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Introduction/Objective. Rib fractures are common in blunt chest trauma (BCT), and when they are associated with pleural complications (PC) – pneumothorax, hemothorax and hemopneumothorax – the treatment of these patients is prolonged and difficult. Without the ability to predict PC after rib fractures in BCT, most doctors are forced to initially treat these patients through observation and conservative treatment. The goal of this research is to determine which of the investigated biomarkers of inflammation – fibrinogen, interleukin-6 (IL-6), and C-reactive protein (CRP) – are significantly associated with the occurrence of PC after rib fracture in BCT, and whether they can be used in stratifying patients for hospitalization and further treatment. Methods. The prospective study included 90 patients with rib fractures caused by BCT. The test group comprised 45 patients with rib fractures and the presence of PC, and the control group consisted of 45 patients with rib fractures without PC. Blood sampling was performed on admission, on the second, third, and fifth day after the injury, and PC were monitored until the seventh day after the injury. Results. Serum values of IL-6 on the second day and fibrinogen and CRP on the second and third day after injury were statistically significantly higher in patients with PC, and IL-6 showed a good discriminative ability in assessing the occurrence of PC on the second day after a rib fracture in BCT. Conclusion. The investigated biomarkers of inflammation – fibrinogen, IL-6, and CRP – can be used as predictors of PC after rib fracture in BCT, and their application can significantly replace clinical observation.

Depopulation of mountains has been an intense and lengthy process in Serbia. This paper will analyze the potential of Kopaonik mountain for the development of tourism, which can be one of the key factors for the demographic revitalization of the entire mountain. In tourism development so far, Kopaonik mountain stands out as one of the most important carriers of mountain tourism in Serbia. The limiting factor in the development so far is the pronounced seasonality of tourism promotion. The aim of the research in the paper will be to identify the factors that influence seasonality phenomena as the main limiting factor for achieving better economic effects.

Introduction/Objective. In this study, we have pointed out the immunohistomorphometric characteristics of somatotropic (GH) and folliculostellate (FS) cells of the male pituitary gland during ageing. Methods. On histological sections of the pituitary gland of 14 male cadavers of different ages, the GH and FS cells were immunohistochemically labeled with corresponding antibodies, monoclonal anti-GH antibody, and polyclonal anti-S100 antibody, respectively. Immunopositive GH- and FS-cells were further morphometrically analyzed using ImageJ software. Results. The obtained results of morphometric analysis showed that the surface area of GH cells increased significantly with age. In these cells, the nuclear–cytoplasmic ratio gradually decreased and became significantly higher after the age of 70 years. The volume density of GH cells has not changed during ageing, while in FS cells this parameter significantly increased in the cases older than 70 years. The nuclear–cytoplasmic ratio of GH cells is negatively correlated with the volume density of FS cells. Conclusion. Based on the obtained results, we concluded that hypertrophy of GH and FS cells occurs in men with ageing and that correlation between the morphometric parameters of these two cell types indicates their mutual interaction.

In the process of loop formation, the weft knitting phase has a dominant place, both from the aspect of forming the loop as well as determination its length and geometric shape. The loop length is the most important technological parameter in the knitted fabrics structure analysis and it is directly a function of sinking depth. The yarn tension in the weft knitting phase is determined by the following parameters: values of yarn tension at the entrance to the knitting system, yarn friction with knitting needles, yarn guiding speed, yarn bending stiffness and yarn angle coverage with knitting needles. Determination the value of yarn tension in the weft knitting phase is extremely important for the reliability of the knitting process. The obtained results show that the maximum values of yarn tension in the loop formation process occur in the weft knitting phase and that they must not be greater than the forces of the elastic limit of the used yarn.

