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I Baća

Publications and source records attributed to I Baća.

17 recordsLinked to original sources
PubMed2005

Technique and survival after laparoscopically assisted right hemicolectomy.

BACKGROUND: The role of laparoscopic colon resection in the management of colon cancer is still controversial. In this article, the surgical strategy and techniques are described, with further consideration of the oncologically relevant aspects. METHODS: Between March 1993 and July 2003, we performed laparoscopic right hemicolectomy in 56 patients with right colon carcinoma. Average age was 74.5 years (range, 17-92). We performed a standardized surgical procedure that included mobilization from the vascularized mesenteric bridges with a window technique, transection of the ileocolic lymphovascular pedicle, and lateral and proximal mobilization of the ileocecum, ascending colon, right flexure, and proximale transversum. After enlargement of one of the trocar incisions the exteriorized colon was resected and an extracorporeal anastomosis was performed in the standard manner. RESULTS: There were no conversions to open. The mean operating time was 119 +/- 38 min, the mean length of resected colon was 27.8 +/- 4.48 cm, and the average width of the clear margins was 6.8 +/- 5.3 cm. One patient died. Lymph nodes were positive in 21 patients. The 5-year survival rate in the 48 patients who were operated on with curative intent was 75%. We have had two local recurrences. The overall 5-year mortality-free fraction was 63%. Cox multivariate analysis showed that the mortality-prognostic factors were tumor stage and length of resected colon, whereas Kaplan-Meier analysis showed that the mortality-prognostic factors were positive lymph nodes and tumor stage. CONCLUSIONS: Our results show that laparoscopic right hemicolectomy for colon cancer can be performed safely. Complications and recurrence rates are comparable to those for left-sided laparoscopic and open procedures. Therefore, we recommend this procedure as the method of choice. Laparoscopically treated patients with stage II and stage III disease have almost the same cumulative rate of survival.

Adenocarcinoma↗
PubMed1988

G-cell hyperplasia in rats with pyloric stenosis.

Since little is known about the pathophysiology of pyloric stenosis, we created a partial gastric outlet obstruction in 13 Wistar rats by placing a nonabsorbable ligature of defined size around the pylorus. Sham operations were performed in 10 rats. The animals from both groups were killed after four months. G-cell count and gastrin content were determined in 10 parallel strips, which were cut by razor blades mounted on a handle. Gastric size and weight as well as thickness of mucosal and muscular layers and serum gastrin concentration were also determined. Body weight of the animals with pyloric stenosis was lower and gastric weight higher than that of the controls. Furthermore, we found an enlarged G-cell area and G-cell hyperplasia, an increased surface area and thickness of the mucosal and muscular layers of the stomach, and in the majority of rats, elevated serum gastrin levels. Total G-cell count was 583,720 +/- 90,561 in the rats with pyloric stenosis and 385,775 +/- 15,820 (mean +/- SEM) in the control rats (P less than 0.04). We conclude that partial gastric outlet obstruction in rats leads to G-cell hyperplasia and that this experiment may serve as a model for pyloric stenosis in man.

Animals↗
PubMed1987

A new round in the discussion on the action of secretin on pancreatic protein secretion: a further study on the effect of secretin on pancreatic secretion in dogs.

Whether or not secretin stimulates pancreatic protein secretion is a controversial question. In this investigation, dose-response studies with different secretin preparations were performed in dogs with two different types of pancreatic fistulae. Pure natural secretin (Karolinska Institute, Stockholm), synthetic secretin (Hoechst, Frankfurt), synthetic secretin (Hoechst, Frankfurt), synthetic D-Ala17-secretin (Roche, Basel), and natural secretin (Kabi, Munich) were tested in dogs equipped with a Thomas cannula for collection of pure pancreatic juice. The synthetic secretin was also tested in dogs with a modified Herrera fistula. Potency of the pure natural and the unmodified synthetic secretins was similar. Whereas protein output was significantly stimulated by these secretin preparations, protein concentrations fell to approximately 10 mg ml-1 with incremental doses of infused secretin. The high protein concentrations of 60 up to 120 mg ml-1 found in pure basal pancreatic secretion, suggest that pancreatic protein output may have been a "washout" phenomenon, and that the increasing protein output values were due to rising volume flow of pancreatic juice which is not completely protein-free. Impure secretin preparations and indirect collection techniques also lead to an elevation of pancreatic protein output.

Animals↗
PubMed1986

Reproduction of postprandial neurotensin plasma levels by intravenous neurotensin and the effect of neurotensin on exocrine pancreatic secretion in humans.

