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Introduction/Objective. Patients with rheumatoid arthritis (RA), osteoarthritis and fibromyalgia, alongside chronic pain, often suffer from functional disabilities, as well as cognitive dysfunction. The objective of this study is to compare the intensity of pain, symptoms of depression, anxiety, and memory ability among rheumatic patients with chronic pain and to compare rheumatic patients to a control group of healthy participants. Methods. The cross-sectional study, which included 110 (82 female; 28 male) patients with chronic pain, was done at the Special Hospital for Rheumatic Diseases, Novi Sad. Depression was determined by Beck?s Depression Inventory, anxiety was diagnosed by Spielberger?s anxiety test, and memory was assessed by the Wechsler Memory Scale. Results. Mean pain intensity in patients with fibromyalgia were statistically significantly higher compared to patients with osteoarthritis and RA (p < 0.05). A statistically significant difference in the psychological status of patients (p < 0.001) and patient memory (p < 0.05) with chronic pain was established, compared to patients in the control group. There was no statistically significant difference in the psychological status of patients, patient memory level, and pain intensity in patients with positive fibromyalgia test results in comparison to rheumatic patients not meeting the criteria for fibromyalgia. Patients with osteoarthritis had a statistically significantly lower memory coefficient in comparison to patients with RA and fibromyalgia. Conclusion. In RA, osteoarthritis, and fibromyalgia patients, clinical factors such as pain, depression, and anxiety play an active role in cognitive impairment and should be considered when planning treatment.

Background/Aim. Planning an elliptical excision of the facial skin, caused by lines of minimum tension, is very important in order to achieve good aesthetic results. The width of the tumor excision affects the possibility of a direct closure of the post-excision defect. The aim of the study was to determine the minimum width of excision that does not affect postoperative symmetry of the face, in relation to the preoperative one, using an objective scanning method with a line laser scanner. Methods. The study included 50 patients of both sexes, older than 50 years, who had verified facial skin tumor and established medical indication for surgical elliptical excision and direct suture. All patients had laser scanning preoperatively, and then seven days and 90 days postoperatively, giving x, y, and z coordinates of 5 cephalometric points on the face, which determined the shape of the examined region. Patients were divided into three groups depending on the width of the excision (< 10 mm, 10?15 mm, > 15 mm). The shape of the examined region among different width of excision was compared, preoperatively, 7 days and 90 days postoperatively, using Procrustes analysis and analysis of the coordinates of cephalometric points. Results. Taking into account preoperative and postoperative x, y and z coordinates of the cephalometric points, statistically significant differences between the group of patients with the width excision < 10 mm and the other two groups (excision width 10?15 mm and > 15 mm) were found. Conclusion. The width of the skin tumors excision < 10 mm does not affect the postoperative facial asymmetry when a post-excisional defect is closed by direct suture.

Background/Aim. The group of genes, known as PAX (paired box), has a great role in organogenesis, as well as in maintaining the normal function of certain cells after the birth. In addition to these genes, the impact on the organogenesis, at the cellular level, has a transmembrane tetratricopeptid group of genes (TMTC). The term polymorphism in the human genome implies variations in the hereditary basis that occur in human populations, the presence of two or more different alleles of one genome in the population. The aim of the work was to determine whether there is an association of PAX3 and TMTC2 genes polymorphism with changes of the face morphology after skin tumor excision and direct suture closure. Methods. The study included 130 patients of both sexes, older than 50 years, with the medical indication for the elliptical surgical excision of the skin tumor. DNA was isolated from 5 mL of peripheral blood. Gene polymorphisms were analyzed with pre-designed single nucleotide polymorphisms (SNP) assays, by allelic discrimination method on REAL-TIME apparatus. The patients were subjected to a laser scanning preoperatively, and 7 and 90 days postoperatively, in order to obtain x, y and z coordinates of 5 cephalometric points on the face, which determined the shape of the medial cheek region. The shape of the medial cheek region, as well as the coordinates of 5 cepahlometric points, were compared among genotypes of both genes preoperatively, as well as 7 days and 90 days postoperatively. Results. A statistically significant difference in the shape of the medial cheek region between wildtype and mutant of PAX3 gene was found preoperatively, while the statistically significant difference in the shape of the medial cheek region was not found between wild-type and heterozygote, nor between wild-type and heterozygote and mutant of PAX3 gene, nor among genotypes of TMTC2 gene. Seven days and 90 days postoperatively, there were no statistically significant differences in the shape of the examined region among genotypes of both genes. Conclusion. Polymorphisms of PAX3 and TMTC2 genes are not associated with the change in the face morphology after the skin tumor excision and direct suture closure of the defect.

