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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.

Purpose: To evaluate the technical feasibility and efficacy of endovascular brachytherapy for prophylaxis of restenosis after femoropopliteal percutaneous transluminal angioplasty (PTA)., Materials and Methods: Ten patients with recurrence of stenosis in the femoropopliteal region underwent PTA followed by endovascular irradiation with Iridium-192 a high-dose rate after-loading technique. We used a single fraction of dose 12 Gy given in 3 mm from the source axis in the stenotic vessel segment., Results: During follow-up of 59-580 days restenosis occurred in four patients 111, 460, 472 and 580 days after irradiation. All other patients are without restenosis. No radiation-associated side effects were observed., Conclusions: Endovascular brachytherapy of restenosis in the femoropopliteal region is technically feasible, and may be done as a part of the PTA. These encouraging results open the possibility of reduction of restenosis by the present method.

The karyotype of a European bird nasal schistosome, Trichobilharzia regenti Horák, Kolárová et Dvofák, 1998, was determined. The chromosome set comprises eight pairs, seven of which are autosomes and one sex pair consisting of ZZ in males and ZW in females. The Z is the largest chromosome of the set, having a submeta-metacentric location of centromere, while the W is a small metacentric chromosome. More than 60% of the analyzed cells originating from both male and female sporocysts contained one or two small submetacentric supernumerary B chromosomes, occurring more frequently in female than in male cells. The formula of the karyotype structure is 2n = 16 + (B), n=5m+1sm-m+ 1sm+Zsm-m/Wm+(Bsm). The C-banding method revealed small pericentric heterochromatin blocks in the sex chromosome Z and all autosomes, except pairs 5 and 6. Satellited pair 5 showed a distinct terminal band representing the nucleolar organizer. Both the W and B chromosomes contained conspicuous heterochromatin blocks at the long arm adjacent to the centromere. The currently described supernumerary chromosomes in T. regenti represent the first record of B chromosomes within the family Schistosomatidae.

Presence of functional immune system is critical for any attempt aimed at improving survival of breast cancer patients by strategies based on immune system manipulation. We evaluated by flow cytometry the phenotype of peripheral blood leukocyte of 43 breast cancer patients. In 11 patients, the phenotype was evaluated before and during the chemotherapy by combination of doxorubicin and paclitaxel (AT). Compared with controls breast cancer patients had significantly higher relative and absolute numbers of CD3 HLA-DR+, CD3+CD69+ and CD14+CD16+, and significantly lower percentages of CD3 and CD8+CD28+ cells. After one cycle of AT, the absolute numbers of CD3 , CD3+CD4+, CD3+CD8+ and CD8+CD28+ cells increased significantly. Present data show a presence of T-cell activation in breast cancer patients. Administration of AT may lead to an increase in functional T-cells in peripheral blood, indicating a potential for combining chemotherapy with immunotherapy in the treatment of breast cancer patients.

Background: Incorporation of doxorubicin hydrochloride into pegylated liposomes (PLD) may decrease chemotherapy side effects and increase the activity. Hyperthermia could further potentiate its effectiveness., Case Report: A patient with skin metastases of breast carcinoma was treated with intravenous infusion of PLD (Caelyx) in combination with ultrasound hyperthermia. Each cycle consisted of infusion of 40 mg PLD absolute dose, followed by 2 fractions of hyperthermia 41-43 degrees C for 45 min 1 and 48 h after infusion. A complete remission was observed after the combination treatment with no significant toxicity., Conclusion: Present observations suggest that the combination of PLD with hyperthermia of skin metastases of breast carcinoma may be an active and well tolerated treatment., (Copyright 2001 S. Karger GmbH, Freiburg)

The genotypes of growth hormone gene polymorphisms (GH-DdeI, GH-MspI, GH-HaeII, GH-ApaI, GH-CfoI) were determined in 78 pigs [Czech Large White sires (CLWsire line) x Polish Large White (PLW) sows, Polish Large White sires x Polish Large White sows], by the PCR-RFLP method. Preliminary studies found only GH DdeI polymorphism to be associated with performance traits. The associations of this polymorphism with growth and carcass traits were investigated. The linear model included the effects of candidate genes, genetic groups, sex and linear covariables of age at slaughter and body weight at weaning. The DdeI polymorphism of the GH gene showed associations with carcass length (P

