Usporedba statističkih klaster metoda u analizi proteina elektroforezom

Standard electrophoresis methods were used in the qualitative and quantitative protein analyses of cerebrospinal fluid (CSF). Disc electrophoresis was carried out for detection of oligoclonal IgG bands in cerebrospinal fluid on polyacrylamide gel. Pairs of CSF and serum were taken from 30 patients, mainly with multiple sclerosis and other central nervous system dysfunctions, polyradiculoneuritis, known as Guillain-Barre syndrome, encephalitis, paraproteinemia, and analyzed. ImageMaster 1D Elite and GelPro specialized software packages were used for fast accurate image and gel analysis. The results obtained from different hierarchic cluster analysis methods were compared. In some cases, despite substantial similarities between electropherograms, different cluster methods produced different dendrograms. Therefore, the cluster analysis should be used cautiously. It offers only additional diagnostic information on the inflammatory conditions of the central nervous system.Standardne metode elektroforeze upotrebljene su u kvalitativnoj i kvantitativnoj analizi proteina cerebrospinalne tekućine (CSF). Detekcija oligoklonalnih IgG proteina u cerebrospinalnoj tekućini provedena je disk elektroforezom na poliakrilamidnom gelu. Analizirani su uzorci CSF i seruma od 30 pacijenata s multiplom sklerozom i drugim oboljenjima središnjeg živčanog sustava kao što su poliradikuloneuritis, poznat kao Guillain-Barre sindrom, encefalitis i paraproteinemia. ImageMaster 1D Elite i GelPro specijalizirani kompjutorski programi upotrebljeni su za brzu analizu slike i gela. Usporedbom rezultata dobivenih iz različitih hijerarhijskih klaster analiza utvđeno je da različite klaster metode ne daju iste rezultate. Usprkos sličnostima elektroferograma različite klaster metode u nekim slučajevima daju različite dendrograme pa je potreban oprez u interpretaciji rezultata. Klaster analiza daje samo dodatne dijagnostičke informacije o upalnom stanju središnjeg živčanog sustava

HIGHER EDUCATIONAL POLICIES: PROBABILITY OF HEIGHT SCHOOL STUDENTS DOR CONTINUED STUDDING ON UNIVERSITIES

Higher Education System reforms, from incorporation of ECTS until present,are evaluative process in Macedonian height educational system. The reforms causedcommercialization of the educational process with multiplication of private educationalinstitutions, and later continued with opening of the new state universities. But, the higherlevel of enrolled height school students on university level are not related with this type ofmultiplication and university education dispersions, but overall is related with implementationof ECTS system. Parallel, the tendency Macedonian students studying abroad is result ofglobal and regional educational policies and liberalization of educational space in general.Yet, Higher education politics, as in the wider region, and in the county refers to dominationin quality and quantity of state own higher educational institutions over private universities.Those tendencies can be seen in the perceptions of height school students for continuation ontheir education on tercial level

