[Complete minimally invasive Ivor-Lewis esophageal resection]. / Kompletní miniinvazivní Ivor-Lewisova resekce jícnu.

INTRODUCTION: Minimally invasive esophagectomy is becoming a standard procedure in the treatment of esophageal cancer. We would like to present our experience with Ivor Lewis esophagectomy completed by minimally invasive technique. METHODS: The primary aim of the study was to analyse potential technical difficulties and intraoperative complications of thoracolaparoscopic Ivor Lewis esophagectomy with intrathoracic anastomosis. A secondary aim of the study was to evaluate postoperative complications according to the Clavien-Dindo classification. The inclusion criterion for the study was a history of thoracolaparoscopic esophagectomy. Multidisciplinary approach was employed in the diagnosis, surgery indications and perioperative care of all patients. RESULTS: Between January 2011 and January 2016, 19 patients underwent completely minimally invasive esophagectomy with intrathoracic anastomosis. There were 13 men and 6 women. Adenocarcinoma was confirmed by histopathological examination in all the patients. The cumulative postoperative morbidity was 68.4%. According to the Clavien-Dindo classification, we recorded grade I complications in 10.5% of the patients, grade II in 15.8%, grade III in 36.8% and grade IV in 5.3% of the patients. Anastomotic leak was the most serious complication; it was initially managed by negative pressure (vacuum) therapy followed by stent implantation. Postoperative mortality was 0%. Mean hospital stay was 12 days and mean stay at intensive care unit was 3.6 days. CONCLUSIONS: The basic oncosurgical principles of radicality need to be respected during minimally invasive procedures. However, functionality, safety, and cost effectiveness have to be preserved as well. In this paper, we present thoracolaparoscopic Ivor Lewis esophagectomy as one of feasible and accessible options of intrathoracic anastomosis. It seems to be safe with respect to technical obstacles, short-term and long-term complications.Key words: esophagectomy - intrathoracic - anastomosis - laparoscopy - thoracoscopy.

Do we really apply fast-track surgery?

AIM: The aim of this study is to show the current view on fast-track programs optimizing the perioperative care. METHODS: Authors searched Medline databases and identified current trials regarding all factors of fast-track programs. They analyzed these trials and identified the most important principles of fast-track programs based on trial analysis. RESULTS: The most important principles are consistent in all individual trials. Most of authors recommend 10-12 issues. All authors emphasize early mobilization of patients after surgery and early introduction of peroral nutrition. Fast-track programs shorten the duration of hospitalisation and decrease morbidity. CONCLUSION: The perioperative care is characterized by a range of trussing traditions. Fast-track surgery optimizes the perioperative care. It is a safe method according to the trials. The implementation of single fast-track surgery factors is very slow (Tab. 2, Ref. 49).

Treitz's hernia.

Treitz's hernia is the eponymous name for a paraduodenal hernia. These are rare hernias that arise in the potential spaces and folds of the posterior parietal peritoneum adjacent to the ligament of Treitz. Presentation may be acute with small bowel obstruction or bowel ischaemia, or with chronic intermittent abdominal pain. Treatment is by surgery, due to the high (50%) lifetime risk of obstruction. Here, we present two cases from our own institution and review the literature regarding the embryology, anatomy, cross-sectional imaging and surgery of these fascinating hernias.

[Laparoscopic total gastrectomy--initial experience]. / Laparoskopická totální gastrektomie--nase první zkusenosti.

The advantages of mini-invasive procedures have been demonstrated in various surgical interventions. The aim of the authors was to describe, on the basis of their own experience obtained in a group of seven patients, the operation procedure of laparoscopic total gastrectomy, to discuss the advantages and to present their initial experience.

Mathematics achievement of children in China and the United States.

First and fifth graders in Beijing and Chicago were given a battery of mathematics test. Whether tested with problems requiring solely computation or with ones requiring application of knowledge about mathematics, American children's performance was consistently inferior to that of Chinese children. Interviews with American children suggested that they like mathematics, believe they are doing well in mathematics, and do not perceive mathematics as a difficult subject. American children's poor performance appears to be attributable, in part, to low motivation for devoting more attention to mathematics. Low standards held by American parents for academic achievement and lower interest in teaching mathematics by American teachers appear to contribute to American children's poor performance.

Mathematics classrooms in Japan, Taiwan, and the United States.

