bluuebunny/crossref_metadata_2025 huggingface dataset:
The seminal coagulum favours passage of fast-moving sperm into the uterus in the black-handed spider monkey
Authors: Hernández-López Leonor , Cerda-Molina Ana Lilia , Páez-Ponce Denisse L , Mondragón-Ceballos Ricardo
Published: July 2008

In addition to gametes, mammalian internal fertilisation has required the evolution of assorted anatomical, physiological and biochemical devices to deal with intra- and inter-sexual conflict such as sperm competition and female cryptic choice respectively. The seminal coagulum of primates and other mammals is viewed as one of such devices. Among primates, the seminal coagulum characteristically occurs in multi-male and multi-female species, leading us to suppose that it intervenes in sperm competition. However, it can also provide cues to the female reproductive tract about male desired or undesired traits, and therefore deter or favour sperm survival and migration. The present work investigates whether the seminal coagulum of the black-handed spider monkey enhances sperm fertilisation chances by improving the female reproductive tract conditions, and if the female reproductive tract is ‘blind’ to semen or behaves selectively towards ejaculates of different males. A series of artificial inseminations were done in five females, using the ejaculates of three different males, one at a time, and measuring the presence of distinct types of sperm inside the uteri at 10, 30 and 60 min following the insemination. The presence of coagulum, menstrual phase, and male and female identity only affected fast, straight-moving sperm, with larger amounts of fast sperm appearing inside the uteri when ejaculates had seminal coagulum, as well as when in the periovulatory phase. There was great intra-uterine fast-sperm variation regarding which male's semen inseminated which female. The results provide evidence to account for sexual conflict in the spider monkey as well as a methodological approach to this kind of study.
Political oratory, power and authority in a medieval Mediterranean kingdom
Authors: Argenter Joan A
Published: July 2008

Historical linguistic ethnography deals with verbal productions in the context of the conditions under which they came into being and the cultural meanings attributed to them at the time. The research procedure in ethnography is fieldwork, but historical linguistic ethnography is based on the examination of texts. Research, however, proceeds not from texts themselves, but from the questions addressed to texts. The linguistic/interactional material presented is drawn from political oratory in medieval Catalan society. The questions to be answered are: How did specific verbal practices interact with political life? What was the role played by codes, code-choice and code-switching? What were the sociopolitical factors that gave rise to and made sense of these verbal resources? In Catalonia, political oratory arose out of clerical oratory. The Church abandoned Latin as the language of preaching when a Catalan language fully separate from Latin developed the lexical and syntactic resources that enabled it to serve as a vehicle for complex discourse. At the same time, a Catalan proto-state was emerging. The political oratory in question was performed at the Cort, an incipient institution of political representation. This was simultaneously a political assembly, a frame defining participants’ roles, a communicative setting, a performance frame, and a traditionally patterned speech event. In this article a particular Cort is analyzed as one such complex event.
Social stratification of language-specific variants of intervocalic /d/ along the Uruguayan-Brazilian border
Authors: Waltermire Mark
Published: July 2008

A situation of language contact between Spanish and Portuguese has existed along the border between Uruguay and Brazil since the first forays of Spanish and Portuguese colonizers into this territory in the early 1800s. As a result, most Uruguayans living along the border speak Portuguese. Dialects of this language spoken in Uruguay (which have been referred to as ‘Dialectos Portugueses del Uruguay’ or ‘DPU’) have been studied extensively (Carvalho 1998, 2003a, 2003b, 2004; Elizaincín 1976, 1979; Elizaincín, Behares and Barrios 1987; Hensey 1972; Rona 1965, to name a few). Surprisingly, very little linguistic research has focused on the Spanish of border communities, which demonstrates considerable influence from Portuguese, especially with regards to phonology. One of the most noticeable influences from this language is the use of occlusive articulations of intervocalic /d/ (which is typically realized as a fricative or phonetic zero in monolingual varieties of Spanish). This research analyzes the social stratification and conditioning of two of these language-specific variants (occlusive [d] and phonetic zero) for 63 bilinguals living in the border community of Rivera, Uruguay.
What should every citizen know about ecology?
Authors: Jordan Rebecca , Singer Frederick , Vaughan John , Berkowitz Alan
Published: July 2008

The level of ecological literacy among the general population in the US and other countries is not known, although there is widespread concern that it is too low to enable effective social responses to current problems. Here, we describe a framework for conceptualizing ecological literacy. This framework combines ideas and approaches from the social sciences with content deemed critical by ecology professionals. We conclude with key contentions and questions that should initiate a dialogue aimed at improving ecological literacy among the public. As ecological literacy was the theme of the 93rd Annual Meeting of the Ecological Society of America in 2008, we believe it is time for this discussion to be expanded, increased in priority, and brought to fruition.
Evaluating the success of public participation in water resources management: five key constituents
Authors: Özerol Gül , Newig Jens
Published: July 2008

