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.

The neurons of the sympathetic trunk as well as the other nerve cells undergo of many changes during life. The most striking of these morphological changes, during normal aging, is the accumulation of lipofuscin-filled vacuoles or neuromelanin. Considering that the pigment is a non-biodegradable and can not be removed by exocytosis, the process of its accumulation in cells is unavoidable. The role of lipofuscin and its impact on cell function is not quite clear. Some authors consider that pigment does not damage the function of the cell, unless it contains lipofuscin in large quantities, and then it mechanically prevents its function so that could lead to cell death. Since we found a very little data in the literature about using morphometric methods in accumulation of pigment in ganglion cells or quantified observed changes, we set that the aim of this study is to confirm the presence of pigment in ganglionar cells of the symphatetic trunk, when it occurs in grater extent, as well as dinamics of its accumulation (quantification of ganglionar cells without pigment, those with partial presence of pigment, and those that were complitely filled with pigment) by using numerical density. For morphometric analysis we used test system M42. To determine the numerical density of ganglionar cells we used a method for thick cuts by Floderus. We found that interneuronal accumulation of lipofuscin is directly correlated with the aging process.

Najčešći maligni tumori kože epidermoidnog porekla su bazocelularni (BCK) i skvamocelularni (SCK) karcinom. U 90 % slučajeva nastaju na fotoeksponiranim delovima tela i direktno su povezani sa oštećenjima kože nastalim dugotrajnim izlaganjem UV zracima, obično kod osoba starijeg životnog doba i svetle puti. Od njihovih posledica godišnje u svetu umre 65000 ljudi. Najvažnija karika u sprečavanju nastanka ovih tumora jeste prevencija, dok njihovo rano prepoznavanje omogućava adekvatniji hirurški tretman sa poštedom okolnog tkiva. Osnovni cilj ovog rada je ispitivanje histopatoloških i kliničko-morfoloških karakteristika BCK i SCK kože glave. Analizom je obuhvaćeno 439 karcinoma (297 (67,7%) BCK, 126 (28,7 %) SCK i 16 (3,6%) BCK+SCK), među kojima je preko 60% dijagnostikovano kod muškaraca, najčešće u sedmoj i osmoj deceniji života, sa najvećom učestalošću BCK na nosu, odnosno na koži gornje polovine kože lica i SCK na usnama, odnosno na koži donje polovine kože lica. Svi karcinomi kože glave bili su češći na desnoj strani. Klinički i morfološki, najveći broj BCK manifestovao se ulceroznim oblikom prosečne veličine 1,2cm i mešanim histološkim tipom, a SCK vegetantnim oblikom prosečne veličine 1,55cm i histološki gradusom I. Najveći broj BCK i SCK bio je odstranjen u celini, za razliku od kombinacije ova dva tumora u kojima je u većini slučajeva bila neophodna i naknadna hirurška intervencija.

A prominent ear, so called a protruding or “lop” ear, is the most common congenital deformity of the external ear. This deformity persists when the mastoid-helix angle (MHA) is higher than 30 degrees. It is relatively common among the population with the incidence of about 5%. The aim of this study is to present surgical procedure and our results using otoplasty with scoring anterior surface of the auricular cartilage. To analyze objective and subjective surgical procedure effects. Between 2011 and 2014 we treated 28 patients. We found statistically high significance p<0.01 in value mastoid-helix angle (MHA) preoperative and postoperative. In patients with bilateral otoplasty the difference between left and right MHAs after surgical procedure is less than 4 degrees. The difference of head-helix distance (HHD) preoperative and postoperative is statistically important with high significance p<0.05. Preoperative satisfaction by personal appearance was better after surgical procedure p<0.05. Complications occurred in 9 cases (32.4%). Otoplasty by scoring anterior surface of auricular cartilage is safe procedure for correction of prominent ear with excellent results on patient satisfaction by personal appearance. Effect of reducing the MHA and HHD is long lasting.

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.

According to the relevant investigations during past decade there is a great increase of malignant skin tumors. By this research we tried to investigate this hypothesis in domestic population and present complicated reconstructive procedure. In this research were included 591 patients with melanomas and carcinomas of head and neck who were surgically treated at our clinic from August 2000. to October 2008. Results of this research showed that 50 patients had melanoma and 541 carcinomas of skin. We have found that men are affected by skin facial carcinomas four times as much as women. The most common location of plano cell carcinoma was the skin of the auricle and lips, while basal cell carcinoma was mostly found on the nose. 62% patients with squamous cell carcinoma who were primary surgically treated survived more than 5 yr. 85% patients with basal cell carcinomas survived more than 5 yr.

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.

Planocellular carcinomas grow rapidly infiltrating the surrounding tissues. Because of that approach to the treatment of the patients must be multidisciplinary. A series of 101 patients with tongue and mouth floor carcinoma were analyzed. All were surgically treated in the period 2000. through 2007. The clinically evidenced local spread (cT) is highly correlated to the intraoperatively and patohistologically evidenced spread (pT) ~84%. The degree of correlation falls with increase of the T stage. The clinically evidenced regional spread (cN) and intraoperatively and patohistologically evidenced of regional spread (pN) presented lower in ~57% correlation then corresponding T categories. The study proves that multidisciplinary approach to the patients with oral carcinomas is the base for their proper treatment. 

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.