A Case Report of Spontaneous Concurrent Bilateral Rupture of the Quadriceps Tendons in a Patient With Chronic Renal Failure

In patients with chronic renal failure, many complications may develop that involve all organ systems, especially the locomotor system. Spontaneous concurrent bilateral rupture of the quadriceps tendons is a very rare complication in patients with chronic renal failure, usually occurring in patients under 50 years of age. Although there are numerous causes that lead to tendon weakness and rupture, most authors agree that secondary hyperparathyroidism plays a major role in the pathogenesis of tendon rupture. Soft tissue and perivascular calcifications, diminished local circulation, reduced tendon elasticity, impaired collagen metabolism, nerve lesions, repeated trauma, and articular swelling contribute to tendon weakness and rupture. A patient is presented in whom spontaneous concurrent bilateral quadriceps tendon rupture occurred at the age of 34, after seven years of hemodialysis therapy. Timely diagnosis and operative management with primary tendon suturing followed by physiotherapy produced a good anatomical and functional result.     

Increased expression of CXCR3 and CCR5 on memory CD4+ T-cells migrating into the cerebrospinal fluid of patients with neuroborreliosis: the role of CXCL10 and CXCL11

The aim of this study was to evaluate the contribution of chemokine receptor CXCR3 and the corresponding ligands CXCL10 and CXCL11 to the recruitment of peripheral blood (PB) memory CD4+ T-cells into the cerebrospinal fluid (CSF) of patients with acute neuroborreliosis. Percentages of memory CD45RO+CD4+ T-cells expressing CXCR3 and CCR5 were significantly enriched in the CSF compared to the PB. Concentrations of CXCL10 and CXCL11 in the CSF of neuroborreliosis patients were significantly higher compared with the corresponding serum samples. Our results suggest that CXCL10 and CXCL11 create a chemokine gradient between the CSF and serum and recruite CXCR3-expressing memory CD4+ T-cells into the CSF of neuroborreliosis patients and that CCR5 also plays a role in this process.     

Children of parents with bipolar disorder. A population at high risk for major affective disorders

Children of parents who suffer from bipolar disorder are largely ignored by psychiatric services despite the fact that they constitute a population at very high risk for major depression and bipolar disorder in adulthood and a wide variety of disorders in childhood and adolescence. Major depression and bipolar disorder are chronic, recurrent disorders that seriously impair psychosocial functioning across the life-span. Evidence suggests that in this population bipolar disorder is preceded by externalizing disorders in childhood in many cases, and by depression in some cases. While heredity provides the vulnerability for the development of these characteristics, being raised by parents who model inappropriate coping skills, create a stressful family environment, and provide inadequate support and structure, contribute to consolidating these characteristics.     

Distinguishing late-onset stress symptomatology from posttraumatic stress disorder in older combat veterans

Objective: To assess the discriminant validity of late-onset stress symptomatology (LOSS) in terms of its distinction from posttraumatic stress disorder (PTSD).

Method: The LOSS Scale, PTSD Checklist – Civilian Version, and related psychological measures were administered to 562 older male combat veterans via a mailed questionnaire. Analyses focused on: (a) comparing associations of LOSS and PTSD with other psychological variables and (b) examining a hypothesized curvilinear relationship between LOSS and PTSD scores.

Results: Compared to PTSD, LOSS was more strongly associated with concerns about retirement and less strongly associated with depression, anxiety, sense of mastery, and satisfaction with life. LOSS also demonstrated a curvilinear relationship with PTSD, such that the positive association between LOSS and PTSD diminished at higher levels of PTSD.

Conclusion: LOSS is conceptually and statistically more strongly associated with a normative late-life stressor than is PTSD, but is less strongly related to mental health symptoms and emotional well-being. Additionally, LOSS seems more related to subthreshold PTSD than it is to clinically significant PTSD. The present findings support the discriminant validity of LOSS.     