Public participation (PP) is increasingly expected to enhance the effectiveness of water resources management. This is recognized in recent legislation such as the European Union Water Framework Directive. We identify five key constituents that affect the success of PP processes and which can be used as indicators thereof. These comprise: 1) the scope of the participants; 2) communication with the public; 3) capacity building; 4) timing; and 5) financing of participation. They are based on the management of resources—namely time, human and financial resources—and on further aspects that emerge from the utilization of these resources throughout the PP process. Drawing on existing case studies from the European Union and Canada, we demonstrate the applicability of our evaluative scheme. We find severe deficits in the PP cases that can all be attributed to the five key constituents. Although not representative, our analysis points to important challenges for water policy, particularly in the European multi-level context.
Combined anaerobic digestion and biological nitrogen removal for piggery wastewater treatment: a modelling approach
Authors: Rousseau P. , Steyer J.-P. , Volcke E. I. P , Bernet N. , Béline F.
Published: July 2008

In order to deal with the environmental problems associated with animal production industrialization and at the same time considering energy costs increasing, a piggery wastewater treatment process consisting of combined anaerobic digestion and biological nitrogen removal by activated sludge was developed. This contribution presents a modelling framework in order to optimize this process. Modified versions of the well established ASM1 and ADM1 models have been used. The ADM1 was extended with biological denitrification. pH calculation and liquid gas-transfer were modified to take into account the effect of associated components. Finally, two interfaces (ADMtoASM and ASMtoADM) were built in order to combine both models. These interfaces set up the COD, nitrogen, alkalinity and charge fractionation between both models. However, for the mass balances between both models, some hypotheses were considered and might be evaluated.
Comparing the performance of UASB and GRABBR treating low strength wastewaters
Authors: Shanmugam A. S. , Akunna J. C.
Published: July 2008

Anaerobic technologies have proved successful in the treatment of various high strength wastewaters with perceptible advantages over aerobic systems. The applicability of anaerobic processes to treat low strength wastewaters has been increasing with the evolution of high-rate reactors capable of achieving high sludge retention time (SRT) when operating at low HRT. However, the performance of these systems can be affected by high variations in flow and wastewater composition. This paper reports on the comparative study carried out with two such high rate reactors systems to evaluate their performances when used for the treatment of low strength wastewaters at high hydraulic rates. One of the two systems is the most commonly used upflow anaerobic sludge blanket (UASB) reactor in which all reactions occur within a single vessel. The other is the granular bed baffled reactor (GRABBR) that encourages different stages of anaerobic digestion in separate vessels longitudinally across the reactor. The reactors, with equal capacity of 10 litres, were subjected to increasing organic loading rates (OLRs) and hydraulic retention times (HRTs) of up to 60 kg COD m−3 d−1 and 1 h respectively. Results show that the GRABBR has greater processes stability at relatively low HRTs, whilst the UASB seems to be better equipped to cope with organic overloads or shockloads. The study also shows that the GRABBR enables the harvesting of biogas with greater energetic value and hence greater re-use potential than the UASB. Biogas of up to 86% methane content is obtainable with GRABBR treating low strength wastewaters.
Heterogeneous photocatalytic ozonation of 2,4-D in dilute aqueous solution with TiO2 fiber
Authors: Giri R. R. , Ozaki H. , Takanami R. , Taniguchi S.
Published: July 2008

Photocatalytic ozonation (O3/UV/TiO2) is an emerging oxidation method for recalcitrant organic contaminants in water. However, immobilised TiO2 catalysts suffer from reduced photonic efficiency. Therefore, TiO2 catalysts with excellent mechanical and thermal properties and enhanced photonic efficiencies are sought. This paper aimed to elucidate the mineralisation of low concentration 2,4-D (45.0 μM) by O3/UV/TiO2 using the world's first high-strength TiO2 fibre in laboratory batch experiments. 2,4-D degradation and TOC removal followed pseudo first-order reaction kinetic. The removal rates for 2,4-D and TOC in O3/UV/TiO2 were 1.5 and 2.4-fold larger than the summation of the values for ozonation (O3) and photocatalysis (UV/TiO2), respectively. O3/UV/TiO2 was characterised by few aromatic intermediates with low abundance, fast degradations of aliphatic intermediates and dechlorination as a major step. The significantly enhanced 2,4-D mineralisation in O3/UV/TiO2 was attributed to increased ozone dissolution and decomposition, and reduced electron–hole recombination resulting in large number of hydroxyl radical (•OH) formation from more than one parallel path. The discrepancies in the organic carbon mass budget were attributed to few apparently major unidentified intermediates, while chlorine mass balance was reasonably acceptable. The mineralisation efficiency of O3/UV/TiO2 with the TiO2 fibre can further be enhanced by optimisation of experimental design parameters. The new TiO2 fibre is very promising to overcome the problem of reduced efficiency of TiO2 catalyst in an immobilised state.
Towards indirect potable reuse in South East Queensland
Authors: Traves W. H. , Gardner E. A. , Dennien B. , Spiller D.
Published: July 2008

Faced with limited water supply options in the longer term and the worst drought on record in the short term, the Queensland Government is constructing the Western Corridor Recycled Water Project which will supply up to 182 ML/day of purified recycled water for industrial and potable purposes. The project is one of a suite of capital works projects in progress which in the longer term will supply up to 10% of the region's potable water supply.
Enhanced heavy metals removal without phosphorus loss from anaerobically digested sewage sludge
Authors: Ito A. , Takahashi K. , Aizawa J. , Umita T.
Published: July 2008

