MFI, BEA and FAU zeolite scavenging role in neonicotinoids and radical species elimination.

Ecotoxicity caused by neonicotinoid pesticides is largely due to oxidative stress on non-target species. Due to the fact that reactive radical species reach the environment, materials intended for pesticide removal should be applicable for the simultaneous removal of reactive radicals, as well. This work uses the spectroscopic, adsorptive and antioxidant responses from MFI, FAU and BEA zeolites as descriptors of their potential environmental importance. Different network structures and Si/Al ratios were correlated with excellent zeolite adsorption properties, as over 200 mg g-1 of investigated neonicotinoids, acetamiprid and imidacloprid, was achieved in one cycle. Additionally, after two regeneration steps, over 450 mg g-1 adsorbed pesticides were retained, in three adsorption cycles. Overall the best results were detected for the FAU zeotype in both tested applications, insecticide adsorption and radical-scavenging performance, with and without insecticides present. The proposed mechanism for adsorption relies on kinetic investigation, isotherm modelling and spectroscopic post-adsorption analysis and targets zeolite hydroxyl/siloxane groups as active sites for insecticide adsorption via hydrogen bonding. Neat, well-defined zeolite structures enable their prospective application in ecotoxic species removal.

Enamel and Dentin Microhardness and Chemical Composition After Experimental Light-activated Bleaching.

OBJECTIVES: To evaluate 1) the influence of five bleaching agents (with additional light activation) on enamel and dentin surface microhardness and chemical composition and 2) the remineralizing potential of artificial saliva and amorphous calcium phosphate (ACP). METHODS AND MATERIALS: The study was conducted on 125 human third molars dissected into quarters for separate enamel and dentin measurements. The bleaching process was performed with 38% and 25% hydrogen peroxide (HP) and 30%, 16%, and 10% carbamide peroxide (CP) gels two times for 15 minutes each time. All bleaching gels were tested alone and in combination with ZOOM2, light-emitting diode (LED), organic LED, and femtosecond laser. A total of 25 bleaching combinations (n=10) were evaluated. Microhardness was measured by a Vickers diamond. Chemical analysis was performed using energy-dispersive X-ray spectroscopy. RESULTS: Bleaching agents used in the absence of light activation caused a significant reduction in enamel and dentin surface microhardness (p<0.001), ranging from 8% for 16% CP to 40% for 25% HP. The effects of different light activations were negligible. After two-week treatment with ACP and artificial saliva, maximum deviation from baseline microhardness was just 3%. Such treatment increased the concentrations of calcium, phosphorus, and fluorine. CONCLUSIONS: An increase in peroxide concentration and gel acidity negatively affected microhardness and concentrations of calcium and phosphorus in enamel and dentin. ACP and artificial saliva stimulated the remineralization of hard tissues.

Salivary antioxidants as periodontal biomarkers in evaluation of tissue status and treatment outcome.

