Epidemiological characteristics of surgically treated civilian traumatic brachial plexus injuries in Serbia

BACKGROUND

Traumatic brachial plexus injuries are generally severe, and in many cases associated with surrounding tissue injuries, which makes them hard to diagnose at the right time. This paper presents etiological and epidemiological characteristics of surgically treated civilian traumatic brachial plexus injuries.

METHODS

This retrospective study included 68 patients, operated due to the traumatic brachial plexus injuries at Clinic for Neurosurgery, Clinical Center of Serbia, during the 11-year period.

RESULTS

The vast majority of injured patients were men in full working maturity. In our study, there were seven different etiological factors. The road traffic accidents were the most common-41 (60.3%), while the motorcycle accidents were the most dominant subtype (53.7%) of all road traffic accidents, and also representing 32.4% of all causes of trauma. Supraclavicular elements of the brachial plexus were injured in more than 80% of patients. A total of 49 (72.1%) patients from our study had one or more associated injuries. The most common associated injuries were bone fractures, brain contusions, and vascular injuries.

CONCLUSION

Although rare, non-war-related severe brachial plexus injuries represent a group of patients carrying high risk of insufficient functional recovery regardless of treatment modality, or surgical technique. Epidemiological and etiological data are therefore very important to identify the groups in risk and to induce preventive actions aimed at these patients.

Real-time chest-wall-motion tracking by a single optical fibre grating: a prospective method for ventilator triggering

OBJECTIVE

The ventilators involved in non-invasive mechanical ventilation commonly provide ventilator support via a facemask. The interface of the mask with a patient promotes air leaks that cause errors in the feedback information provided by a pneumatic sensor and hence patient-ventilator asynchrony with multiple negative consequences. Our objective is to test the possibility of using chest-wall motion measured by an optical fibre-grating sensor as a more accurate non-invasive ventilator triggering mechanism.

APPROACH

The basic premise of our approach is that the measurement accuracy can be improved by using a triggering signal that precedes pneumatic triggering in the neuro-ventilatory coupling sequence. We propose a technique that uses the measurement of chest-wall curvature by a long-period fibre-grating sensor. The sensor was applied externally to the rib-cage and interrogated in the lateral (edge) filtering scheme. The study was performed on 34 healthy volunteers. Statistical data analysis of the time lag between the fibre-grating sensor and the reference pneumotachograph was preceded by the removal of the unwanted heartbeat signal by wavelet transform processing.

MAIN RESULTS

The results show a consistent fibre-grating signal advance with respect to the standard pneumatic signal by (230  ±  100) ms in both the inspiratory and expiratory phases. We further show that heart activity removal yields a tremendous improvement in sensor accuracy by reducing it from 60 ml to 0.3 ml.

SIGNIFICANCE

The results indicate that the proposed measurement technique may lead to a more reliable triggering decision. Its imperviousness to air leaks, non-invasiveness, low-cost and ease of implementation offer good prospects for applications in both clinical and homecare ventilation.

The frequency, characteristics and outcome of infections in patients with acute nonlymphoblastic leukemias

A retrospective study was conducted in 91 patients treated at the Clinic of Hematology in Novi Sad in the period January 1, 1994,-November 15, 1997. The frequency, types, characteristics and outcome of infections were examined. The causative microorganism was determined in 65% of 133 febrile episodes, in 55% Gram-negative bacteria, 39% Gram-positive bacteria and in 6% fungi. Gram-negative bacteria were causative microorganisms in 80% of pneumonia. 77% of skin infections and 93% of urinary infections. Gram-positive bacteria were causative microorganisms in 53% of sepsis, Gram-negative in 41% of sepsis and Candida in 6%. The significant resistance to antibiotics was present in 47% of Gram-negative sepsis (causative microorganisms were Pseudomonas aeruginosa and Acinetobacter species) and in 18% of Gram-positive sepsis (susceptibility to imipenem only in Gram-negative sepsis and susceptibility to vankomycin in Gram-positive sepsis). Infections were the cause of death in 62.8% of patients.

[Modern treatment of leukemia and hematopoietic stem cell transplantation]

The paper presents the possibilities of contemporary treatment of acute and chronic leukemia that have been based on new knowledge and experience we have gathered through clinical and scientific work. Contemporary treatment of leukemia is very complex and requires the application of cytostatics, biological therapy and transplantation of hematopoietic stem cells. The treatment of acute leukemia by cytostatics and induction protocols results in a rather high percentage of remissions, but unfortunately most of them cannot be preserved. Allogenic transplantation of hematopoietic stem cells from bone marrow or peripheral blood have given the best results in the treatment of acute and chronic leukemia. Anti-leukemic effect is bound to the previous chemoradiotherapy, particularly to the activity of donor's immunocompetent cells in the transplant, having an effect of a graft against leukemia. The cleansing of the autograft and isolation of stem cells together with the application of IL-2 will be a significant improvement of the efficacy of autologous transplantation in leukemia. It is realistic to expect that the treatment of malignant diseases such as leukemia will in near future, besides the already existing treatment methods, include molecular therapy at various cell levels, which will make possible a correction of the basic disorder in the process of malignant alteration of hematopoietic cells.