Heavy metals removal without phosphorus loss from anaerobically digested sewage sludge was investigated by conducting batch experiments using hydrogen peroxide and/or iron sulphate under acidified conditions at pH 3. The addition of hydrogen peroxide to the sludge improved the elution efficiencies of As, Cd, Cu and Zn with phosphorus loss from the sludge. The optimum initial concentrations of hydrogen peroxide were. Respectively. 0.1% for As, Cd, Mn and Zn and 0.5% for Cu and Ni. The combined process of 0.1% hydrogen peroxide and 1 g Fe/L ferric sulphate enhanced the initial elution rate of Cu and Cr compared to the addition of either ferric sulphate or hydrogen peroxide, indicating that oxidants stronger than hydrogen peroxide were produced in the sludge. Furthermore, the combined process immobilised phosphorus in the sludge due to co-precipitation with ferric hydroxide or precipitation as ferric phosphate. It was concluded that there is a possibility that the combined process could remove heavy metals effectively without phosphorus loss from anaerobically digested sewage sludge.
Picogram determination of N-nitrosodimethylamine in water
Authors: Hu Ruikang , Zhang Lifeng , Yang Zhaoguang
Published: July 2008

N-nitrosodimethylamine (NDMA) persistence within surface waters is a major concern for downstream communities exploiting these waters as drinking water supplies. The objective of this study is to develop a novel and efficient analytical method for NDMA via different technologies: pulsed splitless gas chromatography–nitrogen phosphorus detector (GC–NPD), large volume injection (LVI) gas chromatography–mass spectrometry (GC/MS) via programmable temperature vaporizer (PTV) inlet or PTV-gas chromatography– triple quadruple mass spectrometry (GC-MS/MS) and continuous liquid–liquid extraction. It was found that the sensitivity required for NDMA analysis by GC–NPD can only be achieved when the NPD bead is extremely clean. LVI via PTV can greatly improve GC-MS system sensitivity for analyzing NDMA. With the help of DB-624 (25 m × 200 μm × 1.12 μm) connected with DB-5MS (30 m × 250 μm × 0.25 μm) in series, PTV–GC/MS could overcome the matrix interference for the trace analysis of NDMA. Variable instrument conditions were studied in detail, with the optimized process being validated via precision and accuracy studies. PTV- triple quadruple GC-MS/MS system could efficiently remove the interference on a single DB-5MS (30 m × 250 μm × 0.25 μm) column with good sensitivity and selectivity. The developed methods have been successfully applied to test NDMA in different types of water samples with satisfactory results.
Adsorption of Cd(II), Zn(II) by extracellular polymeric substances extracted from waste activated sludge
Authors: Lei Zheng , Yu Tian , Ai-zhong Ding , Jin-sheng Wang
Published: July 2008

Adsorption of Cd(II) and Zn(II) ions in single solutions using extracellular polymeric substances (EPS) from activated sludge was investigated. Langmuir and Freundlich models were applied to describe metal adsorption. The results showed that EPS was an effective adsorbent for the zinc and cadmium ions from aqueous solution. The equilibrium metal uptake was increased with increasing the initial concentration of metal ion. Constants calculated from isotherms model showed that the maximum uptake capacity of cadmium was estimated to be 45 mg/g of Cd(II) and 80 mg/g of Zn(II). Both Langmuir and Freundlich isotherms were suitable for describing adsorption of Cd(II) by EPS, while the Langmuir isotherm equation fit the date of Zn(II) adsorption better, indicating that EPS adsorb Cd(II) and Zn(II) by different mechanisms.

Analysis of FTIR spectra demonstrated that C-O-C of polysaccharides at 1,150–1,030 cm−1, group of the amide(I), CH2 group of the lipids, carboxyl and -OH groups of proteins and polysaccharides were involved in cadmium and zinc binding, of which the -OH groups and the C-O-C group of polysaccharides.
Application of excess activated sludge ozonation in an SBR Plant. Effects on substrate fractioning and solids production
Authors: Naso M. , Chiavola A. , Rolle E.
Published: July 2008

This paper provides new insights on the application of the ozonation process for the reduction of the activated sludge production in a sequencing batch reactor (SBR). The study was performed in two identical lab-scale SBRs plant, one for experimental activities (Exp SBR) and one used as control (Control SBR), both fed with domestic sewage. A fraction of the activated sludge collected from the Exp SBR at the end of the aerobic react phase was periodically subjected to ozonation for 30 minutes at three different specific dosages (0.05, 0.07 and 0.37 g O3/gSS) and then recirculated before the beginning of the following cycle.

