Aim To determine a correlation between the localization of the parathyroid gland (PTG), based on ultrasound (US) examination and the operative findings, as well as the correlation between the size of the parathyroid glands measured by ultrasonography (USG) with pathological findings+, and prevalence of enlarged parathyroid glands in various forms of hyperparathyroidism. Methods A total of 83 patients with hyperparathyroidism who had undergone parathyroidectomy over a period of seven years were included in the study. US examinations of the neck and scintigraphy were performed before surgery in 83 and 42 patients, respectively. In the pathohistological analysis, in addition to diagnosis, the size and weight of the parathyroid gland were measured. Results US examination revealed 125 enlarged parathyroid glands and two normal-sized glands. Scintigraphy revealed 52 enlarged and three normal-sized parathyroid glands. Enlarged parathyroid glands were more frequently found in the projection of the lower pole thyroid glands. A significantly higher number of enlarged upper parathyroid glands were found by the operative findings than by US. There was no statistically significant difference in the diagnosis of enlarged parathyroid glands in all three forms of hyperparathyroidism. There was a positive correlation between the size of the parathyroid glands obtained by US and the size of the operative finding (κ=0.51; p=0.00 and p<0.0005, respectively). The relationship between parathyroid gland size measured by ultrasound and pathological analysis showed a positive correlation. Conclusion Ultrasound was useful in evaluating enlarged parathyroid glands, especially in combination with scintigraphy.

Background: Chordoma is a rare malignant neoplasm that predominantly arises from the axial skeleton, but can also develop in unusual locations. However, there are also rare cases of „NOS“ chordoma involving the oropharyx and epithelial-myoepithelial carcinoma of the parotid gland in the same patient. According to contemporary research, chordoma is a rare malignant neoplasm that arises from the embryonic remnants of the notochord. and typically involves the clivus, sacrococcygeal bones or vertebrae. Studies have shown that the incidence of chordoma has been estimated to be one per one million people per year. Chordoma can occur at any age, but most commonly it is diagnosed in the 40–60 year old age group with the male predominance. Objective: The aim of this article was to review the case of a 74-year-old female patient with epithelial-myoepithelial carcinoma of the parotid gland and a case of „NOS“ chordoma involving the oropharyx. Methods: Diagnostic methods were used to examine a female patient with two primary malignant tumors: CT neck scan, CT of paranasal sinuses, ultrasound examination, scintigraphy and operative finding. Case presentzation: Due to the anatomy complexity, complete resection of the tumor through a transoral-transpharyngeal approach was not possible. Intraoperative palpation of the mass revealed well defined submucosal lesion 20x43x46mm beginning at the level of the oro- and hypopharynx and extending superiorly to the nasopharynx, and posteriorly into the spinal canal and intervertebral foramen causing near complete occlusion of the oro and hypopharynx. The patient also underwent extracapsular dissection of the parotid tumor. Postoperative palliative radiotherapy was performed. Conclusion: Surgical treatment remains the mainstay of treatment for EMC and radiation is imperative for patients who refuse surgery and for those with advanced or inoperable diseases.

Aim: The aim of this study was to analyze all the factors (disease symptoms, sinthigraphic findings, biochemical parameters) that occur in patients with hyperparathyroidism, and since hyperparathyroidism itself is a common endocrine disorder. Methods: We analyzed 79 patients with primary, secondary, and tertiary hyperparathyroidism, who underwent surgery. We analyzed mean of age, male: female ratio, representation of different forms of hyperparathyroidism. In our study, we examined the indications for examination and surgery, as well as the most common symptoms and comorbidities. For localization PTG, scintigraphy was performed by a nuclear medicine specialist (at the Clinic of Radiology and Nuclear Medicine) preoperatively. Preoperative values of calcium (Ca), phosphorus (P), and parathyroid hormone (PTH) were determined in all patients, and the same values were measured postoperatively. We also analyzed correlation of dialysis length and parathyroid gland hyperplasia in patients with secondary hyperparathyroidism. Results: In our study mean of years was 51.13 ± 11.83 and most of the respondents were female. The most common operation was subtotal parathyroidectomy. The most common indication for examination of parathyroid glands (PTG) was renal failure. The most common comorbidity was arterial hypertension, which was found in 43 (53.2%) subjects, and the rarest gastrointestinal diseases and pancreatitis, in 1 (1.3%) patients. Scintigraphy showed an equal representation of enlarged lower parathyroid glands (both right and left). The mean values determined preoperatively for PTH were 796.24 pg/ml, Ca 2.58 mmol / l and P 1.35 mmol / l. The mean postoperative values for PTH were 222.33 pg/ml, Ca 2.06 mmol/l and P 1.17 mmol/l. We also showed that was a large correlation between dialysis length and hyperplasia. Conclusion: Hyperparathyroidism is a common endocrine disease, carrying potential complications of many organic systems. In most cases, regardless of the form (primary, secondary, or tertiary), it ultimately requires surgical treatment. For this reason, the clinical picture must be well known, the necessary preoperative diagnostic methods (which are complex), all with the aim of better effect of treatment of such patients.

