Introduction: The human heart is in most cases vascularized by two coronary arteries, the right coronary artery (RCA) and the left coronary artery. The supernumerary coronary artery, which arises independently from the right aortic sinus and passes through sub-epicardial adipose tissue of the pulmonary conus and anterior side of the right ventricle is called the third coronary artery (TCA). Methods: This study consisted of 28 formalin-fixed adult human cadaveric hearts. The presence of the TCA was determined. The position of the orifice of the right and excess arteries in relation to the sinotubular junction was determined, and then also the position of the orifice of the excess arteries “on the o’clock level” in relation to the orifice of the RCA. The radius of these orifices and their distance from the orifice of the RCA were measured. The angle between the aorta and TCA, as well as RCA and conus branch, was measured. Results: A total 11 of specimens had supernumerary arteries. A supernumerary artery was found in two hearts. The angle formed by the aorta with the TCA was 60.09 ± 17.57, while the angle between the aorta and the conus branch had an average value of 89.88 ± 15.92. The orifices of all supernumerary arteries were located below the level of the sinotubular junction. The average diameter of the TCA was 1.49 mm ± 0.41. The average distance between the TCA orifice and the RCA orifice was 2.21 mm ± 1.03. In 45.45% cases, the orifice of TCA was located at the 10 o’clock level. Conclusion: The present study highlights the presence of the TCA. It may constitute a significant collateral circulation contributing to apical and septal perfusion. Interpretation of signs and symptoms of coronary occlusion should therefore include possible contribution of this vascular channel.

OBJECTIVE The hard palate participates in the construction of the oral and nasal cavities and represents the bony barrier between them. Morphological differences of the hard palate are important for forensic medicine, anthropology, anatomy, as well as scientific branches dealing with the study of evolutionary development, populations differences. The aim of this study was to determine sexual dimorphism of hard palate on three-dimensional (3D) models of human skulls using geometric morphometry. MATERIALS AND METHODS The research was conducted on 3D models of 209 human skulls from Bosnian population (139 male, 70 female). On the obtained 3D models, we marked landmarks on the palate using Landmark editor program. Using MorphoJ program we analyzed sex differences of shape and size on hard palate. RESULTS The principal component analysis showed that the first two components (PC1 and PC2) described 55.503% of the total morphological variability of the hard palate. The results of the discriminant analysis showed predictive power for male with 66.91% accuracy and for female with 58.57% accuracy based on the shape and size of the hard palate. The influence of size of the hard palate on its shape was statistically significant (p<0.0001). The results of discriminant analysis based on shape of hard palate showed predictive power for male with 68.34% accuracy and for female with 64.29% accuracy. CONCLUSIONS Sex differences of hard palate are statistically significant and can be used for sex determination in skeletal remains. The percentage of accuracy for determining sex based on the hard palate was higher for men in this study.

Background: The aim of the study was to find out what happens to erythrocytes and their forms during life and after death as a result of high water temperature.Methods: Heat stress was used on a rat model.to investigate the effects of different temperature intensities (37°C and 44°C) and exposure time (20 min and until the time of death) on erythrocyte morphology. Total of 23 Wistar rats were divided into two groups: 37°C as control group and 44°C as trial groups. The trial groups were classified into antemortem the exposure time of 20 min and postmortem groups exposure time until fatal outcome. The anaesthetised rats were exposed to preheated water using the water bath. May-Grünwald-Giemsa colouring technique was applied on blood samples taken from the abdominal aorta. Results: Exposure of Wistar rats to water temperature in groups KG37 and G44 led to a significant changes in core temperature. In the control group, the thermoregulatory mechanism established normothermia, and in G44 hyperthermia was detected during 20 minutes of exposure. The frequency of heat stroke in group G44 was 43.8%. Target cells and anulocytes were predominant in antemortem group at 44°C, while anulocytes and spherocytes in postmortem groups 44°C, respectively. Dacryocytes with spherocytes were significantly higher in postmortem group 44°C than in antemortem group 44°C (p=0.002, p=0.017, respectively).Conclusions: Poikilocytosis is associated with the exposure length and temperature intensity. Following a fatal outcome dacryocytes with spherocytes at 44°C were significantly more than in corresponding antemortem groups.

