Loss of heterozygosity of DPC4 tumor suppressor gene in human sporadic colon cancer

We investigated the prevalence of DPC4 loss of heterozygosity in sporadic colorectal cancer. Thirty-six cases of human sporadic colon carcinoma and corresponding normal tissue samples were examined to evaluate loss of heterozygosity at the DPC4 tumor suppressor locus using variable nucleotide tandem repeat (VNTR) analysis and three polymorphic markers. From 36 analyzed samples 35 (97%) were heterozygous or informative. Loss of heterozygosity at the DPC4 locus was detected in 18 (51%) of informative tumor DNAs. The DPC4 LOH was more frequent in smaller tumors (<5 cm) than in larger ones. There was no correlation between DPC4 LOH and age or sex of patients. There was a negative correlation between DPC4 LOH and histological grade or Dukes' stage of tumors, but without statistic significance. Observed results are in agreement with the view that malignant progression is consequence of many genetic changes. It can be concluded that inactivation of the DPC4 gene plays a role in a multistep process of outgrowth and progression of colon cancer.     

Supplementation of EPA and DHA in pregnant women with type 1 diabetes mellitus

Background/objectiveLower proportions of n-3 PUFAs have been observed in neonates born to diabetic mothers. We aimed to investigate the association between DHA and EPA supplementation during pregnancy complicated with type 1 diabetes on concentration and proportion of fatty acids in maternal and foetal blood.Subjects and methodsWe conducted a prospective randomized, single-blinded, placebo-controlled trial of 111 eligible pregnant women with type 1 diabetes and presented the results of 84 (intervention arm and control arm comprised 42 participants each) of them who successfully finished the trial in an academic hospital. The initiation of EPA and DHA supplementation or placebo started at randomization visit on gestational week 11–12. Blood samples were taken on the first (screening) visit to the clinic (1st trimester, between 8th and 10th gestational week, GW), then in the second trimester (19–24th GW) and third trimester (30th–33rd GW). On the delivery day, a blood sample was taken on fasting just before birth. The umbilical vein blood sample was taken shortly after the delivery.ResultsWe found a significant increase in the intervention group when compared the first and the third trimester for n-3 PUFAs concentration, 4.3 mg/L (3.3–7.6): 10.0 mg/L (7.1–13.7), p < .001. In the intervention group, the concentration of DHA in maternal vein serum was 11.4 mg/L (7.7–17.5), and in umbilical vein serum, it was 5.1 mg/L (3.0–7.7), which was significantly higher than that in the control group, maternal vein serum: median 9.2 mg/L(6.0–12.3), p = .03 and umbilical vein serum: median 3.4 mg/L (2.1–5.6), p = .009.ConclusionThe increased weight gain in pregnancy and concentration and proportions of DHA, n-3 PUFAs with a decreased proportion of AA, n-6 PUFAs, and AA/DHA ratio in maternal and umbilical vein serum summarize the effect of supplementation with EPA and DHA.     

Treating patients with HIV and Hepatitis B and C infections: Croatian dental students' knowledge, attitudes, and risk perceptions

Dentists and dental students can be exposed to the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) during routine work. The aims of this study were to assess a group of dental students' knowledge about HIV, HBV, and HCV infections; assess their attitudes and risk perceptions about the treatment of patients with HIV, HBV, and HCV; and identify factors associated with their knowledge and willingness to treat these patients. An anonymous survey was administered to 534 predoctoral students at the School of Dental Medicine, University of Zagreb, Croatia. The response rate was 71.9 percent. Students' knowledge increased with each year of study. Senior students (in their third, fourth, and fifth years) had more professional attitudes and were significantly more positive about dentists' professional obligation to treat patients who are HIV-positive than were junior students (in their first and second years; p=0.0002). Senior students also expressed significantly more willingness to treat intravenous drug users and patients with hepatitis (p=0.016 and p=0.033, respectively). Female students were significantly more convinced than male students that routine dental treatment carried a significant risk of HIV and hepatitis infection (p=0.025). These students' knowledge negatively correlated with the lack of willingness to treat intravenous drug users and patients with hepatitis, and they expressed their willingness to receive further theoretical and practical education on this topic.     

