bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental and modeling investigations of a hybrid upflow anaerobic sludge-filter bed (UASFB) reactor
Authors: Rajinikanth R. , Ramirez I. , Steyer J. P. , Mehrotra I. , Kumar P. , Escudie R. , Torrijos M.
Published: July 2008

A 9.8-L hybrid UASFB reactor, in which the lower half was occupied by a sludge blanket and the upper half by small floating polyethylene media, was evaluated using wine distillery vinasse as substrate. The reactor was operated for a total period of 232 days at 33 + 1°C. Continuous feeding of the reactor was started with an initial OLR of 2.9 g COD/L·d and then it was increased step wise to 19.5 g COD/L·d by increasing the feed COD, while maintaining a constant HRT (1.05 d). The reactor was equipped with a continuous internal recirculation system from top to the bottom at the rate of 9 L/h (upflow velocity = 0.83 m/h) upto day 159 and then it was reduced to about half on day 160 onwards. It was observed that the reduced recirculation rate did not affect the performance of the reactor with an average CODt and CODs removal efficiencies of 82 and 88%, respectively. A maximum gas production rate of 6.7 L CH4/Lreactor·d was achieved for the highest OLR applied. The specific activity analysis depicts that the activity of the attached biomass was more than 2 times higher than that of the granular sludge. The efficiency of liquid mixing was good through out this study. The packing medium had a dual role in the retention of the biomass inside the reactor: i.e. entrapment of biomass within the support and filtration of the granular biomass, preventing it from going out of the reactor. ADM1_10 model simulated well the dynamic evolutions of the main variables in the liquid as well as in the gas phases.
Linking trading ratio with TMDL (total maximum daily load) allocation matrix and uncertainty analysis
Authors: Zhang H. X.
Published: July 2008

An innovative approach for total maximum daily load (TMDL) allocation and implementation is the watershed-based pollutant trading. Given the inherent scientific uncertainty for the tradeoffs between point and nonpoint sources, setting of trading ratios can be a contentious issue and was already listed as an obstacle by several pollutant trading programs. One of the fundamental reasons that a trading ratio is often set higher (e.g. greater than 2) is to allow for uncertainty in the level of control needed to attain water quality standards, and to provide a buffer in case traded reductions are less effective than expected. However, most of the available studies did not provide an approach to explicitly address the determination of trading ratio. Uncertainty analysis has rarely been linked to determination of trading ratio.

This paper presents a practical methodology in estimating “equivalent trading ratio (ETR)” and links uncertainty analysis with trading ratio determination from TMDL allocation process. Determination of ETR can provide a preliminary evaluation of “tradeoffs” between various combination of point and nonpoint source control strategies on ambient water quality improvement. A greater portion of NPS load reduction in overall TMDL load reduction generally correlates with greater uncertainty and thus requires greater trading ratio. The rigorous quantification of trading ratio will enhance the scientific basis and thus public perception for more informed decision in overall watershed-based pollutant trading program.
Rejection of pharmaceuticals and personal care products (PPCPs) and endocrine disrupting chemicals (EDCs) by low pressure reverse osmosis membranes
Authors: Ozaki H. , Ikejima N. , Shimizu Y. , Fukami K. , Taniguchi S. , Takanami R. , Giri R. R. , Matsui S.
Published: July 2008

This paper aims to elucidate retention characteristics of some pharmaceuticals and personal care products (PPCPs), and endocrine disrupting chemicals (EDCs), by two polyamide low pressure reverse osmosis (LPRO) membranes. Feed solution pH did not have an influence on rejections of undissociated solutes, which was most likely governed by adsorption, size exclusion and diffusion simultaneously. Size exclusion was presumably dominant, especially with tight membranes (UTC-70U). Rejections of the solutes with low dipole moment (<1.0 debye) decreased with increasing octanol–water partition coefficient (Kow). The solutes with large Kow values were most likely adsorbed on membrane and subsequently passed through it resulting in larger diffusion coefficient (Dp). The rejections decreased with increasing Dp values irrespective of their dipole moments. Rejections of solutes with comparatively larger dipole moments might be dominated by diffusion and/or convection rather than their hydrophobicity. However, rejections of solutes with hydroxyl and carboxyl functional groups by UTC-60 increased with solution pH. More than 80% rejections were obtained for degree of dissociation (α)>0.5. Electrostatic repulsion played a key role for rejection of dissociated solutes, especially by loose LPRO membranes. Therefore, assessing the dissociation degree at desired pH values can be a key step to obtain an insight of rejection mechanisms by polyamide membranes.
Efficient nutrient removal from swine manure in a tubular biofilm photo-bioreactor using algae-bacteria consortia
Authors: González C. , Marciniak J. , Villaverde S. , León C. , García P. A. , Muñoz R.
Published: July 2008

