Association between FokI, ApaI and TaqI RFLP polymorphisms in VDR gene and Hashimoto's thyroiditis: preliminary data from female patients in Serbia.

Hashimoto's thyroiditis (HT) is the most prevalent autoimmune thyroid disorder caused by an interaction between genes and environmental triggers. Intrathyroid lymphocytic infiltration may lead to progressive destruction of thyroid tissue and consequently to hypothyroidism. Many studies in different populations have shown association between vitamin D receptor (VDR) gene polymorphisms and various autoimmune diseases, including HT. The study included 44 female patients (mean age ± standard deviation 38 ± 5.4) with Hashimoto's thyroiditis and 32 healthy age-matched, sex-matched and geographically matched controls without personal history of autoimmune and endocrine diseases. Genomic DNA was isolated from peripheral blood-EDTA, and the target VDR gene was genotyped by PCR-RFLP technique after VDR-FokI (rs2228570), VDR-ApaI (rs7975232) and VDR-TaqI (rs731236) restriction enzymes digestion. We used spss 20.0 integrated software for data analysis and found a significant difference in the genotype distribution of VDR-FokI polymorphism between patients with HT and controls (P = 0.009). For ApaI and TaqI, we observed a higher frequency of variant allele in patients with HT, which was not significantly different compared to control women (P > 0.05). The current first and preliminary results identified the association between VDR-FokI gene polymorphism and Hashimoto's thyroiditis in Serbian population. Results need to be supported by further investigations that define haplotype patterns for VDR gene polymorphisms in a larger group of HT patients of both sexes.

Anti-atherogenic effects of 17ß-estradiol.

Estrogens are secreted primarily by the ovaries and placenta, by the testes in men and also produced by peripheral steroidogenic conversion. The 3 major naturally occurring estrogens are: 17ß-estradiol (E2), estrone and estriol, of which E2 is the predominant and most active. The actions of E2 are mediated by at least 3 different receptors - the classical ERs (ERα and ERß) and G-protein coupled receptor 30 (GPR30). E2 signaling in cardiomyocytes involves ERα- and ERß-independent pathways, and treatment with the E2 receptor antagonists (Selective Estrogen Receptor Modulators- SERMs), which are agonists of GPR30, inhibits cardiac cell growth. Effects of E2 in preventing endothelial dysfunction, a prerequisite of atherosclerosis, are well recognized. Atherosclerosis involves interaction between the cells of the arterial wall endothelial cells (EC) and vascular smooth muscle cell (VSMC), as well as migration of macrophages into wall tunica media. It is predominantly developed at sites with abnormally high shear stress, such as bifurcations or branching of arteries, initiated by an injury to the endothelium and exposure to atherogenic lipids and toxins, such as those contained in tobacco smoke or infectious agents. Animal studies have shown effects of E2 in preventing atherosclerosis, inflammation and endothelial or vascular dysfunction. Gender differences along this pathogenic pathway have been also described. We review the data from the available animal and human studies, which focus on anti-atherogenic effects of E2. These studies represent evidence, albeit indirect, for an inhibitory effect of E2 on the progression of coronary artery atherosclerosis.

[Meteorotropism in children with cerebral palsy]. / Meteorotropizam u dece s cerebralnom paralizom.

