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Obstructive sleep apnea (OSA) is characterized by repetitive complete or partial collapse of the upper airway and reduction of airflow during sleep. It is associated with significantly increased daytime muscle sympathetic nerve activity thought to result from the repetitive intermittent periods of hypoxemia during sleep and brain alterations that are likely to result. Different brain regions are affected by subsequent hypoxia/anoxia. Neurodegenerative processes result in measurable atrophy of cortical gray matter in the temporal lobes and posterior cingulate cortex, as well as in subcortical structures such as the hippocampus, amygdala, and thalamus. This study involved a group of firstly diagnosed, therapy-naive, nonalcoholic fatty liver disease (NAFLD) patients, out of which 144 (96 males and 48 females), aged 34–57 (mean 47.88 ± 6.07), satisfied the recruiting criteria for the study and control groups. All the patients underwent MRI scanning, polysomnography testing, and cognitive evaluation. Cognitively, worse results were obtained in the group with OSA ( p < 0.05 ) and NAFLD ( p = 0.047 ). A significant decrease in volumes of cortical and subcortical structures was revealed ( p < 0.001 ). In conclusion, brain deterioration followed by cognitive impairment is, most likely, the result of intermittent hypoxia and anoxia episodes that initiate the domino process of deteriorating biochemical reactions in the brain.

Background: Transsexuality is explained and defined as a gender-identity disorder, characterised by very strong conviction of belonging to the opposite sex and has been associated with a distinct neuroanatomical pattern. Materials and methods: We performed a structural analysis in search of possible differences in grey matter structures based on magnetic resonance imaging scans of the brains of 26 individuals between 19 and 38 years of age. The participants were divided into two groups of 15 controls and 11 transgender individuals. The segmentation of subcortical grey matter was performed using FIRST model a model-based segmentation/registration tool, from FSL software package. Results: The results showed that the volume of the brain region called nucleus accumbens on the left side was significantly smaller in the group of transgender individuals compared to the control. It was the most important parameter which was shown to make distinction between two examined groups. Conclusions: The results also showed decreased volumes of the left thalamus, right hippocampus and right caudate nucleus.

Regardless of the differences in the neonatological practice of different countries in the world, ethical decisions of medical professionals in this field of clinical medicine should be based solely on a comprehensive The approach to the treatment of newborns with life-threatening body malformations has historically been the subject of numerous ethical dilemmas among the medical professionals and the general public. "The case of baby Doe" is certainly the most notable example in the recent medical history of the previously mentioned ethical dilemmas and was the first to result in an official juridical epilogue in a form of a series of legal provisions regarding the medical treatment of severely damaged newborns and objective assessment of the health of the newborn, consideration of indications for potential treatment or palliative care, and always guided by the best interests of the newborn. Eythanasia in any form is an unnecessary solution, dangerous for society in general and medical practice, and instead of its legalization in neonatology, the development of palliative care, as a humanistic approach in the health care of the most challenging patients, should be emphasised.

Funding: This study was supported by the Ministry of Education, Science and Technological Development of the Republic of Serbia (Grant III41020). Background / Aim The sciatic nerve (SN) is a mixed nerve formed in pelvis by joining of L4 - S3 anterior spinal nerve roots. SN can be under the pressure in different regions throughout its course. However, the most frequent site of impingement is under the piriformis muscle which causes the occurrence of piriformis syndrome. High division of SN has its relevance considering the fact that it leads to the compression of nerve resulting in piriformis syndrome. The aim of this study was to determine the connection between anatomical parameters of pelvis and high division of SN, which is considered to be one of the most common causes of piriformis syndrome in both genders. Methods This study was conducted on 28 formalin fixed cadavers of both genders at the Institute of Anatomy, Faculty of Medicine, University of Belgrade (Belgrade, Serbia) and the Department of Anatomy, School of Medicine, University of St Andrews (St Andrews, United Kingdom). For the measuring of required dimensions, we used a ruler and a caliper. Results A statistically significant difference in the values of bispinal and bituberal lines was observed. A high division of SN was found on 58.33% of the male cadavers and 80% of the female cadavers. A statistically significant difference in the mean value of the bituberal line between the male and female sex was also recognised. Conclusion The connection between the anatomical parameters of the pelvis and the level of division of the SN is confirmed. Although on the basis of the results it could be assumed that people with smaller pelvic dimensions would have greater likelihood of developing a piriformis syndrome, the other factors, such as biomechanics related to a wider 'Q angle' in women that could result in a higher incidence of piriformis syndrome, should also be considered. Publisher PDF

Background/Aim. In-depth knowledge of the vascular net-work of the hand is of great importance in modern medicine. The main vessel of the hand is the superficial palmar arch (SPA). As typically described in anatomical textbooks, it arises as a terminal branch of the ulnar artery, which then anastomoses with the superficial palmar branch of the radial artery. However, the SPA is characterized by remarkable variability, which has been the area of interest of many researchers so far. The aim of this study was to exert a comprehensive examination of the anatomy of the SPA. Methods. The research was conducted at the Institute of Anatomy ?Niko Miljanic? on a total number of 14 cadavers. After careful dissection, variations of the modality of formation of the SPA and its distance of the SPA from Kaplan?s cardinal line were observed on the right hands. Collected data were then analyzed statistically in SPSS 11.0 using the Mann-Whitney U test, with the accepted level of statistical significance of p < 0.05. Results. According to Coleman and Anson?s classification, the higher incidence of the incomplete type (57.14%) of the SPA was observed compared to the complete type (42.86%). In addition to this, a statistically significant difference was discovered in the distance of the SPA from Kaplan?s cardinal line between two groups with complete and incomplete types, respectively. The parameter examined in the group with the complete type took the value of 2.13 ? 0.32 cm, while in the group with the incomplete type measured 3.33 ? 0.87 cm. Conclusion. The present study showed a very important complexity in the domain of anatomy of the SPA with numerous clinical implications. For that reason, a thorough evaluation of the hand circulatory system should be considered while planning surgical procedures in order to avoid operative and postoperative complications.