Concentrated animals feeding operations (CAFOs) often pose a negative environmental impact due to the uncontrolled spreading of manure into soils that ends up in the release of organic matter and nutrients into water bodies. Conventional aerobic methods treating CAFOs wastewater require intensive oxygenation, which significantly increases the operational costs. The alternative proposed in this research is the application of micro-algae based systems by taking advantage of the cost-effective in situ oxygenation via photosynthesis. A 4.9 L enclosed tubular biofilm photo-bioreactor was inoculated with an algal–bacterial consortium formed by the micro-algae Chlorella sorokiniana and a mixed bacterial culture from an activated sludge process. C. sorokiniana delivers the O2 necessary to accomplish both organic matter and ammoniun oxidation. The reactor was fed with diluted swine wastewater containing 180, 15 and 2,000 mg/L of NH4+-N, soluble P and total COD, respectively. The photo-bioreactor exhibited good and sustained nutrient removal efficiencies (up to 99% and 86% for NH4+ and PO43−, respectively) while total COD was removed up to 75% when the biofilm was properly established. Liquid superficial velocities up to 0.4 m/s (achieved by culture broth recirculation) hindered the formation of a stable biofilm, while operation at velocities lower than 0.1 m/s supported stable process performance. The high shear stress imposed by the centrifugal recirculation pump disintegrated the large aggregates detached from the biofilm, which resulted in a poor settling performance and therefore poor COD removal efficiencies. Enclosed biofilm photo-bioreactors therefore offer a potentially more economical alternative to conventional tertiary treatments process.
Effect of temperature on Imidacloprid oxidation by homogeneous photo-Fenton processes
Authors: Zaror C. , Segura C. , Mansilla H. , Mondaca M. A. , González P.
Published: July 2008

This paper presents experimental results on the effect of temperature on the rate of Imidacloprid removal from waste water using homogeneous photo-Fenton processes. Experiments were conducted in a 2 L photo reactor set at 15–42°C, initial concentrations in the range of 10 to 40 mg L−1 Fe(II) and 100–450 mg L−1 H2O2; 30 150 min processing times. Initial H2O2 concentration determined the extent of the oxidation process, whereas iron concentration played a key role in the process kinetics. Homogeneous photo-Fenton showed a fast initial reaction leading to 50% Imidacloprid degradation after less than 1 min of treatment, followed by a slower process until full removal was achieved. Rapid Fe(II) oxidation to Fe(III) seems responsible for the initial Imidacloprid removal. Imidacloprid removal fitted well a pseudo-first order kinetic scheme, with apparent activation energy of approximately 31.6 kJ/mole. Untreated Imidacloprid samples showed significant acute toxicity to Daphnia magna and genotoxic effects on Bacillus subtilis. Acute toxicity and genotoxicity remained detectable even after complete pesticide removal, showing that toxic by-products were present. The design and operation of photo Fenton processes should focus on toxicity removal rather than on specific target pollutants.
Photocatalytic inactivation of Flavobacterium and E. coli in water by a continuous stirred tank reactor (CSTR) fed with suspended/immobilised TiO2 medium
Authors: Cohen-Yaniv Vered , Narkis Nava , Armon Robert
Published: July 2008

A photocatalytic continuous stirred tank reactor (CSTR) was built at laboratory scale to inactivate two environmental bacteria strains (Flavobacterium and E. coli) in tap water. Several parameters were found to impact reactor efficiency. Bacterial initial concentration is an important factor in inactivation rate. After 30 minutes of irradiation at 108–109 CFU mL−1 starting concentration, a >5 log reduction was achieved while at 104–106 CFU mL−1 only a 2 log reduction was observed. Water hardness and pH have an important influence on the photocatalytic inactivation process. Soft water, with low Ca+2 and Mg+2 at low pH ∼ 5.3 resulted in increased inactivation of Flavobacterium reaching >6 orders of magnitude reduction. E. coli and Flavobacterium at pH 5 were inactivated by 3 logs more as compared to pH 7 under similar conditions. pH below TiO2 isoelectric point (approximately 5.6) supports better contact between bacteria and anatase particles resulting in superior inactivation. TiO2 powder suspension was compared with immobilised powder in sol-gel coated glass beads in order to exclude the need for particles separation from the treated water. TiO2 suspension was more effective by 3 orders of magnitude when compared to coated glass beads. An interesting observation was found between the two bacterial strains based on their hydrophobicity/hydrophilicity balance. The more hydrophobic Flavobacterium compared to E. coli was inactivated photocatalytically by >3 logs more then E. coli in the first 30 minutes of irradiation interval. The results indicate the importance of the parameters involved in the contact between TiO2 particles and microorganisms that govern the succesful inactivation rate in CSTR.
Solar-powered aeration and disinfection, anaerobic co-digestion, biological CO2 scrubbing and biofuel production: the energy and carbon management opportunities of waste stabilisation ponds
Authors: Shilton A. N. , Mara D. D. , Craggs R. , Powell N.
Published: July 2008

Waste stabilisation pond (WSP) technology offers some important advantages and interesting possibilities when viewed in the light of sustainable energy and carbon management. Pond systems stand out as having significant advantages due to simple construction; low (or zero) operating energy requirements; and the potential for bio-energy generation. Conventional WSP requires little or no electrical energy for aerobic treatment as a result of algal photosynthesis. Sunlight enables WSP to disinfect wastewaters very effectively without the need for any chemicals or electricity consumption and their associated CO2 emissions. The energy and carbon emission savings gained over electromechanical treatment systems are immense. Furthermore, because algal photosynthesis consumes CO2, WSP can be utilised as CO2 scrubbers. The environmental and financial benefits of pond technology broaden further when considering the low-cost, energy production opportunities of anaerobic ponds and the potential of algae as a biofuel. As we assess future best practice in wastewater treatment technology, perhaps one of the greatest needs is an improved consideration of the carbon footprint and the implications of future increases in the cost of electricity and the value of biogas.
Screening of mutations and polymorphism in CFRT gene in men infertile due to oligo- or azospermia
Authors: Kusic Jelena , Radojkovic Dragica , Maletic-Vukotic Vinka , Brankovic Snezana , Savic Ana
Published: July 2008