Introduction/Objective. This 10-year prospective study’s primary objective was to evaluate the incidence of complications of radical retropubic prostatectomy (RRP). The secondary objective was to analyze how RRP affects lower urinary tract symptoms (LUTS) and quality of life (QoL) by using the International Prostate Symptom Score (IPSS). Methods. We analyzed 254 patients who underwent RRP in the period 2009–2018. All complications were graded according to the Clavien–Dindo classification. To assess urinary symptoms and the QoL, all the examinees filled out the IPSS and the International Prostate Symptom Score for QoL (IPSS QoL) questionnaires during preoperative preparation and three, six, and 12 months after surgery. Results. The incidence of complications Clavien–Dindo grade ≤ II and grade ≥ III were 26.4% and 16.5%, respectively. The mean overall IPSS for the entire group of patients after 12 months of follow-up was significantly different from the preoperative baseline value (p < 0.001). Patients with preoperative moderate (IPSS 8–19) and severe urinary symptoms (IPSS 20+) had a statistically significant reduction of urinary symptoms after RRP (p < 0.001). After 12 months, IPSS QoL was statistically significantly lower than the preoperative one (p < 0.05). Conclusion. For patients with clinically localized prostate cancer, RRP is a safe and effective treatment option. It is associated with a higher rate of complications from the Clavien–Dindo grade ≤ II group. RRP has clinically beneficial effects on LUTS in patients with moderate and severe urinary symptoms and the QoL related to LUTS.

Yarn length in a loop is one of the most important technological parameters in knitwear structure analysis. Therefore, determination of the accurate values of yarn length in a loop is of great importance in knitwear structure parameters projection. This paper presents comparative results of the determination of yarn length in a loop based on the loop row height, loop row width and calculated yarn diameter, as well as determination of loop length based on machine technological parameters taking into account needle pace, platinum and needle diameter, platinum and needle curved radius, span angle of yarn with needle and platinum and projected cooling depths. The results obtained show various values of yarn length in a loop.

Background/Aim. Duodenogastric reflux occurs after gastroenteroanastomosis, with or without resection of the stomach (Billroth I, Billroth II), after vagotomy and pyloroplasty, gastroduodenostomy as well as in conservatively treated patients. The aim of this study was to analyse the effect of carcinogenic N-nitroso compounds (MNNG) influence in conjunction with duodenogastric reflux, in the function of time for precancerous lesions development in gastric mucosa. A particular purpose of the study has been to suggest some effective surgical procedures, which could prevent the harmful effects of duodenogastric reflux on gastric mucosa, as a potential activator of carcinogenesis. Methods. The research included 90 experimental, male Wistar rats, divided into 3 groups. The two experimental groups were subjected to two surgical procedures: Billroth II gastric resection (group B2), and the Roux-en-Y reconstruction (group RY), respectively. The control group (group C) animals did not receive any surgical treatment. All groups were administered per os chemical cancerogen MNNG. All anastomoses were performed by extra mucosal suture with monofilament polypropilene 7–0, and 8–0. The animals were sacrificed consecutively, and subjected to total gastrectomy after 8, 16 and 24 weeks. Results. Pathohistological analysis was performed on defined regions of the rat stomach in three time period. The B2 group, at the end of our experiment, showed predominant incidence of severe lesions: hyperplasia (0%), gastritis (0%), metaplasia (6.7%), dysplasia (46.7%), early carcinoma (20%) and carcinoma (26.7%). At the end of our experiment, the RY and C groups showed the similarities of the obtained results related to time with predominant incidence of mild lesions: hyperplasia (13.3% vs 0%, respectively), gastritis (13.3% vs 13.3%, respectively), metaplasia (6.7% vs 13.3%, respectively), dysplasia (66.7% vs 66.7%, respectively), with an extremely low incidence of early carcinoma (0% vs 6.7%, respectively) and no incidence of carcinoma (0% vs 0%, respectively). Conclusion. Without the presence of duodenogastric reflux, MNNG causes a low degree of precancerous gastric lesions. However, direct contacts of MNNG with gastric mucosa, including the presence of duodenogastric reflux, induce precancerous lesions and carcinoma. The percentage of reversible changes decreases with time, while the percentage of irreversible lesions and carcinoma increases. A lack of distinction in the findings between the RY and C groups confirms a gastroprotective role of the Roux-en-Y procedure.