Recirculation of the ozonated sludge to the Exp SBR did not appreciably affect the efficiency of the biological nitrogen and carbon removal processes. Nonetheless, an improvement of the denitrification kinetic was observed. Mixed liquor volatile and suspended solids (MLSS and MLVSS, respectively) concentrations in the reactor decreased significantly with time for long term application of the ozonation treatment. Kinetic batch tests on unstressed sludge taken from Control SBR indicated that the different oxidant dosages (0.05, 0.07 and 0.37 g O3/gSS) and durations of the ozonation process (10, 20 and 30 minutes) used remarkably affected chemical oxygen demand (COD) and organic nitrogen fractioning. In particular, soluble and biodegradable fractions seemed to be higher at lower dosage and longer contact time.
Characterizing denitrification kinetics at cold temperature using various carbon sources in lab-scale sequencing batch reactors
Authors: Mokhayeri Yalda , Riffat Rumana , Takacs Imre , Dold Peter , Bott Charles , Hinojosa Jeneva , Bailey Walter , Murthy Sudhir
Published: July 2008

Wastewater treatment plants in the Chesapeake Bay region are becoming more interested in external carbon sources for denitrification. This is in response to the recent regulations to remediate the Chesapeake Bay, which will limit effluent total nitrogen to near 3 mg/L for plants, thus requiring near complete elimination of inorganic nitrogen species. Since sufficient internal carbon is usually not available for complete denitrification, external carbon is needed to supplement internal sources. Of particular interest is the use of an alternate external carbon source to replace the least expensive source methanol. This study focuses on three commonly available external carbon sources: methanol, ethanol and acetate. The aim of this study was to obtain the specific denitrification rate (SDNR) of the substrates under several conditions. Sequencing batch reactors (SBRs) were set up to first grow biomass to the specified substrate while in situ SDNRs were conducted concurrently. Once the biomass was grown with the corresponding substrate, a series of ex situ SDNRs were performed using various biomass/substrate combinations to evaluate response to substrate combinations at 13°C. Results from this study indicate that the SDNRs for biomass grown on methanol, ethanol and acetate were 9.2 mg NO3-N/g VSS/hr, 30.4 mg NO3-N/gVSS/hr and 31.7 mg NO3-N/g VSS/hr, respectively, suggesting that acetate and ethanol were equally effective external carbon sources followed by much lower SDNR using methanol. Ethanol could be used with methanol biomass with similar rates as that of methanol. Additionally, methanol was rapidly acclimated to ethanol grown biomass suggesting that the two substrates could be interchanged to grow respective populations with a minimum lag period.
Protein S and pregnancy: Report of a case
Authors: Dunjic Radica , Elezovic Ivo , Rakic Snezana , Mikovic Zeljko , Loncar-Stevanovic Helena
Published: July 2008

Protein S is a cofactor of protein S which lowers the activat- ed factors VIII and V. Pregnancy reduces the level of protein S to 40-50% of normal levels but it is not clear whether the lowered protein S levels increase the risk of developing thrombo-embolism during pregnancy. This is a report of a 39-year old woman, multipart whose pregnancy terminated as IUGR and who had previously two stillbirths. After the third pregnancy loss of functional protein S level was 20%. Two months after delivery protein S activity was 60%. As it was suspected that low protein S level was a risk factor of complications in pregnancy anticoagulant therapy was used. Thereafter pregnancy and delivery at 38.5 weeks of gestation were successful and the baby weighted 3400 gr at birth. The aim of this report is to emphasize the important role of follow-up of the level of protein S in pregnancy in order to avoid the risk of thrombo-embolism in pregnancy. Anticoagulant therapy is very successful in such a pregnancy and may ensure safe birth.
Diffusion disorder in liver cirrhosis
Authors: Culafic Djordje , Perisic Mirjana , Rebic Predrag
Published: July 2008

The impairment of diffusion capacity is a very common functional disorder in patients with liver cirrhosis and portal hypertension. Disproportionately higher reduction of the transfer factor compared to restrictive ventilatory disorder, suggests that diffusion disorder is primarily induced by inadequate pulmonary perfusion. The isolated reduction of the transfer factor cannot be only explained in each case by intrapuimonary vascular dilatation.
Left ventricular diastolic function in valvular aortic stenosis after aortic valve replacement
Authors: Ristic-Andjelkov Andjelka
Published: July 2008

In adults with significant sympthomatic aortic valve stenosis, aortic valve replacement is therapy of choice. Replacement of the diseased aortic valve with a prosthetic valve yields relief of left ventricular outflow obstruction. Myocardial remodeling with regression of mass transpires as the heart adapts to the new level of after load. In patients with moderate left ventricular hypertrophy improvement in diastolic function during the first year after aortic valve replacement is visible, while in patients with extreme myocardial hypertrophic changes it was slower.
Histologic variant form of autoimmune hepatitis with prominent zonal necrosis
Authors: Stankovic Ivica , Zlatkovic Marija , Prokic Dragan , Plamenac Pavle
Published: July 2008

Autoimmune hepatitis type 1 in a 8-year old girl is described. The diagnosis was established using International Autoimmune hepatitis group scoring system. In addition to characteristic histologic features of autoimmune hepatitis (periportal hepatitis, piecemeal necrosis and rozettes) prominent centrilobular necrosis was discovered. As an isolate finding in autoimmune hepatitis, this type was described only in five cases. In our unique case centrilobular necrosis is a very important parallel finding previously not detected in autoimmune hepatitis. Some experimental studies suggest that cytokines present in inflammatory cell infiltrate in the liver play a pathologic role in autoimmune liver cell damage.
Effect of hormone replacement therapy on lipids and coagulation factors in postmenopausal women smokers
Authors: Tatovic-Babic Danijela , Beljic Teodora , Drezgic Milka , Trpkovic Dragica , Balint-Peric Ljiljana , Babic Darko , Nikolic Jagoda
Published: July 2008

