Splenic artery pseudoaneurysm as a complication of pancreatic pseudocyst

Introduction. Pancreatic pseudocyst presented as pseudoaneurysm of the splenic artery is a potential serious complication in patients with chronic pancreatitis. Case report. A 42-year-old male patient with a long-standing evolution of chronic pancreatitis and 8-year long evolution of pancreas pseudocyst was referred to the Military Medical Academy, Belgrade due to worsening of the general condition. At admission, the patient was cachectic, febrile, and had the increased values of amylases in urine and sedimentation (SE). After clinical and diagnostic examination: laboratory assessment, esophagogastroduodenoscopy (EGDS), ultrasonography (US), endoscopic ultrasonography (EUS), multislice computed scanner (MSCT) angiography, pseudoaneurysm was found caused by the conversion of pseudocyst on the basis of chronic pancreatitis. The patient was operated on after founding pancreatic pseudocyst, which caused erosion of the splenic artery and their mutual communication. Postoperative course was duly preceded without complications with one year follow-up. Conclusion. Angiography is the most reliable and the safest method for diagnosing hemorrhagic pseudocysts when they clinically present as pseudoaneurysms. A potentially dangerous complication in the presented case was treated surgically with excellent postoperative results

Prefabricated ferrocement sandwich elements in fire conditions

Summary: In this paper the experimental results of two-dimensional non-stationary temperature fields of prefabricated ferrocement sandwich panels in fire condition, were presented. In order to determine resistance to fire, the temperature fields of two walls dimensions of 3000 mm × 3000 mm and a thickness of 190 mm made from precast ferrocement sandwich panels, were analyzed. The first panel has been insulated with styro-concrete, and the second with styro-concrete and expanded polystyrene. The panels were exposed to conditions of real fire corresponding to the standard fire curve defined by the standard SRPS EN ISO 834-1. The tests have shown that, due to the detonations that occur when the panels are exposed to fire, these panels have unpredictable behavior

Electrospun polyacrylonitrile fibers incorporated with microporous carbon for improved airborne PM2.5 filtration

Particulate matter 2.5 (PM2.5) pollutant particles have been identified as significant participants in air pollution, thus, special attention is paid to air filtration as a method of their efficient removal. A novel and simple method of producing nanofiber-based filters for efficient PM2.5 capture with multiple active components are proposed. Electrospun polyacrylonitrile (PAN) polymer was used both as a base filter material and as a precursor for producing microporous carbon nanofibers (MCNFs), which incorporated into the nanofibrous structure of the filter media. The fabricated PAN/MCNFs filters could reach removal efficiency of PM2.5 pollutant particles of up to 99% for with polluted air airflow velocity of 500 ml min−1, showing greater pollutant particle binding affinity with incorporated MCNFs. Experiments also show enhanced mechanical and thermal properties of studied air filters, with the addition of MCNFs – more than 4% and 6% increase in storage modulus and cyclization temperature in comparison to the base PAN filter, respectively. While using a facemask with inserted PAN/MCNFs filter, a reduced temperature variation in the facial region of the user was recorded – several degrees less when compared to a commonly used 3 M Aura 9320+ mask. This opens a possibility of their application in both industrial air filtering and as filters in facemask production

Relationship of short-course preoperative radiotherapy and serum albumin level with postoperative complications in rectal cancer surgery

