Basic and Clinical Neuroscience and Neuroimaging
The Croatian Institute for Brain Research (CIBR) is the largest research unit of the Zagreb School of Medicine, which has been conducting research in the program entitled Neurobiology of Cognitive Development and Cognitive Disorders since 1997. This program currently encompasses 28 individual (intramural as well as extramural) projects in basic and clinical neuroscience, thus representing the single largest program in Croatia. Another program at the CIBR is related to the Pathophysiology of the Cerebrospinal Fluid. During the past six years, researchers at the CIBR published over 100 papers in high-profile international journals, with a focus on human developmental neurobiology, pediatric neuroimaging, and the biological basis and pharmacogenomics of mental and neurological disorders.
Over the past decade, the Department of Neurosurgery (in collaboration with the Croatian Institute for Brain Research, the Center for Clinical Implementation of Neuroscience, the Department of Electroacoustics of the Faculty of Electrical Engineering and Computing in Zagreb, and the Institute of Naval Engineering in Zagreb) has performed significant research on the use of high energy ultrasound on experimental animal neural tissue, and successfully constructed an endoscopic ultrasound contact probe for the use in neurosurgery (so far used in clinical work for third ventriculostomy and endoscopic surgery of third ventricle tumors, with a prospect for application in other fields of endoscopic surgery, such as urology, ENT, and orthopedics).
Ultrasound in Research
The researchers at the School of Medicine who specialized in ultrasound diagnostics have attained international visibility, especially in the early detection of ovarian cancer by the original method of 3D-color Doppler assessment of pelvic tumor angiogenesis, in cardiology at the Clinical Department for Cardiovascular Diseases of the University Hospital Center Zagreb, and abdominal ultrasound at the Merkur University Hospital and Dubrava University Hospital. At the Department for Cardiovascular Diseases of the University Hospital Center Zagreb, interdisciplinary research has recently been initiated, bridging the gap between clinical practice in cardiology and fundamental research in imaging, engineering and physics. In collaboration with researchers from the Faculty of Electrical Engineering and Computing in Zagreb a model-based approach for the quantification of cardiac function, based on cardiac imaging is being explored.
The program of kidney transplantation started in the early 1970s at the University Hospital Center Zagreb, where the establishment of the Tissue Typing Center marked the beginning of a new era for the treatment of patients. Allogenic and autologous bone marrow transplantation programs started in the early 1980s, and programs of heart transplantation (University Hospital Center Zagreb and Dubrava University Hospital) and liver transplantation (University Hospital Center Zagreb and Merkur University Hospital) were routinely performed by the end of the 1990s. Transplantation medicine significantly contributed to the overall development of clinical medicine in Croatia, by triggering off the development of many diagnostic and therapeutic disciplines, such as transfusion medicine, microbiology, immunology, molecular biology, cytogenetics, biochemistry, pathology and cytology.
Biological regeneration of tissues
In the rapidly growing field of molecular medicine and tissue regeneration the Laboratory for Mineralized Tissues is one of the leading research units of the University of Zagreb School of Medicine. In collaboration with the Department of Orthopedic Surgery, bone morphogenetic proteins (BMPs) have been characterized in laboratory and in preclinical trials, and recently several patients with congenital non-union of the tibia were successfully treated with osteogenic protein-1 (BMP 7) at the Department of Orthopedic Surgery. In addition, BMPs and newly discovered cartilage-derived morphogenetic proteins (CDMPs) have been tested for regeneration of articular cartilage chondral defects in large experimental animals, while recent research on BMP-7 has opened a promising avenue for its potential use for kidney regeneration in human medicine.
On 23 October 1983 the first child was born by applying the in vitro fertilization procedure (IVF) at the University Hospital Center Zagreb, thus making Croatia the eighth country in the world where IVF was successfully applied. This was followed by the application of cryopreservation of embryos (1995), intracytoplasmic injection of spermatozoa (ICSI, 1995), aspiration of spermatozoa from epididymis and testis (PESA and TESA), as well as blastocyst transfer (1998), resulting in more than 4,500 children born by IVF and more than 12,000 children born by other procedures of assisted pregnancy all over Croatia.
Clinical Biochemistry and Center for Genomics, Proteomics, and Metabolomics
The Department of Laboratory Diagnostics, with its hematology, biochemistry, immunology, inherited metabolic disorders, toxicology, and transfusion medicine subdivisions, has traditionally been at the forefront of medical science in Croatia. The recently founded Center for Genomics, Proteomics, and Metabolomics endeavors to enlarge the scope of that research and to secure the implementation of cutting-edge research technologies at the School of Medicine. Among a number of research projects and accomplishments, one may point out the discovery of a new mutation on the LDL-receptor gene, and new polymorphisms on cystic fibrosis and apoB100 genes. Other areas of investigation include the etiology and search for molecular markers for hemophilia and von Willebrand disease in Croatian patients.
Advances in Endemic Nephropathy
There is an ongoing interdisciplinary project on endemic nephropathy, chronic tubulointerstitial nephritis often accompanied by upper urothelial cancers in the strictly defined geographical areas, which points to a common etiological agent. Our Croatian-US team confirmed that aristolochic acid is a strong risk factor and obviously the causative agent. The most important findings of these outstanding results were published in the Proceeding of the National Academy of Sciences. In October 2006 the Zagreb School of Medicine hosted the International Symposium “Recent Advances in Endemic Nephropathy: The Role of Environmental Toxins” with basic scientists and clinical investigators from more than 30 universities; conclusions of the meeting were published in the Journal of the American Society of Nephrology (www.endemic-nephropathy.mef.hr ).