Background/Aim. Most surgeons, at the end of corrective rhinoplasty, use endonasal tamponade and external splinting, primarily because of hemostasis and immobilization. Possible complications of this surgery are various. Pain, nose edema, palpebral swelling and ecchymosis, are the most common and usual. The aim of our study was to evaluate the incidence of nonaesthetic complications and the efficiency of corrective rhinoplasty without the use of tamponade and external splint. Methods. One hundred and fiftyone patients, who underwent primary corrective rhinoplasty without endonasal tamponade and without an external splint, were analyzed at the Clinical Centre ?Kragujevac? in Kragujevac, Serbia, in the period 1999?May 2016. The surgeries were done by the same surgeon. Instead of a splint, sterile skin adhesive tapes were used. Study was prospective, consecutive case-series type. We analyzed the possible complications and subjective estimates of the patients who underwent primary corrective rhinoplasty in described fashion. In assessing postoparative pain, the visual analogue scale (VAS) in a range of 1 to 5 was used. Palpebral swelling and ecchymosis, were estimated 24h after surgery, by the Surgeon Periorbital Rating of Edema and Ecchymosis (SPREE) scale ranging from 0 to 5. The degree of restriction of nasal respiration was evaluated by the scale 1?4. The overall comfort of patients in the postoperative period was evaluated according to a scale: good, no opinion, bad. The patient satisfaction with the aesthetic result was analyzed on 7th and 30th day after surgery, by a scale from 1 (very satisfied) to 5 (very dissatisfied). Results. There were 151 patients aged between 18?47 years. Females were more frequent (72.18%). Most of the patients (40.39%) had moderate pain. None of the patients had neither severe nor the worst pain and 59 patients had no pain at all. Eyelid edema and periorbital ecchymosis were moderate in all patients (100%). The other complications did not occur, apart from one (0.66%) unilateral epistaxis, on postoperative day 10. Most of the patients (52.97%), immediately after surgery, could freely breathe through the nose. The general impression of the patient comfort after surgery was mainly good (74.17%). The majority of patients (52.28%), were satisfied with aesthetic result after 7 days, and 52.32% after 1 month. There were very satisfied patients: on day 7 - 27.15% and on day 30 - 39.73%. Conclusion. We concluded that the rhinoplasty without using tamponade and immobilization was safe, comfortable and economical. The degree of pain, edema and ecchymosis were low, as well as the incidence of other complications.

The subjective quality of images (human interpretation) is very important in long-range imaging systems, where the presence of haze directly influences visibility of the scene, by reducing contrast and obscuring objects. Image enhancement techniques - dehazing techniques, are usually required in such systems. This paper compares the most significant single image dehazing approaches, proposes three additional enhancement steps in dehazing algorithms, compares performance of the algorithms and additional enhancement steps, and presents test results on maritime surveillance images, which represent one special case of long-range images.

