bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Enalapril on the progression of chronic renal failure in diabetic nephropathy and nephropathies of and other aethiology: A two-year study
Authors: Trbojevic Jasna , Stojimirovic Biljana
Published: July 2008

Chronic renal failure (CRF) is almost always associated with high arterial blood pressure. Adequate control of hypertension slows down the progression of the disease, Inhibitors of angiotenzin-converting enzyme (ACE inhibitors) have proved to be very efficacious in decreasing high blood pressure. The aim of this study was to assess the influence of ACE inhibitor enalapril on the progression of CRF in patients with diabetic nephropathy and nephropathies of other origin. During 1998 and 1999 thirty patients (20 males and 10 females, aged 525+1.3) have been followed-up at the Department of Nephrology, Clinical Centre of Serbia. On regular monthly controls serum creatinine, urea, calcium and protein levels, creatinine clearance, and blood pressure, were measured. All patients were suggested a low protein diet. Progression of the disease was expressed by the slope of the regression line showing reciprocal serum creatinine values. Proteinaemia was significantly higher in diabetic patients after 12 months (p<0.35) but in the next 12 months the difference between groups disappeared. The same patients had significantly lower serum urea (p<0.05) after 24 months and creatinine values (p<0.05) dur ing the whole study. Other variables changed in the same manner and with similar progression in both groups. The direction of slope lines suggested recovery of kidney function in both examined groups. However, a smaller slope in patients with diabetic nephropathy together with other results showed that enalapril had better influence on slowing down the progression of CRF in this group of patients.
Brucellosis - diagnostic dilemma: Case report
Authors: Bojic Biljana , Vujosevic Milica , Nikolic Svetlana , Dulovic Olga , Grebenarevic Jelica , Milinkovic Zoran , Gvozdenovic Jasna
Published: July 2008

The authors present a case of a 20-year old student from Belgrade, who was admitted to the Institute of Infectious Diseases with fever, muscle and spine pains, strong headacke and malice. During the clinical examination bilateral sacroileitis was found. Serological analyses confirmed brucellosis. Epidemiological data showed that she lived in Kosovo and Metohia in 1997, where she consumed diary products from domestic animals this might be the reason of the acquired infection. With appropriate antibiotic therapy (aminoglycoside, doxicyclin, rifampicin), symptomatic therapy and rehabilitation the disease had favorable outcome; there was no recidive. The authors point out the importance of specific microbiological examinations of patients with fever of unknown origin, especially if the patient has the symptoms that are compatible with brucellosis. In our case it was sacroileitis, as a characteristic complication. As brucellosis is endemic in some parts of our country, there is always a possibility of brucellosis in general medical practice.
Rekombinantni humani hormon rasta u lecenju zaostajanja u rastu dece sa smanjenom funkcijom bubrega
Authors: Jovanovic Olga
Published: July 2008

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Genetsko-epidemioloski aspekti tumora mozga kod dece i adolescenata
Authors: Pavlovic Milen , Jerebinski Mirjana , Pekmezovic Tatjana , Janicijevic Milos
Published: July 2008

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Vakcinacija zena u trudnoci i laktaciji
Authors: Medic-Stojanac Snezana , Petrovic Radmilo , Radulovic Tomislav
Published: July 2008

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Terapija zamenom funkcije bubregu u buducnosti
Authors: Peco-Antic Amira
Published: July 2008

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Iskustva u radu s osobama obolelim od raka u terminalnoj fazi bolesti
Authors: Popov Ivan
Published: July 2008

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Causes of death in patients with long outliving period injured in traffic accidents
Authors: Micic Jelena , Nikolic Slobodan , Mihailovic Zoran
Published: July 2008

As long as a direct chain of events can be traced from the injury to the death, then the initial injury must be considered to be the basic cause of death, and this fact may have profound legal implications for both civil compensation and criminal responsibility. Some of the most difficult problems in forensic pathology concern deaths from which posttraumatic complications are disputed as being fatal causative factors. The agony and dying are irreversible dynamic patho-physiological processes. By autopsy only the morphological consequences of these processes could be noted by dissector. The dynamics of dying, direct correlation between initial injury and death, as well as appearance and development of complications provoked by trauma could be established only by clinical medical data. Therefore medical clinical data are critical for forensic pathologists and for solving the problems about the mode and manner of death in cases with long outliving period. Microscopical findings have only academic and scientific importance and are less useful in daily practice. The authors suggest that all complications of injury must be generally involved in autopsy reports, and all severe injuries should separately be registrated both in medical data and autopsy reports. The finding of cause of death must include all observed severe injuries and not only one of the most severe injuries and its complications.
Duchenne's/Becker's muscular dystrophy: Analysis of genotype-feno-type correlation in 28 patients
Authors: Keckarevic Milica , Savic Dusanka , Culjkovic Biljana , Zamurovic Natasa , Major Tamara , Keckarevic Dusan , Todorovic Slobodanka , Romac Stanka
Published: July 2008