Purpose: To evaluate the technical feasibility and efficacy of endovascular brachytherapy with Iridium-192 in the prevention of restenosis caused by neointimal hyperplasia of transjugular intrahepatic portosystemic shunt (TIPS).Materials and Methods: The endovascular brachytherapy with high dose rate automatic afterloading system was performed in six patients with recurrent of stenosis of TIPS. We used a single dose fraction of 12 Gy delivered at 3 millimeter (mm) from the source axis to the stenotic vessel segment in five patients with spiral Z-stent, and 15 Gy at 5 mm in one patient with Wallstent.Results: Follow-up time ranged from 148 to 639 days. In one patient, restenosis occurred in the treated vessel segment, diagnosed 71 days after endovascular brachytherapy by doppler ultrasound. All other patients were, during the follow-up time, without restenosis in the irradiated vessel segment. Radiation-associated side effects were not observed.Conclusions: Endovascular brachytherapy of TIPS is technically feasible and may be done as a part of the percutaneous revision of the shunt. This pilot study may be the largest experience of treating TIPS restenosis in humans to date. For definitive conclusions, a lot of studies are needed.

The authors assessed serum copper and lipoprotein concentrations in a group of 67 patients hospitalized successively at the cardiological department. During hospitalization they were subjected to selective coronarography with assessment of the angiographic score. In 35 patients the angiographic examination was made during the chronic stage of IHD (group A), in 32 patients it was indicated on account of acute coronary syndrome (group B). The authors found that serum copper concentrations are significantly higher in patients with acute forms of IHD (group B, p < 0.001). Serum copper concentrations do not correlate significantly with lipoprotein concentrations nor with the extent of coronary atheroclerosis (angiographic score).

Surgical extraction of the submascular neovascular membrane (SNM) is one of the new indications for surgery of the macula. The functional results after surgical extraction of the SNM depend on the state of the submascular pigmented epithelium and neuroepithelium which is, last not least, conditioned by the etiology of SNM. The majority of SNM in age-related macular degenerations has a poor prognosis, These SNM are as a rule nourished from several vascular sources and markedly destroy the pigmented epithelium because they penetrate beneath and above it. The authors evaluate in the submitted paper the results of surgical removal of the SNM in two eyes of two patients with age-related macular degeneration. Despite the relatively favourable juxtafoveal localization of the membrane, a non-complicated course of the operation and postoperative course the functional result of the operation in the two eyes was not very satisfactory. Chorioretinal scars with extensive defects of the pigmented epithelium in the region of the macula were the cause of a decline of visual acuity to a level which however could be hardly preserved by a conservative procedure.

Recombination of chromosomes 3A(m) and 5A(m) of Triticum monococcum with closely homeologous chromosomes 3A and 5A of T. aestivum was compared with recombination across corresponding homologous chromosome pairs. Differentiation between the homeologues impacted recombination in the proximal regions of the long arms the most and in the distal regions of the long arms the least. It is concluded that this variation principally reflects allocation of multiple crossovers across an arm and positive crossover interference across chromosome arms. Recombination rates between homeologous chromosomes 5A(m) and 5A differed in the opposite sexes.

Purpose: To evaluate the technical feasibility and efficacy of endovascular brachytherapy with Iridium-192 in the prevention of restenosis caused by neointimal hyperplasia of transjugular intrahepatic portosystemic shunt (TIPS)., Materials and Methods: The endovascular brachytherapy with high dose rate automatic afterloading system was performed in six patients with recurrent of stenosis of TIPS. We used a single dose fraction of 12 Gy delivered at 3 millimeter (mm) from the source axis to the stenotic vessel segment in five patients with spiral Z-stent, and 15 Gy at 5 mm in one patient with Wallstent., Results: Follow-up time ranged from 148 to 639 days. In one patient, restenosis occurred in the treated vessel segment, diagnosed 71 days after endovascular brachytherapy by doppler ultrasound. All other patients were, during the follow-up time, without restenosis in the irradiated vessel segment. Radiation-associated side effects were not observed., Conclusions: Endovascular brachytherapy of TIPS is technically feasible and may be done as a part of the percutaneous revision of the shunt. This pilot study may be the largest experience of treating TIPS restenosis in humans to date. For definitive conclusions, a lot of studies are needed.

