High Expression of DARPP-32 in Colorectal Cancer Is Associated With Liver Metastases and Predicts Survival for Dukes A and B Patients: Results of a Pilot Study.

The purpose of this study was to investigate prognostic significance of Dopamine and cAMP-Regulated neuronal Phosphoprotein 32 (DARPP-32) expression in primary colorectal cancer. The study material consisted of clinical and histopathological data of 100 patients operated for colorectal cancer between 1994 and 1997. For immunohistochemical analysis, specific rabbit antibodies for DARPP-32 were used and the percentage of stained tumor cells was calculated under gross magnification (400 times) on a sample of 500 tumor cells. DARPP-32 expression in the primary tumor was significantly greater in patients with distant metastases compared to patients with no distant metastases (p=0.002). In multivariate regression analysis, DARPP-32 expression in the primary tumor was a significant predictor of distant metastases. With a cut-off point of 76.5%, DARPP-32 expression in the primary tumor significantly influenced both overall and disease free survival, especially for Dukes A and B patients (p=0.037). The results of this study indicate that DARPP-32 may be a potential marker of worse prognosis and a valuable tool for managing further adjuvant treatment in patients with stages Dukes A and B colorectal cancer.

[Guidelines for diagnosis and management of asthma in adults of the Croatian Respiratory Society]. / Smjernice Hrvatskoga pulmoloskog drustva za dijagnosticiranje i lijecenje astme u odraslih.

The global use of guidelines for proper diagnosis and management of asthma was worldwide aimed toward obtaining effective control of asthma. Until now, the most often used guidelines in Croatia were the ones issued by the Global Initiative for Asthma (GINA). Their implementation significantly improved and uniformed the diagnosis and management of asthma at different levels of the national health system. The obtained level of knowledge has enabled the making of local guidelines which acknowledge economic, cultural and even traditional specificities of Croatia. It was supposed that Croatian medical professionals would more effectively use guidelines they actively supported to prepare and which were appropriated to local work environment and medicines available. Therefore, based on current scientific evidence, the Croatian Respiratory Society has prepared Croatian Guidelines for Diagnosis and Management of Asthma in Adults purposed for wide use among Croatian doctors and other health professionals.

[Laparoscopic colorectal surgery]. / Laparoskopska kolorektalna kirurgija.

Laparoscopy is not a standard approach for colorectal diseases yet. This is due to the technically demanding procedure, the necessary equipment and open questions on cancer surgery. In this paper, short-term results in a small group of patients together with a review of the recent publications are presented. Six patients were operated between April 2002 and October 2003, without intraoperative complications or conversions. The average operation time was 120 minutes, and the average hospital stay was seven days. Patients with colorectal carcinoma were operated with curative intent. Recent publications are presenting new information on laparoscopy and colorectal cancer. For an adequate laparoscopic colorectal resection, experience in laparoscopy together with proper education is mandatory.

[Laparoscopic approach to incisional hernia--Carbajo procedure]. / Laparoskopski pristup postoperativnoj ventralnoj herniji--Carbajova operacija.

Incisional hernia is a common entity and occurs often in patients with previous operations in the abdominal cavity and the abdominal wall. In such patients, surgical therapy is challenging, since the recurrence rate varies between 14 and 50%. New technologies enabled the production of a new biocompatible non-adhesive mesh. Such a mesh can be placed inside the abdominal cavity in direct contact with the abdominal organs. A new laparoscopic approach, with original surgical details, was developed by Carbajo. In this article, we are presenting the results of first Carbajo procedure performed at our department in November 2003.