Najčešći nemelanomski maligni tumori kože epidermnog porekla su bazocelularni (BCK) i planocelularni ili spinocelularni (PCK) kože. Nastaju na fotoeksponiranim delovima kože i u 90% slučajeva su povezani sa oštećenjima kože nastalim dugotrajnom izlaganju UV zracima, kod osoba svetle puti i strarijeg životnog doba. Cilj ovog rada bio je ispitivanje kliničko morfoloških i histopatoloških karakteristika obe vrste nemelanomskih karcinoma kože i prekanceroznih promena na koži. Urađena je jednogodišnja epidemiološka analiza najznačajnijih parametara. Od ukupno 50 pacijenata PCK je dijagnostikovan kod 46%, BCK kod (32%), i prekanceroze kod 22%. PCK je češći kod muškaraca 52,8%. Prekanceroze lezije prisutne su kod oba pola podjednako. Muški pol je predominatan za nemelanomske karcinome kože .Od ukupnog broja 72% je muškog pola. Prosečna životna dob kod oba pola iznosi 67.22. Najmlađa osoba imala je 41. godinu dok je najstariji pacijent imao 93 godina. Lice je najčešće zahvaćena regija sa 73,9%. Najučestaliji histološki gradus za PCK je gradus I (60,9%) Interesantno je da je PCK kod žena najčešće bio lokalizovan na leđima 28,6% dok kod muškaraca nismo imali ni jedan slučaj lokalizacije na leđima. Mešovita (43,8%) i nodularna forma(37,5%) su najučestalije u grupi BCK-kože dok je superficijalna tek na trećem mestu(18,8%). Zapaljenski eksudat mononuklearnog tipa bio je prisutan kod svih oblika NMTK i to kao umeren (72%) i izražen(28%). Uspešnost hirurške ekcizije merila se pozitivnim linijama resekcije koje su kod BCK bile kod tri pacijenta(6%)a kod PCK u 6 pacijenata (12%).

The aim of this study was to perform a comparative analysis applied conventional (traditional) and protective mechanical lung ventilation in clinical conditions with regard to intraoperative parameters changes of oxygenation, ventilation and acid-base status. This was a prospective study that included 240 patients. All patients underwent the same elective surgery (classic cholecystectomy). Patients were divided into two groups of 120 patients, A and B. In group A during the operation had received conventional lung ventilation with tidal volume of 10-15 ml/kg body weight, respiratory rate 12/min. and a PEEP zero. In group B was applied protective lung ventilation with a tidal volume of 6-8 ml/kg body weight, respiratory rate 12/min. and a PEEP of 7 mbar. Monitoring of oxygenation included the monitoring SaO2 and PaO2. Monitoring of ventilation included the determination of the value of tidal volume and minute volume ventilation, peak inspiratory pressure (Ppeak), medium pressure in the airway (Paw.mean), PEEP, PaCO2 and EtCO2. Monitoring of acid-base status was performed via determination of the pH values of arterial blood. Monitoring was carried out in four intervals: T1 - 5-10 minutes after the establishment of the airway, T2 - after opening peritoneum, T3 - after removal of the gallbladder, T4 - after the closure of the abdominal wall. All monitoring results are presented as mean. The statistical significance of differences in mean values was tested by t - test mean values in the case of two independent samples. As a statistical significance test taken as standard values p <0.01 and p <0.001. Comparative analysis of the value of SaO2, PaO2, Ppeak did not reach statistical significance. Statistical significance there is in the analysis of values of tidal volume and Paw.mean (p <0.001). Analysis of PaCO2 and pH of arterial blood showed no statistical significance in the first interval measurements but did interval T2-T4 (p <0.001). Based on the results of this study, it can be concluded that the applied types of mechanical ventilation of lungs during the performance of surgical procedures of medium duration, have not led to significant changes in terms of maintaining the parameters of oxygenation, ventilation and acid-base status, and they stayed in normal, physiological range.