The development of nasal avian schistosomes of the genus Trichobilharzia in their final host is poorly known. Therefore, an experimental infection of ducklings (Anas platyrhynchos f. dom.) by T. regenti was performed. The infection resulted in leg paralysis and orientation/balance disorders of birds. The examination of the duck's spinal cord and brain confirmed the presence of developing parasites in pre-patent as well as patent periods. The absence of the worms in other tissues strongly supports our hypothesis that the parasite migrates through the central nervous system (CNS) to its final location in bird nasal mucosa. The injury level is probably dependent on number of parasites as well as yet unknown host factors. The affinity to the CNS seems to be high; also by exposure of experimental animals to low cercarial doses the growing worms in the CNS were found. In addition to the generally accepted view that bird schistosomes may cause cercarial dermatitis of mammals (including man), there is evidence of a partial development of T. regenti in mouse CNS; in certain cases leg paralysis was also recorded. Therefore, the pathogenesis spectrum caused by bird schistosomes in birds/mammals needs to be reconsidered.

Based on 22-year experience with surgery of 2107 benign thyroid tumours and data in the literature the authors evaluate some controversial problems from this sphere of thyrology pertaining to the definition and classification of benign tumours, their diagnosis, treatment and subsequent follow-up. Modern diagnostic procedures indicate that the actual number of true benign tumours is smaller than reported in some statistics and the assumption of monoclonal development of tumours is one of the most fundamental characteristics. The authors consider total lobectomy as minimal surgery, in case of uncertainty as regards possible malignancy further procedures depend on final histological examination. If the final finding alters the diagnosis from an originally benign tumour to a malignant one, the authors recommend a two-stage procedure to implement total thyroidectomy. In the authors' opinion total lobectomy is sufficient also in some variants of follicular adenoma--Hürtle's adenoma or atypical adenoma. Then however subsequent dispensarization is essential. After a partial operation (lobectomy) it is important to ensure substitution with thyroid hormones to suppress the function of TSH.

The authors evaluate their experience with malignant lymphomas of the thyroid gland, recorded in 22 patients from a total of 4501 operated on account of thyroid diseases in the course of 22 years. Although thyroid lymphomas are rare, their number is increasing. In localized findings curative procedures can be used, possibly supplemented by operations of the lymph nodes. The method of choice is still radiotherapy and surgery, in particular in lesions restricted to the thyroid gland. The role of chemotherapy is still controversial.

The overall frequency of troublesome neck pain is estimated to be approximately 34%, and it was observed that the frequency of complaints lasting 1 month or longer was higher in women than in men. The prevalence increased with age with regard to both pain duration and chronic pain. A total of approximately 14% of a randomly selected population meets the criteria for chronic neck pain, with complaints lasting for more than 6 months. It could be that the structural transformation of the intervertebral disc, the uncovertebral processes, and the zygapophyseal joints is a process accompanied by disturbed function, ultimately inducing pain. For diagnosis of radicular and myelopathic syndromes, the physical and neurologic examination is enhanced by neurophysiologic assessment. Electromyography, performed with needle electrodes, is the oldest method to diagnose nerve root compression syndromes and is claimed to have no false positive results. Electromyography for radiculopathy is justified if clinical symptoms, such as muscular weakness, don't correlate with clinical findings (diminished or absent reflex), or for documentation of muscle activity if difficult decompressive surgery is expected. For diagnosis of cervical myelopathy by routine examination, the sensory evoked potentials by stimulation of tibial nerve as well as motor evoked potentials from upper and lower extremities are recommended because clinically "silent" myelopathy can be verified by abnormalities in evoked potentials. During history taking, the symptoms possibly attributed to radiculopathy or myelopathy should be differentiated from primary systemic neurologic disorders such as shoulder angiotrophy ("plexus neuritis"), multiple sclerosis, amyotrophic laterals sclerosis, and peripheral neuropathy. The assessment of range of motion, the functional status of shoulder and neck muscles, and palpatory examination of soft tissue is widely used to determine non-operative therapeutic procedures. However, scientifically, the validity of the different testing procedures has not been evaluated satisfactorily.

