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The aim of the study was to ascertain the existence of intestinal metaplasia in gastric mucosa of patients with gastric carcinoma coupled with H. pylori positive chronic atrophic gastritis and possible connection of IM with the development of gastric carcinoma. The paper presents prospective study that included 50 patients with gastric carcinoma and 50 patients with chronic atrophic H. pylori positive gastritis. All the patients were subjected to gastroscopy as well as biopsy targeted at antrum, lesser curvature and corpus and at the area 1-2 cm removed from tumor lesion. Biopsy samples were sliced by microtome and stained. We analyzed presence, frequency and severity of inflammatory-regenerative, metaplastic and dysplastic changes in the mucosa and evaluated their prognostic value. We typed IM immunohistochemically. This study confirmed responsibility of H. pylori for inflammatory events in gastric mucosa in patients with gastric carcinoma. According to our findings incomplete IM of types IIa and IIb as precancerous lesion is responsible for the development of gastric carcinoma and is associated with chronic atrophic gastritis grade I and II (92% of subjects, p=0.0097, h=1, p=0.01). Thus, the finding of incomplete intestinal metaplasia may be used as an indicator for early gastric carcinoma detection. Patients with patho-histologically verified incomplete intestinal metaplasia associated with active chronic atrophic gastritis of levels I and II represent risk group for the development of gastric carcinoma of intestinal type.

E. Kučukalić-Selimović, A. Skopljak-Beganović, N. Bešlić, A. Begić, Sadžida Begović-Hadžimuratović, Zdenka Drazeta

Ionizing radiation has many practical applications, but it is also, as it is well known, dangerous to human health. The purpose of this study was to estimate the dose and exposure for medical staff involved in sentinel node assay and to determine how safe this assay really is. The theoretical method was used for calculation. Three groups of medical staff were selected: nuclear medicine specialist, nuclear medicine technologist and a surgeon. The results obtained show that the most exposed staff member is nuclear medicine specialist and that dose received by the surgeon is smaller then the dose limit.

Pineal gland has and antistressogenic role. Its main hormone, melatonin, has radio protective effect on endocrine and other dynamic tissues. In our previous study, we have shown that pinealectomy changes the behavior of suprarenal gland in totally irradiated rats. The aim of this study is to evaluate the effect of exogenous melatonin on suprarenal gland of rats with or without pineal gland. Four months after pinealectomy (experimental group) or shampinealectomy (control group), adult Wistar male rats were daily treated with 0,2 mg of melatonin intraperitoneally, during two weeks. Thereafter, all animals were totally irradiated with 8 Gy of Gamma rays produced from Cobalt 60. Animals who survived were sacrificed on the 17(th) post irradiation day. Qualitative and quantitative characteristics of the suprarenal gland were studied using histological methods. The results show that exogenous melatonin had protective role on suprarenal gland in totally irradiated rats and that those effects were more pronounced in the presence of pineal gland.

A. Hasanović, A. Kulenović, F. Sisić

The coronary collateral circulation is an alternative source of blood supply to the myocardium jeopardized by the failure of the original stenotic or occluded vessel to provide adequate blood flow to this region. One hundred coronary angiograms and left ventriculograms of patients with coronary artery disease from the Cardiology Department of University Clinics Centre in Sarajevo were reviewed. The role of collateral circulation in preserving myocardial function was assessed by comparing regional left ventricular contractility in 34 instances of total arterial occlusion and adequate colateral circulation with that in 34 instances of total arterial occlusion and inadequate collateral circulation. Among the group with adequate collaterals, regional left ventricular contraction was normal in 41%, hypokinetic in 53% and akinetic or dyskinetic in only 5%. Among the group with inadequate collaterals, regional contraction was normal in 9%, hypokinetic in 20 % and akinetic or dyskinetic in 70%. These data indicate that collateral circulation plays an important role in preserving myocardial contractility in patients with coronary artery disease.

During the 1992-1995 siege, as well as after the war activities, citizens of Sarajevo were most probably exposed to various potential genotoxic agents. The effects of those potential genotoxins were evaluated by micronucleus-cytokinesis blocked assay. The study included 30 individuals who resided in the area of Sarajevo during the war and the postwar period. Point bi-serial coefficient analysis did not reveal any relationship between the frequencies of binuclear cells with micronuclei as well as total number of micronuclei and smoking habits or gender. Simple linear regression revealed statistically significant positive correlation between the age and micronuclei formation. Due to the war related environmental contamination more extensive study is recommended.

Z. Godinjak, E. Idrizbegović, K. Begić

Following the abdominal surgery, extensive adhesions often occur and they can cause difficulties during laparoscopic operations. However, previous laparotomy is not considered to be a contraindication for laparoscopy. The aim of this study is to present that an insertion of Veres needle in the region of umbilicus is a safe method for creating a pneumoperitoneum for laparoscopic operations after previous laparotomy. In the last three years, we have performed 144 laparoscopic operations in patients that previously underwent one or two laparotomies. Pathology of digestive system, genital organs, Cesarean Section or abdominal war injuries were the most common causes of previous laparotomy. During those operations or during entering into abdominal cavity we have not experienced any complications, while in 7 patients we performed conversion to laparotomy following the diagnostic laparoscopy. In all patients an insertion of Veres needle and trocar insertion in the umbilical region was performed, namely a technique of closed laparoscopy. Not even in one patient adhesions in the region of umbilicus were found, and no abdominal organs were injured.