INTRODUCTION: Members of the Rehabilitation team and families of children with cerebral palsy are daily engaged in various activities with these children. Weather changes (the atmospheric pressure especially) on particular days, cause difficult performance of anticipated therapeutic exercises, occupational therapy, speech therapy, education, daily living etc. The aim of this study was to underline the possible connection between performing daily activities of children with cerebral palsy and weather changes. MATERIAL AND METHODS: There were 16 children with cerebral palsy, 2 to 14 years of age, 8 females and 8 males. Parents of these children got a questionnaire where they had to write down, on daily bases, one of the following: A--correct and easy to perform exercises, B--difficult to perform exercises, C--impossible to perform exercises--the child indisposed, for a period of three months. For the same period of time the atmospheric pressure changes and the temperature were recorded by a professional. RESULTS: Our findings are related to the relationship between the efficiency of physical treatment in children with cerebral palsy and meteorological phenomena. The weather changes did not influence about 75% of the patients. In the other group of patients the unsuccessful exercise was associated with periods of extensive cyclonic activity: 15 to 17 of March 1991 (the decrease of atmosperic pressure from 1010 to 999 mbara), 15 to 17 of April 1991 (the decrease of atmospheric pressure from 1000 to 987 mbara), 5 to 7 of May 1991 (the decrease of atmospheric pressure from 1000 to 987 mbara). DISCUSSION: Before and during cyclonic activity increases the concentration of the positive air iones which interferes with neuromuscular excitation and causes serotonin hyperproduction in the central nervous system, thus causing irritation and the lack of motivation for imposed demanods. CONCLUSION: About 23% of children with cerebral palsy show meteorotropism in terms of weather changes influencing the efficiency of exercises. The cyclonic activity has unfavourable influence on exercises, while the stable atmospheric pressure or anticyclonic activity has a favourable one in children with cerebral palsy who show meteorotropism. So, favourable and unfavourable days for therapeutic exercises can be clearly differed.

[Backache in children]. / Bol u ledima kod dece.

Back ache is a rare phenomenon in children and adolescents, but it is always caused by serious pathologic changes. The aim of this study was to point to pediatricians to the importance of anamnesis and clinical examinations in making a diagnosis.

[Human fetal pancreatic islet transplantation in insulin-dependent diabetics: possibilities of early detection of transplant destruction]. / Tranplantacija ostrvaca humanog fetalnog pankreasa u insulin-zavisnih dijabeticara: mogucnost rane detekcije destrukcije transplantata.

The factors determining the outcome of human fetal islet transplantation in patients with insulin-dependent diabetes mellitus (IDDM) remain unclarified. In this study we analysed the ratio between immunoregulatory lymphocyte subpopulations in order to search for a possible marker of the immune destruction of transplanted islets. Human fetal islets were isolated by collagenase digestion, cultured for 14 days at 37 degrees C, 5% CO2, and implanted under fascia of m. rectus abdominis in 7 IDDM patients (5 pancreata per patient). After transplantation we evaluated simultaneously the level of metabolic control through HbA1c values determined by chromatography, the capacity of insulin secretion through the C-peptide levels (determined by radioimmunoassay) before and 6 minutes after 1 mg glucagon i.v. stimulation, and the ratio between CD4+ and CD8+ lymphocytes determined by immunofluorescence using monoclonal antibodies. We found that metabolic control after transplantation was improved together with the decrease of the insulin daily dose, and the improvement was simultaneous to the increase of both basal and glucagon-stimulated C-peptide levels. Four months after transplantation we detected a remarkable decrease in the secretion capacity, accompanied by the necessity for an increase in daily insulin dose to maintain optimal metabolic control. However, the loss of islet function was preceded by the increase in CD4+/CD8+ ratio, thus reflecting the presumable accumulation of CD4+ inducer T-lymphocytes. When the islet secretion capacity was destroyed, we found a decrease in CD4+/CD8+ ratio, reflecting the recruitment of CD8+ effector cells.(ABSTRACT TRUNCATED AT 250 WORDS)

[Use of cyclosporin A for remission induction in newly-detected insulin-dependent diabetes]. / Primena ciklosporina A u indukciji remisije u novootkrivenom insulini-zavisnom dijabetesu.