Introduction: antibiotic prophylaxis in surgical patients is defined as the use of antibiotics to prevented infection of the operating field. Applies in cases where the infection is not clinically manifested. The aim of this paper is to demonstrate the importance of the prophylactic use of antibiotics in the prevention of postoperative infection for patient's inguinal hernia. Materials and methods: The making of the material used Surgical Clinic KBC Pristina in Gracanica, which is part of the "preventive use of antibiotics in surgical patients, through follow-up prospective study of 200 patients. The first group (study group-Group I) consisted of 100 patients with inguinal hernia, in which we apply the prophylactic use of antibiotics. Study group was divided into two subgroups: (Group IA), 50 patients with inguinal hernia in which the solution methods with installation of mesh. (Group IB), 50 patients with inguinal hernia where the tension applied in the treatment methods of treatment. In the second group of patients (control group-Group II) with the same number of patients in the postoperative tre- atment are therapeutic dose used antibiotics. Research results: In our study, the prophylactic purposes, we used compound II generation cephalosporine cefuroxime (Nilacef), which are given in intravenous bolus, the induction of anesthesia, in a dose of 1.5 grams. In 100 patients examined groups, we used prophylactic cefuroxime 100 ampoules (Nilacefa) of 1.5 grams, whi- le the treatment of 100 patients in the control group used for therapeutic purpose 894 ampoules of different antibiotics. Pos- toperative wound infection in patients with prophylactic application of antibiotics are not recorded, while we were in the gro- up where the applied dose of antibiotics therapeutics wound infection noted in two (2%) patients. The average number of days of treatment the study group, the postoperative period was 2.81 days, while patients with a therapeutic dose of antibiotics the average number of days was 5.28. Cost of treatment cefuroksim 50 patients, the prophylactic use amounted to 32,460RSD, while the cost of antibiotics applied in the postoperative treatment of the control group, in which we applied the therapeutic dose antibiotic treatment, was 253,961.52 RSD, which is 7.8 times more expensive. Conclusion: The prophylac- tic application of antibiotics reduced the non-critical use of antibiotics, the incidence of infection of the operating field, mor- bidity and mortality due to postoperative infection, the frequency of resistance to antibiotics, antibiotics to minimize the ef- fect of Bacterian normal flora of the patient, changes in the defense system of the patient, and thus the cost of hospital treat- ment of surgical patients.

Background: In hernia inguinal regions that are usually on the front wall of the belly may appear epigastric, umbilical and postoperative (incision-ventrale) hernia. Incision (postoperative-ventral) hernia is the kind of hernia that occurs in the area before surgical incision made through the entire thickness of the abdominal wall. Purpose: The aim of this paper is to indicate the frequency incision, epigastric and umbilical hernia, and the validity of some methods used in surgical treatment. Materials and methods: The making of the material used Surgical Clinic KBC Pristina in Gracanica. This prospective study we included 107 (3.43%) patients with hernia abdominal front wall, which were operated in the Surgical Clinic from 2003- 2009th year. Results and discussion: the anterior abdominal wall hernia, are recorded in 48 (44.86%) male patients and in 59 (55.14%) female patients. Age is of great influence on the frequency of anterior abdominal wall hernia, because we have the largest number of hernia 45 (43.14%) recorded in patients older than 61 years. Free hernia we found in 68 (63.55%) and hernia incarcerate of 39 (36.45%) patients. Incision (postoperative) we found a hernia in 44 (41.12%), umbilical in 36 (33.65%) and epigastric of 27 (25.23%) patients. Postoperative hernia is most often occurring after longitudinal laparotomia. We have them registered in 19 (43.18%) patients with infraumbilical, in 10 (22.72%) with supraumbilical, in five (11.36%) with subcostal, with four (9.09%) with transrectal, at two (4.55%) with pararectal laparotomia, in two (4,55%) patients after lumbotomia made with two (4,55%) after Phanensthil incision. The treatment of the anterior abdominal wall hernia in 72 (67.21%) patients, we used prolen net, while in 35 (32.79%) patients made plastic abdominal wall. Drainage was used in 62 (57.94%) operated patients. In 78 (72.90%) patients applied the prophylactic dose of antibiotics, while in 29 (27.10%) patients applied therapeutic dose. The length of treatment of patients who applied prophylactic dose of antibiotics was 2.48 days and length of treatment of patients with therapeutic dose applied was 4.82 days. Prospective studies of patients in the postoperative complications are recorded in four (3.74%) patients. We had wound infection in two (1.87%) and recidive hernia in two (1.87%) patients. Conclusion: This surgical method, when it comes to herniotomia, a direct comparison with the number of postoperative recurrence. Implantation of mesh has found its place and it is a revelation in the resolution of abdominal wall hernia.