Postmenopause and smoking impair lipid profile, induce hypercoagulability and reduce fibrinolytic capacity [1, 2]. Postmenopause induced lipid changes can be reversed by oestrogen replacement [3]. Oestrogens also reduce fibrino-gen level [4] and have beneficial effects on endothelium [5]. Although several studies showed that hormone replacement therapy may increase the risk of thromboembolic diseases, procoagulant oestrogen activity has not clearly been demonstrated. It is well known that smoking accelerates oestrogen metabolism [6, 7], which may attenuate its beneficial effects. The present study was undertaken to determine if there is difference in beneficial effects of oestrogens between smokers and non-smokers in terms of coagulation process and lipids. The examination was a longitudinal one-year, before/after therapeutic study, which included healthy postmenopausal women (FSH levels at least 40 U/l), 30 smokers and 32 non-smokers who were under 55 years of age and postmenopausal period shorter than 5 years. Women with surgically induced menopause received unopposed oral oestrogens, while those with spontaneous menopause were treated with combined oral oestrogen/progestogen therapy. Before entering the study and in three-months intervals total LDL, HDL cholesterol, triglyc?rides and VLDL were determined, as well School of Medicine, Belgrade as plasma fibrinogen prothrombin time, and activated partial thromboplastin time. Neither beneficial nor adverse effects of oestrogens on lipids and coagulation were observed during one-year follow-up in smokers, although subjects with longer smoking history had higher triglyc?rides levels after 12 months of therapy. On the contrary, oestrogen replacement reduced total and LDL cholesterol and increased HDL cholesterol in non-smokers, with no change in triglyc?rides and VLDL level. A decrease in fibrinogen levels and coagulation activity, expressed by protrombin time and partial thromboplastin time, were also observed in hormone replacement therapy in postmenopausal women who did not smoke. Peroral hormone replacement therapy does not induce favorable lipid changes in smokers. Higher triglyc?rides levels observed after one-year therapy in women with a longer smoking history indicate that transdermal replacement maybe more suitable in this group. Peroral oestrogen replacement has no anticoagulant or procoagulant activity in smokers during the early postmenopausal period.
Results of histopathological findings of endometrial changes
Authors: Todorovic Nada , Djordjevic Vera , Antonijevic Slobodan
Published: July 2008

IN METRORRHAGIA Endometrium is a tissue which is in permament changes in the active gynecological period of a female. This can be followed-up through histological, custological and histochemical changes. In determing the morphologic changes and disturbances in endometrium, pathohistological examinations were and still are necessary and irreplaceable in defining the real causes of this phenomenon. The aim of our work is to show the pathohistological results of the material obtained by explorative curettage in metrorrhagia, to determine the aetiology of the pathological process in endometrium, which provokes irregular bleeding, and to check the possible increase in precancerogenic and malignant endometrial conditions over a period of three years. The examinations covered 786 patients who asserted that bleeding was the main symptom of their illness. In all of them explorative curettage was performed mainly in diagnostic and often in therapeutic purposes. The number of examinations are in constant increase. The age of the largest number of patiens was from 41 to 50 years, a period when the anovulary cycle is most frequent which, in turn, causes changes in endometrium which results in irregular bleeding i. e. in metrorrhagia (Tables 1, 2 and 3).The most frequent histopathological changes were manifested by adenomatic hyperplasia (160), then glandular (136) and cystic hyperplasia (92). Eleven cases of endometrial carcinoma were detected. In two of these patients the finding was not confirmed by pathohistological result after the operation or repeated explorative curretage. In 64 patients atypical hyperplasia i. e. Ca in situ was found. Acute endometritis followed by irregular bleeding was observed during inflammatory process of the internal genital organs. In 35 patients chronic endometritis was found after curettage following the extraction of the intrauterine device (in one case after 40 years of carrying). In 103 patients with hyperplasia myomatous changes were noted; this finding correlated with hyperoestrogenism, which is usually present in both disorders. All authors agree that pathohistological examination of endometrium is the most relayable in the search for a correct diagnosis. Despite of all modern diagnostic and technical means, difficulties always arise in the assessment of malignant potential of endometrial hyperplasia. Therefore, the patients with recurrent bleeding caused by hyperplasia should be under intensive gynaecological control.
Our experience in the treatment of acute deafness
Authors: Mihailovic-Kokic Branka , Todorovic Aleksandar , Kokic Zoran
Published: July 2008

The article deals with the results of treatment of 40 patients with acute deafness of unknown aetyology. Better results were obtained in patients with small degree of loss of hearing without vestibular symptomatology and in patients in whom therapy was started earlier. We suggest the early confirmation of diagnosis and urgent use of infusion therapy which improves the perfusion of the inner ear.
Pyometra caused by carrying of an intrauterine device for a period of forty years and chronic endometritis
Authors: Todorovic Nada , Djordjevic Vera , Antonijevic Slobodan
Published: July 2008

