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AIM To examine coagulation factor VIII activity in plasma, as a risk factor for thrombosis, in the patients with diabetes mellitus (DM). Also, to assess its relationship with fibrinogen and fasting blood glucose concentrations and with body mass index. METHODS The plasma coagulation factor VIII activity, plasma levels of fibrinogen and blood glucose concentrations were measured in 30 patients with DM type 1, 30 patients with DM type 2 and in 30 healthy subjects. Body weight and body height were also measured and BMI was calculated. RESULTS The plasma factor VIII activity in patients with DM type 1 and patients with DM type 2 was significantly higher than the values measured in healthy subjects. There was no significant difference in the factor VIII activity between patients with DM type 1 and type 2. The concentrations of fibrinogen and blood glucose in both groups of patients were significantly higher than in the group of healthy subjects. Patients with DM type 2 had a significantly higher BMI compared to healthy subjects, as well as compared to patients with DM type 1. There was a significant positive correlation between plasma factor VIII activity and plasma level of fibrinogen and a significant negative correlation between factor VIII activity and BMI in patients with DM type 2. CONCLUSION Diabetic patients have the elevated plasma coagulation factor VIII activity and increased fibrinogen concentration thus an increased risk of thrombosis and vascular diseases.

GOAL OF THE STUDY To determine the changes of the electroencephalogram and the changes of the quantity in percentage terms of alpha, beta, theta and delta waves in the electroencephalogram in migraine patients after a carbamazepine treatment. Analyze pain characteristics after the carbamazepine treatment of these patients and the efficiency of the carbamazepine treatment in the prevention of new attacks. PATIENTS, METHODS, RESULTS A retrospective-prospective study has been conducted on 40 persons of approximately 42,9 years of age, with normal cranium CT finding, craniogram and fundus. They were divided in two groups: Group A--21 person who prophylactically took a daily dosage of 400 mg Carbamezepin and during acute pain attacks Naproksen; and group B--19 persons who prophylactically took daily dosage of 400 mg Carbamezepin. EEG test was done twice--before and after the medication, in order to check the concentration of different waves in the EEG in percentages. The T-test doesn't show a statistically significant difference between the alpha (p 0,719), beta 1 (p 0,865), beta 2 (p 0,710), theta (p 0,867) and delta (p 0,272) waves for the group A and for the group B alpha (p 0,996), beta 1 (p 0,920), beta 2 (p 0,826), theta (p 0,324) and delta (p 0,820) waves, on the significance level p 0,05 in the EEG at the beginning and the EEG at the end of the examination. The t-test does show a statistically significant difference between the intensity, frequency, duration and relief of pain at the beginning and at the end of the examination for both test groups. CONCLUSION Carbamazepin and Paracetamol do not cause changes in the EEG nor in the quantity in percentage terms of concentration of different waves in the control EEG in patients with vascular headaches. Statistically Carbamazepin and Paracetamol significantly change characteristics of pain and can be used for migraine treatment and prophylaxis.

N. Babic, J. Huskic, E. Nakas-ićindić

Serum and tissue (kidney's) angiotensin-converting enzyme (ACE) activity has been examined in Wistar rats (10 males and 10 females), seven days after unilateral nephrectomy. Renal hypertrophy was determined by measurement of kidney absolute mass. Serum and tissue ACE activity was determined by spectrophotometric method using hippuryl-l-histidyl-l-leucine (Hip-His-Leu) as a substrate. The ACE serum activity was expressed in units that correspond to 1 nmol of hippuric acid released by enzymatic hydrolysis of Hip-His-Leu substrate per minute/ml serum. The ACE tissue activity was expressed in units that correspond to 1 nmol of hippuric acid released by enzymatic hydrolysis of Hip-His-Leu substrate per minute/mg protein or mg kidney's tissue. The ACE serum activity significantly increased (p<0,05) seven days after unilateral nephrectomy. The ACE tissue activity, expressed in units that corresponds to 1 nmol of hippuric acid released by hydrolysis of Hip-His-Leu substrate per minute/mg protein, was higher seven days after unilateral nephrectomy then in kidney control, but the difference was not significant compared to the values determined in kidney control. The ACE tissue activity, expressed in units that correspond to 1 nmol of hippuric acid released by hydrolysis of Hip-His-Leu substrate per minute/mg tissue, was increased seven days after unilateral nephrectomy, which is statistically significant compared to the activity of the same enzyme in kidney control (p<0,01). The results indicate that ACE, probably has an important role in development of adaptive compensatory mechanisms after unilateral nephrectomy.

