DISTALNI SPLENORENALNI ŠANT I PARCIJALNA RESEKCIJA SLEZINE

Size: px
Start display at page:

Download "DISTALNI SPLENORENALNI ŠANT I PARCIJALNA RESEKCIJA SLEZINE"

Transcription

1 RADOVI BIBLID: , 135(2007) 5-6, p UDC: DISTALNI SPLENORENALNI ŠANT I PARCIJALNA RESEKCIJA SLEZINE Predrag GAJIN 1, Božina RADEVIĆ 1, Dragoslav NENEZIĆ 1, Nenad ILIJEVSKI 1, Rada JEŠIĆ-VUKIĆEVIĆ 2, Đorđe RADAK 1 1 Institut za kardiovaskularne bolesti Dediwe, Beograd; 2 Institut za bolesti digestivnog sistema, Klinički centar Srbije, Beograd KRATAK SADRŽAJ Uvod Sin drom hi per sple ni zma je če sta kom pli ka ci ja port ne hi per ten zi je. Ci to pe ni ja u hi per sple ni zmu je, pre sve ga, izazva na sple no me ga li jom. Dis ta l ni sple no re na l ni šant (DSRŠ) Vo ren ( War ren) s par ci jal nom re sek ci jom sle zi ne je ori gina lan hi rur ški me tod či ji je smi sao u re gu li sa wu ci to pe ni je sma we wem uve ća nog tki va sle zi ne. Ciq ra da Ciq is tra ži va wa je bio da se po re đe wem mor bi di te ta i mor ta li te ta u gru pi bo le sni ka le če nih DSRŠ s parci jal nom re sek ci jom sle zi ne u od no su na gru pu bo le sni ka le če nih sa mo DSRŠ pro ve ri pred nost DSRŠ s par ci jal nom resek ci jom sle zi ne u ko ri go va wu sin dro ma hi per sple ni zma. Me tod ra da U pe ri o du go di ne u In sti tu tu za kar di o va sku lar ne bo le sti De di we u Be o gra du ope ri san je 41 bole snik zbog sin dro ma hi per sple ni zma i ezo fa gu snih va ri ko zi te ta iza zva nih port nom hi per ten zi jom. Pr vu gru pu je či nilo 11 mu ška ra ca i de vet že na, pro seč ne s ta ro s ti od 42,3 go di ne, ko ji ma je ura đen DSRŠ s par ci ja l nom re sek ci jom s le zine. Dru gu gru pu je či ni lo 13 mu ška ra ca i osam že na, pro seč ne sta ro sti od 49,4 go di ne, kod ko jih je pri me wen sa mo DSRŠ. Kod svih bo le sni ka je ura đe na en do sko pi ja, pro ce we na ve li či na ezo fa g u snih va rik sa, za be le že na s u pret hod na kr va re wa i en do skop ska le če wa. Ve li či na sle zi ne je oce we na ul tra so no graf ski, kom pju te ri zo va nom to mo gra fi jom ili scin ti grafi jom. Kod svih bo le sni ka je ura đe na an gi o gra fi ja. Za be le že ne s u vred no s ti trom bo ci ta, le u ko ci ta i he mo glo bi na. To kom i po sle ope ra ci je su utvr đe ni: na dok na de kr vi i krv nih de ri va ta, kom pli ka ci je i broj da na pro ve de nih na bol nič kom leče wu po sle ope ra ci je. Bo le sni ci su kon tro li sa ni me sec da na, kao i go di nu da na po sle ope ra ci je. Re zul ta ti U pr voj gru pi je po sle ope ra ci je kod sa mo jed nog bo le sni ka di jag no sti ko va na sple no me ga li ja (5%), dok je u drugoj gru pi bi lo 13 bo le sni ka s ovim po re me ća jem (68%). Sred wa vred nost bro ja trom bo ci ta u pr voj gru pi pre ope ra ci je bila je 51,6±18, /l, a po sle ope ra ci je 118,6±25, /l, dok je u dru goj gru pi pre ope ra ci je bi la 67,6±22, /l, a po sle opera ci je 87, 8±32, /l. Po re đe wem po s to pe ra ci o ne sple no me ga li je u tvr đe no je da po s to ji s ta ti s tič ki zna čaj na raz li ka izme đu pr ve i dru ge gru pe (p<0,05), a po re đe wem bro ja trom bo ci ta po sle ope ra ci je utvr đe no je da po sto ji vi so ko sta ti stički zna čaj na raz li ka iz me đu dve gru pe is pi ta ni ka (p<0,01). Z a k qu č a k DSRŠ s par ci jal nom re sek ci jom sle zi ne je po uz dan me tod hi rur škog le če wa hi per sple ni zma i de kom pre sije ezo fa gu snih va rik sa iza zva nih port nom hi per ten zi jom, ko ji, u od no su na DSRŠ, ima pred nost u ko ri go va wu hi per spleni zma. Kquč ne re či: re sek ci ja sle zi ne; hi per sple ni zam; dis tal ni sple no re nal ni šant (War ren) UVOD Sin drom hi per sple ni zma je če sta kom pli ka cija port ne hi per ten zi je. Od li ku ju ga sple no me ga li ja, mo no ci to pe ni ja, bi ci to pe ni ja ili pan ci to pe ni ja, kao i nor mo ce lu lar nost ili hi per ce lu lar nost kostne sr ži [1]. Sple no me ga li ja se uvek ja vqa u hi persple ni zmu, ali sva ka sple no me ga li ja ne do vo di do hiper sple ni zma. Sple no me ga li ja i hi per sple ni zam u port noj hi per ten zi ji su se kun dar ne po ja ve iza zvane, pre sve ga, pa siv nom kon ge sti jom. Sple nek to mi ja je ši ro ko pri me wi van po stu pak hi rur škog le če wa sin dro ma hi per sple ni zma iza zva nog port nom hi perten zi jom. We na pri me na je in di ko va na u le vo stra noj port noj hi per ten zi ji ko ja je iza zva na oklu zi jom lije nal ne ve ne [2]. Por to si stem ski šant-po stup ci [3, 4], tran sju gu lar ni in tra he pa tič ki por to si stem ski šant (TIPS) [5] i par ci jal na em bo li za ci ja sle zine [6-8] sa mo de li mič no ko ri gu ju sple no me ga li ju i ci to pe ni ju u hi per sple ni zmu. Dis tal ni sple no renal ni šant (DSRŠ) Vo ren (War ren ) s par ci jal nom re sek ci jom sle zi ne je ori gi na lan hi rur ški me tod, či ji je smi sao u isto vre me noj de kom pre si ji ezo fagu snih va rik sa i re gu li sa wu ci to pe ni je sma we wem uve ća nog tki va sle zi ne. CIQ RADA Ciq is tra ži va wa je bio da se po re đe wem morbi di te ta i mor ta li te ta u gru pi bo le sni ka le če nih DSRŠ s par ci jal nom re sek ci jom sle zi ne u od no su na gru pu bo le sni ka le če nih sa mo DSRŠ pro ve ri prednost DSRŠ s par ci jal nom re sek ci jom sle zi ne u kori go va wu sin dro ma hi per sple ni zma. METOD RADA Is pi ti va wem su ob u hva će ni bo le sni ci ko ji su u pe ri o du go di ne hi rur ški le če ni na Odeqe wu va sku lar ne hi rur gi je In sti tu ta za kar di o vasku lar ne bo le sti De di we u Be o gra du zbog ezo fagu snih va ri ko zi te ta i hi per sple ni zma iza zva nih port nom hi per ten zi jom. U stu di ju su ukqu če ni svi bo le sni ci kod ko jih je ura đen DSRŠ, a isto vre meno je di jag no sti ko van sin drom hi per sple ni zma. Bole sni ci su svr sta ni u dve gru pe. Pr vu gru pu je či nilo 11 mu ška ra ca i de vet že na, pro seč ne sta ro sti od 42,3 go di ne, kod ko jih je pri me wen DSRŠ uz isto vreme nu par ci jal nu re sek ci ju sle zi ne (Sli ka 1). Dru gu gru pu je či ni lo 13 mu ška ra ca i osam že na, pro se 293