We concluded that CFTR gene plays a role in the etiology of obstructive azoospermia and that it also could be involved in same cases of impaired spermatogenesis and sperm maturation. Due to the high incidence of CFRT mutations in patients with obstructive azoospermia we suggest screening of CFRT mutations before assisted reproduction.
Teorijski pristup motivaciji za timski rad
Authors: Tomic Vesna
Published: July 2008

nema
Razvoj zenskog i muskog identiteta - diferencijacija roda
Authors: Rakic Zoran , Vujovic Svetlana
Published: July 2008

nema
Epidemic of tularaemia in Nish district
Authors: Kostic Velimir , Jovanovic Branislav , Krstic Milijanka , Jovanovic Maja , Skoric Snezana , Velickovic Zoran , Lako Branislav
Published: July 2008

Tularaemia, as a rare disease, suprised medical workers in 1999 and 2ooo when it was detected and diagnosed in 31 patients. In 1999 patients were registered in villages of the Sokobanja community, and in 2ooo also in other communities in the district of Nish. Patients were peasants, mostly housewives. Glandular form of the disease was dominant. The main clinical symptoms were: tonsillitis, pain in the region of enlarged lymphatic glands and temperature, Bio-humoral syndrome presented accelerated sedimentation of erythrocytes and elevated fibrinogen values. Antibody titer of Francisella tularensis was extremely high in the majority of patients. The disease was cured in all patients: in 27 patients after the first therapy, in 4 subjects after recidivation and 5 patients were surgically treated.
Prenos genetskog materijala bakterije Streptococcus pneumoniae procesom transformacije
Authors: Opavski Natasa , Djukic Slobodanka , Mijac Vera , Ranin Lazar
Published: July 2008

nema
Rizik rupture i prirodni ishod nerupturisanih intrakranijumskih aneurizmi
Authors: Racic Dusko , Kovacevic Miroslav , Marinkovic Slobodan , Djajic Vlado , Kovacevic Igor , Vujkovic Zoran , Vrucinic Zoran
Published: July 2008

nema
Frequency of dysmorphological signs by possum at the home for developmentally handicapped children and adults in Veternik-Novi Sad
Authors: Stojanovic Slobodan , Krstic Aleksandar , Poljacki Mirjana , Tasic Sinisa
Published: July 2008

The authors have examined frequency of dysmorphological signs by POSSUM at the Home for developmentally handicapped children and adults in Vetemik Novi Sad. The aim was to establish possible different hereditary and congenital skin diseases and genetic syndromes in this population. The study was based on the following methods: method of family history including genealogy; dermatoglyphic methods; screening tests methodology in medical genetics; method of cytogenetic analysis; histo-pathological analysis method of dermatovenerologic, genetic and dysmorphologic examinations of skin diseases by analysis of dysmorphological signs on the skin using a special computer programme. The study s, Novi Sad included 504 wards with 269 males and 235 females, and sex ratio of 1:1.14 in favour to males. Non-parametric statistics and Log-linear analysis revealed a statistically significant difference between the incidence of dysmorphological signs in the studied group and the Vojvodina population. The obtained incidence of dysmorphological signs in the examined group is presented in tables. Our results regarding the incidence of dysmorphological signs in the examined group showed significantly increased values in comparison to the population of Vojvodina.
The impact of diabetes mellitus on restoring and maintaining of sinus rhythm in patients with persistent atrial fibrillation
Authors: Potpara Tatjana , Marinkovic-Eric Jelena , Grujic Miodrag , Radojkovic-Cirovic Biljana , Vujisic-Tesic Bosiljka , Petrovic Milan
Published: July 2008

We concluded that diabetes mellitus independently predicts the presence of recurrent atrial fibrillation but does not influence the possibility of sinus rhythm restoration. The relationship between atrial fibrillation and diabetes mellitus needs further investigation.
Adrenal glands of the foetus in (high) risk pregnancies
Authors: Ljubic Vesna , Petkovic Spasoje , Radunovic Nebojsa
Published: July 2008

Improvement of the methods used in prenatal diagnosis will contribute to a timely detection of a diseased fetus, and will be the first step in its recovery. Regulating the pathological condition of the mother will surely contribute to decrease the risk of delivering children with an increased risk of morbidity.
Malignant carcinoid tumor of the pancreas
Authors: Colovic Radoje , Micev Marjan , Colovic Natasa , Zogovic Sergej , Trbojevic Bozo , Stojkovic Mirjana
Published: July 2008

