Savremeni svetski stavovi podrazumevaju limfadenektomiju kao terapijsku proceduru koja je integralni deo radikalne hirurgije karcinoma želuca. Ona se izvodi u pokušaju da se hirurgija malignoma učini što radikalnijom. Cilj svake hirurške procedure je potpuno uklanjanje tumora i svakog tkiva koje njime može biti zahvaćeno. Težnja radikalne hirurgije je u eradikaciji maligne bolesti, a limfadenektomija bitno doprinosi ovom cilju. Limfadenekotmija kod gastričnog karcinoma podrazumeva disekciju limfnih nodusa prve, druge grupe, što se smatra standardnom limfadenektomijom D2. Pored hirurškog načina lečenja karcinoma želuca, koji je ostao dominanatan, u poslednje vreme se razvijaju novi modaliteti lečenja želuca. I pored isticanja u prvi plan značaj hirurškog lečenja i sistematske limfadenektomije, kriterijumi koje je dalo Japansko udruženje za gastrični kancer od 2010g. razlikuje i druge modalitete lečenja gastričnog karcinoma. Karcinome želuca možemo tretirati: endoskopski, laparoskopski, klasičnom hirurškom resekcionom operacijom, hemioterapijom (koja može biti preoperativna i postoperativna) i palijativnom hirurgijom. Svaki od ovih modaliteta lečenja utiče na bolji ishod bolesti pacijenata. Izbor adekavtnog tretmana pacijenta sa karcinomom želuca zavisi od stepena uznapredovalosti maligne bolesti.

The present study was performed to establish the socioepidemiological caracteristics (mean age, male to female ratio), the prevalence of various histological types of meningiomas in the groups of primary and recidivant tumors as well as Cathepsin D immunoexpression. We analysed 50 patients with primary and recidivant intracranial and intraspinal meningiomas who underwent surgery in KBC Zemun during the year 2004, with a two years follow-up. All surgical specimen were evaluated for histologic type of tumor and representative slides were immunostained with the anti-Cathepsin D antibody. In both primary and recidivant meningioma groups the number of mitosis, as factor tumor agressivness, was counted on 10 and 20 HPF and those results were statistically analyzed. A considerable difference was found when the number of mitosis and the histologic tumor grade have been compared with the Cathepsin D immunoexpression. The result lead to conlusion that the immunopositivity of Cathepsin D decreases with higher mitosis count and higher tumor grade.

The presence of free fluid in the pleural space can be a sign of many pathological processes. Some of them may be of inflammatory or hemodynamic origin but others are caused by a malignant neoplasm spreading either in the pleural cavity or from distant site. The importance of establishing the origin of the cells in the pleural fliud lies not only in the fact that a correct diagnosis leads to a correct therapy, but it also is essential in the staging of a malignant tumor. The aims of this study were to evaluate the frequency of various types of pleural effusion and to discuss the value of reactive atypia of mesothelial cells in longstanding effusions. The introduction of a third cathegory of pleural effusion called reactive, would be helpful to the general pathologists to avoid making false-positive diagnosis in the presence of atypical reactive mesothelial cells or missing the diagnosis of a malignant effusion in case when malignant cells are scarse or look like an activated mesothelial cell. In this study, a total of 157 patients from the thoracic department of the General Hospital in Kruševac were examined. Of this number, 33 patients or 21% had the so-called reactive type of pleural effusion. In the everyday practice, one in five patients could be expected to have reactive mesothelial atypia, which may be quite confusing in inexperienced hands.

The aim of our study was analyzing data on concentrations of hazardous and noxious substances in the soil in Belgrade, identifying the most common pollutants, as well as proposing measures for reducing pollution of the soil in Belgrade. 60 soil samples from 30 locations were sampled and tested. The samples were taken in locations in the zone of sanitary protection Belgrade waterworks, near the roads, land within the municipal environment and land in the industrial zones. Deviations are primarily related to the presence of increased concentrations of nickel in the soil, while increased values of other parameters were registered in individual samples at specific locations. In order to improve the current state of soil pollution in Belgrade and prevent further degradation, it is necessary to continue with the systematic monitoring of soil contamination, and implement measures to minimize pollution of land and measures aimed at rehabilitation of existing pollution.

Karcinom želuca je posle karcinoma kolona najzastupljeniji karcinom gastrointestinalnog trakta. Dijagnostika karcinoma želuca najčešće se bazira na primeni kontrasne radiografije, fiberoptičke endoskopije sa biopsijom i histološkim pregledom preparata. Adekvatna dijagnostika veoma je bitna za precizno preoperativno gradiranje tumora i odabir hirurške intervencije. Pravilno odredjivanje stepena uznapredovalosti maligne bolesti od velike je vaznosti za pravilan tretman pacijenata sa karcinomom želuca. Zapadni hirurzi koriste TNM sisttem klasifikacije tumora dat od strane Američkog komiteta za kancer (AJCC), dok istočni hirurzi i Japanci koriste Japanski sistem klasifikacije koji je inaugurisan 1981.godine. Operativno rešavanje karcinoma želuca je svakako osnovni terapijski postupak u lečenju ovog oboljenja. Pre bilo kakvog operativnog rada, za uspešno operativno rešavanje karcinomatozne lezije potrebna je adekvatna preoperativna priprema pacijenata. Na ovaj način smanjujemo broj postoperativnih komplikacija

