Urban garden as lived space: Informal gardening practices and dwelling culture in socialist and post-socialist Belgrade

This paper considers urban gardens as lived spaces which have an important role in reconnecting with nature in an urban environment, but also as an archive of concepts related to culture and everyday life. In this context, the paper studies the character of three of Belgrade's urban gardens and their contribution to the quality of everyday life in the large-scale socialist residential settlements built during the 1970s. Focus is placed on establishing relations between the dwelling culture, social and cultural needs and changes, and the dominant architectural and planning paradigms of modernism and post-modernism. Belgrade's urban gardens were created and developed spontaneously (most often non-legally) as self-organized citizens' acts. Research presented in our case studies confirms the paper's initial assumption that the urban gardens in Belgrade are still considered marginal and certainly not representative urban practices, overshadowed by the planned urban conceptions and sociopolitical actions. In this sense, we may notice the lack of a systematic approach to managing these gardens, and complete absence of legislation either provided by authorities, private or public bodies or even associations. Although the urban gardens emerged in socialism outside of any rules and regulations, they promoted the values of an active relationship between the user, dwelling culture and immediate residential surroundings, and contributed to improving the dwelling culture of the "new working class" in the socialist dwelling units. Also, the gardens were not only a place for producing food in financially difficult times, especially during the post-socialist transition of the 1990s, but above all a place associated with socialization and a "sense of home". Recognizing the benefits of urban gardens and accordingly raising awareness about this concept in the city, together with the adoption of appropriate regulations, would certainly be of immense relevance to urban gardening and generally landscape quality in Serbia

Reconstruction of full thickness abdominal wall defect following tumor resection: A case report

Introduction. 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. Case Outline. 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. Conclusion. 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

BILATERAL TOTAL HIP AND KNEE ARTHROPLASTY IN A PATIENT WITH RHEUMATOID ARTHRITIS. A CASE REPORT

Rheumatoid arthritis (RA) is a chronic, inflammatory autoimmune disorder of unknown etiology characterized by synovial hyperplasia and resulting joint destruction. Despite reduced needs for total joint arthroplasty in the treatment of end-stage damage of the hip and knee in RA, many patients still require hip and knee arthroplasty to restore the hip function and quality of life. We present the surgical treatment of young RA patient with bilateral total hip and bilateral knee arthroplasty at the Clinic of Orthopaedics and Traumatology Clinical Center Niš. Male patient with seropositive RA was implanted with bilateral total hip and knee over a period of 4 years (2008 to 2011). At the time of the first left hip arthroplasty, the patient was 32 years old. Surgical treatment in all arthroplasty procedures passed without complications. At the control examination 3 years after the last surgery, the patient was walking without mobility aids. His walk was safe and stable. The postoperative scars on hips and knees were stable, with no signs of inflammation. The flexion of the knees was possible till 110 degrees, and the extension to the full capacity.The patient resumed his work and life activities, and now he works as a game warden. He normally performs everyday activities, including climbing to the watchtower. Total hip and knee arthroplasty in rheumathoid arthritis patients with advanced joint destruction is a successful solution

Surgical treatment of tibial nonunion after wounding by high velocity missile and external fixators: A case report

Introduction. The missiles of modern firearms can cause severe fractures of the extremity. High velocity missile fractures of the tibia are characterized by massive tissue destruction and primary contamination with polymorphic bacteria. Treatment of these fractures is often complicated by delayed healing, poor position healing, nonhealing and bone tissue infection. Case Outline. We present the management of tibial nonunion after wounding by high velocity missile and primary treatment by external fixation in a 25-year-old patient. The patient was primarily treated with external fixation and reconstructive operations of the soft tissue without union of the fracture. Seven months after injury we placed a compression-distraction external fixator type Mitkovic and started with compression and distraction in the fracture focus after osteotomy of the fibula and autospongioplasty. We recorded satisfactory fracture healing and good functional outcome. Conclusion. Contamination and devitalization of the softtissue envelope increase the risk of infection and nonunion in fractures after wounding by high velocity missile. The use of the compression-distraction external fixator type Mitkovic may be an effective method in nonunions of the tibia after this kind of injury. [Projekat Ministarstva nauke Republike Srbije, br. III 41004

External fixation in the treatment of shooting proximal humeral fracture with bone defect: A case report