Carcinoid tumors arise from argentaffine cells or from a primitive stem cells which may differentiate into anyone of a variety of adult endocrine-secreting cells. Carcinoid tumor of the pancreas is a very rare tumor with less than 50 cases reported in world literature. In literature it is denoted "pancreatic serotoninoma" or "serotonin-producing pancreatic tumor". Due to its rarity the tumor is an unusual cause of carcinoid syndrome. As the carcinoid tumor of the pancreas does not always causes carcinoid syndrome its absence does not necessarily exclude the existence of the tumor. The tumor is frequently malignant. Over 50% of patients have metastases at the time of surgery. This is the reason why radical surgery is not possible in a number of patients. Excisional surgery offers the best chance for recovery or long term survival. We report on a 57-year-old woman with carcinoid syndrome caused by malignant carcinoid tumor of the head of the pancreas without liver or other distant metastases; it was successfully excised with pylorus preserving cephalic duo-denopancreatectomy (after Longmire-Traverso) and radical lymphadenectomy. The diagnosis was established on the basis of histologic and immunohistochemical findings. The patient is symptom free for more than eight months.
Dijagnostika i terapija bronhijalne astme kod starijih osoba
Authors: Mitic-Milikic Marija , Sekulic Srboljub , Vukcevic Miodrag
Published: July 2008

nema
Znacaj magnetske rezonancije u dijagnostici i razumevanju prirode patoloskih promena u multiploj sklerozi
Authors: Mesaros Sarlota , Drulovic Jelena , Stojsavljevic Nebojsa , Levic Zvonimir
Published: July 2008

nema
Mesto i uloga mukocilijarne barijere i transporta u antimikrobnoj odbrani respiracijske sluznice
Authors: Janosevic Ljiljana , Janosevic Slobodanka , Djordjevic Vladimir , Milovanovic Jovica
Published: July 2008

nema
Medical and social factors influencing reproduction in Serbia
Authors: Sulovic Vojin , Ljubic Aleksandar
Published: July 2008

The authors present results of researches whose aim was to determine the factors that may substantially influence population reproduction in the Republic of Serbia, taking into consideration all specific factors, like cultural background, economic situation, health education, health service organization, religious and historical factors, etc. The research was based on the population census from 1981. Seventeen regions of the inner part of the Republic of Serbia, Vojvodina and Kosovo were included in this research. Stratification was made according to the place of living (village, town) age, occupation (farmer, housewife, non and half-qualified, qualified and highly qualified workers) and education (without education, with unfinished or finished primary school, with secondary school, with college or university degree). In this way 2,141 women were questioned with 101 questions by the method of interview. Interviews were conducted exclusively by doctors - gynaecologists. We determined the frequency of the use of contraceptives, intentional abortions, spontaneous abortions, pre-term deliveries, marriage infertility and term deliveries. Thus, 57.4% of women had basic knowledge of contraception, but only 15.9% of them used it; 58.9% of women had intentional abortions; 16.2% of women had spontaneous abortions, 5.1% of them had pre-term deliveries, and 67% of women had term deliveries. Marriage infertility was found in 8.6% of women. When evaluating population health and behavior, we obtained some information and data concerning addicted diseases (alcohol, smoking, drugs, tranquilizers) homosexuality and ways of sexual intercourse. It was concluded that enormous differences existed among certain regions in the Republic of Serbia, which were conditioned by the diversity of the above mentioned influences. Proposals for the measures to be undertaken in the Republic of Serbia in order to regulate population policy, are given.
Estimation of representative blood pressure values in haemodialysed children
Authors: Pejcic Iris , Peco-Antic Amira , Kostic Mirjana
Published: July 2008

The diagnosis of hypertension in patients on chronic haemodialysis is not easy because the blood pressure changes as a consequence of therapy (haemodialysis) and attenuated circadian rhythm of blood pressure is often present. The estimation of representative blood pressure levels is difficult because it is not known whether blood pressures measured before starting or after completion of haemodialysis are predictive for the average interdialytic blood pressure. Our group of patients consisted of 18 children with endstage renal failure, aged 13.5 ? 3.2 years, treated with chronic haemodialysis from 0.1 to 110 (mean 25.8, median 19) months. Ambulatory blood pressure monitoring was performed during 44h interdialytic period. Blood pressure was also measured with sphygmomanometer before starting and after completion of heamodialysis. The average blood pressure values for the last ten haemodialyses were evaluated as well. Multiregression analysis showed significant correlation between interdialytic blood pressure (systolic and diastolic) and blood pressures measured before haemodialysis (r = 0.74; ? < 0.001, r = 0.78; ? < 0.001, respectively) and after haemodialysis (r = 0.76; ? < 0.01, r = 0.6; ? < 0.05, respectively). Statistically high correlation between these blood pressures was also confirmed for the average blood pressure values for the last 10 haemodialyses (r = 0.78; ? < 0.001, r = 0.75; ? < 0.001 and r = 0.78; ? < 0.001, r = 0.86; ? < 0.001, respectively). Our findings show that blood pressures measured before starting or after completion of haemodialysis give good information about interdialytic blood pressure in children on chronic haemodialysis.
Corticosteroid-responsive nephrotic syndrome in children with myelodysplastic syndromes
Authors: Bogdanovic Radovan , Kuzmanovic Milos , Markovic-Lipkovski Jasmina , Ognjanovic Milos , Micic Dragan , Stankovic Ivica , Stajic Natasa , Nikolic Vesna , Bunjevacki Gordana
Published: July 2008

