[Presentation of the medical activity of dr Valentin Lucas as the first specialist of the obstetrics-gynaecology and venerology in Rijeka, Pula and Labin at the end of the 19th and early 20th century]. / Prikaz lijecnicke djelatnosti dr. Valentina Lucasa - specijalista opstetricara-ginekologa i venerologa u Rijeci, Puli i Labinu - krajem XIX.i XX. stoljeca.

Dr Valentin Lucas was born in Labin on 19 March 1873. His ancestors moved to Labin from Gora (near Labin) in the 17th century. Valentin was a common name in his family. His family was well known for having many well educated members including lawyers, doctors, and priests. The last member of their family was Giacomo who committed suicide few years after the Second World War. According to now known facts, we can say that Dr Valen Lucas was the first doctor in Rijeka who specialised in gynaecology, obstetrics and venereology, with the reputation and knowledge from working in Trieste and Vienna. In Rijeka he established his private practice that was visited by patients of different social backgrounds, which we can find in Dr Valentin Lucas' medical records. Just before Ester in 1909, he accepted a job offer as a one year substitute for Dr Manzini, who was a police-doctor for Harbour Master's Office in Pula. Pula by that time had already established an image of a strategic military Austrian-Hungarian port. In hope for a better life thousands of residents moved to already overpopulatedPula. As their new environment could not render their hopes, many were drawn to refuge in immorality and women in prostitution. Dr Lucas had been fighting against prostitution in Pula, especially against secret prostitution, because that was one of his main goals as a doctor. Though his task was not easy, because there were no organised sanitary and administrative services for that popular social deviation. He died in Labin on 18 February 1932.

[Matthias Flacius Illyricus, the younger, professor philosophiae et logicae aristotelis and professor of the practical medicine]. / Matija Vlacic Ilirik mladi, profesor filozofije i aristotelovske logike i profesor prakticne medicine.

The aim of this paper is to offer some new information on the life and work of Matthias Flacius Illiricus the Younger, especially concerning his activity as a medical doctor and university professor. According to our present knowledge, he published 17 of his writings during his lifetime. Matthias Flacius the Younger was born on September 12, 1547 in Braunschweig. His mother Elisabeth had 11 more children with Matthias Flacius the Elder.When Flacius the Younger was 15 (in 1562), his father sent him to Strassburg to study philosophy. According to some scholars (Waltraut Wienke, 2001), Flacius the Younger arrived to Rostock in August 1572 and was granted the title of magister philosophiae on April 1, 1574. According to the sources, that very year he was enrolled at the Faculty of Medicine in Rostock. On April 27, 1579 he was mentioned as lecturing at the Faculty of Philosophy, where he became Philosophiae & Logicae Aristotelis doctor in 1580. It is interesting that only a year later on September 23, 1581, when he was 33 years old, he became Doctor Medicinae by defending a dissertation entitled "De cattarrho; ward darauf zum Dr Med prom". In 1592 he exchanged his position at the Philosophy Chair in Rostock for the medical one, becoming a professor of Practical Medicine. Matthias Flacius the Younger died on April 27, 1593, when he was 46 years old.

Brain iron accumulation in unexplained fetal and infant death victims with smoker mothers--the possible involvement of maternal methemoglobinemia.

BACKGROUND: Iron is involved in important vital functions as an essential component of the oxygen-transporting heme mechanism. In this study we aimed to evaluate whether oxidative metabolites from maternal cigarette smoke could affect iron homeostasis in the brain of victims of sudden unexplained fetal and infant death, maybe through the induction of maternal hemoglobin damage, such as in case of methemoglobinemia. METHODS: Histochemical investigations by Prussian blue reaction were made on brain nonheme ferric iron deposits, gaining detailed data on their localization in the brainstem and cerebellum of victims of sudden death and controls. The Gless and Marsland's modification of Bielschowsky's was used to identify neuronal cell bodies and neurofilaments. RESULTS: Our approach highlighted accumulations of blue granulations, indicative of iron positive reactions, in the brainstem and cerebellum of 33% of victims of sudden death and in none of the control group. The modified Bielschowsky's method confirmed that the cells with iron accumulations were neuronal cells. CONCLUSIONS: We propose that the free iron deposition in the brain of sudden fetal and infant death victims could be a catabolic product of maternal methemoglobinemia, a biomarker of oxidative stress likely due to nicotine absorption.