Background/Aim. The identification of risk factors could play a role in improving early postoperative outcome for rectal cancer surgery patients. The aim of this study was to determine the relationship between short-course preoperative radiotherapy (RT), serum albumin level and the development of postoperative complications in patients after anterior rectal resection due to rectal cancer without creation of diverting stoma. Methods. This retrospective study included patients with histopathologically confirmed adenocarcinoma of the rectum by and the clinical stage of T2-T4 operated on between 2007 and 2012. All the patients underwent open anterior rectal resection with no diverting stoma creation. Preoperative serum albumin was measured in each patient. Tumor location was noted intraoperatively as the distance from the inferior tumor margin to the anal verge. Tumor size was measured and noted by the pathologist who assessed specimens. Some of the patients received short-course preoperative RT, and some did not. The patients were divided into two groups (group 1 with short-course preoperative RT, group 2 with no short-course preoperative RT). Postoperative complications included clinically apparent anastomotic leakage, wound infection, diffuse peritonitis and pneumonia. They were compared between the groups, in relation to preoperative serum albumin level, patients age, tumor size and location. Results. The study included 107 patients (51 in the group 1 and 56 in the group 2). There were no significant difference in age (p = 0.95), and gender (p = 0.12) and tumor distance from anal verge (p = 0.53). The size of rectal carcinoma was significantly higher in the group 1 than in the group 2 (51.37 ± 12.04 mm vs 45.57 ± 9.81 mm, respectively; p = 0.007). The preoperative serum albumin level was significantly lower in the group 1 than in the group 2 (34.80 ± 2.85 g/L vs 37.55 ± 2.74 g/L, respectively; p < 0.001). A significant correlation between the tumor size and the serum albumin level was found (p = 0.042). Overall, postoperative complications were observed in 13 (25.5%) patients in the group 1 and in 10 (17.8%) patients in the group 2 with significant difference between the groups (p = 0.18). A significantly lower level of serum albumin was found in patients postoperative complications and in those who died. A significant difference in anastomotic leakage occurrence between groups was also found (p = 0.039). Male gender and the lower level of serum albumin were significant predictors for anastomotic leakage occurrence (p = 0.05 and p = 0.002, respectively), but preoperative RT had no significant impact on it. Conclusions. A lower serum albumin level, but not short-course of preoperative RT, was significantly associated with postoperative complications development after rectal resection with no diverting stoma

A 60-year experience in the treatment of pancreatic insulinoma in the Military Medical Academy, Belgrade

Background/Aim. Insulinomas are rare benign tumors in the most cases and the most frequent endocrine tumors of the pancreas. A wide spectrum of clinical manifestations in patients with insulinoma is the reason for difficult recognition of the disease with a long period of time between the onset of symptoms and the diagnosis. Diagnostic procedures include Whipple’s triad, 72-hour fast test and topographic assessment. The only currative therapy for patients with insulinoma is operative treatment. Methods. This retrospective study included 42 patients with diagnosis of insulinoma treated in our institution in a 60-year period. In all the patients a demographic and clinical data, types of biochemical methods for diagnosis, and diagnostic procedures for insulinoma localization were analyzed. Tumor size and localization, surgical procedures, postoperative complications and outcome were assessed. Results. A study included 42 patients, 29 women and 13 men. The median age at diagnosis was 43 years. Median time between the onset of symptoms and diagnosis was 3 years. The most common clinical symptoms and signs were disturbance of consciousness and abnormal behavior in 73%, confusion and convulsions in 61% of patients. The diagnosis of insulinoma was estimated by Whipple's triad and 72-hour fast test in 14 patients. Determination of insulinoma localization was assessed by angiography in 16 (36%) of the patients, by ultrasound (US) in 3 of 16 (18.8%) patients, by abdominal computed tomography (CT) in 8 of 18 (44.5%) patients, and magnetic resonance imaging (MRI) in 2 of 8 (25%) patients. Insulinoma was found in 13 of 13 (100%) patients by arterial stimulation with venous sampling (ASVS) and in 13 of 14 (93%) patients by endoscopic ultrasound (EUS). Of the 42 patients, 38 (90.5%) underwent operative procedure. Minimal resection was performed in 28 (73.6%) of the patients [tumor enucleation in 27 (71%) and central pancreatectomy in one (2.6%) of the patients], and the major resection was performed in 9 (23.6%) of the operated patients [distal splenopancreatectomy in 8 (21%) and pancreaticoduodenectomy in one (2.6%) patient]. The overall mortality rate in postoperative period was 2.6% (one patient). Conclusion. A combination of ASVS and EUS as diagnostic procedures ensures high accuracy for preoperative determination of insulinoma localization. Minimal resection such as enucleation shoud be performed whenever it is possible