirmed a trend toward higher intakes of micronutrients. CONCLUSIONS: Research concerned with adolescent weight loss behaviors has focused more on negative than positive health attitudes and behaviors. The present study identified the behavior of "watching" as distinct from dieting. "Watching" was widely utilized by girls in this sample as a way to maintain weight and promote health.

Fast relief: buying time with medications.

The experience of time famine in contemporary U.S. culture affects household decisions about self-care and the use of pharmaceuticals for self-medication. This article examines the manner in which time demands shape lay interpretations of medicine efficacy and drive increases in medication use for adults as well as children. Medicines, like other time-saving commodities, appear to shift the time-power differential in favor of individuals, placing them in control of how time is spent. When there is "no time to be sick," allopathic medicines become time-saving devices that enable women to fulfill responsibilities at work or home while they attend to sick children or to being ill themselves. Medicines are used to beat the clock by increasing one's own capacity to be productive.

[Atherosclerotic plaque hemorrhage as one form of a complicated atherosclerotic lesion]. / Krvarenje u ateroskleroznom plaku kao jedan od oblika komplikovane aterosklerozne lezije.

Atherosclerotic plaque hemorrhage is a form of a complicated atherosclerotic lesion. It is a finding of extravasation of erythrocytes (fresh hemorrhage) or siderophages (old hemorrhage) in the defined atherosclerotic changes. 510 segments of the main epicardial coronary arteries (right coronary artery, anterior interventricular branch of the left coronary artery, circumflex branch of the left coronary artery) were microscopically examined in 50 obduction cases of patients with ischemic heart diseases. Fresh hemorrhage in the atherosclerotic plaque was established in 25 cases, that is in 40 microscopically examined coronary artery segments. It was established in all cases where there was a atherosclerotic plaque rupture, in some segments where process of thrombotic organization occurred, as well as in some segments of arteries which supply the region of early myocardial infarction. All hemorrhages occur inside lipidic and fibrolipidic atherosclerotic changes of intima. The average length of fresh hemorrhage was 0.8 cm. 92.50% of segments with fresh hemorrhages occur in the first 4 cm of the examined arteries. 88% of plaque hemorrhages occur in segments with 76-100% lumen obstruction. Signs of old hemorrhages most often occur in segments with 51-75% and 76-100% lumen obstruction. Siderophages mostly occur in complicated atherosclerotic changes and thrombotic organization.

[Cystic teratoma of the neck]. / Cisticni teratom vrata.

Teratomas of the neck are very rare, and up to now only a small number of cases has been described (10 in adults), while in children it is a more frequent finding (132 described cases). It is judged that up to 4% of all teratomas in children are located in the cervicothyroid region. The paper presents a case of a cystic teratoma of the neck in a male child of 1.5 years of age, which gradually increased in it's size during the course of 12 months prior to operation. The tumor had the dimensions 3.7 x 3.2 x 2.7 cm, it was multicystic, and clinically it gave the impression of a bronchial cyst. Histologically the tumor contained elements of all three primary embryonic germ layers.

[Calcification in atherosclerotic plaque as one of the types of complicated atherosclerotic lesions]. / Kalcifikacije u ateroskleroznom plaku kao jedan od oblika komplikovane aterosklerozne lezije.

Calcifications of the atherosclerotic plaque is the form of a complicated atherosclerotic lesion. It is characterized by granular or massive deposits of calcium chloride inside the atherosclerotic plaque. It was found in at least one of the three main coronary arteries in 43 (86.00%) out of 50 autopsy cases. In all three, coronary arteries calcifications were found in 8 (18.60%) cases, in two coronary arteries in 19 (44.19%), and one coronary artery in 16 (37.21%) cases. Calcifications of atherosclerotic changes which contain fats were statistically significantly more frequently established than those which did not contain fats. In three fourths of cases calcifications were present in segments with significant narrowing of the arterial lumen (group 3 and 4). In 59.61% of calcificated atherosclerotic changes the residual lumen was of eccentric shape, in 20.51% of concentric shape, in 7.69% it was semilunar, and in 12.18% a few lumens were detected (channeled and organized thrombi). Granular deposits of calcium were established 63.46%, while massive in 36.54% of segments of atherosclerotic lesions, but no statistically significant difference in distribution of these two types of calcifications was established in regard to the type of atherosclerotic change.

[Types of atherosclerotic changes in relation to the type of residual lumen and degree of narrowing in coronary arteries in ischemic heart disease]. / Vrsta aterosklerozne promene u odnosu na tip rezidualnog lumena i stepen suzenja koronarnih arterija kod ishemijske bolesti srca.

510 segments of all three coronary arteries in 50 obduction cases of individuals suffering from ischemic (coronary) heart disease were microscopically examined. We examined the type of atherosclerotic change, the degree of narrowness of lumen artery and the type of residual lumen. In the group one of the narrowness of artery lumen 44 segments with fibrotic plaque were found, where concentric shape of lumen dominates. In the group two of the narrowness 176 segments were found. Most of them were with fibrotic plaque, but complicated atherosclerotic lesions were also present. According to the shape of residual lumen the concentric narrow shape dominates. In the group three of the narrowness of the lumen 191 segments were found; considering the type of atherosclerotic change complicated lesions were most common, while lipidic plaque was also present. An eccentric shape of residual lumen dominates this group. In the group four of the narrowness of lumen artery 99 segments were found; in this group we found fibrotic plaque and complicated atherosclerotic lesions. The most common finding of the residual lumen is the type of multiple lumen (channelled thrombi).

[Specific inflammatory processes in collagenosis, degenerative and malignant diseases of the skin of the face and neck during aging]. / Specificni zapaljenjski procesi kolagenoza, degenerativna i maligna oboljenja koze lica i vrata tokom starenja.

