Skin resident memory CD8+ T cells are phenotypically and functionally distinct from circulating populations and lack immediate cytotoxic function.

The in-depth understanding of skin resident memory CD8+ T lymphocytes (TRM ) may help to uncover strategies for their manipulation during disease. We investigated isolated TRM from healthy human skin, which expressed the residence marker CD69, and compared them to circulating CD8+ T cell populations from the same donors. There were significantly increased proportions of CD8+ CD45RA- CD27- T cells in the skin that expressed low levels of killer cell lectin-like receptor G1 (KLRG1), CD57, perforin and granzyme B. The CD8+ TRM in skin were therefore phenotypically distinct from circulating CD8+ CD45RA- CD27- T cells that expressed high levels of all these molecules. Nevertheless, the activation of CD8+ TRM with T cell receptor (TCR)/CD28 or interleukin (IL)-2 or IL-15 in vitro induced the expression of granzyme B. Blocking signalling through the inhibitory receptor programmed cell death 1 (PD)-1 further boosted granzyme B expression. A unique feature of some CD8+ TRM cells was their ability to secrete high levels of tumour necrosis factor (TNF)-α and IL-2, a cytokine combination that was not seen frequently in circulating CD8+ T cells. The cutaneous CD8+ TRM are therefore diverse, and appear to be phenotypically and functionally distinct from circulating cells. Indeed, the surface receptors used to distinguish differentiation stages of blood T cells cannot be applied to T cells in the skin. Furthermore, the function of cutaneous TRM appears to be stringently controlled by environmental signals in situ.

Regulatory allospecific NK cell function is differentially associated with HLA C allotypes.

Major histocompatibility complex I (MHC I) molecules 'silence' natural killer (NK) cell activity. Conversely, NK cell activity is triggered through cells lacking expression of autologous MHC I. Unexpectedly we found that a subset of NK cells is activated rather than silenced when interacting with cells expressing normal levels of autologous MHC I. Instead of inducing an inflammatory phenotype, however, activation led to the secretion of the regulatory cytokines TGF-beta and IL-10. Importantly, in vitro models of allogeneic interactions showed that targets co-expressing HLA C1 and C2 epitopes best supported, or even enhanced, this cell-contact-mediated regulatory NK cell function. Together, these data ascribe a novel pattern of reactivity to NK cells, with potential implications both in autologous and allogeneic systems.

[Neurosurgical treatment of spontaneous intracerebral haematomas]. / Neurohrursko lecenje spontanih intracerebralnih hematoma.

There have been 34 patients with spontaneous intracerebral haematomas (ICH) operated, from the 1st January 2002. Yr to the 31st December 2002. Yr., at the Neurosurgical Department of Trauma Centre (Clinical Centre of Serbia). They all were with the serious disturbance of consciousness. For all these patients, indication for operation was established according to CT findings, state of consciousness, defined Glasgow Coma Score (GCS) and neurological state. Due to the established incarceration or its risk, none of these patients had angiography, so preoperatively we didn't know the reason of bleeding. From 34 operated patients, 22 or 64.7% died and 12 or 35.3% survived. There were 14 patients in the deepest state of coma, where preoperatively GCS score was 3 to 5. Only one patient age 25 survived postoperatively. Other survivors have less disturbed state of consciousness, CT findings without intraventricular bleeding and were also in younger age group.

[Neurosurgical treatment of traumatic intracerebral hematoma]. / Neurohirursko lecenje traumatskih intracerebralnih hematoma.

From January 1st to August 31st 2002 yr., Neurosurgical department of the Trauma Center, Clinical Center of Serbia, has operated 43 patients with posttraumatic intracerebral haemathoma (PTIH). From that number, 9 patients survived and 34 died. Only 4 patients with acute PTIH were in terminal state of incarceration and in spite they were operated immediately, all died. Other 39 patients have delayed PTIH where secondary CT cerebral scans showed the development of posttraumatic intracerebral haematoma that has not been verified at the incipient scanner. Indication for repeated CT scan was found for 19 patients for their focal or general neurological deterioration. 20 patients had no delayed neurological disturbances. Survivors were younger, in lower grade of coma and were mostly with temporal localisation of haemathoma.

The effects of local application of 1% dopamine on intraocular pressure and pupillary diameter.