Members of the genus Trichobilharzia are parasitic in visceral or nasal body parts of their avian hosts. The examination of water snails in South Bohemia revealed a schistosome infection in Radix peregra snails. The experimental infection of ducklings (Anas platyrhynchos, Cairina moschata) confirmed that a new Trichobilharzia species--T. regenti n. sp.--was found. The adults, eggs and larvae (miracidia and cercariae) of the species were morphologically characterized. The adult occupy the nasal blood vessels where they lay the eggs; the miracidia hatch from the eggs directly in the tissue and leave the host during drinking/feeding of the infected birds.

The article has discoursed of a diagnosis and a therapy of bleeding peptic ulcer. There has been used the group of the patients admitted at The Surgical Unit of The Faculty Hospital Motol in Prague during two and half years. Urgent endoscopy and endoscopic treatment of indicated findings have been performed as a common procedures. The surgical therapy has been necessary for the part of this patients. Operation's indications, types of the operations and their timing have been discussed.

Among 35 patients with the preoperative diagnosis of a tumour of the head of the pancreas who had a radical operation at the Surgical Clinic of the Second Medical Faculty Charles University in Prague-Motol between January 1995 and March 1998 a malignant tumour was confirmed in 24 instances. Another nine patients had a histological finding of chronic pancreatitis and the remaining two patients a benign cystadenoma of the pancreas. The 30-day mortality in the whole group is 5.7% (2/35). Both deaths within 30 days after surgery were due to massive haemorrhage into the upper GIT in patients with pancreatic cancer. The haemorrhage developed within 21 and 30 days after surgery. The source of haemorrhage was not proved unequivocally, neither clinically nor post mortem. Obviously late haemorrhage from some gastrointestinal anastomosis was involved. From a total of 24 patients after Whipple's operation on account of a malignant tumour of the head of the pancreas nine died. The mean survival period was seven months after surgery. Fifteen patients survive and after a mean follow-up period of 14 months the median of survival calculated to the date of March 31 1998 is 17 months for stage UICC I and five months for stage UICC III. Because of the short follow-up period the results cannot be compared properly with data in the contemporary literature but they are promising for further work in this sphere of surgery and evidence that it is correct to refute the nihilist view held in the past. Hitherto achieved therapeutic results in this country and abroad certainly do not justify yet an optimistic view as regards the perspective of patients with carcinoma of the pancreas.

The authors analyze the possibility to reduce the number of reoperations of the thyroid gland, based on a group of thyroid operations performed at the Surgical Clinic of the Second Medical Faculty Charles University and Faculty Hospital Motol during the 22-year period from 1975-1997. 507 reoperations from a total number of 4501 thyroid operations amount to 11.3%. In the authors opinion correct indication of the operation is most important as well as the correct extent and technique of the primary operation. The achieved results are except for unilateral temporary lesions of the NLR comparable with primary operations.

Homeologous wheat chromosome arms that differ by the presence or absence of a Nor locus or greatly differ in the numbers of copies of rRNA genes per Nor locus show conspicuous differences in the distribution of recombination. To assess directly the position effects of Nor loci on recombination across chromosome arms, a Triticum monococcum Nor9 haplotype was substituted for Triticum aestivum Nor9 haplotypes on two T. aestivum 1A chromosomes in the isogenic background of cv Chinese Spring. The numbers of rRNA genes in the 1A Nor9 haplotypes are greatly reduced relative to the T. monococcum haplotype. The substitution resulted in reduced recombination rate in the vicinity of the Nor9 locus. An intra-arm compensatory increase was observed in the proximal region of the arm so that the genetic length of the chromosome arm was unchanged. These findings suggest that Nor loci suppress recombination in their vicinity and change recombination patterns in Nor-bearing chromosome arms.

RFLP was investigated at 52 single-copy gene loci among six species of Aegilops, including both cross-fertilizing and self-fertilizing species. Average gene diversity (H) was found to correlate with the level of outcrossing. No relationship was found between H and the phylogenetic status of a species. In all six species, the level of RFLP at a locus was a function of the position of the locus on the chromosome and the recombination rate in the neighborhood of the locus. Loci in the proximal chromosome regions, which show greatly reduced recombination rates relative to the distal regions, were significantly less variable than loci in the distal chromosome regions in all six species. Variation in recombination rates was also reflected in the haplotype divergence between closely related species; loci in the chromosome regions with low recombination rates were found to be diverged less than those in the chromosome regions with high recombination rates. This relationship was not found among the more distantly related species.

