Association between oxidative stress biomarkers and concentrations of some metal ions in the blood of patients with brain tumors and hydrocephalus

Introduction Any substance that induces production of free radicals can be a potential cause of brain damage. The aim of our study was to investigate the relationship between some metal ions and oxidative stress biomarkers in the blood of patients with brain tumor and hydrocephalus. Material and methods Our study included 27 control subjects, 24 patients with brain tumor and 21 patients with hydrocephalus. The activities of superoxide dismutase (CuZn SOD), catalase (CAT), glutathione peroxidase (GSH-Px), glutathione reductase (GR), glutathione S-transferase (GST) and acetyl cholinesterase (AChE), as well as concentrations of reduced glutathione (GSH), lipid peroxides (TBARS) and sulfhydryl groups (SH) were analyzed in the plasma and red blood cells (RBCs) of patients. We also determined the concentrations of Mn, Ni, Co, Cu, Zn, As, Se, Cd, Hg and Fe. Results The higher activity of SOD and concentration of GSH in both investigated groups could indicate higher oxidative stress. We also observed decreased levels of SH groups in both groups of patients. In both groups of patients we detected decreased concentrations of Ni, Co, Zn and Fe (and Mn in brain tumor patients) and increased concentrations of As, Se and Cd in the blood. Interestingly, we observed a higher concentration of Cd in both plasma and RBCs of hydrocephalus patients compared to the patients with brain tumor. Conclusions There are strong correlations between some metal ion concentrations and certain oxidative stress biomarkers in the blood of patients, which supports our hypothesis, but the observed trend needs to be further investigated

Assessment of trace metal alterations in the blood, cerebrospinal fluid and tissue samples of patients with malignant brain tumors

The pathogenesis of malignant brain tumors (MBTs) should be better understood due to the evident association between prolonged exposure to metals and increased risk of MBTs. The present research aimed to find trace metals that could contribute to the pathogenesis of MBTs. Essential trace elements (Mn, Co, Zn, Cu, Se) and relevant toxic metals (Al, Ni, As, Sr, Cd, Ce, Pt, Pb, U) in the serum, cell fraction (CF), cerebrospinal fluid (CSF) and cancerous tissue (CT) samples of MBT patients were analyzed. The results were compared with sex- and age-matched control groups. For the first time, this research showed that elemental profiles of serum, CF, CSF and CT samples in MBT patients were significantly altered compared to the appropriate controls, as well as that higher contents of trace elements (particularly Mn, Se, and Pb) could be involved in the pathogenesis of MBTs. However, the most noticeable change found was the elevated U content, indicating its considerable role as a major cerebral discriminator of the presence/absence of MBTs. The U/Se ratio could be considered as an appropriate blood marker in diagnostic MBT evaluation. The reported results could contribute to better understanding of the poorly understood pathogenesis of MBTs. Furthermore, the reported results could highlight a molecular basis for the pathophysiological changes caused by the hazardous effects of trace metals on brain homeostasis

Intraoperacijska ruptura aneurizme: klinički ishod nakon otvorenog kirurškog zahvata ili endovaskularnog postupka

The aim of this study was to evaluate and compare the outcomes of intraoperative aneurysmal rupture in patients with subarachnoid hemorrhage undergoing open surgical or endovascular treatment. This retrospective study included 742 patients with aneurysmal subarachnoid hemorrhage treated at the Clinical Department of Neurosurgery, Clinical Center of Serbia, during a three-year period. Among them, 167 (31.15%) were treated by clipping and 33 (16.01%) by coiling in the early phase (≤72 hours). The overall outcome and pretreatment variables were analyzed for each group, including between-group difference according to the occurrence of intraoperative aneurysmal rupture. Intraoperative aneurysmal rupture occurred in 14.7% of microsurgical and 2.4% of endovascular procedures. It was more frequent in early procedures as compared with delayed procedures (27.5% and 9.7% vs. 2.2% and 1.1%, respectively). On the contrary, mortality rates were lower in the surgical group (11.4%) than in the endovascular one (60.0%).On the basis of the results obtained, it is concluded that intraoperative aneurysmal rupture is more frequent after open than after endovascular treatment, but clinical outcome is more favorable in the former group.Cilj ovoga istraživanja bio je procijeniti i usporediti ishod liječenja nakon intraoperacijske rupture aneurizme u bolesnika sa subarahnoidnom hemoragijom kod kojih je proveden kirurški ili endovaskularni zahvat. U ovu retrospektivnu studiju bilo je uključeno 742 bolesnika liječenih zbog spontane subarahnoidne hemoragije u Klinici za neurokirurgiju Kliničkog centra Srbije u razdoblju d tri godine. Među njima je 167 (31,15%) liječeno kirurškim, a 33 (16,01%) endovaskularnim zahvatom u ranoj fazi (≤72 sata). Opći ishod liječenja i prijeoperacijske varijable su analizirane za obje skupine bolesnika, uključujući njihovu uspredbu u odnosu na pojavu intraoperacijske rupture aneurizme u ovim skupinama. Intraoperacijska ruptura aneurizme se javila u 14,7% kirurški liječenih i 2,4% endovaskularno liječenih bolesnika. Češće je zabilježena kod bolesnika liječenih u ranoj fazi u usporedbi s onima liječenim u odloženom terminu (27,5% i 9,7%, odnosno 2,2% i 1,1%). Nasuprot tome, smrtnost je bila niža u skupini kirurški liječenih bolesnika (11,4%) nego u skupini bolesnika liječenih endovaskularnim postupkom (60,0%). Na osnovi rezultata dobivenih u ovoj studiji zaključuje se da je intraoperacijska ruptura aneurizme češća tijekom otvorenog kirurškog zahvata u odnosu na endovaskularni, ali da je klinički ishod povoljniji u prvoj skupini

