bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of anogenital warts on life quality of affected patients
Authors: Stanimirovic Branko , Stanojevic Dusan , Vasiljevic Mladenko , Rakic Snezana , Mitrovic Ana
Published: July 2009

Introduction. Anogenital warts represent a clinical manifestation of the infection of the lower female genital tract, human papilloma viruses types 6 and 11. They belong to the group of sexually transmitted diseases and then may be localized either on the female or male genitalia. The aim of the study was to show the effect of anogenital warts on life quality of the affected patients. Material and methods. The study was conducted on 200 female patients using the standardized questionnaire filled in by patients under the researcher's supervision immediately before laser wart removal. Each question out of 15 could be answered by one of the suggested answers: always, almost always, sometimes, rarely and never. The answer 'always' was worth one point, 'almost always' two points, 'sometimes' three points, 'rarely' four points and never 'five' points. Life quality was categorized as bad, tolerable, good, very good and excellent. The lower number of points in the questionnaire indicated the worse life quality and the higher number of points demonstrated a better life quality. Results. The study results showed that the highest number of subjects was in the third and fourth decade of life. The presence of anogenital warts had an effect on life quality in most patients. 5% of subjects assessed their life quality as bad, 16% as tolerable, 45% as good and 23% as very good. Only in 11% of patients the presence of anogenital warts did not have any effect on life quality (c2 = 121.680, p< 0.001). Conclusion. The presence of anogenital warts has a significant effect on life quality of affected patients, indicating the significance of their early detection and treatment.
Neonatal withdrawal syndrome: Case report
Authors: Radunovic-Gojkovic Tatjana , Velisavljev-Filipovic Gordana
Published: July 2009

Introduction. Maternal drug abuse has increased over the past decade. It has a multiple negative influence on a pregnant woman, as well as her newborn. Practically, every drug taken during pregnancy crosses the placenta, and the developing fetus may also be affected by the effects of a drug. After delivery, an infant of a drug-abusing mother may potentially develop neonatal withdrawal syndrome. Existing studies on the neonatal effects of drug exposure in utero are subject to many factors. Many studies have relied on the history obtained from the mother, which is innacurate. Urine testing for drug abuse does not reflect exposure to a drug through pregnancy and does not provide quantitative information. Social and economic deprivation is common among drug abusers, and this factor has a major effect on long term studies of infant outcome. The purpose of this article is to underline the problems during management of a neonatal withdrawal syndrom, and growing incidence of it in our society. Case report. A case of an infant of a heroin-abusing mother is reported. Conclusion. It is very important to take care of an infant with neonatal withdrawal syndrome, but it is also of a great importance to supervise these children for a long period of time.
Decidual transformation in adenomyosis during pregnancy as an indication for hysterectomy
Authors: Jovanovic Bozidar , Petrovic Aleksandar , Petrovic Bratislav
Published: July 2009

Introduction. Incidence of adenomyosis is estimated on 20% in all of extracted uteruses. Clinically, it usually exists asymptomatically, but could be followed with dysmenorrhoea, menorrhagia and pelvic pain. One third of patients with adenomyosis are sterile, however in other two thirds, conception and pregnancy could have normal development, with delivery without complications. One of possible complications related to adenomyosis is rupture of uterus during delivery. Case report. A pregnant woman at the end of the 10th lunar month of pregnancy, showed minimal labour contractions, following amnion rupture and the delivery was terminated by section ceasar. Subtotal hysterectomy was performed because of concominant profuse bleeding. Myometrium was occupied with decidual cells in trabecular arrangement, among which elongated endometrial glands were placed. Surrounding muscle fascicles showed atrophic, apoptic, and occasionally necrotic changes. Myometrial stroma was edematous, and infiltrated with mesenchymal cells, as well as with adipose cells, which were extending toward serosa. Discussion. The patient had been receiving treatment, for a long period, because of sterility without clear etiological factor. A small number of similar cases ends with complications. Here, it is evident that abundant decidual transformation of stromal cells in adenomiosis leads to atrophy and necrosis of muscle cells. Teh reduction of uterine muscle mass causes atony and threating rupture, through separation of muscle cells, and therefore the absence of their synchronized contractions. Conclusion. Atony of uterine muscle could be caused by decidual transformation in adenomyosal fields, atrophy of muscle fascicles, edema of the stroma, mesenchymal transformation, and fibrosis. This leads to a decrease in myometrial contractions, and prolonged postpartal bleeding.
Monetary and exchange rate regimes changes: The cases of Poland, Czech Republic, Slovakia and Republic of Serbia
Authors: Josifidis Kosta , Allegret Jean-Pierre , Beker-Pucar Emilija
Published: July 2009

The paper explores (former) transition economies, Poland, Czech Republic, Slovakia and the Republic of Serbia, concerning abandonment of the exchange rate targeting and fixed exchange rate regimes and movement toward explicit/implicit inflation targeting and flexible exchange rate regimes. The paper identifies different subperiods concerning crucial monetary and exchange rate regimes, and tracks the changes of specific monetary transmission channels i.e. exchange rate channel, interest rate channel, indirect and direct influences to the exchange rate, with variance decomposition of VAR/VEC model. The empirical results indicate that Polish monetary strategy toward higher monetary and exchange rate flexibility has been performed smoothly, gradually and planned, compared to the Slovak and, especially, Czech case. The comparison of three former transition economies with the Serbian case indicate strong and persistent exchange rate pass-through, low interest rate pass-through, significant indirect and direct influence to the exchange rate as potential obstacles for successful inflation targeting in the Republic of Serbia.
Coefficient of structural concordance and an example of its application: Labour productivity and wages in Slovenia
Authors: Verbic Miroslav , Kuzmin Franc
Published: July 2009