BACKGROUND AND OBJECTIVE: One of the major pathologic patterns in periodontitis represents an imbalance among the production of free radicals and local antioxidants resulting in periodontal tissue destruction. The objective of the study was to investigate the influence of non-surgical periodontal treatment on salivary antioxidants and to evaluate their capacity as biomarkers reflecting periodontal tissue condition and therapy outcome. MATERIAL AND METHODS: Sixty-three systemically healthy non-smokers, including 21 periodontally healthy subjects (HC) and 42 patients with current chronic periodontitis fulfilled the inclusion criteria. Half of the patients received scaling and root planing (SRP) and the other half received only oral hygiene instructions. Full mouth clinical measurements, including gingival index (GI), plaque index (PI), periodontal pocket depth, clinical attachment level and saliva sampling were performed at baseline visit and 2 mo after treatment/baseline visit. Total antioxidant capacity (TAOC), albumins (ALB), uric acid (UA), superoxide dismutase (SOD) and glutathione peroxidase (GPX) were evaluated in saliva samples using commercial kits. RESULTS: All measured antioxidants were affected by treatment resulting in significant increase in TAOC (p < 0.005), ALB (p < 0.001), UA (p < 0.001) and GPX (p < 0.001) and decrease of SOD (p < 0.005) in response to SRP, where no differences were observed for any of parameters in the oral hygiene instructions group. Comparison of antioxidant levels between the HC and SRP group showed that before treatment ALB were significantly higher in HC when compared to the SRP group (p = 0.039), and GXP (p = 0.000) and SOD (p = 0.021) levels were significantly higher in the SRP group. Comparison of values after treatment showed that TAOC was significantly higher in the HC than in the SRP group (p = 0.001), but UA was, inversely, significantly higher in the SRP group (p = 0.034). All clinical parameters except clinical attachment level were significantly decreased after SRP and significant correlations were observed between SOD and GI (p = 0.017), SOD and PI (p = 0.011), GPX and GI (p = 0.003) and GPX and PI (p = 0.008). CONCLUSION: Non-surgical periodontal treatment affected salivary TAOC, ALB, UA, SOD and GPX; moreover, these biochemical parameters convincingly reflected periodontal status and tissue response on treatment.

Granulysin Expression in Lymphocytes that Populate the Peripheral Blood and the Myocardium after an Acute Coronary Event.

We aimed to analyse granulysin (GNLY)-mediated cytotoxicity in the peripheral blood of patients with non-ST-segment elevation myocardial infarction (NSTEMI) treated with anti-ischaemic drug therapy. Thirty-nine NSTEMI patients with a median age of 70 years and 28 age-matched healthy subjects were enrolled in this study. On day 7 after MI, the number of GNLY(+) lymphocytes in the peripheral blood increased approximately six-fold of that in the healthy subjects, measured by flow cytometry. On day 14, the number of GNLY(+) cells significantly decreased in T, NKT, and both CD56(+dim) and CD56(+bright) NK subsets. GNLY(+) CD3(+) and GNLY(+) CD56(+) cells infiltrated central zone of myocardial infarction (MI). In persons who died in the first week after MI, GNLY(+) cells were found within accumulation of apoptotic leucocytes and reached the apoptotic cardiomyocytes in border MI zones probably due to the influence of interleukin-15 in peri-necrotic cardiomyocytes, as it is was shown by immunohistology. By day 28, the percentage of GNLY(+) lymphocytes in peripheral blood returned to the levels similar to that of the healthy subjects. Anti-GNLY mAb decreased apoptosis of K562 targets using peripheral blood NK cells from days 7 and 28 after MI, while in assays using cells from days 1 and 21, both anti-GNLY and anti-perforin mAbs were required to significantly decrease apoptosis. Using NK cells from day 14, K562 apoptosis was nearly absent. In conclusion, it seems that GNLY(+) lymphocytes, probably attracted by IL-15, not only participate partially in myocardial cell apoptosis, but also hasten resolution of cardiac leucocyte infiltration in patients with NSTEMI.

Perforin-mediated cytotoxicity in non-ST elevation myocardial infarction.

The aim of this investigation was to examine the role of perforin (P)-mediated cytotoxicity in the dynamics of tissue damage in patients with non-ST-segment elevation myocardial infarction (NSTEMI) treated with anti-ischaemic drugs. We enrolled 48 patients with NSTEMI in this study [age, 71.5 years; 61.5/76 (median, 25th/75th percentiles)]. The percentage of total peripheral blood P(+) lymphocytes was elevated owing to the increased frequency of P(+) cells within natural killer (NK) subsets, T and NKT cells in patients on day 1 after NSTEMI when compared with healthy controls. Positive correlations were found between cardiac troponin I plasma concentrations and the frequency of P(+) cells, P(+) T cells, P(+) NK cells and their CD56(+dim) and CD56(+bright) subsets during the first week after the NSTEMI. The expression of P in NK cells was accompanied by P-mediated cytotoxicity against K-562 targets at all days examined, except day 21, when an anti-perforin monoclonal antibody did not completely abolish the killing. The percentage of P(+) T cells, P(+) NKT cells and P(+) NK subsets was the highest on the day 1 after NSTEMI and decreased in the post-infarction period. CD56(+) lymphocytes were found in damaged myocardium, suggesting their tissue recruitment. In conclusion, patients with NSTEMI have a strong and prolonged P-mediated systemic inflammatory reaction, which may sustain autoaggressive reactions towards myocardial tissue during the development of myocardial infarction.

