[Non-recurrent laryngeal nerve]. / Nervus laryngeus non-recurrens.

AIMS: The paper draws attention to the importance of rare, but important anatomical variety of nervus laryngeus recurrens, s.c. nervus laryngeus non-recurrens, for making thyroidectomy safely. Possible differences in the course of the nerve and the way of preparing the gland for minimizing the peroperation damage are presented. PATIENTS: Three cases out of 1,200 operations on thyroid gland (0.25%) had the anatomical deviation described. RESULTS: The nerve was saved from peroperation damage in two patients with nervus laryngeus recurrens. The third patient with this deviation ended up with permanent unilateral paralysis of the nerve, which indicated erroneous evaluation of nerve branches. CONCLUSIONS: Possible occurrence of rare varieties of nervus laryngeus recurrens point out necessary routine search and careful dissection during thyroidectomy. The diagnosis of nervus laryngeus non-recurrens is not possible in most cases. This contribution draws attention to basic operation procedures, which protect not only nervus laryngeus recurrens in its typical position, but also its varieties such as nervus laryngeus non-recurrens.

[Detection, identification and visualization of the recurrent laryngeal nerve during thyroidectomy--still a surgical dilemma]. / Hledání, identifikace a vizualizace nervus laryngeus recurrens pri tyreoidektomii--stálé chirurgické dilema.

OBJECTIVE: Based on their on experience the authors express their opinion on routine detection and visualization of the NLR during radical surgery of the thyroid gland. They describe standard and alternative steps of surgery leading to protection of the recurrent nerve. MATERIAL AND METHODS: The authors evaluated a group of 735 patients operated during the last thirty nine months which comprised 87% total thyroidectomies, 11.6% total lobectomies, the remainder were almost total operations. The number of visualized nerves was 1367. RESULTS: Unilateral temporary damage of the NLR leading to temporary pareses of the vocal cords was recorded in 19 patients, i.e. 1.39%, bilateral transient paresis in one case, i.e. 0.07%. Permanent damage of one vocal cord after severing of the NLR occurred in 11 patients, i.e. 0.8%, bilateral lesions of the vocal cords were not recorded. CONCLUSION: There are no extensive statistics of thyroid operations without reports on damage of the NLR. With the increasing number of radical operations of the gland also the number of departments increased which recommend unequivocally to seek and visualize the NLR. The authors results support this point of view. They use most frequently a modification of Wang's method and consider as the smallest extent of visualization of the NLR the distance between the branching of the inferior thyroid artery and the entry of the NLR into the larynx.

Factors affecting the mating competence in the unicellular green alga Chlamydomonas eugametos (Volvocales).

Routinely prepared gametes (by flooding 3 week-old agar cultures) showed about 80% mating competence if the opposite sexual partners were mixed together. The mating competence exhibited a strict dependence on the composition of the solution in which the cells were suspended before mixing; it decreased progressively with increasing concentration of nitrates. In contrast, no inhibiting effect was found if urea was used as the source of nitrogen. Other ions present in nutrient media did not show any effect. Mating activity varied according to the spectral composition of light, being higher with a blue light than with a red one. Blue light caused accumulation of vis-à-vis pairs, which were blocked to form zygotes. Freshly released daughter cells in vegetatively grown synchronous cultures had a dual nature--vegetative and sexual one. In these daughter cells, similar rules were found for governing of mating competence to those valid for standard gametes obtained from flooded agar cultures. High mating competence was found in daughter cells released the during dark period in distilled water, nitrate-free media, in the presence of Mg2+ or Ca2+ ions, or in media containing urea. The conditions during which daughter cells are released and the conditions under which they mate can be considered crucial for expression of gametic nature as a mating competence.

[Primary retroperitoneal seminoma]. / Primární retroperitoneální seminom.

The case-history presents a case of a rare retroperitoneal tumour--primary retroperitoneal classical seminoma. This type of tumour accounts for half the extragonadal germinal tumours. From the clinical aspect this group is important as in addition to surgery it can be successfully treated by chemotherapy and radiation. The clinical findings in the authors' patient led to the diagnosis of a retroperitoneal tumour and after repeated examinations the authors concluded on the presence of some form of malignant mesenchymal tumour. A more aggressive surgical procedure implies radical removal of the tumour, and treatment was, based on the final histological diagnosis, supplemented by chemotherapy. Despite the favourable diagnosis of seminomas, we have to foresee in case of a primary tumour in the retroperitoneum a poorer prognosis (sometimes by as much as 50%) and despite all conclusions attention should be devoted to a possible late development a testicular tumour.

[Spontaneous bacterial peritonitis: studies of the incidence and clinical and laboratory chemical parameters]. / Spontane bakterielle Peritonitis: Untersuchungen zur Inzidenz sowie zu klinischen und laborchemischen Parametern.

In a prospective study on 151 patients with cirrhosis of the liver we found 9 episodes of spontaneous bacterial peritonitis (SBP) in 8 patients (5.3% of the whole population or 18% of the ascitic patients). There was a clear difference in WBC-count, polymorphonuclear cell count, LDH and lactate in the ascitic fluid between SBP and controls. Clinical symptoms were discrete. 6 of 8 patients had an advanced form of cirrhosis belonging to Child-grade C. Half of patients died. The clinical situation of the 4 survivors improved after antibiotic treatment. Ascitic analysis of WBC and PMC-count in combination with LDH and lactate may reveal SBP as the reason of fever or clinical impairment in cirrhotics.

[Postprandial delay of drug absorption in a gitoformate model]. / Postprandiale Resorptionsverzögerung von Pharmaka am Modell des Gitoformat.

Oral absorption of gitoformate (Dynocard), a non-renal-dependent cardiac glycoside, was investigated in 8 healthy subjects aged 23-45 years. Plasma concentration-time profiles were obtained once following a 12-h period of fasting, then after intake of a standard high protein meal. The half-life of absorption t1/2a, Cmax and tmax, half-life of elimination t1/2z, and area under the curve (AUC) were compared to evaluate the influence on the bioavailability of gitoformate. t1/2a in the fasting condition (0.36 +/- 0.43 h) is increased when gitoformate is applied after a high protein meal 1.12 +/- 1.12 h). Correspondingly, fasting maximum concentrations are already achieved after 1.4 +/- 1.2 h, but only after 4.8 +/- 1.8 h following the intake of a standard meal. Comparison of AUC (0-168 h) showed that the bioavailability was reduced by 25% after meals.