Aim To compare the prognostic performance of three major risk scoring systems including global registry for acute coronary events (GRACE), thrombolysis in myocardial infarction (TIMI), and prediction of 30-day major adverse cardiovascular events after primary percutaneous coronary intervention (RISK-PCI). Methods This single-center retrospective study involved 200 patients with acute coronary syndrome (ACS) who underwent invasive diagnostic approach, ie, coronary angiography and myocardial revascularization if appropriate, in the period from January 2014 to July 2014. The GRACE, TIMI, and RISK-PCI risk scores were compared for their predictive ability. The primary endpoint was a composite 30-day major adverse cardiovascular event (MACE), which included death, urgent target-vessel revascularization (TVR), stroke, and non-fatal recurrent myocardial infarction (REMI). Results The c-statistics of the tested scores for 30-day MACE or area under the receiver operating characteristic curve (AUC) with confidence intervals (CI) were as follows: RISK-PCI (AUC = 0.94; 95% CI 1.790-4.353), the GRACE score on admission (AUC = 0.73; 95% CI 1.013-1.045), the GRACE score on discharge (AUC = 0.65; 95% CI 0.999-1.033). The RISK-PCI score was the only score that could predict TVR (AUC = 0.91; 95% CI 1.392-2.882). The RISK-PCI scoring system showed an excellent discriminative potential for 30- day death (AUC = 0.96; 95% CI 1.339-3.548) in comparison with the GRACE scores on admission (AUC = 0.88; 95% CI 1.018-1.072) and on discharge (AUC = 0.78; 95% CI 1.000- 1.058). Conclusions In comparison with the GRACE and TIMI scores, RISK-PCI score showed a non-inferior ability to predict 30-day MACE and death in ACS patients. Moreover, RISK-PCI was the only scoring system that could predict recurrent ischemia requiring TVR.

The aim of this study was to assess the role of the Addenbrooke's cognitive examination test (ACE-R) in the evaluation of cognitive status in migraineurs interictally. A total of 44 adolescent patients and 44 healthy controls, matched by age and gender, have undergone ACE-R testing. Migraineurs were additionally questioned about migraine aura features and presence of higher cortical dysfunctions (HCD) during an aura. According to the questionnaire results, patients were subsequently divided into HCD and Non-HCD group. ACE-R scores of migraine patients were significantly lower than in healthy controls (93.68 +/- 3.64 vs 96.91 +/- 2.49; t = 4.852, p lt 0.001). Also, subscores of memory and verbal fluency were significantly higher in the control population. There was no correlation of HCD occurrence with cognitive examination score, although Non-HCD subgroup achieved better score (93.13 +/- 3.91 vs 94.29 +/- 3.30; t = 1.053, p = 0.298). Findings have shown that migraineurs get lower ACE-R test scores, with a tendency to have a poorer outcome in more complex aura. Also, our study has revealed that the ACE-R test is an easily administered test for brief assessment of cognitive status in migraineurs. Future perspectives could be further evaluation of ACE-R test in larger sample size and the impact of migraine with aura on cognitive function in adolescents.

Introduction In schizophrenia patients the lateral ventricle enlargement has mostly been reported in relationship with smaller cortical and/or subcortical brain volumes; and it has been observed that ventricular system growth may be a consequence of the smaller caudate nucleus volume. Bicaudate parameters have been used in the Alzheimer dementia and Huntington's chorea diagnosing in order to evaluate brain changes and the enlargement of the lateral ventricles. Subjects and methods This study has been carried out on 140 patients out of which 70 patients (30 men and 40 women) who met the ICD 10 criteria for schizophrenia and 70 healthy controls (30 men and 40 women) matched on sex and age with the studied group. All of them underwent direct caudatometry and volume computation based on MRI scans. Results Except for the bicorporal line, for all the parameters were obtained the statistically highly significant differences between the examined and control groups. Significant correlation was established for the majority of bicaudate parameters and volumes of the caudate nuclei and lateral ventricles. Discussion Enlargement of the lateral ventricles is one of the most frequent MRI finding in schizophrenia patients. Ventricles are enlarging gradually and frontal horns are more affected than other parts. The increased volumes of the caudate nuclei signalized that ventricular enlargement is not the consequence of the caudate atrophy. Conclusion Bicaudate parameters are reliable parameters for the quick orientation in order to assess the enlarged ventricles in schizophrenia patients.

Studies of psychological condition of patients suffering from nonalcoholic fatty liver disease are rather equivocal about the results: while some claim that NAFLD patients suffer from anxiety and depression more than non-NAFLD controls, others do not withstand those findings. Lower cognitive potentials have also been reported, both in patient related and in animal model-based investigations, and correlated with assessed brain tissue changes. We hypothesized that NAFLD, as a condition, affects the brain tissue and, subsequently, the cognitive state. So we compared findings in 40 NAFLD positive and 36 NAFLD negative patients and correlated their brain tissue volumes with the results of Montreal Cognitive Assessment (MoCA) test. Binomial logistic regression verified the influence of NAFLD state leading to lower cognitive potentials: odds ratio 0.096; 95% confidence interval (CI) 0.032–0.289; p<0.001. Patients with NAFLD had a greater risk to suffer from the cognitive impairment and depression: RR = 3.9; 95% CI 1.815–8.381; p=0.0005 and RR = 1.65; 95% CI 1.16–2.36; p=0.006. NAFLD significantly influenced the cognitive deficit and tissue volume reduction and patients suffering from NAFLD had about four times higher risk of having a cognitive impairment.

objective. To assess the early electrocardiogram (ECG) changes induced by physical training in preadolescent professional football players. design and methods. Ninety-four highly trained male football players (mean age — 12,85 ± 0,84 years) competing in the Serbian Football League (at least 7 training hours/week) and 47 age-matched healthy male controls were enrolled in the study. They were screened by ECG and echocardiography at a tertiary referral cardiocentre. The control group had sedentary life style (less than 2 training hours/week). Characteristic ECG intervals and ECG voltage were compared and reference range was given for preadolescent footballers. results. Highly significant differences between preadolescent athletes and sedentary controls were registered in all ECG parameters: P wave voltage (p 0,05). QTc interval duration in athletes was not very strongly, but indeed positively correlated with left atrium dilatation, left ventricular (LV) end-systolic and end-diastolic dimensions, LV myocardial index (LVMI), LVM/body surface area (BSA) 1,5 and LVM/h 2,7 indices. There was no correlation between QTc interval duration and LVM as well as LV wall thickness. conclusions.

