Possibilities for preservation of coarse particles in pelleting process to improve feed quality characteristics.

Poultry diets are mainly used in pelleted form because pellets have many advantages compared to mash feed. On the other hand, pelleting causes reduction of feed particle size. The aim of this research was to investigate the possibility of increasing the content of coarse particles in pellets, and, at the same time, to produce pellets with satisfactory quality. In this research, the three grinding treatments of corn were applied using hammer mill with three sieve openings diameter: 3 mm (HM-3), 6 mm (HM-6) and 9 mm (HM-9). These grinding treatments were combined in pelleting process with three gaps between rollers and the die of pellet press (roller-die gap, RDG) (0.30, 1.15 and 2.00 mm) and three moisture contents of the pelleted material (14.5, 16.0 and 17.5%). The increased coarseness of grinding by the hammer mill resulted in the increased amount of coarse particles in pellets, especially when the smallest RDG was applied (0.30 mm), but pellet quality was greatly reduced. Increasing of RDG improved the quality of pellets produced from coarsely ground corn, but reduced the content of coarse particles in pellets and increased specific energy consumption of the pellet press. Increasing the moisture content of material to be pelleted (MC) significantly reduced energy consumption of the pellet press, but there was no significant influence of MC on particle size after pelleting and on the pellet quality. The optimal values of the pelleting process parameters were determined using desirability function method. The results of optimization process showed that to achieve the highest possible quantity of coarse particles in the pellets, and to produce pellets of satisfactory quality, with the lowest possible energy consumption of the pellet press, the coarsest grinding on hammer mill (HM-9), the largest RDG (2 mm) and the highest MC (17.5%) should be applied.

Human fetal islet transplantation in type 1 diabetics: comparison of immunological effects between multiple implantation regimens.

Previous studies have suggested that the multiple transplants might be equally metabolically efficient to a single regimen for human adult islets. The aim of this study was to compare immunological and metabolic parameters after each of the two regimens of human fetal islets (HFI). Group A single transplants (n = 9) had 180 +/- 20 x 1000 HFI equivalents (IEQs) implanted via a single intramuscular injection. In group B multiple transplants (n = 8) islets were implanted by three consecutive injections of 60 +/- 10 x 1000 IEQs at 7-day intervals. We analyzed the immunological parameters of CD4/CD8 T lymphocyte ratios; islet cell antibodies (ICAs) and insulin antibodies (IAs). We estimated insulin secreting capacity (ISC) as the metabolic parameter. We observed that the CD4+/CD8+ T-cell ratio increased, peaking on day 90, in similar fashion in both groups: day -1: A = 1.18 +/- 0.03 versus B = 1.19 +/- 0.04; on day 90: A = 1.79 +/- 0.09, versus B = 1.75 +/- 0.08 (P = NS) immediately before the decrease in C-peptide levels. Thereafter the ratios rapidly decreased without statistical differences. The levels of ICAs did not change. The levels of IAs, which were increased before transplant, then decreased without statistical differences between the groups. The values of ISC increased after transplant and then decreased similar to the T-cell ratio. Our results demonstrated that regimens of multiple and single HFIs did not show differences in the kinetics of the immunological response presumably mediating graft destruction. The CD4/CD8 ratio increased as the C-peptide level decreased, peaking on day 90 at the time of a decrease in C-peptide. These results may be useful for clinical studies of HFIs for type 1 diabetic patients.

Primary malignant fibrous histiocytoma of the spleen and liver.

Malignant fibrous histiocytoma (MFH) is a distinct and pleomorphic form of sarcoma, which usually occurs in soft tissues but can be found in bones, kidney, larynx, lung, heart, and even aorta. Since the first description of MFH of the spleen by Govoni et al. in 1982, only 10 cases have been reported in the literature worldwide. We report on a 45-yr-old female with MFH of the spleen and liver, with special emphasizes on immunohistochemical findings.

Hepatosplenic candidiasis after neutropenic phase of acute leukaemia.

Hepatosplenic candidiasis following granulocytopenic periods is a relatively recently recognised problem in immunocompromised patients, particularly in those with acute leukaemia. We present three patients in whom diagnosis of hepatosplenic candidiasis was suspected on the basis of ultrasonographic (US), computed tomographic (CT) findings and confirmed by laparoscopy and biopsy of liver lesions. All three patients were successfully treated briefly with amphotericin B, followed by a longer period of fluconazole. In one patient laparotomy and surgical evacuation of abscesses was performed. This condition could be more often recognised by careful follow-up of liver function test, C-reactive protein level, ultrasonography, CT and MRI after recovery from chemotherapy-induced neutropenia.

Non-secretory solitary plasmacytoma of the spleen.

A case of primary nonsecretory plasmacytoma of the spleen is reported. On laparotomy and splenectomy a 920 g spleen was removed, measuring 16 x 14 x 6 cm. The cut surface of the entire spleen showed that the tumour occupied most of the splenic tissue. A bone marrow aspirate and trephine, skeletal survey showed no signs of myeloma. Biopsy of the liver and regional lymph nodes was normal. Immunocytochemistry of the splenic tumour showed positivity for pan-B and plasma cell markers. After splenectomy the patient was treated with chemotherapy according to protocol VBCMP (M2).