Observations were conducted in Chinese, Japanese, and American classrooms during mathematics classes. Activities in 20 representative classrooms were observed in each of 2 grades (1 and 5) and in each country. Some observations focused on individual children and others on the teachers. Large cross-cultural differences were found in many variables related to classroom structure and management. These differences paralleled differences in achievement in mathematics among the 3 countries. A number of these variables also were significantly related to average level of mathematics achievement within the American classrooms.

Mathematics achievement of Chinese, Japanese, and American children.

American kindergarten children lag behind Japanese children in their understanding of mathematics; by fifth grade they are surpassed by both Japanese and Chinese children. Efforts to isolate bases for these differences involved testing children on other achievement and cognitive tasks, interviewing mothers and teachers, and observing children in their classrooms. Cognitive abilities of children in the three countries are similar, but large differences exist in the children's life in school, the attitudes and beliefs of their mothers, and the involvement of both parents and children in schoolwork.

Cognitive performance and academic achievement of Japanese, Chinese, and American children.

Chinese, Japanese, and American children at grades 1 and 5 were given a battery of 10 cognitive tasks and tests of achievement in reading and mathematics. Samples consisted of 240 children in each grade in each culture. 2 major purposes of the study were to determine possible differences in cognitive abilities of Japanese, Chinese, and American children and to investigate the possible differential relation of scores on cognitive tasks to reading by children of the 3 cultures. Similarity was found among children of the 3 cultures in level, variability, and structure of cognitive abilities. Chinese children surpassed Japanese and American children in reading scores; both Chinese and Japanese children obtained higher scores in mathematics than the American children. Prediction of achievement scores from the cognitive tasks showed few differential effects among children of the 3 cultures. The results suggest that the high achievement of Chinese and Japanese children cannot be attributed to higher intellectual abilities, but must be related to their experiences at home and at school.

Reading disabilities: the case of Chinese, Japanese, and English.

A common hypothesis has considered apparent differences in the incidence of reading disability in Asian and Western languages to be related to orthographic factors. A reading test was constructed in English, Japanese, and Chinese to assess the validity of this proposal. Large samples of fifth-grade children in Japan, Taiwan, and the United States were given the test and a battery of 10 cognitive tasks. Strong evidence was found that reading disabilities exist among Chinese and Japanese as well as among American children. In discriminating between groups of poor and average readers by means of the cognitive tasks, the combined effects of general information and verbal memory proved to be the most powerful predictors in Japan and Taiwan. General information and coding emerged as the most effective predictors for American children. The results cast doubt upon the crucial significance of orthography as the major factor determining the incidence of reading disabilities across cultures.

Effect of PGE1 on PGF2 alpha-induced luteolysis in nonbred ewes.

Fifty-six ewes were used to study the effects of PGE1 or PGE2 plus PGF2 alpha given into the perivascular space of the ovarian vascular pedicle on luteal function of nonbred ewes. All ewes receiving PGF2 alpha had reduced levels of plasma progesterone and unoccupied receptors for LH at 24 hr after treatment regardless even if they received PGE1 or PGE2 concomitantly. Levels of plasma progesterone in ewes receiving only PGF2 apha were reduced further at 48 hour. Plasma progesterone and unoccupied receptors for LH of ewes receiving PGE2 + PGF2 alpha were maintained at 48 hr at levels seen at 24 hr after treatment, while progesterone in ewes receiving PGE1 + PGF2 alpha at 48 hr returned to levels seen in controls at 48 hr and unoccupied receptors for LH were three fold greater than controls.

The temperamental characteristics of Chinese babies.

This paper investigates the usefulness of Carey's Revised Infant Temperament Questionnaire in the Chinese culture and uses the questionnaire to assess the temperamental characteristics of Chinese babies. The revised questionnaire was administered to the mothers of 349 4--8-year-old infants in Taipei, Taiwan. The face validity of the questionnaire was supported within the different context: the distribution of scores was normal, and the mothers had no trouble in answering the questions. While the general pattern of results was similar to those found in Carey's American sample, differences were found, which may be interpreted in terms of response biases, racial differences, or a combination of these 2 factors. The data are analyzed for possible effects of sex and socioeconomic status, and these findings are in turn compared to results of American studies. Observational studies are seen as necessary in the future to understand the nature of cultural differences in temperament. Follow-up studies will examine the different ways a given temperamental characteristic may be responded to by different cultural environments.