Lymphocele and renal transplantation

Lymphoceles are a well-known surgical complication of kidney transplantation. We retrospectively analyzed patients with lymphoceles among our renal transplant recipients. During the last 39 years, we performed 922 renal transplantations. Lymphoceles were diagnosed and treated in 45 (4.9%) patients. We used the following methods: percutaneous drainage with instillation of povidone-iodide in 36 (80%), percutaneous drainage with instillation of tetracycline in one (2.2%), percutaneous aspiration in four (8.9%) and surgical treatment in four (8.9%) patients. In all four (8.9%) patients with relapse, secondary procedure was successful. In total, open surgery was done in five (11.1%) and laparoscopy in four (8.9%) patients. Percutaneous drainage of lymphoceles, with or without the instillation of a sclerosant, is the first-line treatment. Laparoscopic fenestration of lymphoceles has become an alternative to percutaneous drainage, especially in case of post-drainage relapse.     

Cross-sectional biomonitoring of metals in adult populations in post-war eastern Croatia: differences between areas of moderate and heavy combat

Aim

To determine differences in metal and metalloid exposure between residents of areas in eastern Croatia exposed to heavy fighting during the war in Croatia and residents of areas exposed to moderate fighting.

Methods

Concentrations of aluminum (Al), arsenic (As), barium (Ba), cadmium (Cd), chromium (Cr), copper (Cu), iron (Fe), nickel (Ni), lead (Pb), uranium (U), vanadium (V), and zinc (Zn), reported to be associated with military operations, were determined in hair, serum, and urine samples using inductively-coupled plasma mass spectroscopy. A total of 127 and 46 participants from areas of heavy and moderate fighting, respectively, were included.

Results

Compared with participants from areas exposed to moderate fighting, participants from areas exposed to heavy fighting had significantly higher serum concentrations of Al (87.61 vs 42.75 μg/L, P = 0.007), As (5.05 ± 1.79 vs 4.16 ± 1.55 μg/L, P = 0.003), Ba (7.12 vs 6.01 μg/L, P = 0.044), and V (17.98 vs 16.84 μg/L, P = 0.008); significantly higher urine concentrations of As (43.90 vs 11.51 μg/L, P < 0.001) and Cd (0.67 vs 0.50 μg/L, P = 0.031); and significantly higher hair concentrations of Al (12.61 vs 7.33 μg/L, P < 0.001), As (0.32 vs 0.05 μg/L, P < 0.001), Cd (0.03 vs 0.02 μg/L, P = 0.002), Fe (22.58 vs 12.68 μg/L, P = 0.001), Pb (1.04 vs 0.69 μg/L, P = 0.006), and V (0.07 vs 0.03 μg/L, P < 0.001).

