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.

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.

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.

Intracerebral hemorrhage is the deadliest, most disabling and least treatable form of stroke despite progression in medical science. The aim of the study was to analyze the frequency, risk factors, localization and 30-day prognosis in patients with intracerebral hemorrhage. We analyzed 352 patients with intracerebral hemorrhage (ICH) hospitalized at the Department of Neurology Tuzla during a three-year follow up. The following data were collected for all patients in a computerized database: age, sex, risk factors (hypertension, heart diseases, diabetes and smoking) and CT findings. Stroke severity was estimated with Scandinavian Stroke Scale, ICH topography was specified by CT, and outcome at 1st month after onset included information on vital status and disability (modified Rankin Scale, mRS). The most frequent risk factors were hypertension (84%), heart diseases (31%), cigarette smoking (28%) and diabetes mellitus (14%). The most frequent localization of ICH was multilobar (38%), internal capsule/basal ganglia region (36%) and lobar (17%). Within first month died 147 patients (42%). The highest mortality rate was in patients with brain stem (83%) and multilobar hemorrhage (64%). Factors independently associated with mortality were age (odds ratio 1,05 (95% confidence interval 1,02 to 1,08); p=0,001), stroke severity (OR 0,93 (0,92 to 0,95); p<0,0001), multilobar hemorrhage (OR 5,4 (3,0 to 9,6); p<0,0001) and intraventricular hemorrhage (OR 3,9 (2,2 to 7,1); p<0,0001). Favorable outcome at first month (mRS < or = 2) had 45% of the surviving patients with ICH. The best outcome was for the patients with cerebellar hemorrhage (63%), while only 40% of the patients with hemorrhage in internal capsule/basal ganglia region had Rankin scale 2 or less. Hypertension is the most frequent risk factor in patients with ICH. ICHs are mainly localized in lobar and internal capsule/basal ganglia regions. Independent predictors of mortality following ICH are age, hypertension, intraventricular blood extension and stroke severity. Mortality, as well as good outcome at 1 month, is related to the localization of bleeding.

The aim of the study was to explore the effect of lactate on insulin-stimulated glucose uptake in rats. Thirty Wistar rats, weighing 250 - 300 g. were arbitrarily divided into one of three groups (n =10): insulin (1 IU/kg) treated group, lactate (80 mg/kg), and insulin plus lactate treated groups. Blood glucose levels were measured in venous samples collected from the tail vein over 3 hour period after insulin or/and lactate administration in 30-minute intervals. To estimate the influence of lactate on insulin blood level, a total of 20 rats were divided into 4 groups (n = 5): saline, insulin, lactate, and insulin plus lactate treated group, respectively. Sixty minutes after the appropriate application of the same doses of insulin, lactate, and lactate plus insulin, as in the previous part of the experiment, plasma insulin and blood glucose levels were determined in blood samples drawn from the abdominal aorta. Lactate in combination with insulin, in comparison to insulin application alone, caused a dramatic increase in plasma insulin level (p<0,001) and more profound hypoglicaemia (p<0,001). The results of this investigation indicate that lactate application significantly increases the rate of glucose uptake from peripheral blood caused by exogenous insulin action. The possible involvement of lactate in the mechanism of enhanced glucose uptake due to insulin action after physical exercise is discussed.

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.

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.

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).