Duchenne's and Becker's muscular dystrophy (DMD & BMD) is a X linked disease caused by mutations in the dystrophic gene. DMD is the malign form of the disease, which significantly shortens the lifetime of the patient, while BMD has late onset with slow progression. Sixty five percent of DMD and BMD cases are caused by deletion of one or more exons in the dystrophic gene, while duplications cause these diseases in 6 to 7% of the cases. There are two hot spots for deletions and duplications. These are exons in the proximal part of the gene (3rd to 18th) and exons of a distal part of the gene (45th to 52nd). The remaining 30% of DMD and BMD cases are caused by point mutations, small deletions or inversions in the dystrophic gene. The correlation between School of Medicine, University of Belgrade, Belgrade the severity of the disease and the position of deletion shows that most of the out of frame deletions cause DMD phenotype, while in frame deletions result in BMD pheno-type. We report on the results of 28 non-related DMD and BMD patients. In 57% of cases deletions were detected and all were found in the distal hot spot of the gene. These results suggest that in most of the cases, out of frame deletions produce DMD phenotype while in frame deletions result in BMD phenotype. This is in compliance with data from literature.
Pancreatic fistula through the distal common bile duct
Authors: Colovic Radoje , Grubor Nikica , Masirevic Vesna , Ivic Ljiljana
Published: July 2008

Pancreatic fistula is usually caused by acute or chronic pancreatitis, injury and operations of the pancreas. The pancreatic juice comes either from the main pancreatic duct or from side branches. Extremely rare pancreatic fistula may come through the distal end of the common bile duct that is not properly sutured or ligated after traumatic or operative transaction. We present a 58-year old man who developed a life threatening high output pancreatic fistula through the distal end of the common bile duct that was simply ligated after resection for carcinoma. Pancreatic fistula was developed two weeks after original surgery and after two emergency reoperations for serious bleeding from the stump of the right gastric artery resected and ligated during radical limphadenectomy. The patient was treated conservatively by elevation of the drain- age bag after firm tunnel round the drain was formed so that there was no danger of spillage of the pancreatic juice within abdomen.
Primary biliary cirrhosis: Report
Authors: Filipovic Branka , Opric Miroslav , Milicic Anka , Paranos Svetlana
Published: July 2008

Chronic non-suppurative destructive cholangitis, the so-called primary biliary cirrhosis, is characterised by changes, which occur in intrahepatic bile ducts in early stages and in hepatic parenchyma as the disease progresses. The disease gradually evolves into the full-blown picture of biliary cirrhosis. Primary biliary cirrhosis predominantly affects women between 35 and 60 years of age in all social classes and in all races. Our patient was a woman, old 78 years old who admitted for treatment of hypertrophie cardiomyopathy. During the routine laboratory exploration signs of cholestasis were noted: higher values of alkaline phosphatase and gamma glutamyl transferase, combined with low level of platelets, probably of autoimmune origin. Hypercholesterolaemia (7.8 mmol/L) associated with normal values of triglycerides was observed. The main criterion for establishing the diagnosis of primary biliary cirrhosis was the titer of antimito-chondrial antibodies in the serum, which was 1:640. At the same time, she had a urinary infection, caused by Escherichia coli, which confirmed possible relationship between primary biliary cirrhosis and occurence of some Gramm negative bacteria, reported elsewhere. On the other hand, biopsy of the liver was just an auxiliary method, serving for the confirmation of diagnosis. Ursodeoxycholic acid was used as the main drug in the therapy of primary biliary cirrhosis. This case of primary biliary cirrhosis is a worth report because of the comorbidity with cardiac symptoms, which were covering symptoms of hepatic disorder.
Cardiac echinococcosis
Authors: Ivanovic-Krstic Branislava , Kalimanovska-Ostric Dimitra , Vujisic-Tesic Bosiljka , Jovanovic Dragana , Petrovic Predrag , Cvetkovic-Matic Danica
Published: July 2008

Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm) in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.
Cistatin C i proteini male mace molekula kao novi markeri za procenu jacine filtracije u glomerulima
Authors: Jovanovic Dijana
Published: July 2008

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Masna embolija u forenzickoj patologiji
Authors: Nikolic Slobodan , Micic Jelena , Savic Slobodan
Published: July 2008

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Prognoza bolesnika s potencijalno izlecivim karcinomom kolorektuma
Authors: Micev Marjan , Krivokapic Zoran , Popov Ivan
Published: July 2008

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Extracorporeal shock waves lithotripsy of urinary organs in patients with one kidney
Authors: Zogovic Jezdimir
Published: July 2008

Extracorporeal Shock Waves Lithotripsy (ESWL) is a method of choice in the treatment of lithiasis. Surgical treatment is reduced to minimum, which in our case means 1-2%. Contraindications for using this method are: blood coagulation disorders, manifest tuberculosis, pregnancy, over obesity. Thanks to appropriate indications and technique which is used in an adequate way as well as to various endurological manipulations, removal of a stone by this method is safe, trauma is minimised, which is very important for patients with one kidney. During the last three years, usually in hospital conditions, 57 patients were treated in this way. Removal of a stone was performed by Extracorporeal Shock Waves Lithotripsy as mono therapy in 30 (53%) patients; Extracorporeal Shock Waves Lithotripsy by using Double-J catheter in 16 (28%) patients; Extracorporeal Lithotripsy with urine derivation by percutaneous nephrostome in 11 (19%) patients. Endurological methods were used in 27 patients. Disintegration of stone was performed in the proper way. Full success was reached. Two patients had incrustation of ureteral catheter which had to be removed by surgery. In two other patients with inferior function of one kidney, after brief obstruction, hemodialisis was performed. Our results confirm that this method is nonaggressive, tech nically perfect for disintegration of urineorgans stone on all levels followed by small complications which are often solved by endoscopie manipulations.
Asimptomska karotidna bolest - rano otkrivanje
Authors: Radak Djordje , Rancic Zoran , Stojanovic Dragan
Published: July 2008