Background/Aim. The northern part of Kosovo was one of the largest lead and zinc production industries in Europe. Special attention has been paid to the landfill sites of these metals remained after past industrial activities. The inhabitants of Roma camps in this area are collecting led waste they process by crushing and melting in their shacks in primitively organized working environments. Because of all the aforementioned it was necessary to examine the concentration of blood lead level (BLL) in the children aged less than 6 years inhabiting this area, especially taking care of blood analysis of children living in Roma camps. Methods. The study was conducted in the municipality of Leposavić, Province Kosovo and Metohija, Serbia. Totally 78 subjects participated in the study. All the subjects were divided into two groups: the group I consisting of 42 children who lived in the Romas camp, and the group II with 36 children from a city kindergarten. Based on the mathematical model WRPLOT we found out that both groups of patients were in the low risk zone for industrial contamination exposure. Blood analysis was done according to the protocol provided by ESA Lead Care. Results. The average age of participants in the study was 4.60 ± 1.63 years. The mean BBL in the children from the group 1 was 19.11 µg/dL and from the group 2 4.87 µg/dL. There was a statistically significant difference in the mean values of BBL between the groups (U = 39, p lt 0.001). All of the children from the group 1 had BBL greater than 5 µg/dL in comparison to 38.9% of the children from the group 2 (χ2 = 35.75, p lt 0.001). Conclusion. Although both groups were located outside the zone of direct spread of pollution, the results indicate high concentrations of lead in blood of all the examined children. The concentration was higher in the children who lived in the area in which illegal processing of lead waste took place. Uvod/Cilj. Na području severnog Kosova nalazila se jedna od najvećih industrija za proizvodnju olova i cinka u Evropi. Poseban akcenat se stavlja na deponije zaostale nakon ove industrijske proizvodnje. Na ovom području stanovnici u romskim kampovima bave se prikupljanjem olovnog otpada koji prerađuju - drobe i tope, u svojim barakama u primitivno organizovanim radnim sredinama. Zbog svega navedenog, bilo je neophodno ispitati koncentraciju olova u krvi dece mlađe od šest godina koja žive u ovom području, sa posebnim akcentom na analizu krvi dece koja žive u romskim kampovima. Metode. Naše istraživanje sprovedeno je na području opštine Leposavić, Kosovo i Metohija, Srbija, uključujući 78 ispitanika podeljenih u dve grupe: grupa I od 42 dece iz romskog kampa, i grupa II od 36 dece iz gradskog vrtića. Na osnovu matematičkog modela WRPLOT dobili smo podatak da se obe grupe ispitanika nalaze u zoni niskog rizika od izloženosti industrijskom zagađenju. Krv za analizu uzimali smo iz prsta dece. Analiza krvi vršena je prema protokolu predviđenom od ESA Biosciences Lead Care. Rezultati. Prosečna starost ispitanika iznosila je 4,60 ± 1,63 godine. Prosečna koncentracija olova u krvi u grupi I bila je 19,11 µg/dL, a u grupi II 4.87 µg/dL. Postoji statistički visokoznačajna razlika u pogledu koncentracije olova u krvi između ispitivanih grupa (U = 39; p lt 0,001). Sva deca (100%) iz grupe I imali su koncentracije olova u krvi veće od 5 µg/dL, a iz grupe II (χ2 = 35,75; p lt 0,001) njih 38,9%. Zaključak. Iako su obe grupe bile locirane van zone direktnog širenja zagađenja, rezultati ukazuju na visoke koncentracije olova u krvi sve ispitivane dece. Koncentracija je veća kod dece koja žive u sredini u kojoj se odvija ilegalna prerada olovnog otpada.

Treatment of wounds, especially in patients with systemic diseases, is very difficult and time consuming, and it represents great challenge. Complications like infections and impaired healing are regularly seen in these patients, sometimes leaving almost no other treating option, but amputation surgery. In wound healing process, platelets play one of key roles, both in hemostasis, and, by releasing many growth factors, in reepithelization and tissue remodeling. Platelet concentrates are defined as autologous or homologous platelet derivatives with a platelet concentration higher than it is usually in human blood. Concentration of platelets needed to affect wound healing should be 1,000,000/μl. This is a report about patient with pemphigus vulgaris and Type 2 diabetes mellitus, who got injury of the left lower leg. Traditional surgical methods of wound closure and vacuum-assisted closure therapy were ineffective. Homologous platelet gel was used topically, resulting in wound closure, without any adverse effects.

Purpose: SCI are one of the leading causes of disabilities around the world. Length of stay in patients with spinal cord injury depends on many medical and non-medical factors, especially of health-care system and social environment. Material and Method: The study included 529 patients with spinal cord injuries admitted in Clinic for rehabilitation “Dr M. Zotovic”, Belgrade, Serbia, from January 2000 to December 2009. The factors influencing length of stay in our study were: age, gender, neurological level and completeness of injury, etiology of injury, methods of treatment, secondary complications and associated injuries. Length of stay in this study was defined from the date of admission to the date of discharge from rehabilitation. Results: Median length of rehabilitation is 134 days (range, 28.0–533.0). The average age of survey respondents was 46.1±16.8 years. In this study 382 (72.2%) of patients were male and 147 (27.8%) were female. There were 180 (34.0%) tetraplegic and 349 (66%) paraplegic patients. In the multivariate Cox regression model, statistically significant predictors of length of stay were: neurological level of injury (p=0.014), completeness of the lesion (p=0.048), ASIA scale (p Conclusion: Reducing the length of stay would significantly decrease the overall financial costs for patients with spinal cord injury. Construction of the specialized centers for rehabilitation of patients with spinal cord injury and better coordination between primary care and rehabilitation centers would contribute to it.

