Natural radionuclide uptake by mosses in eastern Serbia in 2008-2013.

The results of the study on natural radionuclide content in 102 samples of the moss species randomly collected in 2008- 2013 at 30 locations of eastern Serbia are presented in the paper. The activity concentration values of 238U, 226Ra, 232Th, 40K, and 7Be determined by gamma spectrometry were within the intervals: 238U (1.1-50) Bq kg(-1), 226Ra (1.1-41) Bq kg(-1), 232Th (1.4-28) Bq kg(-1), 40K (64-484) Bq kg(-1) and 7Be (88-227) Bq kg(-1), not standing out of the average data reported for this region. The distribution of the obtained data for 226Ra, 232Th, and 238U activity concentration in the analysed mosses has shown values up to 10 Bq kg(-1) with frequencies 47.1 %, 54.9 % and 48.0 %, respectively. The obtained activity concentration values of primordial 40K and cosmogenic radionuclide 7Be were up to 500 Bq kg(-1) and about 90 % of all the results for 7Be uptake by mosses were in the 200-250 Bq kg(-1) concentration range.

Optical coherence tomography in the evaluation of structural changes in primary open-angle glaucoma with and without elevated intraocular pressure.

Background/Aim: Glaucoma is a progressive optic neuropathy characterized by damage of the retinal ganglion cells and their axons and glial cells. The aim of this study was to evaluate the differences and connections between changes in the visual field and the thickness of the peripapillary retinal nerve fiber layer (RNFL), using optical coherence tomography (OCT) in patients with primary open-angle glaucoma with normal and elevated intraocular pressure (IOP). Methods: This prospective study included 38 patients (38 eyes) with primary open-angle glaucoma with normal intraocular pressure (NTG) and 50 patients (50 eyes) with primary open-angle glaucoma with elevated intraocular pressure (HTG), paired by the same degree of structural glaucomatous changes in the optic nerve head and by age. OCT protocols 'fast RNFL thickness' and 'fast optic disc' were used for testing. The patients' age, gender, best corrected visual acuity (BCVA), IOP, stereometric and functional parameters were compared. Results: The average age of the examined population was 65.49 ± 9.36 (range 44-83) years. There was no statistically significant difference by age and by gender between the two study groups (p = 0.795 and p = 0.807, respectively). BCVA was higher in patients with NTG but there was no statistically significant difference compared to HTG patients (p = 0.160). IOP was statistically significantly higher in patients with HTG compared to NTG patients (17.40 ± 2.77 mmHg vs 14.95 ± 3.01 mmHg, p = 0.009). The cup/disc (C/D) (p = 0.258), mean deviation (MD) (p = 0.477), corrected patern standard deviation (CPSD) (p = 0.943), disk area (p = 0.515), rim area (p = 0.294), rim volume (p = 0.118), C/D area R (p = 0.103), RNFL Average (p = 0.632), RNFL Superior (p = 0.283) and RNFL Inferior (p = 0.488) were not statistically significantly different between the groups. Conclusion: OCT measurements of the RNFL thickness provide clinically significant information in monitoring of glaucomatous changes. There are no differences in the patterns of RNFL defects per sectors and quadrants between NTG and HTG, measured by OCT.

Retinal hemorrhages as one of complications of optic disc drusen during pregnancy.

INTRODUCTION: Drusen of the optic nerve head are relatively benign and asymptomatic. They represent retinal hyaline corpuscles resulting from impaired axoplasmic transport of the retinal ganglion cells of optic nerve in front of the lamina cribrosa. They are usually detected accidentally, during a routine ophthalmologic examination. Most patients with optic disc drusen are not aware of the deterioration of their eyesight because of the slow progression of visual field defects. Damage in visual acuity due to optic disc drusen is rare. CASE REPORT: A 27-year-old female patient in the sixth month of pregnancy visited an ophthalmologist because of a visual impairment described as the appearance of mist and shadows over her right eye. When first examined, her visual acuity in both eyes was 20/20. The retinal hemorrhages framing the bottom half of the optic nerve were seen. Complete laboratory and clinical testing as well as specific ophthalmic examinations (photofundus, computerized visual field, optical coherence tomography, and ultrasound) were performed to exclude systemic causes and they presented no risk for the pregnancy. Echosonographic examination confirmed the presence of bilateral optic nerve head drusen. CONCLUSION: Hemodynamic changes during pregnancy are possible factors for the development of optical disc and retinal hemorrhages. Since treatment of optic disc drusen is limited, recognition of optic nerve drusen as a cause of hemorrhage during pregnancy prevents unnecessary diagnostic and therapeutic interventions.