Pyometra is the accumulation of pus in the uterine cavity, thus streaching its walls and thinning and enlarging the uterus. This change is characteristic of the senium period of life, when the uterus is atrophie with a stenotic cervical canal. It most frequently occurs as a result of secondary infection of the cancerogenic tissue of the uterus and additional stenosation and clogging up of cervical canal by a malignant process. Apart from carcinomas of the body and uterus cervix, pyometra less often can occur in other illnesses such as senile endometritis and senile colpitis. As pyometra most frequently occurs in uterine carcinomas, in detection of this state, we must think of malignancy and direct our examination to this direction. In this paper we present a patient in whom pyometra developed because she carried an intrauterine device for forty years that resulted in chronic endometritis. The main symptoms for which the patient was admited to hospital were abdominal pain and intensive suppurative vaginal excretion a month after removal of intrauterine device. The diagnosis of pyometra was made by gynaecological and ultrasound examinations, and also on the basis of gynecological and ultrasound examinations one month after chronic endometritis was confirmed. On the basis of this finding we suspected that chronic endometritis was caused by this state. By cytological, PAP and histopathological examinations of samples obtained by explorative curettage and biopsy of the uterine cervix, malignant changes were eliminated a possible cause. By laboratory analysis and bacteriological examination of the uterine cavity and vaginal excretion, inflammatory changes of the uterine mocous membrane were confirmed as a cause of the pyometra. This conditions was due to carrying the intrauterine device for more decades. The therapy consisted of dilatation of the cervical canal and evacuation of accumulated suppurative contents and irrigation of uterine cavity with 3% solution of hydrogen peroxide and Povidon. Also wide spectrum antibiotics and uterotonics were given. Such treatment contributed to a fast and effectious recovery.
Uloga glukagonu slicnog peptida-jedan (GLP-1) u regulaciji sekrecije insulina
Authors: Radosavljevic Tatjana , Todorovic Vera , Sikic Branka
Published: July 2008

nema
Reconstruction of supraaortic branches
Authors: Davidovic Lazar , Rancic Zoran , Lotina Slobodan , Kostic Dusan , Markovic Dragan , Pavlovic Sinisa , Maksimovic Zivan , Pejic Miljko , Jadranin Dragica
Published: July 2008

The authors present surgical techniques and distant results of the operative treatment in patients with occlusive lesions of the supraaortic branches. The study included 29 men (55.8 %) and 23 women (44.2 %), with the average age of 54 years. The majority of patients - 44 (84.6 %) had symptoms and signs of the upper extremities ischemia while 25 (48.1 %) had symptoms and signs of cerebral ischemia (the posterior circulation mainly). Among seven patients with isolated cerebral ischemia of the anterior circulation, four of them developed transient ischemic attack (TIA) and three had cerebrovascular insult (CVI). All patients were examined ultrasonographically and angiographically. Operative treatment was performed under general anesthesia. In eight cases the anatomic, and in 44 extraanatomic procedure was applied. Following reconstructive procedures were used: endarterectomy and patch of the brachiocephalic trunk - 2 bypass from ascending aorta - 7, carotid to subclavian bypass - 31 subclavian to carotid bypass - 7, subclavian artery transposition - 3 axillo-axillary bypass - 2. During the follow-up period (10-228 months) eight out of 52 patients exhibited the occlusion of the graft. Six occlusions developed after carotid-subclavian bypass: in two patients reconstructions were performed using Dacron grafts, in three using PTFE grafts and in one patient using autologous vein graft. Two occlusions developed after subclavio-carotid bypass. In both cases the vein graft was used: one was coming from the ipsilateral and the other one from the contralateral subclavian artery. The mean period from the operation to the occlusion of the graft (the mean lasting of the primary flow) was 14.72 years (SE=1.41; 95 % CI=11.96-17.48). There was no statistically significant difference in primary patency and survival without symptoms between patients treated with the anatomic and those treated with the extra anatomic approach. Practically, this means that both approaches were equally good, so that the decision about the approach should be made individually according to the loading factors of each patient. In the case of the carotid-subclavian bypass, according to our results, we recommend the use of the PTFE graft.
Heparin induced thrombocytopenia type ii and myocardial infarction: Two case reports
Authors: Antonijevic Nebojsa , Stanojevic Milica , Perunicic Jovan , Djokic Milan , Mikovic Danijela , Kovac Mirjana , Miljic Predrag , Milosevic Rajko , Terzic Branka , Vasiljevic Zorana
Published: July 2008

