Implementation of IMRT with 4DCT simulation offers possibility to correlate the respiratory movements and position of tumor volume during radiotherapy treatment. The aim of this study is to quantify movements of primary tumor during IMRT treatment in three axes-Z-superoinferiorSI, X-mediolateral ML, Y -anteroposterior AP.This study included 15 patients with lung carcinomareferred to radical radiotherapy. Contouring of GTV was done in the phases FB- GTV FB, phase 0-GTV0, phase 50- GTV 50, and phase MIP-GTV MIP. Comparison was done with GTV FB as basic value. Evaluation was done in three axis-SI, AP, ML. The movements of GTV in relation to X axis were in the range 0.02-0.47 cm, in relation to Y axis in the range from 0.01-0.56 cm, and according to the Z axis in the range of 0.00-0.79 cm. Based on the results of t-test there was a statistically significant difference (p<0.05) related to X axis between the upper and lower lobe. There was no statistically significant difference (p>0.05) between the upper, lower and middle lobes related to Y and Z axis. The test results which were obtained after the 4D CT simulation and planning of IMRT treatment show the importance of high-quality and precise radiation therapy treatment.

Parathyroid gland adenoma belongs to the benign tumor group and is the commonest originator of the primary hyperthyroidism which emerges owing to the both increased and uncontrolled secretion of parathyroid hormone due to the one or more parathyroid glands hyperfunction. The paper outlines the woman case, who was at the prison sentence enduring, and as a result of the supraventricular tachycardia and hemodynamic instability she was hospitalized at the Clinical centre, Kragujevac. The obduction diagnosed atherosclerosis of severe degree, left ventricle hypertrophy, nephrolithiasis, whereas the organs’ cut-outs pathohistological examination showed parathyroid gland adenoma. The cause of death of the particular patient was the myocardial infarction. Parathyroid adenoma of the patient was not detected in time because of the state of neglect and her way of life. The primary hyperthyroidism has significantly speeded up the myocardial damage and the blood vessel atherosclerotic changes.

Laryngeal lipomas are a rare form of a benign mesenchymal tumour containing fatty tissue. They can occur at any subcutaneous location part of the body, particularly in the trunk and lower and upper limbs where fat tissue is more abundant. We present the case of a 66-year-old man complaining of long lasting (3 years) discomphort in his throat, with no breathing or glutition problems. CT scans showed a 3.0-cm fat-containing mass involving the left aryepiglottic fold. The patient was taken to the operating room for excision of the mass using a laryngofissure approach. The final pathologic diagnosis was lipoma. We describe a case of large laryngeal lipoma removed through an external surgical approach in order to prevent any possible recurrence or malignant alteration.

Za postavljanje dijagnoze sepse, najpouzdanije je određivanje PSP u kombinaciji sa drugim markerima sistemske infekcije. Pojedinačno merenje je često bez značaja, tako da je kontinuirano merenje u vremenu, sa trendovima pada ili porasta nivoa markera sistemske infekcije, daleko informativnije. Nivo PSP značajno zavisi od GFR. Kod obolelih od ABI, PSP je solidan pokazatelj sistemske infekcije do težih i prologiranih stadijuma ABI. Kod obolelih od HBI, tumačenje vrednosti PSP je veoma spekulativno, te postoji potreba za definisanjem novihcut-off vrednosti za PSP kod ovih bolesnika. Kod oblelih pod tretmanom HD, pokazan je različit klirens PSP sa različitim dijaliznim membranama. Svakako, nivo PSP se po HD vraća na pređašnji nivo, koji je inače povišen.

The aim of this paper is to analyze the method of term and preterm deliveries of twin pregnancies and vitality of twins at birth. The development of two fetuses in the uterine cavity at the same time is considered a twin pregnancy. Today, due to more often examination and proper treatment, 50% of twin pregnancies end in preterm delivery. We used retrospective study to analyze the delivery method and vitality of twins born term and preterm at Gynecology and Obstetrics Department of General hospital Novi Pazar in the five-year period, from 2009 to 2013. There were 10.489 deliveries in the said five-year period. Out of this number, 118 pregnancies were twin pregnancies and they amount to 1.12% of all deliveries which is in line with world’s standards. About 73% of deliveries were term and 27% were preterm twin deliveries. The analysis of twin vitality showed that first-born twins at both term and preterm deliveries are more vital and in better condition. Second-born twins are generally born with lower Apgar score. Due to liberalization for caesarean section indication, a great number of twin deliveries end in caesarean section. 

