Karcinom stidnice kod mlade žene i terapija multiple skleroze: prikaz slučaja

Vulvar cancer is a rare disease among young women. Risk factors for vulvar cancer are smoking, chronic dermatitis and human papilloma virus infection. However, no correlation between multiple sclerosis and increased risk of cancer has been established. We present a case of vulvar cancer in 35 year old women with multiple sclerosis. Radical vulvectomy with right-sided inguinofemoral lymphadenectomy was performed. Pathohistological analysis confi rmed the diagnosis of a squamous cell carcinoma, grade II, International Federation of Gynecology and Obstetrics (FIGO) IB. Adjuvant radiotherapy was not indicated. After two years of follow up, there was no evidence of the recurrence. The occurrence of vulvar cancer in multiple sclerosis patients may be coincidental. Nevertheless, the long term use of immunomodulatory drugs in multiple sclerosis and incidence of cancer may be associated.Karcinom stidnice je rijetka bolest u mladih žena. Rizični faktori za karcinom stidnice su pušenje, kronični dermatitis i infekcija humanim papiloma virusom. Nije dokazana povezanost između multiple skleroze i povećanog rizika za razvoj karcinoma. Opisujemo slučaj karcinoma stidnice u 35-godišnje žene koja boluje od multiple skleroze. Učinjena je radikalna vulvektomija s desnostranom ingvinofemoralnom limfadenektomijom. Patohistološka analiza potvrdila je dijagnozu planocelularnog karcinoma, gradus II, FIGO 1B. Adjuvantna radioterapija nije bila indicirana. Nakon dvije godine praćenja, nema znakova povrata bolesti. Pojava karcinoma stidnice u mlade bolesnice s multiplom sklerozom, može biti koincidencija. Moguća je povezanost dugotrajnog korištenja imunomodulatornih lijekova u multiploj sklerozi i incidencije karcinoma

Uticaj primene bakterijskih inokulanata i strukture smeše na kvalitet silaže grahorice i ovsa

The experiment was carried out to evaluate the possibility of ensiling common vetch - oat mixtures sown at five different seeding rates. Two effects were studied: seeding rate of common vetch and oat in the mixtures and application of bacterial inoculant. The pH, DM (Dry Matter) content, ammonia nitrogen, soluble nitrogen, lactic, acetic and butyric acids were determined on silages. DLG method was utilized for classification the silage quality. Common vetch and oat were grown in binary mixtures at the experimental field of the Institute for forage crops, Kruševac - Serbia, and were tested at five different mixture rates: pure vetch, 25% vetch + 75% oat, 50% vetch + 50% oat, 75% vetch + 25% oat and pure oat. Application of bacterial inoculant affected higher content of ammonia nitrogen and acetic acid (P lt 0.05), but lower content of soluble nitrogen (P lt 0.05). Depending on the seeding rates of common vetch and oat, 75 : 25 common vetch - oat silage had the highest content of lactic acid and the lowest content of butyric acid. Contents of DM, pH and ammonia nitrogen were similar in all silages ranged from 307.2 to 318.5 g kg-1 , from 4.27 to 4.54 and from 16.1 to 19.1% ΣN, respectively. According to the DLG method for silage quality evaluation, similar quality grades were founded.Istraživanje je sprovedeno da bi se procenila mogućnost siliranja smeša grahorice i ovsa posejanih u pet različitih odnosa. Ispitivana su dva faktora: udeo semena grahorice i ovsa u smeši i primena inokulanta pri siliranju. Sadržaj suve materiije, pH, sadržaj amonijačnog i rastvorljivog azota, kao i sadržaj sirćetne, buterne i mlečne kiseline je utvrđen u silaži. Za ocenu kvaliteta silaže je korišćena DLG i metoda po Weissbach-u. Ogled je postavljen na eksperimentalnom polju Instituta za krmno bilje u Kruševcu, Srbija, i ispitavanja su obuhvatila pet različitih smeša: čist usev grahorice, 25% grahorice + 75% ovsa, 50% grahorice + 50% ovsa, 75% grahorice + 25% ovsa i čist usev ovsa. Rezultati suobrađeni kao dvofaktorijalni ogled, analizom varijanse korišćenjem modela koji objašnjava uticaj structure smeše i primene inokulanta na kvalitet silaže. Primena bakterijskog inokulanta je uzrokovala veći sadržaj amonijačnog azota i sirćetne kiseline (P lt 0.05), ali niži sadržaj rastvorljivog azota. Smeša u kojoj je odnos grahorice i ovsa bio 75:25 sadržala je najveći udeo mlečne kiseline i najmanji udeo buterne kiseline. Sadržaj suve materije, pH i amonijačnog azota je bio sličan u svim silažama i kretao se od 307,2 do 318,5 g kg-1 , od 4,27 do 4,54 i od 16,1 do 19,1% ΣN, respektivno. Na osnovu ocene kvaliteta silaže prema DLG i Weissbach metodi utvrđen je približan kvalitet ispitivanih silaža

