Pilocarpine in the prevention of postirradiation xerostomia.

During radiation therapy to the head and neck region, salivary gland hypofunction commonly develops. The aim of our study was to evaluate whether the sialogogue pilocarpine given during radiation therapy may reduce the severity of xerostomia and salivary dysfunction. Our results showed the pilocarpine-treated group to have a lower frequency of oral symptoms during the treatment than the placebo-treated group. Although salivary flow decreased in all patients, the pilocarpine-treated group had smaller flow reductions. No drug effect was observed in the glands that were completely irradiated. Thus, pilocarpine appeared to stimulate salivary tissues outside the radiation field.

Recruitment in the diagnosis of small PCA tumors.

Acoustic brainstem response (ABR) waveforms were preoperatively analyzed in 86 cases of pontocerebellar angle (PCA) tumors. Absolute (APL) and interpeak latencies (IPL) ipsilateral to the tumor and interaural absolute latency differences of wave V (IAAPLD V) were normal in two patients with small intracanalicular tumors. However, results of latency-intensity studies were abnormal. So, if PCA tumor is suspected, and standard ABRs are normal by usual criteria, the latency-intensity functions should be examined before the test result is reported as negative for an acoustic nerve tumor.

Clinical interpretation of brainstem evoked response audiometry abnormalities in cochlear pathology.

This investigation involved 45 patients with sensorineural hearing loss (SNHL): 24 with Meniere's disease, 18 with acoustic trauma, and 3 with SNHL due to ototoxic drugs. They all underwent pure tone audiometry and standard brainstem evoked response audiometry (BERA). In patients without wave I in auditory brainstem response, electrocochelography (ECochG) was performed. The findings are presented showing that cochlear lesions (beside threshold elevation) cause latency prolongation of wave I, III and V relative to normal latencies at the actual click hearing level. At high stimulation levels, this effect is almost completely compensated for by the fact that cochlear recruiting ears exhibit steeper latency-intensity curves than do normal ears. But, at the same time this pathology does not cause latency prolongation of central conduction time (CCT). Beside this, cochlear lesions will cause, in some cases, deterioration of replicability (poor waveform resolution) of waves preceding wave V. In such cases, the authors strongly recommend electrocochleography (ECochG) to make wave I visible, because they think that it is the best way to verify the diagnosis of cochlear lesion using BERA.

Vertigo as a prognostic factor in sudden hearing loss.

A group of 87 patients suffering from unilateral sudden hearing loss were investigated. They were divided into two groups with and without vertigo, and were evaluated according to the severity of initial hearing loss and shape of tonal audiogram. Twenty-five percent of the patients had accompanying vertigo. Vertigo occurred more often in patients with severe hearing loss in high tone frequencies. Hearing recovery of high tone frequencies was poorer in the patients with vertigo than in those without it, although the initial hearing loss was the same.

[Surgical treatment of central echinococcal cysts of the liver]. / Kirursko lijecenje centralnih ehinokokovih cista u jetri.

While in the treatment of the peripheral Hydatic Cyst of the liver the complete extirpation of the cyst is today recognized as a curing method, at the Central Type of Hepatic Cyst, there are often suggested and performed surgical treatments which in today's phase could be appraised as incorrect. The Central Hepatic Cyst ought to be entirely removed (cyst and pericyst). All vascular and biliary elements, which go from the liver parenchym to the pericyst, must be exactly tied up. The remaining cavity at liver, is always primarily closed with the parenhymatic liver suture. In the case that there exists a wider communication with larger intrahepatic bile ducts or if there is already present the previously existing intermittent icterus, it is necessary to perform a choledochotomy, in order to prevent the appears of the biliary fistulas. The common bile duct ought to be explored, papilla of Vater dilated up to 20 to 22 Ch, the operative Cholangiography performed and an adequately thick T tube placed.

[Acute experimental (endogenous) hepatic coma and the clinical syndrome of acute hepatocellular injury]. / Eksperimentalna (endogena) akutna jetrena koma i klinicki sindrom kod akutnog hepatocelularnog ostecenja.

