Enlarged inguinal lymph nodes very often present a site of metastatic disease. Inguinal
lymph node block dissection is a demanding procedure, which usually requires at least one of reconstructive
...modalities. Among different reconstruction options we selected the tensor fascia lata (TFL)
musculocutaneous flap.
The paper aims at presenting a series of inguinal block dissections, followed by immediate
reconstruction, using the TFL flap, and evaluation of tumor type, flap dimension, complication rate and
the duration of hospital stay.
We present a consecutive case series of 25 conducted block dissections. The defects were
reconstructed using TFL flap, because of the extent and site of the tissue defects, reliability of the flap,
and potentially primarily infected exulcerated tumors.
The reconstruction was successful in all cases, the incidence of surgical complications was 16%,
no further complications, such as lymphedema or gait disturbances, were noted. Primary skin tumors
were predominant (13 cases), followed by genitalia tumors (four cases). The male sex was more frequently
affected (14 vs. 11 cases).
Having in mind that TFL presents as a flap of adjustable size, length, shape, and volume,
with negligible donor site morbidity, and after comparing of our results to those of other authors, we
advise broader use of TFL flap. As a reliable flap, not too difficult to harvest, with a low complication rate,
it must be taken into consideration regarding the benefits for the patient, and, on the other hand, the
surgery cost and duration.
Reconstruction of a full thickness abdominal wall defect is a demanding procedure for general and also for plastic surgeons, requiring vigorous planning and reconstruction of three layers.
We present ...a case of a 70-year-old patient with a huge abdominal wall tumor with 40 years evolution. Surgery was performed under general anesthesia. Full thickness abdominal defect appeared after the tumor resection. Reconstruction followed in the same act. The defect was reconstructed using a combination of techniques, including omental flap, fascia lata graft, local skin flaps and skin grafts. After surgery no major complications were noted, only a partial skin flap loss, which was repaired using partial thickness skin grafts. The final result was described by the patient as very good, without hernia formation.
Omenthoplasty, abdominal wall reconstruction in combination with free fascia lata graft and skin grafts can be one of good options for the reconstruction of full thickness abdominal wall defects.
This paper tackles the phenomenon of hip-hop subculture in Serbia. The goal is to understand its development and to map out its class dimensions and political impulses. The analysis is grounded in ...cultural studies (cf. Hall, 1980). Hip-hop lyrics and symbolism of the hip-hop style are analyzed with a focus on political and class dimensions. The development of hip-hop subculture is divided into two phases. First, during the 1990s, the hip-hop subculture in the Serbian context was in the search for its local identity as a style that originated within the working-class but had its first representatives in Serbia among the middle-class youth. Hiphop’s dialogue with the dizel culture during this period is indicative of this quest for identity. In the second phase, after 2000, hip-hop finds its place in the Serbian society by grounding itself in the working-class and establishing itself as the heir of the dizel subculture of the nineties (Papović and Pejović 2016). It also undergoes internal divisions producing an elitist wing further subdivided into a liberal and conservative part, and an anti-elitist wing with a chaotic political character hosting both radically leftwing and extreme right sentiments.
Treatment options for metastatic melanoma in Serbia are limited due to the lack of newly approved biologic agents and the lack of clinical studies. Also, there is a paucity of data regarding the ...treatment approaches in different tertiary centers and efficacy of available chemotherapy protocols. The aim of this study was to obtain more detailed data about treatment protocols in Serbia based on structured survey in tertiary oncology centers.
Data about the melanoma patients treated in 2011 were analyzed from hospital databases in 6 referent oncology centers in Serbia, based on the structured survey, with the focus on metastatic melanoma patients (unresectable stage IIIC and IV).
A total of 986 (79-315 in different centers) patients were treated, with 320 (32.45%) newly diagnosed patients. There were 317 patients in stage IIIC/IV, 77/317 aged < 50 years. At the time of diagnosis 47.3% of patients were < 60 years of age (24.2% < 40 years, 23% 50-59 years, 52.6% > 60 years). At initial diagnosis 12.5% of patients were in stage III and 4.5% in stage IV. The most common type was superficial spreading melanoma (50-660), followed by nodular melanoma (23.5-50%). Apart from the regional and distant lymph node metastases, the most frequent organs involved in stage IV disease were distant skin and soft tissues (12-55%), lungs (19-55.5%), liver (10-60%), and bones (3-10%). The first line therapy in stage IV metastatic melanoma was dacarbazine (DTIC) dimethyl-triazenoimidozole-carboxamide in 61-93% of the patients, while the second line varied between the centers. Disease control (complete response + partial response + stable disease) was achieved in 25.7% of the patients treated with the first line chemotherapy and 23.1% of the patients treated with the second line therapy, but the duration of response was short, in first-line therapy 6.66 +/- 3.36 months (median 6.75 months). More than 90% of patients were treated outside the clinical trials.
Based on this survey, there is a large unmet need for the new treatment options for metastatic melanoma in Serbia. The development of national guidelines, and greater involvement in international clinical studies could lead to widening of treatment options for this chemotherapy resistant disease.
In this paper, the author argues for a theoretical difference between the modern and postmodern aestheticism and considers their political implications arguing that modern aestheticism carried ...progressive or radical political impulse; whereas, under postmodernism, its character shifted into a reactionary politics. The specific political implications that are derived from these two kinds of aestheticism concern the attitude towards human nature, different kinds of narcissistic tendencies and divergent attitudes towards art/culture. Next, the author uses the examples of Oscar Wilde's Picture of Dorian Gray and Nabokov's Lolita to demonstrate how these differences manifest themselves in the works of these two prominent, if not pivotal, artists related to the aesthetic movement in the history of literature. It is concluded that the politics of Oscar Wilde and Vladimir Nabokov differ radically and these differences stem from the fact that their works embody divergent conceptions of aestheticism.
Cleft lip and palate is a complex congenital anomaly of the orofacial system in children.
The aim of this study was to determine the incidence of live-born children with cleft lip and/or palate ...compared to the total number of children born in the period from January 1, 1990 to December 31, 2007.
Epidemiological investigation was based on the records of live-born children at the Hospital of Gynaecology and Obstetrics of the Clinical Centre Nis. The study included 61,116 live-born children, i.e. 56,905 full-term babies.
The total number of registered clefts during the investigation period was 43 (22 boys and 21 girls). The most frequent were the secondary palate clefts (44.2%); combined cleft were present in 34.9%, while primary palate clefts were reported in 20.9%. In respect to the season and order of birth, there was no statistically significant difference in the frequency of the primary, secondary and complete palate clefts. The age of mothers was not identified as a risk factor for the occurrence of cleft lip and palate.
In the studied period, 43 children were born with the cleft lip and/or palate, equally in boys as in girls. The secondary palate clefts were most frequent. The season and order of birth had no statistical influence on the occurrence of this anomaly.
Traumatic hand amputation is a very severe and rare injury. Replantation and revascularization surgery requires the existence of specialized centres and well-educated teams of microsurgeons. In ...places where there are no such specialized centres for this kind of surgery, traumatic hand amputation is a major concern and quite a challenge, and a successfully performed replantation is a great accomplishment.
We report a case of a successfully survived replanted hand in a 35-year-old male patient with unfortunately bad end result of the treatment. The patient with the amputated left hand (disarticulation) had a surgery 4 hours after injury. The urgent surgical procedure required a debridement, the excision of the first row of the carpal bones, external fixation of the wrist, vascular anastomoses, nerve repair, tenorrhaphy, skin sutures and decompression skin incisions.The successful operation did not have a successful post-operative course due to the patient's psychiatric problems and lack of rehabilitation at the psychiatric institution where the treatment was continued.
Successful surgical performance can unfortunately be ruined due to inadequate further treatment course or the wrong selection for such a demanding surgery. The survival of the amputated hand can be achieved surgically, but achieving refunctioning does not always depend on surgery. It also depends on the very patient, his motivation, rehabilitation, as well as on the proper selection for such a demanding and complex surgical procedure.
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