Novel DNA-binding protein from Drosophila embryos identified by binding site selection

The DNA sequence C/AGAGCGC/AGA, related to binding sites for GAF and Zeste transcription factors, was selected from a pool of degenerate PCR fragments for binding to the cytoplasmic protein of Drosophila preblastoderm embryos. Identical DNA binding activity was also detected in embryonic nuclei. Based on several criteria, such as size, intracellular distribution, sensitivity to ATP and protein kinase inhibitor 6-DMAP, kinetics during development and lack of cross-reaction with rabbit anti-GAF serum, protein recognizing selected sequence was shown to differ from either Zeste or GAF.

Frequency of the delta F508 deletion and G551D, R553X and G542X mutations in Yugoslav CF patients

A study was undertaken to find the frequency of the delta F508 deletion and those of the G551D, R553X and G524X mutations among the mainly Slavic population of Serbia, Bosnia, Herzegovina, and Montenegro and compare the frequencies determined with those in other European populations. The delta F508 mutation was found to account for about 70% of CF genes in central Jugoslavia, where its frequency is significantly higher than elsewhere in Southern European populations.

Sequencing data on the long control region of human papillomavirus type 16

A one base change (adenine at position 7861) in the long control region (LCR) of the prototype sequence of human papillomavirus type 16 was reported. With this correction, a new E2-binding site was revealed, 111 bp and 143 bp upstream from the TATA box and P97, respectively, and 105 bp downstream of the keratinocyte-dependent enhancer. An A to C mutation at position 41 was found in a patient with invasive carcinoma. This mutation falls within an E2-binding site.

Curved DNA without AA/TT dinucleotide step

The evidence is accumulating that dinucleotide steps other than AA/TT affect DNA flexure of AnTm (m + n greater than = 4) containing fragments. However, it is not clear whether macroscopic DNA flexure without AA/TT steps might occur. In this paper we demonstrate the anomaly in electrophoretic mobility of non AA/TT repetitive DNA sequences which is a function of sequence phasing. Therefore, our results show that PyPu (TA) and AG/CT steps, angulary separated by close to 180 degrees from Pu/Py (GC) and GG/CC steps, bend DNA, even in the absence of AnTm tracts.

[Malacoplakia of the kidney]

Malakoplakia is a rare disease expressed as a special type of inflammatory reaction to infection with various bacteria and fungi. This unusual response is based on defective function of the macrophage system. In malakoplakia infiltrates, most cells are macrophages mixed with lymphocytes, plasma cells and fibroblasts. The macrophages (von Hansemann's histiocytes) with intracytoplasmatic inclusions defined as Micaelis-Guttmann bodies are pathognomonic histological findings. The clinical manifestation of the disease depends on the localisation of lesions, most often in the urinary bladder and the kidney. The authors present a case of renal malakoplakia of in a 32-year-old female patient. The symptoms were not enough characteristic for making the true diagnosis. The diagnosis of malakoplakia was established during autopsy. The histopathological examination revealed von Hansemann's histiocytes and Michaelis-Guttmann bodies in malakoplakia infiltrates.

Alterations in chromatin structure during early sea urchin embryogenesis

Sea urchin sperm before fertilization possess the longest nucleosome repeat length yet determined for any chromatin. By the time the fertilized egg gives rise to a blastula or gastrula embryo, the chromatin has a considerably shorter repeat length and, in addition, a sequence of different histone variants of H1, H2A, and H2B has appeared. We have investigated the relationship between these variations in histone composition and concomitant alterations in chromatin structure during the earliest stages of embryogenesis in two species of sea urchin. In contrast to the long repeat distance in sperm, chromatin loaded with cleavage stage histones has a much smaller repeat. Later stages containing predominantly alpha histones display an intermediate spacing. More detailed analysis of the events in the first cell cycle was carried out with polyspermically fertilized eggs. During the first 30 min after fertilization, in which sperm-specific H1 is completely replaced by cleavage-stage H1, the male pronuclear repeat remains unchanged. The decrease toward the repeat length of cleavage stages begins at about the time of DNA synthesis. Higher degrees of polyspermy extend the length of the cell cycle, including the duration of S phase and the length of time to reach the first chromosome condensation. At these higher degrees of polyspermy, the decrease in repeat length is also slowed. We conclude that the adjustment of the arrangement of nucleosomes in embryonic chromatin from that found in sperm can occur within the first cell cycle and that its timing is cell-cycle dependent. The adjustment is separable from a corresponding change in H1 composition.