Introduction: Burns, depending on the degree of severity, induce a significant pathophysiological response in the body. The complement system participates in the body's defenses as well as in immune responses after burn-induced trauma. Objectives: The main objective of the study was to examine how burn severity affects serum C3 and serum C4 complement values; whether burn severity correlates with serum C3 and C4 complement, and establish the predictive value of the serum C3 complement and serum C4 complement for assessing the severity of the burn.  Patients and methods: According to the degree of TBSA, patients were classified into three groups: group with %TBSA<15% (30 patients), group with %TBSA >15% -25% (30 patients), and group with %TBSA > 25% to 40% (30 patients). According to the depth of burns, patients were classified into two groups partial-thickness burns (39 patients) and full-thickness burns (51 patients). We followed laboratory parameters: value serum C3 complement and serum C4 complement on the first and seventh day after burn trauma. Results: Serum C3 complement was significantly lower in patients with %TBSA>25%-40% and in the group with %TBSA>15%-25% compared to patients with %TBSA<15% on the first and seventh day after burn trauma. Serum C3 complement was significantly lower in patients with %TBSA >15%-25% compared to patients with %TBSA<15% on day one and day seven after burn trauma. Serum complement C4 was not significantly different between burn groups on the first and seventh day. Full-thickness burns have significantly lower levels of serum complement C3, compared to partial-thickness burns, on the 1st and 7th day. Full-thickness burns result in a decrease in serum C4 complement compared to partial-thickness burns on the 7th day after burn trauma, but this decrease is not significant. On the 1st day after burn trauma, we found a negative correlation between %TBSA with serum C3 complement. Serum C4 complement was not correlated with %TBSA on the day 1st. Conclusions: %TBSA and depth of burn result in a significant decrease in serum C3 complement but not serum C4 complement. There is a negative correlation of %TBSA and C3 complement but not serum C4 complement on the 1st day after burn trauma. Serum C3 complement is a significant predictor of burn severity. The predictory significance of the C4 complement is not statistically significant.

Introduction: Burn, depending on the degree of severity and depth, induces significant pathophysiological  response of the body. Our study is the  prospective study  for  assessment of  T lymphocyte  immunological changes in patients with burns, with different degrees of  %TBSA  and depth of burns. Research objectives : Objectives of this study were to assess %CD3+Ly, % CD4+Ly,  %CD8+Ly, %CD3+HLA-DR+Ly, %CD4+Ly /CD8+Ly), of burned body with different   %TBSA degrees, different depth burns and to establish predictive value of of immune suppression  these  parameters. Patients and methods: According  to %TBSA, patients were classified into three groups:  mild  burns with TBSA% 25% to 40%  (30 patients).  According to the depth of burns, patients were classified into two groups, partial-thickness burns, (39 patients), and full-thickness burns (51 patients). We followed laboratory  parameters :  % CD3+Ly , % CD3+ CD4+Ly,  % CD3+CD8+Ly,  % CD3+HLA-DR+Ly, CD4 / CD8 (%) lymphocytes (on    day 7th and on   day 14th). Results: Percentage of CD3+ lymphocytes was significantly lower in severe  burns compared to the moderate  heavy  burns  andsignificantly lower compared to the mild  burns . Percentage of CD3+CD4+ lymphocytes was significantly lower in severe burns   compared to moderate  heavy burns   and  in relation to  mild burns  (results on day 14th );  also  are lower in moderate severe burn compared  to  mild burns. On day 14th, the% CD4 / CD8 ratio was not significantly lower in the severe burns versus the moderate  burns. On day 14th, the  % CD4 / CD8 ratio wassignificantly lower in severe burns compared to mild burns; significantly lower in moderateburns  compared  to  mild  burns. % CD3+HLA-DR + cells was significantly lower   in severe   burn and moderately  severe  burns  compared to the mild burns  on day 7th, and also on day 14th .  Full- thickness burns have significantly lower  %CD3+lymphocytes, %CD3+CD4+ lymphocytes,  %CD3+HLA-DR+ lymphocytes, ratio of % CD4/CD8 lymphocytes compared to partial-thickness burns  . Conclusions : Peripheral blood T lymphocytes are one of the key indicators of immunosuppression of patients with burns of different % TBSA and different degrees of burn depth.   Larger %TBSA and full- thickness burns injected stronger systemic immunosuppresion,   compared to smaller %TBSA and partial-thickness burns.

INTRODUCTION The ulnar nerve is a mixed motor and sensory nerve, which making nerve repair more difficult and functional recovery less predictable than pure sensory nerves. Recovery of muscle activity and restoration of sensibility are essential for a functional extremity. A nerve graft, if performed in a tensionless manner, has been shown to generally have better results than an end-to-end approximation performed under tension. PATIENTS AND METHODS In study period from 1993 through 2008, evaluation was performed in 48 patients with adequate follow-up. The mean follow-up period was 3.4 years (range, 24 months to 8.3 years). The average patient age was 32.4 years (range, from 6 to 71 years). There were 37 male patients and 11 female patients. RESULTS We analyzed the effect of the age of the patient, level of injury, graft lenght and denervation time on motor and sensory recovery. Values of p < 0.05 were considered significant. Results of motor (chi-square = 8.04, p = 0.154) and sensory recovery (chi-square = 7.53, p = 0.184) were not significantly better in patients younger than 25 years compared to the group of patients older than 25 years. The level of the ulnar nerve injury had an impact on the outcome, with better results both sensory (chi-square = 161., p = 0.000) and motor recovery (chi-square = 238., p = 0.000) in patients with distal lesions. The results were significantly better in the group with graft lenght less than 5 cm compared to those longer than 5 cm for both sensory (chi-square = 72.6, p = 0.000) and motor recovery (chi-square = 196., p = 0.000). The functional results were significantly better for both sensory (chi-square 13.4, p = 0.020) and motor recovery (chi-square = 133., p = 0.000) in the group of patients with denervation time shorther than 6 months. CONCLUSION The graft length, level of injury and denervation time significantly influenced the functional outcome in both motor and sensory recovery. Better results were in the patients in which the autograft length was up to 5 cm, in patients who were operated within six months from the injury and in patients with distal lesions.

