[Endoscopic balloon dilatation of achalasia under fluoroscopic guidance]. / Endoskopska balon-dilatacija ahalazija kod fluoroskopskom kontrolom.

In 41 patients, aged 17-81 years, with confirmed achalasia, endoscopic balloon-dilatation was performed under fluoroscopic control. Favorable results were achieved in 39 patients--in 36 patients balloon dilatation was successful after the first intervention, and in the other 3 patients dilatation had to be repeated twice, with favorable outcome. Two patients were surgically treated, one for unsuccessful dilatation, and the other for the complication that occurred during dilatation.

[Sutures in digestive surgery]. / Sav u digestivnoj hirurgiji.

Anastomotic leakage remains the most important cause of morbidity and mortality in digestive surgery. Despite the development of new surgical techniques and devices, intestinal anastomose continue to be complicated by leakage even in the best and most experienced of hands. One may explain the persistence of anastomotic leakage in spite of these technical advances on the basis of the dynamic effect that multiple factors (shock, peritoneal sepsis, inadequate intestinal preparation, advanced age, malignancy, malnutrition, coagulopathy, steroid dependence, uremia, radiation therapy, diabetes, perforation, anemia, fecal soiling and deficiency of vitamin C, iron and zinc) have on the healing of an anastomosis. Awareness of these factors and proper precautions by the surgeon can make a high-risk anastomosis less prone to leakage. Collagen is the essential material for composing an anastomosis and the basis of a good surgical suture. Recognition an correction of factors that compromise collagen synthesis, should be the goal of the surgeon. Over the years, numerous anastomotic techniques have been proposed, but the search for the ideal technical anastomosis goes on. Traditional inverting methods ignore the basic principle of accurately opposing clean-cut tissues, and temporary clamping of the gut and crushing of mucosal tissue by intraluminal sutures may damage the microcirculation. Submucosa should always be included in the formation of an anastomosis because it is the strongest intestinal layer and because the collagen has its origin and its synthesis just in submucosa. Monofilament sutures may be more desirable for anastomosis. Staple sutures have minimum tissue reaction. Single layer extramucosal technique has many of the attributes of an ideal intestinal anastomosis. Single interrupted and continuous sutures are not opposite and both give satisfactory results.

[Radiographic study of teeth restored with porcelain and gold veneered crowns]. / Rendgenoloska analiza zuba zbrinutih porcelanskim i fasetiranim krunicama.

Radiographic study was performed to assess the results of the prosthetic therapy of teeth restored with porcelain and gold veneered crowns. Retroalveolar radiographs were used to evaluate the cast post-core-root ratio the presence of empty spaces between post-core and root canal filling. Also, bone resorption, marginal fit of the crowns, caries and proximal contacts were investigated. The failures were registered in a very high percentage for the teeth restored with gold veneered crowns. The poor marginal fit of the crowns, the presence of the secondary caries, and the bone resorption were at a very high level which could alarm the practitioner. The obtained results warn therapists that much greater attention should be paid to the construction of artificial crowns and to the radiographic analysis that gives very useful data on that regard.

[Recurrent acute pancreatitis and biliary microlithiasis]. / Recidivirajuci akutni pankreatitis i biliarna mikrolitijaza.

The ease with which biliary microcalculi migrate through the cystic duct and their frequent involvement in choledochus, may be a high risk for developing of recurrent acute pancreatitis, especially if papilla of vater is blocked. The concomitant presence of acute pancreatitis becomes an indication for litothomy, thorough lavage and surgical or endoscopic sphincterotomy. Twenty-one patients with biliary microlithiasis are reviewed in this article. The authors stress the importance of thorough pre and intraoperative investigation whenever the presence of biliary microlithiasis is suspected and confirm the indications for radical treatment of the disease.

[Microbiological investigation of supragingival dental plaque in patients treated with porcelain jacket and gold veneered resin crowns]. / Mikrobioloska istrazivanja supragingivnog dentalnog plaka u pacijenata zebrinutih porcelanskim i fasetiranium krunicama.