Multiple leiomyosarcoma of the stomach.

Leiomyosarcoma is the second most common non epithelial malignant tumor of the stomach. It is almost always a single lesion. Multiple leiomyosarcomas of the stomach are extremely rare. To our knowledge only three cases have been reported so far. We present a 40 year old female with epigastric pain, nausea, diarrhea, weight loss and melena in whom we diagnosed multiple lesions of the stomach. At operation, we found a total of 11 submucosal or subserosal lesions ranging in size from 0.5 to 6 cm in diameter localized throughout the stomach. Histological examination showed leiomyosarcoma in every lesion. Almost all the lymph nodes along curvatures had metastases. Other lymph nodes, peritoneum, liver and other organs were disease free. A total gastrectomy and Roux-en-Y esophagojejunostomy was performed. She had an uneventful recovery and has remained symptom-free so far (nine months).

Splenic vein thrombosis. Diagnosed with Doppler ultrasonography.

The case of a 31-year-old pregnant woman with an isolated splenic vein thrombosis, diagnosed with Doppler ultrasonography is presented. Routine ultrasound examination in the fourth month of the pregnancy revealed massive splenomegaly of unknown origin. Doppler ultrasonography subsequently revealed splenic venous thrombosis with absence of blood flow. Noteworthy gastric varices were present at the endoscopic examination. On splenectomy, a spleen weighing 2,600 was removed, and numerous venous collaterals were found in the perigastric region. The postoperative course was satisfactory, pregnancy evolved normally, and a healthy female baby was delivered at term. The patient remained in excellent health with normal clinical and laboratory data.

Idiopathic thrombocytopenia associated with Wilson's disease.

We present the case of a 53 year-old patient with idiopathic thrombocytopenia associated with Wilson's disease. Idiopathic thrombocytopenia was diagnosed in August of 1994, and as the response to corticosteroid therapy was poor, the patient underwent a splenectomy in October of the same year. A liver biopsy, which was performed during the operation, showed Wilson's disease in the form of mild, chronic, active hepatitis. The serum ceruloplasmin was low, and the Kayser Fleischer's ring was positive. MRI of the brain showed cortical reductive changes with areas of copper accumulation in the white brain matter. An unusual presentation of Wilson's disease associated with idiopathic thrombocytopenia has not been published as of yet. The diagnosis of Wilson's disease was made at an advanced, adult age, which may implicate a heterozygous genetic configuration.

[Splenic artery aneurysms].

Although the third most frequent aneurysm in the abdomen, after aneurysms of the aorta and iliac arteries, and most frequent aneurisms of visceral arteries, splenic artery aneurysms are rare, but not very rare. Thanks to the new imaging techniques, first of all ultrasonography, they have been discovered with increasing frequency. We present a series of 9 splenic artery aneurysms. Seven patients were female and two male of average age 49 years (ranging from 28 to 75 years). The majority of afected women were multiparae, with average 3 children (ranging from 1 to 6). One patient had a subacute rupture, and 2 had ruptures into the splenic vein causing portal hypertension. The spleen was enlarged in 7 out of 9 patients. The average size of aneurysms was 3,2 cm (ranging from 2 to 8 cm). The preoperative diagnosis of splenic artery aneurysm was established in 6 patients while in 3 patients aneurism was accidentally found during other operations, during splenectomy in 2, and during the excision of a retroperitoneal tumour in 1 patient. Aneurysmectomy was carried out in 7 patients, while a ligation of the incoming and outcoming wessels was performed in 2 patients with arteriovenous fistula. Splenectomy was performed in 6 patients, while pancreatic tail resection, cholecystectomy and excision of the retroperitoneal tumor were performed in 3 patients. Additional resection of the abdominal aortic aneurysm with reconstruction of aortoiliac segment was performed in 2 patients. There were no mortality and the postoperative recovery was uneventful in all patients.

Left-sided gallbladder associated with congenital liver cyst.

BACKGROUND: A left-sided gallbladder is a rare congenital anomaly defined as a gallbladder attached to the lower surface of the left lateral segment of the liver, i.e. to the left of the interlobar fissure and round ligament. CASE OUTLINES: In two women aged 42 and 70 years a left-sided gallbladder was associated with a congenital cyst of the liver. In the first patient, the ectopic gallbladder was an incidental finding at operation for a symptomatic liver cyst; as the gallbladder was normal it was not removed. The second patient underwent operation for chronic calculous cholecystitis, when the left-sided gallbladder and congenital liver cyst were found. An operative cholangiogram was normal, the cystic duct joining the common bile duct from the right side. The gallbladder was removed, and the cyst was de-roofed. Both patients had an uneventful recovery and remain symptom-free at 12 and 9 years respectively. DISCUSSION: To the best of our knowledge, the association of these two congenital anomalies has not been described previously.

[Wound treatment in ancient Greece]. / Lecenje rana u staroj Grckoj.