Background/Aim. Urinary tract infections are still the most frequent complications in patients with spinal cord injury (SCI). The aim of this study was to analyze the factors influencing development of urinary tract infections during rehabilitation in patients with SCI. Methods. This retrospective case/control study including 540 patients with SCI which were rehabilitated in the Clinic for Rehabilitation “Dr Miroslav Zotovic” between January 2000 and December 2009. We used patient files and other avail-able medical documentation for obtaining information contained in this study, such as the manner of bladder emptying, the type of neurological disorder of the bladder, the neurological level and completeness of a lesion, the injury etiology, treatment method, secondary complications and associated injuries, kidney and bladder calculosis, age and sex. Results. Out of the total number of patients included in the study, 152 (28.1%) were without urinary tract infections, whereas 388 (71.9%) had urinary tract infections. There were 389 (72%) male and 151 (28%) female patients. The average age of patients without urinary tract infections was 51.0 ± 15.4 years, whereas the mean age of patients with urinary tract infections was 44.3 ± 16.9 years. The results of our study showed that the occurrence of urinary tract infections during rehabilitation in patients with SCIs was associated with the following factors: combined injuries (OR = 3.5), anemia (OR = 5.67), type of the bladder functional disorder (OR = 40-60) and crystals in urine (OR = 7.54). Conclusion. The physicians should take precautions and try to make the early diagnosis and rapid appropriate treatment of urinary tract infections in patients with SCI who also have functional bladder disorder, combined spinal injuries, anemia or urine crystals.

Background/Aim. The delay method is a surgical, pharmacological and combined method that includes two or more time separated phases, which gives bigger flap surface. In our research we explored the possibility of flap surface enlargement in a new arterialised venous flap (AVF) on an experimental rabbit ear model by the delay surgical method. The aim of this research was to establish vitality surface of our AVF and to maintain the difference in flap vital surface between AVF flaps, with or without performing the delay surgery method. Methods. We used both ears of “Big Chinchilla” rabbits in 10 experimental male animals, divided into two groups, average weight 3-3.5 kg, and average age 8-10 months. In the first (experimental) group, a venous flap was arterialised by our method. In the second (control) group, the venous flap was arterialised 14 days after the delay surgical method. AVF surface was measured on the 1 and 14 days by the method of trapezoid rule. Results. Vital surface on our AVF experimental model was bigger than 87% of elevated flap surface after the delay surgical method. Vital surface on AVF without delay on our experimental model was bigger than 30% of elevated flap surface (p < 0.001). Conclusion. Analysis of previous experimental models on the rabbit ear, non-delayed and delayed (to enlarge flap surface) led us to conclusion that previously created experimental models of non-delayed AVF are hemodynamically negative. Our experimental non-delay AVF model is hemodynamically more positive than previously created models of non-delay AVF and provides better conditions for AVF survival and enlargement of vital flap surface of elevated flap. On the other hand, surgical delay method significantly enlarges vital surface of AFF.