Aims: Nutrient artery is the principal source of nutrition to the long bones. The topography of nutrient foramina on long bones is well known, but it has not yet been established whether the number of nutritive foramina (NF) is related to total bone length. The objective of the present study was to study the correlation of total number of nutrient foramina and long bone length of upper and lower limb to provide detailed data on such features. Study Design: A cross-sectional, descriptive study Place and Duration of Study: Department of anatomy, Medical Faculty University of Sarajevo. Study duration was 3 months. Methodology: In the present study, 300 adult human long bones of the upper (50 humeri, 50 radii, 50 ulnae) and lower (50 femora, 50 tibiae, 50 fibulae) limbs were investigated to determine the number of their nutrient foramina. The nutrient foramina were identified analysed macroscopically and total number of nutrient foramina for each bone was recorded. Total length of each bone within a group was recorded. Statistical analysis was performed to determine correlation between total bone length and number of nutrient foramina, by using SPSS version 17.0 for Windows. Results: A statistically significant negative correlations between the left humerus length and the number of NF was found. A positive correlations between the length of the right radius and the number of NF, the left ulna length and the number of NF, the right ulna length and the number of NF were found. A negative correlations between the length of the left radius and the number of NF and between right humerus length and number of NF were found. A positive correlation between the length of the right and left femur and the number of NF were found. A negative correlation between the length of left tibia and the number of NF was found, as well as negative correlation between the length of right and left fibula and number of NF. Conclusion: Total bone length is not related to the number of nutrient foramina. The number of nutrient foramina does not depend on the total length of the bone, which is important when assessing the success of grafts for transplantation on long bones in taller people.

Abstract Introduction. Present study was performed to verify red blood cell distribution width-to-platelet ratio (RPR) level in rheumatoid arthritis (RA) patients and to examine its correlation with clinical and biochemical indicators of disease activity status. Methods. In this cross-sectional analytical study, 67 patients with RA and 34 age- and gender-matched healthy control subjects were enrolled. Based on the disease activity score 28-ESR (DAS28-ESR), RA patients were divided into subgroups: low disease activity (n = 20), moderate disease activity (n = 22) and high disease activity (n = 25). Laboratory tests included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) concentration, platelet count (PLT), red blood cells count (RBC), red blood cells distribution width (RDW) and fibrinogen concentration. Statistical analyses were carried out using SPSS 13 software. Statistical significance was set at a p-value less than 0.05. Results. There was statistically significant difference (p = 0.006) between RPR in RA patients with different stages of disease activity, with higher values in patients with low disease activity. The RPR showed statistically significant negative correlations with ESR (rho = –0.309; p = 0.012), CRP (rho = –0.421; p = 0.001), swollen joint count – SJC (rho = –0.368; p = 0.002) and tender joint count – TJC (rho = –0.355; p = 0.003), DAS28-ESR (rho = –0.409; p = 0.001), DAS28-CRP (rho = –0.422; p < 0.0005) and Visual analogue scale – VAS (rho = –0.260; p = 0.033) in RA patients. Conclusion. The present study provided evidence that the lower RPR values in RA patients are significantly associated with the disease activity indicators.

Aim To determine the degree of accuracy in determining the sex of the skull based on classical morphometric analysis of the mastoid process. Morphometric analysis excluded a subjective approach expressed in osteoscopic analysis. Methods The study was conducted on a sample of 100 macerated skulls of known gender and age from the second half of the 20th century, including the Bosnian population. Of the 100 skulls, 50 (50%) were male and 50 (50%) were female. Male skulls were on average 60 (47-71) years old and female 57 (43-76) years old. At each mastoid process, 3 measurements were made: mastoid length, mastoid width (medio-lateral diameter) ML) and anteroposterior diameter (AP) of the mastoid process. Results Using the univariate method, we found a significant difference between length, width, AP diameter and size of mastoid processes as well as between gender (p <0.05). Multivariate binary logistic regression showed statistically significant differences in AP diameter of the mastoid process (p<0.05). Conclusion The created model "P" ("P"=exp [X]/1+exp [X]) for sex determination based on mastoid process showed sensitivity of 82% correct prediction for female skulls and 65% accurate prediction for male skulls. This discourse with respect of population standards grants most effective anthropological proof and as such may be suggested for forensic expertise based on human skull.