Wounds probably represented one of the first challenges the first human beings had to face with. Unlike some primitive creatures that are capable to repair even the entire lost part of the body, a simple healing with connective tissue is all that can be expected in human. From the early days through entire history it was tried to find the way to alleviate and to speed up the wound healing and to prevent dangerous or even deadly complications that may take place. A concept set up by Old Greeks that suppuration of wounds is good and laudable maintained almost twenty three hundred years. Through history it was challenged only occasionally, but stayed firm to the end of 19. century when was proved to be wrong.

[Splenectomy technic]. / Tehnika splenektomije.

Splenectomy has been performed in trauma in a number of benign lesions of the spleen and in a certain haematological diseases. When performed for trauma a luxation technique of splenectomy is applied since it allows quick haemostasis. When performed in other indications, the spleen is usually enlarged. In those patients "splenectomy in situ" is recommended. That means, first, division of the short gastric vessels and gastrosplenic ligament, second, ligation of the splenic artery and finally division of the hilar vessels after which the spleen may be simply removed. Details of operative technique, management of accessory spleens and prevention of operative complications are described.

[Splenic artery aneurysm in a patient with Gaucher's disease]. / Aneurizma slezinske arterije kod bolesnice sa Gaucherovom bolescu.

We present a 31-year-old woman suffering from Gaucher's disease in whom during splenectomy a big splenic artery aneurysm was found, 5 x 3.5 cm in diameters; it was due to hypersplenism and compression of the enlarged spleen. In a huge spleen 43 cm in length and 5420 grams in weight, many deposits of glycocerebrosides were found. Cholecystectomy was also carried out for calculous cholecystitis. The recovery was uneventful and the patient stayed in good condition.

[The development of anatomy]. / Razvoj anatomije.

Doctors, particularly surgeons, realise the enormous importance of good knowledge of human anatomy today. It was not so in the past when doctors showed little or no interest for human anatomy for centuries. Dissections of the human body, necessary to study human anatomy, were either forbidden or limited to the corpses of criminals on whom capital punishment was carried out. The authors give a chronology of the development of human anatomy until 19. century when dissections of the human body became almost universally regulated with positive legislation. After the "golden age of surgery" began in 1870. surgeons gave an enormous contribution to anatomy.

[Perforated ulcer in Meckel's diverticulum]. / Perforisani ulkus Mekelovog divertikuluma.

Three cases, two women and one man, aged 27, 47 and 79 years with perforated peptic ulcer of Meckel's diverticulum are reported. All patients had diffuse peritonitis. The exact diagnosis of the cause of peritonitis has not been preoperatively established in any of them. In two patients cuneiform excision (diverticulectomy) was performed, and resection and anastomosis of the small intestine in the third. The female patients, aged 79, after an uneventful recovery suddenly died due to an acute heart failure on the eight day after surgery. In other patient suppuration of the wound occurred and convalescence was prolonged. In all cases microscopic examination revealed ectopic gastric mucosa on the top of the diverticulum with peptic ulcer.

[Nonparasitic true cysts of the spleen]. / Neparazitne prave ciste slezine.

Nonparasitic true cysts of the spleen are rare, but not so rare as it has been thought. Thanks to the new imaging techniques, first of all ultrasonography, they are discovered easily and quickly. Usually, there is only one cyst. Rarely, the patient may have the polycystic liver and the kidney, and the pancreatic disease. We present four patients with nonparasitic true cysts of the spleen. There were three women and one man, 37-years-average age (range from 31 to 45 years). Three patients had solitary splenic cysts. In one patient a large dominant cyst and many small cysts up to 0.5 cm in diameter were found. All patients suffered from left subcostal pain. The size of cysts varied from 6 to 8.5 cm in diameter (average size of 7 cm). All patients were treated surgically by splenectomy, without complications or mortality. Histological findings revealed lyphangiomatic cysts in three patients and epidermoid cyst in one subject. All patients are symptom-free so far.

Retroperitoneal biloma secondary to operative common bile duct injury.

Encapsulated collections of bile ("biloma") may be a sequela of liver trauma, operative injury or disease. Such collections may be intrahepatic or extrahepatic and usually in the supramesocolic compartment of the abdomen. This is a report of a retroperitoneal biloma, an entity that has been reported only twice to date but this is the first secondary to an operative common bile duct lesion. Evacuation of the biloma and reconstruction of the associated biliary stricture were successfully carried out. The patient remains symptom free with normal clinical and laboratory data more than 14 months after surgery.

Some experimental aspects of using lungs as biological oxygenator in extracorporal circulation.

Exposing problem of oxygenators in extracorporal circulation authors consider screen and membrane as the best, in spite of some disadvantages from which the haemolysis is the most cumbersome. In attempt to find the way of solution of this problem, authors have made a number of experiments in animals where they have conducted extracorporal circulation in such way that blood has been oxygenated in own lungs of an animals. Two types of bypass were examined as: right to right bypass (vv. cavae-pulmonary artery), right to right bypass as exposed with possibility of interconnection with classical extracorporal circulation, and finally bypass of the left and right heart. Exposing their experience and results authors consider that use of lungs as biological oxygenator in extracorporal circulation has its justification according to achieved results. In spite of some problems which need further elaboration such experiments are the motive for more work and reflexion in this type of problem.