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Neuro-toxic effects of aluminium, with disorders mainly in motor coordination, have been proved in epidemiological studies of subjects professionally exposed to aluminium. However, there is, as yet, no adequate evidence that neurotoxicity of aluminium leads to progressive dementia and Alzheimer's disease. It is likely that long-term use of drinking water with a high aluminium concentration, with pH about or less than 7.0, and with low fluoride concentration, is associated with the increased relative risk of Alzheimer's disease. ⋯ Results of the studies concerning aluminium concentrations in the brain of patients with Alzheimer's disease are incoherent. To resolve this scientific problem it is necessary to follow-up the prognosis of neurotoxic disorders caused by aluminium. It should be clarified as well whether aluminium in neuro-pathological findings of Alzheimer's disease is an artefact caused by alumino-silicates present in most reagents for tissue-staining.
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Toxoplasmosis is a widely distributed zooanthroponosis, caused by the ubiquitous obligatory intracellular protozoan parasite Toxoplasma gondii. Once infected, the host acquires lifelong immunity induced by the persistence of the parasite in an encysted form. While T. gondii infection in pregnancy has long been known as a significant cause of perinatal morbidity and mortality (congenital toxoplasmosis), its significance as an opportunistic agent has been increasingly recognized during the last decade, particularly with the outbreak of AIDS. ⋯ The paper reviews recent data on the significance of toxoplasmosis as an opportunistic infection in immunosuppressed individuals, such as patients with malignant and systemic diseases treated with immunosuppressive drugs, organ transplant recipients, and, first and foremost, patients with AIDS. A high prevalence of latent toxoplasmosis in Yugoslavia indicates a high local exposure to infection reactivation. While a definitive diagnosis of toxoplasmosis is difficult in the immunosuppressed, its treatability as opposed to a fatal outcome, if untreated, demands that physicians caring for the above categories of patients keep in mind toxoplasmosis and its possible clinical presentations and include them in the differential diagnosis of these conditions.
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Rupture of abdominal aortic aneurysms (RAAA) can take place in one of the 4 following ways: 1. "Open" rupture in the free peritoneal cavity; 2. "Closed" rupture with formation of retroperitoneal haematoma; 3. Rupture into surrounding cavity structures, such as veins and bowels; 4. In rare cases rupture is effectively "sealed of" by the surrounding tissue reaction, and retroperitoneal haematoma is "chronically" contained [1]. The terms "sealed" [2], "spontaneously healed" [3], "leakig" [4] RAAA, were also used in the previous papers connected to this situation. The "sealed" rupture was first described by Szilagyi and associates in 1961 [2]. In their case the rupture was small and haemorrhage was effectively encircled by the tissue surrounding the aortic wall. The slow rate of blood loss contributed to the patient's haemodinamically stable condition. Christenson et al. reported a case of "spontaneously healed" RAAA [3]. Rosenthal and associates described 2 patients who had aortic aneuryms that ruptured several months before repair and contributed to the term "leaking AAA" [4], while Jones et al. introduced the term "chronic contained rupture" [1]. The aim of this paper is the presentation of 5 such patients. ⋯ Between December 1, 1988 and May 30, 1997 411 patients with abdominal aortic aneurysms (AAA) have been operated at our institute. Of this number 137 (33%) had RAAA, while 5 patients (12%) had a contained RAAA (CRAAA). CRAAA were found in 3 male and two female patients, average age 62 years. All of them had a previously proved AAA and initial symptoms lasted for days or months before the admission. In all patients haematocrit, pulse rate and arterial tension during the admission, were normal. All typical signs of RAAA were absent in these patients. Patient 1. A 56-year-old man, smoker, with previous history of arterial hypertension had an isolated episode of abdominal pain and collapse 30 days before the admission. Physical examination revealed a pulsatile abdominal mass. Doppler ultrasonography identified an infrarenal AAA, with right lobular extraaneurysmal mass which displaced the inferior vena cava (ICV). Angiographically (Figure 1a) an unusual saccular intrarenal AAA was detected, while simultaneous cavography (Figure 1b) confirmed the-dislocated inferior vena cava to the right. The intraoperative finding showed infrarenal CRAAA with organized retroperitoneal haematoma between AAA, ICV and duodenum. After aortic cross clamping and aneurysmal opening, the rupture at the right posterior aneurysmal wall was discovered. The partial aneurysmactomy and aortobilliar bypass procedure with bifurcated knitted Dacron graft (16 x 8 mm), were performed. The patient recovered very well. After a 4-year follow-up period the graft is still patent. Patient 2. A 72-year-old woman with low back pain, fever and disuric problems was urgently admitted to the Institute of Urology and Nephrology. The standard urological examination (X-ray, intravenous pyelography, retrograde urography, kidney Duplex ultrasonography) excluded urological diseases. However, intrarenal AAA an a giant aneurysm of the right common iliac artery, were found. The proximal dilatation of the right excretory urinary system was also found by retrograde urography. The patient was transported to our Institute 20 days after the initial symptoms. Translumbar aortography (Figure 3) showed the right common iliac artery aneurysm and gave the false negative picture of normal abdominal aorta because of parietal thrombosis of AAA. The intraoperative finding showed chronic rupture of the posterior wall of the right common artery aneurysm. The retroperitoneal haematoma compressed the right ureter. Both aneurysm have been resected and replaced by bifurcated Dacron graft (16 x 8 mm). The patient recovered successfully. After a 2-year period of follow-up the graft is still patent. Patient 3. (ABSTRACT TRUNCATED)
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Arginase (EC 3.5.3.1) is one of the essential enzymes in the terminal stages of the urea cycle in the liver which participates in the elimination of ammonia from the human body [1, 7]. Except in liver tissue arginase is also present in many human tissues and in the circulating blood cells, especially in erythrocytes and leukocytes. Arginase splits arginase to urea and ornithine that serve for biosynthesis of amino acid proline, glutamic acid and biosynthesis of polyamines-spermine, spermidine and putrescine. Arginase activity is high during the mitotic cycle, with the function in phase S of the cell cycle. The aim of our study was to assess the arginase activity in the blood of children with some haematologic diseases. ⋯ The measurement of arginase activity in plasma and erythrocytes is a good diagnostic indicator for the presence of young erythrocytes and reticulocytes in the circulating blood as is the good sign for the detection of haemolytic processes.
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Almost all patients with invasive cervical carcinoma can be treated with either primary irradiation therapy or primary surgery. Some patients are appropriately treated with the combination of irradiation and surgery. Chemotherapy is not effective as primary treatment of invasive cervical cancer but may be used as additional therapy and when the disease is recurrent or persistent. There are some important advantages of primary extensive surgery over irradiation. The findings at operation and that from the careful pathologic examination of surgical specimens can be very helpful in selection of patients for supplementary postoperation irradiation therapy or chemotherapy, or both [1-6]. ⋯ The findings at operation and that from the careful pathologic examination of surgical specimens are absolutely irreplaceable and important in grading invasive cervical cancer and selection of patients for supplementary postoperate irradiation therapy.