Modified divergence theorem for analysis and optimization of wall reflecting cylindrical UV reactor

In this paper, the modified divergence theorem (MDT), known in earlier literature as the Gauss-Ostrogradsky theorem, was formulated and proposed as a general approach to electromagnetic (EM) radiation, especially ultraviolet (UV) radiation reactor modeling. A formulated mathematical model, based on MDT, for a multilamp UV reactor was applied to all sources in a reactor in order to obtain intensity profiles at chosen surfaces inside the reactor. Applied modification of MDT means that intensity at a real opaque or transparent surface or through a virtual surface, opened or closed, from different sides of the surface are added and not subtracted as in some other areas of physics. The derived model is applied to an example of the multiple UV sources reactor, where sources are arranged inside a cylindrical reactor at the coaxial virtual cylinder, having the radius smaller than the radius of the reactor. In this work, optimization of a reactor means maximum transfer of EM energy sources into the fluid for given fluid absorbance and fluid flow-dose product. The obtained results, for water quality known in advance, give a unique solution for an optimized model of a multilamp reactor geometry. As everyone can easily verify, MDT is a very good starting point for every reactor modeling and analysis

Spontaneous regression of cervical disc herniation in a patient with myelopathy

Introduction. The aim of this work was to present a rare case of spontaneous regression of a herniated cervical disc in a patient with myelopathy. Case outline. A 31-year-old women presented with two weeks’ history of neck pain associated with numbness in her body and all four extremities. Magnetic resonance imaging (MRI) of the cervical spine showed a large posterior medial disc extrusion at the C5–C6 spinal segment, causing myelopathy. The patient refused discectomy that was recommended. She received symptomatic treatment in the form of analgesics, a muscle relaxant, and a hard cervical collar. A follow-up MRI of the cervical spine, performed after 11 months, revealed almost complete regression of disc herniation. The patient’s symptoms subsided completely after one year. Conclusion. In some cases of cervical disc herniation with myelopathy, especially in patients with mild neurological deficit, symptomatic therapy should be considered

Analysis of application of different approaches to secure safe drinking water

In this analysis, the risk systems include the systems within which services sensitive to risk are executed. The complex service of population supply with safe drinking water is considered to be risky. Guidelines for drinking water quality of the World Health Organization (WHO) recommends the use of effective preventive approaches to risk-based management of the safety and quality of drinking water. For example, Food Safety Law of the Republic of Serbia stipulates mandatory application of HACCP system in order to obtain safe drinking water. Different approaches to preventive risk-based management for the sake of the safety and quality of drinking water are applied nowadays. In this paper we consider the following approaches: Original Codex Alimentarius HACCP system and some of its modified versions; International standard ISO 22000: 2005 Food safety management systems - Requirements for any organization in the food chain; Water Safety Plan (WSP) of the World Health Organization (WHO); Generalized HACCP system. All of these approaches are based, to a greater or lesser extent, on the original Codex Alimentarius HACCP system. The paper gives a situation analysis (SWOT analysis) of considered approaches

Modified “in-window” technique for decompressive craniotomy for severe brain injury

Increased intracranial pressure and decreased cerebral perfusion in patients with severe traumatic brain injury are associated with cerebral ischemia and poor outcome. Lowering intracranial pressure is one of the goals of treatment. We analyzed the effects of decompressive craniotomy on intracranial pressure levels and outcome. In addition, we compared the results of decompressive craniotomy performed with our original technique (modified “in-window” technique, with no need for cranioplasty) with results of classic techniques. We formed two groups: 52 patients with TBI (GCS≤8), with monitored intracranial pressure, and the control: 45 patients without intracranial pressure monitoring. In the first group, malignant intracranial hypertension was treated by decompressive craniotomy, using a modified "in-window" technique. Results were analyzed using standard statistical methods. In the first group, with intracranial pressure monitoring, 17/52 had decompressive craniotomy, and significant reduction of intracranial pressure appeared in the early postoperative period (38.82 to 22.76 mmHg, mean), with significant decrease of intracranial pressure at the end of treatment, compared to the control group (mean=25.00, and 45.30 mmHg, respectively). Late complications were similar to results of other studies. Our results were 20% of epileptic seizures, 8% of hydrocephalus, 12% contusion/hematoma progression and 12% subdural hygroma. Outcome (measured with Glasgow Outcome Score-GOS) in the first group, at the time of discharge, was better with decompressive craniotomy than without decompressive craniotomy (GOS=2.47, and GOS=1.00, respectively). Modified "in-window" technique for decompressive craniotomy in severe traumatic brain injury is safe, promising and according to our experience offers a lower rate of complications with no need for additional cranioplastic surgery