This paper deals with the experimental results of the effect of 1% dopamine on intraocular pressure, pupillary diameter and hemodynamic parameters after its local application in the rabbit eye. Our results show that locally applied dopamine caused an initial increase of intraocular pressure (IOP) (1 h), followed by its decrease that was the most pronounced 3 hours later. Mydriasis was an immediate effect of dopamine, which persisted until the end of the second hour. There were no changes in blood pressure and heart rate. Although the exact mechanism of dopamine effect on IOP is not known yet, our results point out that this is mainly due to the decrease fo aqueous humor formation.

[A quiet clinical course in an otogenic brain abscess]. / Tihi klinicki tok otogenog apscesa velikog mozga.

INTRODUCTION: The occurrence of otogenic intracranial complications has been significantly diminished by introduction of antibiotic therapy, improved diagnostic methods and surgical treatment of chronic otitis. Meningitis is still the most frequent otogenic intracranial complication, otogenic brain abscesses are following, while other complications occur rarely (1,2,3). Otogenic meningitis and brain abscesses are often associated, which makes the on time diagnosis of each complication harder. Mortality from otogenic brain abscesses is still relatively high, despite diagnostic and therapeutic achievements (4.5). CASE DESCRIPTION: The aim of this study is to present a patient with brain abscess, which arose quietly, as a consequence of chronic suppurative otitis and to point at possibilities of diagnostics and treatment of this complication. The diagnosis of brain abscess by clinical methods of examination is not always reliable. It is often accompanied by most severe form of meningitis, so that neurological examination, in most cases, reveals only signs of meningitis. In our patient, the abscess has been detected by computerized tomography, in its late stage, when it already had completely formed a capsule and had shown clinically manifesting focal signs. This case is interesting because of quiet and unperceived evolution of brain abscess. In the active phase of chronic suppurative otitis, the patient was receiving antibiotic therapy, which has most likely hidden the early symptoms of evolution of intracranial infections. The appearance of signs of focal intracranial infection (photophobia) required applying computerized tomography revealing brain abscess, which was clearly bounded, with a developed capsule, pointing at its late stage (about two months). These findings lead to a conclusion that an otologist should always keep in mind and check whether there is an intracranial infection in cases of active phase chronic otitis.

[Etiology and incidence of amaurosis in war injuries of the eye]. / Etiologija i ucestalost amauroze kod ratnih povreda oka.

Retrospective analysis of the medical documentation of 506 wounded treated at the Ophtalmological Clinic of the Military Medical Academy, was used to separate the cases where, due to the injury, the eyesight was destroyed or reduced to "the sense and projection of the light". The groups were formed according to the mechanism of injury and etiological factor. In 41.03% of eyes described sight impairment was established on admission, and the perforative injury of the eye was the basic etiological factor in 64.26% of the cases.

[Analysis of treatment of perforating ocular injuries during warfare in Bosnia-Herzegovina]. / Analiza lecenih ratnih perforativnih povreda oka sa bosansko-hercegovackog ratista.

The analysis of 210 patients with penetrating eye injuries was performed. The age of the majority of injured was 20-30 (40%). Most injuries were caused by explosive devices (80%). Entering wounds were found on the cornea in 66.19%, on the sclera in 21.42% and on the limbus in 12.38% of the cases. Traumatic cataract was found in 45.72%, hemophthalmus in 53.33%, detachment of the retina in 40%, intrabulbar foreign body in 51.42%, prolapse of the iris and uvea in 36.19%, and endophthalmitis and hypopyon in 11.42% of the cases. Visual acuity after the operation was more than 0.10 in 37.89% of the cases. The basic principles of the treatment of penetrating eye war injuries were discussed.

[Treatment of severe craniocerebral injuries]. / Lecenje teskih kraniocerebralnih povreda.

During 1992. 19357 patients were examined at the Department for Neurosurgery of the Emergency Centre, Clinical Center of Serbia, out of which 15879 had head injury. In addition to those necessitating hospitalisation, there was also a large number of patients with mild head injury that were not admitted for hospital management and were sent home following initial first aid. The average incidence of these patients was 45 patients per day during 1992. During 1992. a total of 1,978 patients were hospitalised, out of which 1,520 (84%) were injured. A total of 633 patients (25%) were hospitalised due to injuries sustained in traffic accidents. All patients were examined and evaluated according to the standard protocol including GCS as well.