Open Access Macedonian Journal of Medical Sciences

377-381

Authors: Esmail RS, Sharaf WM, Helmy NA, Farrag ARH, Badawi MA, Eldin AAG

Background: Cancer colon is one of the most prevalent cancers in Egypt. Sporadic cancer colon is much more common than familial type; the latter accounting for not more than 30% of the reported cases in different registrations. BRCA1 is a tumor suppressor gene which is proved to be mutated in many cancer types. Limited studies tried to screen its mutation in cancer colon. Aim: This work is aimed to screen BRCA1 mutations using C-terminal antibody in sporadic non familial colonic carcinoma. Subjects and Methods: Fifty colectomy specimens were collected. Sections of paraffin blocks were cut (μm thickness), then stained with Hematoxylin and eosin and evaluated for tumor type and its nuclear grade and its stage. Immunohistochemical studies for BRCA1 were performed. Results: positive nuclear immunostaining of BRCA1 staining was detected in 84% of the cases, with insignificant correlation with both the grade and the stage p ~ 0.42, p ~ 0.31 respectively. Conclusion: This type of staining denies a direct role of BRCA1 axon 11 mutations in sporadic colonic cancer - unlike some sporadic ovarian and breast cancers - and may point to that BRCA1 may share in the early tumorogenesis in a way other than the usual mutation of exon 11.

389-396

Authors: Yasser S, Nagy N, Marei MK

Stem cells from human exfoliated deciduous teeth (SHED) provide a new attractive source for stem cells; in this study we further characterize SHED. SHED were isolated, differentiated using osteogenic/ odontogenic differentiation media, characterized using light microscope, SEM and immunocytochemistry using CD44. Also, Immunohistochemistry using CD44 was performed on extirpated pulp tissues. We found that a naturally exfoliated human tooth contains a population of stem cells that attain morphological homogeneity after the first passage, on adding the osteogenic/odontogenic medium, sporadic nodule-shaped structures were observed after two weeks that were positively stained with alizarin red and von Kossa stains. SHED stained with H& E showed a basophilic, eccentric nucleus with an eosinophilic cytoplasm in which two differently stained areas were clearly distinguishable. Also we found using SEM that SHED spread on the UBM scaffolds surfaces showing multiple filopodia and formed collagen-like structures by the seventh day. After three weeks, seeded scaffolds incubated in osteogenic/odontogenic media showed many mineralized nodules in the ECM. Cultured SHED revealed positive immunoreactivity when treated with CD44. Also, sections of pulp tissue treated with CD44 depict positively stained cells situated mainly in the perivascular areas reinforcing the hypothesis that pericytes may be the origin of SHED.

404-410

Authors: Petlichkovski A, Stojanoski Z, Djulejic E, Georgievski B, Spiroski M

Aim: The aim of this study was to examine the gene frequencies of 16 KIR genes and pseudogenes and KIR genotypes in Macedonian patients with transplanted bone marrow and their sibling donors in treatment of haematological malignancy, and to analyse eventual association of the gene content with the occurrence of a graft versus host disease (GVHD). Material and Methods: The study was performed on 24 patients and their HLA-matched sibling donors. Results: Comparison of KIR gene frequencies between the total 24 donors and healthy Macedonians reveals statistically significant difference for KIR2DS1 (F= 0.481 in the controls group, and 0.76 in the patients group, p=0.004). This significance is even higher when the frequency of KIR2DS1 in controls is compared with the frequency in donors from pairs with GVHD (F= 0.923, P= 0.002). Another significant difference was observed for the frequency of the full-length allele of KIR2DS4*001-002, present in 25.2% of the control individuals, but in as much as 81.8% of the recipients of haematopoietic stem cell (P=0.0005). We did not see any statistically significant difference in distribution of the C1/C1, C1/C2 and C2/C2 groups among GVHD pairs. Conclusion: Our results address the difference between the haematopoietic stem cell transplantation settings with sibling and unrelated donors and suggest that the KIR2DS4*001/002 might be a predisposing factor for severe GVHD in sibling HSCT.

416-422

Authors: Sofijanova A, Piperkova K, Jordanova O

Background: The aim was to investigate whether S100 in serum is a prognostic marker of cerebral injury in term newborn infants with hypoxic ischemic encephalopathy (HIE) after perinatal asphyxia. Material and Methods: All risk neonates with severe asphyxia, admitted to the neonatal and Pediatric Intensive Care Unit at the University Pediatric Hospital in Skopje-Macedonia within 24h of injury were eligible for inclusion in the study. One serum blood sample was obtained from each patient at the 24h post-injury time-point, than day 3 and day 7. S100B levels were measured using ECLIA method (Electro-Chemil-Luminiscence Immuno Assay-Elecsys 2010-Roche Diagnostic). Results: One hundred and nineteen neonates were recruited. The avarage serum S100B levels for the control group (N=48) was 0.12 microgL(-1) (cut-off point). S100B levels were significantly higher in asphyxiated term neonates N=29; M= 0.64. Infants with moderate and severe HIE had significantly higher S100 levels on postnatal day 1 (p = 0.031) and day 2 (p = 0.008) than infants with mild or no HIE. Increased S100 levels were significantly inversely correlated with perinatal pH in the infants and associated with abnormal CTG at admission to the labor ward. Conclusion: Early determination of serum S100 may reflect the extent of brain damage in infants with HIE after asphyxia.

