Our aim was to evaluate risk stratification model, European System for Cardiac Risk Evaluation (logistic EuroSCORE) for patients treated in clinical hospital. EuroSCORE is useful to separate patients into risk groups so that the mortality and morbidity risk can be compared. From 1st January 2006 to 31st July 2006 the total of 124 adults have been operated and were classified according to the EuroSCORE algorithm. We have compared correlation of the predicted mortality and observed mortality (as death within the 30 days following the operation) and frequency of postoperative complications. All patients were divided into three risk groups. The low risk group had 30 patients with 0 death (0%) and 1 morbidity (3,33%). The medium risk group had 59 patients with 0 death (0%) and 4 morbidity (6,77%). The high risk group had 35 patients with 2 death (5,71%) and 5 morbidity (14,28%). Mortality in our clinic is much less than predicted mortality and we can be satisfied with our results. Incidence of complications after cardiac surgery is between 25 and 40% (STS database). Our results are within that range. We recommend logistic version of EuroSCORE as good and simple method to predict postoperative prognosis.

Paper goal is to determine complications after urgent surgical treatment of patient with penile fractures, by using circumferential-degloving technique (degloving penile skin to root of penis). In period between 1998-2006 year, 23 patients have been treated as urgent cases with clinically proven penis fracture, age between 18 and 35. Patients were treated in 3 medical centers in Bosnia and Herzegovina(Sarajevo, Tuzla and Zenica). All 23 (100%) patients were injured during sexual intercourse. In the case of 20 (86,9%) patients partial rupture of corpus cavernosum was verified. Two (8,6%) patients had a complete rupture of urethra and it was primary sutured. In 22 cases (95,6%) spontaneous erection appeared, and in the case of 2 (8,6%) patients penile curvature was verified. Urgent surgical treatment is the best therapy choice, which enables preservation of erection in great number of cases in patients with penile fracture.

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.

The role of Epstein Barr virus (EBV) in the onset of Hodgkin's lymphoma has been a subject of ongoing research. However, confirmation of EBV oncogenic involvement was not possible due to the small number of neoplastic cells characteristic for this type of tumor. Presence of EBV infection in neoplastic and non-neoplastic cells was analyzed in 81 cases of Hodgkin's lymphoma. In neoplastic cells, using an immunohistochemical method, latent membrane protein 1 (LMP1) was found in 33,3% of cases, while in situ hybridization results demonstrated the presence of EBER RNA in 48,1% of the cases. EBER RNA was found in non-neoplastic lymphocytes in 38,3% of cases. EBV is most frequently associated with Hodgkin's lymphoma in the first and seventh decade of life, specifically the nodular sclerosis subtype. No apparent difference was observed in the association of Hodgkin's lymphoma with EBV between genders, or in relation to clinical stage of the disease and average age of the patient. However, association with childhood age is significantly greater in comparison to adults. EBV associated disease shows a significantly greater prevalence in T lymphocytes. Slightly more abundant are cytotoxic T lymphocytes, which are also more frequently in contact with Reed-Sternberg cells, although there is no difference in number and positioning of histiocytes. Variations between the data on the association of EBV with Hodgkin's lymphoma among studies from different parts of the world suggest that factors of age, gender, ethnic background and social status might present biological modifiers of EBV influence on the pathogenesis of this neoplasm. The differences in non-neoplastic infiltrate EBV+ and EBV- lymphoma indicate the effect of the virus on the immune interaction of tumor and host in this disease.