Antioxidant activity of propolis extracts from Serbia: a polarographic approach.

Antioxidant activity (AO) of commercial propolis extracts (PEs), available on Serbian market, was determined by direct current (DC) polarography. Polarographic anodic current of 5.0 mmol L(-1) alkaline solution of H2O2 was recorded at potentials of mercury dissolution. Decrease of the current was plotted against the volume of gradually added PEs. The volume of PE causing 20% current decrease was determined from the linear part of the plot. Antioxidant activity was expressed in H2O2 equivalent (HPEq), representing the volume of PE that corresponds to 1.0 mmol L(-1) H2O2 decrease. Resulting HPEq ranged between 1.71±0.11 and 8.00±0.18 µL. Range of 1,1-diphenyl-2-picryl hydrazyl (DPPH) radical scavenging activity was from 0.093±0.004% to 0.346±0.006%. Total phenolic content (TCP) of PE with superior AO activity was 5.31±0.05% g GAE, while the extract with the lowest activity contained 1.45±0.02% g GAE. Antioxidant activity, determined by polarographic method, was correlated with DPPH scavenging activity (R2=0.991) and TCP (R2=0.985). Validity of obtained results was further confirmed using ANOVA and post hoc Tukey HSD test.

[Prevalence of Chlamydia trachomatis in adults with chronic conjunctivitis in Nisava district].

INTRODUCTION: Chlamydia trachomatis causes many infections, including eye infections. They manifest as inclusion conjunctivitis and trachoma. The agent is transmitted by dirty hands, eyeliners, medical instruments and via swimming-pool water or, in neonates, by passage through an infected birth canal. Due to the nonspecific clinical features at the beginning of the infection and delayed application of symptomatic, anti-allergic and non-specific antibiotic therapy, Chlamydia aetiology is usually established only after laboratory diagnosis in the chronic stage of infection. OBJECTIVE: Determining the frequency of Chlamydia trachomatis antigen in conjunctival and genital samples of adult patients with chronic conjunctivitis in Nisava district. METHODS: Our retrospective study was carried out on 116 patients (63 female and 53 male) with clinical signs and symptoms of chronic conjunctivitis. Chlamydia trachomatis antigen was detected by a direct immunofluorescence test with labelled monoclonal antibodies. RESULTS: From a total of 116 examined patients in 37 patients Chlamydia trachomatis antigen was detected; 17 female and 20 male. Thirty-three of the patients had a bilateral infection and four unilateral. Among 24 patients who were also tested for Chlamydia trachomatis antigen collected by ocular and genital swabs, 19 had conjunctivitis associated with urethritis/vaginitis. CONCLUSION: The studied group of patients showed that the common cause of the chronic conjunctivitis were bacteria, but predominantly Chlamydia trachomatis. In most cases Chlamydia infection occurred bilaterally. The majority of patients had eye Chlamydia infection associated with genital Chlamydia infection. There was no statistically significant difference in the presence of the disease regarding gender.

Transforming growth factor beta1, matrix-metalloproteinase-2 and its tissue inhibitor in patients with pseudoexfoliation glaucoma/syndrome.