A fatty meal releases neurotensin immunoreactivity from the small bowel in humans and dogs, and an infusion of synthetic neurotensin elicits exocrine pancreatic secretion in these species. It is not clear, however, which amount of exogenous neurotensin will reproduce endogenous neurotensin plasma levels as postprandial neurotensin immunoreactivity is composed of several fragments of neurotensin without biologic activity in addition to intact neurotensin. In order to clarify this question, we infused 1.25, 2.5, 5.0 and 7.5 pmol/kg/min synthetic Gln4-neurotensin in four volunteers, determined neurotensin plasma levels with a radioimmunoassay recognizing only intact neurotensin, and collected duodenal contents for estimation of pancreatic secretion. On another day, we determined neurotensin plasma levels after a fatty meal. Reverse-phase high-pressure liquid chromatography (HPLC) was performed on postprandial plasma samples. We found a stimulatory action of neurotensin on pancreatic secretion of volume enzymes and bicarbonate beginning with 1.25 pmol/kg/min neurotensin. The neurotensin plasma level after infusion of this dose of synthetic neurotensin was 69 pg/ml; after the meal, maximal neurotensin plasma concentration was 50 pg/ml (basal neurotensin plasma levels in both investigations were subtracted). HPLC indicated the presence of the tridecapeptide known to be the active molecular form of neurotensin in postprandial plasma. These results suggested that neurotensin plays a role as an endocrine hormone in the postprandial regulation of exocrine pancreatic secretion in humans.

Dietary Fats↗
PubMed1985

Action of neurotensin on size, composition, and growth of pancreas and stomach in the rat.

Since the gastrointestinal peptide neurotensin has a stimulatory effect on the secretion of the exocrine pancreas and an inhibitory effect on secretion and motility of the stomach, we investigated whether chronic parenteral administration of neurotensin would affect pancreatic and gastric growth. We therefore infused synthetic neurotensin subcutaneously (dose, 43 and 282 pmol X kg-1 X min-1) in 20 Wistar rats for 2 weeks using Alzet osmotic minipumps and compared pancreatic weight, DNA, RNA, protein, lipase, amylase, pancreatic polypeptide and insulin with these parameters in 10 control rats from the same litter with subcutaneously implanted plastic cylinders approximately the size of the minipumps. In another experiment, synthetic neurotensin (836 pmol X kg-1) was injected intraperitoneally three times a day for 3 days in 12 rats. Thereafter, we measured pancreatic DNA and in vitro incorporation of [3H]thymidine into pancreatic DNA. These effects were compared with the actions of caerulein and normal saline. Long term infusion of the high neurotensin dose induced an increase of pancreatic weight (control: 0.87 g, neurotensin: 1.02 g) and of DNA (control: 2.5 micrograms; neurotensin: 3.5 micrograms) and pancreatic polypeptide (control: 2.4 ng; neurotensin: 7.4 ng) contents, whereas pancreatic protein, RNA, amylase and lipase contents were not stimulated. In relation to DNA, these parameters even were significantly depressed. Insulin remained unchanged. Intraperitoneal injection of neurotensin induced an increase of pancreatic DNA content and stimulated [3H]thymidine incorporation into DNA (control: 11 000 dpm/g; neurotensin: 15 800 dpm/g pancreas). Moreover, long-term neurotensin infusion with the high dose led to a rise in protein concentration and an increase in the thickness of the gastric antrum; antral DNA concentration was insignificantly stimulated. Parenteral neurotensin in the doses and at the times administered, led therefore, to hyperplasia of the pancreas and induced growth of the gastric antrum. It is concluded that neurotensin can act as a trophic factor on pancreas and gastric antrum of the rat. It remains to be determined whether this represents a physiological effect of neurotensin.

Aging↗
PubMed1983

Interaction of neurotensin, cholecystokinin, and secretin in the stimulation of the exocrine pancreas in the dog.

The effects of exogenous neurotensin, secretin, and cholecystokinin-33 alone and in combination on pancreatic secretion were investigated in dogs prepared with pancreatic fistulae. Neurotensin infused intravenously caused a dose-dependent stimulation of exocrine pancreatic secretion. Increasing doses of neurotensin combined with a constant small dose of secretin potentiated pancreatic output of protein and had a tendency to reduce secretion of the bicarbonate. Increasing doses of neurotensin combined with a constant small dose of cholecystokinin-33 potentiated pancreatic output of bicarbonate and lead to a reduction (insignificant) of pancreatic protein secretion. These observations suggest an interaction of neurotensin with pancreatic receptors for secretin and cholecystokinin.

Animals↗
PubMed1981

Effect of neurotensin on regional intestinal blood flow in the dog.