Pregnancy loss and maternal methemoglobin levels: an indirect explanation of the association of environmental toxics and their adverse effects on the mother and the fetus.

The aim of this epidemiologic study was to point out a relationship between the exposure to products of coal combustion, and complications in pregnancy where one third of causes of stillbirth are still unknown. In the town of Labin (Croatia) a coal-powered thermoelectric power plant is the single major air polluter. We compared the records of miscarriages, premature births and stillbirths in two periods: the control and the exposure period. Data on reproductive loss was based on the records of pregnant women visiting for regular monthly pregnancy checkups. At the time of the epidemiological prospective study, 260 women (n = 138 in the clean period and n = 122 in the dirty period) were considered representative. The data were processed using Chi square and correlation tests. The frequencies of miscarriages and stillbirths were significantly lower in the control than in the exposure period (p < 0.05). Methemoglobinemia and stillbirths recorded over the "exposure" period are significantly higher than in the "control" period (p = 0.0205). The level of methemoglobin in the bloodstream is an worthy biomarker, predictor and precursor of environmental toxics' adverse effects on the mother and fetus, and can indirectly explain the unrecognized level of fetal methemoglobin. Methemoglobin and heme, having prooxidant properties, also cause the early and late endothelial dysfunction of vital organs. Despite our retrospective epidemiological study findings, we emphasize that the rate of reproductive loss represents a hypothetical risk, which needs to be confirmed with further fetal clinical and anatomopatholgical researches about the effects of methemoglobin catabolism products on the fetal CNS.

Consequences of methemoglobinemia in pregnancy in newborns, children, and adults: issues raised by new findings on methemoglobin catabolism.

OBJECTIVE: The aim of this review is to warn about the effects of methemoglobin and its catabolic products and the toxic effects caused by environmental oxidants that cause high-risk pregnancy and may later impair the health of newborns, children and adolescents. METHODS: In our study of pregnant women (n = 36) whose methemoglobin level was >1.5 g/l, we took blood samples from their newborns to determine the frequency of sister chromatid exchange (SCE) by cultivating lymphocytes. The research took place at the Department of Biology and Medical Genetics of the School of Medicine in Rijeka (Croatia). RESULTS: The results have shown that no deviation in the SCE frequency was found in either case (1990). We examined data on the health of newborns collected at perinatal hospital departments in Rijeka (Croatia), the preschool office and school service at the Labin Health Center and continued until they were 18 years of age (2008). The statistics obtained by applying the chi-square test show that the incidences of neonatal jaundice (p = 0.034), heart murmur at a later age (p = 0.011) and dyslalia and learning/memory impairments (p = 0.002) were significantly higher than in children of control mothers (n = 19). CONCLUSION: Depending on the mother's exposure to environmental oxidants, during its development the fetus is more likely to be affected by methemoglobin and hemolysis. Oxidants affect the vascular endothelium of kidneys, brain and other vital organs, because they have the capacity to cross the damaged fetomaternal placental barrier. 'Fetal preeclampsia' is an expected manifestation of the condition. Our research proves our thesis on the pathophysiological relationship between methemoglobinemia and unexplained jaundice and hyperbilirubinemia, heart murmur at a later age, dyslalia and learning and memory impairments that have not exactly been demonstrated yet.

The role of methemoglobinemia in early and late complicated pregnancy.