Uvod : Sekundarne komplikacije i udružene povrede igraju veliku ulogu u funkcionalnom oporavku, morbiditetu, mortalitetu i dužini boravka kod pacijenata sa povredom kicmene moždine. Cilj: Utvrditi ucestalost sekundarnih komplikacija i urduženih povreda kod pacijenatasa sa povredama kicmene moždine u toku rehabilitacije. Metod: Ovaj rad predstavlja retrospektivnu studija koja je obuhvatila 441 pacijenta sa povredom kicmene moždine koji su rehabilitovani u Klinici za rehabilitaciju "Dr M. Zotovic" u Beogradu u periodu od januara 2000. do decembra 2009. godine. Rezultati: Komplikacije za vreme rehabilitacije je imalo 368 (83.4%) pacijenata. Od ukupnog broja pacijenata komplikacije je imalo 127 (78.4%) pacijenata sa netraumatskim i 241 (86.4%) pacijenata sa traumatskim povredama kicmene moždine. Najcesce koplikacija kod obe grupe pacijenata su bile: urinarne infekcije (47.5% kod traumatskih i 64.2% kod pacijenata sa netraumatskim povredama kicmene moždine), spasticitet (56.8% kod netraumatskih i 53.8% kod pacijenata sa traumatskim povedama) i dekubitalni ulkusi (9.9% kod netraumatskih 17.6% kod pacijenata sa traumatskim povredama). Od ukupnog broja pacijenata udružene povrede je imalo 110 (24.9%) pacijenata. Najcesce udružene povrede su bile: povrede glave (38.5%), povrede rebara (34.4%), povrede gornjih i donjih ekstremiteta (21.9%), povrede unutrasnjih organa (1.4%) i povrede karlice (1.1%). Udružene povrede su se javljale samo kod pacijenata sa traumatskim povredama kicmene moždine. Zakljucak: Sekundarne komplikacije i udružene povrede su cesto kod pacijenata sa povredom kicmene moždine u toku rehabilitacije. Adekvatna nega u kucnim uslovima može smanjiti procenat komplikacija.

1 , Zoran Bukumiric 2 , Aleksandra Karadžov Nikolic 3 , Rade Babovic 1 , Aleksandra Sekulic 1 , Srbislav Stevanovic 1 , Slobodan Jankovic 4 1 Klinika za rehabilitaciju "Dr M. Zotovic", Sokobanjaska 13 Beograd 2 ABSTRACT Introduction: Pressure ulcers (PUs) are often secondary complications in spinal cord injury (SCI) patients. Purpose: To investigate the presence and possible factors associated with pressure ulcers in SCI patients undergoing acute and functional rehabilitation. Methods: Th is was a retrospective study of 453 patients with SCI treated at the Clinic for Rehabilitation "Dr M. Zo- tovic", Belgrade, Serbia, between January 2000 and Decem- ber 2009. Factors that were tested for their infl uence on pres- sure ulcers in spinal cord injury patients included age, sex, mechanism of injury, neurological level of injury, complete- ness of injury, spasticity and length of stay. Th e presence and location of pressure ulcers were recorded on admission, dur- ing acute and functional rehabilitation and at discharge. Th e level of statistical signifi cance in our study was set to 0.05. Results: Th e study included 453 patients: 383 (84.5%) did not have a pressure ulcer during rehabilitation, and 70 (15.5%) patients had a pressure ulcer during rehabilita- tion. Of the total number of patients, 333 (73.5%) were male, and 120 (26.5%) were female. Th e average age of patients enrolled in the study was 51.8 ± 17.2 years. In a multiple lo- gistic regression model, one statistically signifi cant predictor of pressure ulcers during rehabilitation was pressure ulcer before rehabilitation (B = 1420, p

Background/Aim. Spinal cord injuries (SCI) could be associated with a significant functional impairment in the areas of mobility, self-care, bowel and bladder emptying and sexuality. The aim of this study was to compare demographic characteristics and functional outcomes of nontraumatic and traumatic spinal cord injury patients. Methods. This study was designed as retrospective case series study. A detailed medical history including sex, age, mode of trauma, and clinical and radiological examination was taken for all patients. Hospital records were used to classify the patients according to the following: mechanism of injury, neurological level of injury, functional outcomes, associated injuries, method of treatment, secondary complications and length of stay. The following clinical scores were measured in the patients: American Spinal Injury Association standards (CASTA), Functional Independence Measure (FIM), and Modified Aschworth score (MAS). Results. Out of totally 441 patients with spinal cord injury, 279 were traumatic patients (TSCI) and 162 nontraumatic patients (NTSCI); 322 men and 119 women. The mean age of the patients was 46.1 ± 19.9 years. Traumatic and nontraumatic populations showed several significant differences with regard to age, level and severity of lesion. When adjusted for these factors patients with traumatic injuries showed a significantly lower FIM score at admission and significantly better improvement in the FIM score at discharge. The two populations were discharged with similar functional outcome. Conclusions. The NTSCI patients in our study were younger, more frequently female, with less complications before rehabilitation and less frequently treated operatively than the TSCI patients. Hospital rehabilitation of the TSCI patients was longer than that of the NTSCI patients, but their functional gain from admission was also higher, so at discharge. Traumatic and nontraumatic spinal cord lesion patients achieved similar results in regard to neurological and functional status.