The anterolateral ligament, a structure that has been known for 130 years, has again attracted the attention both of orthopaedic doctors and anatomists. Since its initial description until now, this structure has had different names. Whether labelled as the mid-third lateral capsular ligament, the anterior oblique band of the fibular collateral ligament or the anterolateral ligament of the knee, this structure has been responsible for the so-called Segond avulsion fractures. The aim of this study was to determine the precise position and layer of the lateral knee compartment within which the anterolateral ligament is located, as well as its type. In this study, the anatomical dissection of the lateral segment of 14 cadaveric knees (six male, eight female; seven right, seven left; average age of subjects: 78 years) was performed. The dissection was carried out in keeping with Seebacher, layer by layer. The anterolateral ligament was identified in seven out of 14 cadaveric knee joints (50 %). The length of the ligament was 41 ± 3 mm, while the width was 4 ± 1 mm and the thickness 1 mm (in the middle section). In 14 % of the cases, the anterior oblique band was identified as a part of the FCL. In all of the knee joints, a part of the fibres of the ITT with the same insertions and direction as the ALL was found, located, however, at a much more superficial level than the ALL. Analysis of the current scientific literature related to the anterolateral ligament and layer-by-layer dissection of the lateral region of 14 cadaveric knees has led to the conclusion that the anterolateral ligament is a thickening of the knee joint capsule located in the third layer of the lateral region of the knee (according to Seebacher) which is not always clearly morphologically differentiated from the remainder of the joint capsule. The anterolateral ligament is unequivocally a part of the joint capsule, which is why any damage to it should be treated in the same way as any other damage to the joint capsule.

Patient: Male, 58 Final Diagnosis: Hydronephrosis Symptoms: Blunt abdominal pain • constipation • constipation Medication: — Clinical Procedure: Extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy Specialty: Gastroenterology and Hepatology Objective: Rare co-existance of disease or pathology Background: Carbohydrate tumor-associated antigen (CA 19-9) has been shown to be upregulated in other malignant tumors including gastric, ovarian, hepatocellular, and colorectal carcinoma as well as benign diseases of the biliary track such as pancreatitis, cholangitis, and choledocholithiasis. According to the available literature, in several cases of benign hydronephrosis and in a few cases of benign renal diseases, elevated CA 19-9 has been noted. Case Report: A 58-year-old Caucasian male patient was admitted in our clinic with complaints about blunt abdominal pain in the past two-month period localized in the right lumbar region and irradiating into the right inguinal area, constipation, abdominal bloating, and intermittent hematuria. The concentration of serum CA 19-9 was 3500 U/mL. Urine cytology provided no signs of abnormality. Intravenous urography visualized right-sided pyelon and ureter duplex with the defect in contrast shade of the pyelon, caused by a stag horn calculus. Contrast added computerized axial tomography of the abdomen and pelvis visualized the pyelon casted concretion spreading throughout the right pyelon, with ureterohydronephrosis with the distal block for passage of the contrast to the distal part of the ureter. Conclusions: There is no doubt that CA 19-9 level is occasionally elevated in patients with obstructive urolithiasis as it was in our case. In the routine medical praxis, urolithiasis should not be neglected in the differential diagnosis of elevated concentrations of CA 19-9 marker.

The aim of this study was to assess the early electrocardiogram (ECG) changes induced by physical training in preadolescent elite footballers. This study included 94 preadolescent highly trained male footballers (FG) competing in Serbian Football League (minimum of 7 training hours/week) and 47 age-matched healthy male controls (less than 2 training hours/week) (CG). They were screened by ECG and echocardiography at a tertiary referral cardio center. Sokolow–Lyon index was used as a voltage electrocardiographic criterion for left ventricular hypertrophy diagnosis. Characteristic ECG intervals and voltage were compared and reference range was given for preadolescent footballers. Highly significant differences between FG and CG were registered in all ECG parameters: P-wave voltage (p p p 1–2 + R V5–6 (p p p p p p p > 0.05). During 6-year follow-up period, there was no adverse cardiac event in these footballers. None of them expressed pathological ECG changes. Benign ECG changes are presented in the early stage of athlete’s heart remodeling, but they are not related to pathological ECG changes and they should be regarded as ECG pattern of LV remodeling.

Maternal deprivation (MD) causes perinatal stress, with subsequent behavioral changes which resemble the symptoms of schizophrenia. The NADPH oxidase is one of the major generators of reactive oxygen species, known to play a role in stress response in different tissues. The aim of this study was to elucidate the long-term effects of MD on the expression of NADPH oxidase subunits (gp91phox,p22phox,p67phox,p47phox, andp40phox). Activities of cytochrome C oxidase and respiratory chain Complex I, as well as the oxidative stress parameters using appropriate spectrophotometric techniques were analyzed. Nine-day-old Wistar rats were exposed to a 24 h maternal deprivation and sacrificed at young adult age. The structures affected by perinatal stress, cortex, hippocampus, thalamus, and caudate nuclei were investigated. The most prominent findings were increased expressions ofgp91phoxin the cortex and hippocampus, increased expression ofp22phoxandp40phox, and decreased expression ofgp91phox,p22phox, andp47phoxin the caudate nuclei. Complex I activity was increased in all structures except cortex. Content of reduced glutathione was decreased in all sections while region-specific changes of other oxidative stress parameters were found. Our results indicate the presence of long-term redox alterations in MD rats.

Morphometric parameters of the lateral ventricle choroid plexus epithelial cells (average area, perimeter, bounding rectangle area, average nuclear area, nuclear perimeter, nuclear circularity and average nucleocytoplasmic ratio) were studied in postnatal and juvenile (10th, 16th and 38th postnatal days) 15 male and 15 female rats. The results were statistically analyzed by factorial ANOVA. Morfometrijski parametri (prosečna površina, obim, površina najmanjeg opisanog četvorougla, prosečna površina nukleusa, obim nukleusa, zaokrugljenost nukleusa i prosečni nukleocitoplazmatski odnos) epitelnih ćelija Plexus choroideus- a lateralnih komora ispitani su na 15 mužjaka i 15 ženki pacova u neonatalnom i juvenilnom periodu (10., 16. i 38. postnatalni dan). Rezultati su statistički analizirani faktorskom ANOVA. Srednje vrednosti površine epitelnih ćelija, površina najmanjeg opisanog četvorougla i obim bili su signifi kantno veći kod pacova starih 16 dana, nego kod onih starih 10 i 38 dana. Nasuprot tome, nukleocitoplazmatski odnos je bio niži kod pacova starih 16 dana, nego kod onih starih 10 i 38 dana. Prosečna površina i obim nukleusa pokazali su slične trendove, dok je zaokrugljenost nukleusa porasla od 10. do 38. dana. Signifi - kantne polne razlike su postojale u vrednostima površine epitelnih ćelija, površina najmanjeg opisanog četvorougla i obima, koje su bile više u mužjaka nego u ženki, kako u grupi staroj 16, tako i u grupi staroj 38 dana. Nukleocitoplazmatski odnos bio je veći u mužjaka nego u ženki starih 10 dana, ali niži u mužjaka starih 16 i 38 dana. U celini, veličina epitelnih ćelija horioidnog spleta porasla je 16. i potom se smanjila 38.. dana, kad je još uvek bila veća nego 10. dana. Veličina nukleusa posle porasta u 16. danu, takođe se smanjila u 38. danu, ali do vrednosti koje su manje nego 10. dana. Opšte smanjenje nukleocitoplazmatskоg odnosa koje je pratilo ove promene indirektno ukazuje na opadanje funkcija. U izučavanom periodu, epitelne ćelije horioidnog spleta mužjaka pacova bile su veće, ali su njihovi funkcionalni parametri postali manji nego u ženki, što bi ukazivalo na polne razlike u dinamici rasta horioidnog spleta pacova.