2 čne sta ro sti od 49,4 go di ne, kod ko jih je ura đen sa mo DSRŠ. Is pi ta ni ci pr ve gru pe su nad gle da ni prospek tiv no, a is pi ta ni ci dru ge gru pe pra će ni re trospek tiv no od go di ne. Svi ope ri sa ni bo le sni ci su pret hod no le če ni ambu lant no ili bol nič ki na Kli ni ci za ga stro en tero lo gi ju i he pa to lo gi ju In sti tu ta za bo le sti di gestiv nog si ste ma Kli nič kog cen tra Sr bi je u Be o gradu. Is pi ta ni ci s obo qe wem je tre su gra di ra ni pre ma sko ru Čajl da Pjua (Child Pugh): se rum ska kon cen traci ja bi li ru bi na, al bu mi na, pri su stvo asci te sa, ne u rop si hi ja trij ski po re me ća ji i pro trom bin sko vreme. Kod svih je ura đe na en do sko pi ja, pro ce we na ve liči na ezo fa gu snih va rik sa, za be le že na su pret hod na kr va re wa i en do skop ska le če wa. Ve li či na sle zi ne je oce we na ul tra so no graf ski, kom pju te ri zo va nom tomo gra fi jom ili scin ti gra fi jom. Ta ko đe, pre ope raci je je ura đe na bi op si ja je tre bo le sni ka. Pot pu na ana li za port nog si ste ma je do bi je na posle an gi o gra fi je, ko ja je ura đe na kod svih bo le sni ka, s tim što je kod po je di nih do pu we na ma no me tri jom. Kod svih is pi ta ni ka su pre hi rur škog le če wa iz mere ne vred no sti trom bo ci ta, le u ko ci ta i he mo glo bina. Kod oko 25% bo le sni ka je pre ope ra ci je ura đe na bi op si ja kost ne sr ži ra di is kqu če wa dru gih uzroka ci to pe ni ja. Kod bo le sni ka pr ve gru pe ura đe na je par ci jal na re sek ci ja sle zi ne uz DSRŠ, a kod bo le sni ka dru ge gru pe sa mo DSRŠ. Kod is pi ta ni ka s ne ja snom etio lo gi jom obo qe wa je tre to kom ope ra ci je je ura đe na bi op si ja. Iseč ci je tre, kao i svih dva de set pre pa rata do bi je nih po sle re sek ci ji sle zi ne, ana li zi ra ni su hi sto pa to lo ški. To kom i po sle ope ra ci je je utvr đena na dok na da kr vi i krv nih de ri va ta. U sva koj gru pi je za be le že na po jed na po nov na in ter ven ci ja zbog rane trom bo ze graf ta. U oba slu ča ja je ura đe na sple nekto mi ja uz me zo ka val ni šant. Svi bo le sni ci su pušte ni ku ći pr ve, dru ge ili tre će ne de qe po sle opera ci je. To kom tog pe ri o da su pra će ne sve po ja ve ko je su kom pli ko va le po sto pe ra ci o ni opo ra vak (mor bidi tet). Kod oko 50% bo le sni ka je ura đe na po sto pe raci o na an gi o graf ska pro ce na pro hod no sti šan ta. Bo le sni ci su kon tro li sa ni me sec da na po sle opera ci je u am bu lan ti In sti tu ta za kar di o va sku lar ne bo le sti De di we, kao i po sle go di nu da na u am bulan ti Kli ni ke za ga stro en te ro lo gi ju i he pa to lo gi ju Kli nič kog cen tra Sr bi je. Pro hod nost šan ta je kontro li sa na ul tra so no graf ski. Ra di pro ce ne ko rek cije sin dro ma hi per sple ni zma, kod svih bo le sni ka je ul tra so no graf ski kon tro li sa na ve li či na sle zi ne i pra će ne su vred no sti trom bo ci ta. U ra du su ko ri šće ni sle de ći sta ti stič ki me todi: χ 2 -test, Stu den tov t-test, Vil kin so nov (Wil kins on) test, Man Vit ni jev (Mann-Whit ney) U-test i Vald Vol fvi cov (Wald-Wolf witz) runs test. REZULTATI SLIKA 1. Ostatak slezine posle resekcije. FIGURE 1. Spleen after resection. U gru pi 1 ci ro za je bi la uzrok port ne hi per ten zije kod 16 bo le sni ka, fi bro za kod tri, dok je kod jednog bo le sni ka, i po red pri me ne svih di jag no stič kih me to da, eti o lo gi ja osta la ne ja sna. U gru pi 2 ci ro za je bi la eti o lo ški fak tor kod 18 bo le sni ka, fi broza kod dva, dok je kod jed nog is pi ta ni ka uzrok portne hi per ten zi je bi la post tra u mat ska trom bo za portne ve ne. U gru pi 1 vi rus he pa ti ti sa B (HBV) sa ci ro zom utvr đen je kod tri bo le sni ka, vi rus he pa ti ti sa C (HCV) + kod dva, al ko hol na i bi li jar na ci ro za kod po jed nog, auto i mu na kod če ti ri, a Vil so no va (Willson) bo lest kod dva is pi ta ni ka. Kod tri bo le sni ka ostao je ne ja san uzrok ci ro ze. U gru pi 2 HBV sa ciro zom je di jag no sti ko van kod pet bo le sni ka, HCV+ i al ko hol na ci ro za kod po tri, bi li jar na kod dva, a auto i mu na ci ro za i Vil so no va bo lest kod po jednog bo le sni ka. Kod tri is pi ta ni ka uzrok ci ro ze je bio ne ja san. U gru pi 1 kod 16 bo le sni ka je za be le že no kr va rewe ezo fa gu snih va rik sa (kod če ti ri bo le sni ka kr vare we se de si lo je dan put, kod se dam dva pu ta, a kod pet tri i vi še pu ta), a u gru pi 2 kod 15 bo le sni ka (kod tri bo le sni ka kr va re we se de si lo je dan put, kod sedam dva pu ta, a kod pet tri i vi še pu ta). U gru pi 1 kod šest bo le sni ka su utvr đe ni va rik si dru gog ste pe na, kod 12 va rik si tre ćeg, a kod dva bo lesni ka va rik si če tvr tog ste pe na. U gru pi 2 su kod po de vet bo le sni ka uoče ni va rik si dru gog i tre ćeg stepe na, a kod tri va rik si če tvr tog ste pe na. U gru pi 1 po lo vi na bo le sni ka je le če na en do skopski, dok je u gru pi 2 osam bo le sni ka le če no ovim meto dom. U gru pi 1 to kom ope ra ci je 16 bo le sni ka je pri milo 1-6 do za kr vi, se dam bo le sni ka je pri mi lo 1-6 doza trom bo ci ta, dok je je dan bo le snik do bio osam do za trom bo ci ta. U gru pi 2 petnaest bo le sni ka je pri milo 1-7 do za kr vi, kao i 1-6 do za trom bo ci ta. U ra nom po sto pe ra ci o nom pe ri o du kod po jed nog bo le sni ka iz obe gru pe do šlo je do trom bo ze šan ta. Ura đe na je po nov na ope ra ci ja sple nek to mi ja uz H-me zo ka valni šant. Po red trom bo ze šan ta, uoče ne su i dru ge posto pe ra ci o ne kom pli ka ci je. U gru pi 1 po sto pe ra cio ne kom pli ka ci je su za be le že ne kod 13 bo le sni ka, odno sno 14 bo le sni ka gru pe 2. (U gru pi 1 kod osam bole sni ka je utvr đe na pro la zna fe bril nost, kod če tiri in fek ci ja uro lo škog si ste ma, kod dva he ma tom, dok je kod jed nog za be le že na pro du že na dre na ža. U gru pi 2 kod osam bo le sni ka je utvr đe na fe bril nost 294

3 to kom po sto pe ra ci o nog pe ri o da, kod tri in fek cija uro lo škog si ste ma, kod če ti ri pro du že na dre naža, a kod jed nog he ma tom). Is pi ta ni ci gru pe 1 su pušte ni ku ći da na po sle ope ra ci je, a is pi ta nici dru ge gru pe da na. Sred wa vred nost po sto pera ci o nog bo rav ka u gru pi 1 bi la je 11,9 da na, dok je u gru pi 2 bi la 11,6 da na. To kom pr ve go di ne po sle ope ra ci je u sva koj gru pi je za be le žen po je dan smrt ni is hod. Kod osta lih ispi ta ni ka šan to vi su bi li pro hod ni, ni su za be le že na kr va re wa ezo fa gu snih va rik sa, asci tes, kao ni en cefa lo pa ti ja. To kom pra će wa sin dro ma hi per sple nizma (ve li či na sle zi ne i broj trom bo ci ta) ni su kontro li sa na dva bo le sni ka kod ko ja je ura đe na sple nekto mi ja sa H-me zo ka val nim šan tom zbog ra ne trom boze DSRŠ. Sta ti stič kom ana li zom de mo graf skih poda ta ka, pre o pe ra ci o nih od li ka, hi rur škog le če wa, ra nog po sto pe ra ci o nog pe ri o da, kao i smrt nog isho da, utvr đe no je da ne ma sta ti stič ki zna čaj ne razli ke u za stu pqe no sti go re na ve de nih obe lež ja iz među dve gru pe is pi ta ni ka, od no sno da su gru pe, prema ana li zi ra nim pa ra me tri ma, ho mo ge ne (p>0,05). U gru pi 1 je kod jed nog bo le sni ka za be le že na sple nome ga li ja po sle ope ra ci je, dok je ona u gru pi 2 za be leže na kod 13 bo le sni ka, što je sta ti stič ki zna čaj no (p<0,05). Sred wa vred nost bro ja trom bo ci ta u gru pi 1 pre ope ra ci je bi la je 51,6±18, /l, a po sle ope raci je 118,6±25, /l, dok je vred nost ovog pa ra me tra u gru pi 2 pre ope ra ci je bi la 67,6±22, /l, a po sle hirur škog le če wa 87,8±32, /l (Gra fi kon 1). Po re đewem vred no sti trom bo ci ta iz me đu dve gru pe is pi tani ka do bi je nih po sle ope ra ci je utvr đe no je da po sto ji vi so ko sta ti stič ki zna čaj na raz li ka (p<0,01). DISKUSIJA Mar ni (Mar ni) i sa rad ni ci [9] su go di ne ispi ti va li da li je DSRŠ kon tra in di ko van kod bo lesni ka sa sin dro mom hi per sple ni zma. Utvr di li su da je kod 17 od 19 ope ri sa nih bo le sni ka do šlo do sta tistič ki zna čaj nog po ve ća wa bro ja trom bo ci ta. Go di nu Ниво тромбоцита (10 9 /l) Level of platelet (10 9 /l) I Група / Group GRAFIKON 1. Broj trombocita posle operacije ispitanika obe grupe. GRAPH 1. Postoperative platelet count in both groups. II da na ra ni je Fe ra ra (Fer ra ra) i sa rad ni ci [3] su iz vesti li o ko ri go va wu le u ko pe ni je kod 57% bo le sni ka, od no sno trom bo ci to pe ni je kod 78% po sle DRSŠ. Puti ni (Put ti ni) i sa rad ni ci [4] su iste go di ne ob ja vi li po da tak o po boq ša wu hi per sple ni zma kod 79% bole sni ka po sle DSRŠ. El Ki šen (el-khis hen) i sa radni ci [10] go di ne su ge ri šu da je sple nek to mi ja kon tra in di ko va na u le če wu hi per sple ni zma iza zvanog port nom hi per te nu ri jom. Isti auto ri is ti ču da je DSRŠ ide a lan po stu pak za le če we hi per sple nizma uz se lek tiv nu dre na žu ezo fa gu snih va rik sa. Lox (Lod ge) i sa rad ni ci [11] go di ne iz ve šta va ju o zna čaj nom po ve ća wu bro ja trom bo ci ta i le u ko ci ta po sle se lek tiv nog šan ta. Bo ćan (Bo cian) i Sol ti sjak (Soltysi ak) [12] su go di ne di jag no sti ko va li hiper sple ni zam kod 64,7% bo le sni ka s port nom hi perten zi jom; po sle DSRŠ zna čaj no po boq ša we je za bele že no kod 70% wih. Po sled we stu di je ta ko đe go vo re u pri log to me. Mi u ra (Miura) i sa rad ni ci [13], kao i Ši lj an ski (Shilyansky) i sa rad ni ci [14] su godi ne iz ve sti li o zna čaj nom po ve ća wu bro ja trom boci ta po sle DSRŠ. Klajn (Klein) i sa rad ni ci [15] su go di ne za be le ži li ko rek ci ju sple no me ga li je kod 64% ope ri sa nih bo le sni ka i ko rek ci ju trom boci to pe ni je kod 81,2% is pi ta ni ka. Al va res (Al va res ) i sa rad ni ci [5] su utvr di li zna čaj no po ve ća we broja trom bo ci ta po sle po stup ka TIPS. Ha se ga va (Ha s e ga wa) i sa rad ni ci [16] i Ta ka gi (Takag i) i sa rad ni ci [17] su za be le ži li zna čaj no sma wewe vo lu me na sle zi ne po sle DSRŠ, uz zna čaj no po veća we bro ja trom bo ci ta. Vid man (Wid man ) i sa radni ci [18] su pro u či li mor fo lo ške i he mo di nam ske pro me ne po sle DSRŠ, te utvr di li sma we we za premi ne sle zi ne i po ve ća we pro to ka u li je nal noj ve ni, a ne na la ze mor fo lo ške i he mo di nam ske pro me ne na li je nal noj ar te ri ji. Ni ši va ki (Ni s hi wa ki ) i sa radni ci [19] su is pi ti va li funk ci ju eri tro ci ta pre i po sle DSRŠ i utvr di li sma we we vo lu me na sle zi ne, kao i zna čaj no skra će we ži vo ta eri tro ci ta, naj vero vat ni je zbog he mo li zne re ak ci je usled po ve ća nog ven skog pro to ka. U po sled we vre me se s re la tiv nim uspe hom prime wu je par ci jal na em bo li za ci ja sle zi ne, ko ja sa mo de li mič no ko ri gu je sple no me ga li ju i ci to pe ni ju u hi per sple ni zmu [6-8]. Če ški hi rur zi [20] su go di ne ob ja vi li pri kaz bo le sni ka kod ko jeg je urađe na re sek ci ja sle zi ne uz DSRŠ, dok je gru pa autora iz Bra zi la [21] ob ja vi la re zul ta te sup to talne sple nek to mi je ko ju su kom bi no va li s cen tral nim sple no re nal nim šan tom. To je su štin ski raz li čit po stu pak u od no su na DSRŠ uz re sek ci ju sle zi ne, budu ći da se iz vo di šant sa to tal nom port nom dre nažom, a iz ve den je kod bo le sni ka kod ko jih je ši stozo mi ja za uzrok port ne hi per ten zi je. Gru pa ki ne skih auto ra [22] je go di ne ob ja vi la re zul ta te le če wa hi per sple ni zma sup to tal nom sple nek to mi jom, ali je ni su kom bi no va li sa šant-po stup kom. Ra de vić i sa rad ni ci [23, 24] su u pe ri o du go di ne na In sti tu tu za kar di o va sku lar ne bo le sti De di we hi rur ški le či li pe de se tak bo le sni ka par ci jal nom re sek ci jom sle zi ne uz raz li či te šant-po stup ke. U na šem is pi ti va wu je pre ope ra ci je kod svih ispi ta ni ka di jag no sti ko va na sple no me ga li ja (naj ve ći 295

