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.

Adult intussusception caused by inverted Meckel diverticulum is infrequent but important clinical entity, presenting with nonspecific symptoms. It may be observed in any age. We report a 26-year-old male patient with intussusception, who was examined several times for abdominal pain accompanied with nausea and vomiting. Basic diagnostics were inconclusive, so the patient was discharged each time with conservative therapy. After the last episode, CT scan showed suspicious intussusception, so the patient was admitted to general surgery ward. The next day there was a complete regression of all difficulties, and he was free of them in the month ahead. Finally, NMR enterography verified the presence of intussusception, and the operative procedure was performed. At laparotomy, ileo-ileal double intussusception was observed and the affected segment was resected with T-T anastomosis. Histopathological examination demonstrated an inverted Meckel diverticulum, measuring 8cm, with ectopic gastric antral type mucosa and ectopic pancreatic tissue. Postoperatively, the patient made an uneventful recovery.

The effect of hyperbaric oxygenation on the treatment of ischemic ulcers on patients with diabetic angiopathy is known, but the effect of HBO t (hyperbaric oxygen therapy) on diabetic claudicates is less known, i.e. to those that havethe second stage of peripheral vascular disease (without ulceration). In this study, we tried to point out the impact of hyperbaric oxygen (HBO) on the development of collateral arteries, i.e. the process of arteriogenesis, and consequently the symptom of claudication. 30 subjects in total were included in the case-control study. Inclusion criteria were: diagnosis of diabetes mellitus for at least five years, as well as Doppler-verified distal angiopathy. The respondents were randomly divided into two groups. The control group (n = 15) was treated by standard methods only.The respondents in the experimental group received 20 HBOTs each in a single-chamber hyperbaric chamber for 70 minutes at a pressure of 2.0 ATA. In this regard the assumptions of the arteriogenic effect of hyperbaric oxygenation, the eventual development of new arterial collaterals it was monitored by Doppler. after 20 HBO treatments and at the follow-up, 3 months after HBO therapy. It was observed that there was a statistically highly significant difference before treatment, in the number of registered functional small blood vessels of the lower leg and three months later, and after 20 HBO sessions, both on the left and the right leg, within the experimental group. There was observed also a highly statistically significant difference in the number of newly formed blood vessels on experimental patients in comparison with the patients from the control group. Our study shows that HBO therapy has a positive effect on the development of collateral blood vessels of the legs and that it may find application in the treatment of patients with diabetes mellitus with angiopathy and claudication disorders. Our study shows that HBO therapy has a positive effect on the development of collateral blood vessels of the legs and that it may find application in the treatment of patients with diabetes mellitus with angiopathy and claudication disorders.

The liver is an organ with many indispensable functions in the body. Liver diseases can be caused by numerous ethiological factors, and are divided into two basic groups, according to an anatomical substrate which is primarily affected – on hepatocellular (parenchymal) and billiard diseases. Approximately 10% of patients with liver disease require a surgical procedure (not including a liver transplant) in the last 2 years of life. Because of its reserves and regenerative abilities, the liver can suffer a great deal of damage before the clinical manifestations of its own dysfunction, which is a challenge for the pre-operative assessment of its condition. The goal of preoperative screening is to determine the presence of preexisting liver disease without the need for extensive or invasive testing. Routine testing of liver function has a low prediction value. The post-operative outcome depends on the nature and severity of the existing liver disease, as well as the type of the operation. It is often necessary to treat complications of severe liver damage, such as coagulopathy, thrombocytopenia, ascites, kidney failure, encephalopathy and malnutrition. Predisposition for infections of patients with cirrhosis requires prophilactic use of antibiotics. Induction of anesthesia, bleeding during surgery, hypoxia, hypotension, the use of vasoactive drugs, and even positioning of patients and surgical techniques can reduce intraoperative and perioperative delivery of oxygen in liver and increase the risk of hepatic dysfunction. Pharmacokinetic parameters of anesthetic agents, muscle relaxants, painkillers and sedatives may be altered in connection with plasma proteins, detoxification in liver etc.. The postoperative liver dysfunction depends on surgical trauma, ischemia during surgery or loss of hepatocite mass, and it can be divided into three groups – hepatocelulcular, cholesterol and mixed liver dysfunction. Posthepatectomy liver failure is one of the most serious complications after the liver resection and is a post-operative deterioration of liver capability to maintain its main functions. In recent years, liver function support systems have been developed. Molecular recirculation system with absorption (MARS), modified fractional plasma separations and adsorption (Prometheus) and bioartifical liver and extracorporal device for assistence of liver activity. Extensive clinical studies are needed to prove the effectiveness of these artefical systems for temporary replacement of the edible functions to its recovery or to transplantation.