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Uloga postoperacione zracne terapije u lecenju ranog karcinoma dojke
Authors: Mladenovic Jasmina , Borojevic Nenad , Sasic Jelena
Published: July 2008

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Relationship of body fatty mass with lipid status in obese working population
Authors: Ivanov Zoran , Ivanov Milena
Published: July 2008

INTRODUCTION Obesity can be defined as an excessive accumulation of health threatening body fat, caused by positive energetic balance. It can be classified according to body mass index as normal body mass, excessive body mass, significant obesity and extreme obesity. According to WHR (waist-hip ratio), it can be classified to android and gynoid type depending on fat tissue distribution. Android type has greater frequency of cardiovascular and metabolic complications, as is occurrence of premature atherosclerosis. As metabolic complications we consider lipid status disorders in obese workers, and these complications are related to body composition. MATERIAL AND METHODS Among 331 workers, we separated 95 persons with BMI > 30 kg/m2. This group was classified according to gender, their body composition has been measured using bioelectri-cal impedance method and, subsequently cholesterol, triglycerides, HDL and LDL levels were determined, searching for relationship of body composition with lipid status fractions p< 0.05. RESULTS High body fatty was found in 33.03% of male and in 37.48% of female subjects. It was found that in male subjects cholesterol levels (6.70 mml/L),triglycerides (2.56 mml/L), limit values of LDL (3.93 mml/Lc and limit values of HDL (1.16 mml/L) were highly risky. Positive insignificant relationship of body fatty mass with cholesterol, triglycerides, LDL, but not with HDL was found. DISCUSSION Results point to highly risky limit values of lipid parameters in male and female subjects. These values can be explained by older age of subjects, their way of life and nutrition regimen, significant comorbidity in this group, and influence on working ability. CONSLUSION It was found that obese male and female subjects have high values of body fatty mass, Male subjects have highly risky levels of lipid status fractions, while in female subjects these are limit values. Insignificant positive correlation of body fatty mass with lipid status fractions in tested population was found. The obtained results are significant regarding morbidity expectation and studies of complications of obese working population, as well as in judgment of working ability.
Preoperative radiologic evaluation of renal cell carcinoma
Authors: Ignjatovic Ivan , Potic Branko , Stojkovic Ivica , Markovic Nebojsa , Stamenic Tomislav
Published: July 2008

Renal cell carcinoma is frequently a matter of urological interest. In recent years there were significant improvements regarding the earlier diagnosis more precise preoperative staging and appropriate therapy. One hundred patients (42-78 years old) with the preoperative diagnosis of renal cell carcinoma were analyzed. Preoperative radiological evaluation included transabdominal ultrasound, intravenous urography, computer-assisted tomography, and angiography. In all patients after radical nephrectomy pathohistological diagnosis was established and patients with the confirmed renal cell carcinoma tumor staging was performed. All histological findings were compared with the preoperative results of radiological examinations. Reliability of all of them is separately determined. Our results confirmed that the most efficient method of preoperative staging was computer-assisted tomography (accuracy 93%). Diagnostic methods that were previously used like intravenous urography and angiography, were not useful for routine diagnostic purposes. Ultrasound is a precise but not an enough informative diagnostic tool (accuracy 87%). Combine used of both ultrasound and contrast computer-assisted tomography is cost-effective, and an enough precise combination for everyday use.
Otogenic brain abscess
Authors: Nesic Vladimir , Janosevic Ljiljana , Stojicic Gojko , Janosevic Slobodanka , Rasulic Lukas , Babac Snezana , Sladoje Radmila
Published: July 2008

Chronic inflammation of the middle ear is the most frequent cause of otogenic complications. Meningitis is the most frequent otogenic intracranial complication, followed by otogenic brain abscesses, while other complications are significantly less frequent. The study is aimed at presenting clinical casuistry of otogenic brain abscesses consequential to chronic suppurative otitis in order to evaluate modern diagnostic and therapeutic possibilities. The study was retrospective and included the patients treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery of the Clinical Centre of Serbia diagnosed with otogenic brain abscess during a five-year period (1996-2000). A total of 9 patients (male to female ratio 8:1), aged 16-68 years, were assessed. The following parameters were analyzed: sex, age groups, place of living, occupation number of hospitalizations, diagnostic procedures, symptoms and clinical signs of otogenic complications, other otogenic complications associated with brain abscess, endocranial localization of otogenic abscess therapeutic procedures (oto-surgical treatment) and intraoperative otological findings. In our group of patients, otogenic brain abscesses were significantly more frequent in male patients in their forties, with median age of 33.5 years. As for the place of living, the patients from the provinces were more frequent, while with respect to their level of education, those with elementary or high school degrees were predominant. The inflammatory process most frequently spread into the endocranium through direct destruction of the bone walls of the middle ear. Diagnostic procedures included history, clinical otorhinolaryngological examination audiological and vestibulological assessment, neurological ophthalmolog-ic and radiographie examinations (CT, MRI). CT is the most reliable diagnostic tool enabling localization of the change, timing of surgical treatment and monitoring of surgical success. Presence of other otogenic complications associated with brain abscess was evidenced in six of our patients. Cerebral localization of abscess was more frequent (7). Four patients underwent previous oto-surgical treatment. The treatment included primary neurosurgical approach (radical extirpation or abscess drainage), followed by radical oto-surgical treatment after improvement of the patient's general condition.
Rabdomiosarkomi nazoparanazalne regije
Authors: Babac Snezana , Stojicic Gojko , Janosevic Ljiljana , Janosevic Slobodanka , Nesic Vladimir , Sladoje Radmila
Published: July 2008