Several reports have documented various forms of glomerular diseases in adults with myelodysplastic syndromes (MDS), but similar reports in children are lacking. We describe two children with MDS-associated with steroid-responsive nephrotic syndrome (NS). Patient 1, who had MDS with myelofibrosis, presented also hepatosplenomegaly, pancytopenia, chronic hepatitis, moderate proteinuria, hypocomplementemia and elevated ANA titer. During initial prednisone treatment proteinuria markedly diminished and partial but transient haematological improvement occurred. Relapse subsequently occurred that was manifested by overt NS and pancytopenia. High doses of prednisolone led to remission of the renal disease but haematological remission did not occur. Persisting pancytopenia and repeated infections terminated in sepsis, two years after the onset of MDS. Patient 2, who had refractory anemia with clonal monosomy 19, manifested bowel disease, hepatospleno- megaly, anaemia and non-organic specific autoantibodies. Prednisone led to both clinical and haematological remission. Haematologic disease relapsed 12 months later, when nephrotic-range proteinuria, haematuria and mild azotaemia were also found. Corticosteroid treatment led to long-lasting renal and haematologic remission, maintained by a small dosage of prednisone. In both patients renal biopsy findings were consistent with those seen in idiopathic NS. A Medline search disclosed 16 cases of glomerulopathy in the course of MDS in adult patients. Clinical features included NS, usually accompanied by renal insufficiency with either acute, chronic, or rapidly progressive glomerulonephritis. On biopsy, membranous nephropathy, crescentic or mesangial proliferative glomerulonephritis and AL amyloidosis, were found. We conclude: (1) that glomerular disease may be present and should be searched for in patients with MDS; (2) that MDS can be added to the list of rare conditions associated with corticosteroid-responsive NS in children.
Alergijska bronhopulmonalna aspergiloza
Authors: Ivkovic-Krstic Gordana , Ljaljevic Jasmina
Published: July 2008

nema
Suplementacija magnezijuma u trudnoci i laktaciji
Authors: Mitrovic Ana , Jovanovic Tomislav
Published: July 2008

nema
Acute renal failure in asphyxiated term neonates
Authors: Pejovic Biljana , Peco-Antic Amira , Dunjic Radica
Published: July 2008

INTRODUCTION Acute renal failure (ARF) is a frequent clinical condition in neonatal intensive care units (NICU). The leading cause of neonatal ARF is perinatal asphyxia (PS). The aim of this study was to examine the relationship between the degree of PS and the severity of ARF in term neonates. METHODS A prospective survey of 31 term neonates with Ps and but without congenital malformations or sepsis was performed in NICU of the regional Hospital of Gynaecology and Obstetrics in Belgrade (average number of deliveries about 6000 per year). ARF was diagnosed in the first 7 days of life when plasma creatinine was above 133 ?m??/L for at least 48 hours while maternal renal function was normal. The degree of PS was determined according to Apgar score (AS) at 1 min. The severe PS was defined as AS < 3 and moderate PS as AS 4-6. RESULTS Twenty neonates (64%) had oliguric ARF with urine output of 0.37 ?0.16 ml/kg/h while the others had nonoliguric ARF with urine output of 2.4 ? 0.7 ml/kg/h. Most of neonates with oliguric ARF (65%) had severe perinatal asphuxia while in those with nonoliguric ARF moderate perinatal asphyxia predominated (73%). DISCUSSION During hypoxic-ischaemic events many organs are injured, and the most vulnerable ones are kidneys and central nervous system. Our results showed a strong connection between perinatal asphyxia and A, which was in accordance with the results of other studies. Neonates with severe perinatal asphyxia had serious impairment of renal function, which was confirmed with strong correlation between Apgar score and plasma creatinine. In neonates with oliguric ARF, but not in those with nonoliguric ARF, the highly positive linear correlations were found between AS and urinary output (r = 0.77; p < 0.01), plasma creatinine (r = 0.78; p < 0.01), fractional excretion of sodium (r = 0.76; p < 0.01), and index of renal failure (r = 0.80; p < 0.01). Only in oliguric neonates with severe perinatal asphyxia (31 %) the outcome was fatal. CONCLUSION We conclude that in tgerm neonates with severe perinatal asphyxia oliguric ARF was the predominant type of ARF. There is a good prediction of the severity of oliguric ARF according to the degree of perinatal asphvxia determined by Apgar score at 1 min.
Problem of diagnosis and extraction of a foreign body in orbit associated with pain
Authors: Jovanovic Milos , Glisic Selimir , Vukovic Dragan
Published: July 2008

The aim of this study was to present the troubles and significance of a proper diagnosis of a foreign body which caused a double perforation of the eyeball and was retained in the orbit. Another reason for this case report was the intensive pain associated with the existing foreign body in the orbit. A male, 54 years old, had a perforating wound of the eyeball caused by a metal foreign body, which stayed in the orbit close to the scierai wall. X-ray and echographic examinations of the orbit were not conclusive regarding the question whether this foreign body was situated within or outside the eyeball. Only CT imaging showed that foreign body produced a double perforation of the eyeball and was externally close to the sciera. Foreign body was extracted by tran-sconjunctival anterior orbitotomy through the inferior fornix, using the electromagnetic probe. Since the first day of injury and up to the eighth day, the patient had intensive deep orbital pain, which was alleviated only partially by analgetics. It could not be explained by secondary glaucoma because IOP was normal or by an inflammatory process, or in any other way. Only the extraction of foreign body from the orbit led to the complete relief of pain. We believe that the pain was caused by compression of foreign body to some of scierai sensory nerves. X-ray and echographic examinations of the orbit are not always a reliable proof in the proper evaluation whether foreign body is within or outside the eyeball in the orbit. Precise diagnosis can be made only by CT imaging. The pain in the orbit may be caused by compression of foreign body to sensory nerves.
Volumetrijska analiza sive mase, bele mase i prostora cerebrospinalne tecnosti u shizofreniji
Authors: Maric Nadja , Kamer Thomas , Schneider-Axmann Thomas , Indra Dani , Jasovic-Gasic Miroslava , Paunovic Vladimir , Falkai Peter
Published: July 2008

