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.

The current practice for removal of benign vocal fold lesions is microlaryngoscopy under general anaesthesia. The technique provides excellent magnification with use of operating microscope and enables the surgeon to work with both hands at the same time. However, in certain cases the technique of indirect laryngoscopic surgery under local epimucous anaesthesia can be used as an alternative. In this article we will give the brief historic perspective of the procedure, indications and technical description, as well as its advantages and limitations. Given the fact that technique is not widely accepted by otolaryngologists, the author will also share some personal remarks on this relatively simple procedure.

Penile tumors are rare neoplasms of the male urogenital tract and represent approximately 1% of all urogenital cancers in men. Squamous cell carcinoma is the most common histological type of these tumors, and is seen in about 95% of the cases. We report a case of a 66 years old male patient presented with large, neglected cancer of the penis, which grew about 6 months, but patient was not motivated for treatment until tumor began to bleed. Patient was operated and tumor was completely removed. The early postoperative course was uneventful and the patient was discharged from hospital Since penile cancers are rare entity, there are counted controversy about the best method of treatment. We believe that the individual approach to each patient relying on existing good clinical practice guidelines is currently the best therapeutic approach.

This article presents a case of patient with acute and complicated dyslipidaemic pancreatitis, managed by team, consisted of the endocrinologists, gastroenterologists and transfusiologists. Dyslipidaemia, predominantly type IV, is a common cause of acute pancreatitis in young patients, especially in the cases of poor compliance (irregular taking of recommended fibrates and failure to comply with the dietary regime). The treatment of acute pancreatitis, regardless of the aetiology, is due to the severity of the condition, the complexity of the treatment, and the monitoring of patients, in the Intensive Care Units. In cases where dyslipidaemia is the cause of acute pancreatitis, in the context of acute care, a therapeutic plasma exchange is often performed. It rapidly and significantly corrects lipid levels, primarily triglycerides. Therapeutic plasma exchange requires the activity of transfusiology team, which are often unavailable in smaller hospitals.

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.

Stvaranje aneurizme leve komore je komplikacija koja može nastati kao posledica infarkta miokarda. Najčešće zahvata apikalni ili anterolateralni zid leve komore (85%) i prati okluziju prednje descedentne grane leve koronarne arterije. Zid prave aneurizme sadrži endokard, epikard i fibrozno ožiljno tkivo. Funkcionalno može biti akinetičan i diskinetičan. Ukoliko kod pacijenta postoje simptomi, kao što su srčana slabost, anginozni bolovi ili komorske aritmije, indikovana je elektivna operacija. Od operativnih tehnika najčešće se koristi Dorova procedura. Od materijala najčešće se koristi politetrafluoroetilen ili perikardno tkivo. Njihova mana je podlžznost kalcifikaciji i retrakciji. Cormatrix je tkivni pač sastavljen od decelularizovane submukoze svinjskog tankog creva. Bogat je kolagenom, glikozaminoglikanima i faktorima rasta. Eksperimentalne studije, sprovođene na životinjama pokazale su da implantacija ekstracelularnog matriksa u područije infarkta srca dovodi do pojave kontraktilnih elemenata, kao i do promene u prirodnom formiranju ožiljnog tkiva

U okviru ovog rada prikazan je slučaj bolesnika sa komplikovanim akutnim dislipidemijskim pankreatitisom u čijem je zbrinjavanju učestvovao tim, koji su činili endokrinolozi, gastroenterolozi i transfuziolozi. Dislipidemija, prevashodno tip IV dislipidemije, predstavlja čest uzrok nastanka akutnog pankreatitisa u populaciji mladih ljudi, posebno u slučajevima nezadovoljavajuće komplijanse (neredovno uzimanje preporučenih fibrata i nepridržavanje higijensko-dijetetskog režima). Tretman akutnog pankreatitisa se nezavisno od etiologije, zbog težine stanja, kompleksnosti lečenja i monitoringa bolesnika, sprovodi u Jedinicama intenzivnog lečenja. U slučajevima kada je dislipidemija uzrok akutnog pankreatitisa, često se u sklopu akutnog zbrinjavanja sprovodi i terapijska izmena plazme, kojom se brzo i značajno koriguju nivoi lipida, prevashodno triglicerida. Terapijska izmena plazme zahteva aktivnost transfuzioloških ekipa, koje su u manjim centrima, često nedostupne.

Penile tumors are rare neoplasms of the male urogenital tract and represent approximately 1% of all urogenital cancers in men. Squamous cell carcinoma is the most common histological type of these tumors, and is seen in about 95% of the cases. We report a case of a 66 years old male patient presented with large, neglected cancer of the penis, which grew about 6 months, but patient was not motivated for treatment until tumor began to bleed. Patient was operated and tumor was completely removed. The early postoperative course was uneventful and the patient was discharged from hospital Since penile cancers are rare entity, there are counted controversy about the best method of treatment. We believe that the individual approach to each patient relying on existing good clinical practice guidelines is currently the best therapeutic approach.

Aktuelna metoda za uklanjanje dobroćudnih lezija glasnica na našem odeljenju je mikrolaringoskopija u opštoj endotrahealnoj anesteziji. Ova tehnika obezbeđuje odlično uveličanje pomoću operacionog mikroskopa i omogućava hirurgu da istovremeno operiše sa obe ruke. Ipak, u nekim slučajevima se kao alternativa može koristiti i indirektna laringoskopska hirurgija u lokalnoj epimukoznoj anesteziji. U ovom članku ćemo napraviti kratak istorijski osvrt na proceduru, indikacije i opis same hirurške tehnike, kao i njene prednosti i ograničenja. Imajući u vidu da ova tehnika nije široko prihvaćena od strane otorinolaringologa, autor će navesti i neka lična zapažanja u vezi sa ovom relativno jednostavnom tehnikom.