INFLUENCE OF THE NUMBER OF PREVIOUS CAESAREAN SECTIONS ON LOWER UTERINE SEGMENT STATE

Determining the lower uterine segment (LUS) state before vaginal delivery and after Caesarean section, including pregnant women with more than one Caesarean section, may be an important step towards prevention from still high maternal and neonatal morbidity and mortality that follow uterine rupture. In pregnant women with one or more previous Caesarean sections, ultrasonic measuring of thickness and estimating the LUS integrity can objectively show the state of uterine scars. The aim of this study was to determine the influence of several previous Caesarean sections on the LUS state in term pregnant women. The prospective study included 62 pregnant women with one or more previous Caesarean sections – the examined group, and 50 pregnant women without Caesarean section – the control group, that after the 37th week of pregnancy had undergone the transvaginal ultrasonic measuring of the thickness of the LUS muscular tissue. In 57 pregnant women from the examined group delivered with another Caesarean section, we estimated, intraoperatively, the LUS integrity in the scar area. On the same occasion, in the scar area, the presence of defect – partial or complete was detected. The research pointed out that the average LUS thickness in the examined group – 1.92±0.95mm was statistically significantly lower compared to the control group – 2.68±0.97mm (p<0.001). The average LUS thickness in 52 examined women with one Caesarean section was 1.92±0.97mm, and in 9 women with two Caesarean sections the average thickness was lower – 1.78±0.82mm, which does not represent a statistically significant difference (p=0.85). In one pregnant woman with three Caesarean sections, the LUS thickness was 3.30mm. We registered the total of 13 pregnant women with a defect in the Caesarean section scar area (12 partial and 1 complete defects), in 12 women after one Caesarean section and in 1 woman after two Caesarean sections. The research results show that women with previous Caesarean section have significantly thinner LUS, compared to the group of pregnant women without scars. With the increasing number of previous Caesarean sections, the LUS thickness decreases, but the difference is not statistically significant. Intraoperatively, the presence of certain LUS classes compared to the number of previous Caesarean sections is not significantly different. Furthermore, the increase in the number of Caesarean sections does not involve a statistically significant increase in the frequency of Caesarean section scar defects, which is in accordance with other authors’ results

Odgovor akutne faze kod Wistar pacova posle kontrolisanog krvarenja

After injury the acute-phase response of the organism activates mechanisms which imply the release of cytokines, stress hormones, and mediators of pain and inflammation. The main function of the acutephase response is to hinder further damage of the injured tissue by activating reparative processes. The increase in the concentration of acute phase proteins and the concurrent decrease in albumins and prealbumins indicate that there is a strong link between the liver and the traumatized site. Considering bleeding to be a major injury it can be supposed that it can result in changes in acute phase proteins concentrations despite the fact that it is not directly related to inflammatory reactions. In order to confirm this presumption the concentration changes in negative and positive acute phase proteins in Wistar rats' blood plasma were measured during a 10 day period after controlled bleeding. The result of the therapeutic effects of transfusion on acute phase proteins was estimated in a group of rats in the so called 'hospital stage' at which the blood loss was recovered by citrate blood transfusions. At the end of the 10th day the rats were monitored for an additional 10 day period. The obtained results confirm that bleeding is an impressive trauma and the acute phase response results in a significant change in acute phase proteins. These changes arise quickly, the highest concentrations were achieved within the first 24 to 72h and thereon they slowly declined.Odgovor akutne faze organizma na povredu tkiva aktivira mehanizme koji podrazumevaju oslobađanje citokina, hormona stresa, medijatora bola i zapaljenja. Njegova glavna funkcija je sprečavanje daljeg i većeg oštećenja povređenog tkiva uz aktivaciju reparatornih procesa. Porast koncentracije proteina akutne faze i smanjenje albumina i prealbumina ukazuje da postoji veza između mesta povrede i jetre. Smatrajući da je hemoragija teška povreda, pretpostavili smo da ona može izazvati promene u koncentraciji proteina akutne faze bez obzira što primarno nije povezana sa inflamatornom reakcijom. U cilju dokazivanja ove pretpostavke tokom 10 dana su praćene promene 'negativnih' proteina akutne faze; albumina i 'pozitivnih'; fibrinogena, α-2 makroglobulina i haptoglobina, kao i β-1 globulina i γ-globulina u plazmi Wistar pacova koji su bili podvrgnuti kontrolisanom iskrvarenju. Za potrebe ovog eksperimenta konstruisan je i novi model kontrolisanog krvarenja, koji je jedinkama omogućio preživljavanje tokom sledećih 10 dana, u toku kojih se merila promena relativnih koncentracija akutno-faznih proteina. Ispitan je i uticaj terapijskog efekta transfuzije na stanje proteina akutne faze na grupi pacova koji su u tzv. 'hospitalnoj fazi' kao nadoknadu izgubljene krvi, dobili infuziju citrirane krvi. Po završetku eksperimenta nadgledano je opšte stanje životinja i praćen je letalitet tokom 10 dana. Rezultati našeg istraživanja potvrđuju pretpostavku da je krvarenje teška trauma za organizam pri čemu se odgovor akutne faze manifestuje značajnom promenom koncentracije odgovarajućih proteina, čije se maksimalne koncentracije registruju u prvih 24-72 časa nakon traume