BACKGROUND/AIM: Transforming growth factor-beta1 (TGF-beta1), oxidative stress and imbalance between matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) may play an important role in pathogenesis of pseudoexfoliation syndrome/glaucoma (PEX Sy/Gl). The aim of the study was to measure concentrations of TGF-beta1, MMP-2, TIMP-2 in the aqueous humor in the examined group, as well as to compare the biochemical findings with the following clinical parameters: degree of chamber angle pigmantation, presence of pseudoexfoliation and the value of intraocular pressure (IOP). METHODS: Aqueous samples from 30 patients with cataract, 30 patients with PEX Sy, 36 patients with PEX Gl, and 42 patients with primary open-angle glaucoma (POAG) were collected during phacoemulsification cataract surgery. TGF beta1, MMP-2, TIMP-2 Fluotokine Multi Analyze Profiling kits and Luminex technology were used to simultaneously measure TGF beta1, MMP-2 and TIMP-2. RESULTS: TGF-beta1, MMP-2, TIMP-2 were detected in human aqueous from all the groups with the highest level in the group with PEX Gl. Statistically, a significant correlation between the levels of TGF beta1, MMP-2, TIMP-2 in the aqueous humor of the patients with PEX Gl and the IOP value was confirmed (p < 0.05). In this group, the positive correlations between the TGF beta1 concentration in the aqueous humor and the presence of pseudoexfoliation (p < 0.01), on the one hand, and between the TIMP-2 level and the presence of pseudoexfoliation (p < 0.05), on the other, were reported. A statistically significant positive correlation of TGF-beta1 and MMP-2, and the degree of chamber angle pigmentation in the PEX Gl group was confirmed (p < 0.05). In the POAG group, TIMP-2 values were in a negative correlation with the degree of pigmentation (p < 0.05), and the IOP value (p < 0.05). CONCLUSION: TGF beta1 and MMP-2 affect the degree of chamber angle pigmentation and the degree of pseudoexfoliation in patients with pseudoexfoliative glaucoma.

[Efficacy of TNF-alpha antagonist and other immunomodulators in the treatment of patients with ophthalmologic manifestations of Behcet's disease and HLA B51 positive vasculitis].

BACKGROUND/AIM: Behcet's disease is genetically conditioned, immune-mediated multisystem occlusive vasculitis of small blood vessels, espesially venules, of unknown etiology. The aim of this study was to analyze the clinical features, disease activity and therapy of the patients with ophthalmologic manifestation of Behcet's disease. METHODS: In this study symptoms and signs of the disease were analyzed both prospectively and retrospectively during the active manifestation of the disease. The diagnosis was reached according to the International Criteria for Behcet's Disease (2006). The treatment effects were evaluated based on the presence of the best corrected visual acuity and the inflammation of the vitreous humour before and after the application of our therapeutic method. The applied therapeutic modality consisted of the primary application of corticosteroid therapy in the active stage of the disease complemented with the choice of drugs from the immunosuppressive group. In this study there drugs were cyclosporine or methotrexate. A treatment refractory patients with poor vision prognosis were treated with a third drug, the biological preparation infliximab, a tumor necrosis factor-alpha (TNF-alpha) antagonist. RESULTS: The mean age of 11 patients with ophthalmologic manifestation of Behcet's disease was 50.6 years. HLA B-5 (51) was positive in 81% of the patients while 36% of the patients had positive pathergy test. Changes in affected eyes included vitritis (100%), posterior uveitis (45%), panuveitis (54%), retinal vasculitis (54%), cystoid macular edema (54%), and cystoid degeneration (18%). Increased intraocular pressure was observed in 27% of the patients. There was no statistically significant variation in disease activity parameters in any of the patients (p > 0.05). A statistically significant improvement in visual acuity (p < 0.05) and a high statistically significant decrease of inflammation of the worst affected eyes (p = 0.001) were detected. CONCLUSION: Our therapeutic method is useful for producing the optimal therapeutic plan for the acute--chronic stage of the difficult ophtamological manifestation of Behcet's desease as well as the prevention of relapse. However the high cost of the therapy and the potential complications should be taken into consideration when prescribing this therapy, especially a TNF-alpha antagonist.

Prognostic significance of intracranial pressure monitoring and intracranial hypertension in severe brain trauma patients.

