Utility of MRI in detection of PET-CT proven local recurrence of pancreatic adenocarcinoma after surgery.

The aim of this prospective study was to investigate the accuracy and inter-observer reliability of MRI in detection of local recurrence (LR) of pancreatic adenocarcinoma (PAC) after surgery, which was proved by PET-CT and access correlation between functional MRI and PET parameters. Forty-five patients who underwent PET-CT and MRI for follow-up purposes after radical operation of PAC were included. Twenty-three were PET positive (study group) and 22 negative for LR (control group). MR examination was performed within one month after PET-CT and three readers who were blind for PET-CT findings searched LR in T2W, 3D-dynamic post-contrast T1W-FS and DWI sequences, respectively. Sensitivity and specificity were calculated while inter-reader agreement was estimated by Cronbach's Alpha reliability coefficient (CARC). Apparent diffusion coefficient (ADC) of LR was correlated with the size (maximal diameter) and functional PET-CT parameters: mean and maximum standardized uptake values (SUVmean, SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG), using Spearman's correlation coefficient (rS). Sensitivity and specificity among three readers in detecting the LR were 70% and 77-84% in T2W (CARC 0.806), 91-100% and 100% in 3D post-contrast T1W-FS (CARC 0.980), and both 100% in DWI sequences (CARC 1.000). Moderate inverse correlation was found between the ADC and SUVmean (rS = - 0.484), MTV (rS = - 0.494), TLG (rS = - 0.519) and lesion size (rS = - 0.567). MRI with DWI shows high diagnostic accuracy in detecting the LR of PAC in comparison to PET-CT as reference standard. ADC significantly inversely correlates with standard and advanced PET parameters and size of LR.

Forensic determination of dental age by cementum thickness of human teeth.

The purpose of this study was to assess the correlation between the known chronological age and the dental cementum thickness (DCT) in male and female subjects in different age groups. MATERIAL AND METHODS: The study sample consisted of 57 donor teeth of both sexes. Teeth were classified by donors' sex and divided into three age groups: 10-19, 30-39 and 60-69 years. Tooth roots were cut with transverse ground sections in the apical, middle, and cervical thirds. DCT measurements were made on photomicrographs of light microscope. The correlation between DCT and the chronological age was calculated using the Spearman correlation coefficient. RESULTS: A positive correlation was found (r=0.47, p <0.001) between DCT and age of the donor. DCT decreased from apical to cervical ground section (median [IQR] apical section 216.72 [128.25-375.00] µm, middle section 158.44 [87.66-284.90] µm; cervical section 96.60 [70.05-165.59] µm). DCT variability was influenced by sex, number of tooth roots and the condition of the tooth crown. The influence differed depending on the location of the section, being most prominent cervically. CONCLUSION: The present study showed correlation of DCT with age, with significant influence of sex, number of tooth roots, condition of the tooth crown and location of the root section.

Psycho-social impact of malocclusion in adolescents in Kosovo.

OBJECTIVE: To assess the psychosocial impact of malocclusion, establish its association with the severity of malocclusion and determine the effects of gender and age in such association. BASIC RESEARCH DESIGN: Cross-sectional study. METHODS: 400 adolescents aged between 12-15 years were randomly selected. Each participant was examined for malocclusion and categorized according to Index of Orthodontic Treatment Need (IOTN) and Dental Aesthetic Index (DAI). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) was used to assess the psychosocial impact of malocclusion. RESULTS: Significant differences were noted between PIDAQ subscales, and grades of malocclusion assessed by IOTN and DAI (p⟨0.05). Gender differences were noted in Dental Self Confidence (DSC), Social Impact (SI) and Psychological Impact (PI) for the same severity of malocclusion (p⟨0.05). IOTN-DHC predicted the total and subscales of PIDAQ scores. Gender and age were the independent predictive variables of the relationship between the PIDAQ scores and the IOTN-DHC grades for the DSC and AC subscales. Gender independently predicted psychological impact. CONCLUSION: Severity of malocclusion, gender and age were related to impacts on the psychosocial wellbeing of participants. Overall, females and older participants experienced worse psychosocial impact.

The effect of high-power ultrasound and gas phase plasma treatment on Aspergillus spp. and Penicillium spp. count in pure culture.