The article presents the underlying principles, derivation and properties of a simple descriptive measure of concordance between two analogous rank structures that we call the coefficient of structural concordance. It is based upon the idea of Kendall's coefficient of concordance, which we extend to two rank structures. As the coefficient of structural concordance is a pure intergroup measure of concordance, it is designed to complement the Kendall's intragroup coefficient of concordance. We apply this descriptive measure by exploring the relationship between wages and labour productivity in Slovenia for the period 1998-2007. We are able to confirm the hypothesis of high concordance between wages and labour productivity, which indicates a stimulative role of wages in production of market traded goods and services.
The Asian crisis contagion: A dynamic correlation approach analysis
Authors: Essaadi Essahbi , Jouini Jamel , Khallouli Wajih
Published: July 2009

In this paper we are testing for contagion caused by the Thai baht collapse of July 1997. In line with earlier work, shift-contagion is defined as a structural change within the international propagation mechanisms of financial shocks. We adopt Bai and Perron's (1998) structural break approach in order to detect the endogenous break points of the pair-wise time-varying correlations between Thailand and seven Asian stock market returns. Our approach enables us to solve the misspecification problem of the crisis window. Our results illustrate the existence of shift-contagion in the Asian crisis caused by the crisis in Thailand.
The thickness of the retrobulbar portion of the optic nerve in Graves ophthalmopathy measured by ultrasound
Authors: Stefanovic Ivan , Paovic Jelena , Kovacevic Igor , Paovic Predrag
Published: July 2009

Introduction. The clinical diagnostic of Graves ophthalmopathy is based on the association of ocular signs and the disease of the thyroid gland. The evolution of the disease involves the development of eye globe protrusion, extraocular muscle thickening pressuring the optic nerve, which can result in its thickness. Objective. The aim of the paper is to find whether the retrobulbar optic nerve thickened and if there was a correlation between its possible thickening and the thickness of the muscles in Graves ophthalmopathy. We also wished to test the theory of compressive aetiology of such thickening using a 30-degree test. Methods. We examined 28 patients with Graves ophthalmopathy. The thickness of the retrobulbar optic nerve was measured by ultrasound on a B-scan using the Schraeder's method and by the largest thickness of the internal muscle. Results. The thickness of the retrobulbar portion of the optic nerve in the 52 analyzed eyes with signs of the disease ranged between 3.24 mm to 6.30 mm, with median of 5.13 mm, indicating that the majority of the patients had optic nerve thickening rating at this value. Forty-eight eyes had a marked retrobulbar optic nerve thickening, with the thickening over 4 mm, while in 4 eyes with signs of Graves ophthalmopathy the thickness of the optic nerve was within normal limits. We detected that 92.3% of the patients with muscular thickening also had a directly proportional thickening of the retrobulbar optic nerve. By using the 30-degree test we confirmed the diagnosis of compressive neuropathy. Conclusion. Patients with Graves ophthalmopathy and thickened muscles, also have a thickening of the retrobulbar optic nerve; the rate of the thickness directly depends on the degree of the muscular thickness. The word is of compressive neuropathy, i.e. the thickness of the optic nerve is the result of subarachnoid fluid stasis caused by the compression on the optic nerve.
Multidimensional acoustic analysis of pathological voice
Authors: Petrovic-Lazic Mirjana , Babac Snezana , Ivankovic Zoran , Kosanovic Rade
Published: July 2009

Introduction. There are subjective and objective ways to examine the effects of vocal therapy in voice disorders. The most precise and objective check-up is the use of computer voice analysis. Objective. The aim of the research was to perform a detailed analysis of acoustic structure of the vowel A before and after voice treatment in patients with vocal fold nodules in order to obtain objective verification of the vocal rehabilitation success. Methods. We examined 30 female patients, aged 34.6?6.69 years, with vocal fold nodules. Acoustic parameters of voice were compared with the control group consisting of 21 subjects without voice pathology. In all persons the vowel A was recorded and analyzed before and after a month of vocal therapy. The success of the vocal therapy was tracked using computer analysis of vocal structure. Signal, noise and tremor parameters were processed. Results. Of the analyzed vowel A parameters: STD, PER, JITA, JITT, RAP, vFO, ShdB, SHIM, APQ, VTI, SPI, F0, NHR, FTRI, eleven improved (p<0.05 and p<0.01). Three parameters (F0, NHR, FTRI) changed showing improvement, but the obtained differences were not statistically significant (p>0.05). Conclusion. Based on the obtained results it was concluded that vocal therapy gave satisfactory results, but that it should be continually applied until full stabilization of the voice.
Clinicopathological characteristics of Barrett's carcinoma, cardia carcinoma type II and distal gastric carcinoma: Influence of observed parameters on the five-year postoperative survival of patients
Authors: Jovanovic Ivan , Alempijevic Tamara , Milosavljevic Tomica , Popovic Dragan , Bjelovic Milos , Micev Marjan , Pesko Predrag
Published: July 2009