Introduction/Objective. The ideal reconstruction procedure after total gastrectomy should replace all lost functions of the stomach. The aim of this study was to evaluate the usefulness of preserving the duodenal passage in subsequent improvement of body weight (BW) and body mass index (BMI) in patients with gastric cancer after total gastrectomy. Methods. A total of 30 patients with gastric cancer were prospectively randomly divided into a group of reconstruction with double-tract (n = 15) and a group of reconstruction with simple Roux-en-Y after total gastrectomy. They were stratified by sex, age, their anthropometric measurements (BW, BMI), primary tumor localization, Lauren’s classification, TNM stage classification, length of hospital stay, operation duration, postoperative complications, and mortality. Postoperatively, BW and BMI were measured at three, six, and 12 months and compared between the two groups. Results. The clinical group of double-tract patients had significantly higher the values of BW in the postoperative period after six (66.6 ± 4.9 vs. 61.7 ± 7.6; p < 0.05 paired Student’s t-test) and after 12 months (67.0 ± 4.9 vs. 62.3 ± 7.2; p < 0.05 paired Student’s t-test) compared to the group of Roux-en-Y patients. On the other hand, the clinical group of double-tract patients also had significantly higher the values of BMI in postoperative period after 12 months (23.6 ± 1.1 vs. 22.5 ± 1.6; p < 0.05 paired Student’s t-test) in relation to the Roux-en-Y group of patients. Conclusion. Reconstruction procedure carried out after total gastrectomy which implies preserving the duodenal passage has significant increase of BW and BMI, compared to reconstruction procedure without the preservation of the duodenal passage.

Background/Aim. Rectal cancer is a major health problem throughout the world, despite the great progress in the treatment and control of the disease. The aim of this study was to determine the effect of mesorectal excision type on local recurrence in patients operated on for rectal cancer within a 3- year period. Methods. The clinical retrospective study was conducted at the Clinic for General Surgery at the Clinical Center in Niš, Serbia, and included 225 patients with rectal cancer. Postoperatively, the patients were observed 36 months. Total mesorectal excision (TME) method was used in 129 (57.33%) patients, and partial mesorectal excision (PME) in 96 (42.66%). There were 145 (64.44%) man and 80 (35.55%) women, average age 66.8 years. Results. In 58 (25.77%) of the patients cancer was localized in the proximal third of the rectum, in 99 (44%) in the medium third, in 68 (30.22%) it was 8 cm of the anocutaneous line. In 167 (74.22%) patients rectal cancer was in T3 stadium. TME was performed in all the patients with cancer in the distal third of the rectum and in 61.61% of the patients with cancer in the medium third of the rectum. PME was performed in all the patients with localized cancer in the proximal third and in 38.38% of the patients with cancer in the medium third of the rectum. Local recurrence occurred in 20 (8.88%) patients, 12 (9.30%) in the TME group and 8 (8.33%) in the PME group, which was not a statistically significant difference. In 75% of the cases, relapse occurred in the patients in T3 stage. Relapse occurred in 55% of the cases in the second year after the surgery. The median survival of all the patients amounted to 35 months. The total mortality of all respondents in a 3-year period amounted to 5.3%. Conclusion. There were no statistically significant differences in the incidence of local recurrence and survival among patients who underwent TME and those underwent PME. The type of mesorectal excision does not affect the incidence of local recurrence in node-negative disease stages.

The concentrations of fifteen metals (Mg, Na, Ca, K, Se, Zn, Mn, Fe, Pb, Cr, Cu, Cd, Sb, Ni, Co) were determined in water from ten artesian wells (AW) in Semberija to obtain a general metal profile of water in this region. Principal components analysis (PCA) was used in this classification. Using principal component analysis two factors controlling the metal variability were obtained, which accounted for nearly 71.5% of the total variance. Natural (lithogenic) factor is represented by PC1, while anthropogenic factor is represented by PC2. PC1 with high contribution of Mn, Mg, Na, K, Ca, Zn and Se accounting for 41.84% of the total variance, while PC2 exhibits high loading for Cd, Ni, Sb, Cr and Pb (29.66%). Three general areas (clusters) with different metal characteristics were detected. Water from artesian wells in first cluster (AW1, AW2, AW3, AW4, AW5 and AW6) had much higher metal concentration compared with those in the second (AW7, AW8 and AW9) and third cluster (AW10). That is as a result of anthropogenic inputs. Also, the analysis of water demonstrated slightly elevated values for Mn (concentrations up to 0.176 mg/L), while concentrations of the other investigated elements are below the values recommended by the World Health Organization (WHO) and the United States Environmental Protection Agency (US EPA). [Projekat Ministarstva nauke Republike Srbije, br. 172047]