Purpose – This paper will explore the importance of material cultural heritage as a factor of an area’s tourism development. Zenica-Doboj Canton is located in the central part of Bosnia and Herzegovina. Canton's development of its tourist offer could be based on its material cultural and historical heritage and tourism in that area could take place throughout the year if other offers of services and products enabled it. This paper has a theoretical and an empirical value since both quantitative and qualitative methods will be used. Methodology – In addition to this, desk research of the existing literature will be carried out and the secondary data will be used to analyze the current state of tourism. Furthermore, authors will conduct an empirical research using qualitative methods of analysis. The empirical research is based on a structured questionnaire. More precisely, the local population of the Zenica-Doboj Canton will be questioned by using a sampling method in order to determine their role and importance in the product of cultural tourism. Based on the conducted survey through the SWOT analysis, the advantages and disadvantages of cultural tourism will be determined. Findings – The positive conclusion of the survey is that residents see cultural tourism as the most representative form of tourism in the Zenica-Doboj Canton whose development could significantly improve the economic situation of this particular area. A model for a product development will be presented in this paper on the basis of the obtained results. Contribution – It is concluded that the population's interest opens up the possibility of adapting the offer to tourists. Therefore, it is necessary to include the local population in the product formation because they are part of the product.

Background: The femur is supplied princially by the diaphyseal nutrient artery which enters the bone throught the nutrient foramen. This supply is essential during the growing period, the early phases of ossification, and in different surgical procedures. The aim of present study was to examine the morphology and topography of the femur nutrient foramen to provide detalied data on such features.Methods: This was a cross-sectional-descriptive study in which we observed 50 femurs. We analysed the number and location of nutrient foramina, the length of the bone, the position of the nutrient foramen regarding to values of FI, correlation between number of nutrient foramen and length of femur, correlation between position of nutrient foramen and side of extremity to which femur belongs.Results: The double foramina were common in right (57.1%) and left (42.1%) femur, mostly located in medial lip of aspera line in right (64.3%) and on the lateral lip in left femur (68.4%), with statistically significant correlation, χ = 4.85; p = 0.03, p <0.05.  The foramina in left (89.5%) and right (96.4%) femur were commonly observed at their middle third, with no statistically significant correlation between position of foramen accordingly to Foraminal Index value and side of extremity on which femur belongs (p=0.56; p>0.05). There is positive correlation between length of right and left femur and number of foramina.Conclusions: The study provides data of the nutrient foramina on femur, which is helpful for clinicians to help preserve bone vascularization during surgery.

Introduction: High opening injection pressure (> 15 psi) can detect needle nerve contact. However, the reliability of injection pressure monitoring to detect needle – nerve or impingement may be affected by syringe size. We hypothesized that monitoring of opening injection pressure (the pressure at which injectate is detected by US) is affected by the size of the syringe used for injection. Methods: After Ethics Commitee approval, 22 gauge 50 mm needles were inserted under US to contact the C5, C6 and C7 nerve roots of fresh human cadavers. Hand-held injections were made using 3 different syringe sizes (5, 10, 20 mL) at a rate commensurate with typical clinical practice. Injections were made bilaterally at each of the above nerve roots. Opening injection pressure data were aquired with an in-line digital pressure recorder using a 60 mL syringe (10ml/min), and injection halted when spread was detected. Results: A total of 48 injection measurements were made. The peak (opening) pressures at which injection commenced in two cadavers were 30.50 psi and 34.07 psi with 5 mL syringe, 29.20 psi and 34.95 psi for 10 mL syringe, 26.03 psi and 29.42 psi for 20 mL syringe, all han-held injection. In automated pump injection 60 mL syringe was used, and maximum achieved pressures were 23.42 psi and 34.03 psi. Opening injection pressures were similar regarless of syringe size (p>0.05). Conclusion: The size of the syringe commonly used in clinical practice of peripheral nerve blockade did not significantly affect the monitoring of the open injection pressure. All injection with the needle – nerve contact resulted in injetion pressure > 20 psi, regardless of syringe size or method of injection. Our findings ate thus consistent with the fluid mechaminc described by Pascal's Law, where pressure exerted anywhere in a confined incompressible fluid system is transmited equally throughout until the opening pressure is reached and injection begins.

Objectives: The main objective of the study is to give a detailed overview of the nutrient foramina and nutrient channels by macroscopic examination of fibula dyaphisis and to determine its utmost important variations for clinical practice. Methods and Materials: This was a cross-sectional-descriptive study in which we observed 50 fibula. We considered only nutritional foramina located at diaphysis of the bone. During the research we determined the following parameters: total number of nutrient foramina on dyaphisis of each bone, value of Foramina Index (FI), the length of the bones, the position of the nutritional foramina regarding to values of FI, and position of nutritionl foramina on the sides of the diaphysis of bone and the obliquity of nutrient canal. The obtained data were statistically analysed using SPSS version 17.0. Results: Nutritional foramina were recorded at 84.0% fibula. In 57.1% fibula nutritional foramina were placed on the facies posterior, in 40.5% on the facies medialis and on 2.4% bones nutritional foramina were on the facies lateralis. All fibula had nutritional foramina located on the middle third of the diaphysis of bone. Distally directed nutritional canals were observed on 90.5% fibula and proximally directed nutritional canalas were observed on 9.5% fibula. There was a negative correlation between the length of the fibula of the right and left limb and the number of nutritional foramina. Conclusion: Knowledge of the topography of nutritional foramina helps preserve bone vascularization during surgery. Keywords: nutritional artery, nutritional canals, fibula, topography