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Juvenile nasopharyngeal angiofibroma: Clinical diagnosis and treatment experience
Authors: Sladoje Radmila , Stojicic Gojko , Janosevic Ljiljana , Janosevic Slobodanka , Nesic Vladimir , Babac Snezana
Published: July 2008

Juvenile nasopharyngeal angiofibroma is an infrequent epi-pharyngeal tumor necessitating particular diagnostic and therapeutic procedures in comparison to other benign epipharyngeal tumors due to its expansive growth tendency. Our retrospective study is aimed at presenting clinical casuistry of the tumor in order to evaluate modern diagnostic and therapeutic possibilities. The study included 13 male patients, aged 13-24 years, who were hospitalized, diagnostically assessed and surgically treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia over the period 1990 - June 2001. The following parameters were analyzed: sex, age groups, preoperative symptoms of the disease, diagnostic methods, embolization, local tumor spreading, number and time of tumor relapses and surgical approach.
Giant liver abscess due to almost asymptomatic common bile duct stone
Authors: Colovic Radoje , Grubor Nikica , Colovic Natasa
Published: July 2008

Solitary pyogenic liver abscess is usually caused by a meta-static infection through the portal blood flow or through the hepatic arterial blood flow from extra-abdominal pyogenic foci. Besides, it may be the result of local inflammatory diseases, such as cholecystitis, hydatid cyst, haematomas particularly with retained foreign bodies, etc. Suppurative cholangitis usually causes multiple pyogenic liver abscesses. Solitary pyogenic abscess is rarely caused by cholangitis, but practically always by suppurative cholangitis. Giant pyogenic liver abscess due to asymptomatic or mild cholangitis is a rarity. We present on a 63 year old man who developed a giant solitary pyogenic liver abscess in whom no other possible cause could be found or anticipated except practically almost asymptomatic choledocholithiasis accompanied with mild elevation of bilirubin content alkaline phosphatase and gamma-GT. The patient was successfully treated operatively. Over 1800 ml. of pus was aspirated from the abscess cavity. Operative cholangiography performed in spite of the absence of gall bladder stones undilated and noninflamed common bile duct stone showed a small nonobstructing distal common bile duct stone. The duct was not dilated, the bile was clear and there were no signs of cholangitis in the inside of the common bile duct. Cholecystectomy and abscess cavity drainage led to uneventful recovery. The patient has been symptom-free for more than 3.5 years.
Da li je vanmatericna trudnoca moguca komplikacija hlamidijske infekcije?
Authors: Djukic Slobodanka , Vivoda Maja , Arsic Biljana , Garalejic Eliana , Opavski Natasa , Mijac Vera , Ranin Lazar
Published: July 2008

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Chronic renal failure (CRF) in children in Jugoslavia
Authors: Peco-Antic Amira , Bogdanovic Radovan , Golubovic Emilija , Djapic Milica
Published: July 2008

The aim of this study was to analyse the demographic variables of chronic non-terminal (CRF) and terminal (TRF) renal failure patients (pts) younger than 19 years treated in Serbia in June 2001. The prevalence of CRF pts was registered as 4,7 per million total population (pmtp) or 14,1 per million child population (pmcp) while corresponding values for TRF pts were 4,5 pmtp or 13,5 pmcp. The incidence of TRF pts during the period Jan.2000-Jan.2002 was 4,35 pmcp. Boys dominated only among CRF pts (34:14); 60,4% beeing between the ages of 6 and 19 yrs while at the time of diagnosis of HBI, 33,3 % of boys were yanger than 2 yrs.The causes of CRF were: reflux nephropathy 58,3%, congenital kidney disease 16,7%, familial/hereditary 14,6% glomerulonephritis 6,2% and Willms tu 4,1%. Reflux nephropathy was also the most common underlying disease of TRF accounted for 36,9% of total cases while glomerulonephritis was responsible for 23,9 %. Reflux nephropathy was associated with neural tube defect in 53,3% and with congenital lower urinary tract obstruction in 66,7%. The most of CRF (81,25%) and TRF pts (95,6%) were from Serbia, the others were from Monte Negro and Republic Srpska. The most of CRF (65%) and TRF (80%) pts were treated in University Children?s Hospital in Belgrade. Of CRF pts 46% had serum sreatinine 100-200 ?mol/l, in 11% of pts it was 400-600 ?mol/l and 2% of pts were in pre-terminal CRF. One third of CRF pts had proteinuria 150-500 mg/l, and second third had proteinuria greater of 1000 mg/l. Anemia was present in 54% of CRf pts, and arterial hypertension in 56%. Hemodialysis was dominant treatment modality for TRF pts and only 23,9% had functioning transplant. Conclusion: This is the first national study of demographic characteristics of pediatric CRF in Serbia. Since its prevalence is considerably lower than that in Western and North European countries the true prevalence is some what higher. The increasing incidence of pediatric TRF from 2,85 pmcp to 4,35 pmcp reflect better diagnosis and treatment of these patients in the recent years.
Esotropia and high ac/a ratio; therapy
Authors: Risovic Dusica
Published: July 2008

