Lipid profile and lipid oxidative modification parameters in the first trimester of high- risk pregnancies - possibilities for preeclampsia prediction.

OBJECTIVES: The goal of this study was to investigate metabolic changes in lipids and oxidative stress parameters in the first trimester of pregnancy with the more specific aim of estimating the significance and strength of researched parameters in the prediction of preeclampsia. DESIGN AND METHODS: The study included 87 high-risk pregnant (HRG) female subjects, 14 with developed preeclampsia (PEC) and 43 healthy pregnant female subjects matched for gestational age (CG). Thiobarbituric acid-reactive substances (TBARS) concentration, lipid hydroperoxides (LOOH), pro-oxidant antioxidant balance (PAB) and total oxidative status (TOS) were measured as oxidative stress markers, while total antioxidant capacity (TAC) was measured as an antioxidative defense parameter. The Atherogenic Index of Plasma (AIP) was calculated as the base 10 logarithm of the ratio of the plasma concentration of triglycerides (TG) to the plasma concentration of high-density lipoprotein cholesterol (HDL-C), with each concentration expressed in mmol/L. RESULTS: The results have shown that lipid indices, especially AIP, were significantly higher in the first trimester of HRG (p < 0.001) and PEC (p < 0.001). Oxidative stress parameters were significantlly higher, while TAC was significantly lower in HRG vs. CG [0.7 ± 0.15 vs 1.1 ± 0.16; (p < 0.001)] and in PEC [0.6 ± 0.12 vs 1.1 ± 0.16; (p < 0.001)] vs. CG. Also, in the HRG, results have shown an independent association of AIP with the preeclampsia development (p < 0.05), while placental growth factor did not show the expected level of significance (p = 0.648). Analysis of the Receiver Operating Characteristics (ROC) curves indicated that certain parameters included in the research model have very good diagnostic accuracy for preeclampsia (AUC = 0.856). CONCLUSIONS: AIP is associated with high-risk pregnancies. Furthermore, our results firmly underscored AIP as a potential marker for preeclampsia prediction.

Monte Carlo investigation of electron specific energy distribution in a single cell model.

Knowledge of microdosimetric quantities of certain radionuclides is important in radio immune cancer therapies. Specific energy distribution of radionuclides, which are bound to the cell, is the microdosimetric quantity essential in the process of radionuclide selection for patient tumour treatment. The aim of this paper is to establish an applicable method to determine microdosimetric quantities for various radionuclides. The established method is based on knowledge of microdosimetric quantities of monoenergetic electrons. In this paper these quantities are determined for the single-cell model for a range of electron energies up to [Formula: see text], using the Monte Carlo transport code PENELOPE. The results show that using monoenergetic specific energies, reconstruction of the specific energy of beta-emitting radionuclides can be successfully done with very high accuracy. Microdosimetric quantities share information about the physical processes involved and give insight about energy depositions, which is of use in the procedure of radionuclide selection for a given type of therapy.

Identification of mutations in the PARK2 gene in Serbian patients with Parkinson's disease.

Mutations in the PARK2 (PRKN) gene are the most common cause of autosomal-recessive (AR) juvenile parkinsonism and young-onset Parkinson's disease (YOPD). >100 different variants have been reported, including point mutations, small indels and single or multiple exon copy number variations. Mutation screening of PARK2 was performed in 225 Serbian PD patients (143 males and 82 females) with disease onset before 50 years and/or positive family history with apparent AR inheritance. All coding regions and their flanking intronic sequences were amplified and directly sequenced. Whole exon multiplications or deletions were detected using Multiple Ligation Probe Amplification (MLPA) method. We identified 12 PD patients with PARK2 mutations (5.3%). Five patients (2.2%) had biallelic mutations and seven (3.1%) were single mutation carriers. Patients with compound heterozygous mutations had earlier onset of the disease compared to non-carriers (p = 0.005) or heterozygotes (p = 0.001). Other clinical features in mutation carriers were not different compared to non-carriers. In our cohort, sequence and dosage variants were equally represented in patients, inducing their first symptoms mainly before the age of 30. For efficient genetic testing strategy, patients with early, especially juvenile onset of PD were strong candidates for both dosage and sequence variants screening of PARK2 gene.

