[Serum angiotensin converting enzyme in patients with primary liver carcinoma]. / Serumska aktivnost angiotenzin konvertirajuceg enzima u pacijenata sa primarnim karcinomom jetre.

Recent studies have shown that serum activity of angiotensin-converting enzyme (ACE; EC 3.4.15.1) significantly decreases in patients with carcinoma of different localizations. There is no information in literature about measuring this enzyme in primary liver carcinoma patients. The serum activity of ACE has been examined on 15 primary liver carcinoma patients, 10 patients with cirrhosis, and 26 healthy subjects. Serum activity has been determined by spectrophotometric method using synthetic substrate Hip-His-Leu. The results were given in units which correspond to one nmol of hippuric acid released by enzymatic hydrolyze of Hip-His-Leu substrate in one minute on serum milliliter. The results have shown that serum activity of ACE increased in patients with cirrhosis (37.06 +/- 2.9; X +/- SEM; p < 0.05), and decreased in primary liver carcinoma patients (23.44 +/- 1.87; p < 0.01), what was statistically significant in comparison with the activity of the same enzyme in healthy subjects (29.90 +/- 2.72). These results point out the possibility of clinical application of measuring serum ACE activity as one of primary liver carcinoma marker in differential diagnosis of the disease.

[Cardiovascular response to the treadmill exercise test in young women in Sarajevo during chronic stress due to the war]. / Kardiovaskularni odgovor pri opterecenju na pokretnom sagu kod mladih zena Sarajeva u uvjetima hronicnog stresa izazvanog ratom.

This study is unique in its approach because it was carried out under extremely hard conditions during intensive war activities. Specific characteristic of this aggressive war was that civilian population was forced to live in war zone for a very long period without enough food, water and energy supplies. It was really stressful to live with cognitiori that anyone at any moment and place could become victim of sudden shelling and shooting of civil targets. The aim of this study was to assess how the war caused stress influenced the function of cardiovascular system and its response on stress exercise in young women. The subjects were selected among the students of Sarajevo University. All of them lived in Sarajevo during whole war period. Nine young women (age 18-21) performed multistage incremental exercise treadmill testing under Bruce protocol. It was planned for each subject to complete two exercise sessions in three months interval, but only five persons completed second session. It was a period of intensive attack on the city so that some of our subjects left Sarajevo and some were wounded. The results of two exercise sessions showed that resting values of cardiovascular variables, were within physiological range but with great individual variations. The mean maximal exercise capacity expressed as metabolic units (METS) was 13.67 +/- 1.00 for the first exercise session and 13.40 +/- 0.89 for the second. Heart rate in response to exercise increased rapidly. It was achieved about 95% of predicted max. There were no significant differences in the results of two exercise sessions. Hyperreactive physiological responses as consequences of war caused stress could not be changed in so short period and under unchanged war conditions.

Serum angiotensin-converting enzyme activity in patients with endemic nephropathy.

Serum angiotensin-converting enzyme was measured in 60 patients with endemic nephropathy and in 30 healthy individuals. According to the arterial blood pressure, the patients with endemic nephropathy were further divided into groups with arterial hypertension (n = 30) and without arterial hypertension (n = 30). The activity of angiotensin-converting enzyme was determined by a spectrophotometric method using hippuryl-l-histidyl-l-leucine as a substrate. The serum activity of angiotensin-converting enzyme was significantly increased in the patients with endemic nephropathy (28.51 +/- 1.64 U/l) as compared with healthy individuals (20.83 +/- 1.33 U/l). The level of the enzyme was further increased if the endemic nephropathy was accompanied by arterial hypertension (37.09 +/- 1.45 U/l). The possible mechanisms of the increase in the angiotensin-converting enzyme activity are discussed.

[Serum angiotensin converting enzyme activity in patients with untreated essential arterial hypertension]. / Serumska aktivnost angiotenzin konvertirajuceg enzima u pacijenata sa netretiranom esencijalnom arterijskom hipertenzijom.

The serum angiotensin converting enzyme (ACE) in 30 patients with untreated essential arterial hypertension, 30 patients with chronic renal failure accompanied with arterial hypertension and 30 healthy individuals was measured. The subjects of both sexes have been old 35-60 years. The serum ACE activity was determined by the spectrophotometric method, using Hip-Gly-Gly as a substrate. The serum ACE activity significantly increased in patients with arterial hypertension (32.48 +/- 2.02; X +/- SEM) and patients with chronical renal failure accompanied with arterial hypertension (37.10 +/- 1.45) when compared to the healthy individuals (20.83 +/- 1.33). Possible mechanisms of increasing ACE activity with the patients suffering of arterial hypertension are discussed.