We have treated 55 children with accommodative esotropia and high AC/A ratio with progressive addition lenses, measured by heterophoria method. All of them wear full hyperopic refraction for distance and addition of +1,00 to 3,5 spheres for near vision. The minimal add that allowed the maximal reduction in the near deviation was prescribed appointed to follow-up control three months after the use of the new lenses, and thereafter every six months. A progressive reduction of the abnormally high AC/A ratio (difference between distance and near deviation measurements) showed 45 children (81,81%) but ten of them (18,19%) deteriorated into non- accommodative esotropia requiring surgical treatment. The age of initial use of progressive-addition lenses ranged from 26 months to 7 years (average: 63,2 months). The age of onset of the esotropia ranged from 7 months to 82 months (average: 28,7 months). The initial add was of +3,00 diopters in 39 children (70,8%). The mean add prescription for whole study group was 2,96 diopters. A progressive improvement of the AC/A ratio achieving normal after a mean of 18 to 24 months in a significant number of cases.
Subjective acoustic analysis of tumor’s dysphonia using 'rbh' scale
Authors: Mitrovic Slobodan
Published: July 2008

The goal of psycho acoustic or subjective voice analysis, in a phoniater's everyday work, is to describe a subjective experience based on the physical parameters created in the process of phonation. The work was a clinical prospective study and the sample consisted of 80 people of both sexes, 40 people with benign and pseudo tumors of vocal cords and 40 people with malign tumors of vocal cords. All the patients were otorinolaringologically and phoniatrically examined. The subjective acoustic analysis was done with the patients pronouncing numbers from 1 to 10 in the comfortable zone. Afterwards, the quality of the voices was estimated in RBH scale. The subjective acoustic analysis found roughness in the voices of 87,50% patients in the first group and the most frequent value was Mod=3 ( intense roughness), 62,50% patients. Hoarseness was present in 90,00 % cases , with largest value Mod=2 (moderate hoarseness), 55,00% patients. In the second group, roughness existed in the voices of 70,00% patients, most often intense one (Mod=3), 30,00% patients. Hoarseness existed in 95,00% cases, 45,00% with moderate (Mod=2) and 35,00% with intense one. T test showed that there is a statistically significant difference between the strength of the roughness determined by the subjective acoustic analysis in the first and the second group, with p<0,01. The difference between the strength of the hoarseness in the first and the second group is also statistically significant, with p<0,01. All the growths on vocal cords irrespective of their nature change the characteristics of the voice, most of all its clearness. In cases of vocal cords tumors, by the subjective acoustic analysis, i.e. the perception of the psycho physiological characteristics of voice, a human ear can register pathological phenomena of the voice but cannot determine the character of the growth on the vocal cords.
"Skip metastasis" of rectosigmoidal cancer
Authors: Vekic Berislav , Radovanovic Dragan , Cvetanovic Miroslav , Zivanovic Jovan , Pavlovic Ivan
Published: July 2008

Aim: In this study we want to point out the existence and significance of skip metastasis of rectosimoid cancer. Material and methods: Seventy patinents with verified rectosigmoidal adenocarcinoma, treated in 5- years period, are included in this study. Diagnose was made upon physical examination, barium enema, rectosigmoidoscopy with positive biopsy and finding of isolated lymph node metastasis. Results: Skip metastasis were found within 6 patients (8.6%); 4 of them were males and 2 females, with average age 67 years. Overall, 13 metastasis were isolated; one patient had them 3 and five patinets had 2 skip metastasis. Conclusion: Radical lymphadenectomy of patinets with rectosimoidal cancer requires dissection of lymph nodes along inferior mesenteric artery and its legation on origin, as much as dissection of paraaortal and paracaval lymph nodes.
Treatment of post-operative pain in old oncology patients with intravenous application of 50% glucose solution
Authors: Jovanovic Nikola , Dzodic Radan , Celebic Aleksandar , Zegarac Milan , Djurisic Igor , Stojiljkovic Dejan
Published: July 2008