214 skin lesions have been analyzed in the paper and 158 cases of Carcinoma basocellulare, 22 cases of Carcinoma planocellulare and 11 cases of melanoma were registered. Concerning localization it has been established that skin of the face is mostly endangered both for malignant and benign lesions. In 10 cases Keratosis senilis, a benign kind of lesion, was diagnosed, Dermatitis post irradiationem was diagnosed in 8 cases and Lupus erythematodus in 5 cases. By histologic analysis the following can be stated: if the degree of degradation and damage of collagen fibers is high, the intensity of lymphoplasm infiltrate density and intensity of mastocyte cells density is reduced. If the degree of decomposition of collagen fibers is lower, the lymphoplasmocyte infiltrates are denser as in the stroma of the lesion as well in edges and in the surrounding dermis. Changes were primarily found in malignant skin lesions, but they are identical in cases of keratosis senilis as a premalignant lesion. However, concerning nonmalignant lesions, depending on exterior factors, long time influence of noxa, collagen fibers and their degree of degradation have an important role in the cell interaction, and more attention should be paid to exploring decomposition of collagen fibers as components of the local immunobiologic reaction of the organism to lesion formation.

[Distribution of macroscopic determination of narrowing of the lumen of coronary arteries in ischemic heart disease]. / Distribucija makroskopski odredenih suzenja lumena koronarnih arterija kod ishemijske bolesti srca.

The paper presents macroscopically analyzed 2600 segments 0.5 cm of length of all three main coronary arteries in 50 consecutive autopsy cases suffering from ischemic (coronary) heart disease. A quarter of segments had had a "critical" lumen narrowness (75% of more). The greatest concentration of "critical" lumen narrowness is within the first 6 cm of length. Similar distribution of "critical" lumen narrownesses was found in the first 4 cm of length of circumflex branch of left coronary artery with a remark that concentration of examined segments was higher between the second and fourth cm. The greatest concentration of "critical" lumen narrownesses was not established, because these segments are evenly arranged along the first 10 cm, when examined according to the assumed thirds. Single coronary disease was found in 10% of cases, double coronary disease in 44%, triple coronary in 44% and stenosis of the left coronary arteries in 2%. On the average 2.3 coronary arteries with "critical" lumen narrownesses were found in each case.

[Correlation of postmortem coronarography and the macroscopic and microscopic determination of luminal narrowing of coronary arteries in ischemic heart disease]. / Korelacija postmortalne koronarografije i makroskopski i mikroskopski odredenih stepena suzenja lumena koronarnih arterija kod ishemijske bolesti srca.

In our work we used 30 consecutive abduction cases of individuals suffering from ischemic heart disease. Postmortal coronarography was performed in all and we examined the narrowness of artery lumen, its degree, existence and locality of the obturatory thrombus, artery domination, state of aortocoronary grafts and the existence of anastomoses. Coronary arteries were macroscopically examined by cuts on every 0.5 cm of the established aims, and then segments were examined microscopically. The gathered results were compared and the degree of agreement of the two methods was calculated. An agreement of 100% was established when determining artery domination and presence of obturatory thrombus, although the number of found thrombi was bigger when macroscopic/microscopic examination was done. The defined degree of artery lumen narrowness was identical in 75% of cases.

[Pathohistologic changes in aortocoronary venous grafts]. / Patohistoloske promene u aortokoronarnim venskim graftovima.

This paper analyses histological changes of venous grafts in 52 obduction cases who had undergone aortocoronary bypass grafting and in whom death occurred after more than 30 days from surgery. The group consisted of 46 males and 6 females. The mean age at the moment of surgery was 51.5, while on the average the patients lived 4.83 years after the surgery. 144 venous grafts were implanted, that is 2.77 per patient. In 49 (34.03%) venous grafts fibrosis intima was established. As in 43 (29.86%) grafts it did not cause occlusion of the lumen greater than 25%, these kinds of grafts were marked as unchanged, normal. In 43 (29.00%) grafts atherosclerosis was established, in 14 (9.72%) fibrointimal proliferation, and in 38 (26.39) lumen obliteration. A year after the surgery the most important pathohistologic change was fibrointimal proliferation, and two years after the surgery and on-atherosclerosis. The percentage of certain pathohistologic types of graft changes, no matter how long patients survived after the surgery was the same in both patients with implants of the coronary artery and those with anterior interventricular branch of the left coronary artery. Grafts implanted into branches of the circumflex artery were statistically significantly more often obliterated. The locality of anastomosis of the venous graft and artery was not occluded in 67.31% of all obduction cases, whereas it was occluded in 32.69% of cases or 32 (22.22%) implanted grafts. Occlusions were caused by atherosclerotic change of the anastomosis in 84.37% of grafts, and by simultaneous occurrence of atherosclerotic change and thromb in 15.63% of grafts.

[Analysis of the cause of death in patients with aortocoronary bypass implants]. / Analiza uzroka smrti bolesnika sa implantiranim aortokoronarnim bajpasom.

This paper analyzes causes of death in 91 autopsied patients in whom aortocoronary bypass surgery was performed as a therapy of ischemic heart disease. Patients who died within 30 days after surgery made up the group of so-called "early deaths", while those who died 30 or more days after the surgery made up the group of so-called "late deaths". The leading cause of death in the group of "early deaths" was myocardial infarction (51%) and then causes of death connected to other systems of organs (38%). Hematopericardium and consequential cardiac tamponade was the cause of death in 8% of cases, while in 3% of cases it was cardiac decompensation. In the group of "late deaths" the most important cause of death was myocardial infarction (56%), and then cardiac decompensation (27%), as well as causes of death connected to other systems of organs (17%).