Nitric oxide (NO) level in serum and renal tissue has been examined in 15 male Wistar rats, body weight 200-250 g, 7 days after unilateral nephrectomy. All rats were ether-anaesthetized and the kidneys were removed by dorsolateral approach. NO concentration in serum and renal tissue was determined by classic colorimetric Griess reaction. Conversion of NO(3)(2-) into NO(2)(2-) was done with elementary zinc. Results have shown that NO concentration in renal tissue is statistically higher in rats 7 days after unilateral nephrectomy then in control renal tissue before compensatory kidney growth (p<0,02). There is no difference between NO concentration in serum before unilateral nephrectomy and 7 days after nephrectomy. These findings suggest that NO may play an important role in mediating the hemodynamic changes associated with reduced renal mass.

Migraine is periodical disorder which is characterized by recurrent headache seizures different in intensity, frequency and duration. Amylases L-1,4 glycol: gluckanohidrolises, (EC.3.2.1.1) are enzymes from hydrolase's group which dissolve starch meaning glycogen. Activity of amylases in serum grows: at acute pancreatitis, at carcinoma of pancreas, heavy necroses of pancreas. Total number of examinees was 92 out of which 45 were male (48.9 %) and 47 female or 51.1 %. Average age of the examines was 42.9. Neuroticism scale which was tested by Cornell scale was 55,03. Out of the total number of examinees 30 or 32,6 were non-smokers while 62 or 67,4 % smoked regularly. The aim of this work is to perform hematological-biochemical test of blood in patients with migraine. In the beginning of this research it was planned for all the patients to have hematological blood test done (sedimentation of erythrocytes, trombocytes, complete blood test and differential blood test) and biochemical blood test (hepatogram, transamynase, amylase, Lactal dehydrogenase, Alkalic phosphatase, ferrum in serum, Glucose, Cholesterol, Calcium and Phosphorus in serum. After reviewing the received values of hematological and biochemical tests, all values were within the borders of normal values. Amylases had higher values at 49 or 53,3 % of patients, and 43 or 46,7 % of patients had normal values of amylases. Normal values of amylases are to 220 U/l measured by I.F.C. at 37 degrees C. Medium value in tested group is 219.09. It means that every second examinee had increased values of amylase in blood; there is no statistics difference of amylase value between sexes.

: Migraine is periodical disorder which is characterized by recurrent headache seizures different in intensity, frequency and duration. Amylases L-1,4 glycol: gluckanohidrolises, (EC.3.2.1.1) are enzymes from hydrolase's group which dissolve starch meaning glycogen. Activity of amylases in serum grows: at acute pancreatitis, at carcinoma of pancreas, heavy necroses of pancreas. Total number of examinees was 92 out of which 45 were male (48.9 %) and 47 female or 51.1 %. Average age of the examines was 42.9. Neuroticism scale which was tested by Cornell scale was 55,03. Out of the total number of examinees 30 or 32,6 were non-smokers while 62 or 67,4 % smoked regularly. The aim of this work is to perform hematological-biochemical test of blood in patients with migraine. In the beginning of this research it was planned for all the patients to have hematological blood test done (sedimentation of erythrocytes, trombocytes, complete blood test and differential blood test) and biochemical blood test (hepatogram, transamynase, amylase, Lactal dehydrogenase, Alkalic phosphatase, ferrum in serum, Glucose, Cholesterol, Calcium and Phosphorus in serum. After reviewing the received values of hematological and biochemical tests, all values were within the borders of normal values. Amylases had higher values at 49 or 53,3 % of patients, and 43 or 46,7 % of patients had normal values of amylases. Normal values of amylases are to 220 U/l measured by I.F.C. at 37 degrees C. Medium value in tested group is 219.09. It means that every second examinee had increased values of amylase in blood; there is no statistics difference of amylase value between sexes.