Since without prospective randomized studies it is not possible to have a clear attitude towards the importance of intracranial pressure monitoring, this study was aimed at examining the prognostic effect of the intracranial pressure monitoring and intracranial pressure oriented therapy in severe brain trauma patients, and at defining optimal intracranial pressure values for starting the treatment. Two groups of patients were treated in the study, one consisted of 32 patients undergoing intracranial pressure monitoring and the second group of 29 patients without intracranial pressure monitoring in the control group. The study was prospective with groups randomized. There were 53% survivals in the intracranial pressure monitored patients and 34% in the control group, with no significant difference in the survival rate between the two groups (chi2=2.11; p=0.15; p>0.05). The average intracranial pressure in the patients with intracranial hypertension who died was 27 mm Hg, while in the patients who survived the average intracranial pressure was significantly lower (Student's t test: t=2.91; p=0.008; p<0.01) and it was 18 mm Hg. We recommend starting intracranial pressure oriented therapy when the patient's intracranial pressure exceeds 18 mmHg during 2 hours of monitoring.

[Operation of traumatic cataract with metal foreign body in the lens].

INTRODUCTION: We present a patient with perforative eye injury, a metal foreign body in the lens and traumatic cataract. The paper emphasises the importance of phacoemulsification in case of patients with a traumatic cataract and the presence of a metal foreign body. CASE OUTLINE: A 41-year-old patient had a perforative wound of the cornea caused by a metal foreign body that also perforated the anterior lens capsule and remained in the paracentral anterior part of the lens. The injury, which happened upon hitting of a hammer against a metal object, showed the presence of a tangential wound of the cornea adapted edges, and a formed anterior eye chamber. The presence of a metal spear-shaped foreign body was partly inside the anterior eye chamber and partly in the central area of the lens. The visual acuity of the injured eye was 0.2. The technique of removing the foreign body out of the lens and the phacoemulsification of the lens with the implantation of intraocular lens is presented. The paracentral wound on the cornea was not sutured because of well-adapted edges. On the first postoperative day there were no inflammatory signs, and best uncorrected visual acuity of 0.8. CONCLUSION: Posttraumatic cataracts with a metal foreign body in the lens require operative treatment in order to remove the foreign body, phacoemulsification and implantation of artificial lens. Because of anterior capsule lesion, special care should be taken in regard to anterior capsulorhexis and appropriate hydrodisection. Ocular hypotonia and possible damage of the posterior capsule in some cases can make phacoemulsification more difficult to perform.

Analysis of pathohistological characteristics of pterygium.

Pterygium internum (external eye layer) shows great recurrence tendency after surgical removal. Its etiology is still unclear and represents a significant problem. The main goal of our study was to explore the interrelationships of pathohistological characteristics of pterygium, namely presence of inflammation, vascularisation degree and fibrinoid changes and on the basis of their analysis to test the possibility of predicting its evolution and recurrence. The analysis was performed on the material taken from 55 patients surgically treated by the technique of Arlt. The specimens were stained using the classical histochemical methods: hematoxylin-eosin (HE), Masson's trichrome, Gomori's reticulin stain and PAS technique. Pterygium is mostly covered by conjunctival epithelium, while in the cap region shows morphology of modified stratified squamous epithelium of the cornea. Structural basis of the epithelium is composed of continuous basal lamina and continuous connective fibers underneath. This connective basis shows fibrinoid changes in the form of oval islets of different size, parallel to convexity of pterygium, or is in the form of unified focus. The number, caliber and the type of blood vessels showed excessive variability. Pathohistological analysis of morphological characteristics of pterygium is adequate basis for prediction of recurrences; as they present the biggest concern in treatment of this widely spread disease.

Ocular manifestation of rheumatoid arthritis-different forms and frequency.

Rheumatoid arthritis (RA) is a systemic inflammatory disease associated with a number of extra-articular organ manifestations. Ocular manifestations involved with RA are keratoconjunctivitis sicca, episcleritis, scleritis , corneal changes, and retinal vasculitus. The etiopathogenesis of this autoimmune disorder is still unknown. Aim of our study was to present different ocular manifestations of RA and their frequency. We have examined 691 patient with the diagnoses of RA. All examined patients were in I or II stage of the disease according to criteria of The American College of Rheumatology. Ophthalmological exam obtained: visual acuity by Snellen sings, biomicroscopy of anterior segment, Schirmer test, tear break-up time (BUT), applanation tonometry and indirect ophthalmoscopy. In all patients with retinal vasculitis fotofundus and in indicated cases fluorescein angiography was preformed. The most common manifestation of ocular involvement was keratoconjunctivitis sicca. Episcleritis was diagnosed in 5.06% patients with RA, while scleritis was present in 2.06% of patients. Diffuse scleritis was present in one patient, while nodular was present in 13 patients. There were no patients with posterior or necrotizing scleritis among examined patients. Sclerosing keratitis was diagnosed in 11 female patients. It is characterized with peripheral thickening and opacification of the stroma adjacent to the site of inflammation. Posterior scleritis or scleromalacia of cornea was not present in our patients, because all of them were in I or II stage of disease. Retinal vasculitis was present in three patients, two male and one female patient (0.45%). Ocular manifestation was present in 27.2% of patients. Women were more affected.