Leuzea carthamoides (WILLD.) DC., Asteraceae, has become an important taxon usable in human practice and animal production in recent years. Originally an endemic plant of southern Siberia, now it is widely grown not only in the Union of Independent States, once the original region of introduction, but also in central and eastern Europe. The principal constituents of the whole plant are ecdysteroids (5 beta-cholest-6-on-7-ene derivatives) and flavonoids. In addition, the aerial part contains sesquiterpenic lactones of the guajanolide type, and the roots contain polyines (on the thiophene base). The present paper comprehensively discusses the occurrence, content and biological activity of these substances, the preparations manufactured from the plant, their use in therapeutic practice, food manufacture and animal production in the world and the Czech Republic. The plant has certainly become a taxon with prospects in the Czech Republic, particularly as the source of 20-hydroxyecdysone, which is getting into the limelight in the world.

Study Design: This study investigated the changes in the lumbar muscles after posterior fusion of the lumbar spine and the potential correlation between muscular changes and the persistence of low back pain., Objectives: To evaluate prospectively the effect of the posterior approach to the spine on the lumbar erector spinae., Summary of Background Data: The posterior approach to the spine leads to considerable alteration of the erector spinae muscles. An eventual correlation between these changes and persisting pain or other clinical symptoms has not been investigated previously., Methods: Seventy-five patients undergoing spondylosyndesis for different indications (43 patients) or a second operation for the removal of internal fixation (32 patients) were allotted to the study. In each patient, four biopsy specimens from the lumbar multifidus muscle were harvested; in 14 patients, biopsies were taken at both operations. Size and distribution of the fiber types (I, IIA, IIB, IIC) were determined, and pain scoring (visual analogue scale) and the presence of neurologic deficits were recorded., Results: At the time of the first operation, 88% of the patients showed pathologic changes (altered internal structure, atrophy, type grouping) in one or more biopsies. Statistical analysis showed a correlation between both age and pain and type II (A + B) atrophy. After surgery, the patients showed significantly more biopsies with denervation signs than before surgery. No correlation could be made, however, between the intensity of pain before or after surgery and the relative number of biopsies with signs of denervation., Conclusions: Posterior surgery causes muscular alterations; however, no correlation with pain or other clinical symptoms could be established. Therefore, in the case of unsatisfactory results after surgery of the lumbar spine, reasons other than muscle damage caused by use of the posterior approach must be considered.

The authors reflect on changes in the approach of surgeons to patients and operations of the thyroid gland in recent years and emphasize those elements which they had favourable experience in recent years.

Patients with lumboradicular pain syndromes with or without sensomotor symptoms and signs often present with discrepancies in clinical and neuroradiologic (magnetic resonance imaging, computed tomography, myelogram) findings that make it difficult to identify a particular nerve root responsible for the patient's complaints. However, two questions usually are discussed for patients with relative indications for surgery: 1) positive predictors for an operation: who are the good candidates for surgery?; and 2) which level or nerve root should be approached to perform minimally invasive surgery? When imaging and clinical findings are not in complete agreement, the surgeon may need additional tests to make important decisions regarding surgery. Neurophysiologic tests can provide such information. However, the surgeon's expectation cannot be satisfied fully because of unanswered questions related to sensitivity, specificity, and positive predictive value of a particular electrophysiologic study.

Chromosome 1A(m) of Triticum monococcum is closely homeologous to T. aestivum chromosome 1A but recombines with it little in the presence of the wheat suppressor of homeologous chromosome pairing, Ph1. In the absence of Ph1, the two chromosomes recombine as if they were completely homologous. Chromosomes having either terminal or interstitial segments of chromosome 1A(m) in 1A were constructed and their recombination with 1A was investigated in the presence of Ph1. No recombination was detected in the homeologous (1A(m)/1A) segments, irrespective of whether terminally or interstitially positioned in a chromosome, whereas the levels of recombination in the juxtaposed homologous (1A/1A) segments was normal or close to normal relative to completely homologous 1A chromosomes. These observations show that Phl does not regulate chromosome pairing by premeiotic chromosome alignment and a mitotic spindle-centromere interaction, as has been suggested, but processes homology along the entire length of chromosomes.