Background. Posttraumatic and postoperative defects of columella and the tip of the nose are difficult to reconstruct. There are several operative methods described in the literature, and many of them are step-by-step procedures with long duration. The aim of this study was to present one-step procedure for reconstruction of the columella and the tip of the nose with island-shaped arterial forehead flap. Case report. A 45-year old man was submitted to surgical excision of basocellular skin cancer. After the excision, a defect of the columella and tip of the nose the remained, 3 × 2.5 cm in dimensions, with exposed alar cartilages. During the same operation, the defect was covered with an island-shaped arterial forehead flap. Postoperative one-year course was uneventful, without signs of tumor recurrence after one year, and further surgical corrections were unnecessary. Conclusion. Considering the results of our operative technique, we believe that middle island-shaped forehead flap is suitable for reconstruction of the columella and the tip of the nose, due to the following reasons: safe vascularization of flap, similarity of the transferred tissue with the excised one, the procedure is completed in one step, simple surgical technique and uncomplicated healing of a flap-harvesting site.

Background/Aim. Soft tissue defects in the distal third of the lower leg are persistent and constitute a major problem in the reconstructive surgery. This study presents an analysis of the anatomical vascularization filed of ascending branch of the peroneal artery ramus perforans (PARS). The aim of this study was to assess reliability of the distal flap on the antero-lateral aspect of a lower leg distal third. Methods. Direct gentiana violet injection into the interosseal perforator of ten fresh cadaveric lower legs with subsequent corrosion acrylic preparation was performed to reveal vascularization filed of the ascending branch of the PARP. Height, length, diameter and communication of perforating branch and its subsequent smaller ascending and descending branches were determined. The CAMIA software was used. Results. Our results show that the PARP is always present. Its origin from the peroneal artery is at the medial height of 66 mm when measured from the inferior border of the lateral malleolus. Medium length of ramus perforans is 51.7mm. After transition through the interosseous membrane, ramus perforans divides into ascending and descending branches. The diameter proximal to the level of bifurcation is 1.37 mm (variation 1.0-1.8 mm), and the diameter of the ascending branch distal to the level of bifurcation is 1 mm. Using CAMIA software, the medium length, width and area of the vascularization filed labeled with gentian violet were calculated to be 164 mm (variation 125-210 mm), 66 mm (57-77 mm), and 10,305 mm2 (6,385 mm2-14,341 mm2), respectively. Conclusion. Our results support the use of fasciocutaneous distal flap, vascularized by the ascending branch of the PARP for reconstruction of soft tissue defects in the distal third of the lower limb, malleolar regions and dorsum.

Background/Aim. Early identification of lymph node (LN) metastases has both therapeutic and prognostic significance in patients with cutaneous melanoma. Ultrasonographic (US) examination of LN morphological characteristics and US of LN morphological and vascular characteristics are diagnostic methods used in identification of regional LN metastases, thus rendering a base for lymphonododisection indication. The aim of this study was to determine validity of these two US diagnostic methods and eventual statistically significant difference between them. Methods. The study included the two groups of the patients with clinical stage III melanoma. The group I included 31 patients followed up by the use of US of LN morphological characteristics due to the fact that US findings described them only. The group II included 30 patients in whom morphological and vascular LN characteristics were followed up. The patients of both groups were examined in the Institute for Radiology, Military Medical Academy using an ultrasonographic unit type Akuson Sequoia Model 2000. After that, therapeutic and elective radical disections were performed. Sensitivity, specificity and accuracy of US examination of LN were checked by histopathological examination. Results. The presence of LN metastases in the group I was suggested by LN enlargement and its extent, while in the group II it was suggested by the ratio of LN length and width in 83.3% of the patients, echogenicity of LN center in 76.7% of the patients, LN resistance index in 73.3% of the patients, pathologic LN vascularization in 86.7%, and pathologic intranodal arborization in 83.3% of the patients. In 67.7% of the patients in the group I and in 93.3% of the patients in the group II matastatic changes of LN were diagnosed by pathohistology. A difference between validities of the two groups was statistically significant (p < 0.05). Conclusion. LN size without other US morphological and vascular characteristics of LN does not provide enough valid US finding for a reliable preoperative identification of LN with metastatic changes in patients with cutaneous melanoma.

