Background: Understanding complex brain networks using functional magnetic resonance imaging (fMRI) is of great interest to clinical and scientific communities. To utilize advanced analysis methods such as graph theory for these investigations, the stationarity of fMRI time series needs to be understood as it has important implications on the choice of appropriate approaches for the analysis of complex brain networks. New Method: In this paper, we investigated the stationarity of fMRI time series acquired from twelve healthy participants while they performed a motor (foot tapping sequence) learning task. Since prior studies have documented that learning is associated with systematic changes in brain activation, a sequence learning task is an optimal paradigm to assess the degree of non-stationarity in fMRI time-series in clinically relevant brain areas. We predicted that brain regions involved in a “learning network” would demonstrate non-stationarity and may violate assumptions associated with some advanced analysis approaches. Six blocks of learning, and six control blocks of a foot tapping sequence were performed in a fixed order. The reverse arrangement test was utilized to investigate the time series stationarity. Results: Our analysis showed some non-stationary signals with a time varying first moment as a major source of non-stationarity. We also demonstrated a decreased number of non-stationarities in the third block as a result of priming and repetition. Comparison with Existing Methods: Most of the current literature does not examine stationarity prior to processing. Conclusions: The implication of our findings is that future investigations analyzing complex brain networks should utilize approaches robust to non-stationarities, as graph-theoretical approaches can be sensitive to non-stationarities present in data.

Objective – The aim of this study was to examine the prevalence of attention deficit/hyperactivity disorder ( ADHD) and to identify comorbid disorders according to subtype of ADHD. Method – The study sample included 404 children aged from 6-12 years old. Parents completed The Child Behaviour Checklist/4-18 to detect internalizing and externalizing psychological difficulties in children. Assessment of ADHD was performed using the Attention-Deficit/Hyperactivity Disorder Test. Results – ADHD symptoms were found in 15% of girls and 12.1% of boys. The differences in the frequency of different subtype of ADHD in terms of the gender were obtained for the subtype of hyperactivity (Z=-2.075, p=0.038). Boys had more pronounced symptoms of hyperactivity compared to girls. There was no statistically significant gender difference for the subtype of impulsivity (Z=-1.422, p=0.155) and inattention subtype (Z=-0.234, p=0.815). The results obtained showed a higher prevalence of internalized and externalized difficulties with the combined subtypes of ADHD compared to other subtypes. Conclusion – ADHD is a complex condition, affecting a significant number of children and therefore it needs to be better identified. Children who seek medical or psychological help have at least one or more comorbid disorder and these problems also need to be appropriately identified and treated.

Objective – The aim of this case report is to present the results of surgical treatment of a patient with the pineal germinoma. Case report – A 12-year-old patient presented with two months history of headache, nausea, and vomiting, following by neuro-ophthalmologic disturbances (Parinaud syndrome). Computed tomography of the head showed a 3 cm mass in the pineal region, followed by obstructive hydrocephalus, and magnetic resonance imaging showed a pineal gland lesion with heterogeneous enhancement on contrast studies, with surrounding peritumoral edema, suggesting pineal germinoma. The patient underwent surgery to place a ventricular-peritoneal shunt, and second surgery using the occipital interhemispheric transtentorial approach to remove the tumor totally. Conclusion – Pineal germinomas that compress adjacent structures result in a typical clinical syndrome with endocrine malfunction, hydrocephalus or neuro-ophthalmological disturbances. A multimodality approach, including chemotherapy, radiotherapy and surgery, can offer excellent chances of free survival, and even cure.

Objective – To analyze the clinical and histological characteristics, as well as to evaluate the results of surgical treatment of pediatric neuroepithelial tumors. Patients and methods – A retrospective study was conducted, including 40 pediatric patients surgically treated at the Clinic of Neurosurgery, University Clinical Hospital Tuzla in the period 2002-2012. During the study we formed groups and the analysis was conducted by age, gender, clinical signs, histopathologic types and type of surgical treatment. The results are presented in tables and expressed by relative values. Results – Neuroepithlial tumors are more common in male patients. There was no statistically significant difference in distribution of neuroepithelial tumors (I‡2=0.400; p=0.527) related to supratentorial and infratentorial localization. Infratentorial neuroepithelial tumors are most common at a younger age (F=6.516; p=0.015). Increased intracranial pressure and seizures are the most common initial presentation of neuroepithelial tumors (I‡2=0.022; p=0.882). There was no statistically significant difference between types of surgical resection and localization of the tumor. Usually we performed total resection (I‡2=0.246; p=0.620). There was a statistically significant difference in tumor grade regarding supratentorial and infratentorial localizations (p=0.013). Infratentorial tumors are higher grade (I‡2=5.495; p=0.019). Conclusion – The most common initial presentations of neuroepithelial tumors are increased intracranial pressure and seizures. Infratentorial tumors are higher grade. The most common initial treatment of neuroepithelial tumors is radical surgical resection.

Objective – We present a case of osteoarthritis in a ten day old newborn who underwent aspiration and drainage on the fifth day after admission instead of on the first day . The aim of this case report is to describe the importance of a team approach and clinical management algorithms for the successful treatment of septic arthritis in newborns. Case report – We describe a 3580 g male baby, who underwent aspiration and drainage on the fifth day after admission to our Unit for septic arthritis of the right knee. After the surgical drainage of the joint, local signs of inflammation began to improve. Microbiological analysis did not reveal the causative agent. Conclusion – Septic arthritis requires early diagnosis, prompt administration of antibiotics and rapid removal of pus by surgical treatment, due to the possible development of serious and irreversible damage, and even lethal outcome. A team approach with treatment guidelines of septic arthritis in newborns is mandatory.