Paralaktičko mjerenje dužina instrumentom Redta 002

Paralaktičko mjerenje dužina instrumentom Redta 002

Prenatal Glucocorticoids: Short-Term Benefits and Long-Term Risks

Glucocorticoids are steroid hormones synthesized in the adrenal gland cortex, and most of their physiological effects are mediated by the glucocorticoid receptor (GR), that acts as a ligand-dependent transcription factor. Coordinate changes in metabolism under glucocorticoid influence provide energy that is instantly and selectively available to vital organs, an enables them to deal with immediate environmental demands, at the expense of anabolic pathways, such as bone formation, reproduction, immunological responses and other, that are being blunted or delayed, under glucocorticoid influence [1-3]. During fetal development the synthesis of adrenal glucocorticoids precedes the establishment of a definitive structure of the gland. In rats, secretion of the main glucocorticoid – corticosterone starts as early as on day 13 of development [4] (term=22 days, short gestation period), while in humans secretion of the main glucocorticoid – cortisol starts in the 8th week of pregnancy (term=40 weeks, long gestation period) [5]. Glucocorticoid receptor mRNA is present in the tissue derivatives of all three germ layers from fetal day 13 onwards, and increases gradually during rat fetal development [6]. Human fetal tissues express GR at the gestational age of 6 weeks, meaning that the machinery for hormone action is prepared at the early stages of development [5]. These facts suggest that endogenous glucocorticoids produced by the fetal adrenal glands have a crucial role in fetal growth and the development of individual fetal tissues [7]. In response to the prepartum rise in glucocorticoids a wide variety of changes known as “preparation for birth” occurs, meaning that the maturational changes in many fetal tissues, essential for neonatal survival, are intensified during the last third of gestation. Namely, circulating glucocorticoids induce fetal lung maturation and surfactant production, trigger a variety of physiological effects on brain cell differentiation and synaptogenesis, stimulate the production of hepatic gluconeogenic enzymes, affect pancreatic -cell development and insulin content, influence renal development and affect the maturation of the immune system [8-10]. Metabolic, cardiovascular and immune adaptations under glucocorticoid influence are fundamental to successfully overcoming birth-related stress and postnatal adaptation of the newborn to environmental challenges [11, 12]. Environmental conditions influence the prevailing nutritional and endocrine status in mothers and fetuses. Numerous animal and human studies have shown that adverse environmental conditions during pregnancy, such as maternal undernutrition [13, 14], stress [15, 16], illness, placental insufficiency [17, 18], as well as prenatal glucocorticoid exposure [19, 20] affect fetal development and postnatal outcome. Changes in the maternal hypothalamic-pituitary-adrenal (HPA) activity, transplacental diffusion of nutrients, hormones and growth factor supply, potently affect the fetal HPA axis influencing glucocorticoid output as well as other developing systems [21, 22]. Gestational age, at which an insult occurs, its nature and intensity, determines the specific tissue or organ which will be affected by the insult. Glucocorticoids are the key mediators between maternal environment and the fetus, and as such are involved in adaptations of the fetus to predicted postnatal environment. Even transient changes in glucocorticoid levels could have longlasting consequences. The outcome might be growth retardation and change in the developmental trajectory, in the direction that best suited to the expected environment [23, 24]. This phenomenon is known as programming. The adaptations caused by suboptimal intrauterine conditions are appropriate if the predicted and actual postnatal environments match, and lead to survival to reproduce in a deprived environment [25, 26]. If there is a mismatch between the environment predicted and the actual environment experienced postnatally, adaptations are inappropriate and result in the development of disease like hypertension, ischemic heart disease, glucose intolerance, insulin resistance and type 2 diabetes [27-29]. In this chapter the latest findings, with clear statements from the literature, as well as own results regarding the endocrine mechanisms of intrauterine programming mediated by glucocorticoids will be analyzed. The causal relationship between a prenatally programmed endocrine axes and their postnatal functioning that affect growth, stress response, metabolism and reproduction will be discussed. In order to better understand mechanisms of fetal glucocorticoid programming of endocrine axes, special attention will be paid to key points of their development

Paralaktičko mjerenje dužina instrumentom Redta 002

Paralaktičko mjerenje dužina instrumentom Redta 002

Treatment of Moderate-sized Kidney Stone with Third-generation Electromagnetic Shock Wave Lithotripter

BACKGROUND: The extracorporeal shock wave lithotripsy (ESWL) is a non-invasive method in the treatment of urinary tract stones and its discovery has led to a complete change in the therapeutic strategy for urolithiasis. Due to the low morbidity and excellent fragmentation of the stones, ESWL has proven to be an effective and non-invasive method in the treatment of renal stones. AIM: The aim of this retrospective study is to evaluate the efficacy and safety of the ESWL as a monotherapy in the treatment of moderate size kidney stones with stone area (SA) of 100–300 mm². MATERIALS AND METHODS: We made a retrospective study of 98 patients with moderate size kidney stones with SA of 100–300 mm², divided into two subgroups, into a group with a SA of 100–200 mm² and with 200–300 mm², treated with ESWL in the period of November 2018–December 2019. The patients were treated with a third-generation electromagnetic lithotripter (Lithoskop®, Siemens Medical Systems, Erlangen, Germany), with a source of electromagnetic shocks (Pulso™) and dual ultrasonographic/fluoroscopic system for detection of the stones. The stone location, size, maximum energy used, localization technique, number of shock waves, sessions, re-treatment rate, and additional procedures were reviewed. All the patients before the intervention had a complete laboratory and radiological examinations. Postoperatively, patients were monitored on the 1st, 30th, and 90th post-operative days. RESULTS: Ninety-eight patients with solitary kidney stone with a SA of 100–300 mm² were treated with ESWL. The study included 58 men (59.18%) and 44 women (40.81%). The average length and width of the stone were 15.47 ± 2.68 mm and 12.99 ± 2.83 mm, respectively. The average surface area of the stones in our series was 203.78 ± 72.85 mm². The mean number of treatments for the entire series of patients was 1.82 ± 0.91. The mean number of shock waves for the total series of patients was 3899.11 ± 40. The mean energy used for the overall patient series was 110106.17 ± 21489.61 mJ. The total re-treatment rate was 47.95%. The entire rate of additional procedures was 19.38%. The overall success rate (SR) in our study was 77.55%. The efficiency quotient for the upper-middle and lower calyx was 55.57, 57.15, and 30.81, respectively. CONCLUSION: ESWL is a safe and effective method in the treatment of renal stones, and we recommend as the first method in the treatment of moderate size kidney stone with a surface area of 100–300 mm². The treatment of each patient should be individualized and take into account all favored and non-favored factors that influence the decision to choose extracorporeal lithotripsy as a method of treatment of medium-sized stones

