Aneurysm is defined as localized arterial dilatation by at least 50% of normal diameter. Abdominal aortic aneurysm (AAA) affects most often male patients, smokers, older than 65 years, and is considered 13th most common cause of death in the USA. Statistics is not very well developed in Serbia due to poor connection of the medical facilities that deal with this problem. Abdominal aortic aneurysm can be asymptomatic for a long period of time, and often her existence can be diagnosed only when it ruptures, which has a mortality rate of more than 90%. This paper shows a male patient, 83 years old, who is admittedto KBC Zemun with symptoms of weakness, exhaustion and anamnestic information that he had a loss of consciousness carlier that day. By means of physical examination and modern diagnostic tools a ruptured abdominal aortic aneurysm has been diagnosed. The patient has been immediately transferred to an OR where he has been urgently prepared for the operation by two anesthesiologists and then surgery has been performed in general anesthesia by all up-to-date protocols. Postoperative recovery period was satisfactory, and the patient was released from hospital in good general condition.

The importance of this paper is in the fact that there is a need for in-hospital protocols for hospitals that do not routinely work with emergency vascular pathology, in order to improve communication among admission ward and other departments (before others with anesthesia dept.) and quicken the path from diagnostic to operation room, where at this moment a lot of valuable time is lost.

The role of elevated C-Reactive Protein (CRP) serum levels has been questioned in gestational diabetes mellitus (GDM) because of the evidences that metabolic syndrome and GDM are related to increased serum levels of inflammation markers (such as CRP). The aim of the study was to evaluate the sensitivity of elevated CRP levels for diagnosis of chorioamnionitis and to compare it with sensitivity of other standard laboratory or clinical signs used in the establishing of diagnosis of chorioamnionitis. Elevated CRP level was present in 93,33% cases. Fetal tachycardia was present in 91,67% cases. Increased white blood cell count was present in 63,33%. A statistically significant difference was found in the level of sensitivity of CRP and of the increased white blood cell count (P<0.01). Elevated C-reactive protein levels were more sensitive than other standard laboratory or clinical signs in predicting chorioamnionitis in women with GDM.

The 50-gram non-fasting one hour Glucose Challenge Test (GCT) is today the one most widely implemented as a screening test for Gestational Diabetes Mellitus (GDM). Positive result of GCT creates a preliminary GDM diagnosis. Diagnosis of GDM labels a pregnancy high risk. Any highrisk pregnancy can cause maternal anxiety. The aim of the study was to investigate pretest and posttest anxiety levels in pregnant women undergoing GCT. Anxiety levels were evaluated by Hamilton Rating Scale for Anxiety (HAMA score). Pretest HAMA score was 7.1±3.34 in the women with preliminary GDM diagnosis, and 6.69±5.51 in the women with negative GCT results. After delivering GCT results, HAMA score was 8.64 ± 8.10 in the women with preliminary GDM diagnosis and 4.29±2.29 in the women without preliminary GDM diagnosis. Pretest levels of anxiety among all pregnant women undergoing GCT were increased. However, this was temporary in women with negative GCT, whose anxiety levels decreased after delivering GCT results. Among women preliminary diagnosed with GDM, posttest HAMA evaluation revealed sustained increased levels of anxiety. Concerns regarding the anxiety caused by screening for GDM were confirmed by the results of our study