The objective of this review was to direct attention about methemoglobin as a biomarker which has an important role in the detection of adverse effects of the oxidative stress, misbalanced production of ROS, RNS and RSS. According to our hypothesis, a pregnant woman continuously inhaling environmental toxics as fuel burning products, will traverse three, not two from current thought, distinct stages. The main difference among present three-stage hypothesis and other hypotheses is the assertion that, in the pathogenesis of early and late complicated pregnancy, methemoglobin takes on an important role. Secondly, we also observed the utero-placental changes as "locus manifesting minoris resistentiae" in complicated pregnancy are not the causes but a consequence of increased systemic oxidative stress. Methemoglobin and hemolysis both occur as a result of oxidative stress, but the prevalent difference between them is that methemoglobin is a reversible phenomenon (oxidant-antioxidant balance) whereas hemolysis, which occurs as a result of oxidative stress on the erythrocyte membrane, is an irreversible event. Methemoglobinemia can additionally exacerbate an existing anemia, stimulating hypoxia that may be dangerous for both mother and fetus. Own prospective study of methemoglobin in pregnancy, revealed a significant rise in the level of methemoglobin >1.5 g/L (r=0.72, p<0.01) in the exposure period, which can be explained on the basis of an oxidant-antioxidant imbalance, resulting in methemoglobinemia. Methemoglobinemia and stillbirth recorded throughout exposure period are significantly higher than those recorded in the control period (p=0.0205), and the frequencies of reproductive loss were significantly lower in the control than in the exposure period (p<0.05). Results suggest that methemoglobin as individual indicator of oxidative stress is an early marker of the identification of women with a pregnancy risk. It has the advantage of being applicable some time before ultrasonic examination becomes feasible. Further support for this assumption will require further investigations that may lead to the supposition that increasing level of methemoglobin is related to environmental toxicities complicated pregnancy and IUGR, preeclampsia, and a high percentage of perinatal mortality and morbidity.

First two months of pregnancy--critical time for preterm delivery and low birthweight caused by adverse effects of coal combustion toxics.

OBJECTIVE: The objective of this study was to define the most critical gestation period for adverse effects of environmental toxics in terms of preterm delivery (<37 weeks) and low birthweight (<2500 g) in humans. STUDY DESIGN: From January 1, 1987 to December 31, 1989, 704 women were included in a retrospective epidemiological study. All were from the district of Labin and lived in the vicinity of a coal power plant Plomin 1, Croatia. This plant is the single large source of air pollution in the area. The coal used for fuel is extremely rich with sulfur, 9-11%. Daily, weekly, and monthly consumption of coal and related SO2 emissions were calculated for each pregnant woman from the beginning to the end of pregnancy. RESULTS: We found that a greater and longer exposure to SO2 emissions during the initial two months of pregnancy resulted in a significantly shorter gestation (end of the first month: -0.0914, p=0.008, end of the second month: -0.0806, p=0.016) and in lower body mass of a newborn (end of the first month: -0.0807, p=0.016, end of the second month -0.0733, p=0.026). CONCLUSION: The results of this study confirm the role of inhaled environmental toxics in the early development of human embryo and in adverse pregnancy course caused by permanent oxidative stress, misbalanced production of reactive oxygen species (ROS), reactive nitrogen species (RNS), reactive sulfur species (RSS), and other unfavorable metabolic processes on early embryogenesis, resulting in growth-arrested cells.

The level of maternal methemoglobin during pregnancy in an air-polluted environment.

The objective of this prospective study was to determine if a correlation could be established between the ground-level concentrations of sulfur dioxide and methemoglobin concentrations in pregnant women when a coal-powered thermoelectric power plant was in operation ("dirty" period) and when it was closed ("clean" period). The location of the power plant, Plomin 1, in Labin, Croatia, was taken into consideration. Blood and urine samples of each pregnant woman in the study were tested three times in the clean period (n = 138) and three times in the dirty period (n = 122), with 1 month between each test. I observed a correlation between the increase in mean values of methemoglobin and the ground-level concentration of SO(2) on corresponding dates during the dirty period (r = 0.72, p < 0.01). In the clean period, the negative mean value of methemoglobin was significant (r = -0.60, p