Introduction. In the past two decades, the increased frequency of distal esophageal adenocarcinoma, esophagogastric junction and proximal gastric adenocarcinoma has been observed. The vast majority of these tumours are diagnosed in advanced stages, when the prognosis is poorer than in other gastric cancers. Objective. The aim of our study was to analyze the demographic and clinicopathological characteristics of patients operated on for Barrett's, cardia and distal gastric adenocarcinomas, as well as to study the influence of manifestations of each cancerogenetic indication on the studied clinicopathological parameters and to analyze the 5-year survival rate of patients surgically treated for cardia adenocarcinoma in relation to the patients operated on for distal gastric adenocarcinoma. Methods. We analyzed gender and age, tumour type, depth of tumour invasion, involvement of blood and lymph vessels in 66 patients surgically treated at the Centre for Oesophageal Surgery of the Institute for Digestive Diseases of the Belgrade Clinical Centre. Results. Except for significant differences in the depth of tumour invasion during surgery, there were no other statistically significant differences between the studied groups of patients. In the patients operated on for Barrett's and cardia cancers, the tumours invaded more deeply the wall layers, i.e. they were significantly more invasive than the distal gastric tumour. The lymph node involvement was present in 87.5% of patients with Barrett's cancer, in 80% with cardia cancer and in 87% with distal gastric cancer. The 3-year survival rate of patients operated on for cardia cancer was 47.4% and the 5-year survival rate was 31.6%, while the 3-year survival rate of patients operated on for distal gastric cancer was 46.2% and the 5-year survival rate was 34.6%. These differences were not statistically significant (Wilcoxon 0,036; p=0,85). Singly, the patients' gender, cancer type and the degree of tumour differentiation had no influence on the length of patients' postsurgical survival rate. Conclusion. At the time of diagnosis cardia cancer and cancers developed at the location of the Barrett's oesophagus, developed significant deeper per continuitatem than gastric cancer. There were no other differences in regard to the analyzed clinicopathological parameters among the tumours of these three locations, and there was no difference between the 3-year and 5-year survival rate between the patients operated on for gastric cancer and cardia cancer. Each studied clinicopathological parameter had no influence on the illness course.
Influence of lithotripsy modalities on complication rate
Authors: Radulovic Slobodan , Milenkovic-Petronic Dragica , Vuksanovic Aleksandar , Vavic Bozo
Published: July 2009

Introduction. Localization of ureteric stones and difference in disintegration success are the most important factors in determining the first treatment approach for ureteric stones. Objective. The aim of our study was to evaluate the difference in complication rate between different ureteric stone lithotripsy modalities. Methods. Two hundred sixty patients with ureteric stones were analyzed in a prospective bicentric study that lasted 1 year. The patients were divided into two groups: I - 120 patients who underwent ESWL (extracorporeal shockwave lithotripsy) treatment and II - 140 patients who were treated endoscopically with ballistic lithotripsy. Results. Ureteroscopic lithotripsy of all pelvic and iliac stones was significantly more successful comparing to ESWL, while lumbar ureteric stone treatment with ureteroscopic lithotripsy was not significantly more successful than ESWL, except for lumbar stones larger than 100mm2 that were significantly better treated endoscopically. In the I group complications after lithotripsy were recorded in 64 (59.3%) and in the II group in 58 (42.0%) patients, meaning that complications were statistically significantly more frequent in the I than in the II group. In the II group complications were significantly more often recorded after treatment of proximal comparing to ureteric stones of other localizations, while in the I group complications were significantly more often detected after treatment of impacted stones than in the II group. Conclusion. Being significantly successful comparing to ESWL, ureteric stone treatment with ureteroscopic lithotripsy should be considered as the first therapeutic option for all, especially impacted stones located in the iliac and pelvic ureteric portion. In spite of absent statistical difference in the success rate, ESWL should be chosen as the first treatment option in all cases of lumbar ureteric stones due to lower complication rate except for stones larger than 100mm2 that should be primarily treated endoscopically.
Internal carotid artery occlusion or subocclusion: Contemporary diagnostic challenges: Case report
Authors: Popov Petar , Radak Sandra , Ilijevski Nenad , Nenezic Dragoslav , Babic Srdjan , Tanaskovic Slobodan , Tasic Nebojsa , Radak Djordje
Published: July 2009

Introduction. Measurement of vessel stenosis using ultrasonography or magnetic resonance is still the principal method for determining the severity of carotid atherosclerosis and need for endarterectomy. Case Outline. A 56-year-old male was admitted to the Cardiovascular Institute 'Dedinje' due to a clinically asymptomatic restenosis of the operated left internal carotid artery (ICA). Angiography and magnetic resonance angiography (MRA) in previous hospitalization had revealed occluded right ICA. However, routine duplex ultrasonography revealed a highgrade restenosis (85%) of the left ICA and subocclusion of the right ICA by an ulcerated plaque (confirmed on repeated MRA). Conclusion. Selective arteriography examination could misrepresent the degree of stenosis especially in patents with the ICA that seems to be occluded. MRA is considered the method of choice for identifying pseudo-occlusions of ICA.
Sepsis as a cause of intrahepatic cholestasis
Authors: Rudic Jelena , Jesic Rada , Culafic Djordje , Sarenac-Kovac Radmila , Bulat Vladislava , Cvejic Tatjana
Published: July 2009