The granuloma is defined as a focal, chronic, mostly mononuclear inflammatory response to present irritants. The Material of the investigation included bronchobiopsy samples taken from 31 TB patients. The histological features of 53 tuberculous granulomas localized in the bronchial structures were determined in the study. The quantity, structure and distribution of the cellular and connective elements in the bronchial structures, as well as in the gra-nuloma, were determined by the quantitative stereome-tric method, using the numerical density as the stereolo-gical variable. The tuberculous granuloma, in the average size of 622x343 microns, was most frequently localized in the internal third of the lamina propria (34% of the ca-ses), at the average distance of 185 microns from the basal membrane. The central part of the granuloma was invaded by epithelioid and giant cells, macrophages, lymp-hocytes, plasma cells and fibroblasts, with the mean numerical density of 84151 mm-3. Lymphocytes were greatest in number, followed by epithelial cells, which were 2.5 times as few as lymphocytes. Giant cells, mostly Langhans in type, were registered in 66% of the granulomas. The mean numerical density of all cells in the peripheral part of the granuloma was 243964 mm-3. The peripheral part of the granuloma was predominantly infiltrated by lymp-hocytes, making 93% of all cellular elements. Caseous necrosis was registered in 13% of the granulomas, and acid resistant bacilli in 11% of the biopsy samples. The mean numerical density of all cells in the central part of the tuberculous granuloma was 84151 mm-3, with predominating lymphocytes and epithelioid cells. The mean numerical density of all cells in the peripheral part of the granulo-ma was 243964 mm-3, with predominating lymphocytes, making 93%. Caseous necrosis and acid-resistant bacilli were registered in every eighth granuloma.

Immunoglobulin A deficiency (IgAD) is the most common form of primary immunodeficiency.

IgAD is characterized by apscence or very low level of serum IgA (<0.7 mg/dL) and normal serum ranges of IgG and IgM. Pathogenesis of IgAD and its molecular and genetic basis is important, knowing that this immunodeficiency is related with epithelial malignancies such as respiratory and gastrointestinal tumors. Aim of this study was to investigate IgAD in patients with gastrointestinal malignancies, as well as to determine potential relation between IgAD and certan type of tumor. The research included 60 patients with confirmed gastrointestinal tumors of various types. For every patient qualitatively were tested levels of serum IgA and anti IgA atibodies, using ID microgel cards (Particle Gel Immuno Assay methods). Levels of serum IgA were also quantitavely tested in reference laboratory. Using Particle Gel Immunoassay method, there was no evidence for decrease of serum IgA or presence of anti-IgA antibodies in our group of patinets. This result was confirmed with quantitative laboratory investigation. This study shows no significant relation between IgAD and gastrointestinal tumors, which is in accordance with actual litarture.

There have only been registered sporadic cases of carcinoma in these patients, which implies that the research should include a larger number of patients.

Also, more detail cognition of molecular and genetic mechanism of IgAD would help in understanding oncogenic effect of this immunodeficiency.

This sudy is performed to determine disease related outcome in metastatic nonseminomatous germ cell testicular tumors (NSGCTTs) in patients with absence of viable cancer (VC) in the postchemotherapy retroperitoneal lymphadenectomy (PC-RPLA) specimen and determine wheter clinical variables can help predict disease progression Among a survey of 163 patients submitted to PC-RPLA from 1980-2005, 126 patients (77%) had no VC (44 fibrosis, 82 teratoma). At mean follow-up (MFU) of 158+/-77.7months, 20 patients (16%) developed recurrences within median free interval of 19.3 montha, with complete response (CR) following applied therapy in 9 patients (45%). Eleven patients (8%) diead (8 of disease, 3 of' other causes). Predictors for poorer recurrence free survival (RFS) were advanced clinical stage (CS) (P<0.016), intermediate/ poor IGCCCG group (p<0.004), and PC-RPLA nodal size (p<0.0007), while for disease-speciphic survival (DSS) included recurrences (p<0.0001), PC RP residual mass (RM) diameter ((p<0.006), worse IGCCCG risk (p<0.0003) and increased HCG at PC-RPLA (p<0.0001). A subset analysis of potential predictors of poorer RFS in patients with fibrosis identified only worse IGCCCG risk (p=0.05), whereas in teratoma were worse IGCCCG risk classification (p=0.01), PC RP RM size (p<0.0005) and unfavorable histology (teratoma with malignant transformation [TT] vs. mature teratoma [MT]/immature teratoma [IMT]Xp<0.0001). Adverse impact on DSS in fibrosis had elevated HCG on PC-RPLA (p<0.013) and in teratoma the presence of unfavorable IGCCCG risk (p<0.0001), worse RP histology (p<0.05) and postoperative recurrence (p<0.0001). The 5-year DSS and RFS rates for all patients with no VC at PC-RPLA were 87% and 85%, while at 10-year were 79% and 75%, respectively (Log rank=13.155; p<0.003). Patients with no VC at PC-RPLA remain at risk of recurrence. Several clinical variables, including CS, intermediate/poor IGCCCG group, preoperative HCG level, diameter of RP RM and postoperative recurrence help better to define which patients are at risk of disease recurrence and survival; as such these patients should be followed regularly in the postoperative period.