Congenital anomalies of the urinary system are relatively common anomalies. In Bosnia and Herzegovina there is no existent unique evidence of congenital anomalies and registries. The aim of this study was to obtain the frequency of different urinary tract anomalies types and their sex distribution among cases hospitalized in the Department of Pediatric Surgery of the University of Sarajevo Clinics Centre, Bosnia and Herzegovina, during the period from January 2002 to December 2006. Retrospective study was carried out on the basis of clinical records. Standard methods of descriptive statistics were performed for the data analysis. Among 289 patients that were surgically treated 62,37% of the patients were male patients, while 37,63% were female patients. Twenty nine different urinary system anomalies types were found in this study. These were: vesicoureteral reflux (99 cases or 30,75%), hypospadias (62 cases or 19,26%), pelviureteric junction obstruction (42 cases or 13,04%), megaureter (35 cases or 10,87%), duplex pelvis and ureter (16 cases or 4,97%), bladder diverticulum (8 cases or 2,48%), ureterocoele (7 cases or 2,17%), stenosis of the external urethral opening (6 cases or 1,86%), ectopic kidney, duplex kidney and pelvis (each 5 cases or 1,55%), polycystic kidneys and urethral stricture (each 4 cases or 1,24%), multicystic kidney (3 cases or 0,93%), kidney agenesis, ureter agenesis, urethral diverticulum, ectopic ureter, horseshoe kidney and fetal kidney (each 2 cases or 0,62%), renal aplasia, urethral atresia, renal cyst, urachal cyst, epispadias, bladder exstrophy, renal hypoplasia, renal malrotation and Prune-Belly syndrome (each 1 case or 0,31%). According to this study, urinary tract anomalies were more common in male than in female patients (62,37%). Generally, the most frequent anomaly type was vesicoureteral reflux in total number of 99 cases, and in females (66 cases), but hypospadias was the most common anomaly in males (62 cases). The anomalies of other systems associated with urinary system anomalies were found in ten cases. These were: cryptorchidism, congenital inguinal hernia, open inner inguinal ring, uterus bicornis unicollis and one case of multiple anomalies.

The study was designed with the main intent to assess and explain the differences between athlete's heart syndrome and the heart of healthy non-athletes, and to distinguish between physiological and pathological heart condition. Prolonged athletic training causes changes in heart that are termed "athlete's heart syndrome". Athlete's heart diagnosis and related issues are a great challenge due to complementary morphological, functional and electro-physiological changes that may indicate both physiological and pathological condition. The study included 150 subjects, of those 100 were active athletes and 50 were in control group. The study protocol included one clinical examination, one electrocardiogram and one echocardiograph for each subject. Average age was 20,51+/-8,51 in the athletes and 21,48+/-2,53 in control group. Significantly higher average left ventricle (LV) mass (401,23 g vs. 143,23 g) and LV mass index (196,05 g/m2 vs. 83,98 g/m2) was found in the athletes (p<0,05). The study showed increased mass and wall thickness with usual inner dimensions of athlete's heart. Systolic and diastolic function of athlete's heart is normal. Athlete's heart with these features is a healthy heart.

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.

The objective of this work is to verify the incidence of incidental prostate adenocarcinoma in patients who underwent radical cystoprostatectomy for invasive bladder carcinoma. We have retrospectively reviewed patients who underwent radical cystoprostatectomy for infiltrative bladder tumors in period between 2003 and 2007 year, 94 men with bladder cancer underwent radical cystoprostatectomy at Urology Clinic-University of Sarajevo Clinics Centre. Mean age of patients was 67 years, with age limits ranging between 48 and 79 years. Pathohistological evaluation was used for all specimens from RCP. We found that 9,57% of cystoprostatectomy specimens in patients with bladder cancer also contained incidental prostate cancer. This result was much lower than overall mean frequency of incidentally detected prostate cancer in other series of cystoprostatectomy cases (range, 23%-68%). In conclusion we recommended digital rectal examination (DRE) and prostate-specific antigen (PSA) test as part of the bladder cancer work up and complete removal of the prostate at cystoprostatectomy to prevent residual prostate cancer.

UNLABELLED The objective of this study was to evaluate cortisol in the saliva and serum of healthy persons and its daily fluctuations by using immunochemical method on a autoanalyzer. Biological samples: Serum from 14 healthy persons and saliva from 18 healthy persons were taken two times at 8 a.m. and at 4 p.m. Immunochemical assay: The principle of this method is the competitive binding of cortisol present in the analyzed sample and cortisol marked with peroxides on binding parts with specific antibodies. STATISTICAL ANALYSIS Student t-test. Cortisol in saliva in the morning: 21,2 +/- 16,2 nmol/l and in the afternoon 12,7 +/- 8,1 nmol/l. Cortisol in serum in the morning: 459, 6 +/- 235,2 nmol/l , and in the afternoon 340,5 +/- 207,5 nmol/l. The concentrations of cortisol in saliva are lower than in serum. Cortisol in the serum in the morning is about twenty times higher than cortisol in the saliva at the same time. Cortisol in the serum at afternoon is about twenty-seven times higher than cortisol in the saliva. Individual variabilities of cortisol in the saliva and serum were found during the day.