Schizophrenia is characterized by diffuse brain abnormalities, some of them involving volumes of three intracranial compartments: gray matter (GM) white matter (WM) and cerebrospinal fluid (CSF). Novel methods, such as Statistical Parametrical Mapping, provide an automated means of comparing structural features across high quality MRI scans and the measurement based on the principles of voxel based morphometry. For the purposes of the present study, we selected sex balanced group of young adults with recent onset illness to assess the effects of the illness on the volumes of compartments and also to minimize the effects of chronicity, medication, sex and aging. Sixty-four subjects were selected from a larger sample (inclusion criteria: age range 18-31). Thirty-one had DSM IV diagnosis of schizophrenia or schizoaffective disorder, 33 were controls. T1 weighted MRI images were acquired on two scanners (1.5T both): a) fast gradient echo sequence, FLASH, 40msec repetition time, 5ms echo time, 40 degree flip angle and b) turbo gradient echo, 12msec repetition time, 4msec echo time, 20 degree flip angle, 1 excitation). The resulting data set consisted of: a) 128 consecutive slices with 1.17mm thickness and 256x256 pixels per slice and b) 160 consecutive slices of 1mm thickness and 256x256 pixels per slice. All 64 images were processed by ANALZYE, and normalized and segmented by SPM99. Following the automatic segmentation of the images into the three intracranial compartments, volumetry was performed based on the principles of voxel analysis. Results were expressed relative to whole brain volume and MANOVA analyses were performed to correct the confounding effects of MRI acquisition center differences and age difference between diagnostic groups. Young adults with recent onset schizophrenia had 6% reduction in GM volume and 14% increase in the volume of CSF, after all confounders were included into analyses (MANCOVA: p=0.006 and 0.0002, respectively). No significant changes in WM volume were evident. In comparison to a few similar studies published recently, all results yielded similar scores regarding effects of recent onset illness and young adult population, thus confirming the reliability of the procedure. In conclusion, global neuropil reduction was discussed as a consequence of the cortical neurodevelopmental disgenesis. It was suggested that neuropil reduction i.e. synaptic and dendritic changes were to induce functional abnormalities and the expression of schizophrenia.
Endoskopija u dijagnostici i lecenju inoperabilnog karcinoma jednjaka nakon radioterapije i kombinovane radiohemioterapije
Authors: Josifovski Jeremija , Radosevic-Jelic Ljiljana
Published: July 2008

Treatment of inoperable (locally advanced) esophagus cancer, even today, has been a subject of numerous clinical researches. Combination of several clinical modalities is needed, of radiotherapy and chemotherapy the most frequently. This combination applied as neoadjuvant or concomitant brought to improvement of treatment results of these patients. Local control is still a big problem, since majority of these patients die of local treatment "failure". Because of that, estimation of the local control is very important, ie. assessment of the tumor response the treatment. For those reasons, a study has been conducted on 52 patients with locally advanced esophagus tumor, who in the first group of 25 patients, were treated only by radiotherapy, and in the second group of 27 patients, by combined radio-chemotherapy. Pretherapy evaluation, evaluation of esophagus stenosis as well as the tumor regression to conducted treatment, were done in all patients by radiography and endoscopy and the findings were compared: there was no statistically significant difference between investigated methods (p>0.05). although bigger number of the tumor complete regressions was verified by radiography (6 in the first group and 5 in the second group of patients) in relation to endoscopic finding (3 in the first group and 2 in the second group of patients), which had no microscopical evidence of remaining disease. Partial tumor regression made greater differences between investigated methods (10:4 in the first group and 6:3 in the second group of patients).
The long-term results of benign bile duct strictures reconstruction
Authors: Colovic Radoje , Bilanovic Dragoljub , Jovanovic Miodrag , Grubor Nikica
Published: July 2008

