A characteristic feature of many cancer types is their ability to metastasise to the skeleton. Bone is the most common site of metastatic invasion, after hematogenous spreading of breast cancer. Early detection of bone metastases is mandatory in the evaluation and management of these patients. Bone scintigraphy is commonly performed in detection and evaluation bone metastases. Tumor markers are present in healthy individuals as well as in patients with malignant diseases but in different concentration. Aim of study was to correlate serum levels of tumor marker Ca (15-3), CEA and presence of bone metastases detected by bone scintigraphy. Study included 25 patients with breast cancer, previously surgically treated. All patients underwent whole body scintigraphy. Ca (15-3) and CEA was measured by radioimmunoassay. Presence, number of bone metastases were correlated with Ca (15-3) and CEA levels. Median age of patients included in study was 50 varying from 30 to 67. Bone scintigraphy revealed bone metastases in 16 (64%) patients. A weak correlation was found between number of metastases and level of Ca (15-3) (r=0.139, p=0.254). Significant differences in Ca (15-3) level was found in patient with metastases compared to patients without metastases (chi square 0, p=1.0). Good correlation was found between number of metastases and serum level of CEA. Correlation between level of two tumor markers Ca (15-3) and CEA was a weak (r = 0.096 , p=0.323). Bone scintigraphy is a sensitive diagnostic toll for detecting breast cancer metastases to bone. Serum levels of tumor markes in isolation can not give complete accuracy about bone metastases.

BACKGROUND AND AIM Bone metastases are of the most frequent in prostate cancer. Serum prostate specific antigen--PSA has been suggested as an accurate means of monitoring prostate cancer. Whole body scintigraphy are currently the most widely used diagnostic procedures for metastases to the bone, the most common site of distant tumor spread. Aim of the study was to determinate relation between PSA level, number of metastases and 99mTc- MDP (methyl-diphosponate) uptake in patients with previous prostatectomy for prostate cancer. PATIENTS AND METHODS Study enrolled 15 patients after previous prostatectomy for prostate cancer (histologically proven). Standard whole body scintigraphy (WBS) was performed 3 hours after intravenous application of 740 MBq 99mTc-MDP. Total PSA was measured by MEIA-Microparticle Enzyme Immunoassay. RESULTS Group 1: 12/15 (80%) patients were with WBS detected metastases. Correlation of PSA level and number of detected bone metastases was good (r=0.79). Correlation of PSA level and uptake intensity of 99mTc-MDP (score 3) was positive and significant (r=0.706). CONCLUSION PSA values were highly predictive for WBS results. PSA values correlated well with number of metastases. We propose no WBS in patients with normal PSA level. WBS is a sensitive diagnostic tool for detecting prostate cancer metastases to bone. PSA levels is good and simpler marker for disease progression, but that neither technique in isolation gives complete accuracy.

Breast cancer is one of the most frequent types of cancer affecting women. After hematogenous spreading of cancer, axial skeleton is most frequently involved. Bone scintigraphy is commonly performed in detection and evaluation of bone metastases. In breast cancer, marker Ca 15-3 is widely accepted in follow-up and detection of disease recurrence. Aim of the study was to correlate levels of tumor marker Ca 15-3 and presence of bone metastases detected by bone scintigraphy. Study included 25 patients with breast cancer, previously surgically treated. All patients underwent total body scintigraphy. Ca 15-3 was measured by radioimmunoassay. Presence, number and location of bone metastases were correlated with Ca 15-3 levels. Bone scintigraphy revealed bone metastases in 16 (64%) patients. 11 (44%) patients with metastases and 1 patient (4%) without scintigraphically visible metastases had elevated Ca 15-3 levels. Significant difference in distribution of metastases was found for spine (t=3.930, p=0.008). Correlation between intensity of radiopharmaceutical uptake and level of Ca 15-3 in patients was positive (r =0.405). A weak correlation was found between number of metastases and level of Ca 15-3 (r=0.139). Significant differences in Ca 15-3 level was found in patients with metastases compared to patients without metastases (chi square 0, p =1.0). Since no significant correlation was found between level of Ca 15-3 and number of metastases, we consider scintigraphy an appropriate method for assessment of bone metastases in breast cancer.

Recent achievements in fields of physics, microelectronical devices and informatical sciences opened huge possibilities of applications in medical specialities. Spread imaging over routine high-resolution instruments continue to be in focus of scientific researches varying from simple staining techniques to most sophisticated photodynamical techniques. Magnetic resonance imaging and computed tomography are radiological specialties, however; we mentioned them for promising achievements in computed data analysis and further improvements of virtual colonoscopy. During the last few years techniques of magnifying endoscopy have been improved including trials with narrow band endoscopy, autoflourescence endoscopy, elastic scattering spectroscopy and laser confocal microscopy. In many indications capsula endoscopy have been applied successfully.

Liver biopsy by needle through skin is safe, simple and valuable method for diagnostic evaluation of liver disease. Diffuse parenchymal diseases as cirrhosis, hepatitis, reactions in drugs could be diagnosed with significant accuracy. With increased usage of CT and MRI as well as ultrasound, it is possible to perform aspiration biopsy of isolated changes with thin needles. In this review, most frequent indications and contraindications for that procedure were described.

