Langerhans' cell granulomatosis in an adult: a 22-year follow up.

A 57-year-old patient with Langerhans' cell granulomatosis (LCG) is presented. During 22 years of treatment, there were five relapsing infiltrations at different sites of the skull bones, which were treated by surgery, local radiotherapy, and chemotherapy. During the last relapse, the right temporal bone was infiltrated by granuloma and the petrous bone was destroyed with an intimate spread to the internal carotid artery. After two palliative surgical resections and ineffective radiotherapy, 12 cycles of chemotherapy (vinblastine plus prednisolone) were applied and a clinical remission of the disease was achieved. Special attention is paid to the complexity of diagnosis and choice of therapy. It is concluded that the behavior of LCG may change with time, and assume an aggressive form of the disease. Chemotherapy is the treatment of choice for this type of multifocal malignant form of LCG. Prognosis of the disease is unpredictable.

Pulmonary blastoma with fatal hypercalcemia.

We describe a 50-year-old, previously healthy male with metastatic pulmonary blastoma associated with hypercalcemic and hyperosmolar complications which caused his death after 5 days. The primary tumor consisted of epithelial [cytokeratin, beta-hCG CEA, neuron-specific enolase (NSE)-positive] and mesenchymal components (beta-hCG, vimentin, NSE-positive, while the metastases had only a mesenchymal component.

Comparison of the postoperative fibrinogen, alpha-1-antitrypsin and alpha-2- macroglobulin concentrations in the blood of wounded soldiers of Croatian Army and peacetime injured civilians.

In 10 wounded Croatian Army soldiers and in 10 civilians with accidental musculosceletal traumatisation, blood concentrations of the 3 acute phase proteins: fibrinogen, alpha-1-antitrypsin and alpha-2-macroglobulin on the 1st, 5th and 10th postoperative day were assessed. On the 5th day after injury, increased concentrations of all 3 acute phase proteins (APP) were found in all patients. The rise of the fibrinogen concentrations in the wounded soldiers was the steepest. On the 10th day after wounding, fibrinogen concentrations in the gorup of wounded soldiers were significantly lower than those in the group of injured civilians. On the 10th day after wounding there were no differences between the 2 groups in the concentrations of alpha-1-antitrypsin and of alpha-2-macroglobulin. The lower fibrinogen concentrations in the wounded soldiers could be explained by the modulation of the general reactivity of the organism to injury, proposed by Woloski, which is induced by stress and microtrauma on battlefield before the wounding.

Hyperdynamic beta-adrenergic syndrome among Croatian soldiers engaged in battle.

A group of 1592 male Croatian soldiers (average age 32 +/- 9, ranging from 19 to 54) were examined by an internist at the war hospital. Elevated blood pressure was found in 80 men (5%); 61 of them had no history of hypertension (Group A), while in 19 patients hypertensive disease had been diagnosed before (Group B). In group A, systolic blood pressure (BPS in mm Hg), diastolic blood pressure (BPD in mm Hg) and heart rate (HR) were 182 +/- 13, 111 +/- 10, and 115 +/- 9; in group B, the values were 184 +/- 12, 108 +/- 8, 85 +/- 11. Electrocardiograms (ECG) and thorax roentgenograms of group A did not reveal any hypertension-caused signs, neither did the examination of the fundus, nor the serum creatinine values yield any abnormal results. The ECG test showed sinus tachycardia (heart rate > 100/min) but an otherwise normal function in group A. In group B, at least one of the laboratory examinations confirmed the previously diagnosed hypertension. Group A was treated with the cardioselective beta-blocker Atenolol (100 mg daily), while in group B, the previous antihypertensive medication was modified and/or increased. All patients were sent back to the front-line. Three days later, blood pressure and heart rate in group A were: BPS 139 +/- 9, BPD 87 +/- 6 and HR 77 +/- 8; and in group B: 156 +/- 11, 95 +/- 8, 75 +/- 7. A significant decrease in systolic and diastolic blood pressure (p < 0.0001) was found in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Some subjective and objective prerequisites to educational integration of handicapped children.

The success of educational integration of handicapped children is dependent upon, inter alia, the attitudes of social groups involved in the integration (subjective prerequisites) and from certain characteristics of the schools in which they are being integrated (objective prerequisites). In the latter case, an investigation was carried out on the attitudes of teachers at regular and special schools, of handicapped and non-handicapped school-children and the parents of both samples of children by means of the Lickert-type questionnaires, and the data processed by means of the multivariate analysis method. In the case of regular school teachers, an analysis was made also of the relationship between their concept of integration and their attitude towards the educational role of the school as an institution and towards their socioeconomic status. The objective prerequisites of integration were estimated by investigating in loco the conditions in regular schools, and through interviews with the responsible school staff. The factor analysis of the random samples investigated enabled factors to be extracted which, in respect to the integration, proved to be favorable to unfavorable. Some of these factors are of a general nature, in the sense that they refer to all the children, whereas other factors are specific, i. e. they refer to the type of disability. An examination of the objective prerequisites of integration produced findings which could lead to a suitable policy in preparing objective conditions for integration. The whole of this investigation was carried out within the framework of a research project of the Faculty of Defectology in Zagreb, lead by Prof. Dr. Franjo Tonkovic.

Scientific work at the Faculty of Defectology in Zagreb, Yugoslavia.

After defining the area of defectological science, as it is understood in Zagreb, three developmental stages of scientific research at the Faculty of Defectology in Zagreb are described: the first stage (1962-1975) was marked predominantly by individual research projects; the second stage (1976-1980) experienced the access to research work of already organized research projects along broad interdisciplinary lines; the third stage (1981 and onwards) is characterised by a larger number of scientific projects, a greater number of researchers, accumulated experience, and a more favorable financial situation. Furthermore, a number of principles are presented which the Faculty has been trying to include in its scientific work. These principles concern mainly the following areas: a) the relationship between theoretical and empirical research; b) the relationship between scientific and societal needs; c) the relationship between research and practice, and d) the relationship between scientific activity and teaching. Following the elaboration of theoretical concepts on "defectology", "special education" and "educational integration of handicapped children"--which will find its reflection also in scientific research--a short presentation is given of scientific research being currently performed at the Faculty, and scientific research planned for the period up to 1985.