Opisujemo slučaj prekomerne hipersplazije lingvalne tonzila kod odraslih uprkos prethodnoj tonzilektektomiji koja je zahtevala inicijalnu traheostomiju da bi se kompletno uklonilo limfoidno tkivo. Raspravljamo o poteškoćama u intubaciji u proceni disajnih puteva.

We present the case of a 46-year-old patient diagnosed with a large solid tumor localized in the right mesentery, and due to the mesenteric position and tumor structure, diagnostic suspicion of GIST was proposal as the most frequent tumor lesion of this localization. After a few days, the patient was discharged from the hospital without postoperative complication, in further follow-up without relapse.

The aim of this paper is to analyze the method of term and preterm deliveries of twin pregnancies and vitality of twins at birth. The development of two fetuses in the uterine cavity at the same time is considered a twin pregnancy. Today, due to more often examination and proper treatment, 50% of twin pregnancies end in preterm delivery. We used retrospective study to analyze the delivery method and vitality of twins born term and preterm at Gynecology and Obstetrics Department of General hospital Novi Pazar in the five-year period, from 2009 to 2013. There were 10.489 deliveries in the said five-year period. Out of this number, 118 pregnancies were twin pregnancies and they amount to 1.12% of all deliveries which is in line with world’s standards. About 73% of deliveries were term and 27% were preterm twin deliveries. The analysis of twin vitality showed that first-born twins at both term and preterm deliveries are more vital and in better condition. Second-born twins are generally born with lower Apgar score. Due to liberalization for caesarean section indication, a great number of twin deliveries end in caesarean section.

Za postavljanje dijagnoze sepse, najpouzdanije je određivanje PSP u kombinaciji sa drugim markerima sistemske infekcije. Pojedinačno merenje je često bez značaja, tako da je kontinuirano merenje u vremenu, sa trendovima pada ili porasta nivoa markera sistemske infekcije, daleko informativnije. Nivo PSP značajno zavisi od GFR. Kod obolelih od ABI, PSP je solidan pokazatelj sistemske infekcije do težih i prologiranih stadijuma ABI. Kod obolelih od HBI, tumačenje vrednosti PSP je veoma spekulativno, te postoji potreba za definisanjem novihcut-off vrednosti za PSP kod ovih bolesnika. Kod oblelih pod tretmanom HD, pokazan je različit klirens PSP sa različitim dijaliznim membranama. Svakako, nivo PSP se po HD vraća na pređašnji nivo, koji je inače povišen.

In this manuscript we report one pediatric surgeon’s experience in childhood inguinal hernia repair. From 2005 to 2008, 402 children with inguinal hernias were operated on by one surgeon. A retrospective survey of their charts was carried out to evaluate the demographics and clinical aspects of these patients. The ages ranged from 20 days to 16 years with a maleto-female ratio of 2.5:1. 64.9% right, 27.1% left, and 7.9% bilateral hernias. Hydroceles were present in 6.2% assosiated hernias. Incarceration occurred in 8.7% of children. An opposite-side hernia developed in 5.7%. 5.3 percent of patients with a hernia repair on the right side later developed a hernia on the left side, and 8.2% of patients with a hernia repair on the left side later developed one on the right side. 4.5 percent of all male patients in this series and 8.6% of female patients developed an opposite-side hernia. While overall recurrence rate was 1.2%, our recurrence rate was 0.25%. There was a 0.24% wound infection rate, and 1 (0.24%) testicle was atrophic at followup. In this study, in the recurrence of childhood hernia, the general surgeon’s intervention was the prominent cause. It is suggested by the study that inguinal hernias on the contralateral side becomes symptomatic within the first six months following initial operation.Therefor, close observation is needed in that time.