Postoperative pain is the most important factor od so called "tumor promotive effect of surgery" ie. of endocrine-metabolic changes having the consequence drop in immune, antiinfective and antitumor defense. Due to presence of organic involutive changes, old people (? 65 years), often have serious side effects during application of usual analgetics. Since hypertonic glucose (33%) given i.v. or per os, works analgesically in small children there is assumption that it can be used in treatment of postoperative pain in old oncology patients. We tested the hypothesis that postoperative pain in old oncology patients can be treated with i.v. application of 50% of glucose solution. 37 oncology patients over 65 years, 26 females and 11 males, operated for breast cancer and soft tissue cancer, werw investigated. Average age of the patients was 72?4 years. 50% Glucose solution was given in two boluses of 20 ml each: the first bolus was given to all patients at the end of anesthesia and the other bolus was given individually after appearance of post-operative pain. Pain intensity (in coefficients of the visual analogue scale VAK = 1-100) and its characteristics were tested by oral testing of operated patients: after weaking from anesthesia, after the first appearance of the pain and 15 minutes after giving of the second glucose bolus. None patient had pain weaking from anesthesia. All tested patients experienced pain during the first 70 minutes and it could be categorized as very strong pain (=82 VAK). The pain was decreased with another glucose bolus by approximately (=56% VAK) so it was classifies in category of bearable pains (=36 VAK). In 9 patients (24,3%) the pain had neuropatic component (filing of "burning") which could not be eliminated by hypertonic glucose but only with application of tramadol. Activation of the central cholinergic transmission is the most significant mechanism of analgesic glucose effect, but, probably there is another one facilitation of entrence of formerly given analgesics in the brain cells. As energetic supstrate, entering all organism cells, glucose could make easier intracell breakthrough of any other analgesic drug, of the peripheral or central action, and final antipain effect could be potential or additional one. It was concluded that 40 ml of 50% glucose solution given in two identical boluses, has good analgesic effect in treatment of postoperative pain in old oncology patients: the pain was not completely eliminated, but it was significantly decreased and became tolerable. Hypertonic glucose neiter eliminates, nor decreases neuropatic component of the pain, so, when the pain appears the therapy should.
Adhesion molecules in Wilms tumor (part I)
Authors: Basta-Jovanovic Gordana , Radojevic Sanja , Djuricic Slavisa
Published: July 2008

Adhesion molekues are glicoprotees which have extracellular, transmembranous and intracytoplasmatic part. They show their basic role is in cell interaction in the tissue on one side and between cells and matrix on the other side. They have an important role in stabile integrity of tumor tissue, as well as in differenciation, prolifferation, apoptosis and metastatic spread of tumorous cells. Since there is very little known facts about adhesion molecule detection and about its significance in Wilms tumor, our intention was to collect all known achievements which could be of importance for better understanding of tumors nature and successful treatment. Especially because of well known fact that in 15% Wilms tumors there are b-catenin mutations, which indicates that there is a disorder in Wnt signal paththat plays an important role in Wilms tumor genesis.
Nutritive support in short Bowel syndrome (sbs)
Authors: Simic Dusica , Djurisic Nebojsa
Published: July 2008

Short bowel syndrome most commonly result after bowel resection for necrosis of the bowel. It may be caused by arterial or venous thrombosis, volvolus and in children, necrotizing enterocolitis. The other causes are Crohn,s disease intestinal atresia. The factors influencing the risk on short bowel syndrome are the remaining length of the small bowel, the age of onset, the length of the colon, the presence or absence of the ileo-coecal valve and the time after resection. Besides nutritional deficiencies there some other consequences of extensive resections of the small intestine (gastric acid hypersecretion, d-lactic acidosis, nephrolithiasis, cholelithiasis), which must be diagnosed, treated, and if possible, prevented. With current therapy most patients with short bowel have normal body mass index and good quality of life.
Appearance of urology at the beginining of xxth century -from the general surgeon up to the highly trained specialist
Authors: Ignjatovic Ivan
Published: July 2008

Evolvement of urology as a separate scientific discipline depends on several factors. Endoscopic diagnostics, radiological diagnostics, and operative techniques in general surgery, had provided an ability to perform more complex and longer operations. Urology had evolved from the great schools of surgery in Germany and France, and their the most important surgeons, who were intersted in urological surgery. The first endoscope was introduced in 1806, and received today?s form in 1879. Application of "X" rays in medicine started in 1895, and it was later applied as a cystography, retrograde pyelography as well as intravenous urography. The most important thing for the operative technique evolution were application of anhestesia, asepsis and new hemostatic devices. During the one century long development, urology had passed the way from completely unknown field, up to the discipline with the best diagnostic preciseness.
Allergy to cephalosporin antibiotics in children
Authors: Atanaskovic-Markovic Marina , Nestorovic Branimir
Published: July 2008

A particular problem is the safety of administering cephalosporins to penicillin-allergic children, because cephalosporin allergenic determinants have not been properly identified. Cephalosporin antibiotics are widely used to treat common infections and are often the first-line prophylaxis before many types of surgery. So the arm of this study is to determine the frequency of allergic reactions of anaphylactic type to cephalosporins and their cross-reactivity with penicillins. At University Children?s Hospital in Belgrade a group of 1,170 children with suspected anaphylactic allergic reaction to penicillins and/or cephalosporins were tested for the last eight years. Skin tests were performed with standard concentration of penicillins and cephalosporins. In children where skin tests were negative single-blind placebo-controlled challenges were performed. In case of positive skin tests further examinations were interrupted and the children were considered allergic to that drug. The frequency of anaphylactic allergic reactions to cephalosporins is 0.2 % to 17 %, and depends on cephalosporins generation. The cross-reactivity between cephalosporins and penicillins is 0.1 % to 14.5 %, and among cephalosporins is 0 % to 11.7 %.
Relevance of vestibulospinal tests after unilateral neurolabyrinthitis
Authors: Babic Borivoj
Published: July 2008