[Topographic localization of an intraocular foreign body by B-scan echography].

BACKGROUND/AIM: In cases of blurred optic media the ultrasound diagnostics offers useful data about eventual presence of intraocular foreign body as well as about its precise localization in the eye. The aim of this study was to retrospectively analyze echographic findings in patients with the diagnosis of intraocular foreign body with a special interest in localizations of a intraocular foreign body in the eye and the presence of an eventual infection - endophthalmitis. The aim of this study was also to confirm the localization of intraocular foreign body by echography and to test the precision of this method. METHODS: We performed analysis of all cases that had been referred to the ultrasound diagnostices, in which the presence of intraocular foreign body had been confirmed in the period of one year. All examinations were done with B-scan and were confirmed during the surgery - vitrectomy. RESULTS: In the one-year period we were contacted by 27 patients with intraocular foreign body. In one injured eye the intraocular foreign body was in the lens (3.70%), in 10 injured eyes (37.03%) intraocular foreign body was in the vitreal body. In 15 patients (55.5%) intraocular foreign body was fixed in the retina. In one patient (3.70%) there was a perforating injury, intraocular foreign body was found in the retrobulbar part of the orbit. In 7 injured eyes (25.9%), with the presence of intraocular foreign body, we found signs of endophthalmitis (organized blurring in vitreal space, thickened choroid). Other accompanying echographic findings were: blood in vitreal space, haemophthalmus in 12 cases (44.4%), retinal detachment in 5 cases (18.5%) and subretinal hemorrhagies in 4 cases (14.8%). CONCLUSION: Ultrasound diagnostics can very precisely show the localization of intraocular foreign body in the eye that is very important in the choice of approach and timing of surgical treatment. Also the echographic diagnostics may find an accompanying endophthalmitis in the posterior segment of the eye, that is very important for an urgent therapeutic approach.

Influence of retrobulbar neuritis and papillitis on echographically measured optic nerve diameter.

BACKGROUND/AIM: Retrobulbar (optic) neuritis is inflammation of the optic nerve that may cause a complete or partial loss of vision. This inflammation can affect a part of the nerve within the eyeball (neuropapillitis) or a part of the nerve behind the eyeball (retrobulbar neuritis). The aim of this study was to establish whether there is a correlation between the diameter of a retrobulbar part of the optic nerve and either visual acuity, prominence of the optic disk (papillitis), or nature of the neuritis (papillitis or retrobulbar). METHODS: We tested 23 patients with retrobulbar neuritis and papillitis. In addition to a complete ophthalmologic examination, the diameter of retrobulbar region of the optic nerve was measured by the B-scan method. Following this, the 30-degree test was carried out. RESULTS: We found an increased thickness of the retrobulbar region in 22 patients and different responses to the 30-degree test, as well as a statistically significant negative correlation between the thickness of retrobulbar part of the optic nerve and visual acuity. CONCLUSION: The retrobulbar part of the optic nerve is thicker in 94% of the patients with retrobulbar neuritis and in all the patients with papillitis. There is a correlation between the reduction of visual acuity and thickening of a retrobulbar part.

[Comparative analysis of histopathological and clinical characteristics of pterygium].

