Genetic variation of the brca1 and brca2 genes in macedonian patients.

The most significant and well characterized genetic risk factors for breast and/or ovarian cancer are germline mutations in the BRCA1 and BRCA2 genes. The BRCA1 and BRCA2 gene mutations strikingly increase breast cancer risk, suggesting that polymorphisms in these genes are logical candidates in seeking to identify low penetrance susceptibility alleles. The aim of this study was to initiate a screen for BRCA1/2 gene mutations in order to identify the genetic variants in the Republic of Macedonia, and to evaluate the association of several single nucleotide polymorphisms (SNPs) in these genes with breast cancer risk. In this study, we included 100 patients with invasive breast cancer from the Republic of Macedonia, classified according to their family history and 100 controls. The methodology included direct sequencing, single nucleotide primer extension method and multiplex ligation probe amplification (MLPA) analysis, all followed by capillary electrophoresis (CE) on an ABI PRISM™ 3130 Genetic Analyzer. We identified a total of seven carriers of mutations in the BRCA1/2 genes. None of the tested polymorphisms was associated with sporadic breast cancer risk, however, polymorphism rs8176267 in BRCA1 and N372H in BRCA2 showed an association with breast cancer risk in patients with at least one family member with breast cancer.

Role of interleukin-8 in differentiation of uncomplicated from complicated parapneumonic effusion.

The aim of this study was to investigate the value and significance of interleukin-8 in differentiation of uncomplicated parapneumonic effusion (UCPPE) from complicated parapneumonic effusion (CPPE). Using an IMMULITE 1000 Analyzer, with chemiluminescent immunometric assay, levels of interleukin-8 (IL-8) were measured in the pleural fluid of patients with UCPPE (n=30), and CPPE (n=30), and three classical parameters (pH, glucose, and LDH) in these two groups. Receiver-operating curves were to assess the sensitivity and specifity of interleukin-8 for differentiating between the two patient groups. IL-8 levels were statistically higher in the CPPE group. A positive significant correlation, was found between levels of IL-8 and and lactate dehydrogenase (LDH) (r=0.68, p<0.05). There was also a positive significant correlation between IL-8 and protein level in pleural effusion (r=0.306, r<0.01). There was a significant negative correlation between levels of IL-8 and pH (r=-0.83, p<0.05), and of IL-8 and glucose in pleural fluid (r=-0.61, p<0.05). A cut-off value of 1805.81 pg/ml, differentiated CPPE from UPPE with a sensitivity of 100% and a specifity of 98%. IL-8 may be used as an alternative marker for the complication of parapneumonic effusion.

Analysis of lung function test in patients with pleural empyema treated with thoracotomy and decortication.

UNLABELLED: The fibrinopurulent phase of pleural empyema has very often been treated with thoracotomy and decortications. MATERIAL AND METHODS: We analyzed the lung function of 19 surgically treated patients in the last 3 years. The lung function was followed up at least 6 months after surgery. RESULTS: Before surgery the expected mean forced vital capacity (FVC) was 4650 ml, the expected mean forced expiratory volume in the first second (FEV1) was 3450 ml, the realized mean FVC was 2850 ml, and the realized mean FEV1 was 1750 ml. The mean FVC 3 months after surgery was 3430 ml, and the mean FEV1 was 1700 ml. The mean FVC 6 months after surgery was 3850 ml, and the mean FEV1 was 2950 ml. DISCUSSION: Early detection and treatment is essential in the treatment of empyema, where the use of thoracic drainage with or without streptokinase or the use of video-assisted thoracoscopic (VATS) decortication were methods of choice in treatment. Later, thoracotomy with decortication was the only treatment solution of the fibrinopurulent phase of empyema, where a trapped lung was frequently detected. CONCLUSION: Thoracotomy with decortication is a useful method of treatment of the fibrinopurulent phase of empyema, which solved the problem and also significantly improved lung function, especially at the follow-up after 6 months.

The advantages of the application of amnion membrane in the treatment of burns.