In this paper we wanted to assess clinical relevance of two vestibulospinal tests: standing test (derived from Romberg test) and past pointing test. In retrospective and prospective study 42 patients have been tested with standing test and 50 patients with past pointing test. All patients suffered from unilateral neurolabyrinthitis that had started from one day to two years prior to examination. All patients had unilateral areflexion, or hyporeflexion on caloric test using 10?C water. Control group consisted of 32 healthy individuals for both tests. Results show that both tests correctly indicate side of the lesion but only during first week of illness. Moreover, even during that first week sensitivity of both tests was below 50 %, which means that more then half results from patients fall within normal findings. We conclude that vestibulospinal tests do not deserve prominent place in assessing patients with vestibular syndrom. Conclusions must be made according to findings obtained from much more precise vestibuloocular tests.
Endogene reinfection as a possible cause of recurrent genital candidose in female patients
Authors: Tasic Suzana , Miladinovic-Tasic Natasa , Tasic Aleksandar
Published: July 2008

The cause of primary, recurrent genital candidosis (RGC), that 5 % of the female population was afflicted with, is still unknown. It is not clear whether RGC is a result of reifection or infection recidive caused by Candida sp. The goal of the study is to examine Candida presence in women?s genital and intestinal tract; by resistotypization of the same isolated species of Candida fungi to prove their identity as well as the validity of the stated thesis that endogenous reinfection may be one of the possible causes of RGC. The study included 70 women (T-group) afflicted with primary RGC who, at the moment of the examination, were in the phase of manifest infection. In the control group there were 70 women (C-group) not afflicted with RGC. The microbiological test consisted of the microscopic and culture examination of women?s genital and intestinal material. The Candida species were differentiated according to the germination test and the biochemical activity measured by commercial Candi-Fast-test (Mycoplasma International France) and Vitec-AMS-system (bioMerieux, France). Candi-Fast test examined the sensitivity of Candida species to antymicotics and determined the resistotypes of isolated species. The study did not show statistically significant difference between examined groups in terms of the Candida presence in intestinal tract. The Candida colonization of intestinal mucosa was proved in 24 women (34.28 %) with RGC. Eighteen women (25.71 %) of the control group, had Candida sp. in intestinal tract. The most frequent RGC agent, as well as most frequent colonizer of intestinal mucosa is Candida albicans (C. albicans - RGC - 84.28 %; T-group - intestinal tract - C. albicans - 87.50 %; C-group - intestinal tract - C. albicans - 94.44 %). In 20 women with RGC there was a presence of identical resistotypes of isolated Candida sp. Identical resistotypes of C. albicans was found in 19 women of the test group, in their genital and intestinal tract. Only in one patient it was recorded the same resistance types of C. tropicalis. In four patients Candida species isolated from genital and intestinal material were not identical. In two women with RGC C. albicans on vaginal mucosa was accompanied by C. glabrata in intestinal tract, while in two more women the presence of various resistotypes C. albicans was identified in genital and intestinal tract.
The level of knowledge of students of medical faculty kragujevac about nosocomial infections
Authors: Ilic Milena , Markovic-Denic Ljiljana , Radojkovic Aleksandra , Kocic Sanja
Published: July 2008

OBJECTIVE: To investigate differences in clinical and pre-clinical medical students' knowledge of nosocomial infections (NI). DESIGN: Cross-sectional survey. RESULTS: Questionnaires were answered and returned by 352 of 453 student (77.7 %). The results indicated that students knew the definition of NI (70.1 % correct answers) and their reservoirs (86 %). The bacteria as etiological agents was the most frequent answer (76.4 %), but 30.9 % students did not knew at least one multidrug-resistant bacteria. About one half of the students (54.4 %) knew that contact was the most frequent mode of NI transmission, but hand washing as preventive measure was cited by only 18.8 % of students. Significantly statistical differences about NI in our country, etiology NI and preventive measures, and perception of risk for transmission of hepatitis B for health-care personnel were founded by year of training, by expectation that final-year medical students as more successfully, while pre-clinical students knew more about mode of NI transmission. Pre-clinical students who had previously finished nursing school knew more about multidrug-resistant bacteria than those who had finished some other secondary school, but showed a lower knowledge about definition and most important preventive measures of NI. Clinical students who had previously finished nursing school knew more about frequency NI in our country, reservoirs and preventive measures of NI than those who had finished some other secondary school. CONCLUSION: Data support the need for additional information about nosocomial infections, especially practical work in prevention, in order to get complete knowledge about nosocomial infections.
Coagulation disorders in the patients with deep vein thrombosis of lower extremity
Authors: Milic Dragan , Pejic Miljko , Stojiljkovic Danilo , Karanikolic Aleksandar , Zivic Sasa , Visnjic Aleksandar
Published: July 2008

