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Historical Article
[Centenary of the Nobel Prize for medicine and physiology].
A centenary of the first presentation of the Nobel Prize for Medicine and Physiology has been the reason to make a survey of all those who had been given this prestigious award and their scientific contributions. The Nobel Foundation and the Nobel Museum with their Internet presentations have been the major source of information in this paper, providing a complete survey of anything related to the Nobel Prize. The following Internet address is a very useful source of information about all the laureates of the Nobel Prize for Medicine: www.almaz.comlnobe/medicine/medicine.
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The aorto-enteric fistula (AEF) is a direct communication between aorta and intestinal lumen. There are primary and secondary forms. Primary AEFs are usually due to erosion of an aortic aneurysm (AAA) into the intestine, while secondary forms are caused by reconstructive procedures on the abdominal aorta. The incidence of primary AEF ranges from 0.1 to 0.8%, and secondary from 0.4% to 2.4% [2-4]. The mortality rate after surgical treatment of secondary AEFs is from 14% to 70% [5]. Therefore, they are of great medical importance. The aim of this paper is the presentation of 9 new cases. ⋯ Sir Astley Cooper was the first who described primary AEFs caused by AAA rupture in 1817 [6], and Brock in 1953, first described secondary AEF developed 6 months after aortic homograft implantation [8]. In 1957, Haberer successfully treated primary AEF by suture of the duodenal defect and aneurysmorrhaphy [9]. In our country Stojanovitsh and Vujadinovitsh in 1966, first treated primary AEF [16]. Their patient died due to MOFS. However, in 1984 and 1985, Lotina successfully treated two patients with secondary AEFs [11] (Figure 3, Sheme 1). The authors also analyzed literature data on the aetiology, pathogenesis, clinical manifestations, diagnosis and treatment of AEFs. In conclusion, the authors suggest: 1. "Omega" extra-anatomic bypass from supraceliac artery trough retroperitonely to femoral arteries; 2. "In situ" replacement of the abdominal aorta using cadaveric homografts; 3. Intraoperative control of bleeding with endoluminal balloon occlusive aortic catheter.
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Acetabular fractures and fracture dislocations of the hip joint are frequently complex, and the precise pathological anatomy is not easily demonstrated by routine radiographs. Conventional radiographs are often supplemented by oblique views [1]. The most commonly used classification of acetabular fractures has been based on conventional radiographs which are, in majority of cases, sufficient to determine the type of acetabular injuries [1-3]. It has been shown that computed tomography is useful method in precise evaluation of the fracture type the soft-tissue damage and integrity of joint space [4-6]. ⋯ Our series demonstrates that in many cases details of acetabular fractures are not well visible on conventional radiographs. Because of the complexity of acetabular fractures, precise pathological anatomy is not easily demonstrated by routine radiographs. In a series of Pearson and Shirkhoda et al. [12,13], one third of acetabular fracture was not apparent on the initial radiographs; however, additional views taken three months later demonstrated a fracture. Mossed fractures should decrease with using the CT, which can also reveal the loose bodies in the joint space, occult femoral haed and chondral acetabular impaction. The size of the posterior wall fracture, and thus the stability of the hip, could be better determined by the CT scan than by a conventional radiograph. In conclusion, the information obtained from CT can help the surgeon to decide whether the surgery is necessary, and, if so, the proper approach. We believe that CT is a very helpful supplement to routine AP and 45 degrees oblique views when surgery of acetabular fractures is in question.