R. Jadrić, S. Hasić, E. Kiseljaković, J. Radovanović, E. Ićindić-Nakas, M. Winterhalter-Jadrić

The aim of our study was to establish the influence of antidepressive drugs on serum and brain beta-endorphins in experimental animals. Experiment was performed on albino Wistar rats. Antidepressant amitryptiline was used, and for quantification of sera and brain beta-endorphins RIA technique. Our results showed difference between sera and brain beta-endorphins concentration in amitryptiline pretreated animals, vs. those in serum and brain of control group treated with 0.95% NaCl. This study shows that use of psychoactive drugs have influence on sera and brain beta-endorphins concentration. Beta-endorphins could be of great importance, used as markers for evaluation of antidepressant drug effects.

A. Suljak-Loncarević, Muhamed Ajanović

Anatomically and functionally, temporomandibular joint (articulatio temporomandibularis) is specific, It consists of incongruent joint surface. The size of mandibular joint surface and its position in relation to facies articularis fossae mandibularis in different positions of mandibulae (central occlusion, central relation) are still subject to the interest of prosthetics. The aim of the research is measuring the lower joint surface by special 3D device that enables acribic precise measuring. Macerated human skulls, property of the Anatomy Institute, Faculty of Medicine, University Sarajevo, were used for the research that has been carried out. Results of measuring of articulating surface caput mandibulae along longer axis (mediolateral diameter) indicate that there are no differences in size of this surface between right and left joints. Results of measuring of articulating surface caput mandibulae along shorter axis (anteroposterior diameter) indicate differences in values of this diameter between right and left sides. Judging by statistical evaluation, differences are highly significant on the level of probability p<0.01. The research has shown differences in the size of this joint surface, on right and left sides, but only in antero-posterior direction. This original scientific work will help better of relationship of TMJ surfaces, what is necessary for treatment of TMD and occlusal imbalances.

D. Nikšić, Amira Kurspahić-Mujicić, A. Pilav, H. Nikšić

Considering that a register for cancer was established in Federation of Bosnia and Herzegovina only recently, basic reliable source for the analysis of cancer mortality trends are the data on death cases caused by such diseases. Lack of census as well as standardized mortality rate data makes the study even more difficult to make. The aim of the study is the analysis of the malign diseases trend in the post-war period according to the available data. The study is the descriptive work on the analysis of the system using linear regression methods for expected trend for the total population and age group from 0 to 64 years. Registered rate of cancer mortality in Federation of Bosnia and Herzegovina in 2004 was 142 per 100000 inhabitants, and indicates input stream in the analyzed period. Total increase in mortality of males and females is 2.5% per year. It is expected that in 2020 around 5000 inhabitants of Federation of Bosnia and Herzegovina will die of some malign disease. Trend of mortality of malign diseases in males is higher than in females and more probable in older population. There is a tendency of mortality decrease in the group of 0-64 years of age. Mortality list of the most frequent locations of cancer has undergone changes. Liver cancer, colon cancer, sigma and rectum cancer as well as lung and breast cancer lead the list. Objective ageing of the population, technological drawbacks, insufficient primary and secondary prevention worsened by socio-economic life conditions will affect the increase in number of people with malign diseases in Bosnia and Herzegovina.

I. Vucković, F. Dilberović, A. Kulenović, Kucuk-Alija Divanović, Alma Voljevica, Eldan Kapur

The blockade of peripheral nerves carries a certain risk of unwanted complications, which can follow after unintentional intraneural injection of a local anesthetic. Up till today, the research of measuring injection pressure has been based on animal models, even though the histological structure of periphery nerve is different for animal and human population, so the application pressure which presages intraneural injection in human population is still unknown. As material in performing this study there have been used 12 Wistar rats and 12 delivered stillborns. After bilateral access to the median nerve, we applied 3 ml of 2% lidocaine with epinephrine, with the help of automatic syringe charger. The needle was at first placed perineural on one side, and then intraneural on the other side of both examination groups. During every application the pressure values were monitored using the manometer, and then they were analyzed by special software program BioBench. All perineural injections resulted with the pressure < or = 27.92 kPa, while the majority of intraneural injections were combined with the injection pressure > or = 69.8 kPa. The difference between intraneural and perineural injection pressures for the two different examination groups (rats and delivered stillborns) was not statistically significant (P>0.05). As prevention from intraneural injections today are in use two methods: the method of causing paresthesia or the method of using the peripheral nerve stimulator. However the nerve injury can still occur, independent from the technique used. If our results are used in clinical practice on human population, than the high injection pressure could be the marker of intraneural lodging of a needle.

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