Hipertenzija kod pasa i mačaka - uzroci i posledice

During the nineties of the past century, several authors underscored the necessity of measuring blood pressure during a regular clinical examination of veterinary patients, because hypertension occurs as an accessory symptom in the course of diseased conditions. In addition to blood pressure measurements, most authors believe that it is necessary also to examine intraocular pressure, like in human medicine. Hypertension can be defined as a chronic increase of the systolic and diastolic blood pressure. Systemic blood pressure is proportionate to the heart rate and total peripheral resistance, while physiological control depends on the reninangiotensin system, aldosterone, prostaglandin, adrenergic and neurogenic factors. Some other factors can also have an influence on the measured values of blood pressure (such as age, sex, race, temperament, environment, and, in part, also how and where the pressure measurement was taken). It has been generally accepted in veterinary medicine than an animal can be considered hypertensive if the measured systolic/diastolic pressures are higher than 180/100 mm Hg. Hypertension can be primary (sometimes also defined as essential or idiopathic) when it is a consequence of several factors which include heart, neurological, kidney, endocrine, and metabolic aspects. Hypertension is defined as secondary when it occurs as a consequence of certain chronic disorders (such as hyperthyroidism, hypothyroidism, hyperadrenocorticism, pheochromocytoma, and diabetes mellitus). Blood pressure can be measured in animals using direct or indirect methods. The oscilometric and the ultrasonographic methods are equally used in the world today. Following detailed studies by large numbers of authors, the physiological frameworks of blood pressure in animals have been precisely determined. Different treatments are applied in the therapy of hypertension in animals, such as: restrictive diets, diuretics, a, and (3 blockers, blockers of calcium channels, vasodilators, ACE inhibitors. Hypertension can also be a state that requires emergency treatment, when it is resolved with aggressive therapy.Devedesetih godina prošlog veka više autora je istaklo neophodnost procene krvnog pritiska prilikom uobičajenog kliničkog pregleda veterinarskih pacijenata, jer se hipertenzija javlja kao prateći simptom za vreme različitih bolesnih stanja. Osim merenja krvnog pritiska većina autora smatra daje neophodno da se obavi pregled očnog dna, kao i u humanoj medicini. Hipertenzija može da se definiše kao hronično povećanje sistoličnog i dijastoličnog krvnog pritiska. Sistemski krvni pritisak je proporcionalan srčanom učinku i totalnom perifernom otporu, dok fiziološka kontrola zavisi od renin-angiotenzin sistema, aldosterona, prostaglandina, adrenergičkih i neurogenih faktora. I neki drugi činioci mogu da imaju uticaja na izmerene vrednosti krvnog pritiska (kao što su starost, pol, rasa, temperament, okruženje i delimično način i mesto merenja pritiska). U veterinarskoj medicini generalno je prihvaćeno da se neka životinja može da smatra hipertenzivnom ukoliko izmereni sistolni/dijastolni pritisci prelaze 180/100 mm Hg. Hipertenzija može da bude primarna (nekad definisana i kao esencijalna ili idiopatska) kada je posledica većeg broja faktora, koji uključuju srčane, neurološke, bubrežne, endokrine i metaboličke aspekte. Hipertenzija se definiše kao sekundarna kada se javlja kao posledica nekih hroničnih poremećaja kao što su hipertireoidizam, hipotireoidizam, hiperadrenokorticizam, feohromocitom i dijabetes melitus). Krvni pritisak kod životinja može da se izmeri direktnim i indirektnim metodama. U svetu se danas podjednako koriste i oscilometrijske i ultrasonografske metode. Nakon opsežnih studija većeg broja autora precizno su utvrđeni fiziološki okviri krvnog pritiska kod životinja. U terapiji hipertenzije životinja koriste se različiti tretmani kao što su: restriktivne dijete, diuretici, α1 i β blokatori, blokatori kalcijumovih kanala, vazodilatatori, ACE inhibitori. Hipertenzija može biti i urgentno stanje kada se rešava agresivnom terapijom