PURPOSE Venous thromboembolism is a relevant social and health care problem for its high incidence, pulmonary embolism-related mortality and long-term sequelae which may be disabling (post-thrombotic syndrome and ulceration). PROCEDURES The aim of our work was to establish the presence of coagulation disorders (hypercoagulable states) in the patients with deep vein thrombosis (DVT) of the leg. Prospectively we have analyzed a group of 30 patients with echosono-graphicaly verified DVT of the leg who were admitted to the department of vascular surgery from August 1st 2000 to July 31st 2001.The following parameters were monitored: prothrombin time (PT) partial thromboplastin time (PTT), fibrinogen (Fib), alpha 2 antiplasmin (A-2 AP), D-dimer (DD), antithrombin III (AT III) and factor VII. FINDINGS Activation of the coagulation process was registered. The values of monitored coagulation parameters are shown in table 1. Plasma levels of monitored parameters in the patients with DVT of the leg were significantly higher than in the control subjects. CONCLUSION In patients with a DVT a hypercoagulable state is common finding. Some parameters of coagulation activity such as D-dimer might be of great interest in the diagnostic strategy of DVT.
Renovascular hypertension in children with neurofibromatosis type 1
Authors: Peco-Antic Amira , Krstic Zoran , Boric Zivko , Sagic Dragan , Kostic Mirjana , Jovanovic Olga , Kruscic Divna , Spasojevic Brankica , Paripovic Dusan
Published: July 2008

Arterial hypertension in pediatric patients with neurofibromatosis type 1 (NF 1) is usually due to renal artery stenosis (RAS) mainly involving the proximal part of the vessel. The treatment modalities are highly individualized. In severe and/or bilateral RAS, antihypertensive drugs are either ineffective or have the potential risk for acute renal failure, while percutaneous transluminal angioplasty (PTA) has limited success due to the ostial localization of RAS and the tough fibrotic tissue involved that is refractory to dilatation Renal autotransplantation has potential advantages when medical control and PTA/or bypass techniques failed. Here we report 5 year-old girl with NF 1 and hyponatremic hypertensive syndrome due to severe bilateral disease, occluded proximal part of the right artery and ostial stenosis (80%) of the left one. Only left kidney was identified on 99 in Tc DTP A, but the right one was visualized on the renal ultrasonography and in the late phase of arterial renography due to well developed collateral circulation. Multiple antihyper-tensive drugs (nifedipine, labetolol and minoxidil) in maximal doses and PTA failed to normalize BP while short term therapy with ACEIwith NF1 and hyponatremic hypertensive syndrome due to severe bilateral renovascular disease; occluded proximal part of the right renal artery and ostial stenosis (80%) of the left one. Only left kidney was identified on 99m Tc DTPA, but the right one was visualized on the renal ultrasonography and in the late phase of arterial renography due to well developed collateral circulation. Multiple antyphypertensive drugs (nifedipine, labetolol and minoxidil) in maximal doses and PTA failed to normalize BP while. short term therapy with ACEI, captopril induced transient acute renal failure. Autotransplantation of right kidney saved its function and improved BP control. Our current case Autotransplantation of right kidney saved its function and improved BP control. Our current case is illustrative for a difficult management of renovascular hypertension in children with NF1. This is the first and up to now the only case of autotransplantation performed in Yugoslavia.
Iga nephropathy: clinical-morphologic correlation
Authors: Basta-Jovanovic Gordana , Bogdanovic Radovan , Radojevic Sanja , Nesic Vidosava
Published: July 2008

IgA nephropathy is glomerular disease caracterized by the presence morphologic changes as wella as the prognosis is in correlation with of IgA dominant or codominant imunoglobuline deposits in glomer-the amount of proteinuria. The prognosis is better in children. ular mesangium which can be demostrated by immunofluorescence. Clinical manifestations of IgA nephropathy in the majority of cases is hematuria which can be macro or mikroskopic, isolated or combined with proteinuria, which can be of nephrotic range. The prognosis o the disease is better if presented with haematuria. Intensity of????.
Neurodevelopmental correlates in schizophrenia
Authors: Ivkovic Maja , Damjanovic Aleksandar , Paunovic Vladimir
Published: July 2008

Contemporary aetiopathogenetic considerations, based on neuro-imaging genetic and developmental neurobiology studies, suggest neurodevelopmental origin of schizophrenia. Several lines of evidence including structural abnormalities on in vivo brain imaging, the excess of prenatal and obstetric complications and the association of congenital and minor physical anomalies with schizophrenia, strongly indicate the neurodevelopmental pathogenesis of schizophrenia. On the other hand, controversial concept of psychotic continuum suggests schizophrenia and depression sharing the same genetic contribution to the pathogenesis. If this would be the case, depression could also be considered as neuro developmental disorder. The aims of the study were to investigate the association between: a) pregnancy and birth complications (PBC), and b) minor physical anomalies (MPA) and schizophrenia or depression. Experimental groups consisted of 60 schizophrenic, 28 major depression patients and 30 healthy controls. All patients were diagnosed according to DSM-IV. Schizophrenic group was divided with regard to PANSS score into positive (n=32) and negative form (n=28) subgroups. PBC information were gathered from maternal recall while MPA were examined by using Waldrop scale for adults. The results showed that negative and positive schizophrenic subgroups had significantly more PBC than depressive group (p<0,05), as well than controls (p<0,001; p<0,05; respectively). There was no significant trend for more PBC in negative than in positive subgroup. All schizophrenic patients had higher rates of MPA than depressives (p<0,05). This trend for more MPA was not significant in comparison with healthy controls. These findings suggest that schizophrenia, especially its negative forms, could be considered as a member of the spectrum of neuro developmental disorders, which does not seem to be the case with depression. PBC and MPA could also be valuable in evaluation of risks for schizophrenia and possible predictive indicators of its development.