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The authors describe the case-history of two ileocaecal invaginations in young children caused by a tumour of the lymphatic system. Rapid diagnosis, using sonography, contributed to a successful surgical solution of the acute abdomen as a prerequisite of early antitumourous treatment. The authors analyze possible causes of invagination focused on the tumourous etiology of this disease so serious in child age.

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The authors present the results of bile cultivation from obturated bile ducts. The bile was obtained during ERCP. The results agree in principle with data reported in the literature. The authors emphasize the regional variability of bacterial strains and their sensitivity. It is thus an ever urgent problem which deserves attention, in particular preventive administration of antibiotics. At the authors department as preventive antibiotic cefoperazone proved useful.

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Based on their own observation the authors describe pneumococcal coxitis in a young man. With regard to the atypical clinical picture of the disease the authors draw attention to the necessity to consider in the differential diagnosis of pain in the inguinal and coxal area also infectious arthritis. This concerns in the first place physicians in the first line of contact.

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The diagnosis of acute appendicitis remains despite all medical advances a difficult task even for an experienced surgeon. In the submitted paper the authors evaluated retrospectively a group of child patients operated with this diagnosis during the last two years in their department, in an attempt to assess the contribution of US diagnosis in acute appendicitis.

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The authors present an account on cultivation findings assembled in defects of the lower extremities of diabetic patients hospitalized at the surgical department of the Pelhrimov hospital. In the polymicrobial flora a relatively high ratio of anaerobic microorganisms was found (58%). Based on the sensitivity, a combination of antibiotics was recommended which could be used in empirical treatment before cultivation results (clindamycin, ofloxacin, gentamycin and azlocillin). The authors prefer results of actual sensitivity tests. The authors discuss principles of collection and processing of microbiological material and treatment. Anaerobic cultivation is specially emphasized.

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The authors describe the method and therapeutic results of liver metastases of colorectal carcinoma in a group of 14 patients followed up for 2 to 33 months. In these patients in five instances (35.7%) resection with subsequent intraarterial chemotherapy (HAI) was possible. In nine instances (64.3%) a chemoport was introduced, as resection was impossible due to the size of the lesion. For checking of the site and patency of the arterial chemoport, the authors recommend the use of port scintigraphy, a method which is accurate, accessible and simple.

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The authors selected among patients who were operated in 1992-1996 on account of affections of the gallbladder and biliary pathways those patients where aerobic and anaerobic bile cultivation was made. The results of the detected bacterial species and their sensitivity to ATB are given in tables. According to the author these investigations may be of benefit to the surgeon when he has to decide on the administration of ARTB without knowing the bacterial strain (prevention or therapy) and thus overcome the time when he will know the results of cultivation.

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The authors discuss the technique of laparostomies. They reflect on the advantages and disadvantages of different methods. They submit a locally modified feasible technique of temporary closure of the surgical wound.

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The authors describe their experience with the use of a Zenoderm implant in large abdominal hernias and hernias in the scar. Satisfactory results were obtained with its use and the authors consider this material equivalent to other implants.

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The author describes the case-history of three subcutaneous abscesses resistant to healing with a very difficult microbiological diagnosis of the specific process. The actinomycotic origin was revealed only after repeated cultivation. Only after detection of the agent and aimed therapy with high PNC doses it proved possible to improve the patients' condition relatively quickly and substantially. Treatment is, however, of a prolonged character.

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In 1986-1989 in the surgical department of the Pelhrimov hospital nine casualties were treated injuries of the spleen by preserving operations of the latter. In three patients the operation formed part of comprehensive treatment in the abdominal cavity and further treatment because of multiple injuries. In two patients the rupture was treated by a stitch with Gelaspon, in one instance by Gelaspon only. Six times splenectomy was performed with subsequent implantation of the tissue into omentum. All patients with the implantations recovered, except one, with out complications on the part of the implant. The authors present the case-history of a patient where on the 13th day day after operation the implant incl. the omentum had to be removed by relaparotomy. The authors did not encounter this complication in the literature. They ascribe it to the greatly reduced immunity of the patient due not only to the splenectomy but also to associated injuries, and thus healing processes facilitating incorporation of the spleen in the new environment were lacking. Despite this in the authors' opinion implantation of lienal tissue into the omentum, corresponding to one third of the original spleen, is a suitable therapeutic method even in district hospitals.

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The authors demonstrate on two case-histories of intestinal invagination in children the effectiveness and aptness of ultrasonographic examination which contributes towards early diagnosis and therapy. They recommend this method therefore in case of obscure findings of the child abdomen as a routine examination.

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The authors discuss the problem of colorectal carcinoma, its diagnosis, treatment and subsequent follow-up of patients under conditions of type 2 hospitals. In the authors' opinion well equipped institutes at this level can provide all necessary care to patients with carcinoma of this type. They emphasize in particular postoperative care and the follow-up of patients for several years.

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The authors submit case-histories of four patients with traumatic ruptures of the aorta where the patients survived for 1-10 days. All cases were fatal. The general condition of the patients did not permit surgical operation. The survival time of the patients provides evidence that in rupture of the aorta it is in some instances possible to make inevitable examinations and operations. If time permits, then transport to a specialized department is indicated. The operation requires satisfactory approach and availability of extracorporeal circulation.

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The authors describe three cases where laparotomy was performed within short time intervals after puncture under ultrasonic control. In none of the patients substantial changes were detected in the abdominal cavity in conjunction with the punctures.

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The author presents the case-histories of four abscesses of the abdominal wall, with a different cause in every patient. It is essential in the event of such purulent processes to seek their cause because only its elimination ensures a final solution of the case.

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The author analyzes, based on examinations of IgA, IgG and IgM immunoglobulin levels in a group of 130 patients with acute and chronic appendicitis the possibility to improve diagnosis of the disease based on changes of the above values. The investigation of these levels was stimulated by the hypothesis that the appendix in mammals plays a similar role as Fabricius' bursa in birds. The assembled results do not confirm that reduced values of these immunoglobulins are one of the causes of appendicitis and the method is not asset as regards improvement of diagnostic possibilities.

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The author describes the case-histories of four leiomyomas in the course of five years, all were the cause of profuse haemorrhage. None of the patients had any major subjective complaints before the haemorrhage. All patients were subjected to gastric resection and recovered.

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The author presents results of appendiceal lavage made after surgical removal in acute and chronic inflammations. The lavage was performed by the author's own method and in the obtained solution immunoglobulin values were assessed. In the majority of cases in both types of inflammation positive results were obtained.

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