BACKGROUND Kidney size may differ between healthy members of Balkan endemic nephropathy (BEN) and non-BEN families. The present study was designed to elucidate this, in comparison with values for BEN patients. METHODS A total of 71 BEN patients (34 males, 64.4 ± 12.0 years), 74 healthy BEN family members (39 males, 49.1 ± 12.2 years), and 59 non-BEN family members (19 males, 49.2 ± 12.3 years) were involved. We measured the longest craniocaudal length and minimal parenchymal thickness on each kidney of all examined subjects using ultrasound. RESULTS No significant difference was found between the kidney length of healthy subjects from BEN (11.0 ± 0.8 cm) and non-BEN families (10.9 ± 0.8 cm), but kidneys were significantly longer than in BEN patients (9.9 ± 1.3 cm). Minimal parenchymal thickness was similar in all three groups. When subjects from each group were divided according to estimated glomerular filtration rate (eGFR), kidney length of the healthy groups was significantly longer than in BEN patients both in stage 1 (p =0.039) and stage 2 (p =0.044) of chronic kidney disease. The parental history of BEN was not associated with kidney dimensions, eGFR, or urinary excretion of albumin and alpha1-microglobulin. CONCLUSION Kidneys of BEN patients were significantly shorter than in healthy members of both BEN and non-BEN families, but no difference was found in kidney length and parenchymal thickness between healthy members of BEN and non-BEN families. No significant association was found between parental history of BEN and kidney size and function either in BEN patients or in healthy members from BEN families. Hippokratia 2015; 19 (4): 304-308.

INTRODUCTION The aim of study was to analyze the influence of bilateral anterior cruciate ligament reconstructions on life quality of patients and their return to sports activities. MATERIAL AND METHODS Thirty-two operated patients took part in this survey during the period of ten years. There were 5 women and 27 men, their average age being 30.46 years (19-55). The participants answered a modified Knee Injury and Osteoarthritis Outcome Score questionnaire set and gave data about preoperative and postoperative periods. RESULTS The participants' age and parameters of Lysholm scale did not correlate significantly with the subjective level of physical activity after the second knee surgery. After the first anterior cruciate ligament reconstruction, 4 participants (12.5%) did not return to trainings, while 28 did (87.5%); 8 patients (25%) did not return to competitions and 24 of them (75%) achieved the competition level of sports activities. After the anterior cruciate ligament reconstruction of contralatera knee, 6 (18.8%) did not return to trainings, while 26 (81.3%) did; 15 patients (46.9%) did not return to competitions, while 17 (53.1% continued to compete without restrictions. The average values of questionnaire scores were between 95.1-98.2 points. Discussion and CONCLUSION Resuming the same or higher level of sports activitie., after the first reconstruction is one of the preconditions for the same injury of another knee. An athlete looses more than two and a half years of competitions on average. Operations of additional meniscu ruptures do not play a crucial role in restitution of sports activities Although we achieved good operative results, only every seconc athlete with bilateral injury has returned to sports activities withou restrictions after the bilateral anterior cruciate reconstructions.

INTRODUCTION The aim of this study has been to identify which risk factors can influence bilateral anterior cruciate ligament injury. MATERIAL AND METHODS Thirty-two operated patients took part in this survey during the period of ten years. There were 5 women and 27 men, with average age of 30.46 years (19-55). The respondents filled in the questionnaire by answering the questions regarding the time when getting injured and operated, mechanism of injuries, genetic and anthropometric data, characteristics of sports and every day activities. RESULTS The incidence of reconstructed bilateral injuries in relation to unilateral ones was 2.3% (50/2168). The age of respondents and side of the injured knee did not correlate significantly with the achieved subjective physical activity level after the second knee surgery. The average time from the first injury to operation was 10 months and 4.3 years since that moment up to the injury of the other knee. It took more than 9 months on average until the reconstruction of contralateral anterior cruciate ligament. The most of athletes were injured in football matches. Three-quarters of athletes returned to competition activities after the first operation, which caused the same injury of the contralateral knee. DISCUSSION AND CONCLUSION Anterior cruciate ligament rupture of the contralateral knee most often occurs in young active athletes within the first four years after the initial reconstruction. Its frequency is not affected by sex, side of extremity, genetic predisposition, type of sport, concomitant injuries and the choice of graft. Returning to the same or higher level of sports activities after the first reconstruction is one of the preconditions for injuring the other knee in the same way.

BACKGROUND/AIM The cell line C6 is a continuous cell line of rat glioma and, as a transplantable line, is frequently used for induction into in vivo model of primary brain tumor. It is believed that, pursuant to its histological traits and biological behavior, this experimental tumor corresponds to human anaplastic astrocytoma of grade II/III, which is characterized by proliferative and invasive potency, and marked cell differentiation. The aim of this study was to determine macroscopic analysis of rat brain with implanted tumor during tumorigenesis, histological features of tumor cells of induced brain tumor and markers of proliferation (proliferation cell nuclear antigen - PCNA, cytokeratin - CK 19) and differentiation (glial fibrillary acidic protein -GFAP) in rat brain with implanted tumor. METHODS To determine histological structure of the brain with implanted C6 cells, we used brain sections stained for hematoxylin-eosin or kresyl violet, whereas other sections were immunohistochemically stained for GFAP, CK 19 and PCNA. RESULTS A statistically significant difference in weights of the left and right brain hemispheres with implanted tumors during tumorigenesis in as soon as 7 days from the day of inducing tumors was revealed. The tumor was of cellular type, with distinct pleomorphism of cells and frequent hyperchromasia of the nucleus. Immunohistochemical staining for PCNA revealed a significant number of positive cells on the days 7, 14 and 21 day following the implantation of C6 cells. CK 19 positive cells were present in both brain hemispheres, and numerous GFAP positive astrocytes were found around the puncture lesion. CONCLUSIONS Within the experimental conditions of the present research, C6 glioma did not demonstrate any relevant deviations concerning development, clinical symptomatology and macroscopic anatomy relative to those already described in the literature.

