Anterior ischemic optic neuropathy comorbid with Factor V Leiden and PAI-1 4G/5G mutation

Acute anterior ischemic optic neuropathy (AION) is a disabling disease which impairs visual functions. AION is characterized by ischemic injury of the optic nerve caused by hypoperfusion in the short posterior ciliary arteries supplying the optic nerve head. AION is a complex multi-factorial disease and is difficult to diagnose based on clinical symptoms and signs alone. We describe the case of a 54-year-old patient affected by AION, with only known risk factors were PAI-1 4G/5G and Factor V Leiden mutation with hyperlipidaemia (Ref. 36). Full Text (Free, PDF) www.bmj.sk.

[Incidence of stroke in central Dalmatia during the war in the Republic of Croatia (1991-1995)]

INTRODUCTION AND METHOD

A retrospective study was made of the incidence of stroke in the Dalmatian region (Split) during the war in the Republic of Croatia (1991-1995), to determine whether the war had affected the incidence of stroke in the population at risk. The data obtained was compared with data regarding the incidence of strokes in the pre-war period (1986-1990).

RESULTS AND CONCLUSIONS

There was a small but significant increase in the incidence of strokes during the war period. There was also a considerable increase in patients with primary intracerebral hemorrhage during this period. The possible causes of this increase in patients with primary intracerebral hemorrhage are discussed.

Peripheral nerve war injuries

OBJECTIVE

The purpose of this study is to evaluate peripheral nerve war injuries sustained during the war in southern Croatia and Bosnia and Herzegovina.

PATIENTS AND METHODS

During the war in Croatia, 713 patients (99% male and 1% female) with wounds inflicted by firearms were examined at the Laboratory of Neurophysiology, University Hospital, Split. The patients, soldiers and civilians alike, ranged in age from 6 to 73 years (average, 28 years). All patients with firearm nerve war injuries underwent detection by electromyography and plurisegmental examination of the damaged peripheral nerve (neurography). The patients were examined and controlled on three occasions: within 2 months after wounding; up to 6 months after wounding; and more than 6 months after wounding.

RESULTS

Single peripheral nerve lesions were present in 80% of the patients, and multiple peripheral nerve or plexus lesions were present in 20% of the patients. Peroneal and ulnar nerves were most often involved (20.9% and 19.8%, respectively). Associated massive injuries to the muscles, large blood vessels, or vital organs were present in 45% of the patients. Wounds were inflicted by shell fragments in 80% of the patients and by projectiles in 20% of the patients.

CONCLUSION

According to our results, better recovery was achieved with conservative treatment and when physical therapy was initiated early with maximal patient cooperation. Electromyoneurographic findings were the most valid in the prognostic classification of war-inflicted peripheral nerve injuries.

Ciliated metaplasia in a patient of Mediterranean origin with gastric adenoma

We report here the first case of ciliated gastric metaplasia in a Croatian patient. This is also the first case of ciliated metaplasia reported in a patient of Mediterranean descent. Cilia were found in slightly cystically dilated gastric glands underneath a gastric adenoma with severe dysplasia. They were visualized by desmin immunohistochemical stain. Cells that presented with cilia were columnar cells, some of them with vacuolization of the cytoplasm. This case report shows that ciliated metaplasia occurs in patients of Southern European origin.

Identification of war victims from mass graves in Croatia, Bosnia, and Herzegovina by use of standard forensic methods and DNA typing

The postmortem remains of sixty-one war victims were excavated from 6 mass graves in Bosnia and Herzegovina one and a half years after interment Using standard identification methods, including the matching of medical and dental records, the recognition of distinguishing characteristics such as the use of clothing and belongings, and video superimposition, 35 persons were identified. For the remaining 26 persons identification efforts continue. DNA typing was performed at the HLA DQA1 locus and five PM system loci. Results from DNA typing were confirmed by other methods. DNA profiles of family members of 150 missing persons are now being developed using the 6 loci. These DNA profiles will then be compared with those generated from the bone and teeth remains of the unidentified victims.

Northern and southern Croatian population data on seven PCR-based loci

Northern and southern Croatian sample populations were typed at seven PCR-based loci -LDLR, GYPA, HBGG, D7S8, Gc, HLA-DQA1 and D1S80. The results show that all loci meet Hardy-Weinberg expectations and that there is little evidence for association of alleles between loci. Allelic frequency distributions at all loci, except HLA-DQA1, show no differences between the northern and southern Croatian sample populations. Moreover, the population data for Croatians are similar to U.S. Caucasians; only HLA-DQA1 for southern Croatians was statistically different compared with U.S. Caucasians. A Croatian population database(s) has been created and can be used for forensic analyses to estimate the frequency of a multiple locus DNA profile.

Splenic-gonadal fusion of the continuous type in an adult female

The first case of a continuous type splenic-gonadal fusion in an adult female is described. This extremely rare anomaly occurs more often in the male where the abnormality may be associated with skeletal abnormalities or cryptorchidism. The few cases of splenic-gonadal fusion in the female previously described were found mainly in infants. The present case of splenic-gonadal fusion occurred as a duct, approximately 10 cm long, extending from the inferior pole of the spleen to a junction in the left ovarian suspensory ligament. The superior two-thirds of this tubular structure consisted of splenic tissue, while the caudal one-third of the duct was composed of fat and fibrous tissue. In addition, two blood vessels, an artery and a vein, were present throughout the entire length of duct, and were located extracapsullary to the spleen in the cranial portion of this anomaly. The patient had no associated malformations in contrast to the majority of patients with continuous-type splenic-gonadal fusions.

Carcinoembryonic antigen immunoreactivity patterns in colorectal cancer: Correlation with morphologic parameters

The expression of carcinoembryonic antigen (CEA) was analyzed immunohistochemically in 100 colorectal cancer specimens. The tumors were divided into three groups, according to the predominant staining pattern which was either apical, cytoplasmic or stromal. CEA localization was apical in 26 cases, cytoplasmic in 48 and stromal in 26 cases. Overall, well differentiated tumors showed apical CEA, whereas the poorly differentiated tumors showed stromal staining. Significant correlation was noted between the CEA staining patterns and histological grading (P<0.001), nuclear grading (P<0.001), mucin synthesis (P<0.01), blood vessels, lymphatic vessels and peripheral nerve invasion (P<0.01), and lymph node metastasis (P<0.01). CEA staining pattern was not correlated with patients' age, sex or gross appearance of tumors and their site of origin, nor the Dukes' classificcation. It is concluded that the CEA immunoreactivity pattern may provide data that are relevant for the prognosis of the neoplastic disease.