Aim: To further examine the neurobiological mechanisms and their outcomes responsible for the PTSD sequelae induced by laboratory animal model and to explore the effects of chronic psychosocial paradigm. We tested the hypothesis that our animal model of PTSD would display abnormalities in glucocorticoid levels that are manifest in people with PTSD and that psychosocially stressed rats exhibit a significantly greater suppression of corticosterone levels than control rats following the administration of dexamethasone.Methods: Animals were divided into two groups. The experimental group was scheduled to exposure to two types of stressors: double exposure to acute immobilization stress, and combined predator-threat stress and daily social stress. There was also administration of dexamethasone in combination with stress exposure.Results: There was a statistical difference between masses of thymus in the stress group and stress group with dexamethasone appliance (p=0.024). We found statistical significance between baseline cortisol and stress induced levels of cortisol and between stress induced group and return to baseline group.Conclusion: Significant changes in HPA activity, reductions in basal glucocorticoid levels and enhanced dexamethasone induced inhibition of glucocorticoid levels have been manifested. All of this is manifested in PTSD patients also as many other stress induces changes.

Background/Aim. The anterior cruciate ligament (ACL) is the most frequently injured ligament of the knee, representing 50% of all knee injuries. The aim of this study was to determine the differences in the morphometry of knee injury patients with an intact and a ruptured anterior cruciate ligament. Methods. The study included 33 matched pairs of patients divided into two groups: the study group with the diagnosis of anterior cruciate ligament rupture, and the control group with the diagnosis of patellofemoral pain but no anterior cruciate ligament lesion. The patients were matched on the basis of 4 attributes: age, sex, type of lesion (whether it was profession- related), and whether the lesion was left- or right-sided. Measurements were carried out using magnetic resonance imaging (MRI). Results. The anterior and posterior edges of the anterior cruciate ligament in the control group were highly significantly smaller (p < 0.01; in both cases). The control group showed a statistically significantly larger width of the anterior cruciate ligament (p < 0.05). A significant correlation between the width of the anterior cruciate ligament and the width (p < 0.01) and height (p < 0.05) of the intercondylar notch was found to exist in the control group, but not in the study group (p > 0.05). The patients in the control group showed a shorter but wider anterior cruciate ligament in comparison to their matched pairs. The control group of patients was also characterized by the correlation between the width of the intercondylar notch and the width of the anterior cruciate ligament, which was not the case in the study group. Conclusions. According to the results of our study we can say that a narrow intercondylar notch contains a proportionally thin anterior cruciate ligament, but we cannot say that this factor necessarily leads to rupture of the anterior cruciate ligament.

Introduction: The interthalamic adhaesion (IA), gray matter connecting both thalami is absent in about a quarter of human brains. Controversies are present about the nature and functional significance of the human IA. Methods: In six adult human brains we investigated the expression of different neuropeptides (somatosatin- SOM, neuropeptide Y-NPY, ghrelin, neurotensin-NT, ACTH, substance P-SP and L-enkephalin-L-Enk) in neurons and/or neuropil of the IA, using immunohistochemistry (streptavidin-biotin technique). Results: In neurons, as well as in fibers, we found immunoreactivity for ghrelin, SOM, L-Enk and NT. However, reactivity for NPY, SP and ACTH was present only in fibers within the IA. Fusiform neurons were immunoreactive for SOM, Ghrelin, L-Enk, and NT, neurons with oval perikaryon for SOM, and L- Enk, triangular neurons showed immunoreactivity for NT (mainly) and multipolar neurons for NT and L-Enk. Conclusion: These findings can contribute to the understanding of the function of IA, and to resolving the question whether it is a vestigial structure. Even if it was vestigial structure, the presence or absence of the IA could be a marker for other, more fundamental genetic/functional differences between human brains with and without the IA. Our results clearly indicate a distinct neuronal organization in the human IA which could have functional significance, and do not support its vestigial nature. Key words: interthalamic adhesion, human brain, neuropeptides, neurons, immunolocalization, somatostatin, ACTH, ghrelin, substance P, neurotensin, neuropeptide Y, L- enkephalin

Background/Aim. The tibial slope is one of the most frequently cited anatomical causes of anterior cruciate ligament trauma. The aim of this study was to determine the possibility of direct measuring of the tibial slope of the knee without prior soft tissue dissection in cadavers. Methods. Measurement was performed on the two groups of samples: osteological and cadaveric. The osteological group consisted of 102 matured tibiae and measurement was performed: indirectly by sagittal photographing of the tibia, and directly by a set of parallel bars. The cadaveric group consisted of 50 cadaveric knees and measurement was performed directly by a set of parallel bars. The difference and correlation between indirect and the direct measurements were observed, which included also measuring of the difference and correlation of the tibial slope on the medial and lateral condyles. Results. A statistically significant difference between the direct and indirect method of measuring (p < 0.01) of 1? was found for the tibial slope on the medial condyle, which is of no practical importance. Direct measurement of the osteological and cadaveric groups of samples did not show a statistically significant difference regarding the values of the tibial slope on the lateral condyle (p > 0.05). However, the slope on the medial condyle, as well as indirect measurement showed a statistically significant difference (p < 0.01). Conclusion. By the use of a set of parallel bars it is possible to measure the tibial slope directly without removal of the soft tissue. The results of indirect, photographic measurement did not statistically differ from the results of direct measurement of the tibial slope.