Histiocytosis x: Recurrent isolated mandibular lesion (case report)

Histiocytosis X usually affects children and adolescents. In our case, a 54-year-old woman was admitted to hospital for evaluating and treatment of an isolated, painless swelling of the left side of the mandible. Orthopanthomogram showed a cystic formation located on the left side of the mandibular body. Radiographs of the scull and body showed no pathologic changes. Laboratory findings did not reveal any abnormality. Surgical enucleation of the mandibular cystic lesion was performed and histopathological analysis confirmed the presence of histiocytosis X. One year after the first operation a relapse formation was found and surgically removed. Resection of the left side of the mandibular body was performed immediately followed by reconstruction of the mandibular defect with free osseos graft taken from the iliac crest. All follow-ups in the period of three years after the second operation showed no sign of relapse

Numerical modeling of disperse material evaporation in axisymmetric thermal plasma reactor

A numerical 3D Euler-Lagrangian stochastic-deterministic (LSD) model of two-phase flow laden with solid particles was developed. The model includes the relevant physical effects, namely phase interaction, panicle dispersion by turbulence, lift forces, particle-particle collisions, particle-wall collisions, heat and mass transfer between phases, melting and evaporation of particles, vapour diffusion in the gas flow. It was applied to simulate the processes in thermal plasma reactors, designed for the production of the ceramic powders. Paper presents results of extensive numerical simulation provided (a) to determine critical mechanism of interphase heat and mass transfer in plasma flows, (b) to show relative influence of some plasma reactor parameters on solid precursor evaporation efficiency: 1 - inlet plasma temperature, 2 - inlet plasma velocity, 3 - particle initial diameter, 4 - particle injection angle a, and 5 - reactor wall temperature, (c) to analyze the possibilities for high evaporation efficiency of different starting solid precursors (Si, Al, Ti, and B2O3 powder), and (d) to compare different plasma reactor configurations in conjunction with disperse material evaporation efficiency

Optimization of the flue gas-flow controlling devices of the electrostatic precipitator of unit A4 in TPP "Nikola Tesla"