UNLABELLED Injuries of hand extensor tendons occur as isolated or combined injury or multiple tendons injuries associated with injuries of other hand structures. Clinical pictures of these injuries depends on the level of occurred injury, and can be expressed in loss of function extension of one or more fingers, wrist and creating contractures. PATIENTS AND METHODS This is five-year retrospective study of 87 patients operated at Clinic for Plastic and reconstructive surgery, Clinical Centre University of Sarajevo. We studied the efficiency of primary surgical treatment in hand extensor tendons injuries in the prevention of hand dysfunction. RESULTS AND DISCUSSION The best recovery results after surgical treatment of hand extensor tendons injury were in zones I, zone II and zone III. But, in zone VII recovery was difficult, and the outcome unpredictable. The most commonly injured zone was zone VI, and in zones of thumb usually violated zone was zone T-III. According to Miller's assessment criteria and recovery functions, after 6 weeks, with excellent finding was 41 (47,1%) and good results 21 (24,0%) of patients, while after 6 months, the excellent results were in 60 (68,9%) and good results in 28,7% of patients, due to well-conducted physical rehabilitation. Only two patient had complications at 6 months after surgery due to very complicated associated injuries of soft tissues and bone structures of the hand. CONCLUSION Results depends in extensivity of injury, anatomic zone, lack of infection, concomitant injuries, skills and operative methods of surgeon.

INTRODUCTION Dupuytren's disease (DD) is a progressive fibroproliferative disorder of the hand causing digital flexion contracture. Treatment goals include removing or releasing the fibrotic cord to allow extension of the affected finger(s) and restoration of hand function. MATERIAL AND METHODS In study period from 2001 through 2008, evaluation was performed in 115 patients. Limited or extensive fasciectomy was performed in all patients. Tubiana classification sheme to rate severity of DD was used. RESULTS There were 106 male patients ( mean age 62.6 years) and 9 female patients (mean age 66.3 years). Before the operation, 38% of all patients were at Tubiana stage I, 32% were at stage II, 22% were at stage III and 8% were at stage IV. Of all patients, 43% were diagnosed with Dupuytren's in only one finger, 39% in two fingers and 18% in three fingers. In 23% of patients DD were diagnosed on both hands. Limited fasciectomy was peformed in 90.4% of patients and extensive fasciectomy in 9.6% of patients. The Tubiana stage achived after surgery was lower in 98% of patients. As a final result after surgery, 66% of patients didn't have contracture, stage I was reported in 28% and stage II in 3% of patients. There were no patients with Tubiana stage III or more after surgery. Postoperative complications were noted in 18% of patients. Wound healing problems were present 12% of patients. Haematoma was reported 5% of patients. Of all patients 22% had diabetes mellitus. CONCLUSION DD is much more common in male than in female patients. Most of the patients are diagnosed at Tubiana stage I and II. Surgical correction has led to an improvement in most patients. Limited fasciectomy is still the gold-standard in DD treatment. Extensive fasciectomy or dermofasciectomy is preformed only in most severe cases.

Introduction: Thermal injury causes the destruction of dermo-epidermal barrier, a natural isolator, which then speeds up the bacterial contamination of the burn wound. Patients and methods: The study is of a retrospective-descriptive character and covers the period from Jaunary 1st 2004 through December 30th 2006. During the survey we took and analyzed the bacterial swabs of 54 patients with burn injuries. Goal: The goal of our study was to present the frequency rate of the infection with the patients with burn injuries treated at the Plastic and Reconstructive Surgery Clinic in Sarajevo. Survey results: Infection was not found with only 7 patients (14,5%). The most frequent causes of infection in the control group of patients were as follows: S. epidermidis (27,4%), S. aureus (21,6%), P. aeruginosa (19,6%). Conclusion: The presence of infection and antibiotic resistance of the isolated bacteria were the cause of a prolonged hospitalisation as well as increased treatment costs of the patients with burn injuries.

Studies indicate that inflammatory mechanisms may play an important role in the pathogenesis of Alzheimer's disease (AD). C-reactive protein (CRP), marker and mediator of inflammation, has been detected in lesions typical for the affected areas of AD brain. There have been conflicting reports on serum CRP concentration in AD. Scarce data exist on association of CRP and measures of adiposity in AD patients. Thus, we investigated serum CRP concentration in fifteen overweight institutionalized patients with probable AD and fifteen age-matched control subjects. Body mass index (BMI) and waist/hip ratio (WHR) were calculated for each subject included in the study. Age, systolic and diastolic blood pressure, BMI and WHR did not differ significantly between the two groups. Serum CRP concentration was significantly higher in patients with AD compared to controls (p<0.0001). Although not significant, positive correlations between serum levels of CRP and BMI and WHR were found. Obtained results support the notion that low-grade inflammation is present in patients with AD. Absence of significant association between CRP and measures of total and central adiposity in overweight AD patients needs further investigation and explanation.