A 40-year-old man was hospitalized in the coronary care unit with chest pain and abnormal electrocardiogram. Twenty days earlier, the patient underwent laparoscopic gallbladder surgery. Due to chest pain and ischemic ECG changes, patient was subjected to coronary angiography. The selective coronary angiography revealed multiple multilateral fistulae arising from the left anterior descending artery, circumflex artery, and the right coronary artery draining to the left ventricle. Multislice computed tomography showed hypoplastic coronary sinus and minor cardiac venous system.

Propellant charge case for a cartridge ammunition, comprising a sleeve housing (3) having a high pressure chamber (7) for receiving a propellant charge and during ignition of the propellant charge with the high pressure chamber (7) communicating the low pressure chamber (12), and a pressure plate (17) for receiving a primer ( 20), wherein the pressure plate (17) is arranged (via a thermally actuated fuse element 22) releasably secured to the sleeve housing (3) or a support plate (13), and wherein one or more of the pressure plate (17) axially fixing the holding elements (26, 27 ) are provided, which are movable radially in a thermally activated actuation of the securing element (22) from its fixing position or be moved.

We used a combination of whole-genome sequencing and in vitro validation to show that mutations that activated at least two pro-growth/survival pathways mediated intrinsic resistance to BRAF inhibition in a melanoma patient. These data demonstrate how in-depth analysis can reveal intrinsic resistance to standard of care, providing an opportunity for alternative therapeutic strategies for patients who are likely to fail first-line treat-575 ment.

Acute kidney injury (AKI) is a complex, frequent and serious clinical problem with high rate of mortality. Therefore there is a serious need for early detection of AKI, with a tendency to detect early stage--RISK dut to start with therapy as soon as possible and prevent irreversible changes in renal function. Study's purposes were to explore the rhythm of urine neutrophile gelatinase associated lipocalin (urine NGAL) concentration changes before and after cardiovascular surgery and compare results of urine NGAL values with results of serum creatinine and creatinine clearance as main diagnostic indicators of renal function in order to define role of urine NGAL biomarker in early diagnosis of acute kidney injure. In the prospective clinical study 150 cardiovascular surgery patients were included. Basal value and concentration of urine NGAL were tested 3, 6 and 12 hours after cardiovascular surgery, and concentration of serum creatinine was tested once per day first three days after surgery. Also creatinine clearance value was calculated according to Cockrof-Goult formula. After above mentioned, rate of acute kidney injure was estimated according to RIFLE criteria. The study results showed that the value of urine NGAL was elevated above cutt-off after cardiac operation in a group of patients who developed AKI (defined according to RIFLE criteria). There were statisticaly significant difference between all four measerments (p < 0.05). There were also moderate positive correlation (0.500 and 0.502) between urine NGAL values and percentage difference of serum creatinine and creatinine clearence. All that indicate that higer values of urine NGAL are followed by higher percentage difference of serume creatinine and creatinine clearence. By using of automated urine NGAL test detection of acute kidney injure is posible 24-48 hours earlier comparing with actual results acquired by determination of serum creatinine concentration. The results of this study will indicate urine NGAL as a reliable biomarker of early acute kidney injure. A combination of early and late markers of kidney damage (urine NGAL, serum creatinine) can greatly contribute to better control the outcome of all those who are a risk group for the development of AKI.

It has long been recognized that alterations in cell shape and polarity play important roles in coordinating lymphocyte functions. In the last decade, a new aspect of lymphocyte polarity has attracted much attention, termed asymmetric cell division (ACD). ACD has previously been shown to dictate or influence many aspects of development in model organisms such as the worm and the fly, and to be disrupted in disease. Recent observations that ACD also occurs in lymphocytes led to exciting speculations that ACD might influence lymphocyte differentiation and function, and leukemia. Dissecting the role that ACD might play in these activities has not been straightforward, and the evidence to date for a functional role in lymphocyte fate determination has been controversial. In this review, we discuss the evidence to date for ACD in lymphocytes, and how it might influence lymphocyte fate. We also discuss current gaps in our knowledge, and suggest approaches to definitively test the physiological role of ACD in lymphocytes.

Viral infection triggers an early host response through activation of pattern recognition receptors, including Toll-like receptors (TLR). TLR signaling cascades induce production of type I interferons and proinflammatory cytokines involved in establishing an anti-viral state as well as in orchestrating ensuing adaptive immunity. To allow infection, replication, and persistence, (herpes)viruses employ ingenious strategies to evade host immunity. The human gamma-herpesvirus Epstein-Barr virus (EBV) is a large, enveloped DNA virus persistently carried by more than 90% of adults worldwide. It is the causative agent of infectious mononucleosis and is associated with several malignant tumors. EBV activates TLRs, including TLR2, TLR3, and TLR9. Interestingly, both the expression of and signaling by TLRs is attenuated during productive EBV infection. Ubiquitination plays an important role in regulating TLR signaling and is controlled by ubiquitin ligases and deubiquitinases (DUBs). The EBV genome encodes three proteins reported to exert in vitro deubiquitinase activity. Using active site-directed probes, we show that one of these putative DUBs, the conserved herpesvirus large tegument protein BPLF1, acts as a functional DUB in EBV-producing B cells. The BPLF1 enzyme is expressed during the late phase of lytic EBV infection and is incorporated into viral particles. The N-terminal part of the large BPLF1 protein contains the catalytic site for DUB activity and suppresses TLR-mediated activation of NF-κB at, or downstream of, the TRAF6 signaling intermediate. A catalytically inactive mutant of this EBV protein did not reduce NF-κB activation, indicating that DUB activity is essential for attenuating TLR signal transduction. Our combined results show that EBV employs deubiquitination of signaling intermediates in the TLR cascade as a mechanism to counteract innate anti-viral immunity of infected hosts.