Possible zinc deficiency in the Serbian population: examination of body fluids, whole blood and solid tissues

Studies indicate that the soil, water and consequently foodstuffs in Serbia are significantly poor in zinc (Zn), and thus, it is likely that there is a Zn deficiency in the Serbian population. This study examined the Zn status in multiple clinical samples, including body fluids (serum, cerebrospinal fluid), whole blood and Zn-rich solid tissues (thyroid and brain tissue). Differences between sex and age were also considered, and comparative analysis of Zn status with other world populations was performed. Serum samples from a large number of Serbian adults approximately had twofold lower Zn amounts when compared to other populations. A similar trend was obtained for whole blood. Males had significantly higher amounts of Zn in serum, whole blood and thyroid tissue samples than females. Higher amounts of Zn were observed in the group older than 50 years. Importantly, in thyroid and brain tissues, Zn was 10- and 20-fold lower, respectively, than reported in the literature. Our results indicate that the population in Serbia could be considered Zn deficient. Therefore, adequate oral Zn supplementation and/or foodstuff fortification should be considered to prevent the deleterious effects caused by Zn deficiency

The human biomonitoring study in Serbia: Background levels for arsenic, cadmium, lead, thorium and uranium in the whole blood of adult Serbian population.

The purpose of this study was to establish reference values (RVs) for the occupationally- and environmentally-important toxic elements in the whole blood of adult Serbian population for the first time. Contaminated drinking water with arsenic, high share of smokers in the country, removing tetraethyl lead from the gasoline and war attack at the end of the twentieth century were some of the reasons to provide background information for arsenic (As), cadmium (Cd), lead (Pb), thorium (Th), and uranium (U) in the blood of the Serbian population. The whole blood samples were collected from the healthy respondents living in the Belgrade and surrounding areas of the capital (n = 305; w/m ratio = 154/151; mean age: 41 ± 2). The concentrations of toxic metals were determined by inductively coupled plasma-mass spectrometry (ICP-MS). Reference values were estimated as the lower limit (LL) and upper limit (UL) of the 95% confidence interval (CI), together with the selected percentiles (P2.5-P97.5). The obtained geometric mean (GM) for As, Cd, Pb, Th, and U were: 0.50 ng/g, 0.32 ng/g, 20.94 ng/g, 0.30 ng/g, and 0.06 ng/g, respectively. The influences of age, sex and lifestyle on results were considered. Women have significantly higher levels of Cd and Th than men. The increased level of Th was observed in the aged group below 40 years, while smokers had significantly higher levels of Pb and double higher level of Cd in the blood than non-smokers (p < 0.05). In comparison with other population groups worldwide, the Serbian population had significantly higher levels of Th and U (up to 100 times higher). These findings could contribute to better understanding of the molecular basis for the development of various health hazards, including the increased incidence of cancer among the Serbian population which need be confirmed by clinical studies

Reference values for trace essential elements in the whole blood and serum samples of the adult Serbian population: significance of selenium deficiency.

This study was aimed to determine reference values (RVs) for the manganese (Mn), copper (Cu), zinc (Zn), and selenium (Se) in the whole blood (B) and serum (S) samples of the Serbian population. Blood specimens were collected from healthy persons (n = 295; women/men ratio = 149/146; mean age: 42 ± 2 years). The RVs were calculated as lower limit (LL) and upper limit (UL) of the 95% confidence interval (CI) and were expressed as percentiles (P) in the range from P2.5 to P97.5. The influences of sex, age, and smoking habits on element profiles were considered. It was found that the contents of B-Cu and S-Cu were higher in women, while the contents of B-Zn and S-Zn were higher in men. Both trace elements were significantly increased in a group of persons above 40 when compared to a younger persons (≤ 40 years). According to smoking habits, increased content was found only for S-Mn in the nonsmoker's group (p < 0.05). Comparing our results to the results reported in other population groups worldwide, the Serbian population had significantly reduced content of Se in both types of samples. This finding could highlight the deficiency of Se in the investigated Serbian population and could contribute to the better understanding of the molecular basis for the increased incidence of thyroid and other diseases in which selenium plays a key role