Brain structural and functional signatures of impulsive-compulsive behaviours in Parkinson's disease.

This study assessed brain structural and functional alterations in patients with Parkinson's disease and impulsive-compulsive behaviours (PD-ICB) compared with controls and PD no-ICB cases. Eighty-five PD patients (35 PD-ICB) and 50 controls were recruited. All subjects underwent three-dimensional T1-weighted, diffusion tensor (DT), and resting state functional magnetic resonance imaging (RS fMRI). We assessed cortical thickness with surface-based morphometry, subcortical volumes using FIRST, DT MRI metrics using region of interest and tractography approaches, and RS fMRI using a model free approach. Compared with controls, both PD groups showed a pattern of brain structural alterations in the basal ganglia (more evident in PD no-ICB patients), sensorimotor and associative systems. Compared with PD no-ICB, PD-ICB cases showed left precentral and superior frontal cortical thinning, and motor and extramotor white matter tract damage. Compared with controls, all patients had an increased functional connectivity within the visual network. Additionally, PD no-ICB showed increased functional connectivity of bilateral precentral and postcentral gyri within the sensorimotor network compared with controls and PD-ICB. Severity and duration of PD-ICB modulated the functional connectivity between sensorimotor, visual and cognitive networks. Relative to PD no-ICB, PD-ICB patients were characterised by a more severe involvement of frontal, meso-limbic and motor circuits. These data suggest ICB in PD as the result of a disconnection between sensorimotor, associative and cognitive networks with increasing motor impairment, psychiatric symptoms, and ICB duration. These findings may have important implications in understanding the neural substrates underlying ICB in PD.

Is it possible to determine the origin of cyst in empty thyroid bed in patient with lingual thyroid?

Some patients with ectopic thyroid gland or athyreotic patients have one or more cysts in empty thyroid bed. The origin of these cysts is uncertain. We present the patient with lingual thyroid gland and small cyst in empty thyroid bed featuring the diagnostic algorithm used and discussing the possible etiologic scenarios.

10 GHz pulse repetition rate Er:Yb:glass laser modelocked with quantum dot semiconductor saturable absorber mirror.

Semiconductor saturable absorber mirror (SESAM) modelocked high pulse repetition rate (≥10 GHz) diode-pumped solid-state lasers are proven as an enabling technology for high data rate coherent communication systems owing to their low noise and high pulse-to-pulse optical phase-coherence. Compared to quantum well, quantum dot (QD)-based SESAMs offer potential advantages to such laser systems in terms of reduced saturation fluence, broader bandwidth, and wavelength flexibility. Here, we describe the first 10 GHz pulse repetition rate QD-SESAM modelocked laser at 1.55 µm, exhibiting 2 ps pulse width from an Er-doped glass oscillator (ERGO). The 10 GHz ERGO laser is modelocked with InAs/GaAs QD-SESAM with saturation fluence as low as 9 µJ/cm2.

Possible implications of TGF-alpha in oesophageal dysmotility in systemic sclerosis.

OBJECTIVES: Hypoxia is a characteristic feature of systemic sclerosis (SSc).Transforming growth factor alpha (TGF-α) has an important role in excessive inflammation under hypoxic conditions. Since oesophageal dysmotility is one of the most common signs of SSc, the aim of this study was to explore the relation between TGF-α and oesophageal dysmotility in SSc. METHODS: The study included 35 patients with SSc and 32 healthy controls matched for sex and age. Serum concentrations of TGF-α were measured using ELISA. Oesophageal motility was assessed by oesophageal scintigraphy. A multiple-swallow test was performed in the study population with 99mTc-DTPA. A region of interest over the entire oesophagus was defined and the retention index (RI) was calculated. RESULTS: Statistically significant differences in serum concentration of TGF-α as well as of RI of 99mTc-DTPA were found between patients with SSc and healthy controls. A statistically significant correlation was found between serum concentrations of TGF-α and RIs of 99mTc-DTPA. This correlation was inverse, i.e. when serum concentrations of TGF-α increased, the RI of 99mTc-DTPA decreased (Spearman rho =-0361, p=0.033). CONCLUSIONS: These results point to a possible relation between TGF-α and oesophageal dysmotility in SSc. Although the results do not explain the exact role of this cytokine in the pathogenesis of esophageal changes, the finding of inverse correlation between TGF-α and oesophageal dysmotility is intriguing and requires further investigation.