Echinococcus is a zoonosis, parasitic disease, caused by echinococcus granulosus, E. multilocolaris, E. Vogeli and E. oligarthus. The most frequent at humans is a cystic form of the disease caused by E. granulosus, and rarely the alveolar one caused by E. multilocolaris seu alveolaris. It can affect all the organs and tissues. The most affected ones are: liver (70- 80%) and lungs (10-25%), while rarely, at 5% it can be found in spleen, kidneys, brain, heart, pancreas, mussels and skeleton. The only secure treatment of the primary echinococcosis is the surgical one. It should start immediately after the diagnosis is set in order to avoid complications which follow echinococcosis. Several surgical methods are used in practice for live echinococcus treatment: partial pericystectomia, total cystopericystectomia and liver resection. Aim of the work is to show the importance of the echinococcus cyst of liver and treatment methods. The patient presented in the work is Dj.G., female, register number of the disease history 355/14.05.2007., 61 years old, hospitalized at Surgical Clinic because of the surgery of echinococcus cyst on the left liver lobe. Diagnosis was set by abdomen USG, CT of the abdomen, and laboratory analyses. During the surgery, we found a big echinococcus cyst localized in the second and third segment of liver, so we did a liver resection as a bisegmetectomia with total ekstirpacija of the cyst. Postoperative flow passed normally and the patient
was on the eight postoperative day sent to further home care in a generally and locally good state.

Autors reports 20 ten old boy received penetrating vulns thorasic with naif at midle linea.subksifoid area. Patient with angina pectoris, hypovolemic shock end cardiac arrest received at department intensive care Clinic hospital centre Prishtine in Gracanica. In cardiogenic arrest under reanimation is introduction in general endotracheal anestesy and intervention surgery. Maden midle sternotomy and verification laesio pericardii under right cordis longth of 20 mm,hematopericard and vulnus at parietis diaphragmalis right ventricular in area septoapicalis.Past evacuation sangui from pericard heart mobilisation and made compresion phingin.Placement closure laesion with cardiorraphia prolen 0000 sec.Cooley.Lesion right pleurae mediastinalis and placement drain in right torasic cavum and drain mediastine in restrosternal area i aspiration undervother sec. Bilay. Fixation sternum with fillum metalicum sec. Kurschner. Reanimation intensive care all time and past realisation complete haemostasis along linae sutturae heart folow up substitution adecquat failure volumen total sangui plasm and cristolid. Realisation total stability hemodinamic and patient move at department intensive care. Control EKG, echocardiography and cardiac ensims 5 and 10 dely psotoperative show fingins corectly. Not signs ischemic laesaoin and disfunction conducti and arrhythmi. Haert pariets is all corectly viability and cinesy.

Obstructive jaundice presents partial or complete blockade in the gall way towards intestinal tract. This blockade is caused by mechanical obstruction in the extrahepatitic bilioductule system. Etiologic factors which cause obstruction of the extrahepatitic gall ways are numerous. One of the reasons of appearing obstructive jaundice is penetration of the cyst parts or cyst sprout into the gall ways. Echinococcus is zoonosis, parasitic disease, caused by echinococcus granulosus, E. multilocolaris, E. vogeli i E. oligarthus. At humans, cystic form of disease caused by E. granulosus appears most frequently, while the alveolar one caused by E. multilocolaris seu alveolaris appears rarely. Aim of the work is to show the importance of the echinococcus cyst of the liver at the appearing of the obstructive jaundice , penetrating the cyst parts or cyst sprout in the gall ways. The patient presented in the work is E.C., male, register number of the disease history 404/05.06.2007, 20 years old, hospitalized at Surgical Clinic because of the surgery of echinococcus cyst on the left liver lobe. Diagnosis was set by abdomen USG, CT of the abdomen, and laboratory analyses. Echinococcus cyst got complicated by its penetration into the gall ways, and manifested by jaundice, the signs of purulent cholangiitis, and bad general state of the patient, so the surgical treatment is absolutely indicated. During the surgery, after the done pericystectomia, cholendochotomia is done because of the enlarged cholangiitis, where the signs of purulent cholangiitis and 5 cyst sprouts are found and removed. Postoperative flow passed normally. Findings of done secondary cholangiography showed normal structure and transience of gall ways, so the T-drain was removed and the patient sent to further home care in a generally and locally good state.