4 preč nik sle zi ne bio je ve ći od 20 cm). Ta ko đe, kod svih bo le sni ka je utvr đe na trom bo ci to pe ni ja. U grupi 1 je po sle ope ra ci je ot kri ven sa mo je dan bo le snik sa sple no me ga li jom (5%), dok je u gru pi 2 za be le že no 13 bo le sni ka s ovim po re me ća jem (68%), što je bi lo sta ti stič ki zna čaj no. Ta ko đe, po re đe wem bro ja trombo ci ta po sle ope ra ci je iz me đu dve gru pe is pi ta ni ka utvr đe no je da po sto ji vi so ko sta ti stič ki zna čaj na raz li ka, pri če mu je broj trom bo ci ta bio ve ći u grupi 1. Po re đe wem osta lih pa ra me ta ra (de mo graf ski po da ci, pre o pe ra ci o ne od li ke, hi rur ško le če we, rani po sto pe ra ci o ni pe riod, smrt ni is hod), po ka za lo se da ne ma sta ti stič ki zna čaj ne raz li ke u za stu pqeno sti ana li zi ra nih obe lež ja iz me đu gru pa. ZAKQUČAK DSRŠ s par ci jal nom re sek ci jom sle zi ne je ori gina lan hi rur ški me tod či ji je smi sao u isto vre me noj de kom pre si ji ezo fa gu snih va rik sa i re gu li sa wu cito pe ni je sma we wem uve ća nog tki va sle zi ne. DSRŠ je po uz dan hi rur ški me tod za pro fi lak su ini ci jal nog kr va re wa i pre ven ci ju po nov nog kr va re wa ezo fa gusnih va rik sa. Me đu tim, DSRŠ sa mo de li mič no kori gu je hi per sple ni zam. Na osno vu re zul ta ta na šeg is tra ži va wa, mo že se za kqu či ti da je DSRŠ s parci jal nom re sek ci jom sle zi ne po uz dan me tod hi rurškog le če wa hi per sple ni zma i de kom pre si je ezo fagu snih va rik sa iza zva nih port nom hi per ten zi jom, ko ji, u od no su na DSRŠ, ima pred nost u ko ri go va wu hi per sple ni zma. LITERATURA 1. Elezović I. Hipersplenizam u portnoj hipertenziji. In: Portna hipertenzija. Radević B, editor. Beograd: Zavet; p Čolović R. Tromboza slezinske vene. In: Slezina. Čolović M, Čolović R, editors. Beograd: Zavod za udžbenike i nastavna sredstva; p Ferrara J, Ellison E, Martin E, et al. Correction of hypersplenism following distal splenorenal shunt. Surgery 1979; 86(4): Puttini M, Marni A, Montes F, et al. Effect of portasystemic shunt on hypersplenism: clinical study in 129 patients with cirrhosis. Am Surg 1979; 45(7): Alvares O, Lopera G, Patel V, et al. Improvement of trombocytopenia due to hypersplenism after transjugular intrahepatic portosystemic scuntplacenent in cirrhotic patients. Am J Gastroenterol 1996; 91(1): Vargas J. Splenic embolization for portal hypertension in children. J Pediatr 1994; 124(1): Tsuji H, Fujishima M. Hypersplenism in liver cirrhosis. Nippon Rinsho 1994; 52(1): Mukaiya M, Hirata K, Yamashiro K, et al. Changes in portal hemodynamics and hepatic function after partial splanic embolization (PSE) and percutaneous transhepatic obliteration (PTO). Cancer Chemother Pharmacol 1994; 33(Suppl): Marni A, Aseni P, Grassi G, et al. Is hypersplenism a contraindication of distal splenorenal shunt? Minerva Chir 1980; 35(8): el-khishen M, Henderson J, Milikan W, et al. Splenectomia is contraindicated for tromocytopenia secondary to portal hypertension. Surg Gynecol Obstet 1985; 160(3): Lodge JP, Mavor AI, Giles GR. Does the Warren shunt correct hypersplenism. HPB Surg 1990; 2(1): Bocian R, Soltysiak A. Effect of the Warren operation on hypersplenism. Pol Tyg Lek 1992; 47(3-4): Miura H, Kondo S, Shimada T, et al. Long-term effects of distal splenorenal shunt with splenopancreatic and gastric disconnection on hypersplenism due to liver cirrhosis. Hepatogastroenterology 1999; 46(29): Shilyansky J, Roberts E, Superina R. Distal splenorenal shunts for treatment of several trombocytopenias from portal hypertension in children. J Gastroinest Surg 1999; 3(2): Klein J, Kral V, Aujesky R, et al. Effect of portosystemic anastomosis on the degree of splenic inhibition. Rozhl Chir 2001; 80(5): Hasegawa T, Tamada H, Fukui Y, et al. Distal splenorenal shunt with splenopancreatic disconnection for portal hypertension in biliary atresia. Pediatr Surg Int 1999; 15(2): Takagi K, Ashida H, Utunomiya J. The effect of splenomegaly on splanchnic hemodynamics in nonalcoholic cirrhosis after distal splenorenal shunt and splenopancreatic disconnection. Hepatology 1994; 20(2): Widman A, Oliveira IR, Speranzini MB, et al. Late morphologic and hemodynamic changes in the splenic territory of patients mansoni s hepatosplenic schistosomiasis after distal splenorenal shunt. Arg Gastroenterol 2002; 39(4): Nishiwaki M, Ashida H, Nishioka A, et al. Red cell survival in patients with nonalcoholic liver cirrhosis befor and after distal splenorenal shunt. J Gastroenterol 1997; 32(3): Tecl F, Tuma J, Valnicek S. A non-traditional procedure in the surgical treatment of portal hypertension in a child. Rozhl Chir 1994; 73(8): Petroianu A, da Silva R, Simal C, et al. Late postoperative followup of patients submitted to subtotal splenectomy. Am Surg 1997; 63(8): Li E, Zhao L, Zhu L, et al. Treating portal hypertension by subtotal splenectomy with retroperitoneal splenic transposition and devascularization:clinical study. Zhonghua Wai Ke Za Zhi 1998; 36(6): Radević B, Ješić R, Sagić D, et al. Partial resection of the spleen and spleno-renal shunt in the treatment of portal hypertension with splenomegaly and hypersplenism. Acta Chir Yugosl 2002; 49(3): Radević B. Dekompresivni šant i resekcija slezine. In: Portna hipertenzija. Radević B, editor. Beograd: Zavet; p