Introduction: Polymicrogyria, the appearance of irregular small and over numbered gyri on the surface of the brain, has been reported as the most frequent finding, when exists, on the temporal lobe. Case Presentation: A patient, male, age of 35, came to the regular head and brain MRI scan due to psychiatric and hormonal treatment within transsexualism. There were no data of epilepsy in a patient’s history. MRI scans were acquired with a 1.5 T Siemens Magnetom system with a standard head coil. Three-dimensional 3D RAGE, contiguous 1.0 mm slice, and 1 acquisition sequence underwent final 3D rendering and subsequent volumetry. On the definitive 3D image, we have revealed an unusual gyrisation on the left temporal lobe which had a picture of partial polymicrogyria. Conclusion: This is a unique finding, to our knowledge, of the unilateral temporal polymicrogyria in a person with transsexualism. Although polymicrogyria is mostly related to epileptifom attacks, its impact on the transsexualism appearance is opened to be examined.

Background Psychosocial stressors either acute or more sustained frequently precede the onset and exacerbation of the symptoms of the functional dyspepsia (FD). Depressive mood and quality of life have been already reported for interference in functional dyspepsia suffering patients. Methods The examination were performed on 60 FD patients (30 females and 30 males), aged 20–79 years, 60 peptic ulcer subjects and 60 healthy volunteers in which we have investigate levels of anxiety and depression, personality traits and quality of life. Result According to the Hamilton Depression and Anxiety Rating Scales, the population with FD had the average score which classified them into the group of patients with the moderate depression (20.57 ± 4.45). Personality traits estimation based on data obtained by the Eysenck personality questionnaire revealed higher neuroticism scores in the group with functional dyspepsia. Both parameters, level of the neuroticism and anxiety level, expressed highly significant level of mutual concordance. Patients with functional dyspepsia reported a greater adverse impact of symptoms of emotional distress and food and drink problems. Conclusion Results are indicating that the depression and anxiety level is the highest in patients with functional dyspepsia and that anxiety level corroborates with the neuroticism level from the Eysenck scale. Psychological disturbances are influencing the quality of life mostly in patients with dyspepsia in the form of emotional distress and the problem with the food and beverage intake.

Background/Aim. Posterior tibial slope is one of the most citated factors wich cause rupture of the anterior cruciate ligament (ACL). The aim of this study was to determine the association of a greather posterior tibial slope on the lateral condyle, that is a lesser posterior tibial slope on the medial condyle, with ACL rupture. Methods. The patients were divided into two groups. The study group included the patients with chronic instability of the knee besause of a previous rupture of ACL. The control group included the patients with knee lesion, but without ACL rupture. Posterior tibial slope measuring was performed by sagittal MR slices supported by lateral radiograph of the knee. We measured posterior tibial slope on lateral and medial condyles of the tibia. Using these values we calculated an average posterior tibial slope as well as the difference between slopes on lateral and medial condyles. Results. Patients with ACL rupture have highly statistically significantly greather posterior tibial slope (p < 0.01) on lateral tibial condyle (7.1? : 4.5?) as well as statistically significantly lesser posterior tibial slope (p < 0.05) on medial tibial condyle (5.0? : 6.6?) than patients with intact ACL. Conclusion. Great posterior tibial slope on lateral tibial condyle associated with the small posterior tibial slope on the medial tibial condyle, that is a positive differentce between lateral and medial tibial condyles are factors wich may cause ACL rupture.

Background To investigate differences in laboratory markers, nutritional status parameters and eating patterns among newly diagnosed patients with functional dyspepsia. Method The investigation was performed on 180 newly diagnosed patients with functional dyspepsia, aged 20–79, which were referred to the gastroenterology unit of the Clinical and Hospital Center “Bezanijska Kosa” from April to October 2009. Rome II criteria were used for further classification. Results ANOVA Bonferroni post hoc correction outlined that concentrations of serum magnesium and calcium were significantly lower in subjects with ulcer-like dyspepsia, while vitamin B12, glucose and immunoglobulin G level was significantly higher in group with dismotility-like dyspepsia. Statistical analysis revealed that the numbers of meal taken per day were significantly different. There was a statistical trend to skipping meals and to eat fast in patients with ulcer-like and dismotility-like functional dyspepsia when compared with non-specific dyspeptic subjects. Conclusion Patients with ulcer-like functional dyspepsia suffered from epigastric pain and burning and from heartburn, while persons with dismotility-like dyspepsia were complaining about postprandial fullness, bloating and early satiety. They skipped meals more frequently and avoided intake of certain supplies which, together with eating habits, provoked or emphasized the annoying symptoms.

The study was conducted on 50 cadavers (32 male and 18 female, aged 15-53 years; mean 34; SD 11) with intact anterior cruciate ligament (ACL), without diagnosed gonarthrosis of the knee joint. The following anatomical parameters of the ACL were measured: the length of anteromedial and posterolateral bundle, the mean length and the width of the ligament, the length and width of tibial insertion, the length and width of femoral insertion. The intercondylar width was measured at the level of popliteal groove. The width of male intercondylar notch (22 mm) was statistically significantly greater (P < 0.05) than the width of female intercondylar notch (18 mm). The width of the male ACL (12 mm) was significantly greater (P < 0.05) than the width of the female ACL (10 mm). The length of the male ACL femoral insertion (14 mm) was statistically significantly greater (P < 0.05) than in the female ACL femoral insertion (12 mm). Accordingly, with greater width of intercondylar notch, men have wider ACL than women. ACL width is in positive correlation with the male intercondylar notch width but it is not in correlation with the female intercondylar notch width. The width of male intercondylar notch correlates with the length and width of ACL femoral insertion. Taking into account the length and width of femoral insertion in examined cadaver knees, double bundle reconstruction would theoretically be possible in 76% of cases.

INTRODUCTION: Frequency of anterior cruciate ligament rupture depends of anatomical parameters of distal femur and intercondylar notch. PURPOSE: Purpose of this work is identification relation between femur length and morphometrical parameters intecondylar notch, measuring in two levels. METHOD: A hundred femur's (medley population of 48 right and 52 left femurs), from osteological collection Department of Anatomy 'dr. Niko Miljanic' in Belgrade measured. Measurement was in two levels. Epicondilar width, width of medial and lateral condyls and intercondylar width, had been measured in level of popliteal sulcus and on the widest place, after that notch width index had been determinated. RESULTS: Absolute values of morphometrical parameters distal femur's are in positive relation with her length (p 0.05). CONCLUSION: Femur's length increasing also produces increasing of absolute anatomical parameters of distal femur which can produce rupture of anterior cruciate ligament, while relative dimensions do not show femur's length increasing.