Background: The most common patohistological finding in primary hyperparathyroidism is adenoma of the parathyroid gland, followed by hyperplasia and the rarest is carcinoma. However, hyperplasia of the parathyroid glands (PTG) is most commonly found in secondary and tertiary hyperparathyroidism. Objective: The aim of this study was to determine the relationship between the localization of the parathyroid glands and pathological diagnosis, as well as the prevalence of individual pathological diagnosis after surgery in patients with hyperparathyroidism. Methods: Analysis of retrospective-prospective database of 79 patients who underwent parathyreoidectomy for hyperparathyroidism in the 7-year study period. Diagnostic methods were used to identify enlarged parathyroid glands as well as to determine their localization: ultrasound examination, scintigraphy and operative finding. Standard hematoxylin eosin staining was used for pathophysiological diagnosis. A correlation analysis between parathyroid gland localization and pathophysiological diagnosis was performed. Results: The median age of the patients were 51 age (range 20-73) and 67,1% of the patients were female. In the total number of surgically removed parathyroid glands (182), the most common pathophysiological diagnosis was hyperplasia. Parathyroid adenoma was found in 21 cases. Other diagnoses (thyroid nodule / tissue, lymph node, thymus, cancer) were found in 11 cases, while a normal finding was found in 12 glands. Pathophysiological diagnosis of hyperplasia and adenoma were more common in the lower parathyroid glands. Using the chi-square test, no association was found between pathophysiological diagnosis and localization of enlarged parathyroid glands. Conclusion: The most common pathophysiological diagnosis in hyperparathyroidism was hyperplasia and was most commonly found in the inferior parathyroid glands. Adenoma as pathophysiological diagnosis is also most commonly found in the lower parathyroid glands, but without statistical significance.

Background: The most common patohistological finding in primary hyperparathyroidism is adenoma of the parathyroid gland, followed by hyperplasia and the rarest is carcinoma. However, hyperplasia of the parathyroid glands (PTG) is most commonly found in secondary and tertiary hyperparathyroidism. Objective: The aim of this study was to determine the relationship between the localization of the parathyroid glands and pathological diagnosis, as well as the prevalence of individual pathological diagnosis after surgery in patients with hyperparathyroidism. Methods: Analysis of retrospective-prospective database of 79 patients who underwent parathyreoidectomy for hyperparathyroidism in the 7-year study period. Diagnostic methods were used to identify enlarged parathyroid glands as well as to determine their localization: ultrasound examination, scintigraphy and operative finding. Standard hematoxylin eosin staining was used for pathophysiological diagnosis. A correlation analysis between parathyroid gland localization and pathophysiological diagnosis was performed. Results: The median age of the patients were 51 age (range 20-73) and 67,1% of the patients were female. In the total number of surgically removed parathyroid glands (182), the most common pathophysiological diagnosis was hyperplasia. Parathyroid adenoma was found in 21 cases. Other diagnoses (thyroid nodule / tissue, lymph node, thymus, cancer) were found in 11 cases, while a normal finding was found in 12 glands. Pathophysiological diagnosis of hyperplasia and adenoma were more common in the lower parathyroid glands. Using the chi-square test, no association was found between pathophysiological diagnosis and localization of enlarged parathyroid glands. Conclusion: The most common pathophysiological diagnosis in hyperparathyroidism was hyperplasia and was most commonly found in the inferior parathyroid glands. Adenoma as pathophysiological diagnosis is also most commonly found in the lower parathyroid glands, but without statistical significance.