The conventional cytology has a longstanding role in the diagnostics of primary and metastatic lung carcinoma. Multiple factors have influence on the choice of technique used: for example, the location of the lesion, its size, interpretation of the radiological imaging, the seriousness of the symptoms, as well as the manual skill and commitment of the physician to certain technique. In this paper, the most important sampling techniques and sample processing are shown as the most important factors of a successful pathohistological analysis.

Sarcoidosis is a multisystemic disease of unknown etiology, which most commonly affects lungs and is characterized by the presence of non necrotizing lymphocyte-epitheloid granulomas. We used the material obtained by transbronchial biopsies of 34 patients having sarcoidosis, 22 (64,7%) women and 12 (35,3%) men, with the mean age of 43,2 years. In this paper, histological characteristics of 102 sarcoid granulomas were established. The quantity, composition and localization of cellular and fibrous elements were determined by quantitative analysis of stereometry, using the numerological density as a stereological variable. The sarcoid granuloma, with the average size of 356x254x microns is most commonly localized in the perivascular region (47% of granulomas). In the central part of the granulomas epitheloid cell, giant cells, macrophages, lymphocytes and plasma cells were found with thw average density of 111751mm 3. The lymphocytes were the most common cell type, followed by three times fewer number of epitheloid cells. The giant cells, most commonly of Langhans cell type, were present in 62% of granulomas. The average numerical density of all types of cells in the peripheral part of granulomas was 241346mm*. In the periphery of the granuloma the most dominant cell population were lymphocytes, which represented 91,5% of all cellular elements. Fibrinoid necrosis was found in 2% of all granulomas. Acidoresistent bacilli were not found. The average density of all cell types in the central part of granulomas was 111751mm*, with lymphocytes and epitheloid cells being the most common cells. The average numerical density of all cell types in the peripheral part of the granulomas was 241346mm 3, with the domination of lymphocytes with 91,5%. Fibrinoid necrosis was present in 2% of granulomas.

The latest version of uterine tumors classification was done in 2003. According to WHO classification, endometrial cancers are divided into two groups, so called Type I and Type II. Endometrioid adenocarcinoma has a higher frequency and belongs to Type I. Serous and clear-cell adenocarcinoma, are forming Type II and by definition, they are high grade cancers with poor prognosis and no clearly defined precursors and predisposing risk factors. In Type I, there is a PTEN mutation and in Type II overexpression of p53. These two biomarkers are used in their differential diagnosis.WHO has defined a three-step system in determining the grade of endometrioid adenocarcinoma in which squamous component has no significance. There are other, two-step, grading systems which are not generally accepted.2009 FIGO classification is still in use for tumor staging and according to that tumors confined to the uterus body are divided into stages IA and IB. In the group of mesenchyme tumors, undifferentiated sarcoma was separated, due to different morphology and immunohistochemical profile compared to leiomyoma and endometrial stromal sarcoma. New terms, like UTROSCT, are accepted as well as new theory about the origin of carcinosarcoma. Common believe is that these tumors have epithelial origin and therefore sarcoma component showed positivity on epithelial and mesenchymal markers too. Large number of new antibodies was discovered which in the diagnosis and differential diagnosis of uterine tumors are only meaningful when used in correlation with the clinical picture and morphological data (endometrial carcinoma vs. ovarian carcinoma, adenosarcoma vs. adenofibroma).