: Goiter frequency and urinary iodine excretion levels were assessed in schoolchildren, aged 7-15 years, living in Tuzla Canton. Goiter frequency was evaluated by clinical examination and ultrasound of the thyroid gland. Goiter by inspection and palpation was found in 19.1% of all subjects, in 19.8% of girls and 18.4% of boys. With regard to updated reference values for thyroid volume reported by WHO and ICCIDD, goiter by ultrasonography was found in 12.9% (n = 62) of all subjects (n = 480). Median urinary iodine was 71.0 micrograms/L. Mild iodine deficiency is observed in Tuzla Canton, based on goiter frequency and urinary iodine excretion. Neonatal TSH results, obtained in the programme of the neonatal thyroid screening, were also analyzed. The frequency of neonatal TSH above 5 mU/L was 12.0% indicating, as two other indicators, mild degree of iodine deficiency in this region. The results underline the inefficacy of iodine prophylaxis with 10 mg K1 per kg of salt in correcting iodine deficiency. On the basis of the study, carried out in the rest of the Federation of Bosnia and Herzegovina, the new regulation was proclaimed in 2001 requiring 20-30 mg of iodine per kg of salt.

In chronic HBV infection, studies of outcome have shown that successful antiviral treatment undertaken early in course of diseases, may improve health and quality of life. Aims of treatment are: decrease of aminotransferase level to normal, histological necroinflammatory reduction, sustain loss of HbeAg and HBV DNA, antibodies on Hbe occurrence and loss of HbsAg with complete eradication of viral infection. Three therapeutical options are available: thymosine, lamivudine and standard interferon alpha. In future options, promising results are expecting from pegylated interferon, adefovire and entecavire.

Advantages in diagnostic and treatment of hepatitis C during the last decade have changed the final outcome of disease. Most important improvements were: development of sensitive, specific and standardized tests for hepatitis C nucleic acid identification, combined treatment with ribavirin and alpha interferon, pegylation of alpha interferon and prove that sustained viral response is optimal surrogate for treatment outcome. Combination of pegyinterferon and ribavirin offered the most efficacious and most suitable treatment with SVR between 54-56%. Results are still dependent of viral genotype and viral load. Due to possible side effects appropriate patient seletion is mandatory.

The important developments have been made in the field of the portal hypertension and the variceal bleeding. Baverno meeting was organized to make consensus in different terminologies about the portal hypertension. Blockers of beta receptors are still mainstay in primary prophilaxis of variceal bleeding and endoscopic variceal ligation is ultimative. Octreotide and terlipressin are as effective as sclerotherapy in initial hemostasis, in addition, octreotid was after and efficacious in prevention of rebleeding. Endoscopic variceal ligation is showed to be superior to endoscopic sclerotherapy for variceal obliteration, especially sequential and simultaneous ligation. First line of treatment for gastric varices is cyanoacrilate glue. In assessment of variceal eradication and prediction of variceal recurrence endosonography plays important role.

BACKGROUND Relationships between Helicobacter pylori infection, inflammatory changes in antral region of gastric mucosa, and duodenal ulcer is well known and documented in a large number of studies. This trial is designed to examine effect of one week regimen of Pantoprazole, Amoxycillinum and Metronidazol to eradication of H. pylori, duodenal ulcer healing and histological changes on gastric mucosa. PATIENTS AND METHODS 30 patients with active duodenal ulcer, H. pylori-positive, 16 male, with average age 47.12 +/- 13.13 yrs (AVG +/- STD) and 14 female patients with average age 44.47 +/- 12.29 yrs were included in trial. Biopsy of gastric antral region were performed in each patient. Patients were given Pantoprazole 40 mg bid, Amoxycillinum 1000 mg bid, Metronidazolum 500 mg bid for 7 days. After 7 days of treatment, control endoscopy was performed with repeated rapid ureasa test for H. pylori and antral biopsy and with verification of duodenal ulcer healing. Patients were followed up for 24.3 +/- 9.7 weeks for occasion of subjective symptoms. RESULTS 96.67% patients were presented with eradicated H. pylori, complete ulcer healing was found in 83.34% patients after one week regimen (13.33% patients with ulcer reduced on one third of previous described), 73.33% of patients were presented with histologically feature of chronic gastritis turned from active to stationary phase. CONCLUSION One week regiment with Pantoprazole, Amoxycilline and Metronidazole is effective, and beside a high rate ulcer healing and eradication of H. pylori it provides an improvement of histological feature of antral gastritis.

BACKGROUND Greater interest for quality of life in chronic diseases has been given recently. Method for examination is application of SF-36 form. In this study we followed changes in quality of life for patients with liver cirrhosis in Bosnia and Herzegovina. PATIENTS AND METHODS 45 patients suffered from liver cirrhosis, 15 in class A, 15 in class B and 15 in class C according to Child, completed answers in form SF-36. 45 healthy control volunteers completed the same form. Results of score were compared to control group and to each other. RESULTS Significantly reduced quality of life in physical functioning and role physical were in class Child A compared to control group. In class Child B significant decrease in score for physical functioning, general health perception and energy and vitality compared to Child A. In Child C 6 of 8 scores were significantly decreased compared to class Child B. Ascites decreased significantly score for quality of life in Class Child B and in class Child C portal encephalopathy decreased quality of life too. CONCLUSION Health related quality of life was reduced in liver cirrhosis. Quality of life was reduced more in disease with more complications.

Liver cirrhosis is characterized with alterations in hepatocytic perfusion, decreasing in number of hepatocytes and with seriously impared synthetic function of liver (hypoalbuminemy, inversion of albumino-globulinic ratio, hypoprothrombinemia). In a group of patients, suffered of liver cirrhosis with complication, we attempted to establish relationships between some of the typical clinical values: body weight in function of ascites evacuation, protein, albumin and value of prothrombin time in function of different groups of activity of aminotransferase in sera (AspAT, AlaAT) of improved and dead patients. We found a positive correlation for different groups of aminotransferase activities and laboratory values typical for liver cirrhosis with complications.