[50 years' of continuing medical education in Sarajevo]. / Pedeset godina kontinuirane medicinske edukacije u Sarajevu.

This year it has been 50 years since the Medical Faculty in Sarajevo was founded. Half a century in existence of a scientific and educational institution represents a period which is sufficient to make a serious retrospective, but also to make a serious analysis and projections for the future. Medical Faculty in Sarajevo was therefore been opened in 1944. There were students in the first generation, who completed the educational process from the first year program of studies. Due to circumstances of war this process at the Faculty was interrupted. On November 16, 1946. Medical Faculty in Sarajevo was reopened and since then it has been continuously working for 50 years, maintaining its educational, scientific and health activities. Former departments of the General Hospital in Sarajevo have grown into its clinical departments and during the period between 1947 until 1952, the majority of its institutes have been already constructed. The development of some of the clinics was however a little bit slower. Within the educational process we can separate four stages in the development of the Faculty; period from 1954 which has been characterized by a classical middle-european educational plan and program; from 1954-1956, the so-called "block system" of monocourse educational process; in the period 1956-1990, a five years study curriculum has been promoted with attempts to reform the educational process; from 1990 until today, the six-years study curriculum has been introduced, being in accordance with the plans and programs of European educational institutions. There were 14,000 students who have throughout this period been enrolled in Medical Faculty in Sarajevo, and 6575 have successfully completed their academic curriculum and obtained the title doctor of medicine. The Faculty has also preserved the continuity of its work under the circumstances of aggression and blockade of Sarajevo. Educational process was maintained without interruptions applying the methods adapted for the circumstances of war, which nevertheless assume full study plans and programs. The results of this work were 164 graduated doctors of medicine, 21 masters of medical sciences, and 17 successfully defended doctoral theses. The Faculty is presently involved in reralization of 15 scientific-research projects with a dominant war-related issues investigates. The Faculty organized or sponsored 9 scientific meetings. The contribution of its professors and assistants, but also of its students was invaluable in this war, some of whom have sacrificed their lives, and some of whom were seriously wounded and remained disabled in their strive to maintain the principles and ethics of their profession.

[The effect of duration of endemic nephropathy on serum angiotensin converting enzyme activity]. / Uticaj trajanja oboljenja na serumsku aktivnost angiotenzin konvertirajuceg enzima u pacijenata sa endemskom nefropatijom.

The effects of duration of disease on serum angiotensin converting enzyme (ACE) was measured in 60 patients with endemic nephropathy (30 men and 30 women) of age between 30 and 60 years. There were formed three groups: patients with endemic nephropathy and duration of disease less than 5 years (n = 23), patients with endemic nephropathy and duration of disease between 5-10 years (n = 17); and patients with endemic nephropathy and duration of disease 10 years and more (n = 20). The serum ACE activity was determined by the spectrophotometric method using Hip-Gly-Gly as a substrate. The activity of enzyme were expressed in units corresponding to 1 nmol of the hippuric acid that was released by the hydrolysis of Hip-Gly-Gly per minute and ml of serum. The results showed that serum ACE activity decreased in group of patients with endemic nephropathy and duration of disease 10 years and more (29.21 +/- 2.25; X +/- SEM) in comparison with group of patients with endemic nephropathy and the duration of disease less than 5 years (35.57 +/- 1.75), which was statistically significant (p < 0.03).

[The effect of postural changes on functional characteristics of the left ventricle in nonpregnant women]. / Uticaj posturalnih promjena na funkcionalne karakteristike lijeve komore srca kod negravidnih zena.

To evaluate the potential influence of positional changes on left ventricular performance and some hemodynamic parameters the systolic time intervals were measured in 90 healthy women aged 19 to 40 years. It was observed the prolongation of total electromechanical systole and left ventricular ejection time, while the preejection period was shortened in left lateral position. These changes were in accordance with significant decrease in systolic, diastolic and mean arterial blood pressure in the same position. Heart rate, calculated stroke volume, cardiac output and ejection fraction did not alter with positional changes.

[Echinococcal disease of the liver]. / Ehinokokno oboljenje jetre.

Hydatid disease is rare and sporadically seen in our region. With the use of modern diagnostic methods the diagnose of echinococcus cyst in the liver is easily and exactly made; most frequently we performed cystectomy paying attention not to disseminate the parasite fluid, and treating the cavum of the pericyst as described by PAPADIMITROU. Using the drainage of subphrenic space we prevent postoperative complications. When the subphrenic abscess appears the hospitalisation period is prolonged, the patient's life is threatened and the treatment is getting expensive.