It has been postulated that some of the recent-onset insulin-dependent diabetics, after the initial use of insulin therapy, might develop the "honey moon period", i.e., a spontaneous remission of the disease, defined as the state of normal metabolic control maintained without insulin therapy. However, it has also been shown that spontaneous remission appears only in 5% of the patients treated with conventional insulin therapy and lasts, most frequently, not more than a few weeks. Different therapeutic regimens of immunosuppression and immunomodulation have been used worldwide in order to induce the remission, based on the findings that an autoimmune process underlies the pathogenesis of this type of diabetes. In this study, we have shown the results of the follow-up analysis of the effects of the treatment with cyclosporin A in 21 recent-onset insulin-dependent diabetics. In 15 of those patients insulin treatment was applied as bi-daily doses of monocomponent insulin preparations, and in 6 of them intensified insulin therapy with human insulin was used. In the first group, the remission was achieved in 46.66% and in the second group in 66.66%, which is a significantly higher incidence than in control groups treated only with insulin, without cyclosporin. Moreover, the duration of remission was longer in the patients treated with cyclosporin. The analysis of the residual beta cell secretory capacity has shown that C-peptide levels (taken as a marker for insulin secretion) were slightly higher in patients with the spontaneous remission than in those with the cyclosporin-induced remission both in basal conditions and after stimulation with 1 mg of glucagon. In the patients with cyclosporin A-induced remission we found an improved basal C-peptide secretion and, even more, we detected a significant improvement in beta cell response to the glucagon stimulation. The analysis of the first-phase insulin secretory response (the insulin response to rapidly injected glucose during the intravenous glucose tolerance test) which has been shown to be impaired very early during the development of diabetes, has demonstrated the lack of its recovery both in the spontaneous and in cyclosporin A-induced remissions. The analysis of the molar insulin/C-peptide ratio has detected the impairments of this ratio which remains decreased both in spontaneous and cyclosporin-induced remissions.

[Treatment of post-traumatic hemarthroses of the knee and ankle in children using transcutaneous electric nerve stimulation]. / Lecenje posttraumatskog hemartrosa kolenog i skocnog zgloba u dece primenon transkutane elektricne nervne stimulacije.

TENS (transcutaneous electric nerve stimulation) was applied in 36 children with knee or ankle hemarthros. Pain was diminished after first or second treatment and completely disappeared at the end of the first or second day. Swelling usually disappeared in the interval between the third and seventh day. At the end of the treatment joint movement was significantly improved. In the control group who received only conventional conservative treatment (puncture, immobilization or inactivity, drugs) swelling and pain were still present after the seventh day and these patients needed additional physiotherapy for next seven days. We consider the TENS a method of choice in the treatment of posttraumatic hemarthros providing that treatment starts immediately after the injury and that it is continually applied during 3-5 days. The patients are advised to use crutches. It is a simple, painless method which is not combined with any additional treatment. Proteolytic ointments can increase and stimulate the therapeutic effects.

[The effect of Hatha yoga on poor posture in children and the psychophysiologic condition in adults]. / Delovanje Hata joge na lose drzanje tela kod dece i psihofizicku kondiciju kod odraslih.

Hatha Yoga's effects on the posture of 15 ten year-old children and also its effects on the psychophysical condition of 15 grown-ups was studied. As symptoms, during the first examination, 12 of the 15 children had head protrusion, 14 had shortened back extensors, all 15 had bent shoulders, relaxation of the frontal abdominal wall and shortened flexors of both the calf and thigh. The condition of all the children was remarkably better after six months of practice, some of the symptoms having completely disappeared (head protrusion, asymmetry of the shoulders, mamillas and hips, shortening of the pectoralis and back extensors), 9 children still had slight to medium relaxation of the frontal abdominal wall, 8 children still had bent shoulders, and 1 child still had shortened calf and thigh extensors. The adults were in a weak or very weak psychophysical condition, they tired easily, they complained of sleep disturbances, fluctuation of emotional state and irritability. After 3 months of practice, the vital capacity of 8 of the adults tested (53.3%) had increased by 435 ml. The time duration of apnoea had lengthened for all of the practicing adults, but with a truly large variation among them (a median of 14%). The deep waist-bend length of all the practicing adults had lengthened by an average of 9.5 cm, and the average length increase for the 3-minute running test was 42 m. All those who practiced, had experienced an alleviation of psychic difficulties.