Over 27 year period (1.01.1974-31.12.2001) a 168 patients (pts) were operated on for benign bile duct strictures of types I to IV according to Bismuth,s classification. Reconstruction of fresh lesions and lesions and strictures of sectoral or segmental ducts were not taken into account. The later are to be the subject of separate publication. There were 107(63,7%) women and 61(36,3%) men of average age of 46 years (ranging from 14 to 76 years). The average time from injury to our reconstruction was 8,2 years. In 162 pts (96,4%) an operative injury was the cause of the stricture, in 150 (89,3%) during cholecystectomy, in 8 (4,76%) during distal gastrectomy for duodenal ulcer and in 4 (2,38%) during surgery of the central hydatid cyst of the liver. In 112 (66,66%) pts 1 to 6 previous attempts of reconstructions had been performed elsewhere. According to the Bismuth,s classification there were 27 (16,07%) strictures of type I, 46 (27,38%) of type II, 66 (39,28%) of type III and 29 (17,26%) of type IV. The most frequent preoperative complications were intrahepatic lithiasis (34%), fibrosis or cirrhosis of the liver in 9,5%, liver abscesses in 6%, bilioduodenal fistula in 4,16% biliary peritonitis in 4,16% and incisional hernia in 8,9% of pts. Suture mucosa-to-mucosa hepaticojejunostomy with 75 cm long Roux-en-Y jejunal limb described by Blumgart was performed in 161 (95,8%), choledochoduodenostomy in 3 (1,8%) and strictureplasty in 2 (1,2%) while in 2 pts the reconstruction was not technically possible. Three pts died during the first 6 months, 2 in whom the reconstruction was not possible and 1 with chronic endemic nephropathy. Eight of the rest 165 pts were lost from follow up being from Bosnia and Croatia due to well known war events. Six out of the 157 pts died in the mean time, 2 due to variceal bleeding (they had cirrhosis and portal hypertension at the time of reconstruction) an 4 due to unrelated causes (2 due to pancreatic carcinoma, 1 due to myocardial infarction and 1 due to stroke). Out of 151 alive fully followed pts, good result (pts symptom-free as after standard cholecystectomy) was achieved in 121 (80,13%), satisfactory (mild occasional symptoms but not cholangitis) in 27 (17,88%) and unsatisfactory result in 3 pts (2%), 2 of which were successfully reoperated (1 passed into group with good and 1 into group with satisfactory results).
Neurological aspects of eclampsia
Authors: Jovanovic Dejana , Beslac-Bumbasirevic Ljiljana , Ercegovac Marko , Stosic-Opincal Tatjana
Published: July 2008

The difficult types of preeclampsia and eclampsia are presented with the neurological symptoms. The break of cerebral autoregulation mechanism plays the most important role in pathogenesis of cerebral vasospasm. Nevertheless eclampsia isn?t just an ordinary hypertensive encephalopathy because other pathogenic mechanisms are involved in its appearance. The main neuropathologic changes are multifocal vasogenic edema, perivascular multiple microinfarctions and petechial hemorrhages. Neurological clinical manifestations are convulsions, headache, visual disturbances and rarely other discrete focal neurological symptoms. Eclampsia is a high-risk factor for onset of hemorrhagic or ischemic stroke. This is a reason why neurological diagnostic tests are sometimes needed. The method of choice for evaluation of complicated eclampsia is computerized brain topography that shows multiple areas of hypodensity in occipitoparietal regions. These changes are focal vasogenic cerebral edema. For differential diagnosis of eclampsia and stroke other diagnostic methods can be used - fundoscopic exam, magnetic resonance brain imaging, cerebral angiography and cerebrospinal fluid exam. The therapy of eclampsia considers using of magnesium sulfate, antihypertensive, anticonvulsive and antiedematous drugs.
Correlation between IL 6 level and syetem-complications following multiple trauma in patients with blunt abdominal injuries
Authors: Gregoric Pavle , Bajec Djordje , Sijacki Ana , Karadzic Borivoje
Published: July 2008

Severe trauma is the third cause of death and the first one in the most vital and young population. In USA more children die of trauma then of all other causes. Blunt abdominal trauma takes 56 % cases of multiple traumas of all etiologies. Among multiple injured patients, near to 50 % have some system-complications, more of 60 % in the group of critically injured (ISS>35). Cytokines play the main role in the inflammatory reaction during the early phase response on trauma. Their secretion predicts system-complications as ARDS, SIRS, even MODS. Hypothetically, level of concentration of Interleukin-6 (IL 6) can improve methods of early diagnostic procedures for detecting SIRS and MODS, when scores are still low (preclinical level), at which stages therapy is more powerful and also cheaper. This prospective study includes 35 multiple injured persons with blunt abdominal trauma (75>ISS>18). We have used standard diagnostic procedures. Concentration of IL 6 was detected with ELISA-test. Levels of IL 6 were significantly higher in correlation with SIRS score groups. Correlation with MODS score was not significant for the lowest scores, but IL 6 showed significant higher levels in the second and the third MODS score group.
Myocardial bridge and proximal complicated atherosclerosis of descending branch of left coronary artery as a cause of sudden cardiac death - case report
Authors: Micic Jelena , Nikolic Slobodan , Savic Slobodan
Published: July 2008

When coronary artery, which is located subepicardially, submerges into myocardium and then, after a short intramural course, again appears subepicardially, it is called embedded coronary, while a part of myocardium above - a myocardial bridge. Muscular bridges are usually small and have no clinical significance. In the proximal part of coronary artery, preceding a myocardial bridge, there occurs a disturbance of blood course and myocardial perfusion, turbulence, collecting of lipids and mucopolysaccharides, lesion of elastica, which all leads to atheromatous lesions of intima of the arterial proximal part and to the resultant complications of atheroma. Degenerative changes of myocardium and its blood vessels, and in connection with it myocardial vulnerability, could be a consequence of this congenital arterial variation. We report a case of a 40-year-old male, without medical data about previous diseases, who died suddenly and unexpectedly in his apartment. The autopsy and microscopical examination revealed an acute ischemic lesion, myocardial bridge in the middle part of the left coronary artery descending branch and the complicated atherosclerotic plaque proximally of this bridge.
"Flash" pulmonary oedema as a clinical manifestation of renovascular hypertension
Authors: Kalimanovska-Ostric Dimitra , Ivanovic Branislava , Ostric Vladimir , Knezevic Vesna , Stojanov Vesna , Simic Dragan
Published: July 2008