AIMS: The aim of this study was to investigate and compare two nonthermal techniques in the inactivation of moulds. METHODS AND RESULTS: High power ultrasound (20 kHz) and nonthermal gas phase plasma treatments were studied in the inactivation of selected moulds. Aspergillus spp. and Penicillium spp. were chosen as the most common mould present in or on food. Experimental design was introduced to establish and optimize working variables. For high power ultrasound, the greatest reduction of moulds (indicated by the total removal of viable cells) was obtained after ultrasound treatments at 60°C (thermosonication) for 6 and 9 min (power applied, 20-39 W). For plasma treatment, the greatest inactivation of moulds was observed for the longest treatment time (5 min) and lowest sample volume (2 ml), (AP12, AP13, PP12 and PP13). CONCLUSIONS: The great amount of applied energy required for achieving a partial log reduction in viable cells is the limiting factor for using high-power ultrasound. However, both treatment methods could be combined in the future to produce beneficial outcomes. SIGNIFICANCE AND IMPACT OF THE STUDY: This study deals with nonthermal food processing techniques and the results and findings present in this study are the root for further prospective studies. The food industry is looking for nonthermal methods that will enable food preservation, reduce deterioration of food compounds and structure and prolong food shelf life.

Pulse carboxyhemoglobin-oximetry and cigarette smoking.

PURPOSE: We used a pulse carbon monoxide (CO)-oximeter to measure the levels of carboxyhemoglobin (COHb) in smokers and non-smokers. Our goal was to determine if this device could not only define smoking status, but also to increase accuracy of self-reported data at various surveys on smoking. METHODS: Thirty-four healthy volunteers participated in this study. Twenty-two of them were current daily smokers; 12 participants were non-smokers who lived alone or with a nonsmoker, and who worked in non-smoking environment. Nicotine dependency level was determined by the modified Fagerstrom questionnaire. Blood COHb levels were measured with a pulse CO-oximeter (Masimo, Radical 7). RESULTS: The COHb levels in both moderate/heavy smokers and light smokers increased significantly after they smoked a single cigarette. This increase persisted for more than 6 h in the moderate/heavy smokers, while in the light smokers COHb levels returned to the baseline level after one hour. The pulse rate of all smokers increased significantly 20 min after smoking. CONCLUSION: We conclude that the CO-oximeter can detect smoking by moderate/heavy smokers and light smokers if they smoked 6 h or 20 min earlier, respectively. We concluded that it could be used as a validation test for smoking at the time of admission to the surgical facility and to increase smoking abstinence during preoperative and postoperative periods. This noninvasive, simple and inexpensive test may also be used at various surveys to increase accuracy of self-reports on smoking.

Do we know how many cancer patients have a family history of cancer?

PURPOSE: It has been estimated that approximately 5-10% of the general population have a family history that is indicative of hereditary cancer, predominately breast and colorectal. However, it is not precisely known how many patients have positive family history of cancer. The purpose of this study was to determine how many cancer patients have positive family history of cancer. METHODS: Patients were interviewed during the first visit to Daily Chemotherapy Hospital (DCH) of the Institute for Oncology and Radiology of Serbia, Belgrade. Data about patient cancer type and cancer types among family members were recorded in the hospital chart and analyzed. RESULTS: During an 8-month period, 677 newly diagnosed cancer patients with 9 cancer types were referred to DCH for chemotherapy. Positive family history (at least one first degree relative) for any cancer type was recorded in 163 (24.1%) patients and in 47 (6.9%) patients for the same cancer type. The highest percentage of the positive family history for the same type of cancer showed patients with breast cancer (9.9%), followed by colorectal (7.2%) and brain tumors (6.25%). CONCLUSION: The overall incidence of positive family cancer history was 31.0% and was higher than expected. Cancer can be more disturbing for persons who already had experience with this disease in a close family member. Those patients need special attention with more intensive and carefully preplanned psychological support.

Characteristics of the craniofacial complex in Turner syndrome.

