[A new indication for transcutaneous cholangioscopy]. / Nová indikace transkutánní cholangioskopie.

The main indication for transcutaneous cholangioscopy through a channel of percutaneous transhepatic drainage are choledocholithiasis, hepatolithiasis and non-malignant or malignant stenosis of the bile ducts. In our department we were able to treat thus repeatedly also complete severing of the biliary pathways. GROUP: Twelve patients with complete severing of the right hepatic ducts (4x) or common bile duct (8x) after cholecystectomy could not be operated on account of great surgical risk or adhesions after operation. On account of cholangitis they had percutaneous transhepatic drainage. After three weeks transcutaneous cholangioscopy was performed and recanalization by means of a needle-shaped knife. The operation was terminated by introduction of a metal prosthesis Palmaz. RESULTS: The method was successful in all patients, there were no complications associated with the procedure. CONCLUSION: Transcutaneous cholangioscopy and recanalization of complete severing of the biliary pathways is a new safe method. It is indicated in patients with increased surgical risk. For restoration of the continuity of the bile ducts a metal prosthesis Palmaz is inserted. Short-term results of treatment are satisfactors, long-term results call for a longer follow up.

[Aggressive angiomyxoma of the female pelvis and perineum, M-8841/1]. / Agresivní angiomyxom zenské pánve a perinea M-8841/1.

Aggressive angiomyxoma of pelvis and perineum was identified in two women (of 31 and 53). Its site was in the right fossa ischiorectalis and vulva. There was not observed any relaps in 60 and/or 9 months after surgery. Amorphous tumour mass was soft with finger-like projections. Spindle and starshaped tumour cells were spread in a loose edematous myxoid vascularized stroma; they had a benign character lacking of mitoses and nuclear atypia. Myxoid stroma could be stained rather faintly with Alcian blue at pH 1. Dilated capillaries, veins and arterioles were a substantial component of the tumour. Nerve and muscle fibres and their fragments were included here and there in the tumour. Tumour cells had a fibroblast ultrastructure which was supported by immunohistology. Discussion comprised differential diagnosis of myxoma, myxoid liposarcoma and myxoid type malignant fibrous histiocytoma among others.

[Percutaneous transhepatic drainage of the bile ducts]. / Perkutánní transhepatální drenáz zlucových cest.

Percutaneous transhepatic biliary duct drainage followed in nearly one quarter of the group of patients with percutaneous transhepatic cholangiography for malignant and non-malignant diseases. A total of 147 drainage operations were performed, thereof 126 (85.7%) successful ones. Drain was successfully introduced in 96 (88.2%) out of 107 patients. In 78 patients, successful or unsuccessful attempts were made once, in 19 cases drainage was performed twice, and in 9 cases three attempts were made. In 1 female patient the attempt had to be repeated 4 times. There were 11 cases of complication in connection with the puncture proper (7.5%), 2 cases required emergency laparotomy, the rest were handled conservatively. There was no lethal complication. In one quarter of the drains introduced, complete loss of function occurred in the course of drainage (slipped-out drain, block). Septic complications threatened unless drainage was restored in time. Proper management of the catheter in place is crucial for the uncomplicated course of drainage. Also important are the patient's cooperation and the nursing personnel's experience. Internal drainage was used in 15 cases. An endoprosthesis was introduced transcutaneously in 1 case. The longest functional drainage ina case of malignant involvement lasted 288 days, in a non-malignant case 330 days and for the next 334 days endoprosthesis was introduced. The average quantity of bile was 1,009 ml/24 hrs. in malignant cases, and 644 ml/24 hrs. in non-malignant cases. The average period of time from the introduction of drainage until surgical operation was 18 days in malignant cases, 11 days in non-malignant cases.(ABSTRACT TRUNCATED AT 250 WORDS)

[Implantation of a bile duct prosthesis through the skin and liver]. / Zavedení náhrady zlucové cévky pres kuzi a játra.

The author presents a brief account on the non-surgical treatment of obstructive jaundice by transcutaneous insertion of a duodenobiliary endoprosthesis. He describes the case of a patient with obstruction of the biliary pathways which could not be treated by surgery where external drainage was used with transcutaneous extraction of concrements and transcutaneous insertion of a duodenobiliary endoprosthesis.

[Zinc metabolism in the mother during pregnancy and the birth weight of the infant]. / Metabolismus zinku matky behem gravidity a porodní hmotnost dítete.

The authors found only an insignificant reduction of the zinc content of leucocytes of pregnant women who were delivered of infants with low birth weights (2500 g). In the remaining women the Zn content of leucocytes did not differ from those in the control group. The plasma Zn concentration was in the IIIrd trimester significantly lower, as compared with the control group and as compared with values assessed during the IInd trimester of pregnancy. The assembled results suggest that in our population in the course of pregnancy Zn deficiency which could retard intrauterine development and cause a reduced birth weight, does not develop.

Recognition of maternal axillary odors by infants.

A series of 5 experiments was conducted to determine whether neonates, at approximately 2 weeks of age, can recognize their parents through axillary odors alone. Breast-feeding infants discriminated between their mother's axillary odor and odors produced by either nonparturient or unfamiliar lactating females. In contrast, breast-feeding infants displayed no evidence of recognizing the axillary odors of their father. Likewise, bottle-feeding infants appeared unable to recognize the odor of their mother when presented along with odors from a nonparturient female or an unfamiliar bottle-feeding female. Several hypotheses were presented in an attempt to account for the differential reactions to maternal odors by breast-feeding versus bottle-feeding infants. It was tentatively concluded that, while breast-feeding, infants are exposed to salient maternal odors and thereby rapidly become familiarized with their mother's unique olfactory signature.

Odor signatures and kin recognition.

The basis of olfactory signatures mediating human kin recognition was investigated in two experiments. The odors of mothers and offspring were correctly matched (by subjects unfamiliar with the stimulus individuals) at a greater than chance frequency. In contrast, subjects were not able reliably to match the odors of husbands and wives. These data support the hypotheses that characteristic individuals odors are genetically mediated and that kin recognition should be facilitated by the similarity of such familiar odors among close relatives.

Recognition of neonates by facial-visual characteristics.

A series of experiments investigated the salience of newborn infants' facial-visual features for recognition and sex identification. Within 33 hours post-partum, mothers recognized photographs of their own offspring when presented with those of unrelated neonates. Furthermore, adult subjects were able to match photographs of unfamiliar mothers and their infants, and determine the sex of neonates, at a greater than chance level of accuracy. Although recognizable facial features are presumably genetically determined, maternal recognition of offspring probably results from brief exposure and familiarization as well as physical resemblance between the infant and other familiar family members, including the mother herself.

Maternal recognition of neonates through olfactory cues.

The role of olfactory cues in maternal recognition of neonates was investigated. Mothers were able to identify the garments worn by their own infants (in comparison to garments worn by unfamiliar infants) through odor alone within the first 6 days postpartum. In a second experiment, mothers who had only limited pre-test exposure to their infants recognized the odor of their infant's garment during tests conducted at 20.5-41.7 hr after delivery. Olfaction may be an especially salient modality for recognition of infants.