Rak jajnika, jajovoda i potrbušnice: kirurško liječenje

Surgery is the cornerstone of eff ective management of the ovarian, tubal and peritoneal cancer. In 2014 the International Federation of Gynecology and Obstetrics (FIGO) published a new classifi cation collectively covering cancer of ovary, fallopian tube and peritoneum as well as malignant ovarian germ cell tumors and malignant sex-cord stromal tumors. Comprehensive surgical staging according to the 2014 FIGO classifi cation system plays an important role in management of apparently early stage of ovarian, tubal and peritoneal cancer. Primary debulking (cytoreductive) surgery followed by paclitaxel and platinum based combination chemotherapy is the cornerstone of the advanced-stage disease treatment. In cases of suboptimal primary cytoreduction, interval debulking surgery performed after two to four cycles of chemotherapy based on the clinical judgment of the gynecologic oncologist is second att empt to achieve optimal cytoreduction. Secondary cytoreductive surgery can be considered in patients with platinum-sensitive locally recurrent ovarian cancer. The volume of residual tumor remaining after these surgical approaches is one of the most important independent prognostic factors for survival.Kirurško liječenje je temelj uspješnog liječenja raka jajnika, jajovoda i potrbušnice. Međunarodno federacija ginekologa i opstetričara (FIGO) u 2014. godini objavila je novu klasifi kaciju koja zajedno obuhvaća rak jajnika, jajovoda, potrbušnice, zloćudne tumore zametnih stanica i zloćudne tumore specijalizirane strome jajnika. Kirurško stupnjevanje bolesti prema FIGO 2014 klasifi kaciji je ključno u liječenju raka jajnika, jajovoda i potrbušnice naizgled ranog stadija bolesti. Primarna citoredukcijska kirurgija i dodatno liječenje kemoterapijom je standardni pristup uznapredovaloj bolesti. Prilikom suboptimalne citoredukcije tijekom primarnog kirurškog zahvata “interval debulking surgery” nakon drugog do četvrtog ciklusa kemoterapije, ovisno o procjeni ginekološkog onkologa, drugi je pokušaj postizanja optimalne ciotredukcije. Sekundarna citoredukcijska kirurgija dolazi u obzir kod pacijentica koje su osjetljive na kemoterapiju, a imaju lokalni povrat bolesti. Veličina rezidualnog tumorskog tkiva nakon kirurških zahvata je najznačajniji prognostički čimbenik na koji se može utjecati tijekom liječenja

Uloga laparoskopije u liječenju raka jajnika

Laparoscopy is usually undertaken in young women with adnexal disease that is believed to be benign, but found to be malignant at surgery. Some surgeons use laparascopy for staging, but mainly for presumed stage I or II ovarian cancer. Also, laparoscopy can be useful for selecting women who can be optimally debulked at primary surgery. There are some concerns about using laparoscopic approach in women with ovarian cancer: port-site metastasis, possibility of intraoperative rupture of tumor and eff ect of pneumoperitoneum. Studies showed that rate of port-site metastasis after laparoscopic surgery in women with ovarian cancer is low and usually occurs when there is peritoneal carcinomatosis or distant metastatic disease. Also, it seems that laparoscopy with CO(2) pneumoperitoneum does not reduce the overall survival in women with intraabdominal metastases. Preoperative rupture, surface capsular invasion and positive peritoneal cytology are more relevant in terms of prognosis than intraoperative rupture, but further research is needed. Conventional laparoscopy and robotic-assisted laparoscopy are comparable in both early and advanced disease. These approaches are not inferior to laparotomy and they are acceptable access in selected patients.Laparoskopija se najčešće koristi kod žena za koje se mislilo da imaju benignu bolest, ali se tijekom operacije ispostavilo da se radi o malignoj bolesti. Neki kirurzi koriste laparoskopski pristup za stupnjevanje bolesti i to najčešće za pretpostavljeni I ili II stadij. Također, laparoskopija može biti korisna za odabir žena kojima se može primarno napraviti „debulking“. Postoji nekoliko briga prilikom korištenja laparoskopskog pristupa: pojava metastaza na mjestu ulaska troakara, mogućnost intraoperacijske rupture tumora i učinak pneumoperitoneuma. Studije su pokazale da je udio metastaza na mjestu ulaska troakara nizak i da se najčešće javlja kod žena koje imaju karcinomatozu peritoneuma i udaljene metastaze. Također, čini se da laparoskopija s CO2 pneumoperitoneumom ne smanjuje ukupno preživljenje žena s intraabdominalnim metastazama. Preoperacijska ruptura, površinska invazija kapsule i pozitivan peritonealni ispirak su važniji za prognozu od intraoperacijske rupture, no daljnja istraživanja su potrebna. Konvencionalna i laparoskopija pomoću robota su usporedivei u ranoj i u proširenoj bolesti.Ovi pristupi nisu inferiorni laparotomiji i prihvatljivi su kod odabranih pacijenata