The submitted historically oriented paper reviews anatomical and surgical prerequisites for the development of thyroid surgery. Operations which up to the middle of the last century were associated with an extremely high lethality and were considered heroic and unjustified, changed due to new findings and procedures into standard operations performed in some thyroid diseases. Despite this, indications for operation and views on some surgical procedures are even in contemporary medicine highly controversial.

Based on their own experience with a large group of patients with thyroid cancers, the authors confirm the higher prevalence of differentiated thyroid cancers both papillary and follicular (1 : 3,5) in females, while the differences in anaplastic and medullary cancers are much less prominent. Survival of females in univariate studies is much higher in both papillary and follicular cancers compared to males, in multivariate studies these differences lose their significance and only in papillary cancers under the age of 40 years at diagnosis and in a subgroup of papillofollicular cancers the differences retain their significance. The authors therefore deduce that differences found in univariate studies are significantly influenced by other factors such as age at the diagnosis and the spread of disease at the diagnosis.

A genetic map of diploid wheat, Triticum monococcum L., involving 335 markers, including RFLP DNA markers, isozymes, seed storage proteins, rRNA, and morphological loci, is reported. T. monococcum and barley linkage groups are remarkably conserved. They differ by a reciprocal translocation involving the long arms of chromosomes 4 and 5, and paracentric inversions in the long arm of chromosomes 1 and 4; the latter is in a segment of chromosome arm 4L translocated to 5L in T. monococcum. The order of the markers in the inverted segments in the T. monococcum genome is the same as in the B and D genomes of T. aestivum L. The T. monococcum map differs from the barley maps in the distribution of recombination within chromosomes. The major 5S rRNA loci were mapped on the short arms of T. monococcum chromosomes 1 and 5 and the long arms of barley chromosomes 2 and 3. Since these chromosome arms are colinear, the major 5S rRNA loci must be subjected to positional changes in the evolving Triticeae genome that do not perturb chromosome colinearity. The positional changes of the major 5S rRNA loci in Triticeae genomes are analogous to those of the 18S-5.8S-26S rRNA loci.

Study Design: Based on prospective assessment, patients with lumbar disc surgery were examined to determine reliable predictors for clinical outcome., Objectives: The prognostic value of a screening checklist developed in a previous study was evaluated in a 2-year follow-up., Summary of Background Data: Outcome studies of lumbar disc surgery document a success rate between 49-90%. It has been shown that a number of medical history data and sociodemographic and psychodiagnostic findings are of prognostic value for the outcome of lumbar spine surgery., Methods: In addition to clinical and neuroradiologic examinations, 164 patients took part in a standardized interview. Eighty-two percent participated in a follow-up performed 2 years after the operation. Preoperative findings, outcome, and prediction of three diagnostic subgroups were compared. Eighty-three (51%) patients had disc herniation only, 29 (18%) had disc herniation and other relevant back diagnoses, and 51 (31%) had no disc herniation but had other relevant back diagnoses., Results: In patients with disc herniation only, good results were observed in 53%, moderate in 19%, and bad in 28%. The accuracy of prediction of the postoperative result was 75% for the patients with good outcome and 86% for those with bad outcome. In the group of patients with diagnoses other than disc herniation, the success rate of the operation was 38% good, 28% moderate, and 41% bad, but the predictor score was not as useful as for the other groups., Conclusion: Patients with a high risk of a bad operation outcome after lumbar discectomy could be identified preoperatively. It is suggested that those patients take part in a pain management approach instead of or in addition to surgical intervention.

Non-metabolic complications after surgery of the thyroid gland must be known because of their specific character. Frequently not only the health but also the patient's life depend on an early and correct solution. The authors discuss different complications and recommend a solution. They conclude that satisfactory anatomical knowledge, adequate surgical training and an experienced anaesthesiologist are with regard to the frequency of complications in thyroid surgery much more important than the type of operation.