Introduction. The causes of intrahepatic cholestasis include cholestatic viral hepatitis, primary biliary cirrhosis, benign recurrent cholestasis, primary sclerosing cholangitis and sepsis. During sepsis, proinflammatory cytokines and nitric oxide cause cholestasis by impairing hepatocellular and ductal bile formation. Case Outline. We report a 48-year-old woman who was admitted to hospital due to malaise, jaundice, fever and pain in the neck. Physical examination revealed jaundice, tachycardia (pulse rate was 120/min), hypotension 90/60 mm Hg. Laboratory findings showed normocytic normochromic anaemia, inflammatory syndrome and abnormal liver function tests indicating cholestasis and hepatocellular necrosis. Abdominal ultrasonography detected hepatosplenomegaly. Chest computed tomography showed bronchopneumonic infiltrates. Percutaneous liver biopsy was performed using a Menghini needle of 1.4 mm. Pathohystological analysis of the liver tissue confirmed reactive, intrahepatic cholestasis. Blood cultures isolated Staphylococcus aureus. After the diagnosis was established the treatment with broad-spectrum antibiotics was carried out, resulting in the improvement of general condition of the patient, regression of inflammatory syndrome, disappearance of cholestasis and regression of pulmonary infiltrates. Abdominal ultrasonography after antibiotic treatment did not show hepatosplenomegaly. Conclusion. Concerning patients with cholestasis of uncertain origin, we should always think of sepsis as a possible cause in order to start antibiotic treatment in time.
Actinomycosis of the caecum simulating carcinoma in a patient with a long-term intrauterine device
Authors: Colovic Radoje , Grubor Nikica , Micev Marjan , Latincic Stojan , Matic Slavko , Colovic Natasa
Published: July 2009

Introduction. Actinomycosis of the caecum is a rare, but most frequently an abdominally localized disease. It often simulates inflammatory malignancy, rarely a periappendicular abscess or Chron's disease and is only exceptionally the cause of intestinal obstruction or bleeding. Case Outline. The authors present a 35-year-old woman with an intrauterine device which remained inserted for over three years, causing the development of pain, fever, vaginal secretion and bleeding that continued even after the device was removed. Ultrasonography showed a tumorous mass of irregular form located close to the uterus, which after a few months developed into a colliquation filled with pus requiring incision. Bacteriological examination failed to show actinomycosis. Due to the tumorous lesions involving the terminal ileum, appendix, caecum, ascending colon and omentum, a right hemicolectomy was performed. Based on histolopathological findings of the resected sample the diagnosis of actinomycosis was made. Therefore, after surgery the patient began treatment with antibiotics resulting in full recovery. Conclusion. Although rare, actinomycosis of the caecum should be taken into consideration in the differential diagnosis of tumorous lesions of the caecoascending part of the colon, particularly if the tumour is associated with inflammation.
Autosomal recessive polycystic kidney disease: Case report
Authors: Stevanovic Radmila , Glumac Sofija , Trifunovic Jovanka , Medjo Biljana , Nastasovic Tijana , Markovic-Lipkovski Jasmina
Published: July 2009

Introduction. Autosomal recessive polycystic kidney disease is the most common heritable cystic renal disease occurring in infancy and childhood. The clinical spectrum of signs and symptoms of this disease is widely variable ranging from perinatal death to a milder progressive form, which cannot be diagnosed until adolescence. Case Outline. A female neonate born in the 35th/36th week of gestation. The findings of all standard medical examinations of the neonate done by the mother were within normal limits. A few days before delivery physicians at a regional medical centre revealed enlarged kidneys and oligohydramnios. The delivery was performed by caesarean section. The vital functions of the newborn were in critical condition so that she was referred to the University Children's Hospital in Belgrade. Soon after admission, despite all undertaken measures, the infant died. Autopsy was done at the Institute of Pathology of the Belgrade Clinical Centre. All findings were typical for autosomal recessive polycystic kidney disease. The kidneys were hugely enlarged, with cystically dilated collecting ducts that almost completely replaced the renal parenchyma. The lungs were mildly hypoplastic. The liver showed dilated portal spaces, with multiple irregularly branching bile ducts. The cause of death was respiratory distress and renal failure. Conclusion. In all cases of congenital anomalies of the kidney with lethal ending it is necessary to perform autopsy and aimed genetic investigation.
Medicolegal aspects of hospital treatment of violent mentally ill persons
Authors: Jovanovic Aleksandar , Jasovic-Gasic Miroslava , Lecic-Tosevski Dusica
Published: July 2009