[Morphologic analysis of the coexisting anomalies of the arteries of the cerebral base and aneurysms: clinical study].

During operations of the aneurysms showing anatomical details is the means that leads to the aim, and it is not only a purpose in itself. Data on details that the surgeons come across during their work and which sometimes represent difficulties during interpretations of angiographic findings and planning operations, as well as the intraoperative orientations and identifications of the elements . Frequency of occurrence of such anatomical details and anomalies may be completely different from the one that autopsy series show. Knowledge of this makes the work of surgeons easier and gives a necessary feeling of confidence during operations. Thus, we decided to conduct a clinical, morphological study based on angiographic and surgical analyses of the explored segments of the Wilson circle. The study included 344 patients from the Institute for Neurosurgery, during the period of 2 years; the patients had complete angiographic diagnosing and operative exploration. Our findings confirm differences in localization of aneurysms according to sex. Aneurysms on the front communicant complex are to a great extent associated with anomalies of the front part of the Wilson circle.

[Screening of risk groups for discovering intracranial aneurysms before rupture].

In development of intracranial aneurysms contribute genetic factors together with smoking, hypertension, diabetes mellitus. Epidemiology studies suggest that as many as 5% of people harbour a cerebral aneurysm by age 75. Rupture of cerebral aneurysm is the most frequent cause of spontaneous subarachnoid haemorrhage (up to 80%.) Annual incidence of SAH is 10-14/100 000, but only 15-20% of aneurysms will rupture, and that will happen probably between 40-60 years. The morbidity and mortality of aneurismal subarachnoid (SAH) continues to be high. It is not possible to predict who has aneurysm and is it going to bleed or not, but it is possible to reveal high risk groups (polycystic kidney disease, Ehlers-Danlos sy, Marphan sy, family history of cerebral aneurysms, suspect de novo aneurysm formation in patients with prior history of cerebral aneurysm). Reviewing data from literature and reporting cases from each group with high risk, that have been screened and aneurysms discovered, authors wish to focus interest on this matter and propose screening program for these groups of patients. The mortality and morbidity in cases treated before rupture is significantly lower than after SAH, so screening programs could save many lives. According to our preliminara data, mostly based on control angiographies after 8-10 zears in patients previouslz operated for intracranial aneurysmas, from 15 angipgraphies 4 revealed new aneurysms (26% in 10 years period) with total number of 6 de novo formed aneurysms, which is not valid due to small number of patients but strongly suggests the importancy of screening program for risk groups.

[Subarachnoid hemorrhage caused by a rupture of a spinal arteriovenous malformation].

The authors report on a patient presenting with subarachnoid hemorrhage that was caused by a rupture of an spinal combined arteriovenous malformation at cervicothoracic junction. The patient was a 30-year-old female, who had exhibited an abrupt onset of severe low neck and occipital pain with radiation into shoulders and vomiting. Neurological examination revealed severe meningism without motor or sensory deficit. Digital subtraction angiography did not demonstrate any intracranial source of bleeding, whereas spinal angiography revealed a spinal arteriovenous malformation at cervicothoracic junction. Endovascular treatment of the malformation was considered for this patient. Occipital and neck pain with radiation into schoulders and severe meningism are clues pointing to a spinal origin of the haemorrhage.

[Cerebral vasospasm after subarachnoid hemorrhage].