A crucial and important factor for successful treatment of burns is the early covering of the burned area with skin substitutes. The covering of the burn requires material that restores the epidermal function and integrates itself into the process of healing. Biological dressings are the golden standard for the temporary covering of burns. All biological skin substitutes are susceptible to early graft reaction and the only exception is the amnion membrane. The importance of the amnion membrane as a biological dressing for burns amounts to: a barrier to bacterial colonization, hastens the epithelisation, and control of water loss. Amnioplasty is a method of application of amnion membrane on the recipient site. In this comparative study, 60 patients with dermal and sub-dermal burns were included. Research was made on an examination group of 30 patients with burns where the method of amnioplasty was applied, and for this amnion membrane conserved in 76% alcohol was used. The control group was made up of 30 patients with burns treated conventionally, and standard methods for the local treatment of burns were applied: exposition, occlusive dressing and initial excision with skin grafting. Pathohistological and microbiological analyses of the bioptical material were made. The degree of the burns was determined through a pathohistological analysis of the bioptical material taken the third day, and in some of the subjects where re-epithelialization was determined on the seventh day, the further re-epithelialization was observed clinically. Pathohistological examination enabled discrimination between bacterial colonization and the invasive bacterial infection. Furthermore, the type of bacterial colonization and infection was determined, which was confirmed with microbiological analysis. The analysis of the results from the microbiological and pathohistological researches of the bioptical material according to the bacterial colonization and infection showed that, although between the examined and the control group there was no statistically important difference, the value of p = 0.067 is close to the statistically important value of p < 0.05. The results of the pathohistological examination of the bioptical material taken the seventh day and analysed according to the re-epithelialization showed that there was a significant difference between the two groups of p < 0.035. It should be mentioned that, although according to the microbiological examinations of the bioptical material a statistically significant difference was not achieved, clinical significance was achieved. The obtained significance of p < 0.035 compared to the re-epithelialization in both groups approved the application of the method of amnioplasty. The histological analysis of the bioptical material not only determines the degree of the burns specifically, but facilitates the choice of method for further treatment, observes the speed of the re-epithelialization and plays an important part in the correct diagnosis and the early start of the specific therapy, important in preventing sepsis. The application of amnion membrane as a biological dressing speeds the re-epithelialization and prevents invasive bacterial infection. Pathohistological examination of the burns is recommended to be established as a standard method in clinical practice.

Right heart haemodynamics after lung resection; the role of the transthoracic echo-doppler cardiography.

We analyzed 80 patients with lung resections due to lung carcinoma operated at the Clinic for Thoracic Surgery. We performed lobectomy or bilobectomy in all cases, the patients were between 50 and 70 years old and the preoperative preparing was the same. The patients were divided in 2 groups; group A -- the patients with anamnesis for myocardial infarction, arrhythmia, pulmonary hypertension or restrictive respiratory disease and group B -- patients without such a history. Echo Doppler cardiography was performed in all cases to measure the main parameters that present the heart-lung hamodynamics. We found some changes even in group B (increased RVEDV, decreased EF, increased pulmonary systolic pressure) which can be a reason for cardiac complications after this type of surgery. The echo-Doppler cardiography is a sensitive and non-invasive method to obtain all valid parameters to present heart-lung haemodynamics.

[Evaluation of our results after emergency thrombectomy in acute iliofemoral venous thrombosis]. / Evaluacija nasih rezultata posle hitne trombektomije kod akutnih iliofemoralnih (I-F) venskih tromboza.

The massive thrombosis of deep venous system of the lower extremities has become object of surgical treatment lately. The authors presented of I-F acute venous thrombosis of the leg upon which was an urgent thrombectomy made. The investigated clinilac material was divided in to 2 groups: I (A) were 78 patients, where as thrombectomy was made in the first 24-48 hours. In group II (B)-18 patients were presedented the control group (C) which were conservatively treated. Results obtained by early thrombectomy justified our active opinion in acute I-F thrombosis. There was no embolisation, no rethrombosis, no postphlebitic syndrome and no mortality.