OBJECTIVE: To identify characteristics of the craniofacial complex in Turner syndrome (TS) patients from Croatian population, to investigate the interrelationship among craniofacial variables and to assess their correlation with age. DESIGN: Cephalometric analysis was carried out on lateral cephalograms of 36 TS patients, aged 10-33 years. Cephalograms of 72 age-matched healthy females with class I occlusion served as control. RESULTS: Logistic regression analysis sorted out two variables as predictors of TS: shorter posterior cranial base length (sella-basion) and reduced mandibular prognathism angle (sella-nasion-supramentale). Sixty-four percent of TS patients and 92% of the controls were classified correctly. After exclusion of the variable sella-nasion-supramentale, three variables were significant predictors of TS: shorter sella-basion, larger cranial base angle (nasion-sella-basion) and shorter subspinale-basion distance. Retrognathic position of the jaws in TS subjects was not correlated with the shape of the cranial base. Correlations with age revealed lack of maxillary longitudinal growth with persistent retrognathism and posterior rotation along with reduced mandibular growth. CONCLUSION: Shorter posterior length and increased cranial base angle along with bimaxillary retrognathism were characteristics of TS patients. Results indicated that deficiency of the X chromosome genes had a direct influence on all three anatomic parts - cranial base, maxilla and mandible - causing irregular growth.

[Therapy of inflammatory changes in Bartholin's glands]. / Terapija zapaljenjskih promena Bartolinijeve zlezde.

INTRODUCTION: Bartholin's glands are bilateral structures whose function begins after puberty, so the diseases of these glands are most common during the reproductive period. Management of the inflammatory changes--abscess and cyst can be invasive and conservative, and quite often the changes become chronic, due to the failure of techniques. The aim of the study was to assess efficacy of various therapeutic approaches in the treatment of the inflammatory changes of Bartholin's glands. MATERIAL AND METHODS: The study was done at the Department of Obstetrics and Gynecology, Clinical Centre in Novi Sad, during the period 1993-1996, at the Dept. of Inflammatory Gynaecological Diseases. The total of 129 patients was treated. The first two years were analyzed retrospectively while during the years 1995 and 1996 a prospective study was done. The analysis of the therapeutic results was done according to the immediate efficacy of the therapeutic approach, incidence of recurrence, length of hospitalization and use of antibiotics. RESULTS: A total of 129 patients was treated, the mean age was 35.4 years. Cysts were treated in 14.7% and abscess in 85.3% of cases. Therapeutic approaches were different during different years. During 1993 and 1994 in majority of cases incision and complete extirpation of the glands were done, and rarely marsupialization, alone or in combination with silver nitrate (AgNO3). In 1995 and 1996 in a majority of cases incision of the gland was performed, together with the AgNO3 application (94.3% in 1995, 64% in 1996). In 1995 total gland extirpation was performed (5.7%) while in 1996 in 9 cases (36%) incision was done. The length of hospitalization was longer in earlier years, the shortest being when incision and AgNO3 application was performed (3.1/2.4 days). The use of antibiotics was significantly lower in the years when incision and AgNO3 were used. DISCUSSION: Our results are in concordance with the results of similar studies except for the fact that in our group the changes were seen more often in the age group 30-39 years. The parity was of no significance. The recurrence of the disease when this method is applied is the same as in other studies--around 3%, whereas the complications were rare. The length of hospitalization and the cost of the antibiotic therapy is of great significance as well, and they can be brought to minimum by employment of this method. CONCLUSION: The therapeutic approach of incision and AgNO3 application in therapy of inflammatory changes of Bartholin's glands is an efficient, safe, simple and cheap method, which can easily be applied in ambulatory conditions.

Comment on "Critical behavior of the chain-generating function of self-avoiding walks on the sierpinski gasket family: the euclidean limit"

We refute the claims made by Riera and Chalub [Phys. Rev. E 58, 4001 (1998)] by demonstrating that they have not provided enough data (requisite in their series expansion method) to draw reliable conclusions about criticality of self-avoiding walks on the Sierpinski gasket family of fractals.

[Perinatal infection with the human immunodeficiency virus]. / Perinatalna infekcija virusom humane imunodeficijencije.