The aim of the study was to verify the presence of mutated tumor suppresser gene p53 in intestinal mucosa with histologically confirmed premalignant lesions and gastric carcinoma, and assess its prognostic value. The paper presents prospective study that included 50 patients with gastric adeno-carcinoma of intestinal type that were treated at Gastroenterohepatology Clinic, and 50 patients with histologically confirmed chronic atrophic H. pylori positive gastritis. In the mucosa biopsy samples, we analyzed presence, frequency and severity of inflammatory-regenerative, metaplastic and dysplastic changes. We typed intestinal metaplasia immunohistochemically and confirmed the presence of p53 onco-protein in antigen positive gastric carcinoma cells, and evaluated its prognostic value. Our results suggest that H. pylori acts as an initiator of inflammatory processes in gastric mucosa, which are followed by emergence of precancerous lesions. p53 is expressed late in carcinogenesis (14%) and as such, may be considered as an indicator of transformation of premalignant into malignant lesion.

The effects of nonsteroidal mycotoxin zearalenone on the lymphoid tissue of thymus in a sense of investigating the subacute toxicity Wistar-albino rats have been examined in the course of the study. We analyzed 42 rats' specimens of both gender, treated with three dosage levels: 0,5; 2 and 4 mg/kg of body weight, after oral submission of the compound, and observed during three different time intervals: 10, 20 and 30 days. Microscopically was semiquantitatively determined lymphophagocytosis (apoptosis) and cortical thymic cellularity. It was percepted statistically significant growth of lymphophagocytosis compared to a dosage (p<0,01), as well as combination of dosage and interval (p<0,001), while gender had no statistically significant influence on tested parameter (p>0,05). Changes in cortical thyme cellularity were not percepted. Effects of applied doses of zearalenone on the lymphoid tissue of thymus were very mild and in correlation with estrogenicity. They are probably the result of interaction with estrogenic receptors.

An examination of neurophysiologic features of median nerve in third trimester of regularly controlled normal risk pregnancies is performed at the Department of Neurophysiology of Primary Health Centre in Tuzla during January / April 2006. Examined group consisted of 40 young females in third trimester of pregnancy, and average age of 25,6 +/- 4,9 years. Control group consisted of young healthy females with average age of 31,1 +/- 4,4 years. Symptoms and signs of carpal tunnel sy. (CST) had 12 patients, but diagnosis is neurophysiologically confirmed in 9 (75%) patients. In group of pregnant females without symptoms 3 (10,7%) patients showed neurophysiologic evidence of CTS. Sensory velocity of right median nerve was significantly lower in pregnant group of patients (p=0,002), but area of sensory potentials on both sides were lower in pregnant group (p<0,0001). Area of CMAP of right median nerve was significantly lower in pregnant group (p=0,0003). Significant differences in CTS group compared with control group were in sensory velocities of median nerve (left median nerve p=0,0007, right p<0,0001), and area of SNAP of both sides (left p<0,0001, right p=0,0001), but area of CMAP right (p=0,0003). In CTS group 7 females had unilateral and 5 had bilateral neurophysiological changes. Our conclusion is that neurophysiological parameters of median nerve in third trimester of pregnancy are changed mainly due to high prevalence of CTS that might disturb quality of life and have psychological and physical implications on future mother. Hence, it is necessary to, continuously, pay enough attention in prevention or treatment of mentioned syndrome in this population group.

Elevated C-reactive protein (CRP) in association with hyperinsulinemia is a significant risk factor for cardiovascular diseases and that plays a key role in the development of the PCOS. We evaluated serum CRP level, before and after metformin therapy in obese women with polycystic ovarian syndrome (PCOS). Thirty five obese women with PCOS [BMI=28,2+/-1,84 kg/m2, aged 20-35 years] were studied. Patients received metformin orally the dose of 850 mg per day. The patients were carefully interviewed, clinically examined, and laboratory tested to eliminate conditions, probable to provoke an inflammatory response which was an exclusion criterion. Subjects were excluded if there was clinical or electrocardiographic evidence of coronary artery disease, a family history of coronary artery disease, a history of smoking, or concurrent oestrogen, antihypertensive, or lipid lowering medication. At all patients we determined CRP, insulin, C-peptide, luteinising hormone, follicle stimulating hormone, oestradiol, testosterone, prolactin, TSh, T3, T4, glucose, fibrinogen and lipid profile, before and after metformin treatment. Mean serum C-RP levels significantly decreased after metformin treatment ((6,37+/-1,72 vs. 1,67+/-0,73 mg/l; p<0,05). Level of insulin reduced for 37% after metformin treatment (234+/-68 vs. 148+/-39 pmol/l). Total cholesterol and low-density lipoprotein cholesterol levels decreased as well. Mean total testosterone levels decreased after metformin treatment too (3,21+/-0,91, vs. 2,31+/-0,72 nmol/l). Elevated serum CRP level significantly correlated to the hyperinsulinaemia (r=0,54). Metformin therapy in PCOS women reduces CRP level, hyperinsulinaemia and cardiovascular risk.