BACKGROUND/AIM: Pterygium internum presents a significant epidemiological problem. Its etiopathogenesis is still unclear. After surgical removal it shows great tendency to recidives. The aim of this paper was to investigate connection between histopathological characteristics (inflammation presence, vascularization degree and fibrinoid changes) of pterygium and its clinical characteristics (duration, size, pterygium grade, presence of Fuchs' spots and recidives) and determine indicators for recidives prediction. METHODS: We analyzed the material taken from 55 patients operated by Arlthi's method. The samples were colored by using standard histochemical methods: hematoxylin-eosin (HE), trichrome Masson painting, Gomora reticulin and PAS technique. RESULTS: Pterygium was mostly covered by epithelium resembling conjunctival, while in the frontal cap region it showed the morphology of plate-layer cornea epithelium. The structural basis of the epithelium was composed of continuous basal lamina and continuous adhesive fibres underneath. This adhesive basis showed fibrinoid changes in the form of oval islands of various size, parallel to convexity of pterygium, or in the form of unified focus. The number, caliber and type of blood vessels showed a pronounced variability. Duration of pterygium and its size were in negative correlation with intensity of inflammation, without statistical significance. Pterygium with a longer period of develepment had negative correlation with the degree of vascularization (p > 0.05). The presence of Fuchs' spots showed a statitistically significant positive correlation with the degree of vascularization (p < 0.05). The intensity of fibrinoid changes was higher in pterygium with Fuchs' spots and in those which recurred (p > 0.05). CONCLUSION: Histopathological analysis of pterygium morphological shapes is a good basis for the prediction of recidives, which present the greatest problem in the treatment of this widely spread disease.

Orbital dermoid and epidermoid cysts: case study.

INTRODUCTION: Dermoid and epidermoid cysts of the orbit belong to choristomas, tumours that originate from the aberrant primordial tissue. Clinically, they manifest as cystic movable formations mostly localized in the upper temporal quadrant of the orbit. They are described as both superficial and deep formations with most frequently slow intermittent growth. Apart from aesthetic effects, during their growth, dermoid and epidermoid cysts can cause disturbances in the eye motility, and in rare cases, also an optical nerve compression syndrome. CASE OUTLINE: In this paper, we described a child with a congenital orbital dermoid cyst localized in the upper-nasal quadrant that was showing signs of a gradual enlargement and progression. The computerized tomography revealed a cyst of 1.5-2.0 cm in size. At the Maxillofacial Surgery Hospital in Nis, the dermoid cyst was extirpated in toto after orbitotomy performed by superciliary approach. Postoperative course was uneventful, without inflammation signs, and after two weeks excellent functional and aesthetic effects were achieved. CONCLUSION: Before the decision to treat the dermoid and epidermoid cysts operatively, a detailed diagnostic procedure was necessary to be done in order to locate the cyst precisely and determine its size and possible propagation into the surrounding periorbital structures. Apart from cosmetic indications, operative procedures are recommended in the case of cysts with constant progressions, which cause the pressure to the eye lobe, lead to motility disturbances and indirectly compress the optical nerve and branches of the cranial nerves III, IV and VI.

[Ocular pseudoexfoliation syndrome].

INTRODUCTION: This study was aimed at providing an update on most recent developments regarding ocular and systemic manifestations and complications, clinical diagnosis and management, and molecular patophysiology of pseudoexfoliation syndrome. METHOD: Review of recent literature and own clinical and laboratory studies. RESULTS: Pseudoexfoliation syndrome is an age-related disease in which abnormal fibrillar extracellular material is produced and accumulated in many ocular tissues. Recent progress and advances have led to improvements in clinical management by understanding the effects of the pseudoexfoliation process on the ocular tissues, by refining diagnostic criteria and applying new treatment regimes, and by developing preventive strategies to reduce surgical complications. Increasing evidence of systemic associations of cardiovascular, cerebrovascular, abdominal aorta aneurysm can provide better understanding and management of this condition, and new therapeutic goal. The current pathogenesis concept describes psuedoexfoliation syndrome as an elastic microfibrillopathy involving transforming growth factor-beta, matrix metalloproteinase oxidative stress. CONCLUSION: Despite extensive research, the exact chemical composition of exfoliation material remains unknown. The presence of pseudoexfoliation should alert the physician to the increased risks of intraocular surgery, most commonly zonular dehiscence, capsular rupture, and vitreous loss during cataract extraction. Its associated clinical signs are important in the detection and management of glaucoma.

[Malignant tumors of auricula and periauricular area].