Efficacy and Safety of Percutaneous Nephrolithotomy: A Single-center Initial Experience

BACKGROUND: In the age of modern medicine, thanks to the development of small-caliber nephroscope as well as various types of intracorporeal lithotripters, treatment options for renal stones have changed dramatically, and the area of percutaneous nephrolithotomy (PCNL) has expanded. Nowadays, PCNL is not only the first choice in the treatment of stones >2 cm, as well as complicated renal stones (staghorn stones, multiple stones, and stones associated with abnormal renal anatomy), but is also the method of optimal treatment for medium-sized stones not treated with other less invasive methods. AIM: The purpose of this study is to assess the efficacy and safety of PCNL as monotherapy in the treatment of renal stones larger than 15 mm. MATERIALS AND METHODS: This study presents a retrospectively prospective study of 14 (4 retrospective and 10 prospective) consecutive patients with renal stones larger than 15 mm treated with PCNL in the period from January 2020 to March 2020 at the GH “8 September” – Skopje. Pre-operative preparation of patients included: A history along with physical examination, a complete blood count and radiological examinations to assess the size of the stones, the anatomical features of the kidney and its function, and to accurately plan the operative approach. PCNL was performed in the prone-position; lithotripsy was performed with a double, pneumatic and ultrasonic intracorporeal lithotripter Swiss LithoClast Master with the use of the Karl Storz 24–26 fr nephroscope. Postoperatively, patients were monitored on the 1st, 7th, and 30th post-operative day, determining the demographic and clinical characteristics, the efficacy of PCNL, perioperative blood loss, the duration of the operative procedure, the duration of hospital stay, and the resulting intraoperative and post-operative complications. RESULTS: The study included eight men (57.1%) and six women (42.8%). The mean age of the patients was 52.35 ± 11.00. In 5 (35.71%) patients, the stones were localized in the left kidney, and in 9 (64.28%) patients in the right kidney. The average body mass index was 25.11 ± 3.92 kg/m². The average area of the stones was 371.24 ± 131.86 mm². Eleven (78.57%) patients had simplex stones, while 3 (21.42%) had complex stones (staghorn stones and multiple stones). The stones were localized in the renal pelvis, upper, middle, and lower calyx at 5 (35.71%), 2 (14.28%), 4 (28.57%), and 3 (21.42%) patients, respectively. The mean value of pre- and post-operative serum hemoglobin was 13.94 ± 1.00 g/dl and 11.77 ± 1.51 g/dl, respectively. The effectiveness of the procedure on the 1st post-operative day assessed by ultrasound diagnostics and kidney-ureter-bladder X-ray was 78.57%. The success rate on the 30th post-operative day after additional procedures was 92.85%. The average operating time in the entire series was 119.28 ± 9.42 min. The average hospital stay was 5.57 ± 1.11 days. The average operative blood loss was 2.19 ± 0.88 g/dl. CONCLUSION: The results of this retrospectively prospective study confirm that PCNL is a minimally invasive, safe, and effective method for removing renal stones. This method, with the development of new technologies, has an increasingly important role in the modern surgical treatment of nephrolithiasis. PCNL can also be performed in the early stages of the learning curve without compromising patient safety and treatment benefits. The procedure is safe and effective, performed even by less experienced urologists if the protocols established for this procedure are followed. This can achieve a rate of success comparable to most established standards without causing major complications

Računanje elemenata klotoide u obliku S-krivulje

Računanje elemenata klotoide u obliku S-krivulje