Conclusion

Differences between populations from eastern Croatian areas exposed to heavy and populations exposed to moderate fighting point to the need for extensive monitoring of metal and metalloid exposure, emphasizing the role of biomonitoring through ecologic and preventive activities.Until recently, in Croatia only food and water have been analyzed for the presence of heavy metals and other toxic elements (1-5). These studies revealed higher than allowable concentrations of toxic metals/metalloid like arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) in food products originating from different Croatian counties, in freshwater fish and brassicas from the Zagreb area, and As, Cd, copper (Cu), chromium (Cr), iron (Fe), radium (Ra), uranium (U), and vanadium (V) in water wells in Osijek urban and rural area, which pointed to the need for metal exposure biomonitoring. Such biomonitoring offers an opportunity to define and evaluate the population groups at high exposure and to develop strategies to reduce future exposure (6).In addition, heavy fighting that took place in Croatia from 1991 to 1995 possibly exposed populations in these areas to excess levels of metals. This points to the need of conducting comprehensive research in order to understand possible long-term consequences of war on population health. Evidence suggests that military action can contaminate the environment with metals (7). Also, lead exposure in professional firearm instructors has been linked to their work with firearms (8,9). Nevertheless, few studies have directly examined long-term effects of metal contamination in the environment following military activity.Combat activities during the 1991-1995 war in Croatia were most intensive in the eastern part of the country, causing heavy casualties and destruction. The environmental consequences of these military operations have not been well studied (10). The establishment of a military defense headquarters in the eastern Croatian city of Osijek was associated with continuous direct exposure of soldiers and civilians to explosive devices and various contaminants, metals in particular (11,12). Indeed, the predominant use of mines and explosive devices during the 1991-1992 war period points to the need of identifying the long-term health effects in soldiers and civilians wounded by these devices (13). The possible association of carcinogenesis with metals and metal alloys used in modern weaponry has been examined in a few studies (14-16). Aluminum (Al), Cd, Cu, and Pb are associated with bombs, Cu with automatic small weapons, and Al, As, Ba, Cd, Cr, Cu, Fe, Ni, Pb, U, V, and Zn with tank shells (7). Epidemiological studies in occupationally exposed humans, mostly retrospective, have demonstrated that As, Cd, Cr, Ni, and Pb are carcinogens. Exposure to compounds of these metals has been shown to correlate with increased incidences of cancer, such as lung cancer (As, Cr, Ni, Pb), skin cancer, bladder cancer, and cancer of lymphatic and hematopoietic systems (As), prostate cancer (Cd), cancer of the nasal sinuses (Ni), and stomach cancer (Pb). Other weapons-related metals (V, Fe) have been classified as possible carcinogens. In addition, excessive exposure to some metals has been clearly linked to specific conditions like renal intoxication, hypertension, cardiac malfunction (Ba), and liver and kidney damage (Cu). In the case of Zn and U, little or no evidence exists of adverse effect on humans (17,18).Studies performed in Croatia have suggested a connection between metal exposure and 1991-1995 war actions. Metal monitoring in the Drava river, which has been regularly conducted since 1976, showed that concentrations of Pb, Cd, and Hg increased in the river water during the war period (19). A study performed in 2002 in Baranja, found the concentrations of these three metals in deer kidney samples to be far above the allowed levels, especially in older animals (20).The aim of our study, designed to be scaled up in the future, was to determine levels of metals and metalloid As derived from explosive devices in adult populations in former combat areas of eastern Croatia, and to compare the levels measured in areas of heavy and moderate fighting.     

Neurogenic muscle hypertrophy in a 12-year-old girl

Muscular hypertrophy secondary to denervation is very rare, but well-documented phenomena in adults. This is the first report of a child with neurogenic unilateral hypertrophy due to S1 radiculopathy. A 12-year-old girl presented with left calf hypertrophy and negative history of low back pain or trauma. The serum creatinine kinase level and inflammatory markers were normal. Magnetic resonance imaging showed muscle hypertrophy of the left gastrocnemius and revealed a protruded lumbar disc at the L5-S1 level. The protruded disc abuts the S1 root on the left side. Electromyography showed mild left S1 radiculopathy. Passive stretching and work load might clarify the origin of neurogenic hypertrophy but there is still a need for further evidence. Clinical, laboratory, magnetic resonance imaging and electromyography findings showed that S1 radiculopathy could be a cause of unilateral calf swelling in youth even in the absence of a history of back or leg pain.     

Profile Changes Following Maxillary Impaction and Autorotation of the Mandible

OBJECTIVE: The aim of this study was the evaluation and prediction of profile changes after Le Fort I osteotomy including maxillary impaction and subsequent autorotation of the mandible. MATERIALS AND METHODS: A group of 42 patients (32 female, 10 male) underwent a Le Fort I osteotomy with posterior impaction after preoperative orthodontic treatment. No surgical intervention in the mandible was performed. Pre- and postoperative lateral cephalograms of each patient were analyzed in two steps using the Wilcoxon and Mann-Whitney U test. All patients were evaluated for vertical and sagittal skeletal and soft tissue changes. These results led to further classification into three groups according to the type and extent of maxillary impaction. These groups included parallel impaction, posterior impaction with additional anterior subsidence, and posterior impaction only. RESULTS: The results of the first evaluation step revealed that the chin had advanced on average by 79%, while the lower face was shortened by as much as 70% in the pogonion point. However, the second evaluation showed that the type and extent of maxillary impaction led to significant changes in these parameters. Parallel maxillary impaction resulted in 100%, posterior impaction in 80% and posterior impaction with anterior subsidence in 50% advancement of the mandible in the pogonion point in relation to the distance covered during impaction. CONCLUSION: This study showed that the change in the facial profile caused by autorotation of the mandible after Le Fort I osteotomy and maxillary impaction can be predicted in relation to the dimensions of maxillary impaction.