In search of the adequate experimental model for creating endogenous coma, the characteristics of which would be identical to the clinical picture of acute hepatic coma in men, the ischaemic method of experimentally originated acute endogenous hepatic coma was applied. The experiment was carried out on 12 dogs in which the terminolateral portocaval shunt with ligation of all the collateral of the arterial irrigation leading to the liver was performed, while the double ligation was performed on the hepatic artery. After the animals had emerged from the postoperative state of shock, the hepatic artery was ligated in local anesthesia and the created state was controlled by clinical observations and laboratory tests. Experimentally created acute endogenous hepatic coma achieved by applying ischaemic method proved to be a good model. Its true value manifested itself in the clinical picture as well as in the laboratory findings which resembled considerably the state of acute hepatic coma in men.

[Early cancer of the stomach as a gastroenterological problem]. / Pocenti rak zeluca kao gastroenteroloski problem.

The article analyzed the problem of early gastric cancer; definition, endoscopic and surgical intraoperative diagnosis and kind of surgical treatment, and also results. It's emphasize importance of the diagnosis early gastric cancer. In that treated cases of early gastric cancer prognosis is excellent (85 -- 92%). The result of 6032 endoscopic examinations are: 360 cases of gastric cancer, and 14 was early gastric cancer. Surgical treated was eleven cases, and they are all have been lived. In the article is extensive discussion the problem of histopathological diagnosis and classification. Extensive is described operative proceed for which we think that is best in treated of early gastric cancer.

[Surgico-technical pecularities of transabdominal gastrectomy in cancer of the stomach]. / Operativno-tehnicke pojedinosti u transabdominalnoj gastrektomiji kod raka zeluca.

The review of basal surgical details in act of the transabdominal gastrectomy at the cases of stomach cancer. These details accelerate operation, and made it more reliable, and what is very important more radical. In the article is discussed indication for volume and kind of the resection, a new position about choice of a digestive anastomosis.

[Anatomo-functional basis of the liver resection technique in the treatment of hepatic echinococcosis]. / Anatomsko funkcinonalna podloga resekcionih metoda jetre u lijecenju ehinokoka jetre

Hepatic resection of segments or lobes in same cases the hydatid desease of liver is necessary surgical therapy. The articl presents anatomy's bases for major hepatic resection. It's also present preoperativne care, technic of surgical therapy and postoperativ therapy. The standard liver functional testes should always be performed, in case functional insuffitiency we recomended different metods of temporary support.

[Surgical problems of acute cholangio-pancreatitis in man and in experiment]. / Kirurska problematika akutnog holangio--pankreatitisa kod covjeka i u eksperimentu

The article tried to find a relationship between billiary tract disease and pancreatitis. Reflux of duodenal contents into the pancreatic duct is the mechanism responsible for activation of pancreatic enzymes. They cause a varying degree of vascular damage and leading to changes from oedema to frank infraction. If this view of pathogenesis is correct it should also explain the relationship between pancreatitis and known aetiological factors.

[Acute necrotizing and hemorrhagic pancreatitis as a surgical problem]. / Akutni nekrotizirajuci i hermoragicni pankreatitis kao kirurski problem

The authors have analysed 235 patients suffering of acute pancreatitis. From that number 42 sick persons had severe pancreatitis with necrosis and hemorrhage. Mortality in this group was 83%. Mortality of the patients who were under the non-operative (conservative) therapy was 95%, and in the same time mortality of the patients who were treated surgically was 72%. Based upon their own experiences, the authors consider that patients with acute necrotizing pancreatitis have to be treated surgically, when there's not change for the better by shock and improvement of patient's condition, when one has respiratory or cardiovasculary distresses, or when electrolytic disbalance is present, in these cases the operation has to be done 48 hours from the beginning of illness. Good drainage to peripancreatic and retroperitonel areas by sump drainage is the most essential part of action, wery useful are cholecystostomy, gastrostomy and jejunostomy.