5 DISTAL SPLENORENAL SHUNT WITH PARTIAL SPLEEN RESECTION Predrag GAJIN 1, Božina RADEVIĆ 1, Dragoslav NENEZIĆ 1, Nenad ILIJEVSKI 1, Rada JEŠIĆ-VUKIĆEVIĆ 2, Đorđe RADAK 1 1 Cardiovascular Institute Dedinje, Belgrade; 2 Institute of Digestive System Disorders, Clinical Centre of Serbia, Belgrade Introduction Hypersplenism is a common complication of portal hypertension. Cytopenia in hypersplenism is predominantly caused by splenomegaly. Distal splenorenal shunt (Warren) with partial spleen resection is an original surgical technique that regulates cytopenia by reduction of the enlarged spleen. Objective The aim of our study was to present the advantages of distal splenorenal shunt (Warren) with partial spleen resection comparing morbidity and mortality in a group of patients treated by distal splenorenal shunt with partial spleen resection with a group of patients treated only by a distal splenorenal shunt. Method From 1995 to 2003, 41 patients with portal hypertension were surgically treated due to hypersplenism and oesophageal varices. The first group consisted of 20 patients (11 male, mean age 42.3 years) who were treated by distal splenorenal shunt with partial spleen resection. The second group consisted of 21 patients (13 male, mean age 49.4 years) that were treated by distal splenorenal shunt only. All patients underwent endoscopy and assessment of oesophageal varices. The size of the spleen was evaluated by ultrasound, CT or by scintigraphy. Angiography was performed in all patients. The platelet and white blood cell count and haemoglobin level were registered. Postoperatively, we noted blood transfusion, complications and total hospital stay. Follow-up period was 12 months, with first checkup after one month. Results In the first group, only one patient had splenomegaly postoperatively (5%), while in the second group there were 13 patients with splenomegaly (68%). Before surgery, the mean platelet count in the first group was 51.6± /l, to 118.6± /l postoperatively. The mean platelet count in the second group was 67.6± /l, to 87.8± /l postoperatively. Concerning postoperative splenomegaly, statistically significant difference was noted between the first and the second group (p<0.05). Comparing the postoperative platelet count between the first and second group, we found that there was a very significant statistical difference, too (p<0.01). Conclusion Distal splenorenal shunt (Warren) with partial spleen resection is a very reliable surgical technique in treatment of hypersplenism and decompression of oesophageal varices caused by portal hypertension and has advantage in treatment of hypersplenism over the distal splenorenal shunt method. Key words: spleen resection; hypersplenism; distal splenorenal shunt (Warren) Predrag GAJIN Klinika za vaskularnu hirurgiju Institut za kardiovaskularne bolesti Dedinje Heroja Milana Tepića 1, Beograd Tel.: Faks: E- mail: gajinp@afrodita.rcub.bg.ac.yu * Rukopis je dostavqen Uredništvu godine. 297

UTICAJ TRONEDEQNE REDUKCIONE DIJETE NA KRVNI PRITISAK, LIPIDNI PROFIL I GLIKOREGULACIJU KOD MORBIDNO GOJAZNIH OSOBA

UTICAJ TRONEDEQNE REDUKCIONE DIJETE NA KRVNI PRITISAK, LIPIDNI PROFIL I GLIKOREGULACIJU KOD MORBIDNO GOJAZNIH OSOBA RADOVI BIBLID: 0370-8179, 135(2007) 7-8, p. 440-446 UDC: 613.2.03:612.12/.13.087 UTICAJ TRONEDEQNE REDUKCIONE DIJETE NA KRVNI PRITISAK, LIPIDNI PROFIL I GLIKOREGULACIJU KOD MORBIDNO GOJAZNIH OSOBA Biqana

More information

TEHNOLOGIJA I UMETNOST

TEHNOLOGIJA I UMETNOST Univerzitet umetnosti u Beogradu DOI 10.5937/kultura1236123R UDK 7.01:001.895 7.01:316.75 pregledni rad TEHNOLOGIJA I UMETNOST Sa že tak: U ovom ra du će mo se ba vi ti onim te o rij skim aspek ti ma,

More information

PORAZ OBRAZOVANJA U DIGITALNOM DOBU

PORAZ OBRAZOVANJA U DIGITALNOM DOBU Fordham University, New York, USA Univerzitet u Nišu, Fakultet umetnosti, Niš DOI 10.5937/kultura1235020D UDK 378.014.3(497.11) 37:316.77 polemika PORAZ OBRAZOVANJA U DIGITALNOM DOBU Sa že tak: Svedoci

More information

Name: Katakana Workbook

Name: Katakana Workbook Name: Class: Katakana Workbook Katakana Chart a i u e o ka ki ku ke ko sa shi su se so ta chi tsu te to na ni nu ne no ha hi fu he ho ma mi mu me mo ya yu yo ra ri ru re ro wa wo n ga gi gu ge go za ji

More information

The Prevalence of Malocclusion among Years Old Children in Foča

The Prevalence of Malocclusion among Years Old Children in Foča Serbian Dental Journal, vol. 62, No 2, 2015 ORIGINAL ARTICLE ORIGINALNI RAD DOI: 10.1515sdj-2015-0007 UDC: 616.314-007-057.874(497.6) The Prevalence of Malocclusion among 11 13 Years Old Children in Foča

More information

UTICAJ MEDIKAMENTNOG I NEMEDIKAMENTNOG LEČEWA NA SMAWEWE FAKTORA RIZIKA ZA KARDIOVASKULARNE I CEREBROVASKULARNE DOGAĐAJE U INTERVENTNOJ STUDIJI

UTICAJ MEDIKAMENTNOG I NEMEDIKAMENTNOG LEČEWA NA SMAWEWE FAKTORA RIZIKA ZA KARDIOVASKULARNE I CEREBROVASKULARNE DOGAĐAJE U INTERVENTNOJ STUDIJI RADOVI BIBLID: 0370-8179, 135(2007) 9-10, p. 554-561 UDC: 616.12:616.831]-008-085-036 UTICAJ MEDIKAMENTNOG I NEMEDIKAMENTNOG LEČEWA NA SMAWEWE FAKTORA RIZIKA ZA KARDIOVASKULARNE I CEREBROVASKULARNE DOGAĐAJE

More information

REZISTENCIJA GQIVA NA ANTIMIKOTIKE: MEHANIZMI NASTANKA, UČESTALOST, PREVENCIJA I KONTROLA REZISTENCIJE

REZISTENCIJA GQIVA NA ANTIMIKOTIKE: MEHANIZMI NASTANKA, UČESTALOST, PREVENCIJA I KONTROLA REZISTENCIJE PREGLEDI IZ LITERATURE BIBLID: 0370-8179, 135(2007) 7-8, p. 486-494 REZISTENCIJA GQIVA NA ANTIMIKOTIKE: MEHANIZMI NASTANKA, UČESTALOST, PREVENCIJA I KONTROLA REZISTENCIJE Sawa M. MITROVIĆ, Aleksandar M.

More information

Decembar 2009, Volume 60, broj 1-2

Decembar 2009, Volume 60, broj 1-2 Decembar 2009, Volume 60, broj 1-2 MEDICINSKI PODMLADAK Stručno-naučni časopis studenata Medicinskog fakulteta u Beogradu MEDICAL YOUTH Medical students' professional-scientific journal, Medical faculty

More information

Гени за имуноглобулин и Т-ћелијски рецептор као молекуларни маркери код деце с акутном лимфобластном леукемијом

Гени за имуноглобулин и Т-ћелијски рецептор као молекуларни маркери код деце с акутном лимфобластном леукемијом 384 Srp Arh Celok Lek. 2009 Jul-Aug;137(7-8):384-390 DOI: 10.2298/SARH0908384L ОРИГИНАЛНИ РАД / ORIGINAL ARTICLE UDC: 616.155.392-097:575 Гени за имуноглобулин и Т-ћелијски рецептор као молекуларни маркери

More information

HIPOSENZIBILIZACIJA VAKCINOM PROTIV DIFTERIJE, TETANUSA I PERTUSISA

HIPOSENZIBILIZACIJA VAKCINOM PROTIV DIFTERIJE, TETANUSA I PERTUSISA RADOVI BIBLID: 0370-8179, 131(2003) 11-12 p. 427-431 UDC: 616.9:615.371 HIPOSENZIBILIZACIJA VAKCINOM PROTIV DIFTERIJE, TETANUSA I PERTUSISA Ma ri na ATA NA SKO VIÆ-MAR KO VIÆ, Bra ni mir NE STO RO VIÆ

More information

Om jer iz gle da: iz ra čun, upo ra ba i tu ma če nje The odds ratio: cal cu la tion, usa ge, and inter pre ta tion

Om jer iz gle da: iz ra čun, upo ra ba i tu ma če nje The odds ratio: cal cu la tion, usa ge, and inter pre ta tion Odabrane teme iz biostatistike Lessons in biostatistics Ma ry L. McHu gh Fa kul tet ses trin stva, Sveučiliš te In dia na po li sa, In dia na po lis, In dia na, SAD School of Nur si ng, Uni ver si ty of

More information

Decembar 2010, Volume 61, broj 1-2

Decembar 2010, Volume 61, broj 1-2 MEDICINSKI PODMLADAK Decembar 2010, Volume 61, broj 1-2 Decembar 2010, Volume 61, broj 1-2 MEDICINSKI PODMLADAK Stručno-naučni časopis studenata Medicinskog fakulteta u Beogradu MEDICAL YOUTH Medical students'

More information

U pu te za ru ko va nje

U pu te za ru ko va nje U pu te za ru ko va nje BML 2410 / BML 2415 / BML 2410 FW / BML 2415 FW Pu njač aku mu la to ra za 12 V / 24 V aku mu la to re 1 Sadržaj: S tra ni ca 1. Važ ne na po me ne 4 1.1 S ku pi na ko ri sni ka

More information

Tes ti ra nje statističkih hi po te za i ne ke zam ke Sta tis ti cal hypot he sis tes ti ng and some pit fal ls

Tes ti ra nje statističkih hi po te za i ne ke zam ke Sta tis ti cal hypot he sis tes ti ng and some pit fal ls Odabrane teme iz biostatistike Lessons in biostatistics i ne ke zam ke and some pit fal ls Ves na Ila ko vac Ka ted ra za bio fi zi ku, me di cin sku sta tis ti ku i me di cin sku in for ma ti ku, Me di

