Biomedical subjects
Publications and source records attributed to N Druzijanic.
Three cases of emphysematous cholecystitis are presented. The role of hyperbaric oxygenation as excellent adjuvant therapy to urgent surgical as well as intensive conservative treatment is emphasized.
This article presents a new bipolar hook for endoscopic surgery. With this instrument monopolar and bipolar current can be used. The advantage of this new instrument is the possibility of using a bipolar current, which is safer than using the monopolar current. The technical details and usage instructions are discussed.
Based on a "field-effect" theory in colon carcinogenesis, and the expression of the disaccharide tumor marker D galactose-beta-[1-->3]-N-acetyl-D-galactosamine (Gal-GalNAc) in the rectal mucus of patients with cancer and precancer of the colon, Shamsuddin developed a simple, accurate, inexpensive, easy to perform and rapid (< or = 15 min) screening test for colonic cancer and precancerous lesions. In this study we examined 137 rectal mucus samples of randomly selected patients with colorectal malignancy or other colorectal diseases to confirm the sensitivity and specificity of this test in Croatia. Additionally, to test the validity of the "field-effect" theory, that the mucosa away from the obvious cancer will show abnormalities as a result of the generalized effect of the carcinogen throughout the entire field of the target tissue, we also monitored a subset of 53 patients post-operatively. Individuals free of colonic or any other malignancies served as control (n = 31). The rectal mucin was smeared on membrane filter and developed by a sequential reaction of galactose oxidase (GO) and Schiff's reagent. The test results were correlated to the findings from colonoscopy/surgery and histopathology. The sensitivity of the test was shown to be 100% and the specificity was 96.8% (p < 0.001). Interestingly, the test was positive in 60% (32 of 53) of the samples collected from patients after tumor resection, showing the persistence of the biochemical changes even though malignant tumors were removed, hence supporting the field-effect phenomenon of carcinogenic stimuli. Five patients out of these 32 (16%) postoperative cases with positive GO test had a tumor recurrence within a year (0.05 < p < 0.10), suggesting that a persistently positive GO test in this population may serve as a predictor of tumor recurrence. We conclude that Gal-GalNAc is an early and intermediate biomarker, suitable not only for the detection of malignancy in its inception, but also for monitoring of people at high risk for cancer, and the efficacy of the cancer therapy as well as secondary prevention by this technology.
BACKGROUND/AIMS: The purpose of this study was to introduce modified intraparietal vagotomy as a safe procedure and a method of choice in the treatment of perforated duodenal ulcers. METHODOLOGY: Eighty-six patients with perforated duodenal ulcers underwent oversewing of the perforated ulcer and modified intraparietal selective vagotomy. The site of perforation was sewn over and an abdominal cavity lavage was performed. The posterior vagal nerve was resected, and a modified intraparietal anterior vagotomy was performed. During the postoperative period, after twenty days, six months and one year, respectively, we analyzed the following data: body weight, signs of gastroesophageal reflux, subjective discomfort, early postoperative complications, gastroduodenoscopic findings, basal acid output (BAO), and maximal acid output stimulated by pentagastrin (PAO). RESULTS: There was no mortality in our group, the post-operative morbidity was insignificant, and the duration of operation was shorter in comparison to other vagotomy methods. BAO and PAO values were similar to those in the literature when proximal selective vagotomy (PSV) was performed. There were no cases of duodenogastric or gastroesophageal reflux nor re-occurrence of ulcer disease, as confirmed by gastroduodenoscopy. According to the modified Visick's criteria, 94% of the patients followed-up were classified as group 1. CONCLUSION: We consider the modified intraparietal vagotomy to be the method of choice in the treatment of perforated duodenal ulcers because of the simple surgical technique involved, the shorter duration of surgery, and the avoidance of standard PSV complications. The surgery can be performed even by a less experienced surgeon, independently of the patient's age and condition. This modification is suitable for laparoscopic surgery.