Angiotensin converting enzyme (ACE) and nitric oxide (NO) have been suggested to be in - The objective of this study is to compare outcomes of coronary artery bypass grafting (CABG) in high-risk patients performed with- (ONCAB) and without -(OPCAB) use of cardiopulmonary bypass. From October 2001 till October 2005, 210 high-risk patients classified according to European System for Cardiac Operative Risk Evaluation (EuroSCORE) (score =or> 5) underwent CABG in Cardiovascular Clinic, University Clinical Centre Tuzla, Bosnia and Herzegovina. 138 patients operated as OPCAB were compared to 72 patients operated as ONCAB. All data were entered in a patient database (DATACOR) and analyzed in SPSS. OPCAB patients received insignificantly less number of grafts than those treated by ONCAB (3,0 vs. 3,2) (p=0,071). Stroke was significantly more common in ONCAB group (2,9 vs. 11,1%) (p=0,034) while the incidence of other postoperative complications and mortality were similar. The ventilation time (4,3 vs. 6,7 hours) (p=0,007), retransfusion volume (392,7 vs. 633,7 ml) (p=0,041) and hospital stay (8,2 vs. 10,1 days) (p=0,031) was significantly less in OPCAB group. OPCAB is safe and effective in treatment of high-risk patients. Avoidance of cardiopulmonary bypass is associated with reduced incidence of neurologic complications, lower intubation time, retransfusion rate and shorter hospital stay, and in our experience the preferred operative method in such patients.

This study was performed in order to investigate possible role of brain beta-endorphins as markers of antidepressive drugs therapy monitoring. Experiment was done using amitriptyline and trazodone as antidepressants. For quantification of brain beta-endorphins we used RIA technique. Our results showed significant decrease of brain beta-endorphins concentration in drug-pretreated animals, vs. those in of control group treated with 0,95% NaCl. The lower values were obtained in trazodone pre-treated animals. This study shows that use of psychoactive drugs have influence on brain beta-endorphins concentration. beta-endorphins could be of great importance, used as markers for evaluation of patient treatment.

Lobus limbicus is an anatomical basis for understanding the temporal epilepsy because it includes not only the focus of temporal lobe infection but of the frontal lobe as well. With it we can explain many of the phenomena accompanying epilepsy (hallucinations, the change of the effects, and so on). The goal of this assignment was to explore the asymmetry of amygdaloidal complex in the patients with complex partial attacks. The results show that the smallest number of patients with epilepsy have a symmetric (same size) amygdaloidal complex on the left side and the right. According to the asymmetry direction the difference in the number of patients with epilepsy is not statistically significant. Coefficient of asymmetry shows that the asymmetry on the left side is more frequent in men, while women have the same distribution on both sides. The greatest differences were found when considering the age factor. So, in all the three groups of evaluated data the differences in average age of patients with epilepsy according to total symm./asymm. were not statistically significant. But, the differences in average age depending on the direction of asymmetry were significant. Patients with longer amygdaloidal complex on the left side are significantly younger, both male and female (related to the axial slice, ant. - post. diameter). Thus, we propose the application of MRI technique in examining the asymmetry of the amygdaloidal complex that we used in this assignment as a template for future examinations in a sense of shedding light on the anatomical functions that underlie neuro-psychiatric dysfunctions.