Introduction. Aqueductus mesencephali is the biggest part of the ventricular system and that is why it is the most common place of intraventricular obstruction of cerebrospinal fluid. This study was done in order to study topographic characteristics of aqueduct more thoroughly. Materials and methods. Transversal sections of mesencephalon were made in three levels. The first section was made caudally immediately from the posterior commissure. The second section was made in the middle part of the superior colliculi, and the third section was made in the rostral parts of the caudal sections of the superior colliculi. Distances of the aqueduct from structures of mesencephalon, obtained on the second section, are: 1. The distance of the aqueduct from the superior colliculi - 6.96 mm; 2. The distance of the aqueduct from the red nucleus - 6.02 mm; 3. The distance of the aqueduct from the substantia nigra - 12.29 mm; 4. The distance of the aqueduct from the interpeduncular fossa - 10.22 mm. Conclusion. Knowledge of the anatomy of the aqueductus mesencephali is very important because of interpretation of patogenesis of hidrocefalus as well as of other syndromes that occure in some pathological processes in the system of ventricles.

Myocardial bridges (MBs) are structures consisting of heart muscle fibers running above the subepicardially positioned coronary arteries. In the light of previous studies, MBs are most often associated with the ramus interventricularis anterior (RIA) which put this vessel into the focus of our research. The purpose of the present study was to determine the frequency of occurrence and quantitative analysis of myocardial bridges over the RIA and its lateral branches. The studied material consisted of 55 Cercopithecus aethiops hearts, of both sexes, preserved in formaldehyde solution. Standard anatomical methods were used in the analysis, with the help of a stereomicroscope. The presence of MBs over the RIA was confirmed in a total of 70.9% samples, with no statistically significant differences related to the gender. In 2 hearts (3.6%) multiple bridges were revealed. The length of the bridges varies in the range of 0.5 mm - 31.6 mm, the distance from the origin of RIA varies between 0.5 mm - 25 mm which makes the proximal third of the anterior (paraconal) interventricular groove most frequently tunneled. The lateral branches of RIA were overbridged in 5.4%, with a single muscular band. The lenght of MBs varied from 6.2 mm - 12.5 mm, and they were localized over the first lateral branch in all cases. Fenomen miokardnog premošćavanja subepikardnih koronarnih krvnih sudova je proučavan na 55 srca malog zelenog majmuna (Cercopithecus aethiops sabeus). Koristeći standardne metode disekcije, identifikovali smo prisustvo miokardnih mostova (MM) na prednjoj međukomornoj arteriji (RIA) na 39 od 55 srca (70.9%), od kojih su 25 (71.4%) bila srca ženki, a 14 (70%) srca mužjaka, što nije pretstavljalo statistički značajnu razliku vezanu za pol (p>0.05). U najvećem broju slučajeva, 96.4% zabeležili smo jedan MM nad RIA, a samo na 2 srca (3.6%) RIA je bila premošćena sa dva MM. Ukupan broj MM u našoj seriji je 41, a njihova najčešća lokalizacija je proksimalna trećina krvnog suda. Dužina MM je varirala između 0.5 mm i 31.6 mm, a češće smo nalazili kraće strukture (do 15 mm). Udaljenost MM od mesta nastanka RIA je varirala od 0.6 mm do 25 mm. MM nad (levim) bočnim granama RIA (r. laterales) smo uočili na 3 od 55 srca (5.4%), i to na 2 srca ženki (5.7%) i na 1 srcu mužjaka (5%), što nije predstavljalo statistički značajnu razliku u odnosu na pol (p>0.05). Dužina MM je varirala od 6.2 mm do 12.5 mm. U svim slučajevim smo našli po jedan MM nad prvom bočnom granom RIA.

The non-human primate model has already been applied in studies about alcoholism in the last decade, demonstrating a high confidence level of similarities between humans and non-human monkeys. Authors indented to establish the definitive model for addiction by investigating the insular blood supply in Cercopithecus Aethiops. In 23 out of 24 Latex injected adult brains, the insula received blood supplied by the M2 segment of the middle cerebral artery (MCA). The cortex was supplied by two separate trunks, while perforating branches originating directly from MCA, individually, or together with lateral striate (lenticulostriate) arteries. Their average caliber was about 120 µm, and the number of its branches ranged from 2 to 9. No left - right asymmetries have been recorded. Similarities with the human vascular pattern have been studied. .

The investigation was carried out on 55 monkey (Cercopithecus aethiops) hearts by stereomicroscopic dissection and measurements. Latex injected specimens and corrosion cast showed that, like in humans, the RCA orifice was usually situated in the middle part of the right aortic sinus, slightly above the free edge of the valve leaflet (82.3%). The long RCA type was the most frequent finding (70.9%), as in humans. Among them, in 7.2% RCA extends its route via the coronary groove, and terminats as the posterior left ventricular branch. In 23.6% RCA terminated as posterior right ventricular branch (short type), and occasionally, in 5.5% RCA terminated as right marginal branch (extremely short type). The first branch of RCA very often was the conal artery (74.5%), what is similar to humans. The blood supply to the sinuatrial node more frequently (85.5%) was by a branch of RCA. Similar to the former, AV node artery most frequently arose from RCA (69.2%). The numbers of descending (rami marginales) RCA branches varied between 1-6, and their origin and distribution resembles the corresponding ones in humans. No statistically significant sexual differences in length and distribution pattern were present. This study shows that the anatomy of RCA or its branching patterns in monkey hearts are very similar to the humans.

Cerebral (sylvian) aqueduct is a narrow channel in the mesencephalon. It lies between the tectum and the tegmentum of the mesencephalon and is surrounded by the periaqueductal gray matter. The aim of this study was to determine the shape of the . aqueduct of sylvius and the structure of its walls in a series of transverse histological sections. Serial transverse sections of the mesencephalon were examined in twenty adult brains of both sexes. Six sections were stained by the hematoxyiin-eosin method. The rostral part of the the aqueduct has a triangular shape with dorsal concavity caused by retrocommissural fossae. In the middle, its shape is oval to irregular, the rostral part has a T shape due to isthmic recess on the floor. Walls of the aqueduct are coated with a layer of prismatic cells. Determination of the morphological and histological features of the mesencephalic aqueduct is important for differentiation between physiological and pathological processes in this region.

This study reminds clinicians that syphilis presents in many guises. Wars, migration and sexual promiscuity prepare the ground for its return as an important cause of neurological and psychiatric syndromes. Our patient's diagnosis was not suspected at earlier admission. Stage III spirochaetosis was improved by high dose penicillin.