428-433

Authors: El Dayem SMD, El Sheikh EAB, Abdou SS, Agaibyi MH, Mahmoud M

Objective: To investigate whether advanced glycosylation end products (AGE) and oxidative stress are augmented in young patients with type 1 diabetes at early clinical stages of the disease. Patients and Methods: The study included 50 patients with type 1 diabetes among those attending the endocrine clinic in National Research Centre and 30 healthy volunteers in the control group. Serum glucose, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), triglycerides, serum creatinine concentrations, glycosylated hemoglobin (HbA1c), urinary albumin/ creatinine ratio, malondialdehyde and pentosidine were assessed. Results: No significant difference was found between age of patients (12.0 ± 3.2 ) and controls (11.0 ± 1.2), P > 0.05. Blood glucose, HbA1c, urinary albumin / creatinine ratio, pentosidine and malondialdehyde were significantly higher in diabetic patients than controls. Pentosidine and malondialdehyde had a significant positive correlation with blood glucose, HbA1c and urinary albumin/creatinine ratio. Conclusion: The present study indicates that accumulation of AGEs, whose formation is closely linked to oxidative stress, and resultant endothelial dysfunction may start early in the course of type 1 diabetes. This means that the risk of vascular complications may be present at an early age and that the best possible glycemic control should be emphasized from the diagnosis of diabetes.

437-443

Authors: Lazarevik V, Kasapinov B

Objective: To determine medical doctors’ attitudes towards the implementation of the new pay-for-reporting system in the public hospital sector. Data Source: An electronic survey was conducted among 303 medical doctors in the Republic of Macedonia using the database of Healthgrouper.com, an online provider of information for healthcare providers. Principal Findings: Majority (61.9%) of all surveyed doctors are against the proposed pay-for-reporting (P4R) reform. Disapproval is much higher among the doctors employed at the public hospitals where 79% consider that pay-for-reporting project has to be abandoned. Doctors are against the proposed P4R system that only measures quantity of the work. According to majority of the doctors current model is subjective; it opens possibilities for bias and missconduct, and puts the clinical teamwork at jeopardy. Conclusions: Massive support against the implemented P4R reform was expressed by the Macedonian doctors employed in the public sector. The model should integrate parameters such as quality and complexity of delivered services to patients. Better integration and engagement of doctors is essential to assure support and smooth implementation of P4R reform as sound policy in practice. The Ministry of Health should set key parameters to be monitored by hospitals to evaluate the success of the P4R system.

453-461

Authors: Petrushevska T

The aim of this review is to give new emphasis to key aspects of the proposed treatment of drug addiction. Surveys for so called “second-line” treatment of drug addiction, with heroin (diacetylmorphine) as a pharmaceutical preparation, started since 1990, but this issue is becoming particularly popular in the last period. Drug addiction according to WHO and International Classification of Diseases (ICD10) is chronic, relapsing disease characterized by compulsive drug seeking and use despite harmful consequences as well as neurochemical and molecular changes in the brain. Drugs generate crime, violence and other social problems that are damaging society as a whole. Drug addiction is medical disorder to which contributes more factors and it is necessary to implement the treatment in multi disciplinary manner - from pharmacological, psychiatric, and social aspect. In recent periods studies are carrying out in several countries in the European region, to provide justification, with the scientific medical evidence, for use of heroin as a pharmaceutical dosage form, for treatment of drug addictions for previously unresponsive group. This review paper is focused on maintenance treatment with heroin, retention of the patients into treatment, whether the dose that is expected to be effective at the same time is safe, which organ (systems) are involved in eliminating the drug from the body, whether the injection is the best way for application of the drug. Purpose of this review paper is not to be supporter or opponent, but to inform, transparently to discuss all aspects and to set conclusions about this type of treatment, within national strategy context.

472-481

Authors: Macedonian Journal of Medical Sciences

We present English abstracts of MSc theses defended in 2011 at the Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Republic of Macedonia. English summaries are published as they are translated by authors and included in the final version of defended MSc. Macedonian Medical Master of Science (MSc) theses are deposited in the Central Medical Library and National and University Library “St. Kliment Ohridski” in Skopje, Republic of Macedonia. At the Faculty of Medicine in Skopje twenty three (23) MSc theses were defended in 2011, eleven (11) MSc are without abstracts (47.8%) and eleven (11) MSc are without Key words (47.8%). Two MSc are not deposited in the Central Medical Library (Kristina Pavlovska, Defended: November 04, 2011 and Igor Kostov, Defended: November 16, 2011) and should be treated as none legally defended MSc. Editorial Board does not take any responsibility either for the content, nor the quality of the abstracts. We conclude that the qualities of the Master of Sciences theses defended in 2011 at the Medical Faculty, Ss Cyril and Methodius University of Skopje, Republic of Macedonia are drastically lower than in the previous year.