Monte Carlo calculations of lung dose in ORNL phantom for boron neutron capture therapy.

Monte Carlo simulations were performed to evaluate dose for possible treatment of cancers by boron neutron capture therapy (BNCT). The computational model of male Oak Ridge National Laboratory (ORNL) phantom was used to simulate tumours in the lung. Calculations have been performed by means of the MCNP5/X code. In this simulation, two opposite neutron beams were considered, in order to obtain uniform neutron flux distribution inside the lung. The obtained results indicate that the lung cancer could be treated by BNCT under the assumptions of calculations.

Doppler parameters of maternal renal blood flow in normal pregnancy.

UNLABELLED: The purpose of this investigation was to evaluate changes in maternal renal arterial blood flow during pregnancy. MATERIALS AND METHODS: The study included 40 non-pregnant, 200 pregnant, and 30 women after delivery. The authors measured pulsatility index (Pi) and resistance index (Ri) in the right and left renal arteries in the hilus. The authors compared the values between non-pregnant and women during first, second, and third trimester and post-partum period and tested correlation with gestational age. RESULTS: The authors did not find a statistical difference in Pi and Ri between the right and left kidneys. There was no difference in Pi and Ri in pregnancy trimester compared to the non-pregnant state. There was no correlation between the values of Pi and Ri and gestational weeks. CONCLUSION: During pregnancy there are no changes in the values of maternal renal Pi and renal Ri. Unchanged total vascular resistance may result from physiological changes of the glomerular filtration rate.

Doses from radon progeny as a source of external beta and gamma radiation.

Great deal of work has been devoted to determine doses from alpha particles emitted by (222)Rn and its progeny. In contrast, contribution of beta particles and following gamma radiation to total dose has mostly been neglected so far. The present work describes a study of the detriment of (222)Rn progeny for humans due to external exposure. Doses and dose conversion factors (DCFs) were determined for beta and gamma radiation in main organs and remainder tissue of the Oak Ridge National Laboratory phantom, taking into account (222)Rn progeny (214)Pb and (214)Bi distributed in the middle of a standard or typical room with dimensions 4 m × 5 m × 2.8 m. The DCF was found to be 7.37 µSv/WLM. Skin and muscle tissue from remainder tissue receives largest dose. Beta and gamma radiation doses from external exposure were compared with alpha, beta, and gamma doses from internal exposure where the source of radioactivity was the lungs. Total doses received in all main organs and remainder tissues were obtained by summing up the doses from external and internal exposure and the corresponding DCF was found to be 20.67 µSv/WLM.

Structures of chaos in open reaction systems.

By numerically simulating the Bray-Liebhafsky (BL) reaction (the hydrogen peroxide decomposition in the presence of hydrogen and iodate ions) in a continuously fed well stirred tank reactor (CSTR), we find "structured" types of chaos emerging in regular order with respect to flow rate as the control parameter. These chaotic "structures" appear between each two successive periodic states, and have forms and evolution resembling to the neighboring periodic dynamics. More precisely, in the transition from period-doubling route to chaos to the arising periodic mixture of different mixed-mode oscillations, we are able to recognize and qualitatively and quantitatively distinguish the sequence of "period-doubling" chaos and chaos consisted of mixed-mode oscillations (the "mixed-mode structured" chaos), both appearing in regular order between succeeding periodic states. Additionally, between these types of chaos, the chaos without such recognizable "structures" ("unstructured" chaos) is also distinguished. Furthermore, all transitions between two successive periodic states are realized through bifurcation of chaotic states. This scenario is a universal feature throughout the whole mixed-mode region, as well as throughout other mixed-mode regions obtained under different initial conditions.

Systolic right ventricular adaptive changes in athletes as predictors of the maximal functional capacity: a pulsed tissue Doppler study.