Cerebral vasospasm causes permanent neurolological deficit or death occurance in 13% of clinical cases. Peak frequency is from 8-10th day after SAH. The purpose of this study is factor analysis that may have influence on vasospasm development , as well as predictor determination. The study is prospective and analysis 192 patients treated in Institute of Neurosurgery, Clinical Centre of Serbia, Belgrade. The majority of patients were admitted in hospital in first four days after SAH, and 184 had GCS over 7. Univariate methods of factor analysis were used, and for significance of predictors influence testing multivariante regression analysis was used. Vasospasm occurred in 22,40% of all cases. No relationships have been found between sex, age, previous hypertension, timing of surgery, appearance of hydrocephalus and intracerebral hematoma, hypertermia or mean arterial blood pressure, with occurrence of cerebral vasospasm. Factors with significantly associated with the occurance of vasospasm were: hearth disease, hypernatriemia, Hct, clinical grade on admission as well as preoperative clinical grade and Fisher CT scan grade. In the first four days after SAH, Fisher scan grade, preoperative clinical grade and Hct, appeared as predictors. After four days, clinical grade on admission and hypernatiemia, showed as poredictors.

[Space reconstruction of the aneurysms of the vertebrobasilary confluence based on conventional angiography--our experience].

Besides current development of the new diagnostic procedures conventional angiography still represents the golden standard in the diagnosing of intracranial aneurysms. Since it gives a two-dimensional image if the presentation of the third dimension is wanted it is necessary to apply appropriate algorithm structures and computers. In this study we show our experience in the application of space reconstruction of blood vessels and aneurysms of the vertebrobasilary confluence in 6 patients operated at the Institute for Neurosurgery, Clinical Center of Serbia. Intraoperative finding in all patients matched the finding that we got by space reconstruction of the blood vessels, which was possible to observe from different angles. Postoperative course in all patients was satisfying. Upon discharge the patients were without rough lateralization of the pyramidal system. Our initial results and their practical agreement with the interoperative finding give us right to recommend this method as the standard for the preoperative diagnostic protocol.

Distal posterior cerebellar artery aneurysm: case report.

Vertebrobazilar aneurysms make about 15% of all intracranial aneurysms, from which one fifth belongs to aneurysms a posterior inferior cerebelli (PICA). Majority of PICA aneurysms is located in the place of separation from a.vertebralis. Aneurysms of distal part of PICA are very rare, according to literature they make 0.5 to 3% of all aneurysms. 70 years old man came to neurologist because sudden headache, pain in the neck and a feeling of stiffness followed by throwing up in stream. On the occasion of medical check up attack of spontaneous subarachnoid hemorhage was suspected. Clinical gradus according to H&H III, initial CT of endocranium showed existence of smaller intracerebellar hematoma next to lateral wall of IV ventricle and trace of blood in the very ventricle without signs of acute hydrocephalus. The seventh day after the hemorrhage angio CT was done and it showed existence of aneurysm on distal part of PICA, more specially in the televelotonzilar segment on the right. After the diagnostics supplemented with standard digital substractional angiography which confirmed nature and localization of the lesion. In the postponed procedure, and in conformity with strategy of surgical timing of aneurysms in the back circulation, patient was operated three weeks after the attack of hemorrhage. Disregarding low incidence of existence of aneurysms of distal circulation (under 1% of all in the back circulation) high level of suspicion should be present and angio CT should be done as screening method, if CT shows hemorrhage which according to localization responses to possible aneurysm.

[Endovascular occlusion of the intracranial aneurysms--an alternative for surgical treatment].

Aneurysms on cerebral blood vessels due to their localization, size, relationship with neurovascular structures, even today, represent besides the constant progress of the diagnostic techniques and instruments in the operating theaters, a great therapeutic challenge. Gigantic aneurysms, aneurysms localized within the cavernous sinus and aneurysms of the vertebrobasilary confluence carry a great perioperative risk of mortality and morbidity. In fact, development of the endovascular procedures for the occlusion of their lumen made possible great progress in the treatment of aneurysms of this localization. In a not so small number of cases endovascular procedure means remodeling of the lumen of the main blood vessel. Endovascular obliteration of aneurysms has a certain advantage as regards the surgical treatment of aneurysms in which, on the basis of the expected natural course and presumed operative risk, may be judged that there exists unacceptably great operative risk. We present a personal series and results in 6 patients with aneurysms of various localizations.