The aim of this study is to examine how the introduction of medical therapy for symptomatic benign prostatic hyperplasia (BPH) might have changed the indications, patient characteristics and outcome in men undergoing transurethral resection of the prostate (TURP) over two decades (1991.- 2011.). All patients who underwent TURP for symptomatic BPH at our institutions in 1991. (before the introduction of medical therapy for BPH), 2001. (when medical therapy was becoming an important therapy for BPH) and 2011. (when medical therapy was the first line therapy for BPH), were reviewed. We assessed the total number of TURPs, indications for surgery, patient age, health status, weight of resected tissue, and pre and post-operative events/ complications. Our institutions provided primary urological care for 989, 1815 and 2162 men > 50 years of age in 1991., 2001. and 2011., respectively. There was a 60% decrease of TURPs from 1991. to 2011. with a slight increase in number in 2001. Failure of medical therapy was not an indication in 37% and 88% of patients in 2001. and 2011., respectively. There was a substantial rise in the percentage of men at risk presenting with acute or chronic retention (AUR and CUR) at the time of their TURPs ( from 23% in 1991. to 55% in 2001. and from 14% in 1991. to 38% in 2011. for AUR and CUR, respectively) (P<0.05). There was also rise in the percentage of patients presenting with preoperative hydronephrosis (2% in 1991., 13% in 2001. and 6% in 2011.) (P<0.05) and gradual decrease of UTI before TURP overtime (14%, 10% and 12%, respectively).The mean operative time was lower in 2011., compared with either of the two previous cohorts (P<0.05), postoperative stays decreased (from 4.1 days in 1991. to 2.7 days in 2001. and 2.1 days in 2011.)(P<0.05), but the number of patients discharged with catheter increase over two decades (from 3.5% in 1991 to 4.8% in 2001., and to 8.8% in 2011.)(P<0.05). The postoperative complications of our three cohorts differed significantly (14% in 1991., 6.4% in 2001. and 20.6% in 2011.)(P<0.05). The increasing use of medical therapy as a first line treatment for BPH has resulted in a dramatic decrease in TURPs which, in turn, has been associated with an apparent increase in risk of poor pre- and postoperative outcomes seems to be related to earlier catheter removal and hospital discharge, although a causal relationship cannot be established. The present study covering the last two decades would suggest that we are not delaying surgery for patients who will eventually require it. We are now selecting the appropriate patients for TURP, rather than using TURP as our only means of BPH therapy as we did two decades ago.

Gastric carcinoma is usually diagnosed using radiologic contrast methods, endoscopic examination with biopsies and histological analyses. In order to determine the stage of the disease, preoperative diagnosis requires determining presence of distant metastasis, malignant lymph node transformation, and involvement of the surrounding structures. Standards for gastric carcinoma staging have international variations, but all of them are based on the routes of metastasis. Different imaging methods are used for diagnosis and staging of gastric carcinoma, each with its advantages and shortcomings, so guidelines for diagnosis and follow-up for this malignoma are established accordingly.

U radu je obrađen jedanaestogodišnji period obolelih i umrlih pacijenata od akutnog infarkta miokarda (AIM) u populaciji Kosovske Mitrovice od 2001-2011 godine. Retrospektivno su obrađeni podaci o pacijentima koji su hospitalizovani na internom odeljenju Zdravstvenog centra u Kosovskoj Mitrovici tačnije u koronarnoj jedinici za period od 2001-2011 godine.Obrađeni su pacijenti uzrasnih grupa od 20- 70 godine.Za napred navedeni period hospitalizovano je ukupno 1380 pacijenta koji su lečeni od akutnog infarkta miokarda. Od ukupnog broja obolelih 894 ili 64,7% su muškarci a 486 ili 35,3% su žene. Stopa obolelih od akutnog infarkta miokarda je 1,9:1 u korist muškaraca. Registrovano je 142 fatalna ishoda 10,3% dok je 1238 bilo nefatalnih infarkta ili 89,7%.

The aim of our study was to evaluate the possibility of ultrasonography in differentiating malignant from nonmalignant cysts in postmenopausal women. The study included 100 postmenopausal women with diagnosis of simple ovarian cysts who were treated surgically at our clinic during the study period. In the group of operated patients the histopathological diagnosis confirmed benign cysts in most cases. In 1% of patients histopathological diagnosis was borderline or malignant tumor of the ovary. The risk of malignancy ranged from 0% in the cyst with a diameter below 50 mm, to 3.57% in cysts over 80 mm. Cyst diameter smaller than 50 mm and the volume of cyst less than 50 cm3 in correlation with the values of serum CA125 and clinical findings represent good algorithm for differentiating malignant from nonmalignant simple cyst.