We report a case of recurrent painful and disabling granulomatous flexor tenosynovitis of the right wrist in 50-year-old female patient. The proper diagnosis was made ex juvantibus after repeated cultivation of Mycobacteria yielded negative results and local disease control was surgically unsuccessful. It was then decided to start at first with oral Clarithromycin at 500mg 2x daily during 6-month period throughout which there was no sign of local recurrence. However, synovectomy had to be performed 3 times in total during the period of two years. While the noninfectious causes were excluded, and infectious agent was not to be determined, the decision was made to administer full anti-tuberculosis medication therapy. At about the same time, we were finally able to obtain a positive Mycobacterium tuberculosis culture after a sudden onset of right axillary lymphadenitis, but only two and half years from the occurrence of first symptoms related to right wrist tenosynovitis.

The historical context of globalization as an organized process, which influenced the majority of national economies linked via international institutional mediators, led to the so called regional economic integration phenomenon. It is interpreted as the efforts of underdeveloped and developing countries to speed up their economic growth and more significantly impact the entire macroeconomic stability by means of some form of regional integration. Nowadays, regional economic integration is one of the pillars for proper functioning of modern economic relations. Experience of developed countries serves as an example to point out that integration processes inevitably contribute to more favorable environment for developing business sector in the countries striving for integration. In the context of global integrations, more frequent forms of regional changes and the establishment of trade blocks come as the consequence as well as the overall need for obtaining trade balance among national economies. Within this context, the European Union is seen as one of the most important regional integration and an imperative in economic, political and cultural segment, as it is the territory with significant economic growth and the region with high living standards.

The introduction of macroprudential stability indicators for risk estimation in financial systems is a hot topic in transition countries. Our examination is focused on the repeating rate of instability in financial systems in Bosnia, Herzegovina and Croatia based on the selection of appropriate macroprudential indicators. Empirical investigation analyzed the statistical data of the National Bank of Croatia and the Central Bank of Bosnia and Herzegovina for the period of ten years between 2003 and 2013. With multivariate logistic regression we create a model based for determination of probability of the occurrence of instability in financial systems based on real values of macroprudential indicators.

Summary The thematic framework of this work is the nominal and real convergence as a determinant for joining the European monetary union. The focus of the work is to prove that realising the criteria of the convergence affects the stability of the European monetary union, that is, that the cause of destabilisation is exactly the fact that certain member nations have not realised the assigned convergence criteria. The financial integration is an important question because it contributes to the economic growth affecting free exchange with the goal of a more efficient allocation of capital; it is the result of the economic theory and the empirical research. Introducing the Euro as a single payment method while losing the monetary sovereignty of the countries which have accepted it is the main reason for forming the European Central Bank. The mission of the European Central Bank is to define and conduct a single monetary policy within the Eurozone. Because of the already mentioned facts, the challenges of conducting the fiscal policy within the Eurozone as well as the key aspects of the monetary unification of Europe have been analysed. The results of this analysis should point out the stability of the EMU by the convergence degree of the member nations from a single monetary area.

Summary With regard to the specific situation and problems in Bosnia and Herzegovina this paper will analyse the effects caused by adhering to the rules of the Washington Consensus, and thus will determine to which extent they have influenced the stability of the macroeconomic indicators in Bosnia and Herzegovina and will explain how the rules affect the stability of macroeconomic indicators of Bosnia and Herzegovina. The main thesis of the Washington Consensus is that by following the measures of the same the macroeconomic situation in the country becomes more stabilised. However, stabilization often cannot sustain in the long term and this situation in the economy can be regarded as quasi-macroeconomic stability. The application of the Washington Consensus produces a quasi-macroeconomic stability of Bosnia and Herzegovina since the high level of unemployment exists due to a low inflation. Contrary to the neoliberal Washington Consensus profile, whose main goal is the maintenance of steady conditions in budgets through fiscal stabilization policies, the paper stresses the need to solve the permanent high unemployment rate as the main macroeconomic problem Bosnia and Herzegovina’s.