In three surgical centres in the Czech Republik three modern two-piece colostomic systems where compared which are at present available in the Czech republik, incl. an attempt to assess how they influence the quality of life of the patients. The investigation comprised 117 patients mean age 59 years-93 after colostomy, 13 with ileostomy. The investigated systems were ConvaTec Combihesive Flexible, Coloplast 2002, Hollister Guardian two-piece ostomy systems with a closed sac and inner filter. The main investigated parameters were: tolerance of the products, preference expressed by the patient, the state of the skin beneath the plaster and the index of general health (GWBI). From the investigation ensued that in the Czech Republic the system ConvaTec Combihesive proved very useful and there probably will not be a demand for a change to another system offered by distinguished producers, as such a change would not entail any advantages. It was revealed that when the ConvaTec Combihesive system is used, the skin is maintained in a good condition which has a favourable impact on the feeling of wellbeing and improves the quality of life.

A linkage map based on homoeologous recombination, induced by the absence of the Ph1 locus, between chromosome 4D of Triticum aestivum L. (genomes AABBDD) and chromosome 4B of T. turgidum L. (genomes AABB) was compared with a linkage map of chromosome 4Am of T. monococcum L. and a consensus map of chromosomes 4B and 4D of T. aestivum based on homologous recombination. The 4D/4B homoeologous map was only one-third the length of the homologous maps and all intervals were reduced relative to the 4B-4D consensus map. After the homoeologous map was corrected for this overall reduction in recombination, the distribution of recombination in the short arm was similar in both types of maps. In the long arm, homoeologous recombination declined disproportionally in the distal to proximal direction. This gradient was shown to be largely caused by severe segregation distortion reflecting selection against 4D genetic material. The segregation distortion had a maximum that coincided with the centromere and likely had a polygenic cause. Chromosomes 4D and 4B were colinear and recombination between them occurred in almost all intervals where homologous recombination occurred. These findings suggest that these chromosomes are not differentiated structurally and that the differentiation is not segmental. In the presence of Ph1, metaphase I chromosome pairing between chromosomes composed of homologous and differentiated regions correlated with the lengths of the homologous regions. No compensatory allocation of crossovers into the homologous regions was detected. In this respect, the present results are in dramatic contrast with the crossover allocation into the pseudoautosomal region in the mammalian male meiosis.

Background: Differentiated carcinoma of the thyroid gland is globally changing its character and occurrence frequency., Methods: Retrospective analysis of patients sent to the Clinic of Nuclear Medicine in Prague, Motole in order to undergo the radioactive iodine therapy during the period from 1960 to 1993 in comparison to the set of patients of the 1950-1959 period., Main Results: A conspicuous change took place in the proportion of papillary and follicular carcinomas. The previous predominance of follicular carcinoma has turned to the predominance of papillary carcinoma, the occurrence of which is increasing. The authors see the causes not only in introduction of iodidation which decreases the occurrence of more aggressive forms of differentiated carcinoma, but also in radioactive fall, as well as in the change of diagnostic procedures., Conclusions: The occurrence of differentiated carcinoma is so far increasing, but in the recent years the increase of more aggressive forms of the disease (follicular carcinoma) has ceased and an expressive increase of less aggressive papillary carcinoma is continuing. (Tab. 1, Ref. 14.).

The nucleolus organizing regions (NORs) on the short arms of chromosomes 1A(m) and 5A(m) of diploid wheat, Triticum monococcum L., are at the most distal loci in the linkage maps of these two chromosome arms. This distal location differs from the interstitial location of the Nor loci on chromosome arms 1BS of tetraploid Triticum turgidum L. and hexaploid T. aestivum L., 5DS of T. aestivum and diploid Ae. tauschii Coss., and 5HS of barley. Moreover, the barley 5HS locus is at a different location than the 5DS locus. However, other markers, including the centromeres, are colinear. These findings showed that the major Nor loci have repeatedly changed position in the chromosome arms during the radiation of species in the tribe Triticeae without rearrangements of the linkage groups. It is suggested that Nor loci may change position via dispersion of minor loci, that are shown here to exist in the T. monococcum genome, magnification of gene copy numbers in these minor loci, and subsequent deletion of the original major loci. Implications of these findings for the use of rRNA nucleotide sequences in phylogenetic reconstructions are pointed out.