The nature of mental disorders, the attitudes and prejudices of the social community towards psychiatric patients, the behavior and treatment of mental patients, all bring about numerous dilemmas and prejudices. When a patient is diagnosed with a mental disorder, he may suffer restrictions in the field of general human rights. However, the biggest problems in clinical practice occur in the treatment of patients who, besides their mental disorder also have a somatic disease. We report a 56-years-old female with a severe renal failure who refused to undergo dialysis. Following the patient's refusal to sign an informed consent, a psychiatrist was called in for consultation and diagnosed an acute psychotic reaction. To manage the delusions and acute psychotic reactions, risperidone in the dose of 2 mg was started. After 22 days, the patient still had marked psychotic symptoms. A psychiatrist, a nephrologist and an anesthesiologist, in the presence of the spouse on the grounds of her life-threatening condition, decided to apply the necessary medical procedures even without the patient's consent. A day after the start of dialysis the patient still had delusional ideas, but without the presence of anxiety, and the patient no longer offered resistance to dialysis. Four days after the first dialysis, the patient was calm, had vague memories about the entire previous period, and signed the informed consent concerning her further treatment.

INTRODUCTION Treatment with recombinant human erythropoietin enabled the correction of anemia in the patients on regular hemodialysis but large individual differences in the dose required to achieve the target hemoglobin level were observed. In this study the erythropoietin resistance index was calculated in patients on hemodialysis in order to examine variations in the response to erythropoietin and factors that influence it. MATERIAL AND METHODS The study included 48 patients (25 males) of mean age 67.5 years, who had been on regular hemodialysis in Samac for 43.9 months on average. All were treated with erythropoietin from the beginning of hemodialysis treatment. Their response to erythropoietin therapy was estimated by the erythropoietin resistance index. RESULTS The use of erythropoietin enabled the correction of anemia but different doses were needed to achieve and maintain the target hemoglobin level. The individual weekly dose of erythropoietin ranged from 15 U/kg/week to 244 U/kg/week and the erythropoietin resistance index ranged from 0.13 U/kg/week/g/l to 2.46 U/kg/week/g/l. A satisfactory erythropoietin response with erythropoietin resistance index below 0.5 U/kg/week/g/l was found in 14 (30%) patients, while 19 (40%) patients had this index above 0.7 U/kg/week/g/l and 10 (21%) above 0.9 U/kg/week/g/l. Multivariate linear regression analysis detected C-reactive protein as a significant predictor of erythropoietin resistance index. CONCLUSION Target hemoglobin levels were achieved and maintained by different doses of erythropoietin in individual patients, which resulted in great individual differences in response as estimated by the erythropoietin resistance index. Multivariate analysis indicated C-reactive protein as a variable significantly associated with this index.

BACKGROUND/AIM The most sensitive indicators for detecting recurrence of well-differentiated thyroid cancer (DTC) are 131I whole body scintigraphy (WBS) and measurement of serum thyroglobulin (Tg). In order to perform it, it is necessary to raise the level of endogenous tiroid-stimulating hormon (TSH), which can be achieved by L-thyroxine withdrawal for 3-5 weeks or administration of recombinant human thyrotropin (rhTSH) without requiring the discontinuation of thyroid hormone therapy. The aim of this study was to assess the effect of rhTSH using in comparison to the traditional thyroid hormone withdrawal in the follow-up of patients with DTC. METHODS This retrospective study included 44 patients, mean age 48.8 years, with DTC divided into 2 groups. The group I consisted of patients (n = 31) in which the analysis in the follow-up (WBS with 131I, TSH, Tg and antiTgAt) made in the hypothyroid state, and group II patients (n = 13) in which they made after the administration of rhTSH. The presence of 13 symptoms and signs of hypothyroidism was investigated on the day of giving 131I. Quality of life was evaluated using a modified form: the quality of life scale (SF-36) completed on the day of giving 131I. RESULTS In both groups, serum TSH reached a very good stimulation level, but significantly higher in the group II (group I 30.3-101.5 microlU/mL, group II 68.6-192.0 microlU/mL, p < 0.05). In both groups, TSH-stimulated Tg was higher (group I 0.1-546.0 ng/mL, group II 0.1-7517 ng/mL) comapred to value during the L-thyroxine therapy (group I 0.1-495.0 ng/mL, group II 0.1-2785 ng/mL). There was no difference in technical quality of WBS obtained from both groups. The patients in the group I had attended 8-13 symptoms of hypothyroidism, while patients in group II did not have symptoms of hypothyroidism. The patients after application of rhTSH, showed statistically significantly better quality of life as compared with those who showed to have L-thyroxine withdrawal, (74-91 points vs 43-62 points; p < 0.05). The rhTSH was well tolerated, with nausea occurring in only one patient. CONCLUSION Administration of rhTSH in the follow-up of patients with DTC prevents the debilitating effects of hypothyroidism contributing to the maintenance of metabolic homeostasis of the organism and preserves the quality of life. RhTSH is safe, effective and easy to use, but is still an expensive product in our country.