Tumor budding refers to an isolated cell or a cluster of up to five undifferentiated tumor cells, located in the stroma close to the invasion frontline of a carcinoma. It has been observed that tumor budding invariably precedes both an invasion into the lymphatic vessels surrounding a tumor and the development of metastases in lymphatic nodes. The aim of this paper is to determine the link between tumour budding, lymphatic vessel invasion and presence o lymph node metastasis in colorectal carcinomas. The study involved 92 cases of colon and upper rectum cancers removed at the Trebinje General Hospital and the Medical Centre in Kosovska Mitrovica. High-grade tumour budding was diagnosed in 66 (71.7%) cases, and lowgrade tumour budding in 26 (20.3%) cases. Lymphatic invasion was detected in 63 (68.5%) cases (55 (87.3%) of these cancers showed high-grade tumour budding, while on the other hand 8 (12.7%) had low-grade tumour budding). Lymphonodal metastases were found in 45 (48.9%) cases (of which 36 (80.0%) were high-grade and 9 (20.0%) low-grade incidents). Based on the ÷2-test, it may be concluded that the distribution of tumour budding in relation to lymphatic invasion (p<0.001) is statistically very significant, which was not confirmed in the case of metastases developing in lymphatic nodes (p>0.05). In conclusion, tumour budding is highly linked to lymphatic invasion, which it most probably precedes. 

The objective of this study that included 34 patients with psoriasis was to assess the reliability of the disease severity measures (i.e. Psoriasis Area and Severity Index - PASI) and the reliability of the health related quality of life measures (i.e. EuroQol EQ-5D Quality of Life Scale - EQ-5D, Dermatology Life Quality Index - DLQI and Psoriasis Disability Index -PDI). High interobserver correlation reliability and good test-retest reliability of PASI scores, as well as good test-retest reliability of EQ-5D, DLQI and PDI scores were achieved. Correlation coefficients between the test and retest scores on DLQI and PDI were higher than those on the dimensions and on EQ-VAS in EQ-5D. Disease severity scores given by PASI and the quality of lify scores given by EQ-5D, DLQI and PDI offered the reliable assessment of both the psoriasis severity and the quality of life of the people with psoriasis.

The authors analysed the importance and results of tympanometric examination by children in preschool institutions of Kosovska Mitrovica, Zvecan, Zerovnica, Socanica, Leposavic, Lesak and Zubin Potok. Children underwent ENT examination, which included clinical ENT examination and accessory diagnostics methods: tympanometric exami-nation and bacteriological analyses of the nose and throat secret. Totally, it have examined 870 children. The most frequent cause of the middle ear impairment was Eustachian tube dysfunction or "willingness of the middle ear for disease" (50,5% cases). Rarely, it was transient effusion in the middle ear and serous otitis media (19,02%). The authors underline a great importance of tympanometric examination by preschool children in detection of middle ear diseases. 

Introduction: Upon teeth are lost, morphological and functional disorders are caused on stomatognathic system. Since a longer period of time, total dentures made on conventional way were the best choice for treating toothless patients. Because of specific configuration of the toothless lower jaw, patients with total dentures mostly suffer problems with lower jaw total denture. From the time when osseointegration was applied as a successful clinical concept, implants have been used as well as for retention and stabilization of the total dentures. Case report: 66 years old male patient underwent surgery where implant-prosthetics rehabilitation of lower jaw is attained with application of four Bredent mini implants, used for retention and rehabilitation of total acrylic denture. The overall process was completed in one session within approximately one and a half hours, with the regular post surgical care and immediate load of implants. Conclusion: Taking into consideration simplicity, safety and non invasive procedure of placing mini implants, as well as their effect on improving quality of life of toothless patients, and economic aspect, we can conclude that along with classical and small implants they present future and method of choice for the rehabilitation of toothless patients.

Hydatid disease is a parasitic infestation by a tapeworm of the genus Echinococcus which represent significant healthcare problem in Montenegro as in many other regions of the earth. The incidence in Montenegro is 4.57/100.000. Communications with bile ducts is one of the most frequent complications of the hydatid disease. Wide communications can be followed with cholangitis and obstructive jaundice. We presented 51 years old patient with obstructive jaundice and hydatid cyst of the liver. Total pericystectomy is golden standard of the surgical treatment, which is, unfortunately possible only in 6-10% of the cases. The usage of the intraoperative ultrasound is standard procedure.

Combustion are hypothermic injuries that can occur due to the contact with electricity, chemicals, dry heat, hot liquid and gas, and radiation. In this work there is a 52 year old patient that was treated from combustion on her both feet and her lower legs. Previously, she was treated as an outpatient in a period of 30 days. For the first time in our department we used hydrofiber bandage with Aquacel Ag silver in treating combustion on patient's diabetic foot. These bandages are impregnated with silver that has antimicrobial effect on a huge variety of bacteria. It soaks in a big amount of liquid and bacteria and it helps in removing necrotic tissue from the wound making autolysis debridement. The patient was treated for 35 days on general surgery department. She was released from the hospital in good general condition and with neat local finding. 

We treated 15 subfertile men with varicocele with combination of subinguinal ligature of spermatic vein or plexus pampiniformis and medicaments. In a five-year period , we registered 5 pregnancies (30%) in female partners of our patients. We consider subinguinal ligature of spermatic vein as minimally invasive and cost-effective initial treatment of "infertile couples".

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.

Gastrointestinal stromal tumors are the most common mesenchymal tumors of the gastrointestinal tract. Anatomic locations, in decreasing, are: stomach (60%), small intestine (30%), colon and rectum (5%), oesophagus (5%). Histogenesis is still unclear, criteria of malignancies are not adapted, biological behavior in not known, and the diagnosis and prognosis are questionaly. Although usually asymptomatic, large gastrointestinal stromal tumor may present with repeated bleeding. Most often diagnosis in mode during the explorative laparotomy and postoperative immunohistochemical analysis of specimen. In this paper we have analized patients with gastrointestinal stromal tumors of the oesophagus. The patient preoperatively diagnosed submucosal tumor of the esophagus presented with repeated gastrointestinal bleeding. After the resuscitation, we performed total gastrectomy. The immunohistochemical analysis proved benign GIST. Surgical resection is a treatment of choice gastrointestinal stromal tumors presented with gastrointestinal bleeding. 

Aim: There is a few data in the literature on the medical significance of Mesobuthus gibbosus whose sting is considered potentially hazardous for human health. In this case two patients in the age of 16 and 25 with diagnosed scorpionism Mesobuthus gibbosus are described.Here is the example of woman 49 years old who had scorpionism, Euscorpius italicus. Case report: The stings by Mesobuthus gibbosus in both cases occurred during the construction work done by tourists. The following general symptomes were noticed: excitement, pulsating pains, muscle cramps in legs, pallor and profuse sweating. Local symptoms were: paresthesis, bruised skin, erythematous swelling with a red spot in the centre.After two years one patient had occasional muscle twitching, extension of superficial vein and pain on her injured leg. Sting by Euscorpius italicus happened in a bathroom while doing her physiological needs. The local symptoms were: swelling, redness and pain. The general symptoms were: numbness of a neck, intensive salivation and nausea. The symptomatic therapy was implemented in all three cases and was successful. Conclusions: Mesobuthus gibbosus and Euscorpius italicus can be found at the Montenegrian coast and represents a real danger for the health of the local community and tourists. Therapy of these scorpionism is only symptomatic.