Heparin-induced thrombocytopenia (HIT) type II is an acquired thrombophylic state and life-threatening immune complication of a heparin treatment mainly clinically manifested by marked thrombocytopenia, frequently by arterial and venous thrombosis, and sometimes by skin changes. Functional assay as heparin aggregation test and 14C-serotonin release assays are used in diagnostics as well as antigen assays of which detection tests for heparin-platelet factor 4 antibodies are most frequently used. Considering the fact that there is no single reliable assays for HIT II detection available, sometimes it is necessary to combine both of the above-mentioned types of assays. We present the case of a 57-year-old patient with an acute anterior myocardial infarction with cardiac insufficiency of III and IV degree according to Killip, recurrent ventricular fibrillation and diabetes mellitus type II developing thrombocytopenia to 37x10 9/l accompanied with typical skin changes. The diagnosis was confirmed by the heparin aggregation test. The second patient aged 70 undergoing the treatment for anteroseptal myocardial infarction and reinfarction of the inferior wall complicated by a cardiogenic shock and acute right bundle branch block developed thrombocytopenia 59x10 9/I on the third day of the heparin therapy, with the remark that he had received a heparin therapy during the first infarction as well. Antibodies against heparin-platelet factor 4 were detected by particle gel ID-HPF4 immunoassay. In both patients, the disease had a lethal outcome despite all then available therapeutic measures applied. Further on we discuss advantages of certain types of tests, a therapy doctrine, need for urgent therapeutic measures, inclusive of the administration of anitithrombins, avoidance of harmful procedures like low-molecular-weight heparins administration and prophylactic platelet transfusion as well as preventive measures.
Suicidal death caused by electrocution: Two case reports
Authors: Nikolic Slobodan , Mihailovic Zoran , Micic Jelena
Published: July 2008

Suicides by electrocution are extremly rare in our country. In these cases, specific or characteristic external lesions caused through contact with conductors at the sites of entry and exit of the current, as well as general autopsy findings, and excluding the other possible causes of death, are important to elucidate them. Dilema if death was sucidal, homicidal or accidental in manner, could be solved through good police investigation, and properly explained circumstantial events. Herein, we reported two cases of suicidal deaths, caused by electrocution. In the first case, it was a male, age of 32, who wraped the electrical cord around his rists, and kiled himself by plugging it in. In second case, it was a female, age of 46, abused by her husband, who commited suicide by putting the switched hear-dryer into the water in bathtube.
Imunski sistem uretre muskaraca
Authors: Sretenovic-Vukicevic Jelica , Milosevic-Jovcic Nadezda , Ciric Dragana , Ilic Vesna , Stefanovic Gordana , Medenica Ljiljana
Published: July 2008

nema
Prevalence and importance of nodal micrometastasis in patients with gastric adenocarcinoma
Authors: Bjelovic Milos , Pesko Predrag , Micev Marjan , Todorovic Vera , Trajkovic Goran , Stojakov Dejan , Sabljak Predrag
Published: July 2008

Micrometastasis is a microscopic (less than 2 mm) deposit of malignant cells separated from the primary tumor. The incidence and importance of occult perigastric lymph node involvement were analyzed in 26 pNO patients using the prospective method. The occult lymph node involvement was detected by immunohistochemical method using the anticyto-keratin 8/18 antibody. Prevalence of clinically significant occult lymph node involvement (Mi+) was statistically significant, and found in 38.5% of pNO patients. Out of tumor characteristics analyzed as possible predictors of occult lymph node involvement, the histological grade (GH) and the involvement of lymphatic vessels within gastric wall (pLl) had significant effect on the respective evaluation. The patients with histological grade 3 and 4 had occult lymph node involvement more often than those with grade 1 and 2 (p<0.05). More than 60% of pL1 patients had occult lymph node involvement LN (Mi+). Due to high prevalence of micrometastatic lymph node involvement, detection with specific immunohistochemical or molecular biology techniques should be a part of routine specimen examination in patients with pNO gastric cancer.
Jovan Jovanovic Zmaj, poet and physician, on the occasion of Zmaj centenary
Authors: Lesic Aleksandar , Bumbasirevic Marko
Published: July 2008

Doctor Jovan Jovanovic Zmaj (1833-1904), a poet and physician, was one of the first members of the Serbian Medical Society, the founder of the ?Srpska knjizevna zadruga", and the member of Serbian Royal Academy of Sciences. He lived and worked in Novi Sad, Belgrade, Zagreb, Vienna, Pancevo and other towns of former Austro-Hungarian Monarchy. Besides medical practice, he wrote poetry for children. He started the magazine for children ?Neven", the first one in our country. Accordingly, he became the founder of children's literature in Serbia. In many of his poems for children, Dr. Jovan Jovanovic Zmaj propagated the healthy style of life and hygienic habits. His messages are actual even today for his poetry is still alive and widely read and appreciated. His personal tragedy, the loss of five children and wife as well, was immortalized in his books of poetry ?Dulici" and ?Dulici uveoci", which are considered the most tragic and gentle poems written in Serbian language. Thus, in his personality, Doctor Jovan Jovanovic Zmaj united two most noble vocations: medicine and literature.
The assessment of severity of lung injury in sepsis
Authors: Arsenijevic Ljubica , Popovic Nada , Kojic Zvezdana
Published: July 2008