AIM: The aim of this study was to extend the analysis of the systolic right ventricular (RV) adaptation to combined endurance and strength training, to assess the utility of tissue Doppler imaging in detecting the degree of these changes and to find independent RV predictors of the maximal functional capacity. METHODS: Standard Doppler and TDI were used to assess cardiac parameters at rest in 37 elite male athletes (16 wrestlers, 21 water polo players) and 20 sedentary subjects of similar age. Progressive maximal test on treadmill was used to assess VO2max. The obtained parameters were adjusted for HR, FFM, and BSA. RESULTS: Wrestlers showed higher VO2max than controls, but lesser than water polo players. RV diameter was larger in athletes. Right atrial pressure (RVE/e) was higher in water polo players than in other groups. Systolic function assessed by tricuspid annular plane systolic excursion (TAPSE) and RVs' was the highest in wrestlers. Global RV systolic parameters myocardial performance index (MPI) and preejection time/ejection time index (PET/ET) were similar. On multivariate analysis systolic parameters were independent predictors of VO2max only in wrestlers: RVs' (beta=3.18, P=0.001) and RV ET (beta=2.32, P=0.001). RVE/e` correlated with RVs' (r=-0.57, P=0.000). TAPSE correlated with RV ET (r=0.32, P=0.015) and RVs` (beta=0.28, P=0.033). CONCLUSION: Systolic function assessed by TAPSE and RVs` has more improved in less endurance athletes. RVs`and TDI ejection time predict VO2max in wrestlers, and possibly in other athletes with lesser right atrial pressure. TDI enables quantifying RV adaptation degree in athletes, but complementary to M-mode technique.

Doses from beta radiation in sensitive layers of human lung and dose conversion factors due to 222Rn/220Rn progeny.

Great deal of work has been devoted to determine doses from alpha particles emitted by (222)Rn and (220)Rn progeny. In contrast, contribution of beta particles to total dose has been neglected by most of the authors. The present work describes a study of the detriment of (222)Rn and (220)Rn progeny to the human lung due to beta particles. The dose conversion factor (DCF) was introduced to relate effective dose and exposure to radon progeny; it is defined as effective dose per unit exposure to inhaled radon or thoron progeny. Doses and DCFs were determined for beta radiation in sensitive layers of bronchi (BB) and bronchioles (bb), taking into account inhaled (222)Rn and (220)Rn progeny deposited in mucus and cilia layer. The nuclei columnar secretory and short basal cells were considered to be sensitive target layers. For dose calculation, electron-absorbed fractions (AFs) in the sensitive layers of the BB and bb regions were used. Activities in the fast and slow mucus of the BB and bb regions were obtained using the LUNGDOSE software developed earlier. Calculated DCFs due to beta radiation were 0.21 mSv/WLM for (222)Rn and 0.06 mSv/WLM for (220)Rn progeny. In addition, the influence of Jacobi room parameters on DCFs was investigated, and it was shown that DCFs vary with these parameters by up to 50%.

Function after intersphincteric resection for low rectal cancer and its influence on quality of life.

AIM: The aim of the study was to investigate function and quality of life after different types of intersphincteric resection (ISR). METHOD: Between January 2006 and February 2008, 45 patients (34 men and 11 women) with distal third rectal cancer underwent curative ISR. Function was evaluated using the Memorial Sloan Kettering Cancer Center bowel function questionnaire and Wexner score, anal manometry and measurements of rectal capacity were also performed. Quality of life was assessed using the Serbian version of the European Organisation for Research and Treatment of Cancer, quality of life questionnaire (EORTC QLQ-C30) and the translated version of the fecal incontinence quality of life scale (FIQL). RESULTS: There were no postoperative deaths. Partial ISR was performed in 22 (48.9%) patients, subtotal ISR was performed in 19 (42.2%) patients and total ISR was performed in four (8.9%) patients. Anastomotic leakage occurred in nine (20%) patients. Five (11.1%) of 45 patients had major (complete) incontinence and a further six (13.3%) patients had continuing frequent faecal leakage 12 months after ileostomy reversal. There was no significant difference in quality of life between the groups in the EORTC QLQ-C30 scale, but this was significantly altered by internal anal sphincter resection in two of the FIQL scales (coping/behaviour and depression/self-perception). CONCLUSION: Although ISR does not affect quality of life in general, the extent of internal anal sphincter resection has a negative impact on symptom-specific quality of life owing to faecal incontinence.