More information

5 -nuk leo ti da za, oksi da cij ski stres i an tiok si da cij ski sta tus kod kon zu me na ta alkohola i bo les ni ka s ci ro zom jet re

5 -nuk leo ti da za, oksi da cij ski stres i an tiok si da cij ski sta tus kod kon zu me na ta alkohola i bo les ni ka s ci ro zom jet re Izvorni znanstveni članak Original scientific article 5 -nuk leo ti da za, oksi da cij ski stres i an tiok si da cij ski sta tus kod kon zu me na ta alkohola i bo les ni ka s ci ro zom jet re 5 -nuc leo

More information

The Japanese Writing System. By Danny Jones

The Japanese Writing System. By Danny Jones The Japanese Writing System By Danny Jones The Japanese Writing System is divided into three types, Hiragana, Katakana and Kanji. Hiragana is used for native Japanese words, and Katakana is used for words

More information

Ilio Volante. Composer: Italia, Rome

Ilio Volante. Composer: Italia, Rome Ilio olante Composer Italia, Rome Aout the artist Was orn in Italy in 1964, he as still a teen ager hen he started his musi studies (saxophone) shoing from the very eginning a partiular predisposition

More information

The Japanese Writing System. Busareddy & Rekha

The Japanese Writing System. Busareddy & Rekha The Japanese Writing System Busareddy & Rekha The Japanese Writing System is divided into three types, Hiragana, Katakana and Kanji. Hiragana is used for native Japanese words, and Katakana is used for

More information

(N) CONTAINS TRACES OF NUTS (V) SUITABLE FOR VEGETARIANS (GF) GLUTEN FREE (S) SPICY PLEASE NOTE: A 10% SERVICE CHARGE APPLIES TO TABLES OF 6 OR OVER.

(N) CONTAINS TRACES OF NUTS (V) SUITABLE FOR VEGETARIANS (GF) GLUTEN FREE (S) SPICY PLEASE NOTE: A 10% SERVICE CHARGE APPLIES TO TABLES OF 6 OR OVER. (N) CONTAINS TRACES OF NUTS (V) SUITABLE FOR VEGETARIANS (GF) GLUTEN FREE (S) SPICY PLEASE NOTE: A 10% SERVICE CHARGE APPLIES TO TABLES OF 6 OR OVER. SOUPS & TEMPURA M ISO SO U P ( V ) Seaweed & tofu soya

More information

appetizer LAWA R BA LI a l a DRE A M L A N D 65. C H IC KE N PA N DA N PE C AT U 70. T U NA SA M BA L M ATA H

appetizer LAWA R BA LI a l a DRE A M L A N D 65. C H IC KE N PA N DA N PE C AT U 70. T U NA SA M BA L M ATA H appetizer nu s an tara c uis in e BU LU N G M E U R A B M I SI C U M I Char g rilled calamari with sea weed salad ser v ed with coconut & chili vine gar dressing LAWA R BA LI a l a DRE A M L A N D Long

More information

Serum and Tear Leptin Levels in Patients with Allergic Conjunctivitis

Serum and Tear Leptin Levels in Patients with Allergic Conjunctivitis ORİJİNAL ARAŞTIRMA Serum and Tear Leptin Levels in Patients with Allergic Conjunctivitis Burak TURGUT, MD, a Jülide KURT, MD, a Nevin İLHAN, MD, b Süleyman Serdar KOCA, MD, c Tamer DEMİR, MD, a Ülkü ÇELİKER,

More information

Supplementary Table 1 PHYC haplotypes of A. thaliana strains.

Supplementary Table 1 PHYC haplotypes of A. thaliana strains. Supplementary Table 1 PHYC haplotypes of A. thaliana strains. No Accessions Stock # Country Latitude PHYC FRI* FLC 1 Aa-0 CS900 Germany 51 Ler Del B 2 Ag-0 CS901 France 45 Ler Wt A 3 Ak-1 N939 Germany

More information

Sanna offers authentic Thai

Sanna offers authentic Thai Sawadee and welcome to Sanna. Sanna offers authentic Thai food with homemade recipes passed through generations. Our menu provides an extensive selection of the most popular Thai dishes from different

More information

PREVENCIJA INFEKCIJA IZAZVANIH HUMANIM PAPILOMA VIRUSIMA

PREVENCIJA INFEKCIJA IZAZVANIH HUMANIM PAPILOMA VIRUSIMA Uni ver zi tet u No vom Sa du Medicinski fakultet Urednica Aleksandra Kapamadžija PREVENCIJA INFEKCIJA IZAZVANIH HUMANIM PAPILOMA VIRUSIMA No vi Sad, 2015. Recenzenti Prof. dr Branko Stanimirović Prof.

More information

PORK + PINOT SUNDAYS

PORK + PINOT SUNDAYS PORK + PINOT SUNDAYS Crispy roast pork Paprika roasted potatoes Radicchio, endive, cos & lemon dressing Green beans with hazelnut crumble & goats curd plus ½ carafe of pinot noir $85 for 2 people Every

More information

Paddy McGinty's Goat

Paddy McGinty's Goat 2 Paddy McGinty's Goat Taditional olk song a. Leslie Helett 5 q 15 4 J â ä he, sue o goat's milk, I mean to have me ill he ound it as a Bill. 9 A & # # no live all oh They â 1 Mis - te Pa - tick - ty,

More information

Dian Zang Chuan Da San Jiao Wen Hua Tan Mi (Mandarin Chinese Edition)

Dian Zang Chuan Da San Jiao Wen Hua Tan Mi (Mandarin Chinese Edition) Dian Zang Chuan Da San Jiao Wen Hua Tan Mi (Mandarin Chinese Edition) If searched for the book Dian Zang Chuan da san jiao wen hua tan mi (Mandarin Chinese Edition) in pdf format, in that case you come

More information

Li Dai Gong Ci Ji Shi (Mandarin Chinese Edition) By Liangren Qiu READ ONLINE

Li Dai Gong Ci Ji Shi (Mandarin Chinese Edition) By Liangren Qiu READ ONLINE Li Dai Gong Ci Ji Shi (Mandarin Chinese Edition) By Liangren Qiu READ ONLINE Download book Zhongguo jiao yu shi dian ( Mandarin - Jiangxi xian dai ge ming shi ci dian (mandarin_chinese edition) book Ren

More information

Gu Shi Qi Meng (Mandarin Chinese Edition) READ ONLINE

Gu Shi Qi Meng (Mandarin Chinese Edition) READ ONLINE Gu Shi Qi Meng (Mandarin Chinese Edition) READ ONLINE If searching for the book Gu shi qi meng (Mandarin Chinese Edition) in pdf form, then you have come on to correct site. We present the utter variant

More information

Choose from our fabulous range of specially selected lunch and dinner menus, or work with our Head Chef to create your very own menu.

Choose from our fabulous range of specially selected lunch and dinner menus, or work with our Head Chef to create your very own menu. P R I VAT E D I N I N G BUFFET Whatever the occasion, our recently refurbished events space should be top of your to-do list! Choose from our fabulous range of specially selected lunch and dinner menus,

More information

Gu Dai Zhe Li Shi Yi Bai Shou (Mandarin Chinese Edition)

Gu Dai Zhe Li Shi Yi Bai Shou (Mandarin Chinese Edition) Gu Dai Zhe Li Shi Yi Bai Shou (Mandarin Chinese Edition) If you are looking for the ebook Gu dai zhe li shi yi bai shou (Mandarin Chinese Edition) in pdf form, then you have come on to faithful website.

More information

Song Shi Liu Bian (Zhonghua Chuan Tong Wen Hua Jing Pin Cong Shu) (Mandarin Chinese Edition) By Zhai Mu READ ONLINE

Song Shi Liu Bian (Zhonghua Chuan Tong Wen Hua Jing Pin Cong Shu) (Mandarin Chinese Edition) By Zhai Mu READ ONLINE Song Shi Liu Bian (Zhonghua Chuan Tong Wen Hua Jing Pin Cong Shu) (Mandarin Chinese Edition) By Zhai Mu READ ONLINE If searching for a book by Zhai Mu Song shi liu bian (Zhonghua chuan tong wen hua jing

More information

Qian Jibo Juan (Zhongguo Xian Dai Xue Shu Jing Dian) (Mandarin Chinese Edition) By Jibo Qian

Qian Jibo Juan (Zhongguo Xian Dai Xue Shu Jing Dian) (Mandarin Chinese Edition) By Jibo Qian Qian Jibo Juan (Zhongguo Xian Dai Xue Shu Jing Dian) (Mandarin Chinese Edition) By Jibo Qian If searching for a ebook Qian Jibo juan (Zhongguo xian dai xue shu jing dian) (Mandarin Chinese Edition) by

More information

Song Shi Xue Dao Lun (Zhongguo Gu Dai Wen Xue) (Mandarin Chinese Edition) By Jie Cheng READ ONLINE

Song Shi Xue Dao Lun (Zhongguo Gu Dai Wen Xue) (Mandarin Chinese Edition) By Jie Cheng READ ONLINE Song Shi Xue Dao Lun (Zhongguo Gu Dai Wen Xue) (Mandarin Chinese Edition) By Jie Cheng READ ONLINE If looking for the ebook Song shi xue dao lun (Zhongguo gu dai wen xue) (Mandarin Chinese Edition) by

More information

The W Gourmet mooncake gift sets are presently available at:

The W Gourmet mooncake gift sets are presently available at: MID-AUTUMN FESTIVAL 2015 Tết Trung thu trong tiềm thức của mỗi chúng ta luôn là ngày của những ký ức tuổi thơ tràn về, để rồi cứ nhớ tha thiết về ngày xưa ấy, có bánh nướng bánh dẻo, có cỗ đón trăng,

More information

A set menu of House Classics. H O U S E S E LEC T PE R PE R S O N A selection of our Chef s favourite House dishes.