BACKGROUND/AIM: Malignant tumors of auricula and periauricular area represent seven percent of all cutaneous tumors. They appear mostly in the sixth and seventh decade. According to histological type they are basocellular and planocellular carcinomas. The most frequent etiology is the sun exposition. The aim of this study was to analyze clinical and histological characteristics and therapy of malignant tumors of auricular and periauricular area. METHODS: Totally 155 patients were treated in ORL Clinic, Clinical Center Nis during the period 1990-2006. The patients were treated surgically (59.35%), by radiotherapy (1.94%) and by combination of the two methods (38.71%). RESULTS: Since the majority of tumors were small and presented on the helix, wedge excision and primary reconstruction were performed (136), while total (9) or partial (10) auriculectomy were done in a small number of the patients. For larger lesions (T4--when lesion is greater than 4.0 cm) and neck metastasis invading cartilage or bone, parotidectomy (15), radical neck dissection (25) and temporal bone resection (9) were performed. CONCLUSION: Carcinoma of auricular and periauricular area should be confirmed by biopsy and histopathologic evaluation. In all cases an adequate excision, margin examination and observation of appropriate lymph node draining regions should be provided.

Study on fisetin-aluminium(III) interaction in aqueous buffered solutions by spectroscopy and molecular modeling.

Spectroscopic (UV/visible and IR) and theoretical studies were used to assess relevant interaction of fisetin, a tetrahydroxylated flavone molecule, and trivalent aluminium in a wide range of buffered aqueous solutions. The chelation sites, stoichiometry, stability and the dependence of the complexes structures on pH and aluminium/fisetin mole ratios were defined. Obtained results implicated successive formation of two complexes with aluminium(III)-fisetin stoichiometries of 1:1 and 2:1. Considering the fisetin molecular structure, results of vibrational analysis and theoretical calculations, it is possible to implicate 3-hydroxyl-4-carbonyl and 3'4'-dihydroxyl groups as those with the possible chelating power. The equilibrium geometries were optimized in vacuum at the B3LYP/6-31G(d) level of theory, which predict structural modifications between the ligand molecule in free state and in the complex structure. The theoretical model has been validated by both vibrational and electronic spectroscopies.

Clinical, histopathological and immunohistological study of lymphoid disorders in the parotid gland of patients with Sjögren's syndrome.

BACKGROUND/AIM: Sjögren's syndrome is a chronic autoimmune systemic disease characterized by polyglandular tissue destruction, leading to keratoconjunctivitis sicca and xerostomia. These patients have 44-fold increased risk of developing salivary gland lymphoma, of which 80% are marginal zone (MALT) type. Having in mind that criteria for distinguishing benign lymphoepithelial lesions from MALT lymphoma are obscure, the aim of this study was to provide practical information that could be integrated into diagnostic practice. METHODS: Among 32 parotidectomies, 27 cases were identified as having benign lymphoepithelial disorders and 5 cases low grade MALT lymphoma. Histological sections were stained routinely with hematoxylin and eosin (H&E and special stains. Immunohistochemical study was performed by LSAB2 method, by using primary antibodies for CD20, CD3, Kappa and Lambda light chains and Cytokeratin (Dako Denmark). RESULTS: The 27 patients with Sjögren's sialoadenitis (22 women and 5 men), and 5 patients with MALT lymphoma (only women) were included in this analysis. According to the Ann Harbor Classification, all patients with MALT lymphoma had stage IE. Both groups of patients had an indolent clinical course, except permanent, rapid parotid enlargement in the patients with MALT lymphoma. Histologically, the periductal lymphoid infiltrate, gradually extended to the acini, completely replacing them by a sea of polyclonal lymphocytes, immunoblasts, germinal centers and plasma cells (confirmed immunohistochemically), but sparing the ducts and preserving lobular appearance. The histological feature of salivary gland MALT lymphoma included heterogeneous B-cell infiltrate that totally or subtotally had effaced the normal glandular structure. Malign lymphoepithelial lesions, representing infiltration of the ductal and epithelial structures by monoclonal neoplastic B-cells, positive for CD20, were highlighted by antibody to cytokeratin. CONCLUSION: The optimal diagnosis of salivary gland MALT lymphoma requires careful integration of clinical, morphological and immunohistochemical results.