One of the clinical manifestations of renovascular hypertenzion (RVH) may be a recurrent pulmonary oedema both in the absence or in the presence of systolic left ventricular dysfunction. This type of pulmonary oedema characterized as "flash" pulmonary oedema is ascribed to elevated angiotensin II concentrations with consequent hypertension as well as to volume overload resulting from decreased pressure natriuresis when there are significant stenoses of both or one renal arteries. The investigation included 30 patients with RVH treated by percutaneous transluminal angioplasty of the stenosed renal artery (PTRA) and/or stent implantation (PTR-ST) and 30 patients with surgical resection of the abdominal aortic aneurysm (AAA). The first group was divided in two subgroups according to the etiology of renal artery stenosis (RAS). In the subgroup with fibromuscular dysplasia (FMD) the mean age was 37.5 years, in the subgroup with atherosclerotic renal artery stenosis (ARAS) 54.8 years and in the group with operated AAA 68.6 years. There were more females than males only in the FMD subgroup (10:3). Two patients of the first group experienced pulmonary oedema, both in the subgroup with atherosclerotic renal artery stenosis associated with atherosclerosis of other arteries. Normalization of the blood pressure following PTRA in both and an uncomplicated course after a surgical myocardial revascularization in one of them illustrates the importance of renal revascularization. Pulmonary oedema occurred preoperatively in four out of 30 patients with abdominal aortic aneurysm in whom significant renal artery stenoses coexisted. Two patients died despite surgery, one patient is clinically stable and the medicament treatment of heart failure is inevitable in the fourth with a left ventricular aneurysm following myocardial infarction. The occurrence or reoccurrence of pulmonary oedema in the absence of other explanation should suggest the possibilty of billateral or unilateral renal artery stenosis requiring renal revascularization for blood pressure regulation as well as for elimination of other manifestations/complications.
Clinical characteristics of the eardrum retraction pocket
Authors: Jesic Snezana , Nesic Vladimir , Djordjevic Vladimir
Published: July 2008

Development of the eardrum retraction pocket, as pathologic finding, depends on Eustachian tube dysfunction, onset of the middle ear infection and site of development of retraction on the eardrum. The study is aimed at: 1. Determining the incidence of eardrum retraction pocket and cholesteatoma within it, as well as at the degree of eardrum retraction; 2. Determining of association between eardrum retraction pocket and changes of the eardrum mucosaand parstensa of the tympanic membrane; 3. Determining of onset and intensity of the bone destruction in eardrum retraction pocket; 4. Examining of Eustachian tube function based on time of mucocilliary transport according to the type of the eardrum retraction pocket. The study is based on the retrospective analysis of the results obtained from the patients treated at the Institute of Oto-Rhino-Laryngology and Maxillofacial Surgery Clinical Centre of Serbia in Belgrade for the diagnosis of the chronic suppurative otitis who underwent otosurgical procedures during the six-year period, from 1996-2001. In our series of 540 patients subjected to otosurgical treatment, the incidence of the retraction pocket of the eardrum was 11.23%. Onset of more severe degree of eardrum retraction was most frequent in the attic. Cholesteatoma was detected in 82.2% of patients of the group with the attic-retraction pocket of the eardrum, as well as in 25% of patients of the group of tensa-sinus retraction pocket of the eardrum. Atrophic changes of the tympanic membrane pars tensa were detected in almost all tensa-sinus retraction pockets of the eardrum. Approximately one half of the attic-retraction pockets of the eardrum were accompanied by eardrum atrophy. Bone destruction of the auditory ossicles was limited to the long process of incus and superior structures of stapes. Time of the mucocilliary transport was significantly longer (p<0.01) in attic-retraction pocket of the eardrum than in tensa-sinus retraction pocket of the eardrum, indicating significance of tube in development of attic-retraction pocket of the tympanic membrane. Reversible changes of the middle ear mucosa were evidenced in three quarters of the tensa-sinus retraction pockets of the eardrum indicating that inflammation is the major factor influencing onset of tensa-sinus retraction pocket of the eardrum.
Some parental characteristics and habits of insulin-dependent diabetes mellitus children
Authors: Sipetic Sandra , Vlajinac Hristina , Kocev Nikola , Radmanovic Slobodan
Published: July 2008

The aim of this case-control study conducted in Belgrade during 1994-1997 was to investigate whether parental demographic characteristics and habits are associated with insulin-dependent diabetes mellitus (IDDM). Case group comprised 105 children up to 16 years old with IDDM and control group comprised 210 children with skin diseases. Cases and controls were individually matched by age (? one year), sex and place of residence (Belgrade). According to %l test results, children with IDDM significantly had five or more family members and they also significantly more frequently had poor socio-economic status than their controls. Higher education of fathers was significantly more frequently reported in diabetic children, in comparison with their controls. Parents of diabetic children were significantly more frequently occupationally exposed to radiation petroleum, and its derivates, organic solvents, dyes and lacquers. During pregnancy mothers of diabetic children significantly more frequently smoked cigarettes and consumed coffee, coca-cola, alcohol and foods containing nitrosamines. Fathers of diabetic children more frequently consumed alcohol.