Background: Thyroid carcinoma comprises tumours with a wide spectrum of aggressiveness. The method of first choice is surgery, however, views on its extent and technique are frequently controversial. The objective of the present work was to demonstrate and justify the procedure used at the author's department in treatment of this tumour., Methods and Results: During 1988-1992 a total of 919 patients with thyroid disease were operated. The female:male ratio was 4.13:1; a benign finding was confirmed in 76.4% and a malignant one in 23.6%. The female:male ratio in patients with a malignant findings was 3.24:1. Most frequently a papillary carcinoma was confirmed--in 59.9%, followed by follicular carcinoma in 23.11%, medullary carcinoma in 7.0%, Hürtle's carcinoma in 4.25%, anaplastic carcinoma in 1.42% and epidermoid carcinoma in 0.47%. Metastases in the thyroid were present in 0.94% and a myeloma or sarcoma both in 0.47%. In retrosternal goitres papillary carcinoma was most frequent (19 patients) followed by follicular (7 patients). As to surgical operations, total thyroidectomy was performed in 47.6%, total lobectomy in 20.3%, subtotal thyroidectomy in 15.1% and subtotal lobectomy in 2.4% of the operated patients. A palliative resection was made in 11.8% and lymphadenectomy in 2.8% patients with a malignant finding on the thyroid gland. Permanent complications (paresis of the recurrent nerve, hypoparathyroidism) occurred in 0.95% of the patients, temporary complications (abscess in the scar, transient hypoparathyroidism, oedema of the vocal cords) in 8.66% of the operations. None of the patients died., Conclusions: Surgical results and experience of the clinic for nuclear medicine support a radical approach to all types of thyroid carcinoma in adults as well as in adolescents.

Reflections on the radicality of thyroidectomy are based on the persisting lack of uniformity as regards terminology, indications and techniques of thyroid surgery. The authors emphasize four basic factors involved in the solution of thyroid diseases: A. respecting the preoperative examination and recommendations of the endocrinologist, B. philosophy of the surgeon and his workplace, C. experience and skill of the surgeon, D. postoperative follow-up and treatment of patients. The necessity of multidisciplinary collaboration emphasized under A is followed under B by a detailed analysis of principles of the workplace as regards indications and technical and tactical aspects. In part C necessary theoretical and personal problems of the thyroid surgeon are summarized. Without careful postoperative check-up examinations and evaluation of the results of operations mentioned under D we cannot speak of radicality of thyroid surgery.

Group 1 chromosomes of the Triticeae tribe have been studied extensively because many important genes have been assigned to them. In this paper, chromosome 1 linkage maps of Triticum aestivum, T. tauschii, and T. monococcum are compared with existing barley and rye maps to develop a consensus map for Triticeae species and thus facilitate the mapping of agronomic genes in this tribe. The consensus map that was developed consists of 14 agronomically important genes, 17 DNA markers that were derived from known-function clones, and 76 DNA markers derived from anonymous clones. There are 12 inconsistencies in the order of markers among seven wheat, four barley, and two rye maps. A comparison of the Triticeae group 1 chromosome consensus map with linkage maps of homoeologous chromosomes in rice indicates that the linkage maps for the long arm and the proximal portion of the short arm of group 1 chromosomes are conserved among these species. Similarly, gene order is conserved between Triticeae chromosome 1 and its homoeologous chromosome in oat. The location of the centromere in rice and oat chromosomes is estimated from its position in homoeologous group 1 chromosomes of Triticeae.

The CA-6000 Spine Motion Analyzer was used to measure the lumbar spine's range of motion (ROM). One hundred and four asymptomatic volunteers were examined to obtain normal values for flexion/extension, lateral bending, and axial rotation. A detailed error analysis was conducted to investigate the inter- and intraobserver reliability of the measurement equipment, the differences between passive and active examination, the effects of stretching exercises before examination, and the diurnal changes related to lumbar spine ROM. Subjects were divided into groups by age and gender. Values for each group were compared with respect to age and gender. The measurements were found to be consistent and repeatable. Stretching exercises were observed to increase ROM. Passive examination was recommended to achieve maximum ROM. ROM was observed to increase during the course of the day. A normative database was established showing significantly decreased motion as age increased, but no gender differences were discovered. The validity of the axial rotation values due to fixation difficulties is questioned.