Thyroid echogenicity: A clue to precise individual dosimetry in radioiodine therapy of hyperthyroidism.

BACKGROUND: Radioiodine therapy is a frequent option in treatment of patients with hyperthyroidism. Despite efforts to plan the thyroid absorbed dose by accounting for the gland size and radioiodine kinetics, the success of radioiodine therapy remains largely unpredictable. The current methods plan the mean thyroid radiation absorbed dose, assuming that it applies to target tissue - the thyroid follicular cells. However, the unique thyroid follicular structure and iodine kinetics may violate this assumption. Upon oral administration and capture by thyroid, the vast majority of time radioiodine spends in organified form in follicular colloidal lumen: the greater the follicle the more radiation is wasted before reaching the target cells. HYPOTHESIS: The (131)I radiation absorbed dose to thyroid follicular cells is less than the average thyroid dose, the more the greater the follicles. Thyroid echogenicity can be used to assess the amount of colloid in thyroid tissue, which in turn can be used to assess the follicle size and adjust the planned absorbed dose to patient-specific thyroid micro-architecture. EVALUATION: Animal data on intrathyroidal iodine kinetics were considered in conjunction with model predictions that relate the size of thyroid follicles with (131)I irradiation of follicular cells. It turned out that the correction factors in the range 5-40% should be applied to oral activities of radioiodine calculated by the standard method. Next, several histology studies documented that normoechogenic thyroids have relatively large follicles, while hypoechogenic thyroids are mostly cellular, with almost empty, small follicles. All these concur with clinical data that Graves' disease patients with normoechogenic thyroids that received 200Gy in thyroid had comparable outcome to Graves' disease patients with hypoechogenic thyroid that received 100-120Gy in thyroid. CONCLUSION: Thyroid echogenicity is a probable clue to a better patient-specific dosimetry in radioiodine therapy of hyperthyroidism; direct evidences and precise estimates of benefits over current practices would be provided by controlled clinical trials.

The role of pelvic MRI in assesment of combined surgical and infliximab treatment for perianal Crohn's disease.

AIM: To evaluate the role of pelvic MRI in diagnosis and assesment of combined surgical and infliximab treatment of perianal Crohn's disease (PACD). METHOD: 24 patients with signs of PACD were prospectively evaluated. They were previously treated with azathyoprin for a period of 6 months to 7 years and antibiotics and than started on Infliximab 5 mg/kg (IFX) at 0, 2 and 6 weeks induction protocol. Luminal CD activity was assesed by colonoscopy. Perianal Disease Activity Index (PDAI) was calculated to evaluate perianal fistulae activity. Surgical examination under anesthesia (EUA) was performed and non-cutting seton placed where appropriate. Pelvic MRI was performed in each patient before Infliximab treatment, and in half of the patients after IFX. MRI criteria were used to asses activity and remission of PACD. RESULTS: 14/24 (58.5%) patients had ileocolitis, 10/24 (41.5%) colitis, and in 22/24 (91.7%) rectum was affected. Median disease duration was 5.5 +/- 2.5 years. MRI revealed simple fistula in 4/24 (16.7%) and complex fistula in 20/24 (83.3%) patients. Abscess was present in 19/24 (79%) patients. Enterocutaneous and recto-vaginal fistula was found in 2 (8.3%) and 3 (12.5%) patients, respectively. Median PDAI before and 8 weeks after IFX treatment was 8.3 +/- 2.08 and 3.5 +/- 1.03, respectively (p = 0.00064). Incomplete response (reduction fistulae drainage by 50%) was found in 10/24 (42%) patients, complete response (no drainage) in 11/24 (46%) patients, while in 3/24 (12.5%) new fistula opened. Control pelvic MRI was performed in 13/24 (54%) patients. Of those, 9/13 (69%) had complete remission according to MRI criteria. Seton was removed after second IFX dose in 15/24 (62.5%) patients and placed again in 2/24 (8%) patients 4 months after completion of IFX treatment. CONCLUSION: In patients with PACD, pelvic MRI before and after IFX treatment is an important diagnostic tool to asses fistula tract localisation, reveal abscess, planning adequate treatment approach and assess the effect of treatment. Surgical decision to remove seton was in accordance with MRI criteria for remission in PACD.