Introduction. This paper deals with medicolegal aspects of the hospital treatment of patients suffering from severe mental disorders and who are prone to violent behavior, dangerous to self and others. Violent acts in this study were defined as deliberate and nonconsensual acts of actual, attempted or threatened harm to a person or persons, and classified into categories of any type of violence, physical violence and nonphysical violence, which is in accordance with approaches used in other risk assessment researches. Outline of Cases. The authors present four cases of mentally ill inpatients whose violent behavior toward self or other persons resulted in self-destruction and physical aggression against other persons. The presented cases involved: 1) selfinjury in a patient with acute organic mental disorder after jumping through a hospital window, 2) suicide by drowning of a patient with acute mental disorder after escaping from intensive care unit, 3) suicide in a depressive patient after escaping from a low-security psychiatry unit, 4) physical violence against body and life of other persons in a patient with chronic mental disorder. Conclusion. The presented cases are considered to be rare in clinical practice and risk of violent behavior and the consequent danger of mentally ill inpatients may be efficiently predicted and prevented with appropriate hospital management based on 1) repeated escalation of violent behavior and 2) protection of the patient and others. Hence, if the physician, in order to prevent harmful consequences, does not apply all the necessary measures, including appropriate diagnostic and therapeutic procedures, as well as treatment in an adequate setting, such act is against the Criminal Law of the Republic of Serbia which sanctions physician's negligence. Also, according to the Law on Obligations of the Republic of Serbia this presents a legal ground for damage claim and the requirement of liability for nonmaterial damage within a civil procedure.
Contraception: Modern trends and controversies
Authors: Berisavac Milica , Sparic Radmila , Argirovic Rajka
Published: July 2009

Ever since ancient civilizations, the possibility of preventing unwanted pregnancies has always been the subject of interest. All available contraception methods have both advantages and disadvantages, and it is up to the doctor and the patient to make a rational choice in each individual case. Many methods for temporary prevention of unwanted pregnancy are used for the purpose of contraception, as well as sterilization, as a permanent method. A large variety of contraceptives offers opting for the most suitable method for each patient, with the highest level of efficiency and safety. With their adequate administration, the rate of unwanted pregnancies should be significantly minimized. Methods used for contraception are constantly improving and simultaneously, new and more efficient ones are being developed. The research in the field of contraceptives is not completed yet and hopefully, in the future, we shall be closer to finding available, efficient, user-friendly medicaments in the prevention of pregnancy and sexually transmitted diseases, with minimum side effects, which is on the verge of perfection. Novelties in the field of contraception must be the theme of continuous medical education of gynaecologists, so that they could provide the right information and give advice to their patients in choosing the most adequate contraceptive.
Flat feet in children
Authors: Vukasinovic Zoran , Zivkovic Zorica , Vucetic Cedomir
Published: July 2009

The authors describe flatfoot, as one of very frequent deformities in everyday medical practice. A special condition of the deformity associated with a calcaneal valgus position and complicated by a knee valgus position (as a consequence of non-treatment) is described. Also, the precise anatomy of the longitudinal foot arches (medial and lateral), definition and classification of the deformity, clinical findings and therapeutic protocols are proposed. The authors especially emphasise that the need for having extensive knowledge on the differences between a flexible and rigid flatfoot, having in mind that the treatment of flexible flat foot is usually not necessary, while the treatment of rigid flatfoot is usually unavoidable.
Efficiency and duality for multiobjective fractional variational problems with (ρ,b) - quasiinvexity
Authors: Mititelu Ştefan , Stancu-Minasian I.M.
Published: July 2009

The necessary conditions for (normal) efficient solutions to a class of multi-objective fractional variational problems (MFP) with nonlinear equality and inequality constraints are established using a parametric approach to relate efficient solutions of a fractional problem and a non-fractional problem. Based on these normal efficiency criteria a Mond-Weir type dual is formulated and appropriate duality theorems are proved assuming (?,b) - quasi-invexity of the functions involved.
Gordon and Newell queueing networks and copulas
Authors: Ciuiu Daniel
Published: July 2009

In this paper we have found an analytical formula for a copula that connects the numbers Ni of customers in the nodes of a Gordon and Newell queueing network. We have considered two cases: the first one is the case of the network with 2 nodes, and the second one is the case of the network with at least 3 nodes. The analytical formula for the second case has been found for the most general case (none of the constants from a list is equal to a given value), and the other particular cases have been obtained by limit.
A dual exterior point simplex type algorithm for the minimum cost network flow problem
Authors: Geranis George , Paparizzos Konstantinos , Sifaleras Angelo
Published: July 2009

A new dual simplex type algorithm for the Minimum Cost Network Flow Problem (MCNFP) is presented. The proposed algorithm belongs to a special 'exterior- point simplex type' category. Similarly to the classical network dual simplex algorithm (NDSA), this algorithm starts with a dual feasible tree-solution and reduces the primal infeasibility, iteration by iteration. However, contrary to the NDSA, the new algorithm does not always maintain a dual feasible solution. Instead, the new algorithm might reach a basic point (tree-solution) outside the dual feasible area (exterior point - dual infeasible tree).
Entity-Level Controls: The Internal Auditor’s Assessment of Management Tone at the Top
Authors: Hansen James , Stephens Nathaniel M. , Wood David A.
Published: July 2009

SUMMARY: The internal audit function’s (IAF) regular interaction with management and continual presence within the organization place it in a unique position to monitor the organization. Although the IAF has significant potential to evaluate and improve corporate governance, research has yet to explore how internal auditors assess an important component of corporate governance—management tone at the top. This paper reports survey evidence of 578 practicing internal auditors related to (1) current internal auditing practices regarding assessing management’s tone; (2) internal auditors’ current assessments of management’s tone; and (3) potential future practices internal auditors could perform to improve management’s tone. In addition, we examine whether the tone at the top is higher in organizations where internal auditors perform tone at the top assessments and if assessments differ based on what level of internal audit professional performs tone at the top assessments.
Systemic Fate of the Adipocyte-Derived Factor Adiponectin
Authors: Halberg Nils , Schraw Todd D. , Wang Zhao V. , Kim Ja-Young , Yi James , Hamilton Mark P. , Luby-Phelps Kate , Scherer Philipp E.
Published: July 2009

OBJECTIVE

The adipocyte-derived secretory protein adiponectin has been widely studied and shown to have potent insulin-sensitizing, antiapoptotic, and anti-inflammatory properties. While its biosynthesis is well understood, its fate, once in circulation, is less well established.