Background/Aim. There is a natural asymmetry in normal female brests. When the difference in the shape, size or position of the breast and nipple-areola complex is visible, surgical correction is the only treatment option and presents one of the greatest challenges for a plastic surgeon. Based on the Nahai classification presented in details, the aim of the study was to present the possibilities of plastic surgery to correct primary (congenital), secondary (developmental) and tertiary (acquired) brest asymmetries. Methods. We conducted a retrospective analysis of female breast asymmetry surgeries performed in the Clinic for Plastic Surgery and Burns, Military Medical Academy (MMA), Belgrade over the last seven years (January 2002 - January 2009). Results. During the above mentioned period, 82 female patients, 18 - 65 years of age, underwent surgery for breast asymmetry. The most frequent asymmetries were developmental, 'pubertal' (n = 43); acquired asymmetries as a consequence of tumor surgery were found in the other 22 patients, while 7 patients were diagnosed with primary asymmetries such as congenital chest-wall asymmetry (Sy. Poland), accessory and tuberous breasts. All patients underwent preoperative ultrasound examination, while hormone status was determined in those with developmental, 'pubertal' asymmetries. The selection of surgical procedure for correction of breast asymmetry depended upon clinical examination findings and patient's wish relating to the shape and size of the breasts. The most of breast asymmetries were corrected by a combination of surgical procedures including primary and secondary reconstruction, reduction, suspension or augmentation mammoplasty. Having combined different surgical procedures, we managed to achieve satisfactory results. The hypertrophic scar formation after reduction mamoplasty was seen in some cases, however, they caused no significant patient's discomfort. Conclusion. Application of plastic, reconstructive and aesthetic surgical principles can considerably contribute to achieving excellent results in corrective surgery for breast asymmetries. In addition to most suitable breast asymmetry surgical procedures choice, motivation of a patient is also very important for achieving satisfactory results.

Introduction. Coloboma is a Greek word, which describes the defect of all layers of the organ, and it can be congenital or as the result of an injury, operation, or some disease. Congenital upper eyelid coloboma is a rare anomaly, with the unknown incidence. The size of the defect is different, but it always involves all layers of the eyelid. This malformation is more frequent at the upper eyelid, and unilaterally, at the junction of the medial two thirds. Sometimes, it can also involve the eye, and may be a component of many syndromes (Goldenhar, Fraser, Manitoba, CHARGE, Cat eye). Case report. We are describing the case of the upper eyelid coloboma with the rare eyebrow anomaly at the three-month old girl, and the result of reconstruction. The baby was treated conservatively with lubricants and overnight patching. Pentagonal excision of the defect was performed in general anesthesia. Three layers of the eyelid were prepared: the skin, muscle and tarsoconjunctival layer. Because of orbicularis muscle malposition, reinsertion and reposition of the muscle fibres were performed. Then, lateral canthotomy was made and the suture of three layers of the eyelid. Catgut suture 7-0 was used for the conjunctiva and muscle. Nylon 6-0 was used for skin suture. Z-plasty was done on the upper part of the pentagonal excision in order to reduce skin tension at the suture line. The operation lasted about 60 minutes and the hospitalization three days. The occlusive dressing was applied for two days. The stitches were removed after seven days. The postoperative swelling of the upper and lower eyelid disappeared in five days. There were no complications in the postoperative period. Conclusion. The main principle of the treatment of eyelid coloboma is surgical reconstruction of all layers of the eyelid, in optimal period, using different surgical methods, which depends on the size of the defect. An early diagnosis is of the greatest importance, as well as the treatment of associated anomalies. Complications of the upper eyelid coloboma depend on the size of the defect, presence of the eye anomalies and the method of reconstruction. This article has been corrected. Link to the correction 10.2298/VSP1611078E

This paper describes hardware implementation of random number generator for session key generation in multiuser high capacity encryption systems. The generator is implemented by non-uniform quantization of avalanche diode noise samples which are modulo 2 added with pseudo random sequence. Physical process statistics stability is achieved by wide dynamic range automatic gain control circuitry of noise amplification stage. Statistic tests of measured results prove the correct operation of implemented device up to 320Mbit/s.