Homogeneity of the flue gas-flow through the chamber of an electrostatic precipitator is one of the basic influencing parameter on dedusting efficiency. This paper presents results of a multiobjective optimization study of the flue gas controlling devices of electrostatic precipitator of 324 MWe lignite fired Unit A4 of TPP "Nikola Tesla" in Serbia. The aim was to achieve better flow homogeneity in the cross-section of the precipitator compared to the original design. Additional constraints were to maintain the minimum as possible overall weight of the proposed design as well as pressure drop through the precipitator. Numerical simulations based on CFD were used to investigate dependence of the velocity distribution in the ducts and precipitator’s chamber with respect to the geometrical parameters of tested concepts of turning blades. A series of 22 detailed full-scale numerical models of the precipitator with different concepts of turning vanes designs were developed. Assessment of the flow field uniformity for each tested design was performed based on the analysis of several homogeneity parameters calculated for selected vertical cross-sections of the precipitator. After the reconstruction according to optimized design, results of measurements confirmed significant improvements of the velocity distribution in the vertical cross-sections of the precipitator, increase of dedusting efficiency and reduction of PM emission

Modeliranje turbulentnog dvofaznog toka aero-smeše sprašenog uglja u gorioničkim kanalima sa jednostepenim turbulatorima

The subject of this work is turbulent two-phase flow through air-coal channel(s) of complex geometry. The aim of this work is numerical optimization of fluid flow and coal particle distribution in reconstructed air-coal mixture channels. The single blade turbulator has been used to increase turbulence in the vertical section of an air-coal mixture channel. Standard k-ω turbulent model has been used for modeling turbulence. Lagrangian multiphase model has been used for discrete phase (coal particles) modeling. Although better particle distribution is reached using single blade turbulators, particle concentration in the evaluation section (where plasma generators will be built in) still remains anisotropic. Because uniform coal particle distribution is of great importance for the proper work of plasma generators, other solutions for achieving this goal will be the object of the future analysis.Predmet ovog rada je turbulentno dvofazno strujanje kroz gorioničke kanale aero-smeše sprašenog uglja kompleksne geometrije. Cilj ovog rada je numerička optimizacija strujnog toka i raspodele čestica sprašenog uglja u rekonstruisanim gorioničkim kanalima. Za povećanje turbulencije, u vertikalnom delu gorioničkog kanala aero smeše ugrađen je jednostepeni turbulator. Za modeliranje turbulencije korišćen je standardni k-ω turbulentni model. Lagranžeov pristup je korišćen za modeliranje sekundarne faze (čestica sprašenog uglja). Iako je upotrebom jednostepenih turbulatora postignuta bolja raspodela čestica sprašenog uglja, koncentracija čestica u prelaznom delu (u kome će biti ugrađeni plazma generatori) ostaje neravnomerna. Kako je ravnomerna raspodela čestica sprašenog uglja od esencijalnog značaja za pravilan rad plazma generatora, druga rešenja za postizanje ravnomerne raspodele čestica će biti predmet buduće analize

Асоцијативни речник српског језика

Pierwsza część słownika asocjacyjnego języka serbskiego

Acute abdomen in a patient with Mayer-Rokitansky-Kuster-Hauser syndrome

Background. Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a malformation of female genital tract (incidence 1 in 4000 female newborn children). It appears as a result of a disorder in the development of Millerian cannals. Etiology is unknown. Syndrome MRKH is the most frequent cause of primary amenorrhoea (90%). Patients with MRKH have a normal female phenotype, with normal pubic hairness and thelarche, and female karyotype (46XX) followed by primary amenorrhoea. Hormonal status corresponds to healthy women, where the appearance of ovarian tumors and tumors on rudiment parts of uterus is possible. Case report. We presented a case of acute abdomen in a patient with previously not diagnosed MRKH. The diagnosis was done during the operation. Small pelvis and an abdominal part were filled with torquated tumor lump, where ovaries, oviducts, uterus or something resembling rudiment of uterus were not recognized through careful examination. Furthemore, the patient had a short, dead-end vagina. Tumorectomy was done and hystopathological finding showed the presence of vascular leiomyoma. Conclusion. The diagnosis of complex syndromes, such as MRKH, can, despite modern diagnostics, be absent for non-medical and psycho-social reasons. We can expect ovarian and uterine pathology on hypoplastic structures in these patients, as well as in healthy women. Vascular leiomyoma in the patients with MRKH was not found in the available literature