RESEARCH DESIGN AND METHODS

Here, we examine the half-life of adiponectin in circulation by tracking fluorescently labeled recombinant adiponectin in the circulation, following it to its final destination in the hepatocyte.

RESULTS

Despite its abundant presence in plasma, adiponectin is cleared rapidly with a half-life of ∼75 min. A more bioactive version carrying a mutation at cysteine 39 is cleared within minutes. Even though steady-state levels of adiponectin differ between male and female mice, we failed to detect any differences in clearance rates, suggesting that differences in plasma are mostly due to differential production rates. In a metabolically challenged state (high-fat diet exposure or in an ob/ob background), adiponectin levels are reduced in plasma and clearance is significantly prolonged, reflecting a dramatic drop in adiponectin production levels.

CONCLUSIONS

Combined, these results show a surprisingly rapid turnover of adiponectin with multiple fat pads contributing to the plasma levels of adiponectin and clearance mediated primarily by the liver. It is surprising that despite high-level production and rapid clearance, plasma levels of adiponectin remain remarkably constant.
Prediction of Metabolic Syndrome by Low Serum Testosterone Levels in Men
Authors: Haring Robin , Völzke Henry , Felix Stephan B. , Schipf Sabine , Dörr Marcus , Rosskopf Dieter , Nauck Matthias , Schöfl Christof , Wallaschofski Henri
Published: July 2009

OBJECTIVE

The aim of this analysis was to assess the prospective association of serum testosterone and dehydroepiandrosterone sulfate (DHEAS) levels with incident metabolic syndrome (MetS) in men.

RESEARCH DESIGN AND METHODS

Data were obtained from the Study of Health in Pomerania (SHIP), a population-based prospective cohort of adults aged 20–79 years. Analyses were conducted in 1,004 men without baseline MetS defined by National Cholesterol Education Program Adult Treatment Panel III guidelines. Testosterone and DHEAS were categorized by age-specific quartiles and Poisson regression models with relative risks (RRs) and 95% CIs were estimated.

RESULTS

After a median follow-up time of 5.0 years, 480 men (47.8%) developed MetS. Testosterone levels decreased with increasing number of MetS components. Testosterone in the lowest quartile predicted MetS (RR 1.38 [95% CI 1.13–1.69]), particularly among men aged 20–39 years (2.06 [1.29–3.29]), even after adjustment for age, smoking, alcohol consumption, physical activity, waist circumference, self-related health, and time of blood sampling. DHEAS levels were not related to incident MetS (0.99 [0.83–1.19]).

CONCLUSIONS

Low testosterone but not DHEAS predicts development of MetS in a population-based cohort of 1,004 men aged 20–79 years. Especially in young men aged 20–39 years, results suggest low testosterone as a strong predictor for incident MetS. Assessment of testosterone in young and middle-age men may allow early interventions in the general population.
Enhanced Hypothalamic Glucose Sensing in Obesity: Alteration of Redox Signaling
Authors: Colombani Anne-Laure , Carneiro Lionel , Benani Alexandre , Galinier Anne , Jaillard Tristan , Duparc Thibaut , Offer Géraldine , Lorsignol Anne , Magnan Christophe , Casteilla Louis , Pénicaud Luc , Leloup Corinne
Published: July 2009

OBJECTIVE

Recent data demonstrated that glucose sensing in different tissues is initiated by an intracellular redox signaling pathway in physiological conditions. However, the relevance of such a mechanism in metabolic disease is not known. The aim of the present study was to determine whether brain glucose hypersensitivity present in obese Zücker rats is related to an alteration in redox signaling.

RESEARCH DESIGN AND METHODS

Brain glucose sensing alteration was investigated in vivo through the evaluation of electrical activity in arcuate nucleus, changes in reactive oxygen species levels, and hypothalamic glucose-induced insulin secretion. In basal conditions, modifications of redox state and mitochondrial functions were assessed through oxidized glutathione, glutathione peroxidase, manganese superoxide dismutase, aconitase activities, and mitochondrial respiration.

RESULTS

Hypothalamic hypersensitivity to glucose was characterized by enhanced electrical activity of the arcuate nucleus and increased insulin secretion at a low glucose concentration, which does not produce such an effect in normal rats. It was associated with 1) increased reactive oxygen species levels in response to this low glucose load, 2) constitutive oxidized environment coupled with lower antioxidant enzyme activity at both the cellular and mitochondrial level, and 3) overexpression of several mitochondrial subunits of the respiratory chain coupled with a global dysfunction in mitochondrial activity. Moreover, pharmacological restoration of the glutathione hypothalamic redox state by reduced glutathione infusion in the third ventricle fully reversed the cerebral hypersensitivity to glucose.