In this paper we describe one novel design of general - purpose platform for digital signal processing and communication applications, based on cutting - edge FPGA technology, internal microprocessor unit and significant amount of available interfaces and additional resources. This platform represents powerful core for research and development tasks in communications at multi - Gigabit level, and strong base for practical implementation of various algorithms at the same time.

[Purpose] The extent of functional independence ultimately achieved by an individual patient will be influenced by a variety of medical and non-medical factors. [Subjects and Methods] this study included 419 patients with spinal cord lesions treated in the Clinic for Rehabilitation "Dr M. Zotovic", Belgrade, Serbia, from January 2000 to December 2009. The patients were divided in two groups according to achievement of increase in Functional Independence Measure (FIM) score of more than 13 at discharge compared to admission. A variety of clinical variables were followed in both groups. [Results] one hundred twenty-one patients (28.9%) showed improvements in FIM score of ≤13, while 298 (71.1%) patients showed an increases in FIM score of >13 at discharge compared to admission. Better functional recovery was observed in patients with non-traumatic spinal cord lesions, lower neurological levels of the lesion (OR = 6.07), and in patients treated surgically, but the level of the spinal cord lesion was the most influential factor affecting outcome. [Conclusion] the patients with spinal cord lesions should not only be grouped by traumatic and non-traumatic lesions only, but also sub-categorized, according to the etiology, level of injury and treatment method.

Background/Aim. The detailed knowledge of the architecture of the upper eyelid is very important in numerous upper eyelid corrective surgeries. The article deals with the detailed anatomy of the major components of the upper lid, which are commonly seen in surgical practice. Methods. This study was conducted on 19 human cadavers (12 adults and 7 infants) without pathologic changes in the orbital region and eyelids. Anatomic microdissection of the contents of the orbita was performed bilaterally on 12 orbits from 6 unfixed cadavers (3 male and 3 female). Micromorphologic investigations of the orbital tissue were performed on 8 en bloc excised and formalin-fixed orbits of infant cadavers. Specimens were fixed according to the Duvernoy method. An intra-arterial injection of 5% mixture of melt formalin and black ink was administered into the carotid arterial system. Using routine fixation, decalcination, dehydration, illumination, impregnation and molding procedures in paraplast, specimens were prepared for cross-sections. Results. The measurement of the muscle length and diameter in situ in 6 nonfixed cadavers (12 orbits) showed an average length of the levator palpbrae superioris (LPS) muscle body of the 42.0 ± 1.41 mm on the right, and 40.3 ± 1.63 mm on the left side. In all the cases, the LPS had blood supply from 4 different arterial systems: the lacrimal, supratrochlear, and supraorbital artery and muscle branches of the ophthalmic artery. The LPS muscle in all the specimens was supplied by the superior medial branch of the oculomotor nerve. The connective tissue associated with the LPS muscle contains two transverse ligaments: the superior (Whitnall’s) and intermuscular transverse ligaments (ITL). The orbital septum in all the specimens originated from the arcus marginalis of the frontal bone, and consisted of two layers - the superficial and the inner layer. In addition, a detailed histological analysis revealed that the upper eyelid’s crease was formed by the conjoined fascia including the fascia of the orbicularis muscle, the superficial layer of the orbital septum, and the aponeurosis of the LPS muscle, as well as the pretarsal fascia. Conclusion. The conducted study provided a valuable morphological basis for biomechanical and clinical considerations regarding blepharoptosis surgery.

Speed, bandwidth, cost efficiency, reliability and security are some of the demands placed on telecommunication today. Fiber optic systems have the advantage of most of these requirements over standard telecommunications solutions and make up the base of all modern communications networks. Although it was initially believed that fiber optic systems would be inherently secure it has been discovered that the unauthorized extraction of information from optical fibers is relatively simple. There are various tapping methods, which are discussed in the paper. Optical taping methods enable the extraction and analyses of large volumes of data transmitting over optical fiber. In response to this problem we propose implementation of advanced encryption standard (AES) algorithm, supported with block chaining method, which is necessary for high capacity systems. The problem of AES implementation at the data rates of 1 Gbps or higher is discussed and one scheme with parallelized structure is proposed for practical FPGA implementation.

In this paper some interesting aspects of practical implementation of AES crypto algorithm, performed by using elements of digital electronics, are described. Also, one example for practical realization of the most complex variant of this algorithm, AES 256, is analyzed in detail through the context of selected realization platform, and achieved results are given.