As recommended by the GEC-ESTRO work group, it is important for the 3D image guided CT, or MRI based brachytherapy of cer-A B C D vical cancer to verify what dose is received by 0.1 cm 3 , 1 cm 3 and 2 cm 3 (D 0,1cc , D 1cc and D 2cc , respectively) of the bladder and rectum volume (1). Intracavitary brachytherapy was applied with applicators type Fletcher tandem and ovoids, once a week on a HDR regime (high dose rate). Delineation of organs at risk (bladder and rectum) was made after each computer tomography (Panel A). The bladder and rectum were delineated on each

OBJECTIVE This study is to define the statistical significance for detection of ESBL producers by the double disk synergy test and molecular test (Check-MDR CT102), microdilution test (VITEK 2 with AES) and double disk synergy test (DDST), as well as the microdilution test and molecular test. MATERIALS AND METHODS Phenotypic testing of 55 isolates Enterobacteriaceae (Escherichia coli (14/55), Klebsiella pneumoniae (34/55), Klebsiella oxytoca (3/55) and Proteus mirabilis (4/55) was performed by VITEK 2 Compact/AES. When this test showed positive results for the ESBL phenotype, then DDST with amoxicillin/clavulanate, ceftazidime, cefpodoxime, aztreonam, ceftriaxone and cefoxitin disks was performed along with Check-MDR CT102 which identified CTX-M, TEM and SHV β-lactamases. RESULTS Applying the McNemar test, we determined that there was a statistically significant difference in the results of detection of ESBLs bacteria using DDST compared to molecular methods (95% CI=41.92 to 54.55; p<0.0001), as well as a DDST and VITEK 2/AES (95% CI=40.13 to 52.73; p<0.0001). We did not find any statistically significant difference in the results of detection of ESBL producers using molecular techniques and VITEK 2/AES (CI=-4,43 to 5,36; p=1). Also we did not find any statistical.. difference between the resistance to cefpodoxime and ceftriaxone (50/50) compared to the results of molecular tests. CONCLUSION In routine daily testing, good detection of ESBLs bacteria, especially CTX-M can be obtained with phenotypic methods with VITEK 2/AES and by DDST with cefpodoxime, and ceftriaksone disks.

OBJECTIVE Serratia marcescens is a well-established as a nosocomial pathogen, resulting in considerable morbidity and mortality in immunocompromised patients. The aim of this study was to investigate an outbreak of Serratia marcescens at the Orthopaedic Clinic of the Clinical Center University of Sarajevo. METHODS A total of 96 strains from 79 patients were isolated. The isolates were identified by conventional methods. Susceptibility testing was performed by the discdiffusion method following CLSI guidelines. Results were confirmed by VITEC-2 Compact. RESULTS From January to December 2010, 96 strains from 79 patients were isolated at the Orthopaedic Clinic of the Clinical Center, University of Sarajevo.The strains were isolated from wound swabs, blood cultures and cerebrospinal fluid. The strains were identifed using current phenotypic methods as Serratia marcescens with identical biochemical characteristics and antibiotic susceptibility patterns. All strains were susceptible to imipenem, meropenem, amikacin, ciprofloxacin, levofloxacin and piperacillin/tazobactam. The infection control team was alerted and after investigation they discovered the same phenotype of Serratia marcescens in the anaesthetic vials used in procedures. This outbreak was extremely difficult to terminate, even with cohorting of patients, sterilisation of equipment, reinforcement of handwashing and deep-cleaning of facilities. The implementation of new control measures terminated the outbreak in February 2011. CONCLUSION Continuous monitoring of nosocomial infections is indispensable. Phenotypic characterization of the isolates is useful for studying the relationship of microbial pathogens. The relationship of one clinical isolate to another during an outbreak is important in motivating the search for a common source or mode of transmission.

UNLABELLED We report a case of an unsual anatomical vascular blood supply to the right kidney. In an analysis of kidneys, by dissection of 39 foetuses, additional renal arteries were found in 18 cases (46.15%). In only one case (2.5%) was it noticed that the right kidney was supplied with blood by three renal arteries, one main and two additional arteries. One of the additional arteries, marked as the upper pole artery of aortic origin, separated from the thoracic aorta at the level of T11 (the eleventh thoracic rib), 1.5 cm above the truncus coeliacus. This artery, after passing through the diaphragm, entered the renal hilus at its upper part and served to vasculate that part of the kidney. CONCLUSION The importance of this study is seen in the fact that anatomic knowledge of variations in the vascularization of the kidneys is of exceptional practical importance. Also, this information may concern transplant surgeons involved in living donor nephrectomies.

In this study, polarized Raman spectroscopy (PRS) was used to characterize the anisotropic response of the amide I band of collagen as a basis for evaluating three-dimensional collagen fibril orientation in tissues. Firstly, the response was investigated theoretically by applying classical Raman theory to collagen-like peptide crystal structures. The theoretical methodology was then tested experimentally, by measuring amide I intensity anisotropy in rat tail as a function of the orientation of the incident laser polarization. For the theoretical study, several collagen-like triple-helical peptide crystal structures obtained from the Protein Data Bank were rotated “in plane” and “out of plane” to evaluate the role of molecular orientation on the intensity of the amide I band. Collagen-like peptides exhibit a sinusoidal anisotropic response when rotated “in plane” with respect to the polarized incident laser. Maximal intensity was obtained when the polarization of the incident light is perpendicular to the molecule and minimal when parallel. In the case of “out of plane” rotation of the molecular structure a decreased anisotropic response was observed, becoming completely isotropic when the structure was perpendicular to the plane of observation. The theoretical Raman response of collagen was compared to that of alpha helical protein fragments. In contrast to collagen, alpha helices have a maximal signal when incident light is parallel to the molecule and minimal when perpendicular. For out-of-plane molecular orientations alpha-helix structures display a decreased average intensity. Results obtained from experiments on rat tail tendon are in excellent agreement with the theoretical predictions, thus demonstrating the high potential of PRS for experimental evaluation of the three-dimensional orientation of collagen fibers in biological tissues.