Colorectal cancer, as one of the leading oncological causes of disease worldwide, is a major challenge in terms of treatment and patient access. Technological advances have made it possible to apply a minimally invasive laparoscopic surgical technique that has proven superior to open surgery. In order to optimize treatment, reduce mortality and morbidity, a perioperative strategy has been developed summarized in the principles of ERAS protocol (Enhanced Recovery After Surgery). The basic postulates of the ERAS protocol include prehabilitation, comorbidity control, prevention of postoperative nausea and vomiting, minimally invasive surgical method, multimodal analgesia, achieving euvolemia, prevention of hypothermia and early mobilization of the patient. The principles of the ERAS protocol are based on evidence to support safety, applicability and effectiveness, however, there are not yet enough studies to examine the long-term benefits of their implementation. The implementation of the ERAS protocol at KBC “Dr Dragisa Misovic -Dedinje” is not complete, but there is significant compliance with the guidelines of the 2018 ERAS Association, which has reduced inpatient stays and the number of postoperative complications. Although there is ample evidence to support the safety and effectiveness of this treatment approach, a multimodal strategy poses a major challenge to traditional surgical doctrine, making its implementation slow and incomplete in practice.

Introduction: Hyperostosis frontalis interna is progressive, irregular thickeness of the frontal bone s internal table. It has been associated with a wide range of syndromes, though we know now that it can occur as an independent entity. Etiology is still unclear, but the most probable hyphothesis is alteration of steroid sex hormons, proven in high frequency among postmenopausal women. It is mostly asympthomatic or it has been accidentally diagnosed after endocranial trauma or postmortal. Because of its progression, in some cases it can cause cerebral cortical compression and varible neurological symptoms. Case report: We present a case of 27 years-old women, hospitalized in Neurosurgical Clinic, because of severe headaches lasting for 3 month. The head CT scan showed a massive, expansive lesion in right frontal bone, with spearing of the superior sagittal sinus and skull midline. Bone bulging does not affect outer table of the frontal bone, but only diploic space and inner table. Pathological analysis of the frontal bone showed marked trabecular thickening both cortical and spongy bone, with corticalisation of spongy bone. Haversian canals showed reduction in number and size, and light fibrosis. The lamellas of the spongy bones were enlarged, with prominent interlamellar bridges and the reduction of interlamellar spaces.In purpose of closer determination of etiopathogenesis,we did immunohystochemical analysis of Estrogen, Progesteron and Androgen receptors in dural tissue. Immunohistohemical stain confirmed nuclear expression of Estrogen and Androgen receptors in dural fibroblasts.Progesterone receptors were negative on immune stain. Conclusion: These results could support the hormonal theory of the cause of hyperostosis frontalis interna.

The fourth Edition of the World Health Organization’s Classification of Tumours of Endocrine Organs from 2017 introduced some novelties based primarily on genetic research, compared to the previous edition from 2004. The most common primary tumors of the adrenal cortex are adenomas, and of the adrenal medulla are pheochromocytomas. As such, these tumors have their specificities in pathohistological diagnosis, by which they differentiate from tumors of other localizations. In the daily work of the pathologist dealing with the diagnosis of the tumor of the adrenal gland, differential diagnostic problems can occur, where biological behavior of the tumor cannot be predicted based on its morphological appearance; this primarily refers to cortical neoplasms and phaeochromocytomas. Scoring systems are used in these cases, Weiss and Lin-Weiss-Bisceglia criteria for cortical neoplasms, and PASS criteria for pheochromocytomas, where by recognizing the suggested morphological parameters, value or score is obtained which predicts the biological behavior of the tumor, i.e. differentiates benign from malignant neoplasms. The accepted algorithm of diagnostics of adrenocortical neoplasms also includes immunohistochemical staining for ki-67, which potentially can differentiate adrenocortical adenoma from carcinoma. Despite the introduction of these scoring systems, the only safe indicator of malignancy is still distant metastasis.

Aim: To evaluate surgical lung biopsies in patients with a clinically and radiologically set diagnosis of ILD. Introduction: Interstitial lung diseases (ILDs) are a group of lung diseases affecting the lung interstitium. These entities share similar clinical and radiological features and are distinguished primarily by the histopathologic patterns on surgical lung biopsy. Material and Methods: The study included 30 patients with a surgical lung biopsy performed in 10-year period at the Institute for Pulmonary Diseases of Vojvodina in Sremska Kamenica. Standard H E stain, special stains for conective tissue and smooth muscle, as well as immunohistochemistry in some cases were used. The patient’s age, sex, clinical symptoms, surgical biopsy type and histological findings were analyzed. Results: Of the 30 patients who underwent surgical lung biopsy, an open lung biopsy according to Claassen was performed in 14 patients, in 12 biopsies biopsy according to Maassen was obtained, while in 4 patients material for histopathological analysis was taken by VATS (Video - Assisted Thoracoscopic Surgery). The most common biopsy site was upper lobe in 16 cases, then lingula in 10, middle lobe in 2, and lower lobe and lung base in 1 patient. By histopathological analysis, diagnosis of UIP in 8, PLCH in 7, sarcoidosis in 6, hypersensitivity pneumonitis in 3, NSIP in 2, LAM, LIP, DIP and ACIF in 1 patient. Conclusion: Diagnosis of ILD is based on history, physical examination, high-resolution CT imaging, pulmonary function tests, and lung biopsy which presents golden standard in diagnostic approach.