A set menu of House Classics. H O U S E S E LEC T PE R PE R S O N A selection of our Chef s favourite House dishes. SELECT A DINING OPTION Whatever the occasion, our stylish events space should be top of your to-do list. With room for up to 20 guests, this area is perfect for private parties or get-togethers with friends

More information

Xianggang Da Shi Ye: Yazhou Wang Luo Zhong Xin (Mandarin Chinese Edition) By Takeshi Hamashita

Xianggang Da Shi Ye: Yazhou Wang Luo Zhong Xin (Mandarin Chinese Edition) By Takeshi Hamashita Xianggang Da Shi Ye: Yazhou Wang Luo Zhong Xin (Mandarin Chinese Edition) By Takeshi Hamashita If you are looking for a ebook by Takeshi Hamashita Xianggang da shi ye: Yazhou wang luo zhong xin (Mandarin

More information

Okluzal Yüz Çürüklerinin Tanı Yöntemleri

Okluzal Yüz Çürüklerinin Tanı Yöntemleri DERLEME Okluzal Yüz Çürüklerinin Tanı Yöntemleri Zuhal KIRZIOĞLU, a Özge ERKEN GÜNGÖR a a Pedodonti AD, Süleyman Demirel Üniversitesi, Diş Hekimliği Fakültesi, Isparta Ge liş Ta ri hi/re ce i ved: 27.03.2008

More information

Pediatri Hemşireliğinde Aile Merkezli Bakım

Pediatri Hemşireliğinde Aile Merkezli Bakım DERLEME Pediatri Hemşireliğinde Aile Merkezli Bakım a a Çocuk Sağlığı ve Hastalıkları AD, Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, Ankara Ge liş Ta ri hi/re ce i ved: 06.06.2008

More information

Crazy About Corn. Oh I am cra zy, cra zy, cra zy, a bout corn, corn, corn. I can eat it up for. din ner or at break fast in the

Crazy About Corn. Oh I am cra zy, cra zy, cra zy, a bout corn, corn, corn. I can eat it up for. din ner or at break fast in the Crazy About Corn Music & Lyrics by Kim Lytton Oh I am cra zy, cra zy, cra zy, a bout corn, corn, corn. I can eat it up for din ner or at break fast in the morn, be cause I'm cra zy, cra zy, cra zy, a bout

More information

PRO GRAM ČI GO TI CA PE DI JA TRIJ SKA IS KU STVA

PRO GRAM ČI GO TI CA PE DI JA TRIJ SKA IS KU STVA Sne ža na Le šo vić *1 PRO GRAM ČI GO TI CA PE DI JA TRIJ SKA IS KU STVA Введение: Тревожный рост эпидемии ожирения у детей и подростков, наряду с отсутствием проверенны и эффективных мероприятий и программы

More information

HIRURŠKI RAD DR VLADANA ĐORĐEVIĆA

HIRURŠKI RAD DR VLADANA ĐORĐEVIĆA ИСТОРИЈА МЕДИЦИНЕ BIBLID: 0370-8179, 136(2008) 7-8, p. 435-440 UDC: 614.23:617.5(091) HIRURŠKI RAD DR VLADANA ĐORĐEVIĆA Radoje ÈOLOVIÆ Institut za bolesti digestivnog sistema, Klinièki centar Srbije, Beograd

More information

Sawadee! At home, Thais will always offer a warm welcome, usually with a cool drink to. of flavours; sweet, sour, hot, salty and bitter.

Sawadee! At home, Thais will always offer a warm welcome, usually with a cool drink to. of flavours; sweet, sour, hot, salty and bitter. Sawadee! At home, Thais will always offer a warm welcome, usually with a cool drink to dampen the summer heat a fresh young coconut is a refreshing start. This is the hallmark of Thai hospitality. This

More information

Tôm càng chiên, rau xà lách romaine, hạt thông, xốt giấm đen. Đầu mực nướng, sữa chua hương cumin, xà lách trộn

Tôm càng chiên, rau xà lách romaine, hạt thông, xốt giấm đen. Đầu mực nướng, sữa chua hương cumin, xà lách trộn Tôm càng chiên, rau xà lách romaine, hạt thông, xốt giấm đen Hàu, khoai tây và ớt bột paprika Đầu mực nướng, sữa chua hương cumin, xà lách trộn Thịt hun khói cuộn chà là, xốt mù tạc hạt Các loại thịt sấy

More information

Fi zio lo gi ja pre bav ne cevi, 2. del

Fi zio lo gi ja pre bav ne cevi, 2. del MED RAZGL 2010; 49: 391 424 PREGLEDNI ^LANEK An dra` Sto `er 1, Jurij Dolen {ek 2, Mar jan Rup nik 3 Fi zio lo gi ja pre bav ne cevi, 2. del Ga stroin te sti nal Physio logy, Part 2 IZVLE^EK KLJU^NE BESEDE:

More information

Ne ka te re pri la go di tve tele sa na napor

Ne ka te re pri la go di tve tele sa na napor Med Razgl. 014; 53 (4): 453 65 Pregledni članek 453 Nej ka Potoč nik 1 Ne ka te re pri la go di tve tele sa na napor Some Body Adjust ments to Physi cal Exer ci se IZvLEČEK KLJUČNE BESEDE: tele sni napor,

More information

MORNING FARE EARLY RISER THE CLASSIC CONTINENTAL COLLEGE OF DUPAGE BREAKFAST BUFFET. Pastry Basket, Assorted Juice & Coffee

MORNING FARE EARLY RISER THE CLASSIC CONTINENTAL COLLEGE OF DUPAGE BREAKFAST BUFFET. Pastry Basket, Assorted Juice & Coffee MORNING FARE n n er or e e er e 12 EARLY RISER $.29 per per on Pastry Basket, Assorted Juice & Coffee THE CLASSIC CONTINENTAL $7. 9 per per on Seasonal Cubed Fresh Fruit Tray tr B t Baker s Choice of Two:

More information

Viet s Cuisine. Contains vegetable, shredded-carrot, shredded dried-mushroom, taro, and one of the followings:

Viet s Cuisine. Contains vegetable, shredded-carrot, shredded dried-mushroom, taro, and one of the followings: Appetizers - Khai V Fried Rolls - Cha Gio, served with a choice of seasoned fish sauces or sweet-nsour sauce Contains vegetable, shredded-carrot, shredded dried-mushroom, taro, and one of the followings:

More information

SET MENU A. SET MENU B per Person (Minimum 2 Persons)

SET MENU A. SET MENU B per Person (Minimum 2 Persons) SET MENU A 20.95 per Person (Minimum 2 Persons) Pork spare ribs marinated in our chef s special sauce Fish cakes served with chilli and peanuts sauce** Chicken Satays Tom kha Gai (Classic Thai Chicken

More information

2. Aromatic Duck Pancake (Served for 2) Shredded crispy duck served with steamed pancakes, cucumber, spring onions and homemade Hoi Sin sauce.

2. Aromatic Duck Pancake (Served for 2) Shredded crispy duck served with steamed pancakes, cucumber, spring onions and homemade Hoi Sin sauce. Starter 1. Mixed Starter (Served for 2) 12.00 An assortment of 5 different canapés (chicken satay, prawn on toast, spring rolls, prawn tempura, chicken wings & prawn crackers). 2. Aromatic Duck Pancake

More information

G E R M A C K S I G N AT U R E PAPER BAGS

G E R M A C K S I G N AT U R E PAPER BAGS G E R M A C K S I G N AT U R E PAPER BAGS Our signature paper bags have a high-barrier, moisture resistant liner to ensure long-lasting freshness. Craft roasted to perfection. Iconic to our industry and

More information

Dinner Menu. Open 7 days a week

Dinner Menu. Open 7 days a week Dinner Menu Open 7 days a week We cannot guarantee that any items are completely allergen free due to being produced in a kitchen that contains ingredients with allergens as well as products that have

More information

Điểm tâm - Appetizer All Homemade Sauces with Garlic and Chilli

Điểm tâm - Appetizer All Homemade Sauces with Garlic and Chilli The Vietnamese cuisine is recently widely known far beyond the borders of Asia due to its richness and diversity. Fresh ingredients, the specialeasiness and balance give it a distinctive taste. The Vietnamese

More information

DANH SÁCH THÍ SINH DỰ THI IC3 IC3 REGISTRATION FORM

DANH SÁCH THÍ SINH DỰ THI IC3 IC3 REGISTRATION FORM Tiếng Anh Tiếng Việt Đã có Chưa có Sáng Chiều Tên cơ quan/ tổ chức: Organization: Loại hình (đánh dấu ): Type of Organization: Địa chỉ /Address : Điện thoại /Tel: DANH SÁCH THÍ SINH DỰ THI IC3 IC3 REGISTRATION

More information

Hospital Acquired Infections Report. Disparities National Coordinating Center

Hospital Acquired Infections Report. Disparities National Coordinating Center Author: Alex Shangraw, MSPH Editor: Madeleine Shea, PhD Hospital Acquired Infections 2011-2012 Report Disparities National Coordinating Center February 2014 Acknowledgements: Shanta Whitaker, PhD, MPH;

More information

Bun & Vermicelli. Chay & Vegetarian Dishes. Add Prawn 4.50 or Meat for 3.95 Add Vegetables, Noodle or Tofu for 2.95

Bun & Vermicelli. Chay & Vegetarian Dishes. Add Prawn 4.50 or Meat for 3.95 Add Vegetables, Noodle or Tofu for 2.95 Bun & Vermicelli 24. Bún Chä Giò - Spring Rolls 9.75 Vermicelli rice noodles with spring rolls, dried shallots and salad. 25. Bún ThÎt NÜ ng - Grilled Pork 9.95 Vermicelli rice noodles with grilled pork,

More information

Colors and Shapes at the Park Part 1

Colors and Shapes at the Park Part 1 _ Ni hao. Wo jiao zhou zhou _ Hello. My name is Jojo Ni hao lu lu _ Hello Lulu Ni hao zhou zhou _ Hello Jojo Wo men qu gong yuan ba _ Let's go to the park Gong yuan _ The park Wo men qu gong yuan ba _

More information

CONVECTIVE DRYING OF THE ROOT AND LEAVES OF THE PARSLEY AND CELERY

CONVECTIVE DRYING OF THE ROOT AND LEAVES OF THE PARSLEY AND CELERY Journal of Agricultural Sciences Vol. 54, No 3, 2009 Pages 205-212 UDC: 635.14+635.53:66.047.4/.5 Original scientific paper CONVECTIVE DRYING OF THE ROOT AND LEAVES OF THE PARSLEY AND CELERY Jelena Marković

More information

Portable Convenient Red/ Orange Vegetable Options for K12

Portable Convenient Red/ Orange Vegetable Options for K12 Portable Convenient Red/ Orange Vegetable Options for K12 Unlimited K12 Menu Solutions: Offer these veggies everyday for dipping with popular entrees like Pizza, Chicken, & Burritos! Red/Orange Veggie

More information

Table 1: Number of patients by ICU hospital level and geographical locality.