Introduction. Shooting injuries of shoulder with destruction of proximal humerus are rare and severe orthopaedic injuries. Case Outline. A 74-year-old patient was wounded at close range by a shotgun. He was wounded in the left shoulder and suffered a massive defect of the proximal humerus and soft tissue. The neurocirculatory finding of the injury extremity was normal. After a short resuscitation, x-ray of the thorax and the left shoulder registered a complet destruction of humeral head. After the primary treatment of the wound under general endotracheal anesthesia, the shoulder was stabilized with an external fixator type Mitkovic, with convergent orientation of the pins, where two pins were placed in the neck of scapula and two in the humeral shaft, because the left scapular acromion was fractured by shotgun projectiles. Conclusion. After radical wound debridement, external fixation is the method of choice for shoulder stabilisation in shooting injury of shoulder with bone defect. If this is not possible, pins of the left external skeletal fixator should be placed into the coracoid process and acromion. The pins can be also placed into the humeral shaft, as done in the presented case, and by which a good stability of the injured proximal humerus, easy approach to the wound for bandaging and reconstructive surgery can be achieved

Coagulation disorders in the patients with deep vein thrombosis of lower extremity

PURPOSE Venous thromboembolism is a relevant social and health care problem for its high incidence, pulmonary embolism-related mortality and long-term sequelae which may be disabling (post-thrombotic syndrome and ulceration). PROCEDURES The aim of our work was to establish the presence of coagulation disorders (hypercoagulable states) in the patients with deep vein thrombosis (DVT) of the leg. Prospectively we have analyzed a group of 30 patients with echosono-graphicaly verified DVT of the leg who were admitted to the department of vascular surgery from August 1st 2000 to July 31st 2001.The following parameters were monitored: prothrombin time (PT) partial thromboplastin time (PTT), fibrinogen (Fib), alpha 2 antiplasmin (A-2 AP), D-dimer (DD), antithrombin III (AT III) and factor VII. FINDINGS Activation of the coagulation process was registered. The values of monitored coagulation parameters are shown in table 1. Plasma levels of monitored parameters in the patients with DVT of the leg were significantly higher than in the control subjects. CONCLUSION In patients with a DVT a hypercoagulable state is common finding. Some parameters of coagulation activity such as D-dimer might be of great interest in the diagnostic strategy of DVT

Fasciocutaneous flaps of the lower leg: Anatomic study and clinical significance

Background/Aim. Soft tissue defects of the lower leg, especially in its distal third, still remain a challenging problem in reconstructive surgery. The aim of this study was to examine septocutaneous system of lower leg vascularization, quantitatively and qualitatively, which is the basis of fasciocutaneous and neurocutaneous flaps. Methods. Septocutaneous systems a. tibialis posterior and a. peroneae were examined by anatomical suprafascial lower leg microdissection of 40 fresh cadavers. Septocutaneous perforators located intermusculary, in deep crural fascia duplicature, were followed from its origin (at main arterial trunks of the lower leg) till the point they reach the deep crural fascia. The number and localization of emergence of the septocutaneous perforators were examined for both above mentioned arterial trunks, and the obtained data were documented by photographs, tables and graphics. Statistical analysis (especially cluster analysis), was used for establishing reliable septocutaneous perforators levels. Results. Septocutaneous perforator systems of the lower leg have constant and reliable pattern of existance. Lower leg length was 36 cm in average, (between 33 and 43 cm). Lower leg was divided in 10 equal segments, 3.6 cm each. A. tibialis posterior and a. peronea had 5 septocutaneous perforators. Cluster analysis of a. tibialis posterior perforators (with diameter ≥ 0.5 mm), discovered 5 reliable levels of septocutaneous perforators. These levels are at 3.6-10.8 cm; 14.4-21.6 cm and 25.2-28.8 cm. For a. peronea reliable perforators were found at 3.6-10.8 cm, 14.4-18 cm and 21.6-25.2 cm. Posterior tibial artery perforators had the greatest diameter (from 0.5-1.8 mm; mean value 1.14 mm and SD = 0,26 mm). A mean diameter for peroneal artery perforators was 0.9 mm. Conclusion. Existance of reliable levels of septocutaneous perforators of the lower leg enables and makes reconstruction of the soft tissue defects of the lower leg, especially its distal third and foot, much easier