[Treatment of patients with spontaneous intracranial hematomas].

Spontaneus intracerebral haemorrhage is a common cause of stroke especially in the young. The term "spontaneuos intracerebral haemorrhage" refers to bleeding without coincident trauma. About 80% of this haemorrhage occur supratentorial in the basal nuclei and they are associated with hypertension. Etiological factors range from congenital vascular malformations (aneurysmas, AVM, cavernomas) to acquired and degenerative vascular and brain conditions. In primary intracerebral hemorrhage arterial hypertension and consequent vascular changes are the major etiological factors. In secondary- nonhypertensive hemorrhage cause may be associated with aneurysms, AVM, tumors, coagulation disorders. Contemporary diagnosis imaging (CT, MRI) and neurological evaluation, allow early diagnosis and effective medical and/or surgical therapy in a majority patients. Without treatment, the risk of mortality and morbidity is high. Medical management involves normalization of blood pressure, reduction of intracranial pressure, control of brain edema and prevention of seizures. In design for operative treatment must be include age of the patient, hematoma size and location, clinical condition, the level of consciousness and patient outcome. The role of surgery remains contraversial.

[Results of the surgical treatment of patients with brain cavernoma that manifested by intracerebral hemorrhage].

Although, for a long time, they have been known as a kind of vascular lesion, cavernomas have mostly been incidental or causative autopsy finding or have subsequently been histologically confirmed after surgical interventions undertaken due to intracerebral and spinal spontaneous hematoma of various localization. The aim of this study was to establish on the basis of the outcome of the operative treatment, whether the surgical interventions were justified and to systematize indications for surgical treatment of the cerebral cavernoma that initially manifested by hemorrhage. The subject of the study was a group of 38 patients who had been operated at the Institute for Neurosurgery during a ten-year period, from 1990 until 2000. The study group consisted of 16 male and 22 female patients. All operated patients had cyst intraparenchymal lesions. In our group of surgically treated patients three had been treated urgently due to spontaneous intracerebral hematoma, and intraoperatively taken material after inspection of the cavum pointed to the fact that cavernoma had been the cause of hemorrhage. All the others, after postoperatively done MRI of the brain, in some even DSA, were completely evaluated, and histologically confirmed. Not one hemorrhaging cavernoma showed signs of subarachnoid hemorrhage, although 60% of operated patients had cortically localized lesion. Most of the operated patients, except for the three mentioned because of urgent intervention did not give massive intraparenchymal lesion that, in the clinical picture, would lead to the change of the state of consciousness. Focal neurologic deficit was a dominant clinical presentation. On the basis of the analysis of the clinically pathologic correlations and direct and longstanding operative results of the surgical treatment of cavernoma, operative treatment is indicated in all superficial lobar lesions as well as in those that are localized in the brain chambers and pineal region regardless of the type of the clinical presentation.

[Neurovascular compression (conflict)]].