Table 1: Number of patients by ICU hospital level and geographical locality. Web-based supporting materials for Evaluating the performance of Australian and New Zealand intensive care units in 2009 and 2010, by J. Kasza, J. L. Moran and P. J. Solomon Table 1: Number of patients

More information

Ling Nan Su Wen Xue Jian Shi (Mandarin Chinese Edition) By Chunsheng Ye

Ling Nan Su Wen Xue Jian Shi (Mandarin Chinese Edition) By Chunsheng Ye Ling Nan Su Wen Xue Jian Shi (Mandarin Chinese Edition) By Chunsheng Ye If you are searching for a book by Chunsheng Ye Ling nan su wen xue jian shi (Mandarin Chinese Edition) in pdf form, in that case

More information

Nei Menggu Zizhiqu Di Tu (Mandarin Chinese Edition) By Zhongguo di tu chu ban she

Nei Menggu Zizhiqu Di Tu (Mandarin Chinese Edition) By Zhongguo di tu chu ban she Nei Menggu Zizhiqu Di Tu (Mandarin Chinese Edition) By Zhongguo di tu chu ban she Wu, Guiqing [WorldCat Identities] - Nei Menggu Zizhiqu di tu by Zhongguo di tu chu ban she 1 edition published in 2001

More information

Welcome to Echo Lake Lodge! Start your day on Mt. Evans with a hearty breakfast served until 11 a.m.

Welcome to Echo Lake Lodge! Start your day on Mt. Evans with a hearty breakfast served until 11 a.m. Welcome to Echo Lake Lodge! Start your day on Mt. Evans with a hearty breakfast served until 11 a.m. Denver Scramble or Omelet Ham, green peppers, onions, mushrooms, tomatoes and cheddar cheese served

More information

New price effective 8/1/17. There will be container charge for carry-out items. Viet s Cuisine. Appetizers -Khai V

New price effective 8/1/17. There will be container charge for carry-out items. Viet s Cuisine. Appetizers -Khai V New price effective 8/1/17. There will be container charge for carry-out items Viet s Cuisine Appetizers -Khai V Fried Rolls or Crispy Fries- Cha Gio, served with a choice of seasoned fish sauces or homemade

More information

NEW PROCESS FOR PRODUCTION OF HIGH PURITY ADN - DEVELOPMENT AND SCALE-UP. Henrik SKIFS, Helen STENMARK Eurenco Bofors AB Peter THORMÄHLEN ECAPS AB

NEW PROCESS FOR PRODUCTION OF HIGH PURITY ADN - DEVELOPMENT AND SCALE-UP. Henrik SKIFS, Helen STENMARK Eurenco Bofors AB Peter THORMÄHLEN ECAPS AB NEW PROCESS FOR PRODUCTION OF HIGH PURITY ADN - DEVELOPMENT AND SCALE-UP Henrik SKIFS, Helen STENMARK Eurenco Bofors AB Peter THORMÄHLEN ECAPS AB ADN Explosive and oxidizer with extraordinary properties

More information

UDAQENI REZULTATI LEÈEWA POVREDA SEKTORSKIH I SEGMENTALNIH ŽUÈNIH VODOVA

UDAQENI REZULTATI LEÈEWA POVREDA SEKTORSKIH I SEGMENTALNIH ŽUÈNIH VODOVA RADOVI BIBLID: 0370-8179, 131(2003) 7-8 p. 314-318 UDC: 616.361-001-08 UDAQENI REZULTATI LEÈEWA POVREDA SEKTORSKIH I SEGMENTALNIH ŽUÈNIH VODOVA Ra do je ÈO LO VIÆ, Go ran BA RI ŠIÆ, Ve li mir MAR KO VIÆ

More information

Lunch Menu. Monday - Friday AM 3.00 PM. From 5.95

Lunch Menu. Monday - Friday AM 3.00 PM. From 5.95 Menu Monday - Friday 12.00 AM 3.00 PM From 5.95 We cannot guarantee that any items are completely allergen free due to being produced in a kitchen that contains ingredients with allergens as well as products

More information

Welcome to our 2018 Christmas catalog.

Welcome to our 2018 Christmas catalog. Welcome to our 2018 Christmas catalog. This year, we will continue to offer items that are unique, handmade by independent U.K. small producers, and not commonly found in supermarkets, so your Christmas

More information

T u c s o n s Te a s e r s

T u c s o n s Te a s e r s T u c s o n s Te a s e r s S h r o o m s Jumbo, hand breaded mushrooms. Deep fried to order and served with our petal sauce. (1) Skewer 4.59 (2) 6.79 H o n e y Ch i p o t l e Wi n g s A one pound portion

More information

Mr Vukašin Badža Fakultet sporta i fi zičkog vaspitanja Novi Sad

Mr Vukašin Badža Fakultet sporta i fi zičkog vaspitanja Novi Sad CRNOGORSKA SPORTSKA AKADEMIJA, Sport Mont časopis br. 18,19,20. Mr Vukašin Badža Fakultet sporta i fi zičkog vaspitanja Novi Sad UTICAJ EKSPERIMENTALNOG PROGRAMA PLESA NA NIVO MUZIKALNOSTI KOD STUDENATA

More information

vietnamesische & süd-ost-asiatische spezialitäten webergasse st. gallen

vietnamesische & süd-ost-asiatische spezialitäten webergasse st. gallen menu LaNS N II vietnamesische & süd-ost-asiatische spezialitäten webergasse 16 9000 st. gallen www.lansin.ch +41 [0]71 223 20 00 start ers Súp Mæng cua 01. vietnamese asparagus crab soup with crab & asparagus

More information

SAVOR MID-AUTUMN FESTIVAL WITH HILTON

SAVOR MID-AUTUMN FESTIVAL WITH HILTON NGỌT NGÀO HƯƠNG VỊ TRUNG THU Hilton tự hào là một trong những khách sạn đầu tiên làm bánh trung thu trong nhiều năm qua. Thiết kế hộp sang trọng và tinh tế, hương vị bánh tinh khiết và chọn lọc với 8 vị

More information

Savor Mid-Autumn Treasures at Hilton Hanoi Opera! Gìn giữ nét đẹp cổ truyền

Savor Mid-Autumn Treasures at Hilton Hanoi Opera! Gìn giữ nét đẹp cổ truyền Gìn giữ nét đẹp cổ truyền Hilton tự hào là một trong những khách sạn đầu tiên làm bánh trung thu trong nhiều năm qua. Thiết kế hộp sang trọng và tinh tế, hương vị bánh tinh khiết và chọn lọc, bánh trung

More information

APPETISER PLATTER APPETISER SUKHOTHAI PLATTER FOR 2 PERSONS AYUTTHAYA PLATTER FOR 4 PERSONS RATTANAKOSIN PLATTER FOR 6 PERSONS

APPETISER PLATTER APPETISER SUKHOTHAI PLATTER FOR 2 PERSONS AYUTTHAYA PLATTER FOR 4 PERSONS RATTANAKOSIN PLATTER FOR 6 PERSONS APPETISER PLATTER SUKHOTHAI PLATTER FOR 2 PERSONS Tod Mun Pla, Popiah Tod, Kai Satay, Yam Sam Oo 38 AYUTTHAYA PLATTER FOR 4 PERSONS Tod Mun Pla, Tung Thong, Chor Ladda, Kai Satay, Yam Ma Mueng 68 RATTANAKOSIN

More information

P1. Chicken Noodle Soup ~ PHO GA P2. Beef Noodle Soup ~ PHO TAI Thin slices of tender beef over rice noodle soup.

P1. Chicken Noodle Soup ~ PHO GA P2. Beef Noodle Soup ~ PHO TAI Thin slices of tender beef over rice noodle soup. P1. Chicken Noodle Soup ~ PHO GA...9.25 P2. Beef Noodle Soup ~ PHO TAI...9.25 Thin slices of tender beef over rice noodle soup. P3. Special Beef Noodle Soup ~ PHO DAC BIET...9.50 Thin slice of beef, beef

More information

Hubei Xin Shi Qi Wen Xue Da Xi (Mandarin Chinese Edition) READ ONLINE

Hubei Xin Shi Qi Wen Xue Da Xi (Mandarin Chinese Edition) READ ONLINE Hubei Xin Shi Qi Wen Xue Da Xi (Mandarin Chinese Edition) READ ONLINE If looking for a ebook Hubei xin shi qi wen xue da xi (Mandarin Chinese Edition) in pdf form, then you've come to the faithful site.