Serum and tissue angiotensin-converting enzyme (ACE) was measured in 20 patients with lichen planus before and after therapy, and in 20 healthy individuals. Serum and tissue ACE activity was determined by spectrophotometric method using hippuryl-l-histidyl-l-leucine as a substrate. The enzyme activity is expressed in the following units: 1 U corresponds to 1 nmol of hippuric acid released by hydrolysis of hippuryl-l-histidyl-l-leucine per minute and one liter of serum or 50 mg tissue. Before therapy, serum ACE activity was significantly increased in patients with lichen planus (35.9 +/- 2.33 U/L) in comparison to healthy individuals (28.16 +/- 1.7 U/L). Tissue ACE activity was increased in patients with lichen planus (2.24 +/- 0.41 U/50 mg) in comparison to healthy individuals (1.86 +/- 0.16 U/50 mg), but the difference was not significant. After therapy, serum and tissue ACE activity decreased and no significant difference in ACE activity was found. The determination of serum ACE activity may be a good non-specific parameter for the assessment of therapeutic effects.

UNLABELLED Left ventricular hypertrophy (LVH) is commonly present in hemodialysis patients (HD pts) and is considered as an independent risk factor for high mortality. Many studies have confirmed sound connection between anemia and LVH in this patients. OBJECTIVE To analyse dystolic function of LVH in uraemic pts during the 6 months human recombinant erythropoectin (rHu-Epo) treatment of anemia, with emphasis on the role of nitric oxide (NO), whose role in regulation of LV diastolic distensibility has been hinted in some recent studies. PATIENTS AND METHODS The study included 20 HD pts, aged 39.6 +/- 5.3 yrs, with the same condition of HD treatment, signs of anemia and echocardiographically verified LVH. Pulse Doppler echocardiography confirmed LV diastolic function as a ratio of early to late diastolic mitral flow velocity (E/A). Nitrate concentration was determined by colorimetric method using Greiss reagent. Renal anemia was treated with rHuEpo. RESULTS Six months rHuEpo treatment of anemia in HD pts with LVH caused significant reduction of LV mass index (p = 0.008). However, we observed unfavourable fall in LV diastolic function (E/A = 0.83, p = 0.007). In the same time, it was found that the serum NO level was higher for 11.8% in HD pts with LVH as compared with the pts with normal LV mass. Also, the significant positive correlation was found between the level of NO and LV mass index before (p = 0.004) and after rHuEpo therapy (p = 0.03), as well as a significant positive correlation between NO and E/A in the same conditions (p = 0.002) and p = 0.049). Level of NO negatively correlates with blood hemoglobin level, but without statistical significance. CONCLUSIONS Correction of anemia with rHuEpo leads to the significant partial regression of LVH. Reduction of diastolic function of LV, observed after diminished LV mass index, could be related to the significant fall of NO level and damaged response of LV to NO. The results of the study strongy suggest that NO can present an important determinant of LV diastolic function in uraemic pts.

INTRODUCTION Anemia has been shown to be a key component of renal failure, as well as of the occurrence of left ventricular hypertrophy (LVH), with special attention paid to the paracrine mechanism of left ventricular remodelling. AIM The aim of the study was to analyze possible association of serum angiotensin-converting enzyme (ACE) activity and LVH in hemodialysis patients with anemia treated with human recombinant erythropoietin (rHuEpo) during six months. METHOD LV geometry was determined by echocardiographic analysis in 20 hemodialysis patients before and after erythropoietin treatment. Serum ACE activity was measured by spectrophotometric method using hippyril-l-histidyl-l-leucin as a substrate. RESULTS Serum ACE activity increased to 47.3% in hemodialysis patients with LVH as compared to patients with normal LV mass. A significant positive correlation was found between the level of ACE activity and LV mass index (p=0.004). Six-month erythropoietin treatment of anemia led to a significant reduction of LV mass index (p<0.008) and serum ACE activity (p=0.003) from the initial values. CONCLUSION The levels of serum ACE activity are associated with LV geometry. Our findings suggested the possibility of simultaneous and modest modulation of LV mass and serum ACE activity with rHuEpo correction of renal anemia.