Ahernia occurs when the contents of a body cavity bulge out of the area where they are normally contained. These contents, usually portions of intestine or abdominal fatty tissue, are often enclosed in the thin membrane that naturally lines the inside of the cavity. Although the term hernia can be used for bulges in other areas, it most often is used to describe hernias of the lower torso (abdominal wall hernias). Hernias by themselves usually are harmless, but nearly all have a potential risk of having their blood supply cut off (becoming strangulated). If the hernia sac contents have their blood supply cut off at the hernia opening in the abdominal wall, it becomes a medical and surgical emergency. Aims of the paper were: 1. to reveal the prevalence of inguinal region hernias (IRH) among all patients being admitted to emergency ward of Surgery Clinic at Gracanica during 2006 and 2. to show treatment efficacy of each surgical methods used. Material and method: Clinical
Center Pristine, Surgery Clinic at Gracanica patients' medical records were analyzed. Prevalence of IRH was monitored during the time frame of 1 year (2006). Basic statistical methods were applied for data analyzing. Results and discussion: During the time observed, 504 patients underwent surgical treatment. Among them, 162 patients (32,14%) were operated on inguinal region hernias. IRHs were more prevalent in males - 146 cases (90,12%) in comparison to 16 cases in females
(9,88%). During the certain time period, IRHs were more prevalent in adults 101 cases (62,35%) than in children 61 cases (37,65%). The vast majority of all operated hernias, belong to group of inguinal hernias 156 cases (96,30%). At the same time, there were only 6 cases (3,70%) of femoral hernias. This observation is in concordance with the data published worldwide inguinal hernias make up 75% of all abdominal wall hernias and occur up to 25 times more often in men than women.
The study, also, revealed incarcerated hernia (part of the intestine or abdominal tissue that becomes trapped in the sac of a hernia) in 6 patients (3,70%) while recurrent hernia was found in 3 patients (1,85%). The most frequently used surgical approaches were: i) Ferrary method in 54 patients (33,33%; ii) Lichtenstein method in 42 patients (25,93%), and iii) Bassini method in 35 patients (22,22%). Postoperative complications were noted in 3 patients (1,85%). Conclusion: Based on the results obtained, one may conclude that efficacy of surgical method used in treatment of IRH is in indirect relation with the number of postoperative recidives the higher the number of hernia recurrences, the lower the efficacy of surgical method is

Biliary calculosis is the most frequent disease of the hepathrombial system. Inflammation of the gall bladder appears in the acute and chronicle form. Acute inflammation presents one of the frequent complications of the gall bladder
calculosis. Acute inflammation of the gall bladder can appear in catarrhal, phlegmonous, gangrenous perforative form. Perforation of the inflamed changed gall bladder can lead to the diffuse biliary peritonitis, pericholecystitis and formation of
pericholecystitis infiltrate or abcess. Very often the acute inflammation of the gall bladder appears in combination with Acute inflammation of the pancreas. For the production of the work the biyearly material of the Emergency Surgical Centre
“Simonida” in Gračanica is used. In the ESC Simonida, in the period from January to December of 2004, 375 patients were operated. In the same period of time we operated 52 (13.86%) patients because of the gall bladder disease and biliary ways.
There were 45 female patients and 7 male ones. Gall bladder disease is 6.5 times more frequent at females in our material. Hard security situation and limited freedom of movement are one of the most important reasons of patients' late report to the
doctor, and appearance of the heavy forms of the inflammation of the gall bladder and biliary ways. The acute form of the inflammation of the gall bladder was noticed at 25 patients. The complications of the disease in the sense of cholecystopancreatitis, choledolithiasis, suppurating cholangiitis, choledolithiasis i cholecystoduodenal fistule were found at 27 patients. Postoperative complications were verified at 3 patients, wound infection at 2 patients and peritonitis at one
patient after drawing ouf the T-drain.

Women sexuality is a complex phenomenon encompassing biological, psychological, emotional and social aspects. The menopausal changes have undoubtedly a significant influence on sexuality. There is a widespread opinion that older women show a fading interest and desire for sexual relations. However, despite of all unavoidable changes brought about by menopause and elder age, the sphere of sexuality remains still very important. The paper reviews the changes occurring in the sphere of sexuality in the older age, influence of menopausal hormaonal changes, psycho-social factors and general health state in these changes, as well as of the possibilities of treating sexual dysfunctions in the menopausal period.