Abstract: Although the public procurement system in Bosnia and Herzegovina is represented the area of the legal profession because it is defined by laws and regulations, it is actually more important for economists and all public officials in the country. The subject of this work is theoretical. and practical aspects of applying the transparency to the system of public procurement in the context of strengthening market competition in Bosnia and Herzegovina, and the market economy in general. The special significance of this work lies in the fact that for the first time, research methods were applied to reveal the market strength of the contracting authorities (buyers) and market competition among suppliers (sellers) in the public procurement market in Bosnia and Herzegovina, as measured by their market shares. Based on such findings, the relations of market strength of contracting authorities and the level of development of competition on the public procurement market in Bosnia and Herzegovina in the period from 2010 to 2012 was examined in terms of choosing more or less transparent procurement procedures. Keywords:public procurement system, transparency, market competition.

The study included the patients treated at the Clinic for Maxillofacial Surgery at „Dubrava“ Clinic Hospital in Zagreb who were planned for microvascular reconstruction using forearm or thigh perforator flaps. Patients with oral cavity cancer were evaluated and placed in two groups (20 in each group), based on the type of perforator flap used for defect reconstruction. Postoperative functional results were evaluated during regular follow up visits through a specifically designed clinical questionnaire. Moreover, an objective voice analysis was done using the acoustic voice analysis Multi-Dimensional Voice program (MDVP). Oral cavity is a specific region, mostly due to the fact that most structures and functions are closely interrelated. Tumor resection defects are commonly reconstructed with the most adequate free flap which enables the patients to have reasonably normal functions of chewing, swallowing, voice articulation and speech. Postoperative prosthetic rehabilitation, duration of hospitalization, local complications with reconstruction and postoperative activity do not depend on the flap type. Length of hospitalization depended primarily on the general condition of the patient and comorbidity and then on the stage of the ailment. The results of this study show that postoperative decannulation and the duration of feeding through the nasogastric tube depends on the stage of the ailment, regardless of the flap choice for reconstruction. Decannulation was the fastest in stage 1, and statistically significantly faster in women. The fastest postoperative mouth eating was in the patients who had stage 1 disease and postoperative speech ability. Speech ability after surgery is not significantly dependent on the extent of resection and the type of dissection. Postoperative speech in patients in both groups, according to the patients and their physicians, was significantly better in the first months after surgery than a year later. The deterioration of the speech ability can be explained by the scar tissue and flap atrophy itself. The majority of patients were not concerned about the aesthetic appearance of the flap (hair coverage), however, they were mostly concerned about the layout and functionality of the donor region and the overall aesthetic impression. The data showed that the success of oral cavity reconstruction and a better quality of life of patients with tumor of head and neck do not directly depend on the reconstruction method.

The oral cavity is a region that is special because its structures and functions are closely related. After tumor resection, the defect is reconstructed bya fl apwhich “ covers ” the defect and restores the functions of chewing, swallowing, articulation, and speech after the surgery. The current literature consists of many published reports that compare different types of oral cavity reconstruction. However, the sum total data are relatively small and in some cases contradictory. New defect closure techniques were introduced during the

Introduction: Skin melanoma has been one of the most researched malignant melanoma of today. Its "popularity" among the researchers and clinicians arises from variety of forms and biological behaviour, it's characteristic appearance, genetic and immunologic certainty and its prognostic uncertainty. Patients and methods: We analyzed 62 patients with a primary skin melanoma diagnosed in the period from January 2001, to June 2010 (patients were divided in two groups; Group A: patients with melanoma development based on pre-existed nevi and Group B: de novo melanomas). The clinicopathological parameters determined for each tumour were histological type, Breslow thickness, Clark level, and pathological disease stage. The results were correlated with expression of estrogen receptor beta (Ers) and Bcl2. Results: Comparing individual groups according to the intensity of positivity in relation to the stage of Clark, we recognize differences in the distribution of patients with pre-existent nevi (group A), but not in de novo melanoma (group B). Significant differences between individual groups for Ers and Bcl2 expression in terms of intensity of positivity in relation to Clark level (III/IV) showed differences in distribution in patients with pre-existing nevi (Group A). After adjusting for age and sex, we found that Ers and Bcl2 expression was significantly higher in patient with pre-existing nevi in higher melanoma tissue compared with thin melanoma tissue. Conclusion: Expression of ER in Clark level III and IV is higher in melanoma arising from pre-existing nevi, giving better chance of survival to our patients in comparison to de novo melanoma.