Malignant epithelial skin tumors

Kirurški je liječeno 55 bolesnika s malignim epitelnim tumorom kože. Na bazocelularne karcinome je otpadalo 69%, a na spinocelularne karcinome 31% malignih epitelnih tumora kože. Na donjoj usni bilo je 41% spinocelularnih karcinoma. Najveći broj oboljelih bio je u sedmom desetljeću života (36%). Oboljeli su najčešće bili poljoprivrednici i domaćice. Najčešća lokalizacija bila je lična regija (62%). Lezije su u svim slučajevima bile manje od 2 cm u promjeru. U 73% slučajeva operativni postupak se sastojao od ekscizije i pokrivanja defekta lokalnim rotacijskim režnjem. U 5 bolesnika sa spinocelularnim karcinomom donje usne učinjena je operacija po Karapandžiću, a u dva bolesnika klinasta ekscizija i suture. U 4% slučajeva malignih epitelnih tumora kože učinjena je ekscizija i defekt je pokriven slobodnim kožnim transplan tatom pune debljine kože. U 15% bolesnika učinjena je ekscizija lezije uz direktne suture. Kod bazocelularnih karcinoma ekscizija je rađena 5 mm od ruba vidljive lezije, a kod spinocelularnih karcinoma ekscizija je rađena 10 mm od ruba vidljive lezije. Nakon patohistološkog pregleda, rubovi preparata bili su u svim slučajevima uredni. Bolesnici su pra­ćeni od 6 mjeseci do 3 godine i zasad nema recidiva.Fifthy-five patients with malignant epithelial tumors were surgically treated. There were 69% of patients with basal cell carcinoma and 31% with squamous cell carcinoma. Forty-one percent of squamous cell carcinomas were on the lower lip. The majority of the patients were farmers and housewives. The most common localization was the facial area (62%). In all cases, the lesions were smaller than 2 cm. In 73% of the cases, surgical procedure consisted of excision and covering of the defect by a local rotation flap. Surgical treatment according to Karapandžić was performed in five cases, and wedge shaped excision and sutures in two patients with squamous cell carcinoma of the lower lip. In 4 cases of malignant epithelial tumor, excision was performed and the defect covered by a free skin graft matching full depth of the skin. In 15% of the cases, excision of the lesion, accompanied by direct sutures, was performed. In the cases of basal cell carcinoma, excision was performed 5 mm from the edge of the visible lesion. In the cases of squamous cell carcinoma, excision was performed 10 mm from the edge of the visible lesion. Pathohistologic examination showed that the edges of the preparates were clean in all cases. The patients were controlled during a period ranging from 6 months to 3 years. No relapses have been reported to date

Common Bile Duct Obstruction Caused by the Hydatid Daughter Cysts

Echinococcosis is a human parasitary disease. In 2002, 29 new cases of liver echinococcosis were recorded in Croatia. Liver is the most common site of hydatid cysts. Nine patients with echinoccocal liver disease were operated in our department in 2002. Here we present a case where a patient with verified hydatid cyst in the left liver lobe developed high fever, jaundice, nausea, vomiting and pain in the upper abdomen. The symptoms were initially ascribed to the acute cholangitis. After unsuccessful antibiotic treatment, computerized tomography and endoscopic retrograde cholangiopancreatography (ERCP) were performed, demonstrating daughter cysts in the common bile duct. During ERCP, papilotomy was made and daughter cysts were extracted. Hydatid cyst was surgically removed, and a communication between the cyst and left hepatic duct was noted during surgery. Pericystectomy, choledochotomy, removal of remaining daughter cysts from the common bile duct, and sutures of left hepatic duct were performed. The patient recovered fully after the surgery. One of the possible complications of the liver hydatid cysts is the communication between cyst and the biliary tree. Such communications are usually asymptomatic, but symptoms can also mimic acute cholangitis and jaundice, which may lead to the misdiagnosis of the patient’s condition

Bypassing major venous occlusion and duodenal lesions in rats, and therapy with the stable gastric pentadecapeptide BPC 157, L-NAME and L-arginine

AIM: To investigate whether duodenal lesions induced by major venous occlusions can be attenuated by BPC 157 regardless nitric oxide (NO) system involvement. ----- METHODS: Male Wistar rats underwent superior anterior pancreaticoduodenal vein (SAPDV)-ligation and were treated with a bath at the ligated SAPDV site (BPC 157 10 μg, 10 ng/kg per 1 mL bath/rat; L-NAME 5 mg/kg per 1 mL bath/rat; L-arginine 100 mg/kg per 1 mL bath/rat, alone and/or together; or BPC 157 10 μg/kg instilled into the rat stomach, at 1 min ligation-time). We recorded the vessel presentation (filled/appearance or emptied/disappearance) between the 5 arcade vessels arising from the SAPDV on the ventral duodenum side, the inferior anterior pancreaticoduodenal vein (IAPDV) and superior mesenteric vein (SMV) as bypassing vascular pathway to document the duodenal lesions presentation; increased NO- and oxidative stress [malondialdehyde (MDA)]-levels in duodenum. ----- RESULTS: Unlike the severe course in the SAPDV-ligated controls, after BPC 157 application, the rats exhibited strong attenuation of the mucosal lesions and serosal congestion, improved vessel presentation, increased interconnections, increased branching by more than 60% from the initial value, the IAPDV and SMV were not congested. Interestingly, after 5 min and 30 min of L-NAME and L-arginine treatment alone, decreased mucosal and serosal duodenal lesions were observed; their effect was worsened at 24 h, and no effect on the collateral vessels and branching was seen. Together, L-NAME+L-arginine antagonized each other's response, and thus, there was an NO-related effect. With BPC 157, all SAPDV-ligated rats receiving L-NAME and/or L-arginine appeared similar to the rats treated with BPC 157 alone. Also, BPC 157 in SAPDV-ligated rats normalized levels of NO and MDA, two oxidative stress markers, in duodenal tissues. ----- CONCLUSION: BPC 157, rapidly bypassing occlusion, rescued the original duodenal flow through IAPDV to SMV flow, an effect related to the NO system and reduction of free radical formation