Takayasu arteritis is a granulomatous vasculitis of unknown etiology that commonly affects the thoracic and abdominal aorta, great vessels, results in segmental stenosis, occlusion, dilatation and aneurysm formation in these vessels. We described case 19-year-old girl with and clinical and radiology manifestation disease. Patient had absent upper-extremity pulses, hypotension, (RP: 90/50 mmHg), easy fatigability and ischemic symptoms. Radiology findings were present Type I - classic pulse less type that involves the brachiocephalic trunk, carotid arteries and subclavian arteries.

In this case report it was shown five cases of passing abdominal organs in thoracic cavum. All of them were women more than 70 years old with symptoms of respiratory illnesses. Their chest-X ray has shown various shadows. They had a long antibiotic treatment in outpatient department before sending to hospital under suspicion of lung or mediastinal tumor. Two of them had anamnesis of trauma a few years ago. All of them had no bronchoscopic intrabroncial changes, two had signs of extramural bronchial compression. All of them had different level of ventilatory insufficiency, with normal laboratory findings, some of them had positional EKG changes. By different diagnostic procedures: chest X-ray, bronchoscopy, gastrointestinal X-ray with contrast, computer thomography of thorax, we found: 2 cases of large hiatal hernia, 1 case of prolapsus whole ventricle in mediastinum, 2 cases of passing ventricle and large part of intestines in thorax. All of them rejected proposed abdominal surgery treatment. We appoint the importance of this appearance to avoid wasting time in appointing the diagnosis, to avoid different diagnostic procedures and long lasting antibiotic treatment, and prevent complications, first of all incarceration of organs.

Purpose. The purpose of this paper is to analyse the contribution of MRI as diagnostic procedure in the preoperative diagnosis of aortic coarctation (CoA), in patients with clinical and echocardiographic suspicion for this disease. Patients and methods. During the period of three years, eight patients were examined, 5 (62.5%) male and 3 (37.5%) female patients with clinical echocardiographic suspicion of CoA. The ratio between male and female patients was 1.7 : 1. The youngest patient was 3 and the oldest 46 years (median age was 15 years). Without administration of contrast media and using body coil the examinations were performed with MR machine Magnetom 1.0 Tesla (»Siemens«), with the slice thickness of 6 mm, Fast spin-echo (FSE) T1W sequences, Cine gradient echo (GRE) sequence with slab 7 mm and time of flight (TOF) sequence with MIP reconstructions were applied. During the examinations the patients underwent also ECG gating. Examinations were done in axial, coronal and oblique sagittal projections with measuring of the dimensions of cardiovascular structures. Results. CoA was found in 8 (100%) patients. In 7 (87.5%) cases, coarctation developed at isthmus and in one case, coarctation was detected at the horizontal part of aortic arch, between the truncus arteriosus of the left carotid communis artery. Aortal insufficiency was found in 7 (87.5%) patients; in four of them (50%), bicuspidia was confirmed (bicuspid aortic valve), 7 (87.5%) patients had slightly expressed hypertrophy of the left ventricle. Two (25%) patients had dilatation of the ascendant aorta, six (75%) wider outgoing vessels of the aortic arch, four (50%) had well developed arterial collaterals and 2 (25%) patients rib notching. In 2 (25%) patients as side finding thymus persistent was found. Average diameter of coarctation was 10 mm. In one patient, CoA was accompanied with stenosis of pulmonary artery, in one with ventricular septal defect, and one with tricuspid insufficiency. The results of MRI 100% were in correlation with clinical and echocardiographic findings. Conclusions. MRI is a non-invasive method of investigation of the heart and large blood vessels and it is more and more an alternative to the invasive angiographic investigations, especially in paediatrics, because there is no radiation at all. It is complementary to the echocardiographic, intra-arterial digital subtraction angiography (IA DSA) and helical CT (SCT).

In a five year long study efficiency of Praziquental in a prevention of human echinococcosis relapses was studied. Study was conducted in a period from October 1996 till October 2000, and it included patients with echinoccosis treated in Clinical Center of Sarajevo University in Sarajevo, and in Hospital Konjic, in Konjic. In the above stated period 136 patients with echinoccosis were treated surgically, and in 30 of them combined therapy with Praziquental was used. Antihelmint therapy was applied in hospital settings for 14 days in a dose of 25-50 mg/kg of body weight with adjuvant corticotherapy. After hospital discharge patients were followed up in outpatient clinics by infectologists, surgeons and pediatricians. Follow up included clinical, biochemical, ultrasonic and radiological investigations. Longest follow up interval was 5.5 years and shortest year and a half. Results of study have shown that in a group of 106 patients, treated only with surgical treatment, there were 12.5% of relapses. In a group of patients that we treated with combined therapy with Praziquental there were not relapses. Our results suggest Praziquental could be a drug of choice for the prevention of relapses in human echinoccosis in a combined therapy.

PURPOSE In order to analyse a contribution of digital techniques in diagnostics of the aortic coarctation (CoA), a grow up of patients in whom the aforesaid disease was found, has been described. MATERIAL AND METHODS There were examined, within 1986 and 1998, 12 patients suspected of CoA and 2 patients were subjected to medical check up of state after operation of this anomaly. There was 12 (86%) men and 2 (14%) women. Six patients were children. Average age of the patients was 25 years. The youngest was 6 and the oldest 51 years old. 12 patients underwent the intravenous digital subtraction angiography, 3 patients underwent computed tomography, and 1 patient was subjected to magnetic resonance imaging. RESULTS There has been found CoA in 10 male patients and pseudo-coarctation of the aorta in 2 female patients advanced in years. A satisfactory diagnostics was possible by use of any of the three methods. CONCLUSION Noninvasive methods of examination, intravenous-digital subtraction angiography (IV-DSA), computed tomography (CT), and magnetic resonance (MR) are and more alternatives to invasive angiographic examinations. Magnetic resonance is suitable especially in pediatrics since radiation could be avoided.