CONCLUSIONS

The data demonstrated that obese Zücker rats' impaired hypothalamic regulation in terms of glucose sensing is linked to an abnormal redox signaling, which originates from mitochondria dysfunction.
The C3a Anaphylatoxin Receptor Is a Key Mediator of Insulin Resistance and Functions by Modulating Adipose Tissue Macrophage Infiltration and Activation
Authors: Mamane Yaël , Chung Chan Chi , Lavallee Genevieve , Morin Nicolas , Xu Li-Jing , Huang JingQi , Gordon Robert , Thomas Winston , Lamb John , Schadt Eric E. , Kennedy Brian P. , Mancini Joseph A.
Published: July 2009

OBJECTIVE

Significant new data suggest that metabolic disorders such as diabetes, obesity, and atherosclerosis all posses an important inflammatory component. Infiltrating macrophages contribute to both tissue-specific and systemic inflammation, which promotes insulin resistance. The complement cascade is involved in the inflammatory cascade initiated by the innate and adaptive immune response. A mouse genomic F2 cross biology was performed and identified several causal genes linked to type 2 diabetes, including the complement pathway.

RESEARCH DESIGN AND METHODS

We therefore sought to investigate the effect of a C3a receptor (C3aR) deletion on insulin resistance, obesity, and macrophage function utilizing both the normal-diet (ND) and a diet-induced obesity mouse model.

RESULTS

We demonstrate that high C3aR expression is found in white adipose tissue and increases upon high-fat diet (HFD) feeding. Both adipocytes and macrophages within the white adipose tissue express significant amounts of C3aR. C3aR−/− mice on HFD are transiently resistant to diet-induced obesity during an 8-week period. Metabolic profiling suggests that they are also protected from HFD-induced insulin resistance and liver steatosis. C3aR−/− mice had improved insulin sensitivity on both ND and HFD as seen by an insulin tolerance test and an oral glucose tolerance test. Adipose tissue analysis revealed a striking decrease in macrophage infiltration with a concomitant reduction in both tissue and plasma proinflammatory cytokine production. Furthermore, C3aR−/− macrophages polarized to the M1 phenotype showed a considerable decrease in proinflammatory mediators.

CONCLUSIONS

Overall, our results suggest that the C3aR in macrophages, and potentially adipocytes, plays an important role in adipose tissue homeostasis and insulin resistance.
Antinuclear Antibody and Rheumatoid Factor in Silica-Exposed Workers
Authors: Aminian Omid , Sharifian Seyed , Mehrdad Ramin , Haghighi Khosro , Mazaheri Maria
Published: July 2009

Antinuclear Antibody and Rheumatoid Factor in Silica-Exposed Workers

A lot of workers in industries such as foundry, stonecutting, and sandblasting are exposed to higher than permissible levels of crystalline silica. Various alterations in humoral immune function have been reported in silicosis patients and workers exposed to silica dust. The aim of this study was to measure antinuclear antibody (ANA) and rheumatoid factor (RF) levels in foundry workers exposed to silica and to compare them with a control group without such exposure. ANA and RF were measured in 78 exposed and 73 non-exposed workers, and standard statistical methods were used to compare them. The two groups did not significantly differ in age and smoking. Mean work duration of the exposed and non-exposed workers was (14.9±4.72) years and (12.41±6.3) years, respectively. Ten exposed workers had silicosis. ANA was negative in all workers in either group. Its mean titer did not differ significantly between the exposed and control workers [(0.39±0.15) IU mL-1vs. (0.36±0.17) IU mL-1, respectively]. RF was positive in two workers of each group. Other studies have reported an increase in ANA and RF associated with exposure to silica dust and silicosis.

In contrast, our study suggests that exposure to silica dust does not increase the level of ANA and RF in exposed workers.
Radioprotective Effects of Quercetin and Ethanolic Extract of Propolis in Gamma-Irradiated Mice
Authors: Benković Vesna , Knežević Anica , Đikić Domagoj , Lisičić Duje , Oršolić Nada , Bašić Ivan , Kopjar Nevenka
Published: July 2009

Radioprotective Effects of Quercetin and Ethanolic Extract of Propolis in Gamma-Irradiated Mice

The aim of this study was to assess radioprotective effects of quercetin and the ethanolic extract of propolis (EEP) in CBA mice exposed to a single radiation dose 4 Gy (60Co). The mice were treated with 100 mg kg-1quercetin or EEP a day for three consecutive days either before (pre-treatment) or after gamma-irradiation (therapy). Leukocyte count was determined in blood drawn from the tail vein, and DNA damage in leukocytes was assessed using the alkaline comet assay. Genotoxic effects of the test compunds were also evaluated in non-irradiated mice. The levels of radioprotection provided by both test compounds were compared with those established in mice that were given chemical radioprotector S-(2-Aminoethy1)isothiouronium bromide hydrobromide (AET). Mice that received pre-treatment were less sensitive to irradiation. Mice given the post-irradiation therapy showed a slight but not significant increase in total leukocyte count over irradiated negative control. Quercetin showed better protective properties than EEP in both pre-treatment and therapy, and activated a higher number of leukocytes in non-irradiated mice. The alkaline comet assay suggests that both natural compounds, especially when given as pre-treatment, protect against primary leukocyte DNA damage in mice. At tested concentrations, EEP and quercetin were not genotoxic to non-irradiated mice. AET, however, caused a slight but not significant increase in DNA damage. Although the results of this study show the radioprotective potential of the test compounds, further investigation is needed to clarify the underlying protection mechanisms.
D-Amphetamine Toxicity in Freshly Isolated Rat Hepatocytes: A Possible Role of CYP3A
Authors: Vitcheva Vessela , Kondeva-Burdina Magdalena , Mitcheva Mitka
Published: July 2009