Anatomy of the central nervous system (CNS) is far beyond the classical approach to anatomy investigations. Studies of the CNS are, nowadays, comprising various fields of medicine, starting from clinical investigations, up to the animal models, so they are useful in studies of different neuropsychiatric diseases and disorders, such as schizophrenia, posttraumatic stress syndrome, and Alzheimer's disease. Serious investigations in the field of the CNS are inseparable from the technological advances in the research, but also in diagnostics. This is the reason why we have gathered, at a glance, the papers that have very little in common. But the file rouge is the anatomy of the CNS and its changes illustrated in this unity in differences. Our initial aim was to illustrate the importance of the knowledge of CNS anatomy, for either the investigators in this field or the clinicians, devoted to solving the problem of serious neuropsychiatric diseases.

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Cavum Septi pellucid (CSP), a cavity between the laminae of the septum pellucidum, for a longer period has been reported as an anomaly of the brain midline, associated with neuropsychiatric diseases, mostly schizophrenia, but also posttraumatic stress disorder, De la Tourette disease, and persons who survived a repeated a serious head trauma, boxers on the first place. Our investigation has been performed on 479 unfixed frozen brains, of the autopsied individuals of both genders, and MRI scans of 250 examinees, out of which 110 had neuropsychiatric illness. In our sample, the prevalence of CSP was 22.96% among the autopsied individuals and 9.2% in examinees who underwent MRI scan. The cause of the death among schizophrenia suffering persons was suicide (18 out of 25 patients). Obviously, CSP is more frequently associated with neuropsychiatric diseases, but a dilemma still exists, did we make a bias in brain suitability for the examination or we did the same mistake in observing clinical cases. A large CSP, though, is an almost certain sign for an underlying neuropsychiatric impairment, especially schizophrenia. The CSP among alcoholics and persons with the priory sustained head blows is probably of the same cause and represents an aftermath of the diffuse axonal injuries, i.e. brain trauma.

Numerous clinical studies have demonstrated an association between early stressful life events and adult life psychiatric disorders including schizophrenia. In rodents, early life exposure to stressors such as maternal deprivation (MD) produces numerous hormonal, neurochemical, and behavioral changes and is accepted as one of the animal models of schizophrenia. The stress induces acetylcholine (Ach) release in the forebrain and the alterations in cholinergic neurotransmitter system are reported in schizophrenia. The aim of this study was to examine long-term effects of maternal separation on acetylcholinesterase (AChE) activity in different brain structures and the density of cholinergic fibers in hippocampus and retrosplenial (RS) cortex. Wistar rats were separated from their mothers on the postnatal day (P) 9 for 24 h and sacrificed on P60. Control group of rats was bred under the same conditions, but without MD. Brain regions were collected for AChE activity measurements and morphometric analysis. Obtained results showed significant decrease of the AChE activity in cortex and increase in the hippocampus of MD rats. Density of cholinergic fibers was significantly increased in CA1 region of hippocampus and decreased in RS cortex. Our results indicate that MD causes long-term structure specific changes in the cholinergic system.

Early separation of rat pups from their mothers (separatio a matrem) is considered and accepted as an animal model of perinatal stress. Adult rats, separated early postnatally from their mothers, are developing long-lasting changes in the brain and neuroendocrine system, corresponding to the findings observed in schizophrenia and affective disorders. With the aim to investigate the morphological changes in this animal model we exposed 9-day-old (P9) Wistar rats to a 24 h maternal deprivation (MD). At young adult age rats were sacrificed for morphometric analysis and their brains were compared with the control group bred under the same conditions, but without MD. Rats exposed to MD had a 28% smaller cell soma area in the prefrontal cortex (PFCX), 30% in retrosplenial cortex (RSCX), and 15% in motor cortex (MCX) compared to the controls. No difference was observed in the expression of glial fibrillary acidic protein in the neocortex of MD rats compared to the control group. The results of this study demonstrate that stress in early life has a long-term effect on neuronal soma size in cingulate and retrosplenial cortex and is potentially interesting as these structures play an important role in cognition.

Maternal deprivation (MD) leads to a variety of behavioral changes in rats which closely resemble the symptoms of schizophrenia in humans. With the aim to investigate the morphological changes which underlie the behavioral insults in this experimental paradigm we exposed 9-day-old Wistar rats to a 24 h MD. At the period of young adulthood rats were sacrificed for morphometric analysis and their brains were compared to the control group. Rats exposed to MD had a decrease in hippocampal volume (71 percent of the control value) as well as a decrease in the size of pyramidal (62 percent of the control) and granular (60 percent of the control) cell layers. Also, there was a decrease in the thickness of the prefrontal, retrosplenial and motor cortex compared to the control group. Analysis of the density of NeuN-immunolabeled neurons revealed a reduction in retrosplenial and prefrontal cortex (70 percent and 81 percent of the control, respectively), while there was no difference in the motor cortex. Western blot analysis confirmed a decrease in NeuN expression in the MD group compared to the control rat brain homogenates. The results of this study show that early stress in life has a long-term effect on the morphology of cognitive brain regions, most probably due to the loss of neurons during postnatal development and further contributes to our understanding of the effects of maternal separation on brain development.

The purpose of this study is to determine the difference in the concentrations of testosterone, 17-β estradiol and progesterone between male patients with and without ACL rupture, as well as the possible effect of these hormones on generalized joint laxity. Male subjects with non-contact knee joint injury were included in this study. Two groups were formed: the examined group, consisting of subjects with ACL rupture and the control group consisting of patients without ACL rupture. After this, the patients from these two groups were paired off on the basis of three factors, level of professional involvement in sports (including the type of sports activity), left or right side of the body and the age of the subjects. In the end, there were 29 pairs (58 subjects). The concentration of sex hormones was determined from saliva specimens with the aid of the Salimetrics enzyme immunoassay. The testing of generalized joint laxity was performed with the aid of the “laxity score” according to Beighton et al. Subjects with ACL rupture have highly statistically significantly greater concentrations of testosterone (p

The purpose of this study was to determine the difference in the concentrations of testosterone, 17-β estradiol and progesterone between female patients with and without ACL rupture and the possible effect of these hormones on generalised joint laxity. Female subjects with non-contact knee joint injury were included in this study. They were divided into two groups: the examined group, consisting of female subjects with ACL rupture, and the control group, consisting of female patients without ACL rupture. In the next step, the patients from these two groups were paired off on the basis of three factors: the level of professional sports involvement (including the type of sports activity), the side of the body where the injury had occurred (left or right) and the age of the subjects. In the end, there were 12 pairs (24 subjects). The concentrations of sex hormones were established from saliva specimens with the aid of the Salimetrics enzyme immunoassay. Generalised joint laxity was tested with the aid of the “laxity score” according to Beighton, Solomon and Soskolne. Female subjects with ACL rupture had significantly lower concentrations of testosterone (p

Cavum septi pellucidi (CSP), especially when longer than 6 mm, has been recognized as a neurodevelopmental anomaly associated with schizophrenia. The present post-mortem study was designed to determine the importance of linear parameters of CSP and to evaluate the possible differences of CSP in schizophrenic patients (n=25 out of 110 CSP+ brains) and normal persons (n=40 out of 110 CSP+ brains). According to our results, schizophrenia patients had significantly longer and wider CSP than normal individuals. Also, statistical analysis revealed a higher suicide rate in CSP-positive patients with schizophrenia.

