[High colonic-vaginal fistulas]. / Visoke kolovaginalne fistule.

In this paper, the authors present the definition, etiology, clinical features, diagnosis and preparations for the surgical treatment of colovaginal fistulas. A ten year experience with 11 female patients with colovaginal fistulas divided according to the causes is reviewed. The fistulas commonly resulted from the surgical treatment, radiotherapy, parturition injuries and Crohn's disease. In the discussion, each group is evaluated with respect to the therapeutic procedure giving some general remarks on this rare clinical condition. Besides the surgical treatment of the fistula, in most cases, the contemporary colostomy is required.

[Histologic type and tumor maturity as prognostic factors in malignant epithelial tumors of the ovary]. / Histoloski tip i zrelost tumora kao prognosticki faktor kod malignih epitelnih tumora jajnika.

A retrospective pathological analysis of 664 patients with malignant ovarian epithelial tumors of coelom epithelium origin was performed. In 93 cases (14%) proliferative tumors were found. Out of the remaining 571 cases a group of 311 cases with the five-year survival in the period 1965-1980 was singled out (39.9% invasive and 98% proliferative tumors). The clinical staging of the illness is the most important prognostic factor. In the clinical stage I the five-years survival was 78.8%, the difference being statistically not significant in relation to the histological maturity of the tumors. For any further clinical stage the five-year rate of survival decreased by about 30%. In the clinical stages II, III and IV survival statistically significantly differed (p less than 0.01) with regard to the histological grade of maturity I, whereas the survival was almost the same in cases with moderately or poorly differentiated tumors. Regardless of the clinical stage of the illness, the five-year survival rate for histological grade I was 71.8%, for grade II 24.5% and for grade III 20.4%. According to the histological type of the tumors, the best prognosis is for mucinous cancers, where the five-year rate of survival was 51.4%, and the worst for undifferentiated (13.3%) and clear-cell cancers (16.7%).

The clinical use of aztreonam.

Aztreonam is the first monobactam antibiotic to be used clinically. It is highly resistant to beta-lactamases, and although its activity spectrum is similar to that of the aminoglycoside antibiotics, it has no effect on gram-positive bacteria. The current study was undertaken to determine the efficacy of aztreonam in treating gram-negative infections caused by multiresistant microorganisms in patients with known sensitivity to penicillins and cephalosporins. Sixty-six patients presented with urinary tract infection (UTI) and 30 with respiratory tract infection (RTI). All patients received aztreonam, between 4 and 6 g/day in divided doses for 10-14 days. Cure was achieved in 59 (89.3%) patients with UTI; in the group with RTI, 20 patients were cured and 4 improved with treatment. Tolerance to the drug was good in both groups, and in no instance did side effects necessitate modification of the dosing regimen.

[Conization and plasty of the uterine cervix under paracervical anesthesia]. / Konizacija i plastika cerviksa uterusa vrsena u paracervikalnoj anesteziji.

First experience with the paracervical block as an anesthetic method for the conization and plastic surgery of the cerviä is presented. The analgesic effect was good, except for one patient where general anesthesia was necessary. The authors recommend the multilocular application of the anesthetic, because the parametrial tissue in non-pregnant women has not the same density, hence a different uptake of the local anesthetic.

[Pseudomyxoma peritonei]. / Pseudomyxoma peritonei

The clinical course of 8 patients with pseudomyxoma peritonei developed from ovariah tumors and 3 from mucocoele appendicis is presented. Except in two instances, all tumors were originally benign, one of them with metastases of kystoma mucinosum to inguinal lymphnods. The treatment was basically surgical and consisted of the removal of sree and organised mucus and, naturally, of the ovarian tumor or muccocoele where possible. Supplementary local chemotherapy with 5 -- fluorouracyl were of some benefit. In one instance, where multiple small pappillomas were found in the visceral and parietal peritoneum, all metastases disppeared after the intra abdominal application of 150 mC of Au.

[Intraoperative cytodiagnosis of ovarian tumors]. / Intraoperativna citodijagnostika tumora ovarija

The authors report on their experience in applying rapid intraoperative cytologic analysis in 83 benign and 54 malignant ovarian tumors of various pathohistologic types. The entire procedure, from the receiving of the material, fixing and staining, up to the cytologic diagnosis, did not last longer than 6 minutes. The cytologic findings were negative in all benign tumors except one (99.3%). In cases of malignant tumors the cytologic diagnosis was correct in 49 cases (96.4%). On the basis of cytomorphologic criteria it was also possible to predict the pathohistologic type of most of investigated tumors. The high overall accuracy rate of intraoperative cytologic examination permits the surgeon to make a quick and adequate therapeutic decision concerning the extent of intervention.