Zemun hospital, the present-day Clinical Hospital Zemun-Belgrade, was founded in 1784, is the oldest hospital in the Serbia. For over two centuries, it blazed the trial and still pioneers in the application of numerous advanced medical achievements and knowledge in this region.

The development of Zemun Hospital in the 19th century was followed by better work conditions and an increasing number of patients. The arrival of doctor Vojislav Subotić to the hospital and his work were key moments in the general improvement of the hospital. Since 1887, the hospital was administered by a society known as „Sisters of Charity of Saint Vincent De Paul“. By the end of 1891, they had constructed a new hospital building.

The 20th century was the most eventful period in the history of Zemun Hospital and it brought many changes. Working through out both world wars, the hospital staff aided those who were wounded or ill, both soldiers and civilians. Throughout this period, the hospital worked in three different countries, under various administrations and owners.

Aim: To investigate immunohistochemical expression and the localization of connexin-43 (Cx-43) in primary lung cancer and its metastases. Introduction: Connexins are transmembrane proteins forming gap junctions that allow intercellular communication. Significance of gap junctions and connexins in lung cancer are not clear enough. Material and Methods: We analyzed autopsy samples of primary and metastatic lung carcinoma from Institute of Pathology in Belgrade. There were 11 primary lung carcinomas, 7 lung cancer metastases in lymph nodes, and 12 haematogenic metastases. We performed immunohistochemical staining for connexin-43 (Cx43) and measured expression (percentage of positive cells and intensity of staining) and localization of Cx43 in primary tumor and its metastases. Results: Lymphatic and hematogenous metastases of lung cancer showed a stronger expression of connexin-43 than primary tumor itself. Unlike 9% of primary carcinoma, 28% of lymphatic metastases and 50% of hematogenous metastases had expression of connexins in more than 50% of tumor cells (p=0.11). The intensity of connexin-43 expression was statistically significantly less in primary lung cancer than in all the metastases together(p=0.04). The expression of this marker was different in different histological types, where small cell carcinoma rarely expressed connexin, while the squamous carcinoma was mostly positive to immunohistochemical staining on Cx43. Dominant localization of expression was the combined cytoplasmic-membranous. Conclusion: Our results showed that lung cancer expresses connexin-43 mostly in cytoplasm as well as on the cell membrane. Further research on a larger sample is required to establish whether Cx-43 could be used as a prognostic biomarker in lung cancer.

Aim: We present an interesting case of unexpected metastatic deposit “signet ring cell” of the gastric cancer in the ureter. Introduction: Ureteral obstruction caused by gastric cancer may occur by any of the following three mechanisms: direct extension from the primary site, peritoneal deposit or lymph node metastasis. Material and Methods: We report the case of a patient with ureteral metastasis as the first and sole manifestation of gastric cancer dissemination two years after he was first diagnosed with gastric cancer. Results: A 52-year old male patient was admitted to the Department of Urology, Clinical Hospital Centre Zvezdara in Belgrade, with a 5-day history of right colic flank pain and high temperature. He had a partial gastrectomy for gastric cancer two years ago and received 8 cycles of chemotherapy. Routine blood test results were normal except elevated creatinine and C-reactive protein levels. An abdominal ultrasound examination and computed tomography revealed grade 3 hydronephrosis and hydroureter. Cystoscopy indicated a tumor measuring 2 cm in size which involved left ureteral orifice. A left nephroureterectomy and transurethral resection of bladder tumor were performed. Histopathological examination of surgical POSTER SESIJA 65 MATERIA MEDICA • Vol. 34 • Issue 1, suplement 1 • april 2018. specimen revealed signet ring cell carcinoma infiltrating lamina propria and tunica muscularis of the left lower ureter. Histopathological examination of the bladder specimen revealed signet ring cell carcinoma identical to those of the ureteral tumor. Conclusion: Ureteral metastases from gastric cancer are extremely rare. Shimoyama reviewed 27 cases of the true ureteral metastasis from gastric cancer. The prognosis is generally poor and the survival for more than 2 years has not been reported in literature.

The skin is the largest organ in our body.Receiving information from the environment allows the role barrier between the human organism and the environment. The histological structure of the skin is variable depending on the part of the organism. The diseases of skin also vary depending on the region. The reason is the local immune status and the external physical, chemical and microbiological environment. The histopathological diagnosis of skin lesions request detailed clinical information. On the other side the histopathological diagnosis of skin lesions provides information on local disease , as well as potential other associated pathological conditions.˝ Extramammary Paget‘s vulvar disease is rare. The pathology of the skin of the vulva is specific both for specific localization, as well as for specific friction and microbiological flora. It is clinically presented as erythematosus or eczematous lesion. It can be local or extensive. Histopathologically, it is characterized by relatively large glandular atypical Paget cells, which are pathognomonic for this disease. These cells have abundant cytoplasm that is granular or vacuolated. Tumor cells are typically localized individually or in groups in the basal and parabasal layers. Immunochemical analyzes are necessary in the diagnosis of Paget‘s disease. The main reason is that Paget‘s disease can be a primary skin disease or associated with non-cutaneous carcinoma primarily of the urothelial or rectal carcinoma . Therefore, it is necessary to recommend that a detailed clinical trial of a patient be conducted in all diagnosed cases of vulvar Paget‘s disease. Mycobacterium marinum is etiological factor of Fish tank granuloma.This Mycobacterium more often causes diseases of fish, both marine and river fish. The humans become infected with Mycobacterium marinuim after contact with skin after micro/trauma Infection is usually localized to the skin.In immunocompromised patients the infection may disseminate or spread to the subcutis and bone. After incubation of few weeks after infection the lesion appear as solitary nodules or plaques.In some cases the disease progresses like suppurative ulcers. Histopathologically there is a wider range of histopathological presentations. Most often you can see abscess, necrosis of wheat and fatty tissue. However, granuloma inflammation is a key morphological substrate. After granuloma inflammation, fibrosis occurs. Since the microscopic image may be somewhat non-specific, clinical data are of great importance for the diagnosis. Multidisciplinarity in the final diagnosis includes microbiological confirmation of the presence of Mycobacterium marinum.

Implementation of IMRT offers possibility to escalate radiation therapy dose without increased acute and late toxicity. The aim of this study is to compare acute and late genitourinary and gastrointestinal toxicity in patients treated with IMRT and 3DCRT technique. This study included 35 patients in study group A treated with IMRT technique, and 35 patients in study group B treated with 3DCRT technique. Patients were selected and referred to radical radiotherapy treatment prostate cancer. Acute genitourinary and gastrointestinal toxicity was evaluated during radiotherapy treatment according to recommendation of RTOG group. Late gastrointestinal and genitourinary toxicity was evaluated during regular control exams after radical radiotherapy treatment for six months. Based on the results χ2 test there was no statistical significant difference (p>0,05) between study group A i B in terms of acute gastrointestinal and genitourinary despite escalated radiotherapy dose in study group B treated with IMRT technique. Based on the results χ2 test there was no statistical significant difference (p>0, 05) between study group A i B in terms of late gastrointestinal and genitourinary toxicity. Intensity modulated radiation therapy is optimal technique in the radical treatment prostate cancer. This technique allows clinical benefit compared with 3D conformal radiotherapy-escalation of radiotherapy dose without increased toxicity in patients treated with IMRT technique.