The effects of various doses of synthetic neurotensin on regional blood flow in different tissue layers of the stomach, small bowel, colon, pancreas, brain, kidneys, adrenal gland, and heart of six dogs was studied using an isotope microsphere technique. Infusion of high doses (20, 40 pmol/kg . min(-1)) of exogenous synthetic neurotensin caused an increase of blood flow in the "muscularis" of duodenum, jejunum, ileum, and colon. Neurotensin infused in a dose (2.5 pmol/kg . min(-1)) raising neurotensin plasma levels to concentrations comparable to those observed after a meal caused an increase of blood flow in the muscular layer in ileum. Our results suggest that one of the physiologic actions of neurotensin may be the regulation of blood flow in the muscular layer of the ileum.

Animals↗
PubMed1979

Regional myocardial blood flow after hypothermic arrest and cardioplegia.

Malperfusion due to increased coronary vascular resistance is presumably one of the factors responsible for incomplete functional recovery of the heart after aortic cross-clamping. Myocaridal blood flow (MBF, radioactive microspheres) was measured before and after 60 min of hypothermic ischemia in 16 dogs on cardiopulmonary bypass. After ischemia the hearts were reperfused for 30 min. MBF was measured in the empty beating heart and in the isovolumetrically contracting ventricle loaded with enddiastolic volumes (EDV) of 10, 20 and 30 ml (intraventricular latex balloon).

Animals↗
PubMed1979

[Comparative studies on pulsatile and continuous flow during extracorporeal circulation. Effects on liver function and endocrine pancreas secretion].

The effects of pulsatile and nonpulsatile flow pattern on pancreas and liver blood flow were studied in nine dogs on cardiopulmonary bypass (CPB). Furthermore, plasma levels of glucose, insulin, glucagon, growth hormone, and cholinesterase were compared in 20 patients subjected to open heart surgery with either pulsatile or nonpulsatile perfusion. Impairment of liver and pancreas function was significantly greater at the end of CPB and 48 h afterwards with nonpulsatile flow as compared with the pulsatile flow pattern. A decrease of intestinal blood flow that was demonstrated in dogs subjected to nonpulsatile perfusion could at least in part be responsible for the difference in postoperative organ function observed in patients after CPB.

Animals↗
PubMed1979

[Regional myocardial blood flow and ventricle function following hypothermic ischemia and cardioplegia].

Regional myocardial blood flow (MBF) and left ventricular (LV) function were measured in 18 dogs after 60 min hypothermic (14-16 degrees C) arrest with (group I) and without cardioplegia (group II). Regardless whether postischemic LV function was severely (group II) or only moderately (group I) impaired, the amount of MBF and its transmural distribution was not significantly altered after 30 min reperfusion. In contrast to topical hypothermia, additional cardioplegia maintained metabolic regulation of coronary flow.

Animals↗
PubMed1979

[Surgical management of traumatic thoracic aortic aneurysms using the TDMAC-heparin shunt].

Rupture of the aorta frequently occurs in major blunt trauma to the thorax, but few patients survive long enough to develop a chronic aneurysm. A TDMAC-heparin-coated shunt was used for operative procedures on the thoracic descending aorta in 5 patients aged 18--40 years. The lesions constituted in 4 recent ruptures and 1 chronic aneurysm. In 3 cases the aneurysm was resected and replaced with a prosthetic graft. End-to-end aorta sutures were performed in the other two cases. One patient died of renal and pulmonary insufficiency. There have been no complications attributable the shunt. The advantage of this shunt include elimination of the need for systemic heparin, avoidance of hypertension during crosslamping, and adequate perfusion of the distal circulation without an interposed pump. Because of the ease of handling and low risk we consider the use of this shunt the preferred method for operative procedures on the thoracic descending aorta.

Accidents, Traffic↗
PubMed1979

[Subdiaphragmatic pacemaker implantation of pacemakers - results of 1150 implantations].

Permanent pacemaker are presently used on patients with chronic disease of the cardiac conduction system, with recurrent Adams-Stokes attacks, and with bradycardia. 1865 pacemakers have so far been implanted in the unit for special thoracic surgery in the University of Heidelberg from 1965 to 1978. In 1.150 (or 61%) patients the pacemaker was implanted using the subdiaphragmatic method. A lower transverse pericardiotomy was performed and the battery was located in the rectus abdominis sheath. In the remaining 715 (or 39%) patients, the electrodes were introduced transvenously and implanted in the endocardium. The battery unit in this case was located beneath the pectoral muscle. The transvenous approach was the method of choice until 1971; from that time onward the subdiaphragmatic approach gradually replaced it as the method of choice. Between 1971 and 1978 80% of the pacemakers were implanted directly into the myocardium whereas only 20% were introduced transvenously. The subdiaphragmatic method completely eliminates the frequent complications of the transvenous approach, such as dislocation of electrodes and others so that it now is our method of choice.

Diaphragm↗