In this study, the authors made the analysis of five patients who had striped tortuous pulmonary density or wide hilus at the standard radiography examination. By the pulmonary intravenous digital subtraction angiography method, a pulmonary varix was discovered in two cases and in one case a wide common mouth of the right pulmonary veins in the left atrium. Mild variation of the dilatation of the pulmonary veins was present in two cases out of which one was with an aberrant draining into the left atrium. Digital angiography, as a simple screening method, give us a possibility of the ambulatory check up of the large number of patients and therefore a more frequent discovery of these, in the most cases asymptomatic anomalies, what eliminates an unnecessary surgical treatment.

We can say that with the traffic's development, more and more, we become faced with aorta's posttraumatic pseudoaneurysm. We diagnosed it, accidentally, in the medical findings, with five patient, by computed tomography, and intravenous digital subtraction angiography, within the thirteen years period. These methods are presented as complementary ones in the matters of diagnose. Diagnose is of the great importance for this disease, considering its unpredictable evolution and a possibility of death outcome.

Anomalies of the system vein entrance into the right atrium are rarity, particularly in the double superior vena cava. As an isolated anomaly it is asymptomatic. Throughout eight years period we have been making computed tomography checks of 4045 patients, and with five of them, meaning 1.2 promil we have discovered double superior vena cava as a random finding. The diagnosis was confirmed by means of a bi-cubital intravenous digital subtraction angiography. The diagnosis of these anomaly is significant for the differential diagnostics from tumor syndrome, as well as for prevention of surprises in studies of the mediastinum.

Percutaneous transthoracic aspiration biopsy (PTAB) is an interventional radiologic procedure for histologic confirmation or elimination of malignant nature of the lesion. The development of digital techniques (introduction of CT and US) and small gauge needles increased the interest for this method. CT scanner enables the accurate determination of the entry point of the puncture guide, precise visualisation of the needle tip and reliable analyses of complications. The type of the puncture needle is very important for establishment of the correct diagnosis. Of 163 Chiba needle punctures the cytologically representative samples were obtained in 84.7% and pathohistologically representative samples in 56%. Of complications the most common was pneumothorax found in 9.7% and alveolar hemorrhage in 9.1% cases. In this paper the method and contribution of the Chiba needles are analysed compared to the results of other authors obtained by other types of needles. Our results are satisfying with small number of complications.

The effect of two-dimensional echocardiography in assessment mitral valve calcifications was compared to computed tomography (CT) in 50 patients with pure rheumatic mitral stenosis (MS). Echocardiography revealed no mitral calcifications in 23 patients, respectively 46 per cent (grade 0). Twelve patients (24 per cent) had calcifications smaller than 2.5 mm (grade 1). Eleven (22 per cent) had moderate calcifications, smaller than one half of length of the anterior mitral leaflet (grade 2) and four (8 per cent) had calcifications larger than one half of the length of the anterior mitral leaflet (grade 3). The last two groups were thought to have clinically important calcifications. Specificity and sensitivity were examined in comparison to CT. By echocardiography, five (ten per cent) false positive findings were found in the group 2. There were neither false positive nor false negative findings in the last two group. The first group when compared with other three groups showed sensitivity of 100, specificity of 85, and predictive accuracy of 81 per cent. But the first two groups together compared with the last two groups showed sensitivity, specificity and predictive accuracy of 100 per cent.

CT-guided percutaneous transthoracic aspiration biopsy presenting one of interventional radiologic procedures, has enabled the sample providing for cytologic analysis. It has been frequently used with the aim of confirmation or elimination of malignant neoplastic process. The main advantages of CT over fluoroscopy are precise needle visualization, documentation of needle tip in the lesion, puncture of small, for fluoroscopy unreachable lesions, as well as the adequate presentation of eventual complications. The authors have analysed, retrospectively, 195 findings of patients, who underwent CT-guided Chiba needle percutaneous transthoracic aspiration biopsy. The finding was cytologically representative in 85.64% of cases, unrepresentative in 14.36%. Out of all complications, pneumothorax (9.74%) and perifocal hematom (9.23%) were most frequent. Contraindications, complications and safety of this very useful method in definitive diagnosing and planning of the adequate therapy have been discussed.

In order to study the mitral cusp pliability and calcification "in vivo" on the basis of the difference in the maximal and effective valve area, the Doppler-echocardiographic and computer tomographic method was used. The cusp pliability on the basis of the difference between the maximal and effective mitral valve area in absolute measures of cm2 was significantly smaller in patients with mitral stenosis, but in the deviations from normal indexed values of cusp pliability excluding the influence of the anatomic or maximal orifice area, there were no significant differences (normal values 0.00 +/- 27%). The normal relationship of the difference between the maximal and effective mitral valve area in absolute measures (y = cm2) and the maximal mitral valve area (x = cm2) is formulated with the regression equation: y = 0.317x - 0.245. The linear correlation of the normal mitral valve area and the stroke volume at rest in patients with the normal mitral valve is very tight. The stroke volume is significantly lower in mitral stenosis, and the time-velocity integral in the diastole or the mitral stroke distance was significantly greater. The relationship of the percentual deviation from the normal indexed values of cusp pliability excluding the influence of the anatomic or maximal orifice area, on the one hand, and the computer-tomographic approximation of calcium incrustation in mitral leaflets on the other are defined with a tight linear correlation. One could conclude that the magnitude of cusp pliability or calcification can be approximated by the Doppler-echocardiographic method.