Peripheral nerve war injuries.

OBJECTIVE: The purpose of this study is to evaluate peripheral nerve war injuries sustained during the war in southern Croatia and Bosnia and Herzegovina. PATIENTS AND METHODS: During the war in Croatia, 713 patients (99% male and 1% female) with wounds inflicted by firearms were examined at the Laboratory of Neurophysiology, University Hospital, Split. The patients, soldiers and civilians alike, ranged in age from 6 to 73 years (average, 28 years). All patients with firearm nerve war injuries underwent detection by electromyography and plurisegmental examination of the damaged peripheral nerve (neurography). The patients were examined and controlled on three occasions: within 2 months after wounding; up to 6 months after wounding; and more than 6 months after wounding. RESULTS: Single peripheral nerve lesions were present in 80% of the patients, and multiple peripheral nerve or plexus lesions were present in 20% of the patients. Peroneal and ulnar nerves were most often involved (20.9% and 19.8%, respectively). Associated massive injuries to the muscles, large blood vessels, or vital organs were present in 45% of the patients. Wounds were inflicted by shell fragments in 80% of the patients and by projectiles in 20% of the patients. CONCLUSION: According to our results, better recovery was achieved with conservative treatment and when physical therapy was initiated early with maximal patient cooperation. Electromyoneurographic findings were the most valid in the prognostic classification of war-inflicted peripheral nerve injuries.

The phenomenon of envy in theory and therapy.

The authors present a review of theoretical views on envy through the developmental perspective of the personality. The theoretical considerations are substantiated by examples from individual and group psychotherapy which illustrate possible approaches to such sensitive feelings as envy.

Oral lichen planus and HLA B.

Oral lichen planus (OLP) is mucocutaneous autoimmune disease of still unknown etiology. Among all etiological factors, OLP can be associated with carbohydrate disorders. As it is known that some HLA B and DR 3/4 antigens are cross-linked, we have determined the frequencies of HLA B antigens in group of 50 Croatian patients (5 males) with OLP and compared them with the 1089 healthy controls. Alterations in the frequencies of several HLA B antigens were noted, in particular, the frequencies of HLA B 15 were 4 times higher, and HLA B18 were 4 times lower compared with controls. The OLP patients with carbohydrate metabolism disorders had more frequently HLA B16, B2 and B40 and the patients with OLP without disturbed carbohydrate metabolism had more frequently HLA B5, B7 and BX. HLA B15 and B18 are closely connected with DR 3/4 antigens in diabetes mellitus, so these particular antigens may predispose a person to a lichen planus.

Oral lichen planus and HLA DR.

Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease, predominantly seen in middle-aged female patients. Histopathologically, OLP includes parakeratosis with T-lymphocyte subepithelial infiltration. In etiology of OLP, chronically liver and biliary diseases, stress-induced hypertension, inheritance and most commonly carbohydrate metabolism disorders including diabetes mellitus are mentioned. Considering the autoimmune nature of the illness and the role of the HLA DR 3/4 antigens in development of diabetes mellitus we hypothesized that the same antigens could play role in the development of OLP. We examined 50 unrelated Croatian patients (5 males) from Institute of Oral Pathology, Faculty of Dental Medicine, Zagreb, with clinical and histopathological diagnosis of OLP. They were all tested for HLA DR and compared with 1089 Croatian controls that underwent the tissue standardization in fathership cases. OLP patients had blood sugar level controlled, and those with HLA DR 3/4 and those with blood sugar level higher then 5.6 mmol/l additionally underwent standard oral glucose tolerance test. Carbohydrate metabolism disorder was found in 13 OLP patients (26%) while 10 of them (20%) had diabetes mellitus type I. This finding is 400 times more frequent than is appearance of diabetes in healthy controls (0.05%) in Croatia.