The histologic finding of teratoma occures in aproximately 40% of all postchemotherapy retroperitoneal lymphadenectomy (PC-RPLA) for disseminated nonseminomatous testicular tumors (NSTT). We evaluated patients undergoing PCRPLA for teratoma to determine risk factors for recurrence and clinical outcome. Among a survey of 193 patients submitted to PC-RPLA due to metastatic NSTT from 1980-2005, we identified 82 patients (42%) who were found to have only teratoma in the retroperitoneum. Sixty-seven patients (82%) received only induction cisplatin-based chemotherapy, and 15 (18%) required 2nd line chemotherapy. PC-RPLA histology revealed mature teratoma (MT) in 86%, immature teratoma (IMT) in 12% and teratoma with malignant transformation (TMT) in 2%. Sixteen patients (19%) relapsed within median free interval of 22 months. Among 13 patients submitted to redoRPLA, discordant histology occurred in 6 patients (46%) (2 TMT, 4 viable germ cell tumors [GCT]), all with worst histology in comparison to primary RPLA. One relapsing patient with only elevated serum tumor markers (STMs) achieved complete response with chemotherapy alone. Two patients relapsed at 21 and 74 months with widespread metastasis and died despite salvage chemotherapy. Seven of 13 patients (54%) who were rendered free of disease (FOD) with redo-RPLA, relapsed again. All but one died despite salvage treatment (2 of chemotherapy related toxicity) within mean survival time (MST) of 86.7+/-26.1 (95% confidence interval [CI], 98.79- 149.21). At mean follow-up (MFU) of 135+/-62.6 months (95% CI, 98.79-149.21), alive and free of disease (AFD) are 90% patients. The probability of being reccurence-free at 5- and 10- year was 87% and 81%, respectively. The 5- and 10- year probability of disease speciphic survival (DSS) were 98% and 89%, respectively. On multivariate analysis residual mass size (p<0.005) and worse IGCCCG risk group (p=0.01) predicted disease recurrence. Patients with residual teratoma after PC-RPLA continue to exibit a 19% risk of recurrence even 10 years after RPLA, with 46% recurrence being with worse histology. These data support that these patients should undergo long-term surveillance of their retroperitoneum in the setting of a large residual mass or elevated IGCCCG classification risk.

The aim of our study was to determine whether there is a relationship of flow through arteriovenous fistula and adequacy of dialysis in patients treated with repeated hemodialysis. The study included 37 patients who were on the program of repeated hemodialysis for more than three months. Patients were divided into two groups according to the flow through the arteriovenous fistula. For each patient, the observed parameters were recorded at baseline and after six months. In both phases of the study, more patients who had reduced flow through the fistula had inadequate dialysis but none of these differences reached statistical significance. The frequency of abnormal values of laboratory parameters was higher in patients who had reduced flow through the fistula, but these differences were not significant in the first phase of the study. Between the two phases of the study in patients with adequate flow through the fistula, there was a reduction in the frequency of pathological values of laboratory parameters, and in the group of the patients with reduced flow rate the frequences remained the same or increased, so that in the second phase of the study the incidence of hypocalcemia was significantly higher in patients with low flow. Satisfactory flow through the vascular access is important, but not decisive factor for good dialysis adequacy and must be viewed within the context of other clinical and laboratory parameters.

Nonspeci¿ c interstitial pneumonia is a type of idiopathic interstitial pneumonia. By de¿ nition, the cases of nonspeci¿ c interstitial pneumonia are those which cannot be classi¿ ed as any other type of interstitial pneumonia. The Material of the investigation included 12 transbronchial biopsy lung samples. The quantity, structure and distribution of speci¿ c cellular elements were determined semiquantitatively, recognizing three levels of the lesions’ intensity: mild/ poor, moderate, and intense/abundant. The interalveolar septa were most frequently moderately thickened (50% of the cases) due to the presence of inÀ ammatory cells and multiplied connective. Of the inÀ ammatory cells, lymphocytes were most common and greatest in quantity (abundant, moderate and poor in 4, 5, and 3 cases respectively), followed by plasma cells and macrophages. The septal connective was moderately and mildly multiplied in 2 and 4 cases respectively. The lumen of the alveoli was in¿ ltrated by lymphocytes and macrophages, while poor peribronchial and perivascular lymphocyte in¿ ltrates were most commonly found. The interalveolar septa were most frequently moderately thickened due to the presence of chronic inÀ ammatory cells, predominantly lymphocytes, as well as to mildly-to-moderately multiplied connective. The lymphocytes usually permeated the septa diffusely. Bronchiolar and blood vessel ¿ ndings were nonspeci¿ c.

The aim of this paper is to show our results in the treatment of femur neck fractures in patients on hemodialysis. The femur neck fractures are more common in patients on hemodialysis than in patients without chronic renal failure. From the year 2000. to 2012, in the Traumatologic center of the CHC Zemun, 12 patients in terminal renal failure with femur neck fractures, were treated. The postoperative rehabilitation, occurence of complications and survival rates were followed. The operative treatment of femur neck fractures by implantation of endoprosthesis in patients with chronic renal failure, although followed by frequent complications, gives the patient a chance to return to normal activity.

LCH is characterized by the presence of Langerhans cells juxtaposed against a backdrop of hematopoietic cells, including T-cells, macrophages, and eosinophils. The investigated material included open lung biopsy samples taken from seven patients (four males and three females) at the mean age of 23.2 years. They were all smokers. The intensity of the histological lesions was semiquantitatively measured, differentiating three intensity grades: mild, moderate and intense. In most cases (3/7), the interalveolar septa were focally and intensively thickened. The inÀ ammatory in¿ ltrates in the septa were focal, intense in 3/7, moderate in 1/7, and mild in 1/7 specimens. Lymphocytes prevailed, followed by macrophages, eosinophil granulocytes, and plasma cells. The lumen of the alveoli was occupied by a few macrophages and lymphocytes, sparse plasma cells and few eosinophil granulocytes. The alveolar cells were focally cuboid in 7 cases. Histiocyte aggregates were detected in all specimens, most frequently localized peribronchiolarly (7/7) and in the intraalveolar septa (4/7). The aggregates had either a clear (15/25), or a relatively clear (10/25) demarcation line against the periphery. The aggregates were predominantly composed of Langerhans’ cells (7/7, abundant), followed by eosinophil granulocytes (abundant in 4/25, moderate in 8/25, sparse in 13/25), lymphocytes (sparse in 10/25 and moderate in 15/25 cases), and plasma cells (sparse in 10/25). The Langerhans’ cells were CD1a and S 100 positive. Histiocyte aggregates were registered in all biopsy samples; the Langerhans’ cells were CD1a and S100 positive.

Arterial hypertension is a major risk factor for increased morbidity and mortality from cardiovascular, cerebrovascular and renal disease, and it is shown that it has its roots in childhood. There is an obvious trend in the incidence of hypertension in the pediatric population, which follows the increase in the prevalence of obesity in this population. The de¿ nition of hypertension has undergone signi¿ cant changes over the past few decades. According to the modern de¿ nition, normal systolic and diastolic blood pressure in children above 90 percentile speci¿ c for age and gender. Given the great importance of the disease, both in medical and in the broader social context, it is necessary to establish clear diagnostic criteria and treatment protocols, and effective programs for prevention and early diagnosis of hypertension in children.