The qualitative and quantitative study of renal cortical structures was performed seven days after unilateral nephrectomy. Adult Wistar rats (10 male and 10 female) were ether-anaesthetized and the kidneys were removed by dorsolateral approach. Renal hypertrophy was determined by measurement of kidney dry mass. The samples of renal tissue were embedded in paraffin, sectioned at 6 microns and stained by azan and haematoxylineosin methods. The volume densities of renal corpuscles, the epithelium of tubules, luminal space of tubules and cortical interstitial structures were calculated using Weibel's multipurpose test system M 42. The qualitative analysis was performed to determine possible structural sex differences of cortical parenchyma during compensatory hypertrophy. There was no significant difference in volume densities of renal corpuscles and distal tubules between control and hypertrophic kidney. The volume density of the epithelium of proximal tubules and interstitial blood vessels were statistically significant increased in hypertrophic kidney compared to the values determined in control kidney. The volume density of luminal space of proximal tubules and interstitial tissues were statistically significant decreased in hypertrophy compared to control kidney. The data from present studies shows that the increase in epithelial volume of proximal tubules and interstitial blood vessels volume have the primary role in compensatory kidney enlargement after unilateral nephrectomy, while renal corpuscles do not participate significantly.

J. Huskic, H. Kulenović, D. Kardum, N. Babic, Z. Knezević

Recent studies have shown that serum activity of angiotensin-converting enzyme (ACE; EC 3.4.15.1) significantly decreases in patients with carcinoma of different localizations. There is no information in literature about measuring this enzyme in primary liver carcinoma patients. The serum activity of ACE has been examined on 15 primary liver carcinoma patients, 10 patients with cirrhosis, and 26 healthy subjects. Serum activity has been determined by spectrophotometric method using synthetic substrate Hip-His-Leu. The results were given in units which correspond to one nmol of hippuric acid released by enzymatic hydrolyze of Hip-His-Leu substrate in one minute on serum milliliter. The results have shown that serum activity of ACE increased in patients with cirrhosis (37.06 +/- 2.9; X +/- SEM; p < 0.05), and decreased in primary liver carcinoma patients (23.44 +/- 1.87; p < 0.01), what was statistically significant in comparison with the activity of the same enzyme in healthy subjects (29.90 +/- 2.72). These results point out the possibility of clinical application of measuring serum ACE activity as one of primary liver carcinoma marker in differential diagnosis of the disease.

J. Huskic, H. Kulenović, D. Kardum, N. Babic, Z. Knezević

: Medical Record contains data about use of health care services of every member of certain population, no matter if they come from preventive or curative health care. Quality of Medical Records is very often in direct as well as indirect connection with health care quality. Better health care systems usually have better Medical Records. These are computer processed and stored on some of contemporary computer media, like: disks, microfilms, magnetic tapes and so-called "smart cards". Good Medical Record should have at least next characteristics: 1. Time dimension, which should contain chronological: past, present and future data, relevant to health care consumers. 2. It should be complete in a sense that every Medical Record must contain adequate medical and other relevant data for health care planning, organization and control. From the aspects of our research described here, it is very important that Medical Records contain all financial data. These usually are consequences of consumption of health care services from various resources of different levels. The results of our research about the application of DRG classification in B&H health system, that have been done in Tuzla University-Clinical Center, show that hospital Medical Records have many inadequacies, both in respect of medical as well as non-medical part. Physicians use very little ICD coding system. There is no uniform anamnesis, no detailed evidences about all hospital services, no adequately defined severity of disease and patient status at discharge. Due to manual based information system, there is no evidence about spending of resources per patient with financial data. The development and application of computer based health information system must go towards direction of solving these problems.

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