How we developed,at the Centre/Institute for Neuromuscular Diseases,differential diagnostics of Spinal Muscle Atrophies / Amyotrophic Lateral Sclerosis (SMA/ALS) and tried to influence the development of the disease

In our research, we placed the emphasis on delimiting fatal diseases against those that have some similar symptoms, but can be improved, even completely cured. More often we succeeded in differentiating the local compressive factor. In our search for early symptoms, we also found physiological, although quite unusual EMG phenomena. High amplitude neural potentials confirmed the malignant disease diagnosis. The spinal angiography discovered arterial pathology, while CT demonstrated localised hydromyelia. Amyotrophic syndromes caused by chronic led intoxications represented a separate group. Patients would recover significantly on d-penicillamine. We applied it successfully in amyotrophic syndromes with laboratory confirmed copper metabolism disorders. A very significant therapeutic effect was obtained in a patient with SMA without similar laboratory, even in recidivism. Exceptionally, we were able to achieve significant remission with corticosteroids, too. The remaining patients, differentiated as certainly fatal, represented a separate group. We tried to elaborate the special psychosocial and ethical problems connected with its outcome in "round table discussions". The first one was in 1989, at the workshop with King Engel, and the second in 1990, on the Fourth Yugoslav Symposium on Neuromuscular Diseases. In 1990, I visited Cicely Saunders and the St. Christopher''s hospice in London, and in 1994 I started to organised hospice movement in Croatia.Key words: amyotrophic syndromes, d-penicillamine, Hospice Movement in Croatia     

Evaluation of radioprotective effects of propolis and its flavonoid constituents: in vitro study on human white blood cells

This in vitro study aimed to evaluate the possible radioprotective effects of the natural substances WSDP, caffeic acid, chrysin and naringin on γ‐irradiated human white blood cells. The effectiveness of tested compounds was evaluated using the alkaline comet assay, the analysis of structural chromosome aberration and the cytokinesis‐block micronucleus assay. The results obtained by the alkaline comet study indicate favourable toxicity profiles of propolis and its polyphenolic components, and confirmed the radioprotective abilities comparable to the chemical radioprotector AET. WSDP and its polyphenolic components were able to reduce the number of necrotic cells. None of tested compounds induced significant genotoxicity, but all of them offered a quite measurable protection against DNA damage. WSDP was found to be the most effective in diminishing the levels of primary and more complex cytogenetic DNA damage in white blood cells. Considering its complex composition, to undoubtedly explain the underlying mechanisms of cyto/radioprotective effects, further studies are needed. Copyright © 2009 John Wiley & Sons, Ltd.     

Short exposures to tunicamycin induce apoptosis in SV40-transformed but not in normal human fibroblasts

When SV40-transformed fibroblasts (line 90VAVI) were exposedto tunicamycin, an inhibitor of N-linked glycosylation, an extensivecell death occured compared with untransformed fibroblasts.A considerable cell loss was obtained within 24 h after tunicamycinaddition, and after 72 h there were hardly any virus-transformedcells alive. A 2-h pulse treatment with tunicamycin was foundto be almost as effective as a continuous 48-h treatment inkilling the cells. Even such a short exposure as 7 min resultedin a drastically decreased cell viability (54%). The morphologyof the dying tunicamycin-treated 90VAVI cells suggested thatthey were undergoing apoptosis. This was also supported by theappearance of nuclear condensation, as assayed by propidiumiodide uptake, which was detectable within 2 h after tunicamycinaddition. Furthermore, analysis of DNA from tunicamycin-treated90VAVI cells by field inversion gel electrophoresis revealedDNA degradation into 50 kbp fragments within 2 h, and conventionalagarose gel electrophoresis showed ‘DNA laddering’,indicating internucleosomal DNA cleavage, detectable after 36h. Together with the finding that tunicamycin within secondscaused an elevation of [Ca²⁺]₁, a well documented early featureof apoptosis in many experimental systems, these results stronglysuggest that tunicamycin-induced cell death in 90VAVI is dueto apoptosis. The short tunicamycin exposure required to triggercell death in 90VAVI indicates that the apoptotic process isirreversibly induced soon after its addition. It seems unlikelythat the pool of one or several specific N-linked glycoproteinscould be depleted during such a short period. Instead the overallaccumulation of unglycosylated proteins in ER might contributeto the apoptotic response in 90VAVI. Tunicamycin also killedand induced DNA degradation in the breast cancer cell line MDA-231.     

Nerve potentials and afferent conduction velocities in the differential diagnosis of amyotrophy of the hand

Nerve action potentials recorded over the elbow after stimulation of the wrist were studied in patients with hand amyotrophy of different origin. In amyotrophic lateral sclerosis the amplitude of nerve action potentials does not change significantly even with extreme muscle wasting and loss of motor units.