BPC 157 therapy to detriment sphincters failure-esophagitis-pancreatitis in rat and acute pancreatitis patients low sphincters pressure.

Possibly, acute esophagitis and pancreatitis cause each other, and we focused on sphincteric failure as the common causative key able to induce either esophagitis and acute pancreatitis or both of them, and thereby investigate the presence of a common therapy nominator. This may be an anti-ulcer pentadecapeptide BPC 157 (tested for inflammatory bowel disease, wound treatment) affecting esophagitis, lower esophageal and pyloric sphincters failure and acute pancreatitis (10 µg/kg, 10 ng/kg intraperitoneally or in drinking water). The esophagitis-sphincter failure procedure (i.e., insertion of the tubes into the sphincters, lower esophageal and pyloric) and acute pancreatitis procedure (i.e., bile duct ligation) were combined in rats. Esophageal manometry was done in acute pancreatitis patients. In rats acute pancreatitis procedure produced also esophagitis and both sphincter failure, decreased pressure 24 h post-surgery. Furthermore, bile duct ligation alone immediately declines the pressure in both sphincters. Vice versa, the esophagitis-sphincter failure procedure alone produced acute pancreatitis. What's more, these lesions (esophagitis, sphincter failure, acute pancreatitis when combined) aggravate each other (tubes into sphincters and ligated bile duct). Counteraction occurred by BPC 157 therapies. In acute pancreatitis patients lower pressure at rest was in both esophageal sphincters in acute pancreatitis patients. We conclude that BPC 157 could cure esophagitis/sphincter/acute pancreatitis healing failure.

Pelvic neurilemmoma.

A case of a 37-year-old man admitted to our Department of Internal Medicine for medical evaluation of hypertension is reported. The patient had a 4-year history of oscillating hypertension prior to admission, however, with no major subjective complaints, except for pollakisuria. Clinical and biochemical assessment revealed no damage to target organs. Laboratory parameters showed normal values, except for hyperlipidemia. On routine ultrasonography of the pelvis confirmed a pelvic tumor of uncertain etiology, with no abdominal lymph node enlargement. No signs of metastasis were found. The patient was transferred to the Department of Surgery, where the tumor was removed in toto. Histopathologic analysis of the tumor, 11 x 8 x 8 cm in size, composed of cellular and mixoid areas with traces of collagenous connective tissue, necrosis, and tiny calcifications with scattered palisading nuclei and Verocay bodies, pointed to the diagnosis of a benign tumor, i.e. neurilemmoma. Postoperatively, the patient's subjective state was excellent, with normal blood pressure values, and without pollakisuria. A very large space-occupying lesion was responsible for compression of the neighboring organs, especially urinary bladder, resulting in pollakisuria. To our knowledge, pelvic localization of neurilemmoma, particularly a large one, is rare.

Fibrin glue-antibiotic mixture in the treatment of anal fistulae: experience with 69 cases.

BACKGROUND/AIMS: To investigate the potential value of the use of the fibrin glue-antibiotic mixture in the treatment of anal fistulae. MATERIALS AND METHODS: This study included 69 patients with idiopathic nonspecific anal fistulae. Patients with IBD (inflammatory bowel disease), TBC, actinomycosis, and cancer were excluded from the study. The microbiological analysis of the discharge of the fistula was done routinely. If there was any doubt about vertical classification of the fistulous tract MR of anal canal was necessary. As regards the vertical disposition, 39 fistulae were classified as intersphincteric and 30 as transsphincteric, and as to the length of the fistulous tract, 24 fistulas had tracts 3.5 cm long. All fistulae were first treated with the lavage of the fistulous tract with antibiotic solution until a sterile microbiological finding was obtained. This was followed by electrocoagulation of the fistulous tract with a special probe for the eradication of granulomatous tissue. Finally the fibrin glue-antibiotic mixture (Tisseel, Immuno Ltd., Vienna, Austria) was applied. RESULTS: After a follow-up of 18-36 months (median 28) 18 patients (26%) had a recurrence; among these, intersphincteric fistula recurred in 9 patients (23%) and transsphincteric also in 9 (30%). Regarding the length of the fistulous tract, a fistula with a 3.5 cm long tract in 5 (11%). CONCLUSION: The analysis showed that the success of the treatment of anal fistulae with fibrin glue-antibiotic mixture was independent of the vertical disposition of the fistula, and was dependent on the length of the fistulous tract. Surgical treatment remains a golden standard for simple fistulae with a tract

Pancreatic head cystadenoma: a case report.

An 18 year-old resident of Zagreb was admitted to our hospital with intermittent pain in the right subcostal region. On examination, a palpable resistance was found in the upper abdomen. After extensive clinical and laboratory tests, a tumor of the pancreatic head, 80-85 mm in diameter, was verified. Cytologically, a diagnosis of microcystic adenoma of the pancreas was established. The patient underwent a cephalic pancreatoduodenectomy with preservation of the pylorus. Six months later the patient was no longer on a diet and, at follow-up, 3 years after surgery, she is symptom-free and feeling well.

Mobile surgical teams of Croatian Special Police Forces: analysis of casualties during combat.

The purpose of this article is to present medical results of mobile surgical teams (MST) supporting units of Croatian Special Police Forces in three attack combat actions. The rate of injury was from 2.0 to 1.3%, Whereas the combat mortality rate was between 0.20 and 0.17%. No postoperative mortality occurred. Heavy injuries were found in 45% of all injured, among them 57% caused by shell fragments. Extremities were involved in 92% of all injuries, whereas 50% were injuries of the calf. All the injured were surgically managed by MST at the site of deployment or in mobile surgical hospitals and evacuated to general hospitals within 12 hours, where 80% of all heavily injured patients underwent additional operations with no postoperative mortality. Eight to 36 months after injury, we found major functional disability in 2% of all injured. NATO schemes served as a basis for the formation of the Croatian war surgical care system with certain modifications dictated by specific situations at the beginning of the aggression against Croatia. MST of Croatian Special Police Force presented second- and third--echelon staged management of the wounded, which was adequate for this type of attack combat situation.