The majority of periodontologists agree that the primary aetiological factor of periodontal disease is dental plaque. The purpose of the study was to investigate the accumulation of dental plaque on the with porcelain jackets and gold veneered resin crowns, and to correlate these findings with the data obtained on the uncrowned control teeth in the same patients. The qualitative analysis of microorganisms in dental plaque did not show a great difference between porcelain jacket and gold veneered resin crowns. However, a high difference was found in the quantitative accumulation of microorganisms in the mature dental plaque (considerably less on porcelain jacket crowns). These findings indicate that dental porcelain is less susceptible to accumulation of bacterial plaque in comparation to resin and even to hard tooth structures.

[Retroperitoneal collection in acute pancreatitis]. / Retroperitonealne kolekcije u akutnom pankreatitisu.

According to the actual universal knowledge and the authors personal experience in treating patients with retroperitoneal collections in acute pancreatitis particularly in severe forms of the sickness, represent a great problem in detecting, diagnostics as well as in the therapy. Antibiotics may be helpful only in preventive care. Meanwhile, the established collections have to be treated only surgically. Drainage procedures are essential and according to the authors experience in 56 patients to the principle of irrigation-aspiration type of continuous drainage-lavage was most successful.

[Drug and surgical therapy of hydatidosis]. / Medikamentozno i hirurusko lecenje hidatidoze.

Surgical treatment of hydatidosis carries the risk of dissemination and recidives. In this paper authors present their experience with combined medico-surgical treatment with Albendazole in 13 patients. Ultrasound, computerized tomography and serological tests were used for diagnosis and follow-up. Microscopic viability test was used for the operated upon patients. In seven patients who were operated after two courses of Albendazole the viability test was negative. Three patients who received two courses of Albendazole after surgery did not show any recidive two years later. Another three patients who received only Albendazole (five courses) showed reduction in size and sings of calcification.

The combined action of X-irradiation, drug and hyperthermia on the DNA in mammalian cells in vitro.

The effects of the alkylating cytostatic drug PTC on the production of radiation-induced single-strand breaks in DNA, and on the repair in L cells incubated at 37 degrees or 42 degrees C were studied. The same amount of SSB is obtained when the cells are treated simultaneously with PTC and hyperthermia as when irradiated with 2 500 rad, but different rate in the rejoining was observed. There is no potentiation of SSB formation by pretreatment of cells with 10 microgram PTC/ml for 2 hours at 42 degrees C before irradiation, but in these cells less effective repair occurs. The effect of PTC on the rejoining of SSB induced with 2 500 rad depends on the drug's concentration and post-incubation time.

Effects of hyperthermia and drug in cultured mammalian cells.

Hyperthermia (42 degrees C) and peptichemio (PTC) applied simultaneously result in an increased killing effect and in a significant induction of single strand breaks (SSB) of DNA molecule. The enhanced killing effect was observed in all circumstances, whenever hyperthermia was applied before, during or after PTC treatment, but the most effective cell killing was obtained when hyperthermia and PTC were applied simultaneously. The results show that PTC concentrations used in these experiments do not induce SSB in DNA molecule during incubation for 2 hours at 37 degrees C. When the cells were exposed to PTC and hyperthermia the induction of SSB was observed. The number of SSB depends on the exposure time and PTC concentration. Cells with a greater number of SSB lost the capacity for repair during post-incubation at 42 degrees C.

Effect of peptichemio exposure on DNA synthesis in a mammalian cell system in vitro.

The effect of Peptichemio (PTC) on the survival and DNA synthesis in mouse L-cells was studied. Experimental data show that a typical dose-survival curve is obtained when L-cells are cultivated in the presence of PTC. Exposure of L-cells to various concentrations of PTC caused an inhibition in cellular ability to synthesize DNA which is evidenced by the decreased incorporation of 3H-thymidine. This inhibition is dependent on the concentration of PTC and the time of exposure.