D-Amphetamine Toxicity in Freshly Isolated Rat Hepatocytes: A Possible Role of CYP3A

The aim of this study was to trace D-amphetamine toxicity in isolated rat hepatocytes and to elucidate a possible involvement of CYP3A in the mechanisms of its toxicity. To this end, male Wistar rats were treated with nifedipine (5 mg kg-1i.p., 5 days), a substrate and inducer of CYP3A. Hepatocytes isolated from nifedipine-treated and control rats were incubated with D-amphetamine at a concentration of 100 μmol L-1, which was determined to be an average toxic concentration (TC50) for the compound. To evaluate the possible toxic effects of D-amphetamine on freshly isolated rat hepatocytes, we assessed the following parameters: cell viability, lactate dehydrogenase (LDH) activity, and glutathione (GSH).

The results showed that nifedipine potentiated amphetamine cytotoxicityin vitro, as follows: cell viability dropped by 65% (p>0.001), GSH by 80% (p>0.001), and LDH activity increased by 190% (p>0.001). To clarify the role of nifedipine in amphetamine cytotoxicity, we used amiodarone, a substrate and an inhibitor of CYP3A. Pre-incubation of nifedipine-treated hepatocytes with amiodarone (14 μmol L-1) significantly lowered amphetamine cytotoxicity.

Our results confirmed the toxicity of D-amphetamine in isolated rat hepatocytes and the involvement of CYP3A in its metabolism and hepatotoxicity.
Comparative Effects of Calcium Channel Blockers, Autonomic Nervous System Blockers, and Free Radical Scavengers On Diazinon-Induced Hyposecretion Of Insulin From Isolated Islets of Langerhans in Rats
Authors: Pourkhalili Nazila , Pournourmohammadi Shirin , Rahimi Fatemeh , Vosough-Ghanbari Sanaz , Baeeri Maryam , Ostad Seyed , Abdollahi Mohammad
Published: July 2009

Comparative Effects of Calcium Channel Blockers, Autonomic Nervous System Blockers, and Free Radical Scavengers On Diazinon-Induced Hyposecretion Of Insulin From Isolated Islets of Langerhans in Rats

Hyperglycaemia has been observed with exposure to organophosphate insecticides. This study was designed to compare the effects of calcium channel blockers, alpha-adrenergic, beta-adrenergic, and muscarinic receptor blockers, and of free radical scavengers on insulin secretion from diazinon-treated islets of Langerhans isolated from the pancreas of rats using standard collagenase digestion, separation by centrifugation, and hand-picking technique. The islets were then cultured in an incubator at 37 °C and 5 % CO2. In each experimental set 1 mL of 8 mmol L-1glucose plus 125 μg mL-1or 625 μg mL-1of diazinon were added, except for the control group, which received 8 mmol L-1glucose alone. The cultures were then treated with one of the following: 30 μmol L-1atropine, 100 μmol L-1ACh + 10 μmol L-1neostigmine, 0.1 μmol L-1propranolol, 2 μmol L-1nifedipine, 50 μmol L-1phenoxybenzamine, or 10 μmol L-1alphatocopherol. In all experiments, diazinon significantly reduced glucose-stimulated insulin secretion at both doses, showing no dose dependency, as the average inhibition for the lower dose was 62.20 % and for the higher dose 64.38 %. Acetylcholine and alpha-tocopherol restored, whereas atropine potentiated diazinon-induced hyposecretion of insulin. Alpha-, beta- and calcium channel blockers did not change diazinon-induced effects. These findings suggest that diazinon affects insulin secretion mainly by disturbing the balance between free radicals and antioxidants in the islets of Langerhans and by inducing toxic stress.
Analysis of Polychlorinated Dibenzo-p-Dioxins and Polychlorinated Dibenzofurans in Soil and Sediment
Authors: Kožul Darija , Romanić Snježana
Published: July 2009

Analysis of Polychlorinated Dibenzo-p-Dioxins and Polychlorinated Dibenzofurans in Soil and Sediment

This review presents methods for the analysis of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs), called dioxins, in soil and sediment. These compounds are produced as by-products of different combustion processes, and because of their persistency and toxicity they present a threat for animal and human health. Due to their high organic matter content, soil and sediment can accumulate dioxins and have become important secondary emission sources. Determining dioxins in these samples is complex because dioxins are present in trace levels and have to be separated from interferences whereas other classes of organic contaminants are present in higher concentrations. After sampling, follows extraction of compounds with a suitable solvent, extract clean-up from unwanted compounds, and qualitative and quantitative analysis. At the end of this review, we gave levels of PCDD/PCDFs found in soil and sediment samples.