INTRODUCTION: HIV infection, eventually resulting in AIDS, represents an important problem of the present days, whereas statistical parameters corresponding with the incidence of its manifestations and lethal outcome deserve great attention and cause anxieity of both general population and medical workers of all profiles. The problem is particularly complicated in the HIV-infected pregnant women. The aim of this paper is to examine epidemiology of HIV and AIDS, influence of HIV infection on the course and outcome of pregnancy, ways of transmission of HIV infection from mother to child, possible effects of progression of HIV infection and medical procedures and approaches in HIV-infected pregnant women. CLINICAL MANIFESTATIONS AND OPINIONS: Some studies from North America and Europe demonstrated an adverse effect of HIV-1 infection on pregnancy outcome, others failed to confirm these findings. Most studies from Africa describe an untoward effect of HIV-1 infection on pregnancy outcome, including fetal wastage, prematurity, low birth weight, stillbirth and neonatal death, but not in terms of embryopathy or congenital abnormalities. The incidence of perinatal transmission varies from 13% and 48%, 13% to 32% for the developed world and 25% to 48% for developing countries. Transmission can take place antepartum, during delivery and postpartum by breastfeeding. Transmission during the first trimester may take place but current data suggest that a substantial proportion of perinatal HIV-1 transmissions take place rather late in pregnancy or during delivery. The apparent absence of viral genome from fetal tissue, presence of a normal immune system at birth, absence of neonatal morbidity and reports of differential viral transmission in twins are arguments in favour of late transmission. One of the greatest concerns for both women and their physicians is the possibility that pregnancy may accelerate the onset of AIDS in mother. Pregnancy itself can be immunosupressive and some investigators have hypothesized that the cumulative immunosupressive effect of HIV-1 infection and pregnancy may accelerate the course of HIV-1 infection in pregnant women. Counselling of HIV-positive women worldwide in regard to their HIV serological status has not proved to influence most women's attitudes towards their subsequent reproductive behaviour. MANAGEMENT AND PREVENTION: HIV-infected women should be offered a possibility of an abortion. Ongoing pregnancies should be carefully monitored and CD4 lymphocyte subsets examined at booking. If the CD4 count is below 200 cells/mm, prophylaxis Pneumocystis carinii and Zidovudine therapy should be initiated. Prevention includes changes of behaviour such as reduction of the number of partners, condom use and early and appropriate treatment of sexually transmitted diseases. Antiviral therapy at birth may prevent this type of HIV-transmission. Also vaginal lavage with virus inactivating products such as chlorhexidine has to be assessed as a possible intervention. Prevention of phase 3 transmission (by breast milk) primarily involves recommendation for seropositive mothers not to breats feed their children. Contraceptives should be strongly advocated as soon as possible after giving birth. CONCLUSION: HIV infection, reproduction and motherhood jeopardize millions of women worldwide. The most appropriate approach in preventing perinatal transmission involves preventing HIV-1 infection in women of childbearing age, including sexual education nd condom promotion at a very young age.

Transvaginal ultrasonographically controlled aspiration of ovarian endometriomas.

Evaluation of the results of the fine needle ultrasonographically directed aspiration of ovarian endometriomas in relation to the efficacy of aspiration of the content, invasiveness, recurrences and complications. The investigation included 30 patients--28 with unilateral and 2 with bilateral ovarian endometriosis in whom 36 aspirations have been performed. Total evacuation of the content was achieved during the first effort in 26 patients versus 4 patients in whom a repeated procedure had to be done. All the patients were controlled during the 1 year post-aspiration period, on average. The recurrence rate was 56.66%. Complications have not been recorded. The transvaginal ultrasonographic fine needle aspiration of the ovarian endometriomas is associated with a high incidence of recurrences but it proved to be a simple, safe, cheap and minimally invasive technique which can be repeated for several times if necessary, in selected patients.

[Placenta percreta--surgical treatment and personal experience]. / Placenta perkreta--hirurski tretman i nase iskustvo.

This is a case report of a female patient with placenta percreta in whom pregnancy was terminated in the XXVII gestational week. The disease was not diagnosed during pregnancy which had a normal course; the suspicion appeared during the third stage of the delivery period and it was confirmed during the operation and subsequent histopathological finding. As profuse bleeding occurred, urgent laparotomy with hysterectomy and unilateral adnexectomy were performed. Thirteen hours after the delivery the infant died.

Drivers' fatigue studies.

This paper summarizes the results of several fatigue studies of bus and truck drivers using different approaches. It presents findings from 24 city bus drivers obtained by the use of biochemical and psychophysiological tests before and after 7 h of driving. It presents an acoustic speech analysis conducted on 34 bus drivers before and after driving. Also, for a small group of city bus drivers, a continual examination of heart rate was carried out by electrocardiorecorder. Questionnaire studies on fatigue are related to the responses of 200 long-distance truck drivers and 107 dump-truck drivers who work in one copper mine. The last approach deals with the analysis of long-distance truck drivers' activities (driving, loading-unloading, resting and sleeping) during trips, based on their individual records. On the basis of these different approaches to bus and truck drivers' studies, clear psychophysiological, speech and subjective changes have been demonstrated and, on a descriptive level, certain symptoms observed during prolonged driving have been interpreted as effects of drivers' fatigue.