Background: The use of peripheral nerve blocks for anesthesia and postoperative analgesia has increased siginificantly in recent years. Many additives to local anesthetics to prolong the duration of analgesia for peripheral nerve blocks have been studied. Dexamethasone has been studied as an effective adjuvant to prolong the analgesia duration of local anesthetics in peripheral nerve block. However, the route of action for dexamethasone and its potential neurotoxicity are still unclear. The aim of this study is to determine possible toxic effects of dexamethasone on peripheral nerve tissue and the dependence of these effects on the place of intraneural applications. Methods and Materials: A rat sciatic nerve block model was used.  The study was conducted in accordance with the principles of laboratory animal care and was approved by the Laboratory Animal Care and Use Committee. Fifty adult Wistar rats (300 g) both sexes were studied. After induction of general anesthesia, the sciatic nerve was exposed bilaterally. Sciatic nerves were randomly assigned by the method of sealed envelopes to recive: intraneural, intrafascicular 2 mL of lidocaine with dexamethasone  (n=25), intraneural, extrafascicular injection  2 mL of lidocaine with dexamethasone (n=25),  perineural 2 mL of lidocaine with dexamethasone  (n=25) and perineural 2 mL of saline 0.9%  (n=25). Injection pressure was continuosly recorded using an in-line digital manometer. Increased injection pressure was used to distinguish intrafascicular from extrafascicular inrtaneural injections. After injection, the rats were awakened and subjected to serial neurologic examinations. Neurologic examination protocol was followed to determine proprioception by tactile placement response, motor function by extensor postural thrust and nociception by withdrawal reflex. On day 3 of the experiment, the animals were sacrificed and the neural tissue histologically examined. Results: Intraneural injections (intrafasciculary and extrafasciculary) of lidocaine in combination with dexamethasone caused neurological deficits and severe pathohistological damage to nerve fibers. All perineural injections (independent of the tested solution), combined with low injection pressure showed a uniform changes, with minimal histological deviation of the normal structure of the nerve fiber. Conclusions: When applied intraneuraly dexamethasone in combination with lidocaine caused nerve fiber damage. However, future studies are required to elucidate the most effective route and optimum dosing range for dexamethasone’s use in this field.

Objective: Morphological differences between sexes are also reflected in the skull bones, which can be used for sex determination of skulls. Our objectives were to observe the osteoscopic features of skulls and determine the frequency of characteristic female features in female skulls and the frequency of characteristic male features in male skulls in the observed sample; also to determine the prediction (effectiveness) of sex determination based on observed morphognostic (osteoscopic) features of the skulls and determine the most frequent and the least frequent morphognostic feature both in male and in female skulls in our tested sample. Methods and materials: The research was conducted on a sample of 211 macerated and degreased adult skulls (139 were male skulls and 72 were female skulls). Qualitative (osteoscopic) analysis included observation of the following: prominence of frontal tuber; prominence of superciliary arch and glabella; appearance of supraorbital margin; appearance of orbit; width of root of nose; prominence of mastoid process; contours of muscle insertions; size of teeth and face shape.         Results: Univariately, all ten observed morphognostic skull features showed statistically significant effect on sex determination, while prominence of superciliary arch and glabella proved to be the best morphognostic features with 90% accuracy, followed by prominence of muscle insertions with 82% accuracy, and prominence of mastoid process with 75% accuracy. Using multivariate binary logistic regression, we tested the effect of observed morphognostic features on sex determination and found that the only morphognostic features that had a statistically significant effect on sex determination were prominence of  superciliary arch and glabella and size of mastoid process. Multivariate effect of the prominence of muscle insertions on sex determination is borderline (p=0.052). Conclusion: Univariately, the greatest predictive effect for prediction of male sex is shown by the prominence of superciliary arch and glabella, prominence of muscle insertions and mastoid process. Multivariately, morphognostic features of prominence of superciliary arch and glabella, as well as the size of mastoid process show a statistically significant effect on sex determination. Effect of the prominence of muscle insertions is borderline. Key words: Skull, sexual dimorphism, osteoscopy, binary logistic regression