Adult respiratory distress syndrome (ARDS) is an acute and severe pulmonary dysfunction. It is clinically characterized by dyspnea and tachypnea, progressive hypoxemia (within 12-48 hours), reduction of pulmonary compliance and diffuse bilateral infiltrates seen on pulmonary radiogram. Etiological factors giving rise to development of the syndrome are numerous. The acute lung injury (AU) is defined as the inflammation syndrome and increased permeability, which is associated with radiological and physiological disorders. Lung injury score (LIS), which is composed of four components, is used for making a distinction between two separate but rather similar syndromes. The study was aimed at the assessment of the severity of the lung injury in patients who had suffered from sepsis of the gynecological origin and its influence on the outcome of the disease. The total of 43 female patients was analyzed. Twenty patients (46.51%) were diagnosed as having ARDS based on the lung injury score, while 23 patients (53.48%) were diagnosed with acute lung injury. In our series, lung injury score ranged from 0.7 to 3.3 in ARDS patients, and lethal outcome ensued in 11 (55%) cases in this group. As for the patients with the acute lung injury, the score values ranged from 0.3 to 1.3 and only one patient from this group died (4.34%). The obtained results indicate that high values of the lung injury score are suggestive of the severe respiratory dysfunction as well as that lethal outcome is dependent on LIS value.
Risk factors for chronic noncontiguous diseases: Twelve-week prospective study
Authors: Lapcevic Mirjana , Vukovic Mira
Published: July 2008

Risk factors (RF) of chronic noncontiguous diseases (CND) are mutual and cannot be observed individually since there is an inter-reaction (interaction of RF in various combinations), what makes so-called personality risk profile for development of particular disease. Almost all CND belong to the group of preventable diseases, because their course may be influenced and changed through RF modification and reduction. Bad habits also contribute to CND incidence. CND prevention is the first priority of primary health care physicians. The main objective of our study was to detect RF in patients during everyday activities of general practitioner, to estimate the risk of CND within the existing RF combination, to show the results of 12-week active monitoring of population with RF of CND, and with already present CND; while the secondary goal was to assess how much population is interested in active collaboration as well as to evaluate the qualification of general medicine teams for work based on defined methodology. The study was multicentric, prospective and interventional. The study included 2086 subjects, aged from 25-64 years, and it was carried out in 17 health centers throughout Serbia in the period January-April 2002. The subjects were selected by method of open clinical experiment. Thereafter, 12-week medical intervention was initiated involving non-pharmacological and pharmacological treatment. The first control was scheduled after 8, and the second after 12 months of intervention. Congruence ?2 test, ANOVA for repeated measurements and Logistic regression were used for statistical data processing. Out of a total of 2086 subjects, the following proportion of them reported specific diagnosis in their medical histories: 77% of them reported arterial hypertension (HTA), 68% - increased body mass (BMI>27Kg/m2), 66% - hyperlipoproteinemia (HLP), 34% - diabetes mellitus (DM), 56% - inadequate physical activity (PA), and 23% - cigarette smoking (CS). On the basis of RF number and combination for genesis and development of CND in our sample, 74.7% of variability (development or risk) may be accounted for angina pectoris (AP), 74.2% for DM+HTA, 70.0% for DM, 79.9% for HTA, 80.8% for myocardial infarction (Ml), and 85.8% of variability (development or risk) for cerebrovascular insult (CVI). Twelve-week intervention resulted in reduction of HTA, HLP, glucose, and PC (p<0.001) levels as well as lower BMI and PA (p<0.5). To accomplish the aforementioned goals, continuous mutual activity of an individual, his/her family, health service and community is required, along with occasional evaluation of the obtained results.
Report of a newborn with hemimegalencephaly in association with Klippel-Trenaunay-Weber syndrome
Authors: Obradovic Slobodan , Vuletic Biljana , Stojkovic-Andjelkovic Andjelka , Igrutinovic Zoran
Published: July 2008

Klippel-Trenaunay-Weber syndrome (KTW) is a rare phacomatosis whose main characteristics are: cutaneous angiomas (vascular nevi), varicose veins (arteriovenous fistulae) and hemihypertrophy of bones and soft tissues. This is a case report of KTW syndrome which was diagnosed in the first days of life on the basis of characteristic vascular nevi on the skin of the trunk and extremities in addition to hypertrophy of the left part of the body. Neuroradiologically verified hemimegalencephaly associated with temporal hemangioma represents a special particularity in our case. Measures of monitoring the child as well as stimulating and therapeutic actions were the issues of discussion.
The significance of ACEi therapy in chronic allograft nephropathy
Authors: Savin Marina , Petronic Vladimir
Published: July 2008

Angiotensin II plays a crucial role in pathologic processes of chronic allograft nephropathy (CAN) leading to chronic and progressive renal allograft dysfunction (CRAD). Systemic and glomerular hypertensions together with proteinuria occur in CAN under conditions of JGA hypertrophy with up-regulated RAS activity in the renal allograft, and they represent independent factors of rapid progression of chronic renal allograft failure. ACEi are safe and efficient antihypertensives with renoprotective effects in patients with CAN. Favorable response to ACEi has been reflected in diminished proteinuria, slow increase of creatininemia, regulation of arterial hypertension and better long-term survival of patients and kidney allografts. Our pilot study highlights the importance of ACEi therapy in CAN after renal transplantation from elder donors (>55 years).