Since Dandy first reported vascular compression of the trigeminal nerve, the concept of neurovascular compression syndrome for trigeminal neuralgia and hemifacial spasm (HFS) has been accepted, and neurovascular decompression has been performed for this condition. The further investigations indicated that some other clinical syndromes such as glossopharyngeal neuralgia, disabling positional vertigo, tinnitus, geniculate neuarlgia, spasmodic torticolis, essential hypertension, cyclic oculomotor spasm with paresis and superior oblique myokymia also may be initiated by vascular compression of the glossopharyngeal, cochleovestibular, intermediate, accessory, oculomotor and trochlear nerves or the ventrolateral medulla oblongata. In this study several hypotheses regarding the development of cranial nerves vascular compression syndromes are presented. It is alsoemphasized the value of high-resolution magnetic resonance tomographic angiography for visualization of vascular compression. The most frequent clinical syndromes caused by vascular compressionof the cranial nerves are discussed regarding the pathogenesis, symptomes and therapy. We present our series of 124 patients with preoperative evidently positive finding of vascular compression to the trigeminal nerve (MRI). Microvascular decompression (MVD) was performed in all of them. Initial postoperative result was excellent in 110/124 (89%) patients,while in 11/124 (9%) patients the pain relief was satisfactory. In the remaining three patients MVD failed. Recurrence of pain after two years reached 19%. Complications were related to diplopia associated with transient fourth nerve dysfunction in 5 (4%) patients, facial motor dysfunction in 4 (3%) patients, transient facial hypesthesia in 27 (22%) patients and partially hearing loss in 4 (3%) patients. Cerebellar hemorrhagic infarction occurred in 1 (0.8%) patient and cerebrospinal fluid leaks appeared in two (1.6%) cases. There was no lethal outcome.

Osteoid osteoma of a cervical vertebral body.

We report a very rare case of 5-year-old boy with osteoid osteoma of the cervical vertebral body. The patient presented with a 6-month history of neck pain with radiation into the shoulder and arm on the left side, which was relieved by ibuprofen. Neurological examination and plain radiographs of the cervical spine were normal. CT scan and bone scintigraphy, rather than MRI suggested the pathological diagnosis, which was confirmed on histological examination. The patient underwent excision of the lesion via an anterior approach with complete resolution of the pain postoperatively.

Enlargement to a saccular aneurysm and subsequent rupture of infundibular widening of posterior communicating artery.

A small dilatation known as infundibular widening (IFw) is frequently seen (7%-25%) on the posterior communicating artery (PComA) at its origin from the internal carotid artery. Development and subsequent rupture of an aneurysm on a previously radiographically demonstrated IFw has rarely been documented. We present two patients who suffered from subarachnoid hemorrhage (SAH). Initial cerebral angiography demonstrated IFw on PComA. They were readmitted to the hospital 9 and 11 years later, after a new SAH. Repeated cerebral angiography revealed an aneurysm arising from the site where the IFw had been seen previously in both cases. The aneurysms were clipped with favorable outcome. This report adds two new cases documenting enlargement of PComAIFw into an aneurysm. Patients with PComAIFw, especially those who have experienced SAH, should be considered for periodic follow-up to rule out the development of an aneurysm over time.

Peripheral nerve war injuries.

OBJECTIVE: The purpose of this study is to evaluate peripheral nerve war injuries sustained during the war in southern Croatia and Bosnia and Herzegovina. PATIENTS AND METHODS: During the war in Croatia, 713 patients (99% male and 1% female) with wounds inflicted by firearms were examined at the Laboratory of Neurophysiology, University Hospital, Split. The patients, soldiers and civilians alike, ranged in age from 6 to 73 years (average, 28 years). All patients with firearm nerve war injuries underwent detection by electromyography and plurisegmental examination of the damaged peripheral nerve (neurography). The patients were examined and controlled on three occasions: within 2 months after wounding; up to 6 months after wounding; and more than 6 months after wounding. RESULTS: Single peripheral nerve lesions were present in 80% of the patients, and multiple peripheral nerve or plexus lesions were present in 20% of the patients. Peroneal and ulnar nerves were most often involved (20.9% and 19.8%, respectively). Associated massive injuries to the muscles, large blood vessels, or vital organs were present in 45% of the patients. Wounds were inflicted by shell fragments in 80% of the patients and by projectiles in 20% of the patients. CONCLUSION: According to our results, better recovery was achieved with conservative treatment and when physical therapy was initiated early with maximal patient cooperation. Electromyoneurographic findings were the most valid in the prognostic classification of war-inflicted peripheral nerve injuries.