More information

CHEF CRAFTED CATERING

CHEF CRAFTED CATERING #RETHINKEVENTS CHEF CRAFTED CATERING SHARING IS CARING HOT HORS D'OEUVRES MIX & MATCH 3 CHOICES $15/GUEST MORE? $5/GUEST FOR EVERY ADDITIONAL HORS D'OEUVRES COLD HORS D'OEUVRES EACH SELECTION SERVES UP

More information

Lun Zhongguo Shi (Qian Binsi Xian Sheng Xue Shu Wen Hua Jiang Zuo) (Mandarin Chinese Edition) By Tamaki Ogawa READ ONLINE

Lun Zhongguo Shi (Qian Binsi Xian Sheng Xue Shu Wen Hua Jiang Zuo) (Mandarin Chinese Edition) By Tamaki Ogawa READ ONLINE Lun Zhongguo Shi (Qian Binsi Xian Sheng Xue Shu Wen Hua Jiang Zuo) (Mandarin Chinese Edition) By Tamaki Ogawa READ ONLINE If you are searching for the ebook by Tamaki Ogawa Lun Zhongguo shi (Qian Binsi

More information

APPETIZER. 101 MIENG KAM Rp TAOHUU THOD Rp TOD MAN PLA (3 pcs) Rp SATAY GAI Rp

APPETIZER. 101 MIENG KAM Rp TAOHUU THOD Rp TOD MAN PLA (3 pcs) Rp SATAY GAI Rp APPETIZER 101 MIENG KAM Rp. 27.500 Fresh spring green with fried shrimps, peanut and herb sauce 102 TAOHUU THOD Rp. 35.500 Fried soy bean cake served with home made sauce 103 TOD MAN PLA (3 pcs) Rp. 49.500

More information

Certificate of Analysis

Certificate of Analysis Brammer Standard Company, Inc. Certificate of Analysis BS 1030 Certified Reference Material for AISI 1030 - UNS Number G10300 Certified Estimate of Certified Estimate of 1 2 1 Value Uncertainty Value 2

More information

Zhonghua Min Guo Tong Ji Di Qu Biao Zhun Fen Lei (Mandarin Chinese Edition) By China (Republic : ) READ ONLINE

Zhonghua Min Guo Tong Ji Di Qu Biao Zhun Fen Lei (Mandarin Chinese Edition) By China (Republic : ) READ ONLINE Zhonghua Min Guo Tong Ji Di Qu Biao Zhun Fen Lei (Mandarin Chinese Edition) By China (Republic : 1949- ) READ ONLINE If looking for a ebook by China (Republic : 1949- ) Zhonghua min guo tong ji di qu biao

More information

APPETIZERS. SAGANAKI sa-ga-na-kee A slab of bubbly Greek Kasseri cheese panflamed at your table. Served with pita bread.

APPETIZERS. SAGANAKI sa-ga-na-kee A slab of bubbly Greek Kasseri cheese panflamed at your table. Served with pita bread. APPETIZERS SAGANAKI sa-ga-na-kee A slab of bubbly Greek Kasseri cheese panflamed at your table. Served with pita bread. SKORTHALIA skor-thal-ya Greek-style dip made with garlic, potatoes, olive oil and

More information

SATAY KAI * Char-grilled marinated chicken served with peanut sauce and cucumber relish

SATAY KAI * Char-grilled marinated chicken served with peanut sauce and cucumber relish APPETISERS * Selection of chef s special Thai starters (to share for two three persons 35.00) 24.00 KAO KRIEB PAK MOH 11.00 * Steamed rice wrap, sautéed chicken, shallots, roasted peanuts, Served with

More information

TR EAT YOUR COF F EE. Treat Your Coffee

TR EAT YOUR COF F EE. Treat Your Coffee Treat Your Coffee TR EAT YOUR COF F EE D e ve l o pi n g a l o n g - t e r m re l a t i o n sh i p wi t h yo u r c u st o me rs de pe n ds o n t h e t i n i e st de t a i l s. In du l ge (t h e c o f fe

More information

APPETIZERS. PO PIAH THORD 8.00 Crispy vegetables Chinese spring roll served with sweet plum sauce

APPETIZERS. PO PIAH THORD 8.00 Crispy vegetables Chinese spring roll served with sweet plum sauce APPETIZERS PO PIAH THORD 8.00 Crispy vegetables Chinese spring roll served with sweet plum sauce PEEK GAI TOD CLUEA 11.00 Fried marinated chicken wings flavoured with crunchy kaffir lime leaves served

More information

Le Veyron. Cafe. From our BriCk Oven Bakers Basket Le Veyron Specialty Cake Tray 95.00

Le Veyron. Cafe. From our BriCk Oven Bakers Basket Le Veyron Specialty Cake Tray 95.00 From our BriCk Oven 20.00 Butter Croissant Zaatar Croissant Chocolate Croissant Cheese Croissant Almond Croissant Fresh Fruit Danish Blueberry Muffin Chocolate Chips Muffin Donut (Nutella, dark chocolate

More information

Thai Boran Set Menu. All set menu s minimum 2 people. Thai Boran Chef s Special Set Menu Per Person. Starter. Thai Boran Crispy Duck.

Thai Boran Set Menu. All set menu s minimum 2 people. Thai Boran Chef s Special Set Menu Per Person. Starter. Thai Boran Crispy Duck. Thai Boran Thai Boran Set Menu All set menu s minimum 2 people Srisachanalai Era 14.99 Per Person Starter Vegetarian Mixed Starter Soup Tom Yum Jae Main Course Curry Of The Day (Red Or Green Vegetarian

More information

3. Thai Dim Sum (G/S/Mo/E/C/*) 6.00 Delicious steamed dumpling with a minced prawn & pork filling topped with special homemade soy&ginger sauce.

3. Thai Dim Sum (G/S/Mo/E/C/*) 6.00 Delicious steamed dumpling with a minced prawn & pork filling topped with special homemade soy&ginger sauce. Starter 1. Mixed Starter (for 2) (P/G/S/F/Mo/N/E/C/Se*) 14.00 An assortment of 5 different canapés (chicken satay, prawn on toast, spring rolls, prawn tempura, chicken wings & prawn crackers). 2. Aromatic

More information

TOGETHER WITH OUR EXCELLENT AND GRACEFUL SERVICE, ENJOY A JOURNEY OF A PERFECT CULINARY & MIXOLOGY EXPERIENCE.

TOGETHER WITH OUR EXCELLENT AND GRACEFUL SERVICE, ENJOY A JOURNEY OF A PERFECT CULINARY & MIXOLOGY EXPERIENCE. QUI'S MENU CREATIONS ARE HEAVILY INFLUENCED BY THE MUSIC AND THE SOPHISTICATED SURROUNDING ATMOSPHERE, DINERS MAY ENJOY GLOBALLY INSPIRED SMALL PLATE SHARING DISHES WITH A CONTEMPORARY TWIST, INVENTIVE

More information

GERMANY (SXF)Berlin Schonefeld- Berlin Schönefeld Airport. Airport Charges

GERMANY (SXF)Berlin Schonefeld- Berlin Schönefeld Airport. Airport Charges 1. Landing 01-Jan-2006 26-Jul-2016 Over 6 tonnes EUR 4.45 Unit rate x MTOW_t 1. On each landing there is a noise surcharge (see Noise charge). 1. See Incentive schemes in attachment. 2. Lighting surcharge

More information

Appertizer & Salad MÓN KHAI VỊ

Appertizer & Salad MÓN KHAI VỊ Vietnamese food is one of the most varied and seductive on the planet a delicious mix of the food of its colonial visitors and age-old native lavours and techniques. Many forces of climate, trade, history

More information

STUDY ON THE PRODUCTIVE POTENTIAL OF SOME VICIA L. SPECIES

STUDY ON THE PRODUCTIVE POTENTIAL OF SOME VICIA L. SPECIES Original scientific paper STUDY ON THE PRODUCTIVE POTENTIAL OF SOME VICIA L. SPECIES Siyka Angelova, Yana Guteva In sti tute of Plant Ge netic Re sources, 4122 Sadovo, Bul garia Sum mary: The study pres

More information

Min Zu Tuan Jie Shi Hua (Mandarin Chinese Edition) READ ONLINE

Min Zu Tuan Jie Shi Hua (Mandarin Chinese Edition) READ ONLINE Min Zu Tuan Jie Shi Hua (Mandarin Chinese Edition) READ ONLINE If you are searching for a ebook Min zu tuan jie shi hua (Mandarin Chinese Edition) in pdf form, then you've come to the correct site. We

More information

Round and bite-sized with many seeds and juice Good in salads

Round and bite-sized with many seeds and juice Good in salads T O M AT O Ripe tomatoes are red, round or oval, 1 to 6. Eat raw; add to salads & sandwiches. Cook by baking, stewing, grilling, stir-frying. Choose smooth tomatoes, slightly soft, bruise free. Serve in

More information

Visual Aids. Developed by: Julie Garden-Robinson, Ph.D., L.R.D. Food and Nutrition Specialist Stacy Halvorson, Extension Associate

Visual Aids. Developed by: Julie Garden-Robinson, Ph.D., L.R.D. Food and Nutrition Specialist Stacy Halvorson, Extension Associate Visual Aids Developed by: Julie Garden-Robinson, Ph.D., L.R.D. Food and Nutrition Specialist Stacy Halvorson, Extension Associate Tortilla (tor ti lla) or (to r-tē-yə) Thin, unleavened pancake made from

More information

Down Sendromlu Çocuklarda Atlanto-Aksiyel Eklem İnstabilitesi ve Sendroma Özgü Diğer Klinik Bulgularla İlişkisi

Down Sendromlu Çocuklarda Atlanto-Aksiyel Eklem İnstabilitesi ve Sendroma Özgü Diğer Klinik Bulgularla İlişkisi ORİJİNAL ARAŞTIRMA Down Sendromlu Çocuklarda Atlanto-Aksiyel Eklem İnstabilitesi ve Sendroma Özgü Diğer Klinik Bulgularla İlişkisi Dr. Nilüfer ÖĞÜN, a Dr. Özlem GİRAY, a,b Dr. Elçin BORA, c Dr. Ayfer ÜLGENALP,

More information

Certificate of Analysis

Certificate of Analysis Brammer Standard Company, Inc. Certificate of Analysis BS 200-3 Certified Reference Material for Nickel 200 - UNS Number N02200 1 Certified Estimate of Certified Estimate of 2 3 2 Value Uncertainty Value

More information

Guangzhou Runming Tea Co. Ltd

Guangzhou Runming Tea Co. Ltd Accessories Catalog Company Address: Telephone: Fax: Website Contact person: Contact Email: Guangzhou Runming Tea Co. Ltd RM305, No. 6, Bai Yun San Xian No. 3, Hebian Rd, Jiahe Str, Baiyun District, Guangzhou,

More information

Daily Lunch Specials 11 a.m. to 3 p.m. Monday Friday

Daily Lunch Specials 11 a.m. to 3 p.m. Monday Friday Daily Lunch Specials 11 a.m. to 3 p.m. Monday Friday Specialita della Casa $12 Special daily entrée served with side pasta Zuppa ed Insalata $10 Soup of the Day with choice of Spinaci or Mediterranea salad

More information