Doses in human organs due to alpha, beta and gamma radiations emitted by thoron progeny in the lung.

This work consists of two parts. In the first part, the doses in the human lung per unit exposure to thoron progeny, the dose conversion factor (DCF), was calculated. Dependence of the DCF on various environmental and subject-related parameters was investigated. The model used in these calculations was based on ICRP 66 recommendations. In the second part, the human lungs were considered as the source of beta and gamma radiation which target the other organs of the human body. The DCF to other organs was obtained as 20 µSv WLM(-1), which is larger than the DCF for radon progeny, which was 13 µSv WLM(-1). This is a consequence of the longer half-life of the relevant thoron progeny than that of the radon progeny. It is interesting to note that after the lungs, where the radiation source is actually located, muscle tissue receives the largest dose.

Relationship between deposition and attachment rates in Jacobi room model.

It is shown in this work that parameters of the Jacobi model, which describes behavior of short-lived radon progeny, are not independent. The relationship between deposition rate of attached radon progeny and attachment rate of their unattached fraction was determined in this paper. It was found that deposition rate increases when the attachment rate is smaller; this effect is more pronounced for larger friction velocity. The deposition rate of attached radon progeny is presented here as a function of friction velocity, ventilation and attachment rate. Deposition rate of attached fraction was estimated in the range 0.012-0.46 h(-1), when attachment rate varies from 10 h(-1) to 100 h(-1).

Primary extranodal marginal zone lymphoma of the uvea associated with massive diffuse epibulbar extension and focal infiltration of the optic nerve and meninges, clinically presented as uveitis masquerade syndrome: a case report.

To report a clinical, histopathological and immunohistochemical findings in a case of primary extranodal marginal zone lymphoma of the uvea associated with massive diffuse extraocular episcleral extension and focal infiltration of the optic nerve and meninges, clinically presented as longstanding uveitis masquerade syndrome. Interventional case reports with histopathological correlation. We describe a 80-year-old male patient with a 3-year history of chronic recurrent hypertensive (pan) uveitis associated with ocular pain, unresponsive to topical and systemic anti-inflammatory, immunosuppressive, antibiotic/antiviral and antiglaucomatous therapy. Because the eye was not salvageable with conservative treatment, enucleation of blind and painful eye was performed. Findings from histopathological and immunohistochemistry examination of the enucleated eye showed an extranodal marginal zone lymphoma of the uveal tract with massive epibulbar extension and optic nerve and meningeal penetration. During almost 3 years of clinical course and 6 months after the enucleation, there were no systemic manifestations of lymphoma, and patient has not required subsequent treatment. Primary lymphoproliferative lesions of the uvea, comprising the iris, ciliary body and choroid are very rare, associated with epibulbar extension extremely and with optic nerve and menigeal penetration exceptionally. Despite its rarity, primary lymphoma of the uvea should be included in the differential diagnosis particularly in older patients with longstanding recurrent uveitis.

Gamma and beta doses in human organs due to radon progeny in human lung.

A great deal of work has been devoted to determine the effect of tissue damage produced by alpha particles emitted from radon and its progeny. (214)Pb and (214)Bi deposited in the human lungs emit beta particles followed by the gamma quanta, which cause smaller damage of tissue in comparison with alpha particles. Because of that, this type of irradiation has not been studied in detail. In this paper, doses from beta and gamma rays emitted by radon progeny (214)Pb and (214)Bi in the lungs have been calculated in all main organs and the remainder tissues of the human body. Human Oak Ridge National Laboratory phantom of adult male and female was used, where simulation was performed using MCNP-4B simulation code. The sources of beta and gamma radiations, namely, the radon progeny were located in lungs. Furthermore, dose conversion coefficients have been calculated.