The forearm radial flap is currently and widely used free flap, based on the branches of the radial artery, and which, additionally, could contain bone, tendons, or cutaneous nerves. Variations of the radial artery were recently encountered and presented during the elevation of such a flap in 32-year-old male, who sustained war gunshot injury of the left hand. This is the first reported case of a double radial artery in a radial forearm flap in our country, which successfully survived on the recipient hand, although its surface was at the lower threshold for the application of a vascular graft. In rising of the radial forearm flap, pre- and postoperative evaluation of arteries is advisable. Clin. Anat. 18:305–307, 2005. © 2005 Wiley-Liss, Inc.

Ulcerative colitis and Crohn's disease, commonly known as inflammatory bowel disease (IBD), draw attention from specialists of various disorders, including gastroenterology, psychiatry, and radiology. The involvement of a cortical influence in the brain-gut axis as well as the interaction of the hypothalamic-pituitary-adrenal axis and the peripheral nervous system provide an initial explanation of the psychological symptoms associated with IBD. The involvement of structures the limbic system, such as the anterior cingulate cortex, the prefrontal cortex, and the amygdala, paves the way for the discovery of the mechanisms underlying depression depression, anxiety, alexithymia, personality traits, and other psychological impairments following the onset of IBD. Psychiatric therapy in IBD patients is almost as important as the gastroenterological approach and consists of pharmacological treatment and psychotherapy. Neither of the available psychiatric treatment methods is considered the golden standard because both methods have side effects, and psychotropic medication can provoke the worsening of IBD symptoms. Thus, both approaches must be applied with awareness of the possibility of side effects. We suggest that psychiatrists and gastroenterologists work together to reach a consensus on IBD therapy to ensure success and to reduce side effects and relapse to the lowest possible rates.

Raman spectroscopy enables non-invasive investigation of chemical composition of biological tissues. Due to similar chemical composition, the analysis of Raman spectra of brain structures and assignment of their spectral features to chemical constituents presents a particular challenge. In this study we demonstrate that standard and independent component analysis of Raman spectra is capable of assessment of differences in chemical composition between functionally related gray and white matter structures. Our results show the ability of Raman spectroscopy to successfully depict variation in chemical composition between structurally similar and/or functionally connected brain structures. The observed differences were attributed to variations in content of proteins and lipids in these structures. Independent component analysis enabled separation of contributions of major constituents in spectra and revealed spectral signatures of low-concentration metabolites. This provided finding of discrepancies between structures of striatum as well as between white matter structures. Raman spectroscopy can provide information about variations in contents of major chemical constituents in brain structures, while the application of independent component analysis performed on obtained spectra can help in revealing minute differences between closely related brain structures.

article i nfo Background: Gallbladder motility has been studied in patients with functional gastrointestinal disorders, such as functional dyspepsia, irritable bowel syndrome and biliary disorders without gallstones and results of these observations are often inconclusive and conflicting. Methods: The investigation was performed on 180 therapy-naive newly diagnosed patients with functional dyspepsia (97 females and 83 males), aged20-79 inwhich we have investigate ultrasonographicallyparameters of gallbladder motility. Results: Bonferroni post hoc correction stressed that fasting gallbladder volume and ejection fraction were signif- icantly distorted in individuals with postprandial distress syndrome, although, the residual gallbladder volume was significantly lower in patients with epigastric pain syndrome comparing with other examinees. Ejection fraction of the gallbladder negatively correlated with body mass index. Conclusion: The impaired contractibility of the gall bladder in patients with functional dyspepsia, based on the results of this study,isillustratedby thechanges intheejection fraction, which was morepronounced inpatients with the postprandial distress syndrome.

The increased presence of cavum septi pellucidi (CSP) was reported among people suffering from schizophrenia, alcoholism or it could be a remnant of an old head trauma. We have tried to compare not only prevalences, but also lengths, widths and depths of the obtained cava in an effort to emphasize the importance of linear parameters in routine diagnostics. On 479 cadavers, 310 male and 169 female, aged 22 to 89; 110 brains had a CSP: 40 persons had no data about prior neuropsychiatric disease, 25 were schizophrenics, 25 alcoholics and 20 received a serious head blow during their lifetime. The prevalence of CSP in the entire group was 22.96%; among normal persons 10.61%; in schizophrenics 83.33%, in alcoholics 58.14 % and in persons with sustained prior head trauma 68.96%. There was a statistically significant difference in ratings, lengths and widths of CSP between schizophrenics, alcoholics, head traumatized and normals. Both length and width were revealed as parameters of importance for CSP selection. CSP is more frequent, longer and wider in persons who are suffering from schizophrenia, alcohol addicts and those who had sustained one or several head blows in the past. Its linear parameters are advisable to be measured.

Posterior tibial slope is one of the most citated factors wich cause rupture of the anterior cruciate ligament (ACL). The aim of this study was to determine the association of a greather posterior tibial slope on the lateral condyle, that is a lesser posterior tibial slope on the medial condyle, with ACL rupture.The patients were divided into two groups. The study group included the patients with chronic instability of the knee besause of a previous rupture of ACL. The control group included the patients with knee lesion, but without ACL rupture. Posterior tibial slope measuring was performed by sagittal MR slices supported by lateral radiograph of the knee. We measured posterior tibial slope on lateral and medial condyles of the tibia. Using these values we calculated an average posterior tibial slope as well as the difference between slopes on lateral and medial condyles.Patients with ACL rupture have highly statistically significantly greather posterior tibial slope (p0.01) on lateral tibial condyle (7.1 degrees : 4.5 degrees) as well as statistically significantly lesser posterior tibial slope (p0.05) on medial tibial condyle (5.9 degrees : 6.6 degrees) than patients with intact ACL.Great posterior tibial slope on lateral tibial condyle associated with the small posterior tibial slope on the medial tibial condyle, that is a positive differentce between lateral and medial tibial condyles are factors wich may cause ACL rupture.