Rak jajnika, jajovoda i potrbušnice: kirurško liječenje

Surgery is the cornerstone of eff ective management of the ovarian, tubal and peritoneal cancer. In 2014 the International Federation of Gynecology and Obstetrics (FIGO) published a new classifi cation collectively covering cancer of ovary, fallopian tube and peritoneum as well as malignant ovarian germ cell tumors and malignant sex-cord stromal tumors. Comprehensive surgical staging according to the 2014 FIGO classifi cation system plays an important role in management of apparently early stage of ovarian, tubal and peritoneal cancer. Primary debulking (cytoreductive) surgery followed by paclitaxel and platinum based combination chemotherapy is the cornerstone of the advanced-stage disease treatment. In cases of suboptimal primary cytoreduction, interval debulking surgery performed after two to four cycles of chemotherapy based on the clinical judgment of the gynecologic oncologist is second att empt to achieve optimal cytoreduction. Secondary cytoreductive surgery can be considered in patients with platinum-sensitive locally recurrent ovarian cancer. The volume of residual tumor remaining after these surgical approaches is one of the most important independent prognostic factors for survival.Kirurško liječenje je temelj uspješnog liječenja raka jajnika, jajovoda i potrbušnice. Međunarodno federacija ginekologa i opstetričara (FIGO) u 2014. godini objavila je novu klasifi kaciju koja zajedno obuhvaća rak jajnika, jajovoda, potrbušnice, zloćudne tumore zametnih stanica i zloćudne tumore specijalizirane strome jajnika. Kirurško stupnjevanje bolesti prema FIGO 2014 klasifi kaciji je ključno u liječenju raka jajnika, jajovoda i potrbušnice naizgled ranog stadija bolesti. Primarna citoredukcijska kirurgija i dodatno liječenje kemoterapijom je standardni pristup uznapredovaloj bolesti. Prilikom suboptimalne citoredukcije tijekom primarnog kirurškog zahvata “interval debulking surgery” nakon drugog do četvrtog ciklusa kemoterapije, ovisno o procjeni ginekološkog onkologa, drugi je pokušaj postizanja optimalne ciotredukcije. Sekundarna citoredukcijska kirurgija dolazi u obzir kod pacijentica koje su osjetljive na kemoterapiju, a imaju lokalni povrat bolesti. Veličina rezidualnog tumorskog tkiva nakon kirurških zahvata je najznačajniji prognostički čimbenik na koji se može utjecati tijekom liječenja

Uloga laparoskopije u liječenju raka jajnika

Laparoscopy is usually undertaken in young women with adnexal disease that is believed to be benign, but found to be malignant at surgery. Some surgeons use laparascopy for staging, but mainly for presumed stage I or II ovarian cancer. Also, laparoscopy can be useful for selecting women who can be optimally debulked at primary surgery. There are some concerns about using laparoscopic approach in women with ovarian cancer: port-site metastasis, possibility of intraoperative rupture of tumor and eff ect of pneumoperitoneum. Studies showed that rate of port-site metastasis after laparoscopic surgery in women with ovarian cancer is low and usually occurs when there is peritoneal carcinomatosis or distant metastatic disease. Also, it seems that laparoscopy with CO(2) pneumoperitoneum does not reduce the overall survival in women with intraabdominal metastases. Preoperative rupture, surface capsular invasion and positive peritoneal cytology are more relevant in terms of prognosis than intraoperative rupture, but further research is needed. Conventional laparoscopy and robotic-assisted laparoscopy are comparable in both early and advanced disease. These approaches are not inferior to laparotomy and they are acceptable access in selected patients.Laparoskopija se najčešće koristi kod žena za koje se mislilo da imaju benignu bolest, ali se tijekom operacije ispostavilo da se radi o malignoj bolesti. Neki kirurzi koriste laparoskopski pristup za stupnjevanje bolesti i to najčešće za pretpostavljeni I ili II stadij. Također, laparoskopija može biti korisna za odabir žena kojima se može primarno napraviti „debulking“. Postoji nekoliko briga prilikom korištenja laparoskopskog pristupa: pojava metastaza na mjestu ulaska troakara, mogućnost intraoperacijske rupture tumora i učinak pneumoperitoneuma. Studije su pokazale da je udio metastaza na mjestu ulaska troakara nizak i da se najčešće javlja kod žena koje imaju karcinomatozu peritoneuma i udaljene metastaze. Također, čini se da laparoskopija s CO2 pneumoperitoneumom ne smanjuje ukupno preživljenje žena s intraabdominalnim metastazama. Preoperacijska ruptura, površinska invazija kapsule i pozitivan peritonealni ispirak su važniji za prognozu od intraoperacijske rupture, no daljnja istraživanja su potrebna. Konvencionalna i laparoskopija pomoću robota su usporedivei u ranoj i u proširenoj bolesti.Ovi pristupi nisu inferiorni laparotomiji i prihvatljivi su kod odabranih pacijenata

Dobroćudni multicistični peritonejski mezoteliom s oponašanjem ginekološke patologije

Benign multicystic peritoneal mesothelioma is a rare pathology that arises from the abdominal peritoneum. It has an affinity to develop on the surfaces of pelvic viscera. It predominantly occurs in women of reproductive age. The most used form of treatment is complete surgical removal. We report a case of a a 21-year-old female patient who presented with unclear diffuse abdominal pain. Transvaginal ultrasound and magnetic resonance imaging of the abdomen and pelvis revealed multiple functional cysts in the projection of the right and left ovary and free fluid in the pouch of Douglas. Laparoscopy was performed and multicystic tumor with thin, smooth walls, filled with clear serous content was found in lesser pelvis spreading to the left paracolic region and under the spleen. The multicystic mass was removed. Histologic examination revealed cystic formations filled with mucous content and formed from connective tissue outside and single row epithelium-mesothelium inside. Definitive diagnosis was benign multicystic mesothelioma of the abdominal peritoneum. The patient was well at one year follow-up.Dobroćudni multicistični peritonejski mezoteliom je rijetka bolest koja nastaje iz abdominalnog peritoneja. Obično se razvija na zdjeličnom peritoneju, najčešće u žena generativne dobi. Najuobičajeniji način liječenja je potpuno kirurško uklanjanje. Prikazujemo slučaj 21-godišnje djevojke koja nam se javila s nejasnom difuznom boli. Transvaginalni ultrazvuk i magnetna rezonanca trbuha i zdjelice otkrili su višestruke funkcionalne ciste u projekciji desnog i lijevog jajnika i u Douglasovu prostoru. Učinjena je laparoskopija i nađen je multicistični tumor s tankim glatkim zidovima ispunjenim bistrom seroznom tekućinom u maloj zdjelici, koji se širio u lijevu parakoličnu regiju i ispod slezene. Multicistična masa je uklonjena. Patohistološka analiza je otkrila cistične formacije ispunjene sluzi i građene od vezivnog tkiva izvana i jednorednim epitelmezotelom iznutra. Konačna dijagnoza je bila dobroćudni multicistični mezoteliom abdominalnog peritoneja. Bolesnica se redovito kontrolira bez znakova bolesti

Optimizacija proizvodnje biodizela kukuruznog ulja metanolizom katalizovanom pepelom kurdeljke

The use of low-cost or priceless feedstocks such as byproducts in biodiesel production results in a reduced overall process costs. The present paper reports the use of corn germs and corn cobs as byproducts from corn-based starch production in the biodiesel production by the methanolysis of the oil extracted from corn germs, catalyzed by the ash produced by combustion of corn cobs. The major aim was to optimize the methanol-to-oil molar ratio, catalyst loading, and reaction time in a batch stirred reactor with respect to the content of methyl ester fatty acids (FAME). The statistical modeling and optimization were carried out using a second-order polynomial (quadratic) model developed by the response surface methodology combined with a 33 factorial design with 3 central points. The FAME content was determined by a high-pressure liquid chromatography method. The analysis of variance showed that only the catalyst amount, the reaction time, the catalyst amount interaction with reaction time and all three quadratic terms were the significant model terms with the confidence level of 95 %. The optimum reaction conditions (the catalyst amounts of 19.8 %, the methanol-to-oil molar ratio of 9.4 mol/mol and the reaction time of 31 min) provided the FAME content of 98.1 %, which was in an excellent agreement with the predicted FAME content (98.4 %). Thus, both corn germs and corn cobs may be suitable feedstocks for biodiesel production.Upotreba jeftinih ili bezvrednih sirovina, kao što su sporedni proizvodi, u proizvodnji biodizela ima za rezultat smanjene ukupne troškove procesa. U ovom radu su prikazani rezultati upotrebe kukuruznih klica i okrunjenog kukuruznog klipa (kurdeljke, krudeljke) kao sporednih proizvoda iz proizvodnje kukuruznog skroba u proizvodnji biodizela metanolizom ulja izdvojenog iz kukuruznih klica, katalizovane pepelom dobijenim sagorevanjem kurdeljke. Glavni cilj je bila optimizacija molskog odnosa metanol-ulje, količine katalizatora i reakcionog vremena u šaržnom reaktoru sa mešanjem u odnosu na sadržaj metilestra masnih kiselina (MEMK). Statističko modelovanje i optimizacija izvršeni su korišćenjem kvadratnog modela, razvijenog metodologijom odzivne površine, u kombinaciji sa 33 faktorijelnim planom sa 3 centralne tačke. Sadržaj MEMK-a je određen metodom tečne hromatografije pod visokim pritiskom. Analiza varijanse je pokazala da su samo uticaji količine katalizatora, reakcionog vremena, interakcije količine katalizatora sa reakcionim vremenom i sva tri kvadratna člana statistički značajni sa nivoom pouzdanosti od 95 %. Pod optimalnim reakcionim uslovima (količina katalizatora 19,8 %, molski odnos metanol/ulje 9,4 mol/mol i reakciono vreme 31 min) dobijen je sadržaj MEMK-a od 98,1 %, koji se slaže sa predviđenim sadržajem MEMK-a (98,4 %). Prema tome, i kukuruzne klice i kurdeljka mogu biti pogodne sirovine za proizvodnju biodizela

Protein fractions as influenced by cultivars, stage of maturity and cutting dates in alfalfa (Medicago sativa L.)

This study was undertaken to determine the relationship between CNCPS (Cornell Net Carbohydrate and Protein System) protein fractions and in vitro RUP (Rumen Undegradable Protein) concentration and the variability of protein fractions among alfalfa cultivars grown in Serbia. Two cultivars of alfalfa (Medicago sativa L.) - Serbian cv K 28 and American cv G + 13R + CZ were sampled at three stages of maturity. Comparing the two cultivars of alfalfa (K 28 vs. G + 13R + CZ) means, there were significant differences in all protein fractions. Two investigated alfalfa cultivars differed significantly (p< 0.01) in RUP content, cv G + 13R + CZ was higher in RUP than cv K 28. Stage of maturity had an effect on proportions of the protein fractions. From a nutritional and breeding point of view, cultivar such as G + 13R + CZ is desirable because it combine higher CP (Crude protein) values with lower protein degradability than cv K 28

Effect of bacterial inoculants application and seeding rate on common vetch-oat silage quality

The experiment was carried out to evaluate the possibility of ensiling common vetch - oat mixtures sown at five different seeding rates. Two effects were studied: seeding rate of common vetch and oat in the mixtures and application of bacterial inoculant. The pH, DM (Dry Matter) content, ammonia nitrogen, soluble nitrogen, lactic, acetic and butyric acids were determined on silages. DLG method was utilized for classification the silage quality. Common vetch and oat were grown in binary mixtures at the experimental field of the Institute for forage crops, Kruševac - Serbia, and were tested at five different mixture rates: pure vetch, 25% vetch + 75% oat, 50% vetch + 50% oat, 75% vetch + 25% oat and pure oat. Application of bacterial inoculant affected higher content of ammonia nitrogen and acetic acid (P< 0.05), but lower content of soluble nitrogen (P< 0.05). Depending on the seeding rates of common vetch and oat, 75 : 25 common vetch - oat silage had the highest content of lactic acid and the lowest content of butyric acid. Contents of DM, pH and ammonia nitrogen were similar in all silages ranged from 307.2 to 318.5 g kg-1 , from 4.27 to 4.54 and from 16.1 to 19.1% ΣN, respectively. According to the DLG method for silage quality evaluation, similar quality grades were founded