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Dragan Primorac, D. Marjanović, I. Gornik, G. Lauc, Šimun Anđelinović, M. Definis-Gojanović, Davorka Sutlović, Damir Primorac et al.

A. Sarac-Hadzihalilovic, A. Kulenović, A. Kučukalić

The aim of this study was to analyze cognitive dysfunction in PTSD. The testing included 79 Bosnian Army veterans, who participated in Bosnian war from 1992 to 1995. Out of 79 tested war veterans, 45 of developed PTSD while 34 did not. The veterans without PTSD where included in the control group. All the war veterans were of the same education level (secondary education) and between 30 and 50 years of age. Rivermead Behavioral Memory Test - RBMT was applied to all the subjects. The test was originally developed for the purpose of everyday memory problems identification. Clear goal of the 10 RBMT subtests is simulation of everyday life situations. PTSD group achieved significantly lower results than the control group. Results of the total score showed highly significant difference between PTSD and control group. Value of the t-test is t=10,056 with significance level of p<0,001. The same conclusion stands for any RBMT subtest. Numerous psychological studies on PTSD patients show more prominent psychological deficit in war veterans. Our study clearly confirms that finding.

The report deals with the case of a 10-year-old girl with chronic cystic fibrosis. She has been repeatedly treated at the hospital. She has been hospitalized due to respiratory deterioration. Cystic fibrosis is a rare disease, inherited autosomaly recessively, but is very complex in terms of diagnostic and treatment (2). The diagnosis is confirmed based on a clinical picture of the child, measure of Chloride in the sweat, chest X-ray, CT thorax, laboratory findings--genetic confirmation CFTR ( cystic fibrosis transmembrane conductance regulator) genes (3), which result in the production of hyper-viscous mucus and chloride malabsorption in the sweat glands ducts (5,6). Bronchial thickening and plugging and ring shadows suggesting bronchiectasis, segmental or lobar atelectasis are often. Computer tomography of the chest can be used to detect and localize thickening of bronchial airways walls, mucus plugging, hyperinflation and early bronchieactasiae. Pulmonary therapy: the object is to clear secretions from airways and to control infection (7). The diagnosis is originally set when she was 4 years old. She is now admitted due to a deterioration of the main disease. Day before admission in the hospital had a higher bodily temperature, cough and difficult breathing. She already treated conservatively (Ceftazidim, Ceftriakson, Kloksacillin) Since the girl is a chronic patient with bronchiectasie chronic walls of bronchi changes full of the mucus, who is not responding to conservative treatment (antibiotics), therapeutic and diagnostic flexible bronchoscopy had to be performed, resulting in a gram-negative bacteria pseudomonas aeruginosa--a typical bacteria for chronically sick C. F. patient. A pseudomonas therapy was prescribed according to the sensitive antibiogram, during which bronchoscopy was given locally on changes mucous pulmozyme and garamycin. Flexible bronchoscopy was performed as therapeutic. Local bronchoscopy findings:by aspiration of tracheo-bronchal truncus it was found hyperemia and a lot of mucous sticky secretion inside of tracheobronchal tree, especially middle lobe right side, lingual and basals part of the lungs. It was performed broncho-alveolar lavage and given steroids on the place of changed inflamed mucous membrane of the bronchi. It was also given pulmozyme to destroid mucous and make better spontaneously expectorations. Control chest x ray was performed and it was better.

There are numerous methods of administering drugs to the body, both passive and active. Active methods include the use of penetration enhancers and assisted drug delivery. One of them is sonophoresis (phonophoresis). This term is used to describe the effects of ultrasound on the movement of drugs through intact living skin and into the soft tissues. Although the exact mechanism of sonophoresis is not known, drug absorption may involve a disruption of the stratum corneum lipids allowing the drug to pass through the skin. In the future, drug release systems aided by ultrasound may be able to provide slow release of vaccines. Researchers are currently exploring the applications in various areas like cutaneous vaccination, transdermal heparin delivery, transdermal glucose monitoring, delivery of acetyl cholinesterase inhibitors for the treatment of Alzheimer's disease, treatment of bone diseases and Peyronie's disease and dermal exposure assessment. The possibilities seem endless. Drug administration through skin patches, with the advent and development of ultrasound-mediated transdermal transport, may soon become the name of the game. Besides, taking into account the varied possible applications of sonophoretic transdermal drug transport in the fields of biotechnology and genetic engineering, we can envision a whole gamut of newer technologies and products in the foreseeable future.

Mirsad Dorić, S. Radović, Suada Kuskunović, Ajna Hukić, M. Babić, I. Tomić, I. Selak

We report a case of exceedingly rare cutaneous neoplasm with histological features of malignancy and uncertain biological potential. The nodular, darkly pigmented facial tumor with central exulceration, size 12 x 10 x 7 mm, of the skin 61-year-old man preauricular left was completely exised. Histologically tumor consists of atypical squamous cells, which express signs of moderate to significant pleomorphism, mitotically active, with foci forming of parakeratotic horn cysts ("pearls"). Characteristically tumor also consists of large number of atypical melanocytes with multifocal pattern, inserted between atypical squamous cells, and which contain large amount of dark brown pigment melanin. Immunohistochemically, squamous cells stain positively with keratin (CK116), melanocytes were stained with S -100 protein, HMB 45, and vimentin, but failed to stain with CK 116. To our knowledge this is the sixth reported case in world literature. The follow-up time of four years no evidence of recurrence or metastasis, similar all reported cases, but it is too short period in estimation to guarantee a benign course. However, it appears that this group of neoplasm may have different prognosis from pure squamous carcinoma or malignant melanoma.

Periapical disease is the result of bacteria, their product, and the host response to them. Early histological studies of diseased periapical tissue have not been able to demonstrate viable bacteria in the lesions studied. Recent reports indicate that many of periapical lesions are indeed infected before and after endodontic treatment. The validity and applicability of the microbial delivery overcome many disadvantages that we see with systemic drugs. In this case report we presented a novel approach of managing chronic diffuse periapical lesion of lower molar based on specific selection of intracanal medicament in combination with direct periapical injection. We used bacterial culturing and antibiotic sensitivity test to select specific intracanal medicament, in addition we presented an intraosseous injection technique to locally deliver the selected medicament directly into the periapical lesion. Our findings are encouraging and promising. The validity and applicability of the technique needs to be tested in a well controlled clinical trial.

S. Salihagić, Z. Hadziahmetovic, Abdulah Fazlić

Peroneal palsy with loss of active dorsal flexion in foot can be surgically treated by anterior transfer of tibialis posterior tendon. Two techniques are available, classic and modified Barr's technique of the anterior transfer of tibialis posterior tendon, with different place of tendon's reinsertion. The aim of the study is evaluation of the degree of active dorsal flexion in foot, and appearance of varus position and hipercorrection of the foot, by comparing the results of the two operative techniques. The study included 40 patients with peroneal irreparable palsies, divided into two equally sized groups. The first group was treated by classic Barr's technique. The other group of patients was treated by modified Barr's technique. The group treated by modified Barr's technique exhibited better functional results. Active dorsal flexion achieved between 950 (in 35% cases) and 900 (in 50% cases), while varus position and hipercorrection of the foot were absent. In the second group of 20 patients, treated by classic Barr's technique, 800 (40%) and 900 (25%) of active dorsal flexion, indicated worse functional postoperative results. Active dorsal flexion of 700 achieved by this method in two cases (10%), represents unsatisfactory functional result. Varus position of the foot was recorded in 5 cases (25%) and hipercorrection in 4 cases (20%). Modified Barr's technique is surgical method with better functional and postoperative results in treatment of irreparable peroneal palsy.

The genotoxic effects of Vitamin C (ascorbic acid) on human lymphocytes in vitro were estimated by analyzing and identifying various chromosome abnormalities, in relation to the concentration of Vitamin C. Testing concentrations of Vitamin C induced different aberrations including the impairment of spindle function. The spindle disturbances can result in mitotic arrest, multipolar spindles and multipolar segregation, errors in chromosome segregation, formation of chromosome bridges and chromosome laggards. The most frequent irregularities were found in anaphase and telophase. A certain number of lymphocytes were arrested at anaphase or telophase (in colchicine-untreated cultures of human lymphocytes). Testing concentrations of ascorbic acid did not induce a significant increase in the number of aneuploid mitoses and were not clastogenic except at the highest concentration (1,000 microg/ml) in colchicine-treated cultures, and in colchicine-untreated cultures of human lymphocytes the pulverization of chromosome was observed. Vitamin C changed the mitotic index value of lymphocytes notably at the higher concentrations (250, 500 and 1,000 microg/ml).

Familial adenomatous polyposis (FAP) is an autosomal dominant illness with the highest risk for appearance of colorectal cancer's disease. In our study, we have used Bethesda criteria that define colorectal cancers which can be tested on microsatellite instability. The aim of our study is make an analysis of microsatellite instability (MSI), appearance of RER+ phenotype, genetic alteration of tumor suppressor genes as like as one of responsible factor for genesis of adenomatous polyposis. The base for this study were shown families with clinical diagnosed FAP. In this study two families with clinical diagnosed adenomatous polyposis were involved. Our study of both families showed that three tumor tissues belonged to RER negative phenotype, but only one belonged to RER positive phenotype. Microsatellite analysis showed instability of mononucleotide marker Bat 40 at 4 samples and Bat 26 at 2 samples, but Bat 25 and in 1 sample. Dinucleotide marker TP 53 did no show any microsatellite alterations. Genetic alteration of tumor suppressor gene APC appeared at 4 samples, p53 at 3 samples, RB1 at 2 samples and NM23 only at 1 sample, but tumor suppressor genes DCC1 and DCC2 were homozygote. Our results are agree with results of earlier studies and also the got results confirm the fact that loss of heterozygosity of tumor suppressor